1979 Legislative Session: ist Session, 32nd Parliament

HANSARD

The following electronic version is for informational purposes only.

The printed version remains the official version.

Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

THURSDAY, JULY 19, 1979

Afternoon Sitting

[ Page

859 ]

CONTENTS

Routine Proceedings

Fisheries Act Amendment Act –– 1979 (Bill M 208). Mr. Howard.

Introduction and first reading –– 859

University of Victoria Foundation Act, 1979 (Bill M 209). Mr. Smith.

Introduction and first reading –– 859

Oral questions.

Late tax payments by forest companies. Mr. Leggatt –– 859

Legislative Assembly brochure. Mr. Barnes –– 860

Dismissal of Margaret Caldwell. Ms. Sanford –– 860

Hat Creek development. Mr. Macdonald –– 860

Alleged manipulation of tomato market. Mr. Stupich –– 861

Arnett appointment. Ms. Brown –– 861

Miscellaneous Statutes Amendment Act, 1979 (Bill 30). Hon. Mr. Gardom.

Introduction and first reading –– 861

Committee of Supply: Ministry of Health estimates.

On vote 128 amendment.

Mr. Howard –– 862

Hon. Mr. McClelland –– 863

Division on the amendment –– 863

On vote 128.

Mr. Gabelmann –– 864

Hon. Mr. McClelland –– 864

Mr. Stupich –– 866

Ms. Brown –– 867

Hon. Mr. McClelland –– 870

Mr. Hanson –– 871

Hon. Mr. McClelland –– 872

Mr. Levi –– 872

Hon. Mr. McClelland –– 872

Mr. Cocke –– 873

On vote 133.

Mr. Cocke –– 873

On vote 135.

Mr. Cocke –– 873

On vote 137.

Mr. Barnes –– 873

Hon. Mr. McClelland –– 873

Ms. Brown –– 874

Hon. Mr. McClelland –– 874

Mr. Levi –– 876

Hon. Mr. McClelland –– 876

Mr. Cocke –– 876

Hon. Mr. McClelland –– 877

Mrs. Dailly –– 877

Hon. Mr. McClelland –– 877

Mr. Lockstead –– 878

Hon. Mr. McClelland –– 878

Mr. Cocke –– 878

Mrs, Wallace .. 878

Mr. Levi –– 878

Hon. Mr. McClelland –– 879

On vote 138.

Mr. Levi –– 879

Hon. Mr. McClelland –– 879

On vote 139.

Mr. Levi –– 879

Hon. Mr. McClelland –– 879

Committee of Supply: Ministry of Human Resources estimates. On vote 140.

Hon. Mrs. McCarthy –– 880

THURSDAY, JULY 19, 1979

The House met at 2 p.m.

Prayers.

MR. BARNES: Mr. James Moore and Mrs.

Donna Moore, along with Judge Donald Ashmanskas, from the Portland,

Oregon, area are visiting with us in the members' gallery. Mr. Moore, a

lawyer, and his wife Donna arrived in Victoria by private boat on this,

their first trip to Victoria. As an aside, Mr. Speaker, I would say

that Mrs. Moore is the former Donna Blum, of late 1940s Jefferson High

School, Portland, Oregon, of cheerleader fame. I note she is still

looking as sharp today as she did in the days of old when Jefferson

High athletic teams were matching that sharpness.

Interjection.

MR, BARNES: I wouldn't have been associated with that, but perhaps I was. It's been a long time.

Mr. Speaker, I would like to ask the Assembly today to join me in welcoming these visitors. I hope their visit will be fruitful.

MR. REE:

We have seven people visiting us this afternoon from Vancouver. They

are supporting the proposal for the downtown stadium. Would the House

welcome Frank Rigney, Gordon Campbell, Martin Zlotnik, Allen Achilles,

Hector McDonald, Randy Iredale and Judith Gelber.

MRS. WALLACE:

This seems to be my week for visitors. We have in the gallery today a

long-time friend of mine. When she and I were young women, more years

ago than I care to think about, we both worked in these precincts. She

went on to become the provincial secretary of the New Democratic Party.

I would like the House to join me in welcoming Jessie Mendel, who is

visiting from Vancouver.

I have the honour of having a

grand-daughter, Carrie Long, visiting from Revelstoke, together with

her friend Carolyn Gibbons; and all the way from Tamworth, Ontario,

another young friend, Miss Tammy Dickeson. I ask the House to join me

in welcoming them.

MR. RITCHIE: It's my pleasure

today to introduce to the House a lady in the Speaker's gallery, Mrs.

Edna McKay. She is the wife of one of our outstanding newsmen from

Chilliwack.

MR. LEA: I'd like to welcome a supporter

of the New Democratic Party in Prince Rupert, Brenda Gardiner, who is

visiting our gallery today to watch the proceedings.

MR. HANSON:

I would like the House to join me in welcoming the parents of one of my

constituents, David Reilly, who is a very active community organizer

here in Victoria. His parents, Mac and Megan Reilly, are here visiting

from Vancouver. Would you please join me in welcoming them.

HON. MR. HEWITT:

Mr. Speaker, I'd like to introduce Mr. Bruce Daniels from the city of

Penticton in the riding of Boundary-Similkameen, along with his guests,

Ann Buus, Eilaine Dixon, Sherril Dixon and Marjory Podd. I'd ask the

House to bid them welcome.

Introduction of Bills

FISHERIES ACT AMENDMENT ACT, 1979

a motion by Mr. Howard, Bill M 208, Fisheries Act Amendment Act, 1979,

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.

UNIVERSITY OF VICTORIA

FOUNDATION ACT, 1979

On a motion by Mr. Smith, Bill M 209,

University of Victoria Foundation Act, 1979, 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

LATE TAX PAYMENTS

BY FOREST COMPANIES

MR, LEGGATT: My question is

directed to the Minister of Finance; it concerns the report of the

auditor-general in which is noted the failure to bill some $43 million

to the forest industry in the fiscal year 1978. She pointed out that

the loss of revenue that year to the treasury was some $26 million. My

question to the minister is whether any penalties have been imposed on

those companies as a result of the late payment, in view of the fact

that her, report discloses that those companies retained some $26

million which should have been in the hands of the minister and the

treasury.

HON. MR. WOLFE: I believe the report of the

auditor-general was reviewed before the public accounts committee at

the last meeting. If I'm not mistaken, the comptroller-general is being

given an opportunity to respond to these statements that have been

made, or the report itself. With regard to the question raised by the

member, I believe there has been a problem for some years in terms of

the transition into a new system of stumpage and so on. It isn't a case

of the companies not being billed, but a delay that developed some

years ago, I'm given to understand, in the system. So I couldn't answer

the specifics of the current lapse that may be taking place, but I'm

sure that you will be able to hear more on this report in terms of the

comptroller-general's response next week.

MR. LEGGATT:

The minister, of course, has had the opportunity of reviewing that

report for some time. In fact, I think it was issued prior to the last

provincial election. Surely now, Mr. Speaker, the minister has had a

chance to assess the loss of revenue in terms of interest. There is

some $26 million that the treasury was denied as a result of late

billing. Can he give the House some estimate of what the loss was in

terms of the current interest rate on that kind of money that was not

collected?

[ Page 860 ]

HON. MR. WOLFE:

Mr. Speaker, I think, if I'm not mistaken, it was clearly brought out

during the review of this report that a lot of these anomalies go back

quite some distance in time to former governments and so on.

SOME HON. MEMBERS: Oh, oh!

HON. MR. WOLFE:

So with reference to any suggestion that there has been a loss of

revenues and so on, I'd be glad to take that question as notice.

MR. LEGGATT: Supplementary.

MR. SPEAKER: When a question is taken as notice, it's difficult to have a supplementary on it.

MR. LEGGATT: A new question, Mr. Speaker.

MR. SPEAKER: Please proceed.

MR. LEGGATT:

Under the provisions of the normal tax collection procedure.... For

example, if I don't happen to pay my property tax on time, I've got to

pay a penalty to the municipality, and I think every other resident of

the province understands that. Could the minister advise whether there

are penalty provisions in terms of the legislation that he has for

collecting stumpage royalties. so that these forest companies are

required by law to pay a penalty for their failure to deliver that $26

million?

HON. MR. WOLFE: I think the member, even

though he comes from Ottawa and is imbued with a deficit philosophy,

will be fully aware of the fact that if there is abuse of the system of

payment by a taxpayer, there are penalties provided. But if, in fact,

billings were delayed, it is not likely that a penalty would have been

exposed.

MR. LEGGATT: I take it then that the

minister's answer is that if it's the fault of the government, it's the

taxpayers who have to take the load rather than the forest industry. Is

that what he's saying?

LEGISLATIVE ASSEMBLY BROCHURE

MR. BARNES:

I have a question to the Minister of Economic Development and Tourism.

Why is the government distributing misinformation to B.C. tourists? The

government spends millions of dollars on the B.C. Government News and

promotions such as the Captain Cook Bicentennial, and government MLAs

have been known to receive foot bridges. But we have the beautiful

British Columbia parliament buildings guide to the legislative

precincts which is entirely out of date. I am wondering if the minister

could explain why it is that the brochure has a 1972 picture of the

Legislative Assembly, when two elections have ensued.

states that there are 55 members in the Legislature when there are 57.

It states that there are 48 electoral districts when there are 51.

Could the minister indicate why we would spend as much money as we do

encouraging tourists to come to British Columbia when we give them

misinformation?

HON. MR. PHILLIPS: Mr. Speaker, I

would advise that member that he ask the question of the minister in

charge of that particular aspect, namely the Provincial Secretary or

the Speaker.

MR. BARNES: Mr. Speaker, I am aware of

the responsibility, but I think that the Minister of Tourism should be

standing up asking that question because he is the one responsible for

encouraging people to come to this province, and this information is

erroneous. I will address the question to the Provincial Secretary.

Perhaps he can answer.

HON. MR. CURTIS: Mr. Speaker,

I expect that an up-to-date brochure will be produced in the very near

future. However, the member should know, sir, that we have some very

fine tour guides, who are this year perhaps showing more visitors

through this building than ever before as a result of the great tourist

year that we're having. I believe that the tour guides are quite

familiar with the number of members and of the structure of this House.

But a new brochure is in order and will be printed in time.

DISMISSAL OF MARGARET CALDWELL

MS. SANFORD:

My question is to the Minister of Labour. It is now a week since the

Minister of Labour advised the House that he was seeking legal advice

surrounding the board of inquiry decision in the Margaret Caldwell

case. Could the minister tell the House whether he has received that

legal advice and, if so, will he then appeal the Caldwell decision to

the courts?

HON. MR. WILLIAMS: I received a report

following the examination of that decision. Further legal questions

remain, and I trust they will be answered very quickly.

HAT CREEK DEVELOPMENT

MR. MACDONALD:

I have a question for the Minister of Education, Science and

Technology, who, at the end of last week, notwithstanding large sums of

money being spent by Hydro for exploratory work at Hat Creek and on the

application to the Pollution Control Board, said that the proposed

development would ravage the countryside worse than Trail had been

ravaged in the early years of Cominco. My question is: did the minister

make that statement after consultation with his colleagues on the Hydro

board, or his colleagues in the cabinet, or was it made in a frolic of

his own?

MR. SPEAKER: Hon. members, if this statement

was made in the House it is open to question. However, statements made

outside of the House, speeches made away from the House, says

Beauchesne, are not to be referred to in question period. It is for the

minister to decide whether the speech was made in or out of the House.

MR. MACDONALD:

Mr. Speaker, are you seriously saying that a statement made by a

minister outside of this House cannot be questioned in question period?

MR. SPEAKER: Hon. member, it is not for me to decide that; those are the rules that have been established by the House itself.

[ Page 861 ]

MR. MACDONALD: Then we might as well pack up the question period.

MR. SPEAKER:

Order, please. Perhaps the members would like to refer to

section

171(z), page 148 of Beauchesne, fourth edition. I would be very happy

to abide by the wishes of the House, but that is what I read there:

"Speeches outside the House not to be referred to in question period."

I think we should just use it as a guideline. We'll let the hon.

minister decide whether he wishes to answer.

MR. LEA:

It might say that in Beauchesne, but in the practice of this House

there has been example after example after example of the fact that

these kinds of questions have been allowed by yourself and by previous

Speakers. It has become the practice of this House. I wonder why, Mr.

Speaker, we are now changing from the practice of this House.

MR. SPEAKER: Hon. members, I am bound by the rules which you have placed in my hands.

MR. MACDONALD:

I'll ask the minister: in view of those statements, were they made in

consultation with members of the board or his colleagues in the cabinet?

further question, Mr. Speaker: in view of the non-answer to that, I ask

him whether the statement made on July 17 by the hon. minister that Hat

Creek coal deposits should be used for gasoline rather than

thermoelectric development is the policy of the government or simply

the opinion of the Minister of Education, Science and Technology.

HON. MR. McGEER:

Mr. Speaker, the benefits to British Columbia which will come from

considering alternative uses of all our natural resources — coal, wood

waste, natural gas — are obviously of extreme importance to investigate

from a scientific point of view. I can assure the member that great

consideration will be given in the future to developing the highest

benefits from of all our natural resources in British Columbia,

including coal.

MR. MACDONALD: Nevertheless, the

minister says that Hat Creek should be used for the production of

gasoline, and not for thermoelectric development. Is that the policy of

the government and of his department? And has it been cleared with B.C.

Hydro and Robert Bonner, the chairman? Has it been cleared with the

Premier? Is that the policy of the government, or is it not?

HON. MR. McGEER:

Mr. Speaker, the ultimate utilization of Hat Creek, or any of our

enormously valuable natural resources, will be unfolding in due course.

ALLEGED MANIPULATION

OF TOMATO MARKET

MR. STUPICH: Mr. Speaker, I have a

question for the Minister of Agriculture. I wonder if he has had any

complaints from one or more of the Vancouver Island greenhouse growers

to the effect that the large chains are manipulating the tomato market

in an effort to break the price of the B.C. produce.

HON. MR. HEWITT:

Mr. Speaker, no, I have not had any official complaints regarding

excess amounts of tomatoes in storage. I was approached by a news media

individual with a press report, but nothing official has come to my

office as yet.

MR. STUPICH: Mr. Speaker, I'm mindful

that I have to phrase this as a question; so I'll ask the minister: has

he discussed this matter with his associate deputy?

HON. MR. HEWITT:

Mr. Speaker, I have requested a report from one of my staff, Mr. Don

Rugg of the marketing branch of my ministry, in regard to whether or

not we do have a surplus of tomatoes in storage.

The member

may recall that we seemed to go through the same problem a year or two

ago; we went into a marketing effort with the supermarkets, only to

find that within a week's time the producers had to short the market.

And so we have to be careful that the statements regarding this amount

of tomatoes in storage are accurate.

ARNETT APPOINTMENT

MS. BROWN:

My question is to the Minister of Human Resources (Hon. Mrs. McCarthy),

and it has to do with the appointment of the Premier's former press

secretary, who has now become a partner in a public relations firm, to

work on the International Year of the Child and Family project. Would

the minister tell me whether this is a contract, whether it's freelance

and exactly how the job is being financed?

HON. MRS. McCARTHY:

Mr. Speaker, the member for Burnaby-Edmonds (Ms. Brown) is referring to

Mr John Arnett, who is a public service employee and who is working, as

he has on other items for the executive council, on the International

Year of the Child and Family,

Introduction of Bills

MISCELLANEOUS STATUTES

AMENDMENT ACT, 1979

Hon. Mr. Gardom presented a message from His Honour the Administrator: a bill

intituled Miscellaneous Statutes Amendment Act, 1979.

Bill

30 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.

Orders of the Day

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

ESTIMATES: MINISTRY OF HEALTH

(continued)

On vote 128: minister's office, $144,082 — continued.

On the amendment.

[ Page 862 ]

MR. HOWARD:

The item I want to make brief reference to is with respect to the

Heroin Treatment Program and the heroin treatment centre. I have a

couple of intriguing wonderments about the financing, although that's

in a later vote. There is $2.8 million which is going to be credited to

the financing of the Heroin Treatment Program. It represents interest

earned on a special purpose fund, the Drug, Alcohol and Cigarette

Education Prevention Rehabilitation Fund. With respect to the interest

earned from that particular fund, part of which is going into the

Heroin Treatment Program, why was money also expended from it for

travel expenses, professional and special services, furniture, office

expenses, and for a variety of other things that don't seem to suit the

purposes of the fund itself In any event, I only raise that as an

introductory reference point. Someone should explain to the House why

interest from a fund is used for purposes which don't appear to be

germane to the particular fund itself.

When it comes to

treatment of heroin addicts, we have to appreciate that attempts have

been made in the so-called treatment area in different jurisdictions

throughout the world. All have had about the same rate of success:

namely, practically no success.

The situation in Lexington

in the United States has been well documented and has been referred to

a number of times in the past. There is no point in going over it

again, except to say that it is probably the most classic United States

reference that exists.

In Canada we have had different

programs operative within the federal prison system, most notably the

pilot treatment program at the Matsqui institution. It was extended

over a number of years and headed by a psychiatrist, Doctor Dan Cragen,

who has since left that position and is now the chief medical officer

of the Canadian Penitentiary Service. In the program at Matsqui, which

extended over a number of years, various psychological and psychiatric

techniques of a counselling nature were followed: role-playing, group

therapy, reward-and-punishment aspects, free passes, free association

and the whole bag of tricks that psychologists and psychiatrists have

developed over the years to try to relate to heroin addicts. The

success of that program can be measured in terms of the rehabilitation

of individuals who were addicted to heroin. The success of that program

is practically nil. I've been told that nearly all of the narcotic

addicts who went through that particular program are either back in

prison again or have been in prison for some time as a result of

further offences against the Narcotic Control Act, or they have died as

a result of overdoses of heroin. The success rate is practically nil.

far as I can understand from reading newspaper accounts about this

proposed Heroin Treatment Program in B.C., it will follow almost

identically the program which was followed in Matsqui, with some

variations depending on the particular theories of the individual

psychiatrist or psychologist who may be working there. I'm sure that

for every heroin addict that exists you'll find a psychologist to team

up with him to play a particular role, to try out his pet theory. I

know there are those who say that because we haven't cured it in the

past, we shouldn't give up trying. I'm not decrying that. I'm just

pointing out that all of the experiences in the past have ended in

failure. Because one raises doubts about the success potential of this

particular program, he shouldn't be subjected to the accusations that

were made yesterday — that those who express those doubts fall into the

category of being people who hope that the program will fail. That is

the farthest thing from the truth.

One interesting part

of this is that the very same types of people in the medical profession

years ago who propounded that methadone could be used as a substitute

for heroin to keep an addict on the street, working and

operative........ It is now identified as a drug within the Heroin

Treatment Act passed by this Legislature, lending the individual who

may be addicted to methadone to being subjected to this type of

treatment and incarceration in this particular institution. What I'm

saying is that on the one hand a few years ago methadone was hailed as

the cure-all and the answer for heroin addiction. It now falls in the

category — as far as this Legislature and this government are concerned

— of itself being a narcotic, and if a person is addicted to that, he

has to be subjected to the type of treatment contemplated under here.

think if you talk with almost any heroin addict and try to get him or

her to relate to you their thoughts and their own inner feelings about

heroin addiction, they invariably will come up with a very simple,

uncomplicated response and answer. They will say that there are two

ways only to cure heroin addiction. One of those ways is for the

individual to want to quit, and that's a difficult task. The other way

is what they loosely refer to as the "Chinese cure, " or an overdose.

Heroin addicts themselves admit freely and honestly that they are not

able to handle that question of addiction, that all the people who have

gone through the variety of psychological programs and psychiatrists'

programs have not been helped, and we're embarking again on repeating

the situation of the past.

I have doubts that it will work.

I have the thought that a few years from now we'll be trying to

identify success rates on a statistical and individual basis, and we'll

come up with the answer that they came up with at Lexington, at

Matsqui, and in other jurisdictions — that this is not the type of

program that will work. We can live in hope, but I think that's the

answer that we're going to find ourselves faced with a few years from

now. For those who are concerned about the money part of it, a few

millions of dollars from now.... We're talking in terms of something in

the nature of $12 million per year towards this particular program.

Multiply that by the number of years the program will have to apply

before we'll be able to get some reading about it, and you're into

quite a few millions of dollars.

I know that it is a very

sensitive area, and I know that propositions put forward in the past

about what one should do about this particular situation or problem are

always approached with a great deal of fear. I want to indicate that

I'm clearly speaking for myself in putting forward a thought. It's not

unique to me. It has been advanced by others at different times in the

past — that is that we will ease the problem that the heroin addict

faces when we remove the profit from the heroin trade. When we remove

the profit-makers from dealing in heroin, from importing the heroin,

from selling it on the market and on the streets, we will then find

ourselves well on the way to a solution.

We have no

difficulty in our society at all in both advertising and promoting the

concept that it's okay for a person addicted to alcohol to be able to

go into a government liquor store and buy alcohol. We don't impinge

upon that choice there. We say it's fine. You're an

[ Page 863 ]

alcoholic.

Okay, we'll continue to sell you booze if you want to continue to buy

it. We place no restrictions in that area at all.

Insofar as

a physically debilitating drug is concerned, alcohol to the system is

far more injurious than heroin. Alcohol injures your liver, causes

death — through excessive use of it — and the development of cirrhosis

of the liver, which, I gather, is the medical term. Alcohol kills off

brain cells when it is consumed and gets into the blood system. It

causes other physical difficulties as well. And they are, so I've been

told by medical people, far more serious to the human physique and the

human being than is heroin itself.

I don't see why we cannot

move ourselves to the point of doing something similar that was done in

Britain countless years ago — that is, provide the drug at cost through

the medical profession, upon an administered or treated basis, with

prescription.

I think — following that kind of activity and

that kind of course — we will remove a fair amount of the criminality

activity that's associated with the heroin trade. We'll remove a fair

amount of the costs of courts and of law enforcement officers in

chasing drug pushers and addicts around the country. It may save a fair

amount of effort and money in our prison system if we could follow that

kind of thought.

I advance that as an individual. It's not

associated in any policy way with what other people with whom I work

have in mind. I know it's a very delicate subject, and I know one can

be subjected to a tremendous amount of abuse by just putting forward

the thought.

But it is a thought that has nagged at the

minds of a great many people, including people in the medical

profession who have dealt with addicts over the years and who have

looked at, and tried to assess, the effect of their work at the

psychiatric and psychological level with individuals. Many of them come

up with the same feeling. They say that if this is the situation which

is incurable to the individual, unless he himself wants to stop, then

why don't we go through the prescription process with respect to it and

provide that chemical to those individuals who, for one reason or

another, internally need it?

I hope, Mr. Chairman, when we

get to the point of examining the effectiveness — or whatever it might

be — of this particular program, that the thoughts that I have

expressed about what is anticipated are wrong. I hope there are

successes out of that; and that comes from a deeply felt conviction

about the need to work in this area to do something. It comes from the

fact that I myself, as an individual, like other members on this side

of the House, have worked over the years with addicts on an individual

basis in attempting to help them get over the rough spots and help them

move out of the area of addiction and into the so-called "straight

life." It comes from that type of relationship with people The ideas I

put forward are not put forward lightly and are not put forward in the

sense that they reflect a great body of concerted opinion within the

party to which I belong. They are put forward in the light of having

talked with others who have worked with addicts, including a great many

psychiatrists, and with a great many medical doctors who have come to a

similar kind of conclusion about the treatment program that might be

effective.

HON. MR. McCLELLAND: Mr. Chairman, I

promise I will make only one very short statement in response to what

the member has said. We recognize that as a position which is taken by

many people in the community. It was one which was put forward, and

considered, when this program was being developed. I might say that I

reject it. It was rejected as a choice for the program; and I believe

the people of B.C. have rejected it.

To go one step further,

I have a feeling, Mr. Chairman, that the least important argument about

what we do with the heroin treatment problem or the heroin problem, or

however you wish to phrase it, is whether or not other things haven't

worked. In my opinion, that's not a good argument, Mr. Chairman.

Otherwise we would not be searching still for cures to many kinds of

diseases. We would have stopped, because other things didn't work.

Let me say that my views about the questions that the member for Skeena raises have been well canvassed in this House, Hansard

is full of them. Anyone who wishes could read it again. But let me just

say that we've put forward this program as a demonstration project on a

five-year basis. We think it's innovative, unusual, and the only one of

its kind in the world. I will, however, recommend very strongly that

the government does not get into the trap of pouring bad money after

good. If the program doesn't work, I hope that I'll have the guts to

admit it, and at that point that the government would stop and go I

some other direction.

MR. COCKE: We are on a broad philosophical discussion here and I would

just like to bring us back to the vote. I thought we were going to take it a

minute ago, but two of my colleagues in the House have decided not to.

The

vote that we're taking now is an amendment to the minister's salary —

reducing his salary — to show a lack of confidence in this minister. We

are talking in terms of the gross mismanagement of health in the

province; we are talking in terms of the unanimous position of

hospitals across the province that they are being placed in a dangerous

position; and we're contrasting that to the university hospital reform

which is going to be lavished a very large operating expenditure.

That's really what we're talking about here. We're also talking about

emergency health services, which are being squeezed to the point where

firemen are being used for transport to hospital. And we're contrasting

that to our Heroin Treatment Program that's admittedly experimental.

Mr. Chairman, I call the question.

Motion negatived on the following division:

YEAS — 24

Macdonald

Barrett

King

Stupich

Dailly

Cocke

Lea

Nicolson

Lauk

Hall

Lorimer

Leggatt

Howard

Levi

Sanford

Skelly

D'Arcy

Lockstead

Barnes

Brown

Wallace

Gabelmann

Hanson

Passarell

NAYS — 29

Waterland

Ritchie

Bennett

McClelland

Ree

Fraser

Mair

McCarthy

Davis

[ Page 864 ]

Mussallem

Wolfe

Brummet

Nielsen

Jordan

Curtis

Williams

Davidson

Gardom

Vander Zalm

Chabot

McGeer

Strachan

Hewitt

Kempf

Segarty

Heinrich

Smith

Phillips

Hyndman

Mr. Cocke requested that leave be asked to record the division in the Journals

of the House.

MR. GABELMANN: As with a lot of members, Mr. Chairman, I

haven't been able to be in here for the entire debate, so I may have

missed the answer to the main query that I have. If so, perhaps the

minister could just indicate that.

I want to ask, first of

all, whether or not you have given any indication as to the timing of

the public release of the so-called Black report. I wanted to talk very

briefly about the difficulties in rural communities with health care.

My constituency has been, as the minister knows full well, the subject

of a great deal of discussion in recent weeks and months concerning

health care, and the minister has responded in some measure. I might

say to the minister that I would like to thank him for his response to

the Zeballos situation. It was a quick response, and it was, in my

judgment, an appropriate response. I appreciate it, the people in

Zeballos appreciate it, and I think the minister, the staff and the

people in the region who are involved deserve full marks for the way in

which that particular problem was handled.

I am not at all

convinced the minister has made the same kind of appropriate response

in the Alert Bay situation. I still have some very grave reservations

that the course of action he has taken will not lead to the kind of

situation we want to develop there. I don't intend, Mr. Chairman, to

get into a public harangue or a public debate with the minister about

the issue, simply because I don't believe that would serve any useful

purpose at this point in resolving the difficulties in Alert Bay. They

have gone beyond questions of health care and health-care delivery

service. They have gone into other, more difficult and sensitive areas,

and I think we all have to be very careful not to exacerbate the kind

of tensions that exist in that community.

In saying that,

and in being very calm and cool about how I handle this whole question,

I would just like to alert the minister to the fact that at least half

the community — probably 60 percent of the community — are not happy

with the response to date. Without the full confidence of the community

in actions taken by health-care workers and the ministry itself, I

think we might find ourselves in more difficult situations in the

months to come. I'm not predicting that; I certainly don't want that to

happen; but I would just like to alert the minister to keep a very

close eye on that situation so that we can involve the entire community

in creating some solutions. At the moment the appointment of Mr. Eric

Powell has some superficial sense to it, but it won't work if the

community doesn't agree — I just want you to be aware of that.

The

reason I started off my comments with the reference to the Black report

is that when I travel around smaller, remote communities in North

Island, after they get through complaining about the roads — which is

always first; no matter where you go in small areas it's the roads they

talk about first — the next issue is health care. For people in that

area, health care is not really completely paid for by Medicare because

for most people there, particularly women who are pregnant, health care

means several flights out to Vancouver or to Victoria, or even just to

Campbell River or Comox. It's a very expensive proposition. Perhaps the

response might be: "Well, that's the cost of living in a remote area."

When it comes to health-care service delivery, whether it is direct

medical attention, as in the case I cited of pregnant women, or whether

it's delivery of mental-health care services — and the whole range of

health-care services that should be provided — I've come to the

conclusion, having had the experience of living in the city and

representing urban citizens in this Legislature, and now having had the

experience of representing an entirely different kind of riding, that

health-care service delivery, like social-service delivery, is often

more important in those remote areas than it is in the city. When I

look at the alcoholism rate in my constituency, and when I look at the

prescription rate for Valium in some of those communities — and that's

no condemnation of doctors when I say that; I suspect that's probably

the easiest way out; but the level of reliance on pills, and Valium in

particular, in those communities is very high.... The opportunity to

have mental-health care workers to deal with when you live in a

community that is surrounded by mountains — and the only space that

isn't mountains or bush is clouds full of rain for ten months of the

year — is needed more in that kind of environment than it is in the

city, where there are all kinds of other resources that people can draw

on. I just want to emphasize that, in my judgment, we should be

spending a disproportionate amount of health-care money for those kinds

of services in rural areas.

I don't want to say much more

about that, other than that over the course of the next year or so I

intend to discuss in more specific detail proposals as to how we can

improve up there that I am, in a sense, still formulating and working

on with people in the community. They don't see me as an opposition

MLA; they see me as part of the government. That's a curious kind of

phenomenon, but it happens. They think I can have some influence over

government policies. I tell them I can't; but I try my best. In

attempting to formulate some answers for rural health-care delivery, it

would really assist me and it would assist the people in the community

if we could have the evidence that's been collected by your ministry,

so that we can be part of the solution rather than complaining about

what your ministry does or doesn't do.

HON. MR. McCLELLAND:

Mr. Chairman, I'd like to answer some of the questions raised by the

member for North Island (Mr. Gabelmann), and I would like to take the

opportunity to answer a few more that were raised, I felt, as part of

my estimates rather than in terms of the vote which was taken earlier.

start with the member for North Island — and to deal with the Black

report first, because the second member for Surrey (Mr. Hall) has also

talked about it a couple of times — the Black report will be released

in its entirety. I need the opportunity — and I think that the ministry

needs the opportunity — to understand it fully before we release it. We

are making those studies now and I'm having some recommendations made

in relation to the Black report at the same time. I would hope that

when we release it in a very

[ Page 865 ]

short

time there will be an opportunity to list some priorities with it as

well, which we can announce in terms of the recommendations that it

will make. So it will be available very shortly.

Mr.

Chairman, I appreciate the member's response to the things that we've

done in Alert Bay. I recognize that many of the people in the community

are not fully happy with the response that we've made. One of the most

serious difficulties is that there is a perception in the community

that the ministry has not acted promptly or adequately in relation to

the question of the competency of the doctor in the community. I have a

difficulty with that, Mr. Chairman, because I don't have the

legislative opportunity to deal with that; that must be dealt with

under the laws of British Columbia. Unfortunately, that's clouding the

whole issue in the community. I have tried to act as promptly and

expansively as possible with what is under my jurisdiction directly,

and that's the reason we've done what we want. I will be keeping a very

close watch on that situation, and have asked Mr. Powell to report to

me on an almost daily basis in terms of what is happening there, and

certainly — if you've read the terms of reference — the one thing that

we've insisted upon is that the tasks of Mr. Powell go beyond that

which was originally requested of me in terms of just the hospital, and

take into account the alcohol problems in the community. With luck, and

with some other moves that we're making in places like Fort Nelson, we

might be able to develop a very good policy for isolated areas, in

terms of the way we deal with certain alcohol problems, out of this

unfortunate situation that we came up with in Alert Bay. So I

appreciate that.

Then, in terms of what a member can do

about influencing future policy, I don't know. Maybe I am naive or

something, but I have a feeling that any member in the community should

have the opportunity to provide input — whether he or she is in

opposition or in the government — and I'm sure that should be treated

in the same way that other community input is, that it all forms part

of the larger picture. I hope that we can deal with things on that

basis.

There were questions raised by the member for Atlin

(Mr. Passarell), who is not in his place at the present time. But I

just wanted to say that in regard to his concerns about the provision

of health care at Dease Lake, I share those. We've been working since

last summer, when I visited Dease Lake last, on a method by which we

can get some improvements to the care and services provided. I'm very

happy to say at this point, Mr. Chairman, that we have contracted with

a nurse to act as the Dease Lake emergency nurse as of August 1, 1979.

She will be contracting with the ministry to provide emergency nurse

services in Dease Lake on a permanent basis, which will be a tremendous

improvement in the delivery of care there. We've just sent out a letter

of confirmation to her. Her name is Kathleen Simmons and she will be

taking up that position on the first of the month.

Mr. Chairman, I wanted to answer one question raised by the member for Burnaby-Edmonds

(Ms. Brown). I can't help the perception the member has from the correspondence

that she reads in the House. On the one question that was raised about the EEG

facility, it isn't operating, but it is approved. The member asked me, Mr.

Chairman, why I didn't tell the administrator. I have a letter dated March

30 to Mr. Norman Barth, administrator, Burnaby General Hospital, and it points

out: "Since my letter to you dated January 9'' — this is not a

letter from me, incidentally; it's a letter from Mr. Glenwright in Hospital

Programs — "Hospital Programs rate board has approved your request for an

EEG service at Burnaby General Hospital. An allowance will be provided in your

approved 1979-80 budget for this service, based on your estimates of the

time needed and the technical time needed." So it is approved, Mr. Chairman,

to the member for Burnaby-Edmonds (Ms. Brown), and I just wanted to make certain

that was covered.

The

member for Cowichan-Malahat (Mrs. Wallace), who also is not in her

place at the present time, raised the matter of rates for long-term

care facilities, particularly the private long-term care facilities.

She complained that the increase to the private-care facilities was

only 50 cents per day over that which they were before April 1 in the

last fiscal year. In the first place, that member chose only one

category of care when picking out that 50 cents, and that's the

personal-care level, which is the easiest level of care to provide.

The

other rates that we have approved are significantly more than that. For

instance, in level 3, from $28.30 to $30 per day is an approved rate,

and there was a total increase of some 7.6 percent across the board on

the interim rates which were approved by me. But we have since been in

conversation with the members of the association which deals with the

private-care facilities, and they've indicated some concerns that the

rates are not enough. I have instructed my staff to enter into

negotiations with them. That is happening, and as a matter of fact I

believe the next meeting is set for next week with the association. But

I have guaranteed to the association that whatever rate we strike will

be retroactive to April 1, 1979, so that they will be able to have that

full rate for their total fiscal year.

The member for

Shuswap-Revelstoke (Mr. King) seemed to have some concern about me

meeting with his hospital board. I don't remember whether it was during

the election or not — perhaps it was — but I meet with hospital boards

all over the province. I have travelled extensively in this province to

meet with the hospitals on their home ground. I feel if I've done

nothing else, and the members may say that I haven't — on that side of

the House, anyway — I feel that I have been extremely accessible to the

hospitals around this province, and I think they acknowledge that. But

the member's hospital is doing very well as far as its finances go. I

might say that as of the end of May this year, it is operating in a

surplus position in this fiscal year. In fact, they've built up a

surplus of some S3,700 in the first few months of this fiscal year.

The

university hospital was raised by the member for Shuswap-Revelstoke,

among others, and I might say that at the present time that university

hospital capital construction is ahead of

schedule and about $1 million

under budget. We can talk about rates for operating costs for that

hospital all we want, and we can say that they are $400, $500 or $600 a

day. Well, the fact remains that we'll know that when the hospital is

in operation. I've disputed that since got into this debate over that

hospital, and I still dispute it.

Mr. Chairman, I think that covers the concerns that have been raised by most of the members up to this point.

MR. CHAIRMAN: The member for Nanaimo.

HON. MR. STUPICH: Did you want to talk about Bulkley Lodge? Is that what you were going to ask about?

[ Page 866 ]

Interjections.

HON. MR. McCLELLAND: Mr. Chairman, I forgot about Bulkley Lodge.

MR. CHAIRMAN: Once again, I recognize the minister.

HON. MR. McCLELLAND:

I just want to say that I haven't met with the board, but my staff have

met with the board and I understand that they've reached agreement on a

rate which is a compromise rate. I think it is in the neighbourhood of

$33. But I understand the board has accepted the rate, and that the

rate includes, I'm told, the provision that a 24-hour registered

nursing service is provided.

MR. STUPICH: I have a

number of questions that I'd like to put to the minister, in response

to questions and concerns from my constituents. One of them, J.

Garside, who wrote a letter to the minister on October 17 asking about

the pending dietitians' registration Act, makes the point that public

awareness of the role of nutrition and good health is growing, but

there's presently no means for people to differentiate between

qualified and unqualified resource personnel when seeking nutrition

information. The minister, assuming he did reply, did not send me a

copy of the letter. I'm not sure whether there was any follow-up, or

whether he has any plans — or any interest, for that matter. I know

there are some problems about registration of dietitians and

nutritionists. I just wondered whether the minister has anything that I

can pass on.

Concern was expressed by a senior citizen in my

community about the increase in ambulance rates from $5 to $15. Her

point was that it is particularly tough on elderly people, who are more

likely to have to call an ambulance than others. I don't know that I

can ask for any quicker action at this time — I'm simply expressing the

concern of that citizen — expressing the concern that I and others have

voiced on previous occasions. That is the way the Pharmacare program

works now. It is tough on people who....

HON. MR. McCLELLAND: It is not my ministry.

MR. STUPICH: I concede that one. The ambulance care is, but that is not. All right.

The

next question, raised by another senior citizen, is about the need for

a dental plan. If there has been any discussion of the dental plan

during the discussion of the minister's estimates, I've missed it. I'd

like to ask the minister what are the notes in the throne speech, and

both budget addresses this year, about the fact that a dental plan

would be introduced this year, whether it has been discussed with the

ministry staff, or whether it is simply in cabinet so far. If it has

been discussed by ministry staff, has it been discussed with the

dentists themselves? How far along is the planning on it? When might we

expect to see something more than the references to a dental plan that

we have seen in the throne speech and in the budget addresses?

have a complaint from a speech pathologist about the preference that

seems to be given to Americans in hiring speech pathologists. The

complaint was passed on to the Member of Parliament as well — this was

about a year ago.

Apparently preference is given to

Americans, and preference is apparently given in further training to

Americans. I wonder whether the minister has any comment on that.

HON. MR. McCLELLAND: Would you repeat that, please? I missed that, Dave. I'm sorry. What was the last question?

MR. STUPICH: Preference, apparently, is given to American speech pathologist

graduates of universities in the United States, as opposed to UBC graduates,

for example I think it is UBC.

There

is concern from an acupuncturist. I know the minister has spoken on

this subject on different occasions. I haven't heard anything in this

present session. I know the previous Minister of Health (Mr. Cocke)

spoke also about his attitude toward acupuncture as a profession, and

whether or not there should be encouragement or discouragement. This

particular letter is from an acupuncturist who feels he is sometimes

being hounded by the ministry staff; certainly by the medical

profession. I wonder whether the minister has any further comments to

make about acupuncturists generally.

There is a complaint

from the president of the Licensed Practical Nurses Association of B.C.

that they are finding it increasingly difficult to find employment,

that because they are practical nurses they command a certain rate of

pay and that the hospitals, in general, are finding ways of hiring

other staff who do not have the training of practical nurses, but who

are prepared to work at lower rates of pay. I wonder whether the

minister has had complaints from the practical nurses about that

situation.

I have a question from the Central Vancouver

Island Union Board of Health. This is a fairly recent one, and, again,

if there has been an answer I haven't seen a copy of it. The question

is about public health engineers being placed in the water resource

section. Concern is expressed by the Central Vancouver Island Union

Board of Health that they might be asking questions of public health

engineers to do with water only, and not with the other health aspects

of water and waste management, and wanting the minister to reassure

them that public health engineers, even though they are under the water

resources section, would be able to deal with other questions in which

they are trained and capable to deal with.

I had a letter

from a constituent who had a very sad and near-tragic experience in the

Ladysmith General Hospital. Rather than read this letter into the

record, what I'll do is have it typed and sent to the minister. I don't

know that there is very much he can do about it, but I'd certainly like

to put it to him and give him an opportunity to comment.

We've

all, I'm sure, had briefs from the chiropractors two briefs, I think —

since the last time we had an opportunity to talk about health matters.

They make what I feel are logical arguments that health care can be

cheaper by extending the number of visits patients can make to

chiropractors. That, if nothing else, keeps these people away from more

expensive treatment for a longer period of time. In spite of that, and

in spite of the fact that there seems to be, I think, growing

appreciation of what they can do for people.... According to their

presentation, under the health-care plan the number of visits people

can make to chiropractors has actually been reduced rather than

increased.

[ Page 867 ]

[Mr. Davidson in the chair.]

MS. BROWN:

I want to talk to the minister about this ongoing survey inside the

ministry in the area of mental health. I tried to start a discussion on

it in question period one day. I asked the minister whether he would be

willing to release the findings of the Cumming survey, so everyone in

the Legislature would get an opportunity to see what was in the survey.

We would know the kinds of things that are happening in mental health

in the province. At that time the minister said he was not prepared to

release the Cumming survey or to tell us what kinds of things were

being turned up by Dr. Cumming in his survey.

I happen to

have a copy of the survey. In particular, I would like to share with

the minister, in case he hasn't seen it, the kinds of things that have

been showing up in the survey done on the provincial boarding homes;

that is the specific one I want to deal with.

I'm not going

to deal with the findings about the community mental health teams.

There seems to be some kind of undercurrent to wipe them out and prove

they are not doing a good job. I'm going to sit on that for a year and

wait and see what happens. If the community mental health teams fall

into jeopardy between now and the next time the minister's estimates

come up, then I'll deal with that part of the report. I will not make

that part of the report public. We should talk about provincial

boarding homes because it's a pretty serious problem. Although this

report has been out since January, I have not noticed any improvement

in the provincial boarding home situation; that's why I want to talk

about it.

I gather from the report that the survey team

visited 31 boarding homes, all in the greater Vancouver area, except

four of them. There are approximately 300 boarding homes in the

province. One can draw pretty good sense about what's going on in the

boarding homes by looking at a little more than 10 percent of them. I

like the categories they were divided into; one category was called

"Close down."

The report says:

"The

quality of care in these homes is bad, with overcrowding, lack of

privacy, uncleanliness, no programs, operators with authoritarian

attitudes, with no concept of rehabilitation, and no expectation of the

clients. The finding was that at least several infractions of licensing

regulations were noticed in each facility in this group."

the 31 homes visited, 6 came under this category. In one instance the

representative found that a home which accommodated 32 was full; 24 of

the residents were psychiatric patients with severe behavioural

problems and multiple physical and mental handicaps. The person goes on

to say:

"On entering the home, I was immediately made aware of a

terrible smell of Lysol and old urine that permeated the whole place. The living

room was crowded with people getting prepared for lunch, with residents pacing

or sitting in wheelchairs or geri-chairs; some appeared groggy and over medicated.

Later we saw residents eating with their hands; some had more on the table than

on their plates. With the exception of one aide, all the staff were off having

lunch."

don't think this person was disturbed by the way in which the patients

were eating. What the person on the survey team was disturbed about was

that 32 people were supervised by one aide, while the rest of the staff

were off having lunch. The person goes on to say that the kitchen was

cluttered and disorganized, with flies swarming around the food. The

kitchen staff were having lunch in the alcove where the medication

trays were set up.

One or two rooms had personal belongings

and, in contrast with the others. they appeared bright. The other rooms

were drab; the beds were saggy, cold and dingy. There were three

bathrooms and they were smelly and grimy." It goes on to say that they

were told that the residents had a bath once a week, in spite of the

fact that at least half of them were incontinent.

There is

no retraining program, and the report goes on to talk about the

overcrowding and the problems as a result of the lack of

rehabilitation. Mainly they talked about the lack of cleanliness. There

were total violations of some of the licence requirements. According to

this report, 6 of the 31 homes visited, most of which are in the

Vancouver area, fall into this category known as "Closed down."

The

second category is called "Backwards." This means many homes in this

group were similar to those above; the only difference was one of

degree. Physical care was somewhat better but little rehabilitation

existed. It was felt that these facilities could be improved by strong

outside direction.

The reason I am raising this report is

because it has been in the minister's hands since January. I have been

waiting for the minister to act on it. I have not raised it before. I

waited for the minister to bring down his annual report to see whether

the annual report indicated that something was going to be done about

this. I kept absolutely silent on this until then. I looked in the

annual report and there is no indication in the annual report that the

minister is doing anything about this,

I raised it in

question period. The minister indicated that he's not prepared to

discuss it. I think it has to be discussed, and it has to be discussed

openly because you've had enough time to start moving on it privately.

You haven't done so yet, Mr. Minister.

The example quoted in

this one is of a custodial home with 28 chronic psychiatric patients

ranging in age from 40 to 65. Again. there are no programs and no

rehabilitation in evidence. It is large. dark and dingy. There was a

feeling of crowding, because all the rooms except the dining room were

small. It goes on and it talks about things like the dining room had a

cage-like area for the nurses who came several afternoons per week. It

talks about the general ugliness of the place. Talk about squeezing —

six people at a squeeze. There was a couple in a tiny bedroom. They are

totally unsatisfactory accommodations.

Everything was small,

including the bathrooms. The report talks about things being

depressing. There were cigarette burns all over the place. The place

had an appearance of deterioration. There was no restriction on smoking

although you're dealing psychiatric people. The lounge could not begin

to hold all of the residents at the time. The bedrooms had four beds

jammed right next to each other. There was no place for personal

possessions and no privacy whatsoever.

The residents, on the

whole, seemed to be just sitting. As the report stated earlier, these

particular places were just a little bit better than the ones that were

designated that they should be closed down.

[ Page 868 ]

How

many of the homes out of the 35 which were surveyed do you think fell

into this category? There were 12 backward homes and 6 that should have

been closed down. That's 18 out of 31 homes. That's more than half of

the homes that were surveyed. We have people in boarding home care who

were discharged from Riverview or from the mental health program.

People are living in boarding homes that violate the licensing

regulations. They are described as overcrowded, dingy, depressing,

unclean and having no program for rehabilitation whatsoever. People are

just sitting there.

The report has categories that it

considered to be "good" and "very good." It's something that we should

talk about as well because we want to talk about the boarding homes

that meet the criteria and are doing a good job, in order to try and

bring up the more than 50 percent of the boarding homes that are below

this according to these kinds of criteria.

The important

thing that came out of this was that the boarding homes that came under

the categories of "good" and "very good" were smaller boarding homes.

Right from the very beginning, for the most part, the survey discovered

that in terms of their ratings, the good boarding homes were likely to

be the small ones, and the bad boarding homes were likely to be the

large ones.

We have six that should be closed down and those

six carry 142 beds. The 12 that were just a little bit better than

being closed down but were totally inadequate had 211 beds. We're

talking about 353 people in the boarding home program who are, for one

reason or the other, forced to live in inadequate conditions. It's an

inadequate situation.

The boarding homes that came under the

categories of "good" and "very good" only house 163 people. One is led

to the conclusion that the majority of the people surveyed in the

boarding homes in the greater Vancouver area, and in the four that are

outside, are living in totally inadequate situations. They are

situations that you should be doing something about.

The

report goes on to say that "41 percent of the places we visited are

unsatisfactory but we feel that they could be salvaged and brought up

to standard, some with considerable effort." It says 27 percent were

definitely substandard and cannot be improved without reduction, first

of all, in the number of clients that are using those particular

boarding homes and either very costly alterations or a change in

management.

I can understand why you would be reluctant to

make this kind of report public. I can't understand is why, although

you've had the report in your hands for so long, there is no indication

that you have started to do anything about it.

The report

brought down a number of recommendations, and there are two that I

would really like to support very strongly. One is the recommendation

that a continuing survey of the boarding homes should be inaugurated

from outside the regions in which they exist. I think that to have

instituted this survey in the first place was a good thing. I'm

distressed that you haven't done anything with the information that you

have received, but it was very good. I agree, certainly, with the

recommendation that a survey team should continue surveying the

boarding homes — and this is outside of the regions — and it goes on to

explain that it thinks this would be much better than having local

supervisors and operators do that. I think that's correct.

The

other recommendation is that attention should be given to the Alberta

system of ensuring that each client in such a system is engaged in a

day program outside of the home. I think that's a very good

recommendation. The idea of the patients just sitting.... I know that

even in the ones that had the categories "good" and "very good," for

the most part they were doing a lot of TV watching. There wasn't very

much else going on.

Another recommendation was that more

attention needed to be given to the supervision of medication in the

boarding home. It says that long periods between reassessments are now

the rule, and quarterly review of all medication by psychiatrists

should be mandatory throughout the province. So, as I said, I didn't

want to bring the issue up, but there it is.

I also have a

response to the survey from the doctors involved with the boarding home

program. That's Dr. Bill Holt, Keith Barnes, Mr. Farry, Christine Klein

and Florence Ireland. In their comments on the boarding home, they made

a couple of really interesting responses, the important one being.... I

didn't mention Dr. Cumming's recommendation that they go into large

apartment blocks. I thought it was kind of crazy, after the survey had

just shown that small is good, that he was recommending large apartment

blocks. But anyway, the boarding-home people under Dr. Holt said that

they certainly agreed with the survey and with the categories that the

boarding homes had been put into, but they did not support his

recommendation for going into highrise apartment blocks.

The

only thing they said was — and I think this is kind of interesting —

that the second cause of the problem in the boarding-home situation is

chronic underfunding of the program, despite the support of the

administration. We come right back again, Mr. Minister, to your

department and to your government. You're not going to have to bear the

burden of this alone, because I know that Human Resources is forced to

pick up the tab for some of this funding, and they're doing as lousy a

job as you are. I know that. But it's your estimates so I'm dealing

specifically with you.

In this report they talk about the

lack of funding coming from Human Resources as well. They say that

chronic underfunding has occurred in the provision of boarding homes

staff, care costs for clients of the program, funding of the desirable

ancillary services such as the sheltered workshops, achievement

centres, work activity programs, funding for the development of

sheltered employment and independent living programs. Funding for these

latter programs has been the responsibility........ And they're very

nice about it; they refer to it as "another ministry of government, "

but we know that they're talking about Human Resources. They go on to

say, of course, that the needs of the psychiatrically disabled have

been traditionally very low in that particular ministry's priorities.

What they don't know is that the needs of anybody have been very low in

that ministry's priorities.

They go on to say that 41 field

staff are trying to meet the needs of 2,080 clients — 41 people.

Compare this with the heroin program. It's interesting, isn't it, that

you have 114 heroin addicts — you know 200 old methadone addicts — and

you have over 300 staff to look after them. But you have 2,080

chronically psychiatrically disabled people, and you have 41 staff,

according to these doctors, to look after them. That's the extent of

the boarding-home resource.

[ Page 869 ]

They

say no new staff have been added to this program since 1973. There have

been no new public service staff since 1971, although the caseload has

increased by 658 in number, not on the heroin program, but on this

particular program. The caseload has increased by 658. The turnover has

almost tripled, and clients referred are significantly more difficult

to manage in the community. It has been many years since the days when

the passive institutionalized person from Riverview represented the

major referral.

They said a third hindrance.... I'm moving

very quickly through this because I see the minister is getting

twitchy. I'm hoping that he's going to tell me that I'm wrong, that in

fact he has acted, he has moved quickly and swiftly, that he has

tripled the staff of the boarding home team, that he's cleaned up all

of the boarding homes, and.... I'm being intimidated, so I'm moving

very quickly.

They go on to say that a third hindrance....

Interjections.

MS. BROWN:

Nobody else speaks for this particular group of the community because

they're locked away and they're shut away. Their families don't visit

them; they have no friends; that's it. Close the door on them. Like

other groups in society, every now and again we should probably take a

good look at what's happening to these people in boarding homes. I am

glad that the ministry instituted this survey. I worked in the system

and I know that during the year I worked at Riverview I had to

discharge patients into some of these boarding homes. I know something

about the quality of care that we must have in those boarding homes if

people are to eventually be ready to return to society as a whole. I'm

concerned that there has not been an increase in staff since 1973.

Dr.

Holt in his response tells us that a third hindrance to the development

of the program has been this new division of responsibility among all

of the ministries for various aspects of the program — long-term care

is doing its thing, Human Resources is doing its thing and, of course,

the clients are falling in between. So I would like to see the ministry

respond to that.

Similarly, the program has had to rely on

the ministry or the division of a ministry for the enforcement of

licensing standards, and you have fallen down on the enforcement of

licensing standards. That's the first thing that I pointed out: the

boarding home program staff have their cooperative part to play in the

monitoring of standards, but they have no actual authority in enforcing

them. A social worker cannot walk into one of those boarding homes and

say: "I'm going to shut you down because you are filthy." They can' t

do it. That has to come from the licensing staff, and they haven't been

enforcing the rules. That is what Bill Holt and these people are

pointing out — that you haven't been doing your job either. There's

been underfunding, and your licensing people haven't been doing their

job. It says: "All the staff can do is to tell the residents that they

don't have to stay in that dirty, filthy boarding home, that if it's

possible to find them another one, they will be removed." But, of

course, there aren't any others to move them to, so they're stuck in

some of those filthy boarding homes.

He goes on to say:

"Following the transfer of the institutional retardation resources to

the Ministry of Human Resources two years ago, the Ministry of Human

Resources at that time said it would take responsibility for all

provision of services to retarded persons, and it just has not being

doing that." I'm not going to deal with that. What Bill Holt is saying

is that most retarded persons who are in residential care are there

because they need long-term care. This is not a part-time visit; this

is not a short-term visit. They are in there because they need

long-term care. And you should start taking another look at the way in

which the program has been divided up between yourself and Human

Resources, because it may be working really great for the ministries

involved, but it hasn't been working worth a bean for the patients who

have had to be living under those things.

Again he goes on

to talk about the low status that the program has always had. And they

come up with recommendations, too, and I endorse every one of their

recommendations. Their first recommendation is that the boarding-home

program staffing has to be immediately brought up to recommended

standards. You don't have to go up to the standards of staffing that

you have for the Heroin Treatment Program; it's not necessary to have

350 staff people to deal with 114 people, as you do under the Heroin

Treatment Program. But you have to do better than 2,000 patients being

cared for by 41 staff. He gives an example of the Surrey mental health

centre, which has a caseload of 180 persons. It has one boarding home

social worker, one case aide, and one-half of an activity worker.

The

second recommendation is that a firm decision be taken by the ministry

that specialized halfway houses, the type of resource for

psychiatrically handicapped persons developed by non-profit societies,

should be funded under long-term care. I know you know the kind of

service Loma Lodge, for example, is involved in, and the struggles that

we had to get that started to deal with young people with psychiatric

problems who are into this kind of thing. He is saying that all of the

programs like this should be under the long-term care program. In

responding, I would appreciate it if the minister would refrain from

making facetious comments about my asking that things go under

long-term care. I believe that there is a place for long-term care in

this province, and I have never denied that. If I had my druthers and I

had to place someone under the care of a ministry because that person

was retarded. I'd rather put them under Health than under Human

Resources, if you must know the truth.

The third

recommendation is that funding be made available to mental health

programs for the development of a range of ancillary programs such as

activity centres, sheltered work-shops, life-skill programs, work

activity programs, individual rehabilitation and sheltered employment

opportunities. I certainly endorse that recommendation.

endorse all of the recommendations brought down by this particular

group of people, because it doesn't make any sense just to have people

sitting there just looking into space or watching TV all the time,

which is what the survey team found when they visited even the houses

which they designated good. It's a matter of degree, because even the

ones that were designated good I don't think are really all that good.

talks about inspectoral staff being added to the public health units,

which I think is a very good idea. I wonder whether you have thought

about that. It is recommended that long-term care legislation now being

drafted include

[ Page 870 ]

clauses

that allow for flexibility in the regulations governing benefits in

order particularly to ensure rehabilitation of persons. I don't know

whether the Mental Patients Association would come under that and

whether the boarding homes that they run would come under that, but I

know that certainly in terms of meeting their needs, there has to be

more flexibility in that kind of recommendation.

Mr.

Minister, you have the report, so I'm not going to belabour the

recommendations, except to say very quickly that the last, that the

ministry designate funds to be used in a community educational program,

is something that has long been awaited, and I think we need it. Every

one of us needs to be educated against discrimination towards the

mentally ill person, and particular effort should be made in respect to

the development of residential community care facilities and housing

for the mentally ill. That is an absolute necessity. It's a must. That

was his eighth recommendation; it probably would have been my second or

third.

The final recommendation he made was that the

ministry undertake to rationalize, with the Ministry of Human

Resources, the present situation in respect to retarded persons. Now

that's a bureaucratic way of saying that the two of you should get your

act together. I think that you should take it away from Human

Resources, quite frankly. I realize that it has something to do with

cost-sharing and one thing and another. But in terms of taking care of

the mentally retarded, take it under your purview, because those people

who are covered by Human Resources are not being well served. They are

not being served perfectly by you, but you are doing a better job than

Human Resources. If the recommendation of rationalization allows you to

take the entire retardation back under your purview, I would certainly

like to make that recommendation to you.

HON. MR. McCLELLAND:

Mr. Chairman, I should answer a couple of the questions, I think. The

matter of the release of the so-called report is.... It's not a report.

It's a survey and it's done by the ministry to ensure that the programs

that we have are looked at so that we can have terms and guidelines.

You know, it's not much different.

What we're doing here

with Dr. Cumming and with a lot of other things in the ministry is not

much different than a public health inspector. Public health inspectors

go out every day of their working lives and they inspect. What we're

trying to do is bring the same kind of continuity into other programs.

This is one of them. You know, it's not a report that we've

commissioned on a special kind of a basis. What we need to do is have

the information so we can work on getting things done.

MS. BROWN: Share the information. Let's talk about it.

HON. MR. McCLELLAND: We're sharing the information with you right now. You don't seem to have any difficulty in having access to the information.

Mr.

Chairman, it's no big secret. It's just an ongoing way in which the

ministry gets things done. One of the first things we did, for

instance, in the long-term care program was to put together a team

which had the responsibility for making sure that any complaints,

whether initiated from the outside or the inside, got looked at and the

facilities got inspected in a hurry so that we could make sure that

those things got changed.

Yes, there are problems with the

boarding home program, and one of the major problems, Mr. Chairman, is

that there was a philosophy that was developed by the previous

government, through its Human Resources ministry, that Riverview should

be emptied as much as possible and that those people should be returned

to the community and cared for in the community.

That's a

concept that no one can really find fault with. But there were not the

resources provided in the community to look after all those people who

were put into the community. That's the problem we have right now:

ensuring first of all that we find out what has happened in the

community. So we must survey, and then we provide the services that we

can in order to make that available.

Mr. Chairman, that's

what we're doing now. There are ways in which those things are dealt

with. One of the best ways, when you're short of facilities — and

boarding homes don't come easily.... Good ones, bad ones, they don't

come easily. People don't put forward that concept as easily as they

might, and that might be part of the educative process that we need to

go through. So when you're short and until you have a sufficiency of

facilities available, you don't close things down lightly. You attempt

instead to work with the people involved to get them to upgrade so that

you don't have to close down. There may come times when, shortage or

no, you have to close down, and I'm told that we have closed three of

the facilities which were surveyed. I don't know whether they were the

ones to which you refer. Then we deal with the others in terms of

getting them to upgrade. That's the reason for the surveys, and, Mr.

Chairman, that's what we're doing.

I had the opportunity one

day to go out with community health workers and visit about five of the

boarding homes in Vancouver. I didn't go outside of Vancouver because I

didn't have the time. I visited many of the other facilities that the

Coast Foundation operates. I've been to Loma Lodge, and we've talked

with them and I understand the difficulties that they have.

The

problem of medication that you raised, Madam Member, is one that we've

already started to improve through a much more accountable system of

medication in those facilities. As for the outside-day programs, we are

insisting now that outside-day programs be part of the licensing. We

understand as well that will impact on us in terms of further financial

resources required, because those are not government operated

facilities. They are privately operated facilities which are funded by

the government. Those things are part of the ongoing reviews that are

made by the ministry, and we'll continue to do that.

MS. BROWN: What about the staffing?

HON. MR. McCLELLAND:

Those are matters that I deal with in Treasury Board, and I attempt to

do what I can. I asked one of the members of my staff to go and have a

look at what the staffing situation is. We have added 24 extra staff in

the field in the past nine months. Those are the kinds of things that

we deal with when we have the surveys which are necessary to tell us

what our problems are, and that is what I hope we will continue to do.

think I have answered, in as brief a way as I can, the questions raised

by the member. We can only promise that review will continue in an

ongoing way, and that we will hopefully respond as quickly as we can to

that review.

[ Page 871 ]

The

only other question is the one of the long-term care responsibilities,

and we're in active discussion with the Human Resources Ministry now to

consolidate some of those. Probably they will come over to the

long-term care program at some point down the way.

The member for Nanaimo (Mr. Stupich) raised a lot of questions, and I'll try and just really skim over them.

[Mr. Rogers in the chair.]

The

chiropractic question is one which I did not want to deal with in

isolation. Others are in the same position as chiropractors —

naturopaths and physiotherapists and others who have the similar kinds

of limits. I've asked for a review from my staff which I can present to

the Treasury Board in terms of what is necessary there.

The

employment problem of licensed practical nurses is one which,

basically, the hospitals must have control over. They set their own

hiring practices. But I can tell you from the contact that I get from

the hospitals that they have one dilemma. The wages of a licensed

practical nurse are now reaching those of a registered nurse. Quite

often hospitals will hire registered nurses because they feel, rightly

or wrongly, that they get more value for their money. I don't know

whether that is the truth or not, but that is what I'm told.

I've

dealt with the matter of public health engineers with a number of MLAs,

and, yes, there was a transfer over to the Environment ministry.

However, we have statutory responsibility to provide certain services

under the Health Act. We will then have to contract, but those services

will still be held statutorily under the Ministry of Health. We will

contract to the Ministry of Environment for those services.

regard to the preference given to speech pathologists and audiologists,

I think that question has largely been answered over the last nine or

ten months. UBC is expanding its curriculum to help us provide more

Canadian-trained people. The problem still is that we are not able, as

much as we would like, to get Canadian-trained people. We've had to go

outside to a large degree. That still must be done within our public

service policy, which says that no one can be hired until the Canadian

market has been fully canvassed. That policy is still in place with the

government.

The dental plan has been discussed with staff,

and it has been discussed with the dentists. The dental profession has

put forward considerable recommendations to the government in terms of

what they'd like to see in a dental plan. The costs and the formulation

of the plan are now being worked within the ministry and with ministry

staff. I can only say at this point that we don't know the total costs.

The first opportunity I have to give those to the public, I will. I can

say, though, that it is a commitment of this government that a dental

plan will be introduced for the people of British Columbia in this

fiscal year.

The ambulance rates was a decision which was made and I realize that it might be a hardship on some.

The

dietitians Act is bound up with a number of other Acts which are before

us. There are a lot of people who want their own self-licensing and

self-regulation Acts. Every government — not only ours — is a little

twitchy about the whole subject. The Attorney-General, at the present

time, has a committee working on some recommendations. It would be my

recommendation, as Minister of Health, that if we don't resolve that

pretty soon, we should tell the dietitians that they should have their

own Act, and we'll bring it in here. In the meantime, we're trying to

come up with a better system. The other day, the member for New

Westminster (Mr. Cocke) mentioned Ontario. They've almost scrapped what

they did before, because they found it difficult to live with. I think

that's all the questions you asked.

Interjection.

HON. MR. McCLELLAND: We're still dealing with the question of acupuncture.

MR. HANSON:

I'd like to raise a couple of points with the minister which I don't

think have been covered in the debate. One of them arises from my

constituency; I'm sure it occurs elsewhere in the province. The

population distribution or demographics of British Columbia are such

that there tend to be more senior citizens here than there are

distributed across the rest of the country. In certain parts of my

riding, James Bay and Fairfield, that figure is higher than either the

provincial or national figure. I don't want to quote the figure for

James Bay off the top of my head, but it is quite high.

The

problem I want to address to the minister is the sad situation that

occurs in a small number of instances where couples who have lived

together for many, many years and who require different levels of care

have to go to different institutions. In fact, yesterday one of these

examples came to my attention here in Victoria, where the wife requires

more care than the husband. After 30 years of marriage they have to go

into different institutions. Surely one of the cruelest things that

could happen to people in their last years is to have to go off into

different institutions for care. If I were ever the Minister of Health,

one of the first things I would do would be to establish a certain

number of beds in institutions for spouses who do require different

levels of care so they could live in the same building. I would like

the minister to look at that, particularly in this city which has the

highest number of senior citizens in the province.

The

second thing I'd like to raise with the minister, on which I've had

considerable correspondence, is the failure of provincial and federal

governments to live up to their obligations in terms of veterans'

accommodation in the former veterans' hospital, the Royal Jubilee.

There does not seem to be the accommodation required.

I have

copies of the transfer agreement containing language which in its

intent seems to want to provide the best possible care for veterans who

are disabled and require permanent care. The definition of "extended

care" is:

"The type of care required by

persons of any age with a severe chronic disability which has usually

produced a functional deficit, who require skilled, 24-hour-a-day

nursing services and continuing medical supervision, but who do not

require all the resources of an acute-care hospital. Most people who

need this type of care have limited potential for rehabilitation, and

often require institutional care on a permanent basis."

That definition generally characterizes the veterans in many institutions.

I have received correspondence concerning people who have experienced long delays in getting into hospital. My

[ Page 872 ]

information

is that in the Royal Jubilee Hospital, for example, there are only 50

beds for extended care. One correspondent said there were 46 beds, but

I think there are 50 beds. But the demand is higher than that. It

should be a high priority. Veterans who require extended care in the

last years of their lives should receive that care. I would like to

hear from the minister what his goals and objectives are now in meeting

the needs of veterans; also his answer concerning my earlier comment

regarding the needs of couples who have lived together for long periods

of time who require different levels of care.

HON. MR. McCLELLAND:

Perhaps I could get a little more information on the specifics of the

complaint about the veterans. I believe we are living up to the terms

of the transfer agreement in making available for the veterans the

things outlined in that agreement. I think we've gone further than

that. The previous government began that move to make available to the

veterans the same facilities outside of the single communities of

Vancouver and Victoria, and to give them preference, as we have in the

long-term care program in facilities other than at the Royal Jubilee or

at the old veterans' hospital at Victoria, or at Shaughnessy.

while those beds may be available only, for instance, at the Jubilee

site, there are others available in other areas, and we will attempt to

continue that. The transfer funds, when spent, will be spent on

veterans' facilities specifically.

For instance, we are

building a new 150-bed extended care unit at Shaughnessy for which

planning is well underway now, and final clearances are just being

given.

The one about the spouses being separated is one that

I thought we had largely dealt with. I issued instructions to our staff

from the beginning that we were to provide the highest possible level

of flexibility to make sure that spouses did not get separated, unless

it became absolutely necessary. There are units available in many of

the facilities which have been going up most recently particularly,

which have opportunities for spouses to spend their time together,

regardless of the level of care they need.

But I think we

would be fooling ourselves if we didn't understand that there will

probably come a time when that may be impossible, just as it may be

impossible for a normal family relationship to continue when one member

of the family can stay in the house and the other member may have to go

into an extended-care facility. That may reach all of us sometime, when

the care we need becomes that extensive.

So there always

will, I think, be a period when loved ones may in fact be separated

because of illness — chronic illness particularly. But it's specific

instruction to our staff that wherever possible — and we've imposed

this on many occasions — spouses are not to be separated simply because

they require a different level of care, unless it becomes absolutely

impossible for the facility to provide that care for them.

MR. HANSON:

I do have a specific case and I would like to bring it to you because I

know that the one spouse is going to Mt. Tolmie and the other is going

into another. I would like to bring that to you because they would be

very happy to have that rectified.

I also talked to an

administrator at one of the long-term care institutions here in

Victoria, and it is not as infrequent as the minister suggests. As they

come to my attention I will bring them to him.

HON. MR. McCLELLAND:

We should all remember there may come that time, for instance, if a

member of a union requires highest level of extended care...or,

perhaps, let's put it the other way around. If a person requires one of

the lower levels of care, for instance, and then that person's spouse

should suddenly become incapacitated to the point where they require

the highest level of care, it may be impossible for that facility to

give that kind of nursing care to the one who requires more care.

there might come a time in our lives when we may have to be separated.

That's all I'm saying — simply because the care cannot be given. But I

have said it is the policy of the ministry at this point to provide the

most flexibility we can to ensure that spouses stay together.

MR. HANSON:

One last comment. I would like to draw the minister's attention to the

multicare facilities in Britain. I think one of his deputies may be

familiar with it. Philosophically and morally, they are trying to meet

that need. I'm not saying people aren't separated when they go into a

hospital. But when you have two elderly people at different levels of

care, I think that we, as a society, have to decide whether we are

philosophically going to try to meet that need. That is the point I'm

trying to raise with you.

HON. MR. McCLELLAND: I

agree with the member, Mr. Chairman. But when one reaches the point

where 24-hour nursing care is required, you're not very far from a

hospital.

MR. LEVI: Mr. Chairman, I got a call a

couple of days ago and I haven't really been to see the ministry about

it. But I wonder if he would make a comment about the spinal cord unit.

I am not now dealing with a specific case, but what happens with the

spinal cord unit in the summer? Is there a gearing down, or is it

maintained at the same rate? One of the observations made by a doctor I

talked to in the case was that if there is not a gearing down, and

there is a maintenance of the standard of service, the service should

really be increased in the summer. Doctors find the greatest intensity

of cases comes during the summer. They're averaging six or seven spinal

cord cases, and some of them, at the moment, are being looked after in

the local hospitals. It's not that the hospitals can't look after them,

but that the rehabilitative process in the spinal cord unit is better.

Now

can the minister tell me what actually happens? If there is a greater

intensity of cases in the summer, as apparently there are because more

people are out in their cars, and there are a number of accidents as a

result of swimming, is it built into that service that they can in fact

receive more people than they normally receive in the rest of the year?

That's really what I'd like to hear from the minister.

HON. MR. McCLELLAND:

Mr. Chairman, I don't think it's a matter of the time of year that

there is low occupancy in the spinal cord unit; that happens from time

to time. The problem, again, is more one of education, rather than

anything, of the physicians in the community. There is some reluctance

— and I don't know why, because I'm not a physician and I'm not

involved that much in the medical

[ Page 873 ]

profession

— from time to time to refer to the spinal cord unit. Physicians are

treating those patients who could be treated in the spinal cord unit in

the local hospitals, as you've mentioned. It's a matter of attempting

to get the physicians used to referring to the spinal cord unit. We

have a committee working on that at the present time among the doctors

in the area, the people at the spinal cord unit and our own staff. I

haven't had a report recently from them on that matter, but I'll

certainly look into it now that you've raised it. But that's the basic

problem — getting that referral into the spinal cord unit so that we

can use it to its full advantage.

MR. COCKE: We've

been on this vote for three days. I'm amazed at the minister's

marvelous, magic responses today. There have been responses to

questions, rationalizing to some extent, but that's....

HON. MR. McCLELLAND: Am I not supposed to respond? That's what this is all about, Mr. Member.

MR. COCKE:

I'm amazed at the minister. He was even listening for a second there,

but he didn't understand, and he normally doesn't. He says: "Aren't I

supposed to respond?" I said I'm amazed at his response today. Mind

you, he's rationalizing a great deal, but the areas where the minister

seemed prepared to respond were the areas in terms of the financing of

our hospital plan in this province and the areas in respect to the

emergency health services.

I suggested to the minister the

other day that cabinet ministers have a priority on the utilization of

government aircraft, and he said: "No, they don't. Never, never,

never." I told him to check the logs of the government aircraft during

the last election when ministers were not allowed to fly. At that

point, there were significantly more flights used for mercy services.

So that's just something for the minister to do in his spare time.

I suggest that some of the questions that the minister has not answered are ones that I asked two days ago, or three days ago.

HON. MR. McCLELLAND: What are they?

MR. COCKE:

They are questions around how you are financing health service, when

it's you against every hospital in the province. I suggested, for an

example, that there are 750 emergency health service members needed in

this province, and you got up and said: "Where did you get that

figure?" He's got it in reports. Mr. Chairman, I had it in reports.

He's got 550 people, and he knows that in the city of New Westminster

right now the firefighters are carrying people to the hospitals when

there's an emergency situation because there is not enough staff on the

whole lower mainland.

I've discussed all of these questions

in long detail, and I'm certainly not going to reiterate my questions

or my detailed discussion today, because we've been all through it. But

I'd just like to suggest, as we get around to the minister's vote, that

the lack-of-confidence motion was warranted, and any concerns that we

have for the carrying on of health care in this province are concerns

that we'll carry with us through this minister's vote.

Vote 128 approved.

Vote 129: administration and support services, $21,327,012 — approved.

Vote 130: preventive and special community services, $35,539,703 — approved.

Vote 131: direct care community services, $180,777,352 — approved.

Vote 132: mental health services, $18,129,440 approved.

On vote 133: Hospital Programs, $649,178,588.

MR. COCKE:

Mr. Chairman, the comment is that it's either grossly inadequate or the

minister should have had an alternative for the way he's running the

hospitals in this province.

Vote 133 approved.

Vote 134: Medical Services Commission, $245,300,000 — approved.

On vote 135: Emergency Health Services Commission, $26,050,883.

MR. COCKE:

Mr. Chairman, this is the vote under which I think the minister should

indicate in some detail why it is that there is an increase of only a

little over a million dollars in a service that has been under financed

and continues to be under financed, a service that this province could

very well be proud of, and is proud of. But it is not a service that is

being properly funded. I just feel that the minister lacks the

priority. This is a minister who can place $12 million down a gopher

hole in terms of his ' heroin program, and yet squeeze a program like

the emergency health service. I think it's a shocking situation.

Vote 135 approved.

Vote 136: Forensic Psychiatric Services Commission, $4,285,498 — approved.

On vote 137: Alcohol and Drug Commission, $12,330,546.

MR. BARNES:

Mr. Chairman, could the minister indicate to the House the progress of

the detoxification centre proposed for Great Northern Way in the north

Mount Pleasant area, indicating the parameters of that project in terms

of the extent to which it will realize some of the overall objectives

of the detoxification program respecting counselling and residential

treatment? To what extent and under what authority will the persons

being admitted stay? How long will they be there? Will it be on a

72-hour basis, long-term? Also, could the minister indicate when the

project will be underway?

HON. MR. McCLELLAND: Mr.

Chairman, I guess when the project will be underway depends to a large

degree on somebody else, not me. I'll tell you, if we had the

opportunity to have that facility open a year ago, if it had been up to

me, it would have been open a year ago

[ Page 874 ]

somewhere

in Vancouver, because the promise I made to the city of Vancouver was

that we would replace that drunk-tank, which has needed replacement and

which must be replaced at the earliest opportunity.

We had a

site at one point, and for one reason or another that site was not

acceptable to the city of Vancouver. We expended a fair amount of money

in developing it — that was the China Creek site — and we had to start

all over again from square one. The city came up with another site. I

think we spent around $100,000 in the development of that site, meeting

every one of the city's requirements in its bylaws. It isn't up to us

to do the things the city is supposed to do in terms of community input

and that sort of thing. What we are supposed to do as the developers is

meet the bylaws, and we did all those things.

The city then

came back to us and said: "We may not be going with this site. How

about looking at another site?" Well, all I said at that point was that

obviously the city's priority was not as high as the priority I had put

on the replacement of the drunk-tank. If it wasn't, then I could have

used that money in a lot of different ways, in a lot of different

communities. So I said to the city: "If you're really don't have this

as a high priority, then tell us and we'll spend the money somewhere

else." If you call that a threat, then it's a threat, I suppose, but I

was anxious to see this program go forward.

Anyway, we're

ready to go with that program. I think the city has agreed at this

point that site on Great Northern Way will be where it is. It's for a

48-bed detox centre. There will be 12 holding beds for the compulsory

detox centre to replace the drunk-tank. The Ministry of Health will be

operating it; the Ministry of the Attorney General will provide those

security people who are required in that kind of facility. I understand

that we hope it will be open next year.

It will not be a

residential treatment facility. We do have a residential treatment

facility now. The newest one is in New Westminster, Pacifica, which is

located at the present time in the YMCA building there. That facility

is going to have an addition to it quite soon, and our residential

treatment facility program is going quite well. That is not part of it.

It's a detox centre meant for a short-term detox stay in a much more

humane and sensible atmosphere than the Vancouver city jail.

MS. BROWN:

I have a couple of questions. I'm kind of curious about Dr. Altman, who

has been hired to head the program. I wonder if the minister can tell

me.... He's got a very impressive curriculum vitae, but it doesn't

really say very much about what his job was prior to coming here.

understand he worked — helping fat people reduce — I think that was the

job he had to do in Montreal somewhere — and he used the behaviour

modification process. There is some question as to whether it was

successful or not, used in that particular setting, and one isn't sure

whether or not he left a successful job to be hired here. So maybe you

could tell us a little bit about what he did before he came here, and

whether anyone has checked out that very long and very impressive

curriculum vitae. Or he was just hired on the basis of an interview and

what you read in the curriculum vitae? I also want to know when his

salary started. Did it start on January 1, or in June when he began his

job? What kind of deal did you work out with Dr. Altman? In other

words, when did he begin to get paid under the particular program?

am also curious, Mr. Chairman, if the minister would tell me whether,

in view of the fact that he is having such a hard time finding addicts

to fit into the program — it shows here 293 staff to cover something

like 106 addicts — whether the program is now drifting into treating

other forms of narcotics. The Act is really quite clear about the fact

that the program is for treating heroin addicts. Are people who are not

heroin addicts and are addicted to other forms of drugs being treated

under the program? I'm thinking specifically of some of the community

groups — the Coast Foundation Society and other places like that —

where they are allowed to treat alcohol and other drug addictions. Is

any of this money going into that too?

According to the code

of ethics which applies to mental health, confidentiality plays a very

important part. I have a copy of the code here and it certainly makes a

big fuss about confidentiality. I am wondering if the minister can tell

me whether the private criminal records of any of the people who are

under the program have ever been released to any of the doctors or

anybody on the evaluation team. I would like to know whether anyone who

is conducting the training program is using any of the involuntary

volunteer patients as examples in the training program. Are they using

persons' names and identifying them quite clearly? Is the minister

aware if this is happening? The code of ethics covers that question

specifically.

HON. MR. McCLELLAND: I don't know

whether anybody is using somebody else's name as an example. I haven't

heard of that. If the member has some information that I should have,

that I should be investigating, I'd be happy to have it. To my

knowledge no private criminal records have been made available to any

member of the assessment panels, and I can tell you that is as up to

date as I can probably get it. I attended a meeting of the assessment

panels about eight days ago, and that specific question was before the

committee, and that had not happened to that point. I am sure it might

be very difficult for it ever to happen under the laws we have now.

Doctor

Altman was hired the same way all civil servants are hired. He went

through a panel of the public service and the public service chose him

as the person who best met the qualifications which were advertised.

Every one of the members of our staff has gone through panels of the

public service for this program.

Interjection.

HON. MR. McCLELLAND:

No, because he's not a member of the staff of that program. He is an

order-incouncil appointment, as you well know, Mr. Member, and that is

a time-honoured way of appointing people to the service of their

provinces.

MS. BROWN: When did his salary start?

HON. MR. McCLELLAND: His salary? I don't know. I'll find out for you before the afternoon is over. It started when he started.

MS. BROWN: Well, I think you should check that out.

[ Page 875 ]

HON. MR. McCLELLAND: I'll check it out, and if there is some difference I'll tell you.

would assume that the public service checked out Dr. Altman's

curriculum vitae. I think Dr. Altman brings a tremendous wealth of

experience and enthusiasm to our program and to this province. I might,

just for the committee — because I know some of the others would be

interested in Dr. Altman's background....

He is a very firm

supporter of the program that we have in place. He comes to us from a

research institute of the Universite de Quebec in Montreal. At the

Universite de Quebec, and during his tenure as an instructor in the

Department of Psychiatry, Harvard Medical School, Boston, he did

extensive research into the psychological and physiological impact of a

variety of treatments for narcotic abusers. His study results, Mr.

Chairman, have been published extensively and he has presented papers

before professional associations in North America and in Europe. He has

a BSc from McGill University, an MA from the University of Western

Ontario, and a PhD in Biopsychology from the University of Chicago. His

professional experience includes a term as visiting professor of

psychology at the Universite de Quebec, Montreal, 1975-79; instructor

of psychology in the Department of Psychiatry, Harvard Medical School,

Boston, 1974-75; associate to the Department of Psychiatry, Harvard

Medical School, Boston; assistant psychologist, McLean Hospital,

Belmont, Massachusetts; part-time lecturer, Department of Psychology,

Northeastern University, Boston. He was an Ontario graduate scholar in

1968-69 and he was awarded the University of Chicago fellowship from

1969 to 1973. He has published extensively in the field of psychology

and is a member of the Canadian Psychological Association.

mentioned last night in sort of an off-the-cuff remark, Mr. Chairman,

that I would be extremely pleased — and I'll make arrangements — when

the House sits again to ask Dr. Altman to come to the Legislature and,

in our media centre in the basement, develop a presentation of our

program for all the members of this House. I'll undertake to do that

and make sure that when we're gathered together here again that will be

done, and I'll make sure that all members have an invitation.

MS. BROWN:

Mr. Chairman, I was impressed with the curriculum vitae and the fact

that Dr. Altman didn't seem to stay anywhere more than one year; I

found that kind of intriguing. I was also impressed by the fact that it

didn't include his last place of employment, and didn't tell us what

job he was leaving from to come here. I checked his curriculum vitae —

and I understand that it wasn't checked before — but it seems that the

behaviour modification program which he was using on overweight people

in Montreal wasn't working. I know it worked on the rats that he worked

with, and I'm wondering whether coming from that to this.... He failed

at that, and now we're giving him a $12 million budget to work on

heroin addicts. It reads beautifully; he did a lot of publishing and

travelled around a lot from place to place. But as I said before, I was

impressed by the fact that it didn't include those two things. We need

to know when the ministry started paying him, as opposed to when he

actually started work.

HON. MR. McCLELLAND: I'lltell you.

MS. BROWN: Okay. Tell me when he got his first paycheque and when he first started work.

HON. MR. McCLELLAND:

Mr. Chairman, I find that kind of a criticism of a professional person

incredible. I could walk into the University of British Columbia, the

University of Victoria, Simon Fraser University or any medical school

probably anywhere and find people who've moved all over the place,

moved around a lot. Professionals move quite a lot. You haven't even

been here for a long time; neither have I.

MS. BROWN: Not once a year.

HON. MR. McCLELLAND:

Oh, it's not once a year. I just read to you the times — 1975 to 1979

in one place at the University of Montreal. That's not one year; it's

four years. You know enough about professions. People do move around,

and they're investigative people to begin with — researchers and people

who are interested in finding out new ideas. They do move from time to

time.

Anyway, Dr. Altman started being paid as a part-time

consultant to help us put together the plan on January 1, 1979, on a

part-time basis. He began receiving his salary as full-time director of

the program in May 1979.

MS. BROWN: Fine. In fact Dr.

Altman started in May and he has been paid since January. How much was

he paid between January and May? Because he was still on his other job

between January and May. He wasn't here between January and May.

HON. MR. McCLELLAND: Well, Mr. Chairman, that's not even unusual. Lots of people serve as consultants while they're in other jobs, and we asked....

MS. BROWN: What was he paid?

HON. MR. McCLELLAND: I don't know. I'll get the amount for you. Why don't you put it on the order paper and I'll get it for you?

MS, BROWN: It's your estimates.

HON. MR. McCLELLAND: Well, I don't know what he was paid. I'll find out for you.

MS. BROWN: You've been squandering the taxpayers' money. What do you mean you don't know?

HON. MR. McCLELLAND:

Mr. Chairman, I'lll find that out for the member, but let's have a

little sense in this debate. That kind of thing goes on all the time in

the professions where you use people who are in existing university

jobs, particularly, to serve as consultants. We would not be able to

function in government if we didn't use people in consultative

positions like that. It happens all the time. It happened in your

government; it happens in this government: and it will happen again and

it should happen, because it's an opportunity for us to have the kind

of expertise that we need, but that we don't have, in the civil

service. We can reach out to universities and use those people. My god,

use some sense.

[ Page 876 ]

MS. BROWN:

He was in Montreal. He was being paid in Vancouver while he was in

Montreal. You've been squandering the taxpayers' money, that's what

you've been doing.

HON. MR. McCLELLAND: Well....

MR. CHAIRMAN:

Order, please. The Chair did not recognize the member for

Burnaby-Edmonds when she rose to speak, and has not yet recognized the

minister. Until such time as the members are going to wait until the

Chair recognizes them, we can't carry on.

HON. MR. McCLELLAND:

Mr. Chairman, I'd like to answer that question from the member who

wasn't recognized. The member knows better. We use people from all over

North America for their professional expertise. You know that one of

the things we're doing now in this government is providing lottery

funds for health-care research projects. It's one of the most exciting

new developments in the use of lottery funds, in my opinion, in years.

We are making available much-needed funds to medical researchers in

this province to come up with new and better ideas and ways in which we

might treat disease or cure disease, if possible.

MR. CHAIRMAN: Order, please. The Chair is not going to tolerate widening the scope of the debate. We're on the Alcohol and Drug Commission.

HON. MR. McCLELLAND:

This is in direct relation to the question that was asked of me. Let me

tell you that one of the ways we set up to ensure that only the most

excellent projects get developed is that we send those project

applications that we get off to Alberta, to Manitoba, to Saskatchewan,

to Quebec, all over Canada to experts in the field to vet those for us

and to send back their expert opinions. We pay for them. That's the way

we maintain excellence in the things we do.

It's that kind

of assurance that will make sure that the money we spend in this

province is spent for good reasons and for excellence and not for the

way it used to be spent. You talk about squandering. You never even

knew where the money was going. We're at least making sure that the

money we spend is for excellent reasons.

Anyway, all the

member has to do is check last year's vote because January 1975 was in

last year's vote and she will be able to check out how much money was

paid.

MR. LEVI: Mr. Chairman, if the minister's got

his estimates book in front of him, under vote 137, I wonder if he

could tell me something. According to the estimate we're dealing with

now, the allocation to the Heroin Treatment Program is $5.3 million

"net of recoveries." What are the recoveries?

We've talked

about a number of figures for the Heroin Treatment Program. In the

estimate book, it shows as $5.3 million, I think. Now what are we

talking about there? "Net of recoveries" — I presume that what we've

got then is a greater budget with something being charged up somewhere

else.

Last year the budget estimate was $3.7 million. Has

the minister any idea what they actually did spend? We are now three

months past the end of the fiscal year. Is this what he's going into

the treatment year with — that is from April 1 — with $5.3

million or is that figure actually more? I find that a little

confusing, Mr. Minister. Perhaps you could enlighten us on that.

HON. MR. McCLELLAND: Mr. Chairman, the estimate of the cost for this fiscal year is $5.3 million.

MR. LEVI: What is "net of recoveries"?

HON. MR. McCLELLAND: What does that mean?

MR. LEVI: What does it mean? It's in the book.

HON. MR. McCLELLAND: Where? Where are you?

MR. LEVI:

On the vote. On page 129 of the estimate book, vote 137, it says Heroin

Treatment Program (net of recoveries) $5.3 million. Now what does net

of recoveries mean in relation to this?

Are we looking at a greater figure or what?

HON. MR. McCLELLAND: No, Mr. Chairman, that's the budget: $5.3 million.

MR. CHAIRMAN: Order, please. I think perhaps I'll accommodate the minister by giving him the page out of the Chairman's book.

MR. LEVI:

If the minister has the relevant page in his hand, perhaps he would

look at it and tell me what "net of recoveries" means. To my knowledge,

the government does not have at the moment cost-sharing arrangements.

Or maybe they've been able to do that. I'd like an explanation just

what "net of recoveries" means in respect to this.

HON. MR. McCLELLAND:

Mr. Chairman, I'll have to get that for you. I'm not exactly sure what

the recoveries are. I assume, though, it has to do with some of the

recoveries we will make from the cigarette, alcohol and tobacco fund,

but I'm not positive of that. If I don't get it before this vote is

finished, I'll get it for you.

MR. LEVI: There is

just one other thing, Mr. Chairman. Last year the budget — if I read it

rightly — for 41 staff was $3.7 million. Then we're going to deal with

the heroin program with 293 staff with $5.3 million. Now is that an

adequate amount of money for 293 staff when you had earlier...? That's

a little confusing, Mr. Chairman.

HON. MR. McCLELLAND:

Mr. Chairman, the gross cost of the Heroin Treatment Program will be

just over $8 million. The recovery, if needed, during the course of the

year would be $2.8 million from the drug, alcohol, cigarette, tobacco

education fund. So that's what the net of recovery is. It would be the

gross cost that would look after the costs of the staffing.

MR. COCKE:

I'm reminded of the minister sat in opposition and the fuss he would

have made when the person who finally came to work in a particular

program, while living in Montreal and working on his old job, received

75 percent of his $35,000 a year, and finally got out here. That was

from January till May, he finally got out

[ Page 877 ]

here in May and went back to work. That minister who was then a member,

would have filibustered the estimates for a week on that. Yet now he

stands up; he's very rational; he says all governments do it. It's a

marvelous thing. It's a "Cass Beggs was okay for us but it wasn't okay

for them" type of thing. Come on, be a little bit consistent. I know

that's asking rather a lot from this minister. There was a situation

where in order to get him, or whatever, they made this extra-special

consideration. The extra-special consideration wasn't bad —

three-quarters of what you're earning in the future, for the period

when you're still not there. We all know it's a behaviour modification

program, and we all know it's an experiment because it's called an

experiment.

Remember I read this out yesterday, to this

extent: "Their application to this population" — and they're talking

about the program — "should be considered experimental." That's what

we're paying $12 million for, an experimental heroin program. I want to

ask the minister this question. Under one of these programs, the

community mental health program, there's a code of ethics. An area in

that code of ethics is that the client has the right to know if he is

being treated by an experimental procedure. He is given the opportunity

to consent. Is that same consideration being given to the heroin

addicts that come into his program? Are they being offered the

information that they are subjects of an experimental program? Are they

told that? Do you have the same level of concern for their rights and

privileges as you have for the rights of those being treated under the

community mental health program? That's the question.

HON. MR. McCLELLAND: The answer is yes. We have the same concern for their rights.

MR. CHAIRMAN: Order, please. If the minister wishes to answer....

MR. COCKE:

I'm afraid the minister didn't understand my question. Are the heroin

addicts, the subjects of this program, told that they are participating

in an experimental plan? This, I think, should be easy to answer for

the minister.

HON. MR. McCLELLAND: I guess it all

depends on what the members think is an experimental plan. This is a

new program in which a number of different kinds of treatment

developments will be used. At the present time the only people who are

involved in the program are those who have volunteered to come into the

program and attempt to deal with the serious addiction problem that

they have. Those people, obviously, are aware that they are into a new

program. They have been searching for years, some of them perhaps all

of their lives from the time when they were in their teens, with no

place to go and no answers. Now they have the opportunity to develop

some of those answers with us in a new and unique program. They come to

us on a voluntary basis with that full knowledge. What do you think is

experimental? It's a new program. I've said it's a demonstration

project; the whole world knows that, and as such so do the people who

are involved in the program.

MR. COCKE: Mr. Chairman,

I will quote from part of the program. This is being used, and this is

precisely what it says on the front page of this urge-