1980 Legislative Session: 2nd 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 17, 1980

Afternoon Sitting

[ Page

3355 ]

CONTENTS

Routine Proceedings

Oral Questions.

Ministry of Education "special mailing" to teachers. Mr. Lauk –– 3355

Reopening of Maplewood poultry plant. Mr. Ritchie –– 3355

Ministry of Education "special mailing" to teachers. Mr. Lauk –– 3356

Grant to Whistler Development Co. Mr. Passarell –– 3356

Legal fees charged to Fort Nelson band. Mr. Brummet –– 3356

Communications between federal and provincial Energy ministers. Mr. D'Arcy –– 3357

Committee of Supply; Ministry of Health estimates. (Hon. Mr. Mair).

On vote 1[4: minister's office –– 3357

Mr. Cocke

Mrs. Dailly

Mr. Nicolson

Mr. Segarty

Mr. Lorimer

Mr. King

Mr. Mitchell

Mr. Passarell

Mr. Stupich

Tabling Documents.

Urban Transit Authority of British Columbia annual report.

Hon. Mr. Vander Zalm –– 3379

The House met at 2 p.m.

[Mr. Davidson in the chair.]

Prayers.

HON. MRS. McCARTHY:

In the gallery today, Mr. Speaker, is a good friend of yours, who is

also a constituent of our Whip, the hon. member for Dewdney (Mr.

Mussallem). I would like the House to welcome Ken Olma.

HON. MR. FRASER:

I'd like the House to welcome today Mrs. Kellett from Canim Lake in the

Cariboo, along with her sister Mrs. Wright and niece Mrs. Neil from the

great province of Ontario.

MR. LOCKSTEAD: We have in

the gallery today the leader of the Real Share Value Party of British

Columbia, Mr. Grant Carson. I ask the House to join me in welcoming him.

HON. MR. WATERLAND:

Rabbi Markowitz advises me that we have a distinguished Canadian author

in your gallery today. I ask the House to please welcome Monte Vanton.

MR. RITCHIE:

I am pleased to introduce to the House today Mr. and Mrs. Jake Friesen,

their daughter Loma, and friend Rosie Loewen from Clearbrook, central

Fraser Valley. Would the House please extend a welcome.

HON. MR. MAIR:

I am very pleased to tell the House today that sitting in the gallery

with my wife is my mother-in-law, Mrs. Dorothy McMicking. I would like

the House to join me in making her welcome.

HON. MR. WILLIAMS:

We have in the galleries today from Auckland, New Zealand, district

court judge Bergin with his wife and daughter, who are visiting British

Columbia. I ask the members to welcome them.

MR. HYNDMAN:

In the gallery today are three hardworking students from Vancouver

South, who are conducting, as a summer project, the Vancouver South

Progressive Cultural Study. Would members welcome Jennifer Sheng, Kim

Perrin and Ranjit Jagpal.

HON. MR. ROGERS: Some

people were hoping that this far along in the calendar year most

students would be out of school and maybe the Legislature would be

adjourned. Nonetheless we are still here. There are 55 grade 10

students from Tupper Secondary School here today with their teachers,

Mr. Sandhu and Mr. MacKenzie. Since they are in school and we are still

in session, I would ask that we mutually welcome each other.

MR. NICOLSON:

In the gallery today are three ladies who are attending the University

of Victoria summer school: a constituent, Margaret Bonser, and two

former students from L.V. Rogers Senior Secondary School who I knew at

that time, Elizabeth and Linda Bossio.

Oral Questions

MINISTRY OF EDUCATION

"SPECIAL MAILING" TO TEACHERS

MR. LAUK:

I have a question for the Minister of Education. On July 14 of this

year all clerical staff in the Ministry of Education were directed to

work on the preparation of an address list of all public school

teachers in British Columbia for the purpose of a "special mailing" on

an unknown matter of a confidential nature. All other clerical work in

the ministry was to be held in abeyance until this task was completed.

Did the minister authorize that directive?

HON. MR. SMITH:

I haven't seen the directive, but I certainly authorized the obtaining

of the lists and it's appropriate that the minister have such a list. I

will authorize the obtaining of lists of teachers in this province to

communicate with them from time to time in the future.

MR. LAUK:

The reference was to a "special mailing" of a confidential nature. It

had nothing to do with communications in the future. Does the minister

understand what directive I am referring to?

HON. MR. SMITH:

I've already answered that I have not seen that communication. I heard

his question. I certainly requested my staff to obtain a list of

teachers, and they will be communicated with from time to time.

MR. LAUK: Did the minister consult with or receive advice from the Premier on obtaining this address list?

REOPENING OF MAPLEWOOD POULTRY PLANT

MR. RITCHIE:

I have a question for the Minister of Agriculture. Considering the

great uncertainty in the B.C. turkey industry today and the concern of

those employees who are presently out of work, I would like to have the

minister tell me what he has been able to accomplish with respect to

the reopening of the Maplewood poultry processing plant at Clearbrook.

MR. BARBER: I thank the member for his question, which he was kind enough to give me notice of.

MR. LEA: And I just happen to have the answer with me.

DEPUTY SPEAKER: Order!

HON. MR. HEWITT:

Mr. Speaker, at least the member for Central Fraser Valley (Mr.

Ritchie) is concerned, I notice the agriculture critic is absent today.

I thought maybe she would ask the same question.

MR. LEA: No, she's over there.

HON. MR. HEWITT: No, she's probably at home or having a holiday.

SOME HON. MEMBERS: Oh, oh! Withdraw!

[Mr. Speaker rose.]

[ Page 3356 ]

DEPUTY SPEAKER:

I ask the member for New Westminster (Mr. Cocke) to take his seat,

please. A point of order has been raised by the member for

Nelson-Creston.

[Mr. Speaker resumed his seat.]

MR. NICOLSON:

Mr. Speaker, on behalf of the member who is not present and on behalf

of all hon. members, I would ask that the Minister of Agriculture

withdraw those remarks in which he implied that the member is away for

some frivolous reason.

DEPUTY SPEAKER: A withdrawal has been asked by an hon. member. Would the Minister of Agriculture undertake to so withdraw?

HON. MR. HEWITT: Yes, Mr. Speaker, I withdraw if it's of concern to the opposition.

the member for Central Fraser Valley, I have communicated with Ottawa

over the last four weeks since the plant has closed for the second

time. I have sent telegrams to Mr. Whelan, the Minister of Agriculture,

Mr. Gray and Prime Minister Trudeau to attempt to indicate to them that

this is a major problem in British Columbia. While it might seem to be

a minor problem to them, it affects the lives of some 135 employees and

turkey producers in this province. I had an opportunity to attend the

Ministers of Agriculture conference in Toronto this week, and had I

been able to pair with the opposition I could have gone down and

eye-balled Mr. Whelan to attempt to implore him to deal with the

matter, which is most important to the agriculture industry of this

province.

When you consider the jobs of the farmers and the

workers in the Maplewood plant.... That opposition doesn't recognize

that we have a duty to perform to the people of this province; you'd

think they would consider that attendance of a meeting such as that

would be most important. I would advise the member for Central Fraser

Valley that I understand that members of the turkey association have

now gone to Ottawa to meet with Mr. Whelan, who has left the Ministers

of Agriculture conference now and is back in Ottawa. They are meeting

with him to implore him to make a decision on this matter in order that

that plant can be reopened.

MINISTRY OF EDUCATION

"SPECIAL MAILING" TO TEACHERS

MR. LAUK:

Continuing my questions of the Minister of Education, Mr. Speaker, I

asked the minister: with respect to this address list of public school

teachers in the province, did he consult with or was he advised by the

Premier?

HON. MR. SMITH: I consulted with a number of people.

MR. LAUK:

I take it then that the answer is yes. Can the minister advise why the

directive states that progress must be reported to the Premier's staff

on a daily basis?

Assuming that the mailing is for a piece

of political propaganda, does the minister agree that this is an abuse

of the taxpayers and of the civil service of the province?

HON. MR. SMITH: No, I don't agree. As I told the member in response to his first question, I have not seen the memo.

MR. LAUK: I undertake to table the memo right after question period, Mr. Speaker.

To the minister, will the opposition be entitled to send out its message to B.C. teachers using the same list?

HON. MR. SMITH: I thought that the member had his own list.

MR. LAUK:

I don't have my own list. Would the minister undertake to provide us

with the list so that we could use the same list to send out our

message to the teachers of the province?

HON. MR. SMITH: No.

GRANT TO WHISTLER DEVELOPMENT CO.

MR. PASSARELL:

My question is to the Provincial Secretary. It relates to a $400,000

grant recently given by the minister to the Whistler Development Co.

for a resort centre. Is it government policy to subsidize the private

developers involved in this project by constructing resort facilities

from the public purse?

HON. MR. WOLFE: Mr. Speaker,

the member is referring to a grant under the recreational facilities

program, I believe. The answer to his question is no.

MR. PASSARELL:

Is the minister extending an invitation to other recreational

developers to apply for construction of tennis courts, golf clubs, ski

chalets and swimming pools by using public funds?

HON. MR. WOLFE:

The member should already be aware that a number of grants in the areas

he's suggesting have already been made throughout the province and in

areas not very far away from where he resides.

MR. PASSARELL:

In view of the minister's announcement of $400,000 for the Whistler

resort, can the minister advise whether he is now turning his attention

to the total lack of playing fields in the Atlin constituency?

HON. MR. WOLFE:

No, I don't think we should allow the impression to be gained that

these grants are for other than community purposes. As has been the

case and the policy in all recreational facilities, including the one

at Whistler, it is for general community purposes; it has been part of

the request from that municipality, in terms of its broad use by the

community at large — not for private developers.

LEGAL FEES CHARGED

TO FORT NELSON BAND

MR. BRUMMET:

Is the Attorney-General aware that the Fort Nelson Indian band is

reportedly faced with a $5 million legal fee for the recent gas royalty

settlement?

HON. MR. WILLIAMS: I was unaware of the

amount mentioned by the member until I saw the press earlier this week.

I was certainly aware that the lawyer who advised the Fort Nelson

Indian band would be paid for his services. Mr. Speaker, I can assure

you and the member that the matter of the management of the funds which

will be received by the band under the agreement and the expenditure of

those funds

[ Page 3357 ]

falls

under the responsibility of the federal Minister of Indian Affairs and

Northern Development. With respect to this legal account, that matter

has already been raised by me with the federal minister and is being

dealt with by his officials.

COMMUNICATIONS BETWEEN FEDERAL

AND PROVINCIAL ENERGY MINISTERS

MR. D'ARCY: Mr. Speaker, it seems to be something of a Fraser Valley

day. My question is directed to the member for the great riding of Langley,

who has all that fine agricultural land in his capacity as Minister of Energy,

Mines and Petroleum Resources.

Did

the minister authorize the leak of his own personal and confidential

letter dated July 16 and addressed to the Hon. Marc Lalande?

HON. MR. McCLELLAND:

I didn't authorize any leaks. Leaks are generally referred to when

somebody, authorized or unauthorized, sneaks around and gives somebody

something they shouldn't have.

I was and still am extremely

angry, upset and disturbed about the actions of the federal minister. I

saw no need, in an incident which has such broad implications...that it

should be public knowledge. The press in our province serves as the

instrument to deliver to the public those things which are of concern

to the public. I have no objection to the people of British Columbia

understanding exactly how their government feels about a matter of such

delicacy and concern.

MR. D'ARCY: Can the minister indicate to the Legislature that he

has decided that in future it will be his practice, when communicating with

ministers of the federal government, that before they receive the communication

someone will take it from his office and nail the communication to the wall

in the press gallery to make sure the press is in receipt of that before the

people in Ottawa are?

HON. MR. McCLELLAND:

If there is some concern that the public of British Columbia shouldn't

know about issues of very deep concern — and all members of this House

should be concerned — then that is the position taken. I have no

objection to the people of this country knowing exactly how I felt

about the events that took place.

MR. D'ARCY: Can the minister tell the House, in view of what he

has said in his answer to my previous two questions, why the letter was marked

"personal and confidential" in the first place?

Interjections.

HON. MR. McCLELLAND:

I would be happy to answer that question for the member. The members

opposite treat this quite lightly. This government, and I as a

minister, find that not only were the actions which were taken by the

federal minister incorrect and improper, but they were wrong and must

not ever be repeated again. It cannot be possible for me, as a minister

of the Crown, to enter into the same kind of delicate, frank and

hopefully confidential discussions about delicate issues facing the

people of British Columbia with the same kind of confidence that I've

had in the past. If the members opposite aren't concerned about that,

Mr. Speaker, then I think they should just stop for a moment and

reconsider their position. It is common practice to have letters

addressed to colleagues — whether in your own government or in

governments with which you have some dealing — labelled "private and

confidential" so that they go directly to the person for whom they

are intended. [Laughter.]

Mr. Speaker, I hope that it's being recorded very carefully that the members opposite find this a joking matter.

don't mind saying that I was angry, and I'm still angry. I find the

actions by the opposition and the minister responsible in this regard

to be extremely disturbing.

Orders of the Day

Mr. Lauk tabled documents.

The House in Committee of Supply, Mr. Strachan in the chair.

ESTIMATES: MINISTRY OF HEALTH

(continued)

On vote 14: minister's office, $165,162.

HON. MR. MAIR:

Mr. Chairman, recognizing that the vote was about to go through, and

the risk I run in rising, I would nevertheless like to rise on two

points. First of all, I would like to assure the hon. member for New

Westminster (Mr. Cocke) that while I have not got anything further to

report on the Pacifica matter — if I may refer to it as that — which he

raised yesterday, my staff is working on it. I do expect a report, but

I think he would agree with me that it makes no sense to come back

piecemeal; I may as well get the searches done and all of the things

necessary before rendering a report.

Of course, if the

member is at any time not satisfied with the progress of that, then he

will question me. I'm not implying that there is anything particularly

serious about it, but I think it does involve some land registry

searches and some searches at the companies office with respect to

societies and things of that nature. So it will take me perhaps a day

or two more.

There is one other matter before we proceed, if

I may. I did — and quite rightly, I think — apologize yesterday to the

members opposite for suggesting that they had brought in the act which

lowered the age of majority in this province. The hon. member for New

Westminster quite correctly called me to task. As I say, I did

apologize because I was wrong. But I do think that in light of the

remarks I made earlier with respect to that — because I was very

critical of that decision insofar as it may have encouraged young

teenager drinking — I should just point out that Hansard of March 17,

1970, has this very short insertion from Mrs. E.E. Dailly, who says:

Mr. Speaker, we in the official opposition are, of course, most pleased to

endorse this bill

— that is, the bill to lower the age of majority —

because as

the Attorney-General stated, we too feel that the young people today are certainly

worthy of having this age dropped to 19. We also feel, of course, as the hon.

Attorney-General

stated, that there are added responsibilities with a bill such as this,

and I think it points up two things that will be necessary, and I hope

that the government will follow along with such a bill.

[ Page 3358 ]

She goes on to make a short statement, which if the member wanted I would read in full.

any event, I only bring this out to point out that while I was wrong in

saying that the New Democratic Party brought in that bill — and clearly

wrong, for which I again apologize, if necessary — the fact of the

matter is that the blame — if I am correct in assuming that teenage

drinking can, to some minor degree at least, be laid to the lowering of

the drinking age — lies with all sides of the House, because as I

understand it, at that time a party called the Liberal Party — which is

not heard of very often in this province these days — also voted for it.

MR. COCKE:

Mr. Chairman, I am becoming very concerned about the replies on the

whole question of Pacifica. A few days ago I charged that the Pacifica

development — that was the alcohol and drug development in New

Westminster — was a development by Wolstencroft Realty, a real estate

developer, and the minister replied that BCBC would be doing the work.

He has since found that that probably isn't the case, that they will be

doing the renting. I would have hoped that by now the minister would

have gone to his predecessor, the Minister of Energy, Mines and

Petroleum Resources (Hon. Mr. McClelland). That left an impression in

my mind today that I'm not too sure I can believe what he says. But in

any event, I would hope that we can get some kind of advice on this

whole question of Pacifica. There has been a tremendous amount of

criticism. I will leave that subject for now.

Last night

just before adjournment, I talked about the deplorable conditions in

the ambulance service headquarters across the province. I brought in a

number of examples indicating how we house these very important people

who are contributing to the life and health of the people here and are

serving us well. It is a program that we should all be proud of. Mr.

Chairman, I think it is a program that this government, over the past

four years or more, has treated with disdain. It has not given the

ambulance program and the emergency health services program the support

that they warrant. I pointed out that Reader's Digest recently had a

three- or four-page

article talking about our paramedics, indicating

what a first-class program it was. Many of us are very supportive, and

naturally I'm very proud of the program.

But recently the

Ministry of Labour sent in an inspector to inspect the premises of the

Emergency Health Services Commission at 483 West 16th Avenue — that's

their major ambulance headquarters in Vancouver. What did that

inspector find out about the ambulance headquarters in Vancouver, which

should be at least — because it was the original headquarters and

houses so many people — the cornerstone of the Emergency Health

Services Commission, in terms of the housing of their very important

people, their ambulance attendants?

I would like to read,

for the record, the letter from that inspector, who incidentally did

his inspection as recently as June 18 this year. His letter is directed

to Mr. Robert M. Baxter, coordinator of Zone G. Incidentally, that is

the zone that takes in the greater Vancouver area for the Emergency

Health Services Commission. He says as follows:

"Dear Mr. Baxter:

"At the request of the Ambulance Employees Union, local

873, I inspected the premises at 483 West 16th Avenue on June 18, 1980. The

purpose of this letter is to confirm our conversation of June 19. The first

part deals with corrective measures required to comply with the Factory Act

and regulations of British Columbia. Following that are a number of recommendations

based on the complaints submitted by the employees and my own observations."

Mr.

Chairman, what I read from here on in are submissions by the Ministry

of Labour to the Ministry of Health telling them what is necessary to

bring this facility up to the level that is required for employees of

any firm or any organization. These people have been living in these

conditions for years. Note that none of these aspects are there now.

This is a directive stating what has to be done to bring it up to the

level required for employees.

"1. Lunch room for ambulance crews. The kitchen and eating

area shall be a self-contained room to be used only for the preparation and

eating of meals, and shall be equipped as follows:

"(

a) The floor shall be impervious to water.

"(

b) The walls and ceilings shall have light coloured washable surfaces

and shall be maintained in a clean and sanitary condition.

"(

c) Exhaust ventilation discharging to the outdoors shall be provided

and shall supply not less than six room-volume air changes per hour.

"(

d) A two-compartment sink shall be provided and shall be connected with a source of hot and cold water.

"(

e) An enclosed cupboard shall be provided for storage of food, dishes and utensils.

"(

f) Sufficient table with impervious-top surfaces and individual chairs equipped with back-rests shall be provided.

"(

g) Appliances for heating and cooling of drinks and food shall be

provided. Because of the nature of the work and the length of the

shifts these appliances should consist of a full-size range and

refrigerator and small appliances normally associated with a domestic

kitchen.

"(

h) Suitable dishes and utensils in sufficient quantity shall be provided.

"(

i) Sufficient waste receptacles with self-closing lids

shall be provided."

None

of these conditions exist now, Mr. Chairman. That's why these

recommendations are in here. That's why he is bringing this to the

attention of the Emergency Health Services Commission.

"2. Lunch room for dispatchers. Provide a lunch room equal to that described

for ambulance crews. A possible alternative would be to allow sufficient time

for the operators to make use of the facilities provided for ambulance crews.

"3. Washrooms. Provide separate washrooms for male and female

employees with separate approaches with signs clearly indicating for which sex

the washrooms are provided." They are not now.

"4. Clothing for ambulance crews.

"(

a) Provide a change room for clothing not worn by employees during working hours, and

"(

b) a separate change room for work clothes which may have been exposed

to toxic, noxious, irritating or infectious material or substances.

[ Page 3359 ]

"(

c) Change rooms in (

a) and (

b) shall have separate approaches and a

shower room containing not less than two showers and shall be located

between the two change rooms to reduce the risk of transferring

contaminants from work clothes to street clothes."

This is

not the case now. They don't even have one shower. They may come in

covered with contaminants, covered with infectious material, covered

with all of these substances, and they haven't even got a shower. The

directive continues:

"(

d) change rooms and

shower rooms shall be heated to a temperature of not less than 68

degrees Fahrenheit or 20 degrees Celsius, measured at five feet above

the floor;

"(

e) exhaust ventilation shall be

provided in change rooms and shower rooms to supply not less than

six-room volume air changes per hour; and

"(

f) each change room shall be equipped with sufficient lockers to

accommodate the maximum number of employees on both shifts."

goes on to make further recommendations. Mr. Chairman, the ambulance

drivers are working in conditions that other workers in our society

would not have to work under, by virtue of the fact that the Ministry

of Labour would go in and close them down. But the Ministry of Labour

would find it very difficult to close down a working headquarters

operated by the Ministry of Health. This isn't unique; this is true of

virtually all of the ambulance headquarters. It's a shocking situation,

in my view.

I suggested to the minister yesterday that he

get on with the minister responsible for the B.C. Building Corporation

and get those headquarters so that the ambulance drivers are not

working under conditions that we wouldn't expect any other person to

work under.

"Health and safety recommendations:

"(

a) provide a route for ambulance crews to allow them

to pass from the vehicle parking area to the change room, washroom and shower

areas without coming into contact with other occupied spaces. The route shall

have an impervious floor covering free of joints, an impervious wall base at

least four inches high to provide a seal at the angle formed by the floor and

side walls. All finishes shall be of a material that will not provide life support

for lice and and other living organisms."

Ambulance

drivers, Mr. Chairman, are faced with some rather unusual situations

when they go to the scene of an accident or to the scene of a severe

illness.

"(

b) provide containers and tight-fitting lids for the

disposal of clothing, linen, blankets, etc., which may have been exposed to

contaminated materials or substances."

"General recommendations:

"Improve the working environment in the dispatch area as follows:

" (

a) provide an improved ventilation system to supply not less than 35 cubic feet per minute per person of clean outside air.

(

b) refinish the walls and ceilings with warm coloured materials having

a reflectance value of not less than 40 percent and not greater than 60

percent.

" (

c) provide a convenient, safe evacuation route in case of an emergency.

''Completion of the lunchrooms, washrooms, change rooms

and shower room is required within a reasonable time. A reply advising us of

completion or your

schedule for this work is required within 30 days.

"Serious

consideration should be given to the recommendations. I welcome your

comments in this respect. I further recommend that a practical set of

minimum standards for ambulance stations be drafted, and these

standards should be based on the nature of the work, the health hazards

involved, and the length of the shifts worked. In this respect I offer

the assistance of this branch.

Yours truly,

The Inspector."

Mr. Chairman, I ask the

minister two questions on this. Firstly, is he going to follow the last

recommendation of setting the standards for all ambulance headquarters?

Secondly, will he advise within 30 days whether or not he's going to

conform to the demands made by this report and by this inspector?

Interjection.

MR. COCKE:

The first question was based on this last recommendation: "I further

recommend that a practical set of minimum standards for ambulance

stations be drafted." I ask the minister if he will do so.

The

second question is whether he will reply within 30 days. The request on

this particular one was: "Completion of lunchrooms, washrooms, change

rooms and shower room is required within a reasonable time. A reply

advising us of completion of your

schedule for this work i required

within 30 days." That's 30 days of the date of this letter.

HON. MR. MAIR: Will you let me have a copy of that letter?

MR. COCKE:

Mr. Chairman, I will provide the minister with a copy of this letter.

I'll have this copied and I'll provide it to you. I'm going to yield

the floor to one of my colleagues very shortly.

Mr.

Chairman, I want to deal just for a moment with two orders-in-council,

1299 and 1300. Order-in-council 1299 provides that John Bell of

Vancouver be engaged as a special consultant on health care to the

Minister of Health for a period commencing June 6, 1980, and extending

until December 31, 1980, at a remuneration not to exceed $10,000.

The

same day, Mr. Chairman. order-in-council 1300 does exactly the same

thing for a company called Pilgrims Endeavours Ltd. I would like to

know what these two consultant firms are doing — one being a consultant

and one being a firm. Another thing is that I find it rather a

coincidence that Mr. John Bell of Vancouver is the consultant that I

marked 1299, and Pilgrims Endeavours Ltd. is operated by Donald H.

Bell. I wonder if there's any relationship between those two people.

Pilgrims is Bell and the other guy is Bell, and I'm just wondering for

whom the bell tolls.

AN. HON. MEMBER: For thee.

MR. COCKE: "For thee, " he says joshingly.

Another one was Apen Consultants, also appointed by order-in-council 20, but that was back in January. Also,

[ Page 3360 ]

Pilgrims were appointed at that point too, but that was for the first six months of the year.

One

other thing: the minister also appointed — and I'm not going to read

all their names — the employees of Deloitte Haskins and Sells

Associates. He names 14, I gather, consultants, accountants etc., who

he appointed as inspectors for private hospitals throughout the

province. I would like to know what they were doing. Now that their

report should be complete, can the minister give us an idea of what he

obtained in terms of a report — what they had to say about the private

hospitals in B.C.? This is no trick question. I just want the answers

to that particular question.

HON. MR. MAIR: You're distinguishing that from the other questions, are you?

MR. COCKE: No, I'm not. This is the trick question.

I'm

most concerned about something that, when I was Minister of Health, I

tried to avoid. We were asked on a number of occasions to use the

social insurance number for medicare. I suggested that it was not a

good idea, because there was a potential of an invasion of privacy. We

are now partly moving in that direction. Hopefully, under this

minister, it will be stopped.

But listen to this. What we're

doing now in the department is computerizing the billing card, which we

are now required to submit to the Medical Plan of B.C., and we're now

required to write out a diagnosis or complaint on that card. Anybody

with access to those computers has access to the fact that I might have

had a nervous breakdown, cancer or some other illness. I think that the

minister better answer this question pretty carefully, because it's a

very sensitive area as far as I'm concerned.

I've got a copy of a letter. I would like to refer the minister to a letter from a Dr. Brian Marr on December 4, 1979.

HON. MR. VANDER ZALM: What's his SIN number?

MR. COCKE: I can't tell it.

HON. MR. MAIR: I didn't ask for that.

MR. COCKE:

No, the Minister of Municipal Affairs, your helper back there, your

continual source of strength and help. That minister probably knows

more about SIN numbers than anybody here. Anyway, I am very concerned.

We can go into this letter in greater detail later.

I would

expect the minister to give me a couple of replies, and I would suggest

very strongly to the minister that the former Minister of Health, the

Minister of Energy, Mines and Petroleum Resources (Hon. Mr.

McClelland), has not given him details on a number of aspects of the

Alcohol and Drug Commission. I suggest that we get a report on the

whole Pacifica project and we get it soon, because I don't think that

it was up front; I think that the whole thing is a scandal, and we must

have an answer on that.

I want the minister to assure the

House that the ambulance headquarters in this province are going to be

brought up to a standard fit for people to work in. That's little

enough to ask for one of the most important services in our province.

The second thing I'd like to ask while he's thinking about that is that

he bring up the numbers to the required number. We've been running with

200 short for months and months.

On a number of occasions I

have talked to ambulance drivers and attendants who have told me that

they've worked hours overtime. That is not good for the health system,

because a person who is absolutely tired out cannot function in that

very trying, vexing, tough job. With that I will either let the

minister answer the questions or yield to my colleagues.

HON. MR. MAIR:

I would like, if I may, to deal with one of two of the questions and

postpone answering a couple of the others until I have a little more

information.

The whole question of the ambulances and the

stations, which I will try to answer in a little more detail in a

moment, is compounded by the extraneous fact — I don't use this as an

excuse but an explanation, and it may assist the members opposite in

directing questions in due course to other ministers — that the

stations themselves are in fact owned by the British Columbia Buildings

Corporation and we rent from them. It is true that we obtain from

Treasury Board the funds to upgrade or otherwise these particular

stations, but the actual decisions on a day-to-day, year-to-year basis

as to what will be done and when it will be done — even though we try

to have our input and influence on those decisions — are made by the

British Columbia Buildings Corporation. I recognize that this poses a

difficulty and, as I say, I am not using that as an excuse. It makes it

difficult to answer in a global sense and it makes it easier to answer

it on a one-by-one basis so that I can check and see where each one is.

I thought I would just throw that out on the table because it will

probably assist the member in knowing why it is difficult for me to

answer directly some of the questions he has asked about it.

to the letters he is going to bring to me, I will deal with those when

I see them. I will take a look at them and then we'll talk about it.

The

two Bells that the member rang are not related. They are ministry

representatives for me directly with respect to lower mainland hospital

projects. Don Bell is from Pilgrims. He is the gentleman from North

Vancouver who has been on the Greater Vancouver Regional Hospital Board

for some time, and the other Bell's name is John Bell. I believe he has

been advising the Ministry of Health in that capacity for two or three

years at least. As the member knows, the sums of money which are spent

in that area are probably greater than the rest of the province

combined, and it helps for the minister to have some direct

representation in the decision-making process at the regional hospital

district level.

The Deloitte Haskins report on private

hospitals. Perhaps it would assist the member if I gave the terms of

reference for this review, which is of private community care

facilities and private hospitals. I don't remember whether these are

the precise terms of reference but, first of all, it is to determine

whether payments provide sufficient funds to cover the cost of these

particular organizations; secondly, to finalize rates for 1980-81; and

thirdly, to develop a rate-setting procedure. I understand that that

report is now complete. I have not seen it. It has not yet reached my

desk but I understand it is complete and will be in my hands very

shortly.

I don't know if I mentioned to the member that the

amount of money that we are spending this year on the hospital stations

is about $500,000 over last year in increased rent. That ought to

reflect itself in upgrading some of these procedures.

I can

tell you about at least one of the projects — the one at 483 West 16th

Avenue. This is going to be moved to new premises. That will alleviate

a considerable amount of the

[ Page 3361 ]

overcrowding.

Two of the ambulances will be moved to 181 West 7th this year. I can go

into more details on that when I have a little more information

directly.

Just dealing very briefly again with the Pacifica

question, I want to repeat that I don't, by postponing giving an

answer, want to imply that there is something sinister or something

terrible or something awful in that situation. I am simply saying that

the member for New Westminster has raised questions of legality, in the

sense that we are talking about registries. We are talking about the

land registry, the companies registry, and who the directors are and so

on. It is going to take me a little time to get that information so

that I can get back to him.

I think some of the answers are

coming in. They are sort of like the elections. The upstate votes are

coming in now and so that I have a chance to sort of digest them,

perhaps I can take my seat and let one of your colleagues ask the

questions. I will listen with one ear, etc.

MRS. DAILLY: I am going to change the topic under discussion right now, so the minister can prepare himself for a new topic.

think most people in British Columbia are aware that the New Democratic

Party has always been in the forefront, and we made it quite clear when

we were the government of this province that we believed in the right

of every public servant to run for political office unfettered and

unencumbered by any government, irrespective of his politics.

have in front of me a memo dated March 17, 1980, which has gone out to

all Ministry of Health staff from one of the the minister's assistant

deputy ministers. The subject of the memo is Ministry of Health policy

guidelines for members of ministry staff sitting on non-governmental

agencies, boards or committees. There are a number of possible

situations listed for all public health staff members. It's made quite

clear, as I go through this, if I may, that the Minister of Health owes

many of his public health staff a further explanation and elaboration

of this memo. In my opinion, it has very serious overtones of

infringement on the rights of every citizen to run for public office

whether or not he is a public servant.

One of the first

situations listed, which I do not quarrel with, refers to when the

minister appoints someone to sit on a board. It is quite clear;

everyone knows that that person is the minister's appointee. I think we

accept the fact that people expect that member to relay the minister's

policy. I have no quarrel with that.

Then we come to the

second

section of the memo. It refers to public servants — health

people — who are not officially appointed but, in the course of their

community activities, have been asked or elected to serve on a board.

It has nothing to do with the minister asking them; the people in the

community have asked them, or they have been elected to serve on a

board. This refers to boards that obtain funding from the Ministry of

Health — I think that should be laid out first. It is stated in the

memo that in most cases it's expected, of course, that there could be

the possibility of conflict which should be clear to other members of

the board, and that the member should make it quite clear that he is

not in any way a spokesman for the ministry and may not commit the

ministry to any funds. To my mind, that's almost an insult to the

intelligence of the public health person who accepts an appointment.

Certainly they understand that. But I think they would find it very

difficult to understand the next statement.

It says:

"However, where a serious conflict, particularly political overtones" —

that's the point I want to emphasize — "are likely to arise. It would

be preferable for him to refrain from voting on the matter or taking

part in any direct submission to government." Then it says: "Similar

remarks would obtain to members in this category regarding the

acceptance of office in dealings with the ministry." The final one

actually states: "This refers to people who may decide to run and are

elected to municipal council." I suppose that means school boards also.

you know, Mr. Chairman, what it actually states in this memo? It says:

"Even though their duties do not lie exclusively in the domain of

health and the minister, here a few problems will arise. However, where

conflicts between the agency concerned" — I presume that could be a

municipal council or school board — "and the Ministry of Health seem

likely, the guidelines mentioned above should apply. " May I repeat

those guidelines? They are the guidelines in which people who have been

elected are told by the Ministry of Health that it would be preferable

for them not even to vote on a matter and not even to take

part in the

making of any direct submissions to government. It goes on to say: "If

there is likely to be a confrontation between the municipality or

agency and the provincial government" — listen to this, Mr. Chairman —

''even though the Ministry of Health is not specifically involved, the

staff member's position as a public servant will need to be taken into

account."

I notice the Minister of Municipal Affairs (Hon.

Mr. Vander Zalm) is yawning. Yet he's a former mayor, involved in

municipal affairs, who acted as the head of his council. Surely he

would not want to face up to the council members, for whom he was

responsible as their chairman, and say: "Look, if you work for the

Ministry of Health, in my council don't open your mouth on any subject

which might end up having political overtones, not only with the Health

ministry but the whole provincial government.'' And that minister

yawns, Mr. Chairman.

"Where a staff member is

likely to aspire to membership in an agency outside of government, and

he has any difficulty in establishing his position vis-a-vis the

government or the ministry, he should discuss his problem with his

immediate supervisor and make the ministry aware of his involvement."

There

are a number of people out there in the public health service of this

province who are also very interested in serving their communities,

whether on volunteer boards, volunteer agencies, municipal councils or

school boards, and they receive this kind of memo. I've had concern

expressed to me by public health staff who say: "Does this mean that I

can't run for municipal council?"

Mr. Chairman, I'm simply

standing up here and saying that surely the Minister of Health —

despite the yawns from one of his colleagues — would be concerned

enough to make it very clear that this kind of memo should be rescinded

so that the public health staff of this province know that they have a

right to run for public office without being told by the Minister of

Health: "There are certain things you cannot vote on, and there are

times when there may be political conflicts to do with the provincial

government, and it would be better if you said nothing."

Mr.

Chairman, I'm not going to go any further on this until I hear from the

minister. I hope I'm going to hear that he.... Well, I'd hate to

think he knew nothing about it, because he has to take responsibility

for this memo. I hope he

[ Page 3362 ]

will

advise all the Ministry of Health staff out in the province that he

repudiates this interference with their democratic right to run for

office.

HON. MR. MAIR: I think we'd better get an

understanding as to what the Ministry of Health — and, I think, any

other ministry of government — is trying to do when it sends a memo of

this sort. It may be that the memo is not worded as well as it ought to

be. After I see a copy of it, I may ask that it be redrawn in different

terms and make clear what the position is.

I share with the

member opposite the feeling, as I'm sure all hon. members do, that

every public servant ought to have the right to take whatever political

action — whether it's running for office or being a member of a

political party, including the Rhinoceros Party, if they wish — and do

whatever he damn well pleases in the political field. I have absolutely

no trouble with that whatsoever.

Quite apart from the

question of a conflict of interest, I may have some trouble with a

member of my staff becoming, let's say, the mayor of a town, or

something like that, because that may take him away from his job to

such an extent that he can't do it properly. Now that's another problem.

Let's

deal with the area in between. This is the area which we tried to

address. If it was done clumsily, then I assure the member that I'll

see that it's redone. We have tried to address the question where there

is a conflict of interest, real or apparent, in what they are doing. I

don't agree with the member that to point out a conflict of interest is

an insult to the public servant.

I can tell you that in my

experience in municipal politics — in public life as well as at the bar —

the whole question of conflict of interest is a very....

MR. LEA: Which bar?

HON. MR. MAIR:

Well, I'll tell you, you name them, I've been there. As a matter of

fact, I've seen people looking just like you there sometimes — before

reformation.

This is probably one of the least understood doctrines of public propriety.

If I may just digress for a moment, Mr. Chairman, to give you an idea of how

this is misunderstood, when I was an alderman on the city council an engineering

firm undertook the job of advising that city council as to a community plan.

That engineering firm was also the engineer for the city, in the sense they

did 95 percent of the work for the city. That engineering firm also acted for

the number one potential developer within the city if the community plan went

through. It also acted for the number two potential developer within that city.

They're a large national engineering company. When I tried to explain to

them that they had enough conflicts of interest to drive a truck through, they

didn't understand what I was talking about, and still don't understand

what I was talking about. As a matter of fact, the Minister of Municipal Affairs

of the day, who happens to be sitting not far from me and across the House,

when I wrote him about that in 1974, he didn't understand either — at least,

he didn't answer the letter. So I can only say that it's a very misunderstood

doctrine that you constantly have to bring to people's attention. You have

to point out to them that it's very difficult to separate your obligation

to the government that you are working for, sometimes under oath, from that

to the government that you are working for outside — that is, the secondary

government, the lesser government — to whom you also perhaps have subscribed

by oath.

think that I can perhaps solve the problem in the short term, Madam

Member, by saying that you cannot serve two masters. You do, sometimes,

have a conflict in the oaths of office. But if the memorandum that we

have sent has gone outside of the parameters that I have talked about,

and is in any way suggesting that people cannot seek public office,

cannot be involved politically, cannot serve where there is no conflict

of interest, then, of course, I will see that it's redrafted.

The

day may come when a person may have to make an election between serving

the master in Victoria and the master in the municipality or the health

board, or whatever it may be that he's on. But I'm certainly going to,

Madam Member, take issue with you if you tell me that I should not

advise my public servants that they cannot, on the one hand, serve on a

board that is seeking funding from the government, services from the

government, or any kind of favour — in the best sense of that word —

from the government, and on the other be part of that government which

is called upon to deliver that money, service or favour. That is

clearly a conflict of interest. Even the most honourable person, who

would be able to recognize that he shouldn't vote on certain things and

all the rest of it, is nevertheless going to be perceived by the public

as having a conflict. The whole transaction is going to come into

question simply because he's there.

As a matter of fact, if

that sounds like a lecture, Madam Member, it's almost a repeat of a

lecture I've heard from that side of the House to this side of the

House. I think it clearly sets out that a conflict of interest is not

only what is, but what appears to be. I haven't seen the memo yet. I

know the member will send it, or a copy of it, across to me, and I will

undertake to take another look at it, and if necessary redraft it, so

as to make it clear that in no way am I trying to infringe upon

anyone's political rights, liberties or anything of that nature, and

make it abundantly clear that all we're trying to prevent is a conflict

of interest, real or apparent.

MRS. DAILLY: I

appreciate the lecture and the points that the minister is making, but

I'm really not too confident yet that the minister takes this as

seriously as I do. I suppose I'm going to have to wait until after he

checks on the memo, which must he in the possession of your staff, Mr.

Minister, because it was issued from one of your assistant deputy

ministers on March 17, 1980. I'm sure it's in your files. I'm just not

comforted, to tell you the truth, that the minister really sees the

danger of even allowing such a memo to go out, and the shock waves that

it can create. It is very heavy-handed and poorly written. It may not

express how the minister feels — which I'm glad to hear him state — but

he's still leaving, in my opinion, a very iffy feeling about this

government, a very uneasy feeling about whether they really do stand up

for the rights of any citizen to run for a board.

I think

it's almost a paternalistic attitude that the minister is inclined to

take. None of us is foolish enough to think that if we're elected to

serve on a board everyone couldn't find some type of conflict of

interest. It's strange that with everyone but public servants we expect

them to understand and to be able to declare it. But with the Ministry

of Health they have to be told like little children. I still say it's

insulting, and I hope the minister will take immediate action on this,

because there are many people out there who may be thinking of

[ Page 3363 ]

running

for public office who have this thing hanging over their heads. I'm

sure the minister will cheek the memo, and I look for-ward very soon,

Mr. Chairman, to see whatever kind of a redraft or assurance is sent

out from that minister to many concerned people.

I just have

one more short point to bring up before I turn the discussion over to

my colleague for Nelson-Creston (Mr. Nicolson). It is a change of

subject, and it's to do with the provision of mumps vaccine. At the

moment this is not provided for at the free clinics on the free basis

as other ones are. I think most of us in this House are aware of the

concern parents have over their children getting mumps because of the

long-term effects, of which, I believe, there are two. In a very small

percentage of our population mumps can result in deafness. I know that

those in the medical field are quite aware of the danger of children

getting mumps, because there are cases where it has left the child

deaf. Also we're well aware that serious mumps infections in young

males and females can result in sterility, particularly in males. I

simply want to ask the minister why it is not provided along with the

other inoculations. Why do parents have to go and buy the mumps

vaccine? I understand that the vaccine is available either by itself or

in a combination called MMR with measles and, I think it's called,

rubella brown. I'm wondering why this combination vaccine which is so

important to our children cannot be given on the same basis as the

others.

HON. MR. MAIR: I cannot at present answer the

question that the member posed to me but I am getting the answer. I'm

sure the member will bear with me, and during the course of these

estimates I'll get that answer back to her.

[Mr. Davidson in the chair.]

did want to make one other point on the question of the memorandum

concerning conflict of interest. Not in any way saying that the method

we used was the best or even satisfactory — I've told the member we'll

review that, and I assure her I will — I think all members will want to

know that many times memos such as that go out to staff because there

have been a number of requests from staff as to just what does

constitute a problem in terms of conflicts of interest. When you have a

ministry as large as mine, composed of people who are obviously so

interested in the medical field, it's not unusual to have a number of

people be called upon — I think the member made this point — by society

in general to join with them in one or other cause or organization, or

become involved in one or other institutions. While I can't say that

this memorandum went out specifically in answer to any request, I do

understand that it was as a result of general requests by members of

staff as to just what their obligations were. In any event I will

review that situation and I will get back to the member.

would like, if I may, to deal with one question raised by the member

for New Westminster (Mr. Cocke) concerning the SIN numbers — I didn't

realize we'd got down to numbering that. But in any event, the letter

that the member referred to me from Dr. Marr did, of course, have a

reply. I have the reply here. I don't know if the member for New

Westminster has a copy of my reply to Dr. Marr. I'm surprised if you

don't.

MR. COCKE: Who's Dr. Marr?

HON. MR. MAIR:

Dr. Marr is the one who wrote about the question of possible invasion

of personal privacy by the Medical Services Commission, concerning the

use of the SIN number. I can perhaps shorten my answer by, first of

all, since we're keeping Xerox, or whatever we use here, very busy

today, undertaking to Xerox this and get it across to you in the

continual flow of documentary information that's going back and forth

here, simply answering this way: the medical plan has always required

the name of the patient and the diagnosis on billing forms. The

information is only accessible to staff, who are sworn to respect the

confidentiality and to sign a form to that effect. I suppose that's the

same type of form that Vital Statistics and all the rest of them use.

The

Medical Services Commission has suggested to the BCMA that the

diagnosis be coded on what's called the ICDA code. The member opposite

may know better than I do what that is. So far we have not had any

indication by the doctors that they're willing to do so.

any event, I will hand this document back — my reply to Dr. Marr — and

will have it sent over, which I think may satisfy the balance of the

member's questions. If not, I'm sure he will deal with it in due course.

MR. NICOLSON:

Mr. Chairman, I'd like to draw the minister's attention to some of the

most forgotten people in British Columbia. They are the mental health

patients who have been "returned to the community." I must say that it

was under our administration that a program was started to return

mental health patients to the community to depopulate Riverview. I've

heard the immediate predecessor to the Minister of Health, the member

for Langley (Hon. Mr. McClelland), get up in the House and brag about

the level to which Riverview had been depopulated and how so many

mental health patients were out in the community.

Well, the

first thing is: out in which community? In the Nelson area we have

about 12 residents out at the intermediate-care Willowhaven Private

Hospital living in the basement of a geriatric facility, which is not

really equipped, in terms of staff, training or even financial

resources, to offer any program for these people. Indeed, it is not

even really equipped to feed these people a proper nutritious diet.

Perhaps it's part of a program of just keeping these people on high

carbohydrates and not quite under absolute nutrition, for fear of the

fact that they might start to get a few of their cells working and get

a little bit hyper. It's really a bad situation. It's a good idea that

has not been followed through.

I submit to the minister that

when we take someone out of Riverview and put him into this situation

where we're just paying boarding-care rates — I could be wrong on what

particular level of care they're getting in terms of a rate for housing

these people.... Even if they were to be getting some of the

intermediate-care rates, it would be a considerable saving, I should

think, from having them housed in Riverview. So when we have placed

people back in these communities, the government has probably saved

some money by taking them out of Riverview and putting them into

so-called boarding-home situations — a boarding home that is not really

a boarding home; a boarding home that is an intermediate-care facility

populated largely by senile geriatric patients. It is a damn poor

environment, but some of these people do the best they can.

happen to live within a mile or less — probably within three or four

city blocks — of this facility. Some of the patients get out and walk

every day and get some exercise. I

[ Page 3364 ]

see

them walking back and forth past our house. The Kootenay Society for

the Handicapped has taken some of them into their sheltered workshop,

but the sheltered workshop is designed for people with mental

retardation. In that particular workshop it is not so much physical

retardation as mental retardation. They're two completely different

kinds of people with different needs. Most of the people with mental

retardation live in their homes with their parents, or else in some

sort of a group-home situation, and come to the Silver King Workshop.

The majority of these people live in a very inadequate environment.

Some

of the things that have happened there at Willowhaven.... The

reason I'm bringing this up is not Willowhaven. This isn't a

constituency matter; I'm afraid that this is probably a province-wide

matter. I'm sure there are many other similar situations in other parts

of the province. I am very concerned that there has not been a

follow-through. I have been bringing this up in estimates for about two

or three years, and I have made other efforts in this respect.

Some

of the things that have happened at the geriatric facility.... One

of the patients deliberately set fire to the room, totally demolished

that room, yet the fire was contained in that room. That happened a

couple of years ago. There was an allegation of rape by one of these

residents. The case was dropped. Perhaps it was not well founded even,

but it is one of the kinds of problems that does arise when you have no

program and minimal supervision. About the best activity is that these

people walk, all day long, along the highway, which is in itself a

little dangerous. It is not the best recreational activity in the

winter when there is snow and very small shoulders that aren't ploughed

anyhow. It is a real crime.

Food in that facility is not

good. It is partly due to the level of funding. I know the owners of

that facility have had it available for sale — it even goes back to

1975 and earlier. They are willing to turn this over, I think at a

reasonable price, to the government. The government could certainly not

replace that facility at the same price. I am not out to criticize the

facility so much. I don't know whose problem it is. I suppose it is

some of the inflexibility of the rate structure for long-term personal

and intermediate care. This particular care home does have a union

agreement. The latest agreement was set under binding arbitration —

after some years' delay, I might add — so that some of their costs are

very much fixed. Their labour costs are very much fixed. It has been

upgraded in terms of hospital accreditation standards, door widths,

etc. It meets a fairly high standard in that respect. I am not out to

criticize the facility but I would point out that the food, from

sources that work in the hospital as well as people whose parents are

there as geriatric residents and from all reports, hasn't been good and

I think it's deteriorating.

Another strange thing about this returning people to the community is that

all 13 of the people I can talk about are men; I know of no women in the Nelson

area that have been sort of returned to the community. That may be my own ignorance,

and maybe I just don't know of any. What I would like to point out is that

they haven't been returned to their community. Only one of them is from

the Nelson area, so it isn't as if we've returned them to an area where

they can have support from their family. I said: "Well, are any of these from

the Nelson area?" I was told: "No." I recognized one name which is an

unusual and well-known name of the area. I said: "Well, surely this person

must be." They said: "Oh, yes, you are right. He is from the Nelson-Balfour

area. " We have taken people out of Riverview and we have put them into

a very inadequate situation.

The

Kootenay Society for the Handicapped have tried to cope with this

problem by taking some of those people and putting them into their

sheltered workshop which, as I said, was really designed more for

mentally retarded handicapped persons. That is not the right way of

describing it in 1980, I guess, but I will apologize for that. The fact

is that when the residents go there, three of the mental patients make

a contribution and the remainder just sit around and chain-smoke

because there is not an adequate program that suits the needs of both

groups. They have proposed a very modest program for ten participants,

the objective of which would be to start out a program in conjunction

with the Silver King, to move it as quickly as possible into the city

of Nelson, then to set up a group home and eventually to assist people

to move more out into the community with minimal supervision. They are

proposing a budget which I think would be an additional $8.45 per day

over the level they are getting in terms of personal care. I think what

they're proposing is to take them from their present level of personal

care funding up to an intermediate-care 2 level, and a differential of

$8.45 per day. Again, I could be out in the reasoning as to the origin

of their figure of $8.45 per day. But what they are asking for as a

special budget is $8.45 per day — about $30,842.50 — so that they can

put on a program for ten participants.

The proposal would be

for a mental health program coordinator with some professional training

at a very modest salary; a mental health worker half-time, who would be

a lay person; and rent, supplies, travel, etc. So for $31,000 they

would get ten people.

[Mr. Kempf in the chair.]

Mr.

Chairman, I think that we owe these people nothing less. I think these

people have really been shunted aside. It's something that I'm reminded

of daily because of living in proximity to the place. Quite naturally,

when these two items which I've mentioned occurred, there was

considerable upset in the community, and people from your ministry went

out and met and set up some improvement in supervision, and I think one

potentially dangerous person, at least, was moved and some things were

done. Right now I'd say that in the community there is a little bit of

a lull, but if anything bad were to happen, it would be very

unfortunate, and the reaction would be very strong.

I'm not

speaking really as a person who lives in the community. I'm speaking as

a person who has seen the program start six or seven years ago, and has

not seen its completion. I've been a member of this House throughout

that time, and I wonder if the minister could tell me how much it costs

a day to look after somebody in Riverview. How much does it cost to be

looking after them in this intermediate-care home at, I think, a

personal-care level? I'm sure your assistant will be able to furnish

that information for you and me. Is it not affordable? Of course, this

proposal is very recent, I think. The most recent proposal of the

Kootenay Society for the Handicapped is dated June 23, 1980. I think it

is a very excellent proposal. I'm glad that they have taken on this

responsibility. I might say that I have made some suggestions along

that line in the past. I would hope

[ Page

3365 ]

that

the minister could take some action on this specific request, but I am

very concerned that this is a more general problem than the one that

we've experienced in Nelson. There's a moral obligation, I think, to

find that kind of funding, even in tight fiscal times. I think that,

like so many investments we can make in health services, if the money

is put in at the right place it can, in the long term, show substantial

savings — even in terms of dollars and cents — and of course pay the

greatest dividend in terms of restoring these people to a dignified,

useful existence.

MR. SEGARTY: I'm pleased that the

member for Nelson-Creston did get up and speak about that subject. It

is one that is very dear to my heart: care for handicapped people in

their own community setting. Last year in Cranbrook we got into a

similar situation and I am pleased that the local Ministry of Health

staff and the Ministry of Human Resources staff in that community were

able to help me come up with a solution to the problem. I'd say it's

something that is misunderstood perhaps throughout the entire province.

was over in Nelson and had some discussion with the board of the

handicapped society, and really how the problem started was with the

idea of returning the handicapped persons to their own community, which

was indeed a great program; whoever was responsible for it is to be

commended.

One of the difficulties with the production

workshops that were set up for handicapped people was that the

government provided the funding for productive handicapped people. Then

the federal government came along with a Canada Works grant, which

enabled the production shops to take in non-productive handicapped

people. Last year those Canada Works grants dried up throughout the

province and the workshops were left with some non-productive

handicapped people, which they really were never equipped to look

after. In the community you've got two settings. You've got the

room-and-board situation where the productive handicapped person is

living in an institution or getting room and board in a community home.

That's paid for through the Ministry of Human Resources. Then you've

got the workshop setting. They were all pretty satisfied that the

non-productive handicapped people were being looked after at the

achievement centre of the Canada Works grant. When the Canada Works

grant dried up, these non-productive people and the workshop were left

with no funds. The licensing for the home service is done through

long-term care, and I guess the staff in the Ministry of Health for

long-term care were satisfied too that there was a life-skills program

being provided.

[Mr. Strachan in the chair.]

Once

they have established the need, then a program should be drawn up to

meet the needs of those non-productive handicapped people. The idea is

being that you start in a community setting in a life-skills program,

then would move into the workshop and from there into the community to

become full participating members of the community and out, perhaps,

working in industry and making your own living.

So there is some misunderstanding there as to where the funding comes from.

The licensing is done through longterm care. They turn over the bill to Human

Resources and perhaps it's in the licensing area that the problem occurs,

Mr. Chairman, to the minister. I know that the situation in Nelson is proceeding

quite well. The board of directors of the handicapped society sent me a copy

of their program; it's an ambitious program.

They've

also received some funding from the lottery grants to help them out of

their situation to try and put some dust-collecting systems in along

with three-phase electrical power. I would like at this time to commend

the Ministry of Labour and its staff in Nelson for providing the

assistance to the Kootenay Society for the Handicapped in getting that

project on stream. It's a project that needs the full community support

and has the full support of government, I'm sure.

MR. NICOLSON:

The member for Kootenay did mention that a similar arrangement has been

structured in Cranbrook to provide the funding. The funding is a

difficult problem because it's the one organization that is funded

through Human Resources, yet these people are in personal and

intermediate care. The arrangement over in Cranbrook, as I understand

it, is that the boarding-home operators are being paid the

intermediate-care level 2, which is $8.45 greater, and then

subcontracting to the society which is providing the service. So that

$8.45 flows through and it appears to meet regulations and is a

workable situation.

HON. MR. MAIR: Mr. Chairman, I'd

like to sort of back up a little bit and deal with a couple of

questions raised earlier by the hon. member for New Westminster dealing

with the 483 West 16th ambulance station. I've got a little update on

the information. I don't think it's any secret that we want out of

there. The reasons that the member has spoken about, of course, are

ample evidence of why we would want out of there.

We have

been in negotiations for some time to move the entire operation —

administration as well as dispatch. The difficulty is finding the right

quarters. Just so that the members opposite know some of the problems,

first of all there is a problem with radio. I understand also it must

be on the Trinity exchange for telephone. I'll need more help on that.

Security

is another problem. It should preferably be government-owned, although

that isn't essential, for lease, I presume, with BCBC. It should be

reasonably close to the Vancouver General Hospital for disaster

purposes and it should be south of False Creek. I understand the

negotiations are now ongoing with BCBC in order to try to accommodate

this move as soon as possible and that further meetings will take place

next week.

I thought I might just give some general

statistics on money, dealing basically just with capital expenditures

in the emergency health services area. Since 1976 — up until this year

— this is a total figure — $1.85 million have been spent on building

rentals, maintenance and improvements for emergency health services.

This year alone in our accommodation vote we will spend $750,000 on

rentals plus an additional $500,000 for relocation and improvements.

The rental, after all, does go basically towards the accommodation and

improvements. We will spend about $1.25 million this year compared to

$1.85 million for all the other years since 1976.

The member

for Burnaby North (Mrs. Dailly) asked me about mumps and immunization.

The note I have is that there is a lack of evidence that mumps is a

public health problem of significance. There is doubt about the

long-term efficacy of any immunization against it, mainly by reason of

the complications that can develop in later years. It would arise to a

greater degree under a mass vaccination program just by reason of the

fact that there are some problems that arise out

[ Page 3366 ]

the vaccination program itself. There would be more problems arising in

later years out of a vaccination program than now arise without it. As

I understand it, it may prevent more people from having mumps and it

may even prevent some people from having mumps as badly, but the

long-term result would be that there would be more problems in later

years with the program than there are now. Our evidence evidently comes

from an internationally known expert — I don't know his or her name but

but I can find that out for the members — in matters of this sort. That

is the principal reason we don't have that program.

Dealing

with the problems raised by the member for Nelson-Creston, I would

assume that much of the speech he made was really to bring to my

attention some of the problems that exist in that particular

institution in his area. He would want me, I am sure, to look into some

of those things more specifically, and of course I undertake to do

that. I might say that this does give me the opportunity to tell you of

the two reviews which I authorized, very shortly after taking office as

the Minister of Health, into the private institutions. One thrust,

which the member for New Westminster (Mr. Cocke) and I have already

spoken about, is the financial aspect. The second one, which is going

on now — I am not sure how long it will go, but I would assume for some

months yet — deals with the quality of care. I think one could

subdivide quality of care into environment, programs, staffing and food.

am always nervous, when we start talking this way, that any remarks a

minister — or indeed a member of the opposition — makes about private

institutions will be taken as a blanket condemnation of them or even a

condemnation of some. I don't want to do that, but I do want to say

that from what I saw very early in the ministry and have seen since, a

review of this nature is long overdue. Even if the review came out and

said everything is just fine all over the province of British Columbia,

at least that would have the effect of allaying some fears, suspicions

and concerns that many of us have. I don't think that that will be the

result, however. I think that some very serious recommendations will

come out of that.

I might say also that the whole object of

the exercise in Riverview now — this is something we are trying to

improve day by day — is a regionalization within so that the staff in

Riverview are familiar with the various areas of the province from

which the patients come, can relate to the specific patients and to

that region and have some sort of a liaison relationship or function so

that in future they can assist in getting the patients, when they go

out of that institution, back into the right milieu within the right

community. This regionalization by geographic area is something that is

going on now. I want the members to know that this is part of our

overall discharge planning for patients leaving Riverview.

have touched upon the reviewing of conditions. I think the member

opposite agreed that these are very difficult problems, because you are

dealing with people who have problems that, for the average person, are

often not pleasant to deal with. They have problems which are difficult

to resolve. The member mentioned the alleged rape case, and I think he

understands the kind of difficulties that kind of allegation causes in

those circumstances. But I think that by and large we are taking steps

to improve our ability to deal with it.

The member asked

specifically about the cost per day at Riverview, which is $87 per day,

I am told. The cost to the facilities ranges from $14.50 to $35,

depending on the level of care and the program provided.

I'm

not sure I got down the appeal question. I have a note — if this

answers the question I didn't note down then I don't have to hear the

question. It is: the appeal can be made on the level by operator.

I think that pretty well answers the main questions that were asked, so I'll take my seat and let you carry on.

MR. LORIMER:

I have had occasion to speak to the minister about some items that

couldn't be resolved otherwise, and I might say that he's been quite

cooperative as far as I'm concerned. He has been tardy; you have to

remind him a number of times and tie a string around his finger, but in

the end he is usually able to resolve the particular problem, and I

appreciate that.

There's no question that the cost of health

care is very extreme. That's nothing new. It always has been that way,

and I accept the fact that it takes a substantial part of the budget to

look after the health of our citizens. But that has always been the

case and always will be the case.

I want to say that the

hospital boards submit their estimates as to their budgets probably

before the first of January, for approval by the department. As far as

I know, as of this time they still haven't received a confirmation,

cutback or what not in those budgets that they're presently working on.

The problem is that the hospitals do not have sufficient funds to carry

out the most efficient health care facilities that they could otherwise

carry out. As an example, in the Burnaby General Hospital any patient

that's able to leave the hospital is taken out on Friday. New patients

are not admitted on Friday unless it's an emergency. The beds are moved

from wards to other wards in order that some of them can be empty for

the weekend. The return of new patients starts on Sunday evening and

continues to Monday. So we have a case of musical beds at the Burnaby

General Hospital every weekend and, I presume, in a number of other

hospitals in the province.

The costs of the facilities of

the hospitals themselves are very extreme, and it would seem to me to

be a waste of money not to have sufficient funds supplied to keep the

operation going on a seven-day-week basis at full swing. The obvious

need for staff weekly days off obviates the necessity, if they do not

have a sufficient number to take their places, to delete the patient

population as much as possible on weekends, and that is what is going

on.

I have a number of items to discuss with the minister,

and I'll be very brief on all items. Maybe he can give some replies in

due course as to what action he is taking with reference to these

questions. I'm quite sure that the matters that I bring up are well

known to him, but I would like to be able to tell people in my area

what things can be looked forward to in the months to come.

happened to be in the White Rock hospital this last weekend, and I

noticed that the top two floors are still not in use. With a crying

need for hospital beds in the lower mainland it was a surprise to me at

this stage that some action wasn't being taken to open up the top two

floors. There may be plans for this, I don't know, but at the present

time I note that there are two floors in the hospital that are not

occupied.

On the question of open-heart surgery, I've come

across an individual in Victoria who has had severe heart problems and

requires an angiogram but can't get into the hospital for a period of

six weeks to have that testing done. This is —

[ Page

3367 ]

especially in the case of heart problems — a very cruel and

difficult wait, to "take it easy, don't do anything, just wait" for the

six-week period until you find out exactly what problems your're

facing. I understand there's been a cutback in open-heart surgery

operations over the last year. I understand that in Vancouver General

there's been a 20 percent cutback, roughly speaking. The waiting period

a year ago in Victoria for open-heart surgery was approximately one

year; what the waiting period is now I'm not sure. But those things

cause great concern to the people that are involved. It's a very

worrisome time and it's a long time. Maybe the minister can tell us

what he has in mind for the years to come regarding additional teams

for these very, very important operations.

I want to talk

for a minute on the New Vista Society and their application for an

intermediate-care facility in Burnaby. This application was made some

nine months to a year ago. They were advised by the ministry that they

were taking a long look at it. There were apparently two problems. One

problem was that the ministry wasn't sure that there was a need for

care homes in the province and there had to be a catalogued

demonstration of need. As an MLA, I know that in my own constituency,

apart from compensation cases, I would guess the major concern is the

individual who comes in with an aunt, mother, father or friend who

requires some extended care, intermediate care, or whatever, in a

hospital.

I think there's no question that every member in

this House has experienced the very same thing. The proof of care, I

think, is not necessary. I think anyone who has had any dealings

whatever with assisting other people in locating beds knows about it,

and anyone who has had the personal experience of trying to find a

place for a member of his family knows what the need really is. You go

from one place to another to another and they will put you down on a

waiting list. You may be No. 200 on waiting lists in a variety of

different homes.

There's obviously a need for a crash

program throughout the province to look after these problems. I agree

that they have expanded greatly in the last few years. People are

living much longer and the demand for this sort of care is much greater

than it was a few years ago. I think the minister has to cope with this

problem, because I don't believe it's going to go away. We need far

more facilities than we have at the present time to look after these

people.

The minister will tell me that there's a new

facility being built in Burnaby on Rumble and Sussex. That's true and

we welcome that facility. But we must remember that these facilities

are not provided for Burnaby citizens if they're located in Burnaby;

they're provided for the whole lower mainland. That's true wherever

they're built. Patients are there from the Fraser Valley and a number

of other places. I can promise the minister that when the new facility

on Sussex is completed — on the day it opens — it will be filled and

there will be a long waiting list. So it's a very big and difficult

problem. I would like to hear from the minister what he would like to

do about it, what he intends to do about it and what plans he has.

The

other matter that was of concern to the ministry was the fact that

there are a number of senior citizens' homes and care homes in Burnaby.

That also is a fact; there are a number. But as I've said before, these

facilities are not only serving people in Burnaby; they're serving the

whole lower mainland,

The New Vista Society were told that

the province was taking a long look, and that's true. They've been

looking now for nine months and there's still no answer to the New

Vista application. I would ask the minister to look in his files or his

ministry files, dust off the application and give a positive response

to the New Vista Society. The New Vista Society, of course, has the

land for the project. They have expertise in home care, they are a

first-rate society and a first-rate operation and provide a very high

standard of care in that

section of Burnaby.

Another

question I would like to pose to the minister is the question of those

people throughout the province who require oxygen. There are a number

of people who have lung or other ailments who do require oxygen in

their homes. The cost of this is extreme. I know that for those who are

on Mincome and so on the service is provided free of charge, and the

wealthy can pay for it. It's the in-between people who have some

savings who are hit very, very hard financially. If a person is on

oxygen for one or two years, it doesn't take long to run through a

substantial amount of savings to pay for this type of necessary care.

Maybe the minister can bring up the problem. I would suggest he provide

oxygen free of charge in cases where it is required. I think it's now a

very heavy burden for our society and our sick people to look after the

cost of oxygen.

The last problem which I intend to bring up

is the question of the cost to those who have kidney ailments who have

to have a dialysis two or three times a week. It's fine if the dialysis

takes place in British Columbia, where it's fully covered, but if it's

provided in another province the recovery fee is the amount that would

be paid if it were done in B.C. or the amount charged in the particular

province. The problem comes up when someone is prevented from visiting

the United States due to the fact that no payment is made at all. It

would seem to me that it is not an expense to the province, because it

would have been provided free of charge if the person had stayed in

British Columbia. I suggest that in the case that I'm familiar with the

individual has her family in the United States. She is prevented from

visiting her people because she can't afford to finance the dialysis

that would take place in the United States. I'm suggesting that the

province pick up whatever is necessary to supply the service in British

Columbia and refund that amount to the individual. The individual would

pay the extra amount which is probably charged for the service in the

United States.

I would hope that the minister would consider

these questions. I know they can be answered quite quickly. With

reference to them, I hope to hear what is going to be done.

HON. MR. MAIR:

To the member for Burnaby-Willingdon, dealing with the hospital board

estimates, I understand that all have now received preliminary

approvals or that plus negotiations between the ministry and the

hospital. I don't want to suggest that the preliminary approval means

that there's been an absence of approval: there are some hospitals with

which we are having some discussions. In any event, I understand that

all of them received these preliminaries prior to April 1 of this year.

Dealing

with the general question of funding, I'm sure the member probably does

know about the joint funding study that has gone on — and perhaps other

members would be interested — for a couple of years now. In the summer

of 1978 a joint funding study was commenced. It is a cooperative effort

between the B.C. Health Association and the Ministry of Health; they

bring to the exercise equal labour, equal influence and equal input.

They have now come down

[ Page 3368 ]

with

a report; it's not secret. I don't know whether we've actually ever

tabled it or released it. In any event, it could hardly be a secret,

because it was done in conjunction with the BCHA. I don't want to go

into it in great detail, but some of the things you may find pretty

interesting.

Let me read two or three things that will give

you an idea of where we're going, not necessarily to answer your

question, Mr. Member, but to give you an idea of some of the things to

which the committee addressed itself. Recommendations with respect, for

example, to strategic planning: "(1) the Ministry of Health should

develop a provincial health plan; (2) a hospital role statement should

be developed from this plan." I hope you'll bear in mind the phrase

"hospital role" — I'll deal with it in a second. It's a very important

part of this. "

(3) The Ministry of Health should upgrade its

provincial health-care planning group to implement the above

recommendations, with a provision for substantial participation of. the

hospitals, related patient-care agencies and the BCHA."

Recommendations

with respect to budget planning: "(1) a contract should be adopted by

the ministry as a means for agreement on budget decisions; (2) a formal

budget policy, including dates of decision points, should be adopted by

the Ministry of Health and made available to hospitals; (3) a review

process and joint review board should be established as a function of

the planning system." It goes on. There are a number of other

recommendations in a number of different areas.

Probably the

two things that strike me — it might strike others a little differently

— are, first of all, that it deals in very real and cogent terms with

the process of hospital budgeting. Within that is contained the ability

of hospitals and the Ministry of Health to budget on a long-term basis.

It may not sound all that difficult but, in fact, it is. I'm sure that

would strike a chord with the member for New Westminster (Mr. Cocke).

When a hospital is trying to budget over a five-year period, it allows

them to be a great deal more open in their budgeting process, because

they can say, not only to themselves but to us, "We're going to need X

number of dollars for labour in 1981. But in 1982 we're going to cut

back on a certain program, so really we won't need that much. But we'll

need a quarter again as much in 1983," and so on. Instead of getting

into the system: "Well. If we need so much in 1981, boy, we'd better

not let go any of that in 1982, or we'll never get it back again." In

other words, they're going to be able to do that in all of the various

functions, if we could put this into effect. And we're going to put it

into effect, because I've insisted that it be implemented at least a

year before my staff really wanted it to be implemented.

This,

of course, is also tied in with the role study — the precise role that

hospitals play in different communities and what areas of health

service they should be concentrating on, because of the peculiar nature

of the community, geography, demography, whatever it is, and what areas

they need not play such an important role in. These two studies are

ongoing so that we can solve, at least to some extent, many of the

problems that the members opposite have raised.

You know,

I'm not naive; I recognize that once we get this implemented and going

well and everything's just fine, there'll be a whole new batch of

problems. Five years from now, if the members opposite and I still are

fortunate enough to be here, we'll be talking about a new set of

problems and all of this will be behind us.

However, I do

want you to know that the budget process which has caused so much

agony, heartache and, I might say, political anguish in years gone by

has been addressed by the government, and I am confident that when this

is implemented a great many of those difficulties will no longer be

with us.

Regarding the heart surgery teams that the member

for Burnaby-Willingdon (Mr. Lorimer) referred to, we have got an

advisory committee made up of physicians in this area. Their

recommendations, I'm told, are generally accepted. They help us keep

abreast of the needs. We already have increased the number at Royal

Jubilee in Victoria, and we're negotiating increases at this point at

Vancouver General Hospital.

Again, I don't want to get into

a controversy, and I wouldn't want the words I'm about to say to be

taken out of context, but there is a bit of controversy about these.

There is some argument from the profession itself that the process is

over-used. I avoid the word "abused, " but the process is over-used.

And some care must be taken not to take all of the requests that come,

even through physicians, totally at face value. In other words, if

somebody were to say to me that there were 25, 50 or 100 people waiting

for this, there may not be all that many that by the generally accepted

medical terms ought to have that process. But in any event, it is a new

and very important development, and we try to keep abreast of it.

The

member for Burnaby-Willingdon (Mr. Lorimer) talks about long-term care,

and says that the problems will increase in the future. Of course they

will. We're not even really into the geriatric age. The baby boom is

going to get into the geriatric age sometime around the turn of the

century, or shortly thereafter. Because of the advances in medical

science over the last few years, which of course will continue, more

and more the acute-care hospital is going to be — not phased out, but

it will no longer be the yardstick by which health services will be

judged. Where at one time we used to judge the ability of a state or a

province or whatever to handle its health needs by the number of

acute-care beds it had, that probably will become a meaningless

statistic in years to come, and we'll be talking about the long-term

care — not just beds, but facilities and programs that we have in

place. The reason I say "programs" is because you can't measure it

again just by institutions or the beds that are available. Probably

more important than that is the degree of home support that is given to

people that are at the geriatric stage where they do need support

because of age and other infirmity.

That home support, of

course, I think, has got to be supplemented again by an intermediate

step between home support and institutional support. We're moving very,

very quickly and I think somewhat dramatically into day care support

where people who would prefer to and can live in their own surroundings

in terms of sleeping and eating and so on, who nevertheless do need

some support, are able through this program to get that support without

being institutionalized.

The question of New Vista and

oxygen were raised. I'll have to check into them for the member. I will

dust off the file on New Vista, as the member has asked me to do. On

the question on the high cost of oxygen, I will try to get an answer

back to the member on that one as quickly as I can. I don't think I'm

all that slow either, Mr. Member. Sometimes the problem is slow of

resolution. I get the answer as quickly

[ Page 3369 ]

as I can, but the problem doesn't get solved as quickly sometimes.

Regarding

the difficult question that the member raises about kidney problems,

dialysis, and costs in the United States and so on, really, I don't

suppose that's much different than a lot of other medical problems

which one might have outside of the jurisdiction of the United States

of America. Our rule simply is that we will pay up to the amount that

they would receive in British Columbia. I recognize that that is going

to work hardship on individuals, but I think we ought to sit down and

think about what the other side of the coin is. If we're going to say

to everybody who has some sort of chronic ailment that we will look

after you while you're in British Columbia and also elsewhere, no

matter what it costs, what implication is that going to have on all of

our payments? After all, it's our money that goes to make up the

Medical Services Commission funding.

All I can say is that

the policy to date has been — and I think I can say "will be" fairly

and honestly so that we don't misunderstand each other — that we will

continue to pay up to the B.C. allowable amount for matters of this

sort. This may be putting it rather strongly, but I don't think that we

can be held to ransom by the non-public health delivery service in

other jurisdictions, because that is really what we are talking about.

We will certainly continue to pay up to the B.C. amount in these cases

but not beyond.

MR. LORIMER: I thank the minister for

his reply. There are two points I would like to make. He mentioned

about some of the open-heart surgery being requested but probably not

required. I would agree that that is probably true but I think probably

you would find a much higher degree of that sort of thing in almost any

other operation, that is, operations are being conducted that are not

required. I don't know if the minister would agree with that but I

think the percentage in other areas would be far higher than what it is

in heart surgery.

I think he misunderstood what I was

driving at on this dialysis matter. My understanding is that no payment

whatever is made if it takes place in the United States. All I am

suggesting is that the same amount that is paid in British Columbia

should be paid. The constituent who came to me with her problem advised

me that her family was in the States and she was unable to visit

because she could get no funds at all. She was quite happy to pay the

hospital and merely get a return directly from the plan for the normal

cost in British Columbia. It wasn't something extra that they were

requesting.

HON. MR. MAIR: Let me just reply briefly

to that point. My understanding and instructions are that that is not

the case. If you will be kind enough to bring that specific problem to

me I will be delighted to look into it and see where we have gone off

the rails.

MR. KING: I am back again, Mr. Minister. I

have some less emotional and volatile issues to deal with today. I hope

the minister keeps his good humour.

I think the minister is

fairly familiar with one of the matters I wanted to raise with him.

That is the emergency health facility for the village of Chase. I

believe the minister and certainly the hospital board in his hometown

of Kamloops has met with the local committee from Chase with the view

to obtaining an emergency satellite facility for the village of Chase.

I am not sure what the exact mileage is from Chase to Kamloops.

HON. MR. MAIR: About 40 miles. It depends whether you are coming or going.

MR. KING: Something in that area. It depends whether you are on the road from Tod Mountain or not.

There

is an extremely heavy traffic flow in that area, particularly in the

summertime, so the transport of patients for emergency treatment can

be a real problem when there is very heavy traffic flow. Of course,

that is the time of the year when frequently there are the kinds of

emergencies that need very rapid attention. Ambulances dodging in and

out of that kind of heavy traffic flow in the summer creates a problem

of its own.

I believe the Kamloops hospital board has

studied the proposition of developing a satellite facility at Chase,

basically containing laboratory facilities, physiotherapy, dietary

counselling and a trauma room. It's a small facility which would enable

the local doctors at that location to give primary emergency treatment

and also to perhaps keep some patients at home who would otherwise have

to travel all the way to Kamloops for minor ailments and so on. They

could perhaps be kept for their laboratory tests to be made and they

could be kept for observation overnight and that kind of thing.

HON. MR. MAIR: Can I ask a question, briefly?

MR. KING: Yes.

HON. MR. MAIR:

Just so I am clear in my mind what the member is driving at, are you

asking for a diagnostic and treatment centre, or something along that

line?

MR. KING: Yes.

HON. MR. MAIR: Okay, thank you. I just wanted to make sure.

MR. KING:

I think trials have been submitted to the minister's office on the

proposal that comes from that community. I am pretty sure I have had

correspondence with him on it. Certainly the ministry has. The proposal

is supported by a wide region in that area. It is not just the village

of Chase itself, as the minister is undoubtedly aware. That is the

primary source of treatment for people from as far around Shuswap Lake

as Anglemont, which is a fairly isolated rural area, an area which once

again in the summer tourist season is very, very heavily congested; so

there is a large population fluctuation at certain times of the year. I

simply ask the minister to be sensitive to the need in that area and to

be alerted to the fact that the local community — and I as the

provincial representative for that area — will be pursuing very

vigorously the acquisition of this kind of facility. I'm not sure what

the cost range is, Mr. Minister. I don't think it's a terribly

expensive thing; as I understand the local committee's aspirations it

would be under the auspices of the Kamloops hospital board, so the

administrative cost would be kept to a minimum and so on. That's one of

the things I wanted to raise, and I ask the minister to familiarize

himself with that and to weigh the need that exists.

One of the other matters I wanted to raise was a letter I received from a constituent, an optometrist in my riding, who

[ Page 3370 ]

makes

the point that apparently a task force was struck — I believe it was in

1976 — to develop a vision-care delivery system for British Columbia.

The optometrists have been pursuing, at considerable expense to

themselves and individual members, the objective which the task force

was set up to study. The request is that the results of that task force

report be released to the public so that the optometrists can obtain

some indication of which way the government intends to proceed on this

matter. I'll just read one of the brief paragraphs from it:

"No

action appears to have been taken by the government to implement any of

the recommendations put forward by the vision-care task force. The fact

that nearly three years has elapsed since the document was completed is

very distressing to myself as well as others within my profession; I

feel this to be an outrageous waste of effort by the dedicated people

involved who have carefully negotiated and made the decisions in

concert to satisfy all involved in the public's best interest."

Perhaps

the minister could review that request. It seems that the task-force

study was done with a view to determining what policy was going to be

set in the visual-care area, and it seems to me only logical and fair

that the optometrists of the province should have access to the

recommendations of that task force, so that they may have an indication

of which policy direction the government intends to take in the future.

Another matter that I wanted to raise with the minister is some method

of providing a more realistic budget for the homemaker groups of the

province. I'm not sure whether this is the total responsibility or a

responsibility at all of the Ministry of Health or whether it's totally

Human Resources, but there is a dimension, as I understand it, of

long-term care involved.

HON. MR. MAIR: We're both finding out about that at the same time.

MR. KING:

Yes. I'm not sure what the division is with the Ministry of Human

Resources, but I do know that in my particular area, particularly in

Salmon Arm, there has been great difficulty in setting a budget which

is realistic and which allows this agency to function with any degree

of continuity. I would be very pleased to discuss this with the

minister in detail, perhaps when we both learn a little bit more about

it, and find out what might be a logical approach to it. It's an area

that I would appreciate some further dialogue on.

The

Shuswap alcohol and drug programs group at Salmon Arm sought funding

for the establishment of a rehabilitation and healing centre in the

North Okanagan–Shuswap area. The previous Minister of Health, Hon. R.H.

McClelland, replied to this request indicating that the facilities at

Vernon and the new Round Lake Indian facility, which is also very close

to Vernon — it's actually just about on the boundary of my riding and

the Okanagan North riding.... It's basically directed toward native

Indian rehabilitation; I'm not sure whether it's solely directed to

Indian use or not.

HON. MR. MAIR: I think it is, but I'm not sure; they think it is, anyway.

MR. KING:

Perhaps it is, I'm not sure. But there is a real need in that area. One

of the things that has happened, Mr. Chairman, is that we have had the

influx of a great number of industrial workers in the region of

Revelstoke–Salmon Arm with the advent of the dam construction; there

is a major new mine slated to open in the Revelstoke area; and indeed

now from Golden to Vernon there is no facility to accommodate alcohol

problems. One of the things that is interesting is that the railroads,

and many of the other industries in that area, are devising and setting

up their own alcohol treatment programs now, which is encouraging and

should be encouraged, in my view, by the government, because there's a

basic responsibility there and it's a good way to come to grips with

the basic problems. Despite that approach, despite a very effective

functioning Alcoholics Anonymous group both in Revelstoke and Salmon

Arm, without any facility to accommodate the treatment on a bit longer

term, those agencies are kind of limited in their effectiveness too. I

would strongly urge the ministry to have a look at the provision of a

facility in that way. In my view the cost is high initially, but the

investment in terms of rehabilitation for people with that kind of

chronic problem is money well spent. It is an investment rather than a

cost. It's something that I would like to see the minister look at.

Another

point that I wanted to raise — and I want to be very quick here; I

think I raised this point earlier, but I'm not sure with which other

minister — is the question of upgrading opportunity for registered

nurses. I'd be pleased to provide the minister with a copy of a letter

I've received from a registered nurse in Armstrong who makes the point

that the kind of health industry that registered nurses are involved in

is the most sensitive, possibly, of any endeavour in the province.

Medical doctors do have constant opportunity for upgrading and

maintaining their education on a concurrent basis with new developments

in medical research and medical science. Nurses lack that opportunity,

and the point that this lady makes, and I believe very eloquently and

well, is that there should be a better facility, a more structured

facility, for the continuity and upgrading of registered nurses'

education. They are dealing with the ill, they are dealing in a very

sensitive way with life and death, and that again I commend to the

minister as an investment rather than a high cost, while still

acknowledging that there is a cost factor at the initial stages. If

there is a program available I'm not sure that program would be

available in the interior. It may well be that there is some kind of

training course available at the coast, but without some expense

encouragement it becomes quite a heavy and onerous burden on an

individual from the interior to undertake. As far as I'm aware there is

no such program available at the moment. In any event I will send the

minister a copy of that letter and ask for his comments on it.

The

final point I wanted to raise is the limited coverage that is available

for chiropractic treatment. My area, particularly the Salmon Arm area,

is a bit like Victoria. There's a large population of senior citizens

in the area attracted by the extremely good weather, the mild climate,

the beauty of the place and, of course, the excellent political

representation they have as well. They are a group in our society that

requires the kind of therapy and treatment that is offered from

chiropractic people within our province. They're concerned that the

amount of coverage under the British Columbia medical plan is

restricted. I believe it's $75 and $100.

One of the things I suggest the minister think about is the fact that the costs for chiropractic treatment — that is the

[ Page

3371 ]

salary

to chiropractors — have accelerated and increased in the same way that

the salaries of doctors, dentists and other professionals have

increased, so that the fixed amount of $75 for chiropractic treatment

is eroded in terms of the professional set-vice cost, thereby reducing

the hours of treatment available to the patient. On the basis of that

inflationary trend alone, I submit to the minister that the amount

should be increased greatly. Quite frankly, I think the day has come

when medical doctors recognize the benefit of chiropractic treatment in

a much broader way than they used to. I suggest that the ceiling be

looked at in a much, much more liberal way; perhaps that's a good

phrase to use with the minister, who may still have some sensitivity to

that term. I suggest that the current fixed rates for chiropractic

treatment are extremely stringent and unrealistic. I appeal as strongly

as I possibly can for reconsideration and an upward escalation of the

allowable amount for chiropractic treatment.

Finally, I have

one other small point to make. It's my understanding that three

regional brain damage centres — I'm not sure what the technical terms

for them are — are being established this summer in Kamloops, Vernon

and Penticton, I think. It's my understanding that these centres are

geared to treat victims of traumatic accidents that have in some way

impaired their mental capacity through brain damage, who require

intensive one-to-one therapy and treatment rather than the kind of

facility that exists at Riverview, which houses people with brain

damage problems, but the aged and the senile as well. I've been advised

by the ministry that these units are coming on stream this year. I

would like to receive a bit of an explanation from the minister of

precisely what the status of this program is and precisely the

perimeters of the area they're designed to serve so that we in the

interior can look forward to some much increased and improved

opportunity for that kind of attention to people from the interior.

HON. MR. MAIR:

To that provocative member over there who constantly comes in here and

raises my hackles with these inflammatory speeches, dealing with the

question of an emergency health facility in Chase, my instructions are

that we have a proposal for a health facility before us now, under

review, probably not to the extent of a D&T centre, but something

just a little below that, to handle the problems that the member has

mentioned. I must say that one thing that I have been addressing my

mind to recently — and I haven't got anything to promise or undertake

to the member except that this is something that I am asking my

ministry to look at — is the question of seasonal requirements for some

areas, whether they be a mountain resort or summer resort, which go all

the way from a fairly large centre in the in-season to a very small

static population in the off-season. This is something I think we must

address ourselves to and we will do it.

Dealing with the task force on vision care, this has been released. I hate to say it, but a copy was sent to every MLA.

AN HON. MEMBER: When?

HON. MR. MAIR: Well, I can find out when, but it was. I have the distinct

memory that it had been released, because I think the member knows that my own

attitude towards these reports is that unless there is something very, very

confidential in them or something that really requires further study before

they go into the public domain, I think they ought to be released. These are

my instructions. If the member didn ' t get one, I didn't mean to embarrass

him. I'm only going on what I've been told and I'm told that this

has happened. I'm told it was more than a year ago. So as we get older we

forget more quickly.

is a very difficult problem that you raise and we're looking at it now

for the purpose of bringing in legislation, hopefully, next spring. As

you know, the different disciplines that get involved in eye care are

three and four in number, all the way from ophthalmologists through

optometrists through the opticians. Standards are nonexistent in some

areas and very, very stringent in others. There's a crossing of

territorial influence from one to another; there are jealousies and

this sort of thing. As a matter of fact, one of the groups, which is

most anxious that legislation be brought in in my community, is one of

the opticians, who happens to feel that, of course, he is very well

trained for his task, but nobody else is that holds himself out as

being an optician.

MR. KING: Totally unlike the lawyers.

HON. MR. MAIR: That's about it.

we certainly are looking at that, but as I say, the report has been

released and if the member cannot find his copy I'll be very pleased to

get one for him.

Dealing with the question of home support

services, perha ps I could just refer to a memorandum that I have in

front of me, which will give some background of where we stand on that.

As of May 1980 there were just over 22,000 people getting homemaker

services in British Columbia. That's compared to about 3,500 in January

1, 1978, so that's a pretty remarkable increase. There are 1,000 of

these people who are eligible for extended care but are able to stay

within the comfort of their own home and family throughout the program.

An additional 4,000 over and above the 22,000 get short-term home-care

nursing, homemaker services or both. The credit here has to be shared,

of course, with the homemaker agencies, of which there were 68 in

January 1978, but there are now 110 to meet the challenge of these new

numbers.

In the homemaker service there are about 7,000

people employed now compared to $2,300 in 1978 and, of course, each

additional care bed required additional staffing. In the beginning the

wages, benefits and working conditions of people involved in this —

homemakers and care aids — were low, there is no question about it.

They have improved dramatically. My figures have them up up to 45

percent, plus benefits, in the last two-and-a-half years. I think that

the problem the member for Shuswap-Revelstoke (Mr. King) raised is

being improved.

Dealing with the question of a

rehabilitation centre and so on, I can't give a specific answer to

that. But I can say that we talked at some length yesterday, and, I

think, the day before, about the Alcohol and Drug Commission and what

it ought to be doing. I think I've indicated to this chamber that I

feel very strongly that it should be doing a heck of a lot more in

terms of alcohol treatment, education and so on and so forth, than

concerning itself with some of the more dramatic drug problems.

Hopefully, this is one of the things we will be able to examine when

Dr. Bonharn's report comes down in July. I don't need to tell the

member, I am sure, that Dr. Bonham and my staff know of my prejudices

in this regard and I am sure they will give them due weight. That may

be no weight at all, but they will give them due weight.

On upgrading opportunities for registered nurses, again,

[ Page 3372 ]

think I can do little more than accept the member's invitation to look

into this matter more thoroughly. I do understand there are more

regional nursing schools going into the regional colleges. When this

happens it will enable the nursing staffs, at least from the various

hospitals in these regions, to negotiate in their contracts — as, I

understand, is being done in some of the lower mainland areas — the

opportunity for educational upgrading in times to come. I think what

prompts the member's question, of course, is the lack of nurses which

we are faced with every time it's summer and it's time to go camping

and take advantage of the three-month leave of absence which one can

take without losing seniority. This will presumably help a lot of

people — who perhaps feel reluctant to come into the breach at this

point because they've been away so long — to upgrade and get

themselves in a position to do that.

On the question of

chiropractors, I have a proposal now before the money men to upgrade

this feature. The difficulty is that the amount allowed is a global

amount, not a per-visit amount, and that, of course, means that the

number of visits allowable under the figures are reduced substantially,

which sort of ties in a little bit with the reason why we had to raise

certain rates lately. Things are going up. We will still give people

the same amount of money, but they won't get as much for it as they

ought to. We are looking into that — more than looking into it; I've

got an application before the powers that be now in that regard.

the assessment centres that the member mentioned, I'd like to, as much

as I'm able, sort of take that a bit on notice and come back with an

answer. We do have geriatric assessment centres which look at instances

where it appears that mental difficulties can be improved. We are

assessing them from that point of view, but that is in the geriatric

area. With the brain damage and so on that the member referred to, I'm

not sure at this point precisely what he is referring to. But I will

look into it and come back with an answer, I hope within the course of

these estimates; if not, I will come back with the answer in any event.

MR. MITCHELL:

In joining this debate this afternoon I think that, if we are

discussing health care, it would be wise to review some of the....

HON. MR. MAIR: Frank, would you be offended if I left for a moment? Notes will be taken.

MR. MITCHELL:

It really doesn't matter if I am offended; you are going to leave. I

will not be offended and I know that your deputy will look after me. In

fact, maybe I'll be treated a little bit better.

I think,

when we review health care and how it affects not only this province

but also the rest of Canada, and how it affects us as individuals, we

should look at the background and how we got to the position we're at

today. We have, some people say, one of the better health care systems

in North America. In 1976 the province and the federal government

negotiated a block funding or fifty-fifty deal in health care. I think

the problems we are faced with today are because we in the province

have not lived up to our share of the fifty-fifty arrangement that was

morally or mutually or publicly given out as our responsibility at the

provincial end.

I feel it is important that we review some

of the figures, the cost and the funds that have been expended on

health in this province and the percentage of the money that was

expended from provincial revenue. I think there are two things we have

to take into consideration: the money that has come from the federal

government, and what percentage of those funds covered our total health

costs.

In 1977-78 the federal share for hospitals was 53.6

percent; for medicare, again, it was 53.6 percent. It meant that the

province was only accepting 46.4 percent of the cost of medical

expenses. In 1978-79 the federal share of our health care — the

combination of both hospital and medicare — went up to 63.5 percent,

which meant that the provincial share dropped to 36.5 percent. In

1979-80 the federal share was 67.4 percent; an all-time low for the

provincial government was 32.6 percent of the costs of health care.

What did that mean? It meant that large sums of money that had been

expended by the federal government — in fact $269 million of federal

money — were allocated to other areas, and the intention of the

principle of a fifty-fifty arrangement.... I am happy to see in the

present estimates that our new Minister of Health is fighting for an

increase in the money to medicare. The combined total of moneys, both

federal and provincial, is 62.1 percent. In fact, the federal medical

share has dropped to 52.4 percent, giving us an overall increase from

32 percent to 47.9 percent.

My big worry, Mr. Minister,

through you, Mr. Chairman, when I review the track record of this

particula