1981 Legislative Session: 3rd Session, 32nd Parliament

HANSARD

The following electronic version is for informational purposes only.

The printed version remains the official version.

Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

THURSDAY, JUNE 11, 1981

Afternoon Sitting

[ Page

6133 ]

CONTENTS

Routine Proceedings

Oral Questions

Conversion of Barclay St. apartments. Mr. Lauk –– 6133

Policing costs in Williams Lake. Mr. Howard –– 6134

Racial discrimination. Mr. Barnes –– 6134

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

On vote 106: minister's office –– 6135

Mr. Cocke

Mr. Mussallem

Mr. Hanson

Mr. Hall

Ms. Sanford

Mr. Lorimer

Ms. Brown

Mr. Passarell

Mr. Leggatt

THURSDAY, JUNE 11, 1981

The House met at 2 p.m.

Prayers.

HON. MR. FRASER: Mr. Speaker, in the

members' gallery today I have a friend, Rev. Neil Vant from 100 Mile

House in the Cariboo riding. Rev. Vant is paying attention to what we

are doing today. He is also a member of the Human Rights Commission.

MR. LAUK:

I would very much like to introduce several guests to the chamber, but

I can't. What I would like to know is where the treasury benches are

this afternoon.

HON. MR. SMITH: Today I have the

pleasant duty to welcome three scholarship candidates to the House.

First of all, the winner of the Queen Elizabeth II Centennial

Scholarship, which is a very significant scholarship in British

Columbia, this year is John Henry Klippenstein, who is in the gallery

with his wife Rosemary. John has won a $20,000 scholarship for

excellence in mathematics. He is an honours graduate of UBC in

mathematics. He is the 1979 winner of the Governor-General's gold

medal, topping the arts and science graduating class. John is going to

be studying mathematics at Warwick University in England.

also have the honour to welcome here today the two runners-up for the

Queen Elizabeth scholarship, both of whom have received scholarships of

$4,000 each. First of all, Miss Isabel Harrison, an honours graduate in

political science from UBC, will be studying at Nuffield College of

Oxford University in England, I believe in the field of industrial

relations. Finally, the other recipient of the runner-up Queen

Elizabeth scholarship is Michael Webb. Like Isabel, he is a graduate of

the University of British Columbia in political science. His interest

is in international relations. He will be studying at the London School

of Economics.

Oral Questions

CONVERSION OF BARCLAY ST. APARTMENTS

MR. LAUK:

Mr. Speaker, can the Minister of Consumer and Corporate Affairs confirm

that owners of an apartment block at 1967 Barclay Street in the city of

Vancouver have served eviction notices on most of the tenants in that

block for the purpose of converting ostensibly to condominiums without

being subject to the Residential Tenancy Act, municipal zoning or the

strata title laws?

HON. MR. HYNDMAN: Mr. Speaker, I can confirm the following. Yesterday

afternoon I received a telephone call from a reporter on the Vancouver weekly

newspaper the West Ender , who related to me details of a report alleging in

substance what the member has just asked. I have not heard from Vancouver city

hall or the planning department of Vancouver city hall. Based on the telephone

report to me of an alleged situation, I advised that reporter that the moment

I heard from Vancouver city hall of any apparent attempt to circumvent the clear

policy of this government, namely that those types of conversions require municipal

approval, I would be happy to move into action. As of this stage I have no evidence

in front of me of anything constituting an attempt to create a loophole. The

moment I do I'll be happy to act, and for that reason I'll take the

question as notice.

MR. LAUK: By an amendment to

section 17(1)(

e) of the Residential Tenancy

Act, introduced by this government last year, the owners of 1967 Barclay Street

have been able to circumvent laws of the province and the municipality that

would otherwise be available to protect tenants. Can the minister confirm that

that loophole to 17(1)(e) — and the notice of that question went to

the minister some days ago — was introduced as a result of representations made

by property speculators — the investor community in the city — as indicated

by the Hansard speech of the minister's predecessor?

HON. MR. HYNDMAN: I have some difficulty detecting what the question is. I think there might be three different questions buried in one sentence.

MR. LAUK:

I in satisfied that this has taken place. If the minister wishes to

investigate and confirm it, fine, I wish he would. The loophole under

17(l)(

e) allows an apartment block to be sold to as many owners as

there are suites, so that all the owners of that block as a whole are

on the title and can therefore circumvent the laws by evicting tenants

immediately under the provisions of owner-occupier, which is really

converting to condominiums without converting to condominiums, if you

know what I mean. Can the minister confirm that that amendment made

last year — that nobody seemed to notice would create this loophole —

was made as a result of representations by the investment community, as

indicated in Hansard by the minister's predecessor?

HON. MR. HYNDMAN:

I have no knowledge of any information which would support the

allegations of the member. At this stage I want to reject completely

the suggestion that there is a loophole. I think the member is advising

the House of some personal legal opinions that he would conclude. May I

simply tell the member this: as far as I am concerned, based on what's

in front of me and on my desk, there is no such loophole. I can

certainly assure the member that if any group of people want to play

cute games with the Residential Tenancy Act in an effort to avoid the

clear policy of this government, which is to require municipal

approvals of conversions, we'll be prepared to act. Once again, as I

said to that member before, on these kinds of issues I am not going to

play judge after he has been the jury. I will first ascertain the facts.

MR. LAUK:

Earlier in the week a letter was delivered by hand to the minister

questioning this section. I would not want to leave the impression that

I have sprung this information on the minister. The minister has now

had several days' notice.

The president of 1967 Barclay

Street Limited is Mr. Douglas Jackie, who is an associate with Farris,

Vaughan, Wills and Murphy, a company which in the fiscal year 1979-80

received $32,000-odd in fees from government. Can the minister assure

the House in respect to those amendments last year that that legal firm

was in no way involved in work relating to that bill?

HON. MR. HYNDMAN: I'd be happy to take that question as notice and report back to the member.

[ Page 6134 ]

MR. LAUK:

The solicitors for 1967 Barclay Street Ltd. are Clark, Wilson and Co.

Mr. Kenneth Teskey is an associate lawyer with that firm, as is one of

the articling students. Both those persons are two of the new so-called

tenants-in-common — that is to say part owners of the block as a whole

— who have given notice to tenants to leave the premises without the

usual provisions of the law. My question to the minister is: can he

assure the House that at no time was Clark, Wilson and Co. Involved in

work relating to advising the government with respect to the amendments

that are of concern here?

HON. MR. HYNDMAN: Again I'm

very happy to take that question as notice. I can certainly tell the

member that with respect to the time since I've assumed this portfolio,

the answer would be a clear no in both cases; but with respect to the

history of the matter, I'll take the questions as notice.

MR. LAUK:

Finally, to the minister: if the facts are as set out here today, has

the minister decided to take immediate action to stop this

circumvention of the law, and protect those tenants at 1967 Barclay

Street?

MR. SPEAKER: I cannot accept an answer to a question that is out of order.

MR. LAUK:

Mr. Speaker, to the minister: I am satisfied by calling city hall, by

calling the tenants, by confirming through land registry and by company

searches that the facts are as I have set them out, as an honourable

member. On those facts has the minister decided to take immediate

action?

HON. MR. HYNDMAN: Mr. Speaker, I would think,

if there is substance to the allegation that the policy and requirement

of municipal approval of a conversion has been subverted, the first

requisite I shall ask for is a complaint or statement from the city of

Vancouver, officially saying that this has happened, producing the

facts in support, and lodging a complaint.

POLICING COSTS IN WILLIAMS LAKE

MR. HOWARD:

Mr. Speaker, in the absence of the Premier today — no doubt unavoidably

— I would like to direct a question to the Attorney-General instead. I

ask the Attorney-General whether the Premier has brought to his

attention four letters sent in April 1980 by the Williams Lake city

council to the Premier, demanding relief from the onerous and

inequitable policing costs which had been imposed upon that

municipality by the province. Can the Attorney-General advise the House

whether those letters have been brought to his attention?

HON. MR. WILLIAMS:

Yes, those letters have been brought to my attention, and in addition

letters have been sent directly to me by the mayor of Williams Lake,

dealing with the same matter.

MR. HOWARD: Mr.

Speaker, in March of this year the Attorney-General advised the mayor

of Williams Lake that he — that is, the Attorney-General — would take

action on the particular complaint of the Williams Lake city council

within ten days. The mayor yesterday advised that he still hadn't heard

from the Attorney-General. Can the minister advise the

House why he has been unable to keep his promise of action within that ten-day period?

HON. MR. WILLIAMS:

Action was taken within that ten-day period, for the purposes of

examining the validity of complaints raised by the mayor of Williams

Lake. It has been fully reviewed by people who are concerned with the

provision of police services in that community. A letter is on its way

to Mayor Mason now.

MR. HOWARD: A letter is on its

way now, so of course one should inquire as to what the letter says.

Has the Attorney-General indicated in the letter his decision to

rectify this matter and take action to relieve the people of Williams

Lake from the onerous burden placed on them by his government with

respect to policing costs?

HON. MR. WILLIAMS: I would

have thought it more appropriate to wait until the mayor had received

my letter. But if the member wishes to know in advance, the position

taken on this matter is that the city of Williams Lake is responsible

to discharge its responsibilities under the law for the cost of

policing for its community. In that letter we have also indicated other

initiatives which are being considered which will provide the kind of

relief which he and other communities in similar situations can expect.

MR. HOWARD:

I wonder if the Attorney-General can advise the House whether this long

delay of more than a year is in keeping with the common practices of

his government in dealing with matters of this nature.

HON. MR. WILLIAMS:

No, it is not common practice. I wish to assure the House and the hon.

member that when matters as important as this are under consideration

by the ministry, we seek to find solutions which are practical and

feasible in order that we can provide the kind of assistance these

municipalities require.

RACIAL DISCRIMINATION

MR. BARNES:

Again, I have a question to the Attorney-General. The Minister of

Labour has admitted knowledge of at least eight previous cross-burning

incidents by the Ku Klux Klan in this province. The most recent

incident at Stave Lake was attended by Klan members bearing firearms.

Would the Attorney-General advise the House whether or not these

persons had permits to bear firearms?

HON. MR. WILLIAMS:

The matters which were attendant upon that particular event were — once

the press, having had advance knowledge, made them public — the subject

of an immediate investigation by the RCMP detachment at Mission and by

other senior levels of the RCMP. The question of the bearing of

firearms is part of that investigation.

MR. BARNES:

My specific question was whether or not they had permits to bear those

firearms. I'd like the Attorney-General to indicate whether or not he

has knowledge of that fact.

HON. MR. WILLIAMS: The

question presumes the nature of the firearms as being that which would

require permits. The investigation indicates that if firearms were

[ Page

6135 ]

used on that occasion they were long guns and therefore not those which require

permits to be carried.

MR. HOWARD:

Mr. Speaker, I rise pursuant to standing order 35. I ask leave to move

the adjournment of the House for the purpose of discussing a definite

matter of urgent public importance, namely the impending closure of

certain schools in School District 88 in Terrace as a result of

dissatisfaction on the part of the Terrace District Teachers'

Association over the disregarding by the board of trustees of the

school district of an agreement between the board and the teachers

arrived at not long ago with the assistance of the Deputy Minister of

Education, Mr. Carter.

MR. SPEAKER: We will review the matter, give it its due consideration and bring a decision to the House.

Hon. Mr. Curtis tabled answers to questions on the order paper.

Orders of the Day

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

ESTIMATES: MINISTRY OF HEALTH

(continued)

On vote 106: minister's office, $205,728.

HON. MR. NIELSEN:

Mr. Chairman, just before the noon-hour break the member for Burnaby

North (Mrs. Dailly) had posed a series of questions with respect to

private hospitals. I believe the member probably included in the

definition of private hospitals those which are known as community-care

facilities but nonetheless owned privately. The private hospital is a

bit more precise term under different legislation. The member for

Burnaby North asked for an opinion with respect to that which she

described as the philosophy of herself and members on the other side of

the House to the place in our society in the delivery of health care

for those engaged in the private sector who are profit-motivated. The

member made reference to a news report, datelined Kamloops, which had

offered their opinion of what I had said the previous evening.

I have stated on occasion that it is my firm belief that there is a very definite

and important role for the private sector to play in, the intermediate-care

field, whether they be private hospitals — which seems to be a bit of an anachronism

with respect to that name — or intermediate-care or community care facilities.

For a number of reasons I believe that to be accurate. The member for Burnaby

North said that she felt there was no place for profit-making in the health-care

delivery. When we examine our health-care system, we find that indeed many aspects

have profit motivation behind them. We could begin perhaps with our medical

practitioners and their various private clinics and, of course, the intermediate-care

facilities or nursing homes and some child-care facilities. We have those who

produce products for health, be they drugs, prosthetics, dentures or whatever.

They are motivated presumably by profit. The specific area involving intermediate

care or private hospitals perhaps could be argued to be somewhat different.

I would be very concerned if we were to eliminate from the overall supply that

component part provided by the private sector. I think it's important to

have some different organization offering those services if for nothing else

but comparison. We have determined in analyses of costs that some private organizations

can deliver a product at a lower cost for various reasons. I can assure the

member and all others that cost is vitally important in this area, but indeed

it is the care of the individual which is supreme.

The

member suggested that perhaps companies or organizations which may be

motivated by profit could — I'm not sure if she said would — offer

substandard care. There are many examples of facilities throughout the

province operated by private individuals and organizations. There are

others operated by non-profit associations, some by community

associations and some are associated with hospitals. We hope the

standard of care is about equal, wherever it may be offered. There is

no question that we could identify a facility and point out what some

people might consider substandard care in a particular area. Our people

within the ministry would be working to correct that, no matter which

facility may be offering what has been identified as substandard care.

Our

people responsible for the program within the ministry have done a

reasonable amount of work investigating complaints, allegations and

simply doing a controlled audit on the level of care. They find that on

a balance you would find equal care standards throughout the system.

They do not share in the argument that non-profit facilities would

perhaps provide better standards than do the profit-oriented facilities.

With

respect to the licensing standards, the staff advise that long-term

care standards apply equally to private and non-profit facilities. We

believe that the private organizations can provide a high level of

care. I know I have visited many, some of which have been in operation

for a good number of years and have provided an outstanding service to

their clientele. In many aspects they could lead the way and show some

other organizations how to run an intermediate-care home.

The

Extendicare company that the member spoke of is a very large

organization. From what I've heard from others, and upon some

investigation, I am advised that it has a highly respected reputation

in this field. They are extensive, and they do have facilities in other

provinces. They purchased Mount Paul Private Hospital in Kamloops. As

well, they manage one facility in British Columbia on behalf of a

nonprofit society and have contracts to manage two other facilities

which are being built in the province now by non-profit societies. So I

think Extendicare has an enviable reputation, and we trust that if they

enter this business in British Columbia they will maintain very high

standards.

I can assure all members that the people

responsible for seeing that standards are met in that area of care

would share anyone's concern if substandard treatment were being

offered to the patients. We have all at some time heard stories about

treatment of individuals or treatment generally offered by a facility.

Upon receiving such information, we dispatch people to investigate,

report back and make demands, should they be in order. to resolve those

problems. I emphasize again that it is the level of care and the

treatment offered to the residents of those facilities which is by far

more important than strictly the fiscal aspect.

The member

asked a series of questions about which I made some notes. I believe

the member asked if the government should accept.... I'm not attempting

to quote you, Mr. Member, and I'm speaking around it perhaps — but I

think the question was: should substandard care be accepted in

profit-making facilities? I would categorically say no.

[ Page 6136 ]

Substandard

care should not be accepted in any of the facilities. There is going to

be a level of care, of course, by comparison with another facility

which may not appear to be equal. But I don't think that would be

considered substandard.

Regulations do require

strengthening, and that is underway. I am advised that the manner in

which the regulations have been produced in the past may not be as

effective as either they should be or were intended to be. I respond to

the concern of the member for Burnaby North about the reliability of

owners in providing facilities and service to those people who may

reside in a facility, and I share that concern. I have asked officials

in the ministry to determine the feasibility of entering into an

agreement, contract or some form of binding obligation with those who

offer such facilities for public use, tied in with a government funding

program, so that the Ministry of Health can be assured that those

facilities will be provided for at least a specific period of time. An

example would be that if an agreement is reached for the current year's

operation, perhaps the following year would be required without any

opportunity of closing, selling or changing. That would be a one-year

period of time when they could give notice that they might wish to drop

out of the program, providing government at least one year's lead time

to attempt to relocate or find new facilities. I think that can be

done. Representatives from one of the organizations representing

private care facilities felt that it would not cause a problem at all.

I would think that there could be concern that the money provided to

these facilities by way of per diem rates should indeed be used for the

care of the people. I hope that is what occurs.

Materials

and labour. I think the member was suggesting: should residents be

expected to put up with less than what they require in materials or

labour? Certainly not. No resident of a facility — privately owned,

community-funded, non-profit or whatever it may be — should be expected

to have any substandard level of care in any of these aspects. We

recognize that when the program was first introduced there was a need

to enter into agreements with private organizations that were already

offering a service to the community. That has remained, with a lot of

new non-profit organizations coming on stream in the last couple of

years and more coming along.

Philosophically, the member

questioned the role of private care facilities. Philosophically, I

would say there is a role. I would say that indeed there is a role for

the private sector in many of the services which are offered to

citizens of the province, not only in health. I am not one who agrees

that government knows best and government can do best. I think there is

certainly room for competition in this area of intermediate care or

personal care, as there is room for competition in many of the

endeavours that government very often attempts to monopolize.

Madam

Member, I can assure you that the number one concern is the well-being

of those individuals who are housed in the facilities. I would not

hesitate, nor would I hesitate to advise any of my officials, to

respond in no uncertain terms to identified substandard care.

recognize that if we are relying on the private sector to provide beds

in this area, to a degree they have us at a disadvantage. The

possibility of threatening to close for resale or redevelopment is

something we recognize and something I believe we can approach. I have

advised the organizations that it is not possible for government to

accept the threat of massive shutdowns of segments of the industry. I

have advised them that if they are to survive as a component in the

intermediate-care, personal-care level, then they are going to have to

agree to a system whereby they can guarantee continuity of beds to the

long-term care program.

I think I have covered those six

questions. I only made very limited notes on them. I think the member

for Burnaby North spoke only about this long-term aspect of health

delivery services. I trust that I covered those points you raised. If

I've missed any I'd be pleased to respond.

MR. COCKE:

The minister, the member for Burnaby North (Mrs. Dailly) and myself

have, I guess, a little difference of opinion with respect to the

private sector and the delivery of health care. Nobody's arguing

whether there should be a private sector or whatever. The problem has

been that the private sector in health care has been irresponsible in

some instances, enough so that it has created a very large problem for

us. Neil B. Cook and Associates found it very much more profitable to

be in the oil business, so they're in the oil business and down the

tube went their private hospital chain. Good old shades of Sandringham,

Let's remember Sandringham Hospital and that Cook empire.

haven't got enough experience with Extendicare, but Trizec are

operating the Windermere Central Park Lodge — a huge place. What are

they doing? They're trying to use slave labour to do a very important

job for the long-term care program, and now they've got themselves a

strike. They know full well that the government are quite prepared to

come in and pay a reasonable price for their participation, but no,

they don't want the government to look at the books and fool around

with them. What did Trizec do? Who are Trizec? First and foremost

they're a subsidiary of the Bronfman empire, and secondly they're into

huge shopping centres and so on and so forth. This is the program they

use to give themselves a pretty face.

In any event I'm very

suspicious of the whole area, as is the member for Burnaby North. Sure

there are some people delivering private health care, small ones. Some

of them are very conscientious and are not doing a bad job. The only

problem is when profit is the motive and some day you get a good price,

what do you do? We've had a net loss in beds in that sector, and the

reason we've got a net loss in beds is by virtue of the fact that it's

more profitable to sell the property and let the residents find

someplace else. New Westminster had a dozen of these private hospitals,

and half of them are gone. Anyway, that's the situation.

want to talk about something allied to this. This morning I alluded to

the whole question of the abysmal waste that has gone on. You can't tie

the can to this minister, nor for that matter can you tie the can to

recent events. The one I'm going to talk about is the absolute fiasco

of the UBC hospital. In face of a situation where we're saying we've

got to keep the old belt tightened, we're going to have to make sure

that in order to pay the does we're going to have to move some money

from here, there or anywhere. We can find it. Meanwhile that minister's

predecessors have had an absolute ball wasting money. One of the

biggest wastes — and I'm going to deal with two or three of them in the

next day or two — was that UBC hospital. I know it cost more, but

basically it was a $32 million investment to produce 240 beds. Why in

the world did we do it? The best advice in North America told us it

doesn't work.

[ Page 6137 ]

Interjection.

MR. COCKE:

Wait a minute. We've got to take responsibility for what those members

over there do, Mr. Member. We can criticize, but we still have to vote

the money.

There are 240 acute beds at the Health Science

Centre. The doctors — except for the academics — didn't want it. The

advice from professionals in the east, because those professionals had

had something to do with that before, was to look at the United States

where a number of these health science centres were built. They found

they weren't working. The occupancy was low. I can take you to one

university hospital that works fine — the University Hospital of

Washington. Why? Because it's in downtown Seattle. What's wrong with

UBC hospital? It's out in the periphery. I ask you, Mr. Chairman, what

happened to McMaster, one of the most beautiful hospitals ever built in

this country? You're preoccupied, so I'll ask everybody: what happened

to McMaster? It ha, s been suffering from a 40 percent occupancy for

years. It's been so bad that on a number of occasions the Minister of

Health in Ontario has closed beds on the periphery in order to try to

force people into McMaster. There's nothing wrong with the hospital.

It's beautiful, but it's in the wrong place. Isn't that what we tried

to tell the then Minister of Energy, Mines and Petroleum Resources

(Hon. Mr. McClelland), but particularly the Minister of Universities,

Science and Communications (Hon. Mr. McGeer), who got it all started?

That was his payoff for coming over.

The UBC hospital has

been and will be the same as McMaster and Sherbrooke — two beautiful

hospitals in this country. The gentleman who was responsible for

Sherbrooke became the Deputy Minister of Health for Canada. What did he

tell me in a meeting I had with him prior to us making a decision to go

the other route? He said to me: "After Sherbrooke, I decided that that

was the biggest mistake I ever made in my life." We told this

government all this, and yet they persevered. They went ahead and

wasted that kind of money in that particular area.

First and

foremost, what they had to do was destroy the concept of the B.C.

Medical Centre. I've often said: I wish to heaven we'd never thought of

that name, because it was the name that was destroyable, not the

concept. It had nothing to do with a geographical place. It had to do

with tying the existing hospitals in with the educational process. It's

working like a dam in Laval. Claude Castonguay was one of the best

ministers of health this country has ever seen, despite the poor

devil's Liberal affiliation. What did he do? He saw the mistakes of

others. He said: "We won't do that in Quebec City. Laval is tied in

with the six hospitals there." He learned from history, but we couldn't

over here. No, we had to go ahead with what has been captioned

"McGeer's Folly." I shouldn't use the member's name, so "The Member for

Vancouver–Point Grey's Folly."

I had to put some stuff

together fast back there in 1976, because in 1975 there was this whole

concept. Let me read it to you. The concept of the B.C. Medical Centre

was — and this is all crossed out and changed. It's a beautiful change

of wording. All the rest of the concept is still there. They had to use

our words, but they had to change the concept. It says: "In 1975, the

government of British Columbia announced its plans to establish a major

provincial teaching and referral centre. This facility will be known as

the B.C. Medical Centre, and it is destined to become a major focus for

clinical teaching of students in medicine and other health professions.

With the development of the centre...." Then it goes on to talk about the objectives and so on.

Listen to this change. It's interesting. It says:

"In 1976, the government of British Columbia announced the

plans to establish a 240-bed acute-care hospital on the campus of UBC. This

will be combined with the campus 240-bed chronic-care hospital and 120-bed psychiatric

hospital to provide a campus medical centre, to assist our downtown hospitals

in training of our undergraduate and graduate trainees in medicine and other

health professions."

Incidentally, the editor has asked: "Should this stay? Will part of the

facilities be known as the B.C. Medical Centre?" The answer was no. Of

course, no. I do regret that major mistake of calling it something that could

be defined. But it went ahead and we know where it went.

want to tell you of the kind of pressure we were under in 1973, 1974

and 1975 around this whole hospital. We had people campaigning in the

Shaughnessy area with the residents around Shaughnessy Hospital. What

were they saying? "It's going to ruin your neighbourhood. They've

already got a hospital there." As a matter of fact, later on they're

getting the children's.... That was planned, incidentally, as you well

know, and so is the high-risk maternity. A citizens' committee in

Shaughnessy, led by one Geoffrey Woodward, was going around.... Where

did he get some very heavy-duty support? The material that he was

distributing to the Shaughnessy residents was bought and paid for by

none other than our friend Dr. Bill Gibson. I have here before me the

invoice and a copy of the cancelled cheque. Who is Dr. Bill Gibson? Dr.

Bill Gibson was the first guy to put the arm on me when I was Minister

of Health, almost a few days later saying that we must have a

university hospital, and I thought that the pressure was so heavy that

we had better look into it very keenly. The university people,

including the fine doctor from Point Grey, were all involved in that

attempt to shoot down what was a splendid concept, and I think it's an

absolute shame.

Mr. Chairman, a few months ago, after the

hospital opened, there was an announcement saying that the 25-bed

surgical ward will be open next week and beginning to perform surgical

operations. Later on in the

article it says: "At the moment 50 medical

beds are open, and Mr. Detwiller says that 25 additional medical beds

and another 25 surgical beds will be open by the end of January." This

was back on January 7. "All 240 beds should be completely open by

midsummer."

Well, then what do we get? We're in early

summer. This is a release of May 25: "Empty-Bed Problem for new

Hospital on Campus at UBC." Incidentally, I must remember sometime to

bring in the recruiting material that was used to try to get people to

that emergency opening. Anyway, this is what was said then: "While just

about every other hospital in B.C. Is complaining about being

overcrowded, the Health Science Centre Hospital at the University of

B.C. held an open house Sunday to attract patients." In other words,

somehow or other we've got to go out and recruit patients for that

hospital. "Said director Ken Kristjanson: 'We don't suffer from a big

waiting list; our problem is empty beds, and I don't quite understand

it.'" All they had to do was look at McMaster, Sherbrooke and all those

health science centre hospitals in the United States that are on the

periphery of the community which don't work. They are beautiful

edifices, beautifully equipped, but they don't work, Mr. Chairman. In

[ Page 6138 ]

the

first place, there is a doctor psychology as well as a patient

psychology. Doctors don't like to trip around 25 miles between

hospitals or whatever, because their time is relatively valuable, and

so it's very difficult to get something like this on the move. As far

as I'm concerned, you can't run a hospital with academics, period. If

anybody has to trip around, let it be the academics under these

circumstances. That's what we were suggesting at the time, and that's

why it's not working now.

Mr. Chairman, Dr. Kristjanson went on to say in this article: "Last Saturday

night I worked in the emergency room at Vancouver General, and most of the people

who came in there were not the type that an already upset person needs to see."

Anyway, he was talking about who they were, but the fact is they were there;

they were hurt and they were bleeding. Anyway, then he goes on to say: "The

emergency department, fully equipped with a staff of 4 doctors specially trained

in emergency care, 12 nurses and 10 beds handles only about 25 patients a day

when it could easily take as many as 75."

think that I have had some fairly good information with respect to who

is coming into that hospital with an emergency. It's the odd person on

campus who has had a cut or people from the 300-bed extended-care

hospital on campus, etc. As a matter of fact, I'm told by some fairly

reliable sources that the average illness in the university's Health

Science Centre Hospital right now is long-term care; most of the 100

people in there are actually chronically ill people. Congratulations

for money not well spent. "All our facilities are under-utilized," Dr.

Kristjanson goes on to say. "I think the reason is lack of public

awareness." Of course there is a lack of public awareness. You build a

hospital out in the weeds, and it's going to be.... You get those

people around. But who's probably one of the healthiest communities in

B.C.? A college or university community. How do you expect to have a

great deal of response to the facility there? I believe that the

Minister of Universities, Science and Communications saw to it that

that hospital was built. He's resigning shortly, or he's not going to

run again. He hopes to go back there to his domain and experiment and

do research happily ever after in a very expensive facility, bought at

the expense of the taxpayers in the province and run at the expense of

the taxpayers in this province. I think it's an absolute shame.

[Mr. Strachan in the chair.]

want to get at my old friend, Mr. Gerry Hobbs. I didn't answer Mr.

Hobbs' letter to the editor. He said that "the NDP health critic was

badly misinformed," when I made my statement last December. [Applause.]

If you can clap to that, then you don't have any sense whatsoever,

because everything I have said has come true about that centre, and

most of you people were here. Most of them were here. It's been

absolutely proven beyond a shadow of a doubt that it's a desperate

mistake.

Mr. Hobbs uses an argument that's often put forward

when anybody raises a health question: don't scare the public. The

responsibility of an opposition is to see a flaw and identify it, and I

don't care what it is. Whatever the portfolio, that portfolio must be

able to defend their actions and be able to defend anything they do, in

the eyes of the people. That's what democracy is all about. For anybody

to indicate that you're scaring the public if you put forward a strong

statement....

MR. KEMPF: I remember when you were Minister of Health, and you talk about democracy.

MR. COCKE: The member for Omineca has just wakened up. He's come out of hibernation, Mr. Chairman. It's spring.

MR. KEMPF: I remember those days.

MR. CHAIRMAN: I will ask the member for Omineca to come to order.

MR. COCKE:

That member used to be a mayor up in Houston, and he was against

progress even then. We were trying to get a nice couple of doctors set

up in Houston. It's working, and he's been angry ever since.

Mr. Hobbs indicates: "The

allegations attributed to Mr. Cocke by your Victoria bureau are

erroneous. It is inconceivable that a former Minister of Health should

have been so casual in his use of misinformation." The information I

used that day, and the information I use today, comes directly from the

facility and the people involved. For that matter, most of the

information is now public. It's folly when they're out recruiting,

trying to get people to use that hospital. He says:

"An experienced manager, let alone a former Health

minister, should know that opening any hospital is carried out

according to a carefully worked out

schedule that first brings into

operation a basic service department, then a single ward, with others

following in sequence. Obviously it's a high standard of care to be

maintained. The full complement of 240 beds should not be put in use

all at once."

Of course not. But they've been phasing this

hospital in since a year ago July and it's still not phased in. How

long does it take to phase in a 240-bed hospital?

It's a

disaster, and it's a waste. That's precisely what we're talking about —

wasting very important health-care money. I said at the time that it's

going to cost about $600 per patient day to run that hospital. I have

not, to this day, seen one word that can argue that point. Oh, I know

there are going to be funds which will be designated as education, but

it's going to cost. Any other hospital works its entire budget out

dividing it up by the number of beds, and that's the way that hospital

should and could — but won't — be run. Oh, sure, they've got it down to

around $270, they say, but that's impossible. If you've got a 240-bed

facility and you've only got a hundred people in there, then naturally

the cost per patient-day is just going to skyrocket. That's another

factor, but I really believe it's a shame.

The warnings came out. I would like to remind you that it was in 1976 when the warnings.... This is an editorial in the Province :

"It was back in March that Education minister Pat McGeer pulled $50

million from his hat and told UBC to give him a spending plan in 60

days or" — do we forget the "or"? — "he would build a medical school in

Victoria." That was the choice. "I'll give you 50 million bucks or I'm

going to build a medical school at UVIC." That was the way the minister

dealt with them, so they had no choice. Finally the doctors

capitulated. What do you do? You've got a relatively newly elected

minister who has this tremendous — I don't know — motivation to commit

grievous errors. As a matter of fact, probably one of the funniest

errors he ever made was when he was trying to sex a whale. He was even

wrong that time. This is where it was important, and he shouldn't have

been wrong. He made a mistake.

[ Page 6139 ]

They

go on to say in their editorial: "Despite much alarm in medical

circles, where the new hospital was considered unnecessary, especially

when downtown hospitals were in greater need of the money, proposals

were submitted within the time limit by UBC president Douglas Kenny."

It's a shame. Don't forget, this is when they had a chance to change

their mind — December 1976. They had lots of warning. Everybody knows

about the warnings. What did Scott Wallace say? "As Dr. Scott Wallace

says, the construction of university hospitals in other centres in

North America with the hospital on campus rather than in the community

has resulted in under use of highly expensive facilities while other

levels of care have been starved for funds." What do we find today in

the province of British Columbia? Those words have come true exactly as

stated.

Congratulations Scotty, wherever you are, up on

Fairfield Road. He was doing a good job, as usual. I couldn't agree

with him politically, but he sure made a lot of sense, as far as I was

concerned, in his advice. Do you know, Mr. Chairman, I used to have

Scotty in from time to time to discuss, when we were government and he

was sitting in the opposition as a Conservative. Incidentally, that's

the only thing he ever was in this House — a Conservative.

MR. KEMPF: You couldn't agree with him, but he made a lot of sense.

MR. COCKE:

your remarks to yourself? Either that or get up and defend the

government for this absolutely incredible mistake. If you've got

something to say, take your courage, take yourself by your lapels, pull

yourself up at your mike and defend what they've done here. Then take

your remarks up to Omineca and see if you can sell them.

MR. CHAIRMAN:

Order, please, I'll ask the member for Omineca not to interrupt, and

I'll ask the member for New Westminster to kindly address the Chair.

MR. COCKE:

Sure, Mr. Chairman. I'm sorry for getting out of order as I do from

time to time. But that member has a way of getting things off the track

a bit.

Anyhow, this was a statement from Scott Wallace: "It would be folly to

build the 240 acute-bed hospital at UBC. There's already a genuine surplus

in this category. What seems to be most needed" — listen to this; this

is 1976 — "are extended-care beds for chronically sick patients, many of

whom are in high-cost beds at the Vancouver General, Victoria General and St.

Paul's."

But

no, Mr. Chairman, we proceeded to waste the $32 million and the

monumental amount of money that it's going to cost to operate that

white elephant. I don't like to talk about any first-class facility the

way I'm talking about it — because it is. They get things before any

other hospital in terms of diagnostic machinery and so on. The fact is,

it's improperly placed. It's in the wrong place. Vancouver is so

logical; there's a health corridor that goes all the way from St.

Vincent's right down to St. Paul's. If you look at that corridor, why

would you ignore it? Why would you then build apart of that acute-care

system way out on the periphery? If that minister had had his way, he

would likely have built it much closer to the cliffs, so that

eventually his sin would be washed away. It is a sin to waste money

that way.

I have tried and tried to persuade. I decided: one

more time, just to have a day in court on this hospital, particularly

in view of the fact that we've got a new minister. I'm not blaming him;

he had nothing to do with it. But his predecessors have made an

absolutely abysmal error. I tic it directly to the Premier, who must

have given support to that proposition to put it over in cabinet. It

certainly wasn't the Minister of Universities, Science and

Communications (Hon. Mr. McGeer) on his own; it certainly wasn't the

Minister of Health on his own. No siree! That was a very sad day. Then

we came to the day when the sod-turning ceremony took place.

"'It

will be a centre for the development of new medical techniques and

resources for ameliorating disease for years to come,' McClelland

said.... 'There has been a lot of controversy as to whether it would be

built.... But now the new facility is a dream fulfilled for people for

many years to come....'

"It has been opposed

by the B.C. Health Association, representing the province's hospitals,

the B.C. Medical Association...and the downtown teaching hospitals, on

the grounds that it will soak up money that could better be spent on

other hospitals and that it will be underused because of its

non-central location."

That was the correct part of this whole question. I regret that we made this abysmal mistake in hospital care in this province.

MS. SANFORD: Mr. Chairman, I ask leave to introduce a group of students.

Leave granted.

MS. SANFORD . Visiting us in the gallery this afternoon is a small group

of grade 6 students from Tsolum Elementary in School District 71, accompanied

by their teacher, Mr. Loughlin. I would like the House to make them welcome.

MR. MUSSALLEM:

Mr. Chairman, if there is a bright star in the firmament of public

service, I do believe it would be burning brightly for this Ministry of

Health. If there ever was a ministry that depicted the golden rules of

faith, it is this ministry. Scripture says: "As you have served the

least of these, so you have served me." There is a ministry that serves

people in this province as no other ministry or government anywhere

else in Canada. I remember very well when the health system first came

to the fore in this government, how the success of the process was

recorded throughout Canada, and how it has grown and prospered ever

since.

I'm not going to speak at length, but I rose in my

place because the socialist critic of the Health ministry took a lot of

time criticizing the university hospital. How he has totally lost sight

of the importance of a university hospital! He attempted to misquote

Dr. Scott Wallace in saying that there should be no university hospital.

AN HON. MEMBER: He's not even listening.

MR. MUSSALLEM:

He may not be listening, but at the same time.... Dr. Scott Wallace was

not opposed to a university hospital, but he wanted more workshops for

doctors in the metropolitan area. That's understandable. When

[ Page 6140 ]

the

critic was Minister of Health he had Dr. Foulkes make a report, and the

Foulkes report carefully pointed out that hospitals were workshops for

doctors — and they are. But the university hospital is not a workshop.

It is a place for academics, for understanding, promotion and

development of the strength of hospitals, of innovations. It will fill

up in time; of course it will.

I'll give you a parallel, Mr.

Chairman. It was only a few years ago that the Oak Street bridge was

built across the Fraser River in Vancouver. Day after day the

newspapers said: "This bridge is unnecessary. We've had photographs. We

don't need a bridge." The Deas Island Tunnel was built. That party in

the newspaper said: "We don't need a tunnel. We don't need any of these

things. We do not need the powerhouses at Peace and Columbia." But

today they're vital to the economy and create the atmosphere and

conditions that make British Columbia a proper place to live in.

The

university hospital is vital to the hospital system. Why can't they

understand that? It is not just another hospital. It is a hospital of

prime importance in an academic area. It's for doctors and scientists

to be able to diagnose and understand the problems that afflict

mankind. You can get that in a hospital in the middle of a city — of

course you can — but not directly. This government has been committed

to building hospitals almost everywhere in British Columbia. An

expansion of a hospital is taking place in my constituency of Dewdney,

as it's needed.

I want to tell this opposition that they

should be mighty careful about criticizing the hospital system in

British Columbia. Yes, they can nit-pick at it, as they're doing, but

let them be careful when they criticize it, because the people in

British Columbia love the way their hospitals are being operated and

they love the doctors and nurses. Anyone who can stand up and criticize

this ministry has to have something wrong with their mental structure.

want to say very clearly that I decry this and will not be party to any

suggestion that the university hospital is unnecessary. It's a

necessary part of the hospital system. It is necessary to the

development of medical practices in British Columbia. I say to the

minister: Well done! Please continue. Special credit goes to him.

HON. MR. NIELSEN:

In response to the question of the UBC Hospital, I would hope that if

anyone hears the comments which have been expressed in the chamber this

afternoon, they in no way would want to take away from the capacity and

capability of the hospital or its staff. Regardless of its location, it

is truly an outstanding health facility. I'm sure the patients who are

being cared for at that hospital are receiving first-class treatment.

understand that there are now 258 doctors on staff at the university

hospital. The patient load is being increased. The Ministry of Health

has asked the officials at that hospital to assist our requirements to

offer hospital treatment to patients, particularly in areas such as the

emergency facilities. I would agree that when the Vancouver General

Hospital emergency facility is jammed and there are empty spaces at the

university hospital, there should be action taken to see that many of

those cases are handled by the university hospital. But from a facility

point of view, it is certainly offering a high standard of care for

those who are in the hospital. I would not wish anyone to feel that if

their doctor were to place them in the university hospital they would

be receiving less than professional care. I'm sure no member is

suggesting that.

MR. HANSON: It's difficult to convey

to you the sense of frustration and anger that members on this side

feel in entering into the debate of this minister's estimates. British

Columbia is one of the most fortunate areas on earth. We're blessed

with resources and wealth. As I stand here now, I know that there are

almost 2,500 people in my own constituency of Victoria waiting to get

into the hospital. Does that make any sense at all, when a government

has a budget of $6.6 billion dollars with access to other revenues

through appropriate taxation of our natural resources — coal, for

example, Mr. Premier? I don't see the Health minister as being

particularly responsible at this point for this dilemma we face here in

Victoria and in other areas of this province. The responsibility lies

with the Premier of British Columbia, because he set the spending

priorities. Those homemaker cuts, the long waiting lists and the lack

of accommodation in the long-term care area does not rest with any

individual minister. It rests with the Premier of this province. That

is where it lies. I hope that as we continue in this debate, the public

is going to recognize that fact.

As I stated, as I stand

here now there are almost 2,500 people waiting to get into hospitals —

about 1,300 or 1,400 at the Royal Jubilee and about 1,000 to 1,100 at

the Victoria General Hospital. Not all of those are urgent, but a

significant portion of them are. There are people with cardiovascular

illnesses and various physical ailments whose condition, each day,

month or year as they wait, becomes aggravated and gets worse. There

are social, psychological and economic impacts on this crisis situation

we have here in Victoria.

Health care is a non-partisan

issue. It's something that cuts across all barriers. It's not a matter

of being one party or another; it's a matter of meeting the need that

is out there, no matter what government is in power.

Recently there have been editorial columns in the Times-Colonist

saying that our acute-care function in Victoria has disappeared. Here

we are the capital city of our great, rich and blessed province, and we

do not have an acute-care capacity here, because unless you are on the

verge of death you are not going to get in. In March 1981, for the

first time, urgent surgery at the Victoria General Hospital was

cancelled, not just once, but four or five times per day. It is really

incredible. I have other constitutuency-oriented letters I'm going to

read into the record about personal circumstances here. Again, I put

the responsibility where it should lie, with the Premier, in not

setting the priorities of his government's spending properly, and

putting health care near the bottom. I know there are a lot of dollars

being spent, but you are not meeting the need, and it is getting worse

every day.

MR. CHAIRMAN: At this point I should point

out to the committee that during Committee of Supply we are not allowed

the latitude to discuss which minister should represent the government

in respect of estimates under consideration, and I would remind the

committee of that. We are on vote 106, the estimates of the Ministry of

Health, and we debate the administrative action of the minister.

MR. HANSON:

I'm just pointing out to all members that the Premier is the senior

minister. The buck stops with him and the problems stop with him. I'm

indicating to him that we have a very serious problem here in Victoria.

Let me just give you an example of the kind of thing that happens when delay occurs. Not only does the physical

[ Page 6141 ]

ailment,

the disease, the injury, the illness become aggravated and got

worse.... As he leaves, the Premier looks at me, shakes his head and

sneers — complete contempt for the problem. The problems get worse as

time goes on, because there's a psychological effect when people are

hurt, ill or waiting to get into hospital. It wears away at the family

and the person waiting to get surgery. There's also an economic impact.

Let

me read you a letter from a doctor in Victoria. This is not necessarily

a life or death case, but this is a case involving orthodontic surgery

— oral surgery. It's a letter to the Minister of Health, with a copy to

my colleague in Victoria (Mr. Barber) and the member for Oak Bay–Gordon

Head (Hon. Mr. Smith). The letter is to protest the treatment received

by our orthodontic surgery patients. This is from Dr. H.W. McDonald and

Dr. Guy S. Dean, in Oak Bay. They point out to the minister that:

"We spend 14 months to 16 months preparing our patients

for surgery, during which time the thoughts of surgery are uppermost in the

minds of these people. They make extensive arrangements for their family, often

the spouse leaving work and arranging day care. They take leave of absence from

their jobs. Some take annual vacation to look after their family. Then at the

last moment — cancelled. Even an hour before the surgery is scheduled. The psychological

impact is devastating. The economic penalty is severe. We then prepare the patients

a second time, only to have it cancelled again — some as many as three times."

He points out that this is not life or death, but these cancellations have

been going on now for some time. It can’t go on. We have long-term care

patients occupying acute-care beds here in Victoria. At the moment there are

about 150 long-term care patients in the Royal Jubilee and about 75 in the Victoria

General. That's 225 people occupying those beds who want to be somewhere

else, but there is nowhere else to go. With 2,500 people waiting for those

beds and 225 waiting to leave to go to the appropriate kind of care facility,

we have an absolutely no-win situation.

The

cancellations occur every day. Let me tell you about some of the delays

which are occurring here in Victoria. For elective surgery, which I

again point out can mean that a person cannot work but is not

necessarily going to die.... It could be cataracts, cartilage or

hernias. There are various kinds of serious things that could aggravate

it, but there are a multiplicity of impacts that even elective surgery

cases have. If you had to have elective surgery for a cardiovascular

operation, you would wait three months. You may be sitting in your

living room at home wondering if you could have a heart attack or if

something could happen. If it was urgent, there would be a month and a

half's wait. That's urgent heart injury. Ear, nose, throat and oral

surgery — elective, four months' wait; urgent, three-quarters of a

month. General surgery, excluding cancer and open-heart — elective, 14

months to get in; urgent, three months. Gynae-obstetrics — elective,

six months; urgent, two months. Neurology, such as a brain operation —

urgent, two and a half months. Does that sound like I'm making it up,

Mr. Minister? Do you think these figures are made up?

HON. MR. NIELSEN: Did someone suggest they were? Did you make them up? Why do you ask?

MR. HANSON: You're not listening, They're interdepartmental memoranda from the Royal Jubilee Hospital.

HON. MR. NIELSEN: Why do you ask that question?

MR. HANSON: Because you're not paying attention.

HON. MR. NIELSEN: According to whom?

MR. CHAIRMAN: I'll ask the minister not to interrupt, and I'll ask the hon. member to address the Chair.

HON. MR. NIELSEN: He's speaking to me directly, and Fin answering him directly.

MR. HANSON:

Ophthalmology — six months, elective; a quarter of a month for urgent.

Orthopaedic — thirteen months. elective five months, urgent. Urology —

ten months, elective: three months. urgent. The average waiting time,

no matter what the illness is eight and a quarter months. Everybody in

here knows somebody waiting to get into the hospital, or has a family

member who is. Urgent surgery of all types — two and a quarter months;

urgent — that means you're seriously ill. They've cancelled cancer

operations here in Victoria. That's urgent. The government spends the

money on the monuments. This is what I can't understand, you see. I

cannot understand it. I could not be part of a government whose

spending priorities were such. I don't understand it. The money is

poured into the monuments — poured into them: downtown Vancouver....The list is long. Yet at the same time, life or death, non-partisan health care is suffering in British Columbia.

the Capital Regional District, the Victoria working group on bed

utilization did a study in February of this year. They said one of the

most important things to deal with in the area of long-term care and

extended-care problems and people being in acute-care facilities is the

homemaker service. It must be beefed up, and there must be more

homemakers. There must be more hours, stimulation programs, decent

assessment. activation programs, and geriatric planning. And what do we

get? Just before this minister's estimates came up there were cuts in

the home-care program, cuts here in the Capital Regional District of a

third of the hours. I needn't point out to the minister that Victoria

happens to have one of the largest groups of senior citizens in all of

British Columbia, in fact all of Canada. It is a good place to come and

live when you're 60 or 65 years of age. There are many people here. So

it is obvious that you have to have extra geriatric planning; you have

to be concerned about the quality of life for the aging population. We

have to have planning that takes into account the needs of people as

they get older and as we all get older, The age distribution curve is

getting older. People aren't having as many children. The working

population is supporting a larger, older non-working population. This

is a fact d life in the western world, but it has a particular impact

here in Victoria. The needs are greater here; therefore there must be

more planning. Anticipation of those needs means more of the kind of

care that is catering to the specific needs of the aging person.

There

are many people who end up in hospitals who shouldn't be there. I don't

mean that they aren't feeling physically unwell, but I mean that they

are in an acute-care bed, getting medication when perhaps the real loss

is loneliness, lack of stimulation, lack of home-care, lack of a sense

of belonging to a community — things that could be done. It's not good

enough to cut out the preventive end, because those people are going to

end up in hospitals.

[ Page 6142 ]

have the facts and figures on the number of long-term beds that are

coming on line. They aren't enough and they're not coming on line fast

enough. And it's not good enough to point back to 1955 or 1972 or

whenever; the problem is getting worse and growing exponentially.

You've been in government for six years; you've had control of the

budget for six years. Now according to the Capital Regional District

long-term care statistics, in 1981 you're supposed to be bringing on

331 personal and intermediate beds. The current actual need is 70 1.

Where are the extended-care beds coming on in 1981? There aren't any in

that column — none.

Oak Bay Lodge is included in the

previous column: personal and intermediate care — 150 beds. Now that is

an institution which was taken over by the province to increase the

capacity at Oak Bay Lodge from roughly 150 very lavish beds from the

Cook Corporation to about 330 beds when it comes on line. The province

took it over and approved the renovations of the Oak Bay Lodge in

November 1979 and the go-ahead was given to bring on 150 very much

needed longterm care beds. Where are they? It is now June 1981. The

province has the money and the go-ahead to give the money, to

accelerate the contracts and to declare an emergency to bring on 150

new beds as soon as possible. My first question to the minister is:

when is Oak Bay Lodge going to be completed? I have a couple of

questions.

MR. HALL: Mr. Chairman, there is no doubt

that the minister has on his desk three or four major problems in the

province today. Having been a minister once myself, I know that there

is nothing probably quite as problematical as having to deal with those

problems during discussion of estimates. However, perhaps a problem

shared might be a problem halved; on the other hand, I suppose the

minister could possibly think it's a problem doubled — but I'm going to

ask him about a couple of problems and see if we can share some

information.

In my riding we're now facing a community

problem of some magnitude at the Surrey Memorial Hospital. I don't want

to discuss policy — I'm not allowed to discuss policy — during

estimates. What I want to say to the minister is that the situation in

Surrey Memorial Hospital, where the doctors have suggested withdrawal

of their services from all committees as long as the abortion issue is

not solved or handled to their satisfaction, is one which is causing a

great deal of public concern. My phone in my constituency office is

going off the hook. I'm sure that the phones are ringing just as

rapidly in the offices of my colleague the Minister of Municipal

Affairs (Hon. Mr. Vander Zalm). I'm sure that the phones are going both

for the position taken by the hospital board and against it. The

minister has been placed squarely in the middle of this situation and

hasn't walked away from it. He has not ducked or disappeared around the

comer. He's looked at it and come out with a number of statements. The

papers on June 9, 10 and 11 have all covered his statements: "Minister

Gets Tough," "Surrey MDs Force Abortion Issue," "Abortion Foes Warn

Health Minister" — that was as late as this morning — and then a story

in the Province about "losing a moral choice."

The point I wish to make to the minister is the question of the timing. I don't

have all the information the minister has, obviously. According to my reading

of the papers and the information the opposition has, the minister appears to

be waiting until he has a full report from the doctors. I want the minister

to act as expeditiously as he can before this issue is used as a rallying point

again for some mammoth confrontation in going around the two electoral districts

of Delta and Surrey–White Rock and signing members up to meet in some huge auditorium

come September to argue about something that is really not arguable. My position

is very clear. I believe that this is a personal matter between a woman and

her doctor. I'm equally convinced in my own mind that this particular surgical

procedure should never ever be used for birth control methods. There's enough

information around that should prevent that unhappy and stupid use of this surgical

technique. Unfortunately I don't think we all do enough to make sure that

that's known. But I do want to urge the minister to move as expeditiously

as he can to bring this (

a) to a head, or (

b) to a solution, if it's within

his power.

I've

long been of the opinion that goes back some length of time that

hospital boards may have outlived their usefulness. There has to be

another method of administering our public institutions that deliver

health services. Not to say — and I think I share this view with the

minister — that I don't agree with community input; there has to be

some. But I think the whole concept of a hospital board as presently

constructed is no longer meeting the situation.

The next

problem is the one which we've been discussing with the minister at

about 2:15 every day: the provision of in-home health care and the

reduced numbers of in-home healthcare service hours. We can fudge and

use semantics and we can talk numbers and do a number of things, but

the fact of the matter is that in Surrey-White Rock those hours that

are available to the public have been reduced about 21 percent. They

were reduced from 26,000 to 20,500 per month. What also has happened is

that there are no longer any full-time workers in the system. There are

275 part-time homemakers now. They're paid about $5 an hour, all

part-time status and working about four-hour shifts. This means that

many patients who only need two hours are the last people to be seen.

Nobody wants only to get two hours' work. Anybody who's got a four-hour

shift wants a four-hour job, not a two-hour job. There's sort of a

built-in inefficiency.

[Mr. Davidson in the chair.]

my area there's also an increase in pressure to provide care to 1,100

senior citizens in Surrey and White Rock. Mr. Minister, you and I met

just on the borders of White Rock the other day to open up an

extended-care home. White Rock has three times more people who are over

70 years of age than the provincial average. The regional long-term

care coordinator is aware of 300 more elderly residents who are in need

of in-home services today. The administrator, Mr. Greg Boorman, as I

mentioned yesterday, says that the ministry just simply hasn't kept

pace with the increased demand in home service.

That

information has gone out in your district as well as mine. That,

coupled with the following information, gives you the state of mind of

the people in Surrey–White Rock regarding this government's attitude

towards homemaking, because at the same time they're reading and

hearing about the homemaker course which is being cut from Douglas

College. About a million dollars is being cut from the Douglas College

budget, and some 90 courses have been dropped as a result. About a

million dollars is being cut from the Kwantlen course, all to do with

homemaker services.

The public isn't stupid. It'll

eventually get the message as to what's going on. Just as you were told

by Mr. Hayes that this is political suicide, I want to share this

information

[ Page 6143 ]

between

you and me while nobody else is listening. The freezing that you've put

into place doesn't take into account the burgeoning areas of South

Surrey or White Rock. You represent one of those areas which has gone

through this growth period, and now is more stabilized. The level at

which you've flash-frozen that activity doesn't meet the situation in

the burgeoning areas like Surrey and White Rock, where you've only got

to check with your colleague from Oak Bay (Hon. Mr. Smith) about the

school population, the other population and what's going on. It is all

of a piece. All of it shows that you're not getting the input from the

membership in the Social Credit ranks south of the river.

Those issues now on the minister's desk — the Surrey Memorial Hospital, the business with the doctors.... That's

all I'm going to say today about doctors, because it's no-touch-'em at

the moment. It's on your desk, and we'll leave it alone. Those are two

huge problems, plus this growing problem that symbolizes an attitude.

These are the three things which are giving the people south of the

river reason to now believe that this government has no intentions of

providing the services that it's claiming in its public utterances.

It's doing less than is required, but more importantly — and this is

the administrative fault that the minister can apply himself to — even

within the strictures given by the Treasury Board, he's not applying

himself to the levels that have been frozen in those areas that are

growing quickly.

HON. MR. NIELSEN: Mr. Chairman, with

respect to the comments just offered by the second member for Surrey, I

agree with him that there are identifiable areas of the province where

the demands are growing and will continue to grow, whether it be for

senior citizens' geriatric services, or for younger people because of

the growth of other communities. But the rationale — for want of a

better term — with respect to the advice which was distributed to the

homemaker agencies for 1981-1982 with respect to targeting a number of

hours less than now being offered.... As I mentioned the other day, the

homemaker service provided approximately 5,300,000 hours of service

last year. The increase in the budget this year permits 5,300,000 hours

to be maintained throughout the province. The rationale for seeking to

have all agencies try to trim down their hours is to allow the

reallocation of some of these hours to districts and areas which are

going to require an increase in hours. The increase provided in the

budget will pay for the increase in the cost of delivering that

service. The hours will remain about the same. The demand is obviously

going to be higher. Within every service provided, we are attempting to

identify where the number of hours which were contracted for last year

can be reduced to provide us with, in effect, some surplus hours which

can be allocated to where the demand is higher, and also to permit new

people to come into the program.

I regret that so many

people are perhaps unnecessarily, but understandably, concerned that

their service may not be as it was last year. I also regret the manner

in which some of these people associated with delivering the service

have handled it.

The question of the Surrey Memorial

Hospital is going to cause a lot of sleepless nights for a lot of

people, I guess. The member is, I think, correct in that it is not just

Surrey Memorial Hospital or just one board or just a committee; it

involves many, many factors. With respect to the member, a personal

opinion, be it his, mine or anyone else's, is just that — a personal

opinion with respect to abortions. The Criminal Code of Canada sets out

procedures, attitudes and legal information, of course. It is the

Criminal Code of Canada which must be served initially. The Criminal

Code of Canada makes certain requirements which permit therapeutic

abortions to occur in hospitals. The Ministry of Health is caught

somewhere in the middle in all of this.

In his statements

and questions today, the second member for Surrey suggested that

perhaps the time has come to give serious consideration to the

structuring of hospital boards and the manner in which these boards

affect the delivery of medical care in hospitals. I agree. I mentioned

that the other day, and I got some very nasty telephone calls. I guess

that's to be expected.

In the original concept of hospitals,

a group of people, usually from a religious order, got together to

provide care for people who were ill: others contributed to their cause

by donating goods or services. It eventually became more formalized,

and then funding began; very expensive facilities were constructed.

usually funded by the public, through a direct government program. Yet

in many instances you still had a very small society effectively

electing a board which allegedly governed the hospital. I agree that

the time has come for a very close examination of that concept.

very general terms, I would think that it is still useful to have a

board of directors in a hospital. I think the board of directors should

represent a number of facets of society: the local community, of

course; perhaps a region; maybe some provincial input: maybe direct

input from a council, by way of a representative — just as we have it

in other committees; and perhaps continued representation from the

society, which in many instances is very likely the owner of the

facility. So there could be a combination; I think it should be

broad-based within the community, with representation from the

professional side as well. It is a conundrum. It is a very difficult

problem. I agree with those members of the House who have spoken to me

about the problem, and said that we really do not need a major

confrontation at the various hospitals around the province over one

issue. We're seeing what can be done to avoid such things. It's a very

difficult situation.

The second member for Victoria (Mr.

Hanson) commented that matters of health, hospitals and so on should

not be partisan. I certainly share that concept with him. I think the

health of our people should not be political. I think we should all be

very pleased that we can take

part in a system which does provide a

very high level of service.

The second member for Victoria

specifically asked when Oak Bay Lodge will be functioning. I'm advised

the patients will be in by mid-December. The first phase is complete,

and it's ahead of schedule, but I'm advised it will be in the December

range.

I don't really know how you even attempt to answer

some of the comments and questions by the second member for Victoria,

because they fall into that category of almost being impossible to

answer.

In 1974, when the member for New Westminster (Mr.

Cocke) was in this position as Minister of Health, he was advised — not

necessarily directly, but by way of news releases — by Dr. Scott

Wallace, who happened to come up for discussion previously today, that

there were more than 2,000 people in the Victoria area waiting for beds

in the hospitals here. The second member for Victoria said we have

2,500 people waiting. We probably have 2,500 people waiting in the

greater Victoria area. I don't dispute the figure, although we do

receive different figures, but it's a large

[ Page 6144 ]

number

of people. They are waiting for elective surgery, what they refer to as

urgent surgery and other medical or hospital procedures which are

required. I also agree with his comment that it doesn't matter whether

it was in '72, '56 or '55; the problem is now. I agree it is now.

There

are beds coming on stream, there are acute-care facilities being

constructed to replace older facilities and there are intermediate-care

facilities in the works. Obviously we can't build them overnight. They

have to be planned some time ahead. In 1972 — I don't know why people

keep choosing that date — there were 472 extended-care beds in the

capital region and today there are approximately 1,400. It's a

considerable increase. There are more coming on stream, which I believe

the member referred to. Intermediate-care facilities which are under

construction now will assist in resolving some of that problem,

although again it is not precisely related. If we opened 150

extended-care beds tomorrow, that would not necessarily release 150

acute-care beds, because there are people in the system who are waiting

for intermediate-care facilities who are not in an acute-care hospital.

The

Victoria hospital boards and members of the staff of the Ministry of

Health have been meeting for a period of time with respect to some

specific problems identified by the two hospitals, their boards and

other interested people. Usually in the Ministry of Health it seems

that the resolution of many of these identified problems comes back to

funding.

The members of the ministry and members of the

hospitals, regional districts and others have looked at the problems

with respect to the two major Victoria hospitals. They have made

suggestions which are being investigated and which all have a

significant cost factor associated with them. I have communicated to a

number of people in the Victoria area what is being considered at this

time. I understand meetings are still going on, although not

necessarily at this very moment. They've identified three areas which

appear to be part of what they refer to as blocking the acute-care

beds. They've made some recommendations, and they are investigating in

some detail how these programs could be implemented should the funding

be available. They recommend discharge planning activities, special

rehabilitation programs, increased home care, long-term care

allocations, improved assessment of home-care staffing, increased

homemaker service and discharge planning units.

I do not

wish to constantly emphasize that a very large part of the problem is a

matter of funding, but in these instances the hospital people and the

hospital programs people have identified the funding associated with

it. It is considerable and would have to be found within the budget if

these were to be implemented. I trust the second member for Victoria

would appreciate that an attempt is being made, in cooperation with the

major hospitals in the Victoria area, to try to resolve some of these

problems which have been identified. Yes, I agree that in Victoria,

with the population increasing and the average age increasing, we are

faced with a very serious problem of responding to the needs of senior

citizens. It's unique in the Victoria area compared to other parts of

the province. Special attention must be paid to that. We are

responding. As I mentioned the other day, it will never be a perfect

system. There could be a shift in emphasis. Perhaps more must be done

for certain areas of the province identified for the peculiar

difficulties they face.

I think I have perhaps responded to

the second member for Surrey with respect to those two issues. I'm not

sure if there was another matter. I didn't make notes on it. I'm sorry.

MR. LORIMER: Mr. Chairman, I wonder if I could have leave to make an introduction.

Leave granted.

MR. LORIMER:

I would like the House to join me in greeting grade 7 students from

Riverway West School and Suncrest School in South Burnaby. They are

presently in the precinct.

MR. HANSON: I would like

to ask the minister, in light of his response to my comments about the

particular problem in Victoria with the large aged population, our

long-term care situation with the acute-care hospitals and the proposed

cuts in the homemaker service, which is contrary to the report the

minister was just citing a few minutes ago.... I'm not asking for

special treatment for Victoria. I'm asking for a response from his

ministry appropriate to the problem we have here in Victoria. It just

seems insane to cut the homemaker service at the same time that beds

are not available in the extended-care, personal- ntermediate and

long-term care facilities. So would he consider reconsidering the cuts

he's announced for the homemaker service here in Victoria?

Secondly,

would he consider the series of solutions indicated in the Victoria

working group on bed utilization study which has been given to him?

They make a few philosophical statements about allowing patients to

realize their potential — physical, social, emotional and so on — and

to look at broader geriatric planning. They propose meeting broader

needs of the aged. Homemakers are just one, but we need to have

stimulation programs, activation programs and other things that will to

some extent alleviate the problems that we see happening in the

acute-care hospitals. In other words, it's more of a community-based,

home-based system, with assistance, funding and support from the

provincial government. Would he seriously look at that as one of the

multi-pronged attacks on a very serious problem?

HON. MR. NIELSEN:

Yes, indeed we would be most pleased to. I believe that is already

underway. There have been a number of innovative suggestions made with

respect to senior citizens' health in the Victoria area — those who

have not yet been identified as requiring any form of hospitalization

or even home care, but rather those people who have simply reached a

certain age and do require a certain amount of stimulation to retain

the level of health which they have at the present time. I believe that

yes, indeed, that is part of the preventive measure and is part of the

concepts which are being considered by the ministry. Obviously the

Victoria area is going to be treated differently than other areas of

the province because of the population factors.

In the

homemakers area, as I mentioned to the second member for Surrey, the

number of hours which have been allocated will be about the same as

last year — 5.3 million. If we are going to enrich any area with extra

numbers, theoretically therefore we have to get them from some other

areas in the province. We believe that we can pick up a number of hours

from elsewhere and reallocate them. Victoria as well as the White Rock

area, as the second member for Surrey mentioned, would be the type of

area where we anticipate an increased demand.

I might

mention that we are receiving, as we expected, very good cooperation

from those people who represent the two Victoria hospitals with respect

to addressing those par-

[ Page 6145 ]

ticular

problems which were identified. Yes, we would look most

enthusiastically at some of these other aspects of maintaining health

as well as treating health for senior people.

MR. HANSON:

I thank the minister for his acknowledgement of that suggestion. It

would be most welcome if he could carry it out. However, I do not want

to see our community.... The minister made a comment that perhaps we

could get hours from other areas. According to the objective needs of

Victoria, we want support for the objective need as determined by the

population and by the demonstrated need in the community. We want that

need met. We certainly don't want to steal from other areas; that is

not our objective. Our objective is to meet the needs of the senior

citizens here in our community and have adequate homemaker care to

ensure that their health does not deteriorate and that they can get the

activation programs and home support that will shore up their health

and give them many more years of happy life. But we don't want to see

hours coming from other members' constituencies. I think the minister

should perhaps clarify that.

HON. MR. NIELSEN: We

have population shifts in the province, obviously. We certainly have

demographic modifications in the province. The needs are identified. We

can't accurately predict how many hours will be absolutely required in

each hospital district. We are therefore allocating 5.3 million hours

to the province. We are asking all health districts to attempt to

reduce their demand at this time by a certain percentage, which would

provide us with some hours which could be reallocated to health

districts which provide us with information that they need an increase

over the previous year's total hours. It's not really stealing, but I

think it is making best use of what is available.

MS. SANFORD:

I was somewhat concerned to hear the minister indicate just now that

there may be allocations of hours in the home-care program from other

areas to Victoria because of the numbers of senior citizens here. It

seems to me that if a given number of hours are required, as determined

by those people now involved in the home-care service, those hours

should not be cut. We should not be facing a 33 percent cut in the

number of hours made available to the people throughout this province.

In a province as wealthy as British Columbia we should ensure that the

health needs of all of our citizens are met. If those hours have been

determined as being necessary in order to maintain people in their own

homes when they require additional attention and help, then we should

not have a blanket 33 percent cut announced by that minister.

the government wishes to save money, it seems to me they should be

looking at areas other than home-care service to the seniors and the

disabled in our province. I think it's a disgrace. Based only on the

anguish and concern that that announcement has caused for the seniors

of our province, the minister should cancel the statement. He should

indicate to the people: The service will remain as it was; you do not

need to worry about having the number of hours cut back. You do not

need to worry that you may have to become a burden on your family. You

do not need to worry that you may have to get on this list for

intermediate care, which is already too long. We as a government will

ensure that your basic health needs are met. Mr. Chairman, that's not

been the case in this province under this government. I too have

letters from constituents who talk to me about not being able to get

into hospitals because of the fact that they've had to cancel elective

surgery and sometimes urgent surgery. They've got themselves prepared —

both physically and mentally — and then receive a phone call saying:

"Sorry, there are no beds." I know other MLAs have raised this with the

minister, and I am sure that he is only too aware of the fact that we

have this desperate shortage.

[Mr. Mussallem in the chair.]

wanted to point out to the minister, Mr. Chairman — and welcome to the

Chair — that there are other economic costs that are often not

determined or are not easily visible as a result of the shortage of

hospital beds in this province. Dr. Adam Little, who is the chairman of

the Workers' Compensation Board here in British Columbia, was

complaining just last week that he feels that skiers and well-known

athletes who play for teams like the B.C. Lions get preferential

treatment in our hospitals. I really don't know if that's what is

happening; I realize that it's probably an admissions policy of the

hospital itself, more than anything else.

Still, Adam

Little, as the chairman of the Workers' Compensation Board, points out

the difficulties that injured workers have in getting the necessary

treatment they need, because of the hospital bed shortage. He points

out that there are additional costs to the people of British Columbia

through the Workers' Compensation board and through the payments that

are paid by the employers of the province because of the fact that

workers cannot get into hospital when they have been injured and need

treatment. Adam Little says that it's a crime to think that the worker

of the province has to wait in order get treatment. In this particular

article Adam Little says:

"The longer he waits

with an injury like that, the less chance he has of getting into the

workforce effectively. We are just compounding his problem, because we

have not been able to keep up with the needs of the people of British

Columbia for hospital beds. Muscles are wasted by the time the worker

does get a bed, and he or she does not make as good a recovery."

This is the chairman of the Workers' Compensation

Board of British Columbia complaining because this government has

fallen so far behind that we have injured workers in this province who

can't get the attention they need and, as a result, in some cases never

get back into the workforce. Dr. Little continues:

"It has been said that if a man is out of the

workforce for six months, he's only got a 50 percent chance of

returning effectively afterwards. I don't know if that figure is

accurate, but it is a figure that has been used. Certainly there is

some truth in the idea: if you don't Let him back into the workforce

quickly enough, your chances lessen very rapidly as he stays out

longer, and that is a cost we all have to bear later on."

This

government doesn't even understand the economics let alone the

suffering that goes on — which makes this costly to the people of

British Columbia, because they have not been giving hospital-bed

construction the priority that it needs. It's not just the construction

of hospital beds, as we said before. If they provided the proper care

for people, to maintain them in their homes, they would not be

occupying acutecare beds as they now are. Sixteen percent of acute-care

beds in this province are occupied by people who should not even

[ Page 6146 ]

in them. That's where those injured workers should be getting the

attention they need when they're hurt on the job. Dr. Little also says:

"There are additional costs as well: while the worker is waiting for

surgery the WCB pays lost wages." The figures for these lost wages are

really quite staggering: in 1980 the WCB paid out nearly $21 million

for medical aid, which includes hospital stays, by the way, and nearly

$75 million in lost wages. So wage-loss payments are up 80 percent over

those of three years earlier, while medical aid was up 38 percent over

that same period. If we cannot provide a space for an injured worker in

this province to occupy a bed, then I say this government should get

out of the business of being government. The sooner they go to the

polls the better, in my view.

[Mr. Strachan in the chair.]

MR. LORIMER:

I think at the present time there would be no argument that the state

of hospital availability is reasonably acute in all sections of the

province. It won't be resolved in a day or two; it will only be

resolved by very aggressive action by the government to try and remedy

the situation, and it'll be an expensive procedure.

I want

to talk briefly, mainly on the one hospital in Burnaby. As I understand

it there are 350 acute beds in the Burnaby hospital, and of those there

are some 80 beds occupied by long-term care patients. The long-term

care hospital itself is filled to capacity, and 80 beds are being used

in the acute-care hospital for the overflow. I know this isn't unusual.

This is probably happening in most of the hospitals in this province

today, but it is something I think the minister should be looking at.

It seems to me that the answer is probably twofold: additions to the

long-term care facilities and the homemaker services, which have, in my

opinion, been very successful.

Of the many problems I

receive in my constituency office I would guess the ones dealing with

getting people into longterm care accommodation probably top the list

of all individual complaints: trying to find beds for some of the older

people who need special care.

I want to mention one or two

things about the long-term general hospital in Burnaby. I mentioned

this last year. A number of the people in there are mentally very alert

and so on, but due to their condition they are confined to bed, and

their only entertainment is watching TV. In the Burnaby long-term care

hospital they don't have adequate receiving equipment to bring in

anything but a snowy picture. The minister may well say that it's a

problem for the hospital board. The hospital board says it a problem of

budget. But it would seem to me to be a very small item, cost-wise, to

provide these people with facilities for TV.

The other

point I would like to mention is the problem in that hospital with some

of those people who are mentally ill as well as being elderly. In some

cases there is a great amount of noise and screaming and yelling

through the day and night that affects those who are mentally alert. It

would seem feasible or possible that if there are no other facilities

for these people, some type of segregation could take place so that

they do not interfere with the enjoyment of life by those who are still

able to enjoy it.

The other matter I would like to bring up

concerns the waste of the capital assets of the hospital. Every weekend

there is a big shuffle of beds. Wards are closed down for the weekend

and beds are moved in. I appreciate it may be a problem of getting

enough staff. If that's the problem, it would seem to me a possibility

that nurses and other assistants might be hired on a part-time basis

with shorter hours. Many people don't want to work eight hours a day as

a nurse or nurse's aide, or whatever. Many people might be tempted to

do their work on a three- or four-hour schedule, or so many hours a

week. That might alleviate this problem. At the present time, we're not

getting our full use out of the hospital, and I think that's another

question that the minister might want to look into.

HON. MR. NIELSEN:

Mr. Chairman, just with respect to that last comment, people

responsible for hospital programs are very concerned, and have been

trying to come up with some answers with respect to that aspect of

wards being closed for weekends, or the lack of operations on weekends.

I am advised by some who have been around for years that it was very

common for operating theatres to be functioning on Saturdays. To a

large degree it is a staffing problem. There is a very real problem

with respect to registered nurses in British Columbia. The association

representing the nurses, and representatives within the ministry, along

with other people in health care delivery, are seriously studying the

problems associated with retaining nursing staffs in hospitals. The

turnover is alarmingly high. The number of nurses who are training and

then not practising is also an alarming situation. There have been many

reasons put forward by nurses themselves, their association and other

professionals. I certainly agree.... The member referred to it as waste

of capital assets. I think that covers the area. It's a matter of

utilizing the tremendous assets we have.

Many thoughts have

been suggested, and a lot of plans are underway to try to better

utilize the facilities we have. It would assist to some degree, but not

completely, in reducing those waiting lists, because you would be

utilizing one seventh more time, if you like, each week. But it is a

problem of staffing and people's habits. It sounds trivial, perhaps,

but sometimes it's a matter of someone simply not wishing to give up

the weekend or even have the surgery performed on a weekend during the

summer, or during other periods of the year. That adds to our

difficulties as well. I'll get the name of that hospital from you, if

it is the Burnaby long-term care or if it has another name, because

what you mentioned sounds very trivial and should be resolved. It

sounds like an engineering question more than anything else.

MS. BROWN:

Mr. Chairman, what I would like to talk about is not just the shortage

but almost the absence of hospital facilities for juveniles and

adolescents. The minister in his opening remarks mentioned the fact

that The Maples in Burnaby was going to be extended. I know that there

is a plan afoot to open five bed units in various parts of the

province, which adds up to a maximum of 20 beds, partially funded

though the Ministries of Health and Human Resources. They will be for

kids with special problems, who need special care. But I don't think

that even that is going to begin to meet the needs of the adolescent

population who really need very special kinds of facilities.

you may know, there was a case recently — and it wasn't the first one —

where the courts had to arrange for a Vancouver youth to be placed in a

special psychiatric facility, a centre for emotionally disturbed

children in Calgary, Alberta. In making that order, the court made it

absolutely clear that the decision was made because there are no

facilities for

[ Page 6147 ]

such

people in British Columbia. I'm not even convinced that when the

additional beds at The Maples come on stream and the five short-term

bed units around the province come on stream, we're still going to be

able to meet the needs of this particular

section of the community.

What we're doing at the present time is spending something.... I think

it says that the city of Vancouver had already spent over $50,000 to

place one youth at the Calgary centre for a year and a half, because

there was no facility here that that child could use. The government is

paying something in the vicinity of $3,000 a month to that particular

centre for emotionally disturbed children.

What I would like

to suggest to the Minister of Health is that the planned expansion is

inadequate. It's going to be insufficient even before it's ready. By

the time it's ready, it certainly still is not going to be meeting the

needs of this particular group of people in the community. The result

of that is that we're going to continue to have young people being

placed in Riverview or in various areas in Essondale, whether it be

Eastlawn, Westlawn or any of the other facilities where a child can be

fitted in. That is not a good environment for a young person to be

placed in, certainly not an emotionally disturbed child. Every time a

because that's what it takes — they've always done it reluctantly and

have never hesitated to state that they were doing this because there

was no other facility available for this particular young person. There

has to be a more serious commitment on the part of the government to

developing both in-patient and outpatient facilities for adolescents

who are emotionally disturbed.

Another thing that I'm not

quite sure of is why it is that these kids end up being the

responsibility of Human Resources, when they're very clearly dealing

with a health problem — emotionally disturbed children. Because they

are the wards of the superintendent of child welfare, we find that

Human Resources gets left having to take responsibility for them. That

is very clearly a health problem. I think the Ministry of Health should

be wresting that responsibility away from Human Resources and

addressing itself to it more seriously. We really need a much greater

commitment, as I said, of both in-patient and out-patient facilities

for emotionally disturbed adolescents.

What's happening at

The Maples? Can the minister explain to us what's really going on

there? We keep hearing conflicting statements about why all the

psychiatrists have resigned and that there's some kind of internal

struggle going on. While this is happening, what is happening to the

adolescents who are in that particular facility? Are they still getting

the same level of care while the staff are having their problems, or is

it deteriorating? Heaven knows, it's bad enough to have inadequate

facilities, but to have the staff going too....

The other

area that I wanted to touch on very briefly is to follow up on my

colleague for Burnaby-Willingdon (Mr. Lorimer) or the plight of

seniors. A number of seniors live in all of the Burnaby constituencies

because there is a lot of housing developed in those constituencies for

seniors. A large number of those people would rather remain at home and

are dependent on the facilities of homemakers. A lot of them are on the

home-care program. Since the decision was made to cut back on that

service, my own constituency has been deluged with calls from

individuals — not from homemakers and not from the homemakers

association, but from seniors living in the Edmonds House, the Vista

residence, the Hall Towers and some in the Doug Drummond. Those are the

three major ones in the Burnaby-Edmonds constituency. They all say the

decision to cut back on the services of their homemaker is going to

create a hardship for them.

I just want to cite one or two

cases, and in particular one person in Hall Towers who just had an

operation for phlebitis in one of her leas and has to go for therapy

but, of course, has to be helped across the street. She doesn't go very

far. She lives on one side of Kingsway and she has to go for her

therapy on the other side of Kingsway. If you've ever tried to cross

Kingsway when both your legs are working properly, you can imagine what

it's like trying to cross it when you've just come from having an

operation for phlebitis in one leg. One of the jobs her homemaker used

to do was to take her to her therapist and back. That was a very slow

process. Including the time the homemaker stayed with her and then took

her back, it took a couple of hours. In addition, the homemaker used to

do her shopping, plus helped generally around her suite. With her

services being cut in half, the decision is made that the homemaker can

no longer take her for her therapy. She cannot 2o for her therapy by

herself. She has no family or relatives to take her for her therapy.

The decision to cut back on that is going to mean that she's not going

to be able to go for her therapy. That means that it's going to take a

longer time for her leg to heal. She's going to need homemaker services

longer in the long run than if she had been able to keep her homemaker

for the present four hours a week she has her.

There is

another case in one of the other buildings where a man of 60 had a

heart attack three years ago. He's still having problems with his heart

and is unable to work. His wife, who is 58, has arthritis throughout

her body — spine, legs and ankles. Both of them have been on home care

and have had a homemaker for the last three years. At first they had a

homemaker twice a week for four hours. Then that was cut to once a week

for four hours. Now they've been told that they're going to be cut to

three hours every two weeks. Neither of these people are able to take

care of themselves, to keep their apartment clean. to get their

shopping done and generally do the kinds of things a homemaker used to

do for them. When I recently spoke to the wife on the phone, her

concern was that without a homemaker her husband was going to have to

be admitted to an extended-care or intermediate-care facility. and the

family was going to be broken up. She could not physically administer

to him in the way the homemaker could. So, again, we're finding that

this decision to cut back their homemaker from. first of all, four

hours twice a week to four hours once a week and now to three hours

every two weeks is going to have quite an impact on this particular

couple.

There is an 86-year-old woman on the 19th floor of

Hall Towers. Her doctor's instruction is that she needs a full four

hours of homemaker service. She has just been told that instead of

having four hours once a week, she is going to end up with two hours

once every two weeks. What is she supposed to do? The end result of

that, of course, is going to be that because she will be unable to take

care of her own needs while living in Hall Towers, she's going to end

up needing an intermediate-care or extended-care bed. There is not

going to be any saving to the government in the long run. In the long

run it's going to be more expensive.

I could go on. There's another couple I heard from in Richmond. I think this couple actually got in touch with the

[ Page 6148 ]

minister,

because they were so concerned. Again, we have a case where both

members of the couple are disabled and need homemaker service — so much

so that they were getting something in the vicinity of 40 hours a month

in homemaker service. They're now being told that they're going to be

cut down to 12 hours a month. There's another 76-year-old woman in

Salish Court who is going to have her homemaker cut from twice a week

to once every two weeks.

I don't think the minister

recognizes, when he says that now the families are being called upon to

deliver these services, that we're talking about people who are alone.

We're talking about widows and widowers who, to a large extent, have no

families to discharge these responsibilities for them. They wouldn't

have asked for the homemaker service in the first place. Most of them

are utilizing the services of a homemaker so they don't have to go into

either an intermediate-care or extended-care hospital. In the long run,

it is better for them emotionally as well as physically. It is less

expensive, in terms of the cost to the government, that these people

should remain at home and be a part of the home-care program.

don't know whether it's possible at this time for the minister to

re-think the decision about lopping off some of the budget of the

home-care program, but I certainly think we have a responsibility to

bring to his attention the fact that that decision is going to create a

hardship on people who can't defend themselves. There is absolutely

nothing that this 75-year-old woman, who's just had her operation for

her phlebitis, or the 92-year-old woman, or the 86-year-old woman can

do, other than ask their MLA to bring to the attention of the minister

that the homemaker discharges a vital service for them, and that to cut

short those hours of service is going to be a real hardship on them and

may result in their having to move out of their present homes and into

a hospital setting — and that is not what they want to do.

HON. MR. NIELSEN:

Mr. Chairman, with respect to the problems of adolescents who require

usually psychiatric treatment, and in many instances some form of

facility which is secure, I appreciate, as I mentioned earlier today in

a more general way, that the facilities which are provided under the

Ministry of Health — be they acute-care hospitals, intermediate or any

level of care — quite frequently by the time they come on stream have

covered off what was identified as a deficit and now we're into a new

era.

The member was correct in that we are adding to The

Maples to provide 26 beds in what they refer to as a secure setting. I

think the case referred to by the member was responded to by members

within the provincial government after there was pressure from the

judiciary with respect to remanding mentally disturbed children and

adolescents into custody. Because of the lack of secure facilities the

Ministry of Health people, upon a fair amount of research, made

arrangements with the Life Centred Learning Hospice — I believe it is

in Calgary — to make use of some of their facilities while The Maples

was under construction. They have the provision of interim residential

accommodation up to ten beds, pending completion of the unit at The

Maples.

The member also asked about what is going on at The

Maples with regard to the internal arguments that are underway between

psychiatrists and administrators or psychiatrists and the Ministry of

Health. We have a number of psychiatrists who assist in the program of

treating these youngsters at The Maples. I believe they are referred to

as session professionals and are paid on a sessional basis. There has

been a reorganization of the facility because of this new added feature

which will be part of it. I gather that those professionals who offer

their services felt that the administrator of The Maples — the overall

complex — should be a psychiatrist.

The position put forward

by the ministry — I've got a paper on it here somewhere — is that there

is need for an administrator of the overall facility, with a

psychiatrist to be in charge of the medical aspect. There is a name

given to that position; it will come to me in a moment, or someone will

get it for me. He would be responsible for the programs from a medical

point of view. We asked Dr. Ransford and others within the ministry to

please sit down and talk with these people and find out what the

disagreement is, because it is the level of care for the youngsters

that is the primary concern.

I understand that the level of

service is still being maintained. I know that they have a meeting next

week to see if their difference of opinion is legitimate, whether it's

misinterpretation or people identifying certain positions by the wrong

names, or whatever it may be. I think it is stabilized for the time

being. There seems to be less of an aura of alarm than there was.

Possibly part of the reason is that the communication was not

functioning as it should have been. We did respond to their concerns

when they were brought to our attention, and the meetings have been

underway. At the moment there is no alarm with respect to the services

being offered to the children there. In addition a 10-bed adolescent

psychiatric unit has been approved at Vancouver General Hospital, which

may alleviate some of the peripheral problem. The question of treating

these youngsters is alarming in the community.

I had a

youngster in my office last weekend who is in need of very specific

treatment. He may be one of a very small number of children who need

the specific treatment he requires. One of the ministries is attempting

to provide suitable treatment for the youngster. The mother has offered

all she believes she can possibly offer to maintain this child at home.

She still wishes to retain the child at home, but the realities of the

situation are very severe, and the mother came to me when I think she

decided and understood that there has to be some assistance, some

facility or some program to assist her in simply maintaining that child

before the effect upon the family is such that the decision would be to

place the child in an institution or some permanent situation, which

she wants to avoid.

The policy of the Ministry of Health is

not to incarcerate these children in institutions such as Riverview.

There was a celebrated case not long ago where a 14-year-old was

treated at Riverview: again, an extremely difficult individual case.

And there is the story of a 16-year-old, I believe, who also had been

treated at Riverview. I trust the Maples addition will at least assist.

It may not resolve the problem completely, but it will assist. It will

provide us with some units to respond to the needs of some of these

children.

The programs which are now being offered by the

provincial government with respect to disturbed children and

adolescents, and perhaps those who are suffering from mental

disturbance at a much younger age, are being responded to by various

sections of the provincial government better than was previously done,

and I hope they will be handled even better in the future. It's a

learning process that even the professionals have recently awakened to.

There are youngsters who, for want of a better description, are

identified as being mentally disturbed. What their specific problem may

be would be up to

[ Page 6149 ]

psychiatrist, psychologist or another medical person to determine, but

for want of a better term they are generally regarded as mentally

disturbed. Many professionals in the field of medicine, even those who

specialize in psychiatry and pediatrics, and others, have spoken to me

in an informal way and have advised me that their professional

attitudes with respect to these problems associated with youngsters

have undergone a tremendous change over the period of time they have

been practising. I was speaking with a pediatrician a couple of weeks

ago who told me in conversation that five years ago while he was

practising he recommended that Down's syndrome children be

institutionalized at birth. He said today his attitude is completely

the opposite. So the attitudes are changing. The demands are also

changing, and therefore the solutions to the problems or the programs

must change.

The member asked why these programs dealing

with adolescent children and others — I guess even the younger children

— are under Human Resources. I ask the same question. I agree it is a

health problem. Aspects with respect to the legal custody of the child

which on occasion come into play may be the reason it's been with Human

Resources. Perhaps it was when, going back some years, the ministry was

known as Health and Welfare and eventually was split, with some

programs remaining with Health and some remaining with what was

referred to as Welfare at that time. I agree with the member that this

problem is basically a health problem, and I would certainly not object

if all these programs.... In fact, I would request that all programs

associated with these youngsters be transferred to Health, and I hope

to see that accomplished one day.

MS. BROWN: I was

really pleased to hear the minister's last comment about transferring

health problems to the care of Health, and out from under the

responsibility of Human Resources. I would suggest that it's quite

possible there was a time when people really did believe that most of

these problems which the young people present were in fact not health

problems, and that's the original reason why they were placed under

Human Resources. Why is Human Resources responsible for autistic

children? It doesn't make any sense to me either — certainly not in

terms of these particular kids.

Since the minister said he

recognizes that, even as you plan facilities, they become obsolete by

the time they actually come into existence, I hope that means there are

plans for extending in-patient and out-patient facilities even further

for adolescents and juveniles in British Columbia, because 36 beds for

the population is not adequate. Twenty-six beds were added to The

Maples and ten to VGH. I know that the Ministry of Human Resources

mentioned these five-bed pods which would be developing around the

province on a short-term basis for severely emotionally disturbed

children. That is not enough. I was hoping the minister would have said

that in fact there are plans on the drawing-board to get on with

expanding those facilities even further.

Since we are

talking about adolescents, I want to point out a couple of areas where

we really have failed in terms of meeting the needs of these children.

As far as we have been able to discern, there is no comprehensive

program to respond to the needs of sexually abused children. That is

another area which the Ministry of Human Resources is trying to address

itself to with its Zenith line, where it's possible for the children

themselves or a relative or neighbour to phone in and say that this is

a child that has problems. Really. after that, the social worker moves

in and starts counselling and hoping for the best, working things out

in terms of the emotional and psychological needs. We actually find

that a lot of the kids who later have serious emotional disturbances

have a history of sexual abuse as children. There is no comprehensive

program to deal with that. I know that the minister sits on the

interministerial committee of cabinet that deals with children. I'm

wondering whether they have started to help Human Resources and

Education to put together any kind of integrated program to address

itself to this.

The other area I would like to mention in

terms of adolescents is the lack of preventive programs on alcohol and

drug abuse. As a member of the interministerial committee on services

to children, the minister is part of putting together an integrated

program. In fact, the emotional disturbance of an adolescent is very

rarely the result of any one thing, and it can very rarely be dealt

with by any one ministry. So the interministerial committee really has

to come up with integrated programs that call on all of these other

ministries, and look at the child as a whole, rather than in sections —

not just look at the education as isolated, etc. I'm wondering if the

minister can tell me whether in fact there is any such program for

alcohol and drug abuse. I recognize that all of the information we're

getting now is that it's alcohol abuse that's on the increase, as

opposed to hard-drug abuse. Certainly I think it's very rare at the

graduation time of year that there isn't a tragic tale tied to alcohol

abuse to tell about some accident involving adolescents. It is a major

concern certainly to teachers as well as parents, and it should be to

the health community as well. I'm wondering whether the minister has

looked at that.

Again dealing specifically with adolescents,

the other area has to do with this business of the needs of teenagers

who become pregnant. That's another program that has to be integrated.

As the minister probably knows, there is a question about the Ministry

of Human Resources funding daycare facilities attached to certain

target schools in the community, which would make it possible for these

teenagers to care for their children while attending school, rather

than what is happening now — that is most of the teenagers who keep

their babies drop out of school and never complete it. But what I

specifically want to talk to the minister about in this regard has to

do with diet and nutrition and that kind of counselling.

Dr.

Tonkin, the assistant professor in the faculty of medicine at UBC, who,

I know, is very familiar to the minister, has just issued a report,

"Child Health Profile: Birth Events and Infant Outcome," and I know

that he sent a copy of this report to the minister, even though it has

not yet been officially released. Certainly some of the statistics that

show up in the report would seem to indicate that this is an area that

calls for some serious attention on the part of the ministry. Now the

report, Mr. Chairman, indicates that pregnancies in the group of

children of the age of 15 and less is really.... Although it has

increased, he doesn't think it's alarming. He believes it involves

something in the vicinity of 200 teenagers a year But that's a lot of

people. I think 200 teenagers are sufficient teenagers that a program

should be developed to address their needs.

What he has also

pointed out is that among this particular early adolescent group there

is a