1974 Legislative Session: 4th Session, 30th Parliament

HANSARD

The following electronic version is for informational purposes

only.

The printed version remains the official version.

Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

MONDAY, MARCH 25, 1974

Afternoon Sitting

[ Page

1573 ]

CONTENTS

Routine proceedings

Pacific North Coast Co-operative Loan Amendment Act,

(Bill 86). Hon. Mr. Lauk.

Introduction and first reading — 1573

Oral Questions

Police protection for cabinet Ministers. Mr. Chabot —

Issuing of policies to ICBC policy-holders. Mr. Smith — 1573

ICBC body shop surcharge. Mr. D.A. Anderson — 1574

Labour Relations Board: interference allegation. Mr. Wallace — 1574

Pollution problem at Surnmerland trout hatchery. Mr. Bennett — 1575

Mines Minister's Bill 31 comments in Kamloops. Mr. Gibson — 1575

Government-operated ICBC auto body shops. Mr. Curtis — 1575

Point of order

Accuracy of Hansard transcript. Mr. McGeer — 1576

Mr. Speaker — 1576

Routine proceedings

Committee of Supply: Department of Health estimates On vote 75.

Hon. Mr. Cocke — 1577

Mr. McClelland — 1579

Mr. McGeer — 1590

Mr. Wallace — 1594

Hon. Mr. Cocke — 1600

MONDAY, MARCH 25, 1974

The House met at 2 p.m.

Prayers.

MR. D.E. LEWIS (Shuswap): Mr. Speaker, seated in the

Members' gallery today are three visitors from the beautiful

Shuswap country: Alderman Bianco, Dr. Harle, and Mr. Dawedow.

I'd like the House to welcome them.

MR. J.R. CHABOT (Columbia River): Mr. Speaker, in the

gallery today we have a group of 32 students from the Columbia

Valley School in Parson, B.C. It's the first contingent of

students to come from my constituency in the 11 years that I

know of — probably the first contingent ever to come from my

constituency to see this House in action.

They also have a teacher with them, Mr. Orlando Pecora. I'm

sure the Premier knows him as well, and I'd like the assembly

to bid him welcome to the assembly.

MR. D.E. SMITH (North Peace River): At three o'clock this

afternoon a group of inspired young hockey players from Fort

St. John will be in the gallery. They are members of the Ross

H. McLean pee-wee hockey team, and they've won the right to

represent northern B.C. at the provincial finals to be held at

Port Alberni this week. I wish them well and I know the House

will join me in that wish as they go to Port Alberni to uphold

the laurels of the north in a pee-wee provincial

tournament.

HON. E. HALL (Provincial Secretary): Mr. Speaker, on April

17 of last year — and by reference I can name order-in-council

No. 1268 of that year — we appointed Dr. Eric Broom as a

consultant to the Provincial Secretary and Minister of Travel

Industry to conduct a study and do an evaluation of all

available services for recreation, physical fitness and amateur

sports and to report and recommend to the government policies

and procedures designed to provide services for the enrichment

of leisure for all citizens of British Columbia.

Mr. Speaker, seated on the floor of the chamber today is Dr.

Broom. I want to welcome him to the chamber and ask the Members

to applaud him because I will ask for permission shortly to

table his report. I think that everybody in the House will

welcome this document which tells us where we are as of today,

and what can be done to look after some of these important

proceedings under the heading of "Leisure Services." I welcome

Dr. Broom.

Introduction of bills.

PACIFIC NORTH COAST NATIVE

CO-OPERATIVE LOAN

Hon. Mr. Lauk presents a message from His Honour the Lieutenant-Governor: a bill intituled Pacific North Coast Native

Co-operative Loan Amendment Act, 1974.

Bill 86 introduced, read a first time and ordered to be

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

sitting of the House after today.

HON. MR. HALL: Mr. Speaker, I ask leave to table the report

on Leisure Services in British Columbia.

Leave granted.

Oral questions.

POLICE PROTECTION

FOR CABINET MINISTERS

MR. CHABOT: A question to the Premier. Have any cabinet

Ministers been provided with police protection in recent

months?

HON. D. BARRETT (Premier): Not to my knowledge.

ISSUING OF POLICIES

TO ICBC POLICY-HOLDERS

MR. D.E. SMITH (North Peace River): A question to the Hon.

Minister of Transport and Communications. Would the Minister

inform the House when ICBC will be issuing, or will they be

issuing, individual policies to the people in British Columbia

that have insured their cars through ICBC?

HON. R.M. STRACHAN (Minister of Transport and Communications): It is

my opinion that individual policies in the old style are not required.

MR. SMITH: A supplemental question to the Minister, Mr.

Speaker. Is this an opinion supported by legal fact? What

opinion have you had from the Attorney-General, or anyone

learned in law, that would support that opinion, particularly

if he gets involved in a very dicey situation with respect to

liability?

MR. SPEAKER: I would point out to the Hon. Members that it

is asking a solution of a legal proposition; and certainly it

was a legal proposition that was put to the House....

Interjection.

[ Page

1574 ]

MR. SMITH: Mr. Speaker, it's a matter that's being brought

up continually by the people who are insured by ICBC and do not

have in their possession any contract to show them the terms of

the coverage.

MR. SPEAKER: Well, it's obviously a legal proposition, but

if the Minister has some statement which he wishes to make....

HON. MR. STRACHAN: I thank the Hon. Member for raising the

question. I would like to remind the Hon. Member that if he

reads the legislation, reads the regulations, there is a

covenant between the Insurance Corporation of British Columbia,

backed by the Government of British Columbia, and the holder of

the individual registration and policy. It's right there.

If the Member will bring me one case where any individual

has a legal problem in making his claim, then I'll certainly

re-examine the whole situation. But until some cases come to me

where there is a legal problem, then I think we're just

threshing straw.

MR. SPEAKER: I would point out to the Hon. Member that it's

been now canvassed at least twice in this House as well as when

the bill was originally introduced. Consequently, it really

isn't proper during oral questions.

MR. SMITH: I don't want to prolong the debate on this

particular matter, Mr. Speaker, but it would seem to me that we

will have these problems come up, although we may not have had

them yet, fortunately. There should now be an amended auto form

available to everyone who has a policy in force in British

Columbia.

MR. SPEAKER: That is for the purpose of debate and it's

certainly not proper in question period.

ICBC BODY SHOP SURCHARGE

MR. D.A. ANDERSON (Victoria): Mr. Speaker, may I repeat a

question I've asked a number of times before — but never yet

received a reply on — to the Minister of Transport and

Communications? What steps is the government taking to

terminate the practice of automobile repair shops charging a

surcharge for repairs done under ICBC policies?

HON. MR. STRACHAN: Well, we've had somebody from ICBC visiting those

few areas where this practice has either been suggested or is in operation,

talking to the individuals concerned and having meetings with them. I'm having

a full report later this afternoon, I expect, from the manager of the corporation.

You can't visit every place at once, and it was the top man who visited the

individual areas. I expect the report later in the afternoon — 3...4...5...6...7...8.... (Laughter.)

MR. D.A. ANDERSON: Supplementary, Mr. Speaker. I appreciate

the Minister's concern on this, but could he please inform us

whether or not it will be possible for those Members of the

public insured by ICBC, who have been charged surcharges in the

last few weeks, to receive some sort of rebate or return on

their money from ICBC for those charges? The problem is that

they feel they're insured by ICBC and they find that their

insurance doesn't apparently cover them.

HON. MR. STRACHAN: I can't give you that assurance at this

time.

LABOUR RELATIONS BOARD:

INTERFERENCE ALLEGATION

MR. G.S. WALLACE (Oak Bay): Mr. Speaker, could I ask the

Minister of Labour whether he intends to investigate some very

serious allegations against the Labour Relations Board? I'm

referring to the certification votes involving the United Steel

Workers of America, the Canadian Association of Industrial,

Mechanical and Allied Workers at Trail and at Annacis

Island.

I understand there has been a serious charge made that the

Labour Relations Board participated in trying to influence a

vote that was taken by the Canadian Association of Industrial,

Mechanical and Allied Workers seeking certification at the

plant called Noranda Metal Industries Limited on Annacis

Island.

HON. W.S. KING (Minister of Labour): Mr. Speaker, I am not

familiar with the report. The Member mentioned Trail and then

mentioned another plant. I'm not familiar with any charge

against the Labour Relations Board.

It is the board's function, however, to investigate any

application for certification that is filed before them. They

customarily investigate by use of a departmental industrial

relations officer, and on the basis of the advice which they

receive from that officer they determine whether or not a vote

should be held. If that's the charge, why I would say that that

is customary practice and within the adjudicative process of

the board. But I'm not familiar with the specific

article you

refer to.

MR. WALLACE: A supplemental question. Perhaps I could

correct the Minister's impression. I think we are talking about

two different things. The allegation has been made by the

regional vice-president of the Canadian Association of

Industrial, Mechanical and Allied Workers that

[ Page 1575 ]

information regarding a vote which had been taken at Cominco

regarding the International Steel Workers was released ahead of

time of this other vote, and that this information was damaging

to the union workers on Annacis Island where the other union's

certification vote was being taken.

The Minister may smile, but we agreed in debate that the

sanctity or the purity of the Labour Relations Board is going

to be the key to the whole new Labour Code. I'm wondering if

the Minister will look into what is a very serious

allegation.

HON. MR. KING: Well, Mr. Speaker, as far as the release of

information involved in any adjudication before the board, it's

actually imperative that the board release that information as

soon as possible. Indeed, that was one of the reasons for the

establishment of a full-time Labour Relations Board: so that

they might be able to adjudicate applications more quickly and,

similarly, that they would release information on the reasons

for their judgment.

Now to suggest that they should withhold those reasons for

judgment simply as a device for interfering or influencing a

vote in some other part of the province is, to me,

irresponsible. So it's important that they deal with the case

before them and not be influenced in that adjudication by any

action that might be going on anywhere else in the

province.

POLLUTION PROBLEM AT

SUMMERLAND TROUT HATCHERY

MR. W.R. BENNETT (Leader of the Opposition): To the Minister

of Recreation and Conservation. I wonder if the Minister could

advise if he's taken any action to solve the pollution problem

at the fish and game trout hatchery at Summerland.

HON. J. RADFORD (Minister of Recreation and Conservation):

Some action has been taken.

MR. BENNETT: Could the Minister, Mr. Speaker, advise what

action has been taken and whether meetings have occurred

between Mr. Ben Marr of Pollution Control Board and Mr. Sparrow

of the Department of Fisheries?

HON. MR. RADFORD: Yes. A pipe was put out 200 feet into the

lake to get rid of any of the effluent that had been apparent

before. This hatchery, of course, has been in operation for 40

years. It was recommended by the Pollution Control Branch some

five years ago to look into it and our government has done

this.

MR. BENNETT: Supplemental. The problem, Mr. Speaker, that

the municipality of Summerland has brought up is that they

believe that putting a pipe 200 feet out into the lake is just putting the problem 200

feet away so it can't be seen. That's the problem that's under

discussion now from one of the municipalities, and that's the

question I asked about.

MR. SPEAKER: Now you're becoming somewhat argumentative.

HON. MR. RADFORD: That was the recommendation from the

consultant that was hired, and I think that has taken place.

The pipe has been put out into the lake; that has been the

recommendation.

MINES MINISTER'S BILL 31

COMMENTS IN KAMLOOPS

MR. G.F. GIBSON (North Vancouver–Capilano): A question, Mr.

Speaker, for the Minister of Mines. In view of the fact that he

assured this House twice that he could not attend meetings of

the B.C. and Yukon Chamber of Mines to discuss Bill 31 publicly

before second reading because it would be a breach of

privileges of this House, I wonder how he squares that with his

attendance and public comment on Bill 31 at a meeting this

weekend in Kamloops.

SOME HON. MEMBERS: Oh, oh!

AN HON. MEMBER: When it's a breach, it's a breach, it's a

breach.

HON. L.T. NIMSICK (Minister of Mines): At the meeting in

Kamloops I only referred to the basics of the bill and I did

not go into detail.

MR. GIBSON: On a supplementary then, Mr. Speaker. Would the

Minister do as much for a planned meeting at Kamloops this

Thursday night held by the chamber of commerce?

HON. MR. NIMSICK: That will be my decision to make, because

the House will be sitting then, and I do try and attend the

House sittings.

GOVERNMENT-OPERATED

ICBC AUTO BODY SHOPS

MR. H.A. CURTIS (Saanich and the Islands): Mr. Speaker, to

the Minister of Transport and Communications. Are there plans

to establish a government-operated or government-sponsored

automobile body repair shop somewhere in the province?

HON. MR. STRACHAN: No doubt the Member's referring to this

morning's paper where Mr. Kinnaird announced that this was

being done.

[ Page 1576 ]

MR. SPEAKER: Would the Hon. Member deal with his own

responsibility, not Mr. Kinnaird's, please?

HON. MR. STRACHAN: Oh, I realize it's not Mr. Kinnaird's. I

just wanted to draw attention to the fact that this is why the

Member asked the question. It was based on this report.

MR. CURTIS: That's your assumption. Answer the question.

HON. MR. STRACHAN: I certainly intend to answer the

question.

Interjections.

MR. SPEAKER: Order, please!

HON. MR. STRACHAN: As soon as they're quiet, Mr. Speaker, as

soon as they're quiet. Now it's only Monday. Keep your good

humour for at least half an hour.

Not necessarily in Nanaimo, not necessarily....

MR. CURTIS: Mr. Speaker, a point of order. I have made no

reference whatever to any newspaper story or news story. I've

asked the Minister a straightforward question. With respect, I

did not mention Nanaimo. I asked if there was a plan to open a

shop in the province — yes or no?

Interjections.

HON. MR. STRACHAN: Okay, Mr. Contriver.

MR. SPEAKER: Order, please! Would the Hon. Minister either

answer or take...?

Interjections.

HON. MR. STRACHAN: Yes, I'm waiting for quiet; I'm waiting

for quiet.

MR. WALLACE: You'll wait a long time in this House for

that.

Interjections.

MR. SPEAKER: If the Hon. Members would keep order it would

certainly expedite the House.

HON. MR. STRACHAN: That's right. Not necessarily

immediately, but certainly.... (Laughter.) He doesn't want an

answer. Okay, let me finish the question, will you?

Interjections.

MR. SPEAKER: Order, please!

HON. MR. STRACHAN: You can't take all that noise as notice,

but it is certainly the intention....

Interjections.

MR. SPEAKER: Order, please! If you want to spend all

question period laughing....

HON. MR. STRACHAN: That's right. You either let me answer or

you don't want an answer.

Not at this time, but it is certainly the intention of the

corporation as soon as possible to build a pilot plan so we

have some yardstick with which to make a valid measure of the

costs of repairing automobiles in British Columbia.

MR. CURTIS: Supplementary, Mr. Speaker.

MR. SPEAKER: Time is up.

MR. CHABOT: Time's up — he's spun it out.

MR. SPEAKER: May I point out to Hon. Members two things that

certainly prolong the delay in question period: First is asking

questions that have already been answered, and should not be

repeated. The second thing is the delay through

interruptions.

SOME HON. MEMBERS: Oh, oh!

MR. SPEAKER: I hope that Members will co-operate on all

sides of the House. I'm trying to be fair about it, but I point

out that I can't extend question time. All I can do is ask for

silence during question period.

Orders of the day.

MR. SPEAKER: Do you have some point?

MR. P.L. McGEER (Vancouver–Point Grey): Before you leave the

chair, Mr. Speaker, I wonder if I could stand on a point of

order with respect to the transcript of Friday's

Hansard . I've just had an opportunity to review the Blues, and on tape 894, page 2, there's a reference to Hon. Mr.

Barrett in which he says: "Oh, withdraw, withdraw!"

Mr. Speaker, I was present and clearly heard the Premier say

a word which is not mentioned in the blues. This was heard by

the press, and I had an opportunity to go down and verify it

with the tape.

MR. SPEAKER: May I suggest to the Hon. Member that he refer

to standing orders, and take the appropriate rule in standing

orders, bringing it to the attention of the Speaker in the

normal fashion, in

[ Page 1577 ]

writing, and I'll deal with this in the proper way.

MR. McGEER: Thank you.

HON. MR. BARRETT: You know very well what the Hansard

editors said.

SOME HON. MEMBERS: Oh, oh!

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

Vote 75: Department of Health, Minister's office,

$82,898.

HON. D.G. COCKE (Minister of Health): Mr. Chairman, I'll

filibuster my vote. (Laughter.) They are getting action, and

they know it.

First I would like to draw your attention, all Members of

the House, to a note that I am sending around to all of you.

This is a note inviting you to take

part in a fitness test that

we are doing through occupational health. It will go on until

the end of the session or beyond that, if you wish. You can

make an appointment; it is going to be voluntary, but I would

like to invite all of the Members of the House to take

part in

this fitness test. It's a good programme.

Mr. Chairman, most of the cabinet have already been through

this test, and it is quite revealing. Unfortunately we haven't

been able to work it out for everybody, but certainly most of

them.

It is an excellent test in that it is not just a fitness

test where they test your vital capacity on a bicycle alone,

but it is also a fitness test in that there are a number of

blood tests and other health tests which I think will prove

valuable to you. I think this is a piece of preventive medicine

that should be going on in an expanded way around the province.

We are right now working and testing out just exactly how far

we can go, and the direction in which we should be going in

this whole area of fitness testing.

Well, Mr. Chairman, there are a number of items that are

going on in the Health department right now. You know of our

aim in the ambulance area. We will have an ambulance emergency

programme in this province over the next months and years that

will have no rival, I'm sure. In a province which contains a

number of remote areas, and in a province that really requires

some upgrading in this area, our dedication and direction is to

see to it that emergency health care is provided.

Talking about the remote areas, I recall last year there were problems in the

fishing fleet about providing health care to those people who were out in Rivers

Inlet and other areas such as that. This year we are going to try our very best

to provide for adequate care for those people who are in those areas. We already

have a programme that is developing, and so I am very pleased that we are able

to keep the promise the Premier made last year, that we would not let these

more remote areas go, as far as the health care process is concerned.

Mr. Chairman, there are other areas that we are dealing

with. Remember, for a long time all sides of the House have

been discussing the whole question of dental care. Last fall,

or at least last spring and summer, we did a dental survey in

this province just to check to find out where people were with

respect to dental care, and we found that there was an even

greater problem than what we had suspected.

One of the real problems, besides the status of people's

teeth, and the kind of shape they are in, is the distribution

of professionals. Where are the dentists, for example, in

Prince Rupert? That's a town of 17,000 people with two

dentists.

Not too long ago the union which operates within the Can-Cel

operation provided the members of that union with a dental

plan, and they were all pleased. They were thinking that they

would be able to take their children to the dentists and have

them looked after. But they couldn't, because there weren't

enough dentists.

These are the questions that we are now working on. We have

made an agreement with the College of Dental Surgeons to

provide a part of a committee, and my department has provided

the other part of the committee, to do some real in-depth work

on direction as to how we can get dental care to the whole

province as quickly as possible.

We are aiming now at the children at as early a date as we

can possibly do it, but we can't go in without a plan because

you would know what would happen under those circumstances.

It's just like winning that very desirable aspect of their

contract in Prince Rupert, when there is nobody there to do the

work.

So these are the questions that surround Health.

Chronic care, Mr. Chairman, is another area that we are dealing with continually,

in the House, and certainly in our department. The Premier has said that this

is the priority in this department, and Mr. Chairman, it is a priority with

us and will go on being a priority. We are going to provide adequate chronic

care in this province.

Right now we are working on our intermediate care. Our beds

are expanding....

MR. G.S. WALLACE (Oak Bay): When?

HON. MR. COCKE: When? — now!

You know, Mr. Chairman, it is interesting to hear that kind

of frivolous remark from the Member who obviously has nothing....

Interjections.

[ Page 1578 ]

HON. MR. COCKE: It's being provided now and in increasing

amounts, in increasing quantities. It is going to go on

increasing and we are moving now in the direction of getting it

out as widely distributed as possible within the next two or

three years.

MR. G.B. GARDOM (Vancouver–Point Grey): Oh, now we know

when.

HON. MR. COCKE: Mr. Chairman, there are a great many

problems. One of the problems of delivering chronic care is

that there must be a home-care backup. There has to be personal

care backup, because we cannot let chronic care be the area

where people are sent because nobody wants to look after them.

We want to provide them care in their own homes for as long as

possible, and that is why it is not some sort of an easy

device, or at least an easy setup that can be brought about

just by snapping one's fingers, because all of these aspects

must work together.

Mr. Chairman, I'm sure that there will be some questions and

some interest in the B.C. Medical Centre. It is doing well;

doing very well. The task force reports are in now, all 25 or

26 or them. What they will be doing over the next few weeks and

months is cutting the fat out of those task force reports, out

of those requests, and so on. What they will be doing is seeing

to it that there is no overlapping. What they will be doing is,

in fact, coordinating the needs with the facilities

available.

I think each component of the Medical Centre will be further

enriched now because St. Paul's Hospital has agreed within the

last week or so to come into the B.C. Medical Centre. Mr.

McConville, the chairman of the board, my department, and the

B.C. Medical Centre have met on a number of occasions and

ironed out any differences that they might have had. Mr.

McConville is announcing that the St. Paul's Hospital with the

backing of the Sisters is coming into the Medical Centre as an

affiliate member of the B.C. Medical Centre. Their member on

the board of the B.C. Medical Centre, I understand, will be Mr.

Longstaffe. We're very pleased indeed to have the St. Paul's

Hospital, which really is in that region, into the B.C. Medical

Centre aspect of the delivery of health care in this

province.

Mr. Chairman, mental health is an area in which I think

we're making real progress. A couple of weeks ago I gave a

report in this House which indicated that Riverview's patient

numbers were down to 2,004, as I recall. It's now down under

the 1,900 level, I understand; I will get the exact figures if

I'm questioned but it's down into that area. We're very pleased

with the progress being made.

The reason for that progress is because of a greater emphasis on community

mental health work. The Vancouver Mental Health Project and the Fraser Valley

project that are becoming better known are taking some of the weight off Riverview.

I'm sure everybody in the House agrees that the place to deal with mental patients

is in their own communities and, wherever possible, is out in the community.

Mr. Chairman, I am very pleased to see that in fact is

occurring. The numbers are something that really excite me

because I think it's the direction everybody wants us to

go.

I'd like to talk just for a second about an area we've been

questioned about. We're getting a great deal of correspondence

in ICBC about this whole question of motorcyclists and how come

their rates are higher than what they suspected they would be,

and so on.

I have a report here that tells just what happening to

motorcyclists in the hospitals of the, province. This is a very

important report. Out of the number of motorcyclists in the

year 1972, the last total year reported, almost 1,000 of them

out of 40,000 wound up in a hospital in this province; 2.5 per

cent wound up in our public hospitals. At the same time, of the

roughly 1,200,000 car drivers, 7,484 wound up in a public

hospital — 0.62 per cent. This means motorcyclists are in there

roughly about four times as often.

The second indicator is the length of stay and hospital

days. Again, hospital days for motorcyclists were 11,072

hospital days out of the 40,000 motorcyclists — 29 per cent. It's a

very rough figure to use as a percentage of that, but at the

same time let's use the 29 per cent so we can compare. Of the car

drivers: 70,000 hospital days or 6 per cent. Five times as many

hospital days for motorcyclists. This is indicative of just how

dangerous that machine is to human lives and human health.

I'm not going to say any more other than we must in our

society became a great deal more careful when driving that kind

of a motor vehicle. I would certainly ask that the young people

forgo driving motorcycles in the normal way on the roads of

B.C. where the hazards are so high. I really feel that is

something we should be looking at seriously because it is a

serious health problem.

There's one other thing. There is no question that we would have saved 700

lives last year had we all worn seat belts in Canada. That's 700 lives last

year; another tremendous health problem that we're really not looking after

unless we do up those seat belts that are recommended. As Minister of Health,

I'm recommending that everybody in this province do up their seat belts. We

don't want to come down hard on people, but we sure want to see people taking

responsibility for their own health. If you think those figures are big, you

should see the number of hospital days given over to people of automobile accidents

who don't die. It's gross, absolutely gross. So for your

[ Page

1579 ]

own protection, for the people of B.C., I suggest to you:

get your seat belts done up because they're going to save your

life or save your health some day.

Interjection.

HON. MR. COCKE: It was pointed out to me that there's a

possibility that the opposition leaders particularly.... I

sometimes wonder where those leaders are. Who is the leader

today of the United Party? Is he in the back row or is he in

the front row? With that, I'll sit down and let the opposition

and the Members of this House who wish to question,

question.

MR. R.H. McCLELLAND (Langley): I can't help thinking that the Health

Minister is concerned about the health of the government when he's worried about

the opposition as much as he seems to be.

MRS. P.J. JORDAN (North Okanagan): Hear, hear!

MR. McCLELLAND: I'd like to thank the Health Minister for

his invitation to take

part in this fitness maintenance

programme that the Premier took

part in some time ago.

HON. D. BARRETT (Premier): I lost 25.

MR. McCLELLAND: Yes, so did I, Mr. Premier, as a matter of

fact, and I intend to lose some more. It hasn't made me as

grouchy as it's made you, though.

AN HON. MEMBER: He was a grouch to start with.

MR. McCLELLAND: With the threat by the Premier to keep us

sitting here all day and all night, however, I may have to send

a representative to take my health maintenance programme.

I was happy, too, to hear the Minister of Health mention

that, as he gets his task force reports in from the B.C.

Medical Centre people, he's cutting out the fat. Perhaps it

might have been a good idea had he followed that same policy

with regard to the report of Richard G. Foulkes, the "Health

Security for British Columbians" report.

I think it's inevitable, now, that we have a look at the

Foulkes report. I don't think it's ever been subject to any

kind of an analysis outside of the medical profession.

Certainly the public hasn't had much chance to listen to some

of the things contained in the health security report. I'd like

to spend a few moments outlining what the official opposition

feels is the scope of the Foulkes report.

Basically, I believe that Dr. Foulkes had the opportunity to do something very

good for health services in British Columbia. Unfortunately he blew it because

his politics got in the way of — his good judgment. Instead of using the report

to delineate the needs of heath care in British Columbia, he used it instead

as a vehicle to vent his frustrations and launch what can only be termed a venomous

attack on our present health-care system, on doctors in the province, on psychiatrists

in the province, and, to his discredit, also on public servants in British Columbia.

Basically, Dr. Foulkes contends that there is no health-care

system in this province. He wants to bum all of the bridges,

throw out the baby with the bathwater, and more, again to his

discredit, he has attempted in this report to drive a wedge

between the public and the health professionals in British

Columbia. He has, unfortunately, produced a political document

concerned more with administrative power than with health

care.

If I could quote briefly from Dr. Foulkes, he says: "The

secret of our success will lie in the management of power. It

is that power which dictates priorities." We always thought if

was the needs of the patients that should have dictated the

priorities in health care in British Columbia. The needs of the

patients, not the management of power. Unfortunately, Dr.

Foulkes seems to have been so bound up in the socialist

obsession to build bigger bureaucracies that he's lost sight,

at least in this report, of human needs.

It's important to ask ourselves why this report was

commissioned in the first place. I would expect, and I thought

when it was commissioned, that it was commissioned to find the

best way to get the most out of that health care system which

Dr. Foulkes himself admits in this report is an industry of

some 40,000 people, spending upwards of $600 million a year of

public money. That's some industry. We expected that what we

would get out of the health security report was some kind of a

design to offer better efficiency and better service in the

management of that incredibly large industry.

Instead, we got two volumes of verbiage discussing all kinds

of things — housing and Indians, tax policy, federal-provincial

relations and most of all, fuzzy philosophy, It's a report that

offers some vicious attacks on the public service of this

province and on the men and women who are serving valiantly in

mental health work in this province.

There is a continuing theme throughout the report — putting

down his associates and questioning over and over again the

abilities of the people in the health service.

[Mr. Liden in the chair.]

There are some sensible suggestions — in fact, a great many

sensible suggestions, many of them recommended by a health

committee which toured this province last year, many of them

recommended

[ Page 1580 ]

by the medical profession itself in their submissions, and

the hospital people in their submissions to the health security

report. We like many of the ideas about progressive patient

care which was contained largely in a federal task force of

some years ago — those ideas for progressive patient care. We

like the ideas contained about the federal sharing that would

be necessary to maintain that kind of a system.

We like the ideas for streamlined hospital planning and

construction. Just as there must be streamlined planning in the

construction of our schools, so must there be in the

construction of our hospitals, We like the ideas about co-insurance charges for outpatient

care, and bringing home care into the hospital insurance

system. That too was one of the urgent recommendations of that

health care committee which traveled all over British Columbia

and found that people in all walks of life were vitally

interested in some kind of a home-care programme. The Minister

of Health mentioned that again today in his opening

remarks.

We like the idea of an expanded ambulance service. We are

happy and congratulate the Minister of Health on his decision

to bring that health care service to all parts of the province

as quickly as possible.

We like the ideas in the report with relation to the use of

paramedical people both in the ambulance service and other

areas.

Of course, a review of financing is vital if we are to

contain the spread of spiraling costs of health care in this

province and all over Canada, as a matter of fact, Mr.

Chairman.

I'm particularly happy with the comments made in the Foulkes

report regarding the removal of the municipal share of health

care costs. Once again, as has been mentioned in this House on

a number of occasions, the property owner in British Columbia

is now reeling under the costs of so many kinds of services,

and unless we give him some kind of relief, then it will make

it impossible and impractical to own land privately in British

Columbia.

There are many technical recommendations with which we can

agree. First aid for teachers in the school: that's a

recommendation which is particularly welcome. Since I have been

a Member of this Legislature, during each session of the

Legislature we have been visited by members of the

Parent-Teacher Association. And year after year their

recommendation has been very strong that we offer to our

teachers courses in first aid and make it mandatory that first

aid be part of the curriculum in schools and certainly part of

the curriculum in teachers' courses.

Occupational health programmes, which have got a pretty good start in British

Columbia, I think need to be upgraded. That was mentioned, as well, in the Foulkes

report, as are proper nutritional programmes for all members of society in all

economic levels. That, too, is mentioned in that report.

I must say, Mr. Chairman, in those 1,200 pages of this

report, there is very little that is new or startling except as

an outlet for the author's political philosophies. The real

nitty-gritty recommendations for health care contained in this

health report could have been prepared by a committee of this

House for a fraction of the cost.

I want to quote from a couple of news reports if I may,

briefly. First of all, from a letter to the editor on The

Vancouver Sun by Dr. M.T. Richards of Vancouver who

says:

"In spite of its bulk, the report does not contain

fundamental and sorely needed changes. Too much emphasis is

placed on transfer of power instead of: what does an average

individual really need and want.

"There is too much condemnation of our past and present

systems which have served us well, without any concrete

evidence that the proposed new system will be any better.

"Most recommendations replace rat catchers by rodent

exterminators at a much greater expense without as much as a

question whether the taxpayer wants to or can foot the bill.

The expression 'eliminate rip-off' appears in several places in

the original report, yet having seen the figure spent on its

preparation, all I can say is that for value received, the sum

of $600,000, or whatever the report happened to have cost at

this point in time, is the biggest rip-off of the taxpayers'

money that I have ever seen in a long time.

"I feel confident that I can prepare a somewhat more

comprehensive report for one-tenth of the price and even post

an equivalent figure as report acceptability rather than

performance bonds."

The writer goes on to state his qualifications, and they

seem to be eminent. But he says that his motto would be, if

making up this kind of report: "no consultant has monopoly for

brains; use people power by tender, not appointment."

What about the cost of the Foulkes report? How much is it

going to ultimately cost the people of British Columbia? Well,

is it $750,000 or $1 million? I think it's time that the people

of this province knew exactly what they were getting for this,

or how much it was costing them for this 1,200-page report.

In the original estimates presented to this House, we were

given a figure for the health security research project of

$125,000. When questioned, the Minister of Health defended that

figure as perhaps too much. He didn't know what it was going to

cost us but, nevertheless, the $125,000 was defended vigorously

by the Minister of Health under question.

But now we are talking about $750,000 or even $1

[ Page 1581 ]

million. How on earth could the Health Minister have allowed

that cost to mushroom like that? Did the Health Minister have

any idea how much the cost was going to be? Did he approve of

the total cost? Does he know yet what the total cost of this

report will be, and does he care?

I think those are questions that deserve some answers to

this House.

How many intermediate beds could we have provided for $1

million? How many nutritionists for the elderly? How many

hearing aids? How much is this report going to cost us, Mr.

Chairman? It's time we knew. It's also time we knew where the

money comes from. We don't see it either in the last estimates

that were presented to us, or in this set of estimates that we

are debating today. There is no $1 million in there for the

health security research project, so where is it coming

from?

We would also like to know what is the status of many of the

people who have been connected with this health security

research project at this time. I notice there have been a

number of names mentioned in the appendices to the Foulkes

report about people who have been associated with the report

from time to time.

However, there is never any suggestion in these appendices

of what these people might be doing — people like Dr. Ransford,

who was hired on, I understand, at $33,000 a year. We've never

seen anything in the budget for that. When do we get some

public disclosure about what those people have done, are doing,

or will be doing, and how much money they have been getting for

it?

There is a Richard Larratt in here. I understand that he was

an electronics engineer, from Manitoba I am told, who has been

hired by this government, also at $33,000, to amalgamate the

MSA, the CUC and the B.C. Medical Plan, at least the computer

sections of it, if my information is correct. But where is he

now? Is he still employed and if so at how much money, and what

has he been doing?

There is a Frank Keeling, who apparently is still employed

by this government. What is his tenure? What is he doing? What

has he been doing? How much money has he been getting for

it?

When are we going to get public disclosure of all of the

professional staff, their salaries, their job descriptions and

their special assignments? When is that going to be tabled in

this House so that all of us can have the opportunity to

scrutinize those job descriptions and what not, and find out

for once and for all where the money that has been going into

this report has really been going? What are the continuing

salaries in relation to the Foulkes report? Where are they in

the budget? How do we find out where the money is coming from?

What about the consultant himself, Dr. Richard Foulkes? What is

his relationship with the government at this point?

I haven't got Hansard but I recall asking the Health

Minister about the $125,000 that was listed for the health

security research project, and I asked the Health Minister at

that time whether or not he wasn't being a little conservative

in his $125,000. We started looking at some of the consultants

who had been appointed by the government, and suggested at that

time that these government jobs often have a tendency,

regardless how temporary, to become very permanent, and they

then become a permanent charge on the taxpayers of British

Columbia.

We were assured at that time that nothing like that would

happen and that when October rolled around the Foulkes report

would be all completed, everybody would pack their bags and go

home and there'd be no more money paid out by this government

in connection with this report. Well, it sure didn't come in

October. We waited several months after October, and now we

find that instead of $125,000 we have, in fact, spent I would

guess a minimum of three-quarters of a million dollars and we

still have a number of consultants apparently still on the

payroll of this government. It is becoming a self-perpetuating

project of government that may never be over.

What are we going to get for our money? That's all we want

to know. What are we going to get for our money?

Dr. Foulkes in his report spends a great deal of time on the

system, or what he calls the "non-system," and he

rejects its worth completely. He says that the system has no

value. He's talking about the health-care system in British

Columbia, and he talks about "decentralization." I'd suggest

that if the provisions made in this report are ever carried

out, the results won't have anything to do with

decentralization but will be the total centralization of all

health services under a monstrous bureaucracy, with Health,

Human Resources and environmental control tied together to

provide the central vehicle on the road to what I can only call

"Big Brotherism."

The proposed system contained in this report is a socialist

nightmare, Mr. Chairman, offering another whole new level of

government with its proposals for an explosion again of more

councils and boards and authorities and secretariats till

they're coming out of our ears. I'd suggest that if you carry

out the suggestions contained in this report you'll never find

enough ex-NDPers to fill all those positions. Then what are you

going to do?

AN HON. MEMBER: Nobody would have time to get sick.

MR. McCLELLAND: The report spends a lot of time talking

about philosophy. In many ways, because it does, it's a

scandal, Mr. Chairman. It's the most political report from a

so-called government

[ Page 1582 ]

agency that I've ever seen, it's the most biased report that

I've ever seen, and if you separate that philosophy — the

politics — then all you really have left is words, words and

more words.

The author, in my opinion, discredits himself on the opening

statement of

Part III of the report where he says: "The

report's philosophy is in accordance with the party's election

platform on these issues." I suggest to you, Mr. Chairman, that

the author of this report and his consultants were not paid

three-quarters of a million dollars or $1 million, or whatever

it cost, to spout socialist propaganda. They were hired to

delineate the health care needs of the people of this province

and they failed miserably in doing that.

Interjections.

MR. McCLELLAND: They weren't hired by the NDP; they were

hired by the Government of British Columbia to do a job for the

people of British Columbia and not to establish a socialist

platform for the last or the next election.

In many ways, Mr. Chairman, this is an egotistical report.

In some sections you can almost feel the conceit permeating the

pages of the report.

In many other ways, Mr. Chairman, this report is a lot like

that infamous White Paper we talked about last week on

education, because it's written in the same kind of public

relations jargon with lots of modern. but utterly vague words

and phrases so much in favour with the socialists.

Mr. Chairman, this report makes a bitter attack on this

province's public servants. I'd just like to take the time of

the House to read a couple of sections in relation to that. He

starts off in Volume One by saying:

"It was soon apparent that because of the limited time span allotted and a generally disappointing

response to requests to civil service personnel for technical

assistance and input, the services of outside consultants would

be required."

The author is saying, Mr. Chairman, that the

civil service of this province refused to help him in his task,

and I can't buy that.

Later on, Mr. Chairman, he continues with that kind of cruel

and ruthless approach to the public servants of this

province:

"It is essential that the British Columbia government be

familiar with the experiences of other CCF-NDP governments, for

example Saskatchewan, in their attempt to achieve new

objectives. Studies indicate that new policies will not be

implemented without major changes in the civil service and government operation."

Then he goes on to say: "A. The theory of civil service neutrality breaks down

when the total goals of the state change." I want you all to hear that: "The

theory of civil service neutrality breaks down when the total goals of the state

change."

Now, this government has been warned on occasion after

occasion that that's the kind of socialist thinking that has

caused the Watergate situation in the United States, because as

long as we have a neutral and honest civil service we'll never

get ourselves into that kind of problem, but as soon as you

start muckin' around with the civil service and making them

toe your political philosophy line, then you start getting into

trouble. That's the course that you're committed to take,

through you, Mr. Chairman, to the Health Minister. I suggest

you'd better back up.

HON. MR. COCKE: Back up from what?

MR. McCLELLAND: Mr. Chairman, the author continues:

"The transfer of power to groups that have been neglected

may fail in its objectives if administrative power is in the

hands of those whose social background and previous training

prevents a sympathetic understanding of the objectives of a new

government."

How political can you get? What a bunch of nonsense, and

what a dangerous philosophy for us to adopt in this

province.

"There may not be a commitment to the purposes that the

government has undertaken to serve. This is summarized in the

following quotation. 'It is most necessary for any government

that those in charge of the various departments shall be

competent and capable of absorbing new ideas and techniques. No

matter how good legislation is, if those in charge of

administering it are unsympathetic or incapable of a now

approach, little good will come of it.'"

Now, I wonder who

that quote is from. A fellow named T.C. Douglas — Tommy

Douglas, a fine socialist.

I'm glad to see that the Members on the other side of the

House are applauding that approach to the public service of

British Columbia because it tells us exactly that you have no

concern for public servants in B.C. and that you will stoop to

any means to make sure that the civil service is politicized to

the highest degree, and that's where the danger lies for the

future of people in British Columbia.

The report continues:

"Concern about the competence and attitudes of senior civil

servants this early in our report may bother some readers.

However, examined in the light of recent Canadian history, it

could be the most important single issue related to the

implementation of political platform policy."

This is not a

report on health care. It's a report on

[ Page 1583 ]

socialism. It's got nothing to do with the health care needs

of the people of this province. What else does it say about the

civil service in this province? It says:

"One of the most important changes required if the new

system is to be effective will be the posture and role of the central

civil service. Its past methods of operation are either ineffective or

inappropriate."

If that isn't an attack on the public servants of this

province, I don't know what it is.

We've heard on a number of occasions from this government

about the 20 years of neglect. Well, Mr. Chairman, I would like

to refute that right now. Perhaps even in the Foulkes report we

might get a clue to where health care policy has been in the

past, because he says, in speaking about British Columbia being

the second province to introduce hospital insurance — British

Columbia being the second province to introduce a provincial

medical-care plan — that in public policy decisions respecting

health services, British Columbia has been progressive.

Progressive, Mr. Chairman.

And what does the Health Minister himself say? What does the

Health Minister himself say about the past policies of

health-care services in British Columbia? In his statement,

refuting, I must admit, some of the comments in the Foulkes

report.... The Minister of Health says in public in this

report: "I believe that we have in British Columbia one of the

best health-care systems in the world." I agree with that: that

we have one of the best health care systems in the world. Let's

put to rest any thought of anything else, once and for all.

Now the report also deals, to a fairly large extent, with

finances, and we can only applaud any search for an improved

system of financing our hospital care costs. But in many ways

this

section is the weakest

section of the whole report. While

costs are a concern of every health authority in the world, you

would have thought that we would have got some kind of a

substantial position paper in this report for negotiation with

the federal government — that we would have got some kind of

policy position for our million bucks. Instead, we missed a

perfect chance to develop some kind of a platform for

renegotiation of health sharing with the federal

government.

Mr. Chairman, the report suggests that the Medicare premium

could be eliminated in this province if personal income tax

could be raised and corporate income tax upped again, which is

a good socialist approach to the whole problem. But I wonder

where the justification for that argument is. It isn't in this

report. Lots of words again, but no justification. Do you have,

or does the author have, any working papers? We haven't seen

them. Who researched this part of it? No answers there. Or is

this just more of the same kind of philosophical fluff off the

top of the author's head?

Recommendation 36 in the report, Mr. Chairman, says that "...patient charges be considered primarily for longer-term

care on the basis of ability to pay and on the basis of

charging for services which substitute for those the patient

would supply himself if healthy." Now that recommendation, Mr.

Chairman, certainly lays the groundwork for a soak-the-sick

policy by this government and gives the Minister something to

hand his hat on for his policy enunciated some time ago of

charging $5.50 per day for health care for the elderly. Here is

the operative phrase that gives him the place that he can

justify his recommendations and his implementation of a

soak-the-sick policy.

I wonder why the socialists, all of them, think that it is

such a sin for an elderly person to be solvent. What's wrong

with that? Every comment we hear from the socialists is

designed to make sure that the elderly get rid of their savings

as quickly as possible. Here we have them with their health

care policy, backed up by this recommendation, where we see

this government giving it to them on the one hand and squeezing

it back out of them with the other.

You know, I really wonder who wrote some of the nonsense in

this report, Mr. Chairman. I suggest that the government might

have some good grounds to demand its money back, because it

sure didn't get its $.75 million or $1 million worth out of

this.

Now on another occasion, Mr. Chairman, there is an item in

the report which, talking about reimbursement of accident

costs, says:

"The sums received from this source by the medical plan are significantly lower than would be

anticipated. It is estimated that the medical plan has received

approximately $150,000 from this source, compared to the

probable potential of $600,000. The hospital insurance system

has a far better record of collection in this regard. "In the

medical plan, however, some insurance adjusters have claimed they do not have to repay

medical plans by virtue of an alleged order-in-council of June,

1972. No such order seems to have been made, and the additional

revenue would appear due from the insurance companies on behalf

of the insured clients."

Now I think we have a right to know what the author means

with regard to this section. Is he inferring some kind of a

deal between the Medical Plan and the insurance companies?

That's what it sounds like, so that the companies don't have to

pay the third party liability.

Mr. Chairman, if the plan has been negligent and the public

has suffered for it, then there should be a commission of

inquiry set up into this problem to find out where we stand.

What does Dr. Foulkes mean, "No such order seems to have been

made"? Now he had a million bucks to fool around with.

[ Page 1584 ]

Couldn't he have found out somewhere with that million bucks

whether or not an order-in-council actually was made? What does

he mean, "No such order seems to have been made"? Doesn't he

know? Don't you know? Is this the best we get for $1

million?

The

section on housing may just be one of the most political

in the entire report, and I wonder how some of the people in

the West End of Vancouver feel about his comments that "the

West End is a most undesirable ghetto." I'm sure they don't

agree with that.

But in connection with the comments about housing in the

report: if it's true — and I expect that it is — that good

health and good shelter are directly related, it is certainly

small comfort that this government has the worst record in

housing starts in a decade. Besides that, they threw another $6

million down the drain to purchase "Downhill" Developments. The

good doctor must find that some kind of a contradiction.

The author recommends that we change the name of the

Department of Health and Department of Human Resources to the

Department of Social Affairs. By nature of the kind of

bureaucracy that this report would seem to be in favour of,

then maybe we should have a really super-super Ministry set up

which would take in all the things the doctor says are related

directly to health care; we might have a Ministry, called the

Environmental Department of Pollution-Free Social Affairs and

Input and Task Force Thrust on Delineation of Re-housing,

because if you are going to go and bureaucratize, you might as

well do it right. And that is what this report is calling

for.

The report, Mr. Chairman, has no regard for the financial

consequences of its statements, and in that way it is an

irresponsible report.

MR. R.T. CUMMINGS (Vancouver–Little Mountain): Have you read it?

MR. McCLELLAND: You bet I've read it, Mr. Member. I'll bet

you haven't, though.

MR. CUMMINGS: Yes, I have.

MR. McCLELLAND: I bet you haven't even cracked the front

cover. No way!

If this report is followed to the letter, Mr. Chairman, and if we set up all

of the commissions and the task forces and the secretariats and the research

institutes and the bureaus and the resource centres and the et ceteras, we would

be spending our whole health budget on running a horribly clumsy system. We

would compound the situation that we've seen develop in British Columbia since

the socialists took control, where it's costing so much now to turn the wheels

of the system that there's nothing left over for care, nothing for programmes

and nothing for people because all the money is going to operate the system.

That's the folly of the socialist philosophy, Mr. Chairman.

We spent perhaps $1 million for this thing and all we got is

about three inches of generalities, opinions and philosophy,

but not very much substance, Mr. Member for Little Mountain

(Mr. Cummings). You should hang your head in shame that you

were part of that.

MR. CHAIRMAN: Order! Address the Chair.

MR. McCLELLAND: Mr. Chairman, I would suggest that the

author of this report will probably go down in the records as

another good friend and supporter of the Health Minister who

got a handsome reward for his political efforts, because it's

certainly a political effort that we're talking about today in

this health report.

I suggest to this government, Mr. Chairman, that if John

Bremer was fired for talking too much, and if you want to make

the penalty in relation to the crime, well then Dr. Richard

Foulkes should certainly be fired. Perhaps the penalty should

go even further than that, if you get fired for just talking

too much, because, like all good socialists, the author can't

seem to take criticism. He reacts to it by wagging his tongue

without ever thinking to get his brain going at the same

time.

Mr. Chairman, when the British Columbia Medical Association

in their newsletter offers some valid criticism of this report,

what does the author do? Well, he flies off the handle, like

any good socialist does. In one news report:

"A maverick group of reactionary B.C. doctors is

deliberately misinterpreting the Foulkes report on provincial

health care, the report's author has charged. Government

consultant Dr. Richard Foulkes says the group, composed mainly

of Surrey-area doctors, traditionally opposed to any change in

the health system, has distributed propagandized summaries of

his report that are complete misinterpretations. Foulkes says

that one doctor who appears to have been misled by the group's

propaganda is Victoria Medical Society president, Dr. Charles

Ireland."

Well, for shame, Dr. Ireland. You have the courage and the

good sense to do a little honest criticism and you're accused

of propagandizing. How about that! Here's another Canadian

Press report:

"Dr. Richard Foulkes, the man who delivered to the

provincial government a blueprint for a new system of medical

care in B.C., said Monday there has been deliberate

misinterpretation of his massive two volume

[ Page 1585 ]

report. In a seven page news release" — even in his news

releases he gets carried away — "he enlarged on earlier

statements he made in visits to different parts of the

province, that a minority group in the B.C. Medical Association

is working hard to scrap the report's main

recommendations."

We go on to another report in the paper on January 12: "'Surrey Doctors Out to Get Me.' Dr. Richard Foulkes charged

Monday that a group of doctors is out to get him."

[Mr. G. H. Anderson in the chair.]

Interjections.

MR. McCLELLAND: Well, all socialists are touchy. I thought

you had noticed that.

"The author said that a minority group in Surrey named the

Reform Group has attacked him personally. 'Throughout the study

the Reform Group, a small group of physicians within the BCMA,

has consistently attacked me personally. Certainly if you were

to look at the back issues of district 6 Surrey newsletter and

you were to examine the back issues of the BCMA News,

you will see that it is concentrated on a personal abuse that

sometimes has verged on libel."

Then we see that reaction happening again with a headline by

John Braddock, The Province medical reporter, that says:

"NDP's Health Consultant Turns on the Government Now."

"An angry Dr. Richard Foulkes charged Wednesday that copies

of his report on possible changes to the B.C. medical system

are not being properly distributed by the provincial health

department.

"He claimed that 400 complimentary copies of the original

print run of 2,000 were to have been distributed by his health

security programme project office. 'Then the Minister's office

took over, so I gave them our lists. Now I don't know what's

going on. For some reason, the report is not getting through.

There's a hell of a squawk up here,' said Foulkes."

"Is nobody competent but me?" He doesn't say that, but

that's the tone of the kind of reaction. Then he goes on to

attack the Reform Group again. Then in reaction to this

attack:

"Foulkes said copies of the BCMA News carrying comments

on his report were distributed to the gathering in Prince George before the

community had read his report. 'They pulled every dirty comment twisted everything.'"

But the editor of the BCMA News says that Dr. Foulkes went to Prince George

expecting to talk to an audience that had no in-depth knowledge of his report.

Instead he found them able to criticize it to the extent that he blew his cool,

lashing out in all directions, including at the Minister. Now, if John Bremer

was fired for talking too much, I suggest there's some evidence there for something.

I wonder, Mr. Chairman, if it is just a small group of crybabies within the

BCMA who are questioning this report. I don't think it is. I think it's a pretty

widespread criticism of this report. I'll make a couple of other quotes and

I'll try and make them brief, Mr. Chairman. In one headline "Foulkes Comments

Question":

"The president of the British Columbia Medical Association,

Dr. K.C. Hill, says that Dr. Foulkes is using the reform group

within the association as a straw man to gain headlines. 'He

knows it, we know it, and it is time everyone knew it,' Hill

said in a statement.

"He added: 'Until now, the B.C. Medical Association has been

content to let Dr. Richard Foulkes make his news-release-a-day

statements concerning his report, but it is time that some of

his questionable comments were brought back to the realities of

the situation.'

"Hill said that Foulkes would have the public believe that

only the so-called Reform Group within BCMA disagrees with his

report. Hill maintained that the great majority of the doctors

in B.C. share the same concerns about the Foulkes report as

does the reform group. 'We also have said that there are many

long overdue changes recommended in the Foulkes report and, in

fact, we recommended many of them to Dr. Foulkes. But there are

also recommendations that we disagree with as a whole

profession, and not just a small part of that profession.'"

In the BCMA News itself, Dr. David Backup, the past

president of the BCMA, opens his comments by saying:

"The often postponed and long awaited Foulkes report is

finally here in shocking pink, which is most appropriate.

"The whole report, with its recommendations, is

based on a wrong initial decision upon a faulty premise, and

that premise, as was pointed out in the headline of one

editorial in one of the daily papers, is 'Wreck First and Build

Later.'

"He also says that no one would argue that the present

system is fault-free. Certainly there are defects and we must

continue to strive to correct them. But it's a good and

comparatively cheap system. To scrap this and start over with a

system based on community health centres, which have failed

abysmally elsewhere in Canada, is to fly in the face of reason

and logic and displays a bulldog tenacity which can only be

politically motivated.

[ Page 1586 ]

"Here's a report made by a man who had a simple initial

choice, made that wrong decision completely and then spent more

than a year building a proper bureaucracy to look after a

theoretical structure that seems doomed to failure. It sounds

like the Peter Principle gone wild.

"The Foulkes report, vehicle for power. There can be no

doubt, the author's protestations to the contrary, that much of

his report was predictable and to a great extent reflects not

one year's work with broad input from all aspects of society,

but rather Foulkes collected and bound — a distillation of the

author's known opinions and published NDP platform, a personal

plus political document, rather than the hoped for honest and

objective appraisal of our health care delivery system and its

faults."

That's the real indictment of this $1 million report.

Another item is by the secretary-treasurer of the BCMA. He

says:

"The Foulkes report is a very dangerous document. It

represents the main thrust of the totalitarian,

medical-political thinking for at least the next decade and

should be recognized as such."

Mr. Chairman, that is from the medical profession, most of

it, not just a small reformed group within the association

which Dr. Foulkes says is attacking him and twisting and

misinterpreting his report.

In relation to some of the comments that are made about

drugs and alcohol, I would like to say that I find them

shocking and almost criminal because if we follow the kind of

fuzzy philosophy contained in the recommendations there,

contained in the same kind of recommendations that we have been

hearing from the Stein commission report.... And I would

like to quote them correctly so I don't misinterpret his

report.

I agree with his comments on recommendation 201 "that the

government give high priority to promoting a coordinated

approach to the prevention, early detection and treatment of

alcoholism and drug addiction." No one can quarrel with that. I

want to say, first of all, that his reference to Alcoholics

Anonymous where he says that some people may not find

acceptable the specific religious approach used by Alcoholics

Anonymous.... I'm not aware that Alcoholics Anonymous is a

terribly religious organization. It's the organization which

can claim probably the only successful and sustaining programme

with alcoholics in our country, and certainly in North

America.

I wonder whether the good doctor knows anything about Alcoholics Anonymous.

I would like to warn the Health Minister, though, that if the chairman of the

Alcohol and Drug Commission keeps attacking and discrediting the Alcoholics

Anonymous programme and demoralizing that programme, those people are going

to be out of the business of looking after alcoholics and that, too, will be

to our shame in this province. Then who will look after them? That's what we

would like to know.

Again, Mr. Chairman, in recommendation 213 in this

report:

"...that in view of the lack of success elsewhere in the treatment of established drug addiction and

the importance of concentrating efforts on the major problem of

alcoholism, the Alcohol and Drug Commission seriously consider

establish a nation-wide programme of addict registration and

supply of maintenance drugs."

I find that totally irresponsible and a phony, criminal

cop-out on behalf of this commission. I would suggest that it

was written not by Dr. Foulkes but by Peter Stein, the chairman

of the Alcohol and Drug Commission.

It takes the false premise again that there is some kind of

a magic cure to be found by the registration process in Great

Britain. But we have had evidence delivered to this House on

other occasions that there is no magic cure for drug addiction

in Great Britain; that there is plenty of illegal activity

connected with drug dependency in Great Britain; that the whole

British programme, contrary to much belief, is aimed at

abstinence and abstinence only and because it's not achieving

abstinence, that the Great Britain authorities are now looking

to other countries to see whether or not their programme is a

failure and if they can adopt some of the platforms and

programmes of other countries, including the United States and

Japan.

Britain is now looking elsewhere. They are not happy with

the kind of programme they have in that country. They are

looking to specific proposals that have been delineated in

Baltimore and which have been given to this government as well — and Japan — which have been made available to this government.

It's a myth that's got to be kicked out right as quickly as

possible that the British system has achieved some kind of

Utopia. It is far from that.

I'll tell you that we will turn this country into a nation

of drug dependency if we follow the kind of irresponsible

recommendations that are contained in recommendation 213. I'd

commend the Health Minister to look to his own conscience and

to come up with some kind of definitive statement that will put

to rest the minds of the people of British Columbia with

relation to the treatment of drugs and drug and alcohol

dependency in this province.

I find a little counter-democratic the recommendation 245 in

which the doctor says that discussion should begin immediately

to prepare

[ Page 1587 ]

legislation to make fluoridation of water supplies mandatory

in this province. I don't know why the doctor has no confidence

in the democratic process but as long as I'm a legislator in

this building I hope that we'll stick to the democratic process

and that if the people want fluoridation, they'll vote for it

and then they'll get it, but that we don't shove anything like

that down their throats.

Mr. Chairman, I find a little counter-democratic as well the

comment made at the opening of

Chapter 3,

Part VI, where it is

said, first of all:

"Bearing in mind the size and difficulty of the task

indicated in

chapter 2, the cabinet must carefully review the

implications of the changes proposed and then make its position

very clear, either by accepting the report in total or by

indicating those parts that it will accept. Having made this

review and decision, the cabinet must then commit itself fully

to implementation."

I find that conceit coming through the pages again in that

kind of a recommendation.

He says that "this requires acceptance of the timetable for

implementation — which is incredibly short, incidentally, the

plan for implementation — "the resources required, the ongoing

costs of the new system." That's right. Buy it or else!

"Once these commitments have been made, the government must

be prepared to stand firm when opposition arises and problems

occur. In a task this large which affects so many people,

opposition will occur."

I'm glad he is going to allow some opposition.

"Mistakes will be made; problems will develop. Those

involved with implementation must know that the government

stands with them and will not vacillate and back away whenever

difficulties arise."

Sounds like ICBC. Nobody is right but me. Don't ever listen

to anybody; just forge ahead and stumble on whether you are

right or wrong. Don't ever take any advice. That's the good

socialist attitude.

He also insists that legislation must come this session —

this session, Mr. Chairman — to review and to revise the

British Columbia Regional Hospital Districts Financing

Authority Act, Community Care Facilities Licencing Act, Dental

Technicians Act, Dentistry Act, Department of Health Services

and Hospital Insurance Act, Hospital Act, Hospital Construction

Aid Tax Repeal Act, Hospital Corporations Act, Hospital

Insurance Act, Medical Act, Medical Grant Act, Medical Services

Act and Regulations, Mental Health Act, 1964, Provincial

Auxiliary Hospitals Act, Public Services Medical Plan Act,

Regional Hospital Districts Act — he wants them all changed — Registered Psychiatric Nurses Act, Tuberculosis

Institutions Act, University of British Columbia Health

Sciences Centre Act, Workmen's Compensation Act, 1968, and the Health Act.

This session!

Are you planning those changes this session, through you,

Mr. Chairman, to the Minister? I'll tell you, we are going to

be here till September. I hope the press got that. We're going

to be here a while to get all those changes this session —

three times a day until September. I'm tired even thinking

about it.

MR. P.L. McGEER (Vancouver–Point Grey): Or until the rugby

season is over. (Laughter.)

MR. McCLELLAND: In concluding my remarks about the Foulkes

report, I would be remiss if I didn't just mention the report's

attitude with regard to mental health services in this

province. I must say that here is the bitter indictment of the

people who have been working within the mental health services

of British Columbia so thanklessly and so heartfully for so

many years. It's an indictment, Mr. Chairman, of a group of

sensitive and caring people who have been struggling to make

life something more worthwhile for people with mental

disorders.

I commend the Health Minister for his remarks immediately

after the report was delivered refuting that attack on the

people working in our mental health system.

I wonder why, while the Minister was at it, he didn't take

the same stand with relation to other offensive sections in

this report. I suggest that the reason he didn't was because

the report does reflect socialist philosophy.

The Minister reassures us in this House that the report is

just to stimulate discussion. I can hardly buy that. The report

was commissioned by a socialist, written by a socialist, and

its terms of reference were based on socialist ideology. What

other result could you expect except a blueprint for socialism?

That's what we got for our $1 million: a blueprint for

socialism instead of a delineation of the real needs to deal

with the health-care problems of the future in British

Columbia.

Before I sit down, I'd like to just mention a couple of

other items of vital interest to the people of B.C., the first

of which has to do with intermediate care.

The Minister in his opening remarks mentioned that we're

going somewhere in intermediate care, but there isn't much

evidence that we're going anywhere. In the budget, for

instance, there's $1 million allocated for intermediate-care

programmes. It's only for research? I don't know what it's for,

but it certainly won't go very far in providing new

intermediate-care beds for the people of British Columbia.

We've got to start going somewhere.

I would just mention again, Mr. Chairman, about that

health-care committee which travelled all over this province to

talk to people in all walks of life about what they thought

were the major needs in

[ Page 1588 ]

health care of its people. If there was one recurring theme

that we heard over and over again, it was that we must make

some kind of provision for the people who are caught in the

squeeze between acute care and chronic care, and for whom we

have not been doing enough either now or in the past. For those

people, who are being discriminated against because they've

been effectively cut out due to financial restrictions of our

health-care system, there wasn't any doubt among the minds of

the literally hundreds of people who came before our committee

in villages and towns and cities all over British Columbia that

that was the one thing they wanted this government to do for

them. They weren't prepared to wait any longer for some kind of

action with regard to those people who are caught in the middle

of the health-care system.

They and the Members of the committee expected that this

government would give it urgent priority. In fact, the Minister

of Health and the Premier have both said that, and the Minister

mentioned it again in his opening remarks. That kind of care

had to be an urgent priority, and yet, even though the Minister

says we're going somewhere, we can't see where we're going. The

people who came to our committee can't see where we're going.

All they see is lack of action.

We got started in a small way in a programme of intermediate

care with the previous government's commitment to the new

intermediate-care hospitals which are on line now. But where do

we go from there? Why don't we continue? Why call a halt to it

now that we have that shaky start? There's nothing in the

annual report, as the Hon. Member points out; there doesn't

seem to be very much in the budget. We can't see any progress

in this area of vital need.

[Mr. Dent in the chair. ]

The Province of Alberta clearly is leading this nation in

making available intermediate care for its citizens. It has an

excellent programme developed and working at pretty reasonable

cost, as I understand it. Why don't we find out from Alberta

what to do if we can't develop our own programmes? I suggested

during another debate in this House a few weeks ago that

perhaps the Standing Committee on Health, Education and Human

Resources should be commissioned to go to Alberta and do a very

thorough study of the Alberta system — or maybe just go into my

office and look in my files; I have all the information on the

Alberta system, and it's a good one. Why don't we go to Alberta

and study that system and see if it can be implemented here?

The Member for Oak Bay (Mr. Wallace) had indicated we can do it

for a pretty minimal cost. I realize he's not the Health

Minister, but the Health Minister might lend an ear from time

to time. Why don't we go to Alberta and study their system?

I might quote even from the Minister of Health himself who said in a press

release on October 1, 1973: "Mr. Cocke confirmed the government's intention

of extending the present B.C. Hospital Insurance Services programme to include

intermediate care as quickly as possible." That was in October of 1973. What

does "as quickly as possible" mean, Mr. Chairman? When can we expect a programme

of intermediate care and when can we expect that intermediate care will be included

in the B.C. Hospital Insurance Services programme in this province? That's a

simple question and one that should deserve a simple answer from the Minister

of Health.

What kind of pressure is the Minister putting on the federal

government to help us develop new programmes? I'm sure the

Minister will agree that much of the delay, much of the

concern, much of the problem in developing these new programmes

is a reluctance on the part of the federal government to

involve itself in cost-sharing for some of these new ideas. I

don't think the Minister will deny that. But then, what

pressure is the Minister putting on the federal government to

make sure that the federal government is as progressive as this

province is in relation to accepting new programmes and sharing

fully in their cost, which is more important still?

I had some comments from people involved with the hospital

in Langley, whom I believe submitted some information to the

research project headed by Dr. Foulkes. They point out the

problem quite clearly. They say, "Unfortunately under the

federal-provincial cost-sharing programmes, facilities such as

nursing homes or services such as home care are not shareable,

thus these are left to the resources of the various communities

or private enterprise." So the programme must be one of extreme

pressure on the federal government to make sure they get with

us on these problems.

What's happening in areas like Langley, and I'm sure in

other areas in the province, is that because of the compassion

of the local hospitals, we have patients occupying acute-care

beds who should be looked after in less-expensive facilities.

You can't blame the local hospital officials for that because

they see the people suffering. They see that if a person is to

be discharged from an acute-care bed at $50, $60 or $70 a day,

for which he pays only $1 a day, it's going to be a severe

hardship on that person to have him discharged and sent,

perhaps, to a facility where he or she has to pay $40 a day or

$30 a day or $20 a day. You can't blame the local officials for

having some compassion for that person who will suffer a severe

financial penalty if he has to be moved from one level of care

to another.

The last task force on health which was implemented by the

federal government said it was very important to consider the

total system of health delivery. That's why I say again that I

appreciate the

[ Page 1589 ]

comments in the Foulkes report about the progressive patient

care idea. But that can never happen unless we have total

co-operation from a financial point of view with the federal

government.

I think it's vitally important that we get that cost-sharing

with the federal government as quickly as possible. The

Minister of Health mentioned again in his opening remarks about

home care. I agree with the Minister that any system of

intermediate care has to be in relation to a programme of home

care as well. I think it's very important that we remember,

however, that a system of home care could turn out to be

counter-productive again if we allow the costs of that kind of

system to get out of control — and they could get out of

control very easily.

There are times when a home-care system, because of the

nature of the costs of it, won't be appropriate. We have to

have the back-up and institutional facilities to go along with

the home-care programme, not the other way around as the

Minister put it, or the whole thing will fail.

The Minister himself, I believe, some time ago mentioned his

insistence that we get on to a home-care programme as quickly

as possible. I have it in Hansard here, but he knows

that's been one of his priorities. The question again is: how

long does it take to implement these priorities? What does "as

soon as possible" mean to the Minister? Those are the questions

I believe have to be answered.

I'll have a number of things I want to raise on specific

votes, perhaps later on in this debate. I want to talk for a

moment about the Minister's interference with the Hospital

Employees Union in relation to the settlement of an agreement

for bringing the discriminatory aspects of the female employees

of the hospital system up to some kind of par with the other

employees of the system.

As I understand it, there was a provision in the last

agreement with HEU which said that hangover grievances would be

settled within the life of the contract. The Minister chose to

take this one aspect of : those grievances to interfere himself

to an incredible degree and to sign a personal agreement with

the Hospital Employees Union as a Minister of the Crown in

relation to a labour grievance. Now we see the situation where

the registered nurses in this province are demanding similar

treatment. And why not?

The Minister's interference in this instance sure shook the

boots of the private sector. They don't understand why he took

to interfere personally in a labour dispute. This year we're

faced with a crushing round of bargaining in the labour sector,

and here we have the Minister of Health interfering on a scale

that is completely unprecedented. No wonder that industry is

quaking and wondering what's going to happen next.

Is the Minister of Education (Hon. Mrs. Dailly) going to start setting teachers'

salaries on her own? Is the Attorney-General (Hon. Mr. Macdonald) going to start

setting salaries for lawyers? Is the woods Minister (Hon. R.A. Williams) going

to set salaries for loggers? What next, Mr. Chairman?

The hospital workers got a very good deal out of this

agreement. Why not? — they had a friend in court. We want to

know why he interfered. I'd wager that the unions in all

sectors this year are going to demand the same kind of

consideration. They want their friend in court as well.

Perhaps, given the incredible performance of the Health

Minister, they have the right to ask for a friend in court. The

Minister's interference is becoming legend; he even interferes

to get his friends jobs at ICBC.

HON. MR. COCKE: Oh, be fair.

MR. McCLELLAND: But I'll tell you this is more important

than that because he may have throttled the chance for fair

bargaining in this potentially volatile year. I must stress

that it is an agreement between the Hon. Dennis Cocke, Minister

of Health, and the Hospital Employees Union, Local 180. It's an

agreement, and there can be no doubt about that.

It goes on to outline the terms of the agreement. There's

one totally phony

section in this agreement which says: "To

ensure that the obligations of free collective bargaining are

maintained and encouraged, it is directed that the Hospital

Employees Union and the hospital's bargaining agent shall

negotiate the timetable for elimination of discrimination in

wages, category and promotion for female employees."

How on earth can you consider that to be anything less than

phony? On the one hand it says we're ensuring that free

collective bargaining be maintained and encouraged, and on the

other hand we're directing the two sides in the dispute to do

something. What's free about that? What kind of collective

bargaining is that, Mr. Minister? It's double talk, that's all

it is.

Then it goes on to say, "If progress towards this goal is

deemed unsatisfactory, the Minister of Health Services and

Hospital Insurance shall undertake suitable measures to ensure

that the goal is achieved." Is that free collective bargaining?

That's deliberate interference by a Minister of the Crown in an

area in which he has no right interfering and had better stay

out of from now on.

lnterjection.

HON. MR. COCKE: Sex discrimination. Be fair.

MR. McCLELLAND: Wages and category and promotion — all areas

which must be left to free collective bargaining without the

interference of the Minister. I'm suggesting you set a

dangerous course

[ Page 1590 ]

for yourself that's going to result in a terrible round of

inflation in this province. Already you've upped hospital costs

20 per cent by your one stupid act.

You've shown no insight; you've destroyed the bargaining

atmosphere. You've not only made the registered nurses

second-class citizens but you've also given no thought to how

it's going to upset the balance. You've set off a chain

reaction that's going to create havoc. The Minister has

unilaterally decided that he can step in and settle economic

problems. I ask, where does he step in next?

What does that do to the Minister of Labour's (Hon. Mr.

King) suggestion that we must maintain a climate of free and

fair bargaining in this province? That's no climate of free

bargaining; it's interference by the Minister to an incredible

degree. It's just another example of this government's need and

obsession to meddle in affairs outside of its competence.

I'd suggest that in this instance not only have you meddled

in areas outside of your competence but you've also destroyed

the morale of some 7,700 registered nurses in this province.

You know the consequences of that action, and I hope you're not

too happy about that.

I'll have more to say about this department on a later

occasion. I thank you very much.

MR. McGEER: I don't intend to speak at any length on this

Minister's estimates; I think we'd like to hear from him in

little more detail on some of the aspects of his

department.

But I must say that one of the few departments that seems to

have worked more smoothly under the present administration

compared with the former one has been the Department of Health.

I really think the Minister is one we can commend for a general

overall performance.

I don't want the government to think I'm going soft here in

opposition, but I would like to quote for the Minister from one

of the great Canadian medical scientists, Dr. Hans Selye who

says, "Man must have recognition. He cannot tolerate constant

censure, for that is what makes work frustrating and

stressful." I don't think we should be constantly censuring the

government. We want to pick our spots.

I'm not going to debate the Foulkes report either at any

length. I tried reading it several times and I kept falling

asleep. I think that may have been what happened to the

Minister because he has been pretty unclear as to what he's

going to do with the Foulkes report except, I hope, to put it

upon the shelf.

I thought the Foulkes report was a mixture of fairly obvious medical comments

and some fairly obvious socialist comments. I suppose that the obvious is soporific;

I found I just couldn't sort through the 200 to 300 recommendations. There just

wasn't the kind of substance in that report that allowed you to get a hold of

a plan for the future of health services in British Columbia.

There were some parts of the Foulkes report that did catch

my attention. I noticed one of the few places where the

Minister disagreed publicly with his consultants. But where I

found myself in an agreement was in the matter of fluoridation

of water supplies. The Minister danced away from that one even

faster than the ones who were formally Ministers of Health

under the Social Credit.

Mr. Chairman, the Minister and some others on the opposition

side have suggested we should go into denticare. I absolutely

agree with that. But I say it is public money being wasted on a

massive scale if we do not couple this with an aggressive

programme to fluoridate our water supply.

British Columbia has one of the worst dental caries problems

in the nation. It has one of the lowest per capita fluoridation

of water supply rates. It does not have a sufficient number of

dentists, particularly in centres away from the greater

Vancouver and greater Victoria areas. To embark on a programme

of denticare without first addressing oneself to the problem of

prevention, in my view, is irresponsible.

Mr. Chairman, what are the authorities upon which I base my

contention for the 12th straight year in this assembly that we

should do something in British Columbia to encourage

fluoridation of water supply?

I start with the World Health Organization which says:

"The effectiveness, safety and practicability of fluoridation as a means of preventing dental caries, one

of the most prevalent and widespread diseases of the world, is

now established. No other vehicles or techniques for the

prophylactic application of fluorides can at present substitute

for the fluoridation of drinking water as a public health

measure."

Mr. Chairman, the Minister of Health (Hon. Mr. Cocke) in

waffling away on this problem of fluoridation of water supplies

has suggested milk and tooth paste and applications in doctors'

offices and so on. It's weak wiffle-waffle, and the World

Health Organization says, "No." The World Health Organization

says: "Looking at the world at large, dental decay represents

an economic drain on both health services and individuals.

Early detection and treatment of dental caries is effective in

controlling diseases and its results.

"Even in those countries with the highest ratio of dentist

to population, however, no more than one-third of the needs of

the people are being met."

British Columbia is probably meeting

less than one-third of the total need.

Yes, we deny what our own former Minister of Health in

Canada has said: "Rarely has any health measure been the

subject of so much study and

[ Page 1591 ]

research. Every allegation of harm has been painstakingly

assessed. The safety of the measure has now been placed beyond

doubt."

The Minister of Health for all of Canada....

MR. H. STEVES (Richmond): Nonsense.

MR. McGEER: "Nonsense," says my health crackpot in

the corner. Here's who has endorsed it: the Canadian Dental

Association, is that's nonsense? Canadian Medical Association,

is that nonsense? Canadian Conference on Dental Research, is

that nonsense? The Canadian Pharmaceutical Association, the

Canadian Public Health Association, the Canadian Society of

Dentistry for Children, the Department of National Health and

Welfare, the Dominion Council of Health, the Health League of

Canada, the Canadian Federation of Business and Professional

Women's Clubs. Even women's lib is for it. Not only all those

people, but former Premier Bennett was in favour of it.

AN HON. MEMBER: That kills it. (Laughter.)

MR. McGEER: I tell you, the breadth of opinion here in

favour of fluoridation staggers the mind. Yet, there's always

some nut somewhere who will say it's harmful; you can always

find one.

I don't think we should let these health crackpots push us

around any longer. No, sir. I think it's time for sane and

sensible people, backed by thorough scientific research

endorsed by every reputable organization in the world that has

knowledge of this subject — I think we should take their

advice. Not the advice from the Member for Point Grey but the

advice of these authoritative bodies that have proved beyond

question the efficacy and safety of this.

We know that right here in British Columbia no more

spectacular evidence has been obtained for the effectiveness

and safety of fluoridation of water supplies than some of our

communities in this province like Prince George, like Kelowna....

AN HON. MEMBER: Are you against freedom?

MR. McGEER: Am I against freedom? Of course I'm not against

freedom; I'm just for good, common sense public health

measures. I'm for chlorination of water supplies; I'm for

pasteurization of milk; I'm for giving to each and every one a

whole variety of agents which immunize them against disease,

and I'm for fluoridation of public water supplies.

Mr. Chairman, I think the Minister's gone out for a drink of

water. I hope it will help his teeth, but I'm afraid it

won't.

You see, if one compares the various provinces in Canada for the percentage

of population that can benefit from this most important of all public health

measures in terms of the proportion of people who are affected, 98 per cent

of people have dental caries. And the overwhelming percentage of dental caries

can be eliminated by this simple, safe measure.

Here are the provinces in Canada and how they stand in this

matter of fluoridation of water supply: Manitoba. 62 per cent;

Ontario 55 per cent; North West Territories 52 per cent; Nova

Scotia 36 per cent; Alberta 36 per cent; Yukon 34 per cent;

Saskatchewan 33 per cent; Canada as a whole 32 per cent; Prince

Edward Island 18.9 per cent; Quebec 10 per cent; and poor old

British Columbia. 7.7 per cent. Isn't that disgraceful, Mr.

Chairman? We're way down at the bottom in Canada in this

absolutely essential public health measure if we're to

contemplate a denticare programme.

The Foulkes report says that all water supplies should be

fluoridated on a compulsory basis. I don't think we need to go

that far because I'm certain that the majority of people have

good common sense about this measure.

There are two ways one could go about it that would be

perfectly successful and perfectly satisfactory: one is to

allow municipal councils on their own initiative to have the

water supplies fluoridated. If the public don't like it, they

can throw them out at the next election.

The other would be simply to reduce the necessary majority

from 60 per cent to 50 per cent. We decide everything in

politics by a simple majority. We decide who'll be government

right here in this House by a simple majority — not 60 per

cent, but a simple majority.

I think the same rules that apply for election of people to

parliament and decisions regarding who should govern the

province should apply to this matter of fluoridation. If the

Minister were simply to change the level to 50 per cent, it

would stimulate a lot of plebiscites around the province and we

would be successful in the way that the Member for Richmond

(Mr. Steves) desires in introducing this important measure.

There are other routes short of the extreme measures of the

Foulkes report. May I just toss them out for the Minister's

consideration?

You know, people from Vancouver, particularly, feel that

they drink mountain fresh water — the best water in the world.

Therefore the idea of adding anything to it always provokes a

lot of prideful people. Here I have an

article that links soft

water to heart disease. There's now a considerable body of

evidence that areas that have a high content of minerals in the

drinking water have lower heart disease among the residents. It

is suggested that maybe a few additives to water, in addition

to chloride to kill the bacteria and fluoride to strengthen the

bones, might be beneficial to overall health.

Mr. Chairman, Members have heard me speak on

[ Page 1592 ]

the subject of fluoridation before, and I'll continue to

speak on the subject of fluoridation until I find a Minister

that brings some action.

I want to talk about another area where the Minister has

been noticeably soft. He was great for physical fitness and

gave that nice little talk and I want to tell him that I'd like

to participate in that programme. I want to participate and I

want to do it when the House isn't sitting. I don't want to be

like the Premier and take my time to go there when there's a

delegation on the front steps and when we're sitting in the

House. But I'll be there.

I think the Minister has been soft on smoking, Mr. Chairman.

Yes, I do. I asked him when he first took over to put great big

"No Smoking" notices on our ferries. There are two reasons for

this, Mr. Chairman. Smoking's a killer. More people die of lung

cancer because they smoke than get killed in automobile

accidents. It's a dreadful way to die and an awful price to pay

for a silly, dirty habit. If people were to stop smoking today,

it would add three years to the lifespan in Canada, and the

amount of money people would save would be enough to allow them

to take a trip around the world as the initial dividend on

their retirement.

growing of tobacco on rich Canadian land that could be used for

growing healthful crops — another disgraceful government

performance but one which this Minister, happily, has no

responsibility for.

But, Mr. Chairman, the Minister could give non-smokers in

British Columbia their rights to inhale a lungful of nice,

pure, oxygenated air and not someone else's dirty, filthy

tobacco smoke.

Interjection.

MR. McGEER: I'm trying to reform my good friend and

colleague, the Member for West Vancouver–Howe Sound (Mr. L.A.

Williams), but you people on the government know that isn't an

easy job. I tell you when he makes his mind up, he makes it

up.

But, Mr. Chairman, I'm hoping to change the Minister of Health's mind because

now, in some jurisdictions, they are passing laws prohibiting smoking in public

places unless there's a sign specifically stating that smoking is possible.

On aircraft, it's now required that part of each aircraft be reserved for non-smokers.

I travel on aircraft a fair amount and I'm sure the Minister does, and he'll

probably know that when this programme was first started, there were two or

three little seats put together for the non-smokers and the children. You could

never get a seat in the non-smoking section. It's grown and it's grown and it's

grown and it's grown. Now, in most aircraft, the majority of the aircraft is

set aside for non-smokers and you still can't get a seat in the non-smoking

section.

I only mention this to illustrate how badly people have

wanted all these years to be spared the intrusions of the

selfish smoker. The politeness and restraint of the non-smokers

has been astonishing. But I think they now ought to start

getting tougher than women's lib, demand their rights to a

lungful of nice, pure air, and say that restaurants, ferries,

theatres, sports arenas — any enclosed space — should have

reserved at least half for non-smokers, where the air can be

clean, and take all the other dirty smokers and sit them off in

a corner and let them pollute each other.

The Minister could bring in legislation this session making

smoking a misdemeanor. We don't want to call it a crime, as the

people do more damage to themselves than they do to others, but

it still should be a misdemeanor to themselves and to others.

Make a nominal fine if they smoke in an area that's reserved

for non-smokers. It's a pretty simple thing to do. The trail

has already been blazed and all we have to do is to improve on

the anti-pollution record of British Columbia.

Now, Mr. Chairman, I'd like to dwell on another, more

ominous health problem where again I don't think the government

is tough enough. I refer to problems associated with narcotics

and other drugs of abuse. British Columbia is the drug capital

of Canada. This is the place that has half of all the nation's

hard-drug addicts.

This, of all places, is where a Minister of the Crown

suggested free drugs. Yes, and he was supported by a physician,

the Member for Oak Bay (Mr. Wallace). I'm glad the Member for

Oak Bay has come to his senses. He's realized what a mistake

this was, that the Holy Grail of the drug addict is to have

free drugs and that the only places on this earth that have

licked the hard-drug problem or beat it down to miniscule

proportions are those places that have been resolutely

determined to run every drug abuser out of the country or into

an institution where he's protected from himself and from

others in the general public.

Our problem here in British Columbia is that there is an

established drug distribution organization. Every spot in it

from the connection down to the lowliest pusher on the street

is well understood. You arrest one guy, put him in jail, and

these days maybe he'll be paroled the same day or the next day,

or maybe not. But even if he doesn't take his former place in

that drug distribution organization, there's somebody else to

do it. The objective cannot be to catch an individual who fits

into a well-known business which supplies 10,000 people in

British Columbia with a daily commodity that they want. You

have to smash the business. You cannot do that without being

just as tough as any country in the world with people who use

drugs as well as people who distribute them.

[ Page 1593 ]

Our problem is that we try and make this artificial

disconnection between the person who pushes and uses and the

person who is the connection and supplies. They're all part of

the problem, and they all need to understand one day that

British Columbia is one place where you don't monkey around

with drugs.

When we get a little backbone in government and in the way

we handle legal problems with regard to drugs in British

Columbia, we'll begin to see this problem decline instead of

increase as it's done for the past 8 or 10 years.

I've no sympathy with the federal government; I think

they've done a lousy job. I think the LeDain commission quite

frankly encouraged the use of drugs all across Canada. I think

it was a mischievous and ineffective commission which did

damage to the country. I'm pleased the Minister of Justice

(Hon. Mr. Lang) had enough common sense to back off from the

recommendations of that commission. I think the commission

recognized in mid-stream that they were doing a lot of damage

and began to poll in their horns. But the fact remains that the

LeDain commission in sum has been mischievous and harmful, and

some people are going to have to pick up the bits that have

come after the LeDain commission.

They exist here in British Columbia. While the LeDain

commission was supposed to be investing drugs in Canada, our

heroin population increased threefold. You can't call that

performance, except in rapid reverse.

I'd like to switch to still another subject where I think

the Minister could make great strides: the problems of medical

research and the efforts that should be made to cure

disease.

There are about 5,000 different ways to die that have been

described so far. I can assure you, as one who has trooped up

and down hospital corridors, they're nearly all unpleasant. We

have a good health delivery system in British Columbia for

those diseases where some help can be given by the medical

profession. Those diseases where genuine help can be given fall

into a minority, a small minority. The bulk of diseases are

ones which people have to suffer through just as they did in

olden times.

The federal government has not been supporting medical research as it should

in Canada. I consider the performance of the federal government in the matter

of supporting medical research to be a national disgrace. I say this because

we started in the early 1960s committing about I per cent as much of our resources

to the curing of disease as did the United States. During the years of the Pearson

administration, there was a fairly rapid growth in Canada of medical research

and we increased to about 3 to 4 per cent of what the United States was spending.

Then, in the last three or four years, there has virtually been an arrest.

It would have been impossible for us to have accelerated

more rapidly and still maintained any kind of reasonable

performance; you can only grow so fast in business or in

medical research or science of any kind. But what has happened

is that there's been a virtual arrest of moneys being made

available. Because of inflation, actually less medical research

is being done in Canada today than two years ago. We should

have continued to accelerate at the most rapid possible pace

until medical research in Canada began to approach in volume

what is appropriate for a nation of our wealth and our

capability.

Perhaps the greatest contribution Canada has made to the

world was the discovery of insulin just over 50 years ago. More

people are alive today because insulin was discovered than

there are Canadians on the face of the earth. The incidence of

diabetes is such that there are more people with diabetes in

the world than there are Canadians, and these people live by

virtue of a Canadian medical discovery.

If you want a way to give to the world, give through

discoveries in health. The capability to do that depends on the

efforts you are prepared to commit as a nation to this

objective.

The Foulkes report completely missed this point; the federal

those who are seeking a cure for cancer or heart disease or

mental illness or any of the afflictions that make our limited

time on this earth less pleasant than it can or should be, the

message comes very clear indeed. Therefore, the responsibility

falls on this Minister of Health, this assembly and this

province, just as it does in every location in the world, to

carry our share.

We have tremendous wealth in this province and this

provincial government has tremendous wealth. Several hundred

million dollars a year are spent on delivery of health care. If

just a small percentage of that — 2, 3, 4 or 5 per cent — were

to be committed to the discovery and the solution of disease

problems for which there now is no cure, we would be setting

off on the highest endeavour that our province could establish

as a provincial goal and multiply many fold the present very

modest activities we have in this regard within the borders of

British Columbia.

I'm not going to spend time rehearsing the details of how

this should be done. I've spoken to the Minister privately on a

number of occasions; I know he sympathizes with the general

proposition.

When I talk about medical research, I'm not talking as in

the Foulkes report about deciding whether it's more efficient

to give this kind of care in this hospital versus that kind of

care in some other hospital. I'm talking about taking dead aim

on the killers in our society: cancer, heart disease, the

diseases that fill our hospitals with ill patients, mental

illness, multiple sclerosis, and on and on and on,

[ Page 1594 ]

where no work of any kind is going on in this province that

has any prospect at all of helping these people. To take the

limited resources we have and kid ourselves that we're doing

effective medical research with the kind of piffling programmes

suggested in the Foulkes report is to miss the meaning of the

mandate. We need to go after the big diseases in a big way. We

have the money to do it, and I would like to see the Minister

today make a commitment to that endeavour.

MR. WALLACE: The whole field of health care is extremely

complex. It represents a very large part of the total budget

and we could spend weeks literally debating health services.

Certainly, with these two enormous pink tomes, we could spend a

lot of time just debating the Foulkes report. I don't think

that's the purpose of the discussion of the Minister's

estimates, although inevitably one should make some comment

about the Foulkes report.

There's a great deal in the report which is very good in

terms of certain issues. I would say, though, that it's a very

difficult report to read. It seems to be somewhat disjointed

and poorly put together. It's poorly documented; many

statements are made which really are not in any way backed up

with good research and documentation. In just talking, I would

say this of any report that was of such far-reaching

consequence and yet which was written so poorly.

As I said earlier in the debate even the very numbering of

the pages and the sections and the paragraphs...It's not easy

to go back to another part of the report that you know you've

read and you can't find the page it's on. This is a frustrating

way to try and deal with it.

But these are small matters. I hope that if anybody else is

contemplating this kind of report that at least they could

probably start with page I and go on 2, 3, 4 in the normal,

standard way and perhaps just deal with chapters and page

numbers. This business of having pages labeled IV-C-21-2-3

makes it very difficult to get through the report and refer

back to pages and so on. But that's a small point.

The general thrust of the report which I think is good is

that it certainly emphasizes universality and the comprehensive

nature of the need in the health services in the field starting

from the most early preventive measure through every grade of

health care,to the most intensive care in the acute hospital,

and the increasing demands for the care of the extended-care

patient and the older age groups.

It talks about coordination and integration. In fact the

report uses these words interchangeably and I am not sure that

is necessarily accurate. These general concepts, I think, are

surely acceptable and form the basis for any kind of complete

programme for the delivery of health care services.

I would say again with some sense of criticism that it does spend a fair bit

of space in the report telling us what we already know. Some of the areas that

are covered, really, are nothing new.

I would question the frequent use of the word "consumer" in

a health report. I think when a patient is sick in hospital and

requires some kind of health care, to talk repeatedly about

that sick person as being a "consumer," I personally

almost take objection to that. I don't look upon a sick person

as a consumer like a consumer buying Idaho potatoes or split

peas in the supermarket. This is a different area of human

affairs that we are talking about.

At the same time, the writer of the report talks about a

greater need for public participation. Throughout the report

there is, I think, a very unfortunate theme that the whole

service is in the hands of the professional and that somehow

the professional is abusing a position of privilege.

Public participation is certainly a very excellent idea and

I've been among the first to support this government in

encouraging lay people to take

part in such functions as

hospital boards and the council of the College of Physicians

and Surgeons, and similar bodies. I think this is certainly

worthwhile.

When you read — and I don't want to spend too much time

specifically on the Foulkes report — but when you go through

the second book, there is this unfortunate implication that the

professionals completely control the service and the individual

who is not a professional is very much entrapped and enslaved

and the professional does whatever he wishes. That's certainly

the clear message that's suggested. I just don't happen to

think that's the case.

Again, I criticize the report in the respect that the writer

makes this rather serious statement with serious ramifications

and he doesn't document it. He doesn't show examples where

professionals because of their privileged position have been

making decisions or carrying out treatments or actions which

are to the detriment of the patient. I must say that it goes

completely overboard in this respect in one

part in the

report.

I can't find it. As I say, the pages are hard to find

sometimes. There is somewhere in the report here and I just

can't put my finger on it. It's IV-C-17-2. You feel like you

are reading the lesson in the church when you have to find out

whether it's the first or second book of this or that.

The statement is made about the "objectivity of the

professional" and not enough responsibility or decision-making

on the part of the patient. It picks out the example of radical

mastectomy, which is the complete removal of the breast. I just

can't imagine that the writer of this report is suggesting that

doctors would undertake such a disfiguring operation for any

other reason that the medical welfare of the patient. The

implication is clearly left in this part of the report that

doctors are somewhat indifferent to

[ Page 1595 ]

the kinds of treatment they might inflict on a female. Now, I don't want to stretch this out any further than that, save to

say that I know enough about the doctors that I have met in my

20 years of practice, and this is the kind of decision which a

doctor very, very seriously ponders before he inflicts some

disfiguring operation on a patient.

This kind of stuff in the Foulkes report is most

unfortunate. I think it's unwarranted. Again, he doesn't come

up with any kind of documentation to suggest that this goes on

except that, as I say, he does talk about the objectivity of

the professional people being questionable.

I might just say, Mr. Chairman, on that particular very

serious operation which is undertaken for breast cancer, let's

get it on the record that there are equal schools of surgeons

who vary greatly in their conclusion as to the best treatment

for this particular problem. I wouldn't for a minute mislead

the House. Some surgeons believe that the patient is as far

ahead simply to have the lump removed as she is to have the

breast removed. I'm not for a moment disputing that. Other

surgeons believe that the most radical possible operation is

the best way to handle it.

The fact is that statistics on this particular disease in

this particular location in the body are available for years

and years and years. It has been a very tragic, frequent

incidence of cancer in women for many, many decades and the

figures are available. We have, as I say, various schools of

thought.

I don't want to belabour the point, but I think it leaves a

very unfortunate impression in this report that the decisions

might be made without objectivity and that the doctor may

indeed be taking a form of treatment which is not in the best

interest of the patient but is done without all the deepest

consideration which I know goes into decisions on this

particular operation.

I don't want to get into great depth either in the whole

question of abortion. We seem to talk about that endlessly and

the picture never changes. But in the

section on the health

care of the problems of women, it says:

"Many women are critical of 'attitudes' towards the important

areas of family planning, therapeutic abortion, sexuality generally, and they

are concerned with the 'objectivity' of professionals.

"Women are placing increased emphasis on

self-determination...Therapeutic abortion committees, decisions

regarding whether or not radical mastectomy is the required treatment

for breast cancer, are examples of these concerns."

As I say, Mr. Chairman, the whole question of abortion is

very much in the federal realm and again I think this report

leaves many things unsaid.

If it were to be of real value and validity, I would feel that this particular

part of the report dealing with women has been done very lightly and inadequately,

as indeed many of the other chapters and to just make these general statements

without any amplification or documentation, I think is one of the regrettable

parts of this report, and we discussed the education White Paper as being platitudes

and so on.

I would have to say, regretfully, that in some of these

chapters which are of extreme importance, the writer — or who

ever wrote this part — makes these bland, general, inaccurate

statements which really, I think, do more harm than good,

simply because they have not been done in sufficient detail, or

documented in an accurate way.

They talk about surgical consent and so on, and I think that

certainly should be explained to the recipient of medical care.

Particularly in a sensitive area such as abortion there should

be more counseling; there should be more availability for

discussion by the patient. But, as I say, there are certain

suggestions made about therapeutic abortion here. I would just

like to quote one paragraph again. It's IV-C-17-4, and it

talks about these abortion committees being a threat to social

justice.

I don't think that this is the kind of statement that really

contributes much when these committees are set up by the

federal government under the Criminal Code of Canada.

What can the Minister of Health in this province do about that,

or what can the physicians providing the service do about

it?

It mentions under the heading of surgical consent: "In this

area of grave concern, that of mutilating surgical operations,

there should be no doubt whatever lingering in the patient's

mind as to the reasons for the surgeon requesting consent."

Well, again, in my experience the very vast majority of