1980 Legislative Session: 2nd Session, 32nd Parliament

HANSARD

The following electronic version is for informational purposes only.

The printed version remains the official version.

Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

MONDAY, JULY 14, 1980

Afternoon Sitting

[ Page

3277 ]

CONTENTS

Routine Proceedings

Tabling Documents.

British Columbia Systems Corporation annual report for the year ending

March 31, 1980.

Hon. Mr. Curtis –– 3277

Oral Questions.

Revenues of provincial treasury. Mr. Stupich –– 3277

Labour action at Glengarry Hospital. Mr. Cocke –– 3278

Alleged chipping of good-quality sawlogs. Mr. King –– 3278

Body-shop surcharges on ICBC rates. Mr. Hall –– 3279

B.C. Tel service. Mr. Mitchell –– 3279

Alleged polygraph testing of welfare recipients. Hon. Mr. Williams replies –– 3279

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

On vote 114: minister's office –– 3279

Mr. Cocke

Mr. Lea

Mr. Mussallem

Mr. King

Mr. Barber

Mr. Hyndman

Mr. Barrett

Matter of Privilege

Alleged bias of Mr. Speaker.

Deputy Speaker rules –– 3303

Mr. Hyndman –– 3303

Routine Proceedings

Tabling Documents.

Occupational Training Council annual report.

Hon. Mr. Smith –– 3304

MONDAY, JULY 14, 1980

The House met at 2 p.m.

[Mr. Davidson in the chair.]

Prayers.

HON. MR. CURTIS:

Mr. Speaker, today I have the honour to introduce a fellow legislator

from another part of the Commonwealth, Mr. John Mathwin, MP, from

Parliament House, Adelaide, South Australia. He is in the gallery.

Would the House make him welcome.

HON. MRS. McCARTHY:

We have in the House today one of Canada's leading authorities on

family life. He teaches at the University of Toronto and has been a

guest lecturer on family life in most of the countries of the free

world. He is in our province for three weeks conducting a course at the

University of Victoria on family issues. I would like the House to

welcome Dr. Benjamin Schlesinger, who is here with his wife Rachel and

his son Michael.

MR. SEGARTY: In the gallery this

afternoon are some very good friends of mine from Cranbrook: Carol and

Milt Howe, their daughters Denette and Susan and their son Michael. I

ask everyone in the House to welcome them here today.

MR. STRACHAN: I ask the House to welcome my wife Beverley, my son Dean and my daughter Jody.

MR. REE: We have a centenary event in North Vancouver, and I ask leave of the House to make best wishes today.

Leave granted.

MR. REE:

We have a young lady celebrating her hundredth birthday in North

Vancouver, Mrs. Bertha Breedon. It is always a special event, seldom

achieved by people today. I ask this House to wish her a joyous day and

health and happiness in the future.

Hon. Mr. Curtis tabled the annual report of the British Columbia Systems Corporation for the year ending March 31, 1980.

Oral Questions

REVENUES OF PROVINCIAL TREASURY

MR. STUPICH:

I have a question to the Minister of Finance. On what date did he

become aware that expenditures presented to this Legislature on budget

day could not be financed out of current revenues?

HON. MR. CURTIS: In order to provide a precise date I will take that question as notice.

MR. STUPICH:

When he was invited to take the post as Minister of Finance, was he

informed by his predecessor or by the Premier that 1980-81 revenues

were substantially exaggerated?

HON. MR. CURTIS: No, I was not informed. The question is based on incorrect information, Mr. Speaker.

MR. STUPICH: Mr. Speaker, is the minister telling the House that revenues have not been substantially exaggerated?

HON. MR. CURTIS: Mr. Speaker, no, I'm not telling the House that.

MR. STUPICH: Mr. Speaker, is the minister telling the House that revenues have been grossly exaggerated?

HON. MR. CURTIS: No, Mr. Speaker, I'm not telling the member that either.

MR. STUPICH: Mr. Speaker, is the minister telling the House anything?

HON. MR. CURTIS:

Mr. Speaker, I pride myself on having been as helpful as possible to

members opposite when questions have been put with respect to this

portfolio and the portfolios which I held previously. When the

questions are logical I attempt to give logical answers.

MR. STUPICH:

Well, Mr. Speaker, I think it's time we started all over, then. My

original question was: was the minister informed at the time he

accepted responsibility for this post that the revenues as presented in

the budget will likely be much higher than the actual revenue for the

period 1980-81?

HON. MR. CURTIS: Mr. Speaker, I think

the member was in the House the other day — in fact, I recall that he

was — when I indicated that this government introduced a process of

quarterly reporting. We are now some two weeks and a couple of days

from the report on the first quarter of the 1980-81 fiscal year, a

process that was introduced by this government to provide the kind of

information the member seeks through questions.

MR. STUPICH:

Mr. Speaker, is the minister telling us that until that quarterly

report comes out he will not know whether or not revenues for the

1980-81 period are in line with, in excess of, or less than the

budgeted figures?

HON. MR. CURTIS: Mr. Speaker, the

member opposite, having served for a short while as Minister of Finance

and having had some experience as a member of government, will know

that revenue and expenditure flows, through the course of any given

year, change quite often. Projections are revised depending on a

variety of circumstances. I tried to explain to the House last week

that one does not put together a budget and expect or reasonably assume

that nothing in that budget will remain absolutely unaltered through

the course of the fiscal year which commences some two or three months

later. I think the member knows that.

MR. STUPICH: On

Friday a press release was issued. It was delivered to my desk this

morning. The minister indicated in that press release that it was

necessary, because of a decrease in revenues below those forecast, for

him to apply what he called a crude instrument of restraint. It would

seem to me that the minister has more information than he is prepared

to give us today.

[ Page 3278 ]

HON. MR. CURTIS: There will be ample opportunity in my estimates. If the House was about to adjourn for some months....

MR. KING: Arrogance.

HON. MR. CURTIS:

No, Mr. Member, not arrogance. I'm not through with the question. You

can be pleasant in the hall, but you're very rude in here at times.

answer the question, I consider a freeze such as was introduced with

respect to the hiring of new public servants to be not the finest

instrument one can use. I described it as "crude." It is. It has been

used before; in fact, it was used by the party opposite when it was in

power. That does not necessarily suggest that it is the finest

instrument that one could use in a time of some uncertainty.

have made it very clear — if the member has read the entire press

release — that we're very hopeful that the freeze on the hiring of new

people within the public service of British Columbia can be lifted

selectively and gradually, and that it won't last very long. I thought

the kind of quick action which I considered appropriate, having

received indications that we are in something of a difficult year. It

is a year when there are a variety of factors well beyond the control

of this House or of this province. There are some difficulties, and

therefore this must be seen for precisely what it is: a signal to all

my colleagues, to deputies and to the managers of government throughout

the province that there is the need for some restraint.

MR. STUPICH:

I wonder whether the Minister of Finance heard the Premier's remarks in

the previous week to the effect that there was no need for any cutback

in government services.

HON. MR. CURTIS: In some

jurisdictions wholesale firings are taking place in the public service.

That is not necessary in British Columbia. That is not even being

considered in British Columbia. What I have done is slow down....

Interjections.

HON. MR. CURTIS:

I consider it necessary to send a signal to the government of British

Columbia, and to the managers of government, that there is some

restraint required at this particular point in time. In the mid-term,

in the longer term, I'm extremely optimistic, but there are some

warning signs with respect to this fiscal year. It would be

irresponsible for any Minister of Finance in any government to ignore

those early warning signs.

MR. STUPICH: Mr. Speaker,

the minister has said there will be ample time to discuss this when

we're considering his estimates. Since the opposition finds out an

adjournment time each day, is the minister telling the House that there

will be no adjournment of the House until we have dealt with his

estimates?

HON. MR. CURTIS: Mr. Speaker, clearly that's up to the House Leader, and the member knows that.

LABOUR ACTION AT GLENGARRY HOSPITAL

MR. COCKE:

Mr. Speaker, I'd like to direct a question to the Minister of Health.

Would the minister report to the House the state of affairs at

Glengarry Hospital? There appears to be a job action in progress, and

I'm informed that the place is locked up. Patients and staff are

inside; there is no communication. Can the minister tell the House

what's going on?

HON. MR. MAIR: Mr. Speaker, I can

only tell the House at this point that there is, as the member has

indicated, a labour dispute, which has resulted in a very unfortunate

situation at Glengarry. My staff are now looking into the matter. I

expect to have word within the next day or two, and I'll be glad to

report to the House when I do.

MR. COCKE: Mr. Speaker, I have a supplementary question. Has the minister assured himself that patient care is not in any way jeopardized?

HON. MR. MAIR:

Mr. Speaker, at this point I am assured, but I'm not assured that that

situation will remain for the foreseeable future, which is why I'm

having my staff look into it right now. As the member knows — and as

the House will know — this is a private dispute over which the

government does not have any direct control. That does not mean we

don't have an obligation to make sure that patients in that hospital

are cared for during that dispute. That is the thing I'm having my

staff look into; that is what I will report to the House.

ALLEGED CHIPPING OF

GOOD-QUALITY SAWLOGS

MR. KING: Mr. Speaker, I have a

question to the Minister of Forests. On June 26 I asked the minister if

he had decided to hold an inquiry into the chipping of good-quality

sawlogs and lumber by sawmill operators. The minister replied by

casting doubt on the photographic evidence presented by the IWA which I

passed on to the minister.

The minister has now received a

letter dated July 7 from Jack Munro, president of the IWA regional

council No. 1, which says the minister's assertion is completely and

totally ludicrous. Has the minister now decided to hold an inquiry into

this matter?

HON. MR. WATERLAND: Mr. Speaker, I

believe I advised the member for Shuswap-Revelstoke at that time that

the monitoring of the use of logs is an ongoing process with the

ministry, and it continues today.

MR. KING: Well, Mr.

Speaker, the minister is aware that he had a direct request to hold a

public inquiry. The suggestion was made that a public inquiry was

necessary because certain people within the industry felt threatened

and intimidated by retaliation if they spoke out on matters of poor

utilization.

Now that the minister has received a very

strong letter from an element of the forest industry saying that there

is wastage by the chipping of first-class sawlogs, is he prepared to go

beyond the normal monitoring he refers to and hold a full-scale inquiry

into the wastage of prime sawlog material in the province?

[ Page 3279 ]

HON. MR. WATERLAND: No, Mr. Speaker.

MR. KING:

Has the minister decided to discuss further with the people who are

making these complaints the source of their complaints and the validity

of those complaints, or is he just ignoring them completely?

HON. MR. WATERLAND:

Mr. Speaker, the ministry and the minister have constant dialogue with

all sectors of the forest industry about many, many subjects.

MR. KING:

That's an admirable quality, Mr. Speaker. Will the minister, then,

respond to the letter from the president of the IWA, in which he calls

the minister's remarks ludicrous, to further elicit from him any

evidence he holds that wastage of prime sawlogs is taking place on a

wide scale in B.C.?

HON. MR. WATERLAND: I respond to all my correspondence.

BODY-SHOP SURCHARGES ON ICBC RATES

MR. HALL:

Mr. Speaker, I'd like to address a question to the Minister of

Agriculture in his capacity as a director of ICBC. When motorists

purchase insurance from ICBC, they're under the impression that they're

buying protection against accident damage with a specified deductible.

The practice of allowing body shops to surcharge individual motorists

under the guise of balance billing denies this principle. Has the

minister decided to recommend to the board that the corporation

reimburse motorists for the full cost of repairs to their vehicles in

accordance with the conditions of the insurance they purchased from the

corporation?

HON. MR. HEWITT: No, Mr. Speaker, I haven't decided that.

MR. HALL:

Mr. Speaker, will the minister agree that this state of affairs, in

which the insured motorist now finds himself uninsured to an unknown

extent, is a deteriorating situation which should be addressed by the

minister, and will the minister advise and confirm that this will be

taken up by him at the next board meeting?

HON. MR. HEWITT:

Mr. Speaker, I understand from ICBC staff that where a motorist is

faced with a damage claim on an automobile, he is made aware by the

claims centre that the rate is $25.60. If he goes to a body shop and

there is a comment regarding an excessive rate over and above $25.60 an

hour, he can come back and be directed to a body shop that charges

$25.60 an hour at the present time.

B.C. TEL SERVICE

MR. MITCHELL:

My question is to the Minister of Universities, Science and

Communications. B.C. Tel plans to withdraw operators from Vernon,

Cranbrook, Nelson, Williams Lake, Dawson Creek and Terrace, and

substitute a computerized system, commonly known in the industry as

TSPS, with centrally based operators. Has the minister decided to ask

the CRTC to hold hearings in these communities, so that local residents

can have input before B.C. Tel cuts service in the interior?

HON. MR. McGEER:

Mr. Speaker, as the member well knows, the British Columbia Telephone

Co. is under the jurisdiction of the CRTC and not the government of

British Columbia.

HON. MR. WILLIAMS: Mr. Speaker, I

wonder if I might have leave to respond to a question posed by the

first member for Vancouver Centre (Mr. Lauk) with respect to the use of

polygraphs.

Leave granted.

ALLEGED POLYGRAPH TESTING

OF WELFARE RECIPIENTS

HON. MR. WILLIAMS: The member

asked me if I was aware of two circumstances. I think it would be

appropriate if I divided my response. The first circumstance to which

the member alluded was stated by him as follows: "We are advised that

the Ministry of Human Resources officials at the local level have

advised welfare recipients, when they report such losses" — these are

losses by reason of theft — "that they will not be considered for a

special allowance unless they have reported the theft to the police."

With respect to that matter I am advised by the Minister of Human

Resources (Hon. Mrs. McCarthy) that that is generally the case.

The

second part of this question was to the effect that the police have

indicated that so many of these thefts have been reported that they

have been using polygraph tests and have done so in consultation with

Ministry of Human Resources officials. The answer is that polygraph

tests are used as an investigative device by the police in this

province, and in these particular cases such use is not as a result of

consultation with Ministry of Human Resources officials. In fact in the

past year only one such polygraph test has been used and that was with

the consent of the person being investigated. As the hon. member knows,

polygraph results are not admissible in a court of law but are purely

an investigative device. However, in view of the concern that was

raised surrounding this particular incident, the following directives

have been issued by my ministry to those forces who have polygraph test

equipment:

"Henceforth all requests for

investigating officers for polygraph tests must be approved by a senior

supervisor from the police force requesting its use with a view to

ensuring that all other methods of investigation have been fully

canvassed prior to the employment of the polygraph. Secondly, before a

polygraph examination is conducted the individual to be examined must

fully understand that the polygraph is voluntary and that a consent be

obtained, either in writing or verbally on tape."

Orders of the Day

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

ESTIMATES: MINISTRY OF HEALTH

(continued)

On vote 114: minister's office, $165,162.

[ Page 3280 ]

HON. MR. MAIR:

On Thursday last several members raised with me a number of questions,

and I would like to start off today, if I may, by dealing with them in

a little more detail than I was able to on Thursday.

The

member for Burnaby-Edmonds (Ms. Brown) raised, during the course of her

remarks, several concerns concerning Burnaby General Hospital, and I

expressed my surprise at that time for a couple of reasons. I had felt

there was a good relationship and understanding between Mr. Norm Barth,

the administrator, and myself. You may recall that I quoted from a

recent letter at that time. Secondly, as far as I could recall at that

time the hospital was in a good financial situation. I have, as I

promised, had the matter reviewed and I'd like, if I may now, to reply

in a little more detail to the hon. member.

I didn't have

the conversation myself but my staff had a conversation with Mr. Barth

over the intervening days. I understand the following is a fair

summation of that telephone conversation. First of all, it would not

appear that there are any operational budget problems. There is

adequate funding for the services which the hospital is expected to

provide and the fact is, as of March 31, 1980, the hospital was in a

surplus position.

Secondly, day-care surgery has not been

curtailed. The hospital does approximately 160 procedures per month and

has remained at approximately that level of service. If the hospital

were to curtail day-care surgery it would not be due to budget but

rather due to the fact that during the summertime there are inadequate

candidates.

There is a waiting period of approximately three

to six weeks for elective surgery and the hospital is satisfied with

that. The waiting list is currently 703, including the 195 for day-care

surgery. The hospital does approximately 700 surgical cases per month.

understand there are no capital budget problems for the present level

of service but there is one minor matter which the hon. member raised

which was substantially correct. There are still a few unfinished areas

following the completion of the expansion program and perhaps these

should have been included in the total expansion program. The hospital,

I am told, has been trying to get minor capital improvement grants to

complete these areas and has requested $54,000 to complete the work.

They received verbal approval for $15,670 of this amount and my staff

are reviewing the remainder of the request. Hopefully all the minor

unfinished areas will be completed in the near future.

The

hon. member for Maillardville-Coquitlam (Mr. Levi) raised a great many

questions. I'm sure that if I attempt to answer them today I'll only

just touch upon a few of them and we'll get into some more detailed

debate. He raised particularly the question of the established programs

financing formula. I did take the time to examine the Blues and try to

extract specific questions but I may not have gotten them all. One of

the questions he asked is: "Are we better off under EPF than we were

under cost-sharing?" I think, Mr. Chairman, that a comparison can only

be made with hypothetical federal cost-sharing funding after three

years of EPF. But in the opinion of the Ministry of Finance analysts,

British Columbia's receipts under EPF are higher than, but nevertheless

very close to, what the province would have received under a

continuation of cost-sharing. Once the levelling-up has been achieved,

probably in the next fiscal year, 1981-1982, growth rates will become

more moderate and the proportion received by British Columbia will

level off or decline.

The Hon. member then raised the

question as to whether or not the principles of medicare, namely

deteriorated in medicare since cost-sharing. The best answer I can give

him is that while this does appear to have happened in other provinces,

the principles remain in force in British Columbia to the same degree

now as they did before cost-sharing.

The hon. member then

raised the question that for health care EPF is based on medical costs

and hospital costs only, and it has led to a neglect of preventive

programs and low-cost alternatives. The very reason, Mr. Member, we've

entered into EPF — or we did at that time — was to give the provinces

more flexibility in providing preventive programs, which British

Columbia has done. Of course, I suppose the most obvious example of

this is the Long-term Care Program. Preventive programs and low-cost

alternatives were not cost-shared prior to 1977 when the deal was made.

The

hon. member has indicated that payments by the federal government have

not increased under EPF at a rate necessary to cope with inflation. I

must respond that the arbitrary budget limits were established under

cost-sharing before 1977, and they are not now operative. The limits

imposed on annual increases and payments to the provinces were imposed

under the cost-sharing scheme and were not part of the EPF agreement.

The

member goes on to talk abut the indexing of premium payments. He says

the middle class to the detriment of the poorer class. I think I tried

to deal with that last week, Mr. Chairman. I'm sure we'll deal with it

again. I don't think that there's any deterioration in terms of access

at all, and certainly there is no deterioration on the grounds that

those who can't afford to pay are in any way prejudiced, because those

payments in fact are made for those who can't afford to pay. However,

this is not done in the same method — and I think we agreed on this

last week — that the member would prefer. We just happened to do it a

little differently.

The member indicated at one point that

the provinces had not driven a good enough bargain, or words to the

effect, and that we should deal with this year, not two years ago.

Probably where you're looking at cost increases of 11 percent, you're

going to get something like 8 percent from the federal government.

You're not even going to make the cost of living in that respect. I

think that's a fairly accurate quote. I must say that it's difficult,

again, to draw a precise comparison since the two factors do not run in

parallel. But assuming that your estimated increase of 11 percent is

correct, at least I can say that the revenues under EPF in 1980-81

increased by 11.5 percent.

The member stated that the

government had not laid sufficient emphasis in its submission to the

Hall commission on the need for preventive health services, and he

commented about the vagueness of lifestyle modifications in the

preventive sense. I would refer the member to page 7 of the submission

to the Hall commission, pointing out that the Home Support Program had

quadrupled between 1977 and 1980 and that the Long-term Care Program

had developed 16 adult day care centres, 17 group homes, and was

looking to much more flexibility and innovation in the delivery of

alternative forms of care.

Without going into it in any

great detail, I suppose it's always a question of opinion as to whether

or not one deals enough with a certain subject, and perhaps we might

have

[ Page 3281 ]

dealt

at greater length with the Hall commission. I felt satisfied and still

do feel satisfied that we gave Mr. Justice Hall a full accounting of

our position in that particular area.

The hon. member also

mentioned something to the effect that the tax transfer is also

earmarked. I thought l had made it clear in the first part of my

remarks that that's one part that is not earmarked. This is the source

of the flexibility for the province to innovate, if it wishes. So

that's one of the areas that is not earmarked.

The hon.

member for Maillardville-Coquitlam (Mr. Levi) and I got into a bit of

a.... I don't think it was a philosophical discussion on preventive

medicine; I think it was perhaps a little more practical than that. It

dealt with whether or not the government ought to be doing more in the

area of discouraging smoking, excessive drinking and that sort of

thing. We had a little disagreement which we've carried on since Public

Accounts as to the benefits of smoking. I thought perhaps I might just

run down a few of the areas where we feel that it makes approaches in

this area very apropos, and some of the reasons for it.

talking to experts in the field, it seems that at least three basic

areas, perhaps four, are very much affected by smoking. I refrain from

using the expression "excessive smoking", Mr. Member, because, as you

know, I think that any smoking, even if it's secondary smoke, is

excessive. In the areas of heart disease, there is no question that the

causal relationship between smoking and heart disease, or at least the

aggravation of it, has been long established. On the question of

strokes, blood pressure control and so on, there is no question that

once again, smoking has an extremely adverse effect there, and there's

no doubt that lung cancer is essentially preventable — not necessarily

lung cancer caused entirely by tobacco smoking, but certainly it is

something that is basically preventable. Also, of course, the effects

of smoking on the unborn have yet to be fully assessed.

There are other areas of preventive medicine where I think we are doing a fair job but must do a much better job.

The

question of accidents. We didn't get into that, but I don't think

there's any doubt now that seatbelts have been proved an important

preventive medicine. I think that perhaps it's for others in the

government to say that the degree of our enforcement of the law is an

issue that we might look at in that regard. We've been taking a rather

tame approach towards it, but there's no doubt that ICBC statistics,

and indeed statistics all across Canada, indicate that this is an area

where we are making some considerable strides.

In the area

of perinatal health — deaths of the newborn — a corresponding reduction

of handicapping conditions can be achieved in the order of about 40

percent. My staff are working on strategies of coordinating increased

perinatal care, with an emphasis on nutrition and more sophisticated

hospital care of the newborn. Expert opinion states that for every

newborn child's life saved there will be two fewer handicapped

children. I think great credit is due to my, predecessor, particularly,

for this.

Another area that we don't think of in terms of

preventive medicine so often that obviously is a very key area is

dental decay. I think we all recognize that a substantial amount of

dental decay — I'm told up to 60 percent — is preventable.

course, I know that we're going to get into at some length the question

of alcohol and drug abuse, so I won't go into that in any great detail

now. I've indicated to the member some of my reasons for not favouring

additional advertising in the electronic media. I notice that I did not

talk about lifestyle advertising, which the advertisers insist it is

not — I insist it is.... As long as you always win the game or the

girl, catch the fish or whatever the prize is, to my way of thinking

it's not just a matter of trying to get you to change brands, it's

trying to tell you that the idea's a pretty good one in the first place.

Those

are some of the matters that we touched on last week. Just before I

take my seat for further questions I would like to raise one issue

which I think was certainly touched on — if not in question period

alone, I think perhaps in my estimates. That's the question of the

university hospital and the suggested cost of $600 per diem. The reason

I raise that now, Mr. Chairman, is that it's come to my attention that

Dr. Mandeville, who is now the president of the BCMA, in circulating a

letter to his colleagues in answer to a letter I wrote, said:

am equally encouraged to see that the government is now prepared to

accept medical input into health planning, and indeed the winds of

change are noticeable in the past month. If they had listened to

medical input they might not have been saddled now with the university

hospital and its $600 per diem rate. The BCMA presented a brief on cost

containment to government four years ago which appears to have been

ignored. There has been similar inaction regarding the Black report."

thought I should bring to the attention of the chamber that this $600

figure has been emphatically refuted by Dr. Price, medical director of

the Health Sciences Centre Hospital. I thought, if I might just take

two or three minutes of the chamber's time, I would just read his

letter, which is addressed to Dr. Mandeville. He says:

"In

your recent president's letter of July 7, 1980, you mentioned a

university hospital and its $600 per diem rate. I assume this refers to

the acute-care unit of the Health Sciences Centre Hospital, University

of British Columbia. As the per diem rate for acute-care unit has not

yet been determined this is clearly a misstatement. Had you enquired,

you would have discovered that hospital per diems are set by the

Ministry of Health after review of the hospital's proposed operating

budget and is related to estimated workload and statistics for the

hospital. As of this writing this review has not yet been completed for

the acute-care unit. However, it is most unlikely the per diem, when it

is determined, will exceed that of the Vancouver General Hospital,

which is currently $253.05 a day."

I pause to say that I mentioned that I think it will be somewhat less than that.

He goes on and finishes:

"It is unfortunate that such an irresponsible and mischievous

rumour should be propagated by an official publication from the president's

office of the British Columbia Medical Association. This can serve no useful

purpose and detracts from the status of the profession."

The

letter from Dr. Mandeville that gave rise to this letter is dated July

7, 1980, and the letter from Dr. Price is dated July 11, 1980.

MR. COCKE:

The minister has allayed our fears. The minister has told us that it's

not going to cost $600 a day to operate the "McGeer Memorial Hospital"

at UBC. I don't

[ Page 3282 ]

know

where they're going to hide the costs of running that highly

sophisticated facility, but I'm here to tell you that if the minister

can come into this House and show us a year from now, two years from

now, or at any other time, a definitive budget for that hospital that

is anything less than $600 a day, taking into account all of its

splendour, I'm going to be the most surprised person on earth.

Mr.

Chairman, I have talked to experts in the field who have had very close

relationships with that — the ultimate of expenditures. One of the

reasons for the fact that the province is in such dire shape is they're

putting on freezes and all the rest of it at the present time. What Dr.

Mandeville says in his letter is the subject of discussion among

experts across the province. I have seen this projection go up in the

last two or three years from $450 to $500 and now to $600 and I've had

a more recent prognostication that takes it to $680 per diem.

I'm

sure that if other aspects of running that hospital are taken on by

other departments then they can reduce the per diem. The minister told

us only two or three days ago that it was going to cost $180 per day

and now his own administrator tells us it's going to be $250. That's a

$70 increase in the per diem in three days; last Thursday that was his

accounting for the cost of operating that hospital. I believe it's a

shocking situation and I really feel rather sorry for the minister

being the one to have to carry the brunt of this problem.

This

was a question that got the now Minister of Universities, Science and

Communications (Hon. Mr. McGeer) to walk across the floor and become a

Socred. He had wanted that acute-care centre at UBC for so long he

ached. When given that promise.... And don't forget that one of the

first things the Socreds did when they came to power was to tear apart

the British Columbia Medical Centre, which would have been good

planning and provided a good thrust for the development of health care

education and health care work. But no, Mr. Chairman, they went the

other way. They destroyed, dismantled and went into these individual

areas of that particular thrust. So they built one, and it's a white

elephant. And it's going to increasingly become more of a white

elephant.

One of the major reasons is that there is not one

element of that hospital large enough on its own to be economical and

all elements of that hospital can best be described as tertiary —

highly sophisticated and very expensive to run. Now if they have the

same disastrous experience that history would have told them they might

expect.... Such has occurred in Sherbrooke, Quebec, and at McMaster in

Hamilton, where they decided to take the hospital away from the people

and put it on the campus where they can't attract the patients. Who

wants to go to the periphery for health care attention? Who wants to go

to the periphery of a community when there's a corridor in Vancouver

providing health care? That minister is going to carry the can as long

as he's there for a mistake made by his predecessor and their

government.

That minister also told us the other day

that he didn't want to be misunderstood. He wanted everybody here to

understand specifically that he wanted the position of Health minister.

He said he almost asked for it. Well, it was relatively common

knowledge on this side that he wasn't all that excited. But let me

quote his colleague, the member for North Vancouver–Seymour (Mr.

Davis). The minister said that he wanted it. In an interview with The Columbian ,

a little newspaper in New Westminster that I happen to pick up every

once in a while, the member for North Vancouver–Seymour said, and I'm

quoting: "About Intergovernmental Affairs minister, Garde Gardom — I

don't know. I don't think Garde knows much about what he's doing,

anyway. Rafe Mair would really like to be in that slot. I don't think

Garde really has any strong views on the area, but Garde can work well

with the Premier."

Obviously the Minister of Health can't

work well with the Premier; and if he can't work well with the Premier,

it strikes me that the Premier put him in one of the toughest, roughest

portfolios of government — and I know a little bit about that, Mr.

Chairman; I held that portfolio at one time, and it is tough. But it

becomes increasingly difficult if you continue to make those kinds of

mistakes. I hope that the minister stops being an apologist for his

predecessor. He's stuck with it; he's stuck with the portfolio that his

colleague describes as one that he didn't particularly want. He wants

to be on the run, discussing the major affairs of Canada, where his

colleague, the Minister of Intergovernmental Relations, finds himself

now, bartering, negotiating the affairs of our country — hopefully not

negotiating away our country, but negotiating, bartering the affairs of

the country.

Mr. Chairman, another thing that burns me about this suggestion that came out of the debate on Thursday....

notice that there is a member back from New York. How can Times Square

live without you, now that they've seen you? And how can they keep you

down on the farm, after you've seen New York? That member for North

Peace River (Mr. Brummet) has had the time of his life; he'll never be

the same again.

Interjections.

MR. CHAIRMAN: Order, please. Will all hon. members please come to order.

MR. COCKE: Mr. Chairman, the prophet from the North Peace tells me I've got a hot future — whatever that might mean.

MR. BRUMMET: Do you want to know where?

MR. COCKE: Mr. Chairman, I'll have lots of good company from North Peace River.

Nurses

are at fault, we hear, health workers are at fault for our tough

situation in health care. The hint is left that one of the reasons for

the increases in rates to people the increases in the cost of the per

diems at the hospitals, the $2 increase in the cost to chronically ill

people in extended care, which is $60 a month.... We see two ministers

using it as a handle. We see the Minister of Health using it where it

best suits his purposes and we see the Minister of Finance (Hon. Mr.

Curtis) using it as well. That, Mr. Chairman, is an absolutely shocking

performance. The minister budgeted $41 million for his increase in this

fiscal period, when — and incidentally it wasn't just the nurses; we're

talking about all of the health sciences people: the nurses working for

the government, the nurses working for the hospitals, the orderlies and

all the rest of the people working in the hospitals — that will cost us

an additional $135 million. That's $176.5 million altogether in this

fiscal period. Sure, it's a lot of money, and sure, they can make

charges that this is the reason that we're in such dire shape; this is

the reason they put freezes on; this is the reason they increased

rates. But you can't have it all ways.

[ Page 3283 ]

[Mr. Hyndman in the chair.]

The

minister has to decide whether or not his budgeting was any good in the

first place and whether or not he could not prognosticate a lot closer

than $135 million out, or come in and say to the House: "Well, we put

the lower figure in so that they wouldn't have too much of our carrot

to look forward to." But don't come in here and give us that plea that

this unexpected expenditure is the reason for all this darkness and

gloom. If they couldn't foresee, as everybody else did.... I read Province

editorials — that's not exactly the most outrageously

expenditure-conscious paper that I've ever seen — acknowledging the

fact that there was some catching up to be done; the same thing with

the other paper, the Sun ; and the same thing with people who are thoughtful about the whole question.

Mr.

Chairman, it's not a good excuse, and I don't like to see people

working in that very important area called health care, carrying the

can for everything bad that happens. If any of us were ill and were

getting the care offered in our major hospitals — when they can afford

to open a door for us — I doubt if we would resent the amount being

paid those health workers. If we do resent it, let's come right out and

say so, but let's not use their increases as excuses for our own total

incompetence.

I believe that one of the reasons I am as

angry as I am about the increases that we saw.... I'm not going to deal

with increases particularly today, other than the one for those who are

chronically ill — $60 a month. Here is a plaintive plea from somebody

in Rainbow senior citizens long-term care lodge in Prince George,

British Columbia.

"I am a resident on the

committee of the above hospital. I am enclosing a copy of a letter I

sent to Rafe Mair, Minister of Health, on June 13 — we registered it

both ways so that we would have proof of delivery — which arrived on

June 17. Needless to say, there was no reply from Mr. Mair.

"As

senior citizens we agree we are pretty disgusted, as I'm sure you will

appreciate. Two dollars a day doesn't sound like much, but when you say

$60 to $62 a month extra, going from $6.50 a day to $8.50 — which in a

year is somewhere near $744 extra — it really hurts. At the same time,

on July 1 our hospital costs go up from $4 a day to $5.50. Ambulances

go from $15 to $19. B.C. Medical is also up. While anybody is away in

hospital, they have to pay both the hostel charges and the hospital

daily charges."

What she is talking about here is that she

is in long-term care and, in order to maintain her bed in long-term

care, those costs per diem go on. If she happens to be moved for a time

— six, seven or ten days, or whatever — into an acute-care hospital for

some condition, which is not unusual, then those rates also apply. She

goes on:

"All this coming in Canada Week,

where we should all feel happy and proud. The $35 extra coming at the

end of July would be a great help from Ottawa, but when it is taken

away again so soon, how do a lot of seniors save for glasses, hearing

aids and many other medical aids not covered by Pharmacare — ordinary,

everyday necessities? Incidentally, isn't the increase approximately 30

to 33 percent? The rentalsman would only approve 10 percent."

This

very articulate old-age pensioner in an extended-care hospital — in a

long-term care hostel — writes and not only tells us what she thinks,

but sends me a signed petition from her fellow patients or residents in

that facility. That says it all.

Where in heaven's name are

this minister's priorities? I have had — and I vouch the minister has

had — letters from all over this province in that same vein. I could

have brought in a stack as high as you like and gone on reading for as

long as you like; but I needn't, because it was all said there. It's

unfair and unfortunate. Not only that, they turn around and try to put

the handle on somebody else — the nurses, the health workers or

whatever.

I suggest that that increase, along with the

others, has to be very carefully thought out by this government, as

well as their policy of indexing from now on. If those people on fixed

incomes, who are most affected by this policy, were also indexed, then

I would say maybe you have a case. But they are not. Not by any stretch

of the imagination are they indexed.

I was reassured a few

moments ago when in reply to the member for Burnaby-Edmonds (Ms. Brown)

the minister indicated that all's well in Burnaby General Hospital.

That gives one a sense of confidence. That gives one a sense that all

is well, because if Burnaby General is going well, surely everywhere

they are doing just fine.

[Mr. Strachan in the chair.]

How

are things in Vernon these days? Vernon Jubilee Hospital is

overcrowded: cancelling surgery, putting patients in corridors,

treatment rooms and even in bath areas. It could reach the same

critical stage which looms before Victoria's Royal Jubilee Hospital: a

possible moratorium on all elective admissions. We're in a desperate

situation, notes the assistant administrator. That was three or four

months ago when all was well. Things are bad now, but then they were

okay. Things are bad now because all the nurses are on holiday. What was their excuse then? All

through the year it has been a disaster. Now they say that the nurses

are all on holidays for the summertime. They have a fortunate contract

where they can take off. I say balderdash. It's a chronic problem. It

has always been a chronic Social Credit problem because of the lack of

priority for health care.

We see announcement after

announcement: a hospital being built here, more beds there. But when

you total it all up at the end of the year, what have you got? You've

got a bunch of very discontented Social Credit MLAs wishing their

government would place some priority on health care in their particular

area. I'll bet you, if we could only hear those speeches, if we could

only hear them stand up and say what they really want to say....

What

about the Premier's own constituency — KGH? That's short for the

Kelowna General Hospital; I'm not all that keen on acronyms, but

everybody uses them, so I thought I would just carry right along with

the way things are done. Kelowna General Hospital is suffering an acute

case of bed-shortage, and no permanent cure is seen by hospital

officials for some time. The result is inconvenience for patients and

an obvious strain on the hospital itself. "We're under tremendous

pressure," says Colin Elliott. Mr. Elliott indicates one of the

reasons we're in such trouble; the big problem is that we have a large

number of acute-care beds occupied by long-term care patients. There

are other reasons. That was two months after the report from Vernon

Jubilee. It goes on and on.

[ Page 3284 ]

These

are just a few little clippings from Kelowna General Hospital. It's

amazing how things happen. Just about the time when the government

looked at its worst, there was an announcement of a couple of million

dollars to be expended at the Kelowna General for — guess what?

Extended-care beds. I don't know how they're doing, but I'll tell you

right now that the message came down the pipe real fast when it

affected that constituency.

MR. COCKE: The Minister

of Municipal Affairs (Hon. Mr. Vander Zalm) says I'm not doing too

badly at the Royal Columbian. Thankfully we got the Royal Columbian off

the ground; we built the basic services. Now the government is going to

build a patient tower; we're not doing too badly. I won't hold my

breath.

I'll tell you right now, they've announced that one

of the best elective surgery hospitals in this province is being

converted by that minister to an extended-care hospital. He talked

about a pilot project the other day; I tried to find somebody who

understood what he was talking about. Pilot project, my foot! It does

not lend itself to extended care. It's a six-storey hospital with

operating rooms, with wide corridors to move patients back and forth.

It is one hospital that is providing really valuable service in this

province, and we find that, down the road, because the minister feels

that he has to make some adjustments, that hospital is going to go out

of service for its present use. Need I now grovel, and say we're doing

fine in New Westminster?

One of the major industries in that

little town is health care — three major hospitals, plus Woodlands

School, plus being very close to Riverview, so that many of the people

working there live in New Westminster, plus a hive of cottage industry

called doctors' offices, because naturally that's where they

congregate. So it is not a constituency that is unaware of health

problems, nor is it a constituency that will take lightly to bad

decisions by Health ministers.

Well, Mr. Chairman, some of

my colleagues are going to deal with some of the local issues around

Victoria. But I will say that they haven't been without problems in the

capital city — nor are they now — which include extremely long waiting

lists for elective surgery and fights over where certain aspects of

health care delivery should take place. It is in crisis here as it's in

crisis elsewhere.

Mr. Chairman, in reply to what the

minister was saying the other day — and I'm raising this correspondence

because the minister was saying the other day that they've had a little

bit of a problem in the emergency situation at VGH — Vancouver General

had a shortage of beds and one thing and another, and so for a few

hours they had to divert patients. That occurred the week before last —

on July 2 or 3, I believe. I'll allude to two pieces of correspondence.

This is a letter dated February 28, 1980 — note that date:

"Dear Doctor:

"As

usual at this time of the year" — that's a good way to start; as usual

at any time of the year, this being now July — "VGH is desperately

short of beds. Elective admissions are being cancelled each day to

accommodate patients who are being sent in as emergencies. While these

patients are usually sick, some of them are not emergencies in the

sense of having an immediate threat to life or limb, or function of

vital organs. Many of them do not need the particular degree of

expertise which is available at VGH, and could be served — cared for —

just as well in other hospitals.

"In order to

solve this problem, we are making the following requests:

(1) Please do

not send patients to the emergency department for admission unless they

truly are emergencies as defined above. If the patient needs community

assistance or home care in order to remain at home, our social service

department can provide the numbers of appropriate agencies to contact.

(2) Do not accept transfers from other hospitals just because they have

no beds."

Mr. Chairman, I'm out of time. I'll come back to

this when the opportunity avails itself. I would, however, like the

minister to be very thoughtful about the delivery of health care, and

the costing of health care, as quickly as he can.

HON. MR. MAIR:

I would like to go back over the questions posed to me by the member

for New Westminster. Getting back to the exchange of letters, which I

read, I don't think that it's fair to say that there has been a $70

increase in the per diem cost at the university hospital over the last

few days, because neither myself nor the doctor replying to Dr.

Mandeville are able to say precisely what it is going to be. He has

said that it will not, in all likelihood, exceed $250. I have said that

I hope it will be around the $180 mark, but I'm not suggesting that we

could not be wrong. I don't think there is any question that the $600

per diem suggestion or figures anywhere near that are totally out of

whack. As the member said, we'll see.

He raised, with some

glee, a remark made by the member for North Vancouver–Seymour (Mr.

Davis). I haven't seen those remarks. With respect to my desire to have

the Health ministry, there is only one person who can answer that

question and it's not the member for North Vancouver–Seymour, nor the

member for New Westminster (Mr. Cocke), nor any other member, or any

other person. I can tell you that I was very happy to be made Minister

of Health. I said that last week.

I can, if you wish,

describe the rather humorous course of events that gave rise to the

misunderstanding by the press, who thought I'd gotten into some kind of

argument with the Premier when in fact I was sitting in Mr. Tozer's

office talking with a number of my colleagues waiting for my turn to

talk to the Premier. We can go into that if you like. They took that to

mean I was having some kind of argument. I think I can tell you,

without betraying confidence, that the discussion took perhaps four or

five minutes and when I found out I was to be Health minister I was

delighted and I still am, notwithstanding the fact that I agree with

the member for New Westminster that it is a very difficult job and

carries with it a lot of pressures.

I don't doubt that we

could double the budget for the Ministry of Health for this year and

still have many problems. We'd still be standing here today with the

Minister of Health — whether it be me or anybody else — being wildly

criticized by the critic for a number of things. Notwithstanding that,

I do enjoy the job. I can tell the member opposite that if I had not

wanted the job I would not have taken it. I am not so enamoured with

public life that I would have to take a job I didn't want. Furthermore,

I think I would find most jobs in the cabinet challenging. If I didn't

I am sure the member opposite, if he ever, god forbid, were to find

himself back in government and he were offered any one of 17 or 18

cabinet posts, would be very happy to take

[ Page 3285 ]

most

of them. I am sure he has thought that out in advance. There aren't

very many — with the exception of some that perhaps call for an

expertise that we don't personally possess — that you wouldn't take

because you've thought about that beforehand.

The question

of the settlements in the health sciences field and the question of the

budgeted amount I cannot answer for the Minister of Finance (Hon. Mr.

Curtis). I am sure he will be questioned and he will answer

satisfactorily in due course as to the things that go into making up

the budget. I can only say that I said publicly at the time that the

figure of 8 percent for the settlements was simply a figure to put in

the budget because you have to put one in there that is over and above

what you've got in. There is no way you're going to put in what you

think is going to happen. The people who are doing the settlement can

read budgets too. If you put in there that you are thinking in terms of

30, 40, 20 or 25 percent you can be sure that would be the floor of

negotiations from that point on. I don't think anybody would criticize

a government who did not wish, through a budget, to flag what they are

prepared to pay in any settlement that came about. As the member knows,

these settlements are reached by forces outside the government

entirely. It is an unfortunate thing for the government in the sense

that they have to pay these things and to a large extent have to carry

the can for the settlements because the public, I think by and large,

believes that the government does play a significant role in these

things and they don't. I frankly think the government is going to have

to examine this process, but not from the point of view of getting

directly involved themselves, because I think that once the government

became the payor of these things then it is only a matter of time

before it becomes a very much worse situation than it presently is. I

think we have to be better informed and have perhaps a better liaison

with the parties that are involved.

Dealing with the

question raised by the member for New Westminster of long-term care

homes and so on, it is a very sympathetic sort of case that one makes

for the proposition that people are not getting as much as they ought

to. I understand that the present old-age security and supplement for

senior citizens is now $375.15 a month and has been since July 1. When

you take from that the $255 a month it leaves about $120 a month for

spending money. This is not a princely sum. I am not pretending that it

is, but one must remember that the $255 per month is total maintenance.

It is not just a matter of board. It is room, board, care and all those

things. While I appreciate the point the member has made I think that,

to put it in perspective, we are talking nevertheless about complete

care and if one has absolutely no private income whatsoever — I know a

great many people don't have it — it is still $120 left over from that.

Dealing

with the Vernon Jubilee Hospital and the Kelowna General Hospital, the

Vernon Jubilee Hospital has two expansions in the planning stage right

now. First of all, there is a new extended-care unit. I understand

there are 75 beds in Vernon Jubilee itself and 133 extended-care beds

will go to the Dellview site, for a total of 188 extended-care beds

which are now are on the planning board. Of course, that doesn't put

them in effect. I appreciate that. It's only natural that the member

may very well want to get to his feet and say: "Well, what's that going

to do next year?" I don't know that I can answer that, but I can say

this. We have addressed ourselves to it, certainly to that extent. The

expansion of acute-care beds in addition to that will be from 155 to

228 and we've also expanded a number of other services — radiology,

laboratory, ambulatory, out-patient and so on — in that hospital. I

don't think it would surprise the member to know that I've been in

close touch and I'm working with the member for Okanagan North (Hon.

Mrs. Jordan) concerning those problems.

Regarding Kelowna

General Hospital, again, you might guess that I've heard from the MLA

in that area, and I might say that we have approval now to improve the

service areas — emergency, out-patient and that sort of thing — which

will be completed by the spring of 1981. In addition, we have just

completed 50 additional extended-care beds and we have 100 additional

extended-care beds approved, which will be available in 1982.

think that I have dealt with most of the questions. I may have missed

one or two, but I'm sure that my friends opposite will bring to my

attention those that I have missed.

MR. LEA: Mr.

Chairman, when a great many people in this province were convinced that

the present minister didn't want the job, they felt quite unsettled

that here was a Minister of Health who didn't particularly want the

job. That was the inference from the press reports and people, I'm

sure, were quite upset to hear that. Having watched the minister in his

brief time in the portfolio, they have become even more distressed. Now

that they know he actually does want the job and he's interested in it,

because he has that kind of record, it frightens everyone, not just a

few people in this province. When you go into an estimate, as a member

of the opposition you think out how best you can articulate what you

see as the problems within a ministry. You try to deal with that in the

best way you can and hopefully offer some constructive suggestions

where you have the expertise or the knowledge.

I have with

me today a letter that I believe sums up the health care system in this

province and our hospitals in a much more articulate way than I ever

could, because all too often from this side of the House and from the

government's side we tend to deal with statistics when talking about

something as human as health care. It's very difficult through numbers,

jargon and health care talk to really let each other and the people in

this province know the kind of problems that individuals within our

society are facing when dealing with the health care system under

Social Credit. The attitudes of the Social Credit Premier and the

Social Credit minister toward an individual, who, in my opinion — in

this letter I'm going to share with the House — makes a heart-rending

plea for help based on her experience and her family's experience with

an encounter with the health care system in this province....

The

letter, which I'm going to read to you in its entirety, because I think

it's all worthwhile — it says it all about the health care system — is

from a constituent of mine, a mother, directed to the Premier of the

province. It says:

The Right Honourable William R. Bennett,

Premier,

Parliament Buildings,

Blanshard Street,

Victoria,

March 25, 1980.

Dear Sir:

We've just gone through an experience that we wouldn't

wish on our worst enemy. We can't help but feel that if this happened to

you you would be more empathetic to the plight of the people

[ Page 3286 ]

that your government's hospital budget is affecting

the most the patients.

Our infant son had open-heart surgery at Vancouver General

Hospital at the age of seven weeks. He was on a heart monitor, which sounds

an alarm if the child quits breathing or the heart stops, as were six other

children in the nursery. Although there should be a nurse in the nursery at

all times to take action if the monitor sounds an alarm, this was not the case,

because there were just not enough available nurses on staff.

The second time our son was hospitalized the monitor was

on for precautionary reasons and so could be disconnected when we fed or played

with our son. One day, after being reconnected, the alarm sounded due to a malfunction

in the unit. I waited to see how long it would take for a nurse or a doctor

to respond to the alarm. After ten minutes I gave up. The alarm was never answered.

Can you imagine what would have happened if he really had stopped breathing

and I had not been there?

Many of the children in the nursery were fed by nose-tubes

since they were too weak to take food by mouth. Because of staff shortages,

the babies were often fed too quickly by a much harried nurse. This caused the

babies to throw up after feeding and many of them would end up lying in their

own vomit for over an hour, because there was no one available to check on them

or to change them.

Lab technicians were also rushed because of staff shortages

and the necessity for each person to do more and more work because of it. Because

of his heart condition our son has poor circulation in his heels, where blood

samples are usually taken at that age. The technicians were supposed to warm

up his foot before taking blood. This increases the circulation and makes it

easier to get blood, creating less trauma for the child. Yet only one technician

felt she could take advantage to do this, and our son had blood work done almost

every day for his two and a half months' stay. We saw children sitting in

dried vomit and diarrhoea because the staff was just too busy to help them.

We overheard staff members complaining about parents calling to see how their

children were doing, because they didn't have time to answer questions and

do their work at the same time.

Morale among hospital staff appeared to be very low and

getting lower every day. Hospitals that are already understaffed are becoming

more understaffed because of budgetary restraints. Fewer and fewer nurses have

to do more and more work in the same amount of time; this is particularly true

on legal holidays. If you want to experience a true horror story, spend a three-day

holiday weekend in a hospital. The movie "The Hospital," which is

supposed to be a black comedy, is all too often true. The truth is more frightening

than any fiction could hope to be.

Many good nurses are leaving Vancouver General Hospital

and other hospitals to go elsewhere due to the low morale and extremely heavy

workload — not to mention the low pay.

This was written, of course, before the pay raise.

Since Vancouver General Hospital is the primary acute-care

hospital for the province, it seems to me that expenditures for high-technology

equipment, such as a CAT scanner for Kelowna General Hospital, which serves maybe

100,000 people, could be put to better use in hiring more nurses and support

staff. Such capital-intensive expenditures should be reversed for the largest

hospitals only.

Perhaps some of the problems of overcrowding and understaffing

will be solved by the completion of the new Children's Hospital, but I don't

think so. What is needed is not more and better buildings, but more concern

and caring on the part of people who control the purse strings. In the health

care field you are dealing with human lives, and no one can tell us that there

exist dollars-and-cents values on any human life, particularly the life of a

little baby. Without children there is no hope at all for the future of mankind.

Because of our son's condition he will have to have

more surgery, and the operation will be quite delicate and serious. Are you

prepared" — this is to the Premier — "to take responsibility if a lack of staffing means that

his monitor alarm can't be answered? Surely there exists a compromise between

the present lack of health-care dollars and the runaway costs of medical care

seen in the United States. Such a compromise should provide good medical coverage

without bankrupting this province. How many children — or adults, for that matter

— must suffer needlessly in the almighty name of fiscal restraint? We have seen,

firsthand, a good deal of this suffering, and we can assure you that it is already

far too many. For anyone to have to endure anything less than the best that

today's health care can provide is unthinkable in a modern society.

Thank you for your time and attention.

Sincerely,

Dawn Winkleman,

Prince Rupert.

How

could anyone, Mr. Chairman, read that mother's and that father's letter

to the Premier and not be concerned? How could their heart not be

touched by this letter? It's a story of children lying in their own

vomit and their own diarrhoea and alarm bells not being answered

because of understaffing and overworked staff in the Vancouver General

Hospital. I'd like to ask everyone: What would you do if you were the

Premier and your received that letter? I'd like you to think about that

a moment, because I'm going to read to you what the Premier did.

Her letter was March 25, 1980. This is dated April 8, 1980.

Mrs. Dawn Winkleman,

218 5th Avenue West,

Prince Rupert,

British Columbia.

Dear Mrs. Winkleman,

This will acknowledge your letter of March 25 in which you

set out your experiences at the Vancouver General Hospital when your baby son

was operated on for open-heart surgery.

I have forwarded a copy of your letter to my colleague, the

Hon. Rafe Mair, Minister of Health, and asked him to look into the situation

as soon as possible. I am confident that the minister will be in touch with

you directly in the near future.

I can understand the deep concern that prompted you to bring

this matter to my personal attention and sincerely hope that your small son's

future surgery will be successful. I also certainly hope you will be spared

the ordeal which you apparently went through when he was last confined to hospital.

Yours sincerely,

Bill Bennett

Wouldn't

that be just a dandy letter to get back? You've laid out the terms,

you've laid out the experience you and your family suffered in the

Vancouver General Hospital, and you get a letter back from the leader

of government saying: "Good luck next time! I hope you don't have the

same problem next time. If you do, write me another letter and I'll

write you another sympathetic one," I suppose.

HON. MR. MAIR: What's the lady's name?

MR. LEA: Dawn Winkleman. I'll now read your letter to her, Mr. Minister. This was April 23:

"Dear Mrs. Winkleman:

"I've

received a copy of your original letter of March 25, addressed to the

Hon. W.R. Bennett, Premier, along with a copy of his reply, dated April

"I too share your concern about the care

and treatment received by your son in the Vancouver General Hospital,

and am asking medical consultants in my ministry to review this matter.

Until this review has been completed, I am not in an advantageous

position to comment further, other than to assure you that the matter

will receive our full attention when the review is complete, and I

should be in a position to write you then."

That's a better letter than the Premier's.

[ Page 3287 ]

But

what happened? Here's this family, with their child going back in for

delicate heart surgery. Can you imagine the fright that you would feel

after having witnessed, firsthand, the experience your child had in

that hospital? And to get these two letters saying: "Well, there'll be

a review — my Minister of Health will look after it." What kind of help

is that for the individual person who comes to government and says:

"Here's the kind of experience I've had"? You would think that, getting

a letter like that, there wouldn't just be a review, there would be an

all-out examination, and that in that time that mother and family would

have heard from this government as to what was found in that review,

and they would assure that mother and father that their child could go

back to Vancouver General Hospital and not suffer the same kind of

indecencies that he suffered the first time. Would anybody take a

chance on putting his child in Vancouver General Hospital if he'd had

that experience and that kind of response from government — not

knowing, when they took their child the next time, whether it had been

reviewed or anything had been done whatsoever? No word after the

initial one.

This is a letter from James Flett, president of the Vancouver General Hospital, to Mrs. Winkleman, dated May 26, 1980:

"Dear Mrs. Winkleman:

"Further

to our telephone conversation with respect to your letter dated March

25, 1980, addressed to Hon. William Bennett, and the subsequent letter

we received from the Minister of Health, dated April 21, 1980 " — I

don't know what that letter was; I wish the minister would let me know

— "I can tell you now that we have reviewed in detail the comments made

in your letter."

The hospital did a complete review. Now I'll give it to you; this is it.

"It

was difficult to review in detail the activities of the unit during the

period mentioned in your letter. It was, however, recognized by our

staff that the staffing of the unit during the period you mention was

of acute concern to us. Your son was nursed in a nine-bed nursery in

the health centre for children. Miss Murphy, our vice-president of

nursing, attempted to review as much as possible the events mentioned

in your letter with the staff who were with us at that time. They

recognized the seriousness of the comments and concerns indicated in

your letter and have been made aware of the anxieties which they caused.

hope that your son is steadily improving and will return for the care

he requires, which you mentioned in your letter. I would be pleased to

meet with you any time you happen to be in Vancouver.

James Flett."

Mr. Chairman, I think

this whole situation, as I've outlined it to the House, is incredible.

It's incredible that the Premier handled it in the way he did — almost

cavalier. You'd think that a Premier would go storming down to the

Minister of Health's office and say: "Look at this letter. Are you

going to allow that woman to go back in the hospital and take her baby

there, not knowing whether the situation has not only been reviewed but

rectified? Are you going to get in touch with her and let her know that

all those problems are not problems any longer, and that you don't have

to be scared out of your wits to take your son into the Vancouver

General Hospital because of the lack of staffing and the overwork of

those staff?" Mr. Flett says, yes, he was concerned at the time,

especially for that period of time. But our information is that it

hasn't improved, that things are possibly going from bad to worse. It's

not good enough.

It's just not good enough for the minister

to tell us he's interested, he really does like his job, he really is

interested in health care, and at the same time for us to have a

government talking about restraint in health care. We have a government

adding further costs to health care for the individual — not a

statistic, but for individuals in this province who have to suffer the

indignity of going through a health care system that this government

can't seem to get a grip on. The past minister was merely incompetent.

I don't believe this minister is an incompetent person; I believe he's

an able person. But what we want to do is to know why, in this

portfolio, he seems to be as incompetent as the last. Is it the

Premier? Is it the government itself? Is it the Minister of Finance

(Hon. Mr. Curtis)? Just what is it in Social Credit that every time

they come to office we have health care crises in this province?

The

minister can tell me he cares about the job; he can tell me he is

really and truly interested in health care. What are you going to do

about it? What have you done about this? There are others; we all have

them. I am sure government backbenchers and ministers have this kind of

letter. What are we, as a legislature, going to do about this kind of

atrocity in our society? There is a person in charge of making sure

this doesn't happen. There is a government that mouths that they are

interested in health care. When we look at statistics we might get one

story, but when we look at an individual case we know they are not

carrying out the mouthings in a mandate to the people of this province.

ask for the review that was done by the hospital. I think this is a

very, very serious situation we are discussing. Because of its

seriousness and because I think it is an indicator of what other

individuals have suffered in our health care system, I think there

should be a full review. I wonder at this point whether or not there

shouldn't be a full-scale inquiry under the Inquiry Act into the health

care system in this province as it exists under Social Credit. They do

not seem to place a high priority on health care, only a high priority

in mouthing that they do feel there should be one.

We have

seen it over and over again: soaring costs in health care, and they

always affect the poor and the working poor more than the middle class,

the upper middle class and the rich. It is like sales tax. You may put

up the charges for medical care premiums in this province; that is

nothing to us in this room, particularly. We can afford to meet those

payments; most of the people in our financial state can. But to the

people at the bottom rung it is indeed a hardship. That is what this

government cannot seem to get through their heads. For the poor and

working poor, health care costs are escalating to the point where

people may not be able to afford them. We can, but there are many

people in this society who cannot. It seems very, very difficult to get

through to this government that there are some people who are not

millionaires, upper middle class or middle class. There are some people

who are none of those things. There are people struggling to make it.

When these health care costs are added on to them, it is oftentimes

more than they can bear. For all of that and for all those increases to

the subscribers of health care in this province, we see this kind of

story during the latter part of last year and the beginning of this

year.

[ Page 3288 ]

is a disgrace. Statistics and mouthings won't solve it. What is the

government going to do about it? I don't care whether it is nursing

costs.... Damn it, in this society, in this province, if we can't

afford good health care then we're fouling everything else up. If we,

with our richness and resources, can't afford to give every single

individual the best of health care, then we are not doing our jobs in

all other areas as a government.

What is going on with that

Social Credit government and health care? It is like the bad old days

under Social Credit before. We have Liberals and Conservatives in that

cabinet over there today. What has changed? Does Social Credit get into

your minds and hearts? Does it actually take you over? We had hoped

that maybe you new people would have brought a change to Social Credit,

but Social Credit has brought a change to you and we're back to the old

bad days of health care in this province.

This is only one

letter. We will be bringing in more. To hell with the statistics; let's

see how the individuals are doing in this province. If there is only

one who goes through this, that is too much, and something has to be

done.

MR. MUSSALLEM: Sometimes it just gets a little

too much and even I, who am prepared to accept a great many things....

There are some times, when we hear the development of debate which is

obviously facetious and not grounded in fact, that we must come up with

a factual reply.

I would like to say that at any hospital

which I have had the privilege to be at or around or in, I find the

patients more than delighted with the service they're getting; that is

an absolute fact. I talked to you about the hospital in Mission and

about the hospital in Maple Ridge. You say that this is not a big

hospital like the Vancouver General. It's a very important hospital,

with the same kind of people requiring the same kind of care as they do

in any hospital in British Columbia. I'm telling you that the people in

the Maple Ridge Hospital and the Mission Memorial Hospital love their

hospitals and the people who are running them and the things they are

doing. The people in Clearbrook, across the river in Delta, in North

Vancouver — go where you please. I'm not acquainted with the Vancouver

General. I know that if there are problems anywhere, you'll find them

in the Vancouver General. I don't know why. Maybe it's because it's so

big.

The honourable opposition asks the question: why is it

that when Social Credit gets into office there are always problems with

the hospitals? I'll give you the reply: there are not problems in the

hospitals. The only problems are with the opposition misreading the

facts of the case.

It was only our party that developed

anything that resembles the health care that we have today. What did

the NDP do during three and a half years? They succeeded in getting Mr.

Foulkes to bring in a report. In substance the Foulkes report said junk

the whole thing and start over again; that's what he said. It's

fortunate that the NDP was not left in power to start such a massive

undertaking, which would have resulted in the greatest debacle that

ever hit this province. It would never have happened, because it

couldn't have been done.

Does our party stand still? No. I've just got to ask who developed the

really great things in health care in the province of British Columbia. Who

brought in the system? Our party. Who brought in extended care? Our party. Who

brought in intermediate care? That intermediate care is one of the finest things

that ever came here. I don't speak to hundreds of people about it, but the

ones who come to me — and they are many — tell me that it's a most marvellous

and humane thing when people can be looked after in their own home or in the

facilities. Everybody is looked after; there are no exceptions. There are always

some who want more. It's an excellent system — intermediate care and intensive

care; good programs. How can anybody argue about it? How can anybody decry it?

I've

been in this House a good many years. I could almost say to the

Minister of Health that the speeches made today could have been

recorded and reported as being exactly the same every year; there has

been no change in tone, quality or substance.

The health

care system here is the envy of North America; certainly it is the best

in Canada. There's no extra cost, no extra charges by doctors. It's

just a good health care system.

I know that the Minister of

Health saw that it became necessary to increase the per diem rate

charged to people in the hospital. I don't think that it has brought in

an awful lot of money. But I do believe that it was fair and just;

those who can't pay it don't pay it, but those who can do. I'll tell

you sincerely that the many people to whom I talk about it....

I've

tried to get a negative answer. But almost everyone who uses the

hospital — and I know many — would say to me that it was mighty little

to pay; it's merely a token according to the level we're being paid

today. Those who can't afford it are not charged a nickel; those who

can are entitled to pay just a little.

I must say that I

can't sit here and take this debate from that negative opposition. It

simply reiterates the same thing this year as last year and the year

before and the past 11 years I've been here — the same speeches, the

same words, not improving.

We hear a heart-touching letter

from a father. I don't like to hear those kinds of letters, but maybe

there are some facts in them. I don't deny that in the massive

structure of our health care system there is one that goes wrong. I

believe that's possible. But I believe that in the large majority

everyone is well satisfied. We've got an excellent system that's under

very good dispensation — properly run, excellent hospitals. We should

be well pleased and thankful that we have a government that can do it.

HON. MR. MAIR:

I'd like, of course, to deal with the questions raised by the member

for Prince Rupert (Mr. Lea). Quite candidly, there's no way that one

can deal with the question he raised, unless one has the full knowledge

of the facts. I'm not saying that what the lady and gentleman alleged

happened didn't happen. I have no way of knowing whether it happened or

not. Nevertheless, it was a very serious situation. For the sake of

argument, I'm going to accept the fact that it did, and that there was

a serious situation.

I would have thought, though, that if

it was something like that was happening with any regularity in our

hospitals around British Columbia one would have seen a demonstration

on the Legislature lawns and there would have been people knocking my

door down on a regular basis to bring to an end the disgraceful

situation within the hospitals. This, of course, hasn't happened. The

reason it hasn't happened is because, by and large, for most days of

the year, most hours of every day, and most minutes of every hour, the

hospitals of this province are very well run indeed. I don't doubt that

there are times in the day-to-day operation of a hospital when

[ Page 3289 ]

things

happen that the hospital wishes didn't, things that have alarming

prospects and maybe even sometimes alarming results, but I don't think

that, if one were to take the letter of this couple at its face value

and accept everything that is said in there as being absolutely

accurate, it is fair to conclude that there is any serious wrong within

either the Vancouver General Hospital or in hospitals in general. It

certainly would indicate that there was something wrong at that time,

something that should have been addressed at that time as something

that was very wrong at that time. But I don' t think that it does any

more than that, for a number of reasons.

If the situation in

the Vancouver General Hospital or any other hospital is anything like

that, the fact that the government doesn't know about that on a daily

basis by reason of mass demonstrations and things of that nature, quite

apart from it being an indictment of the minister and the government,

would be an indictment of every nurse, orderly, doctor, visitor and

patient who happened to be in that hospital for not coming to their MLA

or to their minister or to somebody in authority and screaming from the

rooftops that this sort of thing was going on.

Now I say

that in no way to deny that the story told by the Winklemans is true —

I don't know. All I can say is that one must conclude that it is a very

unfortunate isolated incident, if in fact it did happen as indicated.

One would also have thought, I think, Mr. Chairman, that if the

situation that the Winklemans put forward occurred with regularity in

either the Vancouver General Hospital or in any other hospital in the

province of British Columbia, the Minister of Health would have been

literally bombarded with supplications from the local MLA. I would have

expected that if this had happened in the Vancouver General Hospital on

any kind of regular basis other than an isolated instance, I would have

had the Vancouver members, particularly those for Vancouver Centre

(Messrs. Lauk and Barnes) and Vancouver Little Mountain (Hon. Mrs.

McCarthy and Hon. Mr. Wolfe) and so on, literally on my doorstep day

in, day out, hour in, hour out, until the situation was rectified. So I

think that I've got to say that it could very well be that the

situation indicated by the Winklemans did happen. If it did, it is

truly and sincerely a very regrettable situation and ought never to be

repeated. However, I think we can conclude that it was an isolated

instance by reason of the facts and situations that I have just given

to you.

I don't mean in any way to suggest that these things

don't happen in other hospitals from time to time. When something goes

wrong in a hospital, it is a horror story; we are human and we do err.

We do have problems and staff shortages that we don't foresee. We may

have somebody who goofs off. We may have all sorts of things that

happen. When those things do happen, then the situation that develops

is always not just unfortunate.... That's not a strong enough word. It

is potentially calamitous; we all know that. I think we all know by

watching television programs and reading the newspapers and periodicals

that this sort of thing repeats itself around the world from time to

time. One only has to watch "60 Minutes" on television on Sunday night

to recognize that from time to time this kind of thing happens

everywhere. When it does happen, you have to make sure that it is not

happening on a regular basis and that it is an individual and isolated

breakdown.

Perhaps we should be doing more; perhaps we can

do more. But to think that the member for Prince Rupert would have

meant a general indictment of hospitals or even of the Vancouver

General Hospital as a result of that, I hope, is a mistaken conclusion

to come to. If he is going to indict me personally for that, well,

that's fine. That's fair enough. That's what I'm here for; that's what

he's here for. I'm not going to get into a debate on that. But I think

I can say, from the short time I've been Minister of Health, from the

hospitals I have visited, and from the people I have spoken to in those

hospitals and the patients I have spoken to — and, indeed, from the

hundreds and hundreds of letters I have received — that we really have

hospital care in this province of which we can be truly and justly

proud.

My staff informs me, of course, of something that

ought to go on the record. Along with many other hospitals, Vancouver

General is a fully accredited hospital under the Canadian Council on

Hospital Accreditation. It couldn't have that accreditation if it were

in any way behaving as the member for Prince Rupert indicates that it

was supposed to have on this occasion. Certainly it could not retain

that accreditation if that sort of situation were to persist anything

beyond the most isolated of incidents.

The member for New

Westminster then indicated that.... I thought I went over this before,

and I won't deal with it at any great length unless he insists on the

question of health services and the costs. The statement that I have a

note of is that people may not be able to afford health services. I

want to assure this chamber and the member opposite that that simply is

not so. That will not happen. We've gone into the question of premium

assistance, which has already been extended to a considerable degree in

very recent days. On the question of user charges, the government,

whether it's through Human Resources or some other method, will see

that nobody is ever deprived of ambulance services, hospital care, or

anything of that sort by reason of their inability to pay. So I think

that while we do disagree on how we get that done.... I accept that. We

have a basic philosophical disagreement as to how you do that. You

would have it, I presume, come out of general taxation, whether a sales

tax increase or an increase of personal income tax or corporate tax or

whether you would impose another what I believe was a regressive mining

tax or whatever; you would have it come from a different source and no

one would pay directly out of his pocket. I suggest to you that that is

just conferring an immediate benefit on those of us who can afford to

pay. I don't think that is right. Particularly under our system, those

who cannot afford to pay are never disadvantaged by that reason.

[Mr. Davidson in the chair.]

just would like, before taking my seat, to thank the member for Dewdney

(Mr. Mussallem) for raising the points he did. The experience he has

had in hospitals is, as I say, very similar to my own. It is not to say

there aren't problems and concerns raised. Of course there are, and

they were raised, I'm sure, when the member for New Westminster was the

minister, and I'm sure they were raised with every other Minister of

Health in British Columbia since time immemorial. But I think the fact

of the matter is that if you look at the balance of the letters and

communications we receive from all sources and the few complaints,

generally, that are received, quite apart from any political

differences we may have we can all, regardless of party, be very proud

of the hospital system and the delivery of health services in British

Columbia.

[ Page 3290 ]

MR. KING:

Yes, indeed, it has been a good health system in the province of

British Columbia, but the great concern the opposition is trying to

express today to the minister and to British Columbians generally is

that that first-class health system is breaking down under the current

administration. I was rather appalled at the response the Minister of

Health gave to my colleague for Prince Rupert when he had outlined

absolutely scandalous treatment that a family of British Columbians

experienced during the treatment of their infant son at the Vancouver

General Hospital. The minister got up and defended that terrible

experience by saying: "Well, I am confident it is an isolated case."

colleague read the minister's letter to those people, which promised

there would be a review of the circumstances surrounding those specific

allegations. That was last April, Mr. Minister. Where is the review?

What were the results of that review? Or did you consider it so

frivolous that you didn't even bother to carry through with the

commitment you gave to those concerned parents? If you did indeed

conduct a review, how about being good enough to share that with the

House so that not only those parents but the people of British Columbia

may be assured that that kind of maladministration because of the

stringent purse strings of Social Credit is not going to be visited

upon some other family in the province? That is what we require of you,

not cheap blandishments.

How many cases does the minister

want before he recognizes a crisis? He says: "I never had any

demonstration on the lawn." Therefore presumably the minister takes it

that everything is hunky-dory in the health industry. Does he want them

to have to come over and demonstrate on the lawn of the Legislature

before one can be assured of first-class health care in the province of

British Columbia? Does the minister feel that a family who have just

had a son undertake delicate, serious heart surgery are in any position

to drop all their parental responsibilities and come running over here

and start picketing on the lawn of the Legislature? What callous, crass

nonsense. What do you think you are dealing with, a group of affluent

lawyers? Or perhaps the mining industry? You are dealing with sick

people who are in no position to come and demonstrate on the lawn of

the Legislature. It should be enough of a signal to the minister when

this kind of letter comes to his attention.

I am appalled at

the response he gave. Then he said: "Well, if these things are going

on, why aren't the professionals in the hospitals telling me about it?"

I'll tell you why: because that minister, with his uncontrollable

temper — his volcanic temper — erupts on any criticism. When the

doctors in the city of Victoria outlined the terrible delays in

elective surgery, he immediately set out to shoot the messenger in that

case. He attacked the doctors; he said they were becoming political. It

was a voice in the wilderness. When the nurses of Vancouver General

Hospital outlined the burden placed on them because of shortage of

staff, lack of facilities and lack of adequate training to produce

enough staff to run the hospital efficiently, the minister attacked

them and said they were waltzing off for a holiday, or this, that and

the other thing. Those excuses have come from the minister's office.

Mr. Minister, you have had signals from the professionals in the industry that all is not well.

colleague has outlined a very personal and traumatic experience that

one family encountered. In virtually every field of health care there

have been severe and harsh cutbacks by Social Credit.

Let me

go through a brief file about one small community in this province that

has been trying to obtain a local, community health care facility. In

1979 the city of Armstrong, next to the location of the Minister of

Tourism (Hon. Mrs. Jordan) — and she should be aware of it because

she's had correspondence on it, the same as I have — and the regional

district wrote to the Minister of Health asking that allocations be

made in the budget that year for the construction of a small acute-care

health facility in Armstrong — diagnostic; just the basic 10-bed

facility, I think, is what they were looking for. I wrote to the

minister and supported that application, as did the regional

administrator of the district hospital:

"I am

responding to your letter of November 22, 1979, addressed to my

colleague the former Minister of Health, Hon. R.H. McClelland. It is

gratifying to know that you endorse the regional hospital district's

recent submission stressing the need for a new health care centre in

Armstrong. As no doubt you are aware, my ministry, along with the B.C.

Buildings Corporation, is engaged in a major health centre capital

construction program throughout the province, presently amounting to

approximately $27 million. Such projects are carried out on a priority

basis, and it is envisaged that commencement of the Armstrong centre

will be made in the 1980-81 fiscal year, subject to fundings being

approved. I have requested Dr. H.M. Richards, Assistant Deputy

Minister, Preventive Services, to keep you informed on the future

development of this specific project."

Well, it had been

turned down in 1979-80, and the minister gave me that commitment that

it would be included in estimates for 1980-81. I took it as a

commitment; I accepted it in good faith; but lo and behold, it's turned

down again in this fiscal year.

The local people have been

advocating this minimum health facility for their area for the last

three or four years. They receive commitments, only to be undercut

because of some budgeting restraint that the government introduces

after the fact.

I want to read a letter from Mr. Blattner,

who is the mayor of the municipality of Spallumcheen — and that is the

district that's written — to the minister. I think this outlines the

frustration related to this area of health care in the same way that my

colleague has done with respect to the personal experiences of patients

in overcrowded, understaffed facilities. It's addressed to Dr. Bonham:

"Further

to your letter of June 13, 1980, and earlier letter of May 14, 1980, I

must first comment by expressing extreme disappointment. To my

knowledge, a new health centre for Armstrong-Spallumcheen has been a

priority since 1973. It was in the estimates previously, and according

to your letter it did not even make it to the estimates for the fiscal

year 1980-81. I must assume it was turned down internally. I appreciate

your offer to place this most needed service facility in the 1981-82

estimates' priority list. However, I must say our confidence in

promises is at an all-time low."

That's the mayor talking.

"We

have received local, regional, union board of health and hospital board

support, and I wonder if the issue is purely financial, if the request

has been dealt with by the Treasury Board, or if in fact it was delayed

internally or politically.

[ Page 3291 ]

"We have to explain to the community at large and would

appreciate some answers to our doubts. Please let me know the person or body

responsible for denying the project at this time, and for what reasons. I am

looking forward to an answer that can be defended to the public and bring us

closer to planning for this facility, the need for which has been amply demonstrated."

Again, the administrator of the hospital district wrote to the minister on June 26 of this year.

"Dear Mr. Minister:

"At the regular meeting of the regional hospital district

board held on June 25, 1980, the board again expressed concern over the lengthy

delays in receiving approvals from your office" — I hope the minister is

listening — "and the cumbersome procedures in implementing projects. The

board also expressed concern over the lack of progress in obtaining a health

centre for the city of Armstrong.

"The board therefore respectfully requests that a meeting

be arranged between yourself and representatives of this office to fully discuss

the problems and endeavour to resolve the same. Please advise when and where

it would be convenient for you to meet with us."

wonder if the minister has responded. They're talking about cumbersome,

sloppy procedures, and constant delays through cutbacks in spending in

terms of obtaining the minimum health facilities in that area.

HON. MR. MAIR: What's the date of the letter, Bill?

MR. KING: That particular letter was dated June 26, 1980.

Mr.

Minister, what provokes me about the cutback in virtually all areas of

health care.... I realize that dollars are finite that there's no

infinite supply of dollars. We all know that. We have served in

government too. But what provokes me to no end is the priorities that

the current Social Credit government places with such distorted fashion

on such projects as the fixed link from the mainland to Vancouver

Island, a project of the Minister of Universities, Science and

Communications.

There's money for Dr. McGeer to put up a

couple of seconders out here on the lawn at $10,000 a month so he can

play politics and appeal to a certain constituency in the fight with

the federal government, but not enough dollars to build a basic health

care facility up in the interior of the province of British Columbia

and not enough staff to look after this infant child who, my colleague

outlined, suffered shocking treatment in British Columbia's largest

hospital. Where are your priorities?

We have this government

in the last six months committing themselves to convention centre after

convention centre, to a fixed-link crossing between Vancouver Island

and the mainland, and to lord knows what other kinds of grandiose

schemes for the entertainment and the political interests of certain

members on that side of the House, while at one and the same time they

are squeezing health care dry in this province to the detriment of

people. What kind of priorities do you have?

Do you place

more value on a football stadium in the city of Vancouver than minimum

health care facilities for the aged and the young in this province? I

know dollars are finite.

I know there's a limited supply.

But for goodness' sake direct them to where they're going to do the

most good for the people that pay you and provide the revenue in this

province, and that is the taxpayers. It's not tourists who built the

country; it's our own people, and they are entitled to good quality

health care. You are eroding it, Mr. Minister. You either lack the

courage and commitment to stand up before your colleagues in Treasury

Board and demand the budget you need, or you're indifferent and callous

and don't care. It's one of the two. Certainly there are ample

incidents of the kind of neglect and erosion of minimal health care

services in this province that should make that minister hang his head

in shame.

We've had increased premiums, which the minister

is good at. He's going to put it on a businesslike basis. Let the user

pay. And he says: "If they can't afford it, so what? No harm done."

That's what the minister told us a couple of minutes ago, didn't he? He

said: "Only for those who can afford it. If you can't afford it, it

doesn't hurt." Well, Mr. Minister, I have news for you. My colleague

raised a point about Kelowna General Hospital a while ago and, in case

you're unaware of it, that serves as a regional referral centre from

Golden to the Okanagan, along with Vernon and Kamloops occasionally.

received this letter from an elderly gentleman in my own constituency,

and I'll read it to you for your edification. It's addressed to the

Kelowna General Hospital. It says:

"Sirs:

"Being

a patient in Kelowna General Hospital last summer, I was required to

fill in an admittance form asking what accommodations a patient may

choose. If a four-bed room is not available, the patient has to pay the

difference. I have checked a number of other hospitals here and in the

lower mainland. I find it is not the general practice. This, to me, is

very unfair for a pensioner or whomever. Why is this practice followed

at Kelowna General Hospital?"

I looked into it for the

gentleman. I found out it's not only Kelowna General Hospital now, but

this is an approved practice by the ministry. In other words, if the

kind of accommodation that the patient requires for elective surgery is

not available, then he has to pay the rate that he is housed in, even

if that's a private room.

A letter came from the hospital.

It says the BCHP instructions to hospitals for admission of patients

who are not classified as emergencies read as follows:

"Explain

to the patient a choice of two alternatives: first, to agree to take

other accommodation that is available and pay the appropriate charges

until the desired type of accommodation becomes available; or secondly,

to postpone entering the hospital until he can be admitted to the type

of accommodation desired. I am unable to comment on whether or not

other hospitals follow these instructions. Perhaps some hospitals

turned a blind eye to the instructions, because of the inconvenience of

rescheduling booked elective procedures, which would result if the

patient opted to postpone his hospital admission. "

Now

here's a case where this gentleman refused to enter the hospital. He

couldn't afford it. He's an old-age pensioner on a limited income.

There were no ward facilities — as they used to be called — available.

There were only semi-private or one bedroom or two. He couldn't afford

the rates. He had to put off his elective surgery.

[ Page 3292 ]

want to tell the minister that since he raised the general rates for

medical care in the province of British Columbia, more and more people

on fixed incomes, more and more of the poor in British Columbia, are

indeed postponing elective surgery. They are postponing medical

attention that they should be receiving, which in my view, Mr.

Minister, would be cheaper, because if you wait until a problem becomes

acute, the cost of coming to grips with it is only higher, as is the

danger of infecting and spreading diseases and so on to other areas of

the community. Preventive health care is the cheapest in the final

analysis. Your punitive levies on health care are fine for

millionaires, of which there are about 16 on that side of the House.

They're fine for you. But I wonder how long it is since you've had to

get out and earn a living as the average person in British Columbia

does. You've never had to live like a pensioner does; $4 or $6 a day to

you is nothing. But I want to tell you that when you budget down to the

last dollar so that you can clothe yourself, buy groceries, and pay the

heating fuel costs, you are not in a position to undertake that

additional unanticipated spending.

Your deterrent fees are a

deterrent against health care. They're not a deterrent against abuse;

they are a deterrent against the poor and the aged in this province,

who need health care more than anyone else. It's a shocking situation.

At one and the same time that you are forking out hundreds of millions

of dollars for grandiose athletic programs and God knows what else to

buy votes in the province of British Columbia, it's a shocking

performance.

I say that Minister of Health should do

anything but stand up here and say it's a fine health care program and

we're doing our best. You're not doing your best, Mr. Minister, or you

would be fighting for the necessary budget to deliver the minimal

services that are necessary. We've demonstrated on three occasions —

and we have more; we have lots more — that minimum standards of health

are being denied in British Columbia. That is not good enough for the

opposition if it is good enough for you.

HON. MR. MAIR:

Going back to the question of the Winklemans, of course I certainly

didn't intend to convey — in fact I don't think I did — the impression

that I felt they should have demonstrated on the Legislature lawns.

What I said was that if the situation that they indicated prevailed

throughout the province of British Columbia in hospitals to any degree,

I would have expected that sort of thing to happen.

But I

now have, I might say, Mr. Chairman, the Winkleman file in front of me.

One thing that escaped my attention when the member for Prince Rupert

(Mr. Lea) was reading the letter from Mrs. Winkleman dated March 25,

1980, and may have escaped the member's attention, although I'm not

sure of that, is that this referred to a situation which occurred

between April and June 1979. I was under the impression when I listened

to the member talk that it was a current matter that the Premier was

asked to look into and that somehow we had not done. I don't suggest

that there was any deliberate misleading; I'm just suggesting that I

had understood that that was the case.

MR. KING: Your letter was this year.

HON. MR. MAIR: My letters were this year, Mr. Member; that's true, and so was made very clear.

Now

I have the letter here that I wrote to Mrs. Winkleman on June 26, 1980.

I also have a letter written by Mr. Flett, who is the president of

Vancouver General Hospital, to Mrs. Winkleman on May 26, 1980, which I

think is the letter that the member for Prince Rupert read into the

record. I'd be happy to read this letter or table it after the

estimates — whatever you wish; you can indicate that to me later. But

what it does indicate is that while Mr. Flett is extremely distressed

and did investigate this matter as thoroughly as he possibly could, he

was very much handicapped by the fact that it was almost a year old and

the staff and people who were present at the time of the alleged

incident simply weren't there to give us any answers, which made it

extremely difficult. I am sure the members opposite, being fair, would

acknowledge that that is a very difficult thing for anybody to do — go

back a year and justify that very, very serious complaints have been

made.

I must say, if I may be somewhat light-hearted, that I

was surprised to hear the member for Shuswap-Revelstoke (Mr. King)

accuse me of having an uncontrollable temper. I don't ever recall

throwing rule books at the Speaker in this House, and I don't recall

ever challenging anybody to a fight when I was called a nasty name, as

I have been from time to time. I remember calling the member opposite a

nasty name. I think I called him a moral coward one day and he

challenged me to a fight outside the House immediately.

MR. KING:

On a point of order, the minister has just called me a moral coward and

I want to indicate to the minister that while I take no exception to

that I would point out that at least I have morals.

HON. MR. MAIR:

I presume he means that he has morals but he is cowardly about them. I

don't know what that means. I don't repeat that accusation now, because

it was said in the heat of a debate at the time. I only point out that

if we are going to talk about people having uncontrollable tempers,

those who have demonstrated it by not being able to keep it when having

an argument with the Speaker and throwing their rule book up ought to

be rather hesitant, I think, to criticize other people.

would like to deal with the question of the Armstrong Health Centre.

Perhaps the member can correct me if I am wrong, but there are two

situations at Armstrong of which he complains. One is the health

centre. Armstrong is a subunit of the Vernon Health Board. I must say

that this centre, contrary to what I and my ministry might have wished,

has been given a low priority by the people who authorize the payment

of the money. I am sure that when the member opposite was in

government, from time to time he was not given the priorities by

Treasury Board that he felt were proper. That is why you have Treasury

Board, to establish an overall priority. That has not been given.

do understand that there has been a meeting arranged with me after

estimates, whenever that may be, to discuss the delays in planning for

the acute-care and extended-care problems they have talked about. I

understand that the Vernon Jubilee Hospital has indicated that the

approval mechanisms have approved in their planning and everything is

progressing well at that particular stage.

Interjection.

HON. MR. MAIR: I gather that the member for Okanagan North (Hon. Mrs. Jordan) seconds that motion.

[ Page 3293 ]

would like, because of the general criticisms offered by a number of

members opposite concerning expenditures of the government of British

Columbia in the health area, to just give some facts and figures so

that we know whereof we speak. I am going to just give the percentages

of the budget spent in health for a period from 1970 approximately

through to today. I caution the members that figures up until 1973-74 —

that is the first three figures I will give — will not include Medical

Services Commission payments, but they will thereafter. Here are the

percentages of the health budget of the overall budget in these years.

The period of 1970-71 was 19.69 percent; 1971-72 was 19.41; 1972-73 was

19.40. Then came medicare and a number of other things, including a

change in government. Medicare particularly comes in here and it goes

up to 23.97 percent in 1973-74; 22.62 in 1974-75; 20.94 in 1975-76;

24.58 in 1976-77; 24.51 in 1977-78; 26.67 in 1978-79. According to our

best estimates for the current year, the percentage will be 30.02

percent. I don't know what better yardstick — admitting, as the member

for Shuswap Revelstoke has indicated, that you can play with figures —

you can get than the percentage of our total budget which we are

prepared to spend on health care. I might just put this in dollars,

recognizing, of course, that there is a huge inflation factor. Nobody

need remind me of that. I think that it is nevertheless a pretty

interesting statistic to note that in 1972-73 the total health

expenditure in the province of British Columbia was $400 million. We

estimate for 1980-81, which is our current year, the total expenditures

will be $1.75 billion. This is well over four times as much and we

haven't had 400 percent inflation. We have had inflation, but we sure

haven't had it to that degree.

I want to just go back to the

question of the Vancouver General Hospital because it has been called

into question on the Winkleman case which is, as I say, very, very

difficult if not impossible to answer at this stage of the game. I

think one should know that the capital expenditure program going on in

the Vancouver General Hospital over a three to four year period is

about $100 million. We are going to have the emergency opening next

year and new patients' beds are already in the functional planning

stage. We expect they will be onstream soon. The budget has increased

at VGH from $113 million per year to approximately $120 million per

year. Recognizing that Vancouver General Hospital is the referral

hospital for British Columbia, the largest acute care hospital and all

those things, and recognizing that it is also a very old hospital in

many areas, I think that a rather substantial undertaking is going on

now by the province of British Columbia. Improvement is needed, but

improvement is taking place.

MR. KING: I have just a

short follow-up, Mr. Chairman. I read the letter that the minister

directed to me regarding the Armstrong community health facility. The

minister has now changed his story totally; the minister said it's not

a high priority. That's what the minister just said, and that will be

recorded in Hansard .

HON. MR. MAIR: Not with me — with Treasury Board.

MR. KING: Ah, just a moment now. Mr. Chairman, here's the

letter the minister wrote to me on December 10, 1979. I've already read

the letter, but I'll just read this sentence again: "Such projects are

carried out on a priority basis, and it is envisaged that commencement

of the Armstrong centre will be made in the 1980-81 fiscal year,

subject to funding being approved." That was a commitment last year

that during the current fiscal year, as far as the ministry was

concerned, this project was indeed a priority and you would be

recommending funding.

You

get up now and say that this is not a priority, when other projects

have certainly gone ahead; when there was every indication to all of

the local agencies working on construction and development of this

project to believe that they had the support and encouragement of the

ministry — this was last year — and this year's budget would be a

realistic time frame for construction. It would be absolutely

inappropriate for the minister to suggest that they've been given that

encouragement, that support, when in fact they had no priority. It

would be deceitful to string along local publicly elected agencies into

doing all of the work necessary to develop the plans for a local health

facility and assume they had the support. Indeed, when I got the

minister's letter I believed that was a commitment. It sounds to me

like a commitment from a minister of the Crown, something that always

used to be able to be relied on in the province of British Columbia.

There was a time when a minister's word was good, and you accepted his

statement at face value without having to read between the lines and

seeing if you could ooze out somewhere else.

This was a

commitment, Mr. Minister of Health, and you've gone back on it, and now

you have the gall to stand up and say: "Well, it's not a priority."

Treasury Board doesn't run the Ministry of Health; it's your

responsibility. If you haven't got the gumption to win and to justify

before Treasury Board the minimum standards and expenditures for health

care in this province, then you're admitting that you're not worthy to

be the Minister of Health. Certainly Highways doesn't seem to be

suffering; last year his colleague the Minister of Transportation and

Highways (Hon. Mr. Fraser) extracted over $100 million in special

warrants to finance blacktop. How come he's got all the pull, Mr.

Minister of Health? How many special warrants did you get?

What

kind of distorted priority has that government got anyway? They're

fraught with distortions and false values. When I look at them, Mr.

Chairman, I start to understand; but God help health care in this

province.

HON. MR. MAIR: Mr. Chairman, the member for

Shuswap-Revelstoke has called into question my integrity and my

honesty, which I take exception to. I won't ask him to withdraw, but I

think the record should note that I did take exception to it. Otherwise

I might be taken as having agreed with him for once.

Mr.

Chairman, I'm very glad that I'm a member of a government that has a

Treasury Board that works — a Treasury Board that examines expenditures

and, from time to time, says you can't do the things that you want to

do. Quite frankly, if I were allowed to do all the things that I would

like to do, having no regard to financial restraints, I'm sure that the

Health budget would be three or four times what it is. There is a limit

to the public purse.

Now the member has indicated that I

have misled somebody, and he's quoted from a letter where I said

"subject to funding being approved." I think that is pretty clear.

wrote to Mayor Blattner on July 9 answering his letter of June 27,

saying: "I can only reiterate that your request to replace the

Armstrong health centre was made in this ministry's 1980-81 submission

to Treasury Board." I had under-

[ Page 3294 ]

taken to do this. "The board, however, did not approve the project for this fiscal year."

Yes,

I fight for all the projects I put forward; yes, I win a great many

fights; yes, I lose some of them. If I didn't lose some of them, my

God, we would be bankrupt tomorrow afternoon. You may say that I should

have fought harder for this and less hard for something else, or there

are other priorities that you would have established and you would have

preferred, and I accept that; that's your viewpoint, and you're very

much entitled to it. But to suggest that I have misled you or led

somebody down the garden path or given every indication of support and

encouragement to people just doesn't square with the facts, Mr. Member.

The fact of the matter is: yes, I did say that I approved of it subject

to funding being approved; yes, I did ask for that funding to be

approved; it was turned down; and there we are.

MR. KING:

Mr. Chairman, I have not received the courtesy of a copy of the

minister's letter to Mayor Blattner. I did receive the minister's

letter of December 10 last year, where he promises: "I have requested

Dr. H.M. Richards, Assistant Deputy Minister, Preventive Services, to

keep you informed on the future development of this specific project."

I haven't received the courtesy of a copy of your letter to Mayor

Blattner. If the minister had lived up to his commitment, he would have

explained to the mayor, the local hospital board and myself as the MLA

— as he promised to do — that he had lost his fight in Treasury Board.

Why didn't you do that? If you've got a valid reason, fine. Then I

would like to be taken into your confidence. That's what you promised

to do. You promised to keep me informed, Mr. Minister.

As to

the minister's remark that I should withdraw some implied criticism of

his integrity, if the minister felt slighted I will gladly withdraw.

But I would point out that the minister has stood up and called me a

moral coward. He's the kind of guy who loves to dish it out but can't

take it. Mr. Minister, when it comes to moral fibre we are all

responsible for ourselves. I'm not going to get into a debate on that.

We're here to try to represent the people of British Columbia. I'm not

really interested in what the minister thinks of me personally. I

couldn't care less. I don't think I'd go to him for a recommendation.

What

I'm more interested in is the policy and some consistency and

sensitivity to health care in the province of British Columbia — rather

than $100 million extra paid out through special warrant for highways,

like it was last year; rather than $200 million here and there for

grandiose schemes for football stadiums and trade and convention

centres. As fine as all these things may be — I love football; I like

to see tourism — I think health care comes first. It's as simple as

that. By golly, I don't think it's good enough for the minister to put

on a little puppy dog performance here and say: "I had to roll over and

wag my tail because Treasury Board said no." You're supposed to be a

tough customer, Mr. Minister. You pride yourself on that. You have a

temper to go with it. Why don't you show