1985 Legislative Session: 3rd Session, 33rd 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, APRIL 29, 1985

Afternoon Sitting

[ Page 5837 ]

CONTENTS

Municipal Act Review Committee Act (Bill M206). Mr. Blencoe

Introduction and first reading –– 5837

Women's Career And Employment Opportunity Act (Bill M207). Ms. Brown

Introduction and first reading –– 5837

Oral Questions

Colwood-Langford incorporation. Mr. Mitchell –– 5837

Okanagan bingo operations. Mr. MacWilliam –– 5837

Nautilus club. Mr. Barnes –– 5839

Cottle Hill transmission tower. Hon. Mr. Rogers replies –– 5839

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

On vote 37: minister's office –– 5840

Mrs. Dailly

Mr. Passarell

Mr. Gabelmann

Ms. Brown

Mr. Rose

Mr. Davis

MONDAY, APRIL 29, 1985

The House met at 2:05 p.m.

Prayers.

MR. SKELLY: I ask the House to welcome a group of students

who are in the buildings today — I believe they're in the gallery right

now — from Ucluelet Secondary School. They are accompanied by a group

from Quebec which is taking a tour of the precincts right now. I'd also

like the members to welcome Wendy Doubt from Port Alberni, who

represents the Alberni District Parents' Association, and Dell Kimoto,

also in the gallery, who is the vice-president of the Alberni District

Teachers' Association, Ucluelet sublocal.

HON. MR. GARDOM: It's a pleasure that we have in our

galleries today Mr. Stuart MacKinnon, who is the secretary to the

Canadian Intergovernmental Conference Secretariat. I know that a number

of members know Mr. MacKinnon and would like to pay him a very warm

welcome today.

MRS. DAILLY: I'd like the House to join me in welcoming three

Burnaby friends in the gallery today: Mrs. Strandberg and her two

daughters, Diane and Judy.

MR. PARKS: On behalf of my colleague the Minister of

Environment (Hon. Mr. Pelton) I'd ask the House to join with me in

making welcome a young lad from Mission who has just attained the lofty

achievement of graduating in commerce from the University of British

Columbia. Would you please welcome with me Mr. Ian Adair.

Introduction of Bills

MUNICIPAL ACT REVIEW COMMITTEE ACT

Mr. Blencoe presented a bill intituled Municipal Act Review Committee Act.

MR. BLENCOE: A very quick description and explanatory note.

The purpose of this bill is to establish a committee to regularly

review the Municipal Act and recommend changes that may be made to it.

The committee is composed of representatives of municipal government

from all areas of British Columbia and Members of the Legislature, and

it must report at least once every four years. The intention is to

establish meaningful consultation with all local government — between

this Legislature and local government.

Bill M206 introduced, read a first time and ordered to be placed on

orders of the day for second reading at the next sitting of the House

after today.

WOMEN'S CAREER AND

EMPLOYMENT OPPORTUNITY ACT

Ms. Brown presented a bill intituled Women's Career and Employment Opportunity Act.

MS. BROWN: Mr. Speaker, what this bill basically does is give the government

an opportunity to help women who are interested in moving into the small business

community and into small business enterprises, to help them secure a six-month,

interest-free loan from either the government or one of the lending institutions.

It also gives them counselling and assistance, and in that way does two things.

It expands the small business community which, as we know, is the most important

employment-creating sector of our economy, and it gives women an opportunity

to break out of the poverty cycle in which so many of them find themselves.

Bill M207 introduced, read a first time and ordered to be placed on

the orders of the day for second reading at the next sitting of the

House after today.

Oral Questions

COLWOOD-LANGFORD INCORPORATION

MR. MITCHELL: Mr. Speaker, this would have been to the

Minister of Municipal Affairs (Hon. Mr. Ritchie), but he is not here,

so it is directed to his backup, the Minister of Lands, Parks and

Housing. On November 17, Colwood voted three to one against

amalgamation with the district of Langford in my riding. Recently

Langford voted on two occasions against incorporation. The Minister of

Municipal Affairs has indicated that he is prepared to extend the

boundaries of Colwood into the core area of Langford. The question to

the minister is: will the minister assure this House that he will not

incorporate any area without a vote by the people involved?

HON. MR. BRUMMET: I'll take the member's statement on notice and bring it to the attention of the minister.

MR. MITCHELL: Mr. Speaker, again through the Minister of

Lands, Parks and Housing. The minister announced the intention of

amalgamating Langford into Colwood, one week after the vote had taken

place for the new mayor and aldermen in Colwood. Can the minister

assure this House that there will be no incorporation or amalgamation

of Langford without those people having the right to vote on any

council that will govern them?

HON. MR. BRUMMET: Again, Mr. Speaker, I'll take the member's statement and question on notice and bring it to the attention of the minister.

OKANAGAN BINGO OPERATIONS

MR. MacWILLIAM: Mr. Speaker, in the absence of the Premier I'll direct my questions to the Provincial Secretary.

Would the minister advise why the government has permitted the

wholesale shift of bingo operations onto the premises of a few

commercial establishments in the Okanagan that are in the process of

skimming hundreds of thousands of dollars away from charitable

organizations in those communities?

HON. MR. CHABOT: Mr. Speaker, the member leaves the

impression that the bingo halls in the Okanagan are other than strictly

rent or lease operations. I want to assure the member that all the

bingo licences in the Okanagan and elsewhere in British Columbia are

held by non-profit societies, who make the profit. That's no different

than in what I believe to be the largest bingo hall in British Columbia,

[ Page 5838 ]

which is in Nanaimo and controlled by the Nanaimo

Commonwealth Holding Society. It has a seating capacity of 350 on one

floor and 350 on the second floor. They collected rent of $155,847 last

year. They're doing the same kind of operation, under British Columbia

law, as is happening in the Okanagan.

I don't know if you're embarrassed about the NDP and the four

organizations that are operating in Nanaimo and raising funds for

charities which they favour. Those organizations are: B.C. Tomorrow

Benevolent and Education Association, Harewood Community Association....

MR. SPEAKER: Order, please, hon. minister. At this point the

Chair would have to advise that the answer is now going well beyond the

scope of the question.

HON. MR. CHABOT: Mr. Speaker, on a point of order, the member

raised concern about bingo operations in the Okanagan, and I related to

him that the bingo operations in the Okanagan are no different than the

bingo operations in Nanaimo that are operated by the NDP. They're

strictly space to rent in the Okanagan, just like there is at the

Nanaimo Commonwealth Holding Society.

[2:15]

MR. MacWILLIAM: Unlike Mr. Capozzi's operation, the NDP Nanaimo Commonwealth Holding Society is not a private institution.

However, a supplementary to the minister. Would the minister advise

why the government has terminated four of the six inspectors in the

province, just prior to the opening of the new bingo palace in the

Bennett hardware store in Vernon?

HON. MR. CHABOT: Mr. Speaker, it had no relationship

whatsoever to the bingo parlour in Kelowna, and it would have no

relationship to the bingo parlour operated in Nanaimo. I found that the

role of the inspector was one that primarily duplicated that of the

police force in British Columbia. I found that the inspectors were not

properly trained and informed as to what their rightful role was, and

therefore their positions were terminated. They were terminated shortly

after the new regulations came into force.

That decision, of course, with the expansion and the large size of

bingo halls, such as the one in Nanaimo, is probably of concern to us.

In view of the proliferation of bingo halls in British Columbia, and

their size, I think I will be reviewing the possible need of inspectors

of bingo operations in British Columbia. I'm awaiting a report at this

time from officials in my ministry on information that they have

secured from a visit they made to Edmonton, Alberta, and to Prince

George as well. As soon as I have that report, then I'll be in a better

position, my friend, to determine whether there's a need for these

inspectors to be re-established in different locations in British

Columbia.

MR. MacWILLIAM: A supplementary to the minister. The big

losers in the commercial takeover of bingo operations are the B.C.

Heart Foundation, the cancer society, Salvation Army, United Appeal,

the CNIB, the handicapped bus service and Timmy's Christmas telethon.

What study has the minister made of the impact of inviting a few

private operators in to take over the bingo operations in the Okanagan?

The charitable societies are the big losers.

HON. MR. CHABOT: The member, Mr. Speaker, is under a false

premise. No one was invited to come in and operate or to open up bingo

parlours or bingo barns or bingo halls in British Columbia. It's a

matter of their enticing nonprofit societies to come and operate in

their premises. I don't know if the member is suggesting that the

non-profit societies operating in these larger, cleaner bingo halls in

British Columbia are not worthy of support. I don't know how many

people operate out of these. I know that about 20 or 25 operate out of

Nanaimo. I don't know if the member is suggesting that those non-profit

societies, which make money from operating in leased space owned by

other people who have no direct involvement whatsoever in the bingo

activity, are not worthy of support. But I think that the people who

operate out of some of these bingo establishments like the one in

Kelowna and the one in Nanaimo, and I believe there's one in Prince

George.... I don't know if he's attacking them or not.

I want to say that each and every non-profit society has the

opportunity of operating in the hall they desire. I'm not about to tell

anyone where they should operate a bingo. It's their free choice,

whether they want to operate a bingo in a church basement or in the

Dabbers or wherever. I'll leave that up to the non-profits.

MR. MacWILLIAM: Another supplementary to the minister. Is the

minister aware that certain commercial bingo operations are billing

charitable organizations for staff, which under the regulations are

supposed to be provided by volunteers? I cite sections 1(

a) and 1(

d) in

the revised regulations of November.

HON. MR. CHABOT: I'd ask the member to bring his evidence forward.

MR. MacWILLIAM: Another supplementary. Is the minister aware

that commercial bingo operators are selling and renting bingo supplies

and equipment, contrary to these revised regulations? I cite

section

1(c).

HON. MR. CHABOT: That would be deemed to be illegal, and if

the member has any evidence of that taking place.... We don't want to

operate the way they do in the province of Manitoba, where supplies

were sold to the bingo operators by those who had space to rent. We

don't want that activity to take place in British Columbia. If the

member has some information or evidence to that effect, I'm prepared to

take action forthwith.

MR. MacWILLIAM: I believe that's what the six inspectors were for. However, you fired four of them and there are only two left.

Is the minister also aware that commercial bingo operations in the

Okanagan are handing out lottery branch application forms and receiving

those forms for processing from potential licensees?

HON. MR. CHABOT: The answer is no.

MR. MacWILLIAM: As I said, the minister fired four out of the

six bingo inspectors in February 1985, at the same time allowing

private operators to move into the bingo field. What action has the

minister now decided to take in order to

[ Page

5839 ]

police these activities, which are obviously occurring without the knowledge of this House?

HON. MR. CHABOT: I asked the member who made some allegations

a few moments ago to bring forward evidence if he has it, and he hasn't

brought it forward. I indicated to him my views on the inspectors and

what action I proposed to take on additional inspectors. I know that

you have a set format of asking the questions, and maybe that question

shouldn't have been asked because of the fact that I answered it a

little earlier.

MR. MacWILLIAM: The point of the questions, of course, was to

highlight these individual concerns, and I can bring evidence of those

concerns to the minister. In light of the knowledge that the minister

now has been enlightened with, has he decided to establish a

non-partisan inquiry into the establishment of commercial bingo

operations in the province since the first of this year, before the

service clubs and charitable organizations are hurt any further?

HON. MR. CHABOT: No, Mr. Speaker, I don't think that there is a need for a public inquiry, or a non-partisan inquiry, or an inquiry of any sort.

MR. MacWILLIAM: This is my last question to the minister.

Under the policies of the government, it seems that commercial gambling

and lotteries are the only growth industries in the Okanagan today.

What action has the minister taken to ensure that the regulations will

preserve the nonprofit charitable purpose that the bingo operations

have historically enjoyed?

HON. MR. CHABOT: We make sure that charitable and non-profit

organizations that operate bingos.... We make sure that the percentage

of funds that must go to non-charity does go to non-charity functions.

That's what happens. There's no change, be it in Nanaimo or in the

Okanagan.

NAUTILUS CLUB

MR. BARNES: In the absence of the Minister of Consumer and

Corporate Affairs (Hon. Mr. Hewitt), I wonder if the Minister of

Education and MLA for Prince George would respond to this question

respecting the Nautilus athletic club. Could the minister advise the

House what action he has taken in respect to more than a thousand

Prince George residents who bought lifetime memberships in the Nautilus

athletic club, which has been purchased by an Alberta company and

subsequently sold?

HON. MR. HEINRICH: Mr. Speaker, as can be expected, I'll take

the question as notice on behalf of the Minister of Consumer and

Corporate Affairs and ask him to report back to the House as soon as

possible.

COTTLE HILL TRANSMISSION TOWER

HON. MR. ROGERS: On Friday the member for Cowichan-Malahat (Mrs. Wallace)

inquired about a radio transmitter located on Cottle Hill. The radio transmitter

on Cottle Hill is being constructed by a Canadian company under contract with

the United States Navy. They have leased a parcel of private land on which to

construct the repeater station. It is not on land owned by either B.C. Hydro

or B.C. Telephone Co. It is my understanding that the station is being built

as part of the communications network which supports the joint United States–Canada

naval test activities in the Strait of Georgia. The commanding officer of the

Canadian Forces maritime experimental and test ranges in Nanaimo has responsibility

for overall operations and the security of this system.

Orders of the Day

HON. MR. GARDOM: Before calling supply, Mr. Speaker, I first

want to move that leave be given to the Select Standing Committee on

Standing Orders, Private Bills and Members' Services to meet this

afternoon at 3 o'clock to deal with business of which notice has been

given.

MR. HOWARD: Very regrettably, leave cannot be made available at this time.

MR. SPEAKER: Hon. members, this is one of those times when

leave has two different meanings. Leave does not in essence mean leave;

leave means permission to go ahead on a motion of a vote. Therefore

unanimous leave is not required under standing order 48, and also the

fact that the motion is.... So it would be on division in that case.

Hon. members, it would be incumbent upon me at that time, therefore, to

put the motion through division.

MR. HOWARD: On a point of order, are you saying, Mr. Speaker,

that standing order 48 does not require leave for making a particular

motion sought to be moved by the government House Leader?

MR. SPEAKER: Hon. members, again, for the edification of the

opposition House Leader, the motion appeared — as a matter of fact, was

filed — on Tuesday of last week, appearing on the notice of business on

Thursday. Therefore the two days would have been met under that

criterion.

MR. HOWARD: I draw Your Honour's attention to Thursday last,

April 25, where a similar request was made with respect to the Select

Standing Committee on Health, Education and Human Resources. That

motion was proceeded with by leave only. The government House Leader

asked leave on that occasion to do exactly what is sought to be done

now. I submit to you that standing order 25 should be looked at as

well, which points out that in routine proceedings the items of

business and the daily routine before we get to the orders of the day

identify a variety of things; included therein are motions on notice.

There was no notice given of the motion to permit the standing

orders and private bills committee to meet while the House is meeting.

All notice was given of was notice by the Chairman that the committee

was going to meet, without taking the requisite respectful course of

seeking the approval of the House for that event to take place. I

submit to you that it should not be permissible to proceed in this

fashion, that we are constrained and shouldn't function simply because

the Chairman of a committee thinks it's wise or convenient to proceed

to call the meeting of a committee, when, for the specific purposes of

committee meetings, we set aside Wednesdays, when the House would not

be meeting, for those events to take place so that they could take

place when

[ Page 5840 ]

the House was not meeting. I submit to you that we should not be allowed to proceed today with this motion.

[2:30]

MR. SPEAKER: Hon. members, prior to hearing the point of the

member for Nelson-Creston, I would again advise members, as stated on

page 20 of our Standing Orders :

"...but this rule shall not apply to bills after their introduction, or

to private bills or to the times of the meeting or adjournment of the

House, or to a motion to proceed to the orders of the day. Such notice

to be laid on the Table before adjournment and to be printed in the Votes and Proceedings of that day."

MR. NICOLSON: On a point of order, I've read standing order

48 just recently, Mr. Speaker, and in its entire context it says: "Two

days' notice shall be given of a motion to present a bill, resolution

or address, for the appointment of any committee, for the putting of a

written question, and for the suspension of standing orders" — which is

really what we are discussing, the suspension of standing orders — "but

this rule shall not apply to bills after their introduction...." That

means, of course, that after you've introduced the bill, you can move

that the bill be now read a second time; you can move that the bill be

referred to a Committee of the Whole House for consideration at the

next sitting of the House after today. It also says the rule doesn't

apply to private bills, which, again, means moving third reading and

second readings, etc., of private bills, but not private bills in

Standing Orders Committee. That's what we're talking about, Mr.

Speaker. So what we're talking about is the suspension of standing

orders which say that a committee of the House cannot sit while the

House is sitting.

MR. SPEAKER: Hon. member, on that point, the order of business of that committee is for private bills.

MR. HOWARD: If Your Honour would permit it, I intended also

to make a suggestion to you with respect to the comment you made just a

moment ago about standing order 48 –– I suggest to Your Honour that the

48-hour rule shall not apply to private bills, meaning that two days'

notice is not required for their introduction because private bills

enter the House by an entirely different process than public bills.

There is a petition involved, and notice of that nature is given. That

is what that applies to.

I think the member for Nelson-Creston quite properly pointed out

that we are suspending the standing orders, because standing order 1

prevails. If there's no specific rule in our standing orders, we look

to the practices and customs in the United Kingdom. The practice there,

as Sir Erskine May points out quite clearly, is that committees cannot

meet while the House is meeting, except by permission of the House. You

have to suspend that. In order to suspend that, you need the two days'

notice, which is one part of it.

The other, I think — and most important to remember, Mr. Speaker —

is that the Committee on Standing Orders and Private Bills, which went

over these rules and reported just at the conclusion of the last

session that they would come into effect at this session, specifically

identified the opportunity for committees of the House to meet on

Wednesdays. That was the reason for the rule that says the House shall

not meet on Wednesdays unless a specific action is taken. The House

shall not meet on Wednesdays in order to give committees the

opportunity to meet and not to conflict with the House.

Surely it should be fundamental that the committees are agents of

the House and not the other way around. The notice given by the

chairman of the committee was just that it was going to meet at 3

o'clock today, without regard to the rules and without regard to two

days' notice or 48 hours' notice for that, which is what should

prevail. If the committee wants to meet, I submit that Wednesday is the

appropriate day for it to meet.

MR. ROSE: I won't repeat the comments made by the member for

Skeena about the nature of Wednesday or comment on them further than to

remind the House that for the last two Wednesdays, when we had an

opportunity to meet and discuss private bills, we didn't meet. It was

absolutely a free day at the government's discretion for calling

cabinet meetings or whatever they decided to do.

But I have another point, and it has to do again with standing order

25, and it discusses routine business. It says the order of precedence

on Monday and Tuesday, the government days, are public bills and

orders, private bills and public bills in the hands of private members.

Well, I point out to the House, and to you, Mr. Speaker, to assist you

in making your decision, that if this bill had been through the

committee, I think the government would have every right to call it for

discussion in the House. But it hasn't. We're talking about having a

committee absent itself from the House to meet before it has gone

through the procedure that a bill of this nature needs to endure before

it comes to this House.

MR. SPEAKER: Hon. members, the Chair has listened to opinions

on this particular matter, and I am going to reserve on this matter

until, hopefully, approximately 3 o'clock, when I will have an

opportunity to present a broader opinion to the House and will do so.

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

ESTIMATES: MINISTRY OF HEALTH

(continued)

On vote 37: minister's office, $206,025.

MRS. DAILLY: Last week when we were discussing Health the

minister replied to one of my questions on where he felt his

responsibility as minister and his ministry should be going in future

planning, etc. I have the Blues

in front of me, and he said something that I found a little

disconcerting. He emphasized that the primary role of the minister and

the ministry was as a health provider meeting the problems of today. He

did go on to say that there were some committees structured within his

ministry, however, which were looking at alternative models. I found it

far from satisfactory, Mr. Chairman, and I want to deal with that for a

moment. I'm concerned that the minister, if he really believes that his

primary and main concern is strictly heal the-provision, which

certainly is important.... I'm concerned that this province will not be

ready to meet all the new critical needs in health that are going to be

facing us now and at the turn of the century.

I want to say to the minister that I hope that he feels his mandate as minister goes beyond that. I hope that he is

[ Page 5841 ]

constantly trying to get his ministry to involve

themselves in looking at other jurisdictions which are dealing with

restructuring of health care, with a view to curtailing rising costs

but at the same time providing perhaps unique, quality care.

In line with that, I want to ask the minister if his officials have

had an opportunity to study the structure of health in Finland, which

follows along in a restructuring and a handling of primary-care health

centres, the sort of thing which we on this side have been asking the

minister to look at, and which many other groups in the province have

also been interested in. For the minister's information, I would like

to briefly give him a rundown on how it's organized in Finland, where

they completely reorganized their health delivery based on primary care

in health centres, They introduced a whole new kind of health planning.

The health centre is the basic primary-care unit, providing the general

practitioner, the occupational health, the maternal and child health,

school health, child dental care and physiotherapy services. They now

have their whole country organized on this basis.

My basic question to the minister — I asked you this in the last

session — is: will you not give serious consideration to at least

evaluating and studying the system of community health centres instead

of moving in the direction, which I'm concerned about, of closing down

what we have? That's my first question today.

My next question to the minister is to do with the whole area of

rationalizing the regional delivery of health services. I know this is

difficult for any minister when he tries to restructure community

groups into new ways of delivery. I believe we've talked about it

before, but you still have a problem in British Columbia where the

school districts — I know the minister knows what I'm talking about —

do not coincide with the regional health districts; public health is

done in isolation. I think that for the delivery, so that we can

involve a community better, so that it can be coordinated, so it could

perhaps even case the costs to our Health ministry.... Has the minister

had an opportunity to look into that restructuring so that we can get

those boundaries correlating with each other more?

I'll just leave him with those two questions for now.

HON. MR. NIELSEN: The Ministry of Health is responsible for

the administration of approximately $9 million a day in expenditures

for today's purposes, so obviously the overwhelming function of the

ministry is going to be in providing the health care which is being

consumed by the citizens of our province daily. There are literally

dozens of people who spend a considerable amount of time reviewing

programs and operations in other jurisdictions. They also spend a

considerable amount of time reviewing, on behalf of other

jurisdictions, our process of delivering health care.

I don't believe we've sent officials to Finland recently, but we

have done exhaustive studies in Sweden, Denmark, the United Kingdom,

Germany, the U.S. and other countries. The Finland concept is the

Finland concept; whether it would have any bearing on British Columbia,

I don't know. It's probably contrary to the Charter anyway, no matter

what we do, We would look at it, sure. Our people do study the journals

and the reports from the World Health Organization. We met with some of

the Canadian members of the World Health Organization who are

constantly reviewing — I don't know for what purpose — certain programs

in countries which have far less capability than we would have in

Canada. But yes, we would be vaguely familiar with Finland, perhaps

more specifically familiar with some of the countries we have reviewed

extensively. The clinic concept of Finland could be reviewed: it's not

a problem. Whether it could be incorporated into our system is quite

different. Their system of government is somewhat different, and their

attitudes are somewhat different.

The boundary problem with health districts is not confined to the

delivery of health. We still have some archaic remnants of older

systems. The other day the member for North Vancouver–Seymour (Mr.

Davis) questioned whether union boards of health were still useful or

whether they perhaps had outlived their purpose. That's a question that

could perhaps be considered at some time. Mr. Chairman, I think it is a

problem throughout the province to have different boundaries for

different functions. I think there are about 19 separate boundaries for

different functions. We have school districts, regional districts.

health districts, water districts, forestry and parks, and it does make

it a bit difficult to coordinate, Perhaps there would be good cause to

see if we could not develop common boundaries, particularly in areas of

social services. We are speaking to basically the same people over a

number of issues.

Regional districts may be the place to begin. Perhaps that's where

the boundaries should be for purposes of schools, health and that which

associates itself with services to people, rather than to industry or

the environment. It doesn't really create as many problems as one might

think, because the boundaries for many of these areas are historic and

the people seem to have been able to operate within them for some time.

But that's always subject to change.

[2:45]

MRS. DAILLY: Just to comment on those answers before the

member for Atlin (Mr. Passarell) takes his place, I want to say, to the

minister that I'm glad he has a more open mind on the problems we're

dealing with on lack of coordination and boundaries in the province

than he seems to have in the whole area of community health clinics.

Whether Finland's government is different, whether they are different

people, I think they have the same problems that we do in delivering

health care. Every year this comes up and the minister says, "Yes, we

study it; yes, we look at it," but he still seems to give the

impression of a closed mind on this alternative way of providing health

care. I just say to the minister that I hope when we talk about this

again you can at least say you're going to try to expand the pilot

studies on this, instead of closing them.

HON. MR. NIELSEN: Mr. Chairman, to the member, I will go to Finland and visit their clinics, and report back.

MR. PASSARELL: Mr. Chairman, it's a slice being back. A

couple of questions regarding the constituency. My experience with the

minister has always been helpful. We've always been able to have good

meetings together.

The first issue I'd like to discuss is the Nishga diagnostic centre.

When we met in the minister's office last year, funding was given by

the federal government and a commitment was made by the hon. minister.

What I'd like to know is, where's the funding in regard to those

meetings that we held last year in the minister's office? What stage is

the commitment at by the province in regard to this extremely

worthwhile centre in the Nass Valley that will be servicing five, six

different communities?

[ Page 5842 ]

The second question I would like to direct to the minister is

regarding the Atlin Red Cross outpost. In the community of Atlin where

I live, presently it's a small Red Cross outpost. If I'm not mistaken,

I think the provincial government funds the major part of that. There

are very few Red Cross outposts left that serve the medical problems of

a local community in this province, and I doubt that are left across

this country. In rural isolated areas it's usually the Department of

Indian Affairs who put on a program. Since that one does not fall into

that category, I'm wondering when the provincial government is going to

put some kind of an inner structure in the community of Atlin that

conforms to other communities in the far north of British Columbia,

such as the excellent program that the minister brought in three years

ago in Dease Lake, which is a fine facility.

I'm not faulting the Red Cross. I think the Red Cross provides an

extremely important aspect in the medical facilities, but I think we're

in the twentieth century, and it's about time the community of Atlin

had a proper inner structure medical outpost similar to the one in

Dease Lake.

Those are two questions. Firstly, one regarding the Nishga

diagnostic centre, that worthwhile program, and, secondly, the Atlin

Red Cross outpost. When are we going to get something in Atlin similar

to the community of Dease Lake?

HON. MR. NIELSEN: The question of the services available at

Atlin. Red Cross outposts, I believe, have now been reduced to a

handful throughout the province. There are five or six, I believe; I'm

not quite sure. There would be no difficulty in doing a review of Atlin

to determine how effective that Red Cross outpost is and what the

requirements of the community might be.

The Dease Lake situation was unique. It responded to a very real

problem in Dease Lake and seems to function very well. We would have no

difficulty in reviewing the requirements of Atlin to have an evaluation

made as to what future planning may be required or what structures,

staffing and so on, to meet the needs of the people there. So that's

just a matter of pushing the button and getting someone to review it.

The New Aiyansh diagnostic and treatment centre: I'm trying to find

some specific material on it. As far as I know, it is going along fine.

We committed ourselves to the planning stage. The federal government, I

believe, agreed to accept their responsibility, as we had asked. There

was some confusion and a bit of foot-dragging for a period of time,

because it was a matter of trying to mesh a number of component

authorities in some sequence so authority could be granted under

certain understandings. As far as I know, it has been resolved.

I'll get more information perhaps in a few minutes time. But my

understanding is that the New Aiyansh diagnostic and treatment centre

is proceeding as was planned. I'll get more specific times and dates

once that file comes down from the office. As far as I know, there is

no difficulty that was not foreseen.

MR. GABELMANN: I have three specific issues that I want to raise with

the minister. The first is the Campbell River and District General Hospital

construction. My understanding is that the five-year construction budget includes

a provision for that proposal to come onstream in 1988-89. I don't know

whether I need to spend much time detailing the problems in that particular

hospital, Mr. Chairman.

Again, last week I did a tour with the administrator and the

director of nursing, looking at the totally inadequate situation in the

operating room, intensive care and in several other parts of the

hospital. It confirmed very much the kind of thing that was said back

in 1979 by one of the minister's predecessors, Rafe Mair, who said at

that time: "My staff has advised me that the update of the surgical

suite, X-ray, emergency and central supply areas is of immediate

concern to everyone." Those concerns are more so now than they were

then. The use of the hospital has increased; certainly surgical

procedures have increased over the years. It is, frankly, quite

appalling to spend any time in that particular facility. It's hard to

believe that operations can take place. It's hard to believe that

appropriate nursing can take place in terms of the recovery room. The

intensive care facility, as well, is quite inadequate.

The construction proposal calls not only for redressing these

particular issues but also calls for shelling in a future 40-bed unit.

The hospital now has 100 beds, 90 of which are operating. This would be

an additional 40 for probable use sometime in the mid-'90s, based on

likely needs at that time.

I'd like to get some idea from the minister whether or not the

1988-89 target is likely to be met, and where that particular facility

sits in relation to other priorities in the province. One of the things

that I try to convey to hospital people and to doctors and to others in

the community is that there are other facilities in the province that

are also in need of fixing. They can't believe there is any place worse

in British Columbia than their facility, and I would appreciate it if

the minister could give us some idea as to where his staff feel the

Campbell River hospital fits into the scheme of things. That's the

first issue.

The second is that two and a half years ago a special review team

was sent into the northern part of Vancouver Island — the Port McNeill,

Port Hardy, Port Alice areas — to do an evaluation of the various

hospital facilities in that part of my riding. The review did not

include the Alert Bay hospital — for a variety of reasons, I suspect.

In any event, no action has been taken on that particular review. I

wonder what its status is now and what the minister's thinking is

regarding the development and use of those particular hospitals,

particularly in Port McNeill, Port Hardy and Port Alice — and even

those outside the review, such as St. George's Hospital in Alert Bay.

There is still a fair amount of concern up there as to what plans there

might be for future policy in that area.

The third concern that I have is very much not a constituency issue

— it's one that so far affects a very small proportion of our

population — and that's the whole question of AIDS. It's not a subject

that has, to my knowledge, been talked about in the Legislature before.

I think that the kind of disease it is warrants that there be some

discussion. If I can serve some purpose in raising the topic and

getting it on the table for discussion, I think that purpose alone

would be sufficient, because of the kind of emphasis placed on the

disease and people who might have contacted it.

The minister was kind enough to give me some information a few weeks

ago as to what the ministry knows about the disease — what programs are

in place in Vancouver, particularly at St. Paul's — and indicated that

in terms of research there was a $67,500 grant to assist in a study of

AIDS in male homosexuals. Now AIDS is clearly — if American information

is to be believed and if worldwide information and what's

[ Page 5843 ]

coming out of the Atlanta centre is any indication

— a disease that, while starting in the homosexual community, is

beginning now to spread into the entire community. The numbers so far

are small, but certainly evidence is available that it's a disease that

is not restricted to that particular community.

In any event, even if it were, it's of epidemic proportion among

some segments of our society and great concern is being felt about it.

Fortunately, I think, there is increasing public discussion of it, and

the Vancouver Sun ran

an excellent series of articles just recently on the problem. I raise

it not to ask for anything specific, except perhaps another look at

additional research money that might be made available to assist in

some of the work that's going on in St. Paul's. Perhaps also, some of

the work that could be done might be integrated into the new

biochemistry research facility at UBC. I'm not sure I have the right

name for that facility, but it's the one that was announced the other

day by the Minister of Universities, Science and Communications (Hon.

Mr. McGeer). It seems to me that $67,000 out of, I believe, lottery

money is not much for a disease of this proportion, and some further

assistance might be considered by the government.

I repeat, I raise the topic not for immediate response in terms of

promises to do this, that or the other, but because I believe there are

some issues that don't get raised for a variety of reasons. Sometimes

being the first to raise an issue of this kind in this kind of forum is

a useful exercise in and of itself. I wanted to do that. That's all I

want to say on that particular topic; I would await the minister's

answers.

[3:00]

HON. MR. NIELSEN: Mr. Chairman, the member discussed this

question with me some time back and, as he mentioned, I supplied him

with the information as we had it. The concern in the community over

this particular difficulty — the AID syndrome — is very sincere. It is

alarming from a statistical point of view: 7,000 cases of AIDS have

been reported in the United States, 183 in Canada and 33 in British

Columbia. Fourteen of the 33 in British Columbia resulted in death;

that's a 42 percent fatality rate. The virus that appears to be

implicated in AIDS has been discovered, and scientists are attempting

to learn more. There is a blood test available, apparently only at the

Laboratory Centre for Disease Control in Ottawa. The B.C. Health Care

Research Foundation awarded a grant of $40,000 to a team of researchers

at St. Paul's Hospital and later added an additional $27,500. The B.C.

Health Care Research Foundation reviews all applications for research

money and makes recommendations to the foundation for approval.

I share with the member for North Island the very serious concern

that people in the research world have over this alarming problem, and

I can assure that a great deal of effort is being made to try to find

out more and assist those who are in research.

[Mr. Ree in the chair.]

The member asked about the special review team which traveled

up-Island a couple of years back. Our review teams are primarily

involved in financial audits or operational audits. I believe the

member may have been speaking of a report which began on the northern

Island about the amalgamation of a number of facilities. That may have

been what people were speaking of when a team went up. There's been no

action on that. There was a very brief report — perhaps only a comment

— about the viability and wisdom of amalgamating some of the smaller

hospitals on the north Island. There was a fair amount of local

opposition to the idea, although from an administrative point of view

frequently it is quite useful to share administration, because of the

difficulties sometimes of finding the necessary people to administer

the smaller hospitals. But no action has been taken on the north Island

cluster of hospitals, and I don't believe the subject has had a great

deal of attention over the past short while at least. I think the

amalgamation question was the key.

We met with representatives from the Campbell River hospital a few

weeks back and reviewed their request for capital construction in the

amount of about $16 million to $17 million. We have a five-year

construction program in the Ministry of Health. Because of the

restraint program and the recession, much of that five-year program was

unable to commence when we would have preferred it to commence. The

entire program has been shifted forward.

The Campbell River and District General Hospital representatives

wanted a couple of points. They wanted reassurance that indeed their

program would go ahead at some time, and of course, as every delegation

from every hospital requests, could we perhaps speed it up. We had an

extensive discussion with them. I believe most of their concerns were

met. They genuinely believe that if there were any opportunity to

modify the priority list. please let it be in favour of the Campbell

River hospital. They wish to upgrade their surgical suite, X-ray,

emergency, CST, physio, the laundry, dietary stores, renovations to the

reception and the outpatients and, as the member said, 40 acute beds in

shell.

We were unable to advise the Campbell River folks that they were

going to be changed in a priority list or given a leg up over other

people. The Campbell River hospital is functioning reasonably well.

It's an older facility and in need of certain renovations or changes,

and we hope we can move on that within the

schedule we originally

considered. There would be the planning phases first. and then the

actual construction. We hope that the economy will be in a position

where we can release that kind of commitment.

I mentioned the other day, Mr. Chairman, that I believe the requests

for capital construction in the province total approximately S900

million, so there has to be a lot of thought about the priority. But

the Campbell River hospital is certainly on the list. We would like to

be able to move as quickly as possible. but hopefully it will be within

the original time-frame, subject to the availability of funding.

MS. BROWN: I raised a couple of questions last week, and I

know that the minister has got a lot of answers for me. But I was in

Kamloops this weekend, and a special case was brought to my attention

of a person who was unemployed and stopped paying the medical premium

for himself and his family, because, as you know, when you're on income

assistance you don't get health coverage unless you're unemployable or

a single parent or disabled. So this person stopped paying the health

premiums, and with the result of that now is owing something in the

neighbourhood of $7,000 to $8,000 in hospital bills.

That made me kind of curious. I was wondering whether the minister

ever pulls off the computer these people who are not covered by health

insurance and takes a look at the kinds of bills that they have run up,

and if anything is done about

[ Page 5844 ]

helping them to meet those financial responsibilities. I'd be interested in knowing whether that's done.

HON. MR. NIELSEN: I'd have to get some information, because a

person who is unemployed can apply for premium assistance. I'm not

trying to trap you on something, but you said it was a hospital cost,

which would not relate to a premium at all. The hospital would be under

a different program. They should be eligible for hospital costs if the

person is a resident of British Columbia. But perhaps on that one

specifically we might get the information. I'd be pleased to look into

it.

We have reinstated many people to the program who have simply, on

their own initiative, dropped out. But if it's hospital expenses, I

don't understand why the person would not have been eligible, because

it is not part of the Medical Services Plan, which is only the medical

side. But maybe we could get details on that.

The person should have been, as far as I can see, eligible for

premium assistance. We pay up to 90 percent. It can be made retroactive

in certain instances, so we'll look at that one specifically.

May I just respond to the member for Atlin (Mr. Passarell), who is going out for a cigarette in a moment.

AN HON. MEMBER: Withdraw.

HON. MR. NIELSEN: Sorry, no offence.

New Aiyansh. The planning will be finished this summer for the D and

T centre. The construction is to start immediately. Hopefully it will

be closed in before winter, and it's expected that the centre should

open next spring — 1986. Next spring in Atlin is what — July?

Just a footnote on Campbell River. After the meeting we had with

officials, there was a promise made by the ministry to upgrade critical

areas with minor capital projects. But the entire $16.5 million project

is still scheduled for the later date.

The member for Burnaby-Edmonds (Ms. Brown) asked several questions

last week. In response to them, I believe the first was on the question

of midwifery. The computer has produced a considerable response, but it

may be of general interest to members. The topic of midwifery has been

around for a great deal of time. We receive very little communication

with respect to it. Over the last decade, the government opened new

obstetrical services based on the LDR concept: labour, delivery and

recovery, all provided in a specially designed room in a setting that

is as home-like as possible without sacrificing any of the potential

for high-tech intervention, should that be necessary.

Some hospital procedures in the past — in fact most, I suppose —

were more geared for the convenience of the staff than for the mother

or father. You would find that that is seldom the case today.

Family-oriented maternity care does involve good prenatal classes,

maternal and nutritional counselling, involvement of the father right

through to delivery, and frequently rooming-in, where mother and child

never need be separated.

Most of the time having a child is a natural, normal process, but

there is always the risk, especially to the baby, even in so-called

normal deliveries. For that reason we believe the prospective parents

deserve the best possible backup during this important event. It means

the best physical environment and attendants with the best possible

qualifications.

Officials in the ministry have followed the question of home

delivery and midwifery with great interest. It appears that countries

which used to do a lot of home midwifery are now moving in a very

similar direction as ourselves. Of interest, 30 years ago one-third of

the deliveries in Great Britain were at home; the figures now are about

1 percent, and many of those were not scheduled.

Mr. Chairman, you'll be glad to hear that the perinatal and neonatal

mortality rates are still improving in our province to the point that

early neonatal deaths in 1983, including even high-risk cases, was down

to 4.2 per thousand live births. Similarly, total perinatal mortality

for 1983 was down to 8.7 per thousand live births, which compares

favourably with any jurisdiction. It also compares favourably to a rate

of 12.3 back in 1973. Most important, the sad cases of brain damage are

almost now a rarity.

In B.C. only physicians are registered to do midwifery. There has

been an ongoing push by a number of lay and nursing individuals that

they be registered to practise. A number of years ago there was a

considerable amount of enthusiasm. It seems to have calmed down

considerably. We have not taken a firm stand on that question because

it really hasn't come before us in any forceful way. There have been

inquiries on occasion, but there doesn't seem to be an organized push

the way there was some time back. People within the ministry and the

medical world have advised us that they believe that a less clinical

environment in a hospital provides the best opportunity for the mother

and child and the best opportunity to produce the healthiest child.

The member asked a question with respect to abortions. The number of

hospitals accredited or approved to perform abortions in British

Columbia is 67. The number of hospitals which during the period October

1984 to March 1985 have performed abortions is 47.

The member asked about a couple of grants — for the Vancouver

Women's Health Collective and the Reach Centre Association. The

Vancouver Women's Health Collective has on occasion requested funding.

The Ministry of Health did not respond in the positive with respect to

their last request. It is the opinion of the branch which is

responsible for grants in conjunction with the minister's office that

the services provided by the Vancouver Women's Health Collective

duplicated information and direct services provided through our public

health units, family physicians and obstetricians. We felt that it was

not an essential service from that point of view, and that the

information was readily available from alternate sources.

[3:15]

The Reach Centre Association had a grant of $326,000 in 1983-84. It

was reduced to $239,000 for 1984-85, and $239,000 for 1985-86.

Originally the Reach clinic was established to provide care to the

immigrant and transient population in the east end of Vancouver. There

has been a shift in demographic makeup that has resulted in the clinic

evolving primarily into a family practice clinic. There has definitely

been a changing role in the centre. It is now more of a family practice

clinic than its original purpose for the immigrant and transient

population. We believe the grant is adequate for the quality and level

of services provided. I might add that the grant was $239,000, but the

Medical Services Commission also paid $330,000 on a fee-for-service

basis.

[ Page 5845 ]

The member asked a question with respect to what she referred to as

"granny-bashing, " which is the name given by the media today to the

abuse to the elderly. It is a very serious problem that has been

identified in many jurisdictions. It has been raised in a number of

media reports. Instances of what we refer to as elder abuse are

becoming more visible at a community level, with increasing care in the

home, with day hospitals and day work centres. Staff employed in these

types of facilities report cases of financial abuse or neglect and,

less frequently, physical or sexual abuse. The Seniors Serving Seniors

association of B.C. has provided a brief to the ministry asking for the

province to adopt legislation defining abuse, providing for mandatory

reporting of suspected cases and establishing protection for the

informants. The brief also asks that procedures be set up to facilitate

the reporting and investigation of complaints.

In addition, Mr. Chairman, the Victoria Institute of Gerontology is

sponsoring a study of elder abuse in order to develop a broader

scientific base of data on the types and causes of incidents. We have

not yet been able to gather a great deal of objective information on

the incidence and causes of this phenomenon. At the moment no province

in Canada has moved to establish extensive regulations. We are

encouraging research on the subject. We are monitoring the relative

incidence of abuses reported to our local health authorities. Also, we

are reviewing a report which has been submitted by the Seniors Serving

Seniors association which asks for legislative action.

Mr. Chairman, while we have not reached the point where we have

produced what we consider to be the role we are to play, we are

certainly highly involved in the investigation side, and we are

reviewing the report to us which requests legislation. We have not yet

completed that inquiry, but we certainly have it uppermost in our minds

and intend to pursue it.

MR. COCKE: Mr. Chairman, at this moment I have just one question for the minister. I wonder if the minister would identify his officials.

HON. MR. NIELSEN: The people present in the House today? Mr.

Chairman, for the first time as deputy minister, Mr. Stan Dubas is with

us in the House. Mr. Dubas took over from Peter Bazowski on April 1.

This is the member for Atlin (Mr. Passarell). [Laughter.] Mr. Eric

Denhoff was employed by our ministry as an information officer but is

now with.... We just call him a public relations consultant. Rob Munro

is the man who takes care of all our books — he is our comptroller.

MR. COCKE: Mr. Chairman, by long precedence of the House I

contend that ministry officials are not deemed to be strangers in the

House. But I draw your attention to standing order 23, and that there

is an official who is not an official, who is a private consultant — as

identified by the minister.

HON. MR. NIELSEN: Mr. Chairman, I wonder if we could maybe

ask of the Clerks later to perhaps offer us a definition of "official"

and whether that would include a person under contract. Perhaps that

might resolve it.

Interjection.

HON. MR. NIELSEN: Yes, it is a custom of the House, but....

Interjections.

MR. HOWARD: Mr. Chairman, sometimes I can be helpful to the Chair: I hope this is one of those occasions.

I think the standard for acceptance in the chamber during committee

is that people who are full-time employees in the public service and

are assigned functions and duties as such, such as deputy ministers,

assistant deputy ministers and the like, are accepted — and have been

so for years —as advisers to a minister with respect to either a bill

or estimates, as is the case here. But when we extend beyond that to

people identified — as the minister did — as somebody who is in private

practice but happens to be under contract at the moment to the ministry

for a certain specific purpose.... I don't think we can extend that

acceptance and understanding of what is a stranger. and exempt from

that categorization the gentleman identified as being on contract to

the minister. That is not a public servant, in my view.

If the Chair were to express a thought to that effect, in a very

gentle way, perhaps the gentleman in question would, with ministerial

approval and endorsement, feel obliged to sit in the gallery.

HON. MR. GARDOM: Mr. Chairman, concerning the point that has

been taken, I gather the premise is that a stranger is not a stranger

if that individual happens to be a public official, and that has

been.... There has been a custom of the House — it's a custom, not a

rule — that officials are entitled to be in the House to assist

ministers during estimates. I cannot recall if the specific issue has

ever been raised before; certainly not during the 19-odd years that

I've been here. I think it would be a good point for the Clerks to

consider at some point in time. But the distinction never having been

raised up to this juncture, I think we should just carry on as we are,

subject to a ruling coming down at a later stage.

MR. ROSE: On a similar point of order, it's been my

experience that the ministers are always ably assisted by members of

their own departments. They are, in fact, government officials. I guess

this is right and proper and a custom of this House.

A custom of another House with which I have certain familiarity

indicates a quite different practice during committee. Members of the

opposition who are cross-examining the minister during committee stage

are similarly entitled to have certain kinds of assistance at their

disposal and sitting behind them. It seems to me that what happens here

is that the minister comes in with his army and an opposition member

sits over here armed with a pea-shooter. I would like the Chairman to

take up this particular matter as well, because it seems to me only

democratic that in the committee stage the opposition should have

immediate access to the same kind of expertise — statistics and the

like — that are available to the minister.

MR. NICOLSON: On a point of order, I don't know how long the

memories of Clerks might be, but I remember having the very distinct

advice that it was just not done to bring in a private consultant. When

I brought in the Strata Titles Act in about 1974, I had a great deal of

the work prepared by a

[ Page 5846 ]

private consultant, and would very much have liked

to have had the consultant on the floor of the House to assist. It

certainly was not customary at that time. Somehow it has come about. I

think the matter could be resolved in part.... Or maybe it has; I don't

know if the person has absented himself or not. I certainly recall

getting some advice, and it was deputy ministers and senior

departmental people, but not outside private consultants. So I don't

know where this....

This is just another little testing. I don't think anybody's asked

us if we would object. I don't know if we were consulted as an

opposition. It certainly isn't cooperation and it certainly isn't

partnership.

[3:30]

MR. CHAIRMAN: I think as Chairman I have to take extreme

cognizance, particularly, of the comments of the member for Skeena (Mr.

Howard), in which he has stated that in the past it has been recognized

as practice that advisers to the ministers have been available in the

House to advise the ministers. Using the term "advisers, " because

certainly

section 23 doesn't make reference to.... They're talking

about strangers. But we've had advisers. It's not the first time that

this committee has had a minister served by an adviser who is not an

employee of the ministry. Maybe they have not been identified to the

committee as being a consultant from outside of the committee, but by

the recognition of the person that was here, members of the committee

would have known he was not an employee of the committee. I think that

unless the House wishes to take the position that ministers should not

have any advisers, the Chair certainly would see no objection to a

senior consultant to the minister being in the same category as a

ministry employee.

MR. HOWARD: As you said, Mr. Chairman, if I could, standing

order 23 makes no recognition whatever of individuals, other than

members themselves, as to what their function or capacity might be.

Some come as guests on the floor of the chamber; some come as advisers.

If your ruling and opinion is that people who are identified as

advisers, by whatever categorization, so long as the member who is

listening to that advice says, "This person is an adviser to me, "

whether a public servant, or on contract, or just freely obtained

advice, without contract — just expert opinion.... If that's your

ruling, I think that's very worthwhile. Later this afternoon I'll bring

an adviser along.

HON. MR. NIELSEN: Mr. Chairman, I don't know what the purpose

of all this is, however.... Mr. Denhoff has been working in certain

areas, and he is able to produce information far more quickly than some

others. Nonetheless, standing order 23 says "the Chairman may, whenever

he thinks proper, order the withdrawal of strangers." The Chairman,

therefore, is the person who makes any decision. If it is brought to

his attention that strangers are present, it is the Chairman's

decision: he may, when he thinks proper, order such withdrawal. Other

than that, there is no other action.

MR. COCKE: Mr. Chairman, the practice is that ministers can bring in

public servants who work within their ministry. What we have just done now is

indicated that people other than public servants who will report to a minister

can be brought into the House. I contend now, with this new position, that the

opposition can bring in private consultants, by virtue of the fact that they

are not working for the ministry. We could not conceivably bring in a public

servant, because they're working for the ministry. But now with this new

concept of standing order 23, we have put ourselves in a position as a committee,

which is fine by me, that the opposition can do exactly the same as the minister,

as long as it's an outside consultant.

MR. CHAIRMAN: The Chair has made comments that the practice

has been for advisers to ministers in answering questions and providing

information to the committee and, I guess, particularly to the

opposition, at the time of estimates or in committee with respect to

bills. The meat of the Chair's position is that it is advisers to

ministers that have historically been permitted in the House, and not

advisers to other members of the committee, regardless of what side of

the House they are on.

Interjection.

MR. CHAIRMAN: Well, with respect to the member's specific

question on other members being allowed to bring advisers, the Chair

will take that under reservation, but the practice has been that

ministers have been historically allowed to have advisers on the floor

when their ministries have been subject to examination under estimates,

or for a particular bill.

Shall we continue on vote 37?

MS. BROWN: Yes. I want to thank the minister for the answers

to those questions. I'd like to ask him to reopen the decision on the

Women's Health Collective for a couple of reasons. The first reason

that I am putting forward to him is that the Women's Health Collective

acquires and places at the disposal of the community information which

is used by people who traditionally would not go to the public health

units or even to their doctors.

Interjection.

MS. BROWN: Oh, you want to make a ruling? Okay.

The House resumed; Mr. Speaker in the chair.

The committee, having reported progress, was granted leave to sit again.

MR. SPEAKER: Hon. members, in putting forth an opinion on the

matter that the Chair undertook to resolve, the Chair must express its

grave concern that a matter of this kind is not capable of being

resolved by the ordinary mechanisms available to both the House leaders

and the party Whips. Forcing the Chair to intervene in what is

ordinarily considered routine House business is a situation which

brings little credit to the parliamentary process, and is a situation

not to be encouraged.

The purpose of requiring notice under standing orders is to alert

members as to the business of the day, thus preventing surprise or lack

of preparation and allowing a member to be present, together with

necessary witnesses, in the case of a committee meeting. The members

have drawn to the Chair's attention the provisions of standing orders

25 and 48. Having

[ Page 5847 ]

examined both standing orders, it emerges from the

examination of standing order 48 that notice is not required to fix the

time of a meeting of the House.

A committee is a creature of the House and an extension thereof, and

accordingly it seems to the Chair that if two days' notice is not

required for a motion relating to a meeting of the House, it would

normally not be required for a motion relating to a meeting of a

committee of the House. Bearing in mind that notice of this particular

meeting was printed on the order paper of Tuesday, April 23, and daily

thereafter up to and including today, it would appear that no one in

the House was taken by surprise in relation to the proposed meeting at

3 o'clock today.

In the absence of the notice of the meeting appearing in the Orders

of the Day, the Chair, mindful of the rights of the members, and, in

particular, the rights of the minority, might well view the situation

differently. Today, however, the Chair is of the opinion that the

matter should be determined by the House by the putting of the motion

moved by the government House Leader, which is a motion that the

committee have leave to sit at 3 o'clock today while the House is

sitting.

Hon. members, we are now faced with a motion before us. The member for Skeena seeks the floor?

MR. HOWARD: Yes, to discuss the motion — as to whether or not leave should be given to the committee to meet while the House is meeting.

MR. SPEAKER: One moment, hon. member. Hon. members will appreciate that the debate allowable here is somewhat limited in scope.

MR. NICOLSON: On a point of order, Mr. Speaker, I agree that,

as you say, leave is not required to set the time of a meeting outside

the House. However, I thought the question under consideration was

suspension of standing orders and whether one needs to have a motion on

the order paper for suspension of standing orders. While the time is

not really at issue, it is a fact that.... The time could have been

changed to sit this morning at 10 o'clock and that would have been

probably quite adequate notice. But what we're talking about is the

sitting of a committee while the House is sitting. That, I submit with

respect, is not answered by the ruling. I agree with everything said in

the ruling, but it doesn't rule upon the simultaneous sitting of the

House and a committee. The committee sitting could have been changed to

9 o'clock tonight or 10 o'clock this morning, and it may coincidentally

have been appointed to sit at 3 o'clock this afternoon.

The time is not at issue. It is the simultaneity of the two

sittings. That's what I would expect a ruling on, Mr. Speaker, before

we proceed to debate such a motion — that we need notice of this

motion. Had notice been given last Thursday, it would have been

perfectly in order to order that the House and the committee sit at the

same time — but not without notice.

Interjection.

MR. NICOLSON: Mr. Speaker might find this a laughing matter. I think it's very serious.

MR. SPEAKER: Order, please.

MR. NICOLSON: When we tamper with the rules of the House....

MR. SPEAKER: Order, please.

MR. NICOLSON: We had a committee, of which I....

MR. SPEAKER: Order, please, hon. member.

MR. NICOLSON: With respect, Mr. Speaker....

MR. SPEAKER: Be seated, please, hon. member.

MR. NICOLSON: Well, then the Speaker should....

MR. SPEAKER: The member will come to order.

Interjection.

MR. SPEAKER: Order, please, hon. member. The member should listen to the ruling of the Chair before he makes such comments.

The member for Skeena was seeking the floor.

MR. HOWARD: I thought it was an opinion, not a ruling, Mr. Speaker.

MR. SPEAKER: It is an opinion, hon. member, which I was about to....

MR. HOWARD: With respect, you just used the word "ruling."

MR. SPEAKER: The opinion is the one that was mentioned earlier, hon. member.

MR. HOWARD: I think the opinion expressed will become a ruling very quickly. That's what happens to those things.

This makes a mockery of the long, hard work that the committee did

with respect to these rules during the previous session of the

Legislature. That committee spent many hours trying to develop rules of

procedure that would serve the public interest. That was its primary

goal and objective.

Standing order 2(2), if I could draw it to the attention of the

House, reflected what the committee was trying to do with respect to

the conduct of public business by making it an extraordinary action on

the part of the government to exempt Wednesday from the sittings of the

House. It says: "The House shall meet on Wednesday if the government

shall have so advised the House prior to the adjournment of Tuesday's

afternoon sitting; otherwise the House shall stand adjourned...." The

implication of that is that the House would not meet on Wednesdays

unless the government took the deliberate action of saying by motion

prior to adjournment on Tuesday that it would in fact sit on Wednesday.

It's carried even further with the lost Wednesday question period being

carried forward to Friday to make sure it is still available. The

purpose of the committee in providing the opportunity for the House not

to meet on Wednesdays was specifically that committees of the House

could meet on Wednesdays without conflict. Whether the hour is

established as 3 o'clock or 3:30 or 4, or whatever the time is — and

[ Page 5848 ]

that's part of what we're talking about here — any

time for a Monday sitting between the hours of 2 o'clock and 6 o'clock

would have been inappropriate to the sense of what the committee was

trying to do.

[3:45]

Let's take an example. When Your Honour took the course in your

opening remarks of making reference to the fact that this should have

been resolved at another level, those discussions did take place, yes.

They were unable to be resolved. I'm not going to go into the

discussion that did take place; I don't think that's germane to this.

But those discussions did take place. There was an attempt and a

desirability to try to accommodate the meeting of the Standing

Committee on Standing Orders, Private Bills and Members' Services. I'll

touch on that a little bit later by referring to another notice of a

meeting of this same committee, which was subsequently cancelled.

We have the Health estimates before the committee today. The

Minister of Health is a member of the Private Bills, Standing Orders

and Members' Services Committee. He obviously cannot be in two places

at once, if the committee is going to meet. That's one member of the

committee who is disadvantaged by not being able to be in both places

at once. The Deputy Speaker may be disadvantaged too. If the House is

in committee, the Deputy Speaker is in the chair from time to time. He

also is a member of the Private Bills, Standing Orders and Members'

Services Committee. I myself and the member for Nelson-Creston (Mr.

Nicolson), when we found out that Health estimates would be the first

item up today.... And I should tell you that we were advised at about

10 minutes before 2 o'clock this afternoon, or something of that sort,

through the government Whip's office that this would be the first item

of public business. The member for Nelson-Creston and I are both

desirous of participating in the Health estimates today and find

ourselves unable to do that. We have three members from the opposition

side on that committee.

AN HON. MEMBER: And all three want to take part.

MR. HOWARD: Well, that's for each member to say for himself,

regarding that. I only know because the member for Nelson-Creston and I

talked about it. My colleague from Maillardville-Coquitlam says he

would like to....

Interjection.

MR. HOWARD: Well, wherever he's from. He also indicates to me

as an aside that he would like to participate in the Health estimates

as well.

So there is disadvantage accruing. That's the point that the

committee last year wanted to overcome and prevent. The first instance

of that.... We find that there's a demand by the Chairman of the

Standing Orders, Private Bills and Members' Services Committee that the

House and the committee have conflict with each other, and that members

in it be placed in the impossible situation of having to be, if they so

desire, in two places at the same time — an impossibility, no matter

how agile we are and how desirous we might be. We cannot serve both

things.

When it comes down to the crunch, Mr. Speaker, I find myself obliged

to attempt to serve what I perceive to be the public interest, and I

consider that to be the Health estimates over a private bill. That is

my public conscience that says that. The committee really had high

hopes of working together to serve that public interest, and I think

now that it's up in smoke.

The Committee on Standing Orders, Private Bills and Members'

Services, upon due notice — the same as the notice which is referred to

in the order paper today — met on April 17 at 1:00 p. m., which is a

Wednesday. The House was not meeting. It met for organizational

purposes to elect a chairman and secretary, and to examine the subject

matters that may be coming before that committee, namely notices of

private bills. And it made some tentative arrangements about that.

On the order paper of Friday, April 19 — it's important, I think, to

look at this — the following notice appeared: "Select Standing

Committee on Standing Orders, Private Bills and Members' Services. The

committee will meet at 1 o'clock p.m. on Wednesday, April 24, in the

Oak Room. Business: Bill PR404...." And then it identifies the bill;

it's the same bills as are identified in the notice of meeting for this

afternoon.

Why didn't the committee meet on Wednesday? Because the cabinet was

meeting. That was the information that was given to me by the chairman

of the standing orders committee. We're going to cancel the committee

meeting on Wednesday — April 24 last — because the cabinet is meeting

in Vancouver. Note that there are four members of the cabinet on this

committee who don't mind being disadvantaged now, but couldn't be

disadvantaged then, on April 24.

Why can't the committee meet the day after tomorrow a Wednesday?

Because, once again, I'm told that cabinet is meeting in Vancouver or

someplace, and therefore the committee can't meet. That makes a mockery

of the whole process of attempting to conduct public business in a

rational, sensible way. And it really prostitutes the position of the

committee of last year, that was unanimous in its view that if

Wednesdays are to be set aside for committee purposes, that will serve

the public interest because there won't be that conflict between the

two. Mr. Speaker, I submit to you that the whole process really is

injurious to the public interest.

There would have been, and there was in prior discussions, every

attempt made by me to accommodate the fact that the cabinet was meeting

last Wednesday and therefore the committee had to be cancelled, and

therefore the witnesses with respect to the Chilliwack Foundation and

the Trinity Western College Act were told not to come because cabinet

was meeting. I did try, in discussions, to find a common area of time,

particularly outside the meetings of the House. We talked about Friday

mornings, Monday mornings and different times. Then lo and behold, we

get a notice that says 3 o'clock Monday, without regard to what the

business of the House is.

I find myself in no other position than to be able to express

dissatisfaction with the process, dissatisfaction with the fact that

the cabinet and the government, dictators that they are, are now

dictating to the Chairman of the Standing Orders, Private Bills and

Members' Services Committee and telling him what to do, when it should

be the other way around. He chaired that standing orders committee last

year when we met to study the rules, an able person as chairman who did

a good job. He was on that committee, and he knew what we were trying

to do and went along with it; and at the first test between him and the

cabinet, who buckles under?

The public interest loses in all of this, Mr. Speaker. I think it's a very sad and difficult day when we see public business

[ Page 5849 ]

put to one side because of the whims or idiosyncrasies of this group opposite.

MR. NICOLSON: Mr. Speaker, I too would like to speak against

this motion. You know, this is a little bit of a watershed in terms of

what might have been. When one thinks about all the time that was spent

in trying to enhance the image of parliament.... It is under attack

throughout the democratic world, and one does have to look at ways in

which we should seek to enhance and preserve parliament. Then we took

at this kind of action, and it is certainly injurious to the very

essence of a democracy. We have a chance for some change in this House,

and instead of the government's showing that there was going to be a

change — referring some bills to committees and having some of the

other committees besides Standing Orders, Private Bills and Members'

Services and Public Accounts sitting and working to bring people in, to

allow people to have more direct access and input into the legislation

that affects them — we take the absolute opposite approach.

Now I take the point of view that it would have been within the

powers, I guess of the Chairman.... If the committee meeting is at the

call of the Chair, it would have been within his powers to call a

meeting at 9 o'clock tonight; that would not interfere with the cabinet

meeting on Wednesday or with what is going on in the House today. But

what would it interfere with? It would interfere with some of those

cabinet ministers, who in spite of the money they make are probably too

damn cheap to maintain two homes, one here and one over there. They

find it cheaper to travel back and forth on government aircraft and

commute, when other less remunerated members of this House maintain two

residences. If that's what it's coming down to and that's what this

motion is all about, sitting here when it's convenient for the cabinet

commuters, then I say that this is one of the most antidemocratic acts

and most callous things being done around here.

I don't expect much to be said publicly over there, but I hope there

are a few people on the other side of the House who are going to raise

hell among themselves about this kind of thing going on. When we have

left this House, when our day has come and gone and we're no longer

here, I think you should want to be able to look back and say that you

did something to elevate the level of debate, something to elevate the

workings of this Legislature, that you left it a better place than you

found it in some respect. But if we are going to do this sort of thing

in a cavalier manner — changing rules around and changing schedules

simply to convenience these cabinet commuters.... I want to say, Mr.

Speaker, that I'm ready to work at 9:00 tonight if that's when the

Speaker wants to call this meeting. I'm ready to work in the mornings.

I was here to work this morning. But if this is the way that it's going

to be run, I say that we're doing a real disservice to people who are

coming over here as witnesses to the committee. People must have an ear

on what's going on in the House as well as having an ear to what's

going on in committee. To think that the minister whose estimates are

up for debate is a member of that committee, and we're proposing that

the two things should go on at the same time, is just absolutely

callous. It does a disservice.

When you think that it was just less than 150 years ago that the

Chartist movement in Great Britain tried to reform the House there, and

tried to bring about annual meetings of Parliament and tried to bring

about universal suffrage and things like that.... It looks like we're

trying to go back to those dark, dark days of privilege, where the

House is just a rubber stamp and something that only the privileged can

participate in. It is a real sad and backwards step.

I would hope that the House Leader would withdraw this motion. Let's

not paint ourselves into a corner any further than we already have. I'm

not going to use any strong language. Let's just back off, cool off and

forget it. Let's get together and think about ways in which we can make

that Wednesday work for the Legislature and make it work for the people

of British Columbia.

[4:00]

MR. VEITCH: As the chairman of this committee, I certainly

don't want to see any undue conflict; I certainly want to see the thing

move along in as harmonious a manner as it possibly can. Responding to

the member for Nelson-Creston (Mr. Nicolson), I don't think that any

member of that committee has ever been a rubber stamp for anything. I

think they act in a very independent and very straightforward way. He

and the member for Skeena (Mr. Howard) and also the member for

Coquitlam-Moody (Mr. Rose) are very able and very competent members of

that committee.

We don't really know, Mr. Chairman, whether the estimates of the

Ministry of Health will be up, or whose estimates will be up. We don't

know at this point in time what the business of the House will be once

the Committee of the Whole House resumes. The statement that I made to

the hon. opposition House Leader last week was that there were not

sufficient members here to conduct a meeting, and if you don't have

sufficient members, obviously a quorum would not be in evidence, and

you couldn't hold the meeting anyway.

In answer to the hon. member for Nelson-Creston, we did have some

discussion about a possible meeting this evening, but I believe the

opposition House Leader felt that wasn't an appropriate time for it.

Interjection.

MR. VEITCH: If that is not the case, I'm sorry. I withdraw that.

It appears to me, Mr. Speaker, that the business of the private

bills committee is also the business of this House. In lots of our

discussions during the time we contemplated the new rules, we talked

about the way things were done in other jurisdictions, and we noted —

and the member for Coquitlam-Moody noted on several occasions — that

the committees of the House of Commons in Ottawa meet continuously

during the time the House is in session. So this is not establishing

any precedent or really breaking any rules. I think the people are

here. I think the interveners and the proponents of these bills are

here, and it would be better if the committee did meet with them and

gave them their hearing while they've come a long distance to the

capital to talk with us.

MR. ROSE: I concur with your sentiments, Mr. Speaker, that it

might better have been handled at another level. However, I think that

it was probably ordered from an even higher level, and that's why we're

facing the particular debate that we are today. I think that the

decision to be off for last Wednesday and the previous Wednesday and

probably this

[ Page 5850 ]

next Wednesday has everything to do with what the

objectives and the motivations and the priorities of the government

are. I don't think the Legislature really is considered.

I spent a lot of hours with this committee — hundreds of hours — and

I'd like to say that we got along well. What we were trying to do,

among other things, was to make our Legislature both understandable to

the people at large — the public — and also predictable so that they

would know when things were going to happen. We never really know. Last

Thursday I was excoriated in the media by a member of this august body

because I failed to show up for the organizational meeting of a

committee. Well, excoriated might be too strong a word; I was mildly

chastised on the grounds that I hadn't shown up for a meeting. Well, I

had another meeting of my own caucus committee at that time, and that

delegation had spent a long time and done a lot of preparation and

given a lot of notice about coming here to meet with us. So those are

probably reasonably good, practical ideas for not juggling around the

days of committees.

Wednesday is not a day off. Wednesday is not in the rules as a

cabinet day. Wednesday is a day designated for work in the committees;

that's what it was for. The moment we depart from that kind of

procedure we become unpredictable again and start doing things that I

found appalling when I first came here — the way we treated one

another. If we come to a point where we can attempt in some way to have

a little bit more civility in here, I think all of us, as we did on the

committee.... I think all of us gained a great deal from that

experience. It looked to me like a turning point, from a time when

rancour reigned supreme to a time when we had a situation where we

regarded one another as "the genial member from Point Grey" and the

member for Richmond. We all got along swimmingly on that committee, and

I think we did pretty good work; but it isn't going to take very long

to destroy the kind of mutual confidence and trust built up in the

committee.

I want to be at two committees. I want to be at the Health committee

and at the Private Bills committee. Which committee do I absent myself

from? I thought my job was to be here since I'm up next on the Health

estimates. Therefore I found it difficult to accept the kind of motion

that the House sit when the committee sits.

One final point, and this is a little bit of a rebuttal to the

member for Burnaby-Willingdon (Mr. Veitch). Scholarly as he is, he will

know that the House of Commons has 284 members. Right? And we have 57 —

more to come though, as long as they're the right kind. So if 10

members toddle off to the committee, we've got roughly what? A quarter

of the House? A fifth? Approaching a fifth of the House is gone from

the House, so it might be difficult even to have a quorum in here. We

go off to this committee while the House is sitting, and then this

House grinds to a halt because of a lack of quorum — potentially. The

other thing is that it's much easier with a 10-member committee of a

284-man House — person House; excuse me. It's much more easily covered.

So I think the whole thing is bad procedurally, it's bad for the

Legislature, and I think it's bad manners. Therefore I'm going to vote

against it.

HON. MR. GARDOM: Mr. Speaker, I'd like to volunteer a couple

of observations here, if I may. First of all, I think all members of

the House are addressing this debate and this discussion in good

spirit, and they're to be commended for that. The rules of the House,

Mr. Speaker, are the servants of the House, not the masters, and we're

the first to agree with that. I'm sure that's the general trend of

thinking by all hon. members.

Quite frankly, I would not even have called this today, but for one

reason. I think there was a misunderstanding — no doubt a genuine

misunderstanding — between two people. I'm not a party to that

misunderstanding. But in view of accommodating the members of the

general public, the people who were requested to come did indeed come

to Victoria today. There seems to be a great deal of opposition to the

committee meeting this afternoon, and in view of that fact, I give, on

behalf of the government and indeed on behalf of the opposition, our

apologies and regret to them. But, Mr. Speaker, in view of the

sentiments that have been expressed by members of the opposition and

indeed by the hon. Chairman of the committee, the member for

Burnaby-Willingdon (Mr. Veitch), I think the best resolution of this,

in order to get on with the business of the people and stop dealing

with technicalities this afternoon, is to, with leave, withdraw the

motion. I would ask leave of the House so to do.

But before requesting that leave, I would like to formally give

notice to all members of the House, and certainly the proponents of

Bill PR404 and the proponents of Bill PR406, that it will be

contemplated that this committee indeed will be meeting on the

afternoon of Wednesday, May 8. I trust I've got the right day. Would

you mind looking that up, Mr. Member for New Westminster (Mr. Cocke)?

It is May 8. On that basis, Mr. Speaker, I ask leave of the House to

withdraw the motion.

Leave granted.

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

ESTIMATES: MINISTRY OF HEALTH

(continued)

On vote 37: minister's office, $206,025.

MS. BROWN: I was putting in a plea for the Vancouver Women's

Health Collective to the Minister of Health, on the grounds that the

information which they provide goes to people who are really using a

lot of alternative health resources. If the minister were to visit the

health collective office, he would notice, for example, that a number

of young prostitutes — teenagers, some of them — walk in off the street

and use the material that's there. They won't go to the public health

office; they certainly won't go to their doctors. In addition, because

the information collected deals specifically with disease and things

which affect women, it's all there and it's very easily accessible to

women who need specific information immediately.

In addition, they're doing a good job in terms of printing material,

doing some very minor research, talking to schools, running workshops

and those kinds of things. So I would like to ask the minister to

reconsider his decision about funding for the Women's Health

Collective. In addition, I would like to suggest that they would be

really pleased to have a visit. If he'd like me to arrange that for

him, I would be very happy to do it, but I think if he just walked in

off the street, they would be quite thrilled to see him, to show him

some of what they're doing and to explain the importance of their work.

[ Page 5851 ]

I got the case of the man with the $7,000 to $8,000 medical bill

from an advocacy counselling service in Kamloops. I will certainly

contact them and ask them to make direct contact with the minister,

because they pointed out the lack of his welfare coverage as well.

I want to talk about the Community Care Facility Act and regulations. I'm not sure whether anyone else has raised it or not.

Interjection.

MS. BROWN: You haven't? Okay. In a letter, dated March 5, to

Mrs. Connie Clarke of the Mentally Handicapped People, the then deputy

minister, Mr. Peter Bazowski, indicated that the Ministry of Health had

initiated a total review of this particular piece of legislation and

its regulations. I want to start out by saying thank goodness for that,

because it really did need that review. I want to know if the minister

would share the information with me on the status of that review at

this time. What I need, Mr. Chairman, is the status of the review. I

have some questions which will probably be answered when he starts to

talk about the review.

Also, has Glendale applied for hospital status? I'd like to have an answer to that too.

I'm told by the B.C. mentally handicapped association that the

current

interpretation of the community care licensing regulations for

adults prevents adults with multiple disabilities from living in

licensed group homes if they are unable to transfer themselves from

their wheelchair to their bed. And that seems to be the stumbling

block. It doesn't matter how well they are able to take care of

themselves in every other regard. Simply by virtue of the fact that

they can't get from their bed to their wheelchair or from the

wheelchair to the bed without help, they are deprived of staying in a

group home. There is a very tragic case which I know the member for

Rossland-Trail (Mr. D'Arcy) brought to the minister's attention and to

that of the Minister of Human Resources (Hon. Mrs. McCarthy). Gail

Salewski is a person who is very content to be in a group home.

However, she has been deemed to have to be in a medical institution

simply because she can't get from her bed to her wheelchair. What this

does, of course, is undermine and eliminate a number of opportunities

for community living for a number of adults who are capable of living

independently, except for this one fact of not being able to transfer

from their wheelchair to their bed.

[4:15]

The other issue which I want to raise has to do with a coroner's

inquest: the case of Lyle Lulu, who was asphyxiated by drowning. The

Royal Inland Hospital in Kamloops.... The inquest made four

recommendations directed specifically to the Ministry of Health. One

has to do with constant supervision in the pool; one is about

lifesaving aids being easily accessible with knowledge of same by

supervising staff, and a permanent licensing officer with a suitable

client-resident ratio to provide adequate visitations, etc.; the third

is the fencing required around the perimeter of the property as well as

around the immediate pool area, and so forth and so on. Maybe the

minister could explain whether anything has been done about those very

specific recommendations. It goes on to say that, "While I concur with

the jury's recommendations, I wish to add the following to the Ministry

of Health, " and I just listed those things. So maybe he can respond to

that at this time.

Also, about the wheelchair-to-the-bed thing, Janine Senft is another story which showed up in the November 27 issue of the Times-Colonist .

This is another instance of a young person who feels she can live on

her own and would very much like to live on her own in a group home,

but can't as a result of the decision.

The other issue has to do with the decrease in contributions to

municipalities in terms of funding for health care. I think the

minister might appreciate some feedback as to the impact that that

decrease in funding is having on some municipalities. The senior labour

relations officer for the B.C. Nurses' Union appeared before Burnaby

council and indicated that the laying off of community health nurses

would not be trimming frills, but rather would cut to the core, leaving

little room for an effective program of prevention. The council agreed

with her that they certainly did not want to have to lay off any of

their nurses, but found that they had difficulties as a direct result

of the reduction in the funding contribution from the ministry. As a

matter of fact, I should probably tell the minister that by eliminating

a full-time nurse in Burnaby the following would be lost: meeting the

needs of 619 children at two Burnaby schools; 16 prenatal classes over

a six-month period, with 18 couples per class; health teaching; support

and counselling to a weekly average of 14 mothers and their young

children; twice-monthly child health care sessions, each with between

10 and 12 small children; service to 47 children in day care and 18 in

preschool; postnatal care to 219 babies and counselling to their

mothers — simply by eliminating one nurse,

That gives you an idea of the incredible workload that those

full-time nurses in the school system handle, and also the real

negative impact on the delivery of preventive health care and community

health care if this happens.

Burnaby is not the only municipality that I can give some feedback

on. The Vancouver School Board has decided that a cutback of $134,000

this year in health services led to the removal of 2.5 full-time

community positions, used as sick and vacation relief of school

nursing. This elimination means relief of the school program is

obtained through reduction in the nurses' other areas of

responsibility, the individual and family program. They go on to list a

large number of services that would also not be dealt with as a result

of this, including nutrition deficiencies in children, ulcers, obesity,

anorexia and attempted and successful suicides. It seems that West

Vancouver also has some such concerns as voiced through the North Shore

union board of health.

So maybe the minister could respond to what appears to be a 20

percent decrease. Now I'm never going to go to war to defend my

arithmetic, but it seems to me that the decrease to the municipalities

is in the neighbourhood of 20 percent, and the impact of that is

already being felt. I hope that in the minister's response he will give

some indication that he's thought about this and that there is going to

be some restoration.

Also, how is it possible to decrease the funding for TB control at a

time when it appears to be on the increase? When I visited the North

Shore board of health, I was given a statistic which indicated that the

diagnosed cases in that area had gone from one to 12; and those were

just the ones that were diagnosed. They indicated that although there

was access to immunization, there was no clinical followup, no way of

finding out whether the compulsory immunization was being enforced,

especially among immigrants and students from other provinces. So to

decrease the funding for TB

[ Page 5852 ]

control by 7 percent at this time doesn't really make very much sense.

The other point that I wanted to raise was this. I attended a

conference of immigrant families and health and social services. It was

very well attended and very well represented by Dr. Bill Meekison of

the Ministry of Health and some representatives from the Vancouver

health department. I really believe that the immigrant women — they

were all women at the conference — were very pleased with the responses

which they got to their questions. They made a recommendation to Dr.

Meekison, which he promised to carry to the ministry, about the

business of nutrition guides taking into account the cultural food

biases. They say that, for example, when they go in for pregnancy

counselling they are handed a nutrition guide that says they should eat

lots of apples and — I forget the other thing that they don't like —

meat. This doesn't take into account that a number of them are

vegetarians by religion and so forth and so on, or that the whole

question of poverty also makes it impossible for them to meet the

requirements outlined in the food guide. As a matter of fact, the

United Way brought to the attention of the Ministry of Human Resources

and presumably Health that people living on income assistance can't

meet the food guide. That will be dealt with under another ministry,

but I wonder whether the Ministry of Health has taken these cultural

differences into account and whether the ministry is preparing

nutrition guides that reflect cultural differences.

HON. MR. NIELSEN: The Women's Health Collective grants have

been designated for this year, and the allocation of grants has been

consumed. I think we did advise them that we would keep their request

on file for further consideration. At the moment, the grants have been

allocated.

The Community Care Facility Act is under review at this time. There

has been no resolution as yet. As the member would know, Mr. Chairman,

there have been a number of incidents which have led to the review, and

those problems and those recommendations and advice which has been

offered certainly will be taken into consideration. Actually, there

have been relatively few difficulties with the facilities when you

consider the number of facilities we have in the province, but they

have been somewhat high-profile. It's under review at this time.

The Glendale, to the best of my knowledge, has not applied for

hospital status. I'm not familiar with that particular coroner's

inquest. I've asked staff if they would see if we've received a letter

from the coroner — the one the member referred to. I just don't have

that information. I'm not familiar with that, but I shall see if there

have been communications.

The difficulties we have in allocating space to people who have

multi-handicaps, or certain handicaps, is one of attempting to develop

criteria for care. Because of that a person who requires a certain

facility must undergo some type of investigation as to which facility

is best suited for their needs. I think the member mentioned a Gail

Salewski case, which was at the Endicott Centre. The Ministry of Human

Resources wanted to move this young lady out of the Endicott Centre to

an extended-care bed. The Ministry of Health was required to assess the

needs of this patient to determine if the person was eligible for

extended-care facilities. The Ministry of Health advised the Ministry

of Human Resources that they considered this patient to be

extended-care eligible since she required professional nursing care,

continual medical supervision and other types of care which can be and

are provided in an extended-care unit. The young lady in question is a

client of the Ministry of Human Resources, and therefore it is a

responsibility of the ministry to determine if there should be a

placement. The Endicott Centre is not licensed for this type of client;

it is not an extended-care facility. The ministry assessed the patient

and determined that she was indeed eligible as an extended-care patient.

The wheelchair-to-bed issue is, I think, one of the issues being

considered. That is a measure, I suppose, that was adopted at some time

to determine the appropriateness of certain locations for individual

patients or clients. There is the flexibility and the ability to review

an individual case. Frequently it is literally impossible to write

regulations, because the circumstances of an individual may be unique

to that person, and it's very difficult to draft regulations that would

cover all such cases. So we can and do take it upon ourselves to review

an individual's case to see if alternate accommodation or care can be

available. That's happened on a number of occasions.

The Burnaby municipality made the decision to lay off one nurse. It

is not a provincial health unit, and it was their decision, In the more

broad sense of funding with these municipalities on the lower mainland,

and within the GVRHD — a couple of them at least — the Burnaby school

district contributes part of the cost of the preventive nursing staff

hired by the municipality of Burnaby. The Ministry of Health makes up

the balance of the costs by way of a grant to Burnaby. The school

district proposed a reduction in the grant for 1985 of 6.5 percent. The

grant from education was approximately 1.5 percent. Prior to 1983 the

Burnaby and Richmond school districts hired all the nurses working for

the Burnaby and Richmond health departments respectively. In 1983, as

an example, Richmond school district threatened to terminate all of the

nursing positions. The Ministry of Health negotiated, or at least

worked to negotiate, a solution whereby the municipality of Richmond

took over the nurses on the understanding that the school district and

the Ministry of Health would meet the full costs. A similar arrangement

was offered and implemented in Burnaby, because the circumstances were

very similar.

As a result of the wage settlements, the budget for 1985 has

increased 6.6 percent over 1984. Burnaby school district has advised

that their grant will be $486,000 for 1985, compared with $515,000 for

1984, a reduction of almost 6 percent. So the net impact is a shortfall

of $63,000. The Ministry advised Burnaby health department that it's

not in a position to pick up the shortfall; they must take steps to

reduce their budget by that amount. That is why there has been some

change in the nursing population. It's not a reduction in the grant

from the Ministry of Health, but rather a reduction in the contribution

from the Burnaby school district.

[4:30]

The member made a point that I would hope nutritionists would take

into consideration when they are dispensing their services, including

their advice — that is, understanding their client, understanding what

the client's traditions and diet has been. It would seem to be perhaps

inadvertent, and rather surprising, that a nutritionist would not be

aware of the peculiar customs or habits of an individual, or a group of

people, with respect to advice. You are not going to have much success

in advising a person who has never in their life

[ Page 5853 ]

had a type of diet to suddenly adopt a new diet for

purposes of maintaining their health during a pregnancy, as an example.

It would be far better, I presume — and I'll certainly speak to the

person responsible for working with nutritionists — to understand the

alternative foods which would supply the same nutrition. I'm a bit

surprised that there have been occasions where this has happened, but I

think that could relatively easily be corrected, because it seems to be

common sense.

The ministry has made some materials available to specific ethnic

groups, in revised versions, to try to take into account cultural

differences. As part of the new pilot project in prenatal health, the

ministry has begun a project to raise the birth weight of babies. As

part of the project, material specifically designed for our native

Indian population has been prepared. These are being distributed

alongside our regular publications. So someone has taken into

consideration differences in culture. We are also preparing other

methods of bringing similar information to other major ethnic groups,

with that same thought in mind: recognizing the differences in the

culture. Perhaps we'll achieve that objective within a reasonable

period of time.

The tuberculosis problem. I think it's a case of cycles occurring in

health. For a period of time it was felt that the tuberculosis problem

in the province was really becoming a major thing of the past, and then

we had a couple of flare-ups, most specifically in the city of

Vancouver, which caused a considerable amount of investigation. There

was a case finding survey for tuberculosis in the east end of Vancouver

in March of this year. A total of 1,276 individuals attended special

clinics in the area. Of those, 11 are under treatment for active TB and

another 11 are under investigation for possible TB. The transient

population in that area of Vancouver is at greater risk. The problem is

fairly stable and ongoing, requiring the continuing attention of our TB

control division.

There was an allegation that a Ministry of Human Resources

caseworker was a carrier. This resulted in a thorough review of at-risk

employees during the past winter. This concern about tuberculosis was

shared by the TB control division, the Vancouver health department, the

B.C. Lung Association and other social agencies, and they all

cooperated in a neighbourhood blitz, which resulted in about 20 percent

of the target population being screened. We are very much concerned

about any flare-ups in tuberculosis. I can assure the member that there

will always be adequate funding to respond. We try to estimate what the

incidence of TB will be in the upcoming year, and we try to estimate

what our requirements are to control it, or to test for it. But I can

assure you that there will never be a shortage when it comes to

actually responding to a situation that was not anticipated.

MS. BROWN: I just want to wrap up my comments on this

section, Mr. Chairman, by pointing out to the minister my concern about

the fact that, with a $2.6 billion budget in Health, something in the

neighbourhood of 2 percent — or less maybe — is being spent on

preventive and community health care.

I want to make a couple of philosophical statements, if that is

permitted, about my belief that a health minister should be more

concerned with the prevention of illness than with the treatment, not

only because it's cost-effective but because in the long run that

should be his ultimate mandate: to keep us healthy. It would seem

therefore that a larger proportion of our budget should be going into

those programs which keep us healthy, prevent us from being ill, keep

us out of acute-care wards and generally enhance and improve the

quality of our lives all around.

I do not get any indication, from the small size of the budget on

preventive and community health care, that there is a recognition of

this on the minister's part. I have been told by the health units — and

I've visited quite a few of them and spoken to a number of people in

the community health system — that they are unable to introduce new

programs; they are having difficulties maintaining existing programs

and in fact are even having to cut some programs. They believe — and I

agree with them — that preventive health affects every risk factor

associated with any disease, and there is a lot more that we could be

doing in the way of educating, even to setting an example when it comes

to things like smoking. They would love nothing better than to have a

Minister of Health who doesn't drink and doesn't smoke. No, I think

they wouldn't like a Minister of Health who doesn't drink and doesn't

smoke.

AN HON. MEMBER: What has this to do with the health estimates?

MS. BROWN: Everything. It has everything to do with the health estimates.

Seriously, Mr. Speaker — and I'm going to be very brief there has to

be a better and an increased financial commitment in future budgets for

prevention and community health care. I hope the minister agrees with

me, because if not, I may have to stand again. I know you wouldn't want

me to do that.

HON. MR. NIELSEN: Mr. Chairman, I suppose the percentage for

preventive health and community health care services is relatively

small compared to the entire budget because of the size of the budget

and the tremendous amount that is being spent on non-preventive health

care. The preventive services total approximately $47 million this

year, which is an increase of 4.5 from last year. Nonetheless, a fair

amount of money is spent through our Medical Services Plan and our

hospitals, which really is consumed by what one could refer to as

preventive service as well, but is not identified as such.

Our culture, our society and our history seems to be that in the

area of health care the lion's share has always been to treat illness

rather than to promote health. There are those who even argue that our

medical profession has been trained in that way, and that there are the

beginnings of some change in the philosophy. I agree that there are

areas in public health that could be and should be improved. When the

money is available, I'm sure they will be.

We have had great success over the years with respect to preventive

health care. In fact, many of the programs that we now take for

granted, and which are not necessarily any longer identified as being

preventive health, have improved the well-being of our population

immensely. An example I could offer would be the various immunization

programs introduced over the years, which have to a very large degree

controlled some communicable diseases and other conditions. Such people

as might now contract those ailments would be treated under our regular

health system,

whereas at one time it was a major effort on the part of

prevention — the outbreaks of childhood communicable diseases and some

[ Page 5854 ]

the other diseases which affect the population in

general. So those are no longer as high profile as they once were, but

certainly I think they are an indication of how successful prevention

can be.

Mr. Chairman, we do pay a great deal of attention to our preventive

side. We offer quite a variety of programs throughout the province. We

have increased the budget slightly, to $47,268,000 for this year. I

sincerely believe that if we are going to be able to expand preventive

health care programs in the future to the point where you would reach

agreement with those in that area as to how much money should be spent

and how important those programs are, we truly must gain control over

these incredible expenditures at the other end, at the medical side and

on the hospital side, because it is very difficult to have the two

continue with the incredible increase we've seen over the last number

of years on the acute care side, with moneys being available for

preventive services. We've expanded our health care programs in the

province considerably. Over the last number of years the budgets have

been increasing rapidly. We have not, as I said in my earlier

statement, had the success we wish we had had with respect to medical

services costs.

Mr. Chairman, the budget is over $2.5 billion, most of that consumed

by our hospitals and Medical Services Plan. It doesn't leave a great

deal by way of percentage for programs other than those two. I believe

if we are going to be able to dedicate more of our funding to

preventive care, we must, from a management point of view, gain further

and better control over the expenditures in the medical services and

hospital side. So we don't disagree philosophically; it's a matter of

finding the money and seeing that it is properly utilized throughout

the program.

Mr. Chairman, in the last while there has been, I think, a far

greater awareness in our community generally with respect to

prevention. We have worked with the CNIB, the Western Institute for the

Deaf and other organizations concerned about the difficulties primarily

to children with respect to ailments which could be prevented. We have

worked very hard with organizations and professionals with respect to

prenatal, trying to bring up the weight of these children, and air

ambulance service to bring the youngsters down to Vancouver Children's

Hospital. So we are working on prevention of future difficulties. Our

thrust is to try to produce the healthiest possible child at birth to

give that child the greatest opportunity of health for the balance of

life.

[4:45]

There are some communities where we have some difficulty in filling

positions in the preventive side simply because of the difficulty of

recruiting. Unfortunately, when after a great deal of recruitment we

are able to find a person suitable to take on a position, frequently

they leave soon after because a vacancy becomes available in what they

believe is a more attractive area of the province. So it's an ongoing

problem in B.C. and other provinces as well.

MR. ROSE: I guess, Mr. Chairman, after all the fuss we raised

about the committee meeting while the House is sitting, I pretty well

have to say something about the Health estimates. I don't see my two

colleagues here, but really it was kind of dirty of me to call

attention to that. They'll forgive me.

Mr. Chairman, I've got only one particular topic that I wish to deal

with, partly an educational one and partly a health one. It is the

issue of the medical lab technologists. I'm just giving you that in

case you need to get some information from someone.

Before I get into that, though, I would like to echo the things that

my colleague the member for Burnaby-Edmonds (Ms. Brown) said about

lifestyle and cultural habits and prevention, which is very important.

I think that your culture and your history can actually be a tremendous

load to carry — and I say that with no pun intended — as far as your

eating habits are concerned. Regardless of how much you know about what

is so-called good for you, it's what you like and have learned to eat

that really is the determinant, until you get sick, and then you can't

do those things any longer.

As a personal example, which will be of interest to no one, perhaps,

my own cultural eating habits, because one of my parents grew up in

Prince Edward Island and I was born there, lean to fish, lots of salt —

and we know what that does in terms of the Newfoundlander and heart

attacks and high blood pressure — meat, potatoes, butter and eggs. My

wife, who grew up on the Prairies, eats all kinds of yukky stuff like

yoghurt and cereals and bean sprouts, you know, so she can be lean and

mean. Consequently, even though I know intellectually that I'm digging

my own grave with my teeth, even by following Canada's food rules....

According to some nutritionists they're dead wrong in terms of the best

diet today for individuals in this high-stress, highly refined food,

fast lifestyle that most of us lead. So I think there are some things

such as smoking.... That monkey is now off my back after 30 years of

being a sinner. I was a colleague of the minister in that — and

seatbelt legislation. All those sorts of things combined, I think, will

bring down costs.

Nutrition. Children learning to eat better and to take better care

of themselves is going to ultimately bring costs down, and probably

nothing else. As long as we allow ourselves to keep a polluted

environment, we run that kind of risk of increasing the costs of health

care. If we just look at, say, user fees or deterrent fees as our way

out of spiralling health costs, we're looking absolutely in the wrong

place. So I think the whole environment, not only the social but the

physical environment, all the exhaust fumes and that sort of thing, is

certainly the thing that will probably in the long run — if we have a

long run — be far more important as a reducer of health costs, and an

improver of general health.

Let's get back to the lab technologists. The lab technologists are

assisting paraprofessionals who have had anywhere from two years to

four years, perhaps, of university training, and they work in the labs

at hospitals and other places. They analyze blood tests, test for

infections, germs, mould, yeasts, and all types of things that the

ministry probably knows far more about than I. Nevertheless, there was

a letter to the British Columbia Institute of Technology that quotes

the Minister of Health. I'd like to ask him a few questions about that

letter — no