PROVINCE OF NEWFOUNDLAND AND LABRADOR HOUSE OF ASSEMBLY Volume 1 Number 98 4th. Session 34th. General Assembly VERBATIM REPORT FRIDAY, JUNE 5, 1970 SPEAKER: THE HONOURABLE GEORGE W. CLARKE

JUNE 5th., 1970 Tape no 1137 The House met at 10:30 a.m. Mr. Speaker in the Chair. Page 1 BON. J. R. SMALLWOOD (Premier): Mr. Speaker, I would like to read to the Bouse a letter that I have received from General Carr of the Department of National Defense Training Command. It is addressed to me and it says: "it was most kind of you to take the time to greet me, Major Vardy and my aide-de-camp, Captain Lavoie, in your office on Tuesday, 26 May. It was a real pleasure to see you again so fit and full of energy (we strike out that part). Not in my life will I forget my treatment in the Legislature.

To say it was a humbling experience is to understate the case. While your most thoughtful remarks may not have been justified, nonetheless, they were deeply appreciated. The additional remarks from both sides of the House by yourcolleagues and those in Opposition gave me a ~enewed sense of pride in my heritage." (His heritage as a Newfoundlander, of course). "Rest assured, however, I will not let the occasion and the kind thoughts expressed give me an inflated ego.

"The thing that strikes a person most on returning to Newfoundland is the genuine warmth and sincerity of all those with whom one comes in contact; regardless, of the status of the individual. It is a characteristic of Newfoundlanders , which,in many ways. is unique, While Newfoundlanders have many other unique characteristics as well this one remains in the forefront. I thank you, Mr. Premier. most sincerely,for the extreme kindness shown to me and my colleagues. To the members on both sides of the House. I wish formally to acknowledge the honour shown to me. Yours sincerely, W. K.

Carr, Major General, Commanding Training CommandJ• I think this should be put on the records of the House, from a great and distinguished Newfoundlander whom we were honoured to have visit us here and whom we tried, in return, to honour because he did visit us. ANSWERS TO QUESTIONS BON. W. J. KEOUGH (Minister of Labour): Mr. Speaker, I beg leave to table 6250

June 5th., 1970 Tape no 1137 Page 2 Mr. Keough. the answer to Question 517, in the name of the member fo; St. John's West on the Order Paper of May 20th. HON. E. N. DAWE (Minister of Municipal Affairs and Housing): Mr. Speaker, the answer to Question no. 548, asked by the bon. member for St. Barbe South, on the Order Paper of June 4th. The cost of architect fees in connection with the construction and furnishing of Elizabeth Towers? The answer to the .question - $288,956.91. ORDERS OF THE DAY. On motion of the bon.

Minister of Mines, Agriculture and Resources, a Bill, "An Act ·.To Amend And Consolidate The Law Respecting The Disposal Of Waste Material," read a first time, ordered read a second time on tomorrow. 011 motion of the bon. President of the Council, a Bill, "An Act To Amend The Chairman Of The Board Of Commissioners Of Public Utilities Pension Act, 1968," read a first time, ordered read a second time on tomorrow. On motion of the bon. the Premier, a Bill, "An ~t Further To Amend The ttural Electrification Act, 1963," read a first ti:ne, ordered read a second time on tomorrow. On motion of the bon.

Minister of Mines, Agriculture and Resources, a BUJ, "An Act To Amend The Provincial Parks Act," read a first time, ordered read a second time on tomorrow. On motion that the House go into Committee of the Whole on Supply, Mr. Speaker left the Chair. MR. HODDER CHAIRMAN OF COMMI'l'TEE OF THE WHOLE Item X: Health - 1001-01. MR. A. J. MURPHY: (Leader of the Opposition): Mr.

Chairman, just one question I would like to ask on this heading and this is with reference to the statement issued by the bon. minister on April 17th., with reference to charges made by the bon. member from Placentia West which was with reference to health services in his area on the Burin Peninsula. I was wondering, if anything 6251

.June 5th. • 1970 Tape no 1137 Page 3 Mr. Murphy. haooened since. I think the bon. minister ~as qu!te upset and perhaps rightly .so 0 according to his statement on the thing, and I was wondering, if anything has been resolved on this matter. RON. E. M. ROBERTS (Minister of Health): Mr. Chairman. I havenot had, nor to my knowledge nonaof my officials have had any further communications, with the members concerned,with respect to that matter. MR. MURPHY: We presume that they were unsound. MR. H. COLLINS: Mr.

Chairman, I would like the Minister of Health to clear up this question that I have. ··.About a couple of weeks ago certain accusations were levelled at the optometrist in Gander. For the information of the committee, there is an ophthalmologist employed by the Department of Health in the James Paton Memorial Hospital. One of the only - I was going to say a rare breed, but I suppose that is a wrong term. Mr. Chairman, I think he is the only ophthalmologist which is employed outside the City of St • .John's at the present time.

I understand that the ophthalmologist at Grand Falls is a~out to leave for some point on the Mainland and it is also my understanding that the one ophthalmologist at Corner Brook is about to retire. In view of the all~gations and accusations which were made. apparently there is some conflict between the ophthalmologist and the optometrist at Gander. I wonder would the minister indicate the result of the investigation which, I think, he undertook to have done. Perhaps. he might speak on that. MR. ROBERTS: Mr.

Chairman, I would be delighted to do so and might I thank the bon. member for Gander for his courtesy in giving me notice of the point which enabled me to get the precise information. Mr. Chairman. ··-ophthalmologists are very z:are animals - very valuable people. We have only seven in Newfoundland and that includes Dr. Gillan who. I am told, is leaving Grand Falls. We were extremely fortunate a year or so ago to be able to recruit an ophthalmologist, Dr. Asgar who is now working for us at the Paton Hospital - James Paton Memorial Hospital in Gander. Some weeks ago I had 6252

June 4th., 1970 Tape no 1137 Page 4 Hr. Roberts. a letter from the Chamber of Commerce of Gander relaying a complaint which bad been made to that Chamber by one of the Chamber's members, an optometrist at Gander named Mr. Paxman. The Chamber's concern, in their letter, in very short form was that Mr. Paxman had complained that Dr. Asgar was unfairly competing with them in that Dr. Asgar, according to the Chamber, was using Government facilities for private business. My officials, at my direction, looked into this and there is no substance whatsoever to those charges. Dr.

Asgar is a highly skilled and highly qualified ophthalmologist which means, among other things, that be can measure a person for glasses, it is called a refraction technique and that he can prescribe for glasses Ophthalmologists, of course, can do many other surgical and medical procedures. Mr. Paxman is a qualified optometrist registered with the board in Newfoundland. As an optometrist, basically, all that he can do is measure for glasses. Mr. Paxman feels, apparently, that Dr. Asgar should be prohibited from doing one of the functions for which he i~ qualified and suited; namelyJ prescribing glasses. Mr.

Paxman also feels that Dr. Asgar should not, apparently, in anway deal with people unless Mr. Paxman is not able to deal with them. Neither of those are acceptable - neither of them are correct, Mr. Chairman. Dr. Asgar has the right to prescribe for glasses. He has the ability to and the need is very real in the Central Newfoundland Area, therefore, 1 hope he will continue. Mr. Paxman is qualified to prescribe glasses, and as far as I am concerned he can continue. Dr. Asgar has received numerous complaints of the work being done by Mr.

Paxman - that fittings were wrong, that lenses had been produced with their axes in the wrong direction. Fro~ the medical point of view the work being done was not satisfactory. That difference of opinion might be the real reason underlying the complaints. 6253

June 5 , 1970 Tape no 1137 Page 5 Mr. loberts In any event, Dr. Asgar has now been directed no longer to take prescriptions and forward them to ·an optical company but instead to ask a person who comes to him for patient services to have his glasses made where he wil~ pointing out that there are a number of places he can have them made. There was also a rumor being spread that Dr. Asgar was receiving some form of kickback from the optical company to whom he was referring these glasses. 1 am delighted to say that there is no truth whatsoever in this rumor.

It is completely a baseless statement as the boo. member and I have discussed and that the doctor is practising perfectly ethically, perfectly properly and I am told a very good brand of medicine. Now I hope, Mr. Chairman, that these statements will be given wide publicity. In the Gander area itself the charges made by Mr. Paxman have received wide publicity. This is unfortunate. It is not unfortunate that the charges were advanced. That is fair enough, but want I would not anyone to think they were based on anything other than, apparently; no substance.

I can add only that the administrator of the hospital at Gander, has told me that he, Mr. Howell, together with Dr. Coxon, the senior medical officer at Gander and Dr. Asgar have asked Mr. Paxman to meet with them to discuss the problem. Mr. Paxman informed Mr. Howell, so I am told, that he would take "alternate action to champion his cause." The next action my officials heard of was through the Chamber of Commerce and through the news aedia. So, I do think that there is nothing at all to it. I am delighted that Dr. Asgar is in Gander, Mr. Chairman, and I could only wish we could attact more ophthalmologists.

I do hope that this unfortunate misunderstanding between the ophthalmolog~s and the optometrists will not in any way inconvenience or harass Dr. Asgar. I think Dr. Asgar has been under unfair criticism, and I would be extremely upset if he were to leave 6254

June 5, 1970, Tape 1137, Page 6 -- apb Gander because of this unfair criticism, and it 1a the people of Gander and of the area served by that hospital who would suffer Mr. Chairman. Tb,re is no unfair competition, there is no evidence at all, the evidence is that what is· being done by all sides is perfectly proper. MR. COLLINS: Mr.

Chairman, I thank the minister for his statement and, while we do not usually appeal to the press to cover things which we say in this Bouse, I would second the minister's appeal to the press to make sure that that statement is quoted by the various media, particularly in the Gander area where the complaint was given coverage about two weeks ago. MR. CROSBIE: Kr. Chairman, I have a few questions here that I would like to ask the minister, if he would just note them, then he could deal with them now and I think we will be much quicker going through the estimates then.

Having spent nine months in the Department of Health myself, I realize some of the problems the •inister has to grapple with. There are just four or five broad questions I would like to ask him. One is if he can tell the House what stage, o~ where the minister now is in his negotiations with the laboratory and x-ray technicians or technologists in connection with the salaries position. We understand that the non-professional hospital workers are - have accpeted the offers that were made by the Government.

I believe the minister said yesterday that the hospitals that are run by the boards or non-Government hospitals have had budgets approved that give them sufficient money to pay the increases, and that it is between them and the C.U.P.E. if they have a branch of the union at that hospital to pass on the increases,wbicb presumably they will be doing.

The minister,! think, is still negotiating with the laboratory and x-ray technolo .gists and with the nurses as to whether or not, or just what their position is, whether they are goi~g to accept the general increase that everybody bas been offered or whether because they are a special group there is going to be some special arrangement made ~th them. I 6255 believe Mr. Chairman, that when you are dealing with x-ray and laboratory • r

June 5, 1970, Tapw 1137, Page 7 -- apb technicians. they are special groups.Because of their skills hospitals cannot operate without them and~ we have to be competitive here with the other Provinces the same as we do with doctors. Doubtless, the minister has that in mind. If the minister would sooner one question at a time, than answer it? MR. ROBERTS: It is up to you MR. CROSBIE: Well, okay MR. ROBERTS: Mr.

Chairman, with respect to that question, we are negotiation, we being a committee of the Treasury Board, my colleague the Minister of Supply and Services, my colleague the Minister of Labour and myself with three seperate (well actually there are more than three) but the bon. gentleman mentioned three groups, the nurses, the laboratory technologists and the x-ray technologists. We are also negotiating with two other groups in particular, that pharmacists and the physiotherapists. The physiotherapists are rather a small group, there are I think four or five in Newfoundland at present.

The present status of the laboratory negotiations ·is that the Government have - the Government and the negotiating team for the laboratory people have arrived at a set of proposals which all consider to be satisfactory and these are now I am told being submitted to their member- ship and they vote. That action was authorized by the laboratory technologists at a meeting here at St. John's on Saturday evening past.

With respect to the nurses, I have been in touch with Miss Laracy within the past few days, and we expect,as soon as my colleagues and I can be free,to have meetings with them to discuss the matters affecting nurses. X-ray technologists' meetings have been held within not the past few days. Indeed, although the committee would,be aware of it, a meeting was held last night. At one point, one of my own officials - one of the x-ray technologist officials happen to be sitting in the gallery. I cannot give details. Indeed, it would be most inappropriate 6256

.June 5th •• 1970 Tape no 1137 Page 8 Mr. Roberts. at this stage to reveal any details of what is going on: Basically, we are at no point looking beyond the· $45 a month across the board increase that the Government have authorized. We are looking at the areas that are unique to the various paramedical groups - the various professional groups involved in trying to work out acceptable positions. I think that negotiations to date have been most fruitful. and I am quite hopeful of a satisfactory settlement.

Perhaps, I could add a word; Yesterday he bon. gentleman . asked me a question on orders. and I made a1answer with 2spect to the non-professional groups. I made an answer - I do not think my answer was completely correct. Mr. Chairman. so I would like to make it as correct as I can. The Government have approved the extra money for the $45 a month allotments for the salaries, for the non -professional categories. That money has not been paid to the boards, sir, basically for the reason that the interim supply authorized by the House is not sufficient. We do not have enough money authorized to do it.

We have been in touch, on a continuous basis, indeed before the bon. gentleman's question with CUPE, I think, they are aware of the position. Within a few days, we hope to be able to say at what time the cheques will be paid to the vaDbus employees. In any event, they will be as of the 1st. April. But the point is and I was in error yesterday, Mr. Chairman. The non-Gove~nment operated hospitals do not have, at present, the money to pay these extra increases.

It has been approved, but I did not realize that the interim supply is not enough to allow us, because $45 or $90, say, for two months for 5,000 or 6,000 employees, Mr. Chairman. is just money we do not have in the interim supply authorized by the House. MR. CROSBIE: Than~ you, Mr. Chairman. 6257

June 5th, 1970 Tape 1138 JM - 1 MR. CROSBIE: Thank you, Mr. Chairman. I believe at the beginning of the session the Minister said that he hoped that he would be in a po$ition to table a White Paper on future development of the Health services during this session.

Now, I think everybody could excuse the Minister because of the busyness of the House and so on and on other matters,there is no White Paper ready but I would like to know whether the Minister is going to be in a position to table a White Paper on the future development of the Health services and while he is telling us about that, has the Government made any decision on what the next steps are going to be in hospital contruction?

As the Minister knows there is the great need at the Western Memorial Hospital in Corner Brook for an update in their facilities and an extension to the hospital, I think that is agreeded on all sides. There is Carbonear where the sod was turned by the Premier and myself in September 1967 to replace the present hospital at Carbonear,which is too small now and inadequate, with a new hospital. The plans are all completed, I know that.

There is Twillingate where the Notre Dame Memorial Hospital is also an antiquated hospital and needs to be replaced which is agreeded and architects were appointed to do plans for that hospital, I remember. There is the fact that con$truction of a new wing and new facilities areneeded at the General Hospital particularily, now some of this work may have been done since, particularily with respect to outpatient and emergency services. And architects, I believe, were appointed, in fact it was L.L. Davies, I think. His architectural firm was appointed.

I maybe wrong there now as it might not be that firm, but someone was appointed to do plans for what work should be . done to the General. So there are all those areas apart from, well there is the Bay Roberts area which also has been promised a hospital but I do not know what the position is on that now. I know that the Minister of Municipal Affairs, I will take that up with him when we get to his estimates as to what he has been saying over and around Bay Roberts but I will wait for his estimates. So there are all those areas where the Minister knows new construction is needed and, of course, St.

Clares is unde~ way now. Now we know, it is very obvious that tight monev or no tight money interest rates can go up or down next year but the fact is that the Province can only borrow certain amounts of money 6258

June St:h, 1970 Tape 1138 JM- 2 MR. CROSBIE: each year. So,has the Government decided on what the priorities are going to be with reference to these various areas and,if so,could the Minister tell us what they are? Now in addition, of course, there is the medical school and the Government is committed to the medical school, the university is certainly committed to it, there are students there now and there is going to be an expansion of students next year, there is the problem of the medical school buildings themselves and the university hospital.

Now I believe myself and I would be interested to find out from the Minister, I see no way in which the Province would be able to finance a medical school and university hospital in the next few years but it maybe possible with what help is available from Ottawa to construct a physical plant for a medical school.

Not only that, in my view,although it is very desirable today and all the authorities will tell you that if you are going to have a medical school it must have its own university hospital right along side of it, this is the only way to do it, although that is the optimum, although that certainly is the best, that is the ideal, you can certainly have a medical school using the present hospitals in St. John's without constructing a very expensive university hospital.

My own view is that unless Ottawa is putting up all the money for the medical school and university hospital that the medical school should use the hospitals they now have in St. John's particul~rily, Mr. Chairman, because,as I recall the figures, we have enough hospital beds in St. John's now or certainly will have when the construction at St. Clares is finish. We have ample hospital beds in St. John's for this whole area and also for patients who are referred in from other areas. That being the situation, to my mind to build a four hundred bed university hospital here in St.

John's when there are other areas of the Province that are crying out for adequate hospital bed accommodations such as the West Coast, Port aux Basques, any number of areas you can mention, Carbonear, Twillingate, that it would be criminal in those circumstances to build a separate university hospital. Perhaps ·, Mr. Chairman, in ten years or twenty years when all our other basic needs are overcome the university hospital should be constructed~ So I would be very interested in hearing from the Hinister on 6259

June 5th, 1970 Tape 1138 JM - 3 MR. CROSBIE: what the position is on that and,if possible,when he envisages construction starting on the actual medical school buildings? MR. ROBERTS: Well, Mr. Chairman, let me begin at the point of the medical school .' We have a medical school in Newfoundland now, Sir, and later the Committee will come across the vote of $1.3 million or a little over that Is the major part of the operating cost of the medical school for this year.

We have a first rate medical school with a faculty that, I am told by a number of sources, most recently for example the President of the Canadian Medical Association with whom I met earlier this week mentioned it.but I have had this from a number of sources, we have a medical school with a faculty that has a world standard. The school now has, I believe, twenty-one or twenty-two students in its first year and that is going to be increased to twenty-five or twenty­ six in its-second year and at the same time they will be taking, I believe, thirty-two students into their first year beginning next fall.

The school has buildings, they are now housed in the buildings built to the North of the Thompson Student Centre in the Arts Administration Buildin~ on the campus, those are the wooden buildings immediately to the South of the parkway. Additionally the medical scbool has working a~reements with the St. John's General Hospital, the St. John's Grace General, St. Clares and we are now working towards an agreement with the Hospital for Mental and Nervous Diseases. I believe there are also working arrangements with the hospital at Carbonear and I know they are negotiating with the IGA for their hospitals.

It is perhaps not known and perhaps it should be that the University Medical School is now completely integrated with the General Hospital, the basic facility in this Province. The chief of each medical service at the General Hospital is the professor or head of the correspondin~ medical department at the University. This is similarily true, I believe, of the Janeway. The chief of staff of the Janeway, a man who has done superb work is Dr. John Darte. Dr. Darte is also professor of pediatrics at the university.

The medical school has physical space,! am told, for the next twelve months, it maybe a little cramped but it is adequate. The lon~er ran~e question of the medical school falls into two parts: the buildin~s for the 62GO

June 5th, 1970 MR. ROBERTS: Tape 1138 JM - 4 teaching themselves including some clinical facilities and on the other part the university hospital. The bon. gentleman who just spoke is quite right ~hen he says that by large we have enough active hospital beds in this Province, enough acute hospital beds. We do have beds that need to be replaced, we do have beds that are in the wrong locations but compared to the national averages: Mr. Chairman, we are not too far off. We are a little below, speaking from memory but I think the figure is 6.1 per thousand and the national average is of the order of 6.5 or 6.9.

We are however seriously deficient in psychiatric beds where ou~ per capita number is around half the national average and although we Newfound­ landers are perhaps saner than the rest of Canada we do need more psychiatric beds in this Province. Now, Mr.

Chairman, those are the facts which determine our priorities and while we at this time are not in a position to announce·the details beca4se l~am still working on them and they have yet to come to Cabinet,our priorities will be dictated by the two facts of improving and replacing outdated beds and improving our basic hospital~services and then secondly new psychiatric beds. That will mean that the hospitals which must be done first in Newfoundland and I do not list them in any particular order, I will start on the West Coast and work to the East.

The first is the Western Memorial Hospital at Corner Brook which will be the regional facility for a large area of Western Newfoundland emBracing about 100,000 people. There is now a planning committee representing my officials, the officials of my colleague, the Minister of Public Works and the board of that hospital. I saw in the newspaper the other day where the board is getting after me because the Committee have not met for sometime •. I have not heard from them yet but I am sure I will.

Perhaps the Committee have not met because its chairman, my Deputy Minister,has been absent for more than two months on sick leave. MR. CROSRIE: How is the Deputy Minister? MR. RORERTS: Dr. Miller is fine. I have not seen him since he was in hospital hut my officials do see him and I gather that he is doing very, very well indeed. MR~ROSBIE: He is hack home now, is he? 6261

June 5th, 1970 Tape 1138 JM - 5 MR. ROBERTS: He is in St. John's and perhaps he ma~be back to work within the two or three weeks or a month. The next one coming East from Corner Brook would be in the Twillingate area, the Notre Dame Bay Memorial Hospital. Some improved facilities are needed there. I think no less than two sets of architects were appointed for that hospital and I am not able because I do not have the information to say just what has been decided as to how many beds are needed or what sort.

Coming East from Twillingate we come into an area which in my view badly needs at~ention and that is the Come By Chance,Clarenville area. The Come By Chance Cottage Hospital is one of the first built in Newfoundland, I think it probably was the first, about 1934 or 35. It really desparately needs attention and I think the attention it needs is a new facility. I do not know whether the new facility should be at Come By Chance or Clarenville, in an area to serve a large region. From there, Mr. Chairman, we come into St.

John's where I think we need work done at the General Hospital and work done above all at the Hospital for Mental and Nervous Diseases. At the General Hospital plans have not been prepared. The firm of L.L. Davies or whatever they are called are authoritized to prepare a conceptual plan that has been prepared and I have received it, some of it is very useful but other parts of it will not be so useful but there are no plans as such. This past year we did spend $400,000. to $500,000.,in round figures,improving and extending the outpatient and emergency facilities at the General Hospital.

I think they are now very adequate and they are the basic emergency facilities for this ~ity, for Eastern Newfoundland, and the General is the basic Hospital facility for this Province. I am told that it is a first rate emergency service that they are offering. MR. CROSBIE: The Minister did not mention Carbonear. MR. ROBERTS: No, that is because I forgot to mention it. There is a need for new hospital services on the North side or in Conception Bay. There are plans in existance for the community hospital at Carbonear.

Carbonear has a first rate medical group,like so many of the first-rate medical groups in this Province. Mr. Chairman, it is run by a cousin of mine. The Chief of the Medical Staff at the Western Memorial, as my friend from St. Barbe South would 6262

.June 5th, 1970 MR. ROBERTS: Tape 1138 JM- 6 confirm is , also a cousin of mine as is the chief of staff of the Grace General Hospital who medically is very competent, politically, Sir, does have his weak moments. MR. CROSBIE: He has his aberrations, has he? MR.·ROBF.RTS: He does have his political aberrations, Mr. Chairman, I would concur. However, the basic point and this brings me back to where the hon. gentleman - Oh, before I do that let me mention that we have significantlly improved cottage hospitals within the past three or four years.

We have done a great deal of work at Burin, Grand Bank, Norris Point up in Bonne Bay, the Bonavista Cottage Hospital, we have a project well underway at Channel .• at Springdale we have completed an addition and this year if the Committee approves we hope to do some work at Harbour Breton and to finish some work at Burgeo. The Cottage Hospitals, I think, Mr. Chairman, are probably in the best shape they have ever been in. The final point brings me back tq where the hon. gentleman started and that is my White Paper that I had hoped to be able to table to open the estimates.

I did not because I could not, a combination of a much longer House session than any of us anticipated, the somewhat special circumstances which have acquired my attention is a member of the Government who is Minister of Health and I should add the absence of my 6hief Medical Adviser, Dr. Miller, a man who really has been with the Depart­ ment of Health for thirty-five years. Dr.

Miller has not been able to sit with me in policy formulations and I am not prepared to go to my colleap,ues in Cabinet until I have had the benefit of his advice as well as that of my other officiais. ~1e still intend to produce the White Paper but it will probably be late summer or of that orde~, Mr. Chairman. At that time an essential part of it will be the capital construction programs, these are basic to the develop­ ment of Health facilities in the ·Province and they are probably the largest single questions unresolved. What I have attempted to do is just outline the problems as we see them.

The costs are within our means, the Government of Canada will put up a minimum of about twenty odd millions, I gave the information in reply to a ~uestion but I forget the details, in addition there is a lar~e 62G3

June 5th, 1970 MR. ROBERTS : chunk of - Tape 1138 HR. CROSBIE: That is for the medical school. JH - 7 HR. ROBERTS: It is for teaching and research facilities. New the General Hospital can qualify and possibly the Mental Hospital. It may interest the Committee to know that I have arranged to have the Deputy Minister of Health from Ottawa, Dr. LeClair, come to St. John's. I do not have a firm date but I think he is due next week and he and I will be talking in nitty, gritty details about health resources fund monies for Newfoundland. I think that answers the hon. gentleman's questions but if not I can go on. HR.

COLLINS: Hr. Chairman, - .- the Minister traversed Newfoundland - he ;left out , a substantial

section , in my opinion. I would like the Minister to tell the Committee what the government's yields are, what their plans are in terms of the cottage hospital at Botwood. Hon. members will remember, last year, in the Throne Speech, where the government proposed to close the hospital at Botwood and the cottage hospital at Markland. HR ROBERTS: In the Budget Speech. HR COLLINS: That is right, Mr. Chairman, in the Budget Speech, last year. Subsequently the Government decided against that after considerable pressures being applied from local authorities especially in the Botwood area.

I have been amazed, I was amazed then and still amazed at this_ Government even contemplating closing such a valuable institution as the Cottage Hospital at Botwood especially in view of the fact that Dr. Twomey and the other doctors stationed at that hospital have a record of providing a very, very good service to the people of that area stretching all the way from Fortune Harbour, Leading Tickles back toward Botwood.

Indeed, Sir, the reputation of that doctor and that hospital has been such that we find that many people from other hospital areas such as Grand Falls and Lewisporte and indeed people from the West Coast have gone to Botwood Hospital for surgery at various times. Now last year the Government reversed its decision to close the hospital and during this past summer there was a rumor spread around a~ain that the Government was thinking of closing the hospital this year. They do not know where the rumor came from but it was p.enerally believe that possibly the

June 5th, 1970 Tape 1138 JH - 8 HR. COLLINS: rumor was planted by officials in the Department of Health just to test the reaction of the people. HR. ROBERTS: It was not. MR. COLLINS: l~ell, Hr. Chairman, this was the thinking around Central Newfound- land at the time that the rumor was planted to test the reaction of the people again and, of course, we were more than pleased to hear the Minister's release during the summer months that the Government had no intention of closing that particular hospital.

I would like for the Minister to once again give the Committee the assurance that this hospital will not be closed and I would also like for him to indicate what plans the Government might have for improving that particular facility? I notice also, Mr. Chairman, that there is no reference made to the Cottage Hospital at Fogo and at Brookfield. Both of these hospitals come under the administrative arm and direction of the James Paton Memorial Hospital at Gander.

I would like for the Minister also ~o indicate what Government plans are for these two and also he might indicate to the Committee how successful the Department has been in obtaining the services of a nurse for the t0VD of LaScie and how successful he has been in coming up with nursing facilities for some of the schools particularily the school in the Gander Bay area and the school in the Lethbridge G2G5

June 5th. 1970 Tape 1139 PK - 1 MR. COLLINS : Lethbridge, Bloomfield area. Petitions concerning the need, and both of those areas were presented to this hon. House about a month a~o, perhaps the minister might indicate what suc~ess he has in providing this very necessary service to those particular areas. While I am on my feet, Mr. Chairman, perhaps the minister might also tell the committee, if there is any difference in fees paid to dentists in St. John's as opposed to fees paid to dentists working outside of St. John's? MR. ROBERTS: Mr.

Chairman, on the .question of nurses, I wonder if we could let that stand until we come to the vote for nurses, which is a little further down in the estimates. My failure to mention Central Newfoundland area, of which I have just been chided by .the voice of Central Newfoundland sittin~ on my immediate right, MR. COLLINS: That is just a murmur over there. MR. ROl·JE, F.t.J. Inaudible. MR. ROBERTS: Mr.

Chairman, "People who live in glass huts, should not throw stones.'' I can add nothing to what I said about the Botwood Hospital in behalf of the Government within the passed month or so, it was a month or two, it is not that long ago, except to reject categorically any suggestion that offjdals of my department or of any department of the Government were spreadin~ rumors as trial"ballons. I am aware of the rumors that wereln existence, but I can tell you, Mr.

Chairman, as far as I know, and I am quite certain .! am informed on this point, any fear that these rumors are being spread by my officials is just completely baseless and is completely unfounded. And I would reject it cateJ!orically. The question of the future of the Botwood Cotta~e Hospital, Mr.

Chairman, falls to be considered with the question of the future of all hospital facilities in this Province, and I am not ~oin~ at this stage to go into it, this is a sort of matter we hope to deal with in the t.'hite Paper, and the White Paper will be an outline of ·our thinking and our sug~ested policies, and in that stage we will invite comments, and reactions and criticisms and improvements and so forth. I would not want the member to ret the impression I am talking specifically o~ Botwood, I am not. The cottage hospitals were built, Sir, thirty years a~o 62CG

June 5th. 1970 Tape 1139 PK - 2 MR. ROBERTS: and they vere a brilliant innovation at the time. But a great deal has happened in thirty years the vhole pattern of medicine has changed completely, the whole pattern of health has changed completely. And one of the things ve must do is to see if our facilities should be changed. I can say, however, for the benefit of the member who has a legitimate concern, Botwood is in his constituency, that there will always be doctors and clinics in Botwood, and I would think there vill always be some facilities. The question of how much work? What level of work?

What type of work is to be done there, that is another question, Mr. Chairman, and a much broader one. The matter of the Fogo Cottage Hospital, let me say that we have 1 succeed in recruiting two nurses on an interim basis, we had a very bad situation there last week. The reason why the two young ladies are on an interim basis is that each of them is married and each of them is about to become within a period of months an item in the birtmpart of the vital statistics division. AN . . HON. MEMBER: Inaudible. MR. ROBERTS: They should not be doing what? As a bachelor I do not know.doctor. AN RON. MEMBER: Inaudible.

MR. ROBERTS: They will be able to serve the hospital for a period of months, mean while we have recruited two young ladies in India, vho are qualified nurses, with the specific purpose of coming to Fogo. We are negotiating .with the Canada Immigration and Manpower people to see if we can expedite them. It turns out getting through the Canada Immigration, we Newfoundland~rs, Mr. Chairman, came into Canada very easily, a lot of people cannot come throup,h that quickly. The hon. gentleman mentionmLa Scie, that is under the Baie Verte Hospital, under the Boylen Hospital at Baie Verte.

My colleague the member for White Bay South is needling me daily on the question, we a~ the Government are not trying to recruit a nurse. ~~at I would like to see if we could do is to see if we can improve medical services in a number of areas by tryin~ to find doctors. 62G7

June 5th. 1970 Tape 1139 PK - 3 MR. ROBERTS: With reference to the fees for the dentists there was an anomaly in years passed, several months ago I met with the Dental Association and I agreed to eliminate the anomaly, only fees in question of course, Mr. Chairman, are for extractions by dentists in behalf of indigent patients, who are eligible for as8istaace under the Social Assistance Programs, for some reason it costs less to have a tooth pulled in an outharbour than it did in St. John's, in the past.

That is no longer true, no matter where the tooth is pulled now, Mr; Chairman, the people of Newfoundland will pay the same to the person who pulls it. MR. MURPHY: Did we lower the price in St. John's or raise them'- NR. ROBERTS: No, I fear, Mr. Chairman, that it is the other way around, it was always thus, we have increased the price elsewhere. Perhaps, if ever the hon. gentleman - MR. COLLINS: Was this an oversight or was it the opinion that the tooth was not worth so much. MR. ROBERTS: I do not think that is correct, Mr.

Chairman, but I do not why it happened, it is like a lot of thinrs, it has __ gone .on for twenty years, perhaps before that. Why is it that the Government have provided ambulance facilities to the General Hospital in St. John's, but up until two or three days ago did not provide them in Corner Brook? I cannot answer it, Mr. Chairman, I can say it was that way, will not be that way, why it was, I cannot say. MR. COLLINS: MR. ROBERTS: Who provides ambulance service in Grand Falls and Corner Brook?

In Corner Brook now it is the Government, and in Grand Falls, I suggest it will be the Government in Gander, it is the Government. ''People who live in glass huts, should not throw stones, Mr. Chairman." MR. G. MYRDEN: Mr. Chairman, while we are still on this vote, may I have somethin, to say about the medical facilities on the St. Barbe Coast. As the minister is well aware, it is very atrocious actually, not because they have not tried to help, but because of the shortare, I guess, both of nurses and doctors. 62C~

June 5th. 1970 Tape 1139 PK - 4 MR. MYRDEN: Many years ago, as the minister will remember, there was and used in to be a buildin~ at Port Saunders, which I think, a doctor and a few nurses carried on a small cotta~e hospital. MR. ROBF.RTS: No, no, a nursing station, not a cottage hospital. MR. MYRDEN: But there was a doctor there. MR. ROBERTS: There was. MR. MYRDEN: There is between Norris Point and St.

Anthony a distance of approximately 265 miles, and in thi~ area at the present time there are only, I think, two nurses at Port Saunders, which is a hundred miles from Norris Point, I think, thereareanother two nurses at the Cottage Hospital in Flower's Cove. AN HON. MEMBER.: Three. MR. MYRDF.N: Two or three sometimes, and along that whole stretch of coast, which my bon. friend from St. Barbe North agrees, is quite desperate, he himself needed medical attention one night, and I guess -he will remember that for a long, lon~ while, he was stranded in a storm there.

He ended up in the General Hospital here for a month, but what happened to him that ni~ht? Well, he doesnot mind telling the story, actually what happened he was attending a very special meeting in Flower's Cove, and he came out of the Flower's Cove school and he went flying in the air, that is the last I remember seeing him for a few minutes, and he landed down at the bottom of the steps - MR. ROBERTS: Did he intent to fly or - MR. MYRDEN: ~Tell, I do not know whether he intented to fly, but he went flying, and he landed up at the bottom of the steps there in a very bad shape.

That ni~ht we,both him and !,both stayed in a shack we call it down there Castle River which is anoth~r forty or fifty miles away, and he was in ~reat pain. The next morning we started out, and we started to come up this wsy, we got about ten miles from the cabin, we were stranded right in the middle of a snow drift, but for the good graces of the Highways Department who came along a couple of hours later and took us out, we would be there yet. 6269

June 5th. 1970 Tape 1139 PK - 5 MR. MYRDEN: Anyway, the gentleman in question ended up in the General Hospital, it was quite a long while before we saw him a~ain. But getting back to the medical facilities, Mr. Chairman, I would like the minister to indicate if he can, I know we can get it later on, but there has been a great shorta~e of nurses, both in Trout River, Woody Point which ts on the opposite side of bay, at Bonne Bay. There has been a shortage of nurses right along the coast, at Cow Head which I think they have a nursing clinic and at Daniel's Harbour.

And since now the Hawkes Bay area has become industrailized, many of the people down there including the groups from NARDA have requested and have asked, if some facilities could be put in there throu~h Government assistance or the present operating company, and to bring in a doctor to help the whole area there. Actually,they will be running into Quite a few industrial accidents, because it will be a highly mechanized sawmill industry, and I am afraid they are going to need medical facilities there. If the minister would indicate, Mr.

Chairman, a few of these things, I think, it ~~11 clear up the matter of nurses and doctors along the St. Barbe Coast. 'MR. ROBERTS: Mr. Chairman, the problems of the St. Barbe Coast are extremely well known to me, althou~h the hon. gentleman did not mention it, my own district, of course, is in the same position and the same geo~raphic area.

The basic problem is that we have very lar~e distances and we have relevently speaking very few people, the 300 miles from Deer Lake down to Cape Bauld only has a population of about 35,000 on both sides of the peninsula, about a third of them are on my side in one district, and two~thirds are on the west side, the Straits, the Gulf, which are~ef course two electorial districts. We have at St.

Anthony one of the best hospital facilities in this Province, perhaps a model hospital, a sort of regional hospital, we should try and develop, Sir~ We have at Nor.ris Point a cottage hospital staffed by two doctors, a number of nurses and so forth, which does excellent work, which is only a cottage hospital. We have at Corner Brook the nucleus of a regional hospital, but we do not have the full facilities yet. 6270

June 5th. 1970 Tape 1139 PK - 6 MR. ROBERTS: The problem is one to which I have been ~iving a great deal of attention and I am coming to the conclusion the best way in which we can proceed is to have doctors stationed at a number of points. And I am thinking of the Port Saunders area, the Roddickton, Englee, Main Brook, Conche area. And my colleague from St. Barbe North feels,with some considerable merit, I believe, that we should have a doctor in the Flower's Cove area, which is about · seventy miles from St. Anthony. Mr.

Chairman, each of those areas now has an nursin~ station, which is rather an unique kind of nursing station, They are I.G.A. stations, and they are staffed by midwife nurses, these are the International Grenfell Association, and these nurses are Enlish, Scottish girls. The I.G.A. seems to be able to recruit them, and we never succeed. I am sure my bon. friend has had many pleasant evenings, as of all of us in the area. MR. ~fiJRPHY: The nurses. MR. ROBERTS: The nurses, I think, have pleasant evenings too, Mr. Chairman, perhaps the hon. the member for St. John's Centre;just to disabuse him of that. MR.

MURPHY: I am very doubtful about my unmarried hon. friend - MR. ROBERTS: Well, the bon. gentleman, his profession and theirs, these nurses give amazingly good service, but it is a limited service, they are not doctors. they can diagnose an illness in certain ways. They can p.ive medical treatment in certain ways, and also maternity cases can be handled at the nursing stations. The whole pattern of practice is changing, Mr. Chairman. The I.G.A. are building a superb medical service in the north. More and more maternity cases are bein~ referred to St.

Anthony, more and more cases are goinp, into the hospttal• So, I think, the lines along which we should proceed are the station medical officers with small clinics, no beds, and provide ground ambulance services. We naw have air ambulance services, but to provide ~round ambulance services. ~fR. ~RDF.:N: 1-.'hen the road is p!!ved. 1-ffi. ROBERTS: I.,Tell, that i~ one of the reasons why I am so keen about the White Paper and the belief we have that the road from Deer Lake to St. Anthony 6271

June 5th. 1970 Tape 1139 MR. ROBERTS: will be paved, if for no other reason than to provide good medical services. PK - 7 I do not want to ~o into too much more detail, it ia a matter I am deep in the midst of with my own officials. I can assure the hon. gentleman my constituents are at least as demanding as his, and at least as deserving no more so, no less. A word about the doctor at Port Saunders, about ten years ago Port Saunders was a Government medical station, there was a doctor there. Through a series of unfortunate events the doctor was driven out, quite literally.

It is history, and I do not want to go into it. The doctor is still in the Province, he has done amazin~ly good work. MR. CROSBIE: Yes, he is doing a good job, as I understand it. MR. ROBERTS: He is now in Marystown, he served for the passed two years at Bay L'Argent. A very superior doctor and providing very valuable service for us. After that history occurred, we turned the station over to the l.G.A. and they have provided, I think, two nurses ever since, together with a number of aids and what have you. I think, the station probably has six or seven beds.

But that is basically the history, so we have between Norris - MR. 'MYRDEN: As the hon. minister knows it is becoming industrialized, it is a type of industry that is going to create a lot of accidents , as you know. }~. ROBERTS: Even without that, Mr. Chairman, the whole pattern of medicine is changing, the supply of doctors is easing, it is not to say that I have extremely grave problems in finding doctors at present, but over a period we can see it easing, and I think the time is come that we can.now look to stationin~ doctors much more analogous to our distric medical practice than we now have them ·.

I think that answers the hon. gentleman's question, but if not - MR. MYRDF.N: I asked about the nurses of Trout River and Woody Point - ~. ROHF.P.TS: Well, perhaps when we come to that suhh~ad. Now the member for Hon11vht11 South. 6 2 7 2

June 5th. 1970 Tape 1139 PK - 8 MR. R. BARBOUR: Mr. Chairman, I wonder would the minister tell the committee what are the chances of getting a doctor for this prosperous area, the Musgravetown area, where the people are certainly independent and making a very good living. I do know that the minister's department has been trying quite hard over the year, and I know there is a committee working with the minister. I am just wonderin~, Mr.

Chairman, if the ~inister can tell the committee, if the hopes are favourable, that we may have a doctor in the Musgravetown area to serve an~mere from one to fourteen communities within, let us say, the next three ~onths. MR. ROBERTS: Mr. Chairman, I wish I could answer that specifically for the bon. gentleman, I regret that I cannot. We have had,shall we say, an unexpected shortage arise which has cost us the services of five doctors. And that is a matter I do not want to go into now, there might be an appropriate time later.

But shall we say that five doctors, that we understood would be available for services outside the St. John's, Grand Falls, Corner Brook, the larger centres. MR. CROSBIE: They have brokentheir agreement. MR. ROBERTS: That is a legal conclusion, but I think we are going to test it in court. And there are other steps, shall we say they have not honoured their agreements at this stage. But whether or not they have broken them, is a legal question.

We _have been working with the committee in Musgravetown, there is a very great need for a doctor there, all we can say is that we are going to keep on until we do succeed in finding one. It is a funny business, Mr. Chairman, we bave just succeed in recruiting a doctor for Trepassey, an area that was a hundred miles from St. John's, an area that was badly undoctored. This I think was about the thirty-third time attempt to recruit a doctor for Trepassey. And I gather we still have the doctor. Dr.

Collingwood, who is the man who does this work for us, he had been close on a number of~ccasions, and each time the deal fell through. But, we now have a doctor for Trepassey, perhaps tomorrow we will have one for Musgravetown, it depends we will keep 6273

June 5th. 1970 Tape 1139 PK - 9 MR. ROBERTS: advertising, we will keep looking, we can just hope. MR. MURPHY: Mr. Chairman, is that the first time that there has been a doctor in Trepassey for a great number of years? There used to be one at Ferryland. MR. ROBERTS: It is certainly the first for a number of years, there is now a doctor in Ferryland. :and one in Trepassey. I think, the Sbuthern Shore is probably better served medically than it has been for fifty years. MR. CROSBIE: Mr. Chairman, I would like to come back now to something now on a broader scale, broader canvas for a moment.

I got the implication of the minister's remarks earlier that he agreed that it was not essential to construct the University Hospital within the next four or five years, that the existing hospitals around St. John's can fill in for that purpose, but he never said it specifically. The minister said, that the General Hospital is being used, and there is an agreement with the Grace and so on, and the Mental.

I would like the minister to be specific, if he will or can, on that position because if the University Hospital, if the University takes the adamant position as it has in the past" that the University Hospital must be constructed in conjunction with the Medical School,then I consider the whole project to be most impractical, unless the Government of Canada is going to increase its aid under the Health Resources Fund from the present, approximately $20 million or $21 million, I think, it would have to increase itself, so that it pays at least ninety percent of it.

The whole thin~ would cost $40 million or $50 million. But, if the Government takes a position, which it should, and the University agrees~which it should, and although 6274

June 5. 1970 Tape 11140 P~ge 1 JW HR. CROSBIE: desirable - it is not essential that the University Hospital go ahead in the next few years. that the other hospitals can be used and that makes the whole thing much more sensible, economically and financially. So I would like the minister to give us some more information on that. And also in connection with construction of hospitals.

I have been told the other day. and I do not know whether it is correct or not. but I think it is correct, that the contribution of the Government of Canada now toward hospital construction is ended. · That is the old formula of so much a bed. Now it was never anything really all that substantial- on.an eight or nine million dollar hospital. you might have gotten eight or nine hundred thousand from the Government of Canada, or a million. Can the minister tell us now whether those contributions from the Government of Canada toward the construction of hospitals is ended, which I think it has.

And the minister when he outlined some of the needs of the Island with respect to hospitals, said that there was need of a hospital in Conception Bay north area, which I agree with - there is need of one hospital in that area - but does the minister agree that there is a need for two there? About twenty or thirty miles apart from one another. The minister might answer that.

And finally, we do not want to get too scattered - I have always felt, and certainly since I became minister· of Health, and had to think about it, that one of our great weaknesses here in Newfoundland in the field of hospitals, is that we have no custodial care institution. All our hospital beds Mr. Chairman, are acute treatment beds, and they are very expensive beds to operate as the minister knows.

And if you can increase your tum-around, or whatever the expression is in a hospital bed - if your average length of stay of a patient in a bed is ten days, you need twice as many hospital beds as if you can turn them around in five days. It is very important to have a rapid turnover in hospital-beds are so expensive. Now one of the problems the Government has is that we have nowhere,for example, to take patients from the General Hospital - a patient comes up from St. Mary's Bay - he goes in the General Hospital and has an operation. Now he mttht be 6275

J\ine 5, 1970 tape #1140 Page 2 able to leave that General Hospital in five days, if he or she had somewhere to go where they could be looked after just on a custodial basis. Kind of a convalescent home. He cannot go back to St. Mary's Bay because they are not in fit condition to go down over the road. there is nobody down there probably to look after them when they get there. So they are occupying an expensive bed at the General costing perhaps a couple of hundred of dollars a ~y, when they could be out in a custodial care home, which might cost thirty or forty dollars a day, tecuperating.

And does the minsiter agree that one of the great - one of the most important priorities would be, and certainly very, very much cheaper than building acute hospital bed - the provision of some custodial care institution in the St. John's area, and probably also in the West Coast area. Certainly on the West Coast area also. If the minister could just touch on those points. MR. ROBERTS: Mr. Chairman, may I congratulate the hon. gentleman on the close attention which he has obviously been paying to speeches that I have made, because of course MR. CROSBIE: The minister is going on my old ones probably - .JW MR.

ROBERTS: No Mr. Chairman - 1 am going by the problems the hon. gentleman bequeathed to me, some of which in turn were bequeathed to him. But I congratulate him on reading my speeches with care. Of course I agree with one of the great needs of this Province is for non-acute beds. My colleague the Ron. Minsiter of Public Welfare and I are deep with discussions that we hope will lead to some solutions. We need convalscent beds - we need nursing care beds. We need beds to look after people who are mentally defective, or who are senile. It is ~ot fair to say we do not have any facilities.

It is correct to say we have extremely limited facilities - about thirty beds at the General Hospital are now being used for these purposes - that I think. is a misuse of those beds, but we must do it under present conditions. We have I believe, thirty beds in a ward at the Sanatorium being used for those 6276

J~e 5, 1970 Tape #1140 Page 3 purposes, and in addition of course we have a whole wing, the old San on Topsail Road is being used and I believe about two hundred people - about two hundred and fifteen senile people in that Institution at the present. There are fifty-five at the Hoyles Home; and in addition, a certain proportion of the people who are patients at the Hospital for Mental and Nervous Diseases, are of course, really are not susceptible to:.psychiatric treatment, but are receiving what amounts to custodial care. They are incurable. So Mr.

Chairman, that is one of the areas we have to go into - again that is one of - the bon-gentleman is taking the topic headings for the go White Paper. Perhaps I should mail him a copy of it, and we could.through it in order. But of course that has to be a solution. Now the North Shore go Conception .Bay- I am not going to~ beyond what I said. There is a need for a new facility, and the facility would serve the area that runs, shall we say, all of the Southside of Trinity Bay, and all of the Northside of Conception from Marysvale or Brigus on up. I am not saying that will be the only hospital in the area.

I am saying it will be the basic facility. We have now hospitals at Markland and Old Perlican. As regards to the University - again I am not going to jo much further. I am in the midst, rather involved in delicate negotiations which have been carried on intermittently for months - intermittently in between sessions of the Bouse - a crisis of one sort or another. And to say anything at this stage Mr. Chairman, might jeopardize it. Shall we say that I think it is agreed on.two points are agreed by all concerned. First that to have a medical school at some point we must have a University hospital.

And the second point which is agreed is that a University hospital does not have to be built immediately. Nbw in between that obviously, Mr. Chairman, there is a considerable area for negotiation - it is the area in which I now find myself, but I do not want to go into it. I welcome the bon. gentleman's support for our feeling that the Government of Canada should pick up all of the cost,·capital cost of the University hospital. It is one that we have advanced in other places than this. We are looking in particular to $175 million 6277

June 5, 1970 Tape 11140 Page 4 JW chunk of the Health resources fund, which has been set aside for special projects of national importance. We have been lobbying for some time that we have a special project of national importance and the twenty-five or thirty llli"ilion dollars that a University hospital would cost, that would qualify under that,in our eyes. I may add,Sir, we are not receiving immense support from other Provinces. They think it should be divided on a per capita basis, would which give Newfoundland a matter of several million dollars only.

The other question the bon. gentleman ask~d had to do with the old grant of $2,000 a bed - that program has ended. The Government of Canada unilaterally ended it. They might say we were consulted Mr. Chairman - we were advised. I was not Minister of Health at the time. It might have been during the bon. gentleman's tenure, if not, the absent member,for Burin, might have been the minister who had that particular piece of news. We have drawn the last payment - it is about $900,000 - the cheque came several weeks ago, and has been deposited.

I was a little amused - at one date I had one of my officials come in and pass me a cheque for $900,000 which had come in the ordinary unregistered mail. It seemed a little unusual to me, and I said,"Why would it come unregistered. What happened if it got lost?" The official concerned was a very intelligent young man. He looked at me ana said, "have you ever tried to cash a cheque for $900,000?" Apparently there is no danger.

We have drawn the last payment, Now Ottawa are not out of the capital field, except if they come in under the Health Resources Fund, and I beliwve the Hospital Insurance, under certain limited conditions,will include amortization payments. Very limited. MR. CROSBIE: I realize,Mr. Chairman, that the minister is skating on thin ice on some of these negotiations, so I would n:ot press him any further. I appreciate the subtle task that he has in dealing with all these complex aatters.

And of course we all appreciate his great skill and endurance in his negotiations several weeks ago for which we congratulated him,in negotiating on two aides, in front and in back - twisting -we are all a great admirer of his in certain respects. Now just one laat general question Mr. Chairman, from the minister - what is 'happening with the Provincial Health Council 6278

June 5, 1970 Tape #1140 Page 5 JW when did they last meet? Bas it made any recommendations to the Minister, and can the minister tell us whether he thinks it is being useful at all or not? And also the St. John's Advisory - the Hospital Advisory Council - how often is that being meeting - have they made recommendations to the minister? Does he think that this is a useful - helping the health services in the St. John's area.

And would the minister advise us whether it is the government policy to continue with~concept - when the General Hospital Corporation was established, the General was put under its own Board, which I think has been very successful. I said at the time that they should extend it to the hospital at Gander and the Mental Hospital as soon as time permitted. The hospital at Gander is a large one, and I think should be operated by a Board - would be better operated by a Board, better decentralization. And 1 believe the same is true of the Hospital for Mental and Nervous Diseases.

Would the minister tell us whether it is still contemplated that these large hospitals, like these,would be put under their own hospital corporations, as has happened with the General and others? MR. ROBERTS: The hon. gentleman ~ould just check copies of 37A and B and 38 in the White Paper Sir. Let me deal first with the question of Operations of Hospitals. I made a statement on behalf of the Government several weeks ago at the meeting of the Newfoundland Hospital Association, which set forth our views in detail. And I will be happy to send the bon. gentleman a copy of it. MR.

CROSBIE: I am not on the bon. gentleman's mailing list. MR. ROBERTS: Well I will remedy that directly Mr. Chairman, and the hon. gentleman will then be well-informed - MR. CROSBIE: John Monroe is much better. 1 get one from him every two days. MR. ROBERTS: I do not mind getting them at work Mr. Chairman, but I do resent them when they come addressed to the Hon. Philip Forsey, Minister of Health. I also keep getting mail addressed to Br. James McGrath, Assistant Deputy Minister of Public Health. The hon. gentleman from St. Mary's has 6279

June 5, 1970 Tape #1140 Page 6 not been assistant Deputy Minister of Public Health since 1955, I think. Some people 's mailing list is right up to thefinute. Well I will gladly send the bon. gentleman my speeches. He will have good information and good views. We as a Government,Sir, do not see our role primarily to be JW in the operation of hospitals. It is rather in the supervision of hospital services, their development, their planning, and their co-ordination. I am not going to say, because we are not in a position now to say just when we will be moving further.

I think we are assessing the results of the decision to hand over the ~eneral to a Board, to a Corporation. I think it has worked well. There have been some areas where there are questions. We are working towards a new Hospital Act, which will replace all of the present Hospital Acts with one, a standard, master, piece of legislation. Hospitals would then be incorporated by a virtual Order-in-Council, under the Companies Act. This will not be done in this session, Sir. With respect to the Health Councils, the St.

John's Hospital Advisory Council meet quite regularly, and indeed I have met with them, I think it was in February - I spent a marn~ng with them. Their role seems to be changing, indeed one of the questions I asked them, was to let me have their views on what their roles should be - and they subsequent~y sent me that information. And if I can ever get the chance to settle down,Mr. Chairman, to be Minister of Health, this is one of the areas I want to look at.

Similarly, with the Provincial Advisory Council, which has not met, to my knowledge, since I became minister - I met with their executive - their co-ordinating Committee, and I have had a number of very useful talks with Mr. Stephen French, who is chairman of the Council. There we are looking at revised terms of reference. I am most unhappy with the membership - not with individuals, but I am most unhappy with the way in which the membership is put together. I think that has to be changed. And finally, on the St.

John's area, I think more and more what we will see - the direction in which we are going to move, Mr. Chairman, will be towards a co-ordinating body I suppose from your Advisory body. The need in St. John's Sir, is 6280

June 5, 1970 Tape #1140 for co-ordination. We still have some duplications MR. CROSBIE: Enforced co-ordinations. Page 7 MR. ROBERTS: Well Mr. Chairman, we shall try to operat~ on the adage that honey catches more flies than vinegar. If the honey does not catch flies Sir, we shall have to try other methods to trap them. But certainly - anybody who looks at the health services tn St. John's, would agree that the first thing that has to be done is a much greater degree of co-ordination. We have empire building • We h~ve duplication. We have inefficiencies caused by those actions.

I think they are being cleared up - I think we are making a lot of progress. We have a long way to go yet, and I look to the St. John's Hospital Committee, whatever it is called, whatever its form, to be the body that does that. If they do not do it Sir, somebody else will have to. MR.

CROSBIE: Before we leave Salaries, I think we should ask - within the Speech from the Throne, or .somebody has said - I know the minister said also, that the present hospital legislation that prohibits strikes in hospitals passed in 1967, is going to be repealed and replaced by new collective bargaining legislation for hospital workers. Could the minister say if that is still to be done in this Session? Will it be part of the_whole Government collective bargaining legislation? What is his position now in repealing the 1967 legislation,replacing it? MR. ROBERTS: Mr.

Chairman, our policy was announced in the Budget Speech. The hospital workers will be dealt with either under the Labour Relations Act, as they now are, or under Public Service Collective Bargaining Legislation, and I am not the one to announce wftether or not or what we are going to be doing at this Session. Our policy is clear, and I can assure you we are working towards implementing it - the actual steps I am not in a position to announce at this time. MR. CROSBIE: Can the minister say that admittedly whether he can act under the Labour Relations Act, or under new legislation- but can the minister say 6281

June 5, 1970 Tape #1140 Page 8 JW whether the hospital employees or whatever the name of that Act is, 1967, is going to be repealed, because that certainly is the first step. MR. ROBERTS: Mr. Chairman, we have said it will be repealed, or we will ask the House to repeal it. I cannot say. I just do not know what the Government's legislative business will be. I suppose it depends upon whether we will ever get the Estimates done. If we are really going to be here until Christmas as 1 am beginning to believe, then I think we will get it I done this Session. But I cannot say Mr. Chairman.

I am hot the minister who is responsible for the co-ordination of the Government's legislative program. MR.. CROSBIE: In connection with that last remark Mr. Chairman. I for one, do not think that there is any unnecessary delay on these Estimates at all. On the Estimates is the time when you can legitimately ask for information from the Government as we have been doing this morning. As far as I am concerned, there has not been one second wasted here this morning. We are entitled to ask for information.

Now if the G overnment wants to make speeches to obscure the fact and not give information, or we want to make speeches, that is something entirely different. There is no filibustering going on here. The Estimates up in Ottawa take months to go through the Bouse, well wherever they go through, they take months. And in every other Province they go through the Estimates, and we are doing the same here. There is no time being wasted. If there is any time being wasted, it is speeches from the other side trying to confuse the issue, when information is asked for. But we do not accept that. MR.. ROBERTS: Mr.

Chairman, 1 did not say time was being wasted. The bon. gentleman seems to have a tender conscience. What 1 did say Mr. Chairman, was that 1 am beginning to have doubts as to whether the Session will adjourn before Christmas or not. I am not saying time is being wasted. I am juat saying, I am beginning to have doubts. MR. CIU>SBIE: Well, do not have any doubts. MR.. BURGESS: I agree with the bon. member from St. John's West, -that the bon. Minister of Health has impressed everybody in this Province in that Portfolio, but with reference to the anti-strike legislation in the hospitals r.?~~

June 5. 1970 Tape 11140 Page 9 JW which was passed in 1967. This legislation was passed amidst an extreme crisis where the workers in the hospitals had decided that they were going to go on strike and deprive the hospitals and the people in the hospitals, the patients, of the essential services that are so vital, particularly in times of sickness. Now I can remember quite vividly Mr.

Chairman, at that time that the absolute amount of concern that existed in the minds and the hearts af all of the caucus - in the Liberal caucus at that time, where they did not necessarily want to deprive these people of their bargaining rights by taking this right away from them. But they also had to think in terms of protecting the interests of the patients in the hospitals.

At that time also, it was stated that some other method of insuring at least that there would be, every six months, or once a year, that consideration of the wage standards of these workers wo6ld be taken into consideration, and they would have periodic increases in order to bring them up to a reasonable standard, which they are not getting now. I listened on radio this morning to the discussi6n on the merits, or on the pay scale of nurses and people generally in hospitals.

And I-heard one well-known commentator state that the nursing profession, or the hospital workers were about the worst treated people in Newfoundland. I say that he is right, but also they are the worst treated group of people in the world, essentially. I do not know what it is that attracts this low scale of pay or way they have to exist with it. It must be because of the fact of the Florence Nightingale attitude which they have adopted over the past hundred or two hundred years or so. But there is no question in anybody's mind that these people are underpaid to a great degree.

Now if there is going to be some repeal of this legislation, 1 feel that the faster it can come about - or else some other method that will insure fair treatment of theae people be instituted and implemented with as little delay as possible. MR. MURPHY: Mr. Chairman, there is just one word I would like to say. And I do not want to make a political football out of this hospital legislation, 6283

J.m.e s. 1970 Tape #1140 Page 10 JW or workers. But my mind goes back a few years. when this matte:r was brought in thi.a Rouse. And the:re was one small gr'OUp that thought this very cruel" legislation at the time. AN BON. MEMBER: What small groUp was that? HR.. MURPHY: That vas the small group of Conservatives that were sat here. And it rather grieves me now quite frankly to hear this used as p'olitieal propaganda by people 6284

... ~ · ..... June 5th. 1970 Tape 1141 PK - 1 MR. MURPHY: who were in favour of this thing two or three years ago voted for it. Now I do not want to make a political football out of it, but as I say, at this ti~e we were the ones that stood against it, and we would like to urge and are quite happy to see this statement that some revision will be made in this thing. And any further discussion on it, we will not take

part in it, but just pray that ho~pital workers will be given the same advantage, the same benefits that any other worker in this Province receives. And that is as far as 1 care to go with this. MF. S~·!ALUJ'OOD. Mr. Chairman, I would like to collaborate what the hon. ~entleman has said, I do not remember the eloquence with which he argued then against the anti-hospital strike legislation. He was really very ardent in his argument.

I remember looking across the floor at him and saying, the fact that they work in hospitals, does not effect his thinking, to which his answer was, I' II no • And then I punued the matter by askin~, ''Do you think that this rij:tht to strike is a right that ou~ht to be enjoyed by everyone?" And he said, "yes " , he said, it ought to be enjoyed by everyone.': And I ask, "if he thought, that policemen should have a right to strike?" He said, "yes, he thought they did, they ouRht to have that right.·· Then 1 asked him, "if he thought th~t in the Arrrry, the boys should have a right to form a union and go on strike?" And he said, "yes, he did not see why they sho\lld not have the right to ~o on strike." I said, " would the same thin"K apply to the· Navy." And he said, "yes, the Navy sho~ld have a right, men in the Navy should have a right to form a union, and ~o on strike." "What about the Air Force"?

The same thin~. But I gave up at that point. I still give up, the idea of forming unions in the nations' Armed Forces, form unions and do collective bargaining and go on strike, and setup picket lines. In the Army, Navy and Air Force and the Police Force strikes me as being just about the last word. I think whatever c~se there might be made for allowing a strike in a. hospital, I do not see any case for allowinr it in the forces a society creates to protect it.

I would assume that when any citizen joins the Army voluntarily or involuntarily fie forfeits all kinds of rights, MR • MURPHY : Not the rip,hts of a human being? 6285

June 5th. 1970 Tape 1141 PK - 2 MR. SMALLWOOD': Not the ri~hts of a human being, not the rights of a human being obviously. No, obviously not the rights of a human bein~, only some of the ri~hts of human beings, some of the rights of eitizenship a man gives up when he joins the Armed Forces of his nation.

I did not pursue the question at that time, and asked did the bon. gentleman think that in time of war those rights ought to exist for soldiers, airmen and navy men to form unions and go on strike, if he would insist on their having it in time of war, when a nation's back was to the wall, I did not ask him, and I am sorry I did not. Because at that time he might have , I do not know what answer he would give. MR. MURPHY: Well my answer would be that,as a patriot and in an emergency, he should not have any right to let down his rights, first of all, for defending his own country. MR.

SMALU700D: That is what the bon. gentleman says today, I wonder what he would said then? MR. MURPHY: I would have said the same thing. I still maintain that every human bein~ has the right, if he has ~ot to strike to maintain his rights, he has a perfeet right to do so, and it is injustice on the part of those who force these people to strike. MR. SMALLWOOD: Well, of course, all life,as the hon. gentleman will recognize, all life is a ease of posin~ rights against rifhts, weighting one right against another.

I remember going to New York many years ago to see a play by John Galsworthy, the author of the play that is now being shown Sunday ni~hts, The Forsyte Saga. I remember reading The Forsyte Saga and going to a famous play of John Galsworthy called "Loyal! ties'', the play posed one loyality ap,ainst an­ other. And there eome times when-a man must make a choice between hi6 loyality to his country, his loyality 1 as he sees it,to C.od, his loyality,as he sees it. to his deepest convictions in any matter.

And so you get conseientious objectors, even in war, who say "no, no, I will not go and fight.'_' You had the man who beeame Prime Minister of En~land, Ramsey MacDonald, who was a conscientious objector. MR. ROBERTS: He was put in jail for it. MR. SMAJ,LW)()O: No, MR. ROBERTS: Bertrum Russell went to jail. 6286

June 5th. 1970 Tape 1141 PK - 3 MR. S~ALLWOOD: Bertrum Russell went to jail, he was put in jail by his own cousin. Winston Churchill put Bertrum Russell,his cousin,in jail for bein~ a conscientious objector. There come times when men must be willing to die, not to save their country, but to save their souls. There come. times when a man stacks .up his deepest convictions against his loyality to his country and he decides that his loyality to his deepest convictions must be paramount. Similarly life is full of that, choices, men making choices, full of it, full of it, it is not as simple as it sounds.

Abraham Lincoln said one time;"the time that truth needs its staunches defense is in war."If you think a war is unjust, the defense of your point of view is most urgently needed while that very war, that unjust war,that you think is unjus~is being fought, That is the time to defend your.point of view, you see.

You do not just abandoned your point of view, because there is a war on, if your point of view is that the war is unjust, fhis is why it is that.today in the United States, millions of deeply patriotic Americans people, deeply patriotic, you cannot call into question the patriotism the love of land, the native land, adopted land of tens of millions of American people, you cannot call that into question, because they are against the Viet Nam War. They are out campaigning actively against it, and you have others so deeply and profoundly convinced that rather than serve they leave their country. SOME RON.

MF~F.R: MR. SMALLWOOD: Draft dodgers, that is not cowardice, that is bravery, that is real bravery. That is really fighting up stream against all the sentiment that surrounds them throughtout the entire nation. Some forfeited the love and • affection even of their own families, to stand up for what they believe in. So this thing is not as simpie as it sounds, and the right to go on strike, is a right.

But, that right has t~;osed a human being to liVe , if he is a patient in a hospital. of the human beinp, against the right of If an ambulance arrives at a hospital, and there is a picket line that prevents that ambulance from going in with that sick patient, and that ambulance has to turn around and go back, and stops by the picket line, the pickets are exercisin~ their ri~ht to picket the hospital. But what are they doing to the ri~hts of that patient in that ambulance? !t is some woman bein~ rushed into a maternity hospital, and 6287

JUNE.5th. 1970 Tape 1141 PK- 4 ~· SMALLWOOD: she is sent back, the ambulance is turned back. Now there you have two rights, the right of a baby to be well born, the right of a mother to be well cared for. These are two pretty important ri~hts. The ri~ht of pickets to prevent the hospital from operating, now which right ought to prevail? Life is not quite as simply, you know. to say that everybody should have the ri~ht to strike,regardless of what may happen,is wrong. It is just wron~, it is just wrong.

It is not true, Everybody ou~ht not to have the right to exercise his own rights, if in so doin~, he is dama~ing and hurting other people by preventing their getting medical attention. If you can have a strike against a hospital, why not a strike against every medical doctor?

Suppose a strike were called against all the medical doctors in this Province, and picket lines were thrown around the home of every medical doctor, and nobody was allowed to get til:.t:o see that doctor, he was not allowed to go and practice his medicine, it might be argued that it is the right of people to conduct that strike, and to throw up that picket line or those picket lines, but it is not also the right of the ordinary person to get medical attention; now whether it is in a hospital or otherwise? It is not quite so sim~le. Now on the other hand, that is a purely negative point of view.

That is purely ne~ative. The problem is still there of workers in a hospital, that problem,they are still there in that hospital. They still think they are not getting enough pay, or their conditions are not good enough, and they want to improve them. And the right of every man to improve his lot is a very important right, it is not the final right, but it is a pretty important ri~ht. And what do you '!!o? Do you say well, he shall not be allowed to exercise that right:. because,in so doing, he is going to hurt the ri~hts of other people to ~et help, to save _.life, to prevent death.

You know, that is why you say a strike against the sick and the dying, they have rights too. MR. MURPHY: The point is being stretched in this particular instance, the point was being stretched where these poor domestics and everything else were almost accused of being the death of dyin~ patients and everything else, and here they were the very low strata - 6288

June Sth. 1970 Tape 1141 PK - 5 MR. SMALLWOOD: That is just in passing, the point was just made in passin~ that that is how it was described at the time, a strike against a hospital is a strike against the sick and the dying. It is perhaps a too colourful a way to describe it, although in fact that is what it is. Now it is not a strike against the employers, the owners of the hospital, it is a strike against the patients.

You are not hurting the well directors of the hospital, the owners of it, the managers of it, you are not hurting them particularly, a strike against a hospital, is a strike against the. patients who are in and who want to get in, it is a strike really against them. Technically it is not, technically it is a strike against the Government, if the Government owns the hospital, or the hospital board, or against a church, against whoever happens to own the hospital or manage it, technically it is a strike against them. Actually, it is a str·ike against the sick and the dying. All right.

Now nevertheless the right to live is a pretty important right, so you have the two rights side by side. Now how do you handle it? You have to provide the employees with something, some means, some machinery, some formula, and this is what the Government have been struggling in their own minds and in our meetings in Cabinet, we have been struggling to try to find some formula that will be fair, and fair and not unfair. Not fair to the hospital workers and unfair to others. How do you allow one run of people to get fair play without doling out unfair play to someone else, you see? It is no~ easy is it? MR.

MURPHY: It is possible. MR. SMALLWOOD: It is possible. MR. MURPHY: Because you treat the hospital workers fairly,and with injustices to somebody else. MR. SMALLWOOD: It is possibie with good will, if you are acting in passion. ~. MURPHY: Good will, charity and morality, this is my opinion, it is very simple to say, but these people have a moral right to live as anybody else. ~. SMALLWOOD: Right. But, has anyone got sufficient right to a decent living, as to ~o so far as to kill somebody else? HR. ~IRPHY: Ah, that is stretching it - 6289

.June 5th. 1970 TApe 1141 PK - 6 MR. SMALLlvOOD: Look, look, now supposing in stretchin~ it, in Quebec when the strike took place against the hospitals in Quebec, they closed the hospitals, they ran up picket lines, and these picket lines stopped the ambulances from ~oing into the hospital. MR. MURPHY: I say I could not agree with stopping an ambulance. MR. SMALLWOOD: Well, they did. They stopped the ambulance and made them turn around and ~o back again. Now mind you, that was illegal picketing, lawful picketin~ would not have stopped, lawful picketing.

Peaceful picketing means that you have enou~h people there, and only enough, to notify everybody that there is a strike on. The purpose of picketing is not to use physical violence, not to use physical force, not to assembly in such numbers as to intimidate anyone with threat of physical force or violence, The whole purpose of picketing. which is quite lawful, it is all set out in the Criminal Code, the purpose of picketing is merely to notify everybody concerned, whoever may be or become concerned, to notify all such people that there is indeed a strike on.

Now when you have been notified, you can cross the picket line, you have a legal right to do that, either way in or out, you can cross the picket line, but you cannot cross the picket line,if they are there in unnecessary numbers, numbers unnecessary from the point of view of notifying everybody that there is a strike on, that is the only legal purpose of the picket line, to give notification. Therefore, you cannot assembly in such numbers that a man cannot go in or come out.

They should be a certain distance apart each picket on the line,should be a sufficient distance apart to allow peaceful egress and in~ress, or whatever it is, people passing in and out, including cars, including anyone to exercise your right as a citizen to go in or out of a hospital, or in or out of a factory, or in or out of a Government building, or in or out of anythinp,, whatever right you have, you should not lose, because there is a strike on. The right of the public to ~o in and out should be maintained, should it not? Well, a picket line must not stop that.

But what picket lines have de~enerated into in many cases, is a mob, a mob, 200 or 500 people, and even lar~er picket lines than that. They are not allowed to shout and roar and bawl. They are not allowed to shake their fists. 6290

.Jwe 5th. 1970 Tape 1141 PK - 7 MR. SMALLWOOD: They are not allowed to use violence or threaten i:o use it. A picke ·t line is legal only for one purpose to notify everybody concerned that there is in fact a strike on. Now when ycu know there is a strike on, and the union has that right to notify you by means of picket lines, When you know there is a strike on, you make your own choice, whether you will cross the line or not, it is legal to cros.s it. It might be iDBDoral, but it is lawful to cross it, and the picket line is there to let you know, that there is a strike on, you see. Ani! in Quebec what they did 6291

June 5th, 1970 Tape 1142 JM- 1 MR. SMALLWOOD: in fact was have unlawful picket lines which is always the risk, it is always the danger. When men are on strike, men or women,. for a better life, that is what most men go on strike for, for a better life, for a better means of a decent -life -for themselves, their wives, their children.

They are on strike, it is a tense moment, it is an emotional moment and it can become a hysterical moment and in that mood they are likely to go down in larre numbers in the picket - "Boy, we will beat the bastards, we will bash their brains out, we will do this , we will do that, we will do the other" and -in the hospital strike in the Province of Quebec they turned the ambulances back. Now to me if grave diggers went on strike, that is not very nice but it is not serious, others can go and dig the graves. AN HON. MEMBER: If they were permitted. MR. SMALLWOOD: If they are permitted.

Well, they should be permitted, they ought to be permitted. AN HON. MEMBER: (Inaudible). MR. SMALLWOOD: The army went in and dug the graves. Well, look I cannot think of anything on this earth except army, navy , air force and police where a strike ought not to be allowed except' in hospitals. But if you stop a strike in hospitals, which we did, this House did here and the hon. gentleman voted against it and argued eloquently against it, now we are going to ask the House to repeal it.

Okay, but in repealing it whether we like it or not we have to find some way to prevent strikes.E~en if you do not prohibit them you have to try to prevent them by having some administration, some system that will work, that will bP. practical, that will allow the employees in hospitals to improve their lt.es without going on strike, some kind of arbitration or some kind of collective bargaining system or other. This is wftat we are racking our brains about and I tell you, Mr.

Chairman, that some of the brightest minds we have in the Cabinet, some of the brightest minds have been wrestling with this because they too,like me, like anyone do not want to see a strike in a hospital. That is the one place you should not have a strike and that is in a hospital, that is the one place on this earth. MR. ~RPHY: If you follow any arguments we made in the debate we felt the same 6292

June 5t;h, 1970 Tape 1142 JM - 2 MR. MURPHY: way but to force you or me to jump over a wharf it is suicide, you know. MR. SMALLWOOD: But it is perhaps not quite enough just to prohibit the strike. You have to set up an alternative that will work and yet will prevent strikes from taking place. What we did was say, "There shall not be a strike", that was alL We passed that law, "There shall not be a strike" and if there is there will be these heavy penalties. What we need to do now is to set up an alternative system and this is what we are trying to do. I am sorry I took up so much time, Mr. Chairman. MR.

ROBERTS: Mr. Chairman, just before -hopefully I will get my salary out of it. If I may have one word? MR. MURPHY: Is the Bank Manager still after the hon. Minister? MR. ROBERTS: Yes, my Bank Manager has a very deep interest in me and in Hogan's Pond, Sir. The estimates this year for the Department of Health have been revised.:· We think we will provide a more accurate picture by programing what we do. Accordingly if any hon. member, Mr. Chairman, in the Committee wants to refer sub-head to sub-head he will find last years estimates most confusing.

I hoped to have copies but I was not able to, that little key which relates one to the othe~and let me add also that the revised figures, I have actuals in most cases, are accurate in that they bring the sub-heads together. But sub-head 10(002) now was called 10(006) last year and so forth and so on. So if any hon. member wants to refer perhaps he will get the key from me and I will let him into the secrets. MR. CHAIRMAN: Carried. Shall (01) carry? Carried. Shall (02)(01) carry? Carried. Shall (02) carry? Carried, Shall (03) carry? Carried. Shall 1002(0l)carry? Shall (02)(01) carry? Carried. Shall (02) carry?

Carried. Shall (03) carry? MR. MURPIIT: Computer services, is this the charge to the Department for the use of their computors or is this the -? MR. ROBERTS: No, Sir, that is the amount allocated to us by Supply and Services or Finance. It does not include the Medica Care or the MCP charges. They are several hundred thousand and they are shown 9eparately. MR. CHAIRMi\N: Shall the Item carry? Carried. Shall (09)(01) carry! Carried. -··---- -- Shall (02) carry1 Carried. Shall (06) carry? Carried. Shall 1003(01) carry? 6293

' June 5th, 1970 Tape 1142 JM- 3 MR. MURPHY: Transport Services, on this one, Mr. Minister, would you mind just giving us a run-down on what this would cover here? MR. ROBERTS: Mr. Chairman, this is the vote out of which we pay our senior manage~ent personnel. The top people in this, the chiefs of this division are Dr. Douglas Sheddan and Mr. Robin Burnell and each of them is among the most competent and capable public servants this Province has.

Generally speaking these people are responsible for all of our detailed day to day relations with the hospitals other than those operated by Governments, which means that these people are responsible for the expenditures above $40. million. There are also in the salaries three consultants: the housekeeping, nursing and hospital consultants. These are people who go around to the various hospitals and make suggestions for improvements. It is very knowledgeable and we hope to get more in the years to come. MR. MURPHY: I see there is a decrease in the number of staff and there is 25~000 due to late recruiting.

Would this 25,000, would that be some key personnel. MR. ROBERTS: We have not been able to recruit all of the people we wanted and we are authorized to hire twenty-six people but we doubt if we will get all of them in the year. Now I am not sure but does that deal with the question? MR. MURPHY: Yes, I was just wondering as there is a decrease in 1003,I am looking at, from twenty-nine down to twenty-six but then I was wondering as they say it was due to late recruiting, would it be key people or would it be just - ? MR. ROBERTS: No, I think these are probably lower grade officers.

There are about thirty people in the division and the chief ones, Robin Burnell and Dr. Sheddan, are recruited to be with us for years. MR. MURPHY: Yes, but you say two or three people but why do we not have them there? There are plenty people lookinp, for jobs, this I am wondering about if it is not a doctor or something and a vote is there and many hundreds of people looking for jobs why are they not filled? ~m. ROBERTS: Because they might not be the qualified special people we need. Generally speaking these are not all clerks these are consultants and what have you. 62!)4

June 5th, 1970 Tape 1142 JM - 4 MR. CROSBIE: Mr. Chairman, on page (114) of the salaries, Planning~two commission chairman $8,600. and a vice-chairman $3,600. Is this i. the Provincial Health Council, who are these? MR. ROBERTS: Now what is the sub-head again? MR. CROSBIE: It is page (114) under planning, just above hospital services. MR. ROBERTS: Yes, these are Mr. Stephen French and Mr. Red Ainsworth of V.A. Ainsworth. Mr. French is chairman of the Provincial Council and Mr. Ainsworth is chairman of the St. John's Council and each of them is paid an allowance. In addition Mr. William T.

Keeping is vice-chairman of the Provincial Council and he is paid an allowance and it is covered under the amounts that are shown here, it is covered under this vote. The director grade (3) is the secretary, a full-time public servant who, I forget the gentleman's name but he is secretary to the Provincial Council and also does other work for us. I should add that we hope to expand substantially the whole planning and research functions of the Department of Health.

Hopefully next year when we come back to the House this vote will be a great deal larger or the requested vote will be a great deal larger than it is now. MR. MURPHY : Have this group got a permanent office, Mr. Chairman, or do they just operate with the secretary, who is a full-time employee? MR. ROBERTS: Yes, we keep their records in the Department and they have met in our Board room but we also provide support facilities, mimeographing or if things need to be mailed, this is just done under our general administration. MR. MURPHY: Maybe periodically, say weekly or something like this. MR. ROBERTS: Not weekly.

The St. John's group tends to meet outside because they have access to board rooms and hospitals and so forth. The Provincial ~roup have met pere in the building on occasions when they have met. MR. CHAIRMAN: Shall (01) carry? Carried. Shall (02)(01) carry? Carried. Shall (02)(02) carry? Carried. Shall 1004(01) carry? MR. MURPHY: Mr. Chairman, on 04(01), I would like to ask this question of the Minister. Vital Statistic Returns. MR. RORERTS: The bon. gentleman is wondering what this is. MR. MURPHY: Yes. 6295

June 5th, 1970 Tape 1142 JM - 5 MR. ROBERTS: It is a completely antiquated system. We pay a clergyman ten cents for every name he records and that has gone on, I guess, since the year one. One of the things I hope to get at, it is not very high on the list, but I hope ~o get at it,is revamping the whole system of vital statistics and improving the registery. I guess when it was started perhaps the clergyman was the only person in many of our outharbour districts who would be a convenient point of contact but we have come a long way since then. MR. MURPHY: Yes, that is the point I had in mind, Mr. Chairman.

If I may, can we say that the vital statistics are truly accurate at this time with the system we are operating under? For example, sometimes you have the occasion when people write in to go to the Department to get a birth certificate and what not or so forth and you-·find perhaps he was born in 1896 or 1906 old age pensions and they discoYer perhaps the church had burned down or the registry or something like this. I was just wondering how accurate today is this system? MR. ROBERTS: I think since about 1940,for instance, the modern era, they are completely accurate.

That was when registration, I do not know the precise time, it was about that time, became mandatory, births, deaths and marriages. I do not know if we recorded but· births a~d deaths are the two vital ones. Before that I think it was often on a catch as catch can basis but now our vital statistic system is comparable to any Province. I think the only problems we run into are with older people, I gather the Federal Old Age Pension have a whole set of rules whereby you can prove how old you are.

For example, if you have a sister who is two years older than you and a sister who is two years younger they will take your age. MR. MURPHY: They put it on an affidavit, Sir. MR. ROBERTS: Yes, they have worked it out over the years. MR. MURPHY: Yes. I was just saying the problem actually where you come across so many instances where there is no record of - MR. ROBERTS: That is just the older people, I think. Certainly the last thirty or forty years have been quite good. MR. CHAIRMAN: Shall (04)(01) carry? Carried. $hall (02) carry? Carried. Shall 1011(04)(01) carry? 62!)6

June 5th, 1970 Tape 1142 JM - 6 MR. MURPHY: Is that Professional and Technical Education we are on, Mr. Chairman? MR. ROBERTS: Yes, yes. MR. MURPHY: I was just wondering, Mr. Chairman, if the Minister would inform the . Committee with reference to the class in pharmacy. I know there was a change there some two or three years ago for the apprenticeship aspect but I think it is washed out now where the pharmacists or druggists of today must have some, I do not know how many years but I think it is something like three years university. I maybe wrong on this, and I think originally we had a small class at Memorial.

But since that time, and I stand to be corrected on this, that this has gone out and there is quite some concern. As a matter of fact I think it was Mr. Curtis, I believe, of the Pharmaceutical Association here in St. John's held meetings, I believe, with the Minister,sometime during last year, on this particular aspect of pharmacy. Would the Minister kindly -? MR. ROBERTS: Mr. Chairman, the most recent meeting~ that was yesterday morning. MR. MURPHY: Oh, good. I am right on the ball. MR. ROBERTS: With Mr. Neil Curtis and Mr. Frank Janes and Mr. Thompson, I believe, of the Pharmacy Association.

We have a very serious problem. We have not had a pharmacist graduate or be called, not called to the bar, maybe called to the Mortar and Pestle, this is now the third year. The difficulty is that the association had negotiated with university to replace the apprenticeship articled system under which all or-most, I am sure almost all of the pharmacy system in this Province is qualified with a professional course leading to a degree in Bachelor of Pharmacy. I think they started a couple of years here and then intended to go to Dalhousie which has a faculty of pharmacy.

The University cut that out but whether they were right or wrong is beside the point,as they did cut it out. The University said that it was an austerity measure and one of the gentlemen in yesterday's meeting said to me, "The two thinp;s that were cut out were reduced maintenaace and the pharmacy school. ,. Ye.sterday we went through it again and it was one of the series of meetings. I think the Pharmacy Association will now be approaching the University · to ~et a firm committment from them,one way or the other, a yes or no. Of 6297

June 5th, 1970 Tape 1142 JM- 7 MR. ROBERTS: course. we have no role anymore, Mr. Chairman, because now we pay $2,000. a head at the University for everybody except medical students and we no longer would even consider a grant with strings on it.

Give the University $2,000., they decide• unless they want it developed, you know - If that does not work, we have also been ·.- proceeding, my specialists have been talking with the officials of the Department of Education, with a view to having a course set up at the College of Trades and Technology, a three year diploma course, which would not be as ideal as having a Bachelor of Pharmacy but it would certainly give Newfoundland people well qualified to operate retail drug stores and dispense prescriptions and what have you. So that is where it stands. It will certainly not solve it but we are still at it.

MR MURPHY; Thank you, Mr. Chairman. I was just wondering what qualifications would a professor or a teacher in this have to have to teach apprentices? Could a graduate pharmacist,as such, say the whole Pharmaceutical Association decided that they would take perhaps a night a week, would they be qualified and recognized to do this for apprentices? It does not require a medical doctor, I persume. I am just wondering just what type of instructor it would take? MR.

ROBERTS: I cannot answer that in detail, Sir, because it would be up to the University but I would think the basic requirements would probably be a bacheYor's degree in pharmacy and maybe some graduate work for some courses perhaps such as pharmacology, the relation of drugs to a person, to a human, and a doctor might be needed. In the past the system was, I think, two nights a week pharmacists-to-be went to school and, I believe, they were taught by, among others, pharmacists in practice in this Province. MR. MURPHY: Jack Harris used to do a fair amount of it. MR.

ROBERTS: Yes, I think he did most of the work but it was quite a good system and it worked. Maybe now we are coming to a stage where - it is only this past two or three years that the lawyers came to the magical fifty per-cent mark with law degrees- and of our four judges now, Sir, I think. only one has a degree in law, the other three articled and were then called to the Bar and practised from there. 6298

June 5th, 1970 Tape 1142 JM-8 MR CROSBIE: Mr. Chairman, this is the vote for Memorial University School of pretty Medicine,$1.25 million. The Minister can confirm, I am s~re~ it is right, there is no contribution from the Government of Canada for the operating cost of the Medical _School, so the whole $1,25 million has to be found by the tax payers of this Province or by the Government of the Province. Is there any suggestion at all from Ottawa or is there any hope for any possible agreement from the Government of Canada that it is going to share in the operating expenses of medical schools? Now the Minister.

I know, can say that some of the professors will receive fees through Medicare, which reduces their salaries and various things like that but there is not now, I am pretty sure, any agreement between Ottawa and the Provinces that they are going to share in the actual operating cost of medical schools. Is the Minister negotiating with a view to having Ottawa accept some responsibility? You see Ottawa gets the Provinces in trouble time after time, Mr. Chairman, by agreeing to make grants to the capital cost of facilities in Provinces.

With the medical schools and teaching facilities they are putting up this Health Resources fund where the Province has to find the major share of the money even for the capital cost and we are going to be left with the operating cost and pay the whole operating cost ourselves which in my view is not a burden that the less well off Provinces can carry.

The tax payers of the Province of Newfoundland should not be expected to meet the total operating cost of a medical school that is going to produce doctors half of whom at least, at least half of them will never practice in Newfoundland, half the doctors, the minimum,that go through the Memorial University School of Medicine will not stay to practice in Newfoundland, in fact we will be lucky if we get half of them to stay, tRere is about fifty a year that will graduate. ~ So the Medical School operates in the national interest an4 even international interest, there will be students there from outside of Canada, not just even from Canada, and why should the tax payers of this Province have to find,under the present arrangement.well over half the capital cost, unless no University Hospital goes ahead, and all the operating cost of the Medical School?

It does not make sense. If these are worthwhile projects in the national interest then the Government of Canada should at least share in their op~rating cost. ~low million this year there is $1.25~ thnt the tax pnyers of this Province can ill-afford to be 8pent to opernte the Medical School. t.aRt year -

June 5th., 1910 Tape no 1143 Page 1 Mr. Crosbie. The revised estimates show $850,000. There are other costs that are not shown under this heading, because you had to attract staff to the medical school - people who were advanced in heart surgery or whatever, this involves getting expensive equipment for the General or for somewhere else.

So, there are many other costs in connection with medical schooh, not shown by that vote, which the Province has to bear because we have a medical school, and we have to attract~ to the staff of that school, doctors who have to have expensive equipment, etc. and so on in their specialty.So, could the minister tell us whether any representations are being made to the Government of Canada in connection with the operating costs of this medical school? MR. ROBEirrS: Mr. Chairman, when next I go to Ottawa to see the bon. Mr. Monroe, I must bring the member for St. John's West with me as an assistant •• MR.

CROSBIE: I would be delighted. MR. ROBERTS: Assistant to the Leader of the Opposition or the leader of the other opposition, he could surely come as an assistant to me. There is a lot of merit in what the hon. gentleman says and so why get into an argument~th him. The cost of the medical school is one which is borne by , the people of this Province with the Ottawa Government contributing only on the education side of it - the vote which was carried in the Department of Education's head - Head VI. That is true, also, of any other ed~cational effort.

The ministers ~f health in various provinces have made representations, so far on a relatively informal level,to Ottawa to give us some money to help us with the cost of medical schools. Ottawa comes back and says that through a process known as "geographic appointments" they are helping. You can get an argument on that point. I do not think we should be carried away by the other outside costs. They really are relatively small, Mr. Chairman, and Newfoundland gets full value for '.them. The bon. gentleman mentioned 6300

June 5th., 1970 Tape DO 1143 Page 2 Mr. Roberts; cardiac treatments at the General. That is true, We have put some equipment in there. We put some in Corner Brook also. We put some in the General. That, to me. is an advantage and that is the type of reason that leads me to concl~de that the biggest benefit from the medical school is not the numbers of doctors that it will turn out - we could probably buy thancheaver elsewhere. The biggest improvement is what it does for the quality of medicine and health services in this Province, I think, Mr. Chairman. we are seeing that already.

I think we are seeing significant improvements in a number of hospitals. The hospitals, themselves, gladly. freely and willingly admit this, and they· are working very clo~ely. Just very recently. i.e., one of the major services in one of our major non-Government hospitals is the chief of that service or the deputy chairman of a division at the University's Medical School was made ciief of it. The hospitals are integrating. They are taking advantage. We have managed to attract some men to this medical school. We do not recruit them. We just pay the shots.

They really are outstanding in their field. s~ and I think this is a very great benefit. To come back to what the bon. gentleman said, the $1.2 millions which is up from $850,000 actual last year - that comes out of the pockets of taxpayers of this Province. It certainly is one of the things that we are after Ottawa about, one of the number of areas, is to share in the cost both of this and,when there is a University hospital.to pick up a larger share of the cost of the University hospital. So far Ottawa has been managing to resist our entreaties, Mr. Chairman, but we will just keep on.

I guess like the Chinese water torture,we will eventually win. MR. CHAIRMAN: Carried. Shall 02 carry? MR. ROBERTS: MR. CHAIRMAN: There is no 02. Mr. Chairman. Shall 03 carry'l 6301

Juno 5th. , 19 70 ,,,.po no 1141 hilt:> 1 MI. CROSBIE: 03, Mr. Chairman. These are the - this is the scheme where dental and medical students can be assisted by the Governm~nt in going through dental or medical schools. Now that assistance applies if they go to Memorial University School of Medicine, presumably. MR. ROBERTS: Yes it does, Mr. Chairman. On a slightly lesser amount, I think, we give $2,500 for outside the Province and $1,250 for Memorial. MR.

CROSBIE: Is the agreement still that the student who is assisted through medical or dental school must agree to practise in Newfoundland - in an area where the Department of Health wants them to practise for three years or something like that after he graduates. Is that still .. ? MR. ROBERTS: No, that is not quite it, Mr. Chairman. We require a year of service in the Province for each year in which the student is assisted. If he is assisted for four years, he owes Newfoundland four years service. One half that time - one half the time, Mr.

Chairman, is spent at the discretion of the Minister of Health which by and large is district medical practises. Sometimes we allow students under indenture to us to take residencies in their second year. We have ended the premedical program this year. We no l~nger are accepting any students for aid under premedical, In their premedical and predental years the student aid program is generally, in our view, adequate for that. It might interest the committee to know that we know have 114 students under indenture. I think seventeen plus two - nineteen graduated this year.

As far as I know fourteen of them will be going in practice around the Province, The other five are of a different opinbn. It is year for year with half the time being at the minister's discretion and that means cottage hospital or district medical practice as a rule. MR. CROSBIE: Was there ever a case tried up on tbeMainland. I remember there was one •• ? MR. ROBERTS: Yes the case which the bon. gentleman !nitiated as minister did not come to trial. .It went through the discovery process 6302

.June 5th., 1970 Tape no 1143 Page 4 · Mr. Roberts. and we have now settled out of court on the advice of our counsel. We have got fifty per cent of our claim - a little over $3,000 • It was an unusual case. It is the Attorney General of Newfoundland versus .J. Christ ,- a very unusual thing, when one comes across it in a document. sir. MR. WORNELL: Hr. Chairman, before we get out of this head, I wonder would the bon. Minister of Health tell the House how many dental students will be coming out fully qualified this year •• MR. ROBERTS: Next year. MR.

WORNELL: No, this year and where they may be stationed, because a dentist is badly needed in Bay d'Espoiro : - in Hermitage Distdct as a whole. MR. ROBERTS: Mr. Chairman, dentists are desperately needed everywhere in Newfoundland. We have, only, I think forty-nine dentists in the whole Province. I happen to have a figure here somewhere, if I can find it. I do not know where it is, We have only two graduating this year, sir, and we do not have the right to say where they go. because they do not work for us full time.

They owe us a certain number of years in the Province, and they work·under the Children's Dental Health Plan. We pay them, I think, $6,000 a year. A vote will subsequently be for that. But since the Government, at this stage, do not provide dental services to people. we do not hire them. So, they go where they want provided it is outside the St. John's,Corner Brook area. One of the gentlemen, Dr. O'Brien, I think is his name has chosen to go to Placentia. Ahother gentleman, Dr. Camp,who was badly injured in an automobile accident is now well on the road to recovery.

I believe he has elected to go to Port aux Basque1 This leaves Deer Lake, Bonavista, St. Barbe Coast, the Bay d'Espoir- Hermitage area, the Grand Bank area. We are desperately short. We only have in the Province now1 fifty-nine dentists, Sir. We have had otEdeath during the year. Dr. Ray Downton died, but Dr. O'Brien has come in. We have a net gain of "zero" 6303

June 5th. , 1970 Tape no 1143 Page 5 Mr. Roberta. this year. When Dr. Camp comes into practice in a few months, we will have sixty. We could use about 200 dentists in Newfoundland. It is one of the great weaknesses. We do not have enough and people will not use them. People in Newfoundland will only go to a dentist by and large to have a tooth pulled or to have a tootache fixed. They will not go. They will not send their children for regular care and that, of course, is the real pay-off in dental.. MR. MURPHY: Did you ever try. MR. ROBERTS: Well, Mr. Chairman, •• MR.

MURPHY: Did you ever try to get an appointment. MR. ROBERTS: Well, Mr. Chairman, I guess my own experiences are not comparable because I grew up in a medical family. and you know, we always •• HR. MURPHY: It is not next week or next month now, MR. ROBERTS: It may help the bon. gentleman to know ~that recently I had to see a specialist in Toronto - not a dentist - this was in April - booking up to the end of August. So, it is not unique to Newfoundland. MR. WORNELL: Mr. Chairman, before the bon. minister gets off that subject ~gain, I thank ~im for the answers.

Would he indicate to the House what the position might be for next year? MR. ROBERTS: I cannot answer that specifically sir. There are eleven students now in the - under our dental indenture program. I would guess have that we will, two, three or four of them next year. Not a great number because there is no immediate prospect of any real breakthrough. Dentistry, Mr. Chairman, does notseem to be as attractive to people inclined in the medical world as medicine. I do not know why. May be the money is less does or may be the work is different. It just not seem to be as attractive.

We have no limit, really, on the number of students that we can take in- to this program. If there is any young Newfoundlander who wants to go to dental school, we will gladly give him $2,500•.-to help him on his way through. MR. COLLINS: Mr. Chairman, there are at least three municipalities in Newfoundland and Labrador who have introduced fluorides in their drinking 6304

June 5th., 1970 Tape no 1143 Page 6 Mr. Collins. water system. 1 remember asking a question last year of the minister whether or not the Government did have a policy with regard to fluoridating. I am not sure of the answer at that time, but would the minister indicate .to the committee, if there has been a policy formulated by the department? What are the views of the department as to the merits or otherwise of fluoridation of water sup;lies? MR. ROBERTS: Mr. Chairman, there is no stated policy.

We are working on a policy which may, perhaps, induce municipalities to fluoridate their water and we might help them with the fluoridation equipment. Fluoridation is a funny thing. I gather •• MR. COLLINS: Fluoridation equipment- that is not ••• MR. ROBERTS: The utmost - we might be willing to help.

The fact that it is negligible, just makes it that m~ch easier to find the money, rluoridation is a funny thing, sir, the vast preponderance of medical; dental and scientificevidence is solidly in favour, as far as 1 can find out of the fluoridation, you know, fluoridating water. it is one in which people become,whether rightly or not,unreasonably emotionally. You get ordinarily sensible and logical people thinking fluoridatic; is rat poison or that it softens your brain. It is just literally incredible. MR. CROSBIE: There is no evidence in that in the member for Gander. MR. ROBERTS: No, none at all.

The hon. member from Gander has probably evidence the contrary. Gander has had fluoridation for a number of years and the member from Gander, I think, is truth positive it does not soften one's brain or does not turn one's hair. I am sorry. MR. COLLINS: Hair was grey before. MR. MURPHY: Ask to open his mouth and show his gums. MR. ROBERTS: Yes. But, Mr. Chairman, it is one of the most unique in the whole Public Health field. Nobody gets upset over the fact that we 6305

. . , ... ,~ .... June 5th., 1970 Mr. Robert•. Tapa no 1143 Paa• 7 immunize children against, you know, either the quad shots or the triple shots. , As a matter of fact, the problem is that we do not do enough. But on fluoridation everybody gets uptight and you get screams in the letters - the letters to the editor of the newspapers and so on and so forth. But I am told, and I have done a little research on it, there is absolutely no doubt,on the preponderance of evidence,that fluoridation is an awftiay good thing from dental health.

Despite that, you know, there will doubtless be six letters to the editor in the next week in the newspapers in St. John's saying that I am encouraging rat poison to be distributed . to our children. MR. MURPHY: Mr. Chairman, there is just one thought, and I know that th