1985 Legislative Session: 3rd Session, 33rd Parliament

HANSARD

The following electronic version is for informational purposes only.

The printed version remains the official version.

Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

TUESDAY, APRIL 30, 1985

Afternoon Sitting

[ Page

5875 ]

CONTENTS

Oral Questions

School district budgets. Mr. Rose –– 5875

School board resignations. Mrs. Wallace –– 5875

Property taxes and education funding. Mr. Passarell –– 5876

Princess Marguerite. Mr. Blencoe –– 5876

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

On vote 37: minister's office –– 5877

Mr. Blencoe

Mr. MacWilliam

Mr. Macdonald

Mr. Mitchell

Mr. Lank

Mrs. Dailly

Mr. Cocke

Mr. Rose

Ms. Brown

Mrs. Wallace

On vote 40: preventive and community health care services –– 5892

Ms. Brown

Ministry Of International Trade And Investment Act (Bill 20). Committee stage

section 3 –– 5893

Mr. Williams

Third reading –– 5895

Committee of Supply: Ministry of Human Resources estimates. (Hon. Mrs. McCarthy)

On vote 42: minister's office –– 5895

Hon. Mrs. McCarthy

The House met at 2:04 p.m.

HON. A. FRASER: Mr. Speaker, I don't very often have people

here from the Cariboo, and I'd like to introduce these citizens from

the Cariboo today: Mr. Roger Lagasse, president of Cariboo-Chilcotin

Teachers' Association; Mrs. Forcier, vice-chairperson of the 108 Mile

House parents' group; and Diane Fogel, executive of the 100 Mile House

chapter of the Gifted Children's Association of B.C. I'd like the House

to welcome them.

MR. VEITCH: Mr. Speaker, in the gallery this afternoon is the

business manager for the PVI students' union, Mr. Chris McNaughton. I'd

ask the House to make him welcome.

MR. MOWAT: Mr. Speaker, in the House today I have two guests,

and I'd ask the House to welcome them: Mrs. Rosemary Montgomery, who is

office administrator with the family maintenance project in the

Ministry of Attorney-General, and Mr. Allan Cobbin, who is northwest

district director with the Ministry of Attorney-General.

Oral Questions

SCHOOL DISTRICT BUDGETS

MR. ROSE: I'm just hesitating a little bit, Mr. Speaker,

until the Minister of Education finds his place. I could suggest a

place to him, but he'll find his own.

Since the the deadline for the compliance budgets for school

districts is May 1 — tomorrow — I want to know what action the minister

has decided to take respecting school districts that are unable to

comply with the minister's ruling and yet at the same time preserve

their mandate to provide necessary school services within their

districts.

MR. SPEAKER: Part of the question is in order, hon. member. Part of it would be anticipatory.

HON. MR. HEINRICH: Mr. Speaker, I expect school boards and

the trustees who are responsible for the policy and administration to

comply with provisions of the law — that is, to submit a compliance

budget on the date which is prescribed under the statute.

MR. ROSE: While no one would counsel breaking the law, the

government legislation provides such draconian measures as firing

school trustees, imposing trusteeship, fining trustees and fining the

taxpayers, as was the case in Delta. I'd like to know: has the minister

decided to rule out any of these options, or has he decided to leave

the blanket threat hanging over the lives of people who run the school

system?

HON. MR. HEINRICH: Mr. Speaker, the member for Coquitlam-Moody seems

to be making reference to future actions. I will repeat my earlier answer: I

expect school boards to comply with the provisions of the law and submit compliance

budgets.

MR. ROSE: I wonder if the minister could comment on the

recent changes in the framework by which the provincially funded

portion of the budget was slashed to 55 percent from 60, which meant

that the shared portion of the residences has gone up by 5 percent.

School property taxes are going up 10.9 percent in Vancouver; 15.6 in

Delta; 19.3 in the Charlottes. In view of these dramatic increases in

school property taxes during a period of service cuts, does the

minister now wish to retract his statement to the Vancouver Board of

Trade that the funding system is sound and fair?

HON. MR. HEINRICH: Mr. Speaker, the government grants

available must be distributed equitably. The assessments have gone down

in some areas; and where they have gone down, obviously government

grants must go up. Of course, the reverse is true: where assessments

have gone up, the revenue from that area will be increased, but it's

going to offset those areas where there is a decline. As far as the 55

percent level is concerned, it's nothing more than a reflection of an

equitable distribution of the funds available which have been generated

as a result of the assessment.

MR. ROSE: Will the minister not agree that his new directive

has left the homeowner with an increased share of education funding,

and the province portion saved by $25 million? Would he comment on that

as regards equity?

HON. MR. HEINRICH: Mr. Speaker, in some school districts in

British Columbia the actual amount which will be paid by homeowners has

declined; in other cases it has increased. It's nothing more than a

reflection of the assessment.

Interjection.

HON. MR. HEINRICH: Well, it was also very clear that through

the three-year operation the additional funding has been injected into

the Ministry of Education budget, and I don't really see where the

particular problem is, particularly after you take into consideration

the homeowner grant. The amount paid by the majority of residents in

the majority of school districts in British Columbia is zero.

SCHOOL BOARD RESIGNATIONS

MRS. WALLACE: I, too, have a question for the Minister of

Education, Last night both the chairman and the vice-chairman of the

Cowichan School District, School District 65, resigned from those

positions. The reason was that although the funding bylaw was defeated

by a two to one majority by the duly elected trustees of that school

district, the chairman, under the interim finance act, was forced to

rule that the bylaw carried — even though it was defeated two to one.

Is that the Social Credit version of democracy?

HON. MR. HEINRICH: I think the statute is very clear. If two

trustees are prepared to offer their resignations, there still is a

majority on the board and they are quite prepared to review the budget

and pass the appropriate validating bylaw on or before May 1.

MRS. WALLACE: They did not resign from the board; they resigned as chairman and vice-chairman. And it will be

[ Page 5876 ]

interesting to know whether or not they are able to get two more trustees to take those positions.

My second question relates to Lake Cowichan, School District 66. The

chairman of the school board there has been forced to resign not only

as chairman, but as trustee. The reason is that in order to continue

his education at the post-secondary level, he is forced to leave the

province to get the required courses. Would the minister agree that

this example is symptomatic of the government's onslaught on education?

MR. SPEAKER: The question is out of order.

PROPERTY TAXES AND EDUCATION FUNDING

MR. PASSARELL: To the same minister. Under the new framework for education,

property taxes are going up 69.5 percent this year in the Nisgha School District,

compared with less than 5 percent in West Vancouver. Does the minister agree

that the impact on the Nishga is very unfair, and what has he decided to do

about it?

HON. MR. HEINRICH: Mr. Speaker, I cannot give a specific

response, because I don't have the budgets with me. I'm quite prepared

to have a look at that particular school district, because as I recall

there is a cap on it. Even though the member advances a percentage

increase of what appears to be a large amount, I suspect that the

actual amount of taxation on the homeowner is very small. I think I'm

prepared to bring back further information to the House, and I take the

rest of the question as notice.

MR. PASSARELL: Supplementary. Could the minister please

explain to the House why the taxpayers of the Stikine School District

get hit with a 17 percent increase on property taxes, while residents

of West Vancouver are held to just 4.8 percent?

HON. MR. HEINRICH: Mr. Speaker, there are a number of reasons

for that. Number one, I think we can look at the assessed values of the

property, and it's obvious that the revenues generated are a function

of assessment. Secondly, I think that we can look at the enrolment, and

I can appreciate, when we look at the difference as well on the

per-student cost.... In the Stikine region it's somewhere between

$6,000 and $6,500 per student, and in West Vancouver it's probably in

the order of $3,400 to $3,500. I'm guessing on this, and that's one of

the reasons why. I would further suggest to you as well that, after the

homeowner grant is taken into consideration, the net payable by the

citizens in the Stikine region puts them in a deficit position.

[2:15]

MR. PASSARELL: A last question to the minister. Does the

minister not believe that all children in this province should be

entitled to a fair education, and that residents who live in the far

north should not be drastically hit with increased property taxes

compared to West Vancouver or the metropolitan areas of this province?

HON. MR. HEINRICH: One of the very reasons that we introduced the framework

of the new method for funding the school system in British Columbia was to bring

equity among all school districts, and that is exactly what we have done.

AN HON. MEMBER: That's a sore point, Al.

HON. MR. HEINRICH: That's not a sore point; it's been a good point.

Mr. Speaker, if we were to look at the tax base in the Stikine

region and compare it to any other area in the lower mainland, you

would find a significant differential. We've just been through the

estimates of the Ministry of Education, and I went to great pains to

expand and explore the differences, and why we had to bring some degree

of equity. As a matter of fact, when we go into the Stikine region, I

advise you that the cost involved is per student. We're not as a

government arguing against that at all. What we're saying, though, is

that those areas that can afford to pay a bit more, which is reflected

in their assessments, can share with those areas that have lower

assessments. I would bet any money, Mr. Speaker, that an analysis of

the assessments in the Stikine and the Nishga would find that those are

two districts which are doing very well as a result of the funding

system that we put into place.

PRINCESS MARGUERITE

MR. BLENCOE: I have a question for the Attorney-General, who is responsible for the Princess Marguerite . We've had a number of sailing dates announced for the Princess Marguerite . The local Times-Colonist called it "Chaos in Wake of Fickle Maggie ."

The Princess Marguerite was

scheduled to begin service on May 3, the same day as last year. Then it

was changed to May 9. A Victoria resident last week was told it would

be May 8. Now it's been changed to May 10. Unfortunately, no staff

member at the Princess Marguerite

can explain these various timetables and schedules; there's a lot of

confusion. Can the minister explain to Victoria residents, and to the

traveling tourist exactly what's happening with the Marguerite , or is he just as confused as everybody else?

HON. MR. SMITH: The member, with his usual gentle penchant

for understatement, asks me if I'm confused. No, the only confusion I

have, Mr. Speaker, is from the member.

The inaugural sailing of the Marguerite

is next Friday morning, from Seattle to Victoria. The member has been

invited to attend a sailing on Thursday afternoon, along with the other

members for greater Victoria. Members of the tourist industry and the

visitors information industry are going to Seattle on Thursday for an

unprecedented inaugural voyage. In the past, the inaugural voyage of

the Princess Marguerite was

crew only. The ship went down empty to Seattle and started its first

voyage on Friday. This time, as a promotion, we're taking a number of

citizens down. We're having a reception in Seattle with the tourism

industry in that city, and the member has been invited. So if he's read

his invitation he knows he's on board on Thursday, and knows also that

the inaugural voyage of the Marguerite is Friday from Seattle.

I also would like to acknowledge the support that this e member gave

for the jetfoil, along with the member for Nanaimo (Mr. Stupich).

MR. BLENCOE: The minister's answer is as confusing as his

administration of the Princess Marguerite. Unfortunately no one knows

when the Maggie's going to sail, because we've had a grab-bag of dates

announced to Victoria

[ Page

5877 ]

and to everybody else. I'm wondering if the minister will confirm whether

he has hired Mr. Charles LaVertu, formerly of the press gallery, to clean up

the mess that he and his cohorts have created with the Maggie and all the various

schedules. Does he have to clean it up now?

HON. MR. SMITH: I would think that one of Mr. LaVertu's first duties would be to try to explain the operation of the Marguerite to the member for Victoria. That's a very tall order, but I'm sure that Mr. LaVertu is up to that sort of assignment.

In honour of these questions today, Mr. Speaker, I wore a Princess Marguerite tie.

MR. MITCHELL: On a point of order, I was wondering if the

Minister of Lands, Parks and Housing (Hon. Mr. Brummet), who took a

question on notice yesterday for the Minister of Municipal Affairs, has

an answer that he can give us today.

Interjections.

MR. SPEAKER: Order, please. Hon. member, by the wildest stretch of imagination that does not qualify as even close to a point of order.

MR. ROSE: On the same point of order, I wonder if the learned

Speaker could advise this House if questions taken as notice from

February 18.... I have a list of some 20 or more questions taken on

notice by the government benches for which answers are due and

forthcoming to this House. I wonder if the Speaker could advise this

House how an opposition member.... What is the most appropriate time

for him to seek this kind of information? When is the government going

to answer some of these questions that have been hanging for two months?

MR. SPEAKER: Hon. member, I'll be quite happy to explain the rules to you, other than taking up the time of the House.

HON. MR. ROGERS: Mr. Speaker, on Thursday, April 11, the

member for Mackenzie (Mr. Lockstead) asked me what appears to be a

short question, but one requiring a very detailed answer, regarding the

western accord. I would ask leave to table a written answer to an oral

question.

Leave granted.

HON. MR. ROGERS: Mr. Speaker, I'd also ask leave to table a written answer to a question from the member for Nelson-Creston (Mr. Nicolson).

Leave granted.

Orders of the Day

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

ESTIMATES: MINISTRY OF HEALTH

(continued)

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

MR. CHAIRMAN: Shall vote 37 pass?

So ordered.

HON. MR. GARDOM: On vote 38....

Interjections.

HON. MR. GARDOM: I heard: "So ordered."

MR. CHAIRMAN: So did 1.

Interjections.

MR. CHAIRMAN: The member was not on his feet. When I called

for the vote the committee said aye. There were no negatives, and there

was no other member on his feet. However, we will return to vote 37.

The second member for Victoria wishes to be recognized.

MR. BLENCOE: I appreciate that opportunity.

Mr. Chairman, I have just a couple of things I wish to bring up with

the Minister of Health. The first one is an important one that goes

beyond just the Minister of Health, but I'm sure he'll be very

interested. In this region for some time we have had some problems and

concerns about the dumping of raw sewage into the waters off the shores

of greater Victoria. This has raised a number of concerns: health

issues, environmental issues.... I'm glad to see the Minister of

Environment (Hon. Mr. Pelton) is here today as well.

This morning, Mr. Chairman, the new regional senior medical health

officer for the Capital Regional District indicated in a news story

that he is deeply concerned about the discharge of raw sewage through

short outfalls and to nearby beaches in the Victoria area, particularly

along the area that probably all of us in this House know, the Dallas

waterfront. He says that apart from the direct health implications it's

quite unforgivable for an area as beautiful as greater Victoria to be

discharging its raw sewage out into the saltchuck that affects the

beaches.

The Minister of Environment is leaving; perhaps he will also refer

to this particular issue and we can talk about that later. But I wish

to address the Minister of Health at this time. There has been for a

number of years, I suppose. a controversy surrounding the dumping of

raw sewage, but I don't think there's any disagreement that the

washback and the effects of this unhealthy habit are once again coming

to the front. This morning we have the senior medical health officer

for the Capital Regional District clearly indicating that something

must be done. I hope the Minister of Health is also concerned about

this.

When I was on the Capital Regional District health committee we were

starting to look at the coliform counts that were coming on the air

currents back into some of the areas around Fairfield and Gonzales,

creating a number of health concerns in the community,

I am wondering if the minister is aware of this situation, if he is

taking a course to get involved in this particular health issue,

whether he is prepared to get together with his various colleagues who

also have responsibility for sewage disposal and once and for all come

up with a sewage disposal system that is healthy, not a system that's

basically very primary — a grinding-up system. an Osterizer for sewage

— straight out into the chuck, and with the health implications coming

back to haunt us. Is the minister prepared to take a look, with his

[ Page 5878 ]

colleagues and with the CRD, at proper treatment

for sewage in greater Victoria and once and for all get rid of this

unsightly, unhealthy item from our beaches and our beautiful waters off

Victoria? Could the minister give an initial response to that issue?

HON. MR. NIELSEN: Mr. Chairman, we have a responsibility, and

the medical health officer who works for the CRD has a responsibility,

of identifying that which might constitute a health hazard or a health

problem. It's a seasonal concern as spring threatens. Each year we have

the same report from each municipality that has beachfront property —

exactly the same. It's been going on for many years. In fact, I wonder

if the same story isn't printed each year with a different name, should

the medical health officer have changed. It's the same problem. It's

been a controversy for the last 25 years at least.

There is nothing in the system which prohibits the Capital Regional

District, or any member municipality, from installing a sewer system to

whichever standards they may wish to have. Nothing prohibits the

installation of a sewage system, to whatever standards they feel is

necessary. We don't prohibit that. If they wish to install one, they

have every right to go ahead and install one. They may argue that it

should be cost-shared in some way. We certainly don't prohibit them.

They can have any type of sewage disposal system that meets their needs.

If their sewage disposal system constitutes a health hazard, that's

a different matter. The medical health officer has the responsibility

to determine if a health problem exists. Then, perhaps, certain orders

are issued, and certain bylaws are passed. But the Ministry of Health

certainly doesn't prohibit any such action.

[2:30]

MR. BLENCOE: I'm pleased the minister has admitted that he

has some important responsibility in this particular area. I think one

of the problems is that the issue is not necessarily seasonal; it's

with us all the time. The issue is raised maybe two or thee times a

year, basically because it is a constant issue in the greater Victoria

area. I don't think there is one resident in the greater Victoria area

who would not support a proper sewage treatment facility to deal with

this important issue. We are tired of living with you-know-what off our

backyard, in the water and on the beaches, and our children....

AN HON. MEMBER: Say it, Robin.

MR. BLENCOE: Yes, I'll have to say it in a minute.

One of the basic problems we have, Mr. Minister, is that we have a

government that has to some degree reneged in terms of taking some

financial responsibility and, I guess, some responsibility in setting

some direction with local government, to ensure that the health aspects

are taken care of. Will the minister, now that he's admitted that he

has some responsibility, agree today to indicate to whomever of his

cabinet colleagues have to find the cost-sharing for proper sewage

treatment...? Is he, as one minister in cabinet, prepared to support

sewage treatment in the greater Victoria area, and give provincial

government financial support for cleaning up our beaches and making

Victoria a safe, healthy environment once again'? All the studies are

there that it is not at this time. Will the minister support that?

HON. MR. NIELSEN: Mr. Chairman, I don't know where that

member has been hiding for the past quarter of a century, but this

controversy has been around for at least that long, and the Capital

Regional District and its member municipalities chose in the past to do

nothing about it. It was cheaper to dump it at sea, and that is what

they have chosen to do over the past while. Other municipalities which

did not have the convenience of dumping it at sea chose to take the

time and effort to install a sewage system. The Capital Regional

District did not.

So don't suddenly discover it because the wind is blowing in the

right direction. The problem has been here for a long time. The members

of various councils in Victoria, including you when you were there, did

not solve the problem. I don't remember any resolution coming forward

from the councils to solve the problem. It's not uncommon for people to

say to someone else: solve the problem for us; all it takes is money.

But where have the municipalities and the CRD been over the past

quarter of a century when it was identified as a problem? Why was it

they opted for the lower cost of extending the pipe? I didn't notice a

big hullabaloo and great excitement about installing a treatment centre

that might solve the problem. The resolution was to extend the length

of the pipe. That's the action they took. At that time and in

subsequent years the formula was as it had been for many years — the

2-mill formula. I did not see those municipalities taking advantage of

that formula when it was available at that time, as other

municipalities in the province did. So it's hardly a new discovery.

But, Mr. Chairman, the medical health officer is responsible for

determining if that constitutes a health hazard — not a nuisance, a

health hazard.

MR. BLENCOE: Well, to some degree there is a lot of history

in this issue. The minister is quite correct. I don't disagree with

that. However, there have been a number of occasions, and one I

particularly remember, on which the CRD.... I believe Bob Wright, who

was formerly chairman of the B.C. Steamship Company and a good friend

to this government — I don't know whether he still is — tabled a report

indicating that treatment was the solution and wanted provincial

support for that particular answer to our sewage and health problems in

the greater Victoria area. At that time, and I'm going from memory, I

believe the minister responsible was the minister now responsible for

energy, who then indicated that there was no provincial support for

such a program.

Let's leave that behind. What I'm asking today — and we've asked

many times.... At least, maybe we can agree that we do have a problem.

Forget the history and let's say that maybe the time has come for all

those involved in this particular issue, particularly at the CRD level

and at the provincial level, to get together to see if the province is

prepared to give some support for proper sewage treatment. The basic

reason why the local people won't go for it is that they feel that

putting the financial load of sewage treatment onto the real property

tax payers in Victoria would be just too much of a financial burden.

There also has to be some movement from the provincial side.

All I'm asking the minister today, if he does indeed believe that

there are some health problems and that he as Minister of Health has to

take some responsibility: is he prepared to discuss this with various

colleagues in cabinet, and indicate to the CRD, who I know want to have

a proper

[ Page 5879 ]

way of dealing with this health problem in the

greater Victoria area...? Can we get some resolution and get proper

sewage treatment in the greater Victoria area? That's all I'm asking

for today — some recognition that we can start to get the parties

together, that the provincial government won't say again that they are

not prepared to give some sort of financial support to proper sewage

treatment in the greater Victoria area.

I also have to say that it is not only a health problem, Mr.

Minister. You know, we're always talking about the beauty of this

island and the tourism potential, etc.

MR. CHAIRMAN: Hon. member, we seem to be straying somewhat

from the estimates of the Ministry of Health. Inasmuch as the debate

centres around a health issue, the debate is in order; inasmuch as it

centres around issues that might be better discussed in other

ministers' estimates, it is out of order. To the Health estimates,

please.

Interjection.

MR. BLENCOE: Well, I won't sit down. I know that some members

want me to sit down, but this is a very important issue to greater

Victoria residents, particularly those residents in Victoria who have

had to deal with this issue for — and the minister is right — years and

years. It's time we had some proper resolution, and that we resolved

this unsightly and unhealthy situation. All I'm asking is that the

minister at least admit today that he is prepared to look at some kind

of cooperative framework to deal with sewage treatment for health

purposes in the greater Victoria area. That's all I'm asking — not to

go over the history. I know the minister can't say he's going to

announce some big grant. I know he hasn't got the power to do that,

because it covers a number of ministries. But are we prepared, once and

for all, to take on this issue which is important to every single

resident in greater Victoria?

HON. MR. NIELSEN: So as not to offend the standing orders,

Mr. Chairman, I would refer the member to the issue under the Minister

of Environment, who is responsible for such matters. As it relates to

health hazards, should they be there, my ministry's estimates provide

for certain funding for medical health officers, whose job is to

determine health hazards occurring. But I'm afraid I have no money in

my budget for the funding of sewer systems. The Ministry of Environment

and the Ministry of Municipal Affairs are involved in such matters.

MR. MacWILLIAM: Before we adjourned for lunch I mentioned

that I'd like to come back to some specific concerns in terms of health

issues in the north Okanagan. I'd like to address those at this time.

The minister may recall that a few years back a new wing of the

Vernon Jubilee Hospital opened. Coincidental with that opening an

entire floor of the old wing was closed down and remains closed down at

this point. I think there are approximately 40 beds involved. They

remain empty, although the wing has been refurbished and remodeled.

It's a strange feeling to go in there and look at an entire floor that

remains virtually ghostlike.

The hospital, according to the latest reports that I have at my disposal, faces

an expected deficit of about $900,000 in their budget for this year. The minister

may not be aware — so I want to bring it to his attention — of recent proposed

decisions by the board in light of this budget shortfall. I refer him to a recent

article — April 1985 — in the local paper, the Vernon Daily News . It says:

"The Vernon Jubilee Hospital board of trustees may be forced

in the next two months to make decisions that will see bed closings and staff

layoffs in order to reduce a budgetary deficit expected next year.

"...plans are being made now for the cutbacks, even though the hospital has

not yet been told how much provincial government funding it will receive for

the 1985-86 fiscal year."

Twenty-five beds out of the 155 beds at the hospital are planned for closing

for the period from June through to September.

I would like to point out to the minister that those 25 beds, as has

been mentioned in the paper, are in the surgical ward, and the closure

of the 25 beds in the surgical ward will effectively reduce the

capacity of the ward by, I believe, one-half for the months of July and

August. I might also point out to the minister that the months of July

and August are a critical time for the hospital in terms of delivery of

health care because it is then that the tourist season in the Okanagan

Valley is at its peak. In discussions with one of the local surgeons

and one of the anesthetists in the hospital, I was informed that these

are in fact the peak months for the operation of the surgical ward. It

seems rather difficult to justify the reductions in the operating room

capacity at this busy, busy time.

The waiting-list for elective surgery — from my discussions with

members on the hospital board as well as with physicians — is

approximately four months. It is estimated by extrapolation that the

waiting-list will increase to at least six or seven months by the end

of August or September, reflecting the reduced capacity as a result of

the closures.

Dr. Hartley, who is a local surgeon and also one of the city

aldermen, has called for the hospital board to consider a number of

alternatives. One of the alternatives that Dr. Hartley has called for

is a suggested reduction in administrative staff. I might point out to

the minister that the senior administrator in the hospital receives in

the neighbourhood of $100,000 a year at this time. It seems incredible,

with the top-heavy administrative load in the hospital, that we're

cutting at the wrong end of the stick. Perhaps we should be considering

trimming some of the fat at the administrative level. These are some of

the recommendations that have been made.

I have two questions for the minister in terms of the immediate

crisis that the hospital faces. Number one, will the minister advise as

to the decisions of the recent ministerial review conducted at the

hospital? Will the minister enlighten the House on the recommendations

from that review committee? The process, I believe, has been completed,

and recommendations are forthcoming.

Secondly, I wonder if the minister, in light of these facts that

I've just brought to his attention, would consider a makeup in the

funding shortfall of S900,000, which would help avert the unfortunate

and, in my estimation, the unnecessary closure of these operating

facilities.

[2:45]

HON. MR. NIELSEN: Mr. Chairman, there is no crisis at the

Vernon Jubilee Hospital. They may indeed be projecting a $900,000

deficit; they may have that money in surplus and be quite prepared to

balance it off.

[ Page 5880 ]

July and August for closure of surgical wards is certainly not

unheard of. It's been a tradition for many years. I'm not quite sure

what the member means: the waiting-list is four months. Surely someone

is receiving elective surgery today; they're not waiting four months. I

don't know whether you mean that they have people who are waiting for

four months. Well, I hope they have people booked four months in

advance. What are we going to do? Close down the surgical wards in four

months' time? Of course they're booked in advance. They're probably

booked a year in advance in some instances. I don't know what you mean

by "a waiting-list of four months." We have doctors who have a personal

list of over a year; they have people booked for surgery a year from

now. Hospitals do not function on a 24-hour renewal basis. They plan;

they book surgery months in advance, because it meets certain people's

own personal agenda, the surgeon's agenda and the hospital's agenda. In

fact, Mr. Chairman, they had better plan in advance. They can't decide

on what surgery is going to happen next week and not think beyond that;

that would be nonsense. There is always going to be a waiting-list. If

there isn't a waiting-list, you've overbuilt, obviously. Are you going

to go out and solicit business?

There is no crisis at the Vernon Hospital. We're in contact with the

boards regularly; we review their operating budgets quarterly. They

know the name of the game: they run a deficit, they pick up the

deficit. I believe there are 30 beds scheduled for opening in October.

At the present time it is on

schedule at least: 30 of the 73 new

acute-care beds are due to open in October 1985.

Mr. Chairman, when I visit a hospital and see there are surplus

beds, I am far more pleased than to see a hospital operating beyond 100

percent capacity. One of the reasons we added the 100 beds to that

hospital in 1983 was to build for the future. We weren't just trying to

catch up; we were building for the future. That's not uncommon in many

hospitals in the province.

The member is wrong to say there is a crisis at the hospital. Maybe

in his mind, but it is not a crisis in the minds of the hospital or the

ministry.

For that member's information, the administrator is apparently paid

$78,000 a year, and he also is administrator for the Armstrong hospital

and at least one long-term care facility. That would pay for about

three-quarters of an acute-care bed for a year.

MR. MacWILLIAM: In response to the minister's rebuttal, the

words that I used are merely the words that have been accounted to me

through discussions with the physicians and the health care

professionals at the facility. I might remind the minister that at a

time during the summer months when the surgical ward is in its reduced

capacity, all elective surgery is effectively shut down. I don't

understand how the minister can deflect that as being just a normal

situation. I have been told that there will be no elective surgery for

July and August as a result of attempts to make up the budgetary

shortfall. Naturally we do have waiting-lists; I agree with the

minister. But the fact that doctors themselves have waiting-lists that

exceed a year may indicate that in fact the reason for those

waiting-lists is that they can't get placement on the hospital

waiting-list. I mean, to be waiting over a year for surgery seems

completely incomprehensible to me. However, the facts speak for

themselves. The potential is that elective surgery for July and August

will be shut down if the budgetary shortfall is not made up.

Moving on to a very local problem. The minister in his realm of

responsibility may not be familiar with this, so I'll outline the

details to bring it to his attention. It may seem a minor problem but

in a small community such as Winfield, which is located between Vernon

and Kelowna in the Okanagan, it does have I think a major social impact.

The Ministry of Health has just recently prohibited the use of

dishes and cutlery in the hall for gatherings of larger than 50 people.

The reason for this is the fact that the hall at this time doesn't have

a commercial dishwasher, and they have recommended that there be an

installation of commercial dishwashers in the hall. Now this has

actually caused quite a ripple in the community, because the hall is

very central to a lot of the community functions. The hall has always

met with Ministry of Health regulations; in fact, the hall has been

deemed adequate for over 70 years now, and it's rather puzzling to the

community to suddenly have this change of heart by the ministry.

I might add that the estimated cost of installing commercial

dishwashers to meet with the ministry's recommendations is, in round

figures, about $10,000 for that community. The hall is owned and

operated by the community. That community is presently experiencing in

excess of 20 percent unemployment. It creates a very difficult

situation, a hardship on the residents of the community, to raise these

funds for the installation of the commercial dishwasher, and what it

means is that the hall will virtually be closed down to many of the

community functions.

I would ask the minister three things on this. I wonder if, in light

of this evidence, the minister would reconsider this seemingly

heavy-handed approach to the regulations. After all, they have survived

quite well for 70 years without a commercial dishwasher. Secondly, I

can understand the concerns in terms of upgrading the hygienic aspects

of handling dishes and food, but would the minister consider providing

a time-frame for the acquisition of sufficient proceeds to purchase

such equipment? And lastly, would the minister consider that this

time-frame, say of five years, would be appropriate for raising such

funds? What I am concerned about is that the hall is going to be lost

to a lot of community functions if these regulations have to be adhered

to as stringently as proposed.

HON. MR. NIELSEN: Mr. Chairman, I guess it's a situation of

whether you enforce the regulations or you don't. Certainly I recognize

that at times enforcement of a regulation simply because you feel you

should enforce it can create hardships and apparently in some

circumstances appear to be a rather unreasonable thing to do.

I'll tell you what, I'll make you a deal. I'll contact the public

health officer in the region and find out precisely what their concern

is. Obviously they are concerned about food poisoning or salmonella or

something, but I'll find out why they feet there is any reasonable

cause for alarm. I will also ask them, through our officials, if

perhaps they might advise the people who run the hall of certain other

processes of dishwashing that might overcome some of their concerns,

and perhaps see if indeed they can develop a method whereby they could

be given a period of grace in which to install a commercial dishwasher.

The deal I want from the member is this. In the event of a breakout of

food poisoning at the hall, I would ask the member not to raise too

much of a stink, considering he requested we perhaps not enforce those

regulations.

[ Page 5881 ]

Let me ask the medical health officer there what the problem really

is. I agree with you; for half a century they've functioned. I would

like to know if there have been incidents of problems in the past, and

whether it is in response to something current or quite recent. But

sure, I think you're quite right in saying why not let's consider the

reality of the situation right now and see if we can't offer them some

relief. I'd be more than pleased to do that. But I think, Mr. Member,

basically it is whether you enforce a regulation or you don't enforce a

regulation, and we'll be pleased to get a report from the public health

officer to determine why they feel it's absolutely essential that it be

changed at this time.

I don't know what kind of a dishwasher they're buying for $10,000, but I guess it's pretty heavy-duty.

MR. MacWILLIAM: Well, I must say I do appreciate the

minister's response on that, and to my knowledge there hasn't been any

outbreak of food poisoning or problems as a result of the present

methods. However, my thanks, and I think that if we look into it, we

will see that there may be a way to work around this whole problem. I

know the residents of the community will be very pleased if in fact

that is allowed — giving them a reasonable time interval — and that

they will work toward that.

There is one other issue that I would like to bring to the minister,

in terms of clarifying some comments that the minister made in a

statement a while back in regard to Shaughnessy Hospital and a

particular patient, Mr. Chris Busby. This is more or less to enlighten

the minister on some of the facts that I had at my disposal, and

unfortunately I wasn't available the day the minister did make the

statement. I would just like to take a minute or two to brief him on

some of the facts that I had garnered.

As the minister may recall, Mr. Busby is a patient of a Dr. Van

Peteghem and is scheduled for spinal fusion at Shaughnessy Hospital. I

might mention to the minister.... He was actually correct in bringing

me up short on my statement that the patient had been waiting for

surgery since 1983. In fact the injury occurred in 1981; however, I

guess through the process of the review board at Workers' Compensation

and what not, he didn't get final approval for surgery, apparently,

until September 1984. It does raise an issue in my mind as to why it

took from 1981 to 1984 to go through this process with WCB.

However, other than those simple facts of the dates involved, I

don't have any other specific information in that regard. But it is

interesting that it did take that time, and this patient was in

considerable pain during that period. However, since September 1984

when he was recommended for surgery, he went on the waiting-list, I

guess, at Shaughnessy Hospital on October 1, 1984. The issue that

brought it to mind was a letter from Dr. Arnold, who is also his family

physician in the Okanagan. He was most concerned that the operation had

been continually deferred. In fact, the last correspondence he had was

that the operation would be put off until the summer of 1985.

[Mr. Ree in the chair.]

Now the reason I state to the minister.... These are not my words

but the words of Dr. Arnold. The reason given was the bed closures at

Shaughnessy Hospital. That is stated in his letter to me. I contacted

Dr. Van Peteghem.... Before I get to that, perhaps I'll read the

wording of the letter to me to verify this to the minister. This is a

letter from Dr. Arnold of the medical clinic in Vernon: "On three

occasions, we were led to believe surgery would be anticipated in the

near future as dates got close. We heard nothing from Vancouver. It was

explained at this time that these delays basically had to do with the

recent cutbacks at Shaughnessy. This had significantly affected Dr. Van

Peteghem's OR time." That's a letter under the signature of Dr. Arnold.

Now in contacting Dr. Van Peteghem, this is what I turned up in my

investigation. Dr. Van Peteghem had confirmed that there was a

significant backlog of surgery at Shaughnessy, and his comment was that

he believed this was a result of the reduced availability of the

operating facilities. Scoliosis surgery has a waiting list exceeding

one year. I realize that Dr. Van Peteghem has some special needs in

terms of his specialty that perhaps go beyond the needs of normal

surgery, and that the waiting-list may not be as extensive for other

types of surgery.

However, he related to me that there was a defined need for more

adequate facilities to handle the load of specialized back surgery. One

of the disturbing things that he mentioned — and this was confirmed

with discussions with hospital personnel — was that the operating

facilities were reduced by 75 percent between December 7, 1984, and

January 11, 1985. Basically they shut down everything but about 25

percent of the OR facilities. This apparently was to reflect

cost-cutting measures.

Now the minister earlier in his statement of rebuttal did infer that

the waiting list at Shaughnessy was not extensive. In that respect, he

is right. The waiting list on the books is not that extensive. I did

find out perhaps some of the reason behind this. Prior to November

1984, the hospital allowed only six weeks' advanced booking. In other

words, a physician, if he had a patient he wanted to get onto the

waiting list for surgery, was only allowed to book six weeks ahead. So

that would cap the limit for the waiting-list described by the hospital.

[3:00]

Now the minister had also criticized Dr. Van Peteghem's dumping of

170 patients onto the hospital roster during November 1984. Well, in

discussing this, I found the reason. The reason was that in

mid-November all the physicians, apparently, at the hospital were

requested by the hospital to submit backup waiting-lists in order to

determine the true size of the backlog. This was the reason for Dr. Van

Peteghem submitting that list of 170 patients that he had backed up for

surgery. There are a lot of confusing and extenuating circumstances in

this matter. It's certainly not clear cut. I guess the crux of the

issue does come down to the fact that this poor chap, who is in

considerable pain........ The injury occurred in '81. It seemed to go

about three years before they could finally decide what to do — I

realize there's a lot of consultation involved — and then after that

deferments on the surgery date.

I'll ask the minister two specific questions. First, was the

minister aware of the unregistered backlog that the hospital was

keeping off the rosters with this six-week cap on the waiting-list?

Secondly, does he know how extensive the backlog actually is? I'll

leave him with that.

In

summary, I'd like to point out that as a result of bringing the

issue to the House and the minister's response — I don't know if we had

anything directly to do in the final process — Mr. Busby has finally

had a definitive surgery date booked: June 13. Whether you or I or

anyone in between was

[ Page 5882 ]

in any way involved in the process, at least we've got him into

surgery; that, after all, is the critical issue. Apparently he will

receive treatment at that time.

I'll sit down now and let the minister answer those questions.

HON. MR. NIELSEN: Mr. Chairman, the officials at Shaughnessy

Hospital say the only way to really resolve this particular problem is

to have some other specialists trained in this particular area. Dr. Van

Peteghem went to the United States and took a special course which

provided him with the expertise to be involved in this type of surgery,

which apparently a large number of people require. The hospital says it

is essential to have at least one other specialist trained in the same

thing, because Dr. Van Peteghem simply cannot maintain that schedule.

It is also suggested that some of Dr. Van Peteghem's patients possibly

could be treated by other specialists, because not all of them are

suffering from precisely the same problem. It has been suggested that

because of his particular notoriety and the respect in which he is

held, general practitioners routinely refer their back patients to this

doctor. Naturally it requires a tremendous amount of diagnosis on his

part before he can determine if perhaps he is the only person who can

develop that technique. He now has, I believe, a waiting-list in excess

of 200. So it's continuing to build.

Mr. Chairman, the injury may have occurred in '81, but that does not

necessarily mean there was undue delay in determining that surgery

should be performed. Surgery on the back is not gone about lightly. I

injured my back in 1965 and I haven't yet agreed to have surgery, and

it is unlikely that I will. But obviously, after the injury.... I

am sure that in 1981 various other methods were attempted to correct

the problem rather than go for surgery, which many specialists consider

to be a last resort. So that period of time I think could be reasonably

explained.

I'm pleased that he is booked for June 13. We were in contact with

him and with the doctor and the hospital, but I can assure you that we

did not offer influence of any kind to put the patient ahead of other

patients. That would be the doctor's decision.

The Shaughnessy people do an outstanding job in spinal cord injuries

and back surgery. We are working with the hospital. We hope we can

develop a method whereby at least one other specialist will develop the

same level of expertise to permit some of the backlog of that

particular type of ailment to be recovered. I might add that I have

asked the staff — we have received references to this doctor from other

people — to review the situation, as we did the open-heart situation a

couple of years back, to see if we can make some modifications to try

to take care of some of the backlog in this particular area. They are

actively working on that now.

The closing of a hospital surgical ward or area during the Christmas

holidays is not unusual at all. Hospitals may take advantage of that

period of time when a tremendous number of staff are going to be away

to simply close down a unit rather than have it function at less than

capacity, and they just reschedule. They do indeed save money, but they

also probably develop far better efficiencies through that year than by

trying to operate a surgical ward or operating theatres with inadequate

staffing, when they might be subject to a tremendous number of

cancellations simply because of inadequate staff.

MR. MACDONALD: I just have a couple of simple questions to

the minister. In terms of low back problems, the strange thing is that

abdominal muscles support the back, and if you strengthen your stomach

you sometimes avoid an operation — sometimes, not always. But I just

throw that in as free, medical advice. It's not my question.

My question is about fee-for-service payments, which are going up in

this year's estimates by $49 million, from $464 million to $513

million. There have been very great increases in previous years, but

I'm not going to go into them now. That's about 13 percent. Why is the

minister budgeting another 13 percent for fees for service?

HON. MR. NIELSEN: The increase in the budget for

fee-for-service payments is 3.5 percent over last year's actual costs.

We agreed to increase the budget by 1.5 percent to cover population and

2 percent for utilization. I appreciate that it is that percentage

increase from blue book to blue book. In addition, the agreement with

the BCMA this year will provide that, should the budget be exceeded,

members of the British Columbia Medical Association will absorb the

first 4 percentage points of any overrun. That would amount to about

$36 million.

The member would know that there has been no increase in the fee

schedule itself. It remains as it was last year. There was a 3.5

percent increase over last year's expenditures in the budget. We're

experimenting a bit this year with the concept of overruns and shared

responsibility by the BCMA and the ministry. They have agreed — I hope

they've signed it — that they will cover the first four points over the

budgeted amount. One percentage point is approximately $9 million. We

have the highest fee schedule, although the doctors argue that they're

not the highest paid.

MR. MACDONALD: Mr. Chairman, I note, though, that the

fee-for-service.... I realize that includes something for the dental

and something for the disability plan — $1.9 million — that the doctors

receive, which some other groups in society do not receive. But it is

going up from $464,800,000 to the 1985-86 estimate of $513, 079,000.

That's 13 percent; that's not 3.5 percent. Is that a mistake? What

explains that astronomical increase of $49 million?

HON. MR. NIELSEN: Mr. Chairman, the actual cost of the

Medical Services Plan last year exceeded the blue book estimate. This

year's budget has a 3.5 percent increase over last year's actual

expenditure. That's why there's a variation. The BCMA did agree to no

fee increase and the balance of that formula as I outlined it.

MR. MACDONALD: The minister will be familiar, I suppose, with

some of the figures in the blue book, and some of them are quite

astonishing, if I may say so. You have a Dr. M. Fisher who in 1983-84

made.... I shouldn't use the word "made." How much staff is involved

there I don't know, but it was $496,401.38. I have difficulty

understanding what the 38 cents would represent. One stamp, I guess;

I'm not up to date on the Post Office. But $496,000........ This man, I

believe, was formerly with the methadone clinic. He's been dispensing

Valium and so forth. This is public money. How can we justify that kind

of money going out of the Medical Services Plan? How big was his staff?

Does the minister know? Did he have another doctor working with

[ Page 5883 ]

him, or a nurse that had to be paid? That's almost as much as we're paying in the coalfields.

HON. MR. NIELSEN: Dr. Fisher was the subject of.... I believe

the methadone-dispensing permit was withdrawn. We have increased our

staffing of our methadone clinics, and we are encouraging those people

to go to the clinic rather than to a private practitioner. They still

have freedom of choice, but we are encouraging these people to go to

the clinics rather than private practitioners for two reasons: one,

because the cost is considerably less; secondly, our own clinics have

far greater control over the maintenance of the patient.

The member may recall that over the past year there was a major

action taken with respect to a number of doctors in the Vancouver area

who were dispensing certain drugs. They were subject to investigation,

and charges were laid which led to the disposition in the courts. That

area is under very strong investigation by the provincial and federal

authorities, and there are some resolutions, hopefully, coming forward.

But the $496,000 would not win him first prize in the sweepstakes.

There would be others, you would note, who are upwards of $600,000.

They argue that much of that is for overhead and perhaps other staff.

There are, however, individuals who are nearing the half a million

mark, and it is argued by the BCMA that that is a direct result of

extreme dedication and very hard work. I'm sure that they are

dispensing medicine quite properly, but it's a bit alarming to see such

huge amounts of money going to a single practitioner. The average is

much lower than that, of course. There are anomalies in the system;

there's no question of that. The fee-for-service program generally

works well, but obviously there is an opportunity for taking advantage

of it.

We hope that our agreement now, whereby a percentage of any overrun

is shared, might bring about some discipline within the medical

association itself, with respect to the high rollers.

MR. MACDONALD: Mr. Chairman, what the minister is saying is

that he's sympathetic to some extent with the question. What about the

$496,000, not for serious operations but for dispensing Valium and

things of that kind when there are other people lined up at a food line

without enough to feed themselves? Is the government taking any action?

Does it have nay power to recover any of that money? That is very big

money. I don't think this man had any big office overhead. I know

there's a study in Price Waterhouse of the average overhead of the

medical profession. It is said to be 40 percent, but of course that

document is not made available to the public, who just pay the bills.

[3:15]

You've got another doctor there — you've got to be careful of the

initials — Dr. W.H. Ross: $632,608.35 in this case. Is the government

not interested in making this blue book reflect reality? Why not

publish the true facts with public money? This Dr. Ross may have had

two or three associate doctors with him, or he may not; he may have

been paying a big salary to his nurse, or he may not; he may have been

going to all the medical conventions throughout the world, or he may

not. This is big money. It's staggeringly big money, with no

explanation. Is there any other department of government where public

money goes without an explanation or a check in this fashion?

My particular question is: will any efforts be made to recover any part of that money from Dr. Fisher?

HON. MR. NIELSEN: Mr. Chairman, the patterns of practice

committee reviews the caseload of doctors and the amount submitted to

the plan. We are obliged, under the agreement with the federal

government, the Canada Health Act and our own act. to pay for insured

services rendered, and if a physician is indeed rendering an insured

service we are obliged to pay the fee agreed upon for that service. If

it is suggested that any doctor is not performing the service or,

because of volume, may in some way be negligent in performing his

duties, then that is subject to peer review, either by way of the

patterns of practice or the College of Physicians and Surgeons.

It is argued that a physician practising medicine quite properly can

bill the plan for half a million dollars. That's a tremendous amount of

money. We question whether it is something we should encourage or

tolerate. We certainly don't encourage it. We do have some methods of

reviewing; we have certainly put the message out, and the BCMA have

also put the message out, of the concern about these very high billers.

What we publish in the blue book is simply the amount charged to

that doctor's billing number. He could have associates and it may just

be billed to one number It would be very difficult, I think, to publish

the information and break it down as a matter of course. Much of the

information is only known to Revenue Canada.

Mr. Member, I might point out that the blue book figure is what the

Medical Services Plan pays to the doctor. What he may earn on the side

is not known to us — whether he works for an insurance company or works

for a private corporation or has private patients or whatever. That's

just what we pay.

MR. MACDONALD: Mr. Chairman, I believe what I consider to be

a solution to this problem.... It's a very difficult one. I may speak

on the numbers bill that the minister will be bringing in, because this

attempts in one way to address that problem. But I think it was W.A.C.

Bennett who said: "Let's have a blue book so that we'll have some

control over them." But it's just partial information. It doesn't say

how many doctors; it gives the billing number and the gross. In some

cases there is heavy overhead, depending on the kind of practice. In

other cases the overhead for some of the surgeons, some of whom I

know.... They are $200,000 to $300,000 a year, and some of them have

very little overhead at all because the hospital is providing the

overhead. I won't mention names. and some of them you see every

afternoon. No doubt they do good work. Who knows whether they do more

work than was really necessary?

So really, Mr. Minister, with all respect, I think you have a system

that's running out of control. You could easily require fuller

information in the blue book than W.A.C. Bennett thought was necessary

at that time, including overhead and the number of people who are

participating in a professional way in receipt of that income. That's a

simple thing to do. But at the moment the system seems to be just

running out of control. I think if you mixed them in, as our provincial

council said on the weekend, with some community health clinics with

salaried personnel.... You're going to have a surplus of young, capable

doctors looking for employment. Now they won't be able to get a number

and bill.

[ Page 5884 ]

We should have health clinics that prevent illness as well as

treating it and do so at a reasonable cost to the public, because this

is one area of government that's just running right out of control.

MR. MITCHELL: Mr. Chairman, it might sound a little strange

that I'm going to start off and maybe congratulate the minister and the

ministry. The project that I would like to thank him for and

congratulate him on is the trial program of the adult day-care centre

that has been opened up in the Juan de Fuca Priory extended-care

hospital. From talking to a number of those involved both at the

voluntary level and the hospital level, they're very pleased that they

were given this opportunity to make something that a lot of us in

public life, a lot of us in the community, have been trying to get the

community, to get the society, to get the medical profession.... We

have been trying to get them to understand that it is better to keep

people in their homes if possible, and if that takes a day-care

centre.... I'm not really happy with the particular name of adult

day-care centre, but I think the concept that people have an

opportunity to come to get the socialization, to get the meals, does

fit into the whole concept that many of my colleagues have been talking

about: to bring the concept of community clinics into reality.

I believe there have been many studies that we must look at a

completely different approach than the present illness-payment

procedure that we have in the medical costs today. I believe that the

ministry has made this one pilot project of the adult day-care centres.

There has to be a serious look at setting up some type of community

clinics, some trial programs in an area such as a city or a community,

where it can be tried, where a selection of doctors on a wage can be

there to give the medical treatment. But in conjunction with that,

there has to be a better utilization of the support staff in the

medical profession — the nurses, the therapists. I'm not advocating

that we set up the barefoot doctor routine that is in some of the Third

World countries, but I think we must utilize the particular expertise

that is available. Presently, because of the legislation and

agreements, everything has to be funnelled through doctors. I think

there's a lot of knowledge out there that is not being utilized to its

best.

I don't want to go too far in the community clinics, but I think the

minister should give that a serious look. The continual cost that goes

into health care is fairly terrific. We can pick headline grabbers out

of the blue book but I don't think that's the answer. I think we have

to do the deep study that is needed.

There are a number of other questions I would like to cover. I

brought this one to the minister on a number of occasions, and I

brought it up last year. We still have not recognized that the cost,

the per-day fee for extended care, does hit a certain minority of

families a lot harder than the general public perceives. A lot of

people think of the extended-care hospital as only for senior citizens

who are getting their old-age pension and their various supplements,

and that money goes to cover the $14. There is a group of working

people who do have wives and husbands in extended care, and that

continual $14 a day, plus the cost of maintaining the home, of looking

after children, the additional needs.... If it's the mother in the

hospital for a long period of time, the extended cost that the husband

has for housekeepers, etc. is a drain.

I've asked the minister and the ministry to give it some serious

consideration. If it's a senior citizen and they have ample funding to

cover it from their pensions, that is one case; but where there is

extreme hardship, extreme cost, we should not allow one group to go

into economic bankruptcy because of medical costs. In the modern world

of today, I am sure British Columbia can afford to provide that service

for everyone without the heavy cost.

I have listened to the various statements that the minister has made

on funding to hospitals: that all hospitals are in great shape and are

living within the budgets. It's hard to understand why there have

continually been cutbacks. With the new taxation that was brought in,

in 1984-85 and 1985-86, we are bringing another $166 million into the

system. With that extra money, is it justified to have the continual

cutbacks? I know that in the hospital in my own riding — the Victoria

General on Helmcken — the cutbacks are not obvious until you talk to

the patients and to the nurses. The underfunding, as some

administrators will call it, has set up a situation where they don't

have the money to cover people on sick leave, or people who haven't

turned up, so the nurses who are working have to cover that extra load.

I don't know if it's an attempt to get at nurses who may abuse their

sick leave, or anything like that, but I don't think that method should

be used. If a nurse is required and if the patients need that service,

then it must be provided somewhere. If there is any intent to

discipline people, then it should be done on a different level. There

should be sufficient moneys to cover any sick leave or shortage of

staff.

This is some of the information that is coming from nurses'

associations and from groups — that it seems that every week or month

the nurses on staff have extra duties to do and are running a little

bit faster — although I haven't found any particular patient who has

any complaint about the nursing services that they're getting — and

they recognize that the pressure they're under is becoming quite

terrific at times.

[3:30]

1 would like to change the topic, and follow up two of my

colleagues. Something that the member for North Okanagan (Mr.

MacWilliam) mentioned is a particular problem that we've had on a

number of occasions. When you have someone under the Workers'

Compensation Board appeal or review board getting medical treatment, I

can't understand why, if a doctor has ordered or prescribed an

operation, that operation can't continue, under the hospital or medical

plan.

I had one particular case where I did suggest to the doctor to go

ahead with the case, knowing that we had a year to wait for the review.

But for the last six months before the review there was a continual

harassment from the doctors and the collection agency because that

particular person was not able to make the payment. I spent a lot of

time writing letters and making phone calls to tell the collection

agency that the charge had been passed by the doctor onto that level

because somewhere along the line his particular bill for the operation

was not picked up by the system. I mean, eventually we won the appeal

and it was all covered, but there is that harassment that I don't think

is needed today in our medical system.

I know there are particular cracks in the system that people fall

through. And they seem to all come into my office when they have those

problems. It's something that I think there should be some study made

of so that people don't have that worry about the costs.

One other problem that has bothered me, and I've spoken on this particular issue on other occasions, is the lack of

[ Page

5885 ]

proper enforcement by medical health inspectors on

the problems of septic tanks. Ever since my election in 1979, I

continue to have constituents coming to me with problems of

malfunctioning septic tanks. When you do the background study and

they're dug up, somewhere down the line that land would never have

perked. Somewhere in the health inspector system, property that did not

perk properly was allowed to be subdivided. There have been inspections

made, and as you go along through them they aren't functioning in

accordance with the regulations. After about five years of this we have

managed to get two particular cases before the courts, and there have

been settlements. But they were $11,000 settlements that had to be

made. You can say that it didn't come out of the ministry or it didn't

come out of the CRD, but it did come out of some insurance. But I

think, where you have cases of malfunctioning septic tanks that have

been inspected at the initial level when that particular property was

subdivided, that someone is not doing their job. And I think that, from

the minister through the ministry and down to the regional health

officers, there has to be a tightening up on that particular problem.

It's not so much that the developer can't develop or the builder can't

build, but there is the consumer who buys the home and is stuck with

the additional bill. If he doesn't take the process of going through

the court system to try and get some redress.... A lot of them are

paying $5,000, $6,000 and $7,000 to get a settlement.

In closing, there is one other issue that has been mentioned. At the

present time under your regulations it's not illegal to take septic

sludge out into the woods and dump it. I know that the regional board

in my area and the directors and the various other elected people want

those particular regulations tightened up. We all say that it's

unhealthy and that there has to be a certain procedure for the disposal

of septic sludge, and here we find that according to the wording of the

regulations it is not illegal if it is dumped out in the woods and kind

of abandoned. I think it has gone to various levels — Crown attorneys

and the police have got into it. Is the minister prepared this year to

bring in the necessary amendments, the necessary rewording of those

particular regulations?

HON. MR. NIELSEN: Well, Mr. Chairman, if the member wishes to

let me know later which regulations he is speaking of and cite a couple

of cases, I'd be more than pleased to took at them with respect to the

disposal of sludge.

[Mr. Strachan in the chair.]

The problem with inspections, I suppose, is that usually the problem

developed some time later, and it is not always easy to determine what

type of inspection may have taken place in previous years. I think that

if a septic tank inspection does take place, there should be no reason

for the prospective purchaser of the home to doubt that it is indeed

going to function properly, because that is the purpose of the

inspection. If it is certified, it certainly should be certified

properly, and the person purchasing the home should have no reason to

believe that it is not a proper system.

I suppose there are the pressures before us, with respect to any sewage disposal

system, that you have mentioned — where it fails later. The greater pressure,

however, is on public health officers throughout the province to approve certain

forms of sewage disposal and treatment systems — various types throughout the

province, depending on the topography, seasonal weather conditions, precipitation

and so on. There's probably far greater pressure for public health officers

to case up on the regulations than to tighten up on the regulations. It's

not unlike the floodplain problems we have in other areas of the province, where

it's recommended that you ignore some of the regulations only to later hear

demands for compensation because of flood damage.

Mr. Member, I don't know how we're going to resolve it completely,

because the regulations which are imposed for sewage disposal, be they

septic tank fields or these wonderful Prince George innovations that we

heard so much about.... How we would resolve it to the satisfaction of

citizens when they are making application and tremendous pressure is

brought to bear on public health officers, boards of health or whoever

may be responsible, to be followed by, perhaps in a generation or in a

decade, complaints that the system has failed.... I'd be pleased to

look at the specifics. I know that in your area, particularly, some of

the subdivisions which were approved years back in marsh areas have had

some serious problems. I know the continuing difficulties we have in

northern parts of the province, where weather plays a more important

role than the capability of the soil to absorb. I will be pleased to

speak to our people responsible for that again and see if they have any

thoughts or suggestions. I would simply agree that if a system is

approved, there should be every reason to believe it will not fail

within the period of time it is expected to perform.

I appreciate the member's comments with respect to some of the adult

day-care centre experiments we have conducted in that area. We are

cautiously moving forward in certain other areas as alternatives, but I

think it is the nature of the business of health that you are generally

more cautious than perhaps some people recommend. I think it's

worthwhile to be cautious.

On extreme hardship cases for extended care, of course the Ministry

of Human Resources can be involved. We're always prepared to look at an

individual's circumstance, because there could be extreme hardship that

may not have been identified. I believe there is still legitimate

reason to have a per diem charge for extended care. Most provinces have

it. In extreme hardship cases we're always prepared to look at an

individual case, and in certain circumstances the Ministry of Human

Resources can be involved.

MR. MITCHELL: The minister asked for specifics. On October

30, 1984, the Sooke forum council sent him a letter outlining the case.

He passed it on to the Minister of Environment (Hon. Mr. Pelton), and I

have a copy of the Minister of Environment dated January 14. So

somewhere in your computer or in your files there is a complete report

on it. I can deal with the specifics.

The other case along that particular line is that we have a

malfunctioning septic tank in an apartment building. It is running over

the ground down into the river, and the health department has given

orders to have it corrected. The owner has filed some kind of legal

action against the health department, and everyone says they can't do

anything about it because there is legal action pending. At the present

time you have a septic field that is running over top of the ground and

down onto someone else's property, and because of some case before the

courts nothing can be done. They say it's a counterclaim, but I say

that this sort of legal manoeuvring cannot be allowed to continue to

happen.

Teeth have to be put into the legislation and into the ministry through their health officers. I'm getting fed up with

[ Page 5886 ]

going to health officers and inspectors and being

given a whole series of reasons why they can't enforce something. If

it's illegal, if it's not working, if it's unhealthy, why can't that be

corrected? We've gone up through that middle management, and somewhere

down the line I think that the minister should look at it and get it

straightened out.

HON. MR. NIELSEN: We'll do what we can. I share the member's

concern: when lawyers get into the act, even the simple disposition of

certain materials becomes complicated and mired in unnecessary actions

and counteractions.

Interjection.

HON. MR. NIELSEN: The second member for Vancouver Centre (Mr. Lauk) suggested we get rid of lawyers; is that the comment?

I'll be pleased to follow through with you, and we'll discuss that,

because sure, the legal process should not interrupt common sense. It's

probably contrary to the Charter if we were to interfere, but we'll

look at it.

MR. LAUK: In most areas of society, Mr. Chairman, if you left

it to the lawyers, the solutions would be found. It's trying to follow

our clients' instructions that gets us confused.

I knew I would have a devastating effect on the minister. Would you

like the minister of public works to outfit you with a Jolly Jumper?

Mr. Chairman, I have received a letter from a constituent, and I can assure you....

MR. ROSE: Is it the first one?

MR. LAUK: My colleague for Coquitlam-Moody suggests it's the first one I've received in 13 years.

Mr. Chairman, it's a unique letter because it's the first letter I

have received on this topic, although I have received several phone

calls from constituents complaining about precisely the same issue.

I'll read part of it, but I want the committee to understand that I'm

not at liberty to reveal the name or the hospital in question. It's an

example, I'll tell you from the outset, of the problem of having

hospital administrators and staff collect the per diem from patients

and instituting a system that does not bring about indignity to the

relationship between the patient and the hospital staff. I'll read this

letter in part.

"I was recently a maternity patient at..." —

such-and-such a hospital — "for the period...." — it was less than five

days. "I would like to complain bitterly

about their policy of harassment of patients for payment of their

rooms. On..." — and she names a date — "a woman from the discharge

office visited my room asking for payment of my room up to my day of

discharge. I told her I didn't have my chequebook with me, and neither

did my husband, who was visiting me at the time. I said my husband

would bring a cheque to them the next day at about 11 a.m.

"When he came to visit me at 9:30, I was paged by the nursing

desk and told that someone from the discharge office was waiting in my room

to see me. The same woman was again asking for payment. I told her that I had

already told her yesterday that my husband would be in about 11 this morning

and pay then, which is exactly what he did. The amount of the payment was $192.

I did not say anything to the woman as I felt she was only doing her job, but

I was furious. I felt I was being harassed and treated as if I was some sort

of deadbeat. My husband and I are both employed and always pay our bills promptly

and on time. However, I do not feel that that has anything to do with this situation.

Since I was a maternity patient, I wasn't exactly ill, but I think about

the people in that hospital that are sick. It's bad enough to be sick and

in the hospital, but to be treated as if you were some sort of criminal, which

is how they made one feel, is both deplorable and unnecessary. The use of the

word 'criminal' is how another woman expressed her feelings when they

did the same thing to her.

"I realize in this time of recession and high

unemployment that there are probably a number of people unable to pay

their hospital bill right away. But a sick person does not deserve to

be treated in this manner. I have always admired our system of

universal medicare as compared to that of the United States, but this

incident has certainly brought that opinion into question for me. I

hope you will look into this for me and see if something can be done to

remedy this deplorable policy."

[3:45]

As I say, Mr. Chairman, one letter does not a summer make, but I

have received many phone calls since the per diem policy has been in

place, and requested that they write. I suppose that when you do that,

a constituent forgets about it or their feelings subside in two or

three days and they don't get around to writing. This is one person

who, without a prior phone call, saw fit to take the time to write this

complaint. Now the minister cannot attend at every hospital and do the

collecting himself in his usual charming and diplomatic way, but there

must be some way in which the ministry can provide circulars or

information or training to people in a hospital setting. It's

inconsistent with the proper psychology of patient care to be running

around after them like a collection agency in the middle of their

treatment at the hospital. It's one of the other wrinkles, one of the

other problems, that arises because of the user-pay mindset of the

government. The penalties that we're all paying, not only in increased

taxation because the federal government has withheld grants because of

the government's posture in this regard.... But we're paying also in

this way, through these little indignities that amount to serious

humiliation for these people in the hospital setting. So I thought I'd

put it on the record and bring it to the minister's attention in the

hope that he or his officials could look into providing some sort of

training, memo, practice note or whatever it is that will assist

hospital staff in their relationship with patients vis-à-vis this user

fee and its collection.

HON. MR. NIELSEN: Mr. Chairman, we'd be pleased to, and I'll

get in touch with the member later; perhaps we can get the time, date

and hospital. No one should be subjected to any indignity or harassment

in any of our hospitals on questions of payment. I was rather surprised

at the procedure outlined by that member, and when we get the specific

information we'll be pleased to speak with the hospital and find out

why such a situation would have occurred and whether it's occurring

more frequently than that one time. I'm rather surprised at the way

it's been outlined. It could happen — I've

[ Page

5887 ]

no doubt about that — but we'd be very pleased to look at it specifically.

MR. BLENCOE: This issue is around the Queen Alexandra

Hospital. The provincial ministry approved a 25-bed unit for

adolescents with acute mental illness in mid-1983. Unfortunately that

project has been on hold ever since. There is a great need for this

kind of project. Some weeks ago I asked the minister in question

period; he said he'd get back to me. I wonder if the minister has any

response today, in terms of the funding for this project.

HON. MR. NIELSEN: The funding has not been approved at the

level whereby it would then go ahead. It is still in the application

stage, if you like; it has not received its final approval. We're

familiar with the project, but it has not been approved.

MR. BLENCOE: Will this project be approved in the near future? Can the minister give an indication of that?

HON. MR. NIELSEN: Mr. Chairman, much as I would like to, I cannot give a date. I'm sorry.

MRS. DAILLY: Mr. Chairman, I will be the last speaker on

health in this estimate — just to let the minister know he can rest his

back shortly — except for the member for New Westminster (Mr. Cocke),

who will be bringing up a few areas in health and then moving on to

ICBC.

The areas that I want to finish off with today.... One of them is to

do with amalgamation. I know that the minister brought in amalgamation

in 1984. The reasons for bringing it in were, of course, that it would

be more efficient and cost-saving all round. It was supposed to be a

positive move. Naturally the opposition was ready to look at any

positive move. Well, we've now had an opportunity to study it a bit.

Our main concern, as you remember, was the loss of local input and

local autonomy, but we were ready to go along with the idea of overall

organization, etc.

The only question I have to the minister is.... When I look at the

Fraser-Burrard Hospital Society diagram of their organization, I have

to ask the minister a question. In retrospect, does he really think

it's cost-effective, these new structures? If you look at this.... I'll

just go through it quickly. You've got the board of trustees on the

top, of course; you've got the president, employee relations, the

vice-president of corporate services, the vice-president of direct care

services, the vice-president of direct care services and planning, and

then another vice-president of medical services, and on and on; another

vice-president of finance administration. Underneath all these

vice-presidents we have another whole bureaucracy. I'm just saying to

the minister: perhaps the time has come to evaluate this. If we're

going to end up losing local control and the positive things that went

with that in hospitals, and turn it over to this kind of thing, are we

not just turning it over into another huge bureaucracy? I wonder if the

minister has felt any concern about that.

The next question. I was absent this morning, attending the dental surgeon, getting my practical experience for the estimates.

HON. MR. NIELSEN: Not covered by the plan.

MRS. DAILLY: Unfortunately, no. Maybe someday.

So I'm not sure whether the hole in the ground at St. Paul's was

discussed. Has anyone asked you about it? I wonder if you could give us

a progress report on what's happening at the St. Paul's Hospital. We

are all aware that it was approved by you in April 1983. It's still top

priority with the Greater Vancouver Regional Hospital District. It is

needed to replace.... Not the hole is needed, but the building to go in

the hole is needed to replace the obsolete facility. I was wondering if

the minister could give a report on that. It is causing people some

concern.

Fm pretty sure the minister received an excellent report from the

Medical Association, done in 1984, on health education in B.C. schools.

I just wanted to bring it to his attention, as it brought up some

excellent points, primarily to be dealt with by the school system.

They're all connected closely, of course, with health needs. Just

briefly, I would like to know if the minister agrees with these points.

The major points were that they advocate again that there should be

compulsory physical education in the schools, as they consider it most

important. They are also very concerned about possible error rates in

medication distribution by teachers, and the teachers are concerned

too. My point is inadequate training, Mr. Minister, of teachers who are

often asked to give medication to students.

They are disturbed about the increase in student death, which is

very tragic. They are also very concerned about the lack of family life

education, or sex education, in the schools, and the increase in

pregnancies. I wonder if the minister had time to examine this report

himself, and if he agrees with the Medical Association that these are

vital areas today that should be dealt with in the school curriculum.

One more is nutrition. There is concern that the teaching of

nutrition in our schools, which would inevitably help produce citizens

who in turn could perhaps save health costs, is not being encouraged

enough. About half the schools are really involved in the teaching of

nutrition. So that was the other area.

I have one final question for the minister before I sit down. The

minister referred to it himself in his own speech. We agree with him on

the importance of changing lifestyles so that people have an individual

responsibility for looking after themselves and keeping costs down. Of

course we're talking about fitness, about easing up, if possible, on

tobacco, Mr. Minister, and alcohol, etc. The point is that the minister

knows what I'm talking about, and we encourage it on this side of the

House.

But I do want to make this point at the same time to the minister.

It's rather ironic, but at the same time as we, who might be considered

a comparatively affluent group of people in this Legislature, are

advocating people to go for a healthier lifestyle, I think what we have

to remember is that the choice of a good new healthy lifestyle is

really an empty one if it is, as it is today, severely limited by

unemployment and poverty.

I think this is the irony the Minister of Health faces. He is

advocating a new and healthy lifestyle, but at the same time, because

of the recession in this province — and this is true in other areas

that are suffering from high unemployment — his ministry is being faced

every day with people who don't have that choice. We are finding that

there is greater alcohol abuse, increased child-battering,

wife-battering and bitterness in homes. We are finding more violence

among the youth, divorces, poor diets, unhealthy children. All of

these, the minister knows as well as I do, are the results of high

unemployment and a period of time that we are now embarking

[ Page 5888 ]

upon where we seem to be getting more of a difference between the very rich and the very poor.

So I would say to the minister that this is hardly the time to be

cutting back in areas where we need to beef up — treatment centres and

so on for alcoholics, and social workers. I know this doesn't all come

under Health, but some of it does. I am particularly concerned that at

this time, when we have more teenagers under stress because many of

them come from families who are under stress, we find examples under

his ministry of.... For example, the adolescent unit at Vancouver

General Hospital has been closed down for several months. Most young

people who have been there, and I've talked with some, have said that

without the assistance of that ward — and I pay credit to those who

established it, and to the fact that some of it was under the minister

— they probably would have ended up taking their lives.

[4:00]

So I say to the minister, even though I understand that they say

they'll be taken care of, the greatest reason for keeping this going is

that these young people are with their own peers. If I understand

correctly, when this is closed we will be moving them to a general or

more adult ward. I say to the minister that you really have this

responsibility at this time to emphasize these areas of prevention

because of the situation in this province where they have never been

needed more. So I would ask the minister specifically to do everything

he can to keep up, particularly, the area for adolescent treatment. I

am concerned about the Maples area, where apparently there are great

waiting-lists and so; that there should be any closing back in those

areas. So will the minister give some assurance that as Minister of

Health he too is concerned and will try to keep these things open and

expanded?

HON. MR. NIELSEN: We would be more than pleased to look at

the bureaucratic structure of the Fraser-Burrard society and run it up

against all the other hospitals that we have for peer comparison. We

don't want any of them to become over-bureaucratic. We think there are

methods of improving systems without necessarily adding to the

bureaucracy. So we'd be pleased to look at that to see whether they've

actually developed new programs or developed new fancy names.

The hole in the ground at St. Paul's Hospital has been stabilized.

The slope stabilization program is complete. We do not have the funds

at the moment to go ahead with construction; I think it's a $59 million

project. I would like to see it go ahead. I would like to see the

replacement. I agree that some of the wards at St. Paul's are very

antiquated and we would like to proceed with the next phase of that

project. We were pleased to be able to open one of the phases. We'd

like to go ahead with the next phase as soon as the money is available.

St. Paul's plays a very important role in that area of Vancouver and

that part of the province, and we'd certainly like to see it upgraded

and modernized.

We are discussing the health education package with BCMA — their concepts and

ideas. I share concern in these areas. I certainly am a strong advocate of education

when it comes to lifestyle and health care. I think we underutilize the possibilities

of our school system. I don't know whether we can make some of these things

compulsory. The Charter of Rights probably says you can't, but I certainly

believe that we should work with the Ministry of Education to try to get as

much of this information before the student body as we can; start there to try

to resolve some of the identified problems of our ministry and that the Ministry

of Human Resources discovers. I agree in those general categories that we should

be utilizing the curriculum to transmit this information. So we are going to

be working with the BCMA with respect to that. I believe some meetings have

been set up.

The problems associated with recession and other influences on

society are obviously very real and do have an effect on our ministry,

along with Human Resources, Attorney-General, Education and so many

others. We will pay particular attention to the highly sensitive areas

of the ministry — responsibilities such as the adolescent psychiatric

wards or treatment centres. Yes, we are quite sensitive to them. At the

Maples, as an example, we are proceeding as quickly as possible to

complete the final nine-bed phase of the secure unit. The Young

Offenders Act has, if nothing else, also required that additional

action be taken.

The treatment centres for adolescents are a particular concern.

Vancouver General Hospital has assured me that those youngsters who may

require treatment during the period of time that they'll be closed in

the summer will receive adequate treatment. They have guaranteed that

that will occur. I can assure the member that I would not authorize the

closure of the unit unless I had that assurance. They have assured me

that they will be able to respond quite properly to any youngsters who

may require treatment at that time. I accept that one point which the

member made about peers in the ward, and that it might be uncomfortable

or a bit difficult for a short period of time for an adolescent to be

in an adult ward. I'll take that matter up with the psychiatrists and

administrators of the hospitals. They have assured me that the service

will be there, and it will be quite proper service for them.

I think that covers off those points. I might add, Mr. Chairman,

that the member mentioned my bad back. When she reaches my age she

probably will have the same problem.

MR. COCKE: I concur with the minister. Certainly from time to

time I share his affliction, so I kind of have a sensitive spot in my

consciousness — and in my back — about the whole question.

Mr. Chairman, just a word or two about the whole question of health

care. I'm not going to be dealing with ICBC for five minutes, Mr.

Minister.

[Mr. Ree in the chair.]

First, let me make an observation vis-à-vis this report from the

medical association that the member for Burnaby North (Mrs. Dailly)

just brought up. I now understand why the Minister of Health got rid of

Action B.C. two or three years ago — for all the research they did and

all the first-class work they did. For example, they were finding out

that if children in our schools have one hour a day of physical

education or physical activity, despite the fact that they miss some

academic time, they are physically better at the end of the year, and

they also get better marks at the end of the year than those in the

control situation. We've done that experiment, we found that out, and

what did successive Ministers of Education do with it? Absolutely zero.

Now they're saying that it's not even an essential element of school

activity — the most nonsensical, stupid way of handling information. I

wish the Minister of Health would get back into that activity, doing a

number of other things along the lines of Action B.C. I

[ Page 5889 ]

realize that there was a bit of testiness towards

it because we set it up. In any event, it should be done again, and it

should be out there providing that kind of leadership in terms of real

preventive work.

Mr. Chairman, I just want to make another observation. I think the

minister is absolutely taking the folks who go to the hospitals in this

province to the cleaners. Let me tell you why. He's accepting user

fees. He'll be accepting user fees to the tune of millions and millions

of dollars until 1987. If he accepts user fees longer than that, then

he forfeits the multi-millions of dollars, dollar for dollar, in

federal contributions. This way he gets it both ways. He's going to get

it out of the patients; he's not going to pay it back. By 1987 he's

going to have a change of heart, and that change of heart will give him

the best bang for the buck that one ever heard in one's life. Isn't

that what the minister is doing? I believe so. I believe that the

minister will have a magical change of heart in 1987. I don't know what

minister it will be by then. But by 1987 a policy reversal will take

place. The feds will make their entire contribution for the whole

three-year period, which will be $3 million a month for three years —

something like that; somebody else add it up. It's a nice large sum.

When the time comes, I hope somebody remembers where they heard it

first.

One word about Dr. Clein at the Royal Columbian Hospital,

Incidentally, I have been privy to the Fraser-Burrard Hospital Society

and its magical growth in terms of bureaucracy. Its magical growth is,

of course, largely because of the fact that you haven't got one single

member on the Fraser-Burrard hospital board from the city of New

Westminster, the city that put that hospital together and held it

together all these years. And this government had the temerity to come

along and discharge everybody on that hospital board who was resident

in New Westminster. Let me tell you why. They suspect that some of

those folks might have voted for me. I wouldn't blame them. In any

event, that's the way it is.

HON. MR. NIELSEN: They said they didn't.

MR. COCKE: They said they didn't, but 60 percent do, Mr. Minister.

I suggest that that whole question of Royal Columbian Hospital be

looked at fairly carefully, because I do believe that Dr. Clein, the

neurosurgeon there, was very badly handled. I think that Dr. Clein

should still be there on staff. We are the trauma centre for the whole

lower mainland. There's no question about that. We get more trauma at

the Royal Columbian than anywhere else. Every accident from the PNE

right out to Hope heads straight for the Royal Columbian Hospital

because of the geographies of the situation. It wasn't my intention; it

was just by accident that that happened. But anyway, that's it. Okay,

that's Dr. Clein.

I also want to ask the minister something about the hospital

situation here in Victoria. You've combined the administration. I'm not

going to ask you how much you saved. I'm going to ask you how many

additional bucks it's costing for the administration of these two

hospitals under this new organization.

One last question in this particular area: how many new beds has the

minister built in this province and not opened? How many are still

sitting there without being opened?

HON. MR. NIELSEN: Mr. Chairman, I cannot give the number of

beds which may have been constructed over the last number of years and

are not operating. I would have to do some research into that. In many

instances they were replacement beds, but I'll have to try and dig

through that. I know there are some in Richmond which have not been

opened, but then there are some which were opened and other beds were

closed to compensate.

I'm told the Victoria amalgamation administration costs are not

greater than they were previously. Again, I'd have to get specific

numbers to come up with that. But I'll take a look at the number of

beds. This is a very specific question, and I simply do not have the

answer at this time. But I'll be very pleased to find out how many are

empty — previously constructed in the last couple of years; projects

which have been completed but not opened. I'll have to do an inventory

on that and get the information over to the member.

I certainly will have a pretty thorough look at the administrative

costs of Fraser-Burrard and see what is going on. I hope it's all well,

MR. COCKE: I take it the answer to the user-fee question was

in the affirmative. That's okay, Mr. Minister; I'll just ask you

another question.

The most confusing.... We're getting used to it around here. There

was a day when estimates came out, and you could always follow them

because you could contrast figures from the year before and so on. Now

they've switched them around like crazy. There's just no possible way

you can compare last year with this year, or certainly the year before

that.

[4:15]

I'm going to ask something about emergency health services. Why do

supplementary salary costs — that's account classification No. 2 —

increase from zero to $4,413,300? Why do fees, allowances and expenses

— that's account classification No. 7 — increase from zero to $88,507?

Why have utilities, materials, supplies and equipment, operation and

maintenance increased from $1,795,539 to $7,331,719? Are we purchasing

50 new ambulances? Have ambulance services increased by $2 million?

Where does the remainder of the increase go?

HON. MR. NIELSEN: The ambulance service increase of $2.2

million is the result of an '84-85 reduction option to eliminate fire

station contracts. That was not implemented previously. There was an

unbudgeted wage settlement of $0.9 million; unfunded staff, $0.2

million; and material inflation of 6 percent, another $0.2 million.

That is on the ambulance service.

The asset acquisitions. We have been given authority for the

production, I believe, of 56 ambulances, is it? Twenty percent of the

fleet is to be replaced — 73 ambulances — on an annual basis. In

1985-86 we'll be able to achieve this rotation target. So we are going

to have $1.6 million worth of 50 ambulance units, and $0.2 million for

telecommunications equipment offset. But we're having a major turnover

of some of the ambulances in this year for 1985-86. That is the asset

acquisition.

Did the member ask about the grants and contributions as well?

Interjection.

HON. MR. NIELSEN: Good.

[ Page 5890 ]

MR. COCKE: I'm just worrying about my baby, Mr. Chairman — the emergency health services.

Okay, I'm prepared to go to ICBC now.

MR. ROSE: I'd like to ask a question of the minister on how

much of the increase in EPF health funds have accrued to the ministry

this year over last year. I understand that this year's contributions

are supposed to be something like 7.14 percent higher than the previous

year. Have all the funds destined through EPF for Health actually ended

up being used to finance health care?

HON. MR. NIELSEN: That would be knowledge the Minister of

Finance would have. We receive all our funding from consolidated

revenue. I don't know what the precise total of that EPF amount would

be from the federal government, or how they designated a certain amount

for Health, but the budget obviously far exceeds whatever that amount

may be. We estimate that the federal government covers approximately 42

percent of our operating costs for hospitals and Medical Services Plan.

MR. ROSE: It is alleged that the universities are actually

paid for fully by the student fees of roughly 16 percent, and for this

year, because of the increased size of the EPF grant, British Columbia

actually makes money on the EPF in terms of its own budgetary amounts.

I understand the minister when he says he gets the amount of money

that is turned over to him from Finance, and it is his assumption that

it's 42 percent paid for by the feds and 48 percent by the province.

But is the minister aware of the precise amount that comes under EPF

for health and post-secondary education, and is he assured that those

amounts are not laundered through the Ministry of Finance and not end

up in Health at all, but are siphoned off for some other government

priority?

HON. MR. NIELSEN: Forty-two and 48 is 90 percent, so it would

be 42 and 52. We have every reason to believe that the money allocated

within EPF, although the Minister of Finance does not agree with the

federal contention that there are designated amounts for health or

post-secondary education.... The Minister of Finance considers it to be

a grant under that formula without strings attached.

Our budget will exceed $3 billion this year. The blue book budget is

$2.67 billion or so, and that is far in excess of the total EPF

transfer. Our calculation shows about 42 percent contribution from the

federal government with respect to the costs of medical services and

hospital programs.

MR. COCKE: Well, Mr. Chairman, a few months ago in this House

I spoke about ICBC and the proposition of selling off the general

insurance aspect of ICBC. The then minister in charge of ICBC — who is

now walking in or out, and who knows and who cares? — decided to

totally ignore responsible suggestions concerning that whole question.

Well, those businesslike tycoons over there on the Socred side goofed

it to no end. It was a stupid, absolutely ridiculous proposition, and

no wonder, coming from the member for Boundary-Similkameen (Hon. Mr.

Hewitt).

HON. MR. HEWITT: I'm your MLA. Remember that.

MR. COCKE: Yeah, I've a summer place up there, just for those who wonder why he's my MLA. Believe me, he's never had my vote.

MR. CHAIRMAN: Order, please. Through the Chair to the Minister of Health.

MR. COCKE: Order? Certainly, Mr. Chairman, I'll be orderly.

I'll be orderly as they were disorderly, Mr. Chairman, in selling off a

paying proposition, a window on the entire general insurance industry

and keeping the industry honest. I suggested at the time that it was

the wrong thing to do. I can remember, Mr. Chairman — and we'll

probably see that day return — when people who were outside of a fire

district in this province could not buy insurance for love nor money

from the private insurers. Now we're back to the bad old days. And in

going back to the bad old days we even lost money on the transaction,

according to Der Hoi-Yin, business columnist.

Interjections.

MR. COCKE: Yes.

MS. BROWN: I wouldn't attack her.

MR. COCKE: No, I wouldn't attack Der Hoi-Yin. She has been

attacked before, Mr. Chairman, and those attackers were sorry that they

ever thought of attacking her.

Mr. Chairman, she claims — and there's no question about it — that it was worth $14 million. You got $9 million.

HON. MR. HEWITT: Nonsense!

MR. COCKE: Nonsense. What's a few million here and there?

C.D. Howe said it, and C.D. Howe went down the tube. And that's what is

going to happen to this government because of their carelessness in

handling the people's business. Absolute carelessness.

Mr. Chairman, it was good business. It wasn't going out and doing

anything more than keeping the insurance business very honest in this

province — very much cared-for, by virtue of the fact that ICBC were

involved in it.

AN HON. MEMBER: Are you saying that the private insurers are dishonest?

MR. COCKE: I'm saying that the private insurers are in there

for profit — P-R-O-F-I-T. And however you make profit is good, as far as

the shareholders are concerned. If they get together and decide that

they're riot going to insure certain people or certain groups, they can

do it.

We've seen it all before. What are we talking about? Don't think

that I'm standing up here giving some brand new revelation. These are

the kinds of things that do occur and have occurred, and why wouldn't

we guard against them? No, no, let's sell it off. And in selling it off

we took a real royal taking to the cleaners.

This reminds me. We were talking a minute ago about the hole that

they've built for an extension of St. Paul's Hospital in the West End

of Vancouver. Now if the Minister of Industrial Development or — wait a

minute — the Member for South Peace River (Hon. Mr. Phillips),

Industrial Trade, or Trade and Industrial Development or whatever that

ministry

[ Page 5891 ]

is, if it is every formed.... If he were to have his way he

would take a coal-mining company in there and buy that empty hole. Then

we'd be out of the problem, in the Health ministry, of what you're

going to do with it. But we know about the lemons, Mr. Chairman. The

Minister of Consumer and Corporate Affairs (Hon. Mr. Hewitt) was

instrumental in the selling off of a very profitable....

AN HON. MEMBER: Wrong,

MR. COCKE: Wrong, he says. They made profit every year, Mr. Chairman.

Interjections.

MR. COCKE: Mr. Chairman, isn't it marvellous that we have

members in this House, members who are being paid for out of the public

tax dollars, and they don't even realize that the Minister of Health is

responsible for ICBC. What homework they do in that that back bench,

and one a lawyer and one an engineer and all they do is sit around and

accept the bucks that they get and say they wish they were at home. No

wonder they wish they were at home.

Mr. Chairman, I'd like to know how this minister feels about the selling off of the general insurance aspect of ICBC.

MR. NIELSEN: Well, Mr. Chairman, it's a fait accompli. I

think it was the proper thing for the ICBC corporation to do, The

member mentions a couple of points — that it was making money. It's

awfully tough to sell something losing money. If you are going to put

something on the market, you have a far better opportunity of selling

it if indeed it is a profitable enterprise. So that perhaps was the

reason why the Cumis corporation made an offer on the general insurance

aspect of ICBC. It may be a difference in philosophy, but I do not have

an automatic belief that any person engaged in private enterprise or in

making a profit is not to be trusted. I think that if we were to

automatically have the opinion, as the member somewhat suggested, that

simply because a person is motivated by profit he can't be trusted, or

that because they are a private corporation they can't be trusted, that

would be a sad reflection on the reality of our country and our people.

I think we have adequate ability through our agencies to ensure that

corporations are functioning in accordance with the law and with

regulations. If they are not, there are suitable punishments available.

But I don't think we need a spy among them to ensure that they're going

to operate correctly.

[4:30]

The general insurance division was sold to the Cumis corporation. It

is no longer ICBC's responsibility. The government is not involved with

it directly or indirectly. It will provide the coverage. The terms of

the sale would call for that guarantee, so we feel that it's going to

function quite well. I haven't heard that it's causing any difficulties

so far. As far as I know, it's working quite well. It's certainly

consistent with the government policy of selling off various

arm's-length Crown corporations and getting them back into the private

sector where they properly belong.

MR. CHAIRMAN: The Chair from time to time allows members a

certain bit of leeway in their questioning, but I'm sure the member is

well aware that normal questioning should not involve events in the

ministry that took place under a former minister.

MR. COCKE: Why?

MR. CHAIRMAN: It's well-established parliamentary practice.

MR. COCKE: Mr. Chairman, is ICBC still a Crown corporation? Is the Minister of Health the minister responsible for this Crown corporation?

MR. CHAIRMAN: I'm not saying you cannot discuss ICBC, Mr.

Member. What we're saying is that you cannot discuss specific actions

of a former minister who is no longer responsible for that ministry or

that corporation.

MR. COCKE: I am amused. I've never heard of this before in my

cotton-pickin' life. If you can't criticize a Crown corporation for

what they did.... You know, I'm still criticizing the Social Credit

government for what they did with the two rivers policy, and so on and

so forth, and I think that's quite in order.

But, Mr. Chairman, it's interesting that the difference in

philosophy.... Der Hoi-Yin says: "Is philosophy everything? Certainly

not to bottom-line-oriented free-enterprisers." She's hardly a harsh

critic. Mr. Chairman, there was no answer on that, nor will there ever

be. The fact of the matter is, it was a mistake.

[Mr. Strachan in the chair.]

I was interested that some time ago we had a piece of legislation

before the House — it was recommended by ICBC at the time — about

radar-detector sales being banned. It was withdrawn from the

legislation. And then, hosanna! a number of retailers came out and

gratuitously said they wouldn't sell them anymore. Now imagine this

assembly or this government, which put forward the legislation, being

so terribly lacking in courage as to leave that in the bill so that it

could become law in this province and let industry.... That isn't

all of them, as many retailers are still selling and can sell the radar

detector.

I just give you this as an indication that we should be listening

more to ICBC in the future and discussing things with them. For

example, they said — and the Ministry of Transportation totally ignored

it — that we should not abolish motor vehicle testing, and they said

that there would be so many more accidents as a result of doing away

with it. And it's happening. It's got the Minister of Highways (Hon. A.

Fraser) so embarrassed now that he's out on the highways checking the

trucks and cars one by one: have you got brakes, sir? And if you

haven't, tut tut.

You know, Mr. Chairman, that's a very powerful corporation, and I'm

very proud of ICBC — most aspects of it. I'm not proud of some of the

leadership that's been given it by the government, but I'm certainly

proud of the way they act. They have the stars. They are the people

paying for the claims, and we ignore their recommendations. The

minister says they don't know everything. Well, Mr. Chairman, we should

be listening to them. I hope that this minister will carry the ICBC

message among his colleagues a lot stronger than the former minister

did.

Mr. Chairman, I wonder if I could ask the minister one more question about ICBC rates. There was a rate break....

[ Page 5892 ]

Interjection.

MR. COCKE: I don't know why I keep answering that poor little

member who doesn't even know who is responsible for ICBC. I must

chastise myself from time to time.

There was a reduction in rates for young, first-time drivers who had

gone through driver training. It was said that that rate shouldn't be

reduced by virtue of the fact that there were more accidents and so on.

I wonder if any further studies have been done since that reduction of

rate was taken away.

HON. MR. NIELSEN: Apparently there was one survey or

examination after that change was made, and it showed basically no

difference between the two categories of drivers with respect to

incidence of accidents. There apparently was one examination after

that, and the results were that those who had the training and those

who had not basically showed no difference in their incidence.

MR. COCKE: Mr. Chairman, this minister is new at ICBC. I

congratulate him on his being made responsible for ICBC, but I hope

that he will be responsible for it, as opposed to some of what we have

seen in the past. I feel that the Insurance Corporation of British

Columbia has a very bright future. It provides good service. Sometimes

I get sick to death of the hassles that we go through with claims.

Sometimes it's almost as bad as workers' compensation. I do think that

we had better be much more careful in claims-handling. There is a

tendency, in my opinion, to see to it that both people involved in an

accident are partly responsible, so that they both lose the

safe-driving benefits.

I'm going to leave this for the next session with this minister.

Hopefully he's still the minister in charge of ICBC. Frankly, I don't

know how you've got the time. In any event, good luck to you.

MS. BROWN: I just have one question on ICBC, and it deals

with a number of calls I received in my office. I got a letter that

says it quite well, and it's from a person who is on handicapped

pension and therefore has very limited resources. His problem is a disc

operation. He's not confined to a wheelchair, so the law as it affects

wheelchair people doesn't apply to him. He's on a handicapped pension,

so he's eligible for that, but he's still not allowed to pay for his

insurance on the instalment plan. He is wondering why you don't just

use the same eligibility requirements that the Ministry of Human

Resources uses for defining a disability, because in order to be

eligible for a handicapped pension under Human Resources, believe me,

you have to be very much disabled. He says his car is 19.5 years old.

He hasn't had an increase, as you all know, in his handicapped pension

since October 1983, and he is still expected to come up with the whole

sum of money when his insurance comes due in February. I wonder if the

minister is giving any thought to expanding the definition.

HON. MR. NIELSEN: I haven't, but I'll look into that and talk

to officials of ICBC about how it might affect a person in that

situation. I'm not familiar with it.

MRS. WALLACE: I have a question that I would like to raise

with the minister. I wrote to the former minister a year ago and never

got any answer.

Interjection.

MRS. WALLACE: Oh yes, it's true. So I hope you're going to do better than that, Mr. Minister.

The problem occurred when one of my constituents was told by ICBC

that he had the wrong classification. He had his car insured at the

business classification, and then his job disappeared, like so many

jobs have in Cowichan, and he was unemployed. So he changed the

category to pleasure driving only. Eventually he got a job that started

as a part-time job, and with the pressure of funds and so on, he didn't

get around to changing that category. I think it had been a period of

approximately six months from the time he first started back to work on

a part-time basis until he had an accident.

He has been told by ICBC that he has to pay the towing charges.

Those charges amounted to a total of $1,459.15. That included the

towing and the loss. He was billed for this $1,459.15 just because he

did not get around to revising his category from an 001 to of an 002

classification. That seems a pretty harsh penalty to me for someone who

is in that situation. It's exactly the same penalty if you were driving

while impaired and were involved in an accident. Your insurance policy

doesn't cover, so you would be charged exactly the same in that

instance for the towing and the loss — and rightly so, if that were the

case. But it seems to me to be totally unfair that the same penalty is

applied to a person who, for six months, when he had a part-time job

for some three or four months of that and just hadn't gotten around to

making that revision in their insurance policy....

I'm sure you would recognize that a person who had been unemployed

for some time might find it very difficult to come up with that cash.

It would be something that you would just avoid doing. He knows it was

wrong, that he should have had that done. He didn't have it done. He

resents the fact — and I do too — that he has to pay exactly the same

extra cost as a person who had been impaired and was charged, and had

no insurance coverage. That seems unjust and unfair to me, Mr. Minister.

Vote 37 approved.

Vote 38: management operations, $66,615,137 approved.

[4:45]

Vote 39: Medical Services Commission, $588,602,983 — approved,

On vote 40: preventive and community health care services, $217,313,447.

MS. BROWN: Just to restate my comments of yesterday, it's not

good enough if it's the Minister of Health. The portion of that budget

spent on prevention and community health should be larger. I hope that

in future years either this minister or future ministers will undo this

wrong: too much money going on sickness, not enough going on health.

Let's do something about that, Mr. Minister.

Vote 40 approved.

Vote 41: institutional services, $1,794,176,742 — approved unanimously on a division.

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