1981 Legislative Session: 3rd Session, 32nd Parliament

HANSARD

The following electronic version is for informational purposes only.

The printed version remains the official version.

Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

TUESDAY, JUNE 16, 1981

Afternoon Sitting

[ Page

6211 ]

CONTENTS

Routine Proceedings

Oral Question

Hiring of Frank Ogden. Mr. Hall –– 6212

Appointments to Council of the 80s. Ms. Brown –– 6212

Alleged loophole in Residential Tenancy Act. Mr. Lauk –– 6213

Meeting between Douglas Heal and Premier. Mrs. Dailly –– 6213

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

On vote 106: minister's office –– 6214

Mr.

Hanson, Mr. Gabelmann, Mrs. Dailly, Mr. Passarell, Mr. Lorimer, Mr.

Barber, Mr. Howard, Ms. Brown, Mr. King, Mr. Stupich, Mr. Levi, Mr.

Lauk, Mr. Cocke

Division on an amendment

On vote 107: administration and support services –– 6226

Mr. Cocke

Division on any amendment

On vote 109: direct community care services –– 6227

Ms. Brown

On vote 115: building occupancy charges –– 6227

Mr. Cocke

Division on an amendment

On vote 116: computer and consulting charges –– 6227

Mr. Cocke

Division on an amendment

Committee of Supply; Ministry of Lands, Parks and Housing estimates. (Hon. Mr.

Chabot)

On vote 149: minister's office –– 6228

Hon. Mr. Chabot, Mr. Gabelmann

Tabling Documents

Ombudsman's special report number 2.

Mr. Speaker –– 6231

British Columbia Buildings Corporation report for the year 1980-81.

Hon. Mr. Wolfe –– 6231

The House met at 2 p.m.

Prayers.

HON. MR. BENNETT:

Today is a very special day for one of the members in this House, a

member who is important to us all. Mr. Speaker, I'd like to take this

opportunity, on behalf of all the members of the Legislature, to wish

you a happy birthday. I want to give you the pledge that from now until

the end of the sitting we'll be on our best behaviour to make your job

much easier.

MR. SPEAKER: Thank you.

HON. MR. HYNDMAN:

In the members' gallery today are two very keen students of public

affairs in our province. They are Sandra Chamberlain from Richmond and

Mark Snider from Burnaby. Would members join me in welcoming them.

MR. RITCHIE:

I'm very pleased to introduce to the House Mr. David Barber, who is

Washington correspondent with the New Zealand Press Association. I ask

the House to extend a warm welcome to him.

HON. MR. VANDER ZALM:

In the precinct today is a group of fine students from the Cloverdale

Elementary School. On behalf of myself and the second member for Surrey

(Mr. Hall), I would like the House to welcome them.

HON. MR. HEWITT:

In the gallery today, I think — he was here a moment ago — is my young

son Ron. With him is his friend Guy Weeks. Although I can't see them,

they're probably up there somewhere. I'd ask the House to bid them

welcome.

MR. LAUK: Under standing order 8, I wish to

draw to the Speaker's attention that the Minister of Labour (Hon. Mr.

Heinrich) is not yet in his place. We have questions for him in

question period, and we're very concerned that that standing order is

not being complied with. It might be appropriate for the House to refer

this matter to the standing committee on rules, and perhaps have some

form of ringing the division bells half a dozen times or so, so that

these ministers can find their way into the chamber for question

period. I feel that it's critical during question period that all

members of cabinet should have taken their places. We know that they're

available; they should be in the precincts. Under standing order 8, I

would ask that you ring the division bells.

MR. SPEAKER:

The procedures of the House have been rehearsed quite frequently under

standing order 8. I think the member is well aware of the provisions.

MR. HOWARD: On a point of order, standing order 25, dealing with the

routine business of the House, indicates what the ordinary daily routine of

business shall be. On April 29, Mr. Speaker, I raised a point of order about

standing order 25. At that time I suggested that the standing order was not

being adhered to in that the specific items thereunder — namely, presenting petitions,

reading and receiving petitions, etc. — were not called by the Chair, thus not

affording members of the House an opportunity to take

part in those particular

subheadings of routine business.

April 29, which was some weeks ago — and I don't say this in a critical

way — Your Honour undertook to reserve a decision on the point of order

that I raised at that time. As of today Your Honour has not yet

returned to the House with a decision. I think that that tardiness — if

I can put it respectfully — in not returning to the House with a

decision has placed members in the somewhat awkward position of not

knowing just how they should proceed when routine business is dealt

with in the House. Items under routine business, as I said, are

presenting petitions, reading and receiving petitions, presenting

reports, motions, adjourned debates, etc. This leaves the House in the

position of not having an opportunity to wonder why the Minister of

Labour, for argument's sake, is not in his seat today, and whether or

not he is even in the cabinet after the fiasco we went through

yesterday. But I do raise it as a point of order, Mr. Speaker. I raised

it on April 29. It is now the middle of June, and no ruling has been

forthcoming from the Chair about that matter.

MR. SPEAKER:

Hon. member, the procedures on routine matters are those which we have

followed as long as the memory of the Speaker will reveal. These are

the practices we have followed. Any deviation or review of those

practices can fall into question at any point in time. Questions which

are being raised by the member and those which have flowed from other

points of order are all matters which the Speaker is considering and

has indeed invited the commissioner to review under the Legislative

Procedure and Practice Inquiry Act. That report is not prepared now; it

may well not be prepared before the end of this session. Undoubtedly

there will be several suggestions flowing from that review which I

would trust would be committed to a committee of the House for its

consideration. After all, it will be the House itself that will decide

on matters of such import.

MR. HOWARD: What is your

specific ruling about the point of order I just raised. though, Your

Honour? The point of order I just raised, Your Honour, is the same one

I raised on April 29.

MR. SPEAKER: And it is the same

matter, hon. member, which has been referred for consideration and a

full report to the Legislature when it is prepared.

MR. HOWARD: That is your ruling — that I have no point of order?

MR. SPEAKER: No, that's not a ruling at all.

MR. HOWARD:

Well, I'm raising a point of order with you now, Mr. Speaker. That is,

that standing order 25 is not being adhered to by the fact that

"presenting petitions" was not called by the Clerk at the table.

MR. SPEAKER: Fine, The practice of the House, to the length of the memory of the Speaker, has been adhered to even today.

MR. HOWARD: And that is your ruling?

MR. SPEAKER: That's the ruling.

[ Page 6212 ]

MR. HOWARD: I must challenge that, Mr. Speaker.

Mr. Speaker's ruling sustained on the following division:

YEAS — 28

Waterland

Hyndman

Chabot

McClelland

Rogers

Smith

Hewitt

Jordan

Vander Zalm

Ritchie

Richmond

Ree

Davidson

Wolfe

McCarthy

Gardom

Bennett

Curtis

Phillips

McGeer

Fraser

Nielsen

Kempf

Davis

Strachan

Segarty

Mussallem

Brummet

NAYS — 22

Macdonald

Barrett

Howard

Lea

Lauk

Stupich

Dailly

Cocke

Hall

Lorimer

Leggatt

Levi

Sanford

Gabelmann

D'Arcy

Lockstead

Barnes

Brown

Barber

Hanson

Mitchell

Passarell

Division ordered to be recorded in the Journals of the House.

MR. COCKE: On a point of order, Mr. Speaker, how many people are required for a recording? I saw two standing.

MR. SPEAKER: I think only one is required for that request.

Oral Questions

HIRING OF FRANK OGDEN

MR. HALL:

I'd like to address a question to the Provincial Secretary regarding

the use of Mr. Frank Ogden's media monitoring service by the

government. I'd like the minister to confirm to the House, if he could,

that he was approached by the Minister of Human Resources (Hon. Mrs.

McCarthy) to hire Mr. Frank Ogden, who is a personal friend of the

Minister of Human Resources.

HON. MR. WOLFE: In response to the member's question, no, I cannot confirm that.

MR. HALL:

The minister did however hire Mr. Frank Ogden and his monitoring

service. Did the minister or any of his colleagues consider any similar

service before hiring Mr. Frank Ogden, who is a personal friend of the

Minister of Human Resources?

HON. MR. WOLFE: I'm sure

the government information program service considered many alternatives

to try to provide better service in terms of news information that is

difficult to monitor.

MR. HALL: In all those "many" that the minister mentions, could the minister perhaps tell us one?

Interjections.

MR. SPEAKER:

Order, please, hon. members. The same rules of debate apply in question

period as do in the normal debate, and that is that the member having

the floor shall not be interrupted by other members across the floor.

MR. HALL:

The minister always looks inquisitively over to me when I've asked a

question. He's given a response saying that he is sure that his

ministry looked at many offers of providing the service.

HON. MR. WOLFE: No, I didn't say that.

MR. HALL: Yes, you did.

MR. SPEAKER: Order, please.

MR. HALL: I agree, Mr. Speaker. I should not enter into debate.

The

minister said he was sure that many were considered. I asked the

minister if he can name one service that was considered other than Mr.

Frank Ogden's?

HON. MR. WOLFE: I don't wish to correct the member. What I believe I said was that they must have considered many alternatives.

Interjections.

HON. MR. WOLFE:

The members don't like to listen to answers. They want to laugh and

jostle around. I'm attempting to respond to the member's question. I'm

sure that alternatives to the services offered by this gentleman were

considered. Perhaps the member could tell me of other alternatives

there are. I can tell the member that probably many firms in the

advertising field would be prepared to take on a similar service of

this kind, but it requires sophisticated equipment and is a very

tedious operation. I offer to the member that I'm sure alternatives

were considered.

MR. HALL: Then in view of his

answer, I wonder if the minister would give an undertaking to the House

to come back and give the House full answers to all the services that

were considered by his department in terms of providing this possibly

illegal monitoring service now being provided by Mr. Frank Ogden.

HON. MR. WOLFE: The answer is yes. I'll be glad to provide that.

APPOINTMENTS TO COUNCIL OF THE 80s

MS. BROWN:

My question is to the Minister of Human Resources. I know that Frank

Ogden was appointed by the Minister of Human Resources to serve on the

Council of the 80s. I wonder if the minister can indicate what other

members of the Council of the 80s have received government contracts so

far.

[ Page 6213 ]

HON. MRS McCARTHY:

I would not have knowledge of that. I think there are almost 100

members of the Council of the 80s. They have been chosen from all walks

of life in all parts of the province. They are a volunteer group who do

not receive funding in any way from the ministry. They serve on the

Individual Opportunity Plan, which is a program designed to assist

those on income assistance to become self sustaining and independent.

thank the member for bringing the question forward, because I'd like to

say that the Council of the 80s is doing a very remarkable job. In the

past couple of days, Mr. Speaker, I have knowledge of one council

member in the Surrey area who has spent countless hours and has been

particularly successful with about eight individuals whom they have

been able to help into total independence. I thank you for mentioning

their names, because we are very proud of the council.

MS. BROWN:

Certainly Mr. Frank Ogden is one person who has benefited from being a

member of the Council of the 80s. I notice that another member of the

council, Mr. Leonard Bawtree, has also been awarded a government

contract. I would appreciate it if the minister would take my question

as notice so that we can be up to date as to how many members of the

council are feeding from the public trough.

The minister

announced that the Council of the 80s was to be part of an effort to

encourage social assistance recipients to become gainfully employed and

therefore not be in receipt of government funding. In view of the fact

that both Frank Ogden and Leonard Bawtree are in receipt of government

funding, can we assume that the council has now changed its original

mandate?

HON. MRS. McCARTHY: For the member for

Burnaby-Edmonds to assume anything of the kind is a sad reflection on

the volunteers in this province — no matter what job they take on, no

matter what effort they make — who give of their personal time to serve

the people of this province, whether it be on the Council of the 80s or

in the many volunteer groups throughout this province which are

attached to my ministry, the Ministry of Health or any other ministry,

or in any community effort at all. Let me say that I'm proud of all

those people on the Council of the 80s, who are serving in a volunteer

capacity to help. Any time I can encourage anyone to serve in a

volunteer capacity, I shall continue to do so. I will give them credit,

as will our government and this side of the House, for giving of their

personal time. If it weren't for the many volunteers in this province,

we wouldn't have the quality of life we have.

I'd like to

thank Len Bawtree, who not only gives his time in voluntary service but

who served in this House. He was an excellent member of this House for

some time. I'd like to publicly thank Mr. Frank Ogden, who also gives

of his time voluntarily to the Council of the 80s. I'd like to thank

Mr. George Fierheller, the chairman of the Council of the 80s, who has

a very large business but finds time to give of his time voluntarily. I

will thank each and every one of the members, as I have before and will

continue to do. I don't need to apologize to that member or any member

of this House for the work they have done. I'm delighted to have this

opportunity to thank them publicly.

ALLEGED LOOPHOLE IN

RESIDENTIAL TENANCY ACT

MR. LAUK: I have a question

for the Minister of Consumer and Corporate Affairs. Last week I asked

the minister about a loophole in the Residential Tenancy Act with

respect to owner-occupiers giving notice to several tenants at 1967

Barclay. The minister took the question as notice. Has the minister now

completed his investigation?

HON. MR. HYNDMAN: On

Thursday of this week I would expect to be able to provide a complete

answer to the member. Tomorrow afternoon I'm meeting with the

rentalsman and several of my ministry staff. I want to take a personal

look at the documentation involved.

I can tell the member

that based on what I've seen so far, it appears that there is no

loophole. However, I'd like to defer a final answer until, I expect,

Thursday of this week. I want the member to know that the look I'm

taking is a very intensive personal look. I have requisitioned all the

documentation involved. As I said, it will be over here tomorrow with

the rentalsman and staff. I'll be personally working with them.

MR. LAUK:

I thank the minister for his personal intervention. While doing it, I

bring to the minister's attention by way of a question the fact that an

advertisement has appeared in the Victoria Times-Colonist and,

I think, in other publications from one Jim Ritchie of Century 21

Realty who is asking for owner-occupier investors just along these

lines to take advantage of what I consider to be an apparent loophole.

It may not eventually be one. Has the minister decided to take action

with respect to any other persons by advertising his finding that

there's no loophole and that such action will be discouraged?

HON. MR. HYNDMAN: My answer, which I hope will be down Thursday, will, I hope, deal with that as well.

MEETING BETWEEN

DOUGLAS HEAL AND PREMIER

MRS. DAILLY: I have a

question for the Provincial Secretary. Are you aware that your deputy,

Mr. Heal, is setting up weekly meetings in the Premier's office dealing

with what is called communication planning?

HON. MR. WOLFE:

Yes, I am aware of that, and I'm very happy that this type of.... The

members ask questions they don't appear to want answers for, Mr.

Speaker. Once again, I'm very happy that such a planning meeting does

take place.

MRS. DAILLY: Could you tell the House

why, if it is your deputy, who works under your jurisdiction, setting

up these meetings, you yourself are not directly involved in them?

HON. MR. WOLFE:

Quite simply, Madam Member, because I meet with Mr. Heal on a daily

basis and consult with him. I'm quite aware of the agenda for such

meetings and the results of them. It's simply not possible for the

minister to attend every particular meeting that goes on. I don't see

any great significance in the fact that I'm not participating directly.

I'm aware of the agenda and decisions that are made. It's an effort to

coordinate information programs with other ministries.

MRS. DAILLY:

We have sympathy for the Provincial Secretary, who seems to be so busy

he can't meet with his deputy, and yet the Premier has so little to do

that he is able to find time to meet with him. My question to the

Provincial Secretary is: if all the activity of Mr. Heal is apparently

being centralized under the Premier, or perhaps the Deputy Premier, why

does he still remain as your deputy?

[ Page 6214 ]

HON. MR. WOLFE:

This line of questioning seems to suggest that a deputy of mine does

not have access to discussion with the Premier of this province. I

protest that type of suggestion. If you knew this Premier as I do, you

would realize that he's very approachable and very accessible to

deputies — or anyone else — to discuss matters which are of interest to

the people of this province.

Interjections.

MR. SPEAKER: Order, please. I'm asking the member for Prince Rupert (Mr. Lea) to come to order.

HON. MR. WOLFE: I would ask the member on what basis she takes exception to the fact that my deputy would meet in committee with the Premier.

MR. HOWARD:

Mr. Speaker, I rise pursuant to standing order 35 to ask leave to move

the adjournment of the House for the purpose of discussing a matter of

urgent public importance: namely, the failure of the Minister of

Education (Hon. Mr. Smith) to fulfill his duties of management and

supervision of all provincial schools established under the School Act,

and in particular certain schools in School District 88 which are

currently not in operation and thus are not providing some 4,000

students with the opportunity to complete their educational aspirations

this year.

MR. SPEAKER: Thank you, hon. member. I

will take the matter under advisement. In looking at it briefly, I

would suggest that the basic premise is argumentative and therefore

perhaps would not qualify, but we will reserve decision and bring it

back as soon as it is prepared.

Orders of the Day

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

ESTIMATES: MINISTRY OF HEALTH

(continued)

On vote 106: minister's office, $205,728.

MR. HANSON:

Mr. Chairman, before the break today I was discussing with the Minister

of Health some of the shortcomings in funding for the people who are

severely disabled in British Columbia, and their families. I was

appreciative of the minister's remarks that he would look into the

financial support that is presently granted under the Medical Services

Plan in British Columbia covering therapy and other aspects of support

for the severely disabled. I would like to extend the discussion to

another aspect of the delivery of service to the severely disabled

which I believe the provincial government here in British Columbia

could take some positive steps to redress.

My information is

that in 1964 the federal government, under the Department of Veterans

Affairs, operated offices in various parts of British Columbia and in

the rest of Canada that provided prosthetic and orthotic devices — in

other words, artificial limbs and appliances, etc., for veterans who

were eligible, having been in the Canadian armed services. In 1964 that

service was expanded to allow for non-veterans to gain access to that

particular highly specialized and rather rare service. What happened is

that over a number of years since 1964, severely disabled people in

growing numbers were turning to this agency for assistance.

Approximately 50 percent of all the people getting appliances of this

type were going to this particular agency. Up to 1977 the Ministry of

Health and Welfare of the federal government put forward a proposal to

the provincial governments, through bilateral discussions, that the

provincial governments could assume authority over this service. I have

a piece of correspondence from the federal Deputy Minister of Health

and Welfare dated July 26, 1977, where this proposal was outlined. I

think it's important to read briefly into the record a couple of the

paragraphs of this letter. He states:

"In

order to recognize and to take advantage of the growing trends to which

I have referred" — that was the expansion and the growing need for

prosthetic devices — "and wherever possible to place our staff and

capabilities in the mainstream of this development" — i.e. the

provision of these services through provincial hospital ministries —

"the government has recently authorized a policy that will permit our

department to approach the various provincial jurisdictions with a view

to negotiating transfers of our fittings and repair staff and

facilities to suitable institutions operating within the provincial

public sectors."

This is only meaningful if you understand

the difficulty people experience getting the proper fittings and

appliances in instances of the severely disabled.

This particular deputy minister, Mr. Bruce Rawson, goes on to state:

"The

approved policy also provides for the gradual phase-out of our central

manufacturing, purchasing and storage warehousing services. It is the

intention that the orthopedic footwear facility in Toronto as well as

the production engineering and testing unit would remain as national

facilities, though quite possibly under different administration than

at present." The key of this letter is the following:

"We

plan to undertake progressively and bilaterally with each province the

transfer of the prosthetic services fitting and repair centres to

rehabilitation institutes operated under provincial jurisdiction."

Other provinces of Canada in good faith undertook to take up the

federal government on this proposal. My information is that the

hospital board of Ontario has taken over the centre in Ottawa and also

in Toronto. Through the University Hospital, Edmonton has also assumed

the service, as well as Regina and Halifax.

As the minister

is aware, there are federal offices in Vancouver and in Victoria whose

prime function is to serve veterans and also the severely disabled in

need of appliances and other kinds of support devices. I understand

that in Vancouver they have a staff of about six technicians, three

major technicians and lead hands, stores, offices and management. In

Victoria they have four employees. With this capability, which is

presently in the hands of the federal government and has been

transferred to other provinces.... They've assumed the responsibility,

and it's now integrated into their health-care delivery system. We have

that capability in Vancouver and in Victoria, and the offer is there to

have it administered at the provincial level after bilateral

negotiations with the Health and Welfare officials. My question to the

minister is: what is happening in British Columbia's relationship

vis-à-vis this question?

[ Page 6215 ]

HON. MR. NIELSEN:

The simple answer is that I just don't have the information as to where

they might be in negotiating a bilateral agreement with respect to that

service. I will have to ask staff to provide me with the information as

to when the original recommendation was made; what followed that;

whether the federal government is instituting this program

coincidentally across the country or whether it's to be progressive;

and if it has been offered to us, what we have done. Have we considered

accepting it? Have we rejected it? Is there a specific timetable that

may be involved in it? I just don't have that information with me

today. I've asked staff if they could possibly provide it and

information on what has occurred since 1977.

The concept as

outlined by the second member for Victoria (Mr. Hanson) suggests a

program that could be adopted by a province with probably minimum

difficulty, but I just don't have the information with me on my desk.

I've asked for a response from staff. They may be familiar with where

that program is at. I'll also probably have the opportunity of speaking

with the federal Minister of Health later this week, and that will be

on the agenda.

MR. HANSON: I can understand the

minister's reluctance to take all my figures, but I would like to get

it on the record that when the minister responded to my remarks earlier

in the day he indicated that he understood that the specialty technical

aspects of providing this service were a problem. What I want to convey

to the minister is that in the event that the information I'm providing

you is entirely accurate, and that the federal government is offering

the province of British Columbia this agency to transfer it over to

provide that capability to be integrated in with our own health-care

system here in British Columbia, would he look favourably on bringing

that in at the earliest possible date?

HON. MR. NIELSEN:

I sorry I didn't quite respond to that nuance. I was concerned about

the timetable. Yes, I think it would be an opportunity of acquiring

skills that are otherwise lacking in that field. If these people and

this service were available, it would be of great advantage to transfer

it to ensure that those services remain in British Columbia. Otherwise

I suppose there could be a danger they may be transferred elsewhere.

MR. GABELMANN: I'll be brief this afternoon. There are just a couple of things I want to bring to the minister's attention.

The

first thing relates to an area of health care that I think we are a

little bit behind the times in. We made a decision some years ago to

extend to chiropractic care a certain level of involvement by the

Medical Services Commission in terms of paying bills for up to about

nine visits a year, if I'm not mistaken. I think it would be most

useful if that were extended beyond the present levels, which are, in

fact, less than existed several years ago because of the increasing

cost of each visit. The amount of money was left the same, but the

number of visits has been reduced. I think that's an area that should

be tackled quickly by the ministry.

The second is a more

recent departure in health care and relates to acupuncture. Earlier

this year I personally underwent an acupuncture treatment program for

an affliction that I had and have had for 15 or more years. It was not

able to be treated by people in the traditional medical field. With a

month or two of acupuncture I found relief for this particular

affliction, and I know other people have had similar results with

acupuncture. I paid for the acupuncture entirely out of my own pocket,

which is quite fine for me because I can afford to do that, but there

are a great many people, I think, who could benefit from proper

acupuncture treatment who might not be able to afford paying for it, as

I can. I think the ministry should look at including acupuncture in the

fee

schedule for medical doctors as well.

I think too that

the stress-management programs that doctors are able to provide,

whether it's through hypnosis or a variety of other stress — management

programs, should also, to some extent at least, be included in the fee

schedule.

All these things provide a medical service that

is, I think, increasingly accepted. In recent times there has certainly

been an awareness that there are nontraditional ways of treating

people, and that they have some real legitimacy.

I would

urge that chiropractic levels be increased and acupuncture and

stress-management programs, within certain limits — they obviously have

to be well defined — be included in the fee

schedule as well.

wanted to talk about what is probably, in terms of public comment and

public concern, the second major health-care concern in my

constituency. The first is the acute-care hospital bed shortage and the

programs we talked about late last week relating to long-term care and

home care. I won't go through that again. What is a very real concern

is the public health care in that particular area. The hiring freeze

last year had some very disastrous effects in the Campbell River-North

Island general area. The Upper Island Health Unit's ability to provide

services was curtailed, has been curtailed and is still curtailed,

leading to headlines such as the one I have in my hand: "Area Water

Tests Suspended." The first paragraph is: "The Upper Island Health

Unit's public health inspectors are suspending their bacteriological

tests of private water supplies because of an excessive workload, a

spokesman said this week." This was in April of this year. They go on

to say that people are going to have to find some other solution

because the Health ministry has not provided sufficient staff for the

Health ministry to do the inspections themselves.

The

chairwoman of the health board in our area, who also happens to be the

mayor of Gold River, has been in touch with me on several occasions to

talk about the fact that inspections of swimming pools, restaurants,

buildings, subdivisions — the whole range of inspections that are

normally conducted by the Health ministry — are not being done. In some

cases they are way behind: in other cases they are not being done at

all. This is leading to a level of concern that is fairly rare, I

think, in this kind of issue. In this case the Campbell River municipal

council passed a motion urging that a second health inspector be hired

in that area.

Mayor Fiddick, the chairwoman of the board,

wrote to the minister three or four weeks ago asking for a meeting with

the minister to discuss the crisis which exists up there, not just with

inspectors but also with public health nurses. There are tragic stories

about the ability of the public health system to provide adequate

nursing. It just isn't possible. For example, I read stories about the

public health nurse in the northern part of my constituency who works

half-time. Considering what a job she does, how many hours a week she

is working and the variety of things she has to do, it really is

inadequate.

I'll conclude by saying that if we would spend

the dollars that are required — not excessive dollars; I'm not talking

about Cadillac services — if we would just provide the

[ Page 6216 ]

services

that are required to meet the routine, normal inspection requirements,

if we would spend some additional money on public health nurses, we

would save an immense amount of money, not just 10 or 20 years down the

road, but in the short term. I just don't understand why the cutbacks,

freezes and failures to hire adequate staff always seem to hit those

areas of public health that are right on the front line for the public,

are urgent, and in fact would save taxpayers a lot of money if they

were provided.

We all talk about the need to find a way to

constrain the escalation of health-care costs. One of the obvious ways

to help constrain those escalating costs is to spend more money in the

cheap areas and less money in the expensive areas of the health-care

delivery system. But in my constituency — if not in others — all the

cutbacks and refusals to meet additional and proper staffing levels

occur in those areas of service that are absolutely essential and would

be cheaper. That's what I fail to understand about the policies of the

Minister of Health.

HON. MR. NIELSEN: Mr. Chairman,

with respect to the insured benefits of the Medical Services Plan,

chiropractic care and acupuncture — Mr. Member, I'm sorry, I don't have

the precise history as to why systems were developed — some of these

other benefits were based on a dollar value rather than on numbers of

visits. I'm not quite sure what the rationale was at that time. Because

of the erosion of the dollar, there have been fewer visits. I'm in a

bit of a difficult position, because the chiropractors are negotiating

with the Medical Services Commission now for a new contract. I think

limiting medical services on a raw dollar basis has within it a

deteriorating effect on service. I would think that it should be

reconsidered.

Regarding acupuncture, we fund two clinics at

the present time at Victoria General Hospital and Vancouver General

Hospital. They call them pain clinics. I think they really are sincere

in referring to them as pain clinics. As you know, acupuncture has been

a very controversial treatment for some time. At the moment it is

considered investigative. The treatment itself is — I don't know who

makes this decision — not considered to be an acceptable medical

procedure at this time, under certain rules. Acupuncture, as you know,

is not illegal. I believe it was at one time. It is still in the

investigative process. I have to watch how my personal prejudices enter

into it; I happen to think that it has served a pretty useful purpose.

One of the areas, though, where we do have concern and have had concern

for some time is: let's make sure that the person who may be performing

it is qualified, so we don't have any amateur practitioners. Another

aspect to that, Mr. Member, is the historical conservatism of the

medical fraternity, not just in British Columbia but elsewhere. I think

acupuncture has come a long way over the past decade. Perhaps it's time

to give serious thought to further legitimizing the process. I suppose

it would ultimately be an insured benefit, which would bring it up in

status, as has happened with chiropractic and other treatments.

[Mr. Strachan in the chair.]

Your problem with North Island and public health — health inspectors, nurses

and so on — is very much recognized, as it is elsewhere in the province, particularly

in area where there is substantial growth. In the last couple of week we have

allocated 15 more positions in that area: public health inspectors, nurses, long-term

care assessors and long term headquarters staff. We are much aware of it. We

are attempting to make some changes within the system to provide more people

in the areas which have been identified as critically short of people. Mr. Member,

you may not have been in the House yesterday when I responded to another member

— I think it was the member for Nanaimo (Mr. Stupich) — with respect to the

same problem. One of the problems — believe me, I'm not trying to pass the

buck — is that the time of many of these people who are engaged in that service

is being consumed by very routine, mundane chores which might be best left to

clerical staff or eliminated entirely. We are looking at that most seriously.

agree with you that the emphasis must be on this lower level of

services — not lower in care, but in cost. If we are, in any way, to

prevent our society from really being consumed by escalating costs in

these areas, we must emphasize the lower end rather than, as has been

the habit for many years, the acute-care end of the scale. We are doing

that. It's simply not going to change immediately and overnight. We

have given our people who are responsible for that program very clear

instructions to beef up the program as much as possible, to reassess

their priorities and to try to overcome some of the shortages. Mr.

Member, I'm sure you would probably remind me, if I didn't remind you,

that the cost, relatively speaking, is pretty minimal. We are trying to

free up some money for those specific purposes. Many areas of the

province have the same problem.

MRS. DAILLY: I have

two brief questions for the minister. The first one has to do with the

availability of mumps vaccine. I brought this up with the former

Minister of Health last year. I asked him if it could be arranged so

that mumps vaccine could be available at the free clinics, instead of

parents having to go and buy this vaccine. So my first question to the

minister is: have any changes been made in that area? You'll answer

that in a moment.

The second question has to do with the

marriage commissioners and ministers. I'm not being facetious. I think

this is something that has maybe come to the attention of other members

of the House. It certainly has come to me through correspondence with

some ministers. Their concern is that they are now being asked to

perform marriage ceremonies under the sea, on top of mountains — in

various places. Some people have made decisions that they want to be

married in these different places. It doesn't appear too seemly to some

ministers to have to go to these different areas to perform marriages,

yet they feel that it's their obligation to do so.

Could you

perhaps bring about a change whereby the marriage commissioner would be

allowed to marry outside of the courthouse for some of these rather

special kinds of marriage ceremonies?

HON. MR. NIELSEN:

I have recommended to staff that the act be changed with respect to

civil marriages to eliminate the restriction of the hours and location.

I recognize that some clergymen do not wish to be part of that other

type of ceremony. I think it will be resolved by permitting marriage

commissioners.... I don't think it would be mandatory on their part to

perform those marriages personally, but I think it would be permitted.

I think it is very restrictive at the moment; it says that they shall

be married at the commissioner's office between 9 a.m. and 4 p.m.,

Monday through Friday. I've asked that that be changed so it's more

flexible.

[ Page 6217 ]

Madam

Member, we have ordered a — I'm sorry, I don't have the technical term

— triple-dose vaccine for mumps, measles and rubella. We have a new

supply in the province of maybe 50,000 doses — I'm not sure how much —

and it is free. It is the tri-something vaccine; one injection for all

three diseases. We ordered it some months back, and I believe it is

available now. I would think that clinics and others would probably be

able to get the information. They have been advised through our public

health officials, but I'll make sure they are advised again if they are

not aware of it. It is the latest medical concept and it is available.

MR. PASSARELL:

I have three short questions for the minister. This is a follow-up from

our discussions last week. First, the public health nurses. A petition

was sent to the minister's office approximately six weeks ago by the

residents of Cassiar concerning the public health nurse in the area.

There has been a problem in staffing, in trying to find a full-time

public health nurse out of Fort St. John, where it's administered, I

think. Presently the public health nurse works approximately four days

a month in the community of Cassiar. In those four days she must also

go to Good Hope Lake and Dease Lake, which are considerable distances

from Cassiar. I would certainly hope that the minister could arrange to

have a full-time public health nurse in the community of Cassiar, which

services many surrounding communities. The ironic aspect of this is

that last year there was a full-time public nurse who operated out of

an old trailer; this year there's a new government building and her

time has been cut back to four days a month. Public health nurses

provide excellent medical service in the rural and northern parts of

the province. I would certainly hope — and I say in the strongest terms

— that the minister would see if something can be done this summer to

have a full-time public health nurse in the community of Cassiar.

second question to the minister: has the ministry set up any type of

monitoring program in the Nass Valley concerning Amax? The federal

government started a program last week, if I'm not mistaken, but it was

a very poorly operated program. Does it fall under your jurisdiction to

set up any type of program monitoring heavy metals in residents? We're

not just dealing with native people on reserves, we're dealing with all

the residents of the Nass Valley. There's been an outcry about the

definite need to set up some type of monitoring of the residents' heavy

metal accumulation from eating the fish from Kitsault and Alice Arm.

The

third question I'd like to direct to the minister concerns chiropractic

services. We started to make some positive steps with the previous

Health minister on this. Under the regulations — the minister can

correct me if I'm mistaken on this — to receive funding you have to go

to a chiropractor in British Columbia. The concern that I raised to the

previous Health minister was that there are many residents who live on

the 60th parallel between B.C. and the Yukon who need chiropractic

services. They must go to Whitehorse to receive these services. The

closest chiropractor is in Terrace or Prince George, which are about

600, 700 or 800 miles away. We're dealing with a small number of

people. I doubt if maybe 10 or 20 people a year would receive

chiropractic services in Whitehorse. I was wondering if the ministry

could make some type of an exception for northern residents to receive

funding to go into Whitehorse, which is in the Yukon. We're talking

about maybe 10 or 20 people a year. People aren't going to abuse the

privilege of receiving this type of service outside the province.

Those

are the three short questions I had for the minister. I hope he can

answer them. Before closing I'd like to state that the major problem is

getting the public health nurse on a full time basis. The residents in

Cassiar have sent a petition. I would certainly hope that the minister

could find some type of funding to provide this service.

HON. MR. NIELSEN:

To the member for Atlin, we had the same problem that I mentioned to

the member for North Island (Mr. Gabelmann). We are attempting to

assess those areas to see if we can spring more money either to provide

a full-time nurse or to improve the situation. I'll certainly look at

Cassiar specifically.

I don't know if we do have a

monitoring program with respect to effluent discharge in the Nass

Valley. I'm sure our public health people would be available for

testing of materials that may be brought to their attention, but

whether there is a specific monitoring program, I don't know at the

moment.

Your chiropractors in the Yukon present an

interesting problem. I believe under the regulations a benefiting

physician — or whatever the term might be — must have a billing office

in the province to receive the benefit payments. Perhaps something

could be done just to have a registered office, Maybe that's all that's

required, and it might not be that difficult. I don't know how many

chiropractors there would be in Whitehorse — not too many. It could be

something like that just to be consistent with the regulations. It may

be that a registered office in British Columbia would resolve the

problem. But I'll ask the B.C. Medical people to look at that, because

I'm pretty sympathetic to chiropractors. I know if we were up in Atlin

or somewhere, the member for Burnaby-Willingdon (Mr. Lorimer) and I

would probably be trekking to Whitehorse to get treatment fairly

regularly. I'll look into that. It seems wrong to deny citizens of

British Columbia a service which is readily available in a different

part of the country. I'll certainly look into that. It may be just a

technicality that's never been ironed out.

MR. LORIMER:

I was interested in the exchange between the minister and my colleague

for Maillardville-Coquitlam (Mr. Levi) regarding the use of the

formaldehyde foam for house insulation. I was interested to note that

the minister is looking at it seriously and hopes to have his health

units checking through the area to determine whether or not there is in

fact a health hazard in some of these areas.

I've received a letter from one of my constituents. It's a short letter. I'll read it.

"I'm

writing to you in the hope that you may be able to help me and others.

I am one of those unfortunate people who took the government's advice

and insulated my house with urea formaldehyde foam. I did not take the

grant offer for this. Worst of all, my health is not good. I seem to

have symptoms the doctors can't diagnose. It's only recently that we

have come to the conclusion that it may be the foam that is causing it.

have been told my house is worthless. I am a widow, so you can imagine

my feelings. I desperately want to get out of my home and can't afford

the terrible cost. Any help you can give me and many others in the same

position would be gratefully appreciated."

[ Page 6218 ]

That's

just one case. I'll send the minister a letter advising him of the

addresses of this particular home and another home in Burnaby which

I've received complaints about. I would like the minister to advise me

that I can go down to my office in a few minutes and advise these

people that help is on its way. I think it's a very serious and

worrisome problem — probably more worrisome than serious, but it's

certainly worrisome to the people living in those homes, not feeling

well and convinced that the problem is in the insulation. I hope the

minister will give me something to pass on to these people.

want to talk about home care for a few minutes. Another constituent,

Richard Mielke, was a drowning victim who was revived after a

considerable amount of damage had been done to him. He is now a

paraplegic and unable to look after himself in even a rudimentary

manner. At the present time he is being cared for by his parents — this

fellow is an adult; his parents are getting elderly — and a brother is

helping out. They are receiving services of six hours per day five days

a week, and they can cope at this level. They have been advised that

the amount is being cut down to four hours five days a week. Here's a

case in which I'm told the change in homecare service will undoubtedly,

in a short while, require that this person be put into some kind of

permanent-care facility, because they will be unable to cope with him

any longer. I suggest it would be much cheaper to give the necessary

care, extend it or leave it where it is at the present time, in order

that this person can remain at home and be looked after by people who

are concerned about his well-being. That, I suggest, is much better for

him, and a much better financial situation as far as the government is

concerned. I hope the minister will take a look at this particular case

of Richard Mielke. I'm sure there are a number of similar cases in

which adjustments of the general overall plan of cutbacks may well be

looked at.

I want to speak about a matter involving brain

damage to an adult by the name of Gordon Tibbles. I wrote to the former

Minister of Health with reference to this case, and before he could get

on with it the ministry changed. I subsequently wrote to the minister

when he was new on the job, and I received a letter in which it was

indicated that this person didn't really qualify because it was

questionable whether there was really brain damage or whether he was

just an individual with a very hot temper. The story of this person is

that he was involved in an automobile accident and was in hospital for

a great number of months. He ended up in a wheelchair and went to the

G.F. Strong Rehabilitation Centre. He is now able to walk about and has

improved physically to a great extent. As a high-school student he was

an obstreperous individual and a difficult person to bring up. He went

to the school for school assessment, and at that stage the assessor

made some report. I don't know what it says and neither do the

Tibbleses, but it is now apparent that this report is being considered

as gospel by the Ministry of Health.

This person was never

expelled or suspended from school. He was never in trouble with the

police in any way. There are probably many people sitting in this

chamber who didn't have quite as clean a record as that during their

high school days. The parents of Gordon Tibbles went to the Ministry of

Health, to ICBC, to The Maples, to the Burnaby mental health office and

to their doctors, trying to get assistance and rehabilitation for this

person.

Finally, after some months of effort and coming to a blank door, they were

advised that due to the fact that he was causing damage at the house — breaking

down doors, windows and so on — their laying charges against him would be the

only way that help could come to this individual. This was done for the purpose

of obtaining some help from the Ministry of Health. It was recommended by the

judge at the hearing that this person be put in the care of the Ministry of

Health. It so happened that there was apparently no place for this person to

be placed. He ended up in the west wing of Oakalla, which is not the best wing

of Oakalla to be in if you want to protect your health. It took some days to

get this person out. He has now been referred to the care of his grandmother,

who is in her seventies.

me, this is really an unbelievable situation. Apparently there are no

facilities for an adult who has suffered brain damage. I suggest that,

with the number of motor-vehicle accidents every day, there must be

hundreds of people in this province who are having the same problem as

young Tibbles.

I would like the minister to review this case

again. No help has been given up to now. There have been efforts to try

to get help for the past year. I'm sure that in the extensive system of

mental-health care in this province there must be some place that can

not only care for him, but also attend and assist in his

rehabilitation. This person has come a long way rehabilitation-wise

since the accident. Unless help is given, that person is going to be a

charge on the community forever. I'd like the minister to consider that

matter.

Another matter I want to raise is the question of

hospital care and the need for more staffing at the nursing level. One

of the key areas, of course, in health care is the care delivered in

the hospitals by nurses. I was just reading the annual report of the

Registered Nurses Association for 1980. I note that British Columbia

produced 511 nurses through its colleges, universities and BCIT. In one

year it imported 497 from Ontario, 96 from Quebec, 136 from Manitoba,

100 from Saskatchewan, 209 from.... It goes on and on. In addition, 133

were imported from England and Wales, 24 from Hong Kong, 13 from New

Zealand, 233 from the Philippines, 15 from Scotland and 76 from the

United States.

In my opinion, what is happening is that

we're not producing nurses for the care we have to have. As a result of

this, wards are being closed for weekends in almost every hospital;

they can't be serviced because the staff are working a five-day week,

which is acceptable. But we need more. I suggest that 511 is not nearly

enough. I'm told that the province of Ontario, because it's tired of

educating nurses and staffing British Columbia hospitals due to our

climate, is going to cut down in the number of nursing people it's

putting through its facilities.

I don't know about the

colleges, but I know that BCIT produces about 20 percent of the nurses

in the province. They take in 136 students per year, and for 1982 this

has been cut back from 136 to 68. So we are having a drop in the

nursing production, unless there is a corresponding rise in entrance in

other areas. I am told that there are some 400 to 500 applicants making

application for nursing training, but because of the numbers which are

allowed they are not getting their training. That's a government

decision, as to what goes through.

The other matter I want

to speak about is before the minister at the present time, I

understand. BCIT has applied to open a downtown centre where they can

give part-time nursing training in order that a number of people can

get that training who can get to the downtown area because it is on

transit services and therefore handy to get to. The part-time training

plan takes three or four years to finish, but the

[ Page 6219 ]

advantage

is that you can pick your hours. A number of people who could not go

steadily to university or college to obtain this training can set their

hours to fit in if they must be at home with infant children or

whatever for part of the day. I would guess that a number of people

could get away from the welfare aspects of life and become

self-supporting. It would seem to me that if you are just looking at

the dollars and cents this would be an attractive solution to an

otherwise difficult problem.

I know that the minister is not

responsible for the universities, but he is responsible for providing

nursing staff for the hospitals. I would suggest that he take a look at

the cuts which are taking place and decide how he can obtain proper

quantities of nursing care for the needs. As I understand it, there are

some more hospitals or beds coming on stream in a year or two, and if

we're cutting back on nurses now, the problem ;s going to be magnified

in that period. I am told that this suggestion of a downtown centre is

presently being looked at by the Ministries of Health and Education and

that no decision has been made at the present time. I would like to

hear what the minister has to say about that.

[Mr. Davidson in the chair.],

HON. MR. NIELSEN:

Mr. Chairman, the Ministry of Health has encouraged the Ministry of

Education with respect to the number of students in the nursing

programs. We have offered the opinion that we would not wish to see any

reduction in these programs. In fact, the opposite would be true. The

nursing problem in the province is under review with the Ministry of

Health, the Registered Nurses Association and other organizations who

all recognize that there are problems — not just at the training level,

but in retaining nurses in service once they have qualified. There is a

turnover of nurses that is far greater than we deem acceptable. In some

instances nurses have spent three years training, and have only

practised for a year or so thereafter. Apparently there are a number

who are diverting their studies after completing the nursing course to

enter other aspects of education. What's happening, from what I've been

told, is that we are not getting the product of the training process

which in turn takes on that job for a reasonable period of time. We are

providing numbers, but we are not necessarily getting the length of

service one would expect from that training. In addition to that you

mentioned the particular problems of married women who are nurses, and

the problems of family, which restricts their hours.

We have

asked some of our hospital administrators to advise us how they could

make life easier for nurses with greater experience who now have a

family. They could work short shifts, week-end shifts or other shifts

which may be attractive to them. We should try to use that reservoir of

manpower which is still available but the situation may have certain

unattractive features, and they just choose not to continue on with

their profession. That is being actively reviewed. It is a perplexing

situation that the Registered Nurses Association and others have

discussed in my office. We are offering refresher courses to nurses to

try to encourage those who have retired to get back into the

profession. I had a meeting in my office with the Minister of Education

(Hon. Mr. Smith) and representatives from the Registered Nurses

Association of B.C., and suggestions were made as to how the nurses

could be platooned to receive these refresher courses, specialty

courses and others. That is being very actively pursued. The Ministry

of Health has asked the Ministry of Education not to consider cuts in

the nurses' area. I suppose we are going to see a migration of nurses

from other parts of the world, as has been a tradition for many years,

but we'd like to produce more and keep more on the job. That's a very

important problem.

I seem to be somewhat familiar with

certain aspects of the case you related about young Tibbles, but I have

no hesitation in reviewing that and looking into it in much greater

detail. I probably responded with information that had been provided to

me, but I'll look into it in great detail, As you outlined it to me it

sounds as though it's a situation that particular attention should be

paid to rather than what has happened.

I'll look up in

Hansard the other case you mentioned and look into it specifically as

well. That's a case that should be reviewed individually rather than

broad-brush. As the instructions are worded you look at each case

individually. That sounds as though that's one which should receive

maximum consideration. I'll certainly look into that too, Mr. Member.

MR. LORIMER:

I'm interested in a point that you make that there will be no cutbacks

in admissions for nurses' training, because I'm advised that BCIT has

received information that their class for next year will be cut in half.

HON. MR. NIELSEN: We have recommended that it not be, but it's not our program.

MR. BARBER:

Could the minister tell the committee when chiropractic services last

received an increase in the

schedule of fees as approved by the Medical

Services Plan?

HON. MR. NIELSEN: I'm advised it was

two years ago. The chiropractors and the Medical Services Commission

are at this moment negotiating a new contract. It very likely was a

two-year agreement. If it was two years ago. At the moment they are

negotiating a new contract.

MR. BARBER: If it doesn't

compromise the governments position in those negotiations, could the

minister inform the committee what the government's offer is?

HON. MR. NIELSEN:

The member for North Island (Mr. Gabelmann) earlier asked if we would

consider the advisability of offering benefits such as chiropractic

benefits on a fixed-dollar basis rather than on the number of visits.

As I mentioned to the member for North Island, I don't want to say

anything compromising with respect to negotiations, but I would think a

fixed amount of money has within itself a deterioration of services

offered to people. Because of the inflationary factor you simply have

to cut down the number of visits to accommodate the dollars available.

I would prefer the other way; I would prefer to see the numbers of

visits fixed rather than the numbers of dollars fixed, but maybe not as

much as they want. They may be negotiating for more than the Medical

Services Plan deems advisable. One of the problems, Mr. Member, is that

chiropractic services and some other services are not part of the

federal-provincial cost-sharing, I formula. and it causes its own

problems. The issue you brought forward is part of what is going on

right now by way of negotiation, and it has been very clearly

identified.

[ Page 6220 ]

MR. BARBER:

I've had an opportunity to read some of the reports prepared by people

in the profession of optometry who argue sensibly, I think, and

certainly forcefully, that we require a school of optometry in this

province, that the University of Victoria might be an appropriate

location for it, and that the particular services and facilities both

needed by and offered to persons who would ordinarily take advantage of

these services are, because of the lack of optometrists and facilities

to train them in British Columbia, therefore all the more arguably

needed. I wonder if the minister could tell us what review, if any, is

going on right now in his ministry to examine the establishment of a

school of optometry in British Columbia, preferably — but I'm biased —

at the University of Victoria; and could the minister indicate what the

timetable might be for the execution of such a policy commitment?

HON. MR. NIELSEN:

I'm just advised by staff that a very major review has been underway

with respect to this. The information received is contrary to the

suggestion you made that one is needed. The early information obtained

was that the need was not there. I'm not telling you that it's correct

or it isn't, but that was the early indication after a major review.

They may be wrong, but apparently the first indication was that the

demand and the facts did not suggest that there was that great need.

The study has not been completed; but apparently it is a major review,

and those are the early indications. Obviously there's more to come on

that.

MR. BARBER: I wonder if the minister would be

prepared to make available, either in this committee or — should the

report not be finished until after the Legislature adjourns — publicly,

the advice and recommendations of his committee reviewing the policy

and the problems of optometry services in British Columbia. Will you

make that public, one way or the other?

HON. MR. NIELSEN: Yes. I don't think that's a problem, once the information is available.

MR. HOWARD:

As the minister is well aware, there is a facility in Terrace for those

persons who require long-term and extended care. It's called Skeenaview

Lodge and has been in existence for some period of time. Over the

winter of 1978-79 one of the minister's predecessors came to Terrace

and announced that Skeenaview Lodge was to be phased out over an

18-month period. That 18 months has come and gone and has been somewhat

extended. The rationale for phasing out Skeenaview was that it was far

better for persons who needed such care and attention to be cared for

in their own homes through the homemaker service. That would be fine

for those individuals who have homes and whose needs could be met by

the homemaker service. We are now faced with situation where the

homemaker service is being curtailed or likely to be curtailed and the

availability of care and attention required by those individuals has

been placed somewhat in jeopardy. In the face of that, there still

appears to be the continuation of the decision of government to phase

out and close down Skeenaview Lodge as a facility which would provide

extended care and to replace it with a facility that I smaller in bed

capacity and with a lower level of service namely intermediate care.

The

other part of the program appears to be that those why require the

extended care that is available now in Skeenaview Lodge will be cared

for, once it closes down, in Terrace in a closed-off portion of the

Mills Memorial Hospital, which is an acute-care hospital. In Kitimat

they will be cared for in an unused portion of the Kitimat General,

which is also an acute-care hospital. While there may be beds available

in both of those acute-care hospitals at this moment, the growth and

expansion of industry and of the population there will place at some

point in the near future a demand on those acute-care beds and we will

be faced with somewhat the same situation that prevails here in

Victoria. There is great concern, not only on the part of those

individuals who are currently in Skeenaview, but on the part of their

relatives and a great many people in Terrace and that surrounding area,

that the care and attention these older folks need and must have on an

extended-care basis is not going to be available to them.

There

is great suspicion that the primary reason for phasing out Skeenaview

Lodge is to make available for development purposes a great proportion

of the 20 acres of land upon which the lodge sits. That feeling and

that suspicion exist pretty thoroughly throughout Terrace. Nothing has

been done to dispel that feeling. In fact, B.C. Buildings Corporation

entered the picture recently and said to the Terrace View Society,

which is a society established to handle and manage the proposed 50- or

60-bed facility for intermediate care, that they could have two acres

of the 20. There was no indication what was going to happen to the

other 18 acres.

It would be most helpful if the minister could make some clear statement about

the intentions and hopes of his department, firstly, with respect to a type

of facility in that area now encompassed within the concept of Skeenaview Lodge

and, secondly, with respect to the use of that land for a purpose continuing

to serve the needs of older people in that area — a statement that it is not

going to be turned over to some land or apartment developer, and that the intention

is not to shunt off into a smaller acreage of that area a very limited facility,

both in size and in terms of the level of care provided for residents in that

whole northwest comer of the province. If the minister would make some sort

of comment in regard to those concerns, I'm sure he would go a great way

toward allaying the fears of the residents, the patients, their families and

the people in the area generally.

HON. MR. NIELSEN:

I'm sorry, I'm not familiar with the land question, but I could very

quickly look into that, if it's a land grab that's underway. I am

advised by staff that the reason for what is referred to as a

phase-down of the facility is that the Skeenaview Lodge is slated for

closure in 1983.

That's the information I have. The reason for the phase-down is the age

of the building, and there has been a philosophy offered about provincial referral

centres — the thought that clients should be placed within their own local area

rather than in a provincial referral centre. Terrace will have a replacement

facility to house the existing clients. I think it has been acknowledged that

there is to be a replacement facility. I don't know whether that is to be

on 2 acres of the 20, or what that land relativity is, but I will look at that

and provide the member with the information later. I don't think the land

question has been raised since I have been familiar with this. Perhaps it's

very common in Terrace, but it hasn't been brought forward to me other than

by you just now. So I'll look into that aspect of it.

am advised that there will be replacement facilities to house the

existing clients. I am also told that the Skeenaview is slated for

closure early in 1983 and I would expect that the replacement facility

would have to be constructed prior to

[ Page 6221 ]

that.

I'm just wondering where it may be located. Those are details I don't

have at the moment; I would have to look into them. But you intrigue me

with that land question. I can certainly find out.

MR. HOWARD:

I'm not asking the minister for a reply now. He can do that privately

by letter if he'd like to deal with the land question and the

replacement facility that is proposed on the basis of (1) its size, and

(2) the fact that it will not be an extended-care facility, as I am

advised. It will just be intermediate care, and will basically leave in

a vacuum those people who require extended care in a facility rather

than in a home.

MS, BROWN: In January of this year there was an editorial in the Sun

dealing with confidentiality of medical records. I really just want to

discuss some of the information contained in that editorial with the

minister and ask him whether the same applies here, or whether since

January of this year any attempts have been made to tighten up the

situation.

What the editorial says is that "privacy of

health records is being invaded daily on a huge scale." I'm sorry, this

is a report of the Ontario royal commission. I'll explain why I'm

quoting afterwards.

"This commission spent the

last three years researching this subject, and indicates that privacy

of health records is being invaded daily on a huge scale. Their

confidentiality is being violated as a normal course of conduct.

"What

Mr. Justice Horace Krever discovered is commonplace. For example, there

was evidence that private investigators under contract to insurance

adjusters, using a variety of pretexts, regularly obtain medical

information from doctors or hospital staff for the purpose of setting

aside accident claims. Police investigating possible fraud against the

Ontario Health Insurance Plan were given carte blanche to examine the

medicare records of everybody in Ontario. Lawyers for the RCMP admitted

that, on at least one occasion, confidential medical information was

leaked in an attempt to discredit a member of a radical organization."

What also came out in that report is this:

"It

would be naive to think that the situation described here was unique to

Ontario. Indeed, a number of the witnesses told the commission that the

practices which they described were common throughout North America."

What

I'm really trying to find out from the minister is whether British

Columbia is unique in that these kinds of violations of the privacy of

health records could not happen here.

It goes on to say:

"Judge Krever made a number of recommendations for correcting this

state of affairs, including stricter controls, a guarantee of the right

of individuals to examine and correct their own personal health records

and the right to sue for a minimum of $10,000 for an unauthorized

disclosure." The editorial ended up by saying: "The provincial

government in Victoria might well make use of this report on behalf of

British Columbians."

Has the minister received a copy of

this report of the Ontario royal commission? Has his ministry had a

chance to read it, to look over the recommendations and even begin to

implement some of the recommendations? What the report really says is

that an individual has no access to his own medical records. It's not

possible to see your own medical records. This is top secret. But other

people can see your medical records — investigators and that kind of

thing. That was one issue of privacy I wanted to raise very quickly

with the minister.

Is the minister still responsible for

vital statistics? I've gone through the estimates a number of times and

I can't find what vote it's under. Maybe the minister could tell me

what vote vital statistics comes under. I've combed the estimates with

my fine-tooth comb.

Interjection.

MS. BROWN: Oh, I should have used a larger comb.

number of Ministers of Health down through the ages have promised to do

something about this very archaic piece of legislation. We can quote

from comments made by the previous Minister of Health, the Minister of

Health before that and the Minister of Health before that, ad

infinitum, about the Vital Statistics Act. Is this minister also going

to make a commitment to amend some of the more archaic sections of this

particular act? If so, I would like to specifically draw his attention

to the

section dealing with the registration of the birth of a child.

You may not know this, Mr. Chairman, but as the act presently stands, a

child that is born to a couple who are married.... The only surname

that that child can have is the father's surname. There is no choice

involved. As a matter of fact, the act does not even permit the

double-barrelling of the name. For example, if you and I were married,

the child would be Davidson. It couldn't be Brown-Davidson. If we had a

daughter I would have to call her Brown in order to get my name into

it, and she would be Brown-Davidson. But she couldn't be Something

Brown-Davidson.

Interjection.

MS. BROWN: She'd be brown. There's no question about that. [Laughter.]

the act presently stands, the child's surname is registered as the

surname of the father. Even when the couple come to an agreement and

decide that they would prefer that the child take the mother's name,

this is apparently not acceptable. The previous Minister of Health

received a letter in December 1980 bringing this to his attention. At

that time a commitment was made to do something about this particular

section of the Vital Statistics Act, because it needs to be amended.

I'm just wondering whether the present minister would be interested in

making a commitment and following through with it in terms of amending

that. It was very difficult to get the Name Act accepted. Now a woman

can change her name if she wants to. What a number of women are

beginning to say is that there should be an option. They may never

exercise that option, but it should be on the books anyway that the

surname of the child when being registered at birth could be either the

surname of the mother, the father or both. I just wanted to ask the

minister those two very brief questions.

HON. MR. NIELSEN:

The Ontario report the member spoke of was provided to the ministry. My

staff have advised me that the ministry has taken precautions with

respect to aspects of the invasion of privacy which were identified in

the

[ Page 6222 ]

report,

to attempt to prevent similar occurrences in British Columbia. Mr.

Member, I could not say that there are no intrusions of any kind, but

the report did provide an opportunity for the ministry to be made aware

of specifics. Precautions have been made to avoid that. I agree with

the member that the medical record should have that confidentiality. If

it can be pointed out that it is being abused in an organized way, then

steps should be taken to expressly prohibit that.

I do have

a very strong interest in the Vital Statistics Act. I am concerned

about both the aspect the member spoke of and others. I have made some

mention of some of the changes I would like to see. I've had an

opportunity of speaking with the director, Mr. Burrows, about some of

these long-standing issues. I would like to see some modifications made

in the Vital Statistics Act. I think that a large part of the act was

written at a time when there was quite a different attitude, and it

stuck with us for some time. I couldn't offer any specifics today but,

yes, I do have strong opinions with respect to that Vital Statistics

Act. I hope that we have the opportunity to make some amendments which

would make the Vital Statistics Act relatively modern. I don't know

what the specifics may be. I've heard the report the member spoke of,

and I've seen a copy of that request outlining the problem. We will be

responding to that. I sincerely hope that we'll have the opportunity to

make some major changes to the Vital Statistics Act in a number of

areas to bring it into line with contemporary concepts, or at least

modern concepts.

[Mr. Strachan in the chair.]

MR. KING:

I have a few questions for the minister that I'd like to gain some

information on. The Shuswap nuclear study action group has been active

in monitoring uranium exploration in the Shuswap area around Salmon Arm

and in the North Okanagan generally prior to the moratorium taking

effect. As the minister probably knows, there was a good deal of

activity in that area. The study action group has been advised that the

Ministry of Health has discontinued testing water in that area for

radiation levels, and there's a good degree of concern. There has been

the suggestion, and it's nothing more than a suggestion at this point,

that we do have an abnormally high incidence of leukemia in that area.

They're basically asking for two things: that the water monitoring

continue and that the Ministry of Health consider at least doing a

survey with respect to the incidence of leukemia in Salmon Arm and

surrounding area. I want to reemphasize that there's no empirical data

to back up that concern; nevertheless, it is a concern out of community

experience and knowledge. I draw that to the minister's attention to

see whether or not his ministry is considering any activity along those

lines requested.

There are a couple of other questions I

want to ask the minister. The diagnostic centre for Chase was promised

under the auspices of the Royal Inland Hospital at Kamloops. I think

the minister is familiar with that, and I would appreciate receiving

from him some kind of status report on just where that particular

project is. Is it anticipated that it will be starting this year? It

was promised by the minister's predecessor in 1979, I believe, and

again in 1980. I would very much like to have some indication of where

it's at now. I believe the board of the Royal Inland Hospital is

carrying the ball for it mainly.

The other question is with respect to the acute-care centre in Armstrong, and what the status of that construction program is.

If the minister could answer those questions for me I'd be very grateful.

HON. MR. NIELSEN:

I hope a member of staff who is familiar with the scheduling for Chase

and Armstrong is listening and might be able to get that information to

us.

I met with the board in Kamloops, and at that time we

discussed Chase-Armstrong and Logan Lake, I believe. There were

arrangements made, but I just can't recall the dates and details on

that. I believe it was Chase municipality that offered to run the

centre if we were to provide certain facilities. I believe that was

agreed to. I'd have to get the specifics on Armstrong.

The

member is probably aware that there is a fair number of natural

occurrences of radiation in waters in the general area of the North

Okanagan and other parts of the basin area. The public health division

of the ministry is constantly checking the levels in these waters,

usually in relatively small ponds or sediment areas. There is an

ongoing monitoring program. I don't believe they have identified any

areas of water where there is considered to be the health hazard where

such a warning would not be in evidence or the owner of the property

would be advised not to use it for any purposes.

On the

leukemia aspect I couldn't say if the ministry has attempted to

correlate information with respect to the two: the natural occurrences

of radioactive materials in the waters and perhaps the incidence of

leukemia. It wouldn't surprise me if that has been done, because I'm

sure the medical people within the ministry would have taken that into

consideration. I'm sure one of the reasons they would be monitoring

these levels would be to determine if there's any relationship. But I

would have to ask specifically whether studies have been made and

whether any conclusive information has been brought forward. The people

responsible for monitoring this advised me previously that should the

levels be determined to have reached a certain aspect with respect to

health, they would be taking steps to either acquire the water-holes or

to see that these areas are not used where the public would come in

contact with them for the feeding or watering of cattle or other

animals. A fair amount of study and monitoring does take place in that

area of the province. Perhaps I could get some specific information on

the areas mentioned by the member and perhaps respond to him later. It

is not information which I think would alarm the citizens; I think they

would realize it's a pretty routine monitoring program that is

undertaken.

MR. KING: I want to thank the minister

for his response. I would suggest to him that, rather than delay the

estimates, the minister could get that information on the two hospital

facilities, and on the correlation of any data on radiation with the

incidence of leukemia, to me before the session ends.

Just

for the minister's information, I was surprised to find that there is a

device used by prospectors up in that area now by which they monitor

streams and creeks for the radiation level as a method of trying to

locate the ore body. It certainly seems to me that if they have that

kind of sophisticated and intricate equipment there must be a pretty

high level of radiation from natural sources, as the minister

indicated. It may be possible to liaise with the Ministry of Energy,

Mines and Petroleum Resources to identify those areas that are that

much exposed to radiation that it can be determined through an

instrumentation of the creek, and to have a look at whether or not that

watershed is feeding any wells, domestic water

[ Page 6223 ]

supply or any water supply for livestock. That was something I was surprised to learn just a short time ago.

HON. MR. NIELSEN:

I just have a quick comment on that. I'm sure the ministry would take

advantage of some of the instruments available. I think they're

generally aware and have a pretty good understanding of where those

waters are located.

MR. STUPICH: About two months ago

there was a meeting in the Chase River Moose Hall, where the concerned

citizens committee for better uses for Brannan Lake sponsored a

meeting. Many presentations were made.

During the course of that meeting, representatives from the Ministry

of the Attorney-General said that various members of cabinet, including

the human services committee, had been invited to put forward proposals

for the use of the Brannan Lake facility. I know that one of the

proposals advanced in the community is that it be used for some sort of

long-term care program to relieve the crowding in the hospitals.

I'm wondering whether the minister has supported any such

presentation in the human services committee of cabinet. Is this

minister putting forward any proposals in the cabinet with respect to

use of Brannan Lake for long-term care or some such program?

HON. MR. NIELSEN:

The recommendation from the long-term care program people was that the

Brannan Lake facility would not be suitable for intermediate care. It

was for a number of reasons: the distances and others. But generally,

no.

MR. STUPICH: Just to complete that then, Mr.

Chairman, the Minister of Health is not making any recommendations to

the human services committee of cabinet with respect to any use of

Brannan Lake within his jurisdiction as Minister of Health?

HON. MR. NIELSEN:

That's basically correct. We had been asked to review Brannan Lake for

purposes of long-term care and extended care. The report from the

directors responsible for that said that would not be its best use,

from their point of view. So they have not recommended that it be

converted for that purpose.

MR. LEVI: I want to deal

with a couple of aspects of long-term care. I refer the minister to a

brief to promote public discussion for the purpose of arriving at

recommendations for long-term care legislation, SPARC. On page 3 there

is a

section on rights. They say that because of their failing physical

and mental abilities long-term care program users are particularly

vulnerable to abuses of their basic human rights. It's therefore

imperative that these be stated clearly and guarded carefully. Upon

admission to a program or facility, printed material from the long-term

care program must be given to the program users, their families and the

representatives who would inform them of their rights, responsibilities

and the complaint-review procedure. I want to say to the minister that

there is an assessment process that takes place, where a number of

people go in to inspect the facility.

I refer to the Langley

facility for now, because it's the example that I have. It's called the

Langley Lodge. There was a very long, detailed inspection done of this

particular facility. There were some eight different public servants

involved and they came out with a series of recommendations. This was

done in December 1980 and January 1981. One of the problems that exists

is that there was no follow-up, That is, they were told to do a number

of things; I was out there recently and none of these things had really

been done. That's the one question I want to address to the minister.

opened my remarks with the business about the rights of patients. The

minister knows. and we all do, that older people in these facilities

tend to be, frankly, afraid. They're afraid in one respect that they

may. If they make complaints, get moved out. I was at a dinner for

seniors the other night in Coquitlam. A man I know, who is actually a

seniors counsellor with Human Resources, has been a very active member

of and lives in a long-term care facility. To my surprise, he says that

there are some things wrong, but he just doesn't feel he wants to say

anything. The basic fear he has is that he may get moved out. There is

that kind of problem. There does not appear to be anyone the seniors

can turn to, really, to voice these complaints, without having this

great anxiety about being moved. It's there and it's real. It's not

apparent, it's very real to them.

If the department is going

to the trouble to inspect a place, and particularly this one.... I can

make it available to the minister. I don't want to go into all the

details, but it's an example. It would seem to me that there has to be

a very basic follow-up on the things that have to be done which are

found to be wrong. I'll give you an example. One of the identified

dangers in this particular place was that when you go from the main

part of the building into the activity room there is a ramp. Of course

there are a lot of people in wheelchairs. The ramp isn't very wide. I

looked at it and it's about a foot wide. In January the report said it

was dangerous and should be replaced. You go out there in May and you

find it's still there.

There's another complaint. For some

reason the facility has been charging for incontinence pads. They were

told by the people who did the inspection that that was not to happen,

that it was part of what people pay for, or what the government pays

for in the $8.50 a day. Now there is a whole series of these things.

The question I'm raising with the minister is that the inspection

process may be adequate, but the enforcement process is completely

inadequate. What happens in this sort of situation? There is a range of

things. They talk about fire drill, food, cleanliness. It's a very

adequate report, but there's practically no response to it, according

to people I've talked to and my own observation. I appreciate that in

this particular facility there's a change in the administration: they

are getting a new administrator. But the same problem exists in the

basic inspection process. It's all very well doing inspections, but you

simply have to have an enforcement process as well.

I want

to make one other remark, which goes back to the one I talked about

originally. People in long-term care facilities do need advocates. It's

not really the role of the staff to be their advocates. If we have

senior counsellors, as in Human Resources, then it would pay to

consider the possibility of having some kind of senior counsellor or

advocate in the facility. Somehow there has to be a bridge between the

patients and the administration, particularly in the question of human

rights. There has to be a mechanism whereby people can feel free, but

not in an irresponsible way, to really talk about the problems that

concern them.

[ Page 6224 ]

The

inspection process. This one was adequately done. I don't comment on

all the others. But the problem is that there was no enforcement of the

changes that had to be made. Even at this late date many of those

changes have not been made. They are health changes. They relate in all

manners to health and safety.

The other question is about

the advocacy

part in respect to the rights of patients. That's a

crucial one. As the system gets larger — and it is increasing all the

time — there has to be that kind of advocacy role.

I'd like the minister to respond to those two questions.

HON. MR. NIELSEN:

I hope there's a very good reason why they didn't get back to see

whether what had been recommended or ordered was or was not carried

out. I'll ask a couple of questions with respect to that. I would say

that there's really not much point in inspecting unless you're going to

follow through to make sure that what you've discovered is taken care

of, or you're wasting the time of both the inspector and the people

responsible for the home. I'll find out about that specific one and see

if it's an isolated incident or whether it's something that has to be

resolved. Maybe there's a reason, but I can't see why it wouldn't have

been followed through; it's just common sense.

I suppose the

problem of the rights of citizens in such establishments has been of

concern for a long period of time. Mr. Member, I don't know how that

should be addressed. Perhaps some position could be established or made

available, as you suggested, in the home itself or perhaps in the

ministry. In many instances we are dealing with patients who may find

it very difficult to overcome their latent fears to the point of

speaking out about real or imagined problems, because of what they

consider to be their vulnerability. I don't know whether the Ministry

of Human Resources, as an example, provides that type of service to

these people. I agree, though, that the rights of these patients should

be protected. There should be an opportunity for any of those patients

to be able to contact an individual to determine if their rights are

being violated or if what they consider to be a violation is indeed

that. I would have to ask a lot more questions with respect to that

before I would be able to provide answers to the member's questions. I

agree with him in principle that the rights of these individuals cannot

be ignored simply because they are in a facility, and that they should

be protected.

MR. LEVI: I just have one other item I

want to raise, to get the minister's feelings. There has been a great

deal of discussion in the field of long-term care, particularly about

the effectiveness of the staff in their work. There appears to be a

lack of adequate training of aides even at the first level of care

given. We've had a number of programs which the Health and Human

Resources ministries have gotten into, particularly in the fields of

day-care and financial — assistance workers. Here we have people who

are dealing with a very special kind of service, yet there is no

training at all. There's an incredible turnover — not always — but I

think it's partly because of their lack of training that people who

work in it don't perceive it as being a worthwhile stage of a career.

That happens when you have an incredible turnover. If you've got some

training, it's going to relate to the quality of care that you get. I

think it can possibly lead, because of the kind of training that has

existed in some places.... I have in mind the well-known Priory method,

which was used over here in a number of homes. They were trained in

service.

There needs to be training for this particular

area. This is one of the great weaknesses in this field — the

incredible turnover of people because there is no established career

potential at the ward-aid level. I'm not talking now about registered

nurses or even the LPNs, who also have training. There is a much larger

body of people below that group. They are in day-to-day contact with

these people and have absolutely no training whatsoever. That's one of

the areas that has to be addressed: the training of the first-line

workers. They are the people who mostly deal with the patients. What

plans does the ministry have? Have they looked at that? It's something

that's been talked about. What's going to happen with that kind of

area? We're into a field here that's going to be with us forever on.

With better standards that we get for the training of the people who

are on the line, obviously we're going to get a much better quality of

service. Has the minister got a comment on that?

HON. MR. NIELSEN:

I do not know what training programs may have been prepared or are in

the planning state. I would have to get specific information on that.

As the member pointed out, the long-term care facilities will become a

major part of our hospital care — for want of a better term — more and

more. I agree that we must have consistency, reliability and training

in staff. I don't know whether a formal program has been developed. I

appreciate the comment and agree that it's an area that does affect far

more people than some of the other workers who are involved in it.

There should be consideration given to training of some type at least

that perhaps would result in more of them staying in that position

longer, minimizing the turnover problem. Mr. Member, I would have to

find out specifically if any training program has been developed and

whether any program is about to be implemented or is even available

anywhere within the system now. I'm sorry, I just don't know at the

moment.

MR. LAUK: As will be noted, I'm sure, by a

few members of the House, I seldom speak in estimates. It'll be noted

with great appreciation by most members of the House. However I had

prepared a major statement attacking the Minister of Health. I was

developing a case against this minister from which he could not

possibly have extricated himself. This case goes back many, many years

— one at least. It was brought to my attention approximately 18 months

ago that Sunset Towers has about 800 elderly people residing there. One

of them is an aunt of the hon. second member for Victoria (Mr. Hanson).

These elderly people had a variety of health problems. Most, if not

all, of those health problems did not require hospitalization. They

required some kind of attention at home. I'm not going to get into the

debate on the homemaker service. The minister knows our views full well

on that. It was the kind of cutback that is most regrettable and makes

the least sense if one is going to become efficient in the Ministry of

Health.

However, I did write a letter to several persons on

behalf of the residents of Sunset Towers to obtain nursing care at this

large residence. It seemed appropriate to me that the request of those

residents for a nurse residing there with them made a lot of sense. Now

I don't know who to thank or who to blame, because it ruins my whole

speech. I had at least 45 minutes prepared, and I had written several

letters. Just before his estimates the minister tells me he's going to

supply them with a nurse. What do I say now?

[ Page 6225 ]

I'm

of mixed feelings. I had this case prepared, and I was going to attack

the minister and force him into ignominious resignation, and he goes

and appoints a nurse. I've spoken to some of the people at Sunset

Towers since we got the good news, and they're very, very grateful that

the minister has acted, where his predecessors did not.

want to point out to the minister another problem in my constituency,

insofar as there is a stroke victim club. There are stroke clubs around

the province, and I think everyone can remember a little while ago the Vancouver Sun

article about stroke victims entitled: "A Hardening of Society's

Arteries." It was a sensitive description featuring Jack Richards. Some

of you may remember Jack Richards as a journalist with the Vancouver Sun

who at a relatively early age suffered a massive stroke when he was in

hospital for the removal of a kidney stone — a fairly minor operation —

and as things turned out he suffered a massive stroke. The description

in the

article is particularly poignant.

"Jack

was 57 when he suffered a massive stroke. It happened at the height of

his career as a journalist. He was then editor of the Vancouver Sun

leisure section. In 30 years of writing he had been a sports reporter,

editor, drama critic and finally the author of a widely read book, Johann's Gift to Christmas . Now he can barely write his name. His eyesight has been so badly impaired he can no longer read."

One

of the things Jack Richards does, and one of the only things he does,

is go to these clubs. Every Tuesday at the Vancouver stroke club he

meets with friends who have had strokes. There they take physiotherapy,

speech therapy and other forms of activity with fellow stroke victims.

It is one of the few things, if not the only thing, that brings these

stroke victims out of their seclusion and shut-in status into a society

and a community activity. It is a great benefit. I'm sure all hon.

members will agree that such a stroke club is worthy of support.

April 14.... Leading up to this, it's indicated that the government is

not going to give any money, or little money, to help the province's

stroke clubs. Evidently the government does not consider it to be a

priority, when, in fact, as the

article states, these stroke clubs are

the whole world to many of these members. I'll just read into the

record a letter that was sent to the Minister of Health on April 14.

"For

us, the stroke people, the stroke club is not a frill; it is a

necessity. It is sometimes the only thing that keeps us going. There is

no other chance for us to mingle with people. At other places people

stare at us or else try to help too much. At the club we are accepted

for what we are. There is no other possibility for speech or

physiotherapy once you are out of the hospital. These classes add a

quality to our living. Please help us.

"This

letter was hand-written for the people of a speech class at the stroke

club. The words are all theirs, but no one in the class has the ability

to write legibly."

It is signed by 31 members of the stroke

club. It was sent to me, asking me to encourage the minister to answer

their appeal for funding to at least save this worthwhile organization.

appeal to the minister to take a close look at this situation. I have

met with some of these people at the stroke club. It is truly as it is

set out, and there is no exaggeration. It is worthwhile, and it would

be a responsible and sensitive thing if the ministry could find the

very little money that is required to keep these stroke clubs active in

providing a community and needed therapy for these victims. I wonder if

the minister would not make a policy decision with respect to it.

HON. MR. NIELSEN:

The Stroke Association of B.C. representatives met with me and some of

my staff a month or month and a half back, and we had a very good

discussion with respect to funding. The clubs have not received funding

from the Ministry of Health previously; they've been supported by the

B.C. Heart Foundation and a number of community resources. I believe

the history was that the Heart Foundation had offered to support them

for a period of time, and that funding has simply ended. That's why

they find themselves in deficit problems, along with a couple of other

foundations which had provided some money. I forget the two people who

were in the office speaking about this. I told them that the ministry

would consider a grant with respect to the clubs throughout B.C.,

possibly to the provincial organization, which then might be able to

develop their own priorities. I said we would attempt to see if we

could encourage some of the established foundations to continue on with

their grants. I told the two principals who were in the office that day

that it would be difficult for the ministry simply to assume their

entire budget as they had requested. What they basically wanted was

some assistance for their provincial organization and funding for each

club for some administrative costs. We suggested to them that we could

be in a position to offer them a substantial grant, but that it could

fall short of their total budget. At this juncture we suggested to them

that we felt we should not discourage them from continuing to get

support from such agencies as the B.C. Heart Foundation or others who

may wish to be involved or could be involved.

I can advise

the member that I told the staff to go through the grants which were

being made this year and to find some money for the Stroke Association

of B.C. I don't know the precise figure, but it will be substantial. It

will not meet their total request. I think they agreed with me when we

discussed it. While they may be disappointed, they will not be

completely disappointed. They recognize that they would not be able to

have their entire budget covered in a single effort, but I did tell the

staff to find some money in that vote for those grants, I also told my

staff that perhaps we'll get heat from someone who won't get a grant

this year — not the stroke people, but maybe someone else. But I felt

that this was a priority.

The grant will be substantial. It

will assist them greatly, although it may not meet what they

anticipated as their entire budget for the province. I think the

Ministry of Health can act as an agent on their behalf to discuss with

some of the foundations who had indicated to some of our people that

perhaps they would be prepared to advance moneys for this as well. I

think we have responded in a substantial way. They will be advised of

that in the very near future, once these dollars are worked out. I

think their deadline is fast approaching. I'll remind the staff to make

sure they have that information.

We also suggested to them

that perhaps, because of the timing of the request — the budgets and

the rest — we may have to review the situation part way down through

the year. For the time being we will be providing them with assistance.

It will he substantial. although it will fall short of their entire

[ Page 6226 ]

provincial

budget. We are certainly not turning a deaf ear to their plight. We do

recognize it as a valuable service. We will be offering them a

substantial grant this year. Perhaps there can be more formal

arrangements made for subsequent years.

MR. COCKE:

We've been having a marvellous discussion with the Minister of Health

over the past few days. We've discovered some very grave shortcomings

in the ministry. We've found that the ministry is wasting money by

hurting the most inexpensive end of health care, which is the home care

program. Since the last time anybody in this House spoke on the home

care program, I'm sure every member has had another group of letters

this afternoon, as I did. I saw another five or six just on that one

topic this afternoon. This is a very important situation. I think the

ministry, while not agreeing that there have been cutbacks, agree that

there have been net cutbacks. There have been significant cutbacks to

the extent that people who should be kept in the least alienating

environment, their home, will be going back to acute-care and long-term

care hospitals.

Mr. Chairman, we've reviewed the public

health system. We've found that there was a hiring freeze that crippled

the public health system, which is the preventive area of health care

in our province. We have found shortages of inspectors, public health

nurses, nutritionists and speech and hearing people right across the

province and right across the board. It was impaired and continues to

be impaired. We haven't discussed the whole question of ambulance and

emergency services in our province at great length this year because we

have in other years. Suffice it to say that things are not as they

should be. Last year the ambulance union called for $50 million to hire

300 more drivers and staff. They also called for an upgrading of their

facilities. The Minister of Health at the time gave them $500,000

before the end of the fiscal year. Where are the drivers?

For

instance, in Vancouver on June 11 a decision was made to pull the

paramedic car in Vancouver South. The excuse given was a shortage of

staff. There was no such shortage, and if there was a shortage of

staff, they could have brought in staff on an overtime basis. On June

13, on the downtown east side, they did the same thing. So things are

not great in the emergency-care service either. The life of one of the

ministers in this House was saved by our paramedics.

MR. LAUK: Apart from that it's a good system.

MR. COCKE: Apart from that it's a good system, as the member for Vancouver Centre says.

This

pinching of pennies could cost lives and is not a particularly good

idea. As a matter of fact, it's an awfully bad idea. Right now the

Vancouver fire department is still an absolute prerequisite in saving

lives in Vancouver. I suggest that this is an area that is also at

fault.

As I suggested, there is no point in going on with

the minister's vote and the other votes that we're looking at. I will

just say now that we're prepared to take a look at vote 106. In taking

a look, what do we find? We find an increase of over 50 percent in

travel expense. We find an increase of over 60 percent in office

expense. At the same time, that minister is cutting back on his

home-care service. I therefore move that vote 106 be reduced by $17,058.

Amendment negatived on the following division:

YEAS — 23

Macdonald

Barrett

Howard

King

Lea

Lauk

Stupich

Dailly

Cocke

Hall

Lorimer

Leggatt

Levi

Sanford

Gabelmann

D'Arcy

Lockstead

Barnes

Brown

Barber

Hanson

Mitchell

Passarell

NAYS — 27

Waterland

Hyndman

Chabot

McClelland

Rogers

Smith

Hewitt

Jordan

Vander Zalm

Ritchie

Richmond

Ree

Wolfe

McCarthy

Gardom

Bennett

Curtis

Phillips

McGeer

Fraser

Nielsen

Kempf

Davis

Strachan

Segarty

Mussallem

Brummet

An hon. member requested that leave be asked to record the division in the Journals of the House.

Vote 106 approved.

On vote 107: administration and support services, $21,954,338.

MR. COCKE:

Mr. Chairman, among other things in vote 107 we find buried poor old

vital statistics. It used to be a vote of its own. Now it has been

relegated to fine print down at the bottom of the page under planning

and development. I'm just wondering what's happening to vital

statistics.

I also find a couple of other problems in this

vote. I find travel expense has gone up from $756,000 to $978,000 —

this is an administration vote. We also find office expense — the fancy

offices with lovely rugs and so on — has gone up from $337,600 to

$749,800, an increase of $412,000, way over double. This is when we

can't afford to look after the elderly and people on home care. I

therefore move that vote 107 be reduced by $634,534.

Amendment negatived on the following division:

YEAS — 22

Macdonald

Barrett

Howard

King

Lea

Lauk

Stupich

Dailly

Cocke

Hall

Lorimer

Leggatt

Levi

Sanford

Gabelmann

D'Arcy

Lockstead

Barnes

Brown

Hanson

Mitchell

Passarell

NAYS — 27

Waterland

Hyndman

Chabot

McClelland

Rogers

Smith

Hewitt

Jordan

Vander Zalm

Ritchie

Richmond

Ree

Wolfe

McCarthy

Gardom

Bennett

Curtis

Phillips

McGeer

Fraser

Nielsen

Kempf

Davis

Strachan

Segarty

Mussallem

Brummet

[ Page 6227 ]

An hon. member requested that leave be asked to record the division in the Journals of the House.

Vote 107 approved.

MR. BARNES: On a point of order, did the Clerk mention Hon. Mr. Heinrich's name?

MR. CHAIRMAN: No, hon. member.

Vote 108: preventive services, $50,339,865 — approved.

On vote 109: direct community care services, $336,349,487.

MS. BROWN:

I have three questions dealing with grants. The Planned Parenthood

Association of B.C. applied for $141,000 from the ministry some time in

March of this year. They still have not received a response. The

ministry also made a commitment to Rape Relief in Vancouver to pay some

interim funding of $20,000. They have not yet heard from the ministry.

The Coast Foundation — which, as you know, is a halfway house for

community-based housing for psychiatric patients — applied for $268,654

for the 1981-82 year. They have not heard anything. They've received

some interim funding, but they still have not received that grant. They

also applied to mental health services for a $50,000 operating expense

grant, and they have not received a word from the ministry on that

either. Would the minister explain or make some commitment?

HON. MR. NIELSEN:

The grant allocations have not been completed as yet. There have been

additional requests for funding under our grant system, including the

Stroke Association, as we mentioned earlier. The allocation of the

funds under the grants has not been finalized, but I would think that

staff who are engaged in this activity have been in touch with the

people and hopefully have advised them of any interim financing

arrangements or of when the final decision may or will be made. Not all

of the grants which have been requested can be met completely, but I

believe most of them will have received information as to the

likelihood of their total budget this year and the timetable associated

with that. Total grants have not yet been allocated for this fiscal

year.

Vote 109 approved.

Vote 110: hospital programs, $1,043,175,935 — approved.

Vote 111: Medical Services Commission, $451,814,000 — approved.

Vote 112: Emergency Health Services Commission, $40,644,450 — approved.

Vote 113: Forensic Psychiatric Services Commission, $6,235,795 — approved.

Vote 114: Alcohol and Drug Commission, $10 — approved.

On vote 115: building occupancy charges, $31,613,182.

MR. COCKE:

Here we are again — building occupancy; good old B.C. Buildings

Corporation and their rentals and maintenance and so on and so forth.

What do we see here in the face of the fact that we're denying health

care to certain people in our society. particularly the aged? Here we

see an increase from $30,919,000 to $31,613,182. I would therefore move

that vote 115 be reduced by $694,182.

Amendment negatived on the following division:

YEAS — 21

Macdonald

Howard

King

Lea

Lauk

Stupich

Dailly

Cocke

Hall

Lorimer

Leggatt

Levi

Sanford

Gabelmann

D'Arcy

Lockstead

Barnes

Brown

Hanson

Mitchell

Passarell

NAYS — 26

Waterland

Hyndman

Chabot

McClelland

Rogers

Smith

Hewitt

Jordan

Vander Zalm

Richmond

Ritchie

Brummet

Ree

Wolfe

Gardom

Bennett

Curtis

Phillips

McGeer

Fraser

Nielsen

Kempf

Davis

Strachan

Segarty

Mussallem

An hon. member requested that leave be asked to record the division in the Journals of the House.

Vote 115 approved.

On vote 116: computer and consulting charges, $2,944,110.

MR. COCKE:

Here again, there is a significant increase. The job that the B.C.

Systems Corporation is doing for the Ministry of Health shouldn't even

be discussed in a nice place like this. If you want to find out how the

doctors feel about it, in terms of their response I'm sure you'd have

to have some cotton wool in your ears. They're very slow in responding

to billings. There's mistake after mistake. The Systems Corporation is

a mistake. In any event, we see an additional $627,110 here. I'll be

moving an amendment on this vote in a second, That amendment will bring

our graph up this high. The graph says that you have overspent so far

this year, as far as we can determine, $69,805,687 — $1.9 million in

Health alone. The grand total is $71,778,571, when there are people out

there suffering. I therefore have to move the motion that vote 116 be

reduced by $627,110.

Amendment negatived on the following division:

YEAS — 20

Macdonald

King

Lea

Lauk

Stupich

Dailly

Cocke

Hall

Lorimer

Leggatt

Levi

Sanford

Gabelmann

D'Arcy

Lockstead

Barnes

Brown

Hanson

Mitchell

Passarell

[ Page 6228 ]

NAYS — 26

Waterland

Hyndman

Chabot

McClelland

Rogers

Smith

Hewitt

Jordan

Vander Zalm

Ritchie

Richmond

Ree

Wolfe

Gardom

Bennett

Curtis

Phillips

McGeer

Fraser

Nielsen

Kempf

Davis

Strachan

Segarty

Mussallem

Brummet

An hon. member requested that leave be asked to record the division in the Journals of the House.

Vote 116 approved.

ESTIMATES: MINISTRY OF

LANDS, PARKS AND HOUSING

On vote 149: minister's office, $156,974.

HON. MR. CHABOT:

It's always a pleasure for me to present to the House my estimates as

Minister of Lands, Parks and Housing. It's a quiet and calm type of

ministry, and one with which there aren't too many problems. I'm sure

the members will agree with me that there's a need for voting these

funds at the earliest opportunity so we can get on with the job of

meeting the needs of the people in this province.

In the

last year the public need for Crown land in this province has

escalated, and this ministry has responded to the wishes and desires of

the people of this province. We also provided assistance, and are

continuing to provide it, to over 35 municipalities in the form of land

or financing to help them develop land and prepare it for public use.

For instance, we provided the community of Elkford with $7 million to

develop land which will provide lots for 578 single-family homes and

one multi-home. We provided Sparwood with $1,117 million to develop 187

single-family lots and 66 multi-home sites. We provided financing to

Logan Lake in the amount of $5.2 million, and to other communities such

as Golden, Warfield and Kimberley. We made 27 grants of Crown land to

B.C. communities in 1980 for various community uses. This ministry has

a strong commitment to meet community needs for land for fire halls,

parks and other community uses. We release Crown land to meet the

growing demand for rural, residential and recreational lots, and

because the demand for land is high and the proper use of land is

important we undertook many land-use planning studies in 1980,

including the preparation of a strategy plan for that most heavily

populated area of our province, the lower mainland.

ministry responded to needs for housing in 1980 as well. First-home

grants totalling $20,377,000 helped 14,014 people to acquire their own

homes. Second mortgages amounting to $14,550,000 assisted 2,910 more

people. We spent $5,627,000 on housing for senior citizens; nine

projects were completed and opened. Construction began on eight more,

and another 21 projects are in the design stage. We provided a variety

of subsidies to assist senior citizens with the cost of their

accommodation. In addition — and this is an important responsibility of

my ministry — we provided rent subsidies and conversion loans to help

make available more and better housing for handicapped people. In

addition the housing initiative program provided 2,217 mortgages to

build homes, and mortgages were made available for the construction of

2,851 rental units.

For a moment let us forget the terms,

units and mortgages. What it boils down to is that in 1980 this

ministry has helped literally thousands of people to acquire better

housing.

In 1980 my ministry also answered the need of

people in British Columbia to relax and enjoy our province through our

park system. Our 355 parks rival any in the world. Operating,

maintaining and improving them is a costly but beneficial enterprise:

$1.2 million was allocated to 11 regional districts to help them

acquire land and develop regional parks; 18 local community park boards

received grants totalling $14,000 for park development; 12 grants of

Crown land valued at $1.7 million were provided for community parks;

five new provincial parks and one recreation site were created last

year. The day-to-day work of maintaining parks, keeping the parking

lots in order, repairing and replacing picnic tables and providing

other basic facilities continued. Park attendance figures, which don't

include every person who visits our parks, showed that nearly 15

million visitors came to our park system in 1980; the new provincial

park map which we have produced — the first ever — is now available and

it will doubtless increase that number in the year ahead.

The

year ahead will bring pressures and needs to which my ministry must

respond. We have never before seen pressures such as are now developing

in regard to Crown land. Never before has there been such public

interest in and focus upon the designation of use of our land resource.

Should a certain piece of Crown land be designated for agriculture or

forestry, for homes or for industry? We would need the wisdom of

Solomon to solve some of these conflicts. To make the best and wisest

decisions we'll be engaging in an intensive land-planning process over

the next two years. We will initiate and prepare a discussion paper on

land use for this province. We must continue to aid municipalities in

the development of lands. For example, Fort Nelson, McConachie Creek

and the East Kootenays, along with other communities, will receive

interim financing to assist in putting together land for housing.

The

increasing interest in day-use of facilities in our parks must be

addressed, and also the need for more camping facilities for British

Columbians and for our tourist visitors.

In speaking briefly

about housing — and I'm sure I'll have the opportunity to answer a few

questions as my estimates unfold — predictions are that the influx of

people to British Columbia plus natural growth within the province will

result in the need for homes for 200,000 people in the next five years.

The major housing problem is centred in the lower mainland. The rest of

the province has fared better. But the need must be met not only on the

lower mainland but also in the other areas that are feeling the

pressure as well. In 1980 we had 37,600 housing starts, which is a

record exceeded only in 1973. It is a credit to the productivity of our

provincial housing industry. If we are going to meet the

ever-increasing demand, we are going to have to plan for it and make

some changes. The federal government has been urged to retain and in

fact expand the capital cost allowance in the MURB program.

There

are certain pressures on the housing industry at this time, created

essentially by high interest rates which have caused some contractors

to fall out of the marketplace, at least on a temporary basis. We

understand that CMHC has

[ Page 6229 ]

rejected

8,000 rental units. They are urgently needed, because the interest

rates have placed the required equity figure out of sight for the

builder. That appears to be where we are having our greatest problem —

developing sufficient rental accommodation to meet the needs of British

Columbians and of those who want to be British Columbians.

Municipalities

must look at their zoning to see if it really fits the issues of the

eighties, and at the increasing population and the energy crisis as

well. We're looking at revisions of the Building Code to allow the

conversion of some commercial and industrial buildings to housing

units. I want to propose the extension of the conversion loan prog