1988 Legislative Session: 2nd Session, 34th Parliament

HANSARD

The following electronic version is for informational

purposes only.

The printed version remains the official version.

Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

MONDAY, JUNE 13, 1988

Afternoon Sitting

[ Page

5007 ]

CONTENTS

Routine Proceedings

Tabling Documents –– 5007

Pension (Miscellaneous Amendments) Act, 1988 (Bill 39). Hon. Mr. Veitch

Introduction and first reading –– 5007

Ministerial Statements

Bicycle safety campaign. Hon. Mr. Dueck –– 5008

Ms. A. Hagen

Seniors' Week. Hon. Mr. Dueck –– 5008

Ms. A. Hagen

Oral Questions

School Canadiana. Mr. Harcourt –– 5009

Closure of South Hazelton sawmill. Mr. Miller –– 5009

Sale of B.C. Hydro gas division. Mr. G. Hanson –– 5009

Irradiated food processing. Mr. Rose –– 5010

BCEC sale to Stolle Developments. Mr. Williams –– 5010

Court fees. Mr. Sihota –– 5010

Tabling Documents –– 5011

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

On vote 45: minister's office –– 5011

Mr. Rose

Mr. Harcourt

Mr. Cashore

Mrs. Boone

Mr. R. Fraser

The House met at 2:07 p.m.

Prayers.

HON. MR. VEITCH: On the floor of the House today we have two

very distinguished Canadians. First, when one thinks of the Senate and

of constitutional reform, this name always comes to mind. The hon.

gentleman is a distinguished scholar; he was a distinguished senator

for many years, a university professor and a trade union official. He

ran for public office several times — I think for most political

parties, as a matter of fact. He's best known as one of Canada's

greatest constitutionalists, whose insight and pithy observations are

always highly regarded. He has retired from the Senate and is presently

visiting Victoria. Would you please greet the Hon. Eugene Forsey, PhD.

Accompanying Dr. Forsey today is Mr. Donald Munro, formerly Member

of Parliament for Esquimalt-Saanich. He served his constituency

faithfully from 1974 to 1984. Mr. Munro was the Canadian ambassador to

Costa Rica, Nicaragua, Honduras, El Salvador and Panama. He is now

retired and lives in Sidney, B.C., and he's swapping stories with the

hon. senator. I would ask the House to bid him welcome.

MR. ROSE: On behalf of my party, I feel a little intimidated

in welcoming such distinguished visitors today. First of all, I'd like

to join with the government in honouring a distinguished Canadian — the

senator — one of the founders, I believe, of the League for Social

Reconstruction. He has been a nomadic politician. He once headed the

CCF in Quebec, he was later appointed to the Senate by Pierre Trudeau

and now he appears behind the Socreds. [Laughter.] Despite this, I

think all of us recognize that Senator Forsey has an outstanding

reputation as a constitutional expert, and as we learned today as well

— some of us who had lunch with him — he is an entertaining and

fascinating raconteur. Welcome, Senator Forsey.

As far as my old friend Donny Munro is concerned, I spent a long

time in the House of Commons with him. Perhaps it seemed longer to him

than to me, and as a matter of fact it was longer: he lasted longer. He

had a very distinguished career as a Member of Parliament, and his

background in the diplomatic corps helped a great deal. I would hardly

call him on the left of politics, but again, despite this, he spoke out

about his convictions, and I think he did the Victoria area proud as a

Member of Parliament.

HON. B.R. SMITH: I want to add my words of greeting to Senator Forsey,

who has been an acquaintance of mine for over 20 years. Despite his variegated

and maybe questionable political associations over those years, he has been

an adviser, friend and critic, I think, to many of us in government over many

years, and it was impossible not to he captivated by his letters and his reviews

of articles. If you sent an

article or a draft of something to Senator Forsey,

he gave unstintingly in his positive criticism; what he came back with was usually

about twice the length of your article. He is, without a doubt, the leading

expert in the western world on the King-Byng crisis and probably the best authority

on the prerogative of the Crown, and he has written absolutely impeccable, unsurpassed

material on those subjects over a period of 25 years.

I miss his letters in the Toronto Globe and Mail ,

which I think he just had a short respite from. I remember that when

Meech Lake was starting, those letters were there, and I am sure we are

going to have more of them.

This is a Canadian of great intellect and attainment, so I

congratulate him and also my old friend Don Munro, who served this

country so well at home and abroad.

HON. MRS. JOHNSTON: I would like to recognize three people we

have in the gallery this afternoon: Mrs. Jeanne Lamb, chairman of the

Okanagan-Similkameen Regional District; Mrs. Vanessa Sutton, the

secretary administrator-treasurer of the Okanagan-Similkameen Regional

District, and Mr. Don Lid stone, who is accompanying them. Don

Lidstone, as some of you may recall, formerly worked in the Premier's

office — when the Premier was the Minister of Municipal Affairs — as

his executive assistant, and is now practising municipal law. I would

ask the House to please make them welcome.

MS. SMALLWOOD: I'm very happy that I happened to look up,

because I just noticed a very good friend in the House, and I'd like

the House to recognize and make welcome Mrs. Chris Beddis.

HON. MR. DUECK: In the House today we have a number of people

from the B.C. Head Injury Association. These people are here to talk to

the Ministry of Health in regard to their plight when it comes to

members of their families and people known to them who have this very

severe handicap and must go through life bearing quite a burden. With

us today are Nancy and Howard Wood, Peggy Smith, John Simpson, John

Scollon, Judy Fisher, Betty Craig, Martha Uhlenberg, Loretta Stitilis

and Kim Lubyk. Would the House please make them welcome.

MR. LOVICK: In the House today is a group of students from

Ladysmith Secondary School, along with their teacher Ken Helnikay. I

would ask members of the House to please join me and my colleague the

first member for Nanaimo (Mr. Stupich) in welcoming them.

[2:15]

Hon. Mr. Veitch tabled the annual report of the Ministry of Provincial Secretary and Government Services.

Introduction of Bills

PENSION (MISCELLANEOUS

AMENDMENTS) ACT, 1988

Hon. Mr. Veitch presented a message from His Honour the Lieutenant-Governor:

a bill intituled Pension (Miscellaneous Amendments) Act, 1988.

HON. MR. VEITCH: Mr. Speaker, I move first reading of the bill accompanying the message.

I'm very pleased to introduce this bill, which will upgrade the

public sector pension statutes in a number of ways. Briefly, Mr.

Speaker, the proposed changes are minor in nature. They've been

developed through extensive consultation with plan participants and

respond in a very positive manner to recent general developments in

pension plan design.

[ Page 5008 ]

The result of the proposed changes will be that the public sector

pension plans will be more accessible to public sector employees,

provide greater portability within the British Columbia public sector,

address some of the concerns of women with regard to certain benefit

provisions, and lastly, provide access to the pension plan for older

employees who enter public sector employment.

In conclusion, Mr. Speaker, it's my pleasure to introduce this bill,

which will modernize the design of our public sector pension plans.

Bill 39 introduced, read a first time and ordered to be placed on

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

after today.

Ministerial Statements

BICYCLE SAFETY CAMPAIGN

HON. MR. DUECK: Mr. Speaker, I have two ministerial statements at this time.

I rise today to congratulate the British Columbia Medical

Association for taking a lead role in developing a greater public

awareness of bicycle safety. I'm referring to the special poster

campaign the BCMA announced last week in conjunction with the Insurance

Corporation of B.C., the Bicycling Association of B.C. and the B.C.

Home and School Federation. The intent of the campaign is to encourage

a broader use of cycling helmets, a major factor in reducing deaths and

serious injuries as a result of cycling accidents.

Mr. Speaker, the Ministry of Health is only too aware of the

devastation caused by head injuries in B.C. each year. This year alone

it is estimated that between 300 and 400 victims will endure permanent

severe head injuries. Those 300 to 400 will join the 4,000 to 6,000 who

are already hospitalized. The list grows each year, and this silent

epidemic will leave more people the victims of paralysis, blindness and

mental disorders. Another startling fact is that most victims are in

their twenties or younger, and three out of four are males.

In the future the Ministry of Health will be looking at developing

preventive programs which specifically address the area of head

injuries. Hopefully as part of future strategies we can initiate

programs which will enhance and support the endeavours being undertaken

today by the BCMA and others.

Through our involvement in this area we have become painfully aware

that head injuries have a serious impact on more than the victim alone.

The difficulties faced by families who have to take on lifelong

commitments of caring for victims are an onerous burden indeed. If

through campaigns such as this joint one of the BCMA, ICBC, B.C.

Bicycling Association and B.C. Home and School Federation one potential

victim can be saved, it has a been a worthwhile effort.

On July 1 of this year, the Vancouver Island Head Injury Society

will be embarking from Victoria on a cross-country tour to help create

a greater public awareness of head injuries in Canada, and particularly

in British Columbia. We must salute such endeavours by concerned

citizens' groups.

I'm sure that I can say on behalf of all members of this House that

we wish every success to both the Head Injury Society and to the BCMA

for their respective campaigns.

While we do not have cures for many head-related injuries, we can

prevent them through better education and awareness programs such as

those that I mentioned today. To bicycle riders throughout the

province, I urge you not to jeopardize your health and safety by riding

without proper protection. To the BCMA I offer my congratulations for

helping to address this critical problem.

MS. A. HAGEN: I want to join with the minister today in

speaking to this issue which highlights such a very serious problem for

many people and families in the province. Certainly the idea of

prevention, which is a part of the campaign that the B.C. Medical

Association, ICBC and the B.C. Home and School Federation have embarked

upon, is a very important aspect of protecting young riders in this

very healthful sport.

I would hope also, as we look to this issue and the cost that it has

to young lives and to the families of those young people, that we would

he looking as a government and a province to many of the other aspects

that need to be addressed in order for bicycle safety and protection to

be a reality that prevents injuries. Those issues could involve the

Ministry of Highways, municipalities and many groups within our society

to ensure that this healthful sport and activity could be conducted

with safety. This is a good start. It's one of many initiatives that

need to be taken, and for this start we are happy. Let's continue with

other initiatives that would indeed see fewer injuries in the future.

SENIORS' WEEK

HON. MR. DUECK: If I could rise again and make another

statement, with a special sense of pride I would like to officially

recognize Seniors' Week in British Columbia. I know that many of my

colleagues will agree that I look far too young to say that I can

personally relate to our senior citizens, but in all sincerity, I can

say that after having traveled extensively throughout the province, I

feel I have a very good appreciation of the concerns and opinions of

seniors. More important than my understanding of issues affecting our

elders is the very deep respect I have developed for the immense

contribution they have made in making this province the great place it

is.

As a government, and particularly within the Ministry of Health, we

are strongly committed to ensuring that the senior residents of this

province begin to enjoy the fruits of their labour in building the

strong social and economic core of this province.

Today we have many programs in place which demonstrate our support

of seniors. In our continuing commitment to strengthening families in

British Columbia, we also recognize the very significant role of our

elders in maintaining strong families. In our cultures — be they of

native origin or of immigrant families — there is a deep abiding

respect for the contribution of the senior members of the family and

the wisdom they carry.

It is indeed a very great pleasure and a humbling experience for me

to officially recognize those contributions, which I am sure I do with

the full support of all the members of this House. As we all strive to

maintain dignity and good health in our ageing years, let us remember

with respect that we can all be very thankful to our seniors for that

we which enjoy today.

Let us not forget that there are those too who are less fortunate. For those people, let us demonstrate compassion,

[ Page

5009 ]

understanding and a willingness to work collectively toward providing the necessary

support in their golden years.

To the seniors of this province we owe a special debt. It is a debt we can continue to honour through recognition and action.

Finally, let us never forget the sense of pride and accomplishment in which all our elders share.

MS. A. HAGEN: A moment ago we were talking about pedaling,

and in response to the minister's statement about seniors, I'd like to

talk about brakes. Those would be some breaks for seniors and some

brakes on some of the ways in which this government has not upheld the

rhetoric we find in the minister's speech.

Older people are a very significant force in our society today, and

they do — as the minister has said — bring much wisdom. They also bring

an activism which I find very helpful and healthy. Today I want to

acknowledge that activism which is speaking to the very needs of

seniors and their contribution to society. it is an activism reflected

in the work of seniors' organizations which speak out for seniors and

ask for respect and consultation on decisions that affect them. Many of

those organizations have spoken out recently, and I'm sure we'll

continue to hear from them. We should listen and heed them as a

significant force in our society.

The other groups I want to acknowledge in my response to the

minister's comments today are those older people who are contributing

to the well-being of seniors in our communities, and who are

contributing at this time with very little or no support from the

people of the province. I want to acknowledge their contributions and

say that we should, in honouring them this week, reflect on the ways in

which we can work in partnership with the older people of the province.

In that way, the wisdom they bring and the accumulation of their

contributions to us as people in our society can bear fruit that all of

us want to see. As a society acknowledges its elders and works with

them, so is the well-being of a society nurtured. We on this side of

the House want to ensure that is the way older people in our society

are in fact consulted and worked with, as we plan together for a future

that has been such a major force in our communities.

Oral Questions

SCHOOL CANADIANA

MR. HARCOURT: I have a question for the minister of

post-secondary education about Vancouver Community College closing the

School Canadiana. The school has successfully provided

It's being cut despite the fact that Vancouver Community College

already has waiting-lists for on-campus ESL programs. My question to

the minister is: can he explain why Vancouver Community College is

forced to cut a program like this to cover its deficit if, as he

claims, our colleges are adequately funded?

HON. S. HAGEN: I appreciate the question from the hon.

member. As a matter of fact, I questioned the members of the board who

made this decision. The reason for closing School Canadiana is that

they feel that they can place ESL in more centres in the community to

achieve greater efficiency and access for the people who need it.

MR. HARCOURT: Supplementary. Mr. Speaker, that may come as a surprise

to many members of the ethnic communities and those involved in ESL, because

B.C. spends far less per person on services for new Canadians than do Alberta,

Saskatchewan, Manitoba, Ontario and Quebec — only about $15 per person. School

Canadiana has served ethnic groups well in the past, and today it's particularly

important to the Chinese community. Will the minister take this opportunity

to show his support for multiculturalism and ensure that Vancouver Community

College has enough funds to keep School Canadiana open?

HON. S. HAGEN: Mr. Speaker, this is a decision that the board

at Vancouver Community College has taken. Their commitment is that they

will be able to offer ESL in more centres and to more students who need

ESL courses.

[2:30]

CLOSURE OF SOUTH HAZELTON SAWMILL

MR. MILLER: Mr. Speaker, a question to the Minister of

Forests. Last Thursday, when I asked the Minister of Forests about his

comments on the closure of Westar's South Hazelton sawmill, his memory

failed him. Those present at the meeting have now confirmed that the

minister did say: "You know as well as I do that in any other culture

they would move to look for work." Will the minister now apologize

for this blatantly racist remark?

HON. MR. PARKER: I still don't recall using those words, and I don't see any reason for an apology.

MR. MILLER: I'm quite prepared to take the word of Alice Maitland, the mayor of Hazelton, and say you did say it.

A further question to the minister. You've been appointed the

minister of state for region 6, which has a number of native

communities — they have existed for thousands of years in that region —

that have extremely high unemployment rates. As well, you are

responsible for the sensitive negotiations on the Stein Valley, and we

get disquieting reports about that. Does the minister not think that

public statements of the kind he has made have really destroyed his

credibility and that his only hope of regaining it is a full retraction

and a complete apology?

HON. MR. PARKER: No.

MR. MILLER: Finally, would the minister, faced with the

testimony of people present at the meeting, advise the House exactly

what he did say?

HON. MR. PARKER: I did not keep a record of my conversations with the group, but the members I have spoken to can't recall the comment either.

SALE OF B.C. HYDRO GAS DIVISION

MR. G. HANSON: A question to the Minister of Energy. It's a

question of interest to approximately 4,000 people in this region of

Vancouver Island. Last week, as part of the ongoing process to

privatize certain sections of B.C. Hydro, the minister promised that

mainland gas prices would be frozen until July 1, 1991, even if that

division is sold. Why did the minister not afford the same protection

on gas rates to people in this region?

[ Page 5010 ]

HON. MR. DAVIS: The gas rates in this area — it's a propane

and air system — are high, and there would be no point in freezing the

rates at a high level when there's a possibility of them being reduced.

MR. G. HANSON: The minister might think the prospect of gas

increases of 150 percent is funny, but the people of this area

certainly don't think 150 percent is funny. We don't get natural gas

and we pay more. These particular prospects indicate that a deficit of

$4 million to $5 million is going to be picked up by 4,000 people —

that's a 150 percent increase, or $1,000 per gas customer. Will the

minister give the protection that people in this area deserve?

HON. MR. DAVIS: Hopefully within the next two years, we'll

have a supply of natural gas here on the Island, and the price of gas,

as a fuel, will be much less than the cost of propane air. If the

likelihood that the gas line is built is finalized before the sale of

the facilities here in Victoria, they'll take on added value. Indeed,

the sale of the system here might well be contingent on negotiations

between the province and Ottawa re a gas line to the Island.

MR. G. HANSON: We usually only hear about a gas pipeline

prior to a provincial election, so perhaps there's been some discussion

in cabinet that we're not aware of.

The electricity that serves Vancouver Island through the

Cheekye-Dunsmuir line in the Electric Plus program.... Will the

minister give the people of Vancouver Island a firm commitment in terms

of the same reduced price — noninterruptible — and give the people the

surplus electricity that is theirs?

HON. MR. DAVIS: The Electric Plus program, which was

announced about this time last year, cuts the cost of using electricity

— admittedly, interruptible — to roughly half, and it will continue.

It's a program which is available, however, provincewide. Were natural

gas to be available here, the cost of fuel in this area would be

roughly half of what it is currently.

MR. G. HANSON: The point I'm trying to make to the minister

is that the people of Vancouver Island and this region are second-class

citizens of British Columbia when it comes to energy, and we would like

some action from the minister. We appreciated the step that he took in

Electric Plus. In the short-term, until such time as a gas pipeline is

provided, would he give the people of this province a freeze on gas

prices, or the same non-interruptible electric rates that everyone else

in this province has?

HON. MR. DAVIS: The residents of Vancouver Island are not

second-class citizens in respect to power rates, since the power rates

are general across the province — not exclusive to this area — and oil

prices are comparable across the province. Hopefully we can have

natural gas rates comparable across the province, but that is

contingent on a pipeline being built. To freeze the present gas rates —

the propane air rates in this area — would be to discriminate really

against the people here. We should have the prospect of lower prices

available.

IRRADIATED FOOD PROCESSING

MR. ROSE: To the Minister of Agriculture. Recently the federal Health

minister, in announcing changes concerning irradiated food processing, has allowed

60 days for people to comment on the new regulations under the Food and Drugs

Act. What concerns are being submitted by your ministry to the federal minister

on behalf of the people of this province?

HON. MR. SAVAGE: To my hon. critic, we are filling out a

report within our ministry relative to our concern as it relates to

irradiated food. There have been some studies done that indicate the

concern, and in a number of cases they have not been verified as any

risks to the health of the user or the consumer.

MR. ROSE: Many people in the province are concerned about

irradiated food and the inconclusiveness of the toxicity tests that

have been done already. In view of this concern, has the minister

decided to put a moratorium on irradiated foods in B.C.? Is he prepared

to prohibit the sale of irradiated food until adequate studies are

completed along the lines that this controversial process is being

treated in places like Maine, where it's been banned, and is being

considered for banning in both New Jersey and Ontario?

HON. MR. SAVAGE: We are not at the stage of considering a ban until such time as we have a report from the federal research that's being done.

BCEC SALE TO STOLLE DEVELOPMENTS

MR. WILLIAMS: To the Minister of Economic Development

regarding the sale from BCEC to Stolle Developments at a fire-sale

price. There's now a court case that indicates that $5.5 million profit

is anticipated, some $30,000 per waterfront condo unit. Could the

minister advise why an appropriate appraisal or upset price was not

established and that profiteering on this scale will take place?

HON. MRS. McCARTHY: The member who asked the question puts it

in the context of profiteering and all the words that are so familiar

to him, but I would prefer to bring the correct report back to this

House on the land development in the Songhees, including the piece of

property that he mentions. It has been a very good transaction

undertaken by B.C. Enterprise Corporation. I'll be pleased to give the

detailed response tomorrow.

COURT FEES

MR. SIHOTA: A question to the Attorney-General in relation to

the

schedule of court fees that imposes these unfair and high fees on

litigants in court. Under the rules, a person who is declared to be

indigent can have those fees returned. However, that requires people to

get a lawyer that they can't afford to make an application to go to the

court to have those fees waived. The question to the Attorney-General

is this: is he prepared to establish a non-court process, a

summary

process, whereby those fees could be. waived without the need for

counsel or without the need to take up a judge's time?

HON. B.R. SMITH: Yes.

MR. SIHOTA: If the Attorney-General is prepared to do that,

could he tell this House when? Because people are paying these fees.

How is he going to do it? When can we expect an announcement from the

Attorney-General so that

[ Page 5011 ]

people can seek or have this relief which they desperately need?

HON. B.R. SMITH: We have a Justice Reform Committee that has

held a number of hearings and is writing a report. We'll have that

report this summer. The government is going to make it public and is

going to act upon it. In the meantime, there is a process by which

indigent litigants can get that relief. It's called the registrar of

the court. Those orders can be made.

There was a recent court case in Victoria in which that provision

was interpreted. I think it's quite clear that the registrar has the

authority to forgive those fees. It doesn't require high-priced legal

help to get you through that maze. That's what we're trying to bring

about by this Law Reform Committee: ways in which ordinary people can

get into the courts without huge costs and without consulting lawyers

every time they have to turn around.

MR. SIHOTA: Mr. Speaker, it's somewhat hypocritical for the

Attorney-General to now hide behind the Justice Reform Committee, when

he bypassed it and imposed these fees. If he could do it then to impose

the fees, certainly he can do it now to have a review of the process as

it relates to those fees, and certainly with respect to the registrar

it requires a counsel, particularly for someone who's poor and a client

of modest means.

Is the Attorney-General prepared to establish a process which does

not require counsel or registrar but some type of

summary non-court,

non-chambers process so that people can have these fees waived?

HON. B.R. SMITH: To bring this subject to an end, I said yes,

and I say yes again: I am prepared to look at that. But I would remind

that member that court expenses are a very small part of the cost that

is crippling people from getting their court cases on, through and

decided. It's the time wasted, the time spent, the complicated process

and the legal fees that are killing people.

Hon. Mr. Couvelier tabled the report of guarantees and indemnities

issued for the fiscal year ended March 31, 1988, in accordance with

section 56(8) of the Financial Administration Act.

Orders of the Day

HON. MR. STRACHAN: Committee of Supply, Mr. Speaker.

The House in Committee of Supply: Mr. Pelton in the chair.

[2:45]

ESTIMATES; MINISTRY OF HEALTH

(continued)

On vote 45: minister's office, $305,183.

MR. ROSE: I was just going to get up and explain how much I enjoyed

the part of this debate last Thursday and how forthright the minister was in

dealing with my questions. I wanted to know whether he took my advice or not

about not being too involved and excited, and whether, over the week-end, he

did sit back, put his feet up and have some milk and cookies to bring his blood

pressure down a little bit — and how he enjoyed the cookie I gave him.

In the meantime, with that intervention we perhaps might have a speaker.

MR. HARCOURT: I'm very pleased to be speaking on the Health

ministry estimates. What I want to talk about is the kind of positive

health care system that British Columbians deserve, and what New

Democrats would like to see happen to bring that about. We would like

to see a health care system that provides quality care for all British

Columbians, not just for those who can afford it. We would like to see

health care that allows for equal and fair access to the health

services. Also, New Democrats want a health care system that responds

to the needs of average British Columbians — not the Social Credit

agenda of user fees and cuts and unfairness to ordinary British

Columbians.

Today I want to look at some of those areas where the government is

not being fair to British Columbians. There are four in particular that

I want to bring to the minister's attention. The first is the issue of

privatization, and in particular, Riverview. The second, which

exemplifies the overall unfair approach of the Social Credit

government, is the approach that has been taken to AIDS patients and

their access to the drug AZT. Third is the issue of waiting-lists,

particularly for critical operations to heart patients and to children.

Fourth is the very negative and damaging program of the Social Credit

government to bring about a two-tiered health care system.

In regard to the first item I mentioned — privatization or the

contracting out of services — Riverview exemplifies the haste with

which the Social Credit government has proceeded with their triumph of

ideology over common sense, which the members on this side of the House

have pointed out time and time again. Because we felt it was so

important in this sensitive area dealing with people with severe

difficulties, a number of us met with the officials at Riverview — in

particular, our Health critic, the member for Prince George North (Mrs.

Boone) ; the member for Maillardville Coquitlam (Mr. Cashore), our

Social Services and Housing critic; and our member for New Westminster

(Ms. A. Hagen), who has a specific critic role in regard to the issues

affecting seniors.

I also met — with the second member for Vancouver-Point Grey (Ms.

Marzari) — with officials of the greater Vancouver and Richmond mental

health association. We specifically discussed with them the ministry's

plans and the government's fall 1987 "Mental Health Consultation

Report," which was a draft plan to replace Riverview Hospital. I

appreciate that we have had some remarks from the minister assuring us

that they're making haste slowly, that the quite unrealistic time

frames that were originally being talked about when I mentioned this to

him last fall have been dropped, and that at least in this one small

area, there's a second look taking place from this government whose

leader — the Premier — does not only take second looks, but prides

himself on not listening to what people have to say, particularly after

the by-election result in Boundary-Similkameen.

We have those assurances, and we also have the words of the minister

that this plan to replace Riverview Hospital is going to be full of

benefits. In particular, it's going to be cost effective and humane at

the same time. We have concerns about that, because right now, without

any more changes to

[ Page 5012 ]

Riverview, there is a very serious problem

throughout this province and in my riding in Vancouver Centre in

particular. There is a lack of services right now for patients who have

been deinstitutionalized — let alone the 1,100 people in Riverview.

They lack funding to deal with the existing patients.

I want to make it very clear that we're not criticizing those who

are providing the service, such as the outfits that I just mentioned —

the greater Vancouver and Richmond mental health association, the Coast

Foundation Society or the Mental Patient's Association and others. They

are trying to do a good job with a severe shortage of resources.

That was reinforced when I met with members of the downtown east

side community at the Carnegie library with the senior member for

Vancouver Centre (Mr. Barnes). We met our constituents on Thursday

night, June 9, and once again we had it reinforced how serious the

existing situation is on the streets of Vancouver for people with

emotional and mental disabilities who are on the streets without care

and housing right now — without any further changes to Riverview. As a

matter of fact, there are over 200 people on waiting-lists for housing,

and a number of the boarding homes and other facilities under code are

under threat of demolition by developers' wrecking balls to be replaced

with high-priced condominiums. So the existing situation is quite

severe.

Deinstitutionalization isn't a concept that we disagree with. We

want to make sure, though, that the resources are there to do the job

for these people.

We're also concerned with the remaining 1,100 patients in Riverview,

who cannot, I'm sure the minister would agree, easily be fitted into

the community. There are the 350 or so patients who not only have

severe disabilities but are elderly, are suffering from Alzheimer's

disease and other such disorders. Nor is it proper to have the

criminally disposed on the streets where they could be a danger, most

importantly to the public, but also to themselves. And there are others

— of whom I'm sure the minister and his officials are aware — who

require institutional care because they feel they cannot cope with

society; they cannot cope with the strains of being out on their own or

even in a community care facility.

What we want from the minister and his officials are assurances that

there will be funding in place for these many Riverviews, if I can put

it that way — containment facilities — so that these patients are not

out walking around the streets. This is, I may say, a particular

problem in the Fraser Valley. The officials at Riverview made it clear

that 50 percent of the patients they're dealing with are from the

Fraser Valley, where there are no resources — or very scarce resources

— and that includes the minister's own riding and the ridings of a

number of the members of the government. These people have severe

problems, but there are no facilities in the Fraser Valley for them,

their families, their neighbourhoods.

I have three questions in this area that I would like the minister

to answer. First, can the minister guarantee that the $73 million in

savings from the closing of Riverview are secure and will be funnelled

back into the system to beef up mental health services and provide for

additional housing? Second, can the minister guarantee that there will

be adequate bridge financing for the switch-over period when Riverview

is closed? And third, what guarantee of funds over a longer period of

time is there for these programs that communities clearly need and in

order to catch up on the backlog that I talked about earlier?

The second area that I want to bring to the minister's attention is

the drug AZT. Again, it shows an alarming, disturbing attitude on

behalf of this government and this minister when the government makes a

very clear discriminatory decision not to supply AZT in the way that

other provinces supply it, which is without the patients having to put

up $2,000 to $3,000 of their own money to receive this particular drug.

We find this alarming. Every other province pays the costs and funds

AZT. We're not talking about a huge amount here but about a principle

of how people should be treated. They should be treated fairly and

equitably. We're only talking about a hundred patients in British

Columbia.

We can find no reasonable justification from the explanations that

the minister has made. I know he feels exasperated on occasion when we

ask him some of these questions, but we've only heard one explanation

so far: that is, that we would be overwhelmed by patients moving from

other provinces. The government seems unable to understand and accept

that homosexuals have friends and family too. Why would a man or a

woman living in Toronto or Winnipeg and diagnosed as having AIDS decide

to leave their friends and family behind and move to British Columbia?

We've asked the minister about this for quite a long time.

We have some questions, and they come in the area of fair and

equitable treatment. The minister was willing to withdraw from an

untenable position in terms of supplying hormone drugs to the families

of children with growth deficiencies but wasn't prepared to do the same

thing in regard to AZT. First, why won't the minister act to supply AZT

to AIDS patients in the same way that every other province funds AZT?

And could he try to finally enlighten us on what the real rationale is

behind the government's decision?

The third area that we have concerns about for ordinary British

Columbians is that of the long waiting-list for critical operations. On

December 8 the Minister of Health said in the House: "...I have asked

the advisory subcommittee on cardiac care to look at the standard

practices applied in the field of open-heart surgery in this province

and to consider establishing guidelines which may help to alleviate the

degree of current concern." Mr. Chairman, you will remember that in

December I asked the minister about these long waiting-lists. Funding

was provided to a certain extent to some of the hospitals to try to

cope with this particular problem. When I asked the minister about this

matter a couple of months ago, he responded that the results were

starting to show, that the waiting-list was only 432 people. When I

asked that question in December, the waiting-list was about 400 people.

If that's progress, I'd hate to see real progress, because we are

really starting to get way behind in the waiting-lists.

So I have four questions for the minister on the issue of

waiting-lists. The first is: could the minister advise what the

advisory subcommittee has determined? The second is: what are the

guidelines for open-heart surgery? Third: when will the minister act on

those guidelines? And fourth: when will the committee's results be made

public?

The fourth area I want to place before the minister is that of the

two-tier health care system. What we have seen so far that adds to our

concerns about the establishment of a two-tier health care system are a

number of disturbing initiatives that the minister and the government

have taken. First of all, this Social Credit government has floated a

plan for wealthier patients to pay for their treatment and jump queues.

On top of

[ Page

5013 ]

that, they've had discussions with U.S. health care

management companies about turning over the management of our hospitals

and health care to these private U.S. companies — in anticipation of

the free trade deal, of course.

[3:00]

MR. CHAIRMAN: Sorry, hon. member, your time has expired under standing orders.

MR. ROSE: I am intervening for the very obvious purpose that

my leader hasn't finished his remarks. The standing orders require an

intervening speaker, and I'm it.

MR. CHAIRMAN: If the hon. Leader of the Opposition would bear

with the Chair for just a moment, the member for Burnaby-Edmonds has

asked leave to make an introduction.

Leave granted.

MR. MERCIER: Although the talk by the hon. member was most

interesting, he has a captive audience who have been waiting for this

introduction. There are two couples: Bert and Joyce Whitehead, who have

friends with them from England. Bert and Joyce have helped me in many

election campaigns at the municipal level for many years. They have

been big supporters and are much appreciated. With them are Desmond and

Jean Sear. I'd like the House to make them welcome.

MR. HARCOURT: I was discussing some of the alarming

initiatives, actions and discussions of the Social Credit government

around the issue of a two-tier health care system — one for the rich

and another for the rest of us. I mentioned the trial balloons and the

ideas that have been floated for wealthier patients to be able to go to

private hospitals and queue-jump the waiting-list for very serious

operations. That was floated by the Premier himself. As I said, we've

had ministry discussions with a U.S. health care management company —

in anticipation of this Mulroney trade deal that we think is going to,

in this area of services and in many other areas, be very harmful to

this province.

Thirdly, we had the direct intervention of the Premier to prevent

funding for abortion services, which would have had the effect of

allowing wealthier women freedom of choice while denying poor women the

same right.

Fourth is one that has been received very negatively by many British

Columbians. I may say that as recently as two weeks ago, when I visited

Boundary-Similkameen, this was one of the areas where.... Seniors and

citizens of all sorts felt that the hike of user fees for seniors in

extended-care homes from 75 percent to 85 percent of income was unfair

and was going to deprive a number of our senior citizens of a good

portion — as a matter of fact, 40 percent — of their discretionary

income. British Columbians really feel that this is going too far. I've

talked to a number of seniors who are going to be affected not just in

their toiletries and other basic necessities but in those resources

that allow them to have a sense of freedom. They want to be like most

citizens, to be able to get out and around, to have a cup of coffee

with their friends downtown....

An example that exemplifies the cruelty of this particular move was when I

was in Penticton at the fabulous senior citizens' centre there. I ran into

an elderly gentleman who told me that he was going to lose his cart. He wasn't

going to be able to afford his cart, which allows him to leave the centre and

go two or three blocks downtown to visit with his friends and the people he

grew up with in this fine community of Penticton. That's an example of the

negative impact it's going to have on a lot of our pioneers who built up

this great province of ours.

I would hope that the minister would understand that we didn't just

hear that in Penticton, Osoyoos and throughout Boundary-Similkameen but

have heard, it from scores of British Columbians. Our question is very

straightforward: why won't the minister reconsider this regressive

policy of hiking user fees for seniors in extended care homes from 75

to 85 percent?

We are opposed to this policy of dismantling medicare, which through

guile, subterfuge and a thousand nicks and cuts of user fees is cutting

off services and cutting down the quality of care in the public sector

and therefore increasing the possibilities for the private sector to

take over this service. As the political movement in this country that

started medicare, we are not about to let it be torn down. I want to

make that very clear, Mr. Chairman. We are not going to let this

government realize the cherished goal of the Premier, which is to bring

in a two-tiered health care system. It's unfair; it's not wanted.

Ordinary British Columbians don't want it. The New Democrats in this

province don't want it, and we await with interest the answers of the

minister to these questions.

HON. MR. DUECK: The first question or subject was Riverview,

about closing it down and letting people into the community, and

resources not being available for these people. As we go on and on

through a lot of the suggestions and comments that were being made,

many of them were blatantly erroneous, and I take exception to that.

One should at least stick to the actual facts and how they came about

rather than use certain innuendos. It's unfair to do that. It's unfair

to me; it's unfair to the seniors; it's unfair to anyone in the

community who has to listen to that.

Riverview Hospital. It has been said many times, I've got up in the

House and at other occasions.... We've done a very in-depth report, the

"Mental Health Consultation Report," and that was tabled. The public

has been assured that we were not shutting down Riverview, that many

people had had input into this report — from your side of the House as

well, and we appreciated that. It wasn't the Socred report; it was the

report from all the people involved in mental health — societies and

individuals from all walks of life. I haven't got the figure before me

right now, but it is in the hundreds. Seven hundred, I am told, were

involved in this particular consultation, and unanimously, without

exception, they agreed that it was a good move for those people who

could cope in a facility without endangering themselves or other

people. They should have the opportunity — the same as you and I have —

to live in the community, to have the quality of life that we enjoy,

with the support systems in place.

I have assured everyone, but you keep bringing it up. Perhaps

another individual who has not heard the assurances could be frightened

by this, so we say it again and again. I have said it over and over

again that we are not shutting down Riverview, and when we do downsize

Riverview, those resources will be in place. I've given that statement

in the House, outside the House, in letters and in speeches wherever

I've gone. What more can I say? If you don't believe that, I'm sorry.

I'll just sit down. I can just repeat it again. There will always be a

facility like Riverview. Whether that

[ Page 5014 ]

will be one facility or two or three — maybe one up

north, maybe one in the Okanagan, maybe one in the current location —

we will have to house people who are a danger to themselves and to

others. It's society's responsibility, I believe — my responsibility

and yours as well — that those people have to be looked after, and I

certainly intend to do that. Adequate financing, of course, has to be

there, because it may cost a little more to begin with for this

changeover, and that is something that we will have to took at very

carefully.

There was also mention made about mental health patients in the

community, and my particular community was referred to. I know of no

complaint from my community. I'm sorry, maybe I don't go there often

enough. I go there at least once a week, but I have had no complaints.

We have a new facility there now that houses 30, 1 believe, and the

people in that particular facility and the people in the community are

very happy. There was some concern to begin with, yes. Whenever you

have one of these facilities, people are concerned. I think it's also

our responsibility.... We hope it never happens, but it has done, where

someone who is dangerous takes off and things do occur. I feel very

badly about that. But it can also happen to people that live in very

safe environments with very good neighbours, and suddenly disgusting

crimes are committed. I'm sorry that that happens, and I'm also sorry

it happens occasionally to people who come out of Riverview. It does

happen, and I wish it didn't. We'll do everything we can to avoid that

happening again.

When we talk about the communities themselves in Vancouver, senior

ministry staff meet with the Vancouver city council, the people of the

mental health societies and with anyone interested in seeing what the

problems are. We're sympathetic toward the concerns for mental health

in the city of Vancouver. It is acknowledged that Vancouver has one of

the best urban mental health services in Canada, and I think British

Columbia has one of the best mental health services in all of Canada.

We do from time to time run into some problems, but I don't think

there's any system that is perfect.

In Vancouver, $11 million was spent to provide a full spectrum of

community health services. The Greater Vancouver Mental Health Service,

Coast Foundation Society and Mental Patients' Association are regularly

cited by the federal government, national media, academic authorities

and other provincial organizations as exemplary mental health services

providers. Many developments have occurred to improve services in

Vancouver over the past years. I have a list of them here, and I think

I might as well get them into the record. They are: the development of

Car 87, a joint initiative involving Vancouver city police and mental

health staff in emergency services; commencement of work to replace

Venture and upgrade from 10 to 20 beds; multi-service network projects;

social housing projects; 40 new mental health beds opened in 1987-1988

in greater Vancouver; new initiatives to develop children's mental

health services; an intensive case-management project to follow up

ex-Riverview patients, the interministerial project; case management

for multi-system users; new funding for the Canadian Mental Health

Association to provide a public health education program about mental

illness; committees on effects of deinstitutionalization on the

criminal justice system; an increase in psychiatric sessions at

Vancouver General Hospital; the development of psychiatric service for

the elderly; an extension of emergency services at St. Paul's; creation

of a hospital issues committee; the completion of the Vancouver review;

and it goes on and on.

[3:15]

We have at the present time, I believe, 2,000 beds in the community

for mentally ill patients. You asked about longterm financing. I

certainly would trust that moneys will be available when they get into

the community. I don't know at what stage, whether it's one or two

years down the road, but there will be long-term financing. I

understand that if we did not move them out of Riverview and replaced

the buildings currently on the site, it would cost roughly $100

million. So having that in mind, I would hope that that money can be

used to house people and look after those who are able to get into the

community.

AZT. I didn't know whether we should go into that whole area again,

but the question was asked and I suppose I will have to give my answer

the same as I've done a number of times. It's often referred to that we

are the only province that doesn't fund AZT for AIDS patients. I could

also go on to say we are the only province that does something else

that other provinces don't do, by way of giving extra in some other

areas. Pharmacare is a perfect example. We have a Pharmacare program

that is universal and probably better than most provinces'. I could go

over that Pharmacare program again, with your patience. Since you asked

me, I will do so.

The AZT drug is covered by the province under the Pharmacare program

to AIDS patients with a full or partial coverage for AZT, depending on

which plan or what type of individual qualifies. Coverage differs under

four different plans.

Under plan A, partial reimbursement of costs is made to seniors

holding a valid Pharmacare card who pay a 75 percent dispensing fee to

a maximum annual limit of $125, after which full benefits are provided

by Pharmacare. When that was introduced, you will well remember, those

on GAIN got an extra $125. Again, if we are speaking of the

unfortunate, the poor, I think your comments were very wrong and

erroneous, saying we had a two-tier system. We have provided for

exactly that group that cannot help themselves. That's why we've said

that introduction of the 75 percent dispensing fee was countered by the

extra $125 for the GAIN that those seniors would receive.

Plan B: 100 percent payment of benefits is made direct to pharmacy

suppliers for benefits provided to individual residents in licensed

care facilities. You are talking about the aged; you're talking about

people who can't help themselves. I'm saying to you, and I've said it

before.... It's not as if you don't know, because you are an

intelligent person; you know these things, but you keep bringing them

up. To repeat again: 100 percent is paid,

Plan C: 100 percent payment of benefits is made direct to Pharmacare

suppliers for benefits provided individuals and dependents eligible for

medical benefits under the Social Services and Housing ministry. Anyone

in that category has free Pharmacare. You always wrap them up all in

one flag and say everybody is under the gun, and there's a two-tier

system. Not so. Those people get the total benefit: 100 percent.

Plan D: 80 percent reimbursement of benefit costs above an annual

family deduction of $300 with a maximum of $2,000. We've never had that

portion in there of the $2,000, It came about because the cost of drugs

was constantly going up, and it was felt that there should be an upper

limit. Then we start getting criticism because we put a ceiling on it.

Why did we not then get a thank-you and say the ceiling should be

[ Page

5015 ]

lowered? We had no ceiling before. The change we

made is that we put a ceiling on. You might argue that the ceiling is

too high; that's a different argument. But you are criticizing that we

changed that plan, and we've put a ceiling on it.

You also mentioned: "Why don't you do the same as you do to the

people or the youngsters that have to take the growth hormone?" Again,

you're wrong. They are under the Pharmacare program. It's never been

changed. You haven't done your homework. You haven't looked at what the

program is and how it operates. You're shooting through your hat and

making comments that are not legitimate, that are erroneous. I wish you

wouldn't do that, because it puts us both in a very bad position.

[Mr. Rabbitt in the chair.]

Also, we did an investigation of the AIDS people in the city of

Vancouver, and I would like to say at this time again.... It's happened

before. From your remarks it was insinuated or one was led to believe

that somehow I think the AIDS people shouldn't be looked after. I think

that is wrong. I'd like to correct that. Of course, all I say won't

mean anything to you, because you'll keep coming back and saying that I

don't care about those people and somehow I'm homophobic and all those

words that are being used, That's not so. My natural tendency when it

comes to health and health care is that I feel very strongly and very

deeply that anyone who's sick.... I don't make any difference between

one class and the other, or how they got their illness: whether that

person was intoxicated and slammed into a post and injured himself;

whether he was on a drug and jumped from a building; whether he got

AIDS from some method, whether from a needle because he's a drug addict

or from other activities. That should make absolutely no difference

when it comes to health.

MR. CHAIRMAN: Mr. Minister, I hate to interrupt, but according to standing orders your time has run out.

HON. MR. DUECK: I hope somebody will help me out.

MR. REE: I find the minister's comments very enlightening. I

know it takes a great deal of time to try to get some of these ideas to

penetrate the minds of the opposition. I'd like to hear more from the

minister.

HON. MR. DUECK: I have such kind people on the other side of the House.

Because I was concerned, we also investigated when I heard that some

people could not afford AZT and consequently would go without the drug,

and that perhaps their life would end sooner. It may well be that by

extending a person's life some other drug could be developed, and these

people could be helped in the meantime. I looked into it, because it

was a concern of mine. The drug has helped people live longer. We've

got evidence that it has had some effect on the longevity of those

suffering from this disease.

We found that approximately — I can't give you exact figures, but

they are close — 150 people are using AZT at the present time in

British Columbia. Fifty of them are on social services; they pay

nothing. We believe that another 50 could qualify, don't, and continue

to pay. We believe approximately 50 — again, I'm using approximate

figures; it's very difficult to narrow it down exactly — could also

qualify, or most of them could. They don't bother to make an

application, and they just don't pay and say: "Catch me when you can."

I've given information to the hospitals. I've given information on

the radio on talk shows and have said that any individual out there who

needs to take this particular drug should please contact me or the

Ministry of Social Services and Housing, and we will look at individual

cases. I've made that offer. To date I have not had one call. Is that

fair or not? We have a Pharmacare program for people who need

pharmaceutical drugs. As long as that program is in place, that is how

we operate that part of our ministry programs.

Also, I've never made the statement that if we provided them with

that drug free of charge, people would start moving to British

Columbia. Again, I wish you would not say that in the House as though I

have made that statement, because I haven't. Therefore I want that

stricken from the record; at least, I want my words to go on the record

that that is not so. I have never made that statement, and I think the

member should know that.

In the other question that was asked, mention was made of open-heart

surgery. I'd like to go back some time to when this issue was very much

in the news, as the hon. member certainly remembers. That was when we

were falling behind quite severely. We did have a discussion with the

three hospitals that were doing this procedure. We had funded — I've

mentioned this before — for 2,200, and in that period the hospitals

were only able to do 1,700 because of various reasons. Again, those

reasons are familiar to the member. I know that, because I've mentioned

them often enough. They were the shortage of critical-care nurses and

perfusionists, and other reasons that.... I'm not quite sure if the

money was required in other areas and was used in that way.

I think I made a point of saying this in the House. The records

could be checked, but I'm quite sure I did. As a matter of fact, we had

a news release on it. We have a new operating theatre in VGH, which

gives them a much greater capacity. We have given VGH increased funding

to the tune of $3.4 million. We gave them over $600,000 extra to

increase their angioplasty, which is often used in place of open-heart

surgery, and it sometimes prevents that extra major operation. This is

an operation where they put a little tube in your vein, pump it up and

crush the blockages. They assure me that with this extra funding, the

extra money for the angioplasty and the new operating theatre, they

will be able to catch up with the waiting-list substantially. It should

become an appropriate waiting period for someone wanting that

particular operation.

I believe that a lot of these waiting periods sometimes are due to a

lot of patients wanting one particular specialist. We have records of

that. I am no different from anyone else. If I had a very serious

health problem, I would seek the most knowledgeable expert in that

area, and I would want him or her to look after me. We find that

certain physicians have a long waiting-list; others have a much shorter

waiting-list. We also found that the hospital in Victoria consistently

had a shorter waiting-list, and we've transferred some patients from

the mainland to Victoria to help them, so they could get through this

process sooner.

I can well understand that people are very concerned — and I have

met some of them personally — when they know that their lives may be

ended in a week or two unless they get this operation. I must also say

that when it comes to a person's life, heart disease and a heart

operation, they will not

[ Page 5016 ]

necessarily live because they have that operation.

Records show that's not necessarily so. The doctors and physicians

certainly try their best, and we know that it has helped many hundreds

of people, and they have lived longer.

When we hear these criticisms from many people and check them out,

we find that the physicians themselves have said: "No, we'd better wait

until you get a little stronger. We can't operate on you right now." We

also find that physicians will put people on a waiting-list and say:

"You are not an emergency." I don't make that decision; the Ministry of

Health doesn't make that decision. The physicians themselves make that

decision. When they say that you will be in line next month or the

month after — six weeks, three weeks or whatever it is — that's a

decision made by the hospital and by those physicians.

I think I've said enough about that particular subject. I'm sorry I

am going on like this, but your questions were very in depth, and it's

very difficult to answer them with a yes or no.

[3:30]

MR. ROSE: They were deep questions.

HON. MR. DUECK: They required an in-depth response, because they weren't just superficial "yes or no" questions.

A note was just handed to me, and this may be something you would be

interested in. Waiting times for cardiac surgery or any other procedure

are affected by a number of considerations: urgency of the patient's

condition — I think I mentioned that — choice of physician, choice of

facility, the number of operations performed under category C and D,

waiting period, waiting-list B and C — which is the above. Then these

are applied to the individual institution. Right now the latest

information we have — I'm trying to look at the date — is the end of

December. Royal Jubilee had approximately a two-week waiting period;

St. Paul's had 15 weeks; Vancouver General had 16 weeks. That is

improving day by day with the improvements that I mentioned to you. It

should improve from now on.

You also mentioned a two-tiered system. There is nothing in my

ministry that has ever been discussed.... I've gone on record again and

again as saying that as long as I'm in this ministry as the Minister of

Health, I will fight tooth and nail so that we will not have a

two-tiered system. I sincerely believe this. I don't think that we want

a two-tiered system; I don't think we should have a two-tiered system.

I think if people need medical care — whether they've got no money in

the bank or millions — they should have equal access. I've said this

before, and I say it again.

Senior citizens. Again, I do not believe that we are in any way

penalizing senior citizens. Since we brought in the increased premiums

that were alluded to, would you believe that in British Columbia today

there are 60,000 people who pay less? Mark that down — 60,000 people

pay less than they did before we increased the premium. Is that a small

number? I would say that is a tremendous number of people, and those

are the people who are poor. Why is that? Because we increased the

level for subsidized premium from $3,500 to $6,500 taxable income. It

was $2,500 for the 95 percent premium and $3,500 for the 55 percent

premium; now we say it's $6,500 for the 55 percent premium. Thus we

have 60,000 more in British Columbia who are now paying less.

It really bothers me, because I also travel the province — as you

do, I'm sure, hon. member — and talk to seniors. I go into the homes

and I speak to groups. When I explain what we are doing and how it is

affecting them, sure there will be some that are not happy, but by and

large our senior citizens are well looked after. We have a good system.

We have the best system.

In the next two years we will be adding another 1,200 senior citizen

beds; that's intermediate and extended care. How can you say that we

are not looking after seniors? Not too many years ago we had hardly any

homes. We are increasing them by many every year, and you say that we

are destroying the health care system. I just can't buy that.

We also have to look at the future. We have to say it's not just for

me or you. I think I'm a little older than you, although I have more

hair, but I will go through this life all right. I think they will have

a bed for me. But how about your children? How about your children's

children? It's easy to say: "Give them anything and everything." Why

not give me $150,000 a year for being Minister of Health? That would be

wonderful. Why not give everybody whatever they ask for? What we have

done with senior citizens.... We've got a safety net, and the

worst-case scenario — if I could put it that way — is $150 a month with

everything paid. We are saying that incontinence supplies should not be

charged. Anything in the home should not cost the senior anything

except personal items — if they want a TV, a telephone, things like

that. Everything else should be paid for. If they are the ones I just

mentioned, they are under GAIN. They don't pay premiums; they get $150

each. We are treating couples the same as singles so that they will not

be discriminated against. That was also a change we brought in; before

this change in the structure, couples were treated with somewhat of a

penalty.

That's as much as I need to say on that particular subject. I think

I'm at the end of the list. I may have missed something. If I have, you

can remind me.

MR. HARCOURT: It's true, you do have slightly more hair than

I have, but I'm sure that your deputy minister would agree with me that

there is a well-known expression that we both agree with: God made

perfect people and put hair on the rest of you. My condolences to you,

Mr. Minister.

MR. REE: What about the rest of your body?

MR. HARCOURT: I wouldn't talk like that, Mr. Whip, with a

body like yours. You are one of the reasons we have such a costly

health care system, but it's the minister's problem for the next two

years at least, to have to deal with that kind of ill health. That's

his concern for the next year or two, and then we'll have a New

Democrat Minister of Health to whip the system into good health and

have you jogging finally, not smoking, and doing all the things that

the minister wishes you would do.

MR. REE: In a police state.

MR. HARCOURT: No, not a police state at all. We believe in

good health and citizens figuring that out for themselves rather than

ramming our personal views down the throats of the people of British

Columbia like the Premier wants to do so much. You are the party that

wants to do that. It's Social Credit that wants to ram personal

opinions down the throats of the citizens of this province, not New

Democrats. We're democrats. I would look in the mirror and see who you

are speaking to before you make those statements.

[ Page 5017 ]

I would like to deal with some of the minister's comments.

First of all, Mr. Minister, I have appreciated your taking the time to

go over the items that I mentioned to you. I would briefly like to say

that it is not a question of my believing you or not. I think you are

an honest person and that you work hard at your job. You've said that

two or three times to me, and I just want to assure you that it has

nothing at all to do with my believing the veracity of your remarks. I

do. In turn I want you to feel that I am not trying, through innuendo

and otherwise, to question your credibility. I don't want you to

continually say that I am exaggerating and making blatantly unfair

remarks.

I was talking about the people involved in and around Riverview. I

just want you to do the following things. First of all, we agreed that

the mental health consultation report was a good document and a good

idea. I've given those assurances to the people at Riverview, to the

greater Vancouver and Richmond mental health association, to the city

of Vancouver's health department, to the Coast Foundation, to the

Mental Patient's Association and to your own officials. We've made that

very clear. We have no objection, as a matter of fact. We fully support

the deinstitutionalization approach.

Our problem is that you haven't taken care of the

deinstitutionalization that's occurred. I don't make this up. I have

spoken — and I've made that very clear to officials at Riverview — with

members of my caucus; I have spoken face to face with some of your MLAs

— the member for Point Grey — and to representatives of the greater

Vancouver mental health association, one of whom is Marguerite Ford,

who is now head of the Alzheimer Society, and she's scared witless

about more deinstitutionalization without dealing with existing

problems. It's not me making this up. These are real people; they are

not a figment of my imagination — I'm not in need of these facilities.

These are real leaders in a fine mental health system. The people

working in it are devoted. They need the resources. Right now there's a

need for 200 beds — a waiting-list in Vancouver, without anything more

happening to Riverview. I would feel a lot better.... Again, I'm not

questioning your veracity, Mr. Minister, your use of truthful

statements. I accept that you are. But you are not dealing with my

point.

My point is that there's a problem now. I want assurances from you

that you'll deal with the existing shortage, and that when you do move

to the deinstitutionalization recommended in the consultative report,

there will be funding in place, there will be bridging finance, there

will be facilities. Even though Matsqui has a 30-bed facility, there is

a need, I am told by the officials at Riverview, because half of the

patients who will be deinstitutionalized out of Riverview will be from

the Fraser Valley, and there aren't the resources for them.

I don't make that up. I'm used to preparing my statements carefully,

as a lawyer or as a mayor or as a private developer prepping pro formas

for housing developments. I don't usually do these things off the top

of my head. These are people I've spoken to. Either here or in the

future, I would like assurances from you that you will deal with the

existing problem that I've just talked about, that I confirmed as of

Thursday night with some of my own citizens in the downtown east side;

and that you will deal with some of the problems of new institutions

required in the community, to bring about what you want and what we

want, which is the right of the people in Riverview that we're talking

about — those who can — to have community living with support systems

in place. Those were your own words: "with support systems in place."

That bottom line is what I have been talking about for almost a year.

That is the point I would like you to address, without dealing with

innuendo, unfairness or my questioning your veracity. I don't intend to

do that, and I don't appreciate you doing the reverse. Just deal with

the concerns that I have expressed about the existing problem and about

the potential problem of releasing more people onto the streets without

resources.

Secondly, in regard to the drug AZT, you went into some detail to

miss my point. You talked about all sorts of categories and all sorts

of AIDS assistance that are available. But there are still over 100

patients in British Columbia who do not have equitable access to this

drug. You talked about Pharmacare, you talked about GAIN, you talked

about this, you talked about that, but it still misses my point. There

are 100 people paying $2,000 to $3,000 a year, and they aren't in other

provinces. We think that's unfair. That's my point.

The third issue I wanted you to address was the questions I gave you

on waiting-lists — that is, your advisory subcommittee on cardiac care.

I didn't receive an answer to any of the four questions I asked, which

were:

(1) What has the ministry's advisory subcommittee determined?

(2) What are the guidelines?

(3) When will you act on the guidelines?

(4) When will the committee make their results public?

[3:45]

The last issue. We on this side are pleased that the Minister of

Health is utterly opposed to a two-tier health care system. However,

we'd feel a lot better if the Premier felt the same way. When you have

a one-man government, and a Premier who says that nothing is sacred —

who said that yes, he'd be prepared to look at private hospitals, and

yes, there are no sacred cows in health care; he makes those statements

on quite a few occasions — then I would just hope this is one area

where this one-man government is not going to be able to succeed before

there is a change in government.

HON. MR. DUECK: Again, I don't want to get into an argument

with a lawyer of renown, so I'm not going to take you on at all. I just

want to defend myself. When I get attacked and accused of making

statements that I did not make, I feel I must do that.

You mentioned this task report. Yes, we have it. There are some

things in the report that we are not making public at the present time,

because many things have to be considered before we do. So I can't

really go into depth on that report.

You mentioned the existing situation. That, of course, is an ongoing

thing, because we never have enough people, we never have enough money,

we never have enough beds and we never have enough resources. I assure

you that this is something we're working with on just about a daily

basis. I wish I could have made an announcement a week or two ago on

some of the improvements we have coming, which, could I have done this

a week or two ago, would have helped me a lot in these discussions here

today. But we're not quite ready for that.

We are taking the appropriate steps to correct some of the

shortfalls and, as you said, gaps. This is a clich that's used more

today than it was a few years ago: everybody's falling between the

cracks and the gaps. This is used in every situation where there's a

problem with one segment, whether it's in business or what have you. It

explains it quite well, because some people don't fit into either

little square; they fall between. No one wants to take them on, or

they're

[ Page 5018 ]

forgotten, or they have a situation that doesn't

quite fit the norm. There's no question that we have people like that,

and this is being addressed daily. I think we've made many improvements.

I can assure you that before we move any of the people out when

we're downsizing.... We're not downsizing, but there are a stream of

people who go in and out. That's the way the system works, because they

are appropriately released by the authorities and the psychiatrists,

and they must go back into the community.

We also have some who there's very little opportunity to help,

because they refuse help. I think I brought that out last year, and I

got into all kinds of trouble. But it's true. There are a number who

you can put into an appropriate facility and they do not wish to stay.

By their own choice they go on to other areas, to live in different

surroundings.

There are people who have to be looked after who haven't got the

capacity themselves; I admit that. They need help in many areas, and

you practically have to lead them to that source of help. We're doing

that. If you criticize us for not doing it well enough.... If you can

criticize me in specific areas, I could zero in on it perhaps a little

more accurately.

In general terms — and we're speaking in general terms — we are

somewhat behind. I could stand more resources. I could have more help

out there, but by and large, when we meet with these

service-providers.... With the funds and resources available, I think

the ministry, the people who work for us and the service-providers are

doing a fairly good job and will continue to do so.

MR. CASHORE: I have listened with interest to the dialogue

between the Leader of the Opposition and the Minister of Health as they

have canvassed a variety of topics, and I will be coming back to some

of those topics during my remarks, comments and questions.

I want to say that in reading over the introductory comments of the

Minister of Health, the minister mentioned that he did not want the

discussion of health care in the province to be apolitical discussion.

I would just like to say at the outset that I fundamentally want to

acknowledge that there is a political reality to what we discuss in

this House. More often than not we agree on what the goal is and that

we all want to work together to achieve that goal, but I think the very

nature of the process we're involved in here is that there is a

political reality to it. That's one of the reasons the public has the

opportunity to observe the results of our lively discussion and debate

and to form opinions with regard to the various perspectives that are

held. So it's within that context that I make my comments.

Also, I want to say early in my remarks that I had the opportunity

in the past few months to make extensive use of the medical care system

in the province. I had what some people would consider major surgery on

February 8 in New Westminster. I believe that I received the benefit of

very good quality care at that time. I came out of that procedure with

a great deal of respect for all the people who work in that hospital,

and I felt that I was well served.

I did observe, however, that the working conditions were difficult.

I was in the old

section of the hospital. I understand that there are

some plans in place now for that

section to be replaced; I actually had

an opportunity to discuss that possibility with the physician who

treated me. I was very much aware of staff bending over backwards,

running off their feet to try to keep up with the needs of the

patients. Even some of the people within the hospital whom we don't

often think about — the cleaners — were so busy that they really didn't

have the time to do a decent job. That probably affected their

self-esteem and was a factor in the working conditions in the entire

unit.

Having said that, I just want to support what my colleague the MLA

for Coquitlam-Moody (Mr. Rose) mentioned, which is also a concern of

mine. Although Eagle Ridge Hospital is not located within my riding,

generally half of the people in my riding, those in the northern part,

would tend to go to Eagle Ridge Hospital in an emergency. Perhaps those

in the southern portion of my riding would tend to go to the Royal

Columbian. I've heard announcements on many occasions indicating some

optimism about the possibility of the emergency ward and some of the

unused portions of that beautiful new hospital being used, and we still

await some definite word on that. I hope that the minister would take

the opportunity during the Health estimates to announce that the

emergency ward of Eagle Ridge Hospital will indeed be opened. That

would certainly stand the minister in good stead. Apart from the

political reality that I mentioned a few moments ago, Mr. Minister, it

simply makes excellent sense in the delivery of preventive health care,

which in the long run saves the people of this province a lot of money,

when we take more than just one year to look at a bottom line.

I would like to move on to another point, ask a question and then

listen to the minister respond. In the House exactly two weeks ago

today, on May 29, I asked a question of the minister about the backlog

of children in the Simon Fraser health unit area who require assessment

for speech impairment. When I asked the question, the minister said

that if I could be more specific, he'd be able to give me a specific

answer. At that time one of the specifics was.... I asked the minister

to confirm that there were 150 of these preschool children on the

waiting-list. Since then, I have discovered that in actual fact,

according to people in the community who are very close to this issue,

the minister has received a letter from these people, dated May 29.

These two people — one from the Glenayre Leaming Centre and the other

from the Step-by-Step society — point out that there are approximately

250 children on the speech therapy waiting-list in the Coquitlam area.

Another specific to the minister is that according to people in the

know — and I understand these to be people both involved in the

assessment of speech therapy needs and who are members of the

Reach-for-Speech organization in the area — it takes from one year to

18 months on the waiting-list to receive assessment. Mr. Chairman,

number one, I understand — and it's possible that the minister can

confirm — that this is the most distressing situation in speech therapy

in the entire province. But I don't know that for sure. I certainly

hope that there is no area of the province that is any worse off than

that.

I'm sure that with the minister having declared, especially in

recent months, the importance of a preventive approach, he will

recognize that the formative years — the years between birth and six —

are the years that are most important in terms of making any

adjustments that will enable children to grow and mature in a way that

allows them to fulfil their potential. Those first six years are

crucial years. Given that children don't usually start speaking until

well beyond the first year of life, that leaves a window of opportunity

of some four or four and a half years. If within that

four-and-a-half-year period a parent of a child is faced with a

[ Page 5019 ]

wait of a year and a half, how on earth can we

justify this? We can’t justify it on the basis of this being the

pattern throughout the province, because apparently it isn't. We can't

justify it on the basis of it being a justifiable item to delay for

when we can afford it, because if we don't provide the children with

this service when they need it, it's going to cost us an enormous

amount beyond that in later years in terms of the difficult social

adjustment they will have to deal with and the additional educational

costs.

To the minister: you took my question on notice two weeks ago, and I

understand that. I understand, though, that you have now had ample time

to research my question and to receive a letter almost two weeks ago

from some people in my constituency and also in the constituencies of

the member for New Westminster (Ms. A. Hagen) and the member for

Coquitlam-Moody (Mr. Rose), and to respond. I would hope, Mr. Minister,

that your response would include (

a) some extraordinary measures to

deal with the backlog and (

b) some long-term measures to deal with the

need to have that assessment done without delay.

There should not be a delay of more than six weeks. I believe that

it is a bad economic process if that delay is any longer than that,

because of the damage that can be done. So I will take my seat now and

listen to the minister's response on this point.

[4:00]

HON. MR. DUECK: I want to make a couple of comments also,

because they were part of the introductory remarks. When I said not to

be political when it comes to the health of the people — and I think we

agree on it, and we'll forget it after this — I meant not to use health

to score political points. We are political in the House — there's no

question about it; I accept that; you accept that — but not to score

points. That's what I meant when I made that statement, and I think you

feel the same way about that.

I must say I did not know you had been in the hospital, and I was

going to mention that had I known, I would have visited you — but you

would probably have become more ill if I had. I'm glad you're back in

the House, and you look good.

[Mr. Weisgerber in the chair.]

As far as the statements made or the question asked, you alluded to

perhaps some news with Eagle Ridge. Of course, this is an ongoing

thing, so I'm not spilling anything. We've been discussing this with

the mayors in the areas and with the health professionals. If you

people wouldn't keep me so long in the House on these estimates, maybe

I could already do something about that. I'm not going to say any more

than that.

You mentioned a little bit about preventive health. This is the

thrust this government has and the direction in which it is going and

has instructed me to go. That is preventive health, and that's in all

areas, whether it be diet or exercise or letting your blood pressure go

too high by getting excited in the House. All those things are part and

parcel of looking after yourself.

It also includes such things as smoking and abuse of alcohol. These

are legal commodities, so when I say these things, I'll probably have

half the people on my side here chastising me after this session. But I

do believe that this is all part of preventive medicine. And not only a

small part; I think the

part is so huge — when we talk about alcohol

abuse and cigarette or tobacco use — that thousands of people die every

year. As a matter of fact, 6,000 people die a year in Canada from the

results of the use of tobacco. Having said that, I won't go any further

in talking about those two items. That's also part of the preventive

care: that we can look after ourselves and it won't cost us anything;

as a matter of fact, it could save us money. But do we do that? No, we

ask the government to throw more money at the subject, and somehow the

other things will just go away. I know you don't smoke, and I don't

smoke, so we can talk like that. We like the odd little drink, I'm

sure, but I'm talking about abuse of either product.

In the area of speech therapy and hearing, the difficulty has been

in recruiting therapists. I'm responding to the question that I took on

notice. I'm sorry I didn't respond sooner. Apparently these were ready

some time ago, and I have just neglected to do that. As a matter of

fact, I forgot until you mentioned it, and the light went on. I just

had them brought from the office. It has been a real problem. Our

salaries for speech therapists are not comparable to other employers of

speech pathologists, and we can't seem to keep them. For example,

school districts pay something like $40,000 plus in addition to

attractive benefits, and health therapists quickly move on to school

districts.

As you know, we look after the children until they go into school,

and then the school district looks after them from there. There are

about 20 communities where speech therapy services are either

non-existent or unable to meet the demand. You're right that that is an

area we're looking at very closely, and we are not happy with it at

all. The need for additional speech pathologists is being documented,

and an internal review is looking at a more efficient delivery of

speech services for preschoolers. When you zero in on the Simon Fraser

Health Unit, my information is that the waiting period for services in

that area is anywhere from 12 to 18 months, and that seems excessive. I

wish we could change it soon, but it is a fact that these children have

to wait that period of time.

All the waiting-lists for speech therapy are public information. You

mentioned the other day that you could not get that information. Quite

frankly, it should be easily available to a member of the public upon

inquiry, and I'm sorry if you didn't....

MR. CASHORE: We got it sent.

HON. MR. DUECK: Okay, thank you.

The Simon Fraser unit, incidentally, is one of the heaviest referral

areas of speech therapy for preschool children. We admit that the

present waiting-list of therapists is too high, and the demand for

speech services is of concern to the ministry. The ministry is

currently undergoing a reorganization which will see the amalgamation

of preventive and community care services into a new division, and we

call it community and family health. We believe that by combining those

we can streamline that whole system.

My deputy has done quite a bit since coming back to the ministry,

and I'm thankful to have him back, although he should shut his ears

when I'm talking about him. I refer to him as my old new deputy. He

knows the health care system well. I trust that with my direction and

his enthusiasm, we will be able to correct that waiting-list and bring

it down to a more manageable level. I don't want to use excuses; the

[ Page 5020 ]

waiting-period is too long in that area. I admit that freely. We're trying to correct it.

MR. CASHORE: I want to thank the minister for that response,

but also to say that I would expect within a very short period of time

— possibly one week — something much more definitive. I do appreciate

what the minister is saying with regard to reorganization and the fact

that his deputy is undertaking a number of initiatives; but there is no

question — and I think the minister has recognized that — that this is

a problem of crisis proportions in the Simon Fraser Health Unit area.

Maybe I can just give some additional information. Yes, Mr.

Minister, you are correct: we did manage to get the information with

subsequent phone calls. I wanted to make that clear for the record.

Given that the health unit deals with preschoolers and also with people

who are 20 years of age and older, and based on some 1986 census

figures.... I think you'd find these interesting. The Simon Fraser

Health Unit has four offices: Coquitlam, Port Coquitlam, New

Westminster and Port Moody. We have three speech therapists for those

four locations. One of those speech therapists was going on maternity

leave, and there was some question with regard to whether or not she

would be replaced. I understand now that she has been replaced and that

there are three. But in the Coquitlam health unit the population is

55,926; Port Coquitlam, 22,260; New Westminster, 36,172; and Port

Moody, 12,319. So you can see that in the Coquitlam health unit, where

there's one speech therapist to a population of 55,926, that's a stark

contrast to the Port Coquitlam Health Unit, which has one speech

therapist to 22,260. Perhaps there's some arrangement whereby those

people can share the responsibilities. I'll just say that this is an

absolutely intolerable situation, and I expect to hear something on

this very soon.

I understand that some of the issues that have been pointed out deal

with the difficulty of attracting speech therapists into the health

system, and that there's a real discrepancy in wages between those in

the health system and those in the education system. Some of those

issues have to be addressed, and I think they have t o be addressed

very soon.

Mr. Chairman, I'd like to move on now to another topic. Does the minister want to respond to that right now?

HON. MR. DUECK: Yes, I can give an answer on that right now.

We've just had a little meeting, and we're going to transfer some

people. We're going to get a flying squad to go in there and correct

the situation that exists in your particular riding.

MR. CASHORE: That is very good news, and we will certainly be

following up on that. I appreciate the announcement, and we'll be

getting in touch with the people in our community. I'm sure that they

will look upon it as a report of substantial progress, and I do

appreciate it.

Mr. Chairman, I'm going to move on now to some issues dealing with

mental health. I beg the indulgence of the House, if I recanvass some

topics that my leader has canvassed. I will try not to do so, because I

think he did that very ably, and I listened carefully to the discussion.

During the minister's introductory remarks, I read with interest

that he said: "...decentralization...for the mentally ill, providing

that replacement resources are developed in the community prior to any

corresponding changes at Riverview...." Obviously I've left a couple of

words out there in my writing-down from the transcript, but basically I

understand the minister to have said and reiterated in the House that

there will be no further downsizing until there are corresponding

changes. He says that there will be "no reductions in Riverview

programs until the community system is strengthened and replacement

resources are in place." Therefore, careful attention to patient care

requirements and any community concerns will be required.

I understand that this is the context in which the minister has made

those points, and I want to ask what is happening. If there is no

further downsizing going on, what is the present situation with regard

to the development of community care facilities, group homes and other

types of facilities within the community? Does that mean that these too

are on hold? Or are these developments taking place to prepare for the

day when there can be further downsizing at Riverview? Just what is the

situation at the present time?

HON. MR. DUECK: The "Mental Health Consultation Report" has

been received. I have not yet taken it to cabinet. When it is taken to cabinet,

and they decide whether that's the direction we're going in, that's

when the process will begin. So it hasn't gone that far up to the current

period in time.

[4:15]

MR. CASHORE: I'm still experiencing some confusion with

regard to the development of community care facilities. I would assume

it is still in process. As a matter of fact, I've had some discussions

with people in North Vancouver who have had extensive discussions about

the development of a community care facility in their community. I

would ask the minister to confirm if by what he has just said he means

that there is no continuing development of community care facilities at

this time. Would you clarify that, please?

HON. MR. DUECK: I was talking about the downsizing of

Riverview. That part of the program has not yet begun, because it will

be a direction from cabinet for facilities for downsizing. As far as

the community is concerned, these people who come into the system and

leave the system on a regular basis, which you well know.... I don't

mind admitting that you know more about those areas than even I do,

because that has been your line of work for a long time. We know there

is a service delivery gap from time to time, and we're endeavouring to

identify it and take appropriate steps. During the next few months

we're going to be announcing a significant improvement in the number of

psychiatric beds that will become available. There is quite a plan in

place at the current time, and these announcements will be coming

forward soon.

MR. CASHORE: So I take it that while the minister has stated

that the downsizing of Riverview is on hold, there the process of

developing facilities in the community is still underway.

I would like to point out to the minister that in an

article in the

Vancouver Sun on May 12 the minister referred to 18 initiatives to deal

with the mental health services outlined in the report, and said the

concern that the ministry will keep discharging patients from Riverview

and flooding the city is not correct. However, we do have some

circumstances in the city that, if the downsizing is on hold, are

factors that seem to

[ Page 5021 ]

be enormous. While I welcome hearing that more beds

are going to be made available and that there's an announcement coming

forward, I think that we get into an area here where two of our huge

ministries, the Ministry of Health and the Ministry of Social Services

and Housing, experience what I would call crossovers — in other words,

people leaving the health care system and sometimes going into group

homes and other facilities, and then disappearing for one reason or

another. Possibly things just didn't go well there and they ended up

wandering off downtown or some place, sometimes never to be heard from

again, but quite often disappearing from the health care system and

arriving in the social services system.

I want to ask the minister if, in his role in government, he's had

any discussions with the Minister of Social Services and Housing (Hon.

Mr. Richmond) relevant to the reorganization in that ministry that has

seen the loss of 40 social workers from the Vancouver area at the very

time we're hearing so many stories about the difficult circumstances

being experienced by ex-mental patients. In the context of the

crossovers of people in the health system who end up in the social

services system and the fact that there's a loss of 40 social workers

and that the minister is concerned about what happens to those people,

it seems to me an intolerable situation. If nothing else, there needs

to be some coordination within this government between these two

ministries if the needs of these people are really to be addressed.

HON. MR. DUECK: If you will allow me, I want to go back. I

was looking for this information before, when we were talking about

professional speech and hearing.... We are also cooperating in that

area with Education, in that we're trying to do it as two ministries

rather than each going in its own direction. As a pilot project, we

have funded ten speech pathology positions, approved by the Ministry of

Health. We're developing a private program in communities.... It's not

in all communities, but the communities we are presently looking at —

and in some of them it's already in operation — are Alberni, Lillooet,

Revelstoke, Howe Sound, Burns Lake, Lake Cowichan, North Thompson,

Nechako, Queen Charlotte Islands and Fort Nelson. I say this because of

the concern you had whether we cooperate and work with other agencies

and other ministries.

As far as mental health is concerned, and the question you asked

just now about whether we do in fact liaise with the Ministry of Social

Services and Housing, it just so happens that the deputies of Health

and Social Services and Housing will be meeting with officials of the

city of Vancouver to discuss program crossovers this coming Friday. All

I'm trying to tell you is: yes, we do — and we should do more. I think

ministries have had more cooperation and crossover discussions about

their problems, because so often, especially when it comes to health,

social services and education, so many of these things are not entirely

one or the other; somehow they all dovetail. We are working with the

other ministries, and we will continue to do so. Your remarks were dead

on.

MR. CASHORE: I'm very glad to hear that these discussions

take place, but there must be an enormous sense of concern, realizing

that these crossovers take place and realizing the loss of 40 social

workers from the Vancouver area. I would like to ask the minister to

comment specifically on how he feels about that and how he envisages a

plan he is discussing with the Minister of Social Services on how to

address the concern.

HON. MR. DUECK: Just to clarify, you were talking about

Social Services employees? I cannot comment. Of course it's a concern

if they have lost 40 workers. I suppose it's an even greater concern to

the Minister of Social Services and Housing. I also hope that when they

meet they discuss those problems, because they do impact on Health as

well. I can't comment on what they're doing, why they lost them,

whether they've got some coming, whether they've replaced some of them,

or whether the others will be replaced next week. There has been a

shortage of professional people in many of the health and social

services areas, and it is a problem; it's very real, and it causes us a

lot of concern, no question about it. Very often we're dealing with

children or even adults who have a problem.

I've got some information here that may help. I understand that 36

new staff have been hired into the mental health service centres and

that each centre now has a program coordinator for child and youth

mental health services. These senior clinical staff have the

responsibility to develop and oversee local programs. We're talking

about the children's programs; maybe you weren't zeroing in

specifically on those. Some new staff positions have been filled in

that area — 36 of them, as a matter of fact.

MR. CASHORE: Throughout the province?

HON. MR. DUECK: That's throughout the province, yes.

MR. CASHORE: The reason we can discuss these crossovers, and

the reason it's appropriate to mention the loss of 40 social workers

from downtown Vancouver, even though it comes under another ministry,

is that this ministry has expressed on numerous occasions recently its

holistic approach to the delivery of health care and its belief in a

preventive approach. One preventive approach is to address the things

that oppress people so that their lifestyle can be such that they are

less likely to have a mental breakdown, which is often related to

stress among other factors, and then find themselves back in the health

care system. It works both ways, those crossovers. My only point was

that while I'm pleased to hear about other health care workers coming

into the field, it seems that we're still losing ground on an issue

that you, Mr. Minister, must be concerned about; you have expressed

concern about it. There are some indications that we are losing ground

significantly in terms of these lost people in our society who don't

seem to fit in anywhere. Certainly they are people who spend a lot of

time in a revolving door within the care and keeping of the ministry.

In the "Mental Health Consultation Report," it's interesting that

one of the terms used in referring to the role of a physician in all

this is that the physician would be seen as a gatekeeper, in a position

to decide when a person should be taken into care, based on the Mental

Health Act. and when a person should be discharged. We also know of the

role of the review panel in that. I note that one of the comments of

the Mental Patients' Association is that a more holistic approach would

be to look upon that person as an initiator rather than a gatekeeper,

and to move away, from the strong allegiance to a custodial concept

into a concept in which there is really bridge-building between the

institution and the community.

[ Page 5022 ]

There are a number of organizations doing outstanding work out there

in the community that are outside the health care system. They are

organizations such as the Mental Patients' Association, the Friends of

Schizophrenics, the Alzheimer Society, the Coast Foundation and the

Canadian Mental Health Association.

I note with interest that the minister has recently entered into a

project with the Canadian Mental Health Association. I wonder if the

minister recognizes the resource available in those organizations to

help achieve the kinds of results needed if a program of

deinstitutionalization is to work. You see, Mr. Minister, one of my

real concerns as we go through this process — and it has been

experienced in major cities throughout North America — is that as

people leave institutions.... There is certainly a philosophical basis

for that to take place. As that so-called process is put in place in

order to receive those people in the communities.... I'm not saying

this as any direct accusation with regard to the program. What I am

saying is that I don't see any indication that monitoring and advocacy

services are supported to the extent that they should be if such a

process is going to work.

[4:30]

This has been an extensive experience throughout North America, and

it goes something like this. Increasing numbers of people are in an

institution. In that institution there are some economies of scale, but

as you have pointed out, the cost of maintaining those buildings is

prohibitive. But in a sense the people located in that place are much

more visible. It's a place where the volunteer organizations can go and

focus on that large group of people who happen to be in that

institution. It's a place where the various advocacy or self-help

groups can go and focus.

But when these people go out into the community, as important as

that is and as important as it is that it be done well....

Incidentally, I think it's done better when it is under the aegis of a

society such as the Mental Patients' Association or the Coast

Foundation. I prefer not to see those community care facilities become

private for-profit operations; I personally prefer that they go to an

organization whose bottom line is service. But it's still important

that someone from the ministry with special training in this field

conduct the evaluation, the ongoing monitoring, and also that

organizations such as MPA, the Coast Foundation and Friends of

Schizophrenics receive support so that they can carry on some of the

advocacy procedures.

Indeed, when that happens, it might even result once in a while in a

government being criticized by those organizations. I would think it's

a mark of maturity in government when that government is willing to

enable that group to exist and function, because they best understand

how to help their peers, their colleagues and their friends, even

though the price sometimes is that there will be some constructive

criticism coming from the organization.

I understand that in the city of Vancouver.... I think that while we

often focus on Vancouver, it's for a reason: a great many ex-mental

patients tend to end up in downtown Vancouver. There are also examples

of this type of scenario in other cities and communities throughout the

province, and I think we need to remember that.

I have some figures for the Vancouver area that aren't entirely in

keeping with what I heard the minister say a few moments ago. I believe

I heard him say that there are 2,000 beds in the community for the

mentally ill.

Interjection.

MR. CASHORE: Okay, that's provincewide.

I understand that in Vancouver there are 350 boarding-home beds, 150

independent housing units that ex-mental patients live in, and 100

miscellaneous units, for a total of 600. Yet it's estimated that in the

city of Vancouver there are 20,000 persons living on their own who have

serious mental health problems. I would think that these are people who

come in touch with the system from time to time. Most of these people

live independently in the community now; therefore they have a need for

a resource. I think that the clubhouse models that have been developed

by some mental health organizations are a real opportunity to put

something in place that will help make this plan work. Having said

that, if the ministry was really to examine the financial support

received by those organizations to provide their day care support out

of those drop-in centres, you would find that it would have a

tremendous influence.

It works something like this. If a person who has been in hospital

is on medication and out in the community, after a time when that

person gets up in the morning, where does he or she go? What are the

alternatives? What are the possibilities? Usually this is a person on

limited income. Where can that person go in the community? They might

go down to a pub, and that might be okay. They might go and visit some

of their friends in some part of town, and that might be okay. If

there's a place, if there's a centre that they know of as a warm,

caring and friendly place that they can go, and if the time were to

come that their medication was not doing the job it was intended to do,

more often than not it would be another ex-mental patient who would

take that person by the hand and say: "Come on with me. I think we

should go down and visit the community care team."

It would be those people who would actually be providing the buffer

that prevents those people from completely becoming dysfunctional and

either ending up lost off the face of the earth — and I have seen

people sleeping in dumpsters in the downtown east side — or being taken

back into costly acute care. I would say to the minister that I think

organizations like Coast Foundation, the Mental Patients' Association,

the Friends of Schizophrenics and CMHA — and I'm sure there are others

— would provide a tremendous service if they could be receiving more

support for this type of activity, and it would be a win-win.

Beyond that drop-in centre model, I would also think that these

organizations should be encouraged to provide advocacy services for

other ex-mental patients. I think they have established an excellent

track record over the years with regard to how to do that.

Look at the Mental Patients' Association, for instance. I won't go

into that again this year; I read some of the statistics into the

record last year. There is a progression that certainly has been taking

place over the past seven or eight years that has been documented by

Marilyn Sarti, a court worker with the Mental Patients' Association,

indicating sometimes an alarming increase in the number of ex-mental

patients charged with such things as theft under $1,000, assault and

mischief.

I believe that if the facilities of these organizations that are

trusted by these people could be enhanced.... Maybe it would be a place

where someone could get a free cup of coffee, or maybe a person to help

putting on a pot of soup, something that would create a warm, caring

and compassionate environment so that those people, when they get up in

the morning and go out the door, would know it was there as a

[ Page 5023 ]

positive alternative rather than some of the

alternatives that sometimes lead to despair and rejection and the type

of hurt that results in tragic consequences for them and costly

consequences for all of us on the long run.

MR. CHAIRMAN: The member for Yale-Lillooet requests leave to make an introduction.

Leave granted.

MR. RABBITT: With us in the members' gallery today are three

residents from the district of Logan Lake: Ove Christensen, mayor; Al

Kemp alderman; and Tom Day, administrator. I would ask that this House

give these three residents from the little jewel of Logan Lake a very

warm welcome.

HON. MR. DUECK: The suggestions that the hon. member made

regarding the role that some of these people with mental illness could

play in talking to their peers is certainly interesting, and I think

it's worth pursuing. I should mention that if we are speaking of the

city of Vancouver, I think the member knows very well that the city of

Vancouver is funded by us through the Greater Vancouver Mental Health

Service Society. It may be something that we should discuss with them.

We don't really go into their programming and how they're going to run

their business, but we often consult with them, and this is one area

that I think deserves more discussion and communication. It may work

quite well. We work very closely with many groups, as you know. The

communication is ongoing, and it works well.

We just had a letter — and I'll look for it; I had it just the other

day — where the Canadian Mental Health Association.... We gave them

$500,000 for exactly what you were mentioning, to do a lot of these

things and develop systems to look after mentally ill people.

Maybe our record is not as good as you would like it, but it's not

that bad. We are doing many of the things you are suggesting, and with

your help.... You and I toured a lot of these places last year. It was

certainly an eye-opener for me, and I appreciated your coming with me,

because a lot of these things were very new to me. They still are not

that familiar, but it was a great help and that day certainly gave me

an insight into some of the problems that these people have.

MR. CASHORE: I just wanted to mention that one of those

clubhouse models — I think the one operated by Coast Foundation —

actually has a membership, and they have a self-help program. They are

able to provide employment opportunities and vocational training,

presumably in conjunction with other resources that are available in

the province. They tell me that in 1988 they put 200-plus people

through this process and they managed to place these 200 people.

[Mr. Rabbit in the chair.]

They also mentioned that research indicates that this type of

approach helps to decrease hospitalization by a very high percentage —

as much as 90 percent — which brings me to the last point that I want

to make on the mental health issue. There is just one other point,

while I think of it. I've got two more points I want to make on the

mental health issue.

The first is to read into the record that Health and Welfare Canada

is participating through a grant of $186,000 in a project that will pay

for an evaluation in British Columbia on how two groups of 30

psychiatric patients fare in the community on discharge. One group will

receive an intensive form of community support involving the types of

organizations that I was just talking about. The second group will

receive care from mental health services. The patients receiving

intensive care are expected to be less likely to be placed back in

hospital, according to project director Dr. John Higenbottam. As you

know, Dr. Higenbottam is very well known in this field in British

Columbia, and I'm delighted that he is able to conduct this research. I

believe that when the findings of that research come in, they will give

a clear indication to this ministry of where to put resources. Dr.

Higenbottam is quoted as saving:

"At Riverview, 40 percent of patients discharged are rehospitalized.

That's very tragic. It carries high economic and social costs. We're

basing our study on the Bridge program in Chicago, where only 12 to 14 percent

of patients discharged were rehospitalized within one year."

The point is, Mr. Chairman, that deinstitutionalization in itself is

not necessarily good and it's not necessarily bad; it depends on how it

is done. Obviously there are models that indicate that an appropriate

way of doing it deals with the invisibility of those people once they

are out in the community. There have been other tragic examples where

cities in North America have ignored that fact and these people have

just continued to pile up and become part of the underclass, with

tragic consequences. One day we wake up and say: "My God, what have we

allowed our society to become?" We don't want that in British Columbia,

and yet there are signs. When you go into certain parts of the

province, there are signs that that really is a deep concern.

[4:45]

I just wanted to mention that I was contacted last week by a

father whose 15-year-old son had left home and been on the street. I

tell this story to try to outline the tragic consequences of some of

the problems that people experience who need the benefit of the health

care system. It's not so much to point the finger, but to say that the

incredible dilemma that we have out there indicates that we have to do

an awful lot better job of putting our best thinking together with the

best possible policy in order to help these people.

The first thing that the father told me was that he gets a sense

that the people who are working both in Social Services and Housing and

in Health are awfully busy and that there is a tendency sometimes — at

least he gets this impression — to think that that parent must have

either physically or sexually abused the child. Whether or not he has

any foundation for feeling this, he feels he is being judged and found

guilty before he even has a chance to deal with the situation.

Recently this child, who was on the street, tried to take his own

life. The father thought that at least now he was going to be able to

get some help. He spent the night in the emergency ward, and when the

father was talking to one of the psychiatrists he really got the

impression that his son would be held there for a while. Yet the next

day he was discharged and went back out on the street. The painful

dilemma that the father was asking me about was: "Won't anybody help my

son? I recognize that I haven't been able to help him. Isn't there

anybody out there who will help him?" I tried to explain to him the

narrow

definitions within the Mental Health Act and why it's part of

our reality in terms of our concern for human rights.

[ Page 5024 ]

It really did disturb me that a child of that age could be that

intent on taking his own life and yet not be found suffering from a

disorder of the mind that constitutes a danger to himself. It seemed to

me that at least for a few days he would fit into that category.

It's not something that I am reading into the record to try to say

that this is a glaring fault of this government, but in a way it is a

glaring fault of our society that we haven't found a way to move in and

support a person at that crucial time. I do believe the more we find

that people cannot have sufficient to live on, cannot have hope for the

future and cannot get assessment when they need it, the more we find

that these problems are exacerbated.

The last point I want to make is to say that while the program to

deinstitutionalize Riverview Hospital is on hold, we are left with the

working conditions of the staff there. Admittedly, the minister has

pointed out that the conditions there are really not good to the extent

that it would not be costeffective to repair the facilities. Several of

us went on a tour of Riverview Hospital, and we were really concerned

to see the working conditions.

I would appreciate it if the minister would in his comments

recognize the staff that are there and the conditions they're

experiencing. I understand that there is a hiring freeze, and so there

is a limit on the number of people who may be employed there. I see

both of you shaking your heads, so I'd be interested in hearing some

comment on that. I think we do have some very real morale problems

among the staff working in those circumstances. I understand the

catch-22 the minister is in. The plan is on hold until certain other

things are in place, but while it's on hold I guess you can't be doing

repairs and upgrading the working conditions and the living conditions

for the people there — or perhaps you can. I'm wondering how you're

dealing with that dilemma.

One last comment. I did appreciate the minister's following through

on the discussion that we had in the estimates a year ago that resulted

in our touring the downtown east side together. We should do that

again. It is the area where the vast majority of people end up who are

not able to make it when they come through the system. I want to pay

tribute to the people who work in that area and try to provide some

compassion and care to those people. A great many of them are ministry

staff, and a great many of them are volunteers.

HON. MR. DUECK: The Riverview institution, of course, has now

been changed from our own employees to a society. To the best of my

knowledge there is no freeze on now. I think it's going back to a full

complement. That's what I understand, and I hope it is true, that we're

not holding back where they're needed, we're not going to hire.... I

suppose the society gets X number of dollars like ho