1986 Legislative Session: 4th Session, 33rd Parliament

HANSARD

The following electronic version is for informational purposes only.

The printed version remains the official version.

Official Report of

DEBATES OF THE LEGISLATIVE ASSEMBLY

(Hansard)

FRIDAY, APRIL 11, 1986

Morning Sitting

[ Page

7691 ]

CONTENTS

Oral Questions

Protection for food industry in free trade negotiations. Ms. Sanford –– 7691

Annacis Island bridge cables. Mr. Reid –– 7692

Mr. Lockstead

Government passenger vehicles. Mr. Stupich –– 7692

Easter Seal buses. Ms. Brown –– 7692

Motive fuel costs. Mr. D'Arcy –– 7693

B.C. Rail shares. Hon. Mr. Curtis replies –– 7693

Private Members' Statements

Chiropractors' fees. Mr. Stupich –– 7694

Hon. Mr. Nielsen

Mr. Cocke

Licensing of taxis. Mr. Davis –– 7695

Hon. A. Fraser

Job creation. Mr. Michael –– 7697

Mr. Macdonald

Hon. Mr. Segarty

"Queen's Counsel," Mr. Macdonald –– 7699

Hon. Mr. Smith

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

On vote 37: minister's office –– 7700

Mr. Cocke

Mr. Michael

Ms. Brown

Mr. Parks

Mrs. Dailly

Mr. Blencoe

Hon. Mr. Gardom

FRIDAY, APRIL 11, 1986

The House met at 10:05 a.m.

[Mr. Strachan in the chair.]

Prayers.

HON. MR. CURTIS:

Mr. Speaker, in the gallery today is a constituent of my colleague the

Attorney-General, the MLA for Oak Bay–Gordon Head (Hon. Mr. Smith), and

it's a pleasure to introduce Elizabeth Friesen, who is a nursing

instructor. Would the House make her welcome today on behalf of the

member for Oak Bay.

MS. BROWN: Mr. Speaker, a number

of visitors from California are with us today, accompanied by one

British Columbian: Mr. and Mrs. Bruce Parker from Etna, California,

their daughter, Marianne Brown from Los Angeles, and their other

daughter, Candace Parker from British Columbia. Will the House bid them

welcome.

MR. MOWAT: In the precinct today, and

hopefully in the House later, is Miss Betty McGill, the administrator

of St. Jude's Anglican Home. I ask the House to make her welcome.

Oral Questions

MS. SANFORD: My first question is: where are all the cabinet ministers so we can ask questions?

HON. MR. McGEER: The cabinet ministers are here; where is the opposition?

PROTECTION FOR FOOD INDUSTRY

IN FREE TRADE NEGOTIATIONS

MS. SANFORD: My question

is to the Minister of Agriculture and Food. Has the Minister of

Agriculture and Food authorized any studies of those sectors that would

be at risk should the Premier decide to sacrifice agriculture as a

bargaining chip in the free trade negotiations?

HON. MR. WATERLAND:

I take offence at the member's suggestion that the Premier would

sacrifice any sector of our economy. My ministry is doing a thorough

analysis of what the effects would be on the agriculture industry as we

approach free trade discussions with the United States.

MS. SANFORD:

I'm not sure whether that entails specific studies that are undertaken

to look at the various sectors of the agricultural industry that would

be affected. I'm wondering what steps would be taken to prevent the

loss of over 5,310 jobs in the immediately threatened agriculture and

food processing industries in B.C. Have your studies indicated what

steps you could take in order to avoid the loss of those jobs that are

immediately threatened?

HON. MR. WATERLAND: The member is asking purely hypothetical questions,

the basis of which are probably in the fantasy of the research people in their

caucus. I am afraid I can't answer a hypothetical question like that.

MS. SANFORD:

The minister's answer flies in the face of the statements made by his

own Premier, because his own Premier, when he was in Montreal last

November, said:

"There are those who shy from

the prospect of increased trade with the United States. I do not have

much patience with these people. To my mind they're saying that deep

down inside they doubt that our people — the workers of British

Columbia and Canada — can cut the mustard in competition with their

counterparts in the United States. My position is that all of the trade

issues must be placed on the table, and each country should have an

opportunity to question the other's trading practices. I believe we, as

Canadians, should not exclude items from discussion."

should not exclude items for discussion, which means that all of these

sectors in agriculture are going to be on the table. If that's the

case, agriculture's in deep trouble in this province.

DEPUTY SPEAKER: Is there a question?

HON. MR. WATERLAND: Mr. Speaker, I didn't detect a question, but I certainly endorse the statements made by our Premier.

MS. SANFORD:

Mr. Speaker, this government is intent on pursuing free trade

agreements. What measures will be taken to protect B.C.'s manufacturing

and producing sectors, which will be placed at risk or used as

bargaining chips by the federal government's negotiator? It's clear,

according to the Premier himself, that it's on the table; therefore

they must be negotiated.

DEPUTY SPEAKER: The question does beg future action, and the minister may wish to respond.

HON. MR. WATERLAND:

Mr. Speaker, I don't know where you saw it, but I didn't see a question

at all. It was a rather ridiculous statement made by the member. I

think she feels that the people in Canada and in B.C. are incapable of

competing with others on this continent. I have much more faith in our

people than that, and I'm sure we can compete.

MR. REID: I have a question for the Minister of Highways, since there are no other questions.

MR. BLENCOE: Are you going to ask about automobiles?

MR. REID: Mr. Speaker, can you just shut this pink flamingo up over here, please?

DEPUTY SPEAKER: Order, please.

MR. REID: Mr. Speaker, I'd like to ask the Minister of Highways relative to the cable....

Interjections.

MR. REID: Well, they've got a white swan and a pink goose and a pink swan.

DEPUTY SPEAKER: Perhaps we could get to the question. This is question period.

[ Page 7692 ]

ANNACIS ISLAND BRIDGE CABLES

MR. REID:

Okay. The question I'd like to ask, and I think it's the concern of

those people out there in Surrey and Delta relative to the cable

problem on the Annacis crossing: could the Minister of Highways tell

the House the safety that we can expect on the cables being installed

and the effective date of the opening of the Annacis crossing?

HON. A. FRASER: Mr. Speaker, I will try to give a little rundown on the problem.

First

of all, there are 192 cables involved. Two cables have been rejected

for unsatisfactory socket performance when installed on the bridge. One

has been replaced, and the second has been removed, and the replacement

will be installed within a few days. The reason for the rejection of

the cables is excessive movement of the cable strands within the

sockets before the cable takes up the full load. Three more cables are

being closely monitored, and about six others are being watched. A

complete survey of all the cables has been underway for the last three

months. Based on current performance, we expect to open the bridge in

June, and it will not be opened until we are satisfied with the

performance of all the cables.

[10:15]

This

beautiful bridge built in our province by our contractors, engineers

and consultants has a safety factor of approximately 250 percent

engineered into the structure. Replacement and testing work is being

performed by the contractor under his warranty requirements. This work

is being supervised by the ministry and their consulting engineers. I

might say that we feel the consulting engineers that have been on the

project from the planning stage right through deserve considerable

accolades from all of us. I refer to the firms of Buckland and Taylor —

I believe their address is North Vancouver — and CBA Engineering of

Vancouver.

have a beautiful structure there, and certainly we aren't going to open

the structure unless it is absolutely safe, and I am sure it will be.

We had planned on opening the bridge in June, and I hope we will be

able to make that opening when we originally planned.

MR. REID: Mr. Minister, a supplementary. Is your staff involved in helping to correct the situation on the Cambie Street bridge?

HON. A. FRASER: Mr. Speaker, the answer is no.

MR. LOCKSTEAD:

Further supplementary to the minister. Could the minister tell us who

is bearing the cost of these repairs to the Annacis Island bridge?

HON. A. FRASER:

I just said who that was. The cost is being borne by the suppliers of

the cable on a warranty basis. I might say that the supplier of the

cable is the British government.

MR. LOCKSTEAD: A further supplementary. Can the minister personally guarantee that this bridge will be safe for the next...?

Interjections.

MR. LOCKSTEAD: Personally. And will you resign your seat, Mr. Minister, if the bridge fails?

DEPUTY SPEAKER: Order, please.

GOVERNMENT PASSENGER VEHICLES

MR. STUPICH:

I have a question to the Minister of Finance. The auditor-general's

report, released yesterday, tells us that the government does not have

sufficient information to demonstrate that it receives value for money

with respect to its fleet of more than 6,000 passenger vehicles. Has

the minister decided to place a moratorium on the acquisition of new

vehicles until this report can be considered.

HON. MR. CURTIS:

Mr. Speaker, the member for Nanaimo will appreciate, I'm sure, that the

auditor-general's report reached me at approximately 12 noon yesterday.

It is required, and indeed it is appropriate, that it be presented to

this House at the earliest possible opportunity. Therefore I've had

little more time to read the entire report, or that

section dealing

with the subject of his section, than any other member of this House in

the interval.

I have not decided to place a moratorium. I

welcome the recommendations and comments of the auditor-general. It was

this government which committed to create the post of auditor-general

in the province of British Columbia, and again we have an instance

where the auditor-general, independent from influence of government and

ministers, has identified an area which she considers to be a problem.

I can tell the member that the Ministry of Finance and those involved

with fleet management within government, which is not specifically

within the Ministry of Finance, will be examining that

section of her

report. We will take, I trust, appropriate action, at an early date. I

cannot commit as to when that might be.

EASTER SEAL BUSES

MS. BROWN:

My question is to the Minister of Health, and it has to do with Easter

Seal buses. As a result of a shortfall in revenue, partially due to a

new bingo hall that is skimming off such revenue, the Lions Club have

been forced to discontinue the Easter Seal bus service in Prince

Rupert. Several groups apparently have been sending letters and

telegrams to the government stating that this is an urgent matter and a

severe loss to that community. So far, they have not received a reply.

Can the minister tell me whether the government has decided to make up

the difference for the Lions Club by extending the custom transit to

Prince Rupert, to meet this very important need?

HON. MR. NEILSEN: No, we have not done that.

MS. BROWN:

A supplemental to the minister. Is it possible, then, that the

government has decided to at least meet with the Lions Club people and

with some of the other groups in that area to discuss how this

shortfall is going to be covered? The Easter Seal bus is not a luxury

item; it meets a real need. At least the government could sit down and

discuss with these people how that shortfall could be covered. Has a

decision been made to do that?

[ Page 7693 ]

HON. MR. NIELSEN:

Mr. Speaker, I'm unaware of a request from the Lions Club in Prince

Rupert. Were they to make a request, or if they have and it hasn't been

brought to my attention, certainly I'd sit down and talk to them, to

see if there's some way of resolving that problem.

MOTIVE FUEL COSTS

MR. D'ARCY:

To the member for North Peace River, our Energy minister. I would like

to ask him if he has taken action, or if he has decided to take action,

regarding the continuing high costs of petroleum and natural gas motive

fuels, as set by the industry. I'm not referring to taxes, federal or

provincial, but to the continuing high costs as set by the industry. My

information from the industry is that if they were to maintain the same

profit margin, both at the retail level and the producer level, that

they had when gasoline in this province was 58 cents a litre, the price

should be somewhere around 38 cents right now — based on an average

price of petroleum of $14(U.S.) and $20(Can.) per barrel, which it has

been so far this year.

Also,

has the minister taken action regarding the price of natural gas for

home heat and industrial purposes, which is supposed to be, by the

government's own word, tied to the price of petroleum? In fact, there

has been little or no decrease in the price of natural gas to the

customers of Hydro, Inland, Columbia or any of the other natural gas

utilities, in terms of the price they set for their customers in the

province of B.C.

HON. MR. BRUMMET: Mr. Speaker, as,

I guess, the member knows as well as anyone, the gas price at the pumps

is affected only partly by the raw stock, and there is still some

inventory. Those prices are moving down, and our estimates show that in

that period of time it should probably be at 38 cents a litre. I think

there is some concern about what's going to happen to the price

tomorrow or next week. As I think the member knows, there is a 60-90

days' supply of petroleum that was bought at previous prices. We had

restrictions on it moving up. So I guess, in effect, we in Canada are

hoist on our own petard in that some of those restrictions are

affecting prices moving down. They are moving down, and we'd certainly

like to see them go down. As far as profit margins in the industry are

concerned, I haven't found anyone in the industry talking about profits

right now. Rather, there's concern.

As far as natural gas

pricing is concerned, that is being looked at. As you know from the

Western Accord, there was a concept to deregulate it. But those steps

are not being taken day by day or month by month. When the adjustments

were going up and they were tied to oil prices, they were made once a

year. We may have to move more quickly than that. Again, the price of

the gas from the producer is only one factor in the price at the burner

tip. A large portion of the cost is pipelining, which is based on

capitalization, and that doesn't change. It's also based on the

distribution system, and the cost of that doesn't change. So the actual

price of the gas itself is only one factor. I can only say that we are

looking at it, and that we are considering moving to deregulation by

November '86, as per the Western Accord. When that happens, the

utilities may well be negotiating with producers, and then gas prices

themselves will be a bigger factor.

B.C. RAIL SHARES

HON. MR. CURTIS:

Mr. Speaker, I wish to respond to questions put to me in an earlier

question period. On March 13 the first member for Vancouver East (Mr.

Macdonald), who is not in his place.... He's now in his place.

Interjection.

HON. MR. CURTIS: The member for New Westminster is grumpy again.

[Deputy Speaker rose.]

DEPUTY SPEAKER: Just a moment. The Minister of Finance will take his seat and the member for New Westminster will withdraw that remark.

Interjection.

DEPUTY SPEAKER: The one that the Chair found offensive, making reference to another member.

[Deputy Speaker resumed his seat.]

Interjection.

DEPUTY SPEAKER: The member will simply state that he withdraws the remark. The member for New Westminster, please.

MR. COCKE: I withdraw the remark.

DEPUTY SPEAKER: Thank you. The Minister of Finance continues in response to a question.

HON. MR. CURTIS: Mr. Speaker....

Interjection.

HON. MR. CURTIS: The member for New Westminster is very testy this morning.

DEPUTY SPEAKER: To the answer, please.

HON. MR. CURTIS:

Mr. Speaker, as I said, the first member for Vancouver East (Mr.

Macdonald) asked a question on March 13, and then just a few days ago,

relative to British Columbia Railway preferred shares. I took parts of

his question on notice.

Mr. Speaker, it is a matter of

record that B.C. Rail Ltd. undertook a $200 million issue comprised of

eight million shares in the first half of 1984. The issue can be

identified as $2.1325 cumulative, redeemable, retractable first

preferred shares, series A. They were priced at $25 per share, yielding

9.25 percent per annum, and it is also a matter of record that they

were then and are now non-voting shares.

The offering

memorandum carries a date of May 30, 1984, although I understand that

interested Canadian investment dealers received details of the issue in

the week of May 22, 1984, somewhere through that period. A news story

is available in the Globe and Mail dated May 24, 1984, carrying a general outline of the forthcoming issue. Advertising of

[ Page 7694 ]

the issue also appeared in some Canadian newspapers in the last several days of May of that year.

Mr.

Speaker, that's the background in order to answer the member's

question. I purchased 100 shares of that issue on the open market, and

I have computed that to be 0.0000125 percent of the total issue. The

member did not ask how many shares, but I thought I might assist him in

telling the House that it was in fact 100 shares which I bought with

pride as a British Columbian.

These shares were purchased

on the open market through an investment dealer on June 1, 1984, with a

settlement date June 19, and these were at the issue price of $25 each.

Mr. Speaker, as has been noted by disclosure form, I held the shares

for approximately 13 months, selling them again on the open market

through an investment dealer on June 27, 1985. The selling price was

$27 ⅛ .

Mr.

Speaker, available to the member would be the trading range over the

entire life of the issue from the beginning of June or the end of May,

and indeed over the last 52 weeks. I see that in one 52-week period

ending just a short while ago, the trading price was from $25 ¾ to $28 ⅜ . I trust that answers the member's questions with respect to the B.C. Rail preferred share issue.

[10:30]

Orders of the Day

Private Members' Statements

CHIROPRACTORS' FEES

MR. STUPICH:

My topic this morning is ancillary health services. In saying that, I

think first of the wide range of ancillary health services that are

available, and I think also of the nature of the service and the way in

which that particular service deals with disease. When I use the word

"disease," I'm not thinking about the narrow sense in which it is

usually thought of — that is, a communicable disease — but rather the

derivation of the word, which is lack of ease. So it could be entirely

physical, it could be physiological, or it could be something that is

transmitted.

I think of the way in which these various

health services deal with that kind of disease. I think also about the

cost to the community and whether or not the community can actually

afford to give total health service to everyone. There are some very

exotic operations that in some cases prolong life for a relatively

short time that couldn't possibly be available to everyone. The

community couldn't afford it, so there are questions about that.

[Mr. Ree in the chair.]

the other hand, there are ancillary services which are much less

expensive than the regular health services that are so often resorted

to. I think in particular of those ancillary health services which

depend upon non-surgical procedures, and certainly if we can have

disease control — and I mean there if we can have ease as opposed to lack of ease —

with non-surgical procedures, that's cheaper from the point of view of

the cost to the health program, and it's also cheaper for the patient,

if it can be dealt with reasonably well through non-surgical methods.

The

same thing applies to non-drug methods. There are always questions

about side effects of drugs. If we can have ease through non-drug

methods, it would seem to me that individuals are better off. Certainly

in the cost of the program in general, if not in every particular, we

are also better off.

If the person providing the service

concentrates on prevention, as opposed to dealing with something after

the fact, then too the patient is better off, as is the community.

Mr.

Speaker, recently we've all had a lot of correspondence from one

particular group which is practising health services: the

chiropractors. But I had resolved to raise this subject much earlier. I

had occasion to use a chiropractor in an emergency over two years ago.

I've used chiropractors off and on for the last 35 years, so it's

obvious that I do trust what they're doing and I do get a measure of

relief. If I use them regularly, once every four to six weeks, then I'm

not so likely to have a recurrence of the problem. But I didn't in this

case, and I did have to go in a hurry.

For the first time I

saw what a chiropractor was getting for a first visit. I saw the

receipt: $15. That particular chiropractor spent 50 minutes with me on

that first visit. I asked him how he could afford to keep his office

open if he was getting a gross fee of $15 out of which he had to pay

rent and staff, provide equipment and live. His answer was that his

wife works. She does; she's a chiropractor as well. They share an

office so they're able to keep it open.

I've had occasion

to go to a number of chiropractors on a first visit, and I had no idea

that's all they were getting for that first visit. But in every

instance the first visit is generally quite a long one. Then there are

the subsequent visits. They're not as long, but I found out on the next

visit that for subsequent visits that particular chiropractor got $11.

In that case he spent only 15 minutes with me. But even at that rate I

had to ask the question again: "How can you keep the office open?"

Then

I learned more recently something about the training requirements for

chiropractors, the fact that they do take nutrition for the whole of

their four-year course in college. I understand that doctors are not

required to learn any nutrition at all. Many do, and I give them credit

for it. But chiropractic college requires four years of training in

nutrition. I think that's very important. That was my course of study

at UBC. Of course I found out that we know far more about the nutrition

of all animals and even many insects than we do about people. It's hard

to study people; they live as long as the researchers.

Mr.

Speaker, my plea is for meaningful negotiations between the Ministry of

Health and the Chiropractic Association. I understand there have not

been any results from such negotiations in the past four years. I

believe they have not been fairly dealt with in view of the service

they render, the relative economy of that service and the way in which

they do give ease to the patients who use those services. So my plea is

for real negotiations with the Chiropractic Association on behalf of

those people.

HON. MR. NIELSEN: I'm in a

conflict-of-interest problem with this because I've used chiropractors

for many years as well and have long felt myself a champion of the

chiropractors.

We have been negotiating with the

chiropractors; in fact, we are in negotiations now. The chiropractors,

as I mentioned yesterday, have been very responsible in their demands

and in the negotiations we've achieved over the years. There have been

some improvements in non-financial areas, which I

[ Page 7695 ]

know they are appreciative of and which have assisted them considerably.

This

is somewhat of a different occasion. I don't think there's any argument

between the two sides on this issue. The chiropractors do render a very

important service to the people of British Columbia, and they are well

trained and very responsible. The number of incidents of malpractice or

improper conduct with chiropractors is very, very low — almost

non-existent. I think that's a tribute to their professional standards.

But

we are meeting with the chiropractors. I hope to reach a settlement

with them very soon with our negotiating team. I was speaking with the

president of their organization earlier this week, and we had some

informal discussions about that. I agree with the member for Nanaimo

that the chiropractors have acted in a very responsible way over the

last number of years, and we hope to achieve a settlement with them

that will be agreeable to both sides. I'd like to thank the member for

Nanaimo for his very strong support of a group of practitioners I also

have great admiration for.

MR. COCKE: Mr. Speaker,

the whole question of chiropractic and associated health professionals,

semi-professionals and others is one that has long been under

discussion in this province. It strikes me that we should be moving a

lot faster than we have; since 1981-82 they've had no access to an

improved situation, as the member for Nanaimo (Mr. Stupich) points out.

This

harks back to a situation that I recall very vividly in terms of

treatment of chiropractors and the way the medical profession has

involved themselves in this particular area. In 1972, '73, '74 — that area —

they wanted access to x-ray information, and the medical profession

felt that because of their "inadequate training" they shouldn't have

this access. We had many arguments with them about the whole question

but it never did resolve itself properly. It strikes me that that's

partly the reason the chiropractors now have such difficulty dealing

with the ministry, dealing with the whole service of medical care.

They've proven themselves beyond a doubt, in my opinion, and it's time

they were given a real opportunity to negotiate just like everybody

else and get themselves into a position where they can provide the

service that they so well render.

MR. STUPICH: Just

to get into the specifics, I appreciate the minister's comment and I

hope he will do everything he can to enter into what the Chiropractic

Association believes will be meaningful negotiations.

have a bar graph that compares the cost-price index increases over the

last 15 years with medical doctors' first and subsequent visits,

doctors of chiropractic's first and subsequent visits, as well as

manufacturing wages. The doctors of chiropractic are lowest on this bar

graph, substantially lower than the increase in the cost-price index,

whereas the medical doctors are highest for subsequent visits.

The

minister spoke about some improvements having been made, and yes indeed

they have. For example, they do have access to some x-rays taken by

some doctors and, I believe, in some hospital situations. They are

having a great deal of difficulty getting into hospitals to visit

patients who want to see them, and I think that is something which

should be cleared up.

The previous Minister of Health said, on one occasion, that he felt it should

be dealt with between the Chiropractic Association and the College of Physicians

and Surgeons. That's like the old story about the elephant dancing among

the fleas and saving: "Every man for himself." It's not an equal

contest to have the college dealing with the Chiropractic Association. They

won't get very far if they depend on support from the College of Physicians

and Surgeons.

Since 1979-80 the fee for a medical doctor's first visit has gone up substantially —

from $25 to $40. It would seem to me relatively easy for a medical

doctor to say that it's a first visit; it can be a slightly different

condition and it's a first visit, so they qualify for a very high fee.

With a chiropractor, if the visit is within six months of the first

visit, then it's a subsequent visit and the fee is only $11, even

though it was five months and 29 days. That's my understanding of the

situation. So even the figures don't tell the whole story. I believe

it's easier for doctors generally to say it's the first visit, and very

difficult for chiropractors unless there's a lapse of over six months.

[10:45]

All

the schedules, all the figures.... . the fact that the minister has had

personal experience is perhaps worth more than anything else. One can

only learn about this, and be comfortable with it, from such

experiences. I had my first, as I say, some 35 years ago. I was almost

paralyzed. I had never been to a chiropractor: I had never felt the

need and was afraid to go, but I was persuaded. After two visits I was

walking; uncomfortably, but I was walking. So I do believe in them. I

believe in their service. They do give ease without drugs, without

operations. I believe that the minister should aggressively pursue the

negotiations with the Chiropractic Association so that they feel

something positive is happening.

LICENSING OF TAXIS

MR. DAVIS:

I'm addressing my remarks today to the Minister of Transportation and

Highways (Hon. A. Fraser) because taxi licensing is governed by our

provincial Motor Carrier Act. To a degree, it's also administered by

this ministry, although the local municipalities have authorities as

well.

My comments this morning are in the direction of

deregulation. I'd like to see a measure of deregulation take place in

the industry in B.C., and I'm also in favour of licensing not by

municipalities, particularly small municipalities — small geographically —

but by regional districts. I'd go further. Besides expanding the

geographical area served by individual taxi companies, I'd limit

regulation to conditions of entry and specifically to setting standards

as to quality: the safety of vehicles, the condition of the vehicles,

their excellence in terms of safety for their passengers, cleanliness

and so on.

Following these recommendations, the fares and

the routes would be deregulated and a higher-quality service would

develop. In the lower mainland we have numerous municipalities, a

dozen in the GVRD. Each currently has the power to license taxi

companies. These municipal authorities give their companies permission

to pick up passengers in their own territory. They cannot reach beyond

their own boundaries, thus they lack the power to authorize passenger

pickups in adjoining municipalities. As a result, taxis involved in

intermunicipal traffic — those moving from one municipality to another and back again —

return empty. They deadhead back to their home municipality. There's a

waste of energy, a waste of fuel, a waste of space on the streets,

[ Page 7696 ]

obviously at a cost which is eventually borne by the passengers.

Thus there is a strong economic case for broader area regulation —

regional district administration of taxi licences rather than

administration by individual municipalities. The Economic Council of

Canada looked at the taxi industry Canada-wide a few years ago and

pointed the finger particularly at the greater Vancouver area. They

suggested that costs could be reduced at least 20 percent and perhaps

25 or 30 percent as a result of licensing in a broader area context,

and more than implied — said — that rates, taxi fares, would come down

correspondingly if this more efficient service were possible.

Most

municipalities in the lower mainland now appear to agree with this

opinion. Even the city of Vancouver now seems to be, in principle at

least, in favour of licensing on a broad regional basis. I know that

the Motor Carrier Commission itself has looked at this problem, has

advocated several measured steps in that direction: that is, toward

broad regional licensing and toward the freedom of individual taxi

companies to be full, to have passengers both ways.

I'm

particularly concerned about the situation which now is likely to

develop at Expo, where taxis originating outside of Vancouver city must

return to their home area empty. That doesn't seem to make much sense.

I can imagine visitors from outside of Canada, outside of B.C., hailing

a taxi originating in Burnaby or Richmond or Surrey or on the North

Shore, and in fact being picked up illegally, as it now stands, being

carried a few yards, a few blocks, and then being apprehended by the

police of the city of Vancouver, as has happened frequently. You can

imagine the embarrassment all around. It doesn't make sense, but that,

at the moment, given the city administration, is what happens legally.

The

other aspect that concerns me is the quality of the service. We've read

headlines recently about the Vancouver city police stopping taxis and

examining the condition of their brakes, their cleanliness, the

knowledge of the drivers as to the points of destination around the

lower mainland, and the story is appalling, really. Two out of three

taxis fail the tests. A number are taken to the side of the road and

have to be carted away other than under their own power, because

they're in such bad shape.

I believe that the emphasis of

the province, through the Motor Carrier Act, should be on vehicle

safety, inspection of those taxis, and should require that the

licensing be on a broad regional basis, rather than by individual

municipalities.

HON. A. FRASER: I appreciate the

observations of the member for North Vancouver–Seymour on regional

licensing of taxis. Certainly it is the subject of large public

interest — rightly so — and, as you know, the Motor Carrier Commission

has jurisdiction over all taxis throughout the province, not just the

lower mainland. Then a further licensing exists of taxis by individual

municipalities. I agree with some of the remarks made by the member,

and the Motor Carrier Commission have certainly tried to do something

to resolve all the problems, but I agree they've probably been rather

slow and kept their head down because they have to deal with all the

jurisdictions.

I'll now get down to the lower mainland. They have to deal with all the

municipalities and hear their views. I note in the member's remarks that

he feels that all the municipalities in the lower mainland are in favour of

regional licensing of cabs. I'm not so sure, from my information from the

Motor Carrier Commission, that this is so, particularly with the city of Vancouver.

The situation in the lower mainland, and I mention the city of Vancouver because

there is an inventory in the lower mainland of about 1,000 taxi cabs.... .

. Of those 1,000 cabs, a little better than 50 percent are licensed within the

city of Vancouver. The rest are in the North Shore and Burnaby, Delta, Richmond

and so on.

One

thing that I'm abundantly clear on is that regardless of the

politicians on the councils, the operators and owners of the taxi cabs

in the city of Vancouver are absolutely opposed to regional licensing.

You didn't mention the operators and owners, but it is my opinion, for

what it's worth, that they'll go to any degree to stop regional

licensing. What I'm really saying is that even if we have the

cooperation of all the municipalities — let's say we have — we don't

have the cooperation of the owners and operators. Maybe that isn't a

big issue, but it's a fact of life as I see it today.

would just like to make comments regarding Expo and looking after Expo.

The Motor Carrier Commission has had a lot of dealings with trying to

upgrade and make sure that our visitors are looked after during Expo.

SOME HON. MEMBERS: Clean up those cabs.

HON. A. FRASER:

Yes, and that's going on and will continue to go on, but I think it is

also very important that the Motor Carrier Commission has dealt with

the operators as well as the municipalities, and it's my information

from the Motor Carrier Commission that the changes that are being put

into effect will supply adequate taxi service to our visitors and will

not impair the service to our own citizens as well. Customers will be

encouraged to use cabs from the municipality they are travelling to. I

think this is very important. Information kiosks are being installed to

let visitors know which areas are served by each cab company. Customers

will not have to use the first cab in the lineup.

The Motor

Carrier Commission is working to ensure the public is supplied with

safe, reliable transportation during Expo. It also wants to make sure

that all the taxis in the lower mainland aren't serving Expo visitors

with no service for the residents and business people. As I said, there

are about 1,000 cabs in the inventory in the lower mainland now, and

this is being increased by 10 percent, with room for more if there is a

real need. In other words, cabs are going to be allowed to return from,

say, the airport and pick up a passenger....

DEPUTY SPEAKER: Hon. minister, time is up.

HON. A. FRASER: Thank you.

MR. DAVIS:

I can understand why the Vancouver Taxi Owners Association prefers to

keep things as they are. I would think that up to half of all the taxi

rides in the lower mainland originate or terminate in Vancouver city,

largely because that's a working area, the business centre of the lower

mainland and so on. Therefore, those who operate cabs based in

Vancouver and with the city of Vancouver licenses have an advantage

over taxi companies in the outlying areas. They have a kind of

monopoly. They're reluctant to engage in some more open competitive

situations. They like what they've

[ Page 7697 ]

got. They like the monopoly that they have. That's

understandable. The minister is saying they're a substantial political

force —

a force to be reckoned with, and maybe things should be left as they

are because the Taxi Owners' Association is that kind of political

entity.

As for the city of Vancouver itself, Alderman Don

Bellamy for some years has chaired the taxi etc. committee of city

council, and he tells me — indeed, I've seen press reports to that effect —

that they have changed their view. They don't like the job of licensing

taxis, partly because of the rise in price of taxi licences and so on,

and in theory they agree with regionalization. They have their problems

with the political force in their area — the Vancouver Taxi Owners'

Association. But I think that the province should show leadership, bite

the bullet, break that monopoly and see that we have a better service.

[11:00]

JOB CREATION

MR. MICHAEL:

Mr. Speaker, I take pleasure in rising today to speak about job

creation. I intend to read into the record some facts pertaining to new

jobs that have been created in the province of British Columbia in the

last while. I will also be quoting some excerpts from Hansard —

statements made by the opposition. It's sad, perhaps, in looking at the

opposition today to see only two members in the House, and all of the

members whom I will be quoting are not present in the chamber today.

Nonetheless, Mr. Speaker, I will read it into the record for all to

know what's happening in job creation in the province,

the first Friday of every month Statistics Canada releases figures on

new jobs created in every province in the Dominion of Canada during the

last 12 months. I've taken the time to examine every newspaper that

I've been able to get my hands on in British Columbia since the first

Friday of April, and it's sad to say there's not a single newspaper in

British Columbia that has quoted the true story of the exciting things

that are happening in job creation. I had to go to the Globe and Mail

edition dated Saturday, April 5, in order to find one single

article in

the province quoting the facts. As a matter of fact, if anybody would

care to get a copy of the Province

dated Monday, April 7, 1986, you will see a headline reading: "Real

B.C. Is Seen in Jobless Figures." They go on to say in the first

paragraph: "We said the other day that if the 2.5 million people living

elsewhere in Canada who want to come to live in B.C. knew about our

unemployment, they might think twice. Now that Statistics Canada has

come out with new figures, they might be wise to drop their dreams

altogether." They go on to say that experience shows that Expo 86 was

supposed to have created a lot of work. Not one word, Mr. Speaker, out

of the Vancouver Province that day about the truth of what's happening

in job creation in British Columbia.

Here are the facts,

Mr. Speaker. Fact number one: B.C. created 23,000 new jobs in the month

of March 1986. As a matter of interest, that compares with 1,000 in the

province of Manitoba. Further to that, fact number two: B.C. created

53,000 new jobs in the past 12 months. Further to that, fact number

three: B.C. led all Canadian provinces including Quebec and Ontario —

Ontario being over three times the size of British Columbia, and Quebec

being over twice the size —

in actual new job creations in the month of March 1986. New job

creations totalled 23,000 new jobs in one month, and not one whisper in

one newspaper in British Columbia. They're too busy up there drinking

their coffee and playing with their knitting needles to pay attention

to the things that are happening in this exciting province.

Further

to that, Mr. Speaker, if one wants to go back just 14 short months and

look at the employment figures in January '85 compared to the most

recent, March 1986, you will find 89,000 new jobs created in the

province of British Columbia. Now, Mr. Speaker, those are the facts and

the facts are now on the record. Those are Dominion Bureau of

Statistics facts.

You pick up the Hansard dated March 24, 1986, page 7479 and you listen to the member for Okanagan North (Mr. MacWilliam), debating. He goes on to say:

But every one of those jobs was in the greater Vancouver area.

There wasn't a single job created in the interior regions of this province.

Statistics Canada has indicated that job growth in the interior of this province

was nil, zero, zilch. It all went to the greater Vancouver area.

Now

what are the facts? I went to Statistics Canada, and I asked for a

regional breakdown of job creation. Very, very interesting. What do we

find? In the central Kootenay area, which encompasses my constituency,

Mr. Speaker, in February 1985 there were 30,000 people working. In

March 1986, 13 months later, 36,000 people were working, an increase of

6,000, a full 20 percent increase in those working in that region

during that 13-month period.

Mr. Speaker, I could go on. I can look at all kinds of figures here to show

employment growth in Okanagan-Boundary: 89,000 people working in February 1985;

93,000 working in February 1986, a gain of 4,000. And yet that member says

nothing is happening in the interior of British Columbia. The statistics show

the exact opposite.

[Mr. Strachan in the chair.]

Let's go and look at the Hansard

of the morning sitting of Friday, March 14, 1986. The member for

Cowichan-Malahat (Mrs. Wallace) was speaking. Here is what she has to

say:

This indicates that people have been forced to leave

the Island because there is no work. They're leaving. Our population is

going down.

AN HON. MEMBER: Not true.

That was me, Mr. Speaker. She goes on to say:

That is true. I am talking about Vancouver Island, where it is

going down because there are no jobs here. There is a net loss in the province

as well.

AN HON. MEMBER: That's not true.

Again, that was the member for Shuswap-Revelstoke. She goes on to say:

There's no sense trying to prove things to that member, because

he doesn't listen. He's not prepared to accept facts that point in any

direction other than what he thinks.

DEPUTY SPEAKER: Time has expired, hon. member, and you will have an appropriate opportunity to....

Interjections.

DEPUTY SPEAKER: No, leave will not be asked for or given.

MR. MACDONALD: Does the minister have priority?

DEPUTY SPEAKER: No, as a matter of fact, the government member has spoken....

[ Page 7698 ]

MR. MACDONALD: Well, can we share the time? I'll be very brief.

DEPUTY SPEAKER: We'll share the time. That would be great, yes.

MR. MACDONALD:

Mr. Speaker, very briefly. It's sad that this kind of a speech is made.

The figures lie because they don't explain that we still have about 14

something percent unemployment in this province.

Now maybe it....

Interjections.

MR. MACDONALD: Yes, I know you're talking about how you pulled this away....

Interjection.

MR. MACDONALD: Oh, that fellow makes so much noise. Why doesn't he go sell a wreck?

DEPUTY SPEAKER: Order, please. The second member for Surrey (Mr. Reid) will come to order.

Interjection.

MR. MACDONALD: Go sell a wreck.

Interjections.

[Deputy Speaker rose.]

DEPUTY SPEAKER: Order, please. One moment. The second member for Vancouver East will take his place. The clock will stop. Thank you.

Interjection.

DEPUTY SPEAKER: The second member for Surrey will take his place and remain in order or do so outside of the chamber.

Time

during private members' statements is limited. Therefore it is

imperative that we give every member who wishes to speak as much

opportunity as possible to do so without interjections or

interruptions. Understood? Thank you. Please proceed.

[Deputy Speaker resumed his seat.]

MR. MACDONALD:

I just want to make a simple point. Things have improved slightly in

the province of British Columbia, and the member is right. They've

improved slightly from the morass of unemployment we were in, and have

been in, really, under Social Credit since 1976 and deepening

enormously in 1982-83.

But I get from that member's address

that he is accepting as great something like 14 percent unemployment in

this province. It's a tragedy, but we're beginning to accept it. We're

beginning to accept youth unemployment of 20 percent to 25 percent.

We're beginning to accept unemployment among young native people...

Interjection.

MR. MACDONALD: There he goes again.

...of

50 percent, 60 percent, 70 percent. We must not accept these things as

normal and say how great things are when we have these ghastly

unemployment figures, particularly for young people.

HON. MR. SEGARTY:

Mr. Speaker, it is a pleasure for me to get up and participate in this

debate somewhat. I want to congratulate the member for

Shuswap-Revelstoke (Mr. Michael) for taking the approach that he did in

debate, pointing out that there is economic recovery taking place in

British Columbia. Certainly no member in this assembly does more for

employment creation and job opportunities in his region of British

Columbia than the member for Shuswap-Revelstoke. So I give him credit

for getting up and participating in debate, and as well for getting up

in debate in the spending estimates of each minister of the Crown and

putting forward ideas that will provide further employment

opportunities in his constituency.

Mr. Speaker, the member

for Vancouver East talked about 14 percent as though that was the

accepted position of the government of British Columbia. I have to

concur with the member for Vancouver East that there are too many

people unemployed in British Columbia today. There are too many people

unemployed in our country today, particularly among the young. When the

Ministry of Labour was establishing its budget for 1986-87, we looked

at opportunities that we could provide for young British Columbians in

the development of that budgetary process, recognizing that we have an

awful lot of very enthusiastic and ambitious young British Columbians.

All they need in many cases is a helping hand from government to help

them help themselves through the process. That will be in place and is

currently being addressed by the Ministry of Labour.

Over

the course of debate in the Legislature since 1983.... You will

remember the difficult time that we had as members of government

bringing in a program of economic recovery and renewal in British

Columbia in 1983, recognizing the difficult times that our industry was

going to be in, meeting stiff competition throughout the world for the

products that we manufacture in and supply from British Columbia to

world markets, and recognizing the need to reduce our costs to

industries and businesses across British Columbia. The opposition party

in this province did everything they could to stop that process from

taking place. They voted against every single measure that this

government brought in to reduce the tax and regulation burden on

British Columbia business. Last year the Minister of Finance (Hon. Mr.

Curtis) brought in a budget that would see tax reductions on business

and industry in British Columbia in the amount of $1 billion over a

three-year period. What the member for Shuswap-Revelstoke points out

today is that that program and those policies are working on behalf of

the people of B.C.

MR. MICHAEL: Well, Mr. Speaker,

I'll just read into the record the Vancouver Island net migration

statistics. The last available year's clearly shows an increase — 2,020

people moved to Vancouver Island, not away. Further than that, I'd like

to read into the record the population figures for British Columbia for

the last few years — the growth figures. In 1982 net growth, total

population increase, was 32,025; 1983, 34,559; 1984, 32,653; 1985,

22,612. Yet the members opposite, I read continually in Hansard — and I listen in

[ Page 7699 ]

this assembly —

are talking about population decrease, people moving out of the

province. Let me tell you something about interprovincial migration. It

is true that we've had a loss in the last 12 months, but that trend

changed in the last quarter of 1985. I predict that with what's

happening in Alberta today, we're going to see a net influx in the year

In conclusion, I'm not happy with the unemployment figures in British Columbia —

none of the members in this House are happy. But we have to understand

that we've gone through a very serious international depression,

hurting the very basic industries of this province. If you look at the

things on the horizon — not just Expo and not just the Coquihalla

Highway, but things that are happening positively in the lumber and

pulp industry, the prime rate going down, mortgage rates going down,

oil and gas prices decreasing, and corporations throughout this

province on the upswing.... A lot of things are happening in high tech

and in the motion picture industry. Cruise ships are coming into our

province. Exciting things are happening in the aquaculture industry. A

lot of positive things are happening in this province. But what do we

hear from the members opposite? Negative, negative; gloom and doom.

It's sad that we can't get some positive news out of the opposition.

Why is it that their members in Ottawa aren't standing up and fighting

for a better deal for British Columbia? Read the Hansard

from Ottawa, Mr. Speaker, and you will see the questions asked by the

party of members opposite in Ottawa. There's nothing said about

improving the balance of payments for this province. Those kinds of

things are ignored by their party. They don't care about B.C.

[11:15]

"QUEEN'S COUNSEL"

MR. MACDONALD:

Mr. Speaker, the subject of my discourse this morning is Queen's

Counsel, otherwise known as the letters "QC" after the name of a

lawyer. When I got my own QC, somebody on the street asked me: "What

queens do you act for?" But the term is generally well understood, even

by the Attorney-General of British Columbia (Hon. Mr. Smith), who has

just entered the chamber.

It's my position that QCs are

something lawyers can and should do without, and those that are out

there should be called back in. It is something that is being done in

the province of Ontario at the present time. The new Liberal government

under Premier Peterson is cancelling the QCs — which are outstanding in British Columbia —

because it was becoming a joke in that province. So many were granted

that if you didn't have one, it looked as if you'd been convicted of

some felony, or had been in the provincial cabinet or something — had

committed some kind of serious dereliction. The QCs are really

misleading advertising. People naturally assume that the lawyer who has

the QC has received a Good Housekeeping seal of approval, and that's

not the case at all. A lawyer who does not have the QC can talk as well

and as long and win as many cases as a lawyer who does have a QC. It's

not merit, but the public seems to think it is based upon merit.

Basically, the only change when you are anointed with silk, as I was,

is that you can more plausibly charge a larger bill. That's about the

only change.

We see these QCs being born out of politics. I'm not saying it's bad

politics, but I'm saying.... In the case of the bar association it's

for meritorious service, in many cases — a committee of the Canadian Bar Association,

or something of that kind. For that, the QC is awarded. Or it's awarded

for meritorious service in the vineyards of the politics of the government in

power in British Columbia. Well, that kind of accolade we can do without. I

have an example. I think John Laxton has been through more courts, in one capacity

or another, than almost anyone I can think of, and has performed extremely well

in those courts, high and low. He hasn't got a QC because he supports the

NDP There are exceptions; John Turner appointed Tom Berger to the bench and

therefore judicial appointments were no longer political. If you believe that,

you believe anything.

Basically

it's political, either through the bar or through the politics of the

province of B.C. The list passes through the two chief justices, but

they don't make the list and they don't make the final appointments.

Quite frankly, I think it's a little unfair to the chief justices to be

taking

part in this particular process. In my own case, which the

Minister of Highways keeps bringing up, for many years I was on the

list to be given a QC, according to the late J.O. Wilson, when he was

chief justice; but I never got past either Leslie Peterson, or whoever

the Attorney-General of the day was, until we formed a government in

1972 and I was able to give the invidious accolade to myself, which I

promptly did. I ceased all further appointments, except to reward the

said J.O. Wilson for having put my name forward all those many years,

and then one very meritorious one to the late Ned DeBeck, Clerk of our

House, who was then 92 years of age and had had a very distinguished

career. The Attorney-General's statute says that Attorneys-General have

to give it to themselves, so don't make too big a thing of it that I

gave one to myself.

I think my time is up, Mr. Speaker, in

more ways than one. We should follow the path of Ontario and do away

with QCs I with the possible exception — I'm looking at my friend

opposite — of QCs for those who have served in the office of

Attorney-General.

HON. MR. SMITH:

I enjoyed the remarks of the member for Vancouver East. As always, his

views on this are well known and well expressed, and he did so with a

good deal of levity. We certainly are going to miss him in this place

for his turn of phrase.

The QC subject is, as always, a

vexing one. For ten years very few were appointed, I think only the two

mentioned by the member. In 1982 the government decided to resume the

appointment of QCs. Our act and our situation is very different from

that in Ontario. Prior to the abolition of QCs in Ontario, there were

3,057 out of a profession of 17,741; 17 percent of the practising bar

had these honours. If you went down to the Ontario Court of Appeal as a

silkless British Columbian barrister, you found yourself about 40 feet

away from the ear trumpet of the bench, and a callow youth with five

years' experience in Ontario was pleading his case right under the ear

of the bench.

The situation was very bad in Ontario, and it

had to be addressed, but in British Columbia the situation is exactly

the opposite. Out of a practising bar of 5,818, we have 248 QCs — only 4

percent of the bar. The problem here is that we have not been able to

honour enough of the good practising members with this award. I wish

that we could appoint considerably more; there are many deserving

people in practice, both barristers and solicitors, who should have

this award.

[ Page 7700 ]

It's

interesting that the Law Society of Ontario is very distressed at this

Cuban decree of taking them away retroactively. I guess that they're

going to go and expunge from the gravestone of Arthur Meighen his QC.

They're removing these retroactively. The Law Society of Ontario is

trying to intervene and to have some better method of appointing them

in the future.

I have here a communique from the Law

Society of Ontario, February 28, in which they have recommended to

their members that the basis for granting QCs in the future be the

adoption of the criteria used in British Columbia. That's what they're

recommending, and the criteria in British Columbia for the appointment

of QCs is being generally acknowledged as: firstly, a leading counsel,

or, secondly, recognition by the profession as exceptionally gifted, or

demonstration of exceptional qualities of leadership in the profession,

including participating in the affairs of the profession through its

various bodies, outstanding work in the field of legal education or

scholarship, and public service.

The 23 QCs that were

appointed at the end of December were thought to meet those criteria.

They not only have to pass through a committee of the two chief

justices, but also two members of the Law Society who are chosen for

that purpose have to pass over them. I can assure the member opposite

that my list wasn't all a one-sided thing, where I said: "These are the

ones we are going to have." Some of the people on that list came from

the chief justices and the benchers. Their suggestions were

incorporated and it was finally a list that everybody agreed with.

There

was no disagreement with anybody on the list. I think that if you look

at the list, you would see that there were people on there of differing

political stripes. They were on there because they met the criteria.

Let us, instead of knocking the institution of QCs, try to make more

and better honourable appointments which allow the institution to mean

something, as it always has in this province, I think.

think that the great disappointment was that the tradition lapsed for

ten years because of the policies of the previous government in not

liking to give titles, not liking the idea of awards, not liking the

notion that somebody was going to be singled out for some kind of

award. They didn't like that philosophically. I think most people in

the bar and the public accept these awards if they're done properly and

fairly, and they have been done in British Columbia with a good deal of

temperance.

MR. MACDONALD: Just briefly, you know I

don't think that we should have a class system among the lawyers, and

that's what the Attorney-General is basically proposing. He says "those

who are exceptionally gifted," and so forth, with some very general

phrases, should get the QC. I see the Minister of Health sitting over

there. You could do the same with the doctors. You could say: "QD." Why

should the lawyers only have it? Or bricklayers — QB, Queen's

Bricklayer. Then you would be creating two classes of bricklayer, an

invidious distinction.

Interjection.

MR. MACDONALD: PDQ, yes. Anyway, we'd be swallowing the alphabet before we had finished equalizing things.

would appoint a great many. Instead of 23 this year, I can think of....

. . I see one right across there at the present time in my line of

vision. I now see two. I see other lawyers that could equally,

meritoriously, have been given the QC, but only a few get it. A class

system, and the Attorney-General says: "Don't recall those that are

already out there." Some of those out there are the worst appointments

that have been made since the Emperor Caligula appointed his horse a

proconsul. They are awful.

HON. MR. SMITH: Name names.

MR. MACDONALD:

Oh, I could, but I won't, and so could the Attorney-General. He could

tell about nephews and nieces and everything else if he wanted to. So

could I.

So I say that it should go. We don't need these

two classes of lawyers. It's always going to be, in somebody's opinion,

that: "This one is better." Let the clients judge that; let the public

judge that; let the fellow establish it on his own.

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

ESTIMATES: MINISTRY OF HEALTH

(continued)

On vote 37: minister's office, $207, 950.

MR. COCKE:

Mr. Chairman, I think I would like to lead off with a couple of cases

today. This is under medicare and the recognition of refugees, the

recognition of people who are here under ministerial permits. I know

that the provincial government does not make the distinction as to who

should have a ministerial permit and who shouldn't, but if a person is

here under a ministerial permit, then by virtue of the fact that this

government decided some time ago that foreign students should not have

access to medicare and that they should pay their own way and one thing

and another, a lot of other people have fallen into that same situation.

Let

me give you an example. You've all seen an example recently where the

minister made some changes for a particular family; it was well

publicized. I've got another one, in New Westminster. Here's a young

woman who has been here for two years, is married to a Canadian citizen

and has given birth to a Canadian child, but because of the fact that

she is still here under a ministerial permit — incidentally, asking

right along that she be given landed immigrant status so that she can

apply for Canadian citizenship and all the rest of it.... To this

date she has not received that status. Here's a women with a Canadian

child and expecting another Canadian child, who thanks to the good

offices of our government does not have access to that medical coverage

that the rest of her family would naturally have. Her child could have

it, her husband has it, but she doesn't. The inconsistency of this, as

far as I'm concerned, is absolutely maddening.

[11:30]

was very angry in the first place when I saw that our government

decided to opt against giving foreign students access to our health

care. I thought that it was most inhospitable of us. Despite the

remonstration that I've heard from the member for North

Vancouver–Seymour (Mr. Davis) from time to time, I think that foreign

students happen to enrich our country. I think that their influence,

when they get back home, enriches the cooperation of our country with

other countries. Having said that, I'm really not dealing with that

question now; I've dealt with it before. I'm dealing now with people

who, by virtue of the fact that these orders were

[ Page 7701 ]

brought in, have fallen between the cracks and are ineligible for coverage.

I'm not going to use this person's name in the House — I don't think that I should —

but I can certainly give the minister this person's name. But it goes

beyond that. This person got in touch with an MLA. What about the

myriad other people out there who have no access to our medicare scheme

just by virtue of the fact that they are here under those conditions?

Let me just go over it once more. She's here on a ministerial permit,

married to a Canadian citizen, has given birth already to a Canadian

child and is expecting another little Canadian. But that woman has no

access to our medicare scheme by virtue of the orders that have been

received at the medicare commission.

Will the minister give

me some kind of understanding or some thoughtful answer to the question

that I have raised before I do any other raising of questions vis-a-vis

the medicare system?

HON. MR. NIELSEN: Mr. Chairman,

as I mentioned the other day, the question basically revolves around

definitions of residents and visitors. The definition as such now does

not include visitors to Canada and various other categories of people

as being eligible for the Medical Services Plan.

The

question with respect to refugees and others who are in the country on

ministerial permits brings in, of course, the federal government.

That's not passing the buck, but it is our opinion that the federal

government is responsible for the people they admit to the country. We

play a minor role with respect to ministerial permits when it is a

question of health. The federal government normally, through their

ministry of immigration, request an opinion from the province as to

whether we support the admission to Canada of certain people who have

medical problems. We have the opportunity of responding as to whether

we support it or not. But a refugee or a person here on a federal

ministerial permit, in my opinion, is the responsibility of the federal

government. We do not disagree. We believe the federal government must

assume the responsibility for the needs of that individual if they are

unable to do it themselves.

We have asked the federal

government to please move on this. The member for New Westminster

mentioned a woman who has been in Canada for two years, married to a

Canadian citizen, has given birth to a child and is due to do so again.

I am not evading the point the member made, but my question is: why is

the federal government sitting on the case? Why have they not granted

landed immigrant status to this woman? I don't understand why they

would not do so, and if they were to do that, that person would be

eligible for the coverage.

I have a similar situation in

Richmond, where we have an almost identical situation. The woman has

been here for three or four years, I believe, still waiting for the

federal government to make a decision as to her landed immigrant

status, and I don't understand why they are holding it up. If the

person is unsuitable to be in the country, then why don't they give

them that advice?

But I think we have to recognize what the

regulations of the Medical Services Plan call for and who is eligible

for coverage. There are alternatives — perhaps at a somewhat higher

cost. There are private insurance policies available, and many people

make use of them. But I think the decision is correct, and to some

degree, by way of advice, it is consistent with the Charter of Rights

in Canada in that we are not to discriminate against categories of

people, be they visitors or residents.

So I can sympathize

with an individual case, and perhaps it costs a certain amount of money

for them. But I think to a very large degree it is up to the federal

government to move far more quickly on citizens or individuals who come

to the country and are married to a Canadian citizen and are residing

in the country and are producing young Canadians, by way of birth. I

don't understand why they drag their feet on these things.

But

we have adopted the position of

definitions of residence and visitors,

and it is applied across the board to all, consistent with the spirit

of the Charter, according to our legal advisers. These people are

caught between the stools, as the member said. I share the

responsibility with the federal government. I am not suggesting it is

theirs alone. It is a shared responsibility. It is the law of the land

at the moment. Yes, these people sometimes find themselves in somewhat

of a difficult situation, not because we've created it but because of

circumstances which are real and here at this time.

I think

the correct thing has been done. I think there are certain procedures

which could alleviate the problem for many individuals. I will be

speaking to the federal minister with respect to trying to move these

applications for landed immigrant status through whatever system they

have back there. But a visitor to Canada is a visitor, whether from

Seattle or from Jordan, or some other country. They are to be treated

the same, and they are not eligible for a medical services plan.

MR. COCKE:

The minister says it's the law of the land. It's a regulation of the

land. There was no statute passed in this House providing that kind of

situation. It's a regulation. It's a ministerial responsibility, a

cabinet responsibility. I think the cabinet was dead wrong in what they

did. I think they were most inhospitable.

But getting back

to this point, here we're talking about a person who's relatively

defenceless. The minister says the federal government are dragging

their feet, or maybe they are, or why don't they come to grips with

this situation; either the person should be admitted on a landed

immigrant status or not, but they shouldn't keep on with a ministerial

permit. All very well and good. But that woman had a child in this

province, and that pregnancy was paid for prior to this goofy new

order-in-council that came out making it inaccessible for her. So she

goes from one situation to another.

It strikes me that

people in a relationship like this, with a Canadian husband, with a

Canadian child, should automatically become eligible, and there should

be some way a cabinet can make that kind of distinction. They made a

distinction enough when they said anybody here other than landed

immigrants or Canadian citizens was ineligible. It strikes me you can

make people eligible, providing they have this kind of relationship.

I've given up on trying to make us see the light on students, but

certainly people here in this situation, I believe, should have access

to our medicare scheme.

The minister says: "Oh, private

insurance schemes are available for these people." I ask the minister,

even in his wealthy state, where he.... No, I can't do that,

because he couldn't get pregnant, very likely. But the fact of the

matter is, where a person is pregnant, do you mean to tell me that an

insurance company is going to offer insurance over a certainty in terms

of a claim? I was in the insurance business too

[ Page 7702 ]

long to think that any underwriter would accept

that. They would say that's a pre-existing condition — short as it

might be, it's a certainty, and you don't insure against certainties.

they have no access under these circumstances, unbeknownst to them.

They get a message in the mail. Everything was fine. The first baby was

born. Medicare paid for it. Everything was hunky-dory. They pay their

premiums. But then all of a sudden, out of the blue, they're told:

"Sorry. Your premiums aren't worth the powder to blow them to heck."

What

are you going to do about it? They're going to somehow or another have

to pay for it. And at today's prices, for these situations, that is a

very great hardship. I happen to know where these people live. They

don't live on Snob Hill by any stretch of the imagination. They're just

trying to get along, and trying their best to get that ministerial

permit out of the way and get landed immigrant status. But if those

slowpokes and bureaucrats in Ottawa can't get around to it, I don't

think that we should hold these people hostage. It's just too rough. We

should be a lot more benevolent in this situation than we appear to be.

The minister should take a close look, not only at this one in

particular, but at this type of circumstance that leads me to say

something must be done if we are to come out looking like really

civilized people.

[11:45]

another subject, Mr. Chairman, on Tuesday last, when the minister was

wearing a different hat, but one that was to some extent affected by a

group that I talked about at that time, the Cedar Lodge Society, I

asked the minister if he would somehow or another intervene on behalf

of the people of British Columbia so that the facility the Cedar Lodge

Society has been running can be run by a health group in our province

until such time as a program can be put together. Since I asked that

question I've been informed that the Health Sciences Centre Hospital at

UBC are asking for an interim arrangement until such time as they can

put together a program for mentally affected young adults. Everybody

knows that in our province we have an awful lot of walking wounded in

this particular area. Because of their long history in psychiatric care

out there, nobody could do a better job, in my opinion, of putting

together a program in this marvellous facility at Cobble Hill than the

university's Health Sciences Centre Hospital. Has the minister a few

dollars for the time being to assist them to at least hold this

facility for a better use? I understand that there is an American

outfit bidding for it, a Bible society bidding for it and so on. I

believe that the greatest use of this facility would be on behalf of

the people in B.C. who most need that help. I'm just asking the

minister: has he any news for us at this particular time?

HON. MR. NIELSEN:

No, I have no news. The mental health division is reviewing the

suggestion by the UBC hospital to possibly use that facility for the

specific program the member referred to, but I have no news. I suppose

it really isn't that important, but the society really, I believe, at

one point overextended itself.

MR. COCKE: No question, and then of course they lost out.

HON. MR. NIELSEN:

Yes. But the Health Sciences Centre is looking at the possibility of

developing a program which, I believe, would be useful no matter where

located; and they have spoken with the people about the possibility of

using that facility. So I don't believe the facility is lost to that

purpose. We are discussing it presently, and we'll know pretty quickly

what the feasibility is. I'll try to find the money — maybe the hospital has it.

MR. MICHAEL:

Mr. Chairman, I'd like to pass on to the minister some problems in my

constituency. There are a number of communities looking for additional

health facilities. Armstrong has been looking for a new hospital

facility for many years. I understand that a property has been

identified and that plans are in the works. The Enderby community is

looking for an extension to their facilities. And, of course, Salmon

Ann is looking for a new 100-bed extended-care/intermediate-care

hospital.

I'd like to make a special pitch for the

community of Chase. Chase is located approximately 38 to 40 miles from

Kamloops and probably about 42 miles from the nearest hospital — in

Kamloops, which is the hospital that serves the Chase community. Chase

has a population somewhere in the neighbourhood of 2,000 residents, and

serves quite a perimeter around that community: communities such as

Pritchard, Chase Creek, China Valley and the north shore communities

such as Celista and Anglemont — all look to Chase as their town. To my

knowledge — certainly from any communities that I travel to or am familiar with —

the community of Chase is the largest community without any kind of

health facility. I believe there are three doctors practising in the

community, but they do not even have a diagnostic and treatment centre.

Mr. Minister, I would ask that your ministry give special attention to

reviewing at the earliest possible date.... I know we have had a

lot of correspondence on this, but I have yet to receive a positive

indication that Chase is going to be getting a facility. What they want

is a diagnostic and treatment centre as well as a care facility. There

are a lot of seniors not only in the community of Chase but also in the

surrounding area. Its population is largely retired, and I would say

that if there's any community that I can think of in the areas that I

travel that is deserving of early attention by the Minister of Health

to consider a new health facility, I would have to say that Chase

should be very high on any priority list.

[Mr. Strachan in the chair.]

The

other thing is the question of a speech pathologist situation we have

in the community of Salmon Arm. It's been an ongoing problem. There are

speech pathologists in Salmon Arm, but they all work for the school

board. I believe there are four of them, but someone who is not going

to a school and who has a speech problem has to drive all the way down

to Vernon, and the Vernon people are booked very heavily. They have

quite a caseload, and it means a long waiting list and a lot of

travelling by the people in Salmon Arm who need this type of service. We

had a speech pathologist in Salmon Arm who, I believe, was servicing

Salmon Arm on a half-time basis, the other half being in Armstrong.

Fortunately, or unfortunately, her husband got a job in Victoria and

she had to leave the community, and that position was given to another

community.

I would ask the minister to please have his

staff review the speech pathologist situation in Salmon Arm. I know

there have been some discussions going on between your ministry and the

Ministry of Education as to how the overall speech pathologist

situation is going to be handled in the community of Salmon Ann.

Perhaps it should come under just one

[ Page 7703 ]

umbrella and in such a way that the speech pathologist could look after the entire community.

That

is one of the situations I would appreciate the minister looking at,

and I would ask him to please have a very close look at the situation

in Chase, British Columbia. The community there is very anxious for an

announcement about their centre, their health facility. They have a

society formed and there are hundreds and hundreds of people — I don't

know what the total score is; I believe it's over a thousand now who

have joined that society — backing the committee that was formed to

bring a health care facility to the community of Chase.

Interjection.

MS. BROWN: Well, no, I will not, I'm sorry. My own debate leader is harassing me. She thinks I should....

I'm

not going to go into full flight on this one; I just have one small

issue that I want to deal with, and that's the homemakers. I have been

receiving a number of letters from homemakers in my riding — the aides —

saying that they have not received an increase in their income in five

years. Five years ago the dollar was worth close to a dollar, while

today it's worth 76 cents or something of that nature. But in any

event, on behalf of the homemakers I would like to ask the minister if

he can give me any indication as to whether there is an increase in the

budget for them anyway.

At the same time as the homemakers

are not getting an increase, we are finding a decrease in the number of

hours that they are able to give to any one person. I want to draw

specific attention to a woman living in the Hall Towers who is quite

severely disabled. She gets around very slowly and with the use of two

canes. She has real problems in terms of doing her shopping, getting

out to the bank and dealing with those kinds of errands. Until about a

month ago she had a homemaker who would come in and not just help

around her apartment, in terms of the things that homemakers do, but in

addition would do her banking and her grocery shopping for her. She has

now been informed that this is no longer possible, that the homemaker's

hours are being curtailed and that there is no time for the homemaker

to do her banking or her grocery shopping for her. This is a person who

cannot walk and carry a bag of groceries at the same time. It's not

possible, because she has to use two canes. So here is her dilemma. How

are we going to deal with this particular dilemma? Of course, getting

from Hall Towers to the bank takes her a very long time because she has

to move so very slowly.

I am wondering whether the minister

is considering some of these requests from people whose homemaker

services have been cut, in terms of reinstating their services and, in

addition, is looking at the whole business of the fees being paid

homemakers to see whether there is any possibility for an increase in

their wages.

MR. PARKS: Through you, Mr. Chairman, I would like to extend a rose or two to the hon. minister, and then an urging or two.

MR. BLENCOE: A thistle or two.

MR. PARKS: No, not a thistle. I don't think there is any need to throw any thistles at the hon. minister.

First

I'd like to discuss an institution that I'm sure the hon. member for

New Westminster shares a concern with, and that's Royal Columbian. As

we well know, Royal Columbian Hospital is the largest tertiary trauma

care centre in this province, even larger than Vancouver General

Hospital. I'm very pleased — and this is one of the roses that I'd like to extend to the ministry and the minister —

that they have approved a much-needed and perhaps long overdue

expansion to that emergency facility. They have undoubtedly a

first-class group of professionals in the emergency ward at Royal

Columbian, and I think the delivery of health care services to the

northeast sector — our area — will definitely be enhanced with the much-needed expansion of that emergency ward.

Speaking

of emergencies, Mr. Minister, we have another very fine institution in

my area called Eagle Ridge Hospital. It has been open a couple of years

and we are looking at approximately 110 beds now being licensed and in

use. A few weeks ago we were fortunate to have your ministry open a

discharge and planning unit. However, one of those frequent inquiries

that I receive in my constituency office is: when are we going to have

an emergency ward at Eagle Ridge Hospital? I would certainly urge the

minister to give that some further consideration and hopefully we'll

see that emergency facility initiated in the very near future.

Interjection.

MR. PARKS:

I know that the Fraser-Burrard Hospital Association, which encompasses

both the Royal Columbian Hospital and the Eagle Ridge Hospital, has

embarked on a discussion paper and is inviting community input. I know

the hon. member for New Westminster has given some input and I'm sure

the other community input is very much appreciated by the

administration. But I believe that falls within the administration's

purview as much as the ministry's.

[12:00]

Before I conclude my remarks in these estimates, I would be remiss

if I didn't acknowledge how much I enjoyed, as the former parliamentary

secretary to the Minister of Health, the cooperation I received from

the senior administration. In particular the deputy minister and the

associate deputy ministers were of immense assistance to me in first of

all learning a little bit about an extremely expansive ministry. I came

to an appreciation that British Columbians are indeed very fortunate to

have such dedicated civil servants working on their behalf. So would

the minister please pass on that rose to his senior staff. I'm sure

that all British Columbians, notwithstanding what they read or hear in

the media from time to time, do appreciate that B.C. has the finest

health care delivery system. We are very fortunate to live in British

Columbia

HON. MR. NIELSEN: Just a few quick comments

on the last three members. The member for Shuswap-Revelstoke is one of

the most aggressive MLA lobbyists for his own constituency — Armstrong,

Enderby, Salmon Arm, Chase. He mentioned all of these today, and has

mentioned them many times in the past. All I can say, I guess, now that

he's not in his seat is that all of those are under consideration. The

people of Chase particularly — here's the member now — have been

aggressive in their petition. I have talked with some representatives

from there, and we are giving consideration to their application for a

D and T centre at Chase.

[ Page 7704 ]

Speech

pathology is a very real problem in two areas: a general shortage of

speech pathologists available to us and the role so many play with

other agencies, which restricts their access by other citizens. I

believe the ministries of Health and Education have been working to see

if different utilization could be made of the pathologists, but I

gather there are strong arguments about it. We moved in a similar area

in audiology and made some changes which permitted greater access for

more people; unfortunately, the thing went to court and was overturned,

for some unknown strange reason. We hope to be able to resolve those.

Speech pathology is a problem, and I appreciate what the member was

saying. We're trying to resolve it through the ministries of Health and

Education.

The member for Burnaby-Edmonds (Ms. Brown) was

speaking of homemakers. The individual homemaker works for an agency or

a contractor. It is the contractor or agency who negotiates what these

people are paid. There is no consistent amount paid throughout the

province; it varies from agency to agency. These people are hired by

the agency, and it is for them to determine what the payment is. We

don't negotiate with them at all. There is $48 million allocated for

homemakers in the budget. It serves approximately 30,000 clients in the

province.

The situation with respect to homemakers is that

it is a very fluid circumstance, A homemaker may provide a certain

service to an individual today that will not be required next week. The

individual who may be suffering from a temporary difficulty may in a

week or a month be cured of that problem and no longer require the

service; others' conditions, of course, deteriorate, and they require

greater service. So it's a very variable thing — not consistent at all.

The condition of the individual can change, and the long-term care

assessment people have to determine what the priorities are. People's

conditions do change.

The member mentioned an individual

case. I would like to get the name of the individual, so we could look

at it very specifically to see what the circumstances are. Each person

is to be assessed as to their need, and the hours are developed for

that purpose.

The member for Maillardville-Coquitlam (Mr.

Parks) asked some questions with respect to Eagle Ridge. When Eagle

Ridge was opened, their needs were reviewed by a committee of their

peers — I guess, for want of a better term — as to what should occur at

the hospital, and when. One of their strongest recommendations was that

Eagle Ridge should open without an emergency department. In effect,

they said: "Allow the hospital to mature and develop programs. Attract

the necessary professional staff before you open an emergency." They

said: "Please do not have an emergency ward that cannot respond to the

emergencies that may present themselves at the hospital."

they said: "Allow the various sections of the hospital to mature first,

so they can be there when emergencies are required." I can't give you a

date. There is a general timetable for the further development of Eagle

Ridge. I know the requests are there, but we will move at the

appropriate time.

MS. BROWN: I have a couple of questions to the minister. Has there been an increase in the budget for homemaker services?

Interjection.

MS. BROWN:

Yes. So that's the dilemma that the homemaker organizations run into.

There hasn't been a dollar increase in the amount of money that they

have to spend in terms of homemaker salaries. In addition, the

Vancouver homemaker organization received a memo stating that because

of a budget overrun there would have to be a 17.2 percent reduction in

the number of authorized hours for the Vancouver long-term care program

for the months January to March. Not only is there not an increase....

. .

Interjection.

MS. BROWN: The problem

is that the homemaker service keeps people out of acute-care beds in

hospitals. The more people who can be assisted and helped to stay at

home, the better for everybody: the better for the people involved, the

better for the taxpayer. The homemakers are really involved in

preventive health; that's what's so vital about the service that they

deliver, They're trying, on very low.... The homemakers are not

paid a wonderful salary, by any means. When there is not an increase in

the budget, and they're told that there's been an overrun, obviously

that means that there's been an increase in the service and in the

demand for their service, and that they have to start cutting back;

that's the problem that we run into. Maybe the minister will take into

account that they've been told that something in the neighbourhood of

20,000 hours are going to have to be cut out of their delivery system.

That's the problem that people like this woman in Burnaby, and other

people, are running into. The organization is trying to balance its

books, and is having real problems doing that.

HON. MR. NIELSEN:

I appreciate the difficulties of managing an organization such as

homemaker services, and the difficulties of cost efficiency and the

discipline that's necessary to stay within a budget. The Vancouver

folks were provided with a budget. For the first nine months of their

fiscal year they were not within budget and had to make an adjustment

in the last three months of their fiscal year.

It is

difficult to anticipate precisely what the demand on the service is

going to be because the demand changes almost on a daily basis. New

people make application; others come off, no longer require the

homemaker services. The agencies have to determine what services they

will be offering, what are the most important services, and they really

have to tailor the needs of all their clients to that which is

available in services provided and hours provided. There is no question

that there are some services provided which by rational analysis could

be avoided in order to provide a much more needed service to a new

client.

There is no question about that, and that's not a

criticism. It is simply a matter they have to take into consideration.

The member mentioned the 20,000 hours, and that 20,000 is a large

number. But across the province, if we were to reduce the homemaker

service by 30,000 hours, that would be one hour per client per year. So

while we're dealing in large numbers, the distribution is quite

different.

But the homemaker program is quite successful.

It has assisted many thousands of people by permitting them to carry on

a much more normal life, by eliminating some of the minor problems such

as you mentioned that simply incapacitate the individual in many

instances — shopping and whatever. But I think it is functioning reasonably well: $48 million

[ Page 7705 ]

is a substantial budget for the program, and it has grown significantly over the past four or five years.

is $48,503,000 for the fiscal year we are speaking of. I believe it is

adequate to provide the level of service we have established in the

province. It will require more detail from the management point of

view. In December 1984 it was 361 000 hours of service; in December

1985 it was 394,000 hours of service. So the program has expanded in

hours of service to the recipients. But the budget is $48.5 million. We

are trying to keep that branch within budget, and we will be asking

them to stay within budget as much as possible.

But there

are so many variables in the homemaker service that I believe they can

accommodate those who are truly in need. There are some services which

I don't support at all that are provided on occasion, but the general

services that are common to most people are much needed and provided. I

believe they can tailor their own program to accommodate those in real

need. The individual you spoke of, incapacitated to that degree,

obviously needs assistance, and I am rather surprised that there would

even be discussion that assistance would not be available, because we

do provide services to some people in far less sensitive areas.

It's a trade-off that I think they can make, but if the member would let me have the name later, I would....

Interjection.

HON. MR. NIELSEN: Okay, I will get in touch, and we will look at that one very specifically.

[12:15]

MRS. DAILLY:

I have one quick question just at this time as a follow-up question

before the member for Victoria takes his place. It is a follow-up to

the member for New Westminster (Mr. Cocke), just on a point of

clarification for me. It is to do with the coverage of medicare for

Canadian citizens, and I am referring to babies born here in British

Columbia whose parents are here on a student visa.

Now when

you said "ministerial permits," I wasn't quite clear if that means

somebody here on a student visa. That isn't the same thing.

Interjection.

MRS. DAILLY:

No, I didn't think so. So my question is.... I have had a couple of

cases brought to my attention where these babies were born here, and

yet because the parents were on a student visa, I don't believe they

were granted coverage by medicare.

HON. MR. NIELSEN: After three months.

MRS. DAILLY: After three months they can get coverage — the child? Thanks very much.

MR. BLENCOE:

There are a number of things that I would like to cover in these

estimates. First, some of the things have been touched upon this

morning very briefly, but I would like the opportunity to go into a

little more depth and maybe get some discussion about future direction

of this government.

The first issue I wish to cover is how

we treat the elderly. As the minister knows, in this particular area we

have a high proportion of those senior citizens, the elderly, who do

require a lot of health care and sometimes a high degree of

institutionalization. But the issue that I want to cover this morning

is how we approach health care and how we deal with the elderly in

terms of health matters. I want to refer to an excellent task force on

the allocation of health care resources. The minister may not be aware

of the task force, but I'm sure his deputy is aware of it. It was

commissioned by the Canadian Medical Association in 1984, and its

report is called "Health: A Need for Redirection." It was an excellent

task force. One particular chapter,

chapter 2, was on the elderly, and

it talked about how the health care enterprise should be looking at the

elderly. It had some projections on needs, and on institutions and

long-term care facilities. I will just very quickly read a

section of

the introduction on the elderly, which I think gives an indication of

where I would like to go this morning — and maybe get some response from the minister.

"An

area of major concern to those who appeared before the task force was

the increasing need for more attention to the elderly population. This

concern in itself indicates an encouraging trend toward a greater

awareness that our seniors are likely to play an increasingly important

role in society in the future. For too long the elderly have been

regarded more as a liability than as an asset, and have been ignored by

society, especially in the provision of services, including health

services."

That was the introduction, Mr. Minister. It goes on in this first part of the

chapter to outline the problem in a global sense.

"Time

and again the submissions suggested a new program of care for the

elderly which would emphasize independent and productive living at

home. The majority of elderly people would prefer to be out in the

community living in their own homes rather than in institutions, and

there is strong evidence to suggest that this is not only possible but

economically attractive, if the right support systems could be put in

place. The problem is that at present in many places these support

systems are grossly inadequate."

I won't quote again from

that for a minute or two. To go back to some of the discussion this

morning about, for instance, the homemaker service, the minister has

indicated that there is $48 million. But this report and, I think,

others are indicating that there has to be a strong determination to

really pursue this particular kind of philosophical approach. Not only

is it socially responsible, but it's obviously economically

responsible. I think the minister really has to consider that while $48

million may be a respectable figure, if we're ever to get a handle on

the increasing costs of health care, not only in this province but in

this country, we must start to seriously tackle this prevention side

and this deinstitutionalization side of health care.

The report goes on to state that there is the deinstitutionalization solution.

"If

we continue to put old people into institutions at the rate we do now,

the costs will not only be prohibitive, but we will perpetuate the

callous practice of warehousing the elderly. Old people do not want to

live in institutions, even in the best of them. Governments are worried

about the additional stress on budgets...."

[ Page 7706 ]

And I know we're all concerned about that. This is a very important point:

"The

thrust in the redirection of health care resources undeniably needs to

be in the development of community services to keep the elderly out of

institutions for as long as possible, not only to reduce costs but to

enhance the quality of life."

That is a very important

statement, Mr. Chairman. Again, maybe we're going to get the minister

to respond to that kind of philosophical statement. The task force

report goes on to talk about community services, and specifically

refers to the expansion of the homemaker service. I have to indicate

that this is, of course, on a national basis. But the report does say

that British Columbia is going to be one of the provinces that's going

to feel most the financial implications of this growing problem of

serving the elderly — we're one of the provinces that's going to feel the pinch the most.

"Free

homemakers are often provided only to those with a very low income, and

commercial rates can impose a severe strain on those whose income is

restricted. These services must be more readily available, not only to

replace institutional care but to promote independent living among the

elderly community at large."

Mr. Chairman, I think this report and others — and this is one of

the more recognized task forces in the country; it was commissioned by

the Canadian Medical Association —

are indicating that we have to have a fundamental shift in how we

approach health care, not only in the country but also obviously on a

provincial basis. I would like to hear the minister discuss this

morning how the government of British Columbia is preparing itself for

.... I will go on later to give some statistics for the numbers of

beds and facilities that are going to be required and the astronomical

increases if we continue with the same kind of priority in terms of

institutionalizing. Do we have long-range programs for the things that

I am talking about this morning — for putting our elderly as a first

priority, retaining them in the community? Such things as homemaker

budgets would have to expand dramatically. I'd like to start on that

topic this morning.

[Mr. Ree in the chair.]

HON. MR. NIELSEN:

The homemaker budget has expanded dramatically. In 1978, only

recipients of Human Resources were eligible for homemaker service.

Since that time it has expanded to over 30,000 people. So it has

expanded dramatically. I'm not quite sure what the budget was in 1978,

but I seem to believe the number was about $15 million. It is now $48

million.

The report that the member referred to in his

general statements.... I find no disagreement from a philosophical

point of view. But it's interesting to note, Mr. Chairman, that less

than 7 percent of our seniors are institutionalized. They are very

visible, and when you go to institutions you see great numbers of

elderly people, but about 7 percent or less than 7 percent are in

extended-care or long-term-care facilities: about 21,000 or 22,000 of

the almost 350,000 seniors in B.C. So the vast majority do live in

private accommodation or on their own.

Mr. Chairman,

somewhat quickly on the elderly problem, please recognize that I'm not

criticizing the elderly. It's a fact of life: people do age. But over

50 percent of our health care budget deals with people very late in

life. Forty percent of our institutional costs are paid on behalf of

people in excess of the age of 80. It's a very real part of the cost of

health care. Statistically it is suggested that a person over the age

of 65 requires about three and a half times the health care of a person

under 65. So the seniors certainly are a very major part of our health

care system. The member mentioned some references from a report, and I

think the report has stated the obvious — not that that report isn't

worth considering, but they have stated the correct picture.

must look to the future with respect to our health care and how seniors

are to be taken care of in our society. It extends far beyond health;

it extends to almost every aspect of our society as to how the senior

citizen as part of our society is to be accommodated — not taken care of

as though they were incapable of taking care of themselves, but

assisted and accommodated. Part of it is housing; part of it is health

care; part of it is other forms of assistance; part of it is education.

Recognizing

that senior citizens are a valuable resource and have a role to play in

our society, the federal government recently made a decision that they

would no longer enforce mandatory retirement. It is also statistically

known that the increase in the deterioration of health frequently

occurs upon forced retirement. Statistics are quite alarming with

respect to the maintenance of the health care after forced retirement.

Not that it is just health....

Some programs have been

advanced in other countries with considerable success with respect to

utilizing senior citizens. In Canada there seems to have been a trend

over the last number of years to warehouse senior citizens — it is not a very kind term —

basically to just find a space for them and have them occupy the space.

From the point of view of health, their health begins to deteriorate

badly. A report issued, I believe, last week by medical scientists said

that the most dangerous situation from a health point of view for

senior citizens is the lack of exercise. They deteriorate very rapidly

if they are not receiving adequate exercise. Sometimes it is somewhat

difficult to exercise in a facility that was never designed for that

purpose. That's not unlike what the member said in that report.

are very concerned about the plight of seniors. They represent a major

factor in our health care system, as everyone would know. The seniors

in our province are well provided for. Many programs assist them both

in health and other branches of government. It's a problem that

sometimes is more acute in areas that have enthusiastically sought

retired people to come to their community. The member for

Shuswap-Revelstoke (Mr. Michael) was speaking of Chase. Some time back

Chase made a concerted effort to attract retired people to the area. Of

course, the services then follow. I believe that Nanaimo has made quite

an effort to have retired people move to that community. Thus the need

for increased facilities, including the 150-bed extended-care unit

that's been approved for Nanaimo. I agree that it's a problem that we

have to live with and plan for.

[12:30]

One

quick comment, Mr. Chairman. The member asked about planning. I don't

know which area is most difficult to consider in the future. When you

consider that economists have an almost impossible task to project the

economy of the future, when you get into the field of health care,

there's a National Association of Hospitals who wanted to have a review

of the hospital of the year 2000 or whatever — I'm not sure. What

should we be planning for? Part of the discussion was, can we really

say today? Would we even consider

[ Page 7707 ]

designing

a hospital for the year 2000 today? It's only 15 years away, but would

we be correct? Mr. Chairman, the changes in technology are such and are

happening so rapidly today that the facilities we have could become

redundant in some instances. I mentioned the kidney lithotripter, our

new toy. The success is so phenomenal that since it has been in

operation, the lithotripter at Vancouver General Hospital has maybe

treated almost 200 patients. That represents almost 1,600 bed-days

freed up. If we have success with the excimer laser for arterial

blockages, our heart bypass program could be virtually eliminated, and

all of the facilities that go with it.

In treatment for

elderly people, many ailments which in the past required an elderly

person to remain confined are being conquered. Examples I could use are

the hip replacement, the knee replacement and various other things that

previously were not treatable and the person was confined to a

wheelchair or a bed, or whatever. These are becoming far more common.

The implantation for cataracts — removal of the cataracts and the implantation of lenses —

has freed up literally hundreds, if not thousands, of elderly people.

They are now mobile; they no longer require being cared for in that

traditional way, and their health improves because of that. Many other

features are coming along.

We in the ministry are, I think,

very conscious of the question: how do you service the elderly in this

manner? It obviously is the largest factor in health care, I guess

internationally; certainly in North America. We are very fortunate in

B.C. to have at our disposal adequate funding — others may argue it is not adequate —

to service the elderly patients. In some countries there are quotas

dialysis. One country has a committee which sits to decide who gets the

treatment and who doesn't. In Canada, any person who requires it gets

it. So we are very fortunate.

I very much appreciate the

topic of the elderly. Were I to have the solutions, I would perhaps be

the most sought-after person internationally, because there are

symposiums, conferences, research and studies looking at that question

all the time, including our own people. It is one of the key topics. I

appreciate it having been brought up, and I look forward to hearing

more.

MR. BLENCOE: I appreciate the remarks of the minister. I think this is a useful discussion this morning.

The

minister stated that he wished he had all the answers. Obviously no

minister has all the answers, and no one in this chamber has all the

answers. But I think what we should be doing is starting with a basic

premise. I note with interest that Saskatchewan has adopted three basic

premises for its work on behalf of and with the elderly. I think we can

apply them to all areas in terms of how we deal with the elderly.

Specifically this morning, however, I must deal with health. Those

three basic premises are: independence, integration and involvement.

Those aren't new premises, Mr. Chairman. I think we've all talked about

them for a number of years. I guess what we haven't done is really

taken the time and the planning and the studying and analysis to put

those basic premises into practice, in a terms of how we deal with the

elderly.

I know we're struggling with something that's

really difficult. We're growing and learning in this particular area. I

know I, living in a riding that probably has one of the highest number

of senior citizens in the country per capita, continue to learn and

experience from people in my riding about how we approach the topic of

elderly and those who retire, how we respect them. You know, they're

not put out to pasture. They have some meaning, and they can

contribute. I think we have to look at that, and how we approach

health. I think it's just a matter of us all deciding that those are

the principles, those are the premises. How do we apply those premises

in our daily development of our policies and our budgets and our

long-range planning, for instance, in health?

The minister

talked about looking at ideas and changes. I want to share with the

minister.... and he may or may not be aware of these particular

demographic projections in this task force. It is alarming and

distressing, in terms of the financial implications, if we don't start

to do the things that I'm talking about this morning: accepting these

basic premises, and building upon them.

There are some

incredible projections here. If we continue to carry on health policies

in the same vein we are continuing today, we're going to face some

incredible financial implications. To put this in perspective, total

public health expenditures — that is, by governments and municipalities, excluding private spending —

in 1981, excluding capital expenditures, was $18.5 billion. Of course,

I'm talking on a Canada-wide basis; and you have to prorate that for

British Columbia. I haven't done those formulas, Mr. Chairman. But let

me talk on a national basis. If we continue with the same approach,

primarily as we have today, by the year 2021 demographic changes alone

will increase current expenditures on health care by about 75 percent,

to over $32 billion, if current patterns of providing care remain

unchanged. That's why we continue to say: "Look, we really have to take

a look at things like the homemakers' service and home nursing care and

adult day care and those sort of things."

It indicates

again in this task force that if we don't take a look at

deinstitutionalization, the greatest growth area will be in

long-term-care facilities. I won't give all the numbers, but again it

indicates by the years I have suggested that the greatest area of

increase will have to be in long-term care. Now that's not to suggest

that we shouldn't continue in the meantime, while we try to build

toward a full policy of deinstitutionalization.... that we don't need

further facilities in long-term care today.

I know in

greater Victoria we are in great need, and the minister is well aware

of the pressure that it puts on acute-care beds in our hospitals. If we

don't have the will or the resolve to deal with these facts and these

projections — which are, I think, fairly conservative in terms of the model and the projections they have used —

we are going to have to have a massive expansion of these

long-term-care facilities at great expense to the taxpayer, when it has

been pointed out and proven that deinstitutionalizing, retaining people

in the community, is beneficial not only socially but economically.

These

figures really must concern us all, and I hope in the next few years we

can start to deal with these implications and take a look at some of

the further recommendations in this particular task force. There are

others, and I'm not going to go into the details, but they talk about

the Meals on Wheels expansion, respite care expansion, companion

program expansion, drop-in centre expansion, the whole area of

community health maintenance expansion, that really allow us not only

in a social way but in a financial way to maybe once and for all start

to come to grips with the financial implications of this growing area

of health care for the elderly.

[ Page 7708 ]

Now I don't know if the minister wants to respond to that; if he doesn't, I want to move on to some other particular topics.

HON. MR. NIELSEN: I just want to give a couple of figures

that I think everyone will find of interest — not in defence or in

argument, but just of interest.

Of the people in B.C. who are over 90 years of age...

HON. MR. GARDOM: Ninety?

HON. MR. NIELSEN: Ninety.

HON. MR. GARDOM: That's me.

HON. MR. NIELSEN: Including the House Leader.

...50

percent plus live in their own accommodations, which I think is quite

an amazing figure. At the 85 year level about 27 percent are in

institutions; at the 80 year level, about 14 percent. So it's

interesting that the vast majority remain at home, although it is

certainly a growing situation — a growing problem. But I just wanted to

mention those statistics and then go on to your next question.

MR. BLENCOE: Mr. Chairman, there are two or three other small

items — small in terms of time, but not small in terms of impact on

this particular region —

that I want to touch upon. The first is, again, related to the problems

of the elderly in this community, but it's not just related to this

community per se. It's the problem of the long waiting-list that the

hospice here in Victoria is struggling with. I'm sure the minister is

aware that the hospice here in Victoria is not meeting the community

needs and that there are usually more people on the waiting-list than

the program can deal with. Again, without going into detail, I refer

back to the task force where they talk about this area as being a very

important one that has to expand. I know that in Victoria the hospice

here has been met with open arms and that the community really respects

the work that is carried out there, but unfortunately there is usually

a waiting-list of 40 to 60 people wanting to get into that kind of

environment and community — and we all know what it means to people who

are terminally ill to be able to be placed in such a caring facility at

the end of their days. I'm wondering if the minister can tell us this

morning what plans he has for not only the Victoria hospice but for

other kinds of community facilities like this, and can we look for an

expansion of this particular kind of facility?

HON. MR. NIELSEN:

Just very quickly, because the member next to me wishes to speak on the

subject, the answer would be yes. The hospice is growing and is

becoming far more accepted, and they are learning more about it.

There

are some strange trends with respect to it. In the United States they

have had a reversal in the hospice program. But I think that here, yes,

you will see expansion. I can't be specific as to where or when, but I

think the hospice concept will continue to grow.

[12:45]

HON. MR. GARDOM:

Mr. Chairman, I did wish to briefly enter into this debate. There is

just one topic I would like to discuss with my colleague the Minister

of Health. I know that he and all members are mightily aware of the

fact that I am a great advocate for the medical profession and all

connected with it. I have supported them in the past, I support them at

the present time, and I suppose I will be even more supportive in the

future as this old frame starts to rust and needs some repair. But I

would ask my colleague the Minister of Health if any thought or study

or consultation has taken place concerning changing the concept of what

is essentially pay for piecework — so much to fix the headlights, so

much to fix the burnpers, the wheels, the radiators or the tailpipes —

knowing at the same time that the public purse essentially pays for

about 80 to 90 percent of the educational costs of these fine

professionals. It pays for their garage completely. It pretty well pays

for every tool they use in their garage. When you take everything into

account — and I am not begrudging them this — they happen to be

probably

the highest-paid people, out of the public purse, in the history of the

world. I just wonder whether the system of pay for piecework is one

that is going to be continued or one that is not necessarily implanted

in stone.

Interjections.

HON. MR. GARDOM: I've got my fingers and everything else crossed.

HON. MR. NIELSEN:

I'm concerned that there may be a rush at the emergency wards by

doctors if they hear you say such things. We don't call it piecework,

Mr. Chairman; we refer to it as fee for services.

HON. MR. GARDOM: For parts of the body.

HON. MR. NIELSEN: For parts of the body.

suppose that's the cornerstone of the medical profession's attitude

with respect to their trade: that is, the individual fee for service

rather than a salary basis. Doctors have expressed to me their fear

that if they were paid salaries they would become public servants and

lose their independence. That's the rhetoric. There could be room for

both; there are now doctors who are on salary and doctors who are under

contractual arrangements other than fee for service. It is suggested

that the concept of fee for service provides an opportunity for the

system to be abused. The fee for service adds up. I see you have the

blue book — the financial statements — which indicates that the fee for

service does amount to a considerable expenditure. I have no great

complaint about the fee-for-service concept, provided we can agree with

those who are providing the services that there is a limit to the

expenditure overall.

I'm not quite sure we would get the

same productivity from our medical profession if we were to establish a

salary, presumably with hours of service and so on. I think it's

probably much more flexible as it is today. Some countries have tried

the salaries, with varying results. I am concerned primarily with the

growth in cost. If we can arrange programs whereby the budget is

protected, then I think the fee for service could go along with that. I

know that members of the bar like the idea of being salaried rather

than fee for service.

HON. MR. GARDOM: They're not paid out of the public purse. There's a big difference.

HON. MR. NIELSEN:

I agree; they're not paid out of the public purse. I appreciate that.

But a practice that is accepted in our society is the fee-for-service

concept of payments. The

[ Page 7709 ]

Minister of Intergovernmental Relations indicated that he is a strong supporter of the medical profession —

I think as most people are. The fee for service has been with us for a

long time. I think it is a cornerstone of their attitude, and I

wouldn't hastily suggest that it be completely thrown out.

HON. MR. GARDOM:

I agree indeed, Mr. Chairman, with the sage comments of my colleague.

Not for one moment was I suggesting that it be thrown out. The point

that I was making was: has any thought or study or consultation been

given to perhaps a better method and not necessarily a salary, First of

all, how does one arrive at the rate to fix a carburetor in a human

body or the shocks, or, as I said, the radiator or even indeed the

tailpipe? Where indeed are those rates determined? Is there any public

input into the determination of that specific fee?

HON. MR. NIELSEN:

The fee

schedule 1s established primarily by the profession themselves.

They publish their fee schedule, their rate schedule. The Ministry of

Health, through the Medical Services Plan, reviews that schedule, and

the increases over the years have come as a percentage increase to the

schedule.

The medical practitioners then determine what

particular services are to be modified. It's very much like a master

agreement with the forest industry, where the IWA would work for a

percentage increase, but various components would receive different

increases, if any increases at all. At the moment the general

practitioners feel they are being badly outdistanced by the

specialists. It is really the BCMA who have to make the adjustments

within that fee

schedule to satisfy their own constituents.

have not done that. We do reserve the right to call to their