[ Page 1295 ]

CONTENTS

Routine proceedings

Oral Questions

Mr. Speaker's telephone. Mr. Williams — 1295

Hospital boards to pay cost of in-service training. Mr. Williams — 1295

Telegrams on Bill No. 42. Mr. Smith — 1296

Sandringham Hospital. Mr. Wallace — 1296

Appeal to court order re Kamloops area. Mr. Fraser — 1296

Prosecutions under Mortgage Brokers Act. Mr. Brousson — 1296

Payments to Meneham and Dunsky Advertising. Mr. Schroeder. — 1296

Ferry service in Ocean Falls area. Mr. McClelland — 1297

Purchase of Ocean Falls paper mill. Mr. McClelland — 1297

Man and Resources meeting. Mr. Schroeder — 1297

Committee of supply: Department of Health Services and Hospital Insurance estimates.

Mr. Williams — 1298

Hon. Mr. Cocke — 1310

Hon. Mr. Cocke — 1298

Mr. Kelly — 1310

Mr. Chabot — 1298

Hon. Mr. Cocke — 1311

Hon, Mr. Cocke — 1298

Mr. Wallace — 1311

Mr. Chabot — 1299

Hon. Mr. Cocke — 1311

Mr. Wallace — 1299

Mr. Williams — 1311

Hon. Mr. Cocke — 1299

Hon. Mr. Cocke — 1312

Mr. Williams — 1300

Mr. Wallace — 1312

Hon. Mr. Cocke — 1301

Hon. Mr. Barrett — 1313

Mr. Williams — 1301

Mrs. Jordan — 1313

Hon Mr. Cocke ; — 1302

Hon. Mr. Cocke — 1314

Mr. Wallace — 1302

Mr. Williams — 1315

Mr. Gardom — 1302

Hon. Mr. Cocke — 1316

Hon. Mr. Cocke — 1303

Mr. Fraser — 1316

Mr. Nicolson — 1303

Hon. Mr. Cocke — 1316

Mr. Williams — 1303

Mrs. Jordan — 1316

Hon. Mr. Cocke — 1304

Hon. Mr. Cocke — 1318

Mr. Gardom — 1304

Mr. Wallace — 1318

Mr. McClelland — 1304

Hon. Mr. Cocke — 1319

Mr. Wallace — 1304

Mr. McGeer — 1319

Hon. Mr. Cocke — 1305

Hon. Mr. Cocke — 1320

Mr. Nicolson — 1305

Mr. McGeer — 1320

Hon. Mr. Cocke — 1305

Hon. Mr. Cocke — 1320

Mr. Rolston — 1306

Mr. Wallace — 1321

Mrs. Jordan — 1306

Hon. Mr. Cocke — 1322

Hon. Mr. Cocke — 1307

Mr. Wallace — 1323

Mrs. Jordan — 1307

Mr. McGeer — 1323

Mr. McGeer — 1308

Mr. Nicolson — 1324

Hon. Mr. Cocke — 1309

Hon. Mr. Cocke — 1324

Mr. Williams — 1309

Mr. Nicolson — 1325

Department of Highways estimates.

Mr. Fraser — 1325

Hon. Mr. Strachan — 1328

Hon. Mr. Strachan — 1327

Mr. Chabot — 1329

Mr. Curtis — 1328

Hon. Mr. Strachan — 1329

The House met at 2 p.m.

Prayers.

MR. SPEAKER: The Hon. Minister of Health Services and Hospital Insurance.

HON. D.G. COCKE (Minister of Health Services and Hospital Insurance): Mr. Speaker, I would like to welcome a number of people from New Westminster, former capital city of B.C. I would ask the House to join me in welcoming them.

MR. SPEAKER: The Hon. Minister of Public Works.

HON. W.L. HARTLEY (Minister of Public Works): Mr. Speaker, I would like to introduce a group of 36 students from Hope Secondary School with their teacher, Don Olds. I'm sure you will join me in welcoming them to the assembly this afternoon.

MR. SPEAKER: The Hon. Minister of Mines.

HON. L.T. NIMSICK (Minister of Mines and Petroleum Resources): Mr. Speaker, I would like to …

AN HON. MEMBER: Mike. Mike.

MR. SPEAKER: He's a new Member.

HON. MR. NIMSICK: I always forget that mike. When I started here, there were no mikes. We had to use our own voices and that is the way I've been trained.

Mr. Speaker, I would like the House to join me in welcoming a very important person from Radium Hot Springs — the town of Radium, Mrs. Eileen Madson who is a trustee in the Windermere district and a former NDP candidate.

MR. SPEAKER: The Hon. Member for North Peace River.

MR. D.E. SMITH (North Peace River): Thank you, Mr. Speaker. I would like the House to extend a warm welcome today to the chairman of the Peace Liard Regional District, Mr. E.A. Framst, one of the directors and the administrator of the regional district, who are in the gallery this afternoon.

Introduction of bills.

Oral questions.

MR. SPEAKER: The Hon. Member for West Vancouver-Howe Sound.

MR. SPEAKER'S TELEPHONE

MR. L.A. WILLIAMS (West Vancouver–Howe Sound): Mr. Speaker, I would like to address a question to the Speaker. I notice that you have a telephone at your place. Would you indicate to whom it is connected?

MR. SPEAKER: Directly to my secretary, and she didn't send in what I asked her to.

MR. WILLIAMS: Just as long as it's not God, Mr. Speaker. (Laughter).

MR. SPEAKER: I could use His help too.

HOSPITAL BOARDS TO PAY

COST OF IN-SERVICE TRAINING

MR. WILLIAMS: Mr. Speaker, I would like to address a question to the Hon. Minister of Health. With reference to the in-service training of students in some of our universities and senior schools and their in-service training in hospitals. This covers a number of disciplines. Would the Minister indicate whether his department has any programme which will enable the hospital boards to pay the cost of in-service training?

HON. MR. COCKE: Mr. Speaker, in answer to that question — it's a very fair question, for that matter — we have no programme at this time to finance university and/or BCIT health trainees. However, the department is at the moment discussing the whole question of in-service training. We recognize there is a need to put the young people to work in health services if at all possible, as opposed to going out during the holiday season working on roads or working in some other area that they are not being trained for.

Our department is viewing this very seriously at the present time and we hope we can come up with some kind of programme that will help.

MR. WILLIAMS: Supplementary, Mr. Speaker. Specifically with respect to that part of the training which is required in the sense of practicums and internship: is it in that direction that the Minister is looking at the provision of funds that may be required?

HON. MR. COCKE: Yes. The problem is, of course, that most of the health facilities in the province are totally autonomous or relatively autono-

[ Page 1296 ]

mous, depending on where you want to grade it. Because of their autonomy, they have the right to decide whether or not they will pay a certain group of people.

Traditionally, as you know, interns and other people, even more so in some of the other health trainees' cases, have been brought into the hospitals and have worked for nothing as part of their educational programme. I would like to reverse this trend and make it an opportunity for us to help finance their education. I think it is a very important education. That is the way I feel.

MR. SPEAKER: The Hon. Member for North Peace River.

TELEGRAMS ON BILL 42

MR. SMITH: Thank you, Mr. Speaker. A very short and, I hope, concise question to the Hon. Attorney General. Is the Attorney General passing along the telegrams he has received on Bill 42 to the Minister of Agriculture (Hon. Mr. Stupich) so that the Hon. Minister of Agriculture can keep a close track and records on both the pro and the con side of the debate?

HON. A.B. MACDONALD (Attorney General): I have kept my telegrams and I have had some very good ones. I have told the Minister of Agriculture about them and it has cheered him up tremendously.

Some of them are beautiful, I must let you see them.

MR. SPEAKER: The Hon. Member for Oak Bay.

SANDRINGHAM HOSPITAL

MR. G.S. WALLACE (Oak Bay): To the Minister of Labour. Could he tell the House in light of further discussions which he has had whether there is any further decision regarding the labour-management strike at the Sandringham Hospital?

HON. W.S. KING (Minister of Labour): Mr. Speaker, I am not sure who he is referring to with respect to decisions. The Department of Labour is still involved in discussions with the parties to the dispute. At this particular point there is no further news that I can give the House. We are in consultation with the parties.

MR. SPEAKER: The Hon. Member for Cariboo.

APPEAL TO COURT ORDER

RE KAMLOOPS AREA

MR. A.V. FRASER (Cariboo): Mr. Speaker, a

question to the Minister of Municipal Affairs. Has the Minister issued instructions to any legal firm to pursue an appeal to the court order, seeking to restore the democratic franchise to the residents of the Kamloops area?

HON. J.G. LORIMER (Minister of Municipal Affairs and Commercial Transport): The question is under discussion with my lawyer.

PROSECUTIONS UNDER

MORTGAGE BROKERS ACT

MR. SPEAKER: The Hon. Member for North Vancouver-Capilano, and followed by the Member for Langley.

MR. D.M. BROUSSON (North Vancouver Capilano): Mr. Speaker, I would like to address a question to the Hon. Attorney General. Would the Attorney General advise the House if there have been any prosecutions to date under the Mortgage Brokers Act?

HON. MR. MACDONALD: I'll have to take the question as notice.

MR. BROUSSON: I'm sorry, I didn't hear.

MR. SPEAKER: To take the question as notice and no doubt reply on the order paper.

The Hon. Member for Chilliwack.

FUNDS USED TO PAY

MENEHAN AND DUNSKY ADVERTISING

MR. H.W. SCHROEDER (Chilliwack): The question is directed to the Hon. Premier and Minister of Finance. On February 20 last, in answer to a question, the Premier as Minister of Finance advised the House that there were no advertising contracts in the Department of Finance with Menehan and Dunsky Advertising. As the Minister of Finance acts also as president of the British Columbia Railway, would he advise the House what funds were used to pay the three representatives from Menehan and Dunsky Advertising listed in "The Way Out" bibliography and acknowledgements?

HON. D. BARRETT (Premier): That material was prepared by the group gathered together under professional law as consultants and all the bills will be paid by the B.C. Railway. It is a B.C. Rail proposal and the B.C. Rail will pay for the consultant.

The printing was done by the Queen's Printer.

MR. SCHROEDER: Supplementary: Does Menehan and Dunsky Advertising have any special

[ Page 1297 ]

relationship with this Government since they handled the campaign literature for the election?

HON. MR. BARRETT: No special relationship — just like Bill Clancey. No special relationship. (Laughter).

MR. SPEAKER: The Hon. Member for Langley.

Interjections by some Hon. Members.

MR. SPEAKER: Order, please. There is no point of order. Would you kindly sit down. Order, please. The Hon. Member for Langley.

FERRY SERVICE

IN OCEAN FALLS AREA

MR. R.H. McCLELLAND (Langley): Mr. Speaker, my question is addressed to the Hon. Minister of Lands, Forests and Water Resources. The last time, Mr. Speaker, that the Minister was in the House for the question period, which seems some time ago now, he indicated that he had some rather great plans for the general area of the B.C. middle coast, in particular with reference to Ocean Falls. I'd like to ask, Mr. Speaker, if this planning involved the Minister of Highways in carrying out the former government's undertaking to provide adequate ferry service in that region.

HON. R.A. WILLIAMS (Minister of Lands, Forests and Water Resources): The bulk of the work undertaken to date has been directly with the Crown Zellerbach company itself.

MR. McCLELLAND: Supplementary to the question, Mr. Speaker: There was an authorization by the Treasury Board given to the joint committee, which consisted of the former Minister of Highways, the former Minister of Municipal Affairs and the former Minister without Portfolio, the Member for Mackenzie, to provide ferry service for that area. Has that authorization been cancelled?

HON. MR. WILLIAMS: I might say, Mr. Speaker, that some further consideration has been given to the question of ferry service in that area. That's all I might say at this stage.

MR. McCLELLAND: Mr. Speaker, if there are substitute plans for that area, could the Minister give any indication of what those substitute plans are? Has the authorization for that ferry service been cancelled?

MR. SPEAKER: Excuse me. One minute, please, before we go further in the supplementaries. I take it that this really is directed to the Department of Highways, is it not?

MR. McCLELLAND: Mr. Speaker, I asked the question of the Premier last week. The Premier suggested that the matter must be dealt with under the Minister of Lands, Forests and Water Resources. That's why I've directed this question to him.

HON. MR. WILLIAMS: I think it's really part of the whole general question. We expect that there will be an announcement before very long.

MR. McCLELLAND: Just one further question, then, on the same area, Mr. Speaker. Is there any truth to the rumour that the Government is entering into …

MR. SPEAKER: Order, please.

PURCHASE OF

OCEAN FALLS PAPER MILL

MR. McCLELLAND: I'm sorry, Mr. Speaker. Is it true that the Government is entering into negotiations to purchase the paper mill in Ocean Falls?

HON. MR. WILLIAMS: I accept the question as notice, Mr. Speaker.

MR. SPEAKER: The Hon. Member for Chilliwack.

MAN AND RESOURCES MEETING

MR. SCHROEDER: This question is for the Hon.

Minister of Lands, Forests and Water Resources. Were the Man and Resources programme employees of the government given any instructions to hold a meeting in the Oak Bay Junior auditorium last night? If so, were they advised to place the Government's position on Bill 42 before the assembly?

HON. MR. WILLIAMS: I would like to make it abundantly clear, Mr. Speaker, that the Man and Resources programme, which is being carried forth across Canada under the Canadian Council of Resource and Environmental Ministers, is totally independent. Some funding is provided and was provided under previous budgets. Possibly supplementary funds might be found later this year. But they are totally independent. They have their own regional representatives and govern themselves.

Orders of the day.

House in committee of supply; Mr. Dent in the chair.

[ Page 1298 ]

ESTIMATES, DEPARTMENT OF

HEALTH SERVICES AND HOSPITAL INSURANCE

Vote 87: accounting division, $339,042 — approved.

Vote 88: public health services, general services $2,181,586 — approved.

. One vote 89: public health services, division for aid to handicapped — $733,924.

MR. L.A. WILLIAMS (West Vancouver–Howe Sound): On the question of aid to the handicapped, would the Minister advise whether or not, in the course of the assistance that his department provides, they concern themselves with the matter of construction of facilities for use by the handicapped. We've had speeches in this House — from the Member for North Vancouver–Seymour (Mr. Gabelmann) in particular — raising question as to the adequacy of, apartment construction and public building construction.

It seems to me that since this Minister is involved in matters of rehabilitation and so on, rehabilitation through all aspects of the lives of the handicapped people is an essential thing. We're all particularly concerned about the instances raised by the Member, where handicapped people are living in accommodation which must be patently unsafe by reason of the construction of stoves and kitchen equipment and so on. I would like to know if the department is taking any positive view with regard to recommendations which may go forward to other Ministers concerning changes that must be made.

MR. CHAIRMAN: I recognize the Hon. Minister of Health Services and Hospital Insurance.

HON. D.G. COCKE (Minister of Health Services and Hospital Insurance): Yes, Mr. Chairman, there is a concern around the construction of facilities. There have been capital grants from the Government for construction of facilities but that does not come from the health department. That comes from the Department of the Provincial Secretary.

In our particular situation, which is operating funds or operating grants or paying for services, these are federal matching grants. On that basis we are providing those grants. It could be that in the future, more of the health-oriented granting will be done by the health department, as opposed to that other department. But up to the present time, it has not been. We are trying very hard and as quickly as we can to rationalize some of these anomalies, at least what we feel are anomalies. As soon as we can, we will.

MR. WILLIAMS: On the same subject, Mr. Chairman, last night on television many of the Members had the opportunity of seeing a report which was done on transportation facilities which are available in Vancouver.

HON. MR. COCKE: Transportation?

MR. WILLIAMS: Yes, the Community Transport Society. Many of their customers are handicapped people. One of their greatest needs for transportation is travel to hospitals and doctors for the purposes of physiotherapy and other similar rehabilitative treatment. I understand that this particular service is an expanding one. They're running into financial difficulties. Could the Minister indicate whether or not his department is concerned in this aspect as well?

HON. MR. COCKE: Yes, Mr. Chairman, we're quite concerned about it. However, that financing is done by the Department of Rehabilitation and Social Improvement. As a matter of fact, the Minister of that department (Hon. Mr. Levi) has given a large sum of money in support of some of the transportation facilities in the province. It is not handled directly through health because of another federal sharing arrangement under CAP.

Vote 89 approved.

On vote 90: public health services, prescription drug subsidy plan, $1,563,978.

MR. CHAIRMAN: I recognize the Hon. Member for Columbia River.

MR. J.R. CHABOT (Columbia River): Mr. Chairman, I was wondering if the Minister would give us a little bit of background detail on the prescription drug subsidy plan, such as: how many people are benefiting from this plan? what are the numbers he expects to participate during this current fiscal year? what kinds of guidelines and checks might your department have established to ensure that only those people who genuinely need this type of subsidy will receive this type of subsidy?

I am aware — and I will be informing the drug subsidy plan of it — of two individuals who really shouldn't have these yellow cards to got subsidized drugs. These people are independently wealthy. They're almost as rich as the Minister of Lands, Forests and Water Resources (Hon, Mr. Williams). They shouldn't participate in a drug subsidy plan in this province. Just what kind of security check do you have to ensure that only those people who are in need really participate in the plan?

HON. MR. COCKE: Mr. Chairman, we would have

[ Page 1299 ]

had a pretty good system of keeping control of this situation, had the prescription drug subsidy plan not been messed up during the last election campaign. Prior to that, the subsidy plan was based on the qualifications for a subsidy for Medicare, which is relatively straightforward. It's not quite right yet. I hope that someday we're going to be able to rationalize that. But anybody who qualified for the Medicare subsidy would qualify for the prescription drug subsidy.

But then, unfortunately, the Minister at that time during the campaign indicated on television that anybody with dire need could also qualify, providing he put in an application. Well, everybody has dire need, so they feel. And it's taken us a good deal of time to work our way out of that problem. So, to date our present policy is that those people who qualify for the Medicare subsidy also qualify for the prescription subsidy.

MR. CHABOT: Just on one further supplementary question, Mr. Chairman. The Minister is twisting words. "Dire need" in my opinion would certainly indicate very clearly that people are receiving the overall medical plan subsidy. That's similar to your twist today when you talk about a $25 car insurance. And today it's no longer $25 car insurance. You're twisting words that are …

MR. CHAIRMAN: Order please. Would the Hon. Member be seated. Would the Hon. Member be seated, please. I would ask the Hon. Member not to impute bad motives to the — order please — to any Member of this House. Now, if you want to ask a genuine supplementary which would pursue the subject further, then you may do so.

MR. CHABOT: I'm not imputing any motives, Mr. Chairman and you know it. I'm just saying that he's twisting words and you know that too. It's a fact. All I ask is that he clarify a matter; he says that anyone that qualifies for a subsidy on the medical plan, qualifies for the drug subsidy plan as well. It's my information that only those that qualify for the 90 per cent subsidization qualify for the drug subsidy plan.

There are people that — qualify for 50 per cent of the medical plan, but do not qualify for the subsidy under the drug subsidy plan. I think he should make that abundantly clear.

You have left the impression here this afternoon that those people that do qualify for a subsidy of any amount on the medical plan qualify for the drug subsidy plan — which is not a fact in the understanding of the plan as I know it.

HON. MR. COCKE: Mr. Chairman, it's interesting to say the least. The Member across the way gets up and starts making all sorts of claims about lands, forests, water resources in his questioning. And then he expects me to respond impassively, Mr. Chairman. I don't feel that that's necessary. I respond in like. And I respond to those people who twist …

But anyway, Mr. Chairman, the fact of the matter is as I indicated — and if I didn't I'm sorry — that those who qualify for whole subsidy under Medicare, yes, that's quite right; full subsidy under Medicare — also qualify for the drug subsidy.

MR. CHAIRMAN: I recognize the Hon. Member for North Peace River.

MR. D.E. SMITH (North Peace River): Thank you, Mr. Chairman. This vote was transferred, as I see it, from a previous Minister's jurisdiction into your jurisdiction. Would the Minister tell me the amount of the vote for the last year, as compared to this year? I see this year it's $1,563,978. What was it before?

HON. MR. COCKE: Mr. Chairman, that Member knows perfectly well it was a special warrant of last year's government that was declared after — it was declared after this House rose last time. It was a brand new programme that was in anticipation of events to come. Mr. Chairman, there was no vote for that last year. The expenditure last year…I think there was an election, wasn't there? Yes, the expenditure last year was $371,000.

MR. CHAIRMAN: I recognize the Hon. Member for Oak Bay.

MR. G.S. WALLACE (Oak Bay): Mr. Chairman, could I ask the Minister if he has any thoughts of enlarging or altering this basic concept that he outlined, that the qualifications would be those pertaining to subsidies under Medicare. Is there any thought of expansion or alteration?

HON. MR. COCKE: Yes, Mr. Chairman. What we're trying to do right now…as you know the Medicare Commission also reports to the health department. So what we're trying to do now in both those departments, Mr. Member, through you, Mr. Chairman, is try to design a new kind of formula that will take care of both. The inequity of that kind of formula is perfectly obvious.

The trouble with it is, that this year you might very well be earning $20,000 a year; but because last year you weren't working and you qualify, this year, when you don't need it, you'll be getting a subsidy. Possibly next year, when you're out of work again, you won't be getting a subsidy because of what you're earning this year. We know how unfair it is. And we're trying our very best to try to work out a

[ Page 1300 ]

formula.

MR. CHAIRMAN: I recognize the Hon. Member for West Vancouver-Howe Sound.

MR. WILLIAMS: Mr. Chairman, on the drug subsidy plan the amount to be expended for the subsidy itself in the next fiscal year is $1.5 million. I wonder if the Minister would indicate the basis upon which that allocation is made; because in the interim financial statements for the 9 months ending December 31, 1972, it would appear that only two warrants had been issued under the prescription drug subsidy plan. One was in August for $150,000, which was spent, and one in October for $375,000 of which only approximately $180,000 had been spent. And yet we're indicating next year the cost would be $1.5 million.

Now, as well as that specific detail I think we should have, it's noteworthy, Mr. Chairman, that the employees engaged in the functioning of this plan — 10 in number — are all clerks or clerk-stenographers. And, of course, no one is suggesting that we don't have to have stenographers or clerks functioning. But I think the Minister should clearly indicate who has control over this kind of expenditure.

What members of his senior staff are looking after the management of this subsidy plan, because it is a significant amount of money — and probably one for which much more money should be provided if we're really going to do a job on the subsidizing of prescription drugs. And other Members have spoken on just how essential they are for so many people in our community.

Now, on that same subject, would the Minister please indicate whether he has had any indication of success with the medical profession in the encouragement of prescribing drugs generically, rather than by the use of trade or brand names? This was a programme which I understood the previous administration was attempting to foster, and certain regulations were prescribed in this regard.

Recently I've seen it suggested that the medical profession has in some cases resisted this proposal because of a concern on their part as to the quality of the drug prescribed generically, rather than by trade name. This is, if true, a very serious thing and, I think, one that I'm sure the Minister and his staff must have investigated.

HON. MR. COCKE: Mr. Chairman, first let me say — and I'll answer one of the questions first. As far as the people who are running that programme, the departmental comptroller and the assistant comptroller, who are paid out of another vote, are the executives in charge of that programme — highly qualified, well trained people for that kind of work. O.K.?

The second thing is the income tax — you asked why we're increasing the value of the vote. Well, this year the income tax exemption, as you know, has been increased. That means that there will be a number more people qualified than qualified before. Not only that, this programme is becoming better known throughout the community.

Many people did not know that there was a drug subsidy plan, and many physicians didn't suggest it, and that sort of thing. But it is becoming more widely understood, and more widely utilized. On that basis we don't want to underestimate. We feel that this is a relatively safe and sound estimate of our expenditure this year.

As far as the success with the profession, Mr. Chairman, through you: I don't know. I can't tell you. We haven't had any real serious consideration of this matter in my department, or in this department, since I've been the Minister. We are at the present time discussing the whole question of Pharmacy Act, pharmacy and so on, and so forth, with people in that profession.

As far as whether the doctors are putting on their stamp, no substitutes and that sort of thing, I haven't heard too many reports of that. I am a little bit sympathetic to them insisting that there's a high quality.

Granted, the federal people are now involved in standards. But until such time as they've had an opportunity to assess the wide range of drugs that we have in Canada — as to their standards, as to their quality, it's very difficult to insist that you have no alternative — or at least that you can provide that alternative,

MR. CHAIRMAN: I recognize the Hon. Member for Oak Bay.

MR. WALLACE: Mr. Chairman, I think it's rather important to follow that a little further if I may, in terms of the degree to which we are provincially in serious discussion with the federal government. I'm sure the Minister has just read in the Press the other day about this federal programme called "Quad." I can't remember just exactly how the letters add up to … quality of drugs.

This really, Mr. Chairman, is a very important problem in our society. Nobody questions the fact that we must attempt to provide drugs at reasonable cost. This is a premise we would all totally accept, I'm sure.

The federal government has made several attempts in this direction, and even this latest attempt, called the Quad programme, is running into some serious criticism by people who know what they're talking about. I'm not necessarily just talking about people with vested interests. I'm talking about

[ Page 1301 ]

people who are interested in the chemical assay of drugs and what we call their bio-availability — the degree to which the drug ever gets into your system once you swallow it.

With the ever increasing range of different drugs being discovered and refinements of former drugs, this is a fantastically big job for even the federal government to tackle. Now, I know that they've increased their budget. I don't have the figures right with me, but in the last two or three years they have increased this enormously. Even now the federal people themselves are admitting what a very large task this is, with drugs produced domestically in Canada and drugs that are imported into Canada.

If there's any thought again that doctors in particular are not aware of the tremendous financial burden that it can be to some of the patients, I would strongly say that that is not the case. Once again, it's rather like some of the comments that I made the other day. Primarily the doctor is interested in protecting the patient and in giving the patient drugs which are to be of value. If you pay $2 for a prescription and the drug never gets into your bloodstream, you might as well pay $4 and at least get what you think you're getting in terms of the pharmacological effect.

I think that this is such a big problem and a very vital one, that I wonder if the Minister is considering any closer federal-provincial understanding or committee with this latest federal body trying to solve this problem across Canada.

Would he like to comment on the fact that this is obviously the route we have to go? It's very difficult to carry out this kind of work provincially when so much study and expense are involved. Since the federal government is going into it in an ever increasing degree, perhaps we should be much closer to them in our deliberations on this.

HON. MR. COCKE: Mr. Chairman, when the Ministers of Health met in Regina in October, we had a long discussion on the whole question of drugs. At that time, the Quad programme had been established for some time but I think they merely managed to get to a range of about six drugs. We recognize that if they are going to keep going at that rate, either it would be a failure or something would have to give and the provinces would have to assume some sort of responsibility. I think this is an area where the federal government belongs, and I think they accept that. I think that we should be responding to and cooperating with them as much as we can.

We've met with Manitoba and two or three other western provinces and discussed the whole question of buying of drugs and one thing and another. We feel it can only be done if, in fact, the quality standards are set some place — we feel that the place to do that is in Ottawa. So we're open, and we're cooperating, and we'll do anything we can. Manitoba has threatened, of course, to go on their own programme, but they're too small and so are we. It's just too monumental a task. Therefore we'll do anything we can to help them keep that programme going.

Vote 90 approved.

On vote 91: development of alternative care facilities, $600,000.

MR. CHAIRMAN: I recognize the Hon. Member for West Vancouver-Howe Sound.

MR. WILLIAMS: Mr. Chairman, I wonder if the Minister would indicate precisely how these moneys are to be expended in the next year. We're increasing the appropriation by $100,000 in these estimates. Yet in the 9 months ending December 31, 1972 while there was $500,000 to add, last year — the department had only expended $239,000. What's it for? Who's running the programme? What kind of alternative care facilities are being contemplated for development that would require this kind of money?

HON. MR. COCKE: Well, Mr. Chairman, let's go backwards. Who's running it? The hospitals are running it. This is that community-based home care programme. It didn't get underway last year at all, to the extent that we wanted it to. As a matter of fact, some of the moneys that were in this vote were not used for that programme at all. This year, however, those moneys are to be used for that programme. Ultimately it will be phased into our whole home care programme. We're negotiating with Vancouver right now.

It's very hard to understand, Mr. Chairman, but when you deal with old votes and new votes, it's very difficult. That's why I'm trying to explain — this is a home care programme that last year was in Kamloops, Coquitlam, New Westminster and Victoria. O.K. This year we're expanding it and the health units, together with the hospitals, will run the programme. We hope to expend all of this money and more, Mr. Chairman, because we'll be moving into that other vote on home care. But that's precisely what it is. It's to reduce the utilization of acute care hospital beds by getting people out early and taking care of them at home.

MR. WILLIAMS: Am I to understand, Mr. Chairman, that the hospitals and the agencies in the communities will establish the programme and then submit the programme to your department for approval, along with some estimate of the likely cost, and that then there'll be a grant made to cover those costs? Is that the way it would function?

[ Page 1302 ]

HON. MR. COCKE: Yes, we pay the salaries. Naturally they have to decide roughly on the cost and we estimate what the cost will be. For example, for Vancouver, which is a major undertaking as you can well imagine, there's a large estimate of cost. Therefore we just pay for the service directly — in other words, the salaries or whatever else is entailed in this programme.

MR. WILLIAMS: But surely the hospital which establishes the programme must first submit it to you to get your approval. Are you just giving them carte blanche approval?

HON. MR. COCKE: No, it's the health unit that establishes the programme in cooperation with the hospital. We say to the hospital, "Look, we are going to try to lower your utilization rates. This is the way we'll do it…. . " Now the hospital has to be in total touch with the programme, but the health unit has to do the financing.

MR. CHAIRMAN: I recognize the Hon. Member for Oak Bay.

MR. WALLACE: Mr. Chairman, could I just clarify that this item has nothing to do with the financing of the special care facilities. This is included, I take it, under hospitals and health services — the special care facilities.

HON. MR. COCKE: No, nothing to do with special care.

Vote 91 approved.

Vote 92: Hearing Aid Regulation Act, $15,000 -approved.

Vote 93: grants for health agencies, $813,000 -approved.

On vote 94: narcotic addiction treatment centres, $100,000.

MR. CHAIRMAN: I recognize the Hon. Member for Oak Bay.

MR. WALLACE: Mr. Chairman, we've had a great deal of discussion about this whole subject, and the Minister of Rehabilitation and Social Improvement (Hon. Mr. Levi) has made a statement of general policy.

I wonder if the Minister of Health at this point can tell us more specifically the direction that will be followed in the near future. I know this is a very complicated and difficult subject, but it's also a very urgent one. It is increasing, and the figure here is the same as last year.

The Minister of Rehabilitation and Social Improvment had mentioned — and I agree with this — that the funds should perhaps better be dispersed to the community level. There was an implication, if not an outright statement, that such moneys would not be provided to centralized foundations in metropolitan centres, with very little effective treatment at the periphery. I wonder if the Minister has had the time to work out any kind of new formula, or whether this is just marking time until the new policy develops. Could he comment on that, please?

HON. MR. COCKE: Mr. Chairman, the latter part of your statement is quite right, Mr. Member — this is marking time. The Minister of Rehabilitation and Social Improvement did announce that there are new directions — community-based directions. That's the way we're going to go, but for the time being there's certainly no way that we're going to pull the carpet out from under those agencies that are now functioning, which might very well be, in some cases, part of the new scheme of things.

So we feel that it's absolutely necessary to leave this vote in and continue on with the programmes we have until such time as we have alternatives. It's just like taking a crutch away from a wounded person.

Vote 94 approved.

On vote 95: public health research, $600,000.

MR. CHAIRMAN: I recognize the Hon. Second Member for Vancouver–Point Grey.

MR. G.B. GARDOM (Vancouver–Point Grey): Mr. Chairman, a couple of questions to the Hon. Minister. It seems from recent reports that the federal government will be coming out with the results of its nutritional study around October of this year.

I also read in the paper a very alarming account of Dr. Z.I. Sabry, who's the head of Nutrition Canada. He said there are more foods with less nutritional value creeping into Canadian diets and suggested tighter controls on manufacturers are needed. It carries on:

"The programme 'Give us This Day our Daily Bread' said that one-third of all medical costs are to repair damage from malnutrition — everything from vitamin deficiency to obesity, arteriosclerosis to salmonella poisioning. The programme challenged a long-time medical assumption that children, if left alone, will instinctively choose a healthy and balanced diet."

Mr. Chairman, I don't think we've ever had any indication of provincial strength in British Columbia in this particular area. I'd ask the Hon. Minister: Do we really have public nutritionists in the Province of

[ Page 1303 ]

B.C.? If so, where do they hide? What are they supposed to do? Are there any available programmes? Is there any available material?

I've advocated in this House many times over the years that the nutritional quality of foodstuffs — and of drink too, for that matter — should be taught within our school system. I appreciate that this is outside the area of the Hon. Minister, but the lady Minister (Hon. Mrs. Dailly) is just sitting in front of him and I know the two of them get along exceptionally well together. Perhaps he would be able to use his many charms to influence her to see that we have a school programme along these lines.

I feel very, very strongly that if breakfast cereals, apart from being pleasantly contained and tasty, are nutritionally phony, the public should know about that. I'd say that if what I'd call "Phonyos," by virtue of secret decoders or chances at moon trips, are being shoved onto the breakfast tables in this province, notwithstanding the fact that they are nutritionally bankrupt, then something is wrong and the public should know something about it. Maybe we need a "Nosey Nader" in this province to look into the business of processed foods.

I would ask the Hon. Minister if he would not be in favour of placing a greater emphasis upon a fair and reasonable understanding of packaging, and teaching the people within the province, specifically through the schools, how to relate the cost of product one to the other.

We've got to concern ourselves, as the Minister indicated a few moments earlier in his remarks, as to standards and to quality. I do feel very strongly in this particular area. Our headway in the province has been miserable to say the least. I'd appreciate his comments.

HON. MR. COCKE: Mr. Chairman, let me first say I want to congratulate you on your patience for tolerating a discussion on Marc Lalonde's vote. That research that you are talking about, Mr. Member, is research being done solely by the federal government. But it's very relevant.

As far as our work on nutrition is concerned — and I would hope that you will be as gracious with me as you were with that Member so that I might answer the question — we will have now four times as many nutritionists on our staff as we had last year. Four times as many.

AN HON. MEMBER: How many is that?

HON. MR. COCKE: Four. (Laughter).

Mind you, both metropolitan areas have nutritionists. You will note that we've done TV programmes for this local area on nutrition in recent months. They're going to be shown all over the province.

AN HON. MEMBER: What are their terms of reference? What are their duties?

HON. MR. COCKE: Their duties are, of course, to co-operate with the Hon. Minister, of Education's (Hon. Mrs. Dailly) department. All through our department they do in-service training, for instance, of all public health nurses. They can even teach doctors, can you imagine it, about the feeding of the human being.

Mr. Chairman, we are quite concerned about the whole question of nutrition. We're waiting for the reports that come out of Ottawa on a rather extensive research programme. Some of the reports that we've seen from the States indicate very clearly that cereals just aren't worth the powder to blow them out of the kitchen. I hope that we can do a lot of educating with respect to that.

As a matter of fact our head nutritionist in one of her last little brochures that she's made has been pushing Crunchy Granola for kids. I think that's a very, very much better kind of cereal than ones that they've been accustomed to in the past.

MR. CHAIRMAN: I recognize the Hon. Member for Nelson-Creston.

MR. L. NICOLSON (Nelson-Creston): Thank you, Mr. Chairman.

The responsibility for enforcement of certain regulations falls to the local public health officer, the medical specialist. A problem which comes up here is the hours of work. I refer specifically to a problem where, with commercial campsite facilities, on a weekend such as the Memorial Day holiday weekend, United States tourists overcrowd campsites. I have had complaints of these sites being overcrowded.

MR. CHAIRMAN: Order, please. I would ask the Hon. Member if he wouldn't mind bringing it up under vote 98 rather than vote 95, which deals with public health research.

I recognize the Hon. Member for West Vancouver Howe Sound.

MR. WILLIAMS: Mr. Chairman, I borrow a line from the Attorney General (Hon. Mr. Macdonald) when he sat in Opposition, "What are you doing over there?" You want $600,000 for public health research. You know, these block votes are very, very convenient, but we only spent $270,000 in nine months last year. What do you want the $600,000 for?

handicapped, a $700,000 vote. There are 18 people on staff under that vote, Now here we have $600,000, public health research. What are you doing? What are we researching? Who's doing the

[ Page 1304 ]

research? What areas are we looking into? Dental care?

AN HON. MEMBER: Ottawa.

MR. WILLIAMS: No, Ottawa's carrying on certain significant research programmes. Here we have a $600,000 item for public health research to be done in this province. I think we're entitled to know what is being done and who's doing it.

HON. MR. COCKE: Yes, Mr. Chairman, quite right. Up until now and I'm not sure that it will always be that way most of the research grants have been approved through the universities. In other words, the university has been charged with the responsibility of assessing whether or not this is a good project. That sometimes delays the area.

Let me say this: the expenditures in 1966-67 were $453,000; 1967-68, $494,000; 1968-69, $749,000, and so on. Last year, 1971-72, $522,000; this year to date — now it depends. You give research grants but you don't put all the money in until such time as criteria are met.

Some of the things that we've been doing are glaucoma research, anaerobic treatment of animal wastes research, risk factors among young drivers, 16 to 24 — some research there. We've done some development of moral judgment in-depth adolescence.

I agree, Mr. Chairman, that there should be a greater interest, a greater participation in this whole question of research. But we have to be very, very careful that we're not duplicating. That's one of the great fears.

As a matter of fact, one of your Members is indicating very clearly that we do need some coordinating activity to go into this question of research. Right now the Foulkes committee is looking into that very idea.

MR. CHAIRMAN: I recognize the Hon. Second Member for Vancouver–Point Grey.

MR. GARDOM: Mr. Chairman, while the Hon. Minister was talking about research, are there any steps being taken in dental — if I have his attention — are there any steps being taken in dental research? I wonder if the Hon. Minister could inform me if he happens to know where the closest dentist to the parliament buildings is. While he was giving his last reply my tooth fell out. (Laughter).

HON. MR. COCKE: Mr. Chairman, I offer condolences.

MR. GARDOM: That's typical.

Vote 95 approved.

Vote 94: grants, subsidies for local health services, $575,000 — approved.

On vote 97: health security research project, $125,000.

Mr. CHAIRMAN: I recognize the Hon. Member for Langley.

MR. R.H. McCLELLAND (Langley): Mr. Chairman, my question is perhaps somewhat opposite to the last Member's question about costs. I'm wondering, when the total amount of this vote is $125,000 and the committed full-time salaries are already almost $119,000 plus two other part-time people at $1,500 a month, plus $10,000 already spent for advertising and perhaps more to be spent, how are you going to pay all of that out of $125,000 and will there be more money put into that from some other vote?

MR. CHAIRMAN: I recognize the Hon. Minister of Health Services and Hospital Insurance.

HON. MR. COCKE: Mr. Chairman, last year there was a special warrant. As you know, we weren't elected until August. I set up the health security programme in September and there was a warrant for the balance of last year. This is in the estimates for this year's activities which will only go until October.

As I indicated to the House sometime ago, the health security programme, as far as I'm concerned, is one of the most positive steps this Government has taken with respect to health care. We feel that the work they have already done in advice has more than paid for any expense they put this Government to.

MR. McCLELLAND: Mr. Speaker, with respect, I don't think the Minister has answered my question. In fact, I'm sure he hasn't answered my question, because it would seem to me that regardless of whether the programme is scheduled to end in October or not we seem to be committed for that total amount of money this year.

MR. CHAIRMAN: Order please. The Minister has answered the question, inasmuch as he said that a warrant had been provided until March 31 of this year and that this money is budgeted for the coming fiscal year beginning April 1.

I recognize the Hon. Member for Oak Bay.

MR. WALLACE: I'm not particularly questioning the financial output. I would like to ask a question about the continuing philosophy behind this kind of project. I think the debates so far — Members who

[ Page 1305 ]

spoke on your salary debate, Mr. Minister, through you — have made it very clear that the whole realm and range of health services is a very complicated and expensive one.

The techniques and the discoveries and the new drugs and prostheses and all the breakthrough that occurs almost month by month in this whole field would suggest it is very difficult to maintain services and personnel and medical education and a host of other things in an up-to-date and economical way. I am wondering if the Minister is anticipating…I think this is the second $125,000 we are budgeting for, is it not?

HON. MR. COCKE: Yes.

MR. WALLACE: This was, I think, to be a one-year project when it was first conceived. I am just wondering in the light of: (1) the success that he has described; (2) the complexity of health care and (3) the rapid advances and new treatments in technology, et cetera — whether, in fact, he is considering this as a continuing project and as an integral part of his ministry?

HON. MR. COCKE: Well, Mr. Chairman, I would be anticipating, as I indicated to begin with, that I am sure that out of a $433 million department, we should be spending some money to try to save money. That's what the health security programme is all about; to rationalize and to coordinate the efforts of our department — which is four departments, as you know.

I don't really know. I am sure we will be doing further research; and whether or not Dr. Foulkes or any number of his people will be doing that specific work, I can't say at this time. All I can say is that in a monstrous department with fantastic investments such as this, we will have to have a great deal of help in trying to keep things coordinated.

MR. CHAIRMAN: I recognize the Hon. Member for Langley.

MR. McCLELLAND: Mr. Chairman, I would just like to ask the Minister if it is true then that the $125,000 total vote in this vote 97 means that Dr. Foulkes and the rest of his staff will be paid for a full year's salary for their work from March to October; or will their salaries be prorated up to that time?

HON. MR. COCKE: Well, Mr. Chairman, I guess it is very difficult. Can I just go this way once more and I don't want to be tediously repetitious. There is $250,000 in this programme. Because the programme began during the month of September, the first $125,000 had to be a special warrant. We are now in a session of the Legislature — the balance is $125,000 which is to be the final. At least that is the total amount of the plan now — $250,000.

So those people who started at the very beginning and were on a salary from the beginning — yes, they will be getting that salary throughout the programme, ending in October. Those people who started six months later…there are people coming and going in that programme, but everybody is given a contract that says he is finished in October.

MR. CHAIRMAN: Shall vote 97 pass?

Vote 97 approved.

On vote 98: Local Health Services, $7,779,011.

MR. CHAIRMAN: I recognize the Hon. Member for Nelson-Creston.

MR. NICOLSON: Thank you, Mr. Chairman. As I was outlining earlier the responsibility for enforcement of health regulations at such facilities as tourist camp facilities, tenting grounds, trailer parks, falls to the local public health officer. In recent years we have had some complaints in our area that the enforcement of this thing was not done because the problem arose on weekends; specifically on holidays weekends and most noticeably on the Memorial Day weekend.

Attempts to get the officers out at that time were somewhat unsuccessful and I don't blame these public health officers. After all, they are paid a salary. They are expected to be at work 40 hours a week in addition to normally attending many meetings with ancillary services in the community. They put in a lot of time. So, it is not unreasonable that they could expect to have their weekends to themselves.

I would wonder if there could be some provision made for time off during the week and for time on during weekends where we might anticipate this problem would happen again?

[Ms. Young in the chair]

HON. MR. COCKE: Mr. Chairman, it is very difficult to answer the question. All I can say is that the feedback I am getting in the department is that medical health officers in these various areas throughout the province are working their heads off. I know there are cases that have to be overlooked by virtue of a man's ability to sleep, to work those long hours. All I can say is, that certain circumstances develop in any area where you just can't meet the needs.

We have to sort of build our public health officers and staffs on the basis of the normal, expected, anticipated needs. We are adding 17 new public health inspectors this time around. There are more PHNs. I think I discussed it the other day — 25 or 30.

[ Page 1306 ]

I think we are moving in the right direction.

MS. CHAIRMAN: The Hon. Member for Dewdney.

MR. P.C. ROLSTON (Dewdney): Mr. Chairman, just a question about the relationship of the public health people who are entirely paid for by the taxpayer of B.C. and the private, general practitioners and the specialists who are partly paid for by the private sector. It has been confusing to me to know how to respond — how to see a greater sense of trust and collaboration and sharing between the public health officers, certainly the public health nurses; and we could go down to the public health inspectors, and the private general practitioners.

Now, we are all here. We want to save money; we want to do things in the most proper way. We obviously want good medicine: we want good health. I must say, in my other profession as a pastor, it has often been quite confusing, in fact even embarrassing at times, to see the relationship. Now, I know as a Government we made a commitment towards collaboration and towards a public type of medicine ultimately. I wonder if you could just help us so far in this particular situation?

I have had meetings with all 30 doctors in my riding and we have tried to work out this type of communication and sharing. The other thing I want to ask, of course, is…right now I think we have got to be getting some direction from you as to plants. There seems to be a bit of confusion, in my mind at least, as to how we start gearing for a public type of outreach clinic from hospitals.

Private medicine is largely oriented around the hospital as well as their own offices. But they do a great deal of work in the hospital, using public facilities — subsidized public facilities — and yet we put an awful lot of capital into public health plants, not necessarily anywhere near hospitals. Could you help us in both of these areas?

HON. MR. COCKE: All I can say for Dewdney is they are lucky. The member for Dewdney is providing the kind of liaison that is so lacking in so many areas in the province. He is putting it together up there. He is getting to see doctors and the health officers and so on. I just want to commend that Member for doing a fine job.

Our direction has to be based on the community health and welfare concept. I'm not speaking in terms now of the community health centres specifically, but the kind of communication network that is absolutely essential to provide contact.

Many doctors don't even know where to send a person for some service that that community might have readily available. What we have to do is get that information out and get some sort of coordination of the activities of the area, and the sooner the better. Thanks for your help, Mr. Member.

MS. CHAIRWOMAN: The Hon. Member for North Okanagan.

MRS. P.J. JORDAN (North Okanagan): Thank you, Madam Chairman. I'd like to go back to this business of health inspectors in relation to campsites. I don't want to be misinterpreted because I think I should by nature of our family associations be very conscious of this — but for a while this whole business of health inspection of campsites became an overzealous activity and really rather ridiculous, particularly in the more remote areas of the province.

I would ask the Minister in instructing his staff to rely on local judgment when these inspections are made; to recognize that the needs of a remote fishing camp — which has about a 40-day occupation period, and at that not usually to capacity — would be somewhat different to those in a more populated area where you have public campsites or private campsites that would be working under congestion.

As I understand it, from the engineering point of view a primitive style of chemical privy is much safer as far as ecology is concerned on the waterfront than a septic tank that's only used a few months of the year — maybe two or three months of the year.

We got to the point where we were requiring this type of installation, septic tanks, on remote Waterfront areas where they didn't function property because they were overloaded for a short period of time — maybe even just two or three weeks during the year. Remote campsites are also required to really make available a much larger square foot basage for not only the camping unit, but also 12 ft. set backs for parking plus, I think it was 30 feet or 40 feet for a driveway space. When you get into a small lake there is sometimes just not this much land available nor is it occupied nor is it under that much pressure. So I would ask the Minister in carrying out his duties to not let this prohibit a very enjoyable camping experience for people on the basis of perhaps an overzealous health rule.

I would like to bring to the attention of the Minister and his department the problem of septic tanks in the non-metropolitan areas. I'm not completely conversant with how these people are trained or if they are, but essentially people get their advice on the type of septic tank they need through the health department and the health inspectors. I would compliment the Minister, this is an excellent service. On the other hand, they are not highly technically trained people in this area and all the soil conditions that are run into raise controversy.

It seems that there is no real training programme in British Columbia for people who install septic tanks. Nor is there any real protection for the public

[ Page 1307 ]

when they hire someone who is listed in the telephone book as a septic tank installer.

If you want to put in a septic tank you will sometimes go to your public health inspector and he, without making specific recommendations, will say, "Well, he does a pretty good job." or, "He doesn't do a good job" and "We found it acceptable." There's no way you can be sure that the person you hire for $800 to $1,500 to $2,000 is going to do a proper job.

If the installer takes out the certificate with the health department then the health inspector does have the authority to insist that any omissions…Is the Health Minister going to talk to the Premier all the time, or is he going to listen?

HON. MR. COCKE: He's talking to somebody behind me, Madam Member.

MRS. JORDAN: It's a good subject for you to listen to.

The only protection you have is if you are alerted ahead of time by the health inspector that the installer should take out the certificate from the health office. Then if there is an error they can say to the installer, "You must go back." Even then you have to go to court if there's a problem.

There's really no protection for the public at large that these people are properly trained as to soil conditions; as to the type of septic tank or holding facility that is most suitable; and a guarantee that this work is done properly.

It's a lot of money to build a house. And most of these houses are built by people on a minimum income and smaller incomes. So I would ask your thoughts on this and if there is no such training programme; if there is no such certification programme in British Columbia for septic tank installers, could you get together with your colleagues and investigate the feasibility of doing this?

MS. CHAIRWOMAN: The Hon. Minister of Health.

HON. MR. COCKE: Ms. Chairman, going backwards, you're quite right on the problem that people have with respect to getting a septic tank. It's installed incorrectly, a permit was taken out - and they are down the tube for the money that they've lost. Our public health engineers — and you know that we have a number of engineers working in our department — are most uptight about this and are certainly advising ways and means of getting around this. Up till now there have been problems with pollution control. I think that some of those are going to be reationalized in the not too distant future.

As to how we can set up a programme — even on major facilities there's no advice given by the engineers. So what we would like to see as soon as possible is a much closer liaison between our public health engineers and those people who are installing. It might very well be a course.

MRS. JORDAN: You mean BCIT or the vocational school?

HON. MR. COCKE: Yes, that's right.

Going on to the campsite situation. I persuaded cabinet, as a matter of fact about a month and a half ago, that we should have an order-in-council that would reduce the impact of some rather severe regulations around this whole question of campsites and restaurants, giving the public health inspector a little more latitude so that he can go in there and make his own sort of value judgment.

I think that will relieve the situation that you're describing in areas where there are people for just a portion of the year and not for the whole year — and that they are not overdoing it as far as septic tanks and other…So anyway I think that that's been taken care of. If not, maybe I'll hear from you next year.

MRS. JORDAN: Could I just ask the Minister one more question in relation to this? I must confess I left my notes at home on this so I'm not sure I'm on safe ground.

My understanding is that the public health inspectors, the new ones, are trained at BCIT. Then they come out with a classification into the field and there have been problems where these people are theoretically quite sound, but practically on very shaky ground. They have been signing certificates which have left the health unit in an embarrassing situation. It leaves the chief health inspector having to go between the public and this individual who wasn't competent.

A better way to approach this would be to change the classification procedure. Give these young people the technical training in BCIT and then send them into the field for 6 months or a year internship so that they can relate the technical knowledge that they have achieved with the practical knowledge and also perhaps gain from the experience of those they're working with. Then, if they qualify give them their certificate. Then give another probationary period before they are given a permanent position as far as staff is concerned.

I think it would save your department a lot of problems. I think it would serve the young people much better because they get an awful lot of fairly technical information while they're still relatively young and applying it is difficult. It certainly would appear to serve the public much more efficiently.

MS. CHAIRWOMAN: The Hon. First Member for

[ Page 1308 ]

Vancouver–Point Grey.,

MR. P.L. McGEER (Vancouver–Point Grey): Ms. Chairperson, I don't know if this is the correct vote to …

MS. CHAIRWOMAN: Probably not.

MR. McGEER:…bring up the matter of the stairways up to the Press gallery, but it's very evident that they …

MS. CHAIRWOMAN: I think that comes under public works.

MR. McGEER: Public Works. It may wind up, of course, coming out of the Minister of Health's budget. (Laughter).

Ms. Chairperson, again I want to bring up the subject which I'm not sure best comes under this vote. Perhaps you can give me some guidance on it. This is that under local health services, surely would come the local study of the effects of fluoridation. I said a few words about this the other day in the Legislature and, Ms. Chairperson, they were just a very few words.

I want to say I'm fed up with getting letters from nuts and quacks and screwballs on the subject of fluoridation, which happens every time I make a speech. I realize that most of the people who are not in favour of fluoridation are very reasonable, intelligent people. The problem is that they are exposed to propaganda put forward by nuts and quacks.

There was a perfect example last Friday after I'd made a few remarks — and really a very few remarks about fluoridation, considering the importance of the subject. This was a hotline show, and I'm not going to use the words of description about hotline shows that the Minister of Highways (Hon. Mr. Strachan) used, but certainly I thought that the programme came forth as a result of that speech was not what you would call objective and balanced.

An individual appeared on that programme and what he had to say was discussed at some length. This was a Dr. Mick from the United States, who has offered to put up some huge sum of money — $100,000 or $200,000 — for anybody who could prove that fluoridation did no harm at all. What I want, Ms. Chairperson, is for the Minister of Health to take the $200,000 from that man and put it into facilities for handicapped children.

Here's an opportunity to take one of these charlatans and take his money as well. We've got the data right here in British Columbia that would make it possible for us to have that money for improved health services. We only have to go to our own local health service offices in communities where we've got fluoridation — Prince George and Kelowna — that have been going on for years and years doing nothing but making the teeth better for the people in those communities.

If it can be shown that fluoride is doing some damage, as the people who write to me suggest in these nut letters that I receive, then we should be stopping fluoridation in Kelowna and Prince George. Obviously, we're not going to because it's doing a tremendous amount of good in those communities. Not in Kelowna, Prince George or any of the other hundreds or thousands of communities in North America that do fluoridate their water can we find one single instance of any individual coming to any harm, however small. That's why we should take the $200,000 from that man.

The only place that you can find any discussion against fluoridation at all is in the media, because that's the only place the nuts can get any publicity. So, Ms. Chairperson, here's the chance for the Minister of Health to get a little added money for his budget and do a favour for the people of British Columbia.

You know this hotline programme — and perhaps the Minister of Highways (Hon. Mr. Strachan) in this particular instance had the description right — spent time discussing the approaches of this strange doctor from the United States. But if one had taken time to read the names of the people and the titles of the scientific papers that have either endorsed this measure or proved beyond question its validity, it would have taken more than that whole radio programme. That's how overwhelming the evidence is in favour of this very important public health measure.

You don't have to any longer cite individual papers and individual experiments justifying pasteurization of milk or immunizing people against diphtheria or any of the other great public health measures today. But for some reason we have to keep doing this again and again and again over fluoridation.

So, all right; if it still has to be done here in British Columbia, and we have to find some way of getting a balance in the information that goes out to the public in this province, why doesn't the Minister of Health take this job on? Make that doctor in the United States put his money up. Get it in an air-tight contract. Then use Kelowna and Prince George as examples of proof positive …

AN HON. MEMBER: And Fort St. John.

MR. McGEER: And Fort St. John, yes. Any of the communities — not one single solitary speck of evidence of the slightest harm of any kind. Use that kind of evidence to convince the people of British Columbia to do what they should for the teeth of our coming generation.

[ Page 1309 ]

AN HON. MEMBER: I was told it was a communist plot.

HON. MR. COCKE: Ms. Chairman, I'm surprised at the people wearing the blue today and normally with a red flower in their lapel. Twice now they've spoken on the wrong vote and they're so well informed. Unfortunately, that Member came in a little late, so I thought I would not challenge his speaking on this.

I say to that Member, however, who is so very interested in research, why doesn't the university take up the challenge? You're the people who have the knowledge and the wherewithal. You take up the challenge with that man and win the $200,000 to better educate the people in British Columbia on the whole question. Now, getting back to the Member …

MR. McGEER: Ms. Chairperson, I'd like to ask the Minister what he would be prepared to put up in the way of research funds, because the university doesn't have the staff. He does. But if he will state the amount today, I'm sure that the Faculty of Dentistry would …

HON. MR. COCKE: Ms. Chairman, he missed that vote. I'll talk to you privately.

The Member for North Okanagan (Mrs. Jordan) was discussing the whole question of the education of the inspectors. The young people are having difficulty. It is under study at the present time. I do hope that we can work them in on the same kind of basis that we were discussing when we were discussing the question of health care people working on an on-the-job training type of thing. I think it's a good programme.

MS. CHAIRWOMAN: I recognize the Hon. Member for West Vancouver-Howe Sound.

MR. WILLIAMS: Thank you, Ms. Chairwoman. Would the Minister indicate the extent to which his staff in local health services works with the other departments in matters of the supply of water and in sewage and septic tank treatment in the outlying areas? I will pose to the Minister two specific problems in each of these areas.

In my constituency, in the Village of Pemberton, the water system is many, many, many years old. It is falling apart. In order to have this replaced, a plebiscite has been taken. But the amount of money which is available is less than the total cost. This is something which has to be worked out with the water rights people, I appreciate, but it has the potential of a very serious local health problem.

The system in that village — and I'm speaking only of the village for the moment — is so old that the only way they can find out where some of the water mains are is when they spring a leak. Then they suddenly find water where they never had any reason to believe that there was a water line there. That's just how bad the system is.

In the surrounding improvement district they have the same problem. This past November, when there was a serious freeze before any snow fell, the water mains from the water source froze up. The whole of the Pemberton North Improvement District was without water for a period of two weeks. Many, many thousands of dollars were expended on an emergency basis in trying to provide water for the Pemberton North Improvement District.

The startling thing is that the schools are served by the Pemberton North Improvement District water service. There was a period of time, for two weeks, when the schools were without water. The toilets didn't flush; the urinals didn't function; no water.

This created a very serious situation. As a matter of fact, there are still some areas served by Pemberton North which today don't have water because there's still a fair amount of frost in the ground. It will be another three weeks before all of the lines thaw out. Those people who are without water today are being served by a tank truck, which brings it around and peddles it by the bucket. This is going back 40 or more years in the history of water supply.

I think that as a local health measure, while these problems don't all fall under the Minister's department, they must be of very great concern. I would therefore like to know what kind of coordination there is between the health department and the other departments responsible to ensure that in these old areas, which are expanding, there is proper concern about the delivery of safe, clean water.

The area served by Pemberton North is rapidly expanding. There are mobile home complexes being developed throughout that area. Some of them are without water today. The same problem exists with respect to their septic tanks. The serious question is raised in this particular area as to whether septic tanks really function.

The local health officer, who has the responsibility of approving these, covers a tremendous area — all the Pemberton Valley, all the way down to Squamish and over onto the Sunshine Coast. It's a tremendous job for him. It's an area so large that he can scarcely cover it in a week's travel.

In another part of the constituency…and this isn't a water problem. I'm speaking of the great expansion that has taken place in the Whistler Mountain area — Alta Lake. They've got a water system, and that's fine. That's an area where, geologically, all the ground upon which homes can be built is rocky. There's no drainage field; yet septic tanks have been installed. Some very ingenious attempts have been made to solve the sewage disposal problem.

There has been condominium construction in

[ Page 1310 ]

which they have built their own systems for handling all of the sewage from all of the units in the group. But the question is: where does the effluent finally discharge?

It's becoming increasingly clear that the extensive development in that area is resulting in the discharge eventually finding its way into Alta Lake, Green Lake, Alpha Lake — the whole chain of lakes which are part of the Cheakamus River system. Once it gets into that area, then it flows down the Cheakamus River and through Daisy Lake to eventually come out at Squamish.

As I say, the responsibility really falls upon your one local health officer. It's a very serious one, and I would like to know what sort of relationship there is between the Minister's office and pollution control, which is authorizing the installation of these facilities.

The Minister of Lands, Forests and Water Resources (Hon. Mr. Williams) has one matter before him in this regard where it is proposed to perhaps construct a major hotel complex in that area. If this goes in without any sewage treatment facility, it can create a very serious situation. It could eventually result in the destruction of Alta Lake.

HON. MR. COCKE: Ms. Chairman, the Member is quite right. There are problems in this whole area.

Under 5,000 gallons, our department takes care of granting permits; over 5,000 gallons, that's the Pollution Control Board.

How much coordination or how much communication? None at all. I hate to say it, Mr. Chairman, but that's been the history ever since the breakaway of pollution control from health originally in 1967. I've seen correspondence going right back to before, after and all during.

Our department last year took 30,000 water samples and did 15,000 septic tank inspections. We're quite unhappy. I've had a number in our department come in to see me and say, "Out of 1,000 septic tanks in area 'x"' — and I can't name the areas; I don't want to at this point — "in a particular community, 60 per cent are not working right, 60 per cent are pushing effluent into the streams, the ditches and whatever happens to be handy." We've got a lot of work to do to catch up on that.

My colleague, the Minister of Municipal Affairs (Hon. Mr. Lorimer), is in charge of the water systems in the province as far as granting permits for water systems. We check them. It's up to us to sample them and we do sample continually, as we have in Pemberton. But it's up to his department to grant licences.

You recall that he had a problem over integrating Kelowna with some of the outlying areas. One of the real prime reasons for that was the fact that one area outside of Kelowna had such a bad septic tank situation — and they get their water from the ground only 100 feet down — that we're desperately worried about it and had to, some way or another, get them into the whole community system as far as sewage and disposal and that sort of thing is concerned. We were leaning on him a long, long time before he made that decision; the health department brought it to my attention very early. We're really concerned.

Now as you know, the water as yet is not infected. But it certainly would become that way in the not-too-distant future. We've got a lot of work to do in this province.

MS. CHAIRWOMAN: The Hon. Member for Omineca.

MR. D.T. KELLY (Omineca): I don't really know, Ms. Chairwoman, whether I'm under the right section or not. I am very concerned about a situation that exists in my riding and that is the trouble we have getting doctors to come into our area and stay there.

Right now in my own community we have a doctor who is there on a one or two days a week basis. It's very marginal. One week they might be there three days and the next week they might come one day. Although we have had a permanent resident doctor in the past, it seems that if the income isn't sufficient it's only quite natural that the doctor will eventually leave because he can better himself somewhere else.

For example, if he's young and has just graduated, he wouldn't want to spend too much time in the boondocks, since he might lose out on updating his training and what have you.

I have two communities actually that are in excess of 1,000 people that have no doctor whatsoever. Now they're only 30 or 40 miles from the nearest doctor. But when you take an area such as my riding and most of the central and northern ridings of the province, 30 or 40 miles of icy roads and that type of communication — in some instances telephones are few and far between — it can be like 100 or 1,000 miles.

In my particular town we have a doctor negotiating at the present time. But he's negotiating with a company. I think this is absolutely wrong. I think the people of this community should have this service without having to negotiate with any company or anybody else. That doctor should be made available and, if necessary, I believe the government should give a bonus or at least a subsidy to the doctor to live in that community and to help serve those people.

Up until now we have been on a hit-and-miss basis for almost five months in my particular community with 1,200 people. I'm sure that would keep a doctor busy. In fact, when the out of town doctors come in, they have to accept at least 50 patients in an afternoon. I don't believe a doctor can do 50 patients justice in one afternoon. This is the kind of thing that's going on.

[ Page 1311 ]

I would like the Minister to tell me whether we might expect some help in this matter, Thank you very much.

HON. MR. COCKE: You're quite right, Mr. Member. It's not the right vote, but certainly it's the right problem. There is no vote for that really, other than my own vote.

At the present time — and I've made this announcement time and time again — we are asking doctors. We can't tell them; we can't put them in irons and say, "You must go to a certain area." But we are asking doctors, urging doctors to go to the north, to go to the isolated areas, and to come and see us because we'll make a deal. Not mining companies or other companies — we'll make a deal with people. We've done it before; we'll do it again. Ms. Chairman, I just urge doctors who want to get into the isolated areas to come and have a talk with our department.

Vote 98 approved.

Vote 99: division of laboratories, $1,066,186 — approved.

Vote 100: division of vital statistics, $744,780 -approved.

On vote 101: division of venereal disease control, $260,670.

MS. CHAIRWOMAN: I recognize the Hon. Member for Oak Bay.

MR. WALLACE: Madam Chairman, I'd just like to comment on this. There seems to be little doubt that the incidence of venereal disease has increased. We are faced with an increasing problem of drug resistance to the treatment of some forms of venereal disease. This increase in the budget from $243,000 to $260,000 seems to me to be a rather small increase to deal with what is a substantially increased problem over the last few years.

I don't think we need to go into the many social factors that contribute to this with the lifestyle of many people today compared to a few years ago. But any statistics I have read from publications of vital statistics or in the Press seem to leave little doubt that venereal disease is on the increase.

I wonder two things: whether the Minister would care to give the House some indication of the statistical increase at least in the number of cases treated; and secondly, whether he would consider embarking on a more vigorous programme of public education to alert the public to the fact that what was once a disease which seemed to be almost wiped out when penicillin first came along and other reasons too — social improvement and the general health of the community and preventive methods and so on.

I know this all went through a phase when venereal disease greatly decreased. But now it is on the increase and, as I say, our lifestyles somewhat contribute to an increase; yet the amount of money being allocated is not very much more than the previous year. Would the Minister care to comment?

HON. MR. COCKE: Ms. Chairwoman, I keep looking over there and missing my place. We have a high rate of gonorrhoea at the moment. There were 8,000 cases in the province reported last year. We suspect that there are a great number more than that. We suspect that there are a lot more than that, by virtue of the fact that a lot of people's anonymity is being protected by their own physician and so on.

But in any event we are cooperating on an educational programme. As a matter of fact, the Minister of Education (Hon. Mrs. Dailly) is very seriously looking toward using the film "V.D. Blues" as a possible educational device in the schools. You probably saw it on television the other day. It apparently was an excellent piece of work. So she's considering that.

As far as we're concerned, we're working effectively in our department I think. I think we're holding the incidence down under the circumstances. We've used hippie nurses — you know, like some of our PHNs, that have circulated in the community and provided real good education, telling these kids where to go to get care and help and so on. We're doing our best and we'll certainly try everything we can to keep the incidence down.

MS. CHAIRWOMAN: The Hon. Member for West Vancouver-Howe Sound.

MR. WILLIAMS: Ms. Chairwoman, using these nurses is a great idea. But, Mr. Minister, I note that the number of public health nurses in this division has decreased by one; and you only have one director who has medical specialist qualification. You have a medical specialist part time. You now have a research officer that was there before and these three nurses — three public health nurses. The staff nurses, I assume, are involved in the direct treatment of patients within your own division.

For rural treatment and consultative service, there's an expenditure of $6,800. It seems to be that this is a growing problem…and the Minister didn't answer the question from the Member for Oak Bay (Mr. Wallace) who asked what is the incidence of increase in venereal disease as reported, it is known that there are many who are hiding the disease. What is the incidence of increase over the past 12 months.

[ Page 1312 ]

All the indications are, from what one would read, is there's a growing concern among all of the public health agencies, certainly in North America, about the rising incidence of venereal disease, which once we thought was under control.

I think that one of the difficulties is that during the war there was so much attention paid to this problem, and then along came the so-called miracle drugs. I rather suspect in our communities that people believe that it's all O.K., but we know that it is not.

It's a very serious problem for our young people, particularly with increased mobility. They're moving about this country east and west, north and south. The opportunity for contagion is being expanded tremendously. I just think that the size of the staff that's available here is likely to be inadequate.

I do notice that there is one item under the expenditures, Mr. Minister; Medical services, $20,000. Does this indicate that you purchase services from other practising physicians?

HON. MR. COCKE: Yes, well I can just say this, that the rate in 1941 — 46 per 100,000 — was 460. That went down successively, down to a low of about 208 per 100,000 in 1968. It's gone back up to 366 per 100,000 at the present time. We're not viewing this lightly. As a matter of fact, the direct work that's done in this area is done by the local health services, not out of this vote particularly. The PHNs, the doctors and so on and so forth are doing the direct work.

We've also been cooperating on a couple of LIP grants that have been going to put people into the community on a VD education situation. So, we don't like the increase, and we're not going to live with it any more than anybody else. We know some of it is getting pretty dangerous. I'd like to put on the record too, as a fact, that some of the strains that are coming back from Mexico and from Vietnam are pretty weird strains, and they're pretty tough to control by normal means. Just penicillin won't handle them any more.

MS. CHAIRWOMAN: Shall vote 101 pass?

Vote 101 approved.

Vote 102; Administration and Out-Patient Care, $1,047,047 — approved.

On vote 104: British Columbia Overall Medical Services Plan, $90 million.

MS. CHAIRWOMAN: The Hon. Member for Oak Bay.

MR. WALLACE: Madam Chairwoman, we're on vote 104?

MS. CHAIRWOMAN: Yes.

MR. WALLACE: I'm a little staggered to think that for a second there a vote involving $90 million of medical services was going to be passed by this House without some comment. I had previously meant to stay out of this debate for obvious reasons. I'm a doctor myself. Doctors are not always looked upon by society as being totally objective when it comes to talking about their own services to the community.

But seriously, Madam Chairwoman, this is a very vital subject and I will try to be objective and I don't plan to make a long speech. The fact is that this whole programme of the manner in which health services are to be provided to the citizens of British Columbia is under review by Dr. Foulkes' committee.

Many Members of the House have commented on this and I approve of the attempt to integrate and coordinate the services that are available, and to find better methods of giving better health care to the people in British Columbia; and that's what it's all about.

I would like to recall that the Minister of Health, in his budget speech, commented on the Hastings Report, which was a study of an alternative method of providing doctors and paramedical services to the citizens.

The Minister, I thought, made a very wise statement when he said that the concept of providing health care to the individual patient through a community health clinic might be a wise alternative, but that no doctor would be compelled to function under that particular method of health care delivery if this was not his choice. I think the important thing in health care delivery at the present time is to have two or three alternatives and, if at all possible, to have these methods run in parallel courses so that they can objectively and economically and wisely be evaluated one against or beside the other.

I think it should be put on the record — and I'm not speaking for the medical profession, I'm quoting what the B.C. Medical Association has said — that it is certainly not opposed to the concept of community health clinics; but it sees this as a possible vehicle to provide services such as we've heard tonight in Omineca, that may not be being delivered at the present time.

On the other hand, Madam Chairwoman, I'd like to just make the comment that the machinery by which health services are delivered, important as it is, is not as important as the quality of care which is delivered. We have to equate these two goals. We want the best care for the patient, and yet we want the most economical dollarwise method of delivering that care.

I would like to hear some comment from the

[ Page 1313 ]

Minister on his particular feeling about community health clinics; because if we take an area like Victoria, with which I'm most familiar, it just would seem to me ridiculous to go ahead and start building community clinics when we have all the services already available, but don't have a well-integrated, organized method of providing them to the patient.

I feel that the people of this province are listening and reading very carefully about the project that Dr. Foulkes is undertaking. And I think, in many areas such as the ones we've heard mentioned today, they are wondering if this particular new method is some panacea for the problems of the past.

But whether you build a clinic, or whether you have the present service through private physicians, the fact is that we have to face, Madam Chairwoman, that a doctor on his own, whether he works privately or whether he works through a community clinic, living in a rather isolated area, with no medical personnel to give anaesthetics, or other medical personnel with whom he can consult, or destined to be on call 24 hours a day, 7 days a week — I think it should be put on record that just changing the machinery by which services are provided is not likely to answer his problem.

Unless, of course, the Minister considers that there would be some very definite incentive in various terms. We needn't go into the details, but these could be paid holiday or paid sabbatical leave, special opportunities for the doctor to upgrade his training and go to post-graduate courses, some guarantee of replacement so that he can go on holiday, and so on.

I think it would be remiss if this point were not made quite clear: it isn't just a matter of setting up another method of delivering the service. In the remote areas, a great deal more is involved.

I think, frankly, from the number of times that I've discussed this with other doctors, it's also a question of the doctor's wife. The doctor may be quite willing to go and spend two years — I spent four years in the north country in Ontario - but the fact is that you have your wife and family to consider also. If your wife and family have interests in music or culture or some of these other areas beyond medicine, they're not available in the more remote areas. I think we're just kidding ourselves if we take refuge in some such phrase as "community clinic" as being the solution to the problems of these areas which don't have enough medical care.

In terms of the Medicare plan itself, I'd like to say, Madam Chairman, that with the exception of these areas that we've just discussed, on the whole the Medicare plan is working extremely well, all things considered. It's not perfect, but I would like to say this: both in terms of government administration of the plan and professional freedom in the plan — I'm sure neither side feels they have all they would want — certainly compared to other systems that I have practised under, by and large I would say that in British Columbia the citizen is getting as good and as efficient and as available treatment as he would receive anywhere, either in British Columbia or certainly in Ontario, where I've practised, and above all in the much vaunted British system of the National Health Service.

Too often I feel a little disappointed that the Government perhaps — I seem to be on a promotional kick this afternoon. I'm asking you to talk about venereal disease publicly. But I think we tend to be too negative, Mr. Minister, through you Madam Chairman. Some of the positive, very productive and well worthwhile aspects of Medicare are not really mentioned, when in point of fact there's always lots of time to complain and there's quite a bit of coverage in the media of those deficiencies. I am perhaps as guilty as anyone, by telling the Minister the other day all the different things not covered by Medicare which should be covered.

But that is meant to be placed in context. When we talk about children with cleft palates or people with the oxygen need and so on, they are still a minority. I think that if we look at the total picture, British Columbia has a plan of which it can be proud. I would feel that the spirit of cooperation and the listening ear which the Minister has shown in his early months of office, hold hopes that we can establish a wide, more effective, and more economic Medicare programme in the future.

MS. CHAIRWOMAN: The Hon. Premier.

HON. D. BARRETT (Premier): I'd just like to make a couple of comments on this vote. I note that the Member did pass the comment that it went through. I'm an MLA as well and I have a couple of comments that I'd like to make. I rarely have a chance to do this.

The $90 million vote did go by before debate started on it. Yet 10 years ago in this country there was a major strike by doctors against the first Medicare programme. It was a time of great emotion and great concern. There were great debates raised about the loss of freedom and the whole range of attacks on "communist" governments, "fascist" governments.

It's interesting to note that we're very happy with the fact that we have Medicare in this country. We're very happy with the fact that all political parties now approve of our Medicare system. I'm sorry that it had to be born in such travail, but it's here and let's do everything we all can to improve it.

MS. CHAIRWOMAN: The Hon. Member for North Okanagan.

MRS. JORDAN: Thank you, Madam Chairman. I

[ Page 1314 ]

hadn't intended to speak under this vote at the moment, because I think the Minister is trying very hard to meet some of the very serious problems that there are in medicine today, and he's trying to establish a good relationship with various peoples. We want to give him fair time.

But when the Premier of this province stands up and uses a $90 million health vote to perpetrate a political myth in British Columbia, I object and this party objects. Medical care came into Canada in the Province of Saskatchewan amid strikes because it was the same type of steel-heeled socialist government control there that that Government is trying to bring into British Columbia today under another Act.

HON. MR. BARRETT: Vote against it, then.

MRS. JORDAN: The reason they had the problem was the same reason that that Premier had to get up in this House today under a health vote that is being realistically and calmly debated, and make a political twist out of it. He's trying to capitalize on the health care of the people of this province, so that he can perpetrate more of his extreme socialist, almost marxist, programmes in British Columbia. We won't have it.

Medical care came into British Columbia with a cooperative programme between government and the doctors. The doctors' families in British Columbia put up much money through their association to send a cross-section of doctors to travel around the world in company with some specialists who were put up by the government of British Columbia of that day, the Social Credit government. Some of them were civil servants. They travelled around and they studied many, many, many medical programmes in the world. They came back and jointly — jointly, Madam Chairman — made a recommendation to their respective medical society and the doctors in this province and to the Government of British Columbia.

They jointly brought in a medical programme to British Columbia that gave people, as the Hon. Member for Oak Bay (Mr. Wallace) just said a few minutes ago, the highest standard of medical care for everybody, perhaps in the world. That programme, Madam Chairman, did not cost one single private agency in this province their livelihood or their capital investment. It did not put one single medical health insurance programme under a private agency out of business in British Columbia. It was a voluntary programme, Madam Chairman — a voluntary programme.

That is the way to bring programmes into a province. It has been successful and it will be successful in the future, providing that it works on that basis. It was made a compulsory programme, even though, I believe, 98 per cent of the people of British Columbia were covered voluntarily, without loss to any individual enterpriser. It was made compulsory by the federal government a few years ago when they brought in the national medical care programme.

I point this out, Madam Chairman, because if the Premier of this province and the Minister of Finance wants to play hash-haberdash politics with the health of the people of this province, then someone's got to answer him. We say to that Premier and that Minister of Finance that if he would handle the legislation in the Province of British Columbia on a fair basis, with compensation to individuals who are hurt by that legislation, on a cooperative basis with the industries involved, then we wouldn't have people rioting outside this Legislature tomorrow,

AN HON. MEMBER: We're going to have a riot?

MRS. JORDAN: Demonstrating. I withdraw the statement "rioting." Mr. Chairman, the Hon. Minister of Highways (Hon. Mr. Strachan) knows all about riots because he's been involved in instigating them. The people here tomorrow are concerned about their individual rights, their rights to compensation. . . .

MR. CHAIRMAN: Order, please. Would the Hon. Member proceed with her comments relevant to the estimates. I recognize the Hon. Minister of Health Services.

HON. MR. COCKE: Mr. Chairman, I think we should all keep our cool at a time like this. I just don't see any reason for this irrelevant attack on the Premier of the province.

,Mr. Chairman, I think I would like to discuss a little bit of the history of Medicare, just for moment, in B.C. I understand that no private agencies went down the tube. Let me tell you a few: Fidelity, Fraser Valley, every life insurance company that had a medical plan. She forgot that I used to be in the business. I was there when it occurred. And there were tears flowing down Granville Street and Howe Street such as you never saw. That good old free enterprise Social Credit government — don't give us that!

AN HON. MEMBER: No compensation?

HON. MR. COCKE: Oh, yes. The compensation was nil. Zilch. Nil. Nothing. The reason this province went into Medicare was because it was fought for by the NDP across this country. Yes! The same with hospital insurance.

Interjections by some Hon. Members.

HON. MR. COCKE: No rubbish about it. And everyone across the floor knows it. Those that are

[ Page 1315 ]

honest won't be making those kind of remarks in this House.

Mr. Chairman, I'd just like to answer one or two questions that the Member for Oak Bay (Mr. Wallace) asked about the Hastings report.

I agree with you on the community health centre concept. It is not necessarily the concept that will be best utilized in the very isolated areas. I really feel that in those areas it's going to have to be in some degree in cooperation with health services. We could call these mini-health centres, but I don't really think that that's what we want.

On the urban areas, Mr. Member, I agree with you. We want freedom in this thing. We want to have the doctors operating in the area in which they feel most comfortable. But I say this, and I say it very loud and clear: those doctors and those members of the community — consumers, patients, call them what you — who wish to participate in this particular kind of alternative method should be allowed to participate. As a matter of fact I have announced clearly that they will not only be allowed to but will be encouraged in every way we can, because we need some alternatives at this time.

MR. CHAIRMAN: I recognize the Hon. Member for West Vancouver-Howe Sound.

MR. WILLIAMS: Thank you, Mr. Chairman.

I am sure the Hon. Minister of Health Services and Hospital Insurance is pleased to have this vote in his department now rather than that of the Provincial Secretary (Hon. Mr. Hall), where it was before. Under the previous estimates the Provincial Secretary did have this in his responsibility, and we had some breakdowns.

I wonder if the Minister could tell us: out of the $90 million proposed to be expended, how much will be received from the Government of Canada under the Medical Care Act, how much will be received from the premiums of citizens who belong to the plan, and how much will be contributed out of general revenue from the province?

Dealing with the $90 million expenditure, once the government gets all the money — the previous administration saw fit over the past number of years to publish the information as to the amounts paid to doctors or groups of doctors. This has, understandably, caused a great deal of concern amongst doctors, but also understandably a great deal of concern among the citizens of British Columbia.

The Hon. Member for Oak Bay (Mr. Wallace) said that we get a good standard of medical care in this province. I accept that assessment. Certainly I believe it is acceptable in the larger centres where extensive health care delivery facilities are available. I'm not quite so sure about the outlying areas.

It always seems to me, Mr. Chairman, that the question of how much the doctors are paid under the medical plan has too long been a debate between the department and the doctors. The doctors get all concerned about it, and that's understandable because it's their livelihood. The government gets concerned about it because they've got to provide the money.

The debate has never really clarified, for me, at any rate — and I don't think any other Members in this assembly have any better information — nor for any of the citizens of British Columbia as to whether or not, dollar for dollar of the expenditure of the $90 million, we are really getting the benefits of medical care that we should be.

I know that the Minister's department is considering new techniques for health care delivery. I would like to know whether, based upon those techniques that are under consideration, the citizen can expect to see the number of dollars provided under this plan decrease, either on a per-unit-of-care basis or otherwise. Will the medical profession still see and continue to enjoy an acceptable revenue so far as the practitioner is concerned?

I don't know what the answer is, because with the information that is available to Members and citizens it's impossible to tell whether or not doctors are overpaid. The information that the government has published from time to time would suggest that some doctors receive very large amounts of money from the plan. But no one knows how many patients they see; no one knows what the expenses of operating their practices might be.

I think that the time has come — in fact it's long past — when this situation should no longer continue to exist. I hope that if the Minister, as a result of the investigations that are going on, can indicate that there will be some stabilization of the cost so that it doesn't rise, it would be possible to have the matter placed before a committee of this House so that we could really get down and get some answers. So that when a citizen, a constituent, approaches me and says, "I see that Doctor So-and-so got so much money out of the medical plan. Isn't that an awful lot of money for what he does?" that we've got some answers that we can give.

I think we're entitled to have them. And I think the medical profession is entitled to have the clearest understanding, on the part of Members and of the citizens at large, of their point of view that they are not overpaid for the services that they perform. I think from everybody's point of view it would be helpful to have the air cleared, if that is possible.

If it's not possible and if we find that there are abuses of the medical plan, then I think that should be known too, because it affects the citizen and it also affects the medical fraternity. When one or more members of a profession seem to take unfair advantage of some of the opportunities that profession offers

[ Page 1316 ]

then the whole profession suffers.

I think it's time that we had the clear breeze, the bright sunshine upon this subject which too long has been dealt with murkily. I'm not criticizing anybody when I say that, but it's been shadowy as to how much money is being paid and as to whether we are getting the service for it.

HON. MR. COCKE: Mr. Chairman, I'll go back to the beginning. You asked how much of the $90 million is federal. It's about $70 million. We put up about $20 million for our share. However, the total vote doesn't indicate the total amount going into Medicare. Premiums make up the difference, up to $170 million. That's the total cost of Medicare in the province.

Interjection by an Hon. Member.

HON. MR. COCKE: Yes, another $80 million odd. As a matter of fact I told the Premier one time that I've got the biggest vote of all. I forgot that we didn't include the premium aspect of Medicare under our estimates, but it's there nonetheless.

The $433 million goes up to $515 million or $520 million, if you want to look at it that way. But he'd prefer not to look at it any way when it comes to spending those kinds of sums.

The decrease in this amount is very unlikely. Really, the community health centre or all of these alternative programmes are not aimed at reducing that particular vote. They're aimed at reducing the utilization of hospital and other health services. It's not very likely that this will be cut very much. As a matter of fact I would suggest that we'd like to see this sort of coast along without too many increases.

As far as hospitals are concerned, we can't expect any reduction there, but we want to reduce the percentage of increase that we've been enjoying for some time.

As far as the Blue Book and the whole question of putting the health care and doctors' practice before the House are concerned we could consider that.

MR. CHAIRMAN: I recognize the Hon. Member for Cariboo.

MR. A.V. FRASER (Cariboo): Mr. Chairman, through you to the Minister of Health, while we're dealing here with a plan that supplies, I hope, the majority of the money to the medical profession, I'd like to know if the Minister has any knowledge as to how much extra the doctors are charging over and above the fees in the B.C. Medical Plan. I am quite concerned about it.

I have a note here from a constituent saying that even the receptionist in this certain doctor's office told her that the B.C. Medical Plan paid two-thirds of the doctor's salary and the patient had to pay the other third.

HON. MR. COCKE: Mr. Chairman, we're discouraging it now. There is a right to charge over and above the plan if they meet certain criteria, which include: telling the patient first, announcing how much it is, and informing the commission that they're doing so. We're discouraging it.

If it becomes a wide practice, I'd consider alternatives. I don't look with favour on anybody charging beyond what the plan pays. Now we'll just see how things work out, but I think that there are going to be some adjustments in their fees and so on. We'll see how things work out. I don't look with favour at all on anybody charging over and above the plan.

MR. FRASER: Mr. Chairman, to the Minister, maybe he didn't understand my question: is there much of this going on now?

HON. MR. COCKE: Not a great deal, unless they're not meeting the third criterion. Normally we're told, and I know of some areas where it's happening, but it's not widely practised.

Vote 104 approved.

On vote 105: mental health services, general administration, $3,037,180.

MR. CHAIRMAN: I recognize the Hon. Member for North Okanagan.

MRS. JORDAN: Thank you, Mr. Chairman. Perhaps the Premier, in issuing the vote, would use the title of which service it is under in the future, please.

I would like to ask the Minister of Health one or two questions in keeping with the policy of decentralizing mental health services particularly for patients of a younger age and also those who have up until now been treated in the lower mainland in Riverview and in Woodlands. I fully support this programme that was started by the Social Credit government to bring these people back, hopefully to their own communities or certainly to their own regions.

In doing so, there are problems that have been created. One, of course, is not enough staff within the regions to cope with the developing of programmes for these people when they come back to the communities. It just isn't good enough to bring them out of Woodlands or bring them out of care homes down in the lower mainland and put them in boarding homes in the interior of the province with no activity programmes for them, no occupational programmes and no social programmes.

There are shelter workshops in many parts of the province. They are quite willing to become involved

[ Page 1317 ]

with these people or have them become involved with their programmes. I would think in many instances this is a desirable solution.

The problem of money arises. There was an effort made by the staff and various people to make a monthly grant to the sheltered workshop where these handicapped were attending — I think it was about $50 a month. I understand there were some problems in financing this and in trying to get some help from the federal government and also from the local government.

I would fully support a programme like this. There is just no way the sheltered workshops can carry this extra load and expand their facilities even with the one-third capital grant they get.

My first question to the Minister is: Have you been successful in establishing a monthly stipend to the sheltered workshops where these people are attending or are intending to attend? Also where there are not sheltered workshops, have you undertaken to provide through voluntary services, or to stimulate through voluntary services, or hopefully with trained personnel, some occupational activities and social programmes for these people if they are in boarding homes and there isn't a sheltered workshop that they go to?

Some of them really are just going to be able to respond to motivational programmes. There is no great merit in taking people into a boarding home in a small community and having them vegetate in the garden. They must be out and 99 per cent of them are quite capable of being out to local community activities, fairs.

The sheltered workshop for the North Okanagan which is Vernon took busloads of these students up to the Armstrong fair in Shuswap constituency. They had a whole day and they picnicked and they went around, saw the cattle and kibitzed with the local people including the local MLA. This is a very, very good thing.

These people, in most of these workshops, are attending movies on their own. A lot of them are even working part-time. They must still, even if they work, be kept in a sheltered climate because these people, when they go out, sometimes are very good workers. I know of one instance where a man in his late 30s was probably the best masonry helper you could get — a European told me he was. The people who were employing him wanted to give him more money and the shelter workshop intervened and said they couldn't. They didn't want this because they didn't want him under the pressure that an ordinary employee would be. In other words, he had to be free to be there or not be there as his health situation dictated.

This, I would think, is the danger if there is no professional help or at least, people who are experienced in working with mentally-handicapped people — I don't like that term; I wish I could think of a better one — in communities where it isn't organized. They are capable at times of really producing well or accepting responsibility. But they may not be the next time and should not be allowed to get under this type of undue pressure.

Do you have any intention of expanding the formula for teaching staff or supervisory staff in the sheltered workshops in British Columbia? As it stands, the last time I knew, it was $500 a month for the supervisor for a certain number of students and $300 a month for an assistant. My understanding from the people in these fields is that while the supervisors would certainly like more money, if you had to make a choice, they would like a large budget for assistants.

I take no pride in saying that I think these people who work in this area who are very empathetic, who are called upon to give a tremendous amount of themselves and do a marvelous job are grossly underpaid. I would hope that in time this would be one of the priorities.

I think it is important in doing this that you don't preclude in any way the voluntary help that there is in these centres. Whether it is a high school, a pre-school or an elementary school type of programme, there is no question that a volunteer who isn't under the pressure of employment can give a great deal of understanding and, I think, a great deal of wisdom.

It would be a shame to discourage community participation. In fact, I think you should follow along, although helping as much as you can, to stimulate the community to participate in these areas. It is only by the community, sadly to say, having some of their money in them that they learn themselves how to handle themselves in these situations. Most of the problems in a social situation where there is a mentally handicapped or a physically handicapped person and so-called normal people is that the handicapped people know how to handle the situation but the so-called normal person doesn't.

If you have people who have perhaps never even seen in their own lives handicapped situations, come in and work, whether it's helping in carpentry or driving or whatever it is, this is, in my view, the most effective form of public education that you can have. It is not a matter of reading a leaflet and then learning to adjust yourself. It is a matter of getting involved as a citizen and understanding that these people aren't afraid of you. Certainly they have a lot to give the average person.

I would also ask if there is any thought of expanding or undertaking some type of assistance for transportation to these sheltered workshops. When it was a small group — I think most of them ran around 30 to 50 students — volunteer drivers could cope. Again, I think they should have volunteer drivers. I

[ Page 1318 ]

hope that is your financier up there you are waving to so we I hope, that is your financier up there you are waving to so we are going to get some more money in this area.

While you should still encourage volunteer driving, if there are as many as 50, 75, or 100 people attending these workshops at various times of the week, there should be some provision to supplement an operational budget. I think you will find that most garages in a community or the garages will get together and donate a vehicle. Again I think this is an excellent policy providing the vehicle is safe. It gets the business community into the needs of the handicapped. If you could offer some type of operating assistance for transportation, I believe they would find this very helpful.

HON. MR. COCKE: Yes, Mr. Chairman, you are quite right. We wish to decentralize this whole question of delivering mental health care. One of the ways, of course, is the utilization of sheltered workshops. The Minister of Rehabilitation and Social Improvement (Hon. Mr. Levi) and whatever else he is Minister of — Minister of Welfare — takes care of the financing or the operating costs of sheltered workshops.

We have activity therapists out now and we expect to move them in a widening area across the province. Now the activity therapists, so far, are working around the lower mainland and in the Fraser Valley. We feel that is most important because, as the Hon. Member was pointing out, the last thing that we want to happen is that the new boarding homes or sheltered workshops become the new back wards comparable to the old back wards in the institutions. That could very easily happen. In some instances, I am afraid, it has happened to date.

We are building a halfway house in Burnaby for people getting out of Woodlands. All of these areas are very important areas and certainly we want to move in that direction. Naturally all of this work has to be done in very close liaison with the Department of Rehabilitation because that is very much their activity as well as ours.

As far as vehicles are concerned, I have already provided one.

lnterjection by an Hon. Member.

HON. MR. COCKE: No. Federal government refused to admit that mental illness is an illness. There has been no thought whatsoever in Ottawa of moving into this particular area as far as I can see.

MR. CHAIRMAN: I recognize the Hon. Member for Oak Bay.

MR. WALLACE: Mr. Chairman, I think this is an important part of the total concept in trying to help people with emotional problems. The Minister probably knows, but it should be made plain, that the acute facility in this community, the Eric Martin Institute, is constantly overcrowded with patients in the halls — sometimes 10 or 15 patients over and above the total capacity of the hospital.

It was a hospital which was not well-conceived in terms of its function, in treating the acutely ill person. As the demand becomes greater and as many of the problems of drug abuse and drug overdosage present themselves, the facilities of the Eric Martin Institute are often taxed beyond their safe limits.

It does relate to the subject just mentioned by the lady Member that many of the patients who have been in the Eric Martin Institute have recovered from the more acute phase of their emotional disturbance and could be discharged from the acute facility if some other less acute level of care were available. I know we touched on this when we talked on the Minister's vote. But it really is so important and so vital, in terms of getting the best treatment for the patient and the most suitable kind of environment for the patient, and in saving taxpayers' dollars. It serves both purposes. We must emphasize this intermediate — if that's the word; I know it's not covered by cost-sharing formula from Ottawa. But there again I'd simply say this — even if we go into providing half of the dollar costs which we would be providing anyway if there were a cost-sharing programme …

I've commented on a very successful domiciliary facility which was set up through the hard work of a lady who was a nurse trained in psychiatry and which for a variety of reasons she was unable to continue. I'd like to ask the Minister if there are any suggestions that we should get ahead very quickly with some such intermediate facility in Victoria. Because the population continues to grow, the acute facilities are taxed and many of the patients are simply retained in the Eric Martin Institute because this lesser level of care is available.

On another subject, so that I don't pop up and down, further on in vote 105, Mr. Chairman, there's an item for the operation of Glendale Hospital. We were talking earlier in the debate on the Minister's salary about the question of hospital boards and the fact that the Minister is convinced that administration and participation on the boards of hospitals should serve the patient through a strong identity with the local community. Yet I understand, and I may be corrected if I'm wrong, that all the members of the board of Glendale Hospital are civil servants. It would seem to me that this is a very narrow, restricted concept, particularly in light of the fact that he really feels that hospitals have to have a wide cross-section of the community represented in the board membership. I'd like to hear his comments on the particular setup on the board of Glendale Hospital.

[ Page 1319 ]

HON. MR. COCKE: Mr. Chairman, he's quite right. When I took office the board of Glendale was all civil servants. Note: I say "was" instead of "is," because we've changed all that. We've added two community people to that board and ultimately that board will become much more representative. That's our direction. I think that that's taking the type of responsibility that I indicated at the outset that I would take. So we're partly solving that problem.

But you wouldn't want us to just dump it on a bunch of untrained people and say, "Here, run a multi-million dollar hospital as best you can." You just don't do it that way. You do it according to a properly developed plan. O.K.?

Now as far as Mrs. Pask and her kind of boarding home are concerned, the Department of Rehabilitation and Social Improvement looks after that as well. However, we've been having discussions with Mrs. Pask in our department and do hope that we can find some way of using her particular special talent in the area for which she is best trained.

The Eric Martin Institute is a bit of a disaster. Right from the outset it was not really a place that lends itself to this kind of service. But there we are. We're stuck with a huge hospital and wonder what to do with it. We're stuck with a lot of things.

MR. CHAIRMAN: I recognize the Hon. First Member for Vancouver–Point Grey.

MR. McGEER: I would like to ask a quick question of the Minister. In the early part of vote 105 there are a number of administrative salaries here in Victoria. I'd like to ask the Minister of all those positions are filled at the present time.

HON. MR. COCKE: No.

MR. McGEER: Could the Minister tell us which ones are vacant?

HON. MR. COCKE: Would you like me to give it to you personally or do you want me to go down the list right now?

MR. McGEER: I'm just curious as to how many of them are vacant.

HON. MR. COCKE: Not many are vacant. That is as far as the administration — you're talking about administration here? Not Riverview?

MR. McGEER: Coordinator of adult psychiatry and child psychiatry and mental retardation — are all those posts filled?

HON. MR. COCKE: Yes, they're filled.

Vote 105 approved.

Vote 106: mental health services, division of nursing education, $709,318 — approved.

Vote 107: mental health services, community services, $3,126,204 — approved.

Vote 108: mental health services, in-patient care, $42,932,611 — approved.

On Vote 109: hospital insurance services, $272,046,454.

MR. CHAIRMAN: I recognize the Hon. First Member for Vancouver–Point Grey.

MR. McGEER: Mr. Chairman, I would like to ask the Minister if he's prepared to consider the concept of global budgeting for hospitals. The reason why I raise this subject, Mr. Chairman, is that the present system of budgeting for hospitals does not offer any incentive at all for efficiency and good management within the hospital. The incentives instead are to fill the beds and keep them 100 per cent occupied all the time, because that's the way you get the most money for operating your hospital system.

Quite clearly the hospitals should be able to get funds for efficient care of their patients, for prompt discharge from the hospital, for saving the moneys that are obtained in this fashion to buy more equipment, to provide novel services and to undertake all kinds of things that imaginative hospital boards would undertake if they were able to scrape together the funds to do so.

I'm an old free enterpriser myself, Mr. Chairman. I just like incentive systems wherever they can be developed. Maybe there's a little bit of that in the Minister of Health Services and Hospital Insurance. I realize the philosophy of the Government, but he was kind of a free enterpriser in his day before he got into this political game. Maybe there's that little spark left that would make him see that, given the correct approach on the part of the Government, we'd be able to bring out that same streak in the people that run the hospitals and they would be able to provide better health care at a lower cost.

I'm not recommending, Mr. Chairman, outright competition between hospitals. I don't think we want to run a rip-roaring, free enterprise hospital system. On the other hand, it is important to recognize when disincentives for good hospital care are built into the system. What I would submit, Mr. Chairman, is that we have those disincentives, and that they should be eliminated. The hospital trustees want global budgeting. Is the Minister prepared to go along with their recommendation?

HON. MR. COCKE: Mr. Chairman, in the first

[ Page 1320 ]

place, I do have a heavy load of guilt that I carry around. My past is up to me once a great free enterpriser and now a socialist.

AN HON. MEMBER: Shocking!

HON. MR. COCKE: Anyway, Mr. Chairman, if that scientist across the way — and I'm glad he's a scientist and not a bookkeeper, because if he were we would be ruined as a province - is describing global budgeting. Even great accountants don't know what they're talking about when they talk about global budgeting.

What are you going to do? Are you going to say to a hospital, "Here's X millions of dollars; now if you have too many patients you're out of luck, and if you have too few…. ."

This Government kept its promise and the hospitals were quite surprised. But we kept our promise to give them their first look at a budget early. That's already happened.

Mr. Chairman, we're about as close to global budgeting right now as you can get. Agreed, there are some aspects of financing hospitals that are disincentives. The system is a disincentive. As a matter of fact, there are many people who say that the payment of doctors is a disincentive to reduction of cost. We understand that and we'll try our best to build in incentives for lower utilization.

One of the biggest incentives that I know, so far, is homemakers. Get them out of the hospital as early as you possibly can. And also keep people out of the hospital as much as you can. Those are the kinds of incentives I think we should be building in.

If you ever want a course on global budgeting, come on down to BCHIS and we'll give you a first-hand course on it.

MR. CHAIRMAN: I recognize the Hon. First Member for Vancouver–Point Grey.

MR. McGEER: Just a supplementary point, Mr Chairman. I'm deeply injured that I should first of all be thought of as an accountant in any sense. I'm merely suggesting the kinds of measures that over the years have proved themselves to be effective.

There are many ways that one can develop incentive systems for hospitals. They're all the time wanting to reorient the way they treat patients in such a way as to increase the quality and decrease the cost. But if they're put in a financial straitjacket by formula budgeting, which is really the way we've gone about it, then they're limited in the amount of imagination that they can use.

The Minister has invited me to say how you do it. What you do is establish a formula, like they have been doing for universities, which is based on so much per day for whatever kind of bed it is. Then you leave it to the hospitals. If they can make advantages out of that initial commitment, they keep that and they use it to improve their services. You give them the opportunity to take that initial commitment and readjust it to bring in the new things that are really the hallmark of an alert hospital, and constantly improving patient care.

One more thing if I may, Mr. Chairman, before I sit down. I would like to ask the Minister once more if he will consider including the ambulance system in the BCHIS programme. This has been one of the disgraceful aspects of our hospital care system in B.C. Just yesterday the mayor of Vancouver was saying how he thought it was wrong …

Interjection by some Hon. Members.

MR. McGEER: I've got a sudden pain, Mr. Chairman. (Laughter).

AN HON. MEMBER: You need a doctor.

MR. McGEER: I'll be getting medical advice from my colleague to the left here. However, I'll attempt to regain my composure and struggle on here.

There is a strong case, really, in human terms that can be made for ambulance services operating out of hospitals, as well as sound medical reasons. To have a free enterprise system operating in this fashion, well even I can't see the advantages of it. I think that ambulances should be included under the umbrella of the BCHIS. They shouldn't be put on property taxes.

One complaint, for example, is that somebody dies of an unknown cause. An autopsy has to be performed and the poor relatives get stuck for the ambulance bill just to move the patient to a place where there's proper pathological services for an autopsy to be performed. That's how unjust it all is. To me, nothing could symbolize the new Minister's approach more than to make the announcement today of ambulance services being included under BCHIS.

HON. MR. COCKE: Mr. Chairman, I don't like to make accusations, but if I've ever heard a Waffle, radical socialist, there's one right over there on that side of the House. He wants ambulances under BCHIS.

AN HON. MEMBER: Oh!

HON. MR. COCKE: Shocking!

Mr. Chairman, we're studying that right now and that's the reason that we have something that I must keep mum about. Remember there's a bill on the order paper regarding ambulances. One of the first things we must do is set standards. We're going to do that.

MR. CHAIRMAN: Order.

HON. MR. COCKE: Order? Did you say "Order," Mr. Chairman? He's calling me to order!

[ Page 1321 ]

AN HON. MEMBER: It's the first time on that side of the House.

HON. MR. COCKE: Mr. Chairman, we're interested in ambulances under BCHIS as soon as it can happen but it can't happen until we have the service available.

As far as that global budgeting is concerned, we have the kind of budgeting that you're talking about. The problem was there wasn't enough money in the past. That was the problem. Remember the 70 per cent cut — which has been restored — and that type of thing?

Now they have the right to keep their surplus under our present budgeting system. One of the problems that we have with Ottawa — talking about the Liberals for a minute — is the fact that we don't have those kind of incentives on our cost-sharing situations with the federal government. We've been trying and trying and trying. Anyway, that's where it's at. I think that you'll find that the kind of budgeting we're doing in hospital insurance — sure, it needs some improvement here and there; everything in the world does; even some of the Members of this Legislature do — but it's on the right track and I'm sure it's going to provide for the kind of incentives that you want.

MR. CHAIRMAN: I recognize the Hon. Member for Oak Bay.

MR. WALLACE: Once again, Mr. Chairman, here we've got a sum of $272 million that we're discussing. I'm just a little disappointed that there isn't more participation from the Members in the House who must have contact with the hospital service by one means or another. It's a very large fraction of the Minister's department.

I would like to touch again on this whole question — I know we've talked it over many times but it is so central and so vital — of the abuse of acute beds. There's just no question that in the acute hospitals — I certainly can talk for Victoria with 1,000 acute beds — if the facilities were available, close to half of the patients in the acute hospitals could be somewhere else. The figure may vary from area to area, but in the metropolitan area of greater Victoria there are patients all the time who are in the acute hospital beds simply because the other level of facility doesn't exist.

I mentioned the Eric Martin Institute in the realm of acute mental illness. I am talking now about acute general illness. The Member for Vancouver-Point Grey (Mr. McGeer) was talking about incentives and I'd like to put forward the concept that any area that asks for more acute beds should first be asked if it is providing other levels of care. Because you could go on building acute beds until the cows come home and you would still find patients to put in them. There is no question about that in the mind of anybody who sees the hospital picture.

The fact is that it is the most expensive kind of facility to build. It's the most expensive place to operate. If many of these patients could be looked after in a simpler, cheaper facility, then I think that these should be the levels of care, or the wards of an expanding hospital that should be built first.

We have a good example at the Royal Jubilee Hospital where the previous psychiatric ward, when the Eric Martin Institute was built, was converted to a special facility — and this helps the Minister to get around the problem of cost-sharing with Ottawa. This ward, called the Bay Pavilion, was converted to be used as a sort of, in layman's language, convalescent ward. The patient in the second half of his or her illness is moved to the Bay Pavilion where there's a cafeteria. The patient goes and collects his or her own meals and is responsible for a measure of his or her own care.

The obvious consequence of this is that the acute hospital beds are used for acutely ill people. That's just exactly the way it should be. They're very expensive beds, per se, with automatic and hydraulic methods of raising and lowering the bed at the touch of a pedal and so on. The wards are expensive, with oxygen outlets and expensive lighting fixtures and so on, all of which is necessary in a good acute ward. But if the patients, half the time, are capable of getting up and walking around and feeding themselves and so on, then of course we're just pouring money down the drain to treat people who are not seriously ill in that type of facility for acutely ill patients.

This really frustrates me because, as I said earlier, we've had a royal commission that said this. We've had federal task forces which have said this. We've had provincial studies which have said this, and by golly, I'll bet you Dr. Foulkes puts that at the top of the list of the things that we are doing wrong in our delivery of health care. I predict that he couldn't do otherwise when we've got 30 or 40, maybe 50 per cent of the patients in the acute hospital who could be looked after elsewhere.

So if I sound very emphatic on this, I think it is because it is the one central area where we can provide adequate care and service to patients at lesser cost. We would be freeing up money which could be used for the more sophisticated elements of health care that we talked about the other day: cardiac surgery, transplants and the like.

So I'd wonder if the Minister could comment on whether he has any plans in considering applications by regional hospital boards for new facilities; as to whether he might consider saying to these regional boards, first of all, "Well now, tell me, what do you do with your convalescent patients? Do you took after them in the acute hospital?"

[ Page 1322 ]

Secondly, what about some of the…again to quote the Jubilee Hospital, which has built a tremendous programme of day care, and I haven't got the figures — but something like 30 or 40 per cent of all the surgery at the Jubilee is done on a day care basis. The patient goes to the hospital in the morning, has the operation, and home in the evening, This is perfectly adequate, if the surgery is properly assessed.

I'm not suggesting, obviously, that all operations can be done this way, but in the last few years there's been tremendous progress in realizing that many of these procedures can be done on a day care basis. If the Minister is planning more home care, maybe we could extend that programme still further if we could be guaranteed that a nurse would visit the patient at home for the first two or three days after the operation.

So there's day care service, there's convalescent care, and I think, although the subject is not in order, quickly, I might just say that I think inter-hospital transfer of patients by ambulance could become a very useful tool to expedite and simplify the total use of hospital services by getting the patient moved at the earliest moment. Coverage of ambulance service, even if only for inter-hospital transfer, would be a step in the right direction.

Finally, I have to raise just one matter, Mr. Chairman, an issue that the Minister and I have discussed, regarding the role of the hospital inspector. The Minister, I'm sure knows the case that I refer to, and I'm grateful that he sent me a copy of the latest correspondence on the issue. I don't propose to make a big issue of this particular case. I'd like to talk about a principle.

This is the case that I raised in the House a year ago of a lady who was a supervisor of a private hospital, and who had her authority or approval from the hospital inspector. Her approval to function as a superintendent was removed by the hospital inspector. Without going into the details, the lady concerned feels that she has been unfairly treated and that there's a stigma against her nursing reputation, This lady and her husband appealed to the former Minister of Health and has subsequently discussed the case with the present Minister of Health. The point that I'd like to try and make, Mr. Chairman, is that in a situation such as this, the person against whom the action is taken has no court of appeal.

The decision of the inspector of hospitals cannot be appealed except as in this case where they said, "Well, we'll meet with you, and we'll listen to your complaint." But I think that if we are fair at all and objective, when someone is penalized by employers or any other party, if there has to be some avenue of appeal you don't just go and appeal to the same people who took the original decision.

I don't think, for example, in the dispute in Campbell River regarding a certain school principal — he didn't go before the same people in his appeal as were the people who acted against him in the first place. I think that if we've got any sense of natural justice, and a person is having an action of this kind, it really is not adequate for the Minister of Health to say, well if you come in, we'll give you an informal hearing with no commitment.

When I raised this in the House last year, the then Minister of Health felt, and admitted in the House, that maybe we should develop a better form of appeal for people who lose their jobs or have their professional ability clouded, or any kind of stigma against their ability to carry on their professional duties as a nurse or a doctor or something.

I would wonder if the Minister has given consideration to this and whether he believes and agrees that some form of appeal mechanism should be built in to the role of the hospital inspector. Thank you.

HON. MR. COCKE: Well, Mr. Chairman, I'll go last first, type of thing. In that particular case, I don't really have a great deal to say, other than the fact that that particular person appealed to the court and lost that case. The job …

Interjection by an Hon. Member.

HON. MR. COCKE: Just a second though. Well, O.K. Anyway in the case of the chief hospital inspector in the province, who happens to be the Deputy Minister…and it wasn't this particular Deputy Minister that made that decision, it was the last one. But, as chief hospital inspector, he has a very, very big responsibility to the patients in a private hospital or any kind of a hospital. If he indicates that somebody has not the capacity to be supervisor or whatever, he's probably given it every consideration.

Now as far as developing an appeal procedure for this, it would be almost like developing an appeal procedure for a person who went for a job and then was denied the job. Well, yes, but this was a situation where the person just didn't meet the standards, according to that person. But certainly it is something that we can look at over the years. I don't see much promise about it, as I say. I feel that justice, under these circumstances, is likely to occur in our present situation.

Getting on to the operating costs. You know, it's all very well and good to say that we reduce operating costs. I think, Mr. Chairman, the Member should make it clear that by getting people out of the hospital doesn't reduce the hospital costs to that extent. I agree we're looking at all sorts of things: motel concepts, the intermediate care, convalescent care, rehabilitative care — you know at a lower level.

But the thing is, one of the things which makes hospital costs so high is intensive care, trauma, and a

[ Page 1323 ]

lot of things that push the per bed, per day cost up. Even if you cut the number of beds in half, you wouldn't cut the cost in half by any stretch of the imagination, It would be probably three-quarters or more, by virtue of some of these very, very intensely expensive aspects of hospital care today.

So we must remember that. We are looking and we are working. As a matter of fact, every pronouncement I've made…. . we're going ahead with extended care all over the province. Even in my own constituency, Mr. Member. Shocking, isn't it? About time too, I might add.

But anyway, those are the areas. We understand the abuse of beds. However, there's no alternative for the abuse because there just haven't been the alternatives provided to date. We're going to provide those alternatives and we'll cut down the cost per patient per day, hopefully. By the way, our cost per patient per day is only — Oh, I beg your pardon, our length of stay is 8.78. Our cost per patient-day in this province is still within bounds.

MR. CHAIRMAN: The Hon. Member for Oak Bay.

MR. WALLACE: To quickly follow up. I'm really disturbed at the Minister's comment that — and this is with no disrespect to this Deputy Minister or any other Deputy Minister — but he's suggesting I think, and correct me if I'm wrong, that the deputy minister might not make a mistake in judging the evidence presented to him as to whether a person is adequate for the job they're filling in a private hospital.

Mr. Chairman, with the utmost of respect, I think this is suggesting a tremendous degree of infallability and certainly is not the kind of system on which our society functions.

With respect, if we have to have such a definitive line of authority, let us say that a teacher should not be unjustly dismissed for incapacity to teach or inability, or what have you. I really just can't accept the Minister's explanation that in the role of ability and efficiency of nursing supervision the Deputy Minister of Health should not have anybody else to whom he's responsible other than his Minister for that kind of decision. Because in this case…and, after all, I know your decision in this particular case might be right.

I don't want to go into the elements of this particular case. I'm talking about the principle which seems to exist that a person working in the health field as an RN, and in a supervisory capacity, can have her job taken from her and her authority to continue to perform in her professional capacity removed; and she has no recourse other than to go back to the deputy minister who took the action in the first place. I'm just saying that surely there should be some neutral mechanism, some avenue — it need not be elaborate — of appeal whereby such a person can present her case and feel certain that the decision is not just being made by the person who took the original action.

MR. CHAIRMAN: I recognize the Hon. First Member for Vancouver–Point Grey.

MR. McGEER: Mr. Chairman, I'd like to take three or four minutes to fight for women's rights in hospital matters this afternoon. I'm not going to go into a discourse about how badly paid the female workers are in hospitals compared with their male counterparts because that's been canvassed. I think everybody knows that the hospital insurance service is guilty of great injustices in this regard.

I want to talk about …

HON. MR. COCKE: Hospital insurance service doesn't set salary rates.

MR. McGEER: No, but if the hospital insurance service wanted to be generous and bring about corrections it certainly could do so. I'm sure that hospitals and their workers would leap at the opportunities to see wages equalized. But I understand and I sympathize with the Minister's problem because it would be very expensive to do so.

I'm talking about something which would be far less expensive. It's a particular problem I bring to his attention. This involves the case of a student and his wife.

A few years ago this particular individual was working and his wife was a student. He became head of the family, he qualified for MSA (Medical Services Association) and the family qualified to become eligible for BCHIS at $1 a day. They were newly coming into the province but he got a job right away and so qualified.

Then they went back east to live for a while, returning to British Columbia this year. She had got her education so now she had the job and he was going back to school The wife has the job; she's raising the family.

But now it's very different. Whereas there was no trouble at all while he was working for the family to qualify for BCHIS at $1 a day, when she was working and he was the student it wasn't that way at all because the head of the family now had to be a student — not the women who was working and having to bring home the bread and look after the family. She was probably getting paid less anyway because she was working in a library — and this is another one of those occupations where there's discrimination in pay.

In this particular case it was the BCHIS that made the decision. As everyone knows. If you're going to apply in paying income tax, either husband or wife may qualify as head of a family. But it isn't that way

[ Page 1324 ]

with BCHIS.

There was even a sly suggestion made to this particular individual that his wife, who was working, couldn't qualify as head of the family for purposes of MSA and enjoy the benefits that went to all the employees of the firm for which she worked.

I would like to think that the Minister could see this point and that BCHIS would treat a working husband or a working wife in the same way; that either one, if they were working and bringing home the bread for the family, would qualify as head of the family and would be entitled to BCHIS benefits and none of this business of saying that the husband was head of the family when he was a student. It's clearly not the case. Could the Minister make changes in his regulations accordingly?

HON. MR. COCKE: Well, Mr. Chairman, now the Member for Vancouver–Point Grey has got the Minister of Education (Hon. Mrs. Dailly) mad at me. What more destructive things can he do this afternoon?

Yes, I know about that case. You and I were involved in the correspondence back and forth.

There is an inter-provincial agreement that this question will be handled in that way and that they pay premiums in their own province. It's crazy. Agreed. The Member's right. I hope that eventually we can maybe have some alternative.

The trouble is the present system is working well, and you bring in the exception. It's under these circumstances that it's just proved to be embarrassing. But generally speaking the present system is working well.

MR. CHAIRMAN: I recognize the Hon. Member for Nelson-Creston,

MR. NICOLSON: Mr. Chairman, I'd like to talk a few moments about per diem rates and the manner in which they affect other types of health care that are made available through hospitals.

The Kootenay Lake General Hospital over the past year reduced its average length of stay from 8.1 days to 7.4 days which I think is commendable as the average in the province as just stated by. the Minister is about 8.8 days.

One can only assume that part of the reason for this would be the out-patient programmes that are being offered in the hospital such as the home therapy programme which enables earlier leaving from the hospital because we know that there is a programme for home therapy. Another is the diabetic clinic. There's also an activities programme for in-patients and out-patients to encourage activations, stimulation and remedial development for both physical and mental health.

There's also an in-service training programme for the three hospitals in Nelson, Nakusp and Kaslo. One can only assume that the reduction in average length of stay is perhaps somehow related to this.

I understand that just last December some correspondence passed between the administrator of that hospital, who by the way is doing a fine job in that area.

In talking about per diem rates, I can only think about a recent Peter Sellers' satire that's playing here in Victoria which showed the direction in which one might go in order to beat the per diem rates, in this case the Blue Cross in the United States that this satire was focused on. One of the incidents they showed was wheeling a cadaver out of a room and then the hospital administrator coming along and saying, "Do you realize it's only 11:30? Put him back in the room. We know that our hospital day starts at 12:00 noon, and we have to get that extra day." And so on.

In this case the administrator is obviously doing a good job in Nelson in contrast to the Peter Sellers' parody.

I understand that just now the department is starting to recognize that these other programmes exist. I would wonder what directions the hospital insurance plan is taking to recognize these programmes so as to reward them. We know that the real expense of hospitalization comes in the first two, three or four days and after that it's sort of like a hotel and the costs go down. So that there should be some incentive.

I am wondering if there is an incentive for hospitals which are reducing their average length of stay and using out-patient programmes to follow up and to speed-up recovery.

HON. MR. COCKE: Mr. Chairman, I don't like to throw a little cold water on my colleague's back or on his head or wherever you throw cold water. But for the size of the hospital that you have, you're not really talking about a great reduction. The reason that the average in the province is so much larger — one day longer than yours — is the fact that the big referral hospitals have a much longer length of stay by virtue of the fact that they are a referral hospital. Therefore, the 8.78 compared to your 7. — whatever it was — that's probably partly the reason.

You were talking about your area. Let's remember that when we say that we want to go ahead and acknowledge and work with hospitals as to new and innovative ideas, we want those ideas tested on us first. We don't want to be dictatorial, but we are in a position where we are financing hospitals. If some administrator comes up with some grand and glorious idea that might cost hundreds of thousands of dollars and goes ahead and implements it without consulting us in the first place, then he might be stuck with it.

[ Page 1325 ]

Now, mind you, if they come in and say, "Look, this is the plan we propose. We figure we're going to save this, that and these reasons," and so on, yes, we'll go along with that kind of thing providing we can agree. But we don't say carte blanche to every hospital in B.C., "Go ahead and spend money and see what you can do with it." That's the thing. I want to make that amply clear.

We are looking for all of the rehabilitative programmes, et cetera, that we can find that are helpful in cost-cutting.

MR. NICOLSON: I realize this, that of course with the larger hospitals it would be an unfair comparison. But there is a downward trend from 8.1 to 7.4 in one year. This represents in that particular hospital a saving of over $90,000. Now the combined expense of these programmes in this submission would amount to $18,767. So you could look at a net saving perhaps to the hospital plan of $70,000.

I might also point out these programmes were started about two years ago at the behest of the administration at that time. They were encouraged but were never recognized financially.

Vote 109 approved.

ESTIMATES, DEPARTMENT OF HIGHWAYS

On vote 110: Minister's office, $64,592.

MR. CHAIRMAN: I recognize the Hon. Member for Cariboo.

MR. FRASER: Mr. Chairman, I have a few remarks to make to the Minister of Highways. First of all, we on this side, I think, are happy, all of us, to see you as the Minister of Highways. We realize, of course, that you are not too happy being the Minister of Highways.

HON. R.M. STRACHAN (Minister of Highways): I'm the happiest Minister of Highways you've ever had.

MR. FRASER: You wanted to be the Premier. You'll get there someday, Mr. Minister. We realize that you have a lot on your plate, with the insurance bills and so on — going into the insurance business. You are doing all right.

On behalf of this side, I would like to say that I think the staff in the Department of Highways, certainly the senior staff, are some of the best that we have in the civil service in Victoria. I hope they continue with the good work.

You haven't had the job very long, so there isn't a lot we can say that you have done wrong, Mr. Minister. Of course, you have made a few mistakes and we should remind you of what they are.

I think the worst mistake you made was the laying off of these employees — I don't know if I ever heard how many it amounted to, but I believe it was upwards of 500 in the province. I think you made a great mistake there. Some of those people had been working for a year-and-a-half or two years. Whether or not they were told when the department took them on that they were on a temporary basis, I really think they had some reason to believe that they were probably going to be on permanent after a year or so as employees of the department.

I don't know where that matter is now, but I could tell you that they certainly could be at work now, in your department. As an example, what is happening now in the Highways Department where you know where you are going to do work? Later on, when you can move dirt and so on, the men could be out clearing the right of way and so on, which has to be done. This isn't taking place, and I understand that it won't until the new fiscal year starts.

Of course, the next thing is fire season. If you never get the slashing and burning done, well, of course, you will never get any road work done. I think there is a serious error there. They should be slashing right away ahead of where they are going to work. They should be working on it now and there is lots of that to do. I'm referring to work throughout the whole Province of British Columbia.

I would like to go back again, Mr. Minister, and congratulate you on increasing the new equipment vote in this budget from $3.5 million to $4.5 million. I hope you keep on increasing that so that we can get this department's equipment more up to date.

I'm still not satisfied regarding the specifications when the Minister of Finance's vote was on the floor — I cannot understand why the forestry department are able to get better quality machines than the highways department. If I understood the Minister of Finance correctly, the facts are that each individual department draws their own specifications up and then the purchasing department actually issues the tender call.

Well, I again repeat, Mr. Minister, through you Mr. Chairman, that I would like the man that draws the specifications up for the highways department to go and have a meeting with the man who draws them up for the forestry department, because I'm absolutely sure that we are not getting our money's worth in the highways department and we certainly are in the forestry department.

They are buying a type of grader, for instance, that the forestry department wouldn't even buy and have their sheds. The highways department, in my opinion, should have a better type of machine than the forestry department which, under this system, have definitely got the best type of machine. I use a grader as an example, but it is applying in trucks, it's applying in cats and so on down the line.

[ Page 1326 ]

I think it is a question of a shortage of money. You are partly rectifying that but there is still something wrong there. I don't think, in the end result, that the taxpayers of this province are getting value out of the machinery bought for the highways department. In other words, the specifications aren't good enough to get a quality machine.

The other thing about it is that due to the age of a lot of the equipment that the department has, you have breakdowns and you have lost time. You have a lot of lost time in your machinery in the highways department. This must be costly to everyone. And of course the citizens usually don't see the grader or the snow plough when it should come, because of these things happening.

I would like to touch now a bit on property negotiations in your department. There has been a lot of work done in the highways department, certainly since I have been an MLA. I have never been really satisfied in the way the highways department finalized a negotiation with a property owner. I was wondering if the Minister would take a look and find out just how old the oldest settlement outstanding is, because I have reason to believe some of these have been outstanding for years. I don't know what the problem is. Again, without dealing with individuals, I think the citizen is entitled to better treatment than that. When the department has expropriated an individual's property a lot more speed should be applied to the closing of that deal than has been the case in the past.

I realize that the citizens in a lot of cases want more than the market and so on, but my observations are that this department probably needs more staff. I don't know what it is but it does cause a lot of concern for citizens when it drags on year after year after year. The settlement is finally made but no interest is paid, that I am aware of, regarding this. I think there is a lot of unfair things going on there that need a lot of improvement.

I want to just touch a minute on the chief planning officer. I think that is his title, but he was referred to here last year as the "zoning czar of British Columbia" and things haven't changed very much. To be specific, when the regional districts and the individuals apply, they don't get a reason for the rejection of the zoning.

MR. CHABOT: Just "no."

MR. FRASER: Yes, the answer, is just "no," without any detail. I think that regional boards, municipal councils if they're affected, and the individual citizen should be given a little more of a reason than that. I noted when you first spoke in this House — I believe it was in the throne speech, Mr. Minister, and I would like some comment from you on this — that while there is a lot of "no" answers in this department of yours, it sounded to me that there are going to more "no" answers than "yes" answers. In other words, you are going to strengthen that up further. In view of the short discussion we had on another bill here yesterday, I would like to know just what the highways department's feeling on that is?

AN HON. MEMBER: Oh what?

MR. FRASER: On the general approvals that are going on. You intimated when you spoke, as I understood it in the throne speech, Mr. Minister, that you are going to toughen up more than ever on zoning and planning and so on on approvals in this department.

I would like now to deal a bit with the overall budget. While the budget for the Department of Highways, Mr. Chairman, through you to the Minister is up $33 million, what I am concerned with is that $12 million of this increase, as I read it, goes to the ferry system. I am not going to talk about the ferry system a great deal because we have some people here who know more about that than I certainly do. They have an increase of $12 million in the vote of the department.

That leaves $21 million for all the rest of the Department of Highway's activities. I hardly feel this is enough.

As an example, breaking down the individual departments, the one that is very important is the capital construction section. If my arithmetic is right, the increase there isn't even quite 8 per cent. It concerns me that we can't at least keep up the level of work that has been going on for the last two or three years. I see real trouble ahead. As long as we have the weather, we just won't have the money on the capital side.

That doesn't apply in the maintenance side, I might say. It looks to me like maybe in the maintenance side there is definitely a higher increase than 8 per cent. There might not be too much trouble there along with giving the departments more and better equipment. I am concerned and I would like to hear how you think your department is going to make out with less than an 8 per cent capital increase in the budget of the Department of Highways.

The other thing I would like to bring up here today — and I don't want to be too long here — is that I'd like to know, Mr. Chairman, through you to the Minister, if the Department of Highways — I know they have traffic control divisions and so on — but do they ever consider getting modern when they're talking about speed limits? I've got a little personal problem that I'm not going to tell you about — well, I've got a few too many points.

Where a road is upgraded — and I'll deal with a road that I know the best, the road from Cache Creek north to Prince George has been greatly upgraded and

[ Page 1327 ]

reconstructed and now it's a fairly adequate road. Does the traffic department ever look at a road like that and say that it would be safe at 70 miles an hour? In other words, the only 70 mile an hour speed limit we have in the province that I'm aware of is on the freeway 401 — you haven't changed that number,

ave you, Mr. Minister? You just tore the signs all down. You didn't change the number.

My question is, Mr. Chairman: do they actually look at this? We have good vehicles these days. Is 70 miles an hour a safe speed limit? That's really what I'm saying. I'm saying it is on certain roads. I'm not advocating it on all highways by any means, like the Fraser Canyon or anything; but particularly where they have the road traps up for me.

But with all sincerity the only place we've every had a 70 mile an hour speed limit in this province in on the freeway. I wonder why. Why haven't we got the odd arterial that can be set up to 70 miles an hour? Or doesn't anybody even look at these things. I think it's worth a look at and I certainly would go along with any decisions that department officials make. It would be their job to determine which is an adequate road and a safe road. I'm sure that we have some of them in this province now, other than the freeway, where we could have 70 mile an hour speed limits.

All in all, Mr. Chairman, I'll just conclude on this note. I don't want to get too critical with the new Minister, because I don't think he's going to be the Minister of Highways very long. For that reason I gave him a few questions and will go on from there. Thank you.

HON. MR. STRACHAN: I think we just have time to get these few votes through before we adjourn in 15 or 20 minutes. To facilitate the going, I've written out all my answers before you've asked the questions: No. I is "yes;" No. 2 is "no;" No. 3 is "I'll take it under advisement;" No. 4 is "take "That is an exciting suggestion" No. 7, "If at all possible;" No. 8, "It is not possible;" No. 9, "I don't expect so;" and No. 10, "It is not possible:" No. 9, "1 don't expect so; and No. 10, "Go jump in the lake." (Laughter). So I'll just call out a number and you'll know what the answer is.

With regard to the points raised by the Member for Cariboo (Mr. Fraser), I agree with him. We have a good staff. We did lay off some employees. In some areas of the province you can keep them going the year-round and in others you can't. They were all advised. There will be some rehiring done after the beginning of the new fiscal year, the Member said with regard to the inadequate "new equipment" vote in past the Member said with regard to inadequate "new equipment" vote in past years, the highways equipment is older on the average than the forestry equipment. As you know the newer models are better in many ways. That's really the basic problem, that the highways equipment is much older.

Proper negotiations. I'll take a look at it.

He referred to the attitude of the department on zoning and approvals. I indicated earlier that I was going to be tougher. The answer is, "Yes, I'm going to be tougher than we have been in the past."

The first situation where I had to say "no" to an application for access, for instance, was right in my own constituency — an application that I had personally helped to have made out before I became the Minister …

SOME HON. MEMBERS: Oh, Oh!

HON. MR. STRACHAN:…and I sent it in to the department and the second day I was in office it landed back on my desk with the recommendation that it not be approved.

AN HON. MEMBER: You can sell the property.

HON. MR. STRACHAN: Oh, it wasn't for me. It was for someone in…oh, no! It wasn't for me.

I said to the deputy, "Well, if we're going to start being tough I'd better start in my own bailiwick."

So I said, "No, you can't have the access." We apply it impartially right across the province.

The budget is not enough, the Member says. I agree with him. As you know the Minister of Finance (Hon. Mr. Barrett) on budget day said that his was a job-creating budget. Of course we have the unemployment figures which indicated in the time since he brought down the budget the number of unemployed has been reduced from 90,000-odd to 40,000-odd.

The Minister of Finance also made a significant statement in his budget speech….

Interjections by some Hon. Members.

HON. MR. STRACHAN: I think it's down from 95 to 80 something.

Interjections by some Hon. Members.

HON. MR. STRACHAN: I said that.

AN HON. MEMBER: You said 90 to 40.

HON. MR. STRACHAN: Oh, no. 90 to 80-something. It's only six weeks since the budget came down. That's a pretty good improvement out of this job-creating budget.

The Minister of Finance also said that he had no intention of building up large surpluses just for the sake of building up large surpluses. He said that if the money was available it would be spent.

As you know, these estimates were prepared

[ Page 1328 ]

toward the end of last year. The indications are that under this Government the economy is improving so rapidly that there will be more money. I discussed it with the Minister of Finance and there will be additional moneys spent by the Department of Highways this year over and above what's in the estimates.

Interjection by an Hon. Member.

HON. MR. STRACHAN: I'm telling you now. "Robert the Roadrunner," or "Blacktop Bob," you can have your choice with me. (Laughter).

I'm telling you there will be additional moneys allocated to create jobs in the Province of British Columbia and to better serve the highways department.

Speed limit on two lanes. The only place where there is 70 mile speed limit is on the freeways. It's questionable whether on a two-lane highway you should increase the speed limit above 60.

AN HON. MEMBER: How about with paved shoulders?

HON. MR. STRACHAN: Well, the answer to that is No. 3.

MS. CHAIRWOMAN: The Hon. Member for Saanich and the Islands.

MR. H.A. CURTIS (Saanich and the Islands): Ms Chairperson,

MS. CHAIRWOMAN: Madam Chairman.

MR. CURTIS: Speaking to the vote before the committee at the moment, I would like to say that over a good number of years I feel that we at the local government level in this area have had the closest possible cooperation from the senior departmental people in highways. Unhappily that, until recently, was not the case with the Ministers.

It would appear, on the basis of just a short time in office, that that has changed too.

I would like to avoid, if at all possible, talking about highways in my particular constituency. I have taken a number of matters to the Minister in correspondence and in questions and they can be dealt with in that way without taking up the time of the committee.

In general I would urge the Minister to direct his attention, when he has the time — and I know it's a busy portfolio — and to direct his senior people to increase and continue the cooperation with other levels of government, particularly local and regional.

We had an outstanding example of that under the previous administration in the vicinity of Elk-Beaver Lake where the highways department and the Capital Regional District worked together, avoided the unnecessary construction of an access road and added something well over 60 acres to the very important Elk-Beaver Lake park.

From time to time I think we have the feeling that Highways has been interested only in highways and nothing beyond the edge of the blacktop. This was one of those instances where we were proven wrong and very happily so.

I am concerned about the so-called Island Highway, or the island portion of Highway No. 1, Trans Canada. It seems to me that, quite apart from the obviously necessary widening of this road, we have a steady deterioration in the appearance on both sides of the highway. The Malahat remains relatively attractive, but there are pockets of unsatisfactory and unattractive development further north.

Again, perhaps the Minister of Highways could show leadership in this regard, working with the Minister of Municipal Affairs and with the regional districts in insisting upon better screening of unattractive uses, the introduction of more planting of green after the blacktop has been put down, or as it has been put down. I think the Minister knows the highway better than anyone else in this House and I really don't need to go into much greater detail.

We used to speak here, and our parents used to speak of the great beauty of the Island Highway as you left the greater Victoria area and moved north. It in itself, including the Malahat was a tourist attraction.

I would suggest that we have lost some of that attractiveness over the approximate 140 miles to Courtenay. Not all of it is the responsibility of the provincial jurisdiction. Much of the blame can be laid at the feet of local government or regional government, due to their lack of activity or lack of concern. I would feel that the Minister and his department could show very real leadership in this regard.

On the Blanshard extension, which has plagued greater Victoria for so long and the blame for which can be laid squarely at the door of the previous administration, I am encouraged by the action shown thus far by the Minister in this regard. He is working in the closest possible fashion and has obviously requested his people to work in the closest possible fashion with the local governments concerned, particularly the Municipality of Saanich and, I would assume, the City of Victoria.

This is a good example, which, I hope, will be extended into other areas as a general policy of the Department of Highways.

MS. CHAIRWOMAN: The Hon. Minister of Highways.

HON. MR. STRACHAN: I will just answer those

[ Page 1329 ]

points raised by the Member for Saanich.

Interjections by an Hon. Members.

HON. MR. STRACHAN: They are answered? O.K. — next? (Laughter). No, we'll deal with it tomorrow.

Yes, I certainly do feel that the Department of Highways must cooperate with the various municipal and local bodies that are involved in any area in which we are working. The Island Highway, I agree with you, is in many areas an utter disgrace. This may require interfering with the privilege and rights of property owners by passing legislation to get it cleaned up. I agree, unattractive developments will have to be cleaned up.

MR. CURTIS: Screening will do a lot of it.

HON. MR. STRACHAN: There is a law without a grandfather clause which said any new ones had to be screened, but sometimes the fence is just as unsightly as the car cemetery it is supposed to hide. More planting would certainly do it.

The Blanshard extension: yes, we will certainly continue to cooperate with both Saanich and Victoria to get that settled and the route prepared and built just as rapidly as we possibly can.

MS. CHAIRWOMAN: The Hon. Member for Columbia River.

MR. CHABOT: Madam Chairman, I would like to ask a question of the Minister of Highways relative to the B.C. Ferries. I am wondering whether we are again seeing the hand of Mr. Dunsky in the ferry authority that we have seen relative to the B.C. Railway.

A passenger had a strange experience when travelling on the ferries between Vancouver Island and the mainland. He happened to see some form of advertising on the tables. It was a placemat, and it said, "We hope your trip is pleasant and enjoyable." Signed by David Barrett, Premier of British Columbia. Just prior to that it says, "These ships were built by the people of British Columbia." He was rather appalled, really, that this type of advertising would appear on the menus on the British Columbia Ferry Authority.

AN HON. MEMBER: Why?

MR. CHABOT: Why? I'll tell you why, if you will listen for a moment.

This passenger said: "The vessel I went to Nanaimo on was the Sechelt Queen, formerly the Chinook, built in Seattle. The one I came back on was the Langdale Queen, built in the U.S. and remodeled in Victoria. Then there is the Sunshine Coast Queen, acquired from Quebec, and so on."

Why tell so many lies?

The match folders on board were bought from a Regina, Saskatchewan firm and were made in Japan. NDP is really doing it for local industry. A few moments ago you were telling us how you were so pleased about the new unemployment figures, which are now 8.3 per cent instead of 9.9 per cent certainly that is a seasonal adjustment from January to February.

Interjection by an Hon. Member.

MR. CHABOT: I didn't say "a seasonally adjusted figure. " It is just seasonal adjustment, because Canada is a seasonal country as far as employment is concerned. There are ups and downs depending on atmospheric conditions and weather conditions.

I am wondering whether Mr. Dunsky is promoting this type of thing — telling the people these ships are built by the people of British Columbia when in fact they were built probably in the shipyards of the father-in-law of the Premier of the Province of Quebec and in the State of Washington. I am wondering if this is a policy that has been approved and suggested by the Minister of Highways.

HON. MR. STRACHAN: Well, first of all, it is true the Department of Highways has changed the firm that was doing the ferry advertising. We did change the advertising agency that handled the ferries' advertising.

I called for submissions from five — I think it was five — advertising agencies and the selection was left up to the ferry management. They recommended the outfit that had the advertising for this one — the same firm that was hired by the Social Credit Administration and worked for them for many years. They now have the contract for advertising for the ferries back again. I forget the name.

So Mr. Dunsky has nothing whatever to do with the advertising for the ferries. Oh, he did make a submission. He was one of the applicants, but he didn't get the advertising.

The placemats are obviously printed; I didn't say, "Put this on," or anything else. I haven't even noticed them as a matter of fact. The placemats are ordered to serve all of the ferries, including the ferries that were built in British Columbia. These ferries that were built in Quebec and so on were purchased by the previous administration, not by this administration. That's the answer to that.

Now, book matches and so on: under the previous administration — I haven't altered it — there is a tender called for all the supplies for the ferries by the purchasing commission, and the purchasing commission decides on the basis of the lowest tender as to who will supply what.

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Interjection by an Hon. Member.

HON. MR. STRACHAN: The purchasing commission does it. That is the way it is. The purchasing commission did this and that is why they are on the ferries, I guess.

HON. E.E. DAILLY (Minister of Education): Ms. Chairwoman, I move that the committee rise, report resolutions and ask leave to sit again.

Motion approved.

The House resumed; Mr. Speaker in the chair.

MS. CHAIRWOMAN: Mr. Speaker, the committee reports progress and asks leave to sit again.

Leave granted.

MR. SPEAKER: The Hon. Provincial Secretary.

Filing reports.

Hon. Mr. Barrett files the 34th annual report of the PUC for the calendar year ending December 31, 1972.

Hon. Mr. Barrett files answers to questions.

Hon. Mrs. Dailly moves adjournment of the House.

Motion approved.

The House adjourned at 5:50 p.m.