[ Page 1975 ]

CONTENTS

Routine proceedings

Oral questions

Swampers for transportation systems. Mr. Levi — 1976

Mincome payments to extended-care patients. Mr. Wallace — 1976

Free ferry travel for senior citizens. Mr. Gibson — 1977

Civil service secrecy oaths. Mr. King — 1977

Possible strike by ferry personnel. Mr. Wallace — 1978

Elevator inspections. Ms. Brown — 1978

Committee of Supply: Department of Health estimates

On vote 86.

Mr. Cocke — 1978

Hon. Mr. McClelland — 1981

Mr. Wallace — 1982

Hon. Mr. McClelland — 1986

Mr. King — 1987

Ms. Brown — 1988

Hon. Mr. McClelland — 1993

Mr. Cocke — 1995

Mr. Gibson — 1996

Hon. Mr. McClelland — 1999

Mr. Kahl — 2003

Mr. Levi — 2004

Hon. Mr. McClelland — 2006

Mr. King — 2007

Hon. Mr. McClelland — 2007

Privilege

Discussion of government policy prior to bill introduction. Mr. Speaker rules — 2008

Mr. Wallace — 2009

The House met at 2 p.m.

Prayers.

MR. SPEAKER: Hon. members, before we start into introductions this afternoon, I would like to draw to your attention the fact that an hon. member who served in the previous Legislature from 1972 to 1975 passed away very suddenly yesterday. I refer to the Hon. Roy Cummings, the member for Vancouver–Little Mountain. I am sure that all of the hon. members of this House would like the Speaker, on behalf of all of you, to express to his family appreciation for his service to this province and our prayers for his wife and family in their time of sorrow.

HON. W.R. BENNETT (Premier): Mr. Speaker, I might on behalf of the government extend the sympathies of all of us to the family of the late Roy Cummings.

I knew him as a friend, and he was a friend to all members on all sides of the House. I am sure that his good spirit and friendliness did a lot to help ease some of the debate when it got out of hand in the House. I will always remember Roy as someone who forgot his political arguments and was friendly with all of us. I would like to offer my sympathy on behalf of the government and my own personal sympathy to his family.

MR. W.S. KING (Leader of the Opposition): Mr. Speaker, I appreciate your good grace in raising the matter of Roy Cummings' passing.

Roy, of course, was a colleague of ours in the official opposition, having sat with us in our tenure as government. I know I speak for all of my colleagues when I offer our deepest sympathy to his family and comment that we did indeed appreciate his service to our party and to the province. He was a person of good will and, I think, made a tremendous contribution to our own caucus as well as to the public affairs of this province. We certainly join the rest of the House in noting his passing.

MR. G.F. GIBSON (North Vancouver-Capilano): Mr. Speaker, I would like to associate myself with your remarks and those of the Premier and the Leader of the Opposition. I had the opportunity not only to sit in the House with Roy but to serve on committees with him. He was a man always of a viewpoint of a very interesting nature, bringing a fresh approach to things. He will be missed in this province.

MR. G.S. WALLACE (Oak Bay): Mr. Speaker, I too would like to express my sympathies to Roy's family. He and I had a certain amount of banter back and forth across the floor of the House on many occasions, and one of his outstanding attributes in the House was his sense of humour which we all appreciated, as the Premier stated, often when otherwise the debate became acrimonious. I just want to say that I very much appreciated his friendship, and would like to pass on the good wishes of our party to his widow and family.

MR. C.M. SHELFORD (Skeena): Mr. Speaker, I would like to advise the House, if they don't already know, that a former member of the Legislature, Cecil Steele, who was the member for Omineca until 1952, passed away late last week.

MR. SPEAKER: Hon. Member, I wasn't aware of that, but I'll see that word goes out from the office of the Speaker on behalf of all of the members of the Legislature to his family. Thank you.

HON. R.H. McCLELLAND (Minister of Health): Mr. Speaker, I would like to draw to the attention of the House two visitors we have today in the gallery, Dr. Bill Jory, the new president of the British Columbia Medical Association; and accompanying Dr. Jory is Dr. Norman Rigby, the executive director of the Medical Association. Will you welcome them?

HON. E.M. WOLFE (Minister of Finance): Mr. Speaker, in the galleries is a group of students from Eric Hamber school in Vancouver with their teacher, Miss March. I would ask the House to welcome them here today.

MR. J.J. KEMPF (Omineca): We have with us in the gallery this afternoon some very special people from the constituency of Omineca, Dorothy and Steve Himech, my sister and brother-in-law and their sons Jim, Stanley and Harold, and with them my good wife, Shirley. I would ask the House to welcome them.

HON. J. DAVIS (Minister of Transport and Communications): Mr. Speaker, we have with us in the gallery today Mrs. Evans, the leader of a Girl Guide group from Lynn Valley, and seven girls who are preparing a report on the Legislature. I'd like members to welcome them.

MR. F.A. CALDER (Atlin): In the galleries today are Mr. John Smith of Prince George and his brother James from Winnipeg. Mr. John Smith was my campaign manager in the last election, one of the toughest ones in the business. I'd like the House to welcome them.

[ Page 1976 ]

MR. D.G. COCKE (New Westminster): Mr. Speaker, a note of international friendship — in the gallery today we have Mrs. Anna Ross from the State of Washington and two of her guests. I'd like the House to welcome them.

Oral questions

SWAMPERS FOR TRANSPORTATION SYSTEMS

MR. N. LEVI (Vancouver Burrard): To the Minister of Human Resources: prior to March 31, 1976, there were two transportation systems, one in New Westminster and one in Coquitlam, which we used for the transportation of the elderly. They had a combined budget of $180,000. On April 1 they were merged and the budget appropriated was $117,000, which led to the laying off of a number of people, including people known as swampers — the second person in a car who would be along to assist elderly people for medical appointments and other necessary trips.

In view of the tragic occurrence last Wednesday in New Westminster when an 81-year-old blind man, who was a passenger in the Western Society for Senior Citizens' transportation system, was delivered to a medical building for a medical appointment, and was not able to be escorted into the building and subsequently fell down an elevator shaft and was killed, my question to the minister is: is he prepared to reconsider granting to transportation systems where necessary sufficient money for the positions known as swampers to avoid such tragic occurrences in the future?

HON. W.N. VANDER ZALM (Minister of Human Resources): Mr. Speaker, I do not know the circumstances relating to the particular instance that the member refers to. I don't know if, in fact, there is a relation. However, I will certainly look into that aspect. I hadn't heard about the connection. However, I would like to advise the member that we have reviewed all of the community grant requests because of additional requests that had come in and also because of the ever-growing inflation factor. Certainly, our consideration has not been one of how many people involved or how large the system, but rather what best level of service we can provide with the resources available. On the basis of that we saw fit to recommend the merging of the two systems. I understand it has been reasonably successful. I will certainly investigate, however, the other aspect which the member has raised to see if there is a relation and what it is.

MINCOME PAYMENTS TO
EXTENDED-CARE PATIENTS

MR. WALLACE: Mr. Speaker, I would also like to ask the Minister of Human Resources a question with regard to the government decision announced on Thursday to charge extended-care patients $4 per day. In view of the fact that a letter of May last year was circulated to many of those patients telling them they would no longer be given Mincome, and in view of the latest government decision, could the minister assure the House that as of June 1 all extended-care patients who are entitled to Mincome will receive Mincome?

HON. MR. VANDER ZALM: Mr. Speaker, that is a policy decision. Certainly we will have a statement on that fairly soon.

MR. WALLACE: Mr. Speaker, we seem to be running into real problems. Is the minister telling us that although the $4 decision was taken and it is now May 25, the policy regarding Mincome due to come in on June 1 has not been made?

HON. MR. VANDER ZALM: I'm sorry, I missed the question there. Was that a statement?

MR. WALLACE: No, it was no statement; it was an honest question. I am asking the minister, in light of great concern by many extended-care patients who, starting last May, did not receive Mincome and who will now be paying as of June 1 $4 a day, whether or not they can be assured that as of June 1 they will receive Mincome if entitled to it in order to cope with the additional charge of $4 a day.

HON. MR. VANDER ZALM: Mr. Speaker, certainly the decision previously was that they could not receive both Mincome and the $1-a-day benefits of the extended facilities. There is a change now, of course. The $4 a day means a fourfold increase; in fact, it will be like $120 per month. The Mincome benefits — or the GAIN benefits — are considerably more than that. A formula will have to be devised so there isn't any estate-building and yet an equitable allowance for people in those facilities.

MR. WALLACE: A final supplementary, then, Mr. Speaker. Can I ask the minister if he can assure the patients in extended-care hospitals that at the very least they will receive the old-age pension plus the guaranteed income supplement regardless of what provincial funding may be added to these two allowances for which they qualify?

HON. MR. VANDER ZALM: Mr. Speaker, we have no jurisdiction whatsoever over the pension and the guaranteed income supplement. This is federal legislation.

MR. SPEAKER: That is correct, hon. minister.

[ Page 1977 ]

(Laughter.)

AN HON. MEMBER: He gets B+.

FREE FERRY TRAVEL FOR SENIORS

MR. GIBSON: Mr. Speaker, a question to the Minister of Transport and Communications. On May 3 of this year the minister announced without qualification that senior citizens would travel free on the ferries. Is it true, as inquiries of B.C. Ferries would seem to indicate, that the government has now gone back on that promise to senior citizens by making this benefit applicable only on weekdays?

HON. MR. DAVIS: Mr. Speaker, the benefit will only be available on weekdays. The detailed announcement of rate changes that must be made prior to June 1 will be forthcoming on Thursday of this week.

MR. GIBSON: On a supplementary, Mr. Speaker, I wonder if the minister could indicate to the House his calculations as to how much extra revenue will be coming from the senior citizens by going back on this promise.

MR. SPEAKER: Order! That is not a question.

MR. GIBSON: Mr. Speaker, it's a clear question!

MR. SPEAKER: A very argumentative question, if I might say so.

MR. GIBSON: No, sir, it is not. The original was seven days a week; now it is five days a week. I want to know how much extra revenue the government thinks it is getting out of that.

MR.- SPEAKER: The hon. minister has indicated his statement will be on Thursday, Hon. Member.

MR. GIBSON: Oh, really! He wants to answer, Mr. Speaker.

HON. MR. DAVIS: Mr. Speaker, I would like to make one point quite clear. Senior citizens have not previously been able to travel free on the ferries.

AN HON. MEMBER: Hear, hear!

CIVIL SERVICE SECRECY OATHS

MR. KING: Mr. Speaker, a question to the Provincial Secretary. The Provincial Secretary has finally answered questions admitting that it is her responsibility to see that the oath of secrecy is administered to civil servants.

MR. SPEAKER: Order, please, Hon. Member. Would you please state your question?

MR. KING: Well, Mr. Speaker, I'm just developing the circumstances of the question, which you allow most members to do.

MR. SPEAKER: Unfortunately, too many members have developed too many arguments when presenting questions. I think now we have to get to question period, please.

MR. KING: Mr. Speaker, I am not arguing. I am simply acknowledging the answers that the Provincial Secretary has already given. Order-in-council 103 indicates that all public servants are required to take the public service oath. Last Thursday the minister indicated that certain persons were being exempted from this requirement, but it's her responsibility to see that they are administered. Can the Provincial Secretary tell the House by what authority exemptions to order-in-council 103 have been granted?

HON. G.M. McCARTHY (Provincial Secretary): Mr. Speaker, first of all, there has been no formal exemption of the oath of secrecy to any one person employed by the government by order-in-council.

To answer your question, I should really reply to you that the order in which the oath of secrecy is taken is taken through the office of the Clerk's office, is issued by the Clerk and is very efficiently done. They are doing so in the time that is available to them. I have not interfered with the timing of the taking of oaths; I leave it to the Clerk's office, and I think they are doing a very good job. If you have a specific request for a specific person that you wish to have an inquiry regarding, I would be very pleased to answer that question and find out the answer for you.

To my knowledge, I do not know of any who have not taken the oath, except for the caucus...of the Liberal caucus of which I have had formal knowledge of that particular situation. I have not as yet had an opportunity to speak to the hon. Liberal leader (Mr. Gibson) regarding that situation. But I have had formal knowledge of that. I have no formal or informal knowledge of any others.

MR. KING: Mr. Speaker, a quick supplementary. I wonder if it's not a matter of concern to the Provincial Secretary that the provisions of this order-in-council have been abrogated by the failure of the government to ensure that Mr. Dave Brown took the oath prior to assisting with the compilation of the budget for the province of British Columbia.

SOME HON. MEMBERS: Oh, oh!

[ Page 1978 ]

HON. MRS. McCARTHY: I understand that the gentleman in question did not assist with the drafting of the budget and, as such, was not required to take the oath. As I have mentioned to the hon. Leader of the Opposition, as the people come before the Clerk's office to take the oath, they will be handled by the Clerk's office and, I rather think, rather efficiently. Again, I say to him that it is not, to my knowledge, that anyone is not. If he would like me to have a formal inquiry, I would be very pleased to do so.

MR. KING: On a final supplementary: the Provincial Secretary has said that he was not required to take the oath. Now that's not what the order-in-council says, which is a legally binding document that the government passed. I wish we could get a clear, concise answer from the Provincial Secretary. Are there going to be exemptions from the law or not? If so, on what basis — political patronage?

MR. SPEAKER: Order, please. The supplemental question is clearly argumentative.

MR. G.V. LAUK (Vancouver Centre): Mr. Speaker, to the hon. Provincial Secretary: in view of the fact that there is a motion on the order paper to set up just such a formal inquiry into the activities of one David Brown in the compilation of the budget, which is in dispute, will the minister undertake on behalf of the government to call that today...?

MR. SPEAKER: Order, please! A motion is on the order paper, Hon. Member. You know it is not a matter of question period to consider the same question that is already on the order paper.

POSSIBLE STRIKE BY FERRY PERSONNEL

MR. WALLACE: To the Minister of Transport and Communications: with regard to the seriously troubled ferry service between Swartz Bay and Tsawwassen, and particularly in light of the labour-management difficulties, the work-to-rule procedures, and last week a lightning strike by the teamsters' union which picketed the ferry terminals, and this kind of difficulty, and since much of the current difficulty arises from layoff notices issued to 400 unlicensed ferry employees, and since the employees' union has stated that delay in implementing layoffs until September would ensure continuity and efficiency of ferry sailings during the busy tourist season months, has the minister given any instructions to management to explore this possibility?

HON. MR. DAVIS: Mr. Speaker, in answer to the question from the hon. member for Oak Bay: these are serious matters and they are all under consideration. But the main concern, the main matter, under dispute is overtime. That is the main preoccupation of the union, and it is the main concern of the government which wants to reduce costs and thereby keep fares under control.

MR. WALLACE: On a specific part of the answer, Mr. Speaker, could I ask the minister if he has cancelled any of the 400 layoff notices issued to the unlicensed ferry workers, and, if so, how many have been cancelled?

HON. MR. DAVIS: Mr. Speaker, none has been cancelled, to my knowledge. I'll take that question as notice, however.

ELEVATOR INSPECTIONS

MS. R. BROWN (Vancouver-Burrard): Mr. Speaker, to the hon. Minister of Labour as the minister responsible for the inspection of elevators. Mr. Minister, are you looking into the tragic circumstances which resulted in the death of the 81-year-old blind gentleman in New Westminster last week, failing down an elevator shaft?

HON. L.A. WILLIAMS (Minister of Labour): Mr. Speaker, to the member for Vancouver-Burrard, yes, I saw the report and I've asked for a report from the factories branch of the Department of Labour, which has that responsibility, to ensure that it was not some fault with regard to the mechanism or some failure to inspect that resulted in that tragic circumstance. I'll be happy to provide the member with a copy of the report.

Presenting reports

Hon. Mr. Davis presents the report of the British Columbia Department of Transport and Communications for the fiscal year ended March 31, 1975.

Orders of the day

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

ESTIMATES: DEPARTMENT OF HEALTH
(continued)

On vote 86: minister's office, $101,052 — continued.

MR. D.G. COCKE (New Westminster): Mr. Chairman, there are a lot more questions we want answered before vote 86 finds its way into the history of this House. As you recall, we got very few

[ Page 1979 ]

questions answered last Friday.

HON. R.H. McCLELLAND (Minister of Health): I answered them all for you.

MR. COCKE: The minister says he answered the questions, Mr. Chairman. I suggest that the minister's answers were somewhat inadequate, but in any event I would like to deal with other aspects.

We know that the minister was helped in recovering a rather bad situation by one of his public servants. I would like now, Mr. Chairman, however, to depart from that and the B.C. Medical Centre and just talk for a few moments about what I consider to be a very important innovation in the province of British Columbia, and that's the innovation of emergency care. Now, Mr. Chairman, we found in the early '70s a situation in B.C. where part of the health system was totally ignored. We had a system in British Columbia where we were prepared to look after people's needs with respect to paying their medical bills through a medicare system. We had a system of looking after hospital bills through our, at that time, hospital insurance and, recently, hospital programmes. But, Mr. Chairman, we couldn't really think in terms of getting people to the hospital and, in fact, providing care on the way to the hospital.

Prior to 1972 in this province there wasn't an ambulance act, let alone an emergency-care system. It could very well be that an ambulance could be a light delivery truck, it could have been a small Volkswagen — it could have been anything as far as the law was concerned. But, Mr. Chairman, the system was looked at and the first thing that occurred was an ambulance act. Finally, in mid-term of the last government, an emergency-care system was implemented.

Mr. Chairman, one of the most important aspects of that system wasn't only the co-ordination of the emergency care with the facilities and the professionals, but it was also the recognition of the fact that unless you have trained people — and I mean trained to the extent that they are able to provide care on the way, or at the scene of an accident, or at the scene of an illness, and all the way to the facility — really we weren't doing a proper comprehensive job of health care.

So, Mr. Chairman, one of the first things that was implemented when we moved along towards an emergency-care system was an intensive training programme. That training programme went as far as to develop what we commonly call today "paramedics." That's the last phase of training; that's called an EMA-3. But prior to attaining that expertise, a person had to go through two prior training programmes, one EMA-2 and one EMA-1.

Mr. Chairman, at the beginning of this new government's term the first thing that we heard was that there was to be a real cutback in the area of training, a cutback in the area of equipment, and most of us became quite nervous.

When we see that a co-ordinated system is the only system that can work, we therefore see failure ahead with the kind of attitude that the present government has toward the ambulance service. Let me suggest, Mr. Chairman, that an article appeared on April 2 in the Vancouver Province, that much-heralded newspaper, and the article was talking in terms of ambulance services to be cut. Now the minister said these cutbacks will not endanger health.

Well, Mr. Chairman, the minister certainly has a different attitude from most of us if he feels that cutbacks in this most important, most strategic area will not endanger health. These have been very careful and reasoned approaches, the minister said, that we've taken to live within the money that's available to us. Well, that's it. It's the priority that has been set for that minister, and an unfortunate priority at that. You see, Mr. Chairman, the priority is that there are not sufficient funds to do the job. I think, when we look back at the kind of system that we had in B.C., we see a system that we're about to approach again, and it's with a great deal of reluctance that most people contemplate that kind of disaster.

We've found, Mr. Chairman, that the B.C. doctors are dismayed at the cutbacks in ambulance service. Dr. Norman Rigby, recently introduced to the House, made some comments on behalf of the B.C. Medical Association with respect to those cutbacks. All people involved in health care in B.C. have seen fit over the last number of years, over the last two or three years, to support the direction of comprehensive emergency care for the whole province, not cutbacks to the extent that now we have absolutely no training, no training whatsoever, being done in emergency care. Now how can you support a system of emergency care with no training being done?

We found also, Mr. Chairman, that there was a reduction in vehicles in this province being contemplated. The first we heard was a cutback from 45 vehicles, which were needed, to 25. The most recent report is the cutback from 25 to 15, and that was to avoid further layoffs in the industry. Now I presume there have been some layoffs. I've been told of 11 or 12 actually out of 432. But I would believe that the prices and the trade-offs are totally unsatisfactory, totally unsatisfactory. We should be building this service.

The thing that we must all remember is the critical period, Think in terms of a middle-aged person with a heart attack. It's well known, it's documented, that that five minutes...that very, very important five minutes where expertise and equipment is absolutely invaluable and, in most cases or in many cases, is a

[ Page 1980 ]

total need. So, Mr. Chairman, what we have going for us now is a situation where we're not able to provide the level of care. We're not going toward the level of care. What we did was that we were making moves on an upward curve, and now we're tailing off and going back down.

I hope, Mr. Chairman, that we're not looking here at the situation where this government has decided that maybe emergency care should not be part and parcel of our comprehensive health-care scheme and that it should be turned back to private industry. Because if that's the case, you're not going to have co-ordination. No question, Mr. Chairman, you're not going to have co-ordination.

I have heard from areas as diverse as Revelstoke, for an example, where they had contemplated putting on permanent staff and have been unable to do so. I've heard from places as far removed from Revelstoke as Richmond — Richmond, where they had had a pretty comprehensive service, Mr. Chairman, and Richmond where they need a tremendously comprehensive service. There happens to be the international airport in that particular area. Having withdrawn some of the service, I have heard, Mr. Chairman, of cases where it has taken 35 minutes....

HON. MR. McCLELLAND: Don't spread false stories.

MR. COCKE: The minister says, don't spread the truth. Well, Mr. Chairman.... What's that? Oh, false stories!

Mr. Chairman, that minister has a very agile lip. I listened to him for some years in opposition, and that minister discussing anybody spreading either false stories or rumours.... . It's coming from the wrong source. So I'll just get back to where I was.

Mr. Chairman, the International Airport itself requires a tremendous amount of ambulance service, and beyond that, the community is growing. There have been cases — and the minister knows; he's had reports, as I have — where there have been undue delays because of a lack of service.

HON. MR. McCLELLAND: Even when you were minister.

MR, COCKE: Of course, Mr. Chairman. He said even when I was minister. Yes — you have to develop a programme. Where did we start two years ago? With zilch. We started with, in many cases, morticians doubling as ambulance services, and the rest of it. We've come a long way, and we must go a long way further. This is a very important priority area. If you don't have this, then, Mr. Chairman, I suggest to you that many of the facilities we provide, many of those fantastically expensive facilities....

Remember the other day I charged the minister with spending at a rate that will go right out of style in the next few years on the Minister of Education's (Hon. Mr. McGeer's) pet project out at UBC. I suggest to the minister that they'll be spending $250 a day — $21 million a year — on one little hospital built out on the periphery. Yet he joshes across the floor and suggests that when the emergency-care service was brand new everything didn't happen at once. Yes, we agree. But it takes time, and we don't want to reverse the process; we want to see the emergency-care service as an ongoing service.

We can see the loss of lives. We can see the difference between a properly built emergency-care service and one where people's needs are not cared for at the scene, nor, for that matter, on the way to a facility, a hospital.

Mr. Chairman, that's what we're talking about here. We're not trying to compare a situation where you start from scratch; we're talking in terms of a good base that was left. And I'm arguing that that good base should be built upon.

There is article after article in paper after paper from groups like the ambulance employees' union, concerned.... Mr. Chairman, what does that do? I'll tell you what it does: when a person is working in an area where they feel they have a contribution, a real contribution, to make, they want to get — if they're any good at all — access to all the training that's available so they can really provide. None of that is going on now. I suggest to you that where you have an EMA-1 he should have the opportunity to rise to an EMA-2, and where you have an EMA-2, he should have the prospect of becoming ultimately an EMA-3, if the area supports the need for that particular expertise.

So, Mr. Chairman, what I'm looking for here is assurance from the minister that something is going to be done, something in the face of a real need.

Probably one of the most dedicated groups in this province, probably one of the most sought-after groups in the province, as far as advice is concerned, is SPARC — Social Planning and Review Council of B.C. SPARC is a very influential group. SPARC is a group of people which, certainly in my tenure, I listened to, and I suggest to the minister that he should be talking to people like SPARC right now.

HON. MR. McCLELLAND: I am meeting with them tomorrow morning.

MR. COCKE: That's a good idea. The minister is going to meet with them tomorrow morning.

I just wonder if he'll give them the same kind of commitment he gives all groups that he meets with to date. Mr. Chairman, I suggest to the minister that he immediately go tonight and ask the hon. Minister of Education, who obviously makes the basic decisions

[ Page 1981 ]

around health care in our province, if it's all right to improve the ambulance service, to improve the service that's needed. The minister scowls a little bit about that....

HON. MR. McCLELLAND: I was smiling.

MR. COCKE: I spoke in this House the other day, on Friday, about the question of the Minister of Education making the announcements, and embarrassing the Minister of Health a good deal. He's done it again today. "The Minister of Education, Pat McGeer, and the Minister of Health, Bob McClelland, have announced that agreement in principle has been reached for the transfer of the education centre at Riverview."

I agree. That is an excellent concept, a concept that was started some time ago, letting Douglas College use that facility, Mr. Chairman, why didn't the Minister of Health announce it and say he was turning it over to the Minister of Education, and thereafter the Minister of Education makes any announcement, because it wasn't his jurisdiction? I suggest that that was certainly a better trade-off than the one he had before, because the Minister of Education, announcing the hospital at UBC, announced it on his own.

So will the Minister of Health, Mr. Chairman, admonish his cabinet colleagues, or the Treasury Board, or whoever is necessary, to come up with the funds to provide that emergency care in our province will not go backward but will go forward from this point?

I think that's a very, very important area, Mr. Chairman. There have been cutbacks in service. The other day I asked a question: "Is Habitat being reinforced with ambulance service?" My understanding was that there has been no provision for any additional ambulances at that time. Now there will be a tremendous influx over the next two or three weeks. I would hope that the minister will reassure us that all the needs for that particular conference, or anything else that occurs in this province, will be given the backup it needs.

I suggest, Mr. Chairman, that with the lack of proper equipment being phased in it's going to cost us dearly. What you're expecting under the present circumstance from our equipment is a life of a couple of hundred thousand miles. You know, that's a very hard life for an ambulance — a couple of hundred thousand miles, lasting about 18 years. I suggest that that's not good enough. We should be looking at something better from our very, very important service in our province.

Mr. Chairman, this is not the year to be making these kinds of decisions based on arguments that have been raised around the former government's lack of financial ability. Those arguments are about as hollow as you can get, because I've already shown where the present government has increased the budget a good deal and yet cut back on services. You know, the same kinds of charges could be made this instant about the lack of financial wisdom and the lack of management ability in that government.

Now, Mr. Chairman, we're prepared to see this government spend a few dollars in the right direction. We're prepared to back them when they go to some of the resource industries in our province and suggest to them that they pay a larger portion of the share of the load.

Emergency care must not be turned back to private industry. Emergency care must become more and more part and parcel of what is the human right in British Columbia, and that human right is access to health care — the very best quality health care this very rich province can provide.

Mr. Chairman, I hope that the minister will say some reassuring things to all of us who happen to be left in this committee.

HON. MR. McCLELLAND: Mr. Chairman, just a couple of comments in answer to the questions raised by the member for New Westminster. You know, he's wrong in that he says there is no training going on; there is some training going on because we already have.... During the term of that member's office, when he was Minister of Health, there were nine people went through the EMA-3 programme, which is effectively the paramedic programme, and there are eight more enrolled in that programme today taking their paramedic training. The training in that degree has not stopped.

Mr. Chairman, I wish I could tell you right now that there were no training cutbacks but, unfortunately, those people on that side of the House, when they were government, left this province in a financial shambles. Now to say that there were cutbacks when we had estimates for the emergency health services programme of $12 million in your budget last year, and now $17 million, is just utter nonsense. Sure the training has had to be suspended for a while. We're going to try and get it back as quickly as possible. But when did it stop — when this government was elected? Not on your life. The reduction in training started in August of 1975, when one training group, the EMA-1, was eliminated. EMA-2, the only other training group that was available, was abandoned in late summer of 1975, long before the election. The reason given to the Emergency Health Services Commission? Lack of funds. There was no money left, and that member knows it. It wasn't us that abandoned the training; it was the previous government that abandoned the training, and we're doing everything we possibly can to get it restored again as quickly as possible.

Those are the facts. We don't want to see any loss

[ Page 1982 ]

of service, and we worked very hard with both the commission and the union to attempt to see that those services aren't cut back and lost because we don't want to see people suffer either. To say that there are people dying because of cutbacks in services, Mr. Chairman, is to do a great disservice, not only to the people of this province, but also to those people who are dedicated to seeing that this emergency health service works. I'm talking about the union members and those people who are involved in delivering that service.

Talk about a lack of financial ability. It was the complete lack of any kind of management or concern about fiscal responsibility that put us into this kind of a mess, and it's going to take some doing to get us out; it might take a couple of months to achieve that objective. We're going to restore those training programmes. We're going to restore the service to the communities that may have been cut back slightly because of having to use a few more part-time people than full-time people just as quickly as we can get our financial house in order.

I must just pause for a moment, Mr. Chairman, to thank the members of the union in particular who came into our office in Victoria and sat down with us and attempted to work out ways in which we could compromise so that we could have a balance of new vehicles constructed and no layoffs of staff personnel. The member for New Westminster (Mr. Cocke) is right: there are only going to be about 11 layoffs. We've worked out a compromise with the union to make sure that even those people who are technically going to be laid off will be kept on a spareboard system so that they'll have no reduction in pay, even though they're going to be technically laid off.

Those are the kinds of compromises that we made with the union at the suggestion of the union and at the suggestion of the commission. So we're going to make sure that no one suffers here, Mr. Chairman, and we will restore the training that was stopped, not with the advent of this government...

MR. COCKE: We'll talk about that.

HON. MR. McCLELLAND: ...but the previous government before, and we'll restore it as quickly as we possibly can.

MR. COCKE: Nonsense.

MR. G.S. WALLACE (Oak Bay): Mr. Chairman, I'd like to deal with one or two general areas and also ask the minister one or two specific questions.

I would like briefly to return to the issue of the third hospital scheduled to be constructed on the Helmcken Road site in Victoria. One of the aspects of that project which I emphasized on Friday was that it quite clearly contradicted regional planning as a basic concept. In other-words, the choice that the minister has made for his own good reasons, namely financial, that the hospital should be included on that site, involved contradiction of many of the regional planning concepts, not the least of which is the fact that the health and hospital planning commission has decided that all obstetrical services in the greater Victoria area. would be located at the new third hospital.

Mr. Chairman, if my contention, which I outlined on Friday, that the transportation and highway access to Helmcken Road is as questionable as it appears to be and that traffic tie-ups on the Trans-Canada Highway, the widening of which has now been postponed indefinitely, is a valid observation, I wonder if the minister is aware of the fact that not only will the Helmcken Road hospital be located not close to the greatest population for the total area, particularly in regard to obstetrical patients, but that, under the circumstances I've outlined, hasty access to the hospital for obstetrical patients could be a very serious problem.

I commented on Friday that access of ambulances to the new proposed site for emergency cases might well be a difficulty resulting in delay and persons urgently receiving treatment perhaps not reaching the hospital in time. I would like to ask again: what about obstetrical patients from the whole of the greater Victoria region who will be requiring admission, sometimes in a measure of haste, to the obstetrical facility at Helmcken Road? It would seem to me, in the light of the documented evidence in relation to traffic problems and the physical location of the proposed hospital, that it would be a real chance that we'll have a higher incidence of babies being born en route to hospital.

It isn't, by any means, the one and only reason that I think the minister should take another look at this proposed hospital site, but you should look at the cross-section of reasons. The health planning commission was specifically set up to do detailed and expert studies of all the conditions pertaining to hospital sites, and it seems unfortunate that they've come up with one very clear-cut recommendation, namely the McKenzie-Douglas site. The minister, for the short-term purpose of keeping costs down, is perhaps not only facing increased costs of operating that hospital in that site, but is faced with costs which really nobody can measure at the present time in relation to the highway problems and the cost of developing access to that site.

There is really only one road that gives access to the site at the present time and that is Helmcken Road itself, which is not a wide road, and it would be incredible to conjecture a large general hospital with access only on one side, for obvious reasons, so there has to be a second highway access development somewhere in the region of what is now called

[ Page 1983 ]

Boundary Road, which is a very small road about 10 feet wide and little more than a dirt track. On top of that, both these roads when developed have to intersect with the worst traffic bottleneck in the whole of the greater Victoria area, namely the section of the Trans-Canada Highway from Town and Country to Colwood cutoff.

I don't wish to go over the whole argument again. It's all in the Blues from Friday, but this was an additional point. I'd like to ask the minister if he has been aware of the fact that the hospital in what I consider to be a thoroughly unsuitable site is intended to provide service to all the obstetrical patients in the region, inasmuch as when that hospital is built, obstetrical services at Victoria General and Royal Jubilee Hospital will be phased out.

I would like to move on to the more general subject, Mr. Chairman, of hospital financing, the general problem of hospital financing. I have no wish to in any way inject more trouble into the labour-management scene. I assure you that I am trying to make comments which are objective but very much need to be highlighted if we are to have any intelligent debate about how hospitals are to be financed.

In a letter dated May 13, 1976, from the hospital programmes, Department of Health, signed by Mr. J.G. Glenwright, there are some very significant points that are made about hospital financing. I'd like to quote at least one sentence, which states: "Instead of the traditional line-by-line review of hospitals' estimates, hospital programmes will be providing a composite increase over the 1975 approved budget."

Mr. Chairman, first of all let me say that for many hospitals the 1975 approved budget ended in very substantial deficits. That central point cannot possibly be overlooked or minimized. In other words, the Department of Health policy is that 1976-77 budget will be based on an increase over 1975 approved budgets which have already resulted in substantial deficits at Vancouver General and the Royal Columbian. The Jubilee Hospital finished up with a deficit of $1.2 million, which the minister brought down, I think, by two-thirds by an ad hoc allocation of funds quite recently.

I don't want to get into this hassle again, Mr. Chairman, about ad hoc funds. I have already registered the feelings of many medical administrators and hospital trustees that there is just too much ad hoc bailing out of hospitals to a partial degree at the end of each financial year. That system is dead wrong. It is just like throwing a bone to a dog at the end of the financial year, the bone being two-thirds of the deficit and the dog the hospital administration management.

Though we have been over that already and I won't repeat it, it is wrong that hospitals have to struggle through the year not really knowing until they are halfway through the year, first of all, what their budget allowance will be from the minister and then, secondly, at the end of the financial year be given an ad hoc so-called financial adjustment. It is just the same as the point I made under the estimates on Education where trustees burn the midnight oil trying to figure out how they can economically operate schools or hospitals. Then when they present their budget, as in Victoria one year, they get an ad hoc adjustment of $1 million in 1975-76. But this year there is no such $1 million adjustment. We have the same problem pertaining in the hospital field, as demonstrated just some weeks ago by several of the hospitals having a deficit receiving an adjustment, which is a euphemistic way of saying: we will give you a donation over and above your approved budget to the extent of two-thirds of the deficit.

[Mr. Veitch in the chair.]

At any rate, Mr. Chairman, this circular that was sent to the hospitals dated May 13 is telling the large general hospitals of British Columbia that for 1976-77 there will be a general composite increase of 8.5 per cent based on 1975 approved budgets, which have been shown to be quite inadequate for the demands on these hospitals by the very fact that most if not all of these large general hospitals working on the 1975 approved budget encountered substantial deficits — something of the order, I believe, of close to $3 million at Vancouver General Hospital, $1.2 million at the Royal Jubilee and something under $1 million, I believe, at St. Paul's. These figures may not be precise but they are close enough to make the point.

So for a government that frequently espouses a businesslike approach to administration, I just have to ask: how can you tell the hospitals of this province that they can have an 8.5 per cent increased amount of money in 1976-77 based on a budget in 1975 which in large measure was quite inadequate to meet the demands being put upon the hospitals? Then, to add insult to injury, this circular to the hospitals goes on to say.... This is the point, Mr. Chairman, where I have no wish to intrude into the management-labour dispute that is on a 21-day cooling-off period at the present time. I just wish to be objective in talking about the funding of hospitals and the general policy. I quote from the second page of the circular:

"Your attention is drawn to the fact that funds provided to your hospital on the above basis must cover any increased costs that will be incurred by your hospital as a result of 1976 collective bargaining agreements, including any additional costs that may result from the job evaluation study."

Now, Mr. Chairman, we know that the basic wage increase that is being negotiated at the present time

[ Page 1984 ]

starts at 8 per cent, plus fringe benefits. As I said a moment ago, there is great diversity of opinion as to how much of a percentage increase the fringe benefits will cost, but there is one item in the fringe benefits, namely the job evaluation study...and I've made some inquiries about that, and I understand that the impact of the job evaluation study could be many millions of dollars which neither the minister's department nor the hospital administrators nor, for that matter, the hospital employees' union, can at all accurately measure. So we're talking about hospitals trying to determine the 1976-77 budget, and the minister's saying to them in the circular: "You can get an 8.5 per cent increase, but it's based on 1975's approved budget" — which was inadequate — "and it must include the fringe benefits negotiated in 1976-77 plus the impact of a job-evaluation study."

Now, Mr. Chairman, we've heard the old phrase about buying a pig in a poke, and really, I suppose, in this case the hospitals aren't even being given a choice of buying a pig in a poke. They are being told to take the pig in a poke. They are, in fact, being presented with absolutely impossible financial criteria to live by, other than the simple but tragic option of a cutting back in service, and by service I am talking about the same kind of problem which apparently exists in the ferry service, that people will have to be laid off to live within these kinds of figures.

Now I'm not disputing the clarity of the minister's circular to the hospitals. It was quite clear the policy the minister is implementing, and the associate deputy minister, Mr. Glenwright, I think at least is to be congratulated for not beating about the bush. What he says in this circular is very clear. There is no ambiguity; he spells it out like it is.

But what I'm worried about and what the hospitals are worried about and what the people of British Columbia had better start getting worried about is the fact that the hospitals, the big general hospitals in this province, cannot continue to provide the level of service we've come to expect, rightly or wrongly, on this kind of financial policy decision, because the basic wage increase which has already been put forward in hospital negotiations is 8 per cent plus fringe benefits.

Here we have at the very minimum the government offering hospitals 8.5 per cent, based on 1975 approved budget figures which, as I mentioned, were quite inadequate for the larger, more sophisticated and more expensive general hospitals in the province.

Not only that, the circular goes on to mention that in no way can any new programmes be introduced. I would just again take a passing example of how new programmes that were introduced in the last year or two continue on the basis of their own essential success to be used to a greater and greater degree. The best and most expensive example is cardiac surgery — the coronary bypass operation. More and more people are benefiting from that surgery, and they're often middle-aged men with jobs and families. They are at the peak of their career in relation to the capacity of their job and in relation to their own personal responsibilities, so that it is indeed a surgical technique which is restoring the breadwinner to his job.

On the other hand, Mr. Chairman, I think the government is really not seriously and bluntly looking at the fact that you can't have it both ways. If we are in the position of technology and medical and surgical advances which permit us to provide that kind of restorative surgery to cardiac patients, you just can't sort of turn off the tap because it's getting to be too expensive.

Maybe it s not just this government; maybe it's the whole of society. But there are choices that are going to have to be made, that when the costs of hospitals reaches a certain level, certain people will receive the kind of care which medical research and technology has made possible.

Other people, perhaps with less dramatic illnesses and less obvious means of putting them back to work, will either have to wait longer to get their medical care, or they might never get it. These are some of the choices which face our society not too far down the road.

Another example I could quote is the question of renal dialysis, the costs of renal dialysis and the potential to transplant donor kidneys from — the most simple example — persons who are killed in motor-vehicle accidents, young people with healthy kidneys which can be used to transplant to a person currently receiving dialysis therapy. There are all kinds of other examples.

This isn't meant to be a long medical speech about medical and surgical conditions; I'm talking about the very tough challenge facing all governments in Canada in relation to the financing of health and hospital care.

I just regret that the government takes this simplistic, ball-park approach and says to the hospitals: "All right, you had X dollars in 1975-76, you're going to get X dollars plus 8.5 per cent, and that includes all the demands being made on you for this, this and this" — meaning these differing services, expansion of existing programmes and the fact that some new programmes may be extremely difficult to resist, perhaps impossible to resist, where the community needs the service.

This circular, without any doubt, if it is implemented according to the very clear way in which it's written.... Again I recognize and commend the government, or Mr. Glenwright anyway, for making it very plain in this circular just exactly what the government policy will be.

So I wonder if the Minister could answer a few

[ Page 1985 ]

specific questions on this fundamental policy of hospital funding. In the light of this circular, does the minister plan to have any kind of special meeting or series of discussions with the hospitals to explore the inevitable cutback in service that will have to be implemented? By restriction in service I'm not necessarily saying that it is medical or surgical personnel, but we've had a strike by the ancillary staff, the cleaning staff, the janitorial staff and the secretarial people. In light of that, I would assume that the government is taking a serious look at whether or not all these numbers are as essential to the provision of a high standard of medical and surgical services as might have been considered the case before the strike.

I'm not saying that we can get by with fewer staff in hospitals....

HON. L.A. WILLIAMS (Minister of Labour): Janitors are cheaper than doctors.

MR. WALLACE: Yes, I've got the figures right here. The Minister of Labour, — before he leaves.... I hope he won't hurry away; I hate to chase him out of the House, but....

MR. G.F. GIBSON (North Vancouver-Capilano): Who's cheaper than who?

MR. WALLACE: The Minister of Labour, while he's left the chamber, I'm glad to know that he's aware of some of the hard facts of life in the hospital field: a cleaner-janitor, as of the day he gets employed in a hospital, earns $905.50 a month. This circular is just pointing out that that gentleman or lady will receive 8 per cent, plus fringe benefits, retroactive to January 1, 1976. So we're looking at the real likelihood that, as far as 1976 is concerned, society will be paying $12,000 a year, or pretty close to it, for a cleaner-janitor in a hospital. An RN general-duty nurse at the moment is receiving about $140 more than a cleaner-janitor.

I'm not here to create any impression of criticizing the cleaner-janitors or anybody else in the hospital field, but this job-evaluation study that has been requested by the Hospital Employees Union just simply has enormous potential for impact. I think if I were a registered nurse who had taken three years of training and was carrying the professional responsibility of service to patients, which can involve a very high level of responsibility, and I found that a person starting to push a broom in the hospital corridors is getting only $140 a month less than I'm getting as an RN with three years of training, plus the responsibility factor.... I'm not surprised that there is unrest in the hospital field.

But society as a whole has to answer some of the questions that this kind of situation raises. These questions are: just how much more should a highly skilled professional in the health field receive in relation to unskilled help in hospital?

Another good example, Mr. Chairman: a stenographer can come out of high school and, at present rates of pay, start work in the hospital field at $747.50 a month. We have the same starting salary being paid to a housekeeping aide. Now, again, I know we need those personnel in hospital, and the last thing I am suggesting is that they are not entitled to whatever they can negotiate through their union, but there's got to be a bottom to this supposed endless pit of money that is expected to be put into the health-delivery system. I just wonder if the government is being less than courageous or less than frank with the people of this province in the face of these facts and figures that I've mentioned and the complexity of the situation, to send this kind of circular to the hospitals and say, in effect: "We've got real financial troubles and we can't manufacture the money, et cetera, but you guys in the hospital field get on with an 8.5 per cent increase and do the best you can, because we are outlining in this letter that no way, but no way, is there going to be any increased funding beyond the 8.5 per cent, and we will not approve any new programmes, however worthwhile they might obviously be in relation to providing new services for conditions previously untreatable."

So the specific questions I'd like to ask before I sit down are: first of all.... Well, I suppose the first basic question is: is the minister really aware of the impossibility of hospitals performing their present level of service within these guidelines, assuming that fringe benefits, as yet undecided, will have some very substantial impact? Let's remember, when we are talking about 1 or 2 per cent, we are talking about 1 or 2 per cent of all the salaries in the hospitals, which make up about 80 per cent of the total hospital budget, and that's hundreds of millions of dollars.

Secondly, and I am sure the minister is aware of that problem: what steps is he taking now, rather than waiting for the hassle we have at the end of this financial year to try and adjust budgets that have red ink all over them, what is the minister doing to explore with the hospitals the areas in which cutbacks would best be implemented?

Thirdly: to what degree, if any, does the minister now have information as to the possibility of reducing the number of unskilled jobs in hospital, without which the hospital has demonstrated by the recent emergency situation it might well be able to function? If there is to be an inadequate number of total dollars available for the increased costs of running the hospital, one would have to assume that services that are cut back would have to be the ones of least urgent and serious significance in the provision of actual treatment services. In other words,

[ Page 1986 ]

I suppose what we're looking at is a much longer waiting period for people with so-called elective surgery...

MR. CHAIRMAN: Two minutes, Hon. Member.

MR. WALLACE: ...and I use the word "so-called" advisedly. I don't think it's right of this government, or if it were us or the NDP or any other government, just simply to lay down ball-park figures and tell the hospitals to get on with it when those of us who have some knowledge of the situation realize that some very crucial decisions have to be made down the road. I think these decisions, where possible, should be a combined decision of management, unions and this government facing the inevitable reality that we cannot continue to provide the present level of service within the constraints of the circular of May 13.

HON. MR. McCLELLAND: Mr. Chairman, to the member for Oak Bay: I'm not convinced that the financing formula we have for hospitals now is the best possible financing formula that we could have. Probably it needs some adjustments, but we haven't had a lot of time in which to make those adjustments. Nevertheless, Mr. Chairman, over the years it has kept British Columbia in pretty good line in relation to the costs of service to the population in comparison with other provinces.

Mr. Chairman, the member said that there are choices that face our society. There are all kinds of choices that we are being faced with now and some of those choices have to do with financial decisions because of the restraints we find ourselves in, particularly due to the general economic condition of today. You know, in Ontario they are closing hospitals down, and the Minister of Health (Hon. Mr. Miller) gets pelted with snowballs. Fortunately it doesn't snow much in Victoria. In Saskatchewan.... I just picked up a newspaper from Saskatchewan today, in which it says: "A 5 per cent reduction in the number of approved patient-days under the Saskatchewan hospital services plan is part of an overall $30 million restraint in existing health programmes and rejection of more than $14 million in new programmes in Saskatchewan." The Health minister also announced that government funding of regional hospital councils will end this fall — no more funding for those regional hospital councils.

Mr. Chairman, this is a national dilemma. In fact, it's probably a dilemma that's facing every developed country in the world, and it's one in which we must face some of those choices.

I'm surprised at the member for Oak Bay in one way when he says that here we are setting down limits for the hospitals, and saying: "This is all you can have; that's all there's left." I've heard that same member, Mr. Chairman, stand in the House and say — and I've said it when I was in opposition — why can't you let the hospitals know more quickly what they can expect for their budget year? Here we've made an attempt to tell them that this is what we have available and at the present time that's the kind of restraint under which they have to operate for the coming year and plan their budget accordingly.

Mr. Chairman, I explained on Friday — but perhaps the member wasn't here or didn't hear me — that while we've said that the overall budget increase must be kept to 8.5 per cent, if the member will check the budget he'll see that there's a $68.4 million, increase in the payments for hospitals for operating costs in this budget, plus what will probably be around $9 million or $10 million, or $77.4 million. This is not an 8.5 per cent increase but a 17 per cent increase in the payments to hospitals for this fiscal year.

Much of that is already taken up because of our annualization, the operating costs of new beds; COLA started in 1975 and other services started in 1975. About 8.5 per cent of that 17 per cent is taken up already because of commitments made by the hospitals for things over which they have no control.

Again, Mr. Chairman, in relation to the need to make adjustments at the end of the year, I don't know how else you can do it, because those adjustments are to handle things which neither the hospitals nor the government could foresee in the year. I'm sure the member wouldn't want us to leave the hospitals hanging and say: I'm sorry, you know; we won't pick up those additional costs. So the adjustments are for things we don't know about and that's why they're made. I don't know when else you can make them except at the end of the year when they're known. The member wouldn't want us to give a blank cheque to anyone, which is essentially what's happened in the last couple of years — and that's the reason the hospital costs have gone up almost 100 per cent in three years.

That kind of cost and escalation can't continue, and I'm sure the member knows that. The member knows the pressure that's on this government from the federal government to contain costs and develop alternative systems. The member knows all those things. One way or another we've got to make sure that those costs are contained. The member may not like the way we're doing it, but I would say that we are in consultation with the hospitals, and certainly we will back them up to the hilt in any efforts they have to make to contain those costs.

I hoped, Mr. Chairman, that we had canvassed the subject of the new site for the Victoria hospital, but the member still is not satisfied that we're providing the capital region with the opportunity to get on with the job of building a new hospital within days of approving this site.

[ Page 1987 ]

Mr. Chairman, the member raised some questions about obstetrical services, and I find.... You know, the difference in mileage between those two hospitals is what — two miles? I find it difficult to understand why there would be an increase in delivery of babies in taxi-cabs or Model T Fords just because of a two-mile difference in both ends. What about the people at the other end of the region?

Regardless, Mr. Chairman, of which site is selected, residents in the southern and eastern sectors will have to travel greater distances than they do at present. An obstetrical unit at the Helmcken site will be much more accessible to the young families who are building homes in the western communities, much more accessible with very little extra driving time to residents in the north Saanich area. So it trades off, I believe.

We talked about the costs of services. Mr. Chairman, it's estimated that the cost of an aeration plant and pumping approximately 5,880 feet of a four-inch line to the main sewers of Benjamin and Burnside will be about $200,000.

At the same time, as I tried to explain on Friday, the contours on the east side of the McKenzie site vary by 90-plus feet and therefore automatically place some very severe limitations on the location of the facility at that site.

In other words, what we're saying, Mr. Chairman, is that a very careful evaluation of the two sites doesn't make it nearly as clear that the McKenzie-Douglas site is a better site than the Helmcken site. I could go through all this but I'd just as soon not. What I'd like to say is that our own evaluation of that land places the two sites very close to identical in terms of desirability for a hospital site.

Finally, with the matter of roads: sure, there's a road problem and there will be wherever the hospital goes, including the McKenzie and Douglas site. But the proposed widening of the Trans-Canada, and the McKenzie Road extension to the Trans-Canada, are still projects which are high on the Highways department's list.

MR. G.R. LEA (Prince Rupert): Not true.

HON. MR. McCLELLAND: Sure they are.

Mr. Chairman, I think given all these factors I want to say just once more that I find it very difficult to comprehend the member's assessment of the cost of that land. It's impossible for any responsible government at any level, whether it be municipal, regional or provincial, to just push aside the cost of that land without ever giving any consideration to the people who are going to have to pay for it, who are the taxpayers.

Let me go over it once more: the government is being asked to support a very speculative venture in the purchase of this land which will enable the owner of that site at McKenzie and Douglas to sell for $2.5 million property which was acquired during the past three years for some $374,000. We are being asked to pay $100,000 per acre for land which was purchased at approximately $13,000 an acre. This government just cannot support that kind of speculation. That's all there is to it.

Now if the member wants to argue again that the $2.5 million cost of that property is within line, then let him argue it — that's on his conscience, not mine. But this government will not support the purchase of that land at that price. It's as simple as that.

MR. W.S. KING (Leader of the Opposition): First of all, I wanted to comment on the remarks of my friend from Oak Bay (Mr. Wallace) . We seem to find ourselves quite frequently in discussions on the value of various functions in society, and I found his remarks interesting regarding the salary gap that exists between those people who have a function of cleaning in hospitals as opposed to those with professional training, for instance.

I just draw to his attention that one of the problems has been that some people in professional categories have been somewhat sensitive over the years about any public scrutiny of their real salaries. I think we've heard certain criticism of publicly revealing the blue book or green book appraisals of wages and fees in this province — I'm not sure what the colour of the book was, but I know the colour of some faces when that controversy arose.

So I don't know about the fact that some upward mobility existing for functions in this province that are viewed by some as perhaps less important should be greeted with some scorn and disdain by those in the higher categories. I think ours is a society that prides itself with offering upward mobility for all categories of work in this free-market system of ours.

HON. MR. McCLELLAND: On a point of order — may I leave for a while, now that the member for Oak Bay's (Mr. Wallace's) estimates are up? (Laughter.)

MR. CHAIRMAN: I was wondering when you were going to get back to the minister from Oak Bay. (Laughter.)

MR. KING: Mr. Chairman, I'm on the subject of hospital employees and related health-care salaries and costs. I want to assure the minister that I'll be focusing in on him very shortly.

The point is that I do believe that professional nurses and doctors, and other professional people, are motivated beyond the level of recompense. These are people, I believe, who are dedicated to the vocation they have chosen, the contribution they can make to health care and to the health care of society. So I don't think that the level of wages and the fact that

[ Page 1988 ]

some people who rank below them on the spectrum are coming up somewhat is viewed as a threat to their morale. I disagree with that line of thinking.

The member for Oak Bay did raise a point that I had also discussed last Friday with the Minister of Health — that was the problem of bargaining in the hospital industry this year, the fact that we do have a temporary lull in a serious dispute that has plagued the health industry in this province. We have a 21-day lull imposed by the Minister of Labour (Hon. Mr. Williams), but not the solution to the dispute.

I made the suggestion to the Minister of Health that it is an impossible position to leave the hospitals of the province in when he imposes an 8.5 per cent allowable increase to the total scope of health costs in the province this year. I'm going to suggest to him today, Mr. Chairman, that he should very seriously consider separating the cost of wage increases, the cost of collective agreement renewal, from the general guidelines he has extended to the hospital this year. Because if he fails to do so, it's a dilemma which I do not think the government will want to find themselves in.

I'm sure the Minister of Labour has talked to the Hon. Minister of Health already, and pointed out that the government now has on the floor of this House a bill which subjects all salaries in the public sector to review by the Anti-Inflation Board — that is, the application of a 10 per cent guideline — an 8 per cent guideline in reality, with the possibility held out of an additional 2 per cent for historic relationships for unusually and uniquely justifiable wage and fringe increases. This could perhaps be justified on the basis of higher productivity and so on.

Now if the government has gone that way — and they clearly have, by introduction of this bill — then surely they are duty-bound in good conscience to apply that mechanism, that approach as the criterion, as the benchmark for collective bargaining in the public sector. If the hospitals know that they are free to negotiate whatever level of income and fringes they think is realistic and they can live with, subject to the review of the Anti-Inflation Board, then I say it would be colossal bad faith for the government to impose yet another stricture: the admonition of the Minister of Health, by directive, that they must not go above 8.5 per cent, not just for wages but for the total cost increases of health care in that hospital. This places the hospitals in a position where collective bargaining is nothing more than a charade. It's impossible to consummate a collective agreement with their employees because there is no guarantee that the government is going to back that collective agreement with the necessary funding to allow them to live up to their obligations.

So I say that under the circumstances this year the Minister of Health is duty-bound to give the hospitals of the province an undertaking that he will stand behind the cost of freely negotiated collective agreements as separate from any other guideline he wants to impose on health-care increases in those hospitals. To do less would be to ensure that any bargained agreement in the hospital-employee dispute is absolutely impossible. To do less would be to say, although the government has introduced a bill subjecting this kind of collective agreement to review by the Anti-Inflation Board, with all of their guidelines...and I would point out, Mr. Chairman, that that guideline of the federal anti-inflation programme covers not only salaries in the 8 to 10 per cent levels, but the cost of all fringes too.

So I think the minister would be repudiating the bill that his own government has before the House if he is not prepared to separate the allowable increase in health-care costs from that which accrues from collective bargaining in the current year. I think that his colleague, the Minister of Labour (Hon. Mr. Williams) would welcome and I'm sure must have asked the Minister of Health for this kind of commitment too, because the Minister of Labour is placed in an impossible position unless the government gives the kind of public commitment I have suggested. The Minister of Labour is facing a situation where there's no hope of a bargain settlement in that industry this year. I submit, Mr. Chairman, that that would be an unfair position to place the Minister of Health's colleague in, and I'm sure he doesn't want to do that.

I point that out because I think it's imperative, if there is to be a freely-arrived-at settlement during the 21-day cooling-off period, that a prerequisite is the need for the Minister of Health to give the kind of public undertaking that I ask for now.

In conclusion — and I hope the minister will comment on this — I would just point out that it's not much of a thing to ask for. It's not carte blanche; it's not unrestricted guarantee by the provincial government of whatever the price tag is. It's an undertaking to support the allowable increase which has stood the test and the scrutiny of the Anti-Inflation Board.

I suggest that in all good conscience, Mr. Chairman, the Minister of Health can do no less than give that kind of public undertaking so that the hospitals are clear in terms of what they have to bargain for, so they are clear that when they do consummate a collective agreement in good faith they are not going to be left high and dry, holding the bag with nowhere to obtain those funds from other than the government which is imposing an unrealistic guideline.

MS. R. BROWN (Vancouver-Burrard): I would just like to add a couple of words to the discussion which took place between the member for Oak Bay (Mr. Wallace) and the Leader of the Official Opposition

[ Page 1989 ]

(Mr. King) about the gap existing between the wages paid to the nursing staff at hospitals and the sweepers. I think it's a good idea that one should look at the gap existing between these salaries. Really, a more realistic gap to look at would be the one existing between the nursing staff and the doctors, because I think that it makes much more sense to compare the skill and training and the work being done by a capable nurse with the work being done by a doctor. I think that if we were to take that kind of scrutiny, Mr. Minister, through you, Mr. Chairman, you would find that the gap indeed does need some narrowing.

To compare what a nurse does with what the sweeper on the floor is doing, and to say that he or she is discouraged because the sweeper is making $140 a month less than her salary doesn't tell us really how discouraged she is as compared to the fact that, doing very technical work and very skilful work, she is making thousands upon thousands of dollars less than the doctor who is also one of the health professionals sharing a job with her in the hospital. So I would certainly like to see that particular gap scrutinized to see if there is any way in which it can be closed.

What I really want to talk about today, Mr. Chairman, is the whole focus and direction of the Department of Health. I had hoped that when the minister introduced his estimates to us we would have found out some more about what the department is doing in terms of health and not quite so much about what it is doing in terms of sickness. Because the appalling thing is — I am quoting here from the statistics used by Dr. Bonham, a Vancouver medical health officer — that out of every dollar in this province that is spent on delivery of health, in fact, only 3 cents is spent on health. The rest of it presumably goes in one form or another in terms of treating sickness.

I really don't see us ever closing the gap that exists or reversing this in any way as long as we continue this sort of parsimonious allotting of our percentages to preventive health — to things like research, to dealing with community clinics and community organizations that deal with preventive health rather than with sickness itself.

I am hoping that when the minister responds to my questions he will speak to us more about what the department is doing in terms of preventive medicine — what it is doing in terms of health rather than in terms of sickness.

It is not unusual — this department is not unusual — in its commitment to sickness because, of course, we see that the federal government is doing precisely the same thing. It is cutting back its funding for research, seeing it as not quite as important, frankly, as the kind of money which it is spending on sickness. The latest issue of Psychology Today had a very interesting article in it by Ivan Ilyich. He was talking about the whole commitment of the medical profession to sickness rather than to health. If anyone is going to start turning that around — if anyone is going to start changing that system — surely the Department of Health would be a forerunner and would be a place to start. It can't do it by itself.

We hear from the Minister of Education (Hon. Mr. McGeer) continually about the need to train more doctors, the need for the medical school to turn out more people to deal with sickness and very little from the Minister of Health about what is being done in terms of preventive medicine. How is it that Dr. Bonham can refer to us as the "rocky-liver capital" and the "tooth-rot capital" of Canada? Those kinds of things I would have hoped the department would be addressing itself to.

If I can name a couple of specifics, the Pine Street Clinic which, again, Dr. Bonham talked about when he presented his report to city hall, deals not just in sickness but to a large extent in counselling. It deals with family counselling, it deals in VD counselling, preventive counselling. It also deals in family planning, right? It really is a preventive clinic. It is dealing with groups in the community who don't use the traditional health-delivery system. Yet we find that their funding is being cut back, that in fact they are not being allowed to expand to meet the needs of the community they serve. Because as you know the Pine Street Clinic is actually two clinics in one: there is Water Street and there is Pine Street.

AN HON. MEMBER: There's been no cutback.

MS. BROWN: Okay. Let us put it this way, Mr. Chairman, through you to the speaker. If you give exactly the same amount of money that you gave last year, taking into account the devaluing of the dollar as a result of inflation, that is a cutback.

AN HON. MEMBER: Rubbish!

MS. BROWN: That is a cutback. It was the same kind of reasoning that you used with the rape crisis centres; in fact, it is a cutback because it is not keeping up with the devaluing of the dollar. Plus the fact that — I know you will admit this to yourself — the kind of work which is being done by the Pine Street Clinic is really not being done by any other community clinic.

Interjection.

MS. BROWN: It's not your responsibility alone; the federal Department of Manpower and Immigration use the clinic too. The Indian Centre — the Department of Indian Affairs refers people to the clinic too. But in fact, most of the people who use

[ Page 1990 ]

the clinic...I'm not speaking about it just because it happens to be in the Burrard constituency. It's our good luck that it is there, but it really does do a very unique kind of service for the community at large. Its funding needs to be increased if it is to continue to do the kind of work that it is doing in VD counselling, in family planning and even in basic things like nutrition counselling, which in fact the clinic also addresses itself to.

When I met with some of the members of the clinic recently it seemed to me that the difference between what they needed to be able to do the kind of job they want to do and what they are getting is $15,000. They are not talking about hundreds of thousands of dollars, or millions of dollars, Mr. Chairman; we're talking about $15,000. I think the minister got a carbon copy of the letter which I wrote to Mr. Basford, who is the MP for the riding, asking that the federal government participate in the funding for this clinic because, in fact, it is doing work for Manpower and Immigration as well as for Vancouver and for the Department of Indian Affairs.

The other group, of course, that's involved in the business of preventive health, that should be of great interest to you, has to be the women's health collective. They have submitted a budget to you too, and I would be very interested to know what your response is to them because they also are involved in preventive medicine, in counselling, whether its family planning, breast cancer, these kinds of....

Interjection.

MS. BROWN: The women's health collective. You have a copy of their budget, and I would be interested in knowing what your response is to them in terms of their needs, too.

But, you know, the main thing that Dr. Bonham mentioned in his report to the city of Vancouver — and what I want to draw to your attention today — has got, Mr. Minister, through you, Mr. Chairman, to do with the really strange phenomenon of the birth weight of babies in British Columbia, which is lower, so much lower, than that of so many other parts of the world, including countries which we refer to euphemistically as being underdeveloped. What Dr. Bonham brought out.... He said it had to do with the whole business of the health of pregnant women, and, of course, he talked about the fact that a small baby's not just a small baby. A small baby is susceptible to all kinds of attacks during its infancy.

He talked about two-thirds of the infant deaths and disabilities being found in the low birth-rate group of babies. He talked about the milder forms of brain damage found in this group and learning disabilities. All of these things are associated with prematurity and, in fact, with the health of the pregnant woman during the last part — or even the beginning — of her pregnancy. His suggestion was that with planned nutrition and care of women to complement the clinical care, maybe in British Columbia we could do something about this. We could cut down, in fact, on the number of children who are born underweight. We could cut down, in fact, on the amount of money being spent on brain-damaged children, children with learning disabilities and other forms of handicap which are directly attributable to the health of the mother during the period of her pregnancy.

I think that this is one thing that the BCMC had in mind when it recommended, Mr. Minister, the maternal and children's health facility as a single unit rather than having your pediatric hospital off in one place and trying to upgrade VGH, or upgrade Grace Hospital or St. Vincent's, or whatever. I want to say — and I'm not criticizing either VGH or Grace Hospital — that I've had babies in both of those places, and it wasn't great but it was okay. You know, the facilities weren't the best in the world, but considering the age of the VGH obstetrical ward — and I understand people who had babies there, their grandchildren are now having babies there and it hasn't really changed that much — considering the age of that facility, I think they're doing a pretty good job. There's no question about that.

There isn't any question, either, that Grace, as a maternity hospital, is in many ways superior to VGH. I certainly liked it much better. It was a smaller unit. There wasn't as much chance of picking up all these weird kinds of infections that float around hospitals, because, you know, hospitals are the most unhealthy places to be anyway, even at the best of times, and certainly they're no place to be when you're pregnant. Nonetheless, as a maternity hospital by itself, Grace just is not the facility for one reason or another, even with upgrading, to handle this. So the recommendation that came down was to develop a maternal and pediatric unit all in one.

Now there are a couple of really good things that happen in a unit like this that has nothing to do even with the physiology of what is going on. Mr. Chairman, it means that, for example, when women are in the hospital and they're not particularly busy at some time looking after their own children, they can saunter down into the pediatric wing and, you know, cheer up some of the smaller children there who are in either to have their tonsils out or they're in for a long-term period, or whatever. The whole kind of relationship between woman and child is possible in a unit of this sort. In the other sense, too, it's a really good kind of comfortable and warm place if it is your own child that is in the pediatric unit.

I can remember, with the birth of my last child, because we have an Rh incompatibility in our family, that there was tremendous concern that the baby

[ Page 1991 ]

would have to undergo a mass transfusion because of the bilirubin levels and this kind of thing. It would have meant that my newborn would have been removed from me and taken somewhere else to have this done, as has happened to lots of other women in a similar position.

In a maternal-pediatric unit it all would have happened within easy and comfortable walking distance. It means that I could have had the comfort of walking over and seeing how my baby was doing — you know, the kind of reassurance that really no one can give you. It doesn't matter if your doctor comes into your room 50 times a day and says: "Don't worry, the baby is fine." You're going to worry; it's as simple as that. So with the best intentions in the world, nobody allays your worry when your child is not well.

It's the same kind of thing if it's the other way around — for example, if the mother has an infection and has to stay in hospital for a bit longer. It's an easier arrangement, really, in terms of the children's hospital being so close to the maternal wing. It's good! You know, it's the way the whole thing started back in the beginning when women used to have their babies at home, surrounded by their family. There was this kind of warm giving and taking really, from the very beginning. In fact, this is not a revolutionary concept at all; we were going back to basics with it.

It was also good health, as I said before. It would, in fact, have separated both the children and the mothers from all those other weird kinds of infections that float up and down and around hospitals that you're always coming down with, or the baby is coming down with, if you stay in hospital for an extended period of time.

Economically it would have also made good sense. Every way you look at it, financially, emotionally, psychologically — it doesn't make any difference how you look at it, Mr. Chairman — a maternity-and-child health unit makes good sense. For the first time in British Columbia we were going back to developing the kind of centre that we really could have been proud of, and all kinds of experimental things could have happened there. I hate this long kind of reminiscing, but I can remember back in the days of the VON — you know VONs don't function with pregnant women any more — they used to come and visit you on the first day you went home, and then once a week after that to weigh the baby, check the baby over and see that everything was okay.

Interjection.

MS. BROWN: Oh, yes? Not any more. The birthrate in British Columbia went down and the VON phased themselves out of that delivery service. Now mothers with new babies take their children to a clinic, which is fine, but it is not the same kind of thing. It's not the same kind of relationship you would have — that one-to-one relationship where you would sit down, share a cup of tea and talk about the little strange things that your baby did, which you were sure no other baby in the world had ever done before your baby came along, and which should go down in history...this kind of thing.

That kind of feeling could have begun to happen again in a unit as was recommended by the B.C. Medical Centre in its recommendation for the children and maternal health facility. What happened to that? This is what I want to ask the minister: why was the decision made to separate the two out, to go ahead and build a children's hospital? — which I support. We need a children's hospital in this province.

The Health Centre For Children is a disgrace and it has been for a long time. The facilities are completely and totally inadequate. It's not a happy place to be if you're a sick child. It's even less happy if you're the mother or father of a sick child. You are happy when your kids can get out of that place. They are getting good care. The nursing is absolutely superb, but it is not a warm and friendly place to be.

The other children's hospital — which I also know very well, because as a social worker working with Vancouver neurological, I supervised a lot of children in that hospital who had epilepsy and who were in for an extended period of time — again, it's a good hospital. But the kind of facility that we really need, if British Columbia were going to be as outstanding in its delivery of health facilities to its children as it is in some other areas, has to be built. So I certainly support the building of a children's hospital.

What I want to know is why the minister made the decision to separate out the maternal health unit from the pediatric unit when it is so obvious that the two go together and should remain together. In fact, it was budgeted for.

I have a note here that tells me that $80 million — correct? — $80 million was budgeted, Mr. Chairman, to spend on the development of this unit. Now we find that $30 million is going to go to the building of the new children's hospital, and out of nowhere a mysterious $40 million has arrived to build a new hospital facility at UBC, which is not even going to have an obstetric unit.

It's not even going to have an obstetric unit, which doesn't bother me, quite frankly, because it is not the kind of unit that you want to be in when you are having a child anyway. If you have a choice, and you can't have the kind of unit that the task force designed, then you'd be better off to go to one of the smaller hospitals. You don't want to go into that stainless steel facility they are going to put out there, and which is so inconvenient to everybody. The bus facilities, the parking — everything is wrong about it,

[ Page 1992 ]

so I'm certainly not in support of that unit being built at UBC. And I kind of throw that in as an aside.

The other thing that I wish the minister would give me some explanation of is: why is it that when the parents committee approached Mr. Tullidge — the advisory consumer committee, made up almost exclusively of parents, approached to ask to appear before the task force — they were told that the maternal health unit was not within their purview, that it was not part of the task given to the task force? Who made this decision to split the two units? Who was consulted?

You know, I have attended at least two separate workshops, made up almost exclusively of health personnel and women who use those facilities like myself, who have had their babies in VGH and in Grace Hospital, some in St. Vincent's — and none of us were ever asked. Nobody ever asks us. Nobody ever asks the people who use these facilities to at least make some kind of representation before decisions are made. Who recommended to you, Mr. Minister, through you, Mr. Chairman, that we should go back, you know, take this giant step backward to the separating of the children's hospital from the maternal health unit? Ask us. Ask the consumers. Ask the parents who use these facilities. Ask the parents whose children are in these facilities. Ask the fathers. Ask the mothers. Get some input from us too before the final decision is made about the splitting up of this.

I know that BCMC is supposed to be dissolved by June 15. That's the only reason why I'm raising the issue now, because I'm hoping that it's not final and binding and irreversible. I'm hoping that there is still some hope that the people who use these facilities, the consumers, the parents of the children who use the children's hospital, the women who give birth in VGH and in Grace Hospital and in St. Vincent's, can have some kind of input into the kind of facility that we would like to see developed in this province.

It makes us very unhappy when we have to read statistics like the statistics brought down by Dr. Bonham about the high incidence of underweight children born in this province. We're not an underdeveloped province. We don't lack the facilities, you know, to give our children the very best of everything that we're capable of, and we're not doing that. This decision isn't ensuring that. Does anyone care about the health of pregnant women in this province? Does anyone care about their health and the fact that money spent at the beginning to ensure that healthy normal children are born is money saved, because it means at the end there's not all that money being poured into training retarded children, into taking care of your children with disabilities, into taking care of your children with other handicaps, into looking after those women who come out of that experience with various kinds of illnesses and everything else?

This brings me back to my original point. Out of every dollar 3 cents is all the commitment — and I'm quoting from Dr. Bonham and I could be wrong because Dr. Bonham could be wrong too — but 3 cents out of every dollar is the commitment of your department to health. You know, Mr. Chairman, and I'm addressing the minister through you, that is not good enough. Whether it is spent in research, whether it is spent in developing the kind of health facility as recommended by the task force, the maternal and pediatric unit, this is where it's got to be spent, you know, not at the end.

Money spent here is money saved off of Woodlands. Money spent here is money saved in your juvenile detention homes. Money spent here is money saved in your special schools for special training. You spend the money at the beginning, not at the end.

You've got to dedicate more than 3 cents out of your dollar to health. Don't follow the example of the federal government. They're setting a bad example. You can, you know, cut out a whole new design for the delivery of health care in North America. You can start right here in this little province and set an example. You can start out, Mr. Minister, by allotting more of your dollar to health, and the second thing you can do is commit more of your money to funding those community facilities like the Pine Street Clinic, like the Women's Health Collective Society, like the Mental Patients Association, which I'm going to speak on at great length later on. This maternal and pediatric facility, you've got to save it. You've got to save it because it's good. This is the kind of unit that we need.

Interjection.

MS. BROWN: Don't take my word for it, Mr. Chairman. He shouldn't take my word for it, but in fact what he should do is speak to some of the people who have to use the existing facilities and listen to what they have to say too, as well as to some of the people who work in those facilities.

At the last all-day workshop that I attended on this particular issue, there were nurses, dieticians, doctors and pediatricians. They were rehabilitation-medicine people and they were all saying the same thing — that this is the way it's done. They've started a letter-writing thing in support, Mr. Minister — I am sure you're getting lots of these — asking that this maternal and pediatric unit be saved. If you're not going to save it, at least, Mr. Chairman, we should get a rational explanation for this, because when the facilities are built we are stuck with them for 50 or 60 years. You don't build a hospital facility and then turn around in five or six years and build another hospital facility. So this is really a serious decision about the direction of health in this

[ Page 1993 ]

province. I hope the minister will address himself to it.

HON. MR. McCLELLAND: Mr. Chairman, I appreciate the comments of the member for Vancouver-Burrard. We are seeing part of the dilemma we are in right here in this debate today, with the member for Oak Bay (Mr. Wallace) and the Leader of the Opposition (Mr. King) telling us that we need more money for direct hospital care and the member for Vancouver-Burrard (Ms. Brown) saying we should take the money out of hospitals and put it somewhere else, in some area of prevention. Sure, we have to do that to some degree, but we have to come up with a formula in which we can reach that objective. It's the same objective that everybody in this room has, I think. We know that we have to go into preventive care to a much greater degree than we have now.

I think that over the years provinces have been sort of led down the garden path by the federal government, which offered funding in various kinds of programmes with very little flexibility. The provinces found themselves not planning for the needs of health care in their communities but instead planning to take advantage of the federal funding. I think most of us are sorry now that we took that route instead of pressing the federal government to give us a different form of more flexible funding so that we could advance our own programmes in an orderly way.

I don't think that Dr. Bonham is correct in saying that only 3 cents out of every dollar is spent on prevention. I am told that for direct prevention probably 5 to 6 per cent of our budget for public health is spent. But hospitals do prevention as well. Much of this diagnostic service in hospitals prevents illness and allows physicians to detect illness and so is a preventive measure in itself. So to say just three cents out of every dollar is spent on prevention is really not being fair to the system.

Again, with relation to the grants for clinics such as Pine Street, we recognize too that this was a needed service and is serving, as you mention, a population which probably wouldn't get service if there wasn't a clinic like that one available to them. So that's the reason why we have continued to fund. I don't like to keep going back to the problems that we face financially but we do have some serious problems in this province in relation to the finances available to us at the present time. The Pine Street clinic has an increase in its grant by our department from $64,000 to $75,000 this year, which is about a 17 per cent increase.

Interjection.

HON. MR. McCLELLAND: Well, sure. Mr. Chairman, every group that has come to us has asked for a certain amount of money and said: "Look, here's what we need to operate." I am sure that member (Ms. Brown) would not go on record as saying that we should give every group in this province exactly what they ask for in their budgets because every group will ask for as much as they could possibly get to provide an ultimate service. We've got to say: "Look, let's sit down and decide what we can afford to give you." A 17 per cent increase in one year is not bad.

Mr. Chairman, that's the kind of government action that's responsible and the kind of government action that's necessary in dealing with grants of all kinds. We've done that with the Pine Street Clinic.

In response to the questions about the child and maternal health-care unit, we've made a decision, based on the best possible advice we could get available to our government. That decision was to build a new children's hospital in the city of Vancouver at an estimated cost of $30 million. A lot of people came to us, before we were elected and after, who were very concerned about the closing down of Grace Hospital, who had seen Grace Hospital as a facility which had provided excellent service to mothers. Let's separate the needs for prevention while the mother is pregnant, which is a whole matter of lifestyle again which we are all faced with. Mothers, as well as everyone else, have to take better care of their own health. They have to have services available to provide them with good nutritional counselling and they have to have services provided to them to make sure they are able to know the kind of care they have to give themselves in order that they'll deliver a healthy baby.

That's a problem that we are facing in every area of our society today. We smoke too much; we abuse alcohol too much; we don't get correct physical exercise; we don't do up our seatbelts; we drink and drive — those are all changing areas of lifestyle, Mr. Chairman, and so is the problem of delivering very healthy, normal babies into society. We have to deliver those kind of preventive services to mothers. It's not a problem that has just popped up since this government was elected, but it's one that we are going to have to address ourselves to.

But the member talks, Mr. Chairman, as though the Grace Hospital, and Vancouver General Hospital and the new children's hospital were going to be sitting out in the wings there, never talking to each other, and never consulting, and never cooperating. But that's not true. We hope to provide a very high degree of co-ordination of the activities at both Grace Hospital and at the new children's centre, and to some degree at Vancouver General, and that will be necessary in some cases. There are still lots of details to work out. The people like Grace Hospital and they want Grace to continue.

[ Page 1994 ]

We've made a commitment. The cost of building the child-and-maternal health-care unit was, as you've said, approximately $80 million. We made a commitment to build a new children's hospital for $30 million, and we'll rebuild Grace Hospital for approximately $12 million.

It's okay to say, Mr. Chairman, that that money was budgeted by the previous government, but in this instance as in so many other instances we found that there just wasn't any way to deliver on those commitments. That's why the ambulance service is in a little difficulty right now. That's why you wouldn't have been able to deliver that child-and-maternal health-care centre. That's why the government building in Vancouver has escalated in cost the way it has.

Mr. Chairman, it's easy to say that money was budgeted, but you have to deliver it down the end of the road. What we're attempting to do is deliver the best possible service to both the mothers and children in this province that we possibly can within the resources that we have available.

MS. BROWN: I just want to raise a couple of supplementals to what the minister said.

First of all, Mr. Minister, I think that as far as the Pine Street Clinic is concerned I agree with you. Certainly not everyone who applies to you gets the budget they ask for.

In fact, Pine Street's budget was absolutely bare bones, and the addition they asked for was really to fund the salary of one person, and not the $250 a day that one pays consultants and this kind of thing. It was going to be the salary of one person at $8,000 — that was the salary they asked for, you know — who would be at the reception desk, telephone, everything as it goes.

As you know, the Pine Street Clinic is not only open five days a week, but it's also open Monday nights and Thursday nights too. It's also open on Saturdays, and they find that they would also like to be open on Wednesday nights.

You can't do this when you only have two staff people in the office as such — you know, answering the phone, welcoming people, dealing with files and everything. So that's what they're asking for, a third person to make it possible for them to be able to have these very unusual hours. I don't know very many doctors' offices that operate those kinds of hours, and as I've said before, most of the people who use this clinic just walk in off the street and, you know, they don't make appointments and they don't use the traditional kind of hours.

I think that certainly it would be worth supporting the request I sent through to Mr. Basford to try and get some federal funding in there, which I really think they should be doing. I think they're ripping us off, because immigrants are using that clinic to get their physicals so that they can meet the requirements for the Department of Manpower. and Immigration. Manpower sends people to that clinic. The Department of Indian Affairs uses that clinic.

It makes no difference to me where the $15,000 comes from as long as it's recognized that it's not frills that they're talking about, that they're talking about basics such as one salary plus supplies. That's what it is.

If you could support the request I've put in to Mr. Basford to get Marc Lalonde to come up with some of that money, then at least that would be one way of meeting the budget.

As far as Grace Hospital is concerned, Mr. Chairman, I know that the minister was lobbied to save Grace Hospital. There's nothing wrong in that. If you really believe in something you lobby to save it. What I'm saying is that there are a large number of people, obstetricians, pediatricians, nurses, as well as women who have used Grace Hospital as well at VGH and other places, who say it's not a good facility in the way that this maternal and pediatric unit would have been.

Just upgrading it with $12 million or whatever isn't going to make it the facility we could have...$3 million? $12 million. I understand that this upgrading is going to involve removing 50 new-born bassinets from it; it just doesn't sound kosher — but anyway.... The fact remains that the concept of the maternal and pediatric unit is the one that's a good one. That health unit is a good one, and just because you were lobbied to save Grace Hospital is not reason enough, Mr. Minister, to discard this particular facility.

I certainly hope that the decision is not irrevocable. I hope that you will listen to some of the lobbies from the other side too. Nobody has anything against Grace Hospital, but we're saying that this is superior and this is better if we really are concerned about giving topnotch health care to the people of this province, that's all.

HON. MR. McCLELLAND: I appreciate the member wanting to get more money for a clinic which is in her constituency, and I would try very hard to get one for my constituency too, but we've given them an increase, Mr. Chairman.

Every one of these grants that comes in with a request is an absolute bare-bones budget. But the department has to decide what it can do within the amount of money it has available, and we decided to give 17 per cent to the Pine Street Clinic this year because we know it's a very good facility. If the member wishes, I'd be very happy, through our department, to send a letter to the Hon. Ron Basford supporting your request for federal funds, I'd be very happy to do that, and I've instructed our deputies to do that now, Madam Member.

[ Page 1995 ]

MR. COCKE: Mr. Chairman, I covered this pretty well on Friday, but I just want to remind the Minister o f Health that his discussion vis-à-vis the child-and-maternal-care unit is about as artificial as that minister could possibly make it. He made a political decision in haste. He had consultation with too few people to have made that kind of decision.

Mr. Chairman, I suggested to the minister — that minister that's calling poor-mouth across this province — that his direction is the most wasteful direction that anybody could imagine.

What are you going to do with the high-risk maternity cases? They are going to be sent to the VGH, blocks and blocks and blocks from the pediatric centres, the sophisticated facility that they are going to build with money that comes on a volunteer basis, if Mr. Tullidge is to be believed — and that is that anything over and above making it a hospital for tonsillectomies has to be volunteer money. That's pretty risky, Mr. Chairman.

Interjection.

MR. COCKE: I'm just saying exactly what that chairman of the children's facility said at their annual meeting.

Interjection.

MR. COCKE: Mr. Chairman, the fact is that they were to have in the child-and-maternal-care unit a combined, co-ordinated facility. Right now you're going to have duplication: you're going to have pediatric facilities at the VGH; you're going to have to duplicate those facilities up the hill and then they're going to duplicate them again over at Grace Hospital.

We suggested it to Grace Hospital and, as far as I was concerned, they were in agreement with coming in and running the maternal side of this new unit. Mr. Chairman, the minister has taken us back, taken us back for political reasons, and I think that it's just too bad.

I would like to be able to sit here and listen to that minister with some feeling that he wants to make some progress in health care. But it strikes me that he's making decisions based on taking care of the needs of some of his friends, and that's not good enough.

There's nobody who can tell the broad spectrum that is the people who are intimately involved in delivery of health care across this province — that those two facilities should be divided, and that minister knows it, Mr. Chairman. And they don't have to be built for the phenomenal amount of money that everybody's bandying about. The fact is, the programme came in and that programme was turned down. It was reduced considerably by your own department officials, and valid, too, was their particular case.

Mr. Chairman, just one other word before I sit down. Certainly I don't want to interfere with some of the other questions that are going to be coming up, but the minister was very, very eloquent a while ago in talking about the ambulance service and what was cut out and what wasn't cut out. I've looked over my notes in the intervening period just to see where we were going.

Mr. Chairman, the last EMA-1 programme ended in December — that's when it was supposed to end — and the last EMA-2 programme ended last September. After that, as I recall, emergency health services put in a budget in October and asked for, I think it was six or eight EMA-Is and two or three EMA-2s. Now that was all being looked at. But this minister has just cut it out; then he turns around and blames the former government, the former government which implemented some good solid thinking, some very good research in contrast to the way this minister has treated — disrespectfully, as you can imagine — the tremendous amount of thought and care that went into the development of the child-and-maternal-care institution in this province.

I agree totally with the Member for Vancouver-Burrard (Ms. Brown). She's absolutely right. The body of opinion in this province is that the minister is on the wrong course. I would wish he would be man enough to stand up and admit it, Mr. Chairman, because he's made a terrible blunder in this particular instance.

HON. MR. McCLELLAND: On a point of order. I never expected that I would ever find myself in agreement, at least very often, with the Member for New Westminster (Mr. Cocke). And I don't mind debating with him on issues of health care I but I really think that he's going a little far, and I'd like him to withdraw any suggestion that I'm making decisions to help my friends. I think that's a scurrilous statement for him to make, and one that is out of order in this House.

MR. COCKE: Mr. Chairman, I do not believe that the Minister of Health is serious in asking me to withdraw a statement when I know the people who were lobbying. I knew, for instance, that the Minister of Education (Hon. Mr. McGeer) has lobbied his head off for the total destruction of BCMC. I know perfectly well that the Minister of Health was lobbied within his own group. I am not suggesting anything further than the fact that you were lobbied, and you were lobbied hard. He made decisions, Mr. Chairman, that can be questioned on that basis because he couldn't possibly have developed the kind of research and the kind of background information in the kind of short time that he took to make those decisions,

[ Page 1996 ]

other than to have made those decisions based on suggestions from either his friends or, possibly, his enemies. If he is taking advice from his enemies, so much the worse, Mr. Chairman.

MR. CHAIRMAN: Hon. Member, you are not imputing any improper motives of any kind?

MR. GIBSON: Mr. Chairman, this being my first chance to intervene in this estimate of the minister, I want to extend to him my good wishes in a difficult portfolio. While we may differ on ways of achieving these ends, I know that every member of this House wants for the people of British Columbia the best possible medical care. The minister is charged with looking after that in a very difficult cost position in this year, as in every year, because you can never have the resources you want.

I want to, in that context, quote from something that was written by Ron Longstaff, who is chairman of the St. Paul's board of management, in the BCMA News recently. He noted that in the five years since 1970 expenditures on hospitals have increased by 129 per cent and the per diem rate by 112 per cent. That is quite a rise; there is no question about it. But later on in the article he says this: "When hospital services for British Columbia are compared with the other nine provinces, B.C. stands ninth in terms of per capita cost" — that is ninth out of 10 — "and ninth in terms of operating expenditures per patient-day and first in percentage occupancy." That is from Statistics Canada, 1973. The situation may have changed somewhat in the last couple of years, but I wouldn't think enough to move us too much out of that very low position. So I would suggest to the minister that while he is in a very serious cost position, this kind of thing is ammunition in the constant battle with his colleagues for a greater share of the province's resources.

The most sensible thing the minister has said yet in public, as far as I know, is his emphasis on the field of preventive medicine. I suspect that this is no panacea. Physicians will tell you that they give good advice to their patients all the time — that they are eating too much and drinking too much and so on — then the people go right out and carry on and do the same kind of thing. So it is a long kind of a battle and difficult for all of us to perhaps observe the health habits that we should.

But I just want to read something into the record from the front page of the Wall Street Journal, March 22 of this year. They have been doing a series on the year 2001 as to how things are going to look in our society. A couple of short sentences here — they were talking about health care: "Nothing that emerges from a clinic or a test-tube will contribute nearly so much to better health generally as a little individual self-care in the form of wiser living." I think that is more or less what the minister has been saying.

Another quote: "Health authorities believe that more doctors and hospitals, more and more expensive machines for diagnosis and treatment, and new drugs and vaccine, will have no more effect on good health, overall, than self-imposed changes in the way people live." I think that is more or less what the hon. first member for Burrard (Ms. Brown) was saying a few moments ago, too.

So the question is: what are the precise ways and means by which this appreciation of the need for self-care is going to be brought about in our province to the extent that the government can find ways of doing that? One way, certainly, is by working through the school system. The Minister of Education (Hon. Mr. McGeer) said some good things in those regards. We have to change our physical education programme to make it right across the board, not just the elitist concept of the good athletes participating, but every child in the school system learning in those school years to have good health habits and exercise habits for all their life.

We have to have adult education too, because the problem is certainly more noticeable among adults than among young people, although young people all become adults in due course and have those problems. But the people who really need the emphasis in fitness and amateur sports right now are the adult population.

I would ask the minister if he could tell us a little bit about the concept he has in mind to bring about an increased understanding of this. Certainly part of it will have to be through an advertising programme, I would think. But part of it, too, has to be through tangible financial support for fitness facilities.

Let's look right in our own backyard in the public service of the province of British Columbia. To what extent can we, at a reasonably low cost, provide exercise facilities — enhanced exercise facilities — for people in the public service? I am not talking about the low-cost-gymnasium sort of approach. I know that that does exist to some extent right now. To what extent can we expand it, and to what extent is the government going to be prepared to actively increase their support for fitness programmes and recreational facilities in communities? That is the first line of questioning there on preventive medicine.

A second very general question: could the minister say to what extent he and his officials are pursuing the whole concept of screening programmes? We heard a great deal last session about the concept of mammography, for example, as it relates to breast cancer. In that area and in others, what is the cost-benefit payoff of the sometimes very expensive but useful programmes of this kind in the early detection of disease or disease inclination?

I'd like to pursue this general field of cost-cutting in health care a little bit further, moving past

[ Page 1997 ]

preventive medicine now and asking the minister if he has in his department or if he plans to establish a task force charged with looking at the operating expenditures of the health delivery systems in British Columbia, particularly in the hospitals, and saying: "How can we increase the cost effectiveness of these particular areas?" Does the minister have such a task force in his department? If not, will he consider setting one up that is particularly concerned with cost control?

I wonder if the minister could give us some forecast as to the changing balance in the need for acute beds versus intermediate-care beds versus extended-care beds versus home care. There seems to be a shift in this pattern. I know, in my own community of North Vancouver, the Lions Gate Hospital has found it possible to close some of their acute beds, and yet their extended-care unit is always full with a long waiting list. I know that part of this problem has to do with federal-provincial financial arrangements and so I want to, in this department as in so many others, call for a general fiscal stance of the Province of British Columbia that says: "We want to opt out of federal cost-sharing programmes and get back the tax points instead so that we can spend the money in ways that reflect our own priorities, in this case particularly intermediate care as opposed to acute care which, of course, is eligible for federal-provincial sharing.

I'd like to ask the minister if he will, over the next couple of years, initiate surveys into the extent to which paramedical personnel can be substituted for perhaps, in some cases, overqualified medical personnel, given the particular kind of task that they're being asked to perform. Not being a medical professional, I don't know the extent to which this is possible, but it is at least in theory an area where costs could be cut.

Moving on now to a new area of discussion, we have heard in this debate so far a great deal of discussion about the siting and construction of new hospital facilities in the province, but particularly in the greater Vancouver area. This strikes me, Mr. Chairman, as being an enormously complex question. We've heard passionate arguments on both sides of the case. The expertise is not by any means all within this chamber, but the Legislature does nevertheless have a duty to study the question closely because we're talking about hundreds of millions of dollars. I've heard one estimate of $1 billion over the next decade.

We've seen various briefs. Other members have related to this brief from the advisory consumer's committee to the B.C. Medical Centre. An impressive document I found it, and yet it came out for decisions which the government has seen fit to go the other way on. For example, they came out in favour of the combined pediatric and maternal centre; they came out for the BCMC rather than against it, and it was subsequently disbanded.

Then there's the question of the University of British Columbia medical facility. Now I'm told, Mr. Chairman, and perhaps the minister can tell me if these figures are correct or not, that around North America the average university hospital occupancy runs around 60 per cent, whereas the average downtown, acute-type hospital runs closer to 100 per cent, and that the average stay at a university hospital is almost four days longer at 14 days as compared to 10 days. Now if these two figures are true, they raise large question marks in my mind.

The obvious answer, it seems to me, from a procedural point of view, is to send this whole question to a legislative committee so that we can call expert witnesses and hear in public what there is to be said on both sides of these cases. In looking at a billion dollar decision, I don't think the few months' delay that would be involved would be out of line, and I think it might help take a good deal of the heat and criticism off the government, too, if the minister would agree to that. We could call members of the department; we could call Mr. Allan Kelly, who I believe is senior adviser to the minister of these questions at the moment, at least in respect to Vancouver hospitals. We could call people like Jack Christensen, who, I might say, I don't think has had due recognition for his really selfless efforts on behalf of the hospital situation in British Columbia over the past few years, putting in a great deal of his time travelling around to other areas at his own expense to look at other hospital situations and so on. People like this should be recognized and should have a chance to give, in a public way, the benefit of their tremendous experience and study into these questions.

I say all of this in an attempt to be helpful, because it's clear that there are very strong opinions on both sides of this case, and I'm not convinced that we're going about it in the right way.

Moving from there onto the question of the recent hospital strike, I would like to reflect somewhat on the lessons that I think it taught us. The main lesson to me is that the existing legislation doesn't work; above all, the definition of what is "essential."

In my own community, again on the North Shore, the Lions Gate Hospital had 634 HEU employees. They did not have any pool of manpower such as the student nurse situation which exists at VGH. They had a total of about 1,200 employees, including registered nurses and other small union groups.

Out of that 634 HEU personnel only 29 were designated as being "essential, " the smallest percentage of any hospital that was struck, I believe — In the laundry, which has to work two shift, a day, seven days a week, two union members out of 70 were designated as being essential — two out of 70!

[ Page 1998 ]

So we had a situation where volunteers were coming in, working high-powered and dangerous machinery and there were a few near-misses in terms of serious accidents during that time. There was a situation where five out of 110 union employees in the food service line were designated as being essential, again two shifts a day, seven days a week.

Now I'm not saying this is the minister's fault. This wasn't under his department. What I am saying is that in the long run, that would have led to a serious medical impact, I believe, inside the hospital — but certainly outside the hospital. I know that the minister feels his monitoring inside the hospital showed that medical standards were being kept up, but, Mr. Chairman, people were getting tired. The supervisory staff who had to maintain some of these essential services were getting very run-down, and you can only keep that up for so long.

Outside the hospital, in the community, where people were waiting for so-called elective surgery, you can imagine how a person feels when their doctor tells them that they have a brain tumour, say, or some other symptom that requires surgical intervention to determine exactly what has to be done, and then be told: "But we're sorry. There's a strike on in the hospital. This is an elective situation and we don't know when you can get in there." It's putting it mildly to say that this weighs heavily on the human mind.

I hope that this will never happen again in our province. The 21-day cooling-off period we now have is the right move, and legislation thereafter will be the right move, if it's required.

But what led to this problem in the first place? The pressure, Mr. Chairman, was not on the real parties to the dispute, the pressure in its heaviest sense. The pressure was mostly on people who were sick, inside or outside the hospital, and on the administrative staff in the hospitals — administrative staff. I might say, that had very little to do with HLRA, with controlling HLRA, which, of course, represents many, many hospitals, and the administration of any single hospital isn't going to do much to call the tune there.

The pressure wasn't sufficiently on the government — which, to me, is the real employer, because there's no question that somewhere down the line it's the government that's going to pay the bill. Whatever the settlement arrived at here, it is the government that's going to pay the bill, and therefore it should be the government that is in there, up front, doing the bargaining, in my opinion.

The hon. Leader of the Opposition (Mr. King) suggested another way out. He suggested, in effect, to make the deal and see if the AIB goes along with it. Well, that's fine, and I think we ought to make our agreernent with Ottawa just as quickly as we can on the AIB, although I don't happen to like the way it is being done through Bill 16. But I don't think that's the complete answer, because, to me, before anything goes to the AIB the employer must take some responsibility itself. They must take the line: "What do we think is right in these particular circumstances? Given the comparative situation of the employees, given the ability to pay, what do we think is right?" And I think that the government should have been much more up-front in terms of admitting their responsibility in this regard, because there's no question, however you slice it: it's the government who in the end is going to call the tune on what that settlement is. So let's admit it.

Next, Mr. Chairman, I would ask the minister if we might have a status report on private hospitals. What is the government policy on their continuation? Are they seen as being a useful, continuing aspect of the health-care scene in British Columbia, or are they something to be phased out? I wish the minister would tell us his policy in that regard.

Next on private hospitals, as long as they do continue in operation, what is the government policy on making it possible to have something approximating wage parity?

There is a dispute on at the Glen Hospital right now. The Glen Hospital employees circulated some MLAs last fall and at that time they mentioned that their wages were $2.50 to $2.81 per hour, whereas they compared that with public hospital wages of $4 and over per hour. Now if the discrepancy is really this large, I think it is something for the minister to be concerned about. I appreciate that he does not operate private hospitals, but he does have something to do with the amount of funds that they have. I would ask him if he does not agree in principle that there should be something closer to wage parity for equal kinds of work in equal kinds of institutions.

Other members have mentioned the press release in the last few days that suggested a teaching unit at Riverview Hospital is going to be transferred from the Department of Health to the Department of Education. The question I would like to ask there.... There are certain health programmes, as I understand it, now being taught at this Riverview unit. Will those be continued under the Douglas College superintendency, and will they, hopefully, be upgraded?

The next topic I would raise, briefly, although it's a huge topic, is that of alcohol abuse. Nobody questions the magnitude. Nicole Strickland, recently in an article in the Vancouver Province, put it at a cost something like $250 million a year to the British Columbia economy. A U.S. survey that I saw recently felt that it was about $15 billion a year for the United States, so on that 10 per cent rule of thumb we sometimes use for Canada, that would mean something like $1.5 billion in our country, so perhaps that $250 million for B.C. is not too far off.

[ Page 1999 ]

Of course, the effects go far beyond the effects of dangerous driving, accidents, and so on that we see. Here's another quote from that U.S. study: "An alcoholic employee is absent two and a half times as often as a non-alcoholic; indeed, he's partially absent even when he's working, often, demonstrating much less efficiency than his non-alcoholic colleagues." This is not a legal problem, but a medical problem that is tremendously important in our society. I know the minister recognizes it, because he's made speeches about it. It was one of his first priorities as a minister. What I'd like to know, with some detail on it, is what this government feels it can do about this.

In a related field, I'd like to know the minister's stand on drug abuse. The cost here is also tremendous. It's been put at $250 million a year. It's been estimated that we have something like 10,000 addicts needing something like $70 a day to support their habit. There are all kinds of theories on what ought to be done. There was a member of CLEU who expressed a personal opinion recently that heroin should be decriminalized. It goes all the way from there up to a totally hard line. This minister and the Minister of Education, both, when they were on the opposite side of the House, seemed to be trending rather towards the hard line, in terms of how one goes about combatting drug abuse. I wonder if the minister would, in a general philosophical way, as detailed as he can get it this time, tell us where the government is going to come down on this tremendously important question for British Columbian society.

I have a final question before I sit down. The minister advised us in the House a couple of weeks ago, in response to a question, that he would have his department undertake an investigation of the way in which the abortion law was being interpreted in British Columbia. In response to a later question he said that that report would be made public. What I'm concerned to know at this stage is how that report, when it is concluded and made public, will be followed up. It's a question which is not only one of health but one of law as well. I would ask him if that report, when it's received, will be referred to a cabinet committee of the government for study as, in my view, it should be. It should be taken seriously. Further, would the minister give us an undertaking that he would follow this question up — which is not merely a British Columbia question, as we all know — at the next national conference of Ministers of Health, and try and learn something about the way that other provinces are tackling this very difficult situation?

We heard a good deal in this debate about the important question (if the care of live babies, and how the hospital facilities should be set up for them, but with the British Columbia abortion rate being over double the national average, and running at about 30 per 100 live births, live babies are certainly not the only question that has to be tackled in this regard. So I say to the minister that that report he's getting will be a very important one, and I'm extremely interested to know how he will proceed with it once it is received.

HON. MR. McCLELLAND: Mr. Chairman, I'll try and deal with the items raised in the order that they were raised by the member for North Vancouver-Capilano.

Starting, I guess, with the whole problem of prevention and preventive medicine and education, the member will realize and understand that this whole concept crosses a lot of boundaries in relation to different departments of government. I guess, in reality, you could take in half of the ministries — Recreation and Health and Education and so many others — which is the reason we've attempted to bring together cabinet committees which would co-ordinate the development of these programmes on an inter-cabinet basis. But from the point of view of my own philosophy, and some of the things that we can do and are doing now, certainly education is one of the major thrusts that we'll have to make in the future. I'd go a lot further, I think, than the member, in terms of just physical education in the schools. I think somewhere down the line our schools have got to develop more than that. Physical education by rote never worked in the past, and I don't think it will ever work in the future, but if we can somehow develop in our schools a programme of lifetime sports, rather than the kind of sports that we have to give up when we're just starting to go to pot — at 40 or 38 or 35 — that's probably the way to go down the line.

Interjection.

HON. MR. McCLELLAND: Yes, that's another problem. Recent studies of our young elementary school students have shown that they're going to pot at that young age.

It's not just enough to say: "Let's stand in place and flap our arms." That's not the kind of programme we want to see developed. Those are the kinds of things we are going to do.

Action B.C. Is getting continuing funding from the government, and it's doing a good job in bringing to people the awareness of the need for good physical condition. The programme it put on at the Pacific National Exhibition last year was tremendously successful and we know that it will be successful again this year. The travelling portion of Action B.C., where they go into shopping centres with the Fit Kits and with the programme just to bring that awareness to people is, again, tremendously successful on a pretty small budget. Hopefully, again, we can increase

[ Page 2000 ]

that budget when the time comes along.

Individual health units throughout the province are providing programmes of good fitness for those people who are in contact with them. So that's the kind of programme that is developing.

Most of you are probably aware that in the public service we have at least taken some halting steps in developing physical fitness awareness among the public servants of British Columbia with the physical activity centre on Superior Street here in Victoria. That, too, I understand, is very successful. Hopefully, again, as time goes on and resources allow, those programmes will be expanded.

I will deal with your question about alcohol a little later. But here again, in terms of prevention, I think if there's one area in which we can point with pride it is to the occupational health division of the Public Health department and its screening programme of sorts — first of all, in identifying people in the public service with alcohol problems and, secondly, attempting to catch those people, get them back on the job while they still have a job to go to and while they still have something to lose in terms of not only their jobs, but their family, their dignity and their self-respect. That's a programme, again, that's showing us the area we ultimately have to reach to solve this whole alcohol problem — get the people before they get down to the level where they have lost everything and have nowhere else to go. That programme is working and it is a very excellent programme, one which I am very proud of and which I want to commend our people in occupational health for developing.

The screening programmes of various kinds which the member mentioned — I guess the most visible is the mammography units which have been placed in 26 hospitals in the province. However, most important aspect of that programme, I think, is not just the placement of the units but the evaluation that will go on after those units have been in place for a while, because that's an important accompaniment ot the whole programme.

From the point of view of a mass screening programme, we are going fairly slowly on that because we see some areas of concern. There is a mass screening committee which is reviewing this whole programme. A federal-provincial task force has looked into it as well, and it's felt to be an effective programme. But here again, some of the side effects might be of concern in the proliferation of radiology to the people in risk. So all of those things have to be considered and are being considered. We've just felt that we should wait for the results of that screening committee before we move too quickly into that programme.

It's been agreed that once we do move we will concentrate on the high-risk groups because there is a lesser frequency of testing on the lower risks, and so we will have a lesser frequency of testing on the lower-risk people. So those things are going ahead, and that's a type of preventive medicine which is very important to the women of our society, Mr. Chairman.

You raised a whole philosophy of health care in terms of the relationship between acute-care, extended-care and intermediate-care facilities. I don't know whether you are aware of the position that British Columbia took at the recent Health ministers' conference, but we did take a very strong position on the development of low-cost alternatives coupled with, as you pointed out, a strong request for a commitment from the federal government to give us a global review of all the cost-sharing funding being done between the provinces and the federal government.

[Mr. Schroeder in the chair.]

As you have stated, there has been a degree of inflexibility in all this funding. As I mentioned earlier, we've been sort of led off down wrong paths, perhaps, in developing these low-cost alternatives.

Initially, at the request of the federal minister who offered to get into some sharing of low-cost alternatives, on a short-term basis at least, we said: "Okay, let's accept that right now. As a short-term basis, put the global review in place, but British Columbia is into a lot of these programmes already." We are into home care, we are into some of the low-cost alternatives; and we are into intermediate care on a small degree, but we'd like to get into it on a much larger degree. We indicated to the federal government that we had given a commitment to the people of British Columbia that we wanted to have a full intermediate-care programme in place in this province by the end of the 1977-78 fiscal year.

Unfortunately, British Columbia's position wasn't shared by some of the other major provinces who said that they wouldn't go into even this short-term sharing without the commitment first from the federal government of new cost-sharing proposals. We felt that was wrong, that we should have gone with what we could get now providing we had that commitment about the review. But the federal government said: "Okay, if you don't want it, we'll put it on the shelf until October." We think that's another six-month delay in getting on with some of the programmes we'd like to see started in British Columbia, but we don't have any choice. Hopefully, Mr. Chairman, through you to the member, we'll be able to develop through the First Ministers' conferences all of the things that will be needed to get us into this kind of sharing as quickly as possible and, again, with that kind of flexibility which will allow us to have both a national system of health care to make sure that one province doesn't suffer in

[ Page 2001 ]

relation to another and still have the adaptability to be able to develop our own low-cost programmes in our own province. So that's where we stand on that at the present time.

Yes, we don't have a task force on the university hospital at the present time, but we do have.... Well, we have a task force sitting down to decide where and what kind of facility should be developed, both at the university hospital and at the other major teaching hospitals in the province, because we've said right from the beginning — and I know that this got lost somewhere down the line — that the two have to go hand in hand. There couldn't be a university hospital out there in isolation; it had to be a part of the total package of delivering education to double the size of the output of the medical school of British Columbia.

I believe you said that the statistics show that university hospitals generally have a longer patient stay — four days or something — than perhaps general hospitals do, and that's correct, as I understand it. I'm told, though, that perhaps part of the reason is because there are a lot of referrals of difficult cases made to those hospitals and they stay a little longer because of that.

The other thing on which we've instructed our task force, in its terms of reference, is to ensure that whatever gets built on the UBC site is a family-practice hospital. We're not going to build another white elephant, such as some of the other provinces have. We're going to have a family-practice hospital on that site that will be completely open to family physicians. It won't be a closed hospital, it won't be a white elephant, and it won't be 2,500 square feet per bed.

Interjection.

HON. MR. McCLELLAND: Well, there are a whole lot of people at that end of the municipality that you serve, Madam Member, and it will be a family-practice hospital.

Mr. Chairman, the member talked next about the hospital strike. I couldn't agree with you more that we hope it'll never happen again. It could have been a tragic situation and, sure, there were problems mounting, but I'm sure that the member will have to agree that this was a legitimate labour dispute and that every effort had to be made during that legitimate labour dispute to attempt to get the two parties involved to reach a settlement among themselves, with any help that the Department of Labour could possibly have given to them. I think any other approach to that dispute would have been irresponsible. It was when it appeared certain that that method wasn't going to work and that there was the possibility of those problems mounting in the community — and I'm convinced, Mr. Chairman, that we were providing pretty good patient care under very difficult situations inside the institutions.... But those problems could have started to mount outside and, again, that wouldn't have been tolerable, so the government took some action. I agree with you that it was the right action, and we'll take whatever other necessary action comes up later on.

I don't agree — perhaps my opinion could be changed — that it should be the Department of Health which is in direct bargaining with the unions in relation to hospital disputes and hospital salaries. If we said, Mr. Chairman, that we were going to do away with hospital boards and the Department of Health was going to directly take over the hospitals themselves — and that's been suggested to us by some of the union officials — then, okay, we should get into direct bargaining. But we have a system in this province of societies which operate hospitals and are charged, through the Hospital Act, with all of the necessities of operation of those hospitals, and I just believe that that's one of their responsibilities. Maybe somewhere down the line I'll be proved wrong on that, but at the present time that's the way we're going.

In relation to the private hospitals, the member should know that both the Minister of Human Resources (Hon. Mr. Vander Zalm) and myself, have informed the association on a number of occasions that the minute this session is over we wish to get into negotiation with them on a very in-depth basis to find out what they need to operate the private hospitals. We can't do it right now. It's a very major job. The association has welcomed that approach, and we'll be sitting down with them and coming up with a new funding arrangement as quickly as we can.

Riverview. If the member, Mr. Chairman, had read the rest of that press release that was let out from Riverview, he would have been assured that the health-related programmes are going to be continued and expanded.

It would take an hour and a half to talk about alcohol and drug abuse, I suppose, but basically, I guess, I've mentioned some of the things we're doing in relation to alcohol abuse. During the speech in debate of the budget I went over the costs of alcohol to this province and others, and I wouldn't like to repeat all that at this time. It's a terrible problem. There isn't any doubt about that.

In fact, it's probably our No. 1 health problem and it's the reason that I made a very strong plea at the beginning of our term to have the Alcohol and Drug Commission transferred over to the Health department. Maybe that wasn't necessary but we felt that, rightly or wrongly, the Alcohol and Drug Commission was getting into too much of an arm's length position from government and really wasn't able to co-ordinate all of its programmes with the kind of programmes that we were already doing and perhaps the kind of programmes that we wanted to

[ Page 2002 ]

initiate in the department as well. I think it's going to work out. I think that we're going to be able to develop the kinds of programmes that will at least start to tackle the monumental problem that faces us in relation to alcohol abuse.

One of the areas in which we want to go as quickly as possible — and it's one in which we're in a little dispute with the city of Vancouver, for instance — is in the area of developing a medium-term, at least, rehabilitation centre for alcoholics.

We've got a start on the detoxification centres. Because of the addition now of the new Pender Street detox centre in Vancouver and the decision made just recently not to close down the old Salvation Army detox centre, we have provided the city of Vancouver with 24 more beds than they would have had, come the opening of the Pender Street detoxification centre. So we've got an addition of 24 beds in relation to what would have been built at China Creek. I think China Creek was to be 20 beds. So we're ahead of the game there.

Now we think the next step is to provide a backup for the detox centre, and that's where our priority lies at the present time. It's no good just to build another jail with a few more beds that might be a little fancier than the Vancouver city hall. A detox centre without the back-up facilities could degenerate into just another holding unit where you put them in the front door, they go out the back door and, you know, there's nothing done, really. But if we can get that back-up service as a priority item now, I think that's a start at least. Certainly there's going to be more detox beds needed down the road. Let's get the long-term facility first.

MR. GIBSON: What do you mean by a back-up service?

HON. MR. McCLELLAND: Well, you know, a detox centre is going to hold someone for 24 or 48 or 72 hours. That's not good enough. We need to have somewhere where we can transfer those people who are able to have help into 30 days or 38 days or whatever it is. We think that's the priority now, to back up the present beds that are available. I think there are 44 detox beds available now in Vancouver and, as I say, that's 24 more than there were before.

There's where we want to go next and that's what we're attempting to convince the government to do. In all the programmes of drug abuse, and you've mentioned that I've been called a hotliner...

MR. N. LEVI (Vancouver-Burrard): Hard-liner!

HON. MR. McCLELLAND: ...a hard-liner by that member over there on a number of occasions, and I suppose in some ways I am and I don't apologize for it, and I'm not going to apologize for it now.

Our first concern was what we were doing with the money that was available to the Alcohol and Drug Commission. Again, because I think of this arm's length relationship with the Alcohol and Drug Commission in the past, there really hasn't been, Mr. Chairman, an effective evaluation programme of the areas in which we're providing funding now. We've sent a lot of money out into the community over the last few years, and some of them are doing good jobs, I suppose. Some of them probably aren't. Some of them may be doing nothing at all in relation to helping the drug addict. We don't know. The goal that I've set for the Alcohol and Drug Commission in the Department of Health at the present time is to take this fiscal year....

We've provided the funds that we have available mostly to the existing agencies with hardly any new agencies funded, because we just didn't have the funds at that time. I've said we need to hire a few people who can do the kind of evaluative jobs that will let us know what those programmes are doing. Once we know where we are, then perhaps we can decide in a better way where we're going.

We have set up an advisory council on drug abuse, and that doesn't just include the so-called hard drugs. We're talking about all kinds of drugs including alcohol in this. We think it's a very good representative council, with people from the city of Vancouver, people from the regional district, from the British Columbia Medical Association, from consumer groups....

MS. BROWN: Do you have teenagers on it?

HON. MR. McCLELLAND: Well, we don't have any teenagers yet, but we certainly have the opportunity to bring teenagers in. That's right. I agree that that's a terrible.... That's one of our most pressing problems at the present time, the increasing incidence of teenage alcohol drinking. We don't have a teenager on it. That's a good idea. I'll talk to our Alcohol and Drug Commission about it. Maybe we'll put a teenager on that advisory council.

They've had their first couple of meetings now, and we hope that that advisory council will give us the kind of input that will allow us to develop some ongoing problems in this whole area. I don't have the answers now. I really want though the end of this fiscal year to have some answers to the community programmes that we're funding, and by then as well we'll also have a positive direction in which this province intends to go for the balance of this government's term at least.

Mr. Chairman, I think I've answered, as well as I could, all the questions.

MR. GIBSON: There was one further question I

[ Page 2003 ]

raised, Mr. Minister, through you, Mr. Chairman, and that is the procedure that's to be followed once you've received the report that your department is making on the abortion question.

HON. MR. McCLELLAND: It's difficult for us to say what the procedure will be without knowing what the results of any studies that are done will be. But I've said that we'll make any information that we have public, but what's come to my attention since the announcement that we made, and what I have to advance further with the federal government and others, is that there are at least two studies going on right now into the therapeutic abortion committees — one by the federal government which was announced six months ago by Justice Minister Otto Lang. The committee's report again was to be made public, and, as I understand it, that group has just come to our people for input from us.

At the present time there is also, as I understand it, a study done by, I believe, the Law Reform Commission which is about to be made available to us. I think what we should do is look at those before we enter into any further study by our own department. We will take what we can out of those two studies and then reinforce them with the needs of our own interdepartmental committee.

What I'm saying is that there's no sense in wasting all of the valuable time that's gone into those other two studies. I want to read them before we do anything else, and then from the results of all of the studies we'll decide what route we'll take.

MR. GIBSON: This is something new, Mr. Chairman, so if I could just....

MR. CHAIRMAN: Would the members allow him another supplementary? This is the member for North Vancouver-Capilano.

SOME HON. MEMBERS: No, no!

MR. L.B. KAHL (Esquimalt): I've been waiting since 2:30 p.m. to say something, and I think the member for North Vancouver-Capilano (Mr. Gibson) can have a supplementary in question period.

MR. CHAIRMAN: Order, please, Hon. Member. I think the Chair this afternoon has done everything possible to allow every member an opportunity to speak. The member for Esquimalt has the floor.

MR. KAHL: Thank you, Mr. Chairman. I was pleased to see in the budget the Minister of Health increased in his budget by $148.1 million — an increase of 20.5 per cent — and I was pleased also on a number of other things that the Minister of Health has announced — the new children's hospital, long overdue and much planned for in the previous years of the previous administration, and long overdue

I was also pleased to see the Minister of Health restore a number of staff who were engaged in the home-care programme, and in particular I was pleased to see a recommendation that the Minister of Health made to the hospital commission and the regional board of the Greater Victoria area of a site on Helmcken for a new hospital. That's in my constituency, and I was extremely pleased to see that.

My concern is, although I don't want to accuse anyone of being an obstructionist, that I would certainly like to see, as the Minister has recommended, that we get on with the job. The proposal was that the site could be made available tomorrow and that planning could begin immediately, and I would like to see that happen.

I can understand that the Member for Oak Bay (Mr. Wallace) has some concerns about the location. I can only say to him that in his lengthy debates on the Minister's estimates on the location of the hospital and the poor road access that the individual who ran as the Conservative in the Esquimalt constituency — a Mrs. Dawson — wrote a letter to the newspaper about and suggested that those people not happy with the site and those people who feel the highway would be of great concern in getting into the hospital...Mrs. Dawson suggested in the letter that they write to me.

Well, that was very kind of her and I appreciate it and told her so that it would be nice for all those people concerned to write me a letter. That was a couple of weeks ago and to date I haven't had one letter from anyone in my constituency who's concerned about the site and its effect as to the highway.

I'm sure that the member for Oak Bay realizes as I do, and the hon. Minister of Health and the Minister of Highways, that the situation can be corrected with the four-laning of the highway and proper accesses on and off.

The minister has indicated the reasons why the site at Helmcken was chosen, and I don't think we have to go over those time and time and time again. I would only suggest that the regional representatives in the western sector are very pleased at the location — the proposal of the site — and support it fully.

I've had many discussions with them and they're really pleased that it's about time something was done.

I want to thank the Minister of Health and his department for instituting an ambulance service in the Port Renfrew area — the far end of my constituency. I visited there on Saturday. They are very pleased at that; I want to pass it on to you and thank you.

I am interested too to note that the Minister of Health has made mention of preventive medicine. I think that that's a commendable step. I think that we

[ Page 2004 ]

should all work together in assisting him the next few years to do as much as we can as an assembly to see that that is encouraged.

MR. LEVI: Mr. Chairman, I was interested in the minister's remarks about the Alcohol and Drug Commission. I note that he didn't refer to the other drug problem, which is the heroin problem. I just want to cover for a minute some remarks about the alcohol problem. I think that one of the mistakes that we can make in dealing with the alcohol problem is to have an over-obsession with the Skid Road type alcoholic in terms of the kinds of services that we somehow feel compelled to provide.

I am sure the minister knows, Mr. Chairman, that that group of people represent that 5 per cent of the total problem and that we must move away from the emphasis in terms of the Skid Road alcoholic and look very specifically at the other 95 per cent — the people who live in what is often referred to as suburbia.

One of the programmes that the minister has not mentioned — but no doubt he may cover it — is the project that was started just over a year ago in Victoria — the life enrichment programme which deals with treatment for those people who are employed and are being disabled by alcoholism. That programme is one that is working out well. It is based on a 28-day short-stay programme and particularly emphasizes keeping people on the job and returning those who have perhaps been off the job for a little while because of alcoholism. It's in that direction that there needs to be a heavier emphasis, because we have to look at the other 95 per cent of the problem.

We have not been successful in terms of the detox centre procedure with the so-called Skid Road Road alcoholic. This is still a revolving-door process, perhaps a better revolving-door process than existed when they used to go to Oakalla. At least it's a community-based operation. So I hope that we don't see ourselves going into heavy expenditures in this area. I think that one has to be very practical about this; certainly these people have to be looked after in terms of their basic needs. But a heavy emphasis must be made on the employable, particularly in relation to the kind of cooperation that is available. It's happening with industry because that is a very costly factor for them. They have been cooperative in wanting to pursue programmes like the life enrichment programme.

I am glad, Mr. Chairman, that the minister mentioned the kinds of problems that exist with municipalities in trying to get the zoning and the approval to go ahead with various detoxification centres and other clinics.

These are not easy to accomplish. What I cannot agree with him on is his feeling that somehow the Alcohol and Drug Commission was far away from the government. The attempt there in terms of getting the Alcohol and Drug Commission working through the resource boards was to enlist the help of the community — the help of the citizens of a town or a city, even in the city of Vancouver — to bring pressure to bear on the municipalities to make the kinds of right decisions.

It is interesting to note that we have...that there is in place in Vancouver five clinics — not in the downtown area but rather in the so-called suburban areas. That was done because there was a real attempt on the part. of the commission to go into the community, to win over the people. That was done through the vehicle of the resource boards. Therefore those particular places are now in place. That was why, I think, the philosophy of having them out there.

I think, to be very frank, Mr. Chairman, to the minister, there are difficulties — there are very many difficulties — with trying to operate an Alcohol and Drug Commission if you are going to operate it strictly within the confines of the bureaucracy of the department. That is one of the reasons that it was set up so that it would be apart from the department and it would be able to do the kinds of innovative things that it is not always possible for the bureaucracies to do.

I think that the minister on Friday made reference to the voluntary sector. He was talking about all of those people out there who want to help. He talked about a restoration of that kind of effort. Well, I don't agree with him on that. It's not a question of a restoration; it's a continuation of it. Because there through the aegis of the resource boards again where you have the voluntary sector involved — they were able to make the kinds of strides that they have been making.

I want now to turn to the other side of the drug question, one which the minister has not raised. That is in relation to the heroin question, particularly the hard drug question.

When he was in opposition he was, as he says, and apparently still is a hard-liner. But I would hate to see him, now that he's in a position of making some decisions, getting trapped into the idea that somehow there's a need to move forward on the whole question of compulsory treatment. The minister shakes his head. I would hope that after examining this and looking at the costs and priorities which obviously the minister has in mind, this particular kind of effort — the compulsory-treatment effort — can simply not be a priority of government which has to, as the minister has indicated, appropriate the scarce resources of the budget of his department.

When we talked about it last year, Mr. Chairman, we went to some trouble to look at the costing of such a programme if we were to do the compulsory-treatment programme. If you take 100 addicts and you want to put them into a

[ Page 2005 ]

compulsory-treatment programme, let's leave aside the facility that you're going to operate and look at the costs. I would suggest that your costs run anywhere from $75 to $100 a day to maintain these people. It has been suggested by some of the people in the field that a 90-day kind of programme would be advisable. What you're looking at there is pretty close to $7,000 an addict for 90 days. If you get into the business of looking at 400 addicts, you're looking at something in the order of almost $3 million, and then you're going into endless costs in trying to deal with them.

What I want to say to the minister is this. This is not something that obviously can take place in a short while, but it has to be part of a continuing dialogue with his colleague, the Minister of National Health and Welfare in Ottawa (Hon. Mr. Lalonde) . When I was down there, I used to talk to him about it. Is it ever going to be possible in this country for us to get into a carefully monitored project on a heroin maintenance programme? Frankly, it wasn't something he particularly wanted to hear. I note now that rather than talking about heroin he's quite fascinated with the idea of alcoholism. I accept that in terms of the social cost and social damage alcoholism is by far the greatest problem that we have to face, but we still have a heroin problem.

The thing about the heroin problem is that in the city of Vancouver or in the province of British Columbia it's an industry. It's a terrible industry that makes very high returns. Something in the order of $18 million to $20 million a month is being made from the heroin trade.

Let's leave aside the addicts at the moment and look at what we are going to do with this continually expanding business that has existed in our province for 40 or 50 years. We might well ask ourselves — and I see the Attorney-General (Hon. Mr. Gardom) is here now, so I might as well address it to him — what does the criminal element do with $18 million to $20 million a month? That's well over $200 million a year of money that is being made out of the drug trade and obviously being washed or rewashed and put into legitimate businesses.

So I think that if we're going to look at a strategy for dealing with the heroin problem we have to look at it from two sides. We have to look at it first of all from the addict side and how best to address ourselves to that problem I'm still not persuaded that it's not the way to go — in fact, I'm persuaded it is the way to go: we've got to go to some form of controlled heroin maintenance programme. I think it's important. I don't expect that the minister, after he agrees, can set that off quickly. After all, we have to have the cooperation of the federal government, but we must recognize both in Canada and in the United States that none of the innovative programmes that have been done over the past 10 years have in any way been successful. You don't normally talk about successes in heroin addition. The number of people that get off it is so few that there's very little to talk about. The number of people that get off and go back on is also something to talk about a little bit.

So in terms of the question of heroin, it really does boil down, I suppose, to an economic question. How do we bring ourselves, Mr. Chairman, to bear on the problem itself? Obviously the people that are involved in it — the criminal element — are in it because there's a great deal of money. The amounts of money being transacted are enormous. With $200 million or $250 million a year, you can run a very good hospital programme in addition to your hospital programme. But that money is being taken out of the economy and transmitted through the organized crime into we don't really know where.

Now we have the Co-ordinated Law Enforcement Unit, which has been operating with some success in terms of catching some of the traffickers. It has not had any success in reducing the amount of heroin trade or the number of addicts. One of the strategies that they're using is that it's suggested that what they want to do is to make it so difficult that it will drive up the price of the heroin and somehow the demand will lessen. Well, that's a rather ludicrous argument, Mr. Chairman. It doesn't lessen. It really makes the whole pressure and the rat race stronger for the addicts involved, and consequently crime tends to expand and then the cost of crime.

Recently we had two statements, one by the commissioner of the B.C. Police Commission, and one by Mr. Warren Allmand, the Solicitor-General, both reflecting on the same problem — the increasing police costs related to crime and particularly related to the drug business, which we are told is about 60 per cent, at least, of all crime, certainly in this province.

I would suggest, Mr. Chairman, to the minister that he discuss with his colleague, the Attorney-General (Hon. Mr. Gardom), and that they meet with the CLEU organization and talk about strategy which really relates to an integrated programme whereby if, for example, after a large amount of undercover work they have decided they are ready now to pick up 120 people...and that sometimes happens that the roundups are 100 or 120 people. When that happens a great panic starts on the street. For a few days the supply dries up and people are running around. That might be the appropriate time for an attempt to make available to those addicts, in a controlled situation, the drug through the system that could be operated in the health system.

If it is costing the addicts $200 million a year, what is it costing the citizens of this province in terms of police care, loss of property and that kind of

[ Page 2006 ]

thing? But the important thing is: what would it cost to maintain these people in a controlled way in terms of the drug?

I would suggest, Mr. Chairman, that it costs less than $5 million a year, and yet because we are not able to embark on a more dramatic kind of approach to this problem, the taxpayers of this province are going to continue to be in the same position that they have been in for 30 and 40 years. Now that kind of strategy is something that simply has to be talked about. I am certainly prepared to admit that when I was involved in this thing, both in the field and as a minister, we were not in any way coming to grips with the heroin problem, and that we have to try very dramatic ways of doing it. They do not relate — unless they want to do it in terms of an experimental nature — to some other forms of treatment. The only way that we are going to tackle the heroin problem in a realistic way, over a long-run period, is to simply take the economic incentive out of the drug business. That's not going to be easy, but I think that that's the kind of strategy that we have to use. It's got to be a kind of economic warfare in relation to the drug business.

During the war, Mr. Chairman, the British had a ministry called the Ministry of Economic Warfare. Their total function during the war was to design and put into operation any number of plans that they could come up with to wreak havoc on the enemy's economic system, and they were very successful in some of the things they did.

I'm suggesting, Mr. Chairman, that what we have to do is to develop a strategy for first of all starting economic warfare on the drug industry and to wreck their economic system. The only way that that can happen is if we are prepared to move forward, certainly first of all in terms of discussions — because those are the things that have to take place first — and some understanding on the part of the people that make the decisions, and then by communicating with the public, that this is what is going to happen, and also by making a few admissions that in the past we have not been successful, that the root to the solution of the heroin question is one both of destroying it as an economy for the underworld and dealing with it as a health problem.

It is true that when we started the Alcohol and Drug Commission we started it in terms of not being in the health system because what we wanted to do was bring it into the community. I'm not faulting in any way, Mr. Chairman, the minister for bringing it into his ministry. I think it's an appropriate place to go once a number of the community-based kind of operations were in place, and I would suggest that they were in terms of the kind of co-ordination that was going on, the kind of integration that was going on in terms of the resource boards, in terms of the health procedures. There was an integration process in place. Unfortunately, as this happened, we no longer have the resource boards in place so we no longer have the community input. So your argument that you were worried about the commission being out there and away from the government was not valid when you started that argument, but it does become more valid now that the community input has gone. I guess you had better bring it back in there, unless you are prepared to convince your colleague, the Minister of Human Resources (Hon. Mr. Vander Zalm), that you should really activate your resource boards.

That is a key question. They are a key vehicle in terms of dealing with social problems, because you get to the grass-roots people who pay the taxes. I won't do it now, but I wanted to talk about the attitude that the minister had on Friday — the attitude that some of the members on the other side have, Mr. Chairman, towards the volunteer sector. You know, we are seeing a destruction of part of the voluntary sector, because they've eliminated the resource boards.

The minister says that tomorrow he is going to talk to SPARC. I hope he will be able to explain to them how it was that he cut their budget back by a third. Now there's an operation that was nothing but cooperative with the previous government, and the government before that. They tried hard and have done a number of extremely interesting programmes in terms of the handicapped panel, on which they did an enormous amount of work, and, the kind of education programmes they conduct.

I would hope, through you, Mr. Chairman, that the minister will think about what he did with their budget, and by tomorrow morning do the very thing that he did in respect to the rheumatism and arthritis people — give it a second look and restore the grants. I think it is important that that group, that voluntary group, the very area that he was talking about, that somehow the previous government didn't encourage.... Well, we did encourage, to a large extent, but it's that government, Mr. Chairman, that started to cut back.

I hope, as I say, that the minister will think about it tonight, and in the morning he will say to them: "Based on your performance in the past" — and their performance has been excellent — "we feel that in the best interest of the province and of the people of the community, we should restore your grant." He'll lose no face; second looks at these kinds of things are extremely important. That's really all I want to say at the moment, Mr. Chairman.

HON. MR. McCLELLAND: Very briefly, Mr. Chairman, I know the member's philosophy on drugs, and he knows mine. The Alcohol and Drug Commission itself had as one of its goals a sort of self-destruct button when it wanted to quit and come

[ Page 2007 ]

back in under one of the government departments. And that has happened.

I agree with him on many of the things he said about the zoning problems and the need for long-term treatment, and certainly to dispel the myth about the Skid Road alcoholics, because it is a myth. Really, it's not a great problem, except it's a most visible one to many of us. The other problem is locked in the kitchen at home, or in the mill making mistakes when they're supposed to be on the job. That's the problem we're faced with at the present time.

We're not locked in to any programmes, and that's why I've asked for a year to evaluate what we're doing now, so we'll know where we're at. Mr. Chairman, the member knows perfectly well that we couldn't, in any way, embark on any kind of a maintenance programme on our own; it has to be federally initiated, and it certainly has to be federally based, because we couldn't have a programme sitting in British Columbia without that input from the federal government.

The only other thing I wish to say is that I don't know where we get all this stuff about cutting back grants all the time — cutting back grants to SPARC by a third. We never funded SPARC in the Health department. The federal government funded SPARC; they cut them off and said that they've got until July 1. We have said to SPARC that we'll look at it after July 1. I don't know what else we can do except that. They're coming in tomorrow to see me to talk about transportation, and apparently that's the only item on the agenda, and that's the only item they've asked. But the federal government has cut them off as of July 1, and we've said: "Okay, we'll see what we can do, if we've got any funds available for you at that time."

MR. KING: Mr. Chairman, the Minister of Health is being quite cooperative in terms of providing information and answering questions this afternoon. I note that there is one exception: he has not answered the request I put to him regarding standing behind the cost of any collective agreement signed by the hospital industry this year.

I just want to explain, for the edification of the House — some members perhaps do not appreciate the point I'm making — and that is that the Minister of Health has issued a directive indicating that the global budget of the hospitals will not be allowed to exceed 8.5 per cent this year. That involves the total costs of health care, of the whole range of health services — it might be laundry, or it might be increased food costs. It certainly would reflect any wage increase to the four unions involved in the health-care industry, in the hospital industry, and there are four basic unions involved there.

Now of he sticks to that initiative, it would mean that the portion allowable to the Hospital Employees Union, which is the union now in dispute with the hospital industry...they could only be granted a package, including wages and fringes, in the order of perhaps 2 or 3 per cent. Any more than that, when viewed against the other contracts that are yet to come up, in addition to the general increase in health care costs, would mean exceeding the 8.5 per cent limitation that the minister has sent out by his directive as allowable.

What I'm suggesting is that the minister is quite safe — and I'm not trying to entrap him; I'm trying to assist his colleague, the Minister of Labour (Hon. Mr. Williams) — because it is preferable that both the union and the industry come to a voluntary settlement, rather than be confronted with arbitrary action by government. I'm sure that that would be the government's preference.

So I'm saying that in order to make it possible for the industry to find that voluntary settlement, the Minister of Health could make a simple public commitment to this House that, yes, whatever that package is, I will stand behind it because I'm secure in the knowledge it will have to be reviewed by the Anti-Inflation Board anyway, and that is the process this government has subscribed to by essence of introduction of Bill 16.

Therefore, if you believe in the collective bargaining system, if you believe in urging the parties to come to a voluntary agreement, I suggest that it's incumbent upon the Minister of Health to make this commitment, to make this statement, so the hospital industry knows where they are at in terms of bargaining, so that they know they can make certain commitments at the bargaining table and not have the rug pulled out from under them by the Minister of Health and the government later saying to them: "Look, we won't fund you to that extent."

It's not carte blanche, because you will have the protection of the Anti-Inflation Board through Bill 16 which will retroactively submit all public sector agreements to their scrutiny.

So I urge the Minister of Health to make this statement. It's a roadblock at present in the way of any freely bargained settlement to that important dispute which is facing this province. We are in the simmering of the 21-day cooling-off period, and I hope they can find voluntary agreement before that period expires.

I am sure the Minister of Labour (Hon. Mr. Williams) agrees with me. I am not doing anything other than trying to assist the parties in this respect, and I think the Minister of Health is quite safe in making the kind of commitment I call for, and I wish he would do it.

HON. MR. McCLELLAND: Mr. Chairman, the member knows how much I appreciate his help and I

[ Page 2008 ]

have been asked by the Minister of Labour to pass on his appreciation as well. I answered that question on Friday. I said I couldn't give that commitment at this time.

The hospitals have not been told anything else except: "Here's a budget. There's a certain amount of money available in that budget for hospital programmes. And it means, because of that pool of money available, that here's as much as will allow for an increase."

That's all we have said. It's an overall increase for everything, and as I explained to you on Friday, through you, Mr. Chairman, with the other adjustments which were made, and with the total increase of costs for hospital programmes this year, the total figure is not 8.5 per cent but 17 per cent. But half of that has already been committed and, in effect, has been spent because of unforeseen circumstances which arose. To give that commitment, in my opinion, would not advance the possibility of a quick, orderly settlement of this dispute. In fact, it may act the other way.

MR. KING: Well, Mr. Chairman, I find this absolutely amazing. Here the government has set up an approach, a mechanism by which collective agreements in the public sector will be controlled — will be monitored — and that is scrutiny and review by the Anti-Inflation Board which has, as a guideline, an 8 per cent allowable wage increase, in addition to fringes, with the possibility held out that an additional 2 per cent will be allowed in the case of historical relationships that should be maintained, or in the case of spectacular productivity.

This government is saying: "That's fine." The provincial government is saying: "That's fine. That's what we are going to subscribe to and have applied to the public sector." But the Minister of Health is now saying: "Look, we are not going to subscribe to that for ourselves in the hospital. Industry because the government as the funding agency for all the hospital costs are applying a different criterion."

A directive was issued forth from the Minister of Health's office indicating 8.S per cent overall allowable increase — not just wages, not just the wage costs, but the total global budget increase for health care in those hospitals. I am suggesting, Mr. Chairman, that if that is the case it means either the hospital industry trades off health-care programmes against wages or the Minister of Health does the right thing and says: "Okay. If we are going to deal with wages and fringe benefits through the anti-inflation route, then that should be separated from the global budget of the hospitals in this province."

It must be; otherwise he is setting up a situation, where it is totally impossible for the hospitals to negotiate even, to negotiate with any assurance that their financial commitments will be backed up by the provision of the necessary funds from the government. If that is the case, we are seeing a complete mockery of the collective bargaining approach in the hospital industry.

Now it is pretty clear and it's pretty simple. All I am asking the minister to do is say: "Yes, to the extent that you agree upon a wage and fringe package, I will back it up, subject to the review of the Anti-Inflation Board." If the minister does not do that in the light of his directive which he sent out in the early part of May, holding them to a total increase of 8.5 per cent which, in this time of high inflation, does little more than keep the pace with existing health care, I point out that in no way could the hospital industry in good conscience negotiate a wage and fringe package beyond 2 or 3 per cent under those circumstances.

That is a ridiculous imposition to place upon any management agency in terms of negotiating. I ask the Minister of Health to have another look at this situation or the government will stand guilty of forcing a confrontation with the hospital employees' union and the hospital industry at the expiration of the 21-day cooling-off period.

I'm certain that can't be their objective. I'm concerned when the Minister of Labour says: "We'll legislate." Now if your preference is voluntary settlement, which it should be, then you can do nothing else in good faith than to give the commitment now that the hospitals are free to negotiate within their terms of responsibility, without the financial limitations imposed by the minister's earlier directive of May 6, I believe it was.

MR. WALLACE: May 13th.

MR. KING: May 13. I urge both the Minister of Labour and the Minister of Health to reflect on this, because remember that imposed settlements in an arbitrary way are no guarantee of peace and harmony in that industry or any other. So think hard and thing long about this, and I strongly suggest that you reconsider your position.

The House resumed; Mr. Speaker in the chair.

The committee, having reported progress was granted leave to sit again.

MR. SPEAKER: Hon. Provincial Secretary, I have a statement which I wish to make to the House before we adjourn.

Hon. Members, on Thursday last, the hon. member for Oak Bay (Mr. Wallace) raised as a matter of privilege the fact that the government had, in the words of the hon. member "revealed a very substantial amount of government policy before the bill was even introduced to the House, " the bill in

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question being Guaranteed Available Income for Need Act introduced in the House on May 17.

1 will not review in detail what matters constitute a breach of privilege according to the law of parliament, as the subject has already been fully expounded by previous Speakers.

I refer to the rulings by Mr. Speaker Murray, 1972 Journals at page 192, and Mr. Speaker Dowding, 1975 Journals at page 43, from which it will be seen that the matter raised does not fall within the ambit of privilege.

I also direct the hon. member's attention to the ruling of Mr. Speaker Dowding, 1973 Journals at page 15, where it was stated, and I quote:

"The hon. member's complaint is that a member of the government disclosed a proposed policy to the public before informing the House. No proceedings relating to this policy were in charge of the House or its committees. In examining the authorities, no case can be found in the citations presented by the hon. member holding it to be an offence for the government publicly to announce its intentions. Indeed, this practice has been a common occurrence for many years, and were it a breach of privilege, some ruling must surely be recorded."

Accordingly, I find that no prima facie case of breach of privilege has been established.

MR. WALLACE: Just on a point of clarification in the light of your judgment, Mr. Speaker, which I certainly appreciate and respect: can we have your decision, then, that in question period we will no longer be out of order in asking questions which would involve government in revealing possible policy? It will still be the minister's choice as to whether he or she might answer such a question, but I believe that in the past we have been ruled out of order for asking questions the answer to which would involve a statement of government policy.

MR. SPEAKER: I'll still continue to draw the hon. member's attention to Beauchesne, fourth edition, 1958, which indicates in question period that "a matter of policy raised by a member in question period is clearly out of order." However, if the hon. minister indicates to the Speaker that they are prepared to make a statement, or answer the question, that is their prerogative, but I only point that out, as Speaker, according to the rules of the House.

Hon. Mrs. McCarthy moves adjournment of the House.

Motion approved.

The House adjourned at 6 p.m.