[ Page 3697 ]

CONTENTS

Routine proceedings

Committee of Supply: Ministry of Health estimates.

On vote 169.

Mr. D'Arcy –– 3697

Mr. Gibson –– 3698

Ms. Sanford –– 3700

Hon. Mr. McClelland –– 3701

Mr. Barrett –– 3704

Mrs. Wallace –– 3707

Mr. King –– 3710

Hon. Mr. McClelland –– 3711

Mr. King –– 3712

Hon. Mr. McClelland –– 3714

Mr. Lockstead –– 3714

Ms. Brown –– 3715

Hon. Mr. McClelland –– 3716

Mr. Cocke –– 3717

Mr. Macdonald –– 3718

Hon. Mr. McClelland –– 3718

Mr. Stupich –– 3718

Mrs. Dailly –– 3719

Mr. D'Arcy –– 3719

Mr. Nicolson –– 3720

Hon. Mr. McClelland –– 3720

Mr. D'Arcy –– 3721

Hon. Mr. McClelland –– 3721

Mr. King –– 3722

Hon. Mr. McClelland –– 3722

Appendix –– 3722

The House met at 8 p.m.

MR. C.M. SHELFORD (Skeena): I would like to welcome Dick and Eileen Palmer and their two sons, Allan and Robert. They're over from England and they showed me a good time in London, so I would like the members to welcome them here tonight.

MR. G. HADDAD (Kootenay): Mr. Speaker, this is the second time today that I've had guests. This time I was quite pleasantly surprised to find that my brother-in-law, John Foder, and his wife Donis Foder from Lethbridge came in to visit my wife and 1. I'm delighted to have them here to see this beautiful island. I would ask the House to please extend a welcome.

Introduction of bills.

MR. SPEAKER: Hon. Leader of the Opposition, do you have a bill to introduce?

MR. D. BARRETT (Leader of the Opposition): No, there are no bills; I'm just the next order of business.

I would ask leave of the House, Mr. Speaker, for the rules to be suspended and Motion 13 standing in my name on the order paper to be called and debated.

Leave not granted.

MR. BARRETT: Could I have your ruling, Mr. Speaker?

MR. SPEAKER: I heard a number of noes.

MR. BARRETT: That was very discourteous, Mr. Speaker - not you, Mr. Speaker.

Orders of the day.

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

ESTIMATES: MINISTRY OF HEALTH

(continued)

On vote 169: minister's office, $107,670 -

continued.

MR. C. D'ARCY (Rossland-T rail): I would like to continue questioning the minister - he's had a break for a couple of hours - to try and determine some statistics. Yesterday and again this afternoon I asked him how many new applications for intermediate-care facilities his ministry had processed since it came under his jurisdiction in the spring of last year. He gave us some facetious remarks this afternoon about new approvals. Of course, every approval when it's given, Mr. Chairman, is a new approval; if they would have been approved before they would not have been before him, they would have been in progress, completed and fulfilling the service that they were designed and applied for to fulfil.

The minister, as I said earlier, Mr. Chairman, chose after this responsibility came to his ministry to sit on the old applications from 1975 and early 1976 for around a year. He has since been letting them trickle out. I'm very glad to see that, but I would like the minister to tell the committee just how many new applications since this came under his ministry he has processed and have been duly licensed through the licensing facility, which is and has been under his ministry, and how many of these approvals have been given.

Mr. Chairman, the Ministry of Housing did a reasonably good job in this area. They had to deal with some very intelligent laymen at the local level who had formed intermediate-care societies. They were largely service club people. They then had to deal with CMHC; they then had to deal with the community licensing facilities at the Department of Health; they had to deal with Human Resources, who would have to be looking after the overage payments. Yet a great many of these proposals did meet with approval up to the responsibility going to his ministry. Then we saw the dearth of approvals for approximately 12 months, Mr. Chairman.

I'm still interested in knowing this. The list that he read off yesterday were all old applications; they were all intermediate-care facilities that were in process and progress. The approvals were in progress at the time that he took over the responsibility for these things. I'm very glad he saw fit to approve them but I think it's misleading the House, perhaps unintentionally, Mr. Chairman, if he's going to attempt to have the committee believe that these were in fact new projects when they finally got through treasury. They most manifestly were not.

I'd like to take just brief issue with a statement the minister made this afternoon. He said he can't understand how there could be 200 registered nurses on the lower mainland collecting unemployment insurance while there are 60 jobs to be filled at the UBC extended-care centre. I'd like to point out, Mr. Chairman, that to my knowledge there are no registered nurses on UIC in the lower mainland except those who are on sick leave or maternity leave. What the minister means, I'm sure, is that there are 200 registered nurses who are registered with Canada Manpower for work. That does not mean that all of them or even any of them are collecting unemployment insurance benefits. Indeed, if any of

[ Page 3698 ]

them are, they are doing so illegally. When there is work available in the lower mainland, they are illegally collecting benefits. I would hope that the Unemployment Insurance Commission is taking action in that regard.

Mr. Chairman, one last kick at this thing. The minister had denied that there is a problem on the waiting list for cardiac surgery at the Royal Jubilee Hospital. Mr. Chairman, I called the surgeons involved. I said: "If I needed an operation, when could you work me in?" They said: "Sometime in early February." That's not eight months, that's seven months, Mr. Chairman.

The minister implied that somehow this is kind of like the A&W: you go in and make an order and they give you a number and you wait till they call your number. Of course it's not that way; we're dealing with a life-and-death situation. If somebody has an extremely urgent situation, naturally they're immediately hospitalized and naturally they're worked in as soon as possible. If someone is considered to be less urgent - that is, if they're not in immediate danger of dying, as far as is medically known - then they go somewhere down. So it's not a hard and fast list. You don't say automatically it's going to be six months, seven months or 60 days. Nobody knows that for sure. But there certainly is a very, very long waiting list.

I'm also advised that in the last three or four weeks some eight to ten patients weekly, in addition to this waiting list, have been referred to the Vancouver General Hospital. So for the minister to suggest that there is no major problem here is wrong. By the way, Mr. Chairman, I'm not blaming the minister or intending to hassle the minister about this point, I'm just trying to bring it to his attention and hope that he and his senior officials will see fit to move with all deliberate speed to try and resolve this situation, because I consider it a scandalous situation right here in the city of Victoria.

Mr. Chairman, the minister has not commented yet - perhaps he's missed it in his notes - on his views on the role of nurse practitioners in the province, or what their role should be, not just in the rural and semi-rural areas, but certainly within parts of our urban communities as well. I think the committee should hear his views on that particular issue.

Once again, Mr. Chairman, we are still asking the minister, who likes to think of himself as a bottom-line, businesslike fellow in a bottom-line, businesslike government, to tell us exactly what the cost effectiveness is going to be of the UBC teaching hospital site. Even forgetting for a minute the arguments as to whether or not an expanded medical teaching facility is needed at all, if they put it on the computer to find out, to graduate this many extra doctors per year, to give this many British

Columbians an opportunity to graduate as doctors and probably go somewhere else to find work - some other part of Canada or the world, because there won't be work for them in British Columbia - what is the comparative cost of doing this same expansion using the existing teaching hospital facilities in the lower mainland?

Physically it can be done. I presume that the minister must be convinced that there is a cost effectiveness by doing it with a new 240 acute-bed facility on the UBC campus. Even though he's admitted that he's going to close down 1,157 beds in the same lower mainland area, he apparently thinks that you can build 240 new beds and put in a teaching facility when not only do you not need those extra acute beds, but you can do the teaching in the existing hospitals which are now used today as teaching hospitals in the lower mainland.

I can only assume that if the minister has done his homework at all, or put any thought into this, he can tell us something about the cost effectiveness. If he can't, I think that since we're talking about amounts of $50 million or $60 million, as well as an ongoing commitment of about $20 million a year in operating costs, he certainly should have some questions to answer to this committee and to the people of B.C. All I'm asking is that he show us his analysis of the cost of doing it at the University of British Columbia versus the cost of doing it in the existing teaching hospitals of British Columbia.

MR. G.F. GIBSON (North Vancouver-Capilano): I want to talk to the committee and the minister briefly on the question of heroin.

The minister's appointee and responsibility, Mr. Hoskin, is chairman of the Alcohol and Drug Commission and that commission put out a bulletin dated July 1, which described the disastrous impact of the heroin trade on the province of British Columbia. I'll just read a couple of lines here:

"At least 60 per cent of all known users in the country reside in the province and the heroin trade is now the fifth largest industry in British Columbia, grossing at least $255 million a year." The paper goes on to say:

" T h e ministers" - these are federal-provincial ministers - "have authorized the establishment of a special planning committee, consisting of Dr. Matheson of the Attorney-General's department; Mr. Haskin, Health; Chief Superintendent Niell of the RCMP; Mr. Bourne" - that's Colonel Robin Bourne, I guess - "of the Department of the Solicitor General; Mr. Landry, QC, of the Department of Justice; Mr. Draper of Health and Welfare Canada."

I want to read their terms of reference:

[ Page 3799 ]

"This joint committee is to present firm proposals for an effective campaign aimed at materially reducing the availability of heroin in British Columbia and reducing the numbers of heroin users. These proposals are to be presented to the next minister's meeting in Ottawa in mid-June, 1977."

Here is what I want to ask the minister: will the committee be examining, as one of its options, the option of heroin maintenance? This is an idea which is not new but has lately been gaining currency. It was advanced by the Leader of the Opposition (Mr. Barrett) in this House recently in what I personally thought to be a very courageous speech. It could have gotten him into political trouble, and it may yet do. He was at some pains to say that it was not as yet his party's policy but he had come to that conclusion.

From the other side of the political fence, I believe, I was interested to see in the paper tonight a letter by Thomas R. Braidwood, QC. This is The Vancouver Sun of today's date. The letter is titled: "If the root is money, let's attack the root." I want to quote extensively from Mr. Braidwood's letter because he is a man who has, in his professional dealings over the years, learned a great deal about this question. He says:

"The only reason that risks are taken to import and distribute heroin is for profit. The profit motive is the sole reason why the drug trade prospers; why the pushers flourish; why the middle man, the courier and the syndicates exist."

Speaking of syndicates, Mr. Chairman, the members of this committee will recall the shocking -to me - exposés on the programmes put on by the CBC a couple of weeks ago which gave rise to a considerable call for a commission into organized crime into this province. It's quite clear that the heroin trade is a good deal of the money behind such organized crime as may exist in this province. We do not know the dimensions.

Carrying on with the letter of Mr. Braidwood:

"If the root of this evil is money, why not attack the root? Take the profit out of drugs. The cost to society now is unbelievable - at least $200 a day in thefts per addict. Even this figure would assume that the stolen goods are fenced at par. Then there are the police, the welfare department, the courts, the lawyers, killings, corruption, organized crime, bribery and so on."

"I propose that drugs be free. Let there be the god-like power given to four or five teams of two doctors each to certify a heroin drug habit. We should not complain.if the amount certified is too high. This is not to be a treatment programme. This is to allow an individual to convince a doctor wise in ways of addicts that he is in fact a drug addict and, to that extent, he should be allowed to seal his own fate.

"Once a habit is certified, a picture would be taken of the addict and a driver's licence-type card would be given to the individual certifying his habit. That card would allow a nurse in a specially set up clinic to inject the heroin into the arm of the addict. This latter step is crucial, for if he is given the drug he would probably dilute it and sell it at a profit. The addicts would then not have to steal and would be able to hold down a job and there would be no profit incentive. The cost of heroin to the government would be negligible and the clinic to dispense the drugs would be no more expensive than our VD control clinics. Perhaps even those existing facilities could be used.

"I suggest that we not be soft and not confuse this with treatment. It would be more in the nature of a cure - a cure for all those students, drifters and immigrants who are the victims of pushers for profit. There would be peace of mind for the addict, for he or she need not rob or sell stolen goods, and the constant game of hide and seek from the police would finally be ended. I suggest the programme would be hindered if society tried to reform the addict or treat him. The programme should simply be one of supplying a drug for the addict.

"There would be a problem of other people coming to Vancouver to get the heroin and, in that regard, I suggest a three-year residency requirement. In any event, we have most of the addicts here in Vancouver anyway and having a few more come here would simply be a case of losing a white chip in a blue-chip game.

"Some will say that it is a sin to use public money to buy heroin. But the police are forced to use public money to support informers; they are forced to wiretap, to interfere with our personal liberties, and to give virtual licences to allow dealers in drugs to deal in drugs in order to induce such people to testify in courts. It might even put to rest the expensive CBC exposes and their slanderous inferences."

Interestingly enough, on the same page, again in tonight's Vancouver Sun, there is another letter on the same line and taking the same position.

Mr. Chairman, last year we saw a member of the Co-ordinated Law Enforcement Unit, speaking personally, arguing for heroin maintenance. I have spoken privately to persons connected with the B.C. Police Commission who have expressed their private belief that this is the right way to go. I cannot say that I myself have formed an opinion one way or another. I haven't studied it enough and I'm going to

[ Page 3700 ]

make it a priority over the next few months.

But I do know this: nothing else has worked. The Co-ordinated Law Enforcement Unit has succeeded in making heroin sufficiently expensive that young people are deterred from using it. That is a great step forward. Let no one question that. But that advantage need not be lost in a heroin maintenance programme, because one would still maintain the heaviest possible penalties for persons trafficking in any way in heroin or other drugs of that danger outside of the recognized system.

Mr. Chairman, at this time I'm not asking the minister to endorse a programme of heroin maintenance. I think that would be asking him to go further than he might wish to do at this time. But what I would like to ask - and I ask it most sincerely, without putting any value judgments on it at the moment - is whether he might be prepared to ensure, insofar as he can as one of the provincial ministers responsible, that this federal-provincial committee, which has been struck and outlined in this release by Mr. Hoskin, will, among other things, as a possible remedy for this curse that has afflicted British Columbia for so many years and is responsible for so much of the crime and the financing of crime that threatens to spread into other areas of our society, study, among other remedies, the possibility of heroin maintenance as one of the devices that might be used.

MS. K.E. SANFORD (Comox): Mr. Chairman, I assume the minister wishes to answer these other things later, otherwise I'd be happy to defer to him. Otherwise, I'll just proceed.

I would like to first of all pay tribute to John Glenwright, who is in the hospital construction section of the minister's department. I don't know if his name was mentioned the other day. I certainly know that the various deputies who are now seated behind him were given recognition the other day, but I'm not sure John Glenwright was. I wanted to bring to the minister's attention the fact that John Glenwright did an outstanding job, in my view, in working with the hospital board at Cumberland during a very difficult construction time when various cutbacks and changes were being made and the hospital board at Cumberland was becoming quite upset and agitated at times. John Glenwright did work very well with them. He attended the opening on behalf of the minister; the minister was not there. John Glenwright did, at that time, make some remarks at the official opening held in Cumberland and I neglected then to mention my appreciation for his efforts. I wanted to do it publicly and I am starting with that this evening.

The next issue that I would like to raise with the minister is the one with respect to the out-of-province hospital payments that are made for patients who have to go into hospital, when they are either a student at some university or if they are traveling and become ill and have to be hospitalized. The rates which the department now allows are not nearly adequate in my view. The former government raised the rates twice during the time they were in office. Allowed payments at this time are $75 a day but the average per them rate for hospital care in the province now is $123.75. It doesn't nearly match what the average per them rate is in this province. When the rates were raised previously by the former government they more nearly reflected the actual mean hospital costs at that time.

I'm appealing tonight to the minister to consider raising that $75 rate which is now paid to people who have to go into hospital outside the province. I have a particular case in my constituency where a six-year-old boy has to go to the Mayo Clinic to undergo extensive heart surgery. His parents, who are just ordinary working people, Mr. Minister, are going to find the difference, I think, a hardship. I assume $75 a day would not nearly cover the cost of a bed at the Mayo Clinic these days. For that reason I am asking that you consider raising that $75 a day, which is currently paid to patients who have to enter hospitals outside the province.

The other issue that I would like to raise, Mr. Chairman, relates to the north part of my constituency where various groups have been most concerned about the general mental health of so many of the residents who are forced to live in more rural and remote kinds of communities.

We have more instances of severe depression among some of the isolated communities, Mr. Minister. A lot of them take Valium. Studies have been done on this in the northern part of my constituency. I'm wondering what the minister is prepared to do to assist in alleviating some of the difficult psychiatric or psychological problems that people face when they live in a one-industry town and there isn't much in the way of recreation and so on.

Mr. Minister, if you would just hire a psychiatric nurse and put her in the northern part of the island so at least they would have someone they could turn to for some information and some advice, that would be of some assistance.

The last issue that I wish to draw to the minister's attention, Mr. Chairman, is the one at Comox where the regional hospital district approved a $7 million expansion as a result of very extensive studies that were done by Gray. That programme has now been cut in half. The hospital staff, the administrator and the hospital board have done everything they can in order to cut down on the costs of operating that particular hospital. They've a fine administrator at that hospital. The chairman of the board is a very hard worker in terms of providing the best possible

[ Page 3701 ]

health care in the Comox area.

The chairman of the board was unusually disturbed when he heard about the cutbacks that the minister required in this particular expansion at Comox hospital. The chairman of the board, who is also a high school principal, is not usually very outspoken. But he was very outspoken and adamant in his opposition to the decision made by the minister to cut back in this particular hospital expansion programme.

I would like to quote some of the comments that he made, as reported in the local paper at that time.

"Mr. Hank Schellinck, the chairman of the board, said that in the future, when elderly people require extended-care service, some of them may have to go out of the district to get it.

" 'Blame for the cutback rests squarely on the shoulders of the Social Credit government, ' the disappointed Schellinck said. 'They have selected McGeer's pet project of building a $1 00-million doctor-training hospital at UBC as their priority item and all other hospital programmes in the province are left scrounging around for what's left over.' "

Now that assessment, I think, reflects pretty accurately what the people in the Comox area are feeling about these particular cutbacks - $100 million going to McGeer to build his university hospital while cutbacks of this type are being made in the programmes that have been approved, have been very well researched and studied. I would like to have the minister's comments on the cutbacks at Comox hospital as well.

HON. R.H. McCLELLAND (Minister of Health): The programme for construction at Comox hospital was not approved, as the member says. It never was.

MS. SANFORD: By the regional district - I said that.

HON. MR. McCLELLAND: It was never approved, Mr. Chairman.

MS. SANFORD: By the regional district.

HON. MR. McCLELLAND: This happens quite often. A hospital submits certain estimates for a proposal which it would like to see done. It's happened for ever and ever in terms of building hospitals. Comox hospital put forward a proposal which was somewhere around $6 million or $6.5 million. The hospital did not have the authority because it did not have the money to approve that magnitude of a programme, so that programme was reduced to fit the amount of money that was available. That's the principle of government at all times, or at least it should be: you can only spend what you have in terms of approvals. There wasn't a cutback in a programme that was approved.

I agree that the administrator at the hospital in Comox is probably one of the finest people in the province. I recently had a meeting with the administrator and the board chairman and the entire board at Comox, and I think that everyone agrees now that we move forward as quickly as we can with the programme which has been approved.

I've enjoyed the way the hospital project at UBC has grown over the evening - up to $100 million now. And the member says hospital boards are left scrounging around for what's left over. I'd just like to say - and get it on the record - that in the past five years in British Columbia, up to the year 1976, the average expenditure by the province for the construction of hospitals was approximately $40 million per year over a five-year period. For the next five-year period, from 1976 to 1981, we have approvals from Treasury Board for the expenditure of $100 million a year - a total of $500 million for hospital construction in this province. We're not scrounging around for what's left over, and still it's not enough. It will never be enough, and we recognize that. We could spend the entire provincial budget on providing hospital services. We have to do the best job we can in making the services fit the money that's available.

In terms of mental health in the North Island, I'll check this out for the member, but I believe that one of the new positions which is to be approved in these estimates is for that North Island area. I must say that not only on the North Island but all over British Columbia it's a very serious problem of trying to attract qualified people. It's not so simple as just saying, "put a psychiatric nurse in there."

MS. SANFORD: There's one up there who has applied.

HON. MR. McCLELLAND: Well, okay. I'll check it out and I'll advise the member, but I'm quite sure that one of those positions is for that area. If that's true, then the situation could be corrected quite quickly. Regarding the out-of-province payments that the member commented about, first of all, out-of-province payments within Canada are not a problem. We have reciprocal arrangements with the other provinces and we cover the full cost of care in Canada.

We are reviewing the rates and we intend to change them. It won't be done in this fiscal year, but I'll be putting forward a proposal for the next fiscal year. However, in the meantime, we have adopted as a policy in the department, for cases such as one that would go to Mayo Clinic, for instance, if that service is not available in Canada and it's a medical necessity,

[ Page 3702 ]

on the basis of hardship we have picked up almost all of the cost of those services in the last while. We intend to continue to do that. So that's under review and we intend to do that.

MRS. B.B. WALLACE (Cowichan-Malahat): If the minister wishes to answer the member for North Vancouver-Capilano (Mr. Gibson) 1 would yield to him.

MR. CHAIRMAN: It looks to the Chair as though he doesn't have a question.

HON. MR. McCLELLAND: Mr. Chairman, 1 can't give a quick answer on heroin maintenance. That's an impossibility. Perhaps 1 could comment somewhat on the questions raised by the member for North Vancouver-Capilano. The major question is: is heroin maintenance being considered by this committee, which is a federal-provincial committee? The answer is no. It is not within the terms of reference of that committee.

The debate on narcotic drugs often centres on the issue of the legal status of heroin. 1 discussed this with the federal ministers as well, and the federal government is not considering heroin maintenance in this country - at least that's what I've been told. The problems of our present system are obvious and that's the reason we've established this joint committee. 1 believe that it's the first time that the federal government has ever really agreed that there is a problem of the nature that we have in British Columbia. I'm very encouraged by the fact that the three federal ministers were very quick to respond when the Attorney-General (Hon. Mr. Gardom) and myself went to Ottawa. The result of that, of course, is the committee that we now have.

1 guess it would be remiss of me if 1 didn't make my position on legal heroin known at this time, since the member has raised it and also the Leader of the Opposition raised it during the Attorney-General's estimates. It's one of the longest unresolved problems facing North America - the whole matter of heroin addiction - and certainly the subject of legal heroin is part of that.

Personally 1 oppose a heroin maintenance plan -and I've said that publicly on many occasions - for a variety of reasons, Mr. Chairman, based both on our own knowledge of the heroin user in Canada, and of the situation in the United Kingdom, where heroin has been used as a therapeutic tool for many years.

Contrary to the belief of many Canadians that the United Kingdom's use of heroin as a treatment agent has been an unqualified success, all evidence suggests otherwise. Evaluations to date confirm that in Britain the clinic is a medical rather than drug-dispensing model, and it's the doctor who decides whether it be heroin or methadone that is used, the length of maintenance before withdrawal, and whether the substance is to be taken orally or injected. The programmes now have a commitment to the eventual integration of the addict into the community, and eventual withdrawal.

The English approach is the reverse of what many North Americans feel is a surrender to the wishes of the user. While it is thought the use of heroin would attract a very large percentage of the addict population into treatment, experience has proved, Mr. Chairman, that no convincing evidence exists to show the use of heroin attracted or held more patients in treatment than did methadone, for instance. There is strong evidence that the British clinics are endeavouring to wean users away from heroin and into methadone, and the majority of users under treatment, as a matter of fact, are now on methadone. Addicts on a stabilized dose get no more than necessary for the prevention of withdrawal symptoms and some tranquilizing of anxiety.

Regardless of the supportive role of the clinical staffs, addicts, even on heroin, bargain for more medication. The process becomes a ritualized game played by both parties to the detriment of good therapy. Tolerance develops rapidly, and few addicts under treatment were ever found to be satisfied with the clinic's assessment of their needs. English addicts have stated that the clinics never give enough heroin, and most, on interview, claim they supplemented their clinic prescriptions with so-called "Chinese heroin". These statements are supported by convictions - evidence which shows up to 90 per cent of those on treatment use illicit heroin.

From our own knowledge of Canada, additional data shows that few if any addicts willingly accept other than intravenous injection. That's borne out in the statement that you read and that I haven't read in the Sun yet at this time. They are firmly caught up in the ritual and resent having to use any kind of clinical procedures for their medication. The use of heroin would require injections every five or six hours, three or four times a day. If you allow the addicts to have so-called "carry" privileges so that the addict could do his or her own injections, then of course those privileges could result in further black marketing or trafficking.

There is no evidence that the majority of addicts can be maintained on any kind of stable dose of heroin. Approximately half of the Canadian addicts who receive treatment in the United Kingdom return to Canada because they miss the excitement of the game - the police surveillance, the scoring, trafficking and apprehension - which is just as much a part of making life meaningful and acceptable for them as the drug itself.

There was a recent news story - and I hope to have more information this week on the British system besides what I've given tonight - in the papers

[ Page 3703 ]

that was headlined: "Heroin Addiction in Great Britain Reaches Epidemic Proportions."

"Heroin addiction in Great Britain has reached epidemic proportions, with an estimated 10,000 pushers and a weekly turnover of around $7 million, police and custom officials say. First indications of a huge smuggling racket have been revealed by Scotland Yard and the investigations branch of customs and excise. They have said that this is just the tip of the iceberg."

We are not deluding ourselves, and by the law of averages....

Interjection.

HON. MR. McCLELLAND: Mr. Attorney -General!

MR. C. BARBER (Victoria): Keep the coalition together.

MR. CHAIRMAN: Please proceed, hon. member.

HON. MR. McCLELLAND: It goes on:

"It is thought that as many as 10 cells of smugglers are at work in Britain, operating in such cities as London, Manchester and Liverpool. Between them they could be marketing about five pounds a day, which on an average of $200,000 a pound would put something like $7 million through the hands of the smugglers every week. 'It works like a pyramid, ' the customs officer said. 'No addict could possibly afford the money he would need to obtain, say, a gram a day, which is a fair average figure, so he buys adulterated heroin at lower prices.' Scotland Yard officials believe that more than 40,000 people in Britain are hooked on heroin."

Ten years ago it was 300 that were known in Britain. The source of that newspaper article is The Vancouver Sun and it's a report from Scotland Yard and the British customs and excise branch.

MR. G.R. LEA (Prince Rupert): Has that been researched?

HON. MR. McCLELLAND: Are you listening, Mr. Member? I'll continue.

Mr. Chairman, the problems associated with non-medical heroin use are too many for us to consider a maintenance programme at this time in British Columbia. Problems include dependence upon an extremely addictive drug which becomes the preoccupation of the user, significantly reduced ability of the dependent individual to function normally in society, medical complications associated with repeated administration of an intravenous drug, allergic reactions, possible overdoses and complications arising from the use of multiple drugs, criminal activity that will still be associated with heroin in varying degrees, and the development of a visible heroin-using subculture oriented to the use of the drug.

Given the identified problems, 1 believe it would be desirable to implement a policy on heroin use with the following objectives. These are the broad objectives that we presented to the federal government: to reduce as far as possible the actual use of heroin, to reduce as far as possible the likelihood of individuals being initiated to the use of this drug, to increase as far as possible the social functioning potential of those who are already involved in the use of this drug, to reduce as far as possible the crime and anti-social behaviour that seems to accompany heroin use, and to reduce as far as possible the cost of controlling the use of narcotic drugs, bearing in mind the indirect costs to society of heroin addiction.

MR. BARBER: How are you going to do all this?

HON. MR. McCLELLAND: We're doing a better job than you ever did, Mr. Member.

MR. G.V. LAUK (Vancouver Centre): That's very clever.

HON. MR. McCLELLAND: It's very true.

MR. CHAIRMAN: Order, please, hon. members. The minister has the floor. Please proceed.

HON. MR. McCLELLAND: The fact that heroin, Mr. Chairman, is seen as a desirable or potentially desirable commodity by a significant proportion of the population and that its use will increase with increased availability must not be lost sight of in any discussion of legalizing that drug. So the legal distribution of heroin would have to be designed to minimize abuse and involvement of potential new users.

The fact that heroin is clearly the drug of choice of narcotic addicts and that it can be supplied legally at minimal cost means that legalized heroin would be attractive enough to the narcotic user to encourage him to switch from an illicit to a licit source. Some pharmacological properties of the drug, however, make it difficult to conceive a system of distribution that would not be open to abuse and continuation of the black market. It is a short-acting drug and it must be administered by injection three times or four times a day if the user is to avoid withdrawal symptoms. The implications of this are that a user would have to report three or four times a day to a clinic for his heroin or he would have to be permitted to take some

[ Page 3704 ]

of the medication away with him.

MR. BARRETT: Are you saying every user uses four or five fixes a day, or four or five caps a day?

HON. MR. McCLELLAND: I said three or four times a day, Mr. Chairman - practically every user, that's correct.

The disadvantage, Mr. Chairman, of the first alternative is that the individual's life continues to be centered around drug use and his ability to become involved in employment is curtailed seriously and the risk of the second, of course, is that the control over the medication is lost giving rise to the possibility of diversion of the drug into an illicit market. A black market in heroin will continue, as it has in Great Britain, despite any system of legalized distribution.

MR. LAUK: Who wrote that?

MR. BARBER: Bert Hoskin.

HON. MR. McCLELLAND: The black market arises either as a result of the diversion from the licit system or as a market using illicit sources.

Mr. Chairman, despite all of that, the most obvious answer to the question of legal heroin ...

MR. G.R. LEA (Prince Rupert): Is that the Reader's Digest?

HON. MR. McCLELLAND: ... is that British Columbia could not embark on any kind of legalized heroin maintenance programme on its own; Canada could not embark on any kind of legalized heroin maintenance programme on its own. There is only one possible way that any kind of even a model programme could be developed and that would have to be on a North American model at a site to be selected. There are 300,000 to 500,000 heroin addicts in the United States and without considering them, Mr. Chairman, British Columbia would be in for some very serious problems. We're not considering legalized heroin in this committee and it's my opinion that this would be folly for this province ever to make that consideration.

MR. BARRETT: Mr. Chairman, I'll be very brief.

First of all, I'll review what my position is and I'll review what I said. I'm glad the minister, , at the end, has caught on to part of the problem - that it is a North American problem. My advocacy of heroin maintenance is on an experimental basis and if you'll read Hansard you will note that I said it had to be in co-operation with the United States and with Mexico.

So we agree on one thing: if there are going to be any changes in terms of approaches, it has to be a North American co-operative effort, between medical services and law enforcement agencies in North America.

Now to state or read, as you have, through you, Mr. Chairman, that almost all addicts need three or four fixes a day is frankly incorrect. I would go back and check your figures. I speak, sir, not from the judgmental attitude of the fact that I have spent 15 years of my life working in the field directly with addicts. When you come in this House and try to tell the members of this House....

HON. MR. McCLELLAND: When was the last time you ever worked in the field with anything?

MR. BARRETT: I have worked in the field.... My last parolees were up until the late '60s, because the federal government did not.... Well, the nature of heroin addiction has not changed in the last 10 years to my knowledge and if the minister comes into this House and attempts to tell everybody in this House that almost all addicts need three or four fixes a day, then I say, and my opinion is, the minister has been misled by someone who prepared that material for him. That's my opinion - through you, Mr. Chairman - and I've given you my opinion through the Chair, which is in order - that is, the method is, not necessarily the opinion.

I don't like the words "legalized heroin use." I'm talking about an experimental programme and my friend, the Liberal leader (Mr. Gibson) , knows how sensitive this is politically so he has come out with a true liberal position. "I read a letter to the editor, " he says, "and I see what the Leader of the Opposition says. I haven't made up my mind yet, " he says, "but as soon as I check my mail and find out how it's going, then I'll make up my mind." That's Liberals for you; they'll determine their policy on the basis of how the mail's going. Are you for it or against it, my dear friend?

MR. GIBSON: I'm studying it. (Laughter.)

MR. BARRETT: You're studying it. Hooowee! Well, at least you're one step ahead of those guys. They're not studying; he's reading newspaper clippings. To come into this House and try to politicize this discussion is absurd; I regret the minister has chosen that approach. But now that you have opened this subject, what about methadone maintenance? How do you justify the continuation of a programme of methadone maintenance that is just as addictive and more fiscally manipulative than any heroin maintenance -programme would be?

Don't tell me, Mr. Chairman, that since I left the field, addicts who are on methadone don't save it up any more now that good old Dave is gone. They were saving it up whether I was in the field or not. The first thing they do is get hold of an old used

[ Page 3705 ]

refrigerator, stash it in their little digs, open it up and save their methadone to trade on the street. I know you believe in free enterprise but that's going too far.

I know that the Minister of Human Resources (Hon. Mr. Vander Zalm) would define it as initiative, but does it have to be tax-supported initiative? Methadone saving and methadone peddling is going on. Mr. Chairman, to say that "heroin is bad but we'll give you a replacement in methadone, " is for the government only to play around with one addictive product that is more acceptable emotionally than another.

The other thing that is mentioned by my good friend the Liberal leader (Mr. Gibson) , in reading that letter from Tom Braidwood, is the significant point of the cops and robbers chasing game that goes on in terms of the romance of the use of drugs. Mr. Chairman, if the minister would put down his newspaper clippings and read files and files of research that is available in this parliamentary library, he would find that a significant part of the introduction of the use of heroin to the new user is due to the romanticized aspects of the cops and robbers game around the initial use of heroin. People do not come into clinics and say: "I have a predisposition because of a poor relationship with my mother, I haven't seen my father for five years, and I now want to take my first fix." It doesn't work that way.

We have a social milieu that has existed, and continues to exist, for years in this province. That is the matrix; that is the fertilizer; that is the enabling catalyst for the initiation of the new addict; and that is the psychological atmosphere that exists around the cops and robbers aspect of illegal acts.

Just as politicians get fixed on politics, Mr. Chairman, there has to be a milieu for it to happen. Weird social behaviour takes place given certain circumstances where principles are abandoned on the basis of the romance of that particular placing of an act. I have witnessed, as a politician, people abandoning principles on the basis of opportunism because a whole new matrix appeared politically.

AN HON. MEMBER: Oh no!

MR. W.S. KING (Revelstoke-Slocan): They crossed the floor?

MR. BARRETT: Yes! Yes! Crossed the floor, crossed parties, abandoned principles, all for the lure of the fix of political power!

MR. KING: Shame!

[Mr. Veitch in the chair.]

MR. BARRETT: Yes, Mr. Chairman, I have seen human behaviour modified by the changing political situation that allowed the drug politics to abandon all the cherished principles and commitments to friendships and shockingly destroy the pattern of behaviour that we all grew to respect when people were Liberals and Conservatives.

MR. KING: That must have been politics in paradise.

AN HON. MEMBER: What's that got to do with LSC?

MR. BARRETT: LSC? What is that, my friend?

MR. GIBSON: It's SC - Social Credit.

MR. BARRETT: Oh, Social Credit - the fix!

If it can happen in politics, Mr. Chairman, the analogy fits for other aspects of social misbehaviour.

Interjection.

MR. BARRETT: Yes! Yes! I know it comes as a shock, but the same kind of ego drives, the same kind of political desires that are involved in the romance of politics are the same motivating factors in human psyche when they get involved in drugs.

MR. G.H. KERSTER (Coquitlam): Is that what made you run again?

MR. BARRETT: That's what made me run again. That's right. I got the fix, man. I was going through withdrawal pains until I went back through Vancouver East and now I'm getting my maintenance dose here again with the gang.

You know, I find....

Interjection.

MR. BARRETT: Oh, Mr. Attorney-General (Hon. Mr. Gardom) , you are the biggest fix of all when it comes to old speeches, old positions and hypocrisy. You are loaded with hypocrisy,

HON. G.B. GARDOM (Attorney-General): You're finished!

MR. LEA: You haven't even begun.

MR. BARRETT: Mr. Chairman, I find it interesting and amusing to hear the Attorney -General whisper across, in an almost cherubic voice, saying: "You're finished. You're finished;"

HON. MR. GARDOM: You are.

[ Page 3706 ]

MR. BARRETT: You're fixed by the loss of principle because you got hooked to Social Credit. You are a drug victim yourself - a political drug victim. You got drugged by the possibility of access to power and now you are on a maintenance programme that allows you to rationalize for every illegal act that has taken place under your government.

MR. CHAIRMAN: Hon. member, this is an interesting speech but I would like you to get back to vote 169, if you would.

MR. BARRETT: Thank you very much, Mr. Chairman. I'm waiting for the Attorney-General to come in with calling the motion on the Speaker. If he had been in the opposition he would have had a fit over it.

MR. CHAIRMAN: Vote 169, hon. member.

MR. BARRETT: Oh, yes. Right, Mr. Chairman. So when we talk about human behaviour you do not confine it to symptoms; you must examine causes. When we examine the cause of people to use addictive drugs, or the overuse of alcohol, there are unique factors in every individual human being that come out to a sum total of finding release through the over-use of alcohol or self-abusive drugs such as heroin.

Since we have a reawakening in the community of a desire to discuss the possibility of some North American co-operation of experimenting with heroin maintenance, let's leave it at that. I think that the kind of letters written by Braidwood and the editorial in The Vancouver Sun....

Interjection.

MR. BARRETT: There were two letters and then there was the editorial in The Vancouver Sun. I don't think that the question of evaluating my individual decision, aside from where my party stands, is so important.

I was surprised and pleased to see that editorial in The Vancouver Sun. I thought that was a remarkable editorial in response to what I said personally as a MLA. The Vancouver Sun, as a leading newspaper, took an editorial position: "Hey, wait a minute, maybe we should talk about experimenting with other jurisdictions under proper controls with this approach." And I thought, holy cow, a little bit of light is shining in.

This was not done without some basic research and background. Look at the LeDain commission. The federal government launched the LeDain commission. It did a fantastic job. That research, that documentation is there. I find it incredible that with the LeDain commission report available the minister would come in and read that newspaper clipping as if it was gospel.

Mr. Minister, there is enough documentation of the British experiment to allow you to discard those kinds of occasional newspaper stories that frequently come, when you check them out, without foundation in fact. And I would tell you, Mr. Chairperson, that I find it difficult to understand why the minister would allow himself to read that particular point of view without further backup when you have all the staff at your command and at your fingertips.

The other thing we haven't discussed, now that we've opened this and confined ourselves to heroin, is: what about cocaine? What about coke? It's non-addictive, certainly not psychologically or physically. Coke is non-addictive. The first introduction of coke into North America was into Madame Chiang Kai-shek's well-known backing of an industry known as Coca-Cola. Cocaine was an ingredient at one time of Coca-Cola; they pulled it out before 1890. Coke has been on and off an exotic dilettante drug available for the super-rich.

There is a serious problem growing in North America about the popularization of cocaine among many people. It is becoming a serious problem in terms of evaluating the mores and the directions of a whole new social structure in North America.

Would the minister inform this House whether or not his department has initiated any examination at all of the problems of overuse of cocaine illegally in the province of British Columbia? Where is it being used? How is it coming in? How much of it is available? I think there's a whole social pattern that has to be evaluated here by the minister. Is the minister making an effort in discussions with the federal government to really define under the national narcotics legislation what is addictive, what is not addictive, what is a danger, socially, morally and physically, and what is not?

To have the Attorney-General grunt in between this discussion, saying, "You want to legalize drugs; you want to legalize drugs, " doesn't serve any useful purpose. The last time we had a wild, emotional debate in this House that blinded a rational discussion it was led by the now Minister of Education (Hon. Mr. McGeer) when he brought in that infamous bill on lysergic acid - and that was shameful. We had the wildest, weirdest debate that you can ever imagine. If you think the House is bad now, you go back to those days. Maybe it was a good thing we didn't have a Hansard.

It's not a simple problem. And I think one thing that I want to praise the minister for is that at least the minister has abandoned the simplistic positions he used to have when he sat in opposition. When he was in opposition, he had all the answers about drugs. Now, since he's been the minister, he's found out that

[ Page 3707 ]

some of the statements he made in those good old days, as he might think about them some night, were incorrect.

What about your trip to Japan? 1 am glad you went. I am glad you went. It was very worthwhile. Along with the steambath, it was worthwhile. You had a chance to go and see and learn for yourself that from a distance, when you hear about programmes working in another culture and another legal jurisdiction, they are not appropriate for this culture and this jurisdiction. If you'd have gone further, you'd have seen one country in the world that has completely solved drug addiction - China. 1 don't advocate their approach. But in their culture and their milieu, they have solved the problem of drug addiction.

1 will tell you, on my return from my visit to China, 1 spoke to the Vancouver branch of the Men's Canadian Club, and 1 said: "I've just come back from a place where there are no longhairs, no freaks, no prostitutes and no drug addicts. And guess where it was? It was under communism." You could have heard the wind sucking through the room, because they all believe in those right-wing things. No prostitution, no drug addiction and no long-haired freaks - all in China. Every one of them, 1 thought, was going to go out and buy a little book of Mao as soon as the meeting was over.

It's totally inappropriate to talk about another culture's solutions. Just as China's solution was totally inappropriate, so is Japan's. The minister found in Japan, and he hasn't talked about it publicly, that the cold turkey approach has not been all that successful in Japan, even in their culture. The inherited family discipline that has extended in the past in neighbourhood and total community is beginning to break in Japan too, and they're becoming confused about the approach.

Has the minister ever considered the kind of a hedonistic society that we have developed in North America that panders to short-term solutions, personal gratifications, of desires and wants? Has the minister ever considered the devastating causes on the hyman psyche because of the acquisitive society that we have developed under the name of "free enterprise"? Has the minister availed himself of any social or psychological studies that even drives people out of losing their chauvinism to go and buy suits in Alberta to avoid the 7 per cent sales tax? That's the kind of thing that motivates people to protect their self-interest no matter how much is at stake. It's not simple, Mr. Minister, it's not simple.

1 appreciate your words at the end. If any change was to be made, it would have to be made with the co-operation of the jurisdiction of the United States and with Mexico. But don't abandon listening, reading and thinking.

Mr. Chairman, the last comment is Dr. Kalb's after his 25 years at Lexington. I commend to you more than anything else the most profound material available by a man who gave 25 years of his professional life to the treatment of drug addicts in a confined, rigid, so-called controlled-treatment oriented setting. I repeat very quickly that $60 million was spent in 25 years. Dr. Kalb retired and he said: "We now know two things about drug addicts: (1) they have an insatiable desire for drugs, and (2) they like chocolate cake." Let's understand how little we know, let's open our minds to the possibility of some controlled experiments, and let's look to solutions to this very serious social scourge. But let us not take fixed positions, and then attack each other from those fixed positions.

MRS. WALLACE: After the debate we've been indulging in, it's a bit of change to go back to a local constituency problem, but I would like to discuss with the minister a couple of items in my own area relative to the Central Vancouver Island Health Unit. That particular unit, as the minister knows, serves not just my constituency but other areas. I must speak in regard to the whole health unit.

I'm particularly concerned about the staff shortages, as indicated in their report. This is a point which I raised last year with the minister, and it still remains much the same. There has been some slight improvement. We have one public health nurse unfrozen in Ladysmith, but we still have a frozen position in Duncan and also in Port Alberni. Although that does not relate specifically to my constituency, it does relate to the difficulties on the Island in delivery of health services.

Another area where we're very short is in the area of public health inspectors. There's a grave need for two additional health inspectors. As I pointed out last year, the building boom that's going on is taking up the great majority of their time for the routine things, like checking out sewers and this kind of thing. There is just not time to get around to the other part of their job which includes inspection of food in public eating places. Those are two very severe areas in the field of preventative medicine where there is a shortage of assistance.

The other thing that I would like to mention is the child psychiatrist. That's still missing from the Duncan area. This was a part-time appointment that was stopped last year, and we still have no child psychologist in the Duncan area. This is, again, a very preventative form of health service. A short-term approach on a dollars-and-cents basis on this point in time will see a great deal more expenditure down the road as a result of that short-term approach.

Another thing, not relative to the Vancouver Island health centre but certainly relative to my area, is the intermediate-care situation in Duncan. As the minister knows, there was a great deal of delay

[ Page 3708 ]

originally because of the joint jurisdiction between his ministry and that of Human Resources. Certainly we have the site there; the kitchen facilities are in the extended-care unit. I'm wondering what progress has been made in that particular instance.

There was an alternative suggestion some time ago relative to Queen Margaret School as a possible intermediate-care area. I really never heard the minister's decision on that or whether or not he has even considered that. It might be an alternative, but my own position would certainly be that the original intention was to put that intermediate care in conjunction with the extended-care unit. The property is there, presently owned by the hospital board. I would certainly hope to see that facility going in because my area, like all the others, is experiencing this shortage of intermediate care.

I have people coming to me with insoluble problems, where they are in a position of not being able to cope with an invalided mother or father in their own homes yet still having no place for that parent to go. It's a bad situation that's been around a long time, Mr. Chairman, and, certainly in our particular area, it hasn't improved.

So the general point of view - and moving away from the constituency - there are two comments I would like to make. One has to do with those personal- and intermediate-care homes and the fact that the minister has pointed out that the patients are now on a $6.50-a-day rate and the tab is being picked up by the government. I have had some rather startling letters from some of the operators of these personal-care homes, and their concern about the government rate.

Now the minister indicated earlier that he's talking about bringing in regulations, and so it should be, because we must make sure that those privately operated homes do provide adequate care and are adequately equipped to prevent any possible hazard to residents or patients within those homes. But, Mr. Chairman, if he increases the requirements above what they presently are, then he must also consider increasing the amount of money he's prepared to allow to these people to operate those homes. At the present time.... The paying patients were subsidizing the government patients in those homes. I'm sure the minister is well aware that this is the case in many instances, and again, there is going to have to be something done there or we are going to have even fewer personal-care homes. We've seen them closing and it will continue even more so if he makes regulations even more stringent.

I was very interested in his comments in reply to the member for Comox (Ms. Sanford) who raised the question about mail. The minister said - I believe I heard him correctly - that if the service was not available in British Columbia and if there was a need, his ministry would see that this cost was met.

I'm very interested in this, Mr. Chairman, because 1 have just received, in yesterday's mail, a letter from one of my constituents. It's a copy of a letter to the minister. If the case is as the minister has outlined it, Mr. Chairman, 1 wish he would tell his staff.

This particular constituent of mine had two doctors stating and outlining her needs, outlining the type of treatment she required and stating that this was not available in British Columbia. They were referring her to the Mayo Clinic, making the necessary arrangements for travel and everything else that was required. She's to leave on July 2 1.

"As a result of these doctors' correspondence- -I'm quoting from the letter - "to the Medical Services Plan of British Columbia, they, as well as the hospitals programmes, have replied stating that they would not be permitted to accept liability for any portion of the charges levied." In neither letter was their reason stated.

Now that's in complete contradiction to what 1 understood the minister to say earlier, and I would certainly urge that in this one specific instance - and if the minister doesn't have the letter at hand, I can send him a copy of this one, which is a copy of the letter he received - there is an urgency here because the woman is on her way.... She is not well, she has a serious medical problem and she's going with this financial cloud hanging over her head as a result of replies from that minister's department.

You know, emotional health is a very important thing; it's just as important as physical health. To send a patient to the Mayo Clinic with that kind of a financial burden hanging over her head and that kind of a response from the ministry, and then to find the minister standing up on the floor of this House and saying something that, as 1 understand it, is completely opposite to the kind of reply this woman had, is just not good enough, Mr. Chairman.

Earlier on in this debate there was some mention of the dentistry programme. 1 was interested to hear the minister say that still nothing was happening. Certainly back in 1975 that programme was ready to go and I'm very disturbed to hear that he's still saying nothing is happening. One thing I would like a specific answer to in regard to that: is nothing also happening as to the training of teachers? In January, 1976, the teachers ... they were to train the personnel that were to administer this dentistry programme. It was all set up. They were to start their training at UBC in January of 1976. That did not happen then; it did not happen in January, 1977, and there has to be some lead time on that. I'm wondering when the minister is intending at least to get the personnel trained who will be able to handle that programme because there has to be the lead time if you have any intention of introducing this dental-care programme for the 3- to 18-year-olds through the school system, as was outlined by the

[ Page 3709 ]

report done by UBC. Certainly we should be hearing at least about a date when the personnel are going to go in for their training.

Another point I want to talk about, Mr. Chairman, is the licensed practical nurses of British Columbia. Their association drew up a brief and presented it to the Minister of Health and also to the Ministers of Education and Labour. Now it just happens I'm involved in this particular one because the president of this organization happens to live in my constituency. She writes a rather heart-rending letter because she has had nothing but turndowns. She has had no response from the Minister of Health, no response from the Minister of Education, a brief acknowledgment from the Minister of Labour, and various other closed doors.

The problem is, Mr. Chairman, that these licensed practical nurses are simply being phased out by attrition and by other means and they're being replaced by other personnel - registered nurses and nurses' aides. I'm wondering what the minister is proposing in the way of protection to these licensed practical nurses. I understand that a new wing opened recently at Burnaby Hospital and has stated emphatically that they will not be hiring any licensed practical nurses. Yet we're continuing to train these people, turn them out and offer nothing in the way of jobs for them. That's poor management, Mr. Minister. I'm wondering what you're proposing to do about the licensed practical nurses in British Columbia.

The third thing that I want to deal with in this minister's debate is the problem of nutrition. Way back in February, 1976, the minister issued a news release' talking about our bad eating practices and outlining some of the foods and things that we should be consuming. A news release in 1976 is fine, Mr. Chairman, but it's going to take a lot more than that to really improve Canada's health through improving our eating habits.

We are living in a very complicated society today. There is a very great deal of stress. We are putting the kind of strains on our bodies that perhaps we weren't really intended to have to endure. Shift work is one of the worst thing that happens to us. It's always i been recognized that it's a very abnormal way to live. It upsets the routine; it upsets the family life. It also affects something called "body time." It apparently takes more energy to work in non-normal hours than it does during the daylight hours. Researchers have found too that people who have to work at night sleep on the average 90 minutes less per day, so they're not getting the same amount of rest. The disruption in eating habits, it's also been proven through tests, has been linked to stomach upsets because the digestive processes work more slowly at night.

A recent report that was done by the Labour Council of Metropolitan Toronto said that shift workers die younger. Now this is just one of the stresses that's being put on our society today. Because of those kinds of things, we must put some stress on better eating habits.

In conjunction with that, and again going back to my own locality, the minister gave some assurance that we were going to get a nutritionist in the Vancouver Island Central Health Unit. He said that it would be in the next fiscal year. Now he may be hiding behind the fact that here it is July and we still haven't passed his estimates, but he did have interim supply and 1 would suggest that unless he's going to be very gravely underspent at the end of the year, certainly with the number of new people he's indicating that he's going to take on this year, he should be getting some of them out there. This nutritionist, as far as I'm concerned, from a preventative medicine point of view, is one of the most important people that he could put into the public health field and into the preventative medicine field.

Studies have shown that Canadians do suffer from malnutrition. We are overweight, we have iron deficiency, we have shortage of calcium, we have shortage of Vitamin D, Vitamin C deficiency, and it goes on and on. We are not a well-nourished nation, in spite of the fact that we are a very affluent nation. Because of those things, Mr. Chairman, the minister is going to have to do something more than issue a press release in February, 1976, and hope that somehow people's eating habits are going to improve.

Over the last 30 years, we have had a decrease in the consumption of dairy products of 21 per cent, and decreases in the consumption of vegetables by 23 per cent and of fruit by 25 per cent. Conversely, the intake of soft drinks over the last 30 years has increased 220 per cent. Pastries have gone up 70 per cent and the snack or junk foods have gone up by 85 per cent.

What's causing it, Mr. Chairman? Advertising is one of the big things because the people who produce the food at the processing and distribution levels are not really interested in the nutritive value. They're interested in the dollars and cents they can make out of a given food item. That's the kind of thing they're emphasizing in their advertising. They are advertising on the television, in the newspapers, in the comic books, on the children's programmes, and this advertising of some of those non-food foods is something that that minister should be turning his attention to. 1 see a cereal firm in the United States is being sued for $1 billion because of the kind of advertising they're doing with these sugar-coated whatnots on television appealing to the children. It will be very interesting to see what the result of that particular court case is.

Apart from the lack of nutrition, we're doing

[ Page 3710 ]

something even worse: we're putting additives into our foods that are not only non-nutritious but in many instances harmful. I read during the course of the debates of the Minister of Agriculture (Hon. Mr. Hewitt) that the Conservative member, when he was speaking in Vancouver recently, had indicated that we may be setting up a timebomb with the additives that we're putting in our foods, not for this generation but for the next generation. It's time we had a good look. I know there's a lot of federal responsibility involved and I know it's an interdepartmental responsibility. That minister is going to have to work with the Minister of Consumer Affairs (Hon. Mr. Mair) , with the Minister of Agriculture, and with all members of his cabinet. But unless he can do something more than just an advertisement saying you need so many ounces of protein or so many quarts of milk if you're such and such an age, and then forget about it, that's not good enough.

We've got bread coming out made out of wood, Mr. Chairman, which is advertised as being high in roughage and low in calories. It's non-nutritious. These are the kinds of things that are being perpetrated upon our people and through advertising, as one of the major means of promoting these products, people are being talked into buying them. Now I know it's a free country and we should have the right probably to eat what we want, but do we, Mr. Chairman? When we are moving towards the kind of health-care programmes and the kind of dollars that we're spending on health-care programmes, at least we need a very strong educational programme with nutritionists, with educators, and with some kind of controls to prevent our people being subjected to the kind of advertising of products that bring in the big money rather than the products that bring in the good, healthy citizenry that we'd like to have here in British Columbia. I would urge the minister to take some good strong action in conjunction with the other members of his cabinet to ensure that we do get the kind of programmes that will prevent this junk food from continuing to be consumed here and get some good sound nutritive policies into the minds of the young people coming up.

MR. KING: I have a number of local matters that I would ask the minister to comment on. I don't want to take much time, but there are a few matters of concern that I feel I should bring to the minister's attention. The first one relates to a letter which was sent to the minister, I think it was some time in June - there's no precise date on it. It's from the Kinette Club of the village of Nakusp. I'll just read a portion of it:

"The Kinette Club of Richmond has undertaken a very worthwhile project. In doing this project they have written to all the Kinsmen and Kinette clubs of B.C. for help. The project is to raise enough money to donate to the intensive-care nursery at the Vancouver General Hospital. This ICN is the only referral unit for sick newborns in the province; however, due to the increasing number of referrals, there is a need for more equipment."

It goes on to outline, Mr. Chairman, the considerable donations that have been made by voluntary organizations throughout the province. It closes with this paragraph:

"This is a government responsibility and that responsibility should be carried out by them. If there is not enough equipment, or if the equipment is not up to par, then something should be done through the proper government health channels." The letter is signed by L.K. Coult, secretary.

I would ask the minister to comment, if he would, on what kind of plans he has for beefing up the kinds of . sensitive equipment that are needed in the intensive-care nursery referred to. It is a real problem. Of course, infants from all over the province have to be transferred to this one central location.

Another matter, Mr. Chairman, that I would like to bring to the minister's attention relates to the availability of psychiatric nurses, particularly in the more rural areas of the province. I presume the minister has a copy of the annual report of most of the hospitals throughout the province. I have the one here for the Queen Victoria Hospital in the city of Revelstoke. I point out to the minister that in the medical staff report portion of that annual report comment is made in expressing great satisfaction at the availability of a psychiatric nurse, a Miss Norma Jane Miller, and concern is expressed that there will be assistance available to continue to provide this kind of service to the community. There is some fear that due to restrictions on budget - due to cutback - this is precisely the kind of community service that might have to be curtailed.

There is just a very, very crying need in that area for the services of a psychiatric nurse. I want to point out, Mr. Chairman, that the schools certainly require that service. The debate that was held earlier in this House this evening with respect to drug and alcohol abuse is another area in the total community where the kind of advice and training of psychiatric nurses can be invaluable.

Another matter that I think has been brought to the minister's attention - I'm quite sure it has - is that I've received copies of correspondence to the minister from the senior citizens' association of New Denver and Silverton relating to the senior citizens' home, formerly referred to as The Pavilion, at New Denver. That facility is the only one available of its kind, covering quite an area up in the interior. The

[ Page 3711 ]

facility itself has been much improved and the community is very pleased with it, as I am, but unfortunately the rates for people who are not on welfare are very onerous indeed. The senior citizens association points out that the rate for those senior citizens who do not qualify for social assistance is $7 5 0. That's pretty expensive. It's very, very difficult to handle for seniors in that area.

The minister indicated when he was contacted about this, both by myself and other community organizations, that Mrs. Elizabeth Bristowe was reviewing the rates at New Denver, and indicated that some recommendation would be forthcoming. That was way back in January of this year. I presume that review has been completed by now, and I would appreciate very much receiving some indication from the minister as to whether or not there might be some relief from the kind of rates that are very, very difficult for senior citizens in this province to handle. In come cases, certainly, people can handle them, but in many it's absolutely impossible. It imposes a hardship on other members of the family, in some cases, which creates all kinds of not only monetary problems but social problems as well.

Another matter that I wanted to bring to the minister's attention - again I believe he has had some correspondence on this - refers to the Red Cross outpost hospital at Edgewood in my riding. I have had a number of letters from the Edgewood emergency health services committee and from private individuals in the area pointing out that there is no reimbursement for the expenses of the ambulance attendant driving people who require hospitalization to other cities. Usually they go to either Nakusp or Vernon, Apparently the full cost of transportation is not being met by the ministry. I'll just read this letter from the Edgewood emergency health services committee, at least the relevant portion:

"Once again we would appreciate your help in obtaining some form of reimbursement for our ambulance administrator, as the enclosed copy of a letter being sent to Mr. J. Carson Smith will explain.

"We have tried on at least three occasions to get some action from the ambulance services, even to a personal phone call to Mr. Smith, but to no avail. If he can be of some assistance, we would greatly appreciate your help.

"We have now received satisfactory. . . Oh, that's fire protection.

The ambulance service performs an amazingly vital and frequently used service in that community. It's a logging area mainly, and the accident rate both in industry as well as on the highway system seems to be extremely high for a rather small area. I'm sure the minister has access to the number of trips this ambulance is required to make but I was very, very much surprised by the frequency of its use. It becomes a real hardship unless there's some fair and readily available form of compensation to the operators of the ambulance.

Perhaps I'd ask the minister to comment on those matters. I've got one or two others but I don't want to bring out so many things that the minister forgets them all.

HON. MR. McCLELLAND: I've got them written down, but the last two questions that were raised by the member for Revelstoke-Slocan (Mr. King) I can't answer tonight - the matter of the ambulance service for the outpost hospital. But I've asked the staff to take a note of it. We'll check into it on the first of the week and I'll get back to you as quickly as I can.

The same thing is true with the New Denver senior citizens' home. I can't recall - is that an intermediate-care home? It's a boarding home? Well, Human Resources pays the rates for that. I'm surprised that Mrs. Bristowe hasn't responded to you. Once again, I've asked the staff to look into it tomorrow and I'll get back to you as well.

The problem of the psychiatric nurse: I recall that nurse was put in there because of the distance from Vernon for people in need of service. There's no intention, as far as I'm aware, of that service being curtailed. It's an intention to keep it going.

The donation of the equipment at VGH. We do, of course, supply 100 per cent of the cost for that kind of tertiary equipment if it's approved in our budget. However, it's not unusual at all that volunteer groups such as Kinettes or anyone else will identify what they see as a need in a hospital and go into the community and raise funds to provide equipment like that. And as a matter of fact, I think that's an admirable aspect of volunteerism. Then the government picks up the operating costs of the ongoing equipment needs in the hospital.

That's not to say that the government doesn't have the responsibility to acquire the equipment when it's necessary in the hospital, and we attempt to do that. For that kind of equipment to which you refer, the provincial government picks up 100 per cent of the cost of those services.

[Mr. Schroeder in the chair.]

To the member from Cowichan-Malahat, I don't think I need to comment on the nutrition problems that she raised, except to say that I agree with her. Yes, we need to do more than we're doing. We do have some programmes in planning stages now in terms of education particularly, and I hope that we can speed them up. Certainly we need to do more if we're really serious about preventive health.

I would hope that the schools, as well, would take on a larger responsibility than they're now taking in

[ Page 3712 ]

terms of the provision of food to their students, in terms of candy dispensers and things like that. I notice some encouraging trends that that is happening in some schools. But we'll try and speed up any programmes that we have in terms of changing public awareness. Again, our division of education and information is working on that right now.

The question you raised about the person who had to go to Mayo clinic. I wasn't quite sure whether they were about to go or have already gone.

Interjection.

HON. MR. McCLELLAND: They're going. I would appreciate it if you would please send me that letter. The policy which I stated to you is one that we've adopted in terms of need. There are a couple of criteria which are necessary, however. First is that prior approval must be given and, secondly, that the care must be only available there. We've run into some cases where a doctor has recommended that a patient go to Mayo or some other place for some personal preference when the service could be provided just as well in Vancouver. That's one of the problems we have. I'd appreciate you sending me that letter and I promise I'll look into it right away.

The operators of the private facilities. Yes, we recognize that if we require those people to do more than they're doing now and intend to enforce that, there's a possibility that it may cost them more to do it. I've said earlier that we would be willing to negotiate with them in terms of setting budgets when our new programme comes in place. If we say to them, "You've got to have two more nurses on than you have now, " I would say they would probably make a good case for needing some more money. If we say you have to give an activation programme which you're not giving now, then perhaps we have to raise our rates for that purpose too. But we want to negotiate with them in terms of their budgets.

The intermediate-care facility at Duncan - one of my staff members has advised me that the department was of the opinion that there wasn't enough room on the extended-care site to place this facility. Perhaps that's not right. Nevertheless, in addition to the 433 intermediate-care beds that we approved on April 1,1977, Duncan is down for needing urgent approval as soon as we have a proposal which is acceptable to the ministry, which means that as soon as we get that we will give it the approval, They're in the same category with 250 beds in Prince George and Richmond. I think the Duncan proposal is around 80 beds, if I'm not mistaken. So as soon as we get that, we're prepared to approve it.

I might just add that there are a number of other approvals which are in the planning stage by the societies themselves and which haven't come to us now, for a total for this year alone, if all of them get their requests in to us, of 1,095 intermediate-care beds. Those approvals are forthcoming as soon as we hear from the societies and as soon as we can agree to their programmes.

I know the problem of shortage of staff in public health units; it's one which is common all over the province. We are attempting to address ourselves to that.

I just don't know how to handle one part of that problem that you raised, and that is in areas such as yours, and in the constituency that I represent, which are fast-growing areas presently, the public health inspectors can't get to their real jobs because they're so busy inspecting sewers and septic tanks.

We've had innumerable meetings with our public health people trying to find a way out of this, because I have a feeling that their time could be better spent. At the same time, they say to me that if they let that responsibility go, then who is responsible if that septic tank fails somewhere down the road? I don't think it's just a question of getting more staff to inspect septic tanks. I think maybe what we're talking about now is perhaps a lower level of staff that doesn't need the kind of specialized training that we could have attached to the public health inspector under his direct jurisdiction. That's what we're looking at now.

I had a report from my own constituency not long ago which said that in the summertime 90 per cent of the public health inspector's time is taken up doing that. Certainly if that's true then there are some swimming pools which are not getting inspected, and perhaps rest homes and things like that as well. We're attempting to look at that and find some ways out of that dilemma.

Interjection.

HON. MR. McCLELLAND: Can I get back to you on that? I don't have the answer, but I can tell you that we haven't stopped recruiting because the estimates aren't through. We are recruiting and we're getting Treasury Board approval for new recruitments on an ongoing basis.

MR. KING: Mr. Chairman, one other matter that's come to my attention is with respect to the lack of speech-therapy assistants in the Kootenay area. I have a letter from a constituent in the Slocan Valley area who requires speech therapy for a child and finds it very, very difficult to obtain this service. I think that it was provided through the school for a short period of time, but eventually that was no longer available.

The cost of taking a child to the nearest city where it's provided, which would be Nelson, is very, very high for single parents, people on low income and so on. The transportation is a problem in that area unless you have a private car. There is no regular,

[ Page 3713 ]

reliable transportation means for much of the area. That same shortage of audiologists and speech therapists is apparent throughout the south end of my riding.

I wonder what the minister would think about trying to set up some kind of traveling facility that might cover rural areas on some periodic basis. Perhaps a mobile facility would serve needs where transportation is a problem and where really, the option for parents who now live in rural settings is to move to the larger centres or have their children suffer the loss of this kind of very much needed service.

I would like to know what the minister thinks about that possibility. I think it could be done. That kind of approach has been taken in other areas. If the need is demonstrated - if there is an adequate number of people needing that kind of service - then I think it should be justified.

One of the other problems that has been brought to my attention is with respect to senior citizens in the Kaslo area lacking any transportation services to the city of Nelson where they have to go for a whole variety of medical and health services. I've received a letter from the president of the senior citizens' branch in Kaslo and it's a copy of a letter directed to Dr. J.S. Bland of the health planning and support services. I'll just read it so that the minister can see what the problem in that area is.

"In reply to your communication of January, 1977, may I just say that there are a few people here who had the sad experience of becoming ill and having to go to Nelson or some other distant place to get attention that is not available here. I do not have to tell you of their problems of having to leave their families and friends of so many years.

"Many do not want to have their names mentioned, so I am respecting their wishes. One quite elderly woman, Mrs. Ellsbrook, found it necessary to move to Nelson to be near her husband, who had been confined to Mount St. Francis home, and a day or so later, she died. I saw her only days prior to moving and she appeared no different than she had been for the past year. We who knew her were shocked by the news of her death so soon after her move. We know that there could be many other causes of death, but we would be hard to convince that this abrupt and cruel transplanting of an elderly person does not contribute to loneliness, depression and even death. We know, or are led to believe, that funds are not available for more facilities for the care of the aged and that may be so, but we have discussed some alternatives.

"One of these is that a transportation system is badly needed to go from here to Nelson and return on the same day. The only service we have is a truck - crew-cab type - that brings the mail and freight to Kaslo and will take passengers to Nelson. But they must stay overnight and return on the same truck very early the next morning. This is not satisfactory.

"It is 44 miles to Nelson and many elderly people do not have cars, nor do they drive. Some have families who can take them, but others must take their chances of a ride with friends. This is not acceptable to us. We need proper transportation, possibly B.C. Hydro bus."

Now obviously this is partially a transportation problem, but it does deal basically with the availability of health services, and I would certainly appreciate it if the Minister of Health could draw to the attention of his colleague, the Minister of Municipal Affairs and Housing (Hon. Mr. Curtis) , who is, I believe, responsible for transportation, the obligation that I think government has - that we all have - to provide, as much as possible at least, equality of health opportunities throughout this province. There is a sore need here.

This letter was signed by G.J. Belanger, president of the senior citizens' home in Kaslo. I'd be pleased to provide the minister with a copy of the letter if he would like to have one.

So that's an important matter that bothers rural ridings - I suspect not only my own - and many rural areas throughout this province, and I believe that more attention and more resources should be directed toward meeting those needs and equalizing the opportunity for access to health facilities for all our citizens in the province.

One other matter that was brought to my attention by the corporation of the city of Revelstoke - and I know the minister has had a similar letter because he's responded to it; I have a copy of the minister's response - refers to full-time ambulance staff in the city of Revelstoke. I believe I brought this up last year with the minister where, two years ago, we had a very active training programme underway for paramedics and ambulance attendants. That has been cut back and the city of Revelstoke is very anxious to obtain trained ambulance drivers in that area, particularly the paramedic type who are trained and capable of dealing with emergency situations on the scene.

Again, in Revelstoke, on the Trans-Canada Highway the accident ratio is unbelievable. Rough terrain is involved on the Trans-Canada Highway, particularly east of Revelstoke. I forget exactly what the number of accidents was or what the number of calls was, but I believe it's in the area of 300 calls on average a year for the ambulance in that area. The

[ Page 3714 ]

majority of them, I think, related to highway accidents. The minister did respond on June I of last year, indicating that a review was underway and that the programme might be reinstituted. I would appreciate obtaining, if possible, some encouragement from the minister, because it's very difficult for a small community like Revelstoke to meet a need that's not totally related to their community. A lot of it is a total provincial obligation. Our tourist flow through there is very heavy.

That, I believe, is the last area I had with respect to my local riding. I was interested in correspondence I received, though, from a Mr. Cyril T. Jones of Plus-Minus Resources. I think the minister knows something about this. It quotes the minister quite extensively from Hansard when he was an opposition member.

It seems that the minister's mind has changed since he's become a minister of the Crown rather than an opposition member. Mr. Jones now makes some rather strong allegations against the minister and against the government and in effect is accusing them of usurping his intelligence and his patent, it appears. He quotes, from Hansard on May 14,1974, the Hon. R. McClelland as a former member of the opposition who was then addressing the former Minister of Lands, Forests and Water Resources. He had this to say, as reported in Hansard, Mr. Chairman.

We in British Columbia have an opportunity before us to lead the world in effluent treatment. Yet this minister ... his department and the Pollution Control Board for some reason have chosen to downgrade the effectiveness of the system which does offer hope for the world in the treatment of effluent control.

That was Mr. McClelland's quote from Hansard, page 3085. Since that time, Mr. Jones points out, despite another quotation from Hansard where the member for Langley supported his experiment with the usage of coal and effluent control, nothing has happened since the member for Langley gained access to the treasury benches and is in a position to bring his support into fruition. As a consequence, Mr. Jones makes some pretty tough statements. I would hope the minister has an explanation to give to the House as to why the defender of the rights of this little man who had some initiative and developed through experimentation a device that may be extremely profound in terms of pollution control, not only in British Columbia but throughout the world - why the member for Langley, who at that time was a defender of that little man's rights is now so silent. I'd be interested in hearing why this transformation in this minister's attitude.

HON. MR. McCLELLAND: Mr. Chairman, I'm happy that the member for Revelstoke-Slocan brought that speech back to my mind. That was a good speech in 1974. 1 only wish that while that member was sitting on this side, he had given me the kind of support I needed on that day that he seems to be giving me today. But I didn't get it.

MR. KING: You're in the driver's seat now, Bob.

HON. MR. McCLELLAND: That's correct, Mr. Chairman, and I accept that. As I said the other day in a press interview, when someone else from the press brought up that 1974 speech, the problem, as you and everybody else probably well know, is dealing with experts. Every expert will give you a different answer. That's our problem right now. As I mentioned in the House yesterday, Pat Rogers was doing some work for me on the matter of alternate methods of sewage disposal. That's the exact thing that he's working on at the present time.

I know Mr. Jones' frustration. He's dealt with this thing for 20 years and he can't get anywhere with government. All of us, I think, know that frustration as well. I've met with Mr. Jones on regular occasions and Mr. Jones was in my office the day before yesterday. We're compiling all the material and we're going to try to settle this question once and for all. Either the system is what he says or it isn't. That's the project that's going on now. I'hope in a couple of weeks I'll be able to have something together for it -but it may take a little longer, I'm not sure.

Ambulance training. I said a review was going on. Ambulance training has begun again all over the province and will continue.

I accept your thoughts about elderly transportation. I will talk to the Minister of Municipal Affairs. It can go hand in hand with health-care needs.

The speech therapists problem. I can't give you a definite answer about that one area you talk about, but we do have 40 new therapists in the budget this year. About half of them are transferred over from the school district; the rest are new ones. So we hope to be upgrading that programme.

MR. D.F. LOCKSTEAD (Mackenzie): I have a few questions for the minister. These questions are pretty well constituency matters.

I would like to ask the minister, Mr. Chairman, the first question involving the proposed renovations of the hospital in the Bella Coola Valley. As you well know, that hospital has been there for many, many years. My own feeling is that there should be a brand new facility built in that area. However, I know that currently the plan is to carry out eventually some major renovations in that hospital. The minister may be interested to know that the current hospital has been condemned by the fire marshal, I understand. So major renovations are required. Perhaps the minister could tell me and the people in that area how much money has been allocated for that job and

[ Page 3715 ]

when those funds will be forthcoming.

I must be honest with the minister, Mr. Chairman, and say that I never did agree, and I still don't, with the way they arrived at the formula for funding of these hospitals. I really disagree. It's based on the number of patients and patient days. I really don't think that's a fair way of financing public health in this province. But anyway, we won't get into that.

The second question, Mr. Chairman, is the matter of public health inspection on the Sunshine Coast and the Powell River area. I'm sure the minister is well aware of this problem. In fact, the problem reached the stage, not long ago, when the district gave an ultimatum to the provincial government and to the minister regarding public health inspection, threatening to withdraw services because of lack of people. We had the lack of people, Mr. Chairman, because the funds were not made available. As a consequence, subdivisions were not being approved and for months and months people had many hundreds of thousands of dollars tied up in some of these proposed subdivisions, particularly on the Sunshine Coast, causing a lot of problems for these people.

I was wondering if the minister would now be prepared to release funds so that we could have more public health inspectors in the Sunshine Coast and Powell River area.

The whole area of extended care has been canvassed quite thoroughly in this House, Mr. Chairman, so I won't dwell on that too long except to say that in the St. Mary's Hospital, which is located in Sechelt and the only hospital on that whole Sunshine Coast serving the whole area, there is an extended-care unit. The problem, in my view, is that, first of all, it is too small for the area. Secondly, it is a bit of a hazard as well, Mr. Chairman, in that the extended-care unit in that particular hospital is located on the second floor. Some of the patients in that hospital are a bit uneasy should a fire break out and this type of thing. It is a concern expressed to me when I go to visit that particular area. What I am suggesting here, once again, both in St. Mary's Hospital and the Powell River General Hospital, which has excellent facilities, by the way - we should have more of them.... I know, from time to time, that the department will bring people from the lower mainland area into the extended-care facilities at Powell River, and then people who live in the area can't have their own mothers or fathers in. I have a letter here from a constituent, Mr. Chairman, whose mother, presently living in some facility in Vancouver, is going to have to wait possibly two years to get into the Powell River extended-care wing to be near the family. That is a long time. It indicates to me that we need more facilities, Mr. Chairman.

The whole thing of public-health nurses has been canvassed at some length so I won't go into that. I have one last item, Mr. Chairman. I discussed this matter with the Minister of Energy, Transport and Communications (Hon. Mr. Davis) several weeks ago. That is the matter of senior citizens who, under the Motor-vehicle Act, require a medical in order to obtain a driver's licence. This is fair enough; nobody is complaining about that. The problem is, Mr. Chairman, that when they go for this medical they have to pay for it. I recited the case - and I'll go over this again, very briefly, just to give you one short example - of a 71-year-old gentleman who had just had a medical. Two months later his driver's licence expired. He went back to the same doctor, who had just given him a thorough medical, with the appropriate form. The doctor said, "hello, " signed the form and sent him on his way. But he had to pay. It cost him, I think, $18. I'm not quite sure, but it was some figure in that area. This is utterly ridiculous.

I'm not suggesting that seniors shouldn't have medicals. No senior citizen has suggested to me that they shouldn't either. What I am suggesting to you is that senior citizens should be covered under the B.C. medical plan. I hope that by now the Minister of Energy, Transport and Communications, who has had ample opportunity to discuss this with you and, in fact, only sits one seat down from you, will have discussed this matter with you, as he said he would. If not, I hope you will take it up with him. There is no reason why, through an order-in-council or, as a matter of fact, just by signing a memo, you couldn't rectify this particular situation.

MS. R. BROWN (Vancouver-Burrard): Mr. Chairman, I am going to be very brief. I just want to talk about the hospital which is in my riding. I couldn't allow the minister's estimates to go by without asking him a couple of questions about that little hospital which is located in the riding of Vancouver-Burrard, namely, the Vancouver General Hospital.

In February, in an editorial in The Province, the conditions at the Vancouver General Hospital were reported as being a disgrace. There is evidence to indicate that it has got steadily worse since then. There are continual complaints about the buildings which are crumbling, the sewers which are falling to pieces, and about the patients and employees who are putting up with impossible conditions.

The wards are described as being gloomy and the hospital itself as being seedy. Morale is not very high. There is no criticism of the quality of care. There isn't any question about the fact that it is a good hospital. But it is an old hospital and it has been terribly neglected for one reason or another.

One of the reasons it's been neglected, of course, is because of the decision to build a hospital on the university campus. We were told it was going to be

[ Page 3716 ]

phased down and so all attempts to repair it or keep it in any good kind of shape went out. Then when the decision was made to go for the B.C. Medical Centre again, it was allowed to get run down even further.

What are you going to do about that hospital? It's a disgrace. It's the largest medical unit in the province, one of the largest medical units in Canada. Physically it's an impossible place to work in and it's not a very healthy place to get sick and find yourself in. So 1 would be interested to find out if the minister can give me any reassurances about at least doing something about the sewers on the, gloomy wards and the general physical condition of the hospital.

The other question I want to ask about VGH is: are we going to have to go through this fiasco every year around the whole business of electing a new board in terms of finding one that will vote for abortion versus anti-abortion? It gets increasingly worse. There are all kinds of people signing up to join VGH so that they can vote at elections in terms of whether they are pro-abortion or anti-abortion. That's not the main function of the hospital. People who are signing up to vote in the elections should have a number of other things that they are willing to take into account rather than the abortion issue, but until the minister comes out with some kind of firm policy, the law is there. There isn't any problem about the law, but in terms of insisting that it is carried out and that it is not neglected the way it is in some of the other hospitals - St. Paul's and various of the other hospitals - we're going to go through this fiasco every year with VGH in terms of signing up people to go one way or another as though the only thing VGH does is exist to perform abortions. So 1 would like his comments on that one.

The third thing 1 want to ask the minister to talk about is a child-abuse team in terms of its expansion throughout the province. VGH is the only centre now that has a really good child-abuse team. 1 know that in some of the interior areas they're tied in to the post-partum teams and these kinds of things. But in terms of ensuring that every large community throughout the province has access to the kind of facility that you get through a good and active child-abuse team, 1 would like to know what the minister has to say. You know, Mr. Minister, through you, Mr. Chairman, the delivery of health care in Vancouver is going to go down considerably once the Vancouver Resources Board is finally phased out. The relationship between the delivery of health services....

HON. MR. McCLELLAND: There is a bill on the order paper, Mr. Chairman.

MS. BROWN: Well, I'm not discussing the bill on the order paper; I'm discussing the delivery of health services. The delivery of health services is so tied in with community services in the area that I'm wondering whether the Minister of Health has taken into account what's going to happen to the delivery of health services specifically to people in need. Again I go back to the child-abuse team. The child-abuse team at the hospital is used most extensively by social workers. I'm not talking about the bill; I'm talking about social workers. I don't believe that because there is a bill on the order paper, it's no longer possible to talk about social workers. Now social workers use that child-abuse team. The fact that they're employees of the Vancouver Resources Board is incidental; they use that child-abuse team. The pamphlets, the referrals, the research, all of the services that are tied into the child-abuse team which the social workers have come to depend on, are certainly going to suffer once the particular service which cannot be mentioned is proclaimed. I just want to ask the minister whether he has taken that into account and whether he has made any kind of alternative arrangements in terms of preparing for the kind of cut-back in delivery of health services to this particular constituency or this particular clientele in the Vancouver area once the Vancouver Resources Board has been dismantled.

HON. MR. McCLELLAND: Mr. Chairman, I advise the member that the child-abuse team at Vancouver General Hospital was established at Vancouver General as a provincial resource and it was funded on that basis, just as many of the other programmes at Vancouver General Hospital are. That's not to say that we won't look at the possibility of the hospital-based programme in other parts of the province and it's also not to say that there aren't programmes going on in other parts of the province attached to our public health units at the present time. But the difference between that programme and some of them is that it is hospital-based and probably is closer to the problem. We will look into that expansion as you suggested.

I can't do anything else but agree with you completely that the situation at Vancouver General Hospital in terms of the pro- and anti-abortion thing in relation to the board of directors is intolerable. If you were here yesterday, I did comment that we were planning to expand the society idea into some of our government institutions, but we pulled back because of the situation which has arisen in the last few years at VGH.

It's the policy of the government not to force hospitals to do abortions which don't want to, if that's what you were suggesting with St. Paul's. I believe that needs to be up to the board, but certainly there has to be a look taken at the makeup of hospital boards. We are actively pursuing that at the present time.

It's not only abortions. Other boards have been

[ Page 3717 ]

stacked for other reasons, some for political reasons, sometimes for a different kind of reason that may be the issue in that community that day. So it's not just abortions. We're finding this more and more.

In Prince George, there was a serious problem up there in terms of one group of people who were against another group of people because of the kind of medical care that was being given at the hospital. The problem, of course, is that with the narrowly based interest group attempting to take control of a hospital's day-to-day affairs, you have to assume that they don't have all of the affairs of the hospital in their interest. So if you have some suggestions about how we might restructure hospital boards, I'd be happy to have them, and that goes for any member of the House. We would like to have input on the ways that we can overcome these problems because it isn't going to be easy. I shudder to think, though, if we don't do something, what might happen at the Vancouver General Hospital board meeting next year.

That hospital didn't deteriorate overnight; it took a long time. There isn't any doubt that the major city hospitals have been neglected over the years for a variety of reasons. I said yesterday that it's my commitment that upgrading of Vancouver General Hospital will take place. Those obsolete facilities will be phased out and eliminated. We're working with the board and the executive director of VGH, attempting to work out a programme now in terms of the money that's needed, so that we can go to Treasury Board and ask for approval for that money.

Mr. Chairman, the senior citizens' medical thing. The Minister of Transport and Communications did talk to me about that. At the present time the recommendation is that we don't include medical checkups in the medical plan, but that's a situation which has been ongoing in discussion with the British Columbia Medical Association. It will be considered again, but that's the present recommendation.

The extended-care situation in your constituency. I know it's serious problem to make extended-care beds available. The central-registry thing does cause problems all over British Columbia. It was set up when extended care first started to come into being because there weren't enough beds and there had to be a central registry. But as we get closer to enough beds, hopefully that central-registry approach can be abandoned and then the local communities will be able to make use of their own facilities. But that can only happen when there are enough beds available.

In Powell River, I understand, there are quite a few empty beds in the acute-care section, and perhaps if that's true you might talk to the board and see if they might designate some of those beds as extended-care beds.

Hospital funding I dealt with yesterday. We're looking for new ways. Again, if you have suggestions, give them to me about ways in which hospitals can be better funded in terms of formulas. I know they can be better funded by giving them more money but we're looking at formulas, I think.

The Bella Coola hospital. it's my understanding that $800,000 has been approved for the hospital to cover the term 1977 to 1979 for renovations and additions to the hospital.

MR. D.G. COCKE (New Westminster): Mr. Chairman, our hearts bleed for the former Attorney-General.

Mr. Chairman, I was pleased to hear the minister say that they're going to do something with the downtown hospitals. We had concern that the minister had eyes only for the university. Now he says that he's going to do something with the downtown hospitals.

But, Mr. Chairman, if the minister would go a step further and indicate that he can use that corridor -Shaughnessy, VGH and St. Paul's - as his teaching centres, as opposed to the university hospital, he can have his 160 or 290 or however many medical students he wishes graduate from UBC. You have all the hospital facilities in the world to graduate as many students as you want, providing you put teaching facilities in the teaching hospitals. If you want to you can move as far afield as Burnaby, New Westminster -- well, New Westminster's doing a little bit - and Lions Gate Hospital in North Vancouver.

Mr. Chairman, the alternative is there and I'm sure the minister would be using money far more frugally if he would develop what he now has in place of going out to the university and putting that $50 million.... Incidentally, it is going to cost a good deal more than $50 million. The fact that the minister says that that's the price doesn't really impress me that much. I suspect that the price is going to be considerably more than $50 million for the 240-bed hospital, particularly in view of the fact that their size of the facility is rumoured to be quite extensive.

Interjection.

MR. COCKE: You know, every time that minister comes out of the mine he brings some of the pit with him.

Mr. Chairman, I do think that the minister could take another look, use the corridor that he now has, upgrade those hospitals, make them real teaching hospitals instead of what they are.

Mr. Chairman, the minister has so much money that he can spend all this money out at UBC. But you know, down at poor little Pearson Hospital they've got a ward called ward 3. Ward 3 has 44 patients, and with 44 patients, it has one bathtub. The other one's been broken down since the beginning of May. You know, Mr. Bucks over there can't have enough clout

[ Page 3718 ]

even with the Minister of Public Works (Hon. Mr. Fraser) to get a bathtub fixed.

MR. LEA: That's all they'd need if they were Socreds.

MR. CHAIRMAN: Hon. member, we are on vote 169.

MR. COCKE: That's right, and Pearson Hospital comes right under vote 169.

1 suggest, Mr. Chairman, particularly in view of the fact that ward 3 is a mixture of men and women, that the minister get to work and get his bathtub fixed, and maybe spend just a few dollars that they'd be spending otherwise out at UBC.

One other point that I'd like to raise is the minister's behaviour with respect to Dr. Peter Banks. The minister said that Dr. Peter Banks is playing games.

Interjection.

MR. COCKE: That's right - playing games. The behaviour of the minister towards the past president of the B.C. Medical Association, the Canadian Medical Association, and the British Medical Association, a most prestigious person - and my doctor besides.... The minister makes irresponsible statements like this around this Victoria controversy. " 'The statements made by Dr. Banks are nonsense. He's completely incorrect in his comments from the report, ' McClelland said." Then McClelland went on to say: "I think Dr. Banks is playing games." Well, I understand that there's a difference of opinion but I do think that a minister could be just a little bit more careful in expressing himself, particularly when he's talking about a person who really has great concerns over delivery of health care in this region.

Mr. Chairman, we will be suggesting to the Minister of Education (Hon. Mr. McGeer) when his estimates come up alternatives to the university hospital. I don't really think that there is too much sense in making those suggestions at this time.

MR. A.B. MACDONALD (Vancouver East): Mr. Chairman, I put it to the Minister of Health that neither a dental hygienist, nor a dental assistant, nor an undergraduate dental student can fill a cavity. Am I not right in that? I'm trying to see past the Attorney-General here.

HON. MR. McCLELLAND: Keep going.

MR. MACDONALD: I think I'm right on that. You know, it doesn't make much sense to me that a dental hygienist, for example, a very qualified person.... A navy can fill a pothole in a road, eh? So what's difficult about filling a cavity? In simple cases, why shouldn't the paradental people be able to do some of the simple operations in a dentist's office? Now we've made progress in that respect, Mr. Chairman - cleaning teeth and things of that kind. But there's a tremendous need for dental services, especially in the hinterlands of British Columbia. If my facts are right then the minister should make sure that a simple non-dangerous operation like that should be done by a para-person. That's my question No. 1.

Question No. 2. The minister made a very brave statement that he was going to see that the proposition that somebody who was addicted to heroin might be subjected to compulsory treatment would be written into our laws. Now I say that in the newspaper and that was your statement. I just want to ask you: are you preparing legislation in that respect?

If you want my opinion, Mr. Chairman, there's no solution to this problem in an individual case where there's no will to beat the habit. But in the case of young people who are being hooked, I would think it may be that kind of a proposition might meet with favour, to save somebody from being finally sucked into the drug scene and their life go up in flames, You can't possibly deal with the 10,000. Are you preparing legislation?

Two questions. I waited two days to ask those questions.

HON. MR. McCLELLAND: Well, Mr. Chairman, I've been waiting two days to hear those questions too, with bated breath. I obviously can't talk about whether or not we're preparing legislation - and I won't.

AN HON. MEMBER: Why?

HON. MR. McCLELLAND: Because it's against the rules of the House, that's why. Yes, we're looking into at all times the possibility of doing more with paraprofessional people. We are in constant conversation and negotiations with the professionals on this matter.

I suppose the navy that you talked about who can fill the hole in the road, if they filled the tooth cavity with asphalt, could do that job as well. But they don't at the present time.

MR. MACDONALD: I waited two days, Mr. Chairman and I got two non-answers.

MR. D.D. STUPICH (Nanaimo): Mr. Chairman, a very short letter to refer to - a letter that the minister wrote to a Ms. Lynne Bowen, Secretary of the University Womens Club in Nanaimo, June 6,1977. This may have been touched on before, I don't know;

[ Page 3719 ]

1 haven't heard it. But in the letter he seems to invite a question about it during estimates. The letter to Ms. Bowen reads as follows:

"Thank you for your letter of May 9 expressing concern regarding the appointment of a nutritionist in the Central Vancouver Island Health Unit area. Further attention will be directed to this matter when the House is once more in session, beginning June 13. Your interest in the important subject of nutrition is appreciated."

I take that as an invitation to ask him the question during estimates and I wonder if the minister is prepared to answer, Mr. Chairman.

MR. MACDONALD: He'll give you a non-answer.

HON. MR. McCLELLAND: Mr. Chairman, another member brought that up, the member for Cowichan-Malahat (Mrs. Wallace) . I said I'd look into it and see where that situation is at the present time and get back. I'll make sure that you get a copy.

MRS. E.E. DAILLY (Burnaby North): Yesterday when the minister was speaking at the beginning of his estimates, he mentioned that he and his ministry were very concerned with the great rate in increase of gonorrhea in the province. We're pleased that you're aware of it and you're concerned, but what is your ministry planning to do? Are you planning any public education programme? And secondly, are you working with the Minister of Education in this area at all so that perhaps this can be brought to the attention of some of the students in our public institutions?

HON. MR. McCLELLAND: Mr. Chairman, yes, this has been a subject of discussion not only between the Minister of Education and myself but all of the ministers in the social services committee in terms of working out a programme for education in the schools. And I've just had approval from Treasury Board for a public information programme to run over almost every radio station in the province this summer.

MR. D'ARCY: Before I proceed to my general remarks I did make some inquiries regarding the extent of Human Resources subsidies to people in West Kootenay receiving extended and intermediate care in private institutions, Mr. Chairman. No fewer than 90 per cent are receiving assistance from the Ministry of Human Resources, and yet the minister says, "Oh, very few of the people that are going on the $6.50-a-day comprehensive care as of next January are receiving assistance from the Ministry of Human Resources. Of course, as the minister well knows - and I suppose many other members of the committee do - these people were not necessarily indigent shortly before they needed to enter private nursing-home care. They curiously found themselves without any means of support about the time that they were going to need this kind of care. 1 welcome the change. It would appear that there's some evidence that they artificially created a situation where they were going to need assistance from the Ministry of Human Resources before they went into private care, whereas now it is going to come directly from the Ministry of Health.

However, when we look at the savings that will be made to the Ministry of Human Resources and when we look at the reduction in the provincial acute-care costs because the per diem is going up, one really wonders when the minister says we have $130 million programme, a major proportion of which is going to be federal money. How much of that is new money and how much is going to be a savings in other parts of the Health ministry? How much of that is going to represent savings in the Human Resources ministry?

Certainly 1 welcome the new programme, but 1 question whether or not there is $130 million. In fact, 1 wonder if there is not going to be savings of up to as much as $100 million in the Ministry of Human Resources and the Ministry of Health.

HON. MR. McCLELLAND: Tell me where you got that figure. Where did you get that figure? Tell me where you got $100 million.

MR. D'ARCY: Mr. Chairman, if the minister wants to answer a few questions.... I've asked him a considerable number this evening and he hasn't answered any of them. If he wants to take his place in the debate and answer a few questions instead of making pompous political statements, 1 would be glad to hear them. He is certainly going to get his chance.

I don't believe it has been touched in the remarks on his estimates, but 1 was wondering what is happening in the area of out-patient psychiatric care. Certainly there have been statements by government members over the last few months that they would like to see people in B.C. de-institutionalized as much as possible. It's a philosophy that I would support. 1 would ask what the ministry is doing in this particular area.

1 would also like to ask the minister about the support of the ministry for such things as out-patient group homes, particularly the ones run by the Mental Patients' Association in the lower mainland which I'm quite impressed with. 1 think they serve a real purpose in providing a buffer area for re-entry of mental patients into society. Many of the people administrate the homes themselves and many of the people in these group homes are, in fact, self-supporting. They hold jobs within the community. 1 gather from the representations made

[ Page 3720 ]

to me that the association is not entirely happy with the support they receive from the ministry. I would hope that the minister can reassure the committee that this association is going to receive continuing support.

Mr. Chairman, I have a few questions on the problems at Royal Inland Hospital in Kamloops regarding their stated need for more operating theatres. I'm not entirely satisfied that the hospital has done everything it can do. It would appear that there are some problems in the existing building vis-à-vis the fire marshal's office. I appreciate the fact that the ministry certainly doesn't want to rush into providing expensive facilities that may have to be extensively modified as part of a reconstruction programme. However, there can be no doubt that in one of the fastest-growing communities in the province there is a real need in this particular area and a tremendous backlog of operating cases, both elective and of the more urgent variety.

MR. NICOLSON: I'd like to be very brief and ask the minister about the status of the request for intermediate care in Creston. He's mentioned that other projects which have been under consideration for some time will probably be announced, I think he said, in August or September - in six months or something.

I'd just like to refresh the minister's memory. We did purchase some property contiguous to the Creston Valley Hospital. It is also very well located in town, close enough to the downtown and yet far enough out to be reasonably quiet. There was property purchased by the Ministry of Housing. It was for intermediate care. As you will recall, Mr. Chairman, to the minister, I brought to his attention the fact that there was some danger of one of the negotiations falling through. As a result of bringing that to the attention of the minister, and also to the Minister of Housing (Hon. Mr. Curtis) , there was an arrangement made whereby the hospital board purchased that property.

I feel that the people in the community are not really clear in their minds as to what the government's policy is and how the government would like to see them proceed. There is an intermediate-care society, a registered society, which has been endeavouring to get this going. I believe that the need and the desire for intermediate care in the area is so great that they would be willing to go along with whichever direction the minister wants to proceed in. That is, if the minister wanted to see this done in conjunction with the hospital and through the hospital board, I think the community would go along with that. But it's been kicking around for some time. I think it has suffered and lost some headway under the change of government due to some hesitation.

1 would also like to ask the minister if he would now release the Larsen Bristowe report which was under consideration. Could we have some of this information and find out the feelings of the ministry? I would like to know with respect to the Creston intermediate care if there is some really firm plan coming up on it and if there would be any way in which I could assist in terms of communicating the direction in which the ministry feels it should go. I would say that I think it's wrong to take a firm approach one way or the other. I think it should be dictated by the circumstances in the community and, in many communities, intermediate care could be developed in conjunction with the hospital and the hospital board. In other cases, where a good, viable intermediate-care society exists, I think it could go that way.

I'd like some expression from the minister as to the priority of the question of intermediate care and also what the general feelings are. I'd like to know the status of the Larsen Bristowe report if they're ready to release that.

HON. MR. McCLELLAND: I've answered this question before. I don't know what the Larsen Bristowe report is. There is no such thing as a Larsen Bristowe report. There are two people who work in the ministry who are called Larsen and Bristowe and they've been working very hard on intermediate-care proposals. They were part of the team which developed the new long-term, comprehensive-care programme, but there is no report as such.

Secondly, I'd be very pleased if you would contact the chairman of the Community Care Facilities Licensing Board and offer him your input to any problems that might be arising at the location of that intermediate-care facility. The list of facilities to be improved includes Creston, and if we can work out everything, it is my intention that that approval can be given October 1. If you can be of some help as a go-between, I'd be very happy that that would happen.

To the member for Rossland-Trail, the programme of long-term comprehensive care will cost $138 million. I have no idea where he gets any $100 million figure that would be a saving to the Ministry of Human Resources or anything else. If he has some figures like that I'd sure like to see them.

There isn't any saving to the Ministry of Human Resources to begin with, because the Ministry of Human Resources will still be providing the maintenance for people who need it, and they'll be paying the $6.50 a day, the same as they pay the rates now. Perhaps there is a place with 90 per cent occupancy of Human Resources-supported people, but that's not the case throughout the province. The average is around 50-50. In the private hospitals, the

[ Page 3721 ]

latest report as of December 14, last year, was that 46 per cent of the people were self-pay, and 54 per cent were supported to one degree or another - not totally, all of them.

Those are the latest figures that we have in terms of that. The programme will cost $138 million. The majority share is not coming from the federal government but from the provincial treasury.

You can add as well as 1 can, and there's only the per capita grant which is being made available by the federal government. It's all we get for this programme. It's not only for this programme, but it may be used for other alternative programmes as well. So out of that money that's available we don't get any more.

I think that's all the questions the member raised, Mr. Chairman.

MR. D'ARCY: Mr. Chairman, 1 did have several questions on group homes for mental patients . . .

HON. MR. McCLELLAND: Oh, I'm sorry.

MR. D'ARCY: ... and psychiatric out-patient care. I would also like to again repeat, whether or not the minister wants to give us any indication that he has any position at all on the expansion of services by nurse practitioners.... 1 suppose 1 could repeat some of the questions I've asked several times earlier in these estimates that the minister has simply refused to even comment on, although I suppose that's normal when a minister's estimates are being debated.

One aspect that has not been mentioned except during the estimates of the Ministry of the Provincial Secretary (Hon. Mrs. McCarthy) under the lottery vote, Mr. Chairman, is the question of medical research in British Columbia.

HON. MR. McCLELLAND: 1 answered that yesterday.

MR. D'ARCY: I'm somewhat concerned that in British Columbia traditionally we have never come up to anywhere near the level of other provinces in Canada, and certainly nowhere near the level of funding for medical research that we have seen in the United States. When 1 say the "level" 1 don't mean the total absolute level, 1 mean the level on a basis of our per capita wealth for our per capita population.

1 note that the most recent figures from the United States would indicate that that country spends $8 to $10 per capita on medical research. Our nation spends from $1.50 to $2, and in British Columbia our figure has been even somewhat lower than that. 1 know the minister is indicating that this year we're going to see some improvements in that, but it is my opinion that we're still extremely low.

I think the research people could probably make a very good case that we in Canada have been extremely well done by the limited amounts of medical research funds that we have made available to researchers over the years. For instance, the individuals Enders and Delbecco, who discovered the Salk and Sabin polio vaccines.... Certainly we can easily assume, from what occurred in Canada before that became available, that 70,000 Canadians are living today who may not have been living had they not made that discovery. Certainly we can also assume savings of possibly $200 million a year as a country since 1955. When we consider the discovery of streptomycin in 1945 also by a Canadian, we are again looking at major savings.

There have also been significant discoveries in the area of measles prevention by Canadians, again going back some years. Again we see not only a great saving in human suffering, but a great saving in money.

I appreciate that it has not been government policy of this ministry, or the previous one, or the one before that to put in large amounts of money into medical research.

I was rather critical during the Provincial Secretary's estimates of the fact that such an important funding thing should be tied to anything so volatile as the proceeds from a lottery or anything which I consider to be somewhat frivolous. However, I suppose it is better than nothing. Perhaps the minister can indicate how he personally feels on this and where he intends to go within his ministry.

HON. MR. McCLELLAND: Well, Mr. Chairman, there's been far more than just a slight improvement in medical research funds available. In the past few years there has been about $500,000 a year, as I understand it, available for medical research. This year we'll be getting either of the draws from the lottery, which should amount to about $1,600, 000. That's six times as much money going into medical research as we've had in the past.

Don't forget that Canada pretty well pulled out of research. We should be putting some pressure on them. British Columbia can't handle the research that's needed for Canada on its own. We need all the help we can get in terms of money available,

It's not true that we're in bad shape as compared with other provinces because very few of the other provinces do any research at all. Ontario and Quebec - and Alberta perhaps just starting - are the only provinces that do any research to speak of besides British Columbia.

As I said yesterday, we have the committee set up both in terms of the trust of the research fund and the peer review committee to make sure that the research goes to the best possible direction.

The business of out-patient homes for mental patients. We've increased our grants considerably this year to those homes and we'll continue to do that.

[ Page 3722 ]

Vote 169 approved.

Vote 170: deputy minister's office and support services, $1,414, 550 - approved.

Vote 171: deputy minister and branch support services, community health programmes, $2,870, 519 - approved.

Vote 172: public health programmes, $27,193, 153 - approved.

Vote 17 3: mental health programmes, $16,128, 032 - approved.

Vote 174: special health services, $15,330, 884 -approved.

Vote 175: other health care expenditures, $9,688, 020 - approved.

Vote 176: office of the deputy minister of medical and hospital programmes, $63,980 - approved.

Vote 177: hospital programmes, $615,621, 231 -approved.

Vote 178: government institutions, $53,084, 751 - approved.

Vote 17 9: forensic psychiatric services,

$3,106, 101 - approved.

Vote 18 0: Medical Services Commission $207,300, 000 - approved.

Vote 181: emergency health services, $20,923, 537 - approved.

On vote 182: building occupancy charges, $16,568, 461.

MR. KING: Mr. Chairman, 1 wonder if the minister could give me a breakdown of the square footage of rental occupancy that his ministry occupies and the rate per square foot for payable to the Ministry of Public Works?

HON. MR. McCLELLAND: Mr. Chairman, I'm sorry I'm not able to provide the member with that information tonight. If he really wants it I'll provide it to him at the first opportunity.

MR. KING: 1 appreciate that, Mr. Chairman. That minister seemed to be obsessed with space on previous occasions and 1 would have thought he knew the cost of space rented by his ministry.

Vote 182 approved.

Vote 183: computer and consulting charges, $168,000 - approved.

The House resumed; Mr. Speaker in the chair.

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

Hon. Mr. Gardom moves adjournment of the House.

Motion approved.

The House adjourned at 10:57 p.m.

APPENDIX

99 Mr. Rogers asked the Hon. the Minister of Highways and Public Works the following questions:

1. How much did it cost to operate the Massey Tunnel bicycle/bus service in 1976?

2. What was the per bicycle cost?

3. What was the average load?

The Hon. A. V. Fraser replied as follows:

"I. Cost to operate this service for 51/2 months in 1976 was $13,446.

"2. Cost per bicycle was $8.92 per trip.

"I Average load was 1.2 passengers."