[ Page 1767 ]

CONTENTS

Statement

Fidelity to domestic wines. Mrs. Jordan –– 1767

Routine proceedings

Committee of Supply: Ministry of Health estimates.

On vote 125. Mrs. Dailly –– 1781

Mr. Barber 1767 Mr. D'Arcy –– 1781

Ms. Brown 1767 Mr. Stupich –– 1782

Hon. Mr. McClelland 1768 Hon. Mr. McClelland –– 1782

Mr. D'Arcy 1772 Mr. Levi –– 1784

Hon. Mr. McClelland 1775 Hon. Mr. McClelland –– 1785

Mr. Cocke 1776 Ms. Brown –– 1786

Mr. Lloyd 1778 Hon. Mr. McClelland –– 1787

Hon. Mr. McClelland 1779 Mr. Cocke –– 1788

Ms. Sanford 1780 Hon. Mr. McClelland –– 1789

The House met at 8:30 p.m.

MRS. JORDAN: I rise to ask leave to make a statement.

Leave granted.

MRS. JORDAN: Mr. Speaker, it grieves me to mention that over the dinner hour I learned of a matter that is of grave concern to myself and to members of the constituency in the Okanagan Valley which I represent. As a matter of explanation, I would like to advise you that I understand that when the Premier of this province announced that the government of British Columbia had made a positive decision to subsidize the Fort Nelson extension of the British Columbia Railway in order to keep the lifeline of the northern area's industry and the community of Fort Nelson open - in the interests of the jobs of that area, the lifestyle of the people in that area and provincial development - this announcement, supported and hailed by many British Columbians, was received and celebrated by the mayor of that community, Mayor Schuck, by the indulging in a bottle of imported Bristol Cream sherry. Mr. Speaker, I wish to ask you, on behalf of those people I represent as part of the wine-growing community of this province, to take this bottle of British Columbia produce - amongst the finest wines in the world - Similkameen Superior - grown a British Columbia, processed in British Columbia, providing jobs for British Columbians and helping to contribute to the revenues that will keep that extension open - and present this to him, sir, on behalf of this Legislature in the interest of supporting British Columbian industries which will help keep that extension alive.

Orders of the day.

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

ESTIMATES: MINISTRY OF HEALTH

(continued)

On vote 125: minister's office, $139,851 -continued.

MR. BARBER: I rise at this point in the debate to honour a promise I made to the minister some weeks ago. I indicated, as the result of an extremely wise decision he made, that I would stand in this House and congratulate him for having done so. I wish to honour that promise now.

Starting in October of last year, I initiated a correspondence with the Ministry of Health regarding a previously discriminatory clause in regulations governing the Medical Plan of British Columbia and hospital insurance in this province. The previous regulations had required of pregnant women coming for their interment as it's politely phrased in this province to British Columbia for that purpose to be somehow more qualified than any other patients who would be in this province for any other purpose and, indeed, to stay longer than any other patients would stay at the end of their confinement. After much apparently fruitless and pointless correspondence with the public servants involved around this blatantly and demonstrably unfair provision, I chose to write directly to the minister.

I should like to go on the record now as thanking and congratulating the minister for within a period of two weeks taking a decision which apparently the public servants hadn't been able to take for six months. Thanks to the minister's action, the previously discriminatory regulation was revoked and the same terms and conditions that apply to every other patient in the province entering hospital for purposes of health and recovery now apply to unmarried pregnant women who go in for the same purpose. I just want to go on record now as congratulating the minister for having made that decision.

It's one very small recognition of the fact that women especially in these circumstances are often humiliated by the attitudes we take toward them, by the disrespect and the laughter that's often shown. They were humiliated in this case by a regulation that in a most unfair and unkind way made them feel all the worse as a result of the situation that obviously they didn't want to be in in the first place. So I for one thank the minister for having done that and commend him for having done it so quickly.

MS. BROWN: I'm wondering what the minister is going to do about Vancouver General Hospital and the fiasco we go through every year when they have to elect a new board. It's coming up again in September, and I understand that the membership of the hospital association is now over 10,000. This is a hospital which a couple of years ago could hold its annual meetings in a telephone booth. It's membership is now over 10,000, and all because those who are against women having the choice about whether they should or would have an abortion or not are mobilizing to change the

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board, and those who have worked for years so that women can have this choice are mobilizing to protect the board.

Vancouver General Hospital is one of the only hospitals in British Columbia in which, by law, legal abortions are performed. Prince George is one, and as a result they too go through this same exercise whenever the time comes to have an election to change the board. Last year there were so many people who signed up to become members of VGH and there was so much hostility around the subject of whether VGH should continue to perform legal abortions or not, that there was almost violence; that's how dangerous the situation was. Vancouver General Hospital is not doing anything unusual or anything unique.

According to the law of the land, the general hospital, if it has a board, if it has an abortion committee, makes a decision about whether a woman meets the criteria established by law, which is that her health is in some kind of danger. That's all that VGH does; it has a committee which rules on these decisions. In addition it has chosen to accept the United Nations' definition of health rather than the very limited and confining definition of health which some other hospitals use. Because of this, Vancouver General Hospital is under attack. Is the minister going to intervene or are we going to have to go through this battle year after year to ensure that the one hospital in this province which makes it possible for women to have a choice is going to continue to deliver that service? Once the board is elected, the board has the right to decide, as the board at St. Paul's hospital and Grace Hospital and other hospitals have decided, that they will not allow women this choice. And the forces who are against choice, the anti-choice forces, are now mobilizing their resources to change the board of the Vancouver General Hospital.

Now surely the minister is aware of this and surely the minister knows something about the hard-fought battle which has gone on for many years to get even this very limited resource which we enjoy in this province - it's very limited. There is no such thing as abortion on demand, or everybody having a right to have an abortion if her doctor decides that is best for her - or the woman and her doctor and her husband or whoever making that decision. The choice still rests with the hospital; they still make that decision. Despite that there is only one major hospital in this province which uses the United Nations' definition for health, which makes it possible for women to enjoy some degree of choice in this area. And the chances are that when the elections are fought this year, the forces on behalf of choice will win again; but there is also the possibility that they may lose. Then what happens if they do? If Vancouver General Hospital ceases Lo permit the performance of abortions, what happens to the women in this province who have decided for one reason or another whether through health or age or whatever that they would like to have an abortion? Are we going to go back to the kitchen table abortions? Are we going to go back to the clothes-hangers? Is that the only option that's going to be open to the women of this province?

it's not an option that women of wealth have ever been deprived of, whether it is to fly to another country or visit another province or pay an incredible price to have their abortions. It's the women who have no income or have very limited incomes who are going to suffer. It is their lives that are going to be in jeopardy. It's the young women, the teenagers.

Tonight's newspaper had an article in it saying that teenage pregnancies are up something like 30 per cent in one of the prairie provinces. A large number of these teenage pregnancies are terminated by abortion, for one reason or another.

MRS. JORDAN: Shocking!

MS. BROWN: It is shocking. That they are pregnant is shocking. Why don't we do something about the fact that they are getting pregnant, rather than depriving them of this one option? Why are they being forced into the back room and onto the kitchen table? What is the minister going to do about that? The minister has the option to say that a hospital which presently delivers such a procedure cannot cease to do so regardless of what its board may decide; the minister has that option. But is the minister sufficiently concerned to exercise that option on behalf of VGH and the Prince George hospital? I think it is something that the minister needs to think about very seriously, and to give some kind of response to at this time.

HON. MR. McCLELLAND: I-d just like to make a comment or two about the remarks of the previous speaker. I don't know where the previous speaker thinks that I have the kind of responsibility to step in and overrule what is an elected hospital board. On the one hand, the people tell me: "Keep your hands off the hospital board." Then someone else comes along and says: "Step in and tell the hospital board what they should be doing." You can't have it

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both ways. I'm going to try and protect the hospital board as long as possible as a democratically elected society because I think it's the best system. I recently asked the British Columbia Health Association, which represents the hospitals of this province, whether or not there was a better way. In a study of all of their hospitals and themselves, they concluded that they don't want to change either. They recognize, as I do, that there are some weaknesses in that kind of system, as there are in the kind of system that you and I represent in here. But they sure beat everything else that has been tried or possibly could be tried.

It is not true that there is only one hospital in British Columbia doing abortions.

MS. BROWN: I named two.

HON. MR. McCLELLAND: You named two. There are 17. There are only 35 or so that are accredited. So there are at least half of the accredited hospitals - accredited under the terms of the federal legislation - that are doing abortions now.

Yes, Vancouver General Hospital has a very special problem, but I didn't hear you tell me what we should do about it. Should I say, first of all, that a person who does not believe in abortion because of either religious or some other beliefs should not be allowed to take out a membership and vote in a hospital society?

MS. BROWN: No, that is not what I am suggesting.

HON. MR. McCLELLAND: Or, if I do that, then I have to say that a lot of people who have special concerns about their beliefs cannot take out memberships in hospital societies. I don't think that is the way to go either.

I am not looking forward, nor is the administration of Vancouver General Hospital looking forward, to their annual meeting, because we have had some indication that there are going to be a tremendous number of members at that meeting and we'll have to deal with that in one way or another. I personally attended their last board meeting to see what was happening. I don't think it is going to be good for the hospital if that kind of thing continues; nor will it be good in Surrey where it is also happening, or in Prince George where the same kind of thing is happening. But the answer is not for me to step in and all of a sudden decide that the Ministry of Health is going to run the local hospitals. Nor is the answer for me to tell them that they can't accept memberships. I think we are going to have to appeal to all people involved that single interests should not be imposed upon local hospital boards. Essentially that is what we are being asked to do here on both sides of the question. The thing that bothers me is that if single interest groups gain control of any of our hospitals, whether it be abortion or some other single interest, then the question I have to ask is: will that group be able to have a wide enough view that it can operate the hospital and all of the facilities it makes available to the public?

I think that what I have to do as minister is just wait and see. If it proves at any point down the line that a hospital board is being operated on narrow interest lines, then I suppose the Ministry of Health has to take some action. But I don't see in any way how I can take action at this point when most of what we are talking about is speculation. I have talked with the board, and I've talked with the people involved on both sides as well, and I have appealed to them that ....

I'm sorry, I was a little bit out on the numbers of hospitals which are performing abortions. It's 52, not 17. So there are a number of hospitals performing that service in their communities.

What I've asked those people is to really take a look at what they are doing and make sure that what they want is to provide a total spectrum of health care for our people who are served by those hospitals. I can't do anything else, and I don't intend to do anything else at this point until we see what happens. If the total spectrum of health care is not served, then I would have no choice but to take some kind of action as Minister of Health. But I can't speculate what that action will be at this point, or whether or not there will be any action.

I have quite a lot of confidence in the board of management of the Vancouver General and the other hospitals who are facing the same kind of situation, perhaps on A reduced scale. I will give them every help that the office of Minister of Health can give them and hope that things work out in a proper way for the management of health care for the people of B.C. I can't do much more than that, and I wouldn't want to impose my office any more than that on the hospitals. But I recognize that it is a serious problem.

If there is a political battle to be fought here, I suggest that the political battle is not at the hospital level; it's at the federal level. If people wish to mobilize forces to appeal to the federal government to change anything, then more power to those people. We

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all do that as politicians and I would hope we'd always be able to have that opportunity. But I just think this battle is being fought in the wrong arena and I wish it wasn't. But there is no way I would step in and impose anything on the board at this point.

I'd like to just finish answering the question that was posed by the member for Rossland-Trail (Mr. D'Arcy) . I promised that after supper I would deal with questions he raised about the delivery of hearing aids in the province. I appreciate the things he has said about this whole problem. Many of the things he said have certainly been uppermost in my mind and in the minds of the government while wrestling with a problem that is a tough one and a thorny one.

I have to remind that member that several years ago, the division of speech and hearing was given a mandate to develop accountable services for the speech, language and hearing impaired of British Columbia, and I believe that has been done. Some years ago, five pilot projects were set up around the province - one of them, I believe, in that member's constituency - to test whether or not the programme was viable and whether or not it should be either continued or expanded. It proved to be extremely valuable to the people of the province of British Columbia and it was decided at a point not long ago that the programme would be expanded. Treasury Board approved a submission that I made as Minister of Health to expand that programme into 15 new communities. We're into 10 or 11 of those communities now, I believe, with full programmes, a full range of speech and hearing services for the people of the province.

In so doing, we received representation from the association of private hearing aid dealers who put forward a proposition to government asking that we make a subsidy available to cover the costs of servicing hearing aids sold by private dealers. I promised the dealers that I would look very carefully at that and that I would present it to government on their behalf. I have done that, and the decision made by government was that there would not be a subsidy programme made available. But the dealers have been told at this time that we would make the auspices of our programme available as much as possible in that we would provide them with our bulk-buying capabilities to allow them to take advantage of much lower prices for the product than they can, buying by themselves.

That offer has been made to the dealers at the present time, along with an offer to discuss the possibility of our providing servicing for aids that they sell as well, in terms of low-cost batteries and low-cost servicing and high-quality testing and assessment of the aids that are being sold. I hope that that offer will be accepted. The Workers' Compensation Board as well decided that it would end its subsidy to private dealers of some $175 per aid, and that's been a further blow to those dealers. That's the decision that was made and we've attempted to make a counter offer to the dealers to attempt to help them to remain in business in the communities which they serve now.

The question of Canadian graduates and the hiring of Canadians is one that has bothered me and has certainly bothered the Public Service Commission of the province. The problem is one of getting enough qualified Canadians into this kind of programme. Both the speech and hearing programmes in Canada are very young. Most of them have just started and they graduate a very small number of speech pathologists and audiologists each year. They now, I'm told, graduate around 70 per year in Canada, and 60 of those have selected speech pathology as their specialty. The large majority of them seem to accept positions in the east and the few who do seek employment here, so far at least - and we're hoping that this will change - have almost consistently refused positions in our northern and interior regions where the need is greatest.

Only 11 graduates of Canadian training programmes have completed applications to the division of speech and hearing since January, 1976. Of that number, five were offered employment; only two of them accepted. Only two UBC graduates have fully completed their applications to the division since January, 1976. Of course they were treated the same as, anyone else.

We have been successful, to some degree at least, in attracting Canadians back to Canada, Canadians who have been taking their training in the States. We've employed 10 of those so far. The situation of Canadians going across the line to take their training is not unusual. Over half of the teaching staff at UBC at the speech and hearing programme, including the head of the programme, received their training outside of Canada. Recently we have, with the Public Service Commission, made a cross-Canada recruiting journey. As a result, seven graduating students were invited to apply for positions in our programme.

We have been having, as I'm sure the members are aware, Mr. Chairman, intensive discussions with the University of British Columbia to try to iron out any differences that there are between their programme and us, and the extent to which it is seen to meet the very speciali-

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zed needs of our programme. We are confident that those problems are being resolved.

I might say that of those seven graduating students we did invite to apply in that search across Canada, one has now been hired, two have been offered jobs, one of the applications is presently being processed, and one is being considered, but once again I am told that this person wants to work only in Vancouver and that two of them have accepted jobs somewhere else outside of British Columbia. So, Mr. Chairman, I think that answers that question.

The final thing is that I just want to bring the member for Rossland-Trail (Mr. D'Arcy) up to date on the rates as they compare now with what they were before. For personal care, under the Ministry of Human Resources, the rate was $340. it's now $410. Under intermediate care, there was a flat rate of $500. We now pay $500 for intermediate 1, 625 for intermediate 2 and $860 for intermediate 3. For extended care, the old rate was $750 and we're now paying $1,035 a month.

MS. BROWN: Mr. Chairman, to the minister once again, section 251 of the Criminal Code states that a legal, therapeutic abortion can only be performed in an accredited or approved hospital; that all applications for abortion must be approved by a therapeutic abortion committee comprising at least three members, all of whom must be qualified medical practitioners; that a majority of this committee must certify in writing that "in its opinion, the continuation of the pregnancy would be likely to endanger the life or health of the woman;" and finally, the abortion must be performed by a qualified medical practitioner who is not a member of the committee.

The problem here, Mr. Chairman, has to do with the fact that the Code does not give a definition for the word "health." There may be 52 hospitals in British Columbia performing legal therapeutic abortions, but Vancouver General Hospital and Prince George are the two hospitals that I am aware of which use the World Health Organization definition of health - namely, that it is a complete state of physical, mental and social well-being and not merely the absence of disease and infirmity. They are two of the 52 hospitals that use that definition, consequently most of the legal, therapeutic abortions performed in this province are performed in those two hospitals.

HON. MR. McCLELLAND: Do you have figures on that?

MS. BROWN: Well, I can get the figures for you. It says something like 20 per cent or whatever. But whatever, that is the reason why they're subject to the kind of intense competition and attack on their boards whenever it comes time for an election.

Now as the person responsible for the health of the province, is the minister going to stand by and allow a hospital to refuse to obey the law, as a number of hospitals are doing? Under normal circumstances the boards do not involve themselves in the medical procedures in the hospitals; the boards don't argue about whether the hospital should perform tonsillectomies or appendectomies or gall bladders or whatever. This is an unusual situation, and the question is: is the minister going to stand by and allow the few remaining hospitals which use this particular definition of health to refuse to carry out section 251 of the Criminal Code? That is the question I'm placing before the minister.

I'm not asking the minister to tamper with the boards, to force them to perform abortions or not to perform abortions. We're talking about choices and we're talking about options. No one who does not believe in abortions has to have an abortion; no one is going to force an abortion on someone who doesn't want an abortion.

HON. MR. McCLELLAND: What are you asking me to do?

MS. BROWN: No one is even recommending abortion as a way of life or certainly as a form of birth control. What we're talking about is having the choice or having the option. And what we're talking about is what happens when that option does not exist. We've lived through that period of our life when we saw what happened to women in this country when they didn't have that option. The fact that abortions are not legal doesn't mean that abortions are not performed; we learned that the hard way.

I'm asking the minister: are you going to stand by and allow the kind of fiasco which goes on around the election of a board at Vancouver General Hospital to continue? You say you will intercede when it gets out of hand. Well, at what stage do you consider that it is out of hand?

HON. MR. McCLELLAND: When would you like me to intercede?

MS. BROWN: Well, you have the authority to take the hospital under your administration.

HON. MR. McCLELLAND: Is that what you want

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me to do?

MS. BROWN: You have that authority.

HON. MR. McCLELLAND: Is that what you want me to do?

MS. BROWN: Well, if that is the only way out, if that is the only way to end this kind of procedure that's happening every time that we have elections, that is certainly what you should think about. It's certainly an option that you should explore, because the alternative is not a very good one to contemplate.

HON. MR. McCLELLAND: I guess if the member is recommending that the Ministry of Health take over the operation and administration of Vancouver General Hospital, the answer is no. And I don't know what else I can say. We're not going to stand by and see patient care suffer in this province. If patient care begins to suffer, then the Ministry of Health will take some action. That's the responsibility that I have and that I'll be happy to accept.

I know what the law says and I don't know where you get your information that only two hospitals have that definition of health. That's a definition that's accepted by everybody in the medical profession and everywhere else. But you've forgotten something. It isn't anyone at the board level or anywhere else who decides whether or not a therapeutic abortion is to be performed, it's the physicians. It's a medical decision and it's made by medical people.

MS. BROWN: But the board decides whether the hospital will even establish a committee. The board decides that.

HON. MR. McCLELLAND: Well, that's up to the hospital. First of all, they must be accredited. Secondly, they make their own decisions, and we're going to leave it that way. I'm saying to the member, Mr. Chairman, that there are a number of hospitals in British Columbia which have made the decision to accept that responsibility. It's a tough decision for some hospitals to make. There are some, because of the makeup of their ownership or previous ownership, that have decided not to take on that responsibility as a part of their function. You yourself have said that you don't want to force anybody into taking on that function who does not wish to do that, and I think that's a good decision. In the meantime, though, it's a medical decision that's made by the therapeutic abortion committee and it will always be a medical decision. And for anyone to step in and attempt to make it anything different would be sheer folly.

MS. BROWN: As long as a committee exists.

MR. D'ARCY: Mr. Chairman, first of all I would like to say to the minister that I appreciate his answers on some questions. His answers were incomplete or non-existent on others though. One of the things I would like to discuss again with the minister is if the minister can tell us what to his knowledge is the real or anticipated spending in the private sector on new and improved facilities at the personal or intermediate- or extended-care level. To my knowledge, there is little or none - probably none - either being spent or anticipated to be spent. I was wondering if the minister would like to discuss that with the House.

Mr. Chairman, some time ago he announced his ministry would be making a review of small hospitals in the province - cottage hospitals, I presume; those with usually 40 or 50 acute beds or less. I am wondering if perhaps he has had some report on that, and if he has, if he could make that available to the House.

Also, I would like to ask the minister for some details on one of his favorite subjects -at least one of his favorite subjects when talking to the media - and that is on hospital construction in general. He has spoken of $500 million to $700 million, depending on how enthusiastic he is waxing at the particular moment. I would like to ask how much of that is borrowed money. I suspect that all of it is borrowed money.

HON. MR. McCLELLAND: It's all borrowed.

MR. D'ARCY: I would like to ask how much is borrowed provincial government money and how much is borrowed local government money. Also, how much was already planned as a result of deferrals in the last two years in 1976 and 1977? Obviously, if you are a little bit slow in putting through approvals for a couple of years, in the third year you have room to be pretty generous.

I would also like to know how much this money represents as an improvement or an increase over the normal spending. We see in the estimates there's around $25 million for debt servicing charges for hospital construction current and past. We presume this probably means that the provincial share of capital expenditure for hospitals in the province is around $250 million a year at the present rates of interest. This $500 million then, if

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it is new money, represents only a couple of years expenditure at the present rate. So could the minister tell us whether, in fact, he is merely announcing something that is going on in any event as a result of, perhaps in many cases, long-standing appeals from various hospital boards and regional district financing authorities around the province -expenditures in construction facilities that have been asked for or requested or demanded, however you want to look at it, for a number of years? It's not unusual for construction programmes in various phases to take as long as 10 years in this province. So some of the programmes which he is talking about could go back certainly into the term of the previous government and possibly into the term of the government before that in some cases.

Of course, any MIA can get up and make an announcement about $20 million for schools in his constituency or $20 million for hospitals when a quick check of the record would show that this was the normal expenditure in any given year. Can the minister cast some light on the details of his capital spending programmes and let us know whether he really is coming up with anything new?

Mr. Chairman, I would like to ask the minister also if he could tell us something about mental health services around the province. We had a brief discussion earlier about Riverview. One of the things that has come to my attention about the institutionalized mental health care in this province is that there are fewer people involved. I would like to think that that means that as a province we're more emotionally and mentally fit than we used to be but I don't believe that is the case. I think what is happening is that more and more people are being treated at regional centres such as the one we have in Trail and also by the services of the mental health branch within the community - rather excellent services, I might add, where they are available with proper staffing, which unfortunately is rare around the province.

I have been made aware of a number of areas in the province where there have been strong requests for more and more qualified personnel - in other words, more people in terms of both quality and numbers - because the local authorities think that this is just a great way to treat people in the field. I'm wondering if the minister can give us any indication as to whether he or his deputies plan on approaching the Treasury Board to add some positions in this area because I've had numerous requests from the north, from the northwest, from the East Kootenay and from the Kamloops area for more people in this regard. I think it's one of the excellent things that the ministry can do, because one of the unfortunate parts about institutionalizing people, apart from what I think is the dehumanizing of services, is also that you tend to centralize emotional problems in the lower mainland. In many cases, when people are released from the mental health facilities in the lower mainland they tend to stay right there in the lower mainland rather than return to the community from whence they were originally admitted. So I think it's a very good idea to treat people on an out-patient level within the region in which they live when they run into mental and emotional problems.

Mr. Chairman, I would also like to indicate to the minister that I'm really not very happy with the minister's remarks regarding what he claims is the inability of his ministry or the Public Service Commission to hire people for the speech therapy and audiology programme.

There are some 12 people graduated from UBC who are working outside of the lower mainland. I'd like to have him give us some specific instances where he can name where people refused to go. In fact many of those graduates who are employed in Canada are employed in other provinces, and they had no desire to go to other provinces. But they went there if they wished to work within the field that they'd spent years getting professional training in. Now if the minister has proof of somebody not wanting to go somewhere he or someone else in the lower mainland may consider the boondocks, I'd certainly like to know about it. But I don't believe that he has any such cases.

In fact the information I have is that the 36 graduates are working at 23 different clinics throughout the province. In many cases these people are responsible for setting up completely new programmes including those in the compensation board, which is a government agency not under this minister's control. They have been involved in hospitals only indirectly under this minister's control, and they have been involved with municipal programmes and in school districts in areas as dispersed as Sooke, Penticton, Delta and Prince Rupert. That's hardly a pattern of people who have refused to work outside the lower mainland.

Also I would like to have the minister expand on statements he has made recently and in the past about the lack of practical knowledge of some of these graduates, because according to the ads placed by government in newspapers in Canada and in other areas, there was a requirement for certain practical training. That practical training is easily exceeded by the requirements to graduate from the University

[ Page 1774 ]

of British Columbia.

I am also interested in having the minister talk about some of the specific cases, because the individuals involved have documented some nine cases of people who have applied. Here is a typical one: an applicant applies for a position as an audiologist; transcripts and references were sent together with the application. Receipt of any of these items was not acknowledged by the division of speech and hearing services, and no formal rejection notice was received. And that's typical.

In another case, a person applied for a position of audiologist within the division of speech and hearing services. The application was acknowledged, but the applicant was not requested to send in transcript or letters of reference, and received a formal notice of rejection, with no reasons vis a vis qualifications given.

Typical case history, application 9: application was made for a position as an audiologist. A letter was sent stating there were no audiology positions available at this time but to apply at a later date. Applying a year later, the same response was received by the applicant even though he knew there had been positions filled in that time.

It just doesn't square with the minister's comments. The minister, once again, has not told this House either this evening or in response to the questions from the member for Vancouver-Capilano (Mr. Gibson) , who is not here tonight - he apparently doesn't wish to speak in the estimates - and we've had no response from the minister to the request that he show this House exactly in what ways any of these individuals have failed to qualify. It has not been told by the ministry or by the Public Service Commission. No one connected with it has been able to determine exactly in what way people trained in B.G. or even in other parts of Canada do not qualify.

The minister has stated himself that the number of clinics under his auspices since he has been minister has increased from five to a projected number of 20. obviously these clinics have to be staffed. They must have, I would presume, at least one professional on duty. They probably have a technician as well - at least one. I'm wondering where the minister is finding these people if he's going through this quantum expansion of the service around the province and at the same time not able to give a reason as to why people trained in B.C. at B.C. taxpayers' expense do not qualify for the particular service.

The minister in answering my discussion this afternoon shortly before adjournment talked about the great things that were going to be happening at the hopefully soon-to-be completed medical centre at the University of British Columbia. I would note though that the minister did not comment to the House on the question of who was going to pay the expenses of operating the teaching facilities, and whether it would ' be jointly shared by his ministry and the Ministry of Education, whether that's a matter of discussion between himself and the Ministry of Education, or whether it's going to be borne by one or the other. Certainly it's something that the taxpayers of B.C. would be very much concerned about.

We note, of course, that while this minister is not responsible for the remarks made by the Minister or Education (Hon. Mr. McGeer) , it does seem that that minister does most of the announcements regarding these facilities. He certainly made the statement quite unequivocably on several occasions during the opening of the extended-care hospital that it was going to be for teaching young people. As yet, of course, we know there has been no teaching taking place at all as far as the wards go.

HON. MR. McCLELLAND: Who do you think we're teaching - old people? We're teaching young people.

MR. D'ARCY: There has been some use of facilities in the basement, but this is by faculties and by programmes which were already in operation there. They're using the facilities which are not being used for anything else, using parts of the building. But there is no evidence, to my knowledge at least - and perhaps the minister can cast some light on it - that any of the medical facilities in that building have been used in any way at all. Now certainly this minister has not made statements that they were going to be, but his opposite number in Education has. And I certainly would like to hear more information on it from him.

We also have a further statement that this is not an ordinary extended-care hospital; this is where young people will be coming to learn the problems of the infirm. Well, once again, we would like to know when those kinds of things are going to begin to take place in the facility, because there is a lot of public money tied up in it. We need to know when it's going to start being used for what it was intended to be used for.

Mr. Chairman, I would also like - before I sit down - to ask the minister if he can tell us once more if the audiology and hearing aid programme is standing on its own feet as far as the dispensing of hearing aids goes. I

[ Page 1775 ]

suppose the minister can tell us if the idea is to dispense a good product professionally and at cost. Quite frankly, I wonder how that is possible at the salaries that must be being paid. I notice there was a statement made by one of the members of the board who said, when asked if they were in competition with the private sector: "No, we're not in competition. We're just providing alternative services at less money." If that's not in competition, I would wonder just what being in competition is.

So maybe the minister can let us know exactly how they feel that they're not in competition and when they are going to work out this mutually agreeable programme he is fond of talking about that's going to be satisfactory to people in the industry and to the public and to the taxpayer and to his ministry and the hearing aid board. Neither I nor any other observer - and certainly no one who's particularly close to the thing - has seen any indication that he is making any efforts whatsoever to work out something that could even remotely be called mutually agreeable. What is happening is that he is simply proceeding with the clinics - with the expansion from five to 20 - in areas, which already have, in many cases, adequate service. And to my knowledge there is absolutely no attempt by the ministry to work out something that is mutually agreeable with the people who have been in the industry for many years.

HON. MR. McCLELLAND: Mi. Chairman, I explained the offer that we made to the private hearing aid dealers. I'll be meeting with them and with their association somewhere around the last week of June to discuss that offer. There's no point in me going over it again because I've already explained it once.

The question of how much money is involved in the building of long-term care facilities in the private sector I can't answer right now, but there are a few facilities being built at the present time by the private sector. But it's been no secret that we will, in the long-term care programme - as has been the policy of this province for probably 15 years, I would think - favour non-profit organizations in the health-care field. In areas -Chilliwack is one that comes to mind - where a non-profit facility is offered to us at the same time as a profit facility, then, unless there is something seriously wrong with the offer made by the non-profit facility, we're encouraging them to develop a society and build a facility.

The policy that you requested about small hospitals is in the works now. Our senior staff people are working on that because it's becoming a more and more serious problem, in that small hospitals are seeing their patient days reduced all over British Columbia. They reach a point, of course, where they must keep staff on stream and keep the doors of the hospital open. There comes a sort of point of no return when they can't cut any more staff; they have to keep on a minimum number of people and that costs money. We recognize those needs. But, as I tried to explain earlier, our thrust in the last several weeks has been getting the hospitals' budgets out. Our next step is to get out and get the yearend adjustments done as quickly as possible and then we would hope to be able to sit down with the British Columbia Health Association's help and develop that policy for small hospitals. In the meantime we've been solving a lot of their cash flow problem , so that they're not in any immediate difficulty in most of them - that I'm aware of at the present time.

On the question of hospital construction, I was sure the member would have known that the normal formula for hospital construction is that it is borrowed money. It's always borrow ed money, and it's shared 60 per cent by the province and 40 per cent by the regional districts. That's not new.

MR. D'ARCY: It's new for you to say it.

HON. M. McCLELLAND: No it isn't. It certainly isn't new for me to say it.

MR. D'ARCY: You're talking $500 million, $700 million.

HON. MR. McCLELLAND: Yes. Whose money do you think it is? It belongs to the people of British Columbia, and we attempt to deliver to them the best possible care we can for that money that they send to us, whether it's through the regional districts or whomever it happens to be through. It's 60 per cent province and 40 per cent regional, but it is all raised from the people of British Columbia.

Today I said that there was a $500 million hospital construction programme that covers the five-year period from 1976 to 1981, and that's correct. If we carry that on for another couple of years into the next five-year programme, we have already got approvals for another couple of hundred million dollars, which comes to $700 million over a seven-year period or so. It means a lot of jobs to people in British Columbia and it means a lot of construction, some of which has been on the planning plate for a long, long time. One example is the Victoria General Hospital, which is

[ Page 1776 ]

falling apart and which has been on the planning plate for perhaps 10 years while people fight over where it should go, how big it should be, who should be building it and what should be happening to it. Finally we made a decision; we are building that hospital. That is what we are doing in a lot of other programmes as well.

Vancouver General Hospital has been sitting there complaining for 20 years that I can recall, and getting worse and worse by the year. We've made a decision; we are going to rebuild that hospital and we have committed about $60 million to do it. Those are new programmes. We are not interested in sitting around and having more studies done and studying the death out of hospital construction in this province. We've decided we are going to go ahead with it, and we are going to create jobs while we are doing it. And while we are at it we will create new facilities and improve facilities for people.

You asked if we were approaching Treasury Board for help in developing mental health services in the province. The answer is yes; we are and we have. We hope that this year one of the major thrusts that the Ministry of Health will have will be on the development particularly of rural services in mental health all over this province so that we can do exactly the kind of things that you mentioned: treat people as much as possible in the regions where they live. We know that is not always possible, but it is a good goal for which we should aim.

The augmentation by reallocating certain kinds of positions that we have asked and received approval for will result in expansion of services at Dawson Greek, Fort St. John, Fernie, Merritt, Oliver, Princeton, Fort Hardy, Queen Charlotte City, Quesnel, Salmon Arm, Smithers and Vanderhoof. A number of these areas have been served in the past by traveling clinics. But it has been demonstrated and shown to me quite clearly that more effective services are provided through stabilization by having mental health workers there. We are recruiting as fast as we possibly can to fill those needs in those various areas.

We are also hopefully dealing with some other matters and we're trying to provide more sophisticated services to some areas where it has been very difficult. We hope that part of that will be resolved by the new manpower committee which has just been set up.

The UBC hospital. I don't know what else to say about that except that the costs of the active-treatment hospital will be borne by the Ministry of Health, as the Ministry of Health bears all costs for active- treatment hospitals. There will be a teaching component in that hospital and in Vancouver General and in Shaughnessy and in the new Children's and in St. Paul's, for which we are developing a formula of sharing with the Ministry of Education. The teaching programme is a UBC programme, and I assume that UBC will be responsible for its part of that programme. But there is no question that the Ministry of Health will be responsible for the operating costs of the active-treatment hospital.

As for the speech and hearing programme, the only thing I wish to say further about that is that we are presently in full discussion with UBC regarding ways in which their programme can be modified or improved to suit all of the needs of the province. This isn't a new problem and it is not one that is unique to British Columbia alone; it's one that crops up all over Canada. I've told you that we have been on a recent recruiting programme across Canada and it's one which we will continue to do. Our major emphasis will be on Canadians to fill Canadian jobs.

[Mr. Davidson in the chair.)

MR. COCKE: Mr. Chairman, I have a few words of encouragement and possibly one or two words of wisdom for the Minister of Health.

Don't always be so trusting of your colleagues; that's one of the words of wisdom. You and your colleague, the Minister of Education, are having one heck of a fight, a real fight. And both of you are misleading everyone around this province by trying to indicate that you are not having a fight. It's the best-known secret that I've ever heard in this province. Everybody knows about it, and yet you keep denying it.

The fact of the-matter is that extended-care hospital that was built on the university campus was a teaching hospital. Mr. Chairman, I know it was a teaching hospital because I approved of that teaching hospital, and it was approved so that they could teach geriatrics. Now who's getting sucked in by whom? The fact is that that minister couldn't even make an announcement of a new acute-care centre out there, and his colleague, the Minister of Education, had to make that announcement and now he's taking this lying down.

HON. MR. McCLELLAND: Is this last year's speech?

MR. COCKE: This is not last year's, it's right now. That same minister denied last year that they were having a fight over the opening of the hospital. It was open late because they couldn't get it open because of the fact that they couldn't arrive at a formula for the operating cost of that hospital. Now they're exactly in the same position, only now it's over the question of teaching. Do you know that I heard that minister say: "What are you going to teach - old people?" Imagine, he doesn't even know what that hospital is there for. It's to teach young undergraduates their job in geriatrics. It was put to us that there was a real need in this province to teach geriatrics care to people in the health-care system. You're a failure because your colleague over there is not able to do the whole job. You can't talk him out of his end of the money and so therefore it's going down the tube.

MR. CHAIRMAN: Hon. member, could we just address the Chair?

MR. COCKE: Why, wouldn't that be a nice idea!

You know, you're almost as big a failure as the Minister of Highways.

HON. MR. McCLELLAND: Oh, not that, please!

MR. LEA: Well, he nominated him for leader, remember?

MR. COCKE: Mr. Chairman, he's botched it up. What his colleague wants is as follows: he wants a big 600-bed facility out there named "Pat McGeer." That's all he wants. As a matter of fact, he'll pull the pin on this Legislature the minute he's got it, because he's going to go out there and run it. That's what he wants. You know it all, and the problem is you're not tough enough to stand up to him. It's well known out there.

Now what's really happening? The Minister of Education said a short while ago: "When the two facilities are ready, they will work" -and I'm paraphrasing - "in tandem and then we can introduce the teaching." What nonsense! They've got a facility. It's been running a year despite the fact that they couldn't get it running to begin with because of all their interdepartmental problems. I predict the following will occur, and as a matter of fact, I believe there's been a wire circulating around the countryside from the Minister of Education indicating that what will occur with the budget will be as follows: the Minister of Health will look after the health-care aspect and the Minister of Education will pay some money to the Universities Council that might possibly find its way into the system. But in order to find its way into the system, there will be some very definite decisions made at the university level as to who is going to operate that system.

Mr. Chairman, we continually see the Liberals winning the battles. I feel sorry for those old Socreds over there. I feel particularly sorry for those leadership candidates that were defeated. They seem to come off worse than the others. We have a couple in the House right now.

MR. LEA: Bob's been a member for 15 years.

MR. COCKE: That's right; he's been a member for 15 years. He's a dyed-in the-wool Socred. So therefore, under those circumstances, he actually is two or three notches down.

Mr. Chairman, that geriatrics-care hospital, that extended-care hospital out there, is not functioning in the dimension that led us to make the decision to take it out there. Who was kidding whom in the first place? They made it very, very attractive, the university did. They said: "Come on out and join the process. Come on out and see to it that those undergraduates are given the opportunity to participate in the education process." That's the first thing that I would like to talk about.

I'd also like to say, Mr. Chairman, just a word about the hospital boards and hospital societies. I think we're almost at a point in time where the society running hospitals has to be looked at very carefully. I think maybe we're at a point in time where we're going to have to start thinking in terms of electing people at large. Now I think it should be studied, and I'm not sure that we're asking the right people to do the study when we ask the B.C. Health Association, who all grew up in that particular atmosphere. So naturally they're supporting what is to them Motherhood. I think that it should be independent people that are doing the study of this particular area. So I hope the minister will take a particularly good look at that situation.

Mr. Chairman, I'd also like to talk about Riverview for a moment or two. What happened to my old friend, Bill MacFarlane? I suggest that Bill MacFarlane quit after he found out that he could not fill his staff complement, couldn't get Treasury Board approval. When Dr. Grenier retired he needed an internist out there; you wouldn't bring one in. That %us number one. A couple of psychiatrists gone -you could not bring them in. They've got an non-accredited hospital looking for accreditation out there; it's under-staffed, under-manned, and the Minister of Health cannot or won't do anything about it. Dr. MacFarlane, who was the medical director out there, paid

[ Page 1778 ]

quite a price. He worked for the institution for lo those many years, took an awful lot of responsibility for health care for people in B.C. and could not get any kind of co-operation from this present government and from this present minister. Likely, if somebody had got in touch with the Minister of Education and told him what a serious matter it was, maybe things would have been different. But they didn't get in touch with the Minister of Education and the Minister of Health was no help. And that's unfortunate. Riverview is in a situation which, I would suggest, is desperate. So I would like the minister to say a few words about that.

Just one other word - I think the minister is under a bit of a cloud right now. I was listening to a radio broadcast not long ago and I heard a little bit of an argument around a person by the name of Gates. I wonder if that name rings a bell with the minister. Let me tell you something about Mr. Gates. Mr. Gates was the past president of the Social Credit constituency organization of Langley -that's where the minister comes from. Mr. Gates was on the radio a while ago and, if the minister had been listening, this is what he would have heard him say - or at least he would have heard John Reynolds, who was the hotliner on that programme, telling the chap that the minister had not told this chap to resign. He said they didn't have the authority to tell him to resign. But you know what Gates said? He said publicly on the radio: "The minister is lying." And then he went on to say: "If he doesn't like it he can sue me. Let him." Now that's a minister of the Crown in this province and one of his closest friends and supporters, the president of his constituency organization, who - I guess because some crook or somebody used his telephone to sell drugs - found himself on the street.

What I would like the minister to address himself to is that when people are going around talking that way about a minister of the Crown, it's bad news for all of us, and it's particularly bad news for this government. And it's more particularly bad news for his ministry, particularly in view of the fact that the Minister of Education seems- to have so much power around that ministry. It weakens him, and that's one of the reasons why he can't make his own decisions; that's one of the reasons why things are going sour. Mr. Chairman, I think that the minister should either sue Gates or possibly admit that what Gates says is true.

One other thing that I think the minister might answer is about the whole long-term care situation. If he had to do it over again, would he have allowed himself more lead time?

MR. LLOYD: Mr. Chairman, I hope the committee will indulge me to introduce a couple of my constituents, please: a Mr. Burke Boyd, who is the Prince George Regional Hospital administrator, and Mr. Bruce Mounery, who is the hospital finance director. It happens to be a coincidence that they're in Victoria; they've been down meeting with the Health ministry officials, discussing various budgeting procedures and general hospital-financing concerns. But I'm very pleased to see them in the galleries tonight while we're discussing the minister's estimates.

Mr. Chairman, I would just like to offer a few comments on the Minister of Health's estimates. The Prince George Regional Hospital board are still concerned aver their large operating deficit that exists - something like $500,000, which is costing the regional hospital some $60,000 a year in interest charges. I think it has been made quite clear that this isn't something that came up in the last year or the last two years. This is something that arose four or five or six years ago. I will say that they appear to be quite pleased that the ministry is making a very genuine effort this year to come up with a budget that they can live within. I want to give the hospital board full credit for making every effort to trim their own budget down so that they will come out at the end of this year very close to what the actual budget is.

Of course, getting the budget as early as the hospital boards have received it this year is a tremendous asset to them. As you're probably aware, Mr. Chairman, some of the budgets last year came. out practically a third of the way downstream and then with lengthening the year out to March 31, it made it a very difficult problem for hospitals to live within the budget. So I want to give the ministry full marks for the efforts they made to have the budgets out in record time.

I would also like to give the ministry full credit for the efforts that they've made to look at the budgets. Some of the opposition members have asked about the smaller hospitals, remote hospitals, and what is being done. I would like to say the ministry officials and the minister himself have made great efforts to meet with the hospital boards in my riding, the Mackenzie hospital, the McBride-Valemount hospital boards. Certainly they are taking a very close look at the problems of remote hospitals. I'm sure that's very much appreciated.

I would also like to give particular marks to Dr. Chapin Key for his efforts in trying to

[ Page 1779 ]

rationalize the problems of budgeting in the smaller hospitals and in general just trying to expedite the approval procedures and finding out the answers to many of the problems that bother the smaller boards in more remote areas. That has certainly done a lot to help cut the red tape.

I understand the regional hospital board in my area has recently received a letter in regards to the brief that was presented by the regional hospital board and the medical society concerning what they felt was a lack of medical equipment and medical facilities. Certainly I think they are pleased with the early indications of this. I will be following this up with the board and the ministry to see if we can't get Prince George brought back up to date. Certainly it is nice to see that this minister at least is realizing the problems that we are experimenting in trying to be a full regional hospital.

Also some of the members, particularly the member for Rossland-Trail (Mr. D'Arcy) , were mentioning the long-term care and concern with the conflict with private hospitals. I will have to say that this minister is certainly taking a more positive approach to this than the previous Health minister did or the previous Human Resources minister did. When the Rainbow Hostel ran into problems when I was serving on the city council and the regional district, the only way we could resolve it at that time was for the regional district to step in and fill the gap, to pick up the operating deficit which was incurred between what the patients could afford to pay and what they had to charge to provide this level of care in the community. Certainly it's a real relief. The Ministry of Human Resources mentioned at that particular time that they would pick up the extra costs as long as the senior citizens' society was willing to let any welfare case in the city go into the senior citizens' home and use the facilities. Well, this would be bypassing the purpose for which the facility was constructed and certainly was very distressing to the senior citizens' society, but probably more so to the senior citizens themselves. They were being used as a pawn between the senior levels of government and I think that's a very regrettable situation when something like this can occur.

I certainly give full marks to the regional district at that time for stepping in and filling the gap. Since the Health ministry has come up with the funding of $6.50 per day, it has allowed the senior citizens' home to carry this proposal without regional district's help. They've been able to step out of the picture, which they should be able to since no other regional district has that particular obligation. So again, I think this long-term health care is a very realistic programme. Rather than conflicting with private hospitals, many of which the senior citizens can't afford to even use, it's giving due regard to the senior citizens who built our country. I think this regard is long overdue. Again, I give full marks to the Minister of Health for recognizing this.

As I said, I just have these few brief remarks. Certainly I do speak in favour of the Minister of Health's estimates.

HON. MR. McCLELLAND: So that I don't pile up too many notes, I'll quickly go over the last couple of speakers and thank the member for Fort George for his comments. As I mentioned earlier, the problems of deficits with all hospitals are under review now. As soon we clear out of the way some other serious problems which are more emergent at the present time, we'll be getting down to those immediately.

I should deal with the remarks by the member for New Westminster (Mr. Cocke) . I have a feeling that the only reason he made them was that things were getting perhaps a little too laid back in here and he wanted to wake all of us up, because he was pretty frivolous in his remarks. But I'll answer a couple of the questions that he raised.

About hospital boards being elected, if somebody wants to look into that it will have to be some other minister, because I don't intend to. I don't believe in it and neither does the government, so that's not a possibility at the present time.

For Riverview Hospital, I don't intend to go into all of the letters and wires which were received regarding the resignation of Dr. McFarlane. I think it's enough to say that we accepted his resignation with considerable regret, but we had no choice since it was freely given. I am pleased to say that after a very short period of time following the resignation of Dr. McFarlane we have been able to make the selection of a new clinical director, Dr. Walter Goresky, who has all of the clinical and administrative abilities to follow Dr. McFarlane. Dr. Hislop has been appointed to the position of executive director of Riverview Hospital. Both of these new positions take place June 1, and I know that they will be given the full support of the medical staff and others for what we are all interested in, and that is the betterment of patient care at that institution.

I might say that as far as total staff at Riverview goes, there is more staff today for

[ Page 1780 ]

1,200 patients than there was five years ago for 4,000 patients, and I don't need to say more than that.

Mr. Chairman, the other question that the member for New Westminster raised was about long-term care. He asked whether the minister, if he had it to do over again, would allow more lead time. The answer is no, absolutely not. We considered our programme very carefully. There was no lead time left, because the previous government didn't act in the three and a half years that it was in office, and the lead time had run out. We knew that we would have teething problems, Mr. Chairman, but those teething problems are well worth it now because thousands and thousands of people have benefited by this programme, and thousands more will.

MS. SANFORD: I wanted to raise a situation with the minister which I feel is serious as far air ambulance service is concerned in remote areas. I'm not sure if the minister has been made aware of a recent incident up in the Holberg area with respect to an air ambulance which was required to take out a very seriously injured logger from Holberg.

The situation, Mr. Chairman, is that the doctor in charge at the hospital at CFS San Josef, right near Holberg, phoned immediately for assistance and asked for an air ambulance to be sent in. The air ambulance that was sent in was a very small helicopter. This logger, who was seriously injured and was in critical condition in Vancouver, had to have his leg amputated and nearly bled to death while the people tried to fit the patient into a very inadequate, small helicopter. It took them 45 minutes to try to adjust the seat, to move him from one basket into another, trying to accommodate him in the small helicopter that was sent out in response to the distress call from the doctor at CFS Holberg.

Now, Mr. Chairman, according to the information that I get from the north end of the Island, there are one or two very serious cases that have to be airlifted out from the Holberg area every month. With the inadequate helicopters that are sent in, the medical people up there find that they are unable to give the attention that the patients of ten require during this helicopter trip to Port Hardy, where they are transferred to a jet to be transferred to Vancouver. There is just not the space in the little helicopters to allow for any medical attention during the trip and, of course, they have a terrible problem getting the patient into a small helicopter.

Now I know there have been problems with the federal government and the air ambulance service. The practice, Mr. Chairman, has been to contact the air rescue service at Comox and the federal government then would send out their very well-equipped air ambulance helicopter and transport the patients to a hospital. But the problem has been that the federal government has been charging the provincial government for the use of these helicopters, and the provincial government, this one and the previous one, did not pay the federal government's bills.

I'm not sure, Mr. Chairman, whether the federal government at this stage is digging in its heels and is becoming more reluctant to provide their air rescue helicopter, or whether it may be a problem with communication. Because, as you probably know, the doctors are required to contact a number here in Victoria at the Royal Jubilee Hospital, that number is then relayed to whatever helicopter is available, and that helicopter then attends to the area of the emergency.

But, Mr. Chairman, in this particular case with the injured logger, the doctor found out, or some of the people involved - I'm not sure it was the doctor - that there were, in fact, sitting at the airport in Port Hardy two adequate air ambulance helicopters, but they were not sent. The two pilots of those two air ambulance helicopters were not aware of the emergency and certainly one of them would have been able to attend in very short order if he had in fact been notified.

Now I'm not sure whether it's a problem with the federal government and the fact that the provincial government does not wish to pay the federal government for the use of that air ambulance helicopter, or whether it's a problem with communication through the emergency services programme in contacting those helicopters to get them in. But the situation at the moment is inadequate and the people on the north end of the Island, particularly in areas as remote as Holberg, are very concerned about the situation. When you have one or two patients a month who need this kind of attention, it seems to me that the minister should be aware of it, should make inquiries as to what the problem is to ensure that the adequate air ambulance is sent in there - that is an adequate helicopter large enough to accommodate stretcher cases and to allow medical staff people to accompany the patient.

Since that particular incident, which occurred within the last month, there was another case in Holberg where a two-year-old girl drank a bottle of acetone. Now this doesn't usually result in death, but it does require that the patient get to a hospital and get into intensive care for a period of time. In

[ Page 1781 ]

this case, when the doctor phoned for an air ambulance helicopter, he had to wait four hours before there was any air ambulance sent into Holberg. In emergencies, Mr. Chairman, that is just simply too long for the people to wait.

The other thing, Mr. Chairman, is that the minister perhaps should consider purchasing adequate helicopters that the provincial government itself could use in taking care of cases such as this. What they do now is to contact available helicopters and, as I pointed out, they are completely inadequate to do the job when an emergency occurs.

Mr. Chairman, there's one other issue that I would like to raise with the minister before I take my seat. That relates to the Campbell River extended care. Campbell River has a wing of a building which remains unfinished. The structure is there. All that has to happen is that the interior of that particular wing be finished to accommodate additional extendedcare patients. I'm not sure if the minister himself is familiar with the situation, but I'm making an appeal to the minister to ensure that that structure is completed and that the 19 patients who are now on the list to go into extended care in Campbell River can be accommodated as quickly as possible. Not only are there 19 cases who have been approved for extended care in Campbell River that are now on the list, but there is a long, long list of people who are waiting to be interviewed and assessed and possibly put into the extendedcare programme. I'm wondering, in view of the minister's grandiose announcements about capital construction, why this particular unit has not been completed and made use of as an extended-care unit.

MRS. DAILLY: I would just like to ask the minister a very brief question and it's to do with the megavitamin therapy. I understand the Minister of Human Resources (Hon. Mr. Vander Zalm) several months ago mentioned that there was going to be a government study. But we really haven't heard too much since then and I was wondering if the minister would tell us what perhaps his own feelings are on this. Has the government initiated a study?

The second part of my question to you is: could you tell us if you're working at all with the universities to see if they can get into some very solid research on megavitamins?

MR. D'ARCY; I want to go back to the minister's remarks on financing, because I found them rather curious and rather interesting. The minister said: "Of course everyone knows that there's a 60-40 split in capital programmes and of course everyone knows it's all borrowed money." Then he said: "We are going to spend $60 million to rebuild Vancouver General Hospital."

Now perhaps the minister can tell the House and the people of B.C. what that means. Does that mean that there's going to be $100 million spent on Vancouver General, $60 million of which will be provincial and $40 million municipal, or does it mean that there's going to be $60 million spent, of which $36 million is going to be provincial and $24 million municipal, or does it merely mean that he and his ministry are going to authorize the Greater Vancouver Regional Hospital District to borrow $60 million, of which the Ministry of Health will pick up 60 per cent of the mortgage payment? Is that what he really means? I think it is, but I would like to hear him say it.

He said: "We are going to spend $60 million." I suggest that the government is not going to spend anything like that figure on Vancouver General Hospital. Obviously I use the analogy of the Ministry of Highways; I see the minister is here. If he announces he is going to spend $60 million on capital expenditures on highways, that's what he means: $60 million comes from the provincial treasury. None of it is borrowed money and there is no cost to the local taxpayer. But we have had the minister announce $60 million just for that one project alone.

I'd like to have him tell us how much of that is actually going to be provincial money and how much of that is going to be local money. Is he merely talking about increasing the borrowing authority of the Greater Vancouver Regional District hospitals? I think that is what he really means. I would like to have him stop telling this House and stop telling the province that he and the government are going to spend so many million dollars on capital programmes for hospitals when in fact they are cost-shared programmes and in fact they are borrowed money.

I'd like to return to my earlier series of questions which the minister did not answer. He said that Treasury Board had already authorized a five- to seven-year programme. I can't remember his exact words, but he intimated that it was going to be $100 million a year over a period of five to seven years. I'm very happy to hear that. But what does he really mean? Does he mean that over a period of five years the borrowing authority of the hospital financing is going to be increased by $500 million in the same way that this afternoon the House gave second reading to a bill to increase Hydro's borrowing authority by $700

[ Page 1782 ]

million? Does he mean that he is going to increase their borrowing authority? I would like to hear him tell the House. If that is what he means, I would also like to know how this relates to expenditures of the past. How does that relate to the increases in borrowing authority for that same hospital financing agency for this year and for last year?

Let's go over the last 10 years - that covers three governments, three parliaments and three different Legislatures - and have that indexed for inflation, because the capital cost of construction has increased at a higher rate than the cost of living. Let's find out whether in fact the minister is talking about a real increase or indeed any increase at all. If he is, more power to him. I would like to know whether he is really merely announcing in advance the continuation of programmes which are already in effect and were in effect under the previous government and possibly under the government before that. Is he announcing any actual increase when we consider the inflation factor? If he is, bully for him. But I suspect he is merely talking about a projection of what was already ongoing.

I don't want to hear any more of this stuff: "We, as the government, are going to spend this amount of money." You as the government are not going to spend that amount of money, Mr. Minister; what you are going to do is to allow the hospital authority the authority to increase their borrowing ceiling.

MR. STUPICH: I just have a letter I want to read to the minister. It is addressed to Mrs. Leslie Beckett, Steering Committee for Better Use for Brannan Lake, dated April 26.

HON. MR. McCLELLAND: There's a bill on the floor.

MR. STUPICH: It has nothing to do with the bill, Mr. Chairman.

"I have received your letter requesting information on use of the former Island Youth Centre at Brannan Lake.

"The Alcohol and Drug Commission is currently looking at many available facilities and no decision has been made. In view of the uncertainty, I do not feel it would be productive to talk to your group. When the situation has become a bit clearer, we will be more than willing to discuss our programme with you and the operation of different types of facilities within it."

Signed by John Russell, commissioner, Alcohol and Drug Commission.

My questions are with respect to the "many facilities." What are the many facilities, the available facilities? I wonder which ones were available. Further, with respect to the decision not being made on April 26, just when was the decision made?

MR. CHAIRMAN: These matters might be better covered under legislation.

HON. MR. McCLELLAND: Yes, Mr. Chairman. I think I would probably be out of order if I discussed that last question, since there was a bill introduced in the House today relating to the use that that facility will be put to.

[Mr. Rogers in the chair.]

On the hospital construction question from the member for Rossland-Trail (Mr. D'Arcy) , I'm not here to give him a lesson in how hospital construction has been done in this province ever since regional districts were started. As their first function, regional districts had the opportunity to participate in the construction of hospitals, and they still do. It's never been a secret. Every time I go and talk to a group of people about opening a new facility, I make sure we tell them how much the regional district has been involved. It's all taxpayers' money, so what's the difference? We don't quibble over it.

It does, however, require an approval of all borrowing and all hospital construction from Treasury Board of the provincial government. Until that approval comes, then nothing is done.

The member for Burnaby North (Mrs. Dailly) asked me about megavitamins. We had an initial meeting of a number of people involved in health-care delivery, one way or another, from both the ministries of Human Resources and Health. They concluded, after studying the nature of the problem, that we would not be served well by a provincial study. It properly belongs at the national level.

We have asked to have, first of all, this whole matter of megavitamin use placed on the agenda of the meeting of provincial Health ministers to be held in Whitehorse in early September to ask if they would appeal with us to the federal government to take on a full national study of the use of megavitamins under the health protection branch or under Health and Welfare Canada. If we get that approval at that meeting - and I have no reason to believe that we won't - then we will ask to have it put on the agenda of the next meeting between the Health ministers and the federal government, which I expect will be

[ Page 1783 ]

coming within perhaps a month after that. So our request will be to the federal government and our participation, of course, would be provided. But we think that study is best done at the federal level.

The Campbell River extended-care hospital was raised by the member for Comox (Ms. Sanford) . I have met with the Campbell River executive. I am aware that the hospital facilities are shelled in at the present time. That has been done a lot in the past. Various hospitals, in order to take advantage of money markets as they exist at the present time, have shelled in facilities for use at a future time. However, because those facilities are there in shell form does not mean that we should immediately attempt to make them operable and take on the operating costs at the same time.

When I met with the executive of the Campbell River hospital, they agreed at that time to use vacant beds in the acute-care hospital for extended-care purposes for the time being. I agreed that we would like to leave that for about six months, and if they would come back to me at that time we would re-examine it and have a look at it at that time.

The question you raised about the air ambulance service at Holberg I can't answer specifically. I know that that particular problem has been in my office, and I know that I've answered the doctor in the area recently. I just can't recall all the specifics of that one case. If you'd like, I'll be happy to send you a copy of the reply that I made in that regard. But I can say that any delays we have in regard to either air ambulance or search and rescue air evacuation have nothing to do with any arrangement we have with the federal government in terms of paying their costs.

We've had a dispute - as you recognized, even with the previous government before us -with the federal government, as has almost every province in Canada, over the use of national defence equipment for air evacuation purposes. The provinces take the point that we have armed forces - you can't call them army and navy any more, I guess - which is there and which should, we think, serve the people of Canada in the best way possible. We don't seem to have any wars around right now. That's a pretty good use of their services and it's pretty good training for them, too. They have all the equipment and we've said: "Well, so far we just haven't paid our bills." We've been a bad corporate citizen, I guess, in that regard.

Nevertheless, there is no lack of cooperation from the federal government because of that. The federal government is extremely anxious to provide that service to us whenever we need it. I'm not aware of any serious problems with our Victoria dispatch service with the air ambulance. It's working extremely well. That's not to say that we don't run into problems sometimes, because we always will.

There's a difference between air ambulance and air evacuation. The federal government, for instance, does not want to get into the position where it becomes our air ambulance and their facilities are used as our air ambulance. They'll refuse to do that, of course. We can only use their facilities at a time of real life-and-death situations, where it's an evacuation that must be made immediately or as quickly as possible. At that time we can call air-sea rescue in. As I say, they co-operate very well with the provincial government in that way. We now have in British Columbia, since February 1,1977, a very complete - or as complete as it can be up to this date anyway - air ambulance service.

I was just looking at some figures the other day for 1973 and 1974. In those two years we used the air evacuation service of the federal government 31 times for air evacuation purposes. Since February 1,1977, we have been using our air ambulance service on an average of three per day. In 1977 we had 1,800 flights on air ambulance, and so far this year the rate is running about 1,800 per year again. So it is a completely different service, but it's one that we have to do. About a third of those 1,800 flights is carried by our own aircraft -generally one of the three Citation jets -which are not entirely suitable for that work, but with a lot of help by the ambulance people and the pilots, who enjoy that kind of work, they've been working out pretty well. We use helicopters on a charter basis when we can and when we really have to, and the other two thirds are pretty well all either commercial or charter.

Buying a helicopter I think would be a tremendous idea, and perhaps I'll put it to Treasury Board. The pilot in our group doesn't think it's such a hot idea. I don't know why, but I'll take that one under advisement. I don't know that much about helicopters myself, but on the specific instance you've raised at Holberg, I'll make sure that you get any reply that I've sent to the area regarding it.

MR. STUPICH: I don't really want to belabour this point at this time. The minister has suggested that there is legislation under which I think he said he would be prepared to consider these questions as to just....

HON. MR. McCLELLAND: Ask them again. I'm

[ Page 1784 ]

sorry, I didn't hear them all.

MR. STUPICH: Okay. The letter referred to the Alcohol and Drug Commission currently looking at many available facilities. There are many of them and they're all available, and no decision has been made. That's as recent as April 26, signed by a member of the Alcohol and Drug Commission.

To give the minister time to consider this on the understanding that it is something that could be discussed under that section of the bill dealing with treatment centres, I'm quite prepared to leave it until that time.

HON. MR. McCLELLAND: What was the specific question? Maybe I can answer it.

MR. STUPICH: The specific question is: what were the facilities? It says "many." Well, how many? Where were they? Presumably they're all in B.C. Where were they geographically? It says they were all available, so that narrows it down some. But apparently many available facilities were being considered as recently as April 26. I'd like to know just which ones were being considered in addition to Brannan Lake, and at what date the decision was made to use Brannan Lake. Now if those questions would be in order under section 2 of the bill, then I'm quite prepared to wait until that time. I am not asking the minister to agree to answer at that time, but will he consider them at that time?

HON. MR. McCLELLAND: I'd be very happy to consider them at that time, but I don't know whether I could answer. If they're not out of order now, I'd have to look at that and find out which facilities were being looked at. I could say from a standpoint of good utilization of facilities which the province already has that it's been a practice of at least everybody that's involved in looking for facilities in the Ministry of Health that we look at existing facilities which way not be being used now or may not be being utilized directly. I assume that that is what the letter referred to. British Columbia Buildings Corporation, with the Alcohol and Drug Commission, would be looking at any of those facilities which were available to us around the province, and Brannan Lake was certainly one; I know that the Haney Correctional Institute may have been another one; and there may be parts of Riverview, for instance, which are empty at the present time and may have been looked at. But if you want more detail than that I'll try and get it at the time the bill comes up.

MR. LEVI: As I understand it, in the longterm care programme in respect to the number of people who were taken in.... My figures may not be exactly right, but on top of the number of people who- were being looked after by the Human Resources ministry, which I understand ran to about 7,200 or 7,400, it is my understanding that you took in another 7,000 or 8,000. I'd like the minister to perhaps correct me on the figures, but what I'm asking is: of that number - that is, the new group that went in; those people who were paying for themselves various amounts from $500 or $600 up to, I think, as high as $800 -does the minister have any idea at all what level of payment these people are making? As I understand it, some people are paying between $350 or $400 a month. This is way beyond the $6.50 a day and I understand that these extra payments are for extra amenities. I'd like the minister to comment on just what is happening in respect to people being able to get more service beyond the basic service which is covered by the $6.50 a day. That presumably relates to people who are in the second category; those are the ones who came under the programme in long-term, care.

The other thing I want to ask the minister is: what is happening in respect to the longterm care programme and activation - that is, in respect to people who are in the various facilities - and is, in fact, the programme of activation built into the total programme of long-term care?

The minister probably knows that activation takes a number of forms in terms of activities which can be conducted in the various residences by group workers, people who have some area of specialty in geriatrics. Is this in fact a part of the programme of long-term, care? It was something that was being developed individually in certain homes in the system.

Also I'd like the minister to comment on whether there has been a further adaptation of what's known in the business as the Priory method. I'm not thinking now about the financing; I'm thinking more about the kind of programmes that the Priory run - again, very much involved with activation. The thing is that we're into a situation in terms of long-tem care where people entering long-term care facilities are older people and, with the onset and the broadening of the homemaker programme, people will probably be a good deal older before they actually get into extended care.

Having said this about the activation, we now come to the business of the training that is available to people in terms of the geria-

[ Page 1785 ]

tric field and the policy of the ministry vis-à-vis this kind of training. Now it is possible to get it in some of the community colleges; it's also done on a seminar basis, where people are trained to work with older people - a very important area. And what is the ministry's involvement with the establishment of a gerontological society? Yes, I understand there is one now. What role does the ministry play in terms of that society? Are they active? Do they make some contribution in terms of some grant to the association? And perhaps the minister would give us his views, in terms of his long-term care programme, about the principles of activation. Does lie see this as a necessary part? I don't want him to just say yes, but rather what he sees is happening in terms of this.

Perhaps it's a bit early to tell, because the long-term care programme has only been operating since January, but is there a feeling within the ministry in terms of long care that, if they have the activation programmes, they can probably see for the first time in geriatric care what people are getting out of a long-term care situation? What progress has been made toward multi-level care? That is where people are not simply moved out of one facility because it's longterm care and doesn't cover a lesser type of care. What kind of flexibility is built into that?

And the other thing I would like to ask the minister is - perhaps he would explain it to us, but not in great detail: what is the block funding in relation to the programme that is being financed, in respect to the federal participation and the provincial participation?

Now those are questions I'd like the minister to answer.

HON. MR. McCLELLAND: Mr. Chairman, I can't give you the exact number of beds that are available under preferred accommodation as it relates to the basic charge of $6.50 a day, but there are perhaps more than we thought there might have been. We have recently announced that we put together a team of nurses, who are being trained by Consumer Services, to travel the province and take com-plaints from anyone who feels he's being improperly charged - or, in fact, just talk to people in those facilities. We want to know if there are some serious problems out there, and we think that that's a pretty good combination of our nurses and Consumer Services. I think the one thing that you should know - if you're not already aware of it, Mr. Member - is that the preferred accommodation must in all cases be requested by the client and approved by our long-term care co-ordinator before being charged for, and it cannot be more than $9 more than the basic charge.

Some of these things - through you, Mr. Chairman - sound like some of the questions I asked you when you were over here and I was on that side. The activation programme is certainly included in our new regulations; it must be a part of the programme that's being provided by the facilities. Whether they're non-profit facilities or whether they're profit facilities, we have included, as much as we possibly could, the costs of activation programmes in the rates that we've approved for all of the facilities. We hope that somewhere down the line very soon we will have a pretty good programme of in-service training going, and we hope to develop one of the facilities that is already in existence as a model facility that will be providing that kind of training and to which we can bring people from other facilities and provide them with the kind of thing that you're talking about. It's very much a part of our philosophy in developing the long-term care programme.

I don't know how to answer the question about the Priory method. A lot of the things about the Priory method are exemplary in terms of treating people who are in need of longterm care. However, the government has, over a number of years, also developed some pretty good programmes of its own in some of its facilities. What we need to do is blend those programmes and make sure that the best is what comes out of the end of it.

A gerontological. society, which I understand has now been formed in Victoria, has no direct relationship so far with the Ministry of Health. We haven't had any requests from them for any input. The people involved visit our ministry quite often and anything they need is made available to them. We've had no requests for grants. I assume that we'll get them somewhere down the line.

In answer to the question about flexibility and multi-level care and people improving, there's starting to be some pretty good evidence that people do improve in long-term care. It's no longer true that you shove someone in an extended-care hospital until you shove them out the end. They're going into higher levels of care now from the extendedcare facilities, or lower levels, whichever way you wish to put it. I guess - although I don't have figures for that - that we're having evidence of people coming out. Hopefully that will continue.

I would like to see the programme developed over the next year or so as flexibly as possi-

[ Page 1786 ]

ble so that kind of multi-level access to wherever they need the care most is available. I think if there's one philosophy that we've tried to develop in the long-term care programme, it is that we want to make the appropriate kind of care to fit the patient. If that requires that we bend a few rules once in a while, then I hope we will be able to bend those rules.

The same thing goes, for instance, with men and wives who are need of the same kind of care or perhaps not quite in need of the same kind of care. We've developed some flexibility there and it does mean sometimes that we can't go by the rulebook. I hope that will continue.

MR. LEVI: There was the question of the block funding. If I might just add to that, presumably some of the flexibility that you are able to show in terms of where people are and moving them about is probably as a result of your block funding. You don't have to worry too much about the feds complying with all of the regulations. At least that's what I think; perhaps the minister might comment on that.

Just on the preferred care, if I might just get the minister to repeat it again, did he say that the maximum payment is $6.50 to $9 or is it $9 on top of the $6.50? So in fact, it can be up to a maximum of $15.50 a day.

HON. MR. McCLELLAND: That's the very maximum, yes.

I'm sorry, Mr. Chairman, about the block funding. The effective date of the block funding for health for the long-term care programme - and I cannot speak about the block funding that's recently been announced - was April 1,1977. It was based on $20 per capita, to be escalated on a three-year moving average of the gross national expenditure. The revenue for 1978-79 will be just over $56 million, which is actually less than what we got under the old CAP arrangement. Totally it's more than what we got under the old arrangement by about $29 million. We get a net gain of about $29 million after the programme is over. The costs of our homemaker programme are going to be covered, at least for the time being. I don't know how that will work with the new arrangement through sharing with Human Resources. There's about $6.7 million there for homemakers, which is eligible for sharing.

MS. BROWN: We seem to spend an incredible amount of time under the Minister of Health's estimates talking about sickness. I wonder if we could talk about health for a change and....

MR. STEPHENS: Wellness.

MS. BROWN: Right. I want to raise two issues that I think the minister could make a great contribution to in the area of health.

MR. LEA: Resign!

MS. BROWN: That's the third area.

One of the major causes of accidents with infants is involved in what happens to them in automobiles as a result of collisions of some sort because they are not in a seatbelt.

When the legislation was introduced which made seatbelts mandatory in British Columbia, infants were not included. At that time the reason given was that there were not any approved car seats which were considered to be safe enough for the children. Since that time, of course, evidence has come out that even an inadequate car seat is better than no car seat at all, and that, indeed, the increase of injuries to infants in cars as a result of their not being in a car seat is on the increase. Now I know this is not within your jurisdiction but, as the Minister of Health, I think it's certainly something that the minister should concern himself with and make every effort to ensure that the legislation dealing with the mandatory use of seatbelts is amended to include infants. There are a number of car seats presently on sale in this country that pass the test. They're not perfect by any means, but certainly all the indication is that they're certainly a lot better than no seat at all.

One of the reasons I'm particularly interested in this area is my work on the cerebral palsy ward in the children's hospital in Montreal, where we saw so many of the kids who came into the hospital suffering brain damage as a result of being thrown around on the inside of the car when there was some kind of impact, hitting their head either on the dashboard or on some of the metal areas of the car. That could have been avoided if they had been in some kind of car seat, not necessarily the most perfect one, but a car seat of some sort.

The second area that I want to bring to the minister's attention has got to do with the health of older people in general, and older women in particular. I'm wondering whether the minister has seen the latest Nutrition Canada national health survey.

HON. MR. McCLELLAND: No.

MS. BROWN: No? I want to quote some of the findings of that survey, Mr. Chairman. It

[ Page 1787 ]

says:

It is sadly ironic that women, most of whom spend a good part of their lives telling children to 'finish your soup and eat your vegetables, ' should end up in old age with the worst nutrition habits of any group in Canada. Nutrition Canada's national health and diet survey, the results of which were published in 1974, concluded that 80 per cent of women age 65 and over were overweight, compared with 66 per cent of the men; that about a quarter of the men and almost half of the women in that age group have poor intake of protein; that one half of senior women among the Indians and general population do not have a desirable intake of iron, and that 40 per cent of senior men and about one half of the women of all ages have inadequate calcium intake. Half or more of all women over age 65 also showed inadequate intakes of vitamin A, thiamine and riboflavin and 30 per cent had dangerously high levels of serum cholesterol."

The report goes on, Mr. Chairman, to talk about the really bad eating habits of women over the age of 65. It says:

"Because of factors such as poverty, loneliness, depression and bad dentures, illness and practical difficulties with things like going up and down stairs, many of them give up cooking and eating fresh, nutritious food such as milk, wholewheat bread, lean meat, eggs, fruits and vegetables and replace that with junk food such as coffee, toast and biscuits." It goes on to say, Mr. Chairman, that a number of the things that we associated with old age and take for granted really have nothing to do with it at all, and that in fact it's a combination of bad eating habits, being psychologically withdrawn and leading an abnormally sedentary life. It says: "Medical science has thus far been unable to establish what changes or impairments are due to the normal ageing process and what are caused by misuse, disuse or disease."

I would certainly, first of all, Mr. Chairman, like to bring this report to the minister's attention, because I think it's important that he read it, and secondly I'd like to suggest that the whole business of dealing with nutrition and older people - not just older women, but older people - is certainly something that his ministry should be addressing itself to. I know that there are activation centres and that the whole business of activity for senior citizens is something which both his ministry and the Ministry of Human Resources are presently involved in, but the whole area of nutrition is still one that calls for some more attention on his part.

On April 29 there ums another report on elderly people, this one by SPARC, the Social Planning and Review Council of B.C., dealing with indiscriminate use of drugs. It says indiscriminate prescription, lack of proper counselling and sophisticated promotion of techniques all contribute to the misuse of medication by elderly people. It says: "Among the culprits are pharmacists, physicians and drug companies, all of which influence the choice of drugs and the method of use."

I have a couple of suggestions to make to the minister in this area. First of all I want to ask, in the light of this special report which was released by SPARC and which I know the minister just must have access to, because they send copies of the report to all of us, what his ministry is planning on doing in terms of correcting the situation. One of the things that SPARC recommended was that patients' education monographs - PEMs, as they're called - together with brief pamphlets listing general characteristics of a drug and suggestions for their use, should be made more easily available to elderly people who are on medication.

SPARC themselves undertook this survey and found out that through the distribution of these monographs, a large number of elderly people involved were saying that they were learning things about the medication that they were using which they had not known before and that, in fact, they had benefited from receiving these monographs. One of the really terrible things that they tended to do prior to that was not only to forget to take their medication in some instances, but also to use old medication in other instances, without realizing that the medication was probably beginning to deteriorate or that in fact it does deteriorate after a certain period of time.

So given this information, I am wondering whether it isn't time for the Ministry of Health to institute some regulations or get on a more intensive educational programme or whatever aimed at senior citizens who are taking medication to inform them of some of the characteristics, the effects and the proper use of drugs. Those are the three areas dealing with health which I would really like to see the ministry address itself to.

I have nothing against sickness but I really would like to see the ministry address itself to health once in a while.

HON. MR. McCLELLAND: Mr. Chairman, everyone is for health. One of the big problems, of

[ Page 1788 ]

course, that we always have is that it costs so much money for sickness. I'm not trying to be facetious. I mentioned earlier it takes over $600 million to provide hospital operating costs in this province. That's a good chunk out of our budget. We need to turn that around somehow. You do it with education and every other way, but it's a matter of getting the money turned over and it's not all that easy all the time.

The seatbelt question is really not within my jurisdiction, but I'm certainly interested in it and have been in the whole seatbelt thing from the inception. The things that I've read are pretty controversial and suggest that even those seats which have been approved may not be as good as they should be. I think there's a lot more testing that needs to be done before we get into that.

MS. BROWN: The final decision was that they were better than nothing.

HON. MR. McCLELLAND: By whom?

MS. BROWN: The report that was issued about a month ago.

HON. MR. McCLELLAND: I read that in the paper too but I don't know who said it.

Anyway, in the problem of drug use by elderly people, we're certainly aware of the problems there. We've taken some steps to correct some things. For instance, the new regulations in our long-term care programme require that a pharmacist be responsible not just for making the original prescription but for monitoring it at the long-term care facility level as well. We hope that will bring many abuses to an end.

Pharmacare has a number of things going for it. They have contractual arrangements with pharmacists to do the kinds of very things that you've mentioned - drug profiles, monograms, educational programmes for the elderly and others. We're concerned that there's a lot of professional input when the doctor looks at the patient and when the pharmacist makes the prescription, but it seems to stop there and nobody knows whether or not the prescription is followed, whether the drugs are ever even taken or what ever happens to them from then on. I think that's where the pharmacists and us have got to make sure that there's some good patient education done there, and we're starting that now.

MR. COCKE: Mr. Chairman, I don't know what's happened to the Liberals. They must be out trying to figure out a way to get some of this legislation into orderly language.

Mr. Chairman, the minister, in reply to one or two of the questions that I asked, indicated that I was being somewhat frivolous. I can't believe it. It hurt to the quick. I want to suggest to the minister that I wouldn't want to paraphrase what Ron Longstaffe had to say about the minister, so therefore I'll just quote him directly. He said: "Has many good qualities, but essentially presides over the portfolio, rather than manages it." It would seem to me that even that would be a compliment.

MR. LEA: He acted all right in New York.

MR. COCKE: That, I think, is a compliment.

Mr. Chairman, there's no question that the university hospital has been botched up. It shouldn't have been there in the first place and with respect to the geriatrics care and the extended-care facility out there, for them to have to wait for the geriatrics education which should have been going on right from the outset is a travesty. If the minister thinks that that question was frivolous, he can think again. I personally feel that it is just unfortunate that they can't get their acts together.

I think it is unfortunate that the Minister of Education (Hon. Mr. McGeer) talked the government around into the position now where they're building that hospital in the wrong place, building it out on the campus which is peripheral to the downtown area in Vancouver. Right now one of the problems - and believe me, I have to take some of the blame for this - that they're having at the extended-care hospital is that it's hard to get patients there because it's hard to get visitors to see them. It is peripheral. It's on the outskirts, and it is not the best place for a hospital, and it is particularly not the best place for an acute-care hospital.

We said right from the outset that they can bring the students to whatever facility they designate. They didn't have to have it on the campus, but they insisted. But I wonder how that hospital is going to operate when we find that they can't even have the kind of teaching that the university extended-care hospital was built for in place a year after it is in operation. That shows me that the minister is either presiding over his portfolio or not even getting to the point where he presides.

I would just like to bring one other matter to the attention of the minister. I would like to find out how he feels about it. You had a dialysis unit, the Willow dialysis unit, run by Dr. Kennedy. I've talked to some of the

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people that were involved in self-dialysis there, or doing much of their own patient care. The word that I get is that it is 50 per cent, in terms of operating costs, of what like facilities are elsewhere.

There seems to be a power play, or has been, to get this back into the main stream, into the hospitals again, and it strikes me that this would be a move backwards. Any checking that I've done has led me to believe that the patients in that particular treatment setting have actually come along better; they have better results than those in other facilities. I'd just like to ask the minister what is planned for these people in this particular unit. I think it's a very important programme. As a matter of fact I think the like of it should be increased across the province as it is the kind of programme that has shown that it is really working for the good of the patient.

HON. MR. McCLELLAND: Yes, we agree with that comment. There was a problem and some delay in developing that programme further because of location. That has now been resolved and the programme has been, approved. I believe that it's some $80,000, and the programme will be developed. I think it's about five blocks from Vancouver General Hospital. I'm not exactly sure of the location, but I certainly agree with those comments that you made.

I forgot to answer one question from the first member for Vancouver-Burrard (Ms. Brown) regarding nutrition. I'd appreciate having that. I'm sure it will come across my office desk, but if you want to send it over now, that will be fine. Along with the mental health programmes this year, we hope to place some increasing emphasis on nutritional programmes. We've got a total of about five new nutritionist positions for the various divisions of the province which have been approved this year - Cranbrook, Vernon, Abbotsford, Nanaimo and Prince George. Also there is a total of seven new positions. Some of them are half positions, but there's a total of seven. Some of them are charged directly to the longterm care programme, so I hope that will help.

The House resumed; Mr. Speaker in the chair.

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

Hon. Mr. Gardom moves adjournment of the House.

Motion approved.

The House adjourned at 10:57 p.m.