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CONTENTS

Routine Proceedings

Oral questions.

Cheekye-Dunsmuir transmission line. Mr. Lockstead 789

TV coverage of B.C. Games. Hon. Mr. Curtis replies –– 789

Government policy on Kitimat oil port. Mr. Howard –– 790

Price Waterhouse taxation report. Mr. Stupich –– 790

Port Simpson cooperative. Mr. Lea –– 790

Mental health survey. Ms. Brown –– 790

Refugee Settlement Program of British Columbia Act (Bill 32). Hon. Mr. Williams.

Introduction and first reading –– 791

Attorney-General Statutes Amendment Act, 1979 (Bill 29). Hon. Mr. Gardom.

Introduction and first reading –– 791

Committee of Supply: Ministry of Health estimates.

On vote 128.

Hon. Mr. McClelland –– 791

Mr. Cocke –– 796

Hon. Mr. McClelland –– 800

Mr. Cocke –– 801

Mr. Mussallem –– 802

Mr. Cocke –– 803

Ms. Brown –– 804

Mrs. Jordan –– 811

Hon. Mr. McClelland –– 813

Presenting Reports

Ministry of Forests annual report as at December 31, 1978.

Hon. Mr. Waterland –– 814

Select Standing Committee on Standing Orders and Private Bills third report.

Mr. Mussallem –– 814

TUESDAY, JULY 17, 1979

The House met at 2 p.m.

Prayers.

HON. MR. McCLELLAND: Mr. Speaker, I would like the House to welcome three visitors in the gallery today who are here to watch the proceedings with some degree of interest, I'm sure. They are the president of the British Columbia Medical Association, Dr. Mel Petreman; the executive director of the British Columbia Medical Association, Dr. Norman Rigby; and the public affairs chairman of the B.C. Medical Association, Dr. Gordon Ritchie. They are here somewhere in the gallery, and I'd like us all to welcome them.

HON. MR. GARDOM: I would like to ask the hon. members to bid special welcome to a good and old friend of mine, Mr. Tom Ternoway, from the Fraser Valley.

HON. MR. CHABOT: I'd like to ask the members to join me in welcoming to the House Mr. Metro Tomyn, chairman of the Radium Waterworks District of Radium Hot Springs, B.C.

MR. MUSSALLEM: Please welcome Mr. and Mrs., George Bandringa from Maple Ridge, and Mr. and Mrs. W.G. Veldman from Redlands, California.

MR. HYNDMAN: We have with us today two executive members of the British Columbia Social Credit Youth Auxiliary, both from Burnaby. Would you please welcome Ardell Brophy and Colleen Chin.

Oral Questions

CHEEKYE-DUNSMUIR TRANSMISSION LINE

MR. LOCKSTEAD: My question is to the Minister of Environment. Will the minister agree to make public all reports made on the economic and environmental feasibility of the proposed Cheekye-Dunsmuir 500-kilovolt transmission line to Vancouver Island?

HON. MR. MAIR: No.

MR. LOCKSTEAD: I have a supplementary question. Will the minister now agree to table the so-called Dr. Schaeffer report, which was commissioned by the Environment and Land Use secretariat for his perusal? Will he make that report public?

HON. MR. MAIR: My first difficulty is in identifying the report, since the only report I have which is dated the date the member indicated yesterday has no signature on it. In any event, the answer is no.

MR. LOCKSTEAD: My supplementary question is to the Premier. Does the Minister of Environment's decision to keep secret reports on the proposed 500-kilovolt Cheekye-Dunsmuir transmission line to Vancouver Island reflect government policy on reports affecting the public of British Columbia?

Interjections.

MR. LOCKSTEAD: I have a supplementary question. First of all, I resent that the minister is not answering questions. Secondly, I resent that the government is keeping reports secret. The most secretive government we've ever had in British Columbia sits right over there.

MR. SPEAKER: Order, please. I would remind the hon. members that it is not proper in question period to seek to expose government policy, according to section 171 of Beauchesne.

TV COVERAGE OF B.C. GAMES

HON. MR. CURTIS: Mr. Speaker, recently the hon. second member for Vancouver Centre asked questions in connection with televised coverage of the British Columbia Games. With your indulgence, sir, the answer is not very long.

An agreement was made between British Columbia Games and B.C. Television on November 18, 1977, giving the television organization exclusive coverage rights of competitive sporting events for the 1978 Summer Games in Penticton. On February 20, 1978 this agreement was extended to include coverage rights of the competitive events at the 1979 Winter Games in Kamloops. On September 21, 1978. the agreement between B.C. Games and B.C. Television was extended to include the 1979 Summer Games in Richmond, the 1980 Winter Games in Kimberley and the 1980 Summer Games in Kelowna.

To provide for appropriate games coverage by local cable-television stations, Mr. Speaker, I am pleased to inform the member and the House that an agreement has been reached between British Columbia Television, representatives of the cable television industry in the province and representatives of British Columbia Games. I am informed that the three parties to this agreement are pleased to see that it conforms to the following guidelines: (1) cable television is not restricted in any indepth coverage during the games — that is, background, colour, human interest stories and so on, except by item 3 which I shall mention in just a moment: (2) cable television is required to delay visual coverage of competitive sporting events themselves for, I believe, one week; (3) British Columbia Television has first vantage position at any site during the games; and (4) in future, cable television stations authorized to cover aspects of the games under the terms of this agreement will be required to undertake advance publicity for the games during the zone play-offs. I submit that is most important, because it is the zonal play-offs that are so vital to the success of the British Columbia Games.

Mr. Speaker, I conclude by noting that there is no financial exchange between British Columbia Television and British Columbia Games and that, by contrast, in the province of Alberta the provincial government supplied production costs for television coverage. The agreement between British Columbia Television and British Columbia Games ensures the widest possible television coverage of the games on a continuing basis at no cost to the taxpayer of this province.

MR. BARNES: Mr. Speaker, I would like to thank the minister for that comprehensive reply. It's quite lengthy,

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and I don't feel ready right now to ask all of the questions that I intend to ask. I'd like to have an opportunity to study his answers.

However, I would like to just ask the minister one very basic question and that is: on whose authority did B.C. Television negotiate in reaching an agreement with the B.C. Programmers' Association? You suggested there was an agreement between the programmers and BCTV. Why would they be negotiating in a free-enterprise system?

HON. MR. CURTIS: Mr. Speaker, I know of no prohibition against negotiation in the free-enterprise system. I'm aware of negotiations which took place. I was not party to them at that particular time, bearing in mind that I did not occupy this portfolio at that particular time. There is more than one television network operating in British Columbia, and it appears that British Columbia Television was willing to undertake the most important part, which is not just the coverage of the games themselves — the Summer and the Winter Games — but also local coverage of the zonal play-offs which lead to competition in the games. I'm at loss to further answer the member's question.

MR. BARNES: I have one final question. I accept the minister's explanation; I realize he was not responsible at the time these arrangements were made. However, my question is simply — and he doesn't really have to answer it; I guess he may want to think about it — why, in a free-enterprise system, any cable company or private television company would find itself in a situation where it has to negotiate with one of its competitors in order that it should be free to just cover the games. What restriction should have occurred? How did that happen? Was there an arbitrary agreement that gave an exclusive to BCTV to cover the games, when this was not its right?

HON. MR. CURTIS: Mr. Speaker, I'd like to assist the member, but I'm afraid his reasoning in that question is lost on me.

GOVERNMENT POLICY ON KITIMAT OILPORT

MR. HOWARD: Mr. Speaker, I'd like to direct a question to the Minister of Environment. Has a government policy been determined yet with respect to the proposal for an oil port at Kitimat?

HON. MR. MAIR: No.

PRICE WATERHOUSE TAXATION REPORT

MR. STUPICH: Yesterday I asked the Minister of Finance about a Price Waterhouse report on the effect of taxation on commerce and industry. It could be a very interesting report, and I'm wondering if the minister has any idea at all as to how long it might take to have that report delivered to him. While I'm at it, could he give us some idea of the scope of the inquiry and the target as to the estimated cost of the study?

HON. MR. WOLFE: I don't have that information so I will take the question as notice.

PORT SIMPSON COOPERATIVE

MR. LEA: I have a question for the Minister of Labour. A couple of weeks ago I asked the minister if he knew of any new relationship between the Central Cooperative and the Port Simpson cooperative. At that time he said he didn't know but he would check into it. I wonder if the minister has checked into it and could tell me if there is any special arrangement that he knows of now between the Central Cooperative and the Port Simpson cooperative that didn't exist, say, a month or two ago.

HON. MR. WILLIAMS: There is no new special arrangement involving Central Cooperative with the Port Simpson cannery operation. During the herring season this spring there was, as I told the member earlier, an arrangement whereby certain management services were being provided by the Central Native Cooperative, and they were also using the facilities on a shared basis, in the same way as their cannery was available to Port Simpson fishermen. That arrangement is continuing during this salmon season.

MR. LEA: On a supplementary, has there been a policy adopted by the government that would put the operation of Port Simpson cooperative under the sole management of the Central Coast Cooperative?

HON. MR. WILLIAMS: No, there has been no such policy decision, Mr. Speaker. The arrangement that existed during the herring season and exists today is one worked out between the directors of the Pacific North Coast Native cooperative and the Central Cooperative.

MENTAL HEALTH PROGRAMS SURVEY

MS. BROWN: My question is directed to the Minister of Health. Will the minister tell me whether he has commissioned a survey of mental health programs and services in the province?

HON. MR. McCLELLAND: Mr. Speaker, yes, there has been an ongoing survey of mental health programs in the ministry.

MS. BROWN: Would the minister say who is conducting this survey?

HON. MR. McCLELLAND: The survey is being conducted by Dr. Cumming.

MS. BROWN: I am wondering whether the minister is going to release the survey for public scrutiny or table it in the House at any time.

HON. MR. McCLELLAND: Mr. Speaker, I wouldn't suppose so, although parts of it will become policy. It's an ongoing ministry survey of the services that we provide. That's being done in most parts of the ministry and, I would expect, will always be done.

MS. BROWN: Mr. Speaker, the only reason I asked the question was because I had hoped that the annual report would have had some information in it from the survey so

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that we could discuss it under the minister's estimates. But am I to understand that information is going to be kept within the department, and that no one is going to have any access to it?

HON. MR. McCLELLAND: Mr. Speaker, what we're doing is an ongoing survey of ministry programs. I would believe that every ministry should be doing the same thing, and probably is. It's an ongoing service of government.

MS. BROWN: So share it with us.

HON. MR. McCLELLAND: Well, we will, in terms of the great new programs we'll be providing for the people of British Columbia.

MR. BARRETT: Will the minister file with this House the reports if they have been completed? Have any reports been completed on the mental health section?

HON. MR. McCLELLAND: What reports?

MR. BARRETT: The surveys. Have any of the surveys been completed?

HON. MR. McCLELLAND: Mr. Speaker, this is an ongoing survey which is being done as a part of the government services. It will continue to be done. I would hope that we'll continue to do it forever, so that our programs continue to evolve in a way in which they will become most useful to the people of this province. That will be a continuing part of all of the Ministry of Health services.

MR. BARRETT: I ask the minister specifically if Dr. Cumming has completed any specific area of survey and filed a report on those specific areas to the minister.

HON. MR. McCLELLAND: Yes, Mr. Speaker.

MR. BARRETT: Will the minister make public the completed survey reports that the minister now acknowledges exist, and are in his hands?

HON. MR. McCLELLAND: Mr. Speaker, as I've mentioned before, there's no secret about anything that's happening here. The programs will be made public. The programs will be part of the public service of this province, and that will continue to happen.

MR. BARRETT: Mr. Speaker, the minister is probably not hearing correctly. I'm not asking about future programs, which would be out of order. I'm asking the minister if he's prepared to file the reports that have now been completed, and submitted to him, by Dr. Cumming. Yes or no.

HON. MR. McCLELLAND: Mr. Speaker, it's not a matter of me not hearing the question correctly. It's a matter of the member for Vancouver East not hearing the answer correctly. I've answered it as correctly as I can and as much as I'm going to.

MR. BARRETT: On a further supplementary, is the minister saying that he is not going to file...?

SOME HON. MEMBERS: We want Rosemary! [Laughter.]

MR. SPEAKER: Order, please, hon. members. Let's hear the question.

MR. BARRETT: I asked the minister whether he is prepared to file with this House Dr. Cumming's surveys that have been completed, as confirmed by the minister. Do you intend to file with this House the information that Dr. Cumming has submitted to you in terms of the survey that he has conducted, and you've acknowledged he's conducted? Yes or no.

MR. SPEAKER: The bell terminates question period.

Introduction of Bills

REFUGEE SETTLEMENT PROGRAM
OF BRITISH COLUMBIA ACT

Hon. Mr. Williams presented a message from His Honour the Lieutenant-Governor: a bill intituled Refugee Settlement Program of British Columbia Act.

Bill 32 introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today.

ATTORNEY-GENERAL STATUTES
AMENDMENT ACT, 1979

Hon. Mr. Gardom presented a message from His Honour the Lieutenant-Governor: a bill intituled Attorney General Statutes Amendment Act, 1979.

Bill 29 introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today.

Orders of the Day

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

ESTIMATES: MINISTRY OF HEALTH

On vote 128: minister's office, $144,082.

HON. MR. McCLELLAND: Mr. Chairman, members of the committee will now have before them estimates that detail a very large program of expenditures for the Ministry of Health. For that reason, I might ask the indulgence of the committee to make what might be considered a little longer statement than is usually made at the opening of this kind of a committee hearing.

The sum that we're considering here today, Mr. Chairman, is just over $1.2 billion, a very large commitment and a strong statement of this government's view of the place of health programs in contemporary society.

In terms of dollar values, in terms of services and activities, the Ministry of Health's endeavours are the largest of any jurisdiction in government. The largest portion of the spending we propose will be directed at

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treatment, at relieving people of painful, debilitating conditions and in many cases saving them in life threatening situations.

I suppose that most of us, if we look at society in purely Utopian terms, would desperately hope for the day when the Ministry of Health wasn't needed. We all know that's the kind of ideal we will not achieve. The fact is that for the present and for as long as we can probably see in the future, health ministries are a fact of life, and so they must make fiscally realistic commitments to the maintenance of health and the prevention of disease.

Mr. Chairman, the estimates of this ministry illustrate our government's sincere commitment to preserve and to enhance what is one of the best health systems in the western world. Before I describe in greater detail the direction the ministry proposes to take and some of the policy terms that will be enunciated by the spending estimates which are before us, I would like to mention some of the internal realignments that have taken place in the ministry.

Last fall we undertook a very major reorganization, grouping similar activities in an organization structure that we know in the future will enhance our effectiveness and our accountability for the large expenditures made by the Ministry of Health. In an organization of the size of this ministry, such a restructuring doesn't happen easily. However, I am pleased to be able to report to the members that reorganization is progressing very successfully and some of its effects are already very noticeable.

The person who is responsible for carrying out this reorganization, Dr. Chapin Key, is with me on the floor of the chamber today. I would like the House to recognize Dr. Key. He was appointed Deputy Minister of Health last autumn and I think it's the first chance the House has had to officially meet him. Dr. Key, of course, is known to many members on both sides of the House, as he came to this ministry from Vancouver General Hospital, at least immediately, where he was executive director of that hospital.

I'm sure you will be interested in another senior appointment. All of our community health services, the traditional public and mental health programs plus our new long-term care program are now in a single grouping under Dr. Gerald Bonham, a senior assistant deputy minister. Dr. Bonham came to us last spring from the Vancouver city health department and, of course, previously served with our public health programs. He too is known by many of the members in this House today. His responsibilities fall into two general areas: preventive activities and direct services provided outside of hospitals and other health institutions.

In our reorganization, Isabel Kelly was appointed an assistant Deputy Minister in charge of our direct-care programs. Mrs. Kelly was the first executive director of our new long-term care program which is now just one of her responsibilities. Mrs. Kelly is also sitting in the gallery along with Dr. Bonham and others.

The ministry is now recruiting a senior assistant deputy who will be responsible for the operation of our medical and hospital programs. Another appointment which we hope to make soon will strengthen our planning and development activities, making them an essential part of the working of the ministry's executive.

Also, I thought that members of the House would be interested to know as well that just a few days ago I attended a retirement function for Mr. Harold Price, who left the public service after 43 most distinguished and dedicated years. Again, Mr. Price was a public servant in the truest sense of the word, and I'm sure everyone here wishes him a very pleasant retirement. He would have been with us except he's on that retirement. He's away on holidays right now and I don't blame him.

During the past year, Mr. Chairman, the ministry has taken very tangible measures to heighten citizen awareness of sound health practices. We need to reinforce public awareness that most of our major diseases, certainly those responsible for the greatest death and disability in our society, are preventable. We've combined several sections of the ministry in a new grouping known as health promotion, of which Maurice Chazottes, also known to many in this chamber, is executive director. This is a first step in clearly identifying that part of the ministry's operations which concerns itself with awareness of health, personal behaviour and lifestyle. We believe that these activities should have a readily identifiable presence which is separate from the traditional areas of preventive medicine and public health, and which should certainly be easily distinguished from the cure of disease and the treatment of the sick. Because I believe — and I'm sure it's shared by most here — that we can reduce the demand on expensive medical treatment and hospital care by making people aware of the benefits of a good lifestyle and the consequences of a poor one.

Before I deal with the estimates in more detail, there are two or three general matters I want to raise with the committee. The first has to do with philosophical persuasion more than anything else. Political parties to the left of the political spectrum historically have put forward the argument — and it's accepted by many, I'm sure — that they have a strong tradition of being analytical and aligned with many of society's intellectual movements. This base of intellectualism, history tells us, had no small role in some of the progressive events of the past 100 years. The fact that many of those events didn't do what they set out to do is really neither here nor there.

By contrast with the extreme left, Canadian socialists, according to the history we have before us, have a tradition of being studious and of displaying a certain amount of care and thoughtfulness. It remains a matter of deep concern to me that tradition was abandoned in advertisements sponsored by the New Democratic Party during the last election campaign. I refer specifically to the ads that dealt with the health-care systems; these advertisements were dishonest and lacked intellectual integrity. That's a point that should concern all of us: the absence of intellectual integrity. In its advertising, the NDP portrayed one segment of society as conspiring against the health-care interests of another.

If one wishes to debate the allocation of resources, then the discussion should be on those terms; I'm sure they will be during these estimates. But I will not debate, nor should we be asked to debate, health-resource allocation, as the opposition proposed in those kinds of ads it used during the election campaign, as if a conspiracy were involved. That approach is based on deception; fortunately the public saw through it. But before the public realized they were being duped, that approach, which was deliberately designed to spread fear among the sick and disadvantaged, dirtied the political process in this province at a time when we should

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all be strengthening the credibility of politics and politicians.

There is another issue I hope all of us might reflect on in the future — and particularly the providers of health care. I refer not only to the doctors, nurses and paraprofessionals, but also to the health scientists who are the innovators responsible for much of the life-giving technology we have today. I have a very strong feeling that perhaps the time has passed when we should be telling the people not only what the health system can do but what it cannot do. More and more frequently we come to the conclusion that some of the public's expectations are not realistic; it's not their fault. For too long the public has been led to believe that the health system can cure virtually any condition, no matter how it was caused and regardless of how far it may have progressed. The belief that the health system can do everything for everyone is a hypothesis that unquestionably requires review now. For too long the public has been led to believe that the health system can deliver almost any cure. The facts are that the best we can do in most circumstances is to control disease. There are few conditions today that we can actually cure. Perhaps when the public's expectations come a little closer to reality, the pressures that are forcing our health system into a very scary cost performance will start to ease.

In any event, I hope all members from all sides of the House might have some advice about how we might encourage expectations to become a little more realistic. It's something we won't accomplish overnight. It's something that may require generations of human experience. Obviously there are no easy answers; if there were, we would have had them by now and they would be in place. All of us, I believe, will have to look at bold, and certainly new, initiatives.

Our long-term care program, Mr. Chairman, is an outstanding example of the government's intention to develop alternative methods of providing our citizens with necessary care, especially care that can be provided in their own homes and in their own communities. Another somewhat similar initiative that has been taken by the government is embodied in a new regulation under the Medical Services Act that permits payments to nurse practitioners. We hope that nurse practitioners in some of our isolated areas may eventually provide first-stop health care of a sophistication that exceeds basic nursing care, but that does not require a physician.

But we cannot hope to have everything needed by every single individual at the right place, at the right time, all the time. Obviously, then, Mr. Chairman, we need to make certain that the services and equipment we have are used for the greatest good and for the greatest number. Instead of taking expensive equipment, for instance, and highly skilled personnel to each patient who might need such resources, we are increasingly doing things the other way around. We are trying to take the patient to the most appropriate treatment.

The air ambulance service provided by our Emergency Health Services Commission has been well received by the people of B.C., and increasing use is being made of this service by sick and injured persons. I am happy to be able to report, Mr. Chairman, that during the first eight months of this service patients were carried at the rate of 1,440 a year. That is about four a day. You will also be happy, I am sure, to know this volume has almost doubled in two years.

Between April 1 and June 30 of this year the rate at which we were carrying patients on the air ambulance service was about eight every day — double in two years of service to the community.

As you know, it is one thing to provide a vehicle and the necessary equipment; it is quite something else to have well-qualified persons respond to emergency calls. We have one of the outstanding programs on the North American continent for the training of our paramedical personnel. Our interest in providing early life-support doesn't end there. We have made a number of program commitments, one of which is an arrangement with Douglas College to coordinate the instruction of interested people in the public in basic life support — cardiopulmonary resuscitation. All persons, including members of the general public who take training from qualified instructors in this program, will receive certificates from the Ministry of Health.

The costs of operating the general hospitals of British Columbia have occupied some considerable time in the press and in this House in the past. I am sure they will again during the estimates now before us. Approximately $650 million is provided in these estimates for the operation of our general hospitals in B.C. — a program of expenditures that has increased explosively in recent years. We all know that even though those cost increases could be described as almost stunning, the fact remains that hospitals are an essential service. In fact, going beyond the traditional view of an essential service, they are a service in which more can always be done.

The fact is that hospitals are doing more. They are caring for more people, and ameliorating more disease than at any other time in the past. The best examples can perhaps be found in the dramatic advances in surgery and the huge gains in pharmacological treatments. The use of such drugs as steroids has not only added their prime costs to the cost of health care, but has also made new forms of maintenance therapy available. In other words, we are keeping more people alive than at any time in the past, with modern treatment. That modern treatment quite often adds larger costs in proportion to the number of patients served.

Recent and current examples of high-cost treatment would include things like hyperalimentation, the technique that some of our larger hospitals are using now to totally feed patients intravenously, and computerized tomography, which is revolutionizing, in many ways, radiological diagnosis. We now have both full-body and head scanners in operation at Vancouver General Hospital. I have approved two additional full-body scanners, worth about $1 million each, for Royal Jubilee in Victoria and the cancer clinic in Vancouver. We have allocated another $600,000 to these hospitals for the treatment planning systems that go with the scanners. Computerized head scanners have been approved for Kamloops, Prince George, Kelowna, Royal Columbian in New Westminster and St. Paul's in Vancouver.

Hyperalimentation is a vast improvement over previous methods used. Twelve hospitals, Mr. Chairman, have now been designated to provide this service. Other hospitals will be considered as the program needs are demonstrated. I don't suppose there is a member in this House who hasn't at least one friend or constituent whose life has not been prolonged, or whose disability has not been greatly eased, by such costly medical or surgical techniques provided through a hospital. Indeed, one only needs to read the daily

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papers to know that a contemporary hospital has a very visible impact on modern society.

I want the House, Mr. Chairman, to look, as well, to what is happening on the cost side. I fully expect the House to be as astonished as I was when I first observed that most hospital operating budgets have tripled — many have quadrupled — in ten years. The expansionist nature of hospitals is something we must all come to grips with. Even allowing for general inflation, and the general growth of all labour-intensive programs, I don't think anyone could claim that our hospital outputs, the volume and effectiveness of the services provided, have increased at the same rate as the costs. I am certain, Mr. Chairman, that if we look closely at our hospitals we must come to the view that something needs to be done on a rather urgent basis.

Every dollar invested in curative medicine today is yielding fewer returns than at any other time in the past. So — as Minister of Health, and as elected officials — all of us are faced with a couple of very large dilemmas. One is the one posed by the increasing medical-care needs of our citizens on the one hand, and the dilemma of the diminishing returns on dollars spent on the other hand. It should again be obvious that there are simply no easy answers to either of those dilemmas — nor does the government expect that those answers will come easily.

I don't think, Mr. Chairman, that anybody in the heath-care sector can be running away from those dilemmas or otherwise copping out. We've got to face up to them — and that includes all of us. The mentality of a hospital — or a person in the health-care system, or a politician — that says we can carry on in the same way as we have in the past is of the same mentality, Mr. Chairman, that brought the western world to the brink of an energy crisis. The unquestioned assumptions of the past, whether in energy, health care or virtually any other public sector endeavour, need painful reassessment.

In any event, we in British Columbia are in a bit of an enviable position. Some other jurisdictions in this country have placed far greater restrictions on the operation of their hospitals than British Columbia — 4 percent ceilings are in place in some provinces in this country. We fully expect that we will meet 7.5 percent growth this year, and simultaneously eliminate the debts that hospitals have incurred in recent years.

Some cost savings will be made available through updated management systems. We are encouraging hospitals to look at their administrative procedures and, in a few cases, we are trying to give them actual examples of how they might reduce their paperwork costs. Some of those are in place within the hospitals now.

The point, though, Mr. Chairman, that we need to make is that we will not run away from the problems which face us. We will face them, instead, in a realistic and forthright manner. And we expect the managers of the system as well — the boards of directors and the administrators of individual hospitals or institutions — to take a similarly realistic and sincere view of the situation. I'm not saying we have anywhere near a perfect or ideal system of hospital funding. In fact, I don't think there is any doubt that the system of funding at the present time is out of date. But we are facing up to that.

Quite frankly, our ability to analyse hospitals and their costs carefully, and so distribute more fairly and more equitably the funds which are available, isn't as sophisticated as it should be.

We're seriously concerned over the general issue, then, of equity in hospital financing. We hope that by the end of this year — in fact, we know that by the end of this year — we will have a much more vivid view of hospital funding requirements when the joint funding study which has been underway for about eight months by our ministry and by the B.C. Health Association is complete. This study, I think, is the most extensive analysis ever done in the province of the funding framework. It is being coordinated by Ernst and Ernst, a firm of management consultants with an international reputation in the health-care field. It's a major task that the party opposite did run away from when it was in power.

Another step we're taking toward developing a balanced hospital system involves the role study which is now underway, which has had some publicity in the press already. It's a detailed analysis to determine what services or programs are most appropriate to which hospital in the province. Again, it simply isn't possible for everyone to have everything, to do all the things that they might like to do. When the role study is complete — and that will take a few months, Mr. Chairman — we will have an outline of hospital services that are interactive, a situation in which duplication, hopefully, would be minimized and in which we should be able to feel much more confident than we do now that every dollar spent on hospital care is spent wisely and to the best advantage of everyone.

We don't intend to impose this study on hospitals from the top. We are at present in the midst of another joint study, with the hospitals themselves involved through the British Columbia Health Association in the formulation of the various roles. I'm sure members on the opposite side will realize the complexity of that operation, particularly the member for New Westminster (Mr. Cocke), who may recall the difficulties involved in getting our four or five teaching hospitals to come to some sort of agreement on relative roles. Many others in this House will realize that one of the reasons that it took 10 or 15 years to get a replacement for Victoria General Hospital underway here in the capital city was a continuing argument about what hospital did what in the capital region. The current role study will involve some 100 hospitals, so the problem will perhaps be magnified that many times.

In addition to dealing with those funding problems, the ministry is moving ahead with the largest hospital construction program in the history of British Columbia, investing at the rate of approximately $100 million per year. Many members are familiar with the progress we are making, especially in our metropolitan areas which have been sadly neglected over the years. We have firm construction programs underway in Prince George, Victoria and Vancouver, which will shortly eliminate many of the chronic problems those areas have had to deal with concerning outdated and overcrowded acute facilities.

Starting in Victoria, there will be a flow of about $90 million into hospital construction during the next few years. Victoria General is being replaced, and a very large modernization program has been committed for Royal Jubilee. Greater Vancouver is receiving a very large infusion: the new Children's and Grace facilities on the Shaughnessy site are well under way, and will be opened sometime next year. The virtual rebuilding of Vancouver

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General and St. Paul's is underway; construction is about to start on Eagle Ridge Hospital in Coquitlam; and there is the Delta Hospital — just to name a few, Mr. Chairman. The new hospital at the university will open next year.

We don't expect our hospital utilization problems to be solved by new facilities alone. New programs will be having an impact as well, and undoubtedly will make our acute-care hospital system much more efficient.

Mr. Chairman, just as it took three or four years after their initiation for the day-care surgery and extended-care programs to have an impact on general hospitals, so there will be a lag before the full effects are felt following the introduction of our long-term care program. We know that there are complaints, particularly in the metropolitan areas, that long-term care patients are occupying costly beds in the general hospitals — and that's true. We will probably have to live with this for a while yet, perhaps as long as two years. Between 1,600 and 1,800 new long-term care beds will come on line during this period. We expect that those beds will more than take care of the present deficiencies.

Every member of this House has reason to be proud of our long-term care program. In the last month for which figures are available — February of this year — we had 27,242 people benefiting from this progressive health program. The population of our long-term care program is considerably larger than that of some of our cities in this province. Last month there were just over 12,000 people receiving homemaker services, 1,200 in mental-health boarding homes, and some 14,000 in non-profit and profit-making care facilities. In addition, we had about 5,800 patients at the extended-care level. The program, Mr. Chairman — just as an aside — has had a significant effect on employment as well. During the latter part of 1977, before the program went into effect, we believe there were about 2,000 to 2,300 homemakers employed at various agencies in British Columbia. In contrast, by May 1979 we had over 5,000 homemakers. Our homemaker work force had more than doubled in 17 months.

Mr. Chairman, is my time up?

MR. CHAIRMAN: Yes, it is.

HON. MR. McCLELLAND: Mr. Chairman, I had a couple more statements I'd like to make. I wonder if I could ask for leave.

Leave granted.

HON. MR. McCLELLAND: Mr. Chairman, I know we'll have a fair amount of discussion on the long-term care program. Another matter I think we should mention too is that during the past two months my ministry and the B.C. Medical Association received the terms of a new agreement that will preserve our medical plan in its present state over the two-year term of the agreement. During those negotiations we were determined that there would be no deterioration of our present medicare program. I'm certain that all sides of the House will join me in acknowledging the good will expressed by members of the British Columbia Medical Association when they accepted the terms of that new agreement.

In summary, Mr. Speaker, I suppose that I could say that I believe that we have reached a stage in the evolution of our health programs where the public at large is expecting from us much more than the traditional medical and surgical programs. We're expected to be much more innovative, responsive and realistic. We intend to be realistic, not only in terms of the content of our programs, but also in the terms of society's ability to pay for them. The estimates before the House at this time illustrate that our government is committed to a realistic and rational health system that gives access to British Columbians to as, wide a range of modern health services as possible.

Mr. Chairman, just in closing I want to make reference to a very special problem that we've had in the last while. It has to do with the problems that have been raised in this House on occasion, and certainly in the press, and which have been under scrutiny by the ministry for the last several weeks as a result of the events in the Alert Bay area. Following the tragic death of a child in the Alert Bay Hospital some weeks ago, and the subsequent inquest and then a separate inquiry by the joint hospital committee of the ministry and the BCMA, some recommendations have come forward to the ministry. As a result of those recommendations, I am announcing today that I am appointing a personal representative as a coordinator or administrator, under the terms of the Hospital Act, to work in the community of Alert Bay to help the hospital trustees, the residents and the hospitals in the area resolve the difficulties which have led up to some of these situations.

I might say, Mr. Chairman, that finding such a person has not been an easy task. But I am pleased to announce to the House now that I have secured the willing cooperation of a man who exhibits the degree of leadership and human understanding that the situation and the Alert Bay community deserve. I am therefore appointing today Mr. Eric Powell as my representative in Alert Bay, to act as coordinator for the hospital and the community and the Ministry of Health. He will assist in the implementation of the recommendations made by the committee. I won't go into the recommendations except to say that I will table those recommendations when I have the opportunity when the committee rises.

The first recommendation made by the committee was that the Minister of Health appoint an adviser-coordinator with authority to assist in the implementation of the recommendations. The chairman of the hospital board has wired me asking me to accede to that recommendation. I had said that I would and this now is the appointment of the person who has been chosen to do that.

The recommendations deal with much more than just hospital service, as might be expected. They deal with the widest range possible of the delivery of health services in that area. You'll understand, I'm sure, the delight that I have in telling you of Mr. Powell's acceptance of the invitation to undertake this task, when I tell you that Mr. Powell has a very deep personal feeling and understanding of Alert Bay as a community. Eric Powell was born in Edmonton, was educated at South Burnaby High School, UBC, the Anglican Theological College in Vancouver, and St. Augustine's College in Canterbury, England. He completed his education at the Ecumenical Centre at Basel, Switzerland, and at the Ruel Howe Institute at Berkeley, California.

The coast of British Columbia has been very much a part of Eric Powell's life. He worked as a deck hand on the Columbia Coast Missions hospital ship Columbia in 1951, before accepting a post as a teacher in the remote and

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isolated inlet of Seymour. This position included teaching on a floating logging camp, working in the bunk houses as well as assisting the camp cook. The following year he returned to UBC to complete a BA an a theology degree. During the summer months he was posted in Kingcome until 1958 when he was appointed priest in charge of the area. The district included the Indian villages of Turner Island, Gilford Island, Village Island, New Vancouver and all the logging camps in the area.

In 1960 he was transferred to Powell River with the responsibility of supervising Kingcome Inlet. The following years were years of continued study, with appointments to St. John's and Shaughnessy, Vancouver, St. Michael's and All Angels, Prince George, and as director of programs for the diocese of New Westminster. For many years, Eric Powell has been concerned about interpreting the story of the work of the church with our native Indians on the coast of British Columbia.

In 1961 he invited Margaret Craven, an author from Sacramento, California, to visit Kingcome and work with him on a story to preserve some of the local history as well as write the human story of life in an Indian village. The book I Heard the Owl Call My Name was completed in 1967, and in 1973 a TV film was produced based on this novel. The book and the film reflect part of Eric Powell's understanding of the coast, our last frontier, and challenged us to work together as people, sensitive to each other's cultures.

It's generally accepted, incidentally, that Eric Powell was the model for the priest in Margaret Craven's sensitive work. Mr. Powell has discussed the problems at Alert Bay with me and I have been impressed by his frankness. I earnestly hope that the people of Alert Bay will give him their trust and confidence and will work with him to overcome what is a very difficult situation.

While the Ministry of Health cannot be drawn into local political issues, I am determined that we should meet our obligations in terms of health and hospital care for the people of Alert Bay. Mr. Powell's appointment is one step in a rational approach to the problems of such isolated communities.

While I am basically responding to the request of the chairman of the local hospital board to implement these recommendations, I am going further in my determination to do more than come up with just a band-aid solution. I want to stress that Alert Bay is not the only community in which we are taking planned and positive action. For example, in Port McNeill we will shortly be opening a new ten-bed acute-care hospital within the next month, which cost some $ 1.1 million. In Port Hardy, the overcrowded and outdated hospital there is being replaced by a new 25-bed acute-care unit at a cost of about $4 million. Construction is expected to be completed in about mid-1981.

In Zeballos, which has also experienced problems in clinic accommodation, we are arranging for a mobile unit to be moved from Campbell River. Mrs. Kirk, the village clerk at Zeballos, is now making arrangements to find — a suitable site. We have also asked if the local people would take on the administration of that facility.

Mr. Chairman, I just wish to say in closing that Mr. Powell will also be asked to cooperate with the regional district in that area to ensure that future health care delivery services can be rationally planned. The terms of reference for his task are quite simple. They are simply to provide leadership and assistance to the board of trustees of St. George's Hospital and to the community in the implementation of the recommendations, to consider, in cooperation with the Mt. Waddington Regional Hospital District and the Ministry of Health, the present and future role of the hospital in that area, and to make any other recommendations in regard to health care that would aid the community in resolving its problems.

Mr. Chairman, perhaps the most important part of Mr. Powell's task will be to ensure more opportunity for the native Indians in Alert Bay to have a voice in the organization of health care services in their own community.

Mr. Chairman, with that, I am looking forward to the debate and the questions which will be posed to me in the deliberation on my estimates.

MR. COCKE: Mr. Chairman, obviously whoever wrote the speech for the minister didn't know about our time limitations, but we were only too happy to let him set a new record for the House for a minister's opening remarks.

In any event, Mr. Chairman, I just would like to allude to those opening remarks very briefly. I know that had he probably thought it through a little more carefully, he would have used the insulting material close to the end of his remarks and, in that way, taken my eye off the ball, so to speak, and got me away from criticism and after the minister.

I would like to say, however, that it was very interesting indeed to hear the minister charge the NDP with dishonest advertising — that and dishonest statements. That comes from that member, that minister, whom I recall sitting across the floor in this House when he charged the NDP with caring for indigent children in the Empress Hotel — just for want of something to say in this House. That minister works for a leader, his boss, who went around this province charging the NDP with being National Socialists. My heavenly days, I can't believe it. And the ads that they ran during the campaign! If he had anything to do with it — I know they wouldn't have consulted him, but in any event, he ran with that party — to say the least, they were nothing but the greatest assortment of lies that I've ever seen in my life. But anyway, having said all that, I would just like the minister to remember that we know that he represents a group so filled with mendacity that they have real trouble among themselves, and certainly in the appeal that they have to the people of British Columbia.

Let me get on with some of the things I'd like to say about the minister's estimates, the minister's performance and, hopefully, our need in the future for some real thought in terms of looking for something that could possibly assist us in turning things around in health pre in this province.

I guess, Mr. Chairman, what started the November fiasco — and I refer to the November fiasco of the memorandum on November 15 that came out of the minister's office calling for a 5 percent maximum increase on budgets for all hospitals in British Columbia — what precipitated that more than anything was a twitchy government reacting to Proposition 13 in the United States — a very twitchy, confused, concerned, scared government who were really reacting to that, plus reacting to a little chap by the name of Stephens, who was going around the province extolling the virtues of Proposition 13. Where is he now? However, at that time he brought quite a response from this

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government. One of the first responses, of course, was from the Minister of Health. He's the easiest of the group to carry the message and to do the First Minister's bidding. He's the one who wrote to the hospital boards and said as follows:

"I would like to take this opportunity to thank the hospital boards of trustees and their administrators for their efforts in providing efficient management over the past three years, while attempting to keep hospital operations in line with the growth in the provincial economy."

It's quite a statement. He tells them they're doing well; he's thanking them for what they're doing. Then he goes on to say:

"For many years hospitals have been telling the ministry that one of their major difficulties in achieving good fiscal management has been caused by the delay in establishing approved budgets.

"As you are aware, arrangements were completed last year to change the fiscal year of hospitals to coincide with that of the government. In addition, Hospital Programs has been instructed to process hospital budgets promptly so that you can be notified early in the new fiscal year of your approved budget."

What date is it today? When is our fiscal year? April 1. This is July 17, isn't it? The hospitals still haven't got a clue. Ask them one at a time. Phone the administrators and they're all negotiating with this government. For one reason or another, there has been no satisfactory end of those negotiations. They're all being kept on the back griddle or on the front burner or wherever the minister likes to have them, but nobody is satisfied. I'll tell you, Mr. Chairman, we're in greater chaos now after that particular remark than we've ever been.

Then he goes on, Mr. Chairman, in this famous memorandum:

"In keeping with this new policy, I have to tell you that your estimates for 1979-80 should be predicated on an increase of up to 5 percent over the 1978-79 approved budget expenditures."

[Mr. Strachan in the chair.]

Well, we'll deal with that in a moment or two. But I'll just say, Mr. Chairman, that he knew — and if he didn't, then he should resign — there was no possible way they could live within that limitation.

The minister's been talking about the terrible increase in the cost of health care. I'd like to draw his attention to an article in the February bulletin of the Economic Council of Canada, captioned "Contrary to Current Belief":

"Health care expenditures in Canada have not increased at an excessive rate recently, according to two council economists. In fact, their discussion paper analysing recent trends in the health field finds that health-care costs in Canada compare favourably with those in the U.S. and OECD countries."

In chapter 2 the author demonstrates that a real GNP growth rate of only 2 percent will be able to absorb future demographic pressures on government-insured health expenditures.

"Between 1960 and 1970 the total health-care costs, as a percentage of GNP, rose from 5.6 percent to 7.1 percent, in part an extension of health-care services to those who could not previously afford them. However, between 1970 and 1976, health-care costs, as a proportion of the GNP, levelled off. In 1975 this proportion was 7.1 percent of the GNP: in 1976 it was about 6.8 percent. This means that health-care costs in this period did not increase at a greater pace than the economy's capacity to pay for them. Compare that to the United States, however."

They go on to say that the situation of health-care costs is not as bad as is often thought, and this is particularly obvious when compared with the situation in the U.S.

For those of you who are not aware, the U.S. does not have the kind of medicare and hospital-insured programs we have here, yet their share of the GNP has risen constantly, reaching 8.6 percent in 1976, while in Canada it levelled off at 6.8 in 1972.

It's too bad that not long before the election the Premier didn't make a twelfth change in his cabinet. On second thought, I wonder where in that group we could find a competent person. But I'm sure we could find a stronger and a more competent person than the present Minister of Health — for doing the kinds of things he is doing.

AN HON. MEMBER: The member for North Okanagan (Mrs. Jordan).

MR. COCKE: The member for North Okanagan is jockeying for the Agriculture ministry. But, you know, that's a thought. We might just be able to convince the Premier that would be an optimum change at this time.

I'd like to deal with the hospital situation for a few moments. The hospital situation in this province went from bad to worse; I'm thinking in terms of the VGH problem that surfaced last year. This was the situation that led to the appointment of Peter Bazowski. The minister received the report, and he commented on that report. On page 6 of that report we find some criticism. But in the minister's press release we don't find criticism; we find the minister's answers to the criticism. He said: "I have given the interim board some firm guidelines." I'll come back to that. I want to go to the criticism:

"In closing, let me comment on the criticism that much of the responsibility for problems faced by VGH rests with the provincial government, primarily because of outdated facilities, shortage of day-to-day funding and lack of recognition that this hospital has special status as a provincial teaching referral facility. Much of that criticism may be valid, but we have taken firm and positive corrective measures."

Do you know what those corrective measures are? Those corrective measures are that the minister is now the administrator of that hospital, so anything coming out of there has to come through him. When he made that decision. he said: "I have given the interim board some firm guidelines" — incidentally, this is not an interim board of trustees but is an advisory board — "and they will assist the board in an orderly takeover of responsibility and in laying the groundwork for the permanent board to take over when the method of structuring the new board is changed by amending the Vancouver General Hospital Act at the next session of the Legislature." We're still waiting for that session of the Legislature. Meanwhile, the minister is in charge.

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The minister has an advisory board which is not free to act other than at his bidding. That is an indication of what we have in this minister. We have a minister who is keeping things quiet at the VGH. Why is he keeping things quiet? I say he's keeping them quiet, Mr. Chairman, because things are very bad at the Vancouver General Hospital. Things are very bad across this province in terms of the whole hospital system, and this is one way he can certainly keep that large hospital out of the limelight for the time being. We expected to see some legislation this sitting. We expected to see it last sitting. But, so far, despite his own words saying that it would come forward at the next sitting of the Legislature, nothing has happened. There is a deep quiet. But there isn't so deep a quiet in the other hospitals in the province. I believe in the last session of the Legislature, and, as a matter of fact, the last speech during the last parliament, if anyone cares to refer to Hansard, they will find a speech that I made outlining the problems at the Lions Gate Hospital. I'm not going to regurgitate that situation, only to say that we haven't seen much relief at this point.

What is happening at St. Pauls, another large hospital in the lower mainland, is that they can't pay their bills, and that is as of July 12. Unless things have changed dramatically on the 17th they cannot pay their bills. The hospital is tied by budgetary restraints, said Dr. Hugh McDonald, the executive director, while fighting a losing battle with inflation and the devaluated dollar. McDonald said 17 percent of the hospital's $40 million budget, or $600,000 per month, goes toward supplies. The remaining 83 percent is for salaries. He said many of the suppliers haven't been paid for the past two months." Their willingness at this point to carry the hospital is the only thing that's going for the minister in terms of St. Paul's. The minister is going to jump up say: "But I've alleviated their problem. We're going to wipe out their overruns and their overdrafts at the bank and their deficits. " This was, incidentally, his third try at trying to get things on the track, but we'll go over that in a moment or two.

The Royal Columbian — the last headline I saw was on July 6: "Royal Columbian Slashes 90 Jobs." Financial problems caused by the health budget restrictions would force 90 layoffs on July 15th at the Royal Columbian. That is in addition to 50 jobs through attrition. Here is a press release that I did during the last election, and I said at that time the Royal Columbian hospital in New Westminster might have to lay off as many as 160 employees because it didn't have enough money to pay their salaries. At that time that minister squawked "Foul!" He went around the province screaming "foul," and yet today here it is — 140 so far. What will it be tomorrow? We are within 20 of my prognostication during the election campaign: Oh, that minister whined. He whined within his constituency. I can remember him calling one of our candidates, the worthy candidate who ran against him, a prevaricator, of all things — a mendacious person.

HON. MR, McCLELLAND: I never said that.

MR. COCKE: You didn't?

AN HON. MEMBER: He used the word "liar."

MR. COCKE: He used the word "liar." He just doesn't understand that it's all the same thing. Yes, that is what he called him. I don't know how can he say that, because that is what that candidate was talking about at the time he was quoting me and my prognostication. It was right on, and it is going on across this province, Mr. Chairman.

The minister cried foul. He did it again today in his opening remarks. Let me tell you that any person who wrote a letter like this infamous thing — this letter that was sent out to all hospitals a few days before the election, at public expense over the minister's signature and on his stationery, an electioneering piece of material — should resign his seat never to set foot in this House again.

He has absolutely no inhibitions whatsoever. He is purely political in the worst possible sense, and this is the worst political act that I've seen for an awfully long time. He has the audacity to stand up in this House and suggest that there was something wrong with our advertisements during that election campaign. Shame on that minister, Mr. Chairman. Shame on him for publishing a letter like this and sending it out. Thanks and congratulations to those hospitals that refused — not all of them sent it out to their staff. What a hypocritical standard to take; what a hypocritical action.

Listen to how he leads off. I have been deeply disturbed over the amount of misinformation and, in fact, deliberate falsehoods which have received public attention in recent weeks. "These misleading statements reflect on the hospitals and the health workers of the province, and are a cause for concern among the general public." What rot! What nonsense! On the hospitals? No, they're inadequately budgeted. On the workers? No, they were being laid off and put in a position where they were working double trying to keep up with the demands under those circumstances. The public had and has every right to be concerned, Mr. Chairman, as long as we have a minister who will resort to the tactics that minister will resort to in order to try to get re-elected.

Intimidation of staff, misinformation, Mr. Chairman yes. We know where misinformation comes from. It comes directly from that minister, and it's a shame that the minister should pull off a trick like that. He should immediately stand up.... As a matter of fact, I'll let him stand up right now if he'll say: "I'll get up and pay back the $1,100 that we filched from the taxpayers to put this letter out."

You know, the taxpayers of this province were beset by that government the day before the election. During the election call, they were putting out a publication to every person in this province, the B.C. Government News. It was just the first leaflet of the Social Credit campaign, and everybody paid for it. We also paid for this. We're getting tired of being taken to the cleaners by that group over there. I suggest that minister should have some thought when he cries foul.

Let's review some of the hospitals that saw fit to let the world know what's going on. In the first place, I'd like to talk just for a moment about the Jubilee, which was famous recently because Dr. Scott Wallace got back into the picture. We were glad to hear that he's alive and well. He was calling for the resignation of the chairman of the board of the Jubilee. I won't comment on that, but he was talking about the outrageous situation at the Jubilee. He was particularly outraged by the fact that surgeons and doctors were asked to cut down on their surgery at the Jubilee so that they could stay within budget. Really, what Dr.

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Wallace is saying is: "Is that any way to run a ship?" And he's quite right. So the Jubilee obviously is in a dangerous situation.

We noted a headline in the early paper today — they're closing another ward, blaming it on the nurses, saying there are no nurses available. I've been interested in this, and as a matter of fact I've got some people in the RNABC who have been feeding me some information as to their applications for jobs in the hospital. If the minister stands up in this House and tells us that there's a major shortage of nurses that is causing all these ward closures, I'd sure like to have him prove it, because I don't believe it. I do not believe it.

I'd just like to say that the Victoria General Hospital has also said that there's no possible way that they could live within the 7.5 percent. You know, I'm not going to go into great detail, but there it is.

We have a letter from the minister. He was replying to a "Dangerous Penny-Pinching" editorial in the Victoria Times. In his letter — a long, long letter saying very little.... Let me read you a couple of comments the minister makes in that letter:

"I dispute your statement that Victoria General has been forced to go over budget in 1978. The hospital was informed of this budget allocation for 1978-79 on April 28, 1978, and shortly after the start of the fiscal year. Surely it's the responsibility of the hospital's board of trustees to operate within that budget."

Can you operate within a budget that tells you don't have enough money? I suppose you can if you get increasingly dangerous in your service. But those people felt that they could not operate within that budget and that's exactly what happened. The Victoria Times editorial was quite right. It's dangerous penny-pinching.

MR. BARBER: Even the government appointees on the board agreed.

MR. COCKE: Even the government appointees agreed, my colleague tells me. Mr. Chairman, I suggest that Victoria General is not alone. I say that the little hospital at Powell River is another example. "Powell River Hospital Service Cut Severely by Forced Deficit."

Salmon Arm — it's like a poker game and the government has all the cards. There never is a surplus for a rainy day. "Following government austerity guidelines for hospitals, Shuswap Lake has gone the whole bit on cutbacks," Benham says — and he's the administrator — "from restricted lighting and heating to cutbacks in air conditioning, and motor shutdowns in certain times in non-essential areas." Mr. Chairman, the hospitals are suffering.

In Prince George "Budget Restraints" was the headline; Merritt.... It's all over the province, Mr. Chairman. How can the minister stand up in this House and suggest to us that he's right and everyone else is wrong? How can he have that kind of confidence? What do they say in Merritt? "Financial restraints placed upon the hospitals must necessarily result in a reduced staff, together with possible reduced patient care " How can it be possible? Of course there's going to be reduced patient care.

Burns Lake: "The hospital could face a cutback in staff resulting in a loss of some services," said the hospital administrator on July 4. This is not back in April. This isn't at the turn of the fiscal year. This is now. These are articles that are right up to date, Mr. Chairman.

Comox — the member for Comox (Ms. Sanford) drew this to my attention. Now if there was ever a hospital that was run carefully by the sisters, this is one. It's the same thing, incidentally, with St. Mary's. It wasn't long ago that I saw a comparative article saying that St. Mary's in New Westminster is in great shape. That is not the case, however, when you go and talk to them quietly and personally.

At any event, what does the sister say? The sister says:

"Comox Strathcona Regional Hospital District, regarding the urgent need for extra extended-care beds...."

She goes on to say:

"You are aware of the 5 percent ceiling. Our submission went to approximately 10 percent and the reasons for that figure are stated in the letter and are also a fact of our constant awareness of costs and our continual striving to provide the best patient care at the lowest possible costs."

She says she can't do it. Yet, Mr. Chairman, the minister says they must. Ten percent is her absolute minimum.

I've cited a few and I could go on to cite practically every hospital in this province. But do you know what I'm going to do? I'm going to leave a lot of this to the back-bench Socreds who can get up and tell us how their hospitals are doing in their particular areas. I'm sure they will have some comments.

I was pleased to see Dr. Pacey's comments. He's a responsible person in the medical community. What did he say in the May Medical Journal? He said:

"A crisis now exists in hospital financing. Severe restraint on budget increases has resulted in cost control efforts in all B.C. hospitals. Many dollars have now been saved, but all this restraint has also resulted in severe functional problems which have reduced confidence in patient safety. Administrators have reduced nursing budgets to dangerous levels."

That, Mr. Chairman, is the kind of statement that we've been making, and we've been called irresponsible for having made it. Yet this is a very thoughtful statement by a person who knows. You talk to the doctors in this province, and that's precisely what they're going to tell you. That's what they've been telling the minister, and I'm sure when he gets up he's going to tell us that's quite right.

Those are just a few examples of what's going on, and where it's going on. Mr. Chairman, I'm sure that somewhere along the line I will have somebody give me an opportunity to say a few more words, just like the minister.

I would like to refer the minister to a Vancouver Sun editorial where he talks about the good life. Maybe the minister read it, because it's only a few days ago. I would like to also suggest that in a few minutes I'm going to review just a little bit of the Burnaby General situation. This is the tip of the iceberg.

I would like to say in review, however, that last November he said 5 percent. During the election he said that there could be 7.5 percent, and now he says: "We'll pick up your deficits." Let me tell you what happens through all of this. Nothing. The hospitals are still in an impossible situation; 7.5 percent is actually 5 percent, and

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let me tell you why it's only 5 percent. The other 2.5 percent is going to be required to pick up the increased negotiated raise in the first three months of 1980. Now the Premier doesn't understand that. We know that he has difficulty with most things, but let me repeat it for him. The 7.5 percent is only 5 percent for the following reasons. All of the 2.5 percent increase that the minister so generously gave is going to be required to pick up the increase that has been negotiated for the hospital staffs for January until April of next year. So therefore they're still at a 5 percent situation which is utterly impossible. The minister has created chaos. I see the red light, so I'll give somebody else an opportunity.

HON. MR. McCLELLAND: Could I just quickly answer a couple of those questions, Mr. Chairman? I'm glad for the last couple of remarks, because it cleared up something for me. I understand now the kind of mathematics that member used in running ICBC into a $200 million deficit before they got out of office. I'll be very brief. I just want to refer to a couple of things the member for New Westminster said.

The 5 percent limit was not a limit, but rather an estimate of how much money would be available to the hospitals in British Columbia. It was the first time in the history of hospital funding that they were given some indication in advance of how much money they might have. In the previous administrations, including the one which was headed by the member who previously spoke, hospitals never did know how much money they would have until they were six, seven, eight months into their own budgets. With two or three or four months left, they had to scurry around to find ways in which they might cut back services to meet the government money that was made available for them. That was a stupid way to do things, and we changed it. We've changed those things. The minister then was the member for New Westminster (Mr. Cocke). But those things, hopefully, will continue to improve as we make improvements in the methods by which we fund hospitals.

The member for New Westminster amazes me when he talks about the need for restraint in health-care costs. If it had come from anyone else I would have accepted it. But for that member to say that there's no need for some concern about the way hospital costs and health-care costs are rising is strictly incredible to me, when the whole world is concerned about increasing health-care costs. There have been front-page stories in recent weeks and months in Maclean's magazine, on the television, in Time magazine. I have an article here from U.S. News and World Reports of March of this year. They paint a dramatic, frightening picture of what's happening to the hospital system in the United States because of governments not taking notice of the way those costs are rising. In New York City 25 hospitals have closed, bankrupt; 54 of the 57 voluntary hospitals in New York City lose an average of $2 million a year. One hospital in Atlanta has gone bankrupt and closed its doors. Hospitals in Los Angeles are going bankrupt and closing their doors. The whole world is concerned about health-care costs, and for that member to stand and say that we should not be concerned here in British Columbia is really putting the blinders on in a way which could find us bankrupt ourselves in this province, and unable to maintain the kinds of services which our people both demand and deserve in the future.

So we must reject that there isn't some concern about the rising costs of delivering health-care services. In fact, Mr. Chairman, if that member was not concerned about the rising health-care costs, I wonder why he wrote a letter in 1975 which said: "Dear Hospitals" — or dear somebody — "I am writing at this time to ask for your assistance in restraining the rate of increase and expenditure on health services." It was signed: "Dennis Cocke, Minister." Why did he write that letter if he wasn't concerned about the increasing costs of hospitals?

Listen to the kinds of things we read every day in our newspapers. This one is headlined "Victorious" in the Vancouver Sun: "Hospitals throughout B.C. have been urged to hold the line on spending." That wasn't by me; that was by the former Minister of Health, dated February 14, 1975. "Cocke urges hospitals to hold the line on spending." You know, let's be at least honest about the way things are going.

MR. LEA: What's wrong with that?

HON. MR. McCLELLAND: There is nothing wrong with that, and that's what I am saying, that....

MR. LEA: Ah, but there's a difference between doing that and starving them.

HON. MR. McCLELLAND: Mr. Chairman, there must be....

MR. CHAIRMAN: Order, please. All members will address the Chair, please.

HON. MR. McCLELLAND: Mr. Chairman, for that member to even indicate to this House that there isn't a serious concern about the growth of health-care costs is not serving the needs of the people of this province in any kind of honest way.

The member talks about Vancouver General Hospital, about the minister keeping quiet. There was a problem at Vancouver General Hospital and we attempted to deal with it in the most expeditious manner possible. The member says that we expected to see legislation this session dealing with the permanence of the interim board which was put in place at Vancouver General Hospital. If I'm not mistaken, there was a message bill today before this House which has that provision in it — to make sure that the board that is now in place is legitimized and made the permanent board of Vancouver General Hospital. The member might have expected that sometime this session before he commented that it wasn't coming. It's here in the House, and you'll have the opportunity to debate it before this session is over.

The member talks about other hospitals, St. Paul's included, having problems. Yes, hospitals have difficulty managing; so does everyone have difficulty managing. It's not always easy to stay within budgets. It isn't easy for us personally to stay within certain kinds of budgets, but I'm struck again by the similarity of the things that we see over the years. This is not a new problem. Hospitals have always had difficulty managing.

Here is a headline that all of you can read, I'm sure. It says: "St Paul's is running into debt." You'd think that was yesterday, but it wasn't yesterday. It was in the Vancouver Sun, December 1, 1975. Mr. Ron Longstaff, chairman of

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the board of St. Paul's, said St. Paul's had to use its credit while waiting for late payments from the provincial government. "They" — the government — "always run you at a deficit," said Longstaff about the Minister of Health in 1975.

The other headline is this one, and it will be interesting to all of you: — VGH Broke, Seeks Transfusion." When was that? Yesterday? Last week? No, it wasn't. It was the headline in the Province, November 29, 1975, when the member opposite was the Minister of Health. It says: "Vancouver General Hospital has run out of money. Its executives say it hasn't received considerable sums owed it by the provincial government."

There is another headline: "Government owes VGH $200,000 from two years ago and hasn't paid its bills."

MR. LEA: Oh, $200,000. Isn't that something, Bob?

HON. MR. McCLELLAND: Well, that's just the past bill.

Mr. Chairman, I'm not saying that I'm right and everybody else is wrong. I accept that it's a serious problem that we face, but we must face it. I said in my opening remarks that we won't run away from it. We will attempt to deliver the services in the best way possible, and we will also accept that living within our budgets is not easy at the best of times, but that it must be done if we aren't to bankrupt the taxpayer.

MR. COCKE: Mr. Chairman, I note that the member for Dewdney (Mr. Mussallem) wants to speak, and I'm going to give you a good reason. One, I'm going to have that member charged for practising medicine without being licensed. He's been feeding me vitamin C for a sore eye for days and days, and I can prove it.

By the way, I'd just like to give the minister, while he's been sitting in here, a message from Ottawa. The message is that the federal government has decided that it will not help fund the B.C. Heroin Treatment Program. That's very thoughtful. I would have predicted that.

MR. BRUMMET: Are you happy about it?

MR. COCKE: What do you mean, am I happy about it? What a phony, pouring-water-down-the-gopher-hole program.

MR. CHAIRMAN: Order, please.

MR. COCKE: It goes on to tell you why, Mr. Chairman. The reason is that there is a controversy over the c program. The decision is because of the controversy, and also because it is being challenged in the courts. I just suggested that maybe the minister wanted to think about that for the next little while.

I want to say one word about the Burnaby General Hospital. Here is a hospital that is such pressure that the administrator sends out a letter to all his employees. He tells them, among other things, that the board chairman has clearly reaffirmed the policy that no member of the board, the medical staff or the hospital staff is to provide information to the news media except the administrator. This is the kind of a situation that is dangerous. The minister has people coerced to the extent that they'll send out this kind of memorandum. I think it is just too bad.

I suggest, Mr. Chairman, that this is a situation where we do have a great deal of chaos, and I suggest that the ministry's reorganization isn't helping anything. So maybe the minister had better get on top of his job and see what he can do about ameliorating the problems. If he doesn't, he's likely to get fired. Let me tell you why. The papers in Kelowna say: "KGH Board Plagued by Growing Deficit" — "Kelowna General Continues to Fight for a Just Budget" — "KGH Board Chairman Not Ready to Panic But Almost." That's the Kelowna General Hospital, and the Premier comes from Kelowna. I suggest that minister had better watch himself, otherwise the Premier maybe sometime will get around to reading his home papers.

I thought maybe I would just bring a little levity into the House and talk about the government Whip (Mr. Mussallem). During the election campaign, the Whip, my good friend, got up and did his dance. His dance was as follows: he said that when they closed the 14 beds at the hospital in Maple Ridge it wasn't the fault of the Health ministry — it was the fault of the hospital board there. It was not the fault of the Minister of Health and his budget. It was the fault of the hospital board. I suggest, Mr. Chairman, that if the people in Maple Ridge had sufficient money they wouldn't have closed down that 14-bed ward. But I bet you that member is going to get up and give us a full explanation....

MR. BARRETT: Blame the people for getting sick.

MR. COCKE: Right. He'll give us a full explanation of why that occurred. He is very lucid, and I'm sure that he can inform us.

I think probably the best symptom of this sickness that seems to prevail at the moment in our whole hospital situation is best said by the medical staff of the Royal Jubilee Hospital some months ago, on December 2. What did they say? They put an advertisement in the paper — that's a very unusual thing for a medical staff to do. But they said they had resolved that the public should be made aware of the deteriorating level in patient care which has resulted from government measures of cost control.

The minister said I should have some concern about the increasing health costs. Of course I have, and I had then. But using an atomic bomb to knock out a very small rock isn't my idea of good sense. I think the minister has over-reacted to the extent that I brought out in the first place; and that over-reaction has brought us into a situation where I get these kinds of phone calls. A chap phoned me the other day and he said: ''ll can't get my brother into Shaughnessy. He is dying of cancer and is going, to the cancer clinic every day. He doesn't live here, he lives up-country..." — I'm not going to identify the town for fear of identifying the person — "and he's staying at a relative's house. He is being taken in all the way from New Westminster to the cancer clinic each day, and it almost kills him. The fight we had to put up to get him into Shaughnessy and then finally get him recognized for treatment elsewhere is just ridiculous in this day and age." The one thing the people will tell you out there is that they re prepared to pay for health care. They don't need this kind of squeezing that's going on.

[Mr. Davidson in the chair.]

[ Page 802 ]

Mr.Chairman, I would like to deal with another area for a few minutes. Just to give you a bit of a comparison, let's talk about the cerebral palsy grant that the minister so very helpfully sent a note to his caucus about. The reason he did that was that the cerebral palsy people had put out a press release saying that they're squeezing us and squeezing us to the extent that we just cannot give the service. So the minister does his usual thing. He's very verbose, and he also pins a good deal on this particular letter. He tells us how much the budgets have been from 1973-74 up to 1978-79, and how much the Cerebral Palsy Association has increased its service.

"The Cerebral Palsy Association has of its own volition expanded its mandate to include many types of neurologically handicapped children and has likewise expanded its range of services. As you can see our grant for this organization is now over $1 million and I feel we cannot continue to turn over such large and ever-increasing amounts of public funds to voluntary health agencies without being convinced that this is the most equitable and efficient way to spend funds."

And he goes on to worry about overlapping and so on. Well, Mr. Chairman, he gives round figures: it was $250,000 in 1973, and in 1979-80 it's $1 million. That's the way he treats it. So naturally he can convince the caucus that he's on the right track, squeezing the cerebral palsy people.

Let's look at another way to compare, however. In 1979 there are 1,934 people in the caseload. As recently as 1976-77 there were 902 people in the caseload — over double in three years. And the minister says: "But we can't do that. We can't expand." What happens is that when you provide physiotherapy for people with cerebral palsy in Kelowna and Penticton, others will hear about it and surely will want that for their children afflicted with cerebral palsy. Is it any wonder that there's an increase in demand? There isn't an increase in need; the need is already there. But once you provide the service.... And the minister says: "Shame on us for providing the service."

But you know what he's talking about, in terms of this huge budget of his? He's talking about a few thousand dollars. There have been a number of letters written back and forth, from the association to the minister and from the minister to the association. But, Mr. Chairman, the one thing that I would like to bring to your attention is that the association has proven its need. It has shown everything that's happening and everything that will not happen if the minister doesn't increase his grant from $1,000,034 to $1,234,000 — $200,000 for the needs of some of the most unfortunate disabled people in this province.

This, I think, is the way he's been treating the hospitals. It's the way he treats everything that he touches. But the saddest part of it all is that I really don't think he wants to do this. I don't think he's sufficiently able or strong enough to put a case up to Treasury Board that's going to get the kind of accommodation that is required. He can't do it, so he should quit.

Mr. Chairman, the cerebral palsy people are not alone. As I said, they're just part of the picture.

I would like to just briefly deal with the emergency health services in this province. How many do we need? How many ambulance attendants do we need? We said back in 1974, or 1975, that there was a need.

Interjection.

MR. COCKE: That member's talking about a diagnostic and treatment centre. He doesn't even know what I'm talking about. I'm talking about ambulance service.

Mr. Chairman, there was a need then for 750 people, full-time, and how many have we got now? There are 550 people. He's still 200 short.

The present budget, Mr. Chairman, if it prevails, will mean that there will be further cutbacks. I want to tell you this — and this, as far as I'm concerned, I find to be the most shocking thing. Do you think that cash is the only lack of priority, or that cash is the only situation that is bothering us in the emergency health services situation?

Mr. Chairman, I'm going to need somebody to fill in for a second.

MR. MUSSALLEM: I am amazed when I hear the hon. member for New Westminster decrying our hospital system. It's simply unbelievable. I do not know how anyone can stand in his place in this House and decry the finest hospital system in Canada. It was this government that brought in the first comprehensive health-care system. It was this government that maintained the system.

MS. BROWN: What are you talking about?

MR. MUSSALLEM: Yes, it was this government. It was brought in by another government before our government's day. I won't go into details, but I said "the first comprehensive health-care system" in British Columbia, and that's true.

MS. BROWN: What nonsense!

MR. MUSSALLEM: I want to tell you this in addition: today we have a system that looks after everyone everywhere under any circumstances, with the best and finest facilities that I know of perhaps in the world, and certainly in Canada. I know that in other countries they may have specialized things to do certain jobs, but in British Columbia we have the best care that is known in this country.

To have the hon. member for New Westminster rise in his place and say that care is inferior.... I just have to sit here and cringe and wonder how a man who lives in this beautiful province would stand up and knock his own system. He should stand up and say it is the finest system, it is the best system and everyone is cared for. No one who needs an operation, no one who needs surgery, no one who needs help is denied. Can anyone stand in this House and say this government is not doing it? I say to him that it's not the government, it's the principle that we work on. I regret very much to hear my honourable friend decry a system that is so excellent, so foolproof. There's only one problem with it. We have to hold the line.

I'll tell you, the people of British Columbia will not stand for wasteful expenditure of their money. If this government lets loose and opens the floodgates to hospital care, I can tell you that within one year we would be beyond the scope of our budget.... I compliment the Minister of Health for showing courage in doing what he's done.

I doubly compliment him for his courage in doing what he did when he did it. At the hour the election was called, a

[ Page 803 ]

letter came out to tell the hospitals to hold the line. It was the most unpolitical thing you could do, but it was the honourable thing to do. I wonder if the people of British Columbia recognize that. I wonder if they recognize the fact that he could well have held back those letters for two months and slopped it in afterwards and said: "Now hold the line." But no way, he came forward with a letter when the time was right, and said: "The situation is this way now. You must hold the line."

The letters came out to hospitals to hold the line on the eve of an election. None of us are here because we need the pay. We're here because we want to save this country from the dire results of socialism. By doing what he did, he practically opened the floodgates and turned us out. Yes, he did. But it was the honourable thing; it was the courageous thing, I didn't like it at the time. The Hospital Employees Union sent out word on the radio and letters in the press, saying: "This government is going to close your hospitals. This government is unfair to labour." Just the reverse is the fact. We are a responsible government. We do the thing correctly. We do not wait until we get into trouble before we move.

Ontario is closing hospitals; the hon. minister told you that. Doctors are opting out of the scheme. And the hon. member for New Westminster said: "Ask the doctors." Well, I just did exactly that; I met with 35 of our doctors in Maple Ridge Hospital in one day, and they were totally and completely satisfied with the course the government was taking. They told me that. They said there were problems; but they are not problems that cannot be met. Today, with proper care and with some adjustments, the doctors will remain happy. We need them. They need to be well paid. Let me tell everybody in this House that people who have gone through the course of training they have gone through, and with the responsibilities that they have, must be treated as special citizens. Not that they're the only ones to be treated thus, but they have a big responsibility. I'm telling you, when your child is sick you don't argue about the price, you don't say to the doctor.... You might say a doctor is careless, that he does this or he does that, but when your child is sick you want that doctor right now. In this province it's that way, and I want to say here that I admire the minister for maintaining a ministry that's as reliable and as intensely effective as it is in this province.

All we need here today in this debate is a recording machine which recorded the debates of the opposition parties during all the years since 1967, one year after the other. I could almost tell you verbatim what was going to be said — the same story, the same problems. But we go onward and upward, improving a solid, excellent system of hospital care. I regret that anybody would condemn it.

You mentioned the hospital in Maple Ridge closing beds. I know they closed beds. I was talking to the chairman of the hospital board on the telephone before the meeting, and I said to him: "My friend, there's no need to close beds; don't close the beds; it's not going to do you any good, because the government always comes through. They'll pay you; they've always done it; they'll do it again." He said: "Can you guarantee it?" I said: "No, I can't guarantee it." So what happened? They came through; they paid the bills. But that does not say that the hospital board does not have fiscal responsibility — that is the issue. I don't say there's anything wrong with it, but you can't spend money carelessly, and our hospital is no different than the others.

But I'll tell you we have a bad problem in this bed business. One lady phoned me and said to me: "I can't get an operation because there are no beds." I phoned the doctor, and he said: "Certainly there are beds, but I'm not ready to do the operation yet." So I find out what the doctor says and, according to the proper medical lingo, when they get a bed they'll get her in for elective surgery. It's not the shortage of beds.

No one is without health care in British Columbia. I say to you, my hon. friend, there isn't a better system, there isn't a more competent system, and we're just plain lucky to be living in British Columbia.

HON. MR. HEWITT: With leave, I'd like to make an introduction,

Leave granted.

HON. MR. HEWITT: I'd just like the House to welcome Mr. Bob Kadlec, the president and chief executive officer of Inland Natural Gas, who I have just noticed up in the gallery.

MR. COCKE: I'm delighted that the member for Dewdney (Mr. Mussallem) gave us his opinion of what's going on in the hospital field. I find it difficult to understand, but I'm going to have a talk with him afterwards, and then he's going to be able to explain how it is that the minister is doing all the right things.

I was dealing for a moment with the emergency health services. I said that there was a need for many more ambulance people — we're 200 short right now in this province. Now this is the situation, and I think it's shocking, in view of the fact that, if any area is a preventive area, if any area can save the whole health system a great deal of money and an awful lot of trauma in the long run, it's the emergency services. When you have 200 too few people to man those ambulances, then they have to be late, don't they? The whole idea of an ambulance service is to get them there quickly so that they can provide immediate care which will reduce the complications that occur before they get the person to the hospital. That's the whole idea behind an ambulance service. But it's certainly not a priority with this minister.

As a matter of fact, it was very interesting to see how the government responded to the paramedical training course. When the Minister of Labour (Hon. Mr. Williams) had a slight affliction, which could have cost him his life, all of a sudden the paramedical course and the paramedics became a very high priority in this province; the training plan was restored by the minister. The paramedical training plan still continues, but other courses are not taking place the way they should be in order to create the 200 trained persons we need.

There's something that kind of gives me an idea of just how we feel about the emergency health services. Do you know that in this province a cabinet minister has priority over an ambulance case on government aircraft? You shake your head, Mr. Chairman, but it's true. I have this information from many sources indeed. They are sources sufficiently close enough.... Let the minister stand up and deny it, if he dares. The fact is that the priority for government air flights goes to cabinet ministers, not ambulance cases.

[ Page 804 ]

HON. MR. McCLELLAND: Nonsense!

MR. COCKE: If you think it's nonsense, then you don't know what's going on around you. You're even weaker than I thought you were.

Just to give you an idea how much priority ambulance service gets.... The members for the north just sit there and smile, particularly the member for Peace River. He should know that over two months ago there was Treasury Board approval to secure garages for ambulances in the north; there has been nothing done by BCBC since. Ambulances continue to sit outside in the north, whatever the weather might be.

The communications system is a shambles in the emergency health service. The transmitter sites are absolutely ridiculous. In a very small area by comparison, the Vancouver police have seven transmitter sites. Don't forget — when you are dealing with this kind of transmission you are dealing with line-of-sight transmission. They have seven sites. The ambulance service has two sites in the whole metropolitan area of Vancouver — that's from Vancouver all the way out to the Fraser Valley. So the ambulance people often find themselves in blind spots, where they can't call in. As a matter of fact, there has been no improvement. Some say to me that it has reversed since 1974, and that communications are worse now than in 1974 when the service was set up.

Today, in my town of New Westminster, the fire department is actually so concerned with the service they are transporting people to hospital. I can't believe it — and the minister sits back, so unconcerned. These are the kinds of situations we face here. It's just not good enough.

We're almost back to the old grab-and-scoop days. I'll never forget the way it was when I took over as Minister of Health: there wasn't even an ambulance Act in this province. You could have used an old light-delivery truck; you required no training; it didn't matter. You could be, running a mortuary business and ambulance business together, or you could be running a day service, or whatever. That was all that was required; put it together, grab and scoop.

There is a higher priority paid by this government to property than to people. All you have to do is look at the fire brigades around this province and see how rich they are by comparison to the emergency health services. Not long ago in this House I used the example of Vancouver where there are 800 firefighters and about 200 ambulance people, and far more ambulance calls than fire calls. Naturally, you don't require as many, but you sure require the kind of priority that doesn't leave it for a fire department to transport people to the hospital, particularly in a geographically small town like New Westminster — six square miles. It is not good enough, Mr. Chairman, and yet this is what we get from this minister. This is what we get from the Emergency Health Services Program.

I believe that if we're not careful we're going to go the way of Ontario. Remember Ontario, at one time, was a leader. As a matter of fact we looked to Ontario when we were setting up the Emergency Health Services Program. They had an ambulance service there, but you know what they're doing now? They're farming it all back to the private areas, except in Metro Toronto. I suggest that this is what is going to happen here, unless that minister has a care.

I would like to give an example. I was talking a moment ago about the communication system in the mountains. The Ministry of Transportation, Communications and Highways and the police have a tremendous system. They are in constant contact, and yet, when an ambulance is two miles out of Hope, forget it. If you want to stop that ambulance, you know what you do? Let's say that the reason for calling the ambulance has changed, or there is no need for the ambulance. You know what they have to do at Manning Park? They phone to Manning Park, send somebody up on the highway and flag him down. That is the kind of communications we have in the ambulance service. Yet the police are in constant touch, and even the Ministry of Transportation, Communications and Highways trucks are in constant touch with one another and their base.

I suggest that it is crazy to live with an inadequate system. Let me give you an example from Surrey. There was a medical call in Surrey that involved an emotionally upset person. The phone was ripped off the wall and the windows were broken. The ambulance driver had to drive up a hill a mile away to call the police for help. Why did he do that? Because he was in a dead spot. He could neither hear nor could he be heard by the headquarters.

There was another situation. At 168th and Fraser Highway is a dead spot, and yet that spot was used for three years as an area where an ambulance could park and could respond, and now it's dead. I have another example. For some months Gray Beverage Co., which has a two-way radio system, cut out the paramedics whenever they were on. I suggest, Mr. Chairman, we're in tough shape.

MS. BROWN: I am just going to be speaking, I guess, for a few minutes until our critic regains his voice, and then I will give up my position to him.

I would like to first of all say that the three members for Burnaby — Burnaby North (Mrs. Dailly), Burnaby Willingdon (Mr. Lorimer) and myself — have been sufficiently concerned about the situation at the Burnaby General Hospital that we have been meeting with various representatives of that institution. We have met with some of the medical staff, representatives of the registered nurses, some of the hospital employees, union people as well as HLRA and, of course, with the administrator. We wanted to be absolutely sure about what was happening to Burnaby General Hospital.

One of the reasons, of course, that we were interested was because of that letter quoted by our critic, in which the minister wrote to everyone and said: "...while others are being forced to retreat and cut back, this is not happening to us here in British Columbia. Instead there is careful and steady growth and management of the province's economic health, and this allows us to continue with our commitment to social health."

We decided to investigate and find out to what extent it was accurate, certainly as it applied to Burnaby General Hospital. One of the first things that we came across was an article by Dr. Pacey which was published in the B.C. Medical Journal of May 1979. He talked about the crisis which now exists in hospital financing, severe restraint in budget increases which has resulted in cost control efforts in all of British Columbia. He goes on to say it's not just a matter of saving dollars; if it were just an economic situation, one would not have cause for much concern — but indeed, and I quote: "This restraint has resulted in

[ Page 805 ]

severe functional problems which have reduced confidence in patients' safety. Administrators have reduced nursing budgets to the danger level." I find that particular sentence interesting in view of the fact that the member for Dewdney (Mr. Mussallem) stood on the floor of this House and said we have the best delivery of health service anywhere in the world. I think if that is correct, then the world is in serious trouble indeed. Here we are having a doctor who, presumably, knows a little bit more about what goes on inside the hospitals than the member for Dewdney, telling us that in fact the budgets have been reduced to the danger level. And this is someone who is practising in the hospital.

And, of course, it's clear, Mr. Chairman, that all of the newspaper reporting, on TV and on radio, talking about the situation in the hospitals where people could not have open-heart surgery when they needed it.... This kind of information has somehow not seeped through to the member for Dewdney. The statements he made, one has to take into account, were based on a total lack of information on his part.

However, Dr. Pacey goes on to tell us that in many hospitals nurses are so thinly sprinkled they find it impossible to keep track of patients under their care. I think that certainly is a dangerous situation. And he goes on to say this also reduces the information flow to the physicians.

Mr. Chairman, I recognize that, although Dr. Pacey is from Burnaby and is attached to the Burnaby General Hospital, he was in fact discussing other hospitals in the province as well. But if one just concentrates on what's happening to Burnaby General, I think these statements of his certainly make very good sense in terms of what we know about that hospital. He goes on, and I quote.... And for the benefit of the member for North Peace River (Mr. Brummet) I'm going to use the comments of other doctors as well on the staff of Burnaby General Hospital that support these statements of Dr. Pacey. This is not an isolation, and one has no reason to believe the doctor would be dishonest or display a lack of integrity in stating these facts.

Dr. Pacey tells us that more common now are incidents of undetected oliguria, known as unrecognized death, and other problems. Night shifts are extremely poorly staffed, and reliable patients complain of long delays for simple nursing services. He ends his column in this journal by saying that the B.C. Medical Association and the Registered Nurses Association should pressure government to improve the standard of safety for hospital patients by insisting on safe nursing levels.

I contacted Dr. Pacey and asked him whether, in fact, Burnaby General was one of the hospitals where he felt the patient care was in jeopardy as a result of the shortage of nursing staff and other staff. He said he definitely thought so. He pointed out the fact that Burnaby General Hospital served an older population; that there are a lot of senior citizens living in the catchment area who use Burnaby General Hospital; and that the quality of nursing has to be of a very high calibre to deal with them, because this is a community with a lot of medical problems. He points out that, in addition to that, it's a very fast-growing community. The population of Burnaby is on the increase, and indeed the hospital has been expanding to try to keep up with this. But the fiscal restraints, the budgetary restraints, have certainly been a hardship; the operating budget, he said, is just not able to provide even the basic kinds of services to ensure there is a safe nursing level and safe patient-care level — certainly not in his opinion, anyway.

He said that the doctors in the hospital were asked by the administrative staff if they could assist by recommending areas which could be cut out, what things could be dropped, so that they could live within the budget. The administration is trying to live within the budget. It's a very responsible administration, and they are trying to live within the budget. So they approached the medical staff and asked that they make recommendations and offer suggestions as to what areas could be cut out. What frills were there? What things were the doctors doing which they considered to be unnecessary? What kind of luxury items were involved in terms of the delivery of health care? The doctors found that there was absolutely nothing that they were doing. They felt that they were delivering — or trying to deliver — good basic health care, that they were not indulging in any frivolous or non-essential medical practices. He decided — and he said this quite openly — that he thought the government was playing a shell game with the hospitals and that the medical profession should refuse to go along with this. He said that there was just not enough money to do the job. The member for Dewdney (Mr. Mussallem) would have us believe that the fault, of course, lies with the hospital boards, that it's their fault beds are closed down and hospitals are not doing the job. But, of course, that is not true. It's the government that does not give the hospital boards sufficient funding for their administrations to be able to carry out the job effectively. The administration is hamstrung as a result of the budgetary decisions made by this government.

Later on, I think, we should make some comparisons between how this government chooses to spend its money and the kind of funding it puts into areas that are involved in services to people.

Mr. Speaker, he mentioned three areas in particular that he thought were suffering as a result of the budgetary restraint. He mentioned the coronary care unit, the intensive care unit and enterostoma therapy. He talked about the fact that they were not permitted to open their nuclear medicine and EEG sections — and I'm going to be speaking in more detail on that later.

He said the administration asked them to work out some kind of concept of the number of patient-days that they would be using in 1980. He said: "How do you decide? How do you know how many patient-days the hospital is going to need from one year to the next?" They know how many patient-days they used last year. But when they are dealing, as I said before, with this double factor of a large senior-citizen population — there are a large number of senior citizens' houses in the Burnaby area that fit into this hospital's catchment area — and a population that's growing by leaps and bounds, how do they sit down and make any kind of reliable plan as to exactly how many patient-days they're going to be needing?

Then, Mr. Chairman, I contacted someone else who is also on the medical staff at Burnaby General. He wrote a letter which I would like to read into the record, because it covers a number of very specific areas in the delivery of health care. I particularly hope that not just the minister, but also the member for Dewdney (Mr. Mussallem), is listening. This letter is dated July 15, incidentally, so we're not talking about January or December of last year, or last

[ Page 806 ]

spring; we're talking about the present time at Burnaby General Hospital:

"Dear Mrs. Brown:

"The desire of the provincial government to apply stringent economic measures to the financing of hospitals in British Columbia should be tempered in special situations, and I believe Burnaby General Hospital to be one of them. As you know, Burnaby General Hospital has recently completed expansion of its physical facilities and is now in the process of following through with extending health services to the people of Burnaby and east Vancouver..."

So it's not just the Burnaby area which is served by this hospital, which was designed to be a community hospital for the Burnaby area as well as east Vancouver.

"...many of which are long overdue. It seems strange to me, therefore, that the provincial Ministry of Health has not honoured these commitments, but has indicated withdrawal of major health services which are now being provided for, as they have been in the past, to a population of about 130,000 people."

And here he's specifically talking about the obstetrical services and the pediatric services.

"You will see from the communications which I have provided" — and he sent me a number of letters which I'd also like to refer to — "that there has been an increase in obstetrical cases at the hospital to over 1,200 a year. With the anticipated closure of maternity services at Grace and Vancouver General Hospital in the not too distant future, such services at Burnaby General are bound to expand."

And the enclosure he sent, Mr. Chairman, was a letter from a Mr. Glenwright, Assistant Deputy Minister of Hospital Programs, which went out — and I guess it went to all hospitals — in November 1978. It clearly designed which of the hospitals were going to be included in regional neonatal intensive-care referral units and expanded obstetrical services. He talked about Prince George, the Royal Inland Hospital at Kamloops, the Royal Columbian in New Westminster, Victoria General, the Jubilee, the Vancouver General and the Grace Hospital, but Burnaby General was not included in this list at all. The decision was made that the Burnaby General should refer these particular patients to the Royal Columbian Hospital.

One of the doctors on staff wrote a letter to Dr. Gottschling, the head of the department of obstetrics at Burnaby General, on April of this year, in which he says:

"I am writing in response to a letter that has been received by Burnaby General Hospital over the signature of Mr. Glenwright, Assistant Deputy Minister of Health in the hospital program of the Ministry of Health. You are well aware that the letter suggests that this hospital be designated as a primary-care hospital and complicated problems in obstetrics be transferred to the Royal Columbian Hospital.

"My present management of high-risk cases which I feel would be better attended elsewhere is to transfer them to the Vancouver General under the specific care of Dr. Bryans. I have at times also referred to Grace Hospital under the care of Dr. MacEwan. It is my understanding that should our hospital be compelled to transfer patients to the Royal Columbian Hospital, that I shall no longer be able to choose my consultant, which I may believe is the most capable in the field, and consequently I must allow my patients to be managed at the Royal Columbian Hospital by whoever happens to be on call for that week. You will understand that it is not the machinery, house staff or nurses who have the alternate responsibility and care of high-risk obstetrical patients, but the obstetrician himself. And therefore, as I have faith in these two previously mentioned physicians, I feel it is my right and obligation to the patients to transfer them specifically to their care."

[Mr. Strachan in the chair.]

So what we have here, Mr. Chairman, is a doctor who is saying that in his opinion, to designate the Burnaby General Hospital — which again, I repeat, was built to be a community hospital to meet the needs of the Burnaby community, but as a result of the fiscal policies of this government has now been designated as simply a primary care hospital which has to refer its complications to the Royal Columbian — is to take away from the patient's doctor the right to decide who is going to take care of her patient or his patient if a complication arises.

The Minister of Health has probably never had a complicated obstetrical problem to deal with. If I can say something on behalf of people who use obstetricians and gynecologists, the last thing that you want when there is a complication involved in an obstetrical situation is to be referred to the care of a doctor who is unknown to your own obstetrician, who does not have the respect of your own obstetrician and who is unknown to you.

This is not just with obstetrical services. I'm sure that this is true of any instance in which there is a complication in an illness. But specifically, Mr. Chairman, if I can speak out on behalf of those people who use obstetricians, when there is a complication, to deprive from the doctor the right to decide whom to refer her patient or his patient to is intervening and interfering in a very serious relationship, at a time when the patient is in the most vulnerable situation emotionally as well as physically. This cannot be justified on the basis of saving dollars and cents. It's the kind of thing that Dr. Pacey referred to when he said that this government, in terms of balancing its budget and fiddling around with its financial dealings, is placing the quality and the delivery of health services in this province in jeopardy. This particular obstetrician goes on to say:

"I'm also concerned about the fact that as the Burnaby hospital is located directly between the two major centres of medical care, that we will be forced to transfer patients actually from Vancouver and the East End, on which our practices are founded, far out of their own district to the Royal Columbian Hospital."

Now here is a doctor, a number of whose obstetrical patients are from east Vancouver. He sees them because he has visiting privileges at the Burnaby General. They go into Burnaby General to have a baby. There is a complication. Instead of being able to refer them back to Vancouver where they are from, to the Vancouver General under the care of Dr. Bryans or Dr. MacEwan, the two referring specialists in whom he has particular faith, he is going to be told that he has to transfer them to the Royal Columbian Hospital, and

[ Page 807 ]

any obstetrician who happens to be on call that week suddenly has the job of caring for this doctor's patients. That is a direct interference in the patient-doctor relationship, and I am not convinced that the government has the right to do that. But the government does it because the government is responsible for the funding, and if they decide that the money is not going to go to the Burnaby General Hospital to allow the hospital to give the kind of obstetrical care that should be given, then the patients who go into Burnaby General are at the mercy of the fiscal decisions and the financial decisions of this particular government.

That is just not good enough, and I think more and more people should be told that when they go into Burnaby General Hospital, they'd better beware, because if there are any complications when you go into Burnaby General Hospital, if you have any obstetrical complications, your doctor loses control over you. It's taken out of your doctor's hands. The patient is going to be transferred to the Royal Columbian, and the duty doctor — who may be the best doctor in the world, I don't know.... But this doctor is concerned, anyway, that the care of the patient is going to be taken out of her or his hands, as the case may be. Mr. Chairman, I have another letter here. This one is written to Dr. Van Tilburg from another obstetrician. It says:

" Re the downgrading of obstetric standards at the Burnaby General Hospital.

"Your communication in which proposals by the regional board that Burnaby General Hospital should provide only primary care to its obstetric patients causes me considerable concern. An excellent new facility has been provided in Burnaby...."

The facility is there, paid for, in no small part, by the taxpayers and voters of this municipality, and it appears the owners of this facility are to be denied the type of care for which this new hospital has been designed. So the problem is not the facility. The facility is there. It's the operating cost that isn't there, a direct result of this government's decision to starve the hospitals. We're going to have a white elephant in Burnaby, in fact. We're going to have a beautiful new obstetrical facility sitting empty, doing nothing. Now that is a waste of the taxpayers' money, if nothing else. But even more serious than that is this interfering in terms of the doctor-patient relationship, which is the result of this kind of decision.

This doctor goes on to say:

"Excellence in obstetric care requires a complex team approach involving many members of the community...."

I can't help thinking, you know, that part of the problem we're having with this is because the two services involved, obstetrics and pediatrics, are not the kind of services that Ministers of Health traditionally use. I don't see him shutting down the urology department or some other department that Ministers of Health traditionally use, but obstetrics and pediatrics get chosen to be phased out and shut down.

"The anteparturn patient should have access to first-class family physicians, obstetricians, public health workers and antenna instruction classes. In addition, dietary information, assistance of social workers and home help may all be required.

"When a patient enters hospital for delivery of her child, she should be in a fully equipped facility with a specialized nursing staff. Internal and external fetal monitoring equipment and pH sampling must be available. In addition, there should be a full time intravenous therapy service, with day and night anesthetic coverage, full-time residents and physicians within the hospital, a fully equipped and 24-hour manned blood bank with laboratory backup facilities, together with expert obstetrical and pediatric care and intensive neonatal care.

"There should be a fully developed policy for emergency Caesarean section, which can demonstrably be performed within five to ten minutes of an obstetric emergency having arisen."

This is really absolutely crucial. These are not frills that we are talking about. You can go into a hospital with your doctor telling you that everything is fine, you're going to have a normal birth, there's absolutely nothing to worry about, and something happens between that last sentence of the doctor and the delivery of that child, and the crisis is upon you. That is why it is so urgent that a hospital that services 130,000 people at least has the facilities to leap in immediately that crisis occurs, so that we don't have to lose the life of a child, or we don't have to lose the life of a mother, or we don't have to throw those people into an ambulance and race them down to the Royal Columbian into the care of an obstetrician down there who may be excellent, but who is unknown to the patient and the referring doctor.

It's really a very basic and simple thing that this particular obstetrician is asking for and talking about. This is a community hospital that serves the community of Burnaby and serves Vancouver East, and this is a basic requirement in a hospital like that. It's not happening, simply as a result of the fiscal policies of this government. You can find money to fund Captain Cook foolishness, but you can't find money to give decent health care to this province.

I'm back to quoting:

"You must be fully aware that every single one of these requirements have been met by the Burnaby General, and that continuous studies are underway to make for better existing facilities. The proposal, therefore, to downgrade the services at the Burnaby General was first made before the new expansion had been undertaken, and was not based upon a knowledge of the increased staffing and changes in the case room and pediatric department. This outdated blueprint fails to take into account the fact that Burnaby General Hospital is now delivering 1,186 babies per year."

The doctor who wrote to the head of the department mentioned something like 1,200. He's given a more accurate figure; he says 1,186, a number equal to that of St. Paul's Hospital, which delivered 1,500. The VGH, which is, of course, the largest general hospital, delivered only 2,174 babies.

"While the Burnaby General Hospital figures show a steady increase, those of the Vancouver hospitals are static or falling. To deprive the citizens of Burnaby of their own community facilities would be to deny them of what is justly and properly their due, and would be an injustice not only to them, but

[ Page 808 ]

to all the staff of the Burnaby General Hospital. It is respectfully urged that every endeavour be made to draw to the attention of the minister these unwise proposals which might otherwise be introduced without his adequate knowledge."

That's the reason why I'm reading this letter into the record. I am respectfully drawing to the attention of the minister that his unwise proposals might be introduced without his adequate knowledge. Now he has the information, and I hope he will find it within his powers to review his decision about downgrading Burnaby General Hospital to primary and having serious obstetrical and pediatric cases referred to the Royal Columbian.

I have here a letter from the administrator to Mr. Glenwright, the assistant deputy minister, dated April 10, 1979. In that letter Mr. Barth went on to point out to Mr. Glenwright that Burnaby General has been designated as a community hospital. It has been meeting all of these needs. It can do the job, and he's asking him to take these kinds of things into account. He says: "It is now comprised of 420 acute beds, serving a population of 130,000 people." I don't want to go the whole way through because I have mentioned this before. There are three obstetricians and three pediatricians serving both the community and the hospital in terms of the obstetrical facilities; three modern delivery rooms, four private labour rooms, one two-bed labour room and a three-bed recovery room.

He goes on to talk about the neonatal facilities in our regular nursery with 25 bassinets for the normal neonatals and a special-care nursery with 11 isolets for neonatals requiring special care. He gives the delivery rate for 1978 as 1,269. I don't know what the accurate figure is, but it's somewhere around 1,200. Again, compare that with St. Paul's with its 1,500 and the General with its 2,000.

MR. CHAIRMAN: Hon. member, it is time. I did not give you the three-minute warning because it wasn't brought to my attention. I will now give you a three-minute warning.

MS. BROWN: Thank you.

MR. KING: I rise in my place in this debate to defer to the member for Burnaby-Edmonds, Mr. Chairman.

MS. BROWN: I appreciate that you have as much concern for Burnaby General as I do, and I appreciate you allowing me another 30 minutes.

MR. CHAIRMAN: The member continues on vote 128.

MS. BROWN: Mr. Chairman, I'm reading that administrator's letter again, if I can just proceed with that. He said:

"Over the years our members of the obstetrical service and pediatric service have dealt with those conditions of level 2 as designated by your letter of November 30, 1978, and by the discussions of October 25, 1978, of the complete combined staff of the hospitals involved in a manner of acceptable excellence."

In any event, he goes on to say:

"Therefore would you consider permitting our hospital to provide such services to the community as it was doing, until you decided to change it, without changing our hospital designation? It is not our desire nor our intention to become a regional centre with referral practices. The hospital staff is confident that Burnaby General Hospital can continue to provide level 2 care to mother and child, as it has always done, and as a satisfactory standard of care, as designated by yourself, in your letter of November 30, 1978."

Those were the letters that had to do with the obstetrical situation. Mr. Glenwright writes a lot of letters. On March 29 Mr. Glenwright again sent out to all of the hospitals information about: "Parental Nutrition — Hyperalimentation." He designated the hospitals that will receive funding to do this: Vancouver General, St. Paul's, Royal Columbian, Victoria General, Shaughnessy, Lions Gate, Prince George, Royal Inland, Nanaimo Regional, Trail, Kelowna and the Royal Jubilee. I have an interdepartmental memo from one of the doctors to the chairman of the department of pediatrics, and he says:

"As you may recall, I represented Burnaby General Hospital at a meeting held at the Royal Columbian Hospital concerning the establishment of a secondary referral centre for neonates of that hospital. After hearing what was proposed it became apparent that the new secondary referral centre as being set up at the Royal Columbian Hospital would offer no increased advantage to our neonates from this hospital.

"Since this hospital has opened, the neonates have received adequate primary and secondary care. I have reviewed all neonates who were transferred from this hospital over the past 18 months, and reviewed the reasons for such transfers. All transfer infants have required transfer to the tertiary centre, that is the Vancouver General Hospital. None would have been satisfactorily handled by the Royal Columbian Hospital, as it is only a secondary centre for neonate care. Therefore the Royal Columbian Hospital, as a secondary centre, offers no advantage to our neonates at this hospital."

The Minister of Health, through his deputy responsible for the hospital program, is trying to downgrade the Burnaby General Hospital in an attempt to comply with his fiscal policies.

I want to go back to the original letter, Mr. Chairman, which I started reading, and those attachments which came with the letter, to substantiate some of the statements being made in the letter. He goes on to say:

"As Dr. Poole has stated, the Royal Columbian Hospital has nothing further to offer in pediatrics" — that's the memo I just read — "and most referrals in this area require the tertiary care as provided at the Vancouver General Hospital. These two major services have been an integral part of the Burnaby General Hospital since its inception in 1952. To remove them from this hospital can only be seen as a long step backward in health care delivery in this area, and is totally unacceptable to the medical profession in this area."

I am sorry that the member for Dewdney (Mr. Mussallem) isn't here, because he loves to brag about the forward steps and the great things that are happening in health care in the province. Here are people involved in the

[ Page 809 ]

delivery of health care, and they refer to this decision on the part of the minister and of his government as a long step backward.

"It would be viewed as irresponsible and a lack of appreciation and understanding on the part of the provincial department of health if these plans were pursued.

"I would also like to comment on hyperalimentation, since the health department has chosen to strip this service from our hospital as well. We have provided this service at our hospital for a number of years. We have observed stringent standards when TPN therapy is applied.

"A special medical committee reviews the indications in each instance. We have above-average laboratory and pharmacological back-up facilities necessary to carry out this specialized treatment. As you can see from the enclosures, we have been told again, with virtually no dialogue, no discussion, that this treatment will not be covered if delivered by this hospital by BCHIS. We have been provided with a list of hospitals which are allowed to provide this treatment, over one-half of which are not as large or cover as much as a smaller-population area." (Remember, the Burnaby General Hospital delivers health services to 130,000 people) "Somehow the sick people in our area deserve something better from this government than this.

"As you will note, we are qualified for expansion in nuclear medicine and in electroencephalography. The capital funds for EEG have already been made available. The implementation of this service requires funding for hiring a part-time technician at the least. Yet we are so strapped for funds, we apparently can't even afford that. We are the only sizable hospital in British Columbia without an EEG service; this despite the fact that we have a machine and an approval to deliver this service." (But they have been deprived of the funds to hire the technician and to operate the service.) "We have been negotiating with Victoria for some time."

It's interesting that if you are a resident of Burnaby and you need to have an EEG done on you, you have to go to VGH or to the Royal Columbian Hospital; you can't have it done at the Burnaby General. Again, this is an area with a population that's growing by leaps and bounds. It's one of the only communities in British Columbia that has three MLAs. That shows you the size of the area we are dealing with.

Then he goes on to talk about nuclear medicine. He says: "We've been negotiating with Victoria since 1971 to have a nuclear medicine service." And he gives me a list of the negotiations. First of all, on April 30, the nuclear medicine facilities were endorsed by the BCHIS. Then he points out that in November 1974 sketch plans were reviewed by the continuing advisory committee in nuclear medicine to the BCHIS. The plans were all sketched, BCHIS saw it, and of course it had been endorsed already. On June 7, 1976, plans for the nuclear medicine facilities were again reviewed, this time by the Radiation Protection Bureau of Health and Welfare of Canada. On May 30, 1978, Dr. Sangis submits an outline of the planned facility to the hospital administration, requesting $426,000 for equipment, $70,000 for annual cost of supplies, plus the salary for one physician, two technologists and one secretary.

On February 9, 1979, supplementary information was given to the hospital administration in response to questions from BCHP regarding the projected workload. On March 7 the radio isotope licence was issued by he Atomic Energy Control Board in Ottawa.

So everything is in place, just like the improved obstetrical facilities, just like the improved pediatric facilities, just like the EEG machine. They're all in place. We're not talking about anything that needs to be purchased. We're talking about the lack of funding to operate these facilities, which the people of Burnaby, and indeed all the people of British Columbia, have already paid for through their taxes. The facilities are all there, but they are not being operated. There is no funding for their operation. The people of Burnaby are being deprived of this very, very serious health service.

He goes on to say: "The question arises: when are these expanded services going to be implemented at the Burnaby General Hospital?" I certainly hope that when the minister stands up to respond to some of the questions being raised, he will be able to respond to this.

I want to very quickly read into the record a letter from a neurologist that has to do with the EEG. I think it's important. For one thing, the member for Dewdney (Mr. Mussallem) might get around to reading Hansard one of these days, and he'll find out what the people involved in the delivery of health care have to say about some of these facilities. This letter is written to the chairman of the board of Burnaby General Hospital, Mr. Atchison. It's from one of the neurologists who practises in Burnaby:

"Dear Mr. Atchison:

"We have not met. I joined the staff of Burnaby General Hospital three years ago as a neurologist with full-time affiliation. I'm writing to you about the service of electroencephalography in the hospital. It was a slight to myself and to the department of medicine and the medical advisory committee when we learned in the Vancouver Express on May 25 that the EEG service is to be shelved. It was distressing to learn the news in such an indirect way. We have waited a long time for this service, which was given final approval in Victoria just four weeks ago."

You know, sometimes you say you do, sometimes you say you don't.

"The capital funds for the equipment were already available on the expansion budget and the implementation largely depended on the hiring of one part-time technician, favoured by the government and now reversed by our own hospital without prior discussion with the medical staff.

"Essentially there are four kinds of patients needing the EEG service. With the first two groups, we can carry on fairly adequately as before, by 'farming out' the work to other hospitals covering (1) out-patients, and (2) in-patients needing the service electively or semi-urgently. It will be foolishly dangerous, however, to postpone the service on the two remaining patient groups, as follows...."

Again, we are talking about that word "dangerous" in the delivery of patient care.

[ Page 810 ]

"(3) Those admitted with confusion or disorientation or coma or cerebral catastrophe of unknown cause. Some but not all of these cases are managed in the critical-care area. In general it is impossible to transport the victim to another hospital, because he or she is too sick or depends upon a mechanical ventilator. Very often the correct diagnosis and treatment can be implemented with our existing facilities, but in other examples the life of the patient has to depend on the inspired guesswork, without the help of an electroencephalograph."

One of the most sophisticated nations in the world, one of the most advanced and affluent nations in the world, is subjecting people who go into our hospitals to "inspired guesswork." And the member for Dewdney (Mr. Mussallem) stands up and brags about the quality of health care in this province. If this were an underdeveloped country, we could congratulate them on their inspired guesswork. But this is British Columbia and this is 1979 and we should be ashamed of that.

He goes on to talk about intensive-care patients with brain death. He says:

"Periodically, I have the unpleasant task of disconnecting the life-support systems in a patient considered unsalvageable because of brain death from a variety of different causes. In most cases, I am perfectly happy to do so on clinical criteria without electrical confirmation from an EEG that death has in fact occurred. However, in a few examples, notably after trauma, there are medico legal implications demanding an EEG for the protection of the patient, myself and the hospital. Before disconnecting the patient in a recent example, following a road traffic accident, I was asked by the RCMP to show the EEG. The RCMP wanted proof that person was dead. Of course, there was no EEG to show. More important than the RCMP, it will take just one distraught relative and one clever lawyer to cause a good deal of embarrassment and adverse publicity for Burnaby General Hospital in such a case."

He goes on to say that he hopes this will never happen. For your sake and for all of our sakes, I certainly hope it never happens too. But do you know why this kind of risk is happening? Because there isn't the funding for one part-time technician. One part-time technician — that's all that is called for. It's not there, and you stand up and brag about the quality of health care.

He goes on to say: "Until now, we have muddled through." This makes you feel really good, doesn't it, to know that your doctor is resorting to "inspired guesswork" and "muddling through." That makes you feel really confident. They're hoping, and indeed he puts in brackets: "We've been promised for our EEG service, so that with the new expansion of the IUC" — that's the intensive-care unit — "in September 1979" — and I want to see you operate an intensive-care unit without an EEG — "we could provide the proper service to our patients. I wonder how much longer the inadequacy can be patched over without unnecessary loss of life and/or litigation. The necessity of the service needs no emphasis in a hospital of more than 400 beds."

I want to go back to the original letter from which I was reading, and, Mr. Chairman, I want to remind you that all these letters came from different medical practitioners. They're not all from the same person, so we're not dealing with an isolated incident. There were a number from obstetricians, a number from pediatricians and this one from an neurologist: "Finally, I would like to comment on the layoff of personnel at our hospital. This was done, so we have been told, to keep within the budget."

Burnaby General, you know, is an interesting hospital. When we met with the administrator he explained to us that when he drew up the budget. He did not put one single padded item in it. He cut it right to the bone. He did a very responsible thing because he recognized that health costs are high, and that restraint must be used wherever possible. He hoped Victoria would be able to recognize there was no fat in that budget at all, that everything in that budget was essential. But it was treated exactly the same way as if the budget had been padded. It came back with a $1.2 million shortfall, and it's an attempt — the hospital's attempt — to live with that shortage of $1.2 million which is resulting in the kind of scandal we're having at Burnaby General at this time. Anyway, the minister says there were no layoffs, but this doctor talks about the layoff of personnel at the hospital. And he goes on to say that these were done to keep within the budget.

"Many of those, now jobless, were sincere, devoted health workers — whether they were nurses, orderlies, aides or whatever capacity they fulfilled at the hospital. In fact the majority had roles that directly involved patient care. For example, we now have one orderly working part-time, instead of four, and this in a hospital of over 400 beds."

I understand what orderlies do. The administrator sent me another letter explaining that orderlies work just in certain specific areas, that you don't have orderlies working in maternity or in the pediatrics. So, in fact, they primarily service somewhere between 175 beds or so, not the entire 400 or 600 beds he talks about here — the administrator refers to the hospital as having 600 beds. But in any event, they have one part-time orderly now. The doctor goes on to say:

"Our concern is that these personnel play a very important role as far as the standard of health care is concerned, and without them the standard must, of necessity, fall. If staff reduction to fulfil budgetary requirements must be made, then the health department must indicate to the administration, through guidelines, where these cuts must be made."

As Dr. Pacey pointed out, when they were approached and said, "You come up with ideas for cuts," they said there weren't any, and they wouldn't cooperate.

"It has been our experience with hospital administration that, when staff reductions are made, the first to go are invariably those personnel who are directly concerned with patient care. In its desire to spend the health dollar frugally and wisely, it seems to have escaped the health department that hospital bureaucracies are not any different than other bureaucracies; that the health dollar, instead of being used directly for the sick and the ill, tends to be swallowed up in other ways.

"In conclusion, there is no doubt that the Burnaby General Hospital provides health services on a par with level 2. Despite every attempt of the minister to downgrade it, it still provides that level

[ Page 811 ]

of care. The record shows that we have done — and will continue to provide — such health care. It is the responsibility of the Department of Health to recognize this fact and allow the necessary budgetary requirements that are consistent with this level.

"The people of Burnaby and east Vancouver pay their share of taxes to the public purse, just as those in Langley or Kelowna or Vancouver or wherever, as the case may be. The medical community in Burnaby will continue to strive to ensure these health services will be provided to people in this community as elsewhere. Indeed, it is our responsibility and obligation to do so. "

I really appreciate that information from those members of the medical staff. When I started out, Mr. Chairman, in the beginning, I said we met with members of the medical staff, we met with nursing staff, we met with other hospital employees and with the administrators. Everyone cooperated, because everyone is concerned about the impact of that $1.2 million shortfall on Burnaby General, and on the attempt of the ministry to downgrade it from Level II to Level I.

The minister says there were no layoffs. Nonetheless, what we discovered from our various meetings is that there were layoffs of nursing orderlies, case-room aids, patient transport aids, extended-care nurses' aides, dietary aides, physiotherapy clerks, maintenance clerks, laboratory assistants, store and transportation people and, of course, nursing staff, some people from the paramedical profession and lab personnel.

The member for North Burnaby (Mrs. Dailly) is going to be discussing the nursing layoffs, Mr. Chairman, so I'm not going to deal with the nursing layoffs.

I just want to say that in his explanation, the administrator, Mr. Barth, tried to explain exactly what had happened as a result of that $1.2 million shortfall, which he says....

MR. CHAIRMAN: Three minutes, hon. member.

MS. BROWN: Not again! Mr. Chairman, it was going to result in a patient load reduction of 7,227 days, and a reduction of 78 positions from the hospital, so much so that the staff are now involved with the Labour Relations Board in terms of trying to protect their jobs. When I get an opportunity again, I want to talk in more detail about some of the staff — not the nursing staff, but some of the other staff, some of those 78 positions that are going to be lost as a result of that $1.2 million shortfall.

MRS. JORDAN: I sat here listening with great interest to the member for New Westminster, the former Minister of Health (Mr. Cocke), and also the member who has just taken her place. I can't help but stand now and express my concern about the pattern that is developing here. It is really a continuation from the pattern that became evident during the election. When I hear that member talk about "scandalous" situations.... I've listened to her case and I'm not familiar with the details of it, but there are a few things that I would immediately pick up with concern.

When I hear a physician say, "I took as a personal affront," my ears would perk up. I think it's important that every area in the health field, as in the educational field and any other field, stands up and fights for what they believe is best. But I also think that professional people, perhaps more than anyone else, because of their abilities and their training and the scope within which they have to work, are called upon to exercise more responsibility than anyone else. One of the problems we face in this discussion of the delivery of health care is that each specialty, each part of the health-care team, quite rightly feels that their part is the most important part, their hospital is the most important hospital, their service centre is the most important centre, or their health unit is the most important.

That's commendable but it just doesn't deal with the realities of life. I feel that the minister and this government and what they are trying to do is work with these professional people in terms of establishing priorities and in terms of meeting the realities of the day, which are: how can we provide the type and level of health care service that we have today and that we expect for the future and still be able to afford to pay for it? I don't feel that the two former speakers have contributed constructively to this very serious debate and dilemma.

I think it's an embarrassment to members of this House to have a professional person stand in this hall, married to a professional person, and carry on the type of debate that we have heard this afternoon. I think it's doing it a disservice. I won't just say I think, Mr. Chairman; I believe it is doing a disservice to this province. When we see tactics of fear upon which there are no basis for which it may be founded, when we see manipulation of people in the health services for other than truly health reasons and a high standard of care for the patients in this province and preventive health care, then I call upon all of us to examine our motives and call upon all of us to meet our commitments for which we are sent here.

I had the privilege, Mr. Chairman, of being in Europe last year, and I took the time to go through some parts of the British medical service, the French medical service and the German health service. Mr. Chairman, I came home and almost fell on my knees blessing the health service that we have in this province and in this country. They have tiered medical services in all these countries, but I speak about Britain at this time. There is a tiered system for doctors' care, based on what you can afford. There's a tiered system in the hospitals, based upon what you can afford. There is a tiered system of insurance, based upon what you can afford. And there's a tiered system in the allied services of prenatal care and nursing home care. Mr. Chairman, the people of Britain, who really initiated some of the finest medical care and health care ideas perhaps in the world, today suffer from a second-class medical system and health-care system.

It's interesting to hear our friends the socialists talk about how to handle the health care system. With the greatest respect to my good friend and colleague for New Westminster (Mr. Cocke), I might pose the question: what did he do when he was the Minister of Health? I won't go into the details, but that man became very popular in many areas simply because he would not make a decision. That minister abrogated his responsibilities as minister. I don't want to go over the past — the health minister may not agree with me — but he was in danger of developing a Taj Mahal in this province that would have sapped the health strength, the medical care of all the rest of the province. That has been dispensed with.

[ Page 812 ]

MR. COCKE: You're the ones who built the university hospital. What are you talking about?

MRS. JORDAN: I'll speak to the university hospital. I happen to be involved with a medical family, and I'll talk about referrals. But I would suggest to you, Mr. Chairman, that in England when the socialists took over after the war, it was well on past ten years before they built one single hospital in that country. And today when you go through the hospitals, if the patients in British Columbia had to enjoy those services, they would feel that they were the most down-trodden people in the world. I was in the area of Torbay and Torquay. They have been waiting 20 years to build a new hospital. I don't want to be critical of the hospital that exists now, but believe me, it's just incredible. They cannot build that hospital, because they do not have the money to build it, nor do they have the money to staff it or provide any of the services. This is what this government and this minister is trying to avoid with rational thinking.

I'd like to talk about health care in the United States. I had the privilege of working in it, as did our family. You have to start by looking in magazines such as Reader's Digest and Redbook, all these magazines that people read, and you'll see sample budgets for the young family and sample budgets for the retired person. You look at those budgets, and every one you will see contains a provision of thousands of dollars per year for health care. In the United States, when a person goes into the hospital, they don't pay $1 a day, or $6 a day as a maximum. They pay $30, $40, $50, $90, $150 a day, and that is just for their hospital care to be in that hospital. Every aspirin is charged for; every Band-aid is charged for; every visit that the doctor or physician makes is charged; every intravenous; they even buy their blood and sell their blood.

Mr. Chairman, my point in mentioning this is that we in British Columbia should not be taking part in the type of debate we have heard this afternoon. We should be standing up and working together with the health professionals, with all those in the health field, and with this Legislature and this minister in trying to meet the needs of health care in this province on a rational basis and in a manner that we can afford not only today but tomorrow and 20 years down the line.

The hon. member for New Westminster talked about the federal government saying they wouldn't cost-share in the heroin program. I went out to check on this, and we haven't had official notice. So I phoned Ottawa and I talked to a friend down there and he said: "Pat, all side comments aside, we can't take part because we don't have any money." We have an example in Canada, without being unduly critical of a government that was not responsible, of a government that didn't deal with the realities of the day. We have a federal government that can't afford to take part in many programs, and certainly in the health-care program.

The probably 1 cent per day of the interest charges serving that national debt would give us more money in British Columbia to spend than we could utilize in a year. So again, Mr. Chairman, I would like to say that this government is contributing and trying to solve some of these crucial problems.

We have other problems in our hospitals. It's not a matter of money. We have to look at the money going into our health-care system and we have to look at how we're using it. Is it bringing us the maximum return? It's very easy for all of us to become set in manners of delivery of service or in habits or practices, and sometimes those practices and habits are costly. We are perhaps paying for something through habit rather than something for which we're getting service, and that has to be examined.

The member was talking about a half-day technician, but I would suggest to her that all around this province we could ask for more, more and more. I don't want to touch that specific case but I think it's an example. In the hospital in the North Okanagan, we could want more.

I want to say this, not being critical of our hospital administrator. He's a fine man. He does a good job. But when the minister's statement came about the gross provincial productivity and what he was expecting this year and what our hospitals should be looking towards in terms of revenues, our administration said: "We're going to have to cut back service." That's the thing to say. That's the emotional catch, But then it came out that our hospital administrator was going to be earning $53,000 a year plus expenses. Now I don't deny him that money. All I ask is: can we as a society afford to pay that man that type of wage in this province at this time? It's not a matter of negating his ability. It's a matter of the best use of our money. Is he capable of doing as good a job as he is, or a better job, for less money? Are the moneys we are putting into this system really going where they belong, which is patient service?

I would like to speak solely for myself, not the government that I stand with, but I wonder if, when we're looking at the staffing of our hospitals, we aren't going to have to look at future remunerations. You say cutbacks mean direct patient care, and it is often true that the aide is laid off, or someone like that. But maybe our lab services are too elaborate. Where do we draw the fine line between the advancement of technology in medicine and what is really needed to practise good health care in many of our hospitals?

I would like to mention referrals and I would like to pay a great compliment to this minister. I don't have a file, Mr. Minister, but I have had compliments about the health care system. Our family is involved in medical practice. My husband is an obstetrician; this is no secret. Time after time he comes home and says: "The referral service in this province is incredible." He merely has to pick up the phone and call the Vancouver General, or the physician that he wants to get in touch with there, and within hours he can move a prenatal patient from Vernon to that hospital and that care, and the baby goes inside the mother, which is the best incubator in the world, on the air-ambulance service. It can often happen within two hours, and never have these people been refused service. Now I know it's not convenient to go from Burnaby to Vancouver, but it's not very convenient to go from Prince George or Pouce Coupe or Fort St. John to Vancouver. But we're all going to have to learn to temper our demands, and perhaps our hospitals in the Interior in certain areas, and some of the major hospitals. In Vancouver, are going to have to undertake certain practices of medicine but not others if we're to continue to provide the service that we do.

I just want to say that I've had older people write about the air-ambulance service, Mr. Minister, people who would not be alive today if it hadn't been for that service. It's not just the air ambulance, it's the openness of the hospitals, it's the freedom of choice between patient and doctor, and it's the total system itself. I would call on all members of this

[ Page 813 ]

House to put aside some of the partisan politics and really remember what our commitment is, which is to the patients and the health care of people in this province, and to preventive health care.

Just before I close, Mr. Minister, I will mention something I would like to have addressed in the North Okanagan. Again, it gets into this problem, and I'm not sure there's an answer, but patients on renal dialysis in our area have to travel 50 or 75 miles in all types of weather, often three and four times a week. We try to use the portable machines, but it is a matter of trained personnel being there to give them the assurance they need in using the machines. I'm not asking you, Mr. Minister, through you, Mr. Chairman, for this to be solved today, but I hope that in time we can perhaps even have a travelling technician who would have that expertise, so that we don't have patients who need renal dialysis services travelling long distances in all kinds of weather.

We do have the portable units, but it's that expertise that they need. I would like to then just speak on behalf of the people of Okanagan North, where we have a new health unit underway, where we have an expanded program coming up over the next five years for acute-care services for extended-care services, for intermediate-care services and for service facilities right through this constituency and the hon. member for Shuswap-Revelstoke's (Mr. King's) constituency. This is happening all over the province, and we realize that we do have the best health care standards probably in the world. The people of Okanagan North want to take their part in making it possible so that this type of health care continues, so that we don't end up five years down the line having to close hospitals, and not being able to afford to use the facilities and to have the care that we've worked so hard to provide.

MS. BROWN: On a point of order, Mr. Chairman, I am rising under standing order 42 to correct a statement by the hon. member for North Okanagan and to clarify a misunderstanding that has to do with my husband. He is not on the staff of Burnaby General. He is not an obstetrician, he is not a pediatrician, he is not a neurologist, he is not a hospital administrator. None of the information used in my discussion came from my husband.

I also want to add that in the nine years or seven years that I have been a member of this House, at no time have I ever mentioned the member from North Okanagan's husband, her children or any member of her family nor anyone else's husband, children or member of their family, for that matter. It's in very poor taste for her to mention my husband and what he does.

MR. CHAIRMAN: The Chair can't seem to find a referral under standing order 42 to anything that has gone on here this afternoon.

MRS. JORDAN: On a point of order, let me relieve you of your burden, Mr. Chairman. I don't think you need that order, because at no time in my comments was I addressing anything I said to that member's husband. I can only suggest that her imagination exceeds her time consumption. One shouldn't be so sensitive. I know what her husband does. I know he's not an obstetrician. I didn't involve him and I would hope that the hon. member would meet her commitments and responsibility.

Interjections.

MR. CHAIRMAN: Order, please. Many, many points of order have been discussed. I wonder, however, if we could....

HON. MR. McCLELLAND: I just wanted to answer a couple of questions, because I don't want to have them back up too far as we go along here.

I would like to thank the member for North Okanagan (Mrs. Jordan) and advise her that we will be developing, as we can, new techniques for the delivery and servicing of those people who are required to have dialysis services. That's an ongoing thing in the ministry.

The member for Burnaby-Edmonds (Ms. Brown) took 60 minutes to read three letters. Really, Mr. Chairman, I must compliment her on her reading skills. They're really well advanced. She's a very good reader, and I won't mention her mother again today. [Laughter.]

One of the questions raised in all of those letters that were written.... I must say that I was a little disturbed about the article in the medical journal from Dr. Pacey. I've commented on it in public before, and I don't really think it needs to be commented on again, except to say that there's a responsibility for any member of any profession, should they find some abnormality which causes the kinds of serious conditions to which he referred, to report it to some responsible agency somewhere down the line, rather than just write a letter to a magazine, and that certainly wasn't done. I'm still waiting, as a matter of fact.

The basic question raised in all of those letters is: when are these expanded services going to be provided? It's a question we face all the time. When are these expanded services going to be provided? As I mentioned in my opening remarks, the expansionary nature of hospitals is sometimes alarming, and we could provide every hospital in the province with $1 million CAT scanners and the teams to operate them, but I think we've all accepted the premise that there must be some kind of rational and orderly development of these kinds of technical services, not only because of costs but because it is not costs alone which decide on the type of service which is delivered to the community. It is the expertise which is built up by teams. That expertise is quite often only honed by use.

The paramedics in our ambulance service that the member for New Westminster (Mr. Cocke) mentioned before are an extremely good example. Those highly trained people can only be used in situations where their services are used on a very regular basis. That's true of highly technical equipment, of teams operating equipment in cardiac care units, in obstetrical units, in pediatric units, and in many other areas of medical practice.

Once the usage starts to go down, so do the skills. So we must ensure that not only is there some rational development in the provision of those expensive and highly technical machines, but so must the people who are involved in using them be allowed to use their expertise on a regular basis — or they start to lose their skills. That happens in every kind of trade or profession, and the medical profession is no different, Mr. Chairman.

So the question of when those expanded services are provided is one which must be open to scrutiny at all times. The time that those services are provided is when the

[ Page 814 ]

community can demonstrate the need for those services, and that the services will be used on a regular basis.

The question of obstetric and pediatric services at Burnaby General is one which has raised a great deal of confusion in the community. I might say right now that there is nothing being taken away from Burnaby General. What is being done is that something is being added at the other facilities. In developing those other high-risk services at the areas mentioned — Royal Columbian, Victoria, Vancouver, Prince George and Kamloops — we're making available a service which will see the facilities, the staff and the expertise to provide the finest kind of care for both mothers and babies in at-risk situations.

Mr. Chairman, the member for Burnaby-Edmonds (Ms. Brown) is completely wrong when she says that we are interfering in the doctor-patient relationship. The doctor does not have to refer to Royal Columbian if the doctor does not want to refer to Royal Columbian. The doctor can refer to Grace or the doctor can refer to Vancouver General. The doctor refers to the facility which is most convenient to that doctor — that's all. We don't force anybody to refer to Royal Columbian Hospital in this regard.

The madam member for Burnaby-Edmonds is totally wrong, and so is the person who wrote that letter, in saying that we are downgrading facilities in that hospital. We are upgrading facilities in the regional centres and we are providing the money, the expertise and the staff to upgrade those facilities in the various areas of the province. I want to make that extremely clear. I want to agree with the member, Mr. Chairman, in her remarks that there is a very responsible administration at Burnaby General Hospital. It's a very good administration. They're doing their very best to live within their budget. They're doing it in a responsible way and I congratulate them for that.

I want to respond very quickly to the last couple of questions raised by the member for New Westminster (Mr. Cocke) before he had an attack from the member for Dewdney's (Mr. Mussallem's) vitamin C tablet. I hope he's in good health again, so we can continue with the estimates of the Ministry of Health.

I don't know how that member arrives at a figure of 200 short for ambulance personnel. We're 200 short from what he says we should have. We're not 200 people short in the ambulance service. That's just pure nonsense.

There has been a steady growth of the number of full-time people employed in the ambulance service over the last three years in this province. Prior to April 1, 1976, there were about 430 positions; there are now about 533, up until this fiscal year. There's been a growth of over 100 people in the last three years; that's 30 people per year in the service. It's proposed to grow another 45 people this year in the estimates which are before you now. Those have been approved on a long-term basis by the Treasury Board, as an orderly way to have the service grow. I don't know where this "200 short" comes from. If the member says that there should be 750 people in the service.... Well, you know, he was Minister of Health once. Why aren't there 750 people in the service?

There has been a steady growth. For that member to talk about the training problems available in the Emergency Health Services Program is really laughable. When I became Minister of Health I found, to my horror, that all training programs had been stopped by the previous government. In the summer of 1975 programs were stopped because the government was bankrupt and had no more money. We started those programs again, and they have continued.

In addition, I must mention that we have 2,300 to 2,400 part-time ambulance people in this province who are doing a service for the people of British Columbia. Perhaps this is a good time for us to commend them.

In the past three years we have replaced 117 obsolete vehicles in the ambulance service, and we plan to have another 60 between now and the next fiscal year.

Mr. Chairman, with regard to the communications problem: yes, there have been ongoing communications problems. We're working on those, and we've recently had an approval of $400,000 for equipment purchases which have now been delivered and are due to be installed immediately, and which will relieve many of the Vancouver area problems mentioned by the member, and also problems in other areas of the province. Those things are not in the works but are underway; they'll be done as quickly as we can possibly do them.

The only other question I want to answer, with regard to that member's comments about the emergency There's a rumour that the member for New Westminster (Mr. Cocke) has been trying to spread around this province for the last two years. He tells everybody who will listen to him about it, and that is that in some way this government is going to return the ambulance service back to the private sector. You said it again today, Mr. Member for New Westminster.

Mr. Chairman, I want to tell you right now that is and I would hesitate to use the Ministry of Environment's terms — baloney. It's nonsense. It's a lie. It's not going to happen. I want to say it once and for all: it will not happen as long as this government is in power. I hope that puts it to rest.

The number one priority for government airplanes in this province is air-ambulance service. It is a written policy which has been delivered to every member of this government. It bumps cabinet ministers and it bumps everybody else in this province. It always will as long as this government is in power.

Mr. Chairman, I know that the members are hungry. I would like to move that the committee rise, report great progress, and ask leave to sit again.

The House resumed; Mr. Speaker in the chair.

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

Tabling Documents

Hon. Mr. McClelland tabled a document which he referred to in his opening statements earlier today.

Presenting Reports

Hon. Mr. Waterland presented the annual report of the Ministry of Forests for the year ending December 31, 1978.

Mr. Mussallem, from the Select Standing Committee on Standing Orders and Private Bills, presented the committee's third report, which was read as follows and received:

[ Page 815 ]

"Mr. Speaker, your Select Standing Committee on Standing Orders and Private Bills begs leave to report as follows:

"That the preamble of the following bill has been approved and the bill ordered to be reported without amendment: Bill PR 401, intituled An Act to Amend the Trinity Western College Act.

"All of which is respectfully submitted.

George Mussallem

Chairman."

Hon. Mr. Gardom moved adjournment of the House.

Motion approved.

The House adjourned at 6:04 p.m.