[ Page 3251 ]

CONTENTS

Routine Proceedings

Oral Questions.

Ocean Falls Corporation contracts. Mr. Lauk –– 3251

Mr. King –– 3251

Cablevision. Mr. Mitchell –– 3251

Oil company's compliance with Energy ministry's safety conditions. Mr. Passarell –– 3252

Funding for English as a second language. Mr. Lauk –– 3252

Amberley Building maintenance inquiry. Ms. Sanford –– 3252

Emission standards at Rayonier Port Alice mill. Hon. Mr. Rogers replies –– 3253

Extended-care beds. Mr. Cocke –– 3253

Emergency facilities at Vancouver General Hospital. Hon. Mr. Mair replies –– 3253

Open-heart surgery, Hon. Mr. Mair replies –– 3253

Extended-care beds. Hon. Mr. Mair replies –– 3254

Committee of Supply; Ministry of Transportation and Highways estimates. (Hon.

Mr. Fraser).

On vote 194: general administration-Highways –– 3254

Ms. Brown

Mr. Lorimer

Mr. Mitchell

On vote 195: general administration-Transportation –– 3254

Mrs. Dailly

On vote 196: highway maintenance –– 3255

Ms. Brown

On vote 197: highway construction--capital –– 3255

Mr. D'Arcy

Ms. Brown

On vote 201: motor-vehicle branch –– 3256

Mrs. Dailly

Mr. Lockstead

On vote 204: transportation policy analysis branch –– 3257

Mr. Lockstead

On vote 207: British Columbia Ferries –– 3257

Mr. Lockstead

On vote 208: British Columbia Railway –– 3257

Mr. Lockstead

On vote 210: computer and consulting charges –– 3257

Mr. Lockstead

Committee of Supply: Ministry of Health estimates. (Hon. Mr. Mair).

On vote 114: minister's office –– 3258

Mr. Cocke

Mrs. Dailly

Ms. Brown

Mr. Levi

The House met at 2 p.m.

[Mr. Davidson in the chair.]

Prayers.

HON. MRS. McCARTHY: In the House today we have three visitors that I would like to ask the House to welcome: a good friend, Bill Clancey, and Mr. Adolph Ingre and Mr. Fred Stoochin who are in the Vancouver–Little Mountain constituency. I ask the House to give them all a warm welcome.

MR. LEA: I have two guests to introduce to the House today. Firstly I would like to ask the House to join me in welcoming, from the Queen Charlotte Islands, Joyce McNeice who is visiting in the gallery today. Our second visitor is visiting us all the way from Ontario. Today we are going to be watched professionally because with us today we have Richard Johnston, who is a member of the Ontario House. I ask you to welcome him.

MR. RITCHIE: In the precincts today we have Mr. George Johnston, who along with a group met with the government caucus. I'd ask the House to please extend a warm welcome to Mr. Johnston and his group.

HON. MR. NIELSEN: I'd ask the House to welcome five guests who are visiting today: from Richmond, Mrs. Frances Pearson and Mrs. Patricia Myerscough; and from Sussex, England, Mrs. Nora Dewey, Mrs. Catherine Myerscough and Mr. Bill Hislop.

HON. MR. VANDER ZALM: I'd like to introduce a long-time friend and acquaintance from Surrey, Mr. and Mrs. John and Phyllis Scholefield, and also Mr. and Mrs. Derek Doubleday from Surrey. I would ask the House to welcome them.

Oral Questions

OCEAN FALLS CORPORATION CONTRACTS

MR. LAUK: I have a question for the Minister of Industry and Small Business Development. Can the minister advise what is the current status of the negotiations between Ray Williston of B.C. Cellulose and the Los Angeles Times?

HON. MR. PHILLIPS: No.

MR. LAUK: Can the minister confirm that the Los Angeles Times, through their solicitors, have given Mr. Williston two weeks to make a reasonable offer of settlement before they take legal action?

HON. MR. PHILLIPS: I'll neither confirm nor deny that statement.

MR. LOCKSTEAD: Has this question been asked? Can the minister confirm that the...? I'm sorry, I don't have it. Mr. King?

HON. MR. WILLIAMS: On a point of order, Mr. Speaker, I wonder if the Clerk could extend the time of question period to make up for what the opposition has lost in their confusion.

MR. KING: On this side of the House we have togetherness and we fill in for each other admirably.

Mr. Speaker, I have a question for the Minister of Forests. Can-Cel has announced a chip and flitch mill to replace the pulp mill at Ocean Falls which was closed by the government. Can-Cel is currently searching for a source of low-grade timber for the new facility. Can the minister advise what assistance the Forest Service is going to give to Can-Cel in its search for low-grade material to accommodate that mill?

HON. MR. WATERLAND: Mr. Speaker, to my knowledge Can-Cel is not involved in Ocean Falls at all.

MR. KING: I have a supplementary question. Do I understand then that the minister has had no overtures from Can-Cel in terms of finding a source of low-grade material to develop another kind of plant at Ocean Falls?

Is the minister aware of any supply of unutilized low-grade material that would be available to a new industrial plant of the nature I outlined in the Ocean Falls area? Is that kind of material available for Ocean Falls, Can-Cel or any other entrepreneur that may be interested?

HON. MR. WATERLAND: Mr. Speaker, this matter was covered rather extensively during my estimates. B.C. Cellulose Corporation has been working very closely with my ministry and with consultants in attempts to define areas which had been classified as economically unusable but perhaps could be used under the terms and conditions they are trying to establish — that is, an experimental timber sale — and I believe they have been successful. B.C. Cellulose and their consultants have given a report to my ministry, and it appears that they will be making a request for an experimental timber sale licence on the areas that they have defined in their various consultations.

CABLEVISION

MR. MITCHELL: I was getting a little worried, because my minister wasn't around, but he's arrived. My question is to the Minister of Universities, Science and Communications, the late Mr. McGeer. In view of the fact that the federal government has offered provincial jurisdiction over cablevision, is the provincial government seeking regulatory control over cablevision systems in the province?

HON MR. McGEER: Yes, Mr. Speaker.

MR. MITCHELL: Now that he has indicated that the province is looking for control, has the minister decided to intervene against the proposed takeover of Premier Cablevision by Canadian Cablesystems of Toronto?

HON. MR. MeGEER: No, Mr. Speaker.

MR. LAUK: I have a supplementary question to the Minister of Universities, Science and Communications. The CRTC is investigating whether or not the proposed takeover

[ Page 3252 ]

of Premier Cablevision is in the best interests of, first of all, the system and the province. It's clear that the minister's own officials working in Communications may not be of the view that it would benefit this province. Can the minister confirm that?

HON. MR. McGEER: No, Mr. Speaker.

MR. MITCHELL: I have a supplementary to the same question. Could the minister indicate that, by not intervening, they support the takeover by the Toronto conglomerate?

HON. MR. McGEER: No, Mr. Speaker.

OIL COMPANY'S COMPLIANCE WITH
ENERGY MINISTRY'S SAFETY CONDITIONS

MR. PASSARELL: I have a question for the Minister of Energy, Mines and Petroleum Resources. The Blueberry Indian band have announced their intention to move back into the bush when the Calgary-based Kildonan Oil Company resumes operation in a nearby oil field, following a toxic hydrogen sulfite emission. Can the minister assure the House that the provincial energy ministry is ensuring that safety conditions stipulated by them are being met by the oil company?

HON. MR. McCLELLAND: Mr. Speaker, I'd be happy to take that question as notice and bring an answer back to the Legislature.

FUNDING FOR ENGLISH
AS A SECOND LANGUAGE

MR. LAUK: I have a question to the Minister of Education. The minister recently repeated the call of British Columbia on the federal government to pay what he says is a fair share of the cost of educating new Canadians. The minister used the phrase: "Since the federal government decided to bring new Canadians to this country, Ottawa should fully fund the provinces for the cost of all education and social services for the new arrivals for a period of three years." Can the minister confirm that this means that the provincial government has decided not to expand — and it may indeed cut back — the English as a second language services in the province through his ministry?

HON. MR. SMITH: Well, the member knows full well that the answer to that question would be no. He misunderstands, I think, my comments, which he alludes to. What I said, and what I said in Ottawa to the Minister of Manpower and Immigration, was that because the policy organ of Immigration is the federal government, and because their decisions really are what decides how many new Canadians are going to come to British Columbia, it seemed to us that rather than giving piecemeal grants of various kinds to defray the cost of new Canadians taking full-time courses, taking citizenship training and this sort of thing, there should be some comprehensive payment made by the federal government to the province, to let the province assume a whole array of social services for the first three years prior to citizenship, following which time the province would assume all responsibilities. There is absolutely no intention of the province of British Columbia getting out of responsibilities to educate new Canadians in the second language. From what I have seen in the schools and the colleges, they are doing a very good job. I am just trying to get the federal funding put on a comprehensive and rational basis, which it isn't now.

MR. LAUK: Is the minister saying that the traditional involvement of the provincial government with the federal government on immigration matters has now been abandoned or left dormant?

HON. MR. SMITH: The meaning of that question really quite escapes me. Perhaps its obscurity could be enlightened.

MR. LAUK: It would be helpful if the professor of law at the University of Victoria read the BNA Act. It sets clearly a provision for the provincial government to be involved in immigration and it sets clearly the provincial responsibility for educational matters. ESL programs in Vancouver and elsewhere are hopelessly underfunded and ill-supported by both the provincial and federal governments. Instead of buck-passing. has the minister decided to accept responsibility for these continuing programs?

HON. MR. SMITH: I appreciate the modest, understated tone of the member's question in his preamble. He should know, too, as a student of law, that the prime responsibility in immigration remains with the federal government. It is not buck-passing. It is an attempt to get adequate bucks from both sources into the services for new Canadians.

MR. LAUK: In the school district of Vancouver I am informed that they need at least $5 million to provide ESL services to over 40 percent of the school population. It is a critical problem which has been virtually ignored by this government, both by this minister and by his predecessor. Has the minister decided to take action to expand those programs to meet this very serious need?

AMBERLEY BUILDING
MAINTENANCE INQUIRY

MS. SANFORD: I have a question for the Minister of Labour. Now that eight employees of the Amberley Building Maintenance Ltd. have filed complaints with the labour standards branch over the failure of that company to pay overtime, can the minister advise whether he has referred this case to the Attorney-General with a view to prosecution?

HON. MR. HEINRICH: To the hon. member, I have not referred this case to the Attorney-General's department. I refer to the question, Mr. Speaker, which was asked, I believe, some time ago about whether or not an investigation was being conducted. I so advised the member that an investigation had been started immediately. I can advise the member further that I have requested a detailed report, and I can further advise that that report has as yet not been delivered to me.

MS. SANFORD: I would like to address this question to the Provincial Secretary. I'm wondering, in view of the apparent gross violation of labour standards by a BCBC contractor, whether the minister can assure the House that there are no more such contractors under contract to BCBC.

[ Page 3253 ]

HON. MR. WOLFE: In response to the member's question, I am advised that one undertaking any contractor has in doing a maintenance type contract with the corporation is that they abide by all laws of the province.

EMISSION STANDARDS AT
RAYONIER PORT ALICE MILL

HON. MR. ROGERS: Some time ago I was asked a question by the member for North Island (Mr. Gabelmann) regarding acid rain in the Port Hardy area. It should be emphasized that all rain, including so-called pure rain, is somewhat acidic due to the natural mixing of rainwater with normal atmospheric gases. To date all data collected indicates that there is no trend towards increasing acidity in the rain in Port Hardy.

However, my minister has initiated a joint project with the federal Atmospheric Environment Service to investigate both the background values and the values for individual storms in order to determine any directional influence. This investigation was initiated in January of this year, and field measurements will commence shortly.

As far as his specific question concerning the level of acid rain created by the excessive sulphur dioxide emissions from the Port Alice pulp mill, my ministry has no information at this time which would support this contention. I might point out that the pH values for acid rain in Vancouver are 4.8, in Port Hardy 4.9, and 5.2 in Terrace. So it is somewhat below the normal acid rain.

You did have a further question about the lakes in the area, and I'm getting back to you on that as well.

EXTENDED-CARE BEDS

MR. COCKE: Mr. Speaker, I would like to direct a question to the Minister of Health. In view of the fact that approximately 100 extended-care patients are occupying precious acute-care beds at St. Paul's in Vancouver, can the minister advise whether he would bring new beds for long-term care on stream this year to transfer these patients in that area?

HON. MR. MAIR: Mr. Speaker, I thought that I had received that question already from the member for Burnaby — I forget which one; the lovely lady next to my critic. If that is the case, I have an answer which I will ask leave to bring to the House after question period. If not, I will take the member's question as notice and bring back the answer in due course.

MR. BARRETT: May I ask leave, Mr. Speaker, to introduce two guests whom I missed during the opening?

Leave granted.

MR. BARRETT: Mr. Speaker, I have the privilege of introducing two very good friends of mine, Mr. and Mrs. Bob Stone from North Shore-Seymour. Mr. Stone and I are former rugby colleagues. I ask the House to welcome them here today.

HON. MR. MAIR: Mr. Speaker, I ask leave to provide answers to questions given me in question period on July 8.

Leave granted.

EMERGENCY FACILITIES AT
VANCOUVER GENERAL HOSPITAL

HON. MR. MAIR: Mr. Speaker, the first came from the member for New Westminster (Mr. Cocke), who said:

The situation in the emergency department at the Vancouver General Hospital remains critical. Yesterday the minister told the House that he had asked for a report from his staff. Can the minister now tell the House what action he has taken to ensure that Vancouver residents get treatment in emergency situations?

The emergency department at Vancouver General Hospital operates on a 24-hour basis, as do the emergency departments in several other Vancouver hospitals. Occasionally, due to the fact that all beds in the hospital are filled, it is necessary for the hospitals to ask ambulance drivers to divert patients to other hospitals for a period of time. This is only done after other hospitals in the vicinity have been contacted and alerted to ensure that they are able to provide the service.

In fact, the Vancouver General Hospital has only found it necessary to divert patients to other hospitals on one occasion, for a period of four hours during the early morning. On that occasion it was not because the emergency department was inadequate, but it was due to the fact that all available beds were full. My staff recently met with the administrators of hospitals with emergency departments in the Vancouver area to emphasize the importance of keeping emergency departments open and to ensure the orderly flow of patients.

The first member for Vancouver Centre (Mr. Lauk) then asked as a supplementary: "Can the minister now tell the House when the new emergency facility will be operational, so that further closures at VGH will not be foreseen?" The new emergency facility at Vancouver General Hospital is scheduled to open in May or June of 1981.

OPEN-HEART SURGERY

There was another question from the member for New Westminster: "Open-heart surgery at VGH has been cut back by nearly 50 percent, particularly for some teams. One team that was operating 15 operations a week is now performing eight or less. What action has the minister taken to ensure that British Columbians who require open-heart surgery can get it promptly?'' First of all, the statistics stated by the hon. member for the Vancouver General Hospital are not correct. For some time now the hospital has been handling an average of 10.5 cases per week. However, staff of the ministry are presently working with the Vancouver General Hospital to increase the number of cardiac surgery cases that can be handled each week. This will provide an increase from the present level of 10.5 cases per week to 15 cases per week. In addition, when the new Children's Hospital opens in 1981, children's cardiac surgery will be done there rather than at the Vancouver General Hospital, thus allowing the number of adult cases done at VGH to increase further.

Interjection.

HON. MR. MAIR: It's a person who is half-hearted, Mr. Member, like many of the questions I heard in question period today. I had a little note here that Mr. Lauk would interject at this point.

[ Page 3254 ]

EXTENDED-CARE BEDS

Lastly, from the member for Burnaby North (Mrs. Dailly): "At St. Paul's Hospital there are a number of people who are awaiting admission for serious surgery and cannot get in, particularly in the orthopedic ward, where people are holding up beds simply because there are no other extended-care and intermediate facilities available for them. Can the minister tell us what he is doing to alleviate what I consider to be an emergency situation for these very sick people?" I pause there to say that I assume that is the same or a similar question as the one posed to me today by the member for New Westminster. Staff of my ministry from the divisions of hospital programs and care services are working together in an attempt to move as many extended- and long-term care patients as possible from VGH and St. Paul's to more appropriate facilities. Haro Park, an intermediate-care facility with 212 beds, near St. Paul's Hospital, is opening now. Negotiations are underway to place patients from St. Paul's and VGH in this facility.

Orders of the Day

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

ESTIMATES: MINISTRY OF
TRANSPORTATION AND HIGHWAYS
(continued)

Vote 193: minister's office, $212,089 — approved.

On vote 194: general administration — Highways, $6,423,536.

MS. BROWN: Very briefly, Mr. Chairman, I raised a couple of questions under the general vote of the department, which I guess the minister overlooked and didn't respond to. I wonder if I could put them again.

First of all, are there any plans for upgrading Highway 1? I'm referring specifically to the municipality of Burnaby; I'm talking about additional lanes, that kind of thing.

Secondly, are there any plans to widen Lougheed? We keep hearing that there is a possibility of an extra lane being put on the Lougheed Highway, and we still haven't had a final word on that.

Thirdly, what is in store for Hastings and Barnet Highway? We haven't had a response to that yet.

When I raised the question about what is in store for Kingsway, the minister said nothing. I'm wondering whether he's really sure about that, because surely there is some kind of upgrading, in terms of readjusting the lights on Kingsway and this kind of thing, that he would like to make a comment on.

MR. LORIMER: Last night I asked the minister a couple of questions: what he intended to do regarding the beautification of the area of Canada Way and Willingdon; and secondly, what provisions he intended to supply to help municipalities finance the work that they will have to do for probable automobile clearances, widening of streets, and so on, as a result of the provincial government's action in building the Annacis Island bridge.

HON. MR. FRASER: I have a short detailed answer here to the question the member for Burnaby–Willingdon brought up last evening. First of all, on the highway maintenance facility at Canada Way and Willingdon, a few years ago the ministry erected a cedar fence to screen the yard. We intend to move from this location in the future. This is being pursued at the present time, but no schedule is available on that. I think I could add to the senior staff notes that that it is probably involved with BCBC, on a relocation.

The other question the member asked last evening was that he wanted assurance that the Annacis Island bridge and the highway system will not have expected impacts on the Burnaby street system which will be a problem for Burnaby to solve. On April 21, 1980, the Burnaby council endorsed a report from the Burnaby transportation committee which dealt with the effect of the Annacis bridge on the Burnaby street system. I quote from that report:

"The crossing system proposed does not conflict with the adoptive comprehensive transportation plan for Burnaby. There should be no disruption to residential areas in Burnaby as a result of the construction of the Annacis system. It is expected there will be positive benefits in terms of the development of Burnaby's Big Bend and Metrotown as a result of the implementation of the Annacis system."

"In summary, the effects on Burnaby have been carefully studied by the municipality and the ministry. and the planning takes into account all foreseeable problems and provides for them. The province will assist in solving any unexpected problems through the revenue-sharing and arterial highway programs."

MR. MITCHELL: One of the questions I'd like to bring up to the minister deals with two particular areas in my riding. One is commonly called the Bilston Creek area, and the second one is Marler Drive. They have two things in common: they both flood. They both have subdivisions in the area that have been approved over the years by the Ministry of Highways. On Marler Drive there are seven houses. Because of the flooding of Craigflower Creek every second year, the houses flood. Come spring they clean up, and then the houses are sold to someone else. In many cases the next year another group of people go through the same procedure. Has the ministry any policy to clear the creek to stop the flooding each year, build up and dike the area or change the houses and lift them so they would not have the problem of flooding? This subdivision was approved over the objection of certain people in that area as being in a floodplain back in about 1970-71. Is there any policy within the department of correcting the flood conditions that happen in those areas or alleviating it by moving the houses, lifting them or diking that particular area, especially the one on Marler Drive and, secondly, the Bilston Creek area?

Vote 194 approved.

On vote 195: general administration — transportation, $1,118,973.

MRS. DAILLY: I just wanted some advice. I wish to ask a very brief question regarding truck safety. Would that come under that vote and could you advise me?

[ Page 3255 ]

MR. CHAIRMAN: It would be the opinion of the Chair that the Motor Carrier Commission vote would be appropriate. Unless the minister wishes to....

HON. MR. FRASER: I think a more appropriate vote would be the motor-vehicle branch vote, vote 201.

Vote 195 approved.

On vote 196: highway maintenance, $179,351,848.

MS. BROWN: Mr. Chairman, I'm going to ask my questions for the third time under highway maintenance. Are there any plans for upgrading Highway 1? This is the third time I'm putting that question to the minister. Are there any plans for widening the Lougheed — additional lanes or whatever? That's the third time I'm putting that question to the minister. Also, for the third time, what is in store for Kingsway? Are there any plans to deal with the problem of lighting and that kind of thing?

HON. MR. FRASER: To the member for Burnaby–Edmonds, I was trying to get the answers for you and I think I have them here now. The Trans-Canada Highway through Burnaby, Highway 1, is intended to eventually upgrade to six lanes. However, the Mary Hill bypass at the east end and the Cassiar corridor should be completed for the six-laning of the freeway to be helpful. I would just like to add further to that that I think the six-laning of Highway I is a fair way away. There are a lot of problems and the engineers would like to do the others that I mentioned first.

I'd like to make this observation, though, dealing with the freeway. There probably won't be extra property required. The right-of-way is already there. It's my understanding from an engineering standpoint that there would be no disruption from acquisition of further right-of-way. They could bring the traffic closer naturally by adding two lanes, but it isn't a case, as I understand it, of acquiring further width so this can happen. The width exists. It is a great thing in this day and age when we don't have to acquire housing as an example to make room for expansion, in this case, of a freeway.

Regarding the Lougheed Highway six-laning, we have agreed with Burnaby that this should be done in the future. It is incorporated in the Burnaby transportation plan. No design work has started. I think it's safe to say that if that's the case it's quite a way away. There will be nothing in the way of construction for a considerable length of time.

Regarding the Barnet Highway, this is under design for four-laning through North Burnaby. The design will be complete later this year and I'd like to comment on this. My own comments are that I would like to see that done as soon as possible. I feel differently about that connection than I do about the others. We have some good roads both ways from the others, but we have a missing link here. We have engineering problems with settlement. That's what they are working on. I would hopefully think that something should start in the way of construction on the Barnet in 1981.

You asked about Kingsway. We're working with Burnaby to improve operations at traffic signals and other traffic management, but we're not planning any construction.

Vote 196 approved.

On vote 197: highway construction — capital, $208,209,007.

MR. D'ARCY: Mr. Chairman, I'm happy that the House Leader allowed the member for Burnaby–Edmonds (Ms. Brown) to ask her questions regarding highway upgrading in her riding. He's the member who had the Upper Levels Highway four-laned by the previous government when he was in opposition. So I know he would understand opposition members who want to see improvements to the highways in their constituencies.

Anyway, Mr. Chairman, I have three questions for the minister. First, I'm wondering if he can give some indication as to when his staff would have a first contract ready on what is commonly known as the West Trail approach on Highway 22.

The second question, Mr. Chairman. I would note that almost exactly a month ago I and the locations people from the Nelson region met with Castlegar city council regarding modifications to the Kinnaird interchange. Agreement was reached at that meeting, and I'm wondering if the minister can give us some indication as to when those modifications may proceed. The ministry people indicated at the time that they could be done by ministry staff and would not involve contracts.

The third question involves the widening of Highway 3B between the Trail bridge and the Trail city limits — the Trail bridge to Glenmerry project. There was considerable location work done on this project by the regional staff in 1975 and 1976, but precious little since that time. I'm wondering if the minister can give us some indication as to whether this project is going to get off the back burner or out of the back alley and back into some degree of activity. It seems absurd, Mr. Chairman, that we have a four-lane highway outside the city limits which narrows down to a two-lane highway once you get inside the city limits where the heaviest traffic is.

HON. MR. FRASER: Well, first of all, I would like to answer the member for Esquimalt–Port Renfrew (Mr. Mitchell) regarding flooding in parts of his riding — and I certainly hear about that as well, Mr. Member. Flooding in certain areas has progressively developed as many subdivisions have been approved. The minister has solved a great number working with the Ministry of Environment. In some cases easements have to be acquired through and from other property owners' land. We'll look into Marler Drive as soon as possible. But my observation is that in that area it seems to flare up in different areas, and we'll just have to deal with them at the time. I think your position is that we approved the subdivision, therefore we have some responsibility. That's correct, we have, but so has Environment. But that doesn't mean to say that we can just argue among ourselves; I think we should get on and solve some of the problems.

MS. BROWN: Just very briefly, Mr. Chairman, and first of all, I'd like to again add my voice to that of the member for Burnaby–Willingdon (Mr. Lorimer) in opposition to the Annacis crossing, and to say that, despite the report which the minister read, the eastern area of the municipality of Burnaby is definitely going to be damaged as a result of this crossing going through, and neighbourhoods are going to be destroyed. So I'm totally opposed to that.

However, is there a schedule for the development of the

[ Page 3256 ]

Newcombe-McBride-Stormont connector? Could the minister give me some dates in terms of years, in terms of developing the connector? Also, is the minister looking at alternatives? In speaking earlier on the general vote, I suggested a ring road as a possible alternative, and I didn't get a response from the minister about that. But are we looking at alternatives to the connector in the hope that maybe we won't need that connector after all?

HON. MR. FRASER: Well, first of all, Mr. Chairman, to the member for Burnaby–Edmonds, there isn't a schedule, and the chief engineer is going to tell me whether we're looking at an alternative. There isn't a schedule, so there is nothing imminent, I take from that. I'm advised that the Burnaby transportation plan doesn't show any alternative, and if there were an alternative, it would probably be in New Westminster.

To the member for Rossland–Trail (Mr. D'Arcy), Smelter Hill, as the member knows, involves a new roadway for route 3A from west of the smelter down to Rossland Avenue and downtown Trail. It includes a grade separation structure for the CPR and a structure to carry the plant utilities over the highway.

Right-of-way negotiations for property near Rossland Avenue are well advanced. Joint design work for a culvert under Rossland Avenue is advancing with the city and the Ministry of Environment reviewing the whole culvert problem. The railway underpass and culvert should start this year. The overall design work is being finalized for the West Trail approach, Smelter Hill. We expect to go forward with some of that work this year. As the member knows, Mr. Chairman, we've had to acquire a lot of property there. I think that is fairly well cleaned up — that's my information — so we can move on to the construction stage. We are waiting on a Canadian Transport Commission order for the railroad overpass. I hope we don't have to wait too long on that. Work is expected to start later this year. We want to do some creek culvert work this year.

Regarding the Creston bypass, I have this note. I don't know whether this answers your question, Mr. Member. You asked about Castlegar. Design is in hand to provide a loop in the southeast corner to accommodate the east-bound and north-bound movement and reduce the hazard of runaway vehicles in this movement. The work involves some widening of the structure over Columbia Avenue. When the design is complete we will put it into the program.

I gather from that engineering note that work is not going to start imminently. They are still designing. I would say it will probably start within 12 months. It may be sooner; I don't know.

Vote 197 approved.

Vote 198: Hydro development — Highways, $10 — approved.

Vote 199: engineering branch, $997,476 approved.

Vote 200: weigh scale branch, $3,556,393 approved.

On vote 201: motor-vehicle branch, $15,898,017.

MRS. DAILLY: Mr. Chairman, very quickly to the minister, I know he and his staff are well aware of that recent report from the branch regarding the fact that 67 percent of the tractor-trailers caught in roadside inspections had major safety defects, many of them serious enough to be a hazard. I know this was of great concern to most people who have to travel on our highways and, I am sure, to the minister. I was pleased to see that the minister and his officials announced that they are drafting new regulations on truck safety to reduce evasions of the law. I want to congratulate the minister for moving quickly on it. I wonder if he could give us some idea of what these regulations would be in general.

I have one final question. The number of moped deaths is beginning to soar in B.C. I think the minister must be aware of this. They estimate 28 moped operators will be killed annually in traffic accidents in B.C. We know there are many young people.... I think we are all aware of the recent tragedy of a very close personal colleague of many of ours who suffered a death from this. I wonder if the ministry is considering drafting any regulations with reference to licensing or stiffer laws regarding these mopeds.

MR. LOCKSTEAD: Following on the same topic, I would hope that when the minister is considering the regulations he will remember that there are a number of very small independent trucking operations and, when they are drafting the regulations, will give these people enough lead-time so that the excessive costs of upgrading their vehicles, which they should do, won't cause them to go broke in the process.

Very briefly, Mr. Chairman, in view of the fact that the Premier of this province nine or ten months ago at a convention made a commitment regarding deregulation of highway transport, nothing appears to have been done and the situation is getting worse by the day, as related by one of the spokesmen for the association. Perhaps the minister could comment on that particular aspect as well.

HON. MR. FRASER: In reply to the member for Burnaby North (Mrs. Dailly), the stricter enforcement of commercial vehicles is a pet project of mine. We have checked it out a lot and, as you mentioned, 67 percent of the commercial vehicles that we checked didn't pass. As a matter of fact, around 200 vehicles were taken off the road immediately they were checked. Our plan there is to increase the inspections through the addition of mechanical inspectors. They're a class by themselves. We have to have good mechanical people and we're just in the process now of enlarging that staff, which will get them out further to do more checking throughout the province.

Regarding security of load regulations, there'll probably be changes in that, because there is a grey area in the existing regulations. They do exist, but I think they need tightening up, and that will be forthcoming soon. We have far too much carelessness going on with the security of load factor. They're hauling merchandise without putting binders on, hauling bulldozers without anything at all tying them down. Of course, this causes problems for all the motorists in the province, and that is certainly being enforced a lot more now than it ever was through our weighscale operation.

Regarding mopeds, the note I have on that is that they're treated the same as motorcycles. Apparently our motorcycle regulations are the best in Canada.

The last item from the member for Mackenzie (Mr. Lockstead) was deregulation of the commercial vehicle, whether it be passenger or commercial. We are not contemplating any immediate action on that, although we are look-

[ Page 3257 ]

ing at it because we're getting a lot of complaints about the whole system. We're going to look at the system, but I don't want to alarm the public by saying that we're going to deregulate immediately. I personally have asked that we first of all look at the passenger side. We have two sides to look at really, passenger and commercial.

The appeals are increasing all the time from the Motor Carrier Commission decisions, and they have an extremely heavy workload. It is popular to talk about deregulating. The committee will know that the United States has deregulated the air industry, and they've just recently deregulated the trucking industry. But I think they did that with a lot of provisos. People seem to be concerned and we're taking a look at it. Where it will end up I don't know. I would like to make this observation: I don't think you'll see government doing anything on that subject other than studying for about 12 months.

MR. LOCKSTEAD: Once again, very quickly, on the motor-vehicle branch, I have reams of material but obviously we're not going to get into it at this time. I'm sure the minister understands that on this particular branch we do have instances of double jeopardy — fines, points by ICBC and increased insurance rates, and then we have the motor vehicle branch coming back with further fines and suspensions. In other words, it's double jeopardy in some cases, in my view. I want to take this opportunity with the director of that branch.... When I've taken constituents' problems to them personally, they have been very thoroughly reviewed and occasionally the problem has been resolved. I thought I'd bring that to the minister's attention. I don't require a reply. Hopefully the minister, in his meeting with the senior people in his department, will review that double jeopardy situation.

HON. MR. FRASER: I'll make one observation here, please. I think we've got the best and most efficient motor vehicle branch in the country. I want to put it on the record here that, under the supervision of Mr. Whitlock, I think they do a marvellous job.

Vote 201 approved.

Vote 202: motor carrier branch, $1,150,751 — approved.

Vote 203: motor carrier commission, $329,756 — approved.

On vote 204: transportation policy analysis branch, $1,323,211.

MR. LOCKSTEAD: I have just one short note on this particular branch. As it happens, probably because of the nature of my riding and my interests within the province, the fact is that I deal a great deal with this particular group of people and have found their work to be generally excellent, the brief they present thorough and well researched. I couldn't think of a better opportunity to let the minister know of this very fine branch within his ministry.

Vote 204 approved.

Vote 205: air services branch, $3,108,828 — approved.

Vote 206: Local Airport Assistance Program, $739,568 approved.

On vote 207: British Columbia Ferries, $57,929,127.

MR. LOCKSTEAD: We've covered this topic extensively, and I don't intend to discuss any aspect of this that we've discussed at length, really, over the last two weeks; but I just wanted to remind the minister, and I want it on the record. It's quite obvious, as a result of the B.C. Crown corporations committee hearings into the B.C. Ferry Corporation, and the answers that have been given to us in this House, and other factors, that there are serious problems within the operations of the B.C. ferry system, whether they be the superficial items that we all see, like food and schedules, or more serious problems within management. Frankly, I think that the minister would do well, since this whole matter of water transportation on the coast of British Columbia has been the cause of major — and rightfully so — embarrassment to the government, to review the whole policy. I'm not putting it all on management; there are serious internal problems within the union as well, as we are all aware of. But the fact is I'm telling the minister now — and I don't require an answer at this point — that there are very, very serious problems within the system. I think at the appropriate time the minister must make decisions and take steps to correct the water transportation system on the coast of British Columbia and the problems within the B.C. Ferry Corporation.

Vote 207 approved.

On vote 208: British Columbia Railway, $14,000,000.

MR. LOCKSTEAD: Once again, this is a new item, as far as I am aware, within the ministry. Perhaps the minister would care to take 15 seconds to reply to this expenditure of $14 million.

HON. MR. FRASER: Mr. Chairman, it'll take me a minute or two, not very long, to explain this $14 million vote in this ministry for the British Columbia Railway.

Following the royal commission report — I believe that was in 1978 — they recommended the suspension of rail service from Fort St. John to Fort Nelson. The government did not accept that, but when they didn't accept it we had to upgrade the line. I'm happy to say that we have spent $28 million on upgrading the line from Fort St. John to Fort Nelson, roughly $14 million per year. This is the last $14 million and then we'll have a decent line from Fort St. John to Fort Nelson. This is an upgrading of the existing line; nothing to do with maintenance.

Vote 208 approved.

Vote 209: building occupancy charges, $15,356,000 approved.

On vote 210: computer and consulting charges, $4,080,900.

MR. LOCKSTEAD: This vote, as is quite obvious, has increased by over $1.5 million in one fiscal year, and perhaps the minister would just take five seconds to explain that to us.

As this is the last vote under this estimates, I would like to

[ Page 3258 ]

make two very brief comments. Firstly, this minister, in my view, as opposed to most of the other ministers on the treasury benches, has taken the time to answer questions at length, and in many cases in some detail. That has been appreciated by myself as our party caucus critic.

Last but not least, for the record, while there are many hundreds of people out in the province of British Columbia to whom I promised to raise certain issues in the legislative session if certain actions were not taken, I think in the main my colleagues and I have raised most of those issues that were mentioned. Particularly dealing, once again, with the B.C. Ferry Corporation, if those issues were not raised in this Legislature, they were generally raised during the Crown corporations committee meetings. Once again, I would like to thank the minister for taking the time to answer all of the questions.

HON. MR. FRASER: The member asked why vote 210 is up. I understand the B.C. Systems Corporation couldn't carry out all the work that we need, and this vote will look after that so they can carry out the necessary work.

I just want to thank all the members of the House for their cooperation in the estimates that we have been dealing with for six days and a little part of the seventh.

Vote 210 approved.

ESTIMATES: MINISTRY OF HEALTH

On vote 114: minister's office, $165,162.

HON. MR. MAIR: I realize that I must be brief because the opposition has only set aside six months for these estimates and I wouldn't want to, in any way, cut into their time.

MR. BARRETT: Seven, because of your speech.

HON. MR. MAIR: I would like, if I may, to just briefly summarize a few of my thoughts. I suppose the first thing that impresses anybody who takes on the Ministry of Health — I'm sure my predecessors have all felt the same way — is the sheer size and the terrific zeal and dedication of the large staff of public servants that make it up. I don't think that there is any question that we all agree that the Ministry of Health ministers to the needs of almost everybody in our community and probably is, in that sense, the last line of defence of all the citizens of this province against the ravages of disease and poverty and all those things that unfortunately still beset us. I know that the people of British Columbia expect great things of the health care system. I don't think there is any doubt that this side of the House considers that to be their right. Whatever form these demands take, whether they are high-profile or from those who can't, for one reason or another, articulate their problems themselves, all the public of British Columbia have come to expect first-class health service and this ministry and government intend to continue it.

MR. BARRETT: Is there a doctor in the House?

HON. MR. MAIR: Well, we may need one before the next seven months are out, Mr. Leader of the Opposition.

I think, nevertheless, it would be remiss of me not to dwell for a moment at this time upon the escalation in health costs and in providing the care that the people of British Columbia have rightly demanded. Under our system of universal medical and hospital care, and I suppose under any other system one cares to think of, the money only comes from one source, and that is the public purse. Whether we get that by taxation on resource revenue or from taxation of individuals or indirectly from taxation the federal government imposes — whatever way we get it, it comes one way or another out of the public purse. I don't think there is any question that we are going to have to, in the months and years to come, address ourselves to the problems raised by the expectations that all of us have raised.

When I say all of us I pay tribute to all governments that I can remember as a lifetime British Columbian, which goes back a year or two now, because I think that in the context of the times each government has tried to do its very best to bring good health care to all the people of British Columbia. We have high expectations and we have now reached a budget of $1.55 billion, and even in inflationary terms that is a sum of money which I think staggers most of us. I think that if we're ever going to control the inflation problem in health care it is going to have to be a team effort. I think that we can, through a team effort, control these expenses, not so that we can cut back on health services but so that we can make each inflated dollar go further and do more for the public of this province.

I think that probably the principal attitude I have tried to bring to the ministry as Health minister is in the field of preventive medicine. I have said many times over, as many of my predecessors have, that due to the wonders of medical science we have eliminated most of the communicable diseases, except perhaps the social diseases, and we are now down to the point in our progress where the vast majority of people who find themselves going into the acute care hospital system are going in there not through no fault of their own but perhaps through fault of their own or through the fact that proper preventive medicine procedures have not been followed. I don't think there is any question that when we are talking in terms of preventive medicine we have to talk in terms of alcohol abuse, use of tobacco — there is no such thing as tobacco abuse; it is all abuse — and, I suppose, overeating, which some of us have been guilty of from time to time in the past.

[Mr. Mussallem in the chair.]

Along the same line — I am sure I will hear a great deal about this from the other side of the House — I think that one area of preventive medicine is the unwanted pregnancy. I have been misunderstood, I think, from time to time to be saying that I am going to try to find ways to cut down abortions. What I have said over and over again is what I would like to do is try to find ways whereby we can cut down unwanted pregnancies. I think this is another area of preventive medicine that is very much in the public mind today, and is very important.

I think I can say that in the short time I have been in the ministry I have seen a very interesting approach from the various interested groups in health care — the hospital people, doctors, nurses and so on. There is less and less of an aura of confrontation and more of a desire to cooperate. I hear the Leader of the Opposition chortling a little bit. I might say that when we examine the public accounts for the year 1980-81 I hope you will look at a bill that was rendered for my entertaining three members of the medical profession last

[ Page 3259 ]

week. I think the results of that entertainment, which was a very mild one, I might say, will prove very fruitful and beneficial because peace has been declared.

MR. LAUK: Can you detail what the entertainment entailed?

HON. MR. MAIR: Yes, I can, as a matter of fact. Unfortunately, in view of what went on in the House here last night, I am a little reluctant to for fear that we'd find ourselves out of order.

In any event, I think that generally that gives a bit of a rundown on my view of the ministry. I noted in running through these notes that this is the fourth ministry I've taken through in estimates, which I suppose shows I can't hold a job. In any event, each one is larger, and in each case my remarks have become shorter. I suppose that only goes to show that it's easier to preface War and Peace than one of Somerset Maugham's short stories.

MR. HALL: You know less and less about more and more.

HON. MR. MAIR: That's probably true too, Mr. Member. Of course, we all know that this is show biz — sometimes good, sometimes mediocre, mostly terrible.

I would like to deal with one thing before I introduce the members of my staff who are on the floor and get down to the questions that will be posed to me from the other side.

I'd like to talk about the Emergency Health Services Commission because it's been very much in the news lately. I'm not going to deal with it on a basis of trying to make apologies or promises. I'm going to try and state the facts as they are. I don't think there's any question that we are experiencing some problems with this particular branch of my ministry and I'd like to place it, if I may, in proper perspective.

In 1974 the ambulance services, as many members of this chamber will know, were operated by private operators, funeral parlour operators, municipalities and even fire departments. Not all of these operated on a 24-hour basis, and there were no standards of training or equipment. The provincial ambulance service developed as a result of representations to the government from private operators, municipalities, BCMA, B.C. Federation of Labour and general pressure resulting from the federal government report on ambulance services dated 1968.

I might pause to say that I remember an appalling case, when I was in municipal politics, which certainly proved beyond any doubt that the establishment of this service was necessary. A jurisdictional dispute occurred in what is now my constituency near the area of Clearwater. As a result of a dispute as to who would take the patient, the patient became permanently impaired for life. This is the kind of thing that did go on to far too great a degree in those days.

In January 1978 a four-year plan was developed for the commission. The plan was approved in principle and the intentions were to update it in 1980. I've already indicated in the House that I've already requested an update of that plan. As the same time as the approved plan called for a major input of funds, this province and government embarked upon several other high priority items such as long-term care. There were major demands for increased services in other health areas, and there were major negotiated salary increases, which I think we all know about. The fact is — this is a candid statement and I hope it's taken as such — we have not been able to keep pace with the projected four-year plan. Let there be no mistake about that. However, I'd like to indicate now the tremendous increase in funding that we have provided in this very essential service so that the chamber knows. The budget for the commission in 1975 was $13 million; in 1979-80 it was $26 million. In our current estimates we've included $34 million. So that while we have problems, it's not that we're not trying to address them, because we are. In other words, to put it in normal mathematics that we can all understand, it's about triple now that it was five years ago.

If one looks at the personnel since December 1975, the Emergency Health Services Commission has hired over 200 ambulance crew and dispatchers, and 61 ambulance attendants have graduated as paramedics with a further 20 paramedics under training. While we are currently experiencing some problems — and I certainly don't in any way try to underestimate them — in the provision of these services, I'm sure that all members will agree in fairness that we've made considerable progress. I repeat that I have asked for a review of this service, and I'll give the report due consideration as soon as it is received.

Before I take my place and prepare to answer questions, I'd like to advise the chamber and you, sir, that on the floor of the House are: Dr. Chapin Key, my deputy; Mr. Jack Bainbridge, who's my ADM, support services; Dr. Gerry Bonham, I'm sure known to you all as senior ADM, community health services, and Mr. Bob McDermit, senior ADM, professional and institutional services.

With no further ado I'll take my place and await questions from the hon. members opposite.

MR. COCKE: I'm delighted to see a new minister in this portfolio. As a matter of fact I'm very tempted to congratulate the minister even though he didn't want the ministry. However, we know that he wants the Premier's job. But I do congratulate the people in the province for at least this one token gesture, that we do have a new Minister of Health.

I think the ministry is almost a cinch winner when you think in terms of all you have to do is contracts. I've had a little experience in that respect and so I would say to this minister that it was almost a cinch winner. However, what has happened since we've had the new minister?

Mr. Chairman, we've heard dental care announced on and off and on and off, shaking up the people in the province, having them wonder whether or not they're going to get a dental care plan. I know the minister is having problems, but at the same time the announcement has been "it will be," then "it might be," then "it may be" and then again "it will be." You'll note that there's one thing: we're not seeing the announcement before the estimates, because possibly there would be some criticism of the plan if it occurred at a convenient time during or before the estimates.

[Mr. Strachan in the chair.]

What else did the minister do to place himself in a very difficult position? He said to us earlier that he just healed all the wounds that were created with the Medical Association by having dinner a few nights ago with three doctors. He insulted the Medical Association and thereby insulted every individual doctor in this province. Never have I seen a

[ Page 3260 ]

situation where a Minister of Health, having been invited to one of the most important constituencies that that minister is involved with, turned down that invitation for any reason, whatever government that minister represented and no matter how badly negotiations were going at the time. I remember such outstanding names as Loffmark. I remember other names, such as Martin. They were not people that always had a very first-class dialogue or working relationship with the Medical Association.

I believe that that inference has affected the confidence of that extremely important constituency, the medical profession of this province. So does the minister. He has written a two-and-a-half-page letter to every doctor in this province. I'll be quoting from it later on, no doubt. The letter tells them that everything's lovely in the garden and that he's over his temper tantrum. He ignores other constituents. He ignored the Lung Association recently, and that's a situation that the minister needn't have created. If he didn't want to go, he should have let them know earlier.

Also, he's been the bearer of bad news to all the people in this province. He has told them that he's increasing their direct cost of involvement in medical care and hospital care in this province. He's increased the price of medicare — not on his own, but it's happened. They've increased the cost of long-term care. They've increased the cost to the consumer — the sick — of acute care. They have increased the cost of day-care charges for day surgery.

Mr. Chairman, that minister stood in this House a moment ago and said: "I know where the money comes from; it comes from the public purse." I know where the money comes from under this government; it comes from the individual's purse — the person who is sick. Taxing the sick has always been a Socred policy, and we see it again in this province under this minister.

A note of parochialism in this resume of the minister's major bad moves was his move to close a first-class hospital in New Westminster — St. Mary's. That was an absolute scandal. It was a scandal from this standpoint: it is a hospital that does not lend itself to what he is now contemplating — extended care. We'll go into that in much more detail later, but I think that that's a major mistake by this government and by this minister. Well, Mr. Chairman, the minister panicked. We've seen a note of his panic; we've seen letters to doctors; we've seen a dinner with a group of doctors that's going to solve all his problems.

We see that the dental plan is coming — or so it's announced. However, I have heard more announcements of that dental plan from Allen Garr than I have from the minister. I wonder when the minister is going to level with us and tell us what he's really doing about a dental program for people in this province.

Interjection.

MR. COCKE: I will say this: it won't be until after the estimates, Mr. Member. Mr. Chairman, I suggest that that's the kind of situation we need not have, if the minister really wants to create an aura of success with that portfolio.

Interjection.

MR. COCKE: Mr. Chairman, the first member for Vancouver Centre (Mr. Lauk) says that his denticare plan is toothless. Well, I'll tell you this: there'll be a lot of toothless people in this province waiting for this dental program that was announced and reannounced over and over for the last couple of years.

MR. LAUK: Denture care.

MR. COCKE: Mr. Chairman, he again panicked and he said to the Lung Association: "Well, I was sick, but a miracle occurred at 7 o'clock and I recovered. " He obviously saw Oral Roberts; he certainly didn't see anybody from the Medical Association, because that happened after his confrontation with the doctors.

I say to the people — and he says: "Better luck next time over the rate increases." You know what the solution is for his own future? Indexing. He isn't going to have to ever again announce a rate increase; he's going to index on behalf of the government that took indexing away from people's pensions; he's going to do the reverse with respect to what people pay for their health-care benefits in this province. Mr. Chairman, I predict that they will take the highest calculation that they can possibly find in terms of indexing for indexing medicare premiums, for indexing hospital per diem costs and for indexing all those ambulance fees that have gone up, etc., etc. What a government, Mr. Chairman!

One day I listened to a backbencher on the government side. He no longer sits in this House — thankfully. He represented Vancouver South. He owns a little business called Color Your World. He coloured my world the day he said that people don't appreciate something they don't pay for. I'm suggesting that taxing the sick doesn't make them appreciate what they're getting.

Mr. Chairman, the cabinet ministers, the government backbenchers are as interested in the Ministry of Health estimates as they were interested in Highways — four of them are here! That's exactly the priority that the Social Credit government has always given health care — low on the list; at the bottom of the list, if you can possibly make it. Let me tell you something about the bottom of the list. The minister said, when he opened his debate, that the health care system is the last line of defence. That's where he put it — the last line of defence, not the first line of defence, where it should be, but the last line of defence. He reflects their feelings, and they reflect the feelings of this government in terms of their care about health care and the health-care delivery system in this province. They say: "Better luck next time." It's better luck next time for the Minister of Health, because he never has to announce another increase, and those increases will come as sure as day follows night, with an indexing system for increasing medicare, hospital care, ambulance care and all those other costs to people.

That other little area where I said that the minister was dead wrong was St. Mary's Hospital. What did the minister answer in question period the other day in terms of St. Mary's Hospital? He said: "Well, socialists don't believe in closing acute-care hospitals." What kind of an answer to a question was that? What utter, ridiculous nonsense! A hospital that was rebuilt in the late fifties, 21 years ago, a major renovation, and 13 years ago another renovation.... That hospital is a first-class acute care facility in this province and will not, cannot, lend itself to extended care. Will the minister tell me where he is going to have activity places in a six-story hospital? I hope, over the next six or seven months, as the minister predicts these estimates will go, he is going to

[ Page 3261 ]

explain to us how he is going to create an extended-care facility out of that.

I admit that they did not plan for their long-term care. They were most fortunate that the previous government set up home care in a coordinated way through Human Resources and Health. They also were the beneficiaries of a major building program in extended care; to give you a few examples, the University of British Columbia extended-care facility, Queens Park extended-care facility in New Westminster and a number of others. We purchased five or six long-term care hospitals in this Capital Regional District and built one in Delta and many others, many of which this government now took credit for. In any event, that mistake at St. Mary's Hospital is one they will live with for a long time if they perpetrate that particular situation.

Let me just enunciate a few of the minister's problems, some created by his predecessor, some created by himself and some the creation of a long-time low priority for this particular area. We have an acute-care hospital system falling apart at the seams. There are waiting lists for elective surgery in this province in virtually every health district. There is as long as a year to wait for elective surgery. Some of these procedures are needed desperately because of the pain that the person in that situation happens to be undergoing at this time, yet there is no planning. The answer is: "A shortage of nurses. So be it. Nothing we can do about it; close down a few more beds." We will be going into many aspects of this and some of the things that they've done in other jurisdictions to cure the shortage of nurses.

We'll even do it now. I want to talk about his problems. We will help him out as much as we can over the next while. Hopefully the minister will take some advice from this opposition because the one thing that this opposition stands for is top priority for health care in this province. We always have and we always will.

The minister apologized for his emergency health care service. We will be dealing with that in some detail, but I can tell you this: it is understaffed and underhoused, being in power for four years and a few months, this government has done as little for that service as one could imagine. Then the minister comes up and says that in 1978 they had a four-year plan and now he is going to readjust it to a five-year plan. The same shortage of manpower exists today as has existed for the last two or three years. The same disastrous housing for his staff exists today as has existed for the last number of years. Four-year plans, five-year plans, ten-year plans are of no significance unless they produce results.

That minister had the gall to make a statement that for some reason or another the NDP, who created for this province out of nothing an emergency health care service program without peer in the country.... We only had it for a little over a year and the minister now says that it's our fault that they're in the shape they're in now. Mr. Chairman, he can't be blamed entirely for the problem that they have in emergency health services, but I'll suggest this: there could have been some response in recent months to the dire need for an increased staff. He could have gone to his colleague in BCBC and said: "Look, we are operating out of rat-infested holes — this first-class service." And I have been in many, if not most, of those places that I described the way I did, It's an absolute shocker and I'm going to be bringing pictures into this House of a significant number of our headquarters for our emergency services program. It is an absolute disgrace and an absolute shame that they have to work out of those conditions When morale drowns — sinks — in an important life-saving service like that, then health care is jeopardized and it should not occur.

What other problems does the minister have? He has a Cadillac program created by his predecessor and that Cadillac of Cadillacs in this government — that high-priority program, the Heroin Treatment Program that is like a blotter in the way it soaks up money — somehow has to be dealt with now by this new minister. There are three services in most major communities in this province. There's the ordinary drug and alcohol service; those services rendered by societies, which are partly and sometimes wholly funded by government, and then look down the street at the biggest competitor for people and you find the Heroin Treatment Program. Well, they can't find very many heroin addicts, so they're out proselytizing alcoholics, barbiturate addicts or any other person with any kind of a drug dependency they can find. Why? Because they're getting most of the money and staff. It's an absolute horror story in this province. That minister is going to have to deal with that significant mistake perpetrated by his predecessor on the advice of a number of well-known British Colombians.

I suggest that the minister should deal significantly with this program during these estimates. I believe that the minister should put her on the line. We know that there's a case in terms of civil rights that has gone to the Supreme Court of Canada. Let's not talk about that aspect of it at all. Let's talk about the efficacy of the program, whether or not it's ever worked in any jurisdiction, what we're going to do with it here, and whether it is going to be the program that mires down the whole treatment situation for people who are very, very ill in our society and who are not getting treatment because there's money being diverted for this useless program.

What other problems does he have? I suggest that there's a breakdown in long-term care. That breakdown creates the following problems, because of a lack of long-term care facilities. I lay that squarely at the feet of this government. They talk about all their creation of facilities and all of their hospital buildings. I used to listen to the past minister tell us that $500 million is going into the creation of care facilities. We like to see physical evidence and the physical evidence is not with us. Oh, yes, we've seen some major expenditures. We've seen the expenditure of millions of dollars out at UBC to create a monument to the Minister of Universities, Science and Communications (Hon. Mr. McGeer). That, Mr. Chairman, was one of the last construction jobs that this government did quickly. On everything else they slow down. They deliberately stopped the best system — fast-track construction — where you are able to get a construction job done and beat inflation, as we did with the Royal Columbian Hospital; as they did with Queens Park Hospital, as they did with the renovations at Burnaby General Hospital. Those were our jobs, and many others. They did that for the extended-care facility at UBC as well.

But, Mr. Chairman, that's the end of it. For instance, the new emergency facility that I approved in 1975 on the King Edward grounds, adjacent to the Vancouver General Hospital, was to be the major emergency centre in this province. The minister said today it isn't going to be ready until 1981. Now if that isn't the most shocking situation I've ever seen! Meanwhile they've built a hospital as a monument on the UBC campus, and it's going to have an operating cost that's going to absolutely strike people dead. I said $600 per day, and I've heard more recently that the actual operating costs of that hospital are going to be $680 per patient-day, for a

[ Page 3262 ]

minister's ego. When the Minister of Universities, Science and Communications walked across the floor in this House and joined the Social Credit Party, it cost the people in this province a bundle. And now he wants a $4 billion tunnel from Vancouver Island to the mainland.

Every day when I come to work, Mr. Chairman, I walk right by his ears. Remember, we were talking something about his ears a few years ago. I see his ears out on the lawn: those strange saucer receivers that will put people in touch with the United States of America.

I'm off the estimates; excuse me, Mr. Chairman.

MR. CHAIRMAN: You have three minutes, as well, hon. member.

MR. COCKE: And I'm sure I'll have other times in this debate.

Just to very quickly summarize, there is a breakdown in long-term care because of a lack of facilities. Medicare negotiations have been hampered and handicapped by the minister's attitude and by the tantrum that he had. He does not have a government behind him, and that's the major handicap. He's got single-issue people....

MR. BARRETT: He doesn't want the job.

MR. COCKE: He told us that in the first place. He indicated by his every move that he didn't want the job. Now he's got it. He wanted to be where the Minister of Intergovernmental Relations (Hon. Mr. Gardom) is today, back in Ottawa arguing the big fight.

Mr. Chairman, he's also got single-issue people fighting for control of his hospital boards. He's also got a federal government to contend with, which obviously is going to have to take another look at cost-sharing in light of the way this government has dealt with cost-sharing and the way this government has been loading people down with the costs and diverting into other areas $269 million this year that could have been in health care. No wonder they have a billion dollar surplus, because three or four years of that and it doesn't take long.

HON. MR. MAIR: I know, as I go down my notes, that I'll miss one or two of the points that the member for New Westminster raised, and I know with equal certainty that he will raise them with me until he's satisfied, so there will be nothing lost.

I wasn't going to rise to the bait of the unwanted job aspect, but I think I ought to set the record straight. The press blew it; they came to a bunch of stupid conclusions and thought that I didn't want the job. The fact of the matter is that I want it very much and am delighted to have it. If the members opposite don't believe that, there's nothing I can do about it. I don't really care, except I do think that since it's been put on the record that I didn't want the job, according to the member for New Westminster, I ought to make it perfectly clear that not only did I want the job, but that within the limits that I had, I asked for it and was delighted to get it. Some things happened the following day, such as a personal loss in the family, that prevented me from going to Government House and were misconstrued by the press as being some sort of indication that I didn't want the job and was disgruntled. I think that that explanation ought to satisfy my friends opposite.

I was interested in the comments about the announcement of the dental plan. Yes, there have been some false starts, and I think a plan of that magnitude, regardless of the size on which it starts, is going to be a major medical program in British Columbia for all time, I presume. I don't think it's too surprising that it takes a while to be put together and that there might be a few false starts. But there haven't been anywhere near the false starts that the members opposite would seem to think. Since I've been in government I think there have been two, perhaps three, postponements. The last has not really been a postponement; we're just getting ready to make the announcement. It will be made on July 23. I've no way of knowing how long these estimates will go. It may be that the estimates are still going on at that time, in which case I can be questioned at that time.

I think it's rather easy for my friend Allen Garr, who has no responsibility in the matter, to announce these things over and over again as it suits him. However, I've got to announce them when I'm ready to have the program to announce, and when I'm able, quite frankly, to make that information available to the media throughout the province — the smaller centres, the weekly newspapers, and so on. That takes a little more time than I, as an impatient man, thought was the case.

Dealing with the question of the B.C. Medical Association, I'm sure that the member for New Westminster did not take my light-hearted remarks to the Leader of the Opposition to indicate that I had solved for evermore all the problems between the government of British Columbia and the BCMA with one dinner. I was light-heartedly, I hoped, trying to get across to them that while I'd had a bit of a brouhaha with the upper echelon of the BCMA in weeks gone by, I had had a very friendly get-together with the president, the incoming president and the executive director. While neither they nor I would indicate that at that meeting everything was solved, I think everybody agreed that a good basis had been laid for future negotiations and that a good feeling of harmony existed.

I don't know that I really want to get into too many more details on the question of why I did not attend the dinner, although that was raised. I've made that public on a number of different occasions. Unless the members really want to press that matter — and I will be delighted to go into it if they do — I will just leave it at this: I felt there are some diplomatic niceties left in this world, and when you invite somebody to dinner you don't grossly insult him and the people he represents just prior to that dinner, unless you expect him to come and either have a fight with you or, by not dealing with the question, perhaps be taken to agree with it. I felt as a responsible Health minister that the time for any confrontation, if it were to come — and I don't think it will — was not sometime in April at a BCMA convention but perhaps a year hence. However, as I say, that is always a matter of judgment which people have to make, and my decision was not made on my own; it was made in consultation not only with staff but with my colleagues. As I say, we may have been wrong, but that is always a judgment you have to make.

On the question of the raising of user costs hospital charges and medical charges and so on, I don't know really how the members opposite would cope with inflation were they — god forbid — the government. We have to deal with it; whether we like it or not, it is our problem. The only way we can think of dealing with it is to recognize it is there and to take steps where we can, with the federal government, to

[ Page 3263 ]

fight it and prevent it from happening. To index these charges seemed to us to be a very reasonable thing to do rather than to let the charges subside into really meaningless figures and then bounce them back to double or triple what they were. When you take the figure of $4 as a charge for daily hospital care in 1976 and translate that into 1980 dollars, you come up with the figure of $5.50. Really all we have done is to say that here is a 1980 equivalent of what at least some of us felt was reasonable in 1976.

We tend to think sometimes that the original dollar a day was a very nominal amount. I happened to have been just out of high school and working my way through college at that time in the early 1950s. I'll tell you that a dollar was an awful lot of money. I can remember going on strike, I think it was in 1949 or 1950, and having a contract of $1.17 or $1.20 an hour being the result of that strike, so it was a pretty substantial amount of money in those days.

I think we should go into the question of St. Mary's Hospital a little more carefully. It was not an easy decision to take, and it didn't involve, as I'm sure the member for New Westminster knows, just the question of that hospital alone. The Greater Vancouver Regional Hospital District, in dealing with the entire health care situation in that broad community of Coquitlam, New Westminster, Surrey and all of that general area, had to deal with a number of very difficult situations and some pretty tacky, if I may say, political situations in the small "p" political sense. I am not talking about party politics at all. There were expectations that had been raised in various communities and there were demands made upon the government which made it a very difficult decision indeed. I think the members opposite from Coquitlam, recognizing the situation at Eagle Ridge and recognizing that it had a very distinct tie-in with the Royal Columbian Hospital situation, with the St. Mary's Hospital and with the Surrey Memorial, know that the decision, whether they agree with it or not, was not an easy one and whoever made any decision at all was bound to be considered wrong by some. I think that we ought to know this, that we haven't made a decision that St. Mary's Hospital must become extended care at this time although that is the hope that we have in the future. That is a decision that wasn't a decision of the Ministry of Health and certainly not in isolation but was one that the Vancouver Regional Health District, in looking at the overall delivery of health care in that broad community, felt was the best — not the perfect way to go.

We are hoping that in the years to come — we are talking a couple of years down the road — this will really be a pilot project in the extended-care field. We are looking at many different areas for extended care and many different aspects of it — activation programs, pediatric, adolescent, adult, day-care, all of these various things. There is no question about it that this is a very essential program in this area. It is not an easy thing to bring in. I will be the first one to admit it. St. Mary's Hospital has a very long and distinguished record — I think it is 97 years — and they are a very proud hospital and they have been a great credit to their community. I am sure that no matter what their role in the future is, they will continue to be a great credit to their community. It is certainly not a decision that we have made in trying to avoid them. I had them all in my office some months ago and I will be the first one to admit there were some very disappointed people when we talked about the future, as we saw it, in that community for their hospital. I don't think they ought to have that disappointment and I hope you'll bear with me when I tell you why.

In days gone by — I don't profess to be the expert that my friend for New Westminster does — acute care was really the only thing that one thought of when one thought of health care because we still had the major communicable diseases. We had polio, diphtheria and all of those things. That is how we thought about health care — going to that kind of hospital as a sick person with a disease and being cared for in that context. Now, because we've eliminated so many of these diseases or brought them so much under control, there is no question it is the care of the elderly that has become the major thrust of any health-care program. I am sure the member for New Westminster will agree with that. Instead of just being able to assess our requirements on the basis of acute-care hospitals, we have to look at a broad,100 percent spectrum care for people. That means that when we make decisions involving areas such as Coquitlam, New Westminster and Surrey we are bound to make some decisions which are going to make some people very unhappy indeed. I feel badly that that is so but just because a decision is a difficult one or one that one would prefer not to make doesn't take away the responsibility for making it. That doesn't take away the responsibility for living with it either and I am prepared to do that.

The alcohol and drug program was touched upon by the member for New Westminster and I'm sure he'll touch upon it later on. I understand that others want to talk about it at some length. I think I should just lay the basis by making two broad statements. First of all, I am expecting a report by the end of July from Dr. Bonham on this whole question. I too will leave aside the issue of the Supreme Court of Canada appeal because that is something none of us know how will turn out and I would expect that we are probably looking two or three years down the road before we find out what that is all about anyway, so we can jostle and joust on that if we wish, but I don't think we are going to get very far because none of us knows what is going to happen. I want a full report from Dr. Bonham — I am going to have it, I understand, on schedule by the end of July — concerning our entire program towards people who have a chemical dependency.

I am going to admit a personal prejudice and bias I have. I don't know whether I will be able to implement this bias or whether it will be warranted under the circumstances, but you might as well know it now so we can talk about it if you wish. I think that we are dealing with a multi-use problem and I think that is something which is fairly recent in coming about. It has come about — not entirely but to a large degree — because of the excellent police work that's been done all over North America, indeed all over the world, in dealing with hard drugs, particularly opium derivatives. And it means quite frankly that because the user of hard drugs can't get the dose or strength of dose that he wishes, he tends to turn to other chemicals in order to at least in part make up that dependency. We find, as I presume the member for New Westminster found when he was the minister, that in some of our detox centres you have the same people coming in under the influence of different chemicals on different days, and it's a different situation. So I'm asking and have asked Dr. Bonham to look at the problem from that point of view. I expect a report, and it's going to be a matter of government policy, but I can only, at this point, give you my own point of view.

Dealing with the long-term care program, we knew, Mr. Chairman, from the very outset that it was going to be a difficult three years at least ahead of us when we brought that program in. We knew that the problems that we're now

[ Page 3264 ]

experiencing were going to come to pass. We are doing what we can as quickly as we can. I've told this House before, and I say again, we're working on the basis of about 1,000 beds a year. We're putting great emphasis — as did, of course, the previous government — on home care. We're into day care and various things of this nature which, we think, are going to help alleviate the problems that have developed which, as I say, we knew were going to develop.

The alternative, I suppose, was really to do nothing, because I don't think it's a rational alternative to say that you could implement in a day or a month or even a year a long-term care program that would be totally satisfactory without any impact on the other things that the member opposite has raised, such as elective surgery and so on.

The last note that I think I have is on the UBC Hospital — oh, no, I have two more notes, I'm sorry. Regarding the UBC Hospital, I really think and I sincerely hope that the member opposite, having raised this alarming figure of $660 per day, will give us some indication of what evidence he has as to this, and what occupancy and what budget he's based it on, because my staff instruct me that they feel — and they're only in something of a guessing game, because we haven't got to the point of striking the budget — that their best estimate is around $180 per day. So I think the member opposite may be very alarmed at what he perceives to be the situation, but he certainly, by repeating that in the chamber today, has alarmed other people. I hope that he will give me the basis of the information upon which he based that judgment.

The other thing I wanted to talk about just very briefly before I take my seat in a moment, Mr. Chairman, is again on the emergency health services. I just point out, in answer to the remarks of the member for New Westminster — and I know that he has got pictures; I'm told that he's quite a Karsh with a camera around the various centres — the fact still is that the budget was $13 million in 1975 in that particular area, and it's $34 million this year. That's almost triple. Sure, there has been inflation — no question about that — but the budget that they struck under the circumstances of perhaps 2.2 or 2.3 million people was $13 million, and what we have struck this year, for perhaps 300,000 or 400,000 more people, is $34 million. So I think that that indicates that we at least take the matter as seriously as they did at that time, and I think there is fair evidence to indicate they were taking it much more seriously, and perhaps it's because times are a little better.

In terms of personnel — at the risk of being repetitive — we have hired over 200 ambulance crew members and dispatchers since 1975, and as I indicated in my opening remarks, 61 ambulance attendants have graduated as paramedics and a further 20 paramedics are in training. So at this point, Mr. Chairman, I think I've dealt with most of the matters raised at this early stage.

Oh, one other point I wanted to make, the member for New Westminster in talking about indexing the user costs took a rather gloomy view that we were going to be indexing these costs to the highest available index. That's not so; it's going to be to the Vancouver price index, and that's, I think, consistently been one of the lowest, if not the lowest, in Canada over the last four or five years.

MR. CHAIRMAN: The member for New Westminster.

MR. LAUK: How do you justify user pays? You can't justify it.

HON. MR. MAIR: I don't recognize the member over there, Mr. Chairman.

MR. CHAIRMAN: All hon. members will come to order, please. The Chair has recognized the member for New Westminster.

MR. COCKE: Well, thank you, Mr. Chairman, I was very interested to listen to the minister answering some of the questions that I put to him. I would suggest when the minister began his remarks he said something about how he had been grossly insulted by the Medical Association. Well, I saw that gross insult, and, Mr. Chairman, this minister with a relatively short fuse has tended to insult many others around him a great deal more than the Medical Association.

Mr. Chairman, what's happening? Are you having a nervous reaction to something?

MR. CHAIRMAN: I'm finding that phrase verging on being unparliamentary.

MR. COCKE: Which?

MR. CHAIRMAN: The phrase referring to the Minister of Health, who is a member of this House — that "he was grossly insulting."

MR. COCKE: I'm using his words, Mr. Chairman. I quoted the Minister of Health, who said he was grossly insulted. I'm surprised, Mr. Chairman, that the president of the Medical Association said something about a weak government, and that they really weren't doing their job and so let's get them this year. Well, I think that's just good politics on his part.

AN HON. MEMBER: Very perceptive.

MR. COCKE: Yes. This government has shown no signs of strength in terms of their reaction to health care. I would say they are very weak in health care. Therefore I don't think the minister was grossly insulted. However, I don't think he should have overreacted. He was invited to speak, not to confront. Look at what he says in his first line to the doctors in this province: "I am writing this personal letter to you because I would like you to know my attitudes toward several important issues confronting you as a physician, your profession as a whole, and the government of British Columbia." Interesting choice of words, isn't it? He uses "confronting" in the second line of his first letter to his new constituents. The word he could have used was "facing." But no, he used the word "confronting."

Ah, that minister has been confronted, insulted, and all sorts of things. But I'll tell you, Mr. Chairman, he'd better get a thicker skin if he's going to deal with the health care people in this province. You know, Mr. Chairman, they take their jobs seriously. They take the lives of people in this province seriously. Therefore that minister better take them seriously.

Let me deal just for a moment or two with St. Mary's Hospital. The minister told us all about this long record, and

[ Page 3265 ]

it is a long record — since the 1890s. We don't have the same hospital there, but it is the same society, and it's been there since the 1890s. It's been rebuilt, however, and it was rebuilt for acute care. Now I would ask the minister to do me one small favour. I ask the minister, before he goes on with his silly decision, to go and visit a few extended-care hospitals. The minister made a speech about how important it is we build our system now for the treatment of older people. The first thing you find, Mr. Chairman, in an extended-care hospital is a very large activity centre. That large activity centre on each floor affords people an opportunity to visit despite the fact that they're non-ambulatory. that they can't get around except in wheelchairs, etc. It gives them an opportunity to collectively watch plays, do arts and hobbies, if nothing else watch television, or listen to some children sing: one of the few desirable things about that very alienating experience for these people who have probably served this province and this country well for many, many years.

Now, if we take a facility that does not lend itself to that kind of activity — a facility like St. Mary's, which has up-to-date operating rooms, small functional rooms for acute care, where people are only going to be there for three, four, five or six days — and we try to convert that into an extended-care facility, we're crazy. The minister as much as admitted that it was a political decision. Okay, it's not the big "p"; we'll call it the small "p". Nonetheless, it's politics. The technical report of the Greater Vancouver Regional Hospital District said: "Don't do it." The minister's own task force report said: "Don't do it." St. Mary's Hospital board said: "Don't do it." Why are we doing it? Politics! Now if that isn't the most stupid way to handle a situation like this, I want to know what is. Mr. Chairman, that hospital does not lend itself to that kind of program.

I don't know what you would have to spend. Can I describe it to you for a second? It is a cement structure, reinforced concrete, six storeys high, good large corridors down which we can move people on their way to and from operating rooms.

It's an acute hospital in every sense of the word. It is a hospital where people in New Westminster and its environs enjoy being there as best as one can enjoy being sick. It is a hospital that has a first-class record in acute care and performs one of the most important activities right now, and that is elective surgery. They are not short of nurses; they have not closed down floors; they are doing elective surgery; and they are doing it on a daily basis. Believe me, if you go and talk to the doctors in New Westminster and the surrounding area you'll find that St. Mary's is a very important hospital in this province, and we're going to see it phased out because the minister has a problem somewhere else.

Well, I suggest to the minister that he restudy his bed matrix or whatever else has created this situation or this problem for him and come up with a better idea than phasing out that very important acute-care hospital in this province.

The minister has informed this House that the university acute-care hospital is going to have a $180-a-day per patient operating budget. He wonders where I got the information. I'm not going to name people, but I'll tell you something, Mr. Chairman. Some of the top people in health care in this province.... I have it from university people, top-notch hospital administrators and a number of very important people in this province in terms of health care. If somehow or another you can operate a hospital that lends itself to inefficiency in the first place.... No pot is big enough in terms of each speciality. It never should have been there; it should have been in the hospital corridor. That's number one. It has the highest technology of any hospital in this province in terms of what they're getting. I predict that they'll have a CAT scanner there before you can shake a stick. They will be beautifully equipped. If they're going to charge three-quarters of the charge or whatever to education and if education is going to pick up the tab, that doesn't change the figures. This $180 a day is the most preposterous suggestion that I have ever heard in my life and I would hope that the minister will review that baby. It is so far off that it's not even funny. Mr. Chairman, I can tell you that it's the talk of the town, the medical community and the health care community — the costs of operating that hospital, which is commonly known as the "Pat McGeer Memorial."

I can't understand from the minister's remarks in terms of his reply to indexing or the user pay situation that he has adopted.

Interjection.

MR. COCKE: The member says he's against it when he pays, but he's for it when he collects. There's a lot of good sense in that one.

What we see here is a situation where those who are ill.... That's the reason you have such things as hospital insurance, Hospital Programs, medicare, extended care and long-term care. You have those programs so that people who are afflicted by illness or disease are assisted by the rest of us. Let me put this on the record. I'm opposed to premiums for medicare in any event. The sooner we can get rid of them and on to the income tax sharing system, the better off we'll all be. You see, the way all these costs hit us, it's the impoverished and the aged that really pay. The older people on fixed incomes, whose incomes don't go up with indexing or at the end of a negotiation and whose incomes creep up are the ones most likely to find themselves in an acute-care hospital, extended-care hospital or in an ambulance in this province. Did you ever see the like of this?

What did he do to the ambulance costs? Five years ago the ambulance cost was $5, under the NDP. The Minister of Health said people were abusing it. I asked him for one example of abuse. Not only did he not give me an example of abuse, he never made the remark again as far as I know. However, he raised the rates to $15. The present rates, the minister announces in his press release, are $15 for the first 40 kilometres plus 15 cents per kilometre thereafter, to a limit of $100. It's all changed now. This will be changed to $19 for the first 40 kilometres plus 20 cents per kilometre thereafter to a maximum of $125. Of course, on an air ambulance that costs the government $1,500, they are only going to charge the patient $125. They, don't seem to understand who they are hitting, who they are affecting. We are not arguing for people such as the minister or such as myself who can very easily afford these costs. Tack it on our income tax, but don't hit us with a taxing-the-sick program. That's what we're saying,

This indexing.... We don't have to bother anymore and we'll index it to the lowest common denominator; we will index to the Vancouver consumer price index. I don't care what you attach it to. It is wrong. What this government should be working toward is a program that is going to make it easier for people to get treatment for illness.

The minister talks about preventive care. One of the best preventive care programs he's got is his ambulance service.

[ Page 3266 ]

Why do I say that? For this reason: the quicker you attend people who are ill, the less severe the illness will be in most cases. That's why you have a paramedic program. You reduce the days of stay in the hospital, you reduce the significance of the illness. It is a good preventive program. The minister makes it less available to people who are very concerned about that old-age pension cheque buying enough food for the next month. They think twice before they call the ambulance. They might think three times and they might think four times too often.

Priority for health care is what we ask of this government, not priority for coal pits, for tunnels from Vancouver Island to the mainland, for a bridge over the Fraser — or the River Kwai — or for a junket that cost the people of this province $70,000 for the Minister of Industry and Small Business Development (Hon. Mr. Phillips) to go to Japan but priorities where people live, where they should live, and to help them live a fuller and better life. You are not going to show us that this government has any priorities in that regard as long as these kinds of moves are made by this government.

I am really shocked, particularly with the fact that the minister can impose these charges after the negotiations that went on in Ottawa for many, many years. I remember those negotiations well, because I attended the first few meetings. I attended the first meeting where the then Minister of Health for Canada, Marc Lalonde, said to the provinces: "The federal government would now like to tie its contributions to the increase in the gross national product." Of course, everybody's hair stood on end. Every health and finance minister across the country said no — and rightfully so. We said no because they would no longer be a partner, they would have a decreasing responsibility.

The negotiations went on, and I was still minister when the federal government said: "We agree with Ontario" — incidentally, Ontario was a major tax base — "and other jurisdictions. We will go along with a transferral of tax points." I was very proud to be with the then Premier and Finance minister of this province, now the Leader of the Opposition, who attended that meeting with me. He argued, as this province argued really hard, and as a number of other jurisdictions argued at that time: "What you will do with that is give rich provinces an opportunity to salt and poor provinces a worse deal. Those provinces with a poor tax base are going to suffer; those provinces like this province here can salt." What happened? We went for it, in 1976-77. In 1977-78 total health care spending in this province was: hospitals, $594 million, and medicare, $207 million. The federal contribution, in terms of the old figures and comparing, was $318.7 million out of $594 million, which is 53.6 percent. Medicare was the same: $111 million, 53.6 percent. What happened in 1978-79? There was $631 million spent on hospitals, and $401 million came from the federal government through these tax points, which is 63.5 percent for good old B.C. with our rich tax base. For medicare: $140 million out of $221 million, 63.3 percent. It goes on. Anybody who wants to look at these figures will tell you that we were in a position where we were enriched by these tax moneys that came our way. They created major surpluses in this province, but they've been diverted from health care into surpluses and into Annacis Island bridges and whatever else you want. Incidentally, that is where some of this money was spent by this Legislature this session.

In the facet of that, this minister comes out with an announcement of a major increase in charges to patients and in charges to people for medicare. I think he has something to answer for, and I think that government has something to answer for to all the people in this province, with respect to what they have done to health care as a result of this irresponsibility.

HON. MR. MAIR: First of all, I would like to deal with one aspect of the member for New Westminster's remarks, and I hope we can achieve some understanding on this. We may have a different choice of words, Mr. Member, and I don't for one minute say that my choice is any better than yours. You may use the word "face" where I use the word "confront." You may not like the use of the word "politics," other than in the sense of politics as you see it in this chamber. I have a rather more global definition of politics in my own lexicon, and I suppose that doesn't make me right or you wrong but I think we ought to understand that we may have a bit of a language difficulty because of that. I want you to know that when I used the word "confront" to the doctors I did not mean it in the sense of a confrontation of a disagreeable sort but just exactly as you say, as a synonym for the word "face." If you wish to substitute the word "face" for that, it certainly wouldn't take away from the meaning of the sentence. On the other hand, I don't think that "confronting" takes away from the meaning of it either.

I was very careful to explain that I meant the word "politics" in a strictly non-partisan way, certainly not in the political sense that we use it in this chamber or when we are seeking our jobs, but in the sense of the desires and expectations of people that had been raised and were continuing to be raised and, as a matter of fact, ebbed and flowed depending on the circumstances. I was rather interested to note that during the time I had to make this very difficult decision — the member for New Westminster knew I was doing it, of course, as did the two members for Coquitlam (Messrs. Leggatt and Levi) — there were no questions in question period. That is because, of course, the interests of the various constituencies were different. I don't say that critically. I understand the difficulty the members opposite found themselves in. Quite obviously, what might be specifically good for the constituency of New Westminster might not be specifically good for the constituency of Coquitlam–Moody and, once again, might not be specifically good for the constituency of Surrey or the other Coquitlam. That is as it is. I had to deal with all those constituencies put together and try to find out what was for the greatest good for the entire area, not just the component parts. I can understand how the member for New Westminster would he reluctant to question me in question period at the time I had to make the decision, because his position would be different from those of his colleagues. Now, of course, it is somewhat easier — the decision having been made and being, I presume, virtually irreversible — to question the decision and how it was reached.

MR. COCKE: The mayor of New Westminster told me it wasn't going to happen — that was my authority.

HON. MR. MAIR: I suppose we will hear from them in due course, Mr. Member.

MR. COCKE: From you, indirectly.

HON. MR. MAIR: You can raise it. I am sorry that I misunderstood your question.

[ Page 3267 ]

On the question of elective surgery at St. Mary's, the member makes a good point, but the fact of the matter is that elective surgery is going to continue for at least another three or four years until the Eagle Ridge Hospital is built, by which time the long-term care program impact upon the elective care situation will have considerably abated if not entirely disappeared.

I have a note here somewhere on UBC. I'm piling up so many papers here that a brush fire would be a distinct advantage. No, I don't have it here. In any event, the figure of $180 million that I gave to the hon. member was the figure agreed upon between UBC and the ministry in June 1978. It is agreed upon in the sense that at that time — 1978 — the recommended budget per patient day was $125.62. If you make those into 1980 dollars, it comes to roughly $180. VGH, by comparison, is $253. That's quite apart from the question of the education share of that budget. That hasn't been considered. That would be over and above that.

The member talked about the question of premiums and user charges. I noted that the first member for Vancouver Centre (Mr. Lauk) said across the floor, ''How can you justify them?" and so on. I guess that times come very often in this House where we have a very basic difference in philosophy. I suppose we can stand here for as long as we wish and holler at each other, "You're wrong and I'm right," and so on and so forth. You're not going to convince me and I'm not going to convince you.

I'm going to tell you that in my view, where you have a system such as we have, where those people who cannot afford the premiums have those premiums paid for them in whole or in part, where those people who cannot afford the hospital charges have them borne for them, that is a better system than having it all come out of general revenue, where those who can very well afford what is really less than it costs to feed them will get in essence not a free ride but a substantially reduced ride. It means that the member for New Westminster (Mr. Cocke) and I, under his system, when we go to hospital and pay absolutely nothing except through our tax revenue, are getting a better deal by far than that to which we are entitled. The people who are getting it for nothing and who can't afford it are getting no better deal, because it wasn't going to cost them anything out of their pockets in any event under the system that we're now under.

In any event, this is a basic difference in philosophy between the two sides of this House. I have had this difference with my friend the member for Maillardville–Coquitlam (Mr. Levi) — the former Minister of Human Resources in the NDP government — and others. We simply had to finally say: "Look, we don't agree. That's all there is to it. You think this way, I think that way, and there we are." However, it is for you to say how long we have the philosophical debate. I will, of course, be required and happy to be here as long as it continues.

I'd like to talk for a second about the decision on St. Mary's though, because I don't think the member for New Westminster meant to mislead; perhaps it was my mishearing of what he said. While it is true that the hospital subcommittee of the Greater Vancouver Regional Hospital District questioned the decision to go into an extended-care hospital, the board itself approved the recommendation. There is a distinction.

MR. COCKE: We know that.

HON. MR. MAIR: Be that as it may, we know why the board and the regional district were set up.

MR. COCKE: Why was it an in-camera meeting?

HON. MR. MAIR: In camera, out of camera; there are all sorts of meetings. Your caucus meetings are in camera. That doesn't make them any less valid. This is the decision that was made. I'm not going to pretend that others wouldn't have made different decisions. It was a hard decision to make, but I am prepared to stand by it.

I might say, Mr. Chairman — through you to the members opposite — that health-care planners who are advising the ministry have looked at the plans that we have ultimately, hopefully, for St. Mary's. I am assured that with extensive renovations this facility can accommodate the extended care that I have been suggesting. I stated to the members of the board, when they were in to see me a couple of months ago, that we are not suggesting a traditional extended-care program, but rather a pilot project, a new project, something they can be pioneers in.

We know that there are needs such as an activities lounge, as the member opposite indicates — no question about it. Lounge space, activities centres and all of these sorts of things are going to have to be provided. We know that, but we think that in view of the fact that the hospital already has occupational therapy and physiotherapy, we can provide a rather unique service with a little bit of imagination, ingenuity and, of course, motivation in order to convert that to a pioneer extended-care program.

I've got to say this too. While I know that it may appear to be a fait accompli, there are three or four years to go. Nobody is insisting that any hospital do anything. We are just suggesting that this is the course of action to take. I'm hoping that when the board sees the Eagle Ridge Hospital going into the area where the acute-care demands are going to be the greatest and when the whole matter sort of falls into place, they will feel that the suggestions that have been made to them are valid ones.

MRS. DAILLY: Mr. Chairman, I have been listening to this debate since it started this afternoon. There is one thing that is coming through loud and clear to me and that is that it has a very unpleasant, familiar ring to it. For those of us who were first elected to this Legislature in the sixties and were here prior to the defeat of the Social Credit government in 1972, it takes us right back to the very same debates that took place before this Social Credit government was defeated on the people issues.

Here again we have this new so-called Social Credit coalition government painting themselves right into the same corner again by choice, because apparently when it comes to priorities this new coalition government is no different than the old pre- 1972 government. when it comes to their responsibility to health services in this province. Pre-1972, the two big issues in this province that the old government faced were education and health. Both those areas had deteriorated to such an extent that the people of the province said: "We've had enough." Mr. Chairman, I believe that the attitude of the government in those vital areas had much to do with their defeat in 1972. Now, once again, we find that this government is becoming quite arrogant. They are — I won't say being deceptive, because that would be unparliamentary —

[ Page 3268 ]

not levelling with the people of the province when it comes to the financing of health care in this province.

As our health critic has pointed out earlier today, what was predicted in 1977, when there was a change in the whole matter of federal aid to health costs, has come true. Provinces like British Columbia have taken advantage of the new cost-sharing and are not putting in their share. I have yet to hear the Minister of Health repudiate that statement, which has been made by our health critic. The federal government shares 50-50, but is the province sharing on the 50 percent? All the figures that we have in front of us show once again that the Social Credit government has taken advantage of this change and they've taken advantage of the people of British Columbia when it comes to their health care.

We know that the health budget is exceptionally large and I know if you read the figures, most people would say: — "What a tremendous amount of money is being spent on health." But then we always have to look at priorities. If we look at what this government has committed themselves to in other areas — millions of dollars for stadiums, convention centres, monuments to ministers' and members' egos, bridges and hospitals that are not serving.... The hospital that we're referring to — McGeer's Hospital, as we call it — is not really benefiting the majority of the people of this province who desperately need more health facilities.

I think it's up to the Minister of Health to level with us here in the House today and let us know if he is really ensuring, as Minister of Health, that his ministry is maintaining the agreement which they made with the federal government regarding 50 percent sharing. I don't think the minister has commented on that aspect whatsoever. If he's not going to comment on it, it simply means that out there the people of this province will say once again that this Social Credit government does not put health care first. You know, even from that point of view — and we'll listen with considerable interest to the minister's explanation of that.... That minister said this afternoon in this House that we could philosophically debate the whole matter of user pay and premiums for hours. As we have said many times, the NDP is opposed to premiums. The minister says the Social Credit government believes in them.

The main reason we're opposed to premiums is that when this whole medicare scheme first came in it was based on universality. It was to be universal. Unfortunately, the Social Credit government has chipped away at this basic principle, because as the years go by and they continue to increase the premiums, they are making it increasingly difficult for many people of this province to face up to health costs. The point is that it is not equitable that people who have the money, such as the Minister of Health and the members of this Legislature, as the former speaker said, who are able to contribute and pay the premiums, are not going to suffer. When the minister says, "Ah, but we can take care of them," it's a very, very patronizing attitude. That was the reason that medicare was fought for so hard by so many people, because we wanted to get away from the old days of charity, where people who could not pay for their health costs were known to be put in charity wards and were known to be taken care of by the state. We had that wiped out. We were known in Canada as being in the forefront in this whole area of health care. It is indeed a tragedy to see governments, such as the Social Credit government of British Columbia, bringing our whole scheme to discredit. It is something that many of us had been very proud to talk about when we visited other countries, and I resent very much that this government is eroding the principle of medicare. When the minister says, "Well, you know, they can be taken care of," you can't help thinking of particularly the ambulance area, where the cost of ambulances has been increased dramatically since the Social Credit came in. Are we going to go back to the bad old days, where before some old person is put in an ambulance they are going to be asked: "Have you got the money?" I remember being told this before the NDP became government, and it was one of the most gratifying things when my colleague, the member for New Westminster (Mr. Cocke), became Minister of Health and was able to make the ambulance fees at a level where no one was going to be afraid to call an ambulance because of the cost.

I remember people coming into my constituency office pre-1972 and saying that as they were being wheeled to the hospital in the ambulance they were being asked whether they had the money, even before they were allowed to go to the hospital. I don't know how the Minister of Health, who, I think, on the whole — despite the fact that we have our philosophical differences — is not a mean person.... I'm quite sure that he wouldn't want to be responsible for that sort of thing happening to some of the citizens of this province. I don't know if the Minister of Health really believes in this; is it that he has problems with the Treasury Board and the Premier? Really, it doesn't seem to completely fit in with some of the former statements of compassion that that minister has made to do with other subjects.

Medical premiums in the province of British Columbia have risen 65 percent since the Social Credit took office in 1975. That's really some record, isn't it? There has been an increase of 65 percent in the last five years, and yet who in the last five years — what working person in this province — can say that they have had a steady 13 percent increase in his or her salary, which is what it works out would be necessary if you're going to match the increase which this government has put on people in this province for medicare? It doesn't wash for the minister to say: "We have to do this, and we feel okay about it because everyone's wages have gone up." They have not gone up, comparatively speaking, in the same ratio as the health costs which have been imposed on them by the Social Credit government.

We consider these hospital taxes regressive, and the NDP has never believed in endorsing regressive taxes. As our member, the former Minister of Health, said just a few moments ago, we would rather see it taken from income tax, which may have a lot of problems but at least it's far more equitable. At the moment, with these increases we again are putting fear and insecurity into the minds of many people of this province, particularly the older people who may be caught and who don't have any great extra income. They are going to think twice now, even about extended care, which has gone up and up, as have all the other areas since this government came in.

Basically what I'm trying to say is that this government once again is taking us back to pre 1972. They are not making health a priority. They don't seem to have the same concern for health as for building monuments to themselves with the people's money. If they were cutting back on health but at the same time cutting back on everything, maybe we could all look at it a little more objectively, but they are not. It is completely out of whack — their whole idea of priorities in expenditures. We have ministers over there spending close to $80,000 to take trips around the world, and yet we have

[ Page 3269 ]

hospitals like St. Pauls who have been asking — I don't know the technical term for it — for a computerized tomography body scanner. This was asked for for a considerable time, and why I'm bringing this up particularly is.... I don't know the cost of that, but I'm sure if you added up all the travel expenses of some of those ministers over there, they could have had their scanner. It's priorities; this is what we're talking about. I want to repeat that when the money that is allocated by the federal government is not being matched by the provincial government, as far as I'm concerned we have a government that is sick in its priorities.

You know, if they had really spent the money that should have been spent on health, we wouldn't have to stand up in this House in question period almost every day and ask the minister what he's doing about the blockage when it comes to elective surgery — and also more than elective sometimes — to get into the hospital. They haven't taken their rightful place as far as the citizens of British Columbia go. It doesn't look too hopeful for them, and it looks like the opposition will have to continue with this minister, with his government, bringing these facts to the government's attention, because if there is anything that's important in this world, we all know it's our health. For any government to put a price-tag to the extent that this government is doing.... I say shame on them.

MS. BROWN: Mr. Chairman, I wouldn't want us to be left with the impression that it's only the doctors with whom the Minister of Health has a strained relationship, and that he gets along with everyone else. I was recently speaking to the hospital administrator for the Burnaby General Hospital, and he informed me that he learned about the increases in premium rates from reading it in the media. Presumably he read it in the Columbian or the Sun or the Province. He had never heard a word from the ministry indicating that the rates were going to be increased. He still had not heard whether the patients in the hospital were supposed to have their rates increased too. There had been no communication whatsoever between hospital administrators and the government on this. As a matter of fact, I had to mail him a copy of the press release which I had, because weeks after the decision was made and the press informed and a press release sent out, the hospital administrators had still not received a letter, a card, a phone call or anything from the ministry indicating exactly what was happening and how they were to deal with this. So one of the questions certainly that Mr. Barth has asked me to pass on to the minister is whether it would be possible to improve the communications between the Ministry of Health and the hospital administrators of the province. I'm sure that Mr. Barth is not the only person who did not hear from the minister, because I doubt very much that the minister would have singled out Burnaby General to treat it differently than other hospitals were treated. But certainly Burnaby General Hospital learned about the premium increases by reading it in the press. That's a really strange way in which to run a health care delivery system, Mr. Chairman.

One of the things that our critic, the member for New Westminster, raised with the minister which he has still not responded to is the business of the funding all going into general revenue and not being directly passed on in terms of improving the delivery of health care. If we could deal in specifics and give the minister just a couple of examples of what that means to one community anyway, maybe the minister would reconsider his position on this and start spending all the money allotted by the federal government in this particular area.

A constituent phoned my office recently and mentioned that she needed elective surgery and had been told by, again, Burnaby General Hospital — I'm going to be dealing specifically with Burnaby General Hospital — that there would be a three- to six-week waiting period. She was told this in March. I asked my secretary to phone a week ago when I thought the Health ministry estimates were coming up, just to double-check to see whether there was any improvement whatsoever in terms of the waiting time for elective surgery, and there isn't. Quite frankly, when you speak to the hospital staff and to doctors on staff, you listen to a long list of ways in which the hospital cannot deal with the patients and cannot deal with the demands on its services, because the budget is not sufficient.

Now one of the things that I know happens at Burnaby General Hospital is that when they prepare a budget, it's absolutely a responsible bare-bones budget. There is never any fat; they never pad the budget in any way in anticipation that they will be asked to cut it back by a third or a quarter or whatever, and so by playing this little financial game with the minister they will still end up with exactly how much money they need. They do submit an absolutely responsible bare-bones budget so that when in fact they are asked to cut that budget back, the result of that is some cutbacks in services. One of the results, of course, is this three- to six-week waiting period in terms of elective surgery.

Another thing that is suffering as a result of the budget being as tight and inadequate as it is is that the very useful and productive day-care surgical program has had to be curtailed drastically. I was speaking to one of the surgeons who explained to me that really this was a very good program. What it meant was that someone who needed some minor surgery such as a tonsillectomy or a circumcision or drainage of some kind of superficial skin cyst, tubal ligation, D and C, those kinds of things, would go into the hospital, the surgery would be done and they would be discharged the same day.

The result of this is that they would not be using up expensive acute-care beds, for one thing. For those who worked it would be a minimal loss of time away from their job. It meant that the patients would not have to be admitted and would not have to use up all the staff time. It requires many more nurses, for example, or so many more orderlies and this kind of thing that is always called into effect when someone is using up an acute-care bed in a hospital. Generally the cost is much less if surgery can be done on a day-care basis. The day-care program actually saves money for the hospital and the Ministry of Health. But it also costs money to run the day-care program, and when the hospital has to make decisions about priorities in terms of its budget and it has to operate on inadequate budget and has to start cutting back on things, one of the thing that gets cut back is this day-care program and the staffing for it. For example, the services of a number of the nurses had to be terminated as a direct result of operating on a very, very tight budget. I personally think that is a little bit short-sighted because, in fact, we would be much better off to increase the day-care program and to encourage as much of the minimal surgery as is possible to be done on a day-care basis and probably cut back on some of the people who need the acute-care beds.

The problem is, of course, the continual juggling. That is what I am really suggesting to the minister. I am not criticizing the decision to cut back the day-care program. What I am

[ Page 3270 ]

criticizing is that because the funding which is allotted to the Burnaby General Hospital is insufficient, this kind of juggling has to go on, which in the long-run is more expensive. In a number of instances what has happened is that those people who couldn't get in on the day-care program because of the cutback in staff ended up being accepted as surgery patients being admitted to hospital and using up an acute-care bed, which I'm sure the minister will agree is a more expensive way of dealing with it, not just to the hospital but certainly more expensive in terms of time lost from that person's job and, as I said before, in terms of the cost of nurses and orderlies and all the support services that one needs when one is in hospital. That is certainly one area that I think the minister should think more carefully about when looking at a hospital budget before even suggesting to that hospital that the budget submitted is too much and has to be cut back.

If I can repeat what I said earlier, Burnaby has the practice — maybe it is an idiosyncrasy.... I don't know what it is but Burnaby is in the habit of submitting an absolutely iron-clad, bone-tight budget. They don't leave any fat in the budget and so when they have to cut they end up having to cut services.

A couple of the other things that happened as a result of not having quite sufficient money is that the capital funds needed to complete the renovation program at the hospital could not be dealt with. They are running something like $150,000 to $200,000 short. We are not talking about a lot of money when we deal with the fact that your budget is as large as it is or could be as large as it is if you passed on all the funding which you received from the federal government.

[Hon. Mr. Rogers in the chair.]

Something which in my notes I have as "non-specific areas" were deleted, but now these areas are being used by the staff. Oh, I understand. An example that was given was when the extended care buildings at the hospital were being renovated. Some of the areas were not completed because the feeling was that they weren't being used and it wasn't necessary at that time, and in order to stay within budget, some of the areas were left sort of incomplete. In one corridor, for example, the wiring was left exposed and they didn't bother to paint it and this kind of thing, because they were trying to keep within budget, as Burnaby tends to do. Well, now that corridor is being used, because what's happening is that to get from the main floor to extended care via the physiotherapy area, this corridor has to be used. This is such a minor thing, in fact, and here is the ceiling still ripped out, the wiring still exposed, and it's still not painted simply because it needs a couple hundred thousand dollars; not even that much — somewhere about $150,000 to $200,000.

The same thing is happening in the staff lounge. It says: "The guts are hanging out of the ceiling." I don't know what that means. I guess it's wiring and this kind of thing.

The toilets have not been completed properly. Nothing has been done in terms of finishing those rooms off. I want to repeat: we are not talking about a lot of money, Mr. Chairman. We are talking about somewhere in the vicinity of $150,000 to $200,000 just to deal with the capital costs to complete the renovation program. Burnaby was promised that it would be possible once the need was indicated that these areas were going to be used, that they were necessary, that they were going to come on stream, that the money would be there, and it isn't there.

The other thing, again, that my colleague the member for New Westminster touched on, which when speaking to the administrator from Burnaby General he raised, is this business of the nursing shortage. I know that every time we talk about beds not being used, and sections of the hospital being closed down, the minister assures us that it's because nurses no longer want to nurse, and that is not a fact. In fact, what we are finding is that everything's changed, the whole world's changed, but the attitude toward the kinds of hours and working conditions of nurses it still in the horse and buggy age.

[Mr. Strachan in the chair.]

In other parts of the world — in the United States, for example — they have managed to develop a more flexible way of using the nursing staff. They feed into a computer the number of hours, the kinds of hours, the times that a nurse wants to work, and use the nurses in the way in which they are free to be used or they want to be used. We in this province are locked into an inflexible kind of schedule. You work from 7 to 3; you work from 3 to 11; you work from 11 to 7. Somehow this seems to be chiselled in stone; it's chiselled in granite. Nobody wants to change that system. The result of that is that in fact we do have thousands of nurses in this province who want to nurse, but who cannot fit into that 7 to 3, 3 to 11, and 11 to 7 schedule.

Why is it not possible for a more flexible system to be developed here? We don't have to be innovative. We don't have to be imaginative. We can copy the system from somewhere else. We can go to the United States and find out how they are doing it, because they have a flexible system already in place, where a nurse goes into a hospital and registers with the hospital: "I am free to work X number of hours from such a time to such a time." This information is fed into a computer, and somehow or another, because I don't understand how computers work, it's possible to fit that nurse into the working system of the hospital. They have no nursing shortages in most of those hospitals. They somehow seem to be able to find nurses who are willing to work.

HON. MR. MAIR: Where's that again, Rosemary?

MS. BROWN: In the United States. I can get the exact information from the Registered Nurses Association for you, Mr. Minister, because they certainly have that information.

I have tried to discuss this with some hospital administrators, and I have not run into a willingness to be flexible. I have not found the administrators themselves willing to be flexible about this time schedule. As long as the hospital is not willing to adjust itself to the needs of the staff, there's always going to be a shortage of nurses, even though we have nurses who are willing to nurse. Maybe the government and the ministry are going to have to get into the forefront of this and take some leadership in this direction.

I know that the Registered Nurses Association ran a survey and tried to find out how many of their nurses were still registered and paying their dues each year, but not nursing. They were surprised to find how many nurses they still have on their registry who pay their dues but who are not nursing. They're waiting either for their children to grow up, or they are waiting for a more flexible schedule to be built into the hospital system.

[ Page 3271 ]

When they sent out another survey asking these nurses to explain why they were not nursing, despite the fact that they were retaining their membership in the association and their registration, the answers — 100 to 1 - dealt with the inflexible schedules laid out by the hospitals. They just didn't work for them: 3 to 11 didn't make sense for one reason or another, 7 to 3 didn't make sense, 11 to 7 doesn't make sense or having to work shift always didn't make sense. There are some nurses who are prepared to work the same hours every day. The hospitals aren't willing to accept this. If you are a general duty nurse you have to take your turn and do shift work too. Why? This is ridiculous when there are some nurses who are prepared to work an unpopular shift every day, five days a week, if necessary.

It's as though we are dealing with dinosaurs when we deal with the hospital administration in terms of their inability to adjust to the changing lifestyles of nurses, and you hear a continual complaint. The nurses who are graduating from school these days don't realize that you don't work just from 9 to 5 and you have to work shift work. It's not like the good old days when nurses used to work right around the clock — 12 hours, 14 hours, etc. What would Florence Nightingale say if she were here? She's probably turning in her grave. But it doesn't work anymore. In fact, it's not the nurses who are suffering; it's the health care delivery system that's suffering.

What I am suggesting to the minister is that he take some leadership. If you have to invest some of the dollars in the service into doing some research into this area, inviting someone up from a hospital in the United States where this is happening, or to send someone down — don't go yourself, Mr. Minister; you do too much travelling as it is already — to take a look at that system. The ministry has to do that, because it's quite clear that the hospitals are not going to be dealing with that. I am firmly convinced that once the ministry and the hospital administrators get together and work out a more flexible system in terms of the working conditions and the working hours of nurses, the staff shortages which are being experienced in hospitals today will disappear at once.

HON. MR. MAIR: I'll forget some of the questions. My notes are scanty at best, Mr. Member.

I'd like to deal if I could, first of all, with the question raised by the member for New Westminster (Mr. Cocke) and later the member for Burnaby–Edmonds (Ms. Brown) on the federal-provincial financing arrangements. I must say that when I get into advanced number work — which is anything past grade 1 elementary — I have to work pretty hard in order to get things straight. But I understand, through you, Mr. Chairman, to the members opposite, that in 1977 there was a change in these arrangements. Really the money came from the federal government to ourselves in three different ways — firstly, a cash block grant which was approximately one-half of the formal contribution from the feds and then escalated annually according to population and growth of the gross national product. These funds, which we can sort of put aside for the moment, are allocated specifically to three established programs and tied very closely to criteria upon which the original medicare program was established.

The second is a tax-point transfer, and this is additional personal and corporate income tax points roughly equal to one-half of the former contributions to the provinces. While they are not tied specifically to any one program, it is inferred that these funds must be used in some way for all of the three established programs. This is, I think, where the interesting feature comes in. The three programs are: medicare, hospital insurance or post-secondary education. That last one, Mr. Chairman, is the joker in the deck, because that's the one thing that is inclined to throw people's computations of the figures off, because it's difficult sometimes to compute precisely what that item means in terms of actual dollars.

The third one is a $20 per capita grant to the province escalated in the same way that the cash block grant that I referred to initially was.

Now all the funds earmarked, as I understand it, for health care flow into the consolidated revenue and continue to do so but prior to 1977 these were all entered as contributions from other governments. After this time — that is after 1977 — only the cash block portion was entered in this way, while a tax transfer was entered under the taxes category — and I think it's important to note that the tax transfer program is not specifically allocated to any of the three established programs. Now the figures as I have them — and I must admit that you can pick your set of figures; everybody seems to have a set, but I think these are as close as any.... We're talking in terms of millions of dollars; we will receive approximately $468 million from the federal government in 1980-81 under the tax transfer, and that actually is number two that I mentioned before; approximately $520 million comes out of the cash block grant, plus a transitional cash payment of almost $52 million, and then the extended-care payment is $69 million.

Now, as I understand it, we must, by law, expend a little more than 68 percent of the cash payments — that is under the cash block grant and the traditional cash grant. They must be used specifically for medical or hospital care — and, of course, the extended health-care payment, which is specifically allocated. But the tax transfer portion has no specific allocations tied to it, and I think this is where we're going to have problems. We can dance around with figures forever and a day, but this is the difficulty. And if you try to allocate the tax transfer funds in the same manner as the cash portion, you're going to get into some kind of trouble.

If you look at the magnitude of the post-secondary education budget in addition to the health budget, you can see that there is no difficulty in justifying that all of the funds from the federal government were properly used. I don't think we would have any difficulty — and if we wish, we can go back into this in some detail. I've got figures all over the place here which I will try to master as best as I can; as a matter fact, when the member for New Westminster first asked the question, my first indication was, "D equals 9 divided by 4," so you see that it's going to take a little bit of work. I think that we can make out an irrefutable case for the proposition that the money that is provided to us under the EPF plan is being properly spent by the province of British Columbia in the health field.

Another question raised by the member for Burnaby North (Mrs. Dailly), if I can progress along with her remarks, concerned the question of medicare premiums and how she was philosophically opposed to them, as was her party. I suppose I have to ask the obvious question: why you didn't abolish them, then, when you had the opportunity to do so? I don't mean to embarrass you, but we didn't abolish them because philosophically we don't think they should be abolished; but apparently you didn't do something which you had the opportunity to do.

If I can find the note somewhere here, the number of

[ Page 3272 ]

people that are on premium assistance — and those are people who would stand to benefit under your system, I suppose.... Those who are on 90 percent.... My note says 276,600 families are covered for a total of 448,402 persons.

Now, to repeat, it seems to me — and this is where we have our problem philosophically — that if you were simply to pay all of those persons' medicare or hospital care, whatever the case may be, what you really in effect are doing is paying for their cost, and most of them are getting most of it, if not all of it, right now. At the same time you're going to give those people who can amply afford to pay those premiums a break, because it's only going to come out of the income tax that they pay rather than being a direct charge to them. In other words, even those people who don't use the service are going to be paying for those who do and who can well afford to pay for it. As I say, you know we're in a philosophical dichotomy there, and we can as long as we wish go on with it.

I think you talked about the percentages of increase in the user charges and in medicare, and I have a document which indicates, I think, slightly different figures than yours. If we wish to argue about how big the percentages were, I can perhaps at a later time deal with that. No, there are certainly not going to be any people who have to pony up money before they get into the ambulance or receive health care. Certainly that will not happen as long as this government is in office or I am the Minister of Health. If it happened in an isolated case, I can assure you I would deal with it as quickly as I heard about it and as quickly as I could get to it.

You mentioned, Madam Member — and I'm very surprised — this CAT scanner in St. Paul's Hospital. I think you made some mention of the fact that if some members of the treasury benches hadn't travelled as much as they had in trying to gain markets for our products and to expand our economy, we could have used that money in order to get the CAT scanner that seems to be so earnestly desired by St. Paul's Hospital. I'm surprised, because that CAT scanner was approved for St. Paul's months and months ago. They've had their approval for a long time, so with the greatest respect, I think your information is a little out of date.

MR. COCKE: So did the RCH, and look what you gave them.

HON. MR. MAIR: Well, we gave the RCH.... They were quite happy. I was at the opening, Mr. Member. You know you were at a place that I should have been; I was at a place where I think you should have been, and so we evened out on that day.

Dealing with the member for Burnaby–Edmonds (Ms. Brown) and the administrator of the Burnaby General Hospital, Mr. Barth, I am surprised at what you bring to me from him, Madam Member, because not long after I became Health minister, I believe late in January or early in February, I met with the Health Administrators Association of British Columbia. The executive happens to include the administrator of the Royal Inland Hospital and Mr. Barth was among them. We had a very happy meeting, I thought. As a matter of fact, all the indications were that we had established good rapport.

I had a letter from Mr. Barth as late as June 13 of this year. I can read the whole thing if you wish. It deals with the question we've already talked about. That was the BCMA brouhaha that I got into at their convention, and he wants to dissociate himself from the remarks made by Dr. Petreman insofar as they affected the Health Administrators Association. He closes with this short paragraph: "The Health Administrators Association of B.C. looks forward to building upon positive initial contacts with both your ministry and allied organizations in the hope of strengthening those relations to the benefit of us all." So I had thought, until now, that we had a pretty good rapport, and I hope whatever difficulties we're having are a misunderstanding.

I've got to say also on the question of the increase in costs and the tying of them to the cost of living that we advised all hospital administrators of our intention to do this sometime before the implementation. It may very well be that Mr. Barth did not get his. Thank God I'm not answerable for the royal Canadian mails, or whatever they call themselves these days. That may be the answer, because the other administrators all were advised beforehand so that they would not be faced with the difficulties that you've spoken about.

I'm going to agree with you, of course, and nobody could disagree with you, Madam Member, that everything can be improved, including relationships that you build up. I suppose there's always an ebb and flow in those relationships, depending upon how things are going at the time. Contrary to what has been suggested, I think my relationship with the industries involved in the health field is good. Certainly I've had disagreements with Dr. Petreman, and I'm sure I'll have disagreements with Dr. Mandeville and Dr. March, who is an old personal friend of mine. I'm sure that these things will happen. Quite apart from what you may think of me now, I'd definitely be a lousy Health minister if I didn't have some disagreements from time to time, on behalf of the public that I represent, with the people receiving public dollars. All in all, we have a good contact, a good relationship, and I think that it will continue that way.

I am interested to hear your remarks, Madam Member, on the question of day-care surgery at the Burnaby General Hospital. I might say that we would like to talk to the hospital about enhancing that. We are very happy to expand it and I hope that, arising out of these discussions, we will perhaps be able to get together with Mr. Barth, and through you I invite him to contact us with that in mind.

The renovation program you talked about. My instructions are that we have approved their capital program for this year. So while I don't have the specifics and can't answer the individual things you have mentioned, if you wish — you can let me know — I will look into that, and I can either answer you privately or answer you here, as you wish. I understand that that has already been done.

The nurses. There is no question that we've got problems with respect to that. I think we all understand that this is basically an individual problem between hospitals and their respective staffs. You say I should exercise some leadership. I think perhaps you are right. I think perhaps it is time that the Health ministry found new ways to show some leadership without, on the other hand, appearing to be interfering to the point of running the hospitals. That is always a very difficult line to tread. I think that you would appreciate it.

Some hospitals have more difficulty than others in this respect and some of them have the same difficulties, but for different reasons. Royal Inland in Kamloops, for example, has the shortage-of-nurses problem and doesn't have the same ability to replace as the Vancouver General Hospital

[ Page 3273 ]

does, because, for reasons I can't fathom, people would rather live in Vancouver than in Kamloops. These difficulties do happen.

I think that perhaps you are right. We perhaps should at least try to bring in some general guidelines or offer some more assistance. Because of the situation arising now — I guess it is reactive on my part, but it is the old story of the alligators in the swamps, I suppose — I have certainly asked my staff to see what we can do to alleviate a problem which, as I said in the House yesterday, has been ongoing for many, many years — to varying degrees, to be sure. Nobody seems to be able to predict when it is going to be bad and when it is going to be not so bad. In any event, I think we should perhaps do something about that.

I mentioned a couple of the difficulties in the House yesterday. One of the main difficulties, of course, is that, regardless of what you say, there is, I am instructed, a very strong groundswell of opposition to unhappy hours of work by married ladies who have children. Generally speaking, although there are some who will adapt, most of them want to work the same hours as their husbands do, and there are not enough nurses who are prepared to say: "Yes, we will, on a regular basis, work the hours that are undesirable." You're right, there are some. I'm sure you can always find plenty of people who say: "Yes, I'd just as soon work that shift, because I like to sleep in in the morning and go and do my hobbies or whatever in the afternoon in the daylight." Unfortunately there are just not enough.

I may have missed some of the questions that you asked, Madam Member, but I think I've covered most of the points that you raised.

MR. LEVI: Mr. Chairman....

HON. MR. MAIR: You again? I thought I'd got rid of you.

MR. LEVI: No, I'm following you every inch of the way, Mr. Minister.

I wonder if we can get the minister, after I sit down, to comment on the impact of the new financing mechanisms which have gone on in respect to the federal government. We have discussed this before in this House, and I did hear him talk about the three types of block funding from Ottawa. We have argued, both when we were government and, I think, since then, that there was something really very wrong with the concept that provinces should in fact get themselves into the position where they are accepting block funding. The transfer-payment situation — that is, a tax transfer — was beneficial to provinces that were have provinces.

I can recall during the various conferences I was at that we felt that to go for the tax points was really to break up what was really looked upon as a federal medicare system. That is, we in Canada set out, I think, to achieve a basic minimum standard across the provinces. That was the objective in health. That was the objective, also, in social services. That was the import of the Canada Assistance Plan. Certainly it was the import of the agreements that were made on the various health programs.

That is seeing it from a federalist point of view — that we, as a have province, were as interested in the standards of health care anywhere else in the country as we were.... Not that those have provinces should get into the position.... I recall at the many conferences I was at that you would always hear from Alberta and Ontario that they much preferred to get out of the cost-sharing program idea and get into the tax-point stuff. That was all very nice because it was very advantageous to the have provinces. But it does something to the federalist concept — which I have heard argued on that side of the House too, in terms of the general topic of federalism. It does have some impact on health care in the rest of the country when provinces decide to go this route.

As I understand it, as a result of the earlier declaration that was made, I think in 1975, when Marc Lalonde was minister.... He started to put a cap on the kind of money they were going to make available to the provinces. As a matter of fact, if I remember rightly, 1976 was the first year in which they said: "We will pick up no extra costs beyond 13 percent over the agreed budget." The following year it was 8, the next year it was 8, and then it was 5 percent. I think we are into the last year of the 5 percent.

Now this, presumably, has had some impact on the revenues of the province. I'd like the minister to comment on that. It has had some impact, as I understand it. Three years ago we were looking at something like.... Well, let me put it this way: I think we should deal with this year, not two years ago. Probably where you're looking at cost increases of 11 percent, you're going to get something like 8 percent from the federal government. You're not even going to make the cost of living in that respect. Now this has to have an impact. I think part of this is somehow because of the impact, the readiness, in some respects, the have provinces, who tend to be very powerful at the bargaining table federally, have had on the situation in respect to the costs related to the administration of health care.

Now I know that the federal government was upset about the kinds of costs that they had. That was a problem they got themselves into. They're not very great managers. Even I'm prepared to see that they're not. So they said: "Well, we're going to stop being as generous as we are." And then down the road, around 1977 or 1978, we get the agreements to take the tax points advantages rather than the sharing. Now surely this has to have a very serious impact on the province's financing.

I don't know what the discussions will be in the future. I suppose we're all waiting very eagerly for Mr. Justice Hall's report, which may really only be a report card. He's an excellent man; he's one of the creators of the whole thing. Nevertheless, he may only comment on the fact that back in 1964, when he made a number of recommendations, and then in 1965 and 1966 when the provinces started to come into the general medicare program — and I think this province came in in 1967.... He'll be taking a look at it, because I note that in the minister's brief to the commission in Vancouver he talked about some of the things that the province — I'm not just talking about his government, I'm talking about the governments since 1967 — has been able to do.

I would hope that Mr. Justice Hall will make some comments about the financial problems.... There's no question that the costs only go up. I don't ever recall costs going down in government. Which leads us really to the kinds of measures we can take. We often talk about prevention. I notice that the minister and his predecessor, for example and to their credit, quit smoking and quit drinking. They didn't read after 10 o'clock at night and did wonderful things — lost a lot of weight and look darned good. Surely

[ Page 3274 ]

there's got to be a lot more to preventive health care than that. There's got to be a lot more to it than just talking about smoking being had for you. The Chairman and I agree that smoking is not bad for the Chairman or for myself. We both smoke like a couple of chimneys. Surely that's not really preventive medicine.

I appreciate that when they look at some of the figures, particularly in relation to heart attacks, these are contributing factors. They have been used as examples — so have they been used in terms of the problems of emphysema. But what about the broader understanding of preventive health care? For instance, I hate to lay this onto the schools, but what kind of preventive health care goes on in schools? I think the minister knows as well as I do that sometimes you can walk through schools, take a look at all this fast food stuff and get quite upset about the kind of nutrition habits that people have. Mind you, I'm told by some school principals that we have them there mainly because for some kids that's the only kind of diet they get and it's not all that bad if they're not getting a very good diet in the first place.

What about the broad question of the prevention side? What we've concentrated on in the past years are the service kind in the sense of the ambulance service, the emergency situation, Pharmacare programs, day-care and hospitals, which are concepts that certainly need broadening. I appreciate that all of this, if we were to do it in concert with everything else that's going on, would cost an enormous amount of money. Some very hard decisions have to be made about the kinds of things that we very seriously want to get out of. I don't want to talk now but I'd like to talk later, for instance, in the long-term care area, about the very intensive need that we have in long-term care for day-care programs within long-term care facilities; where people come up the street into that facility for the day and then go out. That's another way; that has to be part and parcel of home care and the homemaker program. What I've really been trying to say to the minister is that surely there have got to be some serious impacts in respect to the kind of financial arrangements that are now available between the federal and provincial governments.

He explained before about where the money goes, the requirement — by statute, I gather — that has to be spent on hospitals and the medicare program. The one, the tax transfer, is also earmarked. But what about the general impact? Has the minister gone through an estimate process? He has presumably been told: "You've got to watch what you're spending here." But surely the kind of decisions that were made three and four years ago, I say to you, have had a very serious impact on the kind of financing that is going on, so much so that I think it has led to the kind of decisions that have been made with respect to increasing premiums and even to the very bold step — it is a bold step — of indexing premiums. As my colleague for New Westminster pointed out, you only have to do it once and then you just look at the consumer price index and say: "Well, I can't help that. That is the consumer price index. It is no longer my fault."

It is like the kind of thing we expected from the Ministry of Human Resources when the great debate went on about indexing GAIN. It never was indexed. Remember the federal government when they indexed old-age pensions? I am quite sure, even to this day, that they rue the fact that they ever did that, because it cost them a lot of money. What is going to happen to the plan you have, given the state of the economy, is that the outcry is going to be very, very long and hard almost every year because — and I appreciate there are people who come under the program where there is the subsidy — it is going to cut into people's disposable income. It is tough enough now. What we have to get from the minister is how we got to this particular kind of situation. Surely it has to go back to the kind of financial arrangements that you agreed to three or four years ago.

[Mr. Hyndman in the chair.]

How do we get out of the inescapable problem of the increase in health costs? It's got to be not just talking about the sometimes rather small programs of preventive health care but something on a broader scale. Again I'm loath to constantly load it on the schools and school districts, but how oriented are our young people in terms of the kind of preventive health care you people have in mind? How do people see the use of the health care system? As I gather the concept, unfortunately, because I think it's a lack of general understanding by the public, we are always dealing with crisis medicine. People usually know enough to see a doctor or somebody because there is a problem. We don't have that kind of discussion publicly, constantly, about the need to have not just lip service to preventive health care but something very specific. Later on in the estimates we would like to make some suggestions about this.

I would have hoped that in the minister's presentation to Mr. Justice Hall he might have elaborated on that, which he really didn't. He did mention some aspects of preventive care. He talked about alcohol and smoking, but what are his views? We're at the beginning of his estimates. I think that we would like to get from the minister some kind of philosophical idea. We've already had him enumerating to us the differences — and there are very great differences between how we see a medicare program operating and the way he sees it. He only says there are differences; I'd like him to categorize for us what these differences are.

We happen to believe, for instance, in terms of people on fixed incomes, that there has to be the broad kind of income support that's available to cover that cost. All right, that's done in respect to 400,000 people in this province. But we know from the facts, when looking at those people who are not getting the salaries, because of people who are organized, that there's another group beyond the 400,000. It's an income test — not a means test as such, but an income test. There's a whole group of people who are also missing that opportunity to get some coverage. That's the great difficulty when you get into the business of maintaining premiums. It's very, very difficult to introduce a universal program and then say that everybody is equal, but bring those people who are a little bit unequal up to a certain level. There's always a group of people in the middle that don't get the advantages of that kind of subsidy. That's why we've argued in respect to the goal of removing those kinds of premiums.

I think it's a worthwhile goal, because one of the interesting things that we found when we dealt with the Pharmacare program.... The minister mentioned that in his brief. Probably one of the most impelling reasons to create a pharmacare program was that in meeting with the pharmacists, I remember they told us that 40 percent of the people who receive prescriptions from doctors as some part of post-operative or continuing care simply couldn't afford to buy those drugs. For me that was an extremely impelling reason, because you spend hundreds and thousands of dollars

[ Page 3275 ]

on some kind of medical treatment and at the end of that treatment is a requirement to have those post-operative procedures, or whatever they call them. They're in the convalescence period and you need some kind of medication to be maintained. Forty percent of people involved in that kind of situation simply couldn't afford it.

Sure, they'd get some kind of sample drugs from their doctors. So that was an impelling reason to make it possible to give everybody an opportunity to have equal treatment, because it was one thing to say that people could go see a doctor, people could get the operation, but not everybody could afford that essential part which came afterwards — the business of drugs. So that's how you get into the provision of Pharmacare.

That's how we should be getting into the provision of denticare, but of course that's a whole new topic which I'm sure my colleague for New Westminster will want to pursue anyway. But that's a difference in philosophy. The minister has indicated, I think, inferentially, that that's not what they believe in; people should pay as they go. It's a little bit like pay as you go on the ferries — pay as you go on the medicare system. But that's a little different. It's almost the same kind of idea, but there's a great difference in that kind of approach, because we know that if we don't make the health system as equal as it should be, and the access....

We all know that there's the access; that's always a question. A study done in Ontario about two years ago talked about access to the system; there was no doubt that people who are bright, and usually in the so-called middle class, make better use of the health care system than people who come from lower socioeconomic brackets. They do, because they understand what it is; they understand what's available. We have an access which to some extent may be universal, but it's the usage. That's the experience they had when Townsend looked at what went on in England some years ago. They looked at this kind of situation. One has to be reminded that although we have a large medicare plan, we should be looking at who is getting the maximum benefit from it and who needs to get more benefit than they are actually getting. I thing that's important too.

Those are the kinds of things that we should also be looking at in terms of the administration of our medicare system. We have an opportunity later on to get far more partisan than I am at the moment. What I'd like to do is get from the minister his perception of where the medicare program is going. Where do they want to take it? We know that, armed with a sufficient amount of information gathered by the previous government, they implemented the long-term care thing. They did something to go towards what I think is only a partial universal medicare system.

Not everybody is taking advantage of the Pharmacare system — I don't think it's under your ministry anyway, but I'll talk about it just generally. There is a deterrent aspect to the way universal Pharmacare is operated. Certainly when you bring in your programs you always want to look at usage. If you think usage is going to be high, then you simply have to put some hurdles in the way to see that the usage is only when it's really needed — that kind of thing. But sometimes people who really need it don't even get access to it. After all, in order to get money back on the universal Pharmacare program today, you've got to spend $101 to get back 80 cents. One hundred dollars is really not that indicative of what is the usual expenditure of a family of four for a year. It's rather high. A lot of people who are in the $50 and $60 brackets will not qualify.

Interjection.

MR. LEVI: Well, you could get it in a lower way. So, again, we're talking about access and utilization.

[Mr. Strachan in the chair.]

I would like to just sit down, and let's hear the minister.... We differ, it's been said before. Where does he think the medicare system is going? What have really been the impacts of having to change the financial systems? What does he have in mind for preventive health care beyond "Don't smoke" and "Don't drink"? Mr. Chairman, with all deference to the minister, I'd like to see him and the former Minister of Health go to some other committee than Public Accounts, because I can smoke when I'm in Public Accounts. These two guys keep getting up and moving motions, and the day of the power and equality of the smoker has gone right down the tube.

HON. MR. McCLELLAND: Read that thing I sent you.

MR. LEVI: Yes, I'll do that.

So I'll sit down in hope that the minister will respond.

HON. MR. MAIR: In light of the hour, I won't deal extensively now with the points that you have raised, but I'll use the advantage of being able to read the Blues and research a little more to be able to give you a little more of a complete answer. As I said to your colleagues from New Westminster and Burnaby North — south? east? west? I can never remember. In any event, I really need a lot of help when it comes to number work. So I have to get it all prepared. And I'll do that. I'll prepare a little bit over the next day or two on the other questions that you have raised with respect to medicare and where we think it's going.

I think I can make a couple of general statements in the few moments that are left before we rise for the evening, and say: don't underestimate the use of tobacco in terms of preventive medicine. I think there are certainly other ways that we can tackle preventive medicine than simply encouraging people and urging them, and educating them when they are young, middle-aged and old, not to smoke.

That certainly is one of the most serious causes of the high costs of health delivery in the province right now. This carries on through alcohol abuse to things I mentioned earlier — obesity and unwanted pregnancies. We could run through all of those things. I'll talk, as I assured the member before, the next time we meet about some of my basic philosophies on this.

Part of it is a rear-guard action that you have to fight. You have to fight a rear-guard action against, with the greatest respect, members like the member for Maillardville–Coquitlam (Mr. Levi), who just took his seat. He will make a case that smoking only bothers somebody else and it doesn't bother him. I guess there are three things that you have to consider: first of all, the damage it does to you, secondly, the damage it does to people who have to inhale the smoke that you get rid of; and, thirdly, the costs that society as a whole must bear for your stupidity and the other person's reluctant inhaling of your smoke. I don't mean this personally but this is one thing that we have to consider.

[ Page 3276 ]

MR. LEVI: I'm taking it personally.

HON. MR. MAIR: Don't take it personally; just don't smoke. If you are going to smoke, don't smoke anywhere near me.

These things carry on through the other aspects of it. I've talked for a long time — and I don't mind; it's probably a good time to do it — telling you why I oppose the advertising of beer and wine on television. Contrary to popular misconception, I am not a teetotaller by any stretch of the imagination. I am sometimes, but I'm not most of the time. I think that those who would argue that it's just another product and if you can sell the product in British Columbia you should be able to advertise it are missing the point. We are not talking about food, soft drinks, underarm deodorants, or anything of that nature. We are talking about a drug, the most serious and most abused one of all. I just don't think the same rules apply. Again, it's a rear-guard action that you have to fight as part of the preventive-medicine thing.

I'm sure we are going to talk more about the question of unwanted pregnancies. I don't think you tackle it by trying to reduce abortions. People who have misunderstood or misquoted me or whatever on that score are really missing the boat. But you do have to tackle it on the basis of unwanted pregnancies and you've got to find some way to overcome that problem. Again, you are fighting a rear-guard action against those people who, rather than see the problem as it is, a preventive-medicine problem, would see it — perhaps not consciously — in an emotional or religious or some other context. This is another difficulty, where you have to fight this kind of a rear-guard action. The same goes for a number of other areas.

We talked a little bit before about the differences in our philosophy on pay as you go and other things. I'll deal with that at greater length the next time we meet, Mr. Member for Maillardville–Coquitlam (Mr. Levi). But I will repeat it for you because I don't think you were in the House when the member for Burnaby North and I spoke about this. I'm not so sure we're really all that far apart. It may just be a different way of getting at the same thing. Perhaps what I am saying is that when you and I go to hospital, $5.50 a day is not an unreasonable impost upon us for that stay. It doesn't even cover the food that we are going to eat. When somebody can't afford that $5.50 a day — we can talk about how you can demonstrate that — then they shouldn't have to pay it. Human Resources or some other way should pick that up. I prefer that way because it means that you and I do in fact pay something we can afford to pay in addition to what we pay by way of taxes. I'm not so sure we really haven't gotten to the same place by different routes. We will talk about that, I'm sure, the next time we get together.

The House resumed; Mr. Davidson in the chair.

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

Hon. Mr. Williams moved adjournment of the House.

Motion approved.

The House adjourned at 5:54 p.m.