[ Page 3355 ]

CONTENTS

Routine Proceedings

Oral Questions.

Ministry of Education "special mailing" to teachers. Mr. Lauk –– 3355

Reopening of Maplewood poultry plant. Mr. Ritchie –– 3355

Ministry of Education "special mailing" to teachers. Mr. Lauk –– 3356

Grant to Whistler Development Co. Mr. Passarell –– 3356

Legal fees charged to Fort Nelson band. Mr. Brummet –– 3356

Communications between federal and provincial Energy ministers. Mr. D'Arcy –– 3357

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

On vote 1[4: minister's office –– 3357

Mr. Cocke

Mrs. Dailly

Mr. Nicolson

Mr. Segarty

Mr. Lorimer

Mr. King

Mr. Mitchell

Mr. Passarell

Mr. Stupich

Tabling Documents.

Urban Transit Authority of British Columbia annual report.

Hon. Mr. Vander Zalm –– 3379

The House met at 2 p.m.

[Mr. Davidson in the chair.]

Prayers.

HON. MRS. McCARTHY: In the gallery today, Mr. Speaker, is a good friend of yours, who is also a constituent of our Whip, the hon. member for Dewdney (Mr. Mussallem). I would like the House to welcome Ken Olma.

HON. MR. FRASER: I'd like the House to welcome today Mrs. Kellett from Canim Lake in the Cariboo, along with her sister Mrs. Wright and niece Mrs. Neil from the great province of Ontario.

MR. LOCKSTEAD: We have in the gallery today the leader of the Real Share Value Party of British Columbia, Mr. Grant Carson. I ask the House to join me in welcoming him.

HON. MR. WATERLAND: Rabbi Markowitz advises me that we have a distinguished Canadian author in your gallery today. I ask the House to please welcome Monte Vanton.

MR. RITCHIE: I am pleased to introduce to the House today Mr. and Mrs. Jake Friesen, their daughter Loma, and friend Rosie Loewen from Clearbrook, central Fraser Valley. Would the House please extend a welcome.

HON. MR. MAIR: I am very pleased to tell the House today that sitting in the gallery with my wife is my mother-in-law, Mrs. Dorothy McMicking. I would like the House to join me in making her welcome.

HON. MR. WILLIAMS: We have in the galleries today from Auckland, New Zealand, district court judge Bergin with his wife and daughter, who are visiting British Columbia. I ask the members to welcome them.

MR. HYNDMAN: In the gallery today are three hardworking students from Vancouver South, who are conducting, as a summer project, the Vancouver South Progressive Cultural Study. Would members welcome Jennifer Sheng, Kim Perrin and Ranjit Jagpal.

HON. MR. ROGERS: Some people were hoping that this far along in the calendar year most students would be out of school and maybe the Legislature would be adjourned. Nonetheless we are still here. There are 55 grade 10 students from Tupper Secondary School here today with their teachers, Mr. Sandhu and Mr. MacKenzie. Since they are in school and we are still in session, I would ask that we mutually welcome each other.

MR. NICOLSON: In the gallery today are three ladies who are attending the University of Victoria summer school: a constituent, Margaret Bonser, and two former students from L.V. Rogers Senior Secondary School who I knew at that time, Elizabeth and Linda Bossio.

Oral Questions

MINISTRY OF EDUCATION
"SPECIAL MAILING" TO TEACHERS

MR. LAUK: I have a question for the Minister of Education. On July 14 of this year all clerical staff in the Ministry of Education were directed to work on the preparation of an address list of all public school teachers in British Columbia for the purpose of a "special mailing" on an unknown matter of a confidential nature. All other clerical work in the ministry was to be held in abeyance until this task was completed. Did the minister authorize that directive?

HON. MR. SMITH: I haven't seen the directive, but I certainly authorized the obtaining of the lists and it's appropriate that the minister have such a list. I will authorize the obtaining of lists of teachers in this province to communicate with them from time to time in the future.

MR. LAUK: The reference was to a "special mailing" of a confidential nature. It had nothing to do with communications in the future. Does the minister understand what directive I am referring to?

HON. MR. SMITH: I've already answered that I have not seen that communication. I heard his question. I certainly requested my staff to obtain a list of teachers, and they will be communicated with from time to time.

MR. LAUK: Did the minister consult with or receive advice from the Premier on obtaining this address list?

REOPENING OF MAPLEWOOD POULTRY PLANT

MR. RITCHIE: I have a question for the Minister of Agriculture. Considering the great uncertainty in the B.C. turkey industry today and the concern of those employees who are presently out of work, I would like to have the minister tell me what he has been able to accomplish with respect to the reopening of the Maplewood poultry processing plant at Clearbrook.

MR. BARBER: I thank the member for his question, which he was kind enough to give me notice of.

MR. LEA: And I just happen to have the answer with me.

DEPUTY SPEAKER: Order!

HON. MR. HEWITT: Mr. Speaker, at least the member for Central Fraser Valley (Mr. Ritchie) is concerned, I notice the agriculture critic is absent today. I thought maybe she would ask the same question.

MR. LEA: No, she's over there.

HON. MR. HEWITT: No, she's probably at home or having a holiday.

SOME HON. MEMBERS: Oh, oh! Withdraw!

[Mr. Speaker rose.]

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DEPUTY SPEAKER: I ask the member for New Westminster (Mr. Cocke) to take his seat, please. A point of order has been raised by the member for Nelson-Creston.

[Mr. Speaker resumed his seat.]

MR. NICOLSON: Mr. Speaker, on behalf of the member who is not present and on behalf of all hon. members, I would ask that the Minister of Agriculture withdraw those remarks in which he implied that the member is away for some frivolous reason.

DEPUTY SPEAKER: A withdrawal has been asked by an hon. member. Would the Minister of Agriculture undertake to so withdraw?

HON. MR. HEWITT: Yes, Mr. Speaker, I withdraw if it's of concern to the opposition.

To the member for Central Fraser Valley, I have communicated with Ottawa over the last four weeks since the plant has closed for the second time. I have sent telegrams to Mr. Whelan, the Minister of Agriculture, Mr. Gray and Prime Minister Trudeau to attempt to indicate to them that this is a major problem in British Columbia. While it might seem to be a minor problem to them, it affects the lives of some 135 employees and turkey producers in this province. I had an opportunity to attend the Ministers of Agriculture conference in Toronto this week, and had I been able to pair with the opposition I could have gone down and eye-balled Mr. Whelan to attempt to implore him to deal with the matter, which is most important to the agriculture industry of this province.

When you consider the jobs of the farmers and the workers in the Maplewood plant.... That opposition doesn't recognize that we have a duty to perform to the people of this province; you'd think they would consider that attendance of a meeting such as that would be most important. I would advise the member for Central Fraser Valley that I understand that members of the turkey association have now gone to Ottawa to meet with Mr. Whelan, who has left the Ministers of Agriculture conference now and is back in Ottawa. They are meeting with him to implore him to make a decision on this matter in order that that plant can be reopened.

MINISTRY OF EDUCATION
"SPECIAL MAILING" TO TEACHERS

MR. LAUK: Continuing my questions of the Minister of Education, Mr. Speaker, I asked the minister: with respect to this address list of public school teachers in the province, did he consult with or was he advised by the Premier?

HON. MR. SMITH: I consulted with a number of people.

MR. LAUK: I take it then that the answer is yes. Can the minister advise why the directive states that progress must be reported to the Premier's staff on a daily basis?

Assuming that the mailing is for a piece of political propaganda, does the minister agree that this is an abuse of the taxpayers and of the civil service of the province?

HON. MR. SMITH: No, I don't agree. As I told the member in response to his first question, I have not seen the memo.

MR. LAUK: I undertake to table the memo right after question period, Mr. Speaker.

To the minister, will the opposition be entitled to send out its message to B.C. teachers using the same list?

HON. MR. SMITH: I thought that the member had his own list.

MR. LAUK: I don't have my own list. Would the minister undertake to provide us with the list so that we could use the same list to send out our message to the teachers of the province?

HON. MR. SMITH: No.

GRANT TO WHISTLER DEVELOPMENT CO.

MR. PASSARELL: My question is to the Provincial Secretary. It relates to a $400,000 grant recently given by the minister to the Whistler Development Co. for a resort centre. Is it government policy to subsidize the private developers involved in this project by constructing resort facilities from the public purse?

HON. MR. WOLFE: Mr. Speaker, the member is referring to a grant under the recreational facilities program, I believe. The answer to his question is no.

MR. PASSARELL: Is the minister extending an invitation to other recreational developers to apply for construction of tennis courts, golf clubs, ski chalets and swimming pools by using public funds?

HON. MR. WOLFE: The member should already be aware that a number of grants in the areas he's suggesting have already been made throughout the province and in areas not very far away from where he resides.

MR. PASSARELL: In view of the minister's announcement of $400,000 for the Whistler resort, can the minister advise whether he is now turning his attention to the total lack of playing fields in the Atlin constituency?

HON. MR. WOLFE: No, I don't think we should allow the impression to be gained that these grants are for other than community purposes. As has been the case and the policy in all recreational facilities, including the one at Whistler, it is for general community purposes; it has been part of the request from that municipality, in terms of its broad use by the community at large — not for private developers.

LEGAL FEES CHARGED
TO FORT NELSON BAND

MR. BRUMMET: Is the Attorney-General aware that the Fort Nelson Indian band is reportedly faced with a $5 million legal fee for the recent gas royalty settlement?

HON. MR. WILLIAMS: I was unaware of the amount mentioned by the member until I saw the press earlier this week. I was certainly aware that the lawyer who advised the Fort Nelson Indian band would be paid for his services. Mr. Speaker, I can assure you and the member that the matter of the management of the funds which will be received by the band under the agreement and the expenditure of those funds

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falls under the responsibility of the federal Minister of Indian Affairs and Northern Development. With respect to this legal account, that matter has already been raised by me with the federal minister and is being dealt with by his officials.

COMMUNICATIONS BETWEEN FEDERAL
AND PROVINCIAL ENERGY MINISTERS

MR. D'ARCY: Mr. Speaker, it seems to be something of a Fraser Valley day. My question is directed to the member for the great riding of Langley, who has all that fine agricultural land in his capacity as Minister of Energy, Mines and Petroleum Resources.

Did the minister authorize the leak of his own personal and confidential letter dated July 16 and addressed to the Hon. Marc Lalande?

HON. MR. McCLELLAND: I didn't authorize any leaks. Leaks are generally referred to when somebody, authorized or unauthorized, sneaks around and gives somebody something they shouldn't have.

I was and still am extremely angry, upset and disturbed about the actions of the federal minister. I saw no need, in an incident which has such broad implications...that it should be public knowledge. The press in our province serves as the instrument to deliver to the public those things which are of concern to the public. I have no objection to the people of British Columbia understanding exactly how their government feels about a matter of such delicacy and concern.

MR. D'ARCY: Can the minister indicate to the Legislature that he has decided that in future it will be his practice, when communicating with ministers of the federal government, that before they receive the communication someone will take it from his office and nail the communication to the wall in the press gallery to make sure the press is in receipt of that before the people in Ottawa are?

HON. MR. McCLELLAND: If there is some concern that the public of British Columbia shouldn't know about issues of very deep concern — and all members of this House should be concerned — then that is the position taken. I have no objection to the people of this country knowing exactly how I felt about the events that took place.

MR. D'ARCY: Can the minister tell the House, in view of what he has said in his answer to my previous two questions, why the letter was marked "personal and confidential" in the first place?

Interjections.

HON. MR. McCLELLAND: I would be happy to answer that question for the member. The members opposite treat this quite lightly. This government, and I as a minister, find that not only were the actions which were taken by the federal minister incorrect and improper, but they were wrong and must not ever be repeated again. It cannot be possible for me, as a minister of the Crown, to enter into the same kind of delicate, frank and hopefully confidential discussions about delicate issues facing the people of British Columbia with the same kind of confidence that I've had in the past. If the members opposite aren't concerned about that, Mr. Speaker, then I think they should just stop for a moment and reconsider their position. It is common practice to have letters addressed to colleagues — whether in your own government or in governments with which you have some dealing — labelled "private and confidential" so that they go directly to the person for whom they are intended. [Laughter.]

Mr. Speaker, I hope that it's being recorded very carefully that the members opposite find this a joking matter.

I don't mind saying that I was angry, and I'm still angry. I find the actions by the opposition and the minister responsible in this regard to be extremely disturbing.

Orders of the Day

Mr. Lauk tabled documents.

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

ESTIMATES: MINISTRY OF HEALTH
(continued)

On vote 14: minister's office, $165,162.

HON. MR. MAIR: Mr. Chairman, recognizing that the vote was about to go through, and the risk I run in rising, I would nevertheless like to rise on two points. First of all, I would like to assure the hon. member for New Westminster (Mr. Cocke) that while I have not got anything further to report on the Pacifica matter — if I may refer to it as that — which he raised yesterday, my staff is working on it. I do expect a report, but I think he would agree with me that it makes no sense to come back piecemeal; I may as well get the searches done and all of the things necessary before rendering a report.

Of course, if the member is at any time not satisfied with the progress of that, then he will question me. I'm not implying that there is anything particularly serious about it, but I think it does involve some land registry searches and some searches at the companies office with respect to societies and things of that nature. So it will take me perhaps a day or two more.

There is one other matter before we proceed, if I may. I did — and quite rightly, I think — apologize yesterday to the members opposite for suggesting that they had brought in the act which lowered the age of majority in this province. The hon. member for New Westminster quite correctly called me to task. As I say, I did apologize because I was wrong. But I do think that in light of the remarks I made earlier with respect to that — because I was very critical of that decision insofar as it may have encouraged young teenager drinking — I should just point out that Hansard of March 17, 1970, has this very short insertion from Mrs. E.E. Dailly, who says:

Mr. Speaker, we in the official opposition are, of course, most pleased to endorse this bill

— that is, the bill to lower the age of majority —

because as the Attorney-General stated, we too feel that the young people today are certainly worthy of having this age dropped to 19. We also feel, of course, as the hon. Attorney-General stated, that there are added responsibilities with a bill such as this, and I think it points up two things that will be necessary, and I hope that the government will follow along with such a bill.

[ Page 3358 ]

She goes on to make a short statement, which if the member wanted I would read in full.

In any event, I only bring this out to point out that while I was wrong in saying that the New Democratic Party brought in that bill — and clearly wrong, for which I again apologize, if necessary — the fact of the matter is that the blame — if I am correct in assuming that teenage drinking can, to some minor degree at least, be laid to the lowering of the drinking age — lies with all sides of the House, because as I understand it, at that time a party called the Liberal Party — which is not heard of very often in this province these days — also voted for it.

MR. COCKE: Mr. Chairman, I am becoming very concerned about the replies on the whole question of Pacifica. A few days ago I charged that the Pacifica development — that was the alcohol and drug development in New Westminster — was a development by Wolstencroft Realty, a real estate developer, and the minister replied that BCBC would be doing the work. He has since found that that probably isn't the case, that they will be doing the renting. I would have hoped that by now the minister would have gone to his predecessor, the Minister of Energy, Mines and Petroleum Resources (Hon. Mr. McClelland). That left an impression in my mind today that I'm not too sure I can believe what he says. But in any event, I would hope that we can get some kind of advice on this whole question of Pacifica. There has been a tremendous amount of criticism. I will leave that subject for now.

Last night just before adjournment, I talked about the deplorable conditions in the ambulance service headquarters across the province. I brought in a number of examples indicating how we house these very important people who are contributing to the life and health of the people here and are serving us well. It is a program that we should all be proud of. Mr. Chairman, I think it is a program that this government, over the past four years or more, has treated with disdain. It has not given the ambulance program and the emergency health services program the support that they warrant. I pointed out that Reader's Digest recently had a three- or four-page article talking about our paramedics, indicating what a first-class program it was. Many of us are very supportive, and naturally I'm very proud of the program.

But recently the Ministry of Labour sent in an inspector to inspect the premises of the Emergency Health Services Commission at 483 West 16th Avenue — that's their major ambulance headquarters in Vancouver. What did that inspector find out about the ambulance headquarters in Vancouver, which should be at least — because it was the original headquarters and houses so many people — the cornerstone of the Emergency Health Services Commission, in terms of the housing of their very important people, their ambulance attendants?

I would like to read, for the record, the letter from that inspector, who incidentally did his inspection as recently as June 18 this year. His letter is directed to Mr. Robert M. Baxter, coordinator of Zone G. Incidentally, that is the zone that takes in the greater Vancouver area for the Emergency Health Services Commission. He says as follows:

"Dear Mr. Baxter:

"At the request of the Ambulance Employees Union, local 873, I inspected the premises at 483 West 16th Avenue on June 18, 1980. The purpose of this letter is to confirm our conversation of June 19. The first part deals with corrective measures required to comply with the Factory Act and regulations of British Columbia. Following that are a number of recommendations based on the complaints submitted by the employees and my own observations."

Mr. Chairman, what I read from here on in are submissions by the Ministry of Labour to the Ministry of Health telling them what is necessary to bring this facility up to the level that is required for employees of any firm or any organization. These people have been living in these conditions for years. Note that none of these aspects are there now. This is a directive stating what has to be done to bring it up to the level required for employees.

"1. Lunch room for ambulance crews. The kitchen and eating area shall be a self-contained room to be used only for the preparation and eating of meals, and shall be equipped as follows:

"(a) The floor shall be impervious to water.

"(b) The walls and ceilings shall have light coloured washable surfaces and shall be maintained in a clean and sanitary condition.

"(c) Exhaust ventilation discharging to the outdoors shall be provided and shall supply not less than six room-volume air changes per hour.

"(d) A two-compartment sink shall be provided and shall be connected with a source of hot and cold water.

"(e) An enclosed cupboard shall be provided for storage of food, dishes and utensils.

"(f) Sufficient table with impervious-top surfaces and individual chairs equipped with back-rests shall be provided.

"(g) Appliances for heating and cooling of drinks and food shall be provided. Because of the nature of the work and the length of the shifts these appliances should consist of a full-size range and refrigerator and small appliances normally associated with a domestic kitchen.

"(h) Suitable dishes and utensils in sufficient quantity shall be provided.

"(i) Sufficient waste receptacles with self-closing lids shall be provided."

None of these conditions exist now, Mr. Chairman. That's why these recommendations are in here. That's why he is bringing this to the attention of the Emergency Health Services Commission.

"2. Lunch room for dispatchers. Provide a lunch room equal to that described for ambulance crews. A possible alternative would be to allow sufficient time for the operators to make use of the facilities provided for ambulance crews.

"3. Washrooms. Provide separate washrooms for male and female employees with separate approaches with signs clearly indicating for which sex the washrooms are provided." They are not now.

"4. Clothing for ambulance crews.

"(a) Provide a change room for clothing not worn by employees during working hours, and

"(b) a separate change room for work clothes which may have been exposed to toxic, noxious, irritating or infectious material or substances.

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"(c) Change rooms in (a) and (b) shall have separate approaches and a shower room containing not less than two showers and shall be located between the two change rooms to reduce the risk of transferring contaminants from work clothes to street clothes."

This is not the case now. They don't even have one shower. They may come in covered with contaminants, covered with infectious material, covered with all of these substances, and they haven't even got a shower. The directive continues:

"(d) change rooms and shower rooms shall be heated to a temperature of not less than 68 degrees Fahrenheit or 20 degrees Celsius, measured at five feet above the floor;

"(e) exhaust ventilation shall be provided in change rooms and shower rooms to supply not less than six-room volume air changes per hour; and

"(f) each change room shall be equipped with sufficient lockers to accommodate the maximum number of employees on both shifts."

He goes on to make further recommendations. Mr. Chairman, the ambulance drivers are working in conditions that other workers in our society would not have to work under, by virtue of the fact that the Ministry of Labour would go in and close them down. But the Ministry of Labour would find it very difficult to close down a working headquarters operated by the Ministry of Health. This isn't unique; this is true of virtually all of the ambulance headquarters. It's a shocking situation, in my view.

I suggested to the minister yesterday that he get on with the minister responsible for the B.C. Building Corporation and get those headquarters so that the ambulance drivers are not working under conditions that we wouldn't expect any other person to work under.

"Health and safety recommendations:

"(a) provide a route for ambulance crews to allow them to pass from the vehicle parking area to the change room, washroom and shower areas without coming into contact with other occupied spaces. The route shall have an impervious floor covering free of joints, an impervious wall base at least four inches high to provide a seal at the angle formed by the floor and side walls. All finishes shall be of a material that will not provide life support for lice and and other living organisms."

Ambulance drivers, Mr. Chairman, are faced with some rather unusual situations when they go to the scene of an accident or to the scene of a severe illness.

"(b) provide containers and tight-fitting lids for the disposal of clothing, linen, blankets, etc., which may have been exposed to contaminated materials or substances."

"General recommendations:

"Improve the working environment in the dispatch area as follows:

" (a) provide an improved ventilation system to supply not less than 35 cubic feet per minute per person of clean outside air.

" (b) refinish the walls and ceilings with warm coloured materials having a reflectance value of not less than 40 percent and not greater than 60 percent.

" (c) provide a convenient, safe evacuation route in case of an emergency.

''Completion of the lunchrooms, washrooms, change rooms and shower room is required within a reasonable time. A reply advising us of completion or your schedule for this work is required within 30 days.

"Serious consideration should be given to the recommendations. I welcome your comments in this respect. I further recommend that a practical set of minimum standards for ambulance stations be drafted, and these standards should be based on the nature of the work, the health hazards involved, and the length of the shifts worked. In this respect I offer the assistance of this branch.

Yours truly,

The Inspector."

Mr. Chairman, I ask the minister two questions on this. Firstly, is he going to follow the last recommendation of setting the standards for all ambulance headquarters? Secondly, will he advise within 30 days whether or not he's going to conform to the demands made by this report and by this inspector?

Interjection.

MR. COCKE: The first question was based on this last recommendation: "I further recommend that a practical set of minimum standards for ambulance stations be drafted." I ask the minister if he will do so.

The second question is whether he will reply within 30 days. The request on this particular one was: "Completion of lunchrooms, washrooms, change rooms and shower room is required within a reasonable time. A reply advising us of completion of your schedule for this work i required within 30 days." That's 30 days of the date of this letter.

HON. MR. MAIR: Will you let me have a copy of that letter?

MR. COCKE: Mr. Chairman, I will provide the minister with a copy of this letter. I'll have this copied and I'll provide it to you. I'm going to yield the floor to one of my colleagues very shortly.

Mr. Chairman, I want to deal just for a moment with two orders-in-council, 1299 and 1300. Order-in-council 1299 provides that John Bell of Vancouver be engaged as a special consultant on health care to the Minister of Health for a period commencing June 6, 1980, and extending until December 31, 1980, at a remuneration not to exceed $10,000.

The same day, Mr. Chairman. order-in-council 1300 does exactly the same thing for a company called Pilgrims Endeavours Ltd. I would like to know what these two consultant firms are doing — one being a consultant and one being a firm. Another thing is that I find it rather a coincidence that Mr. John Bell of Vancouver is the consultant that I marked 1299, and Pilgrims Endeavours Ltd. is operated by Donald H. Bell. I wonder if there's any relationship between those two people. Pilgrims is Bell and the other guy is Bell, and I'm just wondering for whom the bell tolls.

AN. HON. MEMBER: For thee.

MR. COCKE: "For thee, " he says joshingly.

Another one was Apen Consultants, also appointed by order-in-council 20, but that was back in January. Also,

[ Page 3360 ]

Pilgrims were appointed at that point too, but that was for the first six months of the year.

One other thing: the minister also appointed — and I'm not going to read all their names — the employees of Deloitte Haskins and Sells Associates. He names 14, I gather, consultants, accountants etc., who he appointed as inspectors for private hospitals throughout the province. I would like to know what they were doing. Now that their report should be complete, can the minister give us an idea of what he obtained in terms of a report — what they had to say about the private hospitals in B.C.? This is no trick question. I just want the answers to that particular question.

HON. MR. MAIR: You're distinguishing that from the other questions, are you?

MR. COCKE: No, I'm not. This is the trick question.

I'm most concerned about something that, when I was Minister of Health, I tried to avoid. We were asked on a number of occasions to use the social insurance number for medicare. I suggested that it was not a good idea, because there was a potential of an invasion of privacy. We are now partly moving in that direction. Hopefully, under this minister, it will be stopped.

But listen to this. What we're doing now in the department is computerizing the billing card, which we are now required to submit to the Medical Plan of B.C., and we're now required to write out a diagnosis or complaint on that card. Anybody with access to those computers has access to the fact that I might have had a nervous breakdown, cancer or some other illness. I think that the minister better answer this question pretty carefully, because it's a very sensitive area as far as I'm concerned.

I've got a copy of a letter. I would like to refer the minister to a letter from a Dr. Brian Marr on December 4, 1979.

HON. MR. VANDER ZALM: What's his SIN number?

MR. COCKE: I can't tell it.

HON. MR. MAIR: I didn't ask for that.

MR. COCKE: No, the Minister of Municipal Affairs, your helper back there, your continual source of strength and help. That minister probably knows more about SIN numbers than anybody here. Anyway, I am very concerned. We can go into this letter in greater detail later.

I would expect the minister to give me a couple of replies, and I would suggest very strongly to the minister that the former Minister of Health, the Minister of Energy, Mines and Petroleum Resources (Hon. Mr. McClelland), has not given him details on a number of aspects of the Alcohol and Drug Commission. I suggest that we get a report on the whole Pacifica project and we get it soon, because I don't think that it was up front; I think that the whole thing is a scandal, and we must have an answer on that.

I want the minister to assure the House that the ambulance headquarters in this province are going to be brought up to a standard fit for people to work in. That's little enough to ask for one of the most important services in our province. The second thing I'd like to ask while he's thinking about that is that he bring up the numbers to the required number. We've been running with 200 short for months and months.

On a number of occasions I have talked to ambulance drivers and attendants who have told me that they've worked hours overtime. That is not good for the health system, because a person who is absolutely tired out cannot function in that very trying, vexing, tough job. With that I will either let the minister answer the questions or yield to my colleagues.

HON. MR. MAIR: I would like, if I may, to deal with one of two of the questions and postpone answering a couple of the others until I have a little more information.

The whole question of the ambulances and the stations, which I will try to answer in a little more detail in a moment, is compounded by the extraneous fact — I don't use this as an excuse but an explanation, and it may assist the members opposite in directing questions in due course to other ministers — that the stations themselves are in fact owned by the British Columbia Buildings Corporation and we rent from them. It is true that we obtain from Treasury Board the funds to upgrade or otherwise these particular stations, but the actual decisions on a day-to-day, year-to-year basis as to what will be done and when it will be done — even though we try to have our input and influence on those decisions — are made by the British Columbia Buildings Corporation. I recognize that this poses a difficulty and, as I say, I am not using that as an excuse. It makes it difficult to answer in a global sense and it makes it easier to answer it on a one-by-one basis so that I can check and see where each one is. I thought I would just throw that out on the table because it will probably assist the member in knowing why it is difficult for me to answer directly some of the questions he has asked about it.

As to the letters he is going to bring to me, I will deal with those when I see them. I will take a look at them and then we'll talk about it.

The two Bells that the member rang are not related. They are ministry representatives for me directly with respect to lower mainland hospital projects. Don Bell is from Pilgrims. He is the gentleman from North Vancouver who has been on the Greater Vancouver Regional Hospital Board for some time, and the other Bell's name is John Bell. I believe he has been advising the Ministry of Health in that capacity for two or three years at least. As the member knows, the sums of money which are spent in that area are probably greater than the rest of the province combined, and it helps for the minister to have some direct representation in the decision-making process at the regional hospital district level.

The Deloitte Haskins report on private hospitals. Perhaps it would assist the member if I gave the terms of reference for this review, which is of private community care facilities and private hospitals. I don't remember whether these are the precise terms of reference but, first of all, it is to determine whether payments provide sufficient funds to cover the cost of these particular organizations; secondly, to finalize rates for 1980-81; and thirdly, to develop a rate-setting procedure. I understand that that report is now complete. I have not seen it. It has not yet reached my desk but I understand it is complete and will be in my hands very shortly.

I don't know if I mentioned to the member that the amount of money that we are spending this year on the hospital stations is about $500,000 over last year in increased rent. That ought to reflect itself in upgrading some of these procedures.

I can tell you about at least one of the projects — the one at 483 West 16th Avenue. This is going to be moved to new premises. That will alleviate a considerable amount of the

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overcrowding. Two of the ambulances will be moved to 181 West 7th this year. I can go into more details on that when I have a little more information directly.

Just dealing very briefly again with the Pacifica question, I want to repeat that I don't, by postponing giving an answer, want to imply that there is something sinister or something terrible or something awful in that situation. I am simply saying that the member for New Westminster has raised questions of legality, in the sense that we are talking about registries. We are talking about the land registry, the companies registry, and who the directors are and so on. It is going to take me a little time to get that information so that I can get back to him.

I think some of the answers are coming in. They are sort of like the elections. The upstate votes are coming in now and so that I have a chance to sort of digest them, perhaps I can take my seat and let one of your colleagues ask the questions. I will listen with one ear, etc.

MRS. DAILLY: I am going to change the topic under discussion right now, so the minister can prepare himself for a new topic.

I think most people in British Columbia are aware that the New Democratic Party has always been in the forefront, and we made it quite clear when we were the government of this province that we believed in the right of every public servant to run for political office unfettered and unencumbered by any government, irrespective of his politics.

I have in front of me a memo dated March 17, 1980, which has gone out to all Ministry of Health staff from one of the the minister's assistant deputy ministers. The subject of the memo is Ministry of Health policy guidelines for members of ministry staff sitting on non-governmental agencies, boards or committees. There are a number of possible situations listed for all public health staff members. It's made quite clear, as I go through this, if I may, that the Minister of Health owes many of his public health staff a further explanation and elaboration of this memo. In my opinion, it has very serious overtones of infringement on the rights of every citizen to run for public office whether or not he is a public servant.

One of the first situations listed, which I do not quarrel with, refers to when the minister appoints someone to sit on a board. It is quite clear; everyone knows that that person is the minister's appointee. I think we accept the fact that people expect that member to relay the minister's policy. I have no quarrel with that.

Then we come to the second section of the memo. It refers to public servants — health people — who are not officially appointed but, in the course of their community activities, have been asked or elected to serve on a board. It has nothing to do with the minister asking them; the people in the community have asked them, or they have been elected to serve on a board. This refers to boards that obtain funding from the Ministry of Health — I think that should be laid out first. It is stated in the memo that in most cases it's expected, of course, that there could be the possibility of conflict which should be clear to other members of the board, and that the member should make it quite clear that he is not in any way a spokesman for the ministry and may not commit the ministry to any funds. To my mind, that's almost an insult to the intelligence of the public health person who accepts an appointment. Certainly they understand that. But I think they would find it very difficult to understand the next statement.

It says: "However, where a serious conflict, particularly political overtones" — that's the point I want to emphasize — "are likely to arise. It would be preferable for him to refrain from voting on the matter or taking part in any direct submission to government." Then it says: "Similar remarks would obtain to members in this category regarding the acceptance of office in dealings with the ministry." The final one actually states: "This refers to people who may decide to run and are elected to municipal council." I suppose that means school boards also.

Do you know, Mr. Chairman, what it actually states in this memo? It says: "Even though their duties do not lie exclusively in the domain of health and the minister, here a few problems will arise. However, where conflicts between the agency concerned" — I presume that could be a municipal council or school board — "and the Ministry of Health seem likely, the guidelines mentioned above should apply. " May I repeat those guidelines? They are the guidelines in which people who have been elected are told by the Ministry of Health that it would be preferable for them not even to vote on a matter and not even to take part in the making of any direct submissions to government. It goes on to say: "If there is likely to be a confrontation between the municipality or agency and the provincial government" — listen to this, Mr. Chairman — ''even though the Ministry of Health is not specifically involved, the staff member's position as a public servant will need to be taken into account."

I notice the Minister of Municipal Affairs (Hon. Mr. Vander Zalm) is yawning. Yet he's a former mayor, involved in municipal affairs, who acted as the head of his council. Surely he would not want to face up to the council members, for whom he was responsible as their chairman, and say: "Look, if you work for the Ministry of Health, in my council don't open your mouth on any subject which might end up having political overtones, not only with the Health ministry but the whole provincial government.'' And that minister yawns, Mr. Chairman.

"Where a staff member is likely to aspire to membership in an agency outside of government, and he has any difficulty in establishing his position vis-a-vis the government or the ministry, he should discuss his problem with his immediate supervisor and make the ministry aware of his involvement."

There are a number of people out there in the public health service of this province who are also very interested in serving their communities, whether on volunteer boards, volunteer agencies, municipal councils or school boards, and they receive this kind of memo. I've had concern expressed to me by public health staff who say: "Does this mean that I can't run for municipal council?"

Mr. Chairman, I'm simply standing up here and saying that surely the Minister of Health — despite the yawns from one of his colleagues — would be concerned enough to make it very clear that this kind of memo should be rescinded so that the public health staff of this province know that they have a right to run for public office without being told by the Minister of Health: "There are certain things you cannot vote on, and there are times when there may be political conflicts to do with the provincial government, and it would be better if you said nothing."

Mr. Chairman, I'm not going to go any further on this until I hear from the minister. I hope I'm going to hear that he.... Well, I'd hate to think he knew nothing about it, because he has to take responsibility for this memo. I hope he

[ Page 3362 ]

will advise all the Ministry of Health staff out in the province that he repudiates this interference with their democratic right to run for office.

HON. MR. MAIR: I think we'd better get an understanding as to what the Ministry of Health — and, I think, any other ministry of government — is trying to do when it sends a memo of this sort. It may be that the memo is not worded as well as it ought to be. After I see a copy of it, I may ask that it be redrawn in different terms and make clear what the position is.

I share with the member opposite the feeling, as I'm sure all hon. members do, that every public servant ought to have the right to take whatever political action — whether it's running for office or being a member of a political party, including the Rhinoceros Party, if they wish — and do whatever he damn well pleases in the political field. I have absolutely no trouble with that whatsoever.

Quite apart from the question of a conflict of interest, I may have some trouble with a member of my staff becoming, let's say, the mayor of a town, or something like that, because that may take him away from his job to such an extent that he can't do it properly. Now that's another problem.

Let's deal with the area in between. This is the area which we tried to address. If it was done clumsily, then I assure the member that I'll see that it's redone. We have tried to address the question where there is a conflict of interest, real or apparent, in what they are doing. I don't agree with the member that to point out a conflict of interest is an insult to the public servant.

I can tell you that in my experience in municipal politics — in public life as well as at the bar — the whole question of conflict of interest is a very....

MR. LEA: Which bar?

HON. MR. MAIR: Well, I'll tell you, you name them, I've been there. As a matter of fact, I've seen people looking just like you there sometimes — before reformation.

This is probably one of the least understood doctrines of public propriety. If I may just digress for a moment, Mr. Chairman, to give you an idea of how this is misunderstood, when I was an alderman on the city council an engineering firm undertook the job of advising that city council as to a community plan. That engineering firm was also the engineer for the city, in the sense they did 95 percent of the work for the city. That engineering firm also acted for the number one potential developer within the city if the community plan went through. It also acted for the number two potential developer within that city. They're a large national engineering company. When I tried to explain to them that they had enough conflicts of interest to drive a truck through, they didn't understand what I was talking about, and still don't understand what I was talking about. As a matter of fact, the Minister of Municipal Affairs of the day, who happens to be sitting not far from me and across the House, when I wrote him about that in 1974, he didn't understand either — at least, he didn't answer the letter. So I can only say that it's a very misunderstood doctrine that you constantly have to bring to people's attention. You have to point out to them that it's very difficult to separate your obligation to the government that you are working for, sometimes under oath, from that to the government that you are working for outside — that is, the secondary government, the lesser government — to whom you also perhaps have subscribed by oath.

I think that I can perhaps solve the problem in the short term, Madam Member, by saying that you cannot serve two masters. You do, sometimes, have a conflict in the oaths of office. But if the memorandum that we have sent has gone outside of the parameters that I have talked about, and is in any way suggesting that people cannot seek public office, cannot be involved politically, cannot serve where there is no conflict of interest, then, of course, I will see that it's redrafted.

The day may come when a person may have to make an election between serving the master in Victoria and the master in the municipality or the health board, or whatever it may be that he's on. But I'm certainly going to, Madam Member, take issue with you if you tell me that I should not advise my public servants that they cannot, on the one hand, serve on a board that is seeking funding from the government, services from the government, or any kind of favour — in the best sense of that word — from the government, and on the other be part of that government which is called upon to deliver that money, service or favour. That is clearly a conflict of interest. Even the most honourable person, who would be able to recognize that he shouldn't vote on certain things and all the rest of it, is nevertheless going to be perceived by the public as having a conflict. The whole transaction is going to come into question simply because he's there.

As a matter of fact, if that sounds like a lecture, Madam Member, it's almost a repeat of a lecture I've heard from that side of the House to this side of the House. I think it clearly sets out that a conflict of interest is not only what is, but what appears to be. I haven't seen the memo yet. I know the member will send it, or a copy of it, across to me, and I will undertake to take another look at it, and if necessary redraft it, so as to make it clear that in no way am I trying to infringe upon anyone's political rights, liberties or anything of that nature, and make it abundantly clear that all we're trying to prevent is a conflict of interest, real or apparent.

MRS. DAILLY: I appreciate the lecture and the points that the minister is making, but I'm really not too confident yet that the minister takes this as seriously as I do. I suppose I'm going to have to wait until after he checks on the memo, which must he in the possession of your staff, Mr. Minister, because it was issued from one of your assistant deputy ministers on March 17, 1980. I'm sure it's in your files. I'm just not comforted, to tell you the truth, that the minister really sees the danger of even allowing such a memo to go out, and the shock waves that it can create. It is very heavy-handed and poorly written. It may not express how the minister feels — which I'm glad to hear him state — but he's still leaving, in my opinion, a very iffy feeling about this government, a very uneasy feeling about whether they really do stand up for the rights of any citizen to run for a board.

I think it's almost a paternalistic attitude that the minister is inclined to take. None of us is foolish enough to think that if we're elected to serve on a board everyone couldn't find some type of conflict of interest. It's strange that with everyone but public servants we expect them to understand and to be able to declare it. But with the Ministry of Health they have to be told like little children. I still say it's insulting, and I hope the minister will take immediate action on this, because there are many people out there who may be thinking of

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running for public office who have this thing hanging over their heads. I'm sure the minister will cheek the memo, and I look for-ward very soon, Mr. Chairman, to see whatever kind of a redraft or assurance is sent out from that minister to many concerned people.

I just have one more short point to bring up before I turn the discussion over to my colleague for Nelson-Creston (Mr. Nicolson). It is a change of subject, and it's to do with the provision of mumps vaccine. At the moment this is not provided for at the free clinics on the free basis as other ones are. I think most of us in this House are aware of the concern parents have over their children getting mumps because of the long-term effects, of which, I believe, there are two. In a very small percentage of our population mumps can result in deafness. I know that those in the medical field are quite aware of the danger of children getting mumps, because there are cases where it has left the child deaf. Also we're well aware that serious mumps infections in young males and females can result in sterility, particularly in males. I simply want to ask the minister why it is not provided along with the other inoculations. Why do parents have to go and buy the mumps vaccine? I understand that the vaccine is available either by itself or in a combination called MMR with measles and, I think it's called, rubella brown. I'm wondering why this combination vaccine which is so important to our children cannot be given on the same basis as the others.

HON. MR. MAIR: I cannot at present answer the question that the member posed to me but I am getting the answer. I'm sure the member will bear with me, and during the course of these estimates I'll get that answer back to her.

[Mr. Davidson in the chair.]

I did want to make one other point on the question of the memorandum concerning conflict of interest. Not in any way saying that the method we used was the best or even satisfactory — I've told the member we'll review that, and I assure her I will — I think all members will want to know that many times memos such as that go out to staff because there have been a number of requests from staff as to just what does constitute a problem in terms of conflicts of interest. When you have a ministry as large as mine, composed of people who are obviously so interested in the medical field, it's not unusual to have a number of people be called upon — I think the member made this point — by society in general to join with them in one or other cause or organization, or become involved in one or other institutions. While I can't say that this memorandum went out specifically in answer to any request, I do understand that it was as a result of general requests by members of staff as to just what their obligations were. In any event I will review that situation and I will get back to the member.

I would like, if I may, to deal with one question raised by the member for New Westminster (Mr. Cocke) concerning the SIN numbers — I didn't realize we'd got down to numbering that. But in any event, the letter that the member referred to me from Dr. Marr did, of course, have a reply. I have the reply here. I don't know if the member for New Westminster has a copy of my reply to Dr. Marr. I'm surprised if you don't.

MR. COCKE: Who's Dr. Marr?

HON. MR. MAIR: Dr. Marr is the one who wrote about the question of possible invasion of personal privacy by the Medical Services Commission, concerning the use of the SIN number. I can perhaps shorten my answer by, first of all, since we're keeping Xerox, or whatever we use here, very busy today, undertaking to Xerox this and get it across to you in the continual flow of documentary information that's going back and forth here, simply answering this way: the medical plan has always required the name of the patient and the diagnosis on billing forms. The information is only accessible to staff, who are sworn to respect the confidentiality and to sign a form to that effect. I suppose that's the same type of form that Vital Statistics and all the rest of them use.

The Medical Services Commission has suggested to the BCMA that the diagnosis be coded on what's called the ICDA code. The member opposite may know better than I do what that is. So far we have not had any indication by the doctors that they're willing to do so.

In any event, I will hand this document back — my reply to Dr. Marr — and will have it sent over, which I think may satisfy the balance of the member's questions. If not, I'm sure he will deal with it in due course.

MR. NICOLSON: Mr. Chairman, I'd like to draw the minister's attention to some of the most forgotten people in British Columbia. They are the mental health patients who have been "returned to the community." I must say that it was under our administration that a program was started to return mental health patients to the community to depopulate Riverview. I've heard the immediate predecessor to the Minister of Health, the member for Langley (Hon. Mr. McClelland), get up in the House and brag about the level to which Riverview had been depopulated and how so many mental health patients were out in the community.

Well, the first thing is: out in which community? In the Nelson area we have about 12 residents out at the intermediate-care Willowhaven Private Hospital living in the basement of a geriatric facility, which is not really equipped, in terms of staff, training or even financial resources, to offer any program for these people. Indeed, it is not even really equipped to feed these people a proper nutritious diet. Perhaps it's part of a program of just keeping these people on high carbohydrates and not quite under absolute nutrition, for fear of the fact that they might start to get a few of their cells working and get a little bit hyper. It's really a bad situation. It's a good idea that has not been followed through.

I submit to the minister that when we take someone out of Riverview and put him into this situation where we're just paying boarding-care rates — I could be wrong on what particular level of care they're getting in terms of a rate for housing these people.... Even if they were to be getting some of the intermediate-care rates, it would be a considerable saving, I should think, from having them housed in Riverview. So when we have placed people back in these communities, the government has probably saved some money by taking them out of Riverview and putting them into so-called boarding-home situations — a boarding home that is not really a boarding home; a boarding home that is an intermediate-care facility populated largely by senile geriatric patients. It is a damn poor environment, but some of these people do the best they can.

I happen to live within a mile or less — probably within three or four city blocks — of this facility. Some of the patients get out and walk every day and get some exercise. I

[ Page 3364 ]

see them walking back and forth past our house. The Kootenay Society for the Handicapped has taken some of them into their sheltered workshop, but the sheltered workshop is designed for people with mental retardation. In that particular workshop it is not so much physical retardation as mental retardation. They're two completely different kinds of people with different needs. Most of the people with mental retardation live in their homes with their parents, or else in some sort of a group-home situation, and come to the Silver King Workshop. The majority of these people live in a very inadequate environment.

Some of the things that have happened there at Willowhaven.... The reason I'm bringing this up is not Willowhaven. This isn't a constituency matter; I'm afraid that this is probably a province-wide matter. I'm sure there are many other similar situations in other parts of the province. I am very concerned that there has not been a follow-through. I have been bringing this up in estimates for about two or three years, and I have made other efforts in this respect.

Some of the things that have happened at the geriatric facility.... One of the patients deliberately set fire to the room, totally demolished that room, yet the fire was contained in that room. That happened a couple of years ago. There was an allegation of rape by one of these residents. The case was dropped. Perhaps it was not well founded even, but it is one of the kinds of problems that does arise when you have no program and minimal supervision. About the best activity is that these people walk, all day long, along the highway, which is in itself a little dangerous. It is not the best recreational activity in the winter when there is snow and very small shoulders that aren't ploughed anyhow. It is a real crime.

Food in that facility is not good. It is partly due to the level of funding. I know the owners of that facility have had it available for sale — it even goes back to 1975 and earlier. They are willing to turn this over, I think at a reasonable price, to the government. The government could certainly not replace that facility at the same price. I am not out to criticize the facility so much. I don't know whose problem it is. I suppose it is some of the inflexibility of the rate structure for long-term personal and intermediate care. This particular care home does have a union agreement. The latest agreement was set under binding arbitration — after some years' delay, I might add — so that some of their costs are very much fixed. Their labour costs are very much fixed. It has been upgraded in terms of hospital accreditation standards, door widths, etc. It meets a fairly high standard in that respect. I am not out to criticize the facility but I would point out that the food, from sources that work in the hospital as well as people whose parents are there as geriatric residents and from all reports, hasn't been good and I think it's deteriorating.

Another strange thing about this returning people to the community is that all 13 of the people I can talk about are men; I know of no women in the Nelson area that have been sort of returned to the community. That may be my own ignorance, and maybe I just don't know of any. What I would like to point out is that they haven't been returned to their community. Only one of them is from the Nelson area, so it isn't as if we've returned them to an area where they can have support from their family. I said: "Well, are any of these from the Nelson area?" I was told: "No." I recognized one name which is an unusual and well-known name of the area. I said: "Well, surely this person must be." They said: "Oh, yes, you are right. He is from the Nelson-Balfour area. " We have taken people out of Riverview and we have put them into a very inadequate situation.

The Kootenay Society for the Handicapped have tried to cope with this problem by taking some of those people and putting them into their sheltered workshop which, as I said, was really designed more for mentally retarded handicapped persons. That is not the right way of describing it in 1980, I guess, but I will apologize for that. The fact is that when the residents go there, three of the mental patients make a contribution and the remainder just sit around and chain-smoke because there is not an adequate program that suits the needs of both groups. They have proposed a very modest program for ten participants, the objective of which would be to start out a program in conjunction with the Silver King, to move it as quickly as possible into the city of Nelson, then to set up a group home and eventually to assist people to move more out into the community with minimal supervision. They are proposing a budget which I think would be an additional $8.45 per day over the level they are getting in terms of personal care. I think what they're proposing is to take them from their present level of personal care funding up to an intermediate-care 2 level, and a differential of $8.45 per day. Again, I could be out in the reasoning as to the origin of their figure of $8.45 per day. But what they are asking for as a special budget is $8.45 per day — about $30,842.50 — so that they can put on a program for ten participants.

The proposal would be for a mental health program coordinator with some professional training at a very modest salary; a mental health worker half-time, who would be a lay person; and rent, supplies, travel, etc. So for $31,000 they would get ten people.

[Mr. Kempf in the chair.]

Mr. Chairman, I think that we owe these people nothing less. I think these people have really been shunted aside. It's something that I'm reminded of daily because of living in proximity to the place. Quite naturally, when these two items which I've mentioned occurred, there was considerable upset in the community, and people from your ministry went out and met and set up some improvement in supervision, and I think one potentially dangerous person, at least, was moved and some things were done. Right now I'd say that in the community there is a little bit of a lull, but if anything bad were to happen, it would be very unfortunate, and the reaction would be very strong.

I'm not speaking really as a person who lives in the community. I'm speaking as a person who has seen the program start six or seven years ago, and has not seen its completion. I've been a member of this House throughout that time, and I wonder if the minister could tell me how much it costs a day to look after somebody in Riverview. How much does it cost to be looking after them in this intermediate-care home at, I think, a personal-care level? I'm sure your assistant will be able to furnish that information for you and me. Is it not affordable? Of course, this proposal is very recent, I think. The most recent proposal of the Kootenay Society for the Handicapped is dated June 23, 1980. I think it is a very excellent proposal. I'm glad that they have taken on this responsibility. I might say that I have made some suggestions along that line in the past. I would hope

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that the minister could take some action on this specific request, but I am very concerned that this is a more general problem than the one that we've experienced in Nelson. There's a moral obligation, I think, to find that kind of funding, even in tight fiscal times. I think that, like so many investments we can make in health services, if the money is put in at the right place it can, in the long term, show substantial savings — even in terms of dollars and cents — and of course pay the greatest dividend in terms of restoring these people to a dignified, useful existence.

MR. SEGARTY: I'm pleased that the member for Nelson-Creston did get up and speak about that subject. It is one that is very dear to my heart: care for handicapped people in their own community setting. Last year in Cranbrook we got into a similar situation and I am pleased that the local Ministry of Health staff and the Ministry of Human Resources staff in that community were able to help me come up with a solution to the problem. I'd say it's something that is misunderstood perhaps throughout the entire province.

I was over in Nelson and had some discussion with the board of the handicapped society, and really how the problem started was with the idea of returning the handicapped persons to their own community, which was indeed a great program; whoever was responsible for it is to be commended.

One of the difficulties with the production workshops that were set up for handicapped people was that the government provided the funding for productive handicapped people. Then the federal government came along with a Canada Works grant, which enabled the production shops to take in non-productive handicapped people. Last year those Canada Works grants dried up throughout the province and the workshops were left with some non-productive handicapped people, which they really were never equipped to look after. In the community you've got two settings. You've got the room-and-board situation where the productive handicapped person is living in an institution or getting room and board in a community home. That's paid for through the Ministry of Human Resources. Then you've got the workshop setting. They were all pretty satisfied that the non-productive handicapped people were being looked after at the achievement centre of the Canada Works grant. When the Canada Works grant dried up, these non-productive people and the workshop were left with no funds. The licensing for the home service is done through long-term care, and I guess the staff in the Ministry of Health for long-term care were satisfied too that there was a life-skills program being provided.

[Mr. Strachan in the chair.]

Once they have established the need, then a program should be drawn up to meet the needs of those non-productive handicapped people. The idea is being that you start in a community setting in a life-skills program, then would move into the workshop and from there into the community to become full participating members of the community and out, perhaps, working in industry and making your own living.

So there is some misunderstanding there as to where the funding comes from. The licensing is done through longterm care. They turn over the bill to Human Resources and perhaps it's in the licensing area that the problem occurs, Mr. Chairman, to the minister. I know that the situation in Nelson is proceeding quite well. The board of directors of the handicapped society sent me a copy of their program; it's an ambitious program.

They've also received some funding from the lottery grants to help them out of their situation to try and put some dust-collecting systems in along with three-phase electrical power. I would like at this time to commend the Ministry of Labour and its staff in Nelson for providing the assistance to the Kootenay Society for the Handicapped in getting that project on stream. It's a project that needs the full community support and has the full support of government, I'm sure.

MR. NICOLSON: The member for Kootenay did mention that a similar arrangement has been structured in Cranbrook to provide the funding. The funding is a difficult problem because it's the one organization that is funded through Human Resources, yet these people are in personal and intermediate care. The arrangement over in Cranbrook, as I understand it, is that the boarding-home operators are being paid the intermediate-care level 2, which is $8.45 greater, and then subcontracting to the society which is providing the service. So that $8.45 flows through and it appears to meet regulations and is a workable situation.

HON. MR. MAIR: Mr. Chairman, I'd like to sort of back up a little bit and deal with a couple of questions raised earlier by the hon. member for New Westminster dealing with the 483 West 16th ambulance station. I've got a little update on the information. I don't think it's any secret that we want out of there. The reasons that the member has spoken about, of course, are ample evidence of why we would want out of there.

We have been in negotiations for some time to move the entire operation — administration as well as dispatch. The difficulty is finding the right quarters. Just so that the members opposite know some of the problems, first of all there is a problem with radio. I understand also it must be on the Trinity exchange for telephone. I'll need more help on that.

Security is another problem. It should preferably be government-owned, although that isn't essential, for lease, I presume, with BCBC. It should be reasonably close to the Vancouver General Hospital for disaster purposes and it should be south of False Creek. I understand the negotiations are now ongoing with BCBC in order to try to accommodate this move as soon as possible and that further meetings will take place next week.

I thought I might just give some general statistics on money, dealing basically just with capital expenditures in the emergency health services area. Since 1976 — up until this year — this is a total figure — $1.85 million have been spent on building rentals, maintenance and improvements for emergency health services. This year alone in our accommodation vote we will spend $750,000 on rentals plus an additional $500,000 for relocation and improvements. The rental, after all, does go basically towards the accommodation and improvements. We will spend about $1.25 million this year compared to $1.85 million for all the other years since 1976.

The member for Burnaby North (Mrs. Dailly) asked me about mumps and immunization. The note I have is that there is a lack of evidence that mumps is a public health problem of significance. There is doubt about the long-term efficacy of any immunization against it, mainly by reason of the complications that can develop in later years. It would arise to a greater degree under a mass vaccination program just by reason of the fact that there are some problems that arise out

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of the vaccination program itself. There would be more problems arising in later years out of a vaccination program than now arise without it. As I understand it, it may prevent more people from having mumps and it may even prevent some people from having mumps as badly, but the long-term result would be that there would be more problems in later years with the program than there are now. Our evidence evidently comes from an internationally known expert — I don't know his or her name but but I can find that out for the members — in matters of this sort. That is the principal reason we don't have that program.

Dealing with the problems raised by the member for Nelson-Creston, I would assume that much of the speech he made was really to bring to my attention some of the problems that exist in that particular institution in his area. He would want me, I am sure, to look into some of those things more specifically, and of course I undertake to do that. I might say that this does give me the opportunity to tell you of the two reviews which I authorized, very shortly after taking office as the Minister of Health, into the private institutions. One thrust, which the member for New Westminster (Mr. Cocke) and I have already spoken about, is the financial aspect. The second one, which is going on now — I am not sure how long it will go, but I would assume for some months yet — deals with the quality of care. I think one could subdivide quality of care into environment, programs, staffing and food.

I am always nervous, when we start talking this way, that any remarks a minister — or indeed a member of the opposition — makes about private institutions will be taken as a blanket condemnation of them or even a condemnation of some. I don't want to do that, but I do want to say that from what I saw very early in the ministry and have seen since, a review of this nature is long overdue. Even if the review came out and said everything is just fine all over the province of British Columbia, at least that would have the effect of allaying some fears, suspicions and concerns that many of us have. I don't think that that will be the result, however. I think that some very serious recommendations will come out of that.

I might say also that the whole object of the exercise in Riverview now — this is something we are trying to improve day by day — is a regionalization within so that the staff in Riverview are familiar with the various areas of the province from which the patients come, can relate to the specific patients and to that region and have some sort of a liaison relationship or function so that in future they can assist in getting the patients, when they go out of that institution, back into the right milieu within the right community. This regionalization by geographic area is something that is going on now. I want the members to know that this is part of our overall discharge planning for patients leaving Riverview.

I have touched upon the reviewing of conditions. I think the member opposite agreed that these are very difficult problems, because you are dealing with people who have problems that, for the average person, are often not pleasant to deal with. They have problems which are difficult to resolve. The member mentioned the alleged rape case, and I think he understands the kind of difficulties that kind of allegation causes in those circumstances. But I think that by and large we are taking steps to improve our ability to deal with it.

The member asked specifically about the cost per day at Riverview, which is $87 per day, I am told. The cost to the facilities ranges from $14.50 to $35, depending on the level of care and the program provided.

I'm not sure I got down the appeal question. I have a note — if this answers the question I didn't note down then I don't have to hear the question. It is: the appeal can be made on the level by operator.

I think that pretty well answers the main questions that were asked, so I'll take my seat and let you carry on.

MR. LORIMER: I have had occasion to speak to the minister about some items that couldn't be resolved otherwise, and I might say that he's been quite cooperative as far as I'm concerned. He has been tardy; you have to remind him a number of times and tie a string around his finger, but in the end he is usually able to resolve the particular problem, and I appreciate that.

There's no question that the cost of health care is very extreme. That's nothing new. It always has been that way, and I accept the fact that it takes a substantial part of the budget to look after the health of our citizens. But that has always been the case and always will be the case.

I want to say that the hospital boards submit their estimates as to their budgets probably before the first of January, for approval by the department. As far as I know, as of this time they still haven't received a confirmation, cutback or what not in those budgets that they're presently working on. The problem is that the hospitals do not have sufficient funds to carry out the most efficient health care facilities that they could otherwise carry out. As an example, in the Burnaby General Hospital any patient that's able to leave the hospital is taken out on Friday. New patients are not admitted on Friday unless it's an emergency. The beds are moved from wards to other wards in order that some of them can be empty for the weekend. The return of new patients starts on Sunday evening and continues to Monday. So we have a case of musical beds at the Burnaby General Hospital every weekend and, I presume, in a number of other hospitals in the province.

The costs of the facilities of the hospitals themselves are very extreme, and it would seem to me to be a waste of money not to have sufficient funds supplied to keep the operation going on a seven-day-week basis at full swing. The obvious need for staff weekly days off obviates the necessity, if they do not have a sufficient number to take their places, to delete the patient population as much as possible on weekends, and that is what is going on.

I have a number of items to discuss with the minister, and I'll be very brief on all items. Maybe he can give some replies in due course as to what action he is taking with reference to these questions. I'm quite sure that the matters that I bring up are well known to him, but I would like to be able to tell people in my area what things can be looked forward to in the months to come.

I happened to be in the White Rock hospital this last weekend, and I noticed that the top two floors are still not in use. With a crying need for hospital beds in the lower mainland it was a surprise to me at this stage that some action wasn't being taken to open up the top two floors. There may be plans for this, I don't know, but at the present time I note that there are two floors in the hospital that are not occupied.

On the question of open-heart surgery, I've come across an individual in Victoria who has had severe heart problems and requires an angiogram but can't get into the hospital for a period of six weeks to have that testing done. This is —

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especially in the case of heart problems — a very cruel and difficult wait, to "take it easy, don't do anything, just wait" for the six-week period until you find out exactly what problems your're facing. I understand there's been a cutback in open-heart surgery operations over the last year. I understand that in Vancouver General there's been a 20 percent cutback, roughly speaking. The waiting period a year ago in Victoria for open-heart surgery was approximately one year; what the waiting period is now I'm not sure. But those things cause great concern to the people that are involved. It's a very worrisome time and it's a long time. Maybe the minister can tell us what he has in mind for the years to come regarding additional teams for these very, very important operations.

I want to talk for a minute on the New Vista Society and their application for an intermediate-care facility in Burnaby. This application was made some nine months to a year ago. They were advised by the ministry that they were taking a long look at it. There were apparently two problems. One problem was that the ministry wasn't sure that there was a need for care homes in the province and there had to be a catalogued demonstration of need. As an MLA, I know that in my own constituency, apart from compensation cases, I would guess the major concern is the individual who comes in with an aunt, mother, father or friend who requires some extended care, intermediate care, or whatever, in a hospital.

I think there's no question that every member in this House has experienced the very same thing. The proof of care, I think, is not necessary. I think anyone who has had any dealings whatever with assisting other people in locating beds knows about it, and anyone who has had the personal experience of trying to find a place for a member of his family knows what the need really is. You go from one place to another to another and they will put you down on a waiting list. You may be No. 200 on waiting lists in a variety of different homes.

There's obviously a need for a crash program throughout the province to look after these problems. I agree that they have expanded greatly in the last few years. People are living much longer and the demand for this sort of care is much greater than it was a few years ago. I think the minister has to cope with this problem, because I don't believe it's going to go away. We need far more facilities than we have at the present time to look after these people.

The minister will tell me that there's a new facility being built in Burnaby on Rumble and Sussex. That's true and we welcome that facility. But we must remember that these facilities are not provided for Burnaby citizens if they're located in Burnaby; they're provided for the whole lower mainland. That's true wherever they're built. Patients are there from the Fraser Valley and a number of other places. I can promise the minister that when the new facility on Sussex is completed — on the day it opens — it will be filled and there will be a long waiting list. So it's a very big and difficult problem. I would like to hear from the minister what he would like to do about it, what he intends to do about it and what plans he has.

The other matter that was of concern to the ministry was the fact that there are a number of senior citizens' homes and care homes in Burnaby. That also is a fact; there are a number. But as I've said before, these facilities are not only serving people in Burnaby; they're serving the whole lower mainland,

The New Vista Society were told that the province was taking a long look, and that's true. They've been looking now for nine months and there's still no answer to the New Vista application. I would ask the minister to look in his files or his ministry files, dust off the application and give a positive response to the New Vista Society. The New Vista Society, of course, has the land for the project. They have expertise in home care, they are a first-rate society and a first-rate operation and provide a very high standard of care in that section of Burnaby.

Another question I would like to pose to the minister is the question of those people throughout the province who require oxygen. There are a number of people who have lung or other ailments who do require oxygen in their homes. The cost of this is extreme. I know that for those who are on Mincome and so on the service is provided free of charge, and the wealthy can pay for it. It's the in-between people who have some savings who are hit very, very hard financially. If a person is on oxygen for one or two years, it doesn't take long to run through a substantial amount of savings to pay for this type of necessary care. Maybe the minister can bring up the problem. I would suggest he provide oxygen free of charge in cases where it is required. I think it's now a very heavy burden for our society and our sick people to look after the cost of oxygen.

The last problem which I intend to bring up is the question of the cost to those who have kidney ailments who have to have a dialysis two or three times a week. It's fine if the dialysis takes place in British Columbia, where it's fully covered, but if it's provided in another province the recovery fee is the amount that would be paid if it were done in B.C. or the amount charged in the particular province. The problem comes up when someone is prevented from visiting the United States due to the fact that no payment is made at all. It would seem to me that it is not an expense to the province, because it would have been provided free of charge if the person had stayed in British Columbia. I suggest that in the case that I'm familiar with the individual has her family in the United States. She is prevented from visiting her people because she can't afford to finance the dialysis that would take place in the United States. I'm suggesting that the province pick up whatever is necessary to supply the service in British Columbia and refund that amount to the individual. The individual would pay the extra amount which is probably charged for the service in the United States.

I would hope that the minister would consider these questions. I know they can be answered quite quickly. With reference to them, I hope to hear what is going to be done.

HON. MR. MAIR: To the member for Burnaby-Willingdon, dealing with the hospital board estimates, I understand that all have now received preliminary approvals or that plus negotiations between the ministry and the hospital. I don't want to suggest that the preliminary approval means that there's been an absence of approval: there are some hospitals with which we are having some discussions. In any event, I understand that all of them received these preliminaries prior to April 1 of this year.

Dealing with the general question of funding, I'm sure the member probably does know about the joint funding study that has gone on — and perhaps other members would be interested — for a couple of years now. In the summer of 1978 a joint funding study was commenced. It is a cooperative effort between the B.C. Health Association and the Ministry of Health; they bring to the exercise equal labour, equal influence and equal input. They have now come down

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with a report; it's not secret. I don't know whether we've actually ever tabled it or released it. In any event, it could hardly be a secret, because it was done in conjunction with the BCHA. I don't want to go into it in great detail, but some of the things you may find pretty interesting.

Let me read two or three things that will give you an idea of where we're going, not necessarily to answer your question, Mr. Member, but to give you an idea of some of the things to which the committee addressed itself. Recommendations with respect, for example, to strategic planning: "(1) the Ministry of Health should develop a provincial health plan; (2) a hospital role statement should be developed from this plan." I hope you'll bear in mind the phrase "hospital role" — I'll deal with it in a second. It's a very important part of this. "(3) The Ministry of Health should upgrade its provincial health-care planning group to implement the above recommendations, with a provision for substantial participation of. the hospitals, related patient-care agencies and the BCHA."

Recommendations with respect to budget planning: "(1) a contract should be adopted by the ministry as a means for agreement on budget decisions; (2) a formal budget policy, including dates of decision points, should be adopted by the Ministry of Health and made available to hospitals; (3) a review process and joint review board should be established as a function of the planning system." It goes on. There are a number of other recommendations in a number of different areas.

Probably the two things that strike me — it might strike others a little differently — are, first of all, that it deals in very real and cogent terms with the process of hospital budgeting. Within that is contained the ability of hospitals and the Ministry of Health to budget on a long-term basis. It may not sound all that difficult but, in fact, it is. I'm sure that would strike a chord with the member for New Westminster (Mr. Cocke). When a hospital is trying to budget over a five-year period, it allows them to be a great deal more open in their budgeting process, because they can say, not only to themselves but to us, "We're going to need X number of dollars for labour in 1981. But in 1982 we're going to cut back on a certain program, so really we won't need that much. But we'll need a quarter again as much in 1983," and so on. Instead of getting into the system: "Well. If we need so much in 1981, boy, we'd better not let go any of that in 1982, or we'll never get it back again." In other words, they're going to be able to do that in all of the various functions, if we could put this into effect. And we're going to put it into effect, because I've insisted that it be implemented at least a year before my staff really wanted it to be implemented.

This, of course, is also tied in with the role study — the precise role that hospitals play in different communities and what areas of health service they should be concentrating on, because of the peculiar nature of the community, geography, demography, whatever it is, and what areas they need not play such an important role in. These two studies are ongoing so that we can solve, at least to some extent, many of the problems that the members opposite have raised.

You know, I'm not naive; I recognize that once we get this implemented and going well and everything's just fine, there'll be a whole new batch of problems. Five years from now, if the members opposite and I still are fortunate enough to be here, we'll be talking about a new set of problems and all of this will be behind us.

However, I do want you to know that the budget process which has caused so much agony, heartache and, I might say, political anguish in years gone by has been addressed by the government, and I am confident that when this is implemented a great many of those difficulties will no longer be with us.

Regarding the heart surgery teams that the member for Burnaby-Willingdon (Mr. Lorimer) referred to, we have got an advisory committee made up of physicians in this area. Their recommendations, I'm told, are generally accepted. They help us keep abreast of the needs. We already have increased the number at Royal Jubilee in Victoria, and we're negotiating increases at this point at Vancouver General Hospital.

Again, I don't want to get into a controversy, and I wouldn't want the words I'm about to say to be taken out of context, but there is a bit of controversy about these. There is some argument from the profession itself that the process is over-used. I avoid the word "abused, " but the process is over-used. And some care must be taken not to take all of the requests that come, even through physicians, totally at face value. In other words, if somebody were to say to me that there were 25, 50 or 100 people waiting for this, there may not be all that many that by the generally accepted medical terms ought to have that process. But in any event, it is a new and very important development, and we try to keep abreast of it.

The member for Burnaby-Willingdon (Mr. Lorimer) talks about long-term care, and says that the problems will increase in the future. Of course they will. We're not even really into the geriatric age. The baby boom is going to get into the geriatric age sometime around the turn of the century, or shortly thereafter. Because of the advances in medical science over the last few years, which of course will continue, more and more the acute-care hospital is going to be — not phased out, but it will no longer be the yardstick by which health services will be judged. Where at one time we used to judge the ability of a state or a province or whatever to handle its health needs by the number of acute-care beds it had, that probably will become a meaningless statistic in years to come, and we'll be talking about the long-term care — not just beds, but facilities and programs that we have in place. The reason I say "programs" is because you can't measure it again just by institutions or the beds that are available. Probably more important than that is the degree of home support that is given to people that are at the geriatric stage where they do need support because of age and other infirmity.

That home support, of course, I think, has got to be supplemented again by an intermediate step between home support and institutional support. We're moving very, very quickly and I think somewhat dramatically into day care support where people who would prefer to and can live in their own surroundings in terms of sleeping and eating and so on, who nevertheless do need some support, are able through this program to get that support without being institutionalized.

The question of New Vista and oxygen were raised. I'll have to check into them for the member. I will dust off the file on New Vista, as the member has asked me to do. On the question on the high cost of oxygen, I will try to get an answer back to the member on that one as quickly as I can. I don't think I'm all that slow either, Mr. Member. Sometimes the problem is slow of resolution. I get the answer as quickly

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as I can, but the problem doesn't get solved as quickly sometimes.

Regarding the difficult question that the member raises about kidney problems, dialysis, and costs in the United States and so on, really, I don't suppose that's much different than a lot of other medical problems which one might have outside of the jurisdiction of the United States of America. Our rule simply is that we will pay up to the amount that they would receive in British Columbia. I recognize that that is going to work hardship on individuals, but I think we ought to sit down and think about what the other side of the coin is. If we're going to say to everybody who has some sort of chronic ailment that we will look after you while you're in British Columbia and also elsewhere, no matter what it costs, what implication is that going to have on all of our payments? After all, it's our money that goes to make up the Medical Services Commission funding.

All I can say is that the policy to date has been — and I think I can say "will be" fairly and honestly so that we don't misunderstand each other — that we will continue to pay up to the B.C. allowable amount for matters of this sort. This may be putting it rather strongly, but I don't think that we can be held to ransom by the non-public health delivery service in other jurisdictions, because that is really what we are talking about. We will certainly continue to pay up to the B.C. amount in these cases but not beyond.

MR. LORIMER: I thank the minister for his reply. There are two points I would like to make. He mentioned about some of the open-heart surgery being requested but probably not required. I would agree that that is probably true but I think probably you would find a much higher degree of that sort of thing in almost any other operation, that is, operations are being conducted that are not required. I don't know if the minister would agree with that but I think the percentage in other areas would be far higher than what it is in heart surgery.

I think he misunderstood what I was driving at on this dialysis matter. My understanding is that no payment whatever is made if it takes place in the United States. All I am suggesting is that the same amount that is paid in British Columbia should be paid. The constituent who came to me with her problem advised me that her family was in the States and she was unable to visit because she could get no funds at all. She was quite happy to pay the hospital and merely get a return directly from the plan for the normal cost in British Columbia. It wasn't something extra that they were requesting.

HON. MR. MAIR: Let me just reply briefly to that point. My understanding and instructions are that that is not the case. If you will be kind enough to bring that specific problem to me I will be delighted to look into it and see where we have gone off the rails.

MR. KING: I am back again, Mr. Minister. I have some less emotional and volatile issues to deal with today. I hope the minister keeps his good humour.

I think the minister is fairly familiar with one of the matters I wanted to raise with him. That is the emergency health facility for the village of Chase. I believe the minister and certainly the hospital board in his hometown of Kamloops has met with the local committee from Chase with the view to obtaining an emergency satellite facility for the village of Chase. I am not sure what the exact mileage is from Chase to Kamloops.

HON. MR. MAIR: About 40 miles. It depends whether you are coming or going.

MR. KING: Something in that area. It depends whether you are on the road from Tod Mountain or not.

There is an extremely heavy traffic flow in that area, particularly in the summertime, so the transport of patients for emergency treatment can be a real problem when there is very heavy traffic flow. Of course, that is the time of the year when frequently there are the kinds of emergencies that need very rapid attention. Ambulances dodging in and out of that kind of heavy traffic flow in the summer creates a problem of its own.

I believe the Kamloops hospital board has studied the proposition of developing a satellite facility at Chase, basically containing laboratory facilities, physiotherapy, dietary counselling and a trauma room. It's a small facility which would enable the local doctors at that location to give primary emergency treatment and also to perhaps keep some patients at home who would otherwise have to travel all the way to Kamloops for minor ailments and so on. They could perhaps be kept for their laboratory tests to be made and they could be kept for observation overnight and that kind of thing.

HON. MR. MAIR: Can I ask a question, briefly?

MR. KING: Yes.

HON. MR. MAIR: Just so I am clear in my mind what the member is driving at, are you asking for a diagnostic and treatment centre, or something along that line?

MR. KING: Yes.

HON. MR. MAIR: Okay, thank you. I just wanted to make sure.

MR. KING: I think trials have been submitted to the minister's office on the proposal that comes from that community. I am pretty sure I have had correspondence with him on it. Certainly the ministry has. The proposal is supported by a wide region in that area. It is not just the village of Chase itself, as the minister is undoubtedly aware. That is the primary source of treatment for people from as far around Shuswap Lake as Anglemont, which is a fairly isolated rural area, an area which once again in the summer tourist season is very, very heavily congested; so there is a large population fluctuation at certain times of the year. I simply ask the minister to be sensitive to the need in that area and to be alerted to the fact that the local community — and I as the provincial representative for that area — will be pursuing very vigorously the acquisition of this kind of facility. I'm not sure what the cost range is, Mr. Minister. I don't think it's a terribly expensive thing; as I understand the local committee's aspirations it would be under the auspices of the Kamloops hospital board, so the administrative cost would be kept to a minimum and so on. That's one of the things I wanted to raise, and I ask the minister to familiarize himself with that and to weigh the need that exists.

One of the other matters I wanted to raise was a letter I received from a constituent, an optometrist in my riding, who

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makes the point that apparently a task force was struck — I believe it was in 1976 — to develop a vision-care delivery system for British Columbia. The optometrists have been pursuing, at considerable expense to themselves and individual members, the objective which the task force was set up to study. The request is that the results of that task force report be released to the public so that the optometrists can obtain some indication of which way the government intends to proceed on this matter. I'll just read one of the brief paragraphs from it:

"No action appears to have been taken by the government to implement any of the recommendations put forward by the vision-care task force. The fact that nearly three years has elapsed since the document was completed is very distressing to myself as well as others within my profession; I feel this to be an outrageous waste of effort by the dedicated people involved who have carefully negotiated and made the decisions in concert to satisfy all involved in the public's best interest."

Perhaps the minister could review that request. It seems that the task-force study was done with a view to determining what policy was going to be set in the visual-care area, and it seems to me only logical and fair that the optometrists of the province should have access to the recommendations of that task force, so that they may have an indication of which policy direction the government intends to take in the future. Another matter that I wanted to raise with the minister is some method of providing a more realistic budget for the homemaker groups of the province. I'm not sure whether this is the total responsibility or a responsibility at all of the Ministry of Health or whether it's totally Human Resources, but there is a dimension, as I understand it, of long-term care involved.

HON. MR. MAIR: We're both finding out about that at the same time.

MR. KING: Yes. I'm not sure what the division is with the Ministry of Human Resources, but I do know that in my particular area, particularly in Salmon Arm, there has been great difficulty in setting a budget which is realistic and which allows this agency to function with any degree of continuity. I would be very pleased to discuss this with the minister in detail, perhaps when we both learn a little bit more about it, and find out what might be a logical approach to it. It's an area that I would appreciate some further dialogue on.

The Shuswap alcohol and drug programs group at Salmon Arm sought funding for the establishment of a rehabilitation and healing centre in the North Okanagan–Shuswap area. The previous Minister of Health, Hon. R.H. McClelland, replied to this request indicating that the facilities at Vernon and the new Round Lake Indian facility, which is also very close to Vernon — it's actually just about on the boundary of my riding and the Okanagan North riding.... It's basically directed toward native Indian rehabilitation; I'm not sure whether it's solely directed to Indian use or not.

HON. MR. MAIR: I think it is, but I'm not sure; they think it is, anyway.

MR. KING: Perhaps it is, I'm not sure. But there is a real need in that area. One of the things that has happened, Mr. Chairman, is that we have had the influx of a great number of industrial workers in the region of Revelstoke–Salmon Arm with the advent of the dam construction; there is a major new mine slated to open in the Revelstoke area; and indeed now from Golden to Vernon there is no facility to accommodate alcohol problems. One of the things that is interesting is that the railroads, and many of the other industries in that area, are devising and setting up their own alcohol treatment programs now, which is encouraging and should be encouraged, in my view, by the government, because there's a basic responsibility there and it's a good way to come to grips with the basic problems. Despite that approach, despite a very effective functioning Alcoholics Anonymous group both in Revelstoke and Salmon Arm, without any facility to accommodate the treatment on a bit longer term, those agencies are kind of limited in their effectiveness too. I would strongly urge the ministry to have a look at the provision of a facility in that way. In my view the cost is high initially, but the investment in terms of rehabilitation for people with that kind of chronic problem is money well spent. It is an investment rather than a cost. It's something that I would like to see the minister look at.

Another point that I wanted to raise — and I want to be very quick here; I think I raised this point earlier, but I'm not sure with which other minister — is the question of upgrading opportunity for registered nurses. I'd be pleased to provide the minister with a copy of a letter I've received from a registered nurse in Armstrong who makes the point that the kind of health industry that registered nurses are involved in is the most sensitive, possibly, of any endeavour in the province. Medical doctors do have constant opportunity for upgrading and maintaining their education on a concurrent basis with new developments in medical research and medical science. Nurses lack that opportunity, and the point that this lady makes, and I believe very eloquently and well, is that there should be a better facility, a more structured facility, for the continuity and upgrading of registered nurses' education. They are dealing with the ill, they are dealing in a very sensitive way with life and death, and that again I commend to the minister as an investment rather than a high cost, while still acknowledging that there is a cost factor at the initial stages. If there is a program available I'm not sure that program would be available in the interior. It may well be that there is some kind of training course available at the coast, but without some expense encouragement it becomes quite a heavy and onerous burden on an individual from the interior to undertake. As far as I'm aware there is no such program available at the moment. In any event I will send the minister a copy of that letter and ask for his comments on it.

The final point I wanted to raise is the limited coverage that is available for chiropractic treatment. My area, particularly the Salmon Arm area, is a bit like Victoria. There's a large population of senior citizens in the area attracted by the extremely good weather, the mild climate, the beauty of the place and, of course, the excellent political representation they have as well. They are a group in our society that requires the kind of therapy and treatment that is offered from chiropractic people within our province. They're concerned that the amount of coverage under the British Columbia medical plan is restricted. I believe it's $75 and $100.

One of the things I suggest the minister think about is the fact that the costs for chiropractic treatment — that is the

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salary to chiropractors — have accelerated and increased in the same way that the salaries of doctors, dentists and other professionals have increased, so that the fixed amount of $75 for chiropractic treatment is eroded in terms of the professional set-vice cost, thereby reducing the hours of treatment available to the patient. On the basis of that inflationary trend alone, I submit to the minister that the amount should be increased greatly. Quite frankly, I think the day has come when medical doctors recognize the benefit of chiropractic treatment in a much broader way than they used to. I suggest that the ceiling be looked at in a much, much more liberal way; perhaps that's a good phrase to use with the minister, who may still have some sensitivity to that term. I suggest that the current fixed rates for chiropractic treatment are extremely stringent and unrealistic. I appeal as strongly as I possibly can for reconsideration and an upward escalation of the allowable amount for chiropractic treatment.

Finally, I have one other small point to make. It's my understanding that three regional brain damage centres — I'm not sure what the technical terms for them are — are being established this summer in Kamloops, Vernon and Penticton, I think. It's my understanding that these centres are geared to treat victims of traumatic accidents that have in some way impaired their mental capacity through brain damage, who require intensive one-to-one therapy and treatment rather than the kind of facility that exists at Riverview, which houses people with brain damage problems, but the aged and the senile as well. I've been advised by the ministry that these units are coming on stream this year. I would like to receive a bit of an explanation from the minister of precisely what the status of this program is and precisely the perimeters of the area they're designed to serve so that we in the interior can look forward to some much increased and improved opportunity for that kind of attention to people from the interior.

HON. MR. MAIR: To that provocative member over there who constantly comes in here and raises my hackles with these inflammatory speeches, dealing with the question of an emergency health facility in Chase, my instructions are that we have a proposal for a health facility before us now, under review, probably not to the extent of a D&T centre, but something just a little below that, to handle the problems that the member has mentioned. I must say that one thing that I have been addressing my mind to recently — and I haven't got anything to promise or undertake to the member except that this is something that I am asking my ministry to look at — is the question of seasonal requirements for some areas, whether they be a mountain resort or summer resort, which go all the way from a fairly large centre in the in-season to a very small static population in the off-season. This is something I think we must address ourselves to and we will do it.

Dealing with the task force on vision care, this has been released. I hate to say it, but a copy was sent to every MLA.

AN HON. MEMBER: When?

HON. MR. MAIR: Well, I can find out when, but it was. I have the distinct memory that it had been released, because I think the member knows that my own attitude towards these reports is that unless there is something very, very confidential in them or something that really requires further study before they go into the public domain, I think they ought to be released. These are my instructions. If the member didn ' t get one, I didn't mean to embarrass him. I'm only going on what I've been told and I'm told that this has happened. I'm told it was more than a year ago. So as we get older we forget more quickly.

It is a very difficult problem that you raise and we're looking at it now for the purpose of bringing in legislation, hopefully, next spring. As you know, the different disciplines that get involved in eye care are three and four in number, all the way from ophthalmologists through optometrists through the opticians. Standards are nonexistent in some areas and very, very stringent in others. There's a crossing of territorial influence from one to another; there are jealousies and this sort of thing. As a matter of fact, one of the groups, which is most anxious that legislation be brought in in my community, is one of the opticians, who happens to feel that, of course, he is very well trained for his task, but nobody else is that holds himself out as being an optician.

MR. KING: Totally unlike the lawyers.

HON. MR. MAIR: That's about it.

So we certainly are looking at that, but as I say, the report has been released and if the member cannot find his copy I'll be very pleased to get one for him.

Dealing with the question of home support services, perhaps I could just refer to a memorandum that I have in front of me, which will give some background of where we stand on that. As of May 1980 there were just over 22,000 people getting homemaker services in British Columbia. That's compared to about 3,500 in January 1, 1978, so that's a pretty remarkable increase. There are 1,000 of these people who are eligible for extended care but are able to stay within the comfort of their own home and family throughout the program. An additional 4,000 over and above the 22,000 get short-term home-care nursing, homemaker services or both. The credit here has to be shared, of course, with the homemaker agencies, of which there were 68 in January 1978, but there are now 110 to meet the challenge of these new numbers.

In the homemaker service there are about 7,000 people employed now compared to $2,300 in 1978 and, of course, each additional care bed required additional staffing. In the beginning the wages, benefits and working conditions of people involved in this — homemakers and care aids — were low, there is no question about it. They have improved dramatically. My figures have them up up to 45 percent, plus benefits, in the last two-and-a-half years. I think that the problem the member for Shuswap-Revelstoke (Mr. King) raised is being improved.

Dealing with the question of a rehabilitation centre and so on, I can't give a specific answer to that. But I can say that we talked at some length yesterday, and, I think, the day before, about the Alcohol and Drug Commission and what it ought to be doing. I think I've indicated to this chamber that I feel very strongly that it should be doing a heck of a lot more in terms of alcohol treatment, education and so on and so forth, than concerning itself with some of the more dramatic drug problems. Hopefully, this is one of the things we will be able to examine when Dr. Bonharn's report comes down in July. I don't need to tell the member, I am sure, that Dr. Bonham and my staff know of my prejudices in this regard and I am sure they will give them due weight. That may be no weight at all, but they will give them due weight.

On upgrading opportunities for registered nurses, again,

[ Page 3372 ]

I think I can do little more than accept the member's invitation to look into this matter more thoroughly. I do understand there are more regional nursing schools going into the regional colleges. When this happens it will enable the nursing staffs, at least from the various hospitals in these regions, to negotiate in their contracts — as, I understand, is being done in some of the lower mainland areas — the opportunity for educational upgrading in times to come. I think what prompts the member's question, of course, is the lack of nurses which we are faced with every time it's summer and it's time to go camping and take advantage of the three-month leave of absence which one can take without losing seniority. This will presumably help a lot of people — who perhaps feel reluctant to come into the breach at this point because they've been away so long — to upgrade and get themselves in a position to do that.

On the question of chiropractors, I have a proposal now before the money men to upgrade this feature. The difficulty is that the amount allowed is a global amount, not a per-visit amount, and that, of course, means that the number of visits allowable under the figures are reduced substantially, which sort of ties in a little bit with the reason why we had to raise certain rates lately. Things are going up. We will still give people the same amount of money, but they won't get as much for it as they ought to. We are looking into that — more than looking into it; I've got an application before the powers that be now in that regard.

On the assessment centres that the member mentioned, I'd like to, as much as I'm able, sort of take that a bit on notice and come back with an answer. We do have geriatric assessment centres which look at instances where it appears that mental difficulties can be improved. We are assessing them from that point of view, but that is in the geriatric area. With the brain damage and so on that the member referred to, I'm not sure at this point precisely what he is referring to. But I will look into it and come back with an answer, I hope within the course of these estimates; if not, I will come back with the answer in any event.

MR. MITCHELL: In joining this debate this afternoon I think that, if we are discussing health care, it would be wise to review some of the....

HON. MR. MAIR: Frank, would you be offended if I left for a moment? Notes will be taken.

MR. MITCHELL: It really doesn't matter if I am offended; you are going to leave. I will not be offended and I know that your deputy will look after me. In fact, maybe I'll be treated a little bit better.

I think, when we review health care and how it affects not only this province but also the rest of Canada, and how it affects us as individuals, we should look at the background and how we got to the position we're at today. We have, some people say, one of the better health care systems in North America. In 1976 the province and the federal government negotiated a block funding or fifty-fifty deal in health care. I think the problems we are faced with today are because we in the province have not lived up to our share of the fifty-fifty arrangement that was morally or mutually or publicly given out as our responsibility at the provincial end.

I feel it is important that we review some of the figures, the cost and the funds that have been expended on health in this province and the percentage of the money that was expended from provincial revenue. I think there are two things we have to take into consideration: the money that has come from the federal government, and what percentage of those funds covered our total health costs.

In 1977-78 the federal share for hospitals was 53.6 percent; for medicare, again, it was 53.6 percent. It meant that the province was only accepting 46.4 percent of the cost of medical expenses. In 1978-79 the federal share of our health care — the combination of both hospital and medicare — went up to 63.5 percent, which meant that the provincial share dropped to 36.5 percent. In 1979-80 the federal share was 67.4 percent; an all-time low for the provincial government was 32.6 percent of the costs of health care. What did that mean? It meant that large sums of money that had been expended by the federal government — in fact $269 million of federal money — were allocated to other areas, and the intention of the principle of a fifty-fifty arrangement.... I am happy to see in the present estimates that our new Minister of Health is fighting for an increase in the money to medicare. The combined total of moneys, both federal and provincial, is 62.1 percent. In fact, the federal medical share has dropped to 52.4 percent, giving us an overall increase from 32 percent to 47.9 percent.

My big worry, Mr. Minister, through you, Mr. Chairman, when I review the track record of this particular government, is that on many occasions money is being put into estimates and when we get to the next year that money has not been expended. I know that if we can get back to our fifty-fifty share and the province can put a greater amount of money into the health care facilities, we won't have the problems that are facing each one of us as citizens and as MLAs. Each one of us is getting calls about what is actually happening to our health care. We're indexing it. We're raising the co-insurance for hospitals; since 1975 it has been raised from $1 to more than $4. Our health premiums are going up.

I call on the Minister of Health to give serious consideration to the complete abolition of health care premiums. We are one of the last three provinces in Canada that actually still charges a premium for health care. Alberta, Ontario and British Columbia are three provinces that are considered wealthy but we are still collecting a premium for health care. I feel that the minister should give this serious consideration, because what is happening out on the street today is that people who have not paid their premiums are not getting health care — people who for many reasons are not paying it and are not getting service.

I'll give an example that I was personally involved in. Prior to my election I conveyed a gentleman under section 27 of the Mental Health Act — a man who was suffering from a mental illness — to Royal Jubilee Hospital. He was admitted suffering from a mental illness. He was then committed to Eric Martin Institute. The next day when I came on shift I checked to see what had happened to him. When I made inquiries at that hospital, I found that he had been discharged because he did not have his medical premiums paid up. I followed that particular individual through the police records. He was suffering from a mental illness. He ended up back in Victoria, drinking, malnourished, and over a period of going down, he became really violent. I believe he was committed to Riverview in Vancouver. What I'm saying is that people are suffering. They're not getting the treatment, because they haven't paid their premiums, and hospitals and doctors are not going to treat them. That happens.

[ Page 3373 ]

There are people out there who haven't paid their premiums and they are not going to go to the doctor. I feel that when a person is sick there should be no hindrance to his getting into the hospital and getting complete treatment.

I feel that we, as a small minority, one of the last three provinces in Canada who still have a premium.... I sincerely think that it is time we change our attitude toward sickness. It should be a necessity; it should be a right. There shouldn't be anything that stands in the way of complete and 100 percent top medical protection.

[Mr. Davidson in the chair.]

I was talking about how the money in the province has been split up. One of the parts of our medical health is the development of hospitals. I would not like to hang the can on our present Minister of Health for all the problems that have developed in the last four years.

Every one of us at one time or another has received letters from people who are not getting service because we do not have facilities to provide full and proper medical care. In January I received a letter from a constituent who was in the hospital. He wrote a letter to the daily press. I would like to read a letter I received from a doctor who treated my constituent:

"Re: Alexander MacArthur, deceased.

"When this 64-year-old man was admitted to the Victoria General Hospital on January 23, he not only had a coronary insufficiency; he had rather severe bronchitis, and medical treatment was necessary in the early phases.

"But by February 8, 1980, angiograms had been done and his condition was considered to be such that he should have an urgent coronary bypass. He was presented at that time to the open-heart surgery selection committee at the Royal Jubilee Hospital. It was decided to have him returned to Dr. Ian Munro in Vancouver General Hospital, where he had several coronary bypass grafts performed six years previously. Dr. Munro subsequently informed us that he would not be able to handle Mr. MacArthur's case, as he had a waiting list of 80 patients at the Vancouver General Hospital.

"I therefore requested Dr. Brownlee and Dr. Dutton, our heart surgeons, to book the patient as urgently as possible for coronary bypass surgery. Because he was having daily chest pains, he had to remain in the hospital's CC unit at Victoria. I enclosed a progress summary of this man's case, dictated on February 15, 1980."

That's over a month since he entered the hospital.

"Our local facilities were jammed up by younger people with more urgent problems, or just as urgent problems, and because of the limitations of the facilities at the Royal Jubilee Hospital he could not be fitted in.

"Dr. A. Grebneff was in charge of this case. I went on vacation after February 17, and when I returned, I heard that the patient had expired. It is of interest to note that Dr. J.W. Dutton, the heart surgeon, saw the patient at the Victoria General Hospital on February 27, 1980, and his last statement is as follows:

" 'The patient is scheduled for surgery as soon as an operative date can be found on an urgent basis. Our heart surgical team has consistently and repeatedly asked for expansion of facilities to handle the caseload. Mr. MacArthur's case is not unusual.' "

The doctor closes his letter with this:

"This man's daughter asked me to write this letter for her father, who, as you also know, wrote a letter to the Victoria newspaper while he was waiting for his surgery. The delays no doubt aggravated his chances of getting through the surgery."

It brings me back to my opening remarks. Over the last four or five years we have not been maintaining our fair share of cost to the hospitals and the medical services of this province. I know there are many others just like Mr. MacArthur who have suffered. I know the minister has just as many letters of a similar nature. Mr. MacArthur was lying there knowing that he might have died, and he did die. He had the guts to write a letter to the paper pleading for better and more facilities for the sick. I felt that in memory of Mr. MacArthur his letter should be read. I was going to read the autopsy report which supported the delay that caused his death, but I'll bypass that, Mr. Speaker.

I would like to bring to the attention of the minister a survey that I took as the MLA in my annual mail-out. One of the questions I asked in my mail-out was: "How do you feel about the hospital bed situation in greater Victoria?" I received many, many different versions and I could not read some of them that were printed. Ninety-six percent of them stated they were extremely bad. Only 4 percent said they were okay or they could be improved. Ninety-six percent of the people who answered my survey believe that the problem of hospital beds is becoming a disaster in the greater Victoria area. I think one of the reasons, and only one of the reasons, that added to this problem was the delay in bringing back into operation the Priory and Langford to cover some of the extended-care patients that were occupying beds, in the general hospitals. Last fall, with the ex Minister of Health, we had a grand opening of a new health-care facility in Langford. At that time they moved the patients across the lawn to the new fancy building. We had a facility that had been serving the community for the last 10 or 20 years, a facility that had 70 to 75 patients who were being treated within the community. But what did they do to this facility? They shut it down, and at the same time we had many, many extended-care patients occupying beds in the acute section and we needed additional facilities for them. When I went to the chairman of the Greater Victoria Hospital Board and asked why they were shutting down the older section of the Priory, I was told two things: (1) there was not enough money from the department, and (2) it wasn't needed. The fact that it wasn't needed has been proven false. I know that the minister is now opening 40 beds in that facility. What I'm trying to say to the minister is that that particular facility should not have been shut down. While it was still in operation it was still serving the community, and I still feel that those 75 beds, if it had been kept in operation, could have carried on until newer, additional facilities had been built.

Going over some of the constituency problems that each one of us in the riding have, I would like to bring to the attention of the minister, while I'm on my feet, a problem that has faced the Sooke ambulance service. Before I do, Mr. Speaker, I would like to read a comment that the minister made in his opening remarks on July 10. It's from Hansard at page 3259. It states: "In 1974 the ambulance services, as

[ Page 3374 ]

many members of the chamber well know, were operated by private operators, funeral parlours, municipalities and even fire departments."

I must comment, Mr. Chairman, on that offhand remark: "even fire departments." It's been the fire departments of this province both volunteer and professional, who have pioneered and given to the people of British Columbia ambulance care second to none. There are many parts of this area that are still serviced by volunteers in conjunction with the equipment supplied by the minister and the ambulance service. They're volunteers and they give many, many hours of hard work and study to this particular service. Maybe the minister gave that as an offhand remark, but I still feel that "even the fire departments" tends to put it down, and I feel that it is their service that is keeping a lot of people alive today.

But I would like to make an application to the minister, I've gone through your deputies; I've written letters within the ambulance service; I'm again pleading to you. I'll read you a letter that I've received from the Sooke Fire Association. After I received this in September of '79 I went through the other channels and I have yet to receive a positive answer back:

"Dear Sir:

"Attached please find correspondence relating to a continuing problem of this association. The problem is that of manning the ambulance during the day. The situation outlined in this correspondence has not changed, except that it has worsened. The number of calls in Sooke last year was almost 300. Last week there were two occasions where we were able to obtain only one man and we were forced to call the Langford ambulance. This entailed considerable delay. As far as I know there have been no fatalities due to these delays, but the situation is poor. According to the Ambulance Commission's criteria we are entitled to not one but two full-time men, based on the number of calls handled.

"We have corresponded in the past with the Minister of Health, with your predecessor, and with many others about this problem. We are now asking for your assistance."

There is another letter — I won't read it all, Mr. Minister, but this was dated January 19, 1979. It was to Dr. Peter Ramsford, executive director, Emergency Health Services Commission. I'll read one paragraph: "The number of calls has increased from 170 per year in 1975 to 217 calls during the last 12-months period. We are sure you can appreciate the burden this increased demand places on our fire department. "

What I would like to bring to the minister's attention is that the Sooke fire department is in an area where basically the economic viability of that town is lumbering and logging. The majority of those who are involved in the volunteer fire department work in that industry, and during the day from Monday to Friday there is a shortage of trained personnel who are available to take out the ambulance; on weekends and nights there are a lot of wonderful volunteers who come out. What they would like is at least one full-time ambulance attendant. They qualify for two, but if they had at least one fully trained attendant he would be the nucleus that they could build their volunteer ambulance service around. He would be the one who understands the new terminology, trained in the various procedures and life-saving skills; he would be the one who could keep the group together. I believe within that particular community they have a person who has a lot of those abilities and the training, but I know that the group are more than prepared to listen to you, Mr. Minister, or your advisers, and I would like a commitment of at least one full-time ambulance driver in that area before there is a fatality.

In closing, Mr. Minister, I know that maybe you'll have, in future legislation, a dental plan, and I would like to put on the record that I hope that when you bring in your dental plan it will at least provide all the facilities for all the people of the province of British Columbia at least equal to those provided for the MLAs and members of cabinet. I feel that we must take a stand on certain priorities; I think that dental care is now becoming one of those priorities.

In closing, I would like to go on record that I am opposed to the continuing indexing of our co-insurance in the hospitals, the indexing of our premiums. I feel that any indexing of premiums is hitting those people who are sick. I feel that the wealth of the province of British Columbia can provide each one of us with medical care second to none. In a very short period I would like to see that we no longer have premiums. Then there will only he two provinces in Canada that still tack that unnecessary burden onto those who are sick.

HON. MR. MAIR: I wish that the member for Esquimalt–Port Renfrew (Mr. Mitchell) had been in the House when the member for Maillardville-Coquitlam (Mr. Levi) and I entered into a debate on the whole question of the formula for established program financing. It's complicated. It taxes my mind to even learn it once, much less to learn it over two, three or four times, particularly the historical aspect of it.

Apart from the short discussion I will have now, if it's agreeable to him, at this point I think I will ask the member to take a look at Hansard for that time: I went into the facts, figures and explanations at some length. They are not simple; they're quite complicated. I hope the member will be convinced that the position he has taken today is not correct. We used to have 50/50 cost sharing, Mr. Member, but that went out in 1977. We now have a very complicated formula which involves at least three, perhaps four, different methods by which money comes into the provincial treasury. Unfortunately, mingled with the health moneys that come in are education funds. It makes it very easy for one to extract percentages. I don't mean it maliciously, but one can put a sharp pencil to paper; two people — both very well motivated — can do the same thing and come up with different figures.

This is just my criterion, but I think it is an accurate one: starting in 1977-78 the federal contribution, which does include the post-secondary education factor — bearing in mind that the province will have the balance — was 49.8 percent; in 1978-79 it was 49.9 percent; in 1979-80 it was 49.3 percent; in 1980-81 — which, of course, is an estimate — it will be 45.4 percent, which leaves the balance for the province.

[Mr. Strachan in the chair.]

Again, we can go through the rather lengthy learning exercise that I think we'll both have to undergo, without meaning any disrespect to you, Mr. Member. I suspect we both will have to put our thinking caps on. But I hope that, along with what has already transpired in debate, that ex-

[ Page 3375 ]

planation will be sufficient to answer the member's questions.

Also, the member for Maillardville-Coquitlam and I went through a philosophical debate on the question of premiums and user charges. We disagreed, as you and I disagree. I think we arrive at the same point. You must remember, Mr. Member, that the premiums for those who are indigent are 90 percent paid by the Ministry of Human Resources; that leaves an excess of 85 cents per month. Those who are not indigent by the standard of between $1,780 taxable income — something in that area — and a figure of around $2,500 or $2,600 taxable income have 50 percent of the premium paid. So you can see that there's not really a great deal left over. Nobody is being deprived of care by reason of indigence. The Hospital Act has a specific provision that nobody will be refused because of indigent circumstances.

I'm not going to say that cases haven't happened. I don't care what field of endeavour you're in, some case always crops up that one can bring out to show that the general proposition is wrong.

There probably are people who get officious. There probably has been somebody at an emergency ward who said: "Look, if you don't give me the two dollars we're not going to look at your broken bones." And there probably has been some doctor who has said somewhere: "Look, pony up. Let's see the colour of your money. Assure me absolutely by affidavit that your premiums are paid up or I won't look at you." These kinds of things can happen. They very rarely do, but they can happen, and when they do the unfortunate part is that they tend to call the entire system into disrepute. I think, as a general proposition, I can say without fear of any serious contradiction that no one is deprived of medical or hospital services in this province by reason of indigence. As far as this government is concerned it won't happen.

You would get to that point by a different route. You would get there by saying: "Nobody will ever pay any premiums or user charges. It will come out of other tax sources." We can go into all of those tax sources, as we did a couple of days ago. The fact of the matter is that it's a philosophical difference. You would get there by that route and I would get there by the route which says: "Look, those of us who can afford to pay should not get, to that extent, a free ride by reason of having the government pay for it out of general revenue. Those of us who can afford to pay" — and I presume that includes everybody in this room — "ought to pay the modest charges." And they are modest charges — $8.50 a month for medical premiums, $5.50 for acute-care charges, and so on. This is no more than we would pay for perhaps one or two meals a day. For those of us who can afford it, we should bear that burden rather than put an additional burden on the general revenue. You say differently. You say: "No, that's not the way we should do it." Fair enough. If we didn't have philosophical differences we wouldn't be sitting on opposites sides of this chamber. I think that the end result is the same: the people who are indigent and in need have their medical problems taken care of.

On the question of the heart surgery, once again, Mr. Member — through you, Mr. Chairman — without meaning any disrespect, this is something like the question that one gets on a hotline. Somebody puts a proposition and says: "What are you going to do about that?" It's very, very difficult unless you have all the background and all the facts.

Yes, there are some problems that come up from time to time in this area. However, one doesn't hear about all of the happy stories, which about 99 percent of the time they are. I would like to know some more details about this particular case, and I'm sure the member will give them to me, if not publicly, perhaps privately. That might be the best way of doing it. I'd like to know the patient's age and a number of other circumstances, because in questions of heart surgery, bypasses and that sort of thing, priority is given to younger people.

On the question of Juan de Fuca, my instructions are that, yes, it has been re-opened. I think the member indicated that. The difficulty originally was that the fire marshal's report cited so many deficiencies that it simply had to be closed. We decided to meet those deficiencies when we recognized that the long-term care program was going to demand many more beds on a short-term basis, and that accounted for the closure at the time.

I will skip one and just talk about Sooke for a moment. Our estimates this year call for one full-time crew member for Sooke. We will monitor very carefully the calls and the load thereafter and see just where we have to go from there.

I just wanted to deal with some misunderstanding I think the member had about my opening remarks. Trying to call down the fire departments was not my point at all. My point was really to say that, my God, here is a group of dedicated people who have enough emergencies to look after, much less having to look after these. That was the point of my remark. It wasn't an offhand remark at all, although I can see how one might misunderstand it to that extent. I hope that with those few remarks, with the help of Hansard and exchanges between your colleagues and myself, I have answered your questions.

MR. MITCHELL: I have just a couple of questions. I would like to thank you on behalf of the Sooke fire department for at least one full-time member.

Is there a section in some act that guarantees a person hospital and medical care when he is not part of the welfare system? Can he go in there and say: "I get coverage"? You say that they will be treated. Whereabouts do you find it — that a person who hasn't got the money, hasn't paid up, is not a welfare recipient....? It is needed. I say that very seriously, as one who dealt many times with people in that predicament. If there is a section, I would appreciate it.... And I will supply you with a copy of all the letters.

HON. MR. MAIR: I don't know of a specific section of a specific act that guarantees those things which the member opposite has mentioned. But I can say that it is the policy of this government, as it was of your government, as evidenced in statements of the strongest form to hospitals and to the BCMA who in turn have issued their own statements to the same effect, that no one will be deprived of medical treatment or hospital care by reason of indigence.

As I said before, you are probably going to be able, in a province of 2.6 million people, to find some case where some officious busybody got in the way of that statement of principle, intent and policy, and the reality of it and delivery of it. But I am going to say that so far as I am concerned — I think I can make this statement — nobody will be so deprived, and I don't think people are so deprived.

MR. PASSARELL: I have a number of constituency

[ Page 3376 ]

problems I would like to raise with the minister. Let's get a realistic dialogue going, to see if we can alleviate some of these serious problems.

The major concern is in the community of Dease Lake, where there is no health facility. The previous Minister of Health last year made certain assurances to the community that the problem would be alleviated. I would like to offer an invitation to the Health minister to go up into the Atlin riding sometime soon and view the problems to get a first-hand knowledge of what the people in....

HON. MR. MAIR: Just let me out of here.

MR. BARRETT: Take him with you!

MR. PASSARELL: We'll get a pairing agreement.

The community, as the minister is probably aware, has no facility. There was a nurse hired last year at approximately $190 a month; I think that has been increased in 1980. But there is still a definite problem of no facility — a trailer of some sort. The community is growing; there are over 400 people there. It's difficult at times to go the 90 miles to the private hospital in Cassiar. The air ambulance service is a very good program, Mr. Minister, but its dependence on the weather conditions in the north is a problem. At most times in the winter it is very difficult to have an aircraft land in Dease Lake. So I would certainly hope that the minister could get some type of facility into Dease Lake to help the people in that area, as well as give some assurance to the nurse up there that she won't always have to operate out of her house in a crisis.

The second constituency problem is in the community of Atlin. I appreciate the letter the minister sent me concerning the God-bless-you holistic society and the aspect of cosmic surgery. I appreciate the minister's response that cosmic surgery will never take away from conventional services. The group itself is looked upon by members of the community as the only medical facility per se in the near future. The Red Cross operates a first-aid station out of the community of Atlin.

HON. MR. MAIR: Is this still Dease Lake?

MR. PASSARELL: We're in Atlin now.

More and more the God-bless-you holistic society is talking about building their cosmic surgery facility in Dease Lake to help the people of the area. Since the community of Atlin is developing — 400 or 500 people — there is a definite need; the Red Cross outpost there can't cope with the entire services. The holistic society feels that they can come in and be able to alleviate the health problems of the community of Atlin, which has quite a few people upset. They look upon the old methods of doctors as being more trustworthy than cosmic surgery.

Secondly, in the community of Atlin there were a number of problems related by Mr. Jack Green Sr. concerning a problem that his wife faced, a chiropractor problem. Atlin is located very near the Yukon, specifically Whitehorse. She had hurt her back, went up to Whitehorse because that was the closest chiropractor, and it was found that their B.C. Medical didn't take care of the problem. They had to go a chiropractor in British Columbia. When you live in a border town per se in northern British Columbia, often it's closer and more viable to go to the Yukon to receive a chiropractor's help than to drive 400 or 500 miles down to Terrace. Since we're dealing with maybe 10 or 20 cases per year in northern British Columbia, I was wondering if the minister could make some type of an exception for the people of the north so they could go to Whitehorse or Watson Lake in the Yukon and receive chiropractor help instead of driving 400 or 500 miles south to Terrace. We're not talking about too many people, Mr. Minister — at the most 10 or 20 a year.

In the community of Cassiar, as the minister is probably aware, there's a private hospital, a first-aid station that a company operates. There's a definite need for the provincial government to step in further to help in Cassiar since the operation is done more or less entirely by the company. The private hospital in Cassiar does take in quite a large area for people who are coming in. Specifically, people have to drive up to Dease Lake, people south, down to Cassiar from Good Hope Lake and along Highway 37. With the area growing there's a definite need for a provincial first-aid station in Cassiar. It's a lot of trouble that the private company in Cassiar is going through to provide the first-aid station in the community, taking four or five communities in the vicinity.

The other constituency problem is in Stewart. There is a need for greater involvement with the mental health aspects that are associated with an isolated mining community; and support services associated also with the aspect of a rural, isolated area.

A number of letters were written to the minister by the principal of the school, Miss Jennifer Leary, talking of the need for a part-time psychiatric nurse, doctor, or associate to come into Stewart on a regular basis, because of the problems associated with an isolated area in the north. Stewart's population now would warrant a part-time psychiatric assistant.

Concerning dental care, I as well as many residents of the north would want to have some type of guarantee that the north wouldn't be left out of the program entirely, and receive more than a tokenism aspect. There is a definite need for priority from the ministry to help out with some type of travelling dentist to visit northern communities. Two years ago the federal government had a program in which they hired a travelling dentist to come through the area to go into some small rural communities and help the people with their dental problems.

I could make some suggestions to the minister concerning health care in remote areas. These are suggestions of a comprehensive ambulance program. Right now there is an ambulance that is located in Dease Lake by the Ministry of Highways. One of the problems is that the operator of the ambulance has to be a member of the Highways department. At times, specifically on weekends or late at night, it is difficult to get an employee to get into the yard, start the vehicle and take someone up to Cassiar to receive medical assistance. I know that the ministry has provided an ambulance in the community of Atlin, and it is greatly appreciated by many people in the area.

Second is the development of a first-rate emergency facility in isolated areas. Right now we have problems with the jurisdiction in many communities regarding federal and provincial jurisdictions covering the health services of people, depending on whether they are native or white. There is a definite improvement that is needed in isolated communities for some type of emergency first aid stations. These are trailers that the ministry could buy for $10,000 or $15,000 and have them located in the communities, where people know where they can go to.

The third aspect as a suggestion to the ministry is the

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training, licensing and distribution of such professionals and paraprofessionals in the health services area to go into the north and do some type of apprentice training to give some type of assistance to people who don't normally see a doctor, dentist or chiropractor. There is a definite need for the government to set up a more comprehensive program for health trainees for the northern doctors, dentists, etc. It's very similar to a program set up in Australia in which the outback doctors go into communities, flying into the areas, once they receive a radio call to go into it.

More or less that is the last aspect on constituency problems. I certainly hope the minister could answer some of the questions. Dease Lake is the main aspect. One of the problems — I hope we don't fall into some type of philosophical argument about this — is that northern communities supply vast amounts of revenues south and I think people up there are finding themselves, because they are isolated in the north, getting the blunt end of the stick when it comes to health aspects. I hope the minister could alleviate those people's problems by thinking that because they are isolated in the north they receive little. When they look at what is happening in Vancouver and the mainland and the south of this province to see what facilities those people have....

It is unrealistic to believe that every small community in the north is going to have a hospital. That is not the people's feeling or belief, but they would like to have some type of a trailer where, if you do get hurt, you know where to go to to get a band-aid or some type of medical drugs of some sort. At the present time there are some communities where you can't pick that up, specifically Dease Lake. I would appreciate the minister's response to those short questions.

HON. MR. MAIR: A number of the remarks made by the member for Atlin I took to be suggestions more than questions and I want him to know that those suggestions will very much be taken under consideration. I think I could tell you why, particularly, you can rely on that observation. We have on staff now a Mr. Brad Gee, who is director of special care services. The principal reason for his existence on staff is to look into — for want of a better word — remote communities and the problems and needs they have that can't be met in the same way they are met in the larger communities. I am sure the member not only understands but revels in the fact that the smaller, isolated communities have a great benefit accruing to them by reason of their isolation, which is the reason a great many people prefer to live there.

They expect that the number of the services found in the larger areas won't be there, and they're prepared to make some sacrifices in order to have the peace and quiet and the outdoors and the wildlife and all of those things which are of so much benefit to them and not to us. But that doesn't mean that we can't and we must not bring to all people of British Columbia basic health service. That is the object of our exercise, and Mr. Gee is the person on my staff who is given that responsibility. I might say that he has just come back from Dease Lake, from an evaluation of the situation up there. While I don't know that this is the only thing he has recommended, the nurse in question is going to be brought back down into the southern part of the province for retraining and sent back up. So we have addressed ourselves to some extent to that problem.

On the question of the ambulance in Atlin, the member already mentioned that the ambulance is fairly satisfactory. I want you to know that we have a proposal now before Treasury Board to improve that service. So even though you are relatively satisfied, I want you to know that we're going to be on to that.

The chiropractor. You know, that's a very interesting proposition. When I was in the Ministry of Environment, we had a similar problem with Fish and Wildlife, where the checkpoints for the game people were in British Columbia and all of the hunting was done at a point closest to the Yukon territories, where they took off, which meant that they had to go all the way down a lake — I'm not sure which one it was — in order to check out before they went out. I don't know whether we addressed ourselves to that or whether I left that for my colleague who's now got the job; but in any event, at that time I felt that was pretty stupid, and I don't see any reason why we can't do something here. I don't know whether we issue a card or something along that line. But I want you to know that I'll take a look at that and try to come up with an answer, because it doesn't make any sense that an artificial line should separate somebody from having services paid for that would be paid for otherwise, if the chiropractor happened to be in British Columbia.

The private hospital in Cassiar. Again, the ministry is having meetings up there, and the same thing with Stewart. We'll take a greater involvement and I'll have Mr. Gee go in there as part of his duties so that he'll be able to report back to me on that.

Again you mentioned — and I think this was by way of a suggestion rather than a request for any under-taking from me — the question of the dentist. I will undertake to take that up with Dr. Allan Gray, who is in charge of that program, and see what we can do in that regard. As I say, I recognize that most of the things that you have told me are suggestions, and they are ones which I will take very seriously.

I must again advise you that some of the difficulties we have in Atlin are related to something we talked about the other day, and that's the federal government and Indian Affairs. Had it not been for the fact that we got into a bit of a discussion on another ministerial statement yesterday.... I had a ministerial statement on the Alert Bay situation which I meant to make yesterday and if I remember I'll do it tomorrow to give you some idea of the kind of dichotomy we've got ourselves into with the federal government. I hope that because the situation has got so bad it will improve rapidly. I hope that people will start to come to their senses and recognize that there's just no sense going at these things separately; there's just one person we have to concern ourselves with, and that's the member of the general public.

With that, thank you for the suggestions. I will take them up and I'm sure that you will, as you always have, confer with me privately on these matters where need be.

MR. STUPICH: Just over a year ago all of us were subjected to a barrage of letters from patients of chiropractors asking for more coverage for chiropractic treatment. About a year ago. In July, when we were dealing with the Ministry of Health estimates and I asked the then Minister of Health about these requests, I was assured by the then Minister of Health that he was reviewing the whole question of ancillary health services and was not prepared to move on extending the coverage for chiropractic care until he was ready to deliver a package that would include naturopathic physicians and all of the others involved in that category. That review apparently was going on a year ago today. I'm wondering whether the review was ever finished, whether this minister

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is aware of the review, or exactly what is happening with respect to increasing the coverage for that kind of ancillary service.

While I'm on my feet I'd like to ask what this particular minister's attitude is toward acupuncture. The minister smiles and I smile myself in asking the question.

I'd like to relate a personal experience. I had a very bad neck condition late last fall. I went first to a chiropractor — and went several times — and felt that I really wasn't getting much relief. It was bothering me so much I went to a medical doctor who gave me three different prescriptions that I was taking on a daily basis. I continued to suffer to such an extent that I finally went to an acupuncturist. I didn't really care which one of them was doing me any good, as long as altogether my neck got better. I was most impressed with the acupuncturist, I must say. I didn't go there intending to be impressed, because I had previously gone to an acupuncturist for a different problem and received absolutely no relief. However, in this instance the only one to give me any neck exercises at all — and I couldn't help but feel that it was perhaps the exercises that did more than any of the other treatments — was the acupuncturist. I am wondering whether this minister is at all impressed with acupuncturists.

HON. MR. CURTIS: Could you demonstrate the exercises?

MR. STUPICH: Not in here, but if you want to have a look sometime, yes.

HON. MR. MAIR: I would think that this place is the acupuncturists' seminary. There are more needles in here than in the real world.

Dealing with the question of chiropractors, Mr. Chairman, through you to the member for Nanaimo, I have now got a submission before Treasury Board in this regard. I spoke about it just a few moments ago, I suppose just before you came back into the chamber. I have asked that we put that on a more reasonable basis. The difficulty was, as I said earlier, that we allow a global amount for chiropractors and, of course, as their charges go up the number that you are allowed becomes fewer.

On the question of acupuncture, I don't recall — and I certainly have gotten myself into some controversies bringing mail upon my doorstep — anything that has brought quite as much spontaneous mail. It is spontaneous in the sense that it is not something that I have said or done or that the government has done or not done. It seems to be that a lobby has, got this going. There is no question that there is an enormous number of people who feel that this is a good thing, that they get relief and good treatment from it. I think that a great many medical people — physicians and surgeons — feel the same way.

I think the difficulty that we're having is determining who should do it. How do you separate the charlatan from the real practitioner? I'm not suggesting that it has to be a doctor. I'm just asking how you know that the person performing the acupuncture really knows what he is doing and is not somebody who has just jumped in with a set of needles and decided he is going to climb on a good thing?

I can only tell you this, Mr. Member, at this point. One of the early things I did was to take this problem up with the College of Physicians and Surgeons — with Dr. Hutchison. I'm going to continue my discussions with him to see if we can't work out some way that we can license this practice and control it to the extent that the public is protected from those who would practise the art without having any basis for doing so.

My own feelings are that if a person feels better by reason of a treatment, it's not for us, in our very limited wisdom, to say that because it has not been done before in our society, or it does not meet the standards of those who have practiced healing arts in our society hitherto, we should reject it — far from it. We would be rejecting today many healing methods which are current, very satisfactory and very helpful if we applied the standards of even 10, 15 or 20 years ago. My personal prejudice is in favour of acupuncture provided we can find a way to certify those who are truly competent to perform the art. That is something I think we can work on and that I hope by the time we meet again on my estimates — or those of whoever is the Health minister — we'll have solved.

MR. COCKE: I have one or two words on acupuncture. One of the things that we did in 1973 was set up an acupuncture committee. That committee was composed of lay people; as a matter of fact the member for Burnaby-Edmonds (Ms. Brown), the then member for Vancouver-Burrard — which disappeared into the mist somewhere — and a number of other people were on that committee, including physicians and government employees who were physicians as well. One of the reasons we set up a pain clinic at the VGH, and I believe also here at the Royal Jubilee, wasn't only to alleviate pain but to try to find some method of determining how to assess one's ability to perform the art.

I must confess that when I visited China I was very impressed with some of the outstanding medical people's advice with respect to acupuncture. I was in Shanghai Hospital No. 6, which is the hospital that Dr. Chen practises from, and he's probably the world's foremost orthopaedist. He's the one who was sewing on limbs and fingers long before anyone else in the world got around to it. He's probably 15 years ahead of his art and profession. He had a tremendous faith in it, particularly with respect to operations and pain-killing, from that standpoint. So I hope the minister is determined to do something, because really nothing has been happening since.

Many of the doctors themselves have acquired some training. I think what they are trying to do is limit it to their own profession. They are thinking that only doctors can practise this art, and other people, who they consider to be lay people or charlatans, should not. I certainly agree with the minister that you must not leave a wide-open door to charlatans because if you do, believe me, they will come in by the bushel. But if there is some way of testing and....

There should be some way that people can go through a testing process and then have review from then on when they are in the practice. I hope that we do take a real good look at that particular eastern practice of medicine because it has, in my view, something to commend it.

I have one or two other things. Incidentally, I believe that heart surgery has been cut down. I know the minister indicates that it is going along trimmingly at a rate of X. I recall back in January there was a cutback of some 20 percent at VGH. I suspect that is still in force. I really think there are bypasses that should and shouldn't be done, but there is a tremendous demand for it now. I am informed there are people who are in relatively critical shape that are waiting for that surgery. Naturally you always hear of those that die, but

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they may have died in any event. I think the minister should take a real good look at this particular aspect.

You naturally have to be careful you don't over-provide for that rather expensive procedure. When you have so many younger people who, but for a bypass, could be very productive, I think that we should be looking at them very carefully. Of course, some of the older ones could lead a productive, painless life too.

I would like to draw the minister's attention to this beautiful little document. This is the funding application guide from the Ministry of Health, special care services. This government, which told the world when they were seeking election, both in 1975 and in 1979, that they believe in voluntary participation in order to keep prices down, and so on and so forth.... In order to get voluntary participation, it strikes me that one of the things you have to do is back these societies. Now a society seeking funding from this government has to go through more rigmarole and red tape than is believable.

I saw an application the other day, that I think most of us got. It was an application from some project closer, I guess, to the government's heart; I believe it was from the Greater Vancouver Regional District. They needed some large amount of funds. It was a one-page application for this significant amount of money.

But a group offering real service, such as our senior citizen's project in New Westminster, and others, has to go through a monumental amount of paperwork. Heaven knows, when this paperwork gets to Victoria, then the bureaucrats have to go through it, and that's almost a guarantee that they're never going to get it. Who has time to go through this kind of procedure in order to get some funding? It is just absolutely monumental, when you compare it to any form of request that I've ever seen. This is government gone utterly wild. It's to be expected, but I would ask that the government take a second look at this kind of application which really handicaps these groups. They can get all the information they need with an awful lot less paperwork. They're putting everybody in the same category....

MR. LEA: They're probably buying paper from the Los Angeles Times.

MR. COCKE: There's no question that this keeps the forest poor of trees. With this kind of paperwork for each and every funding application, you're going to have to increase the cutting down of trees to make paper.

I also want to, before I sit down, talk to the minister about two.... I don't usually bring case histories into the House to any extent, but there are two cases that I want the minister to look at before tomorrow. One of them is the case in Richmond, and that case, Mr. Chairman, was the Ilse Rinke case, the widow of Rudolf Rinke. The other one is a Langley case, in the Minister of Energy's riding, and that was the Charles Hicks case.

The Minister of Municipal Affairs (Hon. Mr. Vander Zalm) is once again giving the Minister of Health all the help that he can give him, which is less than none.

Anyway, Mr. Chairman, I just wanted to give the minister a warning of that. I would like to hear whether or not his office has looked into either or both of these cases. One concerns the wife of Hicks, who died in a chair in the Langley Memorial Hospital, and there is some problem with respect to whether she was getting proper care and whether they were overworked and so on. I don't want to deal with the case particularly, but I would like to know whether the minister has looked into it or would look into it.

The other one is a case of a person who died a very painful death — that's the Rinke case — outside of hospital, and there is some argument here as to whether or not it was the hospital or whether or not it was the medical profession that decided that she didn't require the service.

So, Mr. Chairman, with that I would move the committee rise....

Interjection.

MR. COCKE: If the minister wants to go and draw attention to the clock, then I'm quite prepared to go until 6:05 p.m. or whatever he'd like. Meanwhile, I move the committee rise, report progress and ask leave to sit again.

Motion approved.

The House resumed; Mr. Davidson in the chair.

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

Hon. Mr. Vander Zalm tabled the annual report for the Urban Transit Authority of British Columbia.

Hon. Mr. Williams moved adjournment of the House.

Motion approved.

The House adjourned at 6 p.m.