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CONTENTS

Ministerial Statement

Health services in Alert Bay.

Hon. Mr. Mair –– 3381

Routine Proceedings

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

On vote 114: minister's office –– 3381

Mr. Cocke

Mr. Gabelmann

Mr. Hall

Ms. Brown

Ms. Sanford

Mr. Levi

Appendix –– 3401

FRIDAY, JULY 18, 1980

The House met at 10 a.m.

[Mr. Davidson in the chair.]

Prayers.

MR. D'ARCY: In the gallery today we have two young adults, occasionally from Castlegar. I'd like the House to join me in welcoming Michael and Rebecca D'Arcy.

HON. MR. CHABOT: Mr. Speaker, in the gallery today we have an old friend of mine, Mr. Gaston Lapalme from Granby, Quebec. We worked together on the railroad, the CPR, in the province of Quebec so many years ago that I wouldn't want to say how many years that was. I want the House to welcome him to Victoria.

HON. MRS. McCARTHY: We have two friends in the House today that I would like you to give a special welcome to. The first one I would like to introduce is Dr. Shrum's executive secretary. As you know, Dr. Gordon Shrum is one of our great British Columbians associated with the building of the tremendous trade convention complex in the city of Vancouver. I would like the House to welcome Maureen Grant. Accompanying Maureen is John Gorham from Toronto.

HEALTH SERVICES IN ALERT BAY

HON. MR. MAIR: If this is the appropriate time, I would like to make a ministerial statement.

The members opposite, and indeed my own colleagues, have from time to time raised the question of the Alert Bay situation, which continues to be a problem for all of us in British Columbia. I thought this would be an appropriate time to bring the House up to date as to where matters stand.

As I have already told the House, I have personally been to Ottawa to meet with the Minister of National Health and Welfare, the Hon. Monique Bégin. I would like to emphasize that this was a special trip, particularly for the situation at Alert Bay and the provision of health services to native Indians. In addition, the staff of my ministry have contacted the Assistant Deputy Minister of Medical Services, Health and Welfare Canada, in an attempt to clarify the present activity of the federal government at Alert Bay. The latest discussion was on Wednesday morning, July 16. The report I can give the House now is as follows.

First of all, there is now a second physician at Alert Bay. This physician is on contract with the federal government, and for a short time only. Secondly, the federal government has now funded for a four-month period the hiring of a hospital administrator and three health board members. I emphasize this is not a hospital board but they have just hired these three members. The sum of the four-month contract is apparently $57,000 to cover salaries and expenses, and it is expected that the administrator and the board members, who will be full-time salaried board members, will review the present health services available to natives and make recommendations as to just what the health service requirements in that area are. Thirdly, Health and Welfare Canada are preparing a proposal for funding of a review on a much longer basis.

They have not, however, received approval from their Treasury Board for these additional funds at this time.

In order to further clarify this matter, I have requested a meeting with Dr. Lyal Black, the Assistant Deputy Minister of Medical Services, Health and Welfare Canada, and can confirm that if he receives approval from his ministry Dr. Black will be in Victoria to meet me next Wednesday morning, July 23.

It's difficult, as you can see from what I've just said, Mr. Speaker, to determine just what the future plans of the federal government are in relation to the provision of health services at Alert Bay. I realize that everyone is aware that health is a provincial matter, however the federal government are involved in the provision of health services to natives in this province, which, of course, complicates the matter.

I might say that in order to meet our responsibilities as the government of British Columbia, I have just approved the planning to proceed for a new hospital at Alert Bay. It should be understood that what I have approved is the planning of this hospital subject to the approval and participation of the regional district, as well as the approval and participation of the federal government on behalf of the native population.

This new facility, if approved by the other two government bodies, would consist of ten acute-care beds, two extended-care beds and three intermediate-care beds.

The requirements for detoxification would still have to be worked out and could be accommodated within the above hospital as planned.

In summary, Mr. Speaker, I thought that this would be an appropriate time to bring the House up to date as to the provision of health care services in this particularly sensitive area of the province.

Orders of the Day

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

ESTIMATES: MINISTRY OF HEALTH

(continued)

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

HON. MR. MAIR: At the risk, once again, of filibustering my own estimates, I will try to answer two questions raised by the hon. member for New Westminster (Mr. Cocke) late yesterday afternoon.

The first question concerned Mrs. Lily Emma Hicks. This was a death which occurred at Langley. I think that I can indicate to the member opposite just by showing him the size of the file that it has indeed been investigated by the ministry. I'd like to give the results of that investigation.

I think a couple of facts are in order, Mr. Chairman. Mrs. Hicks, at the time of her unfortunate death, was 94 years of age. She was admitted to Langley Memorial Hospital on September 10, 1979, and was confused and agitated when admitted. She died, unfortunately, on November 9, 1979.

Apparently she had been placed in a chair and — I don't know what the proper terminology is — made secure in that chair for the purpose of feeding. Ten minutes elapsed between the time she was placed there and when she was found dead. The autopsy report indicates that there was no evidence of trauma or violence, and I think it's important to note that.

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It was investigated completely; I have the autopsy report here. The apparent cause of death was heart stoppage or seizure, and I must repeat that there was no evidence of trauma or violence. I might just read the pathologist's final anatomical diagnosis:

"(1) Arteriosclerosis generalized severe with (a) 50 percent narrowing of right and left coronary arteries and focal myocardial fibrosis; (b) arteriosclerosis of cerebral arteries with cortical cerebral atrophy, especially in the frontal regions; (2) nephrosclerosis and interstitial nephritis; (3) focal myocarditis; (4) no evidence of trauma or violence."

The other question raised by the hon. member for New Westminster yesterday afternoon concerned a Mr. Rinke. This is a rather current matter in the ministry. I received a letter on July 11 which was a copy of a letter dated July 8 from Mr. Ross, who is the administrator at Richmond General Hospital, to Mrs. K. Yamamoto, secretary-treasurer of the United Fishermen and Allied Workers' Union. Unfortunately I haven't yet received a copy of the report prepared by Mrs. Rinke. At this point I have acknowledged receipt of the correspondence — I acknowledged that on July 15 — and I've requested my staff to obtain the details concerning this accident. I assure the members opposite I will review the matter as soon as I possibly can, and as soon as the information is available I'll make it available to them.

I might say, Mr. Chairman, in regard to the Hicks matter, that on the file, ready for my signature when I returned to my office last night, was a letter directed to Mr. Charles Hicks dated July 17 in answer to his letter which has raised concerns about the very unfortunate death of his wife.

I hope that answers the two questions raised by the member for New Westminster yesterday afternoon.

MR. COCKE: The answers with respect to the Hicks and Rinke cases are to some extent, I think, a valuable contribution — particularly in the Hicks case. There has been some doubt in my mind, created mainly by the fact that there was not staff on the scene and it was the husband who discovered this most unfortunate situation.

I guess the trauma of that has probably, if anything, emphasized in his mind what had occurred. I also have a copy of the coroner's report, as does Mr. Hicks. One isn't impressed with technical aspects such as that when there's so much emotion involved. However, as long as the minister is looking into this case and is in touch with Mr. Hicks, I think that's the main thing. There was a rather off-the-cuff letter written earlier, on March 13, by the previous minister. I think that probably re-stimulated his desire to get something going.

Mr. Chairman, I started out the estimates of health care by saying that the government has not shown that health care is a major priority with them. I have seen very little to change my mind or my attitude toward this particular situation. For instance, I see here a letter from a woman who's very badly affected by closure of beds in the VGH — a very traumatic thing as far as she is concerned, because she requires elective surgery.

I have here something that I will read into the record from a person who works at VGH. It is about the whole question of an entire ward, that's very badly needed, being closed down for one reason or another. I hear all the talk about the lack of nurses, nurses on holidays and so on and so forth. Each month of the year has its own excuse. In the summer months there are nurses who are away on holidays. The winter months are heavy because people prefer to go to the hospital during the winter, etc., etc. There's a different excuse for each month of the year.

If we were in these estimates in January or February when we probably should be if this government would only call the House on time.... Yes, Mr. Chairman, I remember the days when we used to discuss the health estimates in this House in the month of February. Now we never even start this House until the end of February, the beginning of March and sometimes later than that. Mr. Chairman, this is the government that says the opposition is holding things up.

Mr. Chairman, one of the matters that convinces me.... I want to make it very clear that I'm not aiming any particular barb at our hospitals per se. They're trying their best. Some are not as well run as others, but basically the people working in hospitals work there because it's a cause as far as they're concerned. It is not easy work; it is not the soft touch; it's a very difficult kind of work, because they're dealing every day with tragedy. Nurses, licensed practical nurses, nurse's aides and other hospital workers and doctors, of course, are all in the same boat. But when those people are constrained by the amount of care they can give, by a government that doesn't really give health care the priority they should, this is the kind of thing that happens — and I'm dealing now with the Rinke case.

This is a very shocking, very sad situation, and I think that since the minister hasn't got it available, I'm going to give him the information. This is a report on that case written by Mrs. Rinke:

"My late husband, Rudolf Rinke, a hard-working labourer all his life since he was 14 years old, died on Saturday June 21, 1980" — just the other day, Mr. Chairman — "at the age of 73. This is actually nothing new, because people die every day — even much younger — but Rudolf's death was very unusual; maybe not that unusual, because it may happen many times in our city, only people, specifically nearest relatives, are not talking about, it, because they are too upset with grief, too stunned to believe something like this can happen in our society in the year 1980 — not 1880 — or just do not know what to do.

"Well, I do not intend to be quiet about this, even if I'm not able to help my husband any more, but maybe bringing this into the open I may be able to help other persons die in dignity.

"To start with, my husband did not die in dignity. He died five minutes away from hospital under the most degrading circumstances. So I will write in my simple words what happened on Saturday, June 21, 1980. Before I do I would like to give you just a short picture of the history of his illness.

"He had angina pectoris, which we kept under control with medication, a balanced diet, usual visits to our family doctor, and every one or two years an examination by a specialist. He survived several heart attacks and only on the first one, eight-and-a-half years ago, was he hospitalized. At the end of May, after seeing our family doctor because he had low blood pressure, I asked for an appointment with our specialist, which was June 2. He discovered a tumour in the rectum and ordered further tests and also made an appointment with a surgeon. The diagnosis: inoperable malignant tumour and also malignant spots in the upper lungs. He was set for an appointment at the cancer clinic on June 27, 1980. On Friday, June

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20, his only complaint was that he felt very slack and retired about 9 p.m.

"Saturday at 10 a.m. he had an appointment with the family doctor to tell him about the cancer. He woke me at 4:30 a.m. on June 21 (feeling sorry to do this), but he could not stand the pain in his back and shortness of breath any longer. From now on I go by what happened during those 14 or 15 hours. The time is not completely correct by minutes, but very close.

"I called the answering service and asked for a return call from a substitute doctor — the family doctor was not on call. The doctor phoned back and advised me to take my husband to the hospital by ambulance. My understanding was he was going to meet me there. The ambulance gave him oxygen. The emergency ward was empty. One or two walking patients were treated for minor injuries. The admitting nurse took blood pressure and asked what the problem was and I gave a short history. The substitute doctor did not show up. A lady doctor finally came and checked his lungs. She told me he had some fluid on his lungs, she would give him a syringe, and also told me that he would urinate for quite some time, for the next hour or two. I asked if he could stay but they said: "No, because there are no beds." I found out later he could have stayed until 11 a.m., because at that time other patients were being discharged and beds were available at that time.

"I insisted on talking to my family doctor. He told me to take him home and bring him back to his office at 10. I called a taxi. I had to bring him outside in his pajamas with no wheelchair.

"He could not get warm in bed and it was quite tiring for him to go from the bathroom. We finally gave up. From 7 to 10 a.m. Pain in the back getting worse. Nitroglycerin doesn't seem to help. Pulse 68. He complains of being very cold and is very restless. I try to calm him down. Have promised to phone the doctor at 10, because he's having an appointment anyway.

"At 10 a.m. I phoned answering service to get in touch. She said that it was impossible because this was his day off. Even after explaining to her that he was waiting for us, she told me that he was only notified if somebody was gravely ill or dead. After I threatened to call the police she finally put me through. The doctor promised to come after he was finished with his patients.

"From here until he finally came my husband got worse by the minute. After 1 p.m. the doctor came, checked the blood pressure and lungs, gave him a hypodermic needle to ease the pain, ordered some liquid medicine and advised that I should continue the heart medication. He told me on the way out that the best for him would be if he had another coronary and could die quickly.

"The injection helped him for about 20 minutes. From then on until he died shortly after 7, he was in agony. When I tried to give him medicine he choked. He could not lie down, even with the pillows. I had him on his back. He couldn't sit up. He tried because he could breathe a little better. He was sweating and shivering at the same time. Because he could not swallow he sucked on a wet cloth. I could not leave him because of his condition and never felt more helpless in all my life. Every minute seemed like an hour to him.

"Finally a neighbour phoned an answering service again and made it urgent that some doctor come quickly. Then I lost track of time and he finally phoned between 4 and 5. I told him my husband was dying, and he said I should give him his medicine. I told him: 'He can't swallow.' He said: 'You should find a way to get it down.' I could hear my husband crying from upstairs and told him I had to get off the phone and attend my husband. He never phoned back and he never showed up.

"For the last two hours of his life my husband was crying in agony: 'Momma, help me. Please help me. I can't take this any longer.' He was fully conscious until the end. His pulse was around 60 but got slower closer to the end. He just had pain all over his body, especially in his stomach and back. Two of my neighbours were at my house when he died. I could only feel a great relief that he did not have to suffer any longer. I also felt so much bitterness and anger and still can't believe that this could happen in the year 1980 with all the modern facilities in hospitals to help a human being not suffer in the last hours of his life."

Mr. Chairman, there is some philosophy here and there are some things that happened after the case. I suggest that this is the kind of thing that happens when hospitals are pressed by virtue of one thing or another — shortage of funding, lack of leadership or just general lack of priority for the provision of health care. This person didn't die in dignity. This person died in a great deal of pain in an age when it's not necessary. If it were in fact 1880 or, for that matter, if it were 1920 there would be some excuse for this. But in an age when we are surrounded by potential care, by hospitals and practitioners....

I've talked to doctor after doctor and they have told me that they have extreme difficulty getting people into beds. One of the problems they have beyond that is that if they take up one bed with this person, then they lose access for their next patient. So if this minister wants to do health service and the provision of health a favour, then I suggest this minister is going to have to get on with it; he is going to have to get out there into the health community and assure that community that they are going to have the backing of this government. If they don't, Mr. Chairman, this government deserves to be turfed out immediately.

To back that one up, let me read you a letter from a nurse in Vancouver: "Dear Mr. Cocke: Thank you for your phone call. It again renewed my will to fight in my own way" — I was answering her call — "and otherwise by the present government, especially in health delivery. The history of this situation...." I'm dealing now with Vancouver General Hospital. I want to tell you, Mr. Chairman, we know who runs VGH. The Minister of Health is the official administrator of that hospital. That hospital has never been taken out of administration since the former minister put it under administration. You have a board, but it is not a board of trustees. It is an advisory board. From that standpoint it is as much a responsibility of the Minister of Health as Pearson.

"The history of this situation is this: On January 2, 1980, we (wards FP-3 and HPA-4, VGH) received word that the government had advised the hospital administration that these rehabilitation wards were to

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be closed and become extended care. The 'become extended care' might have been an assumed possibility, but what else could one assume? This closure was to be April 1 and then June 1. The word now is three phases to the end of September as half extended care and half holiday for rehab, which is what we do now, except much more in the rehab area and a little in extended care. I feel a patient is the last consideration, or the least, and a poor vision of health care amounting to warehousing. These are reasons I feel these wards should not be misused."

Mr. Chairman, G.F. Strong Rehabilitation Centre is absolutely loaded. There needs to be an interim for these people with neurological disorders, backs, accidents, etc. so that they can get them into G.F. Strong in an orderly way. For that matter, they could go to the Holy Family Hospital in Vancouver, which is also a rehabilitation hospital and also loaded to the scuppers. It's the one that takes care of those with victims of circulatory disorders such as strokes, heart attacks and so on who require surgery.

Anyway, this is one of the areas for holding these people, and instead of keeping that area with some rehabilitative medicine going on, we're closing it down and turning it into an extended-care hospital — a desperation move. I understand the need for those extended-care beds. But, for heaven's sake, Mr. Chairman, we also require those beds that are going to lead people back to health, back to a productive life. You don't have that when you start closing down these very important beds.

Mr. Chairman, I'll go on to quote the letter:

"These are reasons I feel the wards should not be misused. At the present there is a good functional medical-surgical team of doctors, nurses, orderlies, physiotherapists and occupational health therapists serving both FP and HPA-4. The concentration of the whole team is the aim and all members have an input, as well as sharing of information. The patient care is not fractured by passing through many hands as it is when they are scattered throughout the hospital. Their progress has been facilitated by this concentration, and enough patients have confirmed this in their progress, combining specialty nursing, therapy and doctors. The concentrated aim of the team is all members' input, shared daily information, no fracturing of patient care — as in many wards — recognition by the patient of their excellent progress, transportation to acute-care areas if this is necessary, through the tunnel. This includes acute medical care, acute surgical care and planned return to surgery, like chondroplasty, bone replacement and any repair. These wards rehabilitate to accepted levels for the G.F. Strong Centre, Shaughnessy Hospital, Workers' Compensation Board, and outpatients level or community care facilities."

You see, this is the ward where they prepare them for these rehabilitation hospitals. The letter goes on to say:

"The screening process is done every Monday to assess the best possible candidates to promote the best use of the beds, those requiring immediate rehab to better return more quickly to work or home."

Mr. Chairman, this person writes like I do, and sometimes it is a little difficult to read. Nonetheless, any mistakes are mine, not hers.

"These are what I consider as highlights against closure. But there are many more reasons, like patients' feelings and peace of mind, rather than mechanical approaches. You will find enclosed a résumé of the ward admission and breakdown."

I have that in my office, Mr. Chairman, and I don't really think it's necessary, but if the minister would like me to, I can quote from it as well.

Now the case is this, Mr. Chairman, put as best I can. For heavens' sake, let's pay some attention to health care. The minister can get up in this House and tell us of this fantastic budget that they have set aside for hospitals. I agree, it's an extremely large budget, no doubt of it. Inflation has taken care of some of it, and a terrible budgeting system which I dealt with for some time, and I felt had to be changed, and still has to be changed. It is a system that rewards a person working at a hospital for burning supplies when it's getting close to the end of the year, rather than let it be shown that there are supplies left at the end of a fiscal year. Because the budget is on an incremental basis. That goes for staff, supplies — the whole thing. Incremental budgeting, Mr. Chairman, should have gone out in the mid-fifties, and it had better go out very soon, because that's one of the things that's breaking us. Anyway, aside from all that, I suggest that the minister is going to have to show absolutely superb leadership in order to get this back on the track.

His predecessor has spent far too much time preoccupied with other areas that were of little significance, and far too little time, Mr. Chairman, in the area that's so important to all of us. Everyone in this chamber, in this town, in this province, is just a step away from the health care system. If they, themselves, have a long step, they're lucky. But I bet they know a lot who are right on the threshold of requiring help. That's what this minister is confronted with, Mr. Chairman. And I just hope that he's going to give us some kind of indication that there isn't going to be this frustration, because there's frustration now. There is frustration throughout the whole health care system in this province.

I think I know better than most, because I've been involved either as a critic or as a minister, and then again as a critic for some 11 years, with the exception of two — but even then I was closely involved in the delivery of health care from the standpoint of a politician. Therefore I know many people involved at every level. I'm charging that there is chaos and frustration in the health care delivery system and there's a government in this province that better start doing something about it.

MR. GABELMANN: This morning I want to talk about three separate issues. The first is the question of health care in Alert Bay. I was puzzled earlier this morning in listening to the minister making his ministerial statement. I tried to determine what it was he was announcing that was new. Perhaps I didn't listen very carefully or don't hear very well, but I didn't hear anything new in that statement concerning health care facilities and services in Alert Bay. It may be that the minister was just trying to demonstrate a concern that he has, and if that was the case, good. I would welcome that.

I want to spend a few minutes this morning talking about health care in that community and I don't want to do it in a partisan or political way. I want to talk about some of the feelings that I think exist in the community and try to talk about, very frankly, some of the dilemmas that I face as the MLA for the area and for that community in particular.

Alert Bay is a community that is very, very sharply

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divided. No one will ever argue about that. It's made very clear when you come in off the ferry. If you turn left you go to the Indian community and if you turn right you go to the white community. Those demarcation lines are very, very clear. You feel them when you get off the ferry going into Alert Bay. It's a feeling in the community; you cannot help but feel the sharp divisions between the two communities. In fact, whenever you talk about Alert Bay you must, I think, talk about two communities, because whether we like it or not, whether we believe in an integrated society or not, that community is not integrated. That is in many ways.... I'll get back to this in a moment. I understand there's something else that needs to happen in the House.

MR. CHAIRMAN: Thank you very much, hon. member. The hon. member for Omineca.

MR. KEMPF: Thank you very much, Mr. Chairman. I would ask leave of the House to make an introduction.

Leave granted.

MR. KEMPF: Mr. Chairman, just arrived in the gallery are two very hard-working and enterprising individuals from a community in my constituency, Fort St. James. They are Josie and Tosh Hirowaturi. I would ask this House to join me in making them welcome.

MR. CHAIRMAN: I thank the hon. member for North Island. Please continue.

MR. GABELMANN: As I was saying, the community is a very divided one. I began to talk about — and I will use the word, although I want to use it carefully and in its proper context — the racism that does exist in that community. Local residents will, of course, deny that automatically and naturally and I understand why that would be denied. But in all of my travels in many parts of the world and certainly in many parts of this country I haven't ever seen a community as clearly divided on racial lines as the community of Alert Bay.

Before I proceed further I just want to read a statement that the Indian chief in that area made in 1914 to the McKenna-McBride cutoff commission. It was Chief Lagius in 1914. In speaking to the commission he said: "I would like to speak on a hospital for me and my tribe. Speaking for the Kwakiutl people, I feel that we ought to have a hospital of our own and a doctor of our own, because although there is a hospital at Alert Bay it is not an Indian hospital."

Those words were uttered in 1914, 66 years ago, and they are true today as they probably were then. There is an overwhelming feeling on the part of native people, from the Nimpkish band, from the All Nations band, and from native people who live in various communities in and around that area, Tuynour Island and others. Whether we agree with it or not, they very much want to have their own health system. Many of them want to have their own education system: many of them want to have their own structures and control over their own lives in a variety of ways.

When I go into Alert Bay, as I've done half a dozen times since the election, I am confronted on one hand by the white community.... I should point out the politics of Alert Bay. Both communities vote for me, by and large. We have party members in both communities. As you can imagine, that makes travelling into Alert Bay fairly difficult for me, because I have to try to continue to get along with everybody in that community. I have tried very hard not to appear to be clearly on one side or the other in the internal arguments that go on in that community, but I have come to an overwhelming personal conclusion that before we can have an integrated community, and an integrated health care system we must have a more segregated one for some years to come.

Let me try to explain to you why I believe that. I have tried to explain this to white people in the community, most of whom reject what I say, some of whom are beginning to understand it. In my judgment, one of the fundamental and most basic causes of problems with native people — health care, alcoholism, social problems, unemployment and on and on — relates to a question of pride. They are no longer a proud people, by and large. They were once a very proud race. Over the last 100 or 200 years, we have knocked that pride out of them in a number of ways. I believe we will not take the first step on the road to curing alcoholism, to resolving health care problems, to making the Indian communities self-sufficient and vibrant again, until Indian people are allowed once again to be able to be proud. For that reason the construction of museums, the restoration of all the artifacts that were taken from them, in Alert Bay's case in 1922, the almost-completed museum in that community.... The development of a clearly defined community with its own leadership and control is very important, because those steps are the first toward the ability to be once again proud as a people.

In Alert Bay that is happening. In other reserves in North Island it is not happening. It is beginning to happen. One of the things they argue that they need — I agree with them — is control over their own health system. They perceive they can gain that control more effectively through federal administration of health as opposed to provincial administration. In this House we might all say it is not logical. Why not have one health care system for all the people on Cormorant Island or some of the situations elsewhere? It doesn't make sense to have two separate systems in a small community like that with 600 whites and 1,000 Indians or thereabouts. But it does make sense if you look at it from the perspective of a downtrodden people, a people who are grasping and fighting, clawing their way back to their roots, as it were.

I appreciate that the minister has been temperate and cautious in his statements about Alert Bay; I have tried very much to use similar judgment in commenting on the problems. But after repeated visits into that community and visits to others.... I have a great many, because 25 percent of my constituents are native Indians. There are a lot of native Indians with whom I deal, and probably the worst reserve in the province is in my riding, Tsulquate in Port Hardy, and probably one of this wealthiest, Cape Mudge on Quadra Island, is in my, constituency, and the whole range in between.

This is not a political question in a narrow sense, but what I have decided is that the most important thing we can do as whites is to allow natives to regain their pride, using whatever mechanisms they require. If we can assist them along that route we will solve, in a generation or two, some of these problems that have gone unsolved for many generations. Allow them their pride and I suspect we will be on the road to ending the massive unemployment, massive alcoholism and the fair degree of illiteracy that exist. In that context, having made that judgment, I am very much in support of the federal government having its own health care system in the corn-

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munity of Alert Bay, as much as possible administered locally by the native people. I say Alert Bay, but it is the Nimpkish band, the All Nations band and others around there — for the sake of simplicity, the Alert Bay natives.

Allow them that, Mr. Minister. Many of my supporters in Alert Bay in the white community won't agree with what I'm saying. I have made every effort when I talked to them to try to persuade them that even though this is going to take a couple of generations, this is the right beginning for the solution of native Indian problems, particularly related to health care. It's going to cost a bit more money in sheer capital dollars doing it this way; I think it will be money well spent. I leave that for the moment; I may get back to it if we get into a bit of a discussion about it.

[Mr. Kempf in the chair.]

On the question of the hospital, there is a lot of confusion about why we need a new hospital in Alert Bay. There is a 35-bed hospital there now. I don't want to get into whether we do or don't need a new facility. There is divided opinion about it. Certainly the village council in Alert Bay wants it; the regional district wants it. They want a 25-bed hospital, as you know. I'll just read something from the Mayor of Alert Bay, as quoted in Gary Goldthorpe's report — and this is Gilbert Popovich, the mayor:

"After many studies and much debate, including two reports — the Grey and Pitkethly reports in February '79 — the Mount Waddington Advisory and Planning Commission unanimously recommended a new 25-bed hospital for Alert Bay. This recommendation was supported overwhelmingly by the regional directors. Eight voted in favour and one was opposed.

"A recent letter from the provincial Minister of Health" — your predecessor in this case — "confirms that hospital utilization in Alert Bay exceeds that of the provincial average. This fact, in our opinion, justifies our demand that a new 25-bed hospital be built in Alert Bay."

You're talking about a 15-bed.... I understand the design of the hospital may allow for 20 at some future date. I hope that's the case. I hope you would consider that the health care situation in general in that community is not typical. We won't disagree about that. It is so atypical as to demand entirely separate and independent evaluation of the need. The alcoholism in that community — it's not confined to the native community, I might add — is a widespread problem in North Island because of the remote nature of the communities, etc. Much of the hospital use is alcohol related. The use on a per capita basis is just so much more than anywhere else in the province. Some may argue that's because people use it as a bit of a hotel and a drying-out place; if so, maybe that's all right. You know, we have to make those kinds of judgments as well. So I would urge that in any consideration of health-care needs, particularly relating to the hospital, you should be very careful to investigate the unique nature of that particular community.

For the moment I'm going to leave the Alert Bay question. The most important message I want to leave is that if we can do something to assist natives in regaining their pride in their own culture and their own lives, we will go a long way toward that first step to repairing the terrible state that exists in most reservations and in most Indian communities.

I'm going to talk about rural health care and rural medicine for a few minutes in a broader sense. One of the features of our society that always strikes me as funny is that we have.... Let me just pick on two very important services that society demands and government provides: one is policing and the other is health care — both important, both urgent. When it comes to providing policemen in communities, we don't have any problems in our society making sure that there is a proportionate representation of policemen in each community. We don't have any difficulties making sure there are four RCMP officers in Alert Bay in the land division and four more in the marine division. We don't have any difficulty throughout the country allocating police resources. We say it's an absolutely required resource, therefore we're going to create a system that makes sure policemen are going to go into these communities, and we assign them.

When it comes to health care we say: "Let free enterprise take it over." So what we have is an excess of doctors in Kelowna where the living is good, and a shortage of doctors in remote communities where the living is not so good. And for some reason we say that because doctors work on this fee-for-service basis, it's their choice as to whether or not they go into a community. We don't say that about RCMP officers. Could you imagine how many RCMP officers would go to Alert Bay if it was based on fee-for-service? You wouldn't have anybody in there.

You might have the odd person with the rare qualities of the kind that led Dr. Pickup to go in there in the first place. You might find the odd RCMP officer with those rare qualities too. But don't we have a double standard, a unique way of dispensing what must be at least as important a service to the community — health care — as policing? Yet we leave health care up to the vagaries of the marketplace, and we say about policing: we're going to make it compulsory, we're going to assign people. It does not makes sense; it is not a fair system.

Many of these communities in North Island require — whether doctors are in there on salary or on fee-for-service — additional supplementary allowances from the government. I was pleased to hear yesterday that you have a chap working on rural and remote health care. That's a very good step, in my judgment — overdue and most welcome.

Let me give you examples. On the whole west coast of Vancouver Island, from Hot Springs Cove all the way up to the north end of the coast in my riding, we've no doctors except for a couple in Gold River. We had a couple in Tahsis and now we have one.

Let me just deal with Tahsis for a minute. When we had two doctors in Tahsis, a husband and wife team, they were able to look after the medical needs of Tahsis, Zeballos, Kyuguot, all the west coast communities. There was a great deal of travel and time spent just getting around. But because they were husband and wife they didn't require the kind of income, nor did they demand the kind of income, that doctors normally would. There is not sufficient work on a fee-for-service basis in that part of the province to justify two doctors in Tahsis. They can't make enough money on fee-for-service. So we now have one, but one doctor is so insufficient that it's beyond describing. One doctor has to travel and to be available for basically a full caseload in the community of Tahsis. Yet they can't attract another one because there wouldn't be enough money generated from fee-for-service.

I would urge very much that when you are considering the rural and remote health care, the whole idea of subsidiz-

[ Page 3387 ]

ing, putting on staff, or finding some way of making sure there is adequate health care in those communities is looked after.

The final issue I wanted to deal with this morning is mental health. There's a group in North Island called the North Island Mental Health Committee. That's the North Island as North Islanders understand it, which is the northern half of the constituency of North Island.

HON. MR. MAIR: That's the real North Island.

MR. GABELMANN: That's the real North Island, and they never let me forget it. Campbell River, as they say, is mid-island; people tend to forget that.

However, in this report — I won't go through it all; I'd just like to read a couple of paragraphs from part of their report — it says. "In Port Alice, according to statistics gathered by Dr. Emanuel over the last nine months" — this is more than a year old — 23 percent of his patients are suffering from psychiatric problems." One out of four of the patients of the doctor in Port Alice were suffering from psychiatric problems. "Of these, 19 percent are neurotic and psychotic symptoms, the remaining 5 percent are due to alcoholism."

In the Nimpkish Valley, according to statistics gathered by the physician serving this area, 50 percent of the female population, and 15 to 20 percent of the male population, are on Valium. Half the women in the Nimpkish Valley are on Valium, a drug commonly prescribed.... We all know what Valium is. And it goes on; they talk about Port Hardy and other areas in North Island.

We have — and it's not just true there; it's true in other parts of British Columbia, and other parts of our country — some very severe emotional and psychiatric problems created by the isolation of the area and the nature of the work. The workforce is predominantly male. The women are living in situations where often the men are working more than the 40-hour week. They're often out in the bush working six, and sometimes seven, days a week. The women are left. As my colleague for Comox (Ms. Sanford) says, many of them are on shift work. Certainly at Utah Mines and other big concerns it's constant shift work, leaving women in those communities with some very real psychological and emotional problems because there is nothing to do. There are no resources, no facilities, no transition houses. The kind of emotional and physical battering that goes on in those communities is quite dramatic. I think that, although some of what I'm saying moves on into Human Resources — transition houses and what not is a Human Resources matter — it all ends up in the Ministry of Health's lap. When you look at what's available for mental health it's totally insufficient. There are not the workers or the facilities.

I had one particular case of a young man in his twenties who should have been institutionalized but couldn't be. He was threatening to kill his father and that kind of thing, and he was still living at home. This is in Port Hardy. They finally put him in a room in an old building. The mother is terrified. I'm not going to go into the details of the particular case, but I have them if the minister is interested — off the record. The facilities and resources are just not there, and the need is absolutely tremendous.

[Mr. Strachan in the chair.]

I must try to leave with the minister my concern as a person who has lived and represented both urban, and now rural, constituencies. The resources that people have in greater Vancouver or Victoria are beyond description as to their plenitude in comparative terms. Now I know that you will say that people choose to live in these communities and that is the kind of lifestyle they want, but that is not always true. Many people are forced because of the economic situation and the job market to live in those communities. They don't have very many resources. The women in particular don't have the kind of resources that they need to try to deal with the isolation and the macho nature of those male-dominated, macho, heavy-drinking communities. I think some preventive health care work, particularly with mental health, in those communities would be a very worthwhile investment in our future.

HON. MR. MAIR: Mr. Chairman, first of all I want to assure the hon. member for New Westminster (Mr. Cocke) that I will look into the Rinke matter. As a matter of fact the letter from Mrs. Rinke has now reached my office. I don't think one can comment any further on the letter, other than to say it is of course a tragic situation. One could hardly help but feel very sad indeed, listening to the letter read out by the hon. member. We are hopeful of course that the palliative care program that we are now bringing in will do something to overcome these difficulties.

I think all of us have a revulsion about dealing with dying people. It is something that is bred into us. Even though it happens to all of us, we don't seem to want to take the time to assist people who are going through that very natural process. This goes for doctors as well as for other people. I think we have a great deal of educating to do in the medical field, with doctors, nurses and all people involved in that situation, so that these kinds of things are rare instead of common occurrences.

I feel very sad at hearing what I heard this morning. I certainly will look into the matter. I don't know that there is anything that I am going to find out that will assist me that I don't already know. That is that we do need to do a great deal more in terms of bringing palliative care to the various hospitals around the province.

The member for New Westminster spoke about closing the rehab beds in Vancouver General Hospital. I want him to know, through you, Mr. Chairman, that this was done in consultation with Vancouver General Hospital and G.F. Strong. It was coincidental with the opening of the fifth floor of G.F. Strong, which created beds that weren't available before. The rehab beds, of course, were converted into extended care. I understand that Shaughnessy is going to take up some of the slack for the problems that the member talked about.

As far as the problems with funding that the member mentioned, yes, I know the old army game. Of course it went on and it probably still does go on to some extent. That is why we brought in the joint funding study in 1978, to see if we could overcome these difficulties. It was instituted by this government and I have great hope for it. I'm not going to stand here and say to the members opposite that it is going to solve all the problems, because of course it isn't going to solve all the problems. Any time you are running large institutions such as Vancouver General Hospital, the hospit-

[ Page 3388 ]

als in Victoria and even hospitals the size of Royal Inland in Kamloops, you are going to have difficulties when it comes to funding. You are going to have people who are going to play budgeting games, and you are going to have governments that are going to anticipate budgeting games that sometimes aren't being played. All these kinds of problems happen, but I think that this is going to go a long way towards putting the funding of hospitals and their budgets on a sensible, modern basis.

I'm not going to argue at great length with the member for New Westminster. Just let me say that I don't agree that there is chaos, great unhappiness and so on in the health care field in British Columbia. You're not going to have a field such as health, where there is so much emotion involved and so many things like the Rinke case that are going to happen no matter what you do in terms of palliative care, where there isn't some unhappiness bubbling up to the surface from time to time. I'm not going to suggest that there aren't problems. I've tried to be very candid with the member for New Westminster and this House about some of the problems we do have. I've also tried to be very candid about what we're trying to do and the time frame within which we are trying to do those things.

I don't want to be trite in my answer to the member for New Westminster, but I really have to go back to something that I said when I became Minister of Health. Usually one regrets things that one says upon becoming a minister. One usually says something very stupid that one has to live down thereafter, but I have no such fears about this.

I said that you could double the budget in British Columbia and you still wouldn't solve the problems. You could quadruple it probably, and there still would be problems bubbling up to the surface that would give rise to lengthy debate in estimates. I suppose it's a matter of semantics. The member opposite says that it's chaotic, and so on. I just don't agree with him. I think, generally speaking, we have one of the world's best health delivery systems in British Columbia. It has problems, to be sure, but nevertheless, I think that it still is extremely good and we're tackling the problems as best we can.

I'd like to deal for a moment with the member for North Island (Mr. Gabelmann). I don't know whether he was taking me to task about the statement I made in the House today. It seems that a minister is damned if he does and damned if he doesn't. What I've been trying to do, Mr. Member, is to keep the members of the House abreast of developments in that very, very sensitive area. Rather than have you come to me and stand up in question period and say, "Why don't you ever let us know what's happening? Are you doing anything?" and "What has the minister done except sit on his duff and ignore the problem?" I've been trying to do just the opposite: keep abreast of the situation and at the same time keep you aware of it.

There are some new developments in what I said today. I think the key one — and this doesn't sound like a big deal unless you've been dealing with the feds, as some of your colleagues have in the past — is that the federal assistant deputy minister of Health is going to come to British Columbia to take a look at the situation and talk to us about it. Instead of sending Dr. Goldthorpe out with a stick to poke into a hornet's nest, which is precisely what he did and no more, they're sending somebody out who really wants to deal with the problem and try to tackle it. I think that part of the news is that we are willing to plan the hospital with the federal government. We're willing to plan a detox centre with them. We're willing to create any type of organizational setup which will help racial lines to be crossed.

Now I know that the member's point is that these matters must remain "segregated," for want of a better word, until such time as the Indian band has recovered the pride that it lost, and all of the things that the member said. I think there is some wisdom in what he does say. Fine. I said today, as a matter of fact, to the press outside when I was asked about the situation in Alert Bay, whether the plans I had would solve the problems: "Of course not. You're not going to solve 300 years of social problems with a hospital." And I fully recognize that. But what I say to the member is that if the federal government does want to get in, does want to handle the situation, fine. I have no quarrel with that.

Let me make it clear. I think we could do a better job. But if the federal government does want to get in and take care of the health problems of the native peoples of British Columbia, then let them do it. That's all I say; let them damn well come and do it, instead of doing a half-hearted job and every time there's a problem, blaming the provincial government. Whether it was your government, our government or future governments, that is traditionally what has happened. Whether it's Alert Bay, Kamloops, Omineca or Atlin doesn't matter; they do a half-baked job and then blame the provincial government and anybody who's close at hand for the deficiencies in their system. I am quite prepared to stand back and let the federal government walk into Alert Bay and tackle that entire problem, as far as the native population is concerned. But for goodness' sake, don't come to us and ask us to form committees with them, ask us to step in and do some of the planning, ask us to come up with some of the funding, ask us to come up with some of the doctors and blame us when we can't, or blame us for the doctors who do come up, at the same time that they're supposed to be taking on the responsibility. Either take on the responsibility 100 percent and do a good job or let us do it, and we will do our very best to do a good job.

You say we couldn't do as good a job. I accept that criticism; I don't know that I agree with it, but I accept it. Our problem is that we simply cannot get the federal government to come in and do more than, as I say, poke a stick in the hornet's nest. I know that you probably think Dr. Goldthorpe did a much better job than that. Well, I frankly and candidly don't agree with you. I think that whether his report, in a private way to the minister, might have been helpful or not is no longer an issue, because he made it public, and I think that he's done no more than exacerbate the tensions and the problems that already existed there without providing any answers or any solutions.

Dealing with the member's comments on rural medicine, I think, quite frankly, that the analogy between doctors and policemen is a little thin at best. For one thing, if policemen were required to carry with them hundreds of thousands of dollars worth of equipment and labour, for each one of them, it might be more analogous, and you might find that society would have a different priority about policemen as well. The fact is that they don't. The fact is also that they are under a discipline; they are under a "force" mentality. They belong to a police force that carries with it traditions, and carries with it also a hope of escape. When one goes to a remote community, presumably, unless one misbehaves oneself, one gets a reward and later on goes into a larger community. I think that the situation is somewhat different. Those of us who have lived in not necessarily remote communities, but remote in the sense that they're not the lower mainland, know

[ Page 3389 ]

that quite often these remote communities, from the policeman's point of view, are where they learn their jobs. You get them fresh-faced and fuzzy-cheeked out of Regina all the time, and you don't get the same kind of quality even in police service that you do in other places.

Yes, I think there is a problem, however. I'm not trying to brush it aside. I think that we're going to have to find, and we are searching very diligently for, other incentives to get doctors into remote communities. Sometimes it isn't just a matter of money. As you know, we do fund doctors in remote communities. But when you don't have doctors under the discipline of a "force" then you can't very well go to them and say, "You must go to Alert Bay," or "You must go to Bella Bella," or "You must go to Namu," or wherever it may be. There's just no way under our democratic system that you can do that, and we're all, of course, very content with that.

As you know, we tried a type of incentive through the licensing system in British Columbia, and the Human Rights Commission struck that down as being undemocratic, or whatever the words were that they used. So it's not that we're not trying to find incentives; it's just that I want to point out to the member that they are difficult to find.

Dealing with the question of mental health in North Island, I assume that the member was really informing me rather than questioning me on that particular thing. I want to tell him that as a result of what he has said I will see that both Mr. Gee and Dr. John Gray are made aware of the situation, and I will dispatch one or both of them into that community. I would be very pleased if the member would provide me with some contact person with whom I can put them in touch.

Dealing with the other remote community problems that you have mentioned, Mr. Member, I'm sure once again you were more telling me about the problem than asking for my solutions, because frankly I don't have them. I concur in what you're saying. There's no doubt that sometimes those are great communities for the bachelor, and quite often the married man becomes a bachelor as soon as he gets there, because he's working for eight hours a day and hunting, fishing and drinking the rest of the time. That creates a terrific void in the life of his lady. I don't know what the answers are. I suppose, really, one has to look at it from a community problem point of view, and communities are going to have to be encouraged, whether by government, private organizations or otherwise, to develop community resources that are going to help people in that situation occupy their time in a meaningful way.

MS. BROWN: Mr. Chairman, I ask leave to make an introduction.

Leave granted.

MS. BROWN: I just noticed sitting in the gallery the baby daughter of the member for New Westminster (Mr. Cocke) and her new husband. I wonder if the House would bid them welcome.

MR. HALL: I listened to the Minister of Health making a response to the member for North Island (Mr. Gabelmann) regarding the analogy of policing and health care. For a minister who had spent a great deal of his time recently bending his mind to the intricacies of the constitution and coming up with some of the original ideas he told us, I really expected better of the minister in dealing with the analogy than saying: "a bright, shining, fuzzy-cheeked constable going to Alert Bay." I think that that kind of conventional wisdom coming from the minister was really almost too much for this side to take. You could have dealt with the analogy a little better than that, I think, Mr. Minister. I don't think anybody should ever allow that kind of cliché to go past in this House without some comment being made about it.

I share the concern of the member for New Westminster (Mr. Cocke) about the Health ministry. For a short while I shared the onerous duties of Health minister, because in 1972 the delivery of health service in this province was split between two ministries. The Provincial Secretary had part of it and the Minister of Health had the other part. I soon got rid of my part to the Health ministry, which I think was a sensible thing to do. I was interested in following it through over the ensuing three years, and even today, like the minister himself and the member, I try to keep as abreast as I can of not only the happenings on the large scene but what's happening in the delivery of the health care system at the constituency level — at the level where it really counts.

I remember, Mr. Minister, that in 1975 a completion of a massive reorganization of the Ministry of Health occurred. For many years the ministry had been in three parts, even allowing for the fact that the medicare part of it was in another ministry altogether. That reorganization was in place in 1975, was inherited by this government that I sit opposite to, and went into 1976 and 1977. In 1977 the mandatory retirement of two senior deputies, Dr. George Elliot and Mr. Bill Lyle, occurred. They were two men who had served the ministry well and had been part of that reorganization. They had both been deputy ministers, but in the reorganizational process took the rank of assistant or associate deputy ministers — whatever was current at that time.

I am fearful of some of the things that are happening — particularly as laid down in a bill currently before the House, which I cannot discuss at great length but may touch fleetingly on as I move through the estimates — which we will call, for sake and ease of reference, the politicization of the public service, in my opinion not contained in explanatory notes of the bill.

In 1977 another reorganization of the ministry took place, not as large as that which took place in 1975. But it was very unusual for that kind of reorganization to follow so quickly. During that reorganizational period, you will be interested to know, Mr. Chairman, the following happened. First of all, the deputy minister, Mr. James Mainguy, a man with 35 years' service, left at 58 years of age. Secondly, Dr. K. Benson, an associate deputy minister with over 30 years of service, went to Kootenay as a medical health officer. Thirdly, an assistant deputy minister, this time in mental health, with 29 years of public service — 57 years of age — left the public service altogether. Fourthly, an associate deputy minister of Hospital Programs went out, having had 24 years of service. Two years after 1975, that little reorganizational exercise took care of.... Well over 110 years of public service went out the door after two years — all well before mandatory retirement. That kind of shock that goes through the public service takes any minister some time to handle, takes any new deputy minister, any new assistant or associate — supernumerary, temporary, acting, unpaid, any rank at all — some time to get over.

What effect does that have on senior staff? I'll tell you what it does. The next thing that happened was that Mr.

[ Page 3390 ]

Scott, the director of public health inspectors, chose to retire after 31 years of service, seven years in advance of his retirement date. The chief of information services chose to retire with 28 years of service, again seven years before mandatory retirement date. The director of epidemiology chose to retire with 30 years of service. That kind of wastage, that kind of reorganization, that kind of loss of experience of public servants is really awfully difficult to understand on this side of the House.

This minister now has to look at those gaps. He filled them all — I don't know if he filled them or if his predecessor filled them — with good people, I'm sure. Time alone will tell that. I don't want the advisers who are sitting opposite and advising the minister to take any of my remarks in such a way as to think I am suggesting they are not going to do a first-class job. What I am saying is that the full effect of over 200 years of public service by men and women leaving the public service well before retirement age is, as I say, a shock, a loss of morale and a wonderment about what is happening in Health.

I say that because that is not the only department it has happened in. This happens to be one that is very, very important, and one in which I happened to have more than a passing interest from 1972 to 1975. I don't mention it to the minister in any critical way at all — he has only just arrived on the scene in terms of Health. I wish him well in putting the ministry together, but I want him to know that we've noticed that. I want him to know we are watching him very carefully. I want him to know we have got our barometers, thermometers, litmus paper out as well, taking the soundings, searching through the entrails, rattling the bones and finding out what is going on over there just as he has.

It is not really a question of semantics, although I know what the minister means when he says: "It's not chaos." But I'll tell you, it's trouble. There is some confusion there, there is some difficulty, and we do wish you well, because, frankly, it is one of the most important things we are dealing with, one of the most important things in this province. I want you to understand, if I can say this to you directly, that that should never happen again. Somebody should be brought to task over that kind of situation.

Now to things in Surrey, if I may — some constituency matters. First of all I'd like to deal with the Boundary Health Unit. Dr. Meekison, in his report to the special meeting involving the municipal council and the MLAs, reported that the Boundary Health Unit is at this time unable to offer to the residents of Surrey a comprehensive speech service. He states that people with a speech problem have to wait up to six months to get attention or they have to leave the municipality and go elsewhere for it. He stated that there is a hearing aid program available from the provincial government, but it's not provided for here in one of their largest health units in the province. I'd like, if I could, to get an update from the minister on that. Again it's a question of making decisions and putting them into operation. Surely in the largest riding and in one of the largest health units in the province we can do better than that.

The next question is in regard to the staffing of the Boundary Health Unit with physiotherapists. Again, the Boundary Health Unit has the largest caseload of any health unit in the province, but we have no staff — only temporary employees. Dr. Meekison reports inability to have permanent employees in that regard.

The second part of his annual report deals with the provincial Long-term Care Program, which leads us into the question of the Peace Arch District Hospital. Here I would like to elaborate a little on the member for Burnaby-Willingdon (Mr. Lorimer), who happened to visit my riding the other day. Maybe the minister has some answers. I'd like to report to you, Mr. Minister, that in the Peace Arch District Hospital 24 long-term care patients are in acute-care beds. We're monitoring the situation, but we are, as in the case of other MLAs, reporting to you the same kind of situation: that acute-care beds are being taken up by long-term care patients. In the 1979-80 year 6,362 long-term care days required the use of 18 acute-care beds in that hospital. It was reported in February of this year that long-term care days totalled 4,944 for the fiscal year ending January 31, 1980. That's 4,600 over the BCHP approved budget. For January of this year alone the long-term care days are 665 over budget in that hospital.

The reason why we get upset about it is that all the planning has gone on. I refer to the report of the special board meeting of the Peace Arch District Hospital and point out that the plan is the completion of the fifth floor of the acute-care hospital to accommodate patients from the extended-care unit, concurrent work on the sixth floor, and all that's really waiting is the approval of the Minister of Health to activate some of these decisions. The timing of the stage will depend on the hospital's ability to prove need. This report is dated March 6; I received it the following month.

What I want to deal with is the hospital's ability to prove need. I again refer you to what appears to be a growing problem with the government in all its works and the gathering of information south of the river. I have some difficulty understanding what's going on. We've got the Minister of Education (Hon. Mr. Smith) besieged by parents regarding the school system in Surrey, South Surrey and White Rock now having to authorize temporary portables and readjust capital expenditure programs. The municipal council has got planners reworking figures. We've got the only school district with a burgeoning school population. Everybody who lives there knows the place is growing. The Minister of Municipal Affairs (Hon. Mr. Vander Zalm), who's also the member for Surrey with me, knows what's going on. I can't understand why you, the Minister of Education and whoever else is involved with social services or public services based somehow on numbers or the presence of people, can't get that information. I'm not berating you or any individual, but it seems to me to be a sorry state of affairs when the Delta-Surrey-west Langley area is growing and growing — and you see it in the newspapers — but the information doesn't seem to get in the cabinet room. I just don't understand that. I don't understand why — unless you're going to nod your head and say it's all done, it's all built since I was last there three weeks ago.

HON. MR. MAIR: Where have you been the last three weeks?

MR. HALL: I've been in here.

The hospital's ability to prove need. I just don't understand that any more than I could understand the response of the Minister of Education when he said: "The pupils have got to be at the door in September before we'll build a school." It's that kind of thing, I think, that infuriates my and the other member's constituents.

The next thing in Surrey is public health inspectors. Here

[ Page 3391 ]

is a memorandum: The ministry directed that public health inspectors cannot initiate work outside the regular workings at the local level. "Any overtime must have the prior permission of the ministry or shall be of an emergency nature, relating directly to food poisoning or communicable diseases" — i.e., rabies — "only."

In the Boundary Health Unit we've got several yearly events that require public health inspections, We have the Cloverdale Rodeo, we have the White Rock Sea Festival, we've got the Cloverdale Fall Fair. For years the Boundary health unit has always looked after those kinds of inspections, and I don't see why they shouldn't continue to look after those inspections on behalf of the local boards of health and the sponsoring societies. Unless the ministerial authority is obtained the public health inspector isn't covered by compensation, should he be involved in an accident. Is that part of the trade union agreement'? Is that a ministerial edict or regulation? If a person is working, surely he is covered. How can you send somebody out to do work for a municipality, to do inspections or to assist in a community effort, and not keep the person covered? That is my short question. I don't necessarily expect to have the answer off the top of your head but sometime, maybe, you could come back.

I see Mrs. Kelly isn't with you today, but I was going to ask if there is a firm, if not rigid, schedule of inspections for care homes, and if one can inspect that register of inspections without getting involved with MLAs who are frequently called and given stories about the conditions in privately operated homes horror stories which may or may not be correct. I think all MLAs know — that they listen to stories and they aren't necessarily always correct. I want to know if there is a register of when the last inspection was made and if there is either a statutory obligation on the part of the director of long-term or community care to inspect at frequent intervals or what frequency that interval is, so the MLA can be assisted in knowing when the inspection last took place and so some evaluation can take place in his or her mind and we can help our constituents.

Now for one that I've had on my desk since 1968 — the King George private hospital. I first suggested to Mr. Dan Campbell when he was then the Minister of Social Welfare, I think it was called then, that we should buy the King George Hospital. I don't want to get involved in negotiations. All I want to know is: have they finished yet, are we in negotiation, or are we out of negotiations? It seems to me that we had an opportunity here, not only in 1968 but recently, to pick up a private hospital in not bad shape for about $1 million less than we could build one for. I was wondering if the minister had completed his negotiations and whether or not we could look forward to some easement in the long-term care situation at the north end of the riding by the purchase of that establishment.

My next question is on laboratories. I have mixed feelings about the presence of the private enterprise motivation in the provision of laboratory services and, if we have it, what kind of control features are on it. I remember we used to have debates in this House when Mr. W.D. Black was the minister responsible for the payments to laboratories. We had many, many debates about this. There has been some discussion that we should use our hospitals and our hospital laboratories. In January of this year a survey was taken in my riding, with the exception of the actual city of White Rock, to see what is happening in the identifiable five communities of Surrey.

In Whalley, with 47,000 people, there are two laboratories. In Guildford, with 26,500 people, there's one laboratory. In Cloverdale there are 10,300 people, with a lab recently approved. Sunnyside has 16,800 people with no laboratory. Newton, with 22,800 people, has a laboratory that has been going two weeks after some struggle between Mr. Weir and a group of doctors. What I'm trying to ascertain is: is there a magic figure? Are we going to use the hospital facilities? Again, are we going to do something before we start to be inundated with requests from south Surrey for improvement, because if you saw the building that's going on in south Surrey and the school population figures that we've already debated in the budget and we will be debating again during education.... No, we've already done education estimates. We debated you in education estimates.

HON. MR. MAIR: Like the Dodgers: wait until next year.

MR. HALL: We did do it. I remember doing it now, a couple of months ago. Again, the kind of figures we will be doing in Municipal Affairs.

It seems to me there's got to be some lead time with this.... It doesn't take much lead time for a laboratory. But why should patients, for instance, in Sunnyside have to go to White Rock if we're totally and utterly committed to this doctor–private enterprise system of handling the laboratory system? What criteria is the ministry laying down about this? What's going on? We could tell these people to get lost; I don't mind telling people to do that at all, it doesn't bother me one bit. I'd like to know whether to pursue the matter or to give them any encouragement whether we should be debating it from a policy point of view in another matter or whether we should be introducing some fresh ideas.

I, too, have a case which I would like the minister to make just a private response to me at some time on, and that is again in the Peace Arch emergency ward. It's the Diak case. I misheard my colleague for New Westminster (Mr. Cocke). I thought he had somehow gotten my file. That can happen.

HON. MR. MAIR: Usually it's across the floor, but I guess you can steal each other's too.

MR. HALL: Oh, there are seagulls down here like you've no idea.

The Diak case was publicized. I can certainly share my correspondence, if the minister doesn't have it. I'm sure he has. It was a bad scene, let me put it that way, where a gentleman did die in very poor conditions in the emergency ward of the Peace Arch. There were editorials written and so on in the local newspapers. It's the Diak case. It's not necessary to respond by any means today in estimates.

I have a couple more things. Elderly people are becoming more and more conscious of their political clout. They group together in the constituencies in old-age pensioner branches and clubs, and so on. They are, I think, becoming aware of the fact that there are certain regulations, which do, to a certain extent, discriminate against them. For instance, there's the chiropractic regulation. It doesn't bother me that there are only 12 treatments for chiropractic per year. It bothers somebody who's older, who believes that that is helping them and they need it, perhaps more than I do,

[ Page 3392 ]

although sometimes after a long day here one could argue that that's not the case. The provincial Health Act places limitations on the number of chiropractic treatments conditional on age. That's an odd thing. I don't like that at all — conditional on age. In short, you can get 12 treatments if you are over 65, and 9 if you are under 65. I think that's a bad law. I'm wondering if the minister.... While I know estimates is not the time to ask for changes in the law, perhaps estimates is the time to point out that there is some discrimination there, although one could argue that reverse discrimination might be a good thing. But that seems to me to be a poor law. Certainly elderly people would have some reason to say: "Let's have more." So I'd like some response on that.

[Mr. Strachan in the chair.]

An interesting case came to me the other day. It was an interesting point that I never, ever considered before. A gentleman with a child — I suppose an adult now — in one of our institutions is being treated.... The institution is Woodlands, and the condition is paranoid schizophrenia and partially retarded. The question is simply: why can't the parent choose a doctor to treat his child? Let's use the word "child" for descriptive purposes. In 1972, which is some time ago, a doctor gave a treatment which resulted in exceptional changes in the daughter's behaviour. After the doctor left, the next doctor refused to follow the same mode of treatment and withdrew this particular treatment and this particular drug.

That continued for about two years when that treatment was reinstituted. Again there was another recovery — and this doctor who recommended the treatment is available to treat this person in this institution — and the parent came to see me and said: "Why can't I have this doctor — Dr. X — treat my child in this place?" And I have no answer for him. Why can't he? I can choose my doctor; you can choose your doctor. This institution is now that child's home; why can't that child be treated by a doctor...? I know some of the answers; I'm not that innocent. In terms of some radical treatments I think I would share the view that, no, you can't. But where the treatment has been tried once, left alone and tried again, and there have been measurable improvements, why can't the patient's or the child's father or parents or guardian have some say in that kind of situation?

It seems to me that the province's Mental Health Act fails to guard some of the patients' rights in that way. I'm not getting terribly excited about it, but there seem to be some loopholes there. We now have a lawyer in charge of Health.

HON. MR. MAIR: A former lawyer, Mr. Hall.

MR. HALL: It might be an interesting thing for you to look at, now that you're not spending so much time on the constitution.

HON. MR. MAIR: I think about it a lot, though.

MR. HALL: Next question. We all have deaths in our family, and I had to deal with one — in another country, obviously — and I was amazed and heartened by the marvellous treatment relatives of mine got in England in a hospice. "Palliative care" is what my colleague from New Westminster (Mr. Cocke) said is the correct description we use here to describe care for people who are dying. He also advised me that a hospital — the Royal Columbian, I think — has on its own set up its own hospice. Having had some experience of going to one of these places and seeing what can be done, as distinct from the normal or acute-care hospital and the situation that could prevail there, I am asking the minister if he has any plans, if there is any way in which we, as a government, could encourage our own hospital boards, if there are any funds set aside — and I realize there are some problems developing with revenue — to encourage the setting up of hospices.

MR. CHAIRMAN: Hon. member, since I wasn't able to give you a three-minute warning, I'll extend the three minutes from this point.

MR. HALL: That's the last thing I have: whether or not there is anything we can do as a government, as a Legislature, to encourage our hospital boards, etc., to move into that field, because I believe that's a really marvellous situation that I saw operating in the U.K., and one which I would certainly — if the minister hasn't seen it, I'm sure he must know of it — describe to him.

HON. MR. MAIR: Mr. Chairman, I was rather interested when the member was speaking and he mentioned that very obviously he had come from another country. It reminded me of a speech I gave in the North Island constituency four or five years ago, and a very English chap, who was obviously just off the boat and asking me questions, said, "By my absence of accent you can certainly tell that I'm English," which probably is the correct way of putting it, when you really think about it.

I've got pieces of paper all over hell's half acre here, Mr. Member, through you, Mr. Chairman, so I hope that you'll forgive me if I ramble all over the place here in answering your many questions. But first of all, with respect to the staff that you talk about that have left, I don't know what case you're making out. If you're suggesting that most or all or any of those retired because of dissatisfaction with the Ministry of Health or the system, then I'd be pleased to hear of it, and we can deal with that one by one or in groups, as you choose. But so far as I'm able to determine, the people that you mentioned — and you happened to miss Doug Weir, who retired early just a couple of weeks ago, much to our sorrow — the information I have is that they simply took advantage of the rather generous terms of their contract with the government and took early retirement. Most of those that you mentioned, too, in making your case, did have long service. I think perhaps after I'd spent 30 years in the government with the Ministry of Health or any other ministry, I'd be inclined to look at Victoria's weather and fishing capabilities and golf courses and give retirement a whirl too. But in any event, we can talk about that further, if you wish.

On the Boundary Health Unit problems that you mentioned, we now have a temporary mobile unit giving speech and hearing services in Ladner. It has been there for six weeks, pending new premises being built in North Delta — the new health centre. I have spoken to the mayor and council in the North Delta area. The member for Delta (Mr. Davidson) has been in touch with me on that. It is going ahead. That's the short answer to that question.

On the long-term care patients in the acute-care beds at Peace Arch District Hospital, first of all, that is a general

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problem that we have discussed in this House in question period and during these debates over and over again. I assure the chamber that we are building long-term care beds as fast as we possibly can to take care of the problem that has developed. Dealing specifically with Peace Arch District Hospital, I understand that discussions are taking place and have been taking place for some time between my staff and the hospital in terms of overall planning as to what precisely that hospital ought to have and what role it ought to play in the community. In talking to one of my staff next to me here, I understand that process will be completed this fall. From that point on we will presumably be able to solve the difficulties that you raise, Mr. Member.

On the question of inspectors, I will accept your invitation if I may, Mr. Member, and come back to you with an answer. I might say to you, if I may — and other members opposite, that in past estimates that I have done in this House I have always scanned Hansard carefully afterwards and provided answers, where I can, to questions that I was unable to answer. Sometimes, of course, members opposite are, for good and obvious reasons, making speeches rather than asking questions. I don't try to get myself into that dichotomy, but where there are specific questions like this I do try to come up with the answers. I'm sure if I don't you will remind me in due course.

The inspection of private hospitals is done through the local medical health officer. He or she should have the information that you need. They are not necessarily done on a regular basis, I think for the obvious reasons. You don't want to do it regularly; you want to do it irregularly so that people don't know that you're coming. I think I mentioned yesterday at some length the two studies we have going on both the financing of those facilities and the way they are being run. Those reports will be down very shortly and I will have a much better idea of where we stand on that.

On King George Private Hospital, my note indicates that we expect a call this afternoon from their lawyer giving a counter-offer to the offer that we made. I might say that either the day I took office, or the Monday following I think it was, I was confronted with a demonstration on the Legislature lawn concerning King George Hospital. My remarks should not be taken as being critical of that, but only to point out that you can get yourself, if you are not careful, between a rock and a hard place on these kinds of private hospital deals.

I will put it in example form, rather than say King George Hospital, so that I don't offend anybody. You can get into the situation where the people who own the hospital in effect hold you up, because they know that they can get great public sympathy and have all sorts of demonstrations and that sort of thing simply by threatening to close down the facility if the government doesn't pay them their price. In cases like that, yes, we do like to buy them where we possibly can. We have negotiations going for quite a number of them at this time. However, there are some — and I will make it very clear to the members opposite — that I have absolutely no intention of paying their price. It's highway robbery and I just won't have it. We'll build our own facilities long before we'll pay that price. I think you recognize that we do have some difficulties there, but we are very hopeful that we will be able to bring King George Private Hospital to a happy conclusion,

Laboratories are another difficult problem. I'm sure the member for New Westminster (Mr. Cocke) had the same difficulties wrangling with this one as I am now having. Quite frankly, I have chosen to postpone making a decision on policy there until I get through my estimates and have time to direct myself to that and to that alone. I'll tell you why. I've got five or six — I'm not sure which — appeals now on my desk, arising out of applications for laboratories. While the policy in the past has been — and I can see no reason why it would ever change — that we prefer public facilities to private, the problem is a little more complicated than just saying that.

Sometimes the private facilities can make out the case that they do a better job, and they will produce books to show that they in fact do a much better job than the public facility. When you examine the situation further, though, you find that the reason for that is that all of the good stuff is being referred to them and all the bad staff is going into the hospital; then there is a curious connection between the people who are doing the referring and the people who are running the laboratories.

So it is a complicated matter. As I say, I beg your indulgence for my lethargy in coming to grips with the matter. However, I do intend to lock myself in my office with it, and with my staff work out some policy which is, I hope, going to work a little better than the one we now have.

I should also say that we have an advisory committee through Medical Services with respect to laboratories — through you, Mr. Chairman, to the member. They are the ones who do advise us on it and we do have a process whereby applications must be made to Medical Services, with an appeal to me. As I say, that's what stacked up this problem in my office at this point in time.

We dealt sometime yesterday with chiropractors, and I told the members who were in the chamber at that time that I presently have got something before Treasury Board that I hope will alleviate some of the difficulties. I'll certainly take a look at the question of the over-65 and under-65. That does seem to me to be a bit of anomaly too. Off the top of my head — and that's all I can do at this point — it doesn't make a great deal of sense to me, but I certainly will take a look at it.

On the question of Woodlands School, I suspect without knowing that that is probably a policy of Woodlands. I would hope that you would take that up with the Minister of Human Resources at the appropriate time. If you wish I'll certainly take it up with her and see if I can get an answer for you. From what you tell me the only conclusion I can come to is that that must be a policy of the institution rather than a policy of our ministry, because nobody around can tell me it's our policy. So I can only assume that it's a policy of the institution, which, as I say, is run by the Ministry of Human Resources.

You've got a twin who sits right down there. He looks just like you, you know, except he's a mean one. He always loses his temper, challenges me to fights and things like that. You don't want to get to know him.

Regarding palliative care, this, to me, is.... Everybody has moved!

MR. KING: You're totally intemperate.

HON. MR. Mair: Well, I intend to be tonight. I'm going to Seattle and I'm going to watch a baseball game tomorrow and I intend to break my diet and be just as intemperate as I possibly can be tonight, Mr. Member.

MR. MACDONALD: Did you insult me or not?

HON. MR. MAIR: You're uninsultable!

[ Page 3394 ]

I did want to be serious about this matter, if I may. We are now operating two pilot projects on the palliative care program. I have no doubt whatever that this will become ministry policy in a big way. In our view, this is not something that can be done just through the hospitals. It's not just an institutional type of a program; it's a program that has to not only have the hospital and the Ministry of Health involved, but, probably most importantly, must have the community involved in it as well. We want to see just how it does work and learn from our mistakes as we go along. After all, our mistakes can't really hurt, because nothing is being done at this point. So anything we do has got to be beneficial.

We want to come forward with a program that, as I said to the member for New Westminster earlier, will take care of this void in health care. It is a shocking state of affairs, and all of us — I assume everybody in this room — would find it very disagreeable indeed to deal with that subject. As a result, people who are dying simply are cut off from care. It rather reminds me of that scene in the movie Farewell to Arms, where they put people in the dying tent and just sort of left them alone. That's something that we are addressing, and I have very, very high hopes indeed for these two pilot projects.

MS. BROWN: I'm really very pleased to hear the minister say that even after the estimates are over he goes over Hansard very carefully and takes a second look at some of the suggestions that have been made, because I think if nothing else, certainly out of this series of question and answers, if we can get the minister to really look at the whole business of the Human Resources and Health access and the way in which Health, by not providing resources, is creating a real hardship for Human Resources, that would be a good result of this.

When I spoke a couple of days ago I talked about this in terms of adolescence, and I just want to touch very briefly on where the same thing happens as it applies to health care services to women. The one area in particular that I want to talk about is the whole area of post-partum counselling. There are all kinds of debates going on around the whole area of depression, whether it really is medical or is socially induced, and who should really take the ultimate responsibility for it.

However, I don't think there's any debate around the post-partum depression issue. For many, many years the medical profession has recognized and has taken full responsibility for the fact that some women, for one reason or another, after the birth of a child, very quickly — maybe within a few days — experience a very severe depression. For other women it is not until six months later, perhaps, when they have a very severe depression, and what we're beginning to find now is that with some women it doesn't occur until even a year or two years later. The medical people themselves have tried to come up with some kind of physiological explanation for this and those of us who have been through the process of having babies recognize that there are some social reasons too. I personally believe that a lot of the depression is rooted in sheer exhaustion. This business of trying to introduce a new infant into the world, feed it every three hours, keep it clean and all these kinds of things, especially if you're breast feeding, takes a tremendous toll on the body of the mother.

There are social reasons too. Nonetheless, the medical profession has taken responsibility for that in terms of saying that there are some kinds of physiological things happening as a result of giving birth and the body readjusting itself, especially at the termination of breast feeding. The end result of this depression is sometimes really severe. We have had some very tragic instances of suicides — there was a very sad case of a woman recently in Surrey — and instances of severe child abuse, even resulting in the killing of the newborn infant in some instances.

As I say, this is recognized as a responsibility of Health. Yet in the Vancouver area we find that the only post-partum counselling service that exists is totally funded by Human Resources. I would like the minister to explain to me why that is so. Why is it that Health is not taking any responsibility at all for not just the funding of the post-partum counselling unit that exists presently in the Vancouver area? I am willing to see the funding shared because I recognize that there are some social reasons too. Certainly the research that has come out seems to indicate that more and more social reasons are tied into exacerbating the physiological phenomena which result from this kind of thing.

Why isn't Health funding this kind of resource and why are not more post-partum counselling referral units being developed around the province? It is not just in Vancouver that women have babies. It is certainly not just in Vancouver that women experience post-partum depression. Maybe the minister could answer that question or at least make some kind of commitment in terms of his department, because the post-partum counselling unit needs more money than it has. It has to expand its service. This woman in Surrey, for example, who took her own life, didn't have access to this. Surrey doesn't have this post-partum counselling service. Health has to move in and take on more of these responsibilities. They can't be left entirely to Human Resources.

The other thing I wanted to talk to the minister about was the Vital Statistics Act. It is a very strange phenomenon with the Vital Statistics Act.

HON. MR. MAIR: You know, I prepared for everything but that.

MS. BROWN: Well, you know, the Vital Statistics Act is not keeping up with the rest of the world. It is still somewhere back in the dark ages, and I wonder if the minister would be prepared to take a look at two things in the Vital Statistics Act. Apparently it is still not legal in British Columbia to register a child in anything but the surname of the father when the two people are married to each other. The minister, I know, got a letter from a couple who are married to each other but decided both to keep their own names. What they would like to do is register their daughter with a doublebarreled name, such as Mair-Cocke or Mair-Brown or something like that.

HON. MR. MAIR: Mair-Brown is satisfactory, but Mair-Cocke never! [Laughter.]

MS. BROWN: Sorry, not Mair-Cocke. I withdraw Mair-Cocke. Mair-Brown or Brown-Mair, whichever you want.

AN HON. MEMBER: The old Brown-Mair....

[Laughter.]

[ Page 3395 ]

MS. BROWN: This is possible if you live in other provinces. In Alberta or Ontario it is possible but in British Columbia it is not legal. The act is very clear that when two people are married to each other the child can only be registered in the father's name. That is not keeping up with the changing times. There should be some flexibility.

The other thing the act still does is to question the legitimacy of the child. The Attorney-General's department, as you know, is working very hard to change the laws to do away with all the stigmas attached to legitimacy, yet the act still asks not who the parents are but whether the parents are married to each other. There are those two amendments that the minister should take a look at. It is probably time to pull the act up anyway and look at it and bring it into the twenty-first century. That wouldn't be a bad idea.

The third topic, very quickly, that I want to touch on is that the Long-term Care Program has one rather inflexible thing about it. That is, what happens to older couples who are at different levels of illness? Surely there is some way we can keep them together. It is ludicrous to start separating people in their eighties and nineties just because one needs a different level of care than the other member of the couple. Maybe the minister could take that into account as well.

The fourth point, very quickly, is the level of care given to women in corrections facilities. It is not good enough. As a matter of fact it is so bad that the Registered Nurses Association has submitted a brief asking that Health take over this responsibility, not leave it under the Attorney-General's department. I think the minister has a copy of the brief; if not I would be very happy to share my copy with the minister. They did some research called "Health Care Facilities in the B.C. Corrections System," and it's just absolutely disgraceful. If the minister doesn't have a copy of this brief I'd like to pass it on, and very, very strongly support the recommendation that it be taken away from the Attorney-General's ministry.

Sometime later in the minister's estimates I would really like to speak at great length on the whole business of the overuse of drugs and tranquilizers by women of all ages. especially older women, and the ways in which doctors are using Valium and other tranquilizers to deal with the problems of isolation, aging and that kind of thing. But I won't deal with that now. If the minister would just handle those four questions I'd appreciate it.

HON. MR. MAIR: The first question is very easy for me to answer: it's simply I don't know. I don't know why Human Resources is the sole source of funding for the post-partum group. I'll find out and I'll let you know what I do find out, Madam Member.

MS. BROWN: No, don't tell me, just take it over. It's a health thing, that's all I'm saying.

HON. MR. MAIR: All right. I'll find out what it's all about and see what the position of the government is. I just don't know.

On the Vital Statistics Act, I tend to agree with you. I think we could clean up some of those sections and bring them.... I don't know whether I can get it into the twenty-first century yet, but I'll certainly do my best to get it into the latter part of the twentieth century. I'll take a look at that. I had the opportunity of using that act not long ago. I changed the spelling of my name. I didn't change my name: people keep saying I changed my name, but I didn't. I simply changed the spelling to conform with that which I've used all my life. It was an interesting exercise.

The long-term care problem that you raise, Madam Member, is probably one of the most vexing problems that comes up in the Ministry of Health. It happened in my constituency several times over the last few years, and it's an extremely vexing question. We can handle it in new units; that's fine. We're now putting into new units sufficient- sized rooms so that we can handle that kind of problem, but the devilish problem is in the older units where it just can't be accommodated properly. If it's any consolation to you to know that I feel very, very strongly about it, very unhappy about it, and that in my constituency I have the same kind of problems that you do and I want to try to do something about it, I suppose that's the best I can say at this point. I don't have an instant solution other than that we are addressing it in the new units as they come along.

Corrections. I think that you're probably going to have to take that up with the Attorney-General (Hon. Mr. Williams.) in his estimates. It's impossible for me to walk over and say: "Look, there's a coup d'état and I'm going to take them over." I'm sure that if you bring it up to the Attorney-General, if there are any objections he might have to that process you'll learn of them then, and if there aren't any there doesn't seem to be any reason why it can't be accommodated. Presumably when his estimates come up you'll discuss that with him.

MS. SANFORD: I'll be quite brief. I just have a couple or three issues that I would like to raise briefly with the Minister of Health.

I know that a number of people have raised with the minister the deplorable situation with the accommodation for ambulance attendants in various parts of the province and the serious situation with understaffing of ambulance attendants and services in B.C. There is one particular situation in Parksville that I would like to draw to the minister's attention. The understaffing there is about 50 percent. They are entitled to approximately twice what they now have based on the 1979 volume allotments.

Fortunately, Mr. Chairman, the ambulance people are moving into a new building, and hopefully that will make their accommodation somewhat more suitable. But they are seriously understaffed.

What particularly concerns me is that the people in the community have been very supportive of the ambulance program, and want to have the best possible ambulance service available to them. As a result, they have gone out and raised funds so the ambulance will be properly equipped. They have purchased a defibrillator for the ambulance. They have also purchased a special drug equipment kit, which the ambulance people are not able to use. They are unable to use either one of these items, because they have neither the staff nor the necessary training in order to make use of this equipment that the community has gone out and purchased for the ambulance people.

They have to have five staff in order to get the additional training. They only have four staff. They are entitled to twice that number. There are only four there, so they're in a vicious circle. They need five in order to get more training so they can operate this equipment; there are only four of them, so they can't get the training. As a result, these two units are sitting there unused. The community has gone out to raise the money to purchase the equipment, and they can't use it.

It's a shame, because in Parksville there is no hospital

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immediately nearby. They have to travel down to the hospital in Nanaimo, which I realize is only 30 miles or so. But if they have to travel up to the Bowser area, for instance, they have a lot longer to travel to get to the hospital — either at Nanaimo or Comox, because that then becomes the choice.

I'm really saying to the minister today — along with all of my colleagues who have already raised this issue on a number of occasions — that the priority has to be changed so that they have the necessary training, and so that there are enough people to staff these various ambulance stations throughout the province. It's a disgrace.

If we just took the money that was utilized for the dishes that are sitting out there on the lawns or took the money that has been spent trying to figure out whether we should have a tunnel to Vancouver Island or not and trained a couple of these guys, then we'd be able to give that basic health service to people that they're not able to obtain, even though they've gone out themselves and raised the money and bought the equipment so that they could have that basic service. It just is not good enough, Mr. Chairman.

I know that we have talked time and time again during this whole week that these estimates have been under discussion about the priorities. Health care has never been a priority with this government. When we see the kind of projects that they're spending money on at this stage, it angers the people in the Parksville area who've gone out and raised money and find that the ambulance people can't even utilize the equipment that they've gone out and purchased. It's another appeal, Mr. Chairman, to change priorities, to get some training done and to get the additional staff. I know that the people in the emergency program feel very discouraged, because time and time again they put in appeals to get additional training done and additional staff members and are unable to do so. Of course, Mr. Chairman, now we have a freeze on hiring, so I guess I'm speaking here without any effect whatsoever until that policy is changed, as obviously they're not going to hire anybody until then.

I'm pleased to hear that the minister is going to go over the Blues, because I have an issue that I wanted to raise. I hope the minister, once his estimates are over within the next few weeks or so, will go back and look at the Blues in order to deal with this one specific issue that I have. Again it relates to a situation that exists in Parksville, Mr. Chairman, where a couple of senior citizens living in Parksville are having some difficulty meeting the financial commitments that they are now forced into. The wife became very ill, was in the hospital in Vancouver and ended up in the G.F. Strong unit for a period of time and is now in a wheelchair. She has been undergoing physiotherapy treatments from a physiotherapist who, through the Ministry of Health, has been coming to her home — this is the community physiotherapist — in order to give her the necessary treatment. She has been doing very well with this community physiotherapist. That program is a good one, Mr. Chairman, and I certainly support it. Unfortunately, the physiotherapist, for whatever reason, is leaving the area, meaning that there is no longer anyone who can go into that home to assist this woman who is in a wheelchair.

Fortunately they were able to obtain physiotherapy treatments through a private physiotherapy unit located in Qualicum. Unfortunately they don't have a car, so they had to make arrangements to get transportation up there. But she is now able to get some treatment through this privately owned, privately operated unit.

The only thing is that she now has to rely on her medicare premiums to cover the cost of paying for those private treatments. The total amount that medicare will pay is $100, which doesn't cover that many treatments. She must have them two or three times a week. I have attempted, through the ministry, to obtain some kind of coverage for her under the Long-term Care Program, so that whatever costs are incurred above and beyond the $100 that is available for coverage under the medicare program would be picked up by the Long-term Care Program. I have been turned down. These people are senior citizens. They cannot afford the additional cost of the private treatments. The community physiotherapist has left the area, and as a result I am appealing directly to the minister today. I hope he will go back over the Blues in order to ascertain whether or not there is some way that those costs can be borne through the Long-term Care Program. At the moment I have been turned down.

I have one other brief point. I cannot understand why it takes as long as it does to get approval for the various intermediate-care units that are being built throughout the province. I understand some of the problems — that the ministry has to work with societies sometimes; they have problems with property acquisitions; they have problems with designs, in that they have to go back and forth between the architect and the society and the regional district, and all these problems that are involved. But it still seems to take far too long to get the necessary approval to begin the construction of these very urgently needed intermediate-care units. There are two within my constituency that are currently going through this process, and it seems to take month after month before we can actually resolve those problems. I am again appealing to the minister to see what he personally can do in order to cut down on the length of time that is required to go through the various processes. I appreciate that they have to be careful, it has to be done properly and everything else, but it is still too long.

I'm wondering if the minister might comment on some of those issues.

HON. MR. MAIR: Mr. Chairman, I noticed that the member opposite said I only have some weeks of estimates left, which disappoints me. I understood we had agreed on six to seven months when I started. As probably the only person in this place who is goofy enough to actually like doing estimates, I really would rather that you didn't cut them any shorter than you feel is necessary.

Interjection.

HON. MR. MAIR: Don't worry about that. If I've got to be in this crazy place I'd just as soon be in here as downstairs, so it's fine with me.

On the question of ambulances, first of all I think I should tell you that the optimal suggestion of numbers of staff in our ambulance system — the largest number ever suggested to us that I know of — is 754. Our current estimates will provide an increase of 101 , or 18 percent over what we now have, and bring that up to 698, which if my mathematics is correct is 56 short of what some people consider to be the optimal, the very top of the house. So I think we are getting to the point where we are going to be able to be quite satisfied with the staffing we have in the system.

As far as the particular problem in Parksville is concerned, I assure the member that I will address myself to it and try to get an answer to her as quickly as possible. I do not

[ Page 3397 ]

accept her suggestion that health is not a priority with this government. I'm not going to get into an argument: it is; it isn't; it is; it isn't. I'm not going to let the record show that I was silent on the subject, because I think that health is the number one priority of this government and has been since we took over in 1975.

As far as the couple in Parksville is concerned, I note that the member did not give me the name of the couple. That may be that she doesn't want it on the record. If she does want to give me the name on the record, fine; if not, perhaps she could let me have the name of the couple privately, on the record or whatever you wish, so that I can look at it.

MS. SANFORD: They have it in the ministry.

HON. MR. MAIR: Okay, but I don't have it. If you want me to look at it, please get their names to me. I certainly will look at it and see whether we can do something. Maybe it will be through Human Resources; I don't know.

The last point that the member raised concerned approval of long-term care facilities. The member to some degree answered her own question by giving all of the hoops that these things have to go through.

Interjection.

HON. MR. MAIR: I'm constantly being interrupted, Mr. Chairman, by that menace over there. I don't know whether he is challenging me to another fight, or what he is doing. He strikes the fear of God into my heart every time he is in this chamber, in any event, so I hope that you will watch very carefully and afford me not only the verbal protection that you usually do but physical protection if necessary.

Some of the hoops that people have to go through — and we have to go through — and you've mentioned a number of them: the societies, acquisition of property, designs. and so on. I suppose there's always going to be some of the delay that can be laid to the bureaucracy in our own ministry. I'll accept that and try to do what I can to clean that up.

Let me tell you where one of the big problems is, and I guess it's going to sound like Ottawa-bashing again, but it really isn't. It's just that CMHC have a number of restrictions, rules, regulations, hoops, etc., of their own. We traditionally find that the very last approval that you get, the very last hoop that you go through with the big delay between the one just before it, is CMHC. I don't say that critically or unkindly; it's a big organization across Canada. It's got thousands of these and other things to concern themselves with. But that is one area that perhaps you would ask one of your colleagues in the federal House to question the appropriate minister about there, and perhaps with his help and my help, we can do some good.

I'm sorry, there was one other question raised about the physiotherapists that I should also point out. I did undertake to look at the specific problem. We are having problems hiring physiotherapists in general. There is a general shortage of them and that does cause us some difficulty. When we do need a replacement — quite apart from the other difficulties the member has raised with me — that is an additional difficulty.

MR. LEVI: Mr. Chairman, I....

HON. MR. MAIR: Are you back?

MR. LEVI: Yes, I'm back. It's the third time for asking. I don't have anything from the riding other than to, not necessarily give the minister a bouquet about the Eagle Ridge Hospital, but to compliment his deputy. I was present at that public meeting and I thought to myself afterwards that the minister made a good choice. He decided not to come himself and sent somebody else. The deputy did very well. It was very impressive because it was a pretty heavy crowd and they were kind of hostile. He laid down a very interesting point of view, and we did get a chance afterwards to say a few words to one another. So I don't want to deal with that. That's now, as I understand it, hopefully, in the works, and it's going to be built.

What I'd like to talk to the minister about is something I touched on earlier in the debate, which is the whole question of access and utilization in terms of the health care system. I want to deal, to some extent, with the Black report. As you know, Wes Black, who used to be a member of this House, was asked to head up a committee. It was actually an advisory committee on medical manpower. What I'd like to do, in case the minister forgot about the.... There was a very interesting foreword by the chairman which, in the way it was written, very much reflects the way that former member of this House used to think. I think in reading it I'd like to comment on it. He says in the foreword to the report:

"The problem presented to your advisory committee on medical manpower was one which has progressively worsened with the passage of time. There are those in the Canadian community who are convinced that the problem defies solution and that the committee will be spinning its wheels and spending taxpayers' dollars with no result. Those are the pessimists. On the other hand..."

This is really Black-sonian prose.

"...there are those who think that right is equidistant from two points of view. These are the compromisers."

He's making available all sorts of definitions here.

"While the committee has listened, it has not been influenced by the pessimists nor the coin-promisers, rather it has taken a point of view, a positive point of view. Your committee's attitude has been one of optimism that a problem does not exist that defies solution."

This is a little bit at odds with what we've heard sometime this week. That's from his point of view.

''Our concern has been for what is right rather than for who is right. In presenting this report your committee was under no misapprehension that the report would please everyone. Indeed it may anger some who will find some recommendations bitter pills to swallow. If such be the case then so be it. We realize that this is a time to stand up and be counted, a time for bold decisions and so we grasp the nettle. Finally, may we suggest that the report be read with an open mind remembering the following basics: 1) control of the delivery system is vital; 2) accountability of everyone involved in it is also vital; 3) the time has come to choose between being part of the problem or part of the solution; 4) through excessive demands by consumers and providers on the health care system the possibility exists of destroying the system, of killing the goose that lays the golden egg.''

[ Page 3398 ]

I presume Mr. Black wrote the foreword. He was part, as members know, of the early history of the medicare plan in British Columbia, because he was the minister at the time who negotiated it and retained interest in the B.C. Medical Services Plan. He has made 68 recommendations in his report. The minister might make note that the questions I'm going to ask him deal with some of the recommendations and whether the government has done anything about the report, which it has had since March 1979.

One of the problems that I started to discuss in an earlier part of the debate was the question of access. Until Mr. Black did his report, at the request of the government, I am not aware that the government had looked at the problems of access to the system and who in fact gets the greater benefit from the system. We do have some studies across Canada. We certainly have the study that was done in Ontario. We have another study, which is called the Interline Study, which was done in Quebec in 1975. Then we have the studies that were done in Saskatchewan in 1976. These studies really dealt with looking at a profile of the people in terms of what quantity of service they get. There were no comments made on the qualitative aspects of the service.

Today we heard from some of the other members, particularly the member for North Island (Mr. Gabelmann), talking about the question in relation to Alert Bay. Some of the things he said might well apply to other areas in the province.

Mr. Black, in his report, specifically talks about rural medicine. He talks about access there. There is no doubt that because of the way the medical system operates — I suppose every professional system operates the same way — the major part of the profession operates in urban areas. That's certainly so in the medical area.

The minister made the observation before that it is very difficult to find some mechanism to get doctors to go to rural areas, for some reason. They dealt with a series of incentives in the report — rather generous incentives. I wanted to discuss one possible incentive with the minister. One of the things which, I think, is often forgotten by the taxpayers is that they, by and large, provide in the order of 80 to 90 percent of all the cost of training anybody who goes to university. They pay fees, and fees are tough enough for students today; nevertheless, if those fees are up to $1,000 you can bet your boots that the cost to the taxpayer is another $4,000 anyway, just for a year. If you are dealing with the medical profession, I've heard the figure used of something in the order of $200,000 to train a doctor. I presume that is just the business of completing his studies and completing internship. I don't know if those figures include the whole question of specialization.

Nevertheless, that is a considerable amount of investment that the taxpayer has made in terms of that profession. I don't know of another professional training that's given at the university that is as expensive as that. Certainly because of the nature of the profession you've got to have very expensive facilities and you have key people that do the instructing.

A proposal that we might think about is along the following lines. There was a time in various governments when they would provide an opportunity for employees in various departments to go and take further professional training. It used to happen in this government. You went and took training for a couple of years and then you were obligated, on a kind of a contractual arrangement, that you would give a minimum of two years' service to the government without moving on to another job. After all, if the taxpayer pays for the training there should be an opportunity for the taxpayer to have the use of the training that the employee has got. They used to tie them to a couple of years.

There is the question of not just separating out the medical profession and saying: "Well, because there's an unordinarily large amount of taxpayers' money spent on this, somehow there is an obligation on the part of the people who have completed the studies to somehow make some kind of contribution to the state." That's a tough one, because it's the only.... If you take the dentists, doctors and specialists within the medical profession, how do you get them to the areas where there's a great shortage?

In his report, Black intended to look at highlighting some of the problem, and he used some figures. He was using some ratios as to what the per capita rate was in certain areas in respect to one part of the province versus the other. As an example he used Vancouver and, I think, the town of Lillooet. Basically the ratio was something like one doctor for some 1,600 people versus an average of one doctor for every 500 or 600 people in the urban areas.

I know that this is a problem that's been wrestled with for a number of years, but when you talk about access to the system and the availability of service in the system, it is not just the question that has been looked at in other provinces, that the middle class get a greater degree of the service because they know how to get to the service. Those are the findings, not just something we've found in Canada, but they've been found in Europe and certainly the work that Bulter, Bonham, Townsend and Gough did in England.... All those studies demonstrated that there was something wrong with the kind of distribution of services.

In British Columbia we have a somewhat different problem. That British experience is okay because you don't really think in Great Britain of rural areas where you are several hundred miles from some centre. We have a unique problem, not just in this province but perhaps in other provinces. Saskatchewan has been able to develop a rather unique kind of rural medicine. We have not been able to do that yet because maybe that is something we've not addressed. That is part of the inequity of the distribution of the system. It is not just the whole question of who gets the service in terms of whether you have a higher income than somebody else, but it is where you live and whether in fact you are getting even the basic kind of service.

I am not aware that the ministry or government has ever examined this question. I'm not aware of anything in public. For instance, the Black report has looked at that. But very little, if in fact any, ongoing research into this whole evaluation.... What we want to do, I suppose, first of all is to get some understanding of what is happening with the system, who gets to it and if there can be some adjustments made. Then, of course, to the all-important question of how we get more equitable services to the rural areas, because that is usually where the services.... Not just rural areas because I think probably you also have the problem in the larger areas — in Kamloops and Prince George — in terms of specialists. That is a problem I can recall existed some years ago when, in order to make the health and human resources thing operate on the Queen Charlotte Islands, there was scheduling of specialists to be flown in as opposed to flying people out was looked at. The specialist dentists were flown in.

[ Page 3399 ]

That is an option too. I am from the urban areas. We don't have this particular kind of problem, we have maybe other problems. But it has always interested me that we have never really come to grips with this problem. If it is a question of incentives to doctors then of course there is the thing of whether in fact we can oblige young doctors who have graduated after having the advantage of a couple of hundred thousand dollars of the taxpayers' money, make a service to the government, who can place them, based on the fact that their subsidization is out of all proportion to any other kind of professional training and on the fact that their potential for return, in terms of earnings, is extremely high. Because of their training, they become among the very highest earners.

So we've created a number of opportunities for people in the medical profession at that level. There is the question of whether some mechanism can be found to tie this to some kind of obligation. I know this may be singling them out, but if we're going to have a system which is equitable, which is not the question of constantly finding new kinds of incentives.... That's always the problem, when you're going to have to say to somebody who has already established himself in the Vancouver area: "We want you to go up north and we're prepared to give you this, this, and this."

I can recall, some years ago, when the government was looking to hire four doctors for the health and human resource boards. What was interesting was that with the medical profession and the health department they came up with an agreed salary and benefits, and as I recall — it was in 1974 — the salary was $45,000 per year. There was a month's holiday with pay, and an option to have three weeks' continuous training. You also received an office, equipment, whatever. It occurred to me at the time: what doctor, in his right mind, wouldn't want that kind of deal? There were set periods; it operates here in Victoria, in James Bay. I don't know what the salary is now, but that's a salaried doctor with a number of incentives.

Now, the thing is, you'd have to go a heck of a lot further along the line to get a sufficient number of people to go up to the other areas of the province, if you were getting into that kind of situation. That's one option that you have. The other option is the one I was talking about, the consideration of the early obligation. If the taxpayer has invested $200,000 in the medical training of a doctor, somehow there has to be some quid pro quo and the doctors have to spend some time making a contribution in terms of the medical system — because the medical system operates not just in the urban areas but in the very important and often neglected rural areas.

We've got to find some kind of balance. I know that we've already taken a run at this in terms of immigrant doctors, and we ran into the Human Rights Code and the Immigration Act. But we're looking down the road. It's not something you implement straight away; it's something that you really have to start discussing, and somewhere down the road, I suppose....

Young people who are going to go into medicine should know that they're going to have to make some contribution to the general well-being of the province in terms of the medical system by agreeing to go to these places — with adequate compensation. But that has to be an understanding, because the investment by the taxpayers is very, very high.

Yet as much as we want to brag about the medical system that we have — and we have a good medical system — there is the question of access. One of the most important parts of the access question is: can one compare the availability of areas? Obviously one cannot. One of the roles of the ministry is to improve that access. That is an important part of making the system work.

Last week in the debate I expressed my unhappiness with block funding, basically because as a general principle in Canada it tended to only give advantages to the have provinces versus the have not provinces. We cannot say across all of Canada that we have an adequate medical system for everybody, because we've moved away from that. That's a sad thing, because when we took the recommendations of the royal commission we were looking at a basic goal of minimal service that would be required in terms of the medical system which would gradually develop, and that has Dot happened.

What we are now dealing with in these estimates, in terms of what the government has control over, is the adequacy of the system in the north versus the south of B.C. That's a tough one to come to grips with. It isn’t just a question — as Mr. Lalonde said, I think three or four years ago — of finding some way of directing doctors to rural areas. I think it's too late to do that. You have to find some way of building into that medical system, because of — and it's underlined — the very heavy expenditure of taxpayers' money in terms of training doctors....

There has to be some understanding by people going into the profession. You can't do it with the people who are already in — but people going into the profession you have some kind of obligation to make some contribution to the service of the province, particularly the medical service, and that you could be required to go to areas. That is, I think, a better idea. It's not a directed thing, it has to be part of a kind of a contract that you enter into when you're going to take medical training.

To some extent, I suppose it's with the doctor, but it's with the dentist too. I'm sure that all ministers when they're wrestling with denticare programs wonder, if they bring in the denticare program, what they're going to do in places like Prince Rupert or Hazelton where maybe there is only one dentist, and all of a sudden you've made available the program. Those are tough questions and these are questions that really need to be debated in a much more public way. The Black report went into some of these questions. It produced some 68 recommendations and he went to some trouble to develop some of the recommendations. The composition of the committee is a good one; the medical profession was there. Dr. Bolton was on it. Mr. Kerr and Mr. Thomson. They did a lot of good work.

Perhaps the minister can tell us as we approach the time of adjournment what the Ministry has done in respect to the Black report since it has had it. It had it presumably over the last 15 months. In respect to making some of the implementations, particularly with the rural medicine one, what has he done? That's the thing that he's made some very suggestions about. There is the whole question, which I just want to mention, that he talks about.... He says on page 21 of the report talking about maldistribution:

"It's evident that the medical care marketplace is incapable of eliminating the maldistribution of physician manpower without direct intervention. Although some controls exist over immigration, the number of places available in medical school and the number of internships and resident physicians, it is clear that they are inadequate to meet the current situation of, generally, oversupply and the problems of maldistribution.

"Unfortunately there are few tested mechanisms

[ Page 3400 ]

available to help solve these difficulties. At present any physician coming to British Columbia may, upon registration with the College of Physicians and Surgeons, immediately commence billing the Medical Services Plan. The choice of practice location has always been open and few hospitals have restricted their privileges strictly according to service needs."

Here he's talking about somebody who is trained, comes into the country and has these kinds of options. I want to go back to what I'm talking about. It's not the ones that are trained; it's the ones that are going to come into the field later on. In fact it's the whole understanding that the student will have about coming into the field, an understanding on how much money is going to be invested by the taxpayer — that he has the understanding that down the road there will be some obligation, where there can in fact be, as he talks about, an intervention. That's a difficult word. When Lalonde used that kind of tone just about everybody fell on his head. It's a tough one to start directing doctors.

What I'm saying to the minister is it's possible to consider the option of looking at the way the students perceive the medical field and what they might do, whether you can build into that a sense of service. I know that we tend to be taking them as exceptions. They are exceptions for the reasons that I've given: not only the heavy investment of taxpayers' money, but also the great potential they have in terms of their earning power. Those things put them apart from other people, more so because the kind of skills they have far exceed the skills other people have in other areas, because they're dealing basically with human life.

Black spent quite a bit of time wrestling with the problems of the maldistribution. He also talked about the problem of the specialists. That was something that he said in which he found that one of the things that concerns them is that the number of practising physicians in terms of being GPs is going down in ratio to the number of specialists, which is starting to gallop upwards. He worries about that because of the basic kind of service. All of these things are starting to be documented. They're certainly documented in terms of the report. I haven't seen the briefs; there are a lot of briefs in terms of this kind of situation. The main thing is what we have got from the minister in terms of whether in fact they've accepted the recommendations of the Black report in any way. What has happened to it? Has he got a committee in his department which is looking at it? Have they made some decisions about what is going to be implemented?

Interjection.

MR. LEVI: I see the Premier wants to make a contribution. I'm sure he wants to make a contribution. But you really don't have anything to contribute on this one. Lots of gas but nothing on this one. This is a very important, complex area, so I think I'd better just carry on and you'd better just listen.

Interjection.

MR. LEVI: No, it's too late, Mr. Premier; you'll have to wait until next week. We've got to just keep going on this one. I mean, you're the one who agreed on the block funding, you know. We could have a whole debate on that one.

Interjection.

MR. LEVI: I can keep going, it's okay. No, you just sit down. If you want to do it in unison I'll tell you when to join in.

There is one question I want to ask the minister, and which I hope he will take note of. One of the observations that Mr. Black made in his report was in respect to the Medical Services and the B.C. Systems Corporation. He had some rather hard things to say about the fact that the MSP staff were having a real difficult time getting enough time on the BCSC computers to be able to do the kind of work that's necessary for them to operate the plan and the whole service they have. He says: "The MSP staff is efficient and competent. Unfortunately, computer time-sharing presents a serious problem...."

MR. KING: Mr. Chairman, I would draw your attention to the clock, with great respect.

MR. CHAIRMAN: My attention having been drawn to the clock, under standing order 4, the, committee reports progress and asks leave to sit again.

The House resumed; Mr. Davidson in the chair.

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

Hon. Mr. McGeer tabled an answer to question 79 on the order paper.

Hon. Mr. Williams moved adjournment of the House.

Motion approved.

The House adjourned at 1:04 p.m.

[ Page 3401 ]

APPENDIX

79 Mr. Lauk asked the Hon. the Minister of Universities, Science and Communications the following questions:

1. How many applications were received for the position of executive director of the B.C. Research Council?

2. How many of the applicants were Canadians?

3. How many senior staff members of the B.C. Research Council applied for the position?

4. In which newspapers was the position advertised?

5. At what salary was the position advertised?

6. What salary was granted to the successful applicant?

7. What was the salary of the former executive director of the B.C. Research Council?

The Hon. P. L. McGEER replied as follows:

"1. 120.

"2. 82.

"3. Three.

"4. (a) Vancouver Sun, (b) The Province, (c) The Daily Colonist, (d) The Globe and Mail, (e) The Financial Post, (f) New Scientist, and (g) Science.

"5. $45,000 and up.

"6. $60,000.

"7. $63,400."