[ Page 6199 ]

CONTENTS

Routine Proceedings

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

On vote 106: minister's office –– 6199

Mr. Cocke

Mr. Levi

Mr. Mussallem

Mr. Hanson

TUESDAY, JUNE 16, 1981

The House met at 10 a.m.

Orders of the Day

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

ESTIMATES: MINISTRY OF HEALTH

(continued)

On vote 106: minister's office, $205,728.

MR. COCKE: Mr. Chairman, we're dealing with the minister's vote. There are of course a number of items that one could deal with under separate votes under the minister's aegis. The trouble is that so many votes in the health field overlap. As a result you often find yourself dealing with long-term care, and then you're dealing with mental health and other areas. We've been talking about the whole question of home care and how it relates to the field, and how it is a great assistance in reducing the impact on the long-term care and acute-care facilities.

In recent months and years I've been watching our facilities described, I believe, as psychogeriatric facilities. I've been seeing a reduction in the number of beds that one would find in such places as Valleyview. I'm talking of a major reduction. The Valleyview care centre has reduced its population to something of the order of 400 at the present time. The impact on the system is that people described as "senile" or with a psychogeriatric condition find themselves in other areas of long-term care or find themselves on a very long waiting list and in the care of their families.

In the Rasmussen report we find recommendation 5, that separate facilities be designed to meet the special needs of the very difficult psychogeriatric client. I agree that the last thing we need are the monstrous facilities of the past. But until such time as there are facilities to take the place of those monstrous facilities, it strikes me that we should not be either leaving people adrift or misplacing them in the system.

Long-term care facilities, either intermediate care, personal care or extended care, are for people who are physically disabled to the extent that they require in-facility care. Generally speaking, we're talking about physical disability. When we mix this group with people with mental disabilities, who are totally lost in the world, have little or no recall and who are acting out, one way or another, through no fault of their own.... When we put people in facilities where there are those who are physically disabled but the others are psychogeriatrics, who spend most of their time screaming or disturbing those around them, I think we are not doing a great service to the system.

I believe that Anne Rasmussen's report should be looked at very carefully in the context of the whole question of long-term care. I know for some time there was an opinion out there that we should place all people who are chronically ill at a certain level within the same facility. But it is not working out, and it strikes me that the Rasmussen report should be looked at very carefully in this respect. While we have an increasing population in the province we also have an increasing population of elderly people, and at the same time we have a decreasing population in facilities which used to house that particular level of care. Where are they going?

I have visited such places as New Vista in Burnaby, and New Vista can hardly be described as a place that would be at the level for those people who are psychogeriatric: it's just a personal-care level with some intermediate care. I have visited in other facilities around the lower mainland, and I find the same thing. We are assessing people with a physical disability and overlooking a mental disability. I think that should be looked at very carefully, because if it's a disturbing influence on those in the facility, then we are not providing the lifestyle that should be guaranteed to those pioneers and to others who are affected by a physical disability. I would hope that the minister is going to take a very good, hard look at this, because it strikes me that this has been a policy for some length of time.

Carrying on for a moment with long-term care, I noted that when the Hospital Employees Union did their report, they called for better fire safety standards. I wonder what the minister is going to do about that. Looking at the report by the Rasmussen committee, I draw the minister's attention to recommendation number 20. It very clearly indicates that there are some real problems in this particular area: not enough fire drills, not high enough fire safety standards and, beyond that, not nearly enough training. So it also is an area that I think the minister should take a look at. This morning I'd like him to give us his opinion of this particular area.

We've been talking about the whole question of long-term care and home-care service as it applies. I've been trying — and it's very difficult — to get information from different districts, particularly all districts. I have talked to enough people around New Westminster, and here's another problem that we find in this whole question of home-care service. We find, for example, that the acute-care early-release home-care program is allotted something of the order of $30,000 per year in New Westminster. What does that represent? This represents five patients, four hours per day, twice a week. When you break that down and think of the numbers of people on early-release programs — being released from a hospital in order that the bed can be made available for somebody else coming in.... I think it's a great idea, but what happens when they only have that much money? The program continues, but it tends to move over into the long-term care program and bleed that program.

You see, the long-term care program in the same area gets about $100,000 a month. Therefore they're called upon to do some of this program. They don't like to turn people down, nor can they turn people down. It would be counterproductive to what they're trying to do in the first place: make beds and facilities available, and ensure that people are in the least alienating environment, their homes.

One other factor comes into this whole mix: a rumour. I'd like to ask the minister whether this rumour is true. We hear that home-care service for the terminally ill is also to be transferred to the acute home-care program. If that's the case, this teeny little program had better be reinforced or we’re in deep trouble. I'd like a couple of answers to those questions with respect to this whole service.

I would like to go to the report on long-term care by the B.C. Health Association and read a couple of stats that I think should bring us into line with what's occurring today. In the first place, 7.8 percent of people in acute-care hospitals are waiting for home-support service. In my mind that figure asks how home care can be available to those people now in their homes when we can’t even make it available to long-term care people who are actually in hospital today. I figure

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that the minister should review this report very carefully. I feel that the B.C. Health Association has always been very conservative in rapping people's knuckles; they just don't go around doing that sort of thing. I think this is a very significant factor.

Further on in the report they make recommendations. On page 27 they recommend that the government be asked to allocate, as a matter of urgency, sufficient resources for all aspects of long-term care programs so that its objectives can be achieved without continuing detriment to the acute-care hospital services available to the people of B.C., and then free the allocation of resources to the home support program, such as home care, homemaker, respite and adult-care programs, sufficient to meet the identified needs.

Mr. Chairman, if we haven't proved anything else in the course of these estimates and in the course of the past few weeks, we have proven beyond a shadow of a doubt that there is a real, urgent need for home care. That need has been identified in this report, in conversations with every district and in the mail. I'm sure if my mail is yea-high, the minister's mail must be twice or three or four times as high. For heaven's sake, if we don't go away from these estimates with anything else, let's go away from these estimates with a commitment from the government to get in there and give priority to this most important service. It's utterly essential.

Incidentally, I referred to the fire regulations. I refer the minister to the long-term care report by the Hospital Employees Union and to the recommendations on page 105 where they ask for new guidelines, that staff be hired in the fire marshal's office to enforce the guidelines, that there be smoke detectors and sprinklers in all facilities and that fire training be provided to all staff, particularly new staff members, etc. There are six recommendations and they should be very carefully looked at.

Before one or two of my colleagues get into the estimates, I would like to talk a little bit more about this whole question of alcohol and drugs. First, I refer to the Cadillac program, the heroin treatment program, and I would like to ask if it is true that the roughly 300 public servants are being seconded to the non-profit programs within the communities. I'm not going to do a value judgment on that, but I would like to know whether or not it's true. I know something has to be done, because we've talked about the Cadillac program for some time now. That heroin treatment program received all of the resources they felt they needed, but there were very few clients for them to look after. So I would like to know what's happening in the area of the integration of the different programs. As I recall, there were three under a previous minister. There was the alcohol and drug program, the non-profit community program, and the Cadillac of them all, the heroin treatment program. I gather, from what we see now, that there seems to be an integration going on, and I would like to know in what direction it's going.

The member for Cariboo (Hon. Mr. Fraser) should be very interested in this. It is a report put out by a task force on municipal policing costs in B.C. You would wonder how that has anything to do with health. Well, it sure has a lot to do with health in Williams Lake, I'm here to tell you. This report tells us that in Williams Lake the SIPPs.... That's a beautiful new acronym which stands for "state of intoxication in a public place." It seems to be an appropriate acronym, because this is their way of describing the number of people being charged with having been in a state of intoxication in a public place. We have statistics for the province. The provincial high in terms of per 1,000 population is Williams Lake.

Interjection.

MR. COCKE: My colleague says that's not a particularly good way of describing this, but it is the provincial high nonetheless.

In Williams Lake we have 265.04 per 1,000 population. Contrast that with Vancouver with 32.26 and Victoria — good old staid Victoria — with 22.59. Let's go back to the figure of 265.04. They're ranking in the province as number one. What do they have to contend with this other than the police? Zero. They have no program whatsoever provided by the alcohol and drug administration. For heaven's sake, a past minister provided a heroin treatment program in Powell River. I don't know if anybody was ever found with heroin in Powell River. It was a very expensive program. Yet now we've all acknowledged that this is our major problem in this province; alcohol is the most abused of all drugs. We find an area like Williams Lake with no program, and yet they rank number one in this report. This report has been out for some time — not too long, but it's been out for a while.

Isn't it interesting that number two is Fort St. John? I'm sure that the member for North Peace River (Mr. Brummet) would be interested in that. They're way down in terms of state of intoxication in a public place. They're down to 106. Can you imagine that number one is 265 and number two drops down to 106 per 1,000. This police report is telling us that you've got to do something about it outside of locked cells. You've got to do something about it in terms of rehabilitation and detoxification, and of what the Alcohol and Drug Commission or the drug and alcohol program — or whatever you're calling it this week — should be doing. It's not being done. If the member for Cariboo won't fight for it, we on this side of the House will.

I want to go over what they say in this report. They say: "The issue is not just the number of arrests but also the number of individuals who are arrested time and time again. These chronic alcoholics need medical attention, not just a chance to sober up in a drunk tank." That's the key. We can go on with this drunk tank business over and over. Sure, they die off. But these are human beings — people with minds, bodies and souls. They should be treated as well as anybody else in the province. If we have a particular area where the flames are high, then for heaven's sake let's get some firefighting in that particular area. I believe it's a sin to leave Williams Lake in the state it's in when you consider....

Interjection.

MR. COCKE: That's not an acronym; that's actual. It's not a SIPP.

I believe that we should really take a look at those two areas. In Williams Lake 75 percent of all crime is the crime of drunkenness. The Attorney-General and the Minister of Health had better get together on this one, because if that's the case up there something should be done immediately. I believe that this report I'm placing is a report that we should all read. I think it's pretty significant, with respect to health care, when we read these particular pages. They certainly apply to some of the immediate needs.

This report goes on to say on page 243: "One problem occurs where facilities are not available in places such as

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Williams Lake, Fort St. John, Terrace, Quesnel and Prince George, where the SIPP problem is most acute." They go on to say that Prince George does have a 20-bed facility used for short-term holding purposes.

We have to do better than we're now doing. Those are two statistics out of a report that should draw the conclusion that something had better be done very quickly; otherwise we are culpable, that ministry is culpable and everybody else with any kind of obligation — and that means every legislator in the province — is culpable. I call on the minister to move in there quickly. Otherwise, what are we going to see in the next statistics? The statistics that we're not reading or seeing now are the other ramifications of this. How many people are in the care of the health system with cirrhosis of the liver, heart disease and all the other illnesses that can be related to this particular chronic problem? I think that is a devastating figure, and I think we'd better put our heads and hearts to work and see to it that this situation is modified, mitigated and put right as quickly as possible.

HON. MR. NIELSEN: Mr. Chairman, the member brought up a number of issues. Responding to the last one first, I think the emphasis for some period of time in the province with respect to the Alcohol and Drug Commission has been on the hard drugs, particularly heroin and some of the other less — forgive me for using the term — "romanticized" drugs. I think that the greatest emphasis the Alcohol and Drug Commission should be responding to is the problem of alcoholism. I spoke with the new executive director, John Russell, the other day, and we had quite a discussion with respect to just that point. In speaking with Mr. Russell, I emphasized my opinion that the Alcohol and Drug Commission should focus primarily and with great emphasis on the problems of alcoholism and alcohol abuse in our society. I think the attention paid to the so-called hard drugs such as heroin and others has been somewhat of a tradition. It's been viewed by many people historically as a scourge in our society, because of its involvement with crime and the international intrigue of heroin smuggling, and it has received a somewhat disproportionate amount of emphasis because of that, I think.

I agree with the member for New Westminster (Mr. Cocke) that alcoholism could perhaps be identified as the number one health hazard in the province, relating to many avenues of life — the personal deterioration of the individual, but perhaps equally important, the impact upon others both physically and socially. One cannot ignore the carnage on the highways which may be directly attributed to alcohol.

The member mentioned the situation in Williams Lake, and I appreciate that some community in the province is going to be in the position of having an extraordinarily high number of these people who are classified as intoxicated in a public place. Williams Lake, with respect to the Alcohol and Drug Commission, only has an out-patient counselling service at the moment. The out-patient counselling service appears to be inadequate for the demand in that community. I will certainly advise Mr. Russell to respond as quickly as possible to Williams Lake, Fort St. John and other identified communities where the incidence of repeat alcohol-associated problems occurs.

The member for New Westminster mentioned that a very high percentage of the crime identified in such a community is that of being drunk. I would perhaps not find it difficult to agree that this particular problem need not be considered a police problem. If the person who is drunk is causing disturbances, then I suppose the police have an absolute duty to become involved; but the drunkenness itself may be much more appropriately responded to by other actions than police action.

I trust that most people in the province would appreciate the major problem that the abuse of alcohol causes in our society. Mr. Russell of the Alcohol and Drug Commission, I and others have recently been discussing the continuing problem of the effects upon teenagers with alcoholic problems. It's a sad reflection on our society that there are so many teenagers who have been identified as having a serious alcohol-dependency problem. We also wish to emphasize, through the commission, the ways and means of attempting to respond to that, because it is an alarming problem and one which is growing. There are probably literally dozens of theories as to why this problem is before us today and why it is increasing in scope. As one of their priorities, the members of the commission will be attempting to identify how the situation with respect to the young drinkers and to those pockets in the province which are identified as having a chronically serious problem associated with alcohol abuse may be improved. We will certainly respond to that. There are 53 voluntary non-profit societies operating programs in the province, and clearly more emphasis is required in more specific areas.

To conclude, I do believe that over a number of years in British Columbia perhaps more emphasis than was required was placed on the so-called hard drugs, and that the problems of alcoholism and alcohol abuse did not receive the full attention they should have. We'll see if we can modify that attitude somewhat. Unfortunately, it's a problem that will be with us forever, I suppose; but at least a great deal can be attempted to try to resolve identified situations. We hope that one of the people on the commission will have direct access to the Attorney-General's ministry, and that such reports as the member referred to would therefore be an integral part of the commission's study rather than peripheral reports which may or may not find their way directly to the commission. The Attorney-General's ministry, along with other ministries, has an important role to play in providing precise information to the commission.

The member for New Westminster spoke of Valleyview. The Valleyview situation may be viewed differently, depending on how you wish to view it. I believe that there were approximately 417 patients in Valleyview last year. About 40 to 45 percent of those who left were discharged back into the community. As the member would know, there is the desire at Valleyview, as in other institutions, to try to treat the people with such success that they may re-enter the community. A number of people who have been at Valleyview have returned home; others have been placed in extended-care facilities or in intermediate-care facilities. We're dealing with a group of people who are at an advanced age — over 70, up to 105 — and their conditions vary a great deal. But there is an attempt being made, as there has been for some time, to have these people return to the community wherever possible. I believe the level of care at Valleyview is adequate. The facilities found for those people who were discharged are generally appropriate for their condition; there will always be exceptions. It isn’t an attempt to deliberately reduce the population but rather an attempt to redirect the population in that facility to other appropriate community facilities where they may be available.

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The member mentioned the fire safety standards question, which was brought forward by the HEU report with respect to long-term care facilities. In their investigation the program directors responsible for the long-term care facilities also identified situations where fire safety standards were not at the level demanded by the fire marshall. I believe the fire marshall has made it clear that they expect modifications to be made. That program is a priority with the long-term care director.

[Mr. Strachan in the chair.]

There are some facilities that would have to be upgraded. The new facilities, of course, maintain those standards demanded by the fire marshal. In some instances it would be a matter of major renovation. Perhaps the decision would be to replace the facility with the standards of today rather than renovating an existing facility. Where facilities are found to have safety standards which are far below the requirements and could be modified relatively easily they would be expected to do that very quickly. Of course there is a cost factor involved that must be considered in the rate structure which is provided to the long-term care facilities to permit recovery of the capital costs of modifying the safety standards relative to the fire marshal's programs.

There have been some major problems in facilities throughout the province with respect to attempted renovation or expansion. As members would know, when certain expansions or renovations are undertaken, it generally falls under a new permit. Therefore the entire building must be modified to meet the fire standards. It's a continuing situation, but I believe it's one that's well understood. Action is being taken to try to bring them in line.

I wouldn't want the House to miss a point which I think is important. While we can discuss specifics and details about programs relative to long-term care, I think all of us can still appreciate that it wasn't long ago in British Columbia when senior citizens or their families were faced with tremendous costs and pressures in sustaining a senior citizen in a personal-care facility — or whatever terminology may have been used at that time. The costs were extraordinarily high. The number of facilities was not unlimited. Decisions made by families were sometimes very difficult. In many instances it led to a tremendous amount of disruption in the home and very difficult personal situations.

That has been vastly improved with the long-term care program. It's a relatively new program. We appreciate that. Actually, it's only about three years old. It's being improved constantly. It is providing a very good service to many people, not without its imperfections and problems which have been specifically identified. It does provide a very good service to a large number of people at minimum personal cost. I think those people who have been able to introduce the system and maintain that system should have some recognition.

MR. LEVI: I want to deal with two things. First of all, I want to talk about the problem of urea formaldehyde, and then I want to talk about long-term care.

Is the minister aware that because of the failure of his community health department to do anything about this problem, thousands of people in this province are slowly being gassed to death by formaldehyde gas? I say this because the problem of the formaldehyde gas comes from the insulation in an estimated 8,000 homes that we know of in British Columbia. The ministry has yet to tackle the problem in any meaningful way through its community health branch.

One of the problems here has been that there seems to be a feeling in the government that it's really a federal problem and to therefore let the federal people carry the can for it. But the problem is really divided into two. One is the health problem, and the other is the financial problem. People who own their homes are suffering. I've written to the minister's colleague, the Minister of Consumer and Corporate Affairs (Hon. Mr. Hyndman), about both problems. I want to address my remarks to the minister. What is his ministry going to do? I've been in touch with his ministry, and all they're doing on this problem at the moment is a review of the literature.

For the minister to get an idea of what the problem is, I'll tell him of a personal experience I had last Saturday afternoon. I visited the home of a man in Vancouver, a Mr. Owens, and spent two and a half hours there. That house was insulated with urea formaldehyde in 1977. As Mr. Owens pointed out, he owns the home. He accepted the publicity from both the federal and the provincial energy departments that everybody should make an attempt at conservation. He was aware of the studies that Hydro had done about heat emissions from houses needing insulation. So he went in for the insulation in 1977. In April 1981 he read an article in the Sun which said that there are some very serious problems arising as a result of this insulation breaking down, particularly health problems. There is a range of other problems, but I want to deal with the health problem because it is within this ministry.

In April 1981 a building-practice note was issued by the National Research Council of Canada, talking about urea formaldehyde foam insulation. In one section they state:

"Occupants of homes in which this insulation was installed have become concerned about the effects of material on their health and on their homes" — let's stay with the health question. "Experts agreed that the likelihood of health problems occurring depends on the duration of exposure and concentration of formaldehyde. In some homes only precautionary steps will be required to reduce the exposure to near-normal levels. In other homes a few additional measures, less complicated and much less expensive than the removal of the foam, will be necessary. In a small percentage of the cases it will be too difficult to reduce exposure and the foam will have to be removed. Steps taken to reduce exposure will usually eliminate any risk to the building structure."

On page 3 they have a description of the symptoms. I want to read this because I went through some of these symptoms last Saturday.

"Exposure to formaldehyde can cause eye, nose and throat irritation, coughing, asthma-like symptoms, headaches, dizziness, nausea, vomiting and nosebleeds. The severity of the reaction depends on the formaldehyde concentration, the duration of exposure and the sensitivity of the individual."

I spent two and a half hours last Saturday afternoon in this house and became aware of eye irritation and an itchiness of the hands. I was accompanied by my wife, who got quite nauseated when we went outside. We spent some time talking to these people, who were in the most unbelievable situation. I am suggesting that the Ministry of Health has done nothing to assist these people in respect to the health question — I'm not talking about the compensation aspect at the

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moment. At this stage of the game when this subject has been known as being dangerous, that ministry has done nothing more than start a review of the literature. That's a very shocking state of affairs. First of all, as I indicated to some of the people I spoke to yesterday, never mind a review of the literature. There are buckets of literature. I can send them a boxful of it. United States Senate committees have looked at it. The federal government has looked at it. What the ministry has to do — and do quickly — is start setting up some standardized health-testing procedures, get into these houses and advise these people on just what danger they are in.

It is the most incredible situation to sit with people who own their home, who have worked all their lives to build it, who find that they've got all sorts of financial losses on the one hand, and on the other are sitting there in abject discomfort. We sat for two and half hours with the windows open, because that's the only way you can exist in the house. There is a danger there, according to the medical people, particularly for people who have respiratory diseases. If anything will exacerbate that problem, it's this formaldehyde gas that is coming out of the walls of some of these houses.

That ministry has done nothing. There has got to be a greater sense of urgency about this. Never mind what the federal government is going to do. The ministry is responsible for health care in this province. This is an environmental health problem. What is needed is some standardized testing. The minister has access to all sorts of resources for this. Go to the B.C. Research Council or to the National Research Council. Set up some testing and advise people that if they are living in a house that is injurious to their health they'll have to get out of it. People have nowhere to go when they're living in a house that they've bought and paid for. It's different if you're renting the house; you simply get out of it. People who've spent 25 or 30 years putting together the money to own the house are sitting in dire danger of their health because of what's coming out of the walls. It's a great tragedy.

It's interesting that when this article was in the paper in April, one man, John Owens, got very vociferous about it. He set up a meeting in the Britannia community centre, and 70 people arrived. Two weeks later they set up another meeting, and 120 people arrived. About three weeks ago they had a third meeting, and over 200 people came. Phone calls were going into the office of Margaret Mitchell, MP, so much so that they now man the phone full-time taking down all the information on the people who have discovered that their houses have been insulated with urea formaldehyde. There is a great problem in keeping records of who has what kind of insulation in his home.

Bear in mind that there was a federal-provincial program which urged people to insulate their homes. This came from the government — an endorsement to do it. Both governments have a responsibility. Never mind the divided jurisdiction; this government has a responsibility in health matters, and it's not doing anything about it. That's the great tragedy in this thing. If you do nothing else — never mind reviewing the literature; that's been reviewed by all sorts of people — set up the testing. What is going on out there right now is that all sorts of private testing companies are going around charging people $100 or $150 for testing which really tells them nothing. In some cases people have had as many as three tests done by three different people, all showing different results.

This is a very serious health question affecting not only adults but children living in the house. There is information about some of the studies of the sudden-infant-death syndrome done in the United States. They have tried to figure out whether there's a link between that kind of insulation and those sudden deaths that take place. In this government this ministry has so far done nothing whatsoever other than to review the literature. In the health department in Vancouver they have a testing procedure. What the minister has to do is get together probably with the rentalsman, who has the best information on housing in all of British Columbia — he's got it on a computer — and start finding out which houses in this province have been insulated with urea formaldehyde. At the moment the estimate is 8,000 homes in the province. They're not sure of the total estimate in the country, so they use figures from 80,000 to 125,000. What is obscuring the health problem is some of the forceful arguments being made by people that they need to be compensated for the damage to the house. That is very true, but that is an entirely separate question and is certainly not the priority question; health is the priority question.

The government is going to have to spend some money. If it's a question of cost-sharing, then I urge you to spend the money and then go chase down the federal government. You've got to set up the testing facilities. It's crucial. There are all sorts of other things that can happen. No doubt there's going to be a need to examine how this material was allowed to be passed by the Canadian Standards and put into the homes to create the dangers that it's creating. All of that can come later. We can only hope that the Canadian Standards people and this government will learn a lesson when people point out to their MLAs and the ministers that they have a health hazard and that we will act very quickly to (a) detect it, (b) evaluate what the level of the hazard is, and (c) do something about it. So far that has not been done.

As I said in the beginning, people are in danger of being gassed to death in a very slow process. When I was in that house and I left, I became completely aware of the symptoms those people were talking about. It was a decided physical discomfort that both of us felt when we left. One cannot disregard that kind of experience any more than the experience of all the hundreds of people who have been in touch with the organization that has now been set up. There is an organization of all of the people who are trying to do something in the two areas.

I'm asking the minister to be aware of this problem and to do something with a real sense of urgency. It's not something that can be ignored. In this province we have the ability to set up emergency measures from time to time when we have catastrophes. We have 8,000 homes in which people are living in an atmosphere injurious to their health, and you have to set up some very quick measures, particularly standardized testing, so that people can have some assurance in terms of a certificate that their health is okay; those that aren't okay had better have something done about them. For instance, you have what could be a very serious evacuation problem. What will you do if you do the testing, and you say to people, "You are living in a house which is injurious to your health," and they turn to you and say, "Well, what am I going to do? I own the house. Where am I going to go?" That's the state of the problem. Nobody from the government has addressed it from the health side.

I would like the minister to answer the questions I'm going to ask him. Are you prepared, as quickly as possible and in the most practical way possible, to do something about the testing? Never mind reviewing the literature. You can go

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to a number of agencies across North America who will tell you what kind of testing facilities they've set up and what result they've had. That's absolutely crucial. You need to know — and you're going to have to deal with some of your colleagues — how much of this urea formaldehyde is in the province, and in how many houses — it's also been used in mobile homes — to find out the level of the problem. The first thing is that you've got to have that testing. Otherwise there's going to be a lot of ripoff out there where people are going to get so desperate they're going to go to these private people who do not have standardized tests, and it's going to be useless. They're being charged anywhere from $50 to $150 for a test. That's the function of the government, because you're in the community health system. This is an environmental matter, and there's nothing as close as the environment of one's home.

I would urge the minister, not as a clash or an attempt to get some publicity, but to go to a few of these places and talk to these people. This has got to be the most difficult situation people can find themselves in. Here are people who are completely independent and who have made their own way in society, and they suddenly find they have to fall back on the only jurisdiction that they've generally stayed away from, and that is the government; and the government has done nothing about this problem so far. I'm asking the minister whether he is aware of the problem and what actions they are taking to do something about ensuring that those people who are living in environments injurious to their health.... What are they going to do about it? First of all, is the minister prepared to do something about the testing? I'm completely uninterested in what the federal government does, because they've got a long-range plan in which they say they're going to do some sample testing. Health matters are provincial jurisdictions.

We have an obligation to move quickly to do something about this problem. This has not been done up to now, and I'm asking the minister if he would make some comments about this.

HON. MR. NIELSEN: Finished?

MR. LEVI: Are you going to make some comments? I want to get on to long-term care.

HON. MR. NIELSEN: Anyone else?

MR. LEVI: What do you mean? I've just laid it out. Answer that. That's pretty serious. What's the matter, don't you have an answer?

HON. MR. NIELSEN: I'll answer you.

MR. LEVI: Well, answer then.

HON. MR. NIELSEN: Are you running the debate now?

MR. LEVI: There we are. I've spent 15 minutes laying it out. He obviously doesn't know anything about it. That's the very point I'm making. That minister's ministry has failed to do anything about this problem. It's traumatic and serious. All I'm asking the minister to do is to give this committee some assurance that they're going to move into the testing area and stop reviewing the literature. Do something specific and concrete so those people out there can have some assurance that if they are living in an atmosphere which is injurious to their health something will be done. I'm asking the minister what he is prepared to do. I can get on with talking about long-term care afterwards. I would like him to respond. I'm quite prepared to yield to the minister.

HON. MR. NIELSEN: There may be other members. Anyone else?

MR. LEVI: We want to hear about this. You've had three days of long-term care, and we're still going on with it. This is a serious problem. Do you know anything about it, and are you prepared to do anything about it? That's all we're asking. Come on.

Interjections.

MR. CHAIRMAN: The Minister of Health.

HON. MR. NIELSEN: I rise only because of the urging of the other members who don't have the floor, Mr. Chairman.

Of course the problem of urea formaldehyde and other substances which may be hazardous to the health of a homeowner is serious. Many substances known to science are hazardous to people, and there is no question that they are in evidence in many homes. Dr. Richards, who is our public health inspector, has indeed been paying particular attention to this problem. The Ministry of Health has not been ignoring the problem. That's a silly statement to make.

The member doesn't wish to hear about the federal government, which is fine. However, he's going to have to hear about the federal government, because they have been and will continue to be coordinating a manner in which homes can be tested. The member says: "Go out there and test it with the equipment." Sure, terrific. Please identify the equipment.

MR. LEVI: I identified the mechanism.

HON. MR. NIELSEN: Identify the equipment which they consider to be reliable in testing. There will be special units for testing homes in Montreal, Toronto and Vancouver. The tests were those recommended by the National Research Council for formaldehyde in the air, formaldehyde in wall cavities and the moisture content of wood. Our ministry does not have the sophisticated testing equipment for formaldehyde. There is a very serious question as to the technical expertise in proceeding with that. There may be such people available in the country who understand these tests and procedures and either have access to the equipment or have the equipment. There's a very strong difference of opinion as to the reliability of some equipment which is now used in monitoring.

There's no question that there are complications associated with this urea formaldehyde. The symptoms have been known and are known to medical authorities. There is grave concern on the part of people who are living in such homes with this material. The effects upon them vary individually depending on their personal condition. The Ministry of Health, provided with the testing equipment and the manpower with the technical expertise, will certainly conduct tests on identified homes. Again, if the equipment and manpower are available, if the process and procedures are uni-

[ Page 6205 ]

form, if the air, wall cavities, moisture content and the rest of it can be tested and if, indeed, it is determined that it is a health hazard, then the occupants would be so advised. I would question the authority of telling the people that they have to move out. As I said, there are many situations and conditions in individual homes or other buildings where it's a health hazard. There's no question about that.

There are many people responsible for determining that. The urea formaldehyde problem is something which has come upon us in Canada over recent months. The people who are responsible for health, building standards and other safety standards have not been standing still. They have been attempting to respond to this. I agree with the member that for the greatest period of time of this controversy the emphasis has been on who's going to pay for tearing it out and replacing it, with less emphasis on the health hazards.

The Ministry of Health in British Columbia is well aware of the concern. Dr. Richards and others are in constant communication with people who are believed to have expertise in this area. It has not been ignored. I don't think there's a simple pat answer. I'm advised that we do not seem to have the appropriate testing equipment. There is concern whether our health inspectors would have had any training in using such equipment in this specific testing process. That has not been ignored. That is part of the conundrum they find themselves in. Of course the ministry would respond to individuals and assist them in determining, to the best of their opinion at least, what the health hazard may be. But we must get the equipment. We must be able to test it from a scientific point of view, know what we're monitoring and what those results say.

It is being coordinated across Canada; at least an attempt is being made to coordinate it across Canada, to have uniform testing and standards, to try to determine what these levels may be. I don't know how many homes may have been insulated with urea formaldehyde, but I am sure that many citizens probably had their homes insulated with this material and are unaware of it. Perhaps others have different material and feel that it's giving them problems as well. I cannot give you the pat answer that it's going to be resolved tomorrow or next week. Yes, it's urgent — very important. People in the public health sector of the ministry are certainly not ignoring it. It's something that they would very much like an answer for, provided they had the equipment and the expertise to make use of it to determine precisely what the health hazard may be. There is some argument from the medical side as to what the danger of the material is, but there is no disagreement that there certainly are identifiable symptoms which occur and are easily recognized, directly attributable to the urea formaldehyde substance.

Some time ago the problem was brought forward to us, involving not insulation but the wallboard in some of the portable school classrooms in the province. The public health inspectors responded to that very quickly, and they were perhaps quicker because the odour of the substance was so obvious that they were able to offer some judgment as to its danger. Changes were made and some students were moved out of these portables. These particular portables have been in place for a long time, but I gather the wallboard itself was beginning to break down and some of the gases were being released, and so they were recognized.

It's not a new question. It is still relatively current with respect to the foam. We rely to a degree on the federal government with respect to what resources they may have available and what resources they make available to us. We cannot resolve this problem immediately or overnight.

Representatives in the ministry are responding to it and are attempting to be as up-to-date as possible on what can be done. We would attempt to accommodate individual citizens in the province who would request a medical or health inspector to inspect their homes, within the limitations we have with respect to equipment or adequate testing procedures. We certainly would respond to that. It is simply not a situation where there is a pat answer — where there are acceptable procedures, the equipment is readily available, and the technicians who can make use of it are readily available. Representatives in the ministry are in constant contact with other areas of the country and the federal government to try to determine precisely what is being done. The federal government has announced they will be testing approximately 2,000 homes in July on a priority basis, responding to the homeowners. As I said, special units will include Vancouver, and testing will be done. I really don't know how we can respond more quickly to it.

If our people in public health are advised of available equipment, or tests which would result in accurate analyses of the air and the rest of it, we would be very pleased to have that information. I am assured by people in the ministry that it is just not readily available. The biggest problem we have right now is the capability of the technicians and others to respond to this with some determination as to their capability of testing. There may be some equipment available somewhere which could perhaps be received. They've been trying and are continuing to try to determine that. They've been in contact with the National Research Council and others. I don't know, specifically, if they've been in contact with the B.C. Research Council, but I would expect they have been. I can find out for sure. It's certainly not being ignored. I agree that it's not being resolved, but not for lack of trying or desire. It's a very complex and difficult problem. At the moment representatives in the ministry are responding to it to the best of their ability.

MR. LEVI: Towards the end of the minister's speech we got to the really serious thing. First of all, if he reads the Blues he'll find out that we're not looking for any pat answers. I didn't ask for that. You talked about standardized testing. You made a statement this morning. If it's picked up by the press that you are now saying that if people in the province want to be tested you'll do what you can.... Let me tell you something: that's not the way you approach the problem. First of all, you've gone through the whole business of saying that no such testing is available. The thing is you've got to be very careful about this. You are raising expectation which you can’t meet. That's the problem.

Yesterday my colleague the first member for Victoria (Mr. Barber) asked you what kind of monitoring went on in the ministry of what was happening in the various sciences and in other jurisdictions around health matters. You indicated that your people are in touch and that you have an exchange of information. I want to point something out to you. The minister would have us believe, Mr. Chairman, that somehow this problem just came upon us in April. In January 1981 a bulletin was issued by the Energy, Mines and Resources department of Canada. It's headed: "Urea Formaldehyde Foam Insulation — Update." They say:

"The fact sheet is designed to inform home owners with urea formaldehyde insulation about the

[ Page 6206 ]

present situation, to identify the agencies that can be of assistance and to provide information and suggestions to reduce and prevent formaldehyde problems. On December 18, 1980, Health and Welfare Canada announced a temporary ban on the use of urea formaldehyde foam insulation for home insulation. The National Health and Welfare expert advisory committee was established to study the potential health hazards of UFFI and recommended a ban on the use of the product pending the final results of their investigations, expected early in 1981."

This was a ban put on by the National Health and Welfare expert advisory committee. I ask the minister to check in his department to see whether they received notification. They go on to say:

"Canada Mortgage and Housing Corporation has withdrawn its acceptance of urea formaldehyde foam insulation. Homes insulated with the product after December 18 are not eligible for Canadian home insulation program grants." That's the second indication — not in April, but in December and in January. "The National Research Council of Canada is currently preparing publications to assist homeowners and contractors in identifying, preventing and correcting UFFI problems."

They then go on to describe the symptoms, which I talked about before.

What we have here may be — let the minister find out before we make some blanket statement — a breakdown of communication between the federal ministry of Health and all the provincial Health ministries as to what those people are doing about a very serious, dangerous matter. Two separate bulletins were sent out, one in December, one in January, one withdrawing it under CHIP — the Canada Mortgage and Housing insulation program — and the other outlining what the problems are.

This is not a new thing. The history is not terribly important right now. We've got to meet a problem. There has been a fair amount of warning on this problem. This thing did not just come upon us in April. I would like the minister to tell us — if not this morning, this afternoon — when they were first advised of this. Don't tell me you were first advised at the time of the school thing that that was all your ministry knew about it and then you looked at the problem and decided to do something about it. I can tell you that in December 1979 the United States Senate had a three-day hearing on this problem. Most of the Scandinavian countries dealt with it four years ago and got rid of it.

We cannot have the minister standing up and speculating that it may or may not be dangerous. I'm not interested in that any more. I'm saying that a greater effort simply has to be made to do something about the testing. It may be that the federal government is going to test, but it's only going to test a few houses in Vancouver. Who is going to test the houses in Coquitlam, Burnaby and Powell River, where they have some? Regardless of what the federal government does.... If they are using some equipment and if you can possibly obtain it, fine. But you have to have something in place when they're finished. You have to be able to say to the people out there, who are getting extremely worried about the health question, what you're prepared to offer them — not the statement that you just made. All you're going to do is drive most of your bureaucrats mad, because you said just before: "If people want to get their houses tested, phone us and we'll see what we can do." Well, the program has to be a little bit more definitive than that.

There is an enormous amount of information on this problem. If you have to send one of your people down to Washington, D.C., then send him down to talk to people who have dealt with this on an expert level. They've dealt with it. They are dealing with it every day. There are numerous scientific agencies looking at this problem. Be in touch with the Scandinavian countries; see what they are doing. One has to have a sense of urgency about this.

If you are going to rely primarily on the federal government's action, then you are abrogating your responsibility as the Health minister. Health is a provincial matter; that's the key thing. You have to take some initiative. You say that your ministry is aware of it; yes, they are. But I point out to you, Mr. Minister, that all they're doing at the moment is reviewing the literature. This is not the preparation of a PhD thesis. All of that work has been done. Testing has been done in a range.... The University of Washington looked at it two years ago. There are people down there who can assist you. You have to move broadly and go to various jurisdictions. The problem is on your desk; it's not on Ouellet's desk. He's down in Ottawa; he's going to do his political number and do some samples. But you're going to be left with the basic problem of dealing with people in this province. If he's doing 2,000 across Canada, then we'll be lucky to get 100 homes tested in Vancouver. That's the problem. Nobody's looking for pat answers.

The minister stood up, and what he was really doing was speculating. We don't want you to speculate. There are numerous places where your ministry can go, but they've got to get beyond the stage of reviewing literature. That's the crucial part. I don't feel that the minister has the sense of urgency that's needed here, because we rarely have the situation where people are actually living in accommodation that is injurious to their health. I don't want the minister to speculate whether it is or isn't. It has long been established by various international agencies that it is injurious to health. Why do you think CHIP cancelled its use? How definitive the sickness is has not been established, but then we don't have that kind of establishment of sickness to that kind of degree anyway. What we have is a fair warning. What we want to hear from the ministry is that they are going to address the problem beyond the stage of the review of literature. That's what they're not doing. They're not doing that at all.

MR. MUSSALLEM: It's interesting to hear the hon. member for Maillardville-Coquitlam. I find nothing specifically wrong with what he said. I don't know how accurate he is. I'm not sure of that.

I must remind the minister about an interesting incident that happened here a couple of years ago, when one of my constituents came to these buildings during a session and presented the Minister of Health with a very detailed report on how vital and dangerous rats were in the schools and the carcinogenic effect they were having on the students. They said that cancer was rife in the schools, and this was the cause. During the summer holidays, he brought out his facts. The study even had bones of the rats. During the summer holidays when schools were closed down, the dampness in the pipes of the ventilating systems were right for poisoned rats. The poisoned rats would somehow find this dampness. I don't know why that was. They would die and decay. All this dust would eventually circulate, because he would find

[ Page 6207 ]

nothing but bones. Where did the rats go? They went into the circulating system in the schools. He said that this was one of the dangers and is why cancer is so rife in our society. Well, perhaps. I'm sure that if anybody breathed enough from one rat they'd get cancer of some kind. What I'm saying is that it wasn't a popular thing to discuss. Nobody wants to hear about dead rats in the pipes in schools.

Anyway, the scientists of the department found out that even if there were, the amount that could reach any one student at any one time was so minuscule.... As a matter of fact, to bring up the point again of whether I would drink Fraser River water.... They say that it will poison you. It doesn't, because there's so much water going down the Fraser River.

Another thing I want to tell you is that it was only a few years ago in New York City.... The newspapers were full of it at the time. They referred to it as the deadly snowfall. It happens in any great city, but New York is the one that comes to mind. It was in those days that they were using lead paint. The lead would flake off the buildings. The children playing in the concrete jungles of that city would receive lead poisoning. This was saved by the fact that lead is no longer used on buildings. It is not a question of whether the thing is deadly, but how much you get of it. In small towns we still painted with lead. It didn't matter. It was how much.

For example, today we are in our gardening time. We are using all kinds of poison. Malathion is a deadly one. If you get Malathion on your hands and you don't wash your hands, you'll get really sick. If you get enough of it you could be very sick. Malathion is in common use. Any gardener will tell you it is used every day but that it's very dangerous. If you get the bait used on slugs on your hands and put it in your mouth, it could make you a little sick; if you got enough you'd be like a slug — you'd soon be gone. All these dangers are around us all the time. The question is how much.

Before we get too excited about the urea formaldehyde thing it should be tested to find out the facts. That's something we don't know. The minister is coming to that. I've got to compliment the minister on the massive way he's handling the questions and how well informed this House is today by his answers. I congratulate the opposition on digging around too. They do a little bit, and they're doing very well.

[Mr. Davidson in the chair.]

What I want to bring out today is the shock and dismay I feel at the enormous and unbelievable cost to the Ministry of Health caused by the consumption of liquor on our highways. I want to mention one particular thing. Mr. Chairman, I'm not getting off the subject; it is costs of the Ministry of Health I'm talking about. In our constituency, six young people were killed in six days on the highways. I have a picture here in this newspaper, but I won't display it, because we're not allowed to any more. The minister has a copy and the member for New Westminster (Mr. Cocke) has one. It is a picture of the hand of a person, a dismembered body. This is a terrible thing. This is liquor. The deaths were caused by liquor consumption. These people are dead. They're not that much cost now, but the social cost to our society, the enormous cost.... As a result of these accidents some may never leave hospital. The enormous cost of drinking and driving in our society is absolutely unknown to us. I would venture to say that if we went into it in full detail we would be able to say.... I have no idea of the figures, but I would venture to say that $1.5 billion is the cost every year to the province of British Columbia.

I asked Inspector Wilson of our RCMP in Maple Ridge what he thought of it. He said: "Well, you can quote me. We can never stop drinking, but our penalties are not severe enough." The Minister of Health must take action. The Ministry of Health must realize the enormous amount it's costing them to maintain this drinking and driving on our highways. It's not only the Ministry of Transportation and Highways; it's the Ministry of Health; it's their responsibility. We need more from the Ministry of Health. The advertising campaigns we've had have been good, but they've accomplished very little.

I think there are several things we can do. One positive thing is that our writers in this legislature and in the media should get out on a campaign and show what is happening to our young people and our older people, happening all around, and the cost to our hospitals — it's unbelievable and disastrous.

Inspector Wilson said that we cannot stop drinking. But he said we could make the penalties much more severe. There's no use going before a judge, and he says: "Three months for your driver's licence." He said: "Take it away for life." Mind you, that's not for him to say. But this is the feeling that's out there in the field. I merely tell you that. I also think that we should raise the drinking age to 21. This would probably not stop, but it would reduce some of the improper use of alcohol by the young. They'll still get it, but not as much. If we get back to the age of 21, it would be helpful and would reduce the enormous cost to the Ministry of Health. Some of these children that I'm talking about in these wrecks in six days.... Some of them may never leave hospital. It will cost hundreds of thousands of dollars. To the families and to all concerned the tremendous and horrendous cost of liquor in our society cannot be overemphasized.

I call on the Minister of Health to take serious consideration.... He's worrying about hospital costs. Within a few years the hospital costs will consume the entire budget of British Columbia if we go on escalating at the present rate. Obviously something must be done. One place we can do it and save billions is the drinking habits of our people. It's the responsibility of all society — mothers, fathers, schools, and the media in particular could do a tremendous job and save the lives of our people in British Columbia.

HON. MR. NIELSEN: In speaking of that topic, the member for Dewdney perhaps illustrates the great difficulty that all of society has; it is a topic that is talked about a great deal, and really very little is done. I agree with the member for Dewdney that the penalties which have been popular seem to have very little, if any, impact on the overall carnage on the highways associated with drinking drivers. I think most areas in Canada continue to disregard the seriousness of that problem, and they are not yet prepared to come to grips so that the penalty is such that drinking and driving would simply not be considered by individuals. The activities of people on the roads, whether they drink or not, contribute greatly to that incredible cost to our society. The Ministry of Health has a certain amount of input into it and tries to bring to the attention of others the tremendous cost — not only in dollars but in injury — to so many people. In some facilities in the province, we have people who are suffering from paralysis. A very large percentage of those people are in hospital because of traffic accidents, and many of those accidents can

[ Page 6208 ]

be linked to the abuse of alcohol. I want to say that I agree with the member for Dewdney in his consideration of how serious a problem it is, but I think it is society's decision by way of governments across Canada and elsewhere, to look at it as a very serious and totally unacceptable situation. I believe the penalties must be appropriate to the offence, rather than the nonsense we've lived with for so many decades.

MR. HANSON: Mr. Chairman, at this point in the minister's estimates, I would like to move on to a problem that affects the most severely disabled people in our society. Recently I met with parent groups from the Pearkes clinic and other people concerned about the lack of financial support given to the severely disabled and their families, and the various kinds of treatment, therapy, appliances and so on that they so desperately need. Before I begin, I would first like to read to you the 1975 United Nations disabled persons declaration which states:

"Disabled persons have the inherent right to respect for their human dignity. Disabled persons, whatever the origin, nature and seriousness of their handicaps and disabilities, have the same fundamental rights as their fellow citizens of the same age, which implies first and foremost the right to enjoy a decent life as normal and full as possible."

As you recall, Mr. Chairman, in the throne speech that we heard some months ago, there was an undertaking on the part of the provincial government. I would like to reiterate those comments:

"Next year has been proclaimed International Year of the Handicapped by the United Nations. During 1981 my government, under the direction of my Minister of Education will initiate regulations pursuant to certain sections of the Human Rights Code of British Columbia to specify a handicap as a characteristic in which discrimination in services, facilities, accommodation and employment are unequivocally prohibited. Major positive initiatives to improve opportunities and access for the handicapped will be undertaken by government ministries with social mandates, notably Health, Labour, Human Resources, Housing, Education and Municipal Affairs."

In other words, Mr. Chairman, the undertaking was made in the throne speech to take positive action in certain ministries. Hence I am raising these issues here today.

I have a number of letters from physicians working with severely handicapped people that identify what specific shortcomings are presently there in terms of inadequate support. I have a letter I would like to read portions of into the record from a doctor who's an orthopedic surgeon. His name is Dr. Wahl, and he works here in Victoria. He outlines to the minister's predecessor some two years ago, using one case as an illustration, the incredible financial impact a severely disabled person has on that family. He states: "I have been an orthopedic surgeon attending a particular child for two years. The girl is severely afflicted with a myelomeningocele problem, with extensive paraparesis. She's had multiple surgeries in the past, which has resulted in bilateral amputations as well as extensive hip injuries, done in Vancouver." He goes on to point out to the minister that he was astounded by the lack of financial support for this girl who had to make repeated trips to Vancouver for treatment and therapy. I think most British Columbians would be shocked to know that the annual limit for therapy and treatment for a severely disabled person in British Columbia is $75. He goes on to point out that the cost of various braces, prosthetic devices, orthotic devices and so on that are required is extremely high. They have a great problem in getting custom-fitting of these devices. There is very little in the way of professional capability for designing and constructing them. It is often done by volunteers. It a well-accepted fact that there are very few professional people available. It's often entirely on the basis of volunteer help and volunteer financial support through things like the "Telethon," Easter seals and so on, which are welcome. But the base support should really come out of general revenue; it should be there to support the families in a much more positive and aggressive way than at present.

This orthopedic surgeon goes on to explain that as people get older they have to be refitted with these devices every year or year and a half. According to the regulations, the MSP will only pay 80 percent of the cost of that particular device, with a certain limit of, I believe, $1,000. I have it here, and I will get to that in a moment. The point is that these things are very expensive; it involves the family paying the money on the barrelhead to the supplier. It may mean $500, $600 or $700 just to cover the 20 percent which the family has to pay. Then, of course, in a year's time they are faced with it again. So that is completely inadequate.

If in this International Year of the Disabled we're going to do something positive, we have to look at increasing the financial assistance for therapy, for the required physical appliances and their fitting, and for accessibility to these fittings, to custom-building, to treatment and so on. We hear great lip-service paid to the idea of mainstreaming people into the school system and into society but very little about the actual moneys necessary to provide the support mechanisms to ensure that those persons have the opportunities they deserve.

Saskatchewan has had the SAIL plan in place since 1975. I'd just like to read the preamble of this plan, because I think it identifies the problems faced by the parents of the severely disabled people. SAIL is Saskatchewan Aids to Independent Living. "The basic program: SAIL is a plan to assist handicapped persons in Saskatchewan to improve their quality of life in the community through the provision of: (a) prosthetic and orthotic appliances without cost to the patient" — not 80 percent, not 40 percent, but no cost to the patient at all.

Dr. Wahl, whose letter I quoted from a moment ago, pointed out that the problem faced by his particular patient was the tip of an iceberg, but it is a very small iceberg. Using Dr. Wahl's comment, I would like to make that point to the minister. The difficulties faced by these people are the tip of the iceberg, but it is a very small iceberg, and a relatively small amount of money would make life a great deal easier for people struggling against extremely high costs for therapy, appliances and their continued needs in society.

The SAIL program, in addition to prosthetic and orthotic appliances without cost to the patient, provides equipment on a free loan basis, including basic mobility aids, environmental aids and respiratory equipment, and repair service. I think the objectives of the SAIL program warrant reading into the record. I think British Columbia would be well advised to look seriously at the SAIL plan and the possibility of instituting it here in British Columbia. The objectives are:

" (a) to remove the financial burden faced by disabled persons in obtaining necessary medical appliances and equipment; (b) to reduce institutional

[ Page 6209 ]

health service costs by assisting handicapped persons to live in their home environment in the community in lieu of receiving institutional care; (c) to consolidate under one program the provisions of equipment to the handicapped undertaken by various government agencies; (d) to coordinate the provision of equipment; and (e) to encourage and promote research into better equipment."

I think it's very difficult for most of us to appreciate what difficulties are encountered by severely disabled persons, I'd just like to reiterate that these are people with full mental faculties who want to live and operate as well as possible in the mainstream of society; but at the same time you can't look to their families to provide all the financial support, in-home care and so on that is required. The families that I have recently met are very dedicated people. They have devoted much of their time to making sure that their children have every possible opportunity. In many instances, I believe, it is done at great personal financial sacrifice to themselves. I think that it's time, in this International Year of Disabled Persons, to give formal recognition to this problem and have the minister respond to a number of specific points. I'd like to outline these now.

First, rather than a $75-dollar-per-patient-per-calendar-year limit on therapy and physiotherapy services, there should be 100 percent coverage available for all therapy sessions, provided that all the medical justification is provided and that it is required. Equal consideration should be given also to charges for occupational and speech therapies for which there is no fee basis.

Second, 100 percent coverage should be available for prosthetic and orthotic fittings, equipment and equipment repairs. As I indicated, it is presently 80 percent paid, but the families must put forward the money and then be rebated that amount from the Medical Services Plan, which is often a financial hardship too. Included in that provision are the necessary fittings and custom-fitting that is required as well. I think more specialists who deal with the specialty fittings should be brought into British Columbia. We can't rely totally on the generosity of volunteer help and volunteer agencies. We really should have some on-line, working-level specialists paid for by the provincial treasury.

Third, 100 percent coverage should be provided for physical-speech and occupational therapy equipment, and repairs as well.

Fourth, services for children diagnosed as having perceptual and motor integration problems should be reviewed and improved, particularly where they are integrated into the public school system. I think if we're going to continue on the orientation, as we all agree to in this House, of mainstreaming disabled people into the school system and into the broader society, we must provide technical and professional support in the school system to ensure that severely disabled people have access to what they require.

I'd like to take my place now and have the minister respond to the points I have made.

HON. MR. NIELSEN: Mr. Chairman, I can't respond in precise detail to the percentages and the specific services which the member identified, but I certainly can respond in a philosophical way, to look at the entire problem. Those within our society who are severely disabled — I think I understand the definition as the member speaks of it — should be given every consideration with respect to any financial hardships they or their families may suffer because of that disability. I think those financial hardships should be minimized, if not totally eliminated. There are relatively few people who are in that category, and I think the member pointed that out. We're not speaking of a large number of people, but about people who have a severe disability, and the difficulties of responding to that are immense. I would agree with the member that one of the difficulties which they must respond to is financial hardship. It should be eliminated as a problem.

There are many programs throughout the province which offer treatment for people who are in this position. There are many organizations who assist as well with respect to transporting people and with housing. There is also the great difficulty of producing various devices, which are generally custom-made for the individual and frequently require a tremendous amount of innovation. We do have a scarcity of technicians in the province which is frightening. The capability of producing some of these devices is really a very fine art and a high degree of skilled craftsmanship is required. I have been attempting over a number of years to interest people in promoting the training of such craftsmen. I know of Pentland's in Vancouver and their workload. They have a very real problem training people in that industry. I understand the gentleman who owns the company is considering retiring, if he hasn't already. He was very concerned about who would follow in his footsteps. He had been taking steps to train a number of people. It’s a very specific skill, and one which we should be promoting. I don't know what the practicalities are of offering these courses in trades schools. I gather they're pretty difficult. But I agree that it's an area we should be emphasizing very much. Mr. Member, I'm going to have to speak with our Medical Services Commission people with respect to what programs may be available.

I'm not concerned that modifying or eliminating percentages, or limiting the number of visits, hours or whatever, would be a severe hardship on the people of the province. It would not be, because we are again dealing with a relatively small number of individuals.

There are many other people who are less severely handicapped in our society who do find financial implications to be a significant factor in assisting in the relief of their hardship. Perhaps that should be looked at as well. I have to be careful that I'm not responding to some of these situations strictly from a personal point of view or from personal experience. For example, there are children who have visual problems, and just the simple supply of eyeglasses can be a considerable hardship on a family, particularly if the children are young and lose their eyeglasses on a regular basis. When they are replaced by eyeglasses which cost several hundreds of dollars a pair, it can become quite a hardship on a family, even though the federal government recognizes a certain income tax exemption for someone who is designated to be legally blind. There are many other problems associated with those who are less severely handicapped, including youngsters who require corrective devices for various problems which are corrective. There is a financial burden on many of those families, and I have no difficulty in responding in a very positive way, from my point of view, into investigating how much of that could be alleviated.

In our province we have a history of people taking a great deal of time and effort in trying to better the lives of people who are suffering from severe handicaps, and it has contributed greatly to the treatment which is available throughout the province.

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I can't really respond in specifics at the moment, and I would be pleased to do that later. I find that I have virtually no area of disagreement with what you have suggested. It's a matter of producing those results, investigating in some detail the specific programs and speaking to experts in the field about what could be modified or improved to give these people a better opportunity of rehabilitation, or at least remove some of their legitimate hardships.

The House resumed; Mr. Speaker in the chair.

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

Hon. Mr. Gardom moved adjournment of the House.

Motion approved.

The House adjourned at 11:58 p.m.