[ Page 4113 ]

CONTENTS

Routine Proceedings

Presenting Petitions

Mr. Blencoe –– 4113

Tabling Documents –– 4113

Oral Questions

Funding of community groups. Mr. D'Arcy–– 4113

Sale of Pacific Coach Lines. Ms. Sanford –– 4113

Accommodation in Terraceview Lodge. Mr. Howard –– 4114

Public schools financing. Mr. Rose –– 4114

Committee of Supply: Ministry of Industry and Small Business Development estimates.

(Hon. Mr. Phillips)

On vote 41: minister's office –– 4115

Mr. Lauk

Industrial Development Amendment Act, 1984 (Bill M201). Second reading.

Mr. Howard –– 4118

Hon. Mr. Phillips –– 4120

Motor Vehicle Amendment Act, 1984 (Bill M202). Second reading.

Mr. Ree –– 4120

Mr. Lockstead –– 4120

Hon. Mr. Nielsen –– 4121

Mr. Ree –– 4121

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

On vote 34: minister's office –– 4121

Hon. Mr. Nielsen

Mr. Cocke

Mr. Segarty

Ms. Brown

Mr. Mitchell

THURSDAY, MARCH 29, 1984

The House met at 2:05 p.m.

MR. KEMPF: In your gallery is Mr. Gordon McFee, chairman of the Regional District of Bulkley-Nechako, and I would like the House to make him very welcome.

HON. MR. BRUMMET: I would like the House to welcome some guests of mine. Two of my sisters are visiting Victoria today, Mrs. Helen Getz from Kelowna and Mrs. Frances Walz from Medicine Hat, who decided while in Victoria to check up on their little brother to see if he was behaving himself. With them is Mrs. Walz's daughter, Mrs. Alvina Morton from Nanaimo, and her daughter Ladean. With them also is a friend, Frances Stewart from Nanaimo. I'd like the House to make them very welcome.

MR. MACDONALD: I wish to welcome students from Templeton Secondary School in Vancouver East with their teachers, Mr. Tysoe and Miss Ferguson.

Presenting Petitions

MR. BLENCOE: I would like to present a petition today, a 6,600-page petition signed by 6,600 fine residents of Victoria. It was conducted under the auspices of the Alliance to Defend Education. The general gist of the petition asks the Premier, directly, to consider no further cuts in secondary education and requests reinstatement of the student grant program. It was done last Friday, when in three hours they collected 6,600 signatures.

The petition reads as follows:

"Dear Premier Bennett:

"I would like to express my opposition to the continued cuts in higher education. In particular the University of Victoria provides a much-needed opportunity for education for British Columbians as well as cultural, social and economic benefits to the Victoria community.

"I would also like to oppose the removal of all student grants. These grants are carefully managed to be disbursed to only the most needy students. The removal of student grants will therefore exclude students who are capable of higher education but too poor to afford it."

I have signed one of the portions of the petition, and I have the rest behind me.

Hon. Mr. Phillips tabled the British Columbia Cellulose Company annual report for 1983.

Oral Questions

MR. D'ARCY: Mr. Speaker, my first question is a general one. Can the House Leader tell me who is the acting Minister of Finance?

HON. MR. SCHROEDER: Mr. Speaker, although the question is out of order, I can answer the member; it is public knowledge. The acting Minister of Finance is the Hon. D. M. Phillips, whose name I can't say in this building, so I'll have to say the Minister of Industry and Small Business Development.

FUNDING OF COMMUNITY GROUPS

MR. D'ARCY: Mr. Speaker, I'd like to thank the government House Leader for taking time to dig in his desk for public knowledge and for relating that to the House.

To the Minister of Industry and Small Business Development in his capacity as acting Minister of Finance: throughout British Columbia hundreds if not thousands of community organizations seek local funds for demonstrably worthy causes on a regional or a provincial basis, and the government from time to time assists various organizations. We support that policy. My question to the acting minister is: what criteria do the minister and government use in determining which charitable causes and organizations are worthy of receiving public funds from government?

HON. MR. PHILLIPS: Mr. Speaker, I want to thank the member for asking that question. On behalf of the Minister of Finance (Hon. Mr. Curtis), I'll take it on notice.

MR. D'ARCY: Mr. Speaker, when he is relaying the question on notice and discussing it with the official Minister of Finance, could he also determine what criteria the minister uses to determine the amount of treasury largess that will be disbursed to those causes deemed worthy of public assistance?

HON. MR. PHILLIPS: Yes, I'll be happy to. Do you mean whether precedent or ongoing...? What criteria do you wish to have? There are several.

MR. D'ARCY: Mr. Speaker, quite clearly there are two questions to be answered here: first of all, how an organization or a cause is selected, having been deemed worthy, and secondly, how much they are to receive — whether it's $5 or $50,000 or anything in between. So we need the criteria on both counts.

HON. MR. PHILLIPS: Mr. Speaker, I thank the member for that question. We'll certainly see that the answer is forthcoming from the real Minister of Finance.

SALE OF PACIFIC COACH LINES

MS. SANFORD: Mr. Speaker, I have a sheet of paper that tells me who is the alternate minister for the various ministries, but it doesn't tell me who is the alternate in charge of bus transportation. Since the Minister of Human Resources (Hon. Mrs. McCarthy) is not here, I shall direct my question to the Minister of Transportation and Highways (Hon. A. Fraser). I assume he will be able to redirect it if in fact it shouldn't be directed to him.

With only two days remaining before Pacific Coach Lines transfers its services to the private sector, bus travelers still have no idea what type of service will be available to them on Vancouver Island after April 1. The depot in Alberni is relocating because of the high rent charged by BCBC, and the station in Courtenay may be forced to move as well. This government is responsible for the operation of PCL for another two days, and I'm wondering what immediate steps the Minister of Transportation and Highways is prepared to adopt in order to clarify the situation and prevent chaos in the bus system on April 1.

[ Page 4114 ]

HON. A. FRASER: Mr. Speaker, if that member had been in the Legislature.... I made a complete report about that subject yesterday or the day before.

MS. SANFORD: I was here and I heard the minister's report, but it doesn't answer the question that I'm posing to him now. The question relates to the avoiding of confusion and chaos. People out there have no answers to the questions they have been asking about the service on Vancouver Island. Would the minister please take steps to clarify that situation?

HON. A. FRASER: Mr. Speaker, I'm not so sure that.... If you have any specifics I'd appreciate having them, but the companies that are taking over are responsible for looking after these things. I don't anticipate any chaos at all like you're referring to.

MS. SANFORD: They don't know anything about schedules. The only thing they know is that there's been a 9 percent increase in the rates that the operation on Vancouver Island will be able to charge. But in terms of the location of some of these depots, what kind of service will be provided? They have no answers at this stage, and I think the minister should clarify that, particularly in view of the fact that the people who are operating the depots right now are put in a very difficult position trying to answer questions from the public about a service that this government is still responsible for, at least for another two days.

Mr. Speaker, I would like to know whether or not the government has been paid in full for the sale of the buses that were formerly under the jurisdiction of Pacific Coach Lines.

[2:15]

HON. A. FRASER: Mr. Speaker, the reason I answered the original question regarding the replacement service is that I have responsibility for the buses. But I'll take the member's question as to whether the government has been paid or not as notice, as that is not in my jurisdiction.

MS. SANFORD: Mr. Speaker, since the sale of PCL was announced by the government, but before the transfer of the company had actually taken place, the buses have been repainted. Who paid for the repainting and refitting of the buses?

HON. A. FRASER: I'll take that question in the same light as the last one, if you are referring to who paid for what with Pacific Coach Lines, because some of those buses have been sold. I don't know who paid for the repairs.

MS. SANFORD: Mr. Speaker, it is unfortunate when ministers aren't here for us to be able to pose these questions to them, because we are not able to get any answers with respect to issues which are of utmost importance to the people of Vancouver Island at this stage. There are only two days left.

Would the minister, when he speaks to the minister responsible for Pacific Coach Lines, undertake to find out from her whether or not she is now prepared to table the contracts between PCL and the three buyers?

HON. A. FRASER: Mr. Speaker, I will bring it to the minister's attention.

ACCOMMODATION IN TERRACEVIEW LODGE

MR. HOWARD: Mr. Speaker, I would like to ask the Minister of Health a question based on the fact that there are some 15 to 20 older citizens, either in Terrace itself or in Skeenaview Lodge, which is in Terrace, who cannot be accommodated in the intermediate-care facility which is presently being constructed by the Terraceview Lodge Society. There is great uncertainty and concern in the minds of those older people as to what is going to happen to them. I wonder if the minister will undertake to proceed very quickly to Terrace himself and meet with the Terraceview Lodge Society and others to work out a solution which will satisfy the concerns that those older people have.

HON. MR. NIELSEN: Mr. Speaker, the specifics have been brought to my attention by staff. I believe one meeting has been held in Terrace with staff some time ago and another is scheduled — I don't know the precise date. I don't know whether I'll be able to accompany staff on that meeting, but the matter is certainly not being ignored. I believe there have been arrangements made for a specific meeting with senior staff in that area to see if it can be resolved.

MR. HOWARD: Inasmuch as two of the senior staff to which the minister has just referred have been to Terrace before and have discussed this particular problem with the Terraceview Lodge Society, have admitted that they are unable to make a decision and don't have the authority to do it, will the minister undertake to go himself? He appears to be the only one with the authority to make that decision with respect to these 15 to 20 older citizens and the concerns that they have. I'm asking the minister if he will go as quickly as is possible and meet with the Terraceview Lodge Society in order that the fears of those older people may be allayed and some comfort given to them.

HON. MR. NIELSEN: Mr. Speaker, if after review the staff feels that it would be necessary for me to attend such a meeting, certainly I would give that consideration. I was hoping that the staff would be able to resolve the problem with representatives of that society. But should they advise me that it's impossible to do so, yes, I would consider taking the trip.

MR. HOWARD: A further supplemental. Will the minister advise if the members of his staff who are going to Terrace have the absolute authority to make a decision? They haven't had that authority up until now. They always come back and say: "We've got to go back to Victoria." It gets a little wearisome. It's becoming crucial. Will the minister give them the specific authority to make a decision on the spot?

HON. MR. NIELSEN: Probably not.

PUBLIC SCHOOLS FINANCING

MR. ROSE: Mr. Speaker, my question is directed to the Minister of Education. Last July the minister announced a three-year financing package for the public school system. It involved approximately a 2 percent reduction in school budgets, on average, per year. I would like to know whether the minister has decided to introduce an inflation factor in the formula to compensate for the losses of purchasing power.

[ Page 4115 ]

HON. MR. HEINRICH: Not at this time.

MR. ROSE: Mr. Speaker, a supplementary. I believe the minister is aware that a 2 percent cut, which adds up to 6 percent in three years.... Adding to that a 19 percent inflation factor at 6 percent per year means devastation to the school system. I would like to know whether the minister is aware that school districts could lose up to 25 percent of their budgets in real dollars over three years, and if he's aware of the devastation this financial loss will cause to local school boards.

HON. MR. HEINRICH: The arguments which are being advanced now by the member are the same as those advanced during my estimates. In response to the question, I wish to advise that we are examining each budget in each district, and I really can't say very much more than that. But it's interesting to note that with the permission to allow school districts to carry forward the surplus from 1983 to 1984 there is a considerable sum of money found within the districts which was not required in 1983 and will be used in 1984. It seems to me that districts are managing prudently and will take full advantage of those sums.

MR. ROSE: It sounds to me as if the minister is accusing the districts of being loaded with money. Is the minister not aware that they can't deficit-finance and therefore they can't come right up to the final dollar of their budgets? Naturally there are going to be some surpluses in some districts, but they're far from rolling in dough or else they wouldn't be required to cut staff the way they have.

HON. MR. HEINRICH: I can refer to the school district in the member's own riding, which carried forward a surplus of $1.1 million. To be very candid, I think that that school district managed very well, and they're to be congratulated, not condemned. I'm encouraging good management. What has happened this time around is that many people have been relying upon school board budgets being traditionally based on historical claims and historical requests for more funding. It seems to me we've just turned it around and asked them to justify the funding, and it's been an exercise which many of them have had some difficulty with. I would say that that applies to everybody on both sides of the House, and for the most part they've done a very commendable job.

HON. MR. SMITH: Mr. Speaker, may I have leave to make an introduction and an announcement?

Leave granted.

HON. MR. SMITH: Mr. Speaker, it is with great pleasure today that I rise to acknowledge and pay tribute to the Deputy Clerk of this Legislative Assembly, Mr. George MacMinn, who has served 25 years in this capacity. He looks older than that, actually, but.... Twenty-five years in this place, which has to entitle someone, I think, to some kind of a merit medal in itself, but George MacMinn has done so with unfailing courtesy, patience, common sense and energy. In addition to his work in this House, he is an acknowledged Commonwealth expert on parliamentary practice and has written a book on parliamentary practice in British Columbia. I can remember his services when I chaired a committee on a matter of privilege involving a wiretap, a very arduous, interesting committee, and Mr. MacMinn gave us superb advice. He has also served as a commissioner appointed under the provisions of the Legislative Procedure Review Act, and he has been a member of the bar since 1954. I am not reading his obituary; I am announcing in the House today that I have this day advised the Lieutenant- Governor-in-Council to appoint Mr. MacMinn as a member of the Queen's Counsel and to confer on him the Honour of Queen's Counsel.

MR. LAUK: I would like to say that George MacMinn is one of the finest experts in parliamentary practice in the history of the Commonwealth — but I can't. Second to myself, Mr. Speaker, Mr. MacMinn is that kind of expert. I certainly appreciate that his elevation as Queen's Counsel — greatly overdue — has finally come about to recognize not only a fine servant of the House but an expert and highly regarded member of the bar of Victoria and, indeed, British Columbia. The NDP congratulates and supports the move of the government.

Orders of the Day

HON. MR. SCHROEDER: I call Committee of Supply.

MR. HOWARD: On a point of order, Mr. Speaker, the advice was given earlier by the government House Leader that this afternoon we would be proceeding to public bills in the hands of private members as the first item of business.

HON. MR. SCHROEDER: The advice we have is that it will happen shortly.

MR. HOWARD: It will come to pass.

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

ESTIMATES: MINISTRY OF INDUSTRY
AND SMALL BUSINESS DEVELOPMENT

(continued)

On vote 41: minister's office, $150,674.

HON. MR. PHILLIPS: Mr. Chairman, I regret that the hon. member representing that great constituency of Prince Rupert (Mr. Lea) is not in the House. I do hope that some of his colleagues will pass the message on to him about what I'm going to say, because before lunch he made an ill-informed speech about high-technology industries and assembly plants and a tax-free area. I was, to say the very least, very disappointed in his attitude. On reflection during the break, I was trying to determine where those thoughts emanating from the would-be leader of the NDP came from. I thought about it and I thought about it, and I remembered a conversation that I had some two years ago with a labour union leader, who said that all of these high-technology industries were sweat shops and ripoffs. I have to tell you that that is not the case.

[2:30]

The reason the labour union leaders take that position is due to the fact that there isn't much room in a high-technology, fast-moving industry for labour unions that are set in their ways. The high-technology industries move very

[ Page 4116 ]

swiftly. In other words, the electronics industry is moving so swiftly and with so many innovations that they may change overnight. You haven't got time to sit down and have a three week discussion as to how you're going to change your assembly line, or to ask permission from a council of labour union leaders in order to bring in a new machine or change the way it's being done. That is the reason. I hate to see those same leaders take the attitude that just because they're not going to be present, there are no jobs for other people. I have visited some high-technology industries and I want to tell you that the old idea of 1,000 persons sitting down and soldering little wires together day in and day out is gone. Those are the old high-technology industries. Today those operations are done by highly sophisticated machinery.

Interjection.

HON. MR. PHILLIPS: Yes, as a matter of fact, a lot of them are done by robots. A lot of the sensitivity and testing is done by computer. So the high-technology sweatshop industry that the member opposite was referring to is not there any longer. The electronics industry is moving so swiftly it has had to upstage.... Demand for the products is growing by leaps and bounds every day. I do hope that the members opposite will relay that information to the member for Prince Rupert (Mr. Lea).

I had the opportunity some four weeks ago to visit a plant on the Malaysian island of Pinang. National Semiconductor employ about 15,000 people in this plant, all in highly sophisticated jobs. That is expanding. Some of the machinery used there is made there. Some of the surrounding industries in Pinang are privately owned. You wouldn't call them high technology industries but they're fabricating industries — fabricating bits and pieces for the plants. They also assemble computers which they use in their own industry. It may be difficult for a layman like me to properly describe how the highly sophisticated electronics industry operates and give you the full vision of what I was able to perceive in a three hour tour of this plant — with explanations, some of which I didn't really understand. But I do want to tell you that the industry is moving swiftly and it is highly sophisticated. Expensive machinery is being developed and used in the plant. There's very little inventory because it's moving via air to the markets of the world.

Japan is not looking for tax-free zones to move their so-called sweatshop industries to. Not at all. As a matter of fact, of some $9.653 billion of foreign investment in manufacturing in Singapore at the end of 1982, $3.282 billion was from the United States of America, $3.781 billion from the European community, only $1.584 billion from Japan, and $1.006 billion from other countries. If we were to establish these taxfree zones here in British Columbia we could bring some of that European technology into British Columbia, and in joint ventures with other Canadian companies it could be used as a stepping-stone into that great and growing China market. As all members of this House know, Canadian business and Canadian people are very well accepted in China. That market is growing at a tremendous rate. The easiest way to explain it to you is that it's like having a country with ten million people come into your marketplace every year. While those ten million are coming into the marketplace, another ten million are being born. So it's a large and growing market.

We have the opportunity right here in Canada, and right here in British Columbia, to link up with other technological companies throughout the world in joint ventures with Canadians. Assembled goods and services can then be exported to China. That's why it is so vitally important that we get on with the job. British Columbia is the place. British Columbia is logistically situated to serve this market. Over and above that, we have a climate here which is good for investment. So we're sitting on the verge of a tremendous opportunity. All we need, as I said this morning, is a little cooperation from Ottawa, a little common sense to emanate out of Ottawa — that is not too much to ask, I hope — and we can carry the rest of Canada into those dynamic decades ahead, just oozing opportunity. That's all we want.

One would think there were going to be nothing but high technology industries established. Let me give you a small outline of some of the opportunities in other industries. For instance, aerospace industry opportunities are here.

Interjection.

HON. MR. PHILLIPS: Yes, maybe Trident. We try once in a while. You started it; we had to finish it. Sorry. I tried to keep your project together, and I was unsuccessful.

Interjection.

HON. MR. PHILLIPS: No, I didn't shut it down, my friend; it was doomed from the day.... If you'd had any brains, you wouldn't have got into it in the first place. But we tried to keep it going. I'm not condemning the ex-minister of industry for that, my friends — not at all. I never would have brought it up.

What about medical equipment? Has that anything to do with sweatshops and assembly lines? No.

Interjection.

HON. MR. PHILLIPS: My friend, you will have your opportunity in just a moment, but I can answer that question. Electronic products, industrial electronics, electronic components, chemicals and petrochemicals, pharmaceuticals, industrial machinery, automotive equipment and industrial robots, oil rig construction.... Believe it or not, the financial community could come here and become established without the controls that Ottawa imposes on them. We could have a truly world financial centre in Vancouver, with just a little cooperation from Ottawa.

Interjections.

HON. MR. PHILLIPS: Oh, they laugh. But there is a world of opportunity waiting at our doorstep — automotive components, communications equipment.... All we need is some common sense and a little assistance from the Ottawa government.

He mentioned that there was no safety in the workplace in some of these sweatshop assembly lines established in taxfree zones. The man is entirely.... I don't know where he's been looking — if he's ever looked at all. I don't know whom he's been listening to. I have been through high technology industries. They want to do good by the country in the area they establish. Those high-technology industries want the people who work there to be satisfied. It's not a ripoff, as the NDP would have you believe. Everybody's happy. Everybody's fine. People are well paid.

[ Page 4117 ]

I want to tell you something else: wages are not the main criterion today. At one time in the history of mankind it might have been, but not today. Do you know what the main criterion is, Mr. Chairman? Trainability and attitude. That's what is important. It's not wages any longer but trainability. He talks about education. Where does the greatest training come from in the electronic industry? On the job. Listening to the member for Prince Rupert (Mr. Lea), you would think we didn't have any education facilities here in this province at all. BCIT is turning out technicians in the high-technology industries every day. Where are they going? They're working with our high-technology industries. Hundreds of them have established in British Columbia in the last eight years under this government, with this little ministry's help through ASEP and other programs. It's happening out there. He talks about education. Why, we just passed a bill in this little Legislature: $16 million for an engineering centre out at the University of Victoria. And he says we're not doing anything for education. He has been on the campaign trail too long; he doesn't know what's going on. What have we got out at the University of British Columbia? Some of the greatest scientists in the atomic energy factory out there that you'll find anywhere in the world. What have we done with interferon? What did this little government do?

Interjection.

HON. MR. PHILLIPS: "Nothing." That's your attitude, isn't it? You don't know that's going on, do you? You just watch the papers in the months ahead, and you will find out that this little government has created a breakthrough in the medical history of mankind. It was put together through BCDC and Discovery Parks and through this little minister of science and technology. Stand by and be educated, my friend; don't sit over there and be dumb. Stand by and you will learn.

What about that research and development centre up there on Burnaby Mountain next to the University of Simon Fraser? I can remember when B.C. Tel bought out that industry. The little member from Vancouver Centre said it was a sham that they'd pull it up and move it out of the province. There we have today, tomorrow, sometime this week or next week B.C. Tel signing a contract in Japan to sell them electronic components because Microtel up there in that little mountain put together by this little government.... They tell us we haven't done anything for education. I'll tell you something, my friends, you have to have the industries go hand-in-hand with the education.

What we want is to establish the industries here, and that's why we want these trade-free zones.

MR. LAUK: Trade-free zones?

MR. PHILLIPS: Well, tax-free zones. Well, yes, they should be trade-free, because you know what happened.... Do you understand how they work? They're free for trade. You know what I mean. I just get so enthusiastic about this, because I can see the opportunities, that I may mix my metaphors once in a while. I do sometimes get frustrated because politics gets involved with common sense, and I love to talk common sense, not politics.

I do hope you will take those little words of wisdom back to the member for Prince Rupert, and I'm very disappointed he isn't here.

I think that I have covered all of the points that the member for Prince Rupert brought up this morning, and now I'll sit down in anticipation of more great, intelligent debate on the great economy of this great province of British Columbia.

[2:45]

MR. LAUK: All over the world there are Third World countries who are trying to attract industries into tax-free zones in areas where there's a vast reservoir of inexpensive labour; where the economies are struggling; where they do not yet have the resources, capital and the education to develop the research and development to create the indigenous type of industrial activity that Canada clearly can, is and should be doing more of. It is an abject confession on the part of the government of British Columbia to admit through this minister that their spearhead — their flagship — of economic development is to attract tax-free zones for so-called high tech.

Let's deal with high tech first of all. Everybody is describing everything as high tech, from ballpoint pens to the pulley and the wheel. What does high tech mean? It's a buzzword. It's a piece of theatre. And that's what this minister is giving us here this afternoon. The committee has heard nothing but the Music Man — a trombone for all the brothers in the families of River City. He's talking about pie in the sky. High tech is really ten feet off the ground. That's what he's talking about. He doesn't even know what's going to go there. The closest we came to a description of what he has in mind for a tax-free zone is a whatchamacallit. We're going to have 15,000 British Columbians building whatchamacallits out here at Roberts Bank or wherever.

He's talking about medical equipment but he won't give us any examples of medical equipment. What's he talking about? Gauze? He's talking about aerospace. What's that? Rubber bands? He's giving us no example, no name of a company, no prospects; just pie in the sky. In other words, his refuge is hot air, Mr. Chairman. The refuge of this government is to talk pie in the sky. This government, through its economic and taxation policies, has brought the economy of British Columbia to its knees. There is more unemployment in British Columbia than in Alabama, Mississippi or Newfoundland. This government's policies have brought the economy of resource-rich British Columbia to its knees. Young people are unemployed and walking the streets. The soup kitchens have never been so crowded since the Depression. and this minister stands up with his fancy $200 silk tie and tells us he is going to build whatchamacallits in a tax-free zone. He has the nerve to talk about ASEP bringing all kinds of high-tech development to the province of British Columbia, but if you look at the budget, ASEP has zero funds this year. What's he talking about, Mr. Chairman? If he's so proud of the program, why has he cancelled it? That's the kind of thing we’re going to get from this government — Third World policies.

I would be interested in hearing the Minister of Industry and Small Business — and lack of development — tell us why, in the throne speech, another economic spearhead is tourism. Tourism: another Third World country spearhead for economic development. All our kids are going to be down there with straw hats and bare feet beside their 1965 Plymouths, waiting to take American tourists on tours for a few pesos here and there. That's the kind of Third World backward mentality this government has. They've taken one

[ Page 4118 ]

of the richest, most industrialized areas of the world and brought it to its knees.

The minister talks about universities. You're closing the universities. Our best brains are packed and ready to leave because the head-hunters from other universities are coming here and stealing the talent. We've spent 35 to 50 years building our universities' strength, our intellectual and scientific strength for research and development in British Columbia, and in one term this government has brought it to its knees. Some of our best scientists, would-be Nobel laureates, are packed and ready at the airport to move to universities and jurisdictions that are paying the price of research and development, and the short-sighted policies of this government are to blame. They can no longer throw up their hands, as they did last year, and say it's the world economy; the rest of the North American economy is slowly but surely recovering, as we are still going down, down, down. Unemployment is the only statistic in this province that is going up.

This minister should be shy indeed to stand in this committee and defend the administration of his department.

HON. MR. PHILLIPS: Mr. Chairman, now I know why that member is no longer the critic for the Ministry of Industry and Small Business Development. He was for a few years but he was demoted and given Education. You will notice that most of his speech was with regard to Education. I'd like to chastise that member for calling the U.S.A., which has established some tax-free zones, a Third World country. I would like to know why that member, representing one of the greatest cities on the west coast of North America, would have the audacity to call the United Kingdom, which is establishing trade-free zones, a Third World country. That member is so far out of date that he is still wearing narrow ties. I have to smile and chuckle, because a few years ago when that member was a critic for industrial development he stood on the floor of this Legislature and chastised me for not bringing in manufacturing plants. Now he calls them sweatshops. There is no hope for that group over there, because they haven't changed.

This morning I pleaded with the opposition members —  you were not in the House, Mr. Member — to come forward with some constructive suggestions as to how we can improve the economy of this province. What do we get? We get more of the same old harping criticism. They have been against every project that has provided jobs for thousands and thousands of people. Negative, harping criticism! That's why they're in opposition and why they will stay in opposition. When we were building the ALRT and providing high-technology jobs, and new technology that can be sold in the rest of the world, they were against it. When we started employing people in northeast coal, they were against it. When we wanted to build the Annacis Island bridge so we could service industry and all the manufacturing plants in the lower mainland, they were against it. They've been against everything this little government has done. All we get is the same old harping, carping criticism from the same old people opposite.

Vote 41 approved.

On vote 42: ministry operations, $43,881,339.

MR. HOWARD: I would like to ask the minister if he really did pay $200 for that tie.

Vote 42 approved.

The House resumed; Mr. Speaker in the chair.

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

HON. MR. SCHROEDER: I call public bills in the hands of private members — Bill M201, in the hands of the member for Skeena.

INDUSTRIAL DEVELOPMENT
AMENDMENT ACT, 1984

MR. HOWARD: Mr. Speaker, for the benefit of the Minister of Industry and Small Business Development (Hon. Mr. Phillips), the bill now before the House is a job creation bill. It's a job creation bill in the private sector, a job creation bill in the processing and manufacturing of aluminium. It's specifically oriented to the northwestern part of the province, because in that part of the province there exists an aluminium smelter. It has been there for some 25 years now. That aluminium smelter, owned and operated by Alcan, came into existence as a result of a bill passed by this Legislature in 1949 or 1950 called the Industrial Development Act. The Industrial Development Act said that its purpose was to establish or expand an aluminium industry in the province of British Columbia.

The bill before us seeks to amend that Industrial Development Act to include therein — to make more certain — that the purposes of the act shall be meant to be interpreted not exclusively as smelting but as the process and manufacturing of aluminium products beyond the primary stage of smelting and in the northwest region of the province, where the smelter exists at the moment.

To assist in getting to the end of creating additional jobs in the aluminium industry — in the further processing stage of it — this bill seeks to see established a local or regional aluminium products development council, upon which representatives of various groups and interests from the area would be appointed by the Lieutenant-Governor-in-CounciI, leaving it as broad as possible to make that selection. The function of that council would be to examine the area, the ideas, the proposals that may come along or may exist and the literature, and to have access to information and statistics and studies within the ministry and the government or any Crown corporation that would lead them in the direction of advancing the cause of the further processing of aluminium products in that area of the province.

The principle behind the council is that people in an area to be affected by industrial development, manufacturing or processing should have some say in the initial stages of it as to what can take place that will and should affect them. The council, after looking at all of this, wouldn't have the authority to make any decisions itself, but could make recommendations to the provincial government on to what might be possible as to what steps may take place.

Surplus electricity is being produced now in that area, electricity that could be available without waiting for any additional dams to be built or the diversion of additional waters and generating capacity to come onstream. It could be made available for a processing plant or plants. It conceives of what I suppose the economists call the value-added concept; in other words, if you take a resource or primary stage

[ Page 4119 ]

of a product and add capital and work to it, you add to its value. You increase its wealth. You employ more people in the process of adding the value to that particular commodity.

[3:00]

I've used the example on other occasions, and I suppose I could use it here as well in an analogous sense: British Columbia is great for exporting raw materials to other countries in order that people in those other countries may be employed in the processing of those raw materials. We export raw logs employing sawmill workers in other countries by that process. Earlier when we were producing copper in large volumes, we exported the copper in concentrate form to other countries, permitting the employment of workers in other countries to smelt, refine and produce it into usable objects: copper pipe, wire, cable, sheets and others. The concept here is to move in another direction and employ people in this province in further processing of aluminium.

Two studies were done by the government on the northwest region of the province — one I believe in 1977 and an update of it in 1982, released by the Minister of Industry and Small Business Development while he was in Victoria, and the Minister of Labour while he was in Terrace. It was a joint release a couple of years ago. Both of those studies emphasized that minerals are the thing we should be looking at in the northwest region and made reference to aluminium being produced in the area already. I maintain that that's the one resource or the one commodity or one product that we can gainfully employ ourselves in pursuing insofar as the creation of additional jobs is concerned.

One of the arguments that is put forward from time to time is that you need to process your raw materials into manufactured or finished products close to the market, rather than far distant from the market. All of that philosophy or economic concept, when followed to its extreme, militates against or makes remote the possibility of having manufacturing facilities close to the resource if that resource is not close to markets. But we have found that it doesn't always follow that you need to do that.

The Toyota plant in Delta is a case in point. Toyota had discussions with the provincial government two or three years ago — something of that sort. As I understand it, they said to the provincial government: "We're not going to produce these wheels. There's something in the neighbourhood of $15 or $20 per wheel difference in cost if we are to do them in Canada vis-à-vis doing them in Japan. Can you work out something to cover that difference?" A variety of plans were looked at, and a variety of proposals were made about how the financing of that plant might be developed and put in place to narrow that gap of whatever that amount of money was. As I understand it, the federal-provincial agreement under what was the industrial development subsidiary agreement came into force and worked out a scheme whereby there is a contribution of something in the neighbourhood of $1 million to $2 million to assist Toyota in establishing the plant there. It's a subsidy. That was one scheme that was worked out so that the general public, including people who live in Terrace, Kitimat and all parts of this province, made a contribution through that agreement as far as the provincial funding was concerned. The federal and provincial governments and Toyota determined that it was possible to establish a manufacturing plant that was far distant from the market. I'm told — if the newspaper articles substantiating this are correct — that roughly 75 percent of the production of that wheel plant will be exported to Japan, which is some distance from the plant. Wheels of that type will be put on vehicles in Japan and then shipped back to North America. There was an arrangement made to build an operation.... I understand the plant is not big enough for the markets, and they're looking at the prospects of enlarging it.

I maintain that if we can process aluminium into another stage beyond its primary smelted ingot stage.... If we can do it in Delta, then we can do it in Terrace. If we can do it one part of the province when it's a far distance from markets, then we can do it in another part of the province. The electricity is there; the people are there; the primary aluminium is there. All I want to do under this bill is to involve the people in the area in a participatory way, examining the prospects, seeking out the advantages, working with government in discussing these things, seeing what the most likely location is for such a plant or plants and making recommendations about that to government. Not to do it itself but to be involved with the private industry in further processing of aluminium. That's the purpose and the interest of the bill. The minister said earlier during his estimates: "Give me some ideas of what you're trying to do." This is the third or fourth year in a row that I've introduced this bill. It met a sorry fate one year by being ruled out of order before it even got debated. That was a time when there were some tense feelings existing in the chamber. At least we're now proceeding along to be able to put the case and put the argument.

The bill does not seek to expend any money. I recognize what the rules are. The appointment of a council by the Lieutenant-Governor does not necessarily involve the expenditure of any money. People can be asked to participate in a voluntary way. We've got this province filled with people who do things voluntarily, who assist others, who volunteer their time and their activity in doing all manner of things. A lot of people in the chambers of commerce volunteer their time, thinking about ways in which they can advance the economy. A lot of people in the trade union movement volunteer their time, seeking ways in which they can advance the interests of the economy. A lot of people outside of those, groups and a lot of people in the professions volunteer their time. The bill conceives that that is a possibility and leaves it to government to make that kind of conclusion. But in order to get by the proscription in the standing orders about the expenditure of public money, it does not conceive that public money will be spent.

If the concept is agreeable and the government says, "Yes, we'll go in that direction; we believe in the idea that people in a community should be involved in participating in those things which might affect them," and wants to accept the bill and then wants to follow with the question of public funds, that's a decision that government would make, and under the rules they would introduce the appropriate legislation to deal with that. But I don't perceive that that is necessary in the particular bill. I just perceive that it's a job creation bill to provide long-term benefits, job stability and employment stability beyond that which now exists in the the northwestern region of the province and take advantage of (1) the surplus electricity that is now in existence and now being generated, (2) the fact that the aluminium is already there and being produced every day of the week and being shipped out of the area, and (3) the fact that we've got an extremely high level of unemployment in the area. A recognition on the part of the government is needed that aluminium is the one product in that area around which we can build additional jobs and additional productive capacity.

[ Page 4120 ]

HON. MR. PHILLIPS: Mr. Speaker, the bill which the member put forward and which he was speaking on is not a job-creating bill; it's a political bill. If it doesn't have an impost on the Crown in asking for some expenditure of funds to help support this council, then there is no law in British Columbia that would not allow that member to go out and to organize these people and to do the very same thing. This ministry would certainly meet with them and provide them with ideas. We don't need the bill. So it's a political bill. I would hope that the member would put the same effort into supporting that Alcan project in his area and get these same people organized to support that great development that's going to take place up there, when the opportunity arises.

The member alluded to a few things on which I would like to straighten out the House. Number one, he alluded to the fact that we export raw logs. He knows very well that the only logs that are exported from the province of British Columbia are a few that become surplus from time to time, and they have to go through a joint council and the exports have to be okayed by the International Woodworkers of America. They have to be okayed by the federal government and they have to be okayed by the industry. It's not a case of exporting logs. Heaven knows we've got enough pressure on us from a number of countries to export raw logs, but it is the policy of this government and will remain the policy of this government not to export raw logs, except those which become surplus. And he talks about exporting raw materials. I want to tell you that he keeps on building that myth that we continually export raw materials, when the very industry he is talking about is importing a raw material from another country and processing it here.

MR. HOWARD: That's right.

HON. MR. PHILLIPS: Sure, you talk out of both sides of your mouth at once. Here we're bringing in a raw material from another country and in his theory we're stealing jobs from that other country because we're bringing in that raw alumina and processing it here. I want to tell you, they haven't changed at all, Mr. Speaker. If he were as interested in what he's talking about, standing up here and making a political speech....

MR. HOWARD: Negative, negative.

HON. MR. PHILLIPS: I'm not negative at all. I'm trying to help the member out, but he just wants to use politics to improve his own image in his own riding because it's at a pretty low ebb. Therefore, Mr. Speaker, I would like to adjourn debate on this particular motion until sometime in the future — possibly the next sitting.

Motion approved on the following division:

[3:15]

YEAS — 26

NAYS — 12

HON. MR. NIELSEN: Mr. Speaker, I call second reading of Bill M202.

MOTOR VEHICLE AMENDMENT ACT, 1984

MR. REE: Mr. Speaker, it's my pleasure to stand here and move second reading of this bill. In the last session of this Legislature I had the honour to present a bill to amend the Estate Administration Act, which increased the sum that could be exempt from administration from $5,000 to $10,000. That amendment to the act was passed by this Legislature, as I said, last session. The purpose of the present bill is to make section 17 of the Motor Vehicle Act compatible with the amendment I had passed through this Legislature in the last session — that is, to increase from $5,000 to $10,000 the value of an estate that contains a motor vehicle, which would allow the transfer of the motor vehicle without probate. By adopting this bill we will relieve small estates — estates under $10,000 — of incurring certain legal fees which would be an inordinately high percentage of the value of the estate.

[Mr. Pelton in the chair.]

During the past year, since the amendment to the Estate Administration Act, I had a constituent who was the son of a deceased come to me. They had an estate which was under $10,000, and were able to take advantage of the amendment to that act last year. Unfortunately, within the estate there were two motor vehicles, and the total estate value, although under $10,000, did exceed the $5,000 as set out in section 17 of the Motor Vehicle Act. It is my pleasure to hope that by submitting this bill I may be able to assist a situation like that, and possibly relieve people of inordinately large legal bills for estates of small value. Accordingly I move second reading of Bill M202.

MR. LOCKSTEAD: Mr. Speaker, I would like to inform you and this House that the opposition will be supporting this private member's bill. It makes eminently good sense, for the reasons outlined by the member for North Vancouver–Capilano.

[ Page 4121 ]

HON. MR. NIELSEN: Mr. Speaker, the government also supports the bill.

MR. REE: I appreciate the support from the government and Her Majesty's Loyal Opposition. I might add, if I may, that the last time this section was amended.... The act came into force in 1960. At that time $500 was exempt. In 1963 it was increased to $1,000, in 1968 it was increased to $5,000, and it has been at that sum ever since. Again, I move second reading of the bill.

Motion approved.

Bill M202, Motor Vehicle Amendment Act, 1984, read a second time and referred to a Committee of the Whole House for consideration at the next sitting of the House after today.

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

ESTIMATES: MINISTRY OF HEALTH

On vote 34: minister's office, $199,325.

HON. MR. NIELSEN: Mr. Chairman, I have some comments prior to detailed discussion of the estimates for the Ministry of Health. It's become commonplace to have the Minister of Health preface his remarks each year by saying that the spending for health has once again reached a record level surpassing that of the previous year. The same observation can be made this year. Expenditures for the Ministry of Health are estimated to be $2.54 billion for the fiscal year 1984-85.

Members of the committee would know that the Ministry of Health is the only ministry which has received an increase in its allocation for 1984-85 — approximately 2 percent, which translates into an increase of approximately $51 million. The preparation of the budget for the Ministry of Health involves many people. It involves a considerable number of people within the ministry and of those in the field delivering health care. We recognize that a $51 million increase amounts to only 2 percent, but an increase in the largest ministry expenditure in the government represents a considerable commitment on behalf of the taxpayers; $51 million would represent the total budget for several ministries within the government.

If it were not for action taken by the government in recent times to allow additional revenue to flow to government, I believe we would probably be debating estimates at some amount less than the $2.54 billion. The Ministry of Health requested an amount of money. That amount was in excess of the capability of the public purse to sponsor it, and other action was necessary. We're familiar with that legislation. I'd like to express my appreciation to my colleagues, who themselves had to review their ministries. In almost all instances they were required to adjust their estimates and reduce their expenditures, while at the same time supporting the Ministry of Health and an increase of $51 million.

[3:30]

The ministry has undertaken a massive task over the past number of years to try to rationalize and develop efficiencies in health care delivery for the province of British Columbia. The growth in health care expenditures is immense. It's not simply a matter of recognizing the inflationary effects on all budgets, including that of Health. The increase in Health expenditure has grown at a rate considerably higher than the inflation rate and other indices which economists or others may choose to compare it to. We have grown in excess of all other increases for a number of reasons, not the least of which is the expansion of certain programs, additional facilities and introduction of new programs, as well as the public's desire for health care and the capability of health professionals to deliver it.

The greatest number in our budget is with respect to grants to our hospital system. Approximately $1.7 billion will be expended in our hospital system this next year. The second major expenditure is with respect to the medical services plan, which pays for the services offered by professionals, be they medical doctors or other practitioners. I think it's fair to say that in the past number of years we have received considerable cooperation and understanding from the community of hospitals in the province. Many have introduced management programs and other programs which have, in our belief, assisted in improving the efficiency of the expenditures. It's obvious that that concept and program has not been complete. There is still more to be done, and I believe the hospitals would not disagree. There can be improvements, ways of saving additional money or of better using the funds which are granted. It has been a very difficult period of time, attempting to coordinate the hospitals and assist the hospitals in reaching that plateau, but the vast majority of hospitals in the province have offered what I consider responsible leadership, and have produced a more efficient product. We're very proud — I'm sure all British Columbians are — of our health care system. We're very proud of our hospital programs. Despite individual difficulties and individual instances, I believe our hospital program offers the people of our province an excellent health care resource.

The medical services cost is somewhat more difficult. While we can, with some certainty, estimate the cost of operating a hospital for a year, it is very difficult to estimate with precision the costs associated with services for which a fee is paid. Over the past year we have had, I believe, excellent communication with the British Columbia Medical Association and other professional associations whose members have the capacity to bill the Medical Services Plan. We have not been able to reach an absolute accord with the British Columbia Medical Association, but we have made considerable progress. The talks are continuing, and I presume they will continue for some time. We have offered ideas and concepts, and the professionals have offered ideas and concepts. We have not reached a consensus or agreement, but that is not because of confrontation. It is simply because there are different points of view and each has been offered to the other for consideration. I think we can expect some success. We have had considerable cooperation from the professionals with respect to trying to contain costs, lower costs where possible or perhaps utilize the funds somewhat differently.

It's a matter of history that we in British Columbia do have what I consider to be an overabundance of medical practitioners, and I believe — I can't offer the words of the BCMA — the British Columbia Medical Association agrees that in total numbers in the province we do have an overabundance of medical practitioners. Quite correctly it should be pointed out that in certain areas of the province we have a shortage, either in raw numbers or in certain specialties. We concur in that as well.

[ Page 4122 ]

We in British Columbia do have the highest per capita ratio of medical practitioners, considerably higher than the national average, and much higher than some of our sister provinces. We are not necessarily concluding that there is an absolute ratio that should stand everywhere and that anything above or below that suggests a deficiency. We do believe, however, that in British Columbia and particularly in greater Victoria, greater Vancouver and the Okanagan there are a number of practitioners in excess of what is actually required. It's a very difficult problem because if you're dealing with total numbers within that total, there may indeed be a deficiency in a certain specialty, and we recognize that as well. The BCMA is cooperating with the ministry in attempting to assist us in resolving what we consider to be a costly problem. It's estimated that a medical practitioner in full-time practice costs approximately $500,000 a year to the public purse; not in personal fees, of course, but including the practitioner's fees plus that which is associated with the practice of medicine such as hospital space and other facilities. I don't think there is too much disagreement about the $500,000 figure. Therefore it follows that the higher the number of doctors you have in your area, the higher the cost is going to be.

We recognize the contribution the medical profession and other professions have made to our health care system, of course. We have had good communications with the organizations over the last couple of years. I am very pleased to advise the members of the assembly that whereas three or four years ago there was a strong confrontative attitude, today there is one of considerable and very genuine cooperation. That in itself does not mean that we will achieve what we are seeking to achieve through cooperation, but it does mean the opportunity is there. I acknowledge that and I thank those people on the other side, if you like — the BCMA side at least — for being as cooperative as they have been.

There is still a tremendous philosophical difference of opinion in this field. Government, the Ministry of Health, while it can indulge in philosophy, at some time must deal with reality, and we must make certain decisions, be they at the hospital level, medical service level or otherwise.

Within the ministry itself we have introduced a considerable amount of what I consider to be excellent management, and have over the past few years been able to reduce our costs — the costs of the ministry itself. There are still efficiencies which will be introduced, which can be introduced and which are being developed. The Ministry of Health deals with a tremendous number of people. It comes in contact with more individuals than any other aspect of the provincial government. Approximately 200,000 people a day could receive care in one form or another through the health care system. The decisions made by the ministry, the management of the ministry and the capability and expertise of those delivering our health care affect almost every individual in the province.

A final comment with respect to our health situation. I would just like to make a few brief comments with respect to the difficulties we believe are very real in the country vis-à-vis the Canada Health Act. It's my hope at this moment that next week I will have the opportunity of joining the other ministers of health in Canada to speak before the Senate committee on the Canada Health Act.

Politics aside, the provincial ministers of health in all provinces have repeatedly sought to have meetings and consultations with the federal Minister of Health to discuss the implications of the Canada Health Act. The telex industry in Canada has probably reaped mass profits by the number of telexes which have gone from the various ministers to the federal minister over the past few months. The theme is the same from province to province and the territories. We believe the act is an error. We believe that the impact the act will have on the Canada health system is far greater than the federal Minister of Health acknowledges. The language used in many of the telexes sent to the federal Minister of Health or other officials contained such words as "devastation," "unnecessary," "serious implications" and other expressions of very serious concern on the part of the ministers.

Unfortunately the federal minister has advised the chairman of the ministers of health that she sees no need for such meetings. She says: "I see little to be gained by a meeting." Unfortunately the meeting will not take place, but we have been advised by the federal Minister of Health that a meeting can be arranged on April 27 for officials to discuss the Canada Health Act. I think it is regrettable that the federal minister was not available, or could not make herself available, for these meetings prior to the introduction of the act, since the introduction of the act and even now at this very late stage of the process. We had no meaningful meetings at any time. There were meetings, yes. There were meetings, not to discuss the Canada Health Act in principle, or the philosophy; there were meetings simply to hear our analysis of the act, and from that some very minor modifications in language were made.

I do not wish to be critical of the federal Minister of Health as an individual, because I have no doubt that Monique Bégin is sincere in what she has been saying about the Canada Health Act and the reasons for it. I do not question her integrity at all. But I do believe that the federal minister and the officials within the federal ministry are either not aware or are ignoring the implications of this legislation.

The ministers of the provinces and territories intend to be in Ottawa next week to try to persuade whoever may be listening to take a certain course. The prognosis is not good. We are very concerned about the effects that act could have. We believe we have an excellent health care program in the province, and we see a possibility of erosion taking place because of the implications of the Canada Health Act.

Mr. Chairman, I will attempt to respond to members' specific questions and look forward to the debate.

[3:45]

MR. COCKE: Well, Mr. Chairman, I rise in this great spirit of cooperativeness. I note that the minister talks about how the medical profession and the hospitals are cooperative. We have a government which is so cooperative that they wait until our Health critic leaves town to go to her brother's wedding until they call the estimates of the Ministry of Health. We asked that it be delayed, but no — progress, progress, progress. In any event, we'll carry on, but it is not the spirit of cooperativeness that we understand. We've been betrayed three times in the last two weeks in terms of miscalling things that are to be coming up in the Legislature — bills and estimates in different order, and so on. So it is no great surprise. The Whips do not even know what the House Leaders are thinking, and vice versa. That has broken down, and I suspect that it will continue to stay broken as long as this government has the arrogant attitude that they can just do what they like any time they want. So there it is.

Mr. Chairman, on this estimate it is marvellous to hear from the minister that they only have a $51 million increase

[ Page 4123 ]

— only 2 percent, he says. He talks about the Health expenditures growing beyond the inflation rate. The minister has been running in the same direction that we have been running lo, these many years. There have not been provisions made to cut costs in the way they should have. We see around us such things going down the drain as community health centres, which can be cost-effective as can be with respect to reducing costs. We see areas such as prevention being affected far more than any other.

[Mr. Ree in the chair.]

Let me give you a couple of interesting little areas in terms of these estimates. What would you think of a government that cuts areas such as prevention in these particular subtitles? They've cut program management by 11 percent. Who can comment? They've increased medical health officers and staff by 3 percent; public health nurses, 1 percent; public health inspection is up 4 percent — remember how bereft we were of public health inspectors, but it's up 4 percent; health education is down; speech and hearing is down 7.4 percent; nutrition is down 3.6 percent; the dental program is down 31.8 percent; epidemiology is down 3.9 percent. This is one very small example of an area where I feel that moneys could be saved in the long run. I know you're not going to make large cuts in hospital care until you get to a point where you keep people out of hospitals.

How do we keep people out of hospitals? One good way is with home care, but that's another area that's been cut rather dramatically. And don't forget that they've been cutting home care ever since April 1981. The cut in homemaker services this year is 2 percent, but there were dramatic and drastic cuts in the first place. That's $1.1 million that we saved there, and waste elsewhere, when for $25 or $30 a day we could keep people in their homes. We send them to an acute-care hospital bed, to begin with, that will cost us anything from $250 to $300 a day. It doesn't seem to me to require a mathematical genius to know that we're on the wrong course.

Adult day care is cut, and cut out in many instances. Overall there's been a decrease in those adult day cares of 15 percent. Again, it's an area of keeping people out of institutions, because that's where the minister has to admit that we're spending our money dramatically.

Emergency health care. We'll get into more details as we go along. They've cut emergency health care — that's the ambulance service — by $1.8 million, a 4 percent cut. Program management is cut by 0.6 percent. The estimate in 1983-4 was $38.1 million. However, in the books for 1983-84 it was $41.2 million. The total for the 1984-85 estimate is $39.5 million. Incidentally, I didn't even see a special warrant to account for the difference. In any event, that's what happened. Air ambulance has a slight decrease of 4 percent. Support services have a very slight increase, and training has had a slight increase of 0.4 percent.

All in all, Mr. Chairman, it strikes me that we should be looking as quickly as possible in this day and age for ways to cut out those requirements for statutory service. If you go to a doctor, your bill gets paid — that's statutory. If you go to a hospital, the government's share of your bill gets paid — that's statutory. Those are the large payments the minister admits to. How do you keep them down? "Cut down on the numbers of doctors," he says. He doesn't say anything about how those doctor services should be rendered. Houston, for example, has gone on fee-for-service. Isn't that marvellous? In Houston what was at one time a community health centre with salaried physicians is all changed. That has now gone to a fee-for-service operation, and so did the doctors. Where the nurses used to be first contact — and I mean trained, skilled nurses — now it's the doctor who must be the first contact. That first contact is costly.

All in all I see us on the wrong path in terms of making the kinds of savings that the minister wants to make. It takes time, and it takes a lot of thought. When you're living from day to day or hour to hour and putting out fires, many of which are ignited from within, you don't have time to study the problems. You don't have time to study the consequences of the direction that one has chosen. I just feel that this is entirely wrong.

I wanted to bring another area to your attention. What do we find from our estimate of medical services? This year we see an increase of $8,272,000. That's only 1.6 percent over 1983-84, but that doesn't mean that that's what it's going to be, because when those bills come in, they must be paid. So that might be an estimate that's somewhat low. I believe that the minister. In his discussion with Monique Begin about the whole question of user fees, this fee, that fee and so on, and the fact that he doesn't like the Canada Health Act, might bear taking a look at the share that is now being put up by first the premium payers in our province — $336,889,900. Deducting that from the $849,631,000, we'd have a net expenditure here of $512 million. But no, you see, Monique pays her share of the $849 million over and above that. And it's not 50 percent now; it's somewhat lower, because the provincial Government didn't do a very good job of negotiating. Let's say it's 40 percent. I think it's closer to 45 percent, even at this late date, but let's say it's at 40 percent. Then you are looking at another $320 million to $340 million. So you add that to the $336 million and you've got almost $700 million. You deduct that from the $849 million. So our net expenditure here in this province from government sources — and I'm not talking about the premiums paid, because that's outside — isn't all that horrendous. The horrendous costs are in hospitals, and have been for some length of time. I consider that they will continue to be until such time as we get together as a planning group and say: "Okay, what can we do to cut these costs in a dramatic way?" We can only do it if we go after those costs by keeping people out, not paying the bills once they get in. Maybe there will have to be additional talks with doctors. It's not the patients who admit themselves to hospitals; it's the doctors who admit them.

I'm just looking through here and will have to find where I've got it down. When one has ten minutes to prepare for a minister~s estimates, it doesn't give one all the chance in the world to put everything together. However, alcohol and drug has been cut significantly. Why that? Why not an increase in alcohol and drug? Can the minister comment on one or two of these questions?

HON. MR. NIELSEN: Mr. Chairman, some of the comments made by the member for New Westminster.... I appreciate the difference between government expenditures and non-government expenditures, but it all comes out of the same pocket. Whether it's through premiums, user fees, taxes or anything else, it comes out of the taxpayer's pocket one way or the other. They pay for the whole system. It can be broken down and shown on actuarial tables and the rest of it

[ Page 4124 ]

how it may be correlated and collected, but it still comes out of the taxpayer's pocket.

The federal government collects money in British Columbia, and it returns some to the province. Good for them. That's what our whole concept of confederation in Canada is about. They're not doing us a favour. They're returning some of the money that they've taken from British Columbia to begin with; and it's nice to see them do so. The federal government tells us their figures are about 43 percent; we think they're slightly lower, but we can agree to almost 43 percent.

[4:00]

The alcohol and drug question. The decrease is due to implementation of the ministry's staffing plan and to a decrease in medical sessions because of reduced demand. The decrease at the detox centres, which make up part of that — 1.7 percent — is due again to the ministry's staffing plan. There has been a slight decrease in contributions to four funded agencies, for various reasons. I've heard the proposals put forward by the member and other people as well. We've listened to the nurses' proposition and proposal, and we've discussed it with them. And we've heard from others. I think it's fair to say that in all of the professional groups there are as many opinions as one would wish to hear. Among the doctors, as an example, there is a very strong difference of opinion on how efficiencies can be achieved. Within the hospital community there are differences of opinion. Yes, we do consult and listen and work with them, but it is something that is continuing; it's not the opportunity of planning for a point in time in the future and building towards that. You have to operate the thing while you're going along. It's like changing a wheel on a truck while you're driving it. We continue to do that. We recognize that it's a very complex system. It involves a tremendous amount of different interpretations and opinions, information, expertise and so on. All in all, however, we're doing a good job. All in all, we're producing a very good health care program in the province. It's not the ultimate, of course, and not one that's going to meet everyone's desires, wishes or expectations, but it's a very good program, an excellent program. We're learning. We're growing. Hopefully we're producing a better product as we go along.

There was reference to the emergency component. I am advised by staff that the decrease, as mentioned by the member for New Westminster (Mr. Cocke), more accurately reflects the estimated expenditure for 1984-85. We will not know our precise expenditures for 1983-84 until the end of this month, but we believe that the forecast indicates that the expenditure will be less than had been anticipated; therefore we believe that this year's estimate more accurately reflects what we believe the costs will be.

The discussion surrounding health costs, whether in British Columbia, other parts of the country or other countries is something that will continue forever. Yes, indeed, some jurisdictions have had a program and then reversed their concept of the program to embrace another concept, and perhaps at some point in time they go back to the original. I would say that's human nature. It seems to occur in many areas of interest. However, nobody has a lock on the absolute answers to health care. There are many complicating factors. The member for New Westminster mentioned the compulsory aspect of payments for doctors and other things. I'm not suggesting that it's negative, but it's a complication. The concept of our medicare system in Canada is a complication.

The concept of our hospitalization program is a complication. Other jurisdictions that do not have the same programs have different methods of approaching a cost containment. They have different tools, and they approach it somewhat differently. We know what we have in Canada, and we know what we have in the province. We're attempting to address the problems in the best way we possibly can, with the maximum of assistance from those who can be utilized for that purpose. Sure, there are going to be better ideas put forward at some time. There may be better ideas accepted and developed at some time, but for the moment we are dealing with what we know while at the same time paying attention to those who suggest that there are alternate or better ways of doing it. We spend a tremendous amount of time in consultation with such people.

The member for New Westminster mentioned home care. I guess if one wished to utilize semantics one could say that there has been a decrease since a certain time. I'm not quite sure what the decrease would be. Are we speaking dollars? Are we speaking numbers of persons receiving care, hours or whatever it might have been? We went through a debate in this House some time ago about homemakers when there had been, I think, a $15-million increase in a budget, and we were constantly being asked to explain why there was a cutback. There are always going to be changes. There are always going to be changes to an individual, and there may be changes in whole numbers, just as there are for people visiting doctors and people going into hospital. We have a good program there as well, and it's a very difficult program to monitor and very costly.

Adult day-care centres. Yes, we agree that they're a good program. Some have simply been put on hold for a period of time; some haven't been completed within the facility, but we expect that in the future they will be.

There is almost no limit to the amount of money we could spend on health care if we embraced everyone's concepts and ideas of what should be offered in that field. There is no question that some programs would counterbalance others and would assist in reducing costs somewhere else. But it's not automatic. Many of the programs which assist become an add-on to the overall system. There is no automatic displacement, as in one homemaker attending a person and that meaning one less person in an acute-care bed. That individual may no longer be in an acute-care bed, but somebody else will be. One does not empty the other. So it becomes an add-on. And it's a good service; we recognize that. There are no simple solutions, no single stroke that's going to resolve the problem. We're fighting a tough problem. Health is a major expenditure. It's a valuable service. It involves a tremendous amount of effort on the part of those who produce the programs. We're working with them, and we'll listen to almost anyone.

MR. COCKE: The minister is right in terms of his own philosophy, which is, I gather, to put out the fire called increasing prices, inflation, or whatever you like. But I think that's where he and I depart, because I believe that the increases are going to continue as long as we overlook alternate forms of services. It's the easiest thing in the world for a ministry or a minister to say: "Where do I cut first?" Having provided oneself with that question, then one says: "Well, I guess we have to cut the non-statutory services." In doing that, I think we do damage to the system.

[ Page 4125 ]

The alcohol and drug cuts, as I indicated, where the cuts are a mere 6 percent.... We have seen in this budget money well spent in this area. Heaven alone knows that the government makes enough money selling booze. I'm not suggesting that we should say that we're going to designate a portion of what we make selling liquor for health care, because then you get yourself into a lot of trouble. I don't think that designated revenue has ever been a particularly good idea. But that same government that makes millions and multimillions.... I haven't got the figure before me, but the last time I saw it it was in excess of $100 million, and I'm sure that it is well up there. In any event, that revenue is part of our taxing process, if you will. Then we say to alcohol and drug people that we're going to cut it back. What we're confronted with is that because we're cutting back alcohol and drug education we're cutting back on the very people who are going to provide us with a reduction in this self-abuse situation. If we continue to cut them back, then we continue to say to ourselves that we will have an ever-increasing number of drunk drivers, or the result of drunk drivers' activities, in the hospitals. I recall that the stay in our hospitals for motorcycle or car accident victims is quite lengthy, and at $300 a day or more, a lengthy term is a very expensive proposition. No wonder hospital care is costing us an arm and a leg. We believe that thoughtful programs can be run that can actually take some of the heat off our whole medical and health system.

When I see funded agencies cut.... Even if they're only cut $328,000, they were cut. If you can remember, Mr. Chairman, it was only a couple of years ago that many of the government programs were somewhat reduced in order that funded programs could continue. Now we have them cut. We certainly have out-patient clinics cut. As the minister suggested, the detoxification centre is cut. Those are not all great, significant cuts, but it is this sort of activity that, in my opinion, places us in a position where we're just loading up the hospitals. And we will continue to load up the hospitals as long as we don't keep people out as best we can. I can certainly remember many successful programs, one of which was in the minister's own riding. I don't know the status of that one right now, but it was directed at young people, and they had a lot of success stories to tell. Every time we keep someone either off the road in that condition, or from getting intoxicated by drugs or alcohol, then we are doing ourselves and the taxpayers of this province a great service. I don't think we're doing the taxpayers a great service by making these cuts in areas so terribly sensitive, and in areas that can create a positive situation for the future.

[4:15]

I've been in many discussions over the years about what to do about this whole prevention thing. I've heard some very highly regarded people saying that prevention is just a fantasy, a dream. I for one don't believe it is. I've heard some experts on both sides, but I for one believe that if we really put our money where our mouth is in this whole area of prevention — and there are so many areas of prevention — we could reduce the impact on our hospitals. I don't think anybody wants to get sick; if they do they are a rare member of our species. I think most people, if given an opportunity, would choose the healthy way rather than the unhealthy way. I have often said in this House that in the old days when one was jogging or out doing one's constitutional — walking quickly or whatever — one was regarded as a kook. Today one is regarded as a person who is taking care of himself — or herself. These feminists get one, don't they? You know perfectly well you can't make that mistake without taking a great deal of lip.

I say that we can help to alter people's lifestyles. I think Participaction did — and is doing — a first-class job. I think Action B.C., that the minister decided to tie the can to, did a first-class job. Yet these are the areas that are gone or reduced in terms of budget, the very areas that should not be. Again one of the programs that Action B.C. did very early was a pilot project in Prince George, and what did they find out? They took two schools — the rest of the schools were control — in which they insisted on an hour of physical education each day. Now you may say that that would reduce the time for academic activities in those two schools. What was the outcome of that year-long program? The kids in the two schools that were supervised in this particular area were not only much more physically fit than their contemporaries in the other schools, but they did better academically. Maybe the oxygen that got into their brains helped. They did not do worse, they did better academically, despite the fact that they had a reduced number of hours in academic activities. What have we seen as a result of that? Well, I can say not a hell of a lot, because I don't see schools adopting that program. We should be pushing it. The Minister of Health should be after the Minister of Education to see to it that those kinds of activities are pursued. Maybe, with that generation anyway, we'll have a reduced number of people vulnerable to ill health.

In terms of the older generation, the minister said: "Well, we've learned to disagree on home care." He haltingly agreed that adult day care was important, but still it's all reduced. Adult day care is extremely important, because this is one of the areas that keep people out of institutional care. I'm worried about homemaker services. We are doing our thing on homemaker services in terms of cutbacks, and yet ironically it strikes me that what we're asking — if I read the minister's mind correctly — is to privatize more of those services. At one time those services were provided by nonprofit agencies, but today more and more are going to profit taking enterprises. So we're going to begetting less for more. We're going to be getting a lot less for more, in my opinion. Non-profit agencies spend about 80 cents of each dollar on salaries, benefits, training and travelling expenses. The other 20 cents goes to administration and fixed overhead costs. There's no profit there; cuts have to come from reducing either staff or services.

What's going to happen when the private firms move in? They can pay their staff less. I see some of that kind of activity going on right now in the construction business. I hope that someday people will take pictures of buildings that are being provided by some of these people who decide there's a cheap way to go, and that is to hire unskilled labour. In any event, I believe that in the long run the private firms are going to be more costly. Here we are, caught right in the claws of a beast that will kill us in this area, because if those costs rise and the minister continues to hold the lid on the overall amount of expenditure for home care, then naturally there will continue to be reduced service.

I guess one of the areas that I hear most about in my constituency in terms of concern over government policy is this whole question of home care. We all get our share of compensation problems, we all get our share of ICBC problems, and we all get our share of welfare problems. But particularly in an area like mine, where some 25 percent plus

[ Page 4126 ]

are seniors, those most vulnerable to illness and those most likely to need these kinds of services.... So I guess I get my share of those problems by virtue of the fact that I come from an area that is growing a little older, but it goes across the province. Anyway, I see the cuts in home care, and at the same time I see this other irony of closing down Tranquille, under the auspices of the Ministry of Human Resources, which is going to create a tremendous load for home care, surely of one type or another. I mean homemakers and other support assistance have to be made available to the people who come out of institutional care. I don't think we're going in the right direction. I said so two or three years ago, and I'm saying so again.

Bed closures. That's one of the minister's ways of keeping people out of hospital. It's kind of an artificial thing that I'm not very fond of, but the acute-care bed closures reduces patients' stays, and reducing patients' stays should mean that there is more home care available. Otherwise you are likely to have the patient back to see you later on.

It's very difficult for anybody — and I agree with the minister in this regard — to stand here and say, "I can save you 1 percent, 5 percent, 10 percent, 15 percent or any other percentage." But I think it's common sense to know that there is a percentage out there; I just don't know what it is. And I don't think anybody could tally that up. But it's just common sense to know that if we can keep people out of hospitals....

Interjection.

MR. COCKE: Unfortunately, Madam Member, the minister can't provide me with the figures. The direction of our program is not to look at those figures; it is to go in the other direction — that is, cut these areas that I feel are so important.

So, Mr. Chairman, again I just say we've got to do something to keep people out of hospitals. One of the good areas is alcohol and drug counselling. One of the great areas is home care, and unless we can provide that home care, the demand will continue to increase for the utilization of our services.

I have seen situations where people have gone to doctors, and they needn't have gone to doctors if they had had their proper home care. The doctor throws up his hands in disbelief, and they wind up going to a hospital, where our costs really spiral. That's that for that particular aspect, Mr. Chairman. I hope the minister can give me some significant reasons why we're not at least paying more attention to what we on this side of the House consider to be a most important area.

MR. SEGARTY: I just have a few items under the Ministry of Health estimates. First, I'd like to thank the minister for providing us with a lot of new support services in the Kootenays over the past number of years: the renovations to the Tom Uphill Memorial Home intermediate-care facility in Fernie, along with the new 60-unit intermediate-care facility in Cranbrook, and the $3.5 million expansion to the Cranbrook and District Hospital. I want to thank the minister sincerely for helping us in those particular areas. Without question they have upgraded health care for the people in the Kootenay riding. Along with that, there has been great improvement in the Columbia River riding. So on behalf of myself and the member for Columbia River (Hon. Mr. Chabot), I want to thank the minister for all of that assistance.

One area of concern is the need to expand current facilities. Over the past few years we have been working to get the three facilities in the Elk valley cooperating more with each other. Three units — the Elkford and District Diagnostic and Treatment Centre board, the Sparwood General Hospital board and the Fernie District Hospital board, along with the Tom Uphill Memorial Home Society, have been cooperating a great deal over the past number of years. I have put a considerable amount of time into trying to get the boards to form one board in the Elk valley to improve the level of service and basically provide more and better services to the people of the Elk valley, with the same amount of funding, by continuing to share not only laundry, dietary, pharmacy and other specialty areas but also administration.

[4:30]

At the present time there is a need to build a new super diagnostic and treatment centre in Elkford. The minister is aware of it, and we've had some good discussion on it. I wonder if the minister could give me some idea where that sits at the present time. I understand that the board of the diagnostic and treatment centre in Elkford have sent down an application to the ministry to release the funding for the planning of that facility. I wonder if the minister could give me some idea of where that is, along with the need in Cranbrook to develop a regional psychiatric ward for people east of the Selkirk Mountains. A lot of people have to be transferred to the Trail hospital or down to the coast to receive that service. While I recognize these are tough times in our economy, I wonder if the minister could give me some idea whether that will commence late next year, early the following spring or maybe late this year. Maybe the minister could give me some idea of what is happening with it.

There is another item of great concern to a lot of senior citizens in the East Kootenays. At the present time there are about 600 people on a waiting list for audiology services in the East Kootenays. You could look at the East Kootenays as being Creston, Golden, Fernie, Sparwood, Elkford, Kimberley and Invermere. The audiologist moved out of the East Kootenays over a year and a half ago. The position has been advertised for some time, but we've had no success in attracting an audiologist to the area. This affects profoundly deaf children as well as senior citizens. It's my understanding that the ministry has gone the advertising route in Canada, but no suitable audiologists are available. It's my understanding that UBC graduates audiologists each year; apparently they lack the clinical experience and so on in terms of qualification. I wonder if the minister could give me some idea how we can get the Ministry of Health and the Ministry of Universities, Science and Communications together to increase the standards of UBC graduates to meet Ministry of Health requirements, or how else we can resolve that very serious problem. I make that plea to the minister on behalf of the MLA for Columbia River and myself. Perhaps the minister could give me some idea as to where we stand with it.

HON. MR. NIELSEN: Mr. Chairman, I could not respond to the member for Kootenay with respect to precise dates or schedules for any of the projects, except in the most general way. I'd rather be specific.

The audiology question is one which we've been wrestling with for a while. There is no easy solution. There is a

[ Page 4127 ]

general shortage of audiologists; there's tremendous competition for them. UBC does graduate some audiologists who, I believe, are quite qualified for positions, should they wish those positions. I think they are graduating six presently — I'm not quite sure of the numbers. I believe all have been interviewed by the Ministry of Health. I think there are a couple who may be interested. Others have already committed themselves to positions somewhere in the country or elsewhere. We have been recruiting. I believe we have been interviewing audiologists in eastern Canada and elsewhere to see if they can relocate in B.C.

There is a serious problem in locating specialists of any kind in certain areas of the province. One of the reasons is that if they are in a relatively competitive market and there is the opportunity to go elsewhere, certain areas of the province may appeal to those individuals, and they move. The really serious problem we have is trying to recruit a person who is likely to stay in the community, rather than filling the position, only to have the person leave shortly thereafter, and again having to try to recruit.

So we're working on the audiologist problem. Indeed we have been speaking with the university and with the minister responsible about possibly expanding the class, if we feel that there is a legitimate need to produce. Just as an aside, Mr. Chairman, an argument we get from eastern Canada and other parts of the country — but mainly eastern Canada — is that we in British Columbia are producing too many medical people. Now they're usually speaking of medical doctors, and they question why we even have a faculty of medicine — why we even produce doctors at all. It has been suggested by two unnamed large provinces that they could produce all the doctors we need. We suggest to them that we feel we have a duty and a responsibility and a right to allow some of our citizens the opportunity of going through medical school in their own province.

The member for New Westminster had some most interesting comments. I agree with some of the comments, in a philosophical sense, with respect to prevention. Certainly the old adage "an ounce of prevention is worth a pound of cure" is pretty obvious. I agree that there can be some success in persuading people to modify their lifestyle or to adopt a healthy lifestyle at an early age. I agree that government has a role to play in that, but it is distressing that a private organization should be required to get a school to consider physical activity as a way to perhaps improve the students' performance. I would think that that idea and concept could come from the school itself, the school board itself or others.

MR. COCKE: It should have, of course.

HON. MR. NIELSEN: Sure. That's why I say it's distressing that a lot of this does not occur through the application of common sense.

We had a discussion some time ago in the House with respect to alcohol and drugs and others, over a different matter. It was a most interesting discussion. The member for New Westminster and others who have put forward the position that prevention can indeed have this massive impact later on down the road, I think, are quite accurate. It can be projected that way. But we do have a serious problem in our society with respect to the abuses which many people are involved in. I suppose one of the areas that is of great concern is that area involving younger people who, if they abuse themselves to the point of ill health, are going to be a charge on society for many years, simply because of their age. We agree that more must be done, and in all areas of our society — health, education and any other area that has an influence on people — to do something about it.

There are alternative forms of services. Yes, there can be many considered, and they are being considered. One of the aspects with respect to shorter periods of time in acute-care facilities.... There has been a reduction in the average length of stay; there are many, many factors associated with that. Costs, however, do not reflect in a precise way the shorter lengths of stay. In fact, the reverse can be true in many instances, because it is the first days of treatment of a patient which are usually the most costly. Some hospitals used to feel they'd like to keep the patient in a few extra days, because the cost of servicing the patient was diminishing. But they were still getting a per them based on the length of stay. So at times one could be led to believe that a quicker turnaround can actually cost you more, and it probably does. But I still think it’s a better use of the facilities.

It's interesting to note that in British Columbia our average acute-care length of stay is now 8.8 days or somewhere near that. In Washington state I think it's about 4.3 days. I think the reason the difference is so obvious is that there is a different incentive to move people through the system in Washington state, and that's called cost. There is an incentive on the part of the patients themselves to move out as quickly as possible. There is an incentive on the part of the doctor to move his patient through as quickly as possible, and on the hospital as well, because they don't wish to be stuck with bad bills. We don't have the same incentive, but it has improved considerably. In fact, in British Columbia the average length of stay is, I think, considerably brighter, from my point of view, than in some other provinces.

I don't have the statistics before me at the moment with respect to services provided in our hospital system, say, for the calendar year 1983 compared with a similar period of time in previous years. But the information I received was quite interesting: while there had been a reduction in the number of acute-care beds at one point, the number of services provided had not fallen off in the next year. I will get that information, because it is a most interesting statistical study.

The member mentioned a few numbers. I'm not going to argue numbers at the moment; I just wish to provide some information which has been provided to me. In alcohol and drug the number in our book for 1984-85, we believe — and we will know in a matter of a few weeks, I guess — the estimate, if expended, will actually be greater than last year's actual expenditure. The estimate in the blue book for 1984-85 will probably exceed the actual expenditure on the program in the previous year; similarly in home nursing and in adult day-care. We believe the estimate provided for 1984-85 will probably exceed the actual expenditure in these areas for the previous year. There are reasons for that. There are reasons why the numbers put forward last year, as an estimate, may not have been achieved in actual expenditure. We actually believe there will be an increase in those areas in dollars spent for the services over the year.

The member for Kootenay (Mr. Segarty) spoke about the concept of amalgamation of a number of facilities in the Elk valley. If I could for just a moment, I'd like to acknowledge what we feel has been a successful venture on the part of the ministry and some of the facilities in the province towards amalgamation, consolidation, coordination or cooperation

[ Page 4128 ]

— whatever word may be offered — and in improved efficiency in administration and in some costs as well. We have had an amalgamation — I suppose that would be the word — at the board level of the two major Victoria hospitals. We believe we've had reasonable success. In the riding of the member for New Westminster, the Royal Columbian Hospital and the Eagle Ridge facility in Port Moody are going to join as a common board to operate the two facilities. We have had good cooperation from the boards. We believe that that too will assist in some of the very real problems in that area. We are continuing to look for opportunities of amalgamation or consolidation throughout the province. Interestingly, most of it has come to us from hospitals themselves. In meeting with chairmen of the boards of hospitals a month or so ago, I believe there were four hospitals that came forward to one of my officials and asked if we would consider some form of amalgamation or consolidation in their area. So we're looking at all of them. We have had good cooperation from the people associated with that. That's a program which, I think, can and will work and will save money for a number of reasons, not the least of which is a drop in the competition between facilities. When they are together as a common board, it's easier for them to understand that perhaps they do not have to duplicate the same facilities or services in each facility, but can work together as one to provide the service to the people of the province.

[4:45]

[Mrs. Johnston in the chair.]

MR. COCKE: I challenge the quorum.

MADAM CHAIRMAN: We have a quorum.

MS. BROWN: Thank you very much, Madam Chairperson.

I was really quite pleased to hear the Minister of Health agreeing that prevention is better than the cure, because I just wanted to raise a couple of issues under the area of prevention. I want to start out first of all by saying that I know that he's not responsible for the area I'm going to be covering with one of these issues, but the reason I'm raising it here is that in the final analysis the cost involved falls on his ministry. I'm talking about the number of young people — children, actually, under the age of six — who are injured or who might even die as a direct result of being involved in automobile accidents when they are riding unrestrainted in a car: that is, neither in a car seat nor with a seatbelt on. So I want to ask first of all whether the minister could secure some figures for me. I'd like to know how many children under the age of six have been hospitalized as a result of being involved in automobile accidents. I'm willing to accept statistics for 1983, 1982 or even 1981 — whatever year statistics are available for.

The second thing I'd like to find out is how many of these children were permanently disabled as a result of being involved in an accident.

The third question is — and I don't know whether hospitals keep these statistics or not: how many children died as a result of being involved in an automobile accident? I'm not asking about children who were involved in accidents outside of a car — kids hit by a car — but about accidents involving children who were riding in a car. And if it's possible, I'd like to know what the cost on the health care system was of caring for those children. As I said before, I'll accept any year, whether it be 1981, 1982 or 1983.

I know the minister is going to tell me, Madam Chairperson, that this doesn't fall under his ministry. I recognize, because I raised this under Transportation and under the estimates of the minister responsible for ICBC.... But as I said earlier, in the final analysis the cost involved in caring for these children falls on the Ministry of Health, and that's the reason I find that this is the source to which I'm coming to get this information.

If we can accept the statistics given to us by the B.C. Medical Association in their educational program that tries to encourage parents — or adults, anyway — with children in the car to use restraints with them, it seems that it's quite costly and a large expense on the health care system. I'm wondering if, taking that into account, the minister would consider having the Ministry of Health itself embark on an educational program.... That's the only thing I can ask for, since Health cannot introduce legislation making the wearing of seatbelts compulsory; that belongs to a different ministry. But I believe that Health can embark on an educational program to advise adults of the dangers and risks involved in having young people under the age of six in a moving automobile when they're not restrained either by a car seat or by seatbelts. I certainly see education as one of the functions of the Ministry of Health, and I'm wondering whether he would consider that.

The second area that I'd like to cover in terms of prevention is the alarming escalation of smoking among teenagers. Smoking in that group is increasing faster than in any other. I know the ministry is aware of the long-term impact of this particular destructive habit on the health care system as well as on the young people themselves. Again, I realize that the only thing the Minister of Health can do is embark on an education program. In fact, some pretty good programs in the past, dealing with the use of alcohol and drugs as well as tobacco, have been the responsibility of the Ministry of Health. I wonder if the minister would tell me whether there are any plans to continue or increase these programs, because it seems that the program has to be introduced to younger and younger kids. Whereas before we found that smoking among older teenagers was the habit, it now seems that younger and younger teenagers are involved in this particular habit, with, as we know, disastrous consequences. I have to admit that I find it particularly disappointing that young female teenagers are the ones most guilty in this respect. I am disappointed that they have not come to recognize the dangers inherent in what they're doing, and exercise some common sense and intelligence in this regard. However, for better or for worse I think there is still a role for the Minister of Health to play here, and I'm wondering if the ministry is going to exercise that mandate.

[Mr. Ree in the chair.]

The third and final area of prevention that I want to deal with has to do with preventive health services to women. As the minister knows, the Ministry of Human Resources has terminated funding for the post-partum counselling program and also for family planning. These are two services which, when they were in existence, were used very extensively. I am wondering, first of all, if the ministry has done any kind of study to find out where the women who were using postpartum are now going. Has there been an increase, for

[ Page 4129 ]

example, in the number of women seeking psychiatric services, or in those ending up in psychiatric wards showing symptoms of post-partum depression? Are they ending up in the psychiatric wards at great expense to the health delivery system? Are they going to psychiatrists, another burden on the health delivery system? If that is the case, has there been any analysis of the increase in cost on the health delivery system as a direct result of the Ministry of Human Resources terminating funding to those two particular groups? I don't know how you measure the impact of the work that family planning does, but if the ministry has been able to do that, maybe the minister can give me those figures too.

The Women's Health Collective: again that's a group that was involved to a large extent in the delivery of preventive health care and health counselling — almost exclusively, I realize, to younger women, but certainly to women who would not use the traditional health delivery systems. Is there anything showing up in the system on the impact of cutting back funding to this particular group? I guess it was a week or two ago that the federal minister responsible for this area indicated that funding for the Women's Health Collective would continue, I think in the neighbourhood of $150,000; so whatever break there was would hopefully have been a very minor one. I'm really anxious to find out whether the ministry is monitoring what happens to the health care system, the costs and pressure on this system, when these preventive services that were funded by other ministries — or even by the ministry itself — are terminated.

HON. MR. NIELSEN: In the last area, Mr. Chairman, I think the capability of the ministry in determining or even gathering that information would require a period of time to have elapsed. It would not be as quick as that. I don't think statistically or just from gathering the information that it would be anywhere near in the system at the moment. A specific attempt could be made to try to identify and follow, and as the member said, it might be very difficult to specifically identify one with the other, but maybe in some round numbers, yes, it's quite possible. I'll inquire into that.

[5:00]

The other two issues are much more specific, and I think more information is known. The member mentioned that the smoking problem with teenagers, for some reason now, seems to have affected the female more than the male teenager, and it has. The incidence of smoking for teenage females is the largest area of growth. It's quite possible it is in relation to the percentage previously, but yes, that is a major concern. I think perhaps it relates to something the member for New Westminster (Mr. Cocke) mentioned too, about the exercise at the various schools. It's unfortunate that there isn't more impetus occurring at that level where the youngsters are exposed for such a long period of time.

[Mr. Pelton in the chair.]

The restraint program for children under six. It follows, Mr. Chairman, that the restraints which are available in automobiles now in some circumstances would not be suitable for very small children, but there are alternatives available. The regular seatbelt apparatus can be utilized by a large number of youngsters under six. As we all know, youngsters are not all the same size. Some are large enough to be restrained by that which is now in an automobile. And there should he a concerted effort to encourage the use of restraints. I would think that it's quite possible you could argue that many parents may simply not even think of a small child requiring restraint, for some reason. There should be, I concur —and the BCMA and I have discussed it as well — an effort made to really get the point across to parents that there is tremendous advantage to having your children under restraint in the car while it's moving, and to think for a moment of the dangers inherent in having the child sitting on the lap of a parent or unrestrained in the back seat in the event of an accident. I would venture to guess that many adults who do up their seatbelts when they get in the car have a youngster floating around unrestrained. I agree that there should be emphasis placed on that, and there is a certain area that I intend to pursue with respect to that. I concur that there should he a tremendous amount of emphasis placed on that.

It's of interest in the area of health promotion, in our preventive services, that four significant issues are being emphasized at this particular time. There are more than four, but these are four which at the moment have been placed in what we refer to as a health promotion unit. They're going to address these four. They are not the four the member spoke of, although — these are not in a priority list — addressing smoking issues is one and raising low birth weights is another. Reducing back injuries and encouraging self-care programs for senior citizens are the others. The health promotion unit will be addressing the smoking issue and will be addressing some of the other issues. I have no hesitation in having them also look at the restraint/seatbelt issue, and see how we might best get that message across so it results in greater utilization.

The other issues. I will ask some of our people whether there is a method whereby they can audit the results of any other program being cancelled, whether there is a direct relationship, and whether we can somehow determine that. I'd be pleased to ask someone in the ministry to see what answer they can come up with.

MS. BROWN: Very briefly, I want to thank the minister for that commitment to do something about the car restraint program for young people, because what we're dealing with, of course, is a group in our society which cannot speak for themselves, so unless all of us speak for them, they remain at risk. I certainly am very pleased that the minister has committed himself to working with the BCMA in terms of the educational job involved in getting that message across to the parents. It would help, though, if I could get those figures that I asked for. Is it possible that the hospital keeps those figures? They do? That's fine. Thank you.

HON. MR. NIELSEN: Just to clarify, it's a combination — ICBC keeps certain records and hospitals others, but we will certainly attempt to, although the numbers are going to be capable of being interpreted liberally, if that's not an offensive word — because records are not necessarily kept of long-term effects relating specifically to that type of incident.

One other comment on the promotions. In our system today within the health program, the major problems today are chronic disease and accidents, so certainly that's an area that deserves attention.

MR. MITCHELL: I'd like to join this debate on a number of issues, and especially I would like to support my colleague from Burnaby-Edmonds (Ms. Brown). I guess we all look at

[ Page 4130 ]

it from a different side of life. Unlike her, I have not visited the hospitals with people who had been permanently injured and had brain damage, especially children from car accidents, but I know from lots of experience — I've seen many children injured in car accidents — that if they had had some type of restraint they wouldn't have been. I can always remember my first coroner's inquest, and I know that your deputy will maybe understand it. This was an accident where damage to the car was only $75, but a person was killed. The coroner asked me if he would have been alive if he'd had a seatbelt. In the early sixties seatbelts weren't something that people thought of in any great degree. I said: "Yes, he would have been." I was sure of that. I think it is the education that has taken place over the years that we all get into our cars today — or the vast majority of us — and buckle up our seatbelt because we have been convinced by media and advertising that it is a way of life.

I think your ministry could use some of the $18 million your government has for advertising for the next step that my colleague is talking about. We will accept it. The normal reaction is that we're against buckling up, but it does save lives.

I have a few other suggestions to the minister that really have bothered myself and many of my constituents. I know philosophically we are in opposition to the government's degree of user fees. I honestly believe that when someone is sick or injured he needs hospital treatment, and I really cannot accept the government's position that people really do go to hospital and abuse the system or use it unnecessarily. In emergency situations people do go there, but it is only one shot — $10. When you go into acute care, 8 to 20 days is an average stay. Many in the community think that all those in extended-care hospitals are senior citizens collecting old-age pension who are automatically covered or people who are on some sort of GAIN or handicapped pension. But there are a large number of citizens in extended-care hospitals, in most cases wives of husbands who are working — husbands who are maintaining a regular job while maintaining a home, with wives in extended care hospitals for which they are now paying $12 to $13 a day.

This is not on a one-shot basis — not 8 to 20 days. They are in there for 30 days a month, 365 days a year. There is added expense of paying the extended care penalty because the wife happened to have MS or some other serious illness where she is confined to hospital for the rest of her life, while he maintains a job and home and is looking after the family. That additional burden from a working man's wages is breaking so many families today. Many husbands have told me it would be cheaper if they could desert their wives and she could sue him as a deserted wife, or if he could leave her. But the love of a wife is not something.... The average man would not want to go through the procedure of divorcing or deserting a wife.

One case that came to my community office is now before the courts. The Gorge Hospital is suing the husband and forcing him to sell the family home to get the 30-odd thousand dollar bill he has run up. She's been in the hospital since the fifties. When it was $1 a day the problem wasn't something that affected him, but in the last eight years, since this present Social Credit government came to power, they have continued to raise the rates. In this particular case this man is a fisherman. He has a small boat and he's in and out of work. He has a lot of problems. After having a wife in hospital as long as he has, I believe there have been other marital problems develop that affect that particular family and that individual.

I will say, through you, Mr. Chairman, to the minister, that I don't think it is all one-sided. The cumulative effect of what has happened with the high extended-care costs to a family year after year is breaking or severely retarding the money available in a lot of working people's homes. In this particular case, he was lucky. His wife eventually reached 65, and she went on old-age pension and was covered. But for all those many years, and especially the last five or six years when the costs have really skyrocketed for the extended-care patients, it was a very serious matter.

I ask the minister to look at those people who are not covered — those people who, as I think the minister once said to me, fall between the cracks. They come from a family and are young, but the breadwinner of the family is being faced with high costs.

I have another issue I would like to bring to the minister's attention. I think maybe it's a philosophical idea that we on this side of the House hold a little more than many of those on the government side, who look at everything from the bottom line or the profit. For one who philosophically does not believe that the cost of medical care is something that should be looked at solely on how much money any group in the community can make, and in particular in the medical profession, have we looked seriously at the compounding effect that medical cost is having on our system? At the present time we do pay on the fee-for-service with nearly a 10 percent compounding effect, and the cost is going up and up.

[5:15]

I think we have to look at a different approach. One of the approaches that I'm convinced government and society must look at is the community health clinics. Doctors are working at a regular salary, and people can be encouraged to go in when they are well. They should be encouraged to look at staying healthy and at nutrition. A lot of the problems that the minister outlined earlier as being the cause of a lot of the illnesses that we suffer down the line are because of neglect. Where community clinics have been tried, there have been beneficial results. Though the minister says age and accidents are the two most important costs, the cost of staying well or the cost of getting sick is still a massive treatment cost.

At the present time, the fee for service of a doctor....

He doesn't see you until you're sick, and if you have a major operation or treatment.... He looks at every visit or operation as more money in his bank account. I know the majority of doctors went into the system because of the money, and they enjoy the wealth that illnesses have given them.

From the community point of view, we must look at other ways of providing the service that the public demands and has a right to expect. We must utilize in the clinics, especially in some of the rural areas, some of the training that has been given to public health nurses. I believe they are designated as rural health nurses. I think we should enlarge some of their services so they can provide a little more leeway in their services. I think we must look at that, especially in a community where we have a lot of rural areas.

The type of service that can be provided by the well educated, well-trained technicians today that are held away from providing services by the medical profession.... As I've said before, leadership can be given by the minister

[ Page 4131 ]

through the medical service and various associations which are today organizing and working toward providing more employment for the people in their groups. I think we should look at such things as midwifery from a positive position: can this service be provided to people who want it at a price that is less than what it is presently costing society? Can that be provided and still maintain the high standards that each one of us feels the community should receive? If we are going to continue to provide medical services and hospitals, we have to look at the alternatives to our present system.

When acupuncturists were first promoted in my younger days, they were viewed as quacks and people that the community wanted to put into jail. Because of a different outlook, people have found that acupuncture is a viable treatment for many illnesses. It was developed in China, and they did not have to hold the high degree of medical training that we're demanding acupuncturists have in this community. As I say, I am not a promoter of acupuncture. I have really no experience in it, but people I have talked to are convinced that it does give some relief. The medical profession have accepted it. If this can be delivered by well-trained individuals for certain types of treatment, I think the minister and his ministry should look at the alternate ways of delivering good health care.

There are philosophical differences in certain parts of the regulations and laws. We do selfishly believe that we in British Columbia should have the best treatment. We have to look at it so that it can be provided at the lowest cost but with high standards maintained. If there are any shortcuts that can be taken to provide that — a little study — I think it's time in our economic development in British Columbia.... It's imperative that not only the opposition but also the government look at how we are going to provide it. I would ask the minister, when he is doing his studies and talking to his think-tanks.... What other methods have they looked at that can maintain a high standard and still utilize the training that a lot of technicians, nurses and people from various medical associations have acquired through our education system? How can that be worked into our medical system and still be covered in one way or another?

HON. MR. NIELSEN: Mr. Chairman, I am quite distressed that I have not had information on that fellow who owes $30,000 for extended care. That's news to me. My officials advise me that it hasn't been brought to their attention. I can't understand how a facility would even permit someone to get that far into the hole. I gather no payments had been made for years to accumulate $30,000, which is a massive amount. I just don't understand how that could even occur. Maybe the member might wish to provide the information later. I don't want to discuss names openly, because it's somewhat confidential, but if you'd like I'd be very pleased to look at it. I'm astonished that they would carry a $30,000 debt for that period of time. I don't know what the details of that circumstance would be.

The effect of a per diem rate, whether for extended, acute or otherwise, is going to differ depending on the capacity of any family to produce revenue, and on how much they earn. I'm not sure if the member is speaking of an income-testing system. I don't think it's breaking families. I don't believe that's correct. Sure, it may be causing some distress to some. I don't think it's a large number, and I don't think it is breaking families. As the member knows, in specific instances we are most pleased to review a particular circumstance to see what the peculiarities of that may be. But I'm astonished that any hospital would permit someone to run up a bill of $30,000 over what must obviously be a considerable number of years. I would be pleased to get the information and look at that one.

"Community clinics" is more a generic term, I suppose, because there are going to be different approaches and attitudes and ideas as to what a community clinic might be. I suppose we have some that could be called community clinics, although they might not meet the criteria of some other clinics. In some instances it's still fee-for- service, but just a slightly different approach. There would probably be an additional cost. It might be a lower cost to provide that specific service, but overall it would be an add-on to the system; people would probably utilize them more, and still utilize the procedure of going directly to their doctor's office and receiving the other services. For that one specific procedure it could indeed be more cost-effective under the right model. The ministry is reviewing the concept of community clinics, and has reviewed a number brought forward by different people with different ideas.

If the member would provide me with some basic information, I would be pleased to have someone review that. The circumstances of that $30,000 indebtedness are significant, and I'd like to know the details. I'm not suggesting a resolution, but I certainly would like to look into it.

MR MITCHELL: I'd really appreciate that. It has been an ongoing problem. The best my community office could do was to provide my campaign manager as the lawyer for it. Yes, I have all the facts and names. It was with the Gorge Road Hospital. They have taken it through the ministry. I'd be more than happy to provide all that evidence.

Just one thing on the community medical centres. One hospital in Seattle — I don't have my notes here — has been in operation for a number of years and they have done some very extensive studies of it. I believe they have their doctors on a fixed fee. The evidence I have read.... One doctor in the community who is a strong supporter of it said that the cost of providing service for X number of people is significantly lower than the cost on a per capita basis under the existing plan.

MR. COCKE: The member for Esquimalt–Port Renfrew is talking about probably the best in North America — the Puget Sound co-op. That co-op had the good fortune of having Dan Evans as governor for a while. He was a Republican; I didn't agree with everything, but I kind of liked the guy. A few years ago he insisted that they include poorer people in that co-op, and the state of Washington, because they liked what they saw, naturally participated to that extent. Their whole program in terms of reduction in use of surgery, compared to any other region or any other group of 200 or 300 people, was absolutely significant. Gall bladders, less than.... I wish I had the figures before me. But the member is quite right. Gall bladders — I think they did something in the order of maybe 15 to 20 percent; appendectomies were 10 percent of the rule; tonsillectomies.... Practically every one of those operations that one can have or not have — I guess they're called elective surgery.... I'm not downgrading elective surgery; some people require it. But I think you have to have the right climate to have doctors

[ Page 4132 ]

working together as a team, and I think that's what they've provided there.

[5:30]

I think that in the United States they're likely to beat us to the gun. The health maintenance organizations — that's what they call them down there — are not likely going to be the ones to push the administration the hardest; it's likely to be the insurance companies. I think Aetna and two or three other insurance companies are very large in the health insurance field, and they're going to insist on some kind of economy. You watch. It's likely to come from the private sector, which will ultimately take on the American Medical Association — which is so violently opposed to that type of thing — and it'll be the irony of ironies. Here we are, blessed with a better plan by far than they've got in the United States but cursed to this extent: people here have the feeling that they have access to the system at very low cost, so they're not going to be pressing for anything better. Here it's going to have to be government that takes the leadership in having community health centres or health maintenance organizations or whatever to replace some of this cottage industry.

Just think about a patient. Suddenly I've got a pain in my left leg or something. I immediately go to my GP. He takes a look at it, and he says: "Okay, I want you to go home and take a couple of whatevers, but meanwhile I want you to see Specialist A." Specialist A, after a decent consultation, says: "This unfortunately isn't one of those areas I handle best, and I'm going to send you to Specialist B." Specialist B gets hold of you and says: "Would you take this prescription for a week, and if it's no better come back and see me." It's not a lot better, so I go back to see him. None of that happens in a health maintenance organization or community health centre. They're all there, they consult, they move you from one place to another, and you get a ready response to your needs. The doctor isn't motivated to keep you coming back or anything like that, because he or she gets a salary regardless of whether anybody comes. I think the old system in China was probably a good idea: pay them not for those who come, but for those who don't require treatment. I don't think they're doing that any more. In any event, I think that kind of organization could be of great service to us.

Doctors are going to be darned afraid, because if you think we're overdoctored now, we certainly would be overdoctored with that kind of program. I've said in this House before, and I'll say it again: it's not going to happen in short order, but it should happen over a generation. It should not be let go; it should be nurtured. I contend we are not nurturing it now. As a matter of fact, those itty-bitty community health centres that have been started are, if anything, going back to the old way. I regret that Houston's going onto a fee-for-service basis. I regret that there's a reduction in the financing of the James Bay organization, and I regret that the Reach clinic is also in that situation. I haven't heard anything about the Queen Charlottes. I hope it's still working. I remember quite clearly that when we started the Queen Charlotte Health and Human Resources Centre, they had a terrible time before they attracted doctors. They were able to attract doctors, and they have front-line nurses to reduce the amount of call upon doctors. I think these are all areas that we should be thinking about.

This is nothing to do with the present minister, but I can recall that with the backing — believe this or not — of the BCMA, the RNABC, certainly of our Health ministry, UBC and.... I forget who else was involved, but a number of organizations were involved in starting the training program for the extended role of the nurse. The course was in place and produced its first crop of extended-role nurses and they had nowhere to go. Doctors finally decided they didn't want to use them. If you had the right kind of structure, you would have the structure for those extended-role nurses to work in. But we don't, and we're not encouraging the structure. I know the minister is under pressure and will be, but I say review and review, and he will take the heat off in the long run if these changes are made. The minister is going to have a tough time with the Medical Association, but I've seen him take a little heat from them before, and it didn't seem to kill him. It did a bit? We all die a little bit every day, Mr. Minister.

I believe that we are going to have to confront that situation, and the sooner we confront it the better. The model has to be changed. Unfortunately the motivation in this country is not the same as they have in areas where access to health care isn't quite so convenient and is a lot more expensive, etc. From that I hope the minister doesn't feel that I'm suggesting that we go wham, wham, wham on the patients in order to make them feel that they need to change the whole system. I think we have to give some leadership, and I think the time has come for that leadership. We started out with pilot projects, but they haven't been nurtured the way they should. They should be nurtured in the future, so why don't we get on with it.

I am no longer the Health critic, but as a stand-in I've got some of the files here. I'm not going to go through and bore you with some of the stats and so on. I would almost have to do research on my feet.

There is one other area that I want to talk to the minister about this afternoon. He said to us earlier in the day that what he did at the Royal Columbian Hospital and Eagle Ridge Hospital and so on and so forth was a great idea in streamlining the administration. He took it over; let's face it. It's going to be a board appointed by the minister. I've got his order-in-council. It's an interesting order-in-council:

"...as it is in the public interest to do so, and whereas the board of managers of the Royal Columbian Hospital and the board of trustees of Eagle Ridge Hospital and Health Care Centre Society have continued to hold office by virtue of section 4 of order-in-council 1444-83, orders that, effective April 7, 1984, they cease to hold office."

At least the minister had the good grace to send them all a "Dear John" letter. He said: "Look, I really appreciate all those things that you've done for us." I read the letter, you know. It was marvellous: a beautiful letter. But I'll tell you, Mr. Chairman, it was a damned insult to me. Do you know who was copied? Not this MLA. It was that MLA, the member for Maillardville-Coquitlam (Mr. Parks), who knows about as much about the workings of that whole scheme of things in New Westminster as he knows about Coquitlam, which isn't much. But in any event, had we all been copied in, there should have been three MLAs copied in: the member for Coquitlam-Moody (Mr. Rose), the member for New Westminster (Mr. Cocke) and the member for Maillardville-Coquitlam, if in fact that's what the minister wanted to do. Either that or none. But why the member for Maillardville-Coquitlam?

Let me tell you who they fired, among others: the former mayor of New Westminster, Muni Evers, who has served for years on the Royal Columbian Hospital board as a dedicated board member. First this government cans him from the PNE

[ Page 4133 ]

board and now they've canned him from the Royal Columbian Hospital board. I put that into the same kind of background as something that happened when I was Minister of Health. The chap who ran against me, John Edmondson, a Socred, was on the Royal Columbian Hospital board.

HON. MR. BRUMMET: You tell this story every year.

MR. COCKE: If the Housing minister doesn't like it, why doesn't he just close his ears? Normally he's not listening in any event.

But we kept him on because he produced. He was a good worker on that hospital board. I don't see why that same kind of practice shouldn't be in effect today. We still haven't got an order-in-council showing who the new board is — certainly it hasn't come to my attention yet. But I predict they will be all or mostly recommendations from the member for Maillardville-Coquitlam. That's a shame. It just tells the people that there is too much politics being played with health care in our province, and health care should be one area where we should be playing less politics and giving far more attention to the cooperation that the minister was talking about early in these estimates.

Naturally people are going to feel resentful, particularly people who have paid the price of volunteerism. The people in the community are going to be resentful, because they're going to say: "Why is it that these orders coming from on high always have to affect the people who've earned their spurs in our communities?" It shouldn't have happened, and it has happened to each and every member on that board. There may be one or two reappointments. We'll see who they may be.

MR. R. FRASER: Aye.

MR. COCKE: That impatient engineer. Why don't you go oil a ball-bearing. "Aye," he says! We're discussing something important like health care, and that member, who's supposed to be a member who's concerned about his constituency.... North Vancouver's got problems as well. Why don't you get up and talk about the Lions Gate Hospital and the problems that they might have — or do you know anything about them?

I would like to see the minister review.... I know that he has taken a hard-line stand in terms of this amalgamation. Well, if that's the way he's going to operate, that's fine. But I don't see why there should be people who have served well and hard not being reappointed to this board. If there is a good reason, then let's hear it.

Interjection.

MR. COCKE: "Fresh blood." Already you're old and worn-out in this House, Mr. Member. We need fresh blood from North Vancouver–Capilano. He's done nothing since he's been here except sit in his chair and do a little heckling. He hasn't done a constructive thing, and his neighbour.... Oh, wait a minute. Sorry. I've got the wrong member. He's the member for....

Interjections.

MR. COCKE: The right member? I had the right member, but I had the wrong....

[5:45]

MR. CHAIRMAN: The hon. member has the wrong subject as well. We're on the estimates for Health.

MR. COCKE: Yes. Mr. Chairman, it's very difficult to remember where they come from because we never hear from them.

I would ask the minister to reconsider the apparent direction. I'm only saying "apparent" because of the fact that the letter was not directed to the sitting MLAs in the areas, but only to one MLA who had absolutely nothing to do with the Royal Columbian from the standpoint of New Westminster members on that board. Over the years the old board of the Royal Columbian always had representation from Coquitlam, New Westminster and the government — and, as a matter of fact, from the Women's Institute, or what have you. I'm not sure that that day hadn't come to a logical conclusion, but I think it's a shame that it went the way it did.

If the minister wishes to answer that, fine; if not, I would move the committee rise and report progress — whichever he wishes.

HON. MR. NIELSEN: Mr. Chairman, we will be making that motion momentarily, but I heard what the member for New Westminster said. I admit that I may not have paid as much attention to the distribution lists for some of those letters as I should have. The member for Maillardville-Coquitlam (Mr. Parks) had specifically asked to be copied on that, because he had been involved in some major discussions with the Eagle Ridge people, and since they were coming together he wanted to be apprised. I accept the comments and criticism of the member for New Westminster. I think he should have been copied, and I apologize for not doing so and also the other chap over there....

AN HON. MEMBER: The distinguished person.

HON. MR. NIELSEN: Yes, the distinguished person, the member for Coquitlam-Moody (Mr. Rose).

Certainly the member for New Westminster will be advised as to the makeup of the new board.

I am sorry, but I will not accept responsibility for the rather peculiar wording of orders-in-council, because, as you know, Mr. Member, that is the work of lawyers. No offence. Frequently the language to a normal — or to another person might not....

Mr. Chairman, I move the committee rise, report progress and ask leave to sit again.

The House resumed Mr. Speaker in the chair.

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

Hon. Mr. Schroeder moved adjournment of the House.

Motion approved.

The House adjourned at 5:50 p.m.