[ Page 5875 ]

CONTENTS

Oral Questions

School district budgets. Mr. Rose –– 5875

School board resignations. Mrs. Wallace –– 5875

Property taxes and education funding. Mr. Passarell –– 5876

Princess Marguerite. Mr. Blencoe –– 5876

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

On vote 37: minister's office –– 5877

Mr. Blencoe

Mr. MacWilliam

Mr. Macdonald

Mr. Mitchell

Mr. Lank

Mrs. Dailly

Mr. Cocke

Mr. Rose

Ms. Brown

Mrs. Wallace

On vote 40: preventive and community health care services –– 5892

Ms. Brown

Ministry Of International Trade And Investment Act (Bill 20). Committee stage

On section 3 –– 5893

Mr. Williams

Third reading –– 5895

Committee of Supply: Ministry of Human Resources estimates. (Hon. Mrs. McCarthy)

On vote 42: minister's office –– 5895

Hon. Mrs. McCarthy

The House met at 2:04 p.m.

HON. A. FRASER: Mr. Speaker, I don't very often have people here from the Cariboo, and I'd like to introduce these citizens from the Cariboo today: Mr. Roger Lagasse, president of Cariboo-Chilcotin Teachers' Association; Mrs. Forcier, vice-chairperson of the 108 Mile House parents' group; and Diane Fogel, executive of the 100 Mile House chapter of the Gifted Children's Association of B.C. I'd like the House to welcome them.

MR. VEITCH: Mr. Speaker, in the gallery this afternoon is the business manager for the PVI students' union, Mr. Chris McNaughton. I'd ask the House to make him welcome.

MR. MOWAT: Mr. Speaker, in the House today I have two guests, and I'd ask the House to welcome them: Mrs. Rosemary Montgomery, who is office administrator with the family maintenance project in the Ministry of Attorney-General, and Mr. Allan Cobbin, who is northwest district director with the Ministry of Attorney-General.

Oral Questions

SCHOOL DISTRICT BUDGETS

MR. ROSE: I'm just hesitating a little bit, Mr. Speaker, until the Minister of Education finds his place. I could suggest a place to him, but he'll find his own.

Since the the deadline for the compliance budgets for school districts is May 1 — tomorrow — I want to know what action the minister has decided to take respecting school districts that are unable to comply with the minister's ruling and yet at the same time preserve their mandate to provide necessary school services within their districts.

MR. SPEAKER: Part of the question is in order, hon. member. Part of it would be anticipatory.

HON. MR. HEINRICH: Mr. Speaker, I expect school boards and the trustees who are responsible for the policy and administration to comply with provisions of the law — that is, to submit a compliance budget on the date which is prescribed under the statute.

MR. ROSE: While no one would counsel breaking the law, the government legislation provides such draconian measures as firing school trustees, imposing trusteeship, fining trustees and fining the taxpayers, as was the case in Delta. I'd like to know: has the minister decided to rule out any of these options, or has he decided to leave the blanket threat hanging over the lives of people who run the school system?

HON. MR. HEINRICH: Mr. Speaker, the member for Coquitlam-Moody seems to be making reference to future actions. I will repeat my earlier answer: I expect school boards to comply with the provisions of the law and submit compliance budgets.

MR. ROSE: I wonder if the minister could comment on the recent changes in the framework by which the provincially funded portion of the budget was slashed to 55 percent from 60, which meant that the shared portion of the residences has gone up by 5 percent. School property taxes are going up 10.9 percent in Vancouver; 15.6 in Delta; 19.3 in the Charlottes. In view of these dramatic increases in school property taxes during a period of service cuts, does the minister now wish to retract his statement to the Vancouver Board of Trade that the funding system is sound and fair?

HON. MR. HEINRICH: Mr. Speaker, the government grants available must be distributed equitably. The assessments have gone down in some areas; and where they have gone down, obviously government grants must go up. Of course, the reverse is true: where assessments have gone up, the revenue from that area will be increased, but it's going to offset those areas where there is a decline. As far as the 55 percent level is concerned, it's nothing more than a reflection of an equitable distribution of the funds available which have been generated as a result of the assessment.

MR. ROSE: Will the minister not agree that his new directive has left the homeowner with an increased share of education funding, and the province portion saved by $25 million? Would he comment on that as regards equity?

HON. MR. HEINRICH: Mr. Speaker, in some school districts in British Columbia the actual amount which will be paid by homeowners has declined; in other cases it has increased. It's nothing more than a reflection of the assessment.

Interjection.

HON. MR. HEINRICH: Well, it was also very clear that through the three-year operation the additional funding has been injected into the Ministry of Education budget, and I don't really see where the particular problem is, particularly after you take into consideration the homeowner grant. The amount paid by the majority of residents in the majority of school districts in British Columbia is zero.

SCHOOL BOARD RESIGNATIONS

MRS. WALLACE: I, too, have a question for the Minister of Education, Last night both the chairman and the vice-chairman of the Cowichan School District, School District 65, resigned from those positions. The reason was that although the funding bylaw was defeated by a two to one majority by the duly elected trustees of that school district, the chairman, under the interim finance act, was forced to rule that the bylaw carried — even though it was defeated two to one. Is that the Social Credit version of democracy?

HON. MR. HEINRICH: I think the statute is very clear. If two trustees are prepared to offer their resignations, there still is a majority on the board and they are quite prepared to review the budget and pass the appropriate validating bylaw on or before May 1.

MRS. WALLACE: They did not resign from the board; they resigned as chairman and vice-chairman. And it will be

[ Page 5876 ]

interesting to know whether or not they are able to get two more trustees to take those positions.

My second question relates to Lake Cowichan, School District 66. The chairman of the school board there has been forced to resign not only as chairman, but as trustee. The reason is that in order to continue his education at the post-secondary level, he is forced to leave the province to get the required courses. Would the minister agree that this example is symptomatic of the government's onslaught on education?

MR. SPEAKER: The question is out of order.

PROPERTY TAXES AND EDUCATION FUNDING

MR. PASSARELL: To the same minister. Under the new framework for education, property taxes are going up 69.5 percent this year in the Nisgha School District, compared with less than 5 percent in West Vancouver. Does the minister agree that the impact on the Nishga is very unfair, and what has he decided to do about it?

HON. MR. HEINRICH: Mr. Speaker, I cannot give a specific response, because I don't have the budgets with me. I'm quite prepared to have a look at that particular school district, because as I recall there is a cap on it. Even though the member advances a percentage increase of what appears to be a large amount, I suspect that the actual amount of taxation on the homeowner is very small. I think I'm prepared to bring back further information to the House, and I take the rest of the question as notice.

MR. PASSARELL: Supplementary. Could the minister please explain to the House why the taxpayers of the Stikine School District get hit with a 17 percent increase on property taxes, while residents of West Vancouver are held to just 4.8 percent?

HON. MR. HEINRICH: Mr. Speaker, there are a number of reasons for that. Number one, I think we can look at the assessed values of the property, and it's obvious that the revenues generated are a function of assessment. Secondly, I think that we can look at the enrolment, and I can appreciate, when we look at the difference as well on the per-student cost.... In the Stikine region it's somewhere between $6,000 and $6,500 per student, and in West Vancouver it's probably in the order of $3,400 to $3,500. I'm guessing on this, and that's one of the reasons why. I would further suggest to you as well that, after the homeowner grant is taken into consideration, the net payable by the citizens in the Stikine region puts them in a deficit position.

[2:15]

MR. PASSARELL: A last question to the minister. Does the minister not believe that all children in this province should be entitled to a fair education, and that residents who live in the far north should not be drastically hit with increased property taxes compared to West Vancouver or the metropolitan areas of this province?

HON. MR. HEINRICH: One of the very reasons that we introduced the framework of the new method for funding the school system in British Columbia was to bring equity among all school districts, and that is exactly what we have done.

AN HON. MEMBER: That's a sore point, Al.

HON. MR. HEINRICH: That's not a sore point; it's been a good point.

Mr. Speaker, if we were to look at the tax base in the Stikine region and compare it to any other area in the lower mainland, you would find a significant differential. We've just been through the estimates of the Ministry of Education, and I went to great pains to expand and explore the differences, and why we had to bring some degree of equity. As a matter of fact, when we go into the Stikine region, I advise you that the cost involved is per student. We're not as a government arguing against that at all. What we're saying, though, is that those areas that can afford to pay a bit more, which is reflected in their assessments, can share with those areas that have lower assessments. I would bet any money, Mr. Speaker, that an analysis of the assessments in the Stikine and the Nishga would find that those are two districts which are doing very well as a result of the funding system that we put into place.

PRINCESS MARGUERITE

MR. BLENCOE: I have a question for the Attorney-General, who is responsible for the Princess Marguerite. We've had a number of sailing dates announced for the Princess Marguerite. The local Times-Colonist called it "Chaos in Wake of Fickle Maggie."

The Princess Marguerite was scheduled to begin service on May 3, the same day as last year. Then it was changed to May 9. A Victoria resident last week was told it would be May 8. Now it's been changed to May 10. Unfortunately, no staff member at the Princess Marguerite can explain these various timetables and schedules; there's a lot of confusion. Can the minister explain to Victoria residents, and to the traveling tourist exactly what's happening with the Marguerite, or is he just as confused as everybody else?

HON. MR. SMITH: The member, with his usual gentle penchant for understatement, asks me if I'm confused. No, the only confusion I have, Mr. Speaker, is from the member.

The inaugural sailing of the Marguerite is next Friday morning, from Seattle to Victoria. The member has been invited to attend a sailing on Thursday afternoon, along with the other members for greater Victoria. Members of the tourist industry and the visitors information industry are going to Seattle on Thursday for an unprecedented inaugural voyage. In the past, the inaugural voyage of the Princess Marguerite was crew only. The ship went down empty to Seattle and started its first voyage on Friday. This time, as a promotion, we're taking a number of citizens down. We're having a reception in Seattle with the tourism industry in that city, and the member has been invited. So if he's read his invitation he knows he's on board on Thursday, and knows also that the inaugural voyage of the Marguerite is Friday from Seattle.

I also would like to acknowledge the support that this e member gave for the jetfoil, along with the member for Nanaimo (Mr. Stupich).

MR. BLENCOE: The minister's answer is as confusing as his administration of the Princess Marguerite. Unfortunately no one knows when the Maggie's going to sail, because we've had a grab-bag of dates announced to Victoria

[ Page 5877 ]

and to everybody else. I'm wondering if the minister will confirm whether he has hired Mr. Charles LaVertu, formerly of the press gallery, to clean up the mess that he and his cohorts have created with the Maggie and all the various schedules. Does he have to clean it up now?

HON. MR. SMITH: I would think that one of Mr. LaVertu's first duties would be to try to explain the operation of the Marguerite to the member for Victoria. That's a very tall order, but I'm sure that Mr. LaVertu is up to that sort of assignment.

In honour of these questions today, Mr. Speaker, I wore a Princess Marguerite tie.

MR. MITCHELL: On a point of order, I was wondering if the Minister of Lands, Parks and Housing (Hon. Mr. Brummet), who took a question on notice yesterday for the Minister of Municipal Affairs, has an answer that he can give us today.

Interjections.

MR. SPEAKER: Order, please. Hon. member, by the wildest stretch of imagination that does not qualify as even close to a point of order.

MR. ROSE: On the same point of order, I wonder if the learned Speaker could advise this House if questions taken as notice from February 18.... I have a list of some 20 or more questions taken on notice by the government benches for which answers are due and forthcoming to this House. I wonder if the Speaker could advise this House how an opposition member.... What is the most appropriate time for him to seek this kind of information? When is the government going to answer some of these questions that have been hanging for two months?

MR. SPEAKER: Hon. member, I'll be quite happy to explain the rules to you, other than taking up the time of the House.

HON. MR. ROGERS: Mr. Speaker, on Thursday, April 11, the member for Mackenzie (Mr. Lockstead) asked me what appears to be a short question, but one requiring a very detailed answer, regarding the western accord. I would ask leave to table a written answer to an oral question.

Leave granted.

HON. MR. ROGERS: Mr. Speaker, I'd also ask leave to table a written answer to a question from the member for Nelson-Creston (Mr. Nicolson).

Leave granted.

Orders of the Day

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

ESTIMATES: MINISTRY OF HEALTH
(continued)

On vote 37: minister's office, $206,025.

MR. CHAIRMAN: Shall vote 37 pass?

So ordered.

HON. MR. GARDOM: On vote 38....

Interjections.

HON. MR. GARDOM: I heard: "So ordered."

MR. CHAIRMAN: So did 1.

Interjections.

MR. CHAIRMAN: The member was not on his feet. When I called for the vote the committee said aye. There were no negatives, and there was no other member on his feet. However, we will return to vote 37. The second member for Victoria wishes to be recognized.

MR. BLENCOE: I appreciate that opportunity.

Mr. Chairman, I have just a couple of things I wish to bring up with the Minister of Health. The first one is an important one that goes beyond just the Minister of Health, but I'm sure he'll be very interested. In this region for some time we have had some problems and concerns about the dumping of raw sewage into the waters off the shores of greater Victoria. This has raised a number of concerns: health issues, environmental issues.... I'm glad to see the Minister of Environment (Hon. Mr. Pelton) is here today as well.

This morning, Mr. Chairman, the new regional senior medical health officer for the Capital Regional District indicated in a news story that he is deeply concerned about the discharge of raw sewage through short outfalls and to nearby beaches in the Victoria area, particularly along the area that probably all of us in this House know, the Dallas waterfront. He says that apart from the direct health implications it's quite unforgivable for an area as beautiful as greater Victoria to be discharging its raw sewage out into the saltchuck that affects the beaches.

The Minister of Environment is leaving; perhaps he will also refer to this particular issue and we can talk about that later. But I wish to address the Minister of Health at this time. There has been for a number of years, I suppose. a controversy surrounding the dumping of raw sewage, but I don't think there's any disagreement that the washback and the effects of this unhealthy habit are once again coming to the front. This morning we have the senior medical health officer for the Capital Regional District clearly indicating that something must be done. I hope the Minister of Health is also concerned about this.

When I was on the Capital Regional District health committee we were starting to look at the coliform counts that were coming on the air currents back into some of the areas around Fairfield and Gonzales, creating a number of health concerns in the community,

I am wondering if the minister is aware of this situation, if he is taking a course to get involved in this particular health issue, whether he is prepared to get together with his various colleagues who also have responsibility for sewage disposal and once and for all come up with a sewage disposal system that is healthy, not a system that's basically very primary — a grinding-up system. an Osterizer for sewage — straight out into the chuck, and with the health implications coming back to haunt us. Is the minister prepared to take a look, with his

[ Page 5878 ]

colleagues and with the CRD, at proper treatment for sewage in greater Victoria and once and for all get rid of this unsightly, unhealthy item from our beaches and our beautiful waters off Victoria? Could the minister give an initial response to that issue?

HON. MR. NIELSEN: Mr. Chairman, we have a responsibility, and the medical health officer who works for the CRD has a responsibility, of identifying that which might constitute a health hazard or a health problem. It's a seasonal concern as spring threatens. Each year we have the same report from each municipality that has beachfront property — exactly the same. It's been going on for many years. In fact, I wonder if the same story isn't printed each year with a different name, should the medical health officer have changed. It's the same problem. It's been a controversy for the last 25 years at least.

There is nothing in the system which prohibits the Capital Regional District, or any member municipality, from installing a sewer system to whichever standards they may wish to have. Nothing prohibits the installation of a sewage system, to whatever standards they feel is necessary. We don't prohibit that. If they wish to install one, they have every right to go ahead and install one. They may argue that it should be cost-shared in some way. We certainly don't prohibit them. They can have any type of sewage disposal system that meets their needs.

If their sewage disposal system constitutes a health hazard, that's a different matter. The medical health officer has the responsibility to determine if a health problem exists. Then, perhaps, certain orders are issued, and certain bylaws are passed. But the Ministry of Health certainly doesn't prohibit any such action.

[2:30]

MR. BLENCOE: I'm pleased the minister has admitted that he has some important responsibility in this particular area. I think one of the problems is that the issue is not necessarily seasonal; it's with us all the time. The issue is raised maybe two or thee times a year, basically because it is a constant issue in the greater Victoria area. I don't think there is one resident in the greater Victoria area who would not support a proper sewage treatment facility to deal with this important issue. We are tired of living with you-know-what off our backyard, in the water and on the beaches, and our children....

AN HON. MEMBER: Say it, Robin.

MR. BLENCOE: Yes, I'll have to say it in a minute.

One of the basic problems we have, Mr. Minister, is that we have a government that has to some degree reneged in terms of taking some financial responsibility and, I guess, some responsibility in setting some direction with local government, to ensure that the health aspects are taken care of. Will the minister, now that he's admitted that he has some responsibility, agree today to indicate to whomever of his cabinet colleagues have to find the cost-sharing for proper sewage treatment...? Is he, as one minister in cabinet, prepared to support sewage treatment in the greater Victoria area, and give provincial government financial support for cleaning up our beaches and making Victoria a safe, healthy environment once again'? All the studies are there that it is not at this time. Will the minister support that?

HON. MR. NIELSEN: Mr. Chairman, I don't know where that member has been hiding for the past quarter of a century, but this controversy has been around for at least that long, and the Capital Regional District and its member municipalities chose in the past to do nothing about it. It was cheaper to dump it at sea, and that is what they have chosen to do over the past while. Other municipalities which did not have the convenience of dumping it at sea chose to take the time and effort to install a sewage system. The Capital Regional District did not.

So don't suddenly discover it because the wind is blowing in the right direction. The problem has been here for a long time. The members of various councils in Victoria, including you when you were there, did not solve the problem. I don't remember any resolution coming forward from the councils to solve the problem. It's not uncommon for people to say to someone else: solve the problem for us; all it takes is money. But where have the municipalities and the CRD been over the past quarter of a century when it was identified as a problem? Why was it they opted for the lower cost of extending the pipe? I didn't notice a big hullabaloo and great excitement about installing a treatment centre that might solve the problem. The resolution was to extend the length of the pipe. That's the action they took. At that time and in subsequent years the formula was as it had been for many years — the 2-mill formula. I did not see those municipalities taking advantage of that formula when it was available at that time, as other municipalities in the province did. So it's hardly a new discovery.

But, Mr. Chairman, the medical health officer is responsible for determining if that constitutes a health hazard — not a nuisance, a health hazard.

MR. BLENCOE: Well, to some degree there is a lot of history in this issue. The minister is quite correct. I don't disagree with that. However, there have been a number of occasions, and one I particularly remember, on which the CRD.... I believe Bob Wright, who was formerly chairman of the B.C. Steamship Company and a good friend to this government — I don't know whether he still is — tabled a report indicating that treatment was the solution and wanted provincial support for that particular answer to our sewage and health problems in the greater Victoria area. At that time, and I'm going from memory, I believe the minister responsible was the minister now responsible for energy, who then indicated that there was no provincial support for such a program.

Let's leave that behind. What I'm asking today — and we've asked many times.... At least, maybe we can agree that we do have a problem. Forget the history and let's say that maybe the time has come for all those involved in this particular issue, particularly at the CRD level and at the provincial level, to get together to see if the province is prepared to give some support for proper sewage treatment. The basic reason why the local people won't go for it is that they feel that putting the financial load of sewage treatment onto the real property tax payers in Victoria would be just too much of a financial burden. There also has to be some movement from the provincial side.

All I'm asking the minister today, if he does indeed believe that there are some health problems and that he as Minister of Health has to take some responsibility: is he prepared to discuss this with various colleagues in cabinet, and indicate to the CRD, who I know want to have a proper

[ Page 5879 ]

way of dealing with this health problem in the greater Victoria area...? Can we get some resolution and get proper sewage treatment in the greater Victoria area? That's all I'm asking for today — some recognition that we can start to get the parties together, that the provincial government won't say again that they are not prepared to give some sort of financial support to proper sewage treatment in the greater Victoria area.

I also have to say that it is not only a health problem, Mr. Minister. You know, we're always talking about the beauty of this island and the tourism potential, etc.

MR. CHAIRMAN: Hon. member, we seem to be straying somewhat from the estimates of the Ministry of Health. Inasmuch as the debate centres around a health issue, the debate is in order; inasmuch as it centres around issues that might be better discussed in other ministers' estimates, it is out of order. To the Health estimates, please.

Interjection.

MR. BLENCOE: Well, I won't sit down. I know that some members want me to sit down, but this is a very important issue to greater Victoria residents, particularly those residents in Victoria who have had to deal with this issue for — and the minister is right — years and years. It's time we had some proper resolution, and that we resolved this unsightly and unhealthy situation. All I'm asking is that the minister at least admit today that he is prepared to look at some kind of cooperative framework to deal with sewage treatment for health purposes in the greater Victoria area. That's all I'm asking — not to go over the history. I know the minister can't say he's going to announce some big grant. I know he hasn't got the power to do that, because it covers a number of ministries. But are we prepared, once and for all, to take on this issue which is important to every single resident in greater Victoria?

HON. MR. NIELSEN: So as not to offend the standing orders, Mr. Chairman, I would refer the member to the issue under the Minister of Environment, who is responsible for such matters. As it relates to health hazards, should they be there, my ministry's estimates provide for certain funding for medical health officers, whose job is to determine health hazards occurring. But I'm afraid I have no money in my budget for the funding of sewer systems. The Ministry of Environment and the Ministry of Municipal Affairs are involved in such matters.

MR. MacWILLIAM: Before we adjourned for lunch I mentioned that I'd like to come back to some specific concerns in terms of health issues in the north Okanagan. I'd like to address those at this time.

The minister may recall that a few years back a new wing of the Vernon Jubilee Hospital opened. Coincidental with that opening an entire floor of the old wing was closed down and remains closed down at this point. I think there are approximately 40 beds involved. They remain empty, although the wing has been refurbished and remodeled. It's a strange feeling to go in there and look at an entire floor that remains virtually ghostlike.

The hospital, according to the latest reports that I have at my disposal, faces an expected deficit of about $900,000 in their budget for this year. The minister may not be aware — so I want to bring it to his attention — of recent proposed decisions by the board in light of this budget shortfall. I refer him to a recent article — April 1985 — in the local paper, the Vernon Daily News. It says:

"The Vernon Jubilee Hospital board of trustees may be forced in the next two months to make decisions that will see bed closings and staff layoffs in order to reduce a budgetary deficit expected next year.

"...plans are being made now for the cutbacks, even though the hospital has not yet been told how much provincial government funding it will receive for the 1985-86 fiscal year."

Twenty-five beds out of the 155 beds at the hospital are planned for closing for the period from June through to September.

I would like to point out to the minister that those 25 beds, as has been mentioned in the paper, are in the surgical ward, and the closure of the 25 beds in the surgical ward will effectively reduce the capacity of the ward by, I believe, one-half for the months of July and August. I might also point out to the minister that the months of July and August are a critical time for the hospital in terms of delivery of health care because it is then that the tourist season in the Okanagan Valley is at its peak. In discussions with one of the local surgeons and one of the anesthetists in the hospital, I was informed that these are in fact the peak months for the operation of the surgical ward. It seems rather difficult to justify the reductions in the operating room capacity at this busy, busy time.

The waiting-list for elective surgery — from my discussions with members on the hospital board as well as with physicians — is approximately four months. It is estimated by extrapolation that the waiting-list will increase to at least six or seven months by the end of August or September, reflecting the reduced capacity as a result of the closures.

Dr. Hartley, who is a local surgeon and also one of the city aldermen, has called for the hospital board to consider a number of alternatives. One of the alternatives that Dr. Hartley has called for is a suggested reduction in administrative staff. I might point out to the minister that the senior administrator in the hospital receives in the neighbourhood of $100,000 a year at this time. It seems incredible, with the top-heavy administrative load in the hospital, that we're cutting at the wrong end of the stick. Perhaps we should be considering trimming some of the fat at the administrative level. These are some of the recommendations that have been made.

I have two questions for the minister in terms of the immediate crisis that the hospital faces. Number one, will the minister advise as to the decisions of the recent ministerial review conducted at the hospital? Will the minister enlighten the House on the recommendations from that review committee? The process, I believe, has been completed, and recommendations are forthcoming.

Secondly, I wonder if the minister, in light of these facts that I've just brought to his attention, would consider a makeup in the funding shortfall of S900,000, which would help avert the unfortunate and, in my estimation, the unnecessary closure of these operating facilities.

[2:45]

HON. MR. NIELSEN: Mr. Chairman, there is no crisis at the Vernon Jubilee Hospital. They may indeed be projecting a $900,000 deficit; they may have that money in surplus and be quite prepared to balance it off.

[ Page 5880 ]

July and August for closure of surgical wards is certainly not unheard of. It's been a tradition for many years. I'm not quite sure what the member means: the waiting-list is four months. Surely someone is receiving elective surgery today; they're not waiting four months. I don't know whether you mean that they have people who are waiting for four months. Well, I hope they have people booked four months in advance. What are we going to do? Close down the surgical wards in four months' time? Of course they're booked in advance. They're probably booked a year in advance in some instances. I don't know what you mean by "a waiting-list of four months." We have doctors who have a personal list of over a year; they have people booked for surgery a year from now. Hospitals do not function on a 24-hour renewal basis. They plan; they book surgery months in advance, because it meets certain people's own personal agenda, the surgeon's agenda and the hospital's agenda. In fact, Mr. Chairman, they had better plan in advance. They can't decide on what surgery is going to happen next week and not think beyond that; that would be nonsense. There is always going to be a waiting-list. If there isn't a waiting-list, you've overbuilt, obviously. Are you going to go out and solicit business?

There is no crisis at the Vernon Hospital. We're in contact with the boards regularly; we review their operating budgets quarterly. They know the name of the game: they run a deficit, they pick up the deficit. I believe there are 30 beds scheduled for opening in October. At the present time it is on schedule at least: 30 of the 73 new acute-care beds are due to open in October 1985.

Mr. Chairman, when I visit a hospital and see there are surplus beds, I am far more pleased than to see a hospital operating beyond 100 percent capacity. One of the reasons we added the 100 beds to that hospital in 1983 was to build for the future. We weren't just trying to catch up; we were building for the future. That's not uncommon in many hospitals in the province.

The member is wrong to say there is a crisis at the hospital. Maybe in his mind, but it is not a crisis in the minds of the hospital or the ministry.

For that member's information, the administrator is apparently paid $78,000 a year, and he also is administrator for the Armstrong hospital and at least one long-term care facility. That would pay for about three-quarters of an acute-care bed for a year.

MR. MacWILLIAM: In response to the minister's rebuttal, the words that I used are merely the words that have been accounted to me through discussions with the physicians and the health care professionals at the facility. I might remind the minister that at a time during the summer months when the surgical ward is in its reduced capacity, all elective surgery is effectively shut down. I don't understand how the minister can deflect that as being just a normal situation. I have been told that there will be no elective surgery for July and August as a result of attempts to make up the budgetary shortfall. Naturally we do have waiting-lists; I agree with the minister. But the fact that doctors themselves have waiting-lists that exceed a year may indicate that in fact the reason for those waiting-lists is that they can't get placement on the hospital waiting-list. I mean, to be waiting over a year for surgery seems completely incomprehensible to me. However, the facts speak for themselves. The potential is that elective surgery for July and August will be shut down if the budgetary shortfall is not made up.

Moving on to a very local problem. The minister in his realm of responsibility may not be familiar with this, so I'll outline the details to bring it to his attention. It may seem a minor problem but in a small community such as Winfield, which is located between Vernon and Kelowna in the Okanagan, it does have I think a major social impact.

The Ministry of Health has just recently prohibited the use of dishes and cutlery in the hall for gatherings of larger than 50 people. The reason for this is the fact that the hall at this time doesn't have a commercial dishwasher, and they have recommended that there be an installation of commercial dishwashers in the hall. Now this has actually caused quite a ripple in the community, because the hall is very central to a lot of the community functions. The hall has always met with Ministry of Health regulations; in fact, the hall has been deemed adequate for over 70 years now, and it's rather puzzling to the community to suddenly have this change of heart by the ministry.

I might add that the estimated cost of installing commercial dishwashers to meet with the ministry's recommendations is, in round figures, about $10,000 for that community. The hall is owned and operated by the community. That community is presently experiencing in excess of 20 percent unemployment. It creates a very difficult situation, a hardship on the residents of the community, to raise these funds for the installation of the commercial dishwasher, and what it means is that the hall will virtually be closed down to many of the community functions.

I would ask the minister three things on this. I wonder if, in light of this evidence, the minister would reconsider this seemingly heavy-handed approach to the regulations. After all, they have survived quite well for 70 years without a commercial dishwasher. Secondly, I can understand the concerns in terms of upgrading the hygienic aspects of handling dishes and food, but would the minister consider providing a time-frame for the acquisition of sufficient proceeds to purchase such equipment? And lastly, would the minister consider that this time-frame, say of five years, would be appropriate for raising such funds? What I am concerned about is that the hall is going to be lost to a lot of community functions if these regulations have to be adhered to as stringently as proposed.

HON. MR. NIELSEN: Mr. Chairman, I guess it's a situation of whether you enforce the regulations or you don't. Certainly I recognize that at times enforcement of a regulation simply because you feel you should enforce it can create hardships and apparently in some circumstances appear to be a rather unreasonable thing to do.

I'll tell you what, I'll make you a deal. I'll contact the public health officer in the region and find out precisely what their concern is. Obviously they are concerned about food poisoning or salmonella or something, but I'll find out why they feet there is any reasonable cause for alarm. I will also ask them, through our officials, if perhaps they might advise the people who run the hall of certain other processes of dishwashing that might overcome some of their concerns, and perhaps see if indeed they can develop a method whereby they could be given a period of grace in which to install a commercial dishwasher. The deal I want from the member is this. In the event of a breakout of food poisoning at the hall, I would ask the member not to raise too much of a stink, considering he requested we perhaps not enforce those regulations.

[ Page 5881 ]

Let me ask the medical health officer there what the problem really is. I agree with you; for half a century they've functioned. I would like to know if there have been incidents of problems in the past, and whether it is in response to something current or quite recent. But sure, I think you're quite right in saying why not let's consider the reality of the situation right now and see if we can't offer them some relief. I'd be more than pleased to do that. But I think, Mr. Member, basically it is whether you enforce a regulation or you don't enforce a regulation, and we'll be pleased to get a report from the public health officer to determine why they feel it's absolutely essential that it be changed at this time.

I don't know what kind of a dishwasher they're buying for $10,000, but I guess it's pretty heavy-duty.

MR. MacWILLIAM: Well, I must say I do appreciate the minister's response on that, and to my knowledge there hasn't been any outbreak of food poisoning or problems as a result of the present methods. However, my thanks, and I think that if we look into it, we will see that there may be a way to work around this whole problem. I know the residents of the community will be very pleased if in fact that is allowed — giving them a reasonable time interval — and that they will work toward that.

There is one other issue that I would like to bring to the minister, in terms of clarifying some comments that the minister made in a statement a while back in regard to Shaughnessy Hospital and a particular patient, Mr. Chris Busby. This is more or less to enlighten the minister on some of the facts that I had at my disposal, and unfortunately I wasn't available the day the minister did make the statement. I would just like to take a minute or two to brief him on some of the facts that I had garnered.

As the minister may recall, Mr. Busby is a patient of a Dr. Van Peteghem and is scheduled for spinal fusion at Shaughnessy Hospital. I might mention to the minister.... He was actually correct in bringing me up short on my statement that the patient had been waiting for surgery since 1983. In fact the injury occurred in 1981; however, I guess through the process of the review board at Workers' Compensation and what not, he didn't get final approval for surgery, apparently, until September 1984. It does raise an issue in my mind as to why it took from 1981 to 1984 to go through this process with WCB.

However, other than those simple facts of the dates involved, I don't have any other specific information in that regard. But it is interesting that it did take that time, and this patient was in considerable pain during that period. However, since September 1984 when he was recommended for surgery, he went on the waiting-list, I guess, at Shaughnessy Hospital on October 1, 1984. The issue that brought it to mind was a letter from Dr. Arnold, who is also his family physician in the Okanagan. He was most concerned that the operation had been continually deferred. In fact, the last correspondence he had was that the operation would be put off until the summer of 1985.

[Mr. Ree in the chair.]

Now the reason I state to the minister.... These are not my words but the words of Dr. Arnold. The reason given was the bed closures at Shaughnessy Hospital. That is stated in his letter to me. I contacted Dr. Van Peteghem.... Before I get to that, perhaps I'll read the wording of the letter to me to verify this to the minister. This is a letter from Dr. Arnold of the medical clinic in Vernon: "On three occasions, we were led to believe surgery would be anticipated in the near future as dates got close. We heard nothing from Vancouver. It was explained at this time that these delays basically had to do with the recent cutbacks at Shaughnessy. This had significantly affected Dr. Van Peteghem's OR time." That's a letter under the signature of Dr. Arnold.

Now in contacting Dr. Van Peteghem, this is what I turned up in my investigation. Dr. Van Peteghem had confirmed that there was a significant backlog of surgery at Shaughnessy, and his comment was that he believed this was a result of the reduced availability of the operating facilities. Scoliosis surgery has a waiting list exceeding one year. I realize that Dr. Van Peteghem has some special needs in terms of his specialty that perhaps go beyond the needs of normal surgery, and that the waiting-list may not be as extensive for other types of surgery.

However, he related to me that there was a defined need for more adequate facilities to handle the load of specialized back surgery. One of the disturbing things that he mentioned — and this was confirmed with discussions with hospital personnel — was that the operating facilities were reduced by 75 percent between December 7, 1984, and January 11, 1985. Basically they shut down everything but about 25 percent of the OR facilities. This apparently was to reflect cost-cutting measures.

Now the minister earlier in his statement of rebuttal did infer that the waiting list at Shaughnessy was not extensive. In that respect, he is right. The waiting list on the books is not that extensive. I did find out perhaps some of the reason behind this. Prior to November 1984, the hospital allowed only six weeks' advanced booking. In other words, a physician, if he had a patient he wanted to get onto the waiting list for surgery, was only allowed to book six weeks ahead. So that would cap the limit for the waiting-list described by the hospital.

[3:00]

Now the minister had also criticized Dr. Van Peteghem's dumping of 170 patients onto the hospital roster during November 1984. Well, in discussing this, I found the reason. The reason was that in mid-November all the physicians, apparently, at the hospital were requested by the hospital to submit backup waiting-lists in order to determine the true size of the backlog. This was the reason for Dr. Van Peteghem submitting that list of 170 patients that he had backed up for surgery. There are a lot of confusing and extenuating circumstances in this matter. It's certainly not clear cut. I guess the crux of the issue does come down to the fact that this poor chap, who is in considerable pain........ The injury occurred in '81. It seemed to go about three years before they could finally decide what to do — I realize there's a lot of consultation involved — and then after that deferments on the surgery date.

I'll ask the minister two specific questions. First, was the minister aware of the unregistered backlog that the hospital was keeping off the rosters with this six-week cap on the waiting-list? Secondly, does he know how extensive the backlog actually is? I'll leave him with that.

In summary, I'd like to point out that as a result of bringing the issue to the House and the minister's response — I don't know if we had anything directly to do in the final process — Mr. Busby has finally had a definitive surgery date booked: June 13. Whether you or I or anyone in between was

[ Page 5882 ]

in any way involved in the process, at least we've got him into surgery; that, after all, is the critical issue. Apparently he will receive treatment at that time.

I'll sit down now and let the minister answer those questions.

HON. MR. NIELSEN: Mr. Chairman, the officials at Shaughnessy Hospital say the only way to really resolve this particular problem is to have some other specialists trained in this particular area. Dr. Van Peteghem went to the United States and took a special course which provided him with the expertise to be involved in this type of surgery, which apparently a large number of people require. The hospital says it is essential to have at least one other specialist trained in the same thing, because Dr. Van Peteghem simply cannot maintain that schedule. It is also suggested that some of Dr. Van Peteghem's patients possibly could be treated by other specialists, because not all of them are suffering from precisely the same problem. It has been suggested that because of his particular notoriety and the respect in which he is held, general practitioners routinely refer their back patients to this doctor. Naturally it requires a tremendous amount of diagnosis on his part before he can determine if perhaps he is the only person who can develop that technique. He now has, I believe, a waiting-list in excess of 200. So it's continuing to build.

Mr. Chairman, the injury may have occurred in '81, but that does not necessarily mean there was undue delay in determining that surgery should be performed. Surgery on the back is not gone about lightly. I injured my back in 1965 and I haven't yet agreed to have surgery, and it is unlikely that I will. But obviously, after the injury.... I am sure that in 1981 various other methods were attempted to correct the problem rather than go for surgery, which many specialists consider to be a last resort. So that period of time I think could be reasonably explained.

I'm pleased that he is booked for June 13. We were in contact with him and with the doctor and the hospital, but I can assure you that we did not offer influence of any kind to put the patient ahead of other patients. That would be the doctor's decision.

The Shaughnessy people do an outstanding job in spinal cord injuries and back surgery. We are working with the hospital. We hope we can develop a method whereby at least one other specialist will develop the same level of expertise to permit some of the backlog of that particular type of ailment to be recovered. I might add that I have asked the staff — we have received references to this doctor from other people — to review the situation, as we did the open-heart situation a couple of years back, to see if we can make some modifications to try to take care of some of the backlog in this particular area. They are actively working on that now.

The closing of a hospital surgical ward or area during the Christmas holidays is not unusual at all. Hospitals may take advantage of that period of time when a tremendous number of staff are going to be away to simply close down a unit rather than have it function at less than capacity, and they just reschedule. They do indeed save money, but they also probably develop far better efficiencies through that year than by trying to operate a surgical ward or operating theatres with inadequate staffing, when they might be subject to a tremendous number of cancellations simply because of inadequate staff.

MR. MACDONALD: I just have a couple of simple questions to the minister. In terms of low back problems, the strange thing is that abdominal muscles support the back, and if you strengthen your stomach you sometimes avoid an operation — sometimes, not always. But I just throw that in as free, medical advice. It's not my question.

My question is about fee-for-service payments, which are going up in this year's estimates by $49 million, from $464 million to $513 million. There have been very great increases in previous years, but I'm not going to go into them now. That's about 13 percent. Why is the minister budgeting another 13 percent for fees for service?

HON. MR. NIELSEN: The increase in the budget for fee-for-service payments is 3.5 percent over last year's actual costs. We agreed to increase the budget by 1.5 percent to cover population and 2 percent for utilization. I appreciate that it is that percentage increase from blue book to blue book. In addition, the agreement with the BCMA this year will provide that, should the budget be exceeded, members of the British Columbia Medical Association will absorb the first 4 percentage points of any overrun. That would amount to about $36 million.

The member would know that there has been no increase in the fee schedule itself. It remains as it was last year. There was a 3.5 percent increase over last year's expenditures in the budget. We're experimenting a bit this year with the concept of overruns and shared responsibility by the BCMA and the ministry. They have agreed — I hope they've signed it — that they will cover the first four points over the budgeted amount. One percentage point is approximately $9 million. We have the highest fee schedule, although the doctors argue that they're not the highest paid.

MR. MACDONALD: Mr. Chairman, I note, though, that the fee-for-service.... I realize that includes something for the dental and something for the disability plan — $1.9 million — that the doctors receive, which some other groups in society do not receive. But it is going up from $464,800,000 to the 1985-86 estimate of $513, 079,000. That's 13 percent; that's not 3.5 percent. Is that a mistake? What explains that astronomical increase of $49 million?

HON. MR. NIELSEN: Mr. Chairman, the actual cost of the Medical Services Plan last year exceeded the blue book estimate. This year's budget has a 3.5 percent increase over last year's actual expenditure. That's why there's a variation. The BCMA did agree to no fee increase and the balance of that formula as I outlined it.

MR. MACDONALD: The minister will be familiar, I suppose, with some of the figures in the blue book, and some of them are quite astonishing, if I may say so. You have a Dr. M. Fisher who in 1983-84 made.... I shouldn't use the word "made." How much staff is involved there I don't know, but it was $496,401.38. I have difficulty understanding what the 38 cents would represent. One stamp, I guess; I'm not up to date on the Post Office. But $496,000........ This man, I believe, was formerly with the methadone clinic. He's been dispensing Valium and so forth. This is public money. How can we justify that kind of money going out of the Medical Services Plan? How big was his staff? Does the minister know? Did he have another doctor working with

[ Page 5883 ]

him, or a nurse that had to be paid? That's almost as much as we're paying in the coalfields.

HON. MR. NIELSEN: Dr. Fisher was the subject of.... I believe the methadone-dispensing permit was withdrawn. We have increased our staffing of our methadone clinics, and we are encouraging those people to go to the clinic rather than to a private practitioner. They still have freedom of choice, but we are encouraging these people to go to the clinics rather than private practitioners for two reasons: one, because the cost is considerably less; secondly, our own clinics have far greater control over the maintenance of the patient.

The member may recall that over the past year there was a major action taken with respect to a number of doctors in the Vancouver area who were dispensing certain drugs. They were subject to investigation, and charges were laid which led to the disposition in the courts. That area is under very strong investigation by the provincial and federal authorities, and there are some resolutions, hopefully, coming forward.

But the $496,000 would not win him first prize in the sweepstakes. There would be others, you would note, who are upwards of $600,000. They argue that much of that is for overhead and perhaps other staff. There are, however, individuals who are nearing the half a million mark, and it is argued by the BCMA that that is a direct result of extreme dedication and very hard work. I'm sure that they are dispensing medicine quite properly, but it's a bit alarming to see such huge amounts of money going to a single practitioner. The average is much lower than that, of course. There are anomalies in the system; there's no question of that. The fee-for-service program generally works well, but obviously there is an opportunity for taking advantage of it.

We hope that our agreement now, whereby a percentage of any overrun is shared, might bring about some discipline within the medical association itself, with respect to the high rollers.

MR. MACDONALD: Mr. Chairman, what the minister is saying is that he's sympathetic to some extent with the question. What about the $496,000, not for serious operations but for dispensing Valium and things of that kind when there are other people lined up at a food line without enough to feed themselves? Is the government taking any action? Does it have nay power to recover any of that money? That is very big money. I don't think this man had any big office overhead. I know there's a study in Price Waterhouse of the average overhead of the medical profession. It is said to be 40 percent, but of course that document is not made available to the public, who just pay the bills.

[3:15]

You've got another doctor there — you've got to be careful of the initials — Dr. W.H. Ross: $632,608.35 in this case. Is the government not interested in making this blue book reflect reality? Why not publish the true facts with public money? This Dr. Ross may have had two or three associate doctors with him, or he may not; he may have been paying a big salary to his nurse, or he may not; he may have been going to all the medical conventions throughout the world, or he may not. This is big money. It's staggeringly big money, with no explanation. Is there any other department of government where public money goes without an explanation or a check in this fashion?

My particular question is: will any efforts be made to recover any part of that money from Dr. Fisher?

HON. MR. NIELSEN: Mr. Chairman, the patterns of practice committee reviews the caseload of doctors and the amount submitted to the plan. We are obliged, under the agreement with the federal government, the Canada Health Act and our own act. to pay for insured services rendered, and if a physician is indeed rendering an insured service we are obliged to pay the fee agreed upon for that service. If it is suggested that any doctor is not performing the service or, because of volume, may in some way be negligent in performing his duties, then that is subject to peer review, either by way of the patterns of practice or the College of Physicians and Surgeons.

It is argued that a physician practising medicine quite properly can bill the plan for half a million dollars. That's a tremendous amount of money. We question whether it is something we should encourage or tolerate. We certainly don't encourage it. We do have some methods of reviewing; we have certainly put the message out, and the BCMA have also put the message out, of the concern about these very high billers.

What we publish in the blue book is simply the amount charged to that doctor's billing number. He could have associates and it may just be billed to one number It would be very difficult, I think, to publish the information and break it down as a matter of course. Much of the information is only known to Revenue Canada.

Mr. Member, I might point out that the blue book figure is what the Medical Services Plan pays to the doctor. What he may earn on the side is not known to us — whether he works for an insurance company or works for a private corporation or has private patients or whatever. That's just what we pay.

MR. MACDONALD: Mr. Chairman, I believe what I consider to be a solution to this problem.... It's a very difficult one. I may speak on the numbers bill that the minister will be bringing in, because this attempts in one way to address that problem. But I think it was W.A.C. Bennett who said: "Let's have a blue book so that we'll have some control over them." But it's just partial information. It doesn't say how many doctors; it gives the billing number and the gross. In some cases there is heavy overhead, depending on the kind of practice. In other cases the overhead for some of the surgeons, some of whom I know.... They are $200,000 to $300,000 a year, and some of them have very little overhead at all because the hospital is providing the overhead. I won't mention names. and some of them you see every afternoon. No doubt they do good work. Who knows whether they do more work than was really necessary?

So really, Mr. Minister, with all respect, I think you have a system that's running out of control. You could easily require fuller information in the blue book than W.A.C. Bennett thought was necessary at that time, including overhead and the number of people who are participating in a professional way in receipt of that income. That's a simple thing to do. But at the moment the system seems to be just running out of control. I think if you mixed them in, as our provincial council said on the weekend, with some community health clinics with salaried personnel.... You're going to have a surplus of young, capable doctors looking for employment. Now they won't be able to get a number and bill.

[ Page 5884 ]

We should have health clinics that prevent illness as well as treating it and do so at a reasonable cost to the public, because this is one area of government that's just running right out of control.

MR. MITCHELL: Mr. Chairman, it might sound a little strange that I'm going to start off and maybe congratulate the minister and the ministry. The project that I would like to thank him for and congratulate him on is the trial program of the adult day-care centre that has been opened up in the Juan de Fuca Priory extended-care hospital. From talking to a number of those involved both at the voluntary level and the hospital level, they're very pleased that they were given this opportunity to make something that a lot of us in public life, a lot of us in the community, have been trying to get the community, to get the society, to get the medical profession.... We have been trying to get them to understand that it is better to keep people in their homes if possible, and if that takes a day-care centre.... I'm not really happy with the particular name of adult day-care centre, but I think the concept that people have an opportunity to come to get the socialization, to get the meals, does fit into the whole concept that many of my colleagues have been talking about: to bring the concept of community clinics into reality.

I believe there have been many studies that we must look at a completely different approach than the present illness-payment procedure that we have in the medical costs today. I believe that the ministry has made this one pilot project of the adult day-care centres. There has to be a serious look at setting up some type of community clinics, some trial programs in an area such as a city or a community, where it can be tried, where a selection of doctors on a wage can be there to give the medical treatment. But in conjunction with that, there has to be a better utilization of the support staff in the medical profession — the nurses, the therapists. I'm not advocating that we set up the barefoot doctor routine that is in some of the Third World countries, but I think we must utilize the particular expertise that is available. Presently, because of the legislation and agreements, everything has to be funnelled through doctors. I think there's a lot of knowledge out there that is not being utilized to its best.

I don't want to go too far in the community clinics, but I think the minister should give that a serious look. The continual cost that goes into health care is fairly terrific. We can pick headline grabbers out of the blue book but I don't think that's the answer. I think we have to do the deep study that is needed.

There are a number of other questions I would like to cover. I brought this one to the minister on a number of occasions, and I brought it up last year. We still have not recognized that the cost, the per-day fee for extended care, does hit a certain minority of families a lot harder than the general public perceives. A lot of people think of the extended-care hospital as only for senior citizens who are getting their old-age pension and their various supplements, and that money goes to cover the $14. There is a group of working people who do have wives and husbands in extended care, and that continual $14 a day, plus the cost of maintaining the home, of looking after children, the additional needs.... If it's the mother in the hospital for a long period of time, the extended cost that the husband has for housekeepers, etc. is a drain.

I've asked the minister and the ministry to give it some serious consideration. If it's a senior citizen and they have ample funding to cover it from their pensions, that is one case; but where there is extreme hardship, extreme cost, we should not allow one group to go into economic bankruptcy because of medical costs. In the modern world of today, I am sure British Columbia can afford to provide that service for everyone without the heavy cost.

I have listened to the various statements that the minister has made on funding to hospitals: that all hospitals are in great shape and are living within the budgets. It's hard to understand why there have continually been cutbacks. With the new taxation that was brought in, in 1984-85 and 1985-86, we are bringing another $166 million into the system. With that extra money, is it justified to have the continual cutbacks? I know that in the hospital in my own riding — the Victoria General on Helmcken — the cutbacks are not obvious until you talk to the patients and to the nurses. The underfunding, as some administrators will call it, has set up a situation where they don't have the money to cover people on sick leave, or people who haven't turned up, so the nurses who are working have to cover that extra load.

I don't know if it's an attempt to get at nurses who may abuse their sick leave, or anything like that, but I don't think that method should be used. If a nurse is required and if the patients need that service, then it must be provided somewhere. If there is any intent to discipline people, then it should be done on a different level. There should be sufficient moneys to cover any sick leave or shortage of staff.

This is some of the information that is coming from nurses' associations and from groups — that it seems that every week or month the nurses on staff have extra duties to do and are running a little bit faster — although I haven't found any particular patient who has any complaint about the nursing services that they're getting — and they recognize that the pressure they're under is becoming quite terrific at times.

[3:30]

1 would like to change the topic, and follow up two of my colleagues. Something that the member for North Okanagan (Mr. MacWilliam) mentioned is a particular problem that we've had on a number of occasions. When you have someone under the Workers' Compensation Board appeal or review board getting medical treatment, I can't understand why, if a doctor has ordered or prescribed an operation, that operation can't continue, under the hospital or medical plan.

I had one particular case where I did suggest to the doctor to go ahead with the case, knowing that we had a year to wait for the review. But for the last six months before the review there was a continual harassment from the doctors and the collection agency because that particular person was not able to make the payment. I spent a lot of time writing letters and making phone calls to tell the collection agency that the charge had been passed by the doctor onto that level because somewhere along the line his particular bill for the operation was not picked up by the system. I mean, eventually we won the appeal and it was all covered, but there is that harassment that I don't think is needed today in our medical system.

I know there are particular cracks in the system that people fall through. And they seem to all come into my office when they have those problems. It's something that I think there should be some study made of so that people don't have that worry about the costs.

One other problem that has bothered me, and I've spoken on this particular issue on other occasions, is the lack of

[ Page 5885 ]

proper enforcement by medical health inspectors on the problems of septic tanks. Ever since my election in 1979, I continue to have constituents coming to me with problems of malfunctioning septic tanks. When you do the background study and they're dug up, somewhere down the line that land would never have perked. Somewhere in the health inspector system, property that did not perk properly was allowed to be subdivided. There have been inspections made, and as you go along through them they aren't functioning in accordance with the regulations. After about five years of this we have managed to get two particular cases before the courts, and there have been settlements. But they were $11,000 settlements that had to be made. You can say that it didn't come out of the ministry or it didn't come out of the CRD, but it did come out of some insurance. But I think, where you have cases of malfunctioning septic tanks that have been inspected at the initial level when that particular property was subdivided, that someone is not doing their job. And I think that, from the minister through the ministry and down to the regional health officers, there has to be a tightening up on that particular problem. It's not so much that the developer can't develop or the builder can't build, but there is the consumer who buys the home and is stuck with the additional bill. If he doesn't take the process of going through the court system to try and get some redress.... A lot of them are paying $5,000, $6,000 and $7,000 to get a settlement.

In closing, there is one other issue that has been mentioned. At the present time under your regulations it's not illegal to take septic sludge out into the woods and dump it. I know that the regional board in my area and the directors and the various other elected people want those particular regulations tightened up. We all say that it's unhealthy and that there has to be a certain procedure for the disposal of septic sludge, and here we find that according to the wording of the regulations it is not illegal if it is dumped out in the woods and kind of abandoned. I think it has gone to various levels — Crown attorneys and the police have got into it. Is the minister prepared this year to bring in the necessary amendments, the necessary rewording of those particular regulations?

HON. MR. NIELSEN: Well, Mr. Chairman, if the member wishes to let me know later which regulations he is speaking of and cite a couple of cases, I'd be more than pleased to took at them with respect to the disposal of sludge.

[Mr. Strachan in the chair.]

The problem with inspections, I suppose, is that usually the problem developed some time later, and it is not always easy to determine what type of inspection may have taken place in previous years. I think that if a septic tank inspection does take place, there should be no reason for the prospective purchaser of the home to doubt that it is indeed going to function properly, because that is the purpose of the inspection. If it is certified, it certainly should be certified properly, and the person purchasing the home should have no reason to believe that it is not a proper system.

I suppose there are the pressures before us, with respect to any sewage disposal system, that you have mentioned — where it fails later. The greater pressure, however, is on public health officers throughout the province to approve certain forms of sewage disposal and treatment systems — various types throughout the province, depending on the topography, seasonal weather conditions, precipitation and so on. There's probably far greater pressure for public health officers to case up on the regulations than to tighten up on the regulations. It's not unlike the floodplain problems we have in other areas of the province, where it's recommended that you ignore some of the regulations only to later hear demands for compensation because of flood damage.

Mr. Member, I don't know how we're going to resolve it completely, because the regulations which are imposed for sewage disposal, be they septic tank fields or these wonderful Prince George innovations that we heard so much about.... How we would resolve it to the satisfaction of citizens when they are making application and tremendous pressure is brought to bear on public health officers, boards of health or whoever may be responsible, to be followed by, perhaps in a generation or in a decade, complaints that the system has failed.... I'd be pleased to look at the specifics. I know that in your area, particularly, some of the subdivisions which were approved years back in marsh areas have had some serious problems. I know the continuing difficulties we have in northern parts of the province, where weather plays a more important role than the capability of the soil to absorb. I will be pleased to speak to our people responsible for that again and see if they have any thoughts or suggestions. I would simply agree that if a system is approved, there should be every reason to believe it will not fail within the period of time it is expected to perform.

I appreciate the member's comments with respect to some of the adult day-care centre experiments we have conducted in that area. We are cautiously moving forward in certain other areas as alternatives, but I think it is the nature of the business of health that you are generally more cautious than perhaps some people recommend. I think it's worthwhile to be cautious.

On extreme hardship cases for extended care, of course the Ministry of Human Resources can be involved. We're always prepared to look at an individual's circumstance, because there could be extreme hardship that may not have been identified. I believe there is still legitimate reason to have a per diem charge for extended care. Most provinces have it. In extreme hardship cases we're always prepared to look at an individual case, and in certain circumstances the Ministry of Human Resources can be involved.

MR. MITCHELL: The minister asked for specifics. On October 30, 1984, the Sooke forum council sent him a letter outlining the case. He passed it on to the Minister of Environment (Hon. Mr. Pelton), and I have a copy of the Minister of Environment dated January 14. So somewhere in your computer or in your files there is a complete report on it. I can deal with the specifics.

The other case along that particular line is that we have a malfunctioning septic tank in an apartment building. It is running over the ground down into the river, and the health department has given orders to have it corrected. The owner has filed some kind of legal action against the health department, and everyone says they can't do anything about it because there is legal action pending. At the present time you have a septic field that is running over top of the ground and down onto someone else's property, and because of some case before the courts nothing can be done. They say it's a counterclaim, but I say that this sort of legal manoeuvring cannot be allowed to continue to happen.

Teeth have to be put into the legislation and into the ministry through their health officers. I'm getting fed up with

[ Page 5886 ]

going to health officers and inspectors and being given a whole series of reasons why they can't enforce something. If it's illegal, if it's not working, if it's unhealthy, why can't that be corrected? We've gone up through that middle management, and somewhere down the line I think that the minister should look at it and get it straightened out.

HON. MR. NIELSEN: We'll do what we can. I share the member's concern: when lawyers get into the act, even the simple disposition of certain materials becomes complicated and mired in unnecessary actions and counteractions.

Interjection.

HON. MR. NIELSEN: The second member for Vancouver Centre (Mr. Lauk) suggested we get rid of lawyers; is that the comment?

I'll be pleased to follow through with you, and we'll discuss that, because sure, the legal process should not interrupt common sense. It's probably contrary to the Charter if we were to interfere, but we'll look at it.

MR. LAUK: In most areas of society, Mr. Chairman, if you left it to the lawyers, the solutions would be found. It's trying to follow our clients' instructions that gets us confused.

I knew I would have a devastating effect on the minister. Would you like the minister of public works to outfit you with a Jolly Jumper?

Mr. Chairman, I have received a letter from a constituent, and I can assure you....

MR. ROSE: Is it the first one?

MR. LAUK: My colleague for Coquitlam-Moody suggests it's the first one I've received in 13 years.

Mr. Chairman, it's a unique letter because it's the first letter I have received on this topic, although I have received several phone calls from constituents complaining about precisely the same issue. I'll read part of it, but I want the committee to understand that I'm not at liberty to reveal the name or the hospital in question. It's an example, I'll tell you from the outset, of the problem of having hospital administrators and staff collect the per diem from patients and instituting a system that does not bring about indignity to the relationship between the patient and the hospital staff. I'll read this letter in part.

"I was recently a maternity patient at..." — such-and-such a hospital — "for the period...." — it was less than five days. "I would like to complain bitterly about their policy of harassment of patients for payment of their rooms. On..." — and she names a date — "a woman from the discharge office visited my room asking for payment of my room up to my day of discharge. I told her I didn't have my chequebook with me, and neither did my husband, who was visiting me at the time. I said my husband would bring a cheque to them the next day at about 11 a.m.

"When he came to visit me at 9:30, I was paged by the nursing desk and told that someone from the discharge office was waiting in my room to see me. The same woman was again asking for payment. I told her that I had already told her yesterday that my husband would be in about 11 this morning and pay then, which is exactly what he did. The amount of the payment was $192. I did not say anything to the woman as I felt she was only doing her job, but I was furious. I felt I was being harassed and treated as if I was some sort of deadbeat. My husband and I are both employed and always pay our bills promptly and on time. However, I do not feel that that has anything to do with this situation. Since I was a maternity patient, I wasn't exactly ill, but I think about the people in that hospital that are sick. It's bad enough to be sick and in the hospital, but to be treated as if you were some sort of criminal, which is how they made one feel, is both deplorable and unnecessary. The use of the word 'criminal' is how another woman expressed her feelings when they did the same thing to her.

"I realize in this time of recession and high unemployment that there are probably a number of people unable to pay their hospital bill right away. But a sick person does not deserve to be treated in this manner. I have always admired our system of universal medicare as compared to that of the United States, but this incident has certainly brought that opinion into question for me. I hope you will look into this for me and see if something can be done to remedy this deplorable policy."

[3:45]

As I say, Mr. Chairman, one letter does not a summer make, but I have received many phone calls since the per diem policy has been in place, and requested that they write. I suppose that when you do that, a constituent forgets about it or their feelings subside in two or three days and they don't get around to writing. This is one person who, without a prior phone call, saw fit to take the time to write this complaint. Now the minister cannot attend at every hospital and do the collecting himself in his usual charming and diplomatic way, but there must be some way in which the ministry can provide circulars or information or training to people in a hospital setting. It's inconsistent with the proper psychology of patient care to be running around after them like a collection agency in the middle of their treatment at the hospital. It's one of the other wrinkles, one of the other problems, that arises because of the user-pay mindset of the government. The penalties that we're all paying, not only in increased taxation because the federal government has withheld grants because of the government's posture in this regard.... But we're paying also in this way, through these little indignities that amount to serious humiliation for these people in the hospital setting. So I thought I'd put it on the record and bring it to the minister's attention in the hope that he or his officials could look into providing some sort of training, memo, practice note or whatever it is that will assist hospital staff in their relationship with patients vis-à-vis this user fee and its collection.

HON. MR. NIELSEN: Mr. Chairman, we'd be pleased to, and I'll get in touch with the member later; perhaps we can get the time, date and hospital. No one should be subjected to any indignity or harassment in any of our hospitals on questions of payment. I was rather surprised at the procedure outlined by that member, and when we get the specific information we'll be pleased to speak with the hospital and find out why such a situation would have occurred and whether it's occurring more frequently than that one time. I'm rather surprised at the way it's been outlined. It could happen — I've

[ Page 5887 ]

no doubt about that — but we'd be very pleased to look at it specifically.

MR. BLENCOE: This issue is around the Queen Alexandra Hospital. The provincial ministry approved a 25-bed unit for adolescents with acute mental illness in mid-1983. Unfortunately that project has been on hold ever since. There is a great need for this kind of project. Some weeks ago I asked the minister in question period; he said he'd get back to me. I wonder if the minister has any response today, in terms of the funding for this project.

HON. MR. NIELSEN: The funding has not been approved at the level whereby it would then go ahead. It is still in the application stage, if you like; it has not received its final approval. We're familiar with the project, but it has not been approved.

MR. BLENCOE: Will this project be approved in the near future? Can the minister give an indication of that?

HON. MR. NIELSEN: Mr. Chairman, much as I would like to, I cannot give a date. I'm sorry.

MRS. DAILLY: Mr. Chairman, I will be the last speaker on health in this estimate — just to let the minister know he can rest his back shortly — except for the member for New Westminster (Mr. Cocke), who will be bringing up a few areas in health and then moving on to ICBC.

The areas that I want to finish off with today.... One of them is to do with amalgamation. I know that the minister brought in amalgamation in 1984. The reasons for bringing it in were, of course, that it would be more efficient and cost-saving all round. It was supposed to be a positive move. Naturally the opposition was ready to look at any positive move. Well, we've now had an opportunity to study it a bit. Our main concern, as you remember, was the loss of local input and local autonomy, but we were ready to go along with the idea of overall organization, etc.

The only question I have to the minister is.... When I look at the Fraser-Burrard Hospital Society diagram of their organization, I have to ask the minister a question. In retrospect, does he really think it's cost-effective, these new structures? If you look at this.... I'll just go through it quickly. You've got the board of trustees on the top, of course; you've got the president, employee relations, the vice-president of corporate services, the vice-president of direct care services, the vice-president of direct care services and planning, and then another vice-president of medical services, and on and on; another vice-president of finance administration. Underneath all these vice-presidents we have another whole bureaucracy. I'm just saying to the minister: perhaps the time has come to evaluate this. If we're going to end up losing local control and the positive things that went with that in hospitals, and turn it over to this kind of thing, are we not just turning it over into another huge bureaucracy? I wonder if the minister has felt any concern about that.

The next question. I was absent this morning, attending the dental surgeon, getting my practical experience for the estimates.

HON. MR. NIELSEN: Not covered by the plan.

MRS. DAILLY: Unfortunately, no. Maybe someday.

So I'm not sure whether the hole in the ground at St. Paul's was discussed. Has anyone asked you about it? I wonder if you could give us a progress report on what's happening at the St. Paul's Hospital. We are all aware that it was approved by you in April 1983. It's still top priority with the Greater Vancouver Regional Hospital District. It is needed to replace.... Not the hole is needed, but the building to go in the hole is needed to replace the obsolete facility. I was wondering if the minister could give a report on that. It is causing people some concern.

Fm pretty sure the minister received an excellent report from the Medical Association, done in 1984, on health education in B.C. schools. I just wanted to bring it to his attention, as it brought up some excellent points, primarily to be dealt with by the school system. They're all connected closely, of course, with health needs. Just briefly, I would like to know if the minister agrees with these points. The major points were that they advocate again that there should be compulsory physical education in the schools, as they consider it most important. They are also very concerned about possible error rates in medication distribution by teachers, and the teachers are concerned too. My point is inadequate training, Mr. Minister, of teachers who are often asked to give medication to students.

They are disturbed about the increase in student death, which is very tragic. They are also very concerned about the lack of family life education, or sex education, in the schools, and the increase in pregnancies. I wonder if the minister had time to examine this report himself, and if he agrees with the Medical Association that these are vital areas today that should be dealt with in the school curriculum.

One more is nutrition. There is concern that the teaching of nutrition in our schools, which would inevitably help produce citizens who in turn could perhaps save health costs, is not being encouraged enough. About half the schools are really involved in the teaching of nutrition. So that was the other area.

I have one final question for the minister before I sit down. The minister referred to it himself in his own speech. We agree with him on the importance of changing lifestyles so that people have an individual responsibility for looking after themselves and keeping costs down. Of course we're talking about fitness, about easing up, if possible, on tobacco, Mr. Minister, and alcohol, etc. The point is that the minister knows what I'm talking about, and we encourage it on this side of the House.

But I do want to make this point at the same time to the minister. It's rather ironic, but at the same time as we, who might be considered a comparatively affluent group of people in this Legislature, are advocating people to go for a healthier lifestyle, I think what we have to remember is that the choice of a good new healthy lifestyle is really an empty one if it is, as it is today, severely limited by unemployment and poverty.

I think this is the irony the Minister of Health faces. He is advocating a new and healthy lifestyle, but at the same time, because of the recession in this province — and this is true in other areas that are suffering from high unemployment — his ministry is being faced every day with people who don't have that choice. We are finding that there is greater alcohol abuse, increased child-battering, wife-battering and bitterness in homes. We are finding more violence among the youth, divorces, poor diets, unhealthy children. All of these, the minister knows as well as I do, are the results of high unemployment and a period of time that we are now embarking

[ Page 5888 ]

upon where we seem to be getting more of a difference between the very rich and the very poor.

So I would say to the minister that this is hardly the time to be cutting back in areas where we need to beef up — treatment centres and so on for alcoholics, and social workers. I know this doesn't all come under Health, but some of it does. I am particularly concerned that at this time, when we have more teenagers under stress because many of them come from families who are under stress, we find examples under his ministry of.... For example, the adolescent unit at Vancouver General Hospital has been closed down for several months. Most young people who have been there, and I've talked with some, have said that without the assistance of that ward — and I pay credit to those who established it, and to the fact that some of it was under the minister — they probably would have ended up taking their lives.

[4:00]

So I say to the minister, even though I understand that they say they'll be taken care of, the greatest reason for keeping this going is that these young people are with their own peers. If I understand correctly, when this is closed we will be moving them to a general or more adult ward. I say to the minister that you really have this responsibility at this time to emphasize these areas of prevention because of the situation in this province where they have never been needed more. So I would ask the minister specifically to do everything he can to keep up, particularly, the area for adolescent treatment. I am concerned about the Maples area, where apparently there are great waiting-lists and so; that there should be any closing back in those areas. So will the minister give some assurance that as Minister of Health he too is concerned and will try to keep these things open and expanded?

HON. MR. NIELSEN: We would be more than pleased to look at the bureaucratic structure of the Fraser-Burrard society and run it up against all the other hospitals that we have for peer comparison. We don't want any of them to become over-bureaucratic. We think there are methods of improving systems without necessarily adding to the bureaucracy. So we'd be pleased to look at that to see whether they've actually developed new programs or developed new fancy names.

The hole in the ground at St. Paul's Hospital has been stabilized. The slope stabilization program is complete. We do not have the funds at the moment to go ahead with construction; I think it's a $59 million project. I would like to see it go ahead. I would like to see the replacement. I agree that some of the wards at St. Paul's are very antiquated and we would like to proceed with the next phase of that project. We were pleased to be able to open one of the phases. We'd like to go ahead with the next phase as soon as the money is available. St. Paul's plays a very important role in that area of Vancouver and that part of the province, and we'd certainly like to see it upgraded and modernized.

We are discussing the health education package with BCMA — their concepts and ideas. I share concern in these areas. I certainly am a strong advocate of education when it comes to lifestyle and health care. I think we underutilize the possibilities of our school system. I don't know whether we can make some of these things compulsory. The Charter of Rights probably says you can't, but I certainly believe that we should work with the Ministry of Education to try to get as much of this information before the student body as we can; start there to try to resolve some of the identified problems of our ministry and that the Ministry of Human Resources discovers. I agree in those general categories that we should be utilizing the curriculum to transmit this information. So we are going to be working with the BCMA with respect to that. I believe some meetings have been set up.

The problems associated with recession and other influences on society are obviously very real and do have an effect on our ministry, along with Human Resources, Attorney-General, Education and so many others. We will pay particular attention to the highly sensitive areas of the ministry — responsibilities such as the adolescent psychiatric wards or treatment centres. Yes, we are quite sensitive to them. At the Maples, as an example, we are proceeding as quickly as possible to complete the final nine-bed phase of the secure unit. The Young Offenders Act has, if nothing else, also required that additional action be taken.

The treatment centres for adolescents are a particular concern. Vancouver General Hospital has assured me that those youngsters who may require treatment during the period of time that they'll be closed in the summer will receive adequate treatment. They have guaranteed that that will occur. I can assure the member that I would not authorize the closure of the unit unless I had that assurance. They have assured me that they will be able to respond quite properly to any youngsters who may require treatment at that time. I accept that one point which the member made about peers in the ward, and that it might be uncomfortable or a bit difficult for a short period of time for an adolescent to be in an adult ward. I'll take that matter up with the psychiatrists and administrators of the hospitals. They have assured me that the service will be there, and it will be quite proper service for them.

I think that covers off those points. I might add, Mr. Chairman, that the member mentioned my bad back. When she reaches my age she probably will have the same problem.

MR. COCKE: I concur with the minister. Certainly from time to time I share his affliction, so I kind of have a sensitive spot in my consciousness — and in my back — about the whole question.

Mr. Chairman, just a word or two about the whole question of health care. I'm not going to be dealing with ICBC for five minutes, Mr. Minister.

[Mr. Ree in the chair.]

First, let me make an observation vis-à-vis this report from the medical association that the member for Burnaby North (Mrs. Dailly) just brought up. I now understand why the Minister of Health got rid of Action B.C. two or three years ago — for all the research they did and all the first-class work they did. For example, they were finding out that if children in our schools have one hour a day of physical education or physical activity, despite the fact that they miss some academic time, they are physically better at the end of the year, and they also get better marks at the end of the year than those in the control situation. We've done that experiment, we found that out, and what did successive Ministers of Education do with it? Absolutely zero. Now they're saying that it's not even an essential element of school activity — the most nonsensical, stupid way of handling information. I wish the Minister of Health would get back into that activity, doing a number of other things along the lines of Action B.C. I

[ Page 5889 ]

realize that there was a bit of testiness towards it because we set it up. In any event, it should be done again, and it should be out there providing that kind of leadership in terms of real preventive work.

Mr. Chairman, I just want to make another observation. I think the minister is absolutely taking the folks who go to the hospitals in this province to the cleaners. Let me tell you why. He's accepting user fees. He'll be accepting user fees to the tune of millions and millions of dollars until 1987. If he accepts user fees longer than that, then he forfeits the multi-millions of dollars, dollar for dollar, in federal contributions. This way he gets it both ways. He's going to get it out of the patients; he's not going to pay it back. By 1987 he's going to have a change of heart, and that change of heart will give him the best bang for the buck that one ever heard in one's life. Isn't that what the minister is doing? I believe so. I believe that the minister will have a magical change of heart in 1987. I don't know what minister it will be by then. But by 1987 a policy reversal will take place. The feds will make their entire contribution for the whole three-year period, which will be $3 million a month for three years — something like that; somebody else add it up. It's a nice large sum. When the time comes, I hope somebody remembers where they heard it first.

One word about Dr. Clein at the Royal Columbian Hospital, Incidentally, I have been privy to the Fraser-Burrard Hospital Society and its magical growth in terms of bureaucracy. Its magical growth is, of course, largely because of the fact that you haven't got one single member on the Fraser-Burrard hospital board from the city of New Westminster, the city that put that hospital together and held it together all these years. And this government had the temerity to come along and discharge everybody on that hospital board who was resident in New Westminster. Let me tell you why. They suspect that some of those folks might have voted for me. I wouldn't blame them. In any event, that's the way it is.

HON. MR. NIELSEN: They said they didn't.

MR. COCKE: They said they didn't, but 60 percent do, Mr. Minister.

I suggest that that whole question of Royal Columbian Hospital be looked at fairly carefully, because I do believe that Dr. Clein, the neurosurgeon there, was very badly handled. I think that Dr. Clein should still be there on staff. We are the trauma centre for the whole lower mainland. There's no question about that. We get more trauma at the Royal Columbian than anywhere else. Every accident from the PNE right out to Hope heads straight for the Royal Columbian Hospital because of the geographies of the situation. It wasn't my intention; it was just by accident that that happened. But anyway, that's it. Okay, that's Dr. Clein.

I also want to ask the minister something about the hospital situation here in Victoria. You've combined the administration. I'm not going to ask you how much you saved. I'm going to ask you how many additional bucks it's costing for the administration of these two hospitals under this new organization.

One last question in this particular area: how many new beds has the minister built in this province and not opened? How many are still sitting there without being opened?

HON. MR. NIELSEN: Mr. Chairman, I cannot give the number of beds which may have been constructed over the last number of years and are not operating. I would have to do some research into that. In many instances they were replacement beds, but I'll have to try and dig through that. I know there are some in Richmond which have not been opened, but then there are some which were opened and other beds were closed to compensate.

I'm told the Victoria amalgamation administration costs are not greater than they were previously. Again, I'd have to get specific numbers to come up with that. But I'll take a look at the number of beds. This is a very specific question, and I simply do not have the answer at this time. But I'll be very pleased to find out how many are empty — previously constructed in the last couple of years; projects which have been completed but not opened. I'll have to do an inventory on that and get the information over to the member.

I certainly will have a pretty thorough look at the administrative costs of Fraser-Burrard and see what is going on. I hope it's all well,

MR. COCKE: I take it the answer to the user-fee question was in the affirmative. That's okay, Mr. Minister; I'll just ask you another question.

The most confusing.... We're getting used to it around here. There was a day when estimates came out, and you could always follow them because you could contrast figures from the year before and so on. Now they've switched them around like crazy. There's just no possible way you can compare last year with this year, or certainly the year before that.

[4:15]

I'm going to ask something about emergency health services. Why do supplementary salary costs — that's account classification No. 2 — increase from zero to $4,413,300? Why do fees, allowances and expenses — that's account classification No. 7 — increase from zero to $88,507? Why have utilities, materials, supplies and equipment, operation and maintenance increased from $1,795,539 to $7,331,719? Are we purchasing 50 new ambulances? Have ambulance services increased by $2 million? Where does the remainder of the increase go?

HON. MR. NIELSEN: The ambulance service increase of $2.2 million is the result of an '84-85 reduction option to eliminate fire station contracts. That was not implemented previously. There was an unbudgeted wage settlement of $0.9 million; unfunded staff, $0.2 million; and material inflation of 6 percent, another $0.2 million. That is on the ambulance service.

The asset acquisitions. We have been given authority for the production, I believe, of 56 ambulances, is it? Twenty percent of the fleet is to be replaced — 73 ambulances — on an annual basis. In 1985-86 we'll be able to achieve this rotation target. So we are going to have $1.6 million worth of 50 ambulance units, and $0.2 million for telecommunications equipment offset. But we're having a major turnover of some of the ambulances in this year for 1985-86. That is the asset acquisition.

Did the member ask about the grants and contributions as well?

Interjection.

HON. MR. NIELSEN: Good.

[ Page 5890 ]

MR. COCKE: I'm just worrying about my baby, Mr. Chairman — the emergency health services.

Okay, I'm prepared to go to ICBC now.

MR. ROSE: I'd like to ask a question of the minister on how much of the increase in EPF health funds have accrued to the ministry this year over last year. I understand that this year's contributions are supposed to be something like 7.14 percent higher than the previous year. Have all the funds destined through EPF for Health actually ended up being used to finance health care?

HON. MR. NIELSEN: That would be knowledge the Minister of Finance would have. We receive all our funding from consolidated revenue. I don't know what the precise total of that EPF amount would be from the federal government, or how they designated a certain amount for Health, but the budget obviously far exceeds whatever that amount may be. We estimate that the federal government covers approximately 42 percent of our operating costs for hospitals and Medical Services Plan.

MR. ROSE: It is alleged that the universities are actually paid for fully by the student fees of roughly 16 percent, and for this year, because of the increased size of the EPF grant, British Columbia actually makes money on the EPF in terms of its own budgetary amounts.

I understand the minister when he says he gets the amount of money that is turned over to him from Finance, and it is his assumption that it's 42 percent paid for by the feds and 48 percent by the province. But is the minister aware of the precise amount that comes under EPF for health and post-secondary education, and is he assured that those amounts are not laundered through the Ministry of Finance and not end up in Health at all, but are siphoned off for some other government priority?

HON. MR. NIELSEN: Forty-two and 48 is 90 percent, so it would be 42 and 52. We have every reason to believe that the money allocated within EPF, although the Minister of Finance does not agree with the federal contention that there are designated amounts for health or post-secondary education.... The Minister of Finance considers it to be a grant under that formula without strings attached.

Our budget will exceed $3 billion this year. The blue book budget is $2.67 billion or so, and that is far in excess of the total EPF transfer. Our calculation shows about 42 percent contribution from the federal government with respect to the costs of medical services and hospital programs.

MR. COCKE: Well, Mr. Chairman, a few months ago in this House I spoke about ICBC and the proposition of selling off the general insurance aspect of ICBC. The then minister in charge of ICBC — who is now walking in or out, and who knows and who cares? — decided to totally ignore responsible suggestions concerning that whole question. Well, those businesslike tycoons over there on the Socred side goofed it to no end. It was a stupid, absolutely ridiculous proposition, and no wonder, coming from the member for Boundary-Similkameen (Hon. Mr. Hewitt).

HON. MR. HEWITT: I'm your MLA. Remember that.

MR. COCKE: Yeah, I've a summer place up there, just for those who wonder why he's my MLA. Believe me, he's never had my vote.

MR. CHAIRMAN: Order, please. Through the Chair to the Minister of Health.

MR. COCKE: Order? Certainly, Mr. Chairman, I'll be orderly. I'll be orderly as they were disorderly, Mr. Chairman, in selling off a paying proposition, a window on the entire general insurance industry and keeping the industry honest. I suggested at the time that it was the wrong thing to do. I can remember, Mr. Chairman — and we'll probably see that day return — when people who were outside of a fire district in this province could not buy insurance for love nor money from the private insurers. Now we're back to the bad old days. And in going back to the bad old days we even lost money on the transaction, according to Der Hoi-Yin, business columnist.

Interjections.

MR. COCKE: Yes.

MS. BROWN: I wouldn't attack her.

MR. COCKE: No, I wouldn't attack Der Hoi-Yin. She has been attacked before, Mr. Chairman, and those attackers were sorry that they ever thought of attacking her.

Mr. Chairman, she claims — and there's no question about it — that it was worth $14 million. You got $9 million.

HON. MR. HEWITT: Nonsense!

MR. COCKE: Nonsense. What's a few million here and there? C.D. Howe said it, and C.D. Howe went down the tube. And that's what is going to happen to this government because of their carelessness in handling the people's business. Absolute carelessness.

Mr. Chairman, it was good business. It wasn't going out and doing anything more than keeping the insurance business very honest in this province — very much cared-for, by virtue of the fact that ICBC were involved in it.

AN HON. MEMBER: Are you saying that the private insurers are dishonest?

MR. COCKE: I'm saying that the private insurers are in there for profit — P-R-O-F-I-T. And however you make profit is good, as far as the shareholders are concerned. If they get together and decide that they're riot going to insure certain people or certain groups, they can do it.

We've seen it all before. What are we talking about? Don't think that I'm standing up here giving some brand new revelation. These are the kinds of things that do occur and have occurred, and why wouldn't we guard against them? No, no, let's sell it off. And in selling it off we took a real royal taking to the cleaners.

This reminds me. We were talking a minute ago about the hole that they've built for an extension of St. Paul's Hospital in the West End of Vancouver. Now if the Minister of Industrial Development or — wait a minute — the Member for South Peace River (Hon. Mr. Phillips), Industrial Trade, or Trade and Industrial Development or whatever that ministry

[ Page 5891 ]

is, if it is every formed.... If he were to have his way he would take a coal-mining company in there and buy that empty hole. Then we'd be out of the problem, in the Health ministry, of what you're going to do with it. But we know about the lemons, Mr. Chairman. The Minister of Consumer and Corporate Affairs (Hon. Mr. Hewitt) was instrumental in the selling off of a very profitable....

AN HON. MEMBER: Wrong,

MR. COCKE: Wrong, he says. They made profit every year, Mr. Chairman.

Interjections.

MR. COCKE: Mr. Chairman, isn't it marvellous that we have members in this House, members who are being paid for out of the public tax dollars, and they don't even realize that the Minister of Health is responsible for ICBC. What homework they do in that that back bench, and one a lawyer and one an engineer and all they do is sit around and accept the bucks that they get and say they wish they were at home. No wonder they wish they were at home.

Mr. Chairman, I'd like to know how this minister feels about the selling off of the general insurance aspect of ICBC.

MR. NIELSEN: Well, Mr. Chairman, it's a fait accompli. I think it was the proper thing for the ICBC corporation to do, The member mentions a couple of points — that it was making money. It's awfully tough to sell something losing money. If you are going to put something on the market, you have a far better opportunity of selling it if indeed it is a profitable enterprise. So that perhaps was the reason why the Cumis corporation made an offer on the general insurance aspect of ICBC. It may be a difference in philosophy, but I do not have an automatic belief that any person engaged in private enterprise or in making a profit is not to be trusted. I think that if we were to automatically have the opinion, as the member somewhat suggested, that simply because a person is motivated by profit he can't be trusted, or that because they are a private corporation they can't be trusted, that would be a sad reflection on the reality of our country and our people. I think we have adequate ability through our agencies to ensure that corporations are functioning in accordance with the law and with regulations. If they are not, there are suitable punishments available. But I don't think we need a spy among them to ensure that they're going to operate correctly.

[4:30]

The general insurance division was sold to the Cumis corporation. It is no longer ICBC's responsibility. The government is not involved with it directly or indirectly. It will provide the coverage. The terms of the sale would call for that guarantee, so we feel that it's going to function quite well. I haven't heard that it's causing any difficulties so far. As far as I know, it's working quite well. It's certainly consistent with the government policy of selling off various arm's-length Crown corporations and getting them back into the private sector where they properly belong.

MR. CHAIRMAN: The Chair from time to time allows members a certain bit of leeway in their questioning, but I'm sure the member is well aware that normal questioning should not involve events in the ministry that took place under a former minister.

MR. COCKE: Why?

MR. CHAIRMAN: It's well-established parliamentary practice.

MR. COCKE: Mr. Chairman, is ICBC still a Crown corporation? Is the Minister of Health the minister responsible for this Crown corporation?

MR. CHAIRMAN: I'm not saying you cannot discuss ICBC, Mr. Member. What we're saying is that you cannot discuss specific actions of a former minister who is no longer responsible for that ministry or that corporation.

MR. COCKE: I am amused. I've never heard of this before in my cotton-pickin' life. If you can't criticize a Crown corporation for what they did.... You know, I'm still criticizing the Social Credit government for what they did with the two rivers policy, and so on and so forth, and I think that's quite in order.

But, Mr. Chairman, it's interesting that the difference in philosophy.... Der Hoi-Yin says: "Is philosophy everything? Certainly not to bottom-line-oriented free-enterprisers." She's hardly a harsh critic. Mr. Chairman, there was no answer on that, nor will there ever be. The fact of the matter is, it was a mistake.

[Mr. Strachan in the chair.]

I was interested that some time ago we had a piece of legislation before the House — it was recommended by ICBC at the time — about radar-detector sales being banned. It was withdrawn from the legislation. And then, hosanna! a number of retailers came out and gratuitously said they wouldn't sell them anymore. Now imagine this assembly or this government, which put forward the legislation, being so terribly lacking in courage as to leave that in the bill so that it could become law in this province and let industry.... That isn't all of them, as many retailers are still selling and can sell the radar detector.

I just give you this as an indication that we should be listening more to ICBC in the future and discussing things with them. For example, they said — and the Ministry of Transportation totally ignored it — that we should not abolish motor vehicle testing, and they said that there would be so many more accidents as a result of doing away with it. And it's happening. It's got the Minister of Highways (Hon. A. Fraser) so embarrassed now that he's out on the highways checking the trucks and cars one by one: have you got brakes, sir? And if you haven't, tut tut.

You know, Mr. Chairman, that's a very powerful corporation, and I'm very proud of ICBC — most aspects of it. I'm not proud of some of the leadership that's been given it by the government, but I'm certainly proud of the way they act. They have the stars. They are the people paying for the claims, and we ignore their recommendations. The minister says they don't know everything. Well, Mr. Chairman, we should be listening to them. I hope that this minister will carry the ICBC message among his colleagues a lot stronger than the former minister did.

Mr. Chairman, I wonder if I could ask the minister one more question about ICBC rates. There was a rate break....

[ Page 5892 ]

Interjection.

MR. COCKE: I don't know why I keep answering that poor little member who doesn't even know who is responsible for ICBC. I must chastise myself from time to time.

There was a reduction in rates for young, first-time drivers who had gone through driver training. It was said that that rate shouldn't be reduced by virtue of the fact that there were more accidents and so on. I wonder if any further studies have been done since that reduction of rate was taken away.

HON. MR. NIELSEN: Apparently there was one survey or examination after that change was made, and it showed basically no difference between the two categories of drivers with respect to incidence of accidents. There apparently was one examination after that, and the results were that those who had the training and those who had not basically showed no difference in their incidence.

MR. COCKE: Mr. Chairman, this minister is new at ICBC. I congratulate him on his being made responsible for ICBC, but I hope that he will be responsible for it, as opposed to some of what we have seen in the past. I feel that the Insurance Corporation of British Columbia has a very bright future. It provides good service. Sometimes I get sick to death of the hassles that we go through with claims. Sometimes it's almost as bad as workers' compensation. I do think that we had better be much more careful in claims-handling. There is a tendency, in my opinion, to see to it that both people involved in an accident are partly responsible, so that they both lose the safe-driving benefits.

I'm going to leave this for the next session with this minister. Hopefully he's still the minister in charge of ICBC. Frankly, I don't know how you've got the time. In any event, good luck to you.

MS. BROWN: I just have one question on ICBC, and it deals with a number of calls I received in my office. I got a letter that says it quite well, and it's from a person who is on handicapped pension and therefore has very limited resources. His problem is a disc operation. He's not confined to a wheelchair, so the law as it affects wheelchair people doesn't apply to him. He's on a handicapped pension, so he's eligible for that, but he's still not allowed to pay for his insurance on the instalment plan. He is wondering why you don't just use the same eligibility requirements that the Ministry of Human Resources uses for defining a disability, because in order to be eligible for a handicapped pension under Human Resources, believe me, you have to be very much disabled. He says his car is 19.5 years old. He hasn't had an increase, as you all know, in his handicapped pension since October 1983, and he is still expected to come up with the whole sum of money when his insurance comes due in February. I wonder if the minister is giving any thought to expanding the definition.

HON. MR. NIELSEN: I haven't, but I'll look into that and talk to officials of ICBC about how it might affect a person in that situation. I'm not familiar with it.

MRS. WALLACE: I have a question that I would like to raise with the minister. I wrote to the former minister a year ago and never got any answer.

Interjection.

MRS. WALLACE: Oh yes, it's true. So I hope you're going to do better than that, Mr. Minister.

The problem occurred when one of my constituents was told by ICBC that he had the wrong classification. He had his car insured at the business classification, and then his job disappeared, like so many jobs have in Cowichan, and he was unemployed. So he changed the category to pleasure driving only. Eventually he got a job that started as a part-time job, and with the pressure of funds and so on, he didn't get around to changing that category. I think it had been a period of approximately six months from the time he first started back to work on a part-time basis until he had an accident.

He has been told by ICBC that he has to pay the towing charges. Those charges amounted to a total of $1,459.15. That included the towing and the loss. He was billed for this $1,459.15 just because he did not get around to revising his category from an 001 to of an 002 classification. That seems a pretty harsh penalty to me for someone who is in that situation. It's exactly the same penalty if you were driving while impaired and were involved in an accident. Your insurance policy doesn't cover, so you would be charged exactly the same in that instance for the towing and the loss — and rightly so, if that were the case. But it seems to me to be totally unfair that the same penalty is applied to a person who, for six months, when he had a part-time job for some three or four months of that and just hadn't gotten around to making that revision in their insurance policy....

I'm sure you would recognize that a person who had been unemployed for some time might find it very difficult to come up with that cash. It would be something that you would just avoid doing. He knows it was wrong, that he should have had that done. He didn't have it done. He resents the fact — and I do too — that he has to pay exactly the same extra cost as a person who had been impaired and was charged, and had no insurance coverage. That seems unjust and unfair to me, Mr. Minister.

Vote 37 approved.

Vote 38: management operations, $66,615,137 approved.

[4:45]

Vote 39: Medical Services Commission, $588,602,983 — approved,

On vote 40: preventive and community health care services, $217,313,447.

MS. BROWN: Just to restate my comments of yesterday, it's not good enough if it's the Minister of Health. The portion of that budget spent on prevention and community health should be larger. I hope that in future years either this minister or future ministers will undo this wrong: too much money going on sickness, not enough going on health. Let's do something about that, Mr. Minister.

Vote 40 approved.

Vote 41: institutional services, $1,794,176,742 — approved unanimously on a division.

[ Page 5893 ]

The House resumed; Mr. Speaker in the chair.

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

HON. MR. PHILLIPS: I call committee on Bill 20.

MINISTRY OF INTERNATIONAL
TRADE AND INVESTMENT ACT

The House in committee on Bill 20; Mr. Strachan in the chair.

Sections 1 and 2 approved.

On section 3.

MR. WILLIAMS: Section 3, Mr. Chairman, deals with the purpose and the function of the ministry. It's clear that it's a pretty limited purpose and limited function that is perceived by this administration because of the background and capacity of the person that will be responsible for it.

MR. CHAIRMAN: Hon. member, I cannot accept a personal reflection upon another hon. member of this House. I will so remind the member that we are all hon. members and personal reflections are quite unparliamentary.

MR. WILLIAMS: The whole business of tailoring goods for foreign markets is something that we have not addressed in this province in a careful, sophisticated way. Just in the last few days the spokesman for the Canada-Korea business council in Vancouver was speaking about the need to specifically tailor our products; that it really won't mean anything if we're just out there doing the rah! rah! rah! salesman operation. That's what it has been in the past under the former amalgamated ministry.

I had in mind an amendment, Mr. Chairman, that would add the following words: "To coordinate all matters relating to provincial trade policy and international marketing among all ministries of this province and the federal government, and all business organizations operating within the province of British Columbia; and to encourage investment in the province by conducting research into overseas investment practices of other nations and making recommendations to the Legislature." I've been advised by one of the Clerks that because that's so much more substantial than what we already have in the bill, it would be, in effect, changing the principle of the bill. So there we are.

Interjection.

MR. WILLIAMS: Yes. In effect: "It's a lightweight bill, and what are you doing taking this seriously anyway?" That's the problem.

The government really isn't taking this question seriously. Studies in the last few years with respect to our basic industries have been ringing the warning bells consistently. Not just one unique study from the Swedes; not just a unique study from Woodbridge Reed; not a unique study from Peter Pearse, and countless other experts. There is now a consistent pattern that we have been failing in terms of developing our industries in the international sphere. It's consistent. We're simply not doing the job. This agency, as I indicated in the previous session, doesn't even plan on moving their library with them; it'll remain in Industry and Small Business. In terms of research there isn't the capacity. It's 0.1 percent of their annual budget to actually carry out research in this significant area.

MR. CHAIRMAN: Does the member wish to propose his amendment?

MR. WILLIAMS: Do you mean in terms of testing the House?

MR. CHAIRMAN: If there's no amendment, I'd just as soon that you speak to the section before us.

MR. WILLIAMS: Well, the section before us is fairly clear: to coordinate matters of trade policy and international marketing. I think that's what I'm discussing. It's abundantly clear.

Is the Chair reconsidering its position?

[5:00]

MR. CHAIRMAN: Please proceed.

MR. WILLIAMS: Clearly we don't have a capacity in this province, and clearly it's not the intent here to develop a capacity in terms of international marketing and developing more sophisticated products. We in British Columbia basically turn out bottom-of-the-line products in terms of our basic industry. We need more specific products in terms of the international demand. We leave ourselves vulnerable in terms of everything we do in our major industry in this province, because we are turning out bottom-of-the-line product: bottom-of-the-line pulp, bottom-of-the-line newsprint, bottom-of-the-line lumber and 2-by-4s. That's the problem in British Columbia: we haven't changed it around here. Nor have we developed our technology to turn out the products that we need in terms of the international marketplace. Our technology is now generations behind in terms of our major industries. For this administration, which labels itself a businessman's government, it's a monumental failure to acknowledge that in newsprint and in pulp we are now virtually two generations behind. Most of our technology is 1950 or pre-1950. As I indicated previously, the Scandinavians are up at something like 7 percent of their technology as pre-1950. That's an incredible lag in terms of being able to compete in the international marketplace.

There's been no effort on the part of this ministry in the past — or the amalgamated ministry in the past — to deal with those kinds of questions. Otherwise, we'd be considering very different bills before the Legislature this year than we are currently seeing. The recent study by the Swedes with respect to our major industry indicates that we probably are two generations behind, and that we have a monumental task in terms of rebuilding to meet the demands of the international markets. As I indicated before, the Europeans are moving into our traditional markets far more effectively than they ever have in the past — into the Pacific Rim and into the United States as well.

When one quizzes the minister in this House about the naive decisions he's made in the past in terms of coal marketing, the response we get is all bluff and blunder, and a comment to the effect that everything's better. Well, it isn't. You just have to look at the numbers in terms of coal delivery

[ Page 5894 ]

and coal prices out of the southeast part of the province to see what a major blunder excess capacity has been in the province. The people of southeast British Columbia are consistently paying a price, in terms of lower price and lower volume, for a product that was a lower-cost product and had all of the infrastructure built within it within the region in terms of railways and towns, by and large already in place. So there has been a consistent pattern of naivety on the part of this ministry, or the previous joint ministry, that does not understand the kind of sophistication that exists outside our boundaries.

Just look at the number of people the Japanese have in Europe in terms of marketing and analyzing the markets of Europe in terms of their penetration versus what we have. It doesn't fit at all or even compare to the Europeans in terms of what they have. But we are light years behind them in terms of having that capability and in terms of truly doing the job that needs to be done. It just isn't there in this proposal. It's not there in this part of the budget, and it's not there in the principle established in this part of the bill.

Clearly the government is simply providing a pleasant spot outside the fray in terms of regular cabinet activities for the minister. It's not a matter of really taking the job seriously. The budget tells us clearly that they're not taking the job seriously. It is just the old kind of travelling salesman routine, and that's not the way the world is anymore. It's a naive view of the way you sell in a country like Japan.

[Mr. Ree in the chair.]

What's our capacity in terms of really meeting their level of sophistication? It just isn't there. In terms of having people abroad who speak the language, it just isn't there. It's unfortunate that this matter is handled the way it is, because it is serious. But equally serious, or more serious, are our problems at home, where we haven't done the businesslike work that is necessary in terms of a liaison with the private sector and working with them — looking at their problems in terms of financing, looking at their problems in terms of technology, looking at their problems in terms of marketing — and then tying the pieces together. There's no evidence that that capacity is going to be here the way this agency has been formulated.

I'm advised that the amendment I had in mind would be out of order, Mr. Chairman, simply because it takes the matter seriously, and the bill doesn't.

HON. MR. PHILLIPS: Well, again it's very difficult to answer that member. He's talking about what he considers to be problems in the forest industry, problems with the structure. So far as this ministry is concerned in the past, I think we'll stake our record up against any province in Canada, as a matter of fact, or any state in the union, with regard to the work we have done.

As I said the other day, if you're going to go and sell, you've got to have your house in order back home. If you want the investment that brings the new technology and brings with it the market and brings with it the money, you've got to have a climate back home which will invite that investment to come to British Columbia, to make a lot of the changes that the member is talking about. That climate is now here, now that there has been a change in Ottawa, now that the great Foreign Investment Review Act, which was supported by the members opposite, who didn't seem to realize the benefits of bringing investment and new technology into the province.... Now that there's a spirit of cooperation with Ottawa and working with Ottawa, now that there's a recognition in Ottawa of the benefits of international trade to all of Canada, working together is what we will be doing. We will be doing research with the federal government, and we will be working with the ministries of international trade and foreign affairs to ensure that the industries of this province indeed find their way into the marketplace.

With regard to research, yes, we have been doing research, and we have been sending out reconnaissance missions. Maybe the member fails to realize that we literally take by the hand hundreds of small businesses who haven't dealt in the international marketplace. We find them a market, and we take them and make contacts. We've been very successful in that regard.

MR. WILLIAMS: Our two major trading partners, Mr. Chairman, are the United States, which buys 44 percent of British Columbia's products, and Japan, which buys 23 percent.

MR. CHAIRMAN: Order, please. Possibly the Chair might suggest that second reading is the broader debate which took place in respect to this bill, and committee is not the place for overall debate on the bill.

MR. WILLIAMS: This section, Mr. Chairman, says: "to coordinate all matters of trade policy." I've just discussed the question of who our major trading partners are. I think the relevance is abundantly clear, even to those with limited capacity.

MR. CHAIRMAN: It's not a criticism, Mr. Member — just as long as it's not a recanvassing of the second reading overall debate.

MR. WILLIAMS: With all deference, to anticipate is hardly the job of the Chair.

Interjections.

MR. WILLIAMS: The Americans.... Yes, when we had a debt load of a quarter of what we've got today. You guys are paying $8 million a day in dead-weight debt. Old Mr. Bennett would really roll around in his grave on that one.

Our major trading partners, Mr. Chairman, are the Americans and the Japanese. The question of how we will accommodate our major market areas is the question that is before us in this section. Our problem is that we don't seem to understand the culture of some of our trading partners. We're naive. We don't understand the way they operate. We have consistently seen that there is a lack of understanding here with respect to the member. Japan, our trading partner, is a great respecter of education, yet everything we do in British Columbia leaves us vulnerable in that area alone.

What are the components of strategy in marketing in terms of dealing with this great nation-state of Japan? I think there are four major points to understand when dealing with the Japanese. One is that they invest as minority shareholders abroad. Two, they set up what they call long-term contracts abroad, which are little more than letters of intent. Three, they have a number of suppliers around the world so that they will have a multiplicity of supply for their needs as they

[ Page 5895 ]

perceive them. Four, they invest and purchase on the basis of consortia, so they band together when they buy abroad with their great trading companies, the big five.

What we've seen under this minister is that he had absolutely no understanding of items two and three. He didn't understand that a long-term contract with these people was simply a letter of intent. That's what's now happened in our coal-fields, much to our chagrin. We're not able to meet our costs of infrastructure, which are considerable: some $700 million invested by the province alone. That naivety has been very costly for us as a provincial administration. Item three, the number of suppliers, they've never really understood either. So we've been the victims there. We've been ready to be multiple suppliers ourselves so that we could face being shaken down in terms of price and in terms of volume. We've been the losers as a result. It's that kind of naivety in dealing with the Japanese that is reflected in that major disaster. Had there been some understanding of the way our number two trading partner operates, we wouldn't be in the boat we're in. It doesn't look like there's been any change so far in terms of understanding and dealing with this major trader across the Pacific.

HON. MR. PHILLIPS: Mr. Chairman, to correct the member, the United States has preliminary estimates for exports for 1984. The United States purchased 50.6 percent and Japan 21.7 percent.

Mr. Chairman, I understand very well the American market and the Japanese market. I want to tell you, the first requisite is that they are welcome in the country, and that has not been the case if you listen to the policies and the speeches by the members opposite. You must ensure, if investment is coming in here, that first of all it is welcome, and the person doing the investment wants to know that the investment is going to be secure. They want to know that there is stability in the country in which they are going to invest, and they want to know that there is going to be stability in the country from which they get their supplies. I'm afraid, Mr. Chairman, that if they relied on the members opposite, the stability and the welcome mat wouldn't be out. The jobs that are presently in British Columbia, supplying goods and services to the international marketplace, and those investments which are presently being made or have been made or will be made in this province, wouldn't be forthcoming if they were government. We don't have to take a back seat to anybody. We have been successful, we will continue to be successful, and we will go out and we will sell British Columbia as a great place to invest, with a stable government and with policies that welcome investment, with policies that will help our industry to sell into the international marketplace without fear of takeover by a government....

Sections 3 and 4 approved.

Title approved.

HON. MR. PHILLIPS: Mr. Chairman, I move that the committee rise and report the bill complete without amendment.

Motion approved.

The House resumed; Mr. Speaker in the chair.

Bill 20, Ministry of International Trade and Investment Act, reported complete without amendment, read a third time and passed.

[5:15]

HON. MR. PHILLIPS: Committee of Supply, Mr. Speaker.

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

ESTIMATES: MINISTRY OF HUMAN RESOURCES

On vote 42: minister's office, $214,384.

HON. MRS. McCARTHY: Mr. Chairman, I'm pleased once again to stand in my place to represent the Ministry of Human Resources and to share with you some of the things that we have done and some of the plans that we have for the future. May I just say that I was absent from the House last week for a couple of days to attend a federal-provincial conference on social services with my colleagues from across this nation and with the new federal minister responsible for Health and Welfare, the Hon. Jake Epp.

I really would like to bring to the House the realization that there is, I think, a very cooperative mood in the country. All of the country has been racked by the recession. The country, and those who represent the social services in this country, have borne the burden of a very difficult time in our country's history. It was those ministers, with whom I share this responsibility across this nation in terms of responsibility for social services, who have, as a matter of fact, in the past few years had to find innovative and very new and interesting ways to meet the problems of the country as it has been racked by the recession. Can I just say that the spirit of cooperation that I found, with all of the ministers across the country, and with the federal minister, was exceptional.

I want to say that we all — the province of British Columbia leading the discussion — talked about temporary assistance to people in need. As I said in my preamble to the conference, of all of the things that have concerned us most as ministers — and I think that would be true for every minister who has held this post prior to my being in it, and who will in the years to come — those concerns regarding people in need have probably leaned heaviest on us. It doesn't matter whether you are providing for people in need in affluent times or in recession times; to change their lives so that they can become independent is probably the greatest concern of any minister, no matter what political party they represent across this nation and or represented in the past in this province.

To find that magic solution that turns people who have not the ability or the opportunity or.... Somehow or other something has happened in their lives, whether it be something to do with their health or with their situation, either mentally or physically. Whatever their condition is, surely our desire as citizens and as ministers who have this responsibility is to do the best we can to make them self-reliant and to have them have the sense of pride that comes with being that way; the opportunity, if you like, to be independent.

That has weighed heavily on my mind for many years. I have, as a matter of fact, seen some rather innovative changes in this country, and I certainly have seen within my own ministry in these past years some very interesting things

[ Page 5896 ]

happening, not the least of which are the Individual Opportunity Plan and the job action program. Later in my estimates, when the rehabilitation vote comes up, perhaps we and the opposition can talk constructively about that. I really view this as a very constructive type of debate in this House. None of us has a comer on any social conscience, and all of us have a responsibility to find the answers.

Surely the Individual Opportunity Plan has been one of the most innovative in this country, and it is looked on as a model by my colleagues across this nation. The job action program, which to this day, in the midst of an upturn in the economy, and in the past, when we were in the midst of a recession, has a 70 percent.... Seven out of ten people who come to us, even in the last two years, have found themselves off welfare within a very few weeks of taking a job action program. That's a tremendous record, with the pressures we have. Whenever we had the highest rate of return on that program, it was when there were very many job opportunities, and it was, at the height of our affluence in this province, an even greater percentage. For any social service to have that rate of return was quite incredible.

We don't took at income assistance as a cure-all but as assistance to make a very difficult situation less difficult. We continue to assist; and we continue to try to meet those challenges and perhaps to do a better job in many ways in the delivery of the service.

During 1982-83, $609.2 million was expended, and in 1984-85, $703.2 million was originally set aside for the income assistance budget, but when the economy did not improve as much as anticipated, we added an additional $166.1 million. In this year we will spend, we estimate, approximately $887.3 million on income assistance to help those who are in need.

You will be pleased to know that we are going to change the traditional method of sending cheques around Christmastime. That's usually a question that gets raised in this House; certainly it gets raised during December. I just want to assure my colleagues in this House that those clients who have usually been issued cheques during the last week of any given month usually are sent those cheques in advance to be sure that they get the cheque to be used in the following month. This year the cheque for January will be issued prior to Christmas, which is a little earlier than normal, to allow clients more flexibility in managing their finances at Christmastime.

Because current unemployment levels have resulted from structural as well as seasonal changes in the economy, the turnover period for our income assistance caseload haa lengthened. During more prosperous times 70 percent of our clients become independent within three months of receiving limited financial assistance from my ministry. It now takea about eight months for that same group of people to get on their feet — in varying times — but that is the.... So 7 percent are off income assistance within eight months.

If I may stress again the importance of understanding that figure, we are constantly striving to decrease the turnover time that we have people on income assistance in the province. It's important for you to know that when you think of people on welfare or income assistance — whatever tern you wish to give it — don't think of them as the same people who are there all the time. The turnover — the opportunity for people to get from income assistance into independence — is really very rapid in this province and always has been The people who will apply for income assistance today are not the same people who are there in three months, five months, four months; and 70 percent of them will not be there at all in eight months. That's an important thing to keep in mind.

In addition, I think it's important to note that the balance of the 30 percent who are left, because of our Individual Opportunity Plan, which is when we start to give that extra attention and extra service to get people off income assistance, immediately within the job action program and Individual Opportunity Plan.... We are successful with 50 percent of that group that is left. Therefore we have traditionally been able in the last four years to turn over and give an opportunity for those on income assistance within a very short time. The ones that we always have difficulty in placing, and the ones that we always have difficulty in finding independence for, is just that small percentage at the end which continues to be there and continues to be our greatest source of concern.

In 1984-85, 6,950 clients per month — were involved in an Individual Opportunity Plan. Of these, an average of 250 per month took part in our job action program. This program trains people in job search and interview techniques and helps people to gain a realistic view of their own value to an employer. Depending on seasonal fluctuations, between 40 percent and 70 percent of all job action participants become self-sufficient.

Could I just mention to you that in terms of the Individual Opportunity Plan, this is a selection. When people are eight months on income assistance they have the opportunity to take retraining, they have an opportunity to perhaps have work clothes bought for them if they have a job to go to. They have an opportunity to select several options: re-education, job training for a specific, upgrading of their skills. There is a selection that they have, and we are there to assist to give that kind of support. For a single parent, it may just be day care.

For a single parent, it may mean that there has to be a different housing situation so shared accommodation can assist her with her children. But whatever it is, we are there to give those benefits and that capability which gives them a goal — whether it be one month or two years — to work towards independence. Seven thousand clients — 6,950 — per month, each and every month, then, enter the individual opportunity plan and within their capabilities and opportunities go into the workplace in varying degrees across this province.

I'd like to just give a minute of my time in introducing our estimates today to the Pharmacare program. In 1985-86 it has budgeted for a 9.4 percent increase, $128.9 million. This has all been earmarked for the Pharmacare program, under which we pay 100 percent of designated prescription costs for seniors, persons in long-term care facilities and ministry clients on income assistance. In addition, it pays 80 percent of the costs for all other British Columbians over the established deductible level. And effective in January of this year that deductible was increased from $175 to $200. By increasing the deductible, government can control costs to the taxpayer and still ensure that assistance for persons with above-average medical needs is met.

[5:30]

I am proud to tell you, too, that this government has been very effective in controlling Pharmacare costs in spite of the apprehension that very many people have that costs are galloping away. As reported by Ottawa's health protection branch, drug costs across Canada rose 15 percent during

[ Page 5897 ]

1982 and another 15 percent in 1983. By contrast, drug costs in British Columbia increased approximately 6.8 and 7.9 percent respectively during those years.

I would also point out that more recently the provincial government has been assisted in controlling Pharmacare costs with the cooperation of pharmacists themselves. This group of professionals is to be commended for voluntarily limiting increases in dispensing fees.

We have in this province many remarkable services to senior citizens. In addition to the Pharmacare program, our ministry assists senior citizens to meet their special needs through several initiatives — for example, the GAIN for seniors supplement, which is available to those whose monthly income from all sources is less than the guaranteed minimum level of $634 for singles and $1,065 for couples. As of October 1984 approximately 47,000 persons over 64 years of age were receiving this supplement. Under the SAFER program 9,800 seniors received financial assistance for rent. And 34,000 seniors were able to travel with bus passes heavily subsidized by my ministry under our bus pass program. Also available through the province are seniors who volunteer as counsellors to provide advice, information and assistance on all matters which concern their fellow seniors.

We were pleased to host a conference in Victoria this year for senior citizens' counsellors, to share ideas and to discuss important issues such as effective use of community resources to help seniors with loss of loved ones; loneliness; shelter alternatives; abuse of the elderly; financial, legal and medical protection; and home support services. That conference, as others that we have held, certainly has proven to be worthwhile. We're always proud of that particular service, which was introduced in this House some years ago by someone who is no longer with us — Isabel Dawson, who was the MLA for Mackenzie. Isabel Dawson introduced that program, as she did the bus service program for seniors. The counsellors' program is probably the most effective in the country — not that the bus pass program is not — and it has been copied by others. This one is unique. This one keeps going. It's incredible that it has lasted this long with so much support from the seniors' community. So it has been a very reasonably priced program but incredibly effective. Seniors talking to seniors, seniors counselling seniors — a very effective program.

Provision of social welfare services, such as services for mentally and physically handicapped individuals, services for families and for protection of children, is the other major area of responsibility assigned to my ministry. I'd like to just address one area of that, and that is to do with the fact that in this province in this past 12 months we have led this North America continent in providing new initiatives for the mentally handicapped. You should all take pride in that.

We do lead North America in a historic break with tradition. In one 12-month period we have successfully placed 264 formerly institutionalized residents into smaller community-based resources. We have closed the Tranquille facility, not because it wasn't doing a good job but because the plant had deteriorated. It was time to close it and to make good on our commitment to deinstitutionalize those who were in institutions, and that we have done. We have done it effectively, humanely and with great style. They are doing a marvellous job in the communities, and I must say that that accomplishment was made possible through a dedicated staff of Human Resources. I have to say that the staff in the Tranquille institution, my own executive staff and those of my ministry, the Ministry of Health which cooperated in this regard, the Ministry of Housing which gave great cooperation in this regard, and particularly that staff in my ministry which led the partnership, if you like, of government resources, were really remarkable.

Then we should give credit to the parents and the relatives of the residents. I guess it must be a wrench for some of those relatives to make the decision. They had been very comfortable, some of them, with their loved ones — their child who now is an adult — who had been there for many years, and I would think that that decision for some was a really remarkable decision to have to make, to perhaps disturb their lifestyle. They would be able to visit every so often — although, sadly, many of them are never visited at all. But, you know, for them to have to make the decision — that perhaps they would have to be taken from Tranquille where they visited many times, and then perhaps have them in another community altogether — was a wrench for them.

In most cases, we were able to bring those clients close to their own family home, and that was a great plus, and that was really what we were trying to do throughout all of the decision-making. We accomplished that quite remarkably. But quite remarkably, too, that brings a decision for families which we aren't sure we would want to make ourselves, and they made it. They made it with tremendous love and tremendous attention to the job that had to be done.

[Mr. Strachan in the chair.]

I would like to tell you that I have had letters since that time — since the move of those Tranquille residents to community-based resources — which would bring tears to your eyes but really make you feel good about what has happened in this province, which has led the North American continent. There are letters from people who have their loved ones from Tranquille now living in a community home, perhaps with three other residents, with 24-hour care, with assistance to go into the community, with the kind of love and surrounding with warmth of the community, able to go for the first time to a store, for the first time to be able to learn how to get on public transportation, for the first time to be able to get up and have breakfast in the morning in a home — not a big large dining room, but a home — and to sit around and watch television with what is now their new-found family, to have young people around and people who come in and visit and volunteers who assist. All of that's so different from what it was prior to our move from Tranquille into these smaller residences.

I'd like to say here and now that I really felt, during that year, that it was a disservice to these young people — these adults — a disservice to the parents, a disservice to all of those who were surrounding the clients at Tranquille, whether they had only staff people to rely on, or whether they had their own families to rely on. There were some people who took that whole year and made it a circus for those people who had enough to bear in having a mentally handicapped person to care for and to make decisions for. I felt that that year was a circus for those people, a cruel circus that need never have been home simply because it was led by people who had a different agenda. That was too bad, but it happened. Perhaps it is a lesson for us, a lesson that when people would do anything for their political agenda rather than for the agenda of the people they serve, perhaps we've

[ Page 5898 ]

gone a little too far in the way we are treating the handicapped in the province. The handicapped should never be the pawns in any kind of political confrontation. Although we'll have confrontation over many things, the handicapped should not be part of that fight.

I'd like to say, though, in spite of all that, in spite of the misinformation that was given, in spite of the attempt, if you like, to turn the deinstitutionalization of Tranquille into something that shouldn't happen, I have to pay tremendous respect and give thanks to the parents and the relatives, the dedicated staff, and many community organizations who did their job and did it well and today are the recipients of provincial funding, operating those group homes and those individual homes across this province for the benefit of the patients or the clients that they serve. As I mentioned, the ministries involved were particularly effective and worked in such a cooperative manner as well.

Already I can tell you that these community placements have been tremendously beneficial. I am very pleased indeed that we have been able to see a positive attitudinal change. That's so important — attitudinal change. These skills are being developed. The attitudes of the neighbourhood are changing; the attitudes of the people in the communities — from increased awareness of the capabilities of the mentally handicapped — have changed completely around. So have the attitudes of the clients themselves. It's a personal approach to the care of the mentally retarded citizens of our province. They, in their lives and the way they turned them around, and in the way that our staff and our community organizations are helping us, are the success that we can feel pride in in terms of the whole achievement of Tranquille.

May I just say that in keeping with our government support for community-based services for the mentally and physically handicapped individual, we have, I am pleased to announce, a 5 percent increase in the subsidy rate paid to non-profit societies which operate achievement centre societies and services. These centres are an integral part of community service which these same people who are now moved into community settings can now take advantage of. They provide a variety of programs aimed at enhancing personal and social skills which will contribute to client independence.

There are other core programs which I should mention to do with the infant development program. This helps children develop in skill areas where they are experiencing significant delays. The Chance program which we run, along with the Ministry of Education, provides personal-care services in the schools to disabled children, plus the specialized residential resources for children who are emotionally disturbed or physically disabled.

Special-needs day care, which is growing in this province and will continue to grow.... That is something to see, where you see these young people who start in day care.... They start integrated with the non-handicapped right in the play-school day-care area or prior to play-school, with the realization that even though the disabled child with them has a special need, they can work together and play together and they aren't any different.

Just imagine the change in our whole outlook on the disabled. By the time that child who is disabled gets into high school, they will have gone through a whole series of educational opportunities with non-disabled children, and they will be good friends. There will not be that barrier and that difference that has always existed in this nation, when people were treated and isolated. There is a real achievement in integrated day care.

Employment initiatives for the handicapped, I'm sure, will come up during the debate, and I'd like to speak to that in a little more detail later; but I think we are giving opportunities to the truly handicapped.

[5:45]

Before discussing my ministry's services in support of families and children, I'd like to take a moment to commend my staff for their continued dedication and high quality of service during challenging times. The responsibilities entrusted to them are vital to the well-being of our society and require great sensitivity and sound judgment. This province's leadership in its range of social services is due in significant part to the dedicated efforts of my staff.

Mr. Chairman, I'd just like to mention that we have been truly honoured in the past few months in having the new minister of social services for this nation ask our deputy minister — the only one across this nation — to assist him in a fact-finding task force that has gone across this country to such places as Winnipeg, St. John, Halifax, Montreal, Toronto, Ottawa and Edmonton. To have one of our people — John Noble, who has served this province so well.... To have invited him as the only provincial deputy minister in this nation to join that federal task force is a great tribute. In the investment of time that has been given, not only has Mr. Noble learned a great deal as deputy minister of this province, but he has also learned that the citizens of the province of British Columbia can hold their heads up high, because wherever he has been meeting we have been held up as the ultimate in social services across this nation. That is a great accolade to this province and to the services which we provide. I'm pleased to tell you that, although we have had to do without him for some meetings, we are so pleased to have that kind of leadership in our ministry and also by the fact that we are revered, in terms of our services, across this nation.

The third example of British Columbia's lead role in providing social services is the new family support program, operated jointly with the Ministry of the Attorney-General. This program is currently underway in the Vancouver area. That pilot has already started to enhance the monitoring and enforcement of maintenance orders and support orders. The major objective is to take much of the burden for pursuing support payments off the shoulders of deserted spouses. How often in this House have we talked about the enforcement of maintenance orders? I would really hope, Mr. Chairman, that I can share with you the success of that program already.

The House resumed; Mr. Ree in the chair.

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

HON. MR. GARDOM: Mr. Speaker, I move that the House at its rising do stand adjourned until Thursday at two o'clock in the afternoon. I do hope that all members will be able to attend the preview opening of Expo's Omnimax. It's really an outstanding event for British Columbia and indeed for the world.

Motion approved.

Hon. Mr. Gardom moved adjournment of the House.

Motion approved.

The House adjourned at 5:49 p.m.