[ Page 2411 ]

CONTENTS

Routine Proceedings

Tabling Documents –– 2411

Oral Questions

Sale of West Kootenay Power and Light Co. Ltd. Mr. Harcourt –– 2411

Mr. Clark

Admission fees to provincial museums. Ms. Edwards –– 2412

Possible addition of third SeaBus. Mr. Clark –– 2412

Mr. Sihota

Soliciting practices of funeral homes. Mr. Blencoe –– 2412

Jobs for disabled. Mr. Cashore –– 2413

Overrun on Coquihalla I project. Mr. Miller –– 2413

Vancouver Trade and Convention Centre. Hon. Mrs. McCarthy replies –– 2413

Committee of Supply: Ministry of Tourism, Recreation and Culture estimates. (Hon. Mr. Reid)

On vote 59: minister's office –– 2415

Ms. Edwards

Mr. Rose

Committee of Supply: Ministry of Forests and Lands estimates. (Hon. Mr. Parker)

On vote 34: minister's office –– 2417

Mr. Williams

Mr. Kempf

Ms. A. Hagen

Hon. Mr. Strachan

Forest Amendment Act, 1987 (Bill 40). Second reading

Hon. Mr. Parker –– 2425

Mr. Williams –– 2426

Hon. Mr. Parker –– 2426

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

On vote 38: minister's office –– 2427

Hon. Mr. Dueck

Hon. Mrs. McCarthy

Mrs. Boone

Ms. A. Hagen

Mr. Rose

Ms. Edwards

Mr. Stupich

Mr. Cashore

The House met at 2:09 p.m.

Prayers.

HON. MR. VEITCH: In the members' gallery today we have the president of the Burnaby-Willingdon Social Credit constituency association, Bill McCarthy; my ministerial assistant's wife, Anne McNaughton, her daughter, Karen Wantke, and her sister, Joyce Taylor, who is a resident of greater Victoria. I'd ask the House to bid them welcome.

MR. HARCOURT: Mr. Speaker, I have an introduction and a congratulations. I'd like to introduce and have the members of the Legislature give a warm welcome to Kathleen Baker, the granddaughter of one of our more illustrious previous members, Rae Eddie.

I'd like to congratulate those members of the Haida who participated in the wave-eating — eating up the waves — from Vancouver to the Charlottes. Twenty people participated in this historic voyage in a canoe carved under the supervision of the master artist of the Haida nation, Bill Reid. On behalf of us all, I'd like to pass on congratulations to those who participated so successfully in that voyage.

MR. PELTON: In the gallery today, from the beautiful city of Mission, British Columbia, is Mr. Hans Rummel and his daughter Marina. Visiting with Hans and his daughter is Nathalie Stappert from Essen, West Germany. On behalf of the second member for Dewdney (Mr. Jacobsen) and myself, I would ask the House to give them a warm welcome.

MRS. BOONE: I'd like the House to join me in welcoming friends of mine who are in the gallery today, Jeremy and Ann Smith, and their daughters Lindsay and Allison — visitors from England — and my mother, Anne Chudley.

MS. CAMPBELL: One of the advantages of having a session that lasts into the summer is the opportunity it allows members to share the Legislature with visitors who might not otherwise see it in action. In your gallery today are members of my own family to whom I have been revealing the wonders of the House and its practice. I was a bit disconcerted when their greatest response came from the disclosure that my colleague and seat-mate, the hon. second member for Cariboo (Mr. Vant), is a member of the Anglican clergy. But there are other wonders and points of amazement in the House.

Would the House join me in welcoming my mother-in-law, Marcelline Eddy, from Mercer Island, Washington, my stepchildren, Abby and Andrew Eddy, from Aylmer, Quebec, and my husband, Howard Eddy.

MR. MILLER: Despite our good qualities, we all know we're here because of the hard work of people in our constituencies. Today it gives me great pleasure to introduce Steve Boggis, president of the Prince Rupert NDP club, and one of the key people in terms of my being in this House today. In the precincts today as well is Steve's wife, Marjorie, and his two children, Shannon and Kenneth. Not only do they have the distinction of being very good, hard-working NDPers from Prince Rupert, but Marjorie is the daughter and Steve the son in-law of the first member for Nanaimo (Mr. Stupich). So I'd like the House to join me in making them welcome.

MR. BLENCOE: Today I had the honour of having lunch with two old friends from Calgary, Alberta: David and Sherri Wylie. They are here visiting our community and of course talking about the Olympics, which will happen in Calgary next year. I also sent them to visit the museum — the last few days, of course, that the museum is admission-free. Would the House please make them welcome?

MS. A. HAGEN: I would like to ask the House to join me in welcoming two very good friends from my constituency of New Westminster, Len Bonn and Ann McLeod, who are seated in the members' gallery. Would you join me in welcoming them.

[2:15]

MS. SMALLWOOD: I'd like the House to join me in making welcome a very good friend of mine, Andrea Eaton. She's a member of the South Surrey-White Rock constituency and a very active community worker.

Hon. Mr. Veitch tabled the annual report of the British Columbia Buildings Corporation for the year ending March 31, 1987.

Oral Questions

SALE OF WEST KOOTENAY
POWER AND LIGHT CO. LTD.

MR. HARCOURT: I'd like to ask the Premier about the recent decision of the Utilities Commission regarding West Kootenay Power. The recent decision by the Utilities Commission states clearly that the commission does not have jurisdiction to control foreign investment in a utility. The sale of West Kootenay Power and Light to UtiliCorp will create no jobs for British Columbians and will put consumers at risk. My question to the Premier is: will the Premier now intervene in the sale of West Kootenay Power to ensure that the ownership remains in Canada?

HON. MR. VANDER ZALM: I think it's fairly evident that at some point in the past when Cominco, a large Ontario company, became involved in the supply of power to residents of British Columbia. no one intervened, and obviously the government stayed out of it then. They have provided a service to the residents effectively and at a good price. I think perhaps we might expect the same from the new private owner of this particular corporation; and certainly the recommendations or the conditions provided by the B.C. Utilities Commission will assure this to a large extent. So there will be no intervention in the marketplace by the government.

MR. CLARK: A supplementary to the Premier. This will be the first time in Canadian history that we allow this monopoly resource, a strategic sector of the economy, to be controlled by Americans. Is the Premier aware that Utilicorp has a questionable reputation in Missouri and that it is in the process of being forced to pay back $10 million to consumers in that region because it illegally overcharged them?

HON. MR. VANDER ZALM: One of the advantages of having a private corporation providing a service to people is that they are probably much more closely monitored than a

[ Page 2412 ]

public company might be; and if a public company overcharged its people by $10 million, it would perhaps never come out in the open. So there is an advantage oftentimes in the policing and the controls that are provided on a private corporation.

I am not aware of what happened in Missouri, but certainly these, I'm sure, were considerations for the federal government when they reviewed the application initially and approved it. So with that approval and with the careful scrutiny that's been given this whole operation through the hearings held by the Utilities Commission, I am satisfied that the process has served us well.

MR. CLARK: A supplementary to the Premier. It is interesting that the Premier will depend on the Mulroney government to protect B.C.'s interest. Well, we won't on this side of the House. Is the Premier aware that three years ago this same company in Missouri was found guilty again of overcharging $2.6 million to the residents of Missouri? I assume he isn't, so I'll give him that information. Will the Premier guarantee in this House that power rates to residents in the region will not go up as a result of this American takeover?

HON. MR. VANDER ZALM: I cannot guarantee what the price will be for power or any other commodity in British Columbia now or at any other time, nor can anyone else, unless we have complete state control over all things.

I think the question is somewhat facetious, but on the other hand, let me assure the hon. member that if he has read the report which was provided us by the Utilities Commission, I am sure he must be satisfied that this issue has been well addressed.

MR. CLARK: The fact is that I'm not satisfied. The Utilities Commission said that foreign ownership was not within their mandate. Has the Premier decided to include the question of nationality of ownership as a consideration for the Utilities Commission in future takeover attempts by America? Or is everything for sale? Is B.C. Hydro going to be sold to American companies?

HON. MR. VANDER ZALM: It's a little tiring to hear some of this hypocritical comment. The one constituency or riding in the whole of this country which has more foreign ownership than any place in Canada is Oshawa, which happens to be the riding for the leader of the NDP federally.

ADMISSION FEES TO PROVINCIAL MUSEUMS

MS. EDWARDS: Mr. Speaker, my question is to the Premier. Admission fees to the Provincial Museum and the two heritage parks go into effect on Wednesday, Mr. Premier. Have you decided to ask your Minister of Tourism (Hon. Mr. Reid) to reconsider his ill-conceived action in imposing these fees on the heritage resources of this province?

HON. MR. VANDER ZALM: The answer is no.

POSSIBLE ADDITION OF THIRD SEABUS

MR. CLARK: A question to the Minister of Municipal Affairs. Since the start of service in 1977, the number of passengers carried on the SeaBus has steadily increased and last year tripled to almost six million. The need for a third SeaBus is clear in terms of service; and it makes sense in terms of jobs as well. Has the minister decided to put another of these popular carriers into service'?

HON. MRS. JOHNSTON: I understand the matter is under discussion by the transit officials at this time.

HON. MRS. McCARTHY: Last Friday there was a question taken on notice, and I'd be very pleased to give the answer now or after question period.

MR. SPEAKER: I think, hon. minister, under our rules we'll leave these until after question period.

HON. MRS. McCARTHY: I'd be happy to do it after question period.

MR. SIHOTA: A supplementary on the last question from the member for Vancouver East to the Premier. In the shipyard in Esquimalt we have gone from a high of 1,400 people being employed there to around 62 now. On December 12, 1980 — and I have the press clipping here — the Premier when he was Minister of Municipal Affairs indicated that a third SeaBus would be en route by 1983. Is the Premier now willing to live up to that commitment and fast-track any plans that may be in the wind so that we can create those jobs necessary before we get on line with the Polar 8 in the shipyards in Esquimalt?

HON. MR. VANDER ZALM: Mr. Speaker, that has already been answered by the Minister of Municipal Affairs (Hon. Mrs. Johnston), but obviously in time we'll definitely be reviewing the needs of transit in the province and a decision will be made by government.

SOLICITING PRACTICES OF FUNERAL HOMES

MR. BLENCOE: A question for the Minister of Labour and Consumer Services. As the minister knows, I have put before him all sorts of evidence of the phone solicitation for cemetery services, which continues to offend thousands and thousands of British Columbians, and that offence continues on a daily basis. It's now mooted and rumoured in the industry that the government is about to allow uncontrolled telephone solicitation for funeral services. Will the minister confirm that that will be the policy of the government?

HON. L. HANSON: No, I will not confirm, because it's not the policy of government. Certainly as government evolves policy it will be announced, but there is no determined policy at this point about cemetery or funeral solicitation.

MR. BLENCOE: Mr. Speaker, I think the minister and the government must be aware that the lack of action by this government in this very sensitive area is creating all sorts of concern. I continually, as I'm sure we all do, get calls from people who are coming out of hospital or are ill, having been subjected to heavy-pressure sales for funeral services.

The last question for the minister. Is the minister aware that there is currently a major buy-up program, or association program, going on in the province of British Columbia, particularly by a Texas-based corporation, Service Corp.

[ Page 2413 ]

International, which is buying up, or associating with, locally owned funeral homes? The thing they do, which they specialize in, is high-pressure sales phone solicitation. Is the minister aware of this concentration of efforts by this industry?

HON. L. HANSON: Yes, I am aware that that corporation is endeavouring to purchase a number of firms in British Columbia. I'm not sure that the government's policy as it relates to solicitation — which, as I said earlier, will be determined — has any relationship to who owns the particular operations.

For the interest and information of the member opposite, there was a task force created of funeral directors, cemetery owners and consumers in British Columbia — Mrs. Ada Brown. There was also a representative of the clergy, as well as a representative of senior citizens' societies. The result of their investigation and discussion is being tabled in my ministry very shortly; that will be submitted to cabinet when that report has been tabled with my ministry. It hasn't been an ignored situation. It certainly is in the process, and I expect that report to be tabled within days.

MR. BLENCOE: On a supplementary, Mr. Speaker. I'm sure the minister is aware of the report circulating in the industry that this government is about to allow unchecked, unfettered phone solicitation for funeral services and cemeteries. That will be — a total offence to the people of British Columbia. My question to the minister: is the minister aware that in the province of Ontario they have just announced on June 25 that Ontario is now moving and will introduce legislation quickly to ban phone solicitation for funeral establishments and to ban extra fees for arranging prepaid services? Will the minister follow the lead of Ontario and ban such phone solicitation?

HON. L. HANSON: Mr. Speaker, in answer to the first question, yes, I am aware of that legislation. But I would suggest to the member opposite that British Columbia doesn't follow Ontario or any other province. We develop our own policies within government and administer them within the province. When that policy is adopted, I'm sure that the members opposite as well as general British Columbians will be made aware of what the policy is.

JOBS FOR DISABLED

MR. CASHORE: To the minister of Social Services and Housing. Four months ago the throne speech stated the government's intention to "soon name a task force to work with the private sector to open up job opportunities for the disabled." The disabled in this province are waiting to consult with you on ways they can become more independent and integrated into society. What action has been taken to date?

HON. MR. RICHMOND: I'd like to inform the member that I've had several meetings with the associations and individuals regarding the disabled. Further to that, there is a task force being put together at this moment under the auspices of the Premier, which includes Rick Hansen and, of course, is being spearheaded by our own second member for Little Mountain (Mr. Mowat). So it has not been ignored; in fact, it's very active at the moment.

MR. CASHORE: Supplementary, Mr. Speaker. I would be interested in knowing when the task force will be completely stated in terms of its membership and when it will meet. Has the minister decided to recommend to his cabinet colleagues an affirmative action program for employment of disabled persons in the public sector?

MR. MOWAT: It's already in place.

HON. MR. RICHMOND: Thank you, Mr. Speaker, and thank you for all the help. I really appreciate that. It's nice to get that kind of help after being away for two or three days.

The member and the House and the people of B.C. will be informed as soon as the task force is in place as to the makeup of that task force. As the member for Little Mountain said, there already is affirmative action by this government regarding the disabled.

MR. CASHORE: Supplementary to the same minister. Other provinces, such as Ontario, have made use of cost shared training funds which are available under the Vocational Rehabilitation of Disabled Persons Act, to help the disabled into the workforce. Why has this government failed to take advantage of this program?

[2:30]

HON. MR. RICHMOND: The question is why we have not taken advantage of this program; it's a program for Ontario. We don't follow Ontario's lead or Manitoba's lead in this province. We're not followers over here, Mr. Member; we're leaders. Having been to conferences twice now with social services and housing ministers, I can tell you we're far out in front of most of the rest of this country.

OVERRUN ON COQUIHALLA I PROJECT

MR. MILLER: One wonders why Mr. Rogers went to Great Britain; nevertheless, a question to the Minister of Transportation and Highways. I wonder if the minister could confirm that a project let on the Coquihalla Highway — namely, the Great Bear snowshed project — which was originally tendered for some $5 million, has in fact come in at just about double that, at about $10.5 million?

HON. MR. MICHAEL: Mr. Speaker, I can't confirm the exact dollars. He's talking about a project in Coquihalla 1, and there was a significant overrun on that particular project because of the seasonal nature of the work.

VANCOUVER TRADE AND CONVENTION CENTRE

HON. MRS. McCARTHY: Mr. Speaker, I'm responding to questions regarding the opening of the new Vancouver Trade and Convention Centre. The questions were graciously taken on notice by my colleagues the Provincial Secretary (Hon. Mr. Veitch) and the Attorney-General (Hon. B.R. Smith) last Friday. I'm disappointed that the member, who made this Legislature a bit of a circus last week by giving me the name of Marie Antoinette — the first member for Vancouver East (Mr. Williams).... I'm sorry that Madame Dufarge is not in the Legislature today to listen to the answers. I would think that when the questions were put to me in such a way, when I was absent on government business, he would have been here, because it seemed a matter of such

[ Page 2414 ]

great importance. I want to put those questions in context, and I want to respond to the questions, and have each member of the House understand the plain, hard, bottom-line, true facts about the opening of the trade and convention centre. Those are the kinds of facts that never get headlines next to the ridiculous and completely ill-founded comments and suggestions that that member of the opposition uses to grab a few drops of ink in the daily press.

So first, Mr. Speaker, there never was any such thing as a $500-per-plate dinner at the opening of the trade and convention centre. There wasn't even a $50-a-plate dinner. The dinner on the eve of the convention centre's opening was paid for by the company which won the contract to be the centre's official supplier....

Interjections.

HON. MRS. McCARTHY: You know, the members opposite should know that each of the contractors who bid to be an official supplier to the trade and convention centre had the official dinner as part of their contract. Everybody dealt on the same level playing-field. There was no cost to the trade and convention centre budget for the opening dinner. So they supplied dinner as part of their contract. They supplied dinner to British Columbians as part of their contract.

In fact, Mr. Speaker, official suppliers to the convention centre, whether they be sound and electrical contractors or staging and setup companies, each provided a certain amount of free services for the opening as part of their official supplier status.

On behalf of the hospitality industry in our province — men and women who work very hard every day to make British Columbia a first-choice travel destination — I resent and I deny the suggestion of the member for Vancouver East that airlines, hotels and tour companies sponsored visiting convention planners at a cost to themselves of some $750,000, on probably the busiest weekend in the whole year with July 1 and the July 4 American holiday, so that they might receive some special treatment in the awarding of government or convention contracts. I think that is a sad reflection on the member who made that intimation and a sad reflection on the psychology and the thinking processes of the NDP in this House.

Mr. Speaker, those companies looked at the opening of the convention centre with a great deal of pride, and like so many other British Columbians, they recognize its potential as an economic generator of tremendous importance, not just for the hospitality industry, but for the entire economy.

Every time one of those convention delegates buys a boiled egg for breakfast or uses a paper napkin at lunch or buys a souvenir made in B.C., they are sending economic ripples throughout our whole economy.

Mr. Speaker, any suggestion that those corporate sponsors will receive extra-special treatment from the government or the convention centre is a slight against those firms and the staff of the centre. No one pressured those firms to participate in the opening. They themselves recognized the importance of the convention planners being invited and realized that in the long term, this opportunity would give them potential customers bringing several thousand delegates to Vancouver and British Columbia. It is on that strictly business basis that the centre and this government will work with those firms and others, to promote the convention industry in British Columbia.

Finally, let me address the cost of the opening, the open house in support of Variety Club "Special Kids," and the convention buyers brought to B.C. as guests of the industry and the centre. Almost 200 of the world's most influential convention planners were our guests. They represent a potential of $450 million in convention sales if they bring only one convention to British Columbia. That in no way accounts for repeat business, and I think that members in this House will know and will agree that any one who visits British Columbia — certainly our Minister of Tourism will agree — definitely will be back again.

As part of our marketing strategy for the centre, we budgeted almost $300,000 to showcase the centre, its versatility and its potential. This strategy covered a five-day group of activities and concentrated particularly on July 3 and 4. That figure, Mr. Speaker, amounts to about 6/10 of 1 percent of potential sales.

We were showing off, and we were presenting to the world a $130 million convention centre, cruise ship facility and hotel combination on probably one of the most beautiful harbours in this world. I'd like to invite members across the floor to try to identify any other firm or any major business that was able to spend as little and gain as much as the new Vancouver Trade and Convention Centre has done with that marketing plan. I'd like you to name any major firm or business that believes that 6/10 of 1 percent is too much to launch a brand-new product into a very competitive industry such as the convention industry; an industry that is worth $30 billion annually on this continent.

I can tell members of this House that the dollars were well spent. They were an investment that has put the Vancouver Trade and Convention Centre at the forefront of the destinations being reviewed by those convention planners. In addition, not only were the planners and buyers impressed with what the centre could do, but the 14,000 British Columbians who toured the centre on opening day and gave so generously to Variety Club's children felt a real sense of pride and accomplishment — the same feeling we had when Expo 86 opened its doors a year ago.

Just to show how much the centre....

MR. SPEAKER: The minister is really making a statement.

HON. MRS. McCARTHY: Yes, I am, Mr. Speaker, in order to answer the many questions raised by the member for Vancouver East last Friday.

MR. SPEAKER: If the minister wants to continue, I'll also allow the opposition time to reply. I think that's only fair.

HON. MRS. McCARTHY: Mr. Speaker, I will answer anything that Her Majesty's Loyal Opposition wishes to put to us in regard to the opening of the trade and convention centre. I think it's really sad, in the year following Expo 86, when I think the whole of the province grew up, to know that the official opposition in this province didn't get the message from the rest of the province when they put negativism behind them and decided to get on with being a real sophisticated part of world trade in this province and in the trade and convention centre.

MR. ROSE: You made the point, Mr. Speaker. What we got was a ten-minute sermonette. We got from the hon. lady

[ Page 2415 ]

not an opportunity, really, to make a full explanation of this; it was more like her part of the estimates. A soliloquy of this length is fine, but I have trouble, Mr. Speaker, as you did, distinguishing between what is a statement on motions, or a ministerial statement.... The minister is free to make those at any time, but to make them as an answer to a question on notice is really unfair to the House, because a response cannot be made to a question taken on notice.

If a question is to be non-argumentative and denied personal references, certainly an answer or a reply to a question taken on notice should be the same. This was filled with personal references. It was filled with propaganda. It obscures the tendering process, and it's an insult to business. I think it's unbecoming of a minister of long experience — a venerable minister in this House — to respond in that way, and I hope, Mr. Speaker, that you'll be able to caution the minister and ask her to respect the House and the members in it.

MR. SPEAKER: I don't want to get into a debate on this issue. Could the minister take her seat for just a moment. I know that when the question was asked last week, there were some personal references made, and I think there were some on both sides. That does not make it correct. If the opposition is asking a question of a minister who is not here, they maybe should expect something to come back in the next week.

I think both sides have had a fair go at this issue. The minister's estimates are coming up, and I think we should proceed with the normal House business.

Hon. L. Hanson tabled an answer to a question from the member for Kootenay (Ms. Edwards) on July 7.

Orders of the Day

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

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

ESTIMATES: MINISTRY OF
TOURISM, RECREATION AND CULTURE
(continued)

On vote 59: minister's office: $228,460.

MS. EDWARDS: I want to conclude my remarks in fairly short order. What I have to say to the minister.... If he has any responses, I'll be delighted if they're positive.

What is clear when one examines what's going on in the Minister of Tourism, Recreation and Culture, and what has been clear with the amount of debate that we've had on these estimates, is that there has been an absolute lack of planning and coordination in the ministry, and there is a centralization of control and a lack of consultation.

[2:45]

I'd like to go over those three issues. If the minister can refute them, I would hope that he can show that this is not the normal way the ministry should be run.

I think it's very clear that there needs to be some planning and coordination. An object lesson is the imposition, mid season, of fees at the Provincial Museum and the heritage parks, and at several of the smaller facilities that the province runs. It becomes very clear when the minister, asked whom he has consulted, says: "The Attorney-General's mother." Evidently it's going to cost $3.50 for each of the $5 fees that is being collected; he would not let the Friends of the Museum go ahead and collect what they assured him would probably be at least $2 on a voluntary basis. He's charging the locals in order, he says, to put on a travelling show. He's going to see that the birds-of-prey show travels. He says it's going to be of some benefit for the people who are here when that show will travel out of the area, and for some reason we're going to charge locals and our visitors to take our artifacts away.

It's very clear that planning was missing on the South Moresby issue as far as the Ministry of Tourism was concerned. The Ministry of Tourism said at the first of the session that they were totally in favour of South Moresby as a park. They were going to work toward getting it as a park. In fact, I was told we weren't going to do anything about the problems of the Strathcona borders because all of the ministry's efforts were going to go toward South Moresby park. All of a sudden the minister says that South Moresby park will be far too expensive for tourists, and he doesn't know if it's going to be a real attraction. It has been an inconsistent response.

The minister's fuzzy thinking comes through when he talks about the cultural tourism campaign put on by the province and the federal government, which began about a year ago. The program was there to coax tourists from various west coast cities in the United States up to Victoria and Vancouver. The minister has claimed, in fact, that the business to the Provincial Museum depends largely on that tourism promotion, and that there were 18,000 more visits to the museum, probably based on that promotion. When we look at what else happened with that promotion, it turns out that the Playhouse Theatre in Vancouver had one of those tickets turned in to the end of February. The Marcuse dance society had one ticket turned in. The Vancouver Opera did better, with six of them. The Pacific Cinematheque had four turned in, but they all turned out to be local people. The Arts Club Theatre had 54 of those promotion tickets turned in to them. There's a great anomaly there, Mr. Chairman. Either the minister is missing something or he is misleading, because what happens.... Either it's because the Provincial Museum is free and therefore can attract 18,000, compared to the largest number — 54 — that were attracted anywhere else, or something's wrong. It's just not a matter of having been coordinated at all.

The minister has had some problems, I think, in planning and coordinating. Look at the way he has treated the hotel industry: increasing the hotel tax by I percent and removing tax relief from seasonal resorts. He has done this in the face of presentations from the Hotels Association for 1984 indicating that this area has probably the highest basic fixed tax for hotels on the continent. He has failed to address the problem of venture capital, which is one of the greatest needs in the tourism industry. The tourism and service industry is where we expect employment to regenerate the economy of this province, and instead of addressing one of the major problems of small business and the tourism industry, which is access to capital, he has done practically nothing in that regard.

His whole approach to casinos and slot machines — which of course is not his alone — has been totally confused. There's a suggestion that there will be some test of slot machines in casinos on boats to see whether we can put them throughout the rest of the province. He has not made any

[ Page 2416 ]

orderly approach to that one. We're not sure what has happened with Gameplan 2000. It has been laid out, but there are people suggesting that it has no particular coordination to it. All these programs have come from the minister, and they really show a lack of coordination.

The centralization of control is an issue that seems to be on the minister's mind. Not only is the government centralized; it seems the minister was reported as having told an organization in the Okanagan that he would see about their request for about $7,000, because he was going to ask the Premier. That kind of centralization is something that I think everybody should know about. He has appointed boards and chairs of boards in these non-profit societies that he has set up to run the facilities within the heritage areas — the museum, the heritage parks and so on. That is obviously totally in the hands of the minister. The minister has chosen that he be in charge. He is going to continue to move the games into the ministry. It's a centralization that I think he perhaps hasn't managed to mention to us all.

Another place where in fact there is a centralization of control is in the number of areas where the minister has some interest, although he may not have some direct control. We wonder how much he has put into the idea of government party hearings for things such as Project Pride, liquor hearings, and so on and so forth, when in fact they could be better heard, better dealt with, by a legislative committee. We wonder if the minister recognized the kind of centralization he was in, and we think he probably did when it came to the PNE and the York-Hannover issue, where Expo equipment was to be sold to the York-Hannover company to set up another theme park related to the PNE, and so on and so forth, all of which was handled by a single person, and the minister recognized that that was going to be happening. That kind of centralization of control is of concern.

The consultation I was talking about that we believe is not there comes out in a number of areas, and I think that it's very clear when we come back to the issue of fees for the museum and the heritage parks. For example, we have the president of the museums association saying that they were not consulted about fees for the Provincial Museum. One begins to wonder.... The minister said that he thought that he had consulted with the museums association because he had consulted with some member of the association. One wonders, then, if that was the same kind of consultation that took place with the librarians. We asked him about his bill the other day, which said that they did not need to be a librarian in order to be appointed a director of that part of his ministry.

On South Moresby, for example, the Tourism Industry Association of British Columbia made it public that they had asked the minister to make South Moresby into a park, and he wasn't listening at the time. Again, the Hotels Association have said that it took a month to arrange an appointment on liquor hearings. These kinds of things that indicate there is no consultation going on, Mr. Chairman, are of great concern to us.

It seems to me that one of the most important things that the minister could do to enlarge the idea of consultation, and also to indicate that there is not this total centralization of power again, is to refer the issue of fees for the Provincial Museum and for the heritage parks, which he says will be under review, to a legislative committee on tourism. There is no reason in the world why that issue should not have a broad look. The minister has obviously not set up a system that has general support. I think that would be a very wise move on his part.

Mr. Chairman, just to try to get to the end of the general remarks that I wanted to make, I want to express my concern with the minister saying that one of the objectives of the ministry is to increase the gross provincial revenues from tourism, culture, recreation, sport and heritage resources. I think that that emphasis, Mr. Chairman, is not what most of the people in this province would want. I think they want an emphasis on culture, recreation and heritage to be different than just increasing revenues for the province.

Before we leave the ministry estimates altogether, Mr. Chairman, I want to ask the minister a very specific question. He told us on Friday that Mr. Ron Butlin, who was the coordinator of the Summer and Winter Games, was not fired. In fact, he repeated that statement. I guess we're going to have to ask Mr. Minister what he means by "fired," because in fact I understand that Mr. Butlin received a communication on May 27 which told him that under paragraph 16 he had been given notice of termination. That is termination for cause. Is that firing, Mr. Minister?

I see the minister chooses not to respond. I think the minister perhaps would like to answer the question whether he meant to mislead the House when he said on Friday that Mr. Butlin was....

MR. CHAIRMAN: Hon. member, sorry; "mislead the House" cannot be tolerated. Will you retract that, please?

MS. EDWARDS: I will retract that, Mr. Chairman.

Did the minister mean to say other than that Mr. Butlin was fired? Because in fact it seems that the evidence shows that he was given a termination notice by the ministry.

HON. MR. REID: Mr. Chairman, inasmuch as the question of Mr. Butlin is a personnel matter within the ministry, I refuse to answer the question.

MS. EDWARDS: Mr. Chairman, when the issue is as public as it has been, I am surprised that the minister is unwilling to give some of the true information. I would think that he would want the truth to emerge at this point. I would like to make it very clear: did the ministry send the letter to Mr. Butlin terminating his contract?

MR. ROSE: I don't think it's satisfactory, Mr. Chairman, for the minister to evade a question on the grounds that it is a personnel matter.

HON. MR. REID: On a point of order, Mr. Chairman, Mr. Butlin is still an employee of the B.C. government.

MR. CHAIRMAN: That is not a point of order, Mr. Minister; I'm sorry about that. The opposition House Leader continues.

MR. ROSE: The minister told us explicitly that he had not been fired. We have a termination notice terminating his employment with the ministry. It's got to be one way or the other. Either the minister was — not misleading the House, but — unintentionally misleading the House on Friday, or there is something wrong. Somebody forged a document called a termination order. You can't have it both ways. You are either fired or you're not fired. Which is it? Was Mr.

[ Page 2417 ]

Butlin fired with cause, or would the minister like to apologize for giving to the House information which is at best questionable?

HON. MR. REID: In answer to the member for Kootenay, Mr. Butlin and the ministry reached a severance package that was mutually agreed upon.

MR. ROSE: Well, it's a little bit like the old question: did he fall or was he pushed? The termination notice that we have in our possession indicates that he was terminated for cause. It doesn't matter how you bought him off; that's irrelevant. The point is, he was fired and you told the House he wasn't. The minister, I think, should very seriously consider apologizing to the House.

HON. MR. REID: Mr. Chairman, if agreement for severance is "fired," then he was fired. We had reached a mutually agreed settlement. I did not fire Mr. Butlin.

MS. EDWARDS: Through you, Mr. Chairman, I think that if in fact you may have changed your mind after the ministry sent a letter to Mr. Butlin which told him he was terminated, the question that you need to answer is: are you aware that the ministry sent a letter to Mr. Butlin that his contract was terminated?

HON. MR. REID: There is no question that we have communicated with Mr. Butlin on an agreeable settlement by correspondence from the ministry. He is still an employee of the ministry for 60 days following the agreement for separation.

MS. EDWARDS: Mr. Minister, would you call his employment right now direct employment, or is he employed through a contract currently?

[3:00]

HON. MR. REID: He's currently employed by contract, which he was.... When I took over the ministry, he was also employed by contract. He was a contractor up until the agreement for him to take the job that he was offered in Washington state.

MR. ROSE: I wonder if the minister can confirm to the House whether or not there was an agreement reached with Mr. Butlin for his termination after he threatened to sue the ministry for wrongful dismissal.

HON. MR. REID: Not to my knowledge.

MR. ROSE: Could the minister advise the House whether or not Mr. Butlin's resignation was requested by the ministry, or was it something he did on his own?

HON. MR. REID: I understand or I recall it was as a request from Mr. Butlin.

MR. ROSE: I wonder if the minister could confirm then that actually he was fired on request. I wonder if a termination notice for cause would not be considered dismissal.

MS. EDWARDS: Mr. Chairman, I have another question of the minister. The minister said yesterday that we will not continue to operate in the province of British Columbia with somebody who is working with some other employer at the same time. Now I wonder if the minister has any indication for me that Mr. Butlin was working for someone else at the same time as he was working for the province of British Columbia, at any time before the letter of termination was sent to Mr. Butlin.

HON. MR. REID: Mr. Chairman, we currently have under contract an employee who has a job in Washington state, by agreement, to finalize the Delta Summer Games, by virtue of an agreement with Mr. Butlin.

MS. EDWARDS: Has the minister any indication that Mr. Butlin was working for anyone else before the time of his termination?

HON. MR. REID: The answer is no.

MR. ROSE: According to the Blues, this Mr. Butlin was terminated because he was engaged by someone outside British Columbia. Now he's just contradicted.... The minister said that he had no indication that he was employed by some other jurisdiction at the time he was working for British Columbia. If that's the case, then why was he fired?

Vote 59 approved on division.

On vote 60: ministry operations, $50,675,347.

MS. EDWARDS: Mr. Minister, I see by the very broad figures that are in vote 60 that there is a 30 percent increase in operating costs. Only 12 percent of that is for salary and benefits, and in fact overall the total increase is only 23 percent. So the operating costs have gone up considerably more than anything else. I wonder if you could give me some idea why that is the case, that that is where the major increase rests.

HON. MR. REID: Mr. Chairman, the answer to that one is the attractions.... There is an increase of about $500,000 as a result of improvements and administration in the two major historical towns of Barkerville and Fort Steele.

MS. EDWARDS: Which part would that be in, Mr. Minister? As I understand the estimates, the major rise is in land, buildings and works. Is that part of it? The other major rise is in data and word processing systems.

HON. MR. REID: If the member is talking about vote 60, the increase over '86-87 in vote 60 is under attraction operations of almost $500,000, and that specifically is for the improvements to the facilities at Fort Steele and Barkerville.

Vote 60 approved.

ESTIMATES: MINISTRY OF FORESTS AND LANDS
(continued)

On vote 34: minister's office, $210,165.

MR. WILLIAMS: Welcome, Mr. Premier; we appreciate your work on the weekend. I think all British Columbians and Canadians do. As to who worked more, yourself or the Prime

[ Page 2418 ]

Minister, that is a moot point; but the benefit is there for all of us and we appreciate that.

I'd like to discuss, Mr. Chairman, the situation of the truck loggers here on the coast; and I'm sorry that the second member for Dewdney (Mr. Jacobsen) has not participated in this debate, as far as I'm aware, on the question of the truck loggers, having been a truck logger through most of his career.

The truck loggers have a serious problem — and I understand that they met with the government caucus in the last week or two. They have basically been getting a flat price over the last five or six years which hasn't gone up with inflation and hasn't gone up with labour costs or equipment costs — has not significantly changed. At the same time, the companies have been able, through the stumpage system, to handle costs beyond what contract prices have been. That's only of importance in good market years, as the past year has been, but the Hopwood report suggested that there could be something in the range of a $100 million difference between the allowances the Crown allows and what the actual truck loggers get.

So these people feel desperately squeezed in the current circumstances. They are, in effect, something like southern sharecroppers: locked into the tough dirty work in forestry, without getting the returns that are justified for them. Some of then have said to us that they think they're being pushed well beyond reason. Some of them said: "We're going to be reduced to mama-and-papa operations, living in a tent, if the big companies have their way," And they say that the only way that they can be saved in the circumstances is if the Ministry of Forests develops a standard contract that will give them some protection, and if the Ministry of Forests demands or requires that there be an arbitration clause, so that they are not just victims. These are medium and small operators dealing with multinational companies, so they're in the squeeze. The companies have been pocketing — certainly in the last year — significant differences between what is allowed under stumpage for the cost of stump-to-dump work and what these people have been getting.

If the government has a strategy to push them against the wall and convert them into non-union gyppo operations, I think you should be honest about it. I don't think that's good for the coast. I think it'll be turmoil. The IWA and trade unions have worked through much of this century to establish reasonable working conditions. That is now in the balance, in terms of the squeeze play that has been going on with the truck loggers.

They point to the examples of the prices for pulp logs, for example. Right now they're getting $21 a cubic metre for truck loggers' work, as I understand it. The member for Dewdney might confirm that, but that's in my notes from the meeting that we had with the truck loggers. At the same time, pulp prices have been going up. The pulp companies are doing extremely well, but they say that the costs are something like $45 in terms of their work. That's a tremendous gap for them to swallow. In effect, the companies are asking the truck loggers to log at a loss. It partly explains why as much pulpwood is left on the ground as is left there. At any rate, what they face is a real squeeze play, regardless of the numbers.

They desperately need an arbitration clause. It's reasonable that the Ministry of Forests should have a standard contract. It's reasonable that they should have arbitration, so that they're not totally at the mercy of the major companies.

The truck loggers also say that there has been collusion in terms of the contract price, that there are monthly meetings between all of the majors on the question of prices and payments to the truck logging people. That as well shouldn't be tolerated by the Ministry of Forests.

They clearly have a reasonable case. They've been doing good work. It's hard, tough work, and it deserves more consideration by the minister and the Ministry of Forests in order to have this sector of the industry survive and make a decent living.

They are also concerned about a whole range of forest policy matters, and I won't take much time on that. You have their brief, as do we. But the whole question of log exports is there, still to be grappled with. A year ago this government approved log exports on a scale unheard of in the modem history of the province, in an area as big as the country of France: all of the central coast, all of the area back of the panhandle, and the Queen Charlotte Islands. There may have been a rationale for it in the tough times in the forest industry. These are not tough times in the forest industry; the rationale is not there. If my memory serves me right, one of the major orders-in-council was in July of last year and was for a year. I haven't checked to see if another order-in-council has come through. But clearly it is not justified. The companies are doing extremely well. There is no need for those levels of export at all, even in terms of your rationale in the past. Those logs should be used for the future of British Columbia, for industry in British Columbia, for new finished products in British Columbia.

Finally, just a little more on tenure. There is a need for that tenure system to be opened to a much greater extent. You can see it as close as 20 or 30 miles away from Victoria. We have these major tenure systems that lock up the land for other uses, and for the reasonable range of uses that we might achieve. I mentioned the north Island Highway from Campbell River to Port McNeill. You get nothing at all along that highway in terms of pluralistic human economic development. You don't get motels, Mr. Minister; you don't get stores or reasonable development; you don't get bed-and breakfast places; you don't get the odd small farm; you don't get the mixture of activity you should reasonably get as you move through countryside — that is, the mixture of human settlement and the genius of individuals working the land. Those are locked-up lands in this whole northern half of Vancouver Island. There has to be a different policy, particularly when you open up highways like the highway north of Campbell River. It's a tremendous opportunity in terms of tourism and a whole range of activities, and all you've got is one little grocery store and gas station at Woss Camp, and maybe one other thing that I can remember. That doesn't make any sense.

Look at the southern half of Vancouver Island, at the range of human activity on the southern Island between Campbell River and Victoria. It's extraordinary what human genius is doing in the southeastern part of the Island. But the western and northern halves of the Island are really locked-up forest empires, and we're the losers. You could have a much more flexible policy, without hurting the forest companies to speak of, and that would be beneficial in economic terms for everybody.

You can apply that here just, say, in Victoria. Look at all the tourism you get in Victoria. You could relate that to some kind of movement through the forest tenures in Cowichan — you've got Duncan, the Cowichan Valley, Port Renfrew and

[ Page 2419 ]

Jordan River. You could have a significant loop if you opened up those lands to a greater extent for a wider range of human activities. That would be an interesting tourist loop, an interesting highway diversion from Victoria, and it would be a nice, pleasant day trip. That's a real opportunity.

[3:15]

The same applies in places like Alberni, Cumberland and Qualicum. You could have a similar loop on that part of Vancouver Island as well. They're now dead ends. There needn't be dead-end roads going to Alberni. There needn't be a dead-end road going to Port Renfrew. Those could be loop roads, tourist roads, providing a whole range of economic activity within the forest. That would be beneficial for us all.

So those tenures are not only limiting new people in terms of the industry; they're also limiting diversity and limiting employment in British Columbia. You don't have to throw them right out, tempting as that might be, because you have an industrial structure there to deal with. But there could certainly be some loosening of these strait-jackets that prevent development in far too much of the province.

HON. MR. PARKER: Mr. Chairman, just to start with the last point first, there is nothing stopping a review of any proposal for an alternative use of a piece of forest land. We'll take a look at each of those cases on its own merit, with a view to a possibly higher land use value. As far as recreational use of the tenures is concerned, that too is part of the integrated land use requirements of this government, not just this ministry. There are opportunities there to be sure, and as these tenures and the management plans mature, those sorts of needs and desires could be addressed — each on its own merit, of course.

Just to drop back to log exports, log exports are a relative matter. If there isn't a market, then the Timber Export Advisory Committee will recommend that an export permit be allowed. If they don't, then it doesn't go out. As far as the standing-green export permits are concerned, they are available in the North Kallum-Bell-Irving area, and will be until 1990, I believe. It was a five-year commitment to the licensees there. In the meantime, those of us from the northwest are trying to get B.C. Hydro to consider extending the power grid from where it ends presently — basically the substation at Aiyansh — to Stewart, and someday maybe we'll see it move right on up Highway 37.

Just to touch a moment on the comment about collusion on prices, it's fine to make those kinds of statements in the House here on behalf of another organization, but if that other organization feels it has absolute proof of collusion on prices, then there is a legal route to take. As I understand it, that's contrary to Canadian law. The truck loggers have been constantly in touch with the ministry offices over the years. They're always welcome. I know a number of them personally. I understand that they would like to see a standard industry-wide contract. Government doesn't normally get involved with individual contracts and individual business. But when we're talking major resource in the province, we've told the truck loggers that we'll certainly take that under advisement. I know I have worked on a standard industry contract committee with the British Columbia Interior Logging Association. It took several years, and we came up with a sample. Some people use it; some people don't.

I can assure the member opposite that neither this ministry nor this government is on a non-union strategy as far as the truck loggers are concerned or any other organization in the province is concerned. Whether the truck loggers are making $21 a metre or $41 a metre or $61 a metre — I have no way of knowing — that's between the licensee and the contractors. If you want to go into the business. I guess you go in and you negotiate. If they feel they're not getting a good deal, then the recourse, in some cases, is through civil law; in other cases, I guess they have to come to government because they feel they're being frustrated any way they turn.

So we've agreed to keep the doors open and keep the lines of communication open and work with them. Perhaps one thing we might think about is looking at a sample contract development, using perhaps the Select Standing Committee on Forests and Lands as a vehicle to help develop something like that. It's something to think about anyway.

MR. WILLIAMS: What about the arbitration clause?

HON. MR. PARKER: Whatever develops with the sample industry contract that's acceptable to all par-ties is fine. If there's one of those in there, I guess that's fine.

MR. WILLIAMS: I'd just like to pursue this point. The big companies don't want it but it's the reasonable thing to do, because we're talking about rabbits bargaining with elephants. They need some help, those rabbits. And that's what we're asking for. We want an arbitration clause in there so that these companies can't be arbitrary. Right now they're saying: "We don't care what your wage costs are, that's what we're paying." They're saying: "We're not considering depreciation, because we don't care about your depreciation problems on equipment." That's not reasonable. So they say they need arbitration clauses in there so that some reasonable third party can deal with the mess they're getting into. They have been squeezed now for half a dozen years. They've been freeloading on the public. They've been putting money in their pocket in the form of stumpage that belongs to the Crown, because they've been squeezing the contractor. The time has come to clean up the act. So the question is: will you accept an arbitration clause in those contracts? Will you require it so that this remaining independent sector of the industry can survive?

HON. MR. PARKER: Yes, we can take that under consideration. I'm not sure that government should be involved in everybody's business. The next thing we know, we'll be involved in your contract with your dry cleaner and yourself. It's tantamount to the same thing when you start poking around in people's private affairs. I don't think that's quite correct. Anyway, sure, we'll take that under consideration.

MR. KEMPF: On that point, Mr. Chairman, the minister is absolutely correct. But what has to be done is that a place has to be made for the small entrepreneur in British Columbia. I was asked about the arbitration clause too, and it's second-best. If that's the only thing they can get, so be it. But that's not the answer, Mr. Chairman. The answer is to make a place in the forest industry in the province of British Columbia for the little guy. If we did that, we wouldn't have to talk about arbitration clauses — not at all. Six or seven years! They've been downtrodden for 40 years. There is no place. Of the annual allowable cut, 6 percent is going to the small business enterprise program. Then you think there's a place for the small guy in the province's major resource. Not at all;

[ Page 2420 ]

there's no place at all. That's why they have to go after such things as arbitration clauses.

I wasn't even going to talk about that. In passing, I wish I could share the enthusiasm of the first member for Vancouver East (Mr. Williams) in regard to what went on on South Moresby on the weekend, but I don't. This province — this country — will rue the day that that happened, mark my words. It's a black day for British Columbia that we couldn't have had the best of both worlds. And we could have; we had a marvellous opportunity. But raw, bare politics was played in Victoria last Saturday afternoon, and that's why we have a national park reserve on South Moresby. We couldn't use a little bit of logic; we couldn't have forestry and tourism together in that most beautiful spot. But we could have. Raw politics was played by two people who think to use that to get re-elected. I'm afraid that at least one of them — the one that has to go to the polls first — is going to have great difficulty.

We were fairly general in our questioning last week in this minister's estimates, but I wish to get a little more specific. First, I'd like an answer to the question I asked last Tuesday, I believe it was. It was: can the minister assure this House that no section 88 money will be utilized to upgrade the extension of the BCR? Can the minister assure this House that no section 88 money — seeing as we're not going to cut out that corporate welfare — will be used in the extension necessary in the British Columbia Railway?

The minister said he didn't know where the money was coming from, and I accept that. I just want to make sure that none of that money is coming out of section 88 credits, because then, in effect, the taxpayers of this province will have paid for the upgrading of that railroad, not the forest companies and the multinationals, who should be paying for it.

I'd like to touch a little more on the truck logger situation, . It's not just the Truck Loggers' Association. It's every small entrepreneur trying to hang on by his very fingernails in this province's major resource industry, the forest industry. What's going on in regard to the prices paid those truck loggers is the same as what's going on in the Vancouver log market. It's price-fixing. You know, the boys get together and say: "Oh, well, we'll pay them so much this year, and if they squawk, they're down the road," And where have they got to go? Nowhere. There is no timber for them in this huge and beautiful province. A bountiful forest industry, but only for a very few who can partake of it.

I called for a proposal to look into what was going on in the Vancouver log market — not just in the log market itself; in the towing and scaling practices on the coast of this province. I want to read into the record of this House the object of the proposal I called for, and I then want to ask the minister if he's still reluctant to call for this proposal and to let a little sunshine in onto that mess over there which has been taking place for 40 years and which has robbed the people of this province of an estimated $1 billion a year.

I read from the proposal which I asked for and received to identify "the true free market value of logs floating free and clear in the vicinity of the port of Vancouver for the years 1948 to 1987," and to reveal what has happened over those years in the Vancouver log market. If I'm wrong, fine. Let a little sunshine in. The concept of free market value to be addressed is as follows:

"Free market value is defined as the highest price in terms of money which a log will bring if exposed for sale in the open market in a quantity, form and provenance of supply such that it will maximize its utility to the purchaser, and further, that it is exposed in the market, allowing a reasonable time to find a purchaser who buys with full knowledge of all the uses to which the log is adapted and for which it is capable of being used, and which the purchaser buys unfettered by any restriction other than those imposed by economics."

What's wrong with that, I ask you, Mr. Minister? What's wrong with finding out what our timber is worth in British Columbia? What's wrong with seeing what's been going on in the Vancouver log market and the towing and scaling practices on our coast? I think we had a bit of a window into that in the Shoal Island situation.

[3:30]

What's been going on since 1947, and are, in fact, those goings-on correct? I have reason to believe they're not, and I'll read into the record, Mr. Chairman, from Timber Rights and Forest Policy, volume I of the report of the Royal Commission on Forest Resources by Mr. Peter H. Pearse. He said back in 1976 — and I quote from the Pearse report:

"The transactions that now dominate the log market are not those between independent sellers and buyers, but rather trades between the large integrated companies. These sales are frequently made subject to an explicit or implied condition that the purchaser will later make available to the seller other logs more suitable to his needs on a reciprocal basis at the market price prevailing at the time of the subsequent transaction.

"Such trends raise serious questions about the continuing effectiveness of log market" — these are Mr. Pearse's words, not mine, Mr. Chairman — "both as a mechanism for efficiently allocating timber to its highest use and for generating prices that accurately reflect log values."

"The task force which studied the log market in some detail was primarily concerned with the reliability of log prices as accurate indicators of timber values, and the high proportion of non-competitive trading was one of several factors that led to doubts about the dependability of indicated prices for stumpage appraisal purposes."

For stumpage appraisal purposes: I didn't say it; it was said by Dr. Peter Pearse back in 1976. And that was 11 years ago. Eleven years ago, and nothing has been done the same as nothing has been done about the chip prices since 1974. We're not only giving the resource away in the forest industry of British Columbia; we're paying to have it taken. Who is the loser? The taxpayer of British Columbia is the loser, to the tune of an estimated $1 billion a year. That would pay our deficit. We wouldn't have to have all those punitive taxes heaped on our heads. So what's wrong with spending a paltry $50,000 to have a proper report done, to know once and for all whether in fact that is the case in British Columbia?

I've got to ask that question of the minister, Mr. Chairman: what is wrong with going ahead with this proposal? I said I was going to get specific, but I'll give the minister a chance to answer.

HON. MR. PARKER: Section 88: I can't say what's going to come to pass on the B.C. Rail extension and financing, whether it's going to go ahead, because I don't know at

[ Page 2421 ]

this time. But I do know there are no section 88 funding applications for that activity to date.

To deal with the log market question, we have a stumpage proposal going out today that's going to be followed through by Deloitte Haskins Sells on behalf of the ministry with industry and other interested parties. If this proposal is acceptable, then the log market won't be a player.

There is nothing wrong with investigating the log market to find out just how good it is or how effective it is or how realistic it is or who the real players are, or any of these other questions that have been raised. As for the proposal that the member for Omineca (Mr. Kempf) keeps waving around in the House, I don't have a copy of that myself.

MR. KEMPF: I tabled it.

HON. MR. PARKER: That proposal may be appropriate, and it might not be appropriate. I think we should have several bids when we're talking about dealing with public funds.

MR. KEMPF: I have no problem with that at all. I don't care whether in fact this exact proposal is used, but something of a similar nature. The reason I say that is because these objects have to be met. We have to find out; we have to do a thorough investigation. I know without a doubt that this proposal will do it.

As far as section 88 money and the BCR are concerned, it's the minister's decision. You make those kinds of decisions, Mr. Minister, so why can't you assure this House that you won't make that kind of decision; that section 88 money will not be used for the extension of the BCR? It shouldn't be used for anything else either, for that matter, because it's coming right out of the taxpayer's pocket. Can you assure this House that section 88 money won't be used to upgrade the BCR? It's no different from a road. Maybe we haven't used it for railroads in the past, but it's no different than road building or road maintenance, and section 88 moneys are used for that: $105.73 million of section 88 credits in this fiscal year alone.

I want to get to another subject, Mr. Chairman. It's having a detrimental effect on small businesses in my constituency and throughout the north, and in the minister's constituency as well. That's the practice, this year for the first time, of having a Bell 205 helicopter roam the region — I'm talking now of the Prince Rupert forest district — effectively on standby. That makes it unnecessary for the local small entrepreneurial companies to be on standby in many instances, and they lose that revenue, placing them in a position of.... In a couple of cases they're facing bankruptcy. If small helicopter companies cannot rely on some of the firefighting business during the summer, they can't hope to exist in these small communities and provide a service year round. So it's a case either of taking a serious look at that or of writing some of these small companies off, and I don't think that's good enough.

I have a couple of questions with respect to that Bell 205 situation. Was the contract for the Bell 205 service obtained through public tender? Will the cost of having this machine do what it's doing compare with the annual expenditure for standby time paid in previous years to local small operators? As I said before, some of these companies exist in your own constituency, Mr. Minister, and I would suggest that it's something we should be seriously looking at. We need these small people. These operators are needed in these very small rural communities, and unless they can depend on some of that business created by forest fire watch standby in the summer, then we're not going to have them. It's as simple as that.

Maybe the minister can answer those questions.

HON. MR. PARKER: Can the member clarify if it's a Bell 205? Or is it a 204 or 206?

MR. KEMPF: I'm told it's a 205.

HON. MR. PARKER: Would that be similar to a helicopter operated by a private individual in Houston?

MR. KEMPF: I know what the minister is trying to do, and that is not acceptable. You're not going to stand here in this House and tell me that because it's a larger machine it can do a better job, faster — ta-da. ta-da, ta-da! I won't accept that. Who cares whether it's a 205, a 204 or a 206. That's immaterial. The fact of the matter is the small entrepreneur is going out of business.

HON. MR. PARKER: Mr. Chairman, I'm just trying to get a little clarification here, but sometimes that's not possible. There are several independent helicopter outfits along Highway 16 West that fly Bell 206 equipment or its equivalent. Where they are properly equipped to carry out whatever duties they may have, whether it's fire suppression or ignition of slash-burning, I believe we should take a good hard look at using local operators wherever possible. But if we're talking about a situation of need, where the terms of reference are that a larger machine than is available locally is required, then I guess we'll go elsewhere and take it under tender. There were two questions asked. First: was the contract obtained through public tender? And second: will the costs compare to the costs of using local operators in previous years? We'll take those two on notice and bring answers back to you.

MR. KEMPF: I'd like to talk for just a moment about woodlots. I'd just like to ask what happened to the legislation that was in the works being drafted with relation to changes in woodlot size. I didn't see any such legislation show up during this session, which I understand is winding down fairly quickly. I'd like to know where it is and why it isn't coming forward. You don't have to be much of an expert to know that the woodlot program is not working very well out there. It's not working very well for the same reason that the small business enterprise program isn't working very well. To make it work well, you have to put more wood into it. And where would you have to get that wood but from the multinational monopolies in this province, and they probably wouldn't like that. It's quite clear in the minds of many people out there that with the woodlot size now in effect in this province, practically no one can make a success of operating on a woodlot — if they can get one. That's usually very, very difficult. However, I would like to know what the minister is going to do about that and when we're going to see some legislation in this House pertaining to woodlots and their size.

[3:45]

[ Page 2422 ]

HON. MR. PARKER: The purpose of woodlots is not to be the sole means of support. They're a means of supplementing income on a rural enterprise, usually a farm or a ranch. There has been no introduction on woodlot sizes in this session, Mr. Chairman, because we in the ministry decided that for the time being the size of woodlots would not exceed the current limit of 400 hectares. Woodlots are part of the forest management strategy, so they are part of the allowable annual cut. If we want to increase that program or any other program, because the allowable cut is a finite amount, we'll have to decide where it's going to come from — whether it's going to come from other allocations, whatever they may be. At this time there is no plan to enlarge woodlots.

As far as the comment that if people can get a woodlot — they can, but it's not of a sufficient size for them to make a living.... I would like to see woodlots more readily available to the people of British Columbia, and for the next little while I'll be working towards that end. I've already had discussions with several woodlot owners' associations. There's nothing like having individuals buying onto forest management programs to see forest management a success. Woodlots are a good means for public education, and they're a good means for intensive silviculture operations, and I'm certainly in favour of woodlots. This time we're not going to increase their size, but we are going to do everything we can to make them a little easier to obtain.

MR. KEMPF: Swift change in the direction of philosophy since March 6 in the Ministry of Forests and Lands, Mr. Chairman. That legislation was already in the works. But you know, you can talk as you like. You can talk glowingly about wanting to make more woodlots available to British Columbians, but in order to do that, it's the same as in the small business enterprise program. In order to make more wood. available for the entrepreneur in British Columbia, you're going to have to bite the bullet, and take it from some of those who already have too much — and there's some of that around too; in fact, there's a great deal of it. I could read you some figures — and I won't bore the House with it today — but there's a great deal of that around.

For the life of me I don't know how this minister is going to live up to a promise made in question period not too long ago to work toward the 25 percent in the small business enterprise program, as has been promised by successive ministers over the years and never come to fruition.

I stood in this House last week and said it should be more; and it should. The only way you're going to create a log market in British Columbia is to make some wood available to the people of this province. The only way you're going to get away from the need for arbitration clauses in the truck loggers' contracts is to put a little free market system back into the forest industry in British Columbia. Since 1947 it has been eroded, and there is no more free enterprise in the forest industry of British Columbia. It's all in the hands of multinational monopolies; it's in a stranglehold, but if you're going to make more woodlots available, if you're going to make at least 25 percent of the annual allowable cut of the province available to the small business enterprise program, you're going to have to bite the bullet. You're going to have to take on the Adam Zimmermans of this world.

Why do you think it is that a member of this Legislature can't get any coverage in the Vancouver Sun or Province? You need only get this magazine, Report on Business, May 1987, and read an article to find out who owns those newspapers and who sits on, the board of those newspapers. It's the same Adam Zimmerman who is on the cover. Try to change it as you might, Mr. Minister, and I wish you luck — I did it last week, and I do it again here today. Try to change it if you like, but it goes much deeper than you might think, although I think as a registered forester, Mr. Chairman, the minister knows. You can't get the true story about the forest industry printed in the major newspapers in this province because Mr. Zimmerman doesn't want it, and he sits on the board of both the Noranda organization and the Vancouver Sun. Funny, isn't it? That's why you can't get the truth printed in the media of British Columbia about the forest industry. That's why it's in the mess it is, and has been since 1947, and probably will be until all of our good timber is gone. And then they too will be gone, and the people of British Columbia will be left to clean up the mess. We're seeing it all over this province, mess after mess left by those multinationals who take what they want and leave what they want, and do exactly as they please. Lots of luck, Mr. Minister.

I want to get a little closer to home. I have a situation here. We've talked a lot about forestry issues, but this minister has responsibility for lands as well, and I'd like to talk for a moment on behalf of one of my constituents, in regard to what I think to be unacceptable practice by the ministry, and how that individual was treated — how any individual is treated with respect to work done on agricultural leases. This little guy.... I wish we would treat the large multinationals in the forest industry the same as we treat the ordinary citizen in British Columbia, Mr. Chairman. Then we'd get someplace. But we don't do that. This guy can't fight back, so we sock it to him. It's unacceptable.

He couldn't get some of his work done on a particular lease because of weather conditions. The minister can understand that; he's a northerner. He knows what our summers can be from time to time. I know that your people in the field don't exactly love this individual, because he speaks his mind. That goes for a lot of people who speak their mind: they're not very well liked in some sectors, Mr. Chairman. But that doesn't make them wrong. This guy is in that situation.

Mr. Minister, I have a response from you, saying: "No, I'm sorry. I'm sorry we can't do anything; that's the policy." Well, anything can be changed. I know — I was minister for a while. You know, we can be just in cases such as Ron Ray. We can help out just a bit that little guy out there who's had a bit of a tough time, and has had some lousy weather, and couldn't get some work done. There's no problem with it at all, and I just want an assurance from the minister here today that he's going to look once again at the Ron Ray situation with a view to helping this fellow out, not with a view to simply saying: "Well, I'm sorry. That's the way it is. You're going to have to pay the trespass."

Again, I say that if we treated other people or the multinational corporations in this manner, we'd probably regain that estimated $1 billion in a heck of a rush. I just want to hear the minister say he'll take another look, with a view to assisting my constituent in this situation. I think it merits just another look.

One last thing: I want to talk a bit about a situation that the minister is very familiar with. I touched on it last week. I know that there's a mess in the area north of Stewart. I know that the practices carried on by some of those companies there are just not acceptable, and I had asked for an investigation of what was going on there, with a view to doing something

[ Page 2423 ]

about it. We've got one company in particular, Tay-M, which is not living up.... Mr. York is not living up to his contract with the provincial government, with respect to his forest tenure; I know that. But not only that; as the minister knows, he's let many, many entrepreneurs hang out to dry, and is not paying them for services rendered, when he has shipped the logs and gotten his money, to the point where logging contractors and log haulers are losing their equipment, going belly-up and having family problems because of it.

It's just not acceptable. I know the minister can't do anything about that, but the minister can sure as heck ensure this House that the practices of companies like that are to the letter of the contract that they signed with this province. I just want to have that assurance.

HON. MR. PARKER: I share the concerns of the member for Omineca on the manner in which forest licensees operate in the Stewart area. He's quite right: your hands are tied from getting involved between the licensee, his contractors and his subcontractors, and it is rather frustrating at times. But you do want to make sure that they are following the absolute letter of the contract between the ministry and the licensee.

On the other matter, I would be pleased to take another look at Ron Ray's agricultural lease problem with a view to seeing what we could do, and I would be pleased to meet with the member for Omineca to follow it through.

MS. A. HAGEN: I'd like to ask the minister to turn his attention to the matter of reforestation and silviculture. In the budget there is a major appendix which outlines the ministry's performance over a number of years, its goals for 1987 and 1988 and gives a thorough outline of the various sources of funding.

I'd be the first to note that this is an area that I've been listening to with much interest because, although I live in a town that has thrived with the lumber industry, it is not an area that I know from the resource management perspective. But I do know that at various times over the last number of years the silviculture activities of the Ministry of Forests have been touted as a major source of employment in the province and that agreements with the federal government for costsharing in this area are in the multimillion-dollar range.

[4:00]

When we are looking at the various communities of the province, many of which have unacceptably high rates of unemployment, when we're looking at the fact that British Columbia still has a major unemployment problem, the highest of any province west of the Atlantic provinces, then activity in this area is extremely important to our economic activity, both in terms of providing employment for workers and also of protecting the long-range interests of our forests.

One area that I have been following with particular interest on behalf of this side of the House is that area of economic activity through job creation that is targeted to the long-term unemployed — the social assistance recipients who have been unemployed for a period of eight months or more, a group of people that both this government and the federal government have identified for special initiative.

The goal of the program which is reflected in what the provincial government has labelled JobTrac is to seek to see what effectiveness there is in providing jobs through various sectors for this group of people. As the budget speech notes in its appendices, the forest JobTrac program, which is funded through the forest stand management fund, provides for the employment of social assistance recipients in forest improvement — primarily silviculture — and notes that this is one of the major activities under that JobTrac program.

There are a number of things that I would like the minister to perhaps help me know a little bit more thoroughly. I am informed, first of all, that last year under this program there was an under expenditure of $6.5 million, and I'd like the minister to indicate what dollars were spent, why that $6.5 million was under expended and what reasons there were for that under expenditure.

In this year's estimates there is an amount of $19.5 million which is allocated for this particular activity under the forest stand management fund, and I understand that that is made up of the $6.5 million and something in the order of another $13 million. The Vancouver Island mayors' fund of about $2 million is in that particular budget and there also is some contribution by Westar of about $0.5 million.

[Mr. R. Fraser in the chair.]

To date I have not been able to get any significant information about activity to utilize those funds, although I would presume, Mr. Minister, that the prime time for employment in the expending of these funds would he in the spring, summer and fall months. When, for example, our human services committee visited Prince George a month ago — almost a month ago to the day from this particular date — we were informed by the one-stop JobTrac office that not one single contract had been let in the Prince George forest region, to their knowledge. They had no information whatsoever about what was happening in the way of hiring under the JobTrac program. They had no information about how that hiring was to take place. They had some vague knowledge that it was happening through the ministry, although this was the one stop shop where the recipients of these job programs should have been referred. At that stage, well into what I would presume to be a high time of activity, nothing was happening.

When we come to JobTrac and all of that employment activity, which is a major economic thrust — the major economic thrust of this government in the way of employment creation — I presume that people in the field would be the very first to know about the activities of government in steering people into projects for those jobs.

Clearly it appears that the people in the field don't know what's happening, I understand that proposals need to come to the ministry through various forest sector people. I would like the minister to outline what is going to be happening with this portion of his silviculture funding. It's a relatively small number of dollars in the total number of dollars outlined in the appendices of the budget speech. I hope that what's happening in that sector is not some indication of what's happening under the ministry operations vote or the section 88 vote or the small enterprise account or the forest resource development agreement, where there are significantly larger numbers of dollars supposedly going into silviculture and reforestation.

So if the minister could give us some indication of what's happening under the forest stand management fund and those proposals, then perhaps we can start with that and see what's happening in the other areas as we follow up.

HON. MR. PARKER: Mr. Chairman, in reply to the member's question on the amounts being spent, in different

[ Page 2424 ]

regions, specifically the Prince George region, I don't have those hard numbers at hand. But I can tell you that the advice I have is that the JobTrac programs are fully subscribed in that region.

The other question goes back to the under expenditure last year in the forest stand management fund. I don't see that little gem of information in my briefing book either, so I'd like to take that on notice, and I'd be pleased to return with an answer.

MS. A. HAGEN: Mr. Chairman, the minister states that the program is fully subscribed in the Prince George region. Could the minister perhaps provide us with some additional details: when that particular activity was carried out, the number of jobs, and any information about the subscription of programs in other parts of the province? In other words, where are we at this stage of the game with that part of the silviculture program in this province?

How far along are we in other regions of the province in subscriptions to the utilization of those funds? Can he tell me how many people have been employed, either globally or — if he has the information — by region? Can he also tell me how those projects are in fact managed? Are they managed through his ministry, or are they managed through operations like the JobTrac program in Prince George? How are people employed in those programs?'

HON. MR. PARKER: Mr. Chairman, entry into those programs is basically through our ministry and also through local employment offices. In Prince George they have the one-stop centre.

We have proposals throughout the province that should cover all the funding for JobTrac in the forestry sector this year, generating about 180,000 man-days. The purpose of JobTrac is to help build a silviculture workforce, and there are some refinements to the JobTrac program in our ministry that we're addressing at this time in consultation with Advanced Education. We hope we'll see a more effective delivery of the program to the people who need it. As far as the training is concerned, we certainly need them as trained silviculture workers, and that's why the program's in place.

MS. A. HAGEN: I understand that last year about 133,000 man-days were created. It would be useful to have clear figures for the number of dollars that were spent last year on this program to generate those dollars, so we could then compare the 180,000 man-days which the minister is projecting for this year.

The other question I would like to ask is: when the minister addresses the matter of refinements, perhaps he would define what those might be. I assume that they might involve more of a training component, but would the minister please identify what he means by that or what kinds of refinements you were looking at in consultation with the Advanced Education and Job Training ministry? So there are those two questions, please.

HON. MR. PARKER: It would probably be best if I could ask the member to please just give me two quick shots, one on each question.

MS. A. HAGEN: Let me first go back to the number of man-days. I understand that last year 133,000 man-days were generated. I wanted to ask the minister what dollars were expended in 1986 and '87 to generate those man-days, given that there was an under expenditure last year — and I still haven't got a clear explanation of that under expenditure of the $6.5 million. So if we could look at last year — the under expenditure, the reason for the under expenditure and the dollars that were actually expended — then we'd have that comparison point. In asking that question, I'm concerned that there was that under expenditure last year, because those are significant job creation dollars, and I think that that's probably something like a third — maybe more — of the budget that should have been expended in '86-'87.

HON. MR. PARKER: There was approximately $12 million spent last year for the forestry worker assistance program, as JobTrac was called in the forestry sector last year. The number of man-days that generated was 139,176. As to the under expenditure on the forest stand management fund, I took that question as notice, Madam Member, and I'll be happy to bring it back to you.

MS. A. HAGEN: The other question was regarding the minister's general comment on the nature of this program and the refinements that you're working on with the AEJT ministry. One of the reasons I want to pursue this — through you, Mr. Chair — is that this whole program is a multi-ministry program and I want to get some handle on who's responsible, who's accountable for various aspects of the program and what the goals of the program are. It's clear that we're looking for job creations and clear that we're looking at training, and I want to know what you have in mind regarding this with your discussions with the Advanced Education and Job Training ministry.

HON. MR. PARKER: We have some ideas that we think might work. We have yet to discuss them with the minister, and I think, out of respect, I should withhold my comments. But there has been a program both on Vancouver Island and in the northwest delivering JobTrac or FWAP or whatever you want to call it — activities. People that have been involved have some suggestions, and we think they're good suggestions, and we'd like to discuss them with the minister. The Minister of Advanced Education and Job Training (Hon. S. Hagen) is basically responsible for JobTrac. Each of us in other ministries has a portion of JobTrac that pertains to our ministry. We think that we can refine it a little bit, and we want to discuss that with the minister, and once I've done that I'd be happy to share it. There's nothing secretive or derogatory about it; I'm just extending a courtesy to a colleague.

HON. MR. STRACHAN: As Minister of Environment, I'll just respond briefly. I recognize the member's concern on her visit to Prince George, and I'll advise the committee that in terms of my ministry and its JobTrac programs, on June 20 I heard of three within the Ministry of the Environment — that's in the Prince George area — so they probably came after your visit. But as far as I'm concerned, they're going well. That's what the parks officials, in my case, told me. So I think we're on track with JobTrac, if you'll pardon the pun.

[4:15]

MS. A. HAGEN: When I asked the minister how people were hired into these programs, he said through his ministry,

[ Page 2425 ]

through the local employment office. These particular employees are to be social assistance recipients. Can the minister please tell me how social assistance people are recruited? Are they people who apply directly to his ministry or through the local employment office? Are we in fact hiring social assistance recipients for the JobTrac program?

HON. MR. PARKER: Yes, we are hiring people from social assistance programs — as I understand it, the 17-to-24-year age group. People come into the program in a number of ways: through the advice of a friend or acquaintance; through somebody they bumped into who's working on the program; through their social worker, Manpower or the forestry office; any number of ways. We want to keep the doors open. We accept references, but the criterion that we have to pay attention to, of course, is the fact that they are social assistance recipients.

MS. A. HAGEN: I would be quite happy to have the minister take this question on notice: is there information available on the number of employees who have been hired in the various forest districts of the province, if the program is fully subscribed at this time?

Vote 34 approved.

Vote 35: ministry operations, $267,798,152 — approved.

Vote 36: fire suppression program, $60,000,000 — approved.

Vote 37: forest resource development subsidiary agreement (ERDA), $68,883,468 — approved.

The House resumed; Mr. Speaker in the chair.

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

HON. MR. STRACHAN: I call second reading of Bill 40.

FOREST AMENDMENT ACT, 1987

HON. MR. PARKER: During first reading of the Forest Amendment Act, I informed the House that this bill introduces the designation and management of wilderness areas in our province, and allows us to take action on changes to our stumpage-pricing procedures, rentals on various forest tenures, royalties charged on timber licences, reducing the impact of the United States export costs when upward stumpage revisions are made — providing the current level of the federal export tax remains in place — and obtaining information on product prices and cost to establish timber prices.

I would now like to take a few moments to enlarge upon these amendments. First, the designation and management of wilderness areas. Our province has a truly exceptional natural heritage. This requires us to make many decisions on the management and wise use of our land and its resources, which calls for all the wisdom and commitment we can muster. Such a commitment also requires knowledge: a clear understanding of precisely what we're dealing with and where the directions we are taking are likely to lead us. Our present system for managing wilderness lands evolved over a long period of time in response to a variety of factors and pressures. These have changed over the years, along with the attitudes towards resource stewardship. What we have seen in the eighties is not a gradual trend in public interest but a dramatic upsurge, with correspondingly urgent demands on government to formulate and implement policies for the wilderness areas under their jurisdiction.

In our province our natural public forest endowment is matched by an extensive provincial park system that has evolved over more than 75 years. Thus, some of the best and most representative wilderness lands have received park protection. However, the demands for wilderness preservation go beyond the existing and potential capacity of any park system and raise questions that extend across our entire provincial land base. Our policies and our legislation reflect this reality. This is exactly what sections of the Forest Amendment Act allow us to do: have an equitable balance between protecting wilderness and encouraging resource development. It will use existing mechanisms in our resource ministries for planning, interagency referrals, and public consultation on land use decisions, and expand these systems where necessary. Central coordination will be handled through the Environment and Land Use Committee and the deputy ministers of the agencies involved.

Most importantly, this legislation will provide a process for addressing individual wilderness areas in a coherent context by establishing a land use strategy which fairly reflects all relevant public interests. This was a key recommendation of the Wilderness Advisory Committee. We believe it is fair to say that this legislation represents the most significant stage in the implementation of the committee's report.

I know that this House will have a strong interest in the forthcoming changes to legislation and to other measures. Over the next number of months our government will be consulting with those who are directly concerned with wilderness issues as part of the communication process established by the legislation. Recreation groups, conservation organizations, tourist associations and resource industry groups will all have the opportunity to find out more about the direction in which this legislation will take us, how we plan to get there and how it will affect their activities.

Mr. Speaker, the public has a part to play in the process. To a great extent the success of this legislation will depend on the approval and understanding of all British Columbians. We are confident that this legislation will meet with their enthusiastic support.

Mr. Speaker, as I mentioned during our first reading of the Forest Amendment Act, the government has been considering for some time changes to our stumpage pricing procedures. Our current stumpage prices are lower than historic levels. Also, they have not risen relative to increases in silviculture expenditures over the past years. As I have said, Mr. Speaker, the government will establish a level of timber pricing that is appropriate for British Columbia. We will announce the changes to accomplish this objective in due course.

While stumpage is the largest contributor to direct forest revenue, rentals on various forest tenures and royalties charged on timber licences are also significant. Sections 11, 14 and 15 of the Forest Amendment Act will allow us to take action on rentals and royalties as part of a balanced package of revenue measures. Changes regarding rentals and revenues will also be announced in the near future.

[ Page 2426 ]

Under section 16 the government wishes to pursue the replacement of the 15 percent federal charge on lumber exports to the United States with measures suitable to British Columbia. As I stated earlier, stumpage increases appropriate to British Columbia will be made. The corresponding reduction in the export tax will then be negotiated with the United States. The timing of such negotiations is unpredictable and beyond our government's control. Mr. Speaker, we do not want the British Columbia forest industry to pay both increased stumpage charges and the full 15 percent export tax on shipments to the United States; therefore section 16 provides a legal basis for refunding a portion of stumpage increases, providing the current level of the federal export tax remains in place. To do otherwise would amount to a double charge on such shipments.

Mr. Speaker, over the years information regarding product prices and cost has been collected from the forest industry for use in establishing timber prices. This information is usually provided voluntarily by most companies, but there has not been a legal requirement to this end in our Legislature. Section 19 of the Forest Amendment Act provides a legal basis for collecting cost information if this is required in the future.

Finally, Mr. Speaker, section 24 of the Forest Amendment Act ensures that stumpage, rental and royalty changes can be implemented for all forest tenures as soon as possible. This will enable us to move effectively and decisively to complete changes in an orderly manner.

Finally, Mr. Speaker, these amendments have been introduced to enable the Ministry of Forests and Lands to be a more effective and efficient manager of the resources in our forested lands. I would like to ask all the members of this House to support these amendments. I move that the bill be now read a second time, Mr. Speaker.

MR. WILLIAMS: The opposition has made it clear for some time how we feel about the revenues we get from this resource. They're totally inadequate; they're totally out of date. We've gone through the whole exercise of the Americans exposing that and putting a whole industry at risk because this administration has been willing to live with essentially a non-collection of rent of the resource, to the point where we get minus numbers for the great public timber of British Columbia. That continues till now.

The amendments brought about here are clearly necessary in order to achieve some modicum of equity in terms of this great asset that the people of British Columbia own. It remains to be seen, though, whether we achieve that through this legislation. You've been promising — this administration and the last — significant change in this area for some time. It is yet to be delivered. It is still some date down the road when it will be dealt with.

Nevertheless there is a need for the legislation, and clearly the export tax has to be accommodated, since it's a reflection of our inadequacies and bad government of the past, and some structure is necessary. Whether this is the rig ht structure is a neat question. Since this government feels so beholden to the major forest industrial companies, this is clearly the way they see the future in terms of dealing with their close linkages with that sector.

Clearly there is a need for information, and it certainly makes sense that royalties, stumpage and rentals be dealt with in a more flexible manner than has been the case in the past. When this kind of flexibility is given to a minister, it carries a significant responsibility. The minister can use these powers for good or for ill, and in accepting this legislation, we're making the pretty grand assumption that he will use them for good. We think it's necessary to make that assumption.

That is a considerable burden on the minister. It's a considerable responsibility, so those kinds of burdens and responsibilities should carry with them processes for openness and access. We've had no evidence of that to date from this minister, in terms of him accepting the need for openness and access in a democratic system.

We've got some concerns about that. I'm a little concerned when he talks about an "appropriate level." That's a nice civil service term; it doesn't mean very much. Maybe I shouldn't say that. It's a nice term that can be used to mean anything.

[4:30]

What happened to the old concept of market value, Mr. Minister — the idea of us getting what the trees are worth? It seems to me a reasonable idea. Market value seems to me a reasonable idea in terms of the pricing of public timber. So when I hear things like "appropriate" and when I hear terms like "balanced" in terms of a pricing system for the public forest, I get a little worried. There is certainly a lot more balance necessary than what we have now; no doubt about that. If that's what balance means, that's good news.

There is such a thing as real value and real market, and we certainly expect that will be the level of income for the province and that they will be real numbers, real value and real market at long last, relative to pulp prices, relative to the real market evidence there, relative to the prices being paid for tenure, which is a reflection of non-collection of rent.

That's what the Queen Charlotte Islands issue is about in terms of compensation to third parties; that's what capitalized value of licences is all about; that's a reflection of the uncollected stumpage and uncollected annual rent that gets capitalized into a huge new capital value in the licence. That's what that is a reflection of. It's an automatic economic truism.

It is the same as for the pulp sector. The underpricing there has been gross, and this legislation allows that to be dealt with. It doesn't require that it be dealt with. So in that sense it's good news.

The whole question of public timber is a question of provincial rights. Accommodating the export tax and bringing this jurisdiction home is important in terms of the constitution of this nation, and in terms of the rights of provinces in Canada to determine their own destiny insofar as the land base is concerned. So with some qualifications Her Majesty's Loyal Opposition see this as a potential benefit for the people of British Columbia, and we welcome it.

HON. MR. STRACHAN: Pursuant to standing orders, I advise the House that the minister closes debate.

HON. MR. PARKER: Mr. Speaker, I ask your assistance. I've just received a proposed amendment to the bill. It's a small item changing the word "rental" and substituting the word "rent." I'm not clear on procedure. It has to do with section 14, item (b)(4): "In prescribing the rates of annual rental" should read "In prescribing the rates of annual rent...."

MR. SPEAKER: I might advise the member that that could be done in committee. You can give informal notice in

[ Page 2427 ]

closing second reading debate, and move the actual amendment in committee stage.

HON. MR. STRACHAN: We'll deal with this one as a matter of courtesy to the member of the opposition, as if we had sent him a note. When it gets to committee, then the information is known to the member, since it is a floor amendment, if you will.

HON. MR. PARKER: Thank you, Mr. Speaker — and through you to the government House Leader, thank you for that advice.

Bill 40, Forest Amendment Act, 1987, read a second time and referred to a Committee of the Whole House for consideration at the next sitting of the House after today.

HON. MR. STRACHAN: Mr. Speaker, I call Committee of Supply.

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

ESTIMATES: MINISTRY OF HEALTH

On vote 38: minister's office, $220,893.

HON. MR. DUECK: Mr. Chairman, I am pleased to be able to present the estimates for the Ministry of Health for 1987-88. The 1987-88 estimates total $3.2 billion. This represents an increase of $237 million — more than the entire budgets of most ministries of the provincial government. The Ministry of Health estimates are a strong reflection of the government's commitment to people, particularly those in need. They reflect our concern to protect and enhance essential expenditures, while recognizing the costs of these services. Health services cannot grow without limit, and health services are not free. The Ministry of Health shares the overall government concern to guard the interests of taxpayers and to spare future generations from excessive debt.

The hospital sector is one of the key elements of our health care system. British Columbia has one of the finest hospital systems in the world. To ensure that these essential services remain strong and effective, hospital programs estimates are increased by $204 million over last year. These funds will enable our hospitals to remain on the leading edge in terms of new technology, such as magnetic resonance imaging, a new technology used for diagnosing central nervous system diseases and other conditions. MRI will be installed in hospitals in hospitals in Vancouver and Victoria. Kidney and bone-marrow transplantation services will continue to expand, and programs will be developed to permit heart transplants to take place in British Columbia.

While moving forward with the most modem technology advances, we must not neglect to maintain the basic core of our hospital system. In 1987 and 1988, health care projects valued at $120 million will commence construction. The construction will create 145 man-years of employment for 1987-88 and 464 in 1988-89. Included in this are four acute care hospital projects, five extended-care projects and two intermediate-care projects. Completion of these projects will provide an additional 23 acute-care beds, 235 extended-care beds and 75 intermediate-care beds.

Presently under construction and due to open this fiscal year are new psychiatric beds at the Queen Alexandra Hospital for Children. and additional extended-care beds at White Rock, Nanaimo, Maple Ridge, Williams Lake, Vancouver and Abbotsford. In Squamish an existing hospital will be replaced with a new hospital.

Improvements, upgrading and renovations will take place in hospitals in Nanaimo, Langley, Vancouver, Prince George and White Rock. A new cardiac unit will be provided at Vancouver General Hospital, and a new cancer clinic in Victoria.

All across the province new funds will be provided from the health improvement fund to meet the increasing demands being placed on the hospital system due to factors such as our aging population. These initiatives, Mr. Chairman, ensure the protection and enhancement of essential hospital services for all British Columbians.

Mr. Chairman, I should also mention the increased allocation of funds to cover the loss in revenue to our hospitals from patient user charges. In order to comply with the Canada Health Act, user charges on hospital services have been eliminated. This was a necessary, responsible step to protect the revenues of the province and to recoup moneys withheld by the federal government. However, I regret the loss of hospital user fees, because these fees were an effective reminder to British Columbians that health care is not a free service. These charges were a nominal payment which have been a traditional part of our hospital services. I have urged in the past — and I will continue to do so in the future — the federal government to reconsider its punitive legislation, which limits the capacity of provinces to control the growth in health care costs.

Mr. Chairman. along with hospitals, medical services constitute a major component of our health care system. This year's estimates for the Medical Services Commission, including Medical Services Plan premiums, reflect an increase of $28 million over last year. This is a modest increase, as a number of steps have been taken to moderate the growth in costs and medical and supplementary benefit services.

British Columbia has experienced dramatic increases in the cost of physician services. Between 1971-72 and 1984-85 — in other words, 14 years — fee-for-service billings by physicians increased by a compounded rate of 14 percent per year, compared to an 8 percent inflation rate. Rising per capita utilization is one of the primary clauses of these growing costs,

To moderate these costs, an agreement between the Ministry of Health and the B.C. Medical Association was reached in 1986 which limited utilization to 2 percent annually over and above an increase in population. In the event that utilization increased beyond 3 percent, it was agreed that negotiations would reopen. Mr. Chairman, I regret to say that increases in utilization have exceeded 5 percent. Accordingly, negotiations with the BCMA have been reopened.

British Columbia's fee schedule continues to be the highest of any province in the country. Moreover, British Columbia faces a significant oversupply of medical manpower for the foreseeable future. In this province we have an average of one physician for every 511 people — the highest ratio in Canada. This compares to one for every 542 in Quebec, one for every 562 in Ontario and one for 678 in Alberta. These facts and the economic circumstances of British Columbia mean that we must limit expenditure on medical services in

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this fiscal year. I am hopeful that we can do this with the cooperation of physicians in the province.

In this budget it has been my objective to ensure access to the broadest possible range of first-class health services. The services of chiropractors, physiotherapists, optometrists, massage therapists, naturopaths and podiatrists make up supplementary benefit services under the Medical Services Plan. This constitutes the broadest range of insured health services of any province in Canada. Moreover, the supplementary benefit services are provided without any cost-sharing by the federal government. In recent years the use of many of these supplementary benefit services has grown substantially. Between 1981-82 and 1985-86 the cost of these services rose 64 percent per capita, or a total of almost $24 million. In order to exercise some control over these increasing costs, effective July 1 of this year a $5 patient-visit charge was introduced for all supplementary benefits, except orthodontic and optometric services. The cost savings associated with this modest patient charge are estimated to be $15 million.

Mr. Chairman, to ensure that these small charges do not inhibit access by those on low income, the charges do not apply to persons whose Medical Services Plan premiums are subsidized in any way. I should also note that an enhanced premium assistance plan was introduced on July 1. The income level for eligibility for premium assistance has been raised so that more low-income persons receive premium assistance. Not only have the income levels been raised, but the premium charge has been reduced from 10 percent of the full rate to 5 percent for those on full subsidy, and from 50 percent to 45 percent for those on partial subsidy.

While protecting those who can least afford to pay, the Ministry of Health is asking other British Columbians to help maintain their medical services. Effective April 1, MSP, premium rates increased by 10 percent. These increases were announced earlier.

[4:45]

Mr. Chairman, in the past year the Pharmacare program has been transferred from the Ministry of Social Services and Housing to the Ministry of Health. This transfer will permit increased efficiency of administration, and is a more logical arrangement of services. The Pharmacare program offers an important and vital service to many British Columbians by reimbursing residents for prescribed drugs and certain nondrug items. Between '81-82 and '86-87 the cost of this program increased threefold, from $54 million to $161 million. Increases at this rate cannot go on forever.

To preserve the integrity of this service while moderating costs, two measures have been taken. As of April 1, senior citizens, except those in long-term care facilities, are being asked to pay 75 percent of the dispensing fee, up to an annual maximum of $125. However, to ensure that this does not harm low-income seniors, recipients of GAIN for Seniors as a supplement are receiving an increase of $125 through the Ministry of Social Services and Housing. Moreover, it is estimated that the average cost per senior will be well below $125, or approximately $78 per year. This is based on an average of 13 prescriptions per year and an average dispensing fee of $6. The full cost of the drug, an average of $16 per prescription, continues to be covered by Pharmacare. We're asking seniors to make a small contribution relative to the cost of the drug. Moreover, by shopping around for lower dispensing fees, seniors can save for themselves and for government.

The second measure intended to control the growth of Pharmacare costs is an increase in the deductible for residents of the province who are under 65 and not eligible for social assistance. For these persons, who make up most of the residents of British Columbia, the deductible has been increased from $200 to $275.

These measures keep prescription drugs affordable for the people of the province while increasing consumer awareness. Further, I believe these measures are responsible steps to control health care costs while ensuring a broad range of services available to all, regardless of their income.

In his budget address, my colleague the Hon. Mel Couvelier, Minister of Finance and Corporate Relations, announced a number of initiatives to help the disadvantaged of our province. I am pleased to say that the estimates of the Ministry of Health continue this theme, with new and strengthened programs to assist the handicapped, the mentally ill and the aged.

Services to the handicapped is a new division within the Ministry of Health, established to develop alternatives to institutional care for severely-handicapped children and adults. Its primary function is to develop systems for supporting families that are caring for handicapped members and to develop community-based service alternatives. Estimates for services to the handicapped are increased by $5.9 million over last year. This will permit increased funding for a number of initiatives.

The child-development centres funded by the Ministry of Health, which are located across the province, will be strengthened. These centres provide physiotherapy, occupational therapy and speech pathology services to children suffering from cerebral palsy and other neuromuscular disorders. Additional funding will permit centres to alleviate shortages of therapy staff and increase the provision of early intervention and health therapies to special-needs children. A new travelling pediatrics specialist team will assist professionals in isolated areas to provide assessment and treatment to these children. In addition, services to the handicapped will be able to increase funding for community placements and group homes for the disabled, day programming and increased funding to Glendale Lodge Society.

Before moving on to other areas in the estimates, I'd like to tell you a little more about the innovative programs that the services to the handicapped division of the Ministry of Health is involved in. Two pilot projects are being carried out, one involving severely handicapped adults and one severely handicapped children. Eleven adults who previously lived in institutions such as Glendale will now live in group homes. A further 60 severely-handicapped adults are planned to be moved to non-institutional settings in this fiscal year.

In the second pilot project, five multiply handicapped children are leaving extended-care institutions such as Queen Alexandra and Sunny Hill Hospitals to live with associate families. Associate families are families that are selected for their parenting abilities and trained to provide for the specific care needs of the handicapped child as part of their own family in cases where the natural family is unable to take care of that particular child. These associate families will be selected in consultation with the natural family. In 1987-88 it is expected that an additional 20 multiply handicapped children will be placed with associate families. Respite care will be provided to families caring for handicapped children in order to provide additional support to cope with the care required by the multiple-handicapped child and to allow the

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family to continue to care for its member in the home. Innovative ways will be explored to support the strengths which only the family can provide as care-giver. These initiatives are major innovations in the provision of services to the handicapped and their families. They will provide maximum autonomy and independence to some of our most handicapped citizens in ways which are cost-effective.

The '87-88 estimates reflect significant increases to assist persons troubled by mental illness and emotional disorders. Mental health services estimates are increased by $7.6 million over last year, with $4.3 million provided for mental health services to children and youth. Youth today are subject to many stresses and challenges. Unfortunately, many of our young people suffer from serious mental and emotional disorders, manifested in suicidal behaviour, alcohol and drug abuse, and family violence. In response to the mental health needs of youth in these circumstances, the Ministry of Health, through a series of staffing and budget increases, is developing a mental health system for children and adolescents. Program coordinators will be added to each of the 36 mental health centres across the province. Cooperative programming with alcohol and drug programs, young offenders services, public health services, hospitals, social services and housing staff will be undertaken to ensure a comprehensive range of services to youth,

The focus of the children initiative will be on the assessment and treatment of children and youth with serious emotional disorders and the allocation of new resources to northern and rural British Columbia. In addition, improved clinical services, development of a residential and treatment pilot project in the capital region and prevention activities will be priorities.

Another major concern of the Ministry of Health is to ensure adequate mental health services across the province. One very effective program in extending psychiatric services to communities distant from the major urban centres is the University of British Columbia's department of psychiatry Outreach programs. In order to provide additional psychiatric resources in the north, $200,000 has been added to this program to provide increased medical manpower in Prince George. The mentally ill and the behaviourally disturbed badly need special care and support to enable them to function as full and independent members of our society. I believe this budget takes a very significant step in this direction.

Persons who suffer from alcohol and drug dependency or abuse represent another sector of our society with special health care needs. Alcohol and drug program estimates are up $2 million over last year, facilitating delivery of a range of treatment prevention and educational services. Among new initiatives undertaken by alcohol and drug programs is an innovative new ward team project currently being implemented at Victoria General Hospital and the Royal Jubilee Hospital. It is estimated that as many as 40 percent of patients on medical wards in general hospitals are admitted because of illness related to underlying alcohol- and drug-related problems. A ward team made up of a senior physician, nurses, a social worker and resident hospital staff will develop better health care treatment plans for these patients. The team will assist physicians in treatment consultation, referral to specialized services and access to support systems in the community outside of the hospital when the patient is discharged. It is hoped that by improving the assessment and treatment of patients with underlying alcohol and drug abuses problems, the length of hospital stays may be shortened, and the likelihood of readmission reduced. In addition, alcohol and drug programs are providing medical consultation and partial funding to the Task Force on Alcohol and Drug Abuse in the Workplace. which held public hearings throughout British Columbia.

[5:00]

It is hoped that participation in this process will help to identify and impact on causes of employee absenteeism due to alcohol- and drug-related problems and to improve productivity in the workplace. Complementing the children's initiative of mental health services and in recognition of the importance of prevention and treatment of alcohol and drug abuse among the youth of the province, alcohol and drug programs will be reallocating $2 million in funds to develop additional, innovative and effective new youth programs.

The elderly make up a growing segment of the population of British Columbia. At present, there are 359,000 persons over 65 in British Columbia, or 12.4 percent of the total population. By the year 2006, their numbers will increase to 541 000, or 14.2 percent of the population. The number of those over 85 will grow even more rapidly, increasing by 127 percent by the year 2006.

The elderly are high users of our health care system. In fact, it is estimated that 48 percent of the health care budget is devoted to the elderly, with those over 85 being particularly high users. The long-term care program is most heavily focused on the elderly, with over 85 percent of this program's services going to this age group. This year's estimates provide $20.3 million over last year. That's an increase of $20.3 million dollars. With these funds we will be strengthening community and institutional services for our elderly citizens.

It is essential that those who care for the elderly are recognized for their efforts. This budget provides wage increases to health personnel in this sector.

The conversion of 463 personal-care beds to intermediate-care standards will be completed in various locations across the province. Replacement intermediate-care facilities will open in Vancouver, Burnaby and Cranbrook, and new intermediate-care beds are open in Vancouver. While care and treatment services are vitally important to the elderly, much can be done to prevent or delay the onset of disability and dependency. In the past year, the Keep Well program was piloted in the New Westminster area to increase the financial independence and general well-being of older adults. This program promotes self-care and encourages isolated elderly to become involved and active, both physically and socially. In the coming year, the Keep Well program will be expanded to other areas of the province. Keep Well is just one of a number of innovative programs administered by preventive services of the Ministry of Health.

I have spoken a great deal today about the treatment and caring programs of the Ministry of Health. However, prevention and health promotion are also major priorities of my ministry. In 1987-88, preventive services are increased by close to $6 million. These funds will permit the development of a variety of programs to promote health and prevent disease. A new vaccine program to limit the spread of hemophilus B influenza will be carried out. This disease afflicts children under the age of five and can lead to severe disability and death.

A non-smoking promotion is a major priority of the Ministry of Health. The Decisions program is a smoking

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prevention program for students in grades 7 and 8. Last year this program was provided to students in over 20 percent of the schools throughout the province. This program will be continued in 1987-88.

The ministry has also entered into a corporate sponsorship arrangement with private companies to make the health promotion dollar go further. For example, arrangements have been made with Kelly Douglas for the promotion of good nutrition through an advertising campaign.

Another major initiative is a five-year speech pathology pilot project which is underway in the Okanagan. This program aims to facilitate cooperation with other community services in the prevention of communication disorders.

One of the major communicable diseases facing us today is AIDS. AIDS is a fatal viral disease for which there is presently no cure. The incidence of this disease is doubling each year. In response to this trend, the Ministry of Health has undertaken a number of major initiatives to prevent the spread of AIDS. An expert provincial AIDS advisory committee has been established, and all blood products in British Columbia are being screened. A comprehensive family life curriculum, including the subject of AIDS, has been developed in cooperation with the Ministry of Education, and an extensive community information and awareness program has been approved for implementation.

In addition to the considerable medical and hospital costs, the ministry has established an AIDS testing and counselling clinic as well as a viral culture laboratory at the British Columbia Centre for Disease Control in Vancouver.

Central to the health care system are the health professionals who staff our hospitals, our public health units, longterm care facilities and homemaker agencies.

MR. CHAIRMAN: Hon. minister, the Chair is most reluctant to interrupt, but your time under standing orders has expired. Perhaps one of your colleagues would intercede and you could continue.

HON. MRS. McCARTHY: I'm certain that all members of the House were enjoying and digesting the information put forward by the minister, and I would ask that he be permitted to continue.

HON. MR. DUECK: Thank you, Mr. Chairman. Since it is such a big ministry, there is a lot to put into the budget speech. It's not that I like to stand here and talk.

I recognize that there have been some concerns respecting the supply and distribution of some health professional groups. The supply of physiotherapists has been of particular concern. The supply of speech pathologists, audiologists, occupational therapists and nurses also comes to my attention. A number of steps have been taken to address these concerns.

The Ministry of Health initiated a grant program for allied health care personnel last year. This program provides grants of up to $5,000 per year to students of health occupations which are in short supply. In the last fiscal year 25 students received these grants, which are provided in return for a commitment to work in specified underserviced areas of the province upon graduation.

Other steps are also being taken to increase the supply of various health professionals. I hope to introduce amendments to the Physiotherapists Act which will facilitate the registration of foreign-trained physiotherapists.

Concerning nurses, a six-month study of nursing manpower in British Columbia is being carried out with the cooperation of the Ministry of Advanced Education and Job Training and with concerned health organizations such as the Registered Nurses' Association of British Columbia and the British Columbia Health Association.

The Ministry of Health is a large, complex ministry with responsibility for an extremely diverse set of programs and services. I believe this budget has taken us a large step forward in meeting the health care needs of British Columbians. It is a fiscally responsible budget which includes some serious measures to control the growth in health care costs. At the same time, it is a budget which seeks to support and strengthen those most in need of health care services.

In closing, Mr. Chairman, I look forward to hearing the comments and questions from members of both sides of the House and encourage all members to give me their suggestions for further improving our health care system. We in the Ministry of Health believe that we have not got all the answers, and I certainly don't stand before you with all the answers. We want suggestions, comments and queries from you, and we ask for those at this time.

MRS. BOONE: I thank the minister for his comments, and I can agree with the last. You certainly don't have all the answers, but then again, neither do we. But we do have some comments and suggestions for you, and I really hope that you listen to them.

Over the past few months since I've been the health critic, I've met with various members of the health community, and it's become very clear to me that we have to take a full look at the health system in British Columbia. We acknowledge that there is a rising health care cost, and we acknowledge that there has to be something done to meet this cost. But I think where we vary is on the approach that your government and your ministry are taking with regard to dealing with the budget, which is increasing. We do have an increasing population, and by the time all of us are seniors, we should be very concerned about how we're going to be addressing the entire budget, and how our health will be taken care of. So it's something that we do have to look at.

What we think we should be doing is looking at alternatives, and one of our concerns is, that the ministry seems to be dealing with things on an illness basis right now, rather than on the basis of keeping well and promoting wellness. You mentioned the Keep Well program in New Westminster. I was amazed to hear a couple of weeks ago that funding for that program has in fact been stopped, and that the people in that community are very upset and very concerned that they will not have that program going on there. As far as I'm concerned, the approach that I see the ministry taking is one that I think should be reviewed, with a look at the alternatives there.

What we are seeing is the ministry dealing in terms of vested interests. The whole area seems to be physician-centred and hospital-based, areas which are mainly interested in maintaining the status quo. They're not that interested in looking at areas that will reduce the costs and the services put on both of those areas, whether it is hospital services or physician-centred services.

What we are also seeing is that at the community level, where there are programs being instituted — and there have been a number of new programs instituted in the communities

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— there is a lack of community control, no budgetary control. The people out there in the communities frequently are not able to determine what they think are their priority items and what is important to their needs, and frequently they have areas cut or areas maintained that they don't feel are in the best interests of the community. We should be looking to put things back into the community-based areas.

We see an inadequate emphasis on public education, and I'm happy to hear the minister mention that there should be some increases there — but not just in the areas of informing people of the hazards of smoking. Of course I support you in informing the public in those areas, and also in providing some information with regard to alcohol, but the public must be informed and educated so that they can become informed consumers, and so that they are aware, when they go to their family physician and request a B scan or a CAT scan or a blood test, of how much that costs. I don't think the public is aware of that right now.

I know that many women go to physicians and ask for a B scan so that, in many cases, they are more aware of the date when their child is going to be delivered. They don't know what that cost is to them in their own home; and you ask for a blood test as well. The consumer ought to be aware of how much these things are costing, so that they, as consumers — we are the payers — are able to make an informed decision as to whether or not these things are really required, or whether they're just things that they would like to have. And those are important things.

There is a federal discussion paper on strengthening the community health services that was printed August 1986. I think it has some excellent points of view. They emphasize the urgent need for concerted actions to strengthen community-based services in Canada, arguing that health and social services currently available.... These are the problems that they see: (1) they are ill-prepared to deal with emerging issues such as chronic illness and the needs of an ageing population; (2) they continue to overemphasize institutionalization of the sick and the aged, and are not adequately equipped to support independent community living; (3) they could be more open to the contributions of individuals, families, volunteers and mutual aid organizations who wish to feel that they are partners in health care; and (4) they do not respond adequately to the needs of persons of low socio-economic status, those from minority cultural or ethnic backgrounds — for example, natives, immigrants or other special needs groups, children, single-parent families and the mentally ill.

[5:15]

This is what the federal government has seen as being some of the problems of our health care system, and I believe the provincial government should be looking at our health care system with a view to putting it back into the community, so that people do not have to look to Victoria for direction. The direction should come from the community, because they are the people who know what the needs in those communities are.

The moves that we have seen coming out of the ministry in the budget seem to be very contrary to the whole philosophy of keeping well. For example, we have the user fees on alternative health. The minister has given us a great rundown as to what they have cost the taxpayers lately, but there are also other viewpoints. The viewpoints that I keep hearing from people who use these services is that these services are keeping them well. They are keeping them in their homes and out of extended-care or acute-care hospital beds. They require these services, and it is not going to be cost-effective to have these user fees there, because in the long run we will be paying for this.

[Mr. Weisgerber in the chair.]

I'll be addressing this a little more. I'm sure my colleague from New Westminster will also be addressing this issue in a further area.

I'm very concerned about the reductions. I find this very difficult to understand because the minister indicates that there will be increases in the mental health budget. Yet I am receiving telephone calls, letters and information from throughout the province indicating that there are severe cutbacks taking place in the mental health services and that, in fact, although there are no government employees being laid off, contracts are being terminated. They're not expiring; the contracts are, in fact, being terminated for the sessional employees who still have perhaps six months to go. These employees are being terminated, their work with the people they are servicing is being terminated, and they are telling me that they have no place for these people to go.

That's a concern of ours. It's a concern because we also see the mental health department turning to priorities and making their priorities acute-care and chronically-ill people, which of course it must be. We must have those priorities, but they are cutting back on the prevention end of things, and cutting back on social needs which include child care, counselling, family counselling, and marriage counselling to an extent. All of these things, I understand, have been cut back and in many cases eliminated.

You mention the children initiatives, and I understand that that program was to go and then the people were given layoff notices. I think that maybe they have had those layoff notices rescinded, but there is some question about the whole process there. What was going on with regard to this program? Was it funded? Isn't it funded? Why was this on-again, off-again process going on?

This will be dealt with a little more in depth as well as regards the mental health services. I'm really concerned that there seems to be some failure to acknowledge the necessity to increase support for the home care services. That's a service that I believe is one that we must develop even more so than we are right now, because we are in a crisis situation with regard to hospital care. We need to keep our people in their homes. We need to keep people out of expensive, acute care beds and hospital areas.

In order to do that, we have to deal with the staff, and that has to do with homemakers. They have been coming to me since before I was elected, I might add, indicating their problems with regard to their funding, wages and their need to have a reasonable wage so that they can live and meet their cost of living. They're not staying in the homemaker service or the home care service because of the poor wages. I think the ministry has to deal with that if we are truly committed to home care, which indeed we should be if we're committed to reducing health care costs. We have to address a reasonable wage for the people who are in that service so that they can maintain that service rather than have people going into hospitals. Again, that will be dealt with a little bit more.

On the user fee issue, the minister dealt with that at length, and we've dealt with that over a period of months as well. I have a totally opposing view on user fees from the

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minister's. He sees this as a deterrent, and I don't think that.... It is a deterrent for some, but it may be a deterrent for those who truly need help. You will not be deterring those people who are on incomes of $20,000 to $50,000 a year. They may not find it difficult to pay a user fee of $5 per visit, but there are many out there who don't qualify for welfare, who don't qualify for assistance, who don't have enough money to make these payments. They are the ones who will be doing without. Those are the people we were talking about with regard to the whole process of prevention. These people need to have that ability to prevent problems becoming worse.

I have here letters I have received from people concerned about the user-fee aspects of the minister's budget. I'm sure he has received copies of all of these — and petitions as well. These people who are writing to you and me are not people who can afford this; they are people who are going to be having a rough time making ends meet. I call them the working poor. You can call them the lower income. It doesn't really matter what you call them, or whether you call them the retired poor. There are people out there who do not qualify for assistance and who are going to have tremendous difficulty making ends meet when it comes to dealing with these user fees. It is not going to have the effect you want it to have. We will find that the increases in hospital care will be higher because people will not be taking the prevention end of this.

I was happy to hear that the minister is building. Social Credit has always been great at building things; they love to build things. I think it comes from the member from Vancouver South. I think he likes to promote his profession there — building hospitals and facilities throughout the province. They're usually facilities that are very much required, but we always find that we fall down on providing services in those facilities through the staffing.

In talking to people in Prince George, I understand that our rehab unit, which was built as a 1983 election promise — opened for two weeks and closed a few days after that — may suddenly become open at some point this fall. That is the sort of thing we are seeing. Facilities are being built, but we don't have the staff to staff them. We are not being given the funds to operate them correctly, and we are not being given adequate amounts of money so we can keep those facilities open.

Throughout the province we have intensive care units that are closed down now. In Delta, just the other day, they closed down their intensive care until August 17 because of shortage of funds and critical care nursing. It's a possibility, they say, that that unit may never open up again. Why are we building more facilities when we can't even staff the ones we've got? We don't even provide the funding to operate those facilities in a proper way.

We must take our priorities in hand and operate the facilities we have correctly and make sure they are staffed properly. That takes some planning; it takes planning with regard to training and with regard to all of the purchasing of equipment. So far, I haven't seen that happen in the ministry.

I was interested to hear you say that you were going to be building a cancer clinic. I'm not sure whether it was in Vancouver or Victoria — I knew it was a V — but in one of those areas down here. Was it Vancouver?

Interjections.

MRS. BOONE: No, it wasn't Vanderhoof.

MR. CHAIRMAN: Hon. member, I point out reluctantly that your time has expired.

MS. A. HAGEN: Mr. Chairman, I have been listening with great interest to the comments of my colleague for Prince George North, and I would hope that she continues with her overview of the Health ministry estimates at this time.

MRS. BOONE: At any rate, there is a city with a V that is getting a cancer clinic. I'm really interested because it didn't go to anyone with a K like Kamloops or PG like Prince George, which is where we wanted it — some place in the interior. I understand that was supposed to be the next place for a cancer clinic.

AN HON. MEMBER: Which one do you want it in?

MRS. BOONE: I am focusing in on Prince George, and that is the area I want it to be in, but we do not have it in either of those areas. The municipalities have come out with a resolution stating that the next cancer clinic should be in the interior. That is what we need; we need to have an extension of our health services so people do not have to come down to the Vancouver region and so families are not torn apart — whether they come from Kamloops or Prince George. We need to have those facilities in the interior. What do we get? We need a new cancer clinic in Vancouver. I find that really interesting.

One of the things I would like you to look at is the bureaucracy. I mentioned this in my original speech. I think the ministry has to take a look at their bureaucracy, and they have to look within. It should be done by somebody outside your own bureaucracy, Mr. Minister.

I was interested to see your health care costs and your health care spending in B.C. You have indicated that it's going to be increasing by $237 million, and your budget states that it will rise by 8.1 percent. That budget shows a rise of only $104 million over the revised spending forecast. The $237 million increase that you mention is over the estimated budget from last year. So when you take it from the budget, and when you take it from the revised budget — what was actually spent — you don't have an increase of $237 million or a rise of 8.1 percent; you have an increase of only 3.4 percent. That's really misleading to tell us that you're increasing your budget by $237 million, because that's not going to be an increase in services. In fact, the increase in services that we'll be seeing in B.C. Is only $104 million — a $104 million increase over the revised budget of last year. That doesn't even make up for the increases that were received in wages for those things.

I'd like to ask the minister some questions with regard to the management area of your ministry. If I can, I'll give you four questions and maybe you can answer them right away. One: what are the differences in your management area between the three areas of communications, information and advertising, and publications? Two: what professional services are purchased in this area? Three: what are the expenses in data and word processing, other than supplies? Four: are these data and word processing systems outside what is known as B.C. Systems — are these costs from other B.C. systems — and is there any money in this budget for Shared Systems Society?

[5:30]

[ Page 2433 ]

HON. MR. DUECK: On the last questions, that's something I'll have to come back to you on. You're asking some very specific questions, and that would have to be taken out of those figures in our budget. We'll get back to you very shortly.

I should mention to you that we never denied that our budget was not eight-point-something percent. We always said it was over last year's budget; we have never misled you or anyone else in the House. We are quite well aware of it. It has been discussed before. It has been brought up in the House that if you take the actual money spent over the money we actually budgeted this year, yes, it amounts to 3.4 percent. You are absolutely correct.

You mentioned a number of things. I think we are talking generalities now, but I would like to touch on them. You mentioned that preventive services are very important, and I couldn't agree with you more. They certainly are important. We've done many things in that area over the past few years. I'm not going to take the credit for all that has happened. I think the credit goes to the minister prior to my taking office — that was Nielsen — and perhaps before him. For example, homemakers, home nursing: would you believe that in homemaker alone — these are people who come and clean your house; you're well aware of that — we spend roughly $52 million? I believe it saves us an awful lot of money in the long run. It's a lot of money, but I think it saves us dollars. So when you say preventive care, I can't argue with you. I think you and I could sit on the same side of the street and agree every time someone had a question.

We're doing many things in the preventive areas. For example, you say anti-smoking is important, but not really that important. That's maybe where we disagree. Some of my best friends smoke. I don't know why they are still best friends, but they still smoke. In many cases the women have taken it up and the men have quit. I have statistics that roughly 30,000 die in Canada per year directly related to smoking in one form or another. So when we say that we're going on an anti-smoking campaign.... And it's not at the adults. We're not trying to convert someone who has done this for years and enjoys it, that that's his pleasure. Goodness' sake, I'm not here to preach or try to convert them. But we must get at the classroom, at the younger people, so that they can make an intelligent decision whether they should or should not. That's what we're trying to do, and I think we agree on that.

We're very heavy on nutrition. We've got nutritionists in most hospitals, and we do emphasize that. Wherever I and my people go we talk about this constantly: your diet, exercise, non-smoking, abuse of alcohol. All these things form part and parcel of reducing health care costs. I may not have mentioned that much in the budget speech, because you can't say everything in there.

I have been very, very hard on people in this particular area. Are we really serious about the cost of health? Are we really serious about the health of our own bodies? We have advertising that shows the most glorious picture of the most beautiful woman — really, the most sexual woman — with the most macho man, both young, in a fast car, the latest car, and there's the bottle of vodka and the Craven "A" cigarette; and then we tell our youngsters: "You shouldn't really smoke, because it's bad for you." We're not really serious. That goes not just for me and the Ministry of Health — I can only do so much — that goes for every one of us. I agree with you 100 percent that we must do more in that area. It's not a limited number of things; it goes on and on and on. You could go on forever, saying the different things we should do, which we don't do. I don't do them. How much exercise have I done since I've come into this ministry? I used to play a lot of tennis; I walked to my apartment and back. So we're all guilty of that. But we are in fact going in that direction.

You also talked about cutting back. We're not cutting back in any area that I'm aware of. We are perhaps cutting back from expectations, or even cutting back by reallocation. In the last cutback kafuffle, this whole thing from the Province and other papers and other media, we were cutting back so many here and so many there. Most of that news came from contractual agreements with various psychiatrists and what have you. But when you really look at the total picture in the province, it amounts to one FTE for the whole province, and that was offset in some other areas. So we're really not cutting back.

Quite frankly, I must admit to you, I will confess, that I could use more people in many areas — there's no question about that; I don't argue that point at all. As a matter of fact, that's been one of my very big concerns since I've been in the ministry. I've spent a lot of time trying to allocate people to the right places and find out why we still have some problems in certain areas. You must also remember that some of the shortage problems you spoke of are not really due to underfunding. In many areas it was due to not being able to get the proper people or the professionals they wanted in that area.

You were speaking about closure of hospital beds in general terms — the specific questions will come a little later. You know as well as I do that come summertime, those hospital beds are going to be closed because doctors go on holidays. Aunt Matilda is coming from England, and her cousin is not going to have her operation at this time. I've been a member of a hospital board for years and years. We've had years when we had no cutbacks, and the same number of beds were closed again. That is the nature of the thing in summer, when people leave. Yes, some of it is due to critical nurses. Some of it is because the specialists most people want for that special operation are on holidays. Yes, some of it is because nurses are away on holidays; their children are home. Some of our best nurses have families, and they too would like a month or two in summer. We also find that summertime saves the hospital society certain dollars. They say: "Okay, this time of year we know what's happening. We'll close so many beds." This is a traditional thing. If you check back to the hospitals, they will always tell you: "We haven't got the funding. We haven't got the staff." But it's really a combination of things. I would say that the major portion is that they haven't got the wherewithal and manpower because they are away on holidays, and they don't require services such as elective surgery. You will find that anything that's an emergency is done. I have followed through on a number of complaints I've had in my office. I've followed them through very conscientiously and found out that in most cases there were alternatives and it could have been done another way; or it had already been done by the time I got to these people.

I will confess to you that the system does not work 100 percent. But I would say that our system in British Columbia is by far, if not the best, then a very close second in Canada, and we're still trying to improve it. I've worked very hard to try to improve it. I've listened to many people. I received the letters you received, plus perhaps ten times more. So I'm aware of these things. There's a balancing act I have to play when I'm in this position: the dollars I get and the dollars I can allocate; it's a fine line. If I could do what you're saying,

[ Page 2434 ]

and line up all the needs and say, "This is what we'll do," it would be a wonderful world, but it wouldn't be a realistic world. That's all I have for now.

MRS. BOONE: I understand the minister will be getting me some information on these questions that I just asked him.

Although the member for Maillardville-Coquitlam (Mr. Cashore) will be dealing with the mental health issues later on, I have received letters, and they say things such as: "I am concerned about the hiring freeze on all positions in the mental health services which will further demoralize an already overworked staff. Loss of staff through attrition will exacerbate a marginal situation here. I am concerned to learn that the hiring freeze means a loss of two psychiatric sessions at our community mental health unit." This is written from a family doctor in the area of Maple Ridge, and I've received several other letters from physicians in Maple Ridge.

I don't understand. I seem to be getting two different stories, one saying there are no cutbacks, and then one from the people out there who are saying: "Yes, by gosh, there are cutbacks out here." I don't quite understand what's happening there, because there certainly appears.... I will be leaving this up to my colleague from Maillardville-Coquitlam, who is going to be dealing with this in a little more depth.

What I am interested in knowing is.... In your ministry support services you've got some reorganization of disaster supplies, giving better control and security, saving space and lowering costs by over $ 100,000 a year from the previous budget that you got out — 1985-86. What I would like to know is how much is allocated for this section this year, whether this money is regionally allocated, and what programs are in place.

This comes from concerns that I've had from some people in the field who are really very much aware that if there were disasters in many of our smaller communities, there are no plans in place. Disasters would not be handled very well, because they haven't set up anything with regard to their own areas. Can you give me this information, please?

HON. MR. DUECK: I understand that that's to do with the arrangement we have with the federal government as to disaster for an airport and what have you. Again, we'd have to take those figures out of masses of figures. I don't show them separately, and that's why you haven't got them separately.

Again, we'll have to get to you later. You're asking some very specific.... You're picking out small amounts in a large basket, and it's very, very difficult. They just don't show them in that form. If you will bear with us, we shall get them for you.

I have a couple of things that I wasn't quite finished with from before, and if you just want to bear with me, I will go over some of the other items that you mentioned just a little earlier.

You also mentioned the cancer clinic; that was Victoria we were speaking of. That is a replacement of the one that exists now — just developing that particular centre. As far as the interior one is concerned, you're right. It's been touted and talked about and schemed for and begged for and threatened for many years in a number of communities. That will come about perhaps in 1989, 1990 — in that range. We've not decided yet whether it's going to be in Prince George, Kamloops or Kelowna; that decision has not yet been made.

We are well aware of your community's concern. Kamloops has been making the same pitch, and also Kelowna. The decision has not been made, but that is the next one. That's where it will be going, in the interior somewhere.

[5:45]

MRS. BOONE: You will probably have to take these on notice as well; perhaps not. In your management, I find a lot of information, a lot of things that I really wanted to get some more information on, because I didn't quite understand what each of these areas did.

You've got a systems division, the purpose of which is to improve and maintain the quality of operational and management information available to the ministry and, where appropriate, to external contacts of the ministry. I want to know what that means. What are the external contacts of the ministry that the systems division is providing services to? Are we providing computer services to private enterprise? What are the services that we are providing to external contacts of the ministry?

HON. MR. DUECK: We certainly don't provide any data service of that kind to anyone but our own, like Medical Services, hospitals and that type of thing — certainly not to the private sector or anyone else outside of our ministry. If that is your concern, we're not selling services of that nature, nor do we provide it for anyone other than our own.

MRS. BOONE: Under the operational review and productivity branch you have: "Independent assessment to senior management as to the efficiency, effectiveness and economy of operations, management controls and information systems in the ministry." Number one, is this an ongoing process? Number two, what was the budget for this for last year? What's the budget for this for this year? And are those assessment reports available to the public and to the opposition?

HON. MR. DUECK: Mr. Chairman, I can't write as fast as you speak. Number two was what?

MRS. BOONE: What was the budget for last year and what is the budget for this year, and are the assessment reports available to the public and the opposition?

HON. MR. DUECK: Mr. Chairman, on the first question, of course it's yes. It's an ongoing audit for the operations to make sure that we are as lean and mean as we can be, without affecting the care. The budget figures we're just going to look up now. The report is only available to the minister, because it's an internal document to the operations of my ministry. I'll get you the budget figures for last year and this year in just a moment. Okay, in '86-87 it was $148,000, and this year it's $225,000.

MRS. BOONE: This branch of the ministry also provides assistance to the private sector health care product manufacturing and service industries. "Assistance was provided to several private sector firms wishing to manufacture health care products to promote sales in B.C."

I understand that interferon is manufactured by a drug company supported by the B.C. government and it is lobbying the government for more dollars while it is unable to keep precedence and doesn't have a market for the product it needs

[ Page 2435 ]

government assistance with. How much money has gone to such companies as Travenol Canada Inc., which are privately owned companies manufacturing health care products? What kinds of incentives have they been offered? What kind of assistance is offered to these companies generally? What kind of health care products are these people helping develop? Is there a criterion that's used to determine who receives any assistance? And how much of your budget was devoted to this area in the last year's budget, and how much is in this year's budget?

HON. MR. DUECK: I think you're referring to Travenol and the interferon group. That money was spent to make sure that it was audited and done in the proper manner so that when we buy supplies from them there's no reason to believe that we're not getting good value. There was no assistance offered in any form at all as far as their operation is concerned. The money spent in this area would be part of the total operation budget that I gave you just a little while ago under this year's $225,000. If you want that separately, then we'd have to go back. If we'd brought in all these items, we'd have to bring in a truckload; but we can get you those things.

MRS. BOONE: I would appreciate it because it seems a strange thing to me for the provincial government to be spending money on assisting the private sector in developing health care products, and I do think we ought to....

HON. MR. DUECK: No assistance.

MRS. BOONE: No assistance in developing health care products. The previous budget that was just tabled the other day indicates those very words: "The branch provides assistance to the private sector health care product manufacturing and service industry." Has the ministry's focus changed since two years ago when that original report came out?

HON. MR. DUECK: I don't know what's happened in the past, of course; that was prior to my time. But there has certainly has been no assistance since I've been in there. But we have given encouragement and we have been monitoring to make sure that the product we purchase from them is in fact legitimate. We have been very careful in that area, and that may have cost us a few dollars with the Purchasing Commission which we have in our ministry.

MS. A. HAGEN: Mr. Chairman, I want to address some comments, raise some questions and have some discussion with the Minister of Health around an area which he identified as a very important one for his ministry, and that is the area of long-term care services.

The minister has described at some length his concern for these services and I note that he has given us some statistics around the rate of growth of this part of our older population — those over 65 — a rate that is going to rise overall to somewhere between 14 and 15 percent. But as he has noted, it is a rate that in the older age groups is rising at a much more rapid rate; we can look at figures anywhere from 120 to 170 percent depending on which of the age groups we're looking at. But clearly, the older group, the people who are 85-plus, are living with us longer. For instance, it's interesting to note that the average age of people in extended care facilities, I understand, is at that 85-year level. I had a chat with my doctor the other day who works a great deal of her time with seniors and with older patients. She was noting that when extended care hospitals began, there were some predictions of the life expectancy of people living in extended care facilities, and in fact we're finding that that's doubling and tripling, and possibly quadrupling, because of the care that is available and the kind of services that are available to that population.

Another figure that the minister noted, which is a very different figure from any I've heard — and I would certainly appreciate his commenting on this a little more — is that something in the order of 48 percent of our health care costs are attributed to the older population. Mr. Minister, the figure that I have usually worked with and one that I have seen in epidemiology studies and a whole range of literature in this field suggests a 35, 36 percent cost in relation to that population of around 12 or 13 percent. I think it is perhaps an important figure for us to have in mind. Clearly, it is a large percentage of your very large budget. Believe me, I am in concurrence with you about the significance of the health care of the elderly as being a very, very important matter for us to be looking at in service delivery today, and in our longterm planning; but I think it is important for us to perhaps have a good, solid figure from the ministry about what proportion of our health care dollars — at a third of the provincial budget that you manage in your ministry — older people do in fact consume.

I think it's useful for us in this discussion to put into our discussion a few other figures. One that has interested me as I have become more and more involved as a kind of lay professional in my life before this particular job with working with the elderly is the rate of institutionalization that takes place in Canada. Again, it's hard to get absolutely hard and fast data, but the study which has been done by the National Advisory Council on Aging toward a community support service for the elderly I think provides probably pretty reliable statistics. The figure that they give is something in the order of 9 or 9.5 percent of the population of the country.

I'd be interested, Mr. Minister, to know whether you have a figure for B.C. In terms of the number of people who are institutionalized — that is, in personal, intermediate care or extended care facilities — as a proportion of the total population of those over 60, 65. I do know — I think this is a significant figure, and it's certainly a significant figure from the long-term planning perspective — that in a number of other comparable jurisdictions, if you like, in terms of standard of living and approach to public perspectives of the importance of social services and health services being managed and coordinated by government, the rate of institutionalization is more at the 5 percent level. If we look at countries in northern Europe, Great Britain, the Scandinavian countries, France, we find that the 5 percent figure is the operative figure there.

I think that's an important figure for us to note from a long-term planning perspective, and I hope the minister might agree with me, Mr. Chairman, that that is a goal to which we should be aspiring. Certainly it is a goal that older people would very strongly support, because there is nothing probably that is more important to the older person than to be able to maintain independent living — autonomy — for as long as that is possible, given the health and safety of that individual.

Again, quoting verbatim from the National Advisory Council on Aging study toward a community support system, that aspiration was probably the aspiration that was most

[ Page 2436 ]

strongly espoused by older people. From a cost-effectiveness perspective and from a quality-of-life perspective — the two important things that are a part of any health system — surely that aspiration of the older person is one that health ministries and all the many people in the various sectors who are concerned with health delivery would support.

I think the other thing that is important for us to have as a perspective in our discussion of long-term care is that we need to deal with the tendency which we all have — perhaps it's a tendency that comes from those of us who are younger but getting older — to think that there is a homogeneous group of people out there who are over 65. In fact, it is a very diverse group of people — diverse in terms of their basic health, in terms of their backgrounds and ethnicity, which means that there are different cultural perspectives, as you would well know, Mr. Minister, that come to bear.

There are also differences that are brought about as a result of the change in lifestyle that we're seeing: smaller families, more of a nuclear family, and some of the breaks that are occurring in families.

[6:00]

In spite of that, the number of people who live with partners is amazing — something like half our elderly. It is significant that about one-quarter of our elderly are living with family members who provide direct support. That doesn't address those of our elderly who have family around them — sons and daughters and grandchildren — within a reasonable distance to provide support. In your ministry, you have a tremendous matrix of services to deal with that population. Whether you're looking at community services, preventive services or continuing care services, all are to some extent going to address the needs of the elderly. The coordination of those services — in fact, the tracking of how those services are delivered — has been a source of fascination for me, as I'm sure it has been for you, Mr. Minister, in getting to know your very large and complex ministry.

I might note at this point that one of the things it would be wonderfully useful for you to do, if you have some influence in giving direction to your staff in this regard, would be to provide some consistency in your annual reports so that we can compare apples and apples and oranges and oranges. I have been looking at these sources of information, and although we can get at a lot of them, they are presented in different ways each year. That makes for, I think, some challenge for all of us to at least be able to see patterns in the ministry, which is important from the point of view of longterm care and long-term planning.

I want to comment, too, about some of the policies that I hear you speaking about, and again perhaps emphasize these a little as we move to some dialogue and some questions.

First of all, it is clear that your ministry is interested in providing home support services. In a few minutes we'll perhaps discuss the scope of those services, and I have some questions that I want to ask about those. But I applaud that approach, and concur that from a long-term perspective, it's something we very much need to address. I have some grave concerns about the manner in which the ministry is going about addressing that particular policy of providing home support, but for the moment IEI's say on the record that that particular perspective is one that I think is the way to go in terms of planning.

Consistent with that particular perspective is the phasing out of personal care facilities. I note in your introductory comments, Mr. Minister, that you gave a figure of around 400 to 500 personal-care beds that are being phased out and upgraded to intermediate care. I've seen various comments about that upgrading and replacement and so on. I want to come back to the realities of that, but putting on the record the policies that we support, that policy is one that we support as well. It's a policy that in its implementation requires substitute services. I want to come back to the issue of substitute services if personal care is in fact to be phased out as a service delivery area.

I know, too, that there is an expansion in the intermediate care level — and to some extent in the extended care level — of the number of people who are being cared for at home. I understand, from talking to some of my home support contacts, that the number of intermediate care clients still in their homes vis-a-vis being in an institution has almost doubled — from 5,000 to 10,000, or something in that range. That kind of perspective goes along with the aspiration of older people. I know, too, that in your ministry at this particular time there is, under the direction of the executive director of your continuing division, a major mandate review that is looking at the whole hierarchy of services available to older people and the role of the ministry in that regard.

What we have then is agreement on the fact that care of the elderly is a major issue in terms of our health care. There are policy initiatives around the maintenance of older people in their homes, which we support. There is a recognition that with the appropriate levels of care, many people who might earlier have been institutionalized may be able to continue for a longer period of time in their own homes. I would again emphasize the statistic that Canada-wide we have almost double the number of people institutionalized. I don't know whether the percentage is similar in B.C., but certainly it's going to fall somewhere over that range, which we might aspire to, of about 5 percent.

Finally, in order to deliver those services, we really have to have an immediate long-term plan if we are to achieve the minister's aspiration of containing health costs.

Having established some of the common perspectives and understanding of the issues, let's look at a baseline to give us some idea of how this system is working. The minister noted to my colleague for Prince George North (Mrs. Boone) that we had expenditures of something in the order of $53 million or $54 million for homemaker services. I'm going to use those as a baseline for those community support services. There are a number that need to be in place, but those are the nuts-and-bolts basic services that people need to have. Going back in the estimate books, it's quite interesting to look at the number of dollars that were proposed for that service in the early 1980s, compared to the estimates for this year.

Going back in annual reports, it's quite interesting to look at the numbers of people who are served by homemakers, according to the ministry statistics. In 1981-82 the estimates allocated $57 million — and I'm going to round figures off — to homemaker services. In 1982-83 it was $65 million. It appears that about $57 million was spent. The years 1983-84 were when things nosedived and services were cut. All of a sudden we went down to $50 million, give or take a few hundred thousand dollars. The next year it went down again to $48.5 million, and it stayed there in 1985-86. There was no increase in 1986-87, and finally in 1987-88 we see some increase in the budget.

Let's look at what happened to the number of clients. Mr. Minister, the figures here are the best that I've been able to

[ Page 2437 ]

arrive at through your annual reports, give or take a thousand. In 1982 there were 27,000 recipients of homemaker service; in 1983, 28,500; in 1984-85, 30,000; in your latest report, 1985-86, the number of people receiving homemaker service is almost 41,000. That's an increase of almost one-third over the previous year.

We are looking here at a very commendable objective which we see reflected in the number of intermediate-care and extended-care people who are in their homes instead of in facilities. The number of people being served at home rather than in facilities is something that we are all in support of. What we're looking at....

MR. CHAIRMAN: Hon. member, your time has expired.

MR. ROSE: I'm tantalized by the line of argument exhibited by my colleague from New Westminster. I'm sitting here teetering on the edge of my seat for what she might reveal if she were allowed to continue.

MS. A. HAGEN: I'm sure lots of older people will provide the member with scandal. I'm not sure whether these figures will, but I certainly am happy to have an opportunity to continue.

What we are looking at is a very significant increase in homemaker services. My understanding is that this is creating a very significant decrease in the services being received by individuals. I know that two or three years ago there was a major review of those services because the program had grown very rapidly, and there hadn't necessarily been time to go back and deal with assessments. But the increase in clients to 40,000 from 27,000 over four years — and I don't know what the figure is going to have been in the last year — to.... Let me start again.

The increase in clients from about 27,000 to 40,000, with a very modest increase in budget over last year, and in fact a discrepancy between the 1982-83 fiscal year expenditures and the planned expenditures for 1987-88 of something in the order of $3.5 million, really gives us cause for concern. We have manifest reasons for that concern because we are hearing again and again from older people that the level of homemaker service they are receiving is too little for them to be able to maintain their independence. I can tell you, Mr. Minister, having worked in the field for five years and talked to families, individual older people, long-term care nurse assessors and volunteers, that it is clear that many people are having great difficulty staying out of institutions with the level of service provided.

Recently in New Westminster we held a health forum. This is just one story that's typical. A man and a woman at that forum, each of them an older or retired person, talked about his father and her mother. His father had been waiting a year and a half, with extreme Parkinson's disease, to get into a facility, and her mother, who was 93, was managing with two hours every two weeks of home support service. Both of these older children, if you like, were themselves experiencing chronic health care. So the issue of the amount of service available to enable people to remain in their own homes is a contentious one, and I would submit, Mr. Minister, that it is less than adequate.

Also within the mandate of your ministry, a provision that existed earlier has been removed, but it still, thank heaven, has some lingering manifestations in the province, and that is that there would be some handyman services available. People don't only need to have their carpets vacuumed, their kitchen floors washed and their refrigerators cleaned out, but they also need some help raking their leaves, dealing with some faulty steps that need repair or getting a light switch into their homes — very basic things in terms of management. So the clients, I would maintain, are not being adequately serviced, in spite of the increase you are offering this year.

[6:15]

Also, you note that there is going to be an increase in wages in the home support programs offered this year. We're looking at a significant increase in the number of people being served, we're looking at a budget that's under the 1982-83 budget, and we're looking at a home care industry which has been literally frozen at no wage increases for a number of years. I would like you to comment on what kind of wage increases are going to be available in the home support sector. How many of the additional dollars will be going into wages? How many of those dollars will be going into service? Can we, in the few dollars that are going to be available over the 1986-87 budget. which is only about $2.4 million — 4.8 percent...? How much of that is going to be going towards wages? And how much of it is going to be going towards the expansion of service because we have more people whom we are supporting in their homes?

I hope I haven't gone too fast, Mr. Minister, for you to be able to pick out of that some questions or some issues that you might want to comment on. I think I'll stop now and perhaps have come comment from you. I have some additional perspectives and questions to ask of you.

HON. MR. DUECK: You asked a question earlier: how many people were in some type of care under my ministry who were over 65? I've got those figures for you now. We have roughly 84,000 over 65 in British Columbia. We have about 60,000 receiving continuing homemaker or nursing care. We have people over 65 in institutions — somewhat over 21,000.

Some of the things you are saying, I practically feel that.... I don't know whether you're on this side and I'm on your side, because we're saying the same things. The only thing that separates us is the dollars. Unfortunately, I haven't got the total authority on that; as a matter of fact, I have very little. I'm on Treasury Board, but when it comes to my ministry, I find that my authority doesn't go too far.

We certainly agree with the concept that people being in their own homes as they become older is cheaper and the quality of life is much better; there's no question about that. I can speak from personal experience. My father is 88 years old — my mother died when I was just a child — and lives in his own apartment with my stepmother, who is not much younger, and they're doing quite well. Not too many years ago, they would be in extended care and would have been being looked after for perhaps the last ten years. So we have moved a long, long way from what you are advocating and what I personally advocate. And I think my ministry does too, and has done in the past. I've emphasized this more and more.

We speak about homemakers' wages. This was one of the first things that confronted me when I came into this ministry. I looked with horror at some of the discrepancies in homemakers — the level of remuneration that they received. I have been working diligently trying to correct that. It appears now that I see a bit of light at the end of the tunnel, and that's as

[ Page 2438 ]

much as I can tell you about this now, because it's future policy; it's not in our budget. But I believe that I will be able to do something about that; at least I hope I can.

When you speak about a budget for homemakers, there was a time — and you're absolutely correct — when we spent more on less people than we do today. Some of it perhaps is because we're more careful in assessing. Secondly, we provided services, in my opinion.... I've asked my ministry to check on that even more, and I have given orders, as a matter of fact, that we will not do gardening, we will not do snow shovelling, and we will not do handyman work. Because I'll tell you right now, and I say this in all sincerity and will speak on this as long as you wish, that when I consume one-third of the total budget, I cannot go beyond that point. As a matter of fact, I could use the total budget and I would still have people on that side saying: "Why don't you do this; why don't you do that?" It is absolutely, physically impossible.

If you speak about reallocation of dollars — perhaps we're spending in one area where we shouldn't, and more of that should go into another area — yes, I can buy that, and I would like to listen to suggestions. But to say that I should spend more, it can't be done without taking it away from somewhere else. Because with one-third of the total budget, when we talk about $3.2 billion, we can't argue that it should be more than that.

You mentioned you are from New Westminster. Of course, your concern would be with that area as much as the total province, but perhaps more in your own area. That pilot project I talked about was a three-year project, and this particular seniors' bureau I think was called New Westminster Seniors' Bureau.

MS. A. HAGEN: I was manager of the project.

HON. MR. DUECK: Okay, then you'll know more about it than 1. We funded it with $250,000. It was meant to run for X number of years, and hopefully at that point in time it will be self-sustaining. It has just not been continued, but we are looking at areas like that, and again it comes back to the dollars. I have spent a lot of my time since I've been in the ministry in the area of trying to get more funding. I know from letters, I know from people like yourself.... I've talked to you before and others from the opposition, and also others from our own government, who have said: "Why can't you do this, why can't you do that or something else for seniors?" It's all very, very important, but at the same time I can't close my eyes and say we'll spend the money; I can't get the money, never mind even if I wanted to. So we have to allocate those funds. The funds that have been allocated, the global budget — that's the budget that I have to live with.

I also have certain areas where I know I can't live within the budget, and I may have to ask for more, or somehow steal it from another area of my ministry where we can shuffle some dollars to an area such as you're speaking of now where it's more needed. Senior citizens occupy a lot of my time, a great deal of my budget, and it's an ongoing thing. You mentioned that you've heard from many people that were not getting the proper service.

I have travelled this province in the last eight months quite extensively. I visited many, many senior citizens' homes, I've talked to hundreds if not thousands of these people, and I've asked them again and again: "Are you being looked after? Are things well for you? Is the food good? Is the service good? Are you happy?" And you know, I have found maybe one or two who had complaints, and I followed those through and they were not genuine. When people get to a certain age they will, of course, be more ready to complain about things that they're not happy with. But by and large, senior citizens are well looked after in our province; and I make this a promise, that as along as I'm in this ministry, I will continue to do that. If you have any specific instances of people who have complained where unjust assessment has been done, I would want to be the first to know, and I would be the first to inquire personally and see why and what happened, and try to correct those errors.

I'm sure that when you have a ministry as large as mine.... We have under my payroll directly — and this does not include the nurses who work for hospitals — just under 7,000 FTEs; and I'm sure that when you talk about 7,000 people, they can't all be very nice people, like you and I!

MS. A. HAGEN: Mr. Minister, one of the first comments I want to make is that my experience of the people who work in your ministry in the field has been first-class, and I want to have on the record that whether they're working directly in your ministry or whether they're people who are administering some of the contract services in home support programs, in large measure those are people who have the well-being of their clientele very much in mind. I think, Mr. Minister, that there is a difference in the perspective that we bring.

[Mr. R. Fraser in the chair.]

I know the problem that you have in getting enough money, and I know that there is a need for us to be developing new and better ways of delivering health care. I also know that matters around health promotion and prevention are ones that we all believe will assist us in that regard. We could spend more time than we're going to have on this and at some time perhaps we will have some opportunity to explore the issue in more depth, but let me ask you a couple of questions in response to your encouragement of my providing you with information about quality, if you like, of care and the necessary care within the mandate of whether it's the home support program or a long-term care facility.

It seems to me that I have heard in my discussions with people in the field, whether it be in hospitals or in long-term care programs in ministry offices, that one of the differences that those various programs have this year in managing their affairs is that they have been told very loud and clear that the Ministry of Health will not fund workload.

[Mr. Weisgerber in the chair.]

And to be sure that the lingo is correct, that the term is correct and that we are understanding this, let me imagine a situation which I know has occurred in my particular health district. I know it's an issue, for instance, with my colleague from Kootenay, because we've discussed this same issue around older people in her community.

Suppose, in delivering on the mandate of your ministry, that the number of homemaker hours that are contracted by nurse-assessors to the various agencies exceeds the number that are budgeted. Can the minister assure me, if that is the case, that that workload will in fact be funded?

[ Page 2439 ]

Let me say, Mr. Minister, that I have a great deal of faith in the integrity of the long-term care program in my district and surrounding districts to deliver the very best quality of care within the mandate that they have, and with the knowledge of the restrictions that exist within your budget. But I know, too, that those people in the field will, instead of you and I discussing the problems, try to solve them — as they should, as the professionals, the people working in the field.

You and I don't have time to go out and deal on a piecemeal basis with individuals, and I don't want to be a party to that. I will certainly advocate for anyone, but I want to know that the system is working, that those people don't need to come to their MLA or to the Minister of Health in order to have the service that they need to have. I want to know that those services will be assessed by competent people, and that they will be able to deliver those services with the recognition of all of the difficulties that we have. Those people have lived with those reduced and restrained budgets for a number of years, and they're realists — believe me, they're realists. If you're a long-term care assessor trying to deal with a clientele of 400 to 500, which is what has been the pattern in my district — somewhat improved recently; but for the last two or three years — with the kind of workload that those people are dealing with, they're doing their darndest to make sure that they are delivering the service.

I want to know whether workload will be funded even if it goes beyond the budgeted amount for my health district, or a neighbouring health district, or my colleague in Kootenay's health district, or any health district in the province, because that then begins to deal with us knowing that services will be delivered. Mr. Minister, remember that every single individual who is maintained in his or her home is going to save the province ten times what it costs to deliver those services. We could get into those comparable costs, but we're looking at something in the order of anywhere from 10 to 20 percent of the cost of institutionalizing people to provide them with support services in their own homes.

[6:30]

So let's deal with that issue of workload and let's be sure when you answer that question — if I may ask this, Mr. Minister — that hopefully that might be something that might apply to adult day care and to some of the other services that are a part of that community support service that your staff is attempting to provide in the most cost-effective and quality assured way in the health districts of the province.

HON. MR. DUECK: You are speaking of workload in both the acute-care hospitals and homemakers, long-term; you're speaking of both. I think they apply in both ways. We have to live within a budget. We set the budget at the beginning of the year, and a global budget is also set for hospitals. They must manage their hospitals within that budget; there's no question about it. We fund workload, no question about that, but we will not fund increased workload.

In other words, they get that global budget at the beginning of the year, the same as I get mine. I cannot go back at the end of the year and say that I need another $50 million or $100 million because something happened out there, that the hospitals were overrun and they had a big overrun at the end of the year, and therefore I need more money. So we do give them a budget at the beginning of the year, with the approximate increase in population and what have you. We arrive at a certain figure, and they must live within that budget and manage their affairs, the same as I have to when I go forward with my budget.

However, when it comes to the homemaker, something I should have mentioned before when I said that I didn't think we should provide all the services that the elderly require is that it's not that they don't need them. But we certainly cannot provide handyman services; we certainly can't provide gardening. We had one incident where this particular person got in touch with me by letter. was very, very upset, and the letter read something like this: "I've been cut back on my homemaker service, and this stops me from doing the volunteer work which I've done for years in a certain organization."

Perhaps that's an extreme example, but because of the shortage of funds, we have asked our assessors to please not cut back on the ones that really need help. If you find cases, and we've found many.... At one time we were much, much easier; if someone wanted homemaker service, they could get it. They needed it, they could use it, but it wasn't essential. We think that health care is health care. It's not providing handyman service; it's not providing a gardener; it's not providing someone to paint the outside of the house. These are not the things that come under my ministry. Maybe there's another ministry that can help in that area, but I will stand very fast on that point and we will just not fund it. I haven't enough money in the budget to do it. We've cut all those items out of the budget and said to these people, to our assessors, that we will no longer fund them as of some time ago, and we are continuing that policy. We will fund workloads, but not increased workloads. They get a budget at the beginning of the year and we expect them to live within that budget, the same as I have to live within my budget.

MS. A. HAGEN: I know that the member for Kootenay (Ms. Edwards) wants to raise an issue that relates to this discussion, and perhaps we'll deal with that in a more explicit and example way. I want to just deal with this matter a little more, and I'll wait for my colleague for Kootenay to ask her question, and perhaps the minister can then respond to both.

Mr. Minister, I think what I hear you saying is that, if in the field, with all of the direction that is coming from your ministry, field workers, long-term care nurse-assessors' and administrators find that there are people in need of service — let's say for a homemaker or for adult day care — and they cannot provide that service without going over the budget that they have been allocated this year, those services will not be funded.

I think, if I know the situation that has occurred in the past, that that is a change in policy. In the past, in consultation with the ministry, looking at the circumstances, that workload over and above the budgeted amount has been approved.

I want to say, Mr. Minister, that that particular move — sympathetic though I may be to your unsuccessful efforts to get more money for your ministry — is counter to the very fundamental principle we're talking about here, and that is that the provision of these various support services, whether in long-term care, homemaker services, home nursing or adult day care — yes, and handyman services, not to necessarily plant a vegetable garden but to do the very essential things that allow a person to stay safely in his or her home....

Those kinds of decisions, I maintain, in the long-term interests that I was elucidating earlier, will not be around us looking to preventive and support services to cut the cost of people in institutions. In my community there are something

[ Page 2440 ]

like 50 people occupying acute-care beds at any one time. Many of those people are there because the coordination and delivery of the necessary support services is not adequate. I don't think there is any argument that you or I are going to have that that kind of situation is simply not a way to manage your health dollars in the most effective way. Somehow we've got to cut through that and somehow we've got to get at that issue, or you're going to be in a worse pickle than you are right now.

Believe me, I've got a lot of sympathy with the kinds of things you're talking about, and I'd be the first to agree with you that there are changes that need to occur; but they're not going to occur unless we deal with the chicken we have while we try to hatch some kind of better system that is going to work.

I think we have to deal with that circumstance now, because once those people go downhill, once they are institutionalized, the chances of their ever moving back into the community — you know it and I know it — are dim. They are really dim, so it's a catch-22 and you don't have much leeway in order to prevent those kinds of things happening.

I think that my colleague from Kootenay, if the Chair might recognize her before you respond, might give you a specific instance, and then I think both of us would be interested in your response. You may wish to respond right now; it's your prerogative.

HON. MR. DUECK: I will respond now, because at this time of day I'd better respond right away or I will forget — I can't write that fast.

You were mentioning people in acute care. The member for Prince George North (Mrs. Boone) just a little while ago said: "You continue building facilities but that's not really what we need." Now you're saying that these people are in acute care but should really be in extended care. They wouldn't be in acute care if they weren't at some risk to themselves, so they should be in an institution like an intermediate care or extended care.

Surely no doctor would put someone into acute care because they couldn't get a homemaker. I mean, there must be one in between. But be that as it may, there could be cases like that, and the doctor and the assessment people make that decision and not always the correct decision. But we know that we have many, as one of you mentioned so ably, who they call bed-blockers. We have those, and I always hate to see it, because the cost of having someone in an acute-care bed is certainly much greater than having someone in an intermediate-care or an extended-care bed or, for that matter, in the home.

However, a few years ago we had an experience where the homemaker services ran practically amok — prior to my time — and something had to be done to lay out some very clearly defined guidelines and policies about what came under Health and what may come under Social Services or moneys from other sources. My ministry looks after health; we do not provide residence, per se; we do not provide all kinds of ancillary services that people may want and rightly should have. We're looking at the health of a person, and the homemaker is just that. We cannot afford to provide the other services that may well be needed but are not health-related.

Now when we find a situation like you mentioned — if someone needs homemaker services, can't get them, and if they can't get them they must be institutionalized, but could live quite well in their own residence or rented apartment, we may allocate from another area to help in this area. We may do that, if it came to a real crunch, but by and large we do expect people to live on budgets, and we do expect them to perform within that budget. With hospitals it's not quite that difficult, because they have so many beds. We know the occupancy fairly close. It's pretty well to a science, and some hospitals do quite well under the budget — other hospitals are always in glue, and it's again, like you mentioned earlier, a matter of management, and it's management in my ministry, it's management in hospitals, it's management everywhere. Some people can just make that dollar go further. It also depends on the acuity of that particular hospital. They may have certain people who have illnesses that may not be the same in another hospital. So with that I'll listen now to what the other member has to say.

MS. EDWARDS: I wanted to make a comment about the number of people who do end up in acute care, when they probably should not be in acute care. The kind of thing that happens is, of course, that a doctor sees a patient and if the patient is probably well enough to go home if there is a certain amount of care available at home, or the patient could stay home and not go into acute care, if there were that degree of care at home, when you have that working, against, if you like, the homemaker service, where the person who is assigning the homemaker service has such a tight budget that cannot be expanded, that person is not likely to be able to have the ability to immediately respond to this kind of situation.

I think my colleague from New Westminster is saying perhaps the same as I am, that we would much prefer, and perhaps you would.... But the idea is that there would be better elasticity at the level of the homecare service than at the acute-bed situation. As you know, if a doctor assigns a patient to an acute-care hospital, it's pretty likely that that patient will be there in the hall or wherever, but the patient will be there. That's far more expensive than having the availability and the possibility of having the home support service for a person in his or her own home.

But, Mr. Minister, all these things are background to the issue that I want to bring up to you, and it's in a letter that you sent to me after I had presented some petitions to the Premier on home support service. What I want to probe a bit is the philosophy that supports the home support and, as you call it, handyman services, although we don't have handyman services in our area at all anymore, despite the fact that we have many homeowners among the people who need home support. But what you've said is that there is a commitment to the philosophy of independent living within the community, rather than the provision of care and facilities.

Now I want to question that word "independent," because in fact many of these people cannot live independently; that's why they need home support. So I'm disturbed by the word and I'm disturbed by a sentence that follows in the letter. It says: "Part of the care plan is gradual reduction in home support to encourage rehabilitation and return to the normal activities of daily living." Now what I'm saying, Mr. Minister, is that in many cases that is an absolute impossibility. There is going to be, with older people who are still maintaining their residences, an inability to be independent. They cannot be rehabilitated to be independent. They cannot return to what you call the normal activities of daily living, because in many cases they're suffering from a degenerative disease, their situation is going to get worse.

[ Page 2441 ]

[6:45]

What the whole idea is, as I understand it, is that we help these people who cannot be independent — they are going to be dependent — and we give them that ability to be dependent and still remain in their homes and out of the institutions. In fact, there is often no hope that they will get better. They may have arthritis, they may have diabetes, they may have any number of diseases in which they are not going to get better. In fact, their dependence will probably become greater. So I would like the minister to respond to this. I think it's alarming that this is laid out as the philosophy to the people, all of whom were writing to you, making petitions to you, as seniors. I know that in some cases they had had acute medical care, and might recover from some kind of surgery to a certain degree, but I'm worried that the philosophy should be stated — that it's not independent living to which we are striving; it is a degree of dependence and that dependency can be supported at a different and less expensive level than through acute care or institutionalized support.

HON. MR. DUECK: I agree with many things you say. There's no question that some people come home from the hospital and will never be able to function without some support. But what I stated to you in my letter — maybe I didn't make it clear — was that many people who go to a hospital go because of a certain ailment, or surgery, or what have you. They rehabilitate, and then we cut them off once they're back to functioning quite well in their own environment. We will then take that service away. That's what I meant: we will cut back whenever the person who does the assessment feels that that they are now functioning again close to the same level as they were prior to going into an institution.

Last year we spent exactly $22.5 million on people who were in hospitals and recovering, and then withdrew, and those people are functioning quite well again.

I know you're concerned, and I know what you're saying, but by and large, other than isolated cases.... And when you take a province, or as many thousands of people as I mentioned to you before who are under this program, there are bound to be and will be many instances where people are unhappy — some justifiably, some not justifiably. These are things we must look at when they occur and are brought to our attention. We will certainly look at it, no question about it.

But there are also many who are complainers and who .are, we feel, in our assessment not functioning like a person of 39 years of age, like me. I mean, they're a bit older and have a problem. My father is a perfect example. He's healthy; he's bright. But when he gets up, he gets up a little slower than I do and walks with his cane and gets very upset at himself for not being able to do the things he wants to do. But he functions. There's no need to have someone come in to help him. It takes him much longer to do something. My stepmother, to make a meal for him and her, takes a long time, and it's an effort. But they do function. I know a lot of people who are much better off than my parents and who would want four hours a day.

I'm saying to you that $53 million in that budget for that care is sufficient. When I hear of anyone who is not getting proper care, I will be the first one to send one of our assessors and say: "Bring me back a report. I want to know." I do not want to be accused of not looking after the elderly, who have built this country and paid their taxes. We have a responsibility to look after them; I agree with you. But I must also balance that with the dollars I have, and this is not easy.

MS. EDWARDS: I want to make the point again that I am alarmed at the minister's saying that S53 million is enough. The point we are trying to make — and I believe you agree with it — is that the age of the population is moving up. There will be more seniors. The cost of health is moving up; the cost of health care for seniors is moving up. We want to keep those costs down. One of the ways to do that is to increase the budget for this group.

I'm not suggesting that you must increase it right now, but what I'm suggesting to you is that you make a statement and indicate that you agree that this is an area where we might expand services in order to save money.

HON. MR. DUECK: I fully agree.

MS. A. HAGEN: On that note — and I'm not sure I'll have the last word — I would suggest, Mr. Minister, that you consider funding workload. As I say I have the greatest respect for and confidence in your staff in the field. I have worked with them in the greater Vancouver suburban area extensively over five years. They are a superb and highly motivated group of people who administer the affairs of your ministry with the greatest dedication to their clientele and to the mandate. But I would suggest to you that you consider that you're going to be serving — I'm using the figures just for homemakers; the latest I have are for 1985-86, and they probably have gone up — 41,000 people, as against 27,000 in 1982, and you're doing it with $4,000 less. Then, somewhere along the line, even though there may have been some people receiving services earlier on who might not have needed them for health reasons, the discrepancy there is too great.

I want to come back a little bit later on to talk about the social services and health coordination, because it's an issue that I think, in terms of long-term planning, we're going to have to address. But I want to stay for another few moments with the long-term care issue.

The minister said a few moments ago that he was very concerned about what he had noted in the way of salaries available to homemakers. He indicated that although the remedy for that was not in the budget, that he was looking at some means of dealing with that. I would appreciate him expanding on that if he is able to do so. I want to just note that in talking to homemaking agencies right across the province, I have found that many of them have been unable to provide any increases over three or four years. What they are finding is that these circumstances are pertaining: first of all that because the training for people who become homemakers is very similar to the training for people who work in facilities — but the rate of pay for people who work in facilities is something in the order of 25 percent to 40 percent better than the pay for homemakers — the turnover rate in the homemaking field is phenomenal.

I think you and I can appreciate, Mr. Minister, that anyone who has to go into a person's home as a stranger, establish a working relationship with an older person, and deal with all the things that are a part of aging, needs to be a person with good skills and the ability to work independently. And those people need to be remunerated at a level that is consistent with other people who are working in the field. There are all

[ Page 2442 ]

kinds of people in the industry who are making barely above minimum wage to wages of $6.50 and $6.75 an hour. I know that there are some agencies that pay better, and some of them have also benefits available to their workers, but right across the industry the concern is there that the quality of the worker cannot be maintained with a turnover rate that now is between 20 percent and 60 percent, depending on the agency. That situation has reached crisis proportions, and it's a situation I know that the minister is well aware Of, because he has been briefed by the Home Support Association.

Could you, Mr. Minister, give us any further indication than your somewhat enticing words that there will be, in this modest increase in budget, which has to deal with increased workload, as well as the wage issue, some other source of funding that will allow agencies to pay their workers fairly and reasonably for the work that they do, and therefore assure all of us that the quality of the care is going to be commensurate with the dollars that are spent? Because it's bad economy not to have workers who are satisfied with that work, who are reasonably remunerated, and stay with their jobs. It's simply more costly every time we have a worker turnover and we have to have a new person go in. Again, I can demonstrate that with horror stories galore, knowing the kind of work that many of these people have to do as they try to deal with the many and different circumstances that they find in each home they go into.

HON. MR. DUECK: Mr. Chairman, I think the quality of care for these people, even if they are underpaid, which they are in many instances, has been excellent. In the reports I get back there are very few instances where quality care has not been given. I also agree that it's more costly to keep them in the hospital extended care rather than have them at home, so we're talking about the same thing. I suppose it boils down to dollars that are required to buy these services, and you know that we contract out. They're not employees of ours, which I'm sure you are very well aware of. When these agencies have contracted out, they in fact have offered services: so many hours for so many dollars. So perhaps knowing full well they couldn't get more dollars, they've cut the price. I'm not naive enough to believe or to tell you,"Sorry, it's up to the contractor; those are the services we bought," which in fact we did. But we also know that if there were more dollars available, the bids would probably come in at a little higher level and the wages would reflect that.

So what I'm saying is that in the current budget, I cannot do anything for homemakers. But I'm telling you — and this is as far as I'll go — that I am doing everything I can, and I see a light at the end of the tunnel, where perhaps something can be done for the homemakers as far as wages are concerned, because I agree there is such a discrepancy from one agency to the other. Or if you want to compare their services with services of that kind in another area of work, I agree that they should have more, and I will do everything on my part to rectify that.

Homemaker services have also had a slight increase this year, I think to the tune of $2.5 million over last year. If I can get a little more money to increase the wages, we can come through the year not too badly. I think we can offer a service that is acceptable — other than certain cases that you may have. I hope that during the course of the year you will — I'm sure you will, because you are very familiar with that particular area — let our department or me know, or whoever you wish to contact, and we will look at every individual case where unjust assessment has been done. Perhaps we can keep that individual in his own home and his own environment longer. That is certainly the more effective way to spend our health dollars. So I have no argument with what you're saying.

MS. A. HAGEN: Just for the record, Mr. Chairman, it is in fact the responsibility of the ministry in terms of those wages, and when we look at what is available under contract with societies that provide intermediate care, for example, and personal care, and the wages in the home support area, it is a matter a dollars, but those dollars are going to have to come from your ministry.

[7:00]

[Mr. De Jong in the chair.]

I'm not sure what "light at the end of the tunnel" means, or what people will determine from that, but I'm sure they will be looking for some brilliant incandescence coming forward from you in the course of the year.

One other issue around the long-term care. I've pursued this at some length not because there are a lot of dollars but because in a sense it's a principle. We're talking here about prevention, health promotion and wise use of health dollars, and I'm talking about these services as symbolic of that kind of approach to the Health ministry, which is part of the challenge that we're all going to be facing over the next 20 years.

It's my understanding that services provided through the homemaker program are eligible under the Canada Assistance Plan for cost-sharing with your ministry. Under the terms of the Canada Assistance Plan, as I understand it, the situation is this. If the service is provided by a non-profit agency, then there can be cost-sharing of the wages and things related to wages, which in the homemaker service is obviously the major cost.

I know that we have within the province private agencies, proprietary agencies; in some small communities those may be a small local business. In the lower mainland the proprietary agencies are in fact much more likely to be large international organizations. I don't need to name them; we all know who those service-deliverers are. It's my understanding too that in the Vancouver area the ratio of the proprietary services to the non-profit services is approximately 45 to 55. In other words, those are the agencies with whom the ministry contracts to deliver those services. Provincewide, approximately 25 percent of the services are delivered by proprietary agencies.

My question, Mr. Minister, is this. Given the philosophy of the Canada Assistance Plan and the philosophy of the nonprofit agencies; given our perspective on this side of the House that health should not be for profit; and given that we have some potential dollars that would be available to you from federal cost-sharing programs — dollars that it has been suggested to me might range as high as $13 million a year — why are we delivering services through any other source within our province, why are we paying multinational health services to make a profit, when that profit is actually costing us through the cost-saving programs available from a senior government that clearly has accepted and is prepared to pay a share of the cost of delivering services?

Since your major problem is dollars, why are we not looking at a service delivery that is non-profit, that would allow for that cost-sharing and would bring additional dollars

[ Page 2443 ]

to this much beleaguered area — to pay people well, to be sure that services are delivered as comprehensively as they need to be, and to relieve the overworked long-term care nurse-assessors in a whole variety of ways which might improve service in this area? Why are we not tapping as broadly as possible the Canada Assistance Plan for these services? In fact, except for the proprietor who is perhaps a non-profit proprietor and who might be the deliverer of service, why do we not have all of our services delivered on a nonprofit basis in this area, and take advantage of that costsharing which would provide some of the dollars that you yourself indicate you would very much like to have to augment these services?

HON. MR. DUECK: Mr. Chairman, it's true that we have non-profit and profit delivery of these services. I suppose that by and large we try to get the best dollar for the taxpayer. Of course, over the years we have lobbied, I think even before my time, to request the federal government to assist on the same level for profit as they do for non-profit societies. At the present time the only province in Canada choosing to go the non-profit society route only is, of course, Manitoba. The others all use a mixture of both.

I suppose one can also say that it's healthy competition when you have both working in that particular field. If you have only non-profit, it may tend to be non-responsible if you haven't got the two competing against each other. So we've found that it has been quite healthy, although I can't help but agree that if we can get some sharing from the federal government, it is certainly a dollar in our pocket. This was, of course, before my time; this is the situation I came into. We've talked about it. I've asked why we don't go to nonprofit, because we get those dollars. I understand that a request has been made on a number of occasions to the federal government to share equally whether it's profit or non-profit, as long as the cost to the taxpayer...the initial bid is the best service and the best price. That's about all I can say on that area at the present time.

MS. A. HAGEN: Well, Mr. Minister, although you note that Manitoba is the only province in this particular sector to go non-profit, I think it might be useful for you at some time to have a look at a study of nursing homes, as we used to call the whole range of services for people who were institutionalized. A study in Ontario of the profit and non-profit sectors is very strongly supportive of the efficacy of the nonprofit sector.

I would simply make two points. First of all, the idea of health for profit is one that we do not believe is in the best interests of health care. I think the ministry has demonstrated over and over again that there are ways to control costs through budgets. Certainly the tendering process for home support programs that is in place in the Vancouver area is one in which both the profit and non-profit sector bid; and there is competition, if you like, where there are multi-agencies within the non-profit sector. So I would hope that the minister recognizes that most of us taxpayers would not like to see our tax dollars going for profit in health. We would like to see them going for services.

We would like to see some means for perhaps some proprietary non-profit. But from the point of view of those programs going to multinationals who are siphoning those dollars out of the country, I would certainly hope that that would be a decision that the federal government would not take. And I would hope that the minister would pursue the issue, because there are, as he has acknowledged, dollars available that would be very helpful in this area, and when we come to look at the expansion of non-institutionalized services, which the ministry is into with mentally handicapped people and so on, it's going to get to be a very significant kind of dollar amount for him to look at.

I'd like to move on, not because there aren't more things that we might explore in this area, but I know that we want to leave this place sometime within the next while, and I have several other things that I want to have an opportunity to discuss. It's hard to know which one to move to right now.

I would like to briefly raise the issue of the coordination between your Health Ministry and the Social Services and Housing Ministry. We've noted and you have spoken, and so has the Minister of Social Services and Housing (Hon. Mr. Richmond), about the fact that things are shifting. Things that used to be in his ministry are now in your ministry. As a result of those changes, there are services and programs that are falling between the slats. I don't want to develop that at great length, but in the same manner that I talked about the longterm care issue, I want to talk in principal about an issue that I think is going to be increasingly important for those two ministries. That is the matter of coordination. I had somebody who was in the homemaker program say to me that one of & best people to work in the homemaker program is a social worker with some health training. Really, they are interlocking disciplines, and the services are very often difficult to define in one ministry or the other.

Perhaps the minister could comment on his ideas about this coordination. It's something we didn't explore with the Minister of Social Services and Housing. It would be nice to be able to open his estimates again, but I know we don't have that option. But I'm sure that the minister might perhaps take the opportunity to comment. Could you give us some indication of what kind of coordination you are looking at between those two ministries. If we don't see that kind of coordination, we are going to see some very definite deficits in the way of service. It makes sense that the two of you have to work together, whether it's with the mentally handicapped or whether it's with the elderly coming out of hospital, or a whole range of areas. I would like the minister to give us some ideas of his thoughts, actions and plans for that coordination.

HON. MR. DUECK: That's very difficult. That question is pretty nearly as difficult as "how long is a piece of string?" because what do we do? We coordinate, we have meetings, we sit on the same Cabinet Committee on Social Policy. Yes, there are times when you change certain parts of a portfolio to another, like with Pharmacare, for example. Rather, I would like to have from you specifics — you say that some people fall between the cracks or between the stools — and then we can get at some issues that concern you. But just to say what coordination there is really is very difficult at this time. We have many things that we do in conjunction with each other, because the services do relate very closely, as you are well aware.

I would like to come back to the homemakers, because I had a note here and I didn't mention it. When it comes to homemakers, we also employ or contract with non-profit and with profit. The ratio there is much greater for non-profit than it is for profit. It's 41 percent homemaker for profit and 10 I percent, roughly, for non-profit — oh, that's not percent, but

[ Page 2444 ]

numbers. So the ratio there is much greater than the figures you quoted for the other services. When it comes to nursing homes, of course, there is no difference. Whether they are for profit or non-profit, the rate is the same, the costs are the same and the return is the same. So other than the quality of service, you may argue that one's better than the other, and I don't think that you can really pinpoint a non-profit society giving better or a for-profit society giving better service. I think it depends so much on the operations. By and large most of them that I have noticed give adequate — if not very good — service.

We have a toll-free line that can be used if they want to find out — for handicapped — whether they come under Health or under Social Services, because there is an area.... Not all handicapped people come under my ministry; neither do they all come under the Social Services ministry. One way to explain it a little more clearly is that if they are medically fragile, they would come under Health; if they are handicapped but can perform some function and can live in a home, in a group home or what have you, they would probably come under the Social Services program. Unless you have some specifics you want to zero in on, and I would be only too glad to follow that through....

[7:15]

This is a little note that was handed to me, and I can't help but smile. We now have the former deputy of Social Services working for Health, so he knows all about that ministry. By golly, if you have any questions that refer to that ministry, just make him go through the estimates again. Oh, he's not even here; he's left.

MS. A. HAGEN: May I have leave to make an introduction?

Leave granted.

MS. A. HAGEN: We have visiting in the House registered nurses — a very appropriate time, I think, for them to be here. I would ask the House to join me in welcoming Jane Crickmore, Shelagh Machin, Marilyn Baines and Jeanette Furber. Welcome to the Health estimates.

Just to clarify our numbers, when I was speaking of the number of profit and non-profit agencies, I was talking in terms of percentages; I think you were talking in terms of the number of agencies. Given the fact that in the smaller communities we're very likely to have a non-profit agency, the 41 profit and 101 non-profit is the agencies. I was talking in terms of percentage — 55 percent non-profit and 45 percent profit — and those are figures that I have from the home support industry. So we are clarifying that whole issue.

You've asked for an instance, Mr. Minister, of the need for coordination between the two ministries. Let me give you one from my own community, and I think you are familiar with this. There is, working under the umbrella of a nonprofit society that has had community support funding from the Ministry of Social Services for 15 years, a centre that works with mentally handicapped people and people with mental illness. It is a centre which is open through the day and in the evening and provides programs and meals. It has recently moved into your ministry. I don't have my notes about that particular program with me, but its title has changed. I think it has now become something called an achievement centre, or it was an achievement centre and it's now become something else. I'm not quite sure of the title that it's given, and I'll name it: it's called the Summit organization. There has been a fair amount of negotiation with your ministry about funding for that program. At issue is the matter of funding for the food program.

Now I know that program well; I know its clientele well. Believe me, in New Westminster, just as we have a large older population, because we are a small, compact community and close to Riverview we have a large population of people who have mental illness as a part of their chronic illness circumstance and need support. We also have a significant number of mentally handicapped people in the community. It's an interesting mix, in fact, in how those people have managed to program, and it's a program that has evolved. Those people are involved in community services; they're involved in independent living. The program offers, I think, a very excellent support and developmental program for those people.

But the foods program is almost at a standstill because of the funding issue. If it goes, the program will go with it. Let's face it, when people have a meal as a part of the program, and for those people often where they live and their ability to manage their meals is at issue.... Good meals are an important part of their continuing good physical health. That program has been negotiating with your ministry for some time. I understand what they're told is that the meals program sits with the Social Services and Housing ministry, and other services fit with your ministry. Now we don't want a meal program in one place and an achievement centre in another. We want to knit them together. I know how much food is a means of encouraging people to participate in other activities. And it's a part of their achievement centre, and they work in the program. So it's those kinds of practical things that relate to what the community is doing and how the ministry then can facilitate the community initiative, imagination and solid programming circumstances. So there's one example, and I'm sure there are others.

With Woodlands, for example, with people leaving for the community and living out in the community, we're going to need to have a mixture of Social Services programs, if you like, and health services. Often the most efficient and effective service delivery is to put them together. Those people don't need the minister saying: "You should be in the other basket; you should be in the other pot." They need to be able to come over here and have you people listen to their consolidated continuum-of-care proposal, and have a reasonable response to that. That's the kind of thing I'm talking about when I ask: what's the philosophy, what's the practice, and how do those things get managed without people having to spend incredible amounts of energy getting all of that sorted out?

So I don't know whether you want to comment, Mr. Minister, but there's an example of the kind of thing that I'm talking about.

HON. MR. DUECK: I think the coordination sometimes is quite important. It may even be at odds with a certain program; it may not even be coordinated too well, which it should be. But really, I don't think that the problem is that food or extra money for something else comes from Social Services, and health comes from my ministry. The funding can come from the community, the volunteer group can come from Social Services, and it should not impact on the health care that we provide. It's just a matter of the funding coming from an area, and not from our budget.

[ Page 2445 ]

I say: "It should not." It may have an impact, and it may not run that smoothly, but it shouldn't. It should coordinate, and coordinate well. Just because the funding comes from another pocket, it should not have an effect on that at all. If you have problems in that area, again, there shouldn't be, and it should be looked at.

MS. A. HAGEN: I appreciate those words, Mr. Minister. In practice it is more difficult, and I think what I'm saying here is that the ministries need to develop some means of facilitating that kind of discussion, so that the one hand knows what the other is doing, and recognizes the relationship between the two programs.

I'd like, perhaps because I have begun to discuss the whole community programming issue, to begin to look at that structure as well. I'm really pleased that the minister is aware of the Keep Well program, and I want to commend the ministry for its initiative in starting that program and in funding a pilot program. It was, I think, a very excellent endeavour in the preventive services area. I want to just make some comments about that program that the minister may not be aware of.

I'll tell you that I concocted the first proposal for that between 2:30 in the afternoon and 10:30 the next morning, so I was involved with it from the ground up. I became aware that the ministry was interested in finding a home for that pilot program through our medical health officer, and it fitted extremely well with the philosophy of the seniors' organization with which I was associated — the Western Society for Senior Citizens' Services, which runs the seniors' bureau in New Westminster. Indeed the minister is quite correct. The program was funded for three years to the tune of $250,000, and I would note, Mr. Minister — you may be aware of this — that there is also associated with it, from the Health Care Research Foundation grant program, additional funding to do some research that I might comment on.

That program was funded as a pilot program, and the minister talked about expanding it. He also talked about it not being self-sufficient, and I want to talk a little bit about that whole question of how the ministry is going to, in its developmental work, recognize some of the roles that it must play if the dollars, the energy and the imagination that went into this program are to be manifested.

The first thing that I want to note about that program — and I think it was unique — is that it was co-managed. I think the ministry could well look at that concept of co-management. There was a steering committee which comprised the project person from preventive services in your ministry; the administrator of the long-term care program; the coordinator of the project, who was a person hired with the funding available; and 1, as director of the seniors' bureau. We four managed that project on behalf of the ministry and the society.

So in my view it was quite a unique model that was developed to put that program through its pilot paces.

At the end of the three years the program had established in the community a whole range of programs that were run by volunteers. There were regular Keep Well drop-in classes and workshops, fun-and-fitness classes in seniors' residences, church basements and various other places in the community. However, there was no plan for who would service those volunteers. There has been a fair amount of discussion about that. There's a manual that's been prepared, a workbook that seniors can use, and a lot of excellent material, stuff that shouldn't go by the board. The peer-counselling program got a good head start with some of the work that was going on with this program.

The agency that I was associated with, the seniors' bureau, was at one time funded as well under the Social Services and Housing Ministry, the then Ministry of Human Resources. There again, in the restraint period of 1983 that program was defunded. Many people here can talk about similar things happening to community organizations in their ridings and constituencies. That program is run almost entirely by volunteers. The seniors' bureau has a clientele of 3,000. It works closely with the long-term care program. It provides the services that you say your ministry cannot provide: handyman service, grocery shopping, outings, assistance with forms, dozens of things. But there's no money to coordinate progress.

Co-management: again, some role for the Ministry of Health, recognizing that we need to be innovators and need to look at different models of care. Also in my community — and again this could be represented in other communities — the hospitals, the long-term care program and the volunteer sector have got together and formulated a proposal for a continuum of care, largely focused on older people to ensure that services are delivered in the most effective service delivery way.

The point I'm making with these illustrations is that what we need to have from your ministry is some mid- and longterm planning to ensure that those support services which you recognize as being key in that whole continuum — to keep people in their homes and out of care homes — do receive some support. In many instances it will be a combination of health and social services because they don't fit neatly into one pocket or the other. But they're best delivered under some umbrella where the older person knows where to go.

You've got a service like that in Matsqui-Sumas-Abbotsford. If you talk to the director there, you'll find a similar perspective. They have a wider range of services, so they are able to earn some money to work in other areas. That's not always going to be the case.

What I'm suggesting is that you look at that Keep Well program, which was an excellent program, well-funded. I acknowledge that and support the ministry on that. That should be accompanied by research that is still going on with a nurse-researcher working with long-term care clients with a care plan, so that they are more independent and need fewer homemakers. Let the ministry be prepared to provide some seed money, some dollars, to that whole community support system. You'll find if you talk to your field workers that this front line will tell you that if those services are not maintained in the communities, then $53 million isn't going to provide the home support services and the other moneys that are needed for adult day care and all the rest of it.

[7:30]

You're going to find those services that you're trying to nurture with a limited number of dollars backed up, because what those services do is take that load off. The people who deliver those services in most instances are volunteers. Without coordination and some support from the ministry — along with the community, which will fund-raise and will support those services — you're going to find yourself in deep trouble.

We've had three or four years of unfunding with a lot of those programs. When I speak of my own community, I want it on the record that I am speaking here because I can speak

[ Page 2446 ]

from a knowledge of what I know in my community from my work, which is reflected all over the province: that the ministry has to be, as it was with Keep Well, a lighthouse group. But it is not good enough to do it for three years and drop it. It's not good enough not to have a long-term plan, because you have wasted money. Unless that plan is there, you will not be able to spread that program without some dollars being available. Those dollars will release peer and volunteer support that will enable that program to deliver on its promise, which was that seniors would help seniors. But they need to have some of that coordination. You've got a letter on your desk right now signed by every one of the people who deliver the regular Keep Well weekly program, saying: "Mr. Minister, we're going to continue to deliver that program, but we need some help. It's not a lot, but we need some help to deliver that program."

On behalf of the continuum of care and the community services that tap seniors helping seniors and others helping seniors, be aware that it's an important program.

I want to make one final comment on behalf of one of my favourite people, who is arthritic, who can't get to her volunteer job in the seniors' bureau without handyDART, and who uses homemaker service. She needs a homemaker, and she needs to get out to do her volunteer work. The two are not mutually exclusive, because of the wholeness of a person. That might mean that, because they're arthritic, they might need some help with their homemaker services. That doesn't preclude that she can go down and man our seniors' support line once a week. She got there by handyDART, for which she pays a service.

Let's remember we're talking about a balanced life for these people, not putting them into a homogenized picture. They are diversified people, they need to have a whole-life experience, and we can support them both in health terms and freedom to be volunteers in that area.

I would welcome some indication that the minister, in looking at how Keep Well is going to continue and at the many volunteer services, will look at ways in which he can co-manage projects and ensure that we do tap the range of volunteer services which can enhance the lives of older people and complement the statutory health services that your ministry must deliver.

HON. MR. DUECK: The Keep Well program you speak of has certainly been a good program. I think it was never intended to carry through further than the three years it operated. As you said, it was funded by a $250,000 grant. I understand it is still in existence with the Simon Fraser Health Unit and we, as the ministry, provide for this particular program. We provide a public health nurse; I think we provide some nutrition guidance and fitness and various things of that kind. But we have not granted any funds since the time this expired.

However, I understand that the ministry is currently introducing the Keep Well model to other B.C. communities and trying to do the same thing to get it on its feet, to get it going. Then, hopefully, some society or an agency will take it on and run with it.

There is only so much we can do. We can't fund all programs continuously — there are so many. They are all worthy. I can't stand here and say we're not going to do that because it shouldn't be done. I'd be a fool if I did that. I can look at these programs and say yes, it's good. It should require funds; it should have funds. But there isn't that much money around.

I could absorb — and I'm not kidding — half of our budget, and I would still find people who say: "You're not doing enough." There is a limit to what you can do. If you call it mismanagement, that we don't fund the right programs and we use it elsewhere where we shouldn't.... I don't think you can accuse us of that. At least in the short period of time I've been in the ministry, I am quite pleased that in most areas it's running quite efficiently. Actually, the people who work in the ministry — from the senior management down to the level you spoke of in the community where the action actually occurs — are conscientious, are doing the best they can and will continue to do so.

I think you asked another question, but you spoke so long I've forgotten. I didn't make notes. I'll have to ask you again if there was something I did not answer. Was it just on the home care program? Perhaps I should ask you to repeat that.

MS. A. HAGEN: The point I'm making to the minister is that it's really important for him to have a very open mind about how he, in his ministry, is going to plan for the delivery of services. When I look at the health estimates and the $1.75 billion going into hospitals, I don't know what you have in what you call health promotion, Mr. Minister. I guess it's in the preventive services area, which is about $71 million. What I'm talking about are some of the things that are part of the new health initiatives.

On the issue of Keep Well, let me be clear. I am talking here about how the ministry nurtures its $250,000 investment. I'm not suggesting that the funding continue at the level that it existed at, but that the ministry be aware that that $250,000 investment and many other investments need to have some long-range plans for their nurturing. That's the kind of thing we're talking about.

I appreciate the work that is going on in the public health area, and perhaps at some time we might discuss it further in the appropriate venue, hopefully within the public health ministry, but perhaps with somebody who is a coordinator of volunteers, rather than necessarily a person whose training is specifically in nursing.

I can assure the minister that I will again and again be raising the issue of the ministry's role in care at the community support level. I have strong support from health people in the field. It's interesting that in the Vancouver and Burnaby health systems there is funding for a coordinator of volunteers, simply because there is a recognition of the services that those coordinators are able to bring into the assistance of health mandates. You're right, Mr. Minister, there's not going to be enough money to fund all of the needs, so the ministry is going to need to be creative and divergent in looking at other ways in which it may develop those services.

I can't leave the concerns of older people without discussing the matter of user fees. I noted some of the figures which the minister gave when he was discussing this whole area. I think we're looking at something in the order of $22 million coming from seniors for Pharmacare fees and another $15 million coming from others, who would include people with handicaps and special needs as well. Then under the user fee issue, something in the order of $15 million will come across the whole sector, but I think considerably from the older population. One of the figures that the minister noted was that the average Pharmacare cost was $78, and the average number of prescriptions was something like $13 a year. That's

[ Page 2447 ]

one example, Mr. Minister, where I think averages are a crock — if I may say so. That is just not a figure that bears any relevance at all.

People with chronic health needs are numerous. I've talked to a lot of older people about this, and those who aren't requiring the alternative therapies and don't use drugs say: "Thank heaven my health doesn't require me to do that." But on the other side of the coin you have people where the cost for them is considerable.

Mr. Minister, I know that in your working up of this user fee concept you have sought to protect some of the people with the lowest income. In that regard you're protecting from the Pharmacare fee about 40,000 of the 350,000 people who are getting provincial GAIN. It's something in that order, so you're protecting one-ninth of the total number. With the user fee, probably you're protecting a higher number. You may have that figure and may want to read it into the record. I'm sure I've seen it, but I don't have it in my notes at this time.

A tremendous number of people are going to bear the additional cost of their drugs, and for many of them that cost is already a burden. Those who are involved with therapies who aren't protected are often multi-users of therapies. My experience, which I know is borne out in studies, is that once one gets to a point where chronic illness of whatever nature has taken hold, then the demands of that person on the health care system increases. We know that. We know that the heaviest users of health care services are people in the last years of their lives. We know that the older people get, the more they draw on our health care dollars.

So what we have here is a very uneven system, and that's why we have in fact moved to universal programs. We've questioned you in question period about this, and you have noted that you want these fees to be a deterrent, and you want them to raise some money. I don't think either of those positions is defensible, quite honestly.

[7:45]

I acknowledge the problem you have. I know you are speaking of how we can get at those dollars. But, Mr. Minister, I don't think that this is the way to do it because you are very likely adding to the cost of service. I noted in one of my releases after the petitions were presented to government from people who wanted the government to reconsider these fees that already, even before the fees have been introduced, that there was a backup of people seeking physiotherapy services at the hospital where the cost, I understand, is something in the order of $50 a service and where the service is more intended for people in hospital care. So they could avoid that fee.

Mr. Minister, do you really mean that these fees are intended to be a deterrent? Do you really mean that you want to see seniors shopping around from one pharmacist to another, instead of staying with their neighbourhood pharmacist who is monitoring that person's drug care and working with that person's doctor? Do you want to send them to the big supermarket which is far away and might take a handyDART trip to get there? That handyDART trip will cost us $10 each way, because that's the subsidized cost of a handyDART trip. Or are we looking at having those people cared for by their doctors and their long-term care nurses and their pharmacist as a team?

Do you really want to have a deterrent that will limit compliance? Is it really your intention to find dollars, as they say, off the backs of people who have a marginal income? I don't want to use the word that they're poor or poverty-stricken or below the poverty line, but they have a marginal income. If they are ill, the cost of their health care is a burden to them, regardless of how you cut it, It's not to everybody, but for those people to whom it is a burden, it is a burden.

Is that really your intent with these user fees? Do you really think that when one-tenth of the senior population lets you know about it, that doesn't reflect that they think this decision on the part of this government is ill-advised and one that should be reconsidered?

HON. MR. DUECK: Mr. Chairman. there were a number of issues the member touched on this last time around. First of all, an open mind. It has sometimes been said that you could shine a flashlight in one side and go right through, that's how open it is: but that's not what you were referring to.

You mentioned that we spend over a billion dollars in hospitals. Surely you are not suggesting we should close those and start going in the other direction, because when people get to that stage in life where they need hospital care, we must provide it. There is no question about that, and we certainly can't do without it. I don't think that was the intention. I must have heard that wrongly.

When you talk about preventive care, I can't help but go on this bandwagon again. We don't even do the things we know we should do, never mind hiring all the people and getting all the money in the world to tell people how to live. We don't even do the elementary things that we know will hurt ourselves and hurt our health. We're not serious about that. Hardly any of us are serious about that. We don't exercise; we don't eat the right food; we smoke too much; we drink too much. I can go on and on and on. But we're constantly talking about dollars that are going to cure it. It will not cure it. We must assist where people need it, but don't tell me preventive care is just throwing dollars at it, because it isn't.

There are so many things we can do. I don't know about you personally, because I don't know how you live and what lifestyle you have. But I'll tell you, I abuse my body; I don't eat properly; I don't eat on time. As a matter of fact, I came down with a bleeding ulcer after about two months in this.... I was going to say "racket," but it's not a racket. In this beautiful business. That was due to my foolishness. I didn't eat on time; I didn't eat lunch; I drank a lot of coffee; I got headaches; I took aspirin; and pretty soon I had stomachaches and I thought: "What's the matter with me?" I got weaker and weaker, and one day.... I think it was you. When you asked me a question, I had to hang onto my desk to stay upright; I had lost all my blood. But I managed all right, because I realized what was happening to me.

We don't look after ourselves, and money will not cure that. That's something we have to do ourselves. I just want to make that very clear.

User fees. Nothing is worse than telling someone that some service is going to be taken away from him. Do you think I like that? Do you think I like going to the various groups.... ? I have spoken to hundreds since I've been in this business, and I've spoken to seniors. I must see more seniors than anyone in this House. Since I've been in this business — eight months — I've seen them all the time, and it's not easy.

Would you believe that I spoke to the annual meeting of the physiotherapists? We had decided to put on user fees. It was announced on a Thursday or Friday, and on Sunday noon

[ Page 2448 ]

at a luncheon I spoke at their annual meeting. They had just got the news, and it wasn't pleasant. I can assure you that we don't do this to be pleasant or to hit a certain group. That's not it at all. We know that dollars must come from somewhere.

I also know absolutely, without a doubt, that it's a deterrent. I have a friend that goes to a chiropractor exactly 12 times a year. I know this guy, and I can tell you right now that he won't go once. That may be an exception, but that's a deterrent. It will also bring dollars into the coffers. We may not have protected the seniors well enough. Maybe the limits aren't correct. But when you take, for example, all the supplementary services other than Pharmacare.... Surely, 12 visits at $5 apiece.... We're talking about $60 if they take the maximum.

We're saying that anyone — they don't have to be on GAIN — even people who are working.... Some of them are on subsidized premiums — MSP. They don't pay.

So we're excluding a number of them; maybe not enough, you could argue, and I could probably agree with you. Since these programs have been announced, I've talked to many.... I was going to say "thousands"; at least hundreds and hundreds of them. I ask them this very question about Pharmacare, and I talk to them about supplementary services. In nearly all cases they will tell me: "I hate you; I don't like it. But we can live with it." I've had more people come to me, phone me, meet me on the street, stop me and talk about these supplementary services and Pharmacare, and invariably they say: "I can afford it, but my friend can't." Another very large group did not understand that we are still paying the total drug cost.

Do you know that we are about the only province that gives a lot of these services? We give more than any province in Canada. Do you know that there is no province in Canada that offers, for example, naturopath and massage therapy? We're the only one. There are many — I could go on and on — that we provide.

Whenever you take something away, it hurts. I don't like it if somebody takes something away from me. I don't care what it is; I get upset. I can understand people getting upset. I'm sure there are some people who need these dollars; I don't question that. But by and large, in our society, with limited funds, we have to be very careful.

Maybe our outer limits are wrong; maybe it should be looked at again. I will accept that. We are hurting some people, because whenever you draw a line and say, "That is the dividing line," the people who are nearest above it or below it are the ones who are affected most. The ones who are on the upper level, or who are away down below, are not affected.

I accept that, but don't tell me that our health care system is not a good system. It can be improved, but it's an excellent system in every respect. I would like suggestions as to how to improve it. It's all concerning dollars. I've heard again and again that there are many other ways of doing it. Yes, there are many other ways of doing it, but in every case.... You talk to doctors, you talk to nurses, you talk to individuals — they've got a bushel of ideas. When it comes down to the final analysis, it's dollars. I go to Treasury Board, and they say: "You've got your budget; live within it." Now I sit there in a balancing act on a wire rope and say: "Where can I take some from to put a little here?" and I take some from somewhere else and put it there. You know, it's very difficult. We decided — and it wasn't Peter Dueck who decided; it was cabinet — that this is the direction we're going to go. We sold the program on that basis, and by and large when I talk to people....

You know, a lot of these letters that I got were instigated by the owners of Pharmacare stores. They had form letters by the hundreds. Who wouldn't sign? You've been in business long enough; have you ever gone around the community and said: "There's an objectionable dog in the community that does whatever dogs do on the lawn. Would you sign this to get this dog off our premises and get this petition to the owner?" And they all sign it. Next day you go around and say: "You know, that dog that this particular individual has is a lovely Doberman pinscher. Surely you wouldn't want it put to death. Would you sign here to request that it not be put away?" And they all sign it again.

Interjection.

HON. MR. DUECK: But it's true that people will. A lot of these letters that came in were genuine concerns, but a lot of them were instigated by the Pharmacare stores. I've spoken to some of them myself, and they had bushels of form letters; and they signed them one after the other. But I did get a lot of letters that were individually signed and addressed to me — many, many letters — where people were unhappy, and I can understand it. We have tried to protect the ones who were most in need. We may not have had a large enough safety net and it may have to be looked at again, but for the time being that is the program that's in place, and that is what we're going to live by.

MS. A. HAGEN: First of all, I want to say that when I made the comment about hospital programs, it is a misinterpretation to suggest that I'm looking at those programs as being non-essential. The discussion that I think we've had here this evening is around the fact that you have a massive budget and you have concerns about how that budget is to be delivered. It is not, I would maintain, a matter just of dollars; it is a matter of planning. That planning is difficult. I'm not suggesting that you don't have the toughest of jobs. But I would say with all earnestness and sincerity that some of the things I've been suggesting and discussing have been in the context of the problem that we all have in terms of providing the services that are important in order to maintain an excellent health program.

I would also like to reinterpret what I think I heard you say around the issue of user fees. We will not agree on the appropriateness of those fees. We could belabour that point, but we've had that through question period and in other discussions. My position I think is clear, and you have made your position clear. But I think I heard you say, Mr. Minister, that you have begun to consider whether the implementation of these fees is entirely appropriate. I hope I can take from that that your ministry will be monitoring those fees and that you will have some system in place to look at whether they achieve your goals; that that will need to be not only a dollar system, but one that looks at whether people are going to more costly alternatives; and that at the end of the year you will be prepared to review either the fees themselves or those who might be exempt from those fees. That was perhaps implied by your statement, and I would hope that's a commitment you might be making at this particular time.

I would note that I've had the opportunity for some time to discuss issues with the minister. There are others that I plan to raise, but I'm going to yield the floor now, because I know

[ Page 2449 ]

there are others who wish to speak on the issues. I thank the minister for the discussion; I think it has been a fruitful one. It has certainly given me some concerns that I plan to raise with him, and not just here. I want him to know that he will continue to hear from me on these issues, because they're important to his ministry and to the people of the province.

HON. MR. DUECK: Just a remark about the monitoring. We do and will continue to monitor it very closely. It's a departure from what has been done in the past, so there's no question about that.

I should also mention that when we talk about deterrents, the user fee was of course taken off, as you well know, from the hospital night stay and day surgery, and also from Emergency. We find now from the hospitals that have reported back that in most cases.... At least, I have had none report back.... Of the hospitals that have reported back, the least increase that has occurred in Emergency in the first month of operation is 25 percent. If that isn't a deterrent, I don't know what is. Maybe that's exceptional because it's Emergency, but we find that that.... I'm very upset about that, because it's a big cost to our health care system. Those people should go to the doctor's office, but they don't. The responsibility rests on every one of us; not just the Ministry of Health or the Minister of Health, but every one of us. That includes doctors, nurses, whoever. Every taxpayer is responsible.

[8:00]

In regard to the premium assistance, I mentioned that perhaps we should look at the safety net. I have some exact figures on that now. Of the total number who are on MSP, 20 percent are exempt from supplementary services. I think that's a very big number — 20 percent. They do not pay user fees. That's a figure you should keep in mind. That net still catches very many people.

Mr. Chairman, could I get leave of the House to make some introductions?

Leave granted.

HON. MR. DUECK: There are two members of the Victoria chapter of the RNABC in the gallery today: Dorothy Boisvert and Anna Marie Wells. Later, I understand, Sue Smith will be visiting us here in the House. Would the House please make them welcome.

MRS. BOONE: Mr. Chairman, I'd like to add my welcome to those members. I hope they learn something from the debate today and go back with some answers for their people.

HON. MR. DUECK: If I may, I can probably answer some questions that the hon. member for Prince George North (Mrs. Boone) had earlier. You asked, I believe, about the locations of these hospital supplies and disaster services. I don't think you would wish me to read them all; there are pages and pages of them. But perhaps it would suffice if we give you a copy of them. Would that be okay? We will do that.

You also asked, I believe, what percentage of the total health care population in British Columbia were elderly. There are 40 percent who are elderly — that would be 65 and up.

MRS. BOONE: I'd like to add a few things with regard to the whole user-fee concept the minister has, to which we, of course, find ourselves in total opposition and on opposite sides of the street in this case. This is a letter which I am sure — yes — the minister received a copy of. It went to the Premier. It puts into perspective some of the problems I think people are having. This person uses medication — eight prescriptions a day. The cost to this person will be $39.04 for each filling, to the maximum of $125 in one year. After he reaches this plateau, he understands that he'll receive a cheque each month for all the prescriptions utilized. He goes on further: "For some to pay $40 or more for their medication would spell disaster. In fact. some will revert to the old days and not get prescriptions filled at all, resulting in extra costs to the government with hospital care, etc."

At a recent forum, it became clear that there was a great concern among the population about the abuse of drugs and prescriptions in the senior population. They were concerned that people are prescribing drugs. But I do not think — and I can't stress this more strongly — that under any circumstances a senior, or any lay person, for that matter, is able to determine what is or is not a required prescription. In many cases, if they have to make a choice between one or the other, they may choose the wrong one or decide not to have either of them, with some really disastrous effects on their health.

A user fee on a prescription drug is not.... It could very well be a deterrent, but you are deterring, Mr. Minister, the wrong people, the people who are the users of those prescriptions and who in fact don't know whether they require that prescription or not. The deterrent — and I don't know how on earth you would do this — must go to the physicians who are giving out those prescriptions.

[Mr. Pelton in the chair.]

This is where we believe we should be having greater effect. If you looked at the services prescribed — your physiotherapist. your massage practitioner, all of these various things — those are the things that can be used and can in fact keep people limber and keep their muscle tone up without using drugs. That's what we would like to see. We would like to see, of course, us getting away from the use of prescriptions as much as possible. We would like to see our seniors not being used by physicians, whether they are doing so inadvertently or because they can't be bothered to use another service — or maybe they're doing so because they don't believe in massage practitioners, physiotherapists or what have you. There are alternatives out there. Holistic medicine is a very important alternative that could in fact stop the use of a lot of prescriptions, that could in fact keep people off drugs and be a deterrent to the overuse of prescriptions that is taking place right now with seniors.

Seniors know and understand that many of them are using too many drugs. But to tell you the truth, they don't know what to do about it because they cannot second-guess their physician, who in many cases, especially with seniors.... Don't forget that they've been brought up to believe that their physician is the all-mighty, all-powerful person who knows the answer to everything. They trust this physician implicitly, so they can't second-guess him. They go off and they purchase their prescriptions, but in many cases, as I said, they will not be able to do so because of the cost of these things.

As I say, there's no doubt at all that it will be a deterrent. But it will be a deterrent for those who can't afford it. It will not be a deterrent for the wealthy; it will not be a deterrent for those of middle income. They can afford these things, and can go off and purchase their drugs and prescriptions quite

[ Page 2450 ]

happily, knowing that they've got thousands of dollars in the bank to cover these things. It is those who are living on minor incomes, who are scraping from day to day and have to pay for all the other items that come up, who are having a lot of problems. They are wondering whether they are going to be able to pay for their shelter, whether they are going to be able to pay for their food, and in those cases they take that choice rather than pay for medication. That's where we have a real objection, and I think the minister has to understand that that is the case.

When you are looking at your alternative medicines as well, the only one they can go to without being referred by their physician is a chiropractor. That is the only case where they can just walk in off the street and get an appointment. Other than that they must go through their physician. The physician makes the recommendation, and once again you are left with people deciding: "Do I require this or not, and what do I do?" Again, you've got a physician who holds these people's lives in his hands. He can either prescribe drugs, which in many cases won't cost them as much, particularly if they are on a medical plan, or he can prescribe an alternative, in which case it could cost them money. In some places those decisions are going to be made, and the physician will be making the choice.

Those are the things that I don't think are healthy for our medical services. They are not healthy for our Medical Plan. We must give people the option of alternatives, so that we can keep them off drugs and prescriptions. You, of course, have indicated just how much prescriptions and our whole Medical Services Plan have increased. In terms of referrals, I don't have to tell you how much doctors are getting each time they refer one of these people to one of these alternatives, and what percentage they are getting. Again, I think you have to deal with your physicians who are prescribing the drugs; you have to deal with your physicians with regard to making referrals that may or may not be required. As I stated, the chiropractor is the only one people can go to without a physician's referral. I have heard stories, and you probably have too, Mr. Minister, of physicians — and I hope there aren't too many of them out there — who refer many people just so they can get their referral fee; I would hope that's not the norm but a once-in-awhile, extreme case. But those things happen.

I would like the minister to tell me just how he expects patients out there, particularly elderly patients who, as I said before, hold their physician in such esteem — when they refer them or recommend a drug, they don't know how to second-guess them — to deal with those types of people. How do they deal with them on the basis of deterrence? Can the minister respond to that, please?

HON. MR. DUECK: To begin with, you read a letter and talked about $125. I assume from that that it was a person on GAIN. I thought you mentioned that after he used up his $125 he would get a cheque back in the mail on any costs over and above. If that is the case, then of course if he's on GAIN he gets an extra $125.

MRS. BOONE: This is $125 for prescriptions, which relates to everybody, I believe. After you reach a maximum of $125, then you have all the rest of the prescriptions paid for. So it's regarding prescriptions, and it wasn't a person on GAIN.

HON. MR. DUECK: Okay, I made a mistake; I thought you were referring to someone on GAIN.

Anyway, you talk about seniors continuously, and everybody talks about seniors. I would just like to say that seniors are not necessarily poor. There are some, but let's not talk about seniors; let's talk about poor people. We're talking about economics. I hear this again and again: "on the backs of seniors." Well, I'll tell you, I wish I had some of the money that seniors have. There are many, many out there who have many dollars and are quite capable of looking after themselves very well, and that includes many people I know. They're not rich, but they can look after themselves and are quite happy to do so.

Also you mentioned: "You've got to look after your physicians." They're not my physicians, and neither are they my ministry's physicians. They're your physicians as much as mine. They're everybody's physicians. They are in private practice; we don't control them.

I think some of the comments you made.... I would like to ask you whether I should question the professionalism of a physician. I don't know how I would do that, other than through the College of Physicans and Surgeons. I sometimes have questions too, but when you say I should check on the physicians, I just don't know how I would tackle that. Could I walk up to a doctor and say: "You're prescribing too many drugs"? Can you imagine the answer I would get? "Are you a doctor? Are you a physician? No. Are you telling me you know whether this person should have drugs or whether he should have alternative services?" So let's be very careful how we throw these terms around. It's so easy to say, "on the backs of the seniors," and, "it's the physician's fault," and "he prescribes drugs and they should have an alternative service instead." Some of the things are true, I'm sure, and many of the things that I mentioned before would perhaps help an awful lot to keep health care costs down and give people much more quality of life than they're enjoying today.

[8:15]

I think you were talking mostly about user fees, and I suppose we will agree to disagree on some of those issues, unfortunately. We're monitoring. We will be able to tell you a little more in a year from now when the next budget comes up, whether it's had an effect, and how many people have suffered because of it. Whenever we find that someone is really suffering, I ask my staff to look into it and make sure what the circumstances are. Thus far I haven't found any. Thus far I've had letters, we've followed them up, and I have not had a case where this caused the person to suffer or go to an acute-care hospital because he couldn't afford the drug. Neither have I heard that they have gone to great lengths to find where they can get it the cheapest, or travelled many miles by taxi to get a dollar discount. I haven't seen that.

I am not at all taking this lightly. I'm not frivolous about it. I know that to someone who can't afford it, even a dollar is a lot of money. But we say we have a safety net. Maybe that net is not big enough, but there is a safety net, and there are thousands of people who are caught by that net and don't pay anything. The system is there, and I guess we'll just have to agree to disagree for the time being. The user fee is there. It will stay — how long I don't know. Maybe another government will change it; maybe we will change it; maybe we'll put an extra user fee on something else. I would love to put a user fee back in the hospital — in emergency. I would do it

[ Page 2451 ]

tomorrow if I could, and I say this quite openly, but unfortunately I can't unless the Canada Health Act is changed; it precludes my doing that.

MRS. BOONE: My question was how you expected these people to second-guess their physicians, who are referring them or prescribing drugs to them which are required, or so they may think. I'm not suggesting that the minister has to, or even can, go out and question the professionalism of the physicians, but perhaps you should look at establishing community clinics with salaried physicians such as we have in James Bay, which was one of the ones established during the NDP session. Perhaps that is the way to get around some of the areas where physicians are overabusing their fee for service. If you look at your budget, you and I both, I'm sure, know just how much goes into fee-for- service. It's an extremely high amount, and it's increasing each day.

But those are some of the areas that I think you have to look at. What we're trying to say to you is: take a different approach instead of the institutional, physician- oriented things. Look to the community basis; look to establishing something where you perhaps have to look at a salary-based position as an alternative to the fee for service; look to some of the alternative ideas around. There are some ideas there, but we seem to be stuck in the mode of institutionalization.

The minister indicated earlier that we were suggesting that we cut back hospital services. We're not suggesting that. But what we are suggesting is that we start to increase the services at the preventive end, the alternative services, so that when we get to the point of having to increase our hospital services, having to increase all of those areas where we have already built up a service at the community-based level to take care of those areas, we have built up a strong home-care base and long-term care areas; we have built up hospices that take care of our needy, rather than having them in acute-care areas.

Those are the things that we are suggesting. We are not suggesting by any means that the minister cut back the institutional services now. We know that's not possible; that's what we have to live with. But in the meantime, we have to build towards the other. Because unless we do, we'll never deal with health care costs in this province. Unless we deal with the alternative areas, unless we start to deal with those things, we'll never, ever be able to deal with health care costs.

I fully agree with your ideas about prevention, and there are many things that we do that we could do, such as smoking and drinking and all of those things. I would fully support, and I do fully support, all the programs that you have implemented on the prevention end of those measures. I support them all, and I'd like to see more of them, because I think it would be a wonderful idea if we set, as Sweden does, the year 2000 to have a smoke-free generation. I understand that we can't stop those already addicted, because it's a very difficult process. We must deal with those who are coming up, the young people out there. I understand that, and I support your stand on that. Anything the minister does on those areas will get the full support of the New Democratic Party.

I would like to ask you a little bit about the Canada Assistance Plan and the funding from the Canada Assistance Plan, just from my understanding of it. I believe that it covers 50 percent, under the agreements with the provinces and territories. The federal government shares 50 percent of the costs incurred by provinces and municipalities in providing — and it's got various things — assistance to persons in need.

It works through these things, and from my understanding of this, I believe that we will probably be receiving some funding for the assistance that we are giving to people. Fifty percent of it comes from the federal government for assistance that we are giving people, with regard to the user fees and the Pharmacare program. Is that correct? Will we in fact be getting back 50 percent of the money that we are taking care of or catching in our catch net that you talk about? Will we be receiving 50 percent of that back from the federal government?

HON. MR. DUECK: Just back to the earlier comments for a minute. First of all, a doctor doesn't get a fee for writing a prescription, which you are certainly aware of. He does not get a fee for that. He gets a fee for a visit only. A referral is not required for a chiropractor, a podiatrist, an optometrist, a naturopath or a dentist. There are only two that it's required for, and that's physio and massage therapy; I believe you're aware of that. So there are many services where a doctor's referral is not required.

As far as federal government sharing versus provincial, the federal government, in one way or another, shares 43.6 percent. That's the figure I have. That was the question you asked, I believe.

MRS. BOONE: Under the Canada Assistance Plan.... The information that I have here is photocopied from a federal booklet. "Basic Facts on Social Security Programs," March 1987, published by the Minister of National Health and Welfare. It indicates that under the agreement with the provinces and territories, the federal government shares 50 percent of the costs incurred by provinces and municipalities in providing various services. Part of this is health care services.

My question is: the services that the province is now providing through assistance in the user fees for those people that cannot pay their user fees, and we are picking up the costs of those user fees.... For the people that cannot pay them, we have that safety net. For those people who cannot afford to pay their portion of the dispensing fees, for those people who cannot afford to pay any of those items, we are picking up the costs. Will this now be cost-shared with the federal government on a 50 percent basis?

HON. MR. DUECK: To begin with, my information is that the federal government shares 43.6 percent in health care, and the services that you mentioned are not shared in any way by the federal government. It's totally provincial cost, and therefore it doesn't affect the federal plan at all.

MRS. BOONE: The item here under the Canada Assistance Plan says they will be covering persons in need — persons who, regardless of the causes of their need, are unable to provide adequately for themselves and their dependents. Eligibility is based on tests. Children who are in the care of a child welfare authority and foster children under the CAP agreement of the province may not require.... It goes on to state the various things. They've got day care, homemakers, home support, similar services to individuals. It would seem to me that under such a situation, where a person is in need and does meet the requirements so that he is getting assistance from the province, the province would be eligible to turn around and claim 50 percent of this back from the federal government. Am I incorrect in this?

[ Page 2452 ]

HON. MR. DUECK: Yes, you are incorrect. From the Ministry of Health, those items are not covered. If a person is in need, whether that's through Social Services and Housing I'm not sure, but under the Ministry of Health these supplementary services are not included. They are totally the responsibility of the provincial government. Whether there is some. assistance available to people in need from other areas and other agencies I would not argue; but not under the health program.

I would like to answer one of the questions. I don't know whether it was the member for Prince George North (Mrs. Boone) or the member for New Westminster (Ms. A. Hagen) who asked about the Summit Achievement Centre. That program is operated by SANE, which also operates a lunch program for recipients of GAIN. The lunch program was not transferred to the Ministry of Health. The society has sufficient funds this year for the lunch program. The Ministry of Social Services and Housing and the Ministry of Health are working very well together in that particular program. I believe the question was whether we cooperated, and we do. I understand that it's working well, and we will continue to do so.

MRS. BOONE: The information that I have here about the Canada Assistance Plan indicates that B.C. received some $593 million. That was in total; for health care, there was $19,795,000 there. But what was this money for, and does it show up in the budget here? Is it put into the global budget? How is it handled?

HON. MR. DUECK: As I just mentioned, we get 43.6 percent for health. Most of that money that you're speaking of is actually money transferred for the Social Services and Housing. It doesn't come into my ministry at all.

MRS. BOONE: The $19 million is strictly for health care. The other areas — there is child welfare, welfare services, homes for special care, general assistance, work activity projects, etc. — total up to much more than that. It's obvious that you don't think the money comes to your ministry. I don't know where it goes then. It would be nice to know where it goes. Maybe you could ask somebody where the money that comes from the federal coffers goes and why it doesn't go into your ministry. I think we should be able to figure that out.

The member for Kootenay would like to get a few words in at this point.

[8:30]

MS. EDWARDS: Mr. Chairman, I just wanted to ask the minister again about a very specific issue that we had begun to talk about before, but I want to add a bit to it.

It's the problem of funding for a residence for mentally handicapped people, and I know the specific instance of which I am speaking is not an individual case. I attended the thirty-third annual general meeting of the British Columbians for Mentally Handicapped People, and one of the resolutions they passed is not particularly new. It says: "...to lobby the Ministry of Social Services and Housing and the Ministry of Health to reconsider their funding formulas so as to make their formulas much more flexible for residential services for the mentally handicapped people."

As I said, I know this is not a new program, but what we have, Mr. Minister, is a case of a lodge where there are 23 mentally handicapped people. They are funded under the Ministry of Health. Almost beside them is a group home run by a non-profit society, which houses four people. They live there and are funded by the Ministry of Social Services and Housing. The larger institution, as I say, has an annual budget of $247,000. It takes care of 23 people with a staff of nine. Practically next door is this group home which takes care of four people and has an operating budget of $220,000, with a staff of 11. That could be quite reasonable. I'm not suggesting that under all circumstances this would not be reasonable. The point is — and the owner of the larger institution says — that the people who stay in his lodge are under the Ministry of Health, but in fact, they have some major problems in trying to get funding for these people. At least five of them would have more funding if they were funded under the Ministry of Health.

He has come to the point where he can no longer upgrade the building in which he houses these people. His taxes are up 27 percent, his food is up, his staff is up, and so on and so forth, and he's still ending up.... He also has to put $16,000 a year into a life skills program. There is no funding from the ministry on that. That is the kind of thing — life skills and social integration — for which funding comes from Social Services and Housing.

His problem is that, under the Ministry of Health, he has people who don't have health problems. If people had health problems, he probably would be getting enough of an allowance per capita to run this institution. Only now is he beginning to have some people who are getting up to age 65 and over, and they are beginning to have health problems. But basically he has healthy people. He says what happens is that by long-term care, he thinks you wouldn't want anybody who was really severely ill — and he doesn't have people who are ill. But he does have people who need social programs. Therefore he is trying to run this institution on considerably less per capita than almost any other comparable institution. He talks about other institutions up the valley where the per capita is $57 a day, or the Attorney-General's facilities where they get $88 a day — and he is running on less than $30 a day.

What I want to put to the minister is: are you considering any moves, any changes, any ways in which the funding for these people is moved out of Health, because they are not ill, their problem is not a problem of health — they're mentally handicapped people? Or are you considering some way in which the particular needs they have will be addressed? As I say, there is no opportunity to fund them for the kind of social integration they need, and it seems to me that — I don't know if you could call it occupational therapy or whatever but — there should be some funding available for these people if in fact they come under the aegis of the Ministry of Health.

HON. MR. DUECK: Mr. Chairman, I can't answer that because if we're funding agencies that haven't got sick people, then obviously they shouldn't be in our ministry, unless they are in an extended care situation where they're over a certain age. But I think something like this that you just mentioned is obviously a concern to you and it would be to me too, but I don't think that I can deal with it at estimates time. That's something you'll have to bring to me and we'll certainly look at it, because there obviously is something not in order. But I can't answer that.

MS. EDWARDS: As I say, this is a specific instance, but it's not unusual. It certainly would be delightful for the

[ Page 2453 ]

person who runs this institution if in fact he could have these people funded under a different ministry, and he has tried. But they are not; they are to be funded under the Ministry of Health. As I say, it's not a single problem.

I'm sort of stumped by your suggestion that it must be a mistake. I'm sure it's no mistake. They've been running this home for, I believe, about 15 years or more, and I can get chapter and verse on it. There has been no increase in funding since 1982. They're still under the Ministry of Health, they can't be funded under the Ministry of Social Services and Housing, and they are mentally handicapped people. I just don't know how we can communicate on this if in fact you're saying that this doesn't happen. It does happen and it's not an unusual situation, I understand.

HON. MR. DUECK: Mr. Chairman, I would like to ask the hon. member how long she was aware of this, why she brings it up now. If you were aware of it for some time, and obviously you were, why wasn't it brought to my attention? I can't deal in riddles. I don't know which one you're talking about; I don't know where it is; I don't know anything about it, and I just can't answer your question. But I would like to deal with it. I hope that you come to me soon, and we will deal with it.

MS. EDWARDS: Mr. Minister, the name of the place is Pioneer Lodge, and of course it has been brought to your ministry for a number of years. But you and I are relatively new at this — right? Pioneer Lodge is in Cranbrook. The lodge has gone through a number of extensions. It is one of the model facilities in the area. In the province it has been used as a model on a number of occasions. Why didn't I bring it up before? It's a problem that I thought would best be dealt with under estimates.

HON. MR. DUECK: I certainly don't object to any questions; that's not the point. I'll go on for two weeks if you want. But if you're going to bring up specific instances, it's going to take a lot of time. I'll find the information and I'll follow it up, and we'll try to give you that answer now. It's something you're trying to get me to say I can't answer, of course; but why don't you do this at a time when we can help these people?

That's really what the exercise is all about. Estimates is something, I think, where you're supposed to ask what we're doing in the ministry and make suggestions as to what we might change; but specifies on certain areas where there may be a flaw, or something is wrong, where someone has fallen between the cracks, I want to know about. But I can't do much about it here at the time of estimates. I will make a note of it. If we can find the answer before we've finished with the estimates, I will give you that answer; if we can't, I will personally meet with you and we'll try to settle that between the two of us and find out what the score is, why we're funding somebody that's well.

Quite frankly, I'd like to push that off on to someone else. If those people aren't sick, I don't need that. I haven't got enough money now to help the people that are ill. So if they're well, I want to shove them off to another ministry.

MS. EDWARDS: Mr. Minister, as I say, I brought it up and didn't give you the name, and didn't make it a specific instance at first, largely because of the discussion that went on at the thirty-third annual general meeting of the British Columbians for Mentally Handicapped People, where there were people at the senior management level from both the Ministry of Health and the Ministry of Social Services. Both of them admitted that this is a major problem; that in fact they're working back and forth.

They admitted that it is a problem that has gone on for years. They said — and I was expecting to hear from you — that we had made some progress on this; that there was some talk going back and forth between the two ministries; that in fact there was some way that the kind of funding that needed to be had for these very specific types of people.... There are all sorts of them in this resolution which they, I am sure, have brought to you; if they haven't yet, they will be bringing it to you. They talk about all sorts of different residential living situations where there has not yet been a satisfactory response between the Ministry of Social Services and Housing and the Ministry of Health. Is the ministry dealing with the Ministry of Social Services and Housing on this? Presumably, as I say, your managers — I believe they were ADMs — were talking about these kinds of talks. What's happening?

HON. MR. DUECK: Mr. Chairman, I have to tell you that we cooperate with the Ministry of Social Services very well. When there are people that aren't looked after by either one, it is a concern of mine for sure. In this particular case, again I must say I can't give you the answer, because I don't know; I have to find out.

MRS. BOONE: I'd just like to ask the minister a few short questions going back to the user fees item. Can you tell me please how the people that are not being charged user fees identified when they go into a service? Whether you go to a chiropractor, physiotherapist, or what have you, how are they identified so that they do not have to pay the user fee or do they have to pay the user fee, and then be reimbursed for that fee?

HON. MR. DUECK: I understand they are now issued new cards, and they have a code on it, and the supplier of the service looks at that and he identifies the individual by that.

MRS. BOONE: Would the minister tell me what the codes are and what they identify? What types of clients do they identify, please?

HON. MR. DUECK: Mr. Chairman, if it would make you happy, I will certainly give that to you, but I haven't got that with me today.

MRS. BOONE: Mr. Chairman, I'm glad to see that somebody is taking care of the minister's health and welfare; I was a little worried about him over there. This has been very arduous on you, no lunch break, no supper break rather, and we're managing okay here, because we can spell each other off. So I'm glad to see that someone's bringing you a few snacks over there. I wouldn't want your ulcer to flare up again. No I wouldn't like that; it's too costly. We can't afford that. I would like to go back to some of the things that I was on originally, which was....

The member for New Westminster has a few items that she'd like to deal with.

MS. A. HAGEN: Recognizing the minister has a large ministry and noting that he and I will have the same endurance record, because I haven't had supper yet either, I

[ Page 2454 ]

thought that before the member for Prince George began to pursue some other areas, it might be well to just develop the whole issue of mentally handicapped people. Because I think it is easier to stay with some themes with the minister as we move along.

Mr. Minister, through you, Mr. Chairman, the ministry has closed Tranquille, which is one of the major residential settings for mentally handicapped people. Woodlands which is in my riding, is in the process of being closed. There is another facility about which I don't know a great deal, but I know the member for Maillardville-Coquitlam (Mr. Cashore) is more familiar with it, and that's the Glendale program in Victoria. I think it's a program to which some of the residents of Tranquille were transferred, residents who were not necessarily able to be out in the community.

[8:45]

Nowhere, Mr. Minister, I think is it more obvious that there is a need for orderly and clearly defined coordination than in this care of the mentally handicapped. A phrase that you used a moment ago leaped out at me, and that was the phrase, "If it isn't about health, don't talk to me." If we're talking about mentally handicapped people, we are clearly talking about a range of services that are required by mentally handicapped people living in the community. I wonder if the minister could take a few moments, perhaps, just to outline the role of his ministry in regard to Woodlands, where there are presently about 500 residents still within that facility — 106 or 110 or so to be placed out in the community through contract this year; the role of his ministry and how he sees in practical terms the working relationship between his ministry and the Ministry of Social Services and Housing. In the context of that, note too that we're looking again at some of the cost sharing that's available from the federal government. It's a complex area. I think that parents and the various associations that come under the umbrella of British Columbians for Mentally Handicapped People have done a great deal of work in preparing for the institutionalization, as have the people who work in the facilities. I'd be really interested to have this minister, who as he notes has been eight months in the job and is learning the parameters of his wide-flung ministry, just comment about his concept of that institution, its planned foreclosure, the role of his ministry, and as those people are in the community, and how that will be interfaced with and work with the Social Services and Housing Ministry, which clearly is going to have a role to play in the programs and support services for those people and for their families. Out of those comments I may have some specific questions to ask the minister, but I'd like to have his overview before I begin with those specifics.

HON. MR. DUECK: Mr. Chairman, to begin with, Tranquille was not closed by the Ministry of Health but by the Ministry of Social Services. Glendale is, of course, under our ministry now, which it wasn't; but it's been transferred. We have an interministry committee of deputies actually working on that to provide a streamlined and proper transfer of these people, who may go into various community and group homes. We also protect each other as to the funding. As you mentioned, it is a complicated process at times, but the cooperation between the two ministries is good, and I think we'll achieve our goal.

The exact time-limits are not quite clear — how long it will take, where we will find these homes and where these people will go. I know that we've made a statement to the parents. We've sent a letter to either parents or relatives, or whoever is involved with some of these people in Glendale, that it will be done in consultation with them. It will not be done in isolation, to make sure that they are at ease and comfortable, and that if an individual is moved they will be consulted — it will be discussed in detail before a move is made. The process will take some time, I'm sure. It's already going on now; the placement activity is proceeding.

Of course, some people will be under the Ministry of Social Services and some will be under Health. They do interrelate. However, we try to look at it from the point of view that a person, whether handicapped or otherwise, who is medically fragile would come under the Health ministry. An individual who is mentally handicapped in some way but can function quite well would probably come under Social Services and Housing. I know that the fine line between the two is sometimes bluffed, and this is where the two ministries have to get together and sort these things out. It is generally done in a way that's best for that particular individual and the family. If you ask some specific questions, perhaps I could be more specific also.

MS. A. HAGEN: Mr. Chairman, I would like to ask a couple of questions. I won't be exploring this in great depth. At this point the ministries are involved with new housing for these residents. We had a discussion a short while ago, Mr. Minister, about the matter of Canada Assistance Plan funding, and I would presume that the same kind of funding may very well be a part of services to this particular community of people. It's also clear that British Columbians for Mentally Handicapped People has a strong commitment to non-profit services, services that are accountable to the community, services where the parents maintain their involvement. Given that this is a golden opportunity to establish services within those parameters with that kind of philosophy, both for the cost effectiveness of the program and the appropriateness of the program in being community-based and accountable to parents in the community, would the minister make a commitment that the housing of the mentally handicapped who are going to be leaving Woodlands will in fact, on every possible occasion, be through the non-profit sector, which would make it possible to tap funding, make it possible for those services to be accountable to families and consistent with a community-based service that's very appropriate for this population?

HON. MR. DUECK: We hope to have the downsizing completed by 1991, if possible, and the federal government is involved. It's roughly 33 percent and 66 percent. We are assisted by the B.C. Housing Management Commission, with, of course, its link through the CMHC, and that comes under Social Services and Housing. There has not been a detailed plan on the downsizing of Glendale to date, but it is in the works, and I hope to report more to the House a little later, when our plan is more defined. But the impetus, if at all possible, is to deinstitutionalize a lot of these people who can be put into homes.

I visited a number of homes — as a matter of fact, one in my own area, and another one in Prince George; and I'm sure the member from Prince George will know that one — and I was absolutely amazed at what I saw. I was told that some of these people could not function, could not move and didn't make eye contact with anyone, and you should see them now in the facility they're in — with care, of course. They are

[ Page 2455 ]

living, communicating individuals. Even if they can't do it with speech, they do it with various equipment.

Quite frankly, this was an experience I had never had the opportunity to see. I was so amazed that I became friends with these people and went back a second time to talk to them, and they knew me immediately. These people are not dumb. It was believed in past years that they were ignorant and somehow deficient mentally. These people are quite bright, but they are in bodies that don't function properly.

So I agree wholeheartedly with the concept of moving people into facilities with proper care, where they can have a quality of life that heretofore was not afforded to them. So this is our program, and this is what we're doing. It's something that is actually very close to me, not because I have any members of my family in that situation, but I was so overwhelmed by this, when I saw some of these homes, that I made it a point to mention to the Premier that we want to concentrate on that and perhaps do more in the future. It's an area where we need to help these unfortunate people, and I'm certainly committed to that.

MS. A. HAGEN: I'm pleased to hear the minister's obviously very personal commitment to deinstitutionalization, and I'm sure that the British Columbians for Mentally Handicapped People, which is one of the finest and most extensively developed volunteer groups in the whole province, will be pleased with those comments. Deinstitutionalization is happening. As far as Woodlands is concerned, it's in the works.

I want to put my question again, because we talked earlier about the need to take opportunities when they occurred.... Sometimes it's difficult to change systems. The minister obviously has faced that in his eight-month tenure, to the detriment, perhaps, of his health. But here we're carving out some new initiatives. Here we're doing things where we're deciding how the world is going to unfold in a downsized and deinstitutionalized program.

Again, I want to ask the minister if he is prepared to make a commitment that those services will be accountable to the community, in the same way that Woodlands has been and that schools are. They are in the public domain. They are administered by non-profit groups which are accountable to the parents and to the community. I want to ask the minister if he's prepared to make that commitment at this time.

HON. MR. DUECK: Well, I certainly don't find it difficult to make a commitment of that kind. I can't see anybody in my position not making that type of commitment. Of course, you're absolutely right: we'll do everything in our power to make sure that these people are properly looked after and that we listen not only to the community but also to the welfare of the individuals and their close ones — relatives or whoever is in charge of their life or has been in the past. I thought I made it very clear that that was one of my concerns — that we look after these unfortunate people. Yes, I have no hesitation in making that commitment.

MS. A. HAGEN: The commitment I am speaking of — and I want to be sure that the minister does understand my question, Mr. Chairman — is a commitment to structures in the way these people will be living in the community that have built in that accountability. That means that they function with boards and they function with some means by which there is input in a formalized way. We are all familiar with how a non-profit society functions, and there are a variety of non-profit groups. There could even be private non-profit groups, provided that the structure is there.

I want to be clear that the minister understands my question. I am not questioning at all, sir, your commitment to the care of these individuals. It is obvious that you are making that commitment, and it's something that has touched you personally in some of the contacts you have made with mentally handicapped people in your travels. But the structure that will be in place is one that we are now evolving as a new system. I am asking again if you are prepared to make a commitment to try to have those structures be non-profit structures, with all of the things that are inherent in the structuring of a non-profit delivery of service.

HON. MR. DUECK: You finally came out with what you really wanted to ask me. You kept asking about commitment, and I make that commitment. So you finally said non-profit and profit. Why didn't you say that to begin with? I would have understood it better. I'm a bit dense, you know; you have to speak very clearly to me.

I cannot make that commitment. We will do the best we can for the individuals; I'll make that commitment. But whether you want profit or non-profit, that is something we will do at the time and consider it. Whichever is best for the taxpayer and for the people. that's what we will do.

MS. A. HAGEN: I would make one final comment to the minister apropos of the discussion we had on the Canada Assistance Plan funding. When we were talking about longterm care, the minister acknowledged that this province is forgoing considerable dollars by virtue of having private for profit proprietary care as well as non-profit care.

If the minister is sincere about the fact that the major problem in his ministry is having the dollars available to provide services, it would appear to me that this is a golden opportunity for him to structure a system that would permit him in some measure to deal with the dollar needs of this particular group that his ministry is responsible for servicing.

One of the merits of the program delivered by non-profit is its accountability to the community and to parents. The other is financial. I think that those two things deal with essential ingredients: quality of care and cost-effectiveness. I would certainly advise the minister, who has asked for our suggestions and our ideas, to look very seriously at this kind of organization and structure in meeting his commitment to these people.

I am sure that you would have no more supportive group than the British Columbians for Mentally Handicapped People, who are an essential group — again, volunteers all — in meeting the mandate for service to people that you have so strongly suggested you share.

[9:00]

HON. MR. DUECK: Mr. Chairman, just in case there is a misunderstanding, in this type of service it would make no difference whether it's home care or whether it's profit or non-profit; there is no difference in the funding. That would not have an effect. In other words, we wouldn't be forgoing any funding whatsoever from the federal government because we gave it to a non-profit or a profit organization.

Incidentally, I understand that some of the staff that operated Tranquille have now gone into business for themselves operating a facility for this type of individual and

[ Page 2456 ]

offering very good service. We've also found in the past that not necessarily because they are for-profit organizations do they operate less efficiently. We find some for-profit facilities operate more efficiently and cost us less than the non-profit ones. So let's not get hung up on that issue, except where the federal government is involved in funding; then of course it does make a difference on that particular portion.

No, we wouldn't make the commitment that we will give it only to one group. I think we'd make the commitment at the time. We would choose the ones that offer the best service for the dollar for the taxpayer, and that's the way it will remain.

MS. A. HAGEN: Maybe I'm getting tired too, Mr. Minister. At one point I thought I heard you say that whether the service was delivered by a profit or non-profit group didn't make any difference to federal funding. Then I thought I heard you say it did. Perhaps you could clarify for me whether the same situation prevails as we discussed it earlier with some of the long-term care programs, where we are forgoing federal dollars when a private proprietary service is provided.

Let me make another point clear. I'm not talking about any one agency, nor am I in fact necessarily talking about the quality of service that's offered at this particular time. I'm talking about some principles. So if you can clarify, Mr. Minister, whether there is federal funding for proprietary service for the mentally handicapped under the Canada Assistance Plan or not, then I think that will clear up what I misheard a moment ago.

HON. MR. DUECK: I was speaking of homemaker before. That is federally shared, but not these facilities. They're strictly at our own expense.

I should correct my statement: it is block-funded by the federal government, but it makes no difference whether it's for profit or non-profit — sorry about that. But the homemaker is in fact shared by the federal government.

MR. STUPICH: I have put a question to the minister previously. He announced some four months ago the construction of a brain-damage facility somewhere on Vancouver Island. I wonder if he is able to tell us more about it this evening.

HON. MR. DUECK: Yes, that was announced in the throne speech. We've looked at it. There's a need for a brain damage facility, no question about it. The decision will have to be made soon. That particular decision is not within the purview of my ministry. I can't give you any detailed information at this time, but in due course it shall be revealed and it will come to light.

MR. STUPICH: I didn't expect much more than that, but I wonder whether the mid-Island area — not necessarily Nanaimo — is being considered. When the minister says "soon," does he mean within the lifetime of this parliament or this session, or can he give me any idea of what "soon" means?

HON. MR. DUECK: When I entered this part of government, one thing that I found very frustrating was that time doesn't mean much. I've been in the past a businessman, and I could move and do things that I liked and when I wanted.But when I'm in this position, I have to be very careful about stating dates or times.

I can only tell you that a decision will certainly be made before I.... Well, I shouldn't say that either. I was going to say before I end my term as Minister of Health, but that may be tomorrow if I don't give you the right answer. The Minister of Finance (Hon. Mr. Couvelier) is listening. Mr. Member, you've been in this business much longer than I have and you know that some questions cannot be answered with a yes or no. They can also not be answered with a time limit. I'm saying that I hope that a decision on this particular issue will be forthcoming soon. It will be announced by way of, press release or in the House. I cannot give you more information at this time, except that it's being reviewed and there is a need for that type of facility.

MR. STUPICH: The member's tenure as Minister of Health depends not one whit on the answer he gives me. It may depend on other things.

One question you didn't answer, and perhaps you'd rather not comment at this time, was that I asked whether or not the central Island area, Nanaimo or wherever, is being considered as a possible site.

HON. MR. DUECK: At this point in time I couldn't answer that because it has not yet been chosen, so I would be wrong if I said that Vancouver Island would not be considered, or if I said the mainland would not be considered. I can't say that, because I have no idea at this point in time where the location will be, whether it's Nanaimo, whether it's Cobble Hill, or where it is. I can't give you that information at this time.

MR. STUPICH: Mr. Chairman, this time it's not a question. It's just to remind the minister that he said it would be somewhere on Vancouver Island. I don't want him to back up on that point. That's far enough back.

HON. MR. DUECK: I never said it would be anywhere. I said the location will be determined soon. I have not made that statement except.... In the throne speech, perhaps, it was mentioned, but I have never made a statement of that kind ever.

MRS. BOONE: Mr. Minister, going through the previous report — 1985-86 — took me a considerable amount of time. I found it very interesting but a little confusing as to some of the things that I found in the management areas — management operations. If you're truly looking at areas that you can cut back in, or if you're looking at areas that are not necessary, I think you should take a good, sound look at this area here. I'd like to read some information to you that was in there.

[Mr. Weisgerber in the chair.]

There's a policy, planning and legislation area. In many cases perhaps these things do not even exist right now, because this was '85-86; but I have a feeling that they probably do. There was a policy branch; a health, economics and planning branch; a research and evaluation branch. The policy branch says that it was responsible for health economics,

[ Page 2457 ]

health manpower and corporate planning, policy recommendations for ministerial and interministerial and intergovernmental decisions and then coordination of legislation and research and evaluation of selected ministry programs.

As I stated earlier, the systems division provides consulting services, systems analysts, systems maintenance and operational systems to support all ministry programs.

Then we move on to the operational review and production branch. That provides independent assessment to senior management as to efficiency, effectiveness and economy of operations, management controls and information systems in the ministry.

The research and evaluation branch, which I just mentioned earlier, provides the research there, and provides statistical analysis and valuation services to various programs within the ministry.

I look at this and say to myself that there's a tremendous amount of analysis here — analyzers, systems people, operational, systems maintenance and management. One can't help but wonder if the ministry really needs to be analyzed., systemized, operationalized and all of these various things as much as it is and in all of these areas. As a government employee in my previous life — I feel like I've been reborn here — I can tell you that we had analysts coming out of our ears at various times. They would come in and analyze and go back to Victoria and make recommendations, all of which established more work for the people in the field, but did very little to make the work out there in the field more efficient. The more analysts you have out there analyzing things, I can assure you, the more work is going to be generated, and generated not for the analysts but for the people in the field.

What we've seen is a growth in many of the government departments — a tremendous growth and mushrooming of sections, with analysts there. Yet the people at the ground level do not have the ability to perform their functions, because they are doing extra work put onto them by the analysts and they are not being given the support to do the various things that are being suggested or to do their main functions, their ordinary functions.

I think that there is a tremendous overlap of service here, and I would like the minister to please explain to the House just why we need all of these various divisions, supports and what have you, and why we need to be analyzed to such an extent. Surely there can be some areas here that can be eliminated or decreased, and surely we can put those services out into the field to deal with the homemakers, to provide the services for the sick, the elderly and the people who can't take care of themselves. Surely we can cut at this level and provide the services out there. Would the minister please respond as to these various divisions — if they still exist, what they're doing and why we have so many of them?

HON. MR. DUECK: I couldn't write as fast as you spoke. You asked about 50 questions there, but I think the gist of it was that administration and analysis of programs.... Have you ever operated any business of more than $100,000, $200,000, $500,000, $1 million, $1 billion, $2 billion, $3 billion?

[9:15]

I would defy any ministry to operate on a 2 percent administration fee, and that's what our total administration is. Would you believe that some of these operations that we have are absolutely essential?

We're constantly looking to where we can improve, where we can eliminate people that are not needed. We do as much as we can on contract so that we don't have to hire that many people if at all possible. We cut in the last.... This was prior to my time, so I'm not going to take any credit for this, but this ministry had just under 10,000 FTEs just a few years ago. We're now at less than 7,000 — something like 6,700. That in itself tells me something about efficiencies. The whole system has grown, but we're way down in FTEs.

I've been in business; nothing like this before, none of these billions of dollars, but I'll tell you, to keep a business like that afloat and make sure where everything is going...... We do a lot of funding for hundreds of agencies. They must all be monitored. We cannot just send out cheques without any monitoring. We have computers, we've got analysts, we've got reviewing teams of various programs. Just answering letters, for heaven's sake — I get between 1,500 and 2,000 letters a month, personally; I'm not speaking of the ministry and all the buildings over there. Can you just visualize what is involved in running a business of that size? To put it in a nutshell, our total administration cost is just 2 percent.

MRS. BOONE: I wasn't questioning the minister's support staff or himself. What I am questioning here are the divisions that seem to have an overlap and, as I say, the systems division. You've got your systems analysis and you've got providing support to all ministry programs — systems maintenance, operating systems. You've got the operational review and productivity branch, which is management controls and information systems in the ministry; research and evaluation branch, providing research, statistical analysis and evaluation services to programs within the ministry. It seems to me that you've got so many various areas analyzing and providing evaluation of various programs that surely there must be an overlap of some of these areas. It can't be possible to have these various things assessing programs and not have some overlap in there.

HON. MR. DUECK: I certainly can't give you a lesson in the operations of the whole thing, because even I don't understand all of it. The only thing I can tell you is that it's not an overlap. All the things you're speaking of are all different areas, and they're all needed to operate this huge ministry. If you wish at some time at a later date, when we've got time — they're beautiful people over there, they're friendly — I'll take you in there and just show you the operations and the computers and what it takes. Just the MSP alone.... I've gone through the whole system, and it's astounding what's done in those businesses.

Fm not saying that we can't be more efficient, because you can always be more efficient. That is, of course, the goal that I and the ministry would like to achieve, and I'm asking them to achieve that. But to say that there is an overlap, that there is some massive inefficiency, is completely wrong. You just don't know what you're talking about.

MRS. BOONE: Well, you're right, I don't understand this, and that's why I'm asking you. But you just told me you didn't know what they did, either, so I don't know how you can say I'm wrong that there's an overlap, because you don't know what they do.

I'd like to question a little bit here with regard to the child development centres. You earlier talked about visiting Prince

[ Page 2458 ]

George and the child development centres there and the people in those centres and how they weren't able to do anything for themselves. I have just been informed that the people attending the child development centres are now being charged user fees for their physiotherapists, as are people that go to private practice. Can the minister explain how you can justify user fees to the child development centres for their physiotherapists?

HON. MR. DUECK: The last question first. Physiotherapists that are under fee-for-service and not under salary with some institution would collect the $5 user fee.

MRS. BOONE: It's obvious that the children in these centres are very special cases, and they do require extensive physiotherapy. Would the minister consider making some exception to the physiotherapists that work in the child development centres, to exempt them from user fees? They understood at one time that they were going to be exempt. Would the minister consider that? These are children who are facing a real uphill battle as it is, and families facing some tremendous difficulties. To face a user fee on top of that is something that many of them just can't.... It will have a tremendous effect on their lives. Would the minister consider reconsidering that?

HON. MR. DUECK: I will consider to consider that.

MRS. BOONE: Also, under the executive services branch there are general grants, and agencies that are funded. Would they be agencies such as health coverage agencies — I'm just trying to think of some — heart associations, cancer clinics? What type of agencies would be funded under those general grants to agencies?

HON. MR. DUECK: Do you want a general outline, or do you want me to go through the whole list?

MRS. BOONE: Just general.

HON. MR. DUECK: Okay. There's the Canadian Cancer Society, Cystic Fibrosis, the child development centres, Meals on Wheels, medical clinics and so on.

MRS. BOONE: Can the minister tell me if the funds for these grants have been increased, decreased or will remain the same for this coming year on those grant systems?

HON. MR. DUECK: I'm sure they've been increased, but I'm just trying to get the figure for you now. While they're looking for that figure, I'll just go back to a statement you made earlier. We are covering so much ground. I know that we want to get through this, so I'm not at all upset that we've covered so much in such a short period of time.

Since 1982, when this government decided to reduce FTEs, reduce ministries, this ministry.... There's been no growth in FTEs since 1982, and with an expanded program. I'm wrong; 30 FTEs, I guess, were added.

MRS. BOONE: Has the minister got the answer with regard to the general grants, or should I go on to something else here?

HON. MR. DUECK: Mr. Chairman, we're looking for that figure. Let's carry on.

MRS. BOONE: I'd like to just generally go on to some of the Medical Services Plan premiums. There are some items there that I think the minister should be aware of. Many persons are not aware that they may be eligible for premium assistance, especially because they themselves must find out how to apply for it, and they must fill in the application form, etc. Has the minister ever considered advertising this item, so that people do know that they can apply for premium assistance? Perhaps you could consider an income tax return for those with a taxable income of less than $3,500.

Many on limited incomes would gladly accept premium assistance, but they don't know that it's even there and available for them, so what they in fact do is go without medical services or end up going to welfare on an emergency basis. Has the minister ever considered doing any kind of overt advertising to make people aware of the premium assistance to those on the lower incomes?

HON. MR. DUECK: The problem is that we're talking about a shortage of funds. I'd hate to take more of the homemaker service amount and use that for advertising, if you know what the cost of advertising is. But I haven't found that.... I've found that people are quite aware, and the ones who aren't, at least in my constituency, certainly let me know, and ask questions. That's why we have all these MLAs in so many areas who should assist people in their area; at least I think that is our duty. I spend all day Saturday and most of Sunday answering questions in my constituency. I am sure you do too. With seniors especially, I find that if one senior knows it, everybody knows it — they have a good network. There may be some who don't know it, but I think that, by and large, people can find out for themselves. I would hate to spend a lot of money on advertising or some other method of.... If there were some way of doing it, I certainly wouldn't want to deprive anyone of getting the money if they were eligible. I am not sure of the method to use. I can certainly think about it, and maybe you could come up with some good suggestions and call me on that sometime.

MRS. BOONE: I don't think we are suggesting a massive campaign, but perhaps just some posters in government agents' offices or medical offices, so that people are aware of the assistance that's there.

I would like to get on to something with regard to the criteria for determining what is covered under the Medical Services Plan. Before the election I had a gentleman come to me from the diabetic association. As you know, they are trying to get the blood glucose testing units covered through the Medical Services Plan. They make a very good case for this, indicating that it would save money and lives, and in many cases, particularly young people, it would save their sight if they were able to administer these tests themselves and get early detection.

I had copies of letters that these people had received from the ministry, going back as much as four or five years, indicating a review just about every six months and saying that they were currently evaluating the process and developing criteria for those areas covered under the Medical Services Plan. Right now there is nothing that establishes what can be covered. It is more or less a bureaucratic decision as to what is covered and what is not covered. As I say, the blood

[ Page 2459 ]

glucose testing units are not covered. Many items for the handicapped are not covered, or they are covered in a one shot deal, such as a wheelchair once, and other items are not. So a process was begun in the ministry about four or five years ago, and the letters I had were about every six months, indicating that they were in fact reviewing this and developing criteria to establish what would be covered under the Medical Services Plan. Is the minister continuing with this process? Can he please tell me when he will develop any criteria to determine what is covered by the Medical Services Plan?

[9:30]

HON. MR. DUECK: I didn't know that this had been reviewed before. I thought I came into this as something new. Yes, I have also reviewed it. Yes, we came up with the figure for the cost of administering exactly what you are talking about, the home blood glucose monitoring equipment. We thought we would perhaps introduce it on a limited basis, for children and high-risk women, such as pregnant women — that type of person. That alone was going to cost in the order of $4.5 million or $5 million. It was then considered and is still being considered. I am bringing it forward — at least, I am going to attempt to introduce it in the next budget year. But this came to my attention after the budget was struck. When the letters started coming in, and not being too familiar with that particular disease, I inquired and got into it further and further. But I didn't know it had been considered by anyone in the past. I thought this was really a new area we were embarking on.

So there is a concern out there. I can understand it. I also know that in the long run it would save us money and certainly much hardship for the people who suffer from that particular disease.

MRS. BOONE: Well, that certainly is welcome. I am glad that the minister has taken that positive action. It will be fully supported from this side of the House when you introduce those things into the Medical Services Plan. I look forward to seeing anything that your ministry establishes to determine the criteria for covering things in those areas as well.

HON. MR. DUECK: I think I did make it clear that that will definitely come under Pharmacare and not MSP.

MR. CASHORE: Mr. Chairman, when it comes to talking about mental health, we're talking about a subject that is at once perplexing and uniting for all of us. All of us seek to achieve mental health. Just as when we are talking about what it is to be handicapped, I think all of us, when we really think about it, are aware that there is a way in which we can all see that we are handicapped. There is a way in which all of us have that which we feel limits our ability to be the people we would like to be. Perhaps collectively as a society we are all handicapped in that we all lack what enables us to become what we would like to become and to provide a kind of a healthy way of life for all members of our society.

So it is when we talk about mental health. One of the things we are about when we are dealing with the many issues that come before this House, and the many ministries that have administrative responsibilities within this House, is that we are dealing with mental health in virtually everything we do. The particular parameters of mental health as they relate to the Ministry of Health tend to be those aspects of health dealing with people who have special needs for special care, people who are acutely ill, often people who are going through the distress, terror and dilemma of a schizophrenic illness. We're dealing with a situation where we're concerned about the person who is going through that, and we are also concerned about the family and loved ones of that person and how the experience of that illness is impacting on the various members of that family.

Indeed, we are dealing with the wider community, because part of wellness is that when people no longer require acute care, there be a nurturing family or caring community to receive them. So when we are dealing with this aspect of the Ministry of Health, I'm sure that all of us are aware that the goal is to achieve a kind of wholeness, a kind of interdependence, a kind of mutual responsibility that functions not only within those acute-care facilities that we call "hospitals" but also in every aspect of our society and of the life that we live. People who go through that experience of walking through the valley of that shadow should be assisted in coming out into the light.

[Mr. Pelton in the chair.]

I think it's important that we acknowledge, as we consider the issues of mental health, that we're in this together. The only way we're going to be able to resolve the dilemmas with regard to mental health for our society and for those who are experiencing acute illness is when we do recognize that we are in this together.

I would just like to mention that I feel in a way, through you, Mr. Chairman, to the Minister of Health, that I'm having an experience of deja vu, having had the first estimates of Social Services and Housing, and here I see you sitting with the same deputy to assist you at this time. I would like to acknowledge Mr. Noble from this side of the House and welcome him into our presence at this time.

There is one question I have. It's not meant to be a zinger, and I don't even expect that it can be answered immediately, but perhaps by 10 o'clock or tomorrow, if we're still on these estimates. I'm having a bit of difficulty relating the supplement to the estimates that we most recently received to the one that we received the time before. When I look at the statistics for mental health, in this year's supplement we find under the column 1986-87 the total for mental health is $117,075,588. That's on page 64. Then when we look in the previous year's estimates, the total estimate for the same year, 1986-87, is $112,445,346. There is a similar discrepancy when we look at the figures for forensic psychiatric services. Since these are estimates and not actual figures, I'm at a loss to explain the difference in those figures.

I think the answer might have something to do with recoveries, but even when I look at those figures that are bracketed for recoveries, it doesn't really jibe, according to my arithmetic. So that would be helpful to me, because I'm trying to track the development of the amount of money that is paid into mental health services year by year.

I can see that the minister wants to answer the question now, so I won't keep talking. Did you want to say something about that now? It's okay with me if you could give me something on it later on.

HON. MR. DUECK: Apparently there were some transfers from other ministries from the Ministry of Social

[ Page 2460 ]

Services — and that's why some of those figures are.... You'd have to look at it very carefully and look at the information we have. But that accounts for the difference and — apparently, from your point of view — inaccuracies.

MR. CASHORE: Mr. Chairman, I'm out of the habit here of recognizing the Chair. Through you to the minister....

MS. CAMPBELL: It's the Chair that's in the habit of recognizing you.

MR. CASHORE: I appreciate that comment. I need all the help I can get at this time of the evening.

The explanation that the minister has given outlines a problem we have in trying to do our job as members of Her Majesty's opposition, in that we have a situation of having to compare apples with oranges when the estimates are changed because these new moneys as a result of transfers are brought in. One of the ways in which we try to make intelligent and knowledgeable comments and comparisons in terms of expenditure is by being able to base our reflection on the same set of circumstances from a previous year. I find that very difficult and frustrating, and I would like to suggest that in future, knowing that there are going to be situations where things are transferred from ministry to ministry from time to time, we still have before us comparative figures that enable us to compare on that basis, because it's awfully difficult to critique intelligently under these circumstances.

Having said that, it's my perception that the amount of money going into mental health services in the last two or three years has not increased greatly. I notice a bit of a reaction on the minister's part there, but I do caution the minister that when you respond to the point I'm making, it's awfully difficult for me to be able to relate to the figures that I'm given when the circumstances between the two separate years are different.

The reason I'm making that point — I don't want to spend a lot of time on this — is that I think it's a very significant issue before us as British Columbians at this time. In the new philosophy that pertains with regard to mental health within this province, in terms of the relationship between acute care in the hospital and community care in the community, I don't think it's any secret that the government embarked on a basically logical and appropriate plan to try to increase the amount of care that is happening within the community, where that can possibly done in a reasonable way.

So there isn't an argument here with regard to that philosophy of treatment. Surely the community is the most healthy place in which people who are ready to be in the community may find care and treatment. However, the point of argument that has carried on throughout the discussion, about the way in which the government has done this — and I think the term here is either downsizing or deinstitutionalization.... I emphasize that nobody is knocking that concept, and nobody is knocking the kinds of words we've heard coming from this government with regard to how that should be handled, which is that there should be mental health services within the community that are adequate and capable and responsible in terms of helping the community adjust and helping that person, when that person is out in the community, deal with those circumstances effectively. So it's on that point that I would question whether or not this ministry is putting adequate resources — human and financial — into enabling the community to be the kind of crucible of care in which people who have left acute situations are able to find the kind of help and health that they need.

Would the minister like to comment on that general kind of a statement?

HON. MR. DUECK: Yes, Mr. Chairman. I think I will admit that I have a member on the opposite side of the House who is certainly much more familiar with mental health care than I am or ever will be, so I'll be very cautious that my answers are either so vague that he doesn't understand what I'm saying, or so accurate that they make sense!

[9:45]

Before I say anything else, I have a figure here for you as far as the increase is concerned. You mentioned earlier the discrepancy in those figures, and I have to agree that if I was on that side of the House and had those figures, I would find it very difficult and I would be just as frustrated.

Some of the things that happen in due course when we make estimates and then finally come up with the revised ones aren't necessarily the fault of my ministry. There are many things that happen, as you well know, but I accept the frustration that you must have.

Taking out all the transfers and coming to a net figure increase in mental health — and these are accurate figures — over last year it's an increase of 6.5 percent, making a total dollar increase of $7,635,000 — and some. So I thought you would probably want to write that down.

As for the comment that we want to look after these people, whether we call it downsizing or institutionalizing, it is certainly the mode that this government is in and the direction it is going. I think we agree on both sides of the House, as you just mentioned, that it's the proper course to take.

I hope that by doing this we will be very cognizant of the many areas in which we can err and that these pitfalls are avoided as much as possible. I hope our senior people, whom I rely on very heavily, will make the right decisions and that we do consult and have the consultative process at all times in mind; that we consult with the home that they're going to, consult with the families that these people belong to, and also with the individual person if you can communicate.

So I agree with everything you've said thus far. The only thing that I am sorry about is that you couldn't get these figures and look at them beforehand.

MR. CASHORE: I appreciate the clarification and the figure of 6.5 percent. It seems to me that it would have to be at least 6.5 percent, given the program that we have been launched into with regard to the very significant changes that are taking place within this province in the field of mental health care. That's not the voice of somebody who wants to shovel money out of the back of a truck by any means. That's the voice of somebody who's saying that the government has recognized that it has launched itself on this transition in mental health care within this province, and that in order to make that transition work, there needs to be a massive, successful job done of preparing the community to handle that transition.

I think where the minister and I come to disagreement has to be with regard to whether or not the government has done what it has said it is going to do in preparing and assisting the community to enable this transition to be made in the most wholesome and helpful way. I don't think that has been as

[ Page 2461 ]

successful as you would like it to be. I think we can point to some data to indicate that there are some very serious problems festering out there as a result of the inadequacy of the follow-up of the second phase of that program.

I would just like to say that the point I am making is underlined to some extent by the fact that we have been promised a review of.... It was going to be a draft mental health plan. We were told on May 7 that that plan would be available within two or three weeks, and I don't think it has been made available to us yet. I'm really wondering what's happening out there. Something doesn't fit. Some part of the plan is on hold or there is some kind of problem. As a member of the opposition, I'm not able to get a handle on it. I don't think it would be a problem for the minister to stand up in this House and say what the problem is. This plan has been promised for so many months now that it's going on to years, and it is still not forthcoming.

I think that something has gone wrong with that plan, and that plan isn't tying in part with the delivery of mental health services in the community. It's awfully hard to put our hands on that. I wonder if the minister would comment.

HON. MR. DUECK: The report you are referring to was a very extensive one with much consultation with many people. I understand there were roughly 2,000 submissions. All I can say is that many things in government are frustrating; they go slower than I would like to see them go. Since we've had so many studies and reports going at the same time, we just couldn't find enough people to complete it. It is getting closer to completion, and we should hear something shortly. It will be made public when it's completed and we decide that it's in the form that we wish to release it in.

If I could just deviate for one moment, with the member's indulgence, to a question asked by the member for Prince George North (Mrs. Boone), I think I gave some misleading information on child development centres and the cost of physios and the $5 charge. There is no user fee for physics in child development centres, but it's very difficult to get physios, as you well know. We're trying to change the legislation to relieve that. We've put an additional $1 million into that program. The problem is that a lot of people cannot wait. They cannot get on with the physiotherapists in the child development centre, and they go to a private physio, and there they would have to pay the $5 charge. I thought I would just mention that.

I'm sorry if I interrupted you. I thought it was important enough that I not give you wrong information. I apologize for that.

MR. CASHORE: I do have a few more questions to pursue with regard to the theme of mental health services in the community. I would like to follow on with that tomorrow, because I know there isn't time before 10 o'clock to deal with those.

Perhaps there is a short question here that I could squeeze in. It has to do with the uniform mental health act that we referred to during some of the legislation discussed here a week or so ago. I wonder if for the record the minister would tell us what the purpose of the uniform mental health act is and give us some idea of a time-line — what we might be able to expect in terms of consultations with other provinces, with a view to when such an act might come into existence.

HON. MR. DUECK: This has been under discussion for some time. I'm sure the member knows more about this than I do. Our executive director of mental health services has participated in a committee of the Uniform Law Conference of Canada preparing model mental health legislation for possible adoption with or without amendments by provincial jurisdictions — in other words, to have a uniform law that applies to all the jurisdictions throughout Canada. Since this is open information and since mental health legislation can be contentious, there is a potential for reaction from consumer groups and legal advocates via the media. This is something that has been worked out by these people on their own, and I think it's very good legislation. I don't know where it is at this time.

The Uniform Law Conference of Canada is comprised of designated representatives from provincial jurisdictions, prepares model acts on selected subjects and recommends them for adoption in the interest of uniformity. Currently a committee of Uniform Law Conference commissioners and mental health directors from seven provinces, including British Columbia, is preparing a draft bill which will eventually be presented to the Uniform Law Conference for consideration. This model act will not be binding on any provincial jurisdiction, but it can be used to promote consistency on key elements of provincial mental health legislation across the country.

My understanding is that the model act, if adopted by the ULC, will be released for public consultation at the provincial level. If, and or when the model legislation is released, I will review the document and its implications to provincial legislation, the context of the feedback, and wide range of concerns of individuals and organizations, and this will probably entail a public consultation process similar to that currently underway with the mental health services planning. So it's in the works. I could probably get you more information by tomorrow. The assistant deputy is not with us today, and I'm sure that he would probably have an update on that.

MR. CASHORE: Mr. Chairman, I would like to take this opportunity to commend the ministry and its staff for pursuing this subject. I think the gift of a uniform mental health act will be something that will be of benefit to all of us in terms of the mental health of all of us. I really do appreciate this sensitive, persistent and consultative way in which this subject has been followed.

Mr. Chairman, I'd like to move that the committee rise, report progress and ask for leave to sit again.

SOME HON. MEMBERS: No.

MR. CHAIRMAN: Shall vote 38 pass?

SOME HON. MEMBERS: No.

MR. CHAIRMAN: You've all heard the motion. Shall it pass?

MR. CASHORE: On a point of order, Mr. Chairman. I'm confused with regard to what is happening right now. I wonder if you could explain it to me.

MR. CHAIRMAN: The question was called that the committee rise, report progress and ask leave to sit again.

[ Page 2462 ]

The question is defeated, so we're still debating vote 38. Shall the vote pass?

On vote 38, the member for Maillardville-Coquitlam.

MR. CASHORE: May I ask a question? Mr. Chairman: I had assumed that we were concluding at 10 o'clock, so I would appreciate clarification on that.

MR. CHAIRMAN: I don't think the time was set for 10 o'clock as a definite time, hon. member, so we will proceed.

MR. CASHORE: I would like to come back to the subject of the services for mental patients who have been discharged from hospital. I think that we're dealing with a subject here that was outlined in an article in the Vancouver Sun on February 26. I would think that your deputies, Mr. Minister, are aware of some of the current concerns that were expressed at that time. It had to do with the fact that there seems to be a shortage of spaces in the two major hospitals — the Vancouver General and St. Paul's — to be able to accept the volume of mental patients brought in by the police, ambulance, by themselves or by their friends. Often these people are either diverted to another hospital....

[10:00]

Sometimes apparently there's a computer process involved in these diversions at times, and sometimes the computer breaks down. Patients who are in an acute stage of illness have to be taken to a number of different places before they're able to get help. According to this article, some of them, because of the shortage of beds, end up being what they call "streeted " — put back out onto the street. It appears we have a serious problem as a result of the changes in beds in hospitals such as Riverview and the downsizing of the number of beds: that increasing numbers of people out in the street require hospitalization, and some of them are not able to get that care when they need it because the beds don't exist. My point is that it appears beds have not been made available to deal with the number of cases that would obviously result from causing those people to leave hospitals such as Riverview.

I wonder if the minister would comment on that.

MR. BLENCOE: Mr. Chairman, could we get a clarification from the government House Leader, through the Chair, on the time expectancy this evening?

MR. CHAIRMAN: Does the government House Leader wish to comment in this regard?

HON. MR. STRACHAN: Well, it's not committee business to discuss what has been done by the Whips. We'll let the Whips discuss that and let the committee continue.

HON. MR. DUECK: We are aware that there are never enough beds in our system at any one given time in any one particular area. The Ministry of Health is, of course, aware of the increasing referrals to Vancouver hospitals for emergency psychiatric care as a result of the increasing population in the greater Vancouver area and a trend for persons with mental illness to migrate to Vancouver. Apparently there has been quite a shift in that area. During recent weeks, Vancouver General Hospital has experienced an unusually high demand for psychiatric treatment. I think this refers back to the time in February that you were referring to.

We are constantly monitoring it. We're doing our best to implement whatever we can to provide space for these people. There is a constant building program going on; there's a constant shifting of priorities. And when we find someone in need, they generally do get accommodated. I don't think we have, in the past, ever turned someone out onto the street because he couldn't be accommodated. But to say to you that we can accommodate them all without any problem and without transferring them would be saying something that isn't true. At times the system is full at one particular hospital and we've had to transfer someone to another facility to take care of them.

MR. CASHORE: I really do regret the implication that the subject we are discussing right now is somehow not worthy of this committee. I'm discussing the subject of the delivery of mental health services in all seriousness. I have expressed in a very genuine way a great deal of appreciation for the Ministry of Health. I appreciate the candour with which the minister is answering my questions, but I do find it difficult to have it implied that this subject is not as vitally important to the people of British Columbia as many other subjects. I would beg the indulgence of the members of the House to recognize this.

To the minister, while you say that facilities are being built and beds are being made available, I think we do have evidence that it's not working. We hear this story in all parts of British Columbia; we don't hear it only in the lower mainland. I'm focusing in on the situation here in the lower mainland. I've heard community workers say that the downtown east side has become a dumping ground for people who are faceless victims of this process of change that is taking place. This is tragic, if indeed it is true. I am endeavouring to discover whether or not this is really true, and whether this government does have answers to the kind of information we have forthcoming from people working in the field.

I would just like to point out that the Mental Patients' Association, an organization that I have worked with for a great many years in the mental health field, and one that has its feet solidly on the ground with regard to these issues, has pointed out to me that there is an increasing incidence of statistical evidence that patients who have been discharged from hospital are increasingly getting into difficulty with the law.

For instance, in June 1983 there were 2,831 court appearances; of those, 1,022 were facing new charges. That means that of that total, a number were facing more than one charge in coming into difficulty with the law. In 1985 that figure went up to 3,094, and in 1986 the number of court appearances of that same group went up to 3,970, with 1,436 facing new charges. That was in the downtown Vancouver area. The most frequent of these charges involved people charged with theft under $1,000, assault, mischief and obtaining food by false pretences.

I think we see an increasing pattern here. There is more and more evidence that people who have a history of mental illness and who are at large in the community are simply not coping. The services are not there to enable them to cope. Some segments of our community feel that these people have been dumped, and there is no follow-up. In a number of years of working in the mental health system....

MR. CHAIRMAN: Order, please, hon. members. The member for Maillardville-Coquitlam has the floor and is

[ Page 2463 ]

doing his best to make some points. I think it is incumbent on every one of us to see that this happens.

MR. CASHORE: I know there has been a continuing problem with the dilemma of a psychiatric patient being discharged from hospital and finding suitable accommodation. That has always been a problem. The point I'm making — and I believe it is borne out with these statistics — is that it's demonstrable that during the phase of downsizing, this problem of mental patients coming before the courts on these petty charges has significantly increased. With all due respect, I think this is an indication that something really needs to be done about this. This is not new information, as I pointed out; most of the points I've made were covered in Bob Sarti's article of February 26 in the Vancouver Sun. I would like the minister of comment on that.

HON. MR. DUECK: I just have one question. Are you suggesting that all these people who committed these crimes were mental patients?

MR. CASHORE: According to the figures I have from the Mental Patients' Association, these are people who that association works with as having been mental patients. What they have pointed out is that there has been an increase in the number of mental patients running into difficulty with the law. I would submit that this is one characteristic that often shows up when health starts to break down.

I do know, for instance, that the community care team in the downtown east side has had staff reductions during the restraint program. I know this has happened in other areas of the province as well. I am saying that the government stated during the beginning of deinstitutionalization that there would be sufficient support within the community, and I think we can find example after example to say that this is really not the case.

So yes, these are people with a history of mental health problems.

HON. MR. DUECK: I don't think we ever said that we would have unlimited funds. We said that we would certainly increase our funding in this area, which we've done by $7.635 million. I'm not saying that is sufficient: I'm not saying that is the ultimate number or the magic number. But we have significantly increased.

The other point I'd like to make is that the Ministry of Health of course has no control over someone who commits a crime. We can't then say: "You must take counselling." We have no right to interfere. They must come to us and ask. We can't ask for counselling. They must commit an indictable crime, where they be put away, whether in prison or in an institution, so it's not.... I'm sure the member is aware — I certainly don't have to tell him — that just because there are all these people in the community committing crimes.... The choices of the Ministry of Health are limited, really, as to those people, unless they're referred by the courts to take counselling, and even then we find again and again that they won't accept counselling. This also applies for people on parole, which I'm sure you're aware of. They are granted parole subject to certain psychiatric treatment, only to find out that it is for one or two times and then they take off — many of them do; many of them, of course, go through with it. So our control is limited when it comes to people in that area of criminal offences, because they have a handicap unless they in fact wish to have this treatment, and then of course our ministry gets involved.

MR. CASHORE: Mr. Chairman, it would be perhaps more possible to get at the truth on this issue when that study is finally tabled; and I do hope that the minister intends to table it when it is available. and I hope that it will be available with all dispatch, because I think the situation is.... For people who live and work in areas where they are having to deal with this situation every day, it is an emergency. It's a crisis, and it cannot be explained by saying: "Well, you know we can't be responsible for every mental patient." That's true. We've always had people in our society who were awfully difficult to deal with. But the preponderance of evidence shows that this situation has drastically increased in the last three years. So I believe that it's very important.

[10:15]

I would like to ask the minister if he will agree with me now that there is a need for that particular issue to be studied in target areas such as the downtown east side, to see if the points that I'm making are in fact true and if there is a problem that could be improved, perhaps through a street level community health clinic or some sort of emergency situation. I know the minister said the other day that he wasn't going to allow a certain situation to happen at Royal Columbian Hospital, and he was going to investigate it. Would the minister also offer the same courtesy to the kinds of crisis situations that ex-mental patients and those who care about them are facing in the streets of our cities?

HON. MR. DUECK: Mr. Chairman, the commitment I have made all along from when I was first appointed is to do the absolute best that I can with the funding that is given to me. I have to tell you quite frankly that I can only do so much, and with the $7 million increase that I got, I'm doing everything I can. I know there has been an increase in this particular area, and the statement I believe you made that this government is not that concerned about this particular problem or this particular segment of society is just not true. At least, from the Minister of Health's point of view it is not true; I have to say that categorically. I'm very concerned about people in that particular society, and about how we are going to resolve it. It can't always be resolved just with money. I'm aware of that. Perhaps you have some ideas, because you've been in that field, and I would not at all be reluctant to speak to you when all this is over and the House is no longer sitting. Maybe we can even tour the area and look at the situation. I would appreciate your help.

MR. CASHORE: Mr. Chairman, I would like to do everything I can to follow up on that suggestion. I was not suggesting that the ministry is not concerned; I believe the ministry is concerned. And such a thing as you and I going into one or two of these areas and visiting with some of the people who work in the area would certainly be a step in the right direction. I would appreciate that opportunity.

MR. ROSE: We can't get the vote tonight; we'll get it tomorrow, okay? So let's rise and report progress.

The House resumed; Mr. Speaker in the chair

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

[ Page 2464 ]

HON. MR. STRACHAN: Mr. Speaker, at the outset — I'll do this now in case I forget tomorrow morning — the Select Standing Committee on Public Accounts, which will be reviewing the auditor-general's presentation of the conference report, will be meeting at 8:15 a.m.

Interjections.

HON. MR. STRACHAN: Oh, it's been cancelled? Totally?

Interjections.

HON. MR. STRACHAN: Cancelled until further notice. Okay, so much for that one.

Hon. Mr. Strachan moved adjournment of the House.

Motion approved.

The House adjourned at 10:22 p.m.