[ Page 2889 ]

CONTENTS

Routine Proceedings

Oral Questions

Free trade and fish-processing. Mr. Miller –– 2889

Emergency health services. Mr. Harcourt –– 2890

Heart surgery waiting-lists. Mr. Harcourt –– 2890

"Gag order" to senior personnel. Mr. Lovick –– 2890

Howe Sound Pulp and Paper Co. Ltd. Mr. Williams –– 2891

Ministerial Statement

Open-heart surgery. Hon. Mr. Dueck –– 2891

Mrs. Boone

Miscellaneous Statutes Amendment Act (No. 4), 1987 (Bill 59). Committee stage.

(Hon. B.R. Smith) –– 2892

Mrs. Boone

Hon. Mr. Dueck

Mr. Skelly

Ms. A. Hagen

Mr. Cashore

Ms. Marzari

Ms. Smallwood

Mr. Sihota

Mr. Blencoe

Hon. Mrs. Johnston

Mr. G. Hanson

Hon. Mr. Couvelier

The House met at 2:09 p.m.

HON. MR. VEITCH: It is very great pleasure that I introduce a gentleman and a lady seated in the members' gallery. Mr. Karl Bertil Eriksson is consul-general of Sweden. Mrs. Karl Bertil Eriksson is also with him. I would ask the House to bid them welcome.

Further, Mr. Speaker, may I take this opportunity to congratulate the B.C. Lions Society for Crippled Children who held their telethon over the weekend. They raised $3,511,366. Fourteen hundred people donated their time to work on the telethon. The Premier and myself were down there, and we were very happy on behalf of the government of British Columbia to donate $40,000, which I'm sure acted as a catalyst in this very worthwhile endeavour.

MR. KEMPF: In the gallery this afternoon is Mr. Russell Brown. Russell is a native of Burns Lake and will soon be partaking in the internship program here in these precincts. I would ask the House to make him very welcome.

HON. MR. REID: I rise to invite some of the opposition members to be at the B.C. film industry for auditions in the coming week, because some of them could use some help. But that's not why I stood.

Mr. Speaker, it's with a great deal of pleasure that I introduce to the House today Mr. Don Bell, the former mayor of North Vancouver and the marketing manager for Canada Safeway.

MR. REE: I would like to echo my colleague's comments and welcome Mr. Don Bell, who has been a good friend of mine and a good supporter for quite a number of years.

Mr. Speaker, I would ask this House to welcome a group of 47 students from Handsworth Secondary School in North Vancouver. They are under the guidance of their teacher, Mr. Jim Adams.

Mr. Speaker, of the group, there are 15 that have done a most commendable job in putting a brief together on the free trade issue, which they have presented to the federal government. Over lunch today they met with myself and the hon. Minister of Economic Development (Hon. Mrs. McCarthy) for over an hour and for lunch period, getting information from the provincial government for the preparation of a brief to the provincial government on free trade. I would ask the House to welcome these students to Victoria and commend them for their efforts.

MR. CHALMERS: Visiting in the gallery today is someone who is a tremendous amount of help to me back in my constituency with my work serving the constituents. She is my assistant, and she is here watching the proceedings this afternoon and visiting with a number of people in Victoria. I would ask you all to help me in giving a warm welcome to Susan Aitken.

MR. SIHOTA: On a similar note, in keeping with the comments made by the second member for Okanagan South, I must report to the House that all of us have constituency assistants and that the best constituency assistant in this province happens to be working in Esquimalt-Port Renfrew. She is seated up there today in the gallery — my constituency assistant, Sheila McFarlane. Would everybody please give her a warryi welcome.

HON. MRS. McCARTHY: I would ask the House to welcome two people in the gallery today. Mr. Henry E. Justesen, who contributed to our educational services earlier in his career and now is in the business community, is in the gallery, along with Mr. H.Y. Yeh, who is one of our international people here to assist us with the economy of the province. Would you please welcome them.

MR. HUBERTS: In the gallery today is a great friend and a constituent of mine, Mr. Martin Oliver. Will the House make him welcome.

Oral Questions

FREE TRADE AND FISH-PROCESSING

MR. MILLER: My question is to the Premier. The east coast Premiers, who did not give Mulroney a blank cheque on the free trade deal, have been able to win concessions, namely that fish caught in Atlantic Canada must be processed in Canada. Why have you failed to win similar concessions for B.C.?

[2:15]

HON. MR. VANDER ZALM: This has not been a matter of negotiations. The Prime Minister has kept us extremely well informed over many long meetings over the past many months. At no time did Premiers negotiate or did the Prime Minister negotiate with Premiers. This is a federal initiative. It's within their power to in effect arrive at an agreement between the United States and Canada.

British Columbia has certainly gained tremendously from the free trade agreement. It will be one of the best things that's happened to the economy of this province. I appreciate that it may be somewhat against socialist philosophy that we establish between two nations the opportunity to trade freely, but it will certainly help all people of this economy, regardless of their philosophy.

MR. MILLER: It's a very interesting revelation by the Premier that the Premiers had no input into the free trade discussions. That's certainly news.

Mr. Premier, we're talking about a $750 million industry and 8,000 jobs in British Columbia. What steps are you prepared to take if the preliminary ruling from GATT is finally approved?

HON. MR. VANDER ZALM: First of all, I should correct what unfortunately happens so often when the member makes a statement such as that. I did not say that we did not have input. There is a difference between input and sitting down to negotiate. We certainly did have every opportunity for input; and input was provided on behalf of people everywhere, including British Columbia.

With respect to the other part of the question, there is a difference between the free trade agreement between Canada and the United States and GATT. We're a member of GATT. GATT makes its rulings. I suppose we could get out of GATT, which means that all sorts of actions could be taken against the country without our having the opportunity to'respond to those actions. The country and the Premiers and the Prime

[ Page 2890 ]

Minister have decided that we definitely want to participate in GATT and want to continue to participate in the GATT process.

MR. SIHOTA: What about fish-processing?

HON. MR. VANDER ZALM: The member says: "What about fish-processing?" It does not mean that every decision that comes down will be to our liking. I think we would have to be like a bunch of spoiled kids if we thought we could be members and still have all things our way.

We will have many decisions made by GATT that will be of benefit to the country and to the province; we will have decisions made by GATT that will require us to make adjustments. We've had good discussions with respect to the decision made by GATT on the processing of fish in British Columbia, and I'm happy to tell the members across the way that it is being resolved very effectively by our federal government at the urging of our provincial government.

MR. MILLER: Again to the Premier. That's not what I hear, but it's interesting to say that all you could do was talk to the Prime Minister; but clearly he didn't listen. I'll restate the question: how come the Atlantic Premiers were successful in getting that kind of protection for processing fish in Atlantic Canada, and you weren't?

HON. MR. VANDER ZALM: The member obviously is not clear on the contents of the agreement. I can appreciate that, because it's a difficult arrangement and the details may appear somewhat confusing, especially when one goes in looking at the details with a very negative view. I will be pleased to provide those details to the hon. member at another time.

EMERGENCY HEALTH SERVICES

MR. HARCOURT: I have a question for the Minister of Health. On November 25, an elderly patient in need of critical care was shuffled around the lower mainland in an ambulance to three different hospitals. I have a letter from the woman's physician addressed to the minister, describing how she was bumped from the Royal Columbian Hospital, was refused admission in Surrey and finally ended up in a chair, at night, in the Langley emergency ward.

I want to quote the doctor, Dr. Warneboldt, who wrote: "It is only a matter of time before somebody dies in an ambulance while being diverted from hospital to hospital." My question is: will the minister recognize the importance of access to vital health care services for all British Columbians, and will he make sure that there are the necessary funds for emergency care at hospitals such as the Royal Columbian?

HON. MR. DUECK: All I can say is that I do recognize the need, and we're doing everything we can to correct it. There have been times, perhaps, as you mentioned, when an ambulance has gone from one place to another. I don't know that particular instance; I haven't got the information in front of me at present. But I can assure you that even with some of the faults in the system, we're providing excellent health care. In that particular case perhaps it was wanting, and it should be corrected. We're constantly reviewing and correcting our plans in delivery service.

HEART SURGERY WAITING-LISTS

MR. HARCOURT: Mr. Speaker, I have another question for the Premier. I'm sure the Premier is aware that on Friday the Health minister told the House that his government is considering allowing another B.C. hospital to provide heart surgery. Can the Premier tell this House when British Columbians who are desperately waiting for this vital health care –– 400, as a matter of fact...? When will the government deliver on the promise given by the minister on Friday?

HON. MR. VANDER ZALM: I think the hon. Leader of the Opposition should know that this should be addressed to the minister. So I will defer to the minister.

HON. MR. DUECK: Mr. Speaker, I think I've gone on record as stating — and I'll say it again — that it is in my estimates for the coming year.

I have a good-news story, and I think this is the time I should mention it. I spent most of my morning yesterday with VGH. Some time ago — in 1986, just before I came into the ministry — we approved $2.7 million for development of their new heart surgery facility. That is not completely finished, but they have moved into the facility. They assure me that they will do their quota of heart surgery before the end of the year. That's where some of our problems were. As I mentioned before, we had allocated funds for 2,200 and some; only 1,700 were done in a 12-month period. They now assure me that they will be able to pick up the slack they were falling short on. The chairman of the board and the president of the hospital also assured me that they have never turned away from the hospital, nor will they ever turn away, someone who is in an emergency. He said: "We make that very, very clear." But having said that, he also said that it's very difficult to make a judgment call, that very often people do have heart attacks or a stroke or what have you at a later time, and because there is a waiting period perhaps emergencies are looked at a little differently than if there were no waiting period. But they assure me that they will catch up with the 90-odd cases that they were behind.

"GAG ORDER" TO SENIOR PERSONNEL

MR. LOVICK: My question is directed to the Minister of Transportation and Highways; it's very short.

Not many days ago the minister formally announced that he was rescinding a gag order that was given to public servants. There is now, however, another gag order, a memo dated December 3 to senior personnel in the Ministry of Transportation and Highways. In that memo the senior personnel are instructed not to talk to the media about "privatization and legislative matters."

My question to the minister is just this: will he assure this House that he will also rescind this gag order, and that he will do so right now?

HON. MR. ROGERS: As I told the member previously, the original communication did not come from my office, nor did the instruction to rescind it. I am not aware of what particular document you are referring to now, but it did not come from my office. I'd be pleased to have a look at a copy of it and find out where it originated. I don't normally take it as my responsibility to rescind instructions given by other people, but I am curious as to why it's come forward. I'd like

[ Page 2891 ]

to see it. I'd like to see if it was done by someone in my ministry or by someone outside of my ministry.

MR. LOVICK: A supplementary, if I might, to the minister. The minister should know that the memo comes over the signature of his deputy minister. And given that we have already had assurances that this new minister is going to take a hands-on approach to the affairs of his department, will he inform the House whether the deputy minister is working entirely on his own initiative, or whether he is in fact in charge of that ministry?

HON. MR. ROGERS: I don't lean over his shoulder and look at everything he signs. I'll certainly find a copy of this. It didn't come with my instructions on it, so we'll see.

MR. LOVICK: Just once more, if I might, again to the minister. Will the minister then at least tell us in this House that he deplores this effort to gag public servants? Will he go that far at least?

HON. MR. ROGERS: I'll look at the memo, see what originated it and make a decision in time.

HOWE SOUND PULP AND PAPER CO. LTD.

MR. WILLIAMS: To the Minister of Economic Development. Yesterday the minister announced a billion dollars, which was short by two-thirds. The question is: the backers of the project, Cantor and Oji, are requesting electricity subsidies. Canfor has made an estimated quarter of a billion in profits for the last two years and next year, and Oji is, of course, a very successful company. Is the minister actively considering a welfare subsidy to these extremely successful companies?

HON. MRS. McCARTHY: First of all, may I just correct the member. When I said that over the next three or four years it could amount to a billion dollars I gave the specific amounts. If he checks Hansard, he will find that the modernization of the mill at Port Mellon would be $280 million, and I announced that the new $355 million newsprint mill for startup in 1991 would amount to $355 million. I said in my statement that the total would be $635 million.

In terms of what benefits the company would need at the present moment, I also mentioned in my statement that they have not asked for anything that has not been asked for by anyone else. It's just a question of.... There has been nothing given and there have been no commitments given to either firm or to the amalgamated firm.

Ministerial Statement

OPEN-HEART SURGERY

HON. MR. DUECK: I'd like to make a ministerial statement, if I may.

Mr. Speaker, I rise today to clarify a comment I made in this House last Thursday, December 3, regarding open-heart surgery. I regret that the general interpretation of my comments was that I personally feel that open-heart surgery is a trendy status symbol. This was a quote that I read out; it was not my feeling. The point I was trying to make is that there is a broad school of thought from the medical profession itself as to whether or not the practice of open-heart surgery is always the best solution to this serious physical problem surrounding heart ailments.

[2:30]

Certainly in the past 20 years, since the first heart transplant operation revolutionized medical practices in this area, many, many lives have been prolonged. But today we are beginning to reach a crossroads of professional thought in this area concerning the potential of exploring alternative options to the traumatic and expensive procedure of heart surgery.

I wish to state today that I deeply regret any misunderstanding which may have resulted from the doctor's comments I quoted in the House last week. I feel it is important, however, to reiterate my contention that alternative methods to open heart surgeries be explored. Even the prestigious Journal of the American Medical Association, in a recent article prepared by four medical doctors, states: "Coronary bypass surgery could be postponed or forgone entirely in a significant fraction of clinically stable patients previously advised to undergo this type of procedure."

This comment was made at the conclusion of a study which was established to look at the question of bypass surgery in relation to other possible medical practices to treat coronary artery disease. A concluding comment from this article states: "This study indicates that second opinions for coronary bypass surgery have merit, and furthermore, that a large fraction of patients will adhere to a contrary opinion provided that adequate psychological support, reassurance and communication with the local physician is carried out."

Perhaps it is time we begin to listen more intently to this learned body of second opinions. In so doing, it may help to put us one step closer to reducing both the medical costs and the agony many British Columbians are now facing as they await admittance for open-heart surgery.

Enormous accomplishments in this field of surgical medicine cannot be denied. Indeed, the very system itself may have become a victim of its own successes. British Columbia provides one of the best health care services in this country. If we wish to maintain, and perhaps improve, that proud accomplishment, we must begin to look for more alternatives which will help sustain the quality of that care. It is for this reason that I have asked the advisory subcommittee on cardiac care to look at the standard practices applied in the field of open-heart surgery in this province and to consider establishing guidelines which may help to alleviate the degree of current concern.

I would like to add in conclusion that I inadvertently referred to the health ethics committee with respect to such a review last week. It is the subcommittee on cardiac care, which falls under the umbrella of the professional advisory committee of the British Columbia Medical Association, that will ensure the continued involvement of the medical profession in reviewing these difficult issues. The ethical committee and the committee on cardiac care are somewhat overlapping, and this is why, perhaps, the confusion comes in.

The ethics committee is to identify and clarify major ethical issues in the field of health care, such as those related to unwanted pregnancies, abortion, euthanasia, genetic engineering and the use of human embryonic tissue for scientific purposes; secondly, to review the range of standards and solutions extant in other health care jurisdictions, to seek and develop areas of consensus in British Columbia in respect to such issues and to advise the Ministry of Health and develop

[ Page 2892 ]

practical guidelines for the handling of such issues by the health field in British Columbia.

The cardiac care committee is to look at and provide the ministry with data on the incidence of coronary artery disease; the criteria of coronary bypass surgery and coronary angioplasty; the number, age-group and sex-mix of patients needing these individual services; data on the number of angioplasty procedures required and repeat procedures and/or eventual coronary bypass surgery and in what time frames; and the impact of coronary angioplasty and coronary bypass surgery and the demand.

I hope this clarifies my position with respect to this sensitive issue. While I recognize the anguish of those who must deal with the uncertainty of heart ailments, it is, as I have stated before, not just a funding issue; but also, as new medical advances occur, the waiting-lists will continue unless we can find some available alternatives. And as I mentioned earlier, we are now catching up with VGH being on stream.

I should mention, too, that with new methods on the market at all times.... I was at VGH yesterday, and they brought in a new lithotripter, which will crush gallstones and eliminate the use of surgery which takes an individual into the hospital for many days. In this way it will be one hour and they can be out. That's on an experimental basis. They already have a lithotripter for kidney stones. With new innovative ideas coming on the market and new technology, I think we are heading in the direction of planned health care, and we will continue to do so.

MRS. BOONE: I thank the minister for giving me advance notice of that. I appreciate having this in advance, as the other one wasn't.

The apology that the minister gives, I think, is owed to all the heart patients out here in British Columbia. I'm sure that they really accept this and welcome the apology you've made.

I also welcome a review of the practices in open-heart surgery with a view to finding more alternatives. I think all of us would like to find alternatives to expensive surgery. However — and this is a big however right now — it is an issue of funding, Mr. Minister; it is an issue of funding right now. We have hospital areas in Royal Columbian Hospital that have the ability to perform open-heart surgery. They can perform about 300 open-heart surgeries, but there isn't the money to equip them. We do not have enough critical care nurses, and the minister constantly quotes that. But we are doing nothing to encourage critical care nurses to come into the field. We do not support them in their efforts to obtain training; we do not give them any funding. We do not even give them leave of absence with pay, Mr. Minister. We give them leave of absence without pay, have them pay for their own training, and then expect them to come into an area and not get any extra money for it. Are we surprised that there are no critical care nurses out there? I'm certainly not.

We have people waiting right now for open-heart surgery. They've been placed there by their physicians. What are the alternatives that you have now? You don't have the alternatives. You are asking these people to wait and are putting them on waiting-lists for surgery in the hope that you're going to find alternatives. You're telling us that you're going to establish guidelines. What guidelines have you got right now? You don't have them. What guidelines do the physicians have? You don't have those either. Will you be using these guidelines under Bill 59 to deny people surgery? Is that what Bill 59 is about?

Which of the many people already out there waiting for open-heart surgery are you willing to tell that they have to wait, that they haven't the option, that there are alternatives for them? There aren't any alternatives. How many more people are we going to see die or wait around while you explore out there to find the alternatives? The people of British Columbia, Mr. Minister, want action right now. They don't want to wait for the alternatives to come about. We can't wait while you go exploring.

Orders of the Day

MISCELLANEOUS STATUTES
AMENDMENT ACT (NO. 4), 1987

(continued)

The House in committee on Bill 59; Mr. Pelton in the chair.

Section 6 approved.

On section 7.

MRS. BOONE: I have some very strong concerns about this section of the bill. This gives the minister some incredible powers, powers that we on this side do not trust this government to use in the best interests of the people of British Columbia.

I'd like to ask the minister, please, if he has any idea what types of treatment may be determined that people do not require.

HON. MR. DUECK: This particular legislation is not what the opposition feels it is at all. It is companion legislation that goes in tandem with what the Medical Services Commission has at this time.

The problem we're having is that certain surgery — for example, if you want to have examples.... And we're doing that now. The Medical Services Commission, in fact, says that one service is not going to be paid for and another service is. They've done it all the time. Otherwise you could have acupuncture or chelation therapy come in, and if we didn't have some restriction, it would all be covered under MSP. So you have to have some regulation that says: "These are the items we're going to cover." Of course, all the ones under the federal act are automatically covered; anything else supplementary, where the province pays out of their own pocket, the Medical Services Commission has that authority under the ministry. But what we didn't have under hospital....

In other words, if somebody had a transsexual operation, which would not be covered under MSP, they could still go to the hospital and the hospital would in fact pay for that patient's days in the hospital. All we're doing now is that if you have something that is not covered under MSP, it will also not be covered under the hospital. That gives me the authority...not me personally but our medical staff has the authority to make that decision.

MRS. BOONE: Set me correct if I'm wrong on this, but I understand that things can be eliminated from the Medical

[ Page 2893 ]

Services Plan by order-in-council, through the regulations. Is that not correct, Mr. Minister?

HON. MR. DUECK: Yes, the same as MSP. We could eliminate any of those supplementary services — which you are well aware of — at any time, but not anything that's under the medical plan with the federal government, where we have the funding relationship with the federal government. Anything that we fund on our own in this province, yes. And we can add also.

So you want us to say that we should not add or eliminate? We've added all kinds of functions in the last so many years under MSP; that was the authority we had. But we never had companion authority with the hospitals. What we're saying now is that if we should eliminate, for example, cosmetic surgery, other than a child in the hospital for medical reasons and what have you, then that individual would not get paid for the doctor's fees. But the hospital would continue to pay, and that person would have no charges for hospital stay.

If it's not covered by MSP, it will also not be covered under the Hospital Act, provided we decide that it shouldn't be. That is a very common occurrence. No one has ever complained about MSP. We add services, we delete services, and it will continue to be so.

[2:45]

MR. SKELLY: What concerns me about this section is that it allows the minister to make the decision after the fact. After the surgery or the procedure has been done by the doctor, after the services have been obtained in the hospital, the minister or the ministry can review the medical evidence and decide whether this is a service that's going to paid for under the Hospital Insurance Act. That makes it extremely difficult for somebody to go to a hospital or to take a particular surgical procedure, because he knows that the minister or the ministry is second-guessing the doctor in the hospital on this issue.

I bring up a case that was brought to me by a physician in Port Alberni, and that's the case of circumcisions. MSP now decides after the fact whether a circumcision is medically required or whether there's some other reason for it. The doctor now doesn't know whether the service is going to be paid for or not, or whether he has to go after the patient or not. As a result, the doctor now goes after the patient in every case for payment of this service.

One of the reasons we have to be concerned about this piece of legislation is that the minister is allowed to decide on a patient-by-patient basis. That's what the legislation says, in any case: that he "determines, on a review of the medical evidence, the qualified person does not require" a particular hospital service. That's why we're concerned about this particular section of the legislation. We don't know what is going to go into the minister's decision. He's not saying that a class of services or a class of procedures.... You're saying that in the Legislature, but you're not saying that in the legislation. How do we know whether a particular patient requires that class of service or not? Now you're taking it upon yourself to do this on a patient-by-patient basis.

This section allows the government, a minister who has no medical training whatsoever, to decide whether a particular patient is going to receive a particular service and be covered under the Hospital Insurance Act for that service. That's why it appears to us to be a dangerous piece of legislation, because you're not barring a particular class of service. You're examining the medical records of a particular patient to determine whether that service or that procedure provided by the doctor in a hospital should be compensated for under the Hospital Insurance Act. How do we know that it's not being done on a political basis? How do we know it's not being done on an economic basis, after you've reviewed that particular patient's medical evidence? I think this gives you a dangerous amount of power. I think that if a particular service is going to be excluded, then it should be spelled out clearly, and it should be excluded, I suppose, for every patient, regardless of the medical evidence.

How are we going to hold the minister accountable in the Legislature for a decision made with respect to a particular person receiving service in the hospital? At all times you should be accountable, and you can't be held accountable here on the medical evidence, because we don't have the right to review it, nor should we have the right to review it. Nor should you have the right to review it.

In my opinion, this is a very dangerous section. A patient can be referred to a hospital by his or her doctor, can receive a service in the hospital, and then after the fact. for reasons known only to the minister, can be disqualified from receiving payment. That's a dangerous situation because the patient can't hold you accountable, the doctor can't hold you accountable and we can't hold you accountable because you're practising medicine without a licence.

HON. MR. DUECK: To begin with, it's not me personally who is going to review the file, that's for sure, because....

Interjection.

HON. MR. DUECK: Well, it has to be the minister because he's responsible for that ministry, which you well know. But it's companion legislation which we have in place now, and the wording is exactly that, and I read from section 4.04(g): "...service that the commission determines, upon review of the medical evidence, is not an insured service because the service so rendered was not medically required by the patient." So in other words, what we're saying is that it is companion legislation to that which has been in place for a long time. In most cases, if someone wants certain surgery — and I again refer to the classic cases such as cosmetic surgery for someone with wrinkles, or perhaps transsexual operations — the doctor will say: "I'm sorry, but these are not covered. It's automatic; it's not going to be covered in the hospital."

Now if an individual comes to the hospital and wants surgery done, and does not know and does not check in advance, there could be cases, as there are cases now under the Medical Services Plan, where we in fact turn them down after they've been to the doctor. But I don't see any other way that this can be done. The way we've got it set up I think is very fair. We have a medical doctor in fact on staff who reviews these cases, which happens not too often because most items that are covered or that aren't covered are well known. So I don't see any problem whatsoever in this area.

MRS. BOONE: There have been changes to some of the things that are covered in Alberta, and I'm wondering if the minister can confirm or deny whether some of these things are being looked at by his ministry with regard to being removed or eliminated. Some of the things that they took out

[ Page 2894 ]

of the Alberta legislation were contraceptive counselling, vasectomies, tubal ligations and circumcision, as we mention here. Is the minister reviewing all of those areas, and is he considering removing these from coverage under the Medical Services Plan?

HON. MR. DUECK: Circumcision is already not covered in our province. With regard to the others, I'm not going to detail what may or may not happen in the future. The items you mentioned are currently not under consideration.

MRS. BOONE: Mr. Minister, you're asking us to put a tremendous amount of faith in you here, because you're not telling us what things are being considered. You're not telling us what may or may not be part of the changes that are coming forth in the future, yet some time down the road we may suddenly find that all of these things that I mentioned — birth control methods, IUD insertions — are not available to people. These things are very, very scary to the public when they don't know. When you put such a thing in blanket legislation like this and then don't tell us what you're considering, and you won't even tell us what's on your agenda, how can we have faith and accept that you are not going to eliminate these things, that it's not going to jeopardize the health of a lot of people? Particularly the things that I mention, of course, affect women to a great extent. How can you expect us to accept this at its face value when you won't tell us what you're considering?

HON. MR. DUECK: Mr. Chairman, I guess as long as governments have been in this present form, governments have added services. Governments have deleted certain services or procedures that they paid for under certain plans. Since we have a universal plan that's partially funded federally and partially provincially only, I think it's the duty and mandate of the government to add.... Over the years I heard no complaint when we kept adding services. Nobody said: "Oh, gee, don't do that without telling us." There may be times when we have to eliminate some, because we want to make sure that this health care system is sound and financially able to carry the basic health care services. Some procedures may be eliminated over a period of time. We have eliminated some and we've added some. This is what I'm saying. All we want is to have companion legislation that covers the same as what's in place now. That's all we're doing with this legislation — making it equal.

MS. A. HAGEN: Perhaps I could pursue the line of questioning in the context of the companiability of these two sections, understanding that the minister has said to us that the purpose of this particular amendment is to bring the Hospital Act into the same context, to use companion language to what exists in the Medical Services Plan.

I think one of the things we are trying to understand here, Mr. Chairman, is what may be affected by this particular program in the way of hospital services. The minister has suggested that there may be services that are not covered under the Medical Services Plan, but because they haven't had this particular clause in the Hospital Act, they may in fact be funded under the Hospital Act.

Perhaps what we might do is to work backwards, recognizing and acknowledging the minister's comment that there may be services that are added or subtracted from those that are covered under our medical plan, whether it's MSP or hospital services. Perhaps the minister could give us some idea of those services that are currently excluded under the Medical Services Plan. Then could he respond to what I might hypothesize: that is, if these are in fact excluded under the Medical Services Plan, and this amendment is passed by this House, we might presume that those same services would be excluded for coverage under the Hospital Act. That might give us some concrete examples of the current state of exclusions. I don't think we're looking to bind the minister to the fact that there might be further exclusions as time goes on, but for now it would at least frame for us what is excluded under the Medical Services Plan and what would be excluded under the hospital services delivery system. I shall try, Mr. Chairman, to keep my eye on the minister instead of that extremely vivid tie of his seatmate, the Minister of Tourism (Hon. Mr. Reid), who is about to leave.

HON. MR. DUECK: Mr. Chairman, the federal government at this time doesn't have a list of medical services that are included or excluded; they just say "medically required." We're going under that same basis. If we feel a certain procedure is not medically required and we no longer wish to include it for coverage by provincial dollars, then we may eliminate that particular procedure. But anything that's medically required is covered under the federal health plan, and that of course won't, change. Even if we tried, we can't change it. That's part of their scheme and agreement with the provinces. But there are certain procedures that require a judgment call and these may.... I'm going back again to perhaps certain experimental surgical procedures. There are all kinds of things that may happen; and some of you come along and say: "Well, I had it done by a doctor, therefore I'm entitled to have this done by the physician and also entitled to have hospitalization." We can't do that. We're saying now that the authority is there under MSP to look at it and say: "No, we're not going to cover this under MSP. It's a judgment call; it's not medically necessary." We're saying we want that same authority to say under the Hospital Act, and we can say: "It's not covered there; we're not going to cover hospital payments either."

MS. A. HAGEN: Perhaps then I could rephrase the question to see if I can get a more concrete answer, because I think there are some more concrete answers. With respect, I think the minister's answer still deals with the broad methods by which one would deal with this. Let me ask then what procedures presently aren't covered by the Medical Services Plan and would presumably not be covered by hospital.

[3:00]

Let me take the minister's own words. He has has given us some indication that there are some classes, if you like, that are excluded from coverage. You've noted that circumcision, for example, is not covered under the Medical Services Plan. Could I presume then that that particular procedure would not be covered with this amendment under the hospital services act?

You've talked about cosmetic surgery, and I'm presuming that possibly that is not covered as a class under the Medical Services Plan. Is that one that would be excluded?

You've talked about transsexual operations. What's the status of that particular procedure under the medical services plan? Does that move into this area?

Are there other areas — and I want to pursue the areas, raised by my colleague for Prince George North (Mrs.

[ Page 2895 ]

Boone), having to do with fertility: procedures having to do with tubal ligations or vasectomies or the insertion of IUDs — that have any exclusion under the Medical Services Plan? And would those then not be covered under the Hospital Services Plan'?

What I'm asking the minister.... I want to try to be very clear, because I recognize that there are two possible answers to these questions, and I'm wanting us to try to find out what those answers are. I'm asking him if there are some classes, procedures, that might be grouped under some headings which are excluded under the Medical Services Plan and which would be affected by this amendment.

I think I'll stop there, because then I will follow with another clarification about matters that might be looked at more on an individual-case basis, rather than on a class basis as a group of procedures.

HON. MR. DUECK: I just want to, again, elaborate and perhaps explain a little more closely what we're looking at and why we need that authority to make that judgment call.

For example, if we said all cosmetic surgery would be eliminated, we would then perhaps come across a situation where a child was born with some disfigurement where cosmetic surgery would be very necessary, and we would not want to exclude that. So there has to be some judgment call by a physician in our ministry who can make these decisions' otherwise, we either eliminate or add, and where do you draw the line?

Other examples: experimental surgery unproven medically; cosmetic surgery without medical requirements — a child would certainly fall under the category of medical requirements, because that child would definitely need that type of surgery. And there's chelation therapy. I've gotten letters by the hundreds wanting us to pay for chelation therapy. Well, until that has been proven medically, we're not going to do it. Under this authority we can say no, not until it's proven medically. But if we had some doctor come along and say, "Yes, I believe in it and I'm going to do it," and we didn't have the authority, we would pay. I think that's unfair to the rest of the citizens.

Abused procedures like excessive or experimental psychotherapy may be another one. There are quite a few which one can list, because we have quite a variety of medical people too, and — I'm sure you're aware of this — you have a difference of opinion where you have all kinds who would say: "I believe this is the right therapy or medical procedure for this particular patient." We say, unless we believe it's medically necessary....

There's no problem with anything federally, because that is decided by the federal law. So we're speaking of things that we fund provincially. I would say that to have this authority in tandem with the MSP is very necessary. It has been a long time coming, and we feel it's going to work well, the way it does with MSP. We have no problems at all with the MSP.

MS. A. HAGEN: I'd like a yes or no answer to this question. I'm not trying to phrase this in the sense of putting the minister on the spot, but I want to just clarify it before I decide whether to pursue a particular line of questioning or to shift my line of questioning.

Would it be fair to say that there are no procedures that are excluded from medical coverage at this time, and that each procedure is, in fact, accepted on its merits? The question I was trying to get at, Mr. Minister, was: at this time what is the list, if it exists, of specific procedures where there is an exclusion, by order-in-council or by whatever procedure it comes through the regulations? I want to know if there is a list of exclusions at this particular time that presumably would be affected by this. I'm not trying to put the minister on the spot at all as to whether there may not be changes in this. I'm wanting to know very clearly what the guidelines are now, what the list is now. Surely the people out there are not taking every one of these cases, nor are doctors trying to figure out in every one of these cases whether it's covered or not. I'll come back to the minister's own comments about circumcision and transsexual operations. Those are two that you've listed. Are they excluded from coverage? Are there others? Have you got the list? Can you give us that list? I went way too far for a yes-or-no answer, Mr. Chairman.

HON. MR. DUECK: I haven't got a list per se. Of course, under the fee schedule we do have thousands of items which are automatically there because they are medically necessary. But there are many things that come to our attention from time to time, and I mentioned some of them. There may be elimination of some programs such as transsexual operations, which you mentioned. It's no secret that some time ago I put a hold on all transsexual operations, but they has not yet been eliminated. Should they be eliminated from MSP, then of course they would not be covered under hospital coverage either. That's an example of what we're getting at.

MR. CASHORE: I find that last comment of the minister very intriguing. If I understand what the minister said, under MSP anything to do with transsexual operations is on hold, and by inference, that would be the same in the case of the hospital plan. Am I interpreting correctly what the minister has said?

MR. CHAIRMAN: I believe the second member for Victoria would like to make an introduction. Shall leave be granted?

Leave granted.

MR. BLENCOE: I appreciate the House allowing me this introduction. In the gallery this afternoon we have 12 students from the Inter-Cultural Association of Greater Victoria who are participating in the ICA's work search program. They are with their instructors,  Suzannah and Anne. Would the House please make these students welcome.

MR. CASHORE: Mr. Chairman, does the minister intend to state in response to my question that transsexual operations would not be allowed following passage of this bill?

HON. MR. DUECK: I'm not saying that at all, but this would give us the authority not to give hospital coverage if they were eliminated from the MSP side. However, all of these operations, of course, are done out of province, and they would have to have prior approval in any event.

MR. CASHORE: I would like to ask the minister if he would explain whether or not the reference he made recently to putting it on hold applies in this case. Does the minister intend to place transsexual operations on hold?

[ Page 2896 ]

HON. MR. DUECK: I have instructed my staff not to give any approval unless it is an operation that is already in process — to complete that particular operation because it requires, I understand, a number of trips to the hospital, not just one. I'm not sure, but we may have some that have gone part way, and I think it would be unfair to not complete that particular surgical procedure. Other than that, I have instructed them to not give approval to any new cases that come forward at this time.

MR. CASHORE: I would like to ask the minister if he would explain to the House, given the qualification he has just made, why he has placed this procedure on hold.

HON. MR. DUECK: That will come out once we do a review of a number of these items, and I cannot comment on that at this time.

MR. CASHORE: I hope the minister recognizes the dilemma that this places us in, having to vote when the response to my question cannot be forthcoming. We need to know the context in which this act will be acted out. If the minister is not able to answer my question, then it compromises our ability as a Legislature to make a knowledgeable decision with regard to what is before us. I am gravely disappointed that that information is not forthcoming.

I would like to ask the minister, with reference to a phrase he used a few moments ago.... I understand that the phrase was "medically required." I would like to ask the minister how he can reconcile the phrase "medically required," understanding that medically required is a "dynamic present reality." If something is medically required, it is medically required here and now. Could the minister explain how that is compatible with the concept of placing something on hold?

HON. MR. DUECK: I understand that we can, if we characterize it as a class, eliminate it from the plan right now without any legislation.

MR. CASHORE: I would like to ask the minister if he could explain how it is possible to place something on hold which may be medically required.

HON. MR., DUECK: That information and further information I will get from my medical people.

MR. CASHORE: I understand that the minister, in order to be able to make the kinds of decisions that he is given the power to make by virtue of the enactment of this legislation, will have to consult with medical practitioners. I would like to ask the minister if he can quote a medical opinion that would justify having placed this procedure on hold as something that, in all cases, is not medically required at this time, it being on hold.

HON. MR. DUECK: Now we're getting into medical practice. I understand that it's not "medically required," but perhaps "psychologically required." You can be very critical on that explanation. Perhaps some people would say it's medically required; I can get opinions from various medical people, and they can go and explain it both ways.

This legislation we're talking about really doesn't affect that, because I can do it right now without an order-in-council. I can classify, categorize and eliminate it. So the legislation that is before us.... We're talking now about something that perhaps we don't agree on. You say it should be covered and maybe we say it shouldn't, although that decision has not yet been made. But this does not affect this legislation; I think we're not talking about this legislation. We can do that as a class right now without an order-in-council, just with the authority we have, and so could you when you were in power.

MR. CASHORE: I would point out to the minister that a few moments ago when he gave two examples of procedures that could be affected by this legislation, he mentioned cosmetic surgery and transsexual operations. It's on the basis of the minister having used that example that we are pursuing it and trying to get some definition around how the minister views this.

Again, I would come back to the point I made a moment ago, that in order to vote knowledgeably on this, we need to recognize that we're dealing with an issue here that comes down to how ethical opinion is achieved with regard to certain types of procedures. This is an incredibly important issue for all of us. For that reason, I think that we are having a very significant discussion at this time in this House.

[3:15]

I would point out to the minister that when we talk about medical opinion, we should realize that the whole range of medical opinion, as recognized by the Ministry of Health, includes all specialties of physicians, from neurosurgery to all aspects of surgical work to general practice to psychiatry.

To just think of psychiatry for a moment, a psychiatrist, in preparing a medical opinion with regard to an individual, will include reports of psychologists, of people who have an awareness of the social milieu of the patient, including all kinds of consultants' reports, in order to make up a composite which forms a medical opinion. Therefore we cannot say that we're talking about something that may be for psychological reasons and suggest that it is somehow excluded from having a medical opinion. It is not. It is part and parcel of a medical opinion. It is basic to it, and I submit that it is immoral to place such a procedure on hold when it very well might be that it is medically required on the basis of those very physicians that the minister should be consulting with in order to form an opinion.

I find it absolutely astounding that such a procedure could be placed on hold when obviously there's medical opinion out there that would overwhelmingly recognize that you cannot base the need for that type of operation on one narrowly defined kind of evidence. I would like the minister to comment on that.

HON. MR. DUECK: We're not talking about legislation that would perhaps affect MSP. We're talking about hospitals. That's what this legislation is all about. The MSP is in place. Our physician can in fact say that this procedure is not medically required and not pay. All I'm saying is that we want companion legislation that will also give us authority to not pay for the hospital stay in case it is a procedure that the Medical Plan does not pay for. So let's not get into the medical side of it, because that legislation is there and it has worked very well. All I'm saying is that we haven't got the companion legislation; I don't think it was ever intended that way. But there may be situations — very few — where the Medical Plan does not pay and yet the hospital would have to

[ Page 2897 ]

provide space for a procedure that was decided not medically necessary by our doctor in the ministry.

MR. CASHORE: My question is this: assuming that this section of this bill passes, once it is enacted will, under the Hospital Insurance Act, sex change operations be on hold? Yes or no?

HON. MR. DUECK: If you're referring to that particular procedure, transsexual operations, this requires prior approval because they're done out of province. They currently are on hold.

MR. CASHORE: I don't think the minister is making clear what is meant by being on hold. I understand the meaning of "prior approval." To me that does not mean being on hold. It means requiring prior approval. In the view of the minister, are those two terms synonymous: to be on hold and to have prior approval?

HON. MR. DUECK: No prior approval has been granted from the time that I put them on hold.

MR. CASHORE: I think we have now got the answer that is the answer, which is that under the present situation and certainly continuing under the future situation if this is enacted, whether the operations require prior approval or not or whether they're conducted out-of-province or not, the minister has decreed that they are on hold.

MS. A. HAGEN: Perhaps the minister could give us some indication of the means by which these decisions are taken. I think we have to look at it both from the context of the Medical Services Plan and of the Hospital Insurance Act, because the minister has indicated that these are companion pieces and that the one has an effect on the other.

The particular amendment that we're looking at speaks about the minister or his designate making those decisions. I want to have some knowledge about how those decisions are made. What is the basis for those decisions? And I'd like the minister to respond in the context of the discussion that we have just had which would perhaps suggest that those decisions may be taken for reasons that may go beyond medical reasons.

HON. MR. DUECK: Mr. Chairman, we do not make any of these decisions in isolation. We never have. Neither does the Medical Services Plan. We consult with the medical committee. We consult with experts — doctors in our ministry — we consult with the committee of the Medical Association, and it is on that basis that we make a decision, MSP. All we're saying now is that when the decision is made that something is not covered under MSP, we also do not want to cover that under the hospital plan. That's what this legislation is about.

MRS. BOONE: I'm getting a little confused as to.... You are unable to tell us what particular things will not be covered under this act, and yet you are saying that this is being put in place in order to go hand in hand with legislation that already enables you to not cover things. I think we've been trying to understand what things will not be covered in hospitals now that you are having difficulty with regard to them being covered under the Medical Services Plan, and now you say you don't want them covered by the hospital plan.

What are the services that you are currently having difficulties with that have brought about this legislation? Where have you found people going and having a service that's not covered by Medical Services Plan, but then they have to pay for the hospital stay? What are the services that you have had to pay for under those things that has brought about this legislation?

HON. MR. DUECK: One example, I suppose I can think of immediately, is cosmetic surgery. We're not covering it under MSP, but we're still covering it under the Hospital Act.

MRS. BOONE: I've talked to your ministry with regard to this and they have been unable to tell me because they say they are reviewing some of the things. Can the minister confirm whether you are currently reviewing many different procedures to have them removed from the Medical Services Plan, and then it would automatically of course be covered by this as well? Can you tell me if you are right now reviewing other areas to be removed?

HON. MR. DUECK: Mr. Chairman, if you're asking whether we may or may not remove some from the Medical Services Plan from time to time, we add from time to time and we remove from time to time. This has been ongoing. There are services that are perhaps going to be removed that don't require hospitalization so it wouldn't affect those; there probably are some that would be removed where hospital services may require it. I cannot give you a list at this time, because I have not yet taken them forward.

MR. SKELLY: I think the concern on this side of the House, Mr. Chairman, is that with these kinds of openings in legislation, ultimately the government can really drive a Mack truck through the medicare program, the medicare and hospital insurance program in the province.

I'm just trying to think of a female relative who lives in California and is covered by medical insurance down there. In fact she buys two or three different plans in order to try to make sure that she keeps covered. Yet when she goes to the hospital or obtains some kind of service from the health insurance scheme she has down there, they let her know after the fact whether she's covered or not, or whether the process was medically required.

Let me give you an example: this female relative had two stillbirths, and one live birth with toxemia. The medical plan told her after the fact that the stillbirths weren't covered, nor were the complications of the live birth that related to the toxemia. When the daughter was ten years old, she was still paying for the ones that weren't born live.

That's what we're concerned about. If the minister has an opportunity to open up the medical plan and open up the hospital insurance service in this province, ultimately what services are going to be covered and what services aren't going to be covered? We know that there are certain lines of political belief that would like to see medicare undermined or destroyed, and one way to do this is kind of through the back door: by ultimately telling people that certain services aren't medically required.

Who determines that? Is it ideologically determined? Is it determined on the basis of religion or politics? That's what we are concerned about, because there is a great deal of religious

[ Page 2898 ]

debate over some of these operations and whether they are medically required. There's a great deal of political debate and ideological debate over whether some of these services are required.

What we're really doing here — and I realize that the MSP has been opened up in this way — is now opening up the hospital insurance service on the same basis. A minister or people that the minister chooses to consult, and generally those are people that are hired by the minister to tell the minister whether something is medically required or not.... It's that process that we're concerned about. And we are concerned about creating these new openings through the back door so that ultimately the medical care system in the province of British Columbia becomes useless.

When I see what people go through, including relatives of mine in California, when ostensibly they're covered by medical care which covers their hospital services as well. and yet so little is covered, because the plan has the right to decide almost after the fact whether a particular service is covered or not or required or not, and the plan can always second-guess the doctors and her personal physicians whom she consults.... Basically she's not covered at all unless they decide to cover her. That's why we're concerned about this section.

We didn't have an opportunity in this Legislature to talk about the way the Medical Services Plan was structured; that was done by a previous Legislature. We have an opportunity today to deal with this section 6 of Bill 59, and that's why we're concerned about giving the minister any more openings that may or may not be used by this minister or this government. After all, Mr. Chairman, we're talking about a government that discusses secondary virginity and whether that is a real medical thing or not. I can recall....

[Interjection.]

MR. SKELLY: I'm treating this issue seriously and we're concerned about it seriously. I can recall when the ladies auxiliary to the Social Credit Party, when I was a member of the Legislature, presented a resolution to the Social Credit convention saying that rapists should be circumcised. It may sound silly, and I think that that resolution was withdrawn.

[3:30]

But there is political comment on medical procedures, and there is ideological and religious input into whether decisions are medically required or not. If we're going to open up medical coverage and hospital insurance coverage, just how is the process going to be conducted? How are we going to determine whether a procedure is medically required or not?

I have a great deal of respect for the member for Maillardville-Coquitlam (Mr. Cashore), who was asking questions about sex-change operations for people who require them. The ministry may have determined already — because they've got this type of surgery on hold; I understand it's being done out of the province — that these are not medically required. Yet when you look at the concept of health as determined by the World Health Organization, a more broadly determined concept of health and what's medically required, some views would suggest that they are medically required for the overall health and happiness of the person involved and that person's relationship with society.

By opening up this section of the Hospital Insurance Act, we may give people with very narrow and very restricted and very ideologically-dominated views of what's medically required the right to open up hospital insurance services, and to determine after the fact what's medically required or not. I think it's a dangerous thing to do unless there is some process that the minister has specified — the broadest possible consultation perhaps. If he's going to eliminate from hospital insurance coverage some of the things that we have on the list from Alberta — and a lot of those things relate to vasectornies, tubal ligations and things relating to methods of birth control.... We don't know if these things are going on the list because there's some question as to whether they're medically required or not. It now appears, Mr. Chairman, that a person can get an abortion virtually at any time because the federal government requires that; but in order to obtain sterilization or some other method to prevent, say, a series of abortions, that person may not be covered for those kinds of operations, because the government can deny them that coverage after the fact.

If the minister informed us how this process of consultation may take place.... Is it done on the broadest possible basis, with the consumers of health services consulted as well as the practitioners and the people providing the hospital services? If we had some idea, or if the minister had in place the process of consultation so that we could be assured that it would be done on the broadest base possible, then I think we could accept an opening up of the hospital insurance scheme in this way. But in the absence of that broad consultative process, it's pretty difficult for us.

HON. MR. DUECK: To begin with, the federal Health Act is very clear. It certainly spells out what is medically required, and we have no argument with that; we couldn't if we wanted to. However, when we're talking about something that's provincial, where we pay the total dollar, we of course take the advice of our senior medical officer, who in turn talks to the physician involved in the particular procedure and with the medical fraternity, and the decision whether it's medically required or not comes from them.

Again, I have to stress that the legislation we're talking about now is the hospital, and as you have seen in the last years it's working very, very well. You can't compare it with California. We have a plan, a scheme, here that is entirely different, and we don't want to use that even as a remote example of what's happening anywhere across the line. I'm very committed to having a very good health care system.

However, there may be some services or procedures that we should look at very carefully, because if we don't, if we didn't have this protection in the MSP, you could in fact, with 6,000 doctors in this province, have some doctor come along and say: "I demand that this be covered because I think it's medically required." You must have some stop-gap where you can have a body of physicians ask: is this a medically required procedure? We're doing that now with MSP and it is working very well. From time to time we'll have somebody across the line or in Europe have some procedure that is not accepted by us at all as medically required, and we will in fact not pay it. But it doesn't affect the hospital scheme, because they're out of province.

When it's something done in this province, if the MSP doesn't cover it, we certainly don't want to cover it under the hospital scheme either, and that's all we're asking for in this legislation.

[ Page 2899 ]

MS. MARZARI: I want to pursue this line of questioning, because I think this is where we're going to find where the mandate is and where the procedures actually lie. The difficulty we have, obviously, is that you are giving yourselves the power, basically through order-in-council, to hire or appoint a person — the minister does this — and to designate that person, on review of the medical evidence, to decide post facto whether or not that individual deserved the treatment that he or she received.

You have just described for my colleague the process which is used now. Let me reiterate or repeat: the senior health officer, in consultation with the medical fraternity in the hospital situation, reports back to you the cluster of services or the nature of the medical attention that is to receive compensation or that is to be covered, and then that comes back to you. That is the procedure which has gone on and which seems to work fine.

What has happened that makes you think that an individual should be appointed or designated or hired by you to do much the same thing? Let me go further than that: as I see it, this individual designated by the minister does not necessarily have any clear procedure to follow. There is nothing in this to tell me who that individual consults with, as my colleague has just pointed out, on what basis the consultation occurs, or at what point that consultation occurs. It's obvious that the consultation is going to occur after the fact of the medical attention being given.

Where do you find your mandate to do this? If you're doing it after the fact, doesn't the Canada Health Act have something to say about it? Are you only going to be conferring with this designated individual on issues and matters which aren't funded by the Canada Health Act? Are there that many procedures that aren't covered by the Canada Health Act, that aren't retrievable in terms of dollars from the federal government?

Also to follow along with previous questioning, who is this person going to be — this one person designated by you — and what will the job description look like for this person? What criteria are you going to use in the hiring or appointing of this person, and from what bodies of medical or consumer experience are you going to accept advice in the hiring of this person? How long does the tenure last of this particular appointment? Does it last forever? Does it last at the discretion of the Lieutenant-Governor? Does it last until the rninister resigns his post? Does it last for one year, five years, ten years? What is this person called — the superintendent of post facto decision-making regarding operations? Is this person male, female? Does this person have a religious bias, as my colleague discussed? Is there going to be a particular political bias that this person should bring to the job?

These procedural questions, I think, have to be answered. I don't think you should establish a position in legislation such as this without spelling those things out very carefully for this House and for the province. Because what you do is you leave in the minds of everyone in this province very strong suspicions that you're kneecapping and undermining and leaving a strong feeling that people should not be approaching the medical health plan in the way they have in previous years, through our previous Canadian history. In fact, everything that we do as parents, as citizens, in terms of our relationship with the hospital is now suspect, is now in limbo until a person that you have designated says whether or not our treatment is legitimate. You can see what kind of fear that would instil in a community.

HON. MR. DUECK: No, I do not see that. These people have been in place for a long time. They are medical people, doctors who are on staff. Are you saying that if we hire a doctor, his opinions are worth less than the doctor you use in your own private life? They work for us under hospital programs and the medical commission. Right now we're rejecting claims that our medical people say are not necessary, and we're not paying for them. All I'm asking under this legislation is that we also don't pay the hospitalization.

Somebody talked about ruining the health plan. Again, I'll go back to "medically necessary." There's nothing refused or turned down that is medically necessary, and this information comes from the medical people.

MR. SKELLY: Under your definition.

HON. MR. DUECK: Under the doctors' definition.

MR. SKELLY: The people you hired.

HON. MR. DUECK: It doesn't matter who hires them. They consult with the medical people. In other words, they're autonomous. They come to a conclusion that this particular procedure is medically not required.

I'll give you an example. Just the other day.... I've received many letters on chelation therapy. We have taken it to our medical people and said: "Look, apparently some people think this is a good procedure and should be allowed and paid for under the Medical Plan." Our people said: "No. Until it has been proven medically, we will not pay. When it's proven medically permissible or advantageous, then it will be added to that list, it will be medically approved, and it will be paid for."

All we're asking for under this legislation is the hospitalization. The other is in place and has been in place and working well for years and years. The same people are going to do this. If a certain procedure is not medically required and the Medical Plan won't pay for it, hospitals won't either.

MR. SKELLY: This will be my last question on this subject. I gave the minister the example of the doctor I spoke to in Port Alberni. I know that the Medical Services Plan has decided that circumcision will not be covered unless medically required. Have we got that straight? MSP says that. The doctor I talked to said: "Look, this is such a small operation and takes such a short time with such a short service required by the doctor and the hospital insurance service. It can be done when mother and baby are still in the hospital, along with all the other services that are billed for at the same time." But now the doctor gets a letter back from the Medical Services Plan to determine whether this thing is medically required.

This doctor tells me that rather than go through a paper war with MSP over whether a particular circumcision is medically necessary or not, he automatically bills the patient. That's a minor item, but I'm just wondering what other services.... The doctors don't want to get involved in a paper war with the Medical Plan or the hospital insurance service. because it's going to create more problems for them and they're interested in the practice of medicine, not in trying to dun MSP or the hospital insurance service for payment for a small item like a circumcision. If they get involved in this kind of bureaucratic paper war over the practice of medicine in other items that you may decide are

[ Page 2900 ]

questionable as to whether they are medically necessary or not, doctors are going to simply turn around and bill the patient and say to the patient: "You do the bureaucratic war with MSP. We're involved in the practice of medicine. We're not going to go to war with MSP over these types of operations."

What's going to happen is that the patient is going to be billed, and that's why we're concerned about the situation developing along the lines that I suggested is happening in California. A patient down there — and I've had kids in the hospital in California myself — gets a list of billings a mile long for everything from shining bedpans to opening the curtains in the morning. All of these things are billed separately. The patient, or the mother of a just-born patient in many cases, isn't capable of making the kind of medical decisions or doing the kind of battle with MSP and hospital insurance that are going to be required if the doctor simply says: "Well, I can't deal with it. I'm going to bill the patient. Let them argue with the Medical Plan and try to recover from the Medical Plan whatever they paid to the doctor." I think it's going to create needless confusion.

[3:45]

That's not to say that I disagree that some services shouldn't be covered by either MSP or hospital insurance services. I think that there has to be some power within the act that allows the people who pay for those services to decide whether those services are required or not. What I'm concerned about is the process. The process isn't spelled out clearly enough here that I can be satisfied that.... Not this minister, because I have some respect for this minister. Not every Socred would get up and apologize as the minister did in the House today.

[Mrs. Gran in the chair.]

But I have some concern that in the future some minister who is more ideologically motivated, or who more rigidly applies his particular beliefs to the practice of medicine and the health system in the province, may say.... I'm concerned about that future minister, who is going to be governed by this legislation as much as you and I are. So that's what I'm concerned about: if you make a hole in this plan big enough to drive a Mack truck through, you might not drive the Mack truck through it, but somebody else might. That's why I'm concerned that you haven't established a procedure here that's adequate to satisfy our concerns about ministers who want to practise medicine, although that concern may not apply to you.

MS. A. HAGEN: A few minutes ago we were discussing a process by which a procedure was in fact denied. I took the minister's comment to suggest that his decision had in part been placed on his own personal perspective on the particular medical procedures which would involve hospital care and operations.

I want to move into another area. I want to explore the matter of how men and women in this province receive medical services that deal with their fertility. That might involve counselling on family planning, on contraception and on other methods of birth control. It might involve decisions that could require hospital procedures for sterilization of men and women. We know that this issue is dealt with not just in medical terms but also in ethical terms. We know that people have many different perspectives which may inform their own personal decisions in this regard. But I don't think that any of us would question the fact that the matter of our fertility and how we exercise responsibly our own decision-making about the size of our families — when and how many children to have, or in fact whether to have children — is very much an ethical as well as a medical matter. I want to ask the minister, since these procedures, whether they be counselling or direct medical practices, either by or with physicians in hospitals.... What would the method be that the minister might use, dealing with this particular legislation, in coming to decisions about the availability, the coverage, for anything to do with one's fertility — either the exercising of it to make one more fertile, or the controlling of it to limit one's family, including sterilization? What would be the bases that the minister would bring to bear in this regard? How would "medically required" be interpreted by this minister in dealing with this particular area of service under the Medical Services Plan and under hospital insurance coverage?

HON. MR. DUECK: Madam Chairman, currently — and that's the way it's been for a long time — it's the medical consultant that we have on staff, and the hospital programs and MSP would make that decision of whether it's medically required. I would get that information, and on that basis the decision would be made.

Currently I don't even see what the MSP does, because they're autonomous and they make that decision. When they say that this is not a medically required procedure, it is not paid for, and they give the clients that information. If it's an out-of-province case, there are certain rules that go there.

But again, we're not speaking about MSP; we're speaking about hospital. The other legislation is in place, and if MSP say it's not medically necessary, then hospitals will also follow the same rule. Because if it's not medically required to have that procedure, or operation or whatever it is, then hospital programs will in turn, through their medical people, I'm sure make the same decision and say it's not required for a hospital stay either.

MS. A. HAGEN: Does the minister know what kinds of definitions or guidelines the Medical Services Plan uses in this regard? Mr. Minister, I recognize that we are not dealing with this plan, but by your own admission we're looking for compatibility between the two. It is impossible to separate them. In fact, the guidelines in place under the Medical Services Plan would surely apply also when this amendment is in place.

We are talking, as you yourself have said repeatedly in this discussion and this debate, about the same language and presumably some commonality in the pursuit of what is medically required. I am asking for a broad definition that guides the Medical Services Plan. Is it the World Health definition, for example, that speaks about health and medical resources related to health as dealing with the mental, physical, emotional and social health of people? What does "medically required" mean in the interpretation of the act?

HON. MR. DUECK: Of course, we are speaking about MSP now, and some of the services you just asked about do not require hospitalization in any event. So they would have no effect under this legislation. We're speaking of procedures that may require hospitalization, because the other is in legislation. We now have people who make decisions about

[ Page 2901 ]

whether or not they are medically required under the MSP. What we're speaking of here is hospitalization.

MRS. BOONE: The minister consistently states that the current act does not allow the hospitals or the government to refuse services, even if they have been denied under the Medical Services Plan. Yet under the benefits section of the Hospital Insurance Act, section 5, it says, "The general hospital services provided under this act are...," and it gives a great list of things. And then it says: "...but do not include transportation to or from hospital or services or treatment for an illness or condition excluded by regulation of the Lieutenant Governor in Council." It says: "No person is entitled to receive any of the benefits under this Act unless it has been certified in the manner provided in the regulations that he requires the service."

It appears to me — and it goes on to do some other things — that there is adequate regulation and legislation here to enable the hospital to deny those services already. Why have we put in a section that, instead of dealing with the Lieutenant-Governor-in-Council regulations, gives the power to the minister to determine what are required services? The act clearly has the ability to deny medical services already. Why are you putting more power into the hands of your ministry and out of the hands of the Lieutenant-Governor?

HON. MR. DUECK: It is absolutely correct that we could exclude certain classes, but again we have areas of concern.... Earlier I mentioned cosmetic surgery. We can't really exclude it as a class because it may be very necessary in one case but not in another. If it's a case of a child born with deformed features, it would be very necessary to do cosmetic surgery, but it may not be medically necessary to have wrinkles removed or a tummy-tuck. And that's what we're speaking of. Those are the only areas.... Yes, you're absolutely right: we can exclude all the others. We have that power now. That's why I cannot see why you're hung up on this, because we're talking about these very few areas that perhaps don't cover the total and the specific areas I mentioned as an example. Other than that we can; we can add and we can eliminate. It's right there in the legislation now.

MRS. BOONE: I fail to understand why the minister is saying that it's right here that you have the ability, whereas half an hour ago you told us that you didn't have the ability to do these things. That's why we needed this legislation: because you had things that were denied by the Medical Services Plan and a doctor could go in and say that they required those things, and you would have to pay for it. You mentioned a certain type of surgery that was being requested, and you said they may have to pay for this under the current legislation. Yet the legislation states here quite clearly that those areas can be denied; you can deny service for an illness or condition excluded by regulation of the Lieutenant-Governor. I'm sure cosmetic surgery could be included in that area. You mention, "...it has been certified in the manner provided in the regulations that he requires the services," so surely that gives you the ability right there to decide whether or not tummy-tucks are required, or facelifts or what have you. That gives you the ability there. Why do you need this legislation here that gives you or your designate the power to determine these things? What are you trying to change, and why do you need that power in your hands when there is already the ability here for our Medical Services Plan to deny various things?

HON. MR. DUECK: I think we're repeating ourselves. I said very clearly a couple of times that we're talking about specific change. We'll deal with individual situations, not classes of services, which are presently covered. I gave the example of cosmetic surgery. That's about as good an example as I can give you at this time. You certainly wouldn't want to exclude it as a class, because with many — especially children — it would be medically required. But we do not wish to pay it where we figure cosmetic surgery would not be a medically required procedure.

MRS. BOONE: I am having a lot of problems figuring out how this is going to work. Are you going to sit down in regulations and say all cosmetic surgery is going to be denied payment under the hospital program? Or are you going to say some services, and then is your designate or yourself going to sit down and go through all cosmetic surgery that comes through the Medical Services Plan and decide what can or can't be covered? Are the people of British Columbia never going to know, when they go in for surgery, whether it's going to be determined by the minister or his designate that this is required?

[4:00]

How is this going to work? You have not laid out any guidelines; you have not established any procedures. We don't know how this is going to work. You have said that some cosmetic surgery could be deemed necessary. At what point are you going to decide if it's necessary? After the surgery is completed, when the bills are all in, are people going to be asked for refunds? Are they going to be billed later on, or are they going to be billed initially and then will have to submit bills to you?

What are the classes? You are talking in terms of classes. What are the classes of surgery, then, that you are looking at that could possibly have some areas come back? Are you going to eventually look, as I said, in open-heart surgery here...? You say: "Coronary bypass surgery could be postponed or forgone entirely in a significant fraction of clinically stable patients." Are you or your designate, after bypass surgery, going to look at it and say that this person was stabilized, and he or she could have been dealt with in a different manner? We don't know....

MADAM CHAIRMAN: The minister rises on a point of order.

HON. MR. DUECK: Madam Chairman. I do not appreciate the bringing in of statements again that I have made certain statements, when I said "from medical people." I don't like to see the opposition keep saying that I made those statements, because I didn't. That's got nothing to do with this, and I object to it.

MADAM CHAIRMAN: Your point of order is well taken. May I suggest that the members address their comments through the Chair and not directly to the minister.

MRS. BOONE: It states here that four medical doctors state: "Coronary bypass surgery could be postponed or forgone entirely.... But that's even worse, because this is saying to me that you've got medical people out there who

[ Page 2902 ]

could possibly say this is not medically required. We don't know, when you haven't told us what it is.

The only thing that you keep bringing up is cosmetic surgery. Tell us, what else is on your agenda? What else is out there that we may find? Once this is passed, what are we going to find sitting there in an order-in-council that is suddenly removed from the Medical Services Plan and thereby will be removed from the hospital plan as well? What's on your agenda, Mr. Minister, with regard to this bill here? Because we sure as heck don't know what it is.

HON. MR. DUECK: It will work exactly the way it's working now. If you went to a doctor and your physician said that whatever you requested was medically not required, you probably wouldn't get paid for it. That's exactly what's happening now. The doctor makes the decision. What will happen now in the hospital is that if you went to a doctor, and he said that this particular service was not required, and with consultation with our people the Medical Services Plan did not pay for that particular service, the hospital wouldn't pay for it either.

It's working well; it's in place now. If you don't like the system the way it's working now, then let's go back and change it. We have a Medical Services Plan that's working very beautifully. We have very few complaints. We have a medical team in hospital programs and in the Medical Services Plan. They consult with the physician, and there are very few cases where anything would come up in any event, because there are normal procedures on the fee schedule. No one's going to argue with anything that's on the fee schedule; it's medically accepted.

All we're saying is that if there is a procedure that is medically not required — and that's the physician that's doing that particular procedure in consultation with our people — and our people agree that that is not a medically required service, then hospitals will not pay for it either — that stay in the hospital.

MRS. BOONE: I've read some of the medical journals and magazines that you've been quoting from lately, and one of them recently stated that perhaps.... A professional said that perhaps allergy testing may not be medically required; perhaps cholesterol testing may not be medically required. There are a load of things out there. Some of them say that they are going to be medically required. Others are going to say that they are not medically required. There's going to be a variety of opinions there.

If you go to a doctor, and the doctor says it is absolutely required, then the Medical Services Plan is going to pay for this even though your doctors may have determined that this particular item is not medically required? Under all circumstances are you going to take the opinion of the patient's doctor over your Medical Services Plan doctors?

HON. MR. DUECK: Madam Chairman, if it was a procedure that was so questionable, they may well phone the Medical Services Plan and ask if this particular procedure is covered. They may well do. I don't know when that happens; it may be never. But because we have such a program.... We're talking about medically required services, and anything medically required is covered.

But are you telling me seriously that we should not have this type of protection? Are you telling me that anyone could go to any doctor, as long as he has a licence, and have the doctor say: "I personally believe it's covered; therefore we will pay"? You're surely not saying that it would be a wideopen program and, instead of spending $1 billion a year, that we would spend $2 billion and keep on going? We have people in place who make that decision on a medically sound basis, because they are medical people. There must be some order. Surely you can't disagree with that.

We are saying that it should also work on the other side as far as hospitals are concerned. You keep going back in the Medical Services Plan and all that. That is in place. All I'm saying is: if it's not medically required, and the MSP does not cover it, then hospitals won't either.

MADAM CHAIRMAN: Hon. members, could the Chair just ask again, please, that you address your comments through the Chair and not to one another.

MRS. BOONE: From my reading of the hospital program thing, I believe that there was already that ability for the ministry to deny services. I just do not understand why there's a need to put this amendment in here, which puts a tremendous amount of power into the hands of the minister and not the Lieutenant-Governor. There is the ability within that system, and you said yourself: why hasn't the system run rampant then? Why hasn't it increased? You seem to think that if there's not this change today, suddenly we are going to have this increase in hospital usage. There hasn't been. The controls have been there; they have always been there. For some reason or other the minister wants more control.

Madam Chair, I don't believe that we will be reaching too much conclusion on this, because it's obvious that the minister is not going to tell us the items on his agenda to have removed from the hospital services. I'm sure they come through the Medical Services Plan as well. I'm disappointed that we haven't been able to get very many straight answers from him, aside from cosmetic surgery. We know that tummy-tucks aren't going to be involved, and we know that sex changes will not be covered. But other than that, we really haven't been able to find out where the system has been abused and which procedures were paid and which were not paid by the Medical Services Plan and consequently were a problem when it came to the hospital services.

I haven't been able to see the problems, and I don't understand why this amendment has come through, unless there is a desire by the ministry to remove more things from the Medical Services Plan and the hospital services — and this amendment was made in order to do that.

I think the member from Port Alberni expressed our concerns very clearly and, as he pointed out, this makes such a hole in this that you can drive a Mack truck through it. I am very concerned that we don't know the agenda here and that we could see some severe changes that would radically change the lives of British Columbians. We will be watching the order paper carefully to see if anything does come through here and if there are things being changed that will affect us.

MS. SMALLWOOD: I have two questions to the minister. Number one, I am interested in knowing when the blue-ribbon committee, the committee on ethics, is going to report, because I fear that this legislation is reflecting the work that that committee is doing. If the minister could comment on that, I have a second question.

[ Page 2903 ]

HON. MR. DUECK: Madam Chairman, I cannot answer that, because they have had a number of meetings and have not reported back to me as to their deadline. I did not give them a specific deadline, so I honestly can't give you an answer as to the date that report will be coming forward.

MS. SMALLWOOD: As a rule, when committees are struck, there are some instructions, some mandate and reference as to the work that is outlined for that committee and a date for completion. When the minister says that he has not given a time-frame for that committee, is the minister communicating with that committee? Does this legislation reflect some work that that committee is doing?

HON. MR. DUECK: I think I read part of the mandate in my ministerial statement. Yes, I have had some reports back from them. This legislation has no connection with that committee whatsoever.

MS. SMALLWOOD: I think our critic for Health outlined some of the actual items that are not being paid for by their medical or hospital plan in Saskatchewan or Alberta. I wonder if the minister is using that province as an example for a program that he is bringing into this province.

HON. MR. DUECK: We are so far advanced in giving good health care, they look at us for examples.

MS. SMALLWOOD: Perhaps the minister could tell us whether he shares the same view as the Premier as to the necessity for contraceptive coverage by the Medical Plan and if the minister, through this legislation, will be expressing that view in not covering those types of services.

HON. MR. DUECK: I'm not quite sure what area you're getting into. It's getting a bit.... I think it's going into birth control and all kinds of areas, I don't know whether that requires hospitalization or not. It didn't in our family. Our children are five years apart and it didn't require any hospitalization as far as birth control methods were concerned.

MS. SMALLWOOD: I'm sure that I don't have to point out to the minister that there are operations, tubal ligations and vasectomies, that do fall into day services for some hospitals. My question, again, is whether or not the minister's legislation would cover that and would be directed by the Premier's own views on those subjects.

HON. MR. DUECK: I am not going to say what may happen in the future. It may be another Health minister; it may be your government that has to make these decisions. I did say earlier that I am not considering those specific items that you just mentioned. They have not been under consideration at this time by myself or my ministry.

[4:15]

MS. SMALLWOOD: Can the minister state for the record that he does not support the exclusion of those items.

HON. MR. DUECK: I did not say that. I said they have not been considered by me at this time. So don't start saying.... I don't know what the future will hold. I'm not going to make statements here that may be next year or the year after.... I'm also not going to make statements that I will. That's future policy. Surely you're not going to ask me what I will do as Health minister with a lot of things a year, two years or three years down the road. I'm saying that at this time I have not given that consideration.

MS. SMALLWOOD: I am asking the minister at this time to state for the record that he does not support the exclusion of those services.

HON. MR. DUECK: I am not going to make that statement at this time.

Section 7 approved on the following division:

YEAS — 33

NAYS — 17

Section 8 approved.

On section 9.

MR. CASHORE: I would like to ask the Minister of Health about section 9, second line from the bottom, where it says "...the number of days of care for which payment will be made...."

I think it behooves the minister to give us some reassurance on this because it could cause consternation to families of persons who require hospital treatment outside the province. Realizing that adequate medical treatment may require, for instance, 25 days, and since the number can be decided through this process, it may be decided that they will only receive ten days of treatment and then be left to their own devices in terms of how to pay the bill.

I would like the minister to explain to the House how that family will know in advance what their situation will be, or will they be left with a horrendous medical bill? Does this section indicate that this government actually intends only to cover a limited number of days on some medically appropriate procedures outside the province?

HON. MR. DUECK: My understanding is that they are told in advance and it's a melcal judgment as to the type of operation, how long it will be. So there has never been a

[ Page 2904 ]

situation where someone had to have medical attention outside who did not have the full coverage for that particular procedure.

MR. CASHORE: I would like to ask the minister, then, if he would give us his undertaking that such assurance will be provided either by entrenching it by amendment in this legislation at this time or by order-in-council at the earliest opportunity. I would like to ask the minister if he would give us that assurance.

HON. MR. DUECK: That particular section as to the time limit is not changed. It's in place and it's continuing exactly the way it is. There is no change to that whatsoever.

MR. CASHORE: Then I would like to ask the minister why it is here. If I may clarify, Madam Chair, my question is: why do we have this before us if it's not a change? I don't understand the minister's comment, because it would indicate that there is no need for this if it's already in place.

HON. MR. DUECK: The way I see it is that this amendment is consequential to the change made in section 25. We changed section 25 and therefore this has to be changed, but there is no change in the time limit — those days. There's no change in that particular part, and that was the question you were asking.

Sections 9 and 10 approved.

On section 11.

MR. SIHOTA: I am quite happy to debate this section because it deals with the repeal of the Investment Contract Act, but I notice the Minister of Finance (Hon. Mr. Couvelier) is not here. It's my understanding the Investment Contract Act would fall under the.... We're dealing with section 11, Mr. Minister, so you're off the hook now. I want you to understand that I wasn't even in the House. I was being nice to you.

I'm dealing with the Investment Contract Act, and I have no problems in dealing with it. But I'm certainly not prepared to make comments with respect to this until the Minister of Finance appears in the House. I don't know what the procedural.... If we can stand it down until the minister returns, that would be fine with me.

Section 11 stood.

Sections 12 and 13 approved.

On section 14.

MR. BLENCOE: I want to pass a few comments on this section, and then maybe the minister will do us the honour of responding.

[4:30]

The reason we have this section 14 before us is, of course, that it's something we should have had some time ago. The minister is aware of that, and I'm not going to go into the details of that. It's unfortunate that we have this retroactive legislation before us, however. We all know that because of the oversight of the minister in the last municipal elections, we are having to deal with this on a retroactive basis. Of course, it could have created — and may indeed still create — some problems; we don't know. Some months before the municipal elections, the minister, through her staff, allowed municipalities to use the provincial voters list, and then suddenly discovered that such permission required legislative change.

Madam Chairman, I don't want to dwell on that particular oversight — and I think it was a major oversight. It's happened before over municipal elections. It happened in the byelections some months ago — changes to who could vote a matter of days before the election. People had voted at the advance poll, and then they changed the rules so that British subjects couldn't vote. That created some real problems. And that was done right in the middle of by-elections. So there seems to be something of a history in this ministry of not dotting the i's and crossing the t's. But I don't want to dwell on that.

Interjection.

MR. BLENCOE: I'm being serious.

What I would like to address is this whole question of what's happening with this government. So many times they think now — and it's symptomatic of what's happening with this government — that rather than use the Legislature for most business on behalf of the people of British Columbia, they can do it just by some sort of news release or an order-in-council or cabinet decision without using the Legislature. It's happening more and more. Here we have another example of this government's thinking: "Well, we don't have to go to the Legislature to change who can vote or what lists can be used at the municipal level. We'll just make a pronouncement that you can use the provincial voters list."

The only comment I make on that specifically is that this government continues to get itself in trouble because it wants to do so much of the people's business outside this chamber. For the second time in a matter of months, without this Legislature approving the change, this government and this minister have got us into a potentially very embarrassing situation. In so many things in the last year we have seen important decisions not being carried out or authorized by this chamber — this-time over changes to the Municipal Act which clearly require legislative change. We nearly got ourselves into — and may indeed be in — a very embarrassing situation. It has to be, once again, a warning to this government that when you are prepared to usurp the roles of parliament and the Legislature, and run government by orders-in-council and special decrees and virtually presidential announcements out of the Premier's office, you're going to run into trouble. It's symptomatic of a government that forgets that the business of the people of British Columbia must be done through this chamber. Once again — this time over a voters list, changing the list that municipalities could use — this minister and this government thought they could do that through making an announcement without reference to the Legislature. It's symptomatic of what's happening to this government and of the state of affairs in the province of British Columbia today.

More and more, we see that citizens are becoming very concerned about the way this government is doing business, and I refer to organizations like the Coalition for Democratic Process, an organization that's starting in Victoria and is now establishing chapters all across this province for people of all political persuasions who are deeply concerned about this

[ Page 2905 ]

government's action and the lack of utilization of the people's Legislature. This retroactive legislation that we have before us is part and parcel of the sickness that is overwhelming this government in terms of it not using the Legislature to do the people's business.

I want to make some other comments about the whole process of voters lists and the municipal election process, because I think it's time for a total review. It's unbelievable now that in the province of British Columbia municipalities can choose whatever voters list they want to use. It's unbelievable that we don't have a process that's laid out — you either do enumeration or you don't do enumeration. It's unbelievable that we don't have a process in British Columbia that tells people, through an enumeration or some sort of process, that there is about to be a municipal election. Ws sort of like if we keep it quiet and we don't tell people through enumeration or proper voters list development.... We really don't want to tell people that there are municipal elections happening in the province of British Columbia.

We also have some confusion in municipal voting. We have situations we still don't work out, where some people in this province have two votes at municipal elections. I could debate all day whether people should have the right to vote twice. But what's happening is that I've got people coming to see me saying that, for instance, in one municipality they go to vote for mayor and aldermen, and they vote for school board in their own home municipality. They then come down to the next municipality, and because they own property, they get to vote again for mayor and aldermen, but inadvertently they vote again for school board for the same school district, because they are given a ballot. And that happens all across the province: they're given a ballot for school board again. The checks and balances of municipal election procedures are very weak and inefficient, and I believe we need to take a look at that process and the election procedures for municipal elections.

I certainly think we need to take a look at who prepares voters lists. We had a situation in this last election, an unbelievable situation, where in Richmond.... Not only did we have in Richmond and every other municipality the potential for a court challenge, because it was said by this minister that the provincial lists could be used, but we had in Richmond a situation where they privatized the development of the voters list. Could you believe it? The fact that you privatize the voters list is bad enough, but guess what, Madam Chairman? Who developed the voters list in Richmond — the Premier's home riding, I might add? Who developed it? Who was given the contract?

MR. JANSEN: Who did?

MR. BLENCOE: Well, guess who. Sid Treur, head of Datex Services, president of the Richmond Independent Voters' Association and Premier Vander Zalm's riding association chief.

AN. HON. MEMBER: Name names.

MR. BLENCOE: I've named names. Here we have a privatized list, and guess who gets the contract to develop the voters list? The president of the riding association for the Premier's own riding association. Here we go.

Interjection.

MR. BLENCOE: Well. Is it wrong? Is it wrong that a voters list should be developed by the private sector — a privatized voters list — and you hand it to a consulting firm....

Interjection.

MR. BLENCOE:.... a voters list developed by the consulting firm that happens to be connected to the Premier by the president of the riding association. Now only in British Columbia, Madam Chairman, could that happen. Only in British Columbia could that situation happen, where a democratic roll of voters is not done by the public sector but by the private sector, and done by somebody who is clearly politically connected not only to the government but to the Premier of this province of British Columbia.

Is nothing sacred? Is nothing sacred in the province of British Columbia? It clearly isn't, Madam Chairman.

AN HON. MEMBER: Everything's Socred.

MR. BLENCOE: Nothing is sacred in the province of British Columbia.

MR. SIHOTA: Not even voters lists.

MR. BLENCOE: Not even voters lists — the basic, fundamental ingredient of ensuring elections are run honestly.

MR. SIHOTA: Fairly.

MR. BLENCOE: Fairly, and that those that get on the list get on the list properly. And here we have in Richmond, whereby.... And this minister allows this to go on. I tell you, Madam Chairman, if there was ever a time we needed a review of the election procedures for municipal government, it's today. But of course, in British Columbia anything goes. Why, we'll privatize all the voters lists. It's unbelievable.

MR. SIHOTA: And they applaud that.

MR. BLENCOE: And they applaud that. Not only do they applaud that but they applaud that in Richmond. And the people of British Columbia, Madam Chairman, must really wonder what kind of government they've got. They really must, when a municipal voters list, the basic ingredient of fair, democratic elections, is developed by a private consulting firm, with no public accountability, by the president of the Social Credit riding which the Premier represents. Well, well, well! That's where we're at in the province of British Columbia. Nothing is sacred, Madam Chairman, not even the voters lists.

Now would this government believe that the provincial voters list should be privatized? Should that be done by the private sector" Should that be done in each riding by Socred president consulting firms? I bet they wouldn't say that, Madam Chairman. Or would they?

Nothing is sacred, quite frankly, it would appear, on behalf of this government. If nothing is sacred, then in my estimation nothing should be Socred in the province of British Columbia.

[ Page 2906 ]

Madam Chairman, we need new municipal rules for voting at municipal elections. Clearly demonstrated in Richmond; clearly demonstrated by all sorts of enumeration problems and voters lists; and now here we're dealing with a retroactive piece of legislation.

In my estimation a committee should review the whole question of disclosures for municipal officials. I think the time has come in the province of British Columbia, as we are suggesting provincial rules, when we should take a look at spending limits, at how much is spent on municipal elections. As my good colleague from Victoria has suggested in a private member's bill, some recommendations regarding running provincial elections in the province of British Columbia, and the requirement after the election is over to submit disclosures about who contributed over a certain amount of money, are needed. I think the time has come in British Columbia when we need to take a look at that sort of thing, not only provincially but municipally. We're in the eighties. I think people want to know. They want to have better disclosure and better conflict of interest rules. They certainly know they won't have better conflict of interest rules at the provincial level. So I believe there needs to be a look taken at the whole process of disclosure for municipal officials, as we have suggested for provincial elections as well.

[4:45]

I think the time has come — and the opportunity for a debate on this section 14 is today — for this minister and this government to recognize that we have some real problems at the municipal level; that it would be a good idea that we review the municipal processes for elections. And at least let's deal with the question of privatizing voters lists, because I don't think that's even acceptable to a Socred British Columbia. I would hope not.

HON. MRS. JOHNSTON: It appears some clarification is required. The section that we're dealing with today is a direct upshot of the proclamation of our Charter of Rights Amendments Act, brought in last April, which in turn was a result of federal legislation in 1985.

The comments by the member opposite certainly go to clarify the difference between the two party philosophies. We had a choice of requiring the municipalities to go to full enumeration, which across this province would have cost them tens of thousands of dollars, or we could have acted in cooperation with the municipalities, as we chose to do, and allow them to use the provincial voters list.

It seems to me, Madam Chairman, that it's important that all levels of government work together in order to save the taxpayers' money whenever possible. The action taken by this ministry and this government resulted in considerable savings to all of the local communities, including your own community, hon. member.

I want to tell you, Madam Chairman, that the doom-and-gloom statements and the suggestions that we would have chaos at the polls and that there are still possible problems coming up are absolutely false. In checking with the UBCM, the representative of all the municipalities, we have been advised that there have been absolutely no complaints with regard to the use of the provincial list. In fact, several compliments were issued because of the smoothness of the operation at the polls.

It seems to me that the member has been repeating statements regarding the preparation of a voters list that are completely contradictory to what he suggests is the opposition position, which is autonomy for local governments. The provincial government doesn't prepare the voters list in the municipalities. This is a decision made by local government. Is the member suggesting that the provincial government go into each of the local council chambers and suggest to them how and who should be preparing their local voters list? I would suggest not. It was a decision made locally, as it should be, and I would hope that we would not attempt to interfere with that type of decision.

I can give the member this assurance, Madam Chairman, as I have on a number of occasions: the entire local election legislation is under review. The review has been underway for some time now, with the most major significant change being that of the three-year election term. The member is well aware of the fact that the review is underway. It is a priority in this ministry, and I would look forward to any suggested improvements that the member would care to send along to us to include in possible changes.

MR. BLENCOE: First, Madam Chairman, I could suggest that perhaps she'd like to use the standing committee on municipal affairs to debate this whole issue. We'll have some hearings with UBCM and key mayors, and we'll talk about this whole thing.

HON. MRS. JOHNSTON: That might be the way to go.

MR. BLENCOE: That might be the way to. go. I think there's some room.

Let me comment, Madam Chairman, about this "I'm suggesting that we tell municipal government what to do." You're saying that you're allowing them to be independent and make their own decisions. But you get to the point where you could say that for everything. Why have a Municipal Act? That's ludicrous. Why don't you just deregulate and get rid of every act that governs everything? Privatize the works. That's where we're at, it would appear. Nothing's sacred. We have legislation and guidelines in the Municipal Act. Is that the attitude: that we're just going to get rid of all regulations and we're going to privatize it all and nothing is sacred; the marketplace will determine everything and the government has no role to play in being a check and balance? The Municipal Act is there in terms of these issues. It gives guidelines. But it was written a long time ago. Is the minister suggesting that we throw out the Municipal Act and all the sections on elections?

What I'm suggesting to this minister is that I've brought to your attention a situation in Richmond where there's a potential problem, and this minister just laughs about it. It's not a laughing matter.

I want to ask the minister a question. Does she approve of privatization of voters lists at the municipal level?

HON. MRS. JOHNSTON: I would suggest that that matter should best be left with local government.

MR. BLENCOE: Are you the Minister of Municipal Affairs? Do you just take total direction? I asked you a question. You are the minister. You have some guidelines. You have the Municipal Act. You have some authority. You have some role to play. I repeat my question to the minister. Do you approve of a Social Credit association president and his consulting firm preparing the democratic voters list in

[ Page 2907 ]

Richmond? Should that be encouraged in other parts of the province of British Columbia? And don't try to say it's up to local government.

MR. JANSEN: Give me a break.

MR. BLENCOE: Give me a break! The only break you're going to get, Mr. Member, is in the next election, when you get removed from office.

MR. SIHOTA: Madam Chairwoman, I want to talk a little about this section because the minister talked about chaos and the Charter of Rights and why this provision was introduced when it was because of the provisions of the Charter of Rights.

The provisions of the Charter of Rights were brought down in April 1982. The provinces were given five years to get their act together and make sure that all statutes complied with the provisions of the Charter of Rights. Five years ago it became evident to the government that the provisions of the Municipal Act would have to be brought into conformity with the Charter of Rights. The issue of Commonwealth citizens was not one that came up between 1982 and 1987. In 1982 everyone knew that Commonwealth citizens would have to be removed from the provisions of the act. It wasn't as if there were a court decision that came down in 1986 that warranted the removal of the Commonwealth inclusion, if I can put it that way.

I appreciate that the good minister wasn't responsible for all those five years in terms of this issue, but the government had five years to bring about the changes necessary for conformity with the Charter of Rights. Surely in that five-year period it would have been possible for the government to have worked out some type of scheme with municipalities to make sure that municipal voters lists were in conformity with the Charter of Rights. Over that time, certainly there must have been some dialogue with municipalities to the effect that: "Look, the Charter of Rights is coming now, and this is how it's going to affect you." I know that there was a team within the Attorney-General's department that was seconded to deal with these types of issues. I happened to be part of a team of people at the University of Victoria that went through every statute in the province over a summer and reviewed all the provisions that offended the handicapped rights provision of the Charter. We did that in the summer of '82 and submitted a report to government on the changes that had to happen. All those changes were in place within a reasonable time after that. I think it was in '84 that the changes came in.

It really came as a shock to me when this provision came down. I stand to be corrected, but I believe that it was in August or April or somewhere last year, and close to the municipal elections. Then right out of the blue we have this flurry of activity because people become concerned that the provisions of the Municipal Act are not corresponding with the Charter. It just makes you scratch your head and wonder what was going on for those previous five years.

I have one question and then I want to make some other comments as time goes on. Can the minister clarify for my own understanding of the issue why it was at that late date — and I confess I don't know whether it was August or September or when it was — that this announcement was made? Why was it that the government did not move on this five years ago when notice was served on it?

HON. MRS. JOHNSTON: Madam Chairman, I wasn't here at that time, so I'm afraid I can't answer that question.

HON. MR. STRACHAN: I would ask if the member for Esquimalt-Port Renfrew could defer debate at this point. We have the Minister of Finance (Hon. Mr. Couvelier), and we have stood down section 11. If that's not convenient, Mr. Member, I will not make that request.

MR. SIHOTA: Why don't we just get this one over and done with, then get started? I don't think we're going to be into this for that long — although I never know what he's going to say.

Interjections.

MR. SIHOTA: Or what I'm going to say. But I'll try to control the second member for Victoria (Mr. Blencoe) if he promises to control me.

Okay, so the minister doesn't know the answer to that question. That's fair enough. I don't know why it had to wait as long as it did.

The other point was the comment that was made about chaos at the polls. I want to put behind the municipal election, and look forward a bit, in light of what will transpire after this provision is passed. I make this point in all seriousness. I come from a municipality where 16,000 people live. As a consequence of the changes here under this legislation, and the embracing of the provisions of the provincial Election Act, the voters list in Esquimalt this year indicated that there were 4,000 resident voters in Esquimalt. Obviously, there are not going to be 16,000, because a number of those people are below the age of voting — which should also be changed to 18, by the way, if we really want to talk about the Charter.

As someone who is obviously interested in the politics of that community — and having run there provincially — I can tell you that roughly there ought to be about 12,000 people registered on the voters list in Esquimalt. Yet there are only 4,000. There are two implications of that. One is that — just as an aside — the numbers that are reflected in terms of who votes are exaggerated. We had a turnout of about 2,000 people in the last municipal election, and the turnout was recorded as 53.9 percent, which really isn't true. It's one-eighth, right? I'm sure the Minister of Finance can quickly tell me what that means in terms of percentages. Anyway, one-eighth of the population actually came out and voted. But there was this exaggeration of the number.

[5:00]

Secondly, there wasn't chaos — I'll grant you that — at the polls, but there was an inordinately large number of people registering on election day in order to get on the voters list. I can certainly say, — because I had more than simply a passing interest in what was going on election day in Esquimalt, that there were a lot of people who have been long-term residents of the community and for some reason were not on the voters list — people who had lived there all their lives. In fact, one of the residents who phoned me up on the day — I think it was November 21 — had received two weeks earlier a little commemorative medal for having lived in Esquimalt for all of that individual's 75 years. It was the seventy-fifth anniversary in Esquimalt, and we did a thing for them all. Yet this person was not on the list.

[ Page 2908 ]

The second point is that as a consequence of the changes that the government brought in at the late date, a number people felt as though they were disfranchised, and that has an obvious effect.

The third, and I think more important, point is that that list is incomplete. The minister talks about the savings that we're going to accrue in the municipalities if they embrace the provincial list. That was the motivation for the ministry to handle things in the fashion that it did. In the case of my municipality, when you have what is obviously an incomplete list of 4,000 people, they're going to have to go back and go over the process of enumeration and find out where those roughly 8,000 people are who didn't get onto the list. So where's the savings? Agreed, there was no need to incur the costs up front, keeping in consistency with comments the minister had made. But on the other hand, now that the election is over, now that the list is incomplete, the municipality is going to have to bear the cost of updating that list, of enumerating more people on the list.

Where is the saving to the municipality? They may have avoided it on the front end, but they're going to have to pay it on the rear end, if I can put it that way — on the back end, I should say. That's not true simply for Esquimalt. I can tell you that it was true in the regional election in Langford and it was true in the municipal election in Colwood. I can't say with certainty whether or not it was true in Sooke, although something tells me that it was. I stand to be corrected on that point.

So the Esquimalt incident is not an isolated incident, as far as I can see. It may be confined to my riding, I don't know. Maybe the people in my riding or in the municipalities in my riding tend to handle these matters in a different way. But it is a problem, and those costs are going to have to be incurred, as far as I can see, to make sure those lists are updated. I think we would all agree in this House that those lists should be as complete as possible. Having made those comments, my question to the minister is this: will the ministry be providing  assistance to those municipalities who now, by virtue of these changes, will have to update their lists?

HON. MRS. JOHNSTON: If by assistance you mean financial, the answer is no. The hope is that while we are reviewing all local government election legislation, there may be — and there will be a very serious look taken at this — some form of combined voters list in order to effect efficiencies and savings.

MR. SIHOTA: I don't want to belabour the point. I appreciate that another minister is here to deal with another issue. I'm also here to deal with the same issues as the Minister of Finance (Hon. Mr. Couvelier), but I would like to complete this discussion. Quite frankly, I apologize to the Minister of Finance if we have taken a little bit more time than had been originally anticipated, but I do want to finish this issue.

I don't see the merit in having some form of combined list. Let me make the case as to why I say that, having spent a little bit of time — not a lot — looking at voters lists and the accuracy of voters lists. We all know, as people who are involved in the political process, that voters move and are constantly on the move, particularly in municipalities like mine, Esquimalt, where there is a large transient population by virtue of the fact of the military base being there — people are coming in and out — and, secondly, by virtue of the fact that there are a lot of apartments.

The residents change fairly quickly and hence, arguably, so does the voters list. I know, from talking to the Leader of the Opposition, that he has the same type of problem in Vancouver Centre, which happens to be his riding and which also is a riding with a tremendous amount of transient individuals in apartments.

Having said that, what happens is that the list you compile today is only good for today and possibly tomorrow, but not for much longer than that. For example, we know from the federal experience that federal election lists have a life during the course of a federal election. It has been statistically demonstrated.... In fact, I would draw the minister's attention to a study that was done in Manitoba, of all places, by the university there on this very issue. It said that the accuracy of a federal list is the best that you can get. It's 96. I percent accurate. It's highly accurate, because that list is compiled during the course of the election campaign.

The provincial list, under the Election Act, is composed in either the second or third — I can't remember — September after the election. In other words, under the current Election Act, I think the list would be compiled in September 1988.

The minister made a comment about a common list. If the federal list which is compiled during the federal campaign is 96.1 percent accurate, we know it's the best situation that we can obtain. We know people move around. We know that the provincial list will be put together in September 1988, which may make it fine for November, but it won't make it particularly fine for November 1988. It will be worth the 96.1 percent in terms of accuracy.

And it will get worse as we get on to further elections, if you maintain a common voters list. It'll get more and more stale by the time you hit the 1990 roster of elections. If it's the ministry's intention, as the minister says, to go to some form of common list — I read that, and the minister can correct me, to mean a municipal-provincial list — then you're going to have a list that has the same problems that the current list has: it's going to be highly and substantially inaccurate. It doesn't fulfil the objective that I think ought to be there in terms of having up-to-date, accurate voters lists. Having provided that information, I trust the minister will see the value in not going towards some form of common lists.

In addition, I think the minister will have to acknowledge — and if she doesn't, I'd like to know why — the need to provide financial assistance to municipalities when they're compiling their lists. You've put them in the position, Madam Minister, of forcing them to compile fresh lists. If you're going to do that, then it seems to me that you ought to share the costs of that, and you ought to depart from your view that there ought to be a common list. I don't think there ought to be a common list; I don't think it works. We saw it in this set of municipal elections. Granted, there was no chaos — at least in my experience, in my riding, and I would trust also from the minister's perspective. There was a problem with the list being deficient.

There are some other comments I'd like to make, but I'll pause at this stage to see if the minister has a response with respect to the common nature of those lists and whether she now sees why we ought not to have that.

HON. MRS. JOHNSTON: I don't know whether I improperly phrased my comment, but it is one area that is being

[ Page 2909 ]

reviewed while we are doing the overall review. Whether that is the final conclusion that we have a combined list, I really have no way of knowing. It's something that we will be looking at seriously.

We will be looking at ways and means of compiling a voters list for the provincial elections, as well as the municipal elections, in the most efficient way. The responsibility for the preparation of the local government voters list lies with the local government.

MR. BLENCOE: I think that the discussion from my colleague from Esquimalt-Port Renfrew is proven with the details and is part of the very reason why I am suggesting that we should be putting this into a committee where we can go through all these various things and not have to debate these intricacies in the House as we are today. I think there are some good points on both sides that we can deal with.

The point I want to make in terms of what I've just been listening to is that it seems to me that I recognize the minister and the government.... We all want to have efficiencies and cut costs. But there comes a time when you have to recognize that a voters list has to be prepared, that it should be up to date and that there should be some mechanism. If there is going to be enumeration, there are going to be costs. We have elections every three years at the local level, and just because you say: "Well, I want to save money; we're not going to have an enumeration at the local level...."

I think my colleague from Esquimalt-Port Renfrew's point is well taken in that I think we have to ensure those lists are up to date. A lot of people get left off or move, and there is no mechanism other than finding city hall and getting it all changed yourself; people don't come to the door or anything like that.

I think there's going to have to be recognition that a voters list, whether it's municipal or provincial, is a pretty important document. It should be updated fairly regularly. And there are going to be some costs with that. I don't think we can avoid that. I keep hearing over and over again that in many areas we want to be saving costs. I have no problem with that. But there comes a time, particularly with the voters list, where there will be some costs, and I think we have come to that, indeed, in the province of British Columbia. Both my colleagues and the Minister of Finance, who was mayor of Saanich, will know that we had voters lists we worked with that were just ridiculous — way out of date.

HON. MR. COUVELIER: Not in Saanich; we used the provincial list.

MR. BLENCOE: No; prior to this election. We had voters lists, but people who had moved or had passed on were on there for years, right?

My colleague from Esquimalt-Port Renfrew has put up some very good points. There has to be a list, even at the municipal level, that has to be updated. You can't just keep adding and subtracting. Every now and then you've got to go back and do a proper enumeration, and there are going to be some costs. The problem is that municipalities are always scared. Of course they are, because their funds are limited — I won't go into the reason for that; that's a whole other debate and they, of course, want to save money.

So the point is well taken that we need to take a look at a cost-sharing formula to ensure that municipal voters lists are updated properly, that there are proper enumerations and that they're not way out of date, so we can avoid some of the problems that we've had in the past. I think, as my colleague from Esquimalt-Port Renfrew points out, that if you do one amalgamated list, you're going to run into other kinds of problems. I think we can avoid them if we do it properly.

[5:15]

MR. SIHOTA: I want to ask the minister a question, and then I may have some comments, depending on the minister's answer. The minister says that she's interested in having the most efficient list possible. Would the minister agree with me that the most accurate list possible is the list that is compiled, let's say, during a month prior to the municipal election? Would the minister agree with that?

HON. MRS. JOHNSTON: I couldn't disagree with that.

MR. SIHOTA: Okay. I note that the minister agrees with that. If, then, in terms of accuracy and efficiency, one of the options that the ministry is considering now.... Because the minister, when I made the comment about a common list, said that that was something that was being considered. And she's quite correct; I didn't hear that word and I probably should have been listening more carefully instead of chattering with one of my friends in here. But I think that it's fair for me to ask the minister if that's being one of the options that's being considered.

HON. MRS. JOHNSTON: I can assure the member that all options are being considered. We will be seeking input as much as we can possibly generate interest, and I will certainly keep in mind the suggestion made that this matter go to committee.

MR. G. HANSON: This is a very interesting and important discussion we're having. The reason I have decided to take my place is that the comments made about the quality of the federal list are very important. It's one of the best enumeration procedures in the western world. As my colleague said, it's a capture — they use that term "capture" — of in excess of 95 percent of the eligible voters. Provincially the capture was far lower. We had 2.1 million citizens 19 years of age and over, with 1.5 million enumerated. Those of you who are quick at doing percentages know that that's substantially lower than the federal capture.

I want to relate to you a discussion which I had recently with administrators at the civic level, who said that there's no point in having a list that isn't of the quality of a federal enumeration list. You'd be better off to have polling stations adequately distributed, and allow every eligible citizen the right to come and swear in, and not have a list at all. You'd be better off to have sufficient polling stations.

I don't know if you're aware of the American elections — and I'd be happy to make this literature available to the minister — where by law the state not only produces campaign literature which is sort of generic, with the person's photo, and they have the responsibility for a page or two of copy, but also issues campaign documentation for the candidates. In the Seattle Post-Intelligencer centrefold, for example, around election time — November 4, I think it was — last year, there must have been easily 600 polling stations in King County.

It's not like the municipal elections where we have seniors and elderly people and people with difficulty in mobility

[ Page 2910 ]

having to go considerable distances to a polling place downtown. I don't know how many they had here municipally, but I don't think there were more than ten to 12 polling stations for the whole of the city of Victoria.

Interjection.

MR. G. HANSON: Saanich is a larger geographic area. I'll be happy to make this information available to you, because one thing that our friends to the south in Washington state do, both in congressional and senatorial elections, is make every church, every school whether elementary, junior high, high school or college and every library a polling station. Do you know that citizens in Washington state or anywhere in the United States can, by law, go into a public library and enumerate themselves? Here, we have to — as I've used the example — climb down an air duct somewhere into some dusty old basement to try to get on a voters list. And we have that problem provincially.

I was intrigued by this municipal administrators' suggestion that they would be better off locally to have a sufficient number of polling places and to allow people to vote in their own neighbourhood by going and swearing in and getting their ballot and voting, rather than mess with a sloppy list.

Sections 14 and 15 approved.

MADAM CHAIRMAN: We'll go back to section 11, which was postponed.

On section 11.

[Mr. Pelton in the chair.]

Interjections.

MR. SIHOTA: The members on the opposite side are always anxious to pass sections. I guess the snow is falling in their ridings and the reindeer are running, and here we are debating legislation.

I don't know if the minister has any introductory comments to make about this, Mr. Chairman. If the minister does, I'll certainly....

Interjection.

MR. SIHOTA: He doesn't. Okay, that's fine. I'll deal with the issue.

We're dealing in this instance with the repeal of the Investment Contract Act. The Investment Contract Act, as I understand it, was introduced back in 1962. It was amended in 1975 by the government; it was an inconsequential amendment. The provisions of the act when they were introduced in 1975 by a Mr. Macdonald, of all people.... Mr. Macdonald simply made reference to the act, to certain problems in the Mortgage Brokers Act, and to the part-time work of people at the Corporate and Financial Services Commission. He felt that there was a need to tie together all the provisions of various types of investment contracts under one act, and at the time introduced a nominal amendment to allow that to happen. Unfortunately, I don't have any record of the debates in 1962, because there was no Hansard at the time.

The government, by virtue of this provision, has chosen to repeal the Investment Contract Act. I think it may be safely said that although there was nominal debate when the act was amended in 1975 — and I don't know how much debate there was in 1962 — there is going to be a little more debate on it today than the two minutes of debate which occurred in 1975.

I have quite a few notes, and I want to make quite a few comments with respect to the Investment Contract Act. Before I do that, Mr. Chairman, I'd like to put a question....

I understand the minister was busy with his seatmate from Saanich, so I didn't want to put forward my question then. I'm sure they are working on solving another problem for another constituent in the riding.

In any event, my question is this: perhaps the minister could indicate, first of all, before I comment in depth on the issue, his reasons for wanting to repeal the Investment Contract Act.

HON. MR. COUVELIER: Mr. Chairman, it certainly is meant as no reflection on Mr. Macdonald. He obviously did a very capable job back in those days, when he had a different set of facts and circumstances to deal with.

The repeal of the Investment Contract Act comes about as a consequence of recommendations and comments made by Lyman Robinson, with his investigation. Clearly there is a need for us to provide more powers to the superintendent and to give us the power to require enough information so that we can effectively monitor the marketplace.

MR. SIHOTA: Perhaps the minister could indicate to me which powers he thought were lacking within the purview of the superintendent of brokers that warranted this change.

HON. MR. COUVELIER: The Investment Contract Act does not allow us to require audited financial statements or details of the company's investment portfolio. It has no requirement for the superintendent of brokers to approve the application form for the investment. The inadequacy of the valuation provisions of asset reserves.... It does not provide adequate powers to the superintendent of brokers to allow him to conduct investigations, freeze property, appoint a receiver or order compliance. By virtue of the lack of these requirements in the earlier piece of legislation, our staff — who are diligent investigators and enforcers of legislation — found themselves unable to adequately do the job that the public has come to expect them to do.

MR. SIHOTA: Could the minister advise me as to his view on the issue of which institutions now would be covered by the Investment Contract Act? If it wasn't repealed, are there institutions that would have been covered by the Investment Contract Act?

HON. MR. COUVELIER: I'm pleased to do that, Mr. Chairman. The only existing firm practising in B.C. who would be affected by the repeal, as I understand it, is the Investors Syndicate. We have had discussions with them, and they are fully in favour of the action. They do agree that the matter needs addressing. They are not offended by the suggestion that they would now be regulated under the Securities Act.

I must also advise the member that we are satisfied that, by virtue of folding them into this Securities Act, there should be no inference drawn about that firm's stability. We are satisfied that it is a responsible player in the financial

[ Page 2911 ]

community, as it has been for many years, and I can assure the member that they are fully supportive of this change.

MR. SIHOTA: I should say that I wasn't trying to attract any adverse inference to Investors Syndicate. Certainly my research indicates that that company is in good stead.

It's kind of ironic to have such short answers from the minister, in light of some of the exchanges that occur in question period — some of the full answers we get from him. Maybe my questions are a little more pointed than they often are in question period. Besides that, it's 5:30 and I'm sure we're both getting tired.

Is the minister saying that, as it sits right now, the company that has taken over Principal Trust — Metropolitan Trust, I believe — is not covered by the provisions of the Investment Contract Act?

HON. MR. COUVELIER: Not being a member of the legal fraternity, I'm not quite sure whether there is some subtle significance to the question. It is my understanding, however, that by virtue of the repeal of the Investment Contract Act, any firm that continues to provide that kind of service would then fall in the net of the Securities Act.

[5:30]

MR. SIHOTA: The subtlety is simply this. It's not so subtle as the minister responded, assuming that the act was going to be repealed. I'm talking about the way the situation sits today, because the act hasn't yet been repealed. I'm sure by the time we get finished on this, it will be. But as it sits right now, given the fact that Principal Trust fell within the provisions of this act, does it not stand to reason that Metropolitan Trust would also?

HON. MR. COUVELIER: I can't say categorically, but I'm happy to check. It is my understanding that Metropolitan Trust does not have a desire to pursue the investment contract aspect of the Principal Group, but rather the trust aspect of the business. I do not believe they are involved in the investment contract business at all. If you like I can have that verified, but that was my understanding. They didn't buy those assets other than the hard assets related to the investment contract business.

MR. SIHOTA: I want to thank the ministker for his answer. I take his word on it. I don't think it's necessary to go back and check. You're probably quite correct. I haven't looed at the documentation with respect to who was taking over what and when and how much of the business was taken over. Certainly, I must say myself, I haven't gone down to Metropolitan Trust to make any investments that would be covered under this act, nor am I aware of any situations where individuals have done that. It's a good point. Logically, if you think it through from Metropolitan's point of view in terms of somebody who'd want to come in and pick up the remaining bits and pieces of Principal Trust, given not necessarily the tax implications but simply some of the general implications, you're probably quite correct, Mr. Minister. It stands to reason that they may well not have picked up the investment contract stuff, if I can put it that way. It's a good point. I didn't look at it that way, and I'll grant the minister that point. That stands to reason when you try to think it through in terms of the situation with Principal.

I think it's fair to say that the reason the government is seeking to repeal the investment contract is as a consequence of the Principal Trust fiasco that we saw in the province. The point remains that Mr. Robinson, when he was asked to do his report, looked at the provisions of the Investment Contract Act. I've read with interest pages 55 to 61 of his report, which deal with the provisions of the Investment Contract Act. Although he doesn't say it in the actual body of the report, it does say in part 17.2 of his recommendations that the Investment Contract Act should be repealed. I take it the government is moving as a consequence of that.

By the way, while I am on my feet and thinking about the report from Mr. Robinson, I would simply like to thank the minister, for the record, for making sure that I was given an advance copy of this report prior to its release to the public. It certainly made it easier for me to respond. The minister may not have liked my response, but I think the point is that....

HON. MR. COUVELIER: You got the headline and I didn't.

MR. SIHOTA: I can't help that, Mr Minister, but I think that it's generally appreciated on this side of the House when those types of gestures are made, and it was in my instance. I must say also for the record, because I think he does read Hansard from time to time, that Mr. Rhodes's briefing was much appreciated by me.

The discussion we then had about the implications of Mr. Robinson's report was also appreciated, I think, by both of us because it helped me to understand the report a lot better. It's truly a fascinating report, and it's the type of report that you would have expected from Mr. Robinson. It's thorough; it deals with many of the issues that came up during the course of the Principal Trust situation. It does not necessarily bring about the type of recommendations that I would have liked to see, but I think some of the recommendations brought forward were quite good.

However, having said that, there were others that weren't great — and of course the minister knows that I commented on that — and certainly there were some that were disappointing. One of the aspects of the report that I found disappointing was the references to the Investment Contract Act. Mr. Robinson said on page 55 of his report: "The terms of reference for this inquiry do not explicitly provide for an examination of the application of the Investment Contract Act." Nonetheless, he went on to raise a number of issues pursuant to the act which resulted in his conclusions.

It seems to me that the repeal of the act is not necessarily the action that should have flowed from this examination of the Investment Contract Act. First of all, it seems to me that the inquiry that the government conducted with respect to Principal Trust ought to have been broad enough to allow for a full examination of the application of the Investment Contract Act.

Secondly, it seems to me that the Investment Contract Act and its provisions ought to be investigated in detail by Mr. Robinson. I note that in his report Mr. Robinson makes reference to section 5 of the report, section 9 of the report; he makes further reference to section 13 of the report, section 17 of the report, section 22 of the report, but bypasses, in my view, a critical component of the act, which was section 10 of the old act. Section 10 of the old act was the section which allowed the superintendent of brokers to take a look at the

[ Page 2912 ]

assets of the company and to make orders when the assets of the company....

Sorry, I was given a note here and I lost my train of thought.

Under the provisions of the Investment Contract Act, the money brought in had to equal the money invested. In other words, if someone made a $100,000 investment, then the money that came in had to be invested in a piece of real estate worth, say, $100,000. So there had to be some type of equilibrium at market value to make sure that the money brought in equalled that being acquired.

I paused a minute ago because I received a note saying that section 20 of the legislation follows this debate, which of course is the piece of legislation that brings in the Securities Act provisions. I guess one of the difficulties I have is the handicap I've got to operate under, not being able to deal with the Securities Act.

I have a question I want to put to the minister before I make any detailed comments on the whole issue. Given the provisions of section 10 of the Investment Contract Act — which I trust the minister is aware of, because I know he has received representations on section 10 — could he explain to me how he sees the power given to the superintendent of brokers under section 10 of the act as being expanded under the changes contemplated, by repealing this act and allowing for it to be covered under the Securities Act?

HON. MR. COUVELIER: First of all, Mr. Chairman, I think I'd better straighten the record. The member seems to have leapt to the conclusion that this repeal of the Investment Contract Act and the folding of the regulatory requirements under the Securities Act arise purely and simply as a consequence of the Principal Trust issue. The member might remember that during the throne speech and the budget speech, this government announced its intention to rewrite all the major pieces of financial legislation extant in this province, because many of them had not been changed or amended for years. There was a need for us to recognize the rapidly changing circumstances in the financial community.

We had served notice well in advance of the Principal issue becoming so contentious that we intended to make these changes to all our financial legislation. I just wouldn't want to leave the impression that we reacted exclusively on the basis of Mr. Robinson's report, although certainly the opportunity for Mr. Robinson to comment was interesting to us, and we took some comfort from the fact that he reached the same conclusion we had, in respect to the existing legislation.

The member went on for about five minutes before he posed his question, and I found myself being distracted a few times, so I'm not quite sure I've grasped the significance of the question. It seemed to me it had something to do with asset valuation as it relates to real estate. No? Maybe you could clarify.

Interjection.

MR. SIHOTA: I'm glad to see the second member for Richmond (Mr. Loenen) is used to quoting me. I trust that this is only the beginning, and he'll continue to quote me on all sorts of things in the future, and eventually come to recognize the virtues of the principles I adhere to. Anyway, it's good to see him here. I missed him for a few days. I haven't been heckled for at least a couple of days. I know that he's here to do his job, and I look forward to his comments.

I'm sorry, Mr. Minister, for that diversion. Maybe I can be a little more explicit by pulling out the investment contract. I don't know if the minister's got a copy of it or not. I don't know if it helps.

Okay. Section 10 of the Investment Contract Act allows for the superintendent to ensure that there's an equilibrium with respect to money taken in and money invested. I will use a real estate situation as an example. If you invest $100,000 in the company, the company then has to buy at market value $100,000 worth of real estate, stocks, bonds or whatever. Under the provisions of section 10 of the Investment Contract Act, the superintendent can by order allow for an adjustment of that equilibrium. He can say that you can buy something that results in a shifting of that matching provision. What I don't understand is.... The investors who felt that they were undone by Principal Trust are quite upset over the provisions of section 10. They want to know what the superintendent of brokers did with respect to section 10 of the Investment Contract Act. I'm sure the minister is well aware, because I know he's received representations from many groups on Principal Trust, and I think most recently from the group in Victoria.

There seems to be a moment in the Principal Trust situation — I think it was around 1983 — where there was an imbalance in terms of money being taken in and what the money went to. To use the words of the act, if I can quickly reference it:

"A registered issuer shall at all times maintain reserves to pay its outstanding investment contracts that, together with all future payments to be received by the issuer on those contracts, or the portions of those future payments still to be applied to reserves, and with accumulations of interest at an assumed rate provided in the contracts, will attain the face or maturity value specified in the contracts when due" — in other words, the reserve shall be maintained on an equilibrium basis — "...or shall maintain reserves of a smaller amount deemed appropriate by the superintendent. The reserves shall at no time be less than the amount for which the registered issuer, under its investment contracts, is liable to pay in cash to the holders of all its investment contracts then outstanding."

[5:45]

It seems, in the Principal situation — to use the words of the act — that at some point the superintendent must have deemed that the reserve equilibrium should have been upset so as to allow for a less-than-equal proportion of money in and assets held. That seems evident from the financial statements of Principal Trust.

I fail to see how the provisions of the Securities Act.... As I say, I'm handicapped a bit, and if I'm out of order the Chairman can so rule, but because we're dealing with section 20 and the two are sort of connected.... How is it that the Securities Act will remedy that problem which is faced in the Principal Trust situation?

HON. MR. COUVELIER: I guess it's the hour, or something. After ten minutes of a monologue my mind starts wandering and I kind of lose the thrust. I believe it's section 11 we're debating, not section 20. Is that correct?

MR. CHAIRMAN: Section 11.

[ Page 2913 ]

HON. MR. COUVELIER: Thank you. The question of the valuation of the assets is a subject of some debate. The member is fully aware that there is the potential of some litigation on the subject. The contention of the government is that the staff acted appropriately within the constraints of the then existing legislation.

The member seems to be suggesting that the staff might not have done that, and wanted some comment. My reaction is that we believe that the staff acted appropriately within the constraints of the Investment Contract Act that applied at the time, and therein lies the need for us to repeal the act and embrace these issues in the protective mechanisms available to us in the Securities Act.

So I cannot in good conscience enter a discussion with the hon. member on the question of an issue that might well end up in the courts. I have said publicly what I have just said in the House: it is our contention that the staff acted appropriately, given the constraints that they operated under.

MR. SIHOTA: Maybe it is the lateness of the hour, and maybe I'm suffering under that as well, because much like the minister, I've been busy all day too. My question wasn't whether or not staff acted appropriately or inappropriately, although that may well be a question later on in our discussion under the Investment Contract Act. However, there was clearly an assumption in the question I posed that the superintendent of brokers, who had the obligation to take a look at the provisions of the Investment Contract Act and to look after the Principal Trust situation, had the authority under the act, to use the words of the act, "to deem otherwise." Surely, if you take a look at the financial statements of Principal Trust, particularly for 1983 and 1984, he must have deemed otherwise.

That's not the issue there — whether or not the staff acted properly or improperly in deeming that. I guess the assumption that I made at that point was that the staff had made that decision. As to the propriety of that decision at this stage, I certainly have no evidence to suggest that that decision was improperly made. So don't misconstrue my comment. Although the question of the propriety of that decision will probably be subject to another question that I'll ask later on when we get into this.

That gets me to the next issue that the minister raised, which is the question of dealing with these types of issues, given the minister's assumption of pending litigation. The minister said that I was aware of pending litigation. I can assure the minister on the record that I'm not aware of any pending litigation. I am aware that a lot of people are upset with what happened in the Principal situation, which is not saying anything too surprising. The minister is aware of that as much as I am. I am also aware of the fact that several people have raised the question of the superintendent of brokers and the propriety of its role with respect to section 10 of the Investment Contract Act; but I have not met anybody to date who has indicated they intend to proceed with some type of litigation on that issue.

Certainly if the act was repealed it would raise an interesting question as to the government's liability in the event of an impropriety. I'm certainly not suggesting any unusual motive on the part of the government, but if the act is gone.... I guess it stands to reason that the act was in place at one point and if a decision was made under the act at the time, then there may well be a legal liability attached to the Crown.

I want to make it clear that I personally am not aware of any wrongdoings by the superintendent of brokers with respect to section 10. What I had hoped was that Mr. Robinson, when investigating this issue, would have examined the role of the superintendent of brokers pursuant to the provisions of section 10 of the Investment Contract Act. Mr. Robinson ought to have investigated the role of superintendent of brokers to determine whether or not the reserves as contemplated under that section were maintained, to explain to the 13,000 investors affected by the legislation one way or the other whether or not the superintendent of brokers had made an appropriate determination when he deemed otherwise. He surely must have deemed otherwise; if he didn't, boy, I tell you, I would really like to know because I would raise questions of the propriety of the actions of the superintendent of brokers. The financial statements of the company speak for themselves. Maybe the thrust of the issue here is the minister's failure to have Mr. Robinson investigate this matter of section 10 and its application.

That may have been the way to handle the issue that I'm raising right now. I want to make it clear to the minister that I'm not jumping the gun one way or the other when I talk about the propriety of the superintendent of brokers' office. Lord knows, I've made enough comments about that office already, without having to suggest that they were doing something improper in the case of section 10, because I don't have any evidence in that regard.

However, to go on to the next point that the minister made, it seems to me, Mr. Chairman. an unusual principle, in terms of handling questions, for one to say that he is not prepared to answer questions with reference to the role of various officials under the old act — if I can call it the old act, because I'm assuming that it's going to be repealed — because of pending litigation. There is pending litigation. I guess litigation could be pending on just about any issue that the government is involved in. There may well be litigation pending with respect to the government's privatization plans. That doesn't prevent the government from talking about its privatization plans. There may be a group out there — a trade union, an individual, a business — that may be saying: "Gosh, we don't think this privatization plan is correct, and we think it violates certain provisions of the Charter." But you don't stop talking about privatization because someone's out there wanting to commence litigation.

We talked earlier about the provisions of the Municipal Act as it relates to voters lists. Again, we don't stop ourselves from talking about that issue simply because there may be an individual out there that may have some litigation pending with respect to the municipal elections that transpired. I put that on the record because, as we get into this debate, I don't think the minister ought to preclude himself from making comments on this issue because of the possibility of litigation. I emphasize that I'm not aware of litigation that's pending at this stage.

I asked the minister at the outset of the discussion a question which related to why the government chose to repeal this legislation. If I understood the minister correctly, he gave me four or five reasons as to why; particularly in reference to the superintendent of brokers' office. He gave to me five reasons as to why the powers of the office ought to be expanded. What I wanted to do was to go through those powers to make the case that there is nothing within the provisions of the Securities Act which would in any way increase some of the powers that the minister referred to. In

[ Page 2914 ]

some cases that's true. In some ways I guess we'll have to leave that debate until section 20 of the legislation. However. It's fair to say that an argument can be made that that's not necessarily the case. I think we'll have that debate when we deal with section 20 of the legislation.

SOME HON. MEMBERS: Aye.

MR. SIHOTA: It's funny. I got into a discussion earlier with the Minister of Municipal Affairs (Hon. Mrs. Johnston) when I was trying to make a serious comment. I'm trying to set the background for some serious comments with respect to this legislation, and I'm getting all the members on the other side all excited, and they want to pass the vote and get on to it. Maybe it's because we're getting to 6 o'clock. Someone says: "Well, maybe because we're all asleep." What do you want me to do? Do you want me to do the blustery routine and get all agitated, so I can get all of you heckling on the other side?

It's pushing 6 o'clock. I think maybe everyone's tired. If we can adjourn.... I pass the appropriate motion to put this over until tomorrow at 2 o'clock.

The House resumed; Mr. Speaker in the chair.

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

Hon. Mr. Strachan moved adjournment of the House.

Motion approved.

MR. SPEAKER: Before adjourning I might remind members that there is a reception in the library tonight for Margaret Hastings, who has spent 34 years in this great institution. I know all members would want to congratulate Margaret and enjoy the reception.

The House adjourned at 5:59 p.m.