[ Page 4989 ]

CONTENTS

Routine Proceedings

Private Members' Statements

Transportation route abandonment. Mr. Darcy –– 4989

Mr. Dirks

Self-advocacy for the mentally handicapped. Mr. Bruce –– 4990

Mr. Jones

The ILO and Bill 19. Mr. Gabelmann –– 4992

Hon. Mr. Strachan

Floodplain policies and regulations. Mr. De Jong –– 4993

Hon. Mr. Strachan

Mr. Stupich

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

On vote 45: minister's office –– 4994

Mrs. Boone

Mr. Mowat

Mr. Loenen

Mr. R. Fraser

The House met at 10:09 a.m.

Prayers.

HON. MR. DUECK: In the gallery this morning is a lovely person from San Jose, California. She is the mother to the assistant deputy in Health, Chris Lovelace. Joining his mother today is Chris Lovelace's wife, Chris. Would the House please make them welcome.

MR. PETERSON: Sitting above me in the members' gallery are two junior active Socreds, two young men who are very dear to my heart, my young sons Ryan and Kevin Peterson. Would the House please join me in making them welcome.

MRS. GRAN: Seated in the gallery today are several grade 7 students from Belmont Elementary School in Langley, along with their teacher Mr. Bereska. Would the House please make them welcome.

Orders of the Day

Private Members' Statements

MR. SPEAKER: By agreement, the member for Rossland-Trail will speak first instead of third.

TRANSPORTATION ROUTE ABANDONMENT

MR. D'ARCY: My thanks to you, Mr. Speaker, and to the member for North Island (Mr. Gabelmann) for this deferral.

I want to talk for a few minutes specifically about the Castlegar-Robson ferry and then on the general topic of transportation abandonment in the province. I remind the chamber that the ferry is an integral part of the British Columbia highway system; that it is, in effect, a floating bridge. As indicated by that, as I've said before, half a million vehicles a year and 900,000 people is more than treble the next busiest ferry in the interior of the province in terms of vehicles, and more than double the number of human beings being transported in any given year. The second busiest is the Needles-Fauquier ferry which is also on the Columbia River. But all other ferries are less than half, and as far as vehicles go, less than a third of the business on the Castlegar-Robson ferry.

The reason I mention that first is because on May 24 a hearing was held by the National Transportation Agency in Castlegar regarding an application by the Canadian Pacific Railway to abandon a little over a hundred miles of the Boundary subdivision of the Canadian Pacific Railway. Lo and behold, we had surrogate representatives of not one but two cabinet ministers from the province of British Columbia there, taking part in due process at the federal level against a transportation route abandonment.

I'm not opposed to their being there, nor do I think it not valuable what was said by the surrogate representations of the Minister of Transportation (Hon. Mr. Rogers) and the regional minister for the Kootenay area — the Minister of Transportation, by the way, sending a surrogate to that meeting even though he is the minister responsible for the abandonment of the Castlegar-Robson ferry.

Not only that, but I think we have to compare the fact that there is absolutely no public discussion or input permitted by the Social Credit cabinet when transportation routes are abandoned or services altered. Yet that cabinet wants to participate in due process when there is a closure mooted of a transportation link in another jurisdiction — even in the same town. Have they no shame — to send cabinet ministers who don't even allow public discussion when they abandon transportation routes?

This leads me to the general principle in this province. The British Columbia government operates two railways: British Columbia Railway and the British Columbia Hydro railway. Any part of either railway or any service on either railway can be altered at a moment's notice simply by an announcement by the government of British Columbia. There is no provision for public discussion. There is no hearing process.

The same is true for any ferry service, whether it be on the coast, in the interior or in the Fraser Valley. There's no provision for any discussion regarding the abandonment or alteration of any transit service anywhere in the province. There is no discussion regarding fare increases, whether it be on the transit services or ferry services, or regarding the imposition of tolls or the privatization of any of these services. Yet the government of B.C. wants to participate in other jurisdictions when there is a due process laid down.

[10:15]

In this chamber as well as outside the chamber, the Transportation minister, the Premier and other ministers — I remember particularly the first member for Kamloops (Hon. Mr. Richmond), the Social Services minister — stated quite clearly that anybody who talked about reduction of services or tolls being established through the process of privatization of the Highways ministry was simply scare-mongering. That's what they said. Yet immediately on review of inland ferry services, we find one ferry service completely abandoned, and the only option for putting it back into service is either by privatization or through transfer to local government and the imposition of tolls. Yet we were assured time and again by spokesmen for the government and apologists for the government outside the chamber that no such thing was going to happen, that there was no fear of privatization, that there would be no abandonments and there would be no tolls imposed. In fact, that is exactly what has happened.

The Minister of Transportation and Highways isn't here, unfortunately, but I would like the government of British Columbia to reconsider its position when it comes to simply saying that they will not brook any discussion. The cabinet minister's reply to me in this chamber when asked about this was that it was a cabinet decision and would not be further discussed.

We know that the other day in a meeting in Osoyoos the Premier expressed surprise when confronted by protesters regarding the Robson ferry and stated: "Gee whillikers, I'll look into it" — like he did in the fall of 1986 when asked about any problem anywhere in the province. That was from a person who has appointed the Transportation minister and who appoints all the cabinet and heads the cabinet, and yet we've been told by the minister that the closure was a cabinet decision and there wouldn't be any reconsideration and there wouldn't be any discussion.

I would like the government to reconsider its position not only on the Robson ferry but regarding any other transportation service provided by the government of B.C. or by

[ Page 4990 ]

a Crown corporation in British Columbia. At least look at what the federal government does when it comes to the alteration of the structure of any transportation service licensed by them in Canada.

MR. DIRKS: I rise as one of those surrogates that was at the May 24 hearing for the rail line abandonment. I'm a little amazed at the mixed message that the hon. member for Rossland-Trail is giving us. Although he said once that he was certainly not opposed to us being there and that this government did submit a response and an opposition to that rail line abandonment, he certainly was using the fact that we were there as a battering ram on another issue. I would take a little exception to that, because it is a mixed message. I think both of these things are important. Certainly the people in the Rossland-Trail constituency, and in the Kootenay region, consider the proposed abandonment of the Castlegar-Midway rail line as very important to their area.

This government certainly has considered that to be very important and has made a strong presentation against that abandonment. Our government — as has the federal government — has invested great sums of money in the past several years trying to prop up the economy of that area.

As you know, Mr. Speaker, our area has lagged in coming out of the recession. Both the federal and provincial governments have recognized that, and over the last several years they have tried through loans and so on to industries like Canpar Industries, Bradford Intercon, Pope and Talbot.... We have tried to boost the economy of that area and have made our submission that CP, rather than looking back and saying how unprofitable the line was in the past, should be looking ahead and at least considering keeping that line in existence and servicing that area over the next several years to see if, indeed, the economy is not picking up as we say it is.

It is an important thing for our area. We feel that we are at the tail end of the dog now with that line, and unless strong representation is made and unless that rail line is kept in place, the economy of that area certainly will deteriorate. I am a little amazed that the member would link those two together and do disservice to the rail line abandonment opposition that has been launched by the government.

MR. D'ARCY: I am delighted to hear the representative of the minister of state for the region reply in the chamber here. While he did not make the statement, the person who he represents — both at the hearing he talks about and in the House — has made a statement.

When asked on May 19 in the city of Trail about the closure of the Robson ferry, the minister of state replied — I wasn't there, but a number of people from the press and from the general public were there: "Ferries are not a regional issue." That's what she said, and that's the person who that gentleman over there represents. Ferries are not a regional issue. In the West Kootenay alone there is the Needles ferry and the Arrow Park ferry in Okanagan North riding; there is the Shelter Bay-Galena Bay ferry in Shuswap-Revelstoke, once again part of the region. In that member's own riding there is the Harrop, the Glade and the Kootenay Lake ferries. Yet he and the minister in charge of the region apparently say ferries are not a regional issue.

On another issue, repeating in this chamber regarding railways but not mentioning the ferry issue, when his own minister says they're not a regional matter, is running away and hiding from the real issue. I would hope that perhaps some effort would be made to address the issue of ferries and the privatization of transportation services in general in B.C., particularly in the southeast region of the province.

SELF-ADVOCACY FOR

THE MENTALLY HANDICAPPED

MR. BRUCE: I'd like to speak about an item that is unique in part to Cowichan-Malahat. Certainly it's a project that's found in a couple of other communities, and it's called Rights Now. I think it's fitting that we look at the editorial in the Times-Colonist this morning under the heading "Other Tracks,  about Operation Trackshoes to be held at Centennial Stadium this particular weekend. Operation Trackshoes is a track meet for the mentally handicapped.

There's one line in the editorial that I think we as a Legislature should take note of, and I might just read it to you: "People with mental handicaps scare many of us. That there is something to fear from them is one of the saddest myths clinging to this kind of handicap." That's quite true. The quality of a society will be measured not by the successes of the strong or the more fortunate, but by the opportunity afforded the less fortunate of our community. Can you imagine what it would be like to go through life seen but not heard, spoken about but not spoken to, looked after but not understood?

In our society, thanks to a group of very concerned people under British Columbians for Mentally Handicapped People, there is a program called Rights Now, a self-advocacy program that will afford the opportunity for the mentally handicapped to work on their own initiative, to become accepted within society as a whole. Several months ago I had one of the most interesting experiences I can think of, when I met in the basement of our city hall in Duncan with a group of some 15 to 20 mentally handicapped people of this Rights Now organization. Three pilot projects have been put together: one in Mission, one in Parksville and one in the Duncan area. I went there really not knowing what to expect, but to come and hear and speak with the people about some of their problems, figuring that perhaps half an hour would be long enough, and after two and a half hours we finally wrapped it up. I found it extremely stimulating, and it opened my eyes in part to another world, a world that for us may be easily accessible, but to many of those who are mentally handicapped there are a tremendous number of barriers. It's really and truly time for all of us in society to take a good look at the difficulties and barriers that face the mentally handicapped in our society.

The major objectives of Rights Now are these. First of all, they would like to increase the awareness of mentally handicapped people of their rights and responsibilities. They're looking to foster strong supportive relationships between volunteers and mentally handicapped people as a means of increasing their involvement in community life and their circles of support and friendship. Thirdly, they would like to develop support networks within the community to enable mentally handicapped persons to assert their rights and to respond to their needs.

Often they find themselves in difficulties just dealing with getting their own apartments and how people view them when they come to rent an apartment or what it is they would like to do with their lives in respect to jobs and the opportunities afforded them or not afforded them in regard to jobs in the workplace.

[ Page 4991 ]

They see themselves, and quite rightly so, as full citizens of this province and of this country. Where we fail is that many of us do not see them as full citizens of this province and of this country. It's not a question of more money and more facilities; nor is it a question of more programs. All of those truly do help, but what it is is how we as a society — people within this community — are going to view the mentally handicapped. Are we going to talk to them, and when we talk to them are we going to listen to them? Are we going to hear their problems and work with them to develop so that they can reach their aspirations to the fullest possible extent?

It's something that many of us should give some thought to, because often we see this group of people and we don't fully open the doors as best we could for them to be full and complete citizens in our society. I would encourage any of you that have groups or associations in your communities to participate and to seek out these organizations and enjoy the comradeship and spirit these people have, their lust for life, their interest in their community and their desire, through their own self-advocacy, to become full and complete partners in our society. It is truly a rewarding experience, and thankfully, through Rights Now opportunities are being provided for people within the community to be there as advocates to respond to the needs of those who have some mental handicaps — not to do things for them that they have difficulty with, but to assist and to tell them that they are on the right track and offer the encouragement.

What's most important with respect to the self-advocacy program of Rights Now is the opportunity for this group of people to gather together once a month or once every two weeks and share among themselves some of the problems they are faced with and to go out into the community and let the community know that they are alive and well. They live as full citizens in that community, and they want the opportunity to fully participate in our society and our community.

MR. JONES: I would like to thank the member from Cowichan-Malahat for his remarks, and I'd like to add to those remarks rather than try to take away from them. I understand the feelings and the concerns of that member because I too had a similar experience recently. I had an opportunity to speak to the People First conference. I assume People First is a very similar organization to the one the member from Cowichan-Malahat describes.

This was a conference of representatives of mentally handicapped organizations from all over the province who gathered together about a month ago at the University of British Columbia and put on a three-day conference entirely organized and run by themselves. It was a very refreshing, rewarding and worthwhile morning for me. I can only echo the comments of the member from Cowichan-Malahat in terms of my reaction to that experience. This group which has similar aims of self-advocacy sees in their name — People First — the recognition that all of us on this planet are unique. We all have our own strengths, our own weaknesses and our individual characteristics, but we all share something in common: we are all people first. These people, particularly from the mentally handicapped community, have to be recognized as that. They have to be able to live their lives with dignity and respect and to be treated as first-class citizens.

The problems that the mentally handicapped community experience are profound ones that we take for granted — problems in housing and in the nominal operations where you are often treated as a child and not as a grownup. Questions of marriage and having children and the things that many of us take for granted are real struggles for these individuals, but they face those struggles with courage, hope and humour. It was a very rewarding experience for me that morning.

[10:30]

I would say to the member for Cowichan-Malahat that not only are the attitudes of society a problem, and clearly I agree with that concern, but there are problems — and I disagree with the member for Cowichan-Malahat when he says there aren't — of money, facilities and programs.

People, particularly mentally handicapped people, have a right to food, shelter, housing, employment, education, advocacy and transportation. It's only just recently that we saw a severe attitude problem on the part of this government when, at the beginning of the National Access Awareness Week for the disabled, the government turned down a transportation plan for handicapped preschool children, a plan that would cost some half-million dollars. As a result of the turning down of that plan, we see the deprivation of opportunities for handicapped people in greater Vancouver. These people need that transportation; they are unable, in terms of those preschool children, to look after themselves in transportation. I think it's a shocking state of affairs to have this situation in the province when we know that the greatest amount of learning takes place in those formative years. The opportunities for handicapped people to attend preschool would certainly be of tremendous assistance and is necessary for them.

I say to the member for Cowichan-Malahat: you're right on in terms of rights for the mentally handicapped, but take some of those concerns that you have to the Social Credit caucus, the cabinet and the Premier. Be an advocate on their behalf and assist them in their self-advocacy to ensure that they do have equal opportunity. Sometimes that requires money, programs and assistance so that they can achieve. Unequal treatment sometimes produces equal opportunity.

MR. BRUCE: I wasn't about to politicize this statement, and certainly I for one wouldn't suggest that all the financial resources necessary to make a complete and fair society for all people of all descriptions is available today — nor, perhaps, will it ever be available. However, individual attitude is extremely important, and it is something that cannot be either legislated or financially provided.

That was the point of the discussion today — our own attitudes, not the financial end of things, not the pocketbook, because that goes without saying. There will always be a requirement for more financial assistance, be it in this field or any other field of service that government provides. However, this is a self-advocacy group. They are looking to be sustaining themselves, which is commendable and something that certainly we should do whatever we can to help with, whether it is providing some seed money so they can be up, fully running and operational, or whether it's being there to provide assistance when necessary.

I wish not to offend this House, but as part of this presentation today I would like, if I may, to just mention a few people who are here in the House with us, people who are representatives of Rights Now. There is Larry Lea, Kevan Rundquist, Darlene Volker, Kelly Telfir, Robert and Janet Thompson, Lorna Gowanlock, Laurie Thompson, Rick Cardy and, with them, their volunteer supporters John Salmen, Terry Murphy, Cathy Lambert and the director of the

[ Page 4992 ]

Rights Now project, Kim Lyster. These people have done, I think, a phenomenally good job in bringing to our attention the needs and aspirations of those who are mentally handicapped and in trying to develop the Rights Now project.

It is up to us not just as legislators but as members of society to do what we can to improve the attitudes and opportunities for these people in our community. They don't want the world; they simply want a place in it. We could make a difference by being there when they need some help. Just think what it would be like for them to go through life being seen and heard, being spoken about and spoken to, being looked after and understood.

THE ILO AND BILL 19

MR. GABELMANN: I want today to make some comments concerning the decision earlier this week of the International Labour Organization, the ILO. I had intended initially to discuss the recommendations made by the ILO, but it occurred to me on reading the press reports this week that what I might better do with my time this morning is talk about the ILO itself, because clearly some members of this House don't understand what it is or who it is.

I'll refer to a couple of press reports. First of all, in the Vancouver Sun on June 8, the Premier is quoted as saying in response to this recommendation from the ILO: "Like I say, it was to be expected. The body is made up of labour organizations, and they tend to view it a little differently than the general populace would."

In another news report on the same day in the Province, the lead is: "A United Nations agency that criticized B.C. labour law has no legal status and is probably misinformed' Premier Bill Vander Zalm said yesterday." Later on in the story, he said: "They (the ILO) are not a legal body per se, I gather. I suppose they got all their information from Mr. Georgetti." That kind of ignorance — in the best sense of the word ignorance — is unfortunate coming from the Premier of this province.

The ILO was established as a direct result of the Treaty of Versaille in 1919. The constitution of the ILO is in fact section 13 of the Treaty of Versaille, which was a treaty that was put together following the First World War in 1919.

In 1946, following the formation of the United Nations, the ILO was the first specialized agency to be associated with the UN. In fact, in 1969 the ILO won the Nobel peace prize for its efforts to improve working conditions.

The ILO is obviously a United Nations organization. The Premier thinks it's made up of labour representatives. In fact, the ILO has as its membership a three-party arrangement dominated by governments: two representatives from government, one from labour and one from management. The committee that made the recommendations affecting last year's Bill 19 was made up of a group of 28: 14 government, seven trade union representatives and seven employer representatives from around the world.

The Premier says the ILO doesn't have any legal status; in fact, it does. Canada was a signatory to the ILO convention that is referred to in this particular recommendation this week. In 1948 Canada ratified and signed convention 87 — "convention" being another word for a rule or a legal document. Convention 87 has entitled the freedom of association and protection of right to organize. Canada signed that document in 1948. The implication of signing the document is that we would adhere to the rules set out in that particular convention.

The Premier also indicated that the ILO was probably misinformed. I wonder if the Premier knows that on January 18 this year the government of British Columbia sent through the federal government to the ILO a major position paper defending itself against the charges which had been initiated by the Canadian Labour Congress. So the government of British Columbia — at least part of it — understood that this was a formal legal process affecting an international law which Canada has signed and ratified. In fact the government of British Columbia made a strong effort to defend itself, and on some points the ILO agreed with the government's position. But on a large number of positions the ILO said that the law in question — the Industrial Relations Reform Act, 1987 — was in violation of the law that we as a country signed. In a series of recommendations — eight in number — they recommended that the law in British Columbia be amended to reflect the convention that we as a country had signed and agreed to. As I say, it's important, I think, for British Columbians to know that we do have international obligations, that we do take part in world law-making, because through the United Nations we have actually signed and agreed to obey certain general rules and policies. When governments in this country disobey, they should be brought to task, and they have been.

HON. MR. STRACHAN: At the outset I would like to offer apologies, I guess, on behalf of the Minister of Labour (Hon. L. Hanson), who was aware that this item was on the order paper and did want to respond to it, but who, because of a previous commitment, cannot be here today. However, I have from my colleague the Minister of Labour a prepared statement with respect to the recent ruling and press release of the Canadian Labour Congress and the British Columbia position on that, which I will read to the Legislative Assembly now and for the benefit of the member for North Island.

[10:45]

"As British Columbia is not a member of the ILO — the Canadian government is — the province of British Columbia was not a party to the complaint made by the CLC to the freedom of association committee of the ILO regarding Bill 19, the Industrial Relations Reform Act. As a member of the ILO, the government of Canada presented the formal response to the Canadian Labour Congress complaint. Labour Canada's office of international affairs advised June 3 that it had not officially received the ILO freedom of association committee's report. Once they receive it they will forward it to British Columbia's Minister of Labour and Consumer Services for his consideration."

As I've said, we have as yet not received that. It would therefore be premature for the minister or the government of British Columbia to comment on the report.

"Once the report is received, the minister will be preparing a response to be presented to the ILO through Labour Canada. As complainant, the Canadian Labour Congress will have received the report directly from the ILO freedom of association committee.

"The Canadian Labour Congress press release implies that the freedom of association committee condemned the whole of Bill 19. Our discussions with Labour Canada indicate that this is not the case. The committee's conclusions and recommendations

[ Page 4993 ]

are apparently directed to a very few specific sections of the legislation. The committee has apparently declined comment on most sections of the legislation and specifically approved certain sections.

"Our discussions with Labour Canada indicate that there may be conclusions and recommendations in the report which require further clarification. The minister's response will seek such clarification and will provide further information which will aid the committee in its interpretation of the legislation. In short, the proper protocol is for the province to respond to the report through Labour Canada. That protocol will be followed. "

MR. GABELMANN: If I'd known that the Minister of Labour hadn't had the report, I could have made mine, faxed to me from Geneva, available to him. I would have assumed, on a report like this, that the Minister of Labour's office would have made some effort to get it, as I did. I find it a little bit astounding that they don't have a copy. However, let me read to the House some of the recommendations so that people know what we're talking about in terms of specific recommendations.

"The committee considers that several provisions contained in Bill 19 on industrial relations are not in conformity with the principles of freedom of association.

"The committee therefore requests the federal Canadian government to invite the government of British Columbia to amend its legislation.

"As regards recourse to compulsory arbitration to put an end to a strike, the committee draws the government's attention to the need to limit the right of public authorities to have recourse to arbitration to cases and circumstances in which strikes may be limited or even prohibited — i.e. in the public service involving civil servants acting on behalf of the public authorities and in essential services, whether public or private — insofar as an interruption of these services might endanger the life, personal safety or health of the population.

"With respect to the obligation on arbitrators to take account of ability-to-pay criteria when making awards, the committee requests the federal government to invite the provincial government to amend its legislation to encourage and promote the development and use of voluntary collective bargaining procedures between employers or employers' organizations, on the one hand, and workers' organizations, on the other hand, to ensure that working conditions of workers protected by the principles contained in convention No. 98 are settled by these means."

As regards the determination of minimum services to be maintained in the essential services, the committee recommends that consultation with the unions and the employers involved be taken first, which does not happen in Bill 19.

"Concerning the right of employers to discipline any worker refusing to obey a back-to-work order, the committee requests the federal government to invite the provincial government to amend its legislation so that employers may in no case, discipline workers as they wish and to limit back-to-work orders to the specific cases mentioned above, i.e. in the event of a strike in the civil service and essential services, in the strictest sense of that term.

"As regards the legislative ban on including secondary boycott clauses in collective agreements, the committee requests the federal government to invite the government of British Columbia not to include in its legislation restrictions on clauses which could be included in collective agreements."

Finally: "The committee draws the attention of the committee of experts" — another ILO committee on the application of conventions and recommendations — "to the effect of this legislation on the application of convention No. 87, which is ratified by Canada."

The ILO has to go through the process of asking the federal government to ask the provincial government, because it's an international organization and B.C. is not a direct party to that, obviously. It is asking the government to change the legislation because it violates the convention we signed.

FLOODPLAIN POLICIES AND REGULATIONS

MR. DE JONG: I'd like to speak very briefly this morning on the floodplain policies and regulations as they apply today.

We know that we have a couple of major rivers in our province, and from time to time, with fast runoff in the springtime, these rivers can present problems, particularly to those "floodplain areas" within the province.

We've had tremendous response from both the federal and provincial governments over the last 30 to 40 years to the 48 floods and subsequent high-water levels, in upgrading the dike system and the foreshores and everything else that goes along with protecting those lands subject to flooding from time to time.

An older pioneer farmer said to me once when we were discussing this matter: "Really, even with an average snow pack, if weather conditions work against normal procedures, we could have floods many more times than we do, because the amount of snow is not really the problem; it's the weather that occurs in the springtime. If it's cold up till the middle of May and all of a sudden you get a hot spell with warm rains, yes, we're in trouble, even with the best of dikes."

With the provincial and federal governments having taken full responsibility for the dikes — which undoubtedly the people living behind the dikes are very happy about — they are now going a little further, and have done for the last couple of years, in protecting what is behind the dikes. I could refer to the situation that happened in Kamloops a few years ago, when a rather new subdivision was threatened by floods and in fact was flooded.

With the policy in place at the present time, there seems to be no recognition given to those who must live on those floodplains — in other words, the farmers. The farmer's home, even though it's a residence, I don't think can be considered under today's policies as residential development. In the municipality that I'm very familiar with, in Matsqui, if we would adhere to the floodplain policies, the houses would have to be built approximately 10 to 12 feet above natural ground level, which is not very acceptable to the individual applying for a building permit. It looks awful, and it doesn't make sense.

1 think that the people in Matsqui and other communities, I'm sure, are very responsive and responsible to local flooding

[ Page 4994 ]

within the diked areas, but just because the senior governments have improved the dikes, I don't think we should subject the people to those policies. In fact, if they don't adhere to them, the liability will fall back on the individual or the municipality that hasn't adhered to them.

I'm a bit concerned about the policies in that respect, because when I read the new policy guidelines, it is suggested that the policies now in place are going to be put into the local zoning or building bylaws, which would make many a home within the floodplain areas non-conforming with the bylaws for one thing, and secondly, it's just not realistic for those on the farming properties.

I must say again that I very much appreciate the efforts that have been made with the dikes and the protection of those who live behind the dikes, but the problem is that we seem to use a policy that we want to apply to all of British Columbia. Whereas it may apply in some areas, I think that the regional aspects come very much into play, and we cannot just accept a universal policy. Secondly, to expect municipalities to incorporate this into bylaws is not only going to be difficult but, I think, unfair, particularly to the farming population in the floodplain areas.

HON. MR. STRACHAN: I'll respond as the minister responsible for the floodplain management plans. I understand the first member for Nanaimo (Mr. Stupich) wishes to speak as well, so I will be quite brief.

Just to bring the assembly up on the status at this point, the Ministry of Environment and Parks — particularly the water management branch, under the very able direction of a very capable young lady by the name of Sandra Smith — has put together the floodplain program that, of course, has been of interest to people in the Fraser Valley, which the member represents. We introduced the concept of floodplain management plans in September 1987, and we hope to have prototype plans in place by September of this year. Under these plans standards for floodproofing of agricultural buildings will be left to the local government in the farming community, provided protection against flooding in severe local storms is established. The floodplain management plan for the district of Chilliwack is presently under preparation. The districts of Abbotsford and Matsqui have requested such plans, and their preparation is regarded as a priority by the ministry,

Further, I can advise the assembly and the member that my deputy minister, Mr. Anthony, will be meeting with the district of Abbotsford on June 20, which is just a couple of weeks from now. So we hope to have all communications and our intent and plans in place soon.

MR. STUPICH: Unfortunately the minister didn't really give us any answers to the questions posed by the hon. member who presented this statement.

The question was: how do you develop bylaws for floodplains, particularly with respect to agricultural residences? I can see the difficulty of imposing restrictions on them to the extent described by the member, where they would have to be ten or 12 feet above the ground. The concern I have, of course, is that if you don't impose such regulations, who pays in the event that there is a major disaster, as there very well may be? The member mentioned that. We never know when it's coming again.

An even greater concern that I have is that there is always the danger that governments are going to take that land out of the agricultural land reserve and allow other kinds of construction, such as housing developments or business and industry, in such areas. What do you do about that situation? It shouldn't come up in the first place. There shouldn't be more building than is absolutely necessary for the farming industry. But there's always the danger it will happen, and once again the question comes up: who's going to pay the shot if there is a major disaster?

I think we'll have to wait for the plans the minister tells us they're working on to see the details before we can really talk about it. But the member's points are well worth considering at this time.

MR. SPEAKER: The second member for Richmond seeks leave to make an introduction.

Leave granted.

MR. LOENEN: It's indeed a delight for me to welcome to the Legislature 19 students of the grade 7 class at the Richmond Christian School. They're accompanied by their teacher, Margaret Venema, and some of the parents. Richmond Christian is a school I attended as a youngster; our children did too, and I served on its board. It's a school that has a place in my heart. I would like the House to join me in extending a very heartfelt welcome to the students. I hope you'll enjoy your stay.

[11:00]

MR. DE JONG: I am encouraged by the comments from both the minister and the member of the opposition. I believe that if we want to be fair, we cannot apply universal policy. I can also appreciate the feeling of government — in this case both governments — having done so much work and having spent an awful lot of money for the protection of people and property, that they should accept some responsibility in regard to the money spent and the protection afforded. However, I don't think the engineers or the governments of the day that improved the diking system were of the opinion that this was a guarantee against flooding. Hence, of course, we have the regulations and the provisions.

At the same time, as I said before, I do not believe that a universal policy such as this should apply to residences, particularly in the farming areas. As the member from the opposition said, this could lead to other things if the regulations were changed. I believe that if a specific reference or notice was given recognizing the agricultural dwellings in the floodplain areas, that would in fact discourage other types of development which are very much more costly when floods do occur. Again, I want to thank the minister for an in-depth study into the various areas which, in my opinion, would lead to a variety of bylaws that could be had in each jurisdiction. However, the general intent in the policies I see still speaks of 0.6 metres below the top of the dike, which is a minor modification, and I don't think that's good enough.

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

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

ESTIMATES: MINISTRY OF HEALTH

(continued)

On vote 45: minister's office, $305,183.

[ Page 4995 ]

MRS. BOONE: There are a couple of different areas I want to cover, but I would like to mention — and I hope that the minister doesn't take offence at this — ambulances again. I know you don't like to talk about ambulances very much, but there are some issues that we have to deal with.

First of all, I don't think anybody in this province would deny that we have one of the best ambulance services in the world, and we have top-notch personnel and an excellent service. As opposition, we are trying to make sure that we maintain that service, and that it is in no way watered down or that it becomes less of a service than what it is, because it certainly is a top-notch service.

In the budget, though, we do have some concerns. The initial one is the implementation of the increase in the user fees — transportation fees that came about — to $35 for the first kilometre plus 35 cents a kilometre. This is a substantial increase for this area, and I would like to ask the minister where this money is going. Does this money go into general revenue? Is that where this money is accumulated, and how much does the minister estimate will be gathered by the province in those fees?

HON. MR. DUECK: I don't think I mind talking about ambulances. I like talking about our ambulance service because I am very proud of it, so why should I mind talking about ambulances and the people who serve so well in that area? You said it correctly: we have a good ambulance service.

You asked one question as to the anticipated 1988-89 revenue with the increase in charges. We believe it will be $9,850,000. That's the total revenue. What's the increase? You asked about the increase derived from that $35 versus the $25, so that would make it about $1.8 million in increased revenues.

The other question was whether the revenue from the ambulances went into general revenue or some other ministry department. All the revenue moneys go to general revenue, and all our moneys that we need come from general revenue. So it really doesn't matter whether it goes to one department or whether it goes into general revenue, and we get it from the main body of money, because it comes in and goes out. If I have a budget of $3.9 billion, it doesn't really matter whether some of the revenue comes in or whether all the revenue goes into the one pot, and then I derive whatever I need from that particular source. I don't make any excuses, and neither do I think it matters. As long as I have a budget of X number of dollars, it will be covered.

MRS. BOONE: No, I was just wondering where I could find it in the budget there. Sometimes it is difficult to find things, as you know. The budget shows, as I indicated, an operating cost increase of 27 percent; that's in utilities, materials, supplies, vehicles, equipment operation and maintenance.... From what I understand, that's gone up 36 percent. I guess both of those areas — operating costs and the other areas, subsection 50 — are substantial increases; very large increases, in fact. I'm wondering what is causing these increases and how they relate to the centralization that took place in the ambulance services throughout the province.

HON. MR. DUECK: Mr. Chairman, the money does not go towards the centralization, but it does cover funding to cover, for example, costs associated with maintaining and servicing the existing fleet and providing most appropriate air evacuation equipment in emergencies. If you're trying to define between the two whether we're spending more money in centralization, the answer is no.

MRS. BOONE: Are you saying that these massive increases, for example the 36 percent increase...? Is it due mainly to operating the ambulances? Subsection 50, 1 understand, has an increase; utilities, materials, supplies, vehicle, and equipment operation and maintenance have increased 36 percent. What I would like to know is why there's been that substantial increase in that area. Is it strictly the air evac? Have we implemented more air evacuation programs? Do we have more air ambulances around? Is this what has happened?

HON. MR. DUECK: Mr. Chairman, I understand it includes also the purchase of ambulances. We have a fleet of 75 extra this year.

Yes, there's an increase in utilization. There's an increase in evacuation by air and in ground ambulance service. I suppose the big increase, including salaries, etc., makes up that amount.

MRS. BOONE: I can't argue with the replacement of some of our ambulances. I dealt with many of those ambulances, and I know that what they were costing the taxpayer was horrendous at times. To replace them makes very good economic sense.

I'd like to ask the minister about the air ambulance service in Prince Rupert. The information that I have is that the air ambulance service.... Is it a helicopter? Yes, it's a helicopter. It has been forbidden to fly in the evening. That virtually leaves that community without any air ambulance service in the evening. What is happening with regard to that whole situation? Here I am showing you my ignorance on this thing. I'm not sure; do helicopters fly at all at night? I don't know if they do or not. If they do, then why can't these fly in the Rupert area? If they don't, then I certainly accept that. Perhaps you can tell me why the air ambulance is not operating in the evening in the Rupert area.

HON. MR. DUECK: Mr. Chairman, this goes back some time, when we contracted with the Lions Club to operate an MBB-105 helicopter in the Prince Rupert area. There was a lot of pressure on from Prince Rupert residents and from the surrounding area for night evacuation. Up to that point we had contracted to various firms and also with the Coast Guard, but it wasn't satisfactory; the community wanted a full-time standby helicopter, with crew, to look after this service. We made a deal with the Lions Club that they would look after all the excess funding that would be required. We would fund the same as we had other years, and they would pick up the balance. We had some concerns about this particular type of helicopter, although we were told it would suffice.

It turned out that on May 22, I understand, the Emergency Health Services Commission temporarily discontinued it because there were some serious safety-related concerns regarding the efficacy of this helicopter to provide night Medivac service to the Prince Rupert area. Because of that, we had no choice but to suspend services until we check out exactly why there is a safety concern. As you can well appreciate, we could not operate that helicopter any longer. It had one pilot, apparently, rather than two, and there was

[ Page 4996 ]

much concern expressed. We're looking at that whole area now: whether we can still come up with a solution. Whether it's two pilots or a different helicopter, I'm not sure. But at the present time, that helicopter is not doing any night flying, and rightly so, because there is a safety concern.

MRS. BOONE: The article says it is pending a full review. Can you tell me what the nature of the review is that's taking place regarding this ambulance service? What is the ministry doing to work around this situation? 

[11:15]

HON. MR. DUECK: I should mention that we have coverage in the Prince Rupert area. The Coast Guard has agreed to pick up the slack or the need for a helicopter in night evacuation. So it's not as though the community is without service. We have a panel of ministry people and outside independent people looking at this issue of safety and whether or not we can continue with that particular type of aircraft.

MRS. BOONE: As my colleague for New Westminster says, I wish I had someone to push my papers around too.

When we get into the ambulance services here, I would like to talk a little bit at this point about the centralization process that took place. I want to make it clear that I'm dealing only with the technology on this issue; we are not talking about staff or anything. We are dealing strictly with the technology. When the centralization took place last fall, there were promises of top-notch technology. Since that time, there have been some problems — not with the personnel, as I said, but with the technology breaking down.

It is my understanding that the technology promised by the ministry still is not in place. I would like the minister to tell us when improvements will come to the communications systems, and when we can expect to have the full technological advances that were promised us in the fall of last year.

HON. MR. DUECK: Mr. Chairman, this has come up a number of times in the House. I appreciate you asking that question again, because when we are talking about evacuations, there is not much room for time. In other words, it has to be done now, and we appreciate that as well as you do.

However, the centralization of this particular service has, in our opinion, been nothing but a great success. I have checked out every complaint that has come not just from the opposition — which perhaps is natural and should be — but also from citizens from the areas that are now having this centralized service.

You say "shuffling papers around"; I'm shuffling too, because nobody can hand me the note I've got on that. However, I think I know the subject well enough to say that we have found absolutely no breakdown in equipment whatsoever. I must tell you very sincerely that I have checked every complaint I have received in my office, because it is a concern when you have someone.... When someone is evacuated or picked up by an ambulance, it is obviously not something that can wait another half hour or hour; it is urgent, and it is an emergency. That's why we call it emergency evacuation or delivery.

In every instance where someone has complained about excessive time limits, I haven't found one. There may be one, and I grant you no system is perfect. But in this particular time since the centralization has taken place, I have to admit I haven't found one. I've asked my people to investigate, and they've done it in every case, and it's always come out clean.

I get these complaints. I still get the odd one — not very many. Most of them say it is due to manpower shift, which I can understand. For example, one particular city or town will lose certain people because it's centralized service. However, we're looking at it in a much more global sense when we look at the total province and how we can deliver this service better. I believe that the answer is in what we've done. The question comes up again and again: how does the individual operating in the centralized service know where a certain street is?

That person doesn't have to know. All they do is pass on that information. It's like a phone call if you're two blocks or so many miles away in another city. My people and the experts tell me it does not make a difference. The service has not been compromised in every instance that has been brought to my attention. If you have some more complaints, I want to know them. I want to know specifically which one, when and where, and I will get you that information. If there is something wrong with our technology or equipment, we want to correct it as much as you do, because we're talking about people's lives. I will not take a second stand on that whatsoever.

MRS. BOONE: Once again, the minister is misreading what I'm saying. I did not ask you about your personnel and how they could dispatch. I'm talking about the communication, the technology there. I know; I have letters. And I can't show you this letter, because it's from an employee of yours who has said: "Please do not use my name or get me involved, because I am scared for my job." There has been a breakdown there. This employee will tell me about pagers that he can't hear because there's such a breakup that they can't hear what's coming through. He mentioned a case where the regional manager was in fact there when Kamloops had to phone them back a second time in order for them to get through. That has nothing to do with the people. That has nothing to do with knowledge or anything like that. It has to do with technology.

I know for a fact that at one time in Prince George the ambulance could not raise the hospital, and they were in the city limits. I know for a fact that around the Christmas season communication lines were broken down completely between Prince George and Kamloops, and they had to pull in a part-timer to sit in the office. I know that that has occurred.

I know that the people out there are nervous about talking to you. You can talk to the regional manager, and he will tell you what you want to hear. If you talk to the employees, you may get what you want to hear, but I'm telling you that they are all very nervous right now about what's happening on their jobs. I can tell you that a lot of them called me after some of the things that we've brought up and were really upset and really concerned because suddenly all the pressure came down on them from up above saying: "Did you talk to this person? Did you come and report this?" That's the fact. The fact is that the people out there right now are very nervous about their jobs.

I don't want this to be a shift onto the people and whether they can cope on their jobs. All I'm asking is that you check out the technology to make sure that there isn't that breakdown in the communication lines so that people can always be assured of getting through. I'm as convinced as you that once the communication lines are there, we have top-notch

[ Page 4997 ]

people who can handle these jobs and cope quite well, but I am really concerned when I hear things about breakup and not being able to get lines through.

I guess my question to you, as I stated earlier, is: are all the technological changes in place right now that you intended to take place? Were they all in place three months ago? I guess that's the question. I don't think you have to answer; I'm getting the reading from the deputy's shrugs and yeses and noes and nods of heads.

If they are all in place, then I think you ought to take a second look and go out and talk not to the regional managers who are going to tell you what you want to hear but to the employees out there — "Is there a problem in your communications system? Are you having a breakup with your pagers? Do you ever have difficulty in reaching these things?" — just in a straightforward manner, so we can be assured that the top-notch people we have are given the proper equipment to deal with.

HON. MR. DUECK: First of all, we have, I understand, the best technology, pagers, etc., that you can possibly get. I will assure you that no one loses their job because they tell us of some breakdown in equipment where we can make an improvement. However, I should also add, while I say that no one will lose their job, that unless some of that information comes through to us.... It's very difficult on this side to do something that will correct it if these people who know of some flaws don't come forward and tell us.

The other thing is that my deputy, Stan Dubas, happens to be the chairman of the emergency health services. He has gone out on a number of occasions riding shotgun on ambulances and talking to the people who are actually in the field, not to the regional managers. He loves that kind of work, and he's done this now on many occasions, and he's continuing to do it.

If there is a problem, please let us know, because we're quite proud of the service and of the equipment we have and the technology that has been put in place. But whether it was there three months ago at this moment I couldn't tell you. Maybe some of this stuff has been changed since that time. I hope it has, because what I'm hearing from you is disturbing to me, and it's certainly disturbing to the chairman of the emergency health services. As I said earlier, that is one area where we cannot say: "So what? If it takes another half an hour, that's not too bad." It must be done now, immediately. So that is one area we are certainly very concerned about, and when there is a problem....

I wish that you would talk to this individual again. I can guarantee you that in my ministry no one loses their job if they come up with a better idea. We might give him a merit certificate for having alerted us to an area of concern. I can say this as minister: that has never been my style of operation, and by golly, if we have anyone in our ministry that practises that style of operation, they will certainly be reprimanded, not the one who gives us that information,

MRS. BOONE: Well, I thank the minister for that message, and I can assure you that I will be passing it on to people so that they do contact you if they have any concerns.

I'd like to talk to you a little bit about the privatizing of the priority 3 and 4 ambulance services. You indicated earlier that that has taken place for some time now on transfers. I would like to know if it is strictly in the Vancouver area that those private transfers have occurred in the past. I don't know of their happening anywhere else. How greatly used are the private transfers of priority 3 and 4 services?

HON. MR. DUECK: We're talking about transfer services other than emergencies. I don't think we are referring to priorities 1, 2 or 3. We are really speaking of transfers that are not emergent. Yes, it's happening mostly in the urban area. As a matter of fact, as far as I know it's been exclusively in metropolitan Vancouver and maybe the Victoria area.

I got a note here that the Emergency Health Services Commission is currently reviewing its mandate and considering options that will enhance the provincial ambulance service's ability to respond to the public in times of emergency with highly trained ambulance personnel. In other words, we're freeing up those people who are the emergency medics who handle emergencies. We're talking about transfers. It's not something new.

I'm sure you are aware that it really began when there was a document circulated from one of our people to a regional manager or director — some of his ideas that he had. It was exactly that. What we have said before, and we restate our policy on this, is that if the hospitals.... We're not making the decision, but we're allowing them to use a transfer service if they feel there is no danger or risk to that patient.

It's not to save dollars. It is really to free up the medics that are on the ambulance team, because we have had cases in the city where they were involved in the transfer of patients, and we found that we could not dispatch the medics where they were needed. Sometimes there are two; there'll be one with the inhalator squad.... The fire department comes first, and ours comes later. Really, the physician makes that decision, because he is ultimately the individual who will say: "No, I'm sorry. We will not transfer this particular patient. It's got to be by ambulance."

Again, the purpose was to free up emergency vehicles for emergencies. It's worked out quite well, and we've done it for some time without any bad effects on the public or the medical profession.

[11:30]

I have a note now that apparently out of 41 ambulances, up to 17 have been taxi service at one time, so I suppose what we're trying to say is that we don't want them to be used as a taxi; the ambulance should be used for emergency delivery. That's what we are doing at this time. I think I mentioned that it has been in place for quite some time, but it's become more evident because it has become an issue. I would really like to put it to rest and say we are doing it again for the better service to the people who need emergency service.

MRS. BOONE: As it has been going for some time now — and the last time I asked the minister this, he indicated that he didn't think there were any standards — is the minister now ready to develop standards and regulations for the vehicles and the employees to ensure that the employees have some medical training? Although these are non-emergencies, they are transferring patients who are ill and could require some kind of medical attention. Is the minister now ready to develop some standards and regulations for the vehicles and also some qualifications for the people who are working in those alternatives to ambulances?

HON. MR. DUECK: I understand they are at minimum standards at this time. It's not satisfactory to us, and we are now developing standards to toughen up on personnel and

[ Page 4998 ]

vehicles — the total package. There are minimum standards before they can even go into this service, but we feel that for our purposes they should be strengthened and tightened up, which we are in the process of doing.

MRS. BOONE: I certainly appreciate that, and I would encourage the minister and the ministry to develop those standards as soon as possible and put those regulations into place, because those vehicles are operating right now. They are transferring patients. We must be assured that all people have not just the minimum standards, but safe standards — safe in terms of the personnel and the vehicles they are operating under. I would ask the minister if those vehicles, for example, have to undergo special testing procedures. Your ministry has a whole department that does nothing but deal with the mechanical aspects of your vehicles and makes sure they are always in top-notch shape and in a safe condition. Are these vehicles required to go through a safety test? Are they required to make sure their brakes are in running order? Is there a minimum safety test for these vehicles?

HON. MR. DUECK: I think I mentioned that there have to be minimum standards, and we are now tightening up on that or making it just a little more to our standards. At the present time, vehicles used in a client transportation service must be licensed under the Motor Carrier Act as a limited passenger vehicle. That's all the standard there is at this time, but that's the one we are tightening up to be closer to what we think is adequate or appropriate for this type of transfer.

MRS. BOONE: I want to thank the minister for his candid answers on the ambulance. Now I am going to move into the Medical Services Plan, so you can shift all your papers around over there and get into that mode.

I mentioned this in my budget speech; it's something that concerned me at the time. When you look at the Medical Services Plan, there have been changes in the whole.... I had a lot of trouble dealing with the budget, as you know — trying to figure out what money went where and how it fit in there. But one of the things I was able to determine was that there was a change in the whole operation of how the Medical Services Plan was dealt with. In the past, the Medical Services Plan showed up only as the amount that the government contributed. All of the Medical Services Plan money was not shown there. The fees were not shown; they went immediately into the Medical Services Plan, and anything that the government added to top up those fees over and above that amount was shown in the budget. This year's budget shows the full amount.

The concern that I had — and I raised this with you last time — was that Medical Services Plan premiums are going into general revenue now, yet the moneys coming back from general revenue into the Medical Services Plan are less than the amount shown in the estimate as the amount raised by the Medical Services Plan, which seems a very strange thing to me. It's in the millions of dollars. It appears to me not quite the right way to deal with things. In the past it always went straight into medical services, and then it was topped up. Now it just seems a little funny in there.

One of the things I'm interested in, though, is that the Medical Service Act states in part 8.06:

"The gross amount of all premiums paid by or for insured persons for insured services under the plan shall be remitted monthly to the commission, and the commission shall pay out of the funds so remitted the expenditures necessary for the operation and function of the plan in accordance with any agreement made by the commission, and the amounts as determined by the commission in payment of insured services, and in the event of any deficiency in the funds to meet the expenditures necessary, the commission shall make application to the minister under section 12 of the Act for moneys to be paid out of the consolidated revenue fund."

According to the Medical Service Act, then, you are actually breaking the act by not putting that money directly into the Medical Services fund and instead putting it into general revenue, as you are doing right now.

HON. MR. DUECK: To begin with, you're right; the moneys collected go directly into consolidated revenue. We're also attempting to raise 50 percent of the total MSP from premiums. I'm told that the Financial Administration Act takes precedence, and apparently there's been a change. I would have to check that out to be absolutely sure, because what you're saying does not comply with our legislation. I can't give you the answer at this time.

But what we have done in the past we do again, because when we talk about MSP, it's an open-ended department, because as the amounts increase, we don't know from year to year how high they will go, and they must be paid. Whether we budget a certain amount or not for that year, it still has to be paid. If it's an overrun, it's paid; if it's an underestimation — which it never is — it still has to be covered. We don't go to the end of that amount in the estimates and say: "Well, we have no more money." It must be covered.

So if your concern is whether there's enough money there to look after the obligation or liability, it's been that way for years. It always increases, it's covered, and it will be paid. We're trying to cover 50 percent of the total MSP budget, which this year will probably be $1 billion or better.... We will try to retrieve 50 percent from the premiums.

Having said that, Mr. Chairman, I would ask leave to make an introduction.

Leave granted.

HON. MR. DUECK: In the gallery today is my wife, joined by my sister and her husband, retired people from the Central Fraser Valley. Because they're retired, they were responsible for getting me out of that community and into this place. I want to thank them for that, and I would like the House to please make them welcome.

MRS. BOONE: I don't quite understand why.... If it all went into general revenue and then all the amount estimated was coming back and being applied to the Medical Services Plan, you could see this merely as a bookkeeping measure. But it seems a little strange to me to be taxing the people more — which is what medical services plans are; they're a tax — and saying that you want to cover 50 percent, and then the money, which is not showing in the budget as going into Medical Services Plan, but that it is being supplemented by general revenue.... That's what it indicates. It indicates to me that you're collecting more money from the people than is actually required to make up the 50 percent in there.

[ Page 4999 ]

The deputy is shaking his head. If that's not true, then why does all that revenue — the estimated revenue from the Medical Services Plan — not show as being applied to medical services premiums in the budget?

HON. MR. DUECK: Mr. Chairman, as to the section of legislation the member opposite referred to, I cannot give you an answer on that. However, it was a request from Finance that it be done in this way. I can assure you that we are not playing around with our figures. The reason is not so that we can perhaps collect more than we receive. Fifty percent is the target. If next year it goes up, we will then raise the premiums. Should it come down, we will then reduce them. But if you have patience with me for just a second, I might be able to clarify it even a little better for you.

The premiums this year will be approximately $555 million, and the total amount of that particular MSP budget is $1,098,826,085. That is about 50 percent. If you want to write them down I'll repeat them for you. Would you like to have that figure? It's very close to 50 percent, and you'll never hit it absolutely on, as you know. There may be some adjustments towards the end of the year, because as people move in there are more premiums, and as people get subsidized premiums there are less. This is very close, and in the past we've always been able to have a fairly accurate figure on this. It's adjusted at the end of the year, and should there be a higher amount projected for next year, then of course the premiums will rise, because we're going to tie it into that 50 percent.

In the past we raised premiums on an ad hoc basis. We would do it every year or every couple of years, but not necessarily tied to any particular amount. Now the government has made a policy that we will try and collect 50 percent of that particular expenditure of roughly $1 billion from premiums. That is what we're doing this year.

MRS. BOONE: It's a very clever way to immediately make the public oppose any increase the government gives to the physicians in payments; any increase the physicians get in payments will automatically increase the medical services premium, and I'm sure people will see it.

[11:45]

One of the things I want to bring out is that when we are talking about the increases in the premiums, which were substantial increases, the Minister of Health and the Minister of Finance keep saying that we have — I forget — the second-lowest premiums in Canada. But they rarely mention that B.C. is actually only one out of three provinces that charge premiums at all. So I don't think that's such a good record for us. It happens that it's the richest provinces that charge premiums; the others carry all their medical services plans out of general revenue, which I happen to believe is what ought to be done. That is a progressive tax; it deals with everybody according to income and deals with people fairly.

The premiums you are charging people do not recognize.... I know the minister will say there's premium assistance out there, but it doesn't recognize the working poor, those who don't qualify for any of the assistance and have some difficulty in making these payments. What you find is that people play a Russian roulette game there. They take a chance. They say: "It is a real expense for me to have to come up with this amount of money each month. I'm going to take a chance that I'm not going to be sick, and I'm not going to pay my medical." That's a scary thing for people to do, but that's a reality that happens to those who don't qualify for any of the subsidies; there are also a lot who don't have their Medical Services Plan premium paid by their employer. A tremendous number of people out there are fine and dandy; they aren't seeing the effect of this. If you happen to be a welfare recipient or one of the people who qualify for assistance, or if you happen to be one of the many in a job function where your premium is paid for, then you're one of the lucky ones. It's the ones in between, who might make $10 more than the amount for the premium assistance, who are having difficulty there.

I was just wondering if the minister had any idea of the number of claims rejected by Medical Services Plan due to people not having their premiums kept up. I tried to get that information for the previous year — because I do happen to know there are rejections — but I was unable to get that figure. I wonder if you have any idea of the number of people who have their costs rejected because their plan has lapsed. Does the minister have some information on that?

HON. MR. DUECK: Mr. Chairman, may I continue at this time? Another member asked for permission, but I'll continue at this time, and then I'll certainly agree to let him speak.

On this total premium issue, it is true that there are only two or three other provinces that have premiums. However, it's a matter of opinion. You say it should be a progressive tax — as you call it — from taxation. That's an option, and it's been discussed and looked at. Some provinces do that and some have premiums. I still want to make it very clear. For example, Ontario has $27.75 a month for a single person and $59.50 a month for a family of two or more. It is more than ours.

The other thing I would like to mention is that because of the premium increase.... You are speaking about people being worse off. That is not so. When we increased the premiums, we also increased the level that a person could qualify for premium assistance. In other words, at $3,500 to $6,500 a year taxable income, they now qualify for assistance. This amounts to 60,000 people in the province now receiving assistance premiums where they did not receive it before. There are 60,000 people that are better off than they were before.

Also, at any given time there are 3,000 families receiving interim premium assistance because they do not qualify for the subsidy. If they run into a problem in one particular month or two months, we say: "That's fine. We will assist you." We truly want to be as fair as possible to people who have a problem.

There are roughly 360,000 subscribers; 60,000, as I told you, are now better off than they were before. I haven't got the figure right here, but roughly 50 percent or 65 percent of the people are subscribers to the plan where the employer pays the premiums, or has a contract to pay half or whatever the contract may be. We are speaking of a plan this year that is much better than before for those who had a problem qualifying. Anyone earning less than $2,500 a year taxable income, of course, receives 95 percent subsidy.

Really, when I look at our plan versus others in Canada — or versus even.... Should we talk about the United States? I just talked to a person this morning from the United States. I'll tell you, I sit back and say, my gosh, how proud we can be of this government of Canada and of British Columbia, not just this government but the people of this province — your

[ Page 5000 ]

government too — that in the past went along with these systems saying that this is really what we give the province and the rest is subsidized in some other way.

In my opinion, it is a good system. We should be proud of it. We should be thankful. Sure, we always want to make it better, but the money has to come from somewhere. The only place you and I disagree is that perhaps it could be done in another way, perhaps a hidden tax where people would pay and wouldn't know what it was for. It could be on a percentage; it could be a sales tax. There are various options, various methods. We've chosen to continue with this.

I think the plan we've got this year is ultimately better than it was ever before because we have 60,000 more people under subsidized premiums. That is an improvement — not 6,000 but 60,000 subsidies over and above the others that received subsidies in the past.

You were talking about the number of rejects. I haven't got that figure, but we certainly can get that. However, in most cases it is not collected by the physician. In other words, he takes a chance on it rather than phoning in to see if the card is good. He does the procedure, whatever it is, and perhaps writes it off himself. Hospitals probably do that as well when it comes to certain procedures. I can get you the information on the total. I don't think it's a large number of them.

I think you know, because you are very well versed about the hospital system and the total health issue, that no individual in British Columbia has ever been turned away whether he's got a card or whether he can pay. Our system treats anyone who needs treatment. That is a foregone conclusion. It has been that way for years. No one is turned away. How much better can you have it? Let's stand up and say "Cheers" for British Columbia.

MR. MOWAT: I'm very pleased to speak on the minister's estimates this morning, coming from Vancouver-Little Mountain, which I guess is probably the medical centre in our province with the number of acute-care hospitals, the major rehabilitation centre located there, the number of extended-care units that we have and the number of senior citizens' residences. In Little Mountain we have a great deal of interest in the Ministry of Health. As we know, it has a great deal of the people's money that it spends. I commend the ministry; I think it does an excellent job. I also commend the member for Prince George (Mrs. Boone) who is the opposition critic and keeps our minister and the ministry on their toes all the time.

[Mr. Weisgerber in the chair.]

There are a couple of issues I would like to talk to the minister about. Some of them are bouquets, and others are areas that I, as a member from Little Mountain, have concerns about. First, Mr. Minister, I think what we're doing through the B.C. Health Care Research Foundation is not told well enough. I know this year you will give something in the neighbourhood of $4.5 million in grants for research. That sum is equalled only by Ontario, and it's not very far behind them.

I think since this was instigated in 1978, there has been over $34 million given. Often the seed money that you give in a grant can be upped eight to ten times. I think the more we can talk about the moneys being given by citizens through your ministry to research within our province, and when the research and some of the exciting developments that have come from the seed money are products, programs or new procedures that benefit so many of the citizens not only in British Columbia but throughout the world....

The other one is the exciting program you just announced for our large hospital — the Vancouver General Hospital — and the addition of $134 million so they can build a much needed tower facility. The recent announcement of your program of treatment for coronary artery diseases of $3.14 million is an exciting program.

I have an area of concern now, and that would be in the St. Jude's Anglican care home. It's been an outstanding facility. It started out as personal care; it's more now into intermediate care. It has been adding on over the years, and it needs to have its plant upgraded. We have corresponded about this, and I get a lot of letters from not necessarily persons in the home care but from their relatives and friends. One of my first questions to the minister is if there is anything on the drawing board for St. Jude's Anglican care home.

HON. MR. DUECK: When it comes to individual hospitals or anything specific, rather than do that in my estimates, it's something that I can give the member anytime he comes to my office. I haven't got it right here at this time, I'm sorry to say. But we can certainly give you that information and would be only too happy to do so.

I am glad you mentioned the B.C. Health Care Research Foundation. True, we don't give it enough coverage. I'm the chairman of that particular committee and yes, we did give $4.5 million for research last year. It is certainly put to use very well when we take into consideration the leverage you mentioned that we can get from using that kind of money. We will endeavour to give that a higher profile. The problem is that we would like to give high profile to a lot of things in the Ministry of Health that we don't today.

This is not directly related to estimates, but since we've touched on the subject, Mr. Chairman, I'm going to take the liberty to say just a couple of words. When it comes to health, my ministry has got to be the complaint department. I hear mostly from people who have a complaint, although we do receive many of the others also. Lately we've had quite a bit more from people who are quite happy. It is a service that we give to the community, and very often the complaints are the ones.... I am the same way. If I have a complaint, I utter that; when I have a compliment, I often don't. I should mention VGH. I think it was mentioned that perhaps spending $150 million when there are so many needs in other areas....

I think to be fair, I have to tell you that it is over a period of a number of years, and it's not for increasing beds per se, but for replacement of dilapidated buildings that are going to fall down soon if we don't do something about it. I'm glad you mentioned that, Mr. Member, and hopefully we can allay your fears on St. Jude's Anglican. I will get you that information.

[12:00]

MR. MOWAT: I'd like to move on to another problem in Little Mountain, and that's the Oakmount Medical Centre. It's on 41st Street in the 800 block, and I know there's been much correspondence. I get a number of calls from the patients who attend there, as well as many of the doctors. I take it, Mr. Minister, that the problem is that it was a full medical centre, and they had a full X-ray department in that facility. The people who run the X-ray department wish to

[ Page 5001 ]

move over to Oakridge to a new building there. These doctors — and particularly the patients, of whom many are elderly — now have to, after they have visited the doctor, go approximately six blocks. It's a very inconvenient thing. They still have an X-ray machine there. The letters that I'm receiving say there will be no financial saving by closing this, because the X-ray still needs to be taken, and consequently they have to get a taxi, or they have problems in getting the person to go down to get an X-ray and then to bring the X-rays back and have them read by the doctor. There is a move afoot for the doctors that ran the X-ray to leave a satellite X-ray lab there. Even if it could be left on two days a week, the doctors in the building would schedule those patients that they feel need X-rays. In the case of an emergency, they really have a problem.

There was some concern that maybe many of the doctors were moving out. The information I received earlier this morning was that there are a few doctors moving out to Oakridge, but they are being replaced by other persons coming from other areas,

I'm wondering if the minister has anything on the Oakmount Medical Centre and the X-ray department.

HON. MR. DUECK: As the member mentioned, Mr. Chairman, there has been quite a bit of correspondence in this regard.

We have been quite selective and careful that we don't have too many labs in one area. The costs that will increase if we have them...whoever desires to establish a lab. I know it may fly in the face of free enterprise, but when it comes to health, we are faced with the two: we are faced with a socialized system and free enterprisers. There has to be some control. We're saying that unless there is a good reason to be made, up to this point in time we felt it was not appropriate to have another lab that close to that location. If there are more physicians moving into that area, maybe in the future we can look at it again. But the reason has been that we have to be most cautious how many labs we have in any particular area.

MR. MOWAT: I don't want to be argumentative with the minister, but I'm sure people realize they don't want to have a number of pictures taken on an X-ray machine, and if they don't get it taken on the Oakmount they have to go down the street to take it, and the government is paying the bill either at Oakmount or at Oakridge. I have some concern that we're inconveniencing a number of elderly people who are doing that. I'll be pleased to talk with you about that.

The next item I have is the problems that a number of persons, particularly those with long-term disabilities, are running into with regard to medical supplies. I guess it becomes an area of concern through Pharmacare: basically, the list of what we cover under Pharmacare as opposed to what persons can receive when they're covered under the health care division provision of services. What we're finding in the community, and particularly after the Premier's advisory council tour, was that there are many people in the community who have long-term disabilities, and their understanding of the Pharmacare program is that Pharmacare, an excellent program, was initiated in our province to take care of the costly ongoing medical needs — supplies, prescriptions — for persons, so it wouldn't financially burden individuals or their families. We're finding now that the Pharmacare list does not cover many of the items that people need when they leave the health care services division, having to give up their medical cards. They give this up, obviously, because they find employment, or they have the financial means to look after themselves.

We find a difference in the Pharmacare program, where it will cover certain items such as colostomy and ileostomy supplies and artificial limbs, but it will not cover urinal supplies, wheelchair cushions, leg braces and a number of items. The list is very long, and I've submitted it to the ministry before. My problem, in a nutshell, is.... I could read the list of the health care services: some things such as wheelchairs, cushions, walkers, crutches, all the problem of bladder-management supplies, bowel management.... When people receive them from health care, they are very reluctant to leave and go into the field of employment, because when they get an income coming in, they lose these services. The services also, of course, cover medical, the doctor, and all their hospitalization. There's a disincentive for those persons that we are now deinstitutionalizing back into the community, trying to move them into becoming independent citizens when they're not covered by Pharmacare.

Mr. Minister, is it not a good policy and a good practice to give them their coverage from the health care services until they have been gainfully employed for a period of time and feel comfortable leaving? Again, they often will not go to work; they will stay on their welfare with their medical coverage. Maybe the minister would like to respond.

HON. MR. DUECK: We've had many discussions on this, and I think the member knows very well that I could not possibly disagree with funding of all these things. How can I disagree? I suppose it's a matter of funding; there are only so many dollars available, and up to this time I have not been able to receive those extra dollars.

However, there has been other progress when it comes to funding for various people. The people with problems with diabetes have asked for years and years to get some relief in the supply of self-blood for the blood glucose monitoring equipment. I can tell you as of today that that announcement is going out. We are now putting that under the Pharmacare program, at least for the ones who are most at risk, like pregnant women and children under 19 years of age. I hope that little by little I am making progress. The diabetic issue has been on my mind ever since I've been in this ministry, because these are people who have to go to hospitals if they don't keep that level accurate. I'm just so pleased that I was able to find a few dollars for this. Hopefully, Mr. Member, I can also do it for those unfortunates you were speaking of. I cannot disagree. I have to agree, but unfortunately my money-well is not overflowing.

MR. MOWAT: I thank you for that commitment to continue, and I commend the Pharmacare program for the expansion in the area of the diabetics.

Next I would just like to talk about Mount St. Joseph Hospital and the expansion program that is taking place there. I must commend the directors of the Mount St. Joseph Hospital society as well as the Mount St. Joseph Hospital Foundation for their expansion programs and their ability to raise funds, which is going to be and has been in the past supported by the ministry. Just to make a comment, the new program that they're expanding on is an exciting one. It's over $3 million, and it's going to be an excellent facility that serves our Little Mountain constituency so well.

The other one I needed to touch on was the amalgamation that has just taken place between Shaughnessy Hospital and

[ Page 5002 ]

the UBC hospital. I think the formation of the University Hospital, with a Shaughnessy campus and a UBC campus, was a very strong move in the right direction. It will eliminate some of the areas of duplication in administration. We're saving, I believe, close to $2 million a year, and I commend the health department, through the ministry, for bringing those two institutions together. Very often institutions get very protective of their territory, and it's encouraging in these days to see the amalgamation of these two fine institutes that do a lot of research.

The last one, Mr. Minister, is Creekview 202, the high-lesion respiratory quadriplegic unit in False Creek. It's an outstanding project and a leader in the world, where we have six persons who were in Pearson Hospital, one of them for 15 years and others for a various number of years, now living independently in the community with support services. I think it's a credit to all the persons in your ministry how this project was put together. Again, there were some concerns that they would not survive in the community. Some of the medical fraternity were against it, but the individuals felt that even though they were on respirators all the time, they would rather go into the community and die in the community than be in an institution.

As a matter of fact, it has been so successful that the ministry, when you commissioned a study after a year and a half, found out that there was an actual dollar saving to have those persons in the community in spite of the amount of support services that they needed. I don't know how to tell the minister this, but it's been so successful that there is now another one on the drawing-boards — I'm not sure if you know this — and it's going to be called Noble House. I'm not sure whether it was named after Mr. John Noble, who did such a great job for this government in his various capacities as Deputy Minister of Health, upon his retirement, but it's called Noble House and it's on the drawing-boards. I'm not sure whether you know it's coming to you, but it's an exciting program.

As I wrap up, I'd just like to say that a program I have brought to the ministry for review recently dealing with the computerization of billings from doctors is an exciting program, as well as the new pharmacology one that was brought to the minister recently.

I don't know whether the minister has any comments on those items, but I would just say how very fortunate I am to have an open door with the minister, because many of the people living in Little Mountain work or receive their treatment in the hospitals. In a recent tour of the province, many persons spoke to us because they have to come to the Vancouver area for their treatment.

HON. MR. DUECK: I don't think that really requires an answer, but I do have to say at this point that the member has been very instrumental in Creekview 202. I visited that facility with him just recently and was certainly very impressed. The second one on the drawing-board.... I just heard about it not too long ago. We have to be very careful that success doesn't run away with us. Every time we have a success, it also means a lot of dollars. But these people really do have an advantage over the life they led before.

The name Noble, I understand, is not after John Noble, although he would certainly deserve it. Apparently it's named after some other Noble in the area.

If I could, I would like at this time to reply to the question asked by the member for Prince George North (Mrs. Boone) in regard to the legality of the funds from premiums that we take in which now go to general revenue. That was in fact changed by an order-in-council that amends the funding arrangement for the Medical Services Plan.

At present, the practice is that medical services premiums applied to the cost of running the Medical Services Plan do not go to general revenue and are not shown as part of the general revenue in Health. Now medical services premiums will go into general revenue, and all the costs of running the Medical Services Plan will come from general revenue. I was also a bit surprised, because we certainly don't want to go against our own legislation.

MR. CHAIRMAN: The first member for Vancouver South asks leave to make an introduction.

Leave granted.

MR. R. FRASER: On behalf of the first member for Vancouver-Point Grey (Ms. Campbell), I would like to welcome to the Legislative Assembly grade 11 students from Kitsilano Secondary School who are here with their teacher, Mr. Roggeveen. I would invite you to join me in welcoming them to the chamber today.

[12:15]

MR. LOENEN: I would just like to congratulate the Minister of Health for doing an excellent job. It's certainly a very difficult portfolio. It's one that has so many emotions attached to it. It carries a greater financial burden than any other ministry. On behalf of my constituents, I would just like to congratulate the minister for the superb job he has done.

Health is so important. It is perhaps one of the most important services this government renders to the taxpayers of this province. We know that he has been able to acquire very substantial increases in funding levels and has responded to many of the concerns raised over the past year. I think that speaks well for him and for this government, because it does show that we are able to respond and that we do have a social conscience.

At the same time, I would like to take this opportunity to bring to the minister's attention some of the concerns that exist in my community. Excellent though the services are, there is always room for improvement. There's always the need to keep current; there's always a need to upgrade ourselves and to stay ahead of other jurisdictions.

Richmond General Hospital is a very fine facility that serves our community exceptionally well. At the same time, as the minister knows — I'm not saying anything new to him — there is a deficit that the board of trustees has to struggle with year after year. I guess this year they are looking at a $1 million deficit. In order to offset that they looked at closure of beds and so on.

I know that your ministry has looked into this. I know that there have been a number of studies, and as a result the board has initiated some management efficiencies that are going to result in some savings. I just want to congratulate the medical staff and the nursing staff, who have all worked together at making those dollars go just a little further, and as far as possible. At the same time, I hope that your staff will recognize the efforts that have been initiated, and that when they come to you for additional funding, you will take that into account.

I also have to congratulate the board for initiating a foundation which will obtain funds through bequests of all

[ Page 5003 ]

kinds and private fund-raising in order to fund some of the extras.

In addition to that, there is one plan that they would very much like to see implemented: the accommodation of the psychiatric ward, which is located in the annex right now, within the main complex. They believe that that in itself will lead to very substantial cost-saving measures. They have also put forward a request for a CAT scanner, and I believe that they have very good reason for making that request.

I would be remiss in my duties if I did not bring some of these items to your attention, Mr. Minister.

I just want to raise two further items. I have enjoyed working with you on a number of these things and have enjoyed your cooperation and response. You are well aware that there is a long-standing concern in my community, as well as in many of the GVRD municipalities, related to cost-sharing in the various community health services. There is a great and perhaps grey discrepancy between the level of participation by some of the municipalities.

I was confronted with this way back in 1983 when I first became an alderman. We had a staff report at that time indicating that, whereas the participation by the average taxpayer in Richmond amounted to — I think at that time —$12 per capita, in Surrey the equivalent amount was less than 50 cents per capita. Those discrepancies continue to exist — in fact they are getting worse — and I know that your ministry has taken a hard look at that. I would very much appreciate an update on that, because I know that you are initiating some efforts to rectify it. It's not only for my community but also for the North Shore, Burnaby, New Westminster and many others.

Finally, I just want to mention that we have a great need in our community for more extended-care facilities. Again, you are aware of that, but I would like to point out that it is a growing concern. When people have grown up in a community and contributed to it, lived their lives there, when their children and friends reside in that community, it is very disheartening, when they need that kind of attention and medical help and service, to have to look elsewhere for it.

I just want to close by reiterating that I have enjoyed the graciousness and the helpfulness of both the minister and his staff.

HON. MR. DUECK: What do I say to that? There's a man who picks you up and then lets you down. I was already giving myself all kinds of kudos, only to come up with it costing me a lot of money. But that's fine; those were all things that we've talked about in the past, and they're certainly very important.

The Richmond hospital. I'm not going to get into the details of our negotiations at this time. However, what you mentioned is basically correct, and it's being looked at and is under discussion at this time.

Scanners. Again we're talking about specific equipment to a specific hospital. I have not promised anything; I am not going to promise anything in estimates as to what will happen in what community. There must be a dozen communities that want a scanner, and they can prove to us that it's absolutely essential and they can save us money. I said to someone the other day that I wish people would quit saving me money, because I can't afford it; I haven't got enough. It gets to the point where you can't afford all these savings. But you're correct that this is equipment that has been well received by many communities.

Cost-sharing. I've talked to you about this before. Historically, it's absolutely true that everyone — New Westminster, Vancouver, North Van, Richmond, Burnaby — has a different formula. They all operate on a different system as to the cost-sharing or the funding-sharing. We are bringing a document forward to cabinet within the next couple of weeks, and we're going to attempt to.... We can't correct the errors that have been made over a period of many, many years, because the cost would just be too much. But we're trying to phase it in over a number of years, and hopefully we'll be successful. We're taking it to a committee of social policy first, then hopefully to cabinet. So the point was well made. I know about it; I knew about it even before I got into this business, when I was on the hospital board, and it's true.

Extended-care beds. I would like at this time to tell the committee that in the next two years we will add 1,200 new extended- and intermediate-care beds. We haven't been lax; we haven't cut back. As a matter of fact, we have expanded, if you look back at the last so many years. There is such a backlog of need. We're spending $140 million-plus in capital construction alone this year. My capital budget for next year has already been set. For the capital expenditure it's $150 million-plus, and that doesn't include the $150 million for VGH, because it's only so much per year.

We are going as fast as we can in that area. At the same time, we are also asking — it was brought up very eloquently yesterday — if we have too many beds. I will have you know, as far as acute-care beds are concerned, we have fewer now than we had a number of years ago, per population. We are keeping people at home, and we're keeping them in intermediate- and extended-care rather than in acute-care. So we are going in the right direction. I am quite satisfied we are doing the right thing but, even in my opinion, not fast enough.

When it comes to government — and I've said this again and again — I'm getting a little bit used to it, but I find it tremendously frustrating. In business you could have a plan, and you did it. You made up your mind, you made a decision, and you moved ahead.

The member there is looking at me with a smile. How many years did you wait for your hospital? It was a relief for me when we were able to go to your community and finally say: "Here it is." Those are the nice things in this ministry, and those are the things I appreciate.

I agree with most of what everybody says, even if it is criticism. I especially agree when you are complimenting me; I have no problem with that.

MR. R. FRASER: Thank you, Mr. Chairman. [Applause.] Yes, right. They already know it's going to be good. I appreciate that.

I've heard people on both sides of the House now ask for more care homes, more services for seniors, more for midwives, more for child care, more nurses, higher rates of pay, CAT scans, machines, cancer centres and everything else. One thing that we haven't said directly to the taxpayer, though, is obviously if we want to do all these things, we want you to give us more money so we can spend it.

I would only want to say to the taxpayers, from my point of view, that while I will certainly be willing as an MLA to listen to any requests they may have for health care facilities, I would remind them that for each person in the province, every year we spend about $1,300 — something in the order of $4 billion a year in health care. If we have anything to think

[ Page 5004 ]

about or to direct our attention to, it's the health care system in England, where they have some 2,000 hospitals and over one million employees, and which, if I view things correctly, is probably going to collapse under its own weight. There must be some limit to what the taxpayers are willing to send us. Every time we ask for something we should remind those taxpayers we are asking them to send us more money and that with that money, we'll take great care.

HON. MR. DUECK: I have to respond to my colleague, at least for a moment. He's absolutely right. In 1974, I think it was $300 per capita; now it's $1,300-plus for every man, woman and child in the province. Would you believe we spend $7,000 every minute? We spend over $10 million a day, 365 days of the year, just on health.

MRS. BOONE: I take some exception to the member for Vancouver South — but then I always do.

The British system right now is a two-tiered system. It's certainly not the health system that was there in the past. As the minister pointed out earlier, if you want to look at a system that's breaking the country, just look down south. That system is not a nationalized system; it is a system that comes out of the pockets of everybody. It's a system that in some areas deals on a medicare system and in some areas on a user system. That one is skyrocketing far above what we have. Our costs in our ministry have been contained; they have been increasing, but not skyrocketing by any means. They have been contained because of the process we have whereby the government body negotiates with the medical profession here all the time, and that has kept the costs contained.

I would like to make a few comments on a few of the things said by the second member for Vancouver-Little Mountain (Mr. Mowat) regarding Pharmacare and the whole idea of the coverage of some of these services. I know the minister has been struggling with many of these things, and I would like to congratulate him, because probably my next question was to ask you what was happening with the blood glucose testing units. I congratulate you and am very pleased to see that the ministry is going to be covering that. When the minister stands up perhaps he can explain to me when that coverage will start, as a very concerned segment of the population of Prince George has been coming to me about this area for many years now. They were visiting me about it before the election, as they probably visited you. As a candidate I had the Diabetes Association in my community coming to me and lobbying me about covering the blood glucose testing unit. Certainly that's something you should be applauded on. I'm very pleased. I would like to know when that coverage is going to start, please.

[12:30]

HON. MR. DUECK: I spoke to the association two or three weeks ago, and at that point I said to them that we were introducing it. I'm quite surprised that you recently spoke to them and they were lobbying you.

Interjection.

HON. MR. DUECK: I see. The official announcement is going out today.

Interjection.

HON. MR. DUECK: Thank you. I just got word that she's complimenting me.

Anyway, I'm happy too that we were able to do this. It wasn't easy, because as you know, I think you asked the same question last year. Certainly when it comes to children we try and do everything possible. As soon as we can get the mechanism in place it is going ahead for the high-risk group. It's not going to be total at this time. Hopefully, next year I can make it for all those who need it.

Interjection.

HON. MR. DUECK: As soon as we can have it in place.

MRS. BOONE: I'd like to go back a little bit. The minister mentioned that 60,000 people now qualify for premium assistance, given that you have raised the minimum amount that people can earn. I raised this last year. I'm just wondering what actions the ministry took to make people aware that there was that raise, so that they could earn more money and still qualify for premium assistance, and how that information gets out to people.

I'm asking you this because I know of several people who've talked to me at different times and said: "I just can't afford this." When I said to them, "Why don't you apply for premium assistance?" they said they didn't know anything about it. In fact, I know of welfare people who have paid their own premiums not knowing that they can get assistance. There's not general knowledge out there with the public as to what this is about. I am wondering what avenues the ministry used to get that information out to the public.

HON. MR. DUECK: I am at a loss at this point in time. My deputy wasn't with us when that announcement was made.

As far as the people in the facilities are concerned, they did receive a letter. It was spelled out that anyone under OAS-GIS would now qualify, and the premiums would be paid for them; so that group of people knew. I'm not quite sure about the others. I think doctors' offices have it in their premises or facilities. I had better get back to you and make sure whether we have enclosed it with the premium statements or exactly what procedure we took. It's a good point, because I've also had people ask me. Just yesterday somebody asked me, and I said: "Well, no doubt you qualify." They didn't know about it, so it's a good point. I'll try and find out.

MRS. BOONE: If the ministry hasn't already done so, then I would certainly encourage them to make some efforts to get information out in your billing — or whatever is done — so that people know that they can qualify and for first-time qualifiers too. Maybe information should be given out for people at the government agent's office, so that it is quite clear and open to them. I know that there are people who are not aware of it and are suffering financially because of that situation.

I'd like to move on to Pharmacare here. I keep looking at the clock, because we are running out of time. I am trying to get as much done as I can at this point. This is a difficult area. I know the minister has struggled over what areas should be contained in Pharmacare, and I am very sympathetic to the second member for Vancouver-Little Mountain about the areas that he would like to see — the different things for the disabled — included in Pharmacare. There seem to be very

[ Page 5005 ]

many different areas that one can cover, so I am sympathetic to the minister as well, who is trying to struggle with all these different things.

I would like to suggest some things to the minister, because I know some areas are having a skyrocketing effect with increasing Pharmacare costs. I expect that we could see this happening even more, since the drug patent act came into being, and we now have increases there.

Before I get into anything, I'd like to ask whether the minister has noticed any increases in our Pharmacare costs since the drug patent act came into being. Have you noticed any substantial changes in the past few months?

HON. MR. DUECK: 1 can't answer that question, other than to say that our forecast for what we will be spending this coming year certainly is up quite a bit; it's now at $178 million. Whether this was taken into consideration when the budget was processed, I'm not sure. I can't tell you whether the increase is due to the Patent Act or whether it's due to more people...well, certainly to a higher cost of drugs. Inflation plays a big part when it comes to pharmaceutical drugs. It's also very interesting to note that people are using more pharmaceutical drugs than ever before per capita. It seems to be going up rather than declining. As to exactly what portion is due to the Patent Act, I can't give you that answer at this time.

MRS. BOONE: As the minister took time yesterday, I'd like to acknowledge that there are in the galleries three people from the RNABC, Victoria chapter: Wendy Underhill, Pat Banks and Sue Smith.

Going on to Pharmacare, then, a concern to you — to all of us, I think — is the overprescribing of drugs that is taking place not just in B.C. but in Canada and the U.S. in many different areas. It has affected seniors to a large degree. The minister indicated last year that the increases in the user fees on the Pharmacare programs were to try to deter seniors from taking those drugs. As you know, I totally disagree with that, because I don't think seniors are capable of deciding what drugs he can or cannot take. I don't think any person is capable of deciding what drugs they can or cannot take.

One of the things we have to deal with is the prescribing of drugs and how it's done. I have had indications that although doctors are very knowledgeable in many fields, many of them are not as up on the pharmaceutical drug scene as they should be, and that to a large extent they depend on the pharmaceutical salespeople who come around promoting their various drugs. As you know, the doctors are not pharmacists, but it has occurred where people have been getting.... There have been some reports of various dosages of medicines given to people having been, in combination, actually lethal. Individually they are fine, but combined they are lethal.

Some areas are instituting programs that I think would be worthwhile looking at in B.C. One is the employment of a pharmacist by the ministry to review the new drugs that come on the scene and to educate or to inform or to assist the doctors in their choice of drugs so that they are aware — giving some assistance to keep the doctors updated. New drugs are coming on the scene every day, and we can't expect the physician to, understand and to be aware of all the implications of all the drugs that come on the scene. To a large extent, they do depend on the pharmaceutical salespeople.

Perhaps it wouldn't be a bad idea for the ministry to look, as some areas have done, at a computerized card which would show the various drugs so that when a person, in particular a senior, purchased a drug from a pharmacist, the computerized card would automatically show all the various drugs that the patient was taking and would alert the pharmacist to any combination of drugs that would not be to the best advantage of the patient. It would allow the pharmacist to contact the physician and make him aware. In some cases, patients may go to one or two different physicians and get different drugs from them. This may be a way.

We as a society do have to deal with this whole issue of the overprescription of drugs to our population. I'd like to hear the minister's comments on some of my suggestions and ask if there is a provincial policy that substitutes generic drugs automatically for more costly drugs that come on the market.

HON. MR. DUECK: Those were good comments. I agree with just about everything you said.

A major study is going on right now with the medical profession, the College of Pharmacists and some other outside experts studying this whole area of prescription drugs and the overprescription and the abuse of drugs. It might interest you that they met just last week and were discussing exactly what you were saying. As a matter of fact, they're talking about a computerized card in the form that you were describing. I think Alberta has something similar in place.

This reminds me of the drug abuse now. They go to various pharmacies and don't use Pharmacare at all. They pay for it in cash — for example, Talwin and Ritalin drug — pay five bucks and sell it down the street for $50; it's good business. They go from one physician to another to get this prescription and make a business out of it. I haven't tried it, but they say you get a pretty good high on it. Although it's not affecting the Pharmacare costs if they pay for it themselves, it's certainly a cost to society if this is happening. It's also an indirect cost, I'm sure, because some of them are prescribing it and putting it through Pharmacare. We find too that certain physicians are more prone to do this, whether knowingly or unknowingly. In Alberta and Ontario they've done a fairly in-depth study. I understand they've really gone public on this, saying: "Look, this is what's happening." I think we'll have to be very careful, because it's apparently moving into our area.

So you are right on in what you're saying, I hope we can do it soon. Maybe we should have meetings with the committee you were suggesting yesterday. We could probably agree on a lot of these ideas so readily. We could expand and maybe do it in a more efficient or quicker way than if someone didn't remind us, so I appreciate your comments.

[12:45]

MRS. BOONE: I thank you, and I look forward to those meetings coming up quite quickly then, so that we can expand this knowledge. If the government were to introduce some of these things, it would get our full cooperation. We could hammer those things out at a committee level and come together with a policy that would be of benefit to all British Columbians. That's what you and I both are here to do, and I am pleased to hear the minister's comments on that.

At this point I'd like to move that the committee rise, report progress and ask leave to sit again.

The House resumed; Mr. Speaker in the chair.

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

HON. MR. STRACHAN: I'd like to wish everyone a very happy, warm and enjoyable weekend.

Hon. Mr. Strachan moved adjournment of the House.

Motion approved.

The House adjourned at 12:46 p.m.