[ Page 12749 ]

CONTENTS

Routine Proceedings

Oral Questions

Free trade with Mexico. Mrs. Boone –– 12749

Privatization. Mr. Lovick –– 12749

Omni-Script Services Ltd. Mr. Sihota –– 12750

Public Accounts Committee meeting. Ms. Marzari –– 12750

Enrolment cuts at Vancouver Community College. Mr. Jones –– 12751

Flight access for physically challenged. Hon. Mr. Rabbitt –– 12751

Presenting Petitions –– 12751

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

On vote 38: minister's office –– 12752

Mr. Perry, Mr. Vander Zalm, Hon. Mr. Parker

MONDAY, JUNE 17, 1991

The House met at 2:05 p.m.

Prayers.

MR. REYNOLDS: As you know, Mr. Speaker, this Legislature has a trophy called the "Speaker's Trophy" for tennis, for which once a year members of this House, Clerks and other staff play against our friends from the media. On behalf of our members, the Clerks, the auditor-general and others, I'd like to report that we defended that honour greatly again this year and beat the media. In deference to them and to show encouragement for next year, we won't give out any scores.

MR. LONG: Mr. Speaker, in the House today I have a friend and a constituent, Mrs. Shirreen Morgan, who is also the SuperHost coordinator for the Powell River area. It's one of the greatest tourist programs that has ever been brought into British Columbia and is emulated around the world today. I would like the House to make her feel very welcome.

HON. MR. FRASER: Mr. Speaker and Members of the Legislative Assembly, it's my pleasure to introduce Ambassador Woo and Consul-General Lee from Korea. Would the House please join with me in making them welcome.

Oral Questions

FREE TRADE WITH MEXICO

MRS. BOONE: My question is to the Premier. The Premier has spent much time changing hats recently and, quite frankly, we're not quite sure where your head is at. Apart from being scared stiff, does the government have an official position on the trade deal with Mexico?

HON. MRS. JOHNSTON: Mr. Speaker, in response to the question from the member opposite, the minister responsible is not in the House at this time. But I would suggest that our main concern is and will continue to be to protect the jobs of British Columbians. As a general principle, we do support free trade, but we want to ensure that the jobs and interests of British Columbians are protected. It's obvious that the member opposite is referring to a statement I made on the weekend, and I'd like to clarify it by telling you that I feel that, the negotiations, if they are going to take place in Ottawa through federal politicians, will really give us cause for concern, because I don't believe that the interests of the workers in British Columbia will be properly represented unless we are able to play an active part in those negotiations. That's our position.

MRS. BOONE: Supplementary to the Premier. Your government was cheerleading on the sidelines through Brian Mulroney's first deal. As a result of that deal, our fruit industry has suffered and our fishing industry was damaged. Now the Premier wants "Trust us" ...to get into the game. Have you decided to direct your minister to develop a position on this deal and to table that position in the House immediately?

HON. MRS. JOHNSTON: I will take that question on notice for the minister.

MRS. BOONE: A new question to the Premier. The free trade deal with Mexico poses serious threats to working people. Has the Premier decided to table in the House all the studies and submissions — and we know that there have been many done in January and February of this year — that this government has received on this very important public issue? Will you table them in the House, Madam Premier?

HON. MRS. JOHNSTON: I will take that question on notice for the minister.

PRIVATIZATION

MR. LOVICK: I also have a question for the Premier. On Saturday the interim Premier said that if she were the real Premier....

HON. MR. STRACHAN: Point of order, Mr. Speaker. As the House is well aware, a member is referred to by the constituency they represent or the cabinet portfolio they hold, and there is no portfolio of interim Premier. I think the House should be advised of that. I find those references to be offensive to parliament.

Interjections.

MR. SPEAKER: Order, please. We've heard more offensive language in the House, but perhaps members could bear that in mind.

MR. LOVICK: I know the other side is often offended by the fact that language sometimes defies reality.

Last Saturday the Premier said that if she were the real Premier, privatization would be "taken off the shelf." Can she advise this House whether the plans to privatize health care, as suggested in the phase 2 documents of her predecessor, have also been "taken off the shelf?"

MR. BLENCOE: Are you looking around for help?

HON. MRS. JOHNSTON: To the member for Victoria, I am not looking around for help, but I'm looking to the appropriate minister. Members opposite appear to have a very serious problem addressing their questions to the ministers responsible. I would suggest that the question would be better put to the Minister of Health.

MR. LOVICK: I asked the Premier to clarify a point that she made acting as Premier. I think we're dealing with an avoidance mechanism here, Mr. Speaker.

Another question to the Premier. What about GAIN? Phase 2 of the privatization program also

[ Page 12750 ]

talked about GAIN, the guaranteed income supplement. Can the Premier advise us whether that may also be "taken off the shelf?"

MR. SPEAKER: The first member for Nanaimo.

MR. LOVICK: Can the Premier advise the House whether education, which was also on the privatization shopping list in the phase 2 documents, will now be "taken off the shelf?" Can she give us that answer?

MR. SPEAKER: Once again, if members would reflect on the rules and just phrase their questions in a grammatically correct way, then the question would.... Might I assist the member with the prefix: has the Premier decided...?

MR. LOVICK: Mr. Speaker, if I offended, needless to say, I am most embarrassed and certainly would not intend I'm glad that the Premier has now had these extra few moments to get her thoughts together. Can she then advise the House whether she has decided if the GAIN privatization plan, as suggested in phase 2 of the original — we're back to education this time — education part of the privatization program, is to be taken off the shelf? Can she advise us on that? Can she clarify once and for all that there isn't a hidden agenda on the part of this government?

HON. MRS. JOHNSTON: I almost feel as if I'm at some type of all-candidates' meeting. If you wanted to have a....

Interjections.

HON. MRS. JOHNSTON: It's a wonderful audience, because we don't generally have these numbers at the meetings. So maybe I should take advantage and make one of my famous campaign speeches.

[2:15]

There appears to be confusion in the minds of the members opposite with regard to some of the statements that have been made during the leadership campaign that is presently taking place in our party. I would like to tell members opposite that our concern on this side of the House has been and will continue to be for the people of the province, whether we're dealing in the area of education, provision of health care or provision of social services. It has been and will continue to be that.

OMNI-SCRIPT SERVICES LTD.

MR. SIHOTA: A question to the Minister of Government Services. Several weeks ago I asked her a question in this House about Omni-Script and rollover pension benefits accruing to that firm. The minister took the question on notice at that time. Could she please advise the House as to when she intends to reply to that question, or has she decided to reply?

HON. MRS. GRAN: The answer is very simple. The employer that you speak of is deemed a privatized employer. Part of the negotiations for privatization as that employees would continue on with their pension benefits. And that's the entire answer.

MR. SIHOTA: Obviously a deal was cut with respect to rollover pension benefits to this firm. Could she advise the House whether that was standard policy during the time the government was proceeding with its privatization policy? Has this been done in other cases?

HON. MRS. GRAN: Mr. Speaker, in all cases of privatization that I'm aware of, where they were government employees, their pension benefits were guaranteed in the same way.

MR. SIHOTA: One final question to the minister. I suspect she's going to take this one on notice; I'll just put it on the record in any event. Would the minister undertake to advise the House the cost of that practice to taxpayers?

HON. MRS. GRAN: I wouldn't want to give you an inaccurate answer. My understanding is that there was no cost to the taxpayer. But I would like to take the question on notice and bring back the proper answer.

PUBLIC ACCOUNTS COMMITTEE MEETING

MS. MARZARI: A question to the Premier. The Premier has repeatedly stated that she has nothing to hide. The Public Accounts Committee is one mechanism through which she can prove that. Has the Premier decided to ask her members to assist in the convening of the Public Accounts Committee at the earliest possible moment or to not block the meeting of the Public Accounts Committee?

HON. MRS. JOHNSTON: Mr. Speaker, I had a bit of difficulty understanding the last part of the question

Interjection.

HON. MRS. JOHNSTON: There was too much noise from the opposition side of the House for me to understand. You started out by saying, hon. member, that we've stated on a number of occasions that we have nothing to hide, and we don't. I wish I could say the same about the members opposite and their secret transition team who went off to Ontario.

HON. MR. FRASER: Who was on that secret transition team?

HON. MRS. JOHNSTON: Yes. Who was on that secret transition team?

I would suggest, Mr. Speaker, that the member put the question to the members serving on that committee. I'm not aware of a problem, but I can tell you that our members are very busy, and maybe there has been a problem with the scheduling.

[ Page 12751 ]

MS. MARZARI: There has indeed been a problem with the scheduling, Madam Premier. The committee was authorized last week, and I as the convener have attempted to have a meeting tomorrow morning, Wednesday morning and Thursday morning — at any time of their convenience. Your members are not available to meet at the earliest possible opportunity, at any time this week, Madam Premier. Have you decided to ask them to assist in the convening of the Public Accounts Committee? That is the question.

HON. MRS. JOHNSTON: I will ask them to assist.

ENROLMENT CUTS AT
VANCOUVER COMMUNITY COLLEGE

MR. JONES: I have a question for the Minister of Advanced Education, Training and Technology. Following some 20 meetings last year between the ministry and Vancouver Community College officials, and following several public meetings with the community and the board, the ministry agreed to fund a program profile for some 9, 900 full-time-equivalent students. Now it appears that the funding level will reduce that number to 8,200 full-time-equivalent students, almost a 20 percent reduction in the number of students attending Vancouver Community College. How does the minister reconcile that tremendous cutback with the statement in the throne speech that education is the most important investment in our province’s future?

HON. MR. DUECK: The figures that were mentioned are erroneous. However, in general terms, British Columbia has funded advanced education very generously. As a matter of fact, it's the best in all of Canada. We spend 27 percent of our budget on education; Ontario spends 18 percent. We spent $690 million on Access for All, and it's been tremendously successful. Therefore I'm saying that as far as education is concerned, in general terms it is good.

However, as far as the community college is concerned, our senior officials are now meeting with the senior officials and chairman of Vancouver Community College. I hope we will have some results which will be in the best interests of the students of the college and the taxpayers of this province.

MR. JONES: To the same minister. I see we're having more meetings. What's needed is not more meetings. We have some $123 million in this budget under the heading "Access and Enrolment." That $123 million would fund some 20,000 college students in addition to what's already existing in the system. Does the minister not feel that this part of the budget is appropriate to be used at Vancouver Community College?

HON. MR. DUECK: The $690 million Access for All program would provide 15,000 extra spaces over a period of some years. The success of that program is such that we will not be able to fund or to have spaces available for everyone who would like to go to college or university. That will remain the situation for some time; it is virtually impossible. However, we've increased spaces by some 2,500 for this coming year. We're now looking at whether we can increase that even more.

What I am saying is that the budget was generous. We're doing everything possible as far as the community college is concerned. They requested fewer spaces this year than last year. We gave them a lift on the spaces that they requested; however, I think an error was made. We're now meeting with senior officials of Vancouver Community College. Very shortly I will be able to bring some news to the House on how we can correct this.

MR. PETERSON: Mr. Speaker, I rise on a point of order relative to question period. The first member for Vancouver–Point Grey asked a question of the Premier on the convening and sitting of the Public Accounts Committee. I'd like to point out to you that it is her job to convene the committee, not the Premier's.

MR. SPEAKER: The Chair would like to point out to all members that the Chair has no idea of, or concern with, the matters of any of the committees, including Committee of the Whole. Really, such matters properly should not be discussed when the House is meeting.

FLIGHT ACCESS FOR
PHYSICALLY CHALLENGED

HON. MR. RABBITT: I have a response to a question from the second member for Boundary-Similkameen on Monday, June 3, 1991, which was taken on notice. Contrary to the member's statement that Mr. Rick Hansen cannot fly into Penticton, I can inform the Legislative Assembly that I have ascertained that Mr. Hansen can travel by commercial air transport to and from Penticton twice daily. Both Air B.C. and Time Air provide Dash-8 transportation, which, I am advised, is fully accessible by wheelchair-bound individuals.

Also, contrary to the member's statement, the Minister of Labour is not responsible for this. The air transport industry is fully regulated by the federal government in terms of safety, transportation regulations and Human Rights. I do agree that human rights does very valuable work in educating the public on these issues, and it is available to the member to provide further consultation.

Presenting Petitions

MR. JONES: Mr. Speaker, I rise today to present a petition.

MR. SPEAKER: The proper time for presenting petitions was just a moment ago, but we will let it go ahead anyway.

MR. JONES: Thank you, Mr. Speaker. The petition is signed by some 300 students at Vancouver Community College, who say:

"We the undersigned are shocked and appalled by the consequences of the budget cuts at Vancouver Community College, King Edward campus. Six months

[ Page 12752 ]

after the 'year of literacy,' budget shortfalls will cause a reduction of over 45 percent in adult basic education. In the ESL division over 800 students will not be able to complete their programs, while thousands of prospective students are on wait-lists for assessment and English language training. Over 95 teachers will lose their jobs at King Edward campus. We urge you to rectify this situation."

I request leave to submit this to the table.

MR. SPEAKER: Leave is not required. Petition is presented.

Orders of the Day

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

ESTIMATES: MINISTRY OF HEALTH

On vote 38: minister's office, $360,045 (continued).

HON. MR. STRACHAN: Mr. Chairman, I want to respond to some questions raised last week by the second member for Vancouver Centre with respect to the new Triage facility in east Vancouver.

The questions were four in nature: dealing with the community reaction to the proposed new Triage facility in east Vancouver; whether the increasing numbers of apparently mentally ill homeless people are a product of deinstitutionalization; what monitoring systems are in place for people discharged from Triage or from the institutions; and whether services are being provided for teenagers.

First of all, in response to the Triage question in general and the replacement facility, I want to advise the committee that the current facilities are really not adequate and do not meet the Community Care Facility Act regulations, and replacement is a high priority. It is a critical component in the system of care to maintain mentally ill individuals in the community

The current proposed site was chosen by the city of Vancouver. The size and cost of the site has dictated that the new Triage be 58 beds in order to meet the per-unit allocation criteria for capital costs set by the B.C. Housing Management Commission.

Triage has not yet submitted an application for the necessary zoning change to make it possible for the project to proceed. Whether or not this project will proceed is a decision of the Vancouver city council and the board of Triage. There have been public meetings, and there will be further hearings if and when the zoning application is considered.

The new facility will be licensed under the Community Care Facility Act, which will impose new standards with respect to professional supervision, staffing and care procedures. In view of the fact that the new facility is larger and the location is more sensitive — closer to schools and residential areas — should the project proceed, Triage will be more restrictive with respect to receiving individuals on parole or who have just been discharged from Riverview. While Triage has not had professional staff running the facility, it maintains close links with the Strathcona community mental health team. Together they provide expert professional care for the residents who need it, and this relationship will continue at a new site.

[2:30]

Some specific issues were raised in the debates last week, and three of the questions dealt with pedophiles, violence, criminal records, deinstitutionalization and monitoring systems.

With respect to the question of pedophiles at the new Triage facility, let me say that pedophiles are no more likely to be at Triage than anywhere else in the community, as pedophilia is not associated with serious mental illness. Presently Triage notifies local schools if there is a pedophile in the facility. This provides the community with better protection, and the policy will be that Triage will not accept any known pedophiles at the new site.

With respect to violence by residents at Triage, some residents have a history of violence, but there have been no incidents of violence at the present site involving the general public, and mentally ill people are no more likely to be violent than anyone else.

As well, dealing with those who have criminal records: some residents at Triage have been involved in the criminal justice system, but generally for trivial offences such as dine-and-dash — which is eating and then not paying for your meal in a restaurant. Should the new site be approved, Triage has agreed not to take direct referrals from the justice system.

The other question the member asked is: are the increasing number of people on the street a product of deinstitutionalization? Let me say that since Riverview has downsized since 1955 from 4,000 beds to the current 1,000, a number of service developments have occurred: treatment technologies have advanced, reducing the need for hospitalization; 725 acute assessment and treatment beds have been added to hospitals; over 2,800 community-based residential beds of various types have been added to the system; and day treatment and activity programs have been set up in most communities.

A joint study involving the Greater Vancouver Mental Health Service Society and the Vancouver General Hospital will also help to determine the home communities of many people with mental illnesses who congregate in Vancouver and why they prefer to live in the city. The implementation of the mental health initiative is being monitored by the Provincial Mental Health Advisory Council, with membership drawn from all the major stakeholders in the mental health community: consumers, professionals, advocates and service providers.

Finally, the second member for Vancouver Centre asked what monitoring systems are there for people discharged from Riverview? Let me advise the committee that Riverview is an active treatment hospital which routinely discharges patients once their illnesses have subsided or stabilized. This is different from the deinstitutionalization process which, over ten years, will provide alternative placement facilities and services for longer-term residents of the hospital.

Once patients have recovered from their illness to the point where they can be maintained in a community

[ Page 12753 ]

setting, they are referred to the community mental health system, where they are actively monitored as community service clients. Some choose not to remain as clients, which is their right, and this limits the ability of the care system to monitor their situations. Riverview and community mental health staff are piloting assertive case management projects which will provide aggressive aftercare to minimize the loss of treatment-resistant clients. Outreach workers have been added to the Vancouver mental health agencies, such as Lookout, St. James Social Service Society and the MPA courtworker program, to link individuals with mental illness to the service.

Finally, what services are being provided for teenagers? Let me answer in this way: the highest priority for mental health services for youth is to provide specialized services in local communities which are coordinated with the community services for youth provided by other ministries and organizations such as hospitals. Specialized consultation is available for youth who are in the care of Social Services and Housing or who are young offenders. Many of these youth are in out-of-home placements such as foster homes and group homes. Clinical assessment and treatment services are provided to individual youths and their family; and referral for specialized services at the Maples, B.C. Children's Hospital, VGH and Jack Ledger House are coordinated through the local mental health office.

There are many more notes, and I guess I could read on, but I did want to first of all brief myself on the issue of Triage. I'm pleased that the member did ask those questions, as I was able to better understand how the replacement is going to come into being and understand some of the questions that the member from Vancouver Centre so appropriately raised, as this is an issue that will no doubt deal with his riding.

With that said, I'll take my place, Mr. Chairman, and anticipate further questions from members of the committee.

MR. PERRY: Mr. Chair, if I didn't know it was against the rules of the House to read from statements, I might have been forgiven for thinking the minister was reading that. It went so fast that I may have to study some of the answers. I was attempting to follow it all. I too had raised some questions and appreciate the response.

Maybe I could begin on a positive note again, since it's been a while since we last continued this debate and it's going on three weeks since we began it. I can begin on a positive note by just finishing off the point I was attempting to make when we ran out of time last Thursday. There's a young Chinese-Canadian boy named Gordon Wu from Toronto whose parents were in Vancouver last weekend. I was going to make the point that he's joined by another young lad from British Columbia somewhere on Vancouver Island in the similar position of requiring a bone marrow transplant as their only possible hope to preserve their lives.

I think any member here putting oneself in Gordon Wu's parents' position could identify with them. I had the privilege of meeting Mr. Wu on the weekend at one of the clinics he had organized, with the help of the Chinese community in Vancouver, to attempt to find a bone marrow donor for his son. Meeting the father and seeing the mother on television, it's pretty hard not to identify with them. Their son has a rare condition that will take his life, because there's no effective long-term treatment for it. He does have the possibility of being effectively cured by a transplant, yet the possibility is very slim because the odds of any given individual matching him as a donor are so slim. In the case of Gordon Wu, the odds are higher of a match for a donor from the same genetic stock or ethnic origin, in this case Chinese. I think his parents have not only done their own family a service but have done the public a tremendous service, as did the parents of Elizabeth Lue last year, by raising this issue and raising the profile of bone marrow transplantation.

I was able to help out a bit, putting my medical skills to a small amount of use by helping to draw some blood on Saturday at the Richmond hospital. It was quite impressive to see the response from the public, particularly the Chinese-Canadian community — people who have, for ethnic and cultural reasons, some hesitance about donating blood or even the act of giving a blood sample, screwing up their courage and coming in, I can see the minister and his staff smiling; they're probably thinking it takes a lot of courage to come and have me draw blood from them. I can reassure them that I didn't miss once.

But seriously, it was really a moving experience to see the clinic. I wanted to mention it here so that the public has the opportunity to get wider exposure. Bone marrow donation, if you match to somebody, is one of the most fulfilling things you can do in life. For a politician, it's probably the ultimate fulfilment. What do I mean by that? My colleague the second member for Nanaimo two years ago was privileged to match her bone marrow to her own brother, who otherwise would have died. She now, unlike the rest of us, is literally able to be in two places at one time, because she is not only here in the Legislature — I don't see her in her seat right now, but she's somewhere in the precinct — she's also at this very moment living in Port Coquitlam, in her brother's marrow and blood; that part of his body is actually her. It's kind of a strange thought — an exciting one for politicians — but it's very important that the public understand more what a precious gift it is, not just to the recipient but to the donor, to be able to actually save another person's life. The average person has very few opportunities in life to do that.

I wanted to mention that there is another opportunity for members of the public — particularly, in this case, Chinese Canadians, because they are more likely to match — to participate next weekend at Richmond General Hospital and also at Mount St. Joseph Hospital.

I wanted to make a suggestion, too, because the Red Cross, for historical and many good reasons, has been naturally rather wary of individual campaigns of this kind. They have cooperated and have tried to help, but have maintained their distance. That leaves the parents

[ Page 12754 ]

in this case having to foot the entire bill, at $75 per test; to attempt to tissue-type donors — in this case at UCLA in the United States; and to foot the costs of the clinic.

Hopefully the real benefit of the clinic will come to Gordon Wu and perhaps to this other young British Columbian, but it's much more likely that somebody else will benefit. So in reality that family is doing the public a tremendous service. Perhaps in Canada, perhaps somewhere else in the world, some child or even an adult will benefit from the work they're doing. We all have a stake in it, therefore.

I think it would be an act of great generosity for the government to contribute something towards the costs, because in reality not only is the family bearing the costs, which is an investment for all of the public of the world.... Anyone who is on this bone marrow registry as a donor is potentially available to someone with a serious blood disorder anywhere in the world. The Wu family and the volunteers who are contributing are bearing that cost now. But they are also doing a tremendous job of breaking through intercultural barriers, breaking the ground in education and encouraging people in an ethnic community which has been reluctant to donate blood in the past. This kind of effort is breaking through that barrier and bringing us much closer together. So I think it would be a great opportunity, if the minister has any discretionary funds, to make some symbolic contribution to that, recognizing that there's enormous benefit for all of us in these campaigns.

I don't know if it's reasonable to expect him to reply now, but I'd ask him to at least consider that possibility in the intervening week. If we wants to reply, I'll sit down for a moment.

MR. BARNES: I'd like to ask the House to grant leave in order that I might make an introduction.

Leave granted.

MR. BARNES: Mr. Chairman, I'm very pleased to notice Jim Kirk, the communications officer from my election planning committee, in the public gallery. If the House would join me in making him welcome, I'd very much appreciate it.

HON. MR. STRACHAN: I'd like to make a couple of comments. At the outset, the member remarked on my reading an answer. He is correct to the extent that speeches should not be read — and I never do read speeches. However, when one is providing technical information — which I was doing — it is quite appropriate to read answers of that nature.

We were chuckling a bit over here as the member was talking about blood-letting. I guess I was thinking of the old barber-surgeons who used to exist. I didn't want the record to show that we were at all being glib or trivializing the issue he brought to us, because it is very serious. I'm happy that he was able to explain that process to the committee and the public from his point of view as a physician.

I can advise the committee, though, that on this issue of bone marrow transplant there is a national unrelated bone marrow registry. It is cost-shared by the province and the feds. It is located in Vancouver and run by the Canadian Red Cross. I'm advised that the British Columbia Ministry of Health was instrumental in the establishment of this registry. Further, I'm advised that my assistant deputy minister Chris Lovelace, who is sitting on my left, is on the advisory committee representing the provinces in this provincial-federal government relationship.

[2:45]

Finally, I can advise the member that I don't have any discretionary money, but if we were to partake in the cost of the tests he's talking about, we would ask for cost-sharing with the federal government, as we do with the rest of this bone marrow registry. I can advise the member that as those tests are done — although the parents of the patient are paying for it — they are registered with this unrelated bone marrow registry. So there is a benefit to the system as a whole and to those who require bone marrow transplants.

MR. PERRY: I raised a number of times earlier in the debate, both in interim supply and in the Health estimates proper, the question of the cardiac surgery waiting-list. I expressed my reservations about the figures offered by the former Minister of Health, suggesting that the average waiting time for cardiac surgery had been reduced in the last year from about 20 weeks to 10.5 weeks. There is a contradiction between that statistic and one available from the Vancouver General Hospital — which does about half the cardiac surgery in the province — where the average waiting-list was 20 weeks. This would suggest that the waiting-list must then have been zero at St. Paul's Hospital and at the Victoria hospitals.

I want to make the issue a bit more concrete by giving an example. Often people are reluctant to bring their personal suffering before the people of B.C., but the second member for Cariboo had a telephone call this morning from a woman who is prepared to share her problem with the public so that the public can know what a typical reality is. I'd like to describe this situation and then ask the minister whether he has revisited the figures we debated a number of times.

The woman in Quesnel is named Juanita Wilson, and she's 66 years old. I don't think her case is particularly dramatic. She's probably an ordinary British Columbian and typical of people in this position. She's been diabetic for a number of years. She's the mother of six children and grandmother of four. She's says she's about to have great-grandchildren soon. She has survived difficult orthopedic surgery in the past. She has had fairly severe angina or heart disease for a number of years. She's now one of those statistics on the waiting-list. In her case the problem is not only pain in her chest that wakes her up three times during the night but also the inability to make her bed, vacuum or dust her house or do the laundry. She now has a homemaker coming in three hours per week to help her with those daily activities, because the exertion

[ Page 12755 ]

exceeds the capacity of her arteries to supply blood to her heart.

She went on the waiting-list sometime between May 10 and May 15, so we don't yet know what her wait-time will be. But she's one of those people who is living under tremendous pressure. She was told that she could expect to be operated on perhaps within two months. I'm told by her cardiologist that although St. Paul's Hospital, where she was referred, is now operating quite smoothly, there's now a worry that in the summertime the number of open-heart operations will be cut back again because of a nursing shortage in summer. In that case, the cardiologist tells me, this woman might wait until November or even Christmastime for her operation.

She doesn't qualify to go to Seattle, because it's too complicated. She has risk factors that are more severe, and therefore the American hospitals do not want to take her on, presumably at the price that was negotiated for these cases. So she sits on the waiting-list, with the anxiety not only in her mind but also in her husband's, her six children's and the grandchildren's. For her it is not a very great consolation to know that.... The minister says the waiting-list has been cut from 20 weeks to 10 weeks on average; I say that that's statistically impossible. It doesn't make sense. It must be longer than that. I'd like to just bring that to the minister's attention and remind him that there are literally hundreds of such people — 700 or 800 at the last count — on that waiting-list.

I'd like to ask hon. members to try to put themselves in the position of that woman, her children or her husband and imagine what it actually feels like. When you speak to the cardiologist who recommended the operation, she will tell you that it is designed to improve her life expectancy, to reduce the chance that she will die prematurely; in other words, to try to save her life. It's not merely for pain control, although in this woman's case that in itself would be a perfectly valid reason for this operation. It is an attempt to save her life. Therefore she's living on tenterhooks.

I'd like to tell the minister also that when we broke off on Thursday last, I quoted from a letter from a doctor I did not name in a British Columbia town I did not name in order to protect the confidentiality of those patients. When I spoke to the doctor to let him know that I had referred to his letter, he told me that what was in the letter was not half of the story. He described to me some further incidents of patients requiring radiation treatments for cancer, some of whom were shipped by ambulance long-distance to Vancouver and then treated to a cab ride home to a neighbour's house after they'd ridden a long distance by ambulance. One was transported by helicopter because of severe pain and subsequently received a questionnaire from the ambulance service that had made the decision to use the helicopter which asked whether the helicopter had really been necessary The patient was asked that by questionnaire. I'd like to re-emphasize that the letter I read from — although it remains anonymous — is very real.

I'd like to ask another question which stems from that. When I spoke to that doctor again, he told me that the patient I referred to had been offered the possibility of being treated in Seattle — as I'd put it, being exported for treatment to the United States. The patient didn't know what costs would be covered, and the primary doctor, the family doctor, who wrote to me also didn't know what costs would be covered and what arrangements would be made. And the reason for that is obvious when you think about it.

Although the ministry agreed to export patients to Seattle, since we don't have the capacity to deliver effective standard radiation treatment for cancer in a timely way in B.C. anymore — we used to, but we don't now — it had the simple option of notifying primary-care doctors or all doctors that this option was available. There's a very simple way to do that: through the Medical Services Plan newsletter. Statements are sent to all doctors every two weeks, with payment, and since nobody ever opens an envelope as fast as one that contains payment, notices included in those envelopes are widely read and do not languish in a mail pile. It would have been very simple to notify doctors of the program in Seattle, of the financial conditions for patients, whether transportation and accommodation costs in Seattle would be covered, whether there would be any bill to the patient and what to do about emergencies or family problems occurring during that time. And it still would be simple to do that. I'd like to draw that to the minister's attention, because clearly there's been a failure of the most basic communication.

I can think of only one reason, and that is that it is acutely and chronically embarrassing to the ministry and the government to have to admit that we must now export patients for cancer treatment. I don't blame them a bit for being embarrassed. I'd be darned well embarrassed had I presided over the erosion of our health care system over the last ten years — or five years — of this government. But embarrassment is no excuse for making the patients into further scapegoats. We do need effective information, and one of the first steps is for the doctors to know how the system operates. I leave that as a suggestion as well.

HON. MR. STRACHAN: I said this last week, but I'll say it again: with respect to the wait-lists, I can advise the committee that the initiatives we have taken have resulted in the average waiting time being reduced from 20 weeks to under 11 weeks for those patients now being treated who have had the surgery. We've surveyed them, and we arrive at those numbers that show that the waiting time has gone down considerably. The member should also be aware — as a matter of fact, the member is aware — that the referring doctor can state whether the case is urgent or emergent and really bump the patient up on the waiting-list.

With respect to the U.S. referrals, the member should know, since he is a physician, that the Cancer Agency and not the Ministry of Health dealt with those protocols and referrals. If the member wasn't aware of that, he is now. He could phone Dr. Klaassen of the Cancer Agency and receive details on that issue if he wishes. But it was not a Ministry of Health initiative,

[ Page 12756 ]

nor was it the doctors' initiative. It was an initiative of the B.C. Cancer Agency

By the way, I met with these people this morning and was pleased to find out that this cancer agency is probably the best such agency in Canada. There is nothing else like it in any of the other Canadian provinces. It does a remarkable job of developing protocols, drug strategy and many strategies to do with handling people who do have cancer. It's our monitoring agency and does an extremely good job. As I said, there's nothing else like it in Canada. I was very pleased to hear that information this morning as I met with them. I think that we British Columbians can be proud of the B.C. Cancer Agency and the remarkably good work they do on behalf of those people suffering from this terrible disease.

MR. CHAIRMAN: The member for Kootenay seeks leave to make an introduction.

Leave granted.

MS. EDWARDS: I very warmly welcome today 25 grade 7 students from St. Mary's School in Cranbrook, with their teacher Ms. Ireson and two of their parents — and perhaps more by now. One of these students expects to become a politician, so I would ask the House to help me welcome them very warmly.

[3:00]

MR. PERRY: The B.C. Cancer Agency, while it has considerable autonomy, is of course funded by the Ministry of Health. Like all hospitals and health institutions, it's a creation of the government of British Columbia and belongs to the people of B.C. Therefore the ministry has responsibility for it. I still think it would be eminently sensible for the ministry to advise physicians in B.C. of the existence of the program. Perhaps the Cancer Agency ought to have done that itself.

Clearly, from the instance I gave and others, the reality is that the primary care doctor — who actually has to handle the patient coming into the office or telephoning, or whose spouse is calling and saying this is not acceptable — needs to know how the program works. There's a simple expedient, which is in the next MSP statement to send out a one- or two-page letter explaining how the program works and what the funding conditions are — be it on Cancer Agency stationery or Ministry of Health stationery. It really wouldn't matter as long as the information is out there.

[Mr. Ree in the chair.]

Before we go further, I'd like to make a comment while we're on the theme of information. I again refer to a point we visited before, which is the change in policy within the ministry under the present minister. The mellifluous tones represented in this Legislature disguise — need I or dare I say it — the ferocity of a pit bull in terms of the jealous guarding of information within the ministry. I complained about this before, but I'd like to draw to the minister's attention again that on this side of the House we continue to have difficulty obtaining basic information from officials within the Ministry of Health, a problem which we never experienced during the tenure of the former Premier's government. There were many things I was critical of but I was never critical — and I'm pleased to say it in the presence of the former Premier — of difficulty of access to information from the staff, with the rare exception of reports that were deliberately withheld by the minister or the former Premier. The staff were courteous enough to give the opposition briefings in advance of legislation under the condition that we respected the confidentiality of the information, and that agreement was always respected to the letter by our side and was freely offered by the ministry. I never experienced any difficulty in having my telephone calls returned promptly, be it from home or at home or under virtually any circumstance. I could offer nothing but praise on that account.

Suddenly, in the last month, something has changed. Maybe it's the absence of the former Premier, for all I know. When we call for information we are finding officials who insist that all inquiries must be routed through the minister's office. The minister has been gracious enough to send me a letter explaining this policy, but I am obliged once again to protest it as unreasonable, because not only is it putting us to a lot of extra work: I feel it's causing acute embarrassment to ministry staff who are public servants and who, after all, have a responsibility to provide information to anyone in British Columbia who needs it — not just the government, not just the opposition, but any British Columbian who pays their salary. So I'd like to encourage the minister, if I could once again, to revisit that policy, and I'll give him the opportunity by reminding him of a number of my outstanding requests for information for these debates.

One would be for the Pharmacare review committee report. I still think that we could serve the public of British Columbia by discussing that report in these debates. There is still time. Some members have rebelled at the proposition that we'll continue the Health debate for three or four weeks, but I have a convoy of elephants outside with additional files in case we need to.

The minister on June 10 undertook to provide me with copies of correspondence relating to Health ministry initiatives on signs warning against the consumption of liquor during pregnancy, and offered to table that correspondence, providing it were not ultra secret, at the earliest opportunity. I suppose it's conceivable that that information might be ultra secret, but I think right now the public is more interested in the Mashat affair than that, and probably the minister could get away with releasing that correspondence.

I made a number of other requests which I thought were before me right now, but I don't find them all. Among other things, I'm still interested to know the information provided by the Greater Victoria Hospital Society about laundry costs so that the House can assess objectively for itself whether the province saved a little bit of money on those Saanich contracting costs, or whether the province lost $1.25 million on that deal.

[ Page 12757 ]

I will attempt to identify the other outstanding requests a little bit later.

One of them that the member for Boundary Similkameen referred to earlier in the debates was disagreement over the number of elderly people living in the School District 16 area of Keremeos. I wonder if the minister has come up with that information. I have in my hands a very interesting proposal from a local pharmacist, Walter Despot of Keremeos, the president of the local intermediate and extended-care society, whose initiatives we've discussed in the Legislature. He makes a very strong and rational case for the need for additional facilities for people in that part of the province. I remember that the minister and the second member for Boundary-Similkameen had some dispute over the figures for elderly people. Mr. Chair, I wonder if the minister could tell us if he has updated the statistics. Can he answer that question for us?

MR. CHAIRMAN: At this moment the Chair would like to point out to the member a reference under standing order 61(3): "The Chairman shall preserve order and decorum in the Committee of the Whole...." Likewise the Chairman would like to bring to your attention the appointment of the Chairman by the House under standing order 15. It's "the Chairman," not "Mr. Chair."

HON. MR. STRACHAN: First of all, to the students from the Kootenays, welcome; and to the student who wants to become a politician, I'll tell you how to do that. You begin by going to the hardware store and getting a bag of marbles, and you put them in your mouth; then you read from Sir Erskine May and from George MacMinn. Occasionally a marble will drop out, and when you have finally lost all your marbles, then you can become a politician.

Now back to the questions. In terms of the policy of providing information to Members of the Legislative Assembly, I'm not aware of making any changes, so I find the member's questions curious. Anything that's available to the public is immediately made available to MLAs as they write. Questions to me that are not on the public record or questions about the Ministry of Health I will attempt to answer as quickly as I can. That's the policy of the Ministry of Health, and it has always been my policy in the many portfolios I have held. I really think members opposite and members in the government benches will agree that my administration of all the portfolios I have held has always been open, and I have always readily and freely agreed to provide as much information as quickly as I can to any member who requests it. So I find it difficult to understand where the member is coming from in terms of releasing information, because it certainly isn't policy to change anything.

In terms of advising the member about upcoming legislation, the reason I haven't offered any advice on upcoming legislation is that we don't have any upcoming legislation this year. If I had some, you would have a briefing. If you spoke to other critics — the Environment critic or the Advanced Ed critic — you would know that in fact it was always my policy to give the critic information and briefing on legislation as it was coming into the House. I think that's better for the process of debate. If I did have any legislation coming forward this year, I certainly would share it with you for the benefit of your input and also for the easier and more understandable passage of the legislation I was presenting.

The Pharmacare report: I haven't seen that yet, Mr. Member, but when I do I will review it, and I see no reason why I wouldn't share it with you. But that will be after I have had a chance to look at it.

In terms of the discussions we're having with Labour and Consumer Services about advising pregnant women about alcohol use or abuse, we have not received the final correspondence on that from the Ministry of Labour and Consumer Services, so there's not much I can provide to you in terms of completing the report. But when that is available, I will let you know that as well.

Now back to the question on Keremeos. I have some information. The second member for Boundary Similkameen said that the population of seniors is 30 percent, and the Ministry of Health said that the population is a little over 22 percent. We agreed last week in our estimates to review our source of data, and this is it. The total population of Keremeos in 1989 was 3,655, and the number of persons over 65 was 912, or 25 percent of the population. These figures, by the way, are provided by the planning and statistics division of the Ministry of Finance and Corporate Relations. All actual figures are for 1989. In 1990 we projected that it would be 25 percent of the population. The projection for 1991 is 26 percent of the population. For 1992 the projection is that 26.8 percent, approaching 27 percent, of the population will be over 65 in the village of Keremeos.

I don't know if this information is earth-shattering, but these are the best projections we have. Our Ministry of Finance and Corporate Relations provides statistics to us categorizing populations by age and sex.

MR. VANDER ZALM: Regarding the advice given to the student about the loss of marbles, I should also say that most politicians often speak for themselves, and not all politicians have lost their marbles.

Before I commence with my comments, I also want to say that I would hope the minister will give me a very brief response, I'm concerned about the length of these estimates. We might still be here in September if the minister continues to filibuster. Frankly, I'm concerned about the cost to the taxpayers for all of this, so I don't mind if it's only a brief response to the point that I want to raise.

But before I raise the point, I want to make reference to something said by the second member for Vancouver–Point Grey. I find it very difficult to criticize him after his complimentary remarks. As a matter of fact, I've had a good rapport with the member for a good while, and I would like to see it continue. But I do have a criticism, although not with respect to what he said about getting advice from the ministry. I too find it much more difficult to get anything from a ministry now than I did only a few months ago. Now

[ Page 12758 ]

I'm not sure that the reasoning is identical, but certainly I too find it much more difficult. Frankly, it's a lesson sitting here as opposed to sitting over there. You find that the bureaucracy oftentimes responds very quickly to one in position, but when you hold a position which is not quite like the one you held previously — more like the average person out there in all the communities we represent — it's much more difficult getting the information. I can't make that criticism about the Ministry of Health, because I've not had the occasion to ask for any information. So present company excluded.

I want to make one comment about something the second member for Vancouver–Point Grey said. I saw it in the Blues, and I don't think it should go totally unmentioned. He made some criticism last week in debate about this member for Richmond, and he intimated in so many words that because I was a Catholic, I was somehow discriminatory with respect to any application or any grant requests from Planned Parenthood. I suppose he could have said Catholic, Presbyterian, Anglican, Evangelical or anything like that, and we as Christians are supposed to simply say that he's talking about discrimination.

[3:15]

When he uses our faith, our religion, in the context of a particular matter where we're dealing with.... That's not discrimination in the eyes of the member. But he should consider that he would not have said Sikh, Moslem, Hindu or any non-Christian denomination, because his comments might have been seen as discriminatory. So I think he should really refrain from using that, in all honesty and fairness to the member. If you can't use an adjective when making reference to a non-Christian member, you shouldn't use it with respect to a member who might be a Christian.

It's ironic that he was talking about discrimination when he raised a person's religion as the reason for that person perhaps having been opposed to funding for Planned Parenthood. That's unfortunate. We see too much of this in our society today, where Christian people often simply sit back and take this. If we were to use the same approach to non-Christian people, it would be seen as something terribly discriminatory. I only raise that to correct the record and to caution the member in his use of a person's religion as to how they might have dealt with a particular request from a group in our province.

The matter I wanted to raise with the minister and the ministry people was something I received from a good friend who has recently gone through some considerable effort to seek a hip replacement. I'll simply give the history of this particular person's attempt to obtain a hip replacement to indicate where much of the problem is in the delivery of health services in the province. Particularly in health it has become horrendously bureaucratic. It's become too much of a big business with little thought of the limited resources available to provide the best service to the people in our province.

On February 20, 1990, my friend went to see his GP, Dr. A, about a hip problem. On February 26, 1990, he went again to see Dr. A and asked him to refer him to an orthopedic surgeon. On April 12, 1990, he went to see Dr. B, an orthopedic surgeon. On April 23, 1990, he went again to see Dr. A to get the results from Dr. B. However, he could not get any positive answers one way or the other. On July 20, 1990 — and this friend of mine was now in some considerable agony — he went to see GP Dr. C and asked to be referred to Dr. D. A friend had told him that Dr. D was a good orthopedic surgeon. Dr. C set up an appointment for him with Dr. D, and he had to wait only one month to see him. On August 20, 1990, my friend went to see Dr. D, who told him that he needed a hip replacement. He said: "I will place you on the waiting-list, and it will be about one year before I can help you." On November 23, 1990, my friend again went to see Dr. D, who said: "If your condition gets really bad, I may get you into the hospital a little sooner." At the beginning of February, 1991, my friend talked to a friend who asked why it was taking so long to get into the hospital. His friend, a lady public servant, said: "I know somebody in the Ministry of Health, and I will find out why it's taking so long." Two days later my friend received a phone call from Dr. E in the Ministry of Health, who struck my friend as being very helpful and who promised to find someone who could attend to this and let him know why the long delay.

On February 11, 1991, my friend went again to see surgeon Dr. D, and Dr. D asked, "Did I take you off the waiting-list?" to which he answered no. At least, if he had taken him off the waiting-list, he had not been told so. A couple of days later Dr. E of the Ministry of Health phoned him, and on about February 13, 1991, said that he had inquired why he was not taken into hospital yet, said that normally it should take three months and unfortunately Dr. E had said a year, but that Dr. F in the Royal Jubilee told this person that he could get in earlier.

Now I could go on. It continues, and there is a long list — a further three pages of referrals — to where eventually my friend does get into the hospital, has a hip replacement, feels a whole lot better and is able to get around. He's very satisfied with the services provided him in the hospital. Incidentally, my friend lives on Vancouver Island and ended up getting his operation in the Fraser Valley.

The point is that he went through a lot of referrals before he came to the hip replacement. I think people in communities throughout this province unfortunately oftentimes go through this again and again. They come to see their doctor, are asked to come back and are referred to a specialist. They then have to go back to their doctor to get a report from the specialist, and it's on and on — referral after referral. The bureaucracy, the system and those involved in the system undoubtedly do well by it. But what about the people that we're supposed to serve? That patient — the person who needed the hip replacement — didn't do so well. Eventually he did, but too often the system caters to those who deliver the service, not those in need of the service.

I must confess that I've been a party to it. I was there. You could easily say, and so you should: "Why didn't you do something about it?" I guess I'm guilty as

[ Page 12759 ]

well. But it's tough. For anyone who has served in that Ministry of Health — which is a massive ministry with a huge bureaucracy, not only of itself, but which it serves throughout the province — it's tough. But it must be addressed. We can't continue with this referral process and with the process beyond the referral that tends to cater to those who deliver the service, as opposed to those in need of the service.

So I would ask the minister that this be given priority consideration by the ministry and this government. Let's start concentrating on the people we serve, as opposed to those who make up the system.

HON. MR. STRACHAN: The first member for Richmond wanted a brief answer, so the brief answer is this: yes. A couple of months ago we put in place a health issue hotline for people to phone if they have any issues they want to bring to our attention.

With respect to the procedure and wait-list, we have also put in place a provincial surgical registry. This registry will assist providers, hospitals, and ultimately patients in making informed choices regarding options for surgery and will assist hospitals in the allocations of their resources to meet the surgical needs of the patients they serve. In other words, the situation that the member for Richmond identifies is a concern of ours as well, and we are attempting to address it as best we can through this provincial surgical registry.

MR. PERRY: If I can, let me very briefly clear up any misunderstanding about the remarks of the former Premier. If I left any impression of criticism of Catholic faith, that was not my intention, and I hope that was not the perception.

Just reviewing the final record of Hansard, I see that what I actually spoke of was — referring to Planned Parenthood, a very effective organization at the dissemination of birth control information — why they had not been able to receive provincial funding. I stated:

"In part, perhaps it relates again to the former Premier's personal biases. Catholic agencies withdrew from the United Way in the past because the United Way accepted Planned Parenthood into its fold. Perhaps it was the Premier's own religious beliefs, because of the withdrawal of the Catholic social agencies from the United Way over that issue, that had prevented Planned Parenthood from getting funding, "

It is a historical fact that the Catholic social agencies withdrew because they were uncomfortable with Planned Parenthood and with the idea of birth control or abortion. Of course, they are entitled to and can be respected for upholding their moral views. The real question was whether that was in the interest of the public for government to decide not to fund Planned Parenthood.

Since the former Premier has brought it up again, I note that when I asked the minister whether he was prepared to consider funding Planned Parenthood, he answered: "To answer the last question first, I won't comment on that organization. I do not know how fairly or unfairly we are treating them." Perhaps he's reviewed that in the interval and would now like to comment about Planned Parenthood?

HON. MR. STRACHAN: I do have some information I'll offer to the committee which has been provided to me. The organization of Planned Parenthood used to be reimbursed through the salary and concessional component of the Medical Services Plan for clinical services provided to Planned Parenthood by physicians. However, this mode of funding ceased at the end of the 1983-84 fiscal year and has not been reintroduced. I know from looking at those dates, having been here as you were, that that was a restraint measure if it took place in those years.

However, the current ministry policy is to provide information through health units, physicians' offices and other outlets on a full range of choices with respect to reproductive health. The ministry has supported the British Columbia Public Health Association in developing a broad range of information on pregnancy prevention and the choices available to women facing an unexpected pregnancy. These pamphlets, as well as videos — which are rented free of charge — are available through the office. The ministry also allows community organizations to make use of available space in the health units, and Planned Parenthood is one of the many organizations which can benefit from this offer.

[3:30]

Physicians can claim for their services for confidential counselling on reproductive health matters, and public health nurses throughout the province are also experts in this area of health. So I would submit that we are endeavouring, in every way we can, to provide as much information, counselling and assistance as we can to those seeking information on reproductive health and on planned parenthood issues not the organization itself. I can assure this committee that the decision not to fund them was obviously a matter of restraint, because many budgets and provisions were cut during the 1983-84 fiscal year. They were done for reasons other than any issue having to do with the politics of reproductive health, but rather with the politics of trying to control our budget during those years of very tough revenues.

However, let me say, from what I can see from this briefing note, that we are offering very good advice and many ways of providing the public with information on reproductive health and on planned parenthood.

MR. PERRY: The point isn't as trivial as it might seem. Planned Parenthood has a reputation in many quarters as being the best agency for the delivery of reproductive counselling and birth control information, particularly to teenagers. I pointed out to the former Minister of Health on July 25 last year, on page 11418 of Hansard, that the ministry had issued a birth control pamphlet largely based on information from Planned Parenthood in which the name of Planned Parenthood was selectively omitted. Other organizations were published as sources of information in the community, and Planned Parenthood was apparently deliberately left off. Now that we are reassured — and I can see the reassurance sinking into other members on this side, particularly the female members of the

[ Page 12760 ]

Legislature; I can see that reassurance reflected in the peacefulness of their faces — that politics has never intervened in the delivery of health services, particularly reproductive health services in B.C., maybe the minister could simply say that Planned Parenthood won't be discriminated against in the future, will be eligible on the same basis as everyone else to compete for grants and will be reinstated to its rightful place of pride in ministry leaflets as a source of good information for the public.

HON. MR. STRACHAN: I can assure the member that if they were left out of any of our information, it wasn't done for any trivial reason. I'm not saying that planned parenthood is trivial, and I hope the member isn't taking my answers to conclude that I am being trivial on this issue. But we feel that in the general area of reproductive health, we are providing for professional services and for the dissemination of a broad, impartial range of information and referrals throughout the province. We feel we're doing this in a most forthright manner. I find it very difficult to accept any criticism of the information that we make available to British Columbians with respect to their reproductive health.

MR. PERRY: Could I return to one of the other interesting points the former Premier made? I thought his example of the experience of a friend requiring hip surgery was an interesting one, so I jumped the queue with one of the papers in my own file to bring it up now in juxtaposition with what the former Premier said.

I have frequently encountered complaints.... I think members will recall that at one time there was an advertisement campaign showing a man requiring hip surgery outside on the steps of the Legislature, attempting to climb the steps and pointing out that he couldn't get up the steps. That may have been a slight exaggeration at the time.

I hope I can pride myself on taking the same approach that the former Premier outlined, of arguing in this Legislature primarily for the people who use the system, and although some hon. members opposite have sometimes intimated otherwise, I've tried to confine my arguments in this chamber to advocacy for patients and people who use the system in general. I think it's a very good approach.

But one of the areas where I've had a lot of trouble in getting through, seemingly, to the Ministry of Health is exactly that situation of joint replacement — principally hip surgery, because it's by far the biggest bulk of the problem. I think it's an intriguing one, because often elderly people, many of whom by definition develop their hip disease when they're elderly through osteoarthritis or other conditions.... Many of that age group went through the war, and a lot of them went through the Depression. Many were immigrants from countries where health systems were less good than here. They tend to be pretty conservative and very patient. They don't complain easily; they don't jump on the phone to their MLA or write to their MLA at the very first complaint. So I've always taken particularly seriously complaints from that sector.

The hip surgery problem has troubled me for several years, because I've never been able to understand the logic, from the government's point of view, that when you need hip surgery for the relief of pain or to improve your mobility, there is an advantage to waiting. That seems ultimately to be the logic of the Ministry of Health argument: that it would be good for you to wait for a little while and think it over and perhaps get used to the pain. Maybe it's so that they will feel more grateful when their pain is relieved. I don't know; I've never really understood that logic.

If the ministry were saying, "We don't want doctors to operate on people who don't need hip surgery, " I'd be behind them 100 percent, and so would most anybody, including most doctors. Virtually all doctors don't believe in surgery when it's not necessary, and certainly the public doesn't want to pay for it. That would be a very sound logic. If the ministry said, "We think too much hip surgery is being done compared to other jurisdictions; not only are we spending too much money on this, we're putting too many people under the knife who don't need it; we want to audit hospitals, find out the indications for the surgery, check to see whether the patients really feel better afterwards, find out what the success rate is, whether some of them are dying during the surgery," all those would be good questions.

I'm happy to say that it's mooted that the ministry is thinking about doing that. Maybe if the minister has a little discretion and gives them a little bit — maybe a thousand dollars or two — they could do that study. Good hospitals should be doing it on their own already. Good hospitals are doing it on their own already, and good doctors are doing it on their own, and good general practitioners — the kind that the Premier described — should be doing it with their patients. They shouldn't refer to doctors who do too much surgery. So we do have some built-in controls. But if the ministry were worried about that, that seems a perfectly legitimate and reasonable argument to make. I, and I think virtually all British Columbians, would back them 100 percent — as long as they respect the usual norms of patient confidentiality, which they would.

But, Mr. Chairman, that is not what I have seen happen. I hear stories of people for whom the rationale for the surgery is impeccable. The pain is severe; it's disabling. The individuals, typically elderly, are waking up at night unable to walk and function as they used to. The only effective remedy is surgery. Drugs sometimes help, but sometimes they cause ulcers, bleeds and all kinds of other problems.

I see people exactly like those described by the former Premier wait for a year. What is the benefit of that wait? Does the cost go down a year later, when it has to be done? Of course not; we all know better than that. If anything, the cost goes up. Is it an edifying experience to suffer pain? Maybe the Old Testament said that, but most people who have suffered pain would say that a day or two would be enough to get the message across — one night perhaps.

[ Page 12761 ]

I've been at a loss, and I've heard doctors complain. I usually try to pin them down: "Have you actually got any people on your list? Let's see it." One of them actually sent me a list. I'm not going to table it because of the names on the list. This is Dr. Stanley Leete up in Campbell River. The ministry could speak with him if they wanted to. He points out, as you will see, that some of them extend back nine months:

"I would like to stress that the hospital here has been extremely cooperative and has bent over backwards to facilitate as much surgery as possible. As you know, the major problem is lack of funding. It seems to me it is an extremely short-sighted policy that the government follows inasmuch as a lot of these patients are in the workforce, and while they are off work, they are just adding to the financial load that our taxes must support. I hope you will be able to help get us a little more financing."

He's not asking for a lot there; what he's asking for is the funding to buy the artificial hip joint, the piece of metal that would go into those people. Let me just follow up in the former Premier's vein, because it's important. I know that Health ministers wriggle under these letters. They don't like to hear them, do they? I see the former minister sitting there; an expression of pain is still on his face two years after hearing some of these stories. They're not nice to hear, but they're salutary. Sometimes the pain should not just be with the people suffering in their hips; there should be a little pain for us sometimes to know what it's like,

Here's someone who preferred not to be identified describing the situation very effectively. It's dated April 12, 1991. The former minister received a copy; he could trace it down if he wanted to. There are the following numbers in the postal code: a 6, an 8 and a 9. This individual writes:

"My doctor, Dr. A, referred me to orthopedic surgeon B for a possible hip replacement. On June 8, 1990, Dr. B confirmed that I would require a hip replacement and that the waiting-period would be approximately nine months. I was shocked that I would have to wait so long for the operation, but I accepted it. I contacted the hospital numerous times up to January 3, 1991, when I was advised I was No. 6 on the waiting-list. This translated into 12 weeks, making the date the first part of April. Dr. B is allowed to perform only two hip-replacement operations per month. I called the hospital on February 21 and was advised I was still No. 6 because the budget for purchasing prostheses, the actual metal joints, was exhausted in mid-February, and there would be no further operations until money was available in the new budget effective April 1, 1991. I was then advised that I could not expect to have my operation until at least July or August. My waiting-period had gone from nine months to 13 or 14 months. I discussed this atrocious situation with both Dr. A and Dr. B on March 2 and March 14 respectively. They both accepted my assessment of my deteriorating condition because it was all too obvious. Please refer to attachment for details."

The attachment, also dated April 10, 1991, is brief, succinct and to the point. It says:

"The following outlines my present condition.

"1. Constant pain.

"2. Sleepless nights.

"3. Walk with the aid of a cane.

"4. Unable to walk more than a few yards at a time.

"5. Left ankle now aches continually from strain of walking unnaturally to favour the hip joint.

"6. Medication has very little effect. It's apparently as strong as it can be without creating stomach problems.

"7. Lack of exercise and waiting for hip operation is creating unwarranted stress.

"8. Due to item 7, I feel that my cardiovascular system is degenerating and will continue to do so until I obtain my hip operation and I'm able to obtain necessary exercise."

That reminds me that I sometimes think there must be people in the Ministry of Health who read that Oliver Wendell Holmes poem, the "Wonderful One-Hoss Shay, " in high school. You, Mr. Chairman, probably read it, as I did. And they believed it. They think that maybe if we wait long enough, people will actually just disintegrate in one go and then they won't cost us anything — instead of having to spend that miserable money on the last few years of life, which health bureaucrats like to complain about so much.

Let me go back to the letter.

"I realize that both the federal and provincial governments have reduced their funds towards the health system. Granted, they have increased their funds, perhaps at least to keep pace with inflation, but it is your priorities in spending such funds that I cannot accept. I have been advised that there is no shortage of nurses, beds or operating facilities in that hospital, just your unrealistic, inadequate amount of money available for the purchasing of prostheses. That is what is creating the unwarranted delays for hip replacement and similar operations. I believe it is time for you and your board to review your priorities, enabling the doctors to do justice to your patients.

"Please advise what steps you will make to rectify this undesirable situation for the benefit of the people served by the hospital."

That one was addressed to the administrator. I imagine that even the administrator — he or she — lost some sleep after getting that letter. But I'd like to know: what did the Ministry of Health do about it?

[3:45]

HON. MR. STRACHAN: The member, Mr. Chairman, has actually answered his own question. You see, he knows, and now the committee's going to know, that we fund hospitals on a global basis. We don't fund hip or cataract or cardiac. We don't set a preference for what procedures a hospital does. I'll say that for the member's benefit again, because he knows what it is; he's a physician. He has attempted to create the impression in this Legislative Assembly that the Ministry of Health decides on procedures. It is the hospital, Mr. Member, that decides on the procedure. I think you have left an incorrect impression with the committee about the establishment of procedures, and I want to set that straight.

I'll say it again, Mr. Member: neither the Ministry of Health, nor the minister, nor the staff — none of those people, none of us — decide which procedures a hospital is going to do. That hospital decides which procedures it is going to do, and you know that.

[ Page 12762 ]

MR. PERRY: I'm really smarting after that one.

HON. MR. STRACHAN: Then why were you lying?

MR. PERRY: Why was I lying? We know, of course, that hospitals have global budgets. The problem is, what are they going to do when the global budget is clearly not sufficient for those needs? The ministry surely has a responsibility to decide — as the ministry has done during external reviews when it has appointed tough external reviewers to walk into a hospital, spend a few days looking around and make recommendations: "This is good; this is not so good; this could be eliminated completely or done better."

The ministry accepts that responsibility. Presumably it accepted some responsibility, or indicated its concern, when it launched the Pharmacare review. We have spoken back and forth over the last few days, regrettably with very little light shed from the government side in response to questions for fact on what I suggested might be the potential for a $50 million saving in the Pharmacare budget for costs of drugs, I suggest that that's feasible. The ministry has undertaken a study which has never been published. It spent money on it, paid consultants $250 each to go to a meeting, and yet the report's not available. Maybe the report could be useful even to hospitals, so that they could adjust their budgets more rationally to allow enough for the prostheses which are clearly needed.

If the ministry really is concerned that too much orthopedic surgery is being done, maybe it could help hospitals — rather than each one of them reinventing the wheel — assess whether all the surgery they're doing is necessary. I don't think it washes just to wash one's hands of that. The ministry is a big bureaucracy. There are 4,000 employees or more in that ministry. There are a lot of talented people who ought to be able to bring some skills to bear on what I think the former Premier was arguing and what I'm certainly arguing: that there are a lot of people in British Columbia who actually are getting less good-quality service now than they were five to ten years ago, and that these delays are often getting worse.

Let me turn to a few other issues, Mr. Chairman. Many members will have received correspondence in the last year or two about a strange condition called chronic fatigue syndrome or myalgic encephalomyelitis. In the United States it's usually referred to as chronic fatigue syndrome; in England, perhaps as ME; and the support groups in B.C. have been referred to as ME groups.

It's a very bizarre and baffling condition. Hundreds of thousands of dollars — maybe more — must have been spent by doctors, and multiple referrals of the kind the former Premier described must have been made, attempting to figure out what is going on in some people experiencing this condition — for want of a better name. The typical individual is a healthy young person — let's say a 14-year-old child, a friend of the member for New Westminster whom she told me about last year, or a seven-year-old child, such as the daughter of good friends of mine. Most members probably have constituents in this situation. There's a young teacher who used to be on the football team at Simon Fraser University, and a teacher in Langley who has become incapacitated. Someone who was in perfectly good health experienced what seemed like a typical childhood or adult viral illness — a temperature, a bit of fever, a few aches and pains — and then never got over it, was left drained of energy, often depressed, with strange muscle pains and a variety of strange symptoms. They never quite got back on their feet. That's what this condition is, and it's one which no specific diagnostic test has been able to pin an exact label on.

I'm sure members must have encountered people in this situation — I see some of them nodding. It's very baffling, because it goes on for so long sometimes. Fortunately most people eventually recover from it, apparently spontaneously.

These people have been organizing a rather effective lobby, I would think; they certainly have been effective in contacting and even pressuring me. I was always interested in this condition, because I once experienced something like it myself when I was in university, and I knew physicians during my training who had looked after people with some kind of similar condition. So I've been listening to them. I've been skeptical, but I continue to listen to them, and I've seen enough in my correspondence to know that something is going on out there. The medical profession as a whole — and the university faculty of medicine and the Ministry of Health, I think — have been quite slow to catch on that there is something happening out there, like other jurisdictions around North America and the rest of the world.

I want to ask a specific question. I know the minister has had correspondence with these groups, as have I. I think some of the advice he's received — perhaps not from the ministry; maybe from medical sources — has perhaps been incautious, and led the former minister to dismiss this issue in the past. But I'd like to ask a specific question: what is the ministry policy — and the rationale for that policy — on the need for a specific evaluation clinic?

The patient groups have requested over and over again a specific chronic fatigue syndrome, or ME, evaluation clinic, perhaps at Shaughnessy Hospital in Vancouver, which could provide a definitive evaluation of patients. I want to make clear to the minister that many patients — or some — seem to see this as a facility which will cure them. I don't personally believe that is possible at the present state of knowledge.

I do believe that an evaluation centre could provide people with a more thorough understanding of their condition, a better expectation of what will happen to them and some sense of security that they have been fully evaluated. I also think that it could save money, because it could save on the redundant, repetitive referrals — that tennis-volley syndrome that those people often experience through being sent to one specialist after another, none of whom has any idea what is wrong of them, but all of whom extract a fee.

I think there is potentially a constructive role for such an evaluation centre. I know the ministry has

[ Page 12763 ]

been quite reluctant to endorse that, and I'm curious to know why.

HON. MR. STRACHAN: Just let me comment on a couple of items the member brought up.

First of all, with respect to Pharmacare — those were his first comments after he ducked the issue of global budgets in hospitals — the member was advised earlier that we would be providing the Pharmacare report as soon as it is available.

With respect to chronic fatigue syndrome, I'll advise the committee that the first member for Nanaimo discussed this issue at some length the other day. I know the member wasn't here, but he obviously hasn't read the Blues either, or Hansard, to understand what our discussion was about. This has been canvassed before, but I'll repeat it for the benefit of the member, and he can perhaps look up the answers in the Blues of last week.

We do have a serious concern with chronic fatigue syndrome. I am advised that there are a few hundred patients suffering from this syndrome. The member talks about people being shuffled from one doctor to another. The reason for that is that the diagnosis of chronic fatigue syndrome is not clearly established by the medical profession, and usually rests on the exclusion of other causes, which is why you would be sent to other physicians — to exclude the other causes and do the testing. There is no specific therapy, and we feel that care by family physicians is appropriate, along with support groups.

What we have done, though, in terms of a strategy, is to ask the dean of medicine at UBC, Dr. Martin Hollenberg, to encourage researchers in the faculty of medicine to apply for grants to study the causes, effects and treatment of this condition, which we feel is appropriate. As a former Minister of Advanced Education, I can say that it is a strategy which has resulted in research being done on other medical concerns and which in many cases has proven to be effective.

That's where we are on the issue at this point. If the member, who is a physician, has any medical advice for the committee or the medical community, I'm sure we'd be delighted to hear it.

MR. PERRY: I'm very flattered that the minister would ask for my opinion, and perhaps he'd even be willing to let me draw blood from him sometime. I'm trying my best, but he hasn't come within range yet. The two sword's-lengths still separate us, and I haven't found a syringe and needle quite that long yet.

Mr. Chair, I actually had read that part of the debates. I know that one of the other members on this side raised it. It hadn't really answered my specific question. I don't think the minister has yet.

I wonder if he's looked at the costs — which I suppose technically the ministry might be able to do — of testing and referrals related to that diagnosis, either chronic fatigue or myalgic encephalomyelitis. Could he tell us what the Medical Services Plan knows about the primary-care referral charges to the plan and laboratory diagnostic tests? I don't suppose he has, but he could. That's what we have computers for, after all. If he did, he might well find that the costs of testing alone right now in this field would warrant the establishment of an evaluation centre.

I agree completely with the ministry's position that the primary-care physician is the best person, in general, to deal with these problems. However, as in other complex diseases such as Lyme disease, multiple sclerosis, ALS — whatever — there often is a value to some interdisciplinary clinic which performs very careful state-of-the-art analysis. Such clinics have been established in this field at the University of Washington in Seattle, for example. They probably will spring up elsewhere in the country.

I've had a number of discussions on this subject with the UBC people, and they seem potentially interested. But, as always, there's a question of how these would be funded. For example, under fee-for-service it's very difficult to do a proper evaluation. Under a once-a-week or even twice-a-month sessional clinic, it might be practical to evaluate people comprehensively and save a lot of money in the long run.

[4:00]

HON. MR. STRACHAN: The member talks about identifying the number of patients and identifying a strategy. It's a bit difficult in terms of our coding system because normally nothing is found. And how do you code something that's not there, except this syndrome that patients feel they have and obviously exhibit some concern about? It's not like ALS or MS or other such diseases. In fact, it's very difficult to categorize.

However, we can look at that in our own administration in terms of identifying and tracking the syndrome and how doctors are managing who deal with patients with the syndrome. I don't know what else I can offer in the debate at this time, Mr. Chairman, except to indicate that the member has indicated a procedure he would like to have put in place in terms of our administration, and perhaps we can do that. But it's not like dealing with a known disease where we have clearly-established tests and diagnoses and can say yes, this is MS or ALS or something else. It's a rather mysterious item at this point and for that reason is difficult to code.

MR. PERRY: Let me turn to another rather different issue. The minister will be aware that within British Columbia hospitals in the last two years, there has been an initiative, funded by another ministry, which was rather unique in North America. These were the chemical dependency resource teams designed to identify patients in hospital who were suffering from alcohol addiction — alcoholism — or dependency on various other drugs and to help them to get into some kind of effective treatment program at the point of maximum opportunity while they were in hospital. Good doctors and nurses have always done that, but it has been one of the great failings of the health professions that probably in alcoholism, as nowhere else, they have failed to have much of an impact on patients. Therefore a lot of people were very excited when that chemical dependency team program was started in British Columbia. It recently ended suddenly

[ Page 12764 ]

and dramatically at the end of a two-year period, when what was assumed to be long term but turned out to be temporary funding was ended. The hospitals were told: if it's so good, carry it on out of your own budgets.

Mr. Chairman, you probably know, coming from your part of the world, that some of the teams were quite popular. In Vernon, for example, there was a strong public reaction against the elimination of the team. In St. Paul's Hospital in Vancouver, where a phenomenal percentage of the patients are affected by alcoholism, there was a lot of concern at that team's elimination.

One of the disturbing things I find is that the teams apparently had no built-in evaluation program. I've been told, in the case of one major hospital, that even the records were being destroyed, presumably through the best of motives: to guarantee patient confidentiality. But that made it almost impossible even in retrospect to look back and see how many people had been seen and what kind of intervention was achieved. I find this very disturbing, because it had drawn a lot of attention. It's the kind of things ministers talked about on public occasions. Presumably many ribbons were cut, and now it appears to have dissolved. The hospitals that are the most progressive and aware of the impact of alcoholism are very upset about it.

In Victoria at Royal Jubilee, Dr. Thornton produced a report — the first of its kind perhaps in North America — suggesting that up to 25 percent of the people in the hospital at any one time were there in direct consequence of their abuse of alcohol. It is a shocking figure. It is absolutely shocking, even for people who work in that field.

I would like to know what the Ministry of Health has done to help hospitals maintain these programs where they seem to be working well or to offer some bridge funding, assistance or any kind of guidance. I am hearing a lot about it not only from the people who worked in those teams and who naturally have a stake, but from people who are independent of them.

The letter from Dr. R.J. Ross in Vernon described the situation in Vernon this way: "Vernon is unique in that it has developed an efficient, effective and inexpensive system of care: the Vernon treatment centre, the hospital chemical dependency team, the Howard House male residential recovery program, alcohol and drug clinic and Round Lake treatment centre. These all work in close cooperation with the 12-step self-help groups." He goes on to pay tribute even to the local MLA.

He describes the Vernon treatment centre where he works, and he describes the chemical dependency teams this way:

"The chemical dependency team interviews patients in hospital when they are most vulnerable. It sees patients daily and influences the care of many more. It has improved the awareness of hospital and medical staff of the disease of chemical dependency. The chemically dependent person is now treated, not ignored. These measures stop repeated hospital admissions. Clear parameters for admission treatment have been developed."

That means treatment of alcoholics, for example, when they come into hospital.

"More work needs to be done, especially in research and education. There is a need to develop techniques for even earlier intervention, especially in emergency...."

"I believe that the provincial government has its priorities wrong. In the name of fiscal restraint, it seems determined to destroy this practical and cost-effective system without consultation and apparent thought. These three programs have had their funding cut."

He's talking about the whole system in Vernon in that case.

What I'd like to ask the minister is: doesn't it trouble him...? Even though this was funded initially out of another ministry, clearly it is in the health realm; the teams were working in hospitals. Nobody else, to the best of my knowledge, funds anything in hospitals aside from the Ministry of Health or voluntary groups. Doesn't it trouble him that we seem to be on the verge of becoming world leaders in addressing alcoholism and suddenly it's just gone without any evaluation, kaput? It's gone without any evaluation, without any remorse. Is the minister thinking of doing anything to get this program back on track?

HON. MR. STRACHAN: As the member has indicated, this is a program within another ministry; it was within the Ministry of Labour and Consumer Services. The chemical dependency resource teams were funded by Labour, and the hospitals were offered the opportunity to take part in this. They had one year and then the 50 percent funding for year two, and they were aware of that, as I understand it, when they first went into the program.

I understand as well that Labour and Consumer Services may be considering a continuation of the program, but I'm afraid the member would have to pose the question to that minister, or write to him.

In terms of the general concern, yes, I do have a general concern for any people who suffer from a disease such as alcoholism or dependency on any type of drugs, and as Minister of Health I would certainly agree with the member's concern. But this specific program is funded through the Ministry of Labour and Consumer Services. The question would be best posed to that minister, but my understanding is that they are reconsidering the program that they put in place two years ago.

MR. PERRY: If we're to believe that the minister's answer indicates some possibility that the Ministry of Labour and Consumer Services will revise its decision, maybe the Minister of Health could consider an urgent directive to hospitals to stop destroying records of patients who have been treated. Clearly it would not be in the interest of a program to continue shredding or burning files — even if for the best of reasons of confidentiality — if we're going to go back to those programs.

I want to pin down the minister a little bit on whether within these estimates that we're debating there are any funds for initiatives within the Ministry of Health in alcoholism, particularly within the hospital system. I'd just like to revisit a column that Denny

[ Page 12765 ]

Boyd wrote in the Vancouver Sun on Friday, May 3. He's one of the few journalists who, perhaps because of his personal knowledge of the problem, seems to write seriously about this issue. Thank heavens he's there occasionally bringing it back to public attention. He points out that Dr. Thorton's study at Royal Jubilee Hospital suggested that the costs of alcoholism just in the British Columbia hospital system are in the order of $72 million per year. Denny Boyd points out that the chemical dependency resource teams were costing approximately $1.5 million per year. Regardless of which ministry it comes out of, it's all related to health and it's all the same taxpayers' money.

I want to point out one accolade that was received. It must be a rare event. Somebody in Toronto actually wrote to compliment us in British Columbia on what we are doing in this field, and to express his concern about those hospital-based teams. This is the president of the Canadian Medical Society on Alcohol and Other Drugs, Dr. James Rankin of Toronto. He wrote:

"It has been known for many years that patients with alcohol- and drug-related problems are heavily over represented in hospital admissions, and that as a group they tend to present us with more serious and complex medical problems than the average patient. As such, they contribute a disproportionate amount to the costs of the hospital system as well as to health care costs generally."

The point I'm trying to make, Mr. Chairman — I see you understand it — is that it's such an important area that we can't afford to have capricious planning and funding — one year on, one year off, two years on, two years off. I believe we clearly need initiatives within the Ministry of Health to deal at the hospital level, at least, with alcoholism and drug abuse problems. If the Ministry of Labour is going to keep alcohol problems for out-patient services — it never made sense to me — at least the Ministry of Health ought to be providing the continuity of making sure that we improve our hospital treatment.

I want to pin that Minister of Health down. Is there anything out of the $5.4 billion budget — is there even a million dollars in there — to deal with alcoholism, which we think is costing at least $72 million a year in hospitals?

HON. MR. STRACHAN: I'll respond to the member again. As he knows — and he may disagree with this — it is an area that has been funded typically over some years now by the Ministry of Labour and Consumer Services, and he should pose the question to that minister.

In terms of hospital records, I don't quite follow what the member is trying to get at. We ask all hospitals to keep all records for seven years. That's a requirement of the Evidence Act. If there are any records being destroyed, we will question who is doing that, and we will begin that questioning now with respect to the hospitals that are allegedly destroying records. My information is that they are to keep records for seven years.

In terms of the general concern the member raises about alcohol, chemical and drug abuse, I can tell him that I share his concern. As the member may or may not know, I and other members of cabinet are on the Kaiser Substance Abuse Foundation. This is a very serious concern in our province, and it's a very serious concern of mine. I don't want the committee to think that we in any way see this as a trivial issue, because it certainly isn't. We are at all times aware of the tremendous cost to society of drug and alcohol abuse. We endeavour in many ways to ensure that we are acting responsible in every way in alleviating that problem.

[4:15]

The member, quite facetiously I hope, points out that we've had one compliment from Toronto. We've had many compliments from many jurisdictions with respect to health care in this province. I can tell you that on the issue of drug and alcohol abuse, one program that the Social Credit government put in place some years ago is probably the most effective program in North America, and that's the CounterAttack program. It's been extremely successful with respect to getting drinking drivers off the road.

In many other areas we have really led North America, including our CounterAttack program, our legislation dealing with driving while impaired and jail sentences — we were the first jurisdiction in North America to impose a jail sentence for a second offence. We take this whole issue very seriously. We've had many more compliments on this and other programs from other jurisdictions, more so than the member alludes to. In no way will I accept the criticism that we are not concerned about alcohol and drug abuse. It is a very serious concern of ours, and in many areas — in many ministries — we are doing all that is possible within our budget and policy to ensure that we are alleviating the cost to society from this type of abuse.

MR. PERRY: Just to remind ourselves that there's a ways to go yet, the quarterly analysis of fatal motor-vehicle accidents — the last quarter I have is October to December 1990 — shows that while the total number of motor-vehicle accident fatalities in B.C. rose only 11 percent, so to speak.... I point out that it's improper to refer to those as "accidents." They are usually more accurately referred to as "collisions" because most of them are preventable. The number in which alcohol was judged to be a contributing factor rose 53 percent in the last calendar year from 106 deaths to 162 deaths. So while CounterAttack is a very good and important program, let's not reassure ourselves too much that we've got that problem in hand.

Just to pursue the treatment of alcohol for a while, I'd like to ask one other specific question, which is what is the fate right now of the special clinic at Sunny Hill Hospital for fetal alcohol syndrome? I've had a number of letters from parents — some of them adoptive parents — of children affected by fetal alcohol syndrome who are some of the most difficult children to raise, some of them with unimaginable personality problems, as well as physical and mental disabilities.

[Mr. Pelton in the chair.]

[ Page 12766 ]

I've been getting letters from parents who are very worried about funding — for example, one dated March 28 from people in Abbotsford saying: "Yesterday we heard some most disturbing news: the fetal alcohol syndrome clinic at Sunny Hill Hospital for Children has been informed that their funding has been withdrawn as of April." It goes on to make a very poignant argument. I won't read the whole letter, but it's quite disturbing to see the situation those parents are in. Can the minister inform us what the status of that clinic is?

HON. MR. STRACHAN: I'm advised that The Sunny Hill Hospital program has been largely informal. The fetal alcohol syndrome resource group, which is a voluntary group of health professionals interested in fetal alcohol syndrome and effects, has been connected on an informal basis with Sunny Hill Hospital. This group has used the hospital to administer research projects and grants, but this is not supported as a hospital-funded program.

Mr. Chairman, I'll also advise the committee that I'm going to be absent for a few moments from the assembly, and my colleague the Minister of Lands and Parks is going to enter into the debate. I will return shortly.

MR. PERRY: I've been waiting for this moment for two years. I remember when the Minister of Lands and Parks held his travelling road show in Vancouver. He wanted to expand the tree-farm licences to cover more than the area of British Columbia, if I remember, and to include Alberta as well. Whatever it was he wanted to do, I remember the pleasure I had of appearing before him at that time. He seemed so uncomfortable that I used up a little more than my allotted time. So it's a pleasure to be standing here looking at him again now.

Last week during the debate we raised the issue of the College of Physicians and Surgeons inquiry into the sexual abuse of patients. We suggested that the minister might want to communicate with the college about the desirability of expanding its committee — not to dictate to the College of Physicians and Surgeons but to communicate the importance of ensuring in the public eye that the committee was seen to function fairly. I wonder if the minister could tell us whether the ministry staff has made any progress in that direction.

HON. MR. PARKER: Mr. Chairman, I will take that question as notice for my colleague the Minister of Health.

I'd like to raise a couple of points in this debate about health care in the northwest. I live in Terrace, and I can tell you that the health care services we get in the community are excellent. The Mills Memorial Hospital has become a de facto regional hospital with a large number of resident specialists. We're grateful to the Ministry of Health for their support for our hospital.

I'd like to point out to the minister that the Terrace Health Care Society is one of the first societies in the province to take on the responsibilities of acute care, intermediate care and extended care. They have an initiative before him and his colleague the Minister of Social Services and Housing for supportive housing, which is the step between independent living and intermediate and extended care. That initiative has come from this community group, the Terrace Health Care Society, and it's one that conserves and uses funds more efficiently. I am pleased that he and our colleague the Minister of Social Services and Housing are reconsidering the submission that was received last fall for the establishment of some 40 units of supportive housing in Terrace. The Ministry of Lands was able to provide the land adjacent to the extended care facility, and therefore the supportive housing facility will be in close proximity to medical care and medical attendants.

I'll defer further comments to the Minister of Health in response to the critic's earlier inquiry.

MR. PERRY: I'll just repeat my question now that the minister's back. Last week we had some brief discussion concerning the College of Physicians and Surgeons' review committee on sexual abuse issues. I think we suggested politely to the minister that it might be worth raising with the college the importance of the public perception of that committee — that it be seen to function unequivocally in the public interest, especially in view of the comments reported in the media of two prominent psychiatrists who work in the field and who encourage the college to widen the membership of that committee to include lay people.

The minister indicated at the time that he was prepared to discuss that with the college. I think he agreed with us that it was reasonable to raise the issue in discussion. I wonder if he could tell us where he's gotten with that.

HON. MR. STRACHAN: With respect to sexual abuse by physicians, the member is correct; we did discuss this last week. A letter is now being prepared for my signature to be sent to the College of Physicians and Surgeons. It will deal with the concept of more public hearings and lay membership on that committee.

With respect to the recent comments made by the member for Skeena, the Minister of Lands and Parks, I have a tendency to agree with him. As a ministry we are now looking at the whole issue of supportive housing, along with the Ministry of Social Services and Housing. There are many excellent suggestions coming not only from Terrace but from other parts of the province and other societies, so we are reviewing that, whole issue now. I can tell the committee, though, that in terms of supportive housing there are now many good agencies in the private sector providing that type of supportive housing. It's nothing new to us, but we are looking at it with some interest, and I will be responding to the member as quickly as we can finalize a response to his inquiry.

MR. PERRY: Let me go back to one other issue that I raised earlier in the debates: the financial situation at Mount St. Joseph Hospital in Vancouver. I exchanged

[ Page 12767 ]

correspondence with the former minister last December, I believe, pointing out that the proposed cuts or layoffs at the hospital, and the closure of wards due to a budget overrun, appeared to me to directly compromise the care of patients who would not have anywhere else to go. I pointed out in my letter to the former minister that I had inspected the surgical ward proposed for closure, and I described in these debates a week or two ago what I saw then: patients with classical, serious medical and surgical problems who required treatment. If they weren't treated there, they would have to be treated somewhere else, perhaps at a higher cost.

Aside from that observation, I recommended to the minister at that time — if memory serves me, it was about December 7 of last year — that the ministry accede to the hospital's request for an external review of its funding so that the truth might out and the chips fall where they may, depending on the result of that report.

I have been asking to see that report now for several months, as have people who work at the hospital, to know whether it in fact confirms the ministry's position that the hospital should be expected to pay back its overrun during the current fiscal year or whether the hospital has a valid case. Perhaps its load has increased so much that its base funding ought to be increased.

[4:30]

I know that the ministry has previously taken the position informally in conversations with hospital administrators and staff, to paraphrase: "You're doing too good a job; why don't you just stop doing such a good job and fewer people will come to you?"

That has always struck me as a strange position. If the ministry said, "You're wasting money," that's one thing. Let's root it out. If the ministry said, "You're doing unnecessary procedures or treating people unnecessarily or keeping them there too long," that's fine. Let's fix that as well. If it said, "You are providing cultural services like enhanced translation or cultural sensitivity for people who only speak Chinese, Polish, Tagalog, Korean or Vietnamese" — the people that the hospital attracts — "but you know we can't afford for people to understand what's being done to them; let's go back to the bad old days when the doctors would just cut 'em open and take it out, and they'll never even know what happened to them...." I remember that from my old days in medical school in Montreal. That often happened. It wasn't the language issue then; it was just a bad way to practise. Surely we've got beyond that.

Those are the questions that occur at Mount St. Joseph. They were widely regarded in their community as a pioneering hospital, the first one in British Columbia to take seriously the issue of equal access to health care for cultural minorities and of surmounting some of those barriers of communication.

Therefore I felt the review was very important. I keep asking for it; I have here in my file a letter from the minister dated May 31, 1991. It is a very polite letter reminding me why I had to write to him and why a telephone call from my staff wouldn't have sufficed. It told me: "With respect to Mount St. Joseph's Hospital, I am advised that the hospital review" — and it was not an external review, whatever it was — "will be complete towards the end of May, and the results will be communicated to the hospital board of trustees shortly thereafter."

So it says that the report would be completed towards the end of May. This has been in the works since late December. It is now June 17, and when I checked today, I'm told by the hospital that it has not yet received this report. So again I have a few simple questions. Is there a review underway? If so, is it an external review, or is it the hospital itself doing the review? Who are the reviewers? How long have they been working? How much have they been paid to do this job, or how much time have they taken off from their other jobs? When will the report be prepared? And will the minister commit that, given the public interest in the issue, those parts of the report that are not inherently confidential or inherently damaging — for example, to an individual employee or patient — will be released in a timely way?

HON. MR. STRACHAN: I'll answer the member quickly and briefly. First of all, a brief description of Mount St. Joseph Hospital. Last year they attempted — for whatever reason — to provide nearly a 20 percent increase in workload. This was far above the population growth or any other model that they would use for the funds provided, so they did end up in a deficit position, which we attempted to respond to.

The review is part of the normal three-year review; it's being done by team one. It's part of their duties, so we don't identify a specific cost to it. It's part of the workload of the regional teams to do these regular reviews, so there's nothing specific we can take out of it.

In terms of patient care, there will be beds closed at Mount St. Joseph. But St. Vincent's Langara Hospital will be opening 225 beds this summer, and they will take the people who are affected by the bed closures at Mount St. Joseph Hospital. These are typically longterm care patients.

MR. PERRY: Mr. Chairman, there is another fundamental illogicality in the approach the minister has just outlined. The minister said that for some reason the hospital increased its workload by 20 percent in the last year, and therefore it ran out of money. If we were to say about any other endeavour that they had increased their workload by 20 percent in a year, we would be applauding. In this case, they are to be penalized because they did more work.

Again, let me be perfectly clear. If the minister said they did work that was unnecessary or of poor quality or that could have been done more cheaply elsewhere or which could have been done to the greater satisfaction of the patients someplace else, those would all be rational arguments to hold against the hospital — or at least to ask it to revisit. I know that most of those arguments don't apply. I think the reason the workload went up by 20 percent — or at least this is what the hospital has told me — is that people in the relevant

[ Page 12768 ]

ethnic communities: the Chinese Canadians, the Vietnamese Canadians, Korean Canadians, many eastern European groups such as Polish and German and the Filipinos specifically feel they get a better quality of service. They feel more comfortable in that hospital, and therefore some of them actually come in from the Fraser Valley to there.

A 20 percent increase in workload means that the capital facilities and the heating costs of that hospital are being amortized that much more rapidly. We're getting 20 percent more productivity out of that capital investment. If we had a huge capital investment sitting empty somewhere else, maybe we would worry about that; at least it would be embarrassing. It doesn't necessarily mean it would be more cost efficient to transfer the people elsewhere.

I really have difficulty following the logic of the ministry position. I emphasize that if their review or study of the hospital suggested that procedures not warranted are being undertaken, that patients who don't need to be treated are being seen there, that people are coming to the emergency department who don't belong there or that lab tests are being done that are wasteful or redundant, it's entirely appropriate for the ministry to be aggressive and to root out that waste as vigorously as it can. It's just a question of wanting to know the truth of what is going on there.

When I visited the hospital, the surgeons told me that their operating rooms are the most efficient in the city of Vancouver, and their turnaround time to wheel a patient in and out and get the next one in and out of the operating room is so much better that some of the surgeons prefer to operate there rather than at other hospitals. They can operate more efficiently and make better use of the capital facility and the human investment — the taxpayers' investment in the nurses who work there.

I'd like to know if that's true. If it is true, then they ought to be a model and a paragon — not a scapegoat. If it's not true, then let's see the facts.

The minister still hasn't answered my question. He indicated to me in writing, just 18 days ago, in a letter dated May 31, that he was advised "that the hospital review will be complete towards the end of May...." He wrote this letter and signed it, presumably knowing that the report had been submitted at that time. Now the hospital tells me they haven't got it. Has it been submitted? If not, does the minister know when it will be submitted? Does he know why he was apparently misinformed about that? How long are people to be left hanging out on the clothesline, waiting to know what their fate will be at that hospital? How long do we have to wait before a rational discussion can begin on what's to be done to deal with that budget deficit?

HON. MR. STRACHAN: First of all, Mr. Chairman on the issue of hospital budgets, hospitals are funded on a global basis, as I've said many times during these discussions. The funding is adjusted by the demographic characteristics of the population that a hospital serves, primarily age and sex, and is based also on population growth and referral patterns. Hospitals are expected to operate to serve their communities' needs with the funds available, and Mount St. Joseph has been doing that for some time but, for whatever reason, exceeded its 1990-91 budget by 20 percent. We question why they would do that. Having been in the hospital business for some time, one would think that they know what a budget means and why budgets are provided and that one does not exceed it.

With respect to the review, I guess the staff who wrote that letter were a bit ambitious in terms of the timing of that review, because it is June 17 now, and as yet we don't have it. But we are expecting it shortly. It will be reviewed by the ministry and then will become the property of Mount St. Joseph. Whether they want to share it with the member opposite is entirely up to them. We don't gratuitously hand out these reviews to all and sundry.

MR. PERRY: Oh, Mr. Chairman, I'm feeling a sense of acute frustration here. I don't know how to ask the question more simply That community has been wrestling with the problem since December. If it were only May 31 to June 17, it really wouldn't be a big deal, would it? It's a question of knowing whether there is a serious problem, as the hospital alleges, or not. Are people going to be affected deleteriously? Are they going to lose important services which were being delivered to them? I don't know the answer to that question; let me make that clear. I visited the hospital to try to get a feeling for myself, and I saw a ward about to be closed that had seriously ill people in it. It had people who had had strokes, who had had hip surgery, who had cancer, including a young woman dying from very advanced cancer. And I thought to myself: "My God, what are they doing? They want to close this ward. Where are those people going to go?" Presumably they are in this hospital because they feel comfortable with it. It's not the most magnificent capital facility, but people like it. That's what people pay for, to have some say in where they can go.

When I listen to the minister I get the impression that he sees in his mind's eye a hospital with a large neon sign, like a Las Vegas casino, beckoning outside: "Come hither, the sick and infirm from all over the lower mainland. Come to me. I will take you in, and I would love to have more of you." The hospital isn't in my riding, Mr. Chairman, but I have been around it and to visit it, and I've not been able to detect any such sign. There's a modest sign that reads "Emergency Department," just like any other hospital, As far as I can discern, the hospital does not deliberately entice people. It does try to give particularly sensitive service to the ethnic communities. After all, it was founded by the Chinese-Canadian community around 1921 specifically because they couldn't get adequate health care in the mainstream hospitals at that time. Chinese Canadians weren't allowed to do medicine then. Chinese-Canadian patients probably didn't get very fair treatment in those days, and they set up a hospital specifically to try to cater to a section of the population which had built a lot of British Columbia but which was not getting its fair share. That's their tradition, and it's a good tradition.

[ Page 12769 ]

So to suggest somehow that they're bringing this all upon themselves goes against my grain, I must say. I'd like to plead on their behalf with the minister. If you've got evidence that they're wasting money, show it to them and give them a chance to fix it. If they won't fix it when you show it to them in private, show it to them in public honestly and get the facts out there in the open.

While we're on that subject, let's turn to another possible review. I have here the review released to the public by the Vernon Jubilee Hospital. This review was conducted by some pretty tough people. In the interior they call them pretty mean honchos or tough customers....

AN HON. MEMBER: Unparliamentary language.

MR. PERRY: Do you just call them unparliamentary in the Cariboo?

Interjection.

MR. PERRY: They're too genteel to call them that in the Cariboo.

These are tough customers who went into Vernon. They're the same ones who have been into a number of other hospitals, and their reports have not always been flattering. Let me put it that way. Their reports have sometimes been pretty downright harsh.

The review of the Vernon Jubilee Hospital, dated March 1991, is virtually uncompromisingly flattering. It says, for example, on page 1, "Standards of care appear to be very high," and the review team "noted the emphasis on quality of care within the medical staff, the nursing department and the other care-providers." Also, "many of the processes supporting the management of care are excellent." A second point on that page: "Waiting-periods have been reduced significantly and are now comparatively low."

On page 5 can be found a very rare comment by a review team — extremely complimentary remarks about a medical staff. Review teams are often — and probably appropriately so — rather critical at times. They point out: "The chief of staff, the chairman of the medical advisory committee and the department heads clearly enjoy an excellent working relationship, and there is respect for each other and respect for the medical staff." So there is a medical staff which works with administration, for a change. "The medical organization appears to function efficiently, and medical issues and concerns are dealt with and, as necessary, brought to the attention of the board. Most important of all, there is a refreshing openness and willingness to discuss and deal with potential problems and to address changing needs of patients." They go on with a number of other very complimentary remarks about the management of the Vernon Jubilee Hospital.

[4:45]

[Mr. Ree in the chair.]

But on page 26 they point out that in 1989, under the former former Minister of Health, the ministry appeared to promise more money than was delivered. Because of the growing problem of waiting-lists for surgery in Vernon, the ministry — in a letter dated July 26, 1989, headed "Programs to Address Surgical Wait lists" — approved programs in funding, including a base funding adjustment of $845,600 and a one-time funding adjustment of $449,800. On the basis of that letter, the hospital opened additional programs, including a pacemaker clinic to insert pacemakers into people whose heart rhythms are failing and who need an electronic pacemaker to keep their heart ticking, and save those people the trip to Kelowna, Salmon Arm, Kamloops or Vancouver — wherever they would otherwise have had to have gone.

They then point out at page 30 that the hospital had gone on to establish those programs but apparently misunderstood the ministry, thinking that the ministry was actually allowing a few extra resources to clear up the waiting-list. Lo and behold, the ministry sounds like it had more of an eye towards a publicity announcement than towards a long-term commitment. For example, a joint-replacement program was begun, dealing with the problem of hip problems that we discussed earlier, which resulted in a substantial rise in the cost of prosthetics — an estimated $200,000, according to this report.

I quote again: "Based on the above and the fact that the hospital is deemed to be efficient, it can be concluded that the Vernon Jubilee Hospital will require an addition to its base funding of approximately $900,000 to maintain current levels of service." It then goes on to argue that, well, if they can't do that, maybe they ought to reduce their capacity and expand the waiting-list again. On page 31 it basically makes that argument: "They are doing a very efficient job. They have done a very high-quality job, but they are fixed at this exact amount. We cannot recommend to the hospital anything other than to do a less good job." That's what they recommend on page 31.

Again, at page 39 they reiterate: "Funding Recommendations. On the basis of funding required to maintain current levels of services, the funding base for the VJH could be increased by $900,000." At page 40 they go on to discuss how, well, if you can't get that, then just cut back and don't do such a good job, and then everything will be all right. So here you have a kind of.... Maybe the first member for Nanaimo will refresh my literary knowledge. I don't know if it comes out of Lewis Carroll or George Orwell or somewhere in between. It's a kind of never-never world where if you do a good job, then you're doing too well, and you should not do such a good job.

What is the net effect of this? Well, a little bit later, on June 6 of this year, the Vernon newspaper quotes the chief of the medical staff, Dr. Christian, who had been so roundly commended by that external review — four of the five reviewers are not physicians, by the way — as saying that the hospital has now cut back its orthopaedic surgery and will be doing fewer of the hip operations the former Premier and I discussed moments ago: "It's really not acceptable that people who are already waiting nine months are now going to be

[ Page 12770 ]

asked to wait 12 months or 18 months for these procedures."

What I'm getting at is that there seems to be something amiss. The idea within the ministry of team reviews of hospitals is clearly good. The idea of external reviews by people with high credibility — good credentials — makes very good sense, particularly when the team reviews are not accepted. But what happens when the review shows that the hospital is doing really well? Do we only listen to them when they say they're not doing a good job and need to be cleaned up? Why, then, do we not listen when they say they're doing a good job? I'd like to know how the minister feels about those. I think the people in Vernon feel a bit burned, and rightly so. They think they were doing a really good job, and the external review confirms that. Now they're told not to work so hard.

HON. MR. STRACHAN: An interesting discussion. The review of the Vernon Jubilee Hospital was done by an external review group: Derek Doe of Deloitte Haskins; Barbara Burke, vice-president of nursing, St. Paul's Hospital; Charles Wright, vice-president, Vancouver General Hospital; and Danny Tulip, vice-president of finance at University Hospital. The major recommendations of the external review were that Vernon Jubilee Hospital should reduce its surgical capacity, that the hospital should implement a strong patient-stay management program and that $250,000 should be added to the base funding of Vernon Jubilee Hospital effective April 1, 1990. We did add that base funding adjustment of $250,000 effective April 1, 1990.

MR. PERRY: What can I say? Sometimes I feel we're not getting very far in this discussion. Hon. members could agree on that perhaps.

Just to try to refresh myself, let me turn to a few preventive issues for a change. I asked the minister earlier in the debates, and I asked the former minister during the interim supply debate, to update us on the hepatitis immunization program. Let me just refresh members' memories, so that they will know what we are talking about.

Hepatitis B, like smallpox, is a disease confined to human beings. It is potentially fatal and causes a great deal of long-term disability and illness and a great deal of acute sickness. Because it's confined to human beings and a vaccine exists to prevent it, it is theoretically subject to elimination from the planet. In 1957 when a Russian doctor suggested that smallpox could be eradicated, nobody believed him. It had been with us for thousands of years, a scourge in biblical times and recently. Eventually he persuaded the World Health Organization that it was possible, and in 1977 smallpox was eradicated.

Hepatitis B could also be eradicated. It's a more difficult challenge because of its mode of transmission, because of the difficulty of detection and because the vaccine is presently more expensive, but it is possible. If we don't blow ourselves up within our lifetime, I suppose we will eradicate hepatitis B from the planet eventually. We certainly should be able to eradicate it in the developed countries. Paradoxically, because the problem is more severe in developing countries, they are actually leading the way.

In British Columbia it's not known exactly how many people contract hepatitis B, become seriously ill from it or die from it each year. It is known that over 1,000 new people infected with the virus are identified each year. Some of those are people who immigrate to Canada, some are people who have had the infection for a long time and are discovered to have it coincidentally, and some are newly infected. But somewhere in that 1,000 people is the number of new infections each year, and perhaps it's higher. We have no way of knowing. The ministry, I gather, is beginning to try to figure out that question.

What we do know is that around 50 people or more die from cancer intrinsic to the liver each year, and that the vast majority of those cases are caused by hepatitis B. Some of those are native British Columbians, and some are immigrants. We also know that hepatitis B is rampant in populations of people who use intravenous drugs and who are sexually promiscuous or sexually active with multiple partners. We also know that the disease is transmitted sporadically, even perhaps by casual sexual contact. It's not clear exactly how it's transmitted in all cases.

Last year a young woman named Bobbi Bower, the mother of a 16-year-old girl who died of severe hepatitis B at Christmas of 1989, cottoned on to the idea that if her daughter had been immunized — which was theoretically possible — she would not have died. She therefore began to promote universal immunization against hepatitis B in conjunction with the Canadian Liver Foundation.

When she wrote to me, something clicked in my brain, and I realized I should have thought of this before. We ought to have been immunizing high-risk people in particular in British Columbia — namely the intravenous drug users and people on the street in places like downtown Vancouver, Prince Rupert and other places where intravenous drugs are used and where there are epidemics of hepatitis.

In conversation with some public health physicians, I learned that I was not the first person — nor was Mrs. Bower — to whom that idea had occurred. In fact, the medical health officers of B.C. had been recommending that to the Ministry of Health for at least four years since the vaccine became available in a recombinant DNA form in 1985 — perhaps the first proposal was made in 1986 — targeted at the ultra-high-risk group: the street drug users.

I pointed out to the Minister of Health in October last year that because of the development of the needle exchange program in Vancouver and Victoria, perhaps for the first time there was a convenient mechanism of access to the ultra-high-risk population who before were marginalized. They now come to a central facility or to a nurse out on the street to exchange needles in an attempt to prevent AIDS infection. Therefore there was a unique opportunity — perhaps the best anywhere in the world — to deal with this problem by rapidly immunizing those street people or at least offering them the opportunity.

[ Page 12771 ]

The ministry in due course did respond and announced in early January that it would begin a program of immunization. Because the timing and the sense of urgency is important to us here, I point out that this recommendation was made to the ministry from within its own staff by people who really knew what they were doing — the medical health officers — as early as 1986.

[5:00]

When I asked the ombudsman to investigate why that was not pursued within the ministry, he did not confirm my suspicion of an administrative bias against street people, although he did not interview people under oath. The information I obtained from people who were there at the time was that a very senior official, at the time of the first proposal, did virtually put his fist through the wall at the idea of immunizing intravenous drug users in the street. I hasten to say that that pre-dates the former minister, his deputy and both assistant deputy ministers, so it doesn't reflect in any way on them.

What I'm getting at is that the government has had notice for a long time that this would be a good idea. In January the ministry announced that it would begin a program. Tenders appropriately were let for purchase of a modest supply of vaccine — enough to immunize about 1,000 people — to target that particular population. It was an excellent first step.

I have two questions. One, has the vaccine been delivered? And if not, why not? Where is the holdup for a program announced in January — for which, the last time I checked several weeks ago, no vaccine had yet reached the street clinic?

Two, will the minister update us on the broader issue of whether we should begin a comprehensive immunization program? I've gone out on a limb on this. It's a controversial area in public health. Developing countries are immunizing their kids. New Zealand is immunizing all their children against a potentially lethal but completely preventable disease. The vaccine has virtually no known side effects — in contrast to some vaccines. The medical health officer for Vancouver supports that concept. The immunization authorities in their brief to the royal commission last fall leaned towards that, particularly during the questioning. Countries with a relatively high risk of infection — Taiwan, Saudi Arabia, Brazil and Italy — have been doing this for several years now. The Americans have also begun a program.

On the basis of some very careful research on price, knowing that the Brazilians could buy hepatitis B vaccine at about $4 (Canadian) per child — not per dose — or $3 (U.S.) per child and $1 (U.S.) per pediatric dose, I believe that in Canada the cost of vaccine to immunize all our children might be in the range of $5 to $10 per child. If you knew that you could prevent in your own child a potentially lethal disease — or one which may lead to severe chronic hepatitis and cirrhosis or to acute illness lasting several weeks or months — if you knew that the vaccine was entirely safe and had no risk of transmitting any illness to you and virtually no side effect, and if you knew that the cost was in the range of $5 to $10 to immunize your child, would you do it or not? I think most of us would elect to immunize our child.

I'd like to ask the minister what consideration has been given by the ministry to being the first province and to stimulating other provinces and the federal government to get off their butts for once and do something imaginative and aggressive in preventive health, rather than waiting for all of the rest of the world to do it first, and to say: "Look, if we go out and let a contract for enough vaccine, tender it and say we won't pay your price because you don't need that price.... You're selling vaccine at $4 to the Brazilians, appropriately subsidizing the poor countries." Don't get me wrong. It's quite reasonable that the pharmaceutical companies should do that. And we should pay a somewhat higher price. That's a progressive move, and I admire that in the pharmaceutical companies. But if we said to them: "Look, we will make a deal that's good for both of us. You can sell a lot of vaccine and tool up your production. We'll get a price that we can afford and that will be beneficial to our people. We can both be happy...."

I've done everything I can think of to stimulate that kind of thinking within the ministry and in the public. I'd like to know where we stand. So the first question is: where's the vaccine for the street people at ultrahigh risk? Second, what is the minister's thinking on comprehensive immunization?

HON. MR. STRACHAN: The member has pretty well described what we're doing, — but to give you some background, yes, there is serious concern about hepatitis B in the province of British Columbia.

In terms of vaccine, the target population is newborns exposed to the virus during birth, intravenous drug users and health care workers — particularly those who are working in the area of sexually transmitted diseases, laboratory technicians, and scientists working for the B.C. Centre for Disease Control. Family members and sexual contacts of infected individuals are also in the group at risk.

We have identified — and the previous minister set aside — $300,000 to vaccinate high-risk individuals against hepatitis B, and by March 1992 we're planning on vaccinating 4,200 British Columbia residents at risk. There was a bit of delay in the program earlier this year because of a supplier being unable to supply single-unit doses. However, that problem has now been remedied, and all the supplies we need are being supplied and delivered to the province in that single unit dose.

With respect to the universality of the program, if we could get the vaccine at the cost the member is suggesting — $4 to $5 a shot — that would be very good. Right now it's $75 for the series of three. We recognize the concern the member has presented. We have been working on this for some time, and we see it as a serious issue, to the extent that, as I said earlier, we have provided $300,000 for the program.

MR. PERRY: I'm not sure — did I miss the answer as to whether the vaccine has been delivered or not?

[ Page 12772 ]

HON. MR. STRACHAN: Yes, it has been.

MR. PERRY: Just to clarify the cost, so that it's on the record, the director of hepatitis control for the World Health Organization, Dr. Mark Kane in Geneva, will confirm that Brazil purchased vaccine at the cost of about $3 (U.S.) per child. That dose is one-quarter of the adult dose in a series of three immunizations, and it works very well. It's been used widely in New Zealand. The estimate I've made of a reasonable cost for immunization of British Columbia infants is based on using a pediatric dose — one-quarter as large as the current adult dose in terms of the Merck product, for example; it's not quite clear what the dose of the Smith Kline and French competing product would be — and three injections. On that basis I estimate that since the Brazilians could purchase vaccine for about $4 per child, we could probably purchase it in Canada in the range of $5 to $10 per child. The total cost, of course, of administration depends on who does it and how it's done; but it need not be substantially greater than that, depending on how it's done.

So I'm encouraged. The vaccine is here, at least. Hopefully the ministry will look at it with some of the same enthusiasm it looks at acute-care costs, hip replacements and other problems of the degeneration of our bodies.

While we're on preventive issues, let me just look at one other, briefly. I gather that reviews of the out-patient teaching centres for diabetes control in B.C. have consistently shown that at least a dozen of them are chronically underfunded. The centres are also, as members know, required to ensure that people qualifying for free home insulin supplies or home glucose monitoring supplies are competent to test themselves. Not only do they do that but they are a very important tool in the modern management of diabetes, which is, I guess, still the third major cause of death in Canada. Can the minister tell me whether I'm correctly informed that reviews have shown problems with the funding of those centres? What is the status of the diabetes out-patient counselling centres?

HON. MR. STRACHAN: Just back briefly to hepatitis B, Mr. Chairman. The member wanted to know how seriously we were looking at the issue. As I said earlier, it's with genuine concern; that's why we made the funding available last year.

Secondly, with respect to the cost of the vaccine, we are currently into discussions with the other provinces to see if we can make a volume purchase to decrease the cost of vaccine to that level the member spoke of — $3 to $5 a vaccination, which is considerably less than the $75 for the series of three we're paying now.

I can't comment further about diabetes. We are looking at the programs in the hospitals now. We don't know if there have been funding problems, Mr. Member, but we are looking at the certification problem.

MR. PERRY: A little bit more pot-pourri, so to speak. The Minister of Health had a hospital-community partnership program with the B.C. Children's Hospital and the CNIB to provide improved services for blind children. The $179,000 grant ended March 31. I gather that the evaluation report was completed and a letter was sent in February from the CNIB or the Children's Hospital requesting continued funding of that program for blind children. Can the minister tell me whether the ministry intends to continue that program under the hospital-community partnership program?

HON. MR. STRACHAN: The partnership funds have generally been increased. With respect to the specific question, the CNIB is seeking additional funding of $216,617. The request has not been supported by Children's. However, the issue will be considered at the next meeting of the Deputy Ministers' Committee on Social Policy, which is coming this month. So we are aware of the issue. I have some sympathy for the CNIB, and will be discussing it soon.

MR. PERRY: Maybe the minister could edify us with some of the reasons behind his response. Maybe the member for Burnaby North can help me. I think it was AVIS, the Association for Visually Impaired Students, who recently briefed the Minister of Education and brought this issue to my attention as well. I gather that the program was considered exemplary by the parents of blind children. Was there some reason why the Children's Hospital did not support that, or is it simply a matter of the letter not yet being received? I've been led to believe that there was an exemplary program.

[5:15]

HON. MR. STRACHAN: Let me just clarify what I said earlier. The program is currently funded at $207,330. The CNIB is seeking additional funding of $216,617. I don't know why the request has not been supported by Children's Hospital, but Children's has generally not been supportive. We are considering this request at the deputy minister level with the deputy ministers of the Cabinet Committee on Social Policy.

MR. PERRY: Just to clarify, then, has the program which expired at the end of the fiscal year been continued at a slightly — or somewhat — higher level of funding?

Interjection.

MR. PERRY: Thank you.

Another miscellaneous question, Mr. Chair. I apologize for jumping around a bit, but they're just popping into my brain. I'm finding this so exciting and stimulating again.

Maybe the minister could clarify an issue that's mystified me for quite a while. I thought of it because of the member for Rossland-Trail's entry into the chamber. I recently received a letter from Dr. Ed Welsh, the director of the dialysis clinic in Trail, describing the problem of a man requiring chronic hemodialysis to stay alive who is, in effect, imprisoned in Trail by his condition; rather, he is imprisoned by his inability to obtain dialysis anywhere else in British Columbia.

It's not that it wouldn't be possible to dialyze him elsewhere, but ministry policy forbids him access to

[ Page 12773 ]

the one possible place where he could be treated. He can't travel to Prince George, Vancouver, New Westminster, Surrey or wherever dialysis facilities are available, because they're fully occupied by local people. They run around the clock, basically, and there's no room for him without shifting out one of the local residents.

In contrast, visitors to British Columbia from other provinces or countries can be dialyzed in Vancouver at a private clinic called the Travellers Dialysis Clinic, run by Dr. Rae and his partners, who are a group at St. Paul's Hospital. I think the minister may find this intriguing, because my party usually has been skeptical about private facilities. But in this case, this facility is the only one of its kind that could meet the needs of travellers. It employs nurses from the St. Paul's Hospital group who are paid at the same rate that they are in the hospital. It employs exactly the same kidney specialists and the same kind of equipment, but it operates across the street in a private building on Burrard Street.

As I understand it, the only people who are forbidden to use the facility, unless they can pay for it out of their own pocket, are British Columbians. Would the cost actually be higher to dialyze them there? I don't think it would be: they still have to be dialyzed.

Let's say that the constituent of the member for Rossland-Trail were to climb onto an airplane and fly to Vancouver. He would still have to be dialyzed Monday, Wednesday or Friday. If he were in Vancouver and it could be done there, it would be no different than if he had remained in Trail — he would still have to be dialyzed. The same supplies would have to be used, the same fee would be charged by the nephrologist and the nurses would be paid at the same unionized rate.

I guess there must be some reason why the ministry doesn't want British Columbians to use that clinic, whereas other travellers can. I am curious to know what it is.

[Mr. Pelton in the chair.]

HON. MR. STRACHAN: First of all, let me say that a kidney dialysis patient can, if they know when they're going to be travelling, write to another hospital to see if provisions can be made for dialysis when they're in that area. In many cases, the service is well subscribed to in the area the traveller would be going to, and there could be some difficulties. But they can certainly always write and ask that question.

In terms of the private situation, the fellow from Trail or anyone else can go there just like any other patient and pay for the service and have it performed.

MR. PERRY: Mr. Chair, I think the minister betrays his youth — in this portfolio, at least. Let's take an example from his own riding of Prince George. I remember a letter I had last year which, if I recall accurately, I referred to the then Minister of Health. I think the minister — at the time, the MLA — may have had a copy of the letter. A man from Chetwynd who was dialyzed in Prince George regularly could not travel to see his grandchildren in Vancouver — not because ministry policy forbids it but because, as the minister just put it, the dialysis facilities are rather "well subscribed." That's putting it rather mildly.

The nephrologists — the kidney specialists — are constantly juggling patients to figure out which one is the sickest and must get on the machine, and which one can be put off for a while: "Which one can we hope will recover and won't need temporary dialysis, and therefore we'll take a chance? We won't dialyze him today. We'll keep one of the regular patients on." Practically speaking, and to the best of my knowledge, it would be unheard of for there to be empty capacity for a traveller to use. The system is much too tight for that. I don't know if it was ever looser, but it's much too tight, and it has been for years. What the ministry policy says, in effect, is that, sure, you can write to the hospital. You can waste the postage, the stamps and the time and be told by the hospital administrator: "Sorry, we can't oblige you. We have such a tight program that we've got to look after local people first." But, in general, you can't travel. Maybe there would be a rare exception. Maybe you could go, for example, from Vancouver to Trail. I don't know. The centres tend to be by far the toughest. Maybe you couldn't go to Trail, but you certainly can't go from Trail to Vancouver. That's why Dr. Welsh was writing to me — it's impossible. You're imprisoned where you are. It doesn't have to be that way, because there is unutilized capacity in the Travellers clinic.

Sometimes I get the feeling — I don't know if I dare say this — that Dr. Rae, who established that clinic to try to give people more freedom, might even welcome it if the Socreds went back to the days of W.A.C. Bennett and nationalized that clinic — said they were for privatization, but pulled a Bennett and nationalized the clinic so that people could get some dialysis when they want to travel. But the reality is that you can't.

What I'm asking is: why does it make sense for other provinces to allow their citizens to travel and pay for the dialysis costs at that clinic up to the same rate that they would pay anywhere else, but British Columbians can't? You could write to the hospital. You could sit around waiting in case somebody died and there was a vacancy, and then if you got in it would be paid for, but you can't go to the unused capacity in that private clinic.

I think we're shortchanging our citizens that way, and I think it's fairly straightforward. I thought there must have been some very illuminating response the minister could make that would have clarified the confusion I felt over this issue for two years. I know that Dr. Rae is such an eloquent advocate for the case that I never really felt there was much I could add, which is perhaps why I haven't raised it in writing with the minister before. But now that I'm on to it, I sure would like to know: does it make any sense?

HON. MR. STRACHAN: There's nothing that money can't fix, and let me tell you that the annual funding now for KDS is $10,624,103. I am advised it was increased in '91-92 by $3.6 million, which has been provided to the kidney dialysis service to address the

[ Page 12774 ]

increasing demand for provision of effective community-based alternatives for patients with kidney diseases.

This will also provide funding for a drug, whose name I can't pronounce, but which is normally referred to as EPO and is apparently quite effective for kidney dialysis patients. So we are recognizing the need the member has addressed, and we are putting more money into KDS and the drug treatment for patients with kidney diseases.

MR. PERRY: Mr. Chairman, I am not questioning that the provision of dialysis service in British Columbia has been effective. Last year in December, unfortunately, it took a front-page story in the Vancouver Sun to get the ministry to increase the funding for the kidney dialysis service, both for erythropoietin and home dialysis. It took the director of that program literally waving in the faces of senior ministry people and the then minister the fact that home dialysis was a lot less expensive — maybe $30,000 per year instead of $40,000 or $45,000 in hospital. That had to be brought before the royal commission. At one point I had to make a midnight call to the Vancouver Sun to get that story into the newspaper to overcome the preparedness of the government to make the facts fit their theory that everything was fine.

So I'm glad we did win that battle, but we're still not getting a very clear answer. It's not a question of asking for more money. Or if it is, maybe the minister could explain it to me. If you've got to be dialyzed in Prince George or Trail, and there's a chronic struggle to fit people into the rotation there, and you're otherwise able to travel once in a while, why should you not be able to get dialyzed somewhere else in B.C., since it's all the same taxpayer paying for it? If there's a very high-quality facility which other travellers from other provinces as well as other countries can use, why should you, just because you're British Columbian, not be allowed to have your dialysis there instead of in a hospital which has non-existent capacity?

If the hospitals had the capacity, this would not be an issue. The only reason it arises is that the hospitals don't have the capacity. The odd person in Trail or Prince George or Chetwynd likes to travel to Vancouver once in a while, like the rest of us. It's a matter of quality of life and a simple solution to people's problems. It's not a huge budget item in the first place, and I don't see where the additional cost lies. Maybe if there were additional costs, the ministry could negotiate that with the traveller's dialysis clinic. I'm still at a loss to understand: is there a rational reason for this policy?

HON. MR. STRACHAN: Well, it's an intriguing argument. As I said earlier, our first priority is to patients in their own home communities. That's what we fund, and we fund for that person's continual service in Trail. As I said earlier as well, we are also increasing the funding and, of course, increasing our capacity for kidney transplants, because that can correct the problem as opposed to just the band-aid approach of KDS, which in some cases is needed a couple of times a week.

I don't know what else I can say to that. We establish as much capacity as we can in the various communities for those people affected with kidney disease, and that's how it works. I don't think I can add much more to it.

MR. PERRY: I think I'll have to be satisfied with small game today. The minister has admitted it's an intriguing argument, and perhaps he'll review that one. I just point out that it is different from the issue people often raise of being allowed to pay for their own hip prosthesis, for example. Private payment for hip prosthesis — although it initially sounds rational, and one could well imagine wanting to do that — undermines universality. In my view this service does not undermine universality; it extends convenience to patients, and it should be at the same cost, or conceivably a lower cost.

[5:30]

The workers in the clinic are not being exploited. They're the same hospital nurses who worked under a union contract across the street, paid the same wage. It's not a question of a sweat shop. The clinical standards are excellent, and they're universally acknowledged to be that way. Maybe it warrants revisiting.

Let me go on to another issue while we're talking about costs. There's a frequent concern around the province about the growth in administrative costs in many systems — not only in hospitals, but elsewhere. Certainly it's a complaint echoed frequently by staff who actually work at the bedside of people in hospitals: administrative costs have skyrocketed in the last 15 years; departments of human relations, for example, have mushroomed; yet working relationships in hospitals don't really seem to be that much better. Vernon is perhaps an unusual exception and a very fine one. I wonder whether the minister could give us some information about how administrative costs have fared in the hospital system as a whole, some detail about how those costs are being handled and what proposals there are to control them in this fiscal year.

It is a common concern in the hospital world, at least at the non-administrative levels, that administrators usually do fairly well. They get nice office space and sometimes refurbish it in a pretty deluxe way. Rumours abound about enormous travel costs, and I think that's very unhealthy for the system. Could the minister provide us with that information either now or later on in the debate? Does he think annual reports of hospitals ought to include a breakdown of administrative costs, where the money is being spent? What measures has the ministry undertaken to ensure that the ultra-high-level administrators are subject to some of the same fiscal constraints as everyone else?

HON. MR. STRACHAN: Generally we review the global budgets of all hospitals and look at what they are spending on services such as operations and other processes and medical procedures, and we also look at their administrative costs. The member knows that

[ Page 12775 ]

executive salaries have been frozen, so that's one way of curtailing the costs. If the member would like to be more specific in terms of what type of administrative costs and increases he's attempting to identify, I would be more than happy to provide the answer to him. Generally, though, I'm advised that administrative costs are not rising alarmingly. There appears to be some stability with hospital budgets in that respect. But if there's a specific question the member wants to ask, Mr. Chairman, I will be more than happy to provide more specific details to him.

MR. VANDER ZALM: Mr. Chairman, I think I should give the second member for Vancouver–Point Grey just a little bit of a break. He has certainly been on his feet for a long while. Perhaps just a little interjection now and again would be of some help.

I just went back to the office and attended to some telephone calls, and one was particularly sad. It was from a mother with four children at home — she's a single parent — whose husband left her a couple of years ago due to a heroin addiction. This couple had a model marriage from what the mother told me; he was a good father, and things went well. They built up a fair business and bought a nice home, and suddenly it all fell apart when the addiction got the best of him. He has been attending treatment programs, and he has participated in various activities at the detox centre. But he walked out, because he could not participate in the part of the program with the treatment that requires a group therapy type of approach. In part it's because of what happened to him in earlier life and what he experienced then that makes it impossible — according to his wife, who is a very nice and a very reasonable person — for him to participate.

She was telling me at length about how she's been trying to get some help for him in the hopes that perhaps — as one would, understandably — they might find some cure, some solution, and she's looking desperately. She's attempting to find a job for herself. She has been getting by on welfare. How it is a mother with four young children could possibly take on a job is beyond me — and, I'm sure, most here. I think it's perhaps her trying to find an outlet for the frustrations and the suffering she's experiencing, but they're trying to get help for the husband.

They can't seem to find it within the system. The system isn't sufficiently flexible, so I'm told, to provide that he might be spared the group therapy and instead given some other psychiatric help. The mother and the children are just waiting at home. Perhaps one day they might be advised that he has overdosed and then all they'll have is an obituary.

So I find this very sad for me as MLA — as I'm sure all of us would — and very difficult to try and get a solution to. I'd simply like to send the mother's name and phone number over to the minister and the ministry people and have someone fairly high up in the ministry see if they can somehow provide some psychiatric help for this husband, for this father, for this person.

I realize that people within the system need to work according to whatever rules they are provided with.

That's one of the unfortunate parts of government: we can't always provide the flexibility required. We have to set up a system. I understand all of that. But when we're told about a specific instance like this, when we're made aware of a mother at home with four children trying to cope, when every moment of living is like a bit of agony, waiting for what might be that fearful message, I think we, as people in government and those serving government through the ministries, should try to make some effort to assist personally on a one-to-one basis. If someone high up in the ministry — perhaps the minister himself might volunteer — would call this mother, I'm sure that you'll find her to be a very reasonable individual. If you could be of some help.... The fact that you called, in itself, would be a tremendous comfort, because it would show we cared. I would certainly appreciate it. It would be a tremendous deed done by the ministry, and it would make my participation in this debate worthwhile. That's my only request now. I've passed on the name to the minister and the ministry people, all of whom I know to be caring. I would request, as a special favour from an MLA on this side — on that side, sorry; both sides, I guess; just as an MLA in the House — that you go that extra little bit and do that.

HON. MR. STRACHAN: The first member for Richmond has supplied the name and number to me. I will give the member my undertaking that we will investigate this immediately and find out if there is any remedy possible. Hopefully, there will be. I will also extend, as the first member for Richmond pointed out, the willingness to intervene on anyone's behalf, if I can, as minister, on a request from any member of this House. When we're dealing with concerns as tragic and upsetting as these, clearly it's incumbent upon all ministers and all members to ensure that we act in a responsible manner towards the people of British Columbia and that in all instances we provide whatever remedy, investigation and assistance that we can. That undertaking is given to the first member for Richmond, and I thank him for sharing this with me, and the name of his constituent.

MR. PERRY: I was glad to hear that point raised. I wasn't sure I could get away with it in this debate, because it now falls under the Ministry of Labour, whereas it naturally falls within the realm of health. I'm glad that the former Premier raised it, and I may come back to the theme later on.

Just continuing with the mixed potage, the minister and I were both sent a letter dated May 21 from Dr. Clark Jamieson, a urologist in Prince George. We've probably both had earlier correspondence from him. He has made an argument both in this letter and an earlier letter for the use of a mobile lithotripter. In case anyone is not familiar with this machine, it's a device with a stone bath to send shock waves of sound into people to break up their kidney stones or gall stones. I've heard rumours that it has converted some Social Credit members into New Democrats in Vancouver, but I don't know if that has anything to do with the

[ Page 12776 ]

failure of this technology to permeate northern British Columbia.

Interjection.

MR. PERRY: I've never been in it myself; I came to the party honestly and naturally.

The argument he makes is that the device can spare people from surgery for kidney stones. Most people know what a kidney stone is; certainly one of the members on this side is familiar with how painful that condition can be. Often kidney stones have required surgery, but a lot of them can be fragmented quite painlessly by this lithotripter device. One has been in use at Vancouver General Hospital for a number of years. In reading Dr. Jamieson's letters — this one and the previous one — I found that the argument seemed relatively cogent: a mobile machine should be mounted on a truck and used for regular appointments at various interior centres to reduce the need for surgery and reduce the need for people to make trips to either Prince George or other centres for that surgery. I wonder if the minister could enlighten me on how the Ministry of Health views this issue. Does it in fact see a lithotripter as a potentially cost-saving device that might provide better service to people? Or does it have concerns that it provides a redundant service?

HON. MR. STRACHAN: I'm aware of the correspondence, although we don't have a copy of it here. Dr. Jamieson's partner is a very good friend of mine. As a matter of fact, he used to live across the street from me in Prince George. So I remember that correspondence.

I guess the answer clearly is that although the technology and the suggestion is good, it's not our highest priority for spending. We are continuing to look at this type of technology. It does have certain applications which we agree with. But as I said earlier, there's nothing that a lot of money can't fix.

I'm advised that we do have other priorities for capital funding, equipment funding. And although we'll look at this with some interest, at this point, particularly in these times of declining revenues, it is not our highest priority. If I'm not mistaken, that's the gist of the letter that I sent back to Dr. Jamieson.

[5:45]

MR. VANDER ZALM: It's an interesting suggestion made by the second member for Vancouver–Point Grey. But having suffered from kidney stones a number of times, it seems to me that if I were living in Prince George and suffered a kidney-stone attack, I wouldn't want to wait until the mobile unit arrived in Prince George before I could have it attended to with a lithotripter. So I'm wondering if perhaps, when the second member for Vancouver–Point Grey, with all of his knowledge in this particular field, gets up again, he could elaborate a little bit more, because it — at least for one who has experienced this and looks at it practically — would not make a whole lot of sense to say that the mobile will be around in two weeks. You can't really continue when you're suffering from kidney stones; yesterday was already too late. Maybe you could elaborate on this.

It certainly makes sense that we have more of these facilities available elsewhere in the province. I think the government certainly has done a commendable job in attempting to get services, facilities and equipment out to the regions, and it's important that we have this available in the northern regions for the people there. A kidney-stone attack limits what you can do when you're living just outside Prince George, Vanderhoof, Smithers, any place else in the north — or, for that matter, any place not within driving distance of the Vancouver General Hospital. So I'm all for getting the facilities and equipment out there, but a mobile unit, at least at first blush, doesn't make a whole lot of sense. So I would ask the member who raised this particular point to elaborate a little bit more on that.

MR. PERRY: I'd be delighted to. I don't think we want to turn this into a private discussion, and I have to admit, to my embarrassment, that I've never seen a lithotripter. I suppose I only have fantasies of what the stone bath is like.

Interjection.

MR. PERRY: Conceptions of it, then. I don't have any idea whether it's even a bath or what it looks like. My idea, I suppose, is to be up at Hot Springs Cove or at that wonderful hot springs in the Queen Charlotte Islands getting lithotripted, but I don't think it's quite that exotic.

Fortunately the letter supplies some detail. Dr. Jamieson's letter says, for example: "I think the point is that the immediate problem can be relieved and the long-term problem can be addressed by the lithotripter, obviating the need for surgery." He explains it this way:

"As you know, I've been corresponding with the former Minister of Health about a mobile lithotripter unit for quite some time, with very little success. The former minister was under the mistaken impression that we wanted this unit only for Prince George or only for the north of B.C. This is not the case. One mobile unit would serve all of B.C., including Vancouver Island. The people living in the greater Vancouver area could continue to attend the fixed unit at VGH. I don't think more than one unit would be required to adequately serve all of the rest of B.C."

Then he explains the point:

"Most patients that have a symptomatic kidney stone" — that's one that's painful — "can be made comfortable and go back to their normal activities simply by inserting a ureteric stent which bypasses the stone."

That means just putting a little bypass tube past it.

"They would then wait for the mobile stone bath to come to their area and would have the kidney stone treated at the time when the stone bath was in their area. This would make it unnecessary for people from all over B.C. to travel to Vancouver to have their kidney stone treated."

In other words, what he's saying is that a lot of people are being sent to Vancouver now and have to pay their own travel costs. The Minister of Health ought to understand, coming from Prince George, that

[ Page 12777 ]

it's a major concern for northern people. They're not getting surgery; they're already being sent to Vancouver for this alternative, less invasive treatment.

The urologist goes on to point out potential cost savings. That's why I was asking the minister what is known about the issue, because I'd like to have these facts.

I quote again:

"The former Minister of Health was also under the impression that a great deal of expertise was required to use this unit. It is a well-known fact among urologists that a monkey could run this unit" — I put that on the record because it may be useful in future — "and very little expertise is actually required. It has been recommended, however, that there be a minimum training program for people running a recognized stone-bath unit. This could easily be arranged and would be done by each doctor wanting to provide this treatment at his own expense."

In other words, the urologist, or whoever, in each town where the van visited could rapidly, at their own expense, learn how to deliver the treatments. It sounds like this would provide a lot of appropriate improvement in the calibre or quality of treatment of people. Does the minister know whether it would save money? What is the capital cost or the range of costs for one of the lithotripters? How does that compare with the amount of money that British Columbians are spending each year to travel down from Terrace or Prince George or wherever to Vancouver to get their stone bath treatment for kidney stones?

MR. CHAIRMAN: The hon. Minister of Native Affairs asks leave to make an introduction.

Leave granted.

HON. MR. SAVAGE: It gives me great pleasure to rise this afternoon and introduce a couple of guests to the Legislature, along with my administrative assistant and her husband. Would this House please welcome Eric and Christine McQuarrie and my administrative assistant's husband, Howard, and of course my administrative assistant, Joane Painter. Would the House please make them welcome.

HON. MR. STRACHAN: I have to observe somewhat tongue-in-cheek that the second member for Vancouver–Point Grey was concerned at the outset of this discussion about a lithotripter that perhaps this type of kidney stone or gallstone....

What's the stone again?

AN HON. MEMBER: Both.

HON. MR. STRACHAN: ....could turn one into a New Democrat. Then I noted that the first member for Richmond has had the procedure, and I can assure you he is not a New Democrat. Obviously it doesn't have that impact; we can conclude that.

Interjection.

HON. MR. STRACHAN: It takes some time, does it? Ninety days? In all seriousness....

Interjection.

HON. MR. STRACHAN: That's very good. The opposition House Leader, who has a remarkably good sense of humour, said: "If it was just gall, he could become a Socred." I think that's funny

Seriously, back to the lithotripter. The second member for Vancouver–Point Grey asked me to identify what the costs would be, and I will do that. I don't have that information available to me now. Let me put on the record, though, that British Columbia was the first province in Canada to have a lithotripter, so we are aware of its value in terms of this type of treatment. The member says he hasn't seen one. Apparently it's just a large bath. You sit in it and the sound waves do their thing and the stones disappear.

He's asked me to identify the costs of a mobile unit. I don't have that information now, nor do I have the letter that I've written to Dr. Jamieson, but I will ask staff to identify what the cost would be. Maybe there is a cost benefit. We'll take that one on notice, Mr. Chairman, and return to the member either in the continuation of my debates or in further correspondence and answer his question.

MR. PERRY: I know we're close to the transition to the debate on bills at 6 o'clock, so I'll try to make the question a little bit more precise in case the minister has time to answer it before we next convene on this subject.

Since B.C. was the first province to get a lithotripter, presumably we know something about whether it has saved us any money or improved quality of treatment, or exaggerated costs. I've heard it said that it was grafted onto the existing surgery and perhaps it produced more surgery. In my response to Dr. Jamieson I've encouraged him that I wanted an answer to that question before I would make a personal judgment on this technology. Maybe we could get some information on that.

I want to mention one other issue, and perhaps when we continue the minister could come back with it. I will serve notice that I'd like to discuss the future of midwifery in British Columbia and what plans, if any, the ministry has for the future of midwifery by trained, licensed midwives in the next fiscal year. Members will know that almost a year ago we passed the Health Professions Act, which allowed for the licensing of new health disciplines under the Health Professions Council. The council was eventually appointed a few months ago, and now I gather the Midwives' Association of B.C. is in the process of applying for licensing.

I'd like to ask, perhaps when we reconvene, how long the minister envisions that process will take. Does he have any explanation for why it took so long to appoint the council, given the apparent urgency of getting that legislation through in the wee hours of the morning last year? Why has the council, after the years that were put into development of the legislation,

[ Page 12778 ]

which I remember discussing in my briefings, apparently been relatively slow in getting off the ground in dealing with licensing applications? And much more interestingly, what vision does the ministry have for using midwives once they're licensed?

When we reconvene these estimates, I will come back to the issue of how we're going to reduce prematurity, and how we're going to use midwives in some more imaginative way than simply grafting them onto the existing services, such as using them as a kind of flying wedge to address the obstetrical patients who are not very well served now — for example, native women, marginalized women in the street communities, poor women, women in some remote communities or segments of the population where there are relatively high rates of prematurity and obstetrical complications and where midwifery offers a possibility of enhancing the service so much that we might actually reduce prematurity and reduce the number of babies born with severe disabilities. I think that's quite an exciting area to discuss, but I'd suggest, with the Chair's permission, that we move to the next order of business.

HON. MR. STRACHAN: I will respond to the second member for Vancouver–Point Grey on that issue in further debates, and he has identified some issues. Of course, we do have the Health Professions Act in place, and we have the Health Professions Council. The member expressed some concern about that, but I will address those issues, as I said, in further debate.

Mr. Chairman, as indicated by the member opposite, we are going to be adjourning this part of the debate and going to other issues in the House, so I move the committee rise and report progress and ask leave to sit again.

The House resumed; Mr. Speaker in the chair.

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

HON. MR. STRACHAN: I move that the House at its rising do stand adjourned for five minutes.

MR. ROSE: I hope there's more to the motion than that. If this is a motion to return, I would like to have an opportunity to speak to that motion. It's more than an adjournment motion. It's an adjournment motion for a time, and because it's for a time, it is then debatable.

MR. SPEAKER: There's no question that it's debatable. Only one member can remain standing, so perhaps the others would take their places.

[6:00]

MR. ROSE: We can't support so early in the session the concept of night sittings. This is a government over there suffering from terminal incompetence. It has nothing to do with the fact that we're opposed to working at night. Many members of this party have had a lot of experience working at night, especially those of us who came in in 1983. That's not the point.

It's not the calendar but how long we've been here that should dictate whether we have night sittings. What we are engaged in now is really just the beginning of estimates. Sometimes they go 150 to 175 hours. We've done nothing like that this year, and we can still remember the Bennett chant: "Not a dime without debate." So we intend to use every opportunity to fully debate the estimates — and any legislation, if there's any coming forward, although the order paper reveals precious little of that kind of material for us.

So it's not the calendar, and it's not that we don't want to work. It just seems to me that we've had all kinds of time since March. We were here for two weeks with all the cameras glowing in this House for the first time — two weeks in March, no budget, and then cut and run. We didn't come back until early in May and then didn't have a budget until May 21. The budget debate took at least one full week. Here we are only just beginning estimates, and suddenly we're confronted with night sittings. I don't think it's fair, and I don't think it's necessary. It's just a government in chaos and confusion. So we're not very pleased about this. There could have been all kinds of time to bring in a budget if we had a government with any kind of competence at all.

In 1984 we had a budget on February 20; 1985, March 14; 1986, March 20; 1987, March 19; 1988, March 24; 1989, March 30; 1990, April 19 — but there were problems showing up then and government turmoil, chaos and confusion.

So what's wrong with a government that can't bring in a budget, that can't even call the House until well into March and then stays here for two weeks, runs on warrants again and then runs away?

If we don't protest this.... That's the government intention now. They want to get out of here. They don't like it here; it's not comfortable for them. They've got a leadership, I'm sorry — they're masquerading as a leadership — race going on. They don't have any delegates turning up to their meetings. There's no interest out there. Mr. Speaker, the government should stay here. This is your best opportunity to get television coverage, because you're certainly not going to get any at your meetings.

So if there's no interest, if the whole leadership race of the Socreds is instant Sominex, then I don't know why they're so anxious to get out there. If they weren't here, they wouldn't get any publicity at all — not one iota.

In addition to that, when we do deal with the estimates, which we haven't done excessively.... We've been very prudent; we've been very careful; we haven't used a lot of lipflap; we've been in there responsibly trying to examine the government spending policies, and we intend to continue to do that.

But what is the government doing? What they're doing is wasting time. Let's take the Finance estimates, just for an example. Are they talking about the finances of British Columbia? Of course they're not. They don't want to talk about the finances of British Columbia;

[ Page 12779 ]

they want to talk about some jurisdiction way over beyond the mountains. They're not interested.

Usually it has been a tradition in this House — and I refer all the members to rule 1, which bases what we do here on the precedents of this House.... The precedents of this House indicate that what happens during the estimate debate is that the opposition gets a chance to examine ministers. We don't get a chance to examine the Minister of Finance. I wouldn't have wanted to examine him too closely personally, but even if we did, we didn't have the chance. But guess what? Between the very astute and probing questions of our critic for Finance, guess who jumps up to protect him? There's the Minister of Health jumping up to protect him. The Minister of Energy has got energy enough to jump up and protect him. They eat hours of the clock. Absolutely intolerable! We can't have that anymore. I think we have to do something about it.

What are they waiting for? You know what they're waiting for? They're trying to provoke this side — honest responsible people, very cautious people, people here with years of experience and commitment to politics, people who have worked at the grass roots and know their policy — not somebody who is just parachuted into some riding because he happens to have a big name or a big voice, like Thumper Rabbitt over there.

You know, we take people here, everybody in this motley group that I represent — well educated, cautious, moderate people who will be very careful. British Columbia's looking forward to these people becoming government, taking the reins of office over from what is a litany of corruption.

Why are we doing the night sitting? To do legislation. Have a look at the order paper. What legislation? There's nothing on the order paper; it's a tabula rasa, a blank white sheet. We'd have no trouble passing most of those things in our sleep; and while we're making our speeches, perhaps that's what you'll do. I hope so.

Interjection.

MR. ROSE: Is that the recycled member from Cloverdale that I hear? It is? Well, he's in a semi-amorphous mood, and I know he's taking a great interest in this debate. I'd like to thank him; I'd like to thank him for the times of '83 when we were doing night sittings and we had to speak for 40 minutes on this side. If it weren't for his heckling I never could have made it. I'd like to thank him for that.

What's the government trying to do here? They're trying to ram through this session because they feel extremely uncomfortable about being here. They want to cut and run like they did in March, while we want to be here responsibly debating legislation and estimates. That is our job, and it is the job we intend to pursue. We don't intend to be just pushed around like something willy-nilly and agree to legislation by exhaustion. That's what they used to say in W.A.C. Bennett's days. Now I said some nice things about him the other day, and I don't take those back, but he certainly loved to keep this Legislature going all night while he went and played pinochle, I'm told.

Anyway, what are we doing? What we're doing here is the government waiting game: a cat-and-mouse game where they're waiting for some kind of bloopers to come from this side that they could take as TV clips and use in their campaign. There will be no bloopers. You're wasting your time here. You might as well get out, because you're not doing anything anyway. But we're going to examine the legislation thoroughly, consistently — and perniciously even — because we don't believe what you're telling us.

Mr. Speaker, we know the government's going to have its way in the end on these late-hour debates. We're well aware of that. We know what they intend to do. We know they can drag on and on — legislation by exhaustion. In the end they'll win the vote. But we can't let this go unchallenged. It would be irresponsible for an opposition to let that kind of thing go unchallenged. They want to ram through the legislation at night sitting — in the dark, when nobody is looking. There's nobody out there looking — except the public. They see through this kind of thing. It'll pass in the end.

The government is suffering not in silence but from a lack of any kind of interest, in spite of the zest of the young Socreds. Nobody is going to their meetings. We've got a Premier sitting over there — I can see her ghost right now. We ask her questions every day....

Interjection.

MR. ROSE: I have been a victim for many years, Mr. Speaker, of the rabbit pack over there. I'm a relatively new member around here, but when Thumper gets after me — when the rabbit gets vicious — I get very nervous.

The leader can't answer any questions. The new Premier — the interim Premier, as some people call her — can't answer questions. She won't answer questions. She flips any questions over to somebody else. Here's a hot potato — you handle it, somebody. Here's another hot potato — you handle it, Stan. We know that she's either incompetent, unwilling to answer the questions or she does not believe in open government. You make your own choice about that.

People don't want any more talk. They want an election — enough jawboning — and they want it now.

MR. SPEAKER: Just so that the Chair can clarify matters, some members believe that this particular debate is not being transmitted because in our earlier session which took place in April we were unable to get the transponder time on the appropriate satellite. Whether it disappoints you or not, the Chair is here to inform you that this in fact is broadcast to those cable networks that have it, and will continue to be for as long as this debate continues.

MR. VANDER ZALM: I'm somewhat surprised, because I had the opportunity to speak to the opposition House Leader a little earlier, and I thought he was quite anxious to really see all of this completed and all of the legislation and budgets dealt with so that in fact he could enjoy retirement during some of the summer

[ Page 12780 ]

weather, if it ever comes — and we're hoping it will come soon. So when he....

MR. ROSE: With you.

MR. VANDER ZALM: Perhaps. If you want good company, I'd like to be there with you.

But I'm surprised that now he stands up — with some conviction, it would appear — and argues against us sitting this evening and other evenings during the coming weeks. He says that it is a government in chaos that would propose such a thing. I quite frankly can't understand it at all.

It seems to me that if we're concerned about legislation getting done, if we're concerned about budgets being dealt with and the questions which we've heard put so well today by the second member for Vancouver–Point Grey addressed, and ample time provided for this as quickly as possible, then we should want to sit evenings and get on with it. I realize too that many members during the course of the day undoubtedly have other things to do and may not spend all of their time in the House. Today, for example, all afternoon except for several times when I took the opportunity to speak to the Minister of the Health, all the time was occupied by the second member for Vancouver–Point Grey. Others on this side — on the NDP side — ought to be well rested, and I'm sure they should be amply ready for debate tonight. If we can save the taxpayers the expense by putting in a longer day, then I am one that would certainly volunteer to do this.

Today I've heard raised by the second member for Vancouver–Point Grey — and he put it very well — many things that we perhaps might wish to see addressed by the Minister of Health.

MR. SPEAKER: Order, please. The member has been here a long time, and you must know that the Chair is not interested in matters which took place in committee. We are only debating now the issue of the time for which the House will recess. While there may be a number of other things we can discuss, the Chair is not interested in hearing any kind of a debate about what's happened in committee. The Chair has no knowledge of these matters, and it should not be brought to the Chair's attention except by way of report.

[6:15]

MR. VANDER ZALM: Thank you, Mr. Speaker, for that advice; I appreciate it very much. I didn't intend to talk about committee, but the member for Coquitlam Moody did raise a number of issues with respect to the motives of government for sitting in the evening. I want to make it very clear that as a member on the government side I wish to sit evenings, because I feel it's to the benefit of the taxpayers. Also, I think there's ample opportunity for us to sort of gear up during the course of the day to come in here during the evenings and address those vital issues which must be addressed as quickly as possible. I would urge all members to support working a longer day if it means getting legislation and budgets dealt with more efficiently and more quickly on behalf of the taxpayers.

Having listened to much debate from the NDP side as to where all the money is required for all of these things and.... I'm sorry, Mr. Speaker, I've heard this said in committee. I say if we're so concerned about dollars and moneys and we want to see this for other programs, let's work a little harder. Let's put our shoulders to the wheel, work at night and save the taxpayers those dollars. Let's get the business done.

MS. PULLINGER: I was fascinated to listen to the former Premier saying a couple of things. One was that he didn't understand why our House Leader was suggesting that we're now into late-night sitting, it appears, because this government's in chaos. I would think that that member, of anybody, ought to understand just what the problem is. It seems to me, Mr. Speaker, that he invented chaos as it pertains to this House.

I guess I can understand that member not understanding what's going on and maybe being in a rush and really feeling like getting at the people's business. After all, he has been away for two weeks' vacation while the rest of us were dealing with the House.

The obvious question we come to when we have a motion so early in the session to adjourn and come back in night sittings is "why?" Why are we having to have night sittings so early — seven weeks into the session? Let's not forget that this Legislature sat in March. We were here March 11, and ten days later the government turned tail and ran because they wanted to hide from the limelight and from public scrutiny. They wanted to bury their chaos, their scandals and the irresponsible government in a barrel and get out. So we were here for ten days and they were gone.

In spite of the fact that we sat in March, that this government has had an entire year to prepare and that we have a long history in this province of year after year that governments bring in budgets on time, this government is unable to bring in a budget on time. It was later than usual the year I was elected, 1989. We sat in mid-March and the budget was brought in at the end of the month. It was late last year; the House didn't even sit until April. This year, we didn't even make it until May.

That's what we mean when we say this government is in chaos: it's consumed by its own internal problems, squabbles and conflicts of interest — the numerous things that have consumed the time and attention of the members opposite. We've seen their leader forced to resign. As one who has spent some time studying B.C. political history, I know that is unprecedented. Never before has a Premier in B.C. been forced to step down in the midst of a scandal. We have a revolving door cabinet. There are only five or six people on the other side of the House who haven't yet sat in cabinet; however, we've got a few months left and maybe those five will make it.

The cumulative effect of the disarray and chaos on the other side of the House is that the people's business is not being done. No one is home on the government side. They're all out trying to beat the bushes to find

[ Page 12781 ]

some Socreds to come out to the all-candidates meetings and the selection meetings.

This government is now in the fifth year of its mandate, getting perilously close to the end. It's desperate. It's facing a leadership convention in the middle of its fifth year, a result of its own actions. We have an interim Premier, and soon a third Premier within one government will be chosen. This government's term is drawing to a close. If it can round up enough delegates, they'll have a new leader soon. And now, amid all this chaos and its own internal problems, this government wants night sittings — after merely seven weeks.

On this side of the House we tend to be relatively fit, our average age is relatively young and we get along with each other, so we don't mind night sittings. We have no problem with night sittings.

I object to this government for two years in a row using special warrants, without any debate, and ramming through $5 billion in interim supply. We now have the rest of the budget to approve, and they want to push that through as quickly as possible. As our House Leader pointed out, "legislation by exhaustion" used to be the trademark of Social Credit. Maybe we're coming back to that. We see a government filibustering its own estimates. It can't defend its own Finance estimates. Instead, it talks about anything but its own estimates because it doesn't want to be scrutinized. It doesn't want to talk about its own estimates.

The government won't answer questions about what it's doing with the people's money. It's evasive; it's filibustering. Suddenly we want night sittings. The government's own problems seem to have dictated the agenda of this House, and I think that's an irresponsible way of doing government.

The budget's been later each year with this administration.

Interjections.

MR. SPEAKER: Order, please. There seems to be a little concern about what we are and what we are not discussing.

Interjection.

MR. SPEAKER: Once again I receive unsolicited advice.

We're discussing the issue of an adjournment for five minutes. Now the scope has gone. Naturally it's going to take more than five minutes to discuss this, and the Chair was anticipating that. The scope of the debate should really not be the whole budget speech and the whole throne speech once again, but should be on the relative merits of adjourning or not adjourning for five minutes.

Your House Leader did a marvellous job of trying to keep it within some kind of relevance. I appreciate that all members have the opportunity to speak on it but do not have the opportunity to revisit all the things you may have wanted discussed and missed during the throne speech.

MS. PULLINGER: I was simply pointing out that we're adjourning for five minutes, yes, but we're going to come back and do the estimates at night sittings. I understand that's what the government's agenda is. It seems to me that if we're going to do that at this early stage of the game, what we're looking at is a reason to get out of here more quickly so they don't have to deal with public scrutiny; they can ram their estimates through at night. It's simply damage control, to get out of here. That is what we on this side of the House are trying to show, and we object to that irresponsible way of doing the people's business.

This government has had five years to try to get it right. Instead of getting better, it's getting worse: the budgets are later every year. It seems to me that the government is getting less capable of bringing in a budget each year, so we end up in night sittings. We have no legislation to speak of. Why are we going to have these heavy-duty, late-night sittings to speed things up?

What we've seen is the government essentially playing hide-and-seek. They're filibustering and avoiding questions. They simply don't want public scrutiny. They want to be out of the public eye so they can get to their leadership convention. The government will have its way, There's more of them than there are of us.

Mr. Speaker, we want to be clear that we on this side of the House object to the way this government functions, and we're not going to accept it without protest. The people are tired of Social Credit games. They're tired of the scandals, chaos and the government's internal agenda taking precedence over the people's business. I think a lot of people in British Columbia would join with me in saying: "Give us an election, please — not night sittings."

HON. MR. FRASER: I can understand why the opposition would like to have an election right away. They know, for example, that as each five minutes go by, the polls are narrowing and our chances of winning again are getting better.

Unlike all the members over there who like to work in set patterns, the members on this side of the House are prepared to debate night and day, as we have in the past. Whether it's a debate over five minutes or five hours, we're always going to be here, because we're never afraid to sit here and do the people's business.

I think it has come as some disappointment to the opposition, when we talk about five minutes, that we've been here so long and have taken as much time going through the estimates as we have. I think they would be interested to know that we have spent twice as long on the Ministry of Education this year as we did last year. So there has been lots of opportunity for debate. The whole idea of this five-minute extension, so that we can go into debate this evening, is to present the people of B.C. with every opportunity to see the kind of work being done in here.

As a member of the government, I'm happy to stand here to go through second reading of the legislation and through the estimates of the ministers' offices and all those things we do so well and have done so consistently for so long, which the opposition finds so

[ Page 12782 ]

upsetting. No wonder they don't want to continue, and no wonder they're fighting about the five-minute recess that we can support.

As for the member over there who promised many years ago to give his raise to charity, I would like to see some documentation of that, along with this member over here. Remember that? He's trying to hide behind his accountant, Mr. Speaker. If he really had done it, I think he would be showing it to us, wouldn't he? No wonder he doesn't want to debate the five-minute recess. He might try to do it to hide himself.

MR. SPEAKER: Again, we could deal with the relevance of the adjournment.

HON. MR. FRASER: We're talking about the five minute recess, Mr. Speaker. We are prepared to discuss the five-minute recess so we can carry on, get the people's business done, go through the estimates and the legislation and show the people again and again that this government's here to stay, and we're ready for the election too.

MR. CLARK: I didn't intend to rise in debate, but the Attorney-General has provoked me, Mr. Speaker. I must say at the outset that I have no problem with adjourning for five minutes or with having debate in the evenings. In fact, I welcome it. I like to have debates; I like to have debates until the evenings. I would like to go every night; I have no problem whatsoever.

What we're debating, Mr. Speaker, just briefly here to make the point, is: why are we going to night sittings so early in the session? Why, Mr. Speaker? It's simple. It's evidence again of the kind of incompetence we've seen time and time again over four and a half long years with this administration. It's drifting along leaderless. I know there's an interim leader there who may get a coronation or may not, but there's no leadership coming from the other side. No legislation. It's just drifting along.

After seven weeks we're forced to go to night sittings. Now why is that? Because there was no budget.

MR. SERWA: On a point of order, Mr. Speaker, the absurdity of debating a five-minute recess for over half an hour has to strike the citizens of the province of British Columbia as absolutely asinine. The cynicism....

MR. SPEAKER: Order, please. If the member is going to rise on a point of order, the member must state a point of order. If the member wishes to enter the debate, he can do so after the first member for Vancouver East, if he's recognized by the Chair.

Interjections.

MR. SPEAKER: Order, please. If the member has a point of order, I'd like to hear it.

MR. SERWA: Mr. Speaker, the member is not being relevant to the motion.

MR. SPEAKER: Thank you. The Chair will take that under advisement, but if relevancy was put to a very firm test by this Speaker, members would have adjourned and been out of here a long time ago.

[6:30]

MR. CLARK: Mr. Speaker, governments in British Columbia run out of money on March 31. You don't need a degree — even a mail-order degree — to know that you run out of money on March 31. We have had a budget before the end of the fiscal year in virtually every year since Confederation. This administration couldn't even bring in a budget before the government ran out of money. It brought in a budget in May, the latest budget since the Second World War, and in fact the latest in history since Confederation if you look at the end of the fiscal year. Because the budget came in so late and because it's getting close to the end of the dying days of this administration, they're forced to go to night sittings so early to try to get the business of the people of British Columbia done in a time-frame that allows them to go on their leadership campaign and to finally call an election.

Mr. Speaker, it's a tragedy. Those who think this is a frivolous debate in terms of having a night sitting or a five-minute delay so we can go into a night sitting, should recognize that in a democracy the most important thing that we do in this chamber is scrutinize the spending and taxing authority of the government. Both sides do that — government backbenchers and opposition members. The government brings in its budget before it runs out of money and is held accountable for its taxing and spending decisions. That didn't happen this year until after we ran out of money, until several billion dollars was spent without public debate, until we had a little mini-session there with the discredited Premier — sitting in the chair — who brought in legislation that said there'd be a tax freeze. That was in March. A couple of months later, there was finally a belated budget that increased taxes.

That's what has happened with this administration. It's drifting along without any leadership. Someone occupies the chair of the Premier, but there's no leadership. She won't answer questions in the House, won't give a leadership position and won't bring in legislation. It's nothing; it's drifting along aimlessly, and that's why it's finally forced, this early in a session, to go to night sittings to try to ram through the legislation so they can get out on the hustings — finally, please — and call an election. That's what we need.

What we've seen in five years is policy du jour — a policy of the day. Every day you've got to read the paper to find out which direction the government's going in. We thought that would end with the retirement of the former Premier. But it hasn't ended, and that's why we're debating this motion to adjourn for five minutes — to make the point that this is not stable government. This is not the kind of government the

[ Page 12783 ]

people expect, where we have a budget that's brought in before the end of the fiscal year.

HON. MR. RABBITT: I just wish to bring the Speaker's attention to page 69, standing order 45(l). I'm sure the Speaker is very aware of it, but I don't know if the opposition members across the floor are. To assist the Speaker, I shall quote: "The scope of debate on this motion is limited strictly to the arguments pro and contra the suggested sitting time or date." Thank you.

MR. SPEAKER: All members have a copy of Standing Orders.

Interjection.

MR. SPEAKER: In that case, there will be a test. [Laughter.] Hon. members, we've had a little frivolity and amusement. We've had violations of this on both sides of the House. I really have to commend the Minister of Labour for bringing the matter to my attention. The Standing Orders are very plain about this: we really can't debate the wide scope of things that members seemed to have missed on a previous opportunity when the debate was unlimited. It's page 69 of this learned tome, second edition, Parliamentary Practice in British Columbia. I would ask you to keep the debate very relevant. We're only discussing five minutes.

MR. CLARK: I know why the Minister of Labour likes to object: they don't like us talking about leadership and their lack of leadership on that side. They don't like it when we point out the obvious: that this is an erratic government that swings from one policy every day, and they don't like it when we talk about the leadership style of the current occupant of that chair. God help us, Mr. Speaker, if she continues on much longer.

Hopefully, Mr. Speaker, we can have night sittings and people will watch and they will see what's so obvious to anybody sitting in this chamber and what's so obvious to anybody who watches these proceedings: the government has lost the moral authority to govern. It's time for an election; it's past time.

HON. MRS. GRAN: Mr. Speaker, I have to add my two cents' worth to this debate. I live in a town called Langley, where people are very aware of what goes on in this House. I think tonight is something that we should all reflect on. The opposition members may not like the fact that the government has decided to sit in the evening, but to stand over there and act like it's something unusual or something that we shouldn't be doing boggles my mind.

I don't know what the cost of sitting in here each day is, but I would guess it's somewhere around $90,000. We could spend that money in far better ways. I can tell you that in Women's Programs that $90,000 can be better spent there than in this House.

Mr. Speaker, I believe that we should sit every night in this House. I believe that when the session starts we should make it as short and as painless as possible for the people who have to pay the bill.

I can't believe that the members of the opposition are having difficulty sitting in the evening. I can't believe it. The opportunity to debate the government that you say is in chaos.... Your job, hon. members, is to sit in this House for as long as it takes to do the job that you're paid to do.

MS. A. HAGEN: I believe it is our job to sit in this House, but not to begin a session at a time when the government has already decided that it's going to get out as fast as possible. Let's remember the issue here. We came into this House on May 7. In earlier times, under an earlier leader, this House would sit in January and February and get its business done appropriately so that the estimates were thoroughly debated and so that the people's business was done.

As the years have gone by, as this government has become more jaded, and more committed to its own agenda, the people's agenda has gone by the wayside. Let's think about what we are debating tonight. We are debating very early in this late session a motion that will give this government another opportunity to cut and run. We already went through that once in this calendar year, in March, when all of us knew, without so much as a by-your-leave, that the government did cut and run with items on the order paper because they couldn't face the fact that we on this side of the House wanted to discuss and debate the people's business. Every day that we were here was painful to them at the end of their mandate because they couldn't face the heat that we were expressing on the part of the public.

I don't intend to repeat the points that have been made by a number of my colleagues on this side of the House, but let's just think about what we have been talking about this afternoon. We've been talking about Health estimates. As late as 4 o'clock this afternoon, expecting that Health estimates were going to be continuing tonight, we were told that instead we're going to begin to examine the thin package of legislation that is a part of this government's agenda at the end of its mandate, such as the Land Title Amendment Act, the Budget Measures Implementation Act, the Range Amendment Act and the Miscellaneous Amendment Statutes Act. We are in prime time tonight on television — the Speaker having advised us we will be on prime time — and we're not looking at the most important set of estimates, but instead we're debating this government's thin legislative package.

The intent of this government is to cut and run; it is to get out of here. We are looking at a five-minute adjournment, which is in fact the pro forma motion for us to sit over the next three nights this week, three nights next week and so on.

We are here, Madam Member from Langley and other members, to debate the people's business and to thoroughly examine estimates. We are here to make certain that the issues on people's minds have an opportunity to be debated thoroughly. As my colleague from Vancouver East said, we are more than ready to debate for as long as necessary to extensively examine the estimates.

We had a week — a bare week — on the Minister of Education's estimates. We need time to look at what I

[ Page 12784 ]

believe is the people's most important agenda: the Health estimates. As we look at the ministries of government, there is a whole range of issues that need to be examined thoroughly.

We object when we know that the agenda of this government is not to do the public's business; it's to get out there and look at the leadership of those people who are trying to assume the leadership of this party. It's for those people who are trying desperately to get re-elected.

That's not our agenda, and we will continue to make our points known around our willingness to do the government's business in a time that's appropriate for the government's business. And Madam Member from Langley, I find it truly disturbing that you believe democracy should be compressed into the shortest time available. What you fundamentally said was that this House should not sit, and that we should be gone from this place where the people's business is done.

After a thousand years of history and after all the years when people fought for control of the purse of government, that really tells us where this government is at this stage of the game. They don't want to do the people's business or have their spending under the examination of the public. That's very disappointing from the member from Langley, of whom I would have thought better.

Mr. Speaker, we object to the government cutting and running and getting on with its agenda. We're here to do the people's business, and we will do it for as long as necessary,

HON. MR. STRACHAN: The most compelling argument I heard in favour of this motion was that presented by the opposition House Leader who said: "We should stay here." That is exactly what this motion is asking us to do.

Let's look at some of the arguments that have been presented, and let's look at what we're doing this evening. The members opposite know that we have four pieces of legislation to do. They're important. The Adoption Amendment Act, 1991, is very important to some members. As a matter of fact, I recall the member for Maillardville-Coquitlam debating this issue years ago at some length, and he was very passionately interested in it. I find it curious why....

Interjection.

HON. MR. STRACHAN: That's exactly what the motion is saying: that we want to debate these very important pieces of legislation. I'm sure the member for Maillardville-Coquitlam, as he has said in years past, wants to get immediately to the Adoption Amendment Act, 1991.

Just a couple more things. The opposition House Leader spoke about doing things in the dark, and I can assure you that in the northern latitudes on June 17, you don't do anything in the dark because the sun continues to shine.

You'll recall that when we adjourned the committee and we reported out, you asked me: "When shall the committee sit again?" I said: "Later, Mr. Speaker." We have every intent of returning to estimates this evening. We are going to go to legislation, and then we are going to go to estimates if it's the wish of the House. So there's no attempt at all to try and avoid argument about the estimate spending.

We've heard some half-hearted repetition of the interim supply debate, but to have the members opposite conclude that we will not be doing estimates is incorrect, and if they would have listened to my motion or if they would have understood what our House Leader put on the agenda for today, they would know that we have every intent of returning to estimates this evening.

With that said, I close my case and I would recommend to all members of the Legislative Assembly that they support the motion that this House do now adjourn for five minutes.

Motion approved.

MR. SPEAKER: Is it agreed by the House that the mace will be left on the table and the procession will not be required? I'll ring the division bell when I return.

The House adjourned at 6:45 p.m.