1992 Legislative Session: 1st Session, 35th Parliament
HANSARD
(Hansard)
WEDNESDAY, JUNE 24, 1992
Morning Sitting
Volume 5, Number 2
[ Page 2993 ]
The House met at 12:04 p.m.
Prayers.
Hon. G. Clark: I call second reading of Bill 71.
MEDICAL AND HEALTH CARE
SERVICES ACT
On the amendment (continued).
A. Warnke: On such a grand and glorious day, among the many others that we've had recently.... Nonetheless, despite the heat -- if I recall where I left off yesterday in support of this particular amendment that we put forward -- it is refreshing to think that we could be thinking of something cool, chilling and all the rest of it to temper these nice warm days.
Hon. Speaker, the reason for our support of this amendment -- and I believe this is where I left off -- is that we are regrettably at a situation now when we have to take advantage of this very last opportunity, if we can, to once again address the problems of Bill 71. We have put forward many arguments. The one outstanding argument, of course, is regarding the process involved. We have argued that what is essential is a sober second look at the legislation before us, not because we simply want to oppose for the sake of opposing but because we've recognized that many people in the medical community and the public are very concerned about this particular legislation. They're particularly concerned that there's going to be a transformation. Indeed, yesterday the Minister of Health did talk about such a transformation occurring, and she acknowledged that the system is undergoing a transformation. The Minister of Health even said that we are facing some scary prospects, and those kinds of concessions did not help alleviate some of the fears that we on this side of the House and the public have towards this particular legislation. If anything, it reinforced all the more the argument that what is needed is some time to re-examine and reassess the future direction of health services.
[E. Barnes in the chair.]
Health services, whether in this province, any of the other provinces throughout Canada or throughout the United States, are facing a really serious, critical problem in the future. This crisis can be foreseen, and indeed it reminds me -- I'm sure it reminds all other members as well -- of the potential crisis we faced in education. In the past, when we saw the so-called baby-boom generation go through our educational system, we met that challenge. But it was an extremely difficult challenge, for which there had to be a huge injection of funds and a tremendous commitment by previous generations: our fathers' and mothers' generation, our grandfathers' and grandmothers' generation. They had to make such a tremendous commitment of time and resources to meet those kinds of challenges.
We're facing those kinds of challenges here as well. What we're doing in terms of presenting legislation is not meeting problems and challenges that face us just within the next year or two. Indeed, the Seaton report itself also anticipates there are a myriad of problems facing the next generation. This will become especially acute by the end of the decade.
My colleagues and I are not convinced, when we hear the Minister of Health, as we did yesterday, acknowledge that we are entering an era of uncertainty, that the future is scary. This then means it is worth our while to sit down and re-examine what we've seen as some flaws in this legislation. It's not the first time that legislation in which there has been some obvious flaws has been brought into this chamber this session. What we're especially concerned about is that when we're entering an era where there are very serious challenges and problems, and a third of the budget is being allocated to Health -- which we'll have the opportunity to analyze later -- it is essential to re-examine the kind of legislation that is being brought forth.
I must admit that I was not comforted by some of the words mentioned by the Minister of Health in response to the first amendment that was brought down yesterday and defeated by the government, because those conclusive remarks by the Minister of Health reinforced the position that there are some very serious challenges facing us.
This opposition is put in a very awkward position. Knowing full well that there are challenges that have been reinforced by the statements made by the Minister of Health yesterday, we are in a position that this may be our last opportunity. That is our role as opposition: to try to apply some sense, hopefully that there is some sort of sober second thought that comes out of the legislation that is being introduced and brought forth. We do not want to lose an opportunity. It is for that that I support the amendment.
I'm not going to repeat what I said yesterday, but we do want to re-examine this role of the commission. What is its role? It still has not been fully spelled out what is the nature, what is the purpose; indeed, we're not even sure what is the composition of this particular commission, what its role is in terms of the role of the various subcommittees that would be established with bringing forth a new commission. That has not been fully explained by the Minister of Health.
There are some ambiguities here that I believe need to be tightened up. Indeed, I think it is in the interest of the government to delay the bringing forth of this legislation and embodying that in public administration. I think it is worth the government's while to re-examine the implications of administering the policy that is going to come from Bill 71. That is a fundamental reason for re-examining this issue, plus the challenges that have come forth. Therefore, given the concerns we have on Bill 71, it was necessary to introduce an amendment to take advantage of one last opportunity for a re-examination of Bill 71. Hopefully all members will support this amendment.
[12:15]
[ Page 2994 ]
C. Tanner: I rise today to speak in the second attempt by this side of the House to ask the government to go slow on this bill. The government saw fit to reject the first amendment to send this bill to a committee for further study and evaluation, which we thought was a reasonable request. We thought we could help the government review this bill with expert witnesses with a different point of view and come up with a bill with which the three million people of this province could enjoy better medical health care, where doctors could practise in an atmosphere of forthrightness and honesty, where all other practitioners of medical health could work with instead of against the Ministry of Health and where the public would be assured that serious and intent scrutiny had been given to this bill.
What we have now is a request on our behalf to wait six months. We had to take this position, because we think the Minister of Health, in collusion with the Minister of Finance, either has an ulterior motive -- they're forcing us to come to this conclusion -- or are not too sure that the bill before us today is necessarily in the best interests of the public.
One of the problems that the opposition finds itself in is to not appear to be repetitious, because we hoped we had convinced the minister in the first instance. When we asked if this bill could be sent to committee, we thought we would convince the minister of the validity of our case. Apparently she doesn't -- or the government side doesn't -- agree with this.
As a consequence I went back over my notes of the last two or three months since the medical fraternity from all over the province has been badgering members from this side, asking us to at least give them a chance to make their case. I had a meeting in my constituency at Saanich Peninsula General Hospital a month ago with a number of doctors who practise medicine in my constituency. I'm just looking over my notes, and I find they made some interesting comments.
They had three major points to make. The first one is that the suggestion that's made in this bill is definitely a major change in what we consider an important part of our lives, the medical system of British Columbia. They felt that under the circumstances they should have some input into that decision; after all, they are the lead practitioners in delivering the system. They should be able to have some input through their elected representatives, not only in the House but through the ministry and the minister, and probably the Minister of Finance, who might be more the motivator of this bill than the Minister of Health.
The point the doctors were making is that they deserve to have some input. They thought that things were moving too fast for them to have that input. As a consequence they asked us, not to represent them in this House or to stand and be their mouthpiece in this Legislature; they asked us to say they have a reasonable request. Why is the minister going so quickly? Why can't she slow down? Who's going to lose? What's going to be lost if we wait six months?
That's why we made the first motion and why we're making the second motion. The point I want to make is that I'm speaking to the amendment specifically.
The second point the doctors in my constituency said is that there's another basic change, which both sides of the House agree to, and that is that we believe we should be making some changes in the medical program in bringing health care to the home, closer to the communities, and keeping people in the environment in which they live on a day-to-day basis as long as we possibly can.
Quite frankly, both before the election, subsequent to the election and definitely in this last meeting that I had with the doctors in my constituency, they made the point that: "Well, Mr. Tanner, do you understand what you're doing when you do that? Do you understand the consequences of that new policy that you're advocating?" They pointed out to me that if you keep a patient in their home for a longer period of time than is normal -- up to what has been the practice in the last two or three years -- they are consequently more sick when they finally come to the hospital.
It hadn't occurred to me, but when you think about it, it makes sense. If we are able to keep a patient who has a debilitating disease in their residence for a longer period of time for a number of reasons.... First of all, it's generally perceived to be better for patient health, and delivery of service to some extent; but is also better for the purse strings of the province if people can be kept in their homes and we don't incur costs by bringing them into hospitals. But as a consequence, those people, when they finally get to hospital, are far more seriously ill, and they need more serious treatment. I think the doctors made a good point. I think that if the Minister of Health agrees with this side of the House -- and I know she does -- that we want to bring health in the community closer to home, then we better seriously talk to the doctors about what is going to happen.
They are going to need, would you believe, more expensive equipment for those instances when the people do finally get to hospital -- not less. Over the long run, keeping that person at home is going to be cheaper, but the cost for specialized equipment when they finally do get to hospital is going to be higher. The doctors made a point of saying to me: "Have you considered this?" Quite frankly, we hadn't. My caucus seriously discussed community health care all the way through the year leading up to the last election. In fact, we campaigned on it, and we very seriously think it is a major cornerstone of our philosophy. But the fact that the doctors say, "Well, this is the consequence of what you're saying; have you thought about it?" deserves consideration. It deserves sufficient consideration that we shouldn't have to rush into it. The place for that consideration would have been at the committee that we suggested before. It wasn't allowed, so now we're asking the minister to wait six months so that those sorts of considerations can be taken into account.
One of the other points that the doctors in my constituency made, and I think it's an equally good one, is that we do have a two-tier system of medicare in Canada -- the two-tier medicare system that everybody in Britain complains about now. If you want what you might call the regular services, you wait six months, but if you want to pay for it, you'll get it a lot more
expensively. This is abhorrent to the people who sit on this side of the Legislature and, I suspect, that side of the Legislature. We don't want a two-tier system of medicine in this country, but in fact we've got one. The second tier happens to be in another country, and that's the United States. That very expensive system is available to those people in this country who have got the income, the enormous income, to be able to afford to go down there and pay the enormous prices expected in the United States. They get the medical service in the States that they can't get here.
What concerns us, if the minister continues on the same path, is that not only will the patients be going down to the United States to get the practice, but our doctors will be down there giving it. We think that deserves attention. We think the point that the doctors made in my constituency deserves consideration. We don't see what the rush is and why that consideration can't be given.
One of the other problems that the doctors had in my constituency -- they made a very strong point of this -- is that the medical health system in this country and in this province today expects the doctor to tell his or her patients: "This service is available to you, but we don't think you should have that service. These tests are needed, but we don't think you're to have these tests. You are of an age when giving you a test for blood count is not going to do you any good. Although it's fashionable, you can't have it." The doctors agree that those sorts of decisions have to be made. The doctors agree that it is about time that the public faced up to the fact that all the things they assume are free have to be paid for by somebody or other. The doctors agree that there is a strong necessity to educate the public to the fact that medicare, although one of the best plans, if not the best plan, in the world, carries a very high cost. The doctors agree that they, being the front-line troops, have a responsibility to make patients understand those very facets of the service that the public has come to accept. But doctors also are looking for help, assistance and direction from the Ministry of Health by saying: "Look, public, this is what it's going to cost you; this is what you're going to have to pay for." They're also saying: "Don't put it on our backs. We're prepared to help. We'll tell the patients, but you've got to tell them first." There is some responsibility on the part of government to tell the world that they can't expect something for nothing for the rest of their lives. The public has to pay their share. They've got to understand that these expensive and valuable services that they need have to be paid for by somebody.
It seems to this member that the government thinks it's the responsibility of the doctors to tell patients about their obligations, but the government wants to accept no responsibility at all for who's doing the funding and for telling the world who has to pay for the costs. The doctors tell me that they don't think that's fair, and I agree with them in this case. This government can't have it all ways. It can't be everything to everybody -- "Oh, just ask, and we'll give you whatever you ask for" -- without telling the people who are the recipients of that generosity that there is a price to be paid; and expecting some 6,000 doctors of this province to take the abuse from the public, who don't like the decisions that have to be made. Everybody has to accept that responsibility. It's unfair to ask one small segment of our society to take it on. This government has to take its share. One of the places they could have taken that share would have been at a meeting of one of our various committees to talk about it.
There's another problem that worries me. This doesn't concern the doctors or the patients; it concerns the ministry. This minister has been in office eight months, give or take a month or two. Actually, this minister has had seven months to learn on the job. We all know that the fact that they're looking for a deputy minister in that ministry was recently advertised. While I have no written proof in front of me, I've got a very strong suspicion that in the circumstances of a new government, a new minister and a new deputy minister, there are problems within the Ministry of Health of this government. On top of all that, they're going to make a major shift in the policy direction they want to take at a time when they're either new or looking for people to fulfil their function. That might be daring, but I think it could be dangerous.
If I had been in the minister's shoes -- in a few years I could very well be -- my reaction would be to go in and look the department over, in terms of personnel, policies, delivery of services and costs, and a year down the road say this is good, bad or indifferent, and make some changes. We're concerned as to what the rush is. Why do they have to make the changes so quickly, when I suspect the minister has to get used to the department and the department has to get used to the minister? We are nervous about that.
We're not criticizing the minister in this case. We're merely illustrating the circumstances we find ourselves in: a new minister, a departed deputy minister, a new policy -- a very basic policy -- and a shift in direction all at the same time. We don't think the hurry exists that the minister obviously does.
On a procedural situation, I have problems making what we used to call, in another place where I sat, "midnight amendments." This piece of legislation was introduced to this House in the last 48 hours or so -- a very short time ago. We've been debating it now for a couple of days, and it's almost inevitable that when you throw something together and make quick amendments -- particularly off the floor -- or when you don't give sufficient thought or bring enough expertise to a piece of legislation, you're going to change it later because it's going to be wrong.
Yesterday we were treated to an exercise in what I consider to be demonstrable democracy by the Attorney General. He introduced a very substantive piece of legislation, which changed -- fortunately, and my God, it's about time -- the direction of information available in this province for the public at large.
[12:30]
Deputy Speaker: Hon. member, we are on the amendment.
C. Tanner: I know. I want to illustrate a point here, Mr. Speaker, and the point is that the minister in-
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troduced that legislation and accepted changes to it -- 50 amendments. This side of the House sat down and worked through those amendments and came to a conclusion with a good piece of legislation. I think that's the way we should be behaving today with the Health minister. We're not, Mr. Speaker, and that's the point I'm making.
If one minister can do it, why can't another? If one piece of legislation can be introduced, discussed, worked over and amended, why can't the Minister of Health do it? Why must the Minister of Health think that her piece of legislation has to be rammed through the House in the last days of the session, when there's plenty of time to give it further discussion?
We have had a little more time to discuss this legislation and read it again overnight, and our worst fears are confirmed. Since we've had more time to review it for the simple reason that we were able to debate a little yesterday, the very things that we've feared and the very things that the doctors told me in my constituency.... There must be thousands of letters pouring in saying: "This is a flawed piece of legislation. Hold up. Stop pushing it through. Wait a minute. Let's look at it a bit." We've looked at it some more. We've had some more time. We've got many amendments we'd like to make, but we're not being given an opportunity to make those amendments and have that discussion. You've got to ask why. What is the minister up to? What is her game plan? What is her hidden motive? What is her ulterior motive?
There's a member in her constituency, Scott Wallace, who very bravely stood up before this election and said that he supported the minister in her attempt to win an election. After the election that same doctor said: "Maybe I've made a mistake." That is a valued member of our community who said: "Look, I took a second look, and I didn't like what I saw." We've taken a second look at this legislation, and we don't like what we see.
We think it's time for this minister to slow up, pay attention to the ministry, pay attention to the medical fraternity. Please, just listen and give us a chance to explain our position to a committee. Let's have another look at this legislation.
One of the reasons we wanted the meeting of our legislative committee on health is that we would like to call some expert witnesses. We would like an opportunity to go through this legislation and hear people from other jurisdictions, perhaps -- certainly from other professions -- make comparisons between ourselves and the United States, between the other great plan in the United Kingdom, which, in my view, is going wrong.... It is not only the Mother of Parliaments but the mother of medicare, I suppose in the democracies anyway. We would like to make some comparisons. We would like to see what happened in the United Kingdom, where they went wrong and how we can avoid falling into the same trap, which we are warned that we are going towards. We are going towards the same precipice that happened in Great Britain. We think we should look at that before we make this diabolical.... Mr. Speaker, may I withdraw that remark? Before we make this important step.
Deputy Speaker: Thank you, hon. member. I appreciate your assistance.
C. Tanner: They have had experience in Britain. I think we should look at it. They have had experience in the United States, of course. We all know that's not what we want. Why not just stop for a while and have another look at it?
For the benefit of members I'd like to read a little article that I happened to come across. This is a quote from Dr. Samuel Freedman, the former dean of medicine at McGill. This is from a magazine article published recently. He was telling some friends of his that he couldn't understand the criticism of Canadian medicare in the United States elections. Some of the criticism down there -- I might be able to use "diabolical" -- by leading American politicians is, to say the least, ridiculous. But Dr. Freedman is explaining to an American friend of his why he's so proud to have been associated -- he's retired now -- with the McGill school of medicine, one of the best in the country, and why he was particularly proud to be associated with the Canadian medicare system that we have in this country. Dr. Freedman wrote: "You know, it's not just a question of health care. We have a system here that is really accepted by the whole spectrum of political opinion. We have conservatives who are as far to the right on most issues as any American conservative, but they are as staunchly for the medicare system as anybody." The principle that everybody who needs medical care can get it, and nobody asks you if you are rich or poor or where you work, has become a national value. "Knowing that everybody gets the same care helps to hold society together. It makes everybody feel equally valued."
There aren't many things in the world that just work, that just make sense. I mean, here are two contiguous countries, one with a system that everybody is more or less happy with, and the other with a system that nobody is happy with; it doesn't work. Yet the one is determined not to learn anything from the other. I just don't understand it. Dr. Freeman is saying that we have a system in Canada that has worked for 40-odd years. It is not radically wrong except that it's getting a little expensive -- expensive in bringing services to the public that they require to be healthy, not expensive as a proportion of our gross national product, because that's been fairly consistent.
The reason that we're nervous on this side is: why tinker with something that is working well? Why make the great changes unless there's an absolute necessity? The practitioners, the very experts in the field, are saying: "Slow up here. Watch what you're doing. Don't get us into trouble. It's working. If it works, don't fix it."
All those things aside, we appreciate that we've got to make some changes. All we're saying on this side of the House is to give us a chance to tell you what they are, not in the formal debate across the legislative floor but in a committee, where we can sit down and have those informal meetings, listen to expert witnesses, hear what the experience in other countries is and really make a rational decision. It's too important to rush into this thing.
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One of the things that astounded me.... I don't know whether other members got it, but the doctors that I spoke to in the hospital in Saanich showed me a booklet that was written by Dr. Olson. It's a booklet of about 25 pages for doctors about how to opt out of the medical system. This is a booklet that has apparently been sent to all of the medical practitioners in the province. This is Dr. Olson's opinion; it's not mine, and hopefully it's not the opinion of most medical practitioners in this province. Olson is saying: "We've been shafted for years. We haven't been getting a fair break. There's only one way we can resolve this problem, and that is to get out. We'll sell our services to the clientele, and we will go back to the system we had before. It's the only fair way we can get a break." Year after year they've.... Of course, I speak of previous governments across the country. They've been squeezed each time.
I guess the icing on the cake that finally did it for the doctors was the last time out when they negotiated with the previous government on a pension. They settled for a pension this year that would resolve their problems immediately but not in the long run. They didn't like it. It got a lot of criticism in the press, and I think rightly so. I don't think that was a good deal. But the fact is that the doctors settled for it. Then this government came in. The Minister of Health and the Finance minister said: "I'm sorry, doctors. That deal is dead. We're tearing that contract up. We don't agree with it." Then they turn around, won't negotiate, and try to ram through the legislation so that they've got the doctors by the throat again. I don't agree with what Dr. Olson was saying, but I most certainly agree with the thought that the doctors have got a raw deal in the last few years in their negotiations with the past government, and they're getting an even tougher deal -- unfairly -- from this government and that minister.
I was going to read a bunch of letters that we've all received -- thousands of letters from doctors -- but the summary of what the doctors' letters are saying.... This isn't just from doctors that have been in the system for years and years. This isn't just from young doctors coming in. This is the whole strata of doctors: the interns who are just starting out after seven or eight years of education, the doctors who have been in the system for 30 or 40 years and are coming to the end of their careers, and everybody in between. This is from specialists, general practitioners and every form of medical practitioner in this province.
They're all saying the same thing: "We don't want anything more than a little consideration, and let's talk about it." I think it's a fair request. I ask every member in this House, particularly those members of the back bench on the government side, with whom we are not in that much disagreement -- nor this government.... All we're asking for is time for a little more consideration. I'm asking every member in this House to stand up and support this amendment, and let's sit down and talk some more for the next six months.
[12:45]
J. Dalton: I had perhaps the misfortune of not being here yesterday in the House, and I understand there were a few fireworks and things that went on. Now that I'm back I don't really think that I've been away, in one sense, because here we are. The government side perhaps has the same feeling.
I did speak on the main motion, and now I am rising on the second amendment. I understand the first one was unsuccessful, which I certainly regret. I think that this bill, of any that have been introduced this session, certainly would have been more than appropriate to refer to committee. I think it would have been an excellent way to give a second thought and some sober reflection on the very important content and aspects of this bill. Unfortunately that was not so, and now we in the opposition are trying to convince the government that at least a six-month hoist would be appropriate to allow other opportunity for discussion and dialogue on such a significant piece of legislation.
I would say that unlike any other bill that's been introduced in this session, Bill 71 is going to revamp the most important social system that government operates: the health system. I would venture a guess that if we were introducing legislation to significantly make changes to the education system, social services delivery or even things such as transportation and forestry -- you name it -- we would not be in such a rush. Quite frankly, I don't understand why, when we are in the business of running a government -- I would hope that we would treat it as a business -- we are trying to ram things through at the last minute that have such import and such potential impact on the health system and health delivery in this province.
It is very unsettling to me personally, and I know it is to many people that I have spoken with -- and I might say that's not just doctors. Many of the people in my constituency and elsewhere who have expressed concern about this legislation are not practitioners or even people involved such as nurses or others in the health care system. They're just people who are potentially patients, or who are patients who have to deal with doctors and nurses and with the hospital system. They are very concerned about what is happening with Bill 71.
The very significant point that other members have made and that I am now making here is that this bill should not be rammed through without proper thought and deliberation. Many ministers, when they have stood up on first reading to introduce a bill, have said "housekeeping." Obviously this bill, which has 52 sections, is not housekeeping. I'm sure the minister would not even suggest that it is, and no one else would.
There is no reason whatsoever to rush this through other than the seeming haste of the government to try and cap doctors' salaries, to impose other viewpoints on the practitioners and others in the system which have not been properly thought out -- lack of consultation, lack of due thought and, I would suggest also, lack of due process. I think that the government, as it is dealing with the very significant changes to health delivery, owes it to all the participants, those within the process and all British Columbians, to properly deliberate and discuss such a significant bill as Bill 71. That is not happening. Obviously it's not happening when a
fairly harmless suggestion of referring this to committee was not acceptable to the government.
I dread to think that presumably the government is not going to accept this amendment either. I guess that's a given, but that doesn't mean that we're going to step aside, as the government would like, and allow this bill to go through. I guess that's the game plan of the government: they were hoping that the opposition would cave in, recognize that summer is underway.... Certainly anyone who had the chance to go out and do their shopping on the steps knows how nice a day it is. But that's not the point. The point is that we are here. We are doing our job in opposition. We are pointing out the very critical nature and content of this bill and the very critical feature of rushing this through without due process and due discussion. We're going to continue on that vein. It is very important that all members give very serious thought to the implications of this bill.
In this same connection, it is interesting when you think of the vast quantity of reviews, commissions, studies and committees that the government has created in many other aspects, but they are not prepared to submit this probably most significant of all pieces of legislation to a review.
We in opposition are not happy with all the reviews, and we've said so many times. They're just another job creation for the friends and neighbors of the government. But I would suggest that if there was to be any review conducted whatsoever, it should be of the health system. It would be very appropriate that if Bill 71 cannot be referred to committee for that sort of approach, then at least we be prepared to put it aside for a while so that all constituent elements, both those involved in the health delivery system and those outside of the system, have an opportunity for further consultation and examination.
Perhaps the government would like to at least entertain the thought that a review of the health system, using Bill 71 as the vehicle, might be appropriate. I suppose I shouldn't raise that suggestion, however, because if it were to be implemented it would no doubt give rise to more appointments of people who perhaps are a little too close to the government in power for anyone's liking. However, that is neither here nor there with respect to the particular amendment that we are speaking to today. This bill, without question, should be delayed. It think it's very important that all members of the House are prepared to give very serious thought to the implications of putting this bill through in its current form.
I would also like to make some other points. Other members have referred to the numerous letters they've received. I have some letters here. I'm not going to read any of those into the record. I think we certainly know the content of all of the letters received from doctors. But I would also point out that it's not just doctors who have corresponded with us, and I'm sure the government side as well. We've had numerous phone calls, personal meetings, things of that nature that have gone on in a very continuous nature dealing with Bill 71. I would also add, hon. Speaker, prior to Bill 71 being introduced just last week, we had Bills 13 and 14. They generated the same volume of concern, the same depth of correspondence through letters, phone calls and personal meetings. The way I see it, the government attempted to introduce some significant changes through Bills 13 and 14. They got a massive amount of reaction and criticism, so now they've withdrawn those from debate and come in with something that is probably even more significant in the nature of Bill 71.
It is certainly not the way to cure the problem to say that Bills 13 and 14 weren't palatable and would not be acceptable to the medical profession and others, so let's try this approach. Certainly the message is very clear, from the numerous letters, phone calls, etc., which we and others have received, that this bill is not acceptable, just as Bills 13 and 14 were not. I think it's very important for the government side to recognize that the correspondence that we have received, and they as well, is not just from people who had nothing better to do for five minutes and thought they would write or make a phone call. These are people who are involved in the system and know full well the very serious implications of Bill 71.
I would point out that it's not just doctors complaining about the possibility of their salaries being capped. Sure, that is a concern for some, but doctors are professional people. Doctors wish to get on with the practice of medicine, not get involved in political wrangles, not get involved in fights and endless discussion that is really not very productive for them or their patients. That is not the nature of doctors. People in other walks of life, in other professions, of course, do incline to be more political or get worked up about issues. Certainly the doctors I've known over the years for the most part tend not to be political creatures. There are a few exceptions, of course, but for the most part doctors wish to get on with the practice of medicine and assisting their patients.
Now what do we have? We don't have doctors being involved in the profession of medicine. We have doctors getting more and more involved in the whole political implications of things such as Bill 71. I don't think that's a terribly useful thing either for the doctors or for the people of this province. If the number of letters and phone calls that have been received by my office and every other member in the opposition are any indication, and they are of the serious nature on the implications of Bill 71, I think that should, if nothing else, give full support for the reason why we wish this bill not be rushed through the House now but be delayed -- and not just delay for delay's sake. That is not the exercise at all. In fact, that's the last thing that we wish. We wish it delayed because of the very serious nature of this bill and what it's going to do to the health system in British Columbia.
Hon. Speaker, I wish as well to make one other point. I was probably more inclined to bring this issue up in the estimates debates on the Health ministry, but I think it's appropriate to make reference to it now. I did allude to it when I made comments on the main motion on this bill two days ago. I referred then to a conversation that my wife and I had with a doctor back in October of last year. The doctor -- and I won't name him personally -- is a neurosurgeon and well respected throughout British Columbia. The comments that he in particular
[ Page 2999 ]
made to my wife and I were that they were concerned, back in October, about the implications of what the new government -- as, of course, it was only four days old then -- would be doing with regard to the health system and health care delivery. Perhaps he had a crystal ball, I don't know, but even four days after the election this doctor was raising very serious concerns about what may happen with the health system in British Columbia.
As a follow-up to that conversation I had with the doctor back in October, he just recently advised me that two of the three neurosurgeons in Lions Gate Hospital, the particular hospital where I had this conversation, have now indicated that they are leaving British Columbia to practise medicine in the United States. They are not headed, as the Minister of Advanced Education stated two days ago, to California for the sunny beaches. One doctor is headed to New York and the other to the state of Iowa, so I don't think that the doctors have necessarily picked out the happiest places in the United States to practise medicine. The point is that those two neurosurgeons are prepared, after practising medicine for many years in British Columbia, to make sacrifices and leave not just the province but the country. I think that's a sad commentary: bills such as Bill 71 are giving the medical practitioners even the thought of leaving this province and this country.
I suppose you could describe that as a true brain drain. We've talked for many, many years in British Columbia about the brain drain to the south. Here you have a classic example of it. These doctors have not given this consideration to moving just a momentary thought. This is obviously something they've had to struggle with for a long time. I think it's very unfortunate that we are losing such qualified practitioners, particularly in the specialty areas such as neurosurgery, because of things such as Bill 71.
In the comments that these doctors made to me, they are concerned about the capping of salaries. They are concerned about that because of the denial of medical service that is built into it. They are also concerned about other implications in this proposed legislation. So it is not just a monetary issue. It's the question of wait-lists at hospitals, doctors not getting sufficient operating time, and their patients, as we well know through other examples, having to go south of the border for medical attention -- things of that nature. It's an ongoing process. Now we have an example -- and I'm sure there are many, many others from other hospitals throughout British Columbia -- of doctors who are prepared to make personal and professional sacrifices leaving this province and this country to carry on the practice of medicine elsewhere. If that's what the minister wishes through Bill 71, that's what is happening. I would hope that the government is certainly not intending that as a consequence of introducing this bill before the House.
[1:00]
So there are some other concerns, hon. Speaker, about this legislation. I hope that the government will give very serious thought to the amendment before the House now, and that the bill will not be passed at this time, but be allowed to sit on the order paper for six months. This bill needs more consultation and dialogue. This is not just a simple housekeeping piece of legislation, as many other bills before us are.
The opposition, in other bills, has been prepared to stand and criticize where warranted. I can assure you, hon. Speaker, that the opposition is certainly going to give more and more criticism on this bill. As I said earlier, I think it is probably the most significant piece of legislation that has been introduced in this session, and we all must be prepared to stand up and make the comments that have to be made so that this bill is delayed in its passage, or at least that all of us will have the opportunity -- both in second reading and committee stage -- to point out the areas where this bill is in need of improvement or further consultation.
There are probably other remarks that could be read into the record. I have indicated, for example, that I am in possession -- as many others are -- of letters from doctors and others. But I don't think it's necessary to provide those details at this time. Other members have read in such comments, and perhaps others will do so as this debate continues. But I would urge this government to give very serious consideration to the implications of trying to ram this bill through the House before we adjourn for the summer, whenever that may be.
I would add that, even though the government feels that summer started on Father's Day -- and I guess it did last Sunday -- summer for the official opposition has not yet started. We are here to do our duty in opposition, and this bill certainly has to be given very serious consideration before it is passed. Hopefully it will not be passed in this session.
P. Dueck: Hon. Speaker, I would like to join this side in asking the minister to hoist or postpone this particular bill for the time being, because I think it is an error to push this bill through at this time. I think there are many.... Excuse me, hon. Speaker, I feel somewhat better. I didn't go to a physician yesterday, because I didn't want to put any pressure on the system.
When this bill was brought forward, to begin with I felt that perhaps there was a reason for bringing it forward and that it was somewhat cowardly. I thought it was there to scare the physicians and that right at the last moment they would postpone it. That was my feeling. As a matter of fact, I told many of my doctor friends.... I have many of them, and they're all good people, although I must say that many of them before the election were no longer with our party. They were with a party that was going to give them everything they wanted, and they are now tremendously disappointed that this government has....
Deputy Speaker: Hon. member, that's most interesting, but I think you should relate to the amendment before us at this time.
P. Dueck: The problem is that when you speak on the hoist motion you've got to say more than just: "I support the bill being postponed." It doesn't mean much unless you give reasons why and you add a little colour to it, so I thought I would do that.
[ Page 3000 ]
I really thought that it was being held over because of the pending legislation -- Bill 13 and Bill 14 -- that was dropped: "We'll put another one in, and surely by this time it will be accepted." But you know, the doctors in the province -- this is by far the majority -- are absolutely, fundamentally opposed to having a bill shoved through without enough discussion to reach an agreement. We've had caps on spending for many years, since 1986 -- ever since I was Minister of Health -- but you must remember that the cap was always agreed to by the parties -- not always willingly. As a matter of fact, I think that in most cases it was quite strenuously objected to by both sides, and generally that makes a good agreement. But by the time it came to the House, it was agreed upon, and that's when the agreement was in fact entered into.
There's another question that I was going to ask the minister, but perhaps it will come up in the estimates, although I can't say at this time. I thought the agreement also had a clause whereby if another agreement is not struck and signed, the old agreement holds until a new agreement is entered into. If that is the case, then certainly there's no rush to put this bill through. I'd have to check my records to be absolutely sure.
When we talk about the health care system, about this bill and about restricting doctors from overspending, I think we're hitting the wrong people, because it's the consumer who pushes up the costs. Can you imagine being a doctor and saying to a patient who comes into the office: "I'm sorry, but I don't think I should look after you, because it's costing the system too much. Maybe you should come back next month or the month after that"? Of course not. When people go to the doctor's office, if that physician will not look after them, they will go next door to the next physician. These people are all in the business of making money. So when you bash the doctors and say: "This is what you must do...." I know that there has to be discipline on the doctors' side too.
There are other options, and I'd like to speak to those during the estimates. I'll just say there are other options that I think work well, and I think that the public, the physicians and the consumers would accept them; and the politicians would be only too happy, and would be wise, to go in that direction, rather than putting through something that is, at best, a short-term solution.
When we talk about this bill and about forcing it through at the end, at the sunset of our sitting.... I think it is; at least I hope it is. I have some tennis to play and a swimming pool to enjoy. So I don't want to be here all summer with you people, especially looking across the way here to the other side. It is not my style to criticize without offering some solutions, and I have some solutions, which I'll bring to the estimates. But for goodness' sake, let's not push this bill through at the expense of bashing the doctors. That's all we're doing. We're saying: "You didn't sign the agreement. We'll fix you. We'll put this bill through, and no matter what happens, you're stuck." And we can do that, because the government has the power; they have a majority. But when you have that power and that majority, you have to act very responsibly, because with power also comes responsibility. I would urge the minister to take another look. Please prove me correct: you did this only to threaten the doctors, and you'll back off at the last minute.
A. Cowie: It's a privilege to stand and support the amendment put forward to the bill and especially to follow the hon. member for Matsqui, who was a very good Health minister in his time. I'm that sure this Health minister can be a really good health minister too, if she just listens to what we have to say.
I will be voting in favour of the amendment, as I said. It is ludicrous for this Legislature to be asked to review 40 pages of legislation and ram it through in just a very short week or so. The official opposition has a responsibility to protect British Columbians and ensure that legislation is properly drafted so that it fulfils the intent of the legislation. I have grave concerns that because of the zeal of this government to get this issue out of the public arena so quickly, it will not be dealt with properly, and British Columbians will not know what the legislation is all about.
Liberals are proud of medicare and support it fully. The medicare act, as you know, was brought in by the Liberals. The Liberal health act was brought in through a Liberal government. The Liberals stand for medical care, and that's exactly why we're opposed to Bill 71 being rammed through this House. Changes to medical care should be studied carefully and thoroughly. That's why I urge members to support this amendment.
Let me give you some of my reasons for being concerned. Bill 71 pays lip service to the Canada Health Act, but totally negates two of the five basic principles. I am referring, of course, to the principles of accessibility and universality. Bill 71 violates these basic tenets of the Canada Health Act. Members of the House are at this point likely to say: surely that can't be so. It is so.
Let me explain more fully to the House how the NDP government of this province pays lip service to accessibility and universality. Let me deal with universality first. This government has condemned the Medical Services Plan premiums. That is a noble virtue, provided they have a means of raising some $800 million or more. That is a serious flaw in the legislation. The NDP wishes to perpetrate a situation where some 60,000 people in this province are not covered, either because they've lost their jobs or their employer does not have adequate coverage. Does this happen anywhere else in Canada? No -- nowhere else except British Columbia. This is a clear violation of the Canada Health Act. It is being flagrantly perpetrated by the NDP government, which says it supports the unemployed and the disadvantaged citizens of this province. The fact that this government would even consider perpetrating this situation is a disgrace to all caring British Columbians.
It is important that the House be allowed the time to thoroughly understand this legislation. It should not be rammed through. It has to be considered properly. A piece of legislation of this importance deserves the opportunity for public review and comment. I recall the cries of the NDP when they were in opposition. I recall the promises made that this legislation would be
[ Page 3001 ]
referred to standing committees -- they won't even consider that at this time -- and that the public would be afforded the opportunity to testify. What hollow words! It's just another broken promise. We've had so many during this legislation.
The other principle of the Canada Health Act which is not upheld in Bill 71 is accessibility. Hon. Speaker, allow me to read sections of 12(1)(c) and 12(2) of the Canada Health Act: "12(1)(c). The Government must provide for reasonable compensation for all insured health services rendered by medical practitioners or dentists." Further: "12(2). Paragraph 12(1)(c) shall be deemed to be complied with if the province has chosen to enter into, and has entered into, an agreement...." Well, we have no agreement at this time. The doctors at the present time are working purely on government edict. This agreement must include "negotiations relating to compensation for insured health services...for the settlement of disputes relating to compensation through conciliation or binding arbitration...." This legislation doesn't allow for that. And "a binding decision may not be altered except by an Act" in this Legislature.
[1:15]
In the interests of public good, it is imperative that this bill include specific sections recognizing doctors' rights to negotiate in good faith. It's something that every supporter of the NDP takes for granted, that every supporter of the NDP expects and that every supporter of the NDP has theoretically, under legislation.... What does this government have against doctors? Is it in the public interest that doctors be forced to leave medicare in order to protect their rights? Or to leave medical care by using their feet and leaving the province? What will be served? Absolutely nothing. In fact, great harm will be upon the innocent British Columbians who need good medical care.
It is the ideology more than anything that upsets me about this government. They want to force this legislation on the doctors. In the public interest I must again ask that Bill 71, as it has been drafted, receive a clear no. I know how angry doctors can get; my father was a doctor. I know how many angry doctors there are in my riding. All of my cohorts here in the Liberal opposition say the same thing: there are many doctors in their ridings who are terribly upset. I'm amazed at the control they have.
Allow me to read from several letters I have received in the last day or so from doctors in Vancouver; these are some of many hundreds. Not wishing to take advantage.... It just so happens these doctors have offices in the hon. Deputy Speaker's riding. I know he can't speak for them, so I'll read a couple of paragraphs from them. They're long letters, but I will deal only with some of what they have to say. This is from Dr. Christopher Thompson, a doctor with an office on Burrard Street. He says:
"I would like to describe the potential impact of Bill 71 on me personally, on the relationship between doctors and government, and finally, on patient care in British Columbia. The order reflects the chain of events which will follow passage of Bill 71, not the order of importance....
"I chose to apply to medical school in 1971."
That is not that long ago. He is not one of the older doctors.
"At that time a number of options were open to me, and many people, including several doctors, suggested that I should choose a career other than medicine."
N. Lortie: Point of order. I would point out to the hon. Speaker that we are debating the amendment, the hoist motion from the opposition side. These letters clearly aren't addressing the issue that we should be debating now. The whole speech by the hon. member across the floor has been focused on the bill. Could we get on with debating the hoist motion. If they are finished talking about it, perhaps we should vote on it, and then we'll get back to debating Bill 71.
L. Fox: While I respect the intent of the previous point of order, I believe it is extremely necessary, if the opposition is going to explain the rationale for delay, that it be allowed to explain some of the concerns of the medical profession that necessitates that delay.
Deputy Speaker: It should be pointed out that there has been some latitude given in explaining the reasons for the six months' hoist. With that, the Chair has recognized the necessity for some scope. Would the member please continue.
[The Speaker in the chair.]
A. Cowie: Thank you, hon. Speaker, for understanding that. Some members don't want to have the information put forward. I understand that too. They don't want to understand.
I will not read the whole letter. I'll read only one paragraph for the member's benefit. I don't want him to fall asleep back there. This is the doctor speaking:
"I have detailed my training" -- unfortunately the member misses all that detail -- "to attempt to give you an idea of my commitment to medicine. I was willing to spend that time, time when my children were growing up, in order to develop the skills necessary to make an important contribution to a health care delivery in British Columbia. I believed -- wrongly, it appears -- that this contribution would be valued by the society."
Actually, I think it is valued by the society; it's just not valued by this NDP government.
"Bill 71 sends me a very clear message. Bill 71 tells me that the government of British Columbia believes that doctors are on par with criminals."
That's rather severe, but that's what the doctor says.
"Every group that I know of in this society, other than criminals, has the right to negotiate its conditions of work and its remuneration. Every other group can go to the negotiating table and bargain. They may win some points and lose other points, but they bargain. Sometimes bargaining fails, and the parties then go on to mediation and arbitration to achieve a solution. The minister says that will not be the way in British Columbia after Bill 71.
"Bill 71 makes no provision for negotiation between the BCMA and government. Fees will be set by the commission, if there is a commission, or by the chair if there is no commission, or by a subcommittee or an appointee of the commission...."
The doctors are clearly not happy about this situation.
I have to also remind the government that if they have no other reason than pure politics, they should listen to the doctors. A doctor talks to every citizen in this province at least once a year. I think they would want those doctors to feel good about this government, but I assure you that they seem to have cut that off. I simply believe that the doctors will talk to their patients and express their feelings about this government. It's very shortsighted on the part of government. For no other reason, they should give the doctors more time to negotiate their conditions.
There is another doctor, Dr. Rae, who is also on Burrard Street. I'll only read one paragraph of this doctor's letter:
"The ceiling placed on the health care budget by the NDP government at this time will result in a projected $60 million shortfall. This shortfall can either be borne by the physicians of this province, by these individuals to work for no remuneration, or physicians will be cut back on the hours and services...."
What the doctor is essentially talking about here is that the health care system will suffer if we bring in Bill 71. That's the point he's getting across. He foresees a reduction in the utilization of diagnostic and laboratory facilities, and he sees the doctors purely acting as a gateway, using government policy. The heart and soul will be taken away from the doctors. That's what they're so greatly concerned about.
His last paragraph will be my last to read: "There is no need to rush through a carefully considered but ill-conceived piece of legislation...." In other words, they want to discuss the legislation. They want to negotiate, and then they'll cooperate fully.
In closing, this House must serve British Columbians responsibly. It is our duty to ensure that medicare in British Columbia continues to be one of the highest-quality care systems in the world. We must stand back from the politics of Bill 71 and review it in the calmness that we can achieve only by sending it to committee or giving it more time, as suggested in the amendment.
I will be voting in favour of the amendment.
F. Gingell: I am disappointed that I have to rise in this chamber today to speak to this amendment. The amendment that was put forward yesterday to have this bill -- the ramifications of it and the concerns that it brings into the minds of medical practitioners, beneficiaries and members of this Legislature -- sent to a standing committee with the word "Health" right in its title was to me clearly an appropriate, proper approach for this Legislature to take. Having to deal with the fact that the amendment was defeated, I would now like to speak to this amendment, which proposes a hoist of this legislation for a period of six months.
Why should we hoist this legislation for six months? What is the purpose? I can assure you that it is not for the purpose of delaying this process and frustrating the government. The intention and purpose is to delay the legislation so it can be considered and thought about. The government can receive the submissions, suggestions, proposals, thoughts and concerns of British Columbians, so that when it comes back in six months' time it is better legislation and better understood. More importantly, exactly as the member for Port Moody-Burnaby Mountain said, as did the Minister of Advanced Education, changes cause concerns. They cause fears and reactions. But it is terribly important when we're dealing with a subject that is so close to our heart, that is the largest single item in our provincial budget that we deal with it carefully and slowly so that people can properly understand the consequences.
I also have concerns, from listening to members of the government speak on this act, that perhaps they don't have all of the facts. Perhaps they are using some incorrect statistics. I heard the Minister of Government Services speaking either to the amendment or to the original bill the other day saying that, in her opinion, there were more doctors per capita in British Columbia than in almost any other province of Canada, and we were above the average. Well, you can make statistics do anything you want them to do on occasion...
Interjection.
F. Gingell: ...even when you come from a background such as mine.
Hon. Speaker, I just wanted to point out to you, if I may, this error that the Minister of Government Services made in the discussion, purely and simply to try to impress upon members of this Legislature that even members of the cabinet don't necessarily have all of the facts clearly understood and at their fingertips, and that that makes it very important for this bill to be set to one side for six months so that people can understand these things.
[1:30]
The question was: how many practitioners are there per capita in British Columbia in relation to the rest of Canada? A very important study, which I'm sure the government has used, has been done by the federal-provincial working group on medical care statistics: "Full-time-equivalent Physicians: Interprovincial Comparisons." Representing this province, I'm really pleased to say, was Dr. Morris Barer from UBC, a very renowned and highly respected physician. You can just take the statistics that this report produces on the face of it. On the face of it, it says that for every 100,000 population, British Columbia has 114.7 general practitioners, compared to a Canadian average of 101.56.
We have to recognize, particularly in an environment like British Columbia where people come to retire, where the weather is warmer in the summer and the winters are far less severe, that many doctors continue to practise as they get older. They tend to spend a little less time, they play a little more golf.... Instead of finishing their practice in Ontario or Nova Scotia and retiring to Florida or to British Columbia.... If you practise medicine in British Columbia to start with, you don't need to retire anywhere: you are already in Canada's retirement haven.
When you look at the number of full-time-equivalents -- the real count -- taking into account those practitioners who bill insignificant amounts every year compared to full-time ones, and you relate the total number of practitioners to the full-time-equivalents, we find that British Columbia has 85.63, compared to a
[ Page 3003 ]
Canadian average of 84.89. Yes, it is fractionally over; it is over by of 1 percent. I'm sure you will agree that that is not a significant difference. The government, in looking at this kind of legislation and having as one of their premises that B.C. is oversupplied with general practitioners.... That simply isn't true; that simply is not what the statistics say.
The second question, having dealt with the question of GPs and why it is so important for this bill to be hoisted for six months so that members of our government can have the time that is necessary for them to understand these statistics properly, deals with specialists. This very important provincial-federal working group, which I'm sure nobody questions, is current. I'm sure it is the information that the provincial government and the Minister of Education used to arrive at the reasons why they were going to move forward with this bill.
In dealing with specialists, British Columbia was fractionally above. There were 75.74 specialists for every 100,000 of the population, with a Canada average of 74.10. So that says that B.C. is right on the average. But the truth of the matter is that when you again take the full time equivalents -- the people who are actually working, not just those who are registered and doing a little work here and a little work there -- and actually condense all of the 2,323 physicians to how many are actually working full-time, the number in British Columbia comes down to 62.75, compared to a Canadian average of 71.26. Clearly the argument that was made by the Minister of Government Services the other day that British Columbia has too many doctors, which she gave as one of the reasons why this bill is so important and has to be dealt with -- "we've got too many doctors" -- simply isn't statistically true. It simply isn't true.
What other reasons are there to cause the concerns that are in our minds that cause us to call for this government to hoist this legislation for six months to allow people to understand it better, and to make representations to this honest, open and consultative government? Well, one can take a particular issue like section 4(1)(c), which deals with an important question. It is worded: "...determine the services rendered by an enrolled medical practitioner, or performed in an approved diagnostic facility, that are not benefits under this Act." That is called, in other words, deinsuring, so clearly deinsurance is an option that this government is considering. It is an option that is very clearly included in this act as one of the options available. I'm not suggesting for one moment that it shouldn't be there -- not at all. But let the people of British Columbia understand that. There has been no question of public consultation on this terribly important issue.
We all know that there has been this work done in the state of Oregon. I'm sure the government of the province of British Columbia isn't planning on just taking the Oregon plan and enforcing it on British Columbians. I'm sure that if this is an option that this bill is going to give the authority to bring into play, there has to be proper consultation. The Canada Health Act, which is referred to under section 4(2), which says: "The commission must not act under subsection (1)" -- the section that I just discussed, which is so important to have a clear understanding of, and that's why we believe that the bill should be hoisted for six months.... It says that they may not act in a manner that does not satisfy the criteria described in section 7 of the Canada Health Act. Now the Canada Health Act is a very complex document and is interpreted by different people in different fashions. You can very easily argue the position that the Canada Health Act requirements forbid deinsurance. You can also interpret it in a much looser fashion -- as done by provincial governments looking for means of dealing with runaway health costs, if that is the way they happen to be describing them -- that deinsurance is permitted.
Well, hon. Speaker, we haven't had any statement from this government on whether they believe that deinsurance is permitted. Or have we? Yes, we have. If they didn't believe that deinsurance was permitted, they would not have put into this act section 4(1)(c).
It is irresponsible to put that in without having first -- not afterwards, but first -- gone through the process of consultation: consultation with beneficiaries, not just doctors. That's why this six-month hoist is so important. It will give them time to go through a consultative process, or at least get it started, so that the people of British Columbia, who are so concerned about this act, will have a clear understanding of what their intentions are under 4(1)(c).
There is another section of the act that I would like to mention, because again it clearly requires a period of time for the provincial government to inform the people of British Columbia and the doctors what their intention is. It's all very well to create permissive legislation and tell us: "Do not worry. Don't be scared. Don't fret yourselves about this. Trust us. We won't do something that is inappropriate." But once you put in the permissive legislation, there needs to be a clear delineation of how the government intends to use it.
I refer at this point to section 32(1)(e), which requires a practitioner or an owner of a diagnostic facility or a representative of a professional corporation.... Those are just words to make sure that doctors practising or people with diagnostic facilities practising through a corporation, perhaps for the purpose of avoiding some income taxes, are not missed by the requirements of this section. They can be told that they have to adopt an appropriate pattern of practice as specified by the commission in the order. This new commission can go and tell doctors and the operators of diagnostic facilities, whether they be incorporated or practising as individuals or as partners, the pattern and the manner in which they practise their profession.
I certainly think the bill should be hoisted for six months. I certainly do believe that it is critically important for the beneficiaries of health care in British Columbia and for medical practitioners to clearly understand the intention of sections 37 and 32(1)(e). You can't just be in there and not worry about it because we will deal with it later. It has to be dealt with now.
I would just like to press the position that it is important for this bill to be hoisted for six months so that it can be considered in greater detail, and that both beneficiaries and practitioners can make representa-
[ Page 3004 ]
tions to their legislators. I wish to read into the record some very brief references from medical practitioners, who seem to have been left out of the picture in this particular issue. I say that because they happen, as in this particular case, to live in a riding that is not represented by a member on this side of the House. So however often and however consciously, with all the right intentions, they have written to their own MLAs, their voice has clearly been silenced in this House.
[1:45]
I believe it is important that this particular medical practitioner, who happens to live in and practise his profession in Prince Rupert -- I see that it is a corporation, so he will be caught very clearly under section 32(1)(e) -- writes: "Attempts at getting the Minister of Health to negotiate in good faith have not been successful...." That's a very clear, unequivocal message. The Minister of Health, as we heard yesterday and the day before, will argue about that. But a negotiation takes two parties. There have to be two people negotiating, and both of them have to feel and believe that a negotiation was taking place. Obviously, in the negotiation that the minister referred to yesterday in this debate and in the debate on the amendment, she may feel that a negotiation has taken place. But I can assure you that the doctors do not.
This particular doctor from Prince Rupert goes on to say: "...and it seems to be more intent" -- that is, the government -- "on setting its own preconceived health care agenda than in negotiating with the doctors of this province." If this bill is hoisted for six months, this doctor in Prince Rupert will have the opportunity to make his thoughts known. I am sure that this letter has been sent to his MLA, but we appreciate that the member has been very busy with other matters and hasn't been able to bring up the concerns of this particular doctor in his constituency.
The Minister of Health is also very intent on hurriedly pushing through legislation that will radically change the Medical Services Plan Act without much debate from the pubic or the doctors of this province. I feel, however, that the changes proposed in the Medical and Health Care Services Act are of such importance that consideration for enactment of the act should be postponed until such changes are fully discussed with the doctors and other health groups and it is fully debated in the Legislature. We are having to turn the debate in the Legislature into a plea for more time so that we can ensure that the medical practitioners and the beneficiaries of the British Columbia health care scheme, who sincerely believe that they have been left out of the process, have their opportunity to be heard if their pleas to their members fall on deaf ears and are not represented.
This particular doctor from Prince Rupert goes on to say:
"...we have a health care system which is considered one of the best in the world. I do realize that changes, even in the best of systems, are necessary, but I also feel that such changes should not be driven by cost alone. Of more importance is the effect of the changes on the patients and the health care givers -- in this case, the doctors. One would expect negatives, but there should also be benefits to both. The changes proposed in Bill 71 do not seem to allow such benefits but rather favour inconveniencing the public in general, demoralizing the doctors and injuring our much-envied health care system."
This need not happen if the government will agree to hoist this act for six months. Even if not to the select standing committee on health and social services, which I personally think would have been a much improved proposal, then they should at least go along with this.
I would like to just deal with one more letter, if I may.
Interjection.
F. Gingell: Yes, don't worry about it; just one more.
This particular doctor is represented by the member for Vancouver-Burrard. This practitioner is the one who brought up the subject that I dealt with a little earlier in my talk today, section 32(e). He says:
"Section 32(e) requires a practitioner to adopt an appropriate pattern of practice as specified by the commission in the order. Does this mean that the commission now has the power to tell a physician how to practice medicine? Will the commission be telling physicians which patients may be operated on, which may receive dialysis treatment, which diseases should be left to run their natural course without any intervention whatsoever? Is there to be no money spent on trying to find a cure for AIDS or trying to ensure that people with terminal disease are given every chance for survival before the inevitable takes place?
"I believe that this approach to the medical profession denies us the ability to strive for the very things that are the cornerstone of our professional existence. All physicians, by their nature and training, try to alleviate suffering and treat disease. If we first have to worry about the Medical Services Commission looking over our shoulders, patients will have no confidence in physicians, and physicians will no longer be able to provide the standard of care and caring that they formerly did."
Hon. Speaker, these are really serious and important concerns. The only way that they are going to be dealt with in a sensible and rational manner is for this bill to be hoisted. We have to hoist this bill and give everybody the opportunity to completely consider what it means. It's a complex and important piece of legislation. As this doctor from Vancouver-Burrard -- another of our poor, silent doctors who are unable to get their position made public in this House except through members of the opposition -- goes on to say:
"There is no need to rush through a carefully considered but ill-conceived piece of legislation when it is going to affect the whole tenor of provision of medical and health care in the province of British Columbia. Surely effective consultation with the parties affected needs to be undertaken before this bill becomes law. Political posturing is not a rational basis for rushing through new legislation.
"If there is to be a new Medical and Health Care Services Act that changes the way health care is delivered in this province, now is the time to seek negotiation with physicians and other health care professionals to ensure that the best legislation is introduced that will continue to entrench in British
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Columbia one of the finest health care systems in the world. To do anything else will result in a destructive confrontation between those directing health care and those delivering health care. This can only work against the aim of providing first-class care within a reasonable budget."
I could not have written those words myself. That is extremely well put. The whole question that we are dealing with is condensed into the real issues. I really do ask the members of this Legislature to consider how we can make the best of this particular situation. It clearly is number one to hoist this bill for at least six months.
Yesterday I spoke....
The Speaker: I regret, hon. member, that your time has expired.
M. Lord: I ask leave to break into this scintillating debate to make an introduction.
Leave granted.
M. Lord: In the gallery visiting with us today we have five British Columbians who have travelled down from the Cariboo to meet this morning with the government caucus social development committee. They are from the IWA Local 425: Wade Fisher and Bill Derbyshire from the Save Our Jobs Committee in the Cariboo, Mitch VanDale and Charlie Wyse from the city of Williams Lake -- he's a councillor there. I bid the House to please make them welcome.
Hon. G. Clark: I am delighted to take my place in this debate, and I look forward to debating it more fully in a few hours. At this time I move adjournment of the debate until the next sitting.
Motion approved.
Hon. G. Clark moved adjournment of the House.
Motion approved.
The House adjourned at 1:56 p.m.
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