1979 Legislative Session: ist Session, 32nd Parliament
The following electronic version is for informational purposes only.
The printed version remains the official version.
THURSDAY, JULY 19, 1979
[ Page 859 ]
Fisheries Act Amendment Act –– 1979 (Bill M 208). Mr. Howard.
Introduction and first reading –– 859
University of Victoria Foundation Act, 1979 (Bill M 209). Mr. Smith.
Introduction and first reading –– 859
Late tax payments by forest companies. Mr. Leggatt –– 859
Legislative Assembly brochure. Mr. Barnes –– 860
Dismissal of Margaret Caldwell. Ms. Sanford –– 860
Hat Creek development. Mr. Macdonald –– 860
Alleged manipulation of tomato market. Mr. Stupich –– 861
Arnett appointment. Ms. Brown –– 861
Miscellaneous Statutes Amendment Act, 1979 (Bill 30). Hon. Mr. Gardom.
Introduction and first reading –– 861
Committee of Supply: Ministry of Health estimates.
On vote 128 amendment.
Mr. Howard –– 862
Hon. Mr. McClelland –– 863
Division on the amendment –– 863
On vote 128.
Mr. Gabelmann –– 864
Hon. Mr. McClelland –– 864
Mr. Stupich –– 866
Ms. Brown –– 867
Hon. Mr. McClelland –– 870
Mr. Hanson –– 871
Hon. Mr. McClelland –– 872
Mr. Levi –– 872
Hon. Mr. McClelland –– 872
Mr. Cocke –– 873
On vote 133.
Mr. Cocke –– 873
On vote 135.
Mr. Cocke –– 873
On vote 137.
Mr. Barnes –– 873
Hon. Mr. McClelland –– 873
Ms. Brown –– 874
Hon. Mr. McClelland –– 874
Mr. Levi –– 876
Hon. Mr. McClelland –– 876
Mr. Cocke –– 876
Hon. Mr. McClelland –– 877
Mrs. Dailly –– 877
Hon. Mr. McClelland –– 877
Mr. Lockstead –– 878
Hon. Mr. McClelland –– 878
Mr. Cocke –– 878
Mrs, Wallace .. 878
Mr. Levi –– 878
Hon. Mr. McClelland –– 879
On vote 138.
Mr. Levi –– 879
Hon. Mr. McClelland –– 879
On vote 139.
Mr. Levi –– 879
Hon. Mr. McClelland –– 879
Committee of Supply: Ministry of Human Resources estimates. On vote 140.
Hon. Mrs. McCarthy –– 880
THURSDAY, JULY 19, 1979
The House met at 2 p.m.
MR. BARNES: Mr. James Moore and Mrs. Donna Moore, along with Judge Donald Ashmanskas, from the Portland, Oregon, area are visiting with us in the members' gallery. Mr. Moore, a lawyer, and his wife Donna arrived in Victoria by private boat on this, their first trip to Victoria. As an aside, Mr. Speaker, I would say that Mrs. Moore is the former Donna Blum, of late 1940s Jefferson High School, Portland, Oregon, of cheerleader fame. I note she is still looking as sharp today as she did in the days of old when Jefferson High athletic teams were matching that sharpness.
MR, BARNES: I wouldn't have been associated with that, but perhaps I was. It's been a long time.
Mr. Speaker, I would like to ask the Assembly today to join me in welcoming these visitors. I hope their visit will be fruitful.
MR. REE: We have seven people visiting us this afternoon from Vancouver. They are supporting the proposal for the downtown stadium. Would the House welcome Frank Rigney, Gordon Campbell, Martin Zlotnik, Allen Achilles, Hector McDonald, Randy Iredale and Judith Gelber.
MRS. WALLACE: This seems to be my week for visitors. We have in the gallery today a long-time friend of mine. When she and I were young women, more years ago than I care to think about, we both worked in these precincts. She went on to become the provincial secretary of the New Democratic Party. I would like the House to join me in welcoming Jessie Mendel, who is visiting from Vancouver.
I have the honour of having a grand-daughter, Carrie Long, visiting from Revelstoke, together with her friend Carolyn Gibbons; and all the way from Tamworth, Ontario, another young friend, Miss Tammy Dickeson. I ask the House to join me in welcoming them.
MR. RITCHIE: It's my pleasure today to introduce to the House a lady in the Speaker's gallery, Mrs. Edna McKay. She is the wife of one of our outstanding newsmen from Chilliwack.
MR. LEA: I'd like to welcome a supporter of the New Democratic Party in Prince Rupert, Brenda Gardiner, who is visiting our gallery today to watch the proceedings.
MR. HANSON: I would like the House to join me in welcoming the parents of one of my constituents, David Reilly, who is a very active community organizer here in Victoria. His parents, Mac and Megan Reilly, are here visiting from Vancouver. Would you please join me in welcoming them.
HON. MR. HEWITT: Mr. Speaker, I'd like to introduce Mr. Bruce Daniels from the city of Penticton in the riding of Boundary-Similkameen, along with his guests, Ann Buus, Eilaine Dixon, Sherril Dixon and Marjory Podd. I'd ask the House to bid them welcome.
Introduction of Bills
FISHERIES ACT AMENDMENT ACT, 1979
On a motion by Mr. Howard, Bill M 208, Fisheries Act Amendment Act, 1979, introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today.
UNIVERSITY OF VICTORIA
FOUNDATION ACT, 1979
On a motion by Mr. Smith, Bill M 209, University of Victoria Foundation Act, 1979, introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today.
LATE TAX PAYMENTS
BY FOREST COMPANIES
MR, LEGGATT: My question is directed to the Minister of Finance; it concerns the report of the auditor-general in which is noted the failure to bill some $43 million to the forest industry in the fiscal year 1978. She pointed out that the loss of revenue that year to the treasury was some $26 million. My question to the minister is whether any penalties have been imposed on those companies as a result of the late payment, in view of the fact that her, report discloses that those companies retained some $26 million which should have been in the hands of the minister and the treasury.
HON. MR. WOLFE: I believe the report of the auditor-general was reviewed before the public accounts committee at the last meeting. If I'm not mistaken, the comptroller-general is being given an opportunity to respond to these statements that have been made, or the report itself. With regard to the question raised by the member, I believe there has been a problem for some years in terms of the transition into a new system of stumpage and so on. It isn't a case of the companies not being billed, but a delay that developed some years ago, I'm given to understand, in the system. So I couldn't answer the specifics of the current lapse that may be taking place, but I'm sure that you will be able to hear more on this report in terms of the comptroller-general's response next week.
MR. LEGGATT: The minister, of course, has had the opportunity of reviewing that report for some time. In fact, I think it was issued prior to the last provincial election. Surely now, Mr. Speaker, the minister has had a chance to assess the loss of revenue in terms of interest. There is some $26 million that the treasury was denied as a result of late billing. Can he give the House some estimate of what the loss was in terms of the current interest rate on that kind of money that was not collected?
[ Page 860 ]
HON. MR. WOLFE: Mr. Speaker, I think, if I'm not mistaken, it was clearly brought out during the review of this report that a lot of these anomalies go back quite some distance in time to former governments and so on.
SOME HON. MEMBERS: Oh, oh!
HON. MR. WOLFE: So with reference to any suggestion that there has been a loss of revenues and so on, I'd be glad to take that question as notice.
MR. LEGGATT: Supplementary.
MR. SPEAKER: When a question is taken as notice, it's difficult to have a supplementary on it.
MR. LEGGATT: A new question, Mr. Speaker.
MR. SPEAKER: Please proceed.
MR. LEGGATT: Under the provisions of the normal tax collection procedure.... For example, if I don't happen to pay my property tax on time, I've got to pay a penalty to the municipality, and I think every other resident of the province understands that. Could the minister advise whether there are penalty provisions in terms of the legislation that he has for collecting stumpage royalties. so that these forest companies are required by law to pay a penalty for their failure to deliver that $26 million?
HON. MR. WOLFE: I think the member, even though he comes from Ottawa and is imbued with a deficit philosophy, will be fully aware of the fact that if there is abuse of the system of payment by a taxpayer, there are penalties provided. But if, in fact, billings were delayed, it is not likely that a penalty would have been exposed.
MR. LEGGATT: I take it then that the minister's answer is that if it's the fault of the government, it's the taxpayers who have to take the load rather than the forest industry. Is that what he's saying?
LEGISLATIVE ASSEMBLY BROCHURE
MR. BARNES: I have a question to the Minister of Economic Development and Tourism. Why is the government distributing misinformation to B.C. tourists? The government spends millions of dollars on the B.C. Government News and promotions such as the Captain Cook Bicentennial, and government MLAs have been known to receive foot bridges. But we have the beautiful British Columbia parliament buildings guide to the legislative precincts which is entirely out of date. I am wondering if the minister could explain why it is that the brochure has a 1972 picture of the Legislative Assembly, when two elections have ensued.
It states that there are 55 members in the Legislature when there are 57. It states that there are 48 electoral districts when there are 51. Could the minister indicate why we would spend as much money as we do encouraging tourists to come to British Columbia when we give them misinformation?
HON. MR. PHILLIPS: Mr. Speaker, I would advise that member that he ask the question of the minister in charge of that particular aspect, namely the Provincial Secretary or the Speaker.
MR. BARNES: Mr. Speaker, I am aware of the responsibility, but I think that the Minister of Tourism should be standing up asking that question because he is the one responsible for encouraging people to come to this province, and this information is erroneous. I will address the question to the Provincial Secretary. Perhaps he can answer.
HON. MR. CURTIS: Mr. Speaker, I expect that an up-to-date brochure will be produced in the very near future. However, the member should know, sir, that we have some very fine tour guides, who are this year perhaps showing more visitors through this building than ever before as a result of the great tourist year that we're having. I believe that the tour guides are quite familiar with the number of members and of the structure of this House. But a new brochure is in order and will be printed in time.
DISMISSAL OF MARGARET CALDWELL
MS. SANFORD: My question is to the Minister of Labour. It is now a week since the Minister of Labour advised the House that he was seeking legal advice surrounding the board of inquiry decision in the Margaret Caldwell case. Could the minister tell the House whether he has received that legal advice and, if so, will he then appeal the Caldwell decision to the courts?
HON. MR. WILLIAMS: I received a report following the examination of that decision. Further legal questions remain, and I trust they will be answered very quickly.
HAT CREEK DEVELOPMENT
MR. MACDONALD: I have a question for the Minister of Education, Science and Technology, who, at the end of last week, notwithstanding large sums of money being spent by Hydro for exploratory work at Hat Creek and on the application to the Pollution Control Board, said that the proposed development would ravage the countryside worse than Trail had been ravaged in the early years of Cominco. My question is: did the minister make that statement after consultation with his colleagues on the Hydro board, or his colleagues in the cabinet, or was it made in a frolic of his own?
MR. SPEAKER: Hon. members, if this statement was made in the House it is open to question. However, statements made outside of the House, speeches made away from the House, says Beauchesne, are not to be referred to in question period. It is for the minister to decide whether the speech was made in or out of the House.
MR. MACDONALD: Mr. Speaker, are you seriously saying that a statement made by a minister outside of this House cannot be questioned in question period?
MR. SPEAKER: Hon. member, it is not for me to decide that; those are the rules that have been established by the House itself.
[ Page 861 ]
MR. MACDONALD: Then we might as well pack up the question period.
MR. SPEAKER: Order, please. Perhaps the members would like to refer to section 171(z), page 148 of Beauchesne, fourth edition. I would be very happy to abide by the wishes of the House, but that is what I read there: "Speeches outside the House not to be referred to in question period." I think we should just use it as a guideline. We'll let the hon. minister decide whether he wishes to answer.
MR. LEA: It might say that in Beauchesne, but in the practice of this House there has been example after example after example of the fact that these kinds of questions have been allowed by yourself and by previous Speakers. It has become the practice of this House. I wonder why, Mr. Speaker, we are now changing from the practice of this House.
MR. SPEAKER: Hon. members, I am bound by the rules which you have placed in my hands.
MR. MACDONALD: I'll ask the minister: in view of those statements, were they made in consultation with members of the board or his colleagues in the cabinet?
A further question, Mr. Speaker: in view of the non-answer to that, I ask him whether the statement made on July 17 by the hon. minister that Hat Creek coal deposits should be used for gasoline rather than thermoelectric development is the policy of the government or simply the opinion of the Minister of Education, Science and Technology.
HON. MR. McGEER: Mr. Speaker, the benefits to British Columbia which will come from considering alternative uses of all our natural resources — coal, wood waste, natural gas — are obviously of extreme importance to investigate from a scientific point of view. I can assure the member that great consideration will be given in the future to developing the highest benefits from of all our natural resources in British Columbia, including coal.
MR. MACDONALD: Nevertheless, the minister says that Hat Creek should be used for the production of gasoline, and not for thermoelectric development. Is that the policy of the government and of his department? And has it been cleared with B.C. Hydro and Robert Bonner, the chairman? Has it been cleared with the Premier? Is that the policy of the government, or is it not?
HON. MR. McGEER: Mr. Speaker, the ultimate utilization of Hat Creek, or any of our enormously valuable natural resources, will be unfolding in due course.
OF TOMATO MARKET
MR. STUPICH: Mr. Speaker, I have a question for the Minister of Agriculture. I wonder if he has had any complaints from one or more of the Vancouver Island greenhouse growers to the effect that the large chains are manipulating the tomato market in an effort to break the price of the B.C. produce.
HON. MR. HEWITT: Mr. Speaker, no, I have not had any official complaints regarding excess amounts of tomatoes in storage. I was approached by a news media individual with a press report, but nothing official has come to my office as yet.
MR. STUPICH: Mr. Speaker, I'm mindful that I have to phrase this as a question; so I'll ask the minister: has he discussed this matter with his associate deputy?
HON. MR. HEWITT: Mr. Speaker, I have requested a report from one of my staff, Mr. Don Rugg of the marketing branch of my ministry, in regard to whether or not we do have a surplus of tomatoes in storage.
The member may recall that we seemed to go through the same problem a year or two ago; we went into a marketing effort with the supermarkets, only to find that within a week's time the producers had to short the market. And so we have to be careful that the statements regarding this amount of tomatoes in storage are accurate.
MS. BROWN: My question is to the Minister of Human Resources (Hon. Mrs. McCarthy), and it has to do with the appointment of the Premier's former press secretary, who has now become a partner in a public relations firm, to work on the International Year of the Child and Family project. Would the minister tell me whether this is a contract, whether it's freelance and exactly how the job is being financed?
HON. MRS. McCARTHY: Mr. Speaker, the member for Burnaby-Edmonds (Ms. Brown) is referring to Mr John Arnett, who is a public service employee and who is working, as he has on other items for the executive council, on the International Year of the Child and Family,
Introduction of Bills
AMENDMENT ACT, 1979
Hon. Mr. Gardom presented a message from His Honour the Administrator: a bill intituled Miscellaneous Statutes Amendment Act, 1979.
Bill 30 introduced, read a first time, and ordered to be placed on orders of the day for second reading at the next sitting of the House after today.
Orders of the Day
The House in Committee of Supply; Mr. Rogers in the chair.
ESTIMATES: MINISTRY OF HEALTH
On vote 128: minister's office, $144,082 — continued.
On the amendment.
[ Page 862 ]
MR. HOWARD: The item I want to make brief reference to is with respect to the Heroin Treatment Program and the heroin treatment centre. I have a couple of intriguing wonderments about the financing, although that's in a later vote. There is $2.8 million which is going to be credited to the financing of the Heroin Treatment Program. It represents interest earned on a special purpose fund, the Drug, Alcohol and Cigarette Education Prevention Rehabilitation Fund. With respect to the interest earned from that particular fund, part of which is going into the Heroin Treatment Program, why was money also expended from it for travel expenses, professional and special services, furniture, office expenses, and for a variety of other things that don't seem to suit the purposes of the fund itself In any event, I only raise that as an introductory reference point. Someone should explain to the House why interest from a fund is used for purposes which don't appear to be germane to the particular fund itself.
When it comes to treatment of heroin addicts, we have to appreciate that attempts have been made in the so-called treatment area in different jurisdictions throughout the world. All have had about the same rate of success: namely, practically no success.
The situation in Lexington in the United States has been well documented and has been referred to a number of times in the past. There is no point in going over it again, except to say that it is probably the most classic United States reference that exists.
In Canada we have had different programs operative within the federal prison system, most notably the pilot treatment program at the Matsqui institution. It was extended over a number of years and headed by a psychiatrist, Doctor Dan Cragen, who has since left that position and is now the chief medical officer of the Canadian Penitentiary Service. In the program at Matsqui, which extended over a number of years, various psychological and psychiatric techniques of a counselling nature were followed: role-playing, group therapy, reward-and-punishment aspects, free passes, free association and the whole bag of tricks that psychologists and psychiatrists have developed over the years to try to relate to heroin addicts. The success of that program can be measured in terms of the rehabilitation of individuals who were addicted to heroin. The success of that program is practically nil. I've been told that nearly all of the narcotic addicts who went through that particular program are either back in prison again or have been in prison for some time as a result of further offences against the Narcotic Control Act, or they have died as a result of overdoses of heroin. The success rate is practically nil.
So far as I can understand from reading newspaper accounts about this proposed Heroin Treatment Program in B.C., it will follow almost identically the program which was followed in Matsqui, with some variations depending on the particular theories of the individual psychiatrist or psychologist who may be working there. I'm sure that for every heroin addict that exists you'll find a psychologist to team up with him to play a particular role, to try out his pet theory. I know there are those who say that because we haven't cured it in the past, we shouldn't give up trying. I'm not decrying that. I'm just pointing out that all of the experiences in the past have ended in failure. Because one raises doubts about the success potential of this particular program, he shouldn't be subjected to the accusations that were made yesterday — that those who express those doubts fall into the category of being people who hope that the program will fail. That is the farthest thing from the truth.
One interesting part of this is that the very same types of people in the medical profession years ago who propounded that methadone could be used as a substitute for heroin to keep an addict on the street, working and operative........ It is now identified as a drug within the Heroin Treatment Act passed by this Legislature, lending the individual who may be addicted to methadone to being subjected to this type of treatment and incarceration in this particular institution. What I'm saying is that on the one hand a few years ago methadone was hailed as the cure-all and the answer for heroin addiction. It now falls in the category — as far as this Legislature and this government are concerned — of itself being a narcotic, and if a person is addicted to that, he has to be subjected to the type of treatment contemplated under here.
I think if you talk with almost any heroin addict and try to get him or her to relate to you their thoughts and their own inner feelings about heroin addiction, they invariably will come up with a very simple, uncomplicated response and answer. They will say that there are two ways only to cure heroin addiction. One of those ways is for the individual to want to quit, and that's a difficult task. The other way is what they loosely refer to as the "Chinese cure, " or an overdose. Heroin addicts themselves admit freely and honestly that they are not able to handle that question of addiction, that all the people who have gone through the variety of psychological programs and psychiatrists' programs have not been helped, and we're embarking again on repeating the situation of the past.
I have doubts that it will work. I have the thought that a few years from now we'll be trying to identify success rates on a statistical and individual basis, and we'll come up with the answer that they came up with at Lexington, at Matsqui, and in other jurisdictions — that this is not the type of program that will work. We can live in hope, but I think that's the answer that we're going to find ourselves faced with a few years from now. For those who are concerned about the money part of it, a few millions of dollars from now.... We're talking in terms of something in the nature of $12 million per year towards this particular program. Multiply that by the number of years the program will have to apply before we'll be able to get some reading about it, and you're into quite a few millions of dollars.
I know that it is a very sensitive area, and I know that propositions put forward in the past about what one should do about this particular situation or problem are always approached with a great deal of fear. I want to indicate that I'm clearly speaking for myself in putting forward a thought. It's not unique to me. It has been advanced by others at different times in the past — that is that we will ease the problem that the heroin addict faces when we remove the profit from the heroin trade. When we remove the profit-makers from dealing in heroin, from importing the heroin, from selling it on the market and on the streets, we will then find ourselves well on the way to a solution.
We have no difficulty in our society at all in both advertising and promoting the concept that it's okay for a person addicted to alcohol to be able to go into a government liquor store and buy alcohol. We don't impinge upon that choice there. We say it's fine. You're an
[ Page 863 ]
alcoholic. Okay, we'll continue to sell you booze if you want to continue to buy it. We place no restrictions in that area at all.
Insofar as a physically debilitating drug is concerned, alcohol to the system is far more injurious than heroin. Alcohol injures your liver, causes death — through excessive use of it — and the development of cirrhosis of the liver, which, I gather, is the medical term. Alcohol kills off brain cells when it is consumed and gets into the blood system. It causes other physical difficulties as well. And they are, so I've been told by medical people, far more serious to the human physique and the human being than is heroin itself.
I don't see why we cannot move ourselves to the point of doing something similar that was done in Britain countless years ago — that is, provide the drug at cost through the medical profession, upon an administered or treated basis, with prescription.
I think — following that kind of activity and that kind of course — we will remove a fair amount of the criminality activity that's associated with the heroin trade. We'll remove a fair amount of the costs of courts and of law enforcement officers in chasing drug pushers and addicts around the country. It may save a fair amount of effort and money in our prison system if we could follow that kind of thought.
I advance that as an individual. It's not associated in any policy way with what other people with whom I work have in mind. I know it's a very delicate subject, and I know one can be subjected to a tremendous amount of abuse by just putting forward the thought.
But it is a thought that has nagged at the minds of a great many people, including people in the medical profession who have dealt with addicts over the years and who have looked at, and tried to assess, the effect of their work at the psychiatric and psychological level with individuals. Many of them come up with the same feeling. They say that if this is the situation which is incurable to the individual, unless he himself wants to stop, then why don't we go through the prescription process with respect to it and provide that chemical to those individuals who, for one reason or another, internally need it?
I hope, Mr. Chairman, when we get to the point of examining the effectiveness — or whatever it might be — of this particular program, that the thoughts that I have expressed about what is anticipated are wrong. I hope there are successes out of that; and that comes from a deeply felt conviction about the need to work in this area to do something. It comes from the fact that I myself, as an individual, like other members on this side of the House, have worked over the years with addicts on an individual basis in attempting to help them get over the rough spots and help them move out of the area of addiction and into the so-called "straight life." It comes from that type of relationship with people The ideas I put forward are not put forward lightly and are not put forward in the sense that they reflect a great body of concerted opinion within the party to which I belong. They are put forward in the light of having talked with others who have worked with addicts, including a great many psychiatrists, and with a great many medical doctors who have come to a similar kind of conclusion about the treatment program that might be effective.
HON. MR. McCLELLAND: Mr. Chairman, I promise I will make only one very short statement in response to what the member has said. We recognize that as a position which is taken by many people in the community. It was one which was put forward, and considered, when this program was being developed. I might say that I reject it. It was rejected as a choice for the program; and I believe the people of B.C. have rejected it.
To go one step further, I have a feeling, Mr. Chairman, that the least important argument about what we do with the heroin treatment problem or the heroin problem, or however you wish to phrase it, is whether or not other things haven't worked. In my opinion, that's not a good argument, Mr. Chairman. Otherwise we would not be searching still for cures to many kinds of diseases. We would have stopped, because other things didn't work.
Let me say that my views about the questions that the member for Skeena raises have been well canvassed in this House, Hansard is full of them. Anyone who wishes could read it again. But let me just say that we've put forward this program as a demonstration project on a five-year basis. We think it's innovative, unusual, and the only one of its kind in the world. I will, however, recommend very strongly that the government does not get into the trap of pouring bad money after good. If the program doesn't work, I hope that I'll have the guts to admit it, and at that point that the government would stop and go I some other direction.
MR. COCKE: We are on a broad philosophical discussion here and I would just like to bring us back to the vote. I thought we were going to take it a minute ago, but two of my colleagues in the House have decided not to.
The vote that we're taking now is an amendment to the minister's salary — reducing his salary — to show a lack of confidence in this minister. We are talking in terms of the gross mismanagement of health in the province; we are talking in terms of the unanimous position of hospitals across the province that they are being placed in a dangerous position; and we're contrasting that to the university hospital reform which is going to be lavished a very large operating expenditure. That's really what we're talking about here. We're also talking about emergency health services, which are being squeezed to the point where firemen are being used for transport to hospital. And we're contrasting that to our Heroin Treatment Program that's admittedly experimental. Mr. Chairman, I call the question.
Motion negatived on the following division:
YEAS — 24
NAYS — 29
[ Page 864 ]
Mr. Cocke requested that leave be asked to record the division in the Journals of the House.
MR. GABELMANN: As with a lot of members, Mr. Chairman, I haven't been able to be in here for the entire debate, so I may have missed the answer to the main query that I have. If so, perhaps the minister could just indicate that.
I want to ask, first of all, whether or not you have given any indication as to the timing of the public release of the so-called Black report. I wanted to talk very briefly about the difficulties in rural communities with health care. My constituency has been, as the minister knows full well, the subject of a great deal of discussion in recent weeks and months concerning health care, and the minister has responded in some measure. I might say to the minister that I would like to thank him for his response to the Zeballos situation. It was a quick response, and it was, in my judgment, an appropriate response. I appreciate it, the people in Zeballos appreciate it, and I think the minister, the staff and the people in the region who are involved deserve full marks for the way in which that particular problem was handled.
I am not at all convinced the minister has made the same kind of appropriate response in the Alert Bay situation. I still have some very grave reservations that the course of action he has taken will not lead to the kind of situation we want to develop there. I don't intend, Mr. Chairman, to get into a public harangue or a public debate with the minister about the issue, simply because I don't believe that would serve any useful purpose at this point in resolving the difficulties in Alert Bay. They have gone beyond questions of health care and health-care delivery service. They have gone into other, more difficult and sensitive areas, and I think we all have to be very careful not to exacerbate the kind of tensions that exist in that community.
In saying that, and in being very calm and cool about how I handle this whole question, I would just like to alert the minister to the fact that at least half the community — probably 60 percent of the community — are not happy with the response to date. Without the full confidence of the community in actions taken by health-care workers and the ministry itself, I think we might find ourselves in more difficult situations in the months to come. I'm not predicting that; I certainly don't want that to happen; but I would just like to alert the minister to keep a very close eye on that situation so that we can involve the entire community in creating some solutions. At the moment the appointment of Mr. Eric Powell has some superficial sense to it, but it won't work if the community doesn't agree — I just want you to be aware of that.
The reason I started off my comments with the reference to the Black report is that when I travel around smaller, remote communities in North Island, after they get through complaining about the roads — which is always first; no matter where you go in small areas it's the roads they talk about first — the next issue is health care. For people in that area, health care is not really completely paid for by Medicare because for most people there, particularly women who are pregnant, health care means several flights out to Vancouver or to Victoria, or even just to Campbell River or Comox. It's a very expensive proposition. Perhaps the response might be: "Well, that's the cost of living in a remote area." When it comes to health-care service delivery, whether it is direct medical attention, as in the case I cited of pregnant women, or whether it's delivery of mental-health care services — and the whole range of health-care services that should be provided — I've come to the conclusion, having had the experience of living in the city and representing urban citizens in this Legislature, and now having had the experience of representing an entirely different kind of riding, that health-care service delivery, like social-service delivery, is often more important in those remote areas than it is in the city. When I look at the alcoholism rate in my constituency, and when I look at the prescription rate for Valium in some of those communities — and that's no condemnation of doctors when I say that; I suspect that's probably the easiest way out; but the level of reliance on pills, and Valium in particular, in those communities is very high.... The opportunity to have mental-health care workers to deal with when you live in a community that is surrounded by mountains — and the only space that isn't mountains or bush is clouds full of rain for ten months of the year — is needed more in that kind of environment than it is in the city, where there are all kinds of other resources that people can draw on. I just want to emphasize that, in my judgment, we should be spending a disproportionate amount of health-care money for those kinds of services in rural areas.
I don't want to say much more about that, other than that over the course of the next year or so I intend to discuss in more specific detail proposals as to how we can improve up there that I am, in a sense, still formulating and working on with people in the community. They don't see me as an opposition MLA; they see me as part of the government. That's a curious kind of phenomenon, but it happens. They think I can have some influence over government policies. I tell them I can't; but I try my best. In attempting to formulate some answers for rural health-care delivery, it would really assist me and it would assist the people in the community if we could have the evidence that's been collected by your ministry, so that we can be part of the solution rather than complaining about what your ministry does or doesn't do.
HON. MR. McCLELLAND: Mr. Chairman, I'd like to answer some of the questions raised by the member for North Island (Mr. Gabelmann), and I would like to take the opportunity to answer a few more that were raised, I felt, as part of my estimates rather than in terms of the vote which was taken earlier.
To start with the member for North Island — and to deal with the Black report first, because the second member for Surrey (Mr. Hall) has also talked about it a couple of times — the Black report will be released in its entirety. I need the opportunity — and I think that the ministry needs the opportunity — to understand it fully before we release it. We are making those studies now and I'm having some recommendations made in relation to the Black report at the same time. I would hope that when we release it in a very
[ Page 865 ]
short time there will be an opportunity to list some priorities with it as well, which we can announce in terms of the recommendations that it will make. So it will be available very shortly.
Mr. Chairman, I appreciate the member's response to the things that we've done in Alert Bay. I recognize that many of the people in the community are not fully happy with the response that we've made. One of the most serious difficulties is that there is a perception in the community that the ministry has not acted promptly or adequately in relation to the question of the competency of the doctor in the community. I have a difficulty with that, Mr. Chairman, because I don't have the legislative opportunity to deal with that; that must be dealt with under the laws of British Columbia. Unfortunately, that's clouding the whole issue in the community. I have tried to act as promptly and expansively as possible with what is under my jurisdiction directly, and that's the reason we've done what we want. I will be keeping a very close watch on that situation, and have asked Mr. Powell to report to me on an almost daily basis in terms of what is happening there, and certainly — if you've read the terms of reference — the one thing that we've insisted upon is that the tasks of Mr. Powell go beyond that which was originally requested of me in terms of just the hospital, and take into account the alcohol problems in the community. With luck, and with some other moves that we're making in places like Fort Nelson, we might be able to develop a very good policy for isolated areas, in terms of the way we deal with certain alcohol problems, out of this unfortunate situation that we came up with in Alert Bay. So I appreciate that.
Then, in terms of what a member can do about influencing future policy, I don't know. Maybe I am naive or something, but I have a feeling that any member in the community should have the opportunity to provide input — whether he or she is in opposition or in the government — and I'm sure that should be treated in the same way that other community input is, that it all forms part of the larger picture. I hope that we can deal with things on that basis.
There were questions raised by the member for Atlin (Mr. Passarell), who is not in his place at the present time. But I just wanted to say that in regard to his concerns about the provision of health care at Dease Lake, I share those. We've been working since last summer, when I visited Dease Lake last, on a method by which we can get some improvements to the care and services provided. I'm very happy to say at this point, Mr. Chairman, that we have contracted with a nurse to act as the Dease Lake emergency nurse as of August 1, 1979. She will be contracting with the ministry to provide emergency nurse services in Dease Lake on a permanent basis, which will be a tremendous improvement in the delivery of care there. We've just sent out a letter of confirmation to her. Her name is Kathleen Simmons and she will be taking up that position on the first of the month.
Mr. Chairman, I wanted to answer one question raised by the member for Burnaby-Edmonds (Ms. Brown). I can't help the perception the member has from the correspondence that she reads in the House. On the one question that was raised about the EEG facility, it isn't operating, but it is approved. The member asked me, Mr. Chairman, why I didn't tell the administrator. I have a letter dated March 30 to Mr. Norman Barth, administrator, Burnaby General Hospital, and it points out: "Since my letter to you dated January 9'' — this is not a letter from me, incidentally; it's a letter from Mr. Glenwright in Hospital Programs — "Hospital Programs rate board has approved your request for an EEG service at Burnaby General Hospital. An allowance will be provided in your approved 1979-80 budget for this service, based on your estimates of the time needed and the technical time needed." So it is approved, Mr. Chairman, to the member for Burnaby-Edmonds (Ms. Brown), and I just wanted to make certain that was covered.
The member for Cowichan-Malahat (Mrs. Wallace), who also is not in her place at the present time, raised the matter of rates for long-term care facilities, particularly the private long-term care facilities. She complained that the increase to the private-care facilities was only 50 cents per day over that which they were before April 1 in the last fiscal year. In the first place, that member chose only one category of care when picking out that 50 cents, and that's the personal-care level, which is the easiest level of care to provide.
The other rates that we have approved are significantly more than that. For instance, in level 3, from $28.30 to $30 per day is an approved rate, and there was a total increase of some 7.6 percent across the board on the interim rates which were approved by me. But we have since been in conversation with the members of the association which deals with the private-care facilities, and they've indicated some concerns that the rates are not enough. I have instructed my staff to enter into negotiations with them. That is happening, and as a matter of fact I believe the next meeting is set for next week with the association. But I have guaranteed to the association that whatever rate we strike will be retroactive to April 1, 1979, so that they will be able to have that full rate for their total fiscal year.
The member for Shuswap-Revelstoke (Mr. King) seemed to have some concern about me meeting with his hospital board. I don't remember whether it was during the election or not — perhaps it was — but I meet with hospital boards all over the province. I have travelled extensively in this province to meet with the hospitals on their home ground. I feel if I've done nothing else, and the members may say that I haven't — on that side of the House, anyway — I feel that I have been extremely accessible to the hospitals around this province, and I think they acknowledge that. But the member's hospital is doing very well as far as its finances go. I might say that as of the end of May this year, it is operating in a surplus position in this fiscal year. In fact, they've built up a surplus of some S3,700 in the first few months of this fiscal year.
The university hospital was raised by the member for Shuswap-Revelstoke, among others, and I might say that at the present time that university hospital capital construction is ahead of schedule and about $1 million under budget. We can talk about rates for operating costs for that hospital all we want, and we can say that they are $400, $500 or $600 a day. Well, the fact remains that we'll know that when the hospital is in operation. I've disputed that since got into this debate over that hospital, and I still dispute it.
Mr. Chairman, I think that covers the concerns that have been raised by most of the members up to this point.
MR. CHAIRMAN: The member for Nanaimo.
HON. MR. STUPICH: Did you want to talk about Bulkley Lodge? Is that what you were going to ask about?
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HON. MR. McCLELLAND: Mr. Chairman, I forgot about Bulkley Lodge.
MR. CHAIRMAN: Once again, I recognize the minister.
HON. MR. McCLELLAND: I just want to say that I haven't met with the board, but my staff have met with the board and I understand that they've reached agreement on a rate which is a compromise rate. I think it is in the neighbourhood of $33. But I understand the board has accepted the rate, and that the rate includes, I'm told, the provision that a 24-hour registered nursing service is provided.
MR. STUPICH: I have a number of questions that I'd like to put to the minister, in response to questions and concerns from my constituents. One of them, J. Garside, who wrote a letter to the minister on October 17 asking about the pending dietitians' registration Act, makes the point that public awareness of the role of nutrition and good health is growing, but there's presently no means for people to differentiate between qualified and unqualified resource personnel when seeking nutrition information. The minister, assuming he did reply, did not send me a copy of the letter. I'm not sure whether there was any follow-up, or whether he has any plans — or any interest, for that matter. I know there are some problems about registration of dietitians and nutritionists. I just wondered whether the minister has anything that I can pass on.
Concern was expressed by a senior citizen in my community about the increase in ambulance rates from $5 to $15. Her point was that it is particularly tough on elderly people, who are more likely to have to call an ambulance than others. I don't know that I can ask for any quicker action at this time — I'm simply expressing the concern of that citizen — expressing the concern that I and others have voiced on previous occasions. That is the way the Pharmacare program works now. It is tough on people who....
HON. MR. McCLELLAND: It is not my ministry.
MR. STUPICH: I concede that one. The ambulance care is, but that is not. All right.
The next question, raised by another senior citizen, is about the need for a dental plan. If there has been any discussion of the dental plan during the discussion of the minister's estimates, I've missed it. I'd like to ask the minister what are the notes in the throne speech, and both budget addresses this year, about the fact that a dental plan would be introduced this year, whether it has been discussed with the ministry staff, or whether it is simply in cabinet so far. If it has been discussed by ministry staff, has it been discussed with the dentists themselves? How far along is the planning on it? When might we expect to see something more than the references to a dental plan that we have seen in the throne speech and in the budget addresses?
I have a complaint from a speech pathologist about the preference that seems to be given to Americans in hiring speech pathologists. The complaint was passed on to the Member of Parliament as well — this was about a year ago.
Apparently preference is given to Americans, and preference is apparently given in further training to Americans. I wonder whether the minister has any comment on that.
HON. MR. McCLELLAND: Would you repeat that, please? I missed that, Dave. I'm sorry. What was the last question?
MR. STUPICH: Preference, apparently, is given to American speech pathologist graduates of universities in the United States, as opposed to UBC graduates, for example I think it is UBC.
There is concern from an acupuncturist. I know the minister has spoken on this subject on different occasions. I haven't heard anything in this present session. I know the previous Minister of Health (Mr. Cocke) spoke also about his attitude toward acupuncture as a profession, and whether or not there should be encouragement or discouragement. This particular letter is from an acupuncturist who feels he is sometimes being hounded by the ministry staff; certainly by the medical profession. I wonder whether the minister has any further comments to make about acupuncturists generally.
There is a complaint from the president of the Licensed Practical Nurses Association of B.C. that they are finding it increasingly difficult to find employment, that because they are practical nurses they command a certain rate of pay and that the hospitals, in general, are finding ways of hiring other staff who do not have the training of practical nurses, but who are prepared to work at lower rates of pay. I wonder whether the minister has had complaints from the practical nurses about that situation.
I have a question from the Central Vancouver Island Union Board of Health. This is a fairly recent one, and, again, if there has been an answer I haven't seen a copy of it. The question is about public health engineers being placed in the water resource section. Concern is expressed by the Central Vancouver Island Union Board of Health that they might be asking questions of public health engineers to do with water only, and not with the other health aspects of water and waste management, and wanting the minister to reassure them that public health engineers, even though they are under the water resources section, would be able to deal with other questions in which they are trained and capable to deal with.
I had a letter from a constituent who had a very sad and near-tragic experience in the Ladysmith General Hospital. Rather than read this letter into the record, what I'll do is have it typed and sent to the minister. I don't know that there is very much he can do about it, but I'd certainly like to put it to him and give him an opportunity to comment.
We've all, I'm sure, had briefs from the chiropractors two briefs, I think — since the last time we had an opportunity to talk about health matters. They make what I feel are logical arguments that health care can be cheaper by extending the number of visits patients can make to chiropractors. That, if nothing else, keeps these people away from more expensive treatment for a longer period of time. In spite of that, and in spite of the fact that there seems to be, I think, growing appreciation of what they can do for people.... According to their presentation, under the health-care plan the number of visits people can make to chiropractors has actually been reduced rather than increased.
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[Mr. Davidson in the chair.]
MS. BROWN: I want to talk to the minister about this ongoing survey inside the ministry in the area of mental health. I tried to start a discussion on it in question period one day. I asked the minister whether he would be willing to release the findings of the Cumming survey, so everyone in the Legislature would get an opportunity to see what was in the survey. We would know the kinds of things that are happening in mental health in the province. At that time the minister said he was not prepared to release the Cumming survey or to tell us what kinds of things were being turned up by Dr. Cumming in his survey.
I happen to have a copy of the survey. In particular, I would like to share with the minister, in case he hasn't seen it, the kinds of things that have been showing up in the survey done on the provincial boarding homes; that is the specific one I want to deal with.
I'm not going to deal with the findings about the community mental health teams. There seems to be some kind of undercurrent to wipe them out and prove they are not doing a good job. I'm going to sit on that for a year and wait and see what happens. If the community mental health teams fall into jeopardy between now and the next time the minister's estimates come up, then I'll deal with that part of the report. I will not make that part of the report public. We should talk about provincial boarding homes because it's a pretty serious problem. Although this report has been out since January, I have not noticed any improvement in the provincial boarding home situation; that's why I want to talk about it.
I gather from the report that the survey team visited 31 boarding homes, all in the greater Vancouver area, except four of them. There are approximately 300 boarding homes in the province. One can draw pretty good sense about what's going on in the boarding homes by looking at a little more than 10 percent of them. I like the categories they were divided into; one category was called "Close down."
The report says:
"The quality of care in these homes is bad, with overcrowding, lack of privacy, uncleanliness, no programs, operators with authoritarian attitudes, with no concept of rehabilitation, and no expectation of the clients. The finding was that at least several infractions of licensing regulations were noticed in each facility in this group."
Of the 31 homes visited, 6 came under this category. In one instance the representative found that a home which accommodated 32 was full; 24 of the residents were psychiatric patients with severe behavioural problems and multiple physical and mental handicaps. The person goes on to say:
"On entering the home, I was immediately made aware of a terrible smell of Lysol and old urine that permeated the whole place. The living room was crowded with people getting prepared for lunch, with residents pacing or sitting in wheelchairs or geri-chairs; some appeared groggy and over medicated. Later we saw residents eating with their hands; some had more on the table than on their plates. With the exception of one aide, all the staff were off having lunch."
I don't think this person was disturbed by the way in which the patients were eating. What the person on the survey team was disturbed about was that 32 people were supervised by one aide, while the rest of the staff were off having lunch. The person goes on to say that the kitchen was cluttered and disorganized, with flies swarming around the food. The kitchen staff were having lunch in the alcove where the medication trays were set up.
One or two rooms had personal belongings and, in contrast with the others. they appeared bright. The other rooms were drab; the beds were saggy, cold and dingy. There were three bathrooms and they were smelly and grimy." It goes on to say that they were told that the residents had a bath once a week, in spite of the fact that at least half of them were incontinent.
There is no retraining program, and the report goes on to talk about the overcrowding and the problems as a result of the lack of rehabilitation. Mainly they talked about the lack of cleanliness. There were total violations of some of the licence requirements. According to this report, 6 of the 31 homes visited, most of which are in the Vancouver area, fall into this category known as "Closed down."
The second category is called "Backwards." This means many homes in this group were similar to those above; the only difference was one of degree. Physical care was somewhat better but little rehabilitation existed. It was felt that these facilities could be improved by strong outside direction.
The reason I am raising this report is because it has been in the minister's hands since January. I have been waiting for the minister to act on it. I have not raised it before. I waited for the minister to bring down his annual report to see whether the annual report indicated that something was going to be done about this. I kept absolutely silent on this until then. I looked in the annual report and there is no indication in the annual report that the minister is doing anything about this,
I raised it in question period. The minister indicated that he's not prepared to discuss it. I think it has to be discussed, and it has to be discussed openly because you've had enough time to start moving on it privately. You haven't done so yet, Mr. Minister.
The example quoted in this one is of a custodial home with 28 chronic psychiatric patients ranging in age from 40 to 65. Again. there are no programs and no rehabilitation in evidence. It is large. dark and dingy. There was a feeling of crowding, because all the rooms except the dining room were small. It goes on and it talks about things like the dining room had a cage-like area for the nurses who came several afternoons per week. It talks about the general ugliness of the place. Talk about squeezing — six people at a squeeze. There was a couple in a tiny bedroom. They are totally unsatisfactory accommodations.
Everything was small, including the bathrooms. The report talks about things being depressing. There were cigarette burns all over the place. The place had an appearance of deterioration. There was no restriction on smoking although you're dealing psychiatric people. The lounge could not begin to hold all of the residents at the time. The bedrooms had four beds jammed right next to each other. There was no place for personal possessions and no privacy whatsoever.
The residents, on the whole, seemed to be just sitting. As the report stated earlier, these particular places were just a little bit better than the ones that were designated that they should be closed down.
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How many of the homes out of the 35 which were surveyed do you think fell into this category? There were 12 backward homes and 6 that should have been closed down. That's 18 out of 31 homes. That's more than half of the homes that were surveyed. We have people in boarding home care who were discharged from Riverview or from the mental health program. People are living in boarding homes that violate the licensing regulations. They are described as overcrowded, dingy, depressing, unclean and having no program for rehabilitation whatsoever. People are just sitting there.
The report has categories that it considered to be "good" and "very good." It's something that we should talk about as well because we want to talk about the boarding homes that meet the criteria and are doing a good job, in order to try and bring up the more than 50 percent of the boarding homes that are below this according to these kinds of criteria.
The important thing that came out of this was that the boarding homes that came under the categories of "good" and "very good" were smaller boarding homes. Right from the very beginning, for the most part, the survey discovered that in terms of their ratings, the good boarding homes were likely to be the small ones, and the bad boarding homes were likely to be the large ones.
We have six that should be closed down and those six carry 142 beds. The 12 that were just a little bit better than being closed down but were totally inadequate had 211 beds. We're talking about 353 people in the boarding home program who are, for one reason or the other, forced to live in inadequate conditions. It's an inadequate situation.
The boarding homes that came under the categories of "good" and "very good" only house 163 people. One is led to the conclusion that the majority of the people surveyed in the boarding homes in the greater Vancouver area, and in the four that are outside, are living in totally inadequate situations. They are situations that you should be doing something about.
The report goes on to say that "41 percent of the places we visited are unsatisfactory but we feel that they could be salvaged and brought up to standard, some with considerable effort." It says 27 percent were definitely substandard and cannot be improved without reduction, first of all, in the number of clients that are using those particular boarding homes and either very costly alterations or a change in management.
I can understand why you would be reluctant to make this kind of report public. I can't understand is why, although you've had the report in your hands for so long, there is no indication that you have started to do anything about it.
The report brought down a number of recommendations, and there are two that I would really like to support very strongly. One is the recommendation that a continuing survey of the boarding homes should be inaugurated from outside the regions in which they exist. I think that to have instituted this survey in the first place was a good thing. I'm distressed that you haven't done anything with the information that you have received, but it was very good. I agree, certainly, with the recommendation that a survey team should continue surveying the boarding homes — and this is outside of the regions — and it goes on to explain that it thinks this would be much better than having local supervisors and operators do that. I think that's correct.
The other recommendation is that attention should be given to the Alberta system of ensuring that each client in such a system is engaged in a day program outside of the home. I think that's a very good recommendation. The idea of the patients just sitting.... I know that even in the ones that had the categories "good" and "very good," for the most part they were doing a lot of TV watching. There wasn't very much else going on.
Another recommendation was that more attention needed to be given to the supervision of medication in the boarding home. It says that long periods between reassessments are now the rule, and quarterly review of all medication by psychiatrists should be mandatory throughout the province. So, as I said, I didn't want to bring the issue up, but there it is.
I also have a response to the survey from the doctors involved with the boarding home program. That's Dr. Bill Holt, Keith Barnes, Mr. Farry, Christine Klein and Florence Ireland. In their comments on the boarding home, they made a couple of really interesting responses, the important one being.... I didn't mention Dr. Cumming's recommendation that they go into large apartment blocks. I thought it was kind of crazy, after the survey had just shown that small is good, that he was recommending large apartment blocks. But anyway, the boarding-home people under Dr. Holt said that they certainly agreed with the survey and with the categories that the boarding homes had been put into, but they did not support his recommendation for going into highrise apartment blocks.
The only thing they said was — and I think this is kind of interesting — that the second cause of the problem in the boarding-home situation is chronic underfunding of the program, despite the support of the administration. We come right back again, Mr. Minister, to your department and to your government. You're not going to have to bear the burden of this alone, because I know that Human Resources is forced to pick up the tab for some of this funding, and they're doing as lousy a job as you are. I know that. But it's your estimates so I'm dealing specifically with you.
In this report they talk about the lack of funding coming from Human Resources as well. They say that chronic underfunding has occurred in the provision of boarding homes staff, care costs for clients of the program, funding of the desirable ancillary services such as the sheltered workshops, achievement centres, work activity programs, funding for the development of sheltered employment and independent living programs. Funding for these latter programs has been the responsibility........ And they're very nice about it; they refer to it as "another ministry of government, " but we know that they're talking about Human Resources. They go on to say, of course, that the needs of the psychiatrically disabled have been traditionally very low in that particular ministry's priorities. What they don't know is that the needs of anybody have been very low in that ministry's priorities.
They go on to say that 41 field staff are trying to meet the needs of 2,080 clients — 41 people. Compare this with the heroin program. It's interesting, isn't it, that you have 114 heroin addicts — you know 200 old methadone addicts — and you have over 300 staff to look after them. But you have 2,080 chronically psychiatrically disabled people, and you have 41 staff, according to these doctors, to look after them. That's the extent of the boarding-home resource.
[ Page 869 ]
They say no new staff have been added to this program since 1973. There have been no new public service staff since 1971, although the caseload has increased by 658 in number, not on the heroin program, but on this particular program. The caseload has increased by 658. The turnover has almost tripled, and clients referred are significantly more difficult to manage in the community. It has been many years since the days when the passive institutionalized person from Riverview represented the major referral.
They said a third hindrance.... I'm moving very quickly through this because I see the minister is getting twitchy. I'm hoping that he's going to tell me that I'm wrong, that in fact he has acted, he has moved quickly and swiftly, that he has tripled the staff of the boarding home team, that he's cleaned up all of the boarding homes, and.... I'm being intimidated, so I'm moving very quickly.
They go on to say that a third hindrance....
MS. BROWN: Nobody else speaks for this particular group of the community because they're locked away and they're shut away. Their families don't visit them; they have no friends; that's it. Close the door on them. Like other groups in society, every now and again we should probably take a good look at what's happening to these people in boarding homes. I am glad that the ministry instituted this survey. I worked in the system and I know that during the year I worked at Riverview I had to discharge patients into some of these boarding homes. I know something about the quality of care that we must have in those boarding homes if people are to eventually be ready to return to society as a whole. I'm concerned that there has not been an increase in staff since 1973.
Dr. Holt in his response tells us that a third hindrance to the development of the program has been this new division of responsibility among all of the ministries for various aspects of the program — long-term care is doing its thing, Human Resources is doing its thing and, of course, the clients are falling in between. So I would like to see the ministry respond to that.
Similarly, the program has had to rely on the ministry or the division of a ministry for the enforcement of licensing standards, and you have fallen down on the enforcement of licensing standards. That's the first thing that I pointed out: the boarding home program staff have their cooperative part to play in the monitoring of standards, but they have no actual authority in enforcing them. A social worker cannot walk into one of those boarding homes and say: "I'm going to shut you down because you are filthy." They can' t do it. That has to come from the licensing staff, and they haven't been enforcing the rules. That is what Bill Holt and these people are pointing out — that you haven't been doing your job either. There's been underfunding, and your licensing people haven't been doing their job. It says: "All the staff can do is to tell the residents that they don't have to stay in that dirty, filthy boarding home, that if it's possible to find them another one, they will be removed." But, of course, there aren't any others to move them to, so they're stuck in some of those filthy boarding homes.
He goes on to say: "Following the transfer of the institutional retardation resources to the Ministry of Human Resources two years ago, the Ministry of Human Resources at that time said it would take responsibility for all provision of services to retarded persons, and it just has not being doing that." I'm not going to deal with that. What Bill Holt is saying is that most retarded persons who are in residential care are there because they need long-term care. This is not a part-time visit; this is not a short-term visit. They are in there because they need long-term care. And you should start taking another look at the way in which the program has been divided up between yourself and Human Resources, because it may be working really great for the ministries involved, but it hasn't been working worth a bean for the patients who have had to be living under those things.
Again he goes on to talk about the low status that the program has always had. And they come up with recommendations, too, and I endorse every one of their recommendations. Their first recommendation is that the boarding-home program staffing has to be immediately brought up to recommended standards. You don't have to go up to the standards of staffing that you have for the Heroin Treatment Program; it's not necessary to have 350 staff people to deal with 114 people, as you do under the Heroin Treatment Program. But you have to do better than 2,000 patients being cared for by 41 staff. He gives an example of the Surrey mental health centre, which has a caseload of 180 persons. It has one boarding home social worker, one case aide, and one-half of an activity worker.
The second recommendation is that a firm decision be taken by the ministry that specialized halfway houses, the type of resource for psychiatrically handicapped persons developed by non-profit societies, should be funded under long-term care. I know you know the kind of service Loma Lodge, for example, is involved in, and the struggles that we had to get that started to deal with young people with psychiatric problems who are into this kind of thing. He is saying that all of the programs like this should be under the long-term care program. In responding, I would appreciate it if the minister would refrain from making facetious comments about my asking that things go under long-term care. I believe that there is a place for long-term care in this province, and I have never denied that. If I had my druthers and I had to place someone under the care of a ministry because that person was retarded. I'd rather put them under Health than under Human Resources, if you must know the truth.
The third recommendation is that funding be made available to mental health programs for the development of a range of ancillary programs such as activity centres, sheltered work-shops, life-skill programs, work activity programs, individual rehabilitation and sheltered employment opportunities. I certainly endorse that recommendation.
I endorse all of the recommendations brought down by this particular group of people, because it doesn't make any sense just to have people sitting there just looking into space or watching TV all the time, which is what the survey team found when they visited even the houses which they designated good. It's a matter of degree, because even the ones that were designated good I don't think are really all that good.
It talks about inspectoral staff being added to the public health units, which I think is a very good idea. I wonder whether you have thought about that. It is recommended that long-term care legislation now being drafted include
[ Page 870 ]
clauses that allow for flexibility in the regulations governing benefits in order particularly to ensure rehabilitation of persons. I don't know whether the Mental Patients Association would come under that and whether the boarding homes that they run would come under that, but I know that certainly in terms of meeting their needs, there has to be more flexibility in that kind of recommendation.
Mr. Minister, you have the report, so I'm not going to belabour the recommendations, except to say very quickly that the last, that the ministry designate funds to be used in a community educational program, is something that has long been awaited, and I think we need it. Every one of us needs to be educated against discrimination towards the mentally ill person, and particular effort should be made in respect to the development of residential community care facilities and housing for the mentally ill. That is an absolute necessity. It's a must. That was his eighth recommendation; it probably would have been my second or third.
The final recommendation he made was that the ministry undertake to rationalize, with the Ministry of Human Resources, the present situation in respect to retarded persons. Now that's a bureaucratic way of saying that the two of you should get your act together. I think that you should take it away from Human Resources, quite frankly. I realize that it has something to do with cost-sharing and one thing and another. But in terms of taking care of the mentally retarded, take it under your purview, because those people who are covered by Human Resources are not being well served. They are not being served perfectly by you, but you are doing a better job than Human Resources. If the recommendation of rationalization allows you to take the entire retardation back under your purview, I would certainly like to make that recommendation to you.
HON. MR. McCLELLAND: Mr. Chairman, I should answer a couple of the questions, I think. The matter of the release of the so-called report is.... It's not a report. It's a survey and it's done by the ministry to ensure that the programs that we have are looked at so that we can have terms and guidelines. You know, it's not much different.
What we're doing here with Dr. Cumming and with a lot of other things in the ministry is not much different than a public health inspector. Public health inspectors go out every day of their working lives and they inspect. What we're trying to do is bring the same kind of continuity into other programs. This is one of them. You know, it's not a report that we've commissioned on a special kind of a basis. What we need to do is have the information so we can work on getting things done.
MS. BROWN: Share the information. Let's talk about it.
HON. MR. McCLELLAND: We're sharing the information with you right now. You don't seem to have any difficulty in having access to the information.
Mr. Chairman, it's no big secret. It's just an ongoing way in which the ministry gets things done. One of the first things we did, for instance, in the long-term care program was to put together a team which had the responsibility for making sure that any complaints, whether initiated from the outside or the inside, got looked at and the facilities got inspected in a hurry so that we could make sure that those things got changed.
Yes, there are problems with the boarding home program, and one of the major problems, Mr. Chairman, is that there was a philosophy that was developed by the previous government, through its Human Resources ministry, that Riverview should be emptied as much as possible and that those people should be returned to the community and cared for in the community.
That's a concept that no one can really find fault with. But there were not the resources provided in the community to look after all those people who were put into the community. That's the problem we have right now: ensuring first of all that we find out what has happened in the community. So we must survey, and then we provide the services that we can in order to make that available.
Mr. Chairman, that's what we're doing now. There are ways in which those things are dealt with. One of the best ways, when you're short of facilities — and boarding homes don't come easily.... Good ones, bad ones, they don't come easily. People don't put forward that concept as easily as they might, and that might be part of the educative process that we need to go through. So when you're short and until you have a sufficiency of facilities available, you don't close things down lightly. You attempt instead to work with the people involved to get them to upgrade so that you don't have to close down. There may come times when, shortage or no, you have to close down, and I'm told that we have closed three of the facilities which were surveyed. I don't know whether they were the ones to which you refer. Then we deal with the others in terms of getting them to upgrade. That's the reason for the surveys, and, Mr. Chairman, that's what we're doing.
I had the opportunity one day to go out with community health workers and visit about five of the boarding homes in Vancouver. I didn't go outside of Vancouver because I didn't have the time. I visited many of the other facilities that the Coast Foundation operates. I've been to Loma Lodge, and we've talked with them and I understand the difficulties that they have.
The problem of medication that you raised, Madam Member, is one that we've already started to improve through a much more accountable system of medication in those facilities. As for the outside-day programs, we are insisting now that outside-day programs be part of the licensing. We understand as well that will impact on us in terms of further financial resources required, because those are not government operated facilities. They are privately operated facilities which are funded by the government. Those things are part of the ongoing reviews that are made by the ministry, and we'll continue to do that.
MS. BROWN: What about the staffing?
HON. MR. McCLELLAND: Those are matters that I deal with in Treasury Board, and I attempt to do what I can. I asked one of the members of my staff to go and have a look at what the staffing situation is. We have added 24 extra staff in the field in the past nine months. Those are the kinds of things that we deal with when we have the surveys which are necessary to tell us what our problems are, and that is what I hope we will continue to do.
I think I have answered, in as brief a way as I can, the questions raised by the member. We can only promise that review will continue in an ongoing way, and that we will hopefully respond as quickly as we can to that review.
[ Page 871 ]
The only other question is the one of the long-term care responsibilities, and we're in active discussion with the Human Resources Ministry now to consolidate some of those. Probably they will come over to the long-term care program at some point down the way.
The member for Nanaimo (Mr. Stupich) raised a lot of questions, and I'll try and just really skim over them.
[Mr. Rogers in the chair.]
The chiropractic question is one which I did not want to deal with in isolation. Others are in the same position as chiropractors — naturopaths and physiotherapists and others who have the similar kinds of limits. I've asked for a review from my staff which I can present to the Treasury Board in terms of what is necessary there.
The employment problem of licensed practical nurses is one which, basically, the hospitals must have control over. They set their own hiring practices. But I can tell you from the contact that I get from the hospitals that they have one dilemma. The wages of a licensed practical nurse are now reaching those of a registered nurse. Quite often hospitals will hire registered nurses because they feel, rightly or wrongly, that they get more value for their money. I don't know whether that is the truth or not, but that is what I'm told.
I've dealt with the matter of public health engineers with a number of MLAs, and, yes, there was a transfer over to the Environment ministry. However, we have statutory responsibility to provide certain services under the Health Act. We will then have to contract, but those services will still be held statutorily under the Ministry of Health. We will contract to the Ministry of Environment for those services.
In regard to the preference given to speech pathologists and audiologists, I think that question has largely been answered over the last nine or ten months. UBC is expanding its curriculum to help us provide more Canadian-trained people. The problem still is that we are not able, as much as we would like, to get Canadian-trained people. We've had to go outside to a large degree. That still must be done within our public service policy, which says that no one can be hired until the Canadian market has been fully canvassed. That policy is still in place with the government.
The dental plan has been discussed with staff, and it has been discussed with the dentists. The dental profession has put forward considerable recommendations to the government in terms of what they'd like to see in a dental plan. The costs and the formulation of the plan are now being worked within the ministry and with ministry staff. I can only say at this point that we don't know the total costs. The first opportunity I have to give those to the public, I will. I can say, though, that it is a commitment of this government that a dental plan will be introduced for the people of British Columbia in this fiscal year.
The ambulance rates was a decision which was made and I realize that it might be a hardship on some.
The dietitians Act is bound up with a number of other Acts which are before us. There are a lot of people who want their own self-licensing and self-regulation Acts. Every government — not only ours — is a little twitchy about the whole subject. The Attorney-General, at the present time, has a committee working on some recommendations. It would be my recommendation, as Minister of Health, that if we don't resolve that pretty soon, we should tell the dietitians that they should have their own Act, and we'll bring it in here. In the meantime, we're trying to come up with a better system. The other day, the member for New Westminster (Mr. Cocke) mentioned Ontario. They've almost scrapped what they did before, because they found it difficult to live with. I think that's all the questions you asked.
HON. MR. McCLELLAND: We're still dealing with the question of acupuncture.
MR. HANSON: I'd like to raise a couple of points with the minister which I don't think have been covered in the debate. One of them arises from my constituency; I'm sure it occurs elsewhere in the province. The population distribution or demographics of British Columbia are such that there tend to be more senior citizens here than there are distributed across the rest of the country. In certain parts of my riding, James Bay and Fairfield, that figure is higher than either the provincial or national figure. I don't want to quote the figure for James Bay off the top of my head, but it is quite high.
The problem I want to address to the minister is the sad situation that occurs in a small number of instances where couples who have lived together for many, many years and who require different levels of care have to go to different institutions. In fact, yesterday one of these examples came to my attention here in Victoria, where the wife requires more care than the husband. After 30 years of marriage they have to go into different institutions. Surely one of the cruelest things that could happen to people in their last years is to have to go off into different institutions for care. If I were ever the Minister of Health, one of the first things I would do would be to establish a certain number of beds in institutions for spouses who do require different levels of care so they could live in the same building. I would like the minister to look at that, particularly in this city which has the highest number of senior citizens in the province.
The second thing I'd like to raise with the minister, on which I've had considerable correspondence, is the failure of provincial and federal governments to live up to their obligations in terms of veterans' accommodation in the former veterans' hospital, the Royal Jubilee. There does not seem to be the accommodation required.
I have copies of the transfer agreement containing language which in its intent seems to want to provide the best possible care for veterans who are disabled and require permanent care. The definition of "extended care" is:
"The type of care required by
persons of any age with a severe chronic disability which has usually
produced a functional deficit, who require skilled, 24-hour-a-day
nursing services and continuing medical supervision, but who do not
require all the resources of an acute-care hospital. Most people who
need this type of care have limited potential for rehabilitation, and
often require institutional care on a permanent basis."
That definition generally characterizes the veterans in many institutions.
I have received correspondence concerning people who have experienced long delays in getting into hospital. My
[ Page 872 ]
information is that in the Royal Jubilee Hospital, for example, there are only 50 beds for extended care. One correspondent said there were 46 beds, but I think there are 50 beds. But the demand is higher than that. It should be a high priority. Veterans who require extended care in the last years of their lives should receive that care. I would like to hear from the minister what his goals and objectives are now in meeting the needs of veterans; also his answer concerning my earlier comment regarding the needs of couples who have lived together for long periods of time who require different levels of care.
HON. MR. McCLELLAND: Perhaps I could get a little more information on the specifics of the complaint about the veterans. I believe we are living up to the terms of the transfer agreement in making available for the veterans the things outlined in that agreement. I think we've gone further than that. The previous government began that move to make available to the veterans the same facilities outside of the single communities of Vancouver and Victoria, and to give them preference, as we have in the long-term care program in facilities other than at the Royal Jubilee or at the old veterans' hospital at Victoria, or at Shaughnessy.
So while those beds may be available only, for instance, at the Jubilee site, there are others available in other areas, and we will attempt to continue that. The transfer funds, when spent, will be spent on veterans' facilities specifically.
For instance, we are building a new 150-bed extended care unit at Shaughnessy for which planning is well underway now, and final clearances are just being given.
The one about the spouses being separated is one that I thought we had largely dealt with. I issued instructions to our staff from the beginning that we were to provide the highest possible level of flexibility to make sure that spouses did not get separated, unless it became absolutely necessary. There are units available in many of the facilities which have been going up most recently particularly, which have opportunities for spouses to spend their time together, regardless of the level of care they need.
But I think we would be fooling ourselves if we didn't understand that there will probably come a time when that may be impossible, just as it may be impossible for a normal family relationship to continue when one member of the family can stay in the house and the other member may have to go into an extended-care facility. That may reach all of us sometime, when the care we need becomes that extensive.
So there always will, I think, be a period when loved ones may in fact be separated because of illness — chronic illness particularly. But it's specific instruction to our staff that wherever possible — and we've imposed this on many occasions — spouses are not to be separated simply because they require a different level of care, unless it becomes absolutely impossible for the facility to provide that care for them.
MR. HANSON: I do have a specific case and I would like to bring it to you because I know that the one spouse is going to Mt. Tolmie and the other is going into another. I would like to bring that to you because they would be very happy to have that rectified.
I also talked to an administrator at one of the long-term care institutions here in Victoria, and it is not as infrequent as the minister suggests. As they come to my attention I will bring them to him.
HON. MR. McCLELLAND: We should all remember there may come that time, for instance, if a member of a union requires highest level of extended care...or, perhaps, let's put it the other way around. If a person requires one of the lower levels of care, for instance, and then that person's spouse should suddenly become incapacitated to the point where they require the highest level of care, it may be impossible for that facility to give that kind of nursing care to the one who requires more care.
So there might come a time in our lives when we may have to be separated. That's all I'm saying — simply because the care cannot be given. But I have said it is the policy of the ministry at this point to provide the most flexibility we can to ensure that spouses stay together.
MR. HANSON: One last comment. I would like to draw the minister's attention to the multicare facilities in Britain. I think one of his deputies may be familiar with it. Philosophically and morally, they are trying to meet that need. I'm not saying people aren't separated when they go into a hospital. But when you have two elderly people at different levels of care, I think that we, as a society, have to decide whether we are philosophically going to try to meet that need. That is the point I'm trying to raise with you.
HON. MR. McCLELLAND: I agree with the member, Mr. Chairman. But when one reaches the point where 24-hour nursing care is required, you're not very far from a hospital.
MR. LEVI: Mr. Chairman, I got a call a couple of days ago and I haven't really been to see the ministry about it. But I wonder if he would make a comment about the spinal cord unit. I am not now dealing with a specific case, but what happens with the spinal cord unit in the summer? Is there a gearing down, or is it maintained at the same rate? One of the observations made by a doctor I talked to in the case was that if there is not a gearing down, and there is a maintenance of the standard of service, the service should really be increased in the summer. Doctors find the greatest intensity of cases comes during the summer. They're averaging six or seven spinal cord cases, and some of them, at the moment, are being looked after in the local hospitals. It's not that the hospitals can't look after them, but that the rehabilitative process in the spinal cord unit is better.
Now can the minister tell me what actually happens? If there is a greater intensity of cases in the summer, as apparently there are because more people are out in their cars, and there are a number of accidents as a result of swimming, is it built into that service that they can in fact receive more people than they normally receive in the rest of the year? That's really what I'd like to hear from the minister.
HON. MR. McCLELLAND: Mr. Chairman, I don't think it's a matter of the time of year that there is low occupancy in the spinal cord unit; that happens from time to time. The problem, again, is more one of education, rather than anything, of the physicians in the community. There is some reluctance — and I don't know why, because I'm not a physician and I'm not involved that much in the medical
[ Page 873 ]
profession — from time to time to refer to the spinal cord unit. Physicians are treating those patients who could be treated in the spinal cord unit in the local hospitals, as you've mentioned. It's a matter of attempting to get the physicians used to referring to the spinal cord unit. We have a committee working on that at the present time among the doctors in the area, the people at the spinal cord unit and our own staff. I haven't had a report recently from them on that matter, but I'll certainly look into it now that you've raised it. But that's the basic problem — getting that referral into the spinal cord unit so that we can use it to its full advantage.
MR. COCKE: We've been on this vote for three days. I'm amazed at the minister's marvelous, magic responses today. There have been responses to questions, rationalizing to some extent, but that's....
HON. MR. McCLELLAND: Am I not supposed to respond? That's what this is all about, Mr. Member.
MR. COCKE: I'm amazed at the minister. He was even listening for a second there, but he didn't understand, and he normally doesn't. He says: "Aren't I supposed to respond?" I said I'm amazed at his response today. Mind you, he's rationalizing a great deal, but the areas where the minister seemed prepared to respond were the areas in terms of the financing of our hospital plan in this province and the areas in respect to the emergency health services.
I suggested to the minister the other day that cabinet ministers have a priority on the utilization of government aircraft, and he said: "No, they don't. Never, never, never." I told him to check the logs of the government aircraft during the last election when ministers were not allowed to fly. At that point, there were significantly more flights used for mercy services. So that's just something for the minister to do in his spare time.
I suggest that some of the questions that the minister has not answered are ones that I asked two days ago, or three days ago.
HON. MR. McCLELLAND: What are they?
MR. COCKE: They are questions around how you are financing health service, when it's you against every hospital in the province. I suggested, for an example, that there are 750 emergency health service members needed in this province, and you got up and said: "Where did you get that figure?" He's got it in reports. Mr. Chairman, I had it in reports. He's got 550 people, and he knows that in the city of New Westminster right now the firefighters are carrying people to the hospitals when there's an emergency situation because there is not enough staff on the whole lower mainland.
I've discussed all of these questions in long detail, and I'm certainly not going to reiterate my questions or my detailed discussion today, because we've been all through it. But I'd just like to suggest, as we get around to the minister's vote, that the lack-of-confidence motion was warranted, and any concerns that we have for the carrying on of health care in this province are concerns that we'll carry with us through this minister's vote.
Vote 128 approved.
Vote 129: administration and support services, $21,327,012 — approved.
Vote 130: preventive and special community services, $35,539,703 — approved.
Vote 131: direct care community services, $180,777,352 — approved.
Vote 132: mental health services, $18,129,440 approved.
On vote 133: Hospital Programs, $649,178,588.
MR. COCKE: Mr. Chairman, the comment is that it's either grossly inadequate or the minister should have had an alternative for the way he's running the hospitals in this province.
Vote 133 approved.
Vote 134: Medical Services Commission, $245,300,000 — approved.
On vote 135: Emergency Health Services Commission, $26,050,883.
MR. COCKE: Mr. Chairman, this is the vote under which I think the minister should indicate in some detail why it is that there is an increase of only a little over a million dollars in a service that has been under financed and continues to be under financed, a service that this province could very well be proud of, and is proud of. But it is not a service that is being properly funded. I just feel that the minister lacks the priority. This is a minister who can place $12 million down a gopher hole in terms of his ' heroin program, and yet squeeze a program like the emergency health service. I think it's a shocking situation.
Vote 135 approved.
Vote 136: Forensic Psychiatric Services Commission, $4,285,498 — approved.
On vote 137: Alcohol and Drug Commission, $12,330,546.
MR. BARNES: Mr. Chairman, could the minister indicate to the House the progress of the detoxification centre proposed for Great Northern Way in the north Mount Pleasant area, indicating the parameters of that project in terms of the extent to which it will realize some of the overall objectives of the detoxification program respecting counselling and residential treatment? To what extent and under what authority will the persons being admitted stay? How long will they be there? Will it be on a 72-hour basis, long-term? Also, could the minister indicate when the project will be underway?
HON. MR. McCLELLAND: Mr. Chairman, I guess when the project will be underway depends to a large degree on somebody else, not me. I'll tell you, if we had the opportunity to have that facility open a year ago, if it had been up to me, it would have been open a year ago
[ Page 874 ]
somewhere in Vancouver, because the promise I made to the city of Vancouver was that we would replace that drunk-tank, which has needed replacement and which must be replaced at the earliest opportunity.
We had a site at one point, and for one reason or another that site was not acceptable to the city of Vancouver. We expended a fair amount of money in developing it — that was the China Creek site — and we had to start all over again from square one. The city came up with another site. I think we spent around $100,000 in the development of that site, meeting every one of the city's requirements in its bylaws. It isn't up to us to do the things the city is supposed to do in terms of community input and that sort of thing. What we are supposed to do as the developers is meet the bylaws, and we did all those things.
The city then came back to us and said: "We may not be going with this site. How about looking at another site?" Well, all I said at that point was that obviously the city's priority was not as high as the priority I had put on the replacement of the drunk-tank. If it wasn't, then I could have used that money in a lot of different ways, in a lot of different communities. So I said to the city: "If you're really don't have this as a high priority, then tell us and we'll spend the money somewhere else." If you call that a threat, then it's a threat, I suppose, but I was anxious to see this program go forward.
Anyway, we're ready to go with that program. I think the city has agreed at this point that site on Great Northern Way will be where it is. It's for a 48-bed detox centre. There will be 12 holding beds for the compulsory detox centre to replace the drunk-tank. The Ministry of Health will be operating it; the Ministry of the Attorney General will provide those security people who are required in that kind of facility. I understand that we hope it will be open next year.
It will not be a residential treatment facility. We do have a residential treatment facility now. The newest one is in New Westminster, Pacifica, which is located at the present time in the YMCA building there. That facility is going to have an addition to it quite soon, and our residential treatment facility program is going quite well. That is not part of it. It's a detox centre meant for a short-term detox stay in a much more humane and sensible atmosphere than the Vancouver city jail.
MS. BROWN: I have a couple of questions. I'm kind of curious about Dr. Altman, who has been hired to head the program. I wonder if the minister can tell me.... He's got a very impressive curriculum vitae, but it doesn't really say very much about what his job was prior to coming here.
I understand he worked — helping fat people reduce — I think that was the job he had to do in Montreal somewhere — and he used the behaviour modification process. There is some question as to whether it was successful or not, used in that particular setting, and one isn't sure whether or not he left a successful job to be hired here. So maybe you could tell us a little bit about what he did before he came here, and whether anyone has checked out that very long and very impressive curriculum vitae. Or he was just hired on the basis of an interview and what you read in the curriculum vitae? I also want to know when his salary started. Did it start on January 1, or in June when he began his job? What kind of deal did you work out with Dr. Altman? In other words, when did he begin to get paid under the particular program?
I am also curious, Mr. Chairman, if the minister would tell me whether, in view of the fact that he is having such a hard time finding addicts to fit into the program — it shows here 293 staff to cover something like 106 addicts — whether the program is now drifting into treating other forms of narcotics. The Act is really quite clear about the fact that the program is for treating heroin addicts. Are people who are not heroin addicts and are addicted to other forms of drugs being treated under the program? I'm thinking specifically of some of the community groups — the Coast Foundation Society and other places like that — where they are allowed to treat alcohol and other drug addictions. Is any of this money going into that too?
According to the code of ethics which applies to mental health, confidentiality plays a very important part. I have a copy of the code here and it certainly makes a big fuss about confidentiality. I am wondering if the minister can tell me whether the private criminal records of any of the people who are under the program have ever been released to any of the doctors or anybody on the evaluation team. I would like to know whether anyone who is conducting the training program is using any of the involuntary volunteer patients as examples in the training program. Are they using persons' names and identifying them quite clearly? Is the minister aware if this is happening? The code of ethics covers that question specifically.
HON. MR. McCLELLAND: I don't know whether anybody is using somebody else's name as an example. I haven't heard of that. If the member has some information that I should have, that I should be investigating, I'd be happy to have it. To my knowledge no private criminal records have been made available to any member of the assessment panels, and I can tell you that is as up to date as I can probably get it. I attended a meeting of the assessment panels about eight days ago, and that specific question was before the committee, and that had not happened to that point. I am sure it might be very difficult for it ever to happen under the laws we have now.
Doctor Altman was hired the same way all civil servants are hired. He went through a panel of the public service and the public service chose him as the person who best met the qualifications which were advertised. Every one of the members of our staff has gone through panels of the public service for this program.
HON. MR. McCLELLAND: No, because he's not a member of the staff of that program. He is an order-incouncil appointment, as you well know, Mr. Member, and that is a time-honoured way of appointing people to the service of their provinces.
MS. BROWN: When did his salary start?
HON. MR. McCLELLAND: His salary? I don't know. I'll find out for you before the afternoon is over. It started when he started.
MS. BROWN: Well, I think you should check that out.
[ Page 875 ]
HON. MR. McCLELLAND: I'll check it out, and if there is some difference I'll tell you.
I would assume that the public service checked out Dr. Altman's curriculum vitae. I think Dr. Altman brings a tremendous wealth of experience and enthusiasm to our program and to this province. I might, just for the committee — because I know some of the others would be interested in Dr. Altman's background....
He is a very firm supporter of the program that we have in place. He comes to us from a research institute of the Universite de Quebec in Montreal. At the Universite de Quebec, and during his tenure as an instructor in the Department of Psychiatry, Harvard Medical School, Boston, he did extensive research into the psychological and physiological impact of a variety of treatments for narcotic abusers. His study results, Mr. Chairman, have been published extensively and he has presented papers before professional associations in North America and in Europe. He has a BSc from McGill University, an MA from the University of Western Ontario, and a PhD in Biopsychology from the University of Chicago. His professional experience includes a term as visiting professor of psychology at the Universite de Quebec, Montreal, 1975-79; instructor of psychology in the Department of Psychiatry, Harvard Medical School, Boston, 1974-75; associate to the Department of Psychiatry, Harvard Medical School, Boston; assistant psychologist, McLean Hospital, Belmont, Massachusetts; part-time lecturer, Department of Psychology, Northeastern University, Boston. He was an Ontario graduate scholar in 1968-69 and he was awarded the University of Chicago fellowship from 1969 to 1973. He has published extensively in the field of psychology and is a member of the Canadian Psychological Association.
I mentioned last night in sort of an off-the-cuff remark, Mr. Chairman, that I would be extremely pleased — and I'll make arrangements — when the House sits again to ask Dr. Altman to come to the Legislature and, in our media centre in the basement, develop a presentation of our program for all the members of this House. I'll undertake to do that and make sure that when we're gathered together here again that will be done, and I'll make sure that all members have an invitation.
MS. BROWN: Mr. Chairman, I was impressed with the curriculum vitae and the fact that Dr. Altman didn't seem to stay anywhere more than one year; I found that kind of intriguing. I was also impressed by the fact that it didn't include his last place of employment, and didn't tell us what job he was leaving from to come here. I checked his curriculum vitae — and I understand that it wasn't checked before — but it seems that the behaviour modification program which he was using on overweight people in Montreal wasn't working. I know it worked on the rats that he worked with, and I'm wondering whether coming from that to this.... He failed at that, and now we're giving him a $12 million budget to work on heroin addicts. It reads beautifully; he did a lot of publishing and travelled around a lot from place to place. But as I said before, I was impressed by the fact that it didn't include those two things. We need to know when the ministry started paying him, as opposed to when he actually started work.
HON. MR. McCLELLAND: I'lltell you.
MS. BROWN: Okay. Tell me when he got his first paycheque and when he first started work.
HON. MR. McCLELLAND: Mr. Chairman, I find that kind of a criticism of a professional person incredible. I could walk into the University of British Columbia, the University of Victoria, Simon Fraser University or any medical school probably anywhere and find people who've moved all over the place, moved around a lot. Professionals move quite a lot. You haven't even been here for a long time; neither have I.
MS. BROWN: Not once a year.
HON. MR. McCLELLAND: Oh, it's not once a year. I just read to you the times — 1975 to 1979 in one place at the University of Montreal. That's not one year; it's four years. You know enough about professions. People do move around, and they're investigative people to begin with — researchers and people who are interested in finding out new ideas. They do move from time to time.
Anyway, Dr. Altman started being paid as a part-time consultant to help us put together the plan on January 1, 1979, on a part-time basis. He began receiving his salary as full-time director of the program in May 1979.
MS. BROWN: Fine. In fact Dr. Altman started in May and he has been paid since January. How much was he paid between January and May? Because he was still on his other job between January and May. He wasn't here between January and May.
HON. MR. McCLELLAND: Well, Mr. Chairman, that's not even unusual. Lots of people serve as consultants while they're in other jobs, and we asked....
MS. BROWN: What was he paid?
HON. MR. McCLELLAND: I don't know. I'll get the amount for you. Why don't you put it on the order paper and I'll get it for you?
MS, BROWN: It's your estimates.
HON. MR. McCLELLAND: Well, I don't know what he was paid. I'll find out for you.
MS. BROWN: You've been squandering the taxpayers' money. What do you mean you don't know?
HON. MR. McCLELLAND: Mr. Chairman, I'lll find that out for the member, but let's have a little sense in this debate. That kind of thing goes on all the time in the professions where you use people who are in existing university jobs, particularly, to serve as consultants. We would not be able to function in government if we didn't use people in consultative positions like that. It happens all the time. It happened in your government; it happens in this government: and it will happen again and it should happen, because it's an opportunity for us to have the kind of expertise that we need, but that we don't have, in the civil service. We can reach out to universities and use those people. My god, use some sense.
[ Page 876 ]
MS. BROWN: He was in Montreal. He was being paid in Vancouver while he was in Montreal. You've been squandering the taxpayers' money, that's what you've been doing.
HON. MR. McCLELLAND: Well....
MR. CHAIRMAN: Order, please. The Chair did not recognize the member for Burnaby-Edmonds when she rose to speak, and has not yet recognized the minister. Until such time as the members are going to wait until the Chair recognizes them, we can't carry on.
HON. MR. McCLELLAND: Mr. Chairman, I'd like to answer that question from the member who wasn't recognized. The member knows better. We use people from all over North America for their professional expertise. You know that one of the things we're doing now in this government is providing lottery funds for health-care research projects. It's one of the most exciting new developments in the use of lottery funds, in my opinion, in years. We are making available much-needed funds to medical researchers in this province to come up with new and better ideas and ways in which we might treat disease or cure disease, if possible.
MR. CHAIRMAN: Order, please. The Chair is not going to tolerate widening the scope of the debate. We're on the Alcohol and Drug Commission.
HON. MR. McCLELLAND: This is in direct relation to the question that was asked of me. Let me tell you that one of the ways we set up to ensure that only the most excellent projects get developed is that we send those project applications that we get off to Alberta, to Manitoba, to Saskatchewan, to Quebec, all over Canada to experts in the field to vet those for us and to send back their expert opinions. We pay for them. That's the way we maintain excellence in the things we do.
It's that kind of assurance that will make sure that the money we spend in this province is spent for good reasons and for excellence and not for the way it used to be spent. You talk about squandering. You never even knew where the money was going. We're at least making sure that the money we spend is for excellent reasons.
Anyway, all the member has to do is check last year's vote because January 1975 was in last year's vote and she will be able to check out how much money was paid.
MR. LEVI: Mr. Chairman, if the minister's got his estimates book in front of him, under vote 137, I wonder if he could tell me something. According to the estimate we're dealing with now, the allocation to the Heroin Treatment Program is $5.3 million "net of recoveries." What are the recoveries?
We've talked about a number of figures for the Heroin Treatment Program. In the estimate book, it shows as $5.3 million, I think. Now what are we talking about there? "Net of recoveries" — I presume that what we've got then is a greater budget with something being charged up somewhere else.
Last year the budget estimate was $3.7 million. Has the minister any idea what they actually did spend? We are now three months past the end of the fiscal year. Is this what he's going into the treatment year with — that is from April 1 — with $5.3 million or is that figure actually more? I find that a little confusing, Mr. Minister. Perhaps you could enlighten us on that.
HON. MR. McCLELLAND: Mr. Chairman, the estimate of the cost for this fiscal year is $5.3 million.
MR. LEVI: What is "net of recoveries"?
HON. MR. McCLELLAND: What does that mean?
MR. LEVI: What does it mean? It's in the book.
HON. MR. McCLELLAND: Where? Where are you?
MR. LEVI: On the vote. On page 129 of the estimate book, vote 137, it says Heroin Treatment Program (net of recoveries) $5.3 million. Now what does net of recoveries mean in relation to this?
Are we looking at a greater figure or what?
HON. MR. McCLELLAND: No, Mr. Chairman, that's the budget: $5.3 million.
MR. CHAIRMAN: Order, please. I think perhaps I'll accommodate the minister by giving him the page out of the Chairman's book.
MR. LEVI: If the minister has the relevant page in his hand, perhaps he would look at it and tell me what "net of recoveries" means. To my knowledge, the government does not have at the moment cost-sharing arrangements. Or maybe they've been able to do that. I'd like an explanation just what "net of recoveries" means in respect to this.
HON. MR. McCLELLAND: Mr. Chairman, I'll have to get that for you. I'm not exactly sure what the recoveries are. I assume, though, it has to do with some of the recoveries we will make from the cigarette, alcohol and tobacco fund, but I'm not positive of that. If I don't get it before this vote is finished, I'll get it for you.
MR. LEVI: There is just one other thing, Mr. Chairman. Last year the budget — if I read it rightly — for 41 staff was $3.7 million. Then we're going to deal with the heroin program with 293 staff with $5.3 million. Now is that an adequate amount of money for 293 staff when you had earlier...? That's a little confusing, Mr. Chairman.
HON. MR. McCLELLAND: Mr. Chairman, the gross cost of the Heroin Treatment Program will be just over $8 million. The recovery, if needed, during the course of the year would be $2.8 million from the drug, alcohol, cigarette, tobacco education fund. So that's what the net of recovery is. It would be the gross cost that would look after the costs of the staffing.
MR. COCKE: I'm reminded of the minister sat in opposition and the fuss he would have made when the person who finally came to work in a particular program, while living in Montreal and working on his old job, received 75 percent of his $35,000 a year, and finally got out here. That was from January till May, he finally got out
[ Page 877 ]
of here in May and went back to work. That minister who was then a member, would have filibustered the estimates for a week on that. Yet now he stands up; he's very rational; he says all governments do it. It's a marvelous thing. It's a "Cass Beggs was okay for us but it wasn't okay for them" type of thing. Come on, be a little bit consistent. I know that's asking rather a lot from this minister. There was a situation where in order to get him, or whatever, they made this extra-special consideration. The extra-special consideration wasn't bad — three-quarters of what you're earning in the future, for the period when you're still not there. We all know it's a behaviour modification program, and we all know it's an experiment because it's called an experiment.
Remember I read this out yesterday, to this extent: "Their application to this population" — and they're talking about the program — "should be considered experimental." That's what we're paying $12 million for, an experimental heroin program. I want to ask the minister this question. Under one of these programs, the community mental health program, there's a code of ethics. An area in that code of ethics is that the client has the right to know if he is being treated by an experimental procedure. He is given the opportunity to consent. Is that same consideration being given to the heroin addicts that come into his program? Are they being offered the information that they are subjects of an experimental program? Are they told that? Do you have the same level of concern for their rights and privileges as you have for the rights of those being treated under the community mental health program? That's the question.
HON. MR. McCLELLAND: The answer is yes. We have the same concern for their rights.
MR. CHAIRMAN: Order, please. If the minister wishes to answer....
MR. COCKE: I'm afraid the minister didn't understand my question. Are the heroin addicts, the subjects of this program, told that they are participating in an experimental plan? This, I think, should be easy to answer for the minister.
HON. MR. McCLELLAND: I guess it all depends on what the members think is an experimental plan. This is a new program in which a number of different kinds of treatment developments will be used. At the present time the only people who are involved in the program are those who have volunteered to come into the program and attempt to deal with the serious addiction problem that they have. Those people, obviously, are aware that they are into a new program. They have been searching for years, some of them perhaps all of their lives from the time when they were in their teens, with no place to go and no answers. Now they have the opportunity to develop some of those answers with us in a new and unique program. They come to us on a voluntary basis with that full knowledge. What do you think is experimental? It's a new program. I've said it's a demonstration project; the whole world knows that, and as such so do the people who are involved in the program.
MR. COCKE: Mr. Chairman, I will quote from part of the program. This is being used, and this is precisely what it says on the front page of this urge-control:
"Caution: It should be understood that the treatment procedures advocated herein were developed and evaluated using members of the general public as clinical subjects. It is not known how well these procedures will generalize in their clinical efficacy to the subset of the general population which has been involved in drug abuse. To this extent their application to this population should be considered experimental."
HON. MR. McCLELLAND: Every new program is experimental.
MR. COCKE: Good enough; every new program is experimental, and they are being informed, the minister says, I gathered.
MRS. DAILLY: I just want to make a quick comment at the conclusion of this vote. In looking at the vote, which is the Alcohol and Drug Commission vote, there is something that strikes me and causes us great concern. The amount of money that this government is presently spending on alcoholism treatment is $6,977,000. In comparison, the amount being spent to treat approximately 140 people for heroin treatment is $5,353,000.
Now, Mr. Chairman, we all know alcoholism is one of the major social diseases in our province and elsewhere. How many alcoholics there are I have no idea, but I do know from recent reading that it's on the increase every day. I just have one simple question to the minister. How can he possibly rationalize spending more than $5 million for 140 people with one social disease and yet only $7 million — slightly under $2 million more — for alcoholism treatment, which involves so many people in this province and, frankly, causes so many other spinoff effects with family breakups, et cetera? I just don't see the rationale. I don't know if the minister wishes to comment on that or not.
HON. MR, McCLELLAND: Well, Mr. Chairman, no, you don't see the rationale because you assume that those.... You know that problems of family break-up, of the corrections system, of social workers, of the problems in our education system caused by alcoholism are the most serious public health problems in British Columbia. In fact, at the present time it's probably the most serious public health problem in the world.
The $6,900,000 reflects not even a small percentage of the money it costs government and taxpayers to deal with the alcoholism problem. We did an interesting comparison not long ago with regard to this development. I wanted to put something in graphic pictures a person could understand quite easily. What we thought we could do was develop a kind of a balance sheet that an accountant might use in terms of profit and loss and what the profit on alcohol is to the province of British Columbia or what the income is — "revenue" is a better word than "profit." The province takes in around $200 million.
MR. LEVI: It's $400 million.
HON. MR. McCLELLAND: No, it isn't. It's about $200 million. Well, $193 million, net. The gross is $400 million, but the so-called profit from alcohol is about $200
[ Page 878 ]
million. But if you balance that with what we actually spend in the costs of alcohol, and alcohol abuse, and alcoholism, you're looking at — and I don't go through the items with you — a job loss alone that probably costs us $100 million in loss of productivity because of alcohol abuse.
The other costs of social services, of child-battering, of the police costs, the incarceration costs, cost us in hard dollars probably another $200 million.
So it's costing us $300 million a year just to deal with the costs of alcoholism. The $6 million or $7 million you have in this estimate deals only with the actual treatment services which we have available. I went through them yesterday. There has been a very significant increase. We have in this province, in every region in British Columbia, a full long-term residential centre for the treatment of alcoholism. There's one in each region of the province now, and growing.
We have detox centres all over this province now in every region of the province. We have, I think, some 130 or 140 out-patient counsellors. I mentioned to you we just opened the first native Indian long-term treatment centre at Round Lake. We've just opened an eight-bed very unique treatment centre for natives in the Queen Charlottes.
Mr. Chairman, the record of treatment and expansion of the treatment programs is one I am extremely proud of in this government. You talk about the difference in two or three words, Mr. Chairman. The reason heroin treatment has to be treated on a different basis is because it's a different problem. It costs us in the minimum $255 million a year for 10,000 or fewer heroin addicts. The cost of the problem to British Columbians is far out of proportion to the numbers involved. That's why it requires action. That's why it requires that the 50 years of debate and philosophical discussion come to an end and that some government has the gumption to get out and do something about it — and this government is doing it.
MRS. DAILLY: Mr. Chairman, I don't intend to keep this vote going. I just would like to say I think the minister and I certainly have an agreement on the social ravages and the cost to society of alcoholism. But in listening to his comments I still feel my basic argument stands. If you compare the amount being spent by this government to prevent alcoholism, I think that still the comparison with the heroin treatment leaves much to be desired. All the fine words and protestations of the minister simply do not add up when you look at the dollar and cents figure.
All I'm asking the minister is to put more emphasis on this major social disease than we see in this other area which has already been discussed in this House.
MR. LOCKSTEAD: I have just a few very brief remarks on this particular vote. I am sorry that due to unusual circumstances this afternoon I missed the opportunity to discuss with the minister cutbacks in positions and hospital beds in the Powell River hospital and other hospitals in my riding because of government finance practices, and the cutbacks in the extended care facility in Powell River.
MR. CHAIRMAN: We are on vote 137.
MR. LOCKSTEAD: I am happy to stay on vote 137, so I'm going to ask the minister at this point if he would consider a request from the Bella Coola area people in the Indian band and in the community to include a new detox centre in the new hospital facility which is being constructed in that community. It only makes common sense, Mr. Chairman, that, in terms of the expenditure of funds, a detox centre be included in that hospital facility. As you well know, particularly in the small remote communities, alcoholism is one of the major problems — and I'm sure you've gone through that in this House today, and I'm sorry I missed it. So I'm asking the minister now if he would consider including, at the request of the people in that community, a detox centre in that facility.
HON. MR. McCLELLAND: I'll certainly take that question under advisement. It is interesting that the member talked about the cutbacks in his constituency at the same time as he talked about the new hospital we're building in Bella Coola.
MR. COCKE: Mr. Chairman, I rise with my usual amusement. I watched that minister and his pontificating in this House about the ravages of alcohol, and he's added less than $100,000 to his alcohol program. What is he pontificating about? It is the most unusual kind of performance I've ever seen. Admit it! The Treasury Board bilked you this year, Mr. Minister, all down the line, and everybody in the province is suffering as a result. Admit it!
MRS. WALLACE: I would like to ask a similar question of the minister as that asked by the member for Mackenzie (Mr. Lockstead), relative to the Duncan area, where, I'm sure the minister is aware, we have a very serious alcohol problem. One of the problems is that we have an extremely high Indian population in the Cowichans, where we've had some very difficult situations with the young people, most of which are attributable to alcohol. We do have a representative there but no facilities and no funding for those facilities. I'm hoping that the minister can tell me that in spite of the cutbacks on this particular vote, there are....
HON. MR. McCLELLAND: There are no cutbacks! Don't be dumb!
MRS. WALLACE: Well, then tell me, Mr. Minister, that in your generosity you are providing funds for those Cowichans in Duncan who desperately need that kind of assistance.
MR. LEVI: I wonder if I could ask the minister a question. The one word that he has been jumpy about all through the estimates is the word "cutbacks." The estimate for last year for alcoholism treatment and rehabilitation was $6,890,000. The estimate for this year is $6,977,000. He has got to maintain the same staff, presumably the same program, and presumably nobody is going to get a pay increase until they sign the contract, and then they get a pay increase. Now how can he tell us that with an increase of $100,000 he is going to be able to maintain 106 employees, if he is going to have to give them a 5 or 6 percent wage increase? How is that going to be possible? What happens? He either reduces his staff, which means he reduces the service.... You can't continue to argue that because you give money somehow the service is not going to be cut
[ Page 879 ]
back, when you are not giving enough money to even maintain the service. Would the minister explain that?
It's all very well for him to say there aren't any cutbacks. We're not just talking about cutbacks in money; most of what we've talked about is cutbacks in service. Will there be a cutback in service in respect to alcoholism treatment and rehabilitation if in fact the budget increase is less than $100,000? How is that going to happen? How is he going to maintain those programs and those staff? That's a fair enough question.
HON. MR. McCLELLAND: There is much to be said for good management. The member, having been part of a government, knows that the pay increases are not necessarily reflected in the vote before you now. They are reflected in the vote of the Ministry of Finance; that has already been debated. The increased salaries do not reflect on that number. The reason there is no increase in staff for the Alcohol and Drug Commission is, with the exception of providing some direct service in terms of industrial alcoholism programs, that we don't provide much service. Ours is a service facility. We fund outside agencies which carry forward the programs under the guidelines set down by our service agency, so it doesn't always become necessary for us to have additional staff to do that. In fact we are now to the point where we have developed guidelines for the delivery of service and where we can easily live with them. It's almost a matter of automatic reporting, in terms of dealing with the services out in the communities.
The programs will be expanded and are being expanded; I've mentioned a few of them today. I mentioned the increase in the treatment centres available. A lot of people don't realize that we have five full treatment centres for alcoholism in British Columbia. That's a record which I think is enviable, and it is not matched by many other parts of Canada. That's about the best way I can answer that question.
Vote 137 approved.
On vote 138: building occupancy charges, $28,638,000.
MR. LEVI: Could the minister tell us the reasons for the $3 million reduction in the building occupancy costs?
AN HON. MEMBER: We sold that desk of yours.
MR. LEVI: You didn't sell that desk. The minister who succeeded me insisted he keep it. Right, Bill? It's a good desk. Having amortized the cost, it's probably invaluable now.
HON. MR. McCLELLAND: During the estimates of the Minister of Finance, I remember him trying to explain this one. He didn't do such a great job of it; I'm not sure that I can either.
It's a pretty complicated formula, based on the actual needs of the ministry. With the number of program changes and moves from ministry to ministry, I'm told it's simply the new, revised formula, based on our actual needs and on the experience we had last year.
Vote 138 approved.
On vote 139: computer and consulting charges, $2,154,000.
MR. LEVI: I got part of an explanation of the reason for the reduction of computer costs from $7 million to $2 million; it's related, I think, to the medical plan. There is a cut of well over $5 million. What exactly has happened there? Where have those costs gone, if they are not shown here?
HON. MR. McCLELLAND: The major reason for the difference is because of the request from the comptroller general, who insisted that charge be transferred to the Medical Services Plan. It's now in the vote of the Medical Services Plan rather than in these computer and consulting charges.
MR. LEVI: Could the minister tell us what the amount is? Let me just explain why I'm asking. In trying to understand the cost as related to the Systems Corporation, we've calculated all of the items appearing under computer and consulting charges. The minister is saying that in respect to part of the operation in the Ministry of Health, some of those computer charges appear under a different vote. Is that really what he's saying? If that's the case, at the moment there is a $5 million cost buried somewhere in his ministry which does not show as a computer cost.
HON. MR. McCLELLAND: It's my understanding that it will show, but not here; it will show under Medical Services Plan. I can briefly tell you what the charges that you're dealing with here are for. They're for the Alcohol and Drug Commission, the Emergency Health Services Commission, direct-care community services, hospital programs, mental health, preventive and special services, vital statistics, and the Forensic Psychiatric Services Commission. The Medical Services Plan estimate will contain that amount within it.
MR. LEVI: I have another question. Does the Medical Services Plan purchase the service from the B.C. Systems Corporation? The minister indicates that it does. Now one other question to the minister. Is the ministry going outside of the B.C. Systems Corporation to purchase computer services? Earlier this year you had a number of advertisements in the paper for programmers.
HON. MR. McCLELLAND: Mr. Chairman, no, those positions which were advertised were to bring us up to a recommended number of interface positions within the ministry. That came about as a result of some lengthy negotiations with B.C. Systems Corporation about the best way they could serve us as one of their major clients. And one of their major recommendations for that was that we needed more interface positions within the ministry which could deal directly with B.C. Systems Corporation to develop our programs in-house. That's what those positions were for and that's the way that's going now.
MR. LEVI: How many?
[ Page 880 ]
HON. MR. McCLELLAND: I forget the numbers at the present time, Mr. Chairman. I can get that for the member if he likes.
Vote 139 approved.
ESTIMATES: MINISTRY OF
On vote 140: minister's office, $206,837.
HON. MRS. McCARTHY: Mr. Chairman, this is the first opportunity I have had to address this chamber as the new Minister of Human Resources for the province of British Columbia.
First of all, I would like to say that I am honoured to be here in that position and I appreciate the tremendous responsibility that it places on me. I also appreciate that all members of this House, regardless of political party, are here to serve the people of British Columbia and that particularly means those in need, those who are elderly and those who, as we have just discussed in the Health minister's estimates, are in need of special medical care. I would think that perhaps that's really what brings most people to public life. So I begin this new responsibility for myself and my estimates in the House today with a few remarks, knowing that I will have a lot of cooperation from both sides of this House, and realizing that we have a job to do for those people who are in need in the province.
That is my responsibility, and my delight to have that responsibility is expressed to you, Mr. Chairman, and to members of this House. When I first sought public life and first came into the public service of British Columbia, I was made a Minister Without Portfolio, and in those years I had hoped as all members who come to this House hope, to be given a responsibility that is specific at one time or another. In that time I had wanted very much to represent this ministry, so today I stand before you very pleased that I do so.
During the time I represented the province as a Minister Without Portfolio in the former Social Credit administration I had the opportunity to do a special study on social services needs in the city of Vancouver. It was the first time a study such as that had been done by a non-professional. As a matter of fact, it took about half a year. It took a lot of meetings and a great many submissions from individuals, face-to-face meetings with professionals and with the users of the service — people on income assistance, elderly people and so on. It was a great experience and it gave me a very great insight, one which continued from my earlier service in another area of public service and community service.
Therefore I am pleased today to say that I have had a very remarkable experience in these six months. With me today to assist in answering your very many questions is — and I am very pleased to pay tribute to my deputy minister — John Noble. In these past six months that I have had this responsibility, Mr. Noble has certainly made my life and my work-day life extremely challenging and easy. I am grateful for the leadership which he has shown in the ministry. I am also pleased to say to you that Robert Whitmore, the assistant comptroller for the Ministry of Human Resources, is here. Although I don't see him in the gallery now — I believe that he is here — Pat Tidball is in the precinct; he represents our Pharmacare program. I am very pleased to have their assistance today and their assistance these past six months.
My colleagues in the Ministry of Human Resources, those who are here today, the executive of that ministry and my self represent a very large group of dedicated people. Some 5,000 people are employed in the Ministry of Human Resources, and that ministry spends between $10 million and $12 million a week. Since we met here a week ago today, we've already spent $11 million of taxpayers' dollars for the very programs which you're going to query me on in these next few hours.
Could I just say, though, in starting to talk of my ministry, that I would very much like to pay tribute to the many people in my ministry, the 5,000, who get very little credit for the work they do. They get a lot of criticism, but not from people in this House. Sometimes their work is very much misunderstood in the community. When they do tremendous things — such as our people do in our ministry no one says anything about it.
There is a tremendous breakdown in our society and that is continual. I'm sorry to say it's a sad commentary on our society but present nonetheless. There is a tremendous deterioration in our family life and a tremendous deterioration in our community life. Our people in our ministry get blamed for those things which really started in the family, in the community and in the individual. I'd like to just pay tribute to all of them, because they serve in silence. They couldn't stay as long as they do, they couldn't work in the dedicated way that they do, if it were not that they are completely dedicated to the job they do.
Also I would like to pay tribute to an army of people. They are countless in numbers, one cannot say how many. We just know there are hundreds of thousands of them in the province of British Columbia. They are called "the volunteers." They serve in many, many areas of the province, in many, many ways. If it were not for the volunteers that we have in our province, our ministry's work would be much more difficult. They save money; they save lives; they save human dignity and they save many of us from the burden of taxation which the citizens of the province of British Columbia are constantly concerned about in terms of social services. Yet they are constantly, I would suggest to you, supportive in terms of what they have provided in the province of British Columbia, and I just want to say a word about that.
We get a tremendous amount of criticism for what is being spent, or not being spent, in social services. I would like to have it on the record today that we should pay tribute to the people of British Columbia who have provided so generously for the people in need: the senior citizens in this province, the children in care in this province, the children who have problems of all kinds in this province and the people who are in need because of illness. Our fellow citizens have provided generously in that regard, and we should pay tribute to them as well.
This is the Year of the Child and Family in British Columbia. I want to just refer to a few things in terms of not only the Year of the Child and Family, but also of the service of our ministry. I want you to know that I'm not going to give you a list of all of the things that we do, because that would take us far beyond the dinner hour and well into the evening. In fact, probably it would take until closing time this evening. I do know, though, that this will
[ Page 881 ]
come out in the debate. I hope that each one of the programs of which we're very proud will be given the emphasis and the kind of attention that it requires.
I do want to say a couple of things about some of the things that we have brought forward in these last few months. In paying tribute today to the minister who preceded me in this portfolio, the hon. member for Surrey (Hon. Mr. Vander Zalm), I would like to make mention of some programs which he put forward which have led the way not only in British Columbia, but in Canada. I mention particularly PREP, which has been an outstanding program in this province, and it has seen many, many families in this province restored to an independent way of life, where they have not only independence, but they have pride and a future. Our former minister did that.
Our former Minister of Human Resources also put in place a program which, at the time, had a tremendous amount of criticism, and I'd like to say that I think it was unwarranted.
I mentioned the taxpayers of the province of British Columbia, and I say they are generous. They have, without question, at any time that they have been called upon to give for those in need, generously provided. That's been the history of British Columbia; that's been the history of our province; that's been the history of our people.
Our former minister put in place an inspectors' program which, Mr. Chairman, I suggest to you, has made sure that those people who would defraud the system.... It's been a highly successful program, and it has said to those people who would defraud the system and take food from the mouths of children who need that food.... They have been stopped from doing that through that inspectors' system, and we should be lauding the former Minister of Human Resources for that program because it puts money where it is needed, not where it has been obtained through fraud.
I also want to say that the handicapped program which our former minister brought forward, the Handicapped Workshop Guild, and the LIFE program — Living Independently For Equality — which sees the handicapped families in our province taken out of institutions and placed within the community so that they, too, can have an opportunity for true life in this province, has been an outstanding program.
I said I wasn't going to go through all of the programs that we have, but may I, in speaking of the handicapped, just tell you what my ambitions and aspirations are for the handicapped in this province.
I was pleased to see that my colleague the Minister of Municipal Affairs brought forward an Act in this legislative session which makes sure that the handicapped will have better access, in terms of physical handicaps, to buildings and so on. We are pleased to see that done.
May I just say that of all the things that we do for the handicapped — the achievement centres, and the Handicapped Workshop Guild, and some of the other programs that we have — one of the handicapped groups in which I have had a lifetime interest has been that of the retarded child in this province, and those who have more recently been diagnosed as autistic. That description is from very recent years, as all of you will know.
It would seem to me that there really isn't any member of this House who needs to feel that there is any other jurisdiction in this country that does a better job in terms of delivering services to the retarded. I can tell you, Mr. Chairman, that I'm very pleased with the program that we have. But there is one area that, because we have been concerned with bringing the people into independent living.... I would like really to have it on record that there are some people who will never be able to come out of an institution.
Under my ministry now we have the institutions of Woodlands, Tranquille and Glendale. May I just say that I would hope that in the very near future — and I am saying this particularly about the Woodlands organization — we are going to be able to have a renovation program which will give better accommodation in the area of Woodlands School, which is so much needed. I am working towards that, and hopefully within the next few months a program can come forward which is going to meet their needs and concerns at Woodlands School.
We have to understand, Mr. Chairman, that is a very old institution, but a great institution with great people who are doing a terrific job. We also understand, and we go along with the fact — as I said, it was initiated by the former minister — that we have the LIFE program that takes people out of that institution. In fact, I am pleased to tell you that there are several who have been taken out of Tranquille and who are now living independently in the LIFE program in the community. But there are some who will never be out of that institution, some who can never leave, by virtue of the tremendous handicaps that they have.
So because of that, I want you to know that moneys will be well spent in order to place an improvement program in Woodlands, and I am hoping to have that before this House in this coming year. I am pleased to tell you of that today, and I know that members on both sides of the House will approve of that.
I also want to pay some tribute to a program for the senior citizens in our province that was initiated on the floor of this House many years ago, and which I every day come to appreciate more and more. It was one of our colleagues, a Minister Without Portfolio some years ago, Isabel Dawson, who started the senior citizens' counselling service in this province. Those people serve throughout this province with a tremendous amount of dedication. The senior citizens' counsellors are senior citizens themselves and they are a corps of people who answer numerous questions that are forever being raised because of the tremendously complicated programs for supplementing senior citizens' incomes which we have between the federal and provincial governments. Because of the multiplicity of those programs, the questions are many and varied, but the senior citizens' counsellors do a tremendous job in that regard. I just would like to tell you that we're very proud of that program, and very proud of the counsellors.
We're proud of some of the other programs. Let me, though, concentrate particularly on two or three things which have come before you as members of the Legislature and which I have announced since becoming minister. I would just like to say that the one program which appealed to employers of the province of British Columbia — to make opportunities available to those on income assistance — has worked out very well. I want to say that it's a very encouraging program. It was not meant to replace PREP, but rather to supplement PREP, and it has worked very well as an adjunct to PREP, in that we called on some 60,000 small and large businesses in the province to make an
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opportunity available. They recognized that if they took somebody into their businesses or their particular areas of responsibility and taught them their profession or their business or their trade, they would be able to give a service to the people of British Columbia that heretofore had been missed.
Not everybody is born to be in business or a lawyer. Not all people have the ability to become doctors. Not all people can go to university, or have the opportunity. There are many people in our society today who don't learn in any educational system even those rudimentary skills that give them that opportunity that opens up a life where they can become independent and raise their families and can do for themselves. Sometimes they miss out on that which other people — and, thankfully, the majority of British Columbians — can enjoy. But because this minority need that extra step up the ladder — that extra chance — we called on those in the business community throughout this province to open up their hearts, and their ideas, and their patience and their love of humanity, to the people who are on income assistance. And they have.
I would just like to share with you a few examples, because I think they are important. We had a construction company which hired three trainees who have now successfully completed the first three months of the company's training program. We've had a pest control company who indicated they'd be able to hire a technician, provided the person had passed the government's qualifying examination. Our ministry subsidized training and the cost of the examination, and that young man is now employed full-time. Take the example of the father of several young children, who had received assistance for a very considerable period of time, who was hired by a trucking company and who is now adequately supporting his family with no help from the province. Then consider the young man who was hired on a one-month trial in the maintenance section of a company's operation who is now a permanent full-time employee. Or the large catering service who hired several women on a part-time basis which will provide them with necessary experience and skills for ongoing employment in the food-service field. And there's the head of a family of four who had been receiving assistance for several years; he was hired as a warehouseman, and the employer reports he is doing an above-average job.
I don't know how you measure the dollar value of this approach, Mr. Chairman. These stories show success, not only in financial terms, but in human terms. Finding a job for a person on income assistance benefits the province and the individual financially. More important, it means the family can feel themselves to be contributing and productive members of society once again. Income-assistance clients, Mr. Chairman — just like anyone else — would prefer to be working. I emphasize that. Let me say, Mr. Chairman, it is our motivation in this ministry to help and support them in their attempt to have that opportunity.
I am pleased that employers are responding to the appeal, and I want to say the work the PREP people have done, in tying in with this program, has been tremendous. One cannot put people who have not had any job skills or opportunities for years and years or months and months into the labour force and expect them automatically to have those skills when they have not had them for so many years. It has to take a lot of patience and counselling. Our PREP people have done that with a very, very dedicated spirit, and they've done it well.
I want to say also that I was very pleased that in February of this year I had an opportunity to announce $31 million in increased funds to those in need in this province — $31 million increase in income-assistance payments to those who are on maintenance. The changes were effective on April 1, and I am very pleased I was able to do that. I was pleased to have the assistance of the Minister of Finance in that regard.
I just want to say that this program, this added $31 million, had within it a couple of new things which I think the House should know about. First of all, let me say it was in response to reports such as the reports from the United Way which said the real concern in the community was the concern on the shelter side of income maintenance. And so this $31 million gave increased shelter allowances.
It improved, however, and I think this is important. Today we have talked — and we hear all over North America — about the cutting of red tape and the deregulation of government. Very clearly and very satisfactorily, it has cleared up some of the tremendous amount of paperwork we have had to do in the ministry, thus freeing some of our people from the very difficult task they have had in looking up many charts and many references and so on.
It's freed them of time to do actual counselling, and it has worked in the province. I can tell you it is part of cutting red tape. It also puts the onus on those who are on income assistance to manage their affairs, and we are helping and counselling them to do that. It gives more equitable distribution of available dollars, and it has allowed the payment of utilities, and so on, to be added. Details of that, of course, can be given during the estimates, but one little area of it I think is important — and it's not very little, because it's $2 million worth, Mr. Chairman.
The incentive-allowance budget has been increased within that program. In that regard, I would like to say the new incentive program, announced in April, is a "first" for the province and something we're pleased to start because every taxpayer in our province has said: "Why is it that you have such a stringent kind of formula for people on income assistance? Why don't you allow them to earn some dollars, and then sort of get off income assistance as they learn a trade or as they learn, somehow, to become independent?" This program, Mr. Chairman, addresses itself to that philosophy. We have established a minimum amount of money that the income-assistance recipient can earn. They can earn it, perhaps, by working in a social services field; they can earn it by temporary work that they can find. In this case we're going to have a pilot project which is going to enable us to read the city of Victoria and greater Victoria on a six-months basis, to allow us to see if this pilot project will be suitable throughout the province. It allows people to retain more of their earnings and finally get off income assistance entirely. We're very excited about that program.
Mr. Chairman, how much time do I have?
MR. CHAIRMAN: The green light is on.
HON. MRS. McCARTHY: I'm sure that the members opposite won't mind if I just wind up a few things that I'd like to talk about, because I think it's important, in this first
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introduction to my ministry, that I draw attention to a couple of other things — if I may.
The guaranteed annual income, of which we have talked so much in this province, was initiated many years ago as a first in Canada by the hon. W.A.C. Bennett. Our government has taken it to the federal — provincial conferences in the last year and the year before, and we are still very much interested in it, Mr. Chairman. I want to tell you there are serious deficiencies in our income maintenance programs throughout Canada, and they have been a subject of much concern by all Canadians. Although we've had many solutions proposed and studied, none of these have been implemented. We just have a proliferation of income maintenance programs which have added to the problems of the system rather than providing a solution. The basis of our problems in the income maintenance system is a multiplicity of uncoordinated programs which all have the same general objective of maintaining income. But because they've evolved independently over time, the system has become characterized by conflicting and poorly defined objectives, lack of communication, lack of accountability and complexity. These characteristics, in turn, have resulted in duplication of payments, duplication of administration, lack of public credibility, payments to those not in need, omission of payments to persons who are in need, general confusion and very high costs.
MR. CHAIRMAN: The time under standing orders has expired.
HON. MRS. McCARTHY: Thank you very much. That's very kind of the opposition to allow a few more minutes, and I'll try to be very quick.
For many years the position of our government has been that the federal government should work together to develop a tax credit system. In this part year the federal government has really opened the way with the child tax credit system. For the first time they have opened the Income Tax Act in order to allow a payment to families across this country. It, as you know, involves modifying the tax system to allow for this payment to individuals below a certain level of income. We have, in this province and in this country, many people who, if they were released from their jobs of paperwork and desk jobs, would like to get into the kind of work that we want done in the community. Surely everyone would agree that this kind of basic-income philosophy would be one which we could all adhere to. It would simplify administration, it would give greater equity and dignity, and it would eliminate the proliferation of overlapping and confusing programs.
I am pleased to tell you that we have a program in our province and in our ministry which addresses the family and the child. I believe it is probably the best this province has ever seen. Not quite a year ago, only last September, 275 family-service workers were added to the staff of the Ministry of Human Resources. This allowed for more attention to be given to counselling, and the success stories that have come from that have been tremendous. I'd like to just say here, not only for that program but of all of our family and children's services....
MS. BROWN: On a point of order. I wonder if the minister's colleagues would at least give her the courtesy of listening to her. They're making so much noise that not even the opposition can hear.
MR. CHAIRMAN: The point of order is well made. The minister continues.
HON. MRS. McCARTHY: Thank you. The day-care programs have seen several thousand children in our province taken care of under the day-care service. All of the services, such as the infant development program, which is a success story that I am excited about and wish I had time to tell you about.... All of those programs, including the interministerial committee for the care of children in crisis that has been going on in these past few months, have been programs of which I think we can be very proud.
But there are two things that I would like to speak of in regard to this Year of the Child and Family. One is new legislation. As you know, we are committed in this House and in this province to bringing in a new family and children's services Act.
Mr. Chairman, that Act can be the best Act in Canada, but not if it is rushed. I do not want to be a part of bringing into this House and before the members of this House something that is done in haste and drafted in haste, because the children in this province and the children yet to be born in this province are far too important to rush such important legislation.
When I took on this ministry, I extended the submissions for the hearings on the family and children's services Act. I can tell you, Mr. Chairman, that we are very pleased that after the publication of the White Paper in August 1978.... Since that time we have received approximately 1,200 written submissions, and it's estimated that submissions from professional organizations alone represent some 100,000 professionals.
I want to tell you that we've also had tremendous individual representation, both at the public hearings as well as by written submissions. They have been concerned and very, very good submissions. Beyond a doubt, I can say that the citizens of this province have a tremendous concern for the well-being of our children. It was expressed in all of those submissions. They speak with strong conviction and commitment to creating a law that will conserve and strengthen our families.
May I please just say that I know that all members of the House will appreciate that the vital import of a statute that is so central to the life of children and their families in this province must not be hastened. The investment of time and interest by parents and friends of children in this process is enormous. I want to say that we are really committed to bringing in the best legislation, which would recognize several things. It is my intention to have a bill before you at the next session of the House, and some of the essential aspects which I have instructed to be included in the proposed legislation will include the reflections from all of these proposals which have come before us. I will just give you some of the key things, so that the members will have some idea.
First, it is paramount that the legislation be clear and easily understandable by reason of its language. Of course, we hope that for all bills, but particularly for one where families must understand — all families in the province.
Second, the new legislation must recognize that parents have a primary responsibility for the care of their children and that children should be removed from the care and custody of their parents only when all other measures which provide for continuing parental care are inappropriate.
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Third, the legislation should contain provisions to provide social services to assist children and their families.
Fourth, the legislation should contain provisions which allow us to enter into agreements with parents to provide services, or to assume temporary care and custody of children when necessary. And you have to know that we aren't always dealing with children in income-assistance families when we have to provide those services; we are dealing with all areas of the province and in all areas of society.
Fifth, the legislation should contain provisions to ensure proper procedures for the investigation and recording of all reports of children in need.
Sixth, the legislation should contain provisions clearly limiting the length of time a child may be in the temporary care of the province by court order. I hope you understand what that is, and I'd be glad to explain. That's very important to me.
As I've said before, I have to tell you that I think this ministry crosses all political lines. I frankly do. We're all concerned with children, and I'm sure there isn't a member in this House who isn't absolutely, desperately concerned that year after year, no matter what administration has been in charge of this province, we still have children in this province whose parents, selfishly, will not give them up for adoption, do not want to take the responsibility, and those children are going through foster home after foster home. I am dedicated to eliminating the kind of never-never land that the foster-child is in this province.
Where parents fail or are unable to resume care and custody of their children who are in temporary care of the province by court order, the legislation provides prompt — and I underline that — judicial procedures for legally terminating the parent-child relationship, and thereby promoting the placement of such children in a permanent home — preferably through adoption, or by vesting their foster parents with legal guardianship. In other words, we want a long-term plan and a life plan for the children who need our special care.
I have several other areas — I'm sorry, I'm not finishing this because of the length of time — that recognize our responsibility as a province towards the children entrusted in our care or custody. Particularly when he or she is in the care or custody of the province, we should deal as nearly as possible with that child as we would with a reasonable parent. A child shall be dealt with without adverse discrimination on the basis of race, religion or ethnic origin; a child shall have the right to have his opinions heard and considered; a child shall have the right to a minimum disruption of his or her life when a change is necessary in the child's guardianship; and so on. I would like to elaborate on that, and I hope that we will have that opportunity in this debate.
May I say that it is a sad commentary on our society that in this province we have child abuse. We had 4,000 children who came into our care in British Columbia between April 1978 and March 1979, and 2,000 of those 4,000 were apprehended for protection purposes. It's a sad commentary on our society, and I want you to know what we are doing about it. We are very concerned about child abuse, and when I was in the House earlier, under a different administration, we brought legislation into the House, which was passed by this House, which made it mandatory to report child abuse in the province of British Columbia.
Because it has become known that reporting child abuse is something that should be done by all professionals and by all citizens, the incidence of reporting child abuse has very much increased in this province. But I still meet nurses who don't know they are protected by that legislation, which allows them to report a suspected abuse case, and allows those cases to be brought before the proper authorities.
In place now, and soon to be operative, will be the child-abuse Zenith line, which will allow any citizen, any professional, anyone who suspects child abuse in the province to phone a Zenith number and have it recorded, which will mean immediate action on that case. Attendant with that is a child-abuse manual produced by the four social services ministries. About 15,000 to 17,000 manuals will be circulated throughout the province, so that all professionals will know exactly what to do in terms of child abuse, how to recognize it, and so on.
I wonder if I could conclude my remarks by saying that I hope the opportunity will come to me in this debate to tell you more about the positive programs for our province. Through the Ministry of Human Resources there are many good programs for the Year of the Child and Family, recognizing that they are not just for this year. They are programs we want to continue because of the emphasis we always want to put on them always, not just in 1979 in the Year of the Child, but in every year for the children of British Columbia.
The House resumed; Mr. Speaker in the chair.
The committee, having reported progress, was granted leave to sit again.
Division ordered to be recorded in the Journals of the House.
HON. MR. GARDOM: Mr. Speaker, I ask leave to proceed to Motion 8 in the name of Mr. Mussallem.
Leave not granted.
MR. MUSSALLEM: On a point of order, Mr. Speaker, I am amazed that leave was not granted in a properly constituted committee of this House. I was authorized to present this motion, and here I am prepared to present it and am denied leave, which is unbelievable.
MR. SPEAKER: Please state your point of order, Mr. Member.
MR. MUSSALLEM: My point of order is that they should recall these nays.
Hon. Mr. Gardom moved adjournment of the House.
The House adjourned at 6:02 p.m.