Manitoba Hansard — 26 March 2014 (Sitting 36, 40th Legislature, 3rd Session)

40-3-36

Manitoba — Debates (Hansard)

Third Session - Fortieth Legislature of the Legislative Assembly of Manitoba DEBATES and PROCEEDINGS Official Report (Hansard) Published under the authority of The Honourable Daryl Reid Speaker Vol. LXVI No. 36 - 1:30 p.m., Wednesday, March 26, 2014 ISSN 0542-5492

MANITOBA LEGISLATIVE ASSEMBLY Fortieth Legislature Member Constituency Political Affiliation ALLAN, Nancy St. Vital NDP ALLUM, James, Hon. Fort Garry-Riverview NDP ALTEMEYER, Rob Wolseley NDP ASHTON, Steve, Hon. Thompson NDP BJORNSON, Peter, Hon. Gimli NDP BLADY, Sharon, Hon. Kirkfield Park NDP BRAUN, Erna, Hon. Rossmere NDP BRIESE, Stuart Agassiz PC CALDWELL, Drew Brandon East NDP CHIEF, Kevin, Hon. Point Douglas NDP CHOMIAK, Dave, Hon. Kildonan NDP CROTHERS, Deanne St.

James NDP CULLEN, Cliff Spruce Woods PC DEWAR, Gregory Selkirk NDP DRIEDGER, Myrna Charleswood PC EICHLER, Ralph Lakeside PC EWASKO, Wayne Lac du Bonnet PC FRIESEN, Cameron Morden-Winkler PC GAUDREAU, Dave St. Norbert NDP GERRARD, Jon, Hon. River Heights Liberal GOERTZEN, Kelvin Steinbach PC GRAYDON, Cliff Emerson PC HELWER, Reg Brandon West PC HOWARD, Jennifer, Hon. Fort Rouge NDP IRVIN-ROSS, Kerri, Hon. Fort Richmond NDP JHA, Bidhu Radisson NDP KOSTYSHYN, Ron, Hon. Swan River NDP LEMIEUX, Ron, Hon. Dawson Trail NDP MACKINTOSH, Gord, Hon. St. Johns NDP MALOWAY, Jim Elmwood NDP MARCELINO, Flor, Hon.

Logan NDP MARCELINO, Ted Tyndall Park NDP MARTIN, Shannon Morris PC MELNICK, Christine Riel Ind. MITCHELSON, Bonnie River East PC NEVAKSHONOFF, Tom Interlake NDP OSWALD, Theresa, Hon. Seine River NDP PALLISTER, Brian Fort Whyte PC PEDERSEN, Blaine Midland PC PETTERSEN, Clarence Flin Flon NDP PIWNIUK, Doyle Arthur-Virden PC REID, Daryl, Hon. Transcona NDP ROBINSON, Eric, Hon. Kewatinook NDP RONDEAU, Jim Assiniboia NDP ROWAT, Leanne Riding Mountain PC SARAN, Mohinder The Maples NDP SCHULER, Ron St. Paul PC SELBY, Erin, Hon. Southdale NDP SELINGER, Greg, Hon. St.

Boniface NDP SMOOK, Dennis La Verendrye PC STEFANSON, Heather Tuxedo PC STRUTHERS, Stan, Hon. Dauphin NDP SWAN, Andrew, Hon. Minto NDP WHITEHEAD, Frank The Pas NDP WIEBE, Matt Concordia NDP WIGHT, Melanie Burrows NDP WISHART, Ian Portage la Prairie PC

1447 LEGISLATIVE ASSEMBLY OF MANITOBA Wednesday, March 26, 2014 The House met at 1:30 p.m. Mr. Speaker: O Eternal and Almighty God, from Whom all power and wisdom come, we are assembled here before Thee to frame such laws as may tend to the welfare and prosperity of our province. Grant, O merciful God, we pray Thee, that we may desire only that which is in accordance with Thy will, that we may seek it with wisdom and know it with certainty and accomplish it perfe ctly for the glory and honour of Thy name and for the welfare of all our people. Amen. Good afternoon, everyone. Please be seated.

ROUTINE PROCEEDINGS Mr. Speaker: Introduction of bills? PETITIONS Mr. Speaker: Seeing no bills, we'll move on to petitions. Beausejour District Hospital– Weekend and Holiday Physician Availability Mr. Wayne Ewasko (Lac du Bonnet): I wish to present the following petition to the Legislative Assembly. And these are the reasons for this petition:

(1) The Beausejour District Hospital is a 30 -bed, acute-care facility that serves the communities of Beausejour and Brokenhead.

(2) The hospital and the primary-care centre have had no doctor available on weekends and holidays for many months, jeopardizing the health and livelihoods of those in the Interlake -Eastern Regional Health Authority.

(3) During the 2011 election, the provincial government promised to provide every Manitoban with access to a family doctor by 2015.

(4) This promise is far from being realized, and Manitobans are witnessing many emergency rooms limiting services or closing temporarily, with the majority of these reductions taking place in rural Manitoba.

(5) According to the Health Council of Canada, only 25 per cent of doctors in Manitoba reported that their patients had access to care on evenings and weekends. We petition the Legislative Assembly of Manitoba as follows: To urge the provincial government and the Minister of Health to ensure that the Beausejour District Hospital and primary -care centre have a primary-care physician available on weekends and holidays to better provide area residents with this essential service. This petition is signed by M. Melanson, J. Penner, T. Hay and many, many more fine Manitobans, Mr. Speaker. Mr.

Speaker: In keeping with our rule 132(6), when petitions are read they are deemed to have been received by the House. Any further petitions? Seeing none, committee reports? Tabling of reports? Ministerial statements? Introduction of Guests Mr. Speaker: Prior to oral questions, I ha ve some guests that I would like to introduce and draw the honourable members' attention to. In the public gallery we have Joe, Alfina and Angelina Grande, who are the guests of the honourable member for Tuxedo (Mrs. Stefanson).

And also seated in the public gallery we have from Blumenort School 45 grade 6 students under the direction of Cameron Hiebert. This group is located in the constituency of the honourable member for Steinbach (Mr. Goertzen). On behalf of all honourable m embers, we welcome all of you here this afternoon. And I seem to have missed this one, but I'd like to draw the attention again to the public gallery where we have with us today Chris Kennedy, retired registrar of the Brandon University, and Kathy Kennedy, host on CJOB radio, who are the guests of the honourable member for Brandon East (Mr. Caldwell).

On behalf of all honourable members, we welcome you here this afternoon.

1448 LEGISLATIVE ASSEMBLY OF MANITOBA March 26, 2014 ORAL QUESTIONS Fiscal Management Government Spending Record Mr. Brian Pall ister (Leader of the Official Opposition): Well, I want to wish the MLA for St. Boniface well with this upcoming first -quarter poll. I know there's a lot at stake for him, and I know that it's an evaluation of his leadership in many ways. The decision to spend the vote tax subsidy in its entirety on taxpayer –using taxpayer money to fund scary fairy -tale attack advertisements was his, and it'll be a measure of his decision.

Those results, of course, will be of interest to his colleagues as well, and I'm sure they'll be watching for different reasons. But the fact remains that there is a pattern emerging here. And this Premier's pattern is very clear: He takes tax money to buy attack ads just before a poll. He splurges on a helicopter purchased just before an election. And, of course, his priorities were not the taxpayers of Manitoba when he did that, when he made those decisions, so this'll be an evaluation of that and his decision-making processes.

Would the Premier acknowledge today that this kind of s pending is not smart spending but rather is selfish spending? Hon. Greg Selinger (Premier): Mr. Speaker, I'd be happy to answer the question, why we think spending in health care is a priority for Manitobans. But before I do that, I'd like to table the document that the Leader of the Opposition referred to yesterday and put that on the record so that people can see it. And, Mr. Speaker, yesterday the Leader of the Opposition again put misleading information on the record.

He indicated in 2001 and 2002 that we had made a futile effort to correct the StatsCan record about the number of people living in Manitoba. And I want it to be clear to him that we do stand up for Manitobans, when Manitobans are undercounted in the province of Manitoba, and they require services and supports like everybody else, that we stand up for them. That's very different than the Leader of the Opposition. And I want him to look at that document and understand that in that period of time, there was –we had alleged that there was a serious undercount of 19,000 people.

And I want him to have that for information because in my next answer I will show him what the result of that intervention was by the provincial government. Mr. Pallister: And the government agenda becomes even clearer, Mr. Speaker: lie, buy and cry, that's the NDP agenda. Lie about somebody else's record to cover up their own lies, buy their way to power with large, giant tax hikes that they promised they would not invoke, and then, even though they're recipient s of incredible amounts of largesse from elsewhere, cry for more like a spoiled teenager.

Now, the biggest boost in federal health -care transfers in the history of federal health -care transfers has occurred during this government's administration. But, oh, my goodness, it's not enough, Mr. Speaker. We have to listen to the NDP whine for more. And no wonder, because they throw money around without concern for results. The Premier himself said in Estimates, medicare is about spending, nothing more than tha t. They see a shiny red helicopter, got to have it; that'd be a great campaign ad, got to have it at any cost.

Break all the rules, the AG says, throw money away; break all the rules and pay for three and get one. Well, that's not smart shopping. Would the Premier just admit that his shopping is focused not on being smart but on being selfish? Mr. Selinger: Mr. Speaker, as I said earlier, we raised an issue with an undercount in Manitoba. I'd like to table a second document for the Leader of the Opposition now, and the members of the Legislature, on what occurred as a result of that intervention by the government during that period of time. * (13:40) We were concerned there were 19,000 people were missing.

The Leader of the Opposition alleged that that was a futile effort, and, in fact, Mr. Speaker, if he looks at the document, he will see that the federal government corrected the record to the tune of 34,000 Manitobans they discovered in Manitoba. So I want to give the Leader of the Opposition the opportunity now to correct the record, to apologize for misleading the House once again about what actually happened the last time this issue came up. Mr.

Speaker, 34,000 were recognized by StatsCan and the federal government as legitimate citizens living in Manitoba and deserving of the supports like all other Canadians get across this country.

March 26, 2014 LEGISLATIVE ASSEMBLY OF MANITOBA 1449 Mr. Pallister: Lie, buy and cry, Mr. Speaker. The Premier should apologize for breaking the laws of our province. That would be a good start. You know, when these poll results come out, I know that his caucus will be standing behind him, Mr. Speaker, but if I were him, I'd check for weapons.

The ides of March might have passed but the weapons might be there, and if the polls don't show that this strategy of deflectio n, of overspending, of promising, of misleading–if that strategy doesn't work, the Premier's out of options, and his colleagues won't be blaming themselves for that. The crisis in our social -service delivery, in our infrastructure delivery, in our justice system, it won't be handled by the ministers. They'll be looking to blame the Premier for it just as much as he's looked to blame everyone else every time something goes wrong for him.

Closing ERs and running longer waiting lines, waiting lists for treatm ent lengthened, waiting lists for ambulances lengthened, and will the health-care minister that just moved from that post take responsibility? No, she'll blame the Premier. So this poll result, I think, the Premier should– Mr. Speaker: Order, please. The honourable leader's time has expired. Mr. Selinger: Let's try one more time. He's got two documents now that unequivocally demonstrate he was wrong, Mr. Speaker. The correction was 30,900 citizens in Manitoba as a result of StatsCan's intervention.

The L eader of the Opposition has the chance to apologize to the Legislature for his misleading information. He has the chance to stand up for Manitobans, Mr. Speaker. He could stand up for Manitobans when the federal government decides to close Veterans Affairs offices. He could stand up for Manitobans when the federal government decides to cancel the band councillor program –band constable program in the province of Manitoba. He has a chance to stand up for Manitobans when it comes to allowing more people to li ve in Manitoba from all around the world.

And once again he has demonstrated today that when he puts information on the record, he never takes responsibility for his errors. He undercounted the number of jobs that was going to be created in Manitoba by our infrastructure program. He used the same approach when he made announcements when he was in office, and today he again refuses to take responsibility for misleading the Legislature. ER Services (Beausejour) Physician Services Mr. Wayne Ewasko (Lac du Bonnet): Mr.

Speaker, yesterday I had the pleasure to stand up in this House and ask the Health Minister a question which, once again, as she has done with many other questions coming from this side of the House, nothing, no answer. So today I ask again, Mr. Speaker, as simply put as I can: Do I have her commitment that during the upcoming spring break and for the many busy months ahead of us, do the citizens –will the citizens have access to a doctor in the ER in Beausejour? Hon. Erin Selby (Minister of Hea lth): I thank the member for the question. We know that people want safe health care close to home.

It's why we are always recruiting to bring in more nurses, more doctors and to make sure that people have access close to home. We understand why the resid ents of Beausejour and the surrounding area are concerned, and ideally we do need physicians to be taking call to ensure that there is always a physician available locally. I know that the region is working with the local physicians to alleviate the burden of those physicians who are taking call to ensure that everybody is taking call to provide full service.

The RHA has regular meetings with the medical staff at the hospital and we feel we are making good progress. But, Mr. Speaker, we are always working to recruit more doctors in Manitoba. Mr. Ewasko: Day after day this minister gets up and repeats her talking -points rhetoric with no plan, Mr. Speaker, with no plan. Fact is past three years the call list at the Beausejour ER have had more and more blanks on it. The temp nurse service has had an increase in usage. What this tells me is that the employees within the IERHA are losing faith in this minister's leadership. She has no plan, just rhetoric.

Why is she putting patients at risk and closing ERs? Ms. Selby: I can tell you that we are always working to recruit more doctors. It's why we're training more doctors. It's why we're increasing rural residencies to doctors, and, Mr. Speaker, we know that our plan is

1450 LEGISLATIVE ASSEMBLY OF MANITOBA March 26, 2014 working. Do we have more to do? Absolutel y, and we will not stop working on it. But because of our aggressive recruitment plans, we have new doctors that are coming into Pine Falls and into Lac du Bonnet, and we will keep working with the people of Beausejour to have more doctors there as well. I know the local RHA is working with physicians in the area to see that all of them take calls so that we can relieve the burden on those who are taking calls. But I can tell you that we are actively recruiting, and the money is always on the table. Mr. Ewasko: Mr.

Speaker, there's a group of concerned citizens with us today in the gallery. This minister has no plan. Call -list blanks are up in the ERs. Temp employees are on the rise. ER services are drastically being reduced, which is putting patients' care at risk. What assurances does this minister give to those citizens of the Beausejour, Brokenhead and surrounding area that during the upcoming spring break and for the many busy months ahead of us citizens will have access to a doctor in the ER in Beausejour? Ms. Selby: Mr. Speaker, we have been working hard to train more doctors and to bring in more doctors.

It's why there are now 562 more doctors working in Manitoba than when they were in government. More than 120 of those doctors are working in rural Manitoba. We know we want to bring in more doctors, and I will assure people of Beausejour and across Manitoba that we will never cut $37 million from rural health care like they did when they were in office. Vita and District Health Centre ER Reopening Timeline Mr. Dennis Smook (La Verendrye) : Mr. Speaker, 19 ERs closed. Medical experts agree having the ER at the Vita hospital closed is like playing Russian roulette with people's lives.

People's lives have been saved by doctors when the ER at the Vita hospital was open. Seventeen hundred people per year visit the ER when it was open and operational. Mr. Speaker, when will this Health Minister stop gambling with the lives of the people in southeastern Manitoba and reopen the Vita ER, or does she just not care? Hon. Erin Selby (Minister of Health): Mr. Speaker, we know that Manitoba families want access close to home. It's why we are always working with our RHAs to continue recruiting. We have not removed any funding to the emergency-room coverage in Vita.

The money for staffing is still on the table and we are actively recruiting. But in order to make sure that we are thinking of patient care and patient safety first, there does need to be a minimum number of doctors, nurses and other health- care professionals available. The Vita health centre is still offering clinical and hospital support, but patient safety must be the top priority. We will keep recruiting. The money is there, but we need to make sure patient safety is our top priority. Mr.

Smook: This government has promised that the ER in Vita would reopen, and 525 days later the people of southeastern Manitoba deserve to know when, what is that day? This government has closed 19 emergency rooms since they took power. People in southeastern Manitoba are starting to wonder if they can trust this new Minister of Health after the former minister's record of closing ERs. Mr. S peaker, when will the ER at the Vita hospital reopen? Ms. Selby: Mr. Speaker, we have turned around that massive exit of doctors that we saw in the '90s under them and we've increased medical seats as well.

When we came into office, they'd cut medical seats down to 70 doctors training a year. We're up to 110 and we're keeping more of them in Manitoba. Do we want more doctors? Absolutely. It's why we've increased rural residencies, it's why we are always actively–to recruit more doctors, it's why our efforts are paying off. We have more than 562 more doctors working now than when we came into office, and more than 120 of them are working in rural Manitoba. We want more doctors, and we're going to keep recruiting and we're going to keep training more of them. Mr.

Smook : With 19 ERs closed, there should be some doctors around.

March 26, 2014 LEGISLATIVE ASSEMBLY OF MANITOBA 1451 * (13:50) The people of southeastern Manitoba deserve a date for when the ER will reopen. No more rhetoric and spin from this minister and her cue cards. The government is gambling on road conditions and ambulance availability when it comes to health care and safety of residents in southeastern Manitoba. Mr. Speaker, when will the ER in Vita reopen and when will this minister stop gambling with the health care of Manitobans? Can the minister tell the residents of southeastern Manitoba and the people in the gallery when the ER at the Vita hospital will open? Ms.

Selby: Mr. Speaker, I can tell the people of Vita that we have not removed the funding to the emergency in Vita. We will still keep recruiting for there. But patient safety has to remain the top priority. There does need to be a minimum number of doctors, nurses and health- care staff in order to keep it open. We do have the clinic open to offer clinic and hospital support. And beyond the 120 doctors we've recruited to rural Manitoba, we see new doctors have just come to Minnedosa, to Pine Falls, to Lac du Bonnet. We will keep working with every region, Mr.

Speaker, to make sure that they have the doctors that they deserve and the access that we think they need. ER Services (Killarney) Physician Services Mr. Cliff Cullen ( Spruce Woods ): Well, Mr. Speaker, the fact is under the NDP government 2,200 doctors have left the province of Manitoba. We are still facing doctor shortages in southwestern Manitoba. Deloraine, Boissevain, Killarney still rotate the emergency -room service on an ongoing basis. T his leaves uncertainty in the communities as people are not sure which ER is going to be open.

Additionally, people now have to travel up to a hundred miles to find an open emergency room. Will the minister commit to restoring the Killarney emergency room to full status, or is this the health care Manitobans can now expect? Hon. Erin Selby (Minister of Health): I do thank the member for the question, because I know that he will be happy to hear that the region is sponsoring four international medical graduates to go through the provincial assessment process who should be able to practise by this spring in various ERs around the region. Mr. Cullen: Well, Mr.

Speaker, this is about patient safety or, in this case, the lack of patient safety. Mr. Speaker, t his government made a promise to residents of Killarney and area that full -time ER service would be available April 1st of this year. Killarney is to have a complement of 5.5 doctors. However, Killarney will be down to one doctor next week. Unless the minister can find four and a half doctors over the course of the next week, this government has broken yet another promise. Is this, in case, the fact? Ms. Selby: Mr.

Speaker, we've got four new doctors coming into the area, and I will keep working until we find more for that area. Mr. Cullen : Well, Mr. Speaker, we will see if Killarney has their emergency room full -time next week. Nineteen ERs closed across the province, many more sharing on- call services. More money going into health care than ever before and Manitobans are getting poorer service than ever before. This government keeps providing lip service and the situation keeps getting worse.

Unless the minister can find four and a half positions –and doctors over the next week, residents will suf fer through yet another broken promise. Is this the patient safety that the minister keeps talking about? Ms. Selby : Mr. Speaker, we have a strong plan to bring in more doctors and it's been working. We brought in more than 562 new doctors in this province since we've been in office. We brought in more than 120 to rural Manitoba, four more coming in the spring to the member's area. We've got new ones coming into Minnedosa, Lac du Bonnet, Pine Falls as well, and we will keep working on it.

We're training more doctors. We're recruiting more doctors and we will keep doing that. What we won't do is cut $37 million from rural health like the Leader of the Opposition did when he was around the Cabinet table and then wonder why all the doctors ran from this province.

1452 LEGISLATIVE ASSEMBLY OF MANITOBA March 26, 2014 ER Services Rural Manitoba Mr. Stuart Briese (Agassiz): What a revelation, Mr. Speaker, after 14 years they have a strong plan and they found four doctors. Mr. Speaker, there are 19 closed ERs in Manitoba and many others on life support offering only part-time services. Emergencies are not bound by time of day or days of the week. When is the Minister of Health going to drop her empty rhetoric and spin and actually take some action to improve ER services in Manitoba? Hon. Erin Selby (Minister of Health): Well, let's put a few numbers on the record.

It's actually more than 560 doctors that we brought in. We've also brought in more than 3,500 more nurses since we've been in office. They actually had record numbers of doctors leaving the province under their watch. And let's talk about nurses for just a moment. Mr. Speaker, they fired a thousand nurses when they were in government. That doesn't leave a lot of people in ERs anywhere in Manitoba. Mr. Briese: Mr. Speaker, 14 years and 2,200 doctors have left this province. There are five hospitals in my constituency and one nearby in Minnedosa. McCreary is short a doctor.

Gladstone and Carberry have part -time ER services. MacGregor has no doctor. Neepawa and Minnedosa are both short of doctors and accepting no patients. She tells us she's got four doctors coming. When the NDP formed government, all these facilities had adequate doctor resources. Why has the Minister of Health ignored patient safety? Why has she actually allowed ER serv ices to deteriorate under her watch? Ms. Selby : Five hundred and sixty -two net new doctors since we've been in government; 120 net new doctors working in rural Manitoba since we've been in government.

Expanded surgical services in rural areas, including in Swan River, Minnedosa, Portage, Morden and Winkler. Renovated hospitals in Brandon, Swan River, Thompson, The Pas, Beausejour, Pinawa, Gimli, Morden- Winkler, Ste. Anne, Steinbach, Shoal Lake, and new ones coming in Selkirk, Notre Dame de Lourdes. I can tell you we will not cut $37 million from rural health and we will not freeze health capital spending like they did. Mr. Briese: For the first time in my life, I have no family doctor in my community or in a nearby community. Mr. Speaker, 2,200 doctors have left Manitoba under the NDP reign of mismanagement.

After 14 years of broken promises, empty rhetoric, will this minister stop talking, actually take some action, any action, that will actually improve ER care in rural Manitoba? Ms. Selby : We've taken a lot of action, and that accounts for more than 560 net new doctors working in Manitoba. Mr. Speaker, one of the first actions we took when we came into government was to take the medical seats that they had cut down to 70 to now training 110 more doctors. They voted against that, of course. We've hired more nurses, we're hired more doctors, and we're having more residencies being trained in rural Manitoba.

We know it's working. Do we have more work to do? Absolutely. And that's why we are always actively recruiting. And we're seeing the benefits of that in Minnedosa, in Lac du Bonnet, in Pine Falls, in many areas around Manitoba, and we will keep working to make sure that everyone has access to a family doctor. Health-Care Services Government Record Mrs. Myrna Driedger (Charleswood): This Minister of Health is so focused on her talking points that she isn't paying attention to the questions or the fears–or the fears–of patients that are being expressed about their closed ERs.

We have a group of residents from rural Manitoba here today, and the behaviour of this minister in answering these questions is very offensive. Mr. Speaker, despite her rhetoric, her and her government are failing Manitoba patients. They're spending more money, but they are not getting the best results for patients. We've gone from hallway medicine to highway medicine to taxicab medicine. I'd like to ask this Minister of Health to tell Manitobans why, despite doubling spending in health care, things are getting worse for pat ients instead of better.

Why are more and more patients more afraid of the health-care system that isn't there for them? Hon. Erin Selby (Minister of Health): Mr. Speaker, last year we had the largest graduating medical class on record, and that's because we're training more doctors. The opposition doesn't get it.

March 26, 2014 LEGISLATIVE ASSEMBLY OF MANITOBA 1453 When you cut medical seats like they did, you train less doctors. When you cut nurses, when you fire a thousand nurses, doctors flee the province. * (14:00) Mr. Speaker, we are seeing more doctors coming to Manitoba, we're seeing more doctors stay in Manitoba, and we will keep working with the regions to make sure we have more doctors because we know how important it is to have health care close to families. It's why we're doing innovative things like mobile clinics to connect over a thousand people with new family doctors.

We'll keep working with the regions and we'll keep bringing in more doctors. Mrs. Driedger: Mr. Speaker, if there are so many doctors in Manitoba, where are they? We've got 19 closed ERs because of no doctors. Does she really know what she's talking about? Despite her rhetoric and because of her lack of leadership, the NDP are failing Manitobans in health care. There are 19 closed ERs. Over 2,200 doctors have left Manitoba because they don't want to work here anymore. We have the lowest retention rate in Canada. Doctors don't want to stay here and work, so we have a revolving door; 2,200 of them have left.

Babies are being born on the side of highways in blizzards in the middle of the night because of no doctor, and now patients are being sent home by taxi in -40° weather in the middle of the night and dying on their doorsteps. I'd like to ask this Minister of Health: Why are so many patients being denied safe care in Manitoba? Ms. Selby: A net new gain of more than 560 doctors since we came into office, and we will keep working. Our plan includes training more doctors. Our plan includes recruiting more doctors.

Our plan includes offering more rural residencies to encourage more doctors to practise in rural Manitoba. Our plan does not include cutting a half billion dollars from our funding in order to fire more nurses and fire more doctors . Our plan definitely does not include firing a thousand nurses. For every nurse they fired, we've hired back three and a half. Mrs. Driedger: Mr. Speaker, news releases do not bring doctors to Manitoba. This Minister of Health just doesn't seem to get it. She does not seem to understand the seriousness of this issue.

This is all about patient safety, and her mismanagement and her lack of leadership is putting patients' lives at risk. This is about grandmas and grandpas; this is about moms and dads; this is about kids and babies falling through the cracks because of closed ERs and doctor shortages. This is about patients who are afraid that they won't get the care they need when they need it. This is not about her rhetoric. So which part of this does the Minister of Health not understand? Ms. Selby : What we get on this side of the House is that Manitobans do not want a two- tier, American-style health -care system.

We know that's what they want. The Leader of the Opposition has said that he would like to see an American, two -tier style of health -care system in this province where people with the biggest wallet will move to the front of the line. Mr. Speaker, that kind of medicine, that's called limousine medicine. Post-Secondary Education Interest-Free Student Loans Hon. Jon Gerrard (River Heights): Mr. Speaker, the Canadian Federation of Students, Manitoba, met with legislators all last week. Their representatives, Dana Hatherly and Hannah Jones, are with us today in the gallery.

They are very concern ed about the level of student debt. Tax exemptions they might get after graduation are not as important to students as the upfront costs and the burden that they will shoulder from their student loans. They have repeatedly asked this NDP govern - ment to c onsider eliminating the interest on student loans, and they have been getting no response. Why did the Premier ignore the students' recommendations in their recent budget? Hon. Greg Selinger (Premier): Interest rates were reduced twice: prime plus a hal f, now prime. Mr. Speaker, bursaries have been increased.

Tuition fees are the third lowest in the country, the lowest in the country for community colleges. The graduate tuition tax rebate allows a student to recover 60 per cent of the money they invest ed in themselves, or their family invested in them, after they graduate from school. And they now can get it while they're in their third and fourth years as well.

1454 LEGISLATIVE ASSEMBLY OF MANITOBA March 26, 2014 They can have access to the graduate tuition tax rebate in years 3 and 4. They have among the lowest rates in the country, and we will continue to find ways to make education affordable. Our increase in post -secondary education this year: 2 and a half per cent for universities, highest in the country, highest in the country last year; and 2 per cent for colleges, among the best in the country. Everywhere else in the country, post -secondary education has been slashed by Conservative govern - ments.

In Manitoba, we've maintained that funding and improved that funding. Mr. Gerrard: Mr. Speaker, si nce 2009, in Newfoundland and Labrador, students have had their burden of interest rates removed from their provincial student loans. Students in Prince Edward Island have also had their debt load lightened with interest-free loans since 2012. It can and it is being done on the east coast. We should know how it can be done here in Manitoba for our students. The students have not been able to get an answer from this government to this simple question.

Has this NDP commissioned any cost analysis or impact studies to assess making student loans interest-free in Manitoba, and will the Premier table the report this week? Mr. Selinger: Mr. Speaker, we've taken a variety of measures to keep the cost of post -secondary education among the most affordable in the country. Just recently we announced $5,000 for everybody that hires an apprenticeship individual in Manitoba and $1,000 for every new employer that takes on an apprentice. And in Manitoba, we want apprentices to get credit at colleges.

We want college students to get advance credit at universities so they can shorten the time that it takes for them to be able to get into a working job with good, strong credentials. Student funding is up. Money for universities is among the highest you've seen across the country. The tuition fees are among the lowest in the country. We've reduced the interest rates on student debt, and we've made it less necessary to take out a loan, because we've improved the bursaries in Manitoba.

And we have a graduate tuition tax rebat e program, the best in the country, which is available in the last two years of a student attending university, partially available to reduce the cost to them going to school. We will look for additional ways to keep university costs affordable for all people wanting to go to university in Manitoba, and we will ensure that Manitoba has a strong post -secondary system which is affordable, accessible, has good quality and gets good results for young people in Manitoba. Provincial Funding Cuts Mr. Gerrard: Mr.

Speaker, students need strong universities funded to provide the resources for an optimal learning environment. In 2011 the government promised it would increase funding to universities by 5 per cent each year for five years. Last year the government broke its promise and cut that increase by 50 per cent. This year the government once again broke its promise, cutting the increase by 50 per cent. This is, sadly, just one more in a long line of the government's broken promises.

When education is so important to help Manitobans and to provide a way out of poverty, why is the government repeatedly breaking its promise to universities and to students? Mr. Selinger: Mr. Speaker, I regret that I have to remind the member, when he was a member of the federal Cabinet, they made the largest reductions to funding to post-secondary education in the history of the country. They slashed funding for post-secondary education. It was a dramat ic reduction. They slashed funding for research.

He was a member of the Cabinet that made the decision to abandon post -secondary education as a federal responsibility in this country, and now it's only 11 per cent of the federal contributions to post - secondary education. That trend of removal of the federal government from supporting post -secondary education was started when the member from River Heights was a member of the federal Cabinet. And today he pretends to support education. When he had the chance, he cut it. He did not support it. Manitoba Music Industry Juno Awards 2014 Mr. Rob Altemeyer (Wolseley): Mr.

Speaker, I don't know, if I was a younger person in Manitoba, and I wouldn't claim to be one anymore, but if I was,

March 26, 2014 LEGISLATIVE ASSEMBLY OF MANITOBA 1455 I might be a little bit exc ited. I might even be a little bit optimistic about what's going on in our province. Just today we found out the Grey Cup is coming to Winnipeg. That's pretty good. We've got exciting new proposals for our downtown, which members opposite left in a shambl es. Things turned around there just a little bit. And you know what? I think there's a music thing going on.

I think there might be some people coming here to share some of the best musical talent that our entire country has to offer, and wouldn't you know it, Manitoba's going to be there with our own musical legacy. Can the minister tell us about the great stuff happening in our capital city these days on the music scene? Thank you. * (14:10) Hon. Ron Lemieux (Minister of Tourism, Culture, Heritage, Sport and Consumer Protection): In Manitoba, we speak music and we're proud to be the host of the 2014 Junos. You know, Mr.

Speaker, Manitoba is where Canada's heart beats, and the industry is stronger than ever, $71 million to our economy, over 4,300 jobs related to the music industry. And in this province, we're proud to have people representing the industry in such a way where we have many nominations and people who have been nominated to receive a Juno. So, Mr. Speaker, we're really proud of Manitoba. Manitoba's where it's at. Today we announced the Grey Cup. The Premier (Mr. Selinger) was there at the announcement of the Grey Cup. We have the Junos. If you left it up to the opposition, there wouldn't be an MTS Centre.

There wouldn't be the Jets. The re wouldn't be Investors stadium and we wouldn't be having the Grey Cup. We wouldn't have the Junos. We would have zero with where the opposition is. So today we celebrate. Manitoba's where it's at. Young people know it. We know it, and we're proud to be the host of the Junos. ER Services Rural Manitoba Mr. Ralph Eichler (Lakeside): Teulon ER hospital has been closed, reopened, closed, reopened. Arborg ER hospital has been closed, reopened, closed, reopened, along with 17 others closed, reopened, closed, reopened. Mr.

Speaker, we know, whether we want to go directly to Winnipeg, whether or not if they can survive the ride, we need some accountability from this government on whether or not it's going to be closed or open. Which is it, Mr. Speaker? Hon. Erin Selby (Minister of Health): This side of the House, we have a proven track record of hiring more doctors, hiring more doctors in rural Manitoba and hiring more nurses. We know the recruiting efforts have paid off in Portage la Prairie, which ha s allowed us to have the full obstetrical services back, but we know that at times there have been some concerns.

When the Virden ER closed, it was concerning, but we worked hard to get that ER open. We rolled up our sleeves, and together with the RHA an d the local community we were able to recruit more doctors. We've got 562 more doctors working in Manitoba now. More than 120 of them are working in rural Manitoba, and we will keep working with communities. The money is always on the table and our recruiting efforts are very aggressive. It's why we see new doctors coming to 'midosa', to Pine Falls, to Lac du Bonnet and many areas. Mr. Eichler: Mr. Speaker, they always say the money's on the table.

They're spinning it like there's no tomorrow. Record t ransfer payments, $159 million on a untendered air 'ambleance' six times more than our neighbours, and they can't keep a hospital open? Really? Come on, what is this NDP's priority? I ask again: Will she commit to keeping Teulon, Arborg and the 17 other ERs open, yes or no? Ms. Selby: On one side of the House you have our plan, which is to train more doctors, which is to recruit more doctors, which is to retain more doctors. Our plan includes hiring more nurses. Mr. Speaker, on their side of the House you have a different plan.

You have a plan to cut half a billion dollars from straight across the board, which doesn't hire more doctors. You have a plan for an American-style, two -tier health -care system so that people who can pay more can move to the front of the line.

1456 LEGISLATIVE ASSEMBLY OF MANITOBA March 26, 2014 And I know they don't like to talk about it, but here was their plan, Health Minister Don Orchard's plan to bring in more rural doctors: It was to give male medical student applicants preference over their female counterparts, because Orchard said that move would help bring in more rural doctors because men are more likely to return to their country roots to practise medicine. He admitted it was a bit– Mr. Speaker: Order, please. The minister's time has expired. Mr. Eichler: Mr.

Speaker, last fall I had a constituent that went to the Gimli ER, then they went to the Arborg ER, then they went to the Selkirk ER, then they went to St. Boniface and almost died in a matter of a few hours. Manitobans deserve and expect they should get proper health care. This minister said money's not a problem. They got lots of money, so why don't we turn it into reality and open ERs like they should, Mr. Speaker, look after all Manitobans? Ms. Selby : Mr. Speaker, firing a thousand nurses doesn't keep an ER ope n. Putting a freeze on all health capital construction doesn't help a health -care system.

Permanently closing an ER in Winnipeg at the Misericordia and four more overnight in Winnipeg doesn't help either and neither does cut $37 million from rural health care. When you add home-care user fees and try to privatize home care, you don't provide better service for anyone, but that was all their ideas when they were in government. ER Services (Hamiota) Closures Mrs. Myrna Driedger (Charleswood): Mr. Speaker, t his Minister of Health seems more concerned with taking partisan potshots at us instead of ensuring that patients in Manitoba are getting safe patient care.

In Hamiota there is a sign on the ER saying that for several weekends it is closed because of doc tor and lab issues. The sign also says, call an ambulance if you are seriously ill. So they have a closed ER, they have no doctors, and they're telling sick people, take an ambulance. We know who has to pay for the ambulance, and it's that patient because they can't provide the service. Mr. Speaker, isn't that two-tier health care? Hon. Erin Selby (Minister of Health): No, Mr. Speaker, two -tier health care is when someone is denied service because they don't have enough money to pay for it.

American- style, two -tier health-care service means that people have to choose between their mortgage or getting an operation. We don't do that in Manitoba. What we do is work to bring family doctors to everyone in Manitoba. Do we have more work to do? Absolutely. And it's why we keep working, why we train more doctors. It's why we've brought in more than 120 doctors to rural Manitoba. It's why we have more than 160 net new doctors in Manitoba. Do we want more doctors? Absolutely. And that's why we offer free medical students for school – for students who want to return to service and work in rural Manitoba.

It's why we have six new family medicine residencies in Brandon, Steinbach and Morden-Winkler to help train them. We will keep working to bring more doctors to Manitoba. Mr. Speaker: Order, please. Time for oral questions has expired. MEMBERS' STATEMENTS Mr. Speaker: It's time for members' statements. Giuseppe "Joe" Grande Mrs. Heather Stefanson (Tuxedo): Today I am very proud to rise in the House to acknowledge one of my constituents who exemplifies the spirit of entrepreneurship and who is equally dedicated to giving back to his community. On March 8th at the Sons of Italy Gala, Mr.

Giuseppe Grande, better known as Joe, was the distinguished recipient of the Canadian Italian business professionals association Entrepreneur of the Year award. This annual award is given to a Manitoban of Italian heritage who demonstrates the entrepreneurial spirit to achieve acclaim within the community. Since launching Mona Lisa Ristorante Italiano in 1983, Joe and his family have created an establishment that not only showcases their passion for amazing Italian food but also their passion for the people of the neighbourhood and beyond.

The restaurant hosts a weekly talent night that features local musicians, and a dining room is actually a dining galleria where local artwork is displayed and sold. Adjacent to the restaurant all are welcome to join the Bocce League in which over 20 teams participate in weekly matches. Joe and Mona Lisa Ristorante family are also dedicated to supporting local organizations by hosting numerous fundraising

March 26, 2014 LEGISLATIVE ASSEMBLY OF MANITOBA 1457 events such as stomp for the human rights and cut for the cure. Mr. Speaker, I ask that all members of the House join me in congratulating Joe for being chosen as the recipient of this award and for his devotion to his community. I wish he and his family continued success for many more years to come. Thank you very much, Mr. Speaker. Purple Day Ms. Melanie Wight (Burrows): Mr. Speaker, today we are painting the Legislature all shades of purple to increase awareness around epilepsy.

Every year on March 26th, people around the world recognize Purple Day, encouraging education and discussion about life with this condition. Epilepsy is a condition of the brain characterized by recurrent seizures. More than 300,000 Canadians are living with this condition. Because there is a broad spectrum of seizure type and frequency, e ach person's case is unique and must be judged and treated individually. Learning about epilepsy, it became clear to me that one of the greatest barriers faced by those with the condition is the stigma that comes with it.

Unfortunately, there is a lack of public understanding around this issue. Epilepsy is not a disease, epilepsy is not contagious, and epilepsy is not a psychological disorder. Mr. Speaker, Purple Day was founded in 2008 by nine -year-old Cassidy Megan of Nova Scotia to break through this confusion, and the movement has since spread around the world. Cassidy's goal is simple and heartfelt: for people everywhere living with epilepsy to know that they are not alone. Cassidy chose the colour purple after the international colour for epilepsy , lavender.

The lavender flower is often associated with solitude, which represents the feelings of isolation experi - enced by those affected by epilepsy and seizure disorders. * (14:20) The Epilepsy and Seizure Association of Manitoba is a strong support er of Purple Day, encouraging schools, workplaces and communities to all hold events and wear the colour purple. Throughout the year, they provide important information and referral services to people living with epilepsy and seizures, and to their families. Mr. Speaker, I encourage all Manitobans to wear purple today and show their support for those with epilepsy.

Through discussion and education, we can improve life for all those affected. Canadian Wheat Board Facility Mr. Blaine Pedersen (Midland): Mr. Speaker, I congratulate the CWB on the announcement of the building of a new state -of-the-art, high -throughput elevator facility just west of Portage la Prairie, Manitoba–this, in spite of the spenDP spending $85,000 to demand a referendum to save the mon- opoly of the old Canadian Wheat Board–this, in spite of the Premier (Mr. Selinger), the former and current Agriculture ministers predicting the ultimate demise of the world of grain marketing as they understood it.

It now appears they were wrong. The new CWB has emerged as a significant player in the open grain market, with a terminal at Thunder Bay, Ontario, and now an elevator facility located in central Manitoba. The CWB has proven the spenDP wrong. Manitoba grain producers from across the province will now have another option to market their production. How could this be possible? We know the spenDP are such top-notch agricultural producers with their vast knowledge in agricultural production.

We know, from the vast marketing experience of the Premier and his Cabinet members, that this is why the spenDP were demanding a referendum on grain marketing to save the old Canadian Wheat Board. However, the spenDP felt it was not necessary to have a referendum for raising the PST. Now, I'm willing to bet that the Minister of Jobs and the Economy (Ms. Oswald) is out there sharpening her scissors to help opening this new facility in which they're not putting any money into. Mr. Speaker, once again, congratulations to the CWB on the announcement of building a state-of-the-art, high -throughput elevator facility.

Congratulations to the RM of Portage la Prairie on attracting the CWB to their municipality. This is great news for the ag industry. Mr. Speaker: Order, please. Order. Royal Manitoba Winter Fair Mr. Drew Caldwell (Brandon East): It takes the cake that members opposite would celebrate 2,000 job losses in the–Mr. Speaker. Mr. Speaker, for 107 years, people have gathered in Brandon to celebrate Manitoba's rich agricultural heritage at the Winter Fair. This year,

1458 LEGISLATIVE ASSEMBLY OF MANITOBA March 26, 2014 from March 31st to April 5th, the Royal Manitoba Winter Fair will bring together people from across North America to celebrate everything agriculture has to offer. One of Canada's largest agricultural events, the Royal Manitoba Winter Fair makes agriculture approachable and fun for those who might never have had the chance to visit a farm. For those who make their living in agriculture, the fair is an opportunity to participate in industry and trade shows, raise awareness about agriculture and showcase their trade.

The Royal Manitoba Winter Fair is also a testament to the substantial role agriculture plays in the lives of thousands of Manitobans. Growing high-quality food is incredibly important to our communities. Agriculture makes up 9 per cent of our 'prodincial' GDP. During the course of the Royal, competitors from across North America will compete in eques - trian events that include Grand Prix show jumping, hackney pony and horse competitions, bar rel racing and many chuckwagon races.

The fair also hosts educational and interactive events that teach people the fundamentals of farming, like junior cattle shows, dairy milking, sheep shearing and petting zoos. Mr. Speaker, the Royal Manitoba Winter F air is part of our heritage and our future. This week- long fair highlights the best that Manitoba agriculture has to offer while celebrating the traditions that our province was built on. Thank you to co- chairs of the Royal Manitoba Winter Fair, Darrell Hack and Wayne Buhr, and also to all the organizers, exhibitors and participants.

Welcome to Rob O'Connor, who is experiencing his first Royal as general manager of the Provincial Exhibition in Manitoba. You help keep our agricultural traditions alive and well. I hope to see many of my fellow members of the Legislative Assembly at the fair during the week, and I encourage everyone to attend this fantastic celebration of Manitoba's agricultural legacy. Thank you, Mr. Speaker. Bill Merritt Hon. Jon Gerrard (River Heights): Mr. Speaker, I rise today in celebration of the life and work of legendary Winnipeg bassist Bill Merritt.

A remarkable musician and consummate humanitarian, Bill Merritt passed away yesterday after repeated battles with cancer. Bill Mer ritt contributed greatly to Winnipeg's world-renowned music scene and was friends with and performed with some of Winnipeg's most successful musicians from the '60s and '70s. He played with many legendary bands during the city's golden age of rock 'n' rol l, including Mood Jga Jga, Fabulous George and the Zodiacs, Be Bop Beluga, Rocky Rolletti and Prairie Dog.

As a founding general manager of the Winnipeg Folk Festival, Bill Merritt guided this province's iconic annual concert event through its early year s into the late '80s. Many Manitoban youth and families have enjoyed and continue to benefit from taking

part in the interactive, performance and circus arts of the Winnipeg International Children's Festival. This organization was founded by Bill Merritt to contribute to community arts development in an inclusive and accessible environment. He will be fondly remembered by family and many, many friends as an extraordinary musician who cared greatly about people. GRIEVANCES Mr. Speaker: The honourable member for La Verendrye, on a grievance. Mr. Dennis Smook (La Verendrye) : Mr. Speaker, today, I rise on a grievance.

My grievance is on this NDP government's mismanagement of our health - care system, the health -care system that belongs to the people of Manitoba. The NDP has mismanaged health care in Manitoba, especially when it comes to the closure of rural emergency rooms. Since this government has come to power, no less than 19 ERs have been closed. Some have been closed permanent ly, som e with reduced services. Mr. Speaker, this results in highway medicine. These closures are putting Manitobans' lives at risk. During the 2011 election, the Premier (Mr.

Selinger) is on record saying, there's nothing more important than ensuring your famil y gets the care they need, regardless of where they live. Well, Mr. Speaker, that is just not happening. All over this province, ERs are closed. This results in many Manitobans being miles away from the closest ER and potentially life-threatening situations. This new Health Minister, as well as the previous Health minister, are mismanaging our health-care system. Just before the 2011 election, STARS was born. I support a helicopter EMS, but

March 26, 2014 LEGISLATIVE ASSEMBLY OF MANITOBA 1459 the way it was done was wrong. The Auditor General slammed the NDP for the way it was handled. How much money could have been saved by doing it right? Is this minister playing politics with people's lives? This Health Minister is justifying not tendering the contract for STARS by saying it would take 18 to 24 months to have a different helicopter service up and running. In the minister's words, many of them may credit–can credit their lives to the service. I wonder which one of the members opposite is this dismissing.

The minister talks about how important lives are, and I agree. Well, Mr. Speaker, it has been now 525 days since the ER at the Vita hospital closed. I know that when the hospital ER was open, the lives of many were saved. Two personal friends were saved at the Vita ER when they suffered heart attacks. If it were not for the doctors at the ER stabilizing them, they would not have made it any further. I would like to ask the minister which one of them she would like to dismiss, because one of them sits here in the Chamber.

Experts agree how important that first hour is, that golden hour, when it comes to the survival of a heart attack victim. * (14:30) Why is this minister not doing more to get these ERs opened? With summer coming, more and more Manitobans will be spending time in rural Manitoba– at their cottages, at weekend retreats. The chances for accidents will increase. All we see is less and less services at rural ERs. More and more blanks on the on-call list. When will this Health Minister take responsibility for these ER closures and do something about it?

The minister keeps telling us we have more doctors, but with 19 rural ERs closed, where are these doctors? We know that about 2,200 doctors have left Manitoba since the NDP have taken power. Manitoba has one of the lowest retention rates in Canada. Within the last year, 439 licensed doctors have left this province. The Conference Board of Canada ranks Manitoba's health-care system as dead last in Canada. Manitobans have the worst access to after-hours primary physicians in Canada. The Premier (Mr. Selinger) promised that every Manitoban has access to a family doctor by 2015.

I'd like to know how he's going to do this. Just another broken promise. Mr. Speaker, it is interesting to listen to the minister blame the federal government and blame the government of the '90s. The bottom line is this NDP government has had 14 years to improve the health-care system in this province. They have broken their word and turned hallway medicine into highway medicine. Mr. Speaker, our health budget now consume s more than 40 per cent of the total provincial budget, but Manitobans aren't seeing any improved services. In 1999, the WRHA's administrative costs were $5.7 million.

By 2003, the costs soared to $16.6 million. In 2011- 12, the WRHA reported administrative costs of $109 million. This NDP government is good at spending money, but with little results. Mr. Speaker, in 2011, the average length of time that paramedics waited in an emergency room was 66 minutes. In 2013, that number increased to 76 minutes. The NDP have made many promises regarding wait times in health care. MRIs–NDP promised eight weeks wait time, the present wait is 18 weeks. CT Scan–NDP promised two weeks, the present time is eight weeks. Good NDP math.

According to the wait your turn report, Manitoba is at the bottom of the barrel when it comes to wait times to see a specialist. With 19 ERs closed, where are all the patients going for health care? When will the Vita ER reopen? More than 1,700 patients visited that ER when it was op en, per year. How much pressure is this putting on other ERs? Can the other ERs even handle the excess or other patients that are visiting? Manitobans are not getting the health care they need or deserve. The Minister of Health (Ms.

Selby) keeps talking about how important patient care is, and, yes, I agree with it, that's the most important thing. So why is this minister not doing something about it but closing 19 ERs? It is time this minister took control and started spending money where it'll make a difference to patient care in Manitoba. It is time to stop making promises that she can't keep and quit gambling with patients' lives. Mr. Speaker, our health- care system cannot take any more NDP mismanagement. Thank you.

1460 LEGISLATIVE ASSEMBLY OF MANITOBA March 26, 2014 Mr. Speaker: Are there any further grievances? ORDERS OF THE DAY GOVERNMENT BUSINESS Mr. Speaker: Seeing none, we'll move on to orders of the day, government business. Hon. Andrew Swan (Government House Leader): Could you please call Committee of Supply. Mr. Speaker: We'll now resolve into the Committee of Supply. Mr. Deputy Speaker, will you please take the Chair. COMMITTEE OF SUPPLY (Concurrent Sections) HEALTH * (14:40) Mr. Chairperson (Mohinder Saran): Order. Will the Committee of Supply please come to order. This

section of the Committee of Supply will now consider the Estimates of the Department of Health. Does the honourable minister have an opening statement? Hon. Erin Selby (Minister of Health): I do. In the face of global economic uncertainty, we continue to focus on what matters most to Manitoba families by protecting and enhancing front -line services that they count on, of course, including health care.

Budget 2014 provides a 2.1 per cent increase, or $110- million increase, in funding for health care to ensure that Manitoba families continue to have access to existing health services as well as continued progress on our commitments to provide even better care. Budget 2014 includes funding for a number of key government commitments. We're continuing progress on our commitment to a family doctor for anyone who wants one by 2015, including more doctors, nurse practitioners and opening new clinics such as ACCESS Winnipeg West at the Grace Hospital and two new QuickCare clinics in St.

Vital and Seven Oak s and, of course, more to come, including in my constituency of Southdale. We are enhancing rural health care throughout recruitments of health -care professionals, beginning construction on new clinics in Swan River and Steinbach, a new ER and MRI in Dauphin, a new ambulance station in Ile des Chênes and a second mobile clinic to visit smaller communities.

We're building a strong care system and supports for families facing cancer, including the expansion of cancer hubs into northern Manitoba and continued progress on our commitment to reduce the cancer patient journey from suspicion to treatment to 60 days or less. We're supporting seniors and enhancing opportunities for them to age close to home through construction of new personal -care homes in Winnipeg, Morden and Lac du Bonnet; celebration of the 40th anniversary of home -care program; and further investments to enhance fire safety in personal-care homes and other facilities.

We're improving emergency care with the launch of an advanced- care param edic program at Red River College, and moving forward with the implementation of other elements of the EMS review including the establishment of the provincial office of the medical director. We're continuing to focus on streamlining administration, increa sing productivity and fighting for better drug prices. We've reduced the numbers of RHAs from 13 to five, cutting over a hundred board and executive management positions and saving over $10 million, and that money has been reinvested into supporting front-line care.

As budget –as committed in Budget 2014, we announced yesterday that we're putting in new caps on corporate spending in the four rural and northern regional health authorities. Rural RHAs will be capped at 3.99 per cent and northern at 4.99 per cent. This, of course, builds on the successful cap of 2.9 per cent–2.99 per cent, rather, put in place for the Winnipeg Regional Health Authority in 2011. But I should note that their actual spending was down to 2.54 per cent in 2012-13.

To further impro ve accountability and transparency in regional health authorities today, we're also putting into place requirements that all CEOs of RHAs, hospitals or personal -care homes need to annually report their expenses such as travel, meals and accommodations, and this information will be publically posted annually in June. We also announced yesterday another major expansion to the Pharmacare 'formularily' –formulary with over 400 new brands and genetic medications being added. Our Pharmacare program is a universal one. An income-based deductible is reached and it is

March 26, 2014 LEGISLATIVE ASSEMBLY OF MANITOBA 1461 one of the most comprehensive in Canada. We're able to add these new products by reinvesting savings reaped through our successful generic drug policies and by taking a joint approach to achieving low p rices for generics in collaboration with other provinces. A lower price negotiated for six generic drugs alone will create over $9 million in annual savings, which will not only mean that we're keeping money in the pockets of Manitobans, but also means saving government, which will then be reimbursed into furth er drug coverage for families.

New drugs being added will help Manitobans with heart disease, preventing strokes to those who've had a joint injury and help with allergies as well as many other conditions. Since 1999, we have added over 4,000 drugs to the Pharmacare program. While other provinces are freezing or cutting health-care spending, in recent years we have made significant progress in bending the cost curve in health spending while protecti ng services and maintaining balance in departments and RHAs. Supporting families facing cancer continues to be a primary focus of our government.

We've intro - duced important new initiative to ensure that patients have access to faster cancer training –testing, rather, diagnosis and treatment by setting the goal of re - ducing the entire patient journey to two months or less. This is a $40-million comprehensive, aggressive and first-in-Canada cancer strategy. It will streamline cancer services and dramatically reduce the wait time for patients between the time that cancer is suspected and the start of effective treatment.

Manitoba currently has the shortest wait time in Canada for radiation therapy, at one week or less, according to the Canadian Institute for Health Information. This is a standard measurement of wait times used by every province, but only captures the wait time from when a radiation specialist declares a patient ready for treatment to the day that the treatment actually begins. This measure does not include the other parts of the patient's journey such as referrals, testing, diagnosis, retesting and the development of the treatment plan.

This new initiative will address the entire journey from when a patient's family doctor first suspects cancer until the treatment begins. The Manitoba cancer patient journey strategy includes accelerating cancer testing by hiring over 50 front-line staff, including eight more pathologists, two new cancer -testing co -ordinators and 35 more technologists; hiring more cancer patient journey navigators who are already working at sites across the province to monitor and help patients and families through their entire journey, identify delays and issues and ensure faster testing, diagnosis and treatment.

It includes bringing faster access to cancer treatment closer to home by expanding our 16 rural chemotherapy sites into full CancerCare hubs, which include patient journey navigators and enhanced services for cancer patients and their families.

We've already launched cancer hubs in communities across the province including Gimli, Selkirk, Dauphin, Swan River, Brandon, Neepawa and Morden, and this year we'll expand services in Flin Flon, The Pas and Thompson. * (14:50) As part of this strategy, we've also launched the First Nations, Metis and Inuit Cancer Control Program to directly engage communities in cancer prevention, treatment and awareness. We've also opened the new Urgent Cancer Care Clinic to help cancer patients get the urgent care they need without needing to go directly to an ER.

We're also covering a hundred per cent of the costs for cancer treatment and support drugs with no deductibles for patients at home and in hospital. In the first year, over 9,600 patients signed up, and we saved over $10 million th rough this best -in-Canada coverage. And I do want to note that Manitoba and Saskatchewan are the only jurisdictions to cover both cancer drugs and the support drugs that deal with the side effects of cancer. Another key focus of Manitoba Health is our commitment to access to a family doctor for all.

And as part of the funding in this budget, I was pleased to announce the location of the province's fifth QuickCare clinic, which will open later this year. This, of course, is one of four more QuickCare clinics in development for Winnipeg, on top of two already in place, and others in Steinbach and Selkirk. QuickCare clinics have already had over 67,000 visits and help to take significant pressure off of our emergency rooms.

They're also just one piece of o ur broad plan to ensure access to a family doctor for all by 2015, an initiative that is not only about connecting those without a doctor to a regular care provider, but also enhancing the care available for those who already have one. Since 1999, we hav e had a net gain of over 560 practising physicians in this province, and we're well over our way to our 2011 collection commitment of 200 more doctors. However, while

1462 LEGISLATIVE ASSEMBLY OF MANITOBA March 26, 2014 doctors are obviously a key part of our family doctor commitment, this plan is about a much broader vision of sustainability, accessible health care for Manitobans and it keeps Manitobans healthier by taking the pressure off our busy hospitals.

It means we're maximizing the role of nurse prac - titioners, physician's assistants and all health- care professionals, as we bring together teams of care - givers to make sure that people get the right care at the right time, including the 14 my health -care teams, the 50 new health -care professionals to work in the doctor's office and help doctors take on up to a thousand more patients each. We are working, of course, in this expansion of family doctors because we know it's an important way to take pressure off of emergency rooms across the province.

And we know that families expect to have safe, quality and timely emergency care. I would also like to take a moment just to thank the staff in both of my constituency office and in my Health office, the Health Department, and the many, many Manitobans who work in our health- care system. They are truly the smartest, most dedicated and most compassionate group of people I have ever had the honour of working with. I benefit from their support every day, but I know that their true motivation is the desire to have the best health -care system that we can for all Manitoba families.

And I am proud that in the face of global economic uncertainty, we continue to focus on what matters most to Manitoba families by protecting those front-line services that they count on–most importantly, health care. Thank you, Mr. Chair. Mr. Chairperson: We thank the minister for those comments. Does the official opposition critic have any opening comments–Minister for Justice. House Business Hon. Andrew Swan (Government House Leader): Yes, this will be very brief. I won't take up the time for Health Estimates. Just to put on the record that the Opposition House Leader (Mr.

Goertzen) and myself had agreed on the arrangement for Estimates, and we may have actually got a little bit ahead of ourselves. We had Health Estimates taking p lace in this room and Healthy Living and Seniors taking place in a different committee room far later. Indeed, the Health and Healthy Living Estimates have been presented together, so I think there's agreement that we'll proceed with Health Estimates and H ealth Estimates only at this point. And then we will negotiate and determine how we then best get to the Healthy Living and Seniors Estimates at an agreed time. Mr.

Chairperson: I thank the honourable Justice Minister. So, it's agreed? [Agreed] * * * Mr. Chairperson: Now, does the official opposition critic have any opening comments? Mrs. Myrna Driedger (Charleswood): Mr. Chair, I do have a few comments to make. I want to welcome the minister to her new role and wish her all the best. It's a extremely challenging role, and I think one that certainly has a lot of ups and downs in it, and do wish her well as she moves forward.

I, too, would like to acknowledge the department staff and all health -care professionals for their hard work and commitment to st riving for better health care. I know that it is hard work to be on the front lines. I know it can be often thankless. As a nurse for 23 years, I fully appreciate those who are striving so hard on a day -to-day basis. I know what they go through.

I can still vividly recall a lot of moments in my career at many different times to try to meet any of the challenges that were before us, and I know there are so many people out there that want to make a difference, both at the level of the department and also at every level of health-care delivery. So I would like to say to all of those people a very humble thank- you for what you are doing every day to try to strive for a better health-care system. And I would like to acknowledge publicly and thank Dr.

Dhaliwa l for his vision and tenacity to ensure that there is a cancer strategy developed and moved forward in Manitoba. I know he worked passionately on that for many, many years, and I think that he may not have gotten as –it as far as he would have liked to, but he has made a significant difference in Manitoba in terms of being a champion for that cancer strategy and moving it forward. He put a lot of work into that and a lot of thought. And I think it was certainly vision and tenacity that brought it to where it was today.

So, publicly, I think a lot of us owe a great deal of gratitude to him, especially as we are reaching the stage in time where a lot of baby boomers and

March 26, 2014 LEGISLATIVE ASSEMBLY OF MANITOBA 1463 seniors are going to be coming into the system. We know that with aging, we certainly see a lot of health challenges, and cancer is going to be one of those big ones. So I just want to publicly say that about Dr. Dhaliwal and to thank him. And with those few comments, Mr. Chair, that is all I have to say at this time. Mr. Chairperson: We than k the critic from the official opposition for those remarks. Under Manitoba practice, debate on the minister's salary is the last item considered for a department in the Committee of Supply. Accordingly, we shall now defer consideration of the line item 21.1.(

a) contained in resolution 21.1. At this time we invite the minister's staff to join us at the table, and we ask that the minister introduce the staff in attendance. Ms. Selby : I would like to thank my critic for her kind words to the incredible work of all our health-care professionals and also the fact that she acknowledged Dr. Dhaliwal who is, of course, a remarkable man, and we do welcome Dr. Navaratnam to the job who, I think, is also an incredibly strong woman, and I look forward to working more with her.

Joining me at the table are Karen Herd, who is the Deputy Minister of Health, Healthy Living and Seniors, and as my critic acknowledged, this is a big portfolio, Health, so when you think of –that Karen not only has Health, but Healthy L iving and Seniors as well, you can imagine that's a big responsibility on some very strong shoulders, so I'm glad to have her joining me today. Alongside Karen is also Nardia –correct me if I say it wrong –Maharaj who is the acting assistant deputy minister and chief financial officer, and, of course, a brilliant woman in her own right.

And Karen–I already introduced Karen, so I should introduce Jean–Jean Cox, who is the assistant deputy minister, provincial policying and programs, and a very hard-working, dedicated professional as well. Mr. Chairperson: Thank you. Does the committee wish to proceed through the Estimates of this department chronologically or have a global discussion? Mrs. Driedger: Certainly, Mr. Chair, I'd recommend a global discussion, because if we went line by line, we would never get out of this room. So I think it'll be a lot speedier just to get through it in a timely fashion. Mr. Chairperson: So, thank you.

It is agreed, then, that the questions for the department will proceed in a global manner, with all the resolutions to be passed once questioning has concluded. The floor is now open for questions. * (15:00) Mrs. Driedger: Prior to proceeding with my questions, I would like to take the time to welcome Ms. Herd to the job. The last time I think I was at this table she was in a different position and, certainly want to welcome her and wish her well. And also, to Ms. Maharaj who is assuming that very challenging role in health care, is dealing with the money and where money goes and how it's spent. And, for Ms.

Cox, I think we have met before at other Estimates. But I welcome you all and do acknowledge the work of the department in often challenging times when we're trying to deal with a health-care system that is like a big ship that doesn't turn very, very quickly. The changes are often quite small but important. A first question, and it comes probably with some confusion for me, just based on the changes that were made with the two different ministries, and it's not clear to m e.

So I just have a few questions just to try to understand that so I can get a better sense, too, of –because they're all mixed into this now. I need to be a little bit more clear as to what I can be asking and can't be. But to the Minister of Health the n, when did the Minister of Healthy Living lose her own department and get put into the Department of Health? Ms. Selby : Yes, of course, we did have a Cabinet change back in October –October 18th, of course, of this past year –that did bring Healthy Living and Seniors into Manitoba Health.

We brought in, of course, the MLA for Kirkfield Park to take over that portion of the portfolio, which is quite fitting, I think, because I know that the member for Kirkfield Park (Ms. Blady) does have many seniors in her neighbourhood and a really great understanding of what seniors need. Certainly, we think that it makes sense to bring the two of them together. There're certainly synergies to bringing these two areas together in that we know how much healthy living infl uences health, how that the healthy–the health system both relies and benefits

1464 LEGISLATIVE ASSEMBLY OF MANITOBA March 26, 2014 from people having a healthy living and the things that they do to encourage it. So I think it was –it's a great way to make sure that we don't lose sight of how important living a healthy lifestyle and all the things that we can do in terms of prevention can lead to better health outcomes.

And I think that this way it actually is a good way to co -ordinate the work that we do that at times does overlap, absolutely, but also allows the Minister for Healthy Living and Seniors to really focus on some of those things and to be sharing those ideas with Health and how they both influence and benefit the things that we're doing on this side of the department. Mrs.

Driedger: I would support some of the minister's comments, too, in that, you know, one would think that if all of that was together, you don't sort of split your thinking into health and healthy living, because if we did focus on healthy living we would be having a very strong i mpact on health, and that you do get your better synergies, I think, if there is a closer attachment, and you would then achieve better continuum of care, better delivery of service, better co-ordination, under, sort of, one roof. That's why I was surpri sed, actually, when the government split them and then had two separate departments.

And to me, you know, I thought that could take away from some of the benefits that could be achieved if it was maintained under one, you know, one roof, so to speak. So I do support what the minister says on that. But the government was certainly adamant at the time that–and maybe I need to ask this of the Minister of Healthy Living, I don't know –but the government seemed to be absolutely adamant at the time that–and actually were critical of us if we would ever have made this same move and brought it back.

Those were the kind of comments that were being made by different NDP MLAs, you know, and saying, well, you would get rid of Healthy Living. Well, in effect, that is wh at the government did and brought it under the umbrella of Health into one department. So has the thinking changed all along the way, then, that they found that it wasn't that beneficial to have the two separate, and was there sort of an awakening that it is better to be done, you know, under one umbrella? Ms. Selby: Certainly in Health we're always open to whether it's new ideas, new innovations.

I think particularly in areas of health one must always be looking at ensuring that we are reviewing practice and making sure that we're doing things in the most efficient and best manner. Now, certainly, when Healthy Living and Health were split, we were still linked within the depart- ment, very happy to have them. We do share some stakeholders in some cases. We have separate ones in other cases.

Really, certainly, we know how important the good work is that happens in the Healthy Living department, and I know that the work that those folks are able to do makes a direct impact on the state of health of Manitobans and their needs in health care. We're formalizing what was already happening. There were lots of links within the department, lots of conversations, of course, between it. This is a way of formalizing the way that had happened already. I know that t he member for Kirkfield Park (Ms. Blady) is a really good role model in the position.

She's a woman who is always advocating for both a healthy lifestyle and for the seniors, both in her constituency and around the province as well. So, you know, I think it's important in health care to always stay nimble and always stay open to ideas and to make sure that we're always reviewing and currently doing what we think is innovative and best practices. And, although we were always happy to b e working with them, we're sort of formalizing what was, for the most part, already happening. Mrs.

Driedger: Can the Minister of Health tell us if the Minister of Healthy Living is a junior minister, then, under the Minister of Health? Does she report to the Minister of Health? Seeing as one budget for the Minister of Healthy Living is significantly smaller–and I will get into that in a couple of questions to find out how you both work a budget when it's all mixed together now –but is the Minister of Healthy Living a junior minister reporting to this Minister of Health? Ms.

Selby: And I would maybe, if I could refer my critic to page 10 of the Estimate book, she'll see there that we have an organizational chart for Manitoba Health, Healthy Living and Seniors, and she can see there that at the top of the chart there are two separate boxes at equal level of Minister of Health and Minister of Healthy Living and Seniors. If you go down from there, it does go to the one deputy minister. We do share a deputy minister, but you can see that there are some separations in terms of advisory committees and appeal boards, Addictions Foundation on one side, other advisory terms.

March 26, 2014 LEGISLATIVE ASSEMBLY OF MANITOBA 1465 * (15:10) But much of what is happening, and you can see if you start at the bottom and wor k your way up, whether it's the Administration and Finance, the Health Workforce, regional policies, public health, primary health, provincial policies and programs, Healthy Living and Seniors, of course, being specifically more towards the Minister of Hea lthy Living and Seniors, but, of course, there is crossover into Health, whether that be in terms of home -care support and health in general of seniors.

So, well, of course, at the top you can see there is a division of two ministers, separate but equal, on the same line. We do work together because, as my critic has mentioned, there is a lot of synergies there and I think it's important to recognize that they do go together quite well, and I think that we can work to both provide strength to both sides of the department. Mrs.

Driedger: So, based on that answer, it then appears to me that this –the Minister of Healthy Living, even with a small budget, is not a junior minister, that she is a full -fledged minister and the two of them are somehow functioning under the umbrella of Manitoba Health, Healthy Living and Seniors. Can the minister tell us then –the last time I was at this table in Health, I believe the budget for Healthy Living was around $40 million. I think somewhere I saw that it might be $55 mill ion. How does–I guess the first question would be, is the budget for Healthy Living in the area of $55 million? Ms. Selby : Mr.

Chair, as we pointed out, the Minister of Health and the Minister of Healthy Living and Seniors, we do share a deputy minister, we share some of the health staff, and certainly we share an interest in making sure that we're providing the best health -care system for Manitobans. But, as the critic also pointed out, we do divide up the responsibilities within it.

So I wonder if, perhaps, my critic might be better off referring some of her more specific Healthy Living and Seniors questions to that minister, who would probably be able to give her a more thorough breakdown of those particular questions that she would have and, perhaps, although we're working globally, that we could focus on the areas that are under the responsibility of the Minister of Health. Mrs. Driedger: Mr. Chair, that's a confusion of these Estimates, though, is because both budgets are all together in this one document.

For me to understand where Health dollars are spent versus Healthy Living dollars are spent, I need to know what that budget is for Healthy Living. Ms. Selby: Mr. Chair, I would be happy to refer the critic to page 11 of the Estimates. She can see t here, there is a breakdown of the budget, and if you look at No. 6 there, Healthy Living and Seniors does have its own line in that breakdown there. Mrs. Driedger: Thank you. That certainly helps me in my understanding. Can the minister then indicate, d id her department absorb all of the staff that were related to the Department of Healthy Living? Ms.

Selby: Yes, we absorbed the staff, but we do, of course, share the deputy minister, administration and finances. Other programs and services, in some cases, support both ministers. Some are more specific to one side of the portfolio and the other. Mrs. Driedger: The –so it's interesting, because we have the Minister of Health here, then, managing a budget of somewhere in the area of 5.2 to 5.3 billion dollars. We have a minister, also, then, given a portfolio for managing a mere $44 million. Why would we need two ministers, then, within this department?

And especially with the minister's comments that it makes sense that it's all under one, why then do we need to have a Minister of Healthy Living? That almost looks more like window dressing than it does anything substantive. Ms. Selby: Well, I think that it's quite clear, and my critic has also said it, that it is important to keep a focus on healthy living and on seniors and all those programs that do so much in the preventative form of it.

I think perhaps more specific questions on what exactly the Minister of Healthy Living and Seniors does, she can probably better answer, day -to-day, what it is that she focuses on and how she meets with groups and shares information and develops policies in that way. Certainly, we believe that patients, families, First Nations, whether it be municipalities, community groups or advocacy groups, any –you know, in my department, I hear from folks like Heart and Stroke and Cancer Society–as well as, of course, just business community and regular folks have a lot of good ideas and a lot of good advice.

And we're always looking forward to having those groups bring advice forward to the minister's office. Mr. Chair, I think it's important that we are able to keep a focus on Healthy Living and Seniors, and I think, again, probably the

1466 LEGISLATIVE ASSEMBLY OF MANITOBA March 26, 2014 Minister for Health Living and Seniors can better explain what she does and what the focus is in her particular area. But certainly, working on prevention and awareness, very valuable work to be done as part of an overall health-care system. Mrs. Driedger: And certainly, the portfolios were always together up until more recently under this government. And it was always a Minister of Health that addressed all of the health along the whole continuum. So, you know, I do, you know, I do see the value of having that one roof.

I don't see the value and the necessity to have a minister, appearing to b e a junior minister that looks like window dressing only, in a position where, if you took that salary and you took the assistant –I mean, there's $200,000 savings right there that could be saved and put into perhaps something on the front lines of health care. But the minister's right, I do need to take that question elsewhere, and it probably is to the Premier (Mr.

Selinger), not to the Minister of Healthy Living, to explain why he would feel the necessity to do that. * (15:20) I'd like to get into, now , the audit by the Auditor General on the helicopter EMS. I've now had a chance to look through a lot of it. I still haven't–want to read it twice to get to the real nitty -gritty, but just based on some of the minister's responses so far, this audit really did slam the government for mismanagement of this contract.

And, you know –and in the answers the minister is giving in question period, I don't get the sense that she understands the seriousness of the allegations made by the auditor, because, based on her answers today, she's just reading her canned points written out for her, and it leaves the impression that she doesn't understand the questions or the issues. She doesn't seem to be at all concerned about the breach of tendering principles –which are r eally significant– or policies or the law that was broken in this.

So I would ask her, because she's running the biggest department in government –there's lots of contracts there. This is a scathing indictment of gross mismanagement by the government on thi s issue. And I appreciate that this minister inherited it, but she doesn't have to defend it if she sees the problems and the errors that were made. And I really–based on her answers today, really have to ask her, does she understand the significance of an audit like that that has slammed the government on how they moved ahead with this HM–EMS contract? Ms.

Selby: I did want to address the first part of the critic's question and talk about the balanced approach that we are taking to continue to protect those services that Manitoba families depend on, while cutting costs and reinvesting them back into the programs that we know. By bringing Manitoba Health, Healthy Living and Seniors together, we certainly found efficiencies in that we have one deputy minister for the entire department. We have one administration and finance for the department as well.

This is really what we've been doing right around government to cut overhead and move resources to invest in growth and steady jobs –good jobs–investments in co re infrastructure, but making sure that we're protecting those investments in health care, education, other services that families depend on. For instance, in Health, I know the member is aware that we brought the RHAs that were–from 13 down to five. That was a savings of $11 million that's being reinvested right into the front lines. I just announced, of course, what we know, that in 2011, we brought in the corporate cap for the WRHA to 2.99 per cent.

And I should commend folks there for their hard work, that they actually came in at two point–I believe it's five four per cent–in the last–their last budget. But the member's probably aware that we just extended that, both in the budget and announcing yesterday that the corporate caps will go to rural RHAs a nd northern RHAs, 3.99 and 4.99, respectively. Because it is –certainly, people want to know that the money that we're spending in health care is being spent in an efficient manner and that it's going to those front -line services that people count on.

Absolutely, that is something that we're looking at in many areas across government and Health –we really have been working on that for some time, and I will commend the previous minister of Health for the work that she started on that. Of course, while we are looking for efficiencies– and as I've said earlier, we're always looking for innovation and making sure that we're providing the newest and best health care that we can on the advice of our medical professionals –our focus is always, of course, on providing the best patient care.

And we know that in circumstances there are times when, in public interest, and when there's only one qualified proponent, that government may tender without a contract.

March 26, 2014 LEGISLATIVE ASSEMBLY OF MANITOBA 1467 In this case, when it was a life -saving service, we'd seen th e good work that had been done on STARS in the flooding of both 2009 and 2011. We felt it was important to continue with that, and we've heard from Manitoba families that, particularly in rural Manitoba, how much they depend on it and how many families and lives have been served by STARS since they have been here. Mrs.

Driedger: You know, I would say to the minister that her answer really doesn't have a lot of credibility, because on one hand she's talking about looking for savings and efficiencies in the system and then on the other hand she's defending a contract where this government knowingly agreed to spend six times more than what a service was worth. So you can't have it both ways on this one and, if, you know, this minister continues to, you know, go down that road, she's going to keep losing credibility with her responses because it's just not matching up.

I asked yesterday whether the minister would provide a copy of the 2009 feasibility study and she didn't answer the question in question period, and I would ask her again right now. Will she provide me a copy of that feasibility study? Ms. Selby : I understand that there may be some privacy concerns with that report. I've asked my department to review it and see what might be able to be released, keeping in mind there may be some privacy issues in that. Mrs. Driedger: What kind of privacy issues?

Because, certainly, you know, any patient infor - mation, which I doubt would be in that report because it was a feasibility study, what exactly would be privacy information? Ms. Selby: As I said, I have asked the department to review it. I know they are working on that. I will see what–which is able to be released and we are hoping that we will be able to provide that very soon. Mrs. Driedger: I appreciate that. I look forward to receiving a copy of that. Can I ask the minister why her government did not follow through on the recommendations of that feasibility study? Ms.

Selby : In November of 2010, of course, our Throne Speech, we did announce our intention to purchase an air ambulance helicopter. While we were investigating potential helicopter -based air ambulance service providers, of course, I know the member will remember that a major event hit. We had the flood of the century that was de vastating to many parts of the province. Just as we had in the floods of 2011–in 2011 we did contract STARS to provide that specialized emergency service by helicopter ambulance.

We know the good work that they did during that time and were able to get to places that we just would not have got to otherwise. Based on the benefit of that service, we did decide to maintain that lifesaving service and we know that STARS, since they've been flying in Manitoba, have gone on over 600 missions and have transported over 400 people that –I have no doubt many of them would credit their lives in being here with the good work that folks were able to do. Mrs. Driedger: Perhaps the minister didn't get the full question.

But the feasibility study was done and it was provide d to government at the end of 2009. The minister mentions a Throne Speech that was in December of 2010, so that's a whole year down the road that's basically been lost. * (15:30) What I am wondering is, if you had followed through at the time of getting that feasibility report and government had it in its hands at the end of 2009, you could have had a helicopter EMS up in the air long before what you really did.

And so I have to ask the minister again, you know, considering that the feasibility study sa id that 35 to 50 lives could be saved annually, that must have perked up a lot of ears in government, and yet – and if the government really cared about patient safety, shouldn't they have acted immediately at the end of 2009, when it said that 35 to 50 lives could be saved annually? Why weren't the recommendations followed through at that time if the government was so committed to patient safety? Ms. Selby : And, yes, as I said, that's right.

In November 2010, the Throne Speech, we announced our intention to purchase the helicopter ambulance. While we were investigating that –potential heli - copter air ambulance service providers, of course, that's when the flood of the century came. At that time, it was determined that we should contract with STARS again, as we had in 2009. We know that they provided a really good service in those times, were able to get to places that we just would not have been able to get to without them. Based on that, we did decide to extend–to maintain the life-saving service that they provide.

1468 LEGISLATIVE ASSEMBLY OF MANITOBA March 26, 2014 We knew that it would take about 18 to 24 months for another option to be available, so in June of 2011 we announced that it was our intention to enter the long -term contract with STARS. They were the only provider who was able to offer helicopter-based ambulance service at that time. We knew that putting a contract to tender for a helicopter ambulance service would have meant ending the service, and during that time we know that STARS was able to transport over a hundred patients, many who, I hav e no doubt, credit their lives to this service.

In some circumstances, when it's in public interest, when there's only one qualified proponent, government may enter a contract without a tender. We think, in the case of this situation, it was the right call for a life -saving service. I think, in the case of a life-saving service, it is a call that a government makes that is the right one when they're talking about such an important service to serve rural Manitoba families. It's not what all governments do. Certainly, I know the Filmon government signed a one -year untendered contract with Connie Curran to look at ways to cut $65 million from hospitals.

We were thinking that, in the case of making a life-saving service and the good work that they had done in 2009 and 2011, that we decided to continue with STARS based on the experience that we had with them during the floods. Mrs. Driedger: The minister is avoiding answering the question. And, certainly, you know, the Department of Health didn't come to a grinding halt with the flood. In fact, I remember asking questions. I think there was maybe one personal -care home that might have been affected where they had to move patients.

So it's not like the department was inundated with having to deal with a lot of things. Other departments certainly were, but not Health. So it's –the minister's explanations aren't really flying right now, because if the department gave the report to the minister at the end of 2009, there was absolutely no reason–no logical reaso n not to act on it, considering what the report's recommendations included and also considering their findings. You know, they are estimating, you know, saving 35 to 50 lives annually. They estimated 600 to 800 patient transports.

So I don't understand, a nd I don't think the minister is giving an adequate answer to this and I think she has to for her own credibility. What happened to that report? We know it got shelved. It was collecting dust, but why didn't the government act on it considering what the contents were of that study? I don't understand that, because that's pretty negligent, then, if the government didn't respond to that at that time. So can the minister take another crack at an answer on this one? Ms.

Selby: Frankly, I'm rather surprised at the lack of understanding that this critic shows for how important health care is to Manitobans and to Manitoba families and, certainly, no less during a major event like the flood of the century. To say that health care's not affected by the flood of the century just shows a lack of understanding and a –perhaps naïveté of how essential health care is. It makes me, I guess, not surprised that she has a leader who is looking to cut half a billion dollars from our system and doesn't understand that that will a ffect health care. Mr.

Chair, I can tell you that during the flooding EMS was severely affected, roads were closed. There were areas that were inaccessible. An ambulance by land could not get to many areas of the province. You could not have landed a plane in those areas. We know that a helicopter ambulance provided life-saving services.

We also know that during a flood of that size, of course, people are displaced from their homes, whether that be people who work at some level in the health-care system –perhaps, yes –also that we know Manitobans who are always seen as the most charitable across the country are also some of the best volunteers, and nothing pulls this province together like a flood situation of neighbours helping neighbours.

I certainly saw –I was in a different department at the time, but I certainly saw everyone from students to faculties at universities in the department that I was looking over at that time stepping away from what would be their normal work of the day and lending a hand. So to think that the flood of the century has no impact on health is incredibly naive, of course, EMS was severely affected. Road closures would severely affect their ability to access patients, to get to situations.

There were areas that they just would not be able to get to, and that we had helicopter ambulance service in Manitoba, thankfully, to be

March 26, 2014 LEGISLATIVE ASSEMBLY OF MANITOBA 1469 able to reach those people that would not be reached in any other way. Mrs. Driedger: The only one naive in all of this is definitely this new Minister of Hea lth who really is appearing to be in over her head on a health issue.

After 23 years in health care as a nurse and all of these years as a Health critic off and on, I can guarantee her that I have a very, very good understanding. * (15:40) I also know that many people in Manitoba were affected by the flood, some dramatically affected, but it doesn't mean that her Department of Health or her office–the minister of the day –should have come to a grinding halt. In fact, the minister just gave everybody th e best reasons why that report should have seen the light of day, and it didn't. Her comments, her responses, actually–and she was right.

That report, therefore, was so critical that her department should have ensured that it was acted on right at that time, to speak to all of the issues that she was talking about. Now, yes, EMS is out on the road; yes, there are road problems. But the people in her department don't come to a grinding halt during a flood. They need–that's when they step up. And the one pe rson that didn't step up is actually the minister of Health of the day because it was the department that created this report, and it was the department that saw the need for all of this; they did their work.

Somehow, in all of this, it was the minister of Health that did not move on this report. And that does raise a lot of questions. The flood should have highlighted the need for looking at a solid provincial helicopter program at that time. That was the first recommendation – approval is given to develop a detailed project plan for a provincial helicopter program. Seems to me, in the midst of a flood, that should've been motivation enough for the minister to move ahead. And yet the minister, for some reason, ignored this report that came forward from her department.

I would like to ask the Minister of Health: Who commissioned that feasibility study? Ms. Selby: Well, of course, the floods in 2009 and 2011, well, of course, they absolutely did highlight the need of having a helicopter ambulance service. It's why we contracted with STARS at that time because we did see that during those major floods when we partnered with STARS, we were able to offer that helicopter service to rural Manitoba families, to places that we just could not access.

We also knew t hat there would take 18 to 24 months for another option to be available in Manitoba, which is why, after seeing the good work that they did, the important work that they did and the fact that we know so many Manitobans have depended on the good work that they've done, and that STARS was the only provider who was able to offer a helicopter-based air ambulance service at that time, that we did go into a contract with them.

We know that if we put the contract out for helicopter ambulance service to tender, it would've meant ending that service, and during that time, of the eight months between the announcement and the signing of the contract, STARS transported over 100 patients. Many of them, I have no doubt, credit their lives to this service. So, absolutely, we did recognize the importance of it, and that is why we signed the contract with them: so that we could continue to cover that population that, in some cases, whether it's remote or just because of a weather incident is –would be unreachable any ot her way.

So, absolutely, the 2011 flood highlighted why it was so important to keep STARS in the province. Mrs. Driedger: Didn't the 2009 flood actually make that point–not the 2011 flood? Ms. Selby : Yes, as we've said today, during the flood of 2009, as well as the flood of 2011, we did contract STARS to provide the specialized emergency medical service that they can provide by helicopter. While we were investigating the potential of a helicopter-based air ambulance service providers, that's when the m ajor flood of 2011 hit –the flood of the century.

So, of course, we went into another contract with them during that flood, and based on that service, decided that we would maintain the life-saving service that STARS does provide. Mrs. Driedger: But could the government not have maintained that service just by continuing with an interim contract? They didn't have to sign this big $100-million, 10 -year contract. They've had –they had STARS –correct me if I'm wrong –but STARS was there under an interim contract twice. Why couldn't that interim contract just have been extended?

Or do another contract, an interim one, and take your time to then properly tender it during that period. I don't see why, all of a sudden, there

1470 LEGISLATIVE ASSEMBLY OF MANITOBA March 26, 2014 was this big panic to get this contract out there–and it was untendered –when, in fact, the government happily had interim contracts. Why didn't they just keep an interim contract going until the tender was out and properly done? Ms. Selby : Our focus, of course, always is on providing the best pat ient care. We know that that's what matters to families. Certainly, in some circumstances, when it's in the public interest, when there is only one qualified proponent, governments do, at times, contract without a tender.

We think that that was the right call, being that this is a life -saving service. We saw the good work that they did during the major floods that we experienced in 2009 and 2011. We partnered with STARS at that time to offer the helicopter ambulance service. We knew that it would take 18 to 24 months for another option to be available in Manitoba, which is why we did announce that we wanted to enter a long-term contract with STARS. They were the only provider at the time that was able to offer a helicopter-based air ambulance service at th at time.

Putting the contract out for tender for a helicopter ambulance service would've meant ending that service, and that –we knew that it was a valuable service. And I would point out that, in 1997, of course, the previous Conservative government did not make any move towards making a helicopter ambulance permanent after the 1997 floods. They didn't acquire a helicopter.

Certainly, we saw the important work that they did and felt that Manitobans know the importance of having that helicopter ambulance service, and that's why we acted on it. * (15:50) And I note that, in 1997, with the other –one of the other major flood events that happened in Manitoba, the former Conservative government did not do anything to make a helicopter ambulance service part of our EMS system. They didn't acquire a helicopter; they did not move forward with making it part of our EMS service. Mrs.

Driedger: If the government didn't tender the contract, how do they know that STARS was the only provider able to offer this service? Ms. Selby : Certainly, we know, at the time, there was no commercial provider in Manitoba that was able to provide helicopter ambulance service. I know this critic has a background in health care and knows that helicopter ambulance service is more specialized; it's not just a transport of patients, it's not just a regular helicopter than can move people, it's a very specialized service.

We knew at that time that it would take 18 to 24 months for another option to be available, which is why we entered into the long- term contract with STARS, who was the only provider at the time that was able to offer that helicopter -based ambulance service. And we did not want to go forward with putting a contract out for a helicopter ambulance service to tender that would've meant ending the service that we had with STAR S. We know during that time a hundred people were moved–and, certainly, see the value in that service. I should say also, Mr.

Chair, helicopter EMS service is not something that just came up, of course. In 2009, certainly, the experience of that flood di d lead us to take a serious look at our capacities and the need for helicopter EMS. A feasibility study was then conducted in 2009, and in the November 2010 Throne Speech we announced our intention to pursue an air ambulance helicopter. While we were doing that, while we were investigating a potential helicopter -based ambulance service, as I said earlier, that's when the major flood event hit, the flood of the century in 2011.

Just as we had done in 2009 and in 2011, Manitoba contracted with STARS to provide that specialized emergency medicine services by helicopter. Based on that, we did decide to maintain the life-saving services. But I should also mention that, when the previous Conservative government contracted for flood service during 1997, they didn't do anything to make it permanent. They didn't do anything to acquire helicopter EMS capacity when that flood was over. We thought it was important to take a look at it at a time when we saw how important it was in 2009 and 2011.

The previous government did not do anything in the way of making it permanent or acquiring helicopter EMS capacity when the floods of '97 were over. Mrs. Driedger: Can the minister explain why she thinks that they would have had to end that service? They could have extended the interim contract with STARS. It's done all the time. Why is she saying that they would have had to end that service when that actually is not true? Ms. Selby: As I've said before, and I'll say it again, in some circumstances, when it's i n the public interest, when there's only one qualified proponent,

March 26, 2014 LEGISLATIVE ASSEMBLY OF MANITOBA 1471 government may enter into a contract without a service. We think in –or, without a tender, rather. We do think that it's the right call when it comes to a life-saving service. Previous gov ernments, the previous Conservative government, entered an untendered contract with Connie Curran with the sole purpose of cutting $64 million from health care, and we know that that resulted in firing of 1,000 nurses.

We think that, when it is a call ab out saving lives, that sometimes you need to put base patient care in the forefront, and knowing that had we waited for another option it would take 18 to 24 months to be available, we did want to enter that contract because we knew that STARS was able to provide the helicopter-based air ambulance service at the time. We know that they had provided very good service in 2009, 2011 as well, and felt that it was important that we continue that service.

And as I've said before, during that eight months between the announcement and the signing of the contract, STARS did transport over 100 patients. * (16:00) So I think when we were looking at wanting to make sure there was no break in service, we went ahead with what we thought was the right call on a life-saving service. Other governments think that it's appropriate to go to contract without tender in circumstances like Connie Curran, when the Conservative government went without tendering her contract for nearly $4 million and resulted in worse health care for people.

Our focus is on providing the best health care. We know that this is an important service for Manitoba families, particularly rural families. We've seen the work that they've done and we felt that it was the right call on this life-saving service. Mrs. Driedger: Can the minister tell us if the government asked STARS if they would accept an extension of the interim contract while the government went ahead and tendered properly? Ms. Selby : We had –certainly had preliminary discussions with Orn ge and Helijet in BC.

They did not express interest, would not have been able to provide the same coverage of service immediately that we had from STARS. We know that Saskatchewan was also interested in STARS at the same time, and through their resear ch, also did not tender their contract with STARS. Certainly, our concern was making sure that we had a continuation of care. We knew that it would take 18 to 24 months for another option to be available. We were concerned that that would put a break in s ervice. We had seen the good service that STARS had done.

We were concerned about not being able to provide a continuality of that service, which is why we decided that it was important to enter into a contract with the life -saving service that STARS can provide. Mrs. Driedger: The minister did not answer the question, and I will ask her again. I believe it is a key question, and the government does owe Manitoba some explanation.

And I'll ask her: Did the government ask STARS if they would accept an exten sion of that interim contract so that there would be no break in service, so that continuity would be in place while the government then moved forward with a proper tendering process? Did they ask STARS if they would accept that extension? Was it even asked? Ms. Selby : As I said, the department did have discussions with Ornge and with Helijet. They did not express interest.

They did say they were not able to immediately provide service to rural Manitoba, which, of course, is the most important service that STARS does provide, is getting to those remote and rural locations that we couldn't reach otherwise. We certainly felt that in the public interest it did merit going forward with an untendered contract, as Saskatchewan did, to be sure that we didn't hav e a break in service.

We know that looking at another option would've taken 18 to 24 months to be available, so we did announce that we wanted to enter the long-term contract with STARS feeling that they were the only provider that was able to offer the helicopter-based ambulance service at the time. We did not want to have a break in service, and we know that the difference of getting a highly-skilled medical team to the patient as quickly as possible can make all the difference.

It's why we have an EMS s ervice that works together to decide who is the first responder, should it be an ambulance, should it be a jet, should it be the helicopter ambulance. We felt that it was important to maintain that service. We saw the good work that they did and that is why, like the government of Saskatchewan did as well, that in the public interest it did merit going forward with an untendered contract to ensure that we could maintain the service provided by STARS at that time.

1472 LEGISLATIVE ASSEMBLY OF MANITOBA March 26, 2014 Mrs. Driedger: The minister is still not answering the question, and it really is a basic yes or no answer that she would give. And the question is, did the government ask STARS if they would accept an extension of that interim contract? Ms. Selby: I will go through the timeline again for the critic. In November, of course, we did announce our intention to pursue air ambulance helicopter while we were investigating the potential helicopter -based ambulance service providers. That is when the 2011 flood hit, a major flood, the flood of the century.

I realize this member dismisses it as not being something that would affect Health. We see that quite differently. We take it quite seriously and see that Health has an incredibly important role to play in times of emergencies of any kind, of course, and all the time. It's why that we continue to make sure that we're protecting front-line services and why when we're facing difficult economic times that we choose to protect nurses and doctors.

And we know they made different choices, probably because of attitudes that we've seen today, that even during a flood that Health somehow is not important in a major weather effect like the flood of the century. We think differently. During the flood of 2009 and 2011, we did bring STARS in. We saw that they brought in specialized emergency service. They were able to reach places that nobody else could get to. Based on that benefit of service, we decided to maintain that life -saving service.

We decided that in this particular case, when it's in the best public inte rest, when there's only one proponent that is qualified to do it, a government sometimes enters a contract without a tender. We think this was the right call. We saw the good work that they had done. We know that, in the time between the announcement and s igning the contract, a hundred people were served by STARS. Many, many, I have no doubt, would credit their lives to this service. So, certainly, we thought it was an important service and we wanted to continue that important service. Mrs. Driedger: And we don't dispute, Mr.

Chair, at all that a helicopter EMS service is critically important. We've always said that. It's about how to do it right that we are raising concerns about, and this government didn't do it right. The auditor has pointed that out. * (16:10) Certainly, helicopter EMS is an invaluable service in rural Manitoba and there have been multiple times where that has been demonstrated. Also, hospitals are equipped to handle these situ- ations. Hospitals don't go– you know, they're used to the challenges that come before them. So it's not like hospitals couldn't handle the challenge over the number of days of a flood.

That's where, you know, all these front-line professionals really step up to the plate, and they do an excellent job. Certainly, a lot of credit goes to them. The Department of Health certainly had a role to play in this, and the minister's office certainly had a role to play. It looks like it's the minister's office where this failed, and the minister isn't answering the question of did the government ask STARS if they would accept an extension. So I am going to answer that question because STARS did answer it to the media, and they said they might have covered a gap in service.

They said, we would certainly consider it. But it app ears that STARS wasn't asked if they would be agreeable to accepting an extension of their interim contract. The government did not even do that. So the government is at fault here for this whole debacle that has happened now, and the auditor rightly slammed them for it. The government didn't even ask STARS if they would stick around. We could've had continuity of service. Manitobans would appreciate that for sure. But it was how the government mismanaged this that is the question here–STARS was never asked .

So, yes, there could've been continuity in service, but it does beg the question of why didn't the government ask STARS to continue on, and then go out and tender the contract. There are qualified proponents out there. I don't know why the minister is indicating there weren't any other ones. There are other ones. They happened to talk to two of them out there, but there are other services out there that might have applied for that. The government doesn't know, though, you know, who the providers are, bec ause they never tendered it.

So, when they say that it would take 18 to 24 months for another option, they could've had an interim contract with STARS for that length of time. They didn't have to stop services. So this

Document details

Collection	Manitoba — Debates (Hansard)
Citation	40-3-36
Type	hansard
Volume / chapter	40th 3rd hansardpdf 36.pdf
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	114ca993078b52970068fb3730913d62de1dbb9e

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