Manitoba Hansard — 29 July 2002 (Sitting 72A, 37th Legislature, 3rd Session)

37-3-72a

Manitoba — Debates (Hansard)

Third Session - Thirty-Seventh Legislature of the Legislative Assembly of Manitoba DEBATES and PROCEEDINGS Official Report (Hansard) Published under the authority of The Honourable George Hickes Speaker Vol. Lll No. 72A- 10 a.m .. , Monday, July 29, 2002

Member AGLUGUB, Cris ALLAN, Nancy ASHTON, Steve, Hon. ASPER, Linda BARRETI, Becky, Hon. CALDWELL, Drew, Hon. CERILLI, Marianne CHOMIAK, Dave, Hon. CUMMINGS, Glen DACQUAY, Louise DERKACH, Leonard DEWAR, Gregory DOER, Gary, Hon. DRIEDGER, Myrna DYCK, Peter ENNS, Harry FAURSCHOU, David FRIESEN, Jean, Hon. GERRARD, Jon, Hon. GILLESHAMMER, Harold HA WRANIK, Gerald HELWER, Edward HICKES, George JENNISSEN, Gerard KORZENIOWSKI, Bonnie LATHLIN, Oscar, Hon. LAURENDEAU, Marcel LEMIEUX, Ron, Hon. LOEWEN, John MACKINTOSH, Gord, Hon. MAGUIRE, Larry MALOWAY, Jim MARTINDALE, Doug McGIFFORD, Diane, Hon. MIHYCHUK, MaryAnn, Hon.

MITCHELSON, Bonnie MURRAY, Stuart NEV AKSHONOFF, Tom PENNER, Jack PENNER, Jim PITURA, Frank REID, Daryl REIMER, Jack ROBINSON, Eric, Hon. ROCAN, Denis RONDEAU, Jim SALE, Tim, Hon. SANTOS, Conrad SCHELLENBERG, Harry SCHULER, Ron SELINGER, Greg, Hon. SMITH, Joy SMITH, Scott, Hon. STEFANSON, Heather STRUTHERS, Stan TWEED, Mervin WOWCHUK, Rosann, Hon. MANITOBA LEGISLATIVE ASSEMBLY Thirty-Seventh Legislature Constituency The Maples St. Vital Thompson Riel Inkster Brandon East Radisson Kildonan Ste.

Rose Seine River Russell Selkirk Concordia Charleswood Pembina Lakeside Portage Ia Prairie Wolseley River Heights Minnedosa Lac du Bonnet Gimli Point Douglas Flin Flon St. James The Pas St. Norbert La Verendrye Fort Whyte St. Johns Arthur- Virden Elmwood Burrows Lord Roberts Minto River East Kirkfield Park Interlake Emerson Steinbach Morris Transcona Southdale Rupertsland Carman Assiniboia Fort Rouge Wellington Ross mere Springfield St. Boniface Fort Garry Brandon West Tuxedo Dauphin-Rob lin Turtle Mountain Swan River Political Affiliation N.D.P. N.D.P. N.D.P. N.D.P. N.D.P. N.D.P. N.D.P. N.D.P. P.C. P.C. P.C.

N.D.P. N.D.P. P.C. P.C. P.C. P.C. N.D.P. Lib. P.C. P.C. P.C. N.D.P. N.D.P. N.D.P. N.D.P. P.C. N.D.P. P.C. N.D.P. P.C. N.D.P. N.D.P. N.D.P. N.D.P. P.C. P.C. N.D.P. P.C. P.C. P.C. N.D.P. P.C. N.D.P. P.C. N.D.P. N.D.P. N.D.P. N.D.P. P.C. N.D.P. P.C. N.D.P. P.C. N.D.P. P.C. N.D.P.

393 1 LEGISLATIVE ASSEMBLY OF MANITOBA Monday, July 29, 2002 The House met at 1 0 a.m. PRAYERS ORDERS OF THE DAY GOVER NMENT BUSINESS House Business Hon. Steve Ashton (Deputy Government House Leader): Mr. Speaker, there is agreement to have Public Accounts and two Committees of Supply running concurrently, and I think we were just confirming which two. There is going to be some confusion. I know Culture is one of them. I think the other question is whether it is Health or Status of Women. I notice the Health critic and the Health Mini ster are here. Can I assume that we will do Health and Culture? Mr.

Speaker: Just a reminder to the honourable Deputy Government House Leader that he would need leave of the House and then he would need to move the motion to change the sequence. Mr. Ashton: Mr. Speaker, I think there might be leave to consider Culture in the Chamber this morning, which it is currently designated, and Health in Room 254 between 10 and 12 this morning. Could I ask if there is leave on substituting Health for Status of Women in Room 254? Mr.

Speaker: Does the honourable member have leave? [Agreed} The honourable Deputy Government House Leader, changing Status of Women to Health, that is for this morning only? Would you have that confirmed? Mr. Ashton: Mr. Speaker, that would be the intent. I believe-and I am not sure of the order of this, but following Culture, if Culture does finish this morning, the intent, I believe, is for Industry, Trade and Mines. It is the following department. I just want to confirm that for critics and ministers. Mr.

Speaker: For clarification to the honourable Deputy Government House Leader, that was already changed on Thursday. That was already done. So now if the honourable Deputy Govern ment House Leader would like to move the motion. Mr. Ashton: Yes, Mr. Speaker, I also believe there is leave not to consider quorum counts and votes this morning. I believe that was arranged by the House leaders. That being the case, Mr. Speaker, I move that the House resolve into Committee of Sup ply, seconded by the Minister of Industry, Trade and Mines (Ms. Mihychuk). Mr.

Speaker: As previously agreed on Thurs day, there will be no quorum counts for this morning. Motion agreed to. COMMIT TEE OF SUPPLY (Concurrent Sections) HEALTH Mr. Chairperson (Harry Schellenberg): Will the Committee of Supply please come to order? This morning, this

section of the Committee of Supply meeting in Room 254 will be considering the Estimates of the Department of Health. When the committee last sat, it was agreed to have a global discussion in all areas and then proceed to line-by-line consideration with the proviso that if a line has been passed, leave will be granted to members of the Opposition to ask questions in passed areas. The floor is now open for questions. Mrs. Myrna Driedger (Charleswood): Mr. Chairperson, I believe when we ended the last

3932 LEGISLATIVE ASSEMBLY OF MANITOBA July 29, 2002 day we sat in Estimates, we were discussing the issue of a ma jor NDP commitment during the election to end hallway medicine. I guess as we were reviewing some of that information-and I will not rehash all of it because I think I cer tainly covered a Jot of my comments on Thurs day.

I would like to add, though, that I still do feel that the NDP bamboozled Manitobans in the last election, not unlike what happened in British Columbia, where the former premier there, Glen Clark, deceived them in an election campaign, claiming the budget to be in surplus when it was not. He bamboozled the people of British Co lumbia at the time, and they never forgave him. Now we see an NDP government in Manitoba bamboozling the people here by promising to end hallway medicine, and they peddled illu sions, I think, to themselves and to the people of the province.

I would like to ask the Minister of Health if he feels it is time now for him to be accountable for his election promise. Will he admit failure, and will he be in a position to apologize to Man itobans for misleading them in the last election? Hon. Dave Chomiak (Minister of Health): Mr.Chairperson, the facts speak for themselves. We put the stats up comparing every week with weeks in 2001, 2000 and the year 1999, and the facts speak for themselves. Mrs.

Driedger: Can the minister confirm that the numbers collected now are not the same as when we were in government because no longer are the stats that are posted on the Web site inclusive of surgical patients or psychiatric pa tients? Therefore, it is not a true comparison, apples to apples. In fact, it is a comparison that certainly does not accurately reflect the then and now. Is the minister aware that the numbers that are posted are not the same as when we were in government? Mr. Chomiak: Mr. Chairperson, I instructed numbers to be posted on the same basis as under the Conservative years.

From my understanding, if we went back to 1998 and if we accurately did portrayals in 1999, the Conservative years would look even worse. Mrs. Driedger: Is the minister then indicating that when the Tories were in government, he is of the assumption that surgical and psychiatric patients were not covered in those numbers? Mr. Chomiak: The numbers that are posted are on the Web site have been put up publicly. There are explanatory comments on the Web site. As I indicated in my first response, the facts speak for themselves. Mrs.

Driedger: Well, certainly I know that there is an explanation attached to those numbers. The explanation does indicate that no longer do the numbers include surgical patients or psychiatric patients. In fact, they only include admitted med ical patients. While I will assume that when we were in government it was admitted patients that were also counted, I believe when we were in government we counted surgical and psychiatric patients.

I understand, and I know it is an ex planation on the site now, that surgical and psychiatric patients are not now counted so that it would not be the comparison of apples to apples. So is the minister then saying that he is of the view that the numbers are being compared exactly the same way? Mr. Chomiak: Since the member asked about my view, I will indicate, every time we put out a number that is more positive than Conservative years, the Member for Charleswood (Mrs. Driedger) says, oh, you are comparing some thing different.

Every time there is a number that is more negative, the Member for Charleswood stands up and flaunts it and says, oh, it is awful, awful. I think the facts on the Web site speak for themselves. The fact that CIHI said there was an 80% reduction in the hallw ay speaks for itself. The Member for Charleswood can make any comments, observations or viewpoints that she would like and she can take them to any forum that she would like. I think the facts on the Web site speak for itself. Mrs.

Driedger: Certainly the minister can have that view, but I guess what I am certainly look ing for is accuracy in comparing numbers . It really, from my perspective, does not have anything to do with one-upmanship. All I am

July 29, 2002 LEGISLATIVE ASSEMBLY OF MANITOBA 3933 looking for is transparency and accuracy so that if indeed we are comparing the same numbers, that would be one thing, and, therefore, if you see improvements, fine, but if we are comparing different numbers and the Government is trying to spin it that things are way better than what they were, all I am looking for is some accuracy in terms of, are we comparing apples to apples?

Certainly my understan ding from looking at the information on the Web site is that we are not comparing exactly the same numbers as when we were in government, because we were including surgical and psychiatric patients. Certainly I having been a nursing supervisor in emergency. I know that you can have numbers of surgical patients that are admitted. You can also have, especially on a weekend, a number of psychiatric patients that are also waiting in ER hallways. In one hospital alone, I can recall a number of those patients there on a Saturday night.

If those patients are now omitted from the number count, then we actually are not com paring apples to apples. Al though the minist er may be trying to spin that they have done such a good job of eliminating hallway medicine, we might very well not even be comparing the same numbers. Therefore, I mean, it is not an accurate reflection of what has really taken place. Mr. Chomiak: The facts speak for themselves. The member tried that same stunt on the cancer figures and was found to be inaccurate. The facts on the Web site speak for themselves.

CIHI independent third-party bodies have observed that we are 80 percent down, have said so. Other jurisdictions have followed our plan. If the intention of health care is to improve it for all Mani tobans and if our goals are to improve the quality of care, then the fact that hallway medicine has been dramatically dealt with in this jurisdiction, I think it is something that we should acknowledge and we should deal with. Mrs. Driedger: Well, certainly I have no prob lem with looking for and expecting accuracy, transparency and accounta bility in the system. I am a huge proponent for that.

I do agree that you are never going to be able to adequately address the challenges in health care unless we are going to look at it honestly, portray it honestly, and deal with it honestly. All I am asking the minister for is infor mation around the numbers, because it certainly says on the Web site that the numbers now that are posted on there do not include surgical and psychiatric patients. In fact, the only numbers that are on the Web site are those that are admit ted.

Having been a nursing supervisor in Emer gency, I know that you can have numerous patients in the hallway, you may have 10 pa tients in the hallway, but if only 2 are admitted, then that is all that is posted on the Web site. So we may really be talking about different numbers. Mr. Chairperson, I know the minister likes to talk about, well, all these dozens of people who were in Concordia Hospital when we were in government. Well, I got a call a few weeks ago that Concordia Hospital was absolutely full.

This man who phoned me said he could not walk down the hallways of Concordia emergency without bumping into stretchers that had patients on them. Yet those patients would never be re flected in the numbers, because it is only admit ed patients who are recognized and put on the Web site. So, in fact, is the minister aware that you can have I 0, 20 patients in the hallway, but you only might have 2, according to the numbers, because we only count admitted patients in those numbers? Is he aware that when the site is up, we are only talking about admitted patients? * (10: 20) Mr. Chomiak: Mr.

Chairperson, first off, I know the member has occasion to talk to indi viduals and raise points. I have been to Con cordia Hospital many times and have never seen it in this state. I have gone unannounced, seen it in the state it was during 1998 and 1999 when, as the newspaper

article indicated, 33 people were in Concordia Hospital at one time. Having said that, Mr. Chairperson, I will indicate for the umpteenth time to the member that we compiled the statistics on the same basis that the former government compiled the statis tics. We made it very clear we would compile it on that basis. The member opposite always, always when there is a number that is more positive for the

3934 LEGISLATIVE ASSEMBLY OF MANITOBA July 29, 2002 Government, says oh, you are comparing apples and oranges, always says that we have changed the way we have compiled statistics, except where the number is worse, in which case the member does not say that. The numbers speak for themselves. We stand by the numbers. They have been reviewed by third-party agencies. The member can make whatever political argument she wants, and she is welcome to make that. I suggest to her the facts speak for themselves Mrs. Driedger: Mr.

Chairperson, while the min ister may like to say the facts speak for them selves, the fact of it is that the only numbers posted on the sites are admitted patients, and it does not include all of the patients that could be in hallways. I can recall a time as a nursing supervisor, end of the evening shift, you try to clear out your stretcher bays so they were all empty, getting ready for the night shift.

And, while all of those stretcher bays were empty, there were four pa tients kept in the hallw ay on stretchers because that was the nurses' view on how to prepare for incoming patients, and they wanted those stretcher beds freed up. Those patients certainly would not have been counted as admitted patients, because they were just there waiting to be sent home. But they were being recovered in the hallway. There are numerous patients that are being looked after in the hallw ay and are not admitted, and will be discharged directly from the hallway. So, Mr.

Chair, while we may hear from the minister that he has, in his view, effectively ended hallway medicine, although his promise was to 100 per cent end it, that, in fact, is not what is happening. There are still, in my mind, some questions about how we represent this view to the patients. Mr. Chairperson, this man that phoned me from Concordia Hospital a few weeks ago was a citizen of Manitoba. He was not a health care professional. He was in there visiting one of his employees and he was absolutely livid.

He was livid because I think he felt that the commitment that was made by this Government to the people of Manito ba back in the election was to end hall way medicine, and he was livid that this Govern ment is continuing to try to represent themselves as having ended hallw ay medicine, and he was appalled. When he phoned me, he was angry. In fact, I believe he also called the minister's office and was quite distressed that hallway medicine still existed. So I think he felt bamboozled by that elec tion promise, and was actually appalled when he called me. He said, what is going on here.

That is not the first call I have had from ordinary Manitobans phoning me and saying, Myrna, there are still patients in the hallway. Are you aware of this? What happened? The NDP pro mised that they were going to get rid of these patients and they are still there. I think people are offended by that and that was why I was asking the minister. I mean, his promise was not just to clear the hallw ays a little bit, his promise was to fully, unequivo cally, end hallw ay medicine. The Premier (Mr. Doer) went so far as to say it was his moral commitment.

So all I am really asking the Minister of Health is whether he is willing to admit that he did not 100 percent keep his promise. Mr. Chomiak: To the member's question, no, Mr. Chairperson. I thank the member for brin g ing to my attention the fact that she talked to a citizen and she felt that he felt that. I took note of that. I am glad the member is conveying the feelings that she felt he felt that to me. I ap preciate that she brings that to my attention. The facts on the Web site speak for themselves. Independent third parties have veri fied those numbers.

The member is wrong, but the member can continue to go on as long as she likes. That is fine. The facts say otherwise. Mrs. Driedger: Mr. Chairperson, I would like to ask the Minister of Health why the WRHA added $1 million to last year's budget to elimin ate hallway medicine. Mr. Chomiak: Mr. Chairperson, can the mem ber give me more specifics as to what she is referring to? Mrs. Driedger: In the financial statements of the WRHA, there is a line item that indicates hallway medicine, and it has a million dollars attached to that line item. I guess it sort of surprised me a little bit when I saw it because

July 29, 2002 LEGISLATIVE ASSE MBLY OF MANITOBA 3935 the mtmster is saying he has ended hallway medicine, and his promise was to end it with $15 million. Then from last year's financial state ments under the WRHA, we are seeing a $1- million line added to that. It is somewhat sur prising when the minister is saying he has elim inated it, and yet we are seeing another million dollars. I have to wonder, are there other millions and millions of dollars going into this, despite an election promise that it was only going to cost $15 million. Mr. Chomiak: Mr.

Chairperson, I do not know if the member is aware of it, but when we put in initiatives to deal with hallway medicine, those are ongoing initiatives that continue over several years. If we were to eliminate the resources, it would go back to what it was in the Con servative days, where we would have dozens and dozens of people in every single hospital day after day, week after week, month after month. So the initiatives we put in place with respect to hallway medicine are ongoing. The member indicated she was director of nursing years ago at St. Boniface Hospital.

May be she saw some initiatives that could be put in place, but when you put them in place, they are permanent initiatives that have to be put in place, because the situation dealing with hallways, as I have said on many occasions, is an ongoing, continuing process. The process is continuing. It is long term. It is ongoing. We have to stay on top of it every single day in order to deal with situations, and sometime situations vary. There are peaks and valleys that occur for reasons that are totally not accountable by particular situations and by the status quo.

There have been peak periods where we have been unable to assess, which is why we put the figures on the Web site, which is why we make the numbers public so we can analyze them and be very transparent, but there have been periods where we sat down and said why have we had, all of a sudden, a peak in attend ance at emergencies?

There was a recent occa sion when we saw a greater increase in the ER, so we said, well, one of the initiatives we should take is to put in place an advertising campaign so the public knows what they should do about when and where they should attend if they have a particular health difficulty. That ER campaign resulted in a document that was sent to all Manitobans through the newspapers that I know is being utilized by thousands of individuals as a reference as to when you should go to ER, where you should go as an option, whom you should phone. You can phone Health Links or you can go to an urgent care centre.

That document was sent out as a public service through Health-and I know the member was critical of it, but we sent it out through Health to try to provide more inf ornla tion, and we will continue to do that. We will continue to provide information to the public about the best utilization, the best practices, and one of the reasons we have the data on the Web site and one of the reasons we analyze that data is to enable us to know how best to manage our resources effectively.

One of the ways of dealing with managing resources effectively is to assess the situation, to assess the individual and the multi-sites and to determine why there is a peak or why there are valleys in terms of attendance. Obviously, the intention is to level it out to the extent possible in the health care system and to try to best utilize your resources based on the leveling out. So there are peaks, there are valleys, but the issue of hallways in dealing with it is ongoing. I do not want to get into a situation, Mr.

Chair person, that occurred in 19 95 leading up to the last election when significant resources were put into the health care system just before the elec tion and then pulled out after the election. We wanted to even it out and balance it out.

I do not know if the member was aware, but a whole series of measures were put in just prior to the '95 election, and I daresay the '99 election, that would have been pulled out post-election if the pattern had followed, the usual pattern that I saw through the nineties. * (10 :30) But the efforts that we put in place are ongoing and continuing and are a variety of efforts to deal with the hallway situation which

3936 LEGISLATIVE ASSEMBLY OF MANITOBA July 29, 2002 changes throughout the year and changes through particular different periods and changes based on assessments out in the commun ity and health situations as they occur. Certain respiratory illnesses occur during different periods of time. Certain other issues arise. There are some traditional situations we have seen at the commencement of summer holi days when all of a sudden visits to the ER peak. That is attributed to a number of factors. Tra ditionally, Mr.

Chairperson, visits and difficulty occur during the holiday seasons based on allowing staff to have some time off and the fact that, for example, physicians' offices are often closed or, in many cases, hours are restricted during holiday seasons. There are a variety of factors that occur. Some are explainable. Some we have still yet to determine in terms of peaks and valleys. The efforts to deal with hallway medicine are con tinuing. They are ongoing. They occur year round, and they will continue now and into the future.

If we let our vigilance down, we will find ourselves back in the situation that occurred in the late 1990s. That is the situation we do not want to find ourselves in. Mrs. Driedger: I would like to ask the minister some questions about the ad campaign. Prior to doing that, I would just like to go back to the situation of this patient at Concordia Hospital. At that time, this man that phoned me also indicated that there was only one MRI working in the city. Although this employee of his was having symptoms that required an urgent MRI, he was not able to get it on a timely basis.

They were told that it was because only one MRI was working in the city. I would like to ask the minister if that is still the situation right now and why. Mr. Chomiak: The member should give me dates and times so that I can check that particular factor. What was the date and time that the member is making the allegations? Mrs. Driedger: I do not have that information now. I certainly will bring it back, but can the minister tell me if, in the last couple of months, there have been situations, or even if, today, we only have one MRI working in the city, or how many we do have working? Mr.

Chomiak: What I will do is, when the member brings dates and times about the alle gations she has brought forward to this commit tee, I will certainly follow up on that particular instance. The member is also asking, if I under stand it correctly, for the past few months, if there were situations where only one MRI was working. I will ask staff to find that out. Mrs. Driedger: I would appreciate finding out more about that particular situation. Perhaps tomorrow we can talk a little bit more about medical equipment.

At this point in time I will move on to some of the questions I have about the emergency room ad campaign. We certainly have been following it, knowing that it started and went from December to February. It cost over a quarter million dollars and certainly would seem a reasonable effort to make to try to inform people about the choices they have when they have to make a decision about where to go. There are people that might not know there are some options like the Health Links line or the Misericordia Urgent Care Centre. There are options of walk-in clinics or visiting physicians.

At the beginning it seemed that it might not be an unreasonable campaign to take on. I guess the question that came to my mind at the beginning of that was, if the minister was so confident that he was managing hallway medicine so well, why did he feel a need to spend over a quarter million dollars trying to keep people away from hospital ERs? Mr. Chomiak: I believe I answered that ques tion already and informed the member that it is an ongoing challenge to work across the system.

If we let our vigilance down, if we just put in resources, say, for example, during an election period, that would not be fair to the public. Our efforts continue on and on, day after day, firstly. Secondly, as I indica ted to the member, there are peaks and valleys with respect to usage and there is a variety of factors with respect to usage that occur. If we can help the public in terms of knowing what to do and how to do it, we will do that. Let me just cite an example. Not to flog the point but just to cite the point, we presently have

July 29, 2002 LEGISL ATIVE ASSE MBLY OF MANITOBA 3937 a public awareness campaign concerning West Nile virus. If we did not do that, I suggest that the ERs, which are already very busy, and doctors' offices, which are already very busy, would be incredibly busy as the public seeks information with respect to this issue. So we are spending money, public money, to advertise and direct the public to provide, as a first contact, Health Links, where Health Links provides the information. Is not that what a health system is supposed to do?

Provide for the most immediate contact, primary care and at least cost but most advantageous. It makes sense to me that the public should know that if they contact Health Links, they can get information. That is just an example. I do not want to flog that particular point because the member was dealing with the emergency campaign, but I use it to cite an example that what we try to do in the health care system is direct people to the appro priate resource at the appropriate time. That is the purpose of an ad campaign. That is why we were very pleased with the ad campaign. That is why we ran the ad campaign.

We will continue to run an ad campaign or ad campaign similar to that as we go throughout the system. I can just cite another example, the child hood injury campaign. We did the childhood injury campaign for the first time in Manitoba history. It was extremely well received. Mani tobans had the opportunity to find out about childhood injury, Manitobans had the oppor tunity to injury-proof their house.

I daresay if we prevented one child from being harmed, the campaign was worth it, because if one looks at the statistics to visits to emergency rooms, one of the ma jority reasons for visits to emergency rooms is childhood injury. So it was not done to prevent specifically visits to ER; it was done to help and protect the public. As a tangential benefit, it probably helped reduce visit s to ER. Now, I am sure the member would not be afraid or would not be against that particular issue, but if it tangentially helped visits against ERs and helped deal with the situ ation, would that make it wrong?

I do not think so, Mr. Chairperson. So we make no apologies for ad campaigns that provide information to the public and are utilized by the public to help make better informed health care decisions. It is very clear both from our own consultations and from the consultations undertaken by the Ro manow commission that the public wants more, not less, health care information. They want to make better and more inforn1ed decisions. That is why you have seen these kinds of public information campaigns.

That is why we sent out a pamphlet and a document that outlined for individuals when, how and why they should utilize ER and other kinds of health services. That is why we will continue to inform the public. That is part of our job, Mr. Chairperson. Mrs. Driedger: As I indicated in some of my earlier comments about this, certainly one has to make efforts to address the numbers of people that are attending at hospitals.

We certainly know from the first poll that the NDP -did soon after they came into government, 40 percent of the people polled indica ted that they did not have to be in an emergency to have their health care needs addressed. I thought that was quite a startling stati stic. It came from talking to people and polling peo ple. It was public comment that 40 percent of them felt they did not need to be there but they were there. So I do not dispute the fact that we need to address how to, I think, better deal with patients who are going to ERs.

Are there ways that they could be directed maybe to a more appropriate place? So I say that, but I do have some further questions about this. The minister had just made a comment about the reasons you do campaigns and if they are effective, then it is a good thing. I guess that is where I am leading in my questions, ques tioning the effectiveness of some campaigns and how we monitor that effectiveness and what we are going to do if campaigns are not effective. He did make some mention of the West Nile campaign and the fact that people needed to be informed. It was an effective campaign.

My question at this point, just on that issue is if the minister felt that things were going so well, why was it taking so long for people to have their calls returned? I know that the Member for Carman (Mr. Rocan) raised that in the House, that he waited for I think it was 24 hours to have his call from Health Links returned. In fact, I

3938 LEGISLATNE ASSEMBLY OF MANITOBA July 29, 2002 was at a barbecue on the weekend and two men that were at the barbecue told me they had also called into the Health Links line and they never had their calls returned. Is the minister aware that these kinds of situations are happening? Is there some kind of follo w-up to be sure that that campaign is an effective campaign by vi rtue of people's calls being returned and their fears being dealt with? * (10:40) Mr. Chomiak: First off, Mr.

Chairperson, I would appreciate if the member could give me the specifics of the two gentlemen she talked to at the barbecue on the weekend, so I can do follo w-up as to why those individuals did not have their calls returned. Just let me outline to the member the scen ario. We were anticipating that there would be a significant uptake in the number of calls that occurred when and if the first bird were to be found in the province of Manitoba. We have had experience in this area through our meningitis campaign and through our water safety cam paigns.

In both cases, the Health Links call line spiked dramatically during the course of both of those issues as a result of increased public concern. So that was anticipated. We also anticipated that would occur, and what we did is we put in place additional resources, so that when the first calls came in regarding the birds, we would be able to have the resources in place to deal with it. So it was not a lack of planning that resulted in the difficulties. What was not anticipated, Mr.

Chairperson, and I have already said this publicly, was the length of time it would take for the individuals who received the calls to provide information to the public. That is where the glitch, which was unanticipated in this instance, occurred. On both the meningitis campaign and on the water safety campaign, it was not as complicated a process to provide information to the individuals as oc curred during the West Nile virus issue in terms of determining the type of bird, determining what should happen with the bird.

It was far more complicated than we actual ly had anticipated, and that resulted in some major difficulties the first several days with respect to the call line. We admitted at the Monday press conference-remem ber, the first bird was found Friday morning. It was late Friday afternoon when I announced some sig nificant measures. So we were going into a weekend. We were dealing with a new and unique situation, the breadth of which, that is, the extent to which individuals who answered the phone had to provide information, we had not fully anticipated.

With respect to the first several days, there was a problem, and we corrected that problem by virtue of hiring additional staff and putting in place different kinds of resources. In fact, Mr. Chairperson, if you will note, the ad campaign that we launched changed as a result of our experience the first weekend. We went from an ad campaign talking about picking up birds to being more specific to individuals, so they would know the type of birds that we were looking for, so that we would Jessen some of the pressures on the Health Links line.

So we did not anticipate the length of time it would take to explain inf ormation to the public. We did adjust, and the last time that I checked, the callbacks were happening almost immedi ately, or if they were not happening almost immediately, they were very shortly thereafter, and that was the last time I checked.

So I do not believe, unless there has been a spike that I am unaware of, and I have not been briefed yet this morning because it is Monday morning, I have not been briefed as to whether or not there has been any specific difficulties, but we do check it on a daily basis to provide information to the publ ic. I might add, Mr. Chairperson, that this also assists us now in terms of our learning curve. We have had the meningitis campaign. We have had the water campaign. To a certain extent, we have had the hepatitis C campaign.

To a certain extent, we have had the family doctor connec tion line campaign, and now we have had the West Nile virus campaign. They have all been different types of information. They have all helped us refine our capacity and our ability to deal with responses. I anticipate that the next time there is a campaign

July 29, 2002 LEGISL ATIVE ASSE MBLY OF MANITOBA 3939 of this kind, the scope and the breadth of information provided by people who receive the calls will be better anticipated so that the next time, that difficulty, for example, will not likely occur. So that is the explanation with respect to why and how it happened, and I would appreci ate it if the member could get me the detai ls of the two gentlemen she talked to at the barbecue, so I could do follow-up and see specifically whether it was, in fact, the first period of time when there were some admitted problems or if it has been more recent. Mrs.

Driedger: Mr. Chairperson, I will indicate to the minister that it was early on in the cam paign, very near the beginning of everything happening, so, certainly, his explanation as to the changes and improvements made as they went along would certainly take care of some of my concems in that area. I may at some point later in Estimates come back to the West Nile. I would like to continue with the ER ad campaign and finish my line of questioning in this area. Can the minister tell me if he tracks the numbers of ER visits to see if his ads have been effective in keeping people away from hospital ERs? Mr.

Chomiak: Yes, we do track the number of visits to ERs, and we look at that information. It helps us detennine, Mr. Chairperson, how visits are going and how we can deal with the capacity in our ERs. I note that during the course of Question Period, the member suggested that our ad cam paign was not effective because, for a period of time, she compared, I believe, the Janua ry or the December to February period with the prev ious December to February period to suggest some how that the ER campaign is not effective.

I suggest to the member opposite that her comparisons are not indicative of the effective ness or non-effectiveness of a particular ad cam paign for a variety of factors, of which I am quite happy to go into. Mrs. Driedger: Well, I think the mmtster is going to have to go into some of those factors because when the campaign started, that very, very beginning of December there were just over 4000 people attending ERs.

At the end of the campaign, the number was up 250 to 300 more people, and basically grew through the time of the campaign, went down in one particular or two particular weeks, and then went up and remained high. So that campaign, you know, his quarter million-dollar campaign was running, and if the intent was trying to encourage people to look at altemative ways, it would seem to me it was not that effective when we went from 4069 visits at the beginning of December and ended the cam paign and spent a good part of the campaign with 4400, 4500 patients visiting ERs.

So, I guess when looking at those numbers, I would ask the minister if he can account for why the campaign was not doing what it was intended to do. * (10 :50) Mr. Chomiak: Yes, Mr. Chairperson, firstly comparing year to year with respect to the num ber of visits to ERs, while it is indicative it is not the total answer because one does not know what factors are influencing attendance and what occurs a particular year.

I think the s�cond flaw in the member's argument is the fact that she compared, I believe, ER and urgent care visits, and I am not sure if that necessarily is indicative of whether or not the ad campaign was effective. For example, if ERs visits per se were down and urgent care visits are up, would that mean the campaign was effective or non-effective? It could be open to

interpretation, but I would suggest if visits to the ERs were down and visits to urgent care were up that might suggest the ad campaign was more effective. Mrs. Driedger: The minister was making some comment about year to year, and just to clarify for him, I was talking only about the time frame of that particular ad campaign, from the begin ning of December of last year and the campaign itself ran to the end of February. So I was not looking at any year-to-year comparisons. I was only looking at the three months that particular campaign was in place and when I look at all of the numbers of visits to ERs, the numbers

3940 LEGISLATIVE ASSEMBLY OF MANITOBA July 29, 2002 certainly climb from the beginning of that cam paign to the end of that campaign. I certainly understand that the Urgent Care Centre was very busy. I understand that Larry Updike, from CJOB, had his son in there and his son was not seen for nine hours. So I am aware that certainly that particular centre could very likely have been busy. Can the minister explain what other factors he might take into considera tion when we see those numbers climb like that and when we see people having to wait nine hours in an urgent care centre? Mr. Chomiak: Mr.

Chairperson, I agree it is a difficulty. I understand Larry Updike's son did attend at the Urgent Care Centre, and I agree nine hours was a difficulty. As I recall from my review of that particular situation, that was a particularly difficult period or day or two. It is not a regular occurrence, but the member might appreciate there are periods, and the member has acknowledged the fact that usage at the Miseri cordia Centre is beyond what actually is even anticipated.

Now, I want to go back to the point at which the member raised her question and that was she provided her statistics that seemed to indicat_e that the numbers of visits were up. I wonder tf the member might cite to me those statistics because I have information that indicates other wise. Mrs. Driedger: Mr. Chairperson, the numbers of visits that I was citing was taken off the WRHA Web site. On a weekly basis the number of people visiting are indicated on the Web site. As I look at those numbers on a weekly basis and track the number of people attending ERs, that is where I obtained my numbers from. Mr.

Chomiak: Can the member specify those numbers because the numbers I have indicate otherwise. Mrs. Driedger: Certainly, Mr. Chair. Novem ber 26 to December 2, 2001, there were 4069 visits. If the minister wants me to go through every week of that particular campaign I can do it or I can cut to the last one, whichever he wants. Mr. Chomiak: Well, I think it is important that I have the member's numbers, because the num bers I have citing statistics show otherwise than what the member has come up with. Mrs.

Driedger: That would be very interesting then, because if the minister's numbers are different, and I am getting my numbers off the WRHA Web site, that, in itself, was going to pose a number of other questions. So I will put forward the numbers that we have taken off the WRHA Web site. December 3 to 9, 4213 visits- Mr. Chomiak: Hold it. December 3 to Decem ber 9, what is it? Mrs. Driedger: 4213. Mr. Chomiak: Thank you, Mr. Chairperson. The member said November 26 to December 7, 4069? Mrs. Driedger: November 26 to December 2, 4069. Mr. Chomiak: Okay, keep going. Mrs.

Driedger: December 3 to 9, 4213; December 10 to 16, 4241; December 17 to 23, 4079; December 24, that week, to the 30th, 4416; December 31 to January 6, '02, 4561; January 7 to 13, 4515; January 14 to 21, 4319; January 21 to 27, 4104; January 28 to February 3 4080· February 4 to 10, 4385; February 11 to 1 ?, 445,2; and the last week of the campaign, February 18 to 24, 4420. I would ask the minister then if he is saying that these numbers are not the same numbers as he has access to. Mr. Chomiak: Mr. Chairperson, I am asking the member to tell me what point she is making by these numbers. Mrs.

Driedger: My point is, from the beginning of the campaign to the end of the campaign, the numbers of visits to emergency rooms increased and did not decrease.

July 29, 2002 LEGISLATIVE ASSE MBLY OF MANITOBA 394 1 The intent of spending over a quarter million dollars is certainly to try to direct people to ap propriate facilities, to try to redirect them away from ERs, so that the ER challenges would certainly be decreased. In fact, that does not seem to be the case with this particular cam paign. The numbers increased during the period of the campaign from beginning to end, and it would appear that the campaign in itself did not work. Mr.

Chomiak: So I understand it correctly, November 26 to December 2, because the num ber of visits was 4069, as cited by the member, and because on the last week of February, from the 18th to the 24th, the number was 4420 visits to ER, the campaign was a failure. Do I under stand the member's reasoning now? Mrs.

Driedger: It was not only during the last week that the numbers were high, it was during a significant period of the whole campaign, that, obviously, if we are going to see a campaign directed at trying to redirect people from visiting ERs and put that kind of money into a campaign, I would have wondered why those numbers per haps did not drop into the 3000-per-week visit rather than staying up there as high and remain ing actually higher throughout the whole cam paign.

But then it leads into the second part of all of this, and that is obviously the numbers of patients visiting emergencies continue to grow, and, in fact, the last numbers I have were for the beginning of July. Right down through from February to the end of the numbers I have, July 1 to 7, the patient visits are over 5000. So they have increased over 1000 patients a week to the ER.

I know that the minister began repeating the campaign again, spending thousands more dol lars, even though the numbers of visits to the ER continue to rise, and it appears that people are either not relating to the campaign or there is some dynamic in here where it is not effectively doing what it was intended to do. So my question is, basically, to the minister: Is he feeling that perhaps there is an alternate way or other things that need to be done other than spending this quarter million dollars on an ad campaign that does not seem to be doing what it should be doing? Mr.

Chomiak : I wonder if the member might consider the fact that when we go into the Christmas and holiday period where we always see a spike up in ER usage, that a usage cam paign might be useful and might have kept the numbers down from what they might, perhaps, have been had there not been a campaign. Secondly, perhaps the member might consider the fact that we might have seen statis tics indica ting a greater usage occurring during a summer period and perhaps reinstituting an ad campaign to keep those already high numbers from going any higher.

Does the member concede, even remotely, that might be a possibility? * (11 : 00) Mrs. Driedger: If that was a possibility, I would almost have to say it is pretty remote. Those numbers, July 1 to 7, were 51 26. We have seen, from almost the beginning of the campaign down to that first week in July, over a thousand patients a week, which is a pretty significa nt number. So, if the mini ster is trying to indicate maybe that number could have been even higher, perhaps. I do see it as somewhat remote.

Where I am leading in all of this is to find out what other alternatives are out there that the mini ster is trying to put into place. He seems to have put this ad campaign into place to try to keep people away. From my perspective, it does not seem to be working that well. I appreciate that sometimes you have to try something, but if it does not work, I guess I am wondering why would you then spend tens of thousands of more dollars repeating it when it is not working. Mr.

Chairperson, if there are other things that could be done to try to address these in creasing numbers of people going to the emer gencies, especially when I go back to that first poll that the NDP did, where the public told them on that phone poll that 40 percent of them were in emergencies and did not need to be there, that they could have gone someplace else,

3942 LEGISLATIVE ASSEMBLY OF MANITOBA July 29, 2002 but they chose to stay in the emergencies, or go to the emergencies. So when I packaged the whole thing, I am asking: Besides this ad campaign, is there any other innovation in place to try to address these numbers so that the emergencies are not being bombarded with people and that people are effectively going to alternative places in the system other than hospital ERs? Mr. Chomiak: Just to clarify, the member indicated that the ad campaign was to keep people away. It is not to keep people away.

The ad campaign is to help people better understand what choices they have. I just want to cite the user's guide which was mailed through the newspapers across the province or across the city. It is entitled: An Emergency Room User Guide. It started with: It is not always easy to know. How do you decide? Now, I know the member has practised as a nurse, so it might seem obvious to her, and it might seem obvious to other people in the health care system, but a lot of times people do not know.

The user guide, which I have personally seen in the homes and on the fridges of dozens of Manitobans and, I daresay, probably thousands-and I am not trying to brag. I am just trying to point out this is not a political thing. This was a very useful document from my view from a health perspective, talked about how to decide where to attend, what an emergency, urgent, less urgent, not urgent, was, how long to wait, what other choices, what other choices are available and what else an individual can do.

It was a very information-friendly, information laden campaign that was to deal with choices that individuals have. It was not designed to keep people away. It was better designed to keep people informed as to what options are available to them and what options are provided to them. That was the purpose of the campaign. That was why this document, this guide was sent out in the form it was and why I think it has been incredibly useful to individuals to have that document, and why I have no hesitation in sug gesting there is nothing wrong with doing that kind of information over and over again.

The member talked about options available. This document talks about choices. It talks about utilizing Health Links. It talks about utilizing your family doctor. It talks about dealing with your own chronic illnesses, and it talks about some specific alternatives to the ER, to utilizing an emergency room. Mrs. Driedger: Can the minister indicate how he did evaluate or measure the usefulness of this? Certainly, one of the more significant ways would be to look at the numbers and where people are going, and, in this case, it seems to have attracted more attention to send people to hospital ERs.

So what would he consider-he indicates evaluating the success of the program and he is deeming it to be successful. I would like to ask him based on what? Mr. Chomiak: Mr. Chairperson, one of the factors was year over year comparable visits to ERs were down quite significantly from the year before during the same period of time in which the ad campaign ran. Mrs. Driedger: So then the minister was just evaluating it by numbers. Is that correct? Mr. Chomiak: Mr. Chairperson, I believe the Member for Charleswood (Mrs. Driedger) criti cized it via numbers. Mrs.

Driedger: Well, when I just asked the minister how he evaluated the success of the program, he is indicating basically that numbers was how he evaluated it. Well, if that is the case then, and the num bers have gone up by 1 000 visits a week, is that not telling him then that it is not successful? Mr. Chomiak: Mr. Chairperson, I suggested to the member that numbers was one factor to evaluate. Secondly, I suggested to the member, and she conceded the fact, I think, logically, that there might have been more visits during the period of time December through February had we not done an ad campaign.

I think she conceded it was possible that the fact that we

July 29, 2002 LEGISL ATIVE ASSEMBLY OF MANITOBA 3943 instituted a campaign when it looked like numbers were going up again might possibly, perhaps, in some instances, perhaps, would be an option to entertain in order to keep numbers down with respect to visits to ERs. Mrs. Driedger: Does the minister have before him the number of visits to the Urgent CarE Centre on a weekly basis in the last little while, and if he could just sum it up as to whether those numbers have remained stable, or if they are going up or down? Mr. Chomiak: Mr.

Chairperson, I do not have in front of me at this moment the number of visits to the Urgent Care Centre over the past little while. Mrs. Driedger: Mr. Chair, can the minister tell me whether or not he feels that having the Ur gent Care Centre in place has helped? Obviously, his inference is that it has made a difference to keeping numbers in ERs down. Just through some of his earlier comments, his inf er ence is that if the ER numbers are down and the Urgent Care Numbers are up, then, in fact, the guide might be doing what it is supposed to do.

Therefore one would then, by looking at that statement, feel that there is a huge benefit to having the Urgent Care Centre in there to take the pressure off hospital ERs. Mr. Chomiak: Mr. Chairperson, I would not want to make overall policy decisions based on one aspect or one

interpretation of the numbers over a limited period of time. So the inference that the member made from my statement with respect to numbers would not be the sum total of the policy decision that we would make with respect to Misericordia Urgent Care Centre. However, as we indicated when the Premier (Mr. Doer) and I toured all of the hospitals and the Urgent Care Centre during the Christmas period, when we attended and visited those par ticular centres, we are advocates of the need for the Urgent Care Centre. Mrs.

Driedger: Would the minister agree that the Urgent Care Centre has effectively taken pressure off hospital ERs? Mr. Chomiak: Mr. Chairperson, the Urgent Care Centre is a key component of our strategy. *( 11 :10 ) Mrs. Driedger: The minister is nicely sliding around and avoiding the answer to this, and his mind is probably working trying to figure out where I am going with my line of questions.

It really is to get his perspective on whether or not he feels that the Urgent Care Centre has played an integral role in helping to keep the pressure off hospital ERs because the Urgent Care Centre obviously sees hundreds and hundreds of pa tients a day. If the Urgent Care Centre was not there, then those same people would be in St. B's ER, Health Sciences' ER, Victoria Hospital's ER.

Those ERs would then be hugely challenged and, in fact, could very likely have a lot more hallway medicine than what we see now, but by virtue of having the Miserico rdia Urgent Care Centre, the pressure is really taken off the hos pital ERs. I guess I would be surprised if the minister does not acknowledge and recognize that. Mr. Chomiak: I indicated at the very onset and indeed our ad campaign is suggestive of the integral part that the Misericordia Urgent Care Centre plays in our overall health care strategy and our overall approach to dealing with issues in the city of Winnipeg and elsewhere.

The difficulty I have is the member's

preamble is so all-inclusive. If I acknowledge it in the affirma tive or negative, I would be acknowledging in the affirmative or negative certain comments the member said that I do not agree with. Mrs. Driedger: Can the mini ster tell me what he does not agree with? Mr. Chomiak: Yes, we have agreed I think to disagree with the member's

interpretations of the numbers vis-a-vis hallway medicine. Mrs. Driedger: Maybe just to get off the merry go-round a little bit, <::an the minister tell me, when I asked him the questions in the House about the particular ad campaign why he tried to confuse the issue by throwing into his answer the campaign related to child injury when he

3944 LEGISLATIVE ASSEMBLY OF MANITOBA July 29, 2002 knew that that had absolutely nothing to do with the particular question that I was asking or about the particular campaign that I was asking him about? Why did he throw in the information on the child injury campaign? Mr. Chomiak: I am sorry the member was confused by my reference. Mrs. Driedger: It definitely was not my con fusion. I certainly know what the minister was trying to do.

It is just too bad, I guess, some times, you know, when we talked earlier about accuracy and accountability and transparency and then when you have answers that mislead the public then you certainly do not get to the kinds of resolutions in health care that you want to see, because then you tend to get into the politics of the issues rather than in looking at the specific problems and the challenges and ways to address them. Certainly, I am aware of what happened with those particular questions.

I guess I under stand where they came from and the minister's desire to throw it out, but it certainly did not help in looking at this issue and trying to have the accountability in answering questions. Mr. Chomiak: Well, with all due respect to the member I do not know what the member is thinking, anticipating or strategizing. I can only respond to the questions and the words that the member puts in front of me in terms of Question Period or in terms of Estimates. I can only answer those questions to the best of my ability with respect to the references that the member makes.

As I recall, the reference by the member to the ad campaign, for what it was worth, was confusing with respect to an advertising cam paign. I answer and continue to answer to the best of my ability. Mrs. Driedger: In reviewing those tapes after and in speaking with a number of people after, there was no confusion certainly on any of their parts in terms of understanding where I was going with that. It certainly did appear that the minister was trying to move away from dealing with the answers to this question, as is so often the case.

However, again, rather than staying on that merry-go-round, I would like to ask the minister whether or not he feels that the Health Links line has been an effective addition to the health care system in dealing with the challenges that are there in health care and whether the innovation of that line has been effective in helping again to take pressure off ERs in the system. Mr. Chomiak: Health Links forms an integral part of our entire approach and our entire sys tem, particularly now that we have expanded telemedicine sites to 23 sites. I can indicate that the future of Health Links is for more, not less. Mrs.

Driedger: Can the minister tell us if there has been an expansion to the number of posi tions at Health Links and if that line is available into rural Manitoba? Mr. Chomiak: Yes and yes. Mrs. Driedger: Can the minister give some indication as to how broadly used and advertised that line is in rural Manitoba? Mr. Chomiak: I cannot give that assurance offhand. It has certainly been part of our West Nile virus campaign. Our campaign aimed at when we did our recent water initiatives in rural Manitoba, Health Links was significant with respect to utilization of the line.

As I recall, dur ing all of the major health occurrences that occurred, Health Links was prominent in terms of the advertising for those particular issues. Mrs. Driedger: Can the minister just clarify that there is a toll-free line available to rural Manitobans for Health Links? Mr. Chomiak: Yes. I think the member is looking at it. Mrs. Driedger: Does the mmtster have any advertising going on in rural Manitoba adver tising the Health Links line so that people know what that number is and can effectively use it? Mr. Chomiak: There is some advertising as we speak with respect to the Health Links line. Mrs.

Driedger: Can the minister indicate if the ER user guide campaign project was tendered?

July 29, 2002 LEGISLATIVE ASSEMBL Y OF MANITOBA 3945 Mr. Chomiak: If memory serves me correctly, I believe it was, but I will confirm that. * (1 1 :20) Mrs. Driedger: I have no further questions in the area of the hallway medicine or the adver tising campaign related to the ER user guide. I would look forward to the information that the mini ster could provide on the tendering process as it relates to that guide. I would like to now move into another area of questioning and ask the mini ster why he does not feel a plan for health care and, as he put it, from higher up is something that is needed. Mr.

Chomiak: I feel that planning is very im portant. I do not know where the member got the impression that I do not feel that planning is very important. It is integral to everything that one does throughout the system. Planning and stra tegic planning and tactical planning are very important. Mrs. Driedger: I am surprised to hear the minister say that because when we started out in the beginning of our Estimates, it was his com ments that he did not think a plan that was set at, I think higher up were his words, was anything that was effective. Now he seems to be saying something somewhat differently.

I wonder if he could clarify that. Mr. Chomiak: I would be quite happy to clarify that. The point I was making with respect to that particular ref erence is that I did not think it was appropriate for the minister's office, our small group of individuals, to outline what the entire plan was for health care in the province of Manitoba. I have seen what can happen in regard to that. What I am saying is that we have to involve the Department of Health, the regions and all Manit obans in the development of speci fic plans.

When I said, "from on high," I usually use the phrase "dictate by fiat." That is, dictate from on high how things must and should be. I have never been in favour of that kind of so called planning. That was the ref erence that I was making with respect to my comments "from on high." If the member keeps looking for a document that is going to come out of my office that says this is what I say is going to be the rule and the law, that is not going to be the case because I do not believe in that type of planning.

I should say to the member that there are regular strategic plans that have been developed by all the regions who deliver the programs. I do not know if the member is cognizant of the fa ct, but for the most part, the regions in Manitoba deliver the programs. The purpose of regionalization was to have the regions, i.e., those that are closer to the actual delivery of programs, to provide the strategic plans and to deliver the programs.

The Department of Health is evolving towards not delivering programs but rather to being the agency that reviews, analyzes, does follow-up of the results, sets the standards and does follow-ups with respect to the regions. Now, that process has been in evolution and continues. But it has been almost in revolution since the Sinclair, Thomas reports. It was very strongly recommended from the Sinclair and Thomas reports that the Department of Health assume a role of standard creator, standard reviewer, et cetera. That was very, very clear in the Sinclair, Thomas reports.

Now, one of the reasons that I did not want to put a fiat from on high the first year in office was because I knew that there were changes coming as a result of Sinclair and Thomas, just as, Mr. Chairperson, I know there are changes coming with respect to Romanow. Romanow will significantly, I suggest, alter the framework of how we are dealing with health <:are in this country. If Romanow does not alter the frame work, then we have some significant changes we have to make in lieu of the failure of Romanow to address that particular issue.

So for me to dictate from on high how I see the health care system, I suggest, is not appropriate . But to get back to the point I was making, as a result of the recommendations in Sinclair and Thomas, the Department of Health has been reorganized. The Department of Health has been reorganized in order to structurally and other wise fulfil the directions and mandates as out lined in those particular reports. So strategic and other planning comes in from the regions. It goes to the department for

3946 LEGISLATIVE ASSEMBLY OF MANITOBA July 29, 2002 review. The department does review, prioritizes, gives feedback to the regions. Tangential with that, or concurrent with that, we have had the recommendations of Sinclair and Thomas that has said the Department of Health should be an agency that is restructured in order to deliver care, not directly but essentially to monitor and to provide standards, et cetera, and to deliver that type of care. To that end, Mr.

Chairperson, there have been some structural changes of a relatively significant nature at the Department of Health as we move out of a delivery of care and as we evolve towards the standard producing the docu mentation, et cetera.

So that is one of the factors, and that is one of the issues that I was, in a sentence or to, alluding to when I made the comment "dictate from on high," because my assumption, and maybe that is not what the member meant when she asked the question, but my assumption was the member was looking for some kind of pronouncement from the minister as to what the health system shall be, that it shall be X, Y and z. Mr. Chairperson, that is not what is going to happen from the minister's office. Rather we have a planning process that is in place. We have strategic plans that are in place.

We have direc tion and strategic goals in place that we expect the regions to deliver and we expect to do follow-up on. I can tell you it is, and I used the words "a revolutionary process." Perhaps that was a bit strong. But it is an evolutionary pro cess most certainly that has developed and gained speed since the Thomas and Sinclair commission reported. There are going to be changes still yet at the Department of Health, as it relates to matters of accountability, standards, et cetera. Let me give one example.

A huge issue that has come to the fore, not just in Sinclair and Thomas but as a result of a number of processes is the question of medical error. The member could admit proba bly that medical error, even five years ago, was not part of the normal discussion in the health care system. Medical error was not a part of the normal discussion.

When we saw that medical error was such a significant factor as a result of Thomas and as a result of Sinclair, and when I had occasion to attend the federal-provincial ministers' confer ence where it was put on the agenda and where we had occasion to find out that John Wade was chairing from the Royal College of Physicians and Surgeons, a national panel that was working on medical error issues, I called in John Wade and we sat down and said, okay, how do we change the nature of how we approach health care in Manitoba as a result of this. We sat down with the regions and we sat down with the department.

We said one of the pieces of advice we were given is do not move too fast ahead of what is happening in the rest of the country, but make some progress. Now, that opens us up to criticism from both ends on that particular issue .. What we did do was have the WRHA, together with the College of Physicians and Surgeons, together with Manitoba Health, together with the college of nurses and other agencies, sponsor a series of discussions and meetings that deal with the issue of medical error and move it forward on our agenda.

Concurrent with that, we brought forward legislation dealing with physician profiles which is not only a recommendation of the Thomas and Sinclair reports but which deal specifically with one of the components of the issue of medical errors. The point I am making with this, Mr. Chairperson, is that this new occurring issue which really did not fit into the planning pro cesses of any that I had seen, of any strategic plans or of any health care documents in the past four or five years, is all of a sudden, what? No. I or 2 or 3 on the agenda as to priorities.

So we now have a significant priority from the Department of Health dealing with medical and error otherwise. I believe it structurally fits under risk management-under health accounta bility, which is a new structure at the Depart ment of Health to deal with the matters that have formed since then, and it forins part of our overall plan in dealing with health care. *( II :30)

July 29, 2002 LEGISLATIVE ASSEMBL Y OF MANITOBA 3947 Again, the point I am making, Mr. Chair person, is that my dictates from on high three or four years ago are not appropriate in a fast changing health care system that has to adapt to different priorities and different needs on an almost daily, if not weekly, basis. That is not to say that the ship is afloat and is going up and down on every issue that arises, rather there are overall objectives, overall goals.

But we have the flexibility, particularly since we reorganized in Sinclair and Thomas, and since we are going into Romanow, we have to have the ability to adapt. If there is one thing that we have certainly learned. If you totally fixate, or set the ship of state on one particular direction, it is very, very difficult to move that ship of state around and to be flexible enough to deal with issues as they evolve, and as they occur.

So one of the guidelines from the Depart ment of Health was Sinclair and Thomas would become a touchstone, a framework under which we would evolve and develop the department, and Romanow is yet to come. Now, there are significant issues that can and will be addressed by Romanow that we have to deal with. I am quite familiar with the Gov ernment of Alberta, who have indicated that they are not waiting for Romanow and they are going to make significant changes in their health care system. I think that is not actually the case.

I think the changes that are occurring in Alberta, or that are yet to occur in Alberta probably are pending Romanow, because we are already close to the month of August and there has not been any real significant change that I am aware of in Alberta with respect to their decision. So I think that they, too, are awaiting developments with respect to Romanow, with respect to the direc tion, with respect to where they are going. Last year the member, and I am not criti cizing the member for this, last year the member said we should look to France, we should do what France does.

I can indicate that we have done reviews of France. I note that the most recent World Health report on France, it does not fare as well as members opposite might have us believe, but there are lessons in France that have been looked at and have been reviewed. We have noted the French bed numbers are hi gher than anywhere else. We have noted their physi cian numbers are higher than anywhere else. We have noted that there is a public-private mix in France. We have noted there are significant taxes in France, et cetera.

We have prepared, and we have looked at other jurisdictions, but the flavour of the week, sometimes, of we should all do this, we should all do that, I think we have to be careful in the health care system. I think we have to be careful not to go one way in the pendulum and go the other way with respect to the pendulum because the pendulum swings back and forth. I think what we did at Manitoba Health is we have our ongoing planning processes, have our strategic plans that are developed by the re gions and reviewed by the Department of Health. That continues.

We have the overall re sponse and redirection and reflection as a result of the Thomas and the Sinclair reports and we have Romanow pending, which will give us some significant direction with respect to how we proceed in the future. Let me give you an example, Mr. Chair person. If Romanow says there are only certain core services that can be provided by a province, but he says those core services should be expanded to include Home Care and Pharrna care, and the federal government should fund those accordingly, that has a significant factor in terms of how Manit oba approaches, overall, its health care.

Because we have, probably, the best Home Care system in the country, and it has been consistently like that, and because we have one of the better, more equitable Pharrnacare programs in the country; a pronouncement by Romanow of that regard will allow us to shift resources around our system, because we will have more federal dollars flowing directly into those two programs than we do right now where we basically fund it entirely from our own jurisdiction. That is an example, Mr.

Chairperson, of both moving forward, but being also cognizant of the changes that can and will occur as a result of the Romanow report pending in the fall of this year. Now, we are not so naive as to think that Romanow will make his pronouncements or his

3948 LEGISLATIVE ASSEMBLY OF MANITOBA July 29, 2002 conclusions and there will not be significant debate and discussion prior to implementation. We are well aware of that, but we have, I think, together with most jurisdictions, conceded that Romanow will have a significant impact on everything that we do because it will have a significant impact on the federal government insofar as it was commissioned by the federal government. How Romanow pronounces could very well decide some significant factors in how we, even as early as next year, deal with health care.

If Romanow says, for example, the present funding arrangements as they relate between the feds and the provinces is adequate, we have some real difficulty with that, because we are down to 14 cents on the dollar funding from the federal government. So, in summation, I wanted to point out to the member that the question of planning, in my view, is always a broader, much more extensive process than simply one or two sentences. If the member misinterpreted my comments as a result of those particular com ments, I hope these have helped clarify the issue for the member. Mrs.

Driedger: I certainly thank the minister for putting his comments forward on that. I will get into that in a minute, but I just do want to clarify one thing that he said because he indicated that when I went to France and came back, I was running around saying, do what France does, and I do not believe the minister intended to mislead anybody, because that is not what was said. When I went to France, it was because the World Health Organization had acknowledged them as being the No. 1 health care system in the world. I was intrigued because they did not have waiting lists.

If you wanted to see a doctor, you could see a doctor in one hour. If you wanted to have a CT scan you could have it the next day, but if it was not convenient for you to have it the next day, you could have it the day after that. Certainly, it was intriguing, and I was curious as to how all of that could be happening. I wanted to know what was in place over there that would make it so. I recognize that France had its challenges too. When I went over there, I certainly had an opportunity to see all sides of it, although it was a very, very short trip and you cannot do much with just a few visits.

Having a meeting with the director general for health care for France, who basically is the deputy minister for health care for all of France, all the 60 miilion people there, it was an incredible meeting, and a wonderful opportunity to get their views on it. This particu lar gentleman is actually a Canadian, and I am not even sure he is still in the job anymore, but he is from Montreal, and he actually had this job as director general and had as many challenges, but it was such an insightful meeting that we had with him.

What he shared with us was certainly inter esting, but never did I come back and say, do what France does, because I know that what works elsewhere does not necessarily work here and that there are many aspects of what we have here that work very well, but we know that access to care is a major, major challenge in this country and province. * (1 1 :40) Certainly what I was looking for was, you know, opportunity to expand my knowledge on how other countries were doing it.

There is such a tendency to only look at the north-south situ ation where Canada looks at just the United States and says, well we cannot have a health care system like that, or we can have aspects of that system, we know 40 million people in the States do not have insurance, et cetera, but by only looking to the north-south picture, there tends to be a lot of feam1ongering that goes on in Canada because we have such a narrow, narrow view of health care.

The World Health Organization, by putting out their report that rated 191 health care sys tems, I think, if we want to talk revolutionary, that certainly had an opportunity to bring people into the state of broadening our vision and looking elsewhere. Mr. Chair, even the people at the World Health Organization, because I also spent a day in meetings there and spent a con siderable amount of time in their library and bookstore and had an opportunity to find out about the challenges they had too in putting together their report.

While there is even some criticism of how that report was put together, I think the greatest

July 29, 2002 LEGISLATIVE ASSE MBLY OF MANITOBA 3949 benefit it did was to open people's eyes up to the fact that this world is very small. We have an opportunity to look at other countries and what other people are doing and to see if we can take the best from what other countries are doing and not touch the things that are not working well. So France had their problems. They cer tainly have more physicians per capita than we do, which is something that helps them deal with their access problem. They also have doctors that make house calls.

If a doctor does not make time to see a patient, if a doctor does not make time to make a house call, then that doctor loses that patient. So the competition amongst the physicians to hang onto patients and treat them very well is certainly there and certainly im proves access to care. They have standards in terms of how many MRis according to the population breakdown. They have certainly set their standards higher than we have here in terms of the number of MRis for their population. They were worried when we were there about a nursing shortage just as they were here.

In fact, people were vocal on a daily basis even though they were chosen as the No. I health care system in the world. I took three days' worth of clippings from French newspapers to try to see if this No. I system in the world was free of problems, and it certainly was not from the headlines in the papers. Although all the headlines were in French, and it took some work to try to remem ber my high school French and translate some of it, I got the flavour that they certainly did have their problems, and they would admit it too.

They were doing some interesting things there in terms of setting patient standards and how they did resolve problems. As I said when I came back from there, it is worth exploring. You can never transport one health care system from one country into another. You would never want to, but even if you could, it may not work here because you have your own culture, your own priorities, your own values, and your health care system has to be built around that.

When I did come back, I thought it was just a great personal growing experience by seeing how other countries addressed their challenges and to see how the World Health Organization moved forward on meeting its challenge to look at health care systems. I think what they did is they opened our eyes to the opportunities to learn from each other.

It was interesting, in talking to people in France, that they said it was common there to look at the countries surrounding France and to compare yourself with your next-door neigh bour, which is very similar here with Canada and the United States, that there is basically almost an automatic response that, when you look at the health care system in Canada, you immediately compare it to the United States. But that is a pretty narrow focus nowadays when we have got the Internet and you have got access to people all over the world. To only look at your neighbour is really not fully beneficial.

You can always learn something from your neighbours, but we should certainly be looking far and wide and be open to what might be working elsewhere, open to reviewing it. You may not like it, but at least you can learn something from it and you might pick up one nugget, one gem that might work here and make a difference. It was interesting to note that Italy was rated No. 2, and with Italy being a next-door neigh bour to France, you can see where the countries there learned from each other.

They looked at what each other was doing and they incorporated best practices from one country and took them into another, and if it worked there, they utilized it. It certainly opened my eyes to the fact that we cannot just be looking north-south. We need to look at what is happening in Canada, but because most of the Canadian provinces have very similar challenges, we may not necessarily find the solutions in our own back yard.

Perhaps if we looked at the countries, all 29, that are doing better than Canada, because Canada was rated 30th, the Americans were rated 37 th, so one would certainly say, well, then why would we want to look at the American system if they were rated 37 ? Why would we not look at numbers 1, 2, 3, 4? Look at Sweden, look at all the countries that are doing better than us in their ratings and find out what it is that they are doing. Certainly, if we want to keep the patient as the centre of focus in all of that, that should be what our goal is in reviewing health care systems.

3950 LEGISLATIVE ASSEMBLY OF MANITOBA July 29, 2002 Mr. Chairperson, I was hoping that the minister would broaden his view and his com ments on health care beyond just fearmongering about what is happening in the United States and that is what is going to happen here, because that really does not do any good for the debate in health care. What will be good for the debate in health care is to have a broader view and to find out what works and what does not work and to find out if there is opportunities for improving our health care system by learning what other countries are doing.

Certainly, that was the intent in my trip to France and to hear some of the comments of the people down there and how they valued their system and how they appreciated the choice they had in health care. That was the one thing that probably struck me most of all because, as we walked on the streets, as we sat in restaurants, as we met people in the hotels or wherever, we stopped to talk to them, and we just asked them. It was like interviews on the street with ordinary people in France, what they thought of their system.

The one thing that really struck me in France was the fact that people value choice, and, in fact, they demand choice. They were very incensed when they were asked by us if some of that choice were to be denied them how they would feel, and they were absolutely incensed because they felt that was their right to have a choice in health care.

They had a passion for it, probably unlike what I have seen here, where they expected it, demanded it and felt it was their right to have a choice in their health care system, that they could go to whichever kind of a hospital they chose or whatever kind of a clinic they chose. Even the director general indicated that was a very significant aspect of people's value of the health care system in France.

Certainly, coming back here and starting to hear more people talk about choice, we maybe are starting to catch up with where people in other countries have been for a long time, and that is that people certainly feel they have a right to a choice in health care and a right to expect timely access to care. Just to clarify for the minister that I did not come back and insist that we adopt what was doing in France, but rather put it forward as an option to look at.

I am sure that, as the World Health Organization moves on to review health care systems again, I do not doubt for a minute that things are going to change because they will tighten up their criteria. France actually will find itself maybe moved out of the top position, and then that, in itself, is going to have big political ramifications, I am sure, for the politicians, who will then have to account for why they are no longer No. 1. In fact, France was not particularly comfortable, I was told, by being given that No. I position.

But what the evaluation of the countries did is it gave us an opportunity to have a look at health care in a much broader way. * (I I :50) The one thing I will conclude about the trip to France was the high, high regard Canada's accreditation program had over there. In fact, the accreditation group in Ottawa was a blueprint, and what they did for health care accreditation here was a blueprint for what they were doing in Europe.

I actually was somewhat embarrassed to end up going to France to find out that here in our own backyard in Canada we had an accreditation program that was acknowledged as one of the best in the world, and that the woman-and I do not totally recall her name; Eva Heideman [phonetic} might be the name-in Ottawa is actually an adviser to the government in France on how to look at health care accredi tation and how all of that leads to improving health care. It certainly opens an opportunity for, I think, us having a good look at what is happening in Canada and what we can do with accreditation.

In fact, in France, their accreditation is very transparent. It is posted on Web sites so that people know where their hospitals are standing as far as accreditation goes. They even have an organization there that is an evaluation body for health. They try to deal with a lot of these issues in a very transparent way, and transparency there includes having information much more readily available to the public via Web sites.

It was a great experience, one I would love an oppor tunity to have in seeing what other countries are doing, because, with the unique challenges that each country has, they will each be managing it in their own way. It was a great experience from

July 29, 2002 LEGISL ATIVE ASSEMBLY OF MANITOBA 395 1 a growth and development perspective for m�. I look forward to saving more money and havmg an opportunity to perhaps go to some other countries. Now that the minister is aware of what I said when I got back and my encouragement for our Government here to broaden its view and look to those 29 countries ahead of us that are doing well and to not feannonger so much about what the Americans are doing, I would encourage him to continue to put some thought into that.

Going back to his comments on a plan and his comments that he did not want to put forward a fiat from on high in the first year, then I wonder, well, what about the second year, what about the third year? If there is no fiat from on high and if there is no grand scheme for health care I am curious how the minister goes about letti�g people know what his vision is for health care what his goals and priorities are if he sort of g�es along with the flow of what is happening from all around him from Manit oba Health or from these reports that come forward with the recommendations in them.

How is it that people know where his vision is and what his goals and priority are for health care? Mr. Chomiak: I thank the member for her explanation of her reference to the French issue. I will acknowledge her comments. I think they were useful. I can indicate that there are several areas that we are looking at with respect to some of the experiences in France that we are imple menting. One of the interesting issues with re spect to accreditation is that the WRHA is accredited as an entire region.

Suffice to say that there are examples of instances and things in other countries that we are specifically looking at. There are some issues in France that we are specifically looking at. I appreciate the member's comments. I know that the World Healt h Organization will be taking other analyses and other care. We will see what happens in terms of their ranking from the ranking that was announced that had taken place in the late nineties. It might be that Canada will be much hig her as a result of changes that occurred, because that was a relatively old ranking.

Having said that, I should reiterate to the member that her "no grand scheme" was a reference to the primary care health model. Just let me explain to the member that I attended and spoke at not the most recent but the pr�vi_ous meeting of the Manitoba Medical Association. We spent a good deal of time discussing the various viewpoints with respect to primary care. My reference to no grand scheme was a refer ence that on primary care we did not want a cookie-cutter approach to primary care.

I know I said that to the member before, and I will say it again, but the member will use what she has to use in terms of her rhetoric. The point that I was making at the MMA meeting was there was no cookie-cutter, grand-scheme approach with re spect to primary health care because I frankly did not find that useful. Nor did the MMA find that useful with respect to one specific model.

In fact, I think if the member reflected on it, it would not be appropriate, because, even under the member's regime, for which the member was government and was the assistant to the Health Mini ster, there was a variety of approaches taken with respect to primary care and a variety of different approaches that are and will be evalu ated as it deals with primary care. I just wanted to clarif y that particular quotation that was uti lized by the member with respect to the overall plan.

As I indicated, not only have we changed the emphasis and changed the nature of the Department of Health to move it towards an evaluator, qualitative evaluator, et cetera, a standards developer, et cetera, but there are other agencies, as well, that do significant work. Things have changed with respect to the last five or six years, as well, with respect to how data is collected. CIHI collects data for all agencies now and does comparative analysis that is then run through the system. It is a third-party, inde pendent review of information as opposed to internally generated information.

It gives us a chance to be comparative with respect to other jurisdictions, to see how we compare and deal with that. We now use CIHI data more signifi cantly across the system. As well, we utilize information from the Manito ba Centre for Health Care and Evalu ation, which was set up under the former, former, former Health Minister, Don Orchard, who attended it with me several months ago

3952 LEGISLATIVE ASSEMBLY OF MANITOBA July 29, 2002 when we formally changed the name and celebrated that anniversary. The data used by the Centre for Health Policy and Evaluation is Mani toba analyzed, statistically valid, weighed data that looks at a whole number of issues and weighs issues in an arm's-length kind of relation ship, and a lot of the data has been very useful and is util ized by the Department of Health with respect to information. The member talked about waiting lists.

The Centre for Health Policy and Evaluation has done a review of waiting lists in Manitoba, and it might be useful if the member would review that report. The second is the centre has also done a review of private versus public and what the effect is on waiting lists. The member, it might useful to review that particular report by the centre to see, in fact, what an independent third party says of the particular experience.

While I suggest that is not the be-ali and the end- all, it certainly is persuasive insofar as it substantiates other data that has been put on the record by other independent third parties when they review that particular issue, but I do not want to belabour an issue that was actually discussed quite extensively last occasion. Just before I close, does the member have any idea when we next meet, which is tomorrow afternoon, where the member is going to go? Just generally continue? Mrs. Driedger: I will certainly be staying on some questions. Mr.

Chairp erson: The time being 12 noon, I am inter rupting the proceedings. The Committee of Supply will resume sitting this afternoon following the conclusio n of Routine Pro ceedings. CULTURE, HERITAGE AND TOURISM * (10 : 10) Mr. Chairperson (Conrad Santos): Will the Committee of Supply come to order, please? This

section of the Committee of Supply has been dealing with the Estimates of the Department of Cul ture, Heritage and Tourism. Would the minister's staff please enter the Chamber? We are on page 59 of the Estimates book, Resolution 14.2.(e). Mr. David Faurschou (Portage Ia Prairie): Mr. Chairperson, I appreciate the opportunity to be here this morning and to discuss the culture component of the Culture, Heritage and Tourism Estimates. I would like to ask the minister in regard to the cultural grants that are being put into the community this coming year.

I see that there has been a reduction once again this year in the amount of support. I would like the minister to clarify the rationale for the reduction. Is there a specific group or organization that is receiving less support or no support this year or is it a general reduction across the board to the par ticipating organizations? Hon. Ron Lemieux (Minister of Culture, Heritage and Tourism): Just on a point of clarification, I am not sure if the Member for Portage Ia Prairie was asking about all the grants under Cul ture, Heritage and Recreation Pro grams, or was it a specific line? I am sorry.

I might have missed that, and I apologize for that. Mr. Faurschou: I believe the Chairperson identified 14.2.(b), Grants to Cultural Organi zations on page 58 as where we were. Am I incorrect in that

interpretation? Mr. Chairperson: May I remind the honourable Member for Portage that that item has been passed. Is there an agreement that we revert back? Mr. Faurschou: Mr. Chairperson, I understood that we were at 14.2, and if that particular line has been passed, could you please identify what line we are on? Mr. Chairperson: We have passed up to (d). We are now in 14.2.(

e) Arts Branch, but if there is agreement to revert-[int erjection} No, okay. Mr. Faurschou: Mr. Chairperson, I will then be specific to the Heritage Grants that are available for distribution this year and be specific to line (d).

July 29, 2002 LEGISLATIVE ASSEMBLY OF MANITOBA 3953 Mr. Chairperson: You have to revert if you have to ask questions from those items that have been passed. Mr. Faurschou: Well, Mr. Chairperson, I said that I would like you to identify the line that has yet to be passed. That was my question, and you stated (d). Mr. Chairperson: Okay. The line that has yet to be passed starts from l4 .2.(

e) onward. Mr. Faurschou: Mr. Chair person, I will ask then the leave of the committee to revert back, because that is the line that I had a couple of questions on in regard to Portage la Prairie. Mr. Chair person: Is that agreed? Mr. Lemi eux: I do not have a problem with reverting back, but just wanting to add that there is a slight decrease there. The reason there was a slight decrease, as I mentioned to the member from Seine River, is that it is dealing with deficit reduction.

There were cuts made in the depart ment, regrettably, and I do not want to rehash the whole issue with regard to the feds, but that is the position we were in. Regrettably, everyone had to look through their departments, and so, in certain places, we made slight reductions. Other places we were able to hold the line, and other places we were able to increase slightly. So I do not have a problem going back and going through it. Mr. Chairperson: So there 1s agreement to revert back. Mr. Faurschou: Mr.

Chairperson, in regard to the obvious understanding that there is need to balance one's budgets, I would, though, like to ask the minister as to the communication with the federal government in this regard and just ask: On that level, have we also seen reduced support for this area from the federal govern ment as well? Mr. Lemieu x: Well, the quick answer is no, and, regrettably, Minister Sheila Copps, who made an announcement just not that long ago and with quite a lot fanfare, and yet we do not know exactly where those dollars are going.

We are trying to pinpoint, and we are trying to nail down the federal government to find out where and how do we access a lot of those doll ars in the large announcement that she made, I think it was, about eight months ago or so. I can be corrected, but it is around that period of time. I understand that the federal government have not made cuts, in fact, came up with a new program, and it is how do we tap into that program is our dilemma right now. We are trying to find out where does Manitoba fit and how do the organizations in Manitoba access those dollars.

I know we have come together with regard to, I guess, a debt-reduction strategy with an art stabilization approach, and we are a partner in that. We have put a million in, and the feds, I believe, have put $2 million in. Then the private sector, with Harold Buchwald and Gail Asper and associates, have also put a million dolla rs, I believe, in, too. So some of the programs we are able to tap into. Others, we do not know exactly what that money-and I believe it was $500 million, I think. It was a substantial amount of money out there. Just reading the newspaper on the weekend, Ms.

Gail Asper wrote a whole col umn in the Free Press commenting about the lack of funding to the arts programs. It is okay for Mani tobans to say, you know, we can be really proud of the fact that per capita we have the best record in funding. The City of Winnipeg is something like second or third from the bottom. I think the mayor has made comments about how the City has to get on board and increase their grants. But the municipalities and the City, in particular, are not very good funders of the arts and they have not been.

What we are trying to do is work in a partnership to say local arts organizations need assistance too from muni cipal governm ents. They cannot just depend on the feds or the Province. We are trying to work together to figure out how we can do this so we do not lose a lot of our arts programs or even see them go downhill as opposed to improving. So the long and the short of it is that the feds have announced a huge sum of money. I do not know how much of that money has really been distributed throughout Canada or Manitoba. We are trying to find out where this money is supposed to go.

How do small communities out side of Winnipeg, where organizations may be

3954 LEGISLATIVE ASSEMBLY OF MANITOBA July 29, 2002 better organized in the city of Winnipeg, a large population, how did people outside of the Peri meter and organizations access these dollars that are out there? * (10:20) No, the feds have not cut back. In fact, they have announced a new program. As a provincial government, even though our record is not just good, it is excell ent in a sense compared to other provinces, it is still not good enough. I mean, the arts community, regrettably, I think it is agreed upon right across the country, need a lot better support than what they are getting.

So somehow we have to wrap our minds around it. Mr. Cha irperson, I know there is going to be a conference held in Hamilton, Ontario, in October. It is bringing all private sector, govern ments and all organizations together to find out how we better fund the arts. It is a huge international conf erence held in Hamilton, right in Minister Copps's backyard. I trust that she will probably be participating and be there, but peo ple are trying to figure out how we do this. Culture is so important and the arts are so important to our society, that is what makes life worth living in many, many communities.

It is not just sport, but the cultural end. The arts community know it well. It is how we fund these organizations. I have a particular bias, and that is a bias outside of Winnipeg, outside the larger centre. I see a lot of organizations that are just barely keeping their head above water. We have to figure out how we are going to do this. We have not come up with a solution yet that is satisfactory to those organizations, nor to us as government. Mr. Faurschou: I really appreciate the minis ter's commitment on record for this very, very vital component within society.

I will say that in Portage Ia Prairie we are most fortunate at the present time to have groups of individuals that are extraordinarily gifted and motivated in this area, extraordinary volunteerism within those organizations. One question I have very specifically per tains to the Manit oba Arts Counc il. In regard to the overall administ ration, if one is adminis tering perhaps a little fewer dolla rs, have they correspondingly reduced as a percentage or dollar �wise? I would be interested in the per centage dedicated to administration at the Mani toba Arts Council as it pertains to their budget. Mr.

Lemieux: Well, I am not going to be cyni cal and say check Hansard, but I will just repeat what I told the Member for Seine River (Mrs. Dacquay). It is around $615, 000. It is about 8.5 percent of the overall budget. Mr. Faurschou: I do not believe Hansard has yet been printed, so I will look to those excerpts when we do get them into the House. As it pertains to the heritage grants, I will say that that area there, I am dismayed to see a reduction, insofar as that heritage once lost is never regained.

You only have the opportunity as it · presents it today, because so much of our history and any artifacts and that, that are available at this time, sometimes are lost and lost forever. In Portage Ia Prairie, right at the present time, we have seen a major initiative, one being to preserve the history of softball in the province and opening of the Softball Hall of Fame and Museum in Portage Ia Prairie just a month and a half ago.

As well, in the same building which was moved-it was former building No. 12 at the CFB Portage, more commonly known as Southport-the building itself was divided into two, softball having one-half the building, and the other half of the building being dedicated to the military history of the Central Plains area. Those individuals, as I say, are extraordinarily motivated in both those pursuits, the two differ ent organizations. So, for the record, Mr.

Chairperson, I do want to congratulate all those that have taken of their time and efforts, and also to encourage persons that perhaps have memorab ilia or arti facts in that line, whether it be baseball or military, be encouraged to come and preserve them through those two now-created entities. Mr. Chairperson, I am also encouraged by the minist er's remarks in regard to the partici pation of the private sector.

Those that have some resources that can go towards preserving our history, I thank them and congratulate them for that, but the point the mini ster has already made, but I do want to emphasize it once again,

July 29, 2002 LEGI SLATIVE ASSEMBLY OF MANITOBA 3955 is to very clearly understand the programs that both the federal and the provincial governments have and to clearly outline that to the lay people of our rural communities so they understand and can participate. I would like to ask the minister: Is it not only his wish and desire, but is the department progressing to a point where vol unteers with maybe a keen interest, yet not really under standing of government bureaucracy, can clearly understand the process? Mr. Lemieux: I thank the member for the question.

This is one of the issues which my pre vious colleague who, as the minis ter, was trying to address and because, you know, we have libraries and we also have regional staff that have access to what grants are available and so on, that this is something we are trying to get better co-ordinated to ensure that they have all the infom1ation, but all the grants are listed on Web sites and all the regional libraries have all that listed.

Having said that, I still have a lot of questions raised to me by individuals, whether it be in Flin Flon or Portage Ia Prairie or Russell or Hadashville are asking me how do they access the grants. In other words, you know, how do they find out about what grants are available and so on. So it is still one that no matter what, no matter how hard we try to pass on this infor mation, there still are some gaps, and we are trying to find out how are we able to fill those gaps and ensure all the organizations know about what is available.

I have to tell you this is not a case of self flagellation, where I am saying the arts com munity and so on and the heritage community need more assistance. This Government, as well as the previous government, did a lot of things trying to work with the arts community. I mean, Mr. Chairperson, we do have the private sector where you have the Richardson family, you have Hartley Richardson and other people in the com munity, whether it be the Aspers, Gail Asper and family, who are generous, generous donators and freely give of their money to organizations and should be congratulated for it.

There is a sector, though; it is the sector that is kind of in between. I think we all recognize the families that are very fortunate and certainly much more well-off than a lot of fan1ilies in Manitoba, but there is a group that is in between that, whether you want to use the label small business or whatever it is, that is really not contributing to the arts or to heritage, and that is the organization that really I think has been missed or overlooked somehow. Mr.

Chairperson, every time someone has a project, they always go to the Asper family or to the Richardson family or to the Moffat family and so on, and are expecting to get huge dollars from them. In many ways, I think it is unfair be cause everyone seems to go to them, and even though they give and give very, very generously, there is a group of small business in Manit oba and elsewhere that are not giving anything. That is a group that we have to somehow impress upon, as they did in Scotland, in Edinburgh. * (10:30 ) Edinburgh have a fringe festival, and this fringe festival is very, very popular.

It brings in millions upon millions and millio ns of dollars to not only Edinburgh but to Scotland. When they went around looking for advertising for their brochures, they went to small stores, small an tique stores and souvenir shops and asked them to contribute. They said, well, why should we contribute? You know, those weirdos bouncing around the streets and conducting their plays do nothing for us. Well, what the fringe festival did, they made a concerted effort to show how much money it was bringing in.

What they did was they, in co-operation with the credit card com panies, determined how much money a lot of shops were actually pulling in as a result of the fringe festival in Scotland and then, lo and behold, now all those companies are contri buting. I would hazard a guess that' all the tourism doll ars and dollars related to the arts community go into a lot of small business in Winnipeg. Just the Indi genous Games themselves coming into this city it is estimated will pump anywhere from $50 million to $60 million into the economy of Manitoba, but certainly $25 million into Win nipeg's economy.

Now, you know, people are saying, well, what do those Indigenous Games have to do with us? Those small businesses are

3956 LEGISLATIVE ASSEMBLY OF MANITOBA July 29, 2002 seeing a big increase, whether it be a restaurant or hotel or souvenir businesses and so on. So there is a sector that is being missed somehow. I believe it has to be explain ed to them in a better way how there is a benefit, not only the money in their pocket, but I guess for the well-being of Manitobans and just for the quality of life that it makes for all of us. Just with regard to Heritage, and I know that the Heritage Grants Advisory Council has a slight decrease in their budget, but you know we have introduced municipal heritage tax credits.

We have commissioned research on Metis settle ment in the Pembina-Em erson area. We have looked at the Franco-Ma nitobaine community and the City ofWinnipeg on interpretative pro gram design review for the Provencher Bridge. We have also declared that the Maison Gabrielle Roy be designated a heritage building, and also we are contributing towards not only the desig nation, but the restoration of the building. So we are doing a lot. Granted, Mr. Chair person, it is not enough, and there are many organizations throughout Manitoba that just feel that they have not had an opportunity to preserve their sites.

The Member for Russell (Mr. Derkach) raised this last week and said that there was a cemetery, there was an area where there were people of Ukrainian ancestry, I believe it is, between Minio ta and Birtle, where there was a trail he was talking about, that this site needed to be preserved because no one knows about it, but yet there are a Jot of people's ancestors buried there, going back a hundred years. Those are the types of sites and centres that are worth preserving. Mr. Chairperson, I am not an expert in the area.

Obviously, people in the Historic Resources branch and others, they are the ones who are experts, but I really feel that heritage is an area where we have done quite a bit. We have a lot more to do, obviously, but there has not really been a concerted eff ort, I think, to the best of my knowledge, on how to approach heritage in our province. We really have not brought in all the players to determine how do we approach heritage over all in our community. We have the Exchange District. We are doing something with Red River College. There are many examples that we can go through.

This is not what Estimates is about, and there is only so much money, as well, so how do you combine that with working with the private sector and working with government and working with the individuals who are volunteers in these areas? How do you best approach the whole issue? I know that there are many artifacts that are sitting in someone's home right now that would be better displayed someplace. I know my own family- I say my family. It is my wife's family. There was a bugle. My wife's great-grandfather was the bugle boy for the Wolseley expedition that came out here to put down the Louis Riel rebelli on.

His bugle was sitting in a plastic bag at home, and they have donated it to the Mani toba Mu seum. So now it is being displayed along with the whole W olseley expedition dis play. These are heritage objects. There are heri tage sites, but heritage objects, as well, that we need to really look at to preserve our history. We have done quite a bit, and I know that, just to give you a slight breakdown, I have a couple of stats in front of me that talks about the Heritage Building Grants Program received 55 grant applications totaling $790,000 for grant assistance.

From these, 34 were approved within the total program budget of $300,000, with 54 percent of the grant projects outside of Win nipeg; 77 percent of those were for community based or publicly owned projects. So 54 percent of the grants projects were outside of Winnipeg. That is important that not everything, just be cause we have two-thirds of the population in Winnipeg, that not all the money sits here.

Just on that point, I would conclude my answer to say that there are so many other pro jects in Manitoba that are worthwhile taking on, whether it be the Icelandic Heritage Museum or the Canadian Mennonite University phase I complex and so on. It is amazing how much we have here in Manitoba. You soon realize how much heritage and history we have that is worth preserving. I think that unless we have a more strategic approach to doing it, we will never have enough money. Mr. Chairperson, the Province will never have enough money unless we try to work with

July 29, 2002 LEGISLATIVE ASSEMBLY OF MANITOBA 3957 the municipalities maybe in a closer way or other levels of government to try to address this. Once again, my colle ague Minister Sheila Copps, the Hon ourable Sheila Copps, is respon sible for culture and heritage at the federal level. I think governments have to sit down, all levels of government, municipal, provincial and federal sit down and have a more strategic approach to heritage. Heritage is a big area but I really think that we have to be able to sit down and discuss this whole issue with our federal partners and municipal partners.

Then there is also the volunteer sector and the private sector that have a role to play. There are many people in the private sector, as I mentioned before, who donate freely and have donated to many heritage projects. Whether it be a project, the grain elevators in Inglis, or other projects, it is important that the private sector as well as the voluntary sector be involved in this strategic approach to heritage. Mr. Faurschou: I do appreciate the mini ster's response. I concur with his observations. We have to make things very clear from the outset and to be strategically minded.

As a small busi ness person, where does one go if they have a keen interest and would like to participate in the preservation of our railway history? Where does one go to accomplish that? In fact, my now deceased father wanted to look to preserving some of the military memorabilia.

Where does one start? * (10:40) I think it has to be very clear, because I know that the curator for the Portage museum, it is known to the public as the Fort la Reine Museum, spends a great deal of time sifting through manuals that are Winnipeg phone book in size trying to search out where that particular museum could apply for support. It is very diverse. It has a number of different components to it, whether it be Ukrainian in nature with the church or whether it be the agriculture com ponent or the fur trade which was fundamental in seeing Fort la Reine being constructed in the first place.

I am glad the m1mster also recognized outside the Winnipeg city limits because Win- nipeg was not always the populace centre of the province insofar as that when one looks at the first distribution of MLAs around the province, Winnipeg did not have the majority ofMLAs by any stretch. In fact, the area in and around Portage la Prairie has representation from six MLAs. Portage la Prairie area has maintained year-round inhabitants since 18 13, one year after the 1812 settlement here near Winnipeg. Being the second oldest community in the province, a lot of persons settled outside.

When we are looking to the heritage of our province, the vast, vast majority of people were spread out along the waterways of Manit oba in the 18 00s. I would like to really encourage the depart ment to streamline, so curators of not only the Fort La Reine Museum but other small museums and heritage organizations throughout the prov ince have effectively a one-stop shopping. Here is the idea of what we have here, and we are looking to build on these three or five project areas, and then perhaps not always have to apply and apply and apply. Let us look at the Van Horn car.

The superintendent of CP Rail that had this rail car constructed for his accommodations, actual resi dency, throughout the construction, through from Portage Ia Prairie west to the Rocky Moun tains. That car was left in Portage Ia Prairie. When the construction was done, it was sold off by the CP Rail, and it was moved north of Por tage and served the purpose of a hunting lodge for upwards to 100 years. Now the car has been retrieved from the Delta Marsh and placed on a couple of rails at the Fort Ia Reine Museum.

For the last half dozen or so years, we have been attempting to try and find where that par ticular artifact could receive funding. CP was extraordinarily, as a corporate sponsor, inter ested in restoring the car; however, they were not interested in restoring it and leaving it in Portage Ia Prairie. They said that they would take the car and either take it east or take it west. Calgary was the first site that they said they would like to place it at and hook it up to a locomotive that I understand was one of the locomotives that pulled it in the mid- 18 80s.

That was not really acceptable to the Board of Directors of the Fort Ia Reine Museum, to see

3958 LEGISLATIVE ASSEMBLY OF MANITOBA July 29, 2002 this car which has been in Portage Ia Prairie for more than I 00 years, leave. So we have not been able to secure any monies for restoration of that car. Even though there is a roof built over the car, it is still con tinuing to age and needs some work. Without the CP being on board, because as I mentioned they want to move the car, we have been basically frozen out to see any support for it. But those are the things that are on the books and left wanting for support.

It seems as if we do not re-apply year after year after year, it is very quickly forgotten about. I am wondering whether the minister could respond, or through the department staff. Do we catalogue projects that are brought forward so that these projects, maybe they cannot be funded this year, but are left as priority items that could be in sequence, or in order of priority, funded at some future date without this constant appli cation and re-application by various curators throughout the province? Mr. Lemieux: I thank the member for the ques tion.

It is very important when, I know, with regard to application and re-applying continu ally, it creates a great deal of frustration for many volunteers who give freely of their time. It frustrates them to no end. But having said that, I know that the Province of Manitoba does contri bute some doll ars towards the Fort Ia Reine Museum in particular.

I was just going to say that it is also very difficult because the reason they are re-applying is because sometimes the criteria or the com munity goals change, or often the different pro grams have different goals, outcomes and priori ties reflecting the needs and requests from the community. The Regional Services people are also there to be working hand in hand with the local volun teers. I have always felt that the Regional Ser vices were there to assist the local organizations in how to massage their application and how to look at it.

I mean, if you applied two or three times and somehow you are not getting a grant or there is something missing, either the organi zation has to do something differently, maybe they are missing something, maybe they have not done enough fundraising themselves or maybe the project is just not something that fits the criteria, Regional Services are there to help people trying to massage their application fonn, trying to say you are missing this, so let us work on that, let us see how we can in the next six months see what you can do to tighten this up, and then maybe the reason why you were rejected or your application was rejected you could then be able to do something about it.

I have never had the opportunity to see this particular car. It must have been quite opulent for its time, if you thin k about the car itself and the day and age when the car was built. We have had experience in Manitoba just recently of a corporation in eastern Canada wanting to take something back to eastern Canada. I refer to the Timothy Eaton statue. The Eaton family wanted that statue to go back to where Timothy Eaton had opened up his first store prior to going to Toronto.

When the Eaton family, to their credit, showed interest to find out if Manitobans and Winnipe ggers were interested in keeping the statue here, they thought there was not a lot of interest in it. Then they found out that it was the workers of

Document details

Collection	Manitoba — Debates (Hansard)
Citation	37-3-72a
Type	hansard
Volume / chapter	37th 3rd hansardpdf 72a.pdf
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	1af601977e593dde93504eee73140cccc5c93554

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