Manitoba Hansard — Sitting 30 (26th Legislature, 5th Session)

26-5-30

Manitoba — Debates (Hansard)

Le g isla t ive As sem bly Of Man it ob a DEBATES and PROCE ED IN GS Speaker The Honourable A. W. Harrison Vol. VII No . 30 2: 30 p.m. Thursday, March 15, 1962. 5th Session, 26th. Legislature Printed by R. S. Evans, Queen's Printer for the Province of Manitoba3 Winnipeg

ELECTORA L DIVISION ART HUR ASSINIBOIA BIRTLE-RUSSELL BRANDON BROKENHEAD BURROWS CARILLON CHURCHILL CYPRESS DAUPHIN DUFFERIN ELMWOOD EMERSON ETHELBERT PLAINS FISHER FLIN FLON FORT GARRY FOR T ROUGE • GIMLI GLADSTONE HAMIOTA INKSTER KILDONAN LAC DU BONNET LAKESIDE LA VERENDRYE LOGAN MINNEDOSA MORRIS OSBORNE PEMBINA PORTAGE LA PRAffiiE RADISSON RIDNELAND RIVER HEIGHTS ROB LIN ROCK LAKE ROCKWOOD-IBERVILLE RUPERTSLAND ST. BONIFA CE ST. GEORGE ST. JAMES ST. JOHN'S ST. MATTH EWS ST. VITAL STE.

ROSE SELKIRK SEVEN OAKS SOURIS-LANSDOWNE SPRING FIELD SWAN RIVER THE PAS TURTLE MOUNTAIN VIRDEN WELLINGTON WINNIPEG CENTRE WOLSELEY NAME J. D. Watt Geo. Wm. Johnson Robert Gordon Smellle R. 0. Llssaman E. R. Schreyer . J. M. Hawryluk Edmond Prefolltalne J. E. Ingebrlgtson Mrs. Thelma Forbes · Hon. StewartE. McLean Q.C. Wll!lam Homer Ham llton S. Peters John P. Tanchak M. N. Hryhorczuk, Q. C. Peter Wagner Hon. Charles H. Wltney Hon. Sterling R. Lyon, Q. C. Hon. Gurney Evans Hon. George Johnson Nelson Shoemaker B. P. Strlckland Morris A. Gray A. J. Reld Oscar F. Bjornson D. L.

Camp bell Stan Roberts Lemuel Harrls Hon. Waiter Weir Harry P. Shew man Oble Balzley Mrs. Carolyne Morrlsori Hon.John Aaron Christians on Russell Paulley J. M. Froese W. B. Scarth, Q . C. Kelth Alexander Hon. Abram W. Harrlson Hon. George Hutton J. E. Jeannotte Laurent Desjardlns Elman Guttormson D. M. Stanes Davld Orllkow W. G. Martin Fred Groves Glldas Molgat T. P. Hlllhouse, Q. C. Arthur E: Wrlght M. E. McKellar Fred T. Klym A. H. Corbett Hon. J. B. Carron E. I. Dow Hon. John Thompson, ·Q. C. Richard Seaborn James Cow an Q. C. Hon. Duff Roblln ADDRESS Reston, Man. 212 Oakdean Blvd. , St.

James, Wpg. 12 Russell, Man. 832. Eleventh St. , Brandon, Man. 2- 1177 Henderson Hwy. , Winnipeg 16 84 Furby St. , Winnipeg 1 St. Pierre, Man. · Churchlll, Man. Rathwell, Man. Legislative Bldg. , Winnipeg 1 Sperllng, Man. 225 Melrose Ave. , Winnipeg 15 Rldgevllle, Man. Ethelbert, Man. Fisher Branch, Man. Legislative Bldg. , Winnipeg 1 Legislative Bldg. , Winnipeg 1 Legislative Bldg. , Winnipeg 1 Legislative Bldg. , Winnipeg 1 Neepawa, Man. Hamlota, Man. 141 Cathedral Ave. , Winnipeg 4 561 Trent Ave. , E.

Klld. , Winnipeg 15 Lac du Bonnet, Man. 326 Kelvin Blvd. , Winnipeg 29 Nlvervllle, Man. 1109 Alexander Ave. , Winnipeg 3 Legislative Bldg, , Winnipeg 1 Morris, Man. 185 Maplewood Ave. , Wlnnlpeg'13. Manltou, Man. Legislative Bldg. , Winnipeg 1 435 Yale Ave. W. , Transcona 25, Man. Winkler, Man. 407 Queenston St. , Winnipeg 9 Roblln, Man. Holmfleld, Man. Legislative Bldg. , Winnipeg 1 · Meadow Portage, Man. 138 Dollard Blvd. , St. Bonlface 6, Man. Lundar, Man. 381 Guildford St. , St. James, Wpg.12 179 Montrose St. , Winnipeg 9 924 Palmerston Ave. , Winnipeg 10 3 Kingston Row, St. VItal, Wpg. 8 Ste.

Rose du Lac, Man. Dom inion Bank Bldg. , Selkirk, Man. 4L ord GlennApts. , 1944 MalnSt. , Wpg. 17 Nesbltt, Man. Beausejour, Man. Swan River, Man. Legislative Bldg. , Winnipeg 1 Bolssevaln, Man. Legislative Bldg. , Winnipeg 1 594 Arl lngton St. , Winnipeg 10 512 Avenue Bldg. , Winnipeg 2 Legislative Bldg. , Winnipeg 1

THE LEGISLATIVE ASSEMBLY OF MANITOBA 2: 30 o'clock , Thursday, March 16, 1962 Opening Prayer by Mr . Speaker. MR. SPEAKER: Presenting Petitions. MR. W. B. SCARTH, Q.C. · (Rive r Heights): Mr. Speaker, I beg to present the petition of Arthur Uniacke Chipman and Others, praying for the passing of

an Act to incorporate St. John's Colleg e Endowment Foundation. MR.. SPEAKER: Reading and Receiving Petitions. MR. CLERK: The petition of Harry Shnoor, praying for the passing of

an Act to validate a Certain Devise in the Last Will and Testament of Esther Shnoor, Deceased. The petition of Frederick J. Douglas and Others praying for the passing of

an Act to incorporate The Church Home for Girls. MR. SPEAKER: Presenting Reports by Standing and Special Committees. Notice of Motion. Introduction of Bil ls. The Honourable Minister of Agricultur e. HON. GEORGE HUTTON (Minister of Agricultu re)(Rockwood-lberville) introduced Bill No. 72 ,

An Act to amend The Rivers and Streams Act. MR. SPEAKER: The Honourable the Minister of Agricult ure. MR. HUTTON introduced Bill No . 70 ,

An Act to amend The Fruit and Vegetable Sale s Act. MR. SPEAKER: The Honourable the Attorney-General. HON. STERLING R. LYON, Q. C. (Attorney-General)(Fort Garry) introduced Bill No. 71,

An Act to amend The Liquor Control Act. MR. SPEAKER: The Honourable the Member for Assiniboia. MR. GEO. WM. JOHNSON (Assiniboia) introduced Bill No. 26,

An Act to amend

An Act to incorporate Trafalgar Saving s and Loan Association. MR. SPEAKER: We have with us this afternoon, 26 pupils from Churchill School , Grade Vlll. They're under the guidance of their teacher, Mr. MacKenzie . The school i� located in Osborrie constituency and represented by Mr. Baizley in the Legisla ture . I am sure that the students by their visit this afternoon will receive some pleasure from watching the proceedings of the Legislature, and I am sure that they are proud and happy to go to Churchill School.

They must recall sometimes that Churchill is a rather famous name in British history, as Sir Winston Churchill was a wartime premier of Britain and a very distinguished public figure. We hope that their stay this afternoon will be pleasant and profitable . Orders of the Day. HON. GEO. JOHNSON (Minister of Health) (Gimli) : •.. to table a return to an Address for Pa pers of Tuesday, March 6th, on the motion of Mr. G. Molg at, Leader of the Opposition. MR . SPEAKER: Orders of the Day. HON . STEWART E. McLEAN, Q.C . (Minister of Education)(Dauphin): Mr.

Speaker , be fore the Orders of the Day, I should like to lay on the table a return to an Order of the House, No. 14, agreed to on March 6th, 1962 , on the motion of the Honourable Member for St. John' s. Also Mr . Speaker, before the Orders of the Day, I have a statement that I expect to read to the House. The Federation of Malaya has a rapidly growing economy and is anxious to ex pand the industrial arts and vocational programs in its school s. To do this it requires trained teachers and the logical place to produce them is in Malaya.

The government of that country has appropriated money for the construction of a school in which it will train teachers of indus trial arts, but it does not have a sufficient number of trained people who can plan, establish and operate such a school . It turned to Canada and asked that the External Aid office in the De partment of External Affairs, operating under the Colombo Plan and Commonwealth Plan and Commonwealth Education Schemes, to provide a part of the staff and some of the equipment for the school . A fine site has already been selected in Kuala Lumpur, the capital of the country.

Some time ago Canada asked Manitoba to help in the recruitment of a principal , a shop director and three teachers. The Government of Manitoba agreed to assist. After considera tioil. it was agreed that Manitoba would find suitable people for these positions and employ them and send them to Malaya on the secondment basis. This plan appears to be working well . March 15th, 1962 Page 735

(Mr . McLean, cont'd. ) On March 25th next five Manitoba teachers will leave for Malaya, B. F. Addy, Director of Vocational Education for the province will remain in Malaya for two months and will give assi stance and advice in preparing the plans for the new building and the drafting of the courses to be offered, After his return to Canada, he will maintain his liaison with the Malayan Depart ment of Education . S. P.

Didcote, now Shop Director at Manitoba Technical Institute will serve as Assi stant Principal and his presence will bridge the gap between Mr: Addy' s departure from Malaya and the arrival later of a principal when one is secured. N. J. Topolniski, now Supe r visor of Shop Courses in Manitoba schools will assist in the layout of shop space and remain as a teacher.J .A. Zuzanski and R. J. Toutant , who have just come to our staff from Winnipeg and St . James respectively, will help plan cou rses in their su bjects and will remain as teachers. The original assignments of all of these persons except Mr .

Addy will be for one year with a provision for extension to a maximum of five years. By having these members of our staff serve Malaya, we will create a real link with an other Commonwealth country. Personal communications have already been established between members in the Department of Education and in Malaya and we have a substantial connection with the project from the earliest planning stages.

We have been told that this is the first se condment arrangement between the External Aid office, a Commonwealth country and a prov incial Department of Educa tion , and it is intended to serve as the forerunner of similar arrange ments unde r Canada's Colombo and Commonwealth Education plans . Although Manitoba will pay salaries and related expenses in the first instance, an agreement has been reacb,ed under which Canada will reimbur se Manitoba in full for all the costs incu rred in this project. During the first week of February , B.

Scott Bateman , Deputy Minister of Education, visited the Federation of Malaya on his return from the Commonwealth Education Conference held in New Delhi, India. Mr . Bateman met with the government officials with whom we will be working on this project and laid the necess ary groundwork for the staff which will follow. MR . GILDAS MOLGAT (Leader of the Oppo sition)(Ste . Rose) : Mr. Speaker , I want to thank the Minister for the statement he just gave us .

Certainly all the members of the House , and I am sure all Canadians , realize the responsibilities that we have in the world today in helping the und er-developed nations, and certainly our own close ties in the Commonwealth would indicate that probably the first steps should be taken with those nations that have that association with us .

It seems to me that the proposa l that the Minister is now making to the House is the direction in which we should be heading, and that is that the work in this field should be done through the auspices of the federal government with the provinces natur ally, having responsibilities in the field of education , providing staff, but it is much better to be do ing this in a combined basis through the federal government rather than for the provinces to be operating on their own in this field.

So, for our group we certainly are very happy to hear that this development is taking place and will be carried on in other areas . MR. RUSSELL PAULLEY (Leader of The New Democratic Party)(Radisson): Mr. Speak er, may I say that while sometimes people are critical of the use of provincial monies outside of the province itself, that this is one field that the government has entered into that has had the continuous sup port of our group . I can say that without hesitation, Mr . Speaker, when the first proposition was laid before this House , I think we were the first, other than the government, to endorse it .

In the world today we're all very cognizant of the fact that we must all live and work together , and there is no better way in which Manitoba and Canada can make a contribu tion to the future destiny of the world than by joining together in the educational fields and working together as we are. MR . HUTTON: Mr. Speaker, before the Orders of the Day, I would like to make a state ment to the House with regard to a furthe r policy to deal with some of the effects of the drought last year, this one in connection to the sup plies -- of making available supp lies of seed oats in the Province of Manitoba.

The acreage annually sown to oats in Manitoba, approximately 1.8 million, is second only to that devoted to wheat production . Oats are thus a very important field grain crop. They are also the most important grain for livestock feed. As a result of a short 1961 crop and the keen demand for oats for feeding, this grain is now in short supply in some parts of the province . It is imperative that farmers have suppl ies of seed oats available to them. Surv eys to date Page 736 March 15th, 1962

(Mr. Hutton, cont'd. ) ..•. indicate that a great many farm ers have not yet made arrange ments for their seed oat requirements . It is imperative that immediate action be taken by these farmers for the following reasons: We cannot affo rd to have the oat acreage materially decreased due to the importance of feed oats to the livestock industry and due to the fact that the oats sown early may have to be used as a substitute for regular cattle pastures. There are acute shortages of oats in some parts of the province and surplus in others. Distribution must take place and this takes time.

There may be a shortage of good quality seed oa ts. If this is the case the need must be known to seed companies soon so they can arrange movements into the province. Weight restrictions are usually in effect on our highways from approximately March 31st to May 25th. Tr uck movements should be made before this time. If municipalities are to be involved in purchas ing and distributing seed to their far mers they must be made aware of the farm ers' require ments at an early date so that they can make necessary arrangements.

In order to stimulate this necessary movement of oats the following policy is being con sidered, this to financially assist in truck movement. The policy will provide for the payment to bona fide far mers and ranchers in this province. Assistance to the amount of 5 cents per ton mile on the homeward movement of oats. Assistance shall only be paid on the one-way mileage in excess of 50 miles and the maximum payment per ton shall be $9 .00. The policy would provide assistance on a maximum of 300 bushels of seed and/or feed oats per farm .

Assistance payable on 300 bushels of oats moved a total one-way mileage of 150 miles would be 8. 5 cents per bushel. The maximum assistance of $9. 00 per ton is payable on a one-way mileage of 230 or more miles. It is important to note what this po_licy can do for individual farme rs . The 300 bushel maximum may be considered to include 125 bushels of seed oats and 175 bushels of feed oa ts. The 125 bushels of seed is suff icient to sow 75 acres of oat crop. The average acreage per farm devoted to oat production is 40 acres in this province.

The 175 bushels of feed oats is considered to be suff icient to carry a herd of 25 cows in a hay shortage situation for a period of 30 days . The 300 bushel maximum can thus do a great deal to allevi ate both the feed and seed shortage situations . I'll just list the terms -of the program. :Applicants must be bona fide farmers or ranchers resident in the Pro vin<Je of Manitoba. This fre igllt assistance applies to the movements of oats by truck only. This freig ht assistance shall be granted only on shipments {)f oats originating in Canada. Assistance will be paid on the one-way mileage in excess of 50 miles.

For instance , if oats are moved 125 miles the assistance granted will be 75 times 5 cents per ton or $3 .7 5 per ton. In order to qualify for assistance the oats must be transported during the period March 15th to May 15th, 1962 inclusive. Application forms may be obtained from agricultural representatives, secretaries in municipalities and local government district administrators .

I would also like to say at this time that this policy has been considered by the Droug ht Committee -- members of the Drought Committee who met for some two hours yesterday afte r noon -- and it was the feeling that a program of this kind was needed in order to stimulate ac tion in this field and get the available oats in Manitoba into a position where they can be utilized.

I should also add that we are not making an announcement at this time with regard to rail frei ght transportation assistance, because the matter is still under negotiation, but we expect that we will be able to make such an announcement at an early date. I should point out, however , that in the case of the movement of oats by rail that the assistance will in all likelihood only apply to oats that carry a control sample certific ate. The reason for this is to safeguard the impor tation and introduction of noxious weeds which are not at the present time prevalent in the Province of Manitoba. MR .

MOLGAT: Again I want to thank the Minister for the statement that he made. It's of course impossible on the very short notice to assess whether this assistance will be suffi cient or not to meet the problem that is facing us . I am very happy to see , however, that he has taken steps to do something about this situation.

Certainly it's urgent that it be done now, because if we let the situation continue then by the time spring comes along and the possible heavy demand for seed oats, the result could be a very sbstantial rise in price , so we'll be happy to assess the statement the Minister made wheri we get copies and see whether in our opinion it's satisfact ory. I think one further step should be taken by the government and that is to make an assessment of the availability of seed oats in other localities. We are told, for March 15th, 1962 Page 737

(Mr. Molgat, cont' d.) •••• example, that the Province of Alberta has substantial surplus. Now there should be some work undertaken, I think, by the department to make sure that we can contact those sources or the farmers can do so . I am somewhat unhappy that some 10 days ago, when we brought this matter in the House, the Minister did not at that time see the urgen cy of having it discussed at that time, but I am happy that now he is able to make a statement. MR. SPEAKER : · Orders of the Day • • . • • • statement. MR. HUTTON: Mr .

Speaker, I would like to enlarge upon the statement that I made in respect to the availability of seed supplies. MR. SPEAKER: Order -- you may not debate his statement. MR. PETER WAGNER (Fisher): Mr. Speaker, I would just like to direct a question be cause it seems to me that the statement is out of order, so I'll just direct myself to a question. The Minister mentioned that there is availability of seed oats. Now my question is : does the farmer procure himself the oats ? He finds another place to get the oats or the Department of Agriculture is going to tell him where the oats can be found? MR.

SPEAKER: Orders of the Day. MR. PAULLEY: •••• on the statement of the Honourable the Minister and that's simply this, that is was quite a comprehensive statement and until such time as we've had an opportun ity of studying the same I think any comments at all should be reserved. MR. SPEAKER: Orders of the Day . MR. HUTTON: • May I answer the question that the Member for Fisher put? MR. SPEAKER: You may answer the question . MR. HUTTON : The Department has been keeping very close tab on the supplies of oats in the province , and we have carried out surveys.

We have , I think you will have noticed in the pape r, we have been making an appeal to the farmers to list their requirements and also their supplies with the department. As a matter of fact at the present time we have some 50 , 000 bushels of seed oats listed with the Soils and Crops Branch, and I am sorry to say that in spite of what we believe must be a shortage in some areas, we have had little or no enquiry for these supplies. These supplies are held by seed companies and by individual farmers.

We do know that supplies are available in Alberta for instance, and anyone -- any municipality that is interested in these supplies can certainly get the information from us. I would point out, however, that as residents of Manitoba we should first of all utilize the supplies of oats that farmers and elevator companies are holding right here in Manitoba before we go off to Alberta and there are many tens of thousands of bushels that are available for use aiJ.d we are bringing in this program to endeavour to stimulate the movement of this grain.

We're not in the first instance· so concerned about the numbers of bushels that are available iil Manitoba but in getting them distributed and used. We feel that this program should help, and if it doesn't then we can only take for granted that the farmers are not concerned about SJ.lpplies and must have them.

Some information coming out of the meeting that was held yesterday was the fact that neither the farm organizations nor the municipalities nor companies representing the farmers, such as the commercial organization s, have had any call or any enquiry to speak of, in respect to the need for seed grain, and this in spite of the fact that to the best of our knowledge there is bound to be some shortage this spring and so it is as a result of our surveys. and our investigations that we are implementing this program and not because of the volume of requests or any volume of requests, for that matter, from the farmers themselves.

MR. WAGNER: Mr. Speaker, a supplementary question. First of all I want to thank the Minister for the long answer and furthermore I'd like to ask, can he tell the House here what more or less the price of a bushel of such oats would be to the farmer? MR . HUTTON: I don't think it would be correct for me to try to indicate the price of seed oats , but what I can indicate is the amount of assi stance that would be available in freight, in getting these oats home. On a 230 mile haul, or with the maximum of assistance of $9 . 00 per ton, it would be approximately 15 cents a bushel assistance that we would offer. MR.

SPEAKER: Orders of the Day. MR. D. L. CAMPBELL (Lakeside) : Mr. Speaker, before the Orders of the Day are pro ceeded with I would like to direct a question to the Honourable the Minister of Agriculture and Conservation . Is the federal government assi sting in the freight assi stance, and I recognize that it's limited at the present time according to the announcement to truck haulage -- is the Page 738 March 15th, 1962

(Mr. Campbell, cont•d. ) •••• federal government assisting in that freight assistance? And my second question Mr. Speaker is: is it not a fact that seed barley is also quite scarce in several areas of the province ? MR.

HUT TON: The answer to the seed barley, we examined this situation yesterday, and I think the Honourable Member for Lakesidew lll appreciate that we have members of the Canadian WheatBoardor havea member of the Canadian Wheat Board, on the Drought Comm ittee, andmem bersof the major graincompanies, the various grain companies, and in their opinion although there might be local shortages of seed barley there wasn •t an over-all shortage and they didn't feel that the question of transportation would be a major problem.

That is, they felt that the areas of shortage would be much smaller and that available supplies would He in closer areas. In respect to the question on federal government participation, we have requested the fed eral government to assist on this program and indications are that they will , but they haven't said so yet. And in the case of the assistance on movement by rail, the railways also are in volved so I'm not at liberty at the present time to make any statement in regard to this.

But we have asked for assistance and I notice from a statement, !believe it was in the Free Pres s, where the Parliamentary Assistant to the Minister of Agriculture was speaking in, I believe it was Regina, Mr . Warner Jorgenson, and he indicated that they were considering these pro grams, of assisting in these programs, and we trust that they will help us on this. MR . SPEAKER: Orders of the Day. Second reading of Bill No . 38 . MR. E. R. SCHREYER (Brokenhead): Before the Orders of the Day, l'd like to direct a question to the Minister of Education.

I would like to ask him if the department has succeeded as yet in drafting a syllabus outlining the course of studies that will be offered at the new MlT and, if so, will copies be available before we enter into estimates on that department? MR. McLEAN: I will be able to tell the members of the House and Committee, on esti mates, the subjects that will be offe red at the Institute of Technology. I don't think that any syllabus will be available for the members at that time. MR. SPEAKER: Orders of the Day. MR. MOLGAT: Before the Orders of the Day there was a newspaper

article last night- this is a .question addressed to the Attorney-General -- regarding a report made by the John Howard and Elizabeth Fry Society. I wonder if the Attorney.:.General has seen a copy of this report yet and will copies of the report be made available to the members of the House? MR . LYON: I have seen a copy of the report; I have only the one copy. I would imagine if application is made to the John Howard Society copies could be obtained from them. MR. SPEAKER: Orders of the Day. Second reading of Bill No . 38 . The Honourable the Provincial Treasurer. HON. DUFF ROBLIN (Premier and Provincial Treasurer)(Wolseley) presented Bill No. 38 ,

An Act to amend The Loans Act for second reading. Mr. Speaker presented the motion. MR. ROBLIN: Mr. Speaker , we covered the ground pretty thoroughly in respect to this matter at the committee stage, and I don't think that there is anything that I could usefully add to what was said then except to repeat that the main principle behind this bill is to facilitate the handling of treasury bills. Mr . Speaker put the question and af ter a voice vote declared the motion carried. MR . SPEAKER: Second reading of Bill No . 45 ,

An Act to amend The Mental Diseases Act. The Honourable the Minister of Health. MR . JOHNSON (Gimli) presented Bill No . 45 ,

An Act to amend The Mental Diseases Act for second reading. Mr. Speaker presented the motion. MR. JOHNSON (Gimli) : Mr. Speaker, this is an amendment to The Mental Diseases Act. The principle here is that the present Act has been interpreted by the Court of Appeal to say that the authority of the Superintendent of what is known as the Psychopathic Hospital -- we now hope it's going to be known as the Psychiatric Institute -- is not-vested-- they have ruled that this authority is vested in the superintendent himself and not in any other physician or psychia trist.

Now the practicalities of the matter are that this has resulted in a lawsuit because on one occasion the provincial psychiatrist did not himself -personally admit the patient. And with the increased activity in this area it is felt highly desirable that this power be vested by the Minis_ March 15th, 1962 Page 739

(Mr. Johnson, (Gimli), con t'd.) •••. ter in other than the superintendent by permitting the supe rintendent to app oint the other psychiatrists in the institution and as admitting authorities . I think this is sensible and practical . The other, it is just a process of evolution . There was a time when the hospital opened, 1917 I believe , it really was -- there was just the one authority then. The other parts of the bill referred to this, the second

section here 1 the way the hospital operat es, the resident psychiatrist who's on dutY at the time is thereby "p ermitted to admit a patient who might come to the hospital at irregular hours , and it also permits the following ad mission. It gives the staff about 18 hours before they have to have a complete psychiatric his tory made. The present Act is in that respect too tight on time. Lastly, the present Act says that any Justice of the Peace, const able, .interested relative, if they feel that a person is mentally disturbed they may bring the patient to the hospital . This third

section in this bill makes it clear that the hospital itself has no liability in the case of people who bring mentally ill people to them until such time as they have admitted them. I think these are very straightforward change s and for the proper efficient operation of the facility. MR. T. P. HILLHOUSE , Q. C. (Selkirk): Mr. Speak er, I will vote for the second reading of this bill but I reserve the right to look into the princip les that are inv olved because I feel that this bill may be granting immunities to people which should not be gran ted. Mr.

Speaker put the que stion and after a voice vote declared the motion . carried. MR. SPEAKER: Second readin g of Bill No . 46 . The Honourable the Minister of Health. MR. JOHNSON (Gimli) pre sented Bill No . 46 ,

An Act to amend The Private Hospit8.1 Act for second reading. Mr.Speake r pre sented the motion . MR. JOHNSON (Gimli): Mr . Speake r, this bill is a companion bill to the changes which are being contemplated in the Manitoba Hospital Insurance Act, in reference to pr ivate hospit als. The members of the committee will realize t�at the only private hospital s in the province are company hospitals in the mining communitie s.

These are the only hospital s that. are licensed pri vately in the province at this time and it substitutes "the commission" for "the Minister" with respect to registering and licensing and inspe ction which are three of the fun ctions which will be passed on to the commission with the companion legislation. Also at the present time the fee -- there's a fee of $5. 00 registration fee and a $10.0 0 licensing fee charged to these company and private hospita ls , which we think is unn ecess ary at this time in the evolution of hospital services, and these are the two principles that are em bodied in this bill . Mr.

Spe aker put the question and after a voice vote declared the motion carried. MR . SPEAKER: Second reading of Bill No. 47 •. The Honourable Mint ster of Health. MR. JOHNSON (Gimli) pre sented Bill No . 47 '

An Act to amend

Chapter 91, 46 and 47 Vie. I intit uled "An Act respecting the Winnipeg General Hospital" for second reading. Mr. Spe aker pre sented the motion. MR . JOHNSON (Gimli): Mr. Speake r, with this General Hospital bill, its self-explanatory note in the front of the bill points out the intent of this particular bill.

We feel that with the large amount of pu blic funds which are now paid to hospital s through tlie consolidated revenue , etc . , that it proba bly is not proper for the Minister of Health, the First Minist er , or the Pro vincial Treasurer, and the Minister of Education to be on the board of that particular hospital . This legislation has not been change d since 1919. The other change here with respect to the represen tation of the City of Winnipe g on the board of that hospital is in compliance with the request from the City of Winnipeg by resolution to lower their membership on the board. Mr.

Speake r put the question and after a voice vote declared the motion carried. MR . SPEAKER: Adjourned debate on the proposed resolution proposed by the Honourable Minister of Welfare. The Honourable the Member for Selkirk. MR. ffiLLHOUSE: Mr. Speake r, if the Honourable Member for Rhineland wishes to speak I'll allow him to do so . I'm not ready to go on . . , . • . MR. J. M. FROESE (Rhineland) : Mr. Speak er, I'm not prepared at this time. MR. SPEAKER: Order stand. Committee of Supp ly. Page 740 March 15th, 1962

MR . ROBLIN: Mr . Speaker, I beg to move, seconded by the Honourable Minister of Health that Mr . Speaker do now leave the Chair and the House resolve into a Committee to consider of the Supply to be granted to Her Majesty. Mr. Speaker presented the motion and after a voice vote declared the motion carried, and the House resolved itself into a Committee to consider of the Supply to be granted to Her Majesty, with the Honourable Member for St. Matthews in the Chair. MR . CHAffiMAN: Department VIIT. Resolution 48 . The Honourable Member for Gladstone. MR .

NELSON SHOEMAKER (Gladstone) : I would like to thank most sincerely the initial report, b11t nevertheless very comprehensive one , that we listened to with much interest yes terday afternoon. I was particularly interested in it and enjoyed very much his comments on his trip t.o Europe , Norway, Sweden and so on.

It seemed to me that the approach to the entire field of health in England, in listening to the Minister's report, was that they are attempting to reduce the number of beds that are required; they're paying particular attention to alternative care of all kinds, and I think that that is the right approach to have. I expect that as a result of his trip overseas that we will see more action in the field of alternative care and so on. I have said on many occasions , Mr.

Chairman, that if I have a favourite cabinet minister on the other side of the House it is the Honourable Minister of Health, and I would like to repeat that again. Now I know that that makes it difficult to criticize him after having made a statement of that kind, and I don't think you will find my remarks today too critical. I was particularly interested, too , in the tribute that the Honourable Minister paid to his staff.

I would like to join with him in that regard and include the Neepawa Health Unit as well , but on that subject I would like to know if a medical doctor of health has been appointed at Neepawa yet. I believe that we are presently without one and have been so for six weeks or so , I believe -- .I am not certain whether he is being replaced or not. I was glad that the Honour able Minister did pay tribute to the medical profession, the hospital boards and everyone else that assists in the field of health and public welfare.

I know that there has been a feeling in the past by certain medical men that their services were not valued by the department as they should be , and it is a fact that many of our present programs, particularly in the field of Medi care, the success or failure depends entirely on the co-operation that the department receives from the doctors and all volunteer groups, so I was glad to hear him pay tribute to them and state openly that he did appreciate their co-operation. I think the Honourable Minister's report in many aspects was excellent.

He told us how the number of T .B. patients had been reduced in number in the last 10 years. The same with polio -- it was the first year in many years we had a polio-free year. In the field of mental health, the report that he gave to us was very, very encouraging.

There was one field that the Honourable Minister did not dwell on very long, and I expect that he intends to do that a little later on in the estimates, but the estimates before us total in dollars something over 20 million, about 20 ·1/2 million, and of the 20 1/2 million, about 51% of it is accounted for under Manitoba Hospital Services, premiums , or plan, and it is one big item there. Hospital Insurance Plan - $10, 378 ,0 00 , so it does account for about 51% of the total estimates under the Department of Health. Now , Mr .

Speaker, I realize that this is the first year that we are going to deal with the two estimates -- that's the one in the health field and one in the field of welfare, two separ ate ministers -- and you may find from time to time that I do get off into the welfare field and I hope that you'll excuse me . I believe that even the Minister had to -- the Minister of Health probably on some various occasions did dwell on welfare at certain times.

In addition to serving as omsbudman in my constituency, as every other member does I suppose to some degree, it is in the field of health and welfare that I personally spend most of my time in serving my electors . There's no question about that.

Last Saturday, for instance, when I was home over the weekend, I had no less than four calls and they all were in the field of health and/or welfare, old age assistance pensions, blind persons' allowance, and social allowances, and Medicare cards, and it's amazing the way that this department is growing by leaps and bounds and there's several reasons for that, but I do appreciate Mr.

Chairman, the co-operation that I have received from all of these agencies, from the Old Age and Blind Per sons Allowances Board, from the Portage Office of the Welfare Office , I believe they call it now -- they used to call it the Department of Health and Welfare -- I appreciate very much the March 15th, 1962 Page 741

(Mr. Shoemaker, cont'd . ) •••• assistance and co-operation that I received from each and every one of them , and I think the Minister does appreciate that I do not submit names to his department or to the Welfare Office in Portage simply to embarrass the government. I do not do that. I am very conscientious -- I think the Minister will agree with me on that. I try to screen out some of the applicants that come in to see me and if I don't think that they qualify I do not submit their names . I try to be fair in that regard.

Over the weekend I did a little research work of my own and I must say that the former Minister of Health, Mr .

Bend, and the present Minister of Health had something in common, and that is that they both seem to never find it difficult to speak for hours on end, and I found a report headed, and I quote: "The Final Debate on the Hospital Services Insurance Act, Bill No . 92 , April 5, 1958 ," and it was on the second readi.Jlg of the Bill we didn't have a Hansard in those days but they had ways of recording what was said, and here the former minister had 19 full pages of what he said at that time , and there were two points of interest in it.

There were a lot more than that but two that I was particularly interested in, and one was this, that I found that the then-leader of the Official Op position and the present Premier agreed with me on so many points, points that I have been rather laughed at now by members opposite , and I find that the Honourable Leader of the Opposition and the present Premier was In favour of - apparently by this document that I have before me he was suggesting that they have a deterrent at that time , and I would like to quote Mr.

Bend, just one sentence on page 2, and he's answer ing the Honourable --he says the honourable member, but immediately above it, he's referring to the Honourable Member from Winnipeg South and I believe that was the Honourable Member for Winnipeg South, and I quote, "an d the Honourable Member spoke and said, 'if you use this deterrent you could cut down your premiums; you could cut down the premium that you're going to give or charge to the people." ' Now, of course, Mr. Bend said that he wasn't in favour of it, but what I'm pointing out is that the then-leader of the Opposition was.

Then again he points out that if -- or Mr . Bend does --that actually about the only saving that you would enjoy with a deterrent would be that it might prevent the abuse of hospitals. Another interesting thing is, and you've heard me say this before, Mr . Chairman, that why couldn't we have two or three different plaus that we might offer to the public ? That is, a $25. 00 deductible or a $50 . 00 deductible, and let the people take the choice. I want to quote Mr. Bend again on that one because the --I am quoting Mr.

Bend again, "Now then, the Hon ourable Member from Winnipeg South raised a very good question here when he said, 'What about alternatives? Why should you just have one? Why couldn't a person come in and say, 'well I want a deductible of so much? I'd like a $50 .0 0 deductible; I'd like a $25.0 0 deductible .'" And Mr . Bend says, "Unfortunately, Mr . Speaker, that is one thing we cannot do. The way the Act is written at the present time in Ottawa, it's uniform terms and conditions and that is religiously applied.

" Now one of the most important points that I would like to raise, and we have raised it before, ls this: The people of this Province, I think ever since the plan was introduced, believe that Ottawa is paying 50% of the premiums . I don't know whether they care or not, the great majority of them, but most of them believe that Ottawa is paying 50%. Well even in April, 1958 , Mr. Bend says, and I want to quote again:" Now then, to give you the e.xact way in which this $27 million is raised," because that's what he says it's going to cost in the first year of opera tion, "I had my figures wrong a few minutes ago .

From Ottawa on the basis of their formula we will get $1 2, 500 , 000 which is roughly 46% ,from premiums we will get 43% , and from the province 11 percent. In other words $3 million from the province , $11 .5 million from the premiums , $12 . 5 million from Ottawa." That's what he said then, and as I said before the people , by and large, the insured people by and large really believe that Ottawa is paying about 50% of the premiums .

I had a farmer in the Arden district not too long ago --this was before the premiums were reduced, I'll admit that --he said to me one day, "Do you know that the Manitoba Hospital Ser vices Plan is costing me $250 .0 0 a year?" I said, ''Well if it's posting you that, it's costing us $500 .0 0 a year. Because if you say it's --it's just twice as bad as you think it is ." Now I want to explain how he arrived at the $250 .0 0.

He has two married sons living in the same yard, help farming with him, so he would have three times, at that time $72 .0 0 and then he had a crippled sister, not crippled to the extent that she qualified for total disability pension but cer- Page 742 March 15th, 1962

(Mr . Shoemaker, cont'd, ) , ••• tainly unemployable, and he had to pay her premiums so he had three premiums at the $72 .0 0 and one at $36 .o o; and I think that comes to about $250. 00. Now in examining today the way that we share in the Manitoba Hospital Services premium, it looks to me as if Ottawa pays about 36 percent. It looks as if the province pays about 37 per cent -- that's today -- and the premiums about 27 percent. Now I'm including the provincial tax. That's the way it looks . I don't think I'm too far out on that and I say, Mr.

Chairman, that since it is a fact that we will soon have four years of experience in this field of hospitaliz ation that it's high time that we pressed Ottawa for a new deal in light of four years' exper ience. Now it was put in four years ago when the people thought Ottawa was paying 50 percent. We know now that they're not, and I don't think that it is too unfair at all to ask Ottawa to look this thing over and come up with a new formula.

I know that it is most difficult to compare the hospital plan to any form of insurance, and I think the Free Press hit it right when they com pared it in this way, and I quote: "Once it is understood that the Manitoba Hospital Services Plan is not insurance, but a form of social security, it becomes clear why its costs have risen and will continue to do so." And that' s one thing perhaps, Mr . Chairman, that we over looked, that it is a form of social security in effect. I said before, Mr.

Chairman, and I was particularly glad to hear the Honourable Minis ter tell us what his plans were in the field of alternative care, because I believe that this is one field that will certainly have to be developed if our plan is going to operate effectively and efficiently and economically. I think it is imperative that we do more in the field of alternative care.

I have told the House twice about what happened to my own aunt and I am not going to tell you that story again, but I have one that is pretty nearly -- well it isn't quite a parallel to that, but I believe it does point up the situation that presently a lot of people of this province find themselves in. And this concerns a fellow that doesn't even live in my constituency. I believe he lives in the constituency represented by the Honourable Member for Lakeside - (Interjection) -- I'll look after it •. But his wife is crippled and has been crippled for some time -- two or three years I guess.

Nobody is denying that fact.

She cannot qualify for -- well I was going to say she couldn't qualify for old age assistance but on second thought I believe she would be presently receiving old age security, so that point wouldn't make any difference, but she was removed to the hospital and she stayed there as long as the authorities would let her stay there -- I don't know just what that length of time was -- and while she was in the hospit al, true, the Manitoba Hospital Services Plan paid the hospital bill , but, come a day, and when they said, "Well, you'll have to get out of this bed; we need this bed for other people and there is nothing more we can do for you here that can't be done in a private nursing home, or at a home of your own, or in one of the institutions." So her husband, being a man in his eighties, he said, "1 can't look after you so I'll have to put you in a home," and I think she was removed and presently is in the -- is it the Fairview Home at Portage la Prairie -- I don't know.

It's well operated anyway, a home at Portage, but now that she's there, who pays the bill ? Why, he has to pay it. That is , his wife was removed from a hospital bed that cost probably $18 .00 a day to one that costs $5. 00 a day, but he-pays the bill , so I say that until we do find more ways, more alternative measures to assist these people, that our plan will not work as efficiently as it should. Now this case is not an indigent, and Mr.

Chairman, I heard the Hon ourable Minister tell us the other day how many indigent persons in this province were being looked after, and that's all to the good, but it never struck me as being quite fair when this man has to pay his premium, his wife's in the home and he has to pay the hospital bill as well, simply by reason of the fact that he's got over $999 .0 0, but he soon won't have that because it's costing about $1, 500 a year more or less to look after his wife. I think we should have more home care, more nursing homes, and more elderly persons housing and so on. Now, Mr.

Chairman, you have heard me in the past suggest that we 8hould probably give some consideration to a deterrent of some kind, and I still think that it ian't such a bad idea. I realize the objections that there are to it. I would like the government to give flOme consideration to introducing in the Manitoba Hospital Services Plan a no-cla!ms bonus for those persons , after a given number of years, who do not need to use their Manitoba Hospital Services Plan. Now this has been worked effectively in the insurance industry and this govern ment is now using it in the Crop Insurance Agency.

Now it's true they have bad no experience yet, the Crop Insurance Agency, but I believe that it is designed so that a no-claims bonus March 15th, 1962 Page 742

(Mr. Shoemaker , cont'd.) •.•• after ten years will reach 40 percent discount. I have the tables here_ before me somewhere, but I intend to use. that when we come to the Department of Agriculture estimates . But the fact that the insurance industry have used it most successfully for a number of years, the fact that this government is going to use it in their Crop Insurance Agency, suggests to me that it could be used effectively in this field as well.

Now if there's something that I think !·kn ow a little bit about, it is the insurance industry, because I've spent about 25 years of my life at it and I know the effect it has had in the automobile insurance indus try. It has reduced the claims frequency considerably. It has done that and it has encouraged many, many people to pay their small clain:is. Just as recently as three weeks ago, I believe, we had a chap come into our office with $568 . 00 cash to pay three third party claims himself - rather than put it through his insurance -- rather than make a claim on his insurance policy.

Now I don't know just the particulars of why he did not want to register a claim on his insurance policy with a claim that size , but nevertheless he paid us $568 . 00 so tb,at we could in turn pay three claims for which he was liable because he wanted to have a clear record on his auto in surance; thereby maintain the good record that he had up to now. It is not my job, Mr. Chair man, to devise the formula that you would use.

We are in the opposition; the members opposite are the government, but I suggest to them that they mi ght give consideration to this and it might be surprising the results that would follow. Now, Mr. Chairman, I haven't been watching the clock -- I guess that you have ,...- and as I said before I do not intend to compete with the Honourable Minister when it comes to talking. I would like to repeat once again that I appreciate the help that I am presently receiving from both the Minister of Health and the Minister of Welfare, and I will be prepared to make a further contribution as we proceed in the estimates .

Thank you very much! MR . JOHNSON (Gimli): Mr. Chairman, before taking more questions I am taking this opportunity to distribute to every member of the House a copy of the Hospital -- the govern ment's

interpretation of the Hospital Plan. These are largely the recommendations of Dr. Willard that I spoke about yesterday, the recommendations of the Manitoba Hospital Survey Board Report and they're put in alphabetical order for your consideration and knowledge-- the name of the hospital, a description of the projept and the year in which the present grants allow these to continue.

I would inform the House that at the risk of being windy again, last night I indicated that we had divided the reports into those under way which have been reported in annual reports, those projects which were approved prior to the survey going in, such as pro jects under way, for instance for Baldur, Brandon, Dauphin, Rehab. Hospital, General and one at Stonewall, and then we had another group of projects approved by the Advisory Board but had not started prior to the Willard Commission, Altona, Ashern, Gilbert Plains and McCreary. These facts are in the annual report.

They're projects for which grants are required which are not part of general hospitals such as the Cancer Foundation Building and health units. And then there were certain projects recommended as emergencies in the Willard Com mis sion report. When you get your copies I could indicate which ones these are to you.

We felt that we hadn't quite -- it would take us some time to complete, to interpret the Willard re port and negotiations with Ottawa with respect to the amount of grant monies available to us which would indicate how fast we could proceed with the implementation of our program, so we called in these hospitals and sought the advice of the Advisory Hospital Commission, and it was decided that certain of these hospitals should be called in and included right away in order to prevent a hiatus of six months before the House met and I could share this with you.

If you have your sheets, the emergencies were Altona, The Fox Memorial in Carberry, the Eriksdale Hospital, Ste. Anne -- (Interjection) -- have you got the sheets? The ones which Willard said we'd have to do something about right away were Altona, Carberry, Eriksdale, Ste. Anne, Swan River, Winkler, Misericordia Nurses Residence and the Victoria General. These were the projects where there were emergency problems and these were discussed with the hospitals concerned as soon as we had made our preliminary review of the report.

There are numerous minor projects , just interior renovations of a minor nature in many of the smaller hospitills in Manitoba, which have been going forward. The big policy decision was that emphasis be given to extended treatment hospitals and projects involving acute hospit ills, acute treatment beds which are associated with the development of chronic facilitie-s, and I could. indicate to the House that included in this group are the municipill hospitills in Winnipeg, Page 744 March 15th, 1962

(Mr . Johnson, Gimli, cont'd.) •••• as you will see here , the St. Boniface General Hospital, Morden, Portage, Steinbach and Dauphin. The reason for this was, as you all know who have perused the report, the board felt very strongly that as soon as possible pilot projects should be approved and developed, and to implement this concept of a more dynamic care program for the -- especially aimed at our senior citizens. And then we have projects associated with active treatment hospitals for example it will complement the development of chronic fac ilities and these call for projects at St.

Boniface Hospital , Portage and Steinbach. And then we added our mental health needs into our grants -- availability of grants. Now the honourable members can f ind all this detailed in the Royal Commission report where it tells the amow;tts, the total amounts that we think would be expended in each year, all the work to go forward as we visualize, plus the source of funds to implement this down below. And if you'd use the Royal Commission report along with the report that I have tabled, this is the proposal that we are making.

Now I want to make it clearly understood that we have written all but a very few , one or two of these hospitals, and told the boards, told them when we expect their project would be going forward, and discussed the recommendations of the Survey Board re port with them, and in most instances I can report to the committee there has been a general acceptance of the Survey Board Report, and af ter discussions with all of the hospitals -- for example , one group who operate four hospitals in the province were anxious to do their program in stages and agreed that they couldn't go forward, for example, in the year that we had recom mended.

We merely say to the people : "This is the year in which grants would-be available in order to carry out the progr.am that we have visualized, and in line with the Survey Board report. " Where we have disagreed with them, they're really of a minor nature . And afte r we have discussed it with all of the hospitals, then we're in a position to fi nalize or to give the final approval in principle, and then of course it will go before the advisory groups for final approval and then into operation.

Now, you may say, "How can you commit fut ure governments, or fu ture -- in the futu re , five , ten years ahead?" I think we have to be entirely frank and realistic about this. Certainly we'll have to approve plans from year to year. There will undoubtedly be variations to this as we review the various hospitals, their programs, in any one year. But we are saying simply in this report, ''This is the year in which you can go forward and which grant funds are expected to be available.

Once you bring in your preliminary plans we will go over them with you again." There are 62 steps we have worked out under the construction division of the Plan which lead the hospital groups through the various stages and necessary requirements before they can begin building. That's why we thought it was important to get those emergen cies under way last June . Now we have to look ahead, ,as I said, eight to ten years, and here we have a survey re port calling for $35 million . We have $15 million under way as you see in the table of the Royal Commission report, and you have your mental health needs.

And we have made provision for $1 .-25 million a year as a government contribution towards the grants. This determines the -speed of implementation. The federal authorities have -- I sent this under confidential cover recently to the national Minister in the hope that I would allow him t<> see the problem in the Province of Manitoba in asking for increased construction grants for the coming year and I have nothing official , but I have reason to believe that we'll be able to get matching federal grants on the basis that we put up the 1.2 million a year.

So I thought I would table that before the honourable members pro ceeded with questions. MR . LAURENT DESJARDINS (St. Bonifa ce): Mr . Chairm an, a question to the Minister. This list that we have here , does that represent just the work in the existing hospitals, or re placing the hospitals now in existence, or has that project any new hospitals , say in a new district? Or maybe if I'd ask the next question it might explain what I mean. On page 5 it lists in Winnipeg, Grace Hospital, the new 250 bed hospital and student nurses' residence.

Well , does that mean that this is a new Grace Hospital adjacent to the existing hospital, or should that read St. James, or is there anything new on this proposed Grace Hospital, the Grace Hos pital being moved to St. James ? Is there anything on that at all? MR. JOHNSON (Gimli): Yes, this is -- probably the only referenc e made in the Survey Board report to the possible relocation of an existing major hospital was the request, as you recall, at the time of the survey, that consideration be given by the board towards relocating March 15th, 1962 Page 745

(Mr. Johnson (Gimli) , cont'd.) •..• that facility in St. James •. In principle we have spoken to the Grace Hospital board and advised them that with the priorities placed on extended care and mental health facilities, that grant funds are at this moment not likely to be available be fore 164 or '65 in full for them to proceed. First you must recall too it takes, in many cases it takes an institution like that maybe a year and a half to plan to get everything ready.

At the present time I have written to the Grace the information I have tabled with you here and I am still in the midst of negotiations with them and I think they have not quite decided just what is the exact course they will follow at the moment. MR. DESJARDINS: ••• from this that definitely there will be at least an extension to the Grace Hospital, or maybe another location, and seeing that this is the priority in '65 - '66 that at that time a decision will be made. In other words the location is more or less left in abeyance for the time being. There's no decision made as yet, is that it? MR.

JOHNSON (Gimli): No, Mr. Chairman, that's the point the -- as you know, two years ago, or last year , the Grace H�spital just completed its new wing in its present site, and if there were a change in plans, if they were not to develop in St. James it would be necessary to work with them on the present structure on the present site. MR. J. M. HAWRYLUK (Burrows): Mr. Chairman, just a question. On more than one occasion I've appealed to the Minister of Health to consider a hospital in the north end, taking care of West Kildonan, East St.

Paul and right up to Middlechurch, which I think is a popula tion of 100 , 000 people , and at the time the Honourable Minister said that there were surveys being made, but I see no mention of any hospital being considered in the north end of,this city, and I just wondered whether that's an oversight or whether it's not considered at all, and I notice the people up there have been asking me and I think there have been other comments made about that and I don't know why it hasn't been considered at all. MR . JOHN SON (Gimli): Mr.

Chairman, the full discussion of that is recorded in the Man itoba Hospital Survey Board Report where it is felt that for that area of the city, the Survey Board have recommended in the future the expansion of the facilities in the Concordia Hospital to serve that area . This was given a lot of study by the Survey Board and this was the recom mendation made, if. you have read that

section of the report. This was one of the requests put to the Survey Board, or one of the studies we asked them to make, and I would suggest the Hon ourable Member reread that. In the meantime we are willing to consider any applications like that at any time.

I believe recently the City of Winnipeg has been discussing this matter further , but we spent 18 months with this Survey Board doing the study which has been done and if you follow that report closely you'll see there are many, many factors affecting the develop ment of new hospital facilities in various parts of the city, and this is dealt with at some length in there. MR. HAWRYLUK: Mr . Chairman, just another-question • .. The reason ls ay·that -- why I can't understand, even if I haven't read the report, is the fact that we did have two hospitals at one time. We had the Children's Hospital and we had the St.

Joseph's Hospital in the north end area. I mean, Concordia•s away out in the Elmwood area and I still feel that the north end still takes care of, as I say, 100, 000 people which I think they're entitled to a hospital of some · kind, and I think every consideration should be given. MR. CHAIRMAN: The member for Seven Oaks. MR. ARTHUR E. WRIGHT (Seven Oaks): Mr. Chairman, after listening to the Honour able Minister for two hours and five minutes yesterday, I recalled my boyhood. Mother had a huge medical book with some very revealing pictures, and every time I had a chance to sneak a look at it I would do so.

Our family doctor was my idol then and I wanted to be one, but con tinually looking at all the flaws and ailments of humanity, I began to wonder if there was such a thing as perfection, and after hearing the Honourable Minister I am still in a daze, but that's not his fault. One could not but be impressed by the magnitude of the task which lies ahead of him. The honourable doctor mentioned the fine work of the increasing number of volunteer groups dedicated to health work, and I wish to express the appreciation of our group for their ___ ,· efforts in this important work. Mr.

Chairman, I recall the former Minister of Health, Mr. Robert Bend, who has been mentioned here this afternoon, saying that he expressed great con cern lest these public-spirited groups would withdraw their support once we started to talk about a more comprehensive scheme of medica! care. I think the trend is that we don't have Page 746 March 15th, 1962

(Mr. Wright, cont'd .) •••. to worry about that part of it. The people of Canada in looking around at the health plans of many lands , are demanding a more comprehensive type of care than that provided by private plans now in existence. The Honourable Minister mentioned the new concept of care in regard to the treatment of the men tally ill , which resulted in 176 less patients at Selkirk Mental Hospital last year. In our group we have realized for a long time that the incarceration of the mentally ill in under-staffed insti tut ions was wrong.

We knew that more trained personnel was required and we also realized it was going to cost money. Every dollar spent on the rehabilitation of the mentally ill pays a good dividend, and I was happy to hear the Honourable Minister say that in 10 to 15 years we will only need about half the present number of beds in our mental hospitals. Now if we are to achieve this, and when we realize that in 1959 Brandon and Selkirk Hospitals were overcrowded to 123% of rated capacity, it's quite apparent that a very great number of trained personnel with a smaller type of hospital will have to be provided.

It's a sad thing to note the number of children born mentally deficient and to hear that psychiatric facilities for children are very limited. After hearing of the success of the "live in, work out" plan of psychiatric care of the Montreal General Hospital I had hoped it might be adopted here. ·U nder this type of treatment a person is able to go to work and upon returning from work goes back to the hospital where he receives treatment and if necessary sleeps, and most patients in the category that are treate d for this are released and cured in about 28 days . I would like to read from page 56 , Mr.

Chairman, of the submission by this government to the Royal Commiss ion on Health Services, because it has something to say about this. Sec tion 56 says, "The immediate need is for adequately trained staff. Greater incentives are re quired to attract interested educated personnel into the field of mental health. There is a chronic shortage of fully qualified psychiatrists . . This will be gradually overcome by our expanded university training program which will, when fully implemented, graduate five certi fied psychiatrists each year.

To meet current needs in our mental hospitals an additional 24 fully qualified psychiatrists are needed immediately to staff positions presently occupied by less qualified personnel. In order to fully implement the newer concepts in the treatment of the mentally ill, it is estimated that an additional 200 employees, mostly nurses, occupational therapists and psychiatric social workers are required at the present time. Only by the provi sion of more intensive care, obtaining more staff, will we reach our objectives of reducing the need for institutional beds.

The requirements for qualified staff will be further intensified with the continued development of community, mental health clinics. Mentally ill persons re quire care and treatment of a highly skilled nature . No differentiation should be made in the approach to try treatment of mental illness as compared to treatment of other types of illness." We will have to provide bursaries on a far greater scale than we have in order to en courage young people to enter the healing arts .

I had hoped to hear of a start of a geriatric centre close to one of our larger hospitals, and thinking of our larger centralized medical centres ; I wonder how much planning goes into them. One sees buildings of all sizes being erected with little or no green belts and with insufficient parking facilities.

To hear that last year was the first polio-free year since 1918 was certainly good news , but when I heard the honourable doctor tell the House the other day about the new Sabin oral vaccine and how much of it was going to Saskatchewan because of their advanced immunization program , I wondered if we are not lagging behind. A news item in The Tribune March 7th states that Saskatchewan has ordered enough vaccine from the Connaught Laboratories at the University of Toronto to protect more than 900 , 000 people. Mr.

Chairman, I know that the population trend in Manito ba is from the rural to the urban areas, but I am wondering if we are not denying our country friends their share of proper medical attention. Seve nty-five point eight of our doctors are practising in the metro area. This leaves the rural areas with a ratio of 1.2 doctors per thous and of population. Again, Mr . C.hairman, the submission to the Royal Commiss ion clearly sets this out.

Section 210, and I quote, "There has been little done in establishing incentives to attract doc tors to rural areas. The province for some years have offered bursaries to needy medical students with the provision that on graduation such a recipient would practise for one year in rural Manitoba for each year of assistance given. Nominal grants have been given to doctors in outlying areas for public health duties performed on behalf of the Department of Health. March 15th , 1962 Page 747

(Mr. Wright, cont'd.) ••••• Provisions under The Health Services Act for municipal doctors, whereby doctors are partially reimbursed from funds obtained through taxation are used in- .·frequently at the present time. Some communities have discussed the feasibility of erecting a doctor's residence and office but this has not been done in many instances. Many communities regard a hospital as a prime incentive to attract a doctor, and the construction of a hospital may in fact be largely carried out with this motive in mind. This measure has not been too effective in some instances. " · I notice too, Mr.

Chairman, that while the estimates for Northern Health Services in total have increased by some $23 ,0 00, salaries are down $1, 800 . Perhaps the Minister will explain this when we come to the Items. I would like to. say a few words on dental services. Here again we come to this question of the shortage of professional help. In the metro area we have one dentist for 3, 143 persons- close to the national average, Mr. Chairman--while in the rural areas we have one dentist for every 6, 800 persons .

At an examination awhile back of 124, 000 children entering school reveal ed that only 16% had received proper dental care. The development of the new dental school and the added emphasis to preventive education is a step in the right direction. In discussing the Willard report, the Honourable Minister warned that hospital care should not be over-emphasized. I take it from this, Mr. Chairman, that the honourable doctor is plac ing the emphasis on prevention of illness to a much greater degree than we now have it.

This is all to the good, but here again we'll run into the serious problem of shortage of trained per sonnel. I think the sole right to license all professional medical groups, including optometrists, chiropodists, chiropractors , osteopaths and naturopaths, should be vested in the University of Manitoba. The affiliation of the various groups with the university would make for greater har mony among the healing arts .

The Honourable Minister gave us an interesting account of his trip to Br itain and the con tinent and he concluded by saying: "Let's not make the same mistake they made." If I have not quoted him correctly I wish he would say now, because I want to ask him if he thinks the British were ill-advised in implementing the National Health Plan. If he thinks they were, I would re mind him that while the Labour Government introduced the idea, it was a coalition government that started the program. Winston Churchill himself welcomed the advent of the National Health Service and no government dare abolish it.

I would like to quote from The Welfare News of re cent date, quoting Winston Churchill. Winston Churchill in 1944 said: "The discoveries of heal ing science must be the inheritance of all, that is clear. Disease must be attacked whether it occurs in the poorest or the richest man or woman, simply on the ground that it is the enemy and it must be attacked in the same way that the fire brigade will give its full assistance to the hwnble cottage as readily as it will give it to the most important mansion.

Our policy is to create a National Health Service in order to ensure that everybody in the country, irrespective of means, age, sex or occupation, shall have equal opportunity to benefit from the best and most up-to-date medical and allied services available." Mr. Chairman, this is an ideal that will not die and while powerful forces are at work to scuttle the plans of the government in our sister province of Saskatchewan, they will fail. I think Abraham Lincoln swnmed it up best when he said: "Public opinion is everything. With pub lic sentiment, nothing can fail; and without it, nothing can succeed.

Consequently, he who molds public opinion goeth deeper than he who enacts statutes or pronounces decisions." Mr. Chair man, the die has already been cast, and as a Star Weekly editorial recently said, "Saskatchewan may trail blaze again. " MR. DAVID ORLIKOW (St; Joh n's): Mr . Chairman, I want to confine my remarks this ·· afternoon to a discussion of the mental health program of the Province of Manitoba, because, Mr. Chairman, the problem of mental health is undoubtedly the greatest unsolved problem which faces Canadian people .

It has been estimated that one person in ten in Canada will require assistance in the field of mental health. It has been estimated that half the hospital beds in the Province of Manitoba are now occupied by people who are mentally or emotionally ill. It has been estimated that between 30 and 50 percent of the people who visit all doctors go there be cause they have mental or emotional problems, and yet, Mr. Chairman, we face a situation where in the entire Province of Manitoba there are at the present time only 27 qualified psychia trists. That being the case, Mr.

Chairman, I must say that while I could agree 100 percent Page 748 March 15th, 1962

(Mr. Orlikow, cont'd. ) ••••. with the sentiments expressed by the Honourable Minister yester day about what is needed; about the fact that the building of more buildings, the provision of more hospital beds for mentally ill people will not solve the problem, and that what we need to do is to get staff . What we need to do is to take the problem into the community rather than isolate it in the old traditional hospitals . I must say, Mr.

Chairman, that it seems to me that the Minister has confused his desire with a program , because the minister says, "we need staf f" , and therefore he assumes that we have staff. Well , Mr.

Chairman, I have had the op portunity, and it's not secret and I presume the Minister has also had the opportunity of reading the brief which the Manitoba Psychiatric Association presented to the Royal Commission on health ser:vices some time ago, and if one compares their asses sment of what is going on in Manitoba and what is needed with what the Minister talked about yesterday, one would think they were talking about, not only about two diffe rent provinces but about two different planets ; be cause any similarity between their assessment and the Minister's, and any similarity betWeen their recommendations and the Minister's, are purely .coincidental--(interjection)--That's my opinion, Mr.

Chairman, and I intend to summarize their assessment of what the situation is in the Province of Manitoba and to summarize their recommendations of what is needed, and to let the members of the House assess for themselves how close we are meeting what they say. Now, Mr. Chairman, what is the situation as they see it? As I said, half of the hospital beds in the Province of Manitoba are occupied by people who are mentally or emotionally ill. We have in the Province of Manitoba, at the present time, only 27 qualified psychiatrists .

This is the total number working either for the government in the.various institutions, or working in private practice--27 qualified psychiatrists . The Manitoba Psychiatric Association in their brief suggest that the minimum number required in the Province of Manitoba to meet the needs of the people of Manitoba is 90. The Minister says that this is my opinion.

I suggest to him that he give some thought to tha:t figure and that he compare the 90 that the Manitoba Psychiatric Association says we need with the 27 we now have, and with the training program--! think he said of five a year, which he says we have begun, and let the Minister and the members calcu late how many years it will be at this rate before we reach the number which the Manitoba Psy chiatric Association says that we require in this province.

In the provincial mental hospitals and in the other provincial services there are now established positions for 26 qualified psychia trists, but at the present time we only have 8 qualified psychiatrists in the provincial service and, of these , four are engaged in almost full -time administrative work. Now, Mr. Chairman, I want to digress just fo r ·One minute to say this, to make it very clear that I am in no way being critical of the work which is being done by this staff. I said last year and I want to make it clear again, that I think we get tremendous service from the staff .

I think the criticism is not of the staff. The criticism which is justly deserved is of the government of Manitoba, present and past; of the Legislature of the Province of Manitoba, pre sent and past; and of the people of Manitoba, present and past; because they just don't realize the importance of what is required. So I want to make it clear that I am not being critical of the staff.

I think they are working tremendously hard to try to do a job and they need to be giv en all the credit we can give them, but this does not absolve the government or the Legislature or the people of Manitoba for not providing the money or providing the staff to do the job which is required. Now we have at the present time active out-patient clinics at Selkirk, Brandon, and at the Psychopathic Hospital in Winnipeg.

I digress for a moment to say that I was glad to hear the Minister say yesterday that, after I think three years of prodding, and I don't want to even take a small part of the credit for myself, but after three years of my reminding him and I don't know how many other people have done it, but we're getting around finally to changing the name of that hospital, because that name was a misnomer and in many cases scared people away be cause they just didn't understand what they were trying to do there.

Now the patient load, even with the aid of the physicians in training who are being used where qualified psychiatrists should be used, is excessive in these out-patient clinics . The patient load in the Brandon Hospital and the Selkirk Hospital is excessive. These are the facts . If the members want to turn to Page 94 of last year's journal, they will see the answers the Minister gave to a series of ques tions which I asked. In the Br andon Hospital there are two certified psychiatrists, one of whom is the administrator.

In the Selkirk Hospital there are two certifie d psychiatrists , one of whom March 15th, 1962 Page 749

(Mr . Orlikow, cont'd .) •..• • is the administrator. Now I ask the Minister and I ask the mem bers, how much individual attention can these two certified psychiatrists give to more than 1, 000 patients who are in each of those hospitals? This is not being critical of them. This is facing the cold hard facts as they are .

If the patient load is going down, it's no thanks to the govern ment program; to a large extent it's thanks to the, fact that there was developed in the last half a dozen or more years the new tranquilizer drug which is the main reason for the reduction in the patient load, not the fact that we have a staff which has the time to devote to the patient which ought to be done. Now, Mr. Chairman, we have mental health clinics in three or four areas. What about the dozens of other towns and cities in Manitoba in which there are no mental health clinics? When will these be available? Well I suggest to you, Mr .

Chairman, that from anything the Min ister has reported up till now, it will probably be 15 or 20 years at a minimum before these are provided, because the training program so far enunciated by the Minister just doesn't give us the staff to really extend this program . Now because the psychiatrists we now have are concen trated in the three provincial hospitals , many patients who require hospitalization must go long distances from home to get the attention. This hinders their rehabilitation and prolongs their hospital stay. The Minister said this very well yesterday.

I ask again, what are w�, doing to really get down to grips with this problem ? We only have eight certified psychiatrists in our in stitutions . We have a shortage of private psychiatrists in Winnipeg and we have no psychiatrists doing private practice in the rest of tlie province. This limits to a tremendous extent the amount of help that can be given to the thousands of people who are unfortunate enough to be ill .

If we are to meet the needs of the people of this province in this field we must face the fact that, first of all, there must be a sharp increase in the number of psychiatrists and other specialists in this field because the psychiatrists cannot do a job adequately, Mr . Chairman, unless you have a sufficient supply of psychologists who can do the testing; unless you have a sufficient supply of properly trained psychiatric social workers . I want to tell the Minister that if we have social worke rs at Selkirk we haven't got enough; and they'.re not trained .

I am not saying that they are not doing the best job which they can, but they certainly can't do the job which proper.ly trained people can do in this field. Now psychiatric practice should be organized on smaller regional psychiatric in-patient units of from lQO to 200 beds, with provision for day care and out-patients. These should be lo cated in the larger cities and small towns of this province . Now our Minister said this yester day. I want to know what plans we have for doing this .

I would be glad if the Minister could an nounce that he has a plan so that in the next five years we will have half the province covered, or in the next ten years we will have the whole province covered. Because I want to say, Mr . Chairman, and I say this with a good deal of regret because there •s no member of this House that I like better than the Minister, but we 've been listening to these lectures of his for three or four years now and the number of qualified people. is, at the present time as far as l can tell, not much greater, if greater at all, than it was when the Minister took office .

Now the number of qualified psychiatrists working in the provincial institutions is completely inadequate to give much, if any, individual attention to patients . The patient load is much too great for the doctors to give the kind of attention which is required according to the modern standards, and yet we have had very little increase in the number of qualified people in the last several years . It has been estimated, Mr .

Chairman, that we need at least three times the numbers of presently avail able psychiatrists, and even more of other personnel such as psychologists, psychiatric social workers, speech therapists, and so on. Our present program of training is not at all adequate in attracting sufficient people into this specialty. There must be an increase in the facilities for post-graduate psychiatric training and other specialties by an expansion of present resident training and the augmentation of teaching hospital staff. I want to know, Mr.

Chairman, why it is impossible-..:and if we're doing anything, I would like to know in some detail what we're doing in the way of loans or bursaries. Surely there are doctors, graduate doctors who would be in terested in going into the field of psychiatry and of practicing in the Province of Manitoba, if this province was willing to invest some money in their training. Now I think it would be money well worth spending if we set aside, say ten bursaries ·of $1, 500 a year, to let graduate doctors get training in psychiatry, either in Manitoba or away from the province.

If we put the same qualifications on our loans in this field as we have done with others in other fields, require them Page 75 0 March 15th, 1962

(Mr . Orlikow, cont'd .) •••.. to come back to practice in the Province of Manitoba for some specified period of time, I'm certain that we could really begin to move in this field . Now psychiatric services for children are in a deplorable state . The rural areas with the exception of Brandon, have virtually no service at all . ln Winnipeg, the Children 's Hospital Child Guidance Clinic provides both diagnostic and treatment services, but they are still unable to cope adequa tely with the ever-increa sing needs . There is need for a resid ential treatment unit for seriously ill childr en.

We have one full-t ime psychiatrist for the five provincial correctional institutions and one '<, federal penitentiary. I'm sorry that the Attorney-General isn't in his seat today , but I can as- sure the l;Iouse that I certainly intend to raise this when we get to his estimates , The provincial psychiatrist in this field has no assistance from a full-time psychologist and so the psychiatrist can offer little beyond diagnostic evaluation in selected cases.

The Courts ask for assistance from the Psychopathic Hospital but there is no real program of sel ection or referral and what we have is done on a haphazard basis . Now one of the important fields which is not being dealt with, Mr . Chairm an, in the field of mental health, is research. The major health problem facing society today is research in this field and we are doing practical ly nothing in this field .

The Advisory Com mittee 'on Mental Health to the federal government has recommended that one twentieth of each dollar spent on mental health should be appropriated for research purposes, and yet in the Province of Manito ba there are no research workers in mental heal th . Why? Because there fs no future and no security of tenure in research work. Funds are available on a year to year basis only. There is a lack of plaxining. There is a need for establishing research centres with full-time profes sional workers assured of tenure of employment and freedom from restrictions on the work on which they embark.

Now I want to deal just briefly with the specific recomm endations which were made by the Manitoba Psychiatric Assoc iation in their brief to the Royal Commission, and I can list them for the Minister and for the members of this comm ittee. No. 1. The concentration of 4, 000 mental ly ill and mentally defective patients in three large rural unders taffed, overcrowded, proviricial government institutions , far rem oved from families and home comm unities. This is the number one problem . Second--Greater Winnipeg has only 75 psychiatric beds in General Hospital for short-term care .

This does not meet the demands and necessitates transfer of patients requir ing longe r term treatment to rural mental hospitals . Now the Minister announced yesterday that the General Hospital would be encouraged to build a 150 bed unit for people who are acutely men tally ill, and this is certainly to be commended, Mr . Chairman. It so happens that the Province of Saskatchewan is now building a comm unity mental health hospital at Yorkton, also of 150 beds .

I checked with them today and I want to tell the Minister what their plans for staff are at that one institution--five qualified certified psychiatrists , two qualified psycholog ists, 69- psychiatric nurses --for one institution of 150 beds . Now compare that, Mr .

Chairman--and I'm not suggest ing for a momen t that the Province of Saskatchewan has reached the millennium , that they have solved their problems-- but compare that, five certified psychiatrists for one institution of 150 beds with our eight psychiatrists in the entire provincial mental health field. 3. --third recom mendation of the Manitoba Psychiatric Ass ociation- -Outpa tient services, both rural and urban, are insufficient to meet patients ' needs with regard to prevention, diagnos is, treatment, follow up and rehabilitation of the mentall ill. 4. There is a severe shortage of psychiatric personnel.

There are only 27 qualified psychiatrists in Manitoba where, according to population, we should have a minimum of 90 . There is also a serious lack of trained psychiatric personnel. That is psychologists , therapists and psychiatric social workers . 5. There is a necessity for further development and expansion in child psychiatric services for the establishment of suitable residen tial facilities for chronic psychotics and severely disturbed children . 6. There is a marked lack of facilities and funds for basic research in mental illness .

Mr , Chairman, these are the observations of the people best qualified in this field; and I leave it to the members of this com mittee to judge how far we are from this situation. Now I want to deal just with some of the--because I recognize that the Minister will say that no province has achieved the standards set by the Manitoba Psychiatric Asso ciation, and this is true . I want to show how little this province is doing as compared to other provinces. I have the latest statistics published by the Dominion Bureau of Statistics--men tal health statistics. March 15th, 1962 , Page 751

_(Mr . Orlikow, cont' d.) •••••• They deal with 1959, but, Mr . Chairman, there's not too much -difference when you compare them with the 1962 figure. And what do we find? Well the per capita operating expenditure of mental institiitions--and if you look at them you see that the Province of Saskatchewan in 1959 spent almost $10 .0 0 per capita; the Province of British Col umbia, just over $8 . 00; the Province of Ontario, just under .$8 . 00; the Province of Prince Ed ward Island, just under ·$8 .0 0; the Province of Manitoba, $6 .00. There is the comparison, Mr. Chairman.

If you look at the amount, the total expenditures for mental "health, the Province of Saskatchewan in 1959, which had almost the same population as we did, spent $8, 678, 000; Prov ince of Manitoba, $5,2 52, 000 . Now it's true in 1962 we're up to over $6 million, but the Prov ince of Saskatchewan has moved to over $10 million. So you can see, Mr . Chairman, how short we are in this respect. Or if you look at another interesting figure, Mr.

Chairman, the cost per patient day of operating the mental hospitals for the year 1959, the average for Canada, $5. 31 a day; the Province of British Columbia, $5 .6 5 a day; the Province of Alberta, $5 .6 1 a day; Province of Saskatchewan $5 .4 3 a d ay; Province of Ontario, $5.5 0 a day; Province of Mani toba, $3.71 a day. Mr.

Chairman, I raise these not to be critical, and again I want to make this very clear that I' m not being critical of the staff, I'm being critical of we, the legisla ture of the Province of Manitoba, and I say that when the Minister gives the kind of report which he gave yesterday, that what he's doing is confusing his desires with his intention to do anything in the near future. Now, Mr .

Chairman, I took the trouble last year to write to some of the other provinces to ask them what kind of services they were providing and what kind of staff they had, and I want to read the figures which I got from these provinces . I'll be very happy to turn these letters over to the Minister and he can look at them. ·I certainly asked nothing that was secret and I got the answers which they supplied us. The Province of Ontario, the Minister of Health, Dr . Dimmon, replied on March the 30th of 1961, and this is what he said: "Staff

Summary: physici ans--certified psychiatrists, 110 ." Now it's true Ontario has six times or six and a half times the population of the Province of Manitoba, but you can calculate how close we are--8 into 110-- 8 as compared to 110 . "Psychiatrists in training, 36; psychologists, 85; so cial workers, 115. " That's the Province of Ontario in 1961. They'r.e probably better by now .

The Province of Brit ish Columbia, 57 doctors--Pm sorry the Minister of Health in British Columbia didn't say how many of those were psychiatrists , but one can assume , I think correctly, that probably two thirds of them are psychiatrists--58 social workers, 19 psychologists . The Province of Sask atchewan, as of March 21st, 1961, certified psychiatrists on staff, 19 ; residents and partly trained psychiatrists , 22--as compared I think the Minister said to a--psychologists, 18; psy chiatric social workers , 30.

Nurses on the staff of the three mental institutions, graduate psy chiatric nurses, 562; psychiatric nursing students, 400 . Now how does that compare with the Province of Manitoba? Well I think it's obvious . Now the Minister talked about the mental health clinics which we are going to establish. I think he said last year, and I was critical last year and I will be critical again, that the mental health clinics, the community clinics which are being established are being staffed with people who are not qualified certified psychiatrists .

Now in the Province of Saskatchewan, they have seven full-time community mental health clinics--in Regina, in Moose Jaw, in Saskatoon, in Swift Current, in Prince Albert and in Yorkton. Each one of these is directed by a qualified psy chiatrist. They have 17 , I think, part-time mental health clinics. They have one at Weyburn, North Battleford, at Assi niboia, at Kindersley, at Biggar, at Rosetown, at Maple Creek, at Shaunavon, at Melford, at Tisdale, at Nipawin, at Davidson, at Estevan, at Leader, at Fort Qu'A pelle, at Grenfell and at Kamsack. ·M r.

Chairman, it's not surprising, therefore, that they are spending this year $10 million for mental health, where we are spending six . So, Mr. Chair man, I want to say that while I can agree with nearly everything which the Minister said in sket ching the objectives of the department with regard to mental health, I want to say this year as I have said in other years, that the objectives do not mean that we are achieving the objective, that me rely to say that this is what we intend to do, does not mean that we are doing it; that merely to say that we have plans does not mean that the plans are in effect.

If one looks at the situation as it really exists; if one takes into consideration that of the few people who are being trained, f!lld they are all too few, that we cannot expect, on the basis of past experience in this or in any other field that all these people will stay with the province. So I can only conclude, Page 75 2 March 15th, 1962

(Mr. Orlikow, cont'd.) •..•• Mr . Chairman, and I say this not in a spirit of criticism but merely in a spirit of disappointment and regret, that in the field of mental health in this prov ince, if we are moving at all, we are moving too late and too slow . • . . • • • . • • . • • • • • • • • . • • Continued on next page. March 15th, 1962 Page 753

MR. CHAIRMAN: Resolution 48 -- MR; WAGNER: Mr. Cha.lrman, I was waiti ng possibly the members to my right were going to say something, but I would like to change the subject now from mental possibly to in sane or sane subjects. Before I start, Mr.

Chairman, I would like to extend my good wishes and regards to the Minister and the Deputy Minister and the staff, because as far as the Fisher constituency is concerned, I don't need to re.mind the members no more that it's mostly disor ganized territory and naturally we're under the local government district and therefore we have a lot of problems that we have to deal direct with the provincial department.

Sometimes I find myself in such a position that I even have to phone after hours to the people in the department or the Minister himself, ask ing for urgent information or assis tance, and I must admit that I -receive very courteous assist ance within the government policy however. To me, Mr. Chair man, the Welfare De partment did not as yet leave the Health Department, to me it's still one, so I want to pass this commendation to the Welfare Department, likewise as to the Health De partment.

I would like to digress from Manitoba as the Honourable Member for Springfield feels that I like always to talk about the federal mat ters , but I feel at the moment that the provincial govern ment has great influence on the federal government, and particularly the Manitoba Government surely has great influence on the federal government, because yesterday I saw a cartoon that our First Minister is just about to shoot our Prime Minister with an old, .old bow and arrow and it seems to me that the Prime Minister of Canada is kind of worried that our First Minister means business.

So, however, maybe our provincial government will take action and try and influence the federal government instead of us talking about a provincial health scheme maybe we can have a whole federal health scheme regardless whether the rich or poor, whether they are healthy or sick, they shall be taken care of. However, when one is healthy he is happy, and if he is happy he is healthy. However, anybody can dispute that by saying that I am not happy about this and about that; surely I am not happy about our provincial health scheroe, but I am happy that I am healthy. So you can dispute that in. any ma nner you wish:.

However, it seems to me that we have re.cognized in Canada as a whole and in Manitoba such scheme s as education and schools and hospital and hydros and telephones and other insti tutions strictly, not I would say state controlled but government implemented and it comes fro Ill the government source. However , when it comes to the health scheme it doesn't seem to iron out the same way; it doesn't seem to pan, some people like to distort that, oh it's -compulsory, it' s dictatorial and the doctor will lose patient relationship, and so on. As far as I am concerned, Mr. Chairman, I believe it's not such a thing.

Doctor and patient relationship is lost when the patient goes to the doctor and cannot afford to pay that bill then that same patient doesn't go to that same doctor again because the doctor tells him well pay me for the last bill. However, I must say the Minister of Health is very aware of tha:t-because not once I·s poke with him and with his department, that patients coroe to me and say, "Pete, we cannot pay the blll, possibly the province would pay the bill. " Naturally the province hasn't got that policy. They say if the patient was an indigent he should have gone to the out-patient department.

Then who is holding that bag? The doctor himself, and he writes monthly or every two weeks to the patient, pay me the bill, pay me the bill; and naturally the patient cannot pay the bill, due to the financial bur den, and the doctor and patient relationship is lost right there. And furthermore on the offset who's suffering -- the doctor or the medical professi on? If we would have an over,..all health scheme the doctor would just write down to the departroent of that particular concern or to the government that I looked after so many patients and this is it.

I don't see nothing compulsory about it, that it's so wicked, it's so terrible , because here in Manitoba we. have compulsory health scheme. We tell the people even which doctor they are going to_ go, what they are going to get. We just tell them, and if you don't want to you're just not going to be looked after -- and this is the out-patient department. When the person is indigent it gets instruction to go to the out-patient departm ent and the out-patient department looks after the person; and the person has no choice of the doctor.

Naturally there are many doctors and they give the best treatment as far as I am concerned, and yet the patient has nothing to say about it. Then when the final exam ination comes along I believe the specialist gives the final examination before the patient is operated on or hospitalized and the doctor is not paid by the patient, but sends his bill to the Province of Manitoba. The Manitoba Government pays the doctor. Does then the doctor feel Page 75 4 March ·I5th, 1962

(Mr. Wagner, cont'd. ) .•... that the patiimt relationship is lost? I don't think so. I would say that the doctor at the out-patient departme nt is sure of his money because he's going to get it, and the doctor in private practice, he has patients that they are not paying him, he's losing money. So naturally we want to have a healthy nation here in Canada and I don't see where the doctor would lose public relationship or patient relationship because it would be an over-all health scheme. However, Mr.

Chairman, I am looking forward, possibly in the near future in 1962 -- I didn't hear all of the Prime Minister's speech on TV last night -- but he surely is speaki ng now in his very friendly voice and he made the rema rk which I'll never forget. He stated that "There are a lot of people that they cannot be heard by the government and there are the voices in the country want to be heard, however, as I am the Prime Minister I hear them wit hout a direct approach. " Possibly the wording is not right, but that's what was expressed, However, Mr. Chairman, then I look for 1962 an over-all health scheme.

And it's not a new health sch eme, we have here 52 countries in the world that have this health scheme and I hope that Canada will be the 53rd in the near future . I have here a paper stat ing Medical Care plans throughout the World, and the source says: "Why do our medical friends tell us that a medical care plan for Saskatchewan would be vicious and improper. " Information based on social security programs throughout the world, 1958, published by the United State s, De partment of Health Education and Welfare. So here we have -- a lot of countries realize the need of over-all health scheme.

I would prefer taking myself from the outs ide world here into Canada, and when Saskatchewan Government went out to the people during the election cam paign with the idea of stati ng that we are going to bring a provincial health scheme they got back into office. Yes.

And here I have another paper stating: "E veryone wants the medical care" and the following excerpt stat es: "Who approved of the provincial health care ?" Saskat chewan Farmers Union; Saskatchewan Federation of Labour; Saskatchewan Urban Municipalit y Association; Swift Current Health Region No. 1 -- there's something to look at -- continuing, Comm ittee of Regional Boards of Health; Canadian Public Health Association, that's Saskatchewan branch; Canadian Association of Social Work, northern and southern Saskatchewan branch; Saskatchewan Saskatoon School , . , •..• .. •• ; the Saskatchewan Psychological Association.

These people approved. Let's take some of our farm groups. National medical care program okayed by Canadian Federation of Agriculture. Let's take Manitoba Farm ers' Union. They claim since 1953 they want a nation al health scheme . Co-ops. Just as recently as January 24th, 19 62; "Co-ops want medical care plan. " And this is what I want to put on record, Mr. Chairman, because this is a good resolu tion and it states this: "The annual meeting of Federated Co-operatives Lim ited held in Saska toon last week passed the following resolution concerning medical care . There was only one dissenting vote.

"Whereas we taxpaying citizens have provided the school and university faci lities that permit ted the medical men of today to obtain their education plus subsidizing each of them during those years of learning; and

whereas we as citizens through taxes and construction build to ·maintain the hos pitals in which most medical men earn a large portion of their income; and

whereas the Manitoba medical men, in a state ment to the press on January 16th publicly op posed the proposed medical care plan in Saskatchewan; and

whereas the failure of a prepaid medical care plan to get under way in Saskatchewan at this time would retard the formation of a national health plan for at least one generation;

Be it resolved that we , the delegates at this the 33rd Annual Convention of Federated Co-operatives Llmlted, respectfully request the Saskat chewan medical men to reconsider their st and and begin immediately to negotiate with our duly elected representatives as would any other group of citizens of democratic lands." Federated Co-operatives is recognized as the most authoritative voice of consumers in Western Canada; the 170 delegates at the convention represent hundreds of thousands of consumers from the Lake head to the Rocky Mountains. Now, Mr.

Chairman, I don't see who is opposed to the over-all health scheme. It seems to me that the majorit y of the people wish to have an over-all health scheme and why are we so slow about it. I just don't know. Possibly maybe our government seems to be dragging the feet. Mr. Speaker, getting back onto the out-patient department. I just wonder how large a figure do we look after or we treat through the out-patient department, and I must admit that it is a very large figure.

I am sure , and I know, from my own experience, that these people are getting well treated by well-organized st aff and doctors, and yet to my knowledge, to my opinion, March 15th, 1962 Page 75 5

(Mr. Wagner, cont1d. ) ••••• this is health scheme _.:_compulsory health scheme. But what I would suggest to the Minister, if it's possible, to speed up that out-patient department, to get in the patients sooner to their beds if necessary, because it takes quite a long time to get a patient from one desk to the bed. It takes as long as four hours. I had an experience not long ago, I took one indigent person to the St. Boniface out.,-patient department and those people are working as fast as possible , sometimes even on the run, and it's not fair.

But however, he ___ started from one desk and then to the other and then from one room to the other and then to the x-rays and down to the report and the statistics that are taken -- it took me four hours before I took the patient to bed. Poss ibly somewhere we can speed it up. Maybe we can eliminate or expand or something -- actually I felt that the patient goes through very much scrutiny, possibly we can elim inate something. I have no suggestion though; but possibly the Minister is very well aware of it and maybe he could say something about it.

However, turning back myself to Mani toba, the hospitalization, sometimes I feel that some people get more than the other. Possibly it's just my feeling, but even some of my own constituents have been looked -- in my opinion they received better attention than some others. So I would like to have a uniform somehow - naturally it's very hard to bring that because nobody can look into one's head and know what the person is thinking. Before I sit down, Mr. Chairman, I would like to bring to the attention of the Minister how often these hospitals are checked and particularly around the country.

For example kitchen -- who looks after -- who is the sole boss. I know the matron is there, but it has been brought to my attention that lots of goods -- shall I use that word -- disappear from the hospital and naturally it's taxpayers money and the check is not very closely made. I was given, by one of the officials of a country hospital, a good paper clipping and he vouched that it's exactly-- he is suspicious that it's happening in their own hospital, ani no doubt it's happening elsewhere, and I shall read it.

It may sound funny, but it's true as the officials of rural hospital areas have proven that it is very close to the truth. So it is written to Dear Ann -- you know -- Ann Landers in the Tribune and was written February 3rd, and here's one of the em ployees write: "Dear Ann Landers: I am em ployed in the kitchen of a government institution and there is so much monkey business going on that I can't keep still any longer. This is not a special institution. I have worked in institutions elsewhere and it's the same.

I've seen institution employees eat gift food which was sent to patients and then deny they saw the package. I have watched employees take home roasts, chicken, cans of coffee and jars of fruit -- trays of crackers are hidden in the oven because no one wants to count them out -- quarts of hot coffee, platters of. crisp bacon and eggs, bowls of butter and stacks of bread disappear into em ployees' dressing rooms. When the Board of Directors and visitors come they are served filet mignon and fresh strawberry shortcake , then they go home and tell everyone the food is great.

No one ever pops in unexpected ly to see what is really going on. Don't tell me to report it, I tried this once and I was laid off the following week. Something must be done from the top. God help the taxpayers." Now, Mr. Chairman, the answer to this: "Dear Friend, I consider your letter a public service. I am sure many institutions need cleaning up and such complaints as yours can help trigger action. A badly run institution is an outrage in a country as well off as ours . It would be unfair, however, to accuse all institutions of waste, incompetence and negligence.

You said no one ever pops in to see what is really going on. In Ohio last year many newspapers printed a page one picture of Governor DiSalle, just after a surprise visit to a mental hospital -- what he saw had made him ill. Ohio State Institution under Governor DiSalle has been vastly improved; most of this continent's institutions still have a long way to go." In other words it seems to be funny, and it's out of proportion, but it possibly has a lot of merit and it has been brought to my attention through the rural area where I have attended. However, Mr.

Speaker, I leave to the Minister to decide when he pops up on the shortcake. In conclusion, I want to make one more short quotation on the over-all health scheme, and this is October 20th, 196 1, Free Press by Dr. Simon Btesh: "Health plan inevitable. Some form of medical care plan will eventually be in force in every country in the world" , says Dr. Simon Btesh·of the World Health Organization. Dr.

Btesh, on a tour of Canada following a world health conference in Los Angeles, praised Saskatchewan's recently established health plan saying it had potentiality of building something very good for the people of the province, like Breat Britain. He predicted the province's plan will eventually work ln a way sim ilar to Page 75 6 March 15th, 1962

(Mr. Wagner, cont•d.) ••••• that in effect in Britain which he says has definitely proved itself. He belit tled the contentions of opponents that prepaid medical care destroys the incentive of doctors and lowers medical standards. There are always adjustments to be made when a plan is instituted he said, but once the people and the doctors adjust to it, it works very well. Now, Mr. Chairman, I am looking forward that this government shall influence the Federal Govern ment by stating that we should go into an over-all health scheme in Canada. MR. CHAIRMAN: Resolution 48 - passed.

Resolution 49, Health Divisi on (1) -- MR. JOHNSON (Gimli): Mr. C hairman, I don't want to hold up these estimates, but I should answer the questions of the honourable members to date, or some of them, if I can. I certainly appreciate all the kind words about our staff and the department as a whole , and I do appreciate the criticism of the Honourable Member from St. John's who is very concerned in the area of mental health .

First of all I do feel that the Honourable Member from Neepawa -- I can assure him that we will have a physician or medical director in hi s unit, I think either today or tomorrow -- I believe it's any day now -- to get on in that very large area. I was particularly heartened by the report of the adv isory meeting of the Neepawa Health Unit Board which met recently; a very enthusiastic and very excellent health unit board. I just want to briefly refer to a few mat ters here.

The Honourable Member from Neepawa has touched on a few points which I have dealt wi th at previous sessions and continues to be a matter of continuing interest to himself, and I'm sure conviction re the use of deterrents in hospitalization and so on. As you know we made a very detailed study of this at the time of the 61-63 estimates and I also have read the comments that preceded the introduction of this Act wi th respect to the use of a deterrent.

The deterrent either has to be of such an amount that it is a real deterrent financially, or it has to be -- if it's just a token amount as a deterrent, it really , I don't think, is a deterrent. A deter rent in itself as you would call it, isn't going to reduce over-a ll costs. One thing you have to continue to bear in mind is that the hospital costs are fixed. Once you build that bed the hospi tal's there for the next 50 years, it has to be staffed, it has to be occupied, or it has to be operated. Your costs are fixed.

The only rea:l control on hospital costs in the world today is going to be the number of beds you build and staff. This is really the only effective deterrent. I think we can, on one side of the coin, be accused of penalizing those who really become ill, and after all, I belleve in some form of local responsibilit y and deterrent in respect to services, I think we all have some compassion in that area; but when a patient's admitted to hospital we all have a moral and legal obligation to see that the high cost acute hospital bed is properly utilized.

The deterrent in one sense is not a money maker if you make it too stiff you are really putting a deterrent against those who are going to use the hospitals the most and probably need the help the most. I would continue to remind the honourable member that on the Royal Commission on Health I think we spel led out very clearly that we felt that the federal government should be sharing in ,interest and capitll;l and depreciation of buildin gs, besides the operating. They certainly are only contributing around 36% when you rule out mental and TB and the present formula.

We also made a pitch in that brief for increased hospital construction grants or a continuing survey of hospital trends and costs , because $2 ,0 00 a bed is not a very realistic figure in acute hospital construction today. I think that one thing we must continue to remember too, is under the present scheme in rural areas our surveys have shown that wi th a dynamic program as we pla n to and hope to develo p staff and the rehabil itation concept, the figures are changing across Canada and ever ywhere almost daily , or these days, on just how many chronic beds do you need in a community.

Ontario are talking about one per thousand. Dr. Wlllard has intimated possibly 1. 5 is an ideal that we should aim for. Britain, I think, is 1. 4 per bed. I think we all agree that these beds should be built in the future adjacent to acute general hospital s so we don't duplicate expensive facilities that may be required. We can build these beds much more cheaply and serve their proper function. I think then that we have a pattern laid down.

I also think it's been our philosophy that if a patient is sick and under the plan and is insured that their costs should be paid in full wi thout the deterrent in view of the premium charge, and I do feel that we also feel that below the plan, below the need for acute medical and nursing care, that our proper role as a government is to meet the needs of those who need help and outside of the hospital . I think there's a great need for the community to be concerned about its aged with respect to March 15th, 1962 Page 757

(Mr. Johnson (Glmll), cont1d. ) •••.. housing and hospital accom modation. The commu nity can measure this much better than we can. However, we 're going to continue to review these mat ters continuously and certainly we have to remain flexible. With respect to reimbursing those who don't use the plan -- you mention the fact that in crop insurance and other insurance areas for non-use we get a refund. I don't know, I think the Canadians have said as hos pital costs rose and we held our. breath that in this area we must pool resources . We must also reallze hospital costs, as I mentioned earlier, are fixed costs.

Pooling resources is very necessary, and if we are going to be giving rebates I think we'd be penalizing certain age groups if this was the way we were going to do it, because the average person over 70 receives 16 days of care a year on an average and our latest figures -- benefits rather from the Hospital plan; and the younger, healthier person rece ives 7. 5 days of care.

I think we must realize too; that half of the cost of the Hospital Plan which is paid by the federal authorities , or 47% now excluding mental and TB, and 36% including mental and TB, and our cost is raised by federal monies from the Federal Treasury. The point I'm trying to make is that I don't think it's realistic to try and develop into this type of -- it's really not an insurance scheme, it's a Manitoba Hospital Services scheme more than it is an insurance scheme, and I don't know how you would divide this up. Re third party liability.

I didn't get the honourable member's point there but I would be -- any problems in that area I think our legislation is pretty clear cut. I'd llke to discuss that matter with him. I appreciate the remarks of the Honourable Member for Burrows. He, I think, certainly re iterated the stand taken by this administration to the Royal Commiss ion. We mentioned also the Geriatric Centre which in these estimates that are before you we're hoping to develop such a teaching centre adjacent to one of the acute hospitals, as the report indicates.

I don't think Saskatchewan's that far ahead of us in our Sabin program,' I think we work pretty closely with the federal government and the other provinces in the development and testing of this vacine with our virus laboratory. I com mend Saskatchewan for sneaking in there first with the first order for 900, 000 doses; but I think we sort of hoped that it would be available across Canada all at once, and I think it probably should have been that way. However, we're going to be hav• ing observers out there during the first testing and be working with them to a degree, I hope.

In the Northern Health Services you asked why the salaries are down. This was because one of the staff was moved into the central office in Winnipeg, a health educator, which re moved about $7, 000 from that budget. Otherwise most of those salaries have been increased in the past year. Dental services. Well, we certainly know of the need in this area. We hope that the lS students , is it, that graduate this year will find their way and begin to tackle this problem.

I think lt's much like the annual report that we've pubHshed again and as we stated in the Royal Commissi on, I don't think we or any other province in Canada are very proud of the availability of dental service . There's a great need in this area. The Honourable Member from St. John's is certainly true in stating that public mental ill ness is certainly the greatest single problem facing Canada today. I would like to make it abun dantly clear to my honourable friend, however, that we have not got our heads in the sand.

This is a constant source of worry to the department, the heavy load being carried by a few in our large institutions. However, when you talk of bursaries for graduate doctors , I don't know of a province in. Canada who have the funds available for training in psychiatry than we have within the province. I think on graduation any young physician who wishes to pursue a career in psy chiatry gets between six and seven thousand dollars a year the first year, $7 , 600 the second year, up to close to 96 in the third and fourth year.

We ask for at least one of those years be spent in a provincial instltutlon, the others in teaching hospitals, the Children'S or the General, or they can go away for a year and we provide bursaries equal to the pay. My advisors tell me that this is as generous as we have to be in order to attract. Certainly I think the challenge to a physician is partly the pay, but I think also partly the concept. Where is the province going? Is this a challenge to me to get into that province and practice. And I hope and pray that we will get more enthusiasm from our newer graduates.

We can look for little help from Britain from now on for new graduates. 50% of their interns are from other parts of the world today. We're going to, as we said last year, start, we have eight or ten in training at the moment. Page 758 March 15th, 1962

(Mr. Johnson (Glmll) , cont'd. ) •.••• In Winnipeg we do have four qualified psychiatrists at the psychopathic hospital, two in Selkirk, two in Portage, two in Brandon. Three are just eligible for writing their certification now in Brandon, one in Selkirk and another certified man in general work at Selkirk. We have a staff of five in our community mental health program for a total of 31 staffed there now, three psychologists in the mental health program, six other junior medical offi cers and five psychia tric boys, nine social workers in that program -w e're adding seven more this year.

I think we are making a start in community mental health. I don't think it's entirely as black as the Honourable Member from St. John's has said. l'm.v ery happy to hear that other provinces are beginning to get some psychiatrists. I would point out to him that in the past y

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Collection	Manitoba — Debates (Hansard)
Citation	26-5-30
Type	hansard
Volume / chapter	26th 5th hansardpdf 30.pdf
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	231bda2ddb3c2db89333e3f7293edcf959593157

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