Manitoba Hansard — Sitting 91 (30th Legislature, 2nd Session)

30-2-91

Manitoba — Debates (Hansard)

THE LEGISLATIVE ASSEMBLY OF MANITOBA 8:00 o'clock, Tuesday , May 20 , 1975 COMMITTEE OF SUP PL Y - DEPARTMENT OF HEALTH AND SOCIAL DEVELOPMENT MR . CHAIRMAN: Resolution 56(h) (3). The Honourable Minister of Health. 27 75 MR . DESJARDINS: Mr.

Chairman, first of all I might say that we hav·e an agreement, I think with all the parties, that we will finish this Resolution 2 on Pa ge 24 , 2(h) (3), and then we will skip to Page 26, No . 4, Inter-Regional Operations Division; and the intent is to try to finish this tonight, and also then move to No. 5, Corrective Services and finish with the Minister there if at all possible tonight. I think that that was the intention. And No . 3, Community Operations Division, this would definitely not be started today.

I had taken notice of one question, also.that I couldn't give the answer on Friday, and unfortunately I don't remember the member that asked me the question. But details were requested on the cost of Manitoba Drug Standards and Therapeutic Committee . That was on Resolution No . 56 , No . 2(d)(2) , and it includes a provision of 8, 600 for fees paid to committee members, and the total cost including printing and .. . areas, travel expense, office cost , advertising, etc ., is estimated for 1975 -76 to a total of 43 , 500 . And, Mr .

Chairman, I think we were nearly finished with (h)(3), but I wou1d want to say something - it was at the hour of 4:30 - the Leader of the Opposition who unfortunately had to be away today, was commenting on that . And I was quite surprised of course - I realized that it wasn't bad strategy at all, it was 4:30 on a fairly uneventful Friday, and itwas pretty good for coverage on Saturday. But I wonder - I think I must ask this question.

The honourable member was chastising the members of the government and the Minister responsible on a special project that he felt had been very successful and that we should have this all across the province; and that is lunch for preschoolers. I think it's fair enough for the Leader of the Opposition to make such a statement, but I think it's also fair for me to try to find out if this is policy of the opposition.

Because I've heard from the Member from Pe mbina, not too long ago, and the Member for Swan River I think, who spoke in this House earlier in the estimates of another department , who felt that this was not something that was acceptable to the party. And I think they also oppose a resolution of the Honourable Member from Fort Rouge. So I doubt very much if the - mind you, it 's certainly the right of the Leader of the Opposition to speak for his party, but again I can't help but wonder out loud if this is actually something that is approved by the members of the opposition.

I think this would be something that if at all pos sible I '<l like to know, because that is a pilot project that we will consider very seriously next year. It hasn't been dropped, but we might increase,and I'm cer tainly interested in any constructive criticism that we could have or support that we might have . Mr . Speaker , as far as I'm concerned, unless there's other questions, this deals with this number . MR . CHAIRMAN: The Honourable Member for Brandon West. MR . McGILL: Mr . Chairman, I think the Minister was endeavouring to deal with some questions which he took as notice at the last session.

There was one I believe the Leader of the Opposition presented to you, and it was in connection with Manitoba 's parentology death rate . He wanted to know when we were discussing vital statistics how our death rate in that area compared with other provinces in Canada and with other countries . I think the Minister stated at the time that the request was made that he would have to get that information. I'm wondering if he has that now? MR. DESJARDINS: I'll have to take it as notice again. I misunderstood this question.

I thought that the Leader of the Opposition was giving us an example and I thought he was satis fied when I told him that we would give him the latest report that we had on vital statistics. I thought this is what he wanted, he was using that as an example to see if there was nine people involved in compiling this vital statistics, what they were occupied in doing. And then also we mentioned that we could touch this, we could talk about that when we looked at the Public Health a little later on. I think you yourself asked a question in that respect for preventive care also.

We suggested that that could be taken in 3. Community Operation Divisions when we dealt with that . But if the honourable member, Mr. Speaker, wants to make this a specific question , would it be satisfactory to him if we had this information when we dealt with Public Works later on. Fine? Thank you.

277 6 May 20, 197 5 SUPPLY - HEALTH MR. CHAIRMAN: Resolution 56 . (h)(3). The Honourable Member for Swan River . MR. JAMES H. BILTON (Swan River): The Minister a few moments ago chose to men- . tion my name with regard to a stand which I took in reference to free. meals and lunches for children . And as is customary with the Minister, he coupled me with my leader - he coupled me with my leader in so much as that he's given the impres sion that there is a difference of opinion . Well I want to assure him, there is a difference of opinion. We in this party are free thinkers, and it has always been so.

And when I commented on this subject in the past, I said that I had no objection to meals and lunches for those children whose parents could not afford to pay for it. But I object, and I object wholeheartedly, to those people sending their children to school and expecting them to have a meal on the state. I think they are shirking their res ponsibilities, Mr. Minister; and you are encouraging them to do so . --(Interjection)--Could we leave our leader out of it for the moment ?- -(Interjection)--I'm telling you that it is my opinion, and Pm entitled to my opinion regardless of how my leader thinks.

This is exactly the way I feel about it. And you're creating, as this government is prone to do, a differential between the people of rural Manitoba and the people of the City of Winnipeg . The people on the street in Sw;m River cannot understand the thinking ofthe government that would open these meal kitchens, because that's all that they're going to become . Why one group of children should have this favour from the public purse as opposed to another, I will never understand. · When in the beginning, Mr. Chairman, this is not neces sary . In my humble opinion, it is the parents' responsibility.

They brought these children into this world and it's for them to find the ways and means to provide for them - and certainly with food. Clothing, you could question, but food .. . And any parent that turns their children out in the morning expecting them to be fed at the local school, is beyond my comprehension, in this province where supposedly we have plenty. · MR. DES JARDINS : Mr. Chairman, I wonder if I could ask a question? MR. BILTON: When I'm finished. MR, DESJARDINS: Well, I' ll speak on a point of order then, Mr . Chairman. MR. BILTON: You haven't got a point of order . MR. CHAIRMA N: Order please . MR.

DES JARDINS : You are no longer .. . MR. CHAIRMA N: Order please. Order please . ORDER PLEASE! Will the Honourable Minister state his point of order . MR. DESJARDINS: My point of order is that my honourable friend is making the same speech as he made on April 7th, which is--(Interjection)--it's his business, right, but it is something under the Minister of Education. --(Interjection)--Well it is . It is under the . . . it's the $200, OOO that he's talking about, the Northern Manitoba Milk Program, which he made the speech under the Minister of Education. MR. BILTON: Is that a point of order, Mr . Chairman? MR.

DESJARDINS : Certainly, if you ... MR. CHAIRMAN: It is, because we 're on Special Projects and Research Support Funds . 56(h)(3) . The Honourable Member for Swan River . MR. BILTON: Mr. Speaker, I' d have been reluctant to rise, but the Minister mentioned my name and he mentioned ,a subject, and surely I have that privilege of speaking to that par ticular comment. And if I choose to repeat what I said a few days ago, that's my privilege . --(Interjection)--It certainly is . When did you become the ruler of this House? MR. CHAIRMAN: ORDER!! We are now getting a conversation between two members.

Address the remarks to the Chair, please . The Honourable Member for Swan River . MR. BILTON: Thank you, Mr . Chairman. I' ve about said all I want to say, other than I' m disappointed that we should be moving into this field of endeavour . I feel in this day and age, and particularly in this province, with money that is being spent in so many ways, that we don't have to get down to that field of endeavour where we have to feed the school children and put up money out of the taxpayer 's pocket. I still feel, Mr.

Chairman, that the parents have a responsibility, and any parent that turns its child out in the morning expecting that child to be fed - not altogether sure, but expecting that child to be fed in a public kitchen, is beyond my comprehension, and I .. . MR. CHAIRMAN: ORDER!! ORDER!! The Honourable Minister. MR. DESJARDINS : Mr. Chairman, we reached an agreement that we would go line by

May 20, 1975 2777 SUP PL Y - HEALTH (MR. DESJARDINS cont'd) ..... line - I certainly wasn't trying to insult my honourable friend. I asked him a question . . . MR. CHAIRMAN: ORDER!! MR. DESJARDINS: ... on lunch and after school - these are preschoolers - and he's repeating and he 's debating again a program that is not even in my estimates, Mr . Chairman . --(Interj ection)--That's right . And if I may then, I'll tell you - I'll tell you - if you'll just shut up for one minute , I'll tell you why I'm entering in it . Mr .

Chairman, on Friday, we were dealing with pilot projects, and we were talking about the lunch and after school centres . This project is part of the early childhood development thrust· , demonstration grants were made in '73 and '74 to three centres, Fort Rouge Child Care Program Board , Westminster Children's Care Centre and Windsor Park Children's Centre . We spent in 1974- 75 , $32,000; and we have 1975-76, $52 , 000 . The Leader of the Opposition made quite a lengthy speech on that , and he chastised this government because he felt that this should be a province-wide program , that is the preschool program .

And the only thing I did this morning, I asked him on Friday, if this was the policy of the opposition, of hi s party. He told me that he was speaking as the leader of this party. I was looking at Hansard, I saw the general principle what my honourable friend said at the time on another program . I also know the feelings of my friend from Pe mbina and others, and all I iisk, all I ask is if actually the members of the Conservative Pa rty agreed with their leader.

They didn't have to give me an answer, but they did give me an answer, and I got an answer today, where the Leader of the Opposition is saying, you should look at your priorities, you should priorize and so on, and this is something that should be province-wide, and one of the members and others are saying they don't agree with it , this is all . MR . CHAIRMAN: The Honourable Member for Riel. MR . CRAIK: Mr .

Chairman, the amount mentioned here by the Minister in, you know, three programs, $52, OOO, out of a total program of $30 8 million for his whole department, in the three lunch and after shhool programs he 's referring to . --(Interjection)--If I gather your remarks correctly, the three programs you referred to of lunch and after school programs, Fort Rouge , Westminster and one other one, amount to $52, OOO of your total estimates .

And it seems to me that whether you're for or against it, these programs aren't government pro grams anyway, they're programs run by three different, I think in this case , church groups - at least the Fort Rouge one is , Westminster is, and the third one probably is as well. And what it is is a subsidy program to help them operate their lunch and after school programs.

And I have to tell you that having been involved in one of those, the one in Fort Rouge and it 's establishment many years ago , that it is a very worthwhile program; it's not a pre school program, it's a lunch and after school program , it's for school age children, children that go to school where they have a working Mother in most cases - maybe there's some pre school get there - but primarily it's aimed at children that go to school and haven't got a Mother at home at lunchtime. They go to the church basement, they get a hot meal and they get looked after for that hour or so at lunchtime.

They come back after school till the Mother gets home from work that evening or at 5 o'clock, and they can hang around, at least they're under care until the Mother gets home from work . They're very worthwhile programs, they're excellent programs. This is not a case of a state run program , it's a case, these pilot pro jects as I understand it , of subsidizing the programs that have been started by private groups to satisfy a particular need in a particular community.

Somehow we 're getting this thing all off course here, because that's all this is, it's a very small program , a very worthwhile program started by private interests, who have found that they can't hack it alone, and between the three of them they're asking for , apparently receiving $52 , OOO .

Now how we 're rolling this into a philosophical debate is more than I can figure out, because that 's exactly what this program is; the lunch and after school program is simply a small program that's been running for many years, under-financed in most cases, and in the total picture of $308 million of budget, amounting to $52 , OOO, isn't a drop in the ocean. You know, I don't even know why we 're even discussing it, really .

I just trust that you're going to carry on supporting it to the extent that it subsidizes an effort by a private group that have recognized a concern, but like all church groups of all denominations .. are hard-pressed for funds and are looking for a little bit of government support to help them out . MR . CHAIRMAN: The Honourable Minister of Health.

2778 May 20, 1975 SUPPLY - HEA LTH MR . DES JARDINS: Mr. Speaker, I would say that it is more than that. Certainly it was initiated by these groups, but it was considered a pilot project to see if it would be done all '3.cross the province . What my honourable friend is saying is absolutely right, and I felt the same as he does now, when his leader chose to make quite a speech at this time and felt that it should be something that the province should establish all across the province, and at the time MR . BILTON : But not in Swan River. MR. DE SJARDINS: Not in Swan River or in Pembina .

And he chastised the government for this, he felt that it should be our policy to have it across all the province. And we stated at this time that that came in in the year - well it didn't come in, it came in before - but this year we have the day care and then we chose to go further in day care because of participation, cost sharing from the Federal Government. The statement that I made today was only an answer of the Leader of the Con servative Party, the Op po sition, on Friday. He's the one that made a big point out of this . MR . CHAIRMAN: The Member for Rhineland. MR .

ARNOL D BROWN (Rhineland) : Thank you, Mr. Chairman. I can't recall whether the question was asked why we spent $1 , 508, 800 on research last year and we're spending $816 , 600 this year. --(Interjection)--Did you answer that one? Then I'm wondering, Mr. Chairman, I don't know if the Minister would want to deal with it over here or maybe want to deal with this under Public Health, is, what is the government doing to prevent mental retardation . Most of the retardation cases occur during childbirth. Now is the government doing anything at all?

Is any research being done in this area, where no doubt, much can be done? MR . DE SJARDINS : I ask my honourable friend, if he could wait until we pass this item and then we 'll be dealing with that. We're still under (h)(3) - 2(h)(3) ; and then we 'll go to Page 26 and then you will cover that there. Okay? I'll tell you why in a few minutes . MR . CHAIRMAN: Resolution 56, (h)(3)-- the Honourable Member for Riel . MR. CRAIK: Mr.

Chairman, before this item gets lost in the shuffle, the Lunch :>nd After School Program, I can suggest to the Minister just from my limited experience in this thing, that the Lunch and After School Program has a pretty sound basis of logic because you can add it up . But these programs that are aimed - the other programs - under the Department of Education which he suggests is out of order here because it 's not in his area of jurisdiction - the programs that come under the Department of Education for Diet Supplem entation within the school itself, including the breakfasts is a little different matter.

You can mount a very strong rationalization for lunch and after school programs . It's a little more difficult for someone to mount a hard argument for the other programs, the Breakfast Programs and the Diet Supple ment Programs within the schools themselves. I don't think you can divorce the two, they're intertwined.

I think when it comes down to Cabinet decision as to where the dollars go, even though there's very few dollars involved here, .the Lunch and After School Program is a much more logical program than getting into the expenditures of large numbers of dollars - dollars which I think exceed by far that going to the Lunch and After School Program . I think that ought to be taken into consideration, because the debate is getting off track here in talking about one thing and meaning another. You can't really divorce the two, you have to look at the two of them together.

I trust that this program that we 're talking about here specifically, which is operated for people where the parent is working and the child has no alternative but to go to a friend or a relative at lunchtime and after school until the working parent gets home, makes a lot of sense. The case where the child can't get a breakfast is a little harder to rationalize, and a program where the child is not getting milk and other diet nutrition requirements is again harder to rationalize. There is a case for the parent being educated.

Now the second case which is a lunch and after school program where the parent - usually a single parent - is working because of financial requirements, is an entirely different matter. The first cases, the Nutrition Program and the Breakfast Programs are just simply, in most cases, now I put the qualifier "most ca ses," are cases where the children are probably suffering because of reasons other than the fact that the parents are having to work .

It's a case of neglect, and in those cases the parents should be gotten to by the social workers or through government advertising or through social pressures: rather than relieving the pressure

May 20, 197 5 27 79 SUPPL Y - HEALTH (MR . CRAIK cont'd) .. ... to look after their children in.those cases, they should be, you know, receiving the brunt of social pressures to start looking after their children. That's not the case in lunch and after school programs . That is financial, economic necessity. MR. CHAIRMAN: The Honourable Minister of Health. MR . DESJARDINS: I must remind my honourable friend that this is not only a meal after school. This is during the lunchhour also, a nd this is not only school-age children, there's less of those, it mostly is preschool children .

I think that we agreed pretty well to see the importance of this progr am , this is what we said on Friday, and I don't know why all this commotion. I wanted to know how the opposition felt, if it was just a member speaking for himself or others. I think I've got my answer on that. We could leave that aside now, it's no use prolonging that . But I'd like to tell my honour able friend that a lot of this work, some of the concern that he has now, when we really get this day care program going, this will be taken care of under Day Care Pr ogram I hope.

But you have a program now who are dealing with preschoolers and some children of school age, and that is not only after school when the parent isn't there, it is during the lunch hour also. So to a certain point it does resemble the breakfast or any other meals in the other department. MR . CHAIRMAN: The Honourable Member for Riel. MR . CRAIK: Yes, Mr . Chairman.

Now that the Minister knows how the Opposition feels we'd like to know how the government feels, because they're the fellows that are doling out the bucks , and $52 , OOO on these programs, Lunch and After School Programs he mentioned is pretty, you know, it's pretty picayune compared tot he argument that 's taking place around it . And if that 's an idea of what the government's opinion is of it, it's not all that healthy looking. MR. DESJARDINS: The government agreed, Mr . Chairman, to look at priorities .

We think that a lot of what we were trying to do , what was meant to be done under this , can now be done under the Day Care Pr ogram , and my honourable friend must know the Day Care Prog ram there's a formula of cost -share with the Federal Government. This is som ething that - it'll be a question of priorities - I'm not saying it's certainly not the first priority right now because Day Care will be our first priority. But it is something that is approved, right now, there has been - I must be honest with my honourable friend - there has been a freeze on that .

There's only these three; there's no new ones on that . We are trying to do this through the Day Care Pro gram and if a day care program can solve the problems that we have , it might be that we won't go ahead with this program . MR . CHAIRMAN: The Honourable Member for Swan River . MR . BILTON: Mr .

Chairman, I thank the Honourable Member for Riel for bringing out the points that were rather important and the points that were causing me a problem, and I regret very much that I caused that confrontation, but the Minister always has a tendency to get me to rise to the bait anyway and now he knows exactly what I was driving at, and I still feel that way; that parents that will turn out youngsters in the morning expecting the state to provide them breakfast , should be damn well ashamed of themselves . MR . CHAIRMAN: Resolution 56(h)(3) -passed.

RESOLVED that there be granted to Her Majesty a sum not exceeding $4 , 091, 100 . (Pas sed) I refer honourable members to Page 26 of their Estimates Book . MR . DESJARDINS: Mr . Chairman, I wonder if it would be helpful to my honourable friend who requested last Friday that I give him a couple of sentences and so on to see what the item will be to facilitate his ... We are dealing now with 4. Inter-Regional Operations Division (a) . And (

a) is provision of overall direction and Management of Division, and provision of profes sional training bursaries. That is the salaries, of course , at the time, the ADM and his central office . I think that we mentioned we have the same staff-man-years we had last year. It's nine on that. Then (2) is Other Expenditures that keep the place going; and

(3) Profes sional Training. That is for the psychiatric nurses, the bursaries for the nurses. I know that we 'll go individually in (a) (

b) and (c) , yes, or (1) (2) and (3) , but I thought I'd give you this information. MR . CHAIRMAN: The Honourable Member for Rhineland . MR. BROWN: I wonder, Mr . Chairman, whether the Minister could tell us just exactly what are the duties and responsibilities of the people employed in this department under (a)(l).

2780 May 20, 1975 SUPPLY - HEAL TH MR . DESJ ARDINS: This is Dr. Tavener, who is now the Chief Medical Consultant, and some of his staff and the people that are looking after Mental Health and Mental Retardates, and the training of nurses, the schools are in Selkirk and Brandon, and all that. This is just the bursary. The rest is paid through the hospital . MR . CHAIRMAN: Resolution 58(a) (!) -passed. (2) -passed . (3) -pass? The Honourable Member for Rhineland . MR . BROWN: I wonder if the Minister could tell us how many psychiatric nurses we have in Manitoba at the present time .

I wonder how many licensed psychiatrists are employed by the Provincial Government . I would like to know what is the ratio per patient and what is the recommended ratio, and what are they doing to improve this ratio? I would like to know how many licensed psychiatrists have been hired in the past year and how many have been hired in the past four years. It seems to me that there is a tremendous shortage of staff. --(Inter jection) --This is only nurses? Okay . And then if you could tell me where we could go under the other. MR . DE SJARDINS: The nurses - there's approximately 1, 200 psychiatric nurses.

Under this program there were 87 that graduated last year; there was another 80 that started their first year last year - approximately 80 . We expect this year to graduate between 65 and 70 and we' ll start another 80 on this program. I think it's the next item , isn't it? -y es, the next item will deal with Brandon and Selkirk and psychiatrists and the questions that you asked. MR . BROWN: I wonder if the Minister could tell me , in the psychiatric nurses, how many ... MR. CH AIRMAN: Order ... oh. MR. DESJ ARDINS: No , it 's all right. MR.

BROWN: ... how many nurses are required in Manitoba to carry out the program, or what is the ratio - the recommended ratio - for how many nurses per 1, OOO people or so on . MR . DESJ ARDINS: I'm informed that there is no shortage of psychiatric nurses, that we 're keeping abreast approximately with what we have. I think that we provide about four hours of care from the nurses per patient per day. MR. CHAIRMAN: 58(a) (3)-pas sed; 3-passed. 58(b) (1 )- pass? MR.

BROWN: Under this item under (b)(l) , I would like to know how many licensed psy chiatrists are employed by the Provincial Government at the present time, and what is the ratio per p atient . What is the recommended ratio and what are they doing to improve this ratio? And how many licensed psychiatrists have been hired in the past year and how many in the last four years? MR. DESJ ARDINS: This is something that we 'll have to take as notice and we'll try to give you this tonight. At this time I can't give you all the staff . I can give you the complete staff in Brandon.

For instance , in Salarie s, in which you have the $12 million and so on , that is not only psychiatrists, this is all people that are in the Brandon Mental Health Centre, in the Selkirk Mental Health Centre, the Winnipeg Psychiatric Institute, the Eden Mental Health Centre, and those for Forensic Services, Community Services for Children and Services to the Central Region. The complete staff-man-years was 1, 340 last year. It is now 1, 319 . The reduction on this was in Selkirk. The laundry now is a private corporation - the people are no longer mem bers of the hospital staff. MR .

BROWN: I wonder if the Minister could tell me how many geriatric patient s there are in mental hospitals in Brandon and in Selkirk at the present time . MR. DESJ ARDINS: Approximately 400 in Brandon and 200 in Selkirk, and this is some thing that the department is looking at . It might be that, especially at Selkirk, we can take a whole building and we hope turn it into a geriatric hospital for these people , and if the Federal Government later on decide to include geriatric hospitals in cost-sharing, well then we would be in line for that.

And more of these people are - I think that my honourable friends know the policy of the government - more of these people will be - we want to decentralize these patients as much as pos sible, so a day might come where we 'll have more of those people who will be in their area instead of sending them all to Brandon and Selkirk and so on . And this is being done now . I think that we could reduce the population of Selkirk from 1, 200 to 400, and Brandon is being reduced by - I don't know exactly. Well , in 1970 the population in Brandon

May 20, 197 5 2781 SUPPLY - HEALTH (MR . DE SJARDINS cont 'd) .. ... was 82 1; in 19 71, 780; 1972 it was 69 1; 173 , 614; and '74, 600; and we hope that there will be more in that trend. Selkirk, from 690 , 605 , 463 , 383 and 351. And Eden, 39, 39 , 34, 30 and 33 . I think that gives my friend an idea of what we 're trying to do . We 're trying to decentralize and have these people back in their own community. MR . CHAIRMAN: The Honourable Member for Br andon West . MR . McGILL: Yes . Mr.

Chai rman , about two weeks ago I as ked a question of the Minister during the question period , and the question was, as I recall, how many licensed or accre dited ps ychiatrists are on staff at Bran don Mental Health Ce ntre , and the Minister took the question as notice at that time . Now I think there have been some questions just asked about the number of ps ychiatrists and I would expect that the Minister has probably done some re search on that matter . I think there is a problem at Br andon and that was the rea son that the question was as ked .

I' m wondering how many there are at prese nt on staff there, and what the establi shment calls for in terms of licensed ps ychiatris ts, and I would like him to compare this situation with Selk irk, if he could , as to whether they have the same staffing problem as Br andon apparently has. MR . DE SJARDINS: No , I think we don't really have a problem in Selkirk. We have six psychiatrist s, two trained , and a total staff of 19; and in Bran don we have only the one psy chiatrist; two are trained but have not passed their last - or six, I should say , and a total staff of 15 .

As I mentioned at that time, I think that I told my honourable friend that we weren't satisfied , we didn't have all the staff and we were trying to recruit. And I will give him , espec ially in Brandon, those 19 position s. There was an MO IV, one , filled by a Medical Director . There was the MO III - there are 4 staff man -y ears approved , 2 are filled, 2 are vacant , so we must try to rec ruit for them .

The MO II, 14 - 6 filled by MO II's, 2 filled by an MO I, 1 filled by an MO I employed part-time two days per week, 2 filled by career re sident s training at Health Scien ces Centre , 1 filled by an MO II now working at Manitoba School for Retarda tes, 2 vacant . So that means 11 filled and giving full-time servic e, 1 filled and giving part-time serv ice, 3 filled but giving no servic e, and 4 vacant . MR . McGILL: Mr . Chairman , I think I understood the Mini ster to say that they have at Br andon one fully accredited psychia trist . MR. DESJ ARDINS: Right. MR .

McGILL : What does the establi shment call for at Brandon? MR . DESJ ARDINS: Well I think that we would like to have, well at least the MO IV, that posi tion is filled by the Medical Direct or , and the MO Ill, so they have four vacancies. If we can get four , we could use those four as psychiatrists and we would hope that the increase in salary that they have , if that was one of the reasons - because I think they rec eived quite an increase - and also the rec ruiting that we are doing now , we hope that we will be able to fill these four vacanc ie s, but that's all I can tell my honourable friend at this time.

MR . McGILL: Well, Mr . Chairman, I gather then that the Minister is saying that what is apparently a chronic problem at Br andon as compared to some ... MR . DESJ ARDINS: Not only at Brandon. MR . Mc GILL: Bra ndon has had a greater deficiency in the number of fully accr edited psy chiatri sts than has Selkirk, and there must be a reason for that. Now the Minister is saying that it 's because the salary scale offered was not sufficient to attract them , but it appears to be attracting almost a full establi shment at Selkirk but not at Brandon.

I wonder , how long has this condition existed at Br andon , and what is the reas on for it , if it is not a salary prob lem ? The last time we talked about this in the House, I believe there were some questions asked , and I got the impres sion from the Mini ster that he really had no concerns about this because there were advert ise ment s being run in papers and that there were many applications coming in for these positio ns , but they appear to be chronically unfilled. Now there must be a reason for this . I'd like to hear from the Minister . MR .

DESJ ARDINS: The impres sion that I was not concerned , this is wrong and this is not what I wanted to give. I did state that we had , in the application we put in , we had 30 people that applied , but we know that some of them wouldn't qualify and I think this is being processed now . I don't know what the latest is on that. I' m not saying either that it was because it was of salaries that we couldn't get them; I made the statement that the increase - this was stated by some of the doctors themselves - that if the increase was the reason , well then we should have some results fairly soon.

I think that it has been more difficult for people

2782 May 20, 1975 SUPPLY - HEAL TH (MR . DES JARDINS cont 'd) .... . to leave Winnipeg> psychiatrists to leave Winnipeg, and I think that my honourable friend knows that some of them that were working for the government ar e now in private business in Brandon also . I also stated that the population of Brandon was decreasing. I don't want to give the impression then that we will have enough psychiatrists because they will have to take care - if they don't stay in Brandon, they will have to go with the patients and so on .

So we are definitely in need of psychiatrists and we 're going to do every thing we can to get them, but it has been very difficult over the years to get people, especially outside of Winnipeg, to get enough psychiatrists to start with, because those people in private business have got a pretty good thing. They don't look after the difficult cases; they send those to Selkirk and Brandon and so on, and we hope to change that. We hope that they will take more of a lead to take care of the patients in the community also. But I will not mislead my honourable friend. We need more psychiatrists.

We'll do everything we can to get them . And I would hope, I said that I would hope that the increase might be a factor - some people have stated that.that was one of the reasons why we couldn't attract them . Well now, there's been quite an increase . And then of course there are some people who are . . . We don't want to give the impression that we 're not doing anything either. We have three men that will graduate come July. I don't know if they'll want to go to Brandon, but there are three of them that we' ve been giving a bursary to, and there's another six who've been receiving a bursary.

Now these are the ones that are working in the ho spital .

They're paid by the hospital the same as any other - they call them, not internes any more, but residents - and six of them are being trained, and we say to them, if you want to train - because it is difficult to get psychiatrists - we will guarantee you to pay you the difference, which was then, before this contract was negotiated, the difference between what you're getting as a resi dent in the hospital and the minimum of an MO I, which would be another ten times $11, OOO that the government pay these people just in order to have them stay with us when they graduate . So there' ll be three come July.

We have no reason to believe that they will default on their arrangements) and then there will be another six anyway that we have now . And if we can induce them to go to Brandon, we will do everything we can. I'm told that eight of them are supposed to go to Brandon . MR . McGILL: Well, I appreciate the Minister's expression of concern for the situation which does exist at Brandon . I understand that the fact that there is only one fully-accredited psychiatrist there is a situation that has existed for some time, anti dating the present Minister's assumption of this portfolio . Can you . . . ? MR.

DE SJARDINS: I don't think we should just say that there's one psychiatrist. That's absolutely true, but there's six others that just have to write their exams, and we 're satisfied that they 're providing the care that we need, so there's actually seven of them. It's true that they're not completely licensed, they didn't pass the exams, but we 're satisfied that they're doing the work, and they should pa ss their exams fairly soon . MR. McGILL: Yes . Well I appreciate that. But, Mr.

Chairman, there is some need to satisfy the requirements of the establishment and have people working there that have the full accreditation that is required. I don't know for how many years this situation has existed. Did the Minister say that there were three or four fully accredited psychiatrists at Selkirk? MR. DES JARDINS: There's six in Selkirk, but they also, besides Selkirk, I think they go from Selkirk and different communities also . The headquarters is Selkirk; it 's not only in the hospital at Selkirk . MR. McGILL: Well I think that applies also to the Brandon Mental Health Centre.

They have an area of responsibility and involvement that requires travelling from the main institu tion . But the fact remains that there is a sad state of difference between the staffing at Brandon and the staffing at Selkirk. And I appreciate the Minister's desire to correct this situation as soon as pos sible because it has existed prior to the Minister's appointment as the Minister of Health, and it is a matter of great concern in the western part of the province . Mr.

Chairmim, there is another matter that I think the present Minister might correct, and that is that it 's been a long time since any Minister of He alth of this government has visited the Brandon Mental Health Centre and gone onto the wards. I think it would do a great deal for the morale and for the general feeling of the fact that somebody cares, that somebody at the provincial level in the office of the Minister is really concerned about what goes on in the care and treatment of patients at that health centre. And I would hope that it 's on the Minister's

May 20, 1975 2783 SUPPLY - HEA LTH (MR . McGILL cont'd) .. .. . agenda that during the next few months he will have an oppor tunity perhaps to go to Brandon and to visit the wards, and to just acquaint himself personally and fully with the responsibilities that the staff out there have. I'm sure that this would be of great assistance to the general morale in the institution . I would also like , while I have the Minister's attention, perhaps to ask him if he would enlarge a little bit on the function and staffing and funding of the Eden Mental Health Centre.

Could he just tell us a little bit about that operation? MR. ·C HAIRMAN: 58(b)( l)-T he Honourable Minister of Health. MR. DE SJARDINS: First of all , I'd like to thank my honourable friend for the suggestion that he made . I think it's a very good point .

I can assure him that shortly, if we can get out of this plac e, finish with the estimates and finish with the session, that I certainly intend to visit Brandon and Selkirk and those other hospitals; not that it can help the patients there - if it 's good for the morale , so much the better - but I can tell him that I myself would like to know firsthand what is going on, and I think it would be of immense service to the Minister.

I think that it 's very easy to sit in an office here and talk about a situation in a place that you don't know too well, and although in the past I've been familiar with the institution at Selkirk, not Brandon. So this is a place that I will be going to fairly soon . As far as Eden Mental Health Centre, I'm told that we have five staff-man-years, and also it is a service that we are more or less contracting with these people. There's five staff man-years that we pay for, and also $486 , OOO . Now this is a smaller place, I think, that was what? About 33 patients? Is that it? 33 patients.

But the situation is under control. MR. CHAIRMAN: The Honourable Member for Rhineland. MR. BROWN: Mr. Chairman, the White Paper on Mental Health recommended a new Act on mental health and a separate one on mental retardation . I wonder if the Department of Health and Social Development has any plans to follow through with this? In the same report it said that there was $4. 2 million of additional federal moneys that was not being taken advan tage of by the province. What is being done about this? MR . CHAIRMAN: The Honourable Minister of Health. MR.

DE SJARDINS: There are some amendments that we 've had some difficulty - we're talking to the Law Reform Committ ee, and the - what is the League for - what's Huband? What's your leader - Human Rights League, and so on , and we would hope that legislation will be ready, that the amendments to the Act will be ready at the next session. MR . BROWN: Mr. Chairman, I would like to know how many adolescents who require mental treatment have had to be sent out of the province in order to receive hospitalized psy chiatric care because such facilities do not exist within the Province of Manitoba.

I would like to know what is the cost of caring for these children outside of the province. Now it seems that the problem of the children in need of psychiatric care is that they have no hospital that they can be sent to . The hard core cases are sent to other provinces who have these facilities, and who charge us plenty for this service. Now this, however, does nothing for the children that can be helped, the disturbed children who, unless they receive psychiatric help, will become delinquents and eventually end up in Headingley or the Youth Centre or any other such facility.

If we can help someone to become self-sufficient who would otherwise be , at the best , on our welfare rolls for life, we could really contribute something to the life of this person. We could contribute a great deal to the quality of his life, let alone the tremendous saving in dollars to the taxpayer of Manitoba . I wonder, is the government contemplating the building of a psychiatric children's hospital? It seems to me that at one time funds were provided. It seems to me that in 1969 $3 million was allocated towards a children's psychiatric hospital.

I wonder if the Minister could tell us what happened to this money and why we have not pro ceeded with this type of facility, which we desperately need. MR . CHAIRMAN: The Honourable Minister of Health . MR . DESJ ARDINS: I think my honourable friend has a very good point. We have, at any one tine between 20 and 40 outside of the province. It is co stly. It costs up to $1, OOO a month. That's where the money's going. I think we have approximately $300 , OOO or so . This doesn't come under this, but I think it's perfectly in order to ask the question here - it's under the Child Welfare.

This is something we 're concerned with. I'm not at liberty to say too much at this time because the Policy Committee of the department has a paper now that we will send to sub-committee of Cabinet . We feel, as my honourable friend , that we should

2784 May 20, 1975 SUPPLY - HEALTH (MR . DE SJARDINS cont'd ) .... . have facilities here to admit these children. We are looking at an establi shment in Winnipeg, and I think that we would also want to look at Brandon. "I think that, especially if we get the proper staff and so on, it 's something that could be done in Brandon in one of the buildings they have there. So this is something that we are aware of. I can't give any specific decision at this time to my honourable friend, but I can tell him that we 're very seriously looking at that and we 're as concerned as he is . MR .

CHAIRMAN: The Honourable Member for Brandon West. MR. McGILL: Mr. Chairman, could I just have that figure again from the Minister? How much is it costing us annually . . . ? MR. DE SJARDINS: Up to $1, 000 a month for each child . MR. McGILL: Can you give us the bill for the last fiscal year in total? MR. DE SJARDINS: This is not under this. This is under the Child Welfare, and I'll take the question as notice and I'll give it to you at that time or give it to you tomorrow if we can, so we don't forget. I think it's around the $300, OOO , but I might be wrong. MR . McGILL: At the same time, Mr.

Chairman, I wonder if the Minister could indicate, are they all going to a single outside of the province institution, or are they being sent to various plac es where there happen to be beds available ? MR. DE SJARDINS: They are being sent to many different places . There are some in Saskatchewan and I think the majority are even going to the States, the United States, and different places . I don't know if I mentioned that this is cost -shared by the Federal Govern ment also . MR. McGILL: Mr.

Chairman, perhaps we could have it broken down, then, by provinces where the out-of-province patients are being treated, whether or not - the percentage in the United States as compared to other provinces . MR. DE SJARDINS: Yes, we 'll get this information, and when we deal with Child Welfare I'll give you the specific, the numbers that we 've had, the cost, and the institutions where they're sent. MR . CHAIRMAN: Re solution 58(b) (I) -passed; (b)(2) - the Honourable Member for Brandon West. MR .

McGILL: The Minister gave us some information on the Eden Mental Health Centre and he stated that the situation was well in hand. Now I wonder if the Minister could explain just what is the problem there, what has been the problem, and what steps were taken to .. . MR. DE SJARDINS: I'm not aware of any problem at all . It was a private ... If I'm right, it was a private institution, and they were serving the purpose .

There was no duplica tion, so we provided the staff-man-years in the amount that I mentioned - I think it was over 400 milli on .(? ) There's no problem and I'm not aware that they had any problem there. MR. McGILL: I'm sorry, Mr. Chairman, I didn't catch that amount . What is the cost annually to the department ? MR. DE SJARDINS: $486, 000 . MR. McGILL: And that is for approximately 31 patients, is it ? MR. DE SJARDINS: 33, but also 200 to 300 outpatients that come in for special care. MR. McGILL: Mr.

Chairman, is this institution under the general direction of the Brandon Mental Health Centre, or is it directly controlled and supervised by the Winnipeg department ? MR. DE SJARDINS: No, it is not. I think I stated that the Brandon, Portage and Selkirk are now under a board composed of senior people in the department. Eden have their own board, but the medical director, I think, the medical policy, is from our Chief Medical Consultant, the Provincial Psychiatrist, Dr. Tavener. MR. CHAIRMAN: (b)(2)- passed. (3) -passed. (b)-pa ssed. (c)( l) -The Honourable Member for Rhineland . MR . BROWN: Mr.

Chairman, last year, above and beyond previous commitments, the Legislature passed for the Department of Health and Social Development an additional allot ment of $900, OOO to be used on behalf of the citizens who are mentally retarded . Now, how much of this money was spent and, if it wasn't all spent, then why was it not spent ? I wonder if it is proper over here to ask the government what it is doing towards a pre vention program in mental retardation. Now, most retardation cases occur during child birth, and is the government doing anything at all?

Is any research being done in this area where, no doubt, much could be done ?

May 20, 1975 2785 SUPPLY -HEALTH MR. DESJARDINS: I was asked the research, and I have the list here. Portage la Prairie has a research grant from the National Health Grants providing . . . training pro grams. Dr. Lowther has a grant for research into medical aspects of the mental retardates from the Manitoba Health Group. There's research into chromosomal abnormalities going on at Children's Centre. Then there's provincial laboratories that are serving -I can't read your writing, I'm sorry. MR. BROWN: Well, I wonder, Mr.

Chairman, whether the Minister is satisfied that everything possible is being done to alleviate these problems during childbirth. MR. DESJARDINS: Yes I am. I think that the new policy that we've had on -I don't know if they were both announced -on Mental Health and Mental Retardates, that we're going away from centralization, that we're going to the communities. We're also discussing - we have a special committee of people from my department and the Department of Education to see that an education is provided these people.

There are many of them that should not be in institutions, that with some care could lead a pretty normal life, and I think that the policy that we have is followed very seriously with much attention by the Federal Government and other provinces, and I think that we are going in the right direction. MR. BROWN: Mr. Chairman, I wonder what the government is doing in order to promote Canadian Associations for the Mentally Retarded to establish in different areas of the province.

From time to time we get reports from people who have to drive 200 miles on Monday to take their child to a mentally-retarded school and come pick them up again on Friday. I am fortu nate that in my area we have such schools and that the mentally retarded are fairly well looked after, but I wonder if the government is doing anything to assist in establishing this kind of an association in areas that do not have these at the present time. MR. DESJARDINS: Wel-l, we're doing this work in the Manitoba School of Retardates.

We are taking some people that probably shouldn't be there, just before they go back to society -that'll be about 70 of them that would be taken in Ninette, the former sanatorium in Ninette, and there would be some group residents that would be established in the communities also. We are also helping in different demonstrating proj ects in the WesMan and Parkland demonstration projects also. The Ninette Centre, Pelican Lake Training Centre, provides 70 beds used to alleviat e the overcrowding of the Manitoba School and we provide the per diem support for Ninette.

That being in the estimate, there's $900,000 for that this year. Of course there is the preschool program and General Purpose grant to cover preschool programs for the retarded operated by local grants of the Canadian Association for the Mentally Retarded -that's another $10, 000; and a Canadian Association for the Mentally Retarded (Manitoba Division) $130, 000; a General Purpose grant to cover consultation to branches throughout the province, to operate community residences, workshops, shelters, and obtain home care and provide vocational rehabilitation. Also, there's $3,456,000 for St.

Amant ward for the support and care of mentally retarded children. An increase in funds are required to expand new facilities and a provision of $497,000 to meet payment on a $3 million provincial construction loan; also additional funds provided to allow 53 extra beds as of October 1st, 1975. So that is a total of about $4-1/2 million for this kind of work. MR. CHAIRMAN: The Honourable Member for Swan River. MR. BILTON: Mr. Chairman, I first of all would like to congratulate the departments. I see there's an increase of over $2 million. This is a great deal ahead of what it used to be.

But I'd like the Minister to tell us how many retardates from Northern Manitoba have been referred to Portage la Prai rie, and how many were referred last year, particularly? And I'd like to take this opportunity, Mr. Chairman, to congratulate Dr. Lowther for his staff ser vices and what he is giving to this operation. Having said that, I'd like to refer to -for the Minister's edification -to the retardate home we have in Swan River, which was commenced by $25,000 contributed through the local Lions' efforts and a $25,000 grant.

From that point on, the government has seen in its wisdom to assist, and are doing an excellent job in that regard. But what I would like to ask the Minister is why they are still canvassing the local people, as they are doing this weekend, to pay a debt that is a construction debt of the original building. I would suggest to the Minister that it has established itself; it's doing an excellent job; and I wonder if the Minister could tell us as to whether or not they intend to expand that

2786 May 20, 197 5 SUPPLY - HEA LTH (MR . BILTON cont'd) ..... effort that is going on in my area. It's well worthwhile and it has the community's support. But I feel that they are overcrowded at the moment and that ·t hey're not getting the attention that they should have with the people that they have - they have young people as well as adults - and I would like the Minister to tell me why they are, at this late date, canvassing the people as they did this weekend, in order to raise funds to eliminate the debt in the original construction that is still being carried on . MR .

CHAIRMAN: The Honourable Minister of Health. MR . DE SJARDINS: There's a grant going to this institution from the Children's Welfare. This will come later on . They are getting a per diem - I don't know exactly what it is now . I think that the people have accepted . . . The original mortgage was raised locally, and I imagine that this is what is being done now . Does my honourable friend know that the acute hospital , there will no longer be an owner's equity, and also the nursing home? And that is not only as of this date . That is anything that is not paid .

So we will start with that and who knows, maybe later on we will be able to expanp it to institutions such as these . I might say to my honourable friend that I can't tell him exactly how many people from the North are in Portage because all the people that need this care are all going to Portage except those that are going to Ninette, and this is what I explained to him, that our policy will be to do something about that to decentralize, to have a proper institution, proper care in the North near their residence, near their parents, and so on .

This is definitely the direction that the department and the government is going . MR . BILTON: I appreciate the Minister's comments. He knows as well as I do that they are dear people, these people that are afflicted in this way, and it has been a problem in Northern Manitoba; and when a child so afflicted is moved to Southern Manitoba, it's a tremendous inconvenience to the parents themselves and certainly to the youngster . And I look forward to something happening in Northern Manitoba to take care of those youngsters that are so afflicted, certainly north of Parallel 53 .

As I mentioned in my remarks, I wonder if the Minister has any thoughts toward expand ing the efforts being made in Swan River to the effect that equipment and the knowhow will be given to these young people to educate themselves . I .know that the school division is doing its part, but in the trades and that sort of thing. I think they have five acres.

That could be extended pos sibly to 40 acres and they could be growiirn their own vegetables and this sort of thing - this is what I'm trying to think of - in the expectation that their hands and minds will be busy in some respects if the department look upon this in a congenialway . MR. DES JARDINS: Mr. Chairman, I have a rough draft here which is far from finished. This is something that we were working on for the policy on mental health treatment, and it 's practically the same - it 's the same policy on mental retardates .

But I think there seems to be enough interest that maybe I should try to look at this rough draft and give you a general idea of where we 're going for mental health programs and mental retardates. The Manitoba Government will develop a new, comprehensive, preventive and community oriented mental health treatment system over the next few years. The department's Mental Health Division already has introduced some components of a new system and now they will be expanded .

The main component s of the new system: at present there are about 40 community health workers in communiti es throughout the province providing assessment, brief treatment, and crisis intervention to patients and their families, as well as con sultation with community professionals. These workers will present the first thrust in the implementation of the new policy, and over the next few years the staff will be increased by 200 by redeploying personnel from the Manitoba Health Centre. A number of personnel development programs also will be created to serve about 600 individuals.

These programs will help individuals who, because .of long term mental problems, have not acquired or have lost self-help, social or vocational skills essential to independent living . In addition, it is intended that 50 community residences be developed over the next two years. Community residences are intended for persons not needing general or mental hospital care but who are not capable of completely independent living .

Although the emphasis will be on developing programs in the community, psychiatric in-patient facilities at Mental Health Centres and at General Ho spitals will of course continue to be essential components of Manitoba 's mental health system. The government now has 1, 350 employees providing mental health services, most of

May 20, 1975 2787 SUPPLY - HEA LTH (MR . DES JARDINS cont 'd) ..... whom work in the two Mental He alth Centres in Brandon and Selkirk. About 1, 130 of these provide in -patient care to 1, OOO patients at the two centres; and 220 provide out-patient services either at one of the two hospitals or in communiti es . These new programs can be developed without increasing our mental health staff at all, by the redeployment and decentralization of the existing departmental staff and programs.

I want to stress that this redeployment and decentralization will be carried out in such a way that jobs of present staff will be protected . It is expected that no one will lose his job or her job through the changes. A half a million dollar retraining program for present and new staff will be introduced and carried out over the next five years. We do not expect these new arrangements to be more costly to the province than the present system, under which there is only limited federal funding, and we expect that some parts of the new system can be cost shared with the Federal Government.

For 197 4-75, the government is spending about $14 . 8 million in total on mental health services, about 85 percent of this on in-patient services . The approach to be taken by the new mental health system follows the principles outlined in the 1972 White Paper on Health Policy and 1973 Cl arkson Report on Mental Health Services . Under the new system, mental health programs will be communi ty-based and closely co ordinated with other community services such as health and social services .

As the new services are expanded, the traditional emphasis on the treatment of mental problems in hospitals will decline . ''The development of community-based mental health programs is a natural part of the general movement and trend towards community-based preventive health care. Community mental health workers will include social servic es, psychologists, psychiatrists and psychiatric nurses. They will work as part of a Regional Health and Social Development team in Community Health C!'lntres, since mental illne ss overlaps many other health and social problems.

Their work will be essentially preventative, since they will deal with mental health problems in the early stages (I think this is what interests you the most) in the home and community . Their work will make possible a considerable reduction in the use of in-patient services . Community mental health workers screen cli ents and refer them to appropriate services in or out of the mental health system. In crisis situations they inter vene where needed, to help prevent problems from developing into more serious ones. For most people seeking help from these workers, out-patient treatment will suffice.

The workers will con sult with other professionals to help them deal with situations not requiring the presence of a mental health professional . Personal development programs would teach people grooming and self-care skills, how to use public services such as transportation, how to mix socially with other people or take a job interview . In some cases this might include vocational training or employment in sheltered workshops such as Skills Unlimited in Selkirk and Winnipeg, and ARM Industries in Brandon , which currently provide services to several hundred former patients.

In smaller centres, these services could be provided by travelling teams on at least a once weekly basis . Community residences could function as permanent homes for persons who are now long-term residents of Mental Health Centres, and some can function as an alternative to short term hospitalization . They could also serve as half-way residences for individuals discharged from hospitals or Mental Health Centres . These residences will supplement the 720 foster home places which are currently occupied by persons who have been mentally ill .

The community-based preventive programs will not entirely eliminate the need for a hospital-based mental health treatment, but most persons with mental health problems do not require hospital care . Since approximately 200 beds are currently available in General Ho spital Psychiatric Units, it would be possible to reduce the in-patient treatment beds at the Brandon, Selkirk and Eden Mental Health Centres from 600 to 200 over the next five years. This will result in a provincial bed-population ratio to . 4 per thousand persons , which corresponds to the ratio recommended by many mental health experts.

The Mental Health Centres presently provide services to about 400 elderly patients only who require heavy nursing care. It is expected that through gradual transfer to personal care homes, the number of such persons in the Mental Health Centres can be reduced to 300 over the next several years, and that those portions of the Mental Health Centres now reserved for the elderly will be designated as Personal Care Hom es .

2788 May 20, 197 5 SUPPLY - HEA LTH (MR. DE SJARDINS cont'd) . . . . . I'm sorry that this is not in a finished form. This is something that will be released fairly soon, but now you have the policy on the mental health and I can say that Mentally Retarded are following pretty well the same poli cy. MR. CHAIRMAN: The Honourable Member for Rhineland. MR . BROWN: Well I'd like to thank the Minister for that lengthy report and that they are considering doing something in this very important field of mental health.

It's something that has been sorely neglected within the province and we're very pleased to see that they are going to take some positive steps in the right direction, we hope . . . . . . continued next page

May 20, 197 5 27 89 SUPPLY - HEALTH MR . CHAIRMAN: The Honourable Member for Brandon West. MR . McGILL: In his report, the Minister mentioned ARM Industries as one that pro vides some continuing therapy for former patients of the Mental Health Centres. There is another occupational centre in the WesMa n Region. It 's the CAMROC - or Canadian Associa tion for the Mentally Retarded Occupational Centre, I believe it is, one that I am somewhat familiar with and one which seems to be doing very good service in the Wes Man community. I wonder if the Minister could tell me how that CAMROC opera tion is fund ed.

I believe that it's ess entially voluntarily supervised and there is a voluntary Boa rd of Director s, but it 's also my information that they have recently had some difficulties with their funding and their obtaining of the ne cessa ry funds for continuing operations. If there are other such occupational centres in the provinc e, and I've no doubt that there are, I wonder what the policy is of the department with res pect to the funding and the continuing autonomy of those occupational centres. MR. CH AIRMAN: The Honourable Minister of Health. MR.

DESJARDI NS: This will be found under the welfare also, but that particular pro gram is now being reviewed, and if it is funded it will be funded on the program of Vocational Rehab. There's no decision yet, and all those are assesse d individ ually. I think that this is som ething that we're organizi ng the department to have the proper staff to look at all these requests that we have. I can tell my honourable friend that, first of all, we will see if they conform to policies of government, if there' s any duplication, and costs and so on, and then we will make a decision.

This one, the final decisi on hasn't been made yet. We will be able to cover more of this under the Community Operation Divis ion. This comes under Community Operation Divisi on. MR. CHAIRMAN: Res olution 58 - the Honourable Member for Brandon West. MR. McGILL: Mr. Chairman, I'm just wondering, the Minister said that the que stion of funding by the department is under considera tion, for that particular one. Perhaps he could give me some indica tion of when that decision is li kely to be announced.

And I also ask, are there any other similar types of occupational centres run by CAMROC in the provinc e, or is that the only one ? Is that unique ? MR. CHAIRMAN: The Honourable Minister of Health. MR. DES JARDINS: I'm afraid that I can't give the information at this time. I wonder if I could take this as noti ce. I'm asking the gentleman in front of me to take that as notice and when we cover the Community Operation Division I hope to be able to give you as much information as possible . MR . CHAIRMAN: Res olution 58(c)(l ) -pas sed. (2) -pass ed. (3) - -The Honourable Member for Rhinela nd. MR . BROWN: Mr.

Chairman, we have a huge expenditure under External Agenci es , $4,4 97, 600. I wonder if the Minister could give us some kind of explanation on where this money is going to be spent, and if he could give us some indica tion of what the difference is between this external agency and the external agency above that, under Community and Institutional Services . MR. CHAIRMAN : The Honourable Minister of Health. MR. DESJARDI NS: First of all, I gave those under this item, I gave them - tha t's the Canadian As socia tion for Mentally Retarded Pre-s chool Program, St.

Amant ward in Ninette - I gave this a little earlier. Now the one under (b) (3 ) is Eden Mental Health Centre. That is the 486, OOO for Eden Mental Health Centre. MR. CHAIRMAN: (3 ) -pass ed . (c) -pas sed. Resol ved that there be granted to Her Majesty a sum not exceed ing $2 9, 670, 600 for Health and Social Devel opment. (P as sed) Resolution 59 (e) (3) - The Alcoholism Foundation of Manitob a, $ 2, 382, 100· -pass ? The Honourable Member for Br andon West. MR. McGILL: Mr.

Ch airman, I wonder if the Minister could give us some explanation of the program that he has undertaken to provide in this general category of Alcohol and Drug Services . I know that I'm familiar with some discussi ons that were held in the west part of the provinc e, and of some of the undertakings which the Minister made in this connection last year in December in respect to a detoxification centre. And I'm anxious to know, and I'm sure

2790 May 20, 19 75 SUPPLY - HEALTH (MR. McGILL cont'd) ..... there are many people in the province who are anxious to know, what stage the program that the Minister is proposing has now reached, and whether or not he can indicate some dates as to the probable opening of such facilities, those particularly that have been previously discussed and previously adopted in principle. The whole matter of the treatment of those afflicted as a result of the non-medical use of drugs is one that I think is growing in its intensity, and places a greater and greater responsi bility on the new Minister in this department.

I couldn't help but notice this afternoon, when there was a debate going on in the Private Members' Hour in respect to the responsibilities of the Chairman of the Manitoba Liquor Commission and some implied criticisms of the general policies and directives relating to the operation of this department, I couldn't help but notice the Minister sitting silently, in a somewhat brooding manner, and I am sure he was con templating the very difficult line which this government is attempting to walk in respect to its responsibilities for those who are suffering from the effects of over -indulgence in alcohol and other drugs, on the one hand, and the active way in which the government is controlling and, in a sense, promoting the sale of alcohol in the province.

I was hoping that the Minister would have been able to enter that debate and to give us the benefit of his feelings in respect to just what he thinks of what I am inclined to feel is a somewhat hypocritical position that the Liquor Commission is taking, and I think it's no more apparent than in some of the advertisements that have been running in papers recently in Manitoba. One such advertisement was sent to me by a constituent, and he has noted on the side certain paragraphs. This advertisement, Mr. Chairman, is one that says: "Beer parlors were for drinking.

" And then it goes on to say how different things are now. And one of the remarks made by the Manitoba Liquor Commission is that our regulations have become updated to the point where alcohol can now be considered an accessory to a contemporary life style. Mr . Chairman, they go on to say tlnt the serving of persons to a state of intoxication is now minimal, the serving of intoxicated persons is practically non-existent. Mr .

Chairman, I suggest that that is not really an accurate statement of the situation, and I'm wondering why the Minister of Corrections and Rehabilitiation is able to sit in silence and observe the implied advertising of the government, the implication that drinking is for everybody; the only thing wrong is that sometimes some people drink a little too much. But, quite clearly, the implication is that, to be with it in our society, alcohol is almost, well, part of our contemporary life style. Well, Mr.

Chairman, there's a clear conflict here between wha t I know this Minister is trying to do, and another branch of his own government which is busy in a somewhat, I would say, hypocritical way, promoting on the one hand that drinking is part of our way of life and no one should object to that, and on the other hand saying tln t under their regulations nobody that's intoxicated is served drinks and so on and so forth, and that people under age are not able to obtain alcohol. So, Mr. Chairman, we realize on this side that the Minister of Corrections and Rehabilitation has a very difficult job to perform.

I wonder if it wouldn't be quite reasonable for him to go to the Chairman of the Liquor Commission and say, "If we could just have your budget for advertising to provide for some of the increasing expense ·of the treatment of alcoholics and for detoxification purposes in our province, that it might be a more reasonable way and a less hypocritical way to face our problems. Mr. Chairman, these just briefly are a few of the questions that arise in respect to the item which we are now questioning, and I would hope that the Minister will be able to give us some encouragement on his activites. · MR.

CHAIRMAN : The Honourable Minister of Corrections. MR. BOYCE: The Member for Brandon West asked me how I sat there during the debate. I would answer him: with great difficulty. I had planned on getting involved in it and when the resolution is up next again I will make a contribution to that debate. Nevertheless, the relationship between the Chairman of the Liquor Control Commission and myself is an excellent one, albeit I was pictured as giving him a hot foot because of a dis agreement here a few years ago over a particular matter.

Perhaps just before I address my remarks to the questions raised by the Member for Rhineland, you will notice that it's the same staff, and in this capacity Dr. Tavener serves as a

May 20, 19 75 2791 SUPPLY - HEALTH (MR. BOYCE cont'd) .. ... statutory member on the Board of Governors of the Alcoholism Foundation, and another hat that we have given him is to act as Deputy Minister for Corrections where it is necessary to have a Deputy Minister in relationship with the Federal Government. Tomorrow we will be leaving to discuss some of these general problems with the Ministers in Victoria at a meeting.

But perhaps if you could ju st bear with me a moment, I'll just bring you up-to-date briefly by drawing your attention to a report that was filed by the Alcoholism Foundation dated January lst, 19 73 - January to December, 1973.

It was a report, one of the many reports that were tabled in the House, and I had the honour to be Chairman of the Alcoholism Foundation at that particular time, and the recommendation of the board to the Minister at the time was that, "Such of the supporting evidence of the LeDain Report that alcohol is the most problematic of abuse drugs, has caused a priority shift, which has resulted in an increase of federal and provincial funding across Canada. Subsequently, everyone wants into the act.

"The situation is compounded by the results of another shift brought about by public inebriants being considered as needing treatment rather than custodial, punitive consideration. Therefore there is a need for refinement of policy as to : "l. Detention of people under the Intoxicated Persons Detention Act vis- a-vis detoxi fication. "2. Detoxification vis -a-vis treatment and rehabilitiation. "3. Priorities of programs in stages of planning, experimentation, enrichment and redundancy.

" And I'm not going to read the whole report but nevertheless I'd like to read that into the record especial ly for the Member for Fort Rouge who had raised some questions. On Page 3 of the report.at that time, in addressing itself to the need for some definition of detoxification as compared to treatment and rehabilitiation, the report suggests: "The momentum towards commitment of additional funds into the field of alcoholism and drug addiction as a sociological, mental health, medical-legal problem is increasing.

The Board is concerned about the increasing pressure by groups who would use the present vogue of detoxi fication to establish catchment facilities which would slant the number of people in treatment and rehabilitiation toward yet-to-be-esta blished programs. "The Board would hasten to add that as further funds are made available, the new and novel should be added and the redundant eliminated. Nevertheless1 as shift takes place it becomes a matter of priorities in which judgments must be exercised.

" Now in reading that to fellow members of the House, this was the recommendation the Board of Governors had made to the previous Minister, and in having been asked by the Premier to assume this responsibility, one of the first things I did was to ask the people who have been involved to come up with this report which I have distributed. Now this is an internal document. It's not a secret document but it is an in-House piec e of work that was done, and if you will turn to Page 17(

a) you will see the alternative which I opted for in this particular . regard. Having opted for this particular option, it became paramount who was going to become involved and help in this reorganization as we shifted from a rather modest program to a control mechanism which would satisfy the Provincial Auditor and members of the Legislature in reporting for the moneys which were being allocated through this agency.

We were very fortunate in Manitoba in that just at this time a Brigadier Stewart Graham, retired from the Canadian Army, had happened to come in to see what role he could play in Manitoba - and I will share with members some of his curriculum of V-Day at some future point in time. General Graham's greatest asset in this reorganization was his administrative ability and his capacity to be brief in a very short time, and he certainly has demonstrated his ability to do so, because in a very brief involvement he read prolificly to become fully apprised of what was taking place in this area.

Further,in this regard there will be presented to you in this current session, an amendment to the Alcoholism Foundation Act, which expands this board to give further representation as far as regionality is concerned. Some of you may recall that one of the suggestions of the Social Planning Audit which was carried out I believe in 196 6, 1967 - I thank the Member for Assiniboia also - bllt the report came out in 196 8, was that in the Health and Social Service field there were a rapidly

2792 May 20, 1975 SUPPLY - HEAL TH (MR . BOYCE cont'd) . . expanding number of agencies who were duplicating services and they should address, the government should address themselves to some co -ordinating effort. Let me go back a bit if I may and come up to this point from a different point .

When this government first came in , an ad hoe group representing all the agencies who were in volved in programs for the alcoholic s reported to the First Minister, the present Minister of Mines and Natural Resources> that the biggest criticism was that the Board of Governors of the Alcohlism Foundation didn't have a broad enough base. So at that time they solicited names from the various agencies and asked the people who were to be appointed to this board not serve the self-interest of the group but act on behalf of all Manitobans .

So to bring this to a further expansion to take in the regional consideration, we' re suggesting that we amend the Alco holism Foundation to raise the number of board members other than the statutory ones, which are the Deputy Minister and the Provincial Psychiatrist and the Director of Rehabilitation , to have 12 rather than 7 members.

When the Member for Rhineland asked, you know, the amount of money which would be given to the various agencies outside of the government or outside of the Alcoholism Founda tion, I gave the members of the Conservative Party and the members of the Liberal Party a statement of intent, which I gave the various agencies last fall at a meeting with them . And the thrust of this statement of intent was that there would not be that much change in the moneys which would be suggested to the Alco holism Foundation be allocated to these particular agencies from that which they received in the prior fiscal year.

But I had issued a challenge, perhaps a challenge not to the existence, but a challenge to the people in the community to help rationalize this, that hop.efully by the next fiscal year the Alcoholism Foundation would be in contractual arrangements with the various agencies who were delivering services in this particular field. A few minutes ago, Mr. Chairman, the Minister of He alth read from a document relating to mental health.

One of the reasons that we are keeping this as close as pos sible together is because there is an inter-relationship between the mental health teams and the alcohol treatment teams and the detoxification, and even correction s. For example, one of the things that has been tossed out for consideration is the helping of famili es by the Federal Government for people who are incarcerated because of conflicts with the law .

So that in trying to keep these organizations together so that we can rationalize it , I've said several times before, and I'm going to keep repeating it , we have a population of a million people, so on the delivery of health services as has been pointed out by Mr. Lalonde and others, that we have to make sure that we do the best we can with the limited resources that we can make available to these people .

To answer in specific amounts for what any agency will be given by the Alcoholism Foundation, the Alcoholism Foundation will be given the amount that is shown in your Estimate Book $2, 382, 100, and within the ministerial request that they be guided by last year's es timates and in keeping with the charge that duplication of services are kept to a minimum , the amounts forwarded will be somewhat similar to what was given last year. Now back to the question raised by the Member for Brandon West relative to the progress being made with the detoxification units .

At the present time negotiations are taking place in various parts of the provinc e, because if you will recall one of the thrusts of the White Paper was that as we move to put in place services, that they be as much as pos sible under local control . In the City of Brandon, for example, the modest programs that we had in Brandon really came about because of the benevolence of Mr. Matheson. May I be allowed to digress, Mr. Chairman?

I would be remiss if I didn't pay tribute at this time to the people who had become involved in this particular problem with not too much public support back in the late Fiftie s, involving such people as Graeme Haig and the former Premier of the province, and Grant Webster , who was up until two years ago the Executive Director of the Foundation and who left to go to Saskatchewan to operate their programs there. But it was the people such as Mr.

Matheson in Brandon , and a few private individuals , and people outside of the government, who really brought the Alcoholism Founda tion up to the point that it has arrived at at the present time . To go back to the specific case in Brandon, there was a modest facility operated under the aegis of the Foundation in Brandon, which I have said previously had an excellent success

May 20, 1975 2793 SUPPLY - HEA LTH (MR . BOYCE cont 'd) . . . . . rate that stood it in the , you know, the higher orders in North America . Presently I understand from the Managing Director of the Al coholism Foundation that negotiations are continuing to the expansion of a facility in Brandon, and I understand that the Foundation has included in the current fiscal year, funds to develop such facilities .

Last Friday I was in The Pas, and in co-ope ration with the Federal Government under the Western Northlands Agreement , where the Federal Government agrees to pay 60 percent of the capital cost of projects, the detoxification unit is being built by and under and through the St . Anthony's Hospital Board, through the co -operation of the Alcoholism Foundation. The capital is being channelled to the St . Anthony's Ho spital Board through the Al coholism Foundation.

The staff and development is being initiated or monitored by the Alcoholism Foundation, and the operation is under the aegis of the Ho spital Board through a director of programs with the Ho spital Board. In other areas, the progress is at different stages, but in keeping with the thrust of the government, that as we move towards a local control system, that as the people in the com munities develop the willingness to become involved , we are turning these facilities over to them. I think that answers the questions that have been posed to me up to this time, Mr. Chairman. MR.

CHAIRMAN: The Member for As siniboia . MR. STEVE PATRICK (Assiniboia) : Thank you, Mr. Chairman. I do have a few questions for the Minister, and I would like the answer at this time. What is the co st of the Preventative Program in his estimates? Are we supposed to take it just as it is listed, or is that the whole involvement of his department in the cost of Preventative Programs ? What is the cost as compared to rehabilitiation? You know, we can differentiate between the two , and perhaps we can break it down .

What is again the cost of the preventative program that he has at the present time in his department for juvenile people, for young people under the age of 18, and what it is for the adult program? Because I'm sure this afternoon's debates were worthwhile and I know that the sales promotion , the mass merchandizing increased the viability for con sumption of liquor and drugs to some extent that caused many of our problems, as pointed out so well in the report that the Minister just tabled .

The report has also indicated that we have at the present time some 16 , OOO people that are dependent in this province on alcohol, and some 30, OOO who are in a serious situation and in a dangerous health situation . Well this is a pretty small province for that kind of statistics, and if statistics have any mean ing, then my question to the Minister is ... and I'm sure that he probably knows this problem as well as any of us here and probably the right person in that department.

I just hope that he'll be tough enough to see that some of that money is allotted for preventative measures, because when we look at 16 , OOO and 30, OOO statistics and what has been happening in the last few years, then I say to the Mnister that it 's time that we start looking at preventative mea sures, because in a preventative measure, Mr. Chairman, the cost is very lit tle, almost negligent , but when we look at rehabilitative programs, t�e costs are enormous, probably, who knows, 50 or 50 time s over what the preventative measures may be .

Not only that, but the cost to society, if you look at 16 , OOO people, or what it means in lo sses to industry, to different businesses , to governments, and loss of real effective work, in loss of wages, we're talking about millions and millions of dollars of our problem, and it 's a serious situation. I hope that the Minister can give me some breakdown of the cost of preventative programs and the cost of rehabilitative programs between the two groups, the adults and the young people .

The other point - I don't know if this is the right area to discuss, but I see that the Minister has in his estimates, Corrective and Rehabilitative Services and Alcohol and Drug Services , and while we're on that point , I know that I would like to know how serious is the problem . And surely I think the Minister should spend some money and find out how serious the problem is. You know, it 's not serious at all to many of us until we have some constituent come to their MLAs with a serious problem when it comes pretty close to home .

Some of the parents have indicated to me, say, my 16 year old daughter or 15 year old son , who is a good student, but his marks started to fall in the last two months just slightly, not too much, and all of a sudden we had to rush him in an ambulance to a hospital because he was on one of those, I guess, trips is what you'd call it in the drug family, and after a full examination, the doctor indicated to the family - and they'll say this is very difficult to indicate to the family

2794 May 20, 1975 SUPP LY - HEA LTH (MR . PATRICK cont 'd) ..... that there would be a complete rehabilitative recovery. There may not be a complete recovery at all , there may be an impairment for the rest of this individual 's life , be it a young girl or a young boy.

So we have serious problems in our school s, and the reason I say serious, I hope the Minister will find out, because I know that none of us can find out where we can get drugs, but you talk to almost any school and the kids know where to get it , so it 's time that maybe the law enforcement officers, and some pressure should be put on our administrators and the school people. Let' s find out who the pushers are within the school system, because it 's only now that we 're beginning to find out how serious and how much damage it can do to our young people.

It's not only on one occa sion that I had a family come to see me. I've had during this session, or during this year, I've had at least three or four that came to see me and said , you know, the doctor tells me, although they're telling about the soft drugs and there should be no harm and no damage, still when the doctors say, well we don't know how much damage there is, and we d:on't know if your child's going to be completely recovered. Well , that shakes, you know, that shakes the parents pretty much , and it shakes everybody within a communi ty very cl ose .

So then it hits pretty close to home when we 're finding out , and I say that the Minister should be able to spend some money and find out for himself, and find out for us, if it is a problem or is it now on the decline , or does the problem seem to be going away. I don't think it 's going away, and I don't think it 'll go away until the Minister finds out .

So I would like to ask him at this time - I know it 's here, but I would like to say, instead of spending millions and millions of dollars, probably 25 to maybe 50 times as much on rehabilitative programs, let 's start looking very seriously on preventative programs, and let 's start using some of that money that accrues to the Chairman of the Manitoba Liquor Corporation for the preventative measures, and I'm sure that every one in this House will support the Minister in that respect .

So I hope that he takes a very very strong stand, and very strong po sition within his Cabinet in respect to much more of a preventative program in this area, and I'd like to hear from the Minister. MR. CHAIRMAN: The Honourable Member for St . James . MR. GEORGE MlNAKER (St. James) : Thank you, Mr. Chairman. I too would like to add a few comme nts with regard to the same subje ct that the Member from As siniboia has been talking on .

As my honourable colleague from Brandon West has indicated earlier, there appears to be a lack of moneys being spent on the rehabilitative part of the Minister's depart ment with regard to alcoholism , yet on the other hand there seems to be, one might describe, a gloat on the part of the Manitoba Liquor Commission in their year end report , on how great their income and profit structure is, and when one looks at those figures and we read them, that one sometimes wonders, as a member of the Legislature, what has happened to our government's thinking on the subject of rehabilitating members of our society who have had this problem and are suffering from it , and to some extent it has been created by the govern ment in their programs and governments before.

We look at the financial statement in the year end Liquor Commissi on report and we see that the government's been able to raise a profit of some $42 million , and also another $9 million in the revenue tax, and also they collected some $33 million in the Government of Canada Customs and Excise Tax.

We look at the total sales last year of. some $1 21 million , there's a revenue to the government of some 83 million plus - and there was $83 . 00 per head, per person, in the Province of Manitoba; yet if we understand the estimate before us the most that we can seem to find for trying to correct a situation that has been caused to a large degree by the government in its effort to sell alco hol , we can only find $2. 50 per head.

I would think that there's something awfully wrong there, and as the Member for Assiniboia said, I am sure that we would support the Honourable Minister in getting more moneys to fight this problem because it would appear from what we have seen happen in the last year with regard to the Liquor Commissi on that either the Government or the Director of the Commissi on feels that to correct the situation of alcoholism is to simply eliminate the product off the shelf.

I particularly relate to the proposed policy that's presently in existence of eliminating fortified wines at a low price would correct the situation of what we have in our society, and to my knowledge it hasn't corrected it . I'm sure the Honourable Minister would probably agree with me that that hasn't corrected the situation, and won' t.

May 20, 197 5 2795 SUP PL Y - HEALTH (MR . MINA KER cont'

d) And I would suggest also to the Honourable Minister, as other colleagues have today, that the advertising on TV to moderate is not the answer. If anything, it probably helps to initiate additional sales strictly by sublimation of the fact that people are reminded that, you know, as long as you drink moderately it 's okay to drink, then you might not even be thinking about it, but if you happen to be watching the TV and are sitting there it might be a good suggestion to get up and go over to the cupboard and find the bottle and have a little shot.

I would suggest that the Honourable Minister stress very strongly with his Cabinet colleagues that to get off that kick of advertising of moderation because I think it's, in my own personal opinion, has the reverse effect on our community, and to put these moneys towards his particular department and towards trying to rehabilitate these citizens who have this problem, in trying to ass ist the Minister in the work that he's trying to achieve. I think that it's not, in my opinion, a fair amount of money being put back into this type of program when one collects some $85 million clear profits .

When you count the tax and the profit that the Commission makes and the Federal Government makes , I don't think it 's out of line, when you 're collecting $85 .00 per head, to increase the amount of moneys that goes back for rehabilitation over $2 .5 0 a head , because that 's all the Minister's presently getting.

I hope that he will be strong with his Cabinet colleagues and get more moneys for his department for this problem , and to convince them that this advertising on radio and TV of moderation is not working like they thought it would, and in fact in our opinion has the reverse effect, is increasing sales and probably increasing the problem. MR . CHAIRMAN: The Honourable Member for Brandon West . MR . McGILL: Mr. Chairman , I think there is no disagreement on this side as to the enormous problem which this Minister has to face, and it's not one that's getting any easier as time goes on .

I know that he must have done some research on his own as to how the problem of alcoholism is growing, and I notice that the Ontario Government is recently looking at this problem with more than its usual concern, and they have made some studies of their own. I'm sure the Minister may be familiar with them, but some of the statistics are rather impressive . It was mentioned in this report that the average Ontario drinker has doubled his consumption of absolute alcohol in the last 30 years . Since World War II the average consumption of alcohol per person in Ontario has doubled .

They have also estimated that the cost to the public purse for treatment of alcohol-related illness and disruption is about $1 50 million a year . That does not count doctors fees, nor does it count the loss to industry and business as a result of over-indulgence in alcohol. Added to that, Mr. Chairman they have indicated that the cost in collisions in automobile insurance, and so forth , is about $1 30 millions a year, and that 43 percent of the Ontario drivers who died in accidents were legally drunk. Mr . Chairman, the problem is no less intense I'm sure in the Pr ovince of Manitoba.

I wonder if the Minister has done any study to indicate how much of the $308 million that the Department of Health and Social Development is spending, or intends to spend this year, will be devoted to what is a self-induced illness as a result of alcohol abuse. Pr obably a good percentage of that could be related to the self-induced illness of people who have used alcohol and drugs in a non-medical way and has caused damage to their own health . I think it's a problem that all government s will have to eventually face more directly than they are at the present time.

How long the.long-suffering taxpayer will continue to accept the bill for self induced illness , particularly illness of this kind, is one that I think needs to be considered in this matter . So when the Minister is replying to the many questions that have been placed in the last few minutes, perhaps he would indicate whether he has made any estimate of the percentage of the total costs of remedial care in health and social development in Manitoba is due in one way or another to the abuse of alcohol and drugs . MR . CHAIRMAN: The Honourable Minister of C0rrections. MR .

BOYCE: The Member for Assiniboia puts me in a very awkward position because I have to admit that we have excellent co-operation between the three Ministers in the Federal Government and our particular area of the responsibility with Mr . Buchanan and Mr . Lalonde and Mr. Allmand because there's a close relationship between the problems that all of us face .

27 96 May 20, 197 5 SUPP LY - HEALTH (MR . BOYCE cont'

d) The Minister for Indian Affairs a nnounced a program where he was going to putting some money into native alcohol programs, and we have asked that the Regional Representative of the Non-Medical use of Drug Directorate sit with the Board of Governors, and there is a relationship between the Board of Governors and the Alcoholism Foundation in the Regional Advisory Group to the Federal non-medical groups , so we hope to have better liaison because of this.

The member points out that, you know, in the field of prevention - now here we have gone from 19 73-74 fiscal year at roughly $1 million to this current fiscal year we 're asking for roughly $2 -1/2 million, or 150 percent increase in two years . Now I'm a little bit conserva tive, and as long as you spell it with a small "c" it doesn't bother me too much , but as I understand things,the most important task facing it in this current fiscal year was to get together the people that could build the type of system that members are suggesting that we have .

And in the field of prevention we have under the item that you see listed as (1) and (2) in Salaries and other Expenditures , we have one individual who actually works for us in the Department of Education who is developing a program which hopefully will be in place by this fall, as well as being in a position to advise us on what we should do in this in the next fiscal year, what we should ask the House for in this regard . Up to this point in time I have to once again give credit to a group who really started with very little under the executive directorship of Mr. Bill Potoroka .

They started off as Alcohol Education Services . They became Alcohol Drug Education Services, and they got together some modest amounts. We, through the Alcoholism Foundation gave them some modest amounts, and the Non-Medical use of Drug people in ottawa gave them some, and really this was outside of the government type of thing . It was a private agency who did an excellent job with rather limited funds. Hopefully as we move down the road and rationalize some of these programs, that the people who are involved with Alcohol Drug Education Services can continue to make a positive con tribution in this regard .

Because I know the people who served with the Board over there are interested people in the community and have , in my judgment, a contribution to make, and hopefully they can serve in expanded capacities as far as advising our office on what we should do in the future. The Federal Minister of Health hazarded the guess that in social costs it was costing us $1 .1 billion in social costs relative to the sale of alcohol. Now the Member for Assiniboia said, p erhaps, yo'.! know , the advertising increases sales . I really don't know .

I was just expressing an opinion, perhaps in itself whether it's a good or bad program in that regard . I think time alone will tell whether it has an effect on people behaving more responsibly if yo'.1 will. But the costs which accrue to the public purse as a result of the sale of alcohol is drawing more attention. The figures seem to hold true in the various research that is coming out, that half of the· traffic deaths which occur are attributable to alcohol in some degree; the crime rate is attributable to alcohol in some degree .

So how we will eventually measure the social costs and what money be put into place to solve the problems which accrue because of the public policy of selling alcohol, is something as the Minister I have to deal with; I have to deal with the fact as it exists, not perhaps as I might see it personally. In the general area of rese arch it seems to hold true as the Member for Brandon West mentioned, that the 80 percent consumption figure, people who in some way or other use alcohol, seems to remain constant.

Of the 20 percent of the people who for some reason or other don't choose to drink, this seems to appear regularly in their literature that one would read . In this regard , Mr. Chairman , I plan to f orward to each caucus - is it caucus or caucuses ? - some of the more pertinent research that does come through .

There is a book that just came in today relative to corrections, it 's on Diversion, it gives you a recap of what is going on in the correctional field, and this I think is a legitimate charge to the public purse; that if we send one copy of each of these things to the various groups they can at least know on what the government is basing some of their thinking. I don't know if it was generally circulated - perhaps I could get copies for the members who are interested - it was a report that came out of Washington - you know, some good things come out of Washington, in fact a goodly number I suppose .

It was Health, Education and Welfare Research , and it's a thumb nail sketch of just where in the field of alcoholism the present current thinking is in this field.

May 20, 197 5 2797 SUPPL Y - HEALTH (MR. BOYCE cont'd) ..... It was just interesting that while the member was talking one of the things that came through was one of the biggest causal factors people think is ambivalence where people are, you know, purporting one standard and personally they behave in another. In regard to the number of people who are in other institutions because of problems with alcohol. It's really pathetic to go out to some of the correctional institutions and see younger people who are in some sort of difficulty.

For example, in many cases where younger people see the keys in the ignition of a car, they just stand there and scratch their head and say, "T here's rather a silly fool" and walk by and leave it alone. But after too many drinks, are into the car and whee and away they go, and now they're in for stealing a relatively ex pensive piece of equipment, and of course they have to suffer the consequence of it.

There's so many people1 in some of the institutions they got drunks and, they seem to be able to control themselves without too much trouble as far as anti-soc ial behaviour is concerned, but with a few too many drinks they become obnoxious to themselves and others. In this regard, back again to why I chose this as a particular approach to the problem; I think it's paramount that if we are to build a system that we have to do it in co-operation with the people that are involved.

You were speaking earlier about forensic services, to build a proper system we have to have people, the different profess ional groups who have historically tried to solve this problem, have been involved with.

In many many instances the first point of contact is with medical practitioners, so historically the only thing that was available to doctors who saw these people with problems was a small place on Nassau Street and as good as it was, and the fellows really did an excellent job with limited means, nevertheless their only alternative was if there was some reason to hospitalize these people they were hospitalized. I do not criticize the medical profession for doing this. It is necessary for us to attract people to fill the jobs in mental health and the system that we are address ing ourselves to at the moment.

It is necessary for us to attract competent psychiatrists and psychologists and the back-up people, as many as we can afford.

For exam ple, the relationship between this particular department - I was in one particular jurisdiction not too long ago and it was drawn to my attention that one of the mental health teams who I was involved with, a person who had gone back to this community had been assis ted in readjusting with their family, and the whole family was helped because of their first involvement with alcohol, but yet it was done through the mental health teams and not directly under this expend iture item. And this happened a week later in another community.

And here again, I want to underline the necessity of working closely with the various people in the field and people in the hospital, the health organization, the various private organizations, the Regional Health people in the Department of Hea lth and Social Development, so that we can truly build a system in which people have confidence. Because if I was a doctor, or some other professional type of person, and somebody came to me, I wouldn' t necessarily send him over to a system that I didn't have confidence in.

It's worthy to note that in a modest program that the Alcoholism Foundation initiated with one of the larger employers in the community, that already, without even scratching the surface, that they are sending five people a month to the facility and their success ratio is astounding. But to build a system, I think it necessary to - Pv e said it before in other regards, that systems don' t fas cinate me; it's the people that operate the systems. MR. CHAIRMAN: The Honourable Member for Ass iniboia. MR. PATRICK: Mr. Chairman, I just have another question, and that's to do in the field of education.

Is there any standardized information that can be distributed say, to parents or people in the education field, or even to, say, Health and Social Service profession als, that there is some standardized information in respect to alcohol, so that we' re not getting ten different pieces of information and it's all contradicting, or some of it is contradicting each other? Is there any standardized education programs? If there isn't such a thing, perhaps the Minister can give some consideration that can be distributed to, say, schools or students or parents, parent teachers, in that field.

I think it would be very important that this type of information come from some people that have a great degree, a considerable degree of expertise in that field, and that type of information, I believe, educational informa tion, should be standardized and could be distributed on request to schools and parents who need it. I hope the Minister can give me some information if he has anything in mind in this area; or is the department doing - or if there is anything in that field at all. The other point that - I don't know where to bring it up - but I know the Minister has

27 98 May 20, 197 5 SUPPLY - HEALTH (MR. PATRICK cont' d) ..... answered most of our questions. But in one area, does the department do any research in the field . . . I know that a couple of cases came to my atten tion, one case particularly, where a young student at the university enrolled in one of the important - specializing in one of the fields, he had to have three or four or five drinks every day, and he finally didn't last too long. I think after six months or so he had to drop out. My question is, what happens? Is there quite a few of the students at the university level?

At one time you never heard of anyone of that age group having problems with drinking, unless there was no information or statistics, but more recently we have this type of information, not only at that level, age 21, 22, but even I know some of the high school teachers have some problems, that a few kids come in - but that doesn' t mean that they have a problem - they come in in the afternoon and they've been to the bar sometimes during the lunch hour. But the point that I'm trying to find out, what happens to the youngsters of 21 or 22 that have taken a few years of excessive drinking?

What has caused them to become an alcoholic, say, at - well, going to college and they have to drop out? Is there any research in that area being done? MR. CHAffiMAN : The Honourable Minister of Corrections. MR. BO YCE: Well, there is,p robably as much research has been done in this area as there has been on the

interpretations of the Bible. You get, you know, just as many opinions as you do researchers perhaps. But nevertheless, as I said earlier, the thing that seems to be most connected with the incidence is society's ambivalence, you know, towards the sale of alcohol. And I'm not proposing prohibition, albeit it may cause a decrease in the incidence of sclerosis of the liver.

But we must remember that society - and really it doesn't make any difference what government is in office; in fact when you're at these meetings I wouldn't know who was who unless you had a program, you know, as far as what political party they belong to, but I'm informed that, you know, about only five percent of the people who drink have problems, problems in the sense that they becom e a problem to society. So that we have to deal with the reality as it is. When you ask the question about, you know, kits for school, these things are extant.

The Alcoholis m Foundation has relied heavily on kits in other jurisdictions, and this is one of the things that Mr. Potoroka over at the Alcohol Drug and Education Services was of great assistance - he' s one of the best scroungers around, has an excellent library, and hope fully he can be involved with us, you know, with his library. But we do have some duplication, and I understand that conversations are going on at the present time with Alcohol and Drug Education Services, because we do have a library over at 270 Osborne also. But this is why I mentioned earlier about this chap who was - his name is Mr.

Sobie - works in the Department of Education for the Department of Health and Social Develop ment, Ministry of Corrections and Rehabilitative Services, in developing this, because we have problems in Manitoba which we need Manitoba approaches to, to solve these problems. MR. CHA ffiMAN: The Honourable Member for Rhineland. MR. BROWN: Thank you, Mr. Chairman. The Minister answered the questions that I posed the previous time and said that funding would be available to these various organizations. But this poses one question, Mr.

Chairman, and that is why has the funding for alcoholism treatment for native people been curtailed, and how much is spent for treatment of alcoholism in the northern parts of the province? MR. BOYC E: I didn't know that the funding had been curtailed and I am assuming that there will be some funding continued for the need of Alcoholism Council, if that is the organiza tion to which the Member for Rhineland is alluding.

The position of the Board of Governors was that the organization known as the Native Alcoholis m Council should be funded for an en dorsement grant which would allow them to operate, to see that there was a fair involvement of programs which had some utility to native people, and I have not been informed of the changes of position of the Alcohol ism Foundation in that regard.

But here again, I would harken back to what I said earlier, that I do not see the necessity of building up duplicate services so that if there is some need to have a facility, a program that under the aegis of the Alcohol ism Foundation that these programs will continue. In fact, I did mention earlier that the Minister of Health in Ottawa had indicated that they would be putting some $3 million a year for the next three years into "N ative Programs". I have a letter from the Minister drawing my attention to the fact that these funds are related to people that are on Reserves.

Now this, of course, causes some difficulty - not insurmountable difficulties, but some difficulties. I would draw your attention to the fact that at various Reservations the different programs had been started

May 20, 197 5 27 99 SUPPLY - HEALTH (MR . BOYCE cont'd) ..... some years ago and they were continuing with these. For exam ple, in Fort Alexander Reserve, primarily because of the Chief and Band Council, they were instrumental in renovating a facility in which people will receive treatment right on the Reserve, that Indian Affairs will pay this organization for the programs which are given to people who are of Treaty status, and the Alcoholism Foundation will pay for those people who are not Treaty status. MR. CHAIBMAN: Resolution 59 (e)(3)-passed; 59 (a)(l)-pass? The Honourable Member for Rhineland. MR.

BROWN: Mr. Chairman, the Minister of Corrections and Rehabilitation has a tremendous responsibility in his portfolio in that he has to work with adult offenders, juvenile offenders, and Alcohol and Drug Services. Now in the question of probation and parole ad ministration, the problem that needs immediate attention must be the question of persons who are apprehended and are on remand. Now will the Minister make an attempt to see that the cases are allowed to appear before court sooner, and will he provide facilities other than Headingley for them?

In the care and treatment of juvenile offenders, are we doing the right thing by putting them in a compound along with other offenders? I think we all agree that counselling is neces sary and advisable, but putting them in a compound with other offenders places them in the danger of, rather than being rehabilitated, they learn more about crime and drugs than what they did before they entered the compound or whatever place they were sent to for treatment.

Now surely we could find better ways of dealing with juveniles, and I can think of one case which happened close to my area where one of the boys stole a truck from a neighbour. He drove it up to Portage la Prairie where he blew the motor on it. The police caught this person and they came back to_ the owner of the truck and they asked him to lay charges against this boy. But the farmer thought that he would rather first go down to the neighbour and see if they couldn't settle this somehow without going through the courts.

And he went down to the neighbour and he asked him if he would replace that motor for him, then he would not press charges. And this farmer said, well, he couldn't replace that motor. He was a small farmer and he didn't have that kind of money. And this other fellow said that, well, he would like to have some compensation for the harm that had been done to his truck. And this other neighbour said, 11 Well, I know what we'll do, 11 he said, 11 if you are going to agree to this, and that is I know that you are very short of help during haying time.

Pll have my boy come over there and help you with your haying. 11 So they agreed to this. The boy went out there and he helped him with the haying. He was a good worker, and after he had paid off his debt on the motor he continued to work for this farmer and he's still working with him to this day. There's a very good relationship between this boy and the farmer that he is working with. And I wonder if we couldn't possibly look for some alternate ways of treating juvenile offenders than what we are doing at the present time. I wonder what the government is doing for the prevention of crimes by juveniles.

Do we have a program in our schools that will explain to juveniles what will happen if they are caught committing crimes ? Are we asking parents to spend more time with their children and learn to understand them better? Are we educating parents that they can detect whether their children are on drugs or on alcohol? What about the adult offenders ? I understand that we have disposed of the dairy at Headingley and there is nothing to do for the inmates over there at the present time.

Now, couldn' t we do something with the in mates over there something si milar to what I related in the care of juvenile offenders ? Maybe they could be working in Provincial Parks or on some kind of road construction or some pro gram to develop the North. I think it's a waste of time putting them in a cell hoping that they' re go ing to be rehabilitated. I think that there is a place for them where they could do something useful and still receive daily counselling that is required. And what about the problems of the North? Is getting together and drinking the only form of entertainment in the community?

To be accepted socially up North, do you have to belong to the drinking group because there is no other form of entertainment or social activity, especially in the native communities? And in connection with marijuana and heroin and all tqe other drugs, are we going to continue to have conflicting studies carried out? I suppose they are about 50-5 0 now; 50 percent say that drugs are har mful and the other 50 percent say that drugs are harmless. When are we going to make up our minds on this issue and take the action that is required?

280 0 May 20, 197 5 SUPPLY - HEALTH (MR. BROWN cont'

d) We have many organizations of volunteer workers who are concerned, and thank God for volunteer workers, but they seem to lack the direction that is needed so that the entire water front of alcoholism and drug abuse can be covered. I hope that the Minister will get together with these people and let them know what his intentions are in his particular responsibilities. r m sure that there is a lot of concern in many of these groups because they do not really know what direction is required of them.

Now this surely must be the Minister's responsibility and I sincerely hope that this direction is going to be forthcoming. MR . CHAIRMAN: The Honourable Minister of Corrections. MR. BOYCE: Well, the Member for Rhineland is to be commended for doing his home work and knowing where to stick the pin.

But with reference to the Headingley Jail, I would just like to report to my fellow members that at latest count, which was last week some time, there were 319 people in Headingley, 13 of whom were not involved in some type of activity, and perhaps one of the se people was the former Minister of Highways, who I happen to like as an individual but when it comes to a correctional system he would stand shoulder to shoulder with his authority, Lawrence Welk. And I still stand by our decision to phase out Headingley farm, because it just did not fit into the current operations.

I don't know what the breakdown of the 13 was who were not involved in some type of a work therapy type of activity, neverthe less I would hazarq a guess that most of these would be remand who could not work on the far m.

The uncertainty as to research - of cou rse, this is why we're elected, and I share the Member for Morris' profound respect for the British Parliamentary system, that it is a matter of judgment that we are elected to these offices to make judgments, and if it were not so, then we could turn it over to the technicians who, you know, could possibly keep us involved in re search from now until doomsday.

I share the Member for Rhineland' s concern; nevertheless it's a very complex problem and through the literature once again comes ambivalence, and it is total societal ambivalence, and it seems that, you know, the just society that we have been striving to build is so just that people have to anesthetize themselves to put up with it. People are becoming involved more and more in different manifestations of escapism, that they are not for some reason or other learning to cope with their existence in a way that they can get along with themselves and others.

And of course this is manifest in many other ways other than in alcohol or drug

Document details

Collection	Manitoba — Debates (Hansard)
Citation	30-2-91
Type	hansard
Volume / chapter	30th 2nd hansardpdf 91.pdf
Language	en
Format	pdf
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Identifier	35aecb2793c58f6702f592e7fcbed42b12087630

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