Manitoba Hansard — Sitting 43 (35th Legislature, 3rd Session)

35-3-43

Manitoba — Debates (Hansard)

Third Session - Thirty-Fifth Legislature of the Legislative Assembly of Manitoba DEBATES and PROCEEDINGS (HANSARD) 39-40 Elizabeth II Published under the authority of The Honourable Denis C. Rocan Speaker VOL. XLI No. 43 • 1 :30 p.m., THU RSDAY, APRIL 9, 1992 Printed by the Office of the Queens Printer. Province of Manltobe ISSN 0542-5492

MANITOBA LEGISLATIVE ASSEMBLY Thirty-Fifth Legislature Members, Constituencies and Political Affiliation NAME ALCOCK, Reg ASHTON, Steve BARRETT, Becky CARSTAIRS, Sharon CERILLI, Marianne CHEEMA, Guizar CHOMIAK, Dave CONNERY, Edward CUMMINGS, Glen, Hon. DACOUAY, Louise DERKACH, Leonard, Hon. DEWAR, Gregory DOER, Gary DOWNEY, James, Hon. DRIEDGER, Albert, Hon. DUCHARME, Gerry, Hon. EDWAR DS, Paul ENNS, Harry, Hon. ERNST, Jim, Hon. EVANS, Clif EVANS, Leonard S. FILMON, Gary, Hon. FINDLAY, Glen, Hon. FRIESEN , Jean GAUDRY, Neil GILLESHAMMER, Harold, Hon. HARPER, Elijah HELWER, Edward R.

HICKES, George LAMOUREUX, Kevin LATHLIN, Oscar LAURENDEAU, Marcel MALOWAY, Jim MANNESS, Clayton, Hon. MARTINDALE, Doug McALPINE, Gerry McCRAE, James, Hon. MciNTOSH, Linda, Hon. MITCHELSON, Bonnie, Hon. NEUFELD, Harold ORCHARD, Donald, Hon. PENNER, Jack PLOHMAN, John PRAZNIK, Darre n, Hon. REID, Daryl REIMER, Jack RENDER, Shirley ROCAN, Denis, Hon. ROSE, Bob SANTOS, Conrad STEFANSON, Eric, Hon. STORIE, Jerry SVEINSON, Ben VODREY, Rosemary, Hon. WASYL YCIA-LEJS, Judy WOWCHUK, Rosann CONSTITUENCY Osborne Thompson Welli ngton River Heights Radisson The Maples Kildonan Portage Ia Prairie Ste .

Rose Seine River Roblin-Russell Selkirk Concordia Arthur-Virden Stei nbach Riel St. James Lakeside Charleswood Interlake Brandon East Tuxedo Springfield Wolseley St. Boniface Minnedosa Rupert sland Gimli Point Douglas Inkster The Pas St. Norbert Elmwood Morris Burrows Sturgeon Creek Brandon West Assiniboia River East Rossm ere Pembina Emerson Dauphin Lac du Bonnet Transcona Niakwa St. Vital Gladstone Turtle Mountain Broadway Kirkfield Park Flin Flon La Verendrye Fort Garry St.

Johns Swan River PARTY Liberal NDP NDP Liberal NDP Liberal NDP PC PC PC PC NDP NDP PC PC PC Liberal PC PC NDP NDP PC PC NDP Liberal PC NDP PC NDP Liberal NDP PC NDP PC NDP PC PC PC PC PC PC PC NDP PC NDP PC PC PC PC NDP PC NDP PC PC NDP NDP

2012 LEGISLATIVE ASSEMBLY OF MANITOBA Thursday, Aprll9, 1992 The House met at 1 :30 p.m. PRAYERS ROUTINE PROCEEDINGS PRESENTING PETITIONS Ms. Judy Wasylycla-Lels (St. Johns): I beg to present the petition of Dianna Hunt, Angie Nieckarz, Allison Marciski and others requesting the Minister of Justice (Mr. McCrae) to call upon the Parliament of Canada to amend the Criminal Code to prevent the release of individuals wher e there is a substantial likelihood of further family violence. Ms.

Becky Barrett (We llington): I beg to present the petition of Susan Stonehill, Morray Nesbitt, Jim Jones and others requesting the government show its strong commitment to dealing with child abuse by considering restoring the Fight Back Against Child Abuse Campaign. Mr. Conrad Santos (Broadway): I beg to present the petition of M.E. Graveline, E.K. Larsen, M. Brodsky and oth ers requesti ng the government show its str ong commitment to dealing with child abuse by considering restoring the Fight Back Against Child Abuse Campaign. READING AND RECEIVING PETITIONS Mr.

Speaker: I have reviewed the petition of the honourable member for Burrows (Mr. Martindale), and it complies with the privileges and practices of the House and complies with the rules (by leave). Is it the will of the House to have the petition read?

The petition of the undersigned citizens of the province of Manitoba humbly sheweth: THAT the bail review provisions in the Criminal Code of Canada currently set out that accused offe nders, including those suspected of conjugal or family violence, be released unless it can be proven that the individual is a danger to society at large or it is likely that the accused person will not reappear in court; and The problem of conjugal and family violence is a natter of grave concern for all Canadians and ·equires a multifaceted approach to ensure that :hose at risk, particularly women and children, be >rotected from fur ther harm.

WHEREFORE your petiti oners humbly pray that the Legislature of the Province of Manitoba may be pleased to request that the Minister of Justice (Mr. McCrae) call upon the Parliament of Canada to amend the Criminal Code of Canada to permit the courts to prevent the release of individuals where it is shown that there is a substantial likelihood of fur the r conj ugal or fam ily viole nce being perpetrated. *** I have reviewed the petition of the honourable member for Transcona (Mr. Reid), and it complies with the privileges and practices of the House and complies with the rules.

Is it the will of the House to have the petition read?

The petition of the undersigned citizens of the province of Manitoba humbly sheweth : THAT the bail review provisions in the Criminal Code of Canada currently set out that accused off enders, including those suspec ted of conjugal or family violence, be released unless it can be proven that the individual is a danger to society at large or it is likely that the accused person will not reappear in court; and The problem of conjugal and family violence is a matter of grave concern for all Canadians and requires a multifaceted approach to ensure that those at risk, particularly women and children, be protected from further harm.

WHEREF ORE your petitioners humbly pray that the Legislature of the Province of Manitoba may be pleased to request that the Minister of Justice (Mr. McCrae) call upon the Parliament of Canada to amend the Criminal Code of Canada to permit the courts to prevent the release of individuals where it is shown that there is a substantial likelihood of fur ther conjuga l or fam ily viol enc e being perpetrated. **" I have reviewed the petition of the honourable member for Radisson (Ms. Cerilli), and it complies with the privileges and practices of the House and

201 3 LEGISL ATIVE ASSEMBL Y OF MANITOBA April 9, 19 92 complies with the rules. Is it the will of the House to have the petition read?

The petition of the undersigned citizens of the province of Manitoba humbly shewe th: THAT the bail review provisions in the Criminal Code of Canada currentl y set out that accused offe nders, including those suspec ted of conjugal or family violence, be released unless it can be proven that the individual is a danger to society at large or it is likely that the accused person will not reappear in court; and The problem of conjugal and family violence is a matter of grave concern for all Canadians and requires a multifaceted approach to ensure that those at risk, particularly women and children, be protected from further harm.

WHER EFORE your petitioners humbly pray that the Legislature of the Province of Manitoba may be pleased to request that the Minister of Justice (Mr. McCrae) call upon the Parliament of Canada to amend the Criminal Code of Canada to permit the courts to prevent the release of individuals where it is shown that there is a substantial likelihood of fu rther conjugal or fam ily violen ce bein g perpetrated. * (1 335) Introduction of Guests Mr. Speaker: Prior to Oral Questions, may I direct the attention of honourable members to the gallery, where we have with us this afternoon 28 seniors from Hamilton House.

These visitors are under the direction of Mary Wilkonski. Hamilton House is located in the constituency of the honourable Minister of Consumer and Corporate Affairs (Mrs. Mcintos h). Also this afternoon, we have 45 st udents from Grade 4, from the Teulon Elem entary School. These students are under the direction of Mrs. Lyle Campb ell. This scho ol is located in the constitu ency of the honourable member for Gimli (Mr. Helwer). On behalf of all honourable members, I welcome you here this afte rnoon. ORAL QUESTION PERIOD Economic Growth Government Strategy Mr. Gary Doer (Leader of the Opposition): Mr.

Speaker, yeste rday, the Minister of Finance (Mr. Manness) stated that we were being selective in quoting the most recent statistics in terms of growth for the province of Manitoba, a growth rate that declined by some 25 percent since the gov ernment has tabled its budget in this Chamber. Today, we have a second set of predictions on the growth in Manitoba, and unfortunate ly, they are even worse. We have gone from 3 percent growth predicted in 19 92, according to the Royal Bank, down to 1. 4 percent growth, a decline of some 50 percent in the projected growth rate for the province of Manitoba.

These are very important numbers, Mr. Speaker. They have an impact on our jobs, on our social assistance . They have an impact on our services and the quality of life in the province of Manitoba. I would ask the Deputy Premier, what impact will these changed forecasts downward have on the programs and services of Manitoba and particularly the vital services of Manitoba like health care which are in so much crisi s today? Hon. James Downey (Deputy Premier): Mr.

Speaker, again let me respond to the member by saying that he is, of course, always prepared to bring to this House the negativism of the New Democratic Party and to continue to work on the negative side of what is going on. Let me say that our government is committ ed to health care, to education, to family services, as has been demonstrated in our budget. There is no change. There are increases in our budget to look after those essential services. Out-Migration Statistics Mr.

Gary Doer (Leader of the Opposition): Well, you have a 50 percent decline in the growth rate o1 this province from an independent agency, not the New Democrats, but from two banks and for twc days in a row, and this government just continues tc whis tle past the economic graveyard of thi! province. Mr. Speaker, last month we saw 8,000 fewet people in the labour force than a year ago. Las· month, in February, Manitoba bankruptcies were thE highest they have been since the 19 30s-the highes they have been since the 19 30s.

Our out-migratior and net migration rate in terms of a per capiu number in the last quarter of 19 91 was the worst ir Canada. We are losing more people than any othe province in Canada on a per capita basis, and ye

April 9, 19 92 LEGISL ATIVE ASSEMBLY OF MANITOBA 2014 this government says, well, everyth ing is okay; happy days are here aga in. My question to the Deputy Premier is: What is he going to do to stop Manitobans from leaving this province and leaving us 1 0 out of 10 in terms of people st aying in the province of Manitoba? Hon. James Downey (Deputy Premier): Mr.

Speaker, one of the things that we have done is to stop putting intolerable taxes on the backs of those taxpayers like the New Democr atic Party did for the last six years of their administra tion, spending $27 million in Saudi Arabia, $30 million on a bridge without a road to it. That is the kind of hemorrhaging that has been stopped by this government. Mr. Doer: I thank the Deputy Premier for his tirade, Mr. Speaker. • (1 340) Employment Creation Strategy Mr. Gary Doer (Leader of the Opposition): Again, let us look at the facts in terms of what is happening to this province. Mr.

Speaker, we are suffering the worst bankruptcy numbers, personal and corporate, since the 19 30s. We are suffering out-migration and net migration worse than any other province in Canada. We have, two days in a row, seen decreased growth rates from two independent agencies dealing with the economy of Manitoba. We have a $90-million increase in expenditures in two budgets for this government for social assist ance, to deal with the 51 percent increase in welfare rates in the city of Winnipeg alone. .1 have another question to the Deputy Premier.

Would it not make a lot more sense to have employable people who are now forced onto social assistance in the province of Manitoba, with both the policies of this government and also the recession , would it not make more sense to have people working? Would it not make sense to have some of those peopl e, those young people who are unemployed and are on welfare right now, working in vital programs that are necessary for the province?

For example, would it not be better to have some of our young people who are on social assist ance, who are emp loyable today, have some of that money from the social assistance budget of $90 million placed in a working program to have projects like Dutch elm disease working in our communities, working across the province, rat her than people being unemployed? Hon. James Downey (Deputy Premier): Mr. Speaker, the mem ber made refe rence to bankruptcies. Manitoba in fact has shown a de crease year over year in both pe rsonal bankruptcies and business bankruptcies, unlike other provinces of this country.

We have in fact seen a lowering of the bankruptcies in this province. Secondly, Mr. Speaker, one thing we have done as well, as a government, is try to remove some of the payroll tax-the job-prohibitive tax that was introd uced by the form er New Demo cratic Party-and introduce a job partnership program for the youth and carry on with some of the youth employment programs for summer activity. There will be many act ivities that they will be employed in through government support. Child and Family Services Response Time Ms. Becky Barrett (Welli ngton): Mr.

Speaker, early this morning, it was rep orted that a two-year-old boy was found in only his diaper outside his apartment building by the caretak er, who immediat ely notified Winnipeg Child and Family Services. At noon, almost five hours later, no representative of Child and Family Services had yet come to investigate the situation. Since the minister's office was also notified of this situation this morning, what action has the minister take n? Can he confirm that the delay was due to the recent recentralization and lack of adequate resources faced by the caseworkers in Child and Family Services? Hon.

Harold Gllleshammer (Minister of Family Services): Mr. Speaker, I will take the specifics of that as notice and get an answer for the honourable member. What I can tell you, as far as the centralization of Child and Family Services, we have seen no diminishing of services in Manitoba, in Winnipeg through the use of Child and Family Services. On top of that, we have introduced a number of reforms that are underway now that we have had the opportunity to talk about in the past and that I am sure we will have an opportunity to tal k about during the Es timates process later today.

The Child Advocate legislation is before the House. The automation of the record keeping

201 5 LEGISLATIVE ASSEM BLY OF MANITOBA April 9, 19 92 within Child and Family Services is underway, and we should have a portion of that program up and running probably late spring and early summer. The high-risk indicators are being used with the front -line workers in the field, so there are reforms going on. If the member chooses to bring specific cases to the floor of the House, this is not the appropriate place to- Mr. Speaker: Order, please. Ms. Barrett : Mr. Speaker, this minister's office was notHied this moming- Mr. Speaker: Order, please. This is not a time for debate. Resources Ms.

Becky Barrett (Wellington) : Is this lack of immediate action or any action-it would appear to me at this point in time-not a blatant violation of the first principle of The Child and Family Services Act, which is the protection of children? Is it not as a direct result of inadequate resources so that caseworkers have twice or three ti mes the number of children to look after that they should have? Hon.

Harold Gllleshammer (Minister of Family Services): I remind the member that the resources that have gone into the Child and Family Services agencies within the province have virtually doubled in the last four to five budgets. The issue is not one of resources. I have already indicated that I would take the specHics of her question as notice. I have every confidence in the professional social workers and the administration who are in charge of the Family Services agencies within the province to react appropriate ly. Ms.

Barrett : Given that there is a continuing lack of adequate resourcing to the Child and Family Service agencies and an enormous two to three to four times increase in caseload above what should be in place to allow for and provide for protection of children, what assurances can the minister give this House and the children of Manitoba that this situation and situations like it, which have happened many times in the past and will happen again unless something is done about it, will not be repeated and that all children in Manitoba will be assured at least of the bare first minimum of basic protection of their lives? ,. (1 345) Mr.

Glll eshammer: I have already indicated that in the new resources that have gone into Child and Family Service agencies over the last few years , this government has dedicated almost 9 percent of new funding to Family Services in this budget, far outst ripping the budget that the member worked on and that they released the day before our budget calling for a 5 percent increase in Family Services budget.

We have dedicated consistently over the last five budgets more resources to this department, and the Family Services are seeing an increase in the amount of funds that they will be able to use for their work in the next budget year. Child and Family Services Communic ation Process Mrs. Sharon Carstalrs (Leader of the Second Opposition): Mr. Speaker, I got the same phone call as the member for Wellington (Ms. Barrett) , and I have been trying since I received that phone call to get in touch with the worker who was apparently supposed to be involved in this particular child.

I have learned that In fact the Child and Family Services agency attended the apartment block within 25 minutes of having been called and that the situation was resolved. I am very pleased to know that, but I want to know why the minister would not have some action in his department that he would not be immediately alerted to this kind of case which was reported to his office this morning. Hon. Harold Gllle shammer (Minister of Family Services) : Wel l, I thank the me mber for the comments, and I think this clearly Illustrates the type of information that members bring to the House for political reasons.

I have every conf idence that the agency, the administration of the agency and the staff there respond to these issues on a daily basis. Some of the information the department has about specific cases is not information that we are going to share in the House or with the public Some of the cases that individuals deal with are incredibly complicated and incredibly sad. I say to you and I have said before that I have thE utmost respect for those front -line workers anc: those administrators who, daily and on a 24-hou basis, seven days a week, deal with some of thE very sad cases in society .

It does not serve anyo.,. well to bring information here in a fashion that whitt

April 9, 19 92 LEGISLATIVE ASSEMBLY OF MANITOBA 2016 it is not hysteri cal, it is certai nly clearly there to misrepresent the facts. Mrs. Carstalrs: Mr. Speaker, with the greatest respect, the minister did not address what I think is a very fundamental question . He is the minister responsible for an extr emely sensitive department, a department which deals with children, in this case, a two-year-old.

I would like to know why someone on his staff did not notify him immediately that there was a breakdown in communication, because when the reporter called the agency, the reporter was informed it was none of his business, but it is every person's business in our community that a two-year-old child would be outside in a diaper at minus 8 degrees. It is everybody's business. I want to know from the minister why he would not have that kind of alert team in his office that would make him aware of that kind of difficulty so that he can ensure that the processes were in place to look afte r this child. Mr.

Gll leshammer: Mr. Speaker, we have hundreds of workers and thousands of cases that are active across this province. Again, the agencies that we fund, whether it be the Winnipeg agency, the Central Manitoba agency, the Westm an agency, the native agencies in the areas of the province where our department does that work, they deal with these cases on a daily basis. Some of these cases are br ought to the minis ter's attention and the department's attention on an ongoing basis. This is the work that those people do. We hear from time to time of specific cases that are ongoing that take some time to solve.

I think that when cases are put in the hands of those agencies, agencies that we fund, agencies that work under provincial legislation, we allow them to do that work, that the ministe r's office and the senior staff do get involved with these agencies on an ongoing basis, but we also allow them to do the work that they are entitled to do. * (1 350) Child Advocate Reporting Process Mrs. Sharon Carstalrs (Leader of the Second Opposition): Mr. Speaker, it is clear that the agency in this case acte d. It is equally true that in other cases, the agency does not act.

We have also seen an example today where the minister's department did not act. Will the minister now tell this House why he is requiring the Child Advocate to report to him? What is wrong with a model that would have the Child Advocate report to this Legislative Assembly so that children would not fall between his department and the agency? Hon. Harold Gllle shammer (Minister of Family Services) : Mr. Speaker, I am very pleased the member has raised that question. Her acting critic raised that question the other day, and I am on the record with the answers to those questions.

We are sett ing up a Child Advocate in this province based on models that exist in Alberta and Ontario. In those provi nces, those advocacy departm ents-or the part of that department works very well. The member and her acting critic, I think, are confusing the role of the advocate with the role of the Ombudsman. We have an Ombudsman who lo oks into per sonal cases and works with government where people feel that government is not serving them. The role of the advocate will be to work with children, and that advocate will come into place when the legislation is passed. I am sure members will support it.

It will be passed this ses sion. We were going to have an advocate in Manitoba, as recomm ended many, many times, that no other government has acted on. That advocate's office will be modelled on advocates in other provinces where it works very well. Lakes and Rivers Copper Sulphate Buildup Ms. Marianne Cerllll (Radisson): Mr. Speaker, the federal government released today its second State of the Environment Report, which raised concerns about the water quality in lakes and rivers in the prairie provinces.

There is mounting pressure then to seriously consider the effects of projects like the Assiniboine diversion and to more strictly enforce regulations that are dealing with chemical use in lakes and rivers. More specifically, I have a letter from the Department of Environment which states that copper sulfate is no longer a registered substance to be used to eliminate algae in lakes in Manitoba. How will the minister ensure that this chemical, which has been used in the past, will not be used in lakes in Manitoba this summer?

2017 LEGISLATIVE ASSEMBL Y OF MANITOBA April 9, 19 92 Hon. Glen Cummings (Minister of Environment) : By not permitting, Mr. Speaker. Ms. Cer llll: Mr. Speak er, there are sti ll communities that are bulletining their intention in the local newspapers to use this substance. Will the minis ter make a comm itment to impleme nting mo re inspec tion of those communities that have used this in the past so it will not be used this summer? Mr. Cummings: Mr.

Speaker, the bulletining that the member refers to, the community, I believe, was somewhat in error in the format that they used in their bulletining, and certainly It was not the intention of the departm ent to permit the use of the material , as was advertised in that bulletin. Ms. Cer llll: Mr. Speaker, one of the communities in question-or one of the lakes in question is Pelican Lake, which is horribly polluted. I would like to ask the minister if he will ensure this lake which has used almost 2,000 pounds in one year of copper sulfate , that there is sediment sampling and testing done in this lake? Mr.

Cummings: Mr. Speaker, it is confirmed that we are now tal king about the same bulletin. As a matter of fact, we are, as I said, not willing to permit the use of the copper sulfa te , and we have very good reasons for not doing that, one of which is that we do not want any buildup. I do take objecti on, however, to the member refe rring to the pollution in the lake.

The last time it was brought to our attention that there was considerable amount of bacte rial lode in the lake, it was found that low water volumes in that lake, which are now being addressed by the stru ctures that have been put in place combined with the high numbers of ducks and geese on the lake, was what was giving the high bact erial rea ding in the wate r. * (1 355) Health Care FaciiHi es Bed Closure Proposal Ms. Judy Wasylycla -Lels (St. Johns): Mr. Speaker, it should be increasingly clear to everyone in this Chamber that there is chaos in our hospital syst em.

Patients are worried, staff are fearfu l, administrators are concerned as a result of this government's secretive approach to changes to our health care system. In particular, the Health Sciences Centre has been trying to deal with this very diffic ult directive from the government to make big cuts to beds in its budget. The board of that facility met last week and discussed its response to this government directive and sent that plan to this minister. Will the Ministe r of Health share that information with the people of Manitoba and table that plan here in this Chamber? Hon.

Donald Orchard (Minister of Health): Mr. Speaker, after yesterday , when my honourable friend brought not one, not two, but three pieces of incorrect information to this House, it almost seems as if it is epidemic that they have what I have come to affectionate ly know for the New Dem ocratic Party as the "leader's disease ." I will not reflect on that bad information that my honourable friend brought to the House yeste rday.

What my honourable friend is correct about is, yes, the Health Sciences Centre and other hospitals have been developing their operational plans to meet their budget allocations for this fiscal year. The process has been one of feeding back into Manitoba health , into our facilities co-ordinator, the associate deputy minister, those plans of action for this fiscal year. Mr. Speaker, those plans are under active consideration by the department.

I would hope that when my honourable friend chooses to move along the Esti mates process so that we reach the hospital line in the Estimates, as I have urged her to do now for 12 hours, we will have a full and complete discussion of the issues with my appropriate staff there. Ms. Wasylycla-Lels: Mr. Speaker, If we cannot get information about this government's plans for our hospitals, could we at least get from this minister the plans of facilities, tabled with this ministe r, in response to this government's directives? Mr. Orchard: Mr.

Spea ker , the plans of government and the respective hospitals will be abundantly clear, as I have indicated several times in the Estim ates process, over the next ensuing several weeks. I just want to note to my honourable friend tha1 when she is making these sorts of requests o1 government, one would assu me from casual observation that those would then become polic) that a New Democratic Party would put in place. I want to remind my honourable friend that an) budgetary plans from hospitals to the Department o· Health have never been shared by New Democr at

April 9, 19 92 LEG ISLATIVE ASSEMBLY OF MANITOBA 201 8 liberal, Conservative government in the province of Manitoba. They are working documents of the ministry. I do not intend to change that longstanding traditi on, neither do I intend to change the policy put in place by Howard Pawley and the NDP of not allowing defici ts in the hospitals. I know my honourable friend from opposition has flip-flopped on that policy, but a little bit of consiste ncy would be appropria te for my honourable friend in her questioning and her future policy development. Ms. Wasylycla-Lels: Mr.

Speaker, never before have we had a government which has refused to provide information about- Mr. Speaker: Order, please. This is not a time for debate . Ms. Wasylycla-Lels: Would the Minister of Health not now agree that it is time to end the fears and concerns and confusion in our health care system and provide, for all of us here in this Chamber and for the public at large, details of this government's plans for hospital beds and budgets? * (1 400) Mr. Orchard : Mr.

Speak er, I have told my honourable friend for the last 12 hours in Estimates that when we get to the hospital lines, those kinds of details on this year's budget can be made available with the appropriate staff. My honourable friend wants to chew away on phantoms. That is her privilege. Mr. Speaker, I reject total ly and completely the false accusation by my New Dem ocrat friends where they say that this is a secretive government.

This government has opened up the discussion process more than any other gov ernment in the history of the province of Manitoba and, I submit, opened the discussion process more than any other government in Canada around health care reform . That is why we have tabled Centre for Health Policy and Evaluation studies on the health care system, to enlighten my honourable friend to the challenges fac ing all Canadians in reform ing the health care syst em. That is why we have tabled, for my honourable friends, the Health Advisory Network reports as I have received them and made them public. Mr.

Speaker, this is the most open government that the province has ever had in its history, and my honourable friend persists in- Mr. Speake r: Order, please. Point of Order Ms. Wasylycla-Lels: This is a very serious matter. The minister has five advisory network reports since last summer, and he has not tabled one or made any of them public- Mr. Speaker: Order, please. The honourable member does not have a point of order. It is a dispute over the facts. Economic Growth Prairie Provinces' Co-operauon Mr. Reg Alcock (Osborne) : Mr.

Speaker, I was interested in some of the infor mation that the leader of the Opposition (Mr. Doer) brought forward today because I think it does underline the very difficult position that this province finds itself in, in part, as a result of changes in federal policy that have I think served to weaken the ties that bind the prairie region toget her. On February 13 and 14, a number of people met in this city to look at some ways in which we can build some strength back into the prairie economy. Represent atives from all three provinces were there.

The Minister of Trade is aware of the outcome of that meeting, which was an attempt to look at the ways in which the prairie provinces can work toget her to build strength in this region. I would like to ask the Minister of Trade if he has had an opportunity to discuss these proposals with his provincial counterparts . Hon. Eric Ste fanson (Minister of Industry, Trade and Tourism): Mr. Speaker, I have received some of the information from that conf erence that took place in Winnipeg. Subsequen tly, I had a discussion with one of my cou nterpar ts in Saskatchewan.

As economic ministe rs, we meet occas ionally as weste rn ministers, and we both agreed that a usefu l topic the next time we meet would certainly be the whole area of western co-operation. Whether one talks about integration is a bit further removed, but there are already areas where we are co-operating in tourism through development of standards and certification and science and technology with an earth-space initiative.

In other areas of co-operation recently, in the environmental field on the environmental Industry side, we are co-operating, so there is extensive co-operation to build on already, and we agreed that the idea of continued co-operation and potential

201 9 LEGISLATIVE ASSEMBL Y OF MANITOBA April 9, 19 92 enhancement would be a very useful topic of discussion at our next meeting. Mr. Alcock: I am very pleased to receive that answer from the minister. Can the minister tell me whether or not the suggestions about creating greater co-operation and perhaps joint research among the prairie telephone systems is one of the items that will be up for discussion at those meetings? Mr. Stefa nson: The honourable memb er for Osborne refe rs to one specific rec ommendation out of, I believe, 12 or 14 or 16 reco mmendations that flowed from that conference.

As I have indicated, at this stag e, discussions would be at a preliminary stage in terms of the whole issue, the areas of co-operation. We are already doing some that I have outlined. I think there is opportunity for more. At what stage we would get to dealing with the specific re comm endations would remain to be se en. Obviously, they also impact on other departments within our government that would require review. Once we have had an opportunity to go through the documentation that flowed from that particular conference in Winnipeg, we will be sharing it with all of my colleagues, Mr. Speaker. Mr.

Alcock: I wonder if the minister can tell us whether he or the Minister of Finance (Mr. Manness) have had discussions with the other two provinces about creating a pension pool for the three provinces to provide capital for the development of projects in the prairie region. Mr. Stefa nson: At this sta ge, Mr. Speaker, no, we have not.

I think most members of the House will recall from the western Premiers' meetings that took place in Nipawin last year, what flowed from that was the concept of the code of conduct in terms of investment promotion to halt, we will call them, the bidding wars that occur occasionally amongst provinces, certainly in western Canada and across all of Canada. That is certainly going to be a topic of discussion.

What the honourable member for Osborne refers to ultimately might be something that certainly as a topic of discussion could flow from that very issue because the whole issue of us competing as provinces for investment, the cost to the taxpayers and so on, is one that is very timely and is actually to be discussed by all internal Trade ministers here in Winnipeg at the end of the month. Winni peg International Airport Protection Mr. Doug Martindale (Burrows): Mr. Speaker, last year, over the objections of the Minister of Transport, the Minister of Housing (Mr. Ernst) , with the support of the Premier (Mr.

Filmon), approved funding for the Rotary Pines project, thus pote ntially jeopardizing 13 0 jobs at Winnipeg International Airport. Now, the City of Winnipeg and the Winnipeg Chamber of Commerce are requesting the provincial government to protect the airport from encroaching development. Does the Minister of Transportation sti ll support airport protection legislation as he did last year and as he did as early as 19 897 Hon. Albert Driedger (Minister of Highways and TransportaUon): Mr. Speaker, most definitely. Mr.

Martindale: Has the Minister of Transport brought to cabinet the pressing need for airport protection legislation on the Alberta model and convinced his colleagues, especially the Premier (Mr. Almon) who is unaware of its success, since much of the land in question is not within the city of Winnipeg but outside city boundaries? Mr. Driedger: I want to indicate that I am working closely with my colleague, as well as my Premier and the City of Winnipeg, in term s of setting up under Plan Winnipeg protection for the airport.

Also, at the same time, there is federal legislation being developed that will also tie into that. I am confident that by the time we are through with this, during the course of this summer, the protection will be in place. Mr. Martindale: The real question is whether the ministe r is going to rely on the City of Winnipeg and Plan Winnipeg, which is not at all reliable. We know that prodevelopment councillors in the past have amended Plan Winnipeg to allow things that are not proper.

Will this minis ter bring in provincial legislation to do what the city is now requesting so that the province can have some control both in the city and outside the city? Mr. Driedger: Mr. Speaker, I want to indicate that the authorities who have power to make certain decisions at the present time, if they will nol adequately address the protection of the Winnipeg airport, the Minister of Urban Affairs (Mr. Ernst) and myself will make sure that they will be addressed properly.

April 9, 19 92 LEG ISLATIVE ASSEMBLY OF MANITOBA 2020 55 Plus Program Indexing Mr. Nell Gaudry (St. Boniface) : Mr. Speaker, it is now clear that the 55 Plus program will again not be indexed to inflation. As a result, those already recognized in law as living below the poverty line will be forced to accept an even lower standard of living. Can the Minister responsible for Seniors tell this House why his government has chosen to deprive seniors in this way? Hon. Gerald Ducharme (Minister res ponsible for Seniors) : Mr.

Speaker, I almost lost a bet when I saw seniors up in the audience and I bet that I would have a question. Mr. Speaker, to the member for St. Boniface, at a time of difficult times, our government has kept payments equal. We are looking after our seniors both in the health field and the family services. This government has its pride to work with the seniors throughout the province with our senior abuse, our financial abuse syst em, throughout all our portfolios, and will continue to benefit the seniors of this province. Mr. Gaudry: Mr. Speaker, I thank the minister for the cheap shot.

Can the Minister responsible for Seniors tell us how the seniors are to pay increased costs of hydro, te lephone, food , clo th ing, all of whic h are increasing, many above the rate of inflation, when this government refuses to provide any help? Mr. Ducharme: Mr. Speaker, we are-not a cheap shot -increasing through our health services, through our many benefits . Unlike the previous administratio n, they taxed those seniors who were at the low level at a percent of 2 percent on the net tax . Mr. Gaudry: Mr.

Speaker, can this minister tell this House the cost of Seniors Day here at the Legislature, and will they consider using these dollars to provide for indexing the 55 Plus? • (141 0) Mr. Ducharme: Mr. Speaker, we have different seniors groups who have come forward to us. We sit down with those seniors groups, and they tell us the different ways they would like their money spent. For instance, on continuing care , we are increasing it on all personal care homes.

If they are concerned about the health care in personal care homes, for instance, as announced by the Health minister, we are going to est ablish 600 personal care homes shortly in this province. That is the way we will benefit the seniors. Port of Churchill Efficiency Mr. John Plohman (Dauphin): Mr. Speaker, the Mini ster of Agricu ltu re's position on the transportation talks is now abundantly clear. His Apri141etter to the Free Press demonstr ates that he has swallowed hook, line and sinker the federal position wi th regar d to Chur chill ra il line abandonment and method of payment.

He says it is all in the name of efficiency. He says the federal government has conducted an internal review of trans po rtat ion eff icien cies to ma ke the transportation system from farm to port more efficient. Since it is well known that Churchill has a $20, at least, advantage in shipping over St. Lawrence ports, I want to ask the Minister of Transportation why he has not informed his Minister of Agriculture (Mr. Findlay) of that fact and whether he agrees with his Minister of Agriculture that in fact shipping more grain through Churchill would not make the system more efficient rather than less eff icient.

Hon. Albert Driedger (Minister of Highways and Transportation): Mr. Speaker, since I took office as Minister of Highways and Transportation in May of '88, many versions and many figures have been thrown about in terms of the advantage or disadvantage of shipping through Churchill. The member well knows that there are opponents to the Port of Churchill. When I had fe deral Minister Shirley Martin out last year to Churchill, the one assurance that she gave me was that there would be precise figur es, accurate information brought forward . That is being worked on by the federal government.

However, I have to indicate that we will be watching the figures and information very closely . We have the assurance that somewhere along the line, when that information comes forward, we will be able to have a chance to dialogue and check, and we will scr utinize very closely that kind of information that is being brought forward. Mr. Plohman: Mr. Speaker, it is clear that that information is already there , and this minister fails to recognize it.

2021 LEGISLATIVE ASSEMBL Y OF MAN ITOBA April 9, 19 92 Why has this minister failed to ensure that the transportation talks, $1 .1 -million consultative sham by the federal government, did not include balanced inform at ion, accu rate inform at ion, on the efficiencies of a greatly expanded role for Churchill? Why did he not make sure that information was in those hearings? Mr. Driedger: Mr.

Speaker, I have the same information that the member had when he was the minister, but I have to indicate to you that there has been lots of additional, which I consider, wrong information that has been out on the hustings and for the public of Manitoba as well as for the federal government in terms of I do not believe that we have accurate information. I believe we have accu rate information, but I believe there is a lot of inaccurate information that is out there.

I am hoping that within the next three, four, six months, we will be able to establish precise figures that are going to be not just beneficial to us, that we use, but that everybody will be able to make themsel ves available of that, which will show that there can be viability in Churchill and that Churchill should stay for the benefit of the people of Manitoba. Mr. Plohman: Mr. Speaker, this minister has the accurate information. Why is he not putting it out there? He knows it is accurate information. I ask him whether he will ensure that his Minister of Agriculture (Mr.

Findlay), his collea gue, travels to the Hudson Bay Route Assoc iation next week with him so that he too can learn the facts about Churchill. Mr. Driedger: Mr. Speaker, I am not going to be taking the Minister of Agriculture along, but I want to indicate that I am prepared to take the member for Ru pertsland (Mr . Ha rper), the memb er for Thompson (Mr. Ashton) and whoever else-if they want a member from the Liberal Party. Not all of them , but certainly I am prepared to take- Some Honourable Members : Oh, oh. Mr. Speaker: Order, please. Mr. Driedger: Mr.

Speaker, let me rephrase that. am prepared to take members of the opposition along, as I did last year, to the Hudson Bay Route Association meeting that is taking place on Monday. We will again have a chance to discuss this, where I will raise serious concerns about the future of Churchill, where I think it is very important that all members of the House are speaki ng from the same song sheet when we deal with this issue. Public Schools Enrollment Decline Mr. Dave Chomlak (KIIdonan): Mr. Speaker, my ques tion is to the Minister of Educa tion.

We have learned that since coming to office, this government has seen enrollme nts at private schools increase by 13 percent or 1 ,245 students while, in the same period of time, enrollments at public schools have decreased 1 percent , or down 1, 907. Can this minister advise the House what steps this government is going to take to prevent the creation of a two-tiered education system in the province of Manitoba? Hon. Rosemary Vodrey (Minister of Education and Training): Mr. Speaker, I would like to remind the honourable member that in the Independent school syst em, some schools set up for many reasons.

Some of them are for religious reasons in this provi nce , and parents in fact have the opportunity of free choice. Mr. Chomlak: Mr. Speaker, the minister is well aware that these schools have been in existence for 75 years. Can the minister answer the question and indicate why the increase , since the Conservatives came to office, is 13 percent in the private schools in enrollment, and it is down 1 percent in public schools? Has it something perhaps to do with government funding at a windfall basis to many schools? Mrs.

Vodrey : I certainly hope that my honourable friend is not indicating that he considers that there are some extremely drastic difficulties within the public school syst em, because we on our side of the House, Mr. Speaker, recognize that the public school system is in fact doing an extremely good job. There are many hard-worki ng teachers and administrators and trust ees working in that syste m. Mr. Speaker : The time for Oral Questions has expired. ORDE RS OF THE DAY Hon. Jim Ernst (Acting Government House Leader): Mr. Speaker, I would move, seconded by Minister of Environment (Mr. Cummings), that Mr.

Speaker do now leave the Chair and the House resolve itself into a commit tee to consider the Supply to be granted to Her Majesty. Motion agreed to, and the House resolved itself into a committ ee to consider of the Supply to be

April 9, 19 92 LEGISLATIVE ASSEMBL Y OF MANITOBA 2022 granted to Her Majesty with the honourable member for St. Norbert (Mr. Laurendeau) in the Chair for the Department of Health, and the honourable member for Seine River (Mrs. Dacquay) in the Chair for the Department of Family Services. COMMITTEE OF SUPPLY (Concurrent Sections) HE ALTH Mr. Deputy Chairperson (Marcel Laurendeau) : Order, please . Will the Committee of Supply please come to order. This afte rnoon this

section of the Committee of Supply meeting in Room 255 will resume consideration of the Estimates of Health. When the comm ittee last sat, it had been considering item 1. (

b) Executive Support

(1) Salaries on page 82 of the Esti mates book. Chairperson's Ruling Mr. Deputy Chairperson: At this time I would like to bring my ruling forward from the other day. On AprilS, 19 92, during the Department of Health Estimates in Room 255, the honourable minister used the phrase, "I can engage in no more debate with hypocrit es." The member for St. Johns (Ms.

Wasylycia-Leis) raised a point of order stating that "they impute motives and cast slander on members of this side of the House." As I mentioned to the committee yesterday, Beauchesne Citations 489 and 490 have ruled the term "hypocrites" both unparliamen tary and parliamentary. A review of the Manitoba Speakers' Ruling has revealed a similar patt ern.

I would draw to the member's attenti on Beauchesne Citation 486(1 ) which state s, "It is impossible to lay down any specific rules in regard to the injurious reflections uttered in debate against particular Member s, or to declare beforehand what expressions are or are not contrary to order; much depends upon the tone and manner, and intention, of the person speak ing; ... " I should also remind all honourable member s that the Chairperson's Rulings, once made, are not subject to question. I would like to remind the honourable minister that I had asked him to withdraw the word "hypocrite." Hon.

Donald Orchard (Minister of Health): I will certainly comply with your request, Mr. Deputy Chairperson. Mr. Depu ty Chair person : Thank you , Mr. Minister. * (1 430) Ms. Judy Wasylycla-Lels (St. Johns) : I am wondering if I can make a sugges tion in the spirit of co-operation that is beginning this set of Estimates. Given the minister's indication that he is prepared to answer questions on hospitals If we proceed to that line, I would make the suggestion that we move directly to 5.(

b) and then having completed that line, return to where we have left off. Mr. Orchard: In the interest of that same spirit of co-operation, let us proceed as we have always done, line by line. The quicker we getto the hospital line, the quicker we will have all of the answers including on Mental Health, Continuing Care, and all of the other very, very important areas of the ministry of Health. I am not hung up on the acute care hospital line alone, I have a ministry of Health of importance to all Manitobans.

I appreciate my honourable friend's singular focus on hospitals only, but there is a much larger department to discuss and I would prefer we discuss that as we always have, in order. Mr. Guizar Cheema (The Maples) : I have not given any thought to that, I tell you very fran kly. I think that the way we have done it in the past and If you want to change and want to have agreement with the House leaders, that is fine. But, as far as I am concerned, I have been told by my caucus to proceed the way we have done in the past. H there is any change from my caucus, then I will proceed .

The direction to me is to proceed line by line. Mr. Steve Ashton (Thompson): Mr. Deputy Chairperson, if the minister is talking about what is normally done in Esti mates, the minister who has been in this House for quite some time should be aware of the fact that there have been different approaches in dealing with Esti mates. It is not unusual in dealing with Esti mates , in terms of a number of departm ents, for the minister to have dealt with all questions on one line item and then pass all the resolutions at the end of Estimat es. I remember several departments where that was done last session .

It is a question of a choice of the committee which is obviously, most significantly, a choice of the minister and the government because presumably the minister and the government has control over the committee. The minister might not have too

2023 LEGISLATIVE ASSEMBL Y OF MANITOBA April 9, 19 92 much control over this committee right now, but I am sur e he would rath er quickly pull in me mbers sufficient to out-vote the opposition. So, it is the government's choice; it is the minister's choice ; and the real bottom line here is not a question of what is normally done. The minister knows that we can normally do anything that is felt advisable. This committee has control over the agenda in that sense. We allow questions of varying degree of varying generality depending on the preference of the minister.

So what the minister is saying, if he is saying that he and his majority on this committee does not wish to move to the hospitals line to be able to deal with the serious questions that have been raised, to be able to give him the opportunity to provide what I thought was an offe r this afte rnoon in Question Period, Mr. De puty Ch airper s on, which is essentially to provide information when we get into the discussion of that line item, we are offe ring him that opportunity.

I believe his response will have very little to do with what is normal in this committee, because as I said, the normal thing is that the committee has control over its agenda. It can deal with whatever it wants. What the minister is saying if he wants to go line by line, if he does not want to follow up on our of fer, is that he does not want to get into the discussions to what is happening in our hospital syst em. He does not want to get into providing the information that day after day after day our Health critic has been attempting to obtain from the minister.

What the minister is doing then is essentially avoiding the very serious questions that are being asked . Mr. Deputy Chairpers on, the minister knows full well the length of time that we often spend in Estimates. I remember when I was Health critic we spent 44 hours. I believe that my successor has spent more than that or close to it and the Liberal Health critic along with the minister in the past several years. What is happening here is we are willing to deal with the hospitals right now. That is the urgent situation.

We need to know what is going on, but we are not in any way, shape or form going to rush throu gh other ite ms that also have legitima te questions that need to be asked. Let us not forget, this committee deals with the budget for the entire year. H we pass a line item or a series of line items, that is it for this year. There is no further discussion in terms of Est imates. What we are saying is in the interests of following up on the kind of offer I thought was made by the minister, to provide the information to see if it is a real offe r, we are saying let us deal with the hospitals now.

H the minister is saying no, he is saying no to answering the questions. He is further stonewalling getting the kind of information that the public wants, not members of the opposition strictl y, Mr. Deputy Chairperson, the public wants. They want to know what is going on in our hospitals. They want to know what is going to be happening in terms of possible bed closures, other changes in term s of the hospital syst em. The minister ought not to play the kind of game that we are seeing on this issue.

The minister ought to say right now, with his control of this committee, that he will be reasonable and follow up on what we feel is a very reasonable offer which is let us deal with the hospitals now. Let us get the information now. Let us clear the air. Let us get the information the public of Manitoba wants. Mr. Cheema: Mr. Deputy Chairperson, being not very particularly astute , I am really puzzled. This is something that was supposed to be discussed among the caucuses and then this issue can be discussed and now they are putting us in a very dHficult situation.

H I say I will support him, they will say that Is supporting the government. If we say we do not want to discuss the hospital, then we are against hospitals. It is my belief that what we have done for the last five years is to follow the directions within the committee. The committe e's normal procedure is to go line by line, and we are not talking about one chair somewhere and we are going to move from here to there. We are talking about a major department, and I will feel more comfortable if we are discussing the whole policy rather than going here and there and whate ver suits the needs of the day.

I think that is very dangerous, and I am not personally going to support that. I want to make it very clear, I will still check with my caucus. Whatev er they want to do, and I am sure they will agree with me, because I think that some kind of game is being played and I am not going to be part of that stupid game. Ms. Wasylycla-Lels: Mr. Deputy Chairperson, I regret that the member for The Maples has made such derogatory remarks about our suggestion . It was not done for political reasons. It was not done to put him in an awkward spot. It was done because

April 9, 19 92 LEGISL ATIVE ASSEMBLY OF MANITOBA 2024 we have a serious, urgent, pres sing matter before us. I remind all members at this committee that after a series of questions over the last 16 hours about general funding policy with respect to hospital s, general health care reform plans of this government, we have been getting no answers. The minister has said, if we just move along quickly to that line, we can get to that informati on.

The minister knows that there are a lot of serious, su bstantive issues between the line we are presently on and the line dealing with hospitals and community health services, and he will be fully aware that we should all have a serious discussion on all major components of his departm ent. It was the ministe r's sugges tion that we could be dealing with this matter in short order if we were on that line, so we are simply following through on that offer and asking the minister to follow through with that offe r. He says the information is ready.

He says that he will tell us what budgets hospitals are getting, what the plans are with respect to reform , what the plans are with respect to bed reduction targets and budget reduction targets for hospita ls. He has the information. We are simply asking, given the urgency of the situation and with the co-operation of everyone here, to move to that line so we can discuss this very serious, pressing matte r.

I want to stress to the minister and others here that we are not raising this as a tactical suggesti on, that hospitals are not our only preoccupation with the health care department and with this minister, but right now we are dealing with a very critical situati on. * (1 440) Ev ery day , we are hearing from hospital department heads and administrators who are perplexed and confused and concerned about di rectives that they are get ting from this government.

Every day, we get letters and calls from patients who are deeply worried and afraid about whether or not they will be able to have access to the quality health care services they believe are a right in this province.

Every day, we ar e hearing from staff, profess ionals, nurses, workers in our hospitals who are living in fear and paranoia, who are living in such fear and paranoia, they are quest ioning whether they are able to actually fully do their jobs because of that overriding concern, a concern and a fear and a paranoia that has been caused by directives for which this government and this minister will take no ownership. Mr. Deputy Chairperson, we cannot allow our hospitals to continue along that path.

We cannot allow for that kind of worry and fear and paranoia and concern to permeate our hospitals, our health care fac ilities that provide such important care to people in urgent situations requiring emergency care , needing su rgery, needing imme diate atte ntion, needing longer term care. It is too much of a risk.

It is far too serious for that and we fe el , given the lack of responsiveness on the part of this government to release its plans, the det ails, to provide information to the public, to the hospitals and to the Legislative Assem bly, that we have an obligation and a responsibility to get to this matter as quickly as possible. The minister has said he has the information ready. Our su ggestion is reason able.

We therefore would ask again if we can all agree to move to line 5.(b} immediate ly, the line dealing with hospitals and community health services, and if the minister needs a little time to get his relevant and appropriate staff here, then I think we would all be willing to co-operate in terms of a short recess for that purpose. Mr. Deputy Chairpers on: I would like to inform mem bers of the commit tee that the correct procedure for considering items in the Committee of Supply is line-by-line manner.

In order to skip ahead or to revert back to lines already passed , unanimous consent of the commi ttee is required. Mr. Cheema: This is the fifth time we have gone through the Health Estimates, and each and every time we had major issues that were affecting the health care of Manitoba, but we always have gone through line by line and followed the procedure. I would like the New Democratic Party to te ll me, do they think that everything else in health care is not important? [inte�ection] No, no, can I just have my time to say what I would like to say? Mr. Deputy Chairperson : Order, please.

At this time I would like to inform the committee that I have made the state ment and it has become quite clear, and I will ask the question, is there unanimous consent to move on to point 5 at this time? No? Then let us carry on with the normal business and we will be dealing with 1 .(b} Executive Support.

2025 LEGISLATIVE ASSEM BLY OF MANITOBA April 9, 19 92 Point of Order Mr. Ashton: I just want to indicate we will be raising this matter again, and I want to give notice to the minister, and I know the Liberal critic, who had some concern, did not have a chance to discuss this with his caucus, that we will raise this again on Monday. The minister may wish to have staff available if he changes his mind over the weekend. This will give the Liberal critic the opportunity to deal with it as well. We will be raising this again. Mr. Depu ty Chai rperson : The honourable member did not have a point of order.

Point of Order Mr. Cheema: Mr. Deputy Chairperson, these things are a part of the caucus discussions. They should have had the discussion with the Minister of Finance (Mr. Manness) who is the House leader, and Mr. Lamoureux, the member for Inkste r, and had those decisions made, and then come back here. Now, next week they are going to again test who is supporting the hospital, who is not supporting the hospit al, that kind of situation. I am not going to get into that. Mr. Deputy Chairperson: Order, please. The honourable member does not have a point of or der. If we could carry on, 1 .(

b) Executive Support. *** Ms. Wasylycla-Lels: Mr. Deputy Chairpers on, let me just thank you for your ruling and indicate to you that we are concerned about the situ ation. We will continue to pursue questions pertaining to hospitals given the current looming crisis in our hospital system and health care syste m, and will keep raising questions about government plans In that area. As my colleague the member for Thompson (Mr. Ashton) has suggest ed, if the minister is still unwilling to give answers , we will suggest again that we move directly to the line dealing with hospitals on Monday.

I would like to begin this afternoon by asking if the minister is now able to respond to my question of the last sitting of Esti mates. When did he first know about the summer bed closures that became extended bed closures at the Health Sciences Centre last summer? Mr. Orchard: Mr. Deputy Chairpers on, I want to generally respond to the gamesmanship played by the offi cial opposition In terms of wanting to advance the Es timates. The reason ostensibly is, according to their contacts of CEOs and I do not know what other numbers of people, that-my honourable friend says, all over.

Well, that is all levels, all over. Now, my honourable friend is therefore maligning every CEO in the health care syst em , that they are personally telling her that every vice-president of every hospita l, every head of a surgical department, medical department, every head of a department is talking to the NDP and giving them these dire stories. Mr. Deputy Chairperson, that is not accurate. My honourable friend, in persisting that all of these people are providing her with all of this information, is maligning a lot of very good professional people.

She could remove the cloud that she is putting over those people if she would simply Identify some of these phantom sources. But, of course, she will not. She prefers to malign every professional caregiver in the health care syst em. She also wants to create the aura that the system Is crumbling. As we sit here and discuss Estimates of the Department of Health, the hospital system is admitting patients who are ill, injured, going in for elec tive surgery, emer gency and urgent surgery . The health care syst em, the hospital system is operating as it operated five days ago, 1 0 days ago, two weeks ago.

People are receiving medical trea tment. People are not dying on the streets because our hospital system has collapsed as my honourable friend might want to create the aura and the im pressi on. When she uses this language that all of these professionals are telling her and her caucus of the chaos and all of the other allegations she makes, she maligns every professional group that is working in a dedicated way to deliver health care services and is delivering those health care services.

The crisis exists in my honourable friend's mind, and here is the problem my honourable friend the New Democrat has, because in, for instance, the province of Ontario, and I want to deal with this right now because I am getting tired of this allegation in Manitoba. In Ontario, thousands of hospital beds are closing under the NDP. Now, is this because they have this malicious spite for health care , that they hate

April 9, 19 92 LEGISL ATIVE ASSEMBLY OF MANITOBA 2026 hospitals, that they hate the patients of Ontario? No, they would prefer not to make those decisions, but they have to because of the fiscal circums tances of Ontario. In Saskatchewan, there was not a $101 million increase in funding to heal th care as we are debating in these Es timates. There is, without a budget, prelim inary indications that the health care system will get 2.6 percent less money than it got last year. Do you th ink the Saskatchewan government compo sed of New Dem ocrats is enjoying having to put that kind of a budget forward?

Of course not. In Mani toba, no suc h chaos ex ists . My honourable friend the New Democrat is frustrated that in each province to the east and west of us, there are those circumstances going on that my honourable friend is so wont to happen in Manitoba, the kind of multi-thousand bed closures, layoffs, curtai lments of service, et cetera , reductions in budgets as is happening in Saskatchewan. She would dearly love that to be happening in Manitoba, so she would have so me legitima te case for complaint.

When it does not happen, my honourable friend maligns all the professional caregivers in the province by saying they are telling her. She will not identify who the "they" are, but she is saying they, these people are telling her of difficulties and of problems in the hospitals, maligning all of those profess ionals who are working with government to develop acti on plans to reform the system of health care. * (1 450) My honourable friend may not like to hear that we have a very, very excellent plan for reform in health care.

She may not like to hear that because it contrasts so starkly with what is happening in Ontario, where I read the analysis of the Ontario reform , that it is the blunt instrument of budget cut so that the system will organize itself from the bottom up and hopefully will be able to care for the needs of the people of Ontario. That is not what we endorse as a reasoned system of change in Manitoba. It is not like the chaos in Saskatchewan where there is 2.6 percent less funding. It is a reasoned approach. I laid it out clearly in my opening remarks Monday, two weeks ago.

We intend to move budget with patient from high cost institutional care to lower cost more appropriate care centres, be that an urban hospit al, be that a rural hospital, be that a personal care home, be that continuing care services in the person's own home, and where we can do that and empty beds in our teac hing hospita ls, for instance-and I have used this example I do not know how many times-we will close the hospital bed at the teaching centre, because we do not believe we should be spending an average of $800 a day to provide for services to a patient who can be cared for in an environment as low as an expense item as $1 10 a day in continuing care .

The people who win in this are the patients requiring care, and also, coincidentally, the tax payer is better served. That is a reasoned plan that I have laid out, that is being discussed at hospital boards. They are developing their plans right now, Mr. Deputy Chairperson, right now. They are reporting back to government as to how they can accommodate the changing environment in health care delivery that is in place right across the length and breadth of this country. They are working in a co-operative fashi on.

They are not saying, as my honourable friend says, these unknown "theys" whom she talks about without identify ing, that this is wrong, this is inappropriate, this cannot be done, this is the wrong thing to do. They are expressing legiti mate concerns about being able to accom modate patient care in a changing environment, but everybody is concerned about that.

They are pleased as CEOs, as board chairpersons, as prof essional care deliverers that at least this government has a plan of action that is under discussi on, of moving services and budgets with the patient, that protects the integrity of care to the individual requiring care , that is underpinned with the kind of research I have shared over the last 14 hours of Es timates about where admissions to the Health Sciences Centre are inappropriate . They can be provided in lower-cost hospita ls, but my honourable friend wants to perpetuate that monolith of hospital care .

That has been her entire and only focus in 16 hours. My honourable friend has not asked anything about any other area. I give credit, again, to my honourable friend, the member for The Maples (Mr. Cheema). He has taken a syste m-wide approach to health care, because you cannot discuss one hospit al, one prof essional group, one program of government in isolation

2027 LEGISLATIVE ASSEMBL Y OF MANITOBA April 9, 19 92 because we are dealing with a health care system and its reform . Now, let me offend my honourable friend that there is reason, there is knowledge, there is research, there is scientific evidence underpinning the plans that we have for reform of the Manitoba health system, the plans that I outlined to my honourable friend for her to listen to, to read time and time again from my introductory remarks in Hansard. My honourable friend does not like that because it is a reasoned approach. It is a planned approach.

It is an approach underpinned with research, with knowledge, with co-operation, with discussion, with consultation, contrasted directly with the two NDP provinces immediately to the east and to the west. I am sorry I cannot deliver the kind of chaos that the NDP are delivering in Ontario and Saskatchewan. I am sorry that I cannot give my honourable friend that political opportunity to make political hay. I am sorry, I do not intend to and never have intended to.

That is why I have spent four years, almost, developing a knowledge and an understanding and a co-operative approach with health professionals in this health care community of Manitoba.

That kind of an approach will deliver the best change, the most progressive reform of health care service delivery in Canada, in this province of Manitoba, not because of me, but because of many hundreds of professionals within the senior levels and all levels of my ministry, from professional groups, research organizations like the Center for Health Policy and Evaluation, Manitobans who have served on the Health Advisory Network and study groups under the Urban Hospital Council, from literally tens of thousands of Manitobans who have provided input, knowledge and information to this government in order that we, as a group of Ma nitob ans, knowledgeable as citiz e ns, consumers, caregivers, administrators, board members and professional civil servants, make decisions that are appropriate for the changing environment of health care delivery.

I know my honourable friend finds that offensive because it has too much logic, it has too much sense, it has too much contrast to the difficulties faced in provinces governed by her soul mates. I cannot do it any differently, and I will not do it any differently. I am sorry I cannot give my honourable friend her narrowed , political approach to carping and harping that she wants to have for her mailers across the length and breadth of Manitoba.

I am sorry I cannot do that, but for my honourable friend to try to interrupt all of the proceedings of this committee that deal with the system of health care, to deal with continuing care, to deal with mental health, to deal with all the other program s that this ministry develops, to have her fixat ion, her lust for knowledge, her total dedication to the hospital system and nothing else satiated, I cannot do that, because I have a system of health care delivery to debate, to answer questions and to proceed through line by line. Mr. Kevin Lamoureux (Inkster) : Mr.

Deputy Chairperson, I know in that past few days where I have come into the Health Estimates, and it seems that we are in around 15 , 16 hours already, and there are a number of issues that need to be raised dur ing the Health Estimates. We are very concerned in terms that the member for The Maples (Mr. Cheema) wants to get on the record on a number of the issues. In Estimates, there are only 240 hours which means it is very limited. We share many of the concerns regarding the hospitals. We, too, are just as interested in the number of bed closures. I understand that the opposition House leader (Mr.

Ashton) has come to the table suggesting that we go to that particular line. As in the past, I would suggest that we go through each line by line so that all areas of the Department of Health are in fact debated. I know that the opposition House leader has come before the committee- Mr. Deputy Chairperson: Order, please. I would like to remind the honourable member for Inkster that we have already concluded the decision on that, and the ruling has already been put in place on it. Ms. Wasylycla-Le ls: Mr.

Deputy Chairperson, first let me note that the minister did not answer my qu estion about the discre pancy between the information he provided on record to the Legislative Assembly with respect to extended bed closures at the Health Sciences Centre and the actual time when he received that information, but we will come back to that. Let me address some of the concerns and issues and suggestions that the minister has made and, as well, deal with some of the statements being made

April 9, 19 92 LEGISLATIVE ASSEMBLY OF MANITOBA 2028 by the liberal members of the Chamber at this committee. Mr. Deputy Chairperson, what we have been asking for over the last 16 hours or more have been the detailed plans of this government for health care reform. That is a general request. That is a matter that covers every line in this budget. When we have asked for those plans, the minister has said we should wait until we get to the line dealing with hospitals. Well, first of all, let me say this is an overall matter. This is not a specific issue.

This has to deal with our health care system in a general sense and the plans underway by this government for that system and for health care reform . * (1 500) Mr. Deputy Chairperson, the minister has just said in his remarks that this government has an excellent plan and refers to his speech, his opening remarks, and other general state men ts made in this committee and in the Legislature, but we never get beyond the fact that the plan has to do with moving the budget from the hospital or the bed to the patient.

We never get beyond broad statements that we are dealing with a change going from high-cost to low-cost care arrangements. We never get beyond any broad platitudes and generalities. We do not know what the plan of this government is for health care reform, and how we are finding out about it is through hospitals, through administrators at hospitals, through staff at hospitals, through professionals at hospitals and through patients at hospitals who are finding out bit by bit, piece by piece about this government's agenda.

So we are engaged in a massive jigsaw puzzle to try to figure out what the health care reform plans of this government are. That is not, in my estimation and in the estimation of the NDP caucus, fair to the people of Manitoba.

In our view, it is only fair and only right and only appropriate for the government to come forward with its plan in terms of how it impacts on hospitals, on com muni ty clinics, on conti nuin g care arrangements, on mental health needs, on doctors' salaries, on the fee-for-service arrangements, on remuneration questions, on technology, all of those aspects which are part of a health care reform plan. Mr. Deputy Chairperson, at no time has this minister ever had the decency to come forward with that kind of a plan. He says the plan before us is an excellent plan, but there is no plan.

We are expected to take the minister's word. I have told the member for The Maples (Mr. Cheema) over and over again and have pointed to examples where we cannot take the minister's word because he has always broken that wor d . He has neve r been up -front and straightforward and direct with us. So, Mr. Deputy Chairperson, we are on this line. We are stuck on this line because it is the appropriate line to hear what this government's plans are with respect to health care reform, so we have a context, a starting place, a way to assess, a way to determine whether we agree or not.

We are going to keep asking for those answe rs, Mr. Deputy Chairperson. We are going to keep asking the general questions and specific questions as we hear about it from communities, from hospitals, from staff, from patients. We are not going to be satisfied with a minister who turns the tables each time and poses the questions back to us and suggests that all of this has to do with a no-deficit policy for hospitals.

Interesting, let me as a footnote note, that suddenly, not consistent with the general remarks made at the beginning of this set of Estimates, but as soon as we got into the issue of the bed reduction targets and the budget reduction targets for hospitals, the minister said out of the blue for the first time that the central part of any health care reform strategy, the starting place, the focal point was the question of no-deficit policies for hospitals, not a better health care system, not a more cost effective system, not a system based on prevention and promotion in the community-based needs, no.

Out of the blue when he did not want to answer questions about hospitals and bed cuts, he throws in this new angle. Mr. Deputy Chairperson, we cannot sit there and accept that nonsense when we know and read about hospitals who believe they are getting zero percent from this government. The minister did not correct the record on that matter, or change it, or tell us if we were right or wrong, or give us the percentages for each hospital. He will not give us something as basic as the percentage increase for each hospital so we can make some judgments and understand his plans.

We are going to ask again for this minister's detailed plans with respect to health care reform , not

2029 LEGISLATIVE ASSEMBL Y OF MANITOBA April 9, 19 92 general platitudes and broad statements that we all agree with obviously, moving from high cost to low cost facilities when one can do it, ensuring quality of patient care at all times. Give us a break, Mr. Deputy Chairperson. Of course, we all agree with those statements. This minister is in charge. This government is calling the shots, and this is the time for us in this Assemb ly and for Manitobans everywhere to hear what those plans are.

I am going to ask again what those plans are, and I am going to also ask the minister if he would like to now clarify the record with respect to the fact that he clearly did not present the truth on July 1 0, 1 991 , regarding the summer bed closures and extended bed closures at the Health Sciences Centre, and also, if he will now provide the information about those closures that he said he would at our last sitting of Estimates. Mr. Orchard: Mr.

Deputy Chairperson, I know my honourable friend Is frustrated, but you know, for my honou rable friend to say it is nonsense for government to be concerned about deficits in our hospitals underpins what I have been saying for the last 14 hours. Howard Pawley's government put in a policy. The member for St. Johns was at cabinet and did not disagree with that policy I presume, because it is a policy of government. She says now that no-deficit policy is nonsense. Point of Order Ms. Wasylyci•Le ls: Mr. Deputy Chairperson, that is an outright fabrication. I did not say the no-deficit policy was nonsense. Mr.

Deputy Chairpers on: Order, please; order, please. Ms. WasylyciKels: He has taken my remarks out of context and he should apologize and withdraw those remarks. Mr. Deputy Chairperson: Order, please. Is It the will of the committee to take a recess? Mr. Orchard: No, absolutely not. Mr. Cheema: Mr. Deputy Chairperson, I will proceed with my questioning. It is too bad the member for St. Johns (Ms. Wasylycia-Leis) is not here, because every time the member gets a chance she just puts on the record a few things which are not even politically correct, you know.

I am not talking about intellectual corrections here, but saying that we are not co-operating and we are not for the health care and we are not dealing with issues. * (1 51 0) I want to deal with the issues in a very systematic way. For the last 16 hours-until we deal with each and every Issue point by point, we will not reach any concl usions. That is the whole issue of the Estimates that you go line by line and you discuss all the issues.

H the sky is falling apart then, we can with the consent of the committee, with the prior consent of the caucus members and with their discussion-and we have done that in the past In a very minor variation. So I want to proceed with the questioning. I asked the Minister of Health (Mr. Orchard) yesterday-! had some concern in terms of the urban hospital working group.

My question here again Is, the minister knows what the working group is saying and now he agrees with the conclusion of that report saying that the same body, Misericordia Hospital, in terms of the emer gency care is not a medically and financially sound one. I would like the minister to note that on June 30, 199 1, we had a discussion in detail on page 3310 .

We made It very clear that some of the things which are very clear in that report, that the closing of the emergency at Misericordia Hospital is not going to be medically sound and not going to be financially sound because it is very clear that the Emergency Department is a gateway to any given hospital- Chairperson's Ruling Mr. Deputy Chairperson: Order, please. Just one moment, please. Due to circumstances beyond my control, I could not bring it forward a few minutes ago, but at this time I would like to ask the honourable member for St. Johns (Ms.

Wasylycia-Leis) to withdraw the word "fabrication" from her last statement. It was unparliamentary under Citation 489. Ms. Wasylycla-Lels: Mr. Deputy Chairperson, I will certainly withdraw that word. Mr. Deputy Chairperson: Thank you very much. *** Mr. Cheema: I was simply emphasizing the point of the recommendation which has come out of the committee, and if the minister's staff would care to read that. It is probably the same discussion that we had at that time. I would strongly recommend

April 9, 19 92 LEGISL ATIVE ASSEMBLY OF MANITOBA 2030 him to cancel the plan for the discontinuation of the Emergency Department atthe Misericordia Hospital from 10 p.m. to 8 a.m. The information is there, and I think that to proceed in any further direction on this particular issue will simply be a wastage of the working group's time and also the other people who are involved, especially people who are taking an active role in terms of the Wolseley Residents' Association. Probably they are not aware of these things.

I think they should be told that this is not a viable option, and I would like to hear what the minister has to say on this issue. Mr. Orchard: Well, Mr. Deputy Chairperson, as I indicated when my honourable friend posed this question I believe yesterday, the working group report was developed and presented to the Urban Hospital Council. I say to my honourable friend that I have kept the process under the Urban Hospital Council consistent with the one that we used with the Health Advisory Network where a report comes to the council, is circulated to affected-maybe modified by the council.

At any rate the report, whet her in its original form or modified by the Urban Hospital Council, is circu lated to the affected facilities for their comment. Their comments are fed back and any other suggestions they might want to make around the issue, and further consultation is encompassed into a report by the Urban Hospital Council, which they make to me. The final report is the only report that I will assume ownership of. Okay? The working group report has not been either recom men ded or not recommended to me by the Urban Hospital Council.

I am hoping that we receive reports this month on some of the issues from the Urban Hospital Council, and I am fully prepared, as I indicated earlier, to share the report and the government's decision and subsequent action plan, if any, on any of those decisions. But look, my honourable friend has indicated his concern about that recommendation or even that issue, period, from square one and I appreciate that concern. In reality, I guess I have to say that is exactly why I said earlier today and have been saying consistently to the member for St. Johns (Ms.

Wasylycia-Leis) that our process in Manitoba is the most open and consultative process there is. (Mr. Bob Rose, Acting Deputy Chairperson, in the Chair) If we did not have those kinds of issues being discussed, there would not be interim reports floating around for people to speculate on, to offer comment on, as the member for The Maples (Mr. Cheema) has offered on. I mean , that is the essence of the strength of our process in Manitoba.

It is the most open process of attempting to come to reasoned decisions that has ever existed in the province, and currently, the most open process that exists anywhere in Canada. That is why, from time to time, I get a little distressed with the accusations by the New Democr atic Party that we have somehow this hidden agenda, this closed-shop approach . I mean, those issues are almost wide open for discussion, but I am not taking ownership of any of the decisions until the Urban Hospital Council has made their final report. I will accept or reject or accept in part some of their recommendations.

I still have those options open to me, and at that stage of the game I am prepared to share with my honourable friends the member for The Maples and the member for St. Johns the report and government's decision and action plan, and it can be critiqued, disagreed with, modifications can be suggested. I am open to those kinds of reasoned suggestions, but I say to all who are listening, that is the whole strength of the open process that we brought in. I will continue to do that and I will run the risk of having speculative discussion around what government might do.

I will take the risk of that and the potential fears that some can generate in the community over those action plans compared to not discussing the issue. I mean, not discussing the issue gets us absolutely nowhere. So, Mr. Acting Deputy Chairperson, I accept my honourable friend's concerns, and I will certainly look forward to receiving his advice on issues as I accept reports and give action plans reflecting them. Mr. Cheema: Mr. Acting Deputy Chairperson, I want to discuss the issue further because the minister says the process is very open, and there are a lot of committees.

That is one of the reasons he is telling us that we get reports, because the process is open, and that is not entirely true. This press release is from January 15 , and the working group met on February 6. How can the minister have a press release and say that the recommendation is already accepted by the council and that was one of the recommendations, and the committee meets almostthree weeks later and says

2031 LEGISL ATIVE ASSEMBLY OF MAN ITOBA April 9, 19 92 they did not have adequate information to make a decision on many issues? That is on page 4 of the report. It clearly says that this is a wrong decision, and they should have consulted them before the minister issued a press release because that does create a lot of fear in the minds of people.

I think we may be wasting some time here because if the consultation was done in a proper way, you have full information and your deputy minister is a chairperson of the meeting of all the working groups, so he, in fact, the government is fully in charge of the whole process, and that is true. It may be that the deputy minister does not discuss everything with the minister, but still, there is a connection within the department and that is the perception.

We want the minister to, in the future , when they are issuing all these press releases, consult with the groups, see what those groups are saying and open up the process. Without that, I do not think that some of the issues, which are very controversial and it will be to the minister's advantage to get people on his side.

When I am going to interrupt something, if it was valid, and it is very, very risky to be constructive in the opposition and we discuss for 16 hours and was there any positive media news? -nil, zip. • (1 520) The only thing is if there is a noise-but we are not going to do that, but I want the minister to be a little bit more sympathetic to the open process. It has to be open, not only from the minister's point of view, but it should be from a public point of view. I would again urge him to open the process to the public more than what they are right now.

I will ask the minister that, as he promised in June of '91 , that he will convey some of the issues that we raised in this committee to the emergency care com mittee because things that we said, the committees are saying exactly the same thing. There are a number of other issues that the committee has brought forward, one issue is the whole creation of a paramedic system which is going to cost about, according to them, $1 .5 million. I will not go into that detail.

I will certainly ask the minister that somebody in his department should read that report and probably let the minister know some of the very controversial issues. My further question is in terms of the next line, not on the Executive Support staff, but on the Evaluation and Audit Secretariat. H we are willing to pass the present line, then we can go further and ask the questions. Mr. Orchard: Ask if you wish, it is the will of the committee. Ms. Wasylycla-L els: Mr.

Acting Depu ty Chairperson, we were at the point of, the minister was I think, going to address some requests made last week, rather earlier this week, regarding extended bed closures at the Health Sciences Centre. I am wondering if he has the information now. Mr. Orchard: Mr. Acting Deputy Chairperson, I was about to pro vide that info rmation, but unfortunately I did not want to provide it without my honourable friend having the benefit of hearing it. I do want to take the opportunity to correct my honourable friend, even though this may cause her some angst.

My honourable friend said to be concerned over hospital deficits is nonsense. I mean, you cannot talk about the provision of health care in changing the way we approach health care if you allow the largest single spending line in your department to operate without any fiscal control. Everybody recognizes that because the dollars you allow, if you allow deficits to balloon in your hospital system, the dollars you consume must come from every other area of the department, a number of which my honourable friend mentioned. You take them from Continuing Care. You take them from Health Promotion.

You take them from Mental Health. You take them from Community Services. My honourable friend further went on to say that we all agree of moving patient services from high-cost institutions to low-cost institutions and lower-cost community alternatives. Well, I know that we all agree about that.

But where I have taken it one step further, which is new, and no government has ever discussed it before, is the intention that when we move those services with the patient from, for instance, the teaching hospitals to a lower-cost institution and/or the community, that we will be closing the bed that was providing those services, I submit inappropriately, at the teaching hospital to save the budget there to move it with the patient. My honourable friend went part way in that she agreed with moving from high-cost to low-cost areas

April 9, 19 92 LEGISLATIVE ASSEMBLY OF MANITOBA 2032 of service provision, but does she agree that it is necessary to close the bed in the high-cost area that was providing the inappropriate service? Because that is where we are moving. That is what we are discussing now with those very same hospitals. If my honourable friend does not agree with that, then my honourable friend ought to state that. Because tha t fund amen tally changes this so-ca lled commitment that we sometimes hear from the New Democrats, that they believe in reform of the health care system. I mean, you cannot have it both ways.

That is why both Hospital line and Community Services line in 15 successive budgets have both gone up in parallel, because as we have placed more services in the community, we have left the beds intact, and there is an old maxim in health care that a bed is never an empty bed. There will always be a patient admitted to it. Those patients do not need to be admitted to some of our very high-cost institutional beds. Services can be provided elsewhere, and when you do, you curtail the service delivery, the patient admission, by closing the bed. That is what happening in Brandon right now.

That is the kind of informed change in the system that the board, the administration, in co-operation with the com munity service providers have been able to achieve. That is as reasonable a model of the kind of reform that can take place as exists, probably, anywhere in Canada. That is why I supported that process in a press conference with the board and the chairman. I will provide my honourable friend with the information she requested, but first of all, I want to indicate to my honourable friend that when she picks pieces of informati on, she tries to leave an impression that is not accurate.

I want to indicate that my honourable friend, when she questioned me in July of last year, she said: Now that we know he knows, will he deny approval for the 60 to 70 beds closed now at the Health Sciences Centre and being extended as bed closures until March 31 , 199 2?

My honourable friend maintains twofold in her qu estions today, fi rst of all, that I did not acknowledge that there was summer bed closures going on, and furthermore, that I indicated in my answer in July that I had no knowledge of summer bed closures, and that secondly, I had approved the extended bed closures and did not give accurate information. Mr. Acting Deputy Chairperson, that is not accurate because in my immediate answer, I said to my honourable friend: Mr.

Speaker, as I indicated to my honourable friend yesterday, summer bed closures are in process right now at the Health Sciences Centre and at a number of hospitals throughout Manitoba. I did not, as my honourable friend alleged yesterday, deny that beds were being closed over the summer period-No. 1 correction of fact for my honourable friend. Secondly, I had a number of other pieces of information that I will not use with the committee. Mr.

Acting Deputy Chairperson, I go on to answe r: My honourable friend said to put those bed closures on hold-and by those, I was referring to the extended closures to March 31 , and by those bed closures, she meant the extended ones that Health Sciences Centre has proposed until the Urban Hospital Council has reported, and a co-ordinated plan taking into account the needs of patients is presented to the people and dealt with. When I indicated that was the second part of her question, here is my answer: That is exactly the status of that proposed extension on a number of beds at the Health Sciences Centre.

No decision has been made to close them, nor will any decision be made to extend any closures beyond September until the Urban Hospital Council examines the impact on the system in Winnipeg. Again, I provided my honourable friend with the information that was accurate in July, that there was no decision to grant the request made in June for extended bed closures when she posed the question in July. So my honourable friend erred factually by saying I denied knowledge of summer closures at the Health Sciences Centre, because I acknowledged the beds were being closed, as I answered, for the summer closure period.

Secondly, my honourable friend alleged that I had given approval to the extended bed closures. My answer clearly says that this issue was not given approval. The Urban Hospital Council was dealing with it. Subsequent to that, the Urban Hospital Council did deal with that issue. Those beds, some 42 of them, have been closed and are closed right now. Those are RR-5, 10 beds; RR-4, 10 beds; CK-3, six beds; WS-5, 12 beds; and D-5, four beds, which were not in the original plan, as I can understand here, but were closed for a

2033 LEGISLATIVE ASSEMBLY OF MAN ITOBA April 9, 19 92 dining room area for geriatric beds. In other words, the room for those beds has been converted into a dining room for geriatric patients at the Health Sciences Centre. * (1 530) But those extended bed closures on those above-mentioned wings were granted after it was determined that the Health Sciences Centre would be able to operate in a reasonable fashion in terms of admissions and service delivery.

There are an additional 23 beds on E-6 that are closed, but they are still considered to be a temporary closure and may, I say only may, be opened depending on decisions by the Health Sciences Centre around the budget process for '92-93. Ms. Wasylycla-L els: Mr. Acti ng Depu ty Chairperson, I appreciate the information. I will not get into the minister's explanation for the apparent discrepancy in terms of information- Point of Order Mr. Orchard : Mr. Acting Deputy Chairperson, there is no discrepancy in the information.

I read from Hansard, July, the time my honourable friend asked her ques tions and all eged I den ied knowledge of summer closures and had approved extended closures. I answered to neither question, as she indicates. There is no confusion around the information except that my honourable friend wants to fabricate untruths. Ms. Wasylycla-Le ls: I would suggest that the minister withdr aw the term "fabricate." pnte�ection] Well, then I will withdraw my withdraw al. The Acting Deputy Chairperson (Mr. Rose) : Order, please.

I have been informed that the term "fabricate" is a variation of the word fabrication, and since we asked the honourable member for St. Johns (Ms. Wasylycia-Leis) to withdraw that word, I would ask the honourable minister to do the same, please. Mr. Orchard: As you wish, sir. The Acting Deputy Chairperson (Mr. Rose) : Thank you, and on the point of order, there is no point of order. ** * Ms. Wasylycla-L els: Mr. Acti ng Dep uty Chairperson, I was not trying to question the minister's explanation.

I simply was pointing out the fact, as I had noted before, that on June 26 his department and his commission received detailed information about extended bed closures, and on July 1 0 the minister said neither he nor any member of his staff, nor the Commission, nor commission staff, nor associate deputy minister were informed. I will leave the record to bear out the issues at hand. Let me ask just a question about the 42 beds that have been permanently closed, and let me not put judgments on the information provided by the minister. Let me ask for a clarification.

Old the minister say that 42 beds of those extended summer closures had then permanently closed, and could I further ask if those beds will be included in the present bed-reduction target to the Health Sciences Centre or are in addition to the target that has been suggested to the Health Sciences Centre by the minister's own department? Mr. Orchard: Mr.

Acting Deputy Chairperson, to again clarify my honourable friend's quandary that she has put herself in, my honourable friend does not acknowledge my answer in which I said summer bed closures are ongoing right now at the Health Sciences Centre and that no approval was given for any extension beyond September, as detailed in the memo from Mr. Thorflnnson. At the July 17 Urban Hospital Council meeting the issue was discussed, and it was concluded that the bed closures would have no impact on other facilities.

As a result of the July 17 Urban Hospital Council meeting, which surveyed the other hospitals, it was determined that there would be no impact on the group of facilities in the Urban Hospital Council to grant the extended closure, and hence it was granted and those beds remain closed. Mr. Acting Deputy Chairperson, I cannot and I will not get Into the discussion of my honourable friend's last question, because I have not been informed by my department of their analysis of the Health Sciences Centre's response to this year's budget.

As I indicated in the Question Period today, their preliminary budget estimates were given to them some several weeks ago. They were preparing plans which would detail their operation, and how they would handle this year's budget. Those plans have been brought back to the ministry. The ministry staff are analyzing those plans, and I have not seen a finalized analysis and approval of those plans. That is why when my honourable friend takes the quantum leap from my answer today in Question Period, saying I have all the answe rs, I am afraid

April 9, 19 92 LEG ISLATIVE ASSEM BLY OF MANITOBA 2034 that I have to tell her that I do not have those answers, because the analysis has not been completed and I have not been informed of how the respective facilities will meet their targets. I fully expect that information to be available when we arrive at the hospital line that my honourable friend wanted to rush to today. That is what I have told her consistently, and she will have her answers when we get to that line. Mr. Acting Deputy Chairperson, I cannot answer the second part of her question.

I want to indicate to my honourable friend that the 42 beds plus four, which were retired from services in order to make a dining room area for geriatric beds, and the 23 beds on E6 still remain out of service. Apparently, the impact on the operations of the Health Sciences Centre appear to be as expected at the Urban Hospital Council meeting of July 17 of minimal impact. I will indicate to my honourable friend why. In 19 89-90 the total admissions to the Health Sciences Centre were 34,052. In 19 90-91 that total admission figure had declined to 32,826.

That is primarily because of the 31 -day nurses' strike where the admissions were down somewhat for the month of January 199 1 . In 19 91 -92 the period of time for which those beds have not been in service, admissions to !he Health Sciences Centre have been 34,31 3, some 250 more admissions than in the last full year of service delivery at the Health Sciences Centre uninterru pted by the nurses' strike. In terms of patient days of service, the 19 89-90 patient days of service totalled 327,026. In 1 990-91 they were down to $31 6,328.

For 199 1 -92, and again I will give my honourable friend the normal precaution that I give, '91 -92 figures are not finalized. They are prelim inary because the year-end is only nine days past, but the preliminary indication on patient days of care is 31 9,631 . • (1 540) That would tend to conform with the direction that we are moving in acute care service provision of shorter average length of stays. As I noted to my honourable friend, the admissions were up, but the patient days were down, so that means that patients were having stays in the hospital of lesser duration. The indication, Mr.

Acting Deputy Chairperson, is that those closures have not adversely affected the level of patient care at the Health Sciences Centre. In fact, it appears as if they have been able to increase admissions with fewe r beds in service. (Mr. Deputy Chairperson in the Chair) Ms. Wasylycla-Lels: Let me ask the minister about the process he has put in place for dealing with the responses by all facilities to this minister's budgetary and restructuring plans.

He has indicated that in the past it has been the Urban Hospital Council that has given final approval for, or some approval-! wish the minister would not shake his head because I am seeking information about how this actually works. I always had unde rstood that approval for changes in our hospitals, bed reductions or cuts or summer bed closures or whateve r, rested with the department and with the minister.

He has indicated that with respect to-for example, last summer 's extended bed closures at the Health Sciences Centre went to the Urban Hospital Council for approval on July 17 , and I appreciate the clarification vis-a-vis the information I had brought to this committee. I am just checking to see, is there a new process then in place in terms of who responds to recommend to plans or proposals in response to government budgetary targets, or what ever, than was previously the case, or am I misunderstanding what the minister has said? Mr. Orchard: Mr.

Deputy Chairperson, the same process exists for approval of hospital budgets that always existed, and that is that government gives the approval to the budgetary plans of the hospitals in terms of the budgetary process. That has existed, I suspect, for as long as we have funded hospitals centrally. What is new to the process, and is the informed part and the progressive part of the system of change we have put in place, is the opportunity to unde rstand the syste m-wide im pact of one institution's proposal.

In the case of the request by the Health Sciences Centre to extend to March 31 certain bed closures, which was an unusual request, we had the opportunity and the benefit of the Urban Hospital Council to seek the opinion of the other institutions that may be affected by such a decision by one institution to indicate whether in fact it would have an impact. That is a reference ability that strengthens the comfort that the ministry has that the decisions we are approving will have minimal impact on the level of patient care delivery.

2035 LEG ISLATIVE ASSEMBLY OF MANITOBA April 9, 19 92 That is the much more informed, much more co-operative, much more enlightened process of change that I refer to and have been referring to consistently for the last year and a half that is envied by all other provinces because none other has an Urban Hospital Council to serve as that sounding board for system-wide change.

That is the new approach, the new and enlightened approach by this government, replacing former approaches that dealt only with individual hospitals without the suf ficient opp ortu nity , I migh t indic ate , of understanding the system-wide impact of individual hospital approval of decisions. Point of Order Mr. Cheema: Mr. Deputy Chairperson, are we still discussing the hospital budget? I do not want to be excluded from the whole process. We had a discussion last Monday, Tuesday, and if we are going to talk about the same issue, then I would like to get some time also. Mr.

Depu ty Chair per son : The honour able member for The Maples did not have a point of order. At this time, I would like to remind the honourable members, we are dealing with item 1. (

b) Executive Su pport. If the mi nister chooses to answer questions In other areas, that is at his discretion. *** Ms. Wasylycla-Lels: Mr. Deputy Chairperson, I will be happy to give up the mike at some point In the near future. I just want to clarify-{interjection] The Minister of Transportation (Mr. Driedger) suggested that it would be next week. Well, I was only continuing on because the member for The Maples said he had no more questions on this line, but if he is reconsidering that, I will certainly pass over the mike in a short time.

I did want to point out that I am asking some general questions here about process that does very mu ch involve the deputy min ister. It is important for us to understand so that we do not ask, in the min ister's words, silly or uninformed questions, and it will become critical over the next short while as more and more rumour s start coming out, so I want to understand.

Now taking what the minister said about the process and what is new in that process, do I take it then that in terms of the present situation, with hospitals responding to how they will meet budget targets by this government and how they will respond to restructuring plans of this government, that all proposals and all plans will come forward and be assessed by the Urban Hospital Council before they go a step further and before any beds are cut or any budgets are finalized? Mr. Orchard: Mr. Deputy Chairperson, that is not what I Indicated in my answer to my honourable friend.

I indicated that government will make the decision, or the ministry will make the decision on approval of requests by Individual facilities where appropriate, as was appropriate last year on the request for extended summer bed closures. We deemed it to be an appropriate vehicle to vet that request by one institution to see whether it would have any impact, and over a series of meetings starting July 17 , the Urban Hospital Council concluded that the system could accommodate such a request by the facility. That is the advantage of the Urban Hospital Council.

We will use appropriately the Urban Hospital Council to seek similar system-wide challenges, but it is not a requirement of process. It is an additional enhanced opportunity that we have put in place to make the process a more informed one. Ms. Wasylycla-Lel s: Mr. Deputy Chairperson, I appreciate that explanation from the minister. I was certainly not trying to leave the impression that I thought it was a requirement.

I am just trying to understand the various steps that will be taken for vetting these proposals and the opportunities that there will be for input and for advice from different sectors of the health care community. I am wondering if-and I would like to refer the minister to a memo that he would be aware of from the president of Health Sciences Centre to all staff following their retreat on March 18 and 19 to try to begin responding to the government's budgetary directives and announced plans for restructuring.

That memo Indicates that the executive staff and board of directors must now take the next step by drafting a set of recommendations to government together with our observations on the impact those rec ommenda tions wou ld have if adopt ed. Government and hospital officials will then review our recommendations, together with those of other hospitals. Final decisions on the restructuring of the provincial health system rest with the government of Manitoba, of course. Is that an understanding on the part of all hospitals, that their plans in response

April 9, 19 92 LEGISLATIVE ASSEMBLY OF MANITOBA 2036 to the current government's targets for the budget and for restructu ring purposes will then happen on a collaborative basis involving all hospit als. I would assume that means all urban hospitals. A (1 550) Mr. Orchard: Mr. De puty Chairperson, if I understand my honourable friend's question, my honourable friend is asking whether the process as outlined in the memo from Mr. Thorfinnson to all staff in that they are developing plans around budgetary numbers and are advancing those plans to government which has the final approval for acceptance, et cetera.

Yes, that system is in place for all hospitals, and all hospital s are in the process of developing their plans of service operation for '92-93. That is the same kind of information that has been brought in for how many years-too many to count, so that is the process. The difference in the process or the advantage in the process that we have compared to previous administrations and even previous years in this administrati on is that we have also the oppor tu nity through the Urban Hospital Council to have the dis cussion of syste m-wide issues if we deem it an appropriate discussion to undertake.

That was the refe rence I made to the request by the Health Sciences Centre last June. That may well be the vehicle used on growing numbers of issues, but the final decision as indicated in that memo rests with government and will always rest with government. We will att empt, as we have, and as we are re infor cing alm ost monthly, our opportunity to seek wider discussion and opinion on issues in health care .

The Urban Hospital Council is one of those forums, and I can name a number of others that are available to us, so that we have a more open opportunity tor discussion around the issues than has ever existed before in the province of Manitoba and, indeed, far more open discussion and decision-making process than any other province in Canada. Ms. Wasylycla-Lels: Just a quick follow -up to that and then I will pass it over to the member for The Maples (Mr. Cheema).

I just wanted to see if I could get an underst anding of t he minister's definition of "appropriate." I know we have had some difficulty in terms of talking about numbers, of proposals pert aining to bed closures . I am wondering, if there is any truth to these numbers of 240 beds being closed at the two tea ching hospitals and another 200 at our community hospitals, if those kinds of numbers warrant special conside ration by the Urban Hospital Council or any other mechanism for consultati on, any input. Is that in line with what the minister means when he says "where appropriate ?" Mr. Orchard: Mr.

De puty Chairperson, my honourable friend is talking in terms of bed closures. I have indicated to my honourable friend that we will be developing syste ms of moving services with the patie nt. Where we remove a p atient and provide the care in a lower cost institutio n and the teaching hospital happened to have been the place where the service was delivered, if we deliver that service in a lower cost place, the bed at the teach ing hospital will be closed. That is part of the process of reform that we are embarked on.

The req uest by the Health Sciences Centre for extended summer bed closures was vetted through the Urban Hospital Council. It was deemed not to have a syste m-wide impact, hence was given approval. Those issues are vetted appropriately to seek syst em-wide advice. Let me give you an example. A couple or three years ago before we had the Urban Hospital Council, following the no-deficit policy put in place by Howard Pawley and the NDP, one hospital was mid-year approaching a significant budgetary pro blem.

One of their proposals for budget containment was to curtail chemo therapy for patients suff ering from cancer. Clearly, Mr. Deputy Chairperson, we did not have the forum of the Urban Hospital Council, but very quickly the decision was made that that would be an inappropriate system-wide decision, because all you would do is move that patient requiring chemotherapy to another institution, and it becomes th eir budgetary problem. That is why the reform process that we are embarked on has the patient as the centre to the theme. The budget as much as possible will move with the patient.

That way you avoid those kinds of inappropriate decisions that would simply transfer costs from institution "a" to institution "b." That is not reform . That is att empting to tra nsfer management problems. We did not accept that, naturally, three years ago. We certai nly would not accept it today. So that is why underpinning the reform process is movement of the budget with the individual. Mr. Cheema: Mr.

Deputy Chairpers on, can the minister tell us within the policy direc tion by the executive support staff and specifically the issue of the LPNs, because that is not part of the major reorganization and has not been very clear with the

2037 LEGISLATIVE ASSEMBLY OF MANITOBA April 9, 19 92 memb ership as such. They are in a major confusion as to what is going to be their role in the future. There are about 3,800 LPNs who are practising in the health care profession, and they do perform many duties which include from the active in the hospital to the personal care homes and in the com mu nities. Some places they are even performing more duties than are legally covered for, because maybe they are the only person who is available for those duties. Manitoba, as the minister knows full well, has done very well in terms of LPNs in this country.

They were suppose to be having one of the best programs. Now with the program out of the Red River College, there has been a moratorium put on that program and there is specula tion and a possibility of a program at the St. Boniface Hospital for the training of LPNs. So these professionals are very worri ed, because they have to decide on a number of issues. Number one is: What is their role going to be now?

The second issue is in the present system and is: For their role in the future system in terms of if they go for further training to be RNs and within two or three years they have to retrain themselves to BNs, what Is going to happen? Are they going to continue to re-educate themselves and not really find a suitable role? We have raised the issue in the House. Atthattime the minister said that he had not received the final reports from the hospitals and other places. I would like the minister to tell us what the government's policy is in terms of the role of LPNs in the reform of the health care system. Mr.

Orchard: Mr. Deputy Chairperson, I think the LPN as a professional group can play a very important role in the health care system today and on into the future . Howe ver, that role may well be changing in some institutions in some areas, because my honourable friend has been informed of the same staffing changes that I have in certain hospitals where under reorganization of staff there will be circumstances where several LPNs would be laid off and replaced with a combination of RNs and nurses' aides in the workplace to provide care and also in these cases to contain budget. * (1 600) Mr.

Deputy Chairperson, I cannot give my honour able friend -and we have had these discussions with the LPN association-a clear answer as to the role of the LPN a number of years out, nor for that matter, given the dynamics on the education side, for the registered nurse with the baccalaureate program being certainly an objective of the professional association MARN to have as a minimum entry to practise. There is a lot of consternation, I guess one might say in terms of nursing education.

We have over the past year and a half, I guess, had a study group on the MARN side which led to the commencement of a collaborative program at Health Sciences Centre. Currently a proposal for St. Boniface is on hold for a similar collaborative program. Now, I do not have perfect answers as to who ought to be the caregivers in the workplace five years out, so what we undertook as a department was in January of this year, because what really speeded up the process was this whole controversy over Red River Community College moratorium on LPN rumour-well, not just a rumour. I mean, the St.

Boniface board actively considered the closure of the school of LPN nursing at St. Boniface I believe In late November. We developed a survey in the ministry, and all institutions have been asked to provide us with their current staffing complement, BN, RN, LPN, nurs

Document details

Collection	Manitoba — Debates (Hansard)
Citation	35-3-43
Type	hansard
Volume / chapter	35th 3rd hansardpdf 43.pdf
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	3a16317efcc262f4022fba52c5ead5a0e681338e

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