Manitoba Hansard — 20 November 1989 (Sitting 74B, 34th Legislature, 2nd Session)

34-2-74b

Manitoba — Debates (Hansard)

LE GISLATIVE ASSEMB LY OF MANITOBA Monday, November 20, 1989. The House met at 8 p. m. CO NCURRENT CO MMIT TEES OF SUPPLY SUP PLY-HEALTH Mr. Chairman (Harold Gilleshammer): I call this meeting to order to discuss the Estimates of the Department of Health. We are on item 4.(

f) Mental Health Clinical: (1 ) Salaries $345, 700-pass. Item

(2) Other Expenditures $15 1, 200-the Honourable Member for Kildonan. Mr. Guizar Cheema (Kildonan): Mr. Chairperson, shall we wait for the NOP? An Honourable Member: No. 1 Hon. Donald Orchard (Minister of Health): I am not getting into this fight, Guizar. Mr. Cheema: I do not think it is right to pass. Can we just wait for a few minutes before they come and scream? Hon . Albert Driedger (Minister of Highways and Transportation): Mr. Chairman, the committee starts at eight o'clock. If they are not here, the action goes on. Pass. Mr. Orchard: The Minister of Highways (Mr. Albert Driedger) is just angry because we have already taken more hours than him in Estimates. *

(2005) Mr. Chairman: On item (f)

(2) Other Expenditures, are there any questions-pass. Item 4.(

g) Mental Health Services: Provides for mental health services through Regional Operations, Mental Health Centres, General Hospitals and Forensic Services, (1 ) Salaries $382,800-the Member for Kildonan (Mr. Cheema). Mr. Cheema: Mr. Chairperson, can the Minister of Health tell us how many positions are vacant in this branch? Mr. Orchard: None. Mr. Cheema: Will it be okay to ask questions, for example, for Brandon and Selkirk Mental Health Centres in this branch so we can deal with it all as one? Mr. Chairman: They are itemized under (

j) and (

k) I believe, further down the page there. Mr. Orchard: Mr. Chairman, I suggested this last week and my honourable friend wanted to go line by line. 3041 If my honourable friend wants to go all up today that is fine with me, I am such a co-operative fellow. I am willing to go with it any way you want to do it. Mr. Chairman: Our procedure is that we go line by line. We are on (g)( 1) Salaries-the Member for Thompson. Mr. Steve Ashton (Thompson): I do not see any difficulty with what is being suggested.

I realize that is procedure in terms of passing items, but I think if one was to look at the way discussion has been, shall we say wide ranging on some items, we have probably been doing it to a certain extent already. If it will assist in expeditiously dealing with this very important department, I agree with it. Mr. Orchard: This would not be tolerated by some of my tougher colleagues, but I am willing to go along with my two honourable friends over here. I am just fully co-operative with them. Any other Minister would stick line by line.

I want both of you to recognize that when you start beating up on me in Question Period. Mr. Chairman: Item (g)

(1) Salaries-pass. Item (g)

(2) Other Expenditures $226, 100-the Member for Kildonan. Mr. Cheema: Can the Minister of Health (Mr. Orchard) tell us, do we have the head of Forensic Services for the Department of Mental Health in the Clinical section? Mr. Orchard: Yes. Mr. Cheema: How long have we had this position filled? Mr. Orchard: As long as I can remember, from both the critic and now Minister, it has been filled. Mr. Cheema: Is this the position which the former administration promised one psychiatrist that they wanted to set up a separate unit for Forensic Services? Is that the position, or is it a separate position? * (2010 ) Mr.

Orchard: I cannot answer for what the previous administration was proposing here. Forensic Services with a physician is part of Mental Health Services here. I cannot comment on what was previously suggested. Mr. Cheema: Can the Minister of Health tell us how many cases, or how many consultation services, are provided by the Forensic Services? Can he provide us with the data? Mr. Orchard: I will give you the actual from last year, from the '88-89 fiscal year, and I will give you what we are projecting in terms of services this year.

Monday, November 20, 1989 In terms of adult forensic services outpatient assessment there were 11 3 actual last year, we are projecting 125 for this year. In inpatient admissions there is an actual last year of 109, and we are projecting for '89-90 at 120. At the Headingley Correctional Institute last year the actual was 1, 112, and that is a significant increase over the year previous where there was 899. We are projecting some 1,200 this year. In terms of follow-up services there were 793 last year actually and we are projecting some 900 for this year. Mr.

Cheema: Earlier I asked a question that the former administration wanted to set up a forensic psychiatry unit that was supposed to be at the new building at the Health Sciences Centre, the new building that the Minister announced a few weeks ago. Will that building have a forensic unit separately? Mr. Orchard: Well, Mr. Chairman, in terms of the discussions we have had starting last fall and ongoing discussions surrounding the proposed psychiatric facility at the Health Sciences Centre, forensic beds are part of the discussions, yes. Mr. Chairman: The Member for Kildonan.

Shall the item pass-the Member for Kildonan. Mr. Cheema: Mr. Chairperson, in this candy, I think there was something implanted there. I think it is extremely important to have a forensic unit especially when we had difficulty attracting clinical staff and we had difficulty attracting the new head of the department from other places, as the Minister of Health (Mr. Orchard) explained the other day. For a teaching program, it is extremely important to have Forensic Services provided at the Health Sciences Centre along with the other unit of psychiatry in this new building. It will go a long way to help there.

Can the Minister assure us whether that will be a part of the total mandate of the building for sure, or are they just going to consider it? Mr. Orchard: My honourable friend is wanting a sneak preview of the Capital Estimates, but that is all right because I am so inclined to give little sneak previews from time to time. No, the issue of forensic beds is very much a part of the redevelopment project at the Health Sciences Centre, very much a part of it. Mr. Cheema: Mr. Chairperson, can the Minister of Health (Mr.

Orchard) tell us the number of individuals providing services for the children and adolescent group, both for the clinical as well as the non-clinical site? Mr. Orchard: Now, bear in mind this is adult forensic services that we are dealing with here. If I am not mistaken, child and adolescent deals with the adolescent forensic services. With my honourable friend's question, the number of people delivering forensic services-I am having a little trouble wanting to know the nature of my honourable friend's question, because there are forensic beds currently in the system at the Health Sciences Centre.

My honourable friend does not want the staffing of those beds, do you? Mr. Cheema: Yes, that is right. Mr. Orchard: Oh, you do. Now you are going to challenge us with something that we are going to have to develop for you. We will be as close as we can, but we cannot provide that tonight. *

(2015) Mr. Cheema: Mr. Chairperson, if the Minister can even supply me with the information tomorrow, that is fine with me. My next question is one of the functions of the Mental Health Services and the directorate is to provide the direction of the operation of Brandon Mental Health Centre and Selkirk Mental Health Centre. Can the Minister of Health tell us how many new patients are being admitted in these two centres? Can he confirm � today that the Selkirk Hospital is not taking any new � patients from the Winnipeg area? Mr. Orchard: The first question was staffing numbers? -(interjection)- Patients?

Oh, admissions. Okay, we will get you that information then. Admissions to Brandon for '88-89, so these are the actuals from last year, were 584, Selkirk 272, for a total of 856 admissions. At the same time there were separations at Brandon of 704, Selkirk 266, for total separations of 970 and inpatients at year-end, so this is just a snapshot as of the end of the fiscal year. Brandon, the patient numbers were 375, Selkirk 298, for a total of 673 and the total under treatment, again I believe-no, these are cumulative figures pardon me.

These are cumulative figures for the year, Brandon 980 and Selkirk 564 for a total of 1,544, a slight decrease in inpatient counts at year-end and an increase in the total number of patients under treatment throughout the year at both facilities. Mr. Cheema: Mr. Chairperson, can the Minister of � Health (Mr. Orchard) tell us how many new patients � were taken or admitted to Selkirk Hospital from the Winnipeg region? Mr. Orchard: Fifteen. Mr. Cheema: Are those patients long term? Mr. Orchard: I am informed that most would be long term, yes. Mr.

Cheema: The concern was expressed to me, and I am sure to the NDP also, that the assessments are not being done in time. The question was raised by the NDP Leader (Mr. Doer) in the House. Can the Minister confirm for us if the number of the evaluation or the admission has dropped as compared to last year? Mr. Orchard: First of all, assessments are being done. That was not an appropriate or a correct statement 3042

Monday, November 20, 1989 that was made . The Act simply does not allow that , as my honour able friend well knows . In terms of-I do not have proje ctions for thi s entire fiscal year, all I have is actu als. My indication is that admissions are up, but discharges are also up and they are projecting a year end volume to be down sligh tly. In other words that the snapshot at the end of the fiscal year, for the patient numbers , at each fac ility is to be down slightly or to be down again . •

(2020) Mr. Cheema: The point I want to make is that there would be less the number of staff we have at Selkirk and Brandon , and the admissions are almost the same as the Minister has said as compared to last year. How are they managing , and how can they provide adequate services for the same number of clients as last year, similar as this year, with the staff number, which is very below the nor mal range as compared to last year? Mr. Orchard : Mr.

Chairman, I will give my honourable friend-i f I can get into the staffing numbers, 620 staff were at Brandon General Hospital at year-end , and it will be down by the end of this year-end by approximately six and a half staff years . Selkirk, there were 463 last year and they will be down by 14 and a half staff years because we have been doing the reorganizat ion and the change. Bear in mind there are greater numbers of admissions, but there are also greater numbers of discharges and the number of patients at year-end, as the snapshot of patient count , is down.

One does not necessarily assume that patients are receiving less services because there are fewer staff . Some of the patients are there for a much shorter time than was the previous history of the institution . I think it is fair to say that at both institutions there are shorter length s of stay as is happening throughout the system , inclus ive of our mental health institutio ns. The absolute numbers , as the snapshot shows you at the end of the year, are down . That is indicative of absolu te numb ers on average throughout the year, I would presume .

You have , certainly , blips as one would expect because there are fluctuations throughout the year. Our staffing ratios compare very favourably with any othe r centres across Canada . There are only two facilities that appear to have a higher staff rat io that I have in terms of an immediate comparison across Canada . Mr. Cheema: Mr. Chairperson , the part of my question was the ratio of the clinical staff at Selkirk . When we know that staff numbers are low , and there was a supposed allegation that the assessments are not being done and patients are not being admitted because of the lack of staff.

Can the Min ister indicate whethe r that is a fair statement , or if he disagrees with the statement , can he give us- he has given us the information that there were 15 admissions this year to Selkirk Hospital. Can he tell us what was the number of admissions last year, the same period? Mr. Orchard: We wou ld have to go back and obtain that number for my honourab le fr iend. What my honourable friend is getting to-and he has neglected to apologize for developing another criticism in advance , which I am really disturbed about because I thought we had a reasonable relationship build ing here.

What my honourable friend is referring to is the psychiatric manpower or person-power situation in Selkirk. As I have indicated to my honourable friend , we have had some changes in staff down . We have got fewer permanent or full time, pardon me, psychiatrists at Selkirk , and that situation is recognized by the ministry as being not acceptable. We are recruiting actively for them.

In the meantime we have engaged in a number of part-time and back-up circumstances to provide those clinical services so that, although the staf fing positions are not permanently filled with people on staff, there are arrangements being made with psychiatrists within and to some degree I guess without the department to provide a service in psychiatric and clinical assessment at Selkirk . •

(2025) Mr. Cheema: Mr. Chairperson , can the Minister of Health (Mr. Orchard) tell us the total number of acute patient psychiatric beds available in Winnipeg general hospitals? Mr. Orchard: The number of acute beds in Winnipeg? I would be more comfortable answering that when we get to the commission staff, because each-there are five hospitals that have acute beds : Grace, Seven Oaks, Misericordia, Health Sciences and St. Boniface. There is a fairly signif icant bed count, around the 200-plus, but I would have to give you more definitive numbers when we get to the commission and I have appropriate staff here.

Mr. Cheema: Mr. Chairperson, we will wait for the commission, but still one of the functions of the Menta l Health Services and this branch is to co-ordinate the services in the genera l hospitals, and I would like the Minister to answer the question if there has been a change in the bed situation as of May 9, '88. Mr. Orchard: Two hundred and fifty-six is the bed number at six hospitals, and I believe that would include Brandon General, or is that six hospitals-just the Winnipeg six? Winnipeg six. Who did I miss then? Misericordia? Yes, 256 beds, Mr. Chairman, and that number I believe is constant.

It has not changed. The only thing that changed in the last 12 or 18 months were the McEwen Building renovations, and those removed the entire bed count for a period of time wherein we had a substantial amount of co operation between the other hospital facilities to make sure we did not run into serious problems . We, with a great deal of co-operation, worked between the facilities and the professionals and the department, managed to get through that very significant closure for, well, I guess up to five months, the McEwen Building, while 3043

Monday, November 20, 1989 renovations were under way, but there was no change in the bed numbers in that period of time. Mr. Cheema: Mr. Chairperson, can the Minister confirm or deny if there were any discussions within his department and the department at St. Boniface Hospital to reconsider the beds at the McEwen Building in terms of there was some suggestion that beds should be probably cut? Was that a formal discussion last year? Mr. Orchard: Yes. That was a proposal that St. Boniface had made. Mr. Cheema: Mr. Chairperson, can the Minister of Health (Mr.

Orchard) tell us if the decision was made to keep the same number of beds and can he share with us information provided to him through the department head of the McEwen Building on what basis were they proposing to cut the beds at the McEwen Building? Mr. Orchard: Mr.

Chairman, I guess to put it in layman's terms the genesis of the suggestion was that we got by without the McEwen Building bed complement for a fairly substantial period of time, and therefore maybe because we put in some substantial support systems and co-operation, the concept was advanced to attempt to leave them closed or just a portion of them, and I cannot tell you what numbers, but it was a portion of them closed on a long-term basis. Two things did not fit with that.

First of all, the maturity of an alternate support system simply was not in our estimation necessarily ready or proven to be a more cost-effective way of delivering service. Second, the need was there. We had some very, very, how would I put it, delicate balancing going on during the whole period of time that the McEwen Building was closed. It required an incredible amount of co-operation. A lot of people involved directly in the system really walked the extra mile to make things go as well as they did during that McEwen Building closing. *

(2030) So clearly we needed the bed complement and all but six were brought into almost immediate service. The balance are going to be in service shortly. It was a reflection of the acute care needs within the system. So that coupled with the fact that we had just spent the dollars renovating, it would have been a little counterproductive, or viewed as counterproductive, if we would renovate some beds and then close them. Mr. Cheema: Can the Minister of Health tell us, is that particular building or beds at St.

Boniface under a teaching hospital review now to reconsider the change of the Government's position in the near future? Mr.

Orchard: The teaching hospital review is focusing first upon the identification as to what is definable, what is demonstrable in terms of the cost per patient day, the staffing hours per patient day as drawn out in Manitoba and Medicare which seem to indicate in rather lucid terms that from the period of time 1973 to 1985, I believe was the time frame involved, we went from having average per-diem costs significantly below the national average to those significantly above for our two teaching hospitals.

The teaching hospitals alone in terms of the resource commitment, it is approximately $400 million between the two hospitals. Because that is such a sizable commitment of resource, it is only natural that one would seek the answer to whether the differences are caused by differences in accounting, the numbers between Ontario for instance or the rest of Canada and Manitoba, or whether in fact we do have more costly teaching hospitals.

You simply cannot afford if it, say, is an apples for apples comparison, if you will, and you are significantly above the national average, some questions have to be asked as to why, because you are simply talking too big a portion of the budget. You are talking 25 percent of the entire ministry's budget in two facilities, two important facilities, but nevertheless the task force is trying to bring further clarity to the Evans Report on Manitoba and Medicare and not specifically involved with the use of the McEwen Building. Mr. Cheema: Mr. Chairperson, this is a very critical question I think.

I would have given the Minister a sort of warning. Now if the situation comes to him and say a proposal comes to him as came last year to close some of the beds, will this administration close beds if it is advised by any professional party? Mr. Orchard: We are dealing in hypothesis in that world of "if" that I cautioned my honourable friend about a couple of weeks ago.

The circumstances under which we will condone the permanent closures of beds within the health care facility is if their medical need can no longer be demonstrated through a change in approach to medicine, i.e., surgical beds, respiratory beds, other beds no longer are needed as inpatient beds, because technology has allowed not-for-admission surgery to take on a major amount of the admission procedures, or a substantial number of admissions, formerly for admission procedures.

In terms of respiratory illness, miniaturization, reliability of home breathing assistance has basically made more people self-reliant and able .i to live outside of the formal institutional setting. , When that happens and the bed is not needed from a program standpoint, because the program is moved to out-patient, yes, we will consider the closure of those beds. It has to be because the program has basically changed so the demand for the bed is not there. Mr. Cheema: Mr. Chairperson, I was asking it specifically for the McEwen Building.

Other questions we will be asking under Manitoba Health Services Commission, because there was a talk last year as the Minister has confirmed. A number of people felt that you have just 45 beds and they were able to manage but with a difficulty. Since we are spending 87 percent of the Mental Health Services budget within the hospital system as compared to 13 percent in the community, what I am asking the Minister is the long-term planning, because something has to be done to change, to have a balance in the system. As long as the decisions are made on a scientific basis or evaluation procedure there 3044

Monday, November 20, 1989 should not be any problem in terms of how do you reallocate the resources. That is what I said, and if suggestions come on professional, people and based on the facts that these resources could be used in an alternate way, I think that is the way most Manitobans would like to see it. There was recently research by the Prairie Research and I have a copy from one of my mailers from MMA, it tells that 46 percent of Manitobans are concerned about health spending. That is the No. 1 priority, how the money is spent for any health projects.

I think people are willing to accept the tough decision as long as it is explained to them in the most appropriate way. There was an event over the weekend-I can provide to the Minister of Health (Mr. Orchard) the copy of what was sent to me by the MMA, the amount of fees I pay them, so once in awhile I get some services. They are supposed to send to me because I pay them $770 a year-that is part of my professional fee and professional relationship. Certainly I will share the information with the Minister. Mr.

Orchard: Despite our little banter back and forth, my honourable friend is asking a very serious question. The proposal, yes, was advanced by St. Boniface on the McEwen Building. I guess it is fair to say that was an institutional proposal and we had to make decisions in terms of the system. Sometimes the two agendas do not necessarily come to the same conclusion.

There is no question that if we can effective ly, and of course this is what proponents of a lesser dependent or a non-dependent in some cases, institutional mental health system would lead you to a very much decreased need for institutional care in mental health. I think it is fair to say that we are moving in that direction but you can only achieve that if you have appropriate supports in the community. *

(2040) For instance, one of the projects in the reorganization, involved the move of 10 chronic long-term patients from Brandon to the Dauphin area with appropriate transfer of resources so that they could be adequately cared for in the community. Subsequently those 10 beds at Brandon were closed. That has happened in the last year and it is a move in the direction, but with the patients went some of the resource of the institution. That is a long-term goal that I think is laudable and achievable and we will end up with a more diverse and more provincially-based mental health system as well.

You are not going to be able to accomplish that as a result of one five month experience in a given summer with fewer acute care beds. Over the longer haul, yes, I think that is quite achievable, but we are only going to achieve it with a substantial amount of understanding of the system and co-operation from all of the various players including the community and the families in terms of a move in such a direction. That is very much why we are so pro-active in terms of work with the various groups and individuals involved with the mental health system in the province.

If you are going to reform the system, move it in the direction that probably everybody says we ought to. You do not do it in a knee-jerk reactive way. You have to be deliberate, direct, but also from time to time more patient than some would want us to be in terms of achieving those longer-term goals. We are working on them, that is clearly part of the reform agenda, but not one that we were able to accede to in the proposal on the McEwen Building beds that were made to us last summer because we did not think the system versus the institution was ready for that significant a change. Mr.

Cheema: I certainly thank the Minister for that answer. I think most people, as I have said, would appreciate to make a decision in the more logical way and not just a quick fix where we would end up paying more tax dollars in the long run. One of the initiatives announced last year was to set up a mobile crisis team demonstration project, and as over the week, last week I gave some written questions to the Minister. One of the questions was: what progress has been made in establishing this crisis team? Mr. Orchard: The mobile crisis team is operational, with all staff hired.

We had envisioned it with three staff years. It is operational, all staff have been hired, and it has been working, Mr. Chairman. It was fully operational September '89. It is very new, and we are hopeful that it works as well as we think it will because the whole idea of course is to try to present to the community a service of earlier intervention that may in some ways, if not curtail, certainly shorten acute care stays and provide a better level of service. Now we-well, I will let my honourable friend ask some more questions. Mr.

Cheema: This project will definitely not only relieve the pressure on some of the emergency rooms, but I think it will also provide the services in some of the home environment too. In most of the care services you would need the families to get the relevant information. If you can reach them at their place and get the relevant information, then that will definitely help. Can the Minister of Health tell us: how many new staff have been added to Winnipeg mental health services to implement this program? Mr.

Orchard: Three and in this case, all three positions have been recruited from the Registered Psychiatric Nurse discipline, yes. Mr. Cheema: Can the Minister of Health tell us: is this program available 24 hours a day? Mr. Orchard: There is a 24-hour on call, but not in terms of having someone. Mr. Cheema: What is the maximum time this mobile crisis team can actually go and make an assessment if they are called upon? Mr. Orchard: Basically, and I say this always with danger that there will be a few hours delay or something like that to make me less than an honest individual, 3045

Monday, November 20, 1989 but basically almost immediate service. Of course, the strength of the mobile crisis team is that they do have knowledge of and accessibility to the other mental health resources in terms of staffing and hospitals. They know the system, so that what they cannot handle, they know how to get the help to handle it. So from that standpoint the service is very, very rapid. Mr. Cheema: Mr. Chairperson, can the Minister of Health tell us, is this service available from 9 to 5, or 24 hours around the clock? Mr.

Orchard: The staff work regular hours in the regions, but the evening hours are when the rotation of individual staff on call takes place to provide the after-hour services. Mr. Cheema: Can the Minister of Health tell us, what is being done or what has already been done to let the public know that such a mobile crisis team does exist, and is this a telephone number which is available to the emergency rooms and various other social agencies? Is there a telephone number? Mr. Orchard: We announced the project last December and the decision was made to implement the project increment ally.

We had staff hired as of August 1, they went through an orientation period of time to acquaint the new staff with Regional Services and the regional staff and their caseloads. *

(2050) For the first month the new team worked only with an existing caseload, to put it that way, and then as of November the team was introduced to the member organizations of the Community Coalition on Mental Health. This then starts to get you more broadly based in terms of your referral service or your availability of service throughout the mental health community. In addition to that, they were introduced to the staff of the Psychiatry Department at Misericordia Hospital.

The next step is to introduce the team and their capabilities, their service levels, to the Health Sciences Centre and then from thereafter to introduce the team to other hospitals, the police department, Klinic, and other institutions that are involved in crises intervention in terms of a mental health service. Mr.

Cheema: As these individuals will be dealing with the first-hand information of a client who is a victim of mental illness and they have to also be careful about The Mental Health Act, can the Minister tell us, have these individuals been given special training to let them know what the provisions are of The Mental Health Act and how to get hold of someone who will be able to guide them in difficult situations? Mr. Orchard: I am not fully familiar with the RPN training courses and capabilities but that is part of their formal training, No. 1.

They then receive further orientation as to what is happening in the system and in fact have the availability of the regional co-ordinator who can provide answers to any questions for which-it is first time involvement and they are really into a new area. Mr. Cheema: I think it will be extremely important for them to be aware of the provisions of The Mental Health Act. I think just to avoid any potential problems because this is a new project and everything should be done to make sure that the system works.

My next question is, as it was provided in written form earlier , that we have three people on this crisis unit, what is being done to have involvement from the consumers of Mental Health services, like former patients, or former clients, or former counsellors, either on a voluntary basis or on a fee for service or whatever other ways they will be paid? I think if someone has gone through these services and for the person who knows what it means to have a mental problem, it will be helpful to the staff to adjust to those needs and also provide support to the family. Mr.

Orchard: Again my honourable friend surely must appreciate that we are really again breaking rather new ground here. We are on a pretty steep learning curve with the mobile crisis team, and certainly I value my honourable friend's suggestions and insight. I cannot ill indicate to him that six months from now or a year • from now we might be taking that. Certainly it is not an unreasonable suggestion that my honourable friend makes. Mr. Cheema: I think the Canadian Mental Health Association deserve a lot of credit for providing some of the information to me and to the other Members of the Legislature.

I shared the information last Thursday. This is one of the recommendations that should be followed, the word "should" probably should not be used, but may be considered in the near future. One of their concerns was what provisions are available for support and for respite to family members who care for persons with long-term mental illness. Mr. Orchard: We have a committee formed right now charged with the mandate to develop guidelines for respite for care givers.

The group is attempting to put in perspective the provincial needs and methods of how we might address those needs and of course the key to making that determination is to get a handle ill on what sort of resource allocation might be needed. • It is again a laudable goal and obviously one that would have benefits should it be achieved and probably a pretty healthy part of the reform of the mental health system.

To date we do not have a significant contribution of resource towards that and before we add, without a longer-term goal and direction for the mental health system, we want to quantify or get a handle on what the project across the province would entail in terms of the demand potentially that is there and how we would meet that demand with what amount of resource and the resource sourced from whence. Mr. Ashton: I have a number of questions in regard to the shift into the community. I know the Minister referenced the Dauphin, Parkland situation.

I know a similar issue was taken by the Brandon Mental Health Centre, I believe, in '87 or '88 involving six long-term patients. What I would like to ask is: what support 3046

Monday, November 20, 1989 mechanisms were put in place for both the Brandon relocation, I believe that was January of 1988, that took place and the Parkland, the Dauphin, relocation of the patients that the Minister referred to. Mr. Orchard: Ten people were involved in terms of leaving the Brandon Mental Health Centre, and each person has the services of the community mental health worker. Four of the individuals are semi-independent and in co-operative living arrangements, and staffing support has been through the Proctor Program. Three are in the St. Christopher licenced facili ty.

One is living with his family in Swan River, and of the 10, two have returned to Brandon Mental Health Centre. We are in the process of identifying another couple of individuals who might fit the program. Additional resources to those I have already mentioned were the addition of an effective half-staff year for an additional-another half-time community mental health worker in the Parkland region. *

(2100) Mr. Ashton: I was just wondering, In terms of the future of such initiatives, what plans there are in terms of further relocations, if any. What type of resources are being put into place? For example, how many proctors are being put into the various regions affected? I am just wondering if the Minister would give us some idea of the future direction. What l have been able to determine is that there has been some success.

I know people in the mental health field do have some concern about the level of support that is provided to ensure that the people relocated have a proper quality of life in the community relocation, but it is certainly something that has been strongly supported by the communities affected. I am wondering if the Minister could give us some idea of future initiatives in this area. Mr. Orchard: I think my honourable friend, in posing the question, has really in fact answered it. There very much has to be a high degree of support in the � community and a willingness for the community to participate.

That is why of course Dauphin, and the Parkland region, was chosen for this particular initiative. I would venture to say that given the success here that we would find more communities willing to participate. The only thing that really inhibits moving in that direction is the availability of community supports, because the community has to be quite highly involved. In the Parkland project, our commitment to staffing was a half SY for the region, which one would say is first blush you say a half SY 10 patients relocated from Brandon Mental Health Centre.

The full year basis of operating involves residential assistants at $45 a day, 365 days a year for those 10 individuals, and then day programming for $20 a day for 260 days a year . It is not simply the additional staffing from the department side. It is having the facilities and the support programs in place that can access the per diems in this case and support the day programming as well. I think you will see other communities mature in the development of those support systems and as they do and appropriate candidates are identified at both Brandon and Selkirk, you will see a gradual move to this.

Let me tell my honourable friend, and I think he already knows this, that this program will not be for every individual who currently is as chronic care in either Brandon or Selkirk. That is why it is rather critical and key to make sure that we do it right, if you will, so that we have successes to talk and to promote the furtherance of the system rather than a negative experience, which takes away from the initiative.

So as I say identification of appropriate client, appropriate community, and an attempt to match the two; we are willing to make those efforts providing we can reallocate the resource as we did in this case from Brandon because we took 10 beds out of service and transferred a substantial amount of the budget. Mr. Ashton: I certainly accept the Minister's point that we have to be careful and not rush into a program of this type. Obviously the success of initial-call them pilot projects if you wish. These two things would certainly be classified as pilot projects as the key to further developments.

You are dealing with some pretty dramatic moves here. I understand in the Brandon situation that the average number of years in the Brandon mental health facility was around the 35-year mark. It was just phenomenal. These were not short-term patients. They were long term clients of the facili ty, and to be able to move the individuals into a community setting is certainly quite a dramatic move. In fact I would like to ask the Minister if there is any feedback on the Brandon relocation. He has provided information on Dauphin, but has there been any preliminary indication of how successful that move was? Mr.

Orchard: I am not sure I understand my honourable friend's question, but you know when I was indicating the status of the 10, two had returned to Brandon Mental Health Centre. Now I do not know the individual circumstances in each case, but I would suspect they may well be individuals, as my honourable friend described, who had been there for 35 years, and they were simply unable to adjust to a different environment. I am not sure I understand my honourable friend's question. Mr. Ashton: I was referring to the initial movement out of the Brandon facility in January I believe of 1988.

There was a relocation of six long-term clients with an average of about 35 years. I am just wondering if there was any indication of how successful that move had been. Mr. Orchard: Mr. Chairman, I think my honourable friend is referring to the Community Residence Project that was developed in January, '88. As far as I know that is working well. As a matter of fact, I met a couple of the individuals at the training centre that was newly opened at Brandon Mental Health Centre, and they seem to be quite happy in terms of their new freedom. 3047

Monday, November 20, 1989 Mr. Ashton: I am certainly pleased to hear that. I am wondering if the Minister could indicate what has been happening in terms of the housing. We have referred to the support services thus far, but in terms of the type of housing facility provided to individuals placed in a community setting, in particular to what degree the department is attempting to provide proper standards in housing, and what type of housing is being made available to individuals in a community setting? Mr.

Orchard: Well, let me indicate that in the project now that my honourable friend just referred to, the six into the residential setting in Brandon, that is working relatively well now although it did experience its growing pains, because maybe some of the support systems were not mature enough when the individuals were first placed in the community. I guess by and large those wrinkles have been essentially resolved. In terms of the housing, I suppose we have a range of renovated to brand new depending on the circumstance and the sponsor group.

There are basic requirements in terms of space and comfort and safety, fire and otherwise that we require, but basically built around trying to assure a reasonable location for individuals. Quite often I think it is an upgrade in terms of physical surroundings. Mr. Ashton: I am wondering the extent to which the department takes into account the views and experiences of consumers in this area, clients.

I am wondering if there is any follow-up, because I know one of the concerns that is often expressed by agencies in this field is in terms of once again quality of life, particularly the desire to have the fullest freedom available for people to live in the community in the fullest extent possible as a normal part of that community. I am just wondering whether there are any mechanisms in place to achieve the input from consumers of the housing. (Mr. Edward Helwer, Acting Chairman, in the Chair) * (211 0) Mr.

Orchard: I think the individuals themselves who are involved in the move from, for instance, Brandon as we have been discussing, to community settings, I think there is a regular-maybe I am using the wrong terminology, regular , but certainly the success and their desires are very much part of the program. That is why, for instance, a couple of the individuals of the 10 involved in the Dauphin project returned to the Brandon Mental Health Centre. That was because that was a choice that they made, that they did not feel comfortable or I guess confident with their new surroundings.

There is I think, a fair attempt at making sure what we provide is viewed appropriately by those to whom we are providing it. Mr. Ashton: Moving to the institutional setting, I as MLA in the past received complaints either from individuals in institutions or from family members of institutions about conditions, allegations of abuse, et cetera, in terms of existing facilities. What I would like to ask the Minister is, what mechanisms are in place to deal with those types of complaints and whether there is any mechanism by the department itself or whether such complaints are strictly dealt with by the institution.

It is always a sensitive issue. I am not trying to make blanket accusations or suggest anything, I am just simply reporting the fact that accusations of abusive situations have been brought to my attention. I would just like to ask the Minister for the department's policy in dealing with such allegations of abuse. Mr. Orchard: There are a number of checks and balances that are in place, and I am assuming I am talking about allegations of what is believed to be inappropriate patient treatment within the facility by staff and/or professionals, et cetera.

When those complaints are received they are investigated first of all with the management of the institution. If there are any irregularities those are corrected and duly noted.

If there is not satisfaction with that process sometimes, let us be frank, if family members are the ones bringing the allegations to Government, they may not be satisfied with the organization providing the care, � doing the investigation and saying that we are all right. � In those cases there is the opportunity to refer the matter to the Ombudsman who has full independent investigative powers, if you will, to assure that no inappropriate actions have been taken at the facilities by staff and professionals. That does not happen all that often.

I do not know whether there has even been one go to the Ombudsman in the last 18 months. I am just gathering more information. The Ombudsman does have a substantial request for investigation, but to our knowledge here the Ombudsman has been satisfied that appropriate measures or appropriate treatment was given. I do not know what conclusions he comes to in terms of resolving the patient complaint, but he did not find fault with the methodolgies used in the institutions. Mr. Ashton: As far as the investigating procedure, the Minister is saying that they look into it.

Is "they" the department or is it the institution itself, with the second recourse being the Ombudsman? The Minister I think is indicating yes, so in other words the departmental � policy in dealing with complaints will be to refer them � initially to the institution, and if they were not satisfied with the internal analysis of the situation to then suggest they talk to the Ombudsman. Mr. Orchard: There is a whole range of opportunities that one can take.

We could go right to the Ombudsman first off, but normally if complaints come through the office or through the chief provincial psychiatrist or through any number of avenues, that the families have to lodge a complaint or the individual has to lodge a complaint, each is investigated. Anything that comes across my desk is referred out to the Mental Health Division and in turn is investigated. First off, a report is requested on the circumstances from the institution, and if in the course of that there is not satisfactory answers given, then a further investigation can be taken by staff.

If that does not resolve the issue, the Ombudsman can be referred to. At the institutions, so that patients 3048

Monday, November 20, 1989 know that this is their right, there is a large sign on each ward which indicates how one might be able to access the Ombudsman and launch a complaint, each sign having the Ombudsman's office phone number so that contact can be made. Mr. Ashton: Mr. Acting Chairperson, I appreciate the information. I think we can all recognize the importance of balancing. The institutions need to be able to have adequate control of the situation in providing this treatment, on the other hand patient's rights, and I appreciate the Minister's answers.

I would just like to ask a couple of questions in regard to the facilities and that is to the average length of stay in both the Brandon and Selkirk facility. There has been a dramatic drop from the early 1980s. In the case of the Selkirk facility from an average length of stay for patients in for less than 365 days from 93.7 to 47.4, and in the case of Brandon, on the same care area of 70. 1 down to 49.6. I would like to ask the Minister if there was any up to-date figures on the trend, whether it is continuing or whether it is stabilized in that particular area. Mr.

Orchard: The latest figures I have for Brandon on patients in the centre less than 365 days is up slightly to 54.9 days; Selkirk is up slightly at 48.2. In terms of patients over one year, both are down from 20 years at Brandon down to 19.4 in terms of the long term; Selkirk 12. 1 down to 10.3. Mr. Ashton: I am just wondering if there is any explanation for that. I realize there is some fluctuation.

Although in the case of the Brandon facility, that would be an increase over the last couple of years, a pretty noticeable increase, and I would assume on the other hand that the figures in terms of the long-term placement, in the case at Brandon at least, would be affected by the movement of the long-term patients out of the facility into the community setting. I was just wondering if there was any indication of why the length of stay has increased. Mr. Orchard: Mr. Acting Chairman, I have one correction to make in terms of '88-89 actual experience.

In '87-88 at Brandon for patients in the centre for less than 365 day was 49.6, and I indicated it was up to 54.9. That is not correct. It is down to 45.6. It is down slightly, but Selkirk's is up slightly by eight-tenths of a day. Mr. Ashton: My apologies, I was temporarily distracted, but I just wanted to indicate in terms of the long-term trend. I am not suggesting- Mr. Orchard: Well, I had the wrong number in there because Brandon for patients in the centre for less than a year, was 49.6, '87-88, and has gone down to 45.6 so it is continuing on basically a trend-line down for the last five years.

Selkirk has basically levelled off, in fact increased. It was 47.4 days for average length of stay less than a year, and it increased to 48.2, slightly up, but essentially you could say that it is continuing 3049 a downward trend to shorter lengths of stay. I think that indicates a couple of things that are positive in terms of ability to provide service. Mr. Ashton: It is positive in terms of the general trend I think.

I am pleased to hear in terms of the revised figure because that shows a general decline of the Selkirk one being within the range of a year to year fluctuation but the general trend is continuing and it is certainly one measure of the general success of changes that have been made in that area. I think it is something that should be watched fairly closely because clearly one of the goals in terms of mental health should be to limit the length of stay, both of long-term and short-term patients.

I think that is absolutely key whether it be in terms of getting people back into the community in a monitored sense or getting people back into the community, period. *

(2120) I would like to ask actually the Minister, he gave some comparative figures in terms of patient loads, various other figures, I would just like to ask what the situation is national ly, how we compare to other provinces in terms of length of stay for both long-term or short-term patients. Mr.

Orchard: We do not have those with us tonight and we will make the best effort to provide those, but again sometimes we have difficulty getting absolutely comparable institutional settings provincially or province to province but to the best we can-you want a comparison as to how Brandon and Selkirk would compare in less than a year's stay to other long-term facilities in other provinces.

To give you an idea of what happens with the two institutions, the Brandon and Selkirk, compared to the hospitals, we have 45.6 at Brandon in the last fiscal year; 48.2 at Selkirk in terms of stays of less than a year averaging in those range, so say between 45 and 50 days. The general hospital psychiatric units are quite dramatically lower with the Health Sciences Centre being 22.4 and Misericordia 29. 7 days and Victoria 24.8 days. So I guess it is fair to say that there is an integration of service with the longer term people being placed for the average longer stay periods in Brandon and/or Selkirk.

The exception to that of course is Grace Hospital in Winnipeg where their stay is very much comparable to the institutions at 49.6, but their patient count includes psychogeriatric individuals who are significantly longer term stay people

whereas the other three hospitals, Health Sciences, Misericordia and Victoria are not so. Mr. Ashton: I appreciate those figures as well although obviously you are dealing with different patients, different clients if you will in terms of the needs, I think that is clearly a reason for the difference. The reason I am asking for the information for the national figures is just to get some sense of how we compare because obviously that is the other criteria we should be looking at. I have a number of other questions. I know we are pressed for time in terms of Health Estimates so if the

Monday, November 20, 1989 Liberal Critic has some further questions I would be more than glad to hand the Estimates back over. Mr. Cheema: Mr. Acting Chairperson, could you pass the

section 4.(

g) and then we could go to 4.(

h) and I have some questions there. The Acting Chairman (Mr. Helwer): Okay, we are on (g)

(2) Other Expenditures, $226, 100-pass. We will go on to item (

h) Child and Adolescent Mental Health Services: provides specialized treatment to children and adolescents with psychiatric disorders in the community. Item

(1) Salaries $776,800-the Member for Kildonan. Mr. Cheema: Can the Minister of Health tell us the number of practitioners providing mental health services to children throughout Manitoba? Mr. Orchard: Yes, I can. In terms of psychiatric professional support we have a half-time psychiatrist in children's mental health at the Mental Health Division. We have eight psychiatrists on part-time contract at the Child Guidance Clinic and four psychiatrists on part time contracts for children's forensic services.

In terms of community mental health workers for the child and adolescent area, Central region has two, one in Portage la Prairie and one in Morden; Eastman region has also two, one in Beausejour, one in Steinbach; the Interlake also has two, one in Selkirk, one in Stonewall; Norman region has two, one in The Pas and one in Flin Flon, and both of those are new recruits just as of this month. Parkland region has two, one in Dauphin and one in Swan River; Thompson region has one in Thompson, for a total of 11; and the Brandon Mental Health Centre has six. Mr. Cheema: Mr.

Acting Chairperson, what is the average waiting period for a simple consultation in this area? Mr. Orchard: I am informed that with the Regional Services throughout Manitoba it would be quite quick, very fast service, very fast investigation. Mr. Cheema: Can the Minister maybe elaborate on what is the fast service in this area in terms of how many weeks would it take for someone to have a psychiatric assessment done for a child in Winnipeg as compared to Thompson and other northern communities? Mr.

Orchard: Pardon me, I am going to have to ask my honourable friend to repeat that because I was dealing with commission staff. We are not going to get to the commission tonight and I thought I would indicate to commission staff-we have half an hour, we could pass it. Mr. Cheema: Mr. Acting Chairperson, I do not think we want to give this Minister the same opportunity he had last year. He was inexperienced and certainly my inexperience and I was between two of the most experienced people in this House, the Member for Churchill (Mr. Cowan) and the Minister of Health.

We ended up discussing most of the stuff in Manitoba Health and the Minister of Health ended up making that half an hour allegation at least 50 times in the House. I would certainly not give him that chance. *

(2130) Mr. Orchard: I was only merely trying to be my usual co-operative self and make that offer because we did have a half an hour. It is fair to say that we are not going to get to the commission tonight. Mr. Cheema: I will ask the Minister what will be the minimum period for a simple assessment for a child in Winnipeg as compared to Thompson or other northern communities. Mr.

Orchard: As I said earli er, the community mental health workers can provide very quick service outside of the City of Winnipeg and in terms of the psychiatric � assessment that we have within Winnipeg, I am not ,_ sure whether we have current-how quickly, where can I find out-I am informed that it is within two days in Winnipeg. Mr.

Acting Chairman, one of the reasons why we have relatively quick access to service is the acute treatment and consultation team concept that we developed and of course the patient group that service is to be provided to are children and adolescents from infancy to 18 years and their families in the City of Winnipeg. We have referrals to the acute treatment consultation team from parents, school systems, hospitals, Child and Family Services, doctors and group homes.

The objectives of the team's work is to provide brief treatment to children and families and to provide consultation to other systems-schools, Child and Family Services, families and doctors, and to co ordinate access to the most appropriate level of mental health intervention. I think that is the important key to the consultation team and to improve co-ordination of jl interventions provided by the Government departments ,. and agencies, and to reduce the waiting time for children and families and to intervene quickly and provide brief treatment.

Staffing is five Ph.D. level clinical psychologists, one occupational therapist, two social workers, and an administrative staff support person. The team is currently undertaking to secure the services of a consulting psychiatrist as well. It commenced operation on October 10, 1989, just very recently , and by November , by early November, less than a month, the team had handled a total of 27 separate cases. (Mr. Chairman in the Chair) They have been actively involved in a critical incident stress debriefing in Charleswood following a series of break-ins.

It appears to be able to deliver on the quick and timely provision of service to reduce waiting lists. It is a significant improvement in service level, Mr. Chairman. 3050

Monday, November 20, 1989 Mr. Cheema: Mr. Chairperson, it is definitely an improvement as of last year. Can the Minister of Health (Mr. Orchard) indicate what the number of staff is dealing with the children at Health Sciences Centre, and how many vacancies are there right now? What is the impact of those vacancies on our teaching program? Mr. Orchard: Mr. Chairman, I think we are going to have to-again we could have got into the commission tonight, because I cannot give those figures to you. We do not have them here tonight, but-oh my, maybe we do have. Do we have the vacancies though?

All we have is the number of staff that have been in place, but I cannot give you the vacancies. We have one i n effect one and a half SYs in terms of child psychiatrists. We have one psychiatry resident, one psychologist, one occupational therapist, one social worker, one head nurse, seven nurses, seven EFTs and nurses, and two child care workers. Mr. Cheema: Mr. Chairperson, that does not answer my question. I am simply asking the number of the children specialists dealing with psychiatry, because I think it is a major concern the number of the staff is at the lowest.

There is one individual who left a few months ago, and that could have impact on the teaching program, especially when the recertification is coming in early 1990. If the Minister does not have the information now, maybe he could provide me when the Manitoba Health Services Commission comes. Mr. Orchard: I am informed that we do have an individual replacing the psychiatrist that left. Mr. Cheema: Mr.

Chairperson, is the Minister saying that we have an adequate number of staff at Children's Hospital and in the Department of Psychiatry to deal with all the caseload and also have the staff of the Child Guidance Clinic, along with providing all the consultation services to the rest of Manitoba? Do we have an adequate number of staff? Mr. Orchard: I guess that is an issue that has been before us, and any answer I give will not satisfy my honourable friend, but what we are attempting to do is work-and there has been a significant amount of co-operation between St.

Boniface and the Health Sciences Centre to attempt to assist whilst efforts are made to enhance the service delivery capabilities. Mr. Cheema: Mr. Chairperson, all that assurance would satisfy the recertification by the Royal College. Mr. Orchard: I do not know what it is going to take to satisfy the Royal College, but these-certifications, is it not called?-recertifications are part of the Health Sciences Centre and St. Boniface's day-to-day living, if you will.

They have in the vast majority of instances succeeded in meeting the requirements of the Royal College, and I would anticipate, hope and expect they will be able to continue to do that exclusive of this issue. Mr. Cheema: Mr. Chairperson, the Minister earlier had given a statement, and that could answer a number 3051 of questions such as the training for the community health workers for children at Ellice Centre. If that is being done, I would certainly be satisfied with that.

Can the Minister of Health tell us how many new initiative programs have been started to deal with the sexual abuse problem, because that was made a concern in the media for the last few months? Mr. Orchard: Let me answer the first question my honourable friend had first. There is a six-month mandatory training period prior to certification and employment in the field of child and adolescent psychiatric services for the staff.

As we discussed earlier on this afternoon, the issue of sexual abuse is one that was brought to regional meetings by the regional co-ordinators as an issue that there is growing focus on, concern about and activity in at the regional level, and I would suspect a more pro-active involvement of regional staff in working with school divisions and family services in the regions. Mr. Chairman: The Member for Kildonan-pass. Item 4.(h)

(2) Other Expenditures $1 6 1,200-pass. Item 4.(

j) Brandon Mental Health Centre: Provides institutional care and treatment for mentally ill persons. 4.(j)

(1) Salaries $1 6,682,500.00. Shall the item pass the Member for Kildonan. Mr. Cheema: Mr. Chairperson, we have discussed the clinic component of both the Brandon and the Selkirk Centre earlier today and on last Friday. We have questions on the issue of non-clinical component. Can the Minister of Health tell us how many positions are vacant in each and every category at Selkirk Mental Health Centre? *

(2140) Mr. Orchard: These figures were as of September and there has been some hiring into positions since that time. I will give you the vacancies as of September some of them hired into. There were -(interjection)- Oh, I cannot give you a photocopy of this, this is top secret.

Of 15 medical staff we have four vacancies; of 31 3 nursing staff we have five vacancies; of resource services, which include dietary, laundry, housekeeping, et cetera, of 106 positions we have four vacancies; in administrative support of 37 we have two and a half, or two years and 26 weeks, so that is two and a half; of 21 and a half positions in clinical records we have one vacan cy. That is it, for a total of 16 and a half vacancies out of a complement of 61 3 and a half, and that is at Brandon. As I say, some of those have been hired, that was as of September. Now let me give you Selkirk.

Do you want the individual, where they are? -(interjection)- Pardon me? The same as I did before? An Honourable Member: Yes. Mr. Orchard: Okay .

Monday, November 20, 1989 Of medical, we have five vacancies out of a complement of 12 and a half; of 245 in nursing, including the school of nursing, four and a half vacancies; one vacancy in seven in psychology; 17 in occupational therapy, one vacant; 79 in resource services, the dietary, laundry, et cetera, one vacancy; one vacancy of 16 in clinical records; and in administrative support we have 25 as a complement with one vacancy. So there are 14 and a half vacancies out of a complement of 451 and a half. Mr. Cheema: Mr.

Chairperson, maybe the Minister can give us, again, a preview of tomorr ow's Capital Expenditure. There was a proposal to construct a 100- bed special psychogeriatric unit at Selkirk. Is that proposal being considered for this year? Mr. Orchard: I do not know how to handle this. My honourable friend keeps wanting these sneak previews. Mr. Chairman: Shall the item pass-the Member for Kildonan. Mr. Cheema: I asked the Minister of Health a question. Mr. Orchard: I intended to deal with the Capital Estimates when we hit the Manitoba Health Services Commission.

I sort of want to follow my honourable friend's advice that we follow this line by line. Mr. Cheema: I think I have failed to convince the Minister of Health that he should probably give the good news this evening, but I think we will wait till tomorrow. Last year there was speculation and certainly a lot of fear among the School of Nursing at Selkirk. Can the Minister of Health tell us whether the School of Nursing will continue to exist? Mr. Orchard: That is the case, Mr. Chairman. Mr. Cheema: If we remember correctly, the Minister of Health (Mr.

Orchard) made some remarks during the discussion last year, and at that time he was not sure. This year certainly he has changed his mind, and that is positive, because I think the School of Nursing is providing a valuable service. I think the Minister deserves credit to change his mind, and certainly we welcome that. Mr. Orchard: My honourable friend is taking liberal liberty with my personal reputation here. An Honourable Member: Liberal liberties, that is bad. Liberties is bad enough, but a Liberal liberty, that is the worst type of liberty. Mr. Orchard: Liberal liberty is the worst kind.

I simply want to tell my honourable friend the question was and my honourable friend ought to know it, because he sat beside the questioner-w as there a review of the psychiatric school of nursing ongoing? Yes there was as there had been for the previous four budget cycles. As I indicated to my honourable friend then, there were no designs to close the school of nursing, as the rumour mill was rampantly grinding out in Selkirk and in the hallowed halls of the Liberal Caucus room. I simply indicate the same exists as I speak to my honourable friend today.

What we have succeeded in doing is to- because everything is dynamic in health care in terms of the training, and the demands on staff and their roles in the system, and psychiatric nursing is no different. Bear in mind, and my honourable friend knows this, that when you go east of this province-am I not correct east of this province there are no registered psychiatric nurses. It is a western phenomenon and I think quite a good one. I think the registered psychiatric nurse has filled a very valued role in mental health services.

In the changing context of reform of the mental health system, new challenges, new goals, new requirements on staff are going to become a reality . To attempt to meet that future, years down the road, we have a psychiatric nursing working group struck involving the association, members of the department and both � schools of nursing, in the Brandon University ,.

Department of Nursing and Health Studies, and the Canadian Mental Health Association, to take a look at what the future role of the registered psychiatric nurse ought to be in terms of meeting current and future challenges and to examine whether their educational preparation appropriately prepares them to meet those current and future challenges.

That study group is very much actively pursuing that investigation and are directed to report to myself and to the Registered Psychiatric Nursing Association of Manitoba's Board of Directors, because the association, as you can expect, is very highly involved in that kind of a discussion. The training at Selkirk and Brandon are ongoing components, but we are investigating with the RPN, as an association, what the future ought to hold, what the future ought to look for.

I think that is a progressive, co-operative move with the association to maintain Manitoba's leadership in terms of registered psychiatric training and training to meet potential challenges and � goals in the future. ,. We are enjoying support from the RPN AM, and I look forward to their eventual report to myself and to their board. Mr. Cheema: Mr. Chairperson, I certainly thank the Minister for that answer.

I think the role of the RPNs and all other professions in the changing mental health system in Manitoba is going to be very crucial, and we will have to use all the resources possible and in the best economic sense and also in the best academic way. I think if it is done in the way this department is dealing, it is certainly moving in the right direction. My final question about Selkirk hospital is: what is the status of day care hospital at Selkirk? Last year there was concern expressed and there were some deficiencies in terms of the availability of staff.

Can the Minister update the information on the day hospital? 3052

Monday, November 20, 1989 Mr. Orchard: Is my honourable friend referring to the proposal by the Selkirk General Hospital in terms of the day hospital proposal? You are not referring to the Selkirk Mental Health Institution? Mr. Cheema: The Selkirk Mental Health Institution. Mr. Orchard: There are six patients at any given time on the program at the Mental Health centre. *

(2150) Mr. Cheema: Mr. Chairperson, I have repeatedly asked this question about psychogeriatric delivery outside Winnipeg. Can the Minister tell us, what is their plan, not only in Selkirk and Brandon but the other places, to expand the delivery of mental health for elderly people and especially to have inpatient assessment units? I think tomorrow the Minister should give us good news about the Dauphin Hospital, so he can probably • go th ere and make an announcement about the I' expansion of the Dauphin General Hospital and to make accommodation for the geriatric day care hospital there. Mr.

Orchard: How much time do you want to spend on this, because I have a lot of resource that I can share with my honourable friend? Mr. Cheema: If you could give me a photocopy that would be fine. Mr. Orchard: This is kind of top-secret stuff again. Mr. Cheema: It is open Government, it should be open. Mr. Orchard: Guizar, you have been hitting me pretty hard tonight, and I am not as nice as I used to be. As part of the reorganization, we have piloted a psychogeriatric project in central Manitoba. We do have that, and I am looking for the right-yes, here we are.

The system commenced operations mid-October 1989, and the staffing involved one registered psychiatric • nurse, one social worker. We have on staff a half-time I' clerical position, and we are recruiting four part-time positions for occupational therapy. We also have a consulting geriatrician and psychiatrist identified to assist us with that program. Basical ly, it is targeted at a group of individuals who experienced the first onset of mental illness at the age of 65 or over in the central region.

What we are attempting to do is prove the efficacy of such a multidisciplinary team in providing early identification, support and assistance so psychogeriatric patients will not be underserviced and then have to rely on the more formal institutional setting for a higher cost level of service. We think this will be effective in assisting families, staff and others in understanding the problem and in assisting with providing support in the community. Mr. Cheema: Mr. Chai rperson, I do not have further questions, I just want to put a few remarks on the record before we end the mental health area.

Certainly , we had a very open discussion, and a number of initiatives have been started by this administration. They are very positive, and certainly we encourage the Minister. We will support him in his way of performing the Manitoba Health care system, and certainly the people of Manitoba will appreciate it in years to come, I think, what is being done. I want to express my sincere thanks for the Executive Director, Marg Watson, if I have pronounced it in the right way, and I wish her the best of luck.

I think she is doing more than expected from any executive director in any department, and especially when we are forming a system. The responsibility is a difficult task, and certainly I think she is not giving any excuse to have a Minister say, well, things are not being properly done. I think she is doing an excellent job and her staff needs the appreciation. We want to thank them for coming over, listening to me and listening to all of us, and certainly that will be helpful. Thank you. Mr. Chairman: Shall the item pass-pass; 4.(j)

(2) Other Expenditures $1, 836,400-pass; 4.(

k) Selkirk Mental Health Centre: Provides institutional care and treatment for mentally ill persons, 4.(k)

(1) Salaries $1 4, 200, 800-pass; 4.(k)

(2) Other Expenditures $2,079,500-pass. Resolution 68. RESOLVED that there be granted to Her Majesty a sum not exceeding $40,609,900 for Health for the fiscal year ending the 31 st day of March, 1990-pass. The Honourable Minister. Mr. Orchard: Mr. Ch airman, I did not take the opportunity to th ank my honourable friend from Kildonan for his compliments, because he has been very precise in his analysis and particularly in his last statement tha t we have had some monumental dedication within the Mental Health Division under this reform effort. I had mentioned that several times.

Individuals, Marg Watson, others have put in a substantial amount of time in attempting to bring about reform of the system. They have brought new programs to the people of Manitoba that will serve us well. They have gone above and beyond in terms of provision of Mental Health Support Services in Lynn Lake, and truly they are doing a remarkable job. I thank my honourable friend for his recognition of that. Mr. Chairman: The hour being 9:56, what is the will of the committee? The Honourable Minister. Mr. Orchard: Mr.

Chairman, possibly with my two honourable friends here, since things have gone so well tonight, could I just give it to my honourable friend, the Member for Kildonan (Mr. Cheema)? That would not be balanced, would it? I will tell you what, I thought we would get to the commission tonight, and if my honourable friends wish, I could leave them with a copy of the capital report so that we can get to the commission tomorrow. Would that be appropriate? I will see what I can find. Mr. Chairman: Committee rise. 3053

Monday, November 20, 1989 SUPPLY-WORKERS COMPENS ATION Mr. Chairman (William Chornopyski): The committee will come to order to begin consideration of the Estimates of the Department of the Environment on page 46. Mr. Gary Doer (Leader of the Second Opposition): Mr. Chairman, I believe we passed the Minister's Salary alrea dy, so we are out of order dealing with the Minister's.

We plan on dealing with a number of policy issues, but we plan on dealing with those policy issues dealing with Workers Compensation in the legislation the Minister has before the Chamb er, which is appropriate, and at the committee dealing with legislation that the Minister has forward. We plan on dealing with those issues there, and I think the Liberals plan that as well.

You could do all those issues under that legislation because that legislation is an omnibus Bill dealing with all the workings of Workers Compensation, and it allows us the latitude, the debating latitude, probably even more so than even -(interjection)- Yes, so we plan on doing it in the legislation. Okay? Mr. Chairman: So it is the will of the committee to pass the Workers Compensation basically. Mr. Doer: It is already passed, you do not have to do anything. No lines, done. Call in the Department of the Environment. SUPPLY-E NVIRONMENT Mr.

Chairman (William Chornopyski): Is it the will of the committee to take a 10-minute recess while we are awaiting the Minister of Environment (Mr. Cummings)? *

(2010) RECESS Mr. Chairman: The committee will come to order to begin consideration of the Estimates of the Department of Environment. We will ask the Honourable Minister for an opening statement. Hon . Glen Cummings (Minister of Environment): Mr. Chairman, I have copies of my remarks for my critics. I apologize for the little bit of delay that I have created at the start of these Estimates. *

(2020) Since the department last appeared before this committee, Mr. Chairman, there have been several substantive changes. Effective April 21 of this fiscal year, the Manitoba Environment became a stand-alone department dedicated to protection and promotion of the environment.

This change emphasizes the Government's commitment to the environment and, as will be indicated later in this presentation, the Government's commitment is not just represented by words, but it is supported by a significant increase in resources, along with the development of a comprehensive plan respecting the strengthening and the reorganization of programs and activities which the department will be putting into place during this fiscal year.

I believe, and I am certain that I am supported by Members of this committee, that concern for the environment has gone beyond provincial and national boundaries, taken on an international significance. I only need to refer to issues such as ozone, greenhouse effect, the ongoing concerns and problems encountered respecting toxic hazardous wastes and the city's drinking water. Clearly Government must be prepared to take forceful action if the environment is to be protected and enhanced.

Directly linked to addressing these environmental issues plus others is the whole sustainable development thrust that is presently in the forefront of public policy. Sustainable development, which is strongly supported by this Government, seems pivotal in protecting the environment to the use of future generations. The economy and environment linkage is � critical if mankind is to survive on this planet, Mr. ,. Chairman. I would hasten to add that the direct impacts of sustainable development initiative will not, in the strictist sense, be immediately felt.

It is going to take some time for the concept to take hold and grow and become a routine part of economic environmental decision making. Before getting into the details of my presentation I do wish to indicate to Members, the department has again prepared Supplementary Information for Legislative Review related to these Estimates. I believe all Members have received a copy of this information, and I would hope that this information will assist Members in the review of my department's Estimates.

I wish to send my thanks to departmental staff, as well as the organization members of the public that relate to the department who participate in an ongoing basis on the programs that we deliver. I now wish to describe in some detail the integrated strategy the department has developed on � environmental issues which will be implemented over � the next two fiscal years. As Members are aware, the new Environment Act was proclaimed effective March 31 . One of the requirements of that Act calls for the preparation and presentation of a State of the Environment Report.

The department is currently undertaking the necessary planning to satisfy this legislative agreement, and as a matter of fact, Mr. Chairman, only this afternoon I was briefed on the outline and who will be authoring this legislative requirement. Additionally , under The Environment Act the department intends to provide or increased monitoring of environmental quality. With respect to the State of the Environment Report and the increased monitoring activities, I will provide details shortly on the resources that were added to these initiatives.

As was indicated during the Throne speech, the department intends to proceed with an amendment to 3054

Monday, November 20, 1989 The Environment Act to provide for greater penalties for those convicted of non-compliance. This Bill has now been tabled, and I look forward to the co-operation of Members opposite to ensure it becomes law before the end of the Session. Additiona lly, regulatory changes will occur in several areas. Specifically, marine discharges into the water will be addressed and municipal landfill regulation will be amended.

With respect to the second major piece of legislation the department is responsible for administering, that is, The Dangerous Goods Handling and Transportation Act, it is our intention to proclaim very shortly Sections 8 and 10 which deal specifically with the licensing procedures relative to handlers of licenseable hazardous waste, licensing respecting the transport of hazardous waste, the licensing of disposal facilities and the process that will be required for licensing to occur.

In addition, under this Act the department has committed additional resource to better facilitate emergency response by the department to make that process more visible to the public. It is our intention, with the co-operation and financial participation of the Government of Canada, to establish a youth employment program which focuses on environment and environmental projects. Although details are not yet developed to the point where I can make an announcement, I do wish to indicate that I see this as an important link to an overall environmental strategy.

With respect to the area of hazardous waste, Manitoba Hazardous Waste Management Corp is aggressively proceeding with the siting progress. They will determine a suitable site for an eventual hazardous waste management facili ty. Conconcurrent with the siting process is the development of an effective hazardous waste management system within the province. This includes aspects such as the manifest system, consideration to establish collection points throughout Manitoba for hazardous waste and undertaking actual hazardous waste disposal activities. Another significant initiative is the whole area of recycling.

A number of activities will occur in this regard. Firstly, it is our intention to introduce and pass recycling legislation this Session which clearly spells out our intentions. A comprehensive Bill, the first of its kind in Canada, has been introduced, Mr. Chairman, and I expect that we will have great public interest in this legislation when it goes through the House. I anticipate there will be more than one group which will wish to address us at the committee stage. I know from private conversations with many of you that this is an area of active interest.

I look forward to successful discussion in this legislature and the co-operation to ensure that it becomes law in the not-too-distant future. I would also point out the discussion document says recycling is now the time. Additional ly, the department will be working aggressively with various interest groups in the province to commence the establishment of many recycling initiatives.

To fund these initiatives we are exploring the establishment of a self-sustained fund which will be forwarded by way of a predisposition fee attached to certain products-pardon me, it should say "be funded by way of a predisposition fee," Mr. Chairman. I believe this is consistent with one of our key principles, and that is that polluters should pay. This funding will used to fund various recycling projects undertaken within the province, and I believe this is a unique approach within Canada.

Proposed legislation on recycling will incorporate the principles on which our recycling initiatives will proceed and will commit the Government to develop and be accountable for a waste reduction strategy. As well, it will highlight the environmental innovation fund referred to earlier . In addition, I originally appointed a Recycling Action Committee to not only advise us on the components of our recycling initiatives but also to assist with the delivery of some of them. A major conference in March 1990 will provide a full component for developing a comprehensive strategy which will be implemented.

Projects currently under development include the Bag Curbside Collection Project, the Establishment of Composting Project and many other projects as the recycling initiative unfolds. Another area of consideration with respect to recycling relates to procurement. Well, Government alone cannot make significant inroads in this area without the public doing the same, and it is our intention as a Government to encourage the purchase of recyclable and recycled products in this province. Those products could include paper and oil.

As related to recycling and waste production, we have seen the creation of a new and unique organization known as ACRE, Association for a Clean Rural Environment. This organization represents an experiment in sustainable development that I know will be the subject of some discussion during these Estimates.

To increase the public awareness and understanding of environmental issues related to rural Manitoba and to this end sponsor research, education, and public participation of rural environmental issues, co-ordinate the funding and management of specific environmental programs as may be assigned to it by the Government or by the board of directors, it will not be a Crown corporation. It will be a non-profit organization. It is based on the notion that if we get together, the people and the institutions will share responsibility for the problem.

Given authority and resources, they are likely to come up with a lasting solution. The first matter to be dealt with by ACRE will be disposable pesticide containers. The third key strategy area our department is embarking on over the course of the next two years deals with the production of our air, water and land resources. It is our intention to enhance it and ensure compliance with transboundary agreements that we have with some of our neighbouring jurisdictions. I wish to again emphasize a significant concern that Manitoba has with respect to a proposed mine development at Shoal Lake.

It will continue to be our 3055

Monday, November 20, 1989 policy to insist that if any development is to be considered in the basin it would be preceded by the most thorough and rigorous assessment possible. Under no circumstances will we tolerate any development that could have negative consequences on the City of Winnipeg's water supply. We will be putting forward our most innovative proposal for the long-term protection of Shoal Lake water quality. In regard to acid rain, we are continuing our monitoring efforts.

We could also continue the enforcement of the regulation that was passed in March 1988 with respect to emissions from HBM&S and the lnco operation in northern Manitoba. It is still our intention to comply with the acid rain reduction program that has been agreed to in 1985. As well I would indicate to Members that we have entered into a federal-provincial Water Quality Monitoring Agreement with the Government of Canada. Under this agreement the resources of both Manitoba and Canada will be co-ordinated to maximize the benefits achieved from water monitoring activities.

The protection of our air depletion of the ozone layer continues to be of major concern both now and the future. Something must be done or in the long term our planet would suffer severe consequences. While Manitoba represents 2 percent of Canada's share of global emissions, it is imperative that we start somewhere. The department is actively working with other provinces and other environmental organizations to ensure a co-ordinated effort. It is our intention to introduce legislation dealing with the protection of the ozone layer.

In this program we intend to address the prohibition of products that are major contributors to the problem. As well, we intend to implement a public information program to better inform the public. We will also be exploring the feasibility of a demonstration project on safe recapture and recycling of CFCs. Finally, in this area the matter of radon will be addressed. Although radon is a naturally occurring problem, I believe again there are some steps in Manitoba that we can take which will assist in alleviating the effects of the problem.

In this regard it is the Government's intention to amend the existing building codes to ensure proper sealing of new homes to prevent the migration of radon into homes. That is being done in co-operation with my fellow Ministers. As well, it is our intention to provide information to the public in order that they might be in a position to properly judge the situation with respect to their personal status and take appropriate corrective steps. It is our intent to ensure the testing industry stays squeaky clean and that no fly-by-night operators are allowed in this area.

On the basis of all the initiative actions I have just addressed, I hope all Members would agree the best way to proceed to deal with the environment is to take certain specific concrete actions. Frankly , I believe the activities I have just outlined speak for themselves. Perhaps the best way to sum it up is to say that not just words but we believe we have lots of action. *

(2030) In a related vein, looking at the ambitious mandate the department has set for itself for the next two years, I would like to make Members aware the department has undertaken, with the assistance of an external consultant, a major review of the department's organization.

With the new legislation being brought into being within the past few years coupled with the continually changing and complex environmental issues the Government is required to deal with, and the department particularly , I believe it is timely that the organization of the department be reviewed to ensure that it is properly structured to respond and deal with issues at hand. It is expected the results of this reorganization review will be completed and in place in the next few months. I wish to provide some information to Members respecting the resourcing related to the activities that I just described.

I am pleased to advise them that in support of the ambitious mandate for the department there will be a significant increase in departmental resources. Overall the resource increase for the '89-90 fiscal year amounts to 14 additional positions plus an excess of $1 million in additional funding. With respect to resource particulars, although we will be addressing these in detail as we carry on with the detailed review of these Estimates, I would summarize the increases in this manner: eight positions plus some $300,000 in funding have been allocated towards Sections 8 and 10 of Dangerous Goods.

When these sections are proclaimed, that will come into place. Significantly these positions will address the assessment and licensing of hazardous waste management facilities, assessment and licensing of transporters of dangerous goods, the monitoring of hazardous waste by way of the manifest system, and through the provision of additional human resources to support our in emergency response function. As well, the staff will be involved in the assessment and licensing of hazardous waste generators.

To put some scope on what this means, we estimate there are some 2,000 generators within the Province of Manitoba that will require assessment and licensing. Some $70,000 in new funding will be devoted towards the department's emergency response activity. These areas that will be covered through this funding include funding to provide for payment of costs incurred in the clean-up of environmental accidents or spills, funding to provide better emergency response training for our staff, and thirdly , funding to provide additional equipment for the emergency response staff, for example, personnel safety equipment.

With respect to the administration of The Environment Act, four additional positions have been approved along with funding in the amount of $1 50,000.00. These positions will be devoted to the following areas: dealing with water related concerns as these relate to the City of Winnipeg; specifically addressing licensing requirements for drainage out falls; and private facilities in three major waste water treatment plants. Though it is expected the licensing activity will take some time 3056

Monday, November 20, 1989 to be accomplished by the department, the department will be working closely with the City of Winnipeg officials to ensure that this process is carried out to the best advantage of the environment. An additional position has been approved to permit the department to continue with its classification of watershed activities.

This process involves identification of water usage for all bodies of water within a watershed, determination of existing water quality and proposed objectives, holding public hearings to develop a plan, and developing discharge units to ensure long-term water quality protection. It is expected that this additional staff and an additional one to two classifications a year will be possible. As referred to earl ier, the department now has a legislative requirement for a state of the environment report.

One additional position related to the water quality aspect and state of the environment reporting has been added to our staffing complement. This position will als o relate to the previously reinforced Canada Manitoba Water Quality Monitoring Agreement. The last position approved in The Environment Act relates to the inspection, monitoring and enforcement of existing licences relative to industrial waste water discharges. As well, this position will deal with the assessment and licensing of new developments.

To support our ambitious public education communication initiatives an additional position has been added to the department's community relations branch. This position will be involved very extensively in the preparation of public information materials and participating in the development of educational curriculum material, and in general support the expected expanded information requirements associated with The Environment Act, The Dangerous Goods Handling and Transportation Act.

The final additional position approved relates to the carrying out of an ecological monitoring project which is required under the Northern Flood Agreement. Although this project is funded through the Department of Northern Affairs, because the Department of Environment has the expertise to oversee this project, responsibility for delivery rests with us. On a more general note, I wish to recognize the continuing contribution on a number of other activities made to the protection and maintenance of our environment.

Worthy of mention is public health inspection activity , water air terrestrial quality monitoring, and laboratory analysis services provided by W. M. Ward Technical Services Laboratory. All of these efforts collectively are critical if we are to maintain the type of environment that we presently have. Mr. Chairman, that concludes my remarks and I would be prepared to work with my critics to go through these Estimates, and once again I wish to apologize for my late arrival. Mr. Chairman: I will now ask each of the critics to make their opening statements. Mr. Gary Doer (Leader of the Second Opposition): Mr.

Chairman, I would like to thank the Minister for his 3057 statement. I am sure this is recyclable paper he is handing out to us tonight. An Honourable Member: I would hope so. Mr. Doer: Would I assume correctly? I thought so, although I note he is reading from non-recyclable paper on his own notes. Mr. Chairman, it is indeed a pleasure to rise on the Estimates of the Environment, probably the most important set of Estimates in this Chamber of all the Estimates this year. I want to make some very, very pointed comments about the Environment Estimates.

First of all, we believe that the Minister, present in the House today, is a Minister who is much more able to deal with the full environmental issues than we had before us previously. We believe that it is a very serious subject and the previous Minister just did not have a grasp on the issues, nothing personal quite frankly, but we often felt that his running of the Department of Environment was consistent with his first statement on the environment. Do you not recall when the former Minister stated, oh, the Department of Environment, it just runs itself, just put it on automatic pilot, it just runs itself?

The Department of Environment does not run itself. We will make very specific comments on the items that have been raised by the Minister. I do say to this Minister as it was very extensive introductory remarks that he provided to this Chamber, and we may disagree with what he is dealing with and how he is dealing with it, but at least we will acknowledge that this Minister has a tremendous amount of items on the agenda of the Department of Environment. Therefore, we take very seriously his comments and will debate what the Government is doing and how it is doing it.

I do applaud the ambitious agenda that is before us because it is certainly loaded with issues that by definition we will disagree with. Nevertheless it is a totally diametrically different approach to the environment than we received last year with this sort of automatic pilot approach to the environment, which proved to be a great deal of political difficulty for the Government last year, and therefore there were changes made by the Premier (Mr. Filmon) quite appropriately so in the stewardship of a very , very difficult, complicated and publicly important department.

We think the Government has a very lengthy agenda. I think that the term sustainable development has been misused by the Government. It has been more development and less sustainable when we proceed through the environmental issues. There is a number of major litmus tests in terms of whether this Government believes in environmental protection or whether it believes in just using public relations terms and sustainable rhetoric rather than really sustainable development.

I suggest to you when we look at every major environmental issue and we are able to take -(inaudible) sustainable and development that this Government has proceeded in a way that has been more consistent with the development side of that equation, not the

Monday, November 20, 1989 sustainable side, I am afraid to say. I think that will change over time and I think the Minister will have some influence in his department, but I think that we have to look through the major issues. An Honourable Member: What about Rafferty? Mr. Doer: Rafferty-Alameda is the first one. It is obviously a major issue of environmental protection for the citizens of Manitoba. I thought the position that the Member for Lakeside, the Minister of Natural Resources (Mr. Enns) and the Minister of Environment (Mr.

Cummings) took in the public hearings, not only did we applaud the Ministers, we came out publicly. We came out publicly and said, yes, right on, an independent full federal Environmental Impact Study. An Honourable Member: Our strategy worked, did it not? *

(2040) Mr. Doer: We did not find any reason to be negative about the positions of the Government. When they came out, I believe the Member for Lakeside, the Minister of Natural Resources (Mr. Enns), came out in the community of Souris, and then the Minister of Environment (Mr. Cummings) came out in Brandon it may have been reversed-they took tremendously positive positions urging the federal Environmental Impact Study to be quite independent and quite extensive and, yes, let us have sustainable development, but let us make sure it is sustainable to begin with.

I thought that was a major departure from the position of the former Minister of Natural Resources and the former Minister of the Environment. We said so publicly. We went on record and we did not quit, but as soon as the court decision came out and the Government immediately changed their position we did not pick around and say-we did not even use the word flip flop-we said, right on. This is very, very positive. Then I was absolutely shocked and I do not want to be cynical, but I watched the First Minister go down to a meeting in Quebec. I know he probably spent a little time with the Premier of Saskatchewan.

I knew the Conservative convention was taking place the weekend after. I know that the Prime Minister met with the Premier of Manitoba that same weekend, it was reported after that. Then all of a sudden we have another conversion on the way to Damascus, but the other way. We have another when Lucien Bouchard, one of the famous Bouchard brothers, one of the famous brothers that is destroying western Canada, Lucien and the other one- An Honourable Member: Benoit. Mr. Doer: Benoit. They sometimes threaten us that if Meech Lake is not passed they are going to leave federal politics and go back to Quebec.

I cannot think of a better reason than to defeat Meech Lake. That is probably-I guess this issue is too serious to make light of it. If they ever gave us a reason to defeat it one guy ruins our railway and the other guy ruins the environment-I cannot think of a better reason. If they think that scares Manitobans, they sure have the wrong track. Of course, they have gone to their second strategy and that is to send out a senator to talk about Senate reform. I was very disappointed when the Minister came first of all he went to Saskatchewan, the federal Minister, and tabled those documents.

He tabled those documents at a press conference. About four seconds after the lights went on for the press conference the bulldozers were already running in Estevan and into that project. I do not know, maybe I am naive, but it sounds to me as if those people knew what was going to happen. I think those people knew what was going to happen. The cats were rolling. Now I am not against the cats rolling into the valley for this project for development. I am opposed to it rolling before we know. An Honourable Member: . . . rode the 600. Mr. Doer: That is right.

Cannons to the left of them, cannons to the right of us, onward, onward, onward rode the 600-the NOP theme song. Those bulldozers started rolling and it was very happy days in Saskatchewan. The Premier of Saskatchewan was at this happy day press conference with Lucien Bouchard, then he came to Manitoba and tabled those same documents an hour and a half, two hours later. I was very disappointed because I think this is a really important issue. I read the licence. I read the documents.

The documents definitely stated, definitely proceeded from the environmental impact that we indeed do not know the effect on the water quality on the Rafferty Alameda project on downstream water in Manitoba. They also said and the Minister knows this, we do not know the sections on water quantity. If you look at the technical report that was released by the former Minister of Natural Resources and read appendix 7, page 7, it is not hard to understand why the Government could not predict what was going to happen with the Rafferty-Alameda Dam. In that

section they clearly have tremendous technical difficulty identifying the water flow to Manitoba. We have the same position on the Rafferty-Alameda Dam as we had in the emergency debate last year. Let us have this go to the environmental court. Let us have the proponents of the project put their position on the table. I do not know whether they are right or wrong. I have heard people say this is going to be great for the Souris River and the Souris River valley. Let us have people that are opposed to it put the data on the table and let us have an independent judgment.

Let us know in the sustainable areas where the water quality and water quantity will be. We were given a licence that I think is not only negative for the Rafferty-Alameda Dam, but I think causes tremendous difficulty for the morality of our environmental position with other provinces down the road. I am citing from memory now, the conditions of the licence that were provided. Conditions 5, 6, and 7, I believe, maybe 5 and 6, maybe 6 and 7 of that licence said the federal Government and the provincial 3058

Monday, November 20, 1989 Government shall determine the water quality objectives in consultation with Manitoba. I have read a lot of legal documents and negotiated about 350 collective agreements- An Honourable Member: Not 350, more like 300. Mr. Doer: Well 300, 350, I should count that someday. There may even be more than 350, I cannot remember. It was over 200 and under 500. I do know conditions of that licence. Every one achieved without a strike. The Minister, and I respect the Minister, stated-he is a good guy, he has a tough job, and I do not want to put the kiss of death on him.

The licence states, "may" and in consultation with the Province of Manitoba. That is not a determining authority for water quality. We do not have any water quality authority in the Agreement. Oh, yes, we will have wishy-washy monitoring committees, and we will have downstream studies, and we will have this, and we will have that. These are very important issues and we are not going to rush, I am sorry. These are very important issues and we do not have any downstream water quality protection in that licence.

I defy anybody to show me in black and white in that licence where Manitoba has legal authority to protect its water quality. That is going to be a tremendous problem down the road. How do you argue one way with the Tory Government in Ottawa and a Tory Government in Saskatchewan and then try, later on if we get into a dispute, and I hope we do not-I hope we get satisfaction from the Government of Ontario.

I hope we do have downstream water quality protection from Shoal Lake to Winnipeg, but I suggest to you that this Minister, by changing the position they took going to court and asking for an independent environmental impact study, has lost the moral precedent in terms of downstream water effect because you cannot argue one way with a Liberal Government in Ontario and try to argue another way with a Conservative Government in Saskatchewan, given the fact that we have already agreed to the licence. I say we are disappointed.

We will continue to criticize and disagree with the conditions of the licence and the fact that the Government has not joined other environmental groups in asking for what we are entitled to, a full and independent environmental impact study, as the technical documents that Lucien Bouchard tabled in Manitoba really recommend. •

(2050) Second, the Minister has letters from all political Parties I believe on Repap. It would be interesting to table the letters for the various political Parties, because I have not read the-I have read our letter on Repap in August of this year I believe, or early September An Honourable Member: An historic reading? You could start reading it again, you know. Mr. Doer: I know that the Member for Wolseley (Mr. Taylor) keeps raising it, but I would like to know what 3059 letter Sharon Carstairs sent to the Minister dealing with Repap. Did it take this piecemeal approach?

An Honourable Member: The hindsight environmentalists are at it again. Mr. Doer: Yes, well, I got rid of the City of Winnipeg exemption, contrary to the gang in 19, when I was Minister of Urban Affairs. I do not need any lecture from the old gang of 19 in here. You see the gang the Liberal-did you see the Liberal gang going on this week? The Minister tabled a little study going on with the waste disposal sites, and who was the first one that attacked them? The Liberals at City Hall. Chris Lorenc was the first one out there attacking the Tories.

I supported the Minister in licensing those sewage treatment sites, but it was the Liberals at City Hall you know, the Member for River Heights (Mrs. Carstairs) always says to us, pick up the phone and talk to your federal Lea der. Pick up the phone and talk to Brian Mulroney. If I was the Minister of Environment, everytime the Liberals asked me a question about City of Winnipeg environment issues, I would ask them to pick up the phone and talk to Ernie Gilroy, Sharon Carstairs' campaign manager, pick up the phone and talk to Chris Lorenc.

Pick up the phone and talk to Christine McKee-all those Liberals now that control City Hall. I will tell you, the Liberals are going to have to be pretty silent on City of Winnipeg environmental issues because they are talking out of both sides of their mouth, one way in this Chamber, and one way in the City Council seat. An Honourable Member: They have been taking lessons from you. Mr. Doer: Mr. Chairman, I will table my letter any day. I want to see the Member for Wolseley's (Mr. Taylor) letter on Repap because I think that is the second litmus test. It is not that popular in The Pas as you know.

Some Honourable Members: Oh, oh! Mr. Doer: Let me finish. It is not that popular in The Pas to say to people, we believe that we should have a full environmental impact study of the first phase, the second phase, and the forestry management stage together. When you say that in The Pas you are not that popular. When you say that to the unions and the workers and the families, it is not that popular .

I have done that in The Pas and I am not that popular, but you cannot say one thing to the Government about Rafferty-Alameda and say another thing in The Pas because you are worried about losing a few votes on the environment. An Honourable Member: No, you did not say the same thing. Mr. Doer: No, Mr. Chairman, we did say the same thing in both communities, and the Minister knows that

Monday, November 20, 1989 because the Minister has our letters. You have our letter. I am sure you have read it. I am pleased that the development has been slowed down and I am pleased to see that Repap, as a corporate management decision, realizes that sustainable development also means sustainable. I am pleased that Repap, and the Clean Environment Commission did not rubber-stamp it quickly because it was a very important environmental issue and Phase 1, Phase 2 and the Forestry Management Issues should be considered together. I do not know where the Government is going with that.

I do not know where they are going with it, but they will have our support for a totally comprehensive review prior to the construction stages proceeding even though it may be in the short run unpleasant, because in the medium run it is sustainable development to do it that way. To do otherwise is to again make mockery of our Speech from the Throne and to make a mockery, quite frankly, of the Minister's own statement in this Chamber. Sustainable development is actually doing it Repap's way, not the way it was first planned, Phase 1, Phase 2, Phase 3 in separate environmental stages.

Dealing with The City of Winnipeg Act, I was pleased to see the Minister point out The City of Winnipeg Act was proclaimed effective March 31 , 1988. Now the Minister and I have had some disagreements about The City of Winnipeg Act, The Environment Act for the City of Winnipeg, and today I noticed just almost minutes before Estimates that the Charleswood bridge project is going to be evaluated with an independent environmental impact study, not an independent environmental impact study. It is going to be conducted by the City of Winnipeg, consistent with The Environment Act of the province.

An Honourable Member: The city is doing it? Mr. Doer: Well, Mr. Chairman, am I surprised? No. tabled two legal opinions in this Chamber that said that was required. I think that if the Minister reads back Hansard he kind of cuffed me like a neophyte bear cub in terms of that recommendation. An Honourable Member: Just your approach, Gary, it was nothing personal. Mr. Doer: No it was not personal but quite frankly we asked the Minister what authority he had to go without an environmental impact study consistent with the Act with the bridge.

We asked him a lot of other questions; the snow in the rivers; the disposal of sewage into the rivers; and the sewage treatment sites. The city is doing it but it is closer to meeting the legal requirement. It is not what I would like. I would like the province to do it because the city is a proponent of the project and -(interjection)- The money is not in the capital budget yet, any group that approves something can disapprove something. Mr.

Chairman, why did we have to wait until the kind of last minutes before the Minister was presenting his Estimates- An Honourable Member: I was not supposed to be in here tonight. Mr. Doer: You were not supposed to be here tonight we are getting a little worried about the way the Minister is issuing these statements and press releases. He has a reputation of being an honest person and straightforward.

We disagree with the Minister on a lot of issues, but I am getting a little worried that you may be getting too controlled by the Premier's control office down there, the public relations Pravda for working for the Premier (Mr. Filmon). I notice a press release dealing with snow not being dealt with until 1992 was issued on a Friday afternoon. I do not think that is the Minister's style. Do they tell you in the Premier's Office to hold off on that announcement because it would be criticized, or did the Minister plan on releasing it at five o'clock on a Friday afternoon? Not his style, what is happening?

Too much control from the Premier's spin doctors in the office? I think so. We do not expect him to be like Boy Stalin, the Member for Pembina (Mr. Orchard), you � know, gag rules and everything else. He has a different • reputation, very disappointed in terms of the City of Winnipeg announcements. We believe that this sweetheart committee with the City of Winnipeg that was established by this Minister's predecessor should be stopped. This Act was not changed to take away the exemption with the City of Winnipeg to set up a sweetheart committee with the City of Winnipeg and the largest municipality.

I believe and will say so strongly that this Minister should cancel that bureaucratic committee immediately as a substitute for The Environment Act. Yes, have liaison with the other levels of Government, federal, provincial and civic, have liaisons with the needed environmental groups, but there is no substitute for implementing the law and The Environment Act with a "bureaucratic committee" that was opposed-the City of Winnipeg was opposed to The Environment Act to begin with. They came before committee, the old gang came before committee and said we do not want to be covered by The Environment Act.

We cannot trust � the City of Winnipeg to follow the obligations in The • Environment Act and that is why the province must act as the independent referee. I believe we should be independent, I do not believe we should allow the city to be the advocate for the bridge and the environmental referee for the bridge. There will be more projects. The same legal precedent that we argued about before will be the basis of many other legal activities in the city and the province.

This Government has two options: it can follow the full Environment Act legally or it is going to be sued with project after project after project, and it is going to come under the new Environment Act kicking and screaming, following the citizens, not leading the way of The Environment Act which I believe is appropriate. Mr. Chairman, the Minister has talked about Shoal Lake. It is a very important issue. We believe that the Minister should be funding some of the community based groups that are helping us out. I think the 3060

Monday, November 20, 1989 community environmental groups are doing a tremendous job in helping us know what the developments are in the lake. Is it not nice when the Department of Environment is taking a vigilant approach to this project, and community groups are taking a vigilant approach to this project in terms of protecting the Winnipeg water supply? •

(2100) We believe that this project must be stopped. We are disappointed that the Minister did not support, nor the Liberals in the House of Commons, an NOP Bill for safe drinking water , a federal Bill that would supersede Environment Acts for safe drinking water. Walter Baker, the Liberal Member for Newfoundland, talked it out last June, and we are going to get it back on the Order Paper in this Session of the House of Commons. We believe that type of Bill should be supported. I hope my Liberal colleagues in this House talk to their Liberal Caucus Members in Ottawa, because we think this is a good Bill.

We also have a similar Bill on safe drinking water in the Ontario Legislature, and we hope the Liberals join the NOP in passing a safe drinking water Bill in Ontario at Queen's Park, because that will give us extra protection over and above just the normal Environment Act. Surely drinking water is different than any other environmental impact issue. Surely drinking water is an extraordinary environmental issue and therefore should be treated in an extra special way. We think the Shoal Lake issue is being vigilantly watched by this Government.

We note the First Minister raised it at the First Ministers' meeting in Ottawa. If there is anything we can do in a co-operative way to raise questions in Ontario to the Liberal Government, if there is anything we can do, I say to the Minister of Environment (Mr. Cummings), if there is anything he wants our caucus to do with our federal counterparts or our provincial counterparts, we are volunteering, Mr. Chairman, to work with this Minister because we do not believe this is a partisan political issue, we believe it must be stopped.

We believe the Rafferty-Alameda project hurts us in the long run but that the Shoal Lake project must be stopped. In terms of legislation, Mr. Chairman, we will be looking very carefully at legislation. I would just note that the other side of legislation-a new legislation and tough fines is enforcement. I do not know of many Tory Governments that have prosecuted many firms on the basis of pollution and with the new Environment Act and the new Dangerous Goods Handling and Transportation Act, there is tremendous power now in those Acts and now we need enforcement.

We do not need great public relations Acts and no enforcement of those Acts. We will be listening to the Minister on the enforcement side through committee. I notice he has extra resources in his department and we will be paying very close attention to the issues of enforcement in all the Bills that he is proposing. In terms of the Hazardous Waste Corporation, Mr. Chairman, we do not agree with the Government 3061 establishing ACRE, and I said this in this Chamber and I was quite disappointed when the Member for Fort Garry (Mr. Laurie Evans), the Liberal Agriculture Critic, supported ACRE.

I do not know whether the Liberal Environment Critic supports ACRE or not, because I know that environmentalists believe that the disposal of pesticides should be done by the Hazardous Waste Corporation, the Crown corporation. I was surprised- 1 do not know whether the Member for Fort - (interjection)- Are you opposed to ACRE? Yes, well, that is why I am confused and that is why I wanted to ask, because the Member for Fort Garry (Mr. Laurie Evans) said, we support ACRE-in this Chamber two weeks ago Fri day . He said, we support ACRE. (interjection)- I did not think the Member for Wolseley (Mr.

Taylor) would support ACRE.- (interjection)- Well, okay, because I cannot figure this one out here. I do not know which Liberal position to accept. I have troubles-what is that? -(interjection)- Well, I know. I kind of hear the environmentalists say, we are opposed to ACRE and then I hear the Liberal Agriculture Critic say, we support ACRE, we have raised it in the House, and I do not know where they stand. An Honourable Member: It is kind of like the slush fund debate. Mr. Doer: Yes, it is like mush, you know, the mush fund.- (interjection)- Well, I know the Liberals are panicking.

The longer they are in this Session and in this Chamber, the further down they are going and I can understand that. Mr. Chairman, we disagree with the establishment of ACRE. We would not be opposed to the Hazardous Waste Corporation being the pre-eminent body for the disposal of pesticides and using groups like ACRE to possibly work in local communities, but to have it the other way around is absolutely contrary to the Hazardous Waste Corporation mandate. I wonder whether the Minister checked this out with the round table, because I do not think he did. I do not think he went to the round table.

I do not think he went to his sustainable development group. I think the sustainable development group they have established, the round table they have established, is a public relations exercise because real issues do not get referred there. They did not refer this here. You did not take ACRE to that group, I know you did not. You just passed it and announced it at the meeting. That is not sustainable development. Mr. Chairman, we also believe that the location of the Hazardous Waste Corporation must be thought out very carefu lly. I notice now that the Liberals are going around Fort Garry and St. Norb

Document details

Collection	Manitoba — Debates (Hansard)
Citation	34-2-74b
Type	hansard
Volume / chapter	34th 2nd hansardpdf 74b.pdf
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	4d1331125f435f9f75f034788c8c43e72335bd2f

Source file is stored in the law ingest library (pdf).