Manitoba Hansard — 13 March 1964 (Sitting 42, 27th Legislature, 2nd Session)

27-2-42

Manitoba — Debates (Hansard)

ELECTORAL DIVISION ARTHUR ASSINIBOIA BIRTLE-RUSSELL BRANDON BROKENHEAD BURROWS CARILLON CHURCHILL CYPRESS DAUPHIN DUFFERIN ELMWOOD EMERSON ETHELBERT-PLAINS. FISHER FLIN FLON FORT GARRY FORT ROUGE GIMLI GLADSTONE HAMIOTA INKSTER KILDONAN LAC DU BONNET LAKE SIDE LA VERENDRYE LOGAN MINNEDOSA MORRIS OS BORNE PEMBINA PORTAGE LA PRAIRIE RADISSON RHINE LAND RIVER HEIGH'l'S ROBLIN ROCK LAKE ROCKWOOD- IBERVILLE RUPERTSLAND ST. BONIFACE ST. GEORGE ST. JAMES ST. JOHN'S ST. MA TTHEWS ST.

VITAL STE, ROSE SELKIRK SEVEN OAKS SOURIS-LANSDOWNE SPRING FIELD SWAN RIVER THE PAS TURTLE MOUNTAIN VIRDEN WELLINGTON WINNIPEG CENTRE WOLSELEY NAME J. D. Watt Steve Patrick Hon,Robert G. Smellie, Q. C. R. 0, Lissaman E. R. Schreyer Mark G. Smerchanski Leonard A. Barkman Gordon W. Beard Hon. Thelma Forbes Hon. Stewart E. McLean,Q. C. William Homer Hamilton S. Peters John P. Tanchak M. N. Hryhorczuk, Q. C. Emil Moeller Hon. Charles H. Witney Hon. Sterling R. Lyon, Q. C. Hon. Gurney Evans Hon. George Johnson Nelson Shoemaker B. P. Strickland Morris A. Gray James T. Mills Oscar F. Bjornson D. L.

Campbell Albert Vielfaure Lemuel Harris Hon. Waiter Weir Harry P. Shewman Hon. Obie Baizley Mrs. Carolyne Morrison Gordon E. Johnston Russell Paulley J. M. Froese Hon. Maitland B. Steinkopf,Q. C. Keith Alexander Hon. Abram W. Harrison Hon. George Hutton J. E. Jeannotte Laurent Desjardins Elman Guttormson D. M. Stanes Saul Cherniac k, Q. C. W. G. Martin Fred Groves Gildas Molgat T. P. Hillhous e, Q.C. Arthur E. Wright M. E. McKellar Fred T. Klym James H. Bilton Hon. J. B. Carroll P. J. McDonald Donald Morris McGregor Richard Seaborn James Cowan, Q. C. Hon.

Duff Roblin ADDRESS Reston, Manitoba 189 Harris Blvd. , Winnipeg 12 Legislative Bldg,, Winnipeg 1 832 Eleventh St., Brandon, Man, 2 - 1177 Henderson Hwy,, Winnipeg 16 102 Handsart Blvd., Winnipeg 29 .steinbach, Man. Thompson, Man. Rathwell, Man, Legislative Bldg., Winnipeg 1 Sperling, Man. 225 Kimberly St. , Winnipeg 15 Ridgeville, Man. Ethelbert, Man. Teulon, Man. Legislative Bldg. , Winnipeg 1 Legislative Bldg. , Winnipeg 1 Legislative Bldg,, Winnipeg 1 Legislative Bldg, , Winnipeg 1 Neepawa, Man.

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John's Ave., Winnipeg 4 924 Palmerston Ave., Winnipeg 10 3 Kingston Row, St. Vital, Winnipeg 8 · Room 250, Legislative Bldg. , Winnipeg 1 Dominion Bank Bldg., Selkirk, Man. 168 Burrin Ave. , Winnipeg 17 Nesbitt, Man. Beausejour, ·Man. Swan River, Man. Legislative Bldg., Winnipeg 1 Killarney, Man. Kenton, Man. 594 Arlington St., Winnipeg 10 412 Paris Bldg. , Winnipeg 2 Legislat.ive Bldg., Winnipeg 1 I I �

THE LEGISLATIVE ASSElVIBLY OF MANITOBA 8:00 o'clock, Friday, March 13, 1964 MR. CHAIRMAN: Before we begin tonight, I would like to make a suggestion that might help to speed things along without undue hurrying.

Most of the things that we have discussed this afternoon, after the opening addresses and so forth, are covered il;l items which will come before us in the Health Division, either the psychiatric or the health services and if they do, and I'm quite sure most anything we will discuss will do that, may I just offer the suggestion that perhaps we might reserve any comments that we have concerning any of these items on hospitals, and so on until we come to those various items, then when we deal with them then make our contribution and the Minister will be able to answer. It will just, I think, speed matters along.

We are just in the beginning now (a) •.. MR. DESJARDINS: Mr. Chairman, Oh, excuse me--I thought you were calling - Were you calling 'a'? Yes, well I think it might be a good idea that we proceed as such, but nevertheless there are certain things that the Minister had started with some answers that we would not gain any time by rehashing this all over when we come in the estimates proper after the salaries, so I think we might as well finish this.

I was asking the Honourable Minister what the policy would be; if there would be any change in the government's policy as we have now; that any new building they would have to raise 20 percent, the first 20 percent , and it seems now that this is practically impossible . We have had an avrfullot of hardship on this; we might even lose the Victoria Hospital, and I cer tainly would like to hear something from the Minister on this. While we are on matters on the funds, I wonder if there is any proposal for raising this mone y for the plan, for getting this money.

The Premier himself not too long ago stated that the Plan was in pretty critical condition financially, that we needed more money. Is it the in tention of the government to raise the premiums soon; or is it the intention of the government to curtail some services? It seems that that might be it to a point when we were told that the Hospitals were told that they would have to hold the line. I would be interested in knowing what's in store for us --how we will raise this money. I think that it's practically impossible . It's wishful thinking to think that the hospitals themselves will be able to raise the money.

The money has to be raised by the Commission ,and therefore the government. I know that the Com mission will have only a certain amount of money, and I think that they will have to fight with the treasury, those who hold the purse, to get a little more money, because I still feel that we'll have to give the services to these people who are paying these premiums. Now there is one thing that I'm

part icularly interested in that I'd like the Honourable Minister when he has time, either tonight , or maybe later on to explain and that's the adminis tration costs. It seems that the cost, we talking only --what is it --about 49 on the dollar but I don't think this is the true picture. It's the amount that we are spending, it seems to be very very high. I spoke on this last year. I feel that we had people in the hospital, administrators that could do a lot of this work. We have duplication now, and I 'd be very interested to know how many employees they have taking care of this administration.

I'd like to know how many they had lastyear, and so on for the last five or six years, ever since this plan was in operation; their salaries, or their raise; and also what is projected for the following year. This administration--it seems to be very high apparently --I can •t verify this, but some of the information that I•m given is that Alberta spends about half the amount that we do on administration. Now as I say, this is something that I 've heard, I haven 't anyproof of that buti think that we are spending an awful lot of money here in admin istrating.

This started as an insurance fund and now it seems that the government has practically taken over the hospitals. They seem to be dictating, telling them what they are going to spend , and the ser_vice that they are going to give, and tell them that they will have to curtail certain things. Now the Minister before dinner was talking about the great importance of research. think he probably misunderstood me. Last night I did mention the business about research and I'm all for it. But what I said was this: what's the use of having research if later on we haven't got the money to put this in practice.

This is what I said, because we are told this year that the hospitals were told, "well this is it and you're not spending another cent," and this appar ently has not been done. There hasn't been any discussions with the administrators on this. Now, I would -- don't want to come back to all the things that I've said yesterday. There's March 13th, 1964. Page 1089

(Mr. Desjardins, Cont'd.) ... one thing that I'd like to !mow though .:..., well, I said this 20 percent and where are y'ou going to raise the. cost of administration? And there's another thing that I brought up yesterday and I'd like to have an answer on this. I still feel that the "nurses should receive some pay. I'm told that the Commission feel that these nurses count; · that they should be doing quite a bit of work and there's no remuneration at all.

I don't think ·'that they should have a high salary, but if we want to at tract the proper.girls --there's a shortage of this, of nurses --I think that maybe they should at least get the $5. 00. At one time they were talking about raising this, and all of a sudden there's nothing at all. I'm very sincere in this; serious when I say I say that I think that those student nurses should be getting something.

We're talking about minimum wages; we're talking about training on the job; we're talking about giving the prisoners something for the work that they are doing; surely to God we could help those young girls when they're in training. Now, there's another question that I wanted to ask. It seems that the physiotherapy --I haven't got the page now --that physiotherapy work for the people in the hospitals, well, this is paid, this is fine.

But then, the out-patient department --the out-patient can receive this physiotherapy, the treatments in certain hospitals, in this Rehabilitation Hospit a l in Winnipeg, but they can't get it, they can't receive anything in St. Boniface. Now to me that doesn't seem reasonable. I'd like to know why. Has anything been changed now? If they're a patient at the hospitals, fine, they get this physiotherapy aid. But if they are out-patients and if the �c::tors want them to keep on these treatments, well if they go to the Manitoba Rehabilit ation Hospital, that's fine, but if they go to St. Boniface, no.

I'd like to know. There must be an answer, there must be a reason for this. It doesn't seem too practical. I think that this again is an other way to keep people in the hospitals. If they need this care the y're going --it's going to be paid for them. Well that's fine they're going to stay in the hospital a few more days, be cause if they have to come out they'll be charged. I think the Honourable Minister is getting the answer now, so I'll probably get satisfaction on this. · Now, Mr. Chairman, I'll follow your suggestion and try to speed this up a bit.

I'd like to get answers now on this from the Honourable Minister on these few·points that I brought up, and then we'll wait. MR. GRAY: I have always and will now accept your suggestion to deal with each item separately. !.don't think that I have ignored your suggestion at any time, but there are just one or two items! wish to mention under the Minister's salary. He could be assured that I'm the· last man in this House to reduce anybody's salary.

At the outset, I want to wish the Minister success in dealing with the estimates, and also in accepting, in my opinion, the most important useful and humanitarian portfolio, and his job I realize will be not so easy; and that I promise as far as I'm concerned will co-operate with you. I realize his position. It's quite easy for a doctor to take up the course of education, it goes together --although I wasn't very happy about the First Minister's choice --not of his successor, but in general.

I think all of the Ministers who have changed their portfolios have done an exceptionally fine job and now for reasons of someone else they have been assigned to different positions. But as I said, a doctor can always be a teacher, but I was a little bit afraid of a reforestation man, a fisherman or a hunting man to get a portfolio which requires medical attention; it requires a big heart --I don't say he hasn't got it --which requires a lot of sympathy; and which requires to put the patients, the suffering of the patients above the dollars.

So take my advice: history will not judge you by the money you will save; but history will judge you by the human beings that you have saved; by the TB cases and other contagious diseases; and particularly your help in the mental institutions, which !think so far, as far as I know is the finest anywhere. So, you need a lot of sympathy and you need a lot of .advice. I realize that my advice is very seldom taken in this House, but nevertheless you canno� throw away my sympathy that came from my heart and I think that you have now in front of you a very very big and important job. Carry on!

We will try and not con demn you on every itelX} which may come up in these estimates. You're also fortunate to submit your estimates now at a time that we are celebrating - well, not exactly celebrating --the Annual National Health Week of March 8th to the 14th, so you still have another day to put in all your good efforts, because the Annual National Health Week looks up to all the Ministers of Health to receive their ideas and ideals. This is being celebrated nationally --supposed to be in every province --and I feel that you are fortunate Page 1090 March 13th, 1964 I

(Mr. Gray, Cont'd.) ... to carry on your estimates in the same week, and perhaps open up your heart a little bit more to those who are now suffering. The main items --I don't say the main items, I'm interested in everything --but the main items in the estimates, looking over it, is the prevention and not so much the cure --although the cure is also important. I have in mind the excellent progress which in our province we have made in the mental institutions.

I might as well, even if Lam condemned tomorrow by someone, I must admit, being here so many years, that a life saved --the lives .saved and the discharge of the mental patients in the last 22 or 23 years in here, I can't help but admire it. Probably you could have done better; you could have done more work; but the work that has been done has accomplished a lot, and whoever is responsible for it, whether the present Minister or the former Minister, both of them are taking this sitnation seriously. I'm not so much pleased with another item of preventative medicine, and this is the TB.

According to the return shown a couple of weeks ago, not very much progress has been made. Of course the justification is that among those in TB you'll find 113 Indians and 130 are Eskimos paid by the Federal Health Department. That doesn't interest me, who pays for it. It comes out of the same pocket. The taxpayer pays for it. But the ta.xpayer is willing to pay. We can not afford --after making such a big progress in tuberculosis treatment and life saving, we find even now a considerable number of patients still carrying around --or carriers of tuber culosis. I think some attention should be given.

This is just as important as anything else that we have to take care of. Now the future program. I say again that our children for whom we have prepared a wonderful world --if Cyprus or some other cotmtry would not interfere --we have given them sidewalks; we have given them buildings; we have given them homes;we have given them uni versities; we have given them health resorts; we have given them health prevention. They could well afford to pay a little bit more when they grow up and not worry about that.

If an other million dollars is necessary to preserve human lives, do it, and you'll get the blessing of the future generation. Don't worry about it. Some members say, "Where is the money coming fr(!m? Where is the money coming from?" When I came into this Legislature the ex penditure was $20 million --the budget. Now it's a $150 million. Where is the money coming from? The money comes from those who can afford to contribute and if they c.an afford to con tribute, they should contribute more. --(Interjection) --in your position so take my advice.

I'm not more intelligent; I'm not more learned; but I'm older anyway --this I'm sure --so it gives me the right to give you some advice. I feel that you have a job to do for the present, for the future and for the coming generations, Don't sell it for a dollar. Don't be a hero by saving money; be a hero by saving human lives. MR. PETERS: Mr. Chairman, I've been waiting quite anxiously since last night, and as the Honourable Minister of Health knows, I'm going to come on to my pet subject of Canada Approved meats. About three years ago, Mr.

Chairman, I brought in a resolution dealing with this subject and at that time there was quite a scare in Ontario. The scare was that certain unscrupulous persons were selling meat from sick and even dead animals to people for human consumption. My resolution at that time received favourable consideration and I thought that by this time we would have had a few forward steps.

I agree with the Minister that it is a very difficult pro position to have all slaughterhouses in the Province of Manitoba under Canada Approved system because water is one big problem, not having water and water pressure and all the rest of it, but what concerns me, Mr. Chairman, is right here in the City of Winnipeg we have --I don't know how many dozen of meat-processing plants that I thought by this time some of them at least would have been under, if not Canada Approved, at least by the Provincial Government - not on a weekly or a monthly or even a daily inspection.

We hear the Minister of Industry and Commerce saying-that we are looking for new jobs to create employment. Here's one field you don't have to look into; you have it right here. We have dozens and dozens of these meat-pro cessing plants in this province and in the City of vVinnipeg, and in the Metro area there is only one that is under the Canada Approved System. Now, Mr. Chairman, these other plants are getting bigger and bigger every day. They can come under the Canada Approved inspection and it doesn't cost them anything. The Federal Governm·:mt will supply the inspectors.

You can drive down almost any street and you '11 see March 13th, 1964 Page 1091

(Mr. Peters, Cont'd. ). . . . these people that are operating these plm1ts advertising -- great big billboards -- to buy their products. Mr. Chairm all, as far as I'm concerned, if they are allowed to. advertise then on big billboards, in there in bold letters, just' as bold as they adver tise their meat products, should be right across the bottom or across the top, "Buy our product but we are not tmder Governm9nt Inspection Callada Approved, or Provincial Governm.ant. We are inspected -- oh, periodically." Even if you inspect it once a day, Mr. Chairman, that's not good enough, and I'll.tell you why.

Although m:>st of these places use Call ada Approved meat that are processed in slaughter houses that are under Call ada Approved inspection, they also get meat that does not come from places that are under government supervision. They cry that they can't afford it, that it's eco nomically impossible for them. This is nonsense, Mr. Chairman, because you Call go into any place where they sell their products alld you're paying more for them thall you are for products that coma out of a plant that is under supervision.

There are mm1y mally meat-processing places in this prqvince, in this city, m1d people have the idea that because they have over the years gained a name for themselves that they are buying Call ada Approved products. They are not. They Call well afford -- it doesn't cost them anything, Mr. Chairm all.. This is what· amazes me; it doesn't cost them allything. They call get these inspectors from the Federal Government alld it's the sallitary conditions that count.

Althouth they are getting Canada Ap proved meats and some meat that is not coming from Call ada Approved plants, they manufacture prQducts and we don't know if they are under Sallitary conditions or not. Certainly I know that the inspector goes there. He may go there -- even if he goes every day, they get to know him and they watch for him, but the minute he's gone, then they go on tli.eir old merry-go-round. Now I Call give you an instarlCe, Mr.

Chairman, where not too mally years ago -- as we all know that there are meats, carcasses that are hauled by truckers and meat that is hauled by the railroads, and if there is an accident where a truck goes off the road and it turns over and there's the meat carcasses in the truck and they get all muckied up, the company or the packer that sends that meat out has the first call on that meat, alld if he feels that he doesn't want it then the insurance company gets it. Where does that meat go to? I've seen some of this stuff, Mr. Chairman.

It's filled with dirt, with oil, with grease, and it finds its way into these plants that do not come under government inspection alld they use it in manufacturing sausage, head cheese and different products like that alld you never see it. When I introduced my resolution, Mr. Chairman, everybody said, "Well, this is just = isolated occasion. It could never ever happen again. 11 Well here I have =.item from the Van ·couver Sun, December 12, 1963, Mr. Chairman, where the firm admits selling cmmed goods with the larvae aJ.ld insects -- dead insects, mold and larvae in it. This .is just a few months ago, Mr.

Chairman, a11d this is just because it got caught up to by accident. The same tiling can happen right here in this province in these meat-processing plallts. Even though they use Canada Approved meats, their sanitary conditions are not up to sc ore, a11d the Minister, he can send hi,s inspectors there every day if he likes, but unles s that inspector is there all day long to see that there is cleallliness in that place, that there's no dirt gets into ally of the equip ment that's there--this is: happening right here -- whether the Minister cares to adri:J.it it or not, this is happening here.

I have a little pla11t -- it was a little meat-processing plant -- right in my own constitu ency that opened up about three or four yaars ago, You go and take a look at that place today. It's expa11ded; it's ten times the size that it used to be, but go in there. Is there =y inspection of any kind? No! If the inspectors come along from the City of Winnipeg or from the Provin cial Department of Health, these fellows get to know them and by the time they get into the back where the processing is done everything is cleaJ.led up. No, Mr. Chairma_n, this with me is -- it's a very sore point wi th me.

If they were Un derselling other products, but you're paying a good high price for it -- some of the products over a dollar a pound -- a11d when you're paying that kind of money, Mr. Chairm a11, then you should be sure that you're getting the best alld we're not getting the best because there's too many things that Call happen. I think I've said enough on thJs item, Mr. Chairman, but I would like to say a few things about what the Honourable Member for St. Boniface mentioned about the nurses not getting any pay -- the nurses in training.

Well I hope he has better luck th= I had because I remember Page 1092 March 13th, 1964

(Mr. Peters, Cont.d.) .•. very clearly, Mr. Chairman, in 1958, the first time I sat in this House, the maiden speech that I made. I mentioned then that the nurses in training were not getting paid enough money; that they should get a little something extra. They were dedicated pe ople and we should try and help them along. Well I sure must have made a good impression on the government because instead of getting $5. 00 they get nothing now. So I hope the Hon ourable Member from St.

Boniface has been able to put a better impression on the government that I was able to in-- (Interjection) -- W«:lll, he can try that too. Now, Mr. Chairman, I want to bring out a little bit about -- I suppose that under new hospitals we can bring that up under The Manitoba Hosp ital Commission, but I want to warn the Minister that I intend to bring up the question of the new hospital that is supposed to start -- or the building of it is supposed. to start this fall-- and that is the Concordia Hospital in Elm wood. We need a hospital there very badly and I mentioned this at the same time in my maiden speech.

Under the

schedule of the Willard Commission, it is supposed to start in the fall of 1964 and I'm just giving the Minister warning that I intend to bring that up at that time. He can take notice of it. Another thing that I want to give notice of is the registered psychiatric nurses at Selkirk, and I'll bring that up under the psychiatric services, but I want to warn him now that I intend to bring it up and he better have the answers ready for me. I had an Order for Return in of how many there are employed and the separations -- the people that have quit -- and it is pretty high.

I want to know -- and I'll tell him now -- if he is recruiting people from overseas, whether they are going to be fully registered people or just practical nurses. This is just a warning for him to be prepared for this. Now there is one other thing that I would like to bring up, Mr. Chairman. I was under the impression that when this hospital scheme was instituted in this province, that in standard ward coverage there would only be four beds for each room.

Much to my surprise during the supper hour, there were some people over at my house this evening and they tell me that in the hospital -- I don't want to mention the name because I don't think it's right, I'll tell the Minister in private if he likes -- that there are eight beds in one room. Then when I told one of my colleagues this, he says, "Well I can go you one better. I'm sure that there was at least -- oh, twelve, fourteen beds in the hospital that he had visited and seen, so this is some thing that I want to get cleared up.

Is it supposed to be that there are only supposed to be four beds in a standard ward or is this still going on the old system where there used to be as many as -- I remember seeing ten and twelve beds in one room. I want to mention about the waiting period of getting into a hospital. I had the experience, Mr. Chairman, of myself waiting to get into a hospital. I suppose I could have waited another month if needed be because it wasn't a serious thing that was wrong with me. It's a thing that I had to have done but I did have to wait one m:mth, and it wasn't that I was waiting for a stan dard ward bed.

I put in for a semi-private and I waited a whole month. The situation is get ting very serious where people have to wait for a long long time to get into the hospital, and if they can't afford semi-private, then unless they're in a very serious condition they wait, I understand, up to two months. Now I think this is wrong, Mr. Chairman, because we're not going ahead as we should have with our hospital building, that we should have had more beds available by now.

As I say, I didn't mind waiting but there are people that-- I understand that it's just this year that can cer is treated as an emergency, that people with cancer or suspected cancer get a bed immedi ately. I understand that a year ago cancer was not considered an emergency. It was considered as urgent but not as an emergency, and these are some of the things I would like to have answers to, Mr. Chairman. The other items that I mentioned, I warn the Minister I'm going to ask them when we get to the items . MR.

WITNEY: In answering some of the questions that have been posed tonight, the policy of 20 percent local equity in a hospital has not been changed and will continue to function in the province. What the Michener Commission will say about that particular matter I couldn't tell you. With respect to the Victoria Hospital, the construction and the renovation program of the Victoria Hospital as recommended by the Survey,Board was approved by the government of June, 1961, within a very few weeks after the Survey Board Report was received. -The hospital March 13th, 1964 Page 1093

(Mr. Witney, Cont'd.) ••• has however encountered difficulty in raising the owner's equity of 20 percent of the total cost as required under the legislation, The government still stands ready to provide the usual financial support as soon as the board of this hospital is able to make the necessary arrangements and in the meantime a considerable amount of planning has been completed. The Honourable Member for St. Boniface asked about any future increases in. premiums, and I can only say to him at this time that there will be no change in the premiums as they stand at present.

With respect to the physiotherapy, the Hospital Commission established a physiotherapy experim·:mt with the municipal hospitals and the Rehabilitation Hospital.

They have not as yet to my. knowledge assessed what the results have been of the experiment, but I understand that it has been underway for the past year at those two places and I have yet at any rate to receive a report as to what the results have been. · I would like to thank the Honourable Member for Inkster for the kind words and the best wish es that he extended to me as the new Minister for Health, and tell him that I think it's al ways wise to listen to the wisdom of those who have lived a little longer than we have and that I will always respect the opinion and the observations that are made by the honourable member.

With respect to TB, TB is no longer a heavy killer of people as it.used to be. It still does apparently cause a fair amount of sickness and we anticipate that tuberculosis is a disease that will be with us for some time, but new methods are being developed all along. Practically over the past five years the methods of treating TB, it is my understanding, have undergone some radical changes and I understand from the. department officials that TB is well under con trol. There are times when it does break out. This is apparently common in all countries and also in other administrations in Canada.

But the methods that they use and with the TB central registry which has a complete file on all TB cases throughout the province, and also a complete file system which takes into account all the cases which may move from, say Saskatchewan to Manitoba or Manitoba to Ontario or from the United States into Canada, or even from other countries such as Great Britain and the western countries, the files are kept up to date so that there is a complete record kept of these people and the necessary precautions can be taken.

I understand that within the past year they have increased the term of observation and checking from five years on former TB patients up to a period of 20 years. In other words, the records will be continually established .and for a period of some 20 years the former people who have had TB will receive constant attention and check-ups to make sure that they do not cause ari.y undue spread of this disease.

The Honourable Member for Elmwood, as I anticipated he would, mentioned the matter of slaughterhouses, and .he has, instead of the slaughterhouses, more or less concentrated his remarks on the processing plants here in Winnipeg which, as revealed in the statemeiltwhich I made the other day and he states too, for processing Canada Approved meats.

I h ave the assu �� ance from the department that all of these establishments do meet the public he alth reqUire ments, but·in view of the statement that hehas made tonight, I would ask that this matter be held until we come to Environmental Sanitation and I will have a further comment to make to him with respect to these processing plants. He has had a statement on the slaughte�houses, but with reS!)eCt to the p�ocessing plants I hope to have more information for him, except to say to him that, as I understand the situation at the present time, that all of them meet the· public health requirements.

There is a co-ordinated campaign on with the federal government and with the provincial government to improve the whole situation of slaughterhouses and of the processing plants within the province to be sure that people are receiving meat that will be safe for consumption. Another factor that may be of interest to him is that the number of slaughterhouses in the country has been reduced quite substantially over the past two or three years.

They are now down from 240 to 55 and an: active program is being developed with those people at the present time to advise them of certain new regulations which we feel will be necessary in order to im prove the establishm:mts and bring them up to a level where we can turn them over to the fed eral government and have them establish Canada Approved facilities. In answering the Honourable Member for St. Boniface and the Honourable Member for Elmwood with respect to the nurses' salaries, I have .found this. is a particularly interesting Page 1094 March 13th, 1964

(Mr. Witney, Cont'd.) .. . subject since not only have these two people mentioned it but it has been mantioned by official groups in my own constituency, and it has come, not only from the labour people in the constituency of Flin Flon but also from the Chambers of Commerce. When I began to look into tllis matter a little closer, I was rather surprised to find though that the Association of Registered Nurses themselves do not approve of nurses receiving payment, and I would like to say that none of the nurses in the hospitals at the present time are subjected to any exploitation of any type.

I learned that the students in the hos.pitals spend about an average of 14 hours a week in providing lectures or in work on the floors and there is about 26 hours that is devoted to other types of training. I'm also advised that the nurses of course receive room and board, that the nurses receive free uniforms, and that there has been considerable improvement over the past years in the working hours and the working conditions, and the areas where these people live have been improved rather considerably.

For instance new nurses' residences have been constructed at Misericordia General Hospital, The Victoria General, The Winnipeg General, The Children's Hospital, The Salvation Army Hospital in St. James and in Brandon, and the Brandon General Hospital will be undertaking construction program in the very near future.

So I m!lst look into this matter futher, except I am interested that the Association of Nurses themselves are recommending that the nurses not be paid since this is a purely educational program, It is also interesting to learn that there is no shortage of nurses who wish to go in -- or student nurses to go in to our hospitals. As a matter of fact I understand that there are more now than can be accommodated in the present facilities. MR . PETERS: Mr. Chairman, I have one further question then regarding the nurses. The Minister tells us that they get uniforms and they get this and they get that.

I would like to know if they are still docked or have to pay for any equipment or anything that they might by accident break, or anything like that. MR . WITNEY: Mr. Chairman, I'm sorry I can't answer the question but I'll get the necessary information. MR . DESJARDINS: Mr. Chairman, would the Minister repeat -- I was trying to get the hours. Did he say 14 hours only -- the nurses spent 14 hours on the floor? MR. WITNEY: Fourteen hours on the wards, Mr. Chairman. MR. DESJARDINS: On the wards. That •s the only time they spend a week, eh?

I think there •s one thing the Minister should mention also, and maybe it doesn •t seem like very much, but I think that they are also payingtuition, $250 or so for three years. Isn •t that a fact that they're paying? --(Inter jection)--They•re not paying anything to register? --(Interjection)--Well board and room then? They're paying something before they go in, It doesn •t cost a girl anything to go in training for a nurse? MR . JOHNSON: Well nothing in connection with the work that I know of. I'm just speak ing from experience. MR. ·DESJARDINS: I'm asking this question.

Does it cost the young girl going in nursing, does it cost her anything? Now, I'm not playing on oo rds. Is it board and room, is it tuition - I don't know -- but isn't it a fact that they have to pay approximately $250 before they are accepted? -- (Interjection) -- It isn't, eh? MR. WITNEY: Mr. Chairman, it is my understanding too that they do not have to make that payment, but the matter can be checked and I can give the honourable member the answer. MR . DESJARDINS: .... is still open.

The Honourable Minister has accepted -- he seemed to show some interest and he feels that with the advice, not the advice, but the sugges tions that he has received today and also from the people of Flin Flon and certain things, that he is not quite sure, that there might be a possibility that we look into this. Can I take this as the answer? MR. WITNEY: I don't think the item need be left open, Mr. Chairman, because the in formation can be obtained for the honourable member. MR . MOLGAT: Mr.

Chairman, I'm very concerned about the government policy on this 20 percent voluntary contribution insofar as hospital construction is concerned, and I really don't feel that the Minister has clearly outlined what the government policy is going to be in this regard. I think that the problem exists mainly here in the Greater' Winnipeg area where apparently the greatest need for major construction exists at this time. Now at the time of the Throne Speech debate I touched on some of the particuj.ar problems March 13th, 1964 Page 1095

(!vir. Molgat, Cont•d.) ... and some of the particular recommendations of the Willard Report, and just to bring the matter up into present context I'll run briefly over it. This is by no means an exhaustive analysis of what the Willard Report recommended; but for example in the case of · the Children's Hospital, it had recommended an addition to be commenced in 19'63·, and this was I believe to provide some 100 additional beds. In the case of the St. Boniface hospital, the sur vey board recommended a 300 bed extended treatment hospital to be constructed on the grounds of St.

Boniface Hospital, and this was recommended to be commenced in 1963 . In the case of the Victoria Hospital, which is probably the one that is the best known at the momsmt in the City of Winnipeg, the recommendations there were for an addition of some 135 beds and the survey board recommends that this project should begin early in 1962. . · Well, here we are in '1964, Mr. Chairman, and not a single one of these projects has yet been started. Now surely when the government commissioned Dr.

Willard and the others to prepare this report, the whole program, the whole idea behind this, and this was stated to us many times by the Minister, was to provide for an orderly systematic construction of hos pital beds according to need, and I agree with the Minister, because if you siniply let any area or any hospital decide by itself that it wants to expand here or there you may end'up with over construction in certain areas; under-construction in others; and not meeting the needs that are evidently before us in the Province of Manitoba. Well the Willard Report went through all this.

It analyzed every hospital in the province, every area in the province, and it came out with these very formal recommendations, specific recommendations, Mr. Chairman, for construction at specific dates. Now the Minister can say, "Well the Willard Report was in error; these were not needed;" but I haven.•t hii'ard the·· Minister say that and I think that the facts and the waiting lists at the hospitals indicate that the Willard Report was not in error.

Now if it is in error I'd like the Minister to say so, but if it's not in error then what I want to know from the government is exactly what steps is the government going to take to resolve this problem. I know.that there is a problem with the 20 percent voluntary, but be that as it may, Mr.

Chairman, if it can •t come out at the moment from voluntary contributions of the public, this does not absolve the government from evolving a policy that will provide for the hospital construction; because unless they come out with a policy, then what is going to hapJ?en, or are they simply depending on Deer Lodge Hospital being transferred to them from the Federal Government to solve this situation for them. If that is their solution, then I would imagine that it's only a temporary one in any case because again the Willard Report has further recommendations.

Now surely the government can't sit back and let hospitals like the Victoria Hospital go into a study of its own to prove once again to the government that the Willard Report was right, and the government not come out with any specific recommendations. If the 20 percent volun tary system is not working, if it is not going to provide for the specific recommendations set out here, then I want to know from the government what is their policy to see to it that these hospitals do get built if these hospitals are needed.

Now they must either tell us these hospitals are not needed or they must come out with a clear-cut policy as to what they're going to do to see to it that they're built. I have not heard·this as yet from the Minister. MR. PAULLEY: Mr. Chairman, I wonder if we're going to have a full discussion at this time on hospitals? I had a few points or questions that I .was going to ask on the matters per taining to hospitals.

I thought maybe we would defer them until we got down to the item on hospitals and hospitalization, but it does seem to me that we're into the area of discussion of hospitals at the present time and maybe it would be as worthwhile now to raise the points. Now first of all my colleague from Elmwood has raised the question in connection with Concordia Hospital in Elm wood. Now a couple of years -·- I'm not positive, Mr. Chairman, whether it was last yea:r: or the year before -- the then Minister of Health gave to the members of this committee a

schedule of contemplated hospital projects for future construction grants for the years 1962-,63 to 1969 -70. I don't know whether it is the intention of the present Min ister to do this or not, but if one looks -- in respect of Concordia Hospital -- one looks at tl).e Willard Report, the report did recommend that insofar as Concordia Hospital was concerned, that there should be increased accommodation provided for with the commencement of building in the year 1964. I believe the Honourable the former Minister of Health will remember that last year I came in here during the discussion of his estimates and I told him of seeing a new Page 1096 March 13th, 1964 I

(Mr' Paulley, Cont'd.) ..• sign up on the property which is owned by Concordia Hospital which I thought at that time indicated that hospital construction was going to take place in the ·fall of 1963, I was corrected by my honourable-friend-� and while I haven't looked up Hansard at all to see whether or not he corrected me by saying that it would commence in the fall of 1964 --I did take a second look at the sign and incidentally, Mr. Chairman, the sign is still there, that construction will commence in the fall of 1964 with the new buildings insofar as Concordia Hospital is concerned.

Now I want to make an appeal, Mr. Chairman, to the Minister of Health that permission is granted and that arrangements are made in order that the expansion may take place insofar as the Concordia Hospital is concerned. I've a little personal interest now, Mr. Chairman, so far as Concordia is concerned, in that -I spent three weeks there last fall.

I was very happy to be there too under the circumstances in which I was rushed in, and had the opportunity while I was there, thanks to the management and the advisory board of the hospital, to be able to sur vey all of the facilities of the hospital, and I'm sure that the former mem�er, the former Min ister of Health will agree with me that there's lots of room for improvement. MR. JOHNSON: I would have brought you flowers had I known you were in. l'IIR. PAULL" EY:Yes, I'm sure, Mr. Chairman, that the present Minister of Education would have brought me flowers had he of known that I was in there. I guess, Mr.

Chairman, that I can be equally sure that there are others that would have liked to have brought flowers to my bier after I had passed through Concordia Hospital. A MEMBER: No, we would have brought beer with your flowers. lVIR. PAULLE Y: However, Mr. Chairman, I do appeal to the Minister to give us a clear decision as to what is going to take place this fall. When one studies the Willard Report we can appreciate the financial aspects of hospital construction. We can also appreciate the fact that the Willard Report was in general a guide to construction for the years ahead.

And while I am not suggesting that the government should not go ahead with construction· as laid down by the Willard Report, I an1 prepared to accept that circumstances do alter som·ewhat from year to year. I want to again come back and appeal for expansion of Concordia Hospital. It is serving a large area and we in the City of Transcona more and more I would suggest, Mr. Chairman, are using the facilities at Concordia Hospital.

If one reads the Willard Report it recommends that there be no other hospital built in East Kildonan or the Elmwood district of the City of Winnipeg or North Kildonan while Concordia Hospital is there. I also want to pay a tribute, Mr.

Chairman, to the people who were the backbone of Con cordia Hospital, the Mennonite people, and indeed the word "Concordia" originated because of the fact that they did set up a sort of an insurance basis for hospitalization where all of the people at that time, of the Mennonite faith in the general area, were taken care of in the hos pital and had for the first time in Manitoba pre-paid hospitalization. I think, Mr.

Chairman, that we in this Legislature and the Government of Manitoba can recognize the contribution that has been made by the Mennonite people in their connection with the Concordia Hospital by see ing that their plans and their dreams are fulfilled. And having said this and paid a tribute to the Mennonite people, for a long time there was the feeling that the Concordia Hospital was solely or, in general, a hospital for the Mennonite population. I want to assure you, Mr.

Chair man, and the Minister of Health, that this no longer is true, that mote and more the hospital is serving all peoples in the general area in which it is located. Now speaking of hospitals in general, Mr. Chairman, I want to direct a question or two, or ask the Minister of He alth, or possibly he may refer this to the former Minister who �s a medical man. I sometimes question, Mr.

Chairman, whether or not we are beginning to get ourselves in the Greater Winnipeg area into the same jackpot as I understand that they are in in many other areas, and I'm thinking right now of the City of Toronto where I understand a survey has been made, and they're beginning to find, as I understand the survey which I read a synopsis of, they're beginning to find that in many cases hospitals are beginning to get too large for efficient operation.

Now I think the committee would agree with me in general that there is a point of no re turn, and I want to ask of the Minister of Health whether in some of these hospitals at the pre sent time in the Greater Winnipeg area, whether we're not reaching the point of no ·return by March 13th, 1964 . Page 1097

(Mr . Paulley, Cont' d.) . . . continuously adding beds to the hospital. I read one or two arti cles where it is now deemed that the proper medium for a hospital is one having, say between three and five hundred beds and no more, that beyond this large number of beds in a hospital you start losing effiCiency, that you have to provide services that are not conducive for the best treatment of the patients in the hospital. Now I don't expect my honourable friend the present Minister to be able to answer this because I appreciate the fact that he may not have had time to study this aspect. All I'm saying, Mr .

Chairman, to him, is. that I have read of this in other jurisdictions and ask, through him, the previous Minister, whether this is not a problem. Also dealing with the question of hospitals and the hospitaliza tion, Mr. Chairman, I wonder whether the present Minister or the previous Minister is in a position to outline to me whether or not certain representations made to me are correct insofar as the services of the hospitals being available to all doctors who are qualified to practice in the Province of Manitoba.

We've had, and I'm sure the Minister has had, many complaints directed to him because people are not able to get into hospitals for treatment, and I think we, as members of the Legislature, can appreciate that there are problems connected with this, but more and more, Mr . Chair man, questions are being directed to me as to whether or not in some of our hospitals, and in particular our larger hospitals, that there is a group of doctors who are receiving favoured treatment in respect of their patients being ·allowed to enter into the hospitals.

Now I'm not going so far as to say that, like the little old red schoolhou se, that the general practitioner is still the answer in the field of medicine as some feel that the li'ttle red schoolhouse is still the answer in education. I'm not going that far . But I still think, Mr. Chairm an, that there is a pl ace here in the Province of Manitoba for the general practitioner, and I sometimes wonder whether or not in our hospitals, and in particular our larger hospitals, whether favoured treat ment is being given to our medical clinics and our specialists and our named doctors .

By named, I mean those that we all hear about and we all take great pride because Doctor so -and so, the specialist, took out my appenqix instead of the general practitioner, who I'm sure could have taken it out on the kitchen table with just as m11ch effectivene ss, but because·of the fact that it was done by a specialist, well then the appendix that came out was a worse appendix than it would have been if the general practitioner had done it. Now I know, Mr.

Chair man, that a lot of people do not agree with me that there is much place in this advanced medical soc iety that we're living in today for the general practitioner . As far as I'm concerned, I would trust my life and limb any day with the general practitioner and feel that they're fully qualified, but I'm sure that many general practitioners, and others I as well, feel that they are being limited in their being able to use the facilities that we through our Manitoba Hospital Services connections and the building·of these hospitals are making the provis ions for them.

I think they're being limited, and I wonder whether or not, and I hope . that I'm not touching on a touchy su bject in the field of medicine and hospitalization, when I . ask the Minister of Health whether or not he .has had any questions directed to him as to the availability of services in the hospitals which are being built, from tho se who are not directly connected with named clinics, be cause Mr.

Chairman, I repeat once again, more and more patients of general practitioners and relatively lesser known doctors in the community are tell- ing me, telling me that they 'r e not able to obtain entrance into hospitals because of the name of their doctor, and in some instanc es, Mr. Chairman, I'll even go so far as to say that after their general doctor has referred them to one of the well-known-in-name doctors they have re- ceived an open sesame into the hospitals in Winn ipeg and they got in a lot quicker .

Now if this is the case -- and I'm only raising it be cause it's been directed to me -- if this is the case, M� . Chairman, then I say that something is wrong. Either something is wrong with the hospitals, those responsible for the entrance to the hospitals of patients, or - and I don't believe this for one moment -- there must be something wrong with the training that is being given to the general practitioner, but again, Mr . Chair man, I say that I don't believe the latter at all . I think they are qualified and I rely on them, but these are some of the pro blems that have been directed to me, Mr.

Chairman, and I wonder whether my medical friend or the present Minister of Health can give me any clarification on this . And again I'll land up ba ck to good old Co ncordia Hospital that gave me darn good treatment for three weeks while I was there, and I urge and beseech the Minister to make it possible for the expansion of that hospital, because it is serving a growing area and the people there are of the highest calibre, Page 1098 March 13th, 1964

(Mr. Paulley , Con t' d.) ... and the staff are really on their toes to render service for people su ch as the Leader of the New Democratic Party who was forced to go in there last October. MR. DESJARDINS : Mr . Chairman, oh, excuse me , would the Minister soone r ans wer now ? I don't know if the Minister received his information but I have verified mine , and I can tell him that at least in one hospital the tuition is $205 .00. Now that's not very much but Pm very surprised to see the former Minister get up and say they're getting free uniforms and so on and not know that there is $2 05. 00 tuition .

No wonde r nothing has been done in this field if they're not familiar . I think this is wrong. I think that the pre sent Minister should make sure that he's familiar with this . Now there's been -- saying that these people were not exploited . Now this was not my word. Now "exploited" is a dirty word. You think of people working in the mines and so on, young children 14 years old; and this is not the picture that I'm trying to paint, but I think that to a point these people are exploited. What I'm told is that they are told how much time they must be on the ward.

The first year they spend 25 percent of their ,time on the wards, the se cond year from 40 to 50 percent, and the third year from 60 to 70 per cent and that' s not - what was I given -- 14 hours. That's more than 14 hours . And now a lot of this time is at ni ght and you don't have to work too long at night to learn how to work at ni ght. They're not getting the education then, and I think that they are used to save money for the Plan. I'm not blaming the Com missi on now . I'm saying that these people are used because this seemed to be such a high cost but this is not fair. Why should they subsidize?

They should have a better chan ce . They should have a month a ye ar less at nig ht and they'd learn an awful lot mo re . These children -- these young girls are going there to learn, not to work for noth ing, and they are spending too much time on the wards and they are spending especially too much time at nig ht. They are told when to go, and I un derstand that in certain hospitals are told that they will have to do with less instruc tors . What is the reason for this ? The Honourable Minister a while ago said that there wouldn 't be any raise in premiu ms .

Now, are we going to be told here today that it won't cost more this year for the Plan to take care of the people ? That it won't cost more next year ? I didn't start by blaming the govern ment. I asked the government to look at this squarely and to see the problem that it's facing -- not only the government , all the people of Manitob a. And I want the government to be honest about this and not to pretend that everything is rosy. This is a problem . Now, I'm not runn ing the Plan for that. They're not the one -- they have to get the money somewh ere . The hospitals can't raise it.

I'm told that they're still going to go ahead with this 20 percent . Well, they won't raise it. A lot of them won't raise it. They'll go back on the same people that'll have to pay for all this , the same people -- the taxes went up and so on . 'I'hey're paying -- they're paying on their differential rates -- they're paying more than actually the difference is .

A while ago the Honourable Minister said that well they didn't expect to have any more raise in premium, but I think that we've got to find some mon ey, and we want to know where this is , because we'll be in real trouble ; and if we can do it and if the government will give the Commission the right to say to these hospitals , "This is what you spend, and you don 't spend another cen t," -- I think that this is not reasonab le , especially when they don 't discuss these things with the admin istrators . I think that they'll have to have anothe r look.

The Minis ter still hasn 't ans wered me about the compulsory part of the Plan, and the Minister still hasn 't answe red me about -- I'm not saying this is everywhere . Th ese hospitals are doin!l" a great job and so is the Commission, but I still say that some people do not receive what they'r e paying for and I'm still saying that the government, or the Hospital Plan, is breaking a contract with some people . Even if it's only one , that's too many. I'm sure that there's an awfulloti:nore than that. We've heard different things ; I'm not going to rehash many things .

I'm not satisfied with this; we were told that there was an experiment in physiotherapy and the Minister hasn't heard any mo re . Why an exper.i ment in certain hospitals when they've got everything ne cessary in, I et's say inSt. Bonifa ce . Why can't they try the same experiments there ? I think that you probably would save beds and save money if this was used, because the people would go to the hospital and come back for these treatment s. And the home care -- we're told they'r e still studying. This is not good enou gh. The people are ready to go.

Deer Lodge politically -- maybe I should skip this one , but I'd still like to know if we're going to go ahead and build this hospital in St. James w:!J.en the Minister tells me that the question is still open about Deer Lodge. This is importa nt . There 's 640 beds there that might be turned over • March 13th, 1964 Page 1099

(Mr . Desjardins , Cont'd.) ... I mean , what are we going to do with this second hospital when we get this ? Now, if there's a good answer to these questions , that's fine, I still - well, maybe we could wait for this administration cost. I still think that V{e're spending way too much money on that, Now, there's another question in this information sheet. In 1960 we were told that there were 43 , 000 residents for about one in every 20 Manitobans who were exempt from paying Manitoba Hos pital Service Plan premiums, I wonder if the Minister could get this information and tell us now, bri ng us up-to-date.

I think that this would help. Now I wonder -- does be understand my question -- this information sheet that we re ceived from the Department of Industry and Commerce. It was over -- this was dated June 24, 1960: "Over 43 ,0 00 resident's , or about one in every 20 Manitobans are exempt from paying Manitoba Hospi tal Service Pla.iJ. premiums, Honourable George Johnson , Health Min ister, has reported. " I wonder if we can have this report up-to-date. Now , there's another thing. We're spending so much money -- we'.re talking about hospitals , and apparently -- now, this mi ght have been corrected.

I'd like to get the answer from the Minister. Apparentiy certain hospitals ,and I remember reading certain things about Concordia Hospital that my friend was talking about -"-these hospitals will not give emergency services at night or times like that. Now, I'm not blaming the hospital if this is the case , but I think that there's riot a single hospital that should not be re ady to accept emergencies.

Now, if they need a grant to pay for this this is a service that we should have, We can't bring som.3body that has been shot to Concordia Hospital and say well, no, there's nobody here tonight; come back at 9 o' clock tomorrow morning, or go to another hospital . Now, as I say, this mi.ght have been corrected, but I'd like to check into this . And I'm again not blaming the hospital , but I think that a hospital with all the facilities that they have, some body should be there on duty.

It mig ht be a senior interne, I don't know, but somebody should be at least on call, where we can give these emergency treatments, because the people will think immediately and automatically of a hospital if there's any injuries , and I think it would be much better. Oh, there's another thing before I sit down.

I understand that the depreciation that is allowed on equipment -- the method of allowing this amount of depreciation is outdated too .· I understand that we're still basi ng our self on equipment of many years ago ; and the cost of :tnany years ago, and I understand that the hospitals have a hard time replacing the. present equipment, and I'm told that this is certainly not adequate. I wonder if the Minister would have anything on it. Continued on next page • • • . • , • . . . . Page 1100 March 13th, 1964

MR. WITNEY: Mr. Chairman, in talking about the 20 percent equity and the matter brought up by the Honourable the Leader of the Opposition.

The 20 percent equity has been the subject of several meetings between the municipal off icials , the hospital authorities and the Manitoba Hospital Com mission over the past month apparently, and it is interesting to note, when I had a meeting with the As sociated Hos pitals in my offic e· at one time, and I was asking them, since I have been in off ice , about this 20 percent equity, that there is not com plete unanimity of opinion in them as to what ought to be done about it.

When I was at the advisory meeting in Ottawa on hospital costs, I found also that this equity pos ition in hospitals varies quite considerably across Canada, and in fact that Manitoba is one of the most generous in this particular field. Here in Winnipeg, in some areas in Winnipeg and out in the country, there has not been diffi culty with the 20 percent equity.

For instance, to my knowledge, I understand that the Winnipeg General Hospital has not had any diffic ulty in raising its 20 percent equity, nor did the Salvation Army hospital have any diff iculty in raisi ng theirs ; in fact I believe they had a vote of the ratepayers in St. James in order to raise the 20 percent equity at that time. And with the St. Bonif ace Hospital, I mentioned to the Honourable the Member for St.

Boniface today that the Hosp ital Com mission did approve back in 1961 for I think it was some 250 extended treatment beds -- that number of 250 can be checked back into the reply I gave you just before we adjourned for the dinner hour. But we have been held up because the hospital, the St. Bonif ace hospital people have been making plans as to what they would do with their whole com plex, and there have been meetings held in the past with the Minister of Health, the former Minister of Health, the Hospital Commi ssion and the St.

Boniface people or the, I believe it's the Grey Nun people who run it, in trying to determine just exactly which way the hospital want to go. And it is my understanding further as I mentioned to the Honourable Member this afte rnoon when we <re re discussing this item, that the St. Boniface Hospital people advised the Hospital Com mission that they would be meeting with them at the end of March in order to advise of their decision.

And so it appears that some of the major hospitals in Winnipeg can raise the 20 percent and others cannot raise the 20 percent; and out in the country, so far at any rate to my knowledge, they' are not having any diffic ulty in raising the 20 percent equity; and I can only ass ure the honourable member that when I spoke the last time I was unaware that there had been these meetings with the municipal off icials with the hospitals and with the Com mission, and it is my understanding that the municipal people particularly are awaiting the Michener report which might have some thing to say about this particular subject.

In speaking re the Concordia Hospital, I note that the Honourable Leader of the NDP -- he did advise me at one time that he would be mentioning this matter, and I'm sor ry that I didn •t get any further info rm ation for him, but I do see that the survey board report recomm ends that the hospital undertake a const ruction program com mencing in '64 to increase the rate of capacity to 150 beds and to provide additional and improved services .

I find that this has been re-scheduled for 1965-1966 for extension to provide 69 additional beds, raising the capacity to 150 beds, and for interior renovation and the preliminary planning is underway at the present time. Now what causes the one year from this report to the figure s that come out now -- I'll be able to get more inf orm ation for you when we deal with the item on the Hospital Commiss ion.

He asked me also if I had had any com plaints from doctors that they were being denied hospital faciliti es, and since my time in offic e, I have not received any com plaint from any doctors, either from the Manitoba Medical Ass ociatior or individual doctors or the College of Physicians and Surgeons ; and it is my understanding, although I stand to be corrected on this point, that the matter of doctors is a policy of the board themselves. But in answer to the direct question, have I received any comp laints, the answer to that is "no. " The Honourable the Member for St.

Boniface asked about the administration costs and the administration cost s of the Hospital Commi ssion amounted in '63 to $1, 524, 700 which repres ented 3. 5 percent of the total disburse ments of the Corn mission -- 3. 5 percent of the total disbursements . I think he also asked for the numbers of staff, and I'm sorry at this mom ent that I have not got that particular inf orma tion. He drew my attention to an

article that had been released in June 24, 1960, that over 23 hospital people had received fre e hospital premiums. I believe that was the ... MR . DESJARDINS: 43 thousand. MR . WITNEY: 43 ,0 00. And in 1963 , over 56, 000 persons were exempt from the payment of premium s, and these include recipients of the Old Age Security Pension with little or no March 13th, 1964 Page 11 01

(Mr. Witney, cont'd) . .. additional income ; all persons in receipt of support from the province; some students between 19 and 21 years ·of age who can qualify as dependants under their parents' registration. In the matter of the nu rses, I just drew to him some of the items at any rate that had been drawn to my attention since I have become the Minister of Health, and I thank him for slipping out to get the further information; and I too will receive further inform ation from the people in the department. .

I think that as for the depreciation of equipment, that is an item that at this mom ent I regret I cannot answer. I would like to draw this mat ter to the attention of the commi ttee, how ever Mr. Chair man, that the 250 beds which are going to be built at the Salvation Army hospital in St. James -- and the Salvation Army hospital at St. James is going to go ahead -- that these 250 beds are approximately a year in advance, and it is my unders tanding that the 174 beds that are being built by the Winnipeg General Hospital at the present time are in advance.

And then we will also be able to use, I think it is 250 beds at the Ar lington Street hospital, which will be vacated by or at least which is run by the Salvation Army -- so in the future we have this added bed capacity com ing into the area of Metropolitan Winnipeg. I have had complain ts . The odd person has phoned stating that they cannot get into the hospitals at this mome nt because they were having what has been termed elective surgery.

I suppose that during the time that I have been in office that there have been some four such com plaints made to me and of course I have heard that there are waiting lists at all of the general - hospitals , but I was interested to find out that when I was at the advisory comm ittee on hospital costs in Ottawa just in January, that this problem is one that is being faced by all hospitals all across this country and indeed, in general, all hospitals , and it's my unders tanding that it is a problem that is faced under the British health scheme at the present time, and I must em phasize again that I have been advised and assured that anybody who needed emergency treatment in the hospitals here in Manitoba will be able to receive that treatment.

On the mat ter of elective surgery though, it is different. The people do have to wait for items that may not be necessary to do this week or possibly the week after that, and I must say that if we were to provide a bed for every occasion that arose I think the honourable member will realize that the cost would rise quite high in hospitals. I think that those are the questions that have been posed to me in the last few minut es. · MR. MOLGAT: Mr. Chair man, insofar as the Willard Report then again, do I gather from the Mini ster that insofar as the St.

Boniface Hospital -- that's the extended treatment hospital -- that the decision not to go ahead with that was strictly the hospital's decision ? Is that correct? MR. WITNEY: That is my unders tanding, Mr. Chairma_n. I understand from the prepared paper that I had this afternoon that in 1961 a decision was made to go ahead with it and then, taking the whole complex of St. Boniface, that the Sisters decided to review the situatinn , which they have been doing, and that they have advised that by the end of Mlirch they would have a decision . MR. MOLGA T: Fine, Mr.

Chairman: I wonder if there has been some correspondence between the government and/or the Manitoba Hos pital Services Plan and the hospital in this regard, and if so whether the Mini ster would be prepared to table that correspondence? HON. GEORGE JOHNSON (Minister of Education) (Gimli): Mr. Chairman, maybe I can help out just at this particular point.

The Hospital Plan Commi ssi on has become such a very wide and fascinating thing but nonetheless expensive, it's very difficult I am ·sure , for the Minis ter to grasp this detail and I think he's doing a tremendous job in comi ng to understand the problems that the Plan presents . Just to be brief, :with respect to the St.

Boniface situati on, and I think the honourable memb er knows that this hospital, like certain other voluntary .... received a letter saying we concurred in the Willard recomm endations and according to our scheme of things planning should start in such and such a year and building in another, and of course the report, as we appr�c iate , has been a blueprint and it was realized fairly early in the game that as new knowledge romes to bear that hindsight is often better than foresight and we wanted to be flexible. The hospital boards were also anxious that we be flexible in looking at the plans. The St.

Boniface Hospital had some -- the administrator s, the Order who own that hospital, met informa lly with Page 11 02 March 13th, 1964

(Mr; Johnson, cont'd ). .. the Chairman of the Hos pital Com mi ssi on and myself last sum mer following a letter from ourselves to them with respect to the recommen dation that had been made some time before. At that mee ting a general discussi on took place following which -- I beli eve there is one letter on file from the Sisters confirmi ng that meet ing . I think that might be avail able to the honourable me mber. While I' m on my feet I may be able to -- I think one point has been brought up here that I mi ght be able to assist with briefly.

I must say that in, oh the privilege of being Minis ter of that department for some time, that I thiO:k we are indeed fortunate in Manitoba in that all the citizens of our province are really most co- operati ve , most progressive and most health mi nded in the operation -- and most patient -- in the operation of such an implemen tation of the Willard Report and the operation and implemen tation of the Hospital Plan itself.

I would say that for any memb er to suspect any po litic al interference I just can honestly not point to any time was the department subject to what could be called political interference in any nasty sense whatsoever. The frankest discuss ions have always taken place between the various boards of the hospitals with the professions, and in trying to do the right thing in making Manitoba's dollars go the furthest, and I think Manitoba can be proud of a first -rate hospital system evo lving. But with respect to the Willard Report, let me sey this , to complement what the Minister has said.

The 20 percent principle of course was evo lved by government -- the government wished to go a long way with voluntary hospi tal boards so that they may· retain their local autonomy, and I have found trustees and hospital people in general favour the autonomous prin- , ciple, and a few years back I think we can all recall that if a hospital had been offered a deal of 20 percent it would have been "bananas from heaven." The 20 percent, of course, was welcomed where we have a municipally-based hospital but the proble m is quite obvious with certain vol untary hospitals that have been mentioned this evening finding certain difficulty in raisi ng the necessa ry local equity, and in discussions with these boards -- there have been many dis cussi ons take place , informal discussions between the various hospital boards that have been me ntioned here tonight, me mbers of the As sociated Hospitals and municipal officials concerned wherein these hospitals lie, all searching, and desi ring by and large nine to one that hospital boards should rem ain se lf-autonomous .

The alternat ive , of course , if the government were to put up all the capital and all the operating you would have , in effect, a DVA system of hospitals , arolving, and I think the fact that hospitals do rema in autonomous is som ething which should be ma intained because after all, for example the reli gious organiz ations and others who have developed their hospitals over the years desire, and I think should, remain autonomous .

The whole matter has been discussed with mu nicipal people and informal discuss ions took place between me mbers of the Hospi tal Com mission and I think the com missi on studying finance, to bring out these proble ms as we have been discussi ng them in the House this evening. What the ultim ate recommen dation will be I think remains to be seen, but I think the boards of the hospitals concerned understand that there may be somet hing in the Commi ssi on report which will point the way towards these voluntary hospitals finding the basis for their 20 percent.

This is a com plex matter and involves the people of Manitoba as a whole . Just quickly, with, respect to the -- but on balance, as the Minis ter has said, your general hospital has gone ahead as scheduled to try and maintain the balance of beds as pre dicted by Dr. Willard. The.. Grace Hos pital is off the deck and approved and future planning there for the future with respect to the former Grace and old Grace Hospital should fit in with a balance of beds that will keep us pretty well on track in the province .

Now with respect to doctors and the ques tion raised by the Member of the NDP and favouritism and so on. I think probably in my time only one or two doctors ever spoke to me about tl;lis ma tter and in those partic ular cases it was largely a ma tter of misunderst anding . I think yqu have to understand that in our large teaching hospitals this is where the more serious cases are treated.

For example, a general practitioner in the country, all his difficult su rgery , all his cancer really gravitates to our larger hospitals at larger centres and especi ally to our teaching hosp itals in Winnipeg and the bigger hospitals . And when the major work and major surgical procedures and so on are carried out in these facilities they naturally have the highly trained specialists in these hospitals and esp eciall y in the teaching hospit als .

Of course you must reme mber the board are entirely resppnsible for the operation of the hospital and the board chooses a chief of medical staff who is responsi ble for the conduct of the madical March 13th, 1964 Page 1103

(Mr. Johnson, cont'd) ... personnel. One hospital, for example, they have an organized medical audit system. Every doctor that wishes to come to the hospital is free to come but on the basis of his qualifications he is given certain privileges within his capab iliti es. This is the board and medical profes sion's met hod of assu ring the public of the safety and the efficiency of their care and this is becomi ng of course mo re refined. I think in Greater Winnipeg under -- most people - many pe ople have a famil y physician ; many people are more sophisticat ed these days.

When baby gets sick they call a pediatrician; when mama gets sick they call an obstetrician; when grandpa gets sick they call a geriatrician; and when he gets sick he just calls the old family doe because we're pretty well expendable .

However, this tends to shape the pattern of staffs in your hospital and I would say on balance -- and I think it is a wonderful thing in Manitoba that very seldom have I heard in my tim e, and people never seemed to hesitate to call when they had a proble m or com plaint, and very seldom did it have anything to do with charges of favourit ism :\ I think that we're fortunate in having a very soli d and able medical fraternity in our pro vinc e and I say that honestly and sincerely, but it is the pattern of things that· tends to -- the way the public use medical services is as mu ch to do with this as anything else .

I know that members of boards that I met in the biggest hospitals are very sensi tive about the GP and the family -- the general practitionel ' -- and certainly I would ' say if anything, si nce the introduction of universal hospitalization, our hospitals have probably been more open than ever before and as I say, the public has a lot to do with the way medical services are used as we have pointE.J out.

I think that it's a vet:Y fascinating thing, but I think in the future in -- general practitioner s,. of course, in the Greater Winnipeg area are co mpe ting with speci alists in these various fields, and a family physician's life in Greater Winni peg is a lot different than in rural areas.

I just thought I'd bring those points out to -- I don't im agine any system is ever perfect but I do think that the audit system such as is in some of the hospitals -- most of them now -- and so on and, the fact that the boards, lay people, voluntary citiz ens, municipal and other men are on these boards, is our assu rance that they're run in a democ ratic -fashion. Of course on certain teaching wards there is a restriction of staff but this is for teaching purposes . However, many GP 's admit their cases to hospital.

If there 's a bed·on the teaching ward a person is sent there , and of course most doctors who have an interes ting patient and wish to share it with other doctors , they usua lly ask the patient. I'm sure that the honourable member from Radis son subm itted to the interne's examination and this case was discussed with the senior people in the hospital. Ho wever, that's my sma ll contribution. I think in general terms when we look back and realize that in 1948 we had 4. 8 beds per thousand in Manit oba, we didn't talk of the crises in hospit aliza tion then.

Today in our Winnipeg area we have seven beds per thous and which is very favourable on the national and world average, and I think these are in faciliti es, they're enjoying a higher standard of care than we thought possible some years ago , and when you consider that 70 percent of the surgery that's done today was not possi ble in 1948, you get some idea of the tremendous advances that have been made through research and other me thods, and the fact that Winnip eg and Manitoba are keeping up. I think this hospital pla n needs a lot of tender loving care in the years to come.

I think many of the questions asked are certainly very necessary, but I think there's a lot of administrative po licy which we've been living with for six years which is good poli cy and quite detailed, and I think it's a ma tter which the Minister can always get answers to, but some of them are compl icated and require a lot of ti me . MR. P.AULLEY: Mr. Chairman, I want to thank the Minister of Education for his education in respect of the situation insofar as the physicians are concerned.

It was most interesting listening to my honourable friend and he tells me -- first of all the present Minister told me that he hadn't had I think he said but one compl aint since he took over, and he took over somewhere toward the latter part of last year so this has been three months . .And my honour able friend the previous Minis ter, who of course is a member of the medical professi on, says that he ha:;> but very few com plai nts , or som ething along this line , insofar as admis si ons to hospitals are concerned. We ll, Mr.

Chair man, I can well understand, particu larly in respect of the Honourable the Minis ter of Education, that it would be rather difficult, I would suggest, at least in manh circums tances , for a man of the medical profession to cry "stinking fish" -- if stinking fish is the proper phraseology -- of the fact that he's having difficulty in having patients adm itted to the hospit als , but I want to say, Mi:'. Chairman, that such is not the case as far as I'm concerned. Now the Minis ter mentions , the minister mentions that it is the Page 1104 March 13th, 1964

(Mr. Paulley, cont'd) ... hospital boards , and I presume that in general it would be the medical hospital board that sets up as to who is going to be granted the privileges of practicing me dicine within the hospital. Pardon? MR . JOHNSON: The board is the authority. MR . PAULLE "(: Yes, the medical board of the hospital. MR. JOHNSON: No , the Board. MR . PAULLEY: Well, the Board. All right. The board; but l would suggest that the board is either domi nated or ma inly influenced by the medical personnel connected with the hospital, because if it wasn't, Mr. Chairman, if it wasn 't, Mr.

Chairman, then we would have non-medical people telling us who were going to practice in the hospitals and I don't think that this would be a desirable situation. I think it must, of necessi ty-, be the medical personnel connected to a hospital who says in .general insofar as qualifications -- there may be other reasons for saying that Joe Blow can •t operate or perform operations in here because of some other factor other than medi cal, and I'm sure it's obvious what I mean, but so far as the rights or the lim itations that are imposed on any doctor is through the medical board of the hospit als , and here , Mr.

Chairman, is where I find that there is a consi derable area of com plaint.

Now, I may have an entirely wrong concep tion of what constitutes a graduate from the faculty of medi ci ne, but 1 presume that when we teach a bo.Y or a girl, when they graduate from our medical coll ege and are entitled to put up their shing le , as a doctor and surgeon usuall y - it's doctor and surgeon I think in this country as against the method which they have over in the old country, Great Britain -- but I presume that once a boy or a girl has been given the certif icate entitling them to practice medic ine and put up a shingle " Dr. Jones M.

D. , Physician and Surgeon," that the facilities should in general be available to them in order that they mi ght treat their pati ents, and if they can't treat their patients at home then I sugge st, then they should not be deprived after having rece.i ved their quali fications to do so, they should not be deprived of the right to treat them in our hos pita ls , but Mr.

Chairman, it's my understanding that they are being deprived of this by virtue of the medical boards, and in particular, as the com plaint has been laid to me, in som e of our larger hospitals , and the sus picions are that the larger cli nics are domi nating the boards of our larger hospitals who are deci ding as to whether Doctor Jones or Doc tor Sm ith or Doctor Johnson is qualified to perform servic es within the hospital.

Now I appreciate the fact as raised by my honourable friend the Minister of Education that we have now in the field of medicine, and surgery or course, specialists who are more qualified to handle certain parts of the anatomy than the general practicione r. But what has been laid to me as comp laints is that more and more you have to have the say-so of one of the specialists before you can obtain entrance into the hospital, and that if you 're just an in dividual who is being treated by a fully qualified doctor, by virtue of him having his shingle M.

D. , you have a lesser chance of being able to use the facili ties of the hospitals to which a contribution of about 80 percent of the cost is now -- and this is in the course in respect of new construction and the likes of that -- being contributed from public treasuries of either the pro vinc ial or federal levels; and this is the point, Mr. Chai rman, that I raise here in the House, and I think that it is a valid point. Now my friend the Minister of Education was speaking a moment ago that we have to be concerned with the area of safety and efficiency of care . Well surely, Mr.

Chair man, if we are going to graduate our young men and women and give them a licence to practi ce, then I respect fully suggest that irrespective of whether they're going to practice here in the Greater Winnipeg areao rwhether they go out into the rural area where there are these sm aller hospit als , that they should be entitled to use, or have at their disposal, the hospital facili ti es .

Why should we be able to grant or -- and this is the way I see it -- grant to a doctor who is a graduate here, entitled to go into practi ce , we allow him in our hospitals outsi de of the Greater Winnipeg area or the sm aller hospitals, we allow him the services of the operating room if there are oper ating rooms and all of the other faciliti es, when here in the Greater Winnip eg area unless he has passed a further medical board, as I understand it, he can't use the facilities of the hos pit als , which brings me to a point, Mr. Chairman.

I wonder, I wonder whether or not -- we may not have reached the time yet but this is possi ble -- but I wonder whether or not it mi ght be a be tter idea that if rather than boards of hospitals who decide whether Joe Blow should be able to use the facilities of the hospital or not, that whether the College of Physicians and March 13th, 1964 Page 1105

(Mr. Paulley, cont'd) ... Surgeons, or in Co llege of Physicians and Surgeons, should be the authority to say that now Doctor Johnson is qualified to practice medicine and surgery, and because of his qualific ations and his capabilities he is therefore qualified to perform services within any hospital under the ambit of the Hos pitalization Plan. Now, I don't know if I'm thinking a little too advanced on this, Mr. Chairman, or whether Pm just talking up in the air, but it does seem to me that this would be a reasonable situation with my conception of when we do graduate a doctor that he is qualified .

I appreciate the fact that after that he can specialize, and if a general practitioner were to call in as a consultant a man who can take out an appendix or a gallstone far better than a general practitioner, then I would say that this is fine , but I would suggest, though, that the general practitioner should have the right of putting the patient in the fi rst instance into the hospital and then calling the expert on , to use it again, appendix, into the case.

But I greatly suspect, and I've had com plaints directed to me in this, that the general practitioner is som ewhat behind the eight-ball in doing it, and that the reverse trend is in effe ct and, as again I said at the off set, I ·greatly suspect that the larger clinics -- with all due respect to them and I know that they're doing a good job - but the personnel attached to the larger clinics have a better chance of getting their patients into the larger hospitals . Now, I'm leaving this for the time being, Mr. Chairman.

Pm sure my honourable friend is going to make a comme nt or two on this, but there was another question that I did ask of the two gentlemen oppos ite, my two medical friends opposite -- the question of the -- I said "point of no return. " I meant "point of diminishing returns" insofar as the largeness of hospitals are concerned, and I would like to hear an opinion from my honourable friends respecting this, because I have read of this . There's one other thing I would like to say to my honourable frie nd, the member for St. Bonifac e.

He mentioned somet hing in connection with Concordia Hospital -- no emergency services or the likes at night. I think that this situation has been overcome. I want to assure him that Concordia Hospital, and �'m speaking from experience, that if anybody needs emer gency service it's there almost within the twinkling of the eye; and there is one thing that Concordia Hospital is proud of, and justif iably so, Mr. Chairman, they have the highest ratio of RN's than any other hospital in the whole of the Greater Winnipeg area and they are the tops as well. . MR. DESJARDINS: Mr.

Chairman, I would like to thank the Honourable Leader of the NDP for this inf orma tion. I'm very pleased to see that this was rectified. I was going to try to wait to see what the Minister had to say on some of these questions , but I'm afraid the lights will go out and I might not have a .chance to get my question in. I don 1t think this is too healthy either. Wonder what's going on. There's one think -- I would like to fe el, as the Minister of Education does, on this question of autonomy and this question of 20 percent.

I agree with him that we must bring this Plan up with loving care, but oft entimes if you think of loving care you think of defending and of protecting something, and I think that this. 20 percent -- we can't just say, well, this is what they want; we had n,o trouble. This is not right. We're going to have an awfu l lot of trouble with this 20 percent. We're going to have an awful lot of trouble, because · the hospitals have no means of raising this money. The Honourable Minister mentioned St. James -- no trouble there at all. Definite ly. They loaded it on the backs of the home owners again.

It's another tax; Now I think, if the Honourable Minister of Education will recall, that at fir st the idea was a very good idea. Pm not suggesting there's anything wrong, but I think that now we have to face this, not close our eyes to it. The idea was that this 20 percent mos tly would come from donations , and we can see now that there's practically no donations at all. The people that were giving donations feel that they .'re probably overtaxed on that. They're paying more than their share. A lot of other people feel that this is the government; this is free ; they don't need any money.

Other people would direct this more for research now, some of their donations. I think these are all fac ts . This is not insulting the Minister, but I think that the Minister should be ready. He has to fac.§l_ this . Now, where will this 20 percent come fro m? This is what I want to know, because it's not going to come from the hospitals . It might come fr om diffe rent municipalities. Is that what we want? Because then it's cos ting more money. It won't be any .donation, and apparently the Minister, the former Minister, has not explained where we will get these fun ds. Page 1106 March 13th , 1964

(Mr. Desja rdins, cont'd) ... - The only thing that I can see, and I'd like to be corrected if I'm wrong -- interjection -- Well, somebody's ..... lights, I don't know. So, the only thing that - Maybe they're trying to save money for the Hospital Plan, I don't know. Maybe this is the way to raise it. MR . MOLGA T: .... they haven't paid the bill. MR . DE SJARDINS: Could we check to see if there's a faulty switch, or if they're trying to be -- interjection -- There's a storm ? Oh. I thought this Shared Services was only comi ng in on Monday. MR. STEINKOPF: .. ... get the Hydro estimates a little fur ther. MR.

DE SJARDINS: I didn't get that. There's not only a storm, but there's no power. I can •t hear you. No, I would like in all honesty -- seriously, Mr. Chairma n I think that we have to look at that, all of us here. The Metro Corporation are very worried about this. Will this be dumped in their lap ? Some people are going to them . Now, will it become the role of the municipalities to pay for this ? This is going on the back of the people. Now, what are we going to do for this 20 percent? If this is where it's going to come fro m, fine . But let's not kid ourselves that this hospital will raise this money.

This is putting too much on them. They can't do it, unless the Municipality of St. James say: "All right, we will take this over. " I do n't think that many hospitals -- we have the example of the Victoria. What•s going to happen? I think that we have to define this , and we can't just say: "Well, they want this," or "This will protect -- there will be more autonomy in this way. This is fine ." This is wishful thinking. I'd love to see that too. And talking about this autonomy, I don't know if this existed much, as the Honourable Minister of Education would have us believe.

I understand that most of the hospitals ,o r all the hospitals , were told, "Well, this is it. No deficit this year or you pay for it yourself. " Now, am I right? This is a question that I'm asking -- is this right? That there will not be any payment of deficits this year? And am I also right when I say that this was not discussed with the admin istrators of these hospitals. I mean, is there a war between these people and the members on the Plan, or haven't we got any confidence in them, or do we think they're trying to rob us ? What's the score ? I think that we should discuss these things with these people.

I think that we should show confi dence in them and I think there'd be a lot more co -operation. Well, if I 'm wrong, my Honourable Minister of Education, tell me . If this was discussed, tell me. I unders tand that it wasn't, and if it wasn't I don't think it's right. The Honourable Minister of Education might think so. I don't think it 's right. I think that these things should be discussed with the diffe rent profe ssional groups , with the administrators of diff erent hospitals; and this is certainly not showing any confid ence in these people.

We're not using -- and thi_s is why I want to question, and I advise the Minister now that when this will come up I certainly will want more info rm ation on the administration costs. I don't care if it's 3. 4 percent. I' m looking at one and a half million dollars. An d then we're paying -- I think that this is not the true picture, because we're paying administrators of certain hospitals who could help in this, and this is the point. I mean are these people going up? Ar e there more emp loyees? That I don ' t know.

This is one of the questions that I ask and I'd appreciate if the Minister would have that ready on Monday so there won't be any delay. No w why should this go up and the hospital will have to have, let's say, less teachers, less instructors? Now the problem is all a problem of money and a co mpulsory plan. We have this plan -- now the government will .. ... to find a way to raise the money, because it's going to go up. We're not going to reduce the cost in the hospitals, not for a few years an:y-way. And I think that we have to take a more realistic look at this 20 percent, for instance.

We'll have to try to use the administrators of these hospitals a little more. I think the members of the Board will have to get some of the work done from these people and they'll have to try to reduce their own administrative costs . Another thing I would like to -- Pm told, and I think I've got part of this question answered, that we 're going on with this hospital in St. James. Pm very pleased to know that. What I would like to know -- we are negotiating with the government, with the fede ral government, for the Deer Lodge Hospital apparently. I would like to know what we will use that for if it's sold.

I'd like to know -- before negotiating, we must be ready. Will this be extended service? Will this be turned into a mote 1? I don 't know what it is, but I'd like to know what we 're going to, why we're negotiating. Do we need it? March 13th, 1964 Page 1107

(Mr. Desja rdins, cont'd). .. And another question that I would -- I don't think there's any call on this. I would like to have this. This is just a simple question. I'd like the Honourable Minister to inform theHouse, is there any study being made, or is there any poss ibility in the near futu re , is there any call for a hospital in the north end of the Greater Winnipeg area? I think this has been questioned. Maybe there's no thought about it at all, but I know that this is a question that is being asked very ofte n.

Now, I would also suggest to the Honourable Minister that he was pretty brave when he said that he hasn't had any but one com plaint in the months. that. he's been there about people not being able to get in the hospitals . I don't know. I hope for his sake that this will not be construed as an invitation to phone him , because I think his switchboard would be pretty busy and·he might need a little more help, because I'm told that the question is a little more serious than that. Maybe they're too busy phoning their own MLA . Maybe this is the reason. I don't know.

And if this is the case , this is all we're doing here today. We're doing our duty, and bringing these com plaints to you, saving you bother in the middle of the night. Yo u're late at night. The people are phoning us, and we're bringing this -- we only have once a year to bring it up and this is what we're doing now. This is what the Honourable the Leader of the NDP is doing, I'ni sure, and this is what I'm doing, so I think we're just showing an awful lot of co -operation. MR. WITNEY: Mr. Chairman, I would like fir st of all to draw this to the com mittee's attention, that when I spoke of the talk!!

I had with the Ass ociation Hosp itals and that there was not unanimity of agreement on the 20 percent, I'd like to just emphasize that those were very info rmal talks that I had with members of the associ ation, as I have had the opportunity to speak with them. The other thing I would like to mention is that we are having a very good co operation with the Sisters of Charity in the St.

Bonif ace Hospital and, while they have indicated they will be in touch with us before the end of March to present their proposals in this respect, I would not like to have left the impression that we were expecting them to be co ming at the end of March because they are working on the problem at the present time. The Honourable Leader of the NDP spoke of the largeness of the hospitals and I had occasi on to ask that myself of the hospital authorities about the largeness of hospitals and he mentioned that some said that there was about 50 0 beds.

I believe that it has been drawn to my attention that there is some feeling that about 1, 500 beds are perhaps the maximum size. All I can say is that as far as I can assess the situation at the present tim e, there is rio real one figure that is available in answer to the Honourable Member's question because some hospitals have a dif ferent type of fu nction, but the largeness of hospitals I'm quite sure is a matter which is being watched by the Manitoba Hospital Commi ssi on. With respect to the hospital costs that the Honourable Member for St.

Bonif ace mentioned, when I was at this advisory commi ttee on cost again, if I recall correctly there was some indication from the minutes -- or not from the minutes, but from' the discussions that took place there, that hospital costs have begun to level off somewhat and over in Saskatchewan I recall that they advised me that since they have had their hospital plan in operation for a period of about ten years, that they have apparently experienced a levelling off of hospital costs .

Now I'm not saying that they're going to, I just draw this to the Honourable Member's attention in some of the discussions that I have had. He asks the question about Deer Lodge -- what will the beds be used for, and when the former Health Minister wrote, it was to t:se these beds as acute beds , in the general com munity of beds throughout the whole of the Metropolitan Area. He also referred to a hospital in the north end.

I can only say to him that I have heard discussion on this matter and I believe that it's being considered by the Hos pital Com missi on in the ocverall consideration that they give to the problems· of beds and hospitals in the Province of Manitoba. I can assure him that I am not making an invitation to phone calls at three o'cl ock in the morning. I' m not very pleasant at three o' clock in the morning. Perhaps I'm not at most times, but at three o'cl ock in the mo rning I'm exceedingly unpleasant, and I was just actually at that time stating just a fact that had taken place. MR. PETERS: Mr.

Chairman, late last year I was down here with a group from Concordia Hos pital and we spoke to the former Minister of Health and at that time he told us that -- and he can correct me if I'm wrong but I'm pretty.sure this is what he said , that the emphasis was on de centralization; instead of building great big hospitals that we'd build sma ller hospitals but we would centralize on laundry services, and in certain hospitals they would have certain facilitie s Page 1108 March 13th, 1964 • I

(Mr. Peters, cont'd) ... such as the Cobalt bomb and diffe rent faciliti es, specialized faciliti es, that they wouldn't be duplicated. Now I'm just wondering, Mr.

Chairman, if this has all been changed now because the present Minister of Heaith says now that they're talking about that the maximum hospital unit should be 1, 500 beds , and if I remember correctly I think the former Minister said the maximum would be about 400. beds and they would have them spread out; they would have a centralized laundry unit and diffe rent h.ospitals would have spec .ialized services as I mentioned, for Cobalt bomb, for this and that and all the rest. I'm just wdtloering on the statement that the Minister has now said that the ma.ximum unit should be 1, 500. I think that's wrong.

And one question the Minister didn't answer me was when I was up before Mr. Chairman, was about this business of having 8 people in one room; and while I am on my fe et I would like to ask this question, now that they've okayed the Grace Hospital to go ahead in St. James, I know that there is an old

part in the Grace Hospital, and they have a newer part -- what are they intending to do with that facility ? I know what Concordia is. intending to do with their facility when they start the construction in building the hospital, that they are going to use it for a residence home for the nurses, and I would ask the Minister to tell me what they're going to do with the facilitie s that they now have at Grace. MR. WITNEY: Mr. Chairman, I would just like -- interjection -- there's plenty of them tonight. Mr.

Chairman, I would like to just make this statement, that I didn't say a maximum hospital size should be 1, 500. I was just drawing it to the attention that these are fig ures that I have heard mentioned. I have no expert opinion myself as to what a maximum size of a hospital ought to be , and as for the centralizing of faciliti es, that matter certainly is still under the cons ideration of the Manitoba Hospital Commi ssion, particularly with respect to such matters as laundries and other such services , but I think I should stop there because I'm not fully conversant with just how far they have gone.

He mentioned about the eight beds to one ward instead of four. I'm sorry, at this moment I can't answer that question. MR. MOLGA T: Mr. Chairman, I want to come back for a moment to the Willard Report again because I really feel that this is of vital impDrtance to the people in Manitoba.

The situation right now, and for some years, has been that the Government of Manitoba collects from every citizen in the province except for those that it covers itself under a welfare scheme or where the provinces cover, but every citizen who can, who is in the fina ncial position to do so, must pay a com pulsory hospital premium . He has no alternative to do this. In addition to this, every citizen must pay 3 percent of his income tax, I believe it is , to the government for the purposes --or is it 6 percent -- 1 percent?

One percent, whatever the figure is, of his income tax to the provincial government to provide hospital services . In view of the fact that this is comp ulsory, Mr. Chairman, then the government has an obligation automatically to provide hospital services to these people, because you cannot force them into contributing, you cannot make them members of the plan on a comp ulsory basis and at the same time not provide them with the fac ilities when. they're needed. Now we've heard a lot of compl aints over the past year or two about people being unable to get in the hospitals.

People who want to go to hospital and need to go to the hospital, and who can't get in; waiting lists at the various hospitals . What I would like to know from the Minister, has he conducted a survey to find out what the waiting lists have been at the various hospitals ? That's one question. The other one then relates, Mr. Chairman, back to my original point that I made some time ago and I discussed three hospitals in particular. Well, the Minister told me that in the case of St. Bonif ace Hosp ital, that was the decision of the hospital itself not to proceed. But there are several others, Mr. Chairman.

What about Children's Hospital? What about Victoria Hospital ? Because we must go back to the time when the Willard Commi ssion was set up. At that time the government said, "Well, hold back on hospital construction. Let's wait and see what the Willard Report is going to recommend. " And they urged the hospitals at that time not to proceed on any cons truction plans -- in fact I have here a clipping from the Free Press , back in March of 196 1. In that clipping, the headline is, "Hospital Off icial Charges Building Program Stalled.

The president of the · Board of Directors of the Children's Hospital charged Tuesday that the hospital's 'very necessary building program' had been delayed because the Willard Commi ssion Report had not been submitted. " So here we are back in March of · •61 and the hospitals are saying they are being delayed in their constraction plans because the Willard Report hadn't been submitted. March 13th, 1964 Page 1109

(Mr. Molgat, cont'd) ... Well, Mr. Chairman, the government had the Willard Commi ssion, and I well remembe.r the ex-Minister he used to tell just wait till the Willard report comes in and everything will be sm ooth and rosy. This is going to be the Bible, for when this is in there'll be no furthe r troubles. And he set it up and I don't quarrel at all with the work that was done. I think this was a sensible approach. An d here's the terms of reference Mr.

Chairman, "The Minister indicated that he would like the recomm endations of the Survey Board to cover the fiv e-year period from 196 1 to 196 5, but that the Board shoutd, in arriving at its decisions , take into account considerations relating to the succeeding five years, 1966 to 197 0. " Well, Mr. Chairman, there's the situation. Back in '61 before the report's in the hospitals are told, "Hold back. " The hospitals at that time wanted apparently to build. They're com plaining that they can't build, and they are waiting for the report. The report is now in.

It's been in -- my copy came to me in August of 196 1; so it's now some 3 1/2 years . Certainly -- well, we're ab.out half way through the period that they were supposed in investigate, and· already we're behind time on some hospitals by as much as a year or two, and there are no programs yet, that I know of, for the construction of these hospitals .

The government still hasn't told me this evening how they're going to overcome · this 20 percent voluntary figure which must come from some where, and I say that it's not good enough for the government to say, "Well, we have to wait and see and let the hospitals dig it up themselves .. " Because it's the government that's accepted the responsibility of the Hospital Services Plan. It's the government that collects the money in premiums. It's the government that collects the income tax to do this.

Auto mat ically then, the government must accept the responsibility to provide the services, arid I want to know from the Minister, what is he doing in the case of, for example , the Victoria Hospital? What is his recomm endation to these people who are prepared to go ahead and build. They have proven that they need the service. They have had their own survey in. addition to the Willard report. What are they doing about the Children's Hospital, where the situation is the same and where I think one of the largest waiting lists is presently in existence ?

Now it's not good enough for the Minister to sit back and say, "Well, they've got to get the 20 percent from voluntary contributions" because if this keeps on, Mr. Chairman, then the hospitals are not going to get built, the services that are guaranteed to the public under the Hospital Services Plan, will not be given to the public and there's no one whom we can blame except the government. MR. WITNEY: Mr. Chairman, first of all I have not made a survey of the waiting lis.ts I that the various hospitals ha:ve.

I have the Hospital Survey Report here which says that the commi ssion continued the implemen tation of the hospital cons truction program which is based on the recomm endations set out in the report of the Manitoba Hosp ital Survey Board submitted in 196 1.

An d the status of the program , as at December 31 st, '33 , is as follows : including certain projects approved prior to the com pletion of the Survey Board Report, 34 construction and renovation projects have been comp leted at a cost of $2 1,4 00, 000, and cons truction of five further projects cos ting $3 million is underway, cons truction of 10 projects cos ting $16 million is expected to com mence in 1964, and 23 additional projects estimated to cost $2 0, 300, 000 have been approved and will be undertaken during the years 1964- 68.

When the honourable member speaks of us being behind I would point out to him that in some cases we are ahead of the Willard Report in hospitals that have raised the 20 percent in the Metropolitan area and I have mentioned them to hirri. I mentioned the Salvation Army Hospital in St. James; I have mentioned to him the Winnipeg General Hospital, and I have mentioned to him the problems that we are having with the St.

Boniface Hospital at the present time, and I understan.d that the two hospitals at the present time that are having diffic ulty with the 20 percent are the Victoria Hospital and the Children's Hosp ital. . Now he asks what am I doing about the Victoria Hospital. The Victoria Hospital's recent brief on the basis of . the study that they had was sent to the Premier and it has been ref erred now to. the Manitoba Hospital Commi ssion.

The brief came in I think roughly about a week ago and I have not had any recomm endation from them at the present time, and I must say to him again that there are some of the hospitals who still want to retain the 20 percent equity because they feel that that helps them to maintain their autonomy. The problem of the 2.0 percent equity is going to be discussed for a while yet, but I have also sai d to him that the Page 1110 March 13 , 1964

(Mr. Witney, cont'd)� .. policy of the government is at theiJresent time to continue with the 20 percent equity. Now I'm not .sure whether I missed something else that the honourable member mentioned except that I did not make a survey of the waiting list. To add this one point, that I don't believe here in Manitoba that our waiting lists are any greater than they are anywhere else in any jurisdiction in Canada as far as I can understand it in sitting and listening to the various administrations speak when they were at the advisory commi ttee on hospital costs.

And I don 't think that anybody in this province who are paying a co mpulsory premium are being denied hospital faciliti es. As I have pointed out, when it comes to an emergency the hospital facilities are there and the people who are on the waiting list -- Pm not sure just at this moment how long they might have to wait but t(ley do receive service. Now if we are to giive service tomorrow - some body comes in and wants to. have something done with his shoulder and they expect to have a bed there tom orrow, then the costs will rise and rise rather substantially.

And I pointed out also that the 20 percent is one of the most generous in the Domi nion of Canada. In Ontario I bel�eve that the -- and here again I'm talking only from what I recall at this meeting -- I believe that the equity in the Province of Ontario is some 40 percent. For the moment that's all !have to say. MR. PETERS: Mr . Chairman, just on the statement that the Minister has made I think he's going to make the people in Elm wood and Concordia Hospital very happy because they have no trouble raising their 20 percent and I hope by the remarks that the Minister has made that we will go on

schedule building that hospital in Elmwood that is needed very sorely for the area of Winnipeg North. We used to have a hospital in Winnipeg North -- St. Joseph •s-- and we had the Children's Hospital that was moved out, and we don't have a hospital at all.

Al l we have is Con cordia left now which is about, I think it's about an 80 -bed hospital, and the plans as I understand them now and-- when we get to the Manitoba Hospital Commi ssion I have something here that has been given to me just a very short while ago -- I haven't been able to study it -- of what they in tend to do, and I think it will be a real shot in the arm for the people living in that area that this hospi tal gets underway in the fall of '64, and the statement that the Minister has just made gives me every hope , and the people in Concordia, to believe that this hospital will start in the fall of this year.

MR . MOLGAT: Mr . Chairman, I just want to clarify one further point then. The govern ment, I take it then, has no policy at the moment, or no intention of changing the policy insofar as the 20 percent. It is not the government's intention to have the municipalities put this up and it's not the government's intention to have Metro put this up. Is that correct? MR. WITNEY: Mr. Chairman, right at this mome nt there is no plan to change the policy.

I understand that some representations are to be made to me, by the papers, from the Metropolitan District of Winnipeg, and certainly in view of the problems I have an open mind to continue to study it, but right at this moment the 20 percent equity is till in effe ct. MR. MOLGA T: But Mr. Chairman, it's not the government's intention to force the municipalities or Metro to take over this responsibility. Is that correct? MR. WITNEY: The policy at the present_ time, Mr. Chairman is 20 percent equity. MR. PAULLEY: Mr.

Chairman, just one point that the Minister mentioned about the question of selective patients going into hospitals and the likes of this. He mentioned the fact that there were provisions in every case of emergency admittance to hospitals -- nobody in an emergency had been kept out of a hospital, so all I ask of the Honourable the Minister, to make sure that there is a growth of availability of hospital beds so that those that are on the selective list for surgical operations and waiting do not become emergencies in order to get into the hospitals .

Now this could well be that we could keep these people who are just waiting for a month or two or four or five months back out of the hospitals until they became emergencies. Now I certainly hope that we 're going to progress to the degree that this won •t be neccessary for too long. MR . PETERS: Mr. Chairman, I asked the Minister a question and I had to go out for a few minutes and I don't know if he answered. If he did then I'll read it in Hansard, but what are they going to do with the facilities of Grace Hospital as it is now when they move into the new one? March 13 , 1964 Page 1111

MR. W1TNEY: I'm getting some si de advice here but I'd better get some -- well, I won't go that far, but I will find out for sure because that particular problem is being negotiated with the Manitoba Hospi tal Commi ssi on at the present time. May I just say to the Honourable the Leader of the NDP, seven beds per thousand at the present time in Manitoba and that is one of the highest in Canada -- not the highest but it's right up on top with the rest of Canada. MR. PAULLEY: May I ask my honourable friend, what province is the highest? MR. W1TNEY: Right at this moment, Mr. Chairman, I haven't got .... MR.

PAULLEY: May I tell my honourable friend what province is the highest? MR . W1TNEY: Oh, certainly . MR. PAULLEY: Pardon? MR. W1TNEY: Certainly. MR . PAULLEY: This poor down-graded province to the west of us . Saskatchewan, Mr. Chairman. MR . WITNEY: Mr. Chairman, ....... say that my wife and family thank you for passi ng 1 (a ). The bills are starting to pile up at home. MR . JOHNSTON : Mr. Chairman, I'd like to ask the Honourable Minister a question dealing with the Manitoba Hospi tal Services Plan . It's my understanding that physi otherapy services are provided under this plan. Is that correct ?

It's provided as part of the service one receives when they pay their premium ? The information I have tells me that thi s is so , but it's only provided in part of the province .

For instance, I understand it's provided in Dauphin, Brandon, the Manitoba Reha b Centre in Winnipeg, and the three municipal hospitals in Winnipeg -- Now it's not available in the other Winnipeg hospitals which perhaps for a Winni peg citizen who requires this service isn't too serious because he can get the service by only travelling a very short distance in Metro Winnipeg, but what about the rest of the provin ce, the equipped hospitals that .are .available to provide the space but they need the physiothera pists? I'm thinking now of the hospitals for instance at Morden or Selkirk or Portage la Prairie .

All these people in the Province of Manitoba pay their premiums . Are they not all· entitled to this service ? Now I know the Minister may say that this will come with time but has not this plan been operating for six or seven years and isn't it just about time this service was made to all of the people in the province ? MR . WITNEY : Mr .

Chairman, it is my understanding that the program was in troduced about a year or two ago and it has been introduced on an experimental bas!s , and one of the problems of course has been to obtain the necessary people for it and we have had in the past I year at the -- I think it is at

Document details

Collection	Manitoba — Debates (Hansard)
Citation	27-2-42
Type	hansard
Volume / chapter	27th 2nd hansardpdf 42.pdf
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	4de975191655fb3ae4b33fa9de9cf210186d3b6a

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