Manitoba Hansard — Sitting 77B (37th Legislature, 3rd Session)

37-3-77b

Manitoba — Debates (Hansard)

Third Session - Thirty-Seventh Legislature of the Legislative Assembly of Manitoba DEBATES and PROCEEDINGS Official Report (Hansard) Published under the authority of The Honourable George Hickes Speaker Vol. LII No. 77B- 1:30 p.m., Wednesday, August 7, 2002

Member AGLUGUB, Cris ALLAN, Nancy ASHTON, Steve, Hon. ASPER, Linda BARRETT, Becky, Hon. CALDWELL, Drew, Hon. CERILLI, Marianne CHOMJAK, Dave, Hon. CUMMINGS, Glen DACQUA Y, Louise DERKACH, Leonard DEWAR, Gregory DOER, Gary, Hon. DRIEDGER, Myrna DYCK, Peter ENNS, Harry FAURSCHOU, David FRIESEN, Jean, Hon. GERRARD, Jon, Hon. GILLESHAMMER, Harold HA WRANIK, Gerald HEL WER, Edward HICKES, George JENNJSSEN, Gerard KORZENIOWSKI, Bonnie LATHLIN, Oscar, Hon. LAURENDEAU, Marcel LEMIEUX, Ron, Hon. LOEWEN, John MACKINTOSH, Gord, Hon. MAGUIRE, Larry MALOWAY,Jim MARTINDALE, Doug McGIFFORD, Diane, Hon. MIHYCHUK, MaryAnn, Hon.

MITCHELSON, Bonnie MURRAY, Stuart NEV AKSHONOFF, Tom PENNER, Jack PENNER, Jim PITURA, Frank REID, Daryl REIMER, Jack ROBINSON, Eric, Hon. ROCAN, Denis RONDEAU, Jim SALE, Tim, Hon. SANTOS, Conrad SCHELLENBERG, Harry SCHULER, Ron SELINGER, Greg, Hon. SMITH, Joy SMITH, Scott, Hon. STEFANSON, Heather STRUTHERS, Stan TWEED, Mervin WOWCHUK, Rosann, Hon. MANITOBA LEGISLATIVE ASSEMBLY Thirty-Seventh Legislature Constituency The Maples St. Vital Thompson Riel Inkster Brandon East Radisson Kildonan Ste.

Rose Seine River Russell Selkirk Concordia Charleswood Pembina Lakeside Portage Ia Prairie Wolseley River Heights Minnedosa Lac du Bonnet Gimli Point Douglas Flin Flon St. James The Pas St. Norbert La Verendrye Fort Whyte St. Johns Arthur-Virden Elmwood Burrows Lord Roberts Minto River East Kirkfield Park Interlake Emerson Steinbach Morris Transcona Southdale Rupertsland Carman Assiniboia Fort Rouge Wellington Ross mere Springfield St. Boniface Fort Garry Brandon West Tuxedo Dauphin-Rob lin Turtle Mountain Swan River Political Affiliation N.D.P. N.D.P. N.D.P. N.D.P. N.D.P. N.D.P. N.D.P. N.D.P. P.c;. P.C. P.C.

N.D.P. N.D.P. P.C. P.C. P.C. P.C. N.D.P. Lib. P.C. P.C. P.C. N.D.P. N.D.P. N.D.P. N.D.P. P.C. N.D.P. P.C. N.D.P. P.C. N.D.P. N.D.P. N.D.P. N.D.P. P.C. P.C. N.D.P. P.C. P.C. P.C. N.D.P. P.C. N.D.P. P.C. N.D.P. N.D.P. N.D.P. N.D.P. P.C. N.D.P. P.C. N.D.P. P.C. N.D.P. P.C. N.D.P.

4599 LEGISLATIVE ASSEMBLY OF MANITOBA Wednesday, August 7, 2002 The House met at 1:30 p.m. ROUTINE PROCEEDINGS PRESENTING PETITIONS Transcona-Springfield School Division Mr. Ron Schuler (Sprin gfield): Mr. Speaker, I beg to present the petition of Dean Magura, L. Orchard, R. Semmler and others praying that the Legislative Assembly of Manitoba request the Minister of Education (Mr. Caldwell) to reverse the decision to split the Transcona-Springfield School Division and allow it to remain as a whole or to consider immediately convening the Board of Reference to decide the matter.

Trans-Canada Highway-Twinning (Virden) Mr. Larry Maguire (Arthur-Virden): Mr. Speaker, I beg to present the petition of Gerald Lund, Leona Joseph, Fred Hey and others praying that the Legislative Assembly of Manitoba request that the Minister of Trans portation and Government Services (Mr. Ashton) consider making the completion of the twinning of the Trans-Canada Highway between Virden and the Saskatchewan border an immediate fiscal priority for his Government and to consider taking whatever steps are necessary to ensure that work begins in the 2002 construction year.

READING AND RECEIVING PETITIONS Transcona-Springfield School Division Mr. Speaker: The honourable Member for Springfield (Mr. Schuler), I have reviewed the petition and it complies with the rules and practices of the House. Is it the will of the House to have the petition read? An Honourable Member: Yes. Mr. Speaker: Clerk, please read. Madam Clerk (Patricia Chaychuk): The petition of the undersigned citizens of th,� province of Manitoba humbly sheweth THAT on November 8, 2001, the Minister of Education (Mr.

Caldwell) announced a split in the Transcona-Springfield School Division but despite repeated requests has been unable to identify any benefits of this decision to the students and taxpayers of said school division; and THAT this decision was not preceded by adequate public consultation as outlined in

section 7 of The Public Schools Act; and THAT this decision would result in significant hardships for the students in both Transcona and Springfield that would affect the quality of their education; and THAT the proposal by the Minister of Education on February 12, 2002, neither alleviates nor remedies these hardships; and THAT this decision results in an increased financial burden on the taxpayers of both the Transcona-Springfield School Division and the province of Manitoba; and THAT on March 13, 2002, the number of resident electors required by The Public Schools Act requested the Minister of Education to convene a Board of Reference to decide the matter.

WHEREFORE YOUR PETITIONERS HUMBLY PRAY THAT the Legislative Assembly request the Minister of Education to reverse the decision to split the Transcona Springfield School Division and allow it to remain as a whole or to consider immediately convening the Board of Reference to decide the matter.

4600 LEGISLATIVE ASSEMBLY OF MANITOBA August 7, 2002 Trans-Canada Highway-Twinning (Virden) Mr. Speaker: The honourable Member for Arthur-Virden (Mr. Maguire), I have reviewed the petition and it complies with the rules and practices of the House. Is it the will of the House to have the petition read? An Honourable Member: Yes. Mr. Speaker: Clerk, please read. Madam Clerk (Patricia Chaychuk): These are the reasons for this petition: Over the years, the Trans-Canada Highway between Virden and the Saskatchewan border has been the site of numerous accidents, a number of which have involved fatalities.

The safety of the motoring public on the Trans-Canada Highway between Virden and the Saskatchewan border would be improved if the twinning of the highway were to be completed. We petition the Legislative Assembly of Manitoba as follows: To request that the Minister of Trans portation and Government Services (Mr.

Ashton) consider making the completion of the twinning of the Trans-Canada Highway between Virden and the Saskatchewan border an immediate fiscal priority for his Government; To request that the Minister of Trans portation and Government Services consider taking whatever steps are necessary to ensure that work toward the completion of the twinning of the Trans-Canada Highway between Virden and the Saskatchewan border begins in the 2002 construction year. TABLING OF REPORTS Hon. Gord Mackintosh (Minister of Justice and Attorney General): Mr.

Speaker, I would like to table the Manitoba Law Foundation Sixteenth Annual Report 2001-2002. Hon. Greg Selinger (Minister of Financ e): I would like to table the following reports: the Supplementary Information for Legislative Review '02-03 Revenue Estimates and the Manitoba Hospital Capital Financing Authority Management Report. * (13:35) ORAL QUESTION PERIOD Cardiac Surgery Report Recommendations Mr. Stuart Murray (Leader of the Official Opposition) : Mr.

Speaker, I would like to take a moment at the onset of my question to commend the Premier and the Health Minister on their handling of the West Nile virus issue to date. There have been some alarming developments in the United States with five deaths in Louisiana and it clearly demonstrates that indeed the West Nile virus issue is a serious one. I know it was probably a difficult decision for him but I commend the Premier for ensuring that all areas of the city of Winnipeg were sprayed, even though it went against some of the residents.

The Premier and the Health Minister are clearly receiving solid information advice from public health officials with regard to the West Nile virus and I applaud them for heeding the advice they are receiving. Mr. Speaker, one area where I think the Premier and the Health Minister could learn from their own example and listen to the recommendations of health officials is in the area of cardiac surgery. Can the Premier indicate what action was taken after his Government received a report on December 6, 2001 entitled:

Summary of Concerns from Members of Departments of Pediatrics, Medicine, Surgery at the WRHA? Hon. Gary Doer (Premier): I know in terms of cardiac surgery, Mr. Speaker, we have maintained the position we took during the election period. The recommendation to close the cardiac surgical program at St. Boniface we have rejected. We have worked to have pediatric surgeries co-ordinated with other western prov inces, including the province of Alberta, for other cardiac surgeries. We are concerned about the shortage of nurses, operating room and intensive care

August 7, 2002 LEGISLATIVE ASSEMBLY OF MANITOBA 4601 nurses. As I understand it, for this August 2002 the enrolment has almost doubled from a year ago for needed nurses in that training program. We know there have been elective surgeries that have been delayed which we know caused tremendous pressure on families and individuals who are due to have surgeries.

We think that with the extra increase in nurses being trained, some of the standby fees that have been implemented that were not comparable between different health centres and having more nurses trained for that intensive work will improve our ability to have cardiac surgery throughout Manitoba. Physicians' Concerns Mr. Stuart Murray (Leader of the Official Opposition) : My question to the Premier was about the report that was received on December 6, 2001. Mr.

Speaker, I understand that members of these departments voiced their concerns about the shortage of cardiac surgeons in Manitoba and the negative impact this shortage is having on patient care. Indeed, they noticed that some actions taken were not in the best interests of patient care. Can the Premier indicate if he or the Minister of Health (Mr. Chomiak) met with any of the surgeons or physicians regarding their concerns about Manitoba's cardiac surgery program and what action they have taken to address those concerns? Hon. Gary Doer (Premier): Mr.

Speaker, we were advised pursuant to the Wade-Bell report, and after the former government rejected the Wade-Bell recommendation to have one administration and two sites. We were strongly advised that our ability to retain cardiac surgeons and ultimately recruit cardiac surgeons would be jeopardized with the recommendation to have just the one site. So we went with the Wade-Bell recommendation as I recall it. We believe, over time, especially when maintaining the cardiac surgical centre at St.

Boniface Hospital that was slated for closure in 2001 and maintaining and enhancing the operating theatres in the Health Sciences Centre, we think will strengthen our position. One of the weaknesses we have had in cardiac surgery has been a shortage of nurses with different-[interjection] Well, a lot of surgeries, with the greatest of respect, when you fire 1000 nurses it does sometimes have an effect on the number of operations that are conducted. We are working very hard to rebuild our nursing capacity in health care. Physician Resources Mr. Stuart Murray (Leader of the Official Opposition): Well, again, Mr.

Speaker, my question to the Premier (Mr. Doer) was with respect to the December 6, 2001 report entitled:

Summary of Concerns from Members of the Departments of Pediatrics, Medicine, Surgery at the WRHA. That is what this issue is about. The waiting list for cardiac surgery for some Manitobans under the Doer government is months, not weeks, but, yes, months. There are also far fewer surgeries being done than there were just three years ago. Along with the wait for surgery, some patients have had to deal with the added stress of being bumped in favour of more important and urgent surgeries. Mr.

Speaker, it is unacceptable or should be unacceptable for the Doer government that some members and one in particular was bumped five times. His surgery was bumped because of their incompetence with health care. My question to the Premier: Is he satisfied that having only five cardiac surgeons working between two hospitals is enough for the WRHA to run a safe, effective and efficient cardiac program, considering there were nine surgeons just last year? * (13:40) Hon.

Dave Chomiak (Minister of Health): As the member knows, we have canvassed this issue extensively during the hours of Estimates debate that we have been engaged in with the Department of Health. I remind the member that the waiting list for cardiac surgery is less than it was in December of 1999. It is less for cardiac surgery. I might also indicate to the member that recently a surgeon did resign, a cardiac surgeon

4602 LEGISLATIVE ASSEMBLY OF MANITOBA August 7, 2002 from the Health Sciences Centre, which had become a subject of concern in this Chamber on numerous occasions, was raised over and over again. Rather than me making a decision on who should be hired and who should be fired, which is not the appropriate role of the Health Minister, we asked for an independent third-party review of the resignation of that particular surgeon, which confirmed the decision that that surgeon should resign. Dakota Tipi First Nation Gaming-Government Action Mr. Leonard Derkach (Russell): Mr.

Speaker, for days in this Legislature we have watched the Minister responsible for Gaming flip-flop in his answers to the House. Had we taken the Minister of Gaming at his word when we first raised the issue in the House, Manitobans would have been left to believe that all gaming on the Dakota Tipi was in full compliance and that the money was being used for the proper purposes, and today we have a Mr. David Doer who would have been getting rich off VLT revenues, money that was supposed to be used for the betterment of the community of Dakota Tipi. My question to the Premier (Mr.

Doer) is this: Why has his Government, knowing full well what was taking place at Dakota Tipi and involving his brother, waited until we pressed the issue in this House to take any action whatsoever? Hon. Steve Ashton (Minister charged with the administration of The Gaming Control Act): Mr. Speaker, I am glad that the member opposite used the phrase "at his word," because yesterday and today no fewer than five times on open-line radio this member alleged that there was a contract between either the Province and the Gaming Commission and Soaring Eagle. I would like to table a letter, Mr.

Speaker, from the Manitoba Gaming Commission which states very clearly that the Gaming Commission is aware an allegation has been made. The commission entered into an agreement with Soaring Eagle to provide audits related to the Dakota Tipi Gaming Commission. Be advised that this is not correct. The MGC has never entered into any contractual arrangement with Soaring Eagle. I would like to ask that member to withdraw that statement, do what the Member for Fort Whyte (Mr. Loewen) did when he made similar accusations that were incorrect, and apologize, Mr. Speaker. Mr. Derkach: Well, Mr.

Speaker, every time this Government gets into trouble, it runs out to someone to write a letter for them. We have seen this time and again. * (13:45) Mr. Speaker: Order. Point of Order Mr. Speaker: The honourable Government House Leader, on a point of order. Hon. Gord Mackintosh (Government House Leader): A point of order, Mr. Speaker. If the honourable member has a question, we would like to hear a question. Would you please remind him that Beauchesne says: Supplementary questions re quire no

preamble. Mr. Speaker: On the point of order raised by the honourable Government House Leader, I would like to remind all honourable members that Beauchesne 409(2): A supplementary question requires no

preamble. *** Mr. Speaker: I would ask the honourable member to put his question, please. Mr. Derkach: I would like to ask the Minister responsible for the Gaming Commission how it is that he and his Premier (Mr. Doer) could say that they knew nothing about the deal with David Doer, when, in fact, the Minister of Gaming acknowledged in this House that he had met with the Dakota Tipi Gaming Commission, that he had met with David Doer. Then how can

August 7, 2002 LEGISLATIVE ASSEMBLY OF MANITOBA 4603 he explain the affidavit that was filed by Mr. Arden Pashe? Mr. Ashton : Mr. Speaker, I would like to know how this member five times on open-line radio can say in response to a question: Did Doer hire Doer? Yes, he did. We later found out that David Doer was hired by the commission to do an audit for the gaming revenues of Dakota Tipi. On the other hand, he is hired by the Province to conduct an audit. This individual was asked by the Province to do an audit of where the gaming revenues are going. Then Mr.

Pashe states very clearly that David Doer was hired by the Gaming Commission to do the audit. I tabled the document that stated very clearly there was no contract. When is that member going to withdraw the fraudulent accus ation and apologize to members of this House? Some Honourable Members: Oh, oh. Mr. Speaker: Order. I would like to take this opportunity to remind all honourable members that decorum is very important to the viewing public. We have guests in the galleries, and we have members that are viewing it on TV. It is very, very important that we all maintain decorum in this House.

Gaming-Ju dicial Inquiry Mr. Leonard Derkach (Russell): Mr. Speaker, I would like to ask the Premier (Mr. Doer) of the Province of Manitoba whether he would do the honourable thing and call an independent judicial inquiry into this matter, seeing that we have seen his minister flip-flop in the House when questions are asked. We tabled an affidavit that clearly says there is an agreement between the Province and David Doer. If, in fact, these are such issues that are not correct, then I ask the Premier, call the inquiry, bring in people under oath and get this matter cleared up once and for all.

Some Honourable Members: Oh, oh. Mr. Speaker: Order. I would like to take a moment to ask each and every member to look up into the gallery, the guests we have and the viewing public. Decorum is very important. I ask the co-operation of all honourable members, please. Hon. Steve Ashton (Minister charged with the administration of The Gaming Control Act): You cannot get up and repeatedly put a fraudulent accusation on the record when you have confirmation it is not true and then demand an inquiry.

Into what, the fact that that member cannot put a statement on the record that is accurate in this case, and he does not have the decency to apologize to members of this House for clearly putting a fraudulent accusation on the record? There was no contract. Some Honourable Members: Oh, oh. * (13:50) Mr. Speaker: Order. I would like to, once again, remind all honourable members the clock is running and decorum is very important to the guests we have in the galleries and to the viewing public. I once again ask the co operation of all honourable members, please. Dakota Tipi First Nation Soaring Eagle Agreement Mr.

Mervin Tweed (Turtle Mountain): Mr. Speaker, this morning the Premier (Mr. Doer) stated on radio that the provincial government has never hired David Doer and Soaring Eagle. Yet the affidavit that we tabled yesterday clearly states that David Doer was hired by the Manitoba Gaming Control Commission to do the audits. My question to the Premier is: Who is telling the truth? Hon. Steve Ashton (Minister charged with the administration of The Gaming Control Act): We know it is not the opposition critic, Mr. Speaker, because, in fact, he still refused to apologize for putting fraudulent information on the record.

Members opposite, this is what they have been doing the last couple of weeks. They are so desperate to try and point to some connection that does not exist. If I agree to have supper with my wife later on today, that is an agreement. What they

4604 LEGISLATIVE ASSEMBLY OF MANITOBA August 7, 2002 alleged was that there was a contract, in fact on open-line radio the Member for Russell (Mr. Derkach) stated that Soaring Eagle was hired by the Premier. That is factually incorrect. It is a fraudulent statement. I call on the members opposite to withdraw that and apologize. Mr. Tweed: Mr. Speaker, I would like to point out the affidavit we tabled yesterday was given under oath.

I would like to ask the Premier why his Minister responsible for the Gaming Com mission told reporters on July 24, and I quote: We have not hired them, nor would we when the affidavit, under oath, clearly shows that David Doer had been hired by the Manitoba Gaming Commission. Mr. Ashton : I do not know what part of this affidavit members opposite do not understand. I do not know what part of the document I tabled from the Gaming Commission which indicated very clearly the MGC has never entered into any contractual agreement with Soaring Eagle.

They get up, they take the word "agreement" in terms of a deadline for providing reports and try and tum it into a contract. There is no contract. I do not know how much more para noid members opposite can get, but the more they keep putting this kind of fraudulent information on the record shows how little of an issue they actually really have. I ask them to clear the record, withdraw that fraudulent comment and apologize to this House. Gaming-Judicial Inquiry Mr. Mervin Tweed (Turtle Mountain): Perhaps, Mr. Speaker, Manitobans are concerned about who is putting fraudulent information on the record.

We have heard day after day from this minister a change of story from time to time, and I would like to ask the Premier (Mr. Doer) now: Will he do the honourable thing and call an independent judicial inquiry into this issue? Hon. Steve Ashton (Minister charged with the administration of The Gaming Control Act): Once again, you cannot get up and put on the record a fraudulent statement. One of the problems here is I know members do not understand terms like compliance. There was no compliance for five years while they were in government.

They do not understand the meaning of the term "auditor," but I think anybody, a grade school kid, could understand the meaning of the word "agreement," the difference between an agreement and a contract. There was no contract, Mr. Speaker. There was no contract. They should withdraw that statement. * (13:55) Dakota Tipi First Nation Gaming-Judicial Inquiry Mr. Leonard Derkach (Russell): Speaker, any kid except for him. Some Honourable Members: Oh, oh. Mr. Speaker: Order. An Honourable Member: Is something? Well, Mr. this not Mr. Speaker: Order.

Once again, I would like to ask the co-operation of all honourable members. We have the viewing public in the galleries, the visitors, we have the viewing audiences on television and decorum is very, very important. I ask the co-operation of all honourable members, please. Mr. Derkach: Mr. Speaker, this is absolutely unbelievable. Outside the House- Some Honourable Members: Oh, oh. Point of Order Mr. Speaker: Order. The honourable Government House Leader, on a point of order? Hon. Gord Mackintosh (Government House Leader): Well, Mr. Speaker, I understand this is a supplementary question.

Would you please remind the member about the long-standing practice? Is this a new question? I did not hear him ask for attention to a new question. Mr. Speaker: On the point of order raised by the honourable Government House Leader, he does not have a point of order. ***

August 7, 2002 LEGISLATIVE ASSEMBLY OF MANITOBA 4605 Mr. Speaker: I recognize the honourable Member for Russell on a new question. Mr. Derkach : Mr. Speaker, outside the House, the Minister responsible for Gaming said, and I quote: They put an affidavit which talks about an agreement, an agreement, not a contract. Now, the Government is into splitting hairs. Yesterday, we tabled in this House an affidavit sworn by a council member from Dakota Tipi who said, and I will quote for the benefit of the minister: An audit was previously provided to the Manitoba Gaming Commission for the years 2000-2001.

However, the said audit did not meet the specific requirements of the Manitoba Gaming Commission. As such, I am advised by David Doer, employee of Soaring Eagle, and do verily believe that the Manitoba Gaming Commission entered into an agreement with Soaring Eagle to provide the said audit on or before August 31, 2002, together with an audit for year 2001-2002. Mr. Speaker, my question to the minister: Will he do the honourable thing today and be open with Manitobans and ask his Premier (Mr. Doer) to call for an independent inquiry to get to the bottom of this, once and for all? Hon.

Steve Ashton (Minister charged with the administration of The Gaming Control Act): Well, Mr. Speaker, it is interesting to see the member already begin to distance himself from the comments he makes outside of the House. What he stated on the public record when the question was asked: Did Doer hire Doer? He said, yes, he did, hire. I want to reference that. We later found out that David Doer was hired by the commission to do an audit. He went on to state: On the other hand, he is hired by the Province to conduct an audit and repeated this two other times.

I just tabled a letter that stated very clearly the MGCC has never entered into any contractual arranged agreement with Soaring Eagle-no hiring, no contract. The member is dead wrong. He should apologize. * (14:00) Mr. Derkach: Mr. Speaker, why is the Premier (Mr. Doer) and his Minister of Gaming covering up the issue? Who is he protecting more? Is his responsibility to protect Manitobans or to protect his little brother? Mr. Ashton: Mr. Speaker, every day I wonder how low the Tories can go, and I think we have just seen the fact there is virtually no limit on how low they can go.

They know, it is proven on the record that there is no contract, no hiring. The member opposite is dead wrong. I would appreciate and I think all Manitobans would appreciate if he would put on the record that he was dead wrong five times earlier, was dead wrong in this Question Period. It is about time he said he was wrong and apologize. There was no contract with Soaring Eagle. Mr. Speaker: The honourable Member for Russell. Some Honourable Members: Oh, oh. Mr. Speaker: Order. The honourable Member for Russell has the floor. Mr. Derkach: Mr. Speaker, it is clear- An Honourable Member: Question. Mr.

Derkach: Well, okay, the question. Mr. Speaker, I would like to ask the Premier whether or not he is prepared today to stand in this House and order an independent inquiry into this matter, as a result of the misinformation that has been put on the record by his minister, the Minister responsible for the Gaming Com mission and the fact that we have tabled documents which the Government today is refuting. Hon.

Gary Doer (Premier): The Manitoba Gaming Control Commission is aware that an allegation-that would be you-has been made that the commission entered into an agreement with Soaring Eagle to provide audits related to the Dakota Tipi Gaming Commission. Please be advised that this is not correct. The MGCC has never entered into any contractual arrangement

4606 LEGISLATIVE ASSEMBLY OF MANITOBA August 7, 2002 with Soaring Eagle, signed Mr. Josephson, executive director. You owe me an apology. Dakota Tipi First Nation Gaming-Judicial Inquiry Mr. Mervin Tweed (Turtle Mountain): I guess now we have confirmation from the Government that they did enter into an agreement with David Doer that would afford him 15 percent of the take on the Dakota Tipi Gaming Commission. My question is to the Premier. Again, will he stand in his place, do the right thing, protect all Manitobans' interests and call an inquiry to get to the truth of the matter? Hon.

Steve Ashton (Minister charged with the administration of The Gaming Control Act): Mr. Speaker, once again, I do not know what it is going to take for members opposite to understand that they were dead wrong. The Member for Russell (Mr. Derkach) has been in this House for a considerable period of time. Sometimes you make mistakes, but when you make a mistake you admit it, like the Member for Fort Whyte (Mr. Loewen) did. When he made fraudulent accusations about Crocus he apologized and withdrew.

I would suggest the Member for Russell and the Member for Turtle Mountain do that, because there was no contract between the Province and Soaring Eagle, period. Mr. Tweed: Then I would ask the Minister of Gaming: Is he saying the affidavit provided and tabled here yesterday that suggests and states David Doer was hired by the Manitoba Gaming Control Commission is lying? Mr. Ashton: I do not want to get into dealing with who is lying on this. I do not know what it takes for members opposite.

I do not quite understand what part of "has never entered into any contractual agreement with Soaring Eagle" they do not understand, but I suspect having all Manitobans understand what this is really all about. Right from day one the only thing that members opposite have been trying to do is establish a connection that did not exist. There is no contractual arrangement involving Soaring Eagle, or there is no contractual arrangement, period. I would suggest to members opposite they stick to the facts and deal with what we try to deal with which is a very difficult situation in Dakota Tipi.

Unlike the members opposite who did nothing for five years, we have acted on real issues. I mentioned it earlier, last week in Question Period, I would suggest they start all their questions with once upon a time, because that would give some indication of how much fact is involved. Mr. Tweed: Clearly the minister is confusing a contract with an agreement. We see it as the same on this side of the House.

I would ask the Premier again, and I ask him on behalf of all Manitobans who are starting to question the Government on their ability to tell the truth in this House: Will he call a judicial inquiry and get to the bottom of this issue so all Manitobans can know the truth? Mr. Ashton: Once again, you cannot keep putting fraudulent statements on the record like members opposite, right from day one, and then call for a public inquiry. I read back when the Member for Lakeside (Mr. Enns) first raised this issue in the House. You know what he talked about being an untendered contract.

He never once mentioned the fact that Soaring Eagle was hired by two parties, by Dakota Tipi and the federal government. It was never hired by the provincial government or the gaming com mission. That was confirmed in answers in this House, was confirmed in a letter I responded to earlier. The members opposite simply do not have an issue. The only thing they are trying to do is smear family members of this Government side with no foundation. Their claims are fraudulent. I would suggest they stick to the facts. Hecla Marina Details of Sale Hon. Jon Gerrard (River Heights): Mr.

Speaker, the sale or other disposal of

August 7, 2002 LEGISLATIVE ASSEMBLY OF MANITOBA 4607 government assets must be done fairly and wisely. One of the assets sold by the Minister of Conservation was the marina at Hecla. I ask the Minister of Conservation to tell this Legislature the process he used to sell the Hecla marina and the results. Who bought the property and for what price? Hon. Oscar Lathlin (Minister of Con servation): I thank the member for the question. The marina that he is referring to had been tendered out.

Proposals came in and after a thorough review of the proposals the offer was made and a sale was finalized to a fellow, I do not recall his name exactly right now, but I am aware of the sale that the member is referring to. Mr. Gerrard: I ask the minister: Can the minister confirm that the Government sub sequently paid about $30,000 to put a sewage line into the marina? Mr. Lathlin: Mr. Speaker, I can confirm that, over the course of several years, members of the public using the restaurant washrooms, campers from the campground nearby were also using the flush-type marina washroom.

They preferred that to the privies that were available in the camping area. As a result of the flow of people coming into the restaurant, the marina, an agreement was reached between the Government and the marina operator that the sewage be connected, with the understanding that the marina would accommodate the public from the nearby campground as well as any of the tourists that may be coming to the marina. * (14:10) Mr. Gerrard: Mr. Speaker, my supplementary to the Minister of Conservation.

I ask the Minister of Conservation whether there was a formal appraisal of the value of the marina done before it was sold and whether the price received approached the appraised value of the property. Mr. Lathlin: Mr. Speaker, again, I can confirm that the proposal call was put out, the tender call was put out, the proposals came in. There were quite a variety of proposals. In the end a decision was made and the best proposal was given to the individual who got the contract. Canadian Military Welcome Home Ceremony Ms. Bonnie Korzeniowski (St. James): My question is for the First Minister.

In recognition of the contribution of military families, our Government has passed legislation preserving their voting rights and driving privileges. Our soldiers have recently returned from Afghan istan. Will the Premier please inform us of any plans to thank these dedicated men and women? Hon. Gary Doer (Premier): First of all, I would like to thank all members of the House for passing Bill 9 that for the first time in Canada allows the members of the military, when they are transferred from other provinces in Canada, to have their merits appreciated for purposes of lower public insurance rates.

I would like to thank members of this House for passing the ability of drivers licences to be maintained for military families and military personnel when they are in theatres of conflict and theatres of peace. Mr. Speaker, I would also like to thank the members for ensuring that people who are fighting for our democracy are not denied their voting rights through absence from this province for over six months. So I will be passing on, on behalf of all members of the Legislature, a small thanks on our behalf for their courage and their dedication to the war against terrorism.

I will reiterate our thanks to the soldiers and families for their peacekeeping efforts a year and a half ago in Bosnia. Further, I will thank the members of the Family Resource Centre who members opposite met as well as ourselves during the committee hearings. I thank them for continuing to keep good ideas about how to make our province more military friendly for the people who serve. Highway Traffic Act Case Review Mrs. Joy Smith (Fort Garry): Mr. Speaker, I recently met with Mr. and Mrs. Choy, whose young daughter was killed in a motor vehicle accident last August on Highway 16. Mr.

Ridd, one of the minister's Crown attorneys, was fined $600 under The Highway Traffic Act as a result of this motor vehicle accident. The Choys

4608 LEGISLATIVE ASSEMBLY OF MANITOBA August 7, 2002 expressed to me a great deal of frustration and sadness with Manitoba's justice system when the death of their daughter results in a $600 fine. Mr. Speaker, I understand the minister brought in a prosecutor from outside the province for this case. Will the minister agree to send the court transcripts to another outside prosecutor for review to ensure that the full extent of the law was brought to bear in this case? Hon. Gord Mackintosh (Minister of Justice and Attorney General) : Well, Mr. Speaker, I will apprise myself of the situation.

If an independent prosecutor was called in, it was done on a professional basis with the professional judgment of the department. So I will look into the situation and report back. Dakota Tipi First Nation Soaring Eagle Agreement Mr. Leonard Derkach (Russell): The Minister of Gaming dares to attack us for trying to smear members of the Doer family, but, Mr. Speaker, let us remember that if we did not press this issue in the House, today David Doer would be taking 15 percent of all revenues that are coming from VLTs in Manitoba. I want to ask the minister- An Honourable Member: VLTs in Manitoba. Mr.

Derkach: Dakota Tipi. Mr. Speaker: Order. Mr. Derkach: Mr. Speaker, I wish to correct that, 15 percent of all revenues coming from the Dakota Tipi VLTs. I want to ask the minister if he can explain what is meant by the sworn affidavit statement of Mr. Arden Pashe when Mr. Pashe says: As such I am advised by David Doer, employee of Soaring Eagle and do verily believe that the Manitoba Gaming Commission entered into an agreement with Soaring Eagle to provide the said audit. Hon. Steve Ashton (Minister charged with the administration of The Gaming Control Act): Mr.

Speaker, earlier today the member opposite made accusations, five times, fraudulent accusations it was a contract. After he has continued to repeat that in the House, after he continues to refuse to withdraw that fraudulent statement, he now asks me to explain what is happening. The only person who needs to explain is that member because the statements he made earlier were fraudulent. That is proven by the documentation from MGCC. I ask the member to withdraw the fraudulent statement. There is no contract. Mr. Speaker: Order. Time for Oral Questions has expired. i Introduction of Guests Mr.

Speaker: I would like to draw the attention of all honourable members to the Speaker's Gallery where we have with us Honourable Ed Picco who is the Minister of Health and Social Services for the Government of Nunavut. Also, we have Mr. Abraham Tagalik, Assistant Deputy Minister of Health; Ms. Joanne Bezzubetz, the executive director of Kivalliq Health and Social Services; and also Marianne Demmer, assistant to the Minister of Health. lnuktitut spoken What I said in Inuktitut was that we are very pleased that you were able to join us today. On behalf of all honourable members, I welcome you here today.

MEMBERS' STATEMENTS Livestock Industry- Tuberculosis Mr. Jack Penner (Emerson): I should say that the Canadian Cattle Producers are meeting in Winnipeg today, tomorrow and the balance of the week. I want to say, Mr. Speaker, that I believe the Canadian Cattle Producers have done an absolutely admirable job of building an industry that is second to none in the province of Manitoba. They have built this industry to about a $1. 5-billion industry, and I believe that in itself is an achievement to be proud of.

This industry is being threatened today by an outbreak of tuberculosis in the Riding Mountain National Park, which the minister and

August 7, 2002 LEGISLATIVE ASSEMBLY OF MANITOBA 4609 her Government refuse to deal with in an adequate way. It is our belief that this industry is being put in jeopardy. The breeding cattle that were normally exported into the United States without impediments are now being threatened by sanctions being put on by the American government and testing that will be required indicating a severe and increased cost in the production and marketing of cattle in this provmce.

We believe that it behooves this Government to take their own Bill 11 and use the authority they have given themselves in drafting this bill which gives them the power to isolate that herd in Riding Mountain National Park and, when the isolation is complete, then to take action and eradicate TB in the Riding Mountain National Park or, by legislation, force the federal government to take action to eliminate tuberculosis in our wildlife herd, thereby protecting our $1. 5-billion domestic industry. * (14:20) We believe the employment these people, these farmers create for the province of Manitoba, the industries that have been built around it need that kind of support, and they need the sincerity of government.

John Fletcher Spirit Award Mr. Gerard Jennissen (Flin Flon): Mr. Speaker, one of the major awards presented at the 2002 North American Indigenous Games in Winnipeg was the John Fletcher Spirit Award. This award was presented to the contingent or team that best exemplified the spirit of teamwork, fair play, respect and integrity throughout the North American games competition week. The relatively small contingent from New Mexico won the John Fletcher Award, which consisted of a powerful piece of art, a massive bluish-grey buffalo carved out of Brazilian sandstone. The sculptor was the very talented Mr.

Irvin Head from Cranberry Portage. This beautiful piece of art was entitled The Embrace and symbolized, not only the friendliness, inclusiveness and unity of the games, but also the artist's own embrace of his culture, art and life. I am very proud of Mr. Irvin Head's achievement, and I know that I speak on behalf of all members of this Legislature when I thank him for his inspirational artwork and wish him continued success. The degree of sophisticated creativity that emerges out of northern Manitoba is truly amazing. Therefore, it was most fitting indeed that a major northern Manitoba artist, Mr.

Irvin Head, was selected to create a masterpiece that was so uniquely symbolic of the spirit of the 2002 North American Indigenous Games. Simplot Plant (Portage Ia Prairie) Mr. David Faurschou (Portage Ia Prairie): Mr. Speaker, I rise today to update members of the Chamber on the progress of the largest construction project underway in the province of Manitoba this year. Just west of Portage la Prairie, the Simplot Canada's new multimillion dollar potato processing plant is taking shape.

According to the company vice-president, Rick Fisch, construction of the $120-million facility in the Poplar Bluff industrial park, and I quote, is really coming along nicely. The plant is expected to be in full operation by the fall of 2003. Currently, some 200 people are working on the construction site at the facility. In fact, construction of the $120-million plant on Simp lot Road will provide 1040 person years of employment. Economic benefits for this project will not stop once construction is completed. The plant will create huge economic benefits as potato acreages rise substantially across the province.

Each acre of potatoes planted means increased sales of farm supplies, as well as the construction of storage facilities and purchases of equipment. Hundreds of Manitobans will be employed on and off the farm in order to supply Manitoba's growing potato industry, all in addition to the hundreds of jobs within the Simplot plant itself. It must be recognized that these benefits will never be realized without the dedication and

4610 LEGISLATIVE ASSEMBLY OF MANITOBA August 7, 2002 hard work of the former Minister of Agriculture, the MLA for Lakeside, Mr. Harry Enns. Years ago, he began discussions regarding this plant which is coming into reality now. Mr. Speaker, on behalf of the members of the Chamber, I would like to thank the honour able member of the Manitoba Legislative Assembly for the constituency of Lakeside for his vision, his dedication towards the develop ment of this province's agricultural industry and for his significant contribution toward the Simp lot processing plant in Portage la Prairie. Poplarfield Reunion 2002 Mr.

Tom Nevakshonoff (Interlake): It is with great pleasure that I rise today to tell of a very special event which occurred in my home town of Poplarfield last weekend. I am referring to the Poplarfield Reunion 2002, which was the third reunion to be held over the last 10 years, the other two being held in 19 92 and 19 97. The two-day event began in Winnipeg on August 3 with a fine dinner reception held at the Garden City Inn owned by the Ledohowski family, formerly of Poplarfield themselves.

Well over 400 people were in attendance, indicating that the expatriate community in Winnipeg is flourishing and is still well attached to its roots in the country. The next day, festivities moved out to the community itself where a picnic and ball tournament were held to entertain the people. The main event of the day was the unveiling of a commemorative plaque at the King Buck Park acknowledging the seven school districts which existed in the pioneer days when all children had to walk to school. The districts were Dehowa No. 1 and No. 2, Leeland, New Star, High Plains, Sharpewood and Reynolds.

In the near future, metal signs at each of the old school sites will be erected. The project was made possible thanks to financial contributions from the provincial Department of Culture, Heritage and Tourism, the Poplarfield Ladies Aid Society, the Poplarfield Development Corporation and the R.M. of Fisher. Special thanks to Bill Grywinski, Ed Ledohowski and others for the time and effort they contributed in successfully implementing this project.

In conclusion, I want to acknowledge the good works of the reunion committees, both in Winnipeg and Poplarfield, who worked so hard over the past decade on the three reunions. Thanks to them, we who attended are now blessed with memories which will be cherished for the remainder of our lives. Gimli Rail Line Hon. Jon Gerrard (River Heights): I rise to talk briefly about the future of the rail lines in Selkirk and Gimli.

For some time now the future of this rail line has been in doubt and the curre�t rail owners have announced that they are going to abandon or decommission this in February if nothing further happens. It is casting a pall over the future of Selkirk and Gimli as these communities and major businesses in these com munities rely on the rail line. When the Minister of Industry, Trade and Mines (Ms. Mihychuk) has responded to the questions in the Legislature, she has been vague, has missed the mark and clearly has not been on top of this file.

Repeatedly, the NDP government has been delinquent, tardy and irresponsible in dealing with the future of Selkirk and Gimli and the rail line. Mr. Speaker, there are major problems here and the Government, instead of trying to address the problems, is fast-tracking other business in the Legislature, while slow-tracking in delaying and impeding any progress on Bill 203 which would have provided one solution. Bill 203 should have gone to committee, but the NDP stood up and blocked the normal democratic process. They blocked public hearings on this bill. This was not the appropriate thing.

We are a democracy here and this should have gone to committee. There is another bill as well, one on decreasing smoking, that has been brought forward and once again the NDP has stood up to block this bill going to committee, blocked public participation, blocked public input and blocked democracy. Too bad. ORDERS OF THE DAY GOVERNMENT BUSINESS House Business Hon. Gord Mackintosh (Government House Leader): Mr. Speaker, would you please

August 7, 2002 LEGISLATIVE ASSEMBLY OF MANITOBA 4611 canvass the House to see if there is leave to waive private members' hour today? Mr. Speaker: Is there unanimous consent to waive private members' hour for today? An Honourable Member: No. Mr. Speaker: No. It has been denied. Mr. Mackintosh: Mr. Speaker, would you canvass the House to see if there is leave to sit until midnight in the Chamber this evening instead of 10 p.m., as previously agreed? I think that is the basis. Mr. Speaker: Is there agreement for the House to sit until midnight this evening instead of 10 p.m., as previously agreed?

Some Honourable Members: No. Mr. Speaker: No, it has been denied. Mr. Mackintosh: I move, seconded by the Minister of Health (Mr. Chomiak), that the House resolve into Committee of Supply. Mr. Speaker, just on a matter of House business on that motion, there are two standing committees meeting tonight outside the House, of course, with the Estimates continuing in the Chamber. Mr.

Speaker: The understanding for this evening is that the two committee rooms will be used for committees and in the Chamber will be Committee of Supply, and, as previously agreed to this morning, we will continue with Committee of Supply. * (1 4:50) COMMITTEE OF SUPPLY (Concurrent Sections) HEALTH Mr. Chair person (Harry Schellenberg): Good afternoon. Will the Committee of Supply please come to order? This afternoon, this

section of the Committee of Supply meeting in Room 254 will be considering the Estimates of the Department of Health. It has previously been agreed to have a global discussion in all areas and then proceed to line-by-line consideration, with the proviso that if a line has been passed, leave will be granted to members of the Opposition to ask questions in passed areas. The floor is now open for questions. Mr. Glen Cummings (Ste. Rose): I understand that our critic and the minister had some discussion about RHA deficits, and it is an important concern in the rural RHAs.

First of all, I am sure the minister is concerned when he see deficits, period. But, over the years, I would suggest in some of the larger hospitals than in the current situation, deficits rise, and boards and governments have to deal with them. Does the minister stand by what I understand was the position early in the year, that no deficits would be funded? Hon. Dave Chomiak (Minister of Health): As we discussed previously, Mr. Chairperson, we advised the RHAs this year that we did not want to fund deficits. Mr.

Cummings: While I was well aware that I thought that was what the minister's position was, I understand that he is prepared to cover the deficit for the Marquette RHA if they, in fact, would willingly and happily amalgamate. Is that the case? Mr. Chomiak: Mr. Chairperson, the two regions that merged, South Westman and Marquette, one had a deficit, the other had a surplus. We thought in following the tradition that had been previously undertaken under the previous government with respect to the establishment of the RHAs that it would not be appropriate to commence the operations of a new RHA in a deficit position.

Mr. Cummings: I am a little slow on the uptake here. Did the minister just say that he thought it would be inappropriate to start the newly merged RHA in a deficit position? Mr. Chomiak: Yes. Mr. Cummings: There has been a number of the funding announcements that have occurred, and this is why I want to make sure I have the

4612 LEGISLATIVE ASSEMBLY OF MANITOBA August 7, 2002 minister very clearly on the record. The funding announcements seemed to be quite substantial, but, in fact, it appeared, on closer examination, that the deficit of the previous year was going to have to be paid out of the current year funding. Is that how the minister is dealing with the deficits in the other RHAs? Mr.

Chom iak: I do not know if the member is aware, but we have managed to reduce the deficits from the vicinity of, when we came into office, in the seventies of millions of dollars down to somewhere in the range of $13 million which is-[interjection} Well, Mr. Chairperson, if the Member for Russell (Mr. Derkach) would allow me to complete my answer. We have managed to reduce it by working with the regions and are continuing. Clearly, we indicated to the regions that we did not want to directly to pick up the deficits that they incurred as a result of funding for the last year, Mr.

Chairperson, and we are working with the indi vidual regions with respect to their financial circumstances. Mr. Cum mings: Well, the usual way that the public and current Government, when it was in opposition, would refer to that type of situation is that there is, in fact, a clawback then. The previous year's deficit is going to be clawed out of the current year's funding, and it leads to an interesting presentation of funding until you realize that there is deficit recovery included in the funding announcement. Mr. Chomiak: No, Mr. Chairperson, that is, in fact, not the case, as I illustrated this morning.

We outlined in the funding announcement this year to the regions that there were a variety of factors and considerations that we were looking at, and we advised them that we required them to maintain core programm ing and major program ming and that the areas of any reductions that they were going to be involved in should be in areas of administration or other areas that are non-essential. Mr.

Cum mings: It would not come as any surprise to the minister that from time to time I have had discussions with the administration of the RHAs, particularly to the west of the city, and when they are told that they must maintain core programm ing, and those guidelines are somewhat loose, I would suggest, that what it amounts to is that they are being invited to run a deficit if they believe that they cannot operate within the funding that they have received. Would that be a correct assumption? Mr.

Chom iak: What we have found from our experience over three budgets has been that we have significantly lowered the deficits, both in total and in individual regions, and we work with the regions in order to accomplish that goal. We are not completely inflexible. We have indicated that we do not want to tolerate deficits. We are working with the regions, and as I said last year and the year before, we continue to work with the regions, and it has served our purposes well, insofar as we have managed to decrease significantly-significantly-the deficit situation. We will continue to work to that end. Mr.

Cu mmings: Well, as my colleague from Russell points out, the minister has had a significant number of dollars to work with, and there are a hundred different ways of balancing budgets. But I want to ask the minister about whether he believes that devolved versus non-devolved facilities should be treated differently in funding them for delivery of services. When the Parkland RHA has money delivered to it for therapy services, occupational therapy being an example, and yet they have not delivered occupational therapy services in the town of Ste.

Rose, to the best of my knowledge, for three years, is that how they are balancing their budget? I mean, that is the very same way that individual hospitals, when they were run by local boards, used to either build surpluses or stay within their budget, that they would be funded but then would not actually spend the money on areas that they were being funded for. Is that an acceptable practice? Mr. Chomiak: I am not trying to be evasive. One of the difficulties that I am having in terms of dealing with specific questions, because we are dealing with general, is that I do not have our

August 7, 2002 LEGISLATIVE ASSEMBLY OF MANITOBA 4613 regional ADM here who could deal with the specific point that the member is making, and that is dealing with occupational therapy as it applies to Parkland. So that example I cannot deal with.

On the general policy point, what we are trying to do is to distribute as fairly as possible, and there was a whole series of criteria that both the regions talked to us about in terms of funding and which we provided to the regions with respect to the funding for the regions, which included increases for estimated wage settle ments, identification of significant issues facing each region and funding allocated for that, allocation for funding increases, balanced alloca tion proportionately based on previous years' funding and adjustments for out-of-globe items, Mr. Chairperson.

So all of these factors were taken into consideration on individual RHAs with respect to the provision of funding. * (15 :00) Mr. Cum mings: I quite appreciate that the minister might not be able to, nor would I expect him to be able to, deal with individual examples such as I just gave, but, as a matter of principle, I believe that he may be finding a difference between those who have deficits and those who do not, that there may well be considerable conflict over the level of services that are being provided.

The example I gave, in my mind, supports that concept of perhaps a large disagreement about whether or not they have been able to maintain services or no. To follow that line of reasoning, the local facilities have been able to, on a part-time basis, hire, on a per-day basis, a therapist to deliver services. They are being told, because it is not a service that is being provided by the RHA, that it will not be funded. So I point that out, No. 1, to raise the minister's awareness that those sorts of things may be occurring out there, but, also, to raise the issue with the minister in terms of deficits.

I made the observation to some of the people in the RHAs that I was talking to that, given the circumstances they found themselves in from time to time, they had very little choice but to end up with a deficit. I am pleased to hear the minister say that he is not inflexible. Can I take that to mean that he is open to discussions at each year-end about the level of funding and deficit that RHAs may incur? Certainly, at the end of the year, when a deficit has been built up, all of a sudden there is only one authority left that can deal with that.

There are only two ways that that can be solved: either there is a funding comes to pay for it, or it has to be clawed back from current-year funding. Then the minister has a dilemma of whether or not he is announcing current-year funding that includes provisions for a clawback, which means that the growth of the revenue, if you will, or the funding to the RHAs is not growing at the same rate as others because they are, as any business would be, finding themselves covering the cost or the clawback of their deficit.

So can I assume the minister is on record as saying that he is prepared to discuss deficits at the end of the year and that continues to be his policy? Mr. Chomiak: The dilemma of indicating that deficits will not be picked up and then subsequently picking up deficits at the end of the year is a vicious circle that can, and will, repeat itself. I think we have managed, through a firm policy on deficits, but a collaborative process with the RHAs, to reduce the deficits significantly, and I see no reason why that will not continue. Mr.

Cummings: Then, in the disagreement between service providers within the RHA and the RHA itself, that is strictly in their purview whether or not they want to fund that service within the facility, even though the assumption is that they would have received funding for, in this case, an occupational therapist. Can I assume that they have the ability to not fund it, even though they have been provided money from the Province? Mr. Chomiak: Mr. Chairperson, is the member talking about a non-devolved facility?

As I understand it, in a non-devolved facility there generally is a purchase agreement that is entered into between the RHA and the non-devolved

4614 LEGISLATIVE ASSEMBLY OF MANITOBA August 7, 2002 facility that covers off all of the issues relating to the provision of services. Mr. Cu mmings: Well, we all know that there is a shortage of therapists out there, so that compounds the problem.

My understanding is that therapy services is something that would have been provided centrally, and, therefore, devolved or not, even though I certainly do not want to mislead the minister, I am talking about a non-devolved facility that devolved or not, somewhere in the system in the Parkland Region and in the monies that flowed to the Central Region, you would have thought that there would be an allowance for this type of service. If there was, then the money is being redirected. If there was not, then that is entirely a different matter.

I am sure the minister may not be able to answer that off the top of his head, but it is an interesting problem, and it is related to budget balancing, and, of course, in an non-devolved facility, that is exactly the same problem that they are dealing with, trying to balance their budget as it is provided. Mr. Chom iak: I thank the member for that advice. It truly is a problem to deal with. Mr. Cum mings: I have another issue, and as so many of these things, there is a specific aspect to it, but I will avoid names.

I want to get the minister on record in terms of how he views the responsibility that he has and his appointees have on the boards of RHAs. I have acquired a copy, and I had no trouble getting it, by the way. I asked for a copy of the conflict of interest guidelines for the RHA that I was inquiring about. It has come to my attention that a board member wrote directly to a manager of a facility demanding disciplinary action against an employee, and, in my view in the beginning, that alone was inappropriate, writing directly to a manager of a facility.

Then, secondly, there was a direct conflict between the business that the appointee was involved in and the service that the employee of the RHA was providing in terms of a third-party benefit. Without putting the precise names on the record, it reduces the minister's capacity to answer the question, so I want to phrase the question this way: Is it appropriate for an appointee to the RHA boards to write directly to a second-level manager asking for disciplinary action? * (15:10 ) Mr.

Chomiak: Generally, during my tenure as minister with respect to matters of this kind, � found it has been prudent for the board in question to resolve the issue with respect to its

interpretation of the guidelines and with respect to the particular action or actions that have taken place. That has been, generally, my experience. There have been instances of issues brought to my attention that I have felt are more appropriately within the purview of the board and have been dealt with by the board, in my experience and recollection, generally satisfac torily. Mr. Cummings: Well, I am in somewhat of a dilemma in this respect as well, but I think the minister might as well share my dilemma because this was seen as a direct attack on the individual.

When the manager responded to the board member, saying that I hope you are satisfied that I have appropriately reviewed this and I am satisfied that no action is required, the response of the board member was then I will go over your head, or I may go over your head, pardon me. I may go over your head. In other words, there was no satisfaction given after the review by the management. I am being very careful to as accurately reflect this as I possibly can because, as the minister knows, in small communities, small fights become bloodbaths, unnecessarily.

But I am quite incensed by this action, and I take it the minister is saying he has never had to remove a board member. Does that mean that his advice to me would be to take this to the local board? Mr. Chomiak: It is difficult to deal with these issues in the abstract. Generally, there have been

August 7, 2002 LEGISLATIVE ASSEMBLY OF MANITOBA 4615 matters that have come to my attention with respect to board and board members. Generally, the most appropriate action has been to have the board itself, as the entity involved, resolve the issue within its own authority. That has been the pattern that has been followed during my tenure as minister.

I think, with regard to this issue, generally if this matter were to come to my attention and the member were to give specifics, I think I would probably direct the concerns to the board with respect to them reviewing their policy on conflict and their rules and regulations in regard to this. But, of course, it is very difficult in the abstract and this is where my legal training comes into ground. There is a variety of issues that arise from it being a non-issue and just a misunderstanding to it perhaps being a far more serious issue. So it is difficult to really deal with the abstract.

The general modus operandi we have followed has been to refer these matters to the board for the board to deal internally with its own members, as is appropriate. Mr. Cummings: I appreciate the difficulty that the minister finds himself in. If this were hypothetical, I would probably very easily have to let him off this line of questioning. This is not hypothetical. The problem is that we have a line employee who was investigated by their superior, and the superior was satisfied there was not a problem, but the board member who made the inquiry said he was not necessarily satisfied with the answer that he got.

I guess I will ask the question which leads me to put it in a hypothetical, unfortunately, and that is if conflict of interest was proven, then it is the minister's appointment. I am suggesting that I have to prove conflict of interest if I intend to pursue this, or the person who was offended by this action. But if conflict of interest were the issue, then the minister would find himself in a position, and I see an affirmative look on his face, that he would have to suspend his appointment. He does accept the responsibility of the appointment of these board members.

I see the minister responding in the affirmative. Mr. Chom iak: Now, there could be a variety of responses to the issue. There could be instances where, for example, if something were proved and it was appropriate, an individual would resign voluntarily from the board with respect to concerns. It is also possible the board could have a resolution to the minister recommending that this board member be removed. But, in the final analysis, the minister does have the authority to remove, to a point, and to remove board members. Mr.

Cu mmings: It struck me, when I first was confronted with this issue, that the very fact that a board member would write directly to a second-level administrator, seeking disciplinary action, was inappropriate. I make no bones about the fact that is where the letter went. It did not go to the CEO. It did not go to the board. It went to a second-level manager, seeking an investi gation and disciplinary action. I am asking the minister, on that aspect, he should be concerned. I would like to know if the minister believes that would be appropriate action, and I will state on the record where I am coming from.

I had responsibility for a Crown corporation, which is not a lot different than what we are talking about here, except there is a different field of representation. But if one of the board members went directly after an employee of that Crown, we would crucify him. I suggest that the RHA boards, while they come from local com munities, that it is equally inappropriate for them to go after a line worker directly to their immediate superior. I would ask the minister if he would be prepared to comment on that aspect. Mr.

Chomiak: In any corporate entity, a non profit or profit corporate entity, the board has certain responsibilities and functions, manage ment has certain responsibilities and functions. It is the purview of management to manage, and it is under the authority of the board to set overall direction and policy guidelines, et cetera. Generally, it is not accepted practice for board members to interfere with the day-to-day operations and management of that corporate entity. Mr. Cum mings: I have one last question that I want to put to the minister in this respect. That is

4616 LEGISLATIVE ASSEMBLY OF MANITOBA August 7, 2002 that, unfortunately, this has left a bit of a bad taste in the community because it was one of his recently appointed board members who took this action against someone who comes about as close to sainthood as anybody we have in our community.

I would like to share the balance of my concerns with the minister privately because this has the potential to give all of us a black eye if it becomes any more public than I have already made it, but it certainly is on the streets in the local community, and the minister will end up with some onus on his shoulders to deal with it. I am quite prepared to drop it there until we have a private discussion. * (15 :20) Mr. Chomiak: I appreciate the member pointing that out, and I do look forward to discussing the matter individually with the member.

We have had experience with matters of that kind, related matters, that we have had to deal with, Mr. Chairperson. Mr. Cum mings: Mr. Chairman, I thank the minister for that, and I guess I will put the minister on notice that I believe there is a strong enough case here that, when I bring it to him with the names involved, he will take strong and appropriate action to deal with the situation because it does no justice to the management process.

I remind the minister that he was an advocate of elected boards when he was in my position, so I guess the appointment versus election probably does not look any more attractive today than it would have three or four years ago, but it does mean that there is a direct line to the minister for which he is going to have to be accountable. I did not quite feel satisfied with the question about whether or not Gladstone qualifies as a hospital that can have 24-hour emergency response, especially when the board of the Central RHA has gone on record as being supportive.

I am certainly well aware that services were reduced under our administration. It was always my understanding that they were reduced because of the availability of doctors. That availability is being tested again because they are now currently on a doctor search, but I am told that doctors were prepared to provide service on a rota basis where they would end up where they might have had a couple of hours in the middle of the night when they would not have had somebody actually on call or available. Is that one of the criteria that stops them from being funded for providing emergency response at Gladstone?

Even today people going in doctors' offices located adjacent to the operating room, frankly, it is not advertised as being available for emergency response outside of regular hours, and there is some question about during regular hours. The community has reached a point where they are seeking some guidance as to how they can best respond to the public demand, which is that the community will deteriorate rap idly if they are unable to put themselves forward as having a doctor on call 24 hours a day. Mr. Chomiak: Mr.

Chairperson, these are always difficult issues concerning rural communities, and in our attempt to maintain and keep services in rural communities, we have worked hard with a number of rural centres to keep facilities open and running. With respect to the Gladstone situation, as I recall there was a question in terms of the volume provided, the number of visits to that particular centre based on the criteria that had been in place for some time. There are a number of factors that are associated with the situation.

I know that we had a temporary arrangement that we had worked out with the community in order to maintain the doctors in that community, and I will have to check with our particular people in that area to find out what the update is in that regard. Mr. Cummings: Well, the minister is on record as saying he does not intend to close facilities. Our administration was on record that we did not intend to close facilities. Distance starts to become an issue in delivery of rural emergency services. In this case, there probably is an on-call cost, and, Mr. Chair, that is why I made the uncomplimentary remark earlier.

I understand the figure is about $250, 000 annually to provide

August 7, 2002 LEGISLATIVE ASSEMBLY OF MANITOBA 4617 on-call costs. Is that money that there would have to be an approval, that would have to be funded directly from Manitoba Health, or is that money that would be funded in addition to, or would it have to come out of the existing envelope of funding that the RHA has? Mr. Chomiak: I can answer in general again. I am just determining whether or not the appropri ate official from the department can be in attendance in order to answer the specifics of that question.

I can answer in general, but I do not want to provide any inaccurate information with respect to this issue. So pending the arrival of staff with this specific issue-and I will tell the member why. It is because it is complicated by the fact that we have entered a new agreement with respect to the MMA, and there is a whole series of other issues that are being dealt with. So I do not want to go on record giving any inaccurate information. Mr.

Cummings: I appreciate that, and, frankly, as the minister probably realizes, one of us has to get something on the record as to what conditions they need to meet or whether they can ever meet the conditions there. So I would be more than willing to tum the questioning over to another line to our critic and await the arrival of someone who could supply the answer. Thank you. Mrs. Myrna Driedger (Charleswood): I think it was yesterday the minister asked me whether or not, Mr. Chairperson, I would want to receive the physician profiles of the five cardiac surgeons in Winnipeg.

At that point, my thought was I would be happy if at least the minister was the one checking into them so that he was satisfied. I would like to ask the minister, if that offer is still open, then I would like to take him up on it and have those physician profiles provided to me. Mr. Chomiak: I will ask the WRHA to provide us with information concerning the profiles of the five qualified cardiac surgeons who perform cardiac surgery within the cardiac program here in Manitoba. Mrs. Driedger: Thank you. I appreciate the minister undertaking to do that.

I would like to ask the minister what his understanding of this particular sentence is when I read it to him. The sentence is: There was a preference for locating the cardiac services at one site for improved patient care, research and teaching capabilities. How does the minister interpret that sentence? Mr. Chomiak: That seems to be an opinion. Mrs. Driedger: That certainly was an opinion. It is on page 29 of the Wade-Bell report where they indicated there was a preference for locating the cardiac services at one site for improved patient care, research and teaching capabilities. I note that the Premier (Mr.

Doer) again in his answer today, I felt, was somewhat mis leading, because within the Wade-Bell report there was a preference. They indicate why it maybe was not that able to occur, but there was a preference for one site. Their reasons behind it are that one site provided for better patient care, better research and better teaching capabilities, which really goes along with all of the experts in the country who are talking about one site for cardiac care. So I just wanted to share that with the minister, and it is on page 29 if he chooses to want to read that page for himself.

I would like to ask the minister in view of talking about our RHA boards, what happened to his election promise to have elected boards? * (15 :30) Mr. Chomiak: I thank the member for pointing out Wade-Bell. We have had this discussion over and over and over again, and, as I indicated, the members opposite decided to nix the program at St. Boniface Hospital and to proceed with a one-site program at Health Sciences Centre. We went along with the recommendation of one program, two sites, and that is the recommendation we are working on.

I note the member has now changed her position and I think is now advocating one site at St. Boniface, but it changes. Nonetheless, Mr. Chairperson, with respect to the issue of election of board members, there have been significant developments in that area

4618 LEGISLATIVE ASSEMBLY OF MANITOBA August 7, 2002 in other jurisdictions. Saskatchewan is moving away from their elected board members. Alberta had an experience with elected boards. It was fairly expensive and it did not have a lot of turnout with respect to their boards. Generally, the early recogmt10n and recommendations in the system to have elected board members has turned around. The general consensus now is not to have elected boards, from the data and the literature generally across the country. Mrs. Driedger: Well, Mr. Chairperson, that data was available prior to the election.

In fact, the Premier of Saskatchewan at that time had even indicated to us when we were in government not to go that route and had a number of recommendations. So that information was cer tainly well known in Saskatchewan at the time, in fact in a number of provinces. Knowing that that information was out there prior to the election, why did the minister make that promise in the election? Mr. Chomiak: Mr. Chairperson, as I indicated to the member, the government of Saskatchewan has in terms of policy, I believe, now moved away from elections as a result of their most recent review.

They have decided to move away from elected boards in Saskatchewan. The Premier that the member is referring to of Saskatchewan is now heading up a federal commission dealing with the review of health care across the country, a commission that I had the honour and pleasure to make a presentation at. I think we are the only political party in the province to make a presentation to that committee and that commission. I was honoured that we as a government were able to do that. We made recommendations with respect to medicare in general.

The member, who in her opening statement kept saying that I refer back too often to the nineties, almost invariably in all of her questions goes back to refight the election. I am prepared to do that and discuss that, but it does run contrary to the comments of the member, who accused me of referring back to the nineties too frequently. I see now in every single question the member going back and back and back and refighting the election and refighting the election. Mrs.

Driedger: Certainly as it is this current Government that made all of those promises in the most recent election and this is their mandate in order to achieve those particular promises, it is a matter of expecting accountability from the Government. It is very timely and very appro priate to be visiting those election promises during this particular mandate, in which they said they were going to fulfil those promises. So, in effect, then, regarding the elected boards, the minister has flip-flopped on another issue. Is he prepared to admit that? Mr. Chomiak: Mr. Chairperson, I do not think I said that. Mrs.

Driedger: Well, the minister certainly did promise elected boards. There is no doubt about that. I will be the one that comments that he has done another flip-flop, but we expected this one to be corning because we did do our homework. We knew that the minister was going to end up flip-flopping on this particular issue. Can the minister indicate whether he has asked for management salaries to be frozen across all of the RHAs, the non-union, senior management salaries? Has he asked those to be frozen? Mr.

Chomiak: If I were the member, I would be cautious in terms of running out and making pronouncements with respect to our election commitments as it concerns boards, just a word of advice to the member with respect to some of her comments. We did ask for a freeze on all senior staff in the RHAs for this year. Mrs. Driedger: I understand also that through correspondence, in particular, the reference I have is in correspondence to the Central Region, the Minister of Health indicated that the covering of RHA shortfalls on a yearly basis will not continue into the 2001-2002 fiscal year.

That particular correspondence was from April 29, 2002. Also in that correspondence to Central Region, the 2002-2003 anticipated shortfalls or year-end deficits will be the RHA's responsibility. The minutes of the board meeting of May 22 of Central Region does indicate: "With the

August 7, 2002 LEGISLATIVE ASSEMBLY OF MANITOBA 4619 receipt of $2.5 million this year, we will once again be heading for a substantial deficit. If no other factors changed, and we had the same costs and activity as last year, the region would possibly have enough money to operate. How ever, this is not the case. The reality is that we do have increased spending needs due to operational costs associated with new programs such as telehealth, volume increases in home care, inflation, additional dialysis costs and others.

In the area of chemotherapy alone, we are facing an operating increase of $200,000 that will impact our bottom line." Further on, in this same area of the minutes for the Central Region Health Authority, they indicate: "The CEO inquired with Manitoba Health whether the plan was for regions to use their equity to fund their deficits or not. This is not viable in the long run. We have to have some serious debates with government to look at options.

One of the major determinants to building a foundation for sound decision making is to investigate whether the major obstacle is not enough resources in the system or lack of authority to determine the use of those resources.

It was suggested that if a campaign to lobby MLAs is undertaken, it should be founded on the need to reconfigure services appropriately." Then a couple of paragraphs down, it says: "It was raised that, when the region presented a deficit budget to Manitoba Health last year, the Government did not take action at that time to say that the deficit would be disallowed." * (15 :40) It certainly appears that the Central Region RHA is having some fairly serious concerns about their deficits, and they are trying to find ways to address them. It looks like they have some valid reasons for seeing costs increase.

It is interesting that they are feeling that they need to lobby MLAs in order to be able to have their issue dealt with. It looks like they also want some investigation into whether the major obstacle is not enough resources in the system or lack of authority to determine the use of those resources. It certainly seems that the RHAs are struggling. It seems a shame that they are feeling that they are not able to be heard by the Government and that they have to take the issue further and set up a campaign to lobby MLAs.

Could the minister tell us why they feel the need to go that route and why they obviously feel the Government maybe is not listening to them? Mr. Chomiak: As I pointed out to the member earlier, there is not a single RHA that does not want more resources in the province of Manitoba. There is not a single RHA or institution that feels they have adequate resources to meet all of the needs across the province. That notwithstanding that we significantly increased the funding to the RHAs from when the member was the assistant to the Minister of Health.

When the member was working for the government, we significantly increased resources. Notwithstanding that, there are demands every day and continue to be. We work with the RHAs. I remind the member that the member recently or last year ran around with a release talking about deficit for one region and going to the media and then being corrected and found out at the year end, in fact, there was no deficit for that particular region. The member reads minutes. The member has read numerous minutes from public board meetings that are held by regional health authorities.

We have ongoing discussions with those health authorities. That is one of the reasons we have been able to reduce the deficits from the $70-million range to the $13 -million range, I would suggest an incredible decrease in terms of deficits over a period of time. At the same time, we have been able to expand services and provide additional services. There is no doubt that there are individual regions that feel, for example, we should do per capita funding. There are some regions that feel we should not do per capita funding. There are some regions that feel that historically they have not been funded their base.

There are some regions that feel that they have grown demographically and so we should fund their base. As I pointed out earlier both this morning and this afternoon in terms of criteria with the funding, we have provided significant increases to the regions, Mr. Chair, and we expect and ask

4620 LEGISLATIVE ASSEMBLY OF MANITOBA August 7, 2002 that the regions are able to operate within the allocations that are provided to them. Mrs. Driedger: Can the minister comment on this particular statement from one of the RHA board minutes: While we went through the process of discussing ideas where operational changes could be made to reduce costs, this is one area where the government does not appear to be prepared to make some hard choices. Why would they feel that way? Mr. Chomiak: That seems to be an opinion that has been cited by that individual. It has been quoted by the member. Mrs.

Driedger: Well, that was a bizarre statement. I did not even understand what the minister meant. These are from the minutes of the board meeting of April 24, 2002, from Central Region RHA. It was in relationship to the 2003-2004 health plan. A presentation, I guess, was made to Manitoba Health. They said: While we went through the process of discussing ideas where operational changes could be made to reduce costs, this is one area where the Government does not appear to be prepared to make some hard choices. What do they mean? Mr. Chomiak: We make hard decisions every day.

When we make hard decisions, the Member for Charleswood (Mrs. Driedger) is the first one to jump up and criticize us for making any kind of decisions. Mrs. Driedger: Well, this really gets at some of the overview that one would look at when we look at what this Government is doing in terms of looking for efficiencies and cost savings. So far really the biggest thing they have done in health care is just spend a lot of money, $650 million to date, putting us at the highest spenders per capita in the country according to CIHI. This almost validates what a lot of us are seeing too.

The Government does not appear to be prepared to make some hard choices, interesting coming from a board of directors in one of the regions also recognizing the same thing that we are recognizing. We are not seeing this Government move in the direction of trying to bring some efficiencies into the system. What we are seeing is the Government continuing to dump more and more money into health care. We have not seen the innovation. You know, the Premier (Mr. Doer) runs around and makes all these comments all over Canada saying, well, the status quo is not good enough.

Yet he has entrenched the status quo here in Manitoba, and we have not moved beyond the status quo with this Government. We seem to be stuck in the status quo here. There are no innovations. There are no effective means of controlling costs here. Rather, we are seeing the costs continue to escalate. It would be one thing if you continue to put money in the system and you saw improvements, but a 22% increase in funding and we are sure not seeing a 22% increase in improvement in patient outcomes.

If that was the case, that would be a whole lot easier to justify what was happening, but we are not seeing those improvements. You still have hallway medicine, you still have all these waiting lists, you have cardiac surgery patients being bumped. So money is obviously not the solution. More things need to be done.

We do not see this Government moving in any direction to put in those innovations and to try to deal with these escalating costs, costs which are eventually going to hit the wall with our increases in Pharmacare costs, technology costs, the costs that will be incurred on the system as we all age and the big baby-boomer cohort reaches that certain age where we are going to cost the system a considerable amount of money at some point. The minister does not seem to be preparing for this. The trends in incidents of cancer are certainly going up.

If one looks over the next decade or two we are going to have some huge impacts on our health care system. There do not seem to be any rays of hope in this province in terms of trying to reign in the spending. I have to ask the minister: Does he really feel that the health care system needs more money? Mr. Chomiak: Well, I have heard that speech before by the member, contradictory as it is among a number of factors. I think it was only two weeks ago or a week ago when a report came out dealing with long stays in the hospital. The member provided some pages from that

August 7, 2002 LEGISLATIVE ASSEMBLY OF MANITOBA 4621 report of an overhead and said, oh, they are cutting nurses. They are cutting nurses. They are firing nurses. She went around saying that, Mr. Chairperson, when the report dealt with inordi nately long stays in our hospital system. I do not know what the member's position is. I assume she is opposed to the Cervical Cancer Screening Program. It is a significant prevent ative measure that has been put in place.

I assume the member is opposed to all of our health initiatives to increase training across the field, be it nurses, be it doctors. * (15 :50) Point of Order Mr. Chairperson: A point of order, the Member for Charleswood. Mrs. Driedger: The minister is truly out of line in putting assumptions like that forward. He has absolutely no proof to substantiate any of that. He thinks he is going to get a good sound bite here, a 1 0-second sound bite that maybe he can use somewhere, but that really is irresponsible commenting by a Minister of Health.

Unless he can provide the facts to back those statements, I would really recommend he not put those on the record. Mr. Chairperson: The point of order is no point of order. It is a dispute of the facts. Let us not use the point of order for debate. I will recognize you, and then you can debate. Thank you. *** Mr. Chomiak: I was only pointing out to the member all of the innovations, and I could go on and on and on with the innovations that have been put in place under this Government that the member does not even acknowledge, Mr. Chairperson, and does not seem to recognize.

So how can we prove to the member the changes that exist, or the changes that are in place when the member refuses to even listen to the issues that we raise, and to the innovations that have been put in place with respect to the health care system. But we have been down this road before, Mr. Chairperson, and what the member went through was similar to her opening address. She just repeated those particular facts. Rather than my countering all of those facts, which I can, and which I have throughout the course of these Estimates, I will just await the next question. Mrs.

Driedger: Well, I have to go back to my previous question because the minister did not answer it. Does he feel that the health care system needs more funding in it? Mr. Chomiak: We have provided significant funding to the health care system, Mr. Chairperson, and all of the projections with respect to all of the prognosticators and all of the indications are that health care spending will increase in the future. The key, of course, is putting in place programs and services that will capture the needs of the population at the least expense to the public treasury. Mrs.

Driedger: I certainly agree with the minister with what is coming down the pike. We probably will see a health care system that is going to need some more funding. But, rather than just always pouring in new money and increasing the base line, is the minister not looking for innovations within the system where they can actually save money? Mr. Chomiak: One of the examples of that is our asthma program that is being rolled out around the regions. Another example of that, Mr. Chairperson, is our palliative care program that is being offered.

Another example of that is our mental health program, the co-addictions, the co morbidity program; the program that deals with first episode psychotic; the PACT program and the myriad of mental health programs; the education program that is put in place; the Mental Health Resource Centre that is a preventative program; the Cervical Cancer Screening that is a preventative program; the mammography province-wide program and the additional services provided in the North; the fact that we are doing more surgeries and expanding the type and approach to day surgeries across the system; the fact that we are moving surgeries around the system; the fact that we are providing surgeries in rural jurisdictions, rather than making individuals always having to

4622 LEGISLATIVE ASSEMBLY OF MANITOBA August 7, 2002 come in to the city of Winnipeg; the fact that we are putting in place expanded residency programs for physicians outside of Winnipeg; the fact that we put in place a program that allows international medical graduates to have an opportunity to practise as doctors; the fact that we put in place a bursary program for medical students with a return-of-service provi sion in an underserviced or other area with respect to the program; the fact that the LPN program is supported in centres outside of Winnipeg; the fact that we have expanded training in all of the professions.

These are all innovations and all developments that are changing the way health care is approached, the community-based approach in a whole variety of areas, and there is more corning. Mr. Stan Struthers, Acting Chairperson, in the Chair Mrs. Driedger: I certainly acknowledge that prevention programs are important and that there does need to be good focus in the area of prevention. But while these particular programs are rolling out under this Government, there continues to be almost $700 million more pumped into health care.

So, obviously, some thing is just not quite fitting here in terms of the kinds of efficiencies, maybe, that need to really be looked at in a much more serious way or reforms to the health care system to, in fact, make it more sustainable. The minister mentioned one item, which I would like some clarification on, and that is more day surgeries. Where does he intend to do those day surgeries? Mr. Chomiak: In a variety of locations. Mrs. Driedger: Can the minister tell me where? Mr. Chom iak: Additional day surgeries are being done in the Pan Am and in several of the community hospitals.

That is the planning for this year. Mrs. Driedger: Certainly we know that the tertiary care hospitals have the most expensive care. Community hospitals would then be the next and less expensive than tertiary cares, and, certainly, day surgeries right outside of the hospitals would be the most cost-effective at all. Yet there is very little activity by this Govern ment to move in that direction, other than to what he says-do more surgeries at the Pan Am Clinic. Does the minister have in front of him the numbers of surgeries done on a monthly basis at the Pan Am Clinic?

I am not talking plastic surgeries or surgeries people might pay for themselves, such as the plastic surgeries but insured service surgeries? How many of those are done on a monthly basis at the Pan Am Clinic? Mr. Chomiak: The last time that I checked with those stats, we were on track to double the number of surgeries by year-end with respect to the surgeries we were providing at Pan Am. Mrs. Driedger: It is interesting hearing the minister say that, because I have been tracking the numbers of surgeries at Pan Am, and while the minister was saying that this past winter, in fact, that is not accurate at all.

The Pan Am Clinic is, as of February anyway, not on track unless things have dramatically changed in March, April, May, June. Things were definitely not on track. In fact, if we are looking at insurance services, the average that they were doing from the time they made their announcement in September of last year until February, they were only doing an average of 130 surgeries a month at the Pan Am Clinic. That only amounts to 1560 surgeries a year, well below the 3000 that they said they were doing. Does the minister have in front of him the number of surgeries per month for March, April, May, June? Mr.

Chomiak: The numbers have increased substantially on a monthly basis; substantially from the February figures the members has, and, as I indicated, we are on track, on a monthly basis, to do the doubling of surgeries by year end. Mrs. Driedger: Well, I will certainly be watching to see what happens, because in September the announcement was made that surgeries were going to be doubled, and, in fact,

August 7, 2002 LEGISLATIVE ASSEMBLY OF MANITOBA 4623 for six months after that, there really was not any activity to substantiate that. So they are really, really going to have to do a lot of surgeries in the next while to even catch up and be anywhere near the 3000 that they promised to Manitobans. The other thing they promised with the Pan Am Clinic is they said that it was going to keep doctors in Manitoba. Was the minister aware that the Pan Am Clinic has lost one doctor and has not attracted any new ones? Mr. Chomiak: Yes. * (1 6:0 0) Mrs.

Driedger: Well, then can the minister tell me what happened to his statements that the Pan Am Clinic was going to be this wonderful centre, and it is going to keep doctors in Manitoba, and it is going to attract doctors. In fact, it has attracted no doctors and it has lost one. How does he justify what he said to what is actually happening in reality? Mr. Chomiak: We have attracted back a first class orthopedic surgeon to Pan Am, Mr. Chairperson. Mrs. Driedger: Would the minister tell me who that would be and when that position arrived at Pan Am? Mr.

Chomiak: I believe it is Doctor Dubberley, if memory serves me correctly, and he is due to start working shortly or has already started working at Pan Am. Mrs. Driedger: Can the minister tell us, as his statement said when they purchased the Pan Am Clinic, that they were going to add new and exciting innovations, can he indicate to me what new an exciting innovations have been added, because last I heard there were no new treatments added? Mr. Chomiak: Mr. Chairperson, I know the member is in a hurry to have all this done, as am I. The member just has to wait and we will see those developments. Dr.

Jamie Dubberley, who is an orthopedic upper-extremities surgeon, as I understand it, was scheduled to start this month. Mrs. Driedger: The mmtster, a number of times, has indicated that by purchasing the Pan Am Clinic he has saved a lot of money. Yet, when asked by a newspaper reporter for proof of that, the minister was not able to provide any proof that, in fact, what he claimed would happen was actually happening. Can the minister actually provide proof that his purchase of the Pan Am Clinic has saved the health care system money? Mr. Chomiak: I believe the Premier (Mr.

Doer) provided that information at a federal ministers' conference, and I believe the member also has that information and has had access to that information. Mrs. Driedger: Well the Premier did not take me on his conference, so I do not know what he presented there to have proof of this. I am certainly not aware of any proof here, because the minister has not been able to provide, in writing, although it has been asked for in the past, the minister has not been able to provide for, on paper, his savings that he claims to have made. So here again we have another situation just like amalgamating the two RHAs.

He says he saved $2.5 million, but he cannot substantiate that. The Pan Am Clinic, he says he saved all this money, but he cannot substantiate that. Where is the proof? Mr. Chomiak: Mr. Chairperson, the member has information with respect to the cost of surgeries. What we did was we were able to negotiate for the surgical services that were provided at another surgical centre, and we were able to lower the cost of the procedures, surgeries, and that excess cost that we lowered for the surgeries we were able to put back into additional surgical programs at Pan Am. Mrs.

Driedger: Well, certainly, the contract ran out at the Western clinic, and the Western clinic felt that they needed more funding to cover 15 extra minutes of what they were actually putting in to do surgery. So, if they were doing cataract surgery, they felt they needed an extra 15 minutes, and the Government was not willing to offer that to them. So, basically, Western lost the contract.

4624 LEGISLATIVE ASSEMBLY OF MANITOBA August 7, 2002 You know, when the minister is out talking that he has made things cheaper at Pan Am, what happened at Western does not seem to have much bearing on what happened at Pan Am. It was just a matter of whether or not they were going to agree with the price the minister was going to pay, and if the minister did not want to pay it, you know, they have enough business that they can carry on doing whatever. Where is the minister's proof? I mean, he is going around saying that he saved all of this money.

How much money has he actually saved and where is the proof, and why is it only in cataracts? If he, in fact, is saying that he is saving money by doing surgeries at the Pan Am Clinic, his claim to fame on saving money rests only with cataracts. If the Pan Am Clinic was so good and so efficient to save him money, why is it only in cataract surgeries? That does not even make sense. If the Pan Am Clinic was doing what it should be doing, it should be doing that across the board on all the insured service surgeries that it is doing, not just cataracts.

So why can the minister not provide proof of his savings which he claims that Pan Am can provide? Why can he not provide proof that he is actually saving money at Pan Am, and why is it only with cataracts that he seems to be focussed? Mr. Chom iak: Mr. Chairperson, I love the way the member rationalizes. The member says, well, Western surgical did not want to do it anyway and so that is really not a saving. Let me just try to make it simple: a thousand dollars for cataract surgery at one location and $700 or $750 at another location. The member can do the math. Each procedure costs less.

Ergo, if you put the same amount of money in, you can do more procedures. A thousand dollars at one location, a negotiation down to provide, if memory serves me, $700 or $750 per procedure, that is a saving any way you cut it, no pun intended. That money has allowed us to do additional surgeries. I do not know what further proof the member requires. The member says, well, they did not want to do it anyway; they are going to make money doing something else. Mr. Chairperson, we were able to negotiate a cheaper rate for a procedure.

The member says that nothing new happens, that we are not reforming, that we are not innovative. So we negotiate a cheaper rate, and the member says: Well, that is not sufficient proof. I do not know what more we have to do to outline that factor for the member: $1,000 a procedure, $700 or $750 a procedure, negotiated downward, cheaper to do. It is cheaper to do it at $700, $750 than at $1,000 a procedure. Mrs. Driedger: Can the minister tell us why he can only quote savings related to doing cataracts and he cannot quote savings related t9 orthopedics, which is really what the Pan Am Clinic is focussing more on?

I understand they are moving away from doing cataracts. I understand that those numbers are decreasing. So, if the Pan Am is so efficient, why can the minister not quote savings related to orthopedics or urology, for instance? Mr. Chom iak: Mr. Chairperson, the member made the point two questions ago. She said it cost more money to do procedures in tertiary care facilities versus community facilities versus day hospitals.

Our plan is to do more day surgeries not in tertiary care facilities, which the member herself said were more expensive, but to do more surgeries, more day surgeries, more orthopedic surgeries in non-tertiary facilities, i.e., community hospitals and day surgical centres. That is what we are doing. That is what we are in the process of doing at this very moment. I suspect that the member will criticize us for moving surgeries from a tertiary care facility to a community hospital, but that is what we are doing. * (16:10) Mrs.

Driedger: The minister probably needs to be just a little bit careful about making assumptions. I have never complained about the moving of, say, orthopedics out of a tertiary centre and into a community hospital. So I think he is grasping a little bit and getting a little carried away with his rhetoric, because certainly if that is going to make the program work better and it is more efficient and it can meet the needs of the orthopedic program, for instance, then I do not see anything wrong with it. So the minister's rhetoric is a bit out of line on that one.

If he is saying that the Pan Am Clinic is so efficient, and we have created this clinic that is

August 7, 2002 LEGISLATIVE ASSEMBLY OF MANITOBA 4625 so efficient and able to save money, why can he only quote savings around cataracts and not around orthopedics when orthopedics is the bulk of the surgery that is done at Pam Am? Are there no savings then that he can quote and table for us, in fact, around orthopedic surgery? Mr. Chom iak: Mr. Acting Chairperson, I know the member would like us to do all of this tomorrow. We are in the process now of moving orthopedics around the system. Mrs. Driedger: The minister is avoiding answering my question on Pan Am.

You know, certainly the minister has said that he would like to move some procedures out of tertiary hospitals. That makes sense to me. It makes good sense because the overhead costs in a tertiary care centre are certainly much higher than in a community hospital, and the costs in a community hospital are higher than in a clinic. So it would make sense certainly to look at efficiencies in the system by having more clinics doing some of these surgeries, but the minister can only quote one clinic. That is the Pan Am Clinic, and that is all he can quote.

So when he is saying that he is doing more day surgeries, it seems he is still doing them in the more expensive areas. He is indicating that more orthopedics hopefully will be done at Pan Am. I will be watching that very carefully because so far, as of February, the average that they were able to accomplish from September, where they only did 69 surgeries that month, February they did get up to 158 , but all of that averaged out to 13 0, which if you extrapolate that over a year, it is just going to be slightly over 15 00 surgeries and nowhere near the 3000 that they promised Manitobans. In fact, the Premier (Mr.

Doer) was talking about in his franking piece that he sent out to his constituents saying that they were already doing 3000 a year. So far, those numbers are not adding up, and, certainly, the minister has all of this rhetoric that we are saving money, but he cannot provide the proof that he is saving money. He has indicated that he has been able to save all this money from cataract surgeries. Why can he not provide the proof, and why are there, then, not those same efficiencies achieved in orthopedics if the Pan Am Clinic was so wonderful at doing what it is supposed to do? Mr. Chomiak: Mr.

Chairperson, the member referenced the savings with respect to the Regional Health Authority previously, and I pointed out to the member that the member had misinterpreted the financial data with respect to the annual report. Let me read from the audited financial statement of the Winnipeg Regional Health Authority: The Health Authority produced an excess of revenue over expenses for the year ended March 31, 2000, of 663,000, leaving an accumulated surplus of 4.8 million. Total revenue for the year was 1.93 million. Expenses were 1. 92.

Of these expenses, 201 related to programs managed directly by the Health Authority, while the balance was flowed through to acute community and long-term care agencies. The direct service program expenses including home care operations, primary health, public health and mental health along with medical numeration, the Health Authority has fully assumed these programs which in large part accounts for the increase in expenditures. For example, the former City of Winnipeg public health program and acute care medical numeration were assumed in January of '99.

In addition, the Health Authority was fully operational during the year as opposed to 1999 which was a ramp-up year. This caused an increase in costs in absolute terms. RHA administrative costs remain comparatively low as a percentage of direct operations management at 4.9 percent. Further to this, the Winnipeg health care system as a whole incurred $40.2 million in administrative and support service costs in 2000 compared to 41. 7 in 1999 which represents 5.5 and 6.5 percent of direct program costs respectively.

The audited financial statements of the Winnipeg Regional Health Authority speak to the point that the member has misinterpreted over and over again, Mr. Chairperson. So I just put that on the record for clarification for the member with respect to an issue that she continues to deal with. I also have indicated to the member that the number of monthly surgeries at Pan Am has

4626 LEGISLATIVE ASSEMBLY OF MANITOBA August 7, 2002 risen significantly, and we are on track to increase and to achieve the levels that we are predicting, Mr. Chairperson. I have also indica ted that we have had significant savings with respect to programs. I know the member wants us to provide programs and privatize certain surgical pro grams. I know the member has advocated strongly for private surgical facilities, but we have been through that debate last year, and I am not sure if we should revisit that debate over and over and over again. Mrs.

Driedger: Can the minister indicate again which audited statements he was referring to? Mr. Chomiak: I think they were the ones that were provided in the House by the member when the member raised the issue a while ago. I simply read from the audited statements that the member provided in the House. Mrs. Driedger: Which year is the minister reading from? Mr. Chomiak: The reports that we are reading from are from the annual report of the Winnipeg Regional Health Authority. Mrs. Driedger: The minister seems to be having difficulty understanding my question. What year of audited statements is he reading from? Mr.

Chomiak: '99-2000. Mrs. Driedger: What year did the minister purchase the Pan Am Clinic? Mr. Chomiak: September 2001. Mrs. Driedger: Can the minister then indicate, he was reading something from the audited statement that was prior to the purchase of the Pan Am Clinic, so can he tie the two together as to why he would be reading something from statements that were well in advance of when he purchased the Pan Am Clinic? Mr. Chomiak: No, Mr. Chairperson, what I was outlining for the member is the member is indicating that there had not been savings at the Winnipeg Regional Health Authority.

I was simply reading the audited statements to the member in reply to a previous question raised this morning. Mrs. Driedger: Mr. Chairperson, there has to be a name for this kind of skating around accountability related to the questions. I know that the minister does have not the proof that the Pan Am Clinic is saving money. In fact, if one were to look at the cost of cataract surgery at the Misericordia Health Centre, for instance, and the cost of a cataract procedure at the Pan Am Clinic, it is virtually impossible to be able to put a price tag on what it would cost at the Misericordia Health Centre.

In fact, an FOI that I received asking for a comparison of cost to do cataract surgery at the Mis and the cost of doing cataract surgery at the Pan Am Clinic said they were unable to cost out a cataract procedure at the Misericordia Health Centre. It was not possible within our existing financial systems.

So, therefore, how can the minister tell us he is saving money by doing cataract surgery at the Pan Am, when his own FOI tells me that there is no way to do a true cost comparison between what it actually costs at the Misericordia Health Centre, because overhead costs are not able to be figured at the Misericordia Health Centre? So there is no true way of being actually able to distinguish costs. That is a problem in our health care system, and the minister well knows that until we have an information technology system and the kind of database we need, it is very difficult to compare costs.

You can compare fee-for-service of what it costs a physician. A clinic can tell you what their overhead costs are because a clinic can much more readily do it. The hospitals cannot do that because we do not have a way of putting price tags on procedures in hospitals. So, in fact, his own FOI indicated to me that they were unable to, well, in fact, it was probably from the WRHA, that they were unable to cost out a cataract procedure at the Misericordia Health Centre, that it was not possible within our existing financial systems. So how can the minister claim but not provide proof that it is cheaper?

August 7, 2002 LEGISLATIVE ASSEMBLY OF MANITOBA 4627 * (1 6:2 0) Mr. Chomiak: Two points, Mr. Chairperson. First off, the contract entered into with the private facility was a couple of hundred dollars more than the cost at Pan Am, point one. Point two, Mr. Chairperson, the member in her own statement said, and I quote, it is cheaper to do services at community hospitals and day surgeries than at tertiary care facilities. The member made that point herself.

It is well acknowledged that the overhead costs associated with a stay in a tertiary care facility versus care in a community hospital ver sus care in a day surgery centre is substantially less, Mr. Chairperson. That goes without saying. Mrs. Driedger: Well, the minister has to admit that within the way we fund our tertiary, our hospitals, really, with global funding, there is no real way to put actual price tags on that. We do have a sense that everything is cheaper.

In fact, the minister acknowledged it in his own news release that the efficiencies that the Pan Am had achieved as a private clinic and the cost-effectiveness of the Pan Am as a private clinic were the reasons that attracted him to wanting to buy it. So the minister has certainly acknowledged that there was merit to what private clinics could provide in the system.

While the minister indicates that I advocate for private clinics, we did debate on his bill, and the minister neglected to mention that it was publicly funded private clinics, where the private clinic would bear the cost of the overhead, and the Government would pay for the cost of the service so that no patients had to pay for anything. So, if the minister wants to run around saying that I advocate for private clinics, he might want to throw in there that I advocate for publicly funded private clinics, which is quite different.

But it is his fearmongering that takes him down that road and his ideology that takes him down that road, trying to stir up public fear around the area. But, certainly, if he wants to be factual with what he puts out there, he certainly might want to indicate that I am in favour of medicare and I am in favour of publicly funded but private clinics. Why would we not be, when the minister himself acknowledged how well run Pan Am was as a private clinic, how cost-effective it was?

I mean, I could pull out his news release and if the minister wants me to, I can read off all of his accolades about the Pan Am Clinic and why he bought it. He certainly had wonderful things to say about what they were like when it was a private clinic. That was the reason he said he chose to buy it. So there is certainly merit, obviously in his mind, with private clinics and that they can do some good, and certainly there is an appearance, and a very likely probability, that they are more cost-effective than hospitals because they are able to actually track their costs,

whereas under global budgets, hospitals cannot do that. But it is obvious, from what we know so far, and what we can determine with the dollar signs attached to everything out there, that there are efficiencies that you can achieve with private clinics, but it is very difficult to say what that same procedure might cost in a hospital because we do not have the systems in place to be able to tell us that.

But the minister is indicating that certainly, with his purchase of the bricks and mortar of the clinic, he has been able to achieve some savings in the system and yet, when a reporter asks him to prove it, he cannot prove it. When I ask him to prove it, he cannot prove it.

In fact, it will be interesting to watch what happens with the Pan Am Clinic and to see if the minister, down the road, will come clean and provide us with the savings that he is proclaiming that the clinic can actually provide, and if they will actually be able to do what he is saying they can do, and that is 3000 surgeries a year, because they certainly, up until February of this year, have not been heading in that direction. I do know that the minister has sunk more money into buying equipment there. In fact, the last time we checked, they have put another $40,000 into buying new equipment.

So, in fact, the transition costs themselves were $76,000. So the purchase of the bricks and mortar has now become more than the $4 million with the addition of more equipment that needed to be put into the Pan Am Clinic. We certainly will be watching, as I said, Mr. Chairperson, on this area because it is important

4628 LEGISLATIVE ASSEMBLY OF MANITOBA August 7, 2002 that we look at doing more day surgeries, and while the minister has indicated that he is going to be doing more, he still has not chosen the most cost-effective place to be doing them. He is still keeping them in the hospitals, and according to the Manitoba Centre for Health Policy and Evaluation, we are only going to have enough beds in the system in the future if we continue with the trend started in the nineties to do more day surgeries and move those surgeries out of the hospitals. So what is the minister's plan?

Is it just to have the Pan Am Clinic and then do more day surgeries in community hospitals? Are the community hospitals not already maxed out in terms of the number of day surgeries that they are doing? Mr. Chomiak: I do not understand what part the member did not get. Additional surgeries in Steinbach, surgeries in Ste. Anne, surgeries in Thompson, moving obstetrical surgeries from St. Boniface Hospital to Concordia Hospital, over 200 surgeries in July at Pan Am, Mr. Chair person. I do not know how many more times I have to go through that data. I will go through it again.

Additional surgeries in Steinbach, surger ies in Ste. Anne, surgeries in Thompson, additional surgeries at Pan Am, moving of surgery from St. Boniface tertiary care facility to Concordia community facility. I do not know how many more times I have to indicate that. Now I am going to jump to another issue because I- Mrs. Driedger: Just clarification, the minister talks about Thompson, Steinbach, Ste. Anne-I am talking about day surgeries. Is he talking about day surgeries when he says he is moving surgeries and doing more surgeries in Thompson, Steinbach and Ste. Anne?

My question was around day surgeries and is his response about those hospitals related to day surgeries? Mr. Chomiak: The member is asking about day surgeries then. More day surgeries at Pan Am, Mr. Chairperson, more obstetrical day surgeries at Concordia I understand, and I believe some of the surgeries with respect to the Ste. Anne and Steinbach are day surgeries, but I will confirm that. In fact, I am almost certain of that. * (1 6:30) Mrs.

Driedger: Well, I am asking the minister then because, while there may be some day surgeries going on in those facilities, according to the Manitoba Centre for Health Policy and Evaluation they have indicated that we need to continue with the trend to do more day surgeries. I would

Document details

Collection	Manitoba — Debates (Hansard)
Citation	37-3-77b
Type	hansard
Volume / chapter	37th 3rd hansardpdf 77b.pdf
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	6603f6b7d145e899e864a0de76cbddcabb92350a

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