Manitoba Hansard — 9 May 1975 (Sitting 80, 30th Legislature, 2nd Session)

30-2-80

Manitoba — Debates (Hansard)

TH E LEGISLATIVE ASSEMBLY OF MANITOBA 2:30 o'cl ock, Friday, May 9, 1975 INT RODUCTION OF GUESTS 2333 MR. CH AIRMAN: Before we proceed this afterno on, I would like to draw the attention of the honourable members to the gallery where we have 30 students of the Tuxedo Shaftsbury School, Grade 11 standing under the di rection of Mr. Perrett. The school is located in the const ituency of the Honourable Member for Charleswood. We also have 12 students of the Sanford Collegiate under the direction of Mr. Hew.

This school is locate d in the cons tituency of the Honourable Member for Morris, On behalf of all members of the Ass embly I bid you welcome this afternoon. SUPPLY - HEALTH AND SOCIAL DE VELOPMENT MR. CHAIRMAN: Page 23 of your Estimate Books. Resolution 55(a)(2)-- The Honour able Member for Fort Rouge. MR, AXWORTHY: Thank you, Mr. Chairman. I just want in this warm-up period to perhaps pursue some of the questions that we began to look at this morning and I was som ewhat intrigued , Mr.

Chairman , and I direct my co mments through you to the Minister, about the way in which the estimates of this department are pres ented.

As I listened to the Minister present his des cription of activities and his re-definition of the new organizati onal chart, the thought struck me that this kind of des cription has been heard many times before and yet still begs the fundamental question and that is, with all the resources being applied to the Department of Health and Social Development and with all the reorganizing of individuals and to different kinds of position and to new organizational arrangement, is the health and welfare of Manitoba any better off as a result of all this. It seems to me , Mr.

Chairman, that one of the things we desperately lack in the presentation, or have lacked in the prese ntation of this repo rt, is so mething perhaps similar to what we receive when the Minister of Finance presents a budget where he at least tries to give some indicators of the economic health of the province based upon certain investment figures, or employment figures or what ever the case may be.

And yet when we come to a department which co nsumes almost a third of that budget, we are not really given any information to find out whether over the succeeding y€ars, the particular quality and standard of health or, the standard and quality of the position of those in lower income which is the other part of the responsibility of the department, have perspectively andm easurablybeen improved or changed.

And that it really isn't fair in many cases to try to establish for memb ers of this co mmittee some rationale for determining whether in fact the Minister is living up to his respo nsibilities as he' s supposed to simply by talking about really what are mechanical things. Because I would suggest to you, Mr.

Chairm an, that you can talk about new progr ams, I think the Minister talked about new geriatric programs and new alternate care programs and new pharmacare programs, without really saying whether in fact the kind of conditions that those programs are suppo sed to meet are any worse or any better or what are we aiming at when we introduce these progr ams ? What kind of thing are we trying to do with that program. Are we simply trying to enable older people to live longer ? Are we trying to insure not only do they get old but that during their elderly years they in fact live a healthier life during that.

Is it simply a survival philoso phy or is it in fact an impro vement philosophy. And yet increas ingly, I find myself - I think I share or am really part of a large group of people in this pro vince who are beginning to wonder about some of the relevance of these programs , in terms of whether we keep extending them, expanding them, enlarging them, changing them, altering them, whether we end up really any different, any better off than we were before.

I'm not saying that that isn't so , I'm just saying that the Minister and his department and this executive function has provided us with really no basis for determining that, and we're supposed to sim ply judge upon new programs in a vacuum, and simply saying, are we supposed to agree that all new programs are good and all old programs are bad or are we supposed to be much more realistic and say, here is a condition that had to be met, that is here is a certain number of people in the province who are facing certain problems and we want to improve their condition to this poin t.

We want to improve their nutrition, we want to improve their ability to be mo bile, we want to improve their ability to make a living , we want to improve their ability to enjoy clear air, whatever the condition may be, and that's what the new program is trying to do . Instead we got kind of a mechanical list of what we're doing and what we're not doin g

2334 May 9, 1975 SUPPLY- HEALTH (MR, AXWORTHY cont'd) .. ... and how we're economizing without really saying what the impact is going to be, what the consequences are. I would suggest, Mr. Chairman, that it is for that reason that the Department of Health and Social Development has become as gargantuan and as unwieldy as it is simply because we sort of keep adding extensions and additions on to this initial structure without really knowing why we're doing it.

Someone comes up with a helluva good idea and is able to get some Assis tant Deputy Minister to think it's a good idea and the memos go through and the Minister who is also trying to put out fires with doctors and everything else says well okay I'll pass that and signs a slip and off we go, and before you know what was an experimental program then becomes a demonstration program, a demonstration program becomes a committed program and before you know it, you're into four or five million dollars and you end up sort of saying hey, where have we gotten to, and has it really changed things very much.

And I would suggest if you begin to look at some statistics or indicators, and I don't have them all in front of me, Mr, Chairman, but I am raising this kind of question for this reason, is that we don't really have, I guess if you want to call it a state of the health kind of position put forward by the Minister, we really have a program, organizational statement which really is pretty useless when you get down to it, you know, and when you really fundamentally look at it, it's a pretty useless statement that the Minister provided because it doesn't tell us an awful lot other than he's got ...

It's like saying that I've shuffled the chairs around on the deck of the Titanic, yes, we've moved them into a different location. The ship still may be going down but we're going to be going down in a different somewhat seating arrangement than we were last year. I find that to be a really kind of a sad commentary that when we're spending well over $3 00 million, it's a pretty substantial amount, and when we are trying to -- (Interjection) -- Oh my God, we're sinking, that's right. I would like to raise that, Mr.

Chairman, because I think that there are some critical issues that haven't been faced in this department concerning the capacity of the Department of Health and Social Development to identify some of the areas of interest that should be looked at and because they may not fit a particular philosophy or a particular approach are not being looked at, and whether really in fact that there is, at the present time, the reaction time and the response time to these issues that there should be.

So as a result we are simply extending and promoting for the sake almost of extension and promotion as opposed to having clear-cut objectives. And where that becomes a serious concern to me, Mr.

Chairman, is in this re spect, that when we run into a problem which I think we all face - and I don't put special blame upon the present Minister of Health and Social Development, in fact I would cover this total Legislature with the allocation of blame - when we look at the kind of almost expediential growth in health cost care that we're facing, I suppose to the point where if it keeps going the way it is we could easily bankrupt the province in three or four years if we just simply kept on the same line of thought.

One reason why we're heading that way is that we don't know what we're trying to do with health care. We don't know what kind of direction we're aiming at be cause we don't have really a measure of what we're trying to achieve with it. Are we trying to say we should be eliminating the incidence of cancer in the province in order to allow people who are over 45 who have by far the highest morbidity rate with cancer to live healthier lives within that period, and is that why we should be putting more money into cancer research a�d surgery and all the rest of the preventative progtall'.ls.

Or are we trying to say that we're trying to deal with the sort of state of mental health in the province, and I must paraphrase that, Mr. Chairman, by saying some of the interesting statistics that I did come across was that Manitoba leads the country in terms of psychiatric admissions. A MEMBER: F-ive years of NDP government! MR, AXWORTHY: Well I was going to say, and I think the only cause I can find in the change of statistics is from the point of time when this government got elected, Two things happened. We began to admit more people into mental institutions and the suicide rate jumped.

And I think the suicide rate jumped particularly around the Richardson Building and the Lombard area of Winnipeg and people hurtling themselves out of windows because of economic depression or something, but the fact is that here is some interesting and somewhat, I suppose alarming, statistics that presumably the mental health of Manitobans is not as good as it should be, MR. DESJARDINS: On a point of order, just for directions. I was under the impression that this year there was an agreement that we would keep the Minister's salary to the end and

May 9, 197 5 2335 SUPPLY - HEALTH (MR. DESJARDINS con t'

d) o ... 0 talk about this kind of policy or generalities that the honourable member is speaking now. I thought that this was the idea, to go line by line and then finish with that and I see that we're covering the waterfront right now. I don't really care but I would like to have some direction on that to know what we're supposed to do. MR. CHAIRMAN: The poin t is well taken. I would caution the honoura ble member to address himself to 55(a)(2). And before I recognize him again I would like to draw • Order please. Or der please. INTRODUCTION OF GUESTS MR.

CHAIRMAN: Before I ask the honourab le member to continue , I would like to draw the attention of the honourab le members to the gallery where we have 30 students of the Arden School, Grades 5 and 6, under the dire ction of Mr. John To ews. This school is located in the co nstituency of the Honoura ble Member for Gladstone. On behalf of the mem bers of the Chamber I bid you welcome this afternoon. The Honourab le Member for For t Rouge. SUPPLY - HEALTH AND SOCIAL DEVELOPMENT Con t'd MR. AXWORTHY: Well, Mr.

Chairman, --(Interjection)-- Yes , I'd like too Well I think that in present circumstances it's more than easy to keep cool I think because we're al most being frozen out by the kinds of answers we're being given. I simply want to suggest, Mro Chairman, that on the point of order raised by the Minister either I'm mistaken or he's mistaken, but I would like to suggest to him that under 55(a)(2) we are talking about the execu tive function of government. We're talking about salaries being paid to senio r policy makers in his department.

And as I listened to his introduction he in fact pointedly and directly used that introduction to suggest that he was reorga nizing the department to gain better policy ad vice, to provide better admini stration and more effectiveness, and I would say that if we are talking about the executive function being performed by the administrative organization of his department under

Section 55(a)(2) then that' s exactly what I'm talking about. Is it being orga nized to deal with the kind of pro blems we have to face with. And I don't intend to cover the waterfront , I intend to co ver matters dealing with Health and Social Develo pm ent. If he wants to deal with the waterfront, he should go and deal with the Harbour Boa rd Commis sion in the federal level. Because I want to deal really with the capacity of his present organizational structure to co pe with the kinds of requirements that this House has in determining whether he is policy -m aking in an effective way or not. MR.

DESJARDINS: Mr. Speaker, it' s immaterial to me how we proceed , but I was in formed that I had up to an hour to introduce my estimates - and that of course was left to me how to us e that, that wasn't under (2) at all, it was just when my estimates started - and that we were then going to go line by line, that after that we would finish with the Minister's salary, that we could cover the whole department. Now, you know, there's always many ways to get around some way, if we don't want to deal with it this way.

He' s not right when he says that this item is dealing with all the senior people and the policy makers, it' s dealing with the Deputy Minister. And I guess he can stretch the point and make the same speech on the Deputy Minister' s salary if he feels that the Deputy Minister is running the department. This is fineo I'm not going to quarrel with him, I just want him to know. You know, I've been here four mon ths , I could probably get a darn good speech that my staff could write and really try to con these people across the aisle.

It is a very big depart ment, I thought it would be much better to go line by line, to talk about exactly the programs that my friends want to talk about. It would certainly be of some benefit to me and to them, I'm ready to accept any criticism, any co nstructive criticism and I'm not compla ining. If this is your wish or this is the wish of the Opposition that we are supposed to go back to what we were doing befo re, start and stay on this and cover the whole department, that's fine. And my honourable friend is right. That's the question. Am I right or is he right in our understanding?

But I want you to know , Mr. Chairman, and my honoura ble friends that I'm not complaining. I just want to know what rules we're playing with. You know, he could stretch this and say this is the Deputy Minister. He' s right. I'm not going to argue with him but was that the intent of this Hou se when they changed the rules or agreed to change the rules ? MR. CHAIRMAN: Order please. I think the point is well taken. I think if the honoura ble

2336 May 9, 1975 SUPPLY - HEALTH (MR. CHAIRMAN cont'd) ... •. member wants to debate the general policy of the department, it is under the Minister's salary. The Honourable Member for Fort Rouge. MR. AXWORTHY: Well, Mr. Chairman, I don't want to belabour the point because I think the Minister's belaboured it much too long already. But I would like to suggest to him - and I don't intend to give the same speech when the Minister's salary comes up, I have a totally different speech about his own personal capacity to carry out the job.

What I am concerned about at this stage is in his introduction and on his development of this particular line of argu ment as we got into it this morning, he is describing the re-or ganization of the department into a new form of division of responsibility between one Deputy Minister who is looking after ad ministration, one who's going to look after policy. We are trying to find out whether in fact that is the way in which we should be approaching the problems of the department, and I certainly intend to go line by line because in a lot of them there are very many important and specific points.

But what I am trying to suggest to the Minister now, if he cares to listen, is that in deal ing with re-organization and dealing with the attempts to construct a departmental structure and approach that would enable him to carry out the executive function, which is in my mind a sense of overall planning, overall co-ordination, overall sort of assessment of the relevancy of programs, I'm saying that at this point we don't have any such thing. And if we have to make a specific criticism under this point, that's the criticism we're making.

I don't care how many Deputy Ministers he re-organizes or shifts around or puts into new chairs or sits down sort of, whether he has sort of an advisory board, or doesn't have an advisory board or whatever it is, the fact of the matter is that I think that the department is still basically really a haphazard one.

And that it doesn't really have any relevancy because it doesn't know what it's trying to do, it's simply trying to sort of decide things as issues arise as opposed to trying to zero in and focus on specific objectives related to improving certain health conditions, whether it's to deal with people who are unhealthy and we want to make them healthy, or try to keep people who are healthy in the same state. I was simply using the illustration that

whereas when we received in some cases the presentation by other Ministers looking at the function of their executive part of their depart ment, we are able to make some judgments about the relevancy of those structures by having indicators to determine whether in fact there is some success or failure, and I'm simply say ing, here all that we have is a description of programs. And frankly programs in a vacuum are really pretty irrelevant. They may achieve something, but if you don't have anything to measure them against what's the point of doing them.

I think that is the fundamental fact that we're trying to aim at. I would take your advice, Mr. Chairman, I don't want to cover the whole department, I think that that is not my intention, but I do want to raise some very serious reservations really about the present planning and organizational function of this department in terms of what it is trying to achieve.

Particularly because of its immense command upon the budget of this government and particularly because we must sort of be sort of adjusting ourselves to the question of do we presently have the executive capacity in this department to relate expenditures to actual functions and purposes so that we can ensure that we're going to get some real results from our money, because we, frankly, can't do everything. We have to begin deciding what we want to do. If this is the place to bring it up then that was the point of my remarks.

And I think that in carrying out with that I would simply suggest that the Minister would have been much better spending his time rather than trying to rebut a procedural matter, trying to suggest or at least concede that perhaps he was not right, or that improvements will be made by the time we get to the same part of the estimates next year, in being able to present to this House a realistic appraisal really of the state of health of the province in terms of pro viding specific indicators and then determining really how he has set up his reorganization to focus upon those. And in saying that, Mr.

Chairman, I would like to then continue to ask the Minister some questions because I don't think that we got full answers this morning, and I'm sure there are full answers available, really about the, not only the organizational connections inside his department but really the relationships that have existed by those other sorts of creatures of government that have emerged in recent years called Planning and Priorities and HESP and all the rest of it. Because there was a time, Mr. Chairman, when I believe that HESP was the sort of godfather of health and social policy in the province and every time someone wanted

May 9, 197 5 2337 SUPPLY - HEALTH (MR. AXWORTHY cont'd) •.... to do something there was some directive or fiat coming down from this thing called HESP. Now I find out that the Minister of Tourism and Recreation is actually chairing that and while I have great admiration and confidence in the Minister of Tourism and Recreation, I think it would be useful to know where is the planning and policy making function residing at this present time? Is it in this new structure that the Minister talks about? Is it in HESP? What does HESP do? Is it simply to evaluate what comes up through the department itself.

Did the policy planning group or whatever it is the Minister described sitting in the department actually develop it and HESP just evaluate it or does it come from the top down. Those are the kind of things that we are concerned about in this initial stage to determine whether in fact we have the kind of machinery that we should have in order to get proper health and social planning in this province. So perhaps we can start on that. MR. DESJARDINS: Well, Mr.

Chairman, I will try to expend a little more to satisfy my honourable friend although I must confess that I didn't realize that I would have to answer for HESP at this time but I see where my honourable friend has a valid point when he talks about planning in this field of health. And I purposely did not go into details in my introduction.

As you know, I haven't been in that department very long, I guess that everybody that takes over certain responsibilities sees different things as a different style and starts by what he thinks himself is his responsibility, are his priorities to do the kind of things that we all want, and I don't think that there would be much of an argument if we started talking about what we want for the people of Manitoba in this field. I will try, nevertheless, to give him an idea of how I see the planning taking place. First of all I should explain that HESP is nothing more than a sub-committee of Cabinet.

There's been too much work in Cabinet, you meet once a week or so, there's so much work and that you want to give it a little more, should I say, study and so on,so the Cabinet has been formed, there's been certain committees, sub-committees and HESP is one of them.

So Cabinet might have certain programs that they normally would originate, they will ask HESP to develop it and there are certain things that are very important that might originate in our department or in the Department of Education and so on and instead of going straigh t to Cabinet, the routine is that we go to HESP where these people will scrutinize a little more and then the minutes of HESP, like all the minutes of sub-committees have to be approved by the Cabinet.

My honourable friend mentioned the question of planning and, you know, maybe I'm going to walk a tight-rope because I can only say what I personally feel. I was away from the govern ment, I was away from this House for a year and I did work in this field of health and I've had some impressions, some feelings and I don't know if this will meet with the approval of my colleagues on this side of the House.

But I must say that I felt that the planning in this depart ment left an awful lot to be desired, my honourable friend is right, and we had a situation where the people didn't know who was doing the planning for what and it was that there was very little planning, there's so much going on in this department that you had, you know, these pro grams were right on you and there was not enough long-range planning.

In the last year, not just now, the last year I think that the Minister, with his staff, and I was a member of his staff during that time, I think we tried to remedy this and my honourable friend is probably talking about the White Paper which - they had a staff of HESP, the present Deputy Minister of the department was the secretary of HESP at the time and he developed through the guidance of Cabinet and sub-committee of HESP, and I certainly don't think that any responsibility has to be placed, or credit has to be placed on the shoulders of any members of the staff.

This was the sub-committee of HESP that wanted certain policies and the staff of HESP at the time, the planning in this field was mostly left with the people on HESP and that created difficulties at a time - there's no point in hiding that - at the Commission, for instance, the Manitoba Health Service s Commission, but this was rectified about a year ago, that these people, most of the planning, many of these people were then assigned to the Manitoba Health Services Commission, we tried to set up a planning group out there and this is one of the reasons my honourable friend feels that I'm attaching too much importance in the changing of chairs or organizing the top echelon.

Well I can't quarrel with him if this is the way he feels, but I think it's the most important for me anyway, I see things in a different way, I have the responsibility. I'm not a conformist, I don't really believe that you have to go by the same style all the time of this routine that we've had. I think that a lot of that is passe, so in this large department I've tried to, instead of one or two persons having all the responsibilities,

2338 May 9, 1975 SUPPLY - HEALTH (MR. DESJARDINS cont'd) ....• there's an awful lot of administration and so on,so we appointed Mr. Johnstone as Associate Deputy Minister in charge of administration. There is a lot of programs.

The Manitoba Health Services Commission is more than an insurance group for the pro vince, you know, it's not that they don't really deliver the program like the department does, and this is very important because there's a lot of new programs that have to be improved and my honourable friend, the Leader of the Opposition this morning was talking about single unit delivery which we definitely are trying to do. So the Deputy Minister is focusing on that. He is going to try to make these programs work. At one time he had to look at administration and so on and there was too much.

It became a bottleneck as far as I'm concerned and this is not what we wanted. Well the Deputy Minister will look at the delivery of the program and this has been organized with two Assistant Deputy Ministers. This is the - I shouldn't say it's the important part of the department, they're all important, but this is where the direction is going. Then we have a group of medical people in the department who I felt should be elevated to work like professionals and so on and that they could certainly serve the department as advisors in this field and so on and we could make better use of them. So we had Dr.

Tavener as the Chief Medical Consultant, to co-ordinate their efforts, to act as a liaison, we were talking this morning of having liaison with different people that work in this field who are experts and this is what we want to do and we are using Dr. Tavener and the staff of doctors to work on this. The Commission, well we'll come back to the commission later on. We have a director out there and there's a bill in front of you to have some minor changes in the commission because there is no idea to con anybody here.

There is no doubt that the policy even at the commission will be determined by the government but that leaves an awful lot of work for the commission. Now there are two other important steps that are not completely finished and one is in the planning - excuse me, there is something else that has been decided since then that I forgot. Instead of just talking to one or two fellows or having a fellow that might have been a farmer or a funeral director who all of a sudden won an election as a Minister of Health, doesn't become an expert from one day to the other.

So to take advantage of the knowledge that different people have, the senior people set up a policy committee that meets every week with the senior people in there as the permanent members of this policy committee and any other directors of any program is invited and they come as full members of the committee, it's an internal policy com mittee, and we either look at directives from Cabinet, either Cabinet directly or through the sub-committee of HESP or anything that might originate in our department, and we prepare this, we give it a good run.

What I am trying to do also instead of having just what we might call the idea people come in with a program that might look very good on paper but that might be very costly and so on, we have the administrators in there on this team, all these people that develop these programs or these papers will tell us what we'll be locked into and what will it mean in two years and three years and to see if there's a proper evaluation mechanism to see that this is a good pro gram that we should continue and also to consult and to advise in the best way to get some federal bucks in there and cost-sharing and so on.

So this is going to be done. We had difficulty with the institutions that are under the government in Selkirk and Brandon and so on, so instead of having just an administrator there has been an internal board of senior people, chaired by Dr. Tavener, the chief psychiatrist for the province who will be responsible for these hospitals. There's a very important one which my honourable friend talked about, it's the planning.

In my lack of knowledge I felt that we can build a large planning division that would do all the planning and so on and we gave this an awful lot of thought, and it came in that the planning - when I say planning, I'm talking about evaluation of what research, statistics and development of programs and so on, so this work is practically done now and I think we will set it up that I think we'll see that part of this planning team will be done at a higher level, at the policy com mittee close to the Minister and so on, the evaluation will be done by people that are not actually delivering the service because we want this a little removed.

It wouldn't be fair to have the same people develop the program, sell the program, be responsible for delivery of the program and then evaluating these programs, so this will be done mostly at the resource under Mr. Johnstone and so on. And then there's the one that will get the implementation of the program and so on. I'd be pleased to discuss that with my friend or announce it in the

May 9, 1975 2339 SUPPLY - HEALTH (MR. DESJARDINS cont'd) ••••• House when we've got something definite and final on that, we haven't got at this time. There is another area that concerns me very much. I think that in this department there is about $20 million that are going to outside agencies. I think one of the worst things that ever happened in this province and probably in other provinces, as far as I'm concerned is the LIP programs. LIP programs were coming in that were supposed to be make-work programs.

The Federal Government placed some money, and I'm not going to comment on how it was done because I don't know if any other parties could have done better, but this worked for a year or so and all these people then are running to the province because the Federal Government will drop them and the first thing we know we have programs that might be policy, might not be policy. So this has been a difficult situation. We need more staff than we have at the present to look at that. Unfortunately we haven't been able to give the information to people as fast as we would like to give them.

We want a board first of all that will look - I'm talking about in ternally now - that will look at the program to see first of all if it's government policy, to see if it makes sense, to see if there's not repetition and to see also if there are some programs that we have ourselves that this is not duplication and so on. This is a very difficult thing to do because everybody wants money from the government and they all do a pretty good job of lobbying.

I know that you've aware of that because I am sure that most of you have received letters from one group or another that the government doesn't want to give them the money and so on. So this is something that has to be looked at very thoroughly. I personally am very much in favour of voluntary work. There are certain things that are done now, and even through

an act of legislation, a responsibility of govern ment that is being delivered by some of these people. So this is another area that we're not completely set up and I hope that we will pretty soon and I think that this will improve the situation. As I said, I purposely did not go into all these details when we came in because I was under the impression, and I stand to be corrected if I was wrong, that this would be ex actly the best way because, you know, I would be accused of choosing the programs that I want. I have some terrific speechwriters that work for me.

I could have a terrific speech in no time and I thought it would be much better, there's no point in me conning me, and I've got a heck of a lot to learn. Also that if we went line by line and go with every single one, I'm not going to try to evade any one at all, any programs at all. We focus on a program and talk about the merits of the program and then having seen the weak spot of the department and so on that you would hit me at the end on the Minister's salary. So it doesn't matter that much to me how we do it.

I want to assure my honourable friend that I am not trying to evade anything, that I'll try if I haven't got the information, I'll try to get the information on any of the programs. Now I think that it's a little more than just mechanics. I think that this organization, which was started - it's not something that I started with, but started and gradually it's falling into place - it was started a few years ago. And I think that finally where we can spread the work and go to the top man for certain jobs, I think that we will be much better.

But that is not to say that the government has no idea where they're going, they have no policy at all, I don't think that's the case at all. As I said this morning, it is a department, it is an area where Manitoba has led in many ways and no doubt they'll make mistakes. You know, you can al ways find somebody that will wrap themself all in cotton batting and then lock the room or something, they're not going to be in trouble, they're not doing a damn thing. We'll make mistakes, we'll make a lot of mistakes, but I can assure you that it won't be because of lack of sincerity or lack of trying.

And I would hope, and I think this is the idea here today, that while we go through this exercise that the opposition will keep me and the rest of our staff on our toes and will point out if they feel if we're going in a direction that might not be for the best of Manitoba, and I think together with a strong opposition and with a government that cares, that we will be able to provide the kind of services that our people are entitled to, the people that I'm sure all of us would want to give them. MR, AXWORTHY: Thank you, Mr. Chairman. I appreciate the Minister's response.

I think that it's certainly much clearer now about the locus of where some of the decisions are being made, and I would hope that I didn't ... I was trying to listen quite carefully to what the Minister had to say, and I believe what I heard him say is that the former planning function, executive planning function that used to be exercised under the sub-committee of Cabinet, called HESP, has now been basically disbanded, and that the staff of that has been transferred

2340 May 9, 1975 SUPPLY - HEALTH (MR. AXWORTHY cont'd) . . . . • in part to the Health Services Commission. I believe that was in part, that would raise to me: First the question is then, does the Health Services Commission become the place where, in fact, we can assume that the overall plan of allocating resources into health will be determined. I also believe then he said that there was a policy group composed of senior members of the department that meet with the Minister on a regular basis to determine that.

I would like first to determine whether the White Paper on Health Care, having been developed by HESP, has it been washed out, or is it now being implemented, or has it been elaborated upon? Coming down to the point of, I'm still trying to determine whether when the Minister sits down to decide when he brings his estimates before this House, and it's getting these different kinds of reco=endations for program, in the health care field for example, whether there is some blueprint that he's working with at this stage, or whether that planning group has taken several steps back and is starting with a new blueprint.

And let me continue, Mr. Chairman, by saying that if there is such a thing, if there is some kind of rough set of guidelines as to where you're trying to push the health delivery system in the province, could we know about it? Do we know roughly what the basic priorities are at this stage? Well what does this policy planning group now say, at least in the interim before the final document is revealed to the world? Where are we now? What kind of priorities have been set by this group? And the other question, which I think was raised this morning, Mr.

Chairman, was, at what point and where exactly does the public get plugged into this? At what point do the many agencies, all the way from the professions, the medical professions, through to the other kinds of health agencies which are working the field, at what point are they asked to come in and determine whether their own activity fits this kind of internal blueprint that the Minister, I believe, says he now has some sense of what he's working on? I wonder if he could answer those two questions. MR. DESJARDINS: I don't want to mislead.

I am not saying that with the work of the White Paper group or HESP is all to be started over again. That's not the case at all. I think that it was clearly indicated at the time, during the last few years, what became policy. Many of these White Paper recommendations became government policy. There has been an awful lot of change in the last few years, and at the risk of disappointing the members of the oppo sition, I might say that this year I would want to hold back a bit and get the things that we've started going, make sure that it's done properly, because, you know, we've had so many things going on.

I'm not saying there's not going to be any new programs. We have the dental care for children; it's going to take an awful lot of work to get this thing going properly. There is this kind of work. Now the White Paper group was assembled, and many of them had been seconded from the Manitoba Health Services Commission, and they were preparing I guess what you could call the guideli nes in this field for the government, and this was done. Then when they tried to go ahead with these projects it caused a difficulty because of not always the best relationship with the Commission that was a bit independent.

This is what I'm admitting now. So discussing with the Minister at the time when the White Paper group had pretty well finished their group,or the planning group that had been seconded and attached to HESP; there was a reason for that, and now they have got this large staff at HESP and the planning will be done at the Department and the Commission. But a year ago most of these people were transferred to the Commission. We have received . . .

I think this is what we had during the estimates, when we went in front of Cabinet, this is what we hit for, mostly for people that would evaluate the program, the planners, and so on, and we had an increase of quite a few staff man-years in that direction, and we will work very closely with the Commission. Maybe I should say now to make sure that my honourable friend understands, instead of waiting until this bill goes through, that it will not change the Commission too much except it will make it quite clear that the policies will be the responsibility of the government.

It's no use pretending and playing games because no one would believe it anyway. So this is clearly the responsibility of the department, so the planning will be done in conjunction with the two groups. But now the policy committee - again I don't want to mislead - the policy committee hasn't got a mandate to say, here you're going to develop something like the White Paper did, it's.something that will always - while I'm there anyway - will remain. It is something that

May 9, 1975 2341 SUPPLY - HEALTH (MR. DESJARDINS cont'd) .•..• instead of having an idea that maybe somebody in the department somewhere thinks it's a good idea and they all of a sudden hit you with this, or bring it to HESP or something, will not go anywhere until it's gone through the policy com mittee, where it will have to be a pretty good program becaus e you'll have everybody taking pot shots at it, and it works quite a bit like the Opposition.

You have administrators that will find out, to see, yes this is good, but if you modify it you will be able to cost-share with Ottawa, somebody that knows these things, not just a fellow that has a good idea but doesn't know how to work it; another fellow will tell you what the cost will really be and what you will be tied in the next year, and the next year, and then you will have somebody that is responsible for the delivering of these programs and will say, yes on paper this is terrific but when it comes to deliver there is no way that it could be done unless you change this.

So it will be this kind of a committee. But, you know, there's no big thing that my honourable friend said that we are going to announce to the world in a few months, or sometb.ing about policy. We will take the policies as they come along. Now to try to tell you that I foresee in this coming year, a big announcement in this field, no, I think that we've got to do well what we're doing, there's a bit of re-organization. It's been done in steps and during the last few years.

Let's go back to even when the previous government was there, because I don't think that's an ideology thing, it's a big department, two departments that were fused together for certain reasons, because most of these deliveries is done by the same people through the same method. So I certainly will commit myself to any time that there is any direction of government, any new policies, to inform the House and to inform the public. MR. CHAIRMAN: The Honourable Minister of Tourism and Recreation. MR. TOUPIN: Mr.

Chairman, to set the record straight and the Honourable Member for Fort Rouge, I'd like to inform him in as clear a language as I possibly can, the Order-in Council appointing the HESP committee and its members is still in force. It hasn't been re voked.

There has been a change in the policy of the operation of HESP itself in regard to its main responsibility as intended at the beginning, and still remains, in regard to reviewing existing policy, in regard to contemplating new policy for the departments that sit on HESP, and any delegated policy pertaining to Cabinet, as intended to be reviewed by HESP, that is still in force. The working group as it was actually constituted is no longer with HESP.

The working group was sent back to the respective departments, being Education especially, Health and Social Development, and when a study is to be conducted in regard to reviewing a policy, whether it be existing or contemplated, a secondement of staff takes place from the given de partments to HESP, which is call ed HESPO, Health, Education and Social Pl anning Officials, that review the policy and make recommendations to Cabine t. Now Cabinet takes a decision pertaining to that recommended policy, whether it be had by the Pla nning and Research Sec retariats of the given depar tments or HESP itself.

But HESP, as was intended at the beginning, remains the ongoing .. . holding hands of administrative matters is no longer with HESP and in my mind was never intended. . . . • . continued on next page

2342 May 9, 1975 SUPPLY - HEALTH MR. AXWORTHY: Well, Mr. Chairman, I thought that I was clear when the Minister of Health and Social Development described it. I'm not so sure now that the Minister of Tourism and Recreation has got up to sort of redescribe it, really whether we're not back again in that kind of Byzantine maze work. It's no wonder, Mr. Chairman, that we don't have a very clear cut policy because if it has to try to . . . if any piece of policy tries to wend its way through all those channels, it's no wonder that I'm sure that the papers are bound to get lost in I don't know how many desks. Mr.

Chairman, I think that is the concern I'd raise. I sympathize in a large part with the task of the Minister trying to bring some cohesion to all these kinds of things, and I think maybe where we are at fault is that we've become so mesmerized by this planning func tion, or whatever it is, that we've almost sort of begun to think that you have planning if you have a number of people doing it, which I don't think is the case at all. What strikes me, Mr.

Chairman, in particular is that one of the causes for a high degree of confusion in the pub lic mind, and in the minds of professionals outside, and in the minds of those who are in the various parts of the health caring services, is that they don't know who is making decisions, and they don't know what the decisions are, and they don't know where we 're trying to head. As a result what happens is that everyone tries to make his case, and everyone tries to make his representation.

I would suggest that one of the serious causes of conflict presently in the province, as we see our kind of regular Friday afternoon demonstrations, or whatever they may be, is simply that I don't think the government has yet come clean as to what it wants to do.

I know that there's a certain reluctance to commit yourself to saying, here's where we want to go, but other governments have over periods of time- I know they use White Papers or Green Papers or Orange Papers, or whatever it is, and they intend to engender some discussion and some reaction so, at least, there may be the building of a consensus between all the disparate parts of the system. I realize just how large and really complex the whole health care delivery sys tem is in the province, there's just so many parts to it. But it seems to me that if each

part is simply setting its own objectives according to its own peculiar vested concerns without any relationship to some overall objective, then that's why we wind up sort of having people wanting more money and people wanting more programs, because they don't feel that . . . there's no sense of where they're aiming at, and that's the point I'm trying to get at. At what stage do we get from this government a very clear definition of saying, okay, frankly folks this is what we think has got to happen in the next five or ten years in the health care in the province.

These are the priorities, this is where we think the money should go, this is the way we want to do it. Now let's find out what you think. So that there is that kind of ability to react, to discuss, to consult in a fairly open kind of way, as opposed to - I really think what is happening now is that we're like a group of blind men trying to go through a mine field at midnight, that everyone is sort of inching his way slowly and sometimes panicking and jumping up and sort of running. As a result we 're having the kind of explosions that we get ourselves into.

I realize the Minister is new and sincerely I think that I'm encouraged in part by his honesty in saying that there wasn't planning going before, or that the planning that was going on was bad. I think it's a frank admission and I think one that we appreciate. But what I am ask ing for now is, where do you go from here?

Even if you want some time, and I certainly, for one, am prepared to say, take all the time you need between now and next year, at least, to come up with that kind of set of recommendations to the province about where we should be put ting our health dollars and where we think the real priority for health care is. But when does it come out open?

When does sort of the hospitals and the doctors, and the nurses and the para medical professionals and the health caring agencies and the suppliers and the public and the clients and the patients, and all the rest, when do we find out, and when do we get a chance to sort of react to this kind of thing so that through some procedure of exchange, we can at least develop a generally agreed upon set of objectives, and then I think many of the problems that the Minister now faces in having to put out fires and deal with angry clients, would be eased because there would be some common set of principles. MR.

DESJARDINS: Mr. Chairman, I'm now convinced more than ever that our real weak spot is a Minister that could really explain what's going on or some kind of PR department. Because what my honourable friend is asking for ... I did admit that we've had difficulties because of the planning, especially at the Commission, and so on, and I'm saying that this was done. The White Paper group, the group under HESP, did a lot of good work but we've got - I

May 9, 1975 2343 SUPPLY - HEAL TH (MR. DE SJARDINS cont'd) ..... would venture to say, more than any other province in Canada, we know where we're going. My honourable friend knows that because we've made some public statements re the rationalizat ion of hospital and nursing home bed s. That's one thing, and we can talk about that for quite awhile . I think that we know where we're goin g. I have announced a policy, and I think that it was clear at the time, re geriatric care, which is something that we 'll be the first one in Canada to do in this area.

We have tried to get people out of institution s, very much . This is a clear-cut poli cy . We are going to try to do that in the mental field , and any other field , have more people outside or stay in their com munity . I would hope that you will see the days that there won't be a Selkirk and Brandon, that there will be areas in different communiti es , and so on . We've closed many beds, and we'll close more , in Brandon and Selkirk. That's a clear -cut poli cy . We've talked about community health centres, that's anot her thing .

W e've talked about district health system , and this is what I was talking about this morning, that you will have the people in an area , we'll start with . . . there will be some kind of a pilot project going on in the Ci ty that I announc ed, in St.

Bonif ace , because of their geriatric hospit al , and so on , but this will be mos tly in the rural points where you get people ... the present board of hospit als, the present board of nursing hom es, the peopl e that are delivering home care , the people that are giving public nursing, mental health, and so on , and we will try to as much as pos sible have the single unit delivery ... This board will present to the government the kind of program that they want, and they will decide in the priorities within - there are certain things that are covered by the government of course.

So, you know, I think it's a little unfair - we'll always have people that criticize us , especially, as I said this morni ng, when we're leading, but I think it's not right to say that this go vernment doesn't know where we're going and that we are not telling the public . I think that the policies that I explain now are very important polici es, policies that oth er provinces haven't stated , that we're stating quite clearly and strongly, and even thou gh there's been some criticism, and we can take the one on geriatric care that's going on . Now who do we discuss it with?

Well we will have these different board s. --(Interjectio n)--Well of course there's the welfare side also . We know exactly what we want. We would like to try and get the unemployed employable people back to work as much as possi ble . I must say that I 've always had a hang-up over that, I see that this is very much exaggerated . There is not that many but we still want to do more in this. I think that the best way to do it is have some incen tive for the people to work and help the working poor and so on.

In this we're working very hard with the other provinc es, with the Federal Government because this is something that needs participation by the Federal Governme nt. In the field of health also we've been the leaders at these conferences where we 're trying to have the Federal Go vernment to agree to give us a little bit more flexibility instead of insuring only ... the acute beds were the easiest way to do because we get half the money from Ottawa to build more and more acute beds that are not needed , and then we haven't got the proper personal care beds or home care service and so on .

But there 's an indication that the ten provinces and the Federal Government are quite close to this and I see some marked improvement very soon on this. So , you know, there are certain things that we know we want but we 're depending on the Federal Gov ernment in certain areas . Now as far as discussing with people . Just a few months before the former Minister left, he agreed for instance to meet with the Colleg es of Physicians more often and I' ve met with them and after the session I intend to meet mor e often with them , to look at standards, to look at different things that we need .

As I say, we will meet with the Board s. And maybe this is the time to talk about the medical prof essi on because I think some of my remarks have been mis tmderstood or misrepres ented . There is nothing that I personally would like more than to discuss the question of health with the medical prof es sion . I say the medical profes sion because we've had some peop le, the same people that are wearing different hats , I' ve asked different doctors to co me and advise us on certain things , to work on certain committee s, it's been terrific.

They just tell us what they think and that's it, take it or leave it, this is my advice , the expertise that I have, my interest, and so on . It's been very difficult to work with the MMA as an organi zation , and it's easy to understand because when I was chairman of the Commis sion I suggested to the MMA, well where do you want to be plugged in - I' m ready , when we're just developing programs and so on , that was mos tly what concerned them, in the

2344 May 9, 1975 SUPPLY - HEALT H (MR. DESJARDINS cont'd) ..... responsibilities of the commission and so on - so where do you want to be plugged in. I can even plug you in before we go to the Minister to help us give the proper advice to the Minister. And the answer was, well that's impossible because if we send you a doctor that is representing the MMA he'll be afraid to talk, or if he says something that you use in there, that might not be approved by the MMA or the general membership. Because they have to report to the MMA and I'm convinced that this will not work.

I want to have a consultative committee with the MMA to deal with economics mostly and to have general discuss ion, we had our Deputy Minister who was quite interested in those community clinics and so on who was invited, suggested by us to go and discuss with the MMA and with the con sultative committee this general question .

I think it was a very good thing because then the president of the MMA went around the rural areas and discussed that with the medical doctors and those people that were so afraid that the government was trying to take everything over and that every doctor would be working for the government and so on, have been relieved. You know, there is not this fight that some might want to think or think that there is with the medical profession at all , far from it , I think that we're possibly closer now.

I think that there's been a good start with the former Ministers and I certainly want to pursue this and this is , as I said earli er , one of the reasons why we set up the chief medical consultant to liase with these groups, so I think that we will improve in this way. And as far as the public, well what better way than to go ahead and set up these boards that will represent, that will be made up of every type of people that are dealing with the care in their own communities, people that are on boards of hospitals, nursing homes, home care, doctors , public health nurses and so on.

I think that we are very much in the right direction, so you know maybe we're not telling our story well enough. I think that in the last four years, I think that now the people are starting to think, to realize that they don't have to be so afraid of this government, that all voluntary groups will be thrown out, that every doctor will be employed by the government, because this is not the intention at all. And when I took the stand that I did with the MMA and I said that I will not accept that they will threaten us by withdrawing services , this is exactly what I meant .

And I'm not stacking the cards against the medical profession because they've got enough to keep me on my toes and to keep me honest, because the last thing that I want to do, and this government wants to do, is to see these people opting out. I think that one thing that I want to establish , that we're going to sit down like intelligent people , people that respect each other and not one group that's afraid of the other, and unfortunately during the last year this is what was happening.

We'd meet in consultative committee, we've had a good rapport, everybody was happy, the next day there was a press statement that the commission or the government wasn't acting in good faith and so on. And that has to stop. You can only work with this kind of attitude for awhile.

I defy anybody who said there's been name calling from both sides to look, from the day that that contract was signed - what was that? - January last year in '74, to see where the government attacked the doctors and to any issue until I took my strong stand when I asked the medical profession to let me address them and answer their questions. And I want to make it quite clear that we are going to get the proper people, the proper staff, that we'll know what's going on in the rest of the province , across Canada, that we'll recommend the fairest

schedule of fees possible and we will discuss with the MMA on this. But , after, in good faith, once we've decided or what we . . . this is it. There will not be this threat because we will not accept that, I will never accept that they're going to threaten me by saying I'm going to with draw service. Because this is a profession that has fought for the right to work within or out side of a government program and they have this right.

They have this right in this province and there's other provinces who are not socialistic government that haven't got that right , you know, and let's talk about that with my honourable friend from the conservative party who has made statements that I kind of rejected because I don't know if he really knows what he's say ing on this, or if he knows what's going on in other provinces, and that is the part that I don't like at all. You can't be on both sides at the same time , say that was a good statement but the Minister is grandstanding.

You've got to do certain things sometim es when you've got a res ponsibilit y. And I'm saying, but there will be this threat. There will be this threat that if they feel in their fairness, the medical profession feel that our

schedule of fees is not adequate, well then they will withdraw and that's the last thing we want to do. Because that would hurt the plan. But then we're also protected, we don't think that they will be able to march all the people ... it's okay for the profession who didn't really understand what was going on. To

May 9, 1975 2345 SUP PLY - HEALTH (MR. DESJARDINS cont'd) .. ... this day a lot of them were telling me that they thought that we were trying to prevent them from opting out of the plan. And when they'll have to think of collecting their own fees and so on, that's worth something. When we started Medicare they were saying we'll work for 85 percent of the cost, because of that. So I'm going to be kept honest. I've got no stacked decks. I'm sure of that.

You know, you 're not respected if you 're always falling on your knees and kissing somebody else 's boots , once in a while you've got to get up and stand up to some people. When they know that this is going to be your attitude then they're going to start working like this and this is what I hope and I think will happen. When this is over , we will sit down like intelligent people, we will look at the problems and so on, and I think that we're more advanced than again , most of the provinces. To my honourable frie nd, I say do you know what happens in a Liberal government?

In Quebec , for instance, the doctors there, there's three groups. Those that are opting in get paid directly by the government the same as they do here. Some are opting out as a question of principle but they don't extra bill. The patients are paid the full amount and they give it to the doctor. There's a third group who are opting out and who extra bill ; the doctor doesn 't get a cent and the patient doesn 't get a cent. Not one cent. The taxpayer will say , we'll not pay it. I'm not saying this is good but I'm telling you what is happening in other provinces.

So I think it is only fair, and if my friend doesn 't think that I'm right I want him to tell me now and I want him to tell the public, because I don't think that this is the attitude of his party. I want him to know where I went wrong and should I say yes, we are going to accept the responsibility of you with-drawing servi ce . If that is the case you can't have it both ways.

You can't say to a pro fession, yes, the taxpayer, the citizens - not only the taxpayers, the citizens of this province through legislature will say to you, all right , you license your own group, and that's quite a privil ege, then you work on the standard of care that your members should give to the people. You're going to determine that. You're also going to make sure that the ethics of your pro fession as determined by your own group will be kept up.

And then you will also police, inspect, invest igate, you will also reprimand, punish, suspend or disbar if you want, and then all of a sudden when they've got all this , they're going to come and say to the government, and there's no agreement except this one agreement, if you won't accept this as full payment, we're going to pay you directly. And you know you've seen what happens since these characters started taking over planes and so on and if you let somebody just threaten you on something you 're finished , there's no point in having any government.

So I'm not too concerned, I think that after a certain period we'll sit down like responsible people and we'll be able to come out with certainly, I would hope, a fair and a good

schedule of fees and people work together in accepting their responsibilities. I'm sorry I got carried away, I'm covering the waterfront now but I think you led me into this and I don't know if I answered your last question. MR. CHAIRMAN: The Honourable Member for Fort Rouge. MR. AXWORTHY: Mr. Chairman, as the Minister says, he kind of opened up a whole new set of questions and I'll adhere to your ruling , Mr.

Chairman, and not try to cover it all , but I would like to determine from the Minister from his previous remarks relating to the doc tors and the position that he now finds himself in in terms of the future planning of medical services in the province, whether he feels that now that the particular issue over the salaries of the doctors in the public employ have been settled - and I tend to agree that perhaps some of the tough talk that was entered into may have had a certain cathartic effect , I would hope it would - but could he indicate now, has he taken any initiative to the Manitoba Medical Associ ation to enter into a continual consultative process for the planning of these things.

I wasn't clear from his remarks if he said that he is only dealing with the Colleges of Physicians and Surgeons or whether he's going to let the dust settle and let sort of tempers cool and let things sort of work their way out before he takes his initiativ es, but could he perhaps indicate without necessarily committing his hand like a good poker player, what he would see happening let's say within the next six months in terms of entering into a more formal relationship with the MMA in terms of this kind of discussion .

What does he have in mind as a plan of action in dealing with them to get their involvement in development of these plans ? MR . CHAIRMAN: The Honourable Minister of Health and Social Development. MR . DESJARDINS : The College , we want to meet - this was something that was planned before - I want to meet with them more often, talk about the standards and try to increase the

2346 May 9, 1975 SUPPLY - HEALTH (MR. DESJARDINS cont'd) ....• standard of care. As far as the MMA, there was a con tract signed with the Manitoba Health Services Commission and I think that today there was first reading of

an Act dealing with the Manitoba Health Services Commissi on, I think there was a bit of hypocrisy in the past that you had a commission that was supposed to be independent and everybody knew that they had to go to the government because all the money came from the government, it wasn't raising or bringing any money in at all. Now that change will be, except that it will be made quite clear that the policy will be the responsibility of the government.

There is certainly room for the commission , some of the things should be taken out of the par tisan politics, for instance , when you're looking at where you should build hospitals and so on and one of the tasks , only one, I don't want to mislead and say that the commission will become just an advisory committee , but it will be an advisory committee and it will do certain work as requested by the Minister and so on. So having said that, there is another thing that seemed to be a bit ridiculous to me that the government is paying all the shot and you've got somebody else negotiating .

You know, who are you kidding, who are you fooling. So one of the things that we would want to do is get some people that will - I'm talking about the doctors now - who will look at a schedule, who will work with them the same way, and I intend to shortly, at least when I finish these estimates or at the end of the session, to have a good meeting with the MMA and as we say, maybe by then the dust will settle and the people will say , both sides will feel that by getting together we've got more to win and I think this will be done, and talk very seriously with them on the economics.

I think that most of the discussion with the MMA will be mostly economics because that's the nature of their organization and so on, so I think that this will be done. And as far as the, now that we've started again I' m the easiest guy to suck in , now I'm talking about a million other things , but let's talk about negotiating with the hospital people and the nurses and so on. What we'd probably be inclined to do, not bring in legislation but we would have somebody that would sit at the bargaining table as an observer , and there is no doubt that this observer will be taking

part in any discussion of the government side or the management side - I mean not while they're speaking to the employees , that observer will keep his mouth shut and see what's going on - but then this is the person that will be able to liase better with the government and to tell management how far government is ready to go because government must provide the money. I hope that this will work, it's working in certain pro vinces , because that'll be the first step and if this works you will rely more , you will not take anything away or very little from the board , they will run their own thing.

If not, the only alternative that they would have is the government start negotiating directly like they do in cer tain provinces and so on, and I'm certainly not ready to do that unless it's the only thing left . This is what I think we're inclined to try this year , so there will be more open, frank discus sion I think and nobody will be fooled, I hope. MR. CHAIRMAN: The Honourable Member for Rhineland. MR. BROWN : Thank you, Mr. Chairman . I was just going to make a few comments over here.

I am very pleased at some of the statements that the Minister of Health is making and that he is saying that the doctors will be allowed to have some input possibly into some of the policy making. I would be the first one to agree that policy is the responsibility of govern ment but, if we are going to come up with good policy , with efficient policy, then there'll have to be some input in it from the medical profession. There is just no other way. The medical profession is involved in every program that this particular department is responsible for and doctors will have to be consulted.

Now it seems to me that part of the problem in the recent negotiations came from the fact that the doctors understood, and I believe that the Minister himself made the statement in the House, that there was some agreement between the Department of Health and Social Development and the medical profession that things would be discussed before policy was being implemented . Now apparently this was not the case in the geriatric services review that the government is carrying out.

The way I understand it, the doctors were notified four days ahead of time before the policy was announced - is when they received the first inkling of what was happening as far as geriatric services was concerned. Two days after they received this paper, they met with - I don't know, I' m not quite sure who they met with, either with Cabinet or with the Manitoba Health Services Commission - and they were told at that time that this policy already had been approved and that they had had absolutely no input into this particular

May 9, 1975 2347 SUPPLY - HEALTH (MR. BROWN cont'd) .•... review . This review deals not only with geriatric services but also substantially with acute bed situations and I think that the doctors were quite put out because they had not been consulted on this whole program. MR . CHAIRMAN: The Honourable Minister of Health and Social Development. MR. DESJARDINS: I think my honourable friend misunderstood . There's doctors and tbere's tbe MMA.

I think that what we want, what we're saying , that people that have been trained in a certain way, and it shouldn't be only doctors , there's the paramedical people that have an awful lot to offer also and maybe we should include them once in a while . Now my honourable friend said that I agreed in the House, admitted, that we had an agree ment that we would deal with policies witb the MMA . That is not the case.

There was a letter signed by my honourable friend when he was Minister of Health, that was a declaration of policy and the things that I read - and I offered to table this letter but everybody told me that they had it - were quite specifica lly, were talking about those dealing with the economics , and tbe commitment from tbe government was, we will not change this without at least letting you know. Okay? That declaration of policy, that's number one. And we will live up to that.

Those are the things that, can you opt in or out of the plan, will the Colleges of Physicians police and license , and I say, we want to reinforce those . So there's no problem there. The minute that we want to change this we will discuss with them. But that is not to say that everything that we plan in this field of health that we will give veto to the medical profession. In effect this is what, although they claim they don't want this, is exactly what they would get if we follow the suggestion of my honourable friend. Let's look at this geriatric .

There's not toomany experts in this field , geriatric ians, in Manitoba, in Canada. Now when we start dealing with this, I had a choice. Go to the medical profession and say, give us somebody to work on that, or try to pick the best brains, the best offer, who might not even be a member of the MMA , and say here, no commitments, you 're just committed to do your best, give me your advice. If I ask the MMA , you know what's going to happen.

They're going to decide who they're going to send , fine , they know as much as I do, no doubt; this person will not be able - and this is what I said to my honourable friend - they will not be able to make any contribution without going to the executive and then tbe executive will have to call a general meeting of the 1, 200 people, and you think you can plan like that? And you know what's going to happen? The GP's are going to say to hell with you to the special ists, and the rural people will say the hell with you to the city doctors.

Because it is a political - they have their political battles like we have in this House. And I say this is impossible . But don't , my honourable friend , ever say or pretend that we haven't discussed with members of the medical profession. We've talked to the best and we've had people that - outsiders , doctors, also , and not members of this party and so on who have been here for months working at the Health Science Centre discussing this with the Dean of the Medical College , with everybody, and this is being done.

Now the only thing I'm saying , and I'll let the MMA be tbe judge of that, the minute that you can .. . if you want to do something, give us somebody tbat you choose , but not somebody that's going to go and report to them before tbey make a contribution to this committee in plan ning. There is no way that we'll ever do that, give a veto to any group not more than the - well any gr oup. You know, are we doing that with the lawyers? In this agreement the medical profession wanted to make sure that we couldn't get anybody on contract unless they said so .

They're free enterprisers , that we respect , that have a patient-doctor relation , are going to tell other people that are employed by a government, or a government, you can't employ any body. Carry this a little further. You should do that with the lawyers . You should do that with the engineers. You should do that with the accountants. The engineers. There is no way that you can do that. That doesn't mean that I'm against these people when I'm saying .. . I had a situation, and I'm not faulting anybody, with the Medical Director of Selkirk . Did a hell of a good job in keeping the place open.

He's considered management. But because of the set -up, you know you have a trade union that might represent different locales but not one that is considered management and Local so and so will go and vote in the other one. But that same medical director was attending meetings of the MMA where he's clapping and voting for these people to support the closing of the hospital that he's tried to keep open. I'm not faulting him, I'm faulting the system. And this is what I say, when it's realized that we will talk to the medical profession . If it can be done with the Ml\fA fine, I doubt if it can be done, because that

2348 May 9, 1975 SUPPLY - HEALTH (MR. DESJ ARDINS cont'd) ...•. is a union that is looking at the economics and they're ready to give full mandate to their executive when it comes to getting more money for them. And I'm not saying this sarcastically, that's the name of the game. But not when it's time to plan. I wanted to know - we were talking about building a hospital in the north end when I was at the Commission - should they have a Maternity Division and so on. I'm told no, not for a hospital with 100 beds .

To consult the committee , I asked the MMA, you know, here's a chance to show that we 're working together . We 've got a political decision to make and you 're the expert in this field , tell us, it'd be a hell of a lot easier if you tell us we can't do it , if we say that the MMA .•. No way, and I'm not blaming them, politically, they couldn't do it .

They were afraid to bring it to the association, the president had my letter in his pocket that it was agreed between he and I, I'm not faulting him, if possible I'll pull this letter out at this time , and there was no way, because the GP 's want something, the specialists want something else, and they are not ready . And you should see the correspondence that I have . And the specialists want something, as I said with the GPs, and then the rural people are concerned .

So I'm saying that the MMA , the old antenna there is the economics of it all, and there's conflict of interest, there's got to be conflict of interest . And you don't plan where there' s conflict of interest . And you don't plan when you're starting to develop something, that you ask a profession or a group. There 's no privile ged class in society . There shouldn't be. Maybe there are . You don't give anybody a veto to see if it doesn 't class with their own feelings and so on.

You take an individual - it's the funniest thing, you can have the same fellow with his MMA hat on, can be the most milita nt guy in the world and then he takes his hat off and becomes Dr . so and so, and he 's not even worried about money. And I want to talk to him when he's not worried about money, when I'm talking about planning and the people of Manitoba . That's all I'm saying . And that's all I've said . This is not something new. This is all I've said all along. MR. CHAIRMAN: The Honourable Member for Rhineland. MR . BROWN : Mr .

Chairman , I don't think that we have ever said that the MMA should have the power of veto, we certainly do not agree with that. But if the Minister could have pointed out to us that so and so many months before he made the announcement of the geriatric services review that he sent a study over to the MMA , allowed them to make some kind of an input and then if the Minister would have made his decision, whatever his decision would have been , I do not think that we would have argued the point, because that's the Minister's prerog ative .

But when he does not consult with these people, when he gives them absolutely no time to have any input into our health care policy then we do become concerned . Another thing I believe that we are concerned about. We 've noticed so many many studies going on within the Provi nce of Manitoba, and we do have very good medical men, is that these studies are done by people who come from outside of the province, who come from outside of Canada, they come from all over the place . Now why can we not utilize the talent that we have within the Province of Manitoba . This is a genuine concern . MR .

DESJ ARDINS: ..• it will be the last time . I want to try to tell my honourable friend about the facts of political life for one thing. I repeat that this was done, and I'll take the example that you selected , not that I did . We had a committee that started on this geriatric committee . There has been a hospital here, a municipal hospital, and I wish my friend would listen because I'm not going to go through this too many times . And I'll try to tell him exactly how it happened without hiding anything. There is a municipal hospital which has been doing great work, it's a free-s tanding geriatric hospital .

There's been a report before , there's been study and most of them if not all of them recommended these geriatric hospitals should be closer to acute beds, where you can get people out of acute beds and get them in geriatric beds and so on. There is one that was built at St. Boniface . All right . All the commitments - and now I'm going back to my former position as Chairman of the Manitoba Health Services Commission - there was a stack like this of commitments by different governments, including ours, commit ments, political commitments to build this municipal hospital .

All our advisers and planners were saying that's the biggest mistake in the world . So I got in touch with the Minister and I said, all right , here , you 're going to get slapped. Would you authorize me to talk to the board and have one good try of the best brains that we can find to come in and let's see what we can do for the people. No political thing, it might be hard on you and so on. He said , go ahead.

May 9, 1975 2349 SUPPLY - HEALTH (MR. DESJARDINS cont'

d) I met with the board of the municipal hospitals , told them, they were disappointed, they were very fair . The Chairman was very fair . We even had a joint statement to the press that we would make this study. I tried to look for the best people to give us advise on that. Took Dr . Alcock who is tbe director of this hospital, medical director , who has been working with these people for a long time . Because this hospital was so involved , the Dir ector of this hos pital, the Administrator of this hospital was put on this committee.

Then I went out to get one of the best , most experienced geriatr icians , probably one of the only ones, Dr . Skelton who is director of this hospital in St . Boniface, that's his job, his . . • Then I went out to have another fellow who has nothing to do with this government either , Dr . MacDonald who has been running the Deer Lodge Hospital, this kind of servi ce, for the Federal Government, who's still working for the Federal Government. Does my friend think this is a pretty good group, these three so far ? Could you shake your head one way or another and give me an idea , you know, where I went wrong.

This became the committee, and there are three doctors in there. And then, because it was a diffi cult position, you had a doctor that was the director of a hospital that wanted to build 400 or 500 beds . There was no way that you can put him on the spot or the other doctors , so we got somebody from the Commission to act as chairman , and then we got somebody from the staff of the Commission to say give them all the help they want because they've got to have an answer in six months. Okay . Then there was another doctor, chief consultant at the Commission , Dr . Antles who also became part of this committee.

This committee looked at all the situation of beds and so on of geriatric care . I committed myself that in six months they would have an answer, I didn't know what the answer was, we'd do the best but it would be for the people of Manitoba , the patients of Manitoba, and I said before we did anything that we would meet with the commission and talk to them . I had set up a bed utilization committee for Winnipeg because we had a shortage of beds .

The administr ator, it's not just the doctors, the doctor's not necessarily the best fellow to know about acute beds and all that, he knows the patient care but don't kid yourself that a doctor is a great administrator, or that all of them are great adminis trators, you know, there's a limit to what I'll agree with. All of tbe administrators of the hospitals in the city , they sat in this committee . The College of Physicians had somebody, the MMA had somebody. They came out - it was very difficult, I guess there is no answer , this was a different study to see what we can do.

They came out, there's a shortage of beds, there's a shortage of beds. You know, all right. Well the main thing it was found that it's not a shortage of acute beds, it's a shortage mostly of personal care beds . All right . I said to them, when we have this report of this committee on geriatrics, we will discuss with you on that and they had somebody representing the MMA and so on. So when tbis report came in, the report in anci the work, as I kept in touch with them and so on because the report came in with certain recommendation but there was the former. for all the work .

When the government pretty well had an idea of where it was going, I had to very fast, because you understand the political situation, I had to follow my commitment to discuss this before releas ing anything with the board of the municipal hospital, with the Bed Utilization Committee . We were talking with Dr . Clarkson and the data study that was working at the Health Science Centre , we had to talk with them because there was an idea that there were too many beds there, that they should close so many, but bring some of those geriatric beds there .

I had to touch base with Seven Oaks but that certainly was an improvement, that we were going to have a hospital with only a hundred beds, and now we have a hospital witb about 250 beds . I have to check with them. I have to check with St . Boniface Hospital who is going to start kind of a pilot project .this time , and I had to check with the Medical College who had to see that there was an orderly transfer of these kind of beds, all at once. And I don't know, I'm sure my friend is not too naive , when you talk to one, ball game's over .

The first thing that the Commission did exactly what they were going to do, it was a Commission - when I say "I" , I was Chairman of the Commission at the time . The Commissi on met with the board, of course they knew what they were recommending and so on but they thought . . . well immediately I got a phone call from the chairman who wanted to talk to me immediately and before even coming to my office , there was a press release and there was an appeal to the people and so on, "Don't let the government do that" and so on, and I had to move .

2350 May 9, 1975 SUPPLY - HEALTH (MR. DESJ ARDINS cont'd) .•.•. So I hastened a press release that I was going to have, I said let's have it sooner . I was chastised because I didn't tell the House first if you remember and I think my honourable friend was invited to this meeting , and then also the commission was instructed to meet immediately with that committee that you were talking about. Now I say to my honourable friend , is there any other way that you can do it without having somebody that's going to try to knock the program or something . You know, you don't give ammunition to the enemy.

If somebody, you know that they're going to knock it , then you've got to move fast and I don't think you are that naive . This is all I'm saying. Now, can you tell me that we didn't deal with the people that knew something about it, that we didn't try . MR , CHAIRMAN: Res olution 55(a )(2) -- The Honourable Member for Roblin . MR , McKENZIE : I don't know if my questions come under this item . I suspect that they do .

I got an Order for Return here which I submitted for the . . . how many occasions between January lst and December 31, 1973, were aircraft leased , loaned or government aircraft used by the Premier and Cabinet Mini ster s, and who used the aircra ft, etc., etc . Well , I'm kind of uptight about the return, for the reasons are quite manifold . --( Interjection)--C ertainly . -- (Interjection)- -I'm referring, Mr .

Chairman , and members of the committee , to a flight that was made by the former Minister of Health and Social Development to Winnipeg , Ottawa and Charlottetown on the 24th of September, 1973, and then another flight from Charlottetown to North Bay on September 26 , 1973, and they used an MU2 aircraft and the passe ngers were Schneider , Edwards, Peters on the flight from Winnipeg to Charlottetown; then Schneider, Edwards , French and Peters with the Minister on the flight from Charlottetown to North Bay . And as you go through this Order for Return, Mr .

Chairman , you will find this is the only flight that's been made by this MU2 aircraft for this distance . There is one other flight in this Order for Return where the Minister of Highways went to Saskatchewan - North Battleford - but outside of that, all the flights are within the Province of Manitoba . But this one was made to Charlottetown and the cost to the taxpayers is listed at $632 . 70 . Now that likely includes , I suppose , all the meals and the accommodation, etc., etc. , but I don't see how you can fly an aircraft from Winnipeg to Charlottetown for 632 bucks.

And then this flight from Charlottetown to North Bay, I guess they must have drove back from North Bay to Winnipeg , but it says it's 1, 700 miles from Charlottetown to North Bay and I can't verify that mileage . I think either the first one's wrong - it's 1, 710 miles from Winnipeg to Charlottetown so there's got to be some thing wrong with the other one, Charlottetown to North Bay . That one apparently is not correct . And the figures are . . . MR. CHAIRMAN: Order . I think that that question would be perhaps best asked under the Minister's salary .

MR , DESJ ARDINS : .•. there was an Order for Return on this ... more details . -- (Interjection)--No, you 're talking about - not this year. MR . McKENZIE : I got it on the 3rd of April , 1975 . It was returned ... MR. DESJARDINS: Oh, that's all departments . But there is one specifically on the same thing for the Department of Health and that should be tabled · in this House any day now. MR . CHAIRMAN: Order please. I mean this is not under the item that's under discus sion . If you have an item dealing with something of that nature, I think it should be raised under the Minister's salary .

Now while I'm on the point, I think I might also say that the debate is becoming repetitious on one thing. Now I think you've either got to ... You've wandered all over the globe here . Now we're under Administra tive Salaries under Executive Function, and I think that the questions should be pertinent to that. MR , McKENZI E: Mr . Chairman, I do submit , and very humbly, that this would be an executive function where the Minister was using his ... to go to Charlottetown. MR. CHAIRMAN: The Minist er' s salary is not under discussion at this time .

Now the honourable member knows that on the Minister's salary , the Minister makes his introductory remarks . We don't discuss the Minister's salary until the last item. That is the way that we have been operating. Now I wish that the honourable member would not persist . I think that if he wants to bring the item up that he's talking about now, bring it up at the end when we 're on the Minister's salary . MR . ENNS: Mr . Chairman, on the same point of order . MR , CHAIRMAN: Order please. I have made a ruling and I'm not going to sit and argue with the honourable members about it .

May 9, 197 5 SUPPLY - HEALT H MR . ENNS: Mr. Chairman, then I raise a point of order . MR . CHAIRMAN : What is your point of order ? 2351 MR . ENNS: My point of order is that the particular item brought to your attention by the Member for Roblin is, I admit, not one that falls into the general ambit of some of the headi ngs in the departme nt, Welfare Ad visory Committee, Resources Division, Statistics Branch, somethin g lik e that . It obviously deals wi th the proper headin g Executive Function that we 're dealing with. We 're not dealing with the Minis ter' s Salary.

He is not specifically referring to the Minister' s asp ect of this but we 're talkin g about ... we have such innocuous items as Other Expenditur es, Salaries, and these certainly, one would assume that it is not the rank and file of the department that fly in chartered aircrafts and fly around this country in chartered aircrafts, but it is releg ated to the senior executive members of the department un der the Executive Function that we 're now dealin g with in its broadest scope. Now I accept your ruling, Mr.

Chairman, that we 're not dealing in the whole waterfront of the department that we normally take in when we discuss the Minister's salary, but I would ask you, then, for some directio n for myself and for the Member for Roblin, to indicate to us under which specific heading, if we want to be specific - and he is being very specific ; he is talking about executiv e members of the department chartering aircraft to fly to di fferent parts of this country, and it is executives of the department that are doing it - under which specific heading, as we go headin g by heading , should we raise that matter and should we get some answers to the question s raised by the Honourable Member for Roblin .

MR. DE SJARDINS: I would resp ectfully submit that maybe you should allow discussion at this time, because if I was to be asked to point out under what item this should be discussed, I think that this is the place becau se we 're tal king about the expense and so on . My reason for risin g earlier, I thought that my honourable friend was referrin g to an old Order that he had, because I know that there was somethin g, a question asked in this House that was accepted not too long ago, and that hasn 't been filed yet .

But if he has some other information, if this was asked, I think this is the place to discuss it and wi th your permissio n I'd like to MR . CHAIRMAN: Order. MR . DE SJARDINS: All right . MR . CHAIRMAN: We are on Salaries . Salaries, to my way of thinking, do not include expenditur es . Now if the honourable member wants to raise it under (3 ) that's fine and dandy , but (2 ) is Salaries and salaries is what we're going to stick on . 55(a)( 2)- -passed; 55(a)( 3)- MR . McKENZ IE: I apolog ize for being out of order . I thought we were on (3 ) and I apolo- gize for speaking out of turn .

I think the questio n , this Order for Return , first of all how come that this is the first time the MU2 aircraft was flown that great distance, 1, 710 miles ? And, of course, the reason for the mission, I think, deserves an answer. In these figures that' s given , the fixed cost is $376. 20 and the variable cost on the flight from Winnipeg to Charlott etown is $256 . 50 . The total is $6 32 . 70. Now are the costs of that flight charged back to the Minister's department ? That's one ques tion. Why they used the charter ?

And the other one : What is the rate per mile of the aircraft that' s charged back to the department on that flight ? MR . DESJARDINS: ... the same questio n , I will not endeavour to read it now because this was asked in the House and this will be filed in the House with the information and the total costs . Now as far as why was this the first trip, I suppose bec ause they just bought the plane . It was new . Somebody had to have the first tri p. I don' t think that that 's too important . Now , why was the plane used to go outside of Manito ba ? I would say that this was a ministerial decisio n .

I don't know really why . There 's a possibility that they wanted to have so many people - they might have stopped to visit some hospital or somethin g. I don't know , and I can' t answer for the Minist er, but as far as I'm concerned this is something that can be done . When I was Minister of Tour ism, I' ve used the plane to go up North and so on, to go into different areas. I know that some people in the staff, the years previous to that, took the plane to go to the States to do certain work. It was a little costly.

When all the facts are known, it mi ght be that it was justified and in fact that there might have been a saving of money, but this was the Minis ter of the day made a decisio n that he had a right to make, and that is about all I can say , Mr. Chairman . MR . CHAIRMAN: The Honourable Member for Lakeside . MR . ENNS: Mr . Chairman, I believe that implicit in the questioning of this item by the

2352 May 9, 1975 SUPPLY - HEALTH (MR . ENNS cont'd) .. ... Honourable Member for Roblin of course is the question of, you know, when senior members and the Minister travel to places, you know, major centres of our country, why not use the regular carriers like Air Canada? And the only question would be one of comparison cost . What was the cost comparison had the mission travelled with Air Canada, for instance , or CP Air, as compared to private charter ? That's a question.

Now, you know, we're dealing with a department that spends $300 million per annum, and somewhere along the line of course one would also like to believe that economy and concern for the dollars is expressed , particularly in a department like this, ri ght at the top, right at the Minister 's level , ri ght out of his office . So I think the Honourable Minister could resolve this question and we could get on with the more important aspects of the department very quickly if he gave us some indication that, is this a practice that he intends to pursue during his tenureship of office?

Is their savings to the public purse by the use of this aircraft as compared to regular carriers such as Air Canada? And, you know, I think we can all accept , indeed that's why we build up our own government air services craft , when it's a question of flying up to isolated communities, to flying up to visit some northern locations where regular air service is not always available or if it's not conveniently available.

But, sir , when you're flying or when you're going to a major centre in Canada such as Charlottetown, which surely has to rank next with Toronto and Montreal, then, you know, one has to question why not use our own government carrier , namely Air Canada ? But again , Mr .

Chairman, I don't want to prolong it and I think specifica lly, and in defer ence to the people of Charlottetown, the question should be asked : Was this a junket on the part of the former Minister and was he taking his friends along for a little ride where he could pop in and out of different places, you know, stop at some roadhouses or what have you on the way down, or was it in fact, you know, a money-saving venture on the part of the then Minister of Health and Social Development? Thank you, Mr . Chairman . MR. DESJARDINS : Mr .

Chairman, let me say, first of all, that this Order for Return was accepted by myself on March 17th and I know that we have the information now - I saw it yesterday; it's being prepared in the right form, and I hope that you'll have it in a day or so. So all the information will be given. Now some of the questions, you know, what am I going to do? Well, first of all, I think the question was . . . Personally I'm afraid of those little planes; I'm much better in a large plane, so if we can get a 747 I'll go on a 747. I don't like these little planes.

I think that it was obvious that--(Interjecti on)--I 'm going on a diet. MR. MILLER: It won't take off. I can go on a single-eng ine . MR. DESJ ARDINS: You can go on a pigeon, never mind a single engine. I would say that at times, you know, there is no doubt that the cost of this plane is more than a single fare, return fare, on Air Canada. It depends how many people were on that plane, for one thing. It depends on the stops that it has made.

If they gain a few days by stopping and doing their business in certain areas where they didn't have to rent rooms, that I don't know - I'm not suggesting this is the case but this is something when the Order for Return would come, I would suggest that that could be discussed, and I guess that the Minister can, unless he feels that he wants to say something at this time . But I can't say any more . MR. CHAIRMAN : The Honourable Minister of Tourism and Recreation. MR. TOUPIN : Mr . Chairman, I'm not going to make a long speech.

I don't have the habit of standing up in the process of estimates of one of my colleagues, but I was the Minister of Health and Social Development at that time . Circumstances surrounding the decision by myself to use the MU2 to go to Charlottetown for a conference of Mini sters - there were some stopovers; the plane was full. I believe there were seven passengers on the plane. The cost comparison was made prior to departure as compared with Air Canada and CP Air, and there was the cost of accommodation that would have had to be taken into consideration that was actually discussed prior to booking the MU2.

I personally have not renewed the practice of taking the MU2 out of the province since. I have in many cases taken it within the province. I know of some of my colleagues that have taken it out of province since we've had the lease on the MU2. I think my decision was based on , first of all, (1) cost; (2) time constraints - I had to be back in Winnipeg with some of my what I consider to be important officials, back at a certain time . I was not the only Minister there with the Government Air Service plane. I was

May 9, 1975 2353 SUPPLY - HE ALTH (MR. TOU PIN cont 'd) . . . . . one of fo ur , and not the furthest either . Alberta was there with its private plane , and there were three other provi nces involved in having their own plane, and I believe that their deci sion was based on the same as mine , being time const raint, costs , and practice equally in regards to ... I, myself, cannot fly in a small plane . I become ill . I can fly on a big plane as the

schedule ea:µ be accommoda ted , but in that case it couldn 't. But I haven't made a practice of using the MU2 or any other plane under Government Air Service to fly out of province since . MR . CHAIRMAN: The Honourable Member for Roblin . MR, McKEN ZIE: Mr. Chairman, and the Ho nourable Minister - I thank him for the infor mation , but the reas on that I raised the question was because this was the first time the MU2 flew that distance. The one other flight was North Battleford . Then ther e' s got to be somet hing wro ng with the mileage here because it's 1, 710 miles from Winnipeg to Charlot te town .

I buy that, but then on the return flight from Charlo ttetown to North Bay it's 1, 700 miles and it doesn't say that the Minister came back to Winnipeg . The flight was terminated in North Bay and it's still 1, 700 miles from North Bay to Charlotteto wn. That's what it says in the Return. So if that's the reasons that the figures are so out-of- date , they're not fresh, some thing is wrong with the figures that were given . There's other areas in the Return but it's anot her department .

But there 's somet hing wrong with the figures; and I would hope the Minister would take it in good faith, that's the reason I raised it because it's so obvio us . That's the first flight in that Ord€r for Return outside of Manitoba and Saskatchewan and the mileage is not corre ct. MR , DE SJARDINS: There 's a mi stake there and we'll have the figures checked . I thank the honourable mem ber . MR . CHAIRMAN : The Honourable Leader of the Opposi tion . MR . SPIVAK: I' m not s o sure that this matter is somet hing that should be left alone .

Not at all . --(Interjection) --! just wonder , really, at this point whether the presentation that has been given to us is accurate or not . You know , the Order for Return dealing with the mileage is inaccurate . The explanation given by the Minister is that it was easier to go by the MU2, and I don't know its length of range before it has to refill . It was to meet certain time con straints that the Minister has talked abo ut, but my understanding of Air Canada 's

schedule is that it operates daily through the major centres in Canada , and there are pos sibilities of being able to make co nnection s. I don't know what costs we 're talking about but we 're talking about a cost which is chargeable to the public purse , a cost that is borne by the public in the dis charge of responsibilities of the Minister , and I think that there is a question that has to be raised as to concern for the administration with respect to attitude in spending public money . MR . CHAIRMAN: The Honourable Minister of He alth and Social Developme nt. MR .

DESJARDINS: On March 17th, the following Order was --(Interjectio n) --Just a minute please - the breakdown of individual expenses for each member of the government dele gation which attended the Provincial Ministers of Health Co nference held in Charlot tetown, September 24 -26 , 1973 . And I would like to suggest to my honourable friend that l 'm commit ting myself this time to have this answer next week while my estimates are still going . I won der if we could wait till we get the proper figures, if anything, before we argue on this.

I will make a commitment to have this answer while my estimates are still going on . MR, SPIVAK: Then if the Minis ter is going to undertake that we will have this file with us so that we 'll be able to deal with it even if we deal with it under his estimates, under his ministeri al salary , then that's agreed , that 1 s fine, and I would assume that the breakdown will deal with the obvious error as well, with respect to--( Interjectio n)--Well it has to dovetail with the information supplied because it's obvious that there has been an error made in the first Order of Return filed - not by the Minister , but one

section of the government dealing with the mileag e involv ed . MR . CHAIRMAN: Resol ution 55(a)(3)--The Honourable Member for Rhineland . MR . BROWN: Mr . Chairman , we have an item here of $82 , 200 . I wonder if the Minister could give us a bit of a breakdown on this . MR . DE SJARDINS: Well, this covers wages and other as sistance; profes sional fees, other fees; furniture and office equipment rentals; printing and stationery supplies; postage; telephone and telegraph equipment; automobile mileage charged and accessories; advertising exhibits; publication s; freight; express and cartage; travelling; misc ellaneous not

2354 May 9, 197 5 SUPPLY - HEA LTH (MR . DESJARDINS cont'd) ..... clas sified elsewhere; educational assi stance; grants to ho spitality; Provincial Ministers Welfare Co nference; Health and Social Development Advi sory Co uncil; for new Minister 's off ice - which was nothi ng . No , there's nothing for that. That's to come . So is that the information to satisfy my . . . Woul d you want an item for . . . MR . SPlV AK: Fine . MR . CHAIRMAN : (a)(3) --passed; (b)(l) --passed; (b)(2)--The Honourable Member for Fort Rouge . MR . AXWORTHY : Mr .

Chairman , there 's not much time left and I think there are some fairly important iss ues under this area that I perhaps could begin to raise with the Minister .

In this item under the Welfare Advisory Board , the is sue that has been really, as far as I can understand it, still of some dispute between the Ci ty of Winnipeg and the provincial department in which the Welfare Advisory Bo ard has found itself having to intervene on several occasio ns, is dealing with the application of the property tax rebate to welfare recipients, and where munici palities in the province have attempted to work out schemes where municipal welfare assi stance wo uld be reduced in like amount to the rebate system that would go on , and that the Welfare Advisory Board I think over the past year or two has been forced to publicly intervene in some of these iss ues in order to try and clarify , and I would wonder if the Minister at this time would indicate whether the government has sat down with the municipalities and worked out a system whereby there would be no particular restriction or penalty imposed upon welfare assis tance, which is cost-s hared in part by the Provincial Governme nt, to the municipalities in relation to the rebate system .

MR . DESJARDINS: Mr . Chairma n , I' d like to say at this time that we 're not satisfied with the situation the way it is now . I think that the Adviso ry Co mmittee has done its work properly . It's made certain recommendations to us . It was a little late in co ming . It might result in a change in legisla tion and this is somet hing that will be studied, the whole situation, because there is an awful lot more problems than my honourable friend - and I am sure that he knows that - has suggested, and of course a lot depends on what's going to happen in Ottawa on this thing.

But in the comi ng mont hs, after the sessi on ends, this will be looked at and I think there will be majo r changes in this . MR. AXWORTHY : Well, Mr . Chairman , I' m pleased to hear the Minister 's answer . I' m wondering if he co uld indicate , in the short term , particularly in terms of procedures to be carried out in the next year or within the next several months with the new rebate system and cost of living rebate that has been admin is tered, what will be the exact posi tion in relation to the municipalitie s? Has that situation been clarified ?

Has some understanding been reached with the municipalit ies as to how this particular sum of money should be passed on , and do they all under stand very well that it is not necessarily to be penalized or to be reduced from the amou nt ? MR. DE SJARDINS: The problem there is we're limited in what we can do . As my honourab le friend knows, this was passed on by the government to the munic ipalities, to the individual muni cipalities, and what they've done hasn't always pleased us and this is one of the main issues that I want to look into . MR . CHAIRMAN : The Honourable Member for Roblin . MR . McKENZIE: Mr .

Chairman, I have a couple of questions to the Ho nourable Minister under the Welfare Advisory Co mmit tee, and of co urse it looks here like there's been a reduc tion of some $2 3, OOO to the philosophy of the Welfare Advisory Co mmit tee, and I' m wondering now if the Minister is considering using some volun teer servic es or is he considering now to use some of the municipal advice that's available in the country for information on that particu lar su bject matter ?

Because this has been a longstanding quarrel in the coun try, that the municipal people have , over the years, been left without their resourc es in some of the com mittee meetings that have been held by the Welfare Advi sory Committee in the areas, and some meetings, Mr . Chairman and members of the commi ttee, they have been considered . And of course it goes back, Mr . Chairman , to the whole philo sophy of the welfare system , and that is of co urse , are the right people being helped ?

This is the one that historically keeps coming up all the time when we deal , and the Welfare Advisory Committee have done a reaso nably good job . I have sat in with them on occasion. But I wonder now , is the Minister reshaping the welfare structure under this Advi sory Com mittee , or what is the reason for the large cut in expenditures that we see under this item ?

May 9, 197 5 2355 SUPPLY - HEALTH MR . CHAIRMAN : Order please . The hour being 4: 30, Private Member s' Hour ... MR . AXWORTHY: It's my understanding that the Minister will not be available Monday to continue est imate s. I wonder if he could give us some indication as to what the particular order will be, whether we'll continue with Correctio ns and Rehabilitation or whether there will be another est imates being consider ed . MR . CHAIRMAN: The Honourable Minist er of Urban Affairs . MR . MILLER : Mr .

Chairman, it is poss ible that we may con tinue Healt h and Social Development Estimates, which means that the Minis ter for Corrections and Rehabilitation may be on . On the other hand, we 're just checking now, it's possible that we will go into Capital Supply . . . . . . con tinued on next page

2356 May 9, 1975 COMMITTEE OF SUPPLY - HIGHWAY S MR. CH AIBMAN (Mr, Walding) : Order please. The meeting will come to order. I direct the at tention of honourable members to Page 29 in their Es timates book. Resolution 64(a )(l ) , The Honourable Member for Birtle-Russell. MR. GRAHAM: Mr. Chairman, I believe it' s under the Motor Vehicle Branch that most of the Highways Traffic Act comes into force, and I'd like to ask the Minister how many amendments to the Highway Traffic Act have been passed by the Legislature and not proclaimed and are not in effect in the province today.

MR, CHAIBMAN: The Honourable Minister. MR , USKIW: My guess is that it' s about six. MR , GRAHAM: Do we have any indication of what those sections are and why they have not been proclai med? MR , USKIW: Not at this point in time, Mr. Chairman. MR . CHAIRMAN: The Honourable Member for Morris. MR . JORGENSON: The ques tion I would like to ask deals with the licensing of those farmers who do custom harvesting in the State s. I understand this year that the Motor Vehicle Branch are going to be compelling these people to buy a truck licence rather than the ordinary farm licence which they have been using in the past.

I wonder if the Minister could explain the rat ionale for asking these people who, in my view, in that process of going down to the States and earning money, come back here and pay a considerable amount to the government in the form of taxes, both re venue tax and income taxes, why they must be le vied this addi tional charge of having to buy a truck licence rather than going down there with farm licence s. MR, CHAIBMAN: Mr. Brako. MR. JOE BRAKO: It' s a matter of coinciding with the classed system of driver licences throughout thE) Dominion of Ca nada and the United states. MR .

JORGENSON: I wonder if the Minister could explain just exac tly what that means. I'm afraid that he's lost me somewhere along the way . MR. BRAKO: I've just been informed that you're talking about a licence plate rather than a driver's licen ce . MR. JORGE NSON: Yes, a licence pla te. That' s right. MR . BRAKO: Under the Highway Traf fic Act, the farme r' s plate cannot be used for commercial purp oses, and this will also then, of course, tie in to your class of licence which you will be getting depending on what cat egory the truck the farmer is driving enters into. MR .

CHAIRMAN: The Honourable Member for Morris. MR . JORGE NSON: No, that still does not satisfy me. I wonder if he can explain the reason for it. I'm not sure that this whole thing is jus tified nor is it equita ble. First of all, the farmer leaves here to go down to the State s, and the only period of time that he uses that particu lar truck on the highway - and one assu me s that the purpose of these licences is to ensure that the user is going to pay a share of highway construction and maintenance - the only time those trucks are used is from the time they leave the farm er' s yard until they ge t to the border.

That is the only time they are used in Manitoba. From there on they're in United States country and they're charged every state they go through. Every state they go through, whether they do any harvesting there or not, they are charged a levy of about 30 to - it varie s from about $30. 00 to about $80. 00 for these trucks to move through the state in which they are going. For example, to do down to Oklah oma they go through North Dakota, South Dakota, Nebraska, Kansas, and then Oklah oma.

So that in five separate states they're being charged, and tha t's unders tandable because they're using the highways down there and on the way back they'l l be using the roads to haul the grain and to haul the machine s. But why in Ca nada ? Now, they understand that it' s perfectly justified to increase their insurance rates because the liability, as was explained by Mr. Dutton here the other day, the liability is greater and the awards down in the States are much higher. So they are perfectly prepared to pay the additional insurance rates in keeping with the re sponsibilities and the liabilit ies.

But why the licen ce ? You know, I'm be ginning to wonder if governments are ac ting more like pirates and highwaymen than they are lik e governments. I can see no justification whatsoever for the additional charge of about $230 for a farmer who lives, for example, along the border . Let' s take the case of a farmer at Holb stadt who has three miles to go before you get to the border . That' s the only time that he uses Canadian roads and Ca nadian territory, and yet he has to pay about $230, and then as soon as he gets into North Dakota then there' s another $30 . 00.

When he gets to the next state then he pays some more, and so on until he gets down to where he is

May 9, 1975 2357 SUPPLY - IITGHWAY S (MR. JORGENSON cont'

d) o o .•. going to start harvesting. You know, the Sheriff of Nottingham didn' t have near as much trouble as these people have, and Robin Hood was a piker, you know, compared to what we have in the form of legitimate governments today. And I just can' t understand why they must be charged an additional $250 for that kind of a licence plate when in fact he is not going to be operating in the Province of Manitoba. MR. CHAIRMAN: Mr. Dygala. MR. DYGA LA: Mro Chairman, in response to the member' s que stion.

There was an amendment passed in 1972, I believe - it could have been in 1971 but I think it was in 1972 - to the Highway Traffic Act with respect to the use of farm truck plates. Up to that point there really was no legislation whatsoever governing the use of farm truck plates and there was a great number of complaints from people about the abuses of farm truck plates.

Now one of the principles that were enacted was that the· use of vehicles, trucks, registered as farm trucks, that such trucks could not be used in any commercial enterprise where the person is receiving compensation other than in connection with his own farming and . • • MR. JORGENSON: May I inte rject at this point and ask if that applies in the Province of Manitoba or if it applies in the United States as well ? MR. DYGALA : Well, let me finish that. I'l l come to that part of the question.

So that as matters now stand, any truck that has farm truck plates on it can only be used in connection with that person' s farming operation. He can haul whatever goods to market or from, for his own purposes or uses on his own farm, and for his own personal transporation as well. Now when you get into a commercial enterprise, which is what this is, then the person will have to obtain a commercial truck plate, a CT plate. Now Manitoba does have currently reciprocity arrangements with some of the states.

Where a commercial truck plate is issued with extra provincial authority, or reciprocity authority, then the reciprocating state would not impose an additional levy. Now in the United States at the moment, there is a new plan that has been devised and is being implemented, known as the International Registration Plan.

Under that scheme of registration - and this is principally having to do with commercial truck vehicles - every state, the home state, would impose a registration fee according to the fee payable to that state, and that state in turn would remit to the other state a proportion of that fee, depend ing on the miles travelled in the other ju risdiction. Now Manitoba at the present time is con sidering that particu lar plan. There's been no decisi ons made with respect to whether we go into it or not. There's also ramifications. But as matters now stand, Mr.

Ch airman, any farmer who is engaged in these kinds of operation and has a farm truck plate on his vehicle, could not use it. MRo CHAIRMAN: The Honourable Member for Morris. MRo JORGENSON: Well does that mean .•• does this new arrangement mean that when they go down to the States now, if they have a truck plate, a commercial truck plate, that they will not be charged these additional levies that they've been charged in the past going through those states ? MR. DYGALA : Only in those states, Mr. Ch airman, with which Manitoba has an existing reciprocity agreement. I can' t give you the list at the moment, Mr.

Chairman. I know we hav� a reciprocity agreement with North Dakota, South Dakota, Minnesota, Nebraska - I' m not sure about Kansas; Texas yes; Oklahoma, I'm not certain about. MR. JORGENSON: I wonder if you - maybe not at the moment - but I wonder if you could undertake to supply us with that list. MR. DYGALA: Yes. MR. JORGENSON: A further question then. What happens when the farmer comes back? Now he is equipped with CT plates that prevents him from hauling his own

Document details

Collection	Manitoba — Debates (Hansard)
Citation	30-2-80
Type	hansard
Volume / chapter	30th 2nd hansardpdf 80.pdf
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	848ec4a04e02080530ccc8cf042dc4fde307f23b

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