Manitoba Hansard — 21 April 1987 (Sitting 31A, 33rd Legislature, 2nd Session)

33-2-31a

Manitoba — Debates (Hansard)

LEGISLATIVE ASSEMBLY OF MANITOBA Tuesday, 21 April, 1987. Time - 1:30 p.m. OPENING PRAYER by Madam Speaker. MADAM SPEAKER, Hon. M. Phillips: Presenting Petitions . . . Reading and Receiving Petitions . . . Presenting Reports by Standing and Special Committees . . . MI NI ST ERIAL STAT EMENTS AND TABLI NG OF REPOR TS MADAM SPEAKER: The Honourable Minister of Employment Services and Economic Secu rity. HON. L. EVANS: Yes, Madam Speaker, I have a brief statement to make.

Madam Speaker, I am pleased to inform the House that our government will be sponsoring job referral and placement services for students, youth and employers throughout Manitoba again this summ er. On May 4, doors will open at 34 Manitoba Youth Job Centres which will be operated by local sponsoring committees with financial support from my Department of Employment Services and Economic Secu rity.

Each of these offices will be run by a student Manitoba Youth Job Centre Mana ger, assisted by the local committee which is made up of representatives from various sectors in the commmunity, such as school, business, farm, youth and women's groups. Also, on May 4, student coordinators hired by the province will join their Federal Government counterparts in 10 Student/ Youth Employment Centres operated jointly by the two levels of government.

The student coordinators and managers at all 44 centres find summer job opportunities for students and youth by alerting businesses, organizations and the CQ,':llmunity that young people are available to work ;1d need jobs during the summer months. They also refer registered students and youth to employers looking for help, and also assist them in conducting their own job searches. The Manitoba Youth Job Centres and Student/Youth Employment Centres play an important role, along with our major provincial job creation programs, in helping young Manitobans to obtain summer jobs and valuable work experience.

In 1986, over 12 ,000 students and unemployed youth found summer jobs through our 43 provincially sponsored job centres. We anticipate, Madam Speaker, that the centres will be very active again this year, helping students, youth and employers make the connections they need to fill their summer job requirements. Thank you. MADAM SPEAKER: The Honourable Member for Brandon West. MR. J.

McCRAE: Madam Speaker, we on this side thank the Minister for his statement this afternoon, and as one who attended the opening of one of these youth centres, job centres, a year ago, I can say that I think this type of thrust does have some support in the communities and does, indeed, go some distance toward helping employers and employees get together.

On the other hand, Madam Speaker, programs like this, as laudable as they may be in creating short-term summer work for students, which is important - as a father of students and one who lives in a neighborhood where there are a number of them, I can tell you these kinds of programs are needed - however, as a substitute for real jobs strate gy, I think that we should be looking at other methods of creating work for people in this province. We talk about creating a healthy economy for working men and women and young men and women.

Well, Madam Speaker, that's going to be very difficult to achieve unless we do something to create a better investment climate in this province generally. I ref er, for instance, Madam Speaker, to the tax regime in this province which, as I understand it, is at least the second worst in this whole country; and we are told by the Canadian Federation of Independent Business, whose members create most of the jobs in this province, that this province is the worst place in all of Canada to invest.

And so as far as honourable members on this side of the House are concerned, we feel that this government has a very long way to go, Madam Speaker, to repair much of the damage it has done with all its taxes and its anti-business labour laws, and as we have found out recently , anti-worker labour laws. This government still has a long way to go, and until we see some progress that way, I suppose we will be seeing more of this type of program in the future. But it is short term, Madam Speaker, and doesn't in any way serve to provide this province with the kind of economic climate we need to put Manitobans to work.

MADAM SPEAKER: The Honourable Minister of Agriculture. HON. B. URUSKI: Madam Speaker, I have a statement to make. I want to express my great disappointment and concern about the significant decline in Wheat Board initial prices for the 1987-88 crop year, which were announced yesterday. A further 18 percent average decline on top of last year's already low prices will inflict further economic and social hardship on many thousands of Western Canadian grain and oilseed farmers. At these prices it will be largely impossible to cover cash operating costs, let alone service debt and provide family living.

Last year's drastic price reductions cancelled out any special measures undertaken by the Manitoba Government to counteract the decline in farm income. This further reduction now places grain and oilseed farmers in the worst income situation they have faced since the 1930's. 1113 and

Tuesday, 21 April, 1987 My government had called for holding the initial prices at last year's levels. Even those levels required the Federal Government to supplement existing support programs with the special $1. 0 billion payment. The interim Western Grain Stabilization Plan payment also announced by the Federal Government is, of course, of small consolation to the 17 percent of producers who are not in the program. At the farm gate, the new initial prices amount to about $2 per bushel for wheat and about $1 per bushel for barley.

How can any government expect farmers to remain viable with today's costs when they receive 1930 prices for their product? My government ·has called for a more effective protection against the devastating impact of the U.S. Farm Bill and the trade wars on Canadian grain farmers. We have proposed major changes in the Western Grain Stabilization Program which would tie support more closely to the cost of production. We have also proposed that the plan should provide for individual farmer and crop support.

If the Federal Government is not prepared to immediately implement these changes, then I call on my colleagues in this House, and members opposite, to join with me in pressing the Federal Government for retaining initial prices at their 1986-87 levels. Many farmers have had difficulty obtaining operating credit due to the declining grain prices of the last few years. These problems prompted all Provincial Ministers of Agriculture to call for a national operating loan guarantee program to supplement provincial programs.

These lower prices will create even greater difficulty for farmers who have been having trouble obtaining operating credit. In addition, a new group of farmers will now be unable to obtain operating credit without a government guarantee. With this latest drop in grain prices, the potential costs of operating a loan guarantee program are greater than the resources of any Provincial Government. I ask members opposite to join with me in asking the Federal Government to establish a national operating loan guarantee program.

To not cooperate in this area, Madam Speak er, would be a great disservice to Manitoba farmers who need all the assistance government can provide at this time of economic difficul ty. MADAM SPEAKER: The Honourable Member for Virden. MR. G. FINDLAY: Thank you, Madam Speaker. I thank the Minister for his statement here this afternoon, although it's awful late in coming. We've been in a debate for help for agriculture in Manitoba for well over a year, since the last election, and this government has yet to come forward with any constructive program that would match what Saskatchewan and Alberta have been doing.

Madam Speaker, agriculture is a joint and shared responsibility under

section 85 of the Constitution, and the Minister knows this full well. If he looks to the west, Saskatchewan and Alberta have, in 1986, recognized the problem and put in place very significant farm support programs for operating loans, particularly in Saskatchewan, for fuel rebates, for fertilizer rebates, for incentives to invest in the livestock industry. Madam Speaker, these are very depressing times in terms of the ability of this country to produce and sell grain on the export market. There is no question about that, every farmer knows that.

The reality of the initial price announcement yesterday is indeed very devastating. Madam Speaker, this province needs to get together with the two western provinces and go to Ottawa and ask for a new extensive special grains program similar to what was done in 1986, and it appears now that the amount of money the taxpayers of Canada must put up to keep our farmers on the land is going to be about double what it was last year.

This Minister would be serving the farmers of Manitoba better today if he came forward and said that he supports that sort of program, that sort of additional financial income for the farmers of Manitoba in 1987, Madam Speaker. Instead, he has not done that; he's asking for something else that is already in place in the Province of Saskatchewan and, to some degree, in the Province of Alberta.

We have, in the Province of Manitoba, federal money coming in through the Western Grain Stabilization of some $13 0 million in the interim payment announced yesterday; over $1 50 million in the combined payments in 1986; and a special grains payment coming into the province, $151 million, Madam Speaker. It's time the Province of Manitoba started to put some money up themselves. The total federal contribution to agriculture in this province last year, Madam Speaker, was over $530 million, and this Provincial Government put in well under $10 0 million.

I think it's time that this Provincial Government came forward with some meaningful programs to try and do its fair share of supporting the agricultural industry of this province, Madam Speaker. I would ask the Minister if he would like to make another statement, to stand up and say whether he supports the special grains program for 1987 and is calling upon the consumers of Canada to contribute through this in an extensive fashion? Thank you, Madam Speaker. MADAM SPEAKER: Notices of Motion . IN TRODU CTIO N OF BILLS HON. A. MACKLING introduced Bill No. 18 ,

An Act to amend The Securities Act; Loi modifiant la

loi sur les valeurs mobilieres. HON. R. PENNER introduced Bill No. 19 ,

An Act to amend The Limitation of Actions Act and The Highway Traffic Act and to Repeal The Unsatisfied Judgment Fund Act; Loi modifiant la

Loi sur la prescription et le Code de la route et abrogeant la Loi intitulee "The Unsatisfied Judgment Fund Act." IN TR ODU CTION OF GU ESTS MADAM SPEAKER: Before moving to Oral Questions, may I direct the attention of honourable members to the gallery where we have 58 students from Grade 11 from the Warren Collegiate. The students are under the direction of Messrs. Jake Wiebe and George 1114

Tuesday, 21 April, 1987 Shableck. The school is located in the constituency of the Honourable Member for Lakeside. We have 30 students from Grade 11 from the Sisler High School. The students are under the direction of Miss Debbie Perih and the school is located in the constituency of the Honourable Member for lnkster. We have 30 students from Grade 6 to 11 from the Ralph Maybank School, under the direction of Mr. Helgason, and the school is located in the constituency of the Honourable Member for Fort Garry. On behalf of all of the members, we welcome you to the Legislature this afternoon.

ORAL QU ESTIO NS Sugar beet industry - assistance to laid -off emplo yees MADAM SPEAKER: The Honourable Leader of the Opposition. MR. G. FILMON: Thank you, Madam Speaker. My � question is for the Premier. , Last week, the Premier received a letter from the president of B.C. Sugar Compa ny, who are the owners and operators of the Manitoba Sugar Refinery in Fort Garry. The letter said: "I must stress that there is no possibility of being shut down for just one year and maybe reopening in 1988 or later. The industry once shut down is gone forever.

I am saying this so there will be no misunderstanding by anyone on the finality of closure." My question to the Premier is: Has his government put in place any plans to assist the 93 permanent, and 150 part-time workers, the 68 workers in the trucking industry, to find alternate employment because of the impending shutdown of the Manitoba Sugar Refinery in Fort Garry as a result of his government 's stub born refusal to enter into and sign a Tripartite Stabilization Agreement with the producers in Ottawa to save the sugar industry for Manitoba? MADAM SPEAKER: The Honourable First Minist er. HON. H.

PAWLEY: Madam Speaker, I see the Leader of the Opposition continues to negotiate on behalf of Ottawa, and continues to present the case on behalf of his friends in Ottawa. Madam Speaker, the Minister of Agriculture has, on numerous occasions, indicated his willingness to provide in excess of $3 million over the next 10 years, commencing with a payment of some $31 5,000 this year, towards the sugar beet producers in the Province of Manitoba in order to permit them to plant a crop.

Madam Speaker , in fact, on the basis of that assistance, on the basis of 19 85 assistance, which was purely at that time a federal program of assistance, the amount of assistance would far outweigh, far exceed the amount of payment which is expected for the grain producers of this province. Sugar beet industry - tripartite agreement MR. G. FILMON: Well, Madam Speaker, I'm sorry that the Premier refuses to stand up on behalf of the workers and the sugar beet producers of Manitoba.

Given the concern that was expressed just a few moments earlier by his Minister of Agriculture for the plight of the grain producers of Manitoba, a concern that I think rings hollow given his stub born refusal to enter into a tripartite agreement; given that current weather conditions, Madam Speaker, would see the seeding taking place this very week in Manitoba to ensure that our crop of sugar beets is seeded; and given that every day that the weather persists and the sugar beets are not allowed to be seeded, the quality and indeed the production of the crop are disappearing right before our very eyes, will the Premier set aside his partisan, petty differences with Ottawa and stand up for the workers of Manitoba, stand up for the sugar beet farmers of Manitoba, and stand up for the industry of Manitoba and sign the tripartite agreement today?

MADAM SPEAKER: The Honourable Minister of Agriculture. HON. B. URUSKI: Madam Speaker, if I ever saw the Leader of the Opposition repudiating the comments made by his colleague, the Member for Brandon West, it is in his statement in terms of standing up for workers. It is his Member for Brandon West who has continually attacked the right of workers to organize. Madam Speaker, let it be clear that on March 20 of this year we made a proposal to the Federal Government, and it was the Federal Government that did not acknowledge or even want to discuss that proposal.

Madam Speaker, we had met with the Federal Government on March 30 of this year at which time the Federal Government did not want to even discuss the merits of our proposal, and it's been those members opposite who have continually attempted to negotiate on behalf of Ottawa in this House. Madam Speaker, the announcement by the president of B.C. Sugar is that clearly the other shoe of the layoff notices that they provided to workers indicated that, in fact, we're going to put some more pressure on the negotiating of this program.

Madam Speaker, over the weekend we final ly, at our request, met with representatives of the Federal Government, the Hon. Charlie Mayer and the Hon. Jake Epp. They have indicated that they are now prepared to reconsider their earlier position and staff are to be meeting and reporting to us. That meeting should have been held weeks ago, Madam Speaker, and this situation certainly would not have developed. I continue to ask members opposite to talk to their colleagues and not negotiate on their behalf. Hospitals - closure of beds to control deficit MR. G.

FILMON: Madam Speaker, I regret that the Premier won't stand up for the workers of Manitoba. We'll see the industry disappear before he overcomes his stub borness. Madam Speaker, on another matter of great concern, there of course were continuing reports over the weekend - and this is again a question for the Premier and I hope that he'll consider responding to this one - of bed closures at hospitals and pending bed closures at hospitals throughout the province: Health Sciences 1115

Tuesday, 21 April, 1987 Centre intending to close 10 0 beds, most of them permanen tly, within the next couple of months; the Brandon General Hospital, which closed 29 beds permanently last year, is planning again to close 49 more this summer; Victoria General Hospital is planning, Madam Speaker, to close 48 beds on an indefinite basis; Concordia, 30 on a temporary basis; Seven Oaks, Grace, St. Boniface and Misericordia are also considering bed closures. MADAM SPEAKER: Does the honourable member have a question? MR. G.

FILMON: My question to the Prem ier, Madam Speaker: Is it his government's policy to propose and approve the closure of active treatment and surgical beds in the hospitals of Manitoba as the best way of saving costs for our health care system? MADAM SPEAKER: The Honourable Minister of Health. HON. L. DESJARDINS: Madam Speaker, it's quite obvious that the Leader of the Opposition got too much material because all he can do is repeat, repeat and repeat. Therefore, I will give him the same answer that I gave him last week and the week before. MR. G. FILMON: Why don't you give it to your Premier, so he can ... . HON.

L. DESJARDINS: He knows it, but you don't. You're the one who repeats the question.- (lnterjection) No, but I have the responsibility for the Department of Health, my dear friend. MR. G. FILMON: He makes the final decision, so he's going to approve the closures, eh! SOME HON OURABLE MEMBERS: Oh, oh! HON. L. DESJARDINS: Madam Speaker, what I did say, we are meeting with the hospitals. We agree with our honourable friend that we have to be careful with the deficits and, therefore, the hospitals should be careful with their deficits, and they are now proposing to us how to stay within their budgets.

That will be considered, a decision will be made. It is not the suggestion that comes from us as you said; it is a suggestion that will come from the hospitals. We will look at the proposals and we will give an answer to them and also make sure that the public of Manitoba knows the answer. MR. G. FILMON: Madam Speaker, my further question is again to the Premier and I would hope that he would have the courage to answer on behalf of this government. Madam Speaker, the proposals that have been put forward by all the hospitals that I listed in the

preamble to my first question involve the closure of well over 200 active treatment and surgical beds in Manitoba over the next few months. Will his government approve the closure of these beds as the way in which to save money in the health care system of Manitoba today? MADAM SPEAKER: Order please. That question is substantially the same as the previous question. Hospitals - gov't approval of bed clo sures MR. G. FILMON: May I just indicate that the Minister of Health indicated that it will be the government's prerogative to review that matter. It's not the Health Services Commission's proposal.

My question to the Premier is: Will he and his government be the ones to make the final decision on approval of the closure of well over 200 beds of active treatment and surgical beds in Manitoba? MADAM SPEAKER: The Honourable First Minist er. HON. H. PAWLE Y: Madam Speaker, the Minister of Health dealt with that question. The difficulty with the Leader of the Opposition, he continues to repeat the same questions from day to day.

It does become very monotonous, I think, for Manitobans, as a whole, to hear the same questions day after day, the same answers day after day, rather than fresh questions and fresh answers. MR. G. FILMON: Madam Speaker, given that the Premier refuses to answer whether or not he will take the responsibility for the closure of . . . MADAM SPEAKER: Order , order please. References to whether a Minister answers a question or not are not in order. The Honourable Leader of the Opposition. MR. G.

FILMON: Madam Speaker, will the Premier tell us, is this his idea of fulfilling his campaign promise to preserve and enhance the quality of health care in Manitoba, to close over 200 active treatment beds? Is that his idea of preserving and maintaining the quality of health care in Manitoba? MADAM SPEAKER: That question seeks an opinion. Would you like to rephrase it? The Honourable Leader of the Opposition to rephrase his question. Hospitals - gov't policy re bed clo sures MR. G. FILMON: Yes, Madam Speaker.

Is it the policy of this Premier's government to allow the closure of over 200 active treatment beds as a way of fulfilling his promise of preserving and maintaining the health care quality in this province? MADAM SPEAKER: The Honourable Minister of Health. HON. L. DESJARDINS: Madam Speaker, again it's the same question. I told my honourable friend that the suggestion and the proposal of hospitals will be reviewed by the Manitoba Health Services Commission who will make the recommendation. Madam Speaker, it is obvious that they don't want to take any responsibility at all.

They're trying to make cheap political . . . We will accept the responsib ility. 1116

Tuesday, 21 April, 1987 We have increased in a very few years the budget of this department by 17 5 percent. The Federal Government has cut down their contribution and, Madam Speaker, it is going up and up and up. We will look at better ways to keep on the standards we have now, to improve the standards and to cut down on the costs. There is no way in the world that we can keep up with that, but you don't give a damn. You're just trying to make some political . . . and if we have to deinstitutionali ze, we would deinstitutionalize . SOME HONOURABLE MEMBERS: Oh, oh! MADAM SPEAKER: Order please, order please. .

HON. L DESJARDINS: . . . but if there is a way, and if there is a way to have surgery without having all those beds open, we will close some beds, but we will retain the health service . . . MADAM SPEAKER: Order, order please. � HON. L. DESJARDINS: . . . one of the best in the world right here in Manitoba, even if you don't want to help and you accept the responsibility for that. SOME HONOURABLE MEMBERS: Oh, oh! MADAM SPEAKER: Order please, order please. May I remind honourable members that questions and answers are to be addressed through the Chair, not back and forth across the House at each other.

Child abuse - tabling of internal review re deaths MADAM SPEAKER: The Honourable Member for St. Norbert. MR. G. MERCIER: Thank you, Madam Speaker. I have a question for the Minister of Community Services. The External Review Report, by Dr. Sigurdson and Professor Reid, indicated on pages 3 and 4 that the review team's analysis of child deaths reveals the need for not only a reliable risk assessment tool, but also standards to which the agencies are accountable, and a willingness to review all child abuse deaths in a fashion that permits the system to learn from its mistakes.

Madam Speaker, in view of this recommendation, would the Minister undertake to table in the House the internal review of her department into the role of her department's policies and procedures and the role of child welfare agencies in the death of four infants last spring? MADAM SPEAKER: The Honourable Minister of Community Services. HON. M. SMITH: Madam Speaker, I think the comment about the risk assessment tool, the development of standards, and the role of the Chief Medical Examiner was raised last week, and I indicated my support for the recommendations.

With regard to the application in these particular child deaths of last year, the reports that are shared with the agencies can be developed in some reform and made public. We would welcome the role of the Chief Medical Examiner should an inquest be deemed desirable. Again, of the five deaths that were investigated, three of them, there is no court action pending or contemplated; one there has already been a sentencing; and in another case there has been a finding of negligence against the mother and the sentencing remains to be done.

But we welcome the involvement of the Chief Medical Examiner in reviewing any of these deaths in future. For some reason, historically, children's deaths have not been treated in the same way as adult deaths and we think it's time for the total system to tighten up and give an exhaustive review of children 's deaths. Child abuse - Chief Medical Examiner, inquests into deaths MR. G.

MERCIER: Madam Speaker, I didn't really get from that answer whether the Minister would table in the House the internal review of her department, but the review stud y does indicate the staff of the Department of Community Services have no training in investigative functions in child deaths, and that is the basis for the recommendation that the Chief Medical Examiner be authorized to investigate the role child welfare agencies in her department has played in deaths where the children are in care.

Would she be prepared to request the Chief Medical Examiner to conduct inquests into these four or five children's deaths? HON. M. SMITH: Madam Speaker, I've already said I have no problem with the inquest. Whether it's appropriate to have an inquest after the court hearings is something that I'd need some legal advice on. With regard to the investigative role of people in the department, it's our belief that there is a multi disciplinary role here because we're dealing not only with medical issues but with social issues, indeed with legal issues.

All along we have said that our commitment is to build a multi-disciplinary committee that can work cooperativ ely, each contributing the wisdom of their particular discipline to, in time, prevent child abuse, we devoutly hope, but in the meantime to do the very best we can to have a system that gives timely and effective support to the children. Child abuse - Chief Medical Ex aminer - review of dept's role MR. G. MERCIER: Madam Speaker, I'll ask a final supplementary question, a very simple one, and hopefully we'll get a very direct answer.

Will the Minister table the internal reviews in the Legislature, the whole reviews, and will she request the Chief Medical Examiner to conduct an independent review of the role her department and the child welfare agencies played in these deaths, particularly in view of the comments I referred to her that are contained in the review by Dr. Sigurdson and Professor Reid? HON. M. SMITH: Madam Speaker, I said that the report was shared with the agency and that we are prepared, 1117

Tuesday, 21 April, 1987 after they've had their discussion of it, to present a

summary of the report and make it available to members opposite. But it has been the custom, where we're dealing with specific staff and with specific families, to observe the confidential ity, and I think that that is an important factor. Again, with regard to the review of the Chief Medical Examiner, I repeat, we support the role of the Chief Medical Examin er, but just want to identify that there is a social system, a legal system, as well as a medical health system that has to undergo review, and it's going to be the multi-disciplinary review that's going to come up with the most appropriate recommendations.

Special Needs children - discussion paper MADAM SPEAKER: The Honourable Member for Fort Garry. MR. C. BIRT: Thank you, Madam Speaker. My question is to the Minister of Education. For some time we, on this side, have been arguing and pushing the government to allow greater parental involvement and input into the decisions as it relates to special needs children in the school system. Recently, the Minister of Education sent out a paper called "The Appropriate Education Student Placement and Parent Involv ement.

" My question to the Minister is: When was this document prepared, who prepared it, and what sort of distribution has it received? MADAM SPEAKER: The Honourable Minister of Education. HON. J. STORIE: Yes, Madam Speaker, the paper that the Member for Fort Garry is referring to was prepared by the department, people in Child Care and Development, and has been distributed to groups who have expressed an interest in the issue of special placement over the last number of years.

It is intended as a discussion paper and, hopeful ly, the groups who have received a copy, or individuals who want a copy, will be providing advice and points of discussion for the preparation of a policy for distribution throughout the province. Special Needs children - public input re discussion paper MR. C. BIRT: As of last week, MAST, the Provincial Home and School, MARL, the Visually Handicapped, the League for the Physically Handicapped, the Manitoba Learning Centre and other people who have been involved and would be interested in this paper have not received a copy of this particular document.

I would ask the Minister that he give wide circulation to this particular document, and also ask if he'd be prepared to consider - it says at the end that they want comments by June 1 of this year so that they can finalize guidelines for June 30 of this year to put in place for the fall of this coming year - I would ask that the Minister give consideration to wider circulation to those people who have, perhaps, a greater stake in this particular document; and also ask if he'd consider extending the time to allow greater public input so that a full policy position can be developed by the public and the Department of Education?

HON. J. STORIE: Madam Speaker, of course the member knows the dilemma that he places us in when he makes that request. I'm certainly prepared to share the discussion paper with anyone who has an interest. I've indicated that the groups that have contacted us and indicated a special interest in this on a continuing basis have been provided with a copy of this discussion paper. It is an important issue, one that has been discussed in many forms over many years.

I would be somewhat reluctant to see a delay in this discussion phase because the longer we delay it, the more unlikely it is that we'll be able to have in place by December a form for parents who have special placement problems to ensure that their involvement, their participation is active and real, and that's the real goal. If there are additional concerns about any policy that's finally developed, obviously there will be ample oppo rtunity over the intervening months and subsequent months to amend the policy . Special needs children - Charter of Rights Review Committee MR. C.

BIRT: A final question to the Minister of Educa tion. He has indicated in the past that there is a Charter review team he created in the Department of Education, and I believe also that there is a subcommittee in the Attorney-General's Department. I would ask if the Minister has had an opportunity to have this position paper reviewed by one, or both, of those organizations and what comments, if any, have they made of it, or have they had an opportunity to review this position paper? HON. J.

STORIE: Madam Speaker, the Charter of Rights does not now, or never has, spurred all of the interest of parents in education. The fact is that this is a policy that I think many people will deem to be an appropriate one regardless of the implications of the Charter on The Public Schools Act or any of the regulations that flow from The Public School Act. This is an important poli cy. It's being dealt with not because of any necessity on the part of fear of a Charter compliance case; it's being followed because I think it's good educational practice.

It's good for the parents; it contributes to the sense that people can be involved in the educational system; and I assume that most of the groups who have expressed interest, expressed an interest on that basis, not because of any perceived threat or necessity coming from the Charter of Rights. Highways Review - request for refund of fee paid MADAM SPEAKER: The Honourable Member for Arthur. 1118

Tuesday, 21 April, 1987 MR. J. DOWNE Y: Thank you, Madam Speaker. I have a question for the Minister of Municipal Affairs. In view of the fact that he spent $55,000 of taxpayers' money to hire a former colleague and Cabinet Minister to carry out a report, Madam Speaker, which reported that Manitoba needs a long-range funding program for roads and bridges, a fact that every Manitoban, every councillor and everyone in the province knew, except the Minister of Municipal Affairs, will he ask for the $55,000 back from that former Cabinet Minister?

Madam Speaker, in view of the fact that the Minister has spent $55,000 of taxpayers' money to support a former - plus expenses - Cabinet colleague and we get nothing more than a phony consultant's report that doesn't even have a firm dollar value to it as what his recommendations would cost, will he ask for the $55,000 back from that individual, plus expenses? MADAM SPEAKER: Order please. That question repeats in substance a question already answered or to which an answer has been refused. The Honourable Member for Arthur . MR. J. DOWNE Y: Madam Speaker, believe you me, I'm serious.

If the Minister doesn't think I am, I am. Highways - future contracts MR. J. DOWNE Y: A further question. Is the Minister of Municipal Affairs carrying out another contrac tual agreement with that same individual for the coming year and, if so, how much money are we paying him this coming year? MADAM SPEAKER: The Honourable Minister of Municipal Affairs. HON. J. BUCKL ASCHUK : Thank you very much, Madam Speaker. It's indeed interesting to note my critic's views about the needs of rural Manitoba. I want to assure him that the report is a very good report.

Madam Speaker, I rise to give an answer and I can't even hear myself for the noise from the critic. The report, in fact, is a very good report I will be releasing it within a couple of weeks, and the member will then be assured that it does reflect the needs of rural Manitoba as enunciated by many of the elected officials from rural Manitoba. Second ly, there is not a further contract with that individual from the Department of Municipal Affairs. Anstett, Andy - future gov't contracts MADAM SPEAKER: The Honourable Member for Arthur with a final supplem entary. MR. J.

DOWNE Y: Madam Speaker, to the First Minister . Will his former Minister of Municipal Affairs, one Andy Anstett, be getting a contract from any other department of government for the coming year? MADAM SPEAKER: The Honourable First Minister. HON. H. PAWL EY: Madam Speaker, I'm not sure, but I would certainly welcome the services of Mr. Anstett at any time. Mr. Anstett has provided, I think, innumerable services to the Province of Manitoba as a Minister of Municipal Affairs and also has done a good job of providing service to the Province of Manitoba during the past year.

Churchill Public Housing - eviction of teachers MADAM SPEAKER: The Honourable Member for River Heights. MRS. S. CARSTAIRS: Thank you, Madam Speaker. My question is to the Minister of Housing. Can the Minister tell the House if her department is continuing its pursuit of the eviction of the teachers from the Churchill Public Housing Project? MADAM SPEAKER: The Honourable Minister of Housing. HON. M.

HEMPHILL: Madam Speaker, I'm pleased to report to the House that when representation was made to my department indicating that there was some concern over moving teachers out in the middle of the academic school year, that we agreed with the concerns that were raised and indicated that the teachers would not have to be moved until the end of the school term. Churchill Public Housing - lease for teachers MRS. S. CARSTAIRS: A supplementary question. I thank the Minister for her fine sense and treatment of teachers during the academic year, but I would like to pursue the issue.

The question is: Does she still maintain that the contract for the housing in Churchill was based on a temporary permission for teachers to occupy it,

whereas I have a letter, as does she, which indicates that the original contract was in fact a 50-year lease for the teachers in the Churchill School Division? HON. M. HEMPHILL : Madam Speaker, as I indicated before in the House, that when the housing was first built it was built at a time when there was not optional housing available for the residents of that community.

When it became clear that one of the greatest needs for that housing at that time, and there was no other housing available for them, was for the professionals - and that would be the teachers and the nurses, and we know how important it is to have teachers and nurses come into northern and remote communities - at the time, there was not a waiting list or a need for the original purpose for building the housing - and that was social housing - so an accommodation or an agreement was made, Madam Speaker, that we would provide that housing at that time because there was no alternative housing.

Now there is, Madam Speaker, for the teachers and nurses to be accommodated in other housing. Because we now have a waiting list for people that are entitled and qualify under the social housing criteria, it's important that they also have options, Madam Speaker. 1119

Tuesday, 21 April, 1987 Churchill options - housing for teachers MRS. S. CARSTAIRS: With a final supplementary to the same Minister, Madam Speaker. The housing was built for teachers, with teachers involved in the planning of that housing accommodation. Will the Minister provide teachers also with the option of where they will live in the Town of Churchill? HON. M.

HEMPHILL: Madam Speaker, the teachers now do have some alternative housing available to them that was not available before, and one of the reasons that there are now options for them, and for other people, including some special supports for mortgages, is because this government has taken the position that it is very, very important for us to have alternative housing, other than social housing, available to residents of northern and remote communities.

It's because of our programs that housing has gone into that northern community and to other communities throughout the province that had no alternative housing before, and we will continue those programs. Home Care - quidelines to receive MADAM SPEAKER: The Honourable Member for Emerson. MR. A. DRIEDGER: Madam Speaker, my question is to the Minister of Health. The Premier last week proudly indicated a 40 percent increase in the estimates for home care year over year. Can the Minister of Health indicate whether there have been any changes in guidelines, requalification, for people who qualify for home care?

MADAM SPEAKER : The Honourable Minister of Health. HON. L. DESJARDINS: Madam Speaker, no, we're not contemplating any changes. In fact, we hope to improve and enlarge the home care program so it could take care of some people who in the past have not been taken care of even if they were in the hospitals or personal care homes. We hope that we could afford these people to live at home and still get the home care possible to make this possible. MR. A. DRIEDGER: To the same Minister, Madam Speaker.

Is the Minister indicating that there are no cutbacks in guidelines which restrict people from qualifying for home care? HON. L. DESJARDINS: Yes, that' s what I'm saying. Headingley - study re secession from City of Winnipeg MADAM SPEAKER: The Honourable Member for Charleswood. MR. J. ERNST: Thank you, Madam Speaker. On March 27, I forwarded a petition from a group of citizens in Headingley to the Ministers of Municipal and Urban Affairs requesting an implication study on the secession of that community from the City of Winnipeg.

I would ask the Minister of Urban Affairs if he is now in a position to respond to that request and to advise when that study might be undertaken? MADAM SPEAKER: The Honourable Minister of Urban Affairs. HON. G. DOER: Yes, thank you, Madam Speaker. I haven't had an opportunity to discuss it with my colleague, but I certainly intend to do so. We're discussing a number of items that arise out of the City of Winnipeg review and arise out of our White Paper dealing with urban sprawl, and I would be prepared to advise the member opposite accordingl y. City of Winnipeg Act Review - tax assessment MR. J.

ERNST: A supplementary question to the Minister of Urban Affairs, Madam Speaker. Given that up to this point the government has refused to deal with the question of untoward taxation in the community of Headingley and other areas of the city, and the fact that now he's not goi ng to deal with this, as I gather, unless he's dealing with it in the same context as the rest of The City of Winnipeg Act review, will the Minister now address the question of the probems of the people of Headingley, of South St. Vital, of South Tr anscona, and deal with this issue immediately? HON. G.

DOER: We did have extensive public consultation at the committee stage on the bill. Madam Speaker, we are concerned about the situation and we've said we would study it with the City of Winnipeg over the next year and discuss it with the Minister of Municipal Affairs. I think it's important to remember, Madam Speaker, when we're talking about unfair taxation, that many of the people, notwithstanding some of the hardships that may present, are being assessed at six cents per square foot for their land when somebody on Magnus Avenue is being assessed at $2 per square foot for their land value.

So, Madam Speaker, let's keep the record straight in terms of fairness and taxation in terms of assessments. Lotteries Foundation - discrimination re umbrella groups MR. J. ERNST: I have a new question, Madam Speaker, to the Minister responsible for the Manitoba Lotteries Foundation. On March 26, Madam Speaker, I asked the Minister to look into a case of alleged discrimination between two umbrella groups under the auspices of the Manitoba Lotteries Foundation. The Minister at that time indicated she would respond; to date she has not. Can she now respond?

MADAM SPEAKER: The Honourable Minister responsible for Lotteries. 112 0

Tuesday, 21 April, 1987 HON. J. WASYLYCIA-LEIS: Thank you, Madam Speaker. I would be happy to provide the Member for Charleswood with any information he requires. I've looked into that particular issue raised by the member and did not find any case of discrimination, so did not feel it necessary to report back to the House, Madam Speaker. Virden - landfill site - ta bling of corr espondence MADAM SPEAKER: The Honourable Minister of the Environment. HON. G. LECUYER: Thank you, Madam Speaker.

I wish to table for the House, in response to a question, documents or letters that I've had with the town of Virden in response to a question raised by the Member for River Heights on April 9. Li brary funding - City of Winnipeg MADAM SPEAKER: The Honourable Member for Springfield. MR. G. ROCH: Thank you, Madam Speaker.

To the Minister of Culture, Heritage and Recreation: Given the desperate situation of the City of Winnipeg's public library system which has only experienced one marginal increase amounting to 33 cents per capita in six years of an NDP Government; and given the fact that there are serious deficiencies in the national comparison specifically regarding the number of volumes acquired per capita, where Winnipeg runs the lowest, and there has been a documented attempt by the City of Winnipeg to rectify this disastrous state of affairs by providing additional funding; and given the fact that this government has expressed a commitment in the Throne Speech towards the library system in Manitoba, will the Minister grant a request made by the Manitoba Libraries Development Committee, and I quote: "That the Minister of Culture, Heritage and Recreation immediately establish a $2 per capita grant from the Manitoba Lotteries Foundation for the purchase of library books and materials."?

MADAM SPEAKER: The Honourable Minister of Culture and Heritage Resources. HON. J. WASYLYCIA-LEIS: Thank you, Madam Speaker. I'm pleased to have the opportunity to clarify this government's record with respect to libraries in this province and to clearly indicate that our record on this matter is major and significant and outstanding by any other record across this count ry. Madam Speaker, we have responded by providing a sizeable per capita increase to the City of Winnipeg Public Library as well as responded to a very sharp need in rural Manitoba.

Madam Speaker, I would suggest that the member raising this question look at the facts, and I would be glad to table the facts as we have ascertained them, which clearly show that the Province of Manitoba 1121 provides among the highest per capita increases to any city public library anywhere in this country while the City of Winnipeg is at the bottom of the heap.

I would be quite happy to table this information so that all members could peruse the facts and to determine the situation and know that we have acted responsibly at a time - and members opposite will know - when it is fairly difficult to provide increases of this nature. So I think our record stands on its own. Library funding - double standard MR. G. ROCH: A new question to the same Minister . The City of Winnipeg library system's annual provincial grant of $2.33 per capita, in comparison to the rural Manitoba provincial grant per capita of $4.25, clearly raises a serious question.

Why does his NDP Government choose to perpetuate a double standard when it comes to the much needed funding for library services for the benefit of all the people of Manitoba? HON. J. WASYLYCIA-LEIS: I'm again pleased with an opportunity to present the facts to members opposite and clear up some obvious misunderstandings on their part. Let me repeat the facts, Madam Speaker. This year saw a grant increase of approximately $160,000 to the City of Winnipeg.

That follows on the heels of a $500,000 one-time-only grant for book acquisitions provided or just received in January, as well as a previous 12 percent increase in the per capita increase. Madam Speaker, I think the member would be foolish to try to compare the Winnipeg public library system with the rural library system. There are clear differences and a much greater need in rural Manitoba.

I make no apologies for ensuring that the rural public library system keeps pace with the kind of increases that are provided to the City of Winnipeg, regardless of the fact that that makes a difference in per capita arrangements, Madam Speaker . It's like comparing apples and oranges, or like comparing a Cadillac with a Volkswagon, and I think the member should understand the situation in rural Manitoba before making those kinds of conclusions. Library funding - ur ban and rural MR. G. ROCH: Madam Speaker, I fully understand the situation in rural Manitoba much more than the Minister.

A new question to the same Minist er, Madam Speaker: The Minister has acknowledged in the past, and I quote from Hansard of 1986, page 3314, " ... an area that has an intrinsic role in the education and development of people in the community is the continued support of Manito ba's public libraries. How can the people of Manitoba maintain any trust in this government when the Minister increases the rural per capita grant by a mere 21 percent when book prices alone have increased by almost 60 percent over the last four years? HON. J.

WASYLYCIA-LEIS: I'm having a little difficulty understanding that question, but I'll certainly try. Madam Speaker, we have taken our commitment to improving library services throughout Manitoba very

Tuesday, 21 April, 1987 seriously by providing a significant increase for both the Winnipeg public library system and the Manitoba rural library system. Both increases are well beyond the cost of living and will make it possible to see major improvements in the library system. I would suggest, Madam Speaker, to the member opposite, that if he does understand the needs in rural Manitoba, then he will understand that the need for a significant increase in that area is desperately needed. MADAM SPEAKER: The time for Oral Questions has expired. OR DERS OF THE DAY MADAM SPEAKER: The Honourable Government House Leader.

HON. J. COWAN: Madam Speaker, I move, seconded by the Minister of Finance, that Madam Speaker do now leave the Chair and the House resolve itself into a committee to consider of the Supply to be granted to Her Majesty. MOTION presented and carried and the House resolved itself into a Committee to consider of the Supply to be granted to Her Majesty with the Honourable Member for Burrows in the Chair for the Department of Agriculture, and the Honourable Member for Lac du Bonnet in the Chair for the Department of Health. CONCUR REN T COMMITT EES OF SUPPLY SUPPLY - HE ALT H MR. CHAIRMAN, C.

Baker: Committee, come to order. We're starting with 3.(a)(1), page 90, Community Health Services (Operations). The Member for Pembina. MR. D. ORCHARD: Thank you, Mr. Chairman. Mr. Chairman, I believe but I couldn't find it in my notes or in Hansard, but I believe we've already discussed the three SY's who were, last year, under the appropriation of Operations Support. Now I recall an answer where two went to Northern Health and one went into the Regional Services. Is that correct? HON. L. DESJARDINS: There are five to Northern Health now, and two for ... MR. D. ORCHARD: No, no, let's not get into that.

Specifically the change in Estimates this year over last is Operations Support, three SY's are no longer there. We simply have Regional Services. Where did the three SY's from Operations Support go? HON. L. DESJARDINS: One went to Mental Health and the other went in along with the ADM, the director and a secretary of health. That's Robson, the new executive direct or. MR. D. ORCHARD: Was Robson one of the three SY's in Operations Support last year? HON. L. DESJARDINS: Yes, he was. MR. D. ORCHARD: And he and, presumably , a secretary are now part of the SY's under Regional Services? HON. L.

DESJARDINS: In the Program Support. MR. D. ORCHARD: Okay. Mr. Chairman, can the Minister give us - like there's from last year the print estimate at 685.75 SY's, we're now being asked to approve 740.25 SY's for an increase Of 54.5. Can the Minister indicate where these people are to be located in Regional Services? HON. L.

DESJARDINS: In 1986-87, there were 25.5 SY's approved for resource coordinators at home care, 5 approved for vacation relief in home care; 14 transferred from mental health centres to the regions, 4 transferred to program directorates - I don't know what that means - then in 1987-88, there'd be 7 more - and you've got that - 5 to support Northern Health New Initiatives and then 2 to support Limestone New Initiatives, for a total of 51.26. MR. D. ORCHARD: Mr. Chairman, what regions are those staff located in? HON. L. DESJARDINS: Which ones are we talking about now, the new ones for this year or what? MR. D.

ORCHARD: Mr. Chairman, last year, we had 685.75 SY's; this year, we've got 54.5 more. What regions did they go into? What's the breakdown between the three Winnipeg regions and the seven regions outside of Winnipeg? How many SY's went to Winnipeg? How many went to the seven regions outside? HON. L. DESJARDINS: I can give you the total - 740.25 - where they are. The distribution as now, I haven't got where these extra people went. I can get that. Right now I can give you the regional distribution of staff. I can give you the 1985-86 adjusted, the 1986-87 adjusted, and the requests.

So you'll have it then, the changes. Regional directors, Winnipeg region in 1985-86 - that's the first one I'll give you - is 256.75. The next one that I'll give you is the adjusted in 1986- 87, the 292.75, and the request for this year is 292.75. Westman: 90, 92.40, 92.40. Eastman: 57, 58.30, 58.30. Central: 55, 57.40, 57.40. Interlake: 61, 63.80, 63.80. Parklands: 64.5, 64.70, 67.70. Norman: 55.5, 56.70, 57.70. Thompson: 44, 44.20, 47.20. On allocated, there weren't any in 1985-86. In 1986- 87, there were 3 requested, for a total of 683.75, 733.25 and 740.25. MR. D. ORCHARD: Mr.

Chairman, do I take from that answer then that 36 SY's - I didn't total the ones outside of the City of Winnipeg, for the seven regions outside of the City of Winnipeg - but am I correct to assume from those figures that there are 36 additional SY's in the City of Winnipeg, year over year? 1122

Tuesday, 21 April, 1987 HON. L. DESJARDINS: Yes, 256.75 to 292, that's right. MR. D. ORCHARD: Mr. Chairman, we'll discuss those numbers after I get a little more information. Mr. Chairman, in terms of the detailed Estimates, page 64, we have, on Severance/Vacation Pay, a 214 percent increase on severance and vacation pay. Why the substantial increase in Severance/Vacation Pay on termination? HON. L. DESJARDINS: The increase is required to bring the allotment more in line with actual expenditures. The actual 1985-86 was 122.9 and 1986-87 was 212.7. MR. D.

ORCHARD : And Overtime/Standby pay is up by 100 percent; well it's doubled over last year. Why is Overtime/Standby pay double over last year? HON. L. DESJARDINS: The increase is required as part to bring the allotment more in line with actual expenditures - actual in 1985-86 was $90,000; in 1986- 87 was 107.3 - and also to provide for increased overtime in some regions due to the inability of staff to take compensatory time off due to staffing levels being unable to keep pace with caseload increases. MR. D.

ORCHARD: Are either one of those two items that we've just discussed primarily paid in the Winnipeg region versus the other seven regions? HON. L. DESJARDINS: Yes, most of the change would be in the Winnipeg region. MR. D. ORCHARD : Mr. Chairman, we've got a new allowance in here, Remoteness Allowance, for $216,000, rounded. To whom is that to be paid, for what purpose, and why is it a new item this year? HON. L. DESJARDINS: This was something that was taken out of Salaries before, and we were instructed to have a special explanation, a line for that, which we hadn't had in the past, and that's 215.8.

That would be in remote stations such as nurses up north. MR. D. ORCHARD: Mr. Chairman, if that was accounted for as Salaries last year, where was it in Salaries - in managerial, professional, administrative support, term, all four or none of the above? HON. L. DESJARDINS: It would be in the latter two, the professional and technical and some administrative support and also some in term. MR. D. ORCHARD: That would make for an interesting . . . now presumably then, the $215,000 in the adjusted vote of $15,773,212 includes the remoteness allowance that was paid last year. Is that correct? HON. L.

DESJARDINS: I didn't get the figures on that. That includes out of the 21, did you say and the 23. Or the 15 on professional? MR. D. ORCHARD: Yes. HON. L. DESJARDINS: Yes. MR. D. ORCHARD: Mr. Chairman, can the Minister provide me with organizational charts? Three things I'd like to request; first of all, the regional map of Winnipeg which shows the three new regions. Those weren't available last time, last year, at Estimates time.

And if the Minister could provide to me an organizational chart of the Winnipeg region before the reorganization, as well as an organizational chart which would indicate the regional organization under now three regions and an executive dire ctor . Could those three pieces of information be available now? And I'll turn the floor over to anyone else who might have questions. HON. L. DESJARDINS: Three or two? You asked for the chart, the region chart in Winnipeg. Oh, the two before and after, yes; including the role if any, when there's a dual role of the community services. MR. D. ORCHARD: Yes.

And the breakdown in terms of the areas that Winnipeg's been physically divided into the three regions now. The regional map. And I would peruse those whilst, if anyone else had questions, I'd just ... that information. HON. L. DESJARDINS: Yes, we'll get it for today; at least for tonight. MR. D. ORCHARD: We may have to flip back for a few questions if we happen to pass this item. HON. L. DESJARDINS: Fair enough. MR. CHAIRMAN: The Member for River Heights. MRS. S. CARSTAIRS: Thank you, Mr. Chairman. Can the Minister tell me what were the new initiatives in Northern Health which required the new five SY's? HON. L.

DESJARDINS: Regional program development initiatives in the Northern Health Program, you want to know where, not the function of those . . . MRS. S. CARSTAIRS: No, I wanted to know what new initiatives there were. HON. L. DESJARDINS: Oh. I'll give you the function then also. It was to provide access to early diagnosis, treatment and follow-up of disease for residents of northern and difficu lt-to-access communities, and then to provide comprehensive public health services in maternal and child health, health promotion and communicable disease control programs .

The activity identification would be primary care clinics; 24-hour emergency first aid service; referral to position where indicated; home visiting; well-baby and three-year-old assessment clinics; individual and group counselling; immunization; screening for early disease detection. The result that we expect from that would be provision of public health services in north and difficult-to-access communities; surveillance, treatment and follow-up of communic able diseases; increased attendance at the well-baby clinic. They are in Parkland 11 23

Tuesday, 21 April, 1987 Region, one in Pelican Rapids, one in Ebb and Flow, Crane River, one Waterhen and Mallard; Thompson Region, one in Wabowden; Norman Region, one in Cormorant. MRS. S. CARSTAIRS: In amongst these initiatives, is there anything in the northern communities which is encouraging Native women in particular to nurse their babies?

I raise this because it's come to my attention that what is happening with the removal of many of these northern mothers from their Native reserves and moving them into communities that we are, yes, having a much lower mortality rate, that the delivery is much safer and it's far better as far as the child is concerned. Then the child is going back into that community with bottled formula and that bottled formula is not continued.

The child is then going on a mixture of sugared water, Tang and goodness knows what else, and we are losing - in fact, these children are having all of their teeth removed at the age of two by dentists because they're afraid of the massive infection in these children's mouths. Do we have any kind of program going on now which would encourage the nursing of these infants so that their long-term health, not their immediate birth health, is better protected? HON. L.

DESJARDINS: . . . give you in details of what is actually going on, I guess we'd have to find out from the people in the North that are delivering services, but I can tell you that we've had discussions with some of the reserves over there and they are quite concerned with the same, not only that, but other reasons of the high mortal ity. They have suggested that we train nurses and it was felt that the best way would be to train Native nurses from The Pas and they're asking for a baccalaureate and that's being discussed with the Minister of Education at this time. MRS. S.

CARSTAIRS: Is the Minister contemplating, in the area of Regional Health Delivery systems, going to a use of midwifery in the northern or remote communities? HON. L. DESJARDINS: I have no problem with the principle and it is done in other areas. I don't classify this the first priority because right now I'm concerned if there's a surplus of doctors, that is something that's supposed to be discussed between the medical profession and the MMA and the nursing profession. The fact is that if it's an add on, then it's not a priority, do you know what I mean?

If you just have the doctor and a midwife and so on, I don't think we can afford it at this time, certain ly. So we're looking at it, as I say it's not the first priority. We'd sooner start to see what the nurses could do in primary care. I think that's first, delivering some of the primary care in maybe community clinics and so on.

The Advisory Council on the Status of Women have a committee that is working on the paper on that and we, the Manitoba Health, was represented on this subcommittee by a consultant from our Child Health Directorate, and the paper should be released in the office of the Minister responsible, in the spring of '87, but what I said still stands. I'll be very careful to make sure that it's not an add on, but the principle, I have no problem with it, providing they're trained people. I'm not talking about quacks or somebody that has a gift and so on, I'm talking about progerly trained nurses. MRS. S.

CARSTAIRS: I think the Minister and I are under the same wavelength here. I'm talking about nurses who then had advanced midwifery training, who would be then placed in the remote communities with the idea of in fact providing the care, not adding on to the doctor's bill by providing two levels of care, midwifery and obstetrician. I'm talking about replacing the obstetrician with, in fact, the midwife. HON. L. DESJARDINS: That's our main concern right now and some people feel that it shouldn't be a priority . If you have a surplus of doctors at this time, there's not much point. MR. D. ORCHARD: Mr.

Chairman, last year when we were discussing Regional Services, we spent a fair bit of time talking about the pending breakout of Winnipeg into three regions as compared to one regional service and we got into an extended debate on how that might be done. Mr. Chairman, I'm at a bit of a loss to ask some specific questions without the organizational charts available or with the regional map of Winnipeg.

In view of the fact that we want to speed along with the Estimates process, I'd just like the Minister to indicate whether the breakup of Winnipeg as one region into three regions has been successful, and if things are working well and if services are being delivered in an orderly fashion, as a result of the breakup? HON. L. DESJARDINS: As I stated, we'll try to give you the information as soon as possible. We should have it for this evening anyway. So far we're pleased.

The results seem to be going in the right direction, but the three regional directors have been in place approximately seven months now and there are still some of the transfers taking place and that won't be all finished until approximately June or so, so we'll know better next year than we know now. But so far we're satisfied with the direction, the way it was going, because it wasn't going well at all before that. MR. D. ORCHARD: Mr. Chairman, let me understand whether I have the idea of what the system used to be.

The system used to be a regional director for the City of Winnipeg, one individual, and there were six, presumably , area directors who had presumably suboffices throughout the City of Winnipeg providing their services from those offices. I believe they were called - I'm not sure - but I think they were called area directors, yes, area directors. Now those have been replaced by an executive director of the region, Mr. Robson, and three regional directors.

My question to the Minister is: In placing your three regional directors who have been in place for approximately the last seven months, can the Minister indicate whether any of the individuals who served as area directors under the old Winnipeg system where Winnipeg was one region, if any of those individuals (

a) applied for the regional director's position, the three 1124

Tuesday, 21 April, 1987 of them; and (

b) whether any of those individuals were successful in the competition to be hired? HON. L. DESJARDINS: Some applied, not all of them, and those who did apply were not successful. MR. D. ORCH ARD : Mr. Chairman, that begs the question: Where did the three successful regional directors come from? Were they within the system in Manitoba or were they outside the system, outside the province? HON. L.

DESJARDINS: One was from within the system, and second one worked for the AFM, and the third one was a former Winnipeg nurse who had been in Calgary for awhile and who applied from Calgary Now, this is just an observation. It's easy to say this at this time, but we were hoping that certain people - the people who were in region before - applied. We felt that they would have probably had a good chance of being selected, but for some - a wrong reason or they were not interested in applying. MR. D. ORCHARD: Mr.

Chairman, it's my understanding that right now you are in the process of - because you had six basic area directors before and now they're replaced by three regional directors HON. L. DESJARDINS: Excuse me. Let me make that correction, it was five, not six. Wait a minute, no, sorry , my mistake. No, you were right, six, I was thinking of something else. MR. D. ORCHARD: Mr. Chairman, given that there were six area directors before and now they're replaced by three regional directors, are there any floating supervisors currently on staff? HON. L. DESJARDINS: What do you mean by floating?

They're all assigned to regions. All the supervisors are assigned to a region. MR. D. ORCHARD: Is there such a position as a floating supervisor within the department, within the regions of Winnipeg? HON. L. DESJARDINS: Do you mean from programs to programs or from region to region? MR. D. ORCHARD: That would be my next question when I find out if in fact there are floating supervisors. HON. L. DESJARDINS: First of all, they're all assigned to regions and some of them have responsibilities for more than one program area; but there's no floating, the way I would understand the word "floating." MR. D.

ORCHARD: Then does that mean there are in fact floating supervisors in each of the regions, in each of the three regions in Winnipeg? HON. L. DESJARDINS: Not the way I understand the word "floating." They are assigned to a region and some of them though are responsible for a number of programs in the same region. MR. D. ORCHARD: Okay. Let us get into more specifics then, Mr. Chairman. You've got three Winnipeg regions. Are there three offices in each of the regions? HON. L. DESJARDINS : Could we wait until we give you the charts on that? MR. D. ORCHARD : Maybe, Mr.

Chairman, what we should do is move off Regional Services and deal with that this evening when the charts are here. HON. L. DESJARDINS: Let's do that, let's wait. MR. D. ORCHARD: Mr. Chairman, on the understanding that we'll be dealing with the Regional Operations this evening, then we can move to presumably the next item on the Estimates. MR. CHAIRMAN: 4.(a)

(1) Mental Health Services, Program and Management Support. The Member for Pembina. MR. D. ORCHARD: I would make a suggestion to the Minist er. Of course we can do it under Program and Management Support, but why would we not deal with this area in general terms? Mental Health has been subject to ... HON. L. DESJARDINS: Yes, it's the same people, it's all right. MR. D. ORCHARD: Yes, because you've got the same people in place all along. Mr.

Chairman, last year when we dealt with the Mental Health Estimates, the Department, I have to admit to you, and anyone who may take the time to read Hansard, to indicate that I'm not an expert in the delivery of mental health. I have discussed with a number of people in the mental health field areas regarding the program delivery of mental health, and that stimulated last year's discussion, whereby we talked and we made a comparison in general about Saskatchewan and their method of delivering mental health as compared to the Province of Manitoba and our system that we use in Manitoba.

The striking feature between the two, and this is what struck me last year when I went into full discussions, the striking feature last year in mental health when you compared Manitoba and Saskatchewan is the very dramatic difference that Saskatchewan had in the fact that their program was very much decentralized, very much community based, very much away from the institutional format of program and service delive ry. Mr.

Chairman, when we take a look at statistics, and subsequent to last year's discussions in Estimates, just recently CBC has done a documentary on that very comparison that we talked about last year in Estimates, indicating that there is a very, very dramatic difference in the per capita costs and in the method of delivery between Saskatchewan and Manitoba. I'm trying to find my chart, but Manitoba, if I can find the right breakdown of figures - Manitoba has a 1125

Tuesday, 21 April, 1987 system whereby institutional care for mental health services consumes 87.5 percent of our budget, leaving 12.5 percent of it for basically what one would consider to be community-based or non-institutional mental health services. It has been identified I think in a number of reports - the most recent one of course being the Pascoe Report - that it would be an aim of the government to move toward a community-based mental health system.

The government, the NOP have given that approval in principle, and I guess I have to say that after last year's discussions I thought that we were maybe making a move along the lines of providing more community based care, but that doesn't seem to be the case. The Minister might recall that I used as a specific example that he could choose, for instance, the Parklands Region as a region that he already has established in rural Manitoba to start first with the community-based delivery mode in Manitoba to see whether it has application, to see whether it is workable, to see whether it could happen.

I also suggested that one of the three regions that the Minister was newly creating in Winnipeg could likewise be set aside and used for a similar experimental basis, if you will, in Winnipeg. The Minister indicated some interest in that concept, but I note in both Throne Speech, Budget Speech, Minister's opening remarks that there's no reference to any efforts to move along those lines. Mr.

Chairman, we've got a government that constantly cries poverty when it's talking about any program, any service in the Province of Manitoba and is constantly saying that they don't have money to fund mental health, or fund health in general. I guess recent figures in Saskatchewan indicate that they spend, in total, somewhere in the neighbourhood of $100 million for delivery of mental health programs in the Province of Saskatchewan, somewhere between 90 and 100, when you make the full comparison. In Manitoba we spend $150 million for the delivery of mental health services.

A Minister who is crying poverty and is searching for ways of finding cost containment and improving service delivery should legitimately take a look at the Saskatchewan system, because I don't think anybody argues with the fact that it is a superior system. It's probably one of the better ones for mental health delivery in North America. It's well supported by the citizens of the province, by professionals who are working throughout the length and breadth of Saskatchewan, not simply primarily in Winnipeg as we have in Manitoba. It would appear as if the Saskatchewan system is a very cost-effective system.

Saskatchewan per capita costs are reported to be, according to compilations from Statistics Canada, $38.29 per capita. That's one of the lowest in Canada; I believe it is the lowest in Canada. No, pardon me, the Yukon Territories is lower , but basically , in terms of the provinces outside of the Territories, it's the lowest in Canada. Manitoba has, again, the luxury if you will; luxury is certainly the wrong way of being the highest cost per capita for psychiatric care of all the provinces in this nation.

This has similar ringings and echoes to the health care system, the hospital system where once again we're above national averages in terms of our cost per patient day in hospital. Mr. Chairman, when the CBC aired this documenta ry, I think they put sufficient research into it and I don't think they erred very far in terms of their presentation of the numbers.

So that I think we can assume the figures put out in the CBC document ary, which are backed up by Statistics Canada and. backed up by other available sources of numbers, aren't too far wrong, that Saskatchewan has a much more economic system for mental health. They have done it because they chose primarily to de-emphasize the institutions. Weyburn at one time, I believe, when the Premier of Saskatchewan, I believe it was T.C. Douglas, had something like 2, 700 residents in his home consistency of Weyburn and he chose to embark upon this experiment in mental health, if you will.

It's been followed by successive administrations, has given us a system in Saskatchewan where now I believe the residents are down to less than 200 at Weyburn, or 180, or something like that. The economic impact of that on Weyburn no doubt was substantial. Because you don't take a facility with 2,700 people and reduce it to less than 10 percent without a sizeable impact on the community . Now a similar trend in Manitoba would mean that, for instance, Brandon and Selkirk would be wound down essentially, because if it can be done in Saskatchewan, presumably it can be done in Manitoba.

I know the Minister of Health may take exception to this, but I think one of the larger problems in terms of providing community-based mental health in Manitoba is resistance by the Premier of this province.

I don't believe, No. 1, he understands the potential; and, secondly , as was evidenced over the weekend, where an industry that's in some difficulty in the Premier's consistuency comes in and meets with him, I think the Premier is very much afraid to go to a community-based system in Selkirk, because it would mean substantially a very dramatic reduction in the level of activity at the Selkirk Mental Health Centre. I have no question the jobs that are currently there in the community of Selkirk would be distributed throughout the Province of Manitoba.

Now, two things have been a hallmark of this administration under Premier Pawley: first of all, has been a centralization towards Winnipeg of a lot of services, certainly away from rural Manitoba. Land Titles Office is one example, and we can take other examples. The Premier and this government don't appear to be willing to take the necessary steps to fully integrate mental health into the communities.

I think that is an attitude that will exist as long as this Premier is the Premier of the province, because he hasn't got the political courage that his mentor, who he often mentions in the House from time to time when it's convenient, former Premier Douglas from Saskatchewan, this Premier Pawley doesn't have the courage and the political will to do what his mentor did in Saskatchewan.

At a time when the number of things are impacting on the health care system, I find it absolutely unacceptable that the Minister and the government would not be undertaking some initiatives along the lines of moving mental health services into the communities. I had opportunity this winter - and this is a personal aside - to spend overnight with an individual. The individual is a retired gentleman; he and his wife live in one of the smaller communities in rural Manitoba. He had a malignancy which was operated on, and the family was under a considerable amount of stress, and 1126

Tuesday, 21 April, 1987 he had a mental breakdown. He just couldn't stand all the pressures put togeth er. The last thing he wanted to do was leave the home and leave the family and go Brandon, but he did make that decision. It was a very tough one for him; it was a tough one for the family. After a reasonably lengthy period of time he received the care he needed and was back home. The point I'm making with this is that in Saskatchewan that same individual would not probably have had to drive more than 50 miles to receive his treatment in a community-based setting.

The family, which I don't think there's a more important aspect of mental health than family support, support from friends and families. When you have people from Northern Manitoba, you have people from Swan River, from Westman - not so much Westman because Brandon is relatively close - but still you have people driving considerable distances away from family and friends to receive mental health services. That by itself has to add to the length of time it takes for the patient to recover and add the cost to the system.

I think that's one of the main reasons why you have Saskatchewan with a vastly superior system costing Saskatchewan residents over $38 per resident, where ours cost $139 per capita for a less useful system. So my question to the Minister is: When will we see some evidence that the government recognizes there are dollars to be saved, No. 1; No. 2, that there are improvements in the service and the level of delivery of service that can be made through a community based mental health system? When are we going to see some evidence from the government that they're going to move? We've heard the commitment.

I think this is the third set of Estimates. We didn't hear it as much this time as maybe we had last year, where the Minister started out on mental health with a statement to the committee. So my question is, out of frustration, to the Minister: When are we going to see some action? HON . L. DESJARDINS: I'd like to thank my honourable friend for his remarks and I agree with him in many of the things that were said, and other things of course I disagree. Let me say right from the start that we realize and we agree that the Saskatchewan model is the best in Canada. There's no doubt about that.

It took them 25 years to get that program though. And also that they're in somewhat of trouble now. They're cutting down on staff and cutting in areas; they're in a bit of trouble. In other words they face pretty well the same problems that we do. Now one thing that should be corrected immediately is the false information that came out, because of the CBC documentary, that gave the wrong figures. And now my honourable friend stated, well, that was fair game, that I should have been on the CBC myself.

I purposely suggested, it was a very busy time and when I was approached, I said get staff; the staff could go ahead and they will give you those details that I haven't got, but if you want to talk to me about the policy, I will after. But the details, I'll have to bring somebody with me and so on because they have been working on that and I haven't got all the latest. Now let me say this, that as soon as that program was done, I received, and I'd sent our ADM and asked him ii he'd go and he went for us. And he was very forthright, very honest in his answers.

Now he was disturbed, and those are his words, he phoned me after and told me that he was disturbed with the way that some of the things were quoted. Not everything. And it is obvious that we didn't get the true figures from Saskatchewan or some other provinces when you say we're the highest. We've measured; and Saskatchewan will go, one minute it's 3820 then it's 111. Different figures than they give. Now these CBC documentary figures were quoted on the per capita cost to Manitoba of $139.24 and in Saskatchewan $38.20 based on the total cost for Manitoba of $152.2 million and Saskatchewn $39 million only.

Now Saskatchewan figures did not include (

a) psychiatric components of four general hospitals; (

b) psychiatric components of personal care homes and Manitoba costs include these. The revised figures obtained for Manitoba and Saskatchewan include Manitoba total costs, $154.8 million - that was mental health programming 155.2; social allowance to the mental health client 2.6. And Saskatchewan the total cost when all components are added is $155 million. And these revised Saskatchewan figures were obtained from the Executive Director of Mental Health for Saskatchewan. So, yes, Saskatchewan has a very good plan. It took them 25 years. It's not perfect.

But let's remember that they're doing, they've done some of the things we're doing. I'm not saying it's wrong, but they have taken certain residents and called them psychogeriatric residents. And that's fair enough. There's some people that are a certain age and there's a lot of people in personal care homes that are senile also and therefore, they are people that qualify, that should be in personal care homes. They're psychogeriatric but they're still in some institution. It's a change. Now there's also a concern that we have.

Apparently when this was done, it was done quite fast at that time, and although I said they had 25 years to do it. But they apparently have had a lot of people still hanging around Regina. And we have to be very careful. I said that we started that a few years ago, I'm not talking about the Saskatchewan model, that we wanted to deinstitutionalize in the time of Tulchinsky and so on. But we had nothing in place. You heard me quote this and this was in this area of mental health. And that is a dangerous thing, and we had to reverse our stand and that set us back. We weren't ready.

First of all, the community wasn't ready to accept that. The community in those days, were hiding the mentally ill somewhere, the seniors and so on. And that is changing some. And then the proper staff. And you have in certain countries, in certain cities in the States - not only in the States, here also, many of the bag ladies and bag men and so on are people that are mentally ill, that are walking around. And you can't forget that, and I'm told that there was a certain amount of that in Saskatchewan too. Maybe you can't help it when you change. I don't know. But that is a concern. I want to say something else.

Well, you know, I can't help but think of the qu estions, the irresponsible questions of the Leader of the Conservatives and I say the Leader because he's the one - I haven't seen those 11 27

Tuesday , 21 April, 1987 kinds of questions here yet. The question about deinstitutionalizing the other hospitals and trying to make a big thing and try to say that we've decided already about closing beds. And it's the same principle that we're doing here. We've talked about - there was something that I think is greatly unfair and I'm going to deny this immediately that it is the Premier of the province that doesn't want to go in that direction. That is absolutely false. I've never had any directive to change that at all.

We are committed in principle, the Pascoe Report, I'm not talking about the amount of money, the Pascoe Report was accepted, I made an announcement and a speech and that becomes the policy or the principle of this government. We've moved in many of the recommendations that we were given. Not as fast as I would like to, I'll repeat that again. I haven't had all the money in this area because we are behind times, that I would like to have.

But we're moving in that direction, we will have a 10 0 bed psychogeriatric hospital in Brandon fairly soon that we'll move away from the hill, and that is not more beds, that is we'll transfer the staff and the 100 patients from the hill in that area. We're also working, trying to set up 15 psychiatric beds for acute care patients at the General Hospital in Brandon. So we're moving in that direction. Not as fast as I'd like to but we are moving in that direction nevertheless with the funds that we can get. I have now a plan -(lnterjection)- Yes, these are some of the things that happened in '86-87.

The Mental Health Directorate was strengthened by the hiring of two additional staff persons and the transfer of two staff from other areas, bringing the total staff complement to seven. The Proctor Program was further strengthened by the addition of 17 spaces, bringing the total num ber of spaces to 39. It's not that much but at least we're moving. The program is further refined and now covers group as well as individual programs. Funding was provided to the Self-Help Society , a self-help group for mentally ill persons formed through amalgamations of Pheonix House and People At Last.

Funding was provided to the CMHA to develop 15 spaces for support of housing for mental health clients. There was an addition of 15 spaces to the existing Independent Group Living Program offered by Winnipeg region, a total of 30 new spaces in support of housing and a role study is being completed at the Brandon and Selkirk Mental Health Centres. The objective is to clarify the roles of the centres and to identify patients who could be relocated to live in the communi ty. There's some of the things that were changed. We started setting up an advisory committee, a very good advisory committee, very representative.

We've had good meetings, a very interested chairman and a five year plan proposing new direction in the development of mental health services has been prepared. It has been given to this advisory committee. The plan is currently being reviewed by that committee. In fact, that is finished now, I think we've got the paper and their recommendations. I met with them again, and some of the staff. It includes representatives from groups, professionals outside of government following which will be, in fact that has been presented to the committee of Cabinet now.

A committee has been established and is working in developing a model for delivery of psychogeriatric services. Standards have been developed for residential care facilities for our mental health clients. Plans for a short term acute care forensic unit at the Health Sciences Centre have been finalized. Construction of the 10 0 beds, I've talked about that, the Rideau Park in Brandon and the same 100 bed construction in Selkirk to be known as Thomas Prince. That will close and we'll get 100 people out of these institutions.

Senior staff of the Mental Health Division has visited Saskatchewan to obtain a closer understanding with the Saskatchewan mental health system. The Mental Health Advisory Committee is beginning its second year of operation and will be providing policy advice on several significant issues. A psychogeriatric assessment unit is being started at Brandon Mental Health Centre. Outreach services of Selkirk Mental Health Centre have been transferred to Winnipeg Region and the Mental Health Directorate has developed models for a spectrum of residential care services in respect to a day program.

A major study of the Community Mental Health Service system is to be in very shortly to identify clearly and accurately the existing and future needs for community-based services . There is another project of six additional beds, project growth, as another project in Winnipeg. Now as far as decentralization, I will say without any hesitation here, and I've never had any directive from my leader , the Premier of this province, to do anything else, that we are going in the direction of, if anything, to decentralize. So I certainly don't want to centralize and that might involve some of our regional staff and so on.

Now that's not going to be done in a day or so, but we're moving in that direction. So, as I say, I have no hesitation in endorsing, and I'm speaking for the government when I say that, the program in Saskatchewan. As I say, it's not perfect, but it's a good program. We have no directive, and I can assure you the Premier is not saying, no, because of Selkirk, we can't do that. MR. D. ORCHARD: I have no doubt that the First Minister , the Premier , has not sent any directive around saying that you don't touch Selkirk Mental Health Centre. I would fully expect he hasn't.

But the Premier presumably is the one who provides government leadership, direction and my simple observation is that this First Minister does not have the political courage to actively pursue the development of community-based mental health services when it would be in all likelihood at the expense of a major institution in his own back yard. It's not a case, Mr. Chairman, of the Premier having any directive about saying don't touch Selkirk Mental Health Centre, of course not. But the Premier does not have to do that. All he has to do is simply not express any desire or interest and nothing happens.

That would appear to be what in fact is the kind of leadership being offered by the Premier - nothing is happening. I hate to be that blunt and that tough with this Minister, but that is the reality of the last three years. The Minister makes reference to 100 bed facilities in Brandon and Selkirk and additions to the psychiatric unit in Winnipeg in the Health Sciences Centre. Again, Mr. Chairman, that follows the pattern which has been established and continues over the last 112 8

Tuesday, 21 April, 1987 number of years of (

a) institutional care; and (

b) institutional care based in the communities it is currently based in: Brandon, Selkirk and Winnipeg. Because every one of those facilities, and additions, are in the major centres in those three communities. There is no branching out into the Dauphins if you will, or the Thompsons or the Swan Rivers, or branching out to provide additional services, for instance, in Winkler, Morden, where Winkler has Eden Mental Health Centre. We are tending to concentrate still, all of our services, in three major centres and primarily one major centre, namely Winnipeg. That's always been the argument that's been made.

Every time you approve new initiatives in mental health, it is generally in those three communities. There has not been any, for instance, expansion beyond those three communities, Winkler being the exception, Winkler being the sole exception. Mr. Chairman, it's my understanding that in terms of - and I know, that's why I said earlier on in my opening remarks, the figure isn't simply $50 million of expenditures in Saskatchewan. I know that. The figure is not simply a $50 million expenditure for mental health services in Saskatchewan, it is higher. That's why I used the figure around the $1 00 million mark. HON.

L. DESJARDINS: It is the same as Manitoba, a little more. MR. D. ORCHARD: Mr. Chairman, you indicated the same as Manitoba. I don't have figures that indicate that. Mr.

Chairman, part of the Saskatchewan system is that, for instance, in a regional hospital - and I'll use the example, maybe I'm using the wrong communitites, but it's my understanding, for instance, in Swift Current, the Mental Health Services Division of the Department of Health will negotiate for bed space so that they have, not necessarily a free standing psychiatric unit in Swift Current, but rather have it as part of the hospital administration so that they have staffing, support staff expertise in Swift Current.

The same thing applies in Weyburn; the same thing applies in Yorkton; the same thing applies in North Battleford; the same thing applies I believe in - it slips me now but the northern community where John Diefenbaker was from - Prince Albert, and of course Regina and Saskatoon as well. Now, Mr. Chairman, we don't have this Minister, three years after the Pascoe Report moving in those kinds of directions. We don't have, for instance, Dauphin, where there is a keenly interested group willing to take on the challenge of community-based mental health delive ry.

There is no format, there is no opening for them to cooperate with the government. It's almost as if their interest has been shelved. You know, it isn't as if this is a partisan political issue because I suggested to you last year, why don't you approach them, make Parklands Region an example. Mr. Chairman, the Minister last year thanked me for my remarks. He said he agreed with most of them, but we're still here looking at inaction and nothing happening.

Now I appreciate the Minister's got financial problems and I appreciate the potential political problem that the Premier might have, even the political problem that the Minister of Economic Security might have rep resenting Brandon East, even the problem my own MLA would have representing Brandon West if Brandon and Selkirk were de-emphasized. Mr.

Chairman, I don't have access to the Minist er's latest figures that he used, but I think there is no question that the Saskatchewan system, if not more economic to deliver - which all figures outside of the latest ones the Minister has given me seem to indicate - certainly it is a better system in that you have professionals and support people in practically every region of Saskatchewan, and I think the figure is 50 miles.

If you don't go further than 50 miles for expert help in terms of mental health, either psychologists, psychiatrists, mental health workers, now that is vastly different than what we have in the Province of Manitoba. You know, that is the area that I don't see any focus, any planning, any discussion to see how you resolve that problem. I'd like the Minister to tell me if there are some initiatives in the works to provide support staff in the various regions of this province for the delivery of mental health. HON. L.

DESJARDINS: Yes, I did say last year and I'm saying again that I agree with a lot of things that were said. I also stated that - if my honourable friend doesn't want to believe me, I can't force him to - not only in our directive, but that the First Minister is going along with the recommendations that we are making. Without any hesitation, I'd be very careful, I wouldn't close doors, you know that. I've been around for awhile and you've been around also and I wouldn't close doors. I can tell you, without any hesitation, that we want to go in that direction.

One thing I can be criticized for and I can always be criticized for that, we're not going as fast as people would like us to go, no doubt. But then I think the members around this table know the problems that we're facing now - and people who have been around government for awhile who think you can do all kinds of things in a year, it takes a long time to do that. There is the political consideration, there are all kinds of things. But I can tell you this, that we are, for instance, let's look at Selkirk and I'll put this on the record. There are approxiately 350 patients - 325 to be exact.

We're going to take 100 of them to put in the psychogeriatric ward. Don't forget that we're not going to move directly what Selkirk takes care of and just close every bed and start building somewhere else. We haven't got that luxu ry, that would be kind of stupid. So we are saying, all right, there are going to be 100 beds then for that area, we will have roughly 45-50 beds of acute care beds. That's getting people out of the institution, psychiatric acute care beds in the Selkirk Hospital, that's the next concern. Then you'll always have an institution.

You'll have an institution for people with brain damage and some of the people there for awhile, but we can cut that down to maybe 100 or so eventually, and then the other areas, we're moving. We started moving with 100 beds in Brandon and 100 beds in Selkirk, of psychogeriatric beds, away from that administration, and the next thing probably we will consider certainly other beds, some acute care beds in different areas in the rural areas, and that is a recommendation of the five-year program that we have. I think that you'd 1129

Tuesday, 21 April, 1987 be maybe surprised, well, pleasantly surprised, when we can announce the recommendation of Cabinet, when Cabinet makes a final decision on the five-year program on mental health that we have. So I can assure you that you will see things moving, maybe not as fast as you'd like, or as far as I'm concerned, not as fast as I'd like to see, and that's because of lack of funds and the organization. We want to make sure to get things properly done. MR. D. ORCHARD: Mr. Chairman, you know, again the two examples that the Minister has used of basically deinstitutionali zing is to basically move from institution (

a) in Selkirk to new institution (

b) in Selkirk, 100 people, and the same thing as in Brandon. HON. L. DESJARDINS: Well, if that's what you're saying, you have to admit that is exactly what was done in Saskatchewan, so don't think that all the people of Saskatchewan were out. Some of those people, in other words, that is the first phase and that's why some people feel we're not going fast enough, but that is the first thing. There are some people will not be able to go anywhere else and, because you're being mentally ill, there are some people who normally would be in a personal care home also.

It's psychogeriatrics, that's completely accepted; so call it an institution, if you want, it is. Where are you going to put those people? Where are you going to put these people? I mean certainly it would be a crime to let them run around the streets and become bag ladies and bag men like we have now in some of the major cities, and we don't want that. I certainly don't apologize for that if you want to call it - it's certainly deinstitutionalizing that institution, that is, the mental hospital.

Then the acute care beds, some beds there will take care of people who will go into the commun ity, but they will need the treatment, exactly what you were saying about that friend of yours, and we want to do that not only in those centres. Bring that in the North and all through the different regions where there's a population to do it, at least in certain centres, not every single commu nity, of course. Then you will always need the institution, but a much smaller institution, and part of that should be instead of putting it all in one area, fine, it could be the next step.

If we see that we need more psychogeriatric institutions or hospitals, whatever you want to call it, fine. The next one could be in the North or Thompson or somewhere else; and I might say that our staff, Mr. Mclean, especially the ADM, and Mr. Walters, the direct or, are discussing with Dauphin and all the areas that you mentioned. We're not moving as fast as they'd like to see, that's granted; I haven't got the money to move that fast. MR. D. ORCHARD: Mr. Chairman, the issue, well, basically in terms of the Pascoe Report, a couple of questions here.

I think we have to remember that the Pascoe Report now was accepted in'84 by the government. We're now into '87 and I think the Pascoe Report laid out a five-year plan, and I hear the Minister indicating now that basically you're developing a five year plan in consultation with the community, etc., etc., to plan to implement certain things.

I guess I simply say to the Minister I believe that's what the Pascoe Report was designed to do back in'84, was to give you a planning target, a goal, a framework to utilize in terms of provision and reform in mental health - provisions of services and reform in the mental health system. Now, three years later , what we're doing as a result of Pascoe is yet again doing some more studying to implement some five-year plan. HON. L. DESJARDINS: But that was part of the recommendations. MR. D. ORCHARD: Mr.

Chairman, the Minister indicates that was part of the recommendations, and you know there were a number of recommendations there, including the expenditures of more monies in terms of community base. The Minister has indicated that he hasn't been able to meet with those expenditures, and that is considered by those people in the mental health community to be a repudiation, a failure to carry out what Pascoe had indicated. Now, in that regard, Mr.

Chairman, the other day I asked if the Minister and staff, and the ADM provided me with the mental health estimated expenditures out of Research and Planning Directorate, which took us up to'85-86. Are there any preliminary figures that are available for '86-87, because what they tend to give one, when you follow them line by line, is basically a continuation of the same trend; i.e., the institutional model of care. Now I asked Mr.

Mclean, when he gave me this on Thursda y, if I could just take a normal percentage increase, and he thought that would be a reasonable extrapolation of'85-86 figures to get to '86-87; i.e., basically no shift from the spending patterns that were laid out. Maybe I should pose that question if that's basically correct. HON. L. DESJARDINS: You won't show any shift now. What you'll have in the Commission then is the Eden Mental Health. We can give you that. Linden Place, we can give you that pretty well. Then we should be able to give you Brandon and Selkirk. I want to say something about the Pascoe Report.

I know the Canadian Mental Health Association talked about the money. At no time, and make that very clear , when I said we accepted in principle the Pascoe Report, I made it very clear at that time that we were not talking about any money which was a suggestion - this is what we'll be needing so much a year. We accept the recommendation in principle, not the amount of money, which you don't do anyway. I don't know of any government that's going to say your're going to do that and obligate somebody else. Many of the main recommendations were to change

an act that's going to be presented to you today - not today. Did I say today? I meant this Session. Also, one of the first things they wanted us to do was set up the advisory committee and the main advisory committee, the Minister's advisory committee, and the community committees also. And what we're saying, whether we set up this committee to work with us, we've looked at this, and now we're continuing with what we have in front of 1130

Tuesday, 21 April, 1987 Cabi net because it was vague then. Of course, before you talk to those people, we want to develop that with those people. This is what we're suggesting, that we work with them and also, certain ly, we've started to work with the Minister's advisory committee. So that's what I mean. We're not reinventing the wheel or starting all over again. We're just going from there to bring in suggestions and something more concrete as we go along. MR. D. ORCHARD: Mr.

Chairman, maybe some specific ques tions because we can debate the philosophy of how quickly the Minister is moving and how rapidly they're progressing. Mr. Chairman, in the Treasury Board Submission where the $8 million overexpenditure for home care was brought forward, one of the cost containment measures that was approved under the Treasury Board Subm ission was the deferral of Mental Health New Initiatives of $103,000.00. What new initiatives were those that were deferred and when were they deferred to? HON. L.

DESJARDINS: First of all, that, of course, as I say, is part of the recommendation that's going in front of Cabinet. This is not approved by Cabinet yet. This is what the recommendation is going on and it's something that is known, our position on that. Cu rrently there are 725 patients - 325 in Selkirk and 400 in Brandon. We are going to transfer to pschogeriatric beds 100 from the community of Selkirk and 100 from Brandon. That will be 200. Then we will need in those areas acute care beds. The acute care was taken care of in the Brandon Mental Hospital and also in Selkirk.

That will be now at the General Hospital the way it is everywhere else. So that will make another 100 or so. Then in the community there will be another further 120. That is at the end of five years, that is going on, and this is what happens. There will be another 120 that will be taken out of Selkirk and 120 from Brandon. That will be 240. That will leave those remaining in the smaller institutions a total of 185. So that's going from 725 to 185 in five years; that's what we intend to do. On your last question, in the the ADM's office there is an operation there of $16.8 thousand that are under spent.

The Chief Provincial Psychiatrist, 68.6 - that was salaries because that position is not filled at this time because he was only part time. The Mental Health Directorate, the operating was 460.5 and the External Agency, 142 ... - (inaudible) For Forensic Services, in salaries there was 68.6 under expended and 15.1 overexpended in operating. In Child and Adolescent Mental Health Services, 153.9 in salaries underspent and overspent 11. 1 in operating. Brandon Mental Health, in salaries unders pent 282.4, and in operating there was actually 72.6 overspent.

In the Selkirk Mental Hospital, the salaries, there was 71.1 underspent and in operating there was 23.5 underspent. For salaries, that was 635.5 underspent, and operations 544.4 underspent. Now the salaries, there was the Chief Provincial Psychiatrist, position vacant; Forensic Services, there 1131 was a position vacant, that's medical; Childhood and Adolescent, there were two; Brandon Mental Health Centre is seven; and Selkirk Mental Health Centre, one. Actually the programs that we didn't go ahead with this year, we weren't ready with the Proctor Program.

We're underspent, but we did go with 20 more in 1985- 86 and 39 more in 1986-87. In Community Residences, we've got 12 the first year and 51 more, although we're underspent. They are a result of a delay in filling the vacancies and a directo r for a position devoted to Community Residences and Day Programs, and the development of the new programs was further delayed by the time it takes to obtain community involvement and commitments that we have. MR. D. ORCHARD: Mr.

Chairman, that doesn't answer the specific question about what was the Mental Health New Initiative - New Initiatives, plural - that were deferred as a cost-saving measure? HON. L. DESJARDINS: You've got the amount of money and where, but you want to know why. Is that it? MR. D. ORCHARD: I want to know what it was. Like, what were the Mental Health New Initiatives that were deferred? HON. L. DESJARDINS: There were three programs that were partly deferred, I mentioned what was done. There's the Community Residences, the Proctor Program and the Day Program.

They received approximately $1.2 million, and there was 400 and something that was expected. MR. D. ORCHARD: Mr. Chairman, that gets us right into the nub of the issue.

When I expressed a lot of alarm over the $8 million overexpenditure in Home Care and the fact that, presuma bly, your internal audit people indicated that there was lack of financial control - the program was out of control - I made the point with you, within Regional Services, that you had programs in Services to Seniors, Gerontology being one of them, Hearing Conservation, Health Promotion, where the Other Expenditures were reduced in order to tailor your spending to the $8 million overexpenditure. The same thing has happened here. I'll just read to you from your Health Estimates Book.

Under the Mental Health Directorate, one of the activity identifications - well, okay, I'll read the objectives first off: "T o develop, coordinate and promote a comprehensive range of mental health services in both the community and hospital sectors." Part of the Activity Identification: "E nsures interaction and coordination of institutional and community-based mental health services; Develops a comprehensive range of alternatives to institutional care . . . "and a number of other initiatives.

And Expected Results: "Ex pansion of community-based services, including residential and day programs; improved coordination of mental health services. " Now when we go through the over and underexpenditures, we find that in Mental Health Directorate, which has those goals as a department or as a division of your department, while salaries are

Tuesday, 21 April, 1987 going up, we find that Other Expend itures were decreasing by some 37 percent, resulting in the curtailment of programs which move Mental Health Services into the community delivery mode. That's where, Mr. Minister, as I've urged on you before, you have to know within your department that things are running well. If you can't offer that assurance, other programs and other people in Manitoba suffer because of a program being financially out of control. Here, sir, is another example.

Your Treasury Board Submission says you had to defer Mental Health New Initiatives, some of which were Proctor Program, the Community Residences Program and the Day Program. Those are programs which put services into the commun ity to get more to a community-based mode of mental health delivery, all of which were not expanded at the rate you expected last year to do for a number of reasons, one of which is you had to tailor your spending to come up with money for an out-of-control expenditure in one division of your department, and this is where $460,000 came from. Mr.

Chairman, now I think the Minister can see how we go full circle where I've asked him consistently , can you assure me that the dollars that we are approving for you to spend every year are spent efficiently? Are they reaching the people who you want to serve and to help, who we as elected people and the taxpayers want to help? Are the services reaching those people who need them? Mr. Chairman, when you've got Home Care Assistance out of financial control, you can't offer that assurance.

But at the same time, we can come to innumerable lines in your Estimates where your staff costs are the same or up, but the Other Expen ditures (i.e., the monies they have to deliver the programs we hired the staff to do) are being drastically cut, and you're not seeing the expansion of community-based mental health, in this case, as we didn't see with Health Promotio n, etc., etc. That's how serious it is within the department, Mr. Mini ster. That is where I consistently will be coming to you, asking for those kinds of assurances because as a government - and Opposition had no difficul ty.

We've never argued with you that you should not go to a communi ty-based system. I think we've consistently encouraged you to do that. I think whenever we have approached elections, I think we have, by and large, told those who survey us for opinions prior to elections as to what direction we as a political party would move in. The Progressive Conservative Party has endorsed the implementation of community-based mental health services. We haven't run interference; we haven't thrown any roadblocks in your way; we've given you support. But yet, Mr. Ministe r, you haven't been delivering on the programming.

You say that you would like to deliver faster, you'd like to have more money. Mr. Ministe r, that argument is running very hollow because you didn't expend your $160,000 that members of this committee approved for you last year, most of it in new initiatives to provide community-based support in mental health. We gave you the authority to do it, we gave you the encouragement to do it, but you didn't deliver . That is where, I think legitimately, the members in the mental health community who are pushing you are saying you failed and your government has failed, and $460,000 is proof - 37 percent underfunded.

And I go back to you and I say that the prime reason for it, no doubt, is the fact that home care was financially out of control and you had to come up with the money somewhere. HON. L. DESJARDINS: Well, Mr. Chairman, I would hope that the members of this committee would be consistent and, yes - I think I'm getting a dirty look. The member feels that he has been consistent. Let me explain. Yes, it's true that he has been making a case; the one that I say unf ortunate remark that was exaggerated when they say that it was completely out of control. Now I say that the money was well spent in home care.

I'm saying that it leaves the system a lot to be desired. We had all these arguments last week and I agree with that; it could change. Now, my honourable friend is talking as if all of a sudden this is something brand new. This has been done ever since I've been in the House. There have been some areas that you felt you thought you were going to spend at a more faster pace which that hasn't been done, Now, why did we have to underspend? For a number of reasons. Some it it, we were too optimistic. We were thinking that we could go ahead at this time and it was wishful thinking.

It takes awhile to discuss with the commun ity. The same thing, for instance, I had a five-year capital program. Some areas, no matter what, was supposed to be ready for construction this year, and that's done every year by every government, unfortunately or fortunat ely, whatever the case might be, that they are not ready when they think that they would be, and that happens in here, too. Even if we would have had all the money in the world, some of this money wouldn't have been spent.

No doubt when we realized that we were going to have a deficit, all right, then there was effort in the last few months or so, that was done a number of years, to say, hey, where are you now, where are your programs? That money hadn't been spent up to now, not because we were waiting to spend it on something else, because we couldn't move fast enough. So they say you haven't spent that, maybe some of that money would have been spent in the last two months or so. They said, no, all right, you'll have a big enough deficit, you don't do it anymore.

Now, if we want to talk about out of control and so on, in the way that we've been funding home care, when you have a program like home care, it's going to be impossible, and I've said that, and it's going to be the same thing next year. It's going to be impossible to have it right. Fine, I hope that we can improve the system, and I hope that we can improve our objective, but the situation is that we won't be right on because you don't know who is going to be sick.

You don't know when it's going to be needed and as you go along, will I wait another year to change things if I can, and if we can deinstitutionalize something and if I need more home care? Then, all right, I will spend it because I'm saving mon ey. Where I said you're not consistent, you can't have it both ways. You can't criticize us and make your own point of all this discussion and of these Estimates on 1132

Tuesday, 21 April, 1987 a thing that we are out of control and we then are spending more money in home care, and then in question period crucify me because I'm talking about getting the hospitals to stay within their budget. If it's poor business for me to be overspent, isn't it poor business from the hospitals also? But that then is the Opposition, not so much this member, but the members of his party are using and are having it both ways. That's exactly what I said to these people, you've got to be responsible.

You're getting "I t's worse and worse and you're spending all kinds of money that you haven't got, you've got to stay within your budget." (Mr. Deputy Chairman, M. Dolin, in the Chair.) Now, purposely some of the members of the Opposition are saying that you're cutting - they call it cutting - and they make a list, two or three times a week, want to make sure to scare the public, that these are the beds that we want to close. I'm not talking about individual members, all the members are doing that.

I think that my honourable friend who is the health critic knows a little better and is not going to do that, not as much, because he knows we have to do that. He knows that and that's what we're trying to do, but his leader is going out and making some irresponsible statements like he did today in saying and listing, wants to make sure it's in Hansard. I mean it's obvious, we weren't born yesterd ay. You know what he's after; he wants it both ways. We're being criticized because we don't stay within our budget.

We're being criticized for saying, well, hey, we spend enough that we can't have that much a deficit, we've got too big a deficit we're told, so the money that wasn't spent at a certain date, that is being done by different governments, different colours of government who say, okay, you don't spend any more. If you haven't spent that, that's too bad. If you don't spend it this year, you'll have to wait. So that's a delay of a few months. It's not the end of the world. And why? Because there's another priori ty. Yes, there's a priori ty. That is a priority and fortunately, sure, you wonder if we had more mon ey.

Too bad we didn't know in the Roblin years and the Schreyer years what was facing us. We could have maybe done, we should have done more for prevention and so on. But right now, when you've got a certain amount of money, you've got to go with the priorities, and home care is a priority and will be a priori ty. It was supported and was financed by overdraft, the same things as hospitals were for a long time, that a certain amount of the deficit was approved and practically all of it. Well, it's getting out of control there, too.

If there's any place that's getting out of control, it is the deficit in the hospitals. We have to pay for that, too. It's not just for home care; it is to pay for the deficit of the hospitals that we've cut some of these programs also, to help, so we won't go too far in the deficit. So it is a very difficult situation. We're getting in an area where the Federal Government is saying we can't go on with the deficit and it's okay for them to say that. Now we had a responsibility, we started this universal program but unfortunately we're not going to pay any more.

Now that we've got all these things set up, all these hospitals built because of the way that they were only financing acute care beds, so people built too damn many acute care beds because they were only paying 50 cents on a dollar. They couldn't care, build personal care homes, that wasn't covered. There wasn't a penny spent for mental health for years in this country and we're paying for it now.

We're going through a very difficult situation and we're trying to say we're going to keep the best program in the world, the best universal program in the world, but we'll have to change the way of delivering that, and that could improve facilities but we have to do certain very difficult things. I was chastised, the opening remarks, that I'm not providing leadership and then if we try to do something, well, then I get the kind of help, which is fair enough, that's what they want. Again, I say my friend hasn't been too vocal in the House in question period, not like some of those other members.

I don't know if it's purposely done but half of them are the guys who are saying what, the deficit? Well, I don't know if it's still a battle between the right wing and the left wing. I don't know if that still goes on or if that's patched up. But in the meantime we're told you've got a big deficit and the other people are saying spend more, and people are saying you don't know how to run, you couldn't run a peanut stand, you've got a deficit on home care, but what the hell, why are you cutting the hospital's deficit? Because it's good business for hospitals to have deficits, but not for us.

So fine, that's not the kind of thing that's going to help the people of Manitoba. It's going to be hard enough to make these changes and to try to keep th

Document details

Collection	Manitoba — Debates (Hansard)
Citation	33-2-31a
Type	hansard
Volume / chapter	33rd 2nd hansardpdf 31a.pdf
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	9ee291826287b2b3e84701248ee5a723f98d738b

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