Manitoba Hansard — 22 May 2001 (Sitting 33, 37th Legislature, 2nd Session)

37-2-33

Manitoba — Debates (Hansard)

� � Second Session- Thirty-Seventh Legislature ofthe. Legislative Assembly of Manitoba DEBATES and PROCEEDINGS Official Report (Hansard) Published under the authority of The Honourable George Hickes Speaker Vol. LI No. 33 - 1:30 p.m., Tuesday, May 22, 2001 ISSN 0542-5492

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

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

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

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

2013 LEGISLATIVE ASSEMBLY OF MANITOBA Tuesday, May 22, 2001 The House met at 1:30 p.m. PRAYERS ROUTINE PROCEEDINGS PRESENTING PETITIONS Manitoba Hydro Lines Routes Mr. Ron Schuler (Springfield): Mr. Speaker, I beg to present the petition of Olga Klopick, Walter Klopick, Hannalore Potschka and others, praying that the Legislative Assembly of Manitoba request that the Minister responsible for Manitoba Hydro (Mr. Selinger) consider alternative routes for the additional 230kV and SOOkV lines proposed for the R.M. of East St. Paul. Kenaston Underpass Mr. Frank Pitura (Morris): Mr.

Speaker, I beg to present the petition of Chad Newell, Canee Cormier, Howard Kroeger and others, praying that the Premier (Mr. Doer) of Manitoba consider reversing his decision to not support construction of an underpass at Kenaston and Wilkes. Mr. John Loewen (Fort Whyte): Mr. Speaker, I beg to present the petition of Tom Fiehr, Bob McShane, J. Vandal and others, praying that the Premier (Mr. Doer) of Manitoba consider reversing his decision to not support construction of an underpass at Kenaston and Wilkes. READING AND RECEIVING PETITIONS Manitoba Hydro Lines Routes Mr.

Speaker: The honourable Member for Springfield (Mr. Schuler), I have reviewed the petition, and it complies with the rules and practices of the House. Is it the will of the House to have the petition read? Some Honourable Members: Yes. Mr. Speaker: Clerk, please read. Madam Clerk (Patricia Chaychuk): The petition of the undersigned citizens of the prov ince of Manitoba humbly sheweth: THAT the R.M. of East St. Paul has the highest concentration of high voltage power lines in a residential area in Manitoba; and THAT the R.M. of East St.

Paul is the only jurisdiction in Manitoba that has both a SOOkV and a 230kV line directly behind residences; and THAT numerous studies have linked cancer, in particular childhood leukemia, to the proximity of power lines. WHEREFORE YOUR PETITIONERS HUMBLY PRAY THAT the Legislative Assembly of Manitoba request that the Minister responsible for Manitoba Hydro consider alter native routes for the additional 230kV and SOOkV lines proposed for the R.M. of East St. Paul. Kenaston Underpass Mr. Speaker: The honourable Member for Morris (Mr.

Pitura), I have reviewed the petition, and it complies with the rules and practices of the House. Is it the will of the House to have the petition read? Some Honourable Members: Yes. Mr. Speaker: Clerk, please read. Madam Clerk (Patricia Chaychuk): The petition of the undersigned citizens of the province of Manitoba humbly sheweth: THAT the intersection at Wilkes and Kenaston has grown to become the largest unseparated crossing in Canada; and THAT the volume of traffic for this railroad crossing is twelve times the acceptable limit as set out by Transport Canada; and

2014 LEGISLATIVE ASSEMBLY OF MANITOBA May 22, 2001 THAT vehicles which have to wait for trains at this intersection bum up approximately $1. 4 million in fuel, pollute the environment with over 8 tons of em1ss1ons and cause approximately $7.3 million in motorist delays every year. WHEREFORE YOUR PETITIONERS HUMBLY PRAY THAT the Premier of Manitoba consider reversing his decision to not support construction of an underpass at Kenaston and Wilkes. Mr. Speaker: The honourable Member for Fort Whyte (Mr. Loewen), I have reviewed the petition, and it complies with the rules and practices of the House.

Is it the will of the House to have the petition read? Some Honourable Members: Yes.

Madam Clerk: The petition of the undersigned citizens of the province of Manitoba humbly sheweth: THAT the intersection at Wilkes and Kenaston has grown to become the largest unseparated crossing in Canada; and THAT the volume of traffic for this railroad crossing is twelve times the acceptable limit as set out by Transport Canada; and THAT vehicles which have to wait for trains at this intersection bum up approximately $1. 4 million in fuel, pollute the environment with over 8 tons of emissions and cause approximately $7.3 million in motorist delays every year.

WHEREFORE YOUR PETITIONERS HUMBLY PRAY THAT the Premier of Manitoba consider reversing his decision to not support construction of an underpass at Kenaston and Wilkes. Mr. Speaker: The honourable Member for Charleswood (Mrs. Driedger), I have reviewed the petition, and it complies with the rules and practices of the House. Is it the will of the House to have the petition read?

Madam Clerk: The petition of the undersigned citizens of the province of Manitoba humbly sheweth: THAT the intersection at Wilkes and Kenaston has grown to become the largest unseparated crossing in Canada; and THAT the volume of traffic for this railroad crossing is twelve times the acceptable limit as set out by Transport Canada; and THAT vehicles which have to wait for trains at this intersection bum up approximately $1. 4 million in fuel, pollute the environment with over 8 tons of emissions and cause approxi mately $7.3 million in motorist delays every year.

WHEREFORE YOUR PETITIONERS HUMBLY PRAY THAT the Premier of Manitoba consider reversing his decision to not support construction of an underpass at Kenaston and Wilkes. * (1 3:35) TABLING OF REPORTS Hon. Drew Caldwell (Minister of Education, Training and Youth): Mr. Speaker, I am pleased to table, on behalf of the Minister of Conservation (Mr. Lath! in), the 200 1 -2002 Supplementary Estimates of the Sustainable Development Innovations Fund for legislative review. INTRODUCTION OF BILLS BilllS-The Mortgage Amendment Act Hon.

Scott Smith (Minister of Consumer and Corporate Affairs): I move, seconded by the Minister of Education, Training and Youth (Mr. Caldwell), that leave be given to introduce Bill 15 , The Mortgage Amendment Act (Loi modifiant Ia

Loi sur les hypotheques), and that the same be now received and read a first time. His Honour the Administrator, having been advised of the contents of this bill, recommends it to the House.

May 22, 200I LEGISLATIVE ASSEMBLY OF MANITOBA 20I5 I would also like to table the Administrator's message. Motion presented. Mr. Smith: We are proposing to amend The Mortgage Act to require reverse mortgage lenders to provide specified information to prospective borrowers about the costs and conditions of reverse mortgages. The bill provides a cooling off period and stipulates the consequences when required information is not provided. Motion agreed to. Introduction of Guests Mr.

Speaker: Prior to Oral Questions, I would like to draw the attention of all honourable members to the gallery where we have with us today from Crystal City Elementary School 17 Grade 4 students under the direction of Mr. Larry Hamilton. This school is located in the constituency of the honourable Member for Turtle Mountain (Mr. Tweed). Also seated in the public gallery, from 60 Chesterfield, 29 visitors under the direction of Mr. Aubrey Asper. This group is located in the constituency of the honourable Member for Riel (Ms. Asper). On behalf of all honourable members, I wel come you here today.

ORAL QUESTION PERIOD Grace Hospital Future Status Mr. Stuart Murray (Leader of the Official Opposition): Mr. Speaker, we learned that the future of Grace Hospital as a community hospital is at risk due to the WRHA plan that would basically see the Health Sciences Centre take some of the 60 to I 00 of the 13 5 medical beds at Grace Hospital over. As the Health Sciences Centre takes over a majority of the Grace Hospital's medical beds, those Health Sciences Centre patients clearly will be relocating to the Grace Hospital. We understand, Mr.

Speaker, that there is a need to operate on a regional basis, and we recognize that that is a very important feature, but we also recognize that we must use our resources as effectively as possible. Considering that the Grace Hospital is the most challenged facility to deal with patients already in the hallways, is there even space at the Grace Hospital that will allow this plan to work? Hon. Gary Doer (Premier): Mr. Speaker, there are a number of proposals in the Winnipeg regional health care sector to try to improve patient care and not run a deficit.

One would note that the Winnipeg Regional Health Authority has stayed within their budget in our first year in of fice, unlike the litany of deficits that were run in previous years. Mr. Speaker, this, as I say, is a proposal. It is being reality-checked with different facilities, including doctors, some of whom agree with the idea, some of whom disagree.

Unlike the action to close the intensive-care units at the Grace Hospital and all the other hospitals in Winnipeg save two, we are looking at the proposals with the health care staff and with the people on the front lines of health care to ensure that patient care is first and foremost in the decisions that we are making to make our health care system more efficient and therefore more effective for our patients. Mr. Murray: Well, Mr. Speaker, on the basis that there is a so-called reality check, I would like to table a May I6 letter from Dr.

Pat Harris to the Health Minister, which outlines her concerns about this plan. I would just like to table that to the House. Mr. Speaker, in that letter that was sent on May I6 from Dr. Pat Harris, it reads, and I quote the

section in here. It talks about a closed unit of 60 to I 00 beds at the Grace Hospital effectively eliminates medical services at the Grace Hospi tal being available to the community. Mr. Speaker, can the Premier explain how Grace doctors, those doctors that are currently practising, using those beds will be able to continue their family practice if there will be fewer beds available for their practice? * (13:40)

20 16 LEGISLATIVE ASSEMBLY OF MANITOBA May 22, 2001 Mr. Doer: Mr. Speaker, obviously the retention of doctors is always part of the decision making that goes on. As I say, there is just a proposal. The issue for us will be patient care. Individual doctors have different privileges at different health care facilities. That is something that is obviously a factor that has to be considered, but patient care also must be considered. When we came into of fice, Manitoba had patients in the hallways and were spending- [interjection] There are no patients in the hallways today at Grace Hospital.

We also were spending more money per capita than any other jurisdiction in Canada. So on the one hand we had many improvements to make on patient care, which we are working towards, and on the other hand we also have many changes to ensure that cost-effectiveness is part of the future of health care. We will not be able to have a medicare system that is sustainable if Manitoba has the highest per capita spending on health care. Having said that, certainly the privileges of doctors is important, but the privileges of patient care across the system is also very, very important for us. Mr.

Murray: Well, it is always interesting to hear the other side talk about patients come first when they might be actually kicking them out of the beds. In the letter that Doctor Harris sent, she stated that, while the WRHA initially explained the plan would improve bed management and improve efficiency, they later acknowledged that they had no evidence to suggest their plan would improve patient outcome, bed management or even reduce patient days in hospitals, Mr. Speaker. It pretty much sums up this entire Government's approach to health care, which is absolutely no plan for health care.

While the WRHA could provide no evidence that this would improve services, can the Premier please explain to Doctor Harris and other Grace doctors how this plan benefits Manitobans? Mr. Doer: Mr. Speaker, with the greatest respect to the Leader of the Opposition, it is not uncommon to have a disagreement, particularly when it deals with individual doctors' privileges at a particular hospital, a disagreement between the doctors at the Winnipeg Regional Health Authority and the doctors at a specific hospital.

Absolutely the decisions that must be made for purposes of our decision making, any recommendations that we will receive, and as I said, this is only a proposal, any recom mendations that we will receive must deal with patient care, it must deal with the retention of doctors, it must deal with patient stays at a facility. At one point the patient stays at Grace Hospital were one of the longest in Winnipeg, Mr. Speaker, but there were factors that were important to that, including the aging population in the western part of Winnipeg that was using the hospital.

So patient care cost-effectiveness will be part of the evaluation of proposals, not final decisions. Disagreements between doctors, that will take place. It always does and it probably always will. Finally, Mr. Speaker, the members opposite used to move neurosurgery from one hospital to another and then try to evaluate it after they had made the move. We are evaluating the medical merit of this before a decision is made. * (13: 45) Grace Hospital Future Status Mrs. Myrna Driedger (Charleswood): Mr.

Speaker, Doctor Harris, a cancer specialist, informs us that the WRHA plan will form a closed unit at the Grace Hospital to be staffed with physicians from the Health Sciences Centre. Considering that the Grace Hospital is already the most challenged emergency room dealing with patients in their hallways in the province, can the Minister of Health explain to us where all of these patients are going to go if the Health Sciences is taking over most of their medical beds, because it is those beds that would normally be accessed by those patients waiting in the hallway at the Grace Hospital.

Where will all those patients go? Hon. Dave Chomiak (Minister of Health): Firstly, unlike members opposite, the hallway

May 22, 2001 LEGISLATIVE ASSEMBLY OF MANITOBA 2017 numbers have been recognized in Manitoba as having done the best job in the country of dealing with hallway medicine. In fact, a national report indicated an 80% improvement in Manitoba, and Manitoba's plan is being followed in other provinces. The proposal by the doctors of WRHA considers better bed utilization in management across the city of Winnipeg to provide for better utilization. Mr. Speaker, I might indicate it is a conflict between some of the internal medicinists and some of the family medicinists.

This proposal was presented by the doctors of the WRHA to the doctors of Grace Hospital for review and input and that review and input has been provided. It is unfortunate that one doctor wrote a letter to all of the media and copied members opposite last week and without providing the other side of the debate, but we will listen to what the doctors recommend best. Mrs. Driedger: Mr. Speaker, could the Minister of Health also explain, if he is going to be taking over 60 of the 81 medical beds at Concordia Hospital, could he tell us what will happen to the patients that need to access that hospital?

Is there actually a plan in place for the patients that need to access that emergency department? What will happen to all of those patients? Mr. Chomiak: Mr. Speaker, the plan would entail the utilization of beds across the system, something that was promised for 1 0 years by members opposite and was not implemented. It will entail the use of a central bed registry, something that was first promised by members opposite in 19 93 and still has not been implemented.

The plan will entail the complete utilization of Grace Hospital as it exists but with an expanded capacity to have medicine patients, including patients from Grace Hospital, utilize Grace Hospital. The program, as described by doctors and as proposed by the doctors at the WRHA, would utilize beds across the system. It is a proposal that is being reviewed by the WRHA, and we will adhere to what the experts and the doctors in the system recommend with regard to patient care. Mrs.

Driedger: Can the Minister of Health indicate, because of the Health Sciences Centre length of stay being ranked as, and I quote according to the Hay report, one of the worst in the country, is this one of the reasons for this initiative? Mr. Chomiak: No, Mr. Speaker. In fact, this system is similar to a system that was put in place concerning ICU beds by members opposite when they were government that saw the utilization of ICU beds across the system and resulted in less ICU beds being utilized across the system per capita versus any other city across the country.

It is a similar recom mendation that is being proposed by the same doctor who proposed the recommendation that was accepted by members opposite for the ICU beds. Bethel Hospital Nursing Staff-Firings Mr. Peter Dyck (Pembina): I would like to table a letter from a nurse advising her of the termination of her employment with the Bethel hospital in Winkler. Could the Minister of Health explain why he fired more than 60 nurses at the Bethel hospital in Winkler? Hon.

Dave Chomiak (Minister of Health): As the letter indicates, this letter served notice of the merger of the Boundary Trails hospital of the regional health authority in central Manitoba and the result of the integration. All positions will be posted and they will be eligible for positions. It is- Some Honourable Members: Oh, oh. Mr. Speaker: Order. * (13 :50) Mr. Chomiak: Mr. Speaker, last week the members were trying to take credit for the closure of two hospitals in amalgamation with one hospital. Now that the movement is taking place, they are distancing themselves.

This is a normal administrative matter, and it has been known for years that they were going to meld the two hospitals together. Morden Hospital Nursing Staff-Firings Mr. Peter Dyck (Pembina): Could the Minister of Health then explain why he also fired more than 80 nurses in the Morden hospital?

20 18 LEGISLATIVE ASSEMBLY OF MANITOBA May 22, 200 1 Hon. Dave Chomiak (Minister of Health): Mr. Speaker, the member opposite ought to know that the two hospitals are being closed in order to amalgamate at the Boundary Trails hospital. An Honourable Member: Oh, they are closing hospitals down. Firing nurses and closing hospitals. Mr. Speaker: Order. Mr. Chomiak: Thank you, Mr. Speaker. Unlike members opposite, we are not closing 14 00 acute care beds, which were closed during the regime when members opposite were in power. Victorian Order of Nurses Firings Mr.

Peter Dyck (Pembina): I do not think this minis ter is getting the question, but I will try another one. Why did he fire more than 35 0 VON nurses? Hon. Dave Chomiak (Minister of Health): Mr. Speaker, as the member knows, we put in place a decision with respect to the amalgamation of the VON within the WRHA- Some Honourable Members: Oh, oh. Mr. Speaker: Order. Mr. Chomiak: Unlike the decisions that were made during the '90s, positions have been created for all of these nurses who have been dealt with, Mr. Speaker, and they all have positions in the system. unlike what happened- Some Honourable Members: Oh, oh.

Mr. Speaker: Order. Mr. Chomiak: Yes, Mr. Speaker. There is not only the same number of beds but there are additional beds. Positions have been created for those nurses, unlike in the '90s when nursing programs were cancelled and nurses were forced to go to the United States to find jobs in other jurisdictions, because they were laid off outright and had no access to any jobs. Mr. Speaker: The Member for Pembina, on a new question. *( 13 :5 5) Health Care System Nursing Shortage Mr. Peter Dyck (Pembina): On a new question.

Manitobans know that during the 19 99 election, members opposite promised to immediately hire new full-time nurses. Manitobans also know those nurses have not been hired, and, in fact, the nursing shortage has doubled since the Government took office. Can the Minister of Health explain why he has fired some 500 nurses in the last few months when the nursing shortage has doubled under his watch? Hon. Dave Chomiak (Minister of Health): Mr. Sp eaker, the rate of full-time nurses under our Government has gone up. That is the first point.

The second point, we are now training more nurses in Manitoba than any time in the past decade. We have doubled. Just today we announced another 25 nurses in a training program available to nurses in Manitoba, in addition to the 97 that were in the diploma program, in addition to the largest class in the BN program ever. So we are training more nurses, and we have expanded the number of full-time jobs, and there is more to come. Mr. Dyck: Can the Minister of Health tell Manitobans how his firing of approximately 500 nurses is different from the previous admin istration's redeployment of nurses?

What is the difference? Explain it. Mr. Chomiak: The difference is when those nurses were fired by the previous government they had to come here. They were fired by Connie Curran. They had to come here to beg for jobs and there were no jobs available in Manitoba because they closed the beds. Mr. Dyck: This minis ter obviously has a different set of rules for everyone. Why will this minis ter not be judged by the same standards as we were judged by? Mr. Chomiak: Mr. Speaker, I am quite happy to be judged by the same standards. The standard is that we have done an 80% reduction of people in the hallways.

Second, we have exactly doubled the number of nurses in training today than when

May 22, 200 1 LEGISLATIVE ASSE MBLY OF MANITOBA 20 19 those minis ters left office. Third, we have expanded the Faculty of Medicine to train more doctors for the first time in a decade. Fourth, we have created training programs for rural and northern doctors to keep in rural and northern Manitoba, unlike members opposite. Fi fth, we have opened beds, not closed them. Regional Health Authorities Budgets Mr. Darren Praznik (Lac du Bonnet): I must admit I am enjoying watching this Minister of Health face the realities of health care that he denied when he was in Opposition. Mr.

Speaker, I want to ask this Minister of Health, given that his administration provided only $11 6 million in increased funding to all regional health authorities and that each and every one of them today are struggling to live within their budgets and continue to provide even the same level of service as they did last year, what process he has put in place to deal with those regional health authorities to be able to live within the budgets that have been provided and still meet the health needs of people across our province. * (14: 00) Hon.

Dave Chomiak (Minister of Health): It is interesting that members opposite were accusing us of spending too much money. The budget allocations we made were fairly provided. It was a larger increase than last year and larger than almost every single budget that had been provided by members opposite. We are working with those regions to deal with those particular funding allocations. In most cases they got more, not less. There is in creased programming going on. We have expanded dialysis. We have expanded chemotherapy.

We have expanded the number of provisions for training of physicians, and we will continue to work with them. Mr. Praznik: I want to ask this Minister of Health, who just told the people of Manitoba he has expanded services, can he tell the people of Manitoba how many regional health authorities have told him, in their plans to deal with the budget, that they will no longer accept additional dialysis patients in order to live within the budgets that he provided. Mr. Chomiak: We are working with the regional health authorities in order to deal with their financial situations.

I might add for members opposite that that same member stood up last year in the House and said the Winnipeg Regional Health Authority was $10 million in deficit and we were going to lay of f people and stop programs, and in fact he was wrong then. I said we are working with the regions to deal with the situation, and we continue to work with the regions. We tried to get our budgets out ahead of time, Mr. Sp eaker, so we were not going back as members opposite did with huge deficits, six months, eight months, ten months into the year. Mr.

Praznik: I would ask the minis ter: Sin ce he says the Winnipeg Health Authority does not have a deficit, I would like to ask him to confirm that that authority is still carrying a $1 0-million deficit on their books, and I want to ask him if he is going to pay it this year. Mr. Chomiak: Mr. Speaker, unlike other years, I can indicate we gave the budgetary allocations to all the regions ahead of time. The vast majority of funding- Some Honourable Members: Oh, oh. Mr. Speaker: Order. Mr. Chomiak: Thank you, Mr. Speaker.

The WRHA, for the first time in its history and the first time in a long time, came in with a balanced budget. The single largest entity in Manitoba came in with a balanced budget last year which was a first and speaks to recommendations in the Webster report and recommendations in various reports about getting financial information out ahead of time and working with the regions in order to best manage those health care dollars for the benefit of patients. Highways Capital Program Delay Hon. Jon Gerrard (River Heights): Mr. Speaker, my question is to the minis ter of highways.

The minis ter waited until the last few days to announce or confirm the budget for the highways for this year's construction season. Normally the budget for the highways in the

2020 LEGISLATIVE AS SEMBLY OF MANITOBA May 22, 2001 construction season would be available in February or March. I would ask the minis ter: Why has he been so slow and so delinquent in his conduct of his normal duties? Hon. Steve Ashton (Minister of Transportation and Government Services): Mr. Sp eaker, I am very pleased to get a question on the highways capital construction budget and outline the fact that this year we are putting $10 3.9 million into Manitoba's roads.

The member opposite may actually appreciate the fact that it is the first time we are going to have any federal funding on our highways in more than five years. In terms of the timing in the capital construction budget, we are a month ahead of last year. In fact, I even checked, Mr. Sp eaker, the previous government released the highways capital budget as late as June 10. This year we are out, and we are pleased to say to Manitobans we have our construction budget out. By the way, we also increased, since we came into government, our maintenance budget by 8 percent. We are reinvesting in Manitoba's roads. Mr.

Gerrard: Mr. Speaker, the minister uses some flowery language to cover up the problem. I ask the minis ter: When Chris Lorenc and the Manitoba Heavy Construction confirmed there is 75% unemployment because he is slow, how could the minister have messed up so badly? Mr. Ashton: I have met with Chris Lorenc. I have met with the Heavy Construction Associa tion. I can tell you that one of the concerns they have is not just in terms of construction here in the province. In fact, our capital program is out. We have $27 million already under tender, but it is also with the City and also with the federal government.

I can say what I said to the Heavy Construction Association. We appreciate some of their concerns, but our capital budget is out there. We are investing in Manitoba roads. Mr. Gerrard: Mr. Sp eaker, I ask the minis ter of highways, knowing that he is still a little bit behind Saskatchewan-a long way behind Saskatchewan in the amount of his budget. But, recogmzmg that the equipment in the heavy construction industry in this province is the oldest of any province in Canada, I ask the minis ter: When is he going to get his act in order?

When is he going to get a planning cycle in the framework so the heavy construction industry can be in much better shape? Mr. Ashton: With all due respect to my colleague in Saskatchewan, I hardly think we need to compare our road situation with Saskatchewan. In fact, we have one of the lowest gas taxes in the country. We reinvest pretty well every cent that we raise in terms of gas taxes in our highway system. What would help, Mr. Speaker, will be if the federal government reinvested more than about we will get maybe three or four cents on the dollar this year.

They reinvested the ten-cents-a litre plus the GST; in fact, maybe the member could help us with his colleagues in Ottawa because that is at the root of why we need more money on our highway system here. We take in our money and we reinvest it, and the federal government takes it out, period. Child and Family Services Aboriginal and Metis Agencies Mr. Gerard Jennissen (Flin Flon): Mr. Speaker, last year the Government signed a memorandum of understanding with the Manitoba Metis Federation and First Nations in regard to the responsibility for child welfare services throughout Manitoba.

Could the Minister of Family Services and Housing give this House an update on the devolution of the responsibility for Child and Family Services? Hon. Tim Sale (Minister of Family Services and Housing): Yes, last summer we signed the last of the three memorandums of agreement with the MKO group, and so we began the implementation process in the fall. There were study groups of about 200 line staff and management staff who worked on seven different subject areas of legislation, service delivery, subjects like that. They reported by the end of December.

Those separate reports are now being compiled together into a master plan

May 22, 200 1 LEGI SLATIVE AS SEMBLY OF MANITOBA 202 1 that will come before the Assembly of Fi rst Nations, the Manitoba Metis Federation, MKO and Cabinet for its review in the later summer, early fall of this year. I might say that the co-operation among the four partners has been exemplary, and I expect to see specific actions taking place in the very next little while with the Metis Federation beginning to assume the actual responsibili ty for delivery of some services to their children and families.

So it is moving ahead in a very deliberate way, and we have also been pleased to provide guarantees of reasonable job offers for all current employees in the system. Midwifery Services Provincial Plan Mr. Edward Helwer (Gimli): Mr. Speaker, I recently heard from a constituent who was concerned about the lack of midwifery services available in the Interlake region. Although some RHAs have submitted their proposals to Manitoba Health to introduce and to expand midwifery services for expectant mothers, other RHAs still have yet to submit their proposals.

In light of the variation of midwifery services currently provided throughout Manitoba, could the Minister of Health please indicate what actions his department has taken to ensure that midwifery services are available to Manitoba families as guaranteed in The Midwifery Act? Hon. Dave Chomiak (Minister of Health): Mr. Speaker, we were honoured and pleased as a Government to have the opportunity of introducing a midwifery program in the province of Manitoba, the result of many years of work that I acknowledged and indicated in this House for some time.

It was launched fairly effectively and has resulted, I believe, if memory serves me correctly, in 26 midwifery positions around the province, with the plan to have the service provided all across the province. Mr. Helwer: Mr. Speaker, could the Minister of Health please provide my constituents with a timetable as to when they can expect midwifery services to become available in the Interlake region? Mr.

Chomiak: As members opposite might appreciate, last year was the first year in the history of Manitoba that we were able to offer a midwifery service that was put in place by legislation and a lot of work and a lot of funding. It is still rolling out, and I do not have a definitive time frame that I can give to the member today. * (14 : 10 ) Emerson Hospital Construction-Funding Mr. Jack Penner (Emerson): Mr. Speaker, in the 12 99 budget the Minister of Fi nance of the Progressive Conservative government tabled a budget in the House indicating that there was $4.8 million slated for an Emerson hospital.

Could the Minister of Health indicate to this House today what happened to those $4.8 million that were slated for new hospital construction in the town of Emerson? Hon. Dave Chomiak (Minister of Health): Mr. Speaker, as I have indi cated to the member last year in Estimates and during the process, we reviewed the entire capital wish list that was put in order by members opposite. Just several months before the election, a wish list of capital items was rolled out by the Government.

For 10 years Emerson had been asking for a facility, and all of a sudden just before the election it appeared on a wish list of capital. We reviewed all of the capital items. We assessed them against criteria of priority. Capital needs and capital requirements always exceed capital demand across the system. Mr. Penner: Mr. Speaker, I think what has just happened is that the Minister of Health has deceived Manitobans. There was clearly- Some Honourable Members: Oh, oh. Mr. Speaker: Order. The honourable Government House Leader, on a point of order. Point of Order Hon.

Gord Mackintosh (Government House Leader): Very simply, Mr. Speaker, would you

2022 LEGISLATIVE ASS EMBLY OF MANITOBA May 22, 2001 remind the member that a

preamble requires no supplementary. Mr. Speaker: The honourable Member for Emerson, on the same point of order. Mr. Jack Penner: Mr. Speaker, it is very clear that the Minister of Finance had a line item in the 19 99 budget indicating $4.8 million slated for new construction at the Emerson hospital for a new facility. Now, this minis ter has clearly indica ted to Manitobans that it was just a wish list. I think the minis ter owes Manitobans an apology and especially if he- Some Honourable Members: Oh, oh. Mr. Speaker: Order.

Prior to ruling on the point of order raised by the honourable Government House Leader, I would just like to remind all honourable members that a point of order should be pointing out to the Speaker a breach of the rules or the use of unparliamentary language. Just a reminder to all honourable members. On the point of order raised by the honourable Government House Leader, I would like to take this opportunity to remind all honourable members that Beauchesne's Citation 409(2) advises that a supplementary question should not require a

preamble. I would ask the honourable Member for Emerson to please put your question. * * * Mr. Jack Penner: Mr. Speaker, I would like to ask the mini ster: What happened to the $4.8 million that was clearly identified as a line item in the Budget of Manitoba in 19 99? Did it go to the Pan Am Clinic to buy the facility at the Pan Am Clinic? Some Honourable Members: Oh, oh. Mr. Speaker: Order. Mr. Chomiak: Mr.

Speaker, as I indicated, we reviewed all of the capital items that were announced in the 19 99, just preceding the election, capital budget, many things that had been on the books and suggested for a decade when the member opposite was a member of Cabinet. We reviewed all of them. The vast majority went forward, but we funded what we were capable of funding, not something where capital dollars were not available. South Eastman Regional Health Authority Budget Mr. Jim Penner (Steinbach): Mr.

Sp eaker, it is well known that the southeast regional health authority gets the least amount of funding per capita of all the RHAs in the province. Can the minis ter tell my constituents if he has rethought his inadequate funding of the southeast regional budget? Hon. Dave Chomiak (Minister of Health): Mr. Speaker, we reviewed all of the budgets and all of the requests from all of the regions as per the practice. We provided them with what we thought was a reasonable allocation of funds in order to undertake their roles and responsibility in health care.

There have been some regions that are having some difficulty. We are working with all regions. Mr. Sp eaker, the vast majority of money that is going to all the regions is balanced. There are some regions that are having difficulty, and we are working with them in order to fund that. Mr. Jim Penner: Can the minister inform my constituents of the southeast regional health authority if they will have to cancel chemo therapy and surgery programs to ensure that they do not run a deficit? Mr. Chomiak: Mr.

Speaker, one of the things that we are doing that did not happen previously is we are trying to get regions to live within their budget. Last year we succeeded for the first time that the WHRA lived within its budget. We are trying to- Some Honourable Members: Oh, oh. Mr. Speaker: Order. Mr. Chomiak: We gave what we viewed was a reasonable and fair allocation to the regions. I might indicate there are some areas that we are still working with the regions, but at least we are

May 22, 2001 LEGISLATIVE AS SEMBLY OF MANITOBA 2023 working at the front end of the budget process not at the back end, as was the pattern when members opposite were in government, when the funding would be shortfalled at the end of the year. Bed Reopenings Mr. Jim Penner (Steinbach): The second supplementary is I would like to know if the minister can inform my constituents if the beds that were closed at Ste. Anne Hospital, La Verendrye area and the Steinbach Hospital will be reopened by the South Eastman Regional Health Authority. Hon.

Dave Chomiak (Minister of Health): The member opposite knows that that particular region closed temporarily beds because of shortages of staff. The CEO, at the press conference, indicated that the problems had been built up in the 19 90s when members opposite were government and cancelled nursing programs and cancelled doctor positions, and that was why they were forced now to deal with the shortages of staff. It is temporary, unlike the 19 90s when members opposite ordered the permanent closure of beds. Victoria Hospital Oncology Unit Mrs. Joy Smith (Fort Garry): Mr.

Speaker, on a number of occasions the Minister of Health has spoken publicly about the new oncology unit planned for the Victoria Hospital and has spoken publicly about the funding that has been provided for that facility. Mr. Speaker, I would ask the minis ter to indicate when this project will receive an official public announcement. Hon. Dave Chomiak (Minister of Health): Mr. Speaker, I have had occasion to speak to the member opposite about that facility, and we have dealt with it. As we know, the proposal to expand at Victoria Hospital has been on the books now for about three years.

I indicated publicly that, in fact, it will be going ahead, and it will be part of the capital announcements we will shortly be making. Mr. Speaker: Time for Oral Questions has expired. MEMBERS' STATEMENTS Forest Indus try Mr. Harry Enns (Lakeside): Mr. Speaker, I want to thank the Manitoba Forestry Associa tion and the Forestry people in the Department of Conservation for what has become a tradition in this Chamber, that is the presentation of these trees on Arbor Day.

While it is entirely inappropriate to mention the absence or presence of a member, it is not inappropriate to express some regret of the absence of a formal statement that acknowledges the importance of the forestry industry in the province of Manitoba. Mr. Speaker, it is a very important part of the economic well-being as well as recreational well-being of the province of Manitoba. And despite some of my tree-hugging friends opposite, I impart this particular bit of knowl edge to all of my members.

Today in North America there is 20 percent more of our land masses covered by forest despite a hundred years of active forestry, and that applies to Manitoba as well. That is why I am particularly concerned that they would forgo hundreds of millions of dollars of development for, I still call them Abitibi in the eastern part of our province, failing to come to an agreement for those workers in Powerview to maintain one of the longest forestry operations in the province of Manitoba simply by not coming to terms with them and providing them with the needed resources that that operation needs. Mr.

Speaker, for those of us who have treasured these trees, and for some of us who have been around, we have got a bit of a forest growing at home with these trees. I must admit they have not all survived, but I, with pride, point to the ones that I got 15 years ago, 20 years ago. They are doing quite well. I encourage all members to nurture them with care, as we should indeed all our forests, and they will grow for you. * (14: 20)

2024 LEGISLATIVE AS SEMBLY OF MANITOBA May 22, 200 1 Mr. Gregory Dewar (Selkirk): Mr. Speaker, I want to, as well, pay tribute to the Manitoba Forestry Assoc iation who provided us today with these trees. These trees that members see before them are white spruce, which is Manitoba's official provincial tree. The trees represent a $40-million industry to Manitoba, an industry with potential to provide new economic opportunities for northern Manitoba in particular.

Manitoba Conservation is currently exploring how we can allocate valuable hardwood to the numerous communities and organizations that have indicated interest in assessing these resources. These seedlings were provided by the Manitoba Forestry Association, the oldest conservation organization in Mani toba. The MFA has long been a partner of this Department of Conservation, helping to promote forest management and wise use of this valuable resource.

The same partnership is organizing a forestry value-added conference for the next year, which will explore partnership opportunities between primary and secondary forest companies, big and small, in this province. Mr. Speaker, once again, I want to thank the Manitoba Forestry Associa tion for providing us with these trees today. Thank you very much. Justice Gordon J. Barkman Mr. Jim Penner (Steinbach): Mr. Sp eaker, on May 2 of this year, Justice Gordon Barkman of Steinbach retired as a justice of Manitoba's Court of Queen's Bench after having served on the bench for 29 years.

Many in this Chamber will know by reputation the quality work of Mr. Barkman over the years in this challenging position. During his time as a justice, he presided over numerous civil and criminal matters and did so with distinction. Mr. Barkman received his appointment after 21 years of private practice in the Steinbach area. On the ni ght of April 26, 19 72, he received a phone call asking him if he would accept an appointment as a judge, and the next day he was appointed as a justice to the County Court, which later merged with the Court of Queen's Bench. Upon his retirement, Mr.

Barkman noted some of the challenges and difficulties that come along with the position of a judge, most notably not being able to be involved in community organizations, fundraising activities or being able to hold offices in the community. Despite this, he noted that his time on the bench was rewarding and without regrets. In reflecting upon the role of a judge, former Supreme Court of Canada Chief Justice and Manitoba resident Brian Dickson stated that "once on the bench, the trial judge does not simply and automatically tum into an impartial being; judges are human." Indeed, Mr.

Barkman reflected the qualities that society expects in our judicial offices, and he did so in a very human and real way. Mr. Speaker, on behalf of all members of this House, I would like to extend my best wishes to Justice Gordon Barkman upon his retirement from the bench and to offer grateful thanks for his many years of service. Children Online Protection Committee Mr. Jim Rondeau (Assiniboia): Mr. Speaker, I am pleased to speak to this House about the work being undertaken by this Government in co-operation with Child Find Manitoba.

With the participation of Child Find Manitoba, a new committee, the Children Online Protection Committee, which will include representation from government, police, the community, Internet providers, will examine new ways to protect children on the Internet. The provincial government is committing $41 ,000 to support the work of this new committee, which will report to the Attorney General. One of the first tasks of this committee will be to develop a tip line, which will help the public report instances of child pornography and child luring.

This Government is serious about ending exploitation in all forms, with particular attention now being paid to technologies such as the Internet, which child predators use to attract children. This initiative to combat Internet stalking through a cyber tip line will be the first of its kind in Canada. Manitoba has been leading the way in urging the federal government to enact strict new laws to prevent Internet crimes, particularly child luring. By working together

May 22, 200 1 LEGISLATIVE AS SEMBLY OF MANITOBA 2025 with organizations such as Child Fi nd Manitoba, we will be better able to ensure that our laws and policies keep pace with new advances in technology. I invite all members of this Legislature to join me in wishing the new Children Online Protection Committee success in carrying out its important mandate. I also wish the best to Child Find in all its eff orts on behalf of Manitoba's children. Thank you very much, Mr. Speaker. Manitoba Tourism Community Partnership Award Mr. Denis Rocan (Carman): Mr.

Speaker, would like to speak to the House this afternoon to congratulate the recipient of the recently awarded Manitoba Tourism Community Partnership Award. The award is given to an alliance of local communities, organizations or businesses formed to work together to increase tourism and tourism services to an area of Manitoba. This year the Gathering of Nations became the recipient of the award. The Gathering of Nations is a partnership between the local cultural groups and a partnership between the towns within our circle.

It is the mandate of the Gathering of Nations to host a yearly multicultural event, which will provide the opportunity for people to understand each other more fully, to live and work together so that all communities are strengthened, and to educate ourselves and each other about our different cultures. The organization is also entirely run by volunteers. Congratulations to the communities of Somerset, Swan Lake, Holland, Notre Dame de Lourdes, Treherne, St. Leon, Pilot Mound, Crystal City, and St. Claude. Without your continued endorsement and enthusiasm the Gathering would not exist today.

The 2000 Manitoba Tourism Community Part nership Award trophy will be proudly displayed in each community. Once again, congratulations to everyone involved. Thank you very much, Mr. Sp eaker. ORDERS OF THE DAY Hon. Gord Mackintosh (Government House Leader): Mr. Speaker, would you canvass the House to determine if there is consent to vary Estimates by moving from Room 254 the Estimates of Family Services and Housing and Healthy Child Manitoba into the Chamber ahead of Executive Council. That is to apply permanently. Mr.

Speaker: Is there unanimous consent of the House to vary the sequence for consideration of Estimates by moving from Room 254 the Estimates of the Department of Family Services and Housing and Healthy Child Manitoba into the Chamber ahead of the Estimates for Executive Council? This change is to apply permanently. Is there agreement? [Agreed] Mr. Mackintosh: Mr. Speaker, would you please also seek consent of the House to move from Room 255 Intergovernmental Affairs into the Chamber to follow Family Services and Housing and Healthy Child Manitoba, that change to apply permanently? Mr.

Speaker: Is there unanimous consent of the House to move from Room 255 the Estimates of the Department of Intergovernmental Affairs into the Chamber to follow Family Services and Housing and Healthy Child Manitoba, with the change to apply permanently? Is there agreement? [Agreed] Mr. Mackintosh: Mr. Speaker, I move, second ed by the Minister of Family Services and Housing, (Mr. Sale) that the House resolve into Committee of Supply. Motion agreed to. * (14 :50) COMMITTEE OF SUPPLY (Concurrent Sections) HEALTH Mr. Chairperson (Harry Schellenberg): Good afternoon.

Would the Committee of Supply please come to order. This

section of the Committee of Supply will be considering the Estimates of the Department of Health. There was a previous agreement on this committee to have a global discussion of the

2026 LEGISLATIVE ASS EMBLY OF MANITOBA May 22, 200 1 entire department, and after completion of all outstanding questions, of all questioning, pass all resolutions. We will continue with a global discussion. We are open for questions. Hon. Dave Chomiak (Minister of Health): On May 16 , the Member for Charleswood (Mrs. Dreidger) requested a listing of all indivi duals currently under contract with the department along with an outline of their responsibilities.

There are 11 indivi duals currently under employment contract agreement with the department, and their names, places and titles and a brief outline are going to be outlined here. Number one: Dr. Joel Kettner, Chief Medical Officer of Health, represents the department in those areas where autonomous physician expertise is necessary, such as during public health emergencies; and also ensures that the statutory requirements of The Public Health Act are implemented. Two and three, Dr. Allan Downs, Dr.

Duncan Gillespie, medical assessor advisors, responsible for the development and imple mentation of policy respecting insured benefits assessment and recommendations respecting the payment of insured services in complex claims, to ensure that there is credibility with the medical profession, physician advice and backup as deemed essential to the claims assessment process. Number four, Dr.

Jack Kettler, Director, Medical and Clinic al Discipl ine, provides professional, medical and psychiatric leadership at SMHC; participates in the development and implementation of policies and clinical programs at the centre; is responsible for admissions assessment treatment and discharge of all patients at this centre; and directly supervises all medical staff and consultants; establishes and maintains a close working relationship with regional health authority, mental health caregivers to ensure seamless delivery of psychiatric services.

Number five, Robert James, SAS programmer methods analyst provides collaborative epidemiological research to various public health projects; supports the development, implementation and maintenance of the provincial diabetes surveillance system; prepares aggregate data files to estimate inci dents, prevalence and mortality rates for specified compli cations in health service utilization patterns in subpopulation with and without diabetes. Number six, Dr.

Lawrence Elliott, medical epidemiologist, provides leadership and development of epidemiological resources to support the environment and development of population-based information and analysis; provides leadership and co-ordination of an active portf olio of epidemiological research analysis projections directed at assessing and analyzing health status and trends, health determinates and the eff ects of population based on epidemiological research; provides leadership to assigned health programs and activities that require epidemiological support, example, surveillance of immuniz ation programs, communicable and non-communicable diseases; provides epidemiological consultation to public health practitioners regarding outbreak investigations; investigates, studies and designs and development of population health information system.

Number seven, Dr. Tim Hilderman, medical health officer, is part of the provincial team of medical health officers of health; works closely with the Public Health branch, Manitoba Conservation and other relevant stakeholders; participates in strategic planning and deciding programs to protect, promote and preserve the health of indivi duals in Manitoba; provides a resource to the province as a whole by sharing information, assisting in the identification, evaluation communi cation response to health issues in Manitoba. Number eight, Dr. Valerie Crem [phonetic] is part-time, .6; No. 9, Dr.

Catherine Cook, is part-time, .48; No. 10 is Dr. Paul Devalier [phonetic], part-time, .8; No. 11 is Dr. Pierre Perdu [phonetic], part time, .7. The above doctors function as medical officers of health in their region. They are members of their respective regional senior community health management team and work closely with all levels of public health staff. They participate in strategic planning and

May 22, 200 1 LEGISLATIVE AS SEMBLY OF MANITOBA 2027 designing programs to protect, promote and preserve the health of individ uals in their region. They provide expertise with regard to health information, health status assessment, health risk assessment, surveillance risk communic ation, health promotion, health production, and program evaluation. Also, Mr. Chairman, on March 17 , the Member for Portage la Prairie (Mr. Faurschou) requested a status report on the redevelopment of Portage hospital and their 200 1 -2002 operation health plans.

Regional Health Authority, Central Manitoba, requested a project to provide the city of Portage Ia Prairie and the northern half of the region with a new regional hospital. Portage District Hospital was originally constructed in '56 and many additions and renovations have occurred since then resulting in a multiwinged building configuration. Regional Health Authority, Central Manitoba, has strategically planned for two regional hospitals, Boundary Trails Centre and Portage regional hospital.

The Portage District General Hospital feasibility study, commis sioned in September '99, found architectural engineering issues related to the existing hospital and that the structure placed limitations on the delivery of programs and services. The authors recommended construction on an alternate site at a probable cost of $44,590,000. Central RHA endorses the findings in a letter to the minister dated January 25.

The City of Portage la Prairie council supported construction of a new facility and stated the required land and infrastructure is available. * (15: 00) There is argument to support partial or complete redevelopment; however, the facility is still functional and could continue current services for a number of years until a major capital project could be entertained. The decision to proceed on a capital project would need to be based on consideration of competing priorities and fiscal parameters. Mr.

Stuart Murray (Leader of the Official Opposition): I would like to ask the Minister of Health if he has had an opportunity to have a discussion with Mr. Roy Romanow specifically with respect to his mis sion, I guess, that was tasked to him by the Prime Minister of Canada to look into the situation of health care. Mr. Chomiak: No, I have not had direct conversations with Mr. Romanow, although I did have conversations concerning the proposal to appoint such a commission in the period of time leading up to Mr. Romanow's appointment. Mr.

Murray: Just to clarify, there is a clinic that was built in The Maples Surgical Centre, as it is called. I just wondered if the minis ter could tell me if under the current legislation that facility is allowed to have four beds in its facility. Mr. Chomiak: There are several pieces of legislation that deal with the matter of surgical centres or clinics. There are two matters to be considered. Firstly, there is

an act that has been in existence in Manitoba since the 19 20s called The Private Hospitals Act, which indicates that for a private hospital to function it requires the permission of the minis ter to do so. The definition of a private hospital under The Private Hospitals Act is four or more beds. Secondly, there is legislation under The Health Services Act concerning the utilization of clinics in the province of Manitoba.

Under legislation passed by the previous government, surgical clinics who offer services that are provided under the Canada Health Act cannot charge for those services unless they have an agreement with the Minister of Health. Mr. Murray: I think my question to the minis ter was: Under the current legislation are clinics such as The Maples Surgical Centre allowed under the current legislation to have up to four beds in that clinic? Mr. Chomiak: Under the current legislation, with respect to beds they can have as many beds as they like. Mr.

Murray: Under the current legislation that exists in Manitoba, as we are questioning the Minister of Health on this date, under the current legislation would the minis ter clarify whether under the current legislation The Maples Surgical Centre is not a hospital?

2028 LEGISLATIVE ASSEMBLY OF MANITOBA May 22, 200 1 Mr. Chomiak: Under the current legislation a hospital is a hospital designated under a specific act or a hospital is defined under The Private Hospitals Act. Mr. Murray: Perhaps if I could ask the minis ter in a yes-or-no answer, under the current legislation is The Maples Surgical Centre a private hospital? Mr. Chomiak: A private hospital is a facility with four or more beds that is designated by the Minister of Health. Mr. Murray: Is the minis ter indicating to us that he then has designated The Maples Surgical Centre as a private hospital? Mr.

Chomiak: I have not designated The Maples Surgical Centre a private hospital, nor has The Maples Surgical Centre applied to be a private hospital under the act. Mr. Murray: So I would hope that perhaps the minis ter, in meetings with the Premier, could also remind him that Maples Surgical Centre under the current legislation where the minis ter has notion, as I understand he probably does-we can get into an ideological debate on this but I suspect he has legislation at hand to change the current legislation.

But clearly I believe that, when I asked the Premier, he went on at all sorts of lengths, and I very much appreciate the fact that the Minister of Health today is stating that The Maples Surgical Centre is not a private hospital. Mr. Chomiak: Mr. Chairperson, there has been some confusion concerning The Maples Surgical Centre based on advice that The Maples Surgical Centre provided to individuals. I am advised that they advised the College of Physicians and Surgeons that, in fact, they were intending to be a private hospital in Manitoba.

I am advised of that and I am advised also that the principal, Doctor Godley when he appeared on open-line radio, also indicated his intention to be a private hospital under the current legislation. That is what I am advised. Following those particular-[interjec tion} Well, if the Member for Charleswood has comments, she can make those comments. An Honourable Member: I will. Mr. Chomiak: Mr.

Chairperson, following those recent discussions and following those discussions, both on radio and the application provided, we contacted Doctor Godley for the Jetter that the members opposite have, I believe, because they made it public, outlining what the criteria are respecting a clinic in Manitoba and the operations of a private hospital, which we clarified for Doctor Godley. There were a number of issues concerning The Maples Surgical Centre that came to our attention. For example, Doctor Godley indicated on open-line radio that one of the things he wanted to conduct in Manitoba was colonos copies.

He advised the open-line host that in fact it was not paid for in Manitoba. In fact two calls came right out on open-line to indicate that in fact those procedures are covered in Manitoba. So there was some confusion, I think, on the part of Doctor Godley, the principal there, as to what the laws and the rules and regulations are in Manitoba. When we heard what Doctor Godley had intended or had suggested he was going to do, we were very quick to clarify with him what the particular status was in Manitoba.

He was probably unfamiliar with our legislation, and we endeavoured to outline for him what the criteria was in our legislation. The amendments to The Health Services Act dealing with surgical centres was in fact brought in by members opposite in 19 98, I believe. Secondly, The Private Hospitals Act has been in place since the 19 20s. We advised Doctor Godley that anyone coming into Manitoba should be aware of these particular acts.

We also indicated at the time, and I indicated to Doctor Godley, that in fact the issue of private hospitals was one that we were addressing and that we intended to ensure that private hospitals with overnight stays did not become commonplace in Manitoba, something that was a huge problem in other jurisdictions and a continuing problem.

In keeping with the spirit of the way hospitals have functioned in Manitoba, we advised Doctor Godley that we would be reviewing the legislation to ensure that overnight stays do not become commonplace, as practice in Manitoba, because I do not know if the member opposite appreciates the impli cations of

May 22, 2001 LEGISLATIVE AS SEMBLY OF MANITOBA 2029 that but the implications of anyone opening a private hospital and of fering overnight services could have profound implications in terms of access in our facility and in terms of providing services to our population. It is ironic coming out of an era we have in the past decade that there would be an attempt to go towards private hospitals and we wanted to ensure that such did not occur in Manitoba, in keeping with the traditions and spirits of Manitoba.

The legislation that was passed in '98 was an attempt by the former government to deal with the issues of private hospitals and the implications under the Canada Health Act. The minis ter at the time stated categorically that they would not allow private hospitals in Manitoba, firstly. Secondly, the minis ter at the time, I believe it was the Member for Lac du Bonnet (Mr. Praznik), also indicated that this was a solution that was being entered into by the then-Manitoba government until the Manitoba government could built up the capacity within the public system to offer the services that were being offered.

Keeping in mind that particular spirit, I was surprised at the member opposite's change of position in that regard in advocating for private hospitals and the expansion of private hospitals, and for the expansion of private clinics. Nonetheless, that is the position taken. In a democracy, we often have various viewpoints. Having said that, Mr. Chairperson, in keeping consi stent with Manitoba policy, we intend to adhere to the principle of not allowing private hospitals in this jurisdiction but continu ing to try to offer a varied range of options to our population. Mr. Murray: Mr.

Chairman, the interesting thing about it that I find fasci nating is the minis ter says that Doctor Godley was not aware of the current legislation, and so he had to inform him what the current legislation says. I think, if that is the case, I find it very strange that the current minister, as he makes statements in the media when he makes comments about The Maples Surgical Centre, refers to it as a private hospital. Perhaps the minis ter does not know the legislation.

You talk about confusion; confusion reigns when the person who is supposed to understand what the legislation means does not understand it or misleads the public. * (15:10 ) So I find it somewhat unfortunate that both the minis ter and the Premier (Mr. Doer) go on at length about this particular clinic as a private hospital when they know full well that it is absolutely under the current legislation not a private hospital.

It even is more interesting I find that when you go through this process and you ask the questions, as I did with the Premier, that there is sort of the 15 -minute long answer about all sorts of issues and concerns and everything that talks about patients, when, in fact, are we not talking about the safety of patients? When is it that a politician should understand that patients should be discharged over doctors?

If that is the kind of debate that this Government and this minister want to get in, well, then I think the public are quite delighted to have that kind of debate, because clearly there is no plan in terms of where this minis ter or this Government wants to take health care unless it is ideologically driven in the sense that we know best, that heaven forbid that there should be a patient that has some surgery performed, that they may not be prepared to be discharged, and, lo and behold, though, boy, we better put in legislation, because that sure would not be a good thing for the patient.

We better make sure that we ship them out to a hospital or a hotel by taxi, because, after all, ideology says that we are supposed to know and if we are the Government we dictate what should happen. Well, I can tell the minister that if he wants to and if the Government wants to have an open and honest debate about how Manitobans, how patients view health care in this province, then I believe they should look at all options that are available.

If they want to start bringing in legislation to start slamming down things that are right for patients according to medical doctors, whether it is Alex Chochinov or others, I mean, I certainly am no expert on the medical front, but neither is my honourable member over there. I think that we have got to rely on those people that are experts. When the medical field

2030 LEGISLATIVE AS SEMBLY OF MANITOBA May 22, 200 1 starts to tell the politicia ns that they should be looking at other ways to improve what is right for the people in Manitoba, and that is a better health care system, that patients should come before politicians, I find it very uncanny that both the Premier and the Minister of Health take a tack to say, well, you know, we know better, and, by the way, when Doctor Godley came into town he was misi nf ormed and we made sure that he understood what the legislation was.

Well, if that is the case, then why does the minister constantly mislead when he is making media statements or in the House, go on at length about this private hospital that Doctor Godley is running. It clearly is not. We have asked for clarification.

I think that we have seen a history of this minister and the Premier, and I asked him the same questions, mini ster, that I would ask you: When you mis lead Manitobans, as you did, to say that you would solve hallway medicine in six months with $15 million, your budget has gone up by 22 percent, you talked yourself quite openly with some sort of sense of pride about a Web site that you can go to to monitor how many people are in the hallways, my question really becomes: How is it that Manitobans will look upon you with credibili ty when you now look at someone who wants to come in to work with Workers Compensation and MPI just as the Pan Am clinic did, the same kind of regulations, relationship that they had, and everything seemed to be going quite fine there, other than your Government feels you have to own the bricks and mortar?

So here is a guy that comes in, and he wants to set up a clinic. On his own nickel he wants to have a relationship with Workers Comp and with MPI, and your feeling is from your Government that, no, you do not want to do that, because somehow that would not be good for Manitobans. I think if the minis ter honestly believes that they know better than what the public deserves in terms of where they want to go with health care, I say to the minis ter, bring that debate to the public and let the public decide. So I just would ask, I would caution the minis ter that health care is a very, very serious issue.

I know that the minis ter is very aware of that. I do not pretend to know more about it than he does, but what I do say is that, when there are issues that are clearly looking at putting the safety of patients at risk, why is it that the minis ter will let his ideology get in the way of what is right for the patients? Mr. Chomiak: Mr. Chairperson, where does one start in that rather meandering ideological speech of the member?

Let me start with the word "misleading." It was the member's own critic, the Member for Lac du Bonnet, who went out, showed a photo of some fishing buddies, and said that was Doctor Postl and Doctor Hildahl with the Premier, who went fishing. He went publicly and said that. It was the member opposite who came up and talked about friends of the Premier getting a special deal. The friend of the Premier who campaigned for the Tories, whose picture was in a Tory campaign, that was the friend of the Premier that the members opposite talked about.

So the member opposite should be very careful in how he makes allegations regarding the word "mislead." The entire debate has been misled by members opposite. Now, to talk about the issue, let us talk about the issue of private versus public. We are very happy to have that debate in Manitoba. We welcome the debate in Manitoba, and we will have the debate, Mr. Chairperson. Let us review the situation. In 19 98, when surgical centres opened up in Manitoba and surgical centres started offering insurance services, the then-government of the day was fined thousands of dollars a month for paying the fees.

In order to get around those particular fees, the present Government put in legislation. What did they do, Mr. Chairperson? What did the present Government do? They gave the Minister of Health the right to designate surgical centres. Our friends in the then-government gave the Minister of Health the right to designate which centres would be able to provide insurance services and what centres would not be able to provide insurance services by legislation, and we supported that because it served a practical purpose.

The practical purpose it served was to deal with the issue of demand and the issue of access to health care.

May 22, 2001 LEGISLATIVE AS SEMBLY OF MANITOBA 203 1 * (15 :20) Corresponding to that was the situation in Alberta, where in Alberta the entire system of surgery in one particular area shifted over to the private sector, and the Government of Alberta had no ability to control the surgeries done because every single facility and doctor in the private sector were being fined by the federal government and, consequently, brought in their infamous Bill 11 , which caused a good deal of debate across the country with respect to how health care should be funded and provided for, Mr. Chairperson.

The infamous Bi ll 11 provided for private hospitals in Alberta. In the most recent federal election in November, the members opposite, friends in the Alliance tried to make this issue, two-tiered health care, an issue in the election, and it became very clear, in the November election, that the members opposite and their friends in Alliance did not succeed in convincing the Canadian public that, in fact, a two-tiered, privatized health care system is the way that Canadians wanted to go. So, Mr. Chairperson, we in Manitoba looked at the present situation, and we reviewed the present situation.

We reviewed it in order to try to determine what options would be available to us, in Manitoba, to deal with this situation. We had the situation of the private hospitals in Alberta. We had the situation of Ontario's latest initiative to go towards privatized medicine. We superimposed that upon discussions that we had had at the federal-provincial level with other Health ministers that the difficulty with the proliferation of private clinics and private hospitals was that it increased waiting lists, and it caused grave difficulty in other provinces. So, Mr.

Chairperson, we said why do we not attempt to meld the best of two systems together, the advantages of surgery centres, which all of the reports indicate we must move towards surgical centres and more day surgeries and the cheaper cost evident in those facilities, and the utilization of our acute care facilities for more complex procedures versus the overall privatization or the overall public system. We think we have a made-in-Manitoba solution, something that has been a feature of Manitoba since the 19 60s: innovation in health care.

The innovation in health care that was brought in by former NDP governments, the home care and the pharmacare, which, I am sure, were opposed by members opposite, are seen as na tionwide benefits. Frankly, any ma jor benefits, the major personal care home construction system that has been put in place was brought in by an NDP government, probably opposed by members opposite, but, nonetheless, is now considered a standard feature of our medicare system. We thought that the utilization of a surgical centre in the public system would provide for benefits in the entire system.

So we said we have the advantage in Manitoba of a public system, a private system, where we still have contracts with private care providers, and a system where we take a private and mold it into the public system, which we think any moderate and, I think, any open-minded person viewing, not someone who is bound ideologically to their private free enterprise system, which any open minded individ ual would review and say that makes for some benefit. We had the further information, Mr.

Chairperson, that studies undertaken by the centre for Health Policy and Evaluation in Manitoba showed that, when you run a private system beside a public system, the waiting lists get longer. The Member for Charleswood (Mrs. Driedger) said those are two, very, very small studies.

Well, I thank the Member for Charleswood for pointing that out, but we are faced with the other option of the blind ideological stampede towards privatization by members opposite and their friends in the Alliance that they tried to do in the federal election, that they are trying to do now in Manitoba, this blind adherence to the private system and this system that has to be put in place. We say no. We do not want to be ideo logical; we want to be practical. We want to look at what the practical solutions are. The members opposite say private and private at all costs. We say there is a different way in Manitoba.

There is a way of coming down the middle and looking at options. We still retain all ofthe options, and we retain all of the flexibility associated with that particular system. So in Manitoba we are going to begin a debate on the system of operating within this type of system. We think, from our perspective, that it is the best of all worlds.

2032 LEGISLATIVE AS SEMBLY OF MANITOBA May 22, 200 1 Mr. Chairperson, I would like to indicate that there are a variety of extensive advantages with utilizing this system, which we hope to provide for increased, faster service and better utilization across our system. We are not bound to blindly closing beds, as was done over the past decade, laying off nurses with no positions, as was done over the past decade. What we want to do is have, in a very steady, systematic way, a moving forward, something that has happened pretty dramatically across the system in the past 18 months.

Now, the member opposite keeps indicating that somehow we in the Government are "mis leading the public" by virtue of talking about private hospitals. The issue of private hospitals came up and was introduced by the proponent coming in to Manitoba. We indicated at the very start that the issue of private hospitals was one which we would not, as a government, in keeping with Manitoba tradition, permit. The members opposite may want to have private hospitals.

They may have changed their position from their previous position of the previous Member for Lac du Bonnet, who when he was Health Minister indicated that they did not support private hospitals. Members may have changed their position, but we believe we are taking the position that is consistent with what Manitobans want. So the issue for us is the provision and the care of services. Members opposite have said we should fund The Maples Surgical Centre.

The members opposite want us to fund every single clinic that opens up in Manitoba, every time a clinic opens up in Manitoba, all the time when a clinic opens up in Manitoba. That was not their policy and it was not their policy for good reason, because the ability to provide access and the ability to deal with volume is something that the Government, in a one-payer system, is very crucial to the effect of functioning of a medicare system.

Members opposite seem to have· reversed their long-standing position that now says fund every single private clinic that opens up in the system. [interjection] The Member for Russell says who says that. Clearly the members opposite have asked for us to fund The Maples Surgical Centre, holus-bolus, Mr. Chairperson. An Honourable Member: We never said that. Just because we asked the questions. Mr. Chomiak: Oh, the Member for Charleswood (Mrs. Driedger) said just because they answered the questions. Mr. Chairperson: On a point of order, the Member for Russell. Point of Order Mr.

Leonard Derkach (Russell): You know, Mr. Chair, this minis ter does it in the House, does it in commit tee, does it in front of the cameras, continually mis leads Manitobans, and as a matter of fact puts inaccuracies on the record. It is becoming a trait of his, and it is becoming a little tiresome because I think he should speak the truth instead of shaping the truth to his own liking, shaping the facts to his own liking. No one that I recall on our side of the House has ever said, and ever asked the minis ter, to fund The Maples Surgical clinic. No one has said that. No one has asked the minister to do that.

We have asked a Jot of questions, but we have never indicated that the minis ter should fund this facility. The minis ter makes a whole bunch of allegations about who this party is friends of, and again, it is to shape his own political agenda and his own philosophy. Well, I am sorry, that just does not cut ice. In this committee we are expected to ask the minis ter some questions, and we will continue to ask the questions. He may not like them; and, to bum up time, he may sit there and pontificate for a long time.

But indeed it does not get us anywhere in terms of real answers to some very serious questions in health care. Mr. Chairperson: On the same point of order, the honourable minister. Mr. Chomiak: Mr. Chairperson, the member does not have a point of order. It is a dispute over the facts. I might suggest it was the member's own leader who brought up the word "misleading," which I think is very unfair in this committee. If members want to have a frank discussion, then I would suggest that he talk to his leader and not ask him to introduce elements of that kind.

Members opposite are very sensitive in terms of some of their positions, and they are very- [interjection] Well, members opposite will not even let me deal with the

May 22, 200 1 LEGI SLATIVE AS SEMBLY OF MANITOBA 2033 member's point of order. Good heavens, does that not suggest defensiveness? Nonetheless- An Honourable Member: They have reason to be defensive. * (15 :30) Mr. Chomiak: Well, yes, the member indicates that they do have reason to be defensive. It is a dispute over the facts. It is very clear, and members can very clearly deal with that issue by simply stating in the microphone that they support the public health care system. The members can simply state the facts, and then we will be able to proceed on that basis, but they have not done that. Mr.

Cha irperson: On the same point of order, the Member for Charleswood. Mrs. Driedger: On the same point of order, Mr. Chairman. It is interesting that we seem to be going in the same circles we went in in the last Estimates, where every time a year ago I asked questions on certain issues because I felt it was my job as a critic to seek accountability from the minis ter, that he would then skew the question to indicate that the member does not approve of this or does not approve of that. I think his most famous lines were around the issue of the two year diploma program.

He struggled and struggled with that one through the whole set of Estimates and probably the whole last year and was never quite sure where we stood on it, but he certainly used that to his political advantage time and time again and skewed information and was not particularly forthcoming in many of his responses last year. He seems to be going in the same direction again this year. We have never indicated that we supported funding of every single clinic that was to open in Manitoba. In fact that is absolutely ridiculous.

The minis ter likes to sit back and smile now because he thinks he has scored some points, but in fact this kind of little game-playing I find quite offensive because all we do in opposition is ask the questions because that is our job. We are there to make sure that all of the avenues are explored when decisions are made. The m1mster tends to get very defensive himself, very hysterical sometimes with his answers. I think he really spoils the whole process of Estimates because this is supposed to be about questions and answers. It is supposed to be about accountability.

It is not supposed to be about seeing who can outmaneuver with words and play the political games. I think that really does a disservice to Manitobans especially around this whole debate around private/public health care. In his typical fashion he wants to fearmonger. He wants to label The Maples clinic as a hospital. He uses that over and over again. He uses the words "user fees" over and over again when he knows full well that there are no user fees for insured services at any of the clinics that are private and fund public health services.

So the minis ter has deliberately on a number of occasions, I believe, misled the public in terms of using the words "private hospital," in terms of throwing out "user fees," and I think it is a poor attempt at fearmongering and scaring the public. Mr. Chairperson: Order, please. I will have to rule on this point of order. There is no point of order. It is a dispute over the facts. I would remind all honourable members that a point of order is to indicate a breach of the rules and is not a time for debate. *** Mr. Cha irperson: The honourable minis ter, to continue. Mr. Chomiak: As I was continuing, Mr.

Chairperson, I would hope members opposite would deal with the facts and the issues and not try to confuse it by spurious points of order and try to get their points on the record by virtue of doing that. If they want to have a frank discussion, then we ought to have a frank discussion, and we should not deal with spurious points of order that have no relationship whatsoever to the issue in an attempt [interjection] I do not know. So I appreciate the ruling. It allows me to get back to the issue at hand, which is the entire question that was forwarded by the Member for Kirkfield Park (Mr.

Murray), the Leader of the Opposition, who put a number of facts on the

2034 LEGISLATIVE ASS EMBLY OF MANITOBA May 22, 200 1 record that were inaccurate, and I was attempting to deal with it. As I was saying, this issue of private hospitals and private clinics is bigger than any of us here in Manitoba. It is a pretty fundamental issue. The member opposite was concerned that the two studies that showed private clinics operating beside public clinics were small studies and should not be utilized. What does the member suggest that we utilize in terms of it other than ideology which seems to be the pattern they follow?

The members opposite seem to indicate they are not countering with studies that show otherwise. We have studies that show even in Manitoba that the waiting lists went up when you operated private beside public. That is evidence. That is factual evidence. We have studies from Alberta that say the same thing. That is evidence, factual evidence, of what happens when you run a private clinic beside a public system. It is based on good advice.

I have indicated on many occasions to members opposite that when I first attended federal-provincial conferences the minis ters collectively discussed the issue of private clinics and private hospitals as being one of the fundamental difficulties that each minister was dealing with in their own respective jurisdiction. I witnessed a major discussion in that regard at the Western Premiers' Conference between premiers with respect to dealing with the issue of private clinics and private hospitals. I defined for the Member for Kirkfield Park (Mr.

Murray), in my first or second response, specifically what the rules are concerning private hospitals as it exists in Manitoba and the rules concerning surgical centres as they exist in Manitoba. How much clearer can I be than to outline what the present criteria are for members opposite? I outlined the criteria. Whatever position members choose to take is the position I assume they arrive at as a caucus. Whatever questions members choose to ask, I assume it is something they arrive at as a caucus. There is nothing to be embarrassed about if you have a particularly ideological position that you are holding.

That is fine, that is the position that you hold. If it happens to be simi lar to the Alliance Party in the last federal election, then so be it, Mr. Chairperson. I do not know why you would be ashamed of that. Clearly, if that is your position, that is your position. If your position is not that, then I wish members opposite would state specifically what their position is, if that is not what their position is. I notice a reluctance to do so, so I can only conclude that they have changed their position from what they had indicated when in fact they were the particular government and they were in power. So, Mr.

Chairperson, I think I have outlined for members opposite the questions that were posed by the Member for Kirkfield Park, and I look forward to continuing debate on the issue of private-public in Manitoba. Mrs. Driedger: Mr. Chairman, I would like to indicate that the Member for Kirkfield Park (Mr. Murray) has given his regrets that he could not stay to listen to that long answer, but he did have an appointment in Portage Ia Prairie and did have to leave.

I would like to ask the minister because he did say that access and demand was an important issue for him, and I wonder if that was the case why he would not have at least explored, I mean he did not even return Doctor Godley's calls. He did not even go down and have a look at this clinic, and this was all prejudged before this doctor even came into Manitoba.

I am curious, I really am, if this minister is talking about the need for good access to care, meeting patients' demands, why he at least would not have been courteous enough to show Manitoba hospitality, to return what I understood could be about three phone calls, and why he was not courteous enough to at least then be open and up front with Doctor Godley and state his opinion. I mean he just gave us this long-winded answer about the importance of, you know, if you have ideology, that is fine.

Well, if that was the case then, and if it is his ideology prohibiting him from speaking to Doctor Godley, I mean why could he have not at least been courteous enough to put that forward to Doctor Godley, instead of being rude and not returning the calls.

May 22, 200 1 LEGI SLATIVE AS SEMBLY OF MANITOBA 2035 Why would he not have even looked at the clinic just to see if there was any innovative oppor tunity there that would have helped patients in Manitoba? Mr. Chomiak: Mr. Chairperson, I believe that Doctor Godley called my office from a cellphone, I do not know, in B.C. or somewhere else, indi cating that he had discussions. We passed it on to our appropriate officials to deal with. We, very early in the process, outlined to Doctor Godley what the position was of Manitoba with respect to what criteria were present in Manitoba.

There is a variety of demands and a variety of people that contact us regarding expansion, and regarding particular issues that they wish the Government of Manitoba to fund. I do not think the member is suggesting that I have to meet, or should meet, with every single person that comes to Manitoba and wants us to fund a particular project or particular item.

The appropriate regional health authority, if members believed in regionalization, which I assume, unless they have changed their position on that too, but if members believed in regionalization, I would assume that the appropriate response would be to have the regional health authority determine the needs, determine the requirements and determine what matters ought to be reviewed.

Doctor Godley then appeared on radio programs, and then made a number of pro nouncements, which from what I am advised were not accurate concerning the situation in Manitoba, which is one of the reasons why we wrote to him to clarify some of the difficulties and some of the problems that he was having as it relates to his view of what the situation was in Manitoba and the situation concerning the provision of services here in Manitoba. * (15: 40) The member opposite ought to know that I try to meet with as many individ uals as possible and to discuss as many issues as possible with the appropriate individuals.

There are numerous doctors that have discussed the issue, and that is very interesting, Mr. Chairperson, because both when I was critic and as minis ter a lot of doctors came to me and said why would the Government not operate surgical centres because they are the most appropriate means of providing services to us and to doctors.

It was doctors that actually lead the fight for the provision of surgical centres and the providing of services in surgical centres, and encouraged us in Manitoba to take a look at the process that, in fact, we are looking at, as it relates to the Pan Am situation and the melding of a particular system with another system.

I am also familiar with the experience that was taking place under the previous government when they went into the Assiniboine Clinic exercise and launched a pilot project, quite secretly, I might add, with respect to Assiniboine Clinic, and did a review in terms of providing doctors with payments outside of the regular system in review of the Assiniboine Clinic, which was innovative and which was an attempt to deal with it differently.

I looked at the results of the Assiniboine Clinic when we reviewed this, and it is very clear that there were a number of issues that we had to try to deal with before we entered into a venture of this kind. Mr. Chairperson, the member opposite suggests that the Minister of Health should meet with every single individ ual who has a plan. We try to meet and talk with as many individuals as possible.

In this particular instance, Doctor Godley very quickly made it clear and made it clear to officials, as I understand it, at the College of Physicia ns and Surgeons he had contracts that he had already entered into and he intended to open a private hospital, I believe. I think that was unfortunate, because it then suggested he did not understand the situation specifically here in Manitoba. So The Maples Surgical Centre was contacted by Manitoba Health. We outlined the criteria. We discussed it with Doctor Godley. We discussed with Doctor Godley the provision of services.

We did know that there were interesting developments in B.C. concerning Doctor Godley and his clinic, that he did extensive WCB work, that there were issues concerning the clinic. We contacted Doctor Godley and outlined to him what our criteria was in Manitoba, how we dealt with the issue in Manitoba. I think that was conveyed to him in

2036 LEGISLATIVE ASS EMBLY OF MANITOBA May 22, 200 1 writing, rather than through a telephone message, whereby if I spoke to him in a telephone message at least we had on the record what the Manitoba position is. I think it is prudent that we had on the record for Doctor Godley what the Manitoba position is, rather than a telephone message to a cellphone left by Doctor Godley to my particular office. We contacted him and advised him what the situation was in Manitoba. Doctor Godley continued to construct, as I understand it, his private clinic.

He continued to work on his private clinic and received authorization from the College of Physicians and Surgeons. I believe he is planning to operate and offer services. That is certainly his right. I have consi stently said, it is his right. If he wants to open a clinic, he can open a clinic, provided that he adheres to provincial legislation. We outlined that provincial legislation to him. He is prepared. He is aware of that. He can then proceed to operate his clinic as he sees fit. Members opposite are indic ating that somehow we used the terms "private hospital" and "private clinic" interchangeably.

I might indicate, Mr. Chairperson, that the concept of opening a private hospital was one that came up when Doctor Godley came in. We wanted to make it very clear to Doctor Godley what legislation is, because there is confusion as to what constitutes a private hospital and what constitutes a private clinic. We wanted to outline to Doctor Godley what those particular criteria were. The member opposite indicates I may have not been hospitable to Doctor Godley. I do not want to debate the issue as to whether or not I should have immediately called him or written a letter.

If the members preferred I immediately call him and not write a letter, I think that was the wrong decision. I think it was already prevalent in the media. The media already were coming to me because of some media broadcast that had been undertaken by that indivi dual asking what our position was. I had to lay out our position, which I thought was consi stent with Manitoba legislation for some period of time, which had been The Private Hospitals Act and The Health Services Insurance Act.

I indic ated, however, that if any individ uals attempted to get around the legislation by virtue of looking for loopholes in the act that we intended to upgrade the act and that we intended to upgrade it to deal with issues of patient care. I look at a February 16 report in The Winnipeg Sun where it is alleged, in The Winnipeg Sun, that a surgical centre in Van couver allegedly permitted a client to pay for a friend's surgery last year, an infraction of the federal government's laws that govern medicare.

We have an investigation of an alleged violation, an individual posing as a party to pay out of pocket, said Frank Fedyk, Ottawa's acting director general of Intergovernmental Affairs. That was a report in The Winnipeg Sun. So when Dr. Godley came and vowed that he would open a surgical centre, I indicated publicly that we would not allow a private hospital, which we had been inf ormed earlier he had asked for but that he could open a private clinic; he had the right to do that. That is, in fact, what he has done, and we are continuing to monitor the situation.

But we are not backing down from our position that we think we have a creative way of dealing with the issue of private medicare in this country that would meld the best of all of the situations in the country. We did not want to go the Bill II way in Alberta, and I wonder if the member opposite could indicate to me whether or not that is, in fact, what she would propose. What we wanted to do, Mr.

Chairperson, is develop a made-in Manitoba solution that would take the advantages of the private system and meld it into the public system, because one thing we do know is that we have studies that indi cate that it is preferable to have a system that is public and not to have private beside public, because the waiting list, in fact, from the studies will be longer. There is much more I could say on this, Mr. Chairperson.

I do know that The Maples Surgical Centre originally did want to incorporate as for overnight stays which implies a private hospital, and I think it has always been Manitoba policy not to permit private hospitals. Good heavens, the previous government closed 14 00 acute care beds in the public

May 22, 200 1 LEGISLATIVE AS SEMBLY OF MANITOBA 2037 hospital system. We have been attempting to expand the system. We intend to incorporate the best elements of the private system in our public system through the use of the Pan Am centre, as well as maintaining a stream of contracted service, as well as maintaining service in the public sector, the traditional acute care system which seems to me, Mr. Chairperson, to be prudent and the best of all worlds. Mrs.

Driedger: It certainly seems from the minister's statements where he indicates four overnight beds implies a private hospital, certainly makes the link that this must be where the minister got the idea from, that The Maples clinic was a hospital. In fact, Doctor Godley, I have heard on the radio, correct this misleading statement that he is not a hospital; he is a surgical centre. That is what he always intended to be, and yet the minis ter has chosen to use the words "private hospital" several times since, which does make for some interesting conjectures as to why this would be happening.

The minis ter had then played around a little bit with the whole issue of, well, should I talk to him or should I write a letter; maybe I should not write a letter; a letter is good. Fine, I think a letter is great. I think it is good to have things in writing. I am not saying in any way that that was not something that should have been done.

It just seemed to me a little bit odd that in a province where you certainly would hope that there is some innovation in terms of addressing health care, that the minis ter would have at least had the courtesy to return the phone calls of somebody who was coming into Manitoba who was going to try to look at improving access and demand for patient care. The minis ter certainly did not have to go down that road at all, but it would have been interesting at least not to slam the door shut immediately and at least look at alternatives. Then the minis ter could have made an informed decision.

But in this case, it becomes obvious that it was not a very informed decision. It looks like it was just strictly an ideological one. In the end, one has to wonder what benefits might have arisen from such a situation if the minis ter had truly felt that access and demand and trying to improve patient care was where we needed to go. * (15 :50) The minister has also indicated that Doctor Godley made inaccurate statements. Well, maybe he would not have made inaccurate statements if the minis ter had taken the time to phone him in the first place and given him the information about Manitoba.

Instead, now the minister goes around criticizing Doctor Godley, saying that Doctor Godley was inaccurate, but, certainly, that could have been prevented, and the minis ter certainly has chosen not to do that. The min ister has also indica ted that there are criteria available in Manitoba to make decisions in looking at such clinics as Doctor Godley's and whether a government would or would not go down the road of accessing service in one of those clinics. I wonder if the minis ter could explain what those criteria are. Mr. Chomiak: Mr.

Chairperson, when we came into office, we maintained the contracts that had been put in place by the previous admini stration with respect to contract of services to private facilities. We also recognized that there was a need for some increased demand, obviously, and that by providing an enhanced surgical capacity at the Pan Am clinic we would have in fact that particular information. It seems to me it would be helpful if the member could outline if their position is not to support holus-bolus private clinics, as I think it is simi lar to the Alliance.

Then the member perhaps could outline for us what their particular criteria of support are. That would be helpful and useful in the debate, Mr. Chairperson. With respect to the criteria we deal with, there are a variety of criteria that are looked at by the WRHA with respect to patient volumes, patient requirements, and patient needs. Those requirements come up through government through the Estimates process that I am sure the member is familiar with. I think that we follow generally in that regard the prudent policy. Mrs.

Driedger: I did not hear in that answer any of the criteria that the minis ter had referenced. He had indicated that there are criteria available in Manitoba to make decisions. I would assume that those criteria should be something that he

203 8 LEGISLATIVE ASS EMBLY OF MANITOBA May 22, 200 1 might have top of mind, because obviously they, one would assume, were used in making the decision about slamming the door shut on The Maples Surgical Centre. So I would hope that the minis ter could come up with the specifics in terms of what those criteria are. Mr. Chomiak: Mr. Chairperson, the member keeps ref erencing how we stopped Maples Surgical Centre. I do not understand what the member is talking about. Perhaps the member can outline for us. The Maples Surgical Centre can operate in Manitoba.

I have always said it can operate in Manitoba, provided it adheres to Manitoba legislation. There is nothing stopping Maples clinic from providing services in Manitoba providing it meets the criteria listed under the College of Physicia ns and Surgeons and providing that it reaches the criteria as in Manitoba legislation. The Maples surgical clinic can operate in Manitoba under those particular factors. We are not in the practice of licensing over the phone anyone who wants to come in and have an operation. There are processes that one goes through in the health care system that entail review, Mr. Chairperson.

If The Maples Surgical Centre had initially, I think, provided Manitoba Health with an overview of what they intended to do I think that things would have worked a lot smoother, rather than a phone call and then public relations. I am not criticizing Doctor Godley, but I think that a written proposal to Manitoba Health, which would be the normal, prudent business practice, forwarded to Manitoba Health, might have helped to better deal with the situation. As I indic ated, The Maples Surgical Centre applied for, as I understand it, licencing under The College of Physicia ns and Surgeons Act.

It was reviewed and it was found to be acceptable under The College of Physicians and Surgeons Act. I presume it is open or operating as a private clinic. We are at this point adhering exactly to the same policy that was in place when the member opposite was the legislative assistant to the Minister of Health, someone who she, in her opening statement, indicated had great vision and had a great respect for. Well, the policy that we are presently under is the same policy that was put in place by members opposite. Under the present circumstances, nothing has changed.

So I do not know what the member opposite is trying to determine, but I think we have to agree on a number of things, firstly that we are going to try to be innovative in the Government in order to provide a variety of approaches and support to providing health care. It is clear members opposite want us to fund private clinics. If they do not want us to fund private clinics, they ought to state that. With respect to private hospitals, I do not know what the member's position is. It appears that they are backing off a position of support to private hospitals.

I do not know, but the member could clarify their position by simply letting us know. With respect to the debate as to whether or not I should have returned a phone call to Doctor Godley that he phoned and made a proposal, I am not sure that any Minister of Health would accept a proposal over the telephone or that it would be prudent for any Minister of Health to accept something over the telephone in that kind of a fashion. I think a written correspondence provided to us is the way we dealt with Doctor Godley.

Once we had heard what the plans were, we wrote back to Doctor Godley outlining what the position is in Manitoba. So I do not know what the member is suggesting we ought to have done. As far as I am concerned, we are probably better off simply dealing with the issues in question. That is what the position is with respect to the operation of these private clinics, whether the member supports amendments to The Private Hospitals Act, whether the member wants the status quo or whether the member wants us to return to a private, for-profit system. That is the kind of discussion I think we ought to have.

I think that is the kind of discussion that would move the debate forward and would assist all Manitobans in determining what is the best way to deal with this and the variety of issues affecting us in health care across the system. * (16: 00) Mrs. Driedger: If the minister says he is not going to interfere with The Maples Surgical

May 22, 200 1 LEGISLATIVE ASSE MBLY OF MANITOBA 2039 Centre, will he indicate whether or not he will allow workmen's comp cases to be referred there as well as MPI cases? Mr. Chomiak: As I understand the rules and regulations, as I understand them, Workers Compensation cases are referred by doctors to particular centres. I believe that is the same pattern for MPI. Mrs. Driedger: Could the mini ster then indicate why a Jetter would have been sent from workmen's comp to Doctor Godley indicating that unless there is government approval they cannot send workmen's comp cases there? Mr.

Chomiak: The member will have to provide me with a copy of that particular letter, and then I will be in a better position to comment on it. Mrs. Driedger: I will defer that question then to another day, and I would like to bring that letter back here for some discussion. At this point in time, I would like to switch gears a little bit and talk about the Pan Am Clinic. I wonder if the minister could indicate for me, out of the physicians or people who received the $700 in good will, who those shareholders are. Mr. Chomiak: The member referred to $700.

The $700,000 was part of the total package that was negotiated with respect to Pan Am by the WRHA. I think it is public knowledge who those particular recipients of the funding are. If it is not public knowledge, if I am in a position to provide that information, I will endeavour to provide it. Mrs. Driedger: The minis ter has ind icated that the $700,000 was part of a physician recruitment and retention plan. Could he tell us how many physicians were involved in receiving that money and whether or not other than physicians might have received that money? Mr. Chomiak: The member speaks of it in the past tense.

It is not in the past tense. No money has changed hands, as I understand. So I just correct the member in that regard. Of course, the deal that was agreement in principle and of which due diligence was provided, reviewed the particular agreement. From my understanding of the agreement, and I will check this out, the individuals who received this were shareholders originally and were, for the most

part if not exclusively, physicians. Mrs. Driedger: The minister has certainly taken a little bit of latitude in referencing my association to a quote-well, not even a quote, by associating me with comments made in an

article written by a newspaper reporter. He very slickly-and he smiles a little bit because he knows- An Honourable Member: You should not call newspaper reporters slick. Mrs. Driedger: I was not. I was calling the Minister of Health slick. He slickly inferred that I had made a comment, because he said that I was commenting in an

article that made reference to the fact there were 11 shareholders. Now it was the newspaper reporter that indicated 11 . All I was commenting on was that this particular mini ster did not seem to like private clinics. The minis ter very slickly associated my comment with the reporter's statement that there were 11 shareholders. I note that he took some glee in making that association during Question Period one day and appears to continue to take some glee in it, which is very deceptive, actually, in trying to make that association.

The member had indicated there were not 11 , so he must obviously be aware of what that number is. I think the number 9 has been thrown around a little bit. He has also indi cated that those 9 people were physicians and that this was a great recruitment and retention plan. I under stand that there may not be just physicians in terms of people that got those bonuses. There could be some physicia n that had more than one share, that might have had two or three shares. So then in fact we would have had some physicia ns making more money certainly than the others in the sharing of that $700,000.

I wonder if the minis ter might have had time to thumb through his binder and find out who those shareholders were, how many there were, whether they were all physicia ns and who they might be.

2040 LEGI SLATIVE AS SEMBLY OF MANITOBA May 22, 200 1 Mr. Chomiak: I note in the member's long

preamble that, if the member wants to have a realistic discussion, then using words like "slick" and "deception" is not becoming a member of the Chamber. We would have a lot better discussion, I suggest, if the member would cease and desist. Whether the member is defensive because she made a wrong statement to the media is not my concern. We all often on occasion are misquoted. We all do not have our quotes appear the way that we necessarily attribute them. That happens on occasion. If the member really wants to have a straight discussion here, then using words in her

preamble like "slick" and "deception" is not conducive to that kind of a discussion. If the member wishes to continue, then I have no choice than to outline and point out the member's inconsistencies, which does not move this whole system forward. I would suggest that the member cease, but I will leave that up to her in that regard. The member keeps wrongly referring to the word "bonus" with respect to this par ticular factor. When the members opposite bought Greater Winnipeg Gas and had a secret deal and provided $65 milli on as good will, what would the member call that?

Not only did they provide $65 million, but they kept it from the public. We, in this agreement, did something that was unprecedented. We provided the due diligence, and we provided it publicly. Contrast that with the Centra Gas deal, where $65 million in good will was provided. To then attribute that to "bonus" and try to make a political issue out of it is suggestive to me of political mis chief at its best. There are other words that attribute to it. I am going to try to cease and desist and try to deal with this issue in the fashion and the questions in terms of how they were asked.

The member asked about whether it was nine and eleven and whether or not all of the indivi duals were actually physicia ns, et cetera. I will endeavour to try, and if I can release that information to the member, then I will endeavour to do so. Mrs. Driedger: Just to correct some statements again that the minister chooses to make, indic ating I was misquoted by the media, I was not misquoted by the media. All I had indi cated in that particular

article was that this Minister of Health did not appear to like private clinics. That was the beginning and end of my quote with the media. It was not misquoted; it was very accurate. If there is any politic al mischief going on, it is certainly not on my

part in this particular issue. Can the minis ter indicate, when we look at the $700,000 that is being paid for the surgical partnership business, why the payment would be contingent upon ongoing participation by surgeons? That seems to be a little bit contrary to the ability of a doctor to function within a professional capacity. It is begging a lot of questions by a number of physicians out there. I would wonder why this minis ter would force these doctors to have to stay and sign a five-year non-competition agreement.

The only way they can get their money is by staying and having ongoing participation in the Pan Am Clinic. I am wondering why the minis ter would put that into place. It does seem an odd way to treat professional surgeons. * (16:10 ) Mr. Chomiak: I do not understand exactly where the member is coming from.

First they criticize the $700,000 as "a bonus" and that we should not do that, but then, when we attach conditions to it that would permit these physicia ns to only obtain that funding if they stay and in fact provided the surgery that we want to do and that somehow that is something that is necessarily wrong in the system, Mr. Chairperson, when there are all kinds of remuneration and all kinds of different types of bonuses, and this is not a bonus, but different types. Just recently we announced, for example, our loan program to medical students.

Our loan program, we will forgive the loan if the medical student practises in a region of Manitoba, in the cases of third-year students, rural and northern, in the case of fourth-year students, any part of Manitoba. They do not have to repay the loan if they practise in some part of Manitoba. Would the member suggest that somehow that is wrong? Is the member objecting to that

May 22, 200 1 LEGISLATIVE AS SEMBLY OF MANITOBA 204 1 too, to trying to find doctors to participa te in underserviced areas? There are a variety of situations where physicians are remunerated in different fashion. I cited earlier the Assiniboine Clinic model, where the physicians there were put on salary by members opposite and only salary by members opposite. I do not believe they were allowed to bill fee for service at the time. I do not believe they were at that time they were at the Assiniboine Clinic, but, because the whole thing was secret, we were not sure.

Is the member suggesting, because we try different means and approaches to retaining physicia ns, that somehow that is wrong? Does the member want to maintain exclusively the status quo system? We indicated this is a different approach and a different kind of approach to the health care system. We are short of doctors. Some decisions taken in the '90s, and part of the factors are world-wide, contribute to a significant difficulty in recruiting and attracting doctors.

So this innovative approach, I think, encourages doctors to stay, and if they do not stay, they have less access to that particular-! do not think that it is necessarily bad because it is different. I think that different ways of retaining doctors is an important part of our system, where you have to put in place all kinds of mechanisms to ensure that we retain doctors. The new era is to retain doctors. [interjection] I thank the Member for Charleswood. So there are some innovative ways, and there are innovative approaches that we are looking at with respect to retention of doctors.

We have recently had reports from rural Manitoba that suggested retention is the key factor. I think the general feeling amongst human resource people is that retention is the way to go, and anything innovative that would retain physicians, I think, ought to be looked at, provided that it makes sense. This is one example. Another example is the announcement we made on Friday, where we are asking the medical students and medical residents, in return for a grant or loan, to do a return of service, otherwise they have to repay the loan. That is another innovative approach.

I do not know what the member's position is on that, but we think generally, because we have underserviced areas, because we have difficulty, it is a win-win situation. It is a win for the student because they help to reduce their very severe debt load. It is a win for the province because we get to utilize doctors in under serviced areas. So the retention portion was a portion put in in order to try to retain doctors in this system providing surgery, and it seems to me that it is a prudent thing to do. Mrs.

Driedger: Was the minis ter asking me the question of what I thought of his loans that he offered to the medical students? I will indic ate that I was supportive of that with the media. My concern would certainly lie in the area of what happens after they have fulfilled their obligation by staying here and working; then they end up in a situation where they are very highly taxed in this province. I noted, even from an

article in the paper, one of the doctors indica ted the same thing. With the salaries that they do bring in, it is one thing to get the forgivable student loans, but, once their obligation is paid off, then they are so highly taxed that it does make them want to look elsewhere. As far as the loan program, I was supportive of that but certainly would have some concern and criticism over the high taxes that physicians would have to pay after that and how it could certainly hurt their wanting to stay here and work in Manitoba.

The minis ter has indicated that this initiative of his, this $700,000, would encourage doctors to stay at the Pan Am Clinic. Well, it certainly would because that would be the only way they are going to get their money is if they stay and be paid off over three years, and it was contingent upon ongoing participation by surgeons. If that was the only way you could get your money, of course you would stay. You did not have a choice, and that would be a lot of money to walk away from. The five-year non compet

Document details

Collection	Manitoba — Debates (Hansard)
Citation	37-2-33
Type	hansard
Volume / chapter	37th 2nd hansardpdf 33.pdf
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	a59b5f9293a361dc02edf78149eb562072d95b0a

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