ISSN 0542-5492 Fifth Session - Thirty-First Legislature of the Legislative Assembly of Manitoba DEBATES and PROCEEDINGS 30 Elizabeth 11 Published under the authority of The Honourable Harry E. Graham Speaker VOL. XXIX No. 39A- 2:00p.m., TUESDAY, 17 MARCH, 1981 Office of the Queen's Printer for the Province of Manitoba

LEGISL ATIVE ASSEM BLY OF MANITOBA Tuesday, 17 March, 1981 Time - 2:00 p.m. OPENING PRAYER by Mr. Speaker. MR. SPEAKER, Hon. Harry E. Gr aham (B irtle­ Russell): Presenting Petitions . . . Read ing and Receiving Petitions . . . PRESENTING RE PORTS BY STANDING AND SPECIAL COM MITTEES MR. SPEAKER: The Ho nourable Mem ber for Radisson. MR. ABE KOVNATS: Mr. Speaker, the Comm ittee of Supply has adopted certain resolutions, directs me to report the same, and asks leave to sit again. I move, seconded by the Honourable Member for Virden, report of committee be received. MOTION presented and carried. MR.

SPEAKER: Ministerial Statements and Tabling of Reports ... Notices of Motion ... Introduction of Bills . INTRODUCTION OF GUES TS MR. SPEAKER: At this time I would like to draw the honourable members' attention to the gallery where we have some students from Sacre Coeur School, under the direction of Mrs. Legras. This school is in the constituency of the Ho nourable Memb er for Winnipeg Centre. We also have 37 students of Grade 9 standing from Louis Riel School, under the dir ection of Miss McKenzie. This school is in the constituency of the Honourable Member for St. Boniface.

We have 26 students of Grade 5 standing from Marion School, under the dir ection of Mrs. Poitras. This school is in the constituency of the Honourable Member for St. Boniface. On behalf of all the hono urable mem bers, we welcome you here this after noon. I should also like to in form the honourable members that just prior to arriving in the Chamber I received a telegram add ressed to the Speaker of the House, Province of Manitoba. "Dear Mr. Speaker: On behalf of the membership of the Irish Association of Manitoba, we would like to wish all members of the Legislative Assembly a happy St.

Patrick's Day." ORAL QUESTIONS MR. SPEAKER: The Ho nourable Leader of the Opposition. MR. HOWARD PAWLEY (Selkirk): My question is to the Minister of Education. Does the Student Aid Branch withhold fu nds for the cu rrent year to students pertaining to student aid while an audit is undertaken in respect to the previous year's receipt of student aid, as appears to have been the case with one Debbie Jansen? MR. SPEAKER: The Honourabl e Mi nister of Education. HON. KEITH A. COSENS (Gimli): I'm not sure, Mr. Speaker, whether the honourable member when he refers to the . previous year means this particular school term.

This would apply to the 19 80-8 1 school year. Yes, that can take place but not to a year previous in fact. MR. PAWLEY: Mr. Speaker, then further to the Minister. Can the Minister acknowledge that these audits have taken up to six months in some instances, forci ng a numb er of students to quit university because of their inabili ty to continue in university because of the non-receipt of moneys due to the delay in completing these audits? MR. COSENS: Mr.

Speaker, it's quite possible that there have been some cases that have taken six months, due to the problem of getting the required information to conduct the audit. In that case the onus is on the particular student to provide that information. If for any number of reasons that is withheld then there is a great delay. But I do point out to the honourable member that the onus is on the student to provide that information. MR. PAWLEY: Mr. Speaker, then further to the Minister. Does this not amount to a presumption of guilt since the student is required to go without aid during the time space of the audit itself?

MR. COSENS: I suppose as in any audit, Mr. Speaker, there is some presupposition that there is something wrong in that case and until the proper credentials and information are supplied to prove that in error, then really little action can be taken. I might only say to the honourable member that of the cases that have been referred to the Ombudsman he has found no irregularity in the particular procedures followed by the Student Aid Branch. MR.

PAWLEY: Then further to the Minister, in view of the statements that have been made by the Student Aid Branch's Director to the effect that most of the adjustments are quite minor and quite small, is the Minister prepared to launch a cost benefit analysis in order to ascertain whether or not this review has in fact enjoyed benefits in excess of the cost of the review, and the hardship that's been caused to a large number of students? MR. COSENS: Mr. Sp eaker, I'm not going to comment on that particular item called hardship because I think that is & rather subjective topic.

The honourable member is interested in the relationship of cost to recovery, in 19 78-79 the cost of the auditing process was some $73,000.00. The recovery was $42 6,000.00. In 197 9-80 the cost was some $80,000; the recovery was some $32 1 ,000.00. MR. SPEAKER: The Honourable Member for St. Boniface. MR. LAURENT L. DESJARDINS: Mr. Speaker, my question is to the Minister of Health. What step is the 1773

Tue sday, 17 March, 1981 Minister taking to make sure that the standards are maintained at the St. Adolphe Nursing Home during the present strike? MR. SPEAKER: The Honourable Minister of Health. HON. l.R. (Bud) SHER MAN (F ort Garry): Mr. Speaker, the Standards Divi sion officers of the Commission are on site at the St. Adolphe Nursing Home to ensure that standards in terms of nursing care are being maintained. Further to that there has been a doctor on site, who has offered his opinion as to the lev els of care being ma inta ined We'r e watching it very closely Mr. Speaker. MR. DESJARDINS: Yes, Mr.

Speaker, do es the Minister feel that people who've just finished a shift in the St. Norbert Nursing Home could be properly bussed to St. Adolphe and start another shift? Would that help maintain the high standards in the nursing home? MR. SHERMAN: Well Mr. Speaker, that certa inly doesn't represent ideal working conditions. I'm not sure that is necessarily the case. There cert.3inly has been some transposition of staff from St. N1Jrbert to St. Adolphe, but I don't have any confirmation that the stacking of shifts alluded to by the Honourable Member for St. Boniface is taking place. In any event, Mr.

Speaker, I repeat, we are monitl)ring the situation very closely and we'll take whateuer steps are necessary to ensure that the quality of nursing care is maintained at the acceptable level. MR. DESJARDINS: Yes Mr. Speaker, would the Minis ter then check and verif y to see if my information is correct? Also, while he's doing it, would he kindly check to see if these peopll! that are coming from St. Norbert to St. Adolphe, are they qualified to do the tasks they're asked to pe,rform? MR. SHERMAN: I'll take both those que·stions as notice for response to the honourable member, Mr. Speaker. MR.

SPEAKER: The Honour able Memb er for Inkster. MR. SIDNEY GREEN: Mr. Speaker, I'd lik1� to direct a question to the Attorney-General. In li!Jht of the information that the Attorney-General of Saskatchewaan has gone to Britain to tr? to avoid the Trudeauization of the Canadian, is the Min ister able to advise as to whether there is now any coordination between the other provinces and the Pr ovince of Saska tchewan with respe,ct to the present constitutional dispute? MR. SPEAKER: The Honourable Attorney-General. HON. GERALD W.J. MERCIER (Os borne): Mr. Speaker. Mr.

Romanow from Saskatchewan was in touch with me last week to indicate that h � wished to attend the next meeting of Ministers from the seven provinces who had met a week from la�;t Friday in Winnipeg. There was no meeting of Ministers last week. but there was a meeting of official�; from eight provinces. including Saskatchewan, to deal with certain refinements to Vancouver con:;ensus and amending formula and to review certai n other strategy that might be recommended to the First Min isters of the eight provinces, Mr.

Romanow advised me that he had prearranged the trip to England and left for England last Saturday, and that he was going there to meet primarily with Labour M.P.s and other Members of Parliament that he had an opportunity to meet with and would be in touch with us when he returned from his trip. MR. SPEAKER: The Hono urable Memb er for Inkster. MR. GREEN: Mr. Sp eaker, I'd like to ask the Attorney-General whether there is any significance to be attached to the fact that as of yesterday, no appeal of the decision of the Court of Appeal of the Pr ovi nce of Man itoba had been filed with the Supreme Court of Canada.

MR. SPEAKER: The Honourable Attorney-General. MR. MERCIER: Mr. Speaker, there is absolutely no significance to that at all, that the Notice of Appeal will be filed prior to the end of the time limit which is up to April 4th. I expect it will be filed within a matter of a few days. MR. SPEAKER: The Honourable Member for Inkster with a final supplementary. MR. GREEN: Yes, Mr. Speaker.

Can the Attorney­ General tell us whether it is possible that an appeal which was participated in by six provinces and the Province of Manitoba, can be joined by any other number of provinces should they desire to do so, prior to the matter being heard by the Supreme Court of Canada? MR. MERCIER: Mr. Speaker, when the Notice of Appeal is filed in the Supreme Court, all provinces will be given notice to be given an opportunity to partici pate in the hearing before the Supreme Court. I antici pate that Nova Scotia most certainly will join the six other provinces in the appeal before the Supreme Court. MR.

SPEAKER: The Hono ur able Mem ber for Transcona. MR. WILSON PARASIUK: Thank you, Mr. Speaker, my question is di rected to the Minister of Health and it concerns the industrial strike at St. Adolphe. Could the Minister inform us whether his inspectors have inspected complaints from nurses tha t they are und erstaffed and overworked to the poin t of exhaustion? That people being brought in from St. Norbert to work a double shift at St. Adolphe, in fact, are being required to work as nurses aides when they don't have qualifications to work as nurses aides?

And could he indicate whether in fact patients are being awakened at 4:00 p.m. to take them through their daily routine, instead of 7:00 or 8:00 a.m. because of the critical situation at the St. Adolphe Nursing Home? MR. SPEAKER: The Honourable Minister of Heal th. MR. SHERMAN: Mr. Speaker, I'm not in a position to confirm any of those things at the moment. I am 1774

Tuesday, 17 March, 1981 concerned with the state of care and the condition of operations at the St. Adolphe Nursing Home and that's why the Standards Division officers of the Comm ission have been dispatched some time ago and have been on site to monitor and to report to us. I have had unconfirmed reports that the standard of care may not be what is desired in the system and we have requested that the Standards officers make more intensive checks at different hours of the day.

I know the whole subject is under intensive scrutiny by the Commi ssion. it's a concern to both my colleague, the Minister of Labour and myself and we are attempting to satisfy ourselves and the public that quality care is being maintained. If it is not being maintained , Mr. Spe aker, we will certainly take whatever steps are necessary to ensure that it is; but I do not have final conclusions on such suggestions as those made by the Honourable Mem ber for Transcona as yet. MR. SPEAKER: The Honourable Mem ber for Transcona. MR. PARASIUK: Mr. Speaker, I just wanted to correct part of my question.

The patients in St. Adolphe are being wakened at 4:00 a.m. instead of 6:00 a.m. as I indicated in my question. I'd like to ask a supplementary to the Minister, whether in fact the Minister is satisfied with an inspection proc edur e, generally with respect to private profit-making nursing homes whereby the health inspectors from the Manitoba Health Services Commis sion contact the pr ivate pr ofit- making corpor ations at least one day in advance of their coming out to inspect these facilities to tell them that they are coming out for a spot inspection.

Is the Minister satisfied that this procedure of inspection indeed provides the government with a clear indication as to whether the conditions of care in the nursing homes are sufficient from the point of view of the workers, sufficient from the point of view of the patients, sufficient from the point of view of the relatives involved? MR. SHERMAN: I would not be satisfied if that were the case, Mr. Speaker, nor am I satisfied that the case is as it has been represented by the Member for Transcona. I don't know that I can add anything to wha t I have said. We are monitoring the situation intensively.

If that standard of care is not up to the necessary re quir eme nts of the Manitoba Health Services Commi ssion and our Personal Care Home Program, whatever action is necessary to rectify it will be taken and will be taken without delay. I will have more information on that subject later today. At this point in time all I can say is it's being re­ exam ined and re-evaluated very intensively, Mr . Speaker. MR. SPEAKER: The Honourable Mem ber for Churchill. MR. JAY COWAN: Thank you, Mr. Speaker.

My question is to the Minister of Labour, the Minister responsible for The Workplace Safety and Health Act and I would ask the Minister if he can indicate what action has been taken by his departme nt in respect to improvement orders which were given to the St. 1775 Adolphe Nur sing Home and Lodge on February 5, 1981, impr oving ord ers which outl ined poor housekeeping conditions, broken windows, improper electrical connections, leaking roofs, dangerous disrepair of floor coverings, unacceptable exit door conditions and improper maintenance procedures overall in that home. MR.

SPEAKER: The Honourable Minister of Labour. HON. KEN MacMASTER (Thompson): Mr. Speaker, ma intenance orders have been issued in regard to maintenance requireme nts of that home. I can't tell the Member for Churchill exactly where that's at, at this stage. MR. COWAN: As many of the improvement orders had a due date of February 19 or late February, can the Minister indicate if his department has made a re-visit to that facility in order to ensure that the St. Adolphe Nu rsing Home and Lodge management was in fact living up to the conditions outlined in those improvement orders? MR. MacMASTER: Mr.

Speaker, I can't give the member the assurance that they have re-visited that particular structure. MR. SPEAKER: The Honourable Memb er for Churchill with a final supplementary. MR. COWAN: Thank you, Mr. Speaker. I'd ask the Minister if he's then prepared to undertake to examine the situa tions and to determine what action has been taken in respect to these impr ovement orders by both his depar tment and the management of the St. Adolphe Nurs ing Home and report back to the House as to the results of that investigation? MR. MacMASTER: Mr. Speaker, I asked that exact question of my staff two days ago. MR.

SPEAKER: The Honourable Member for Fort Rouge. MS. JUNE WESTBURY: Thank you, Mr. Speaker. My question is addressed to the Deputy Premier and refers to the Western Power Grid and the statement of the Premier of Saskache wan indicating that agreements must be reached to share the burden of losses in the first decade of operation and to share profits later. Would the Minister please confirm the statement of anticipated losses, indicate what the amount of the anticipated losses is and the expected cost to the Manitoba taxpa yer of the expected losses. MR. SPEAKER: The Honourable Minister of Energy. HON. DONALD W.

CRAIK (Riel): Mr. Speaker, I think what was probably being referred to by the Saskatchewan Premier was the fact that in capital­ intensive projects, like Hydro projects, there is a heavy front-end load that occurs and that it impacts most heavily in the early years. Mr. Speaker, Hydro power tends to have a flatter pricing curve than energy sources that are tied to non-renewable resources, Mr. Speaker, and I believe that was the ref erence. Of course there have been pr ojects

Tuesday, 17 March , 1981 undertaken in Manitoba, Mr. Speaker, where there was no need for the money to have been spent in the first place, amounting to as high as $.5 billion plus the associated losses on foreign currencies stacked on top of it that don't provide one ounce of energy or one kilowatt or one jewel or whatever it is, Mr. Speaker. That isn't I don't think what the Premier of Saskatchewan was referring to.

He was referring to· the natural phenomena that occurs on projects such as this that have a fairly heavy front­ end impact and there is a requirement to even that out through pr oper financing mec hanisms or methods. MS. WESTBURV: Mr. Speaker, that was a very interesting non-answer. Would the Minister tell us whether financial negotiations on the Western Power Grid are still in the preliminary stage as indicated by the Premier of Saskatchewan? MR. CRAIK: Mr. Speaker, they've been under way for some time and they are well advanced. All of these studies have been operational for close to three years now.

Some don't seem to have any trouble adapting, making a decision in three years; some do. it remains to be seen whether a decision that is appropria te and beneficial to Manitoba is made. I can indicate to the Member for Fort Rouge the intent is that any transaction that is entered into with regard to power export will be one that is self­ sustaining, will stand on its own, will pay for itself and produce a return for the people of Manitoba. MS. WESTBURV: Mr.

Sp eaker, in view of the Minister 's com ments that studies are pretty well complete, would he tell the House the price for cost recovery to Manitoba for power delivered at the Saskatchewan gate and the Alberta gate? MR. CRAIK: Mr. Speaker, I'm unable to give the member an answer in terms of cents per kilowatt­ hour or whatever it may work out to be. I expect that the final formula, in all likelihood, will perhaps be not quite as simple as that, although it will be possible to get a pretty good idea from it. it will depend somewhat on the financing arrangements that are used.

I want to thank the Mem ber for Fort Rouge for standing and asking questions which are important to Manitoba, because we're not getting them from the official Opposition. MR. PAWLEY: Mr. Speaker, further to the Minister reporting for Hydro. The Minister indicated some two months ago that a fea sibility s-tudy had been completed pert aining to interconnections, the value of same.

In view of this, in order that the Opposition may be fully informed, as all Manitobans, what the Minister is proposing, what has been put together, will the Minister table that report in this House so that it is open and available to all to examine? MR. CRAIK: Well Mr. Speaker, if the Leader of the Opposition had even a modicum of interest in this topic and, if there is one, it has to be a negative one, Mr. Speaker, he sat there now for the first time in this sitting of this Legislature, he's asked a question.

Now I want to tell the Leader of the Opposition that it was probably the Member for Fort Rouge that asked the last question in this regard about three 1776 months ago, several months ago, in this House, who had the interest in asking that question and it was answered. The answer to the question was, and this will also indicate the level of interest that he and his party have in this, the answer was the studies were comm issioned by the three prairie provinces, the three Premiers will make the decision eventually as to the disposition of any of the reports that have been developed.

I can assure the Leader of the Opposition and his other disinterested friends across the way, that there are any number of reports that have been done, and stu dies, internal studies, external studies that eventually I would presume would be in the public arena and he will have full access to them. MR. PAWLEV: Mr. Speaker, all that we can note from the Minister's response is that he has a very thin skin for some reason or other. Rather than such a thin skin, the Minister could very well table the reports and the studies in this House, so that there would be openness of information.

Obviously the Minister is hypersensitive because of the position he's been placing himself in. To the Minister of Health, can the Minister of Health, further ... MR. SPEAKER: Or der, order please. The honourable member on another question? MR. PAWLEV: Yes, Mr. Speaker. MR. SPEAKER: The Honourable Member for Emerson. Order, please. Order, please. MR. ALBERT DRIEDGER: Thank you, Mr. Speaker, I have a question to the Minister of Transportat ion. I wonder if the Minister could give us an update on the status of the winter roads in Manitoba. MR. SPEAKER: The Ho nourable Min ister of Highways. HON.

DONALD ORCHARD (Pembina): Once again Mr. Sp eaker, I want to thank a member of the Conservative government taking interest in making sure that the freight is hauled to communiti es in Northern Ma nitoba, when ob vio usly there is no interest over on that side of the House. The winter roads system Mr. Speaker, is still operative and we have the majority of the freight . . . winter roads, it's not available. MR. SPEAKER: Order, please. The Honourable Member for Rupertsland on a point of privilege. MR. HARVEV BOSTROM: Yes, Mr.

Speaker, the member is seeming to imply that members on this side are not interested in the winter roads system. Mr. Speaker, if we do not ask questions in this House it is because we have an intimate knowledge of what is happening on those roads and we know exactly what is happening there. (Interjection)- MR. SPEAKER: Order, please. Order, please. The point raised by the Ho nour able Mem ber for Rupertsland was an explanation, it was not a point of privilege. The Honourable Minister of Highways. MR. ORCHARD: Yes Mr. Speaker, if I could carry on with my answer when the Opposition seemed to be

Tuesday, 17 March, 1981 quite sensitive about looking after some of their constituents -(I nterjection)- MR. SPEAKER: Order, please. Order, please. May I suggest to all honourable members that the period of questions is to seek information and to provide that information to honourable members. The Honourable Leader of the Opposition. MR. PAWLEY: Further to the Minister of Health. The Minister of Health ind icated a little earlier that he was quite satisfied with the work that had been done by way of his health inspectors pertaining to the St. Adolphe Nursing Home. In view of that, Mr.

Speaker, my question is to the Minister of Health. Why is it that, pursuant to questions posed by the Member for Churchill, we find that it is not the inspectors within the Minister's department, but inspectors within Health Safety Department of the Labour Department that has di scovered th at the conditions at St. Adolphe Nursing Home were indeed, quite wanting? MR. SHERMAN: Mr. Speaker, in the first place, I did not indic ate that I was satisfied.

I ind icated the precise opposite, not the precise opposite, but I indicated that we are monitoring the situation very intensively to ensure that standards of care are being properly maintained. That is different from ind icating that I am satisfied. If I were satisfied I wouldn't be monitoring it, Mr. Speaker. In the second instance, for the edification of the Honourable Member for Selkirk, we're talking about two di fferent subjects entirely.

We're talking about levels of nursing care, standards of nursing care in the home, which are monitored by the Standards Division of the Health Services Comm ission and we're talking about workpla ce safety and health and condition of physical plant, which fall under the aegis of my colleage, the Minister of Labour. MR. PAWLEY: Mr. Speaker, then further to the Mi nister of Health.

Is the Mini ster of He alth suggesting that he ascertains no connection between the circumstances as di scovered by the inspectors within the Department of Health and the conditions under which his own inspectors in his own department should be checking into insofar as the circumstances at the St. Adolphe Nursing Home? MR. SHERMAN: There is certainly a connection in the general context, Mr. Speaker.

The questions that were asked of me earlier in today's question period had to do with a current strike situation at the hospital and the maintenance of necessary levels of nursing care during that work stoppage, or that ind ustrial dispute. Certai nly I would concede the honourable member's point that in a general sense, if conditions and standards in terms of physical plant and safety, etc. are not satisfactory at the St. Adolphe Nursing Home, that would have an impact on the general atm ospher e and gen eral care of the home.

It's something that has been brought to the attention of my colleague, the Minister of Labour and myself and something that we're deeply concerned about and addressing at this moment. MR. DRIEDG ER: Mr . suppleme ntary qu estion Speaker, for the have a Mi nister of Transportation. Could the Minister indi cate how long he thinks the roads will still be open, or is there a date of closure anticipated? MR. ORCHARD: Thank you, Mr. Speaker. Yes, Mr. Speaker, we have informed the carriers that, as of Friday of this week, the winter roads system in Northern Manitoba will be closed. That means, Mr.

Speaker, that ther e will be no more insurance coverage available for anyone using the road. The road will probably still be operative and one may travel on it, but after Friday of this week, those using the road will travel at their own risk, Mr. Speaker. MR. SPEAKER: Th e Hono urable Member for Elmwood. MR. RUSSEL L DOERN: Mr. Speaker, I'd like to di rect a question to the Minister of Government Services.

Can he confirm that there are several hundr ed vehicles in the government fleet, with up to double the mi leage guideli nes, namely 246 ,000 kilometres rather than 12 8, 000 or up to 16 0,000 miles on some vehicles rather than 80,000? MR. SPEAKER : The Honourable Mi nister of Government Services. HON. WARNER H. JORGENSON (Morris): I can't say tha t I pers onally checked each veh icle to determine the mileage that's on them, Mr. Speaker. All I can say is that we have not reached what we consider to be the optimum of trade-i n, about 25 percent of the fleet or 80,000 miles.

We hope that situation will be reached within a short period of time. MR. DOERN: Mr. Speaker, I'd like to ask the Minister whether he doesn't have a concern for the safety of civil servants because of the condition of these vehicles and the high mile age and the possibility of breakdown; whether he doesn't have a concern about civil servants who have heavy highway driving requirements. MR. JORGENSON: Mr.

Speaker, of course I have a concern that those vehicles are not used beyond what could be their rated capacity and we are endeav ouring to ensure tha t those vehicles are traded in at the proper time and we hope, as I said earlier and as I said during the Estimates, we hope that we'll be able to reach that position before too long. MR. SPEAKER: The Ho nourable Mem b er for Elmwood with a final supplementary. MR. DOERN: Mr.

Speaker, I'd also like to ask the Minister whether it isn't a fact that this is costing the government money and that they could save money with a program of regular preventive maintenance over breakdown and crisis response and also by replacing these vehicles at 80,000 miles; that the government is in fact spending more money because of its present policy rather than the other way round. MR. JORGENSON: Mr. Speaker, that is precisely the reason we initiated the policy in the first place. MR. SPEAKER : The Honourable Member for St. Johns. 1777

Tue ·sday, 17 March, 1981 MR. SAUL CHERNIACK: Thank you, Mr. � .peaker, I'd like to ask the Honourable, the Attorney-General whether he has. without my knowledge, giv en the information which he promised on March 10th would be given "tomorrow", which would have been March 11 th. dealing with the nature of information that should have been provided to a widow on tt e death of her husba nd, as to the cause of dea th. I'm wondering if I missed hearing it or if the Attorney­ General now has the information? MR. SPEAKER: The Honourable Attorney-Gomeral. MR. MERCIER: Mr. Speaker, I apologize to the Member for St.

Johns. I meant to speak to him at the end of last week to ind icate to him that I wasn't able to keep th at commi tment to prol'ide the information the following day. I do expect it this week and I will provide it to him as soon as I receive it from the department. I'm sorry that I wa:m't able to make that commitment. MR. CHERNIACK: Mr. Sp eaker, I th ink the Honourable Minister and I accept his expl<:nation.

I wonder if at the same time I could refeo him to yesterday's Hansard Page 16 98, wherein the Minister of Government Services stated that he had referred to the Honourable, the House Leader a question which I had asked about the delay in the filing of returns that had been outstanding for, in •)ne case almost two years and in the other sever al cases about a year, and I had asked the Honourable, the Minister of Government Services back on 1\t arch 6th if explanations could be given to us for the delay and also an indi cat ion of when we could reasonably ex pect the replies.

The page numb er for the Attorney-Gene ral's information is 1413 of Hansard, March 6th. · I wonder whether he has had an opportunity to commence the investigations in that regard. MR. MERCIER: Mr. Sp eaker, the Mir ister for Government Services did bring that matter to my attention. I expect to be able to very shortly advise as to when the Orders for Return will be filed. MR. CHERNIACK: My final supplementary dealing with the orders, Mr. Speaker, is whether the Minister could indicate how we are doing with bills?

How many more we can expect and particularly whether there are any more bills of profession.il society nature which will be presented to us and wnich could possibly be more orderly dealt with, if we knew how many to expect in this session? MR. MERCIER: Mr.

Speaker, I anticipate t1 at we will be bringing forward approxi mately - eond to be cautious I want to use approxima tion! : because obviously something will arise which we haven't had an opportunity to consider yet or there may be some urgency attached to bringing forward a piece of bill - I expect that there will be approxi mate!�/ a total of 30 bills, government bills brought for ward . (Interjec tion)- No. approxima tely 30 in total. Not including, Mr. Speaker, a bill that may or may not arise out of the Liquor Review Repor·: which is expected very shortly which I have not seen, Mr.

Speaker. including the ones we have already. Now. Mr. Speaker, with respect l.o priv ate members' bills. I anticipate that there wi I be some 1ns six bills brought forward in the self-gov erning profession, six altogether. MR. SPEAK ER : The Ho nourable Member for Rupertsland. MR. BOSTROM: Thank you, Mr. Sp eaker . My question is to the Minister of Northern Affairs.

In light of his statement that his view of the solution of the unemployment in the north lies in better roads, I would ask him if he can indicate what new roads, new access to communi ties and/or resources his gov ern ment has constructed and is planning to construct, within the term of their government. MR. SPEAKER: The Hono urable Mini ster of Northern Affairs. HON. DOUG GOURLAY (S wan River): Well, Mr.

Speaker, as the members opposite know we are in the negotia tions for a new agreement with the Federal Government and we have anticipated that there would be a continuation of the Road Building Program in the North. However, we have not finalized the details of that agreement at this point. So I wouldn't want to comment further on that particular aspect of it at the present time. But within the Northern Affairs communities we have budgeted for internal road systems in many of the communities, many of the No rthern Affairs commun ities, for internal road improvement and additional new roads. MR. BOSTROM: Well, Mr.

Speaker, in light of the experience that we have seen in the House here over the past several years of this government, I would ask the Minister how the North can expect to benefit from any new or improved roads when obviously the priority for high way expenditur es is going to the Prog ressive Con servative constituencies and not to Northern Manitoba. MR. GOURLAY: Well, Mr. Speaker, I'm getting sick and tired of all this rhetoric from the other side with respect to -(Int erjectio n)- with all this rhetoric about what isn't happening in the North and I can tell you, Mr.

Speaker, that during the last three years of this government . . . Mr. Speaker, I'd very much like to tell you what's happened with respect to job creation in Northern Manitoba in the case of the Communities Economic Dev elopment Fund. I'm glad the Mem ber for Brandon East is here because he had asked this qu estion dur ing the Standing Comm ittee on Economic Development. As I pointed out to him I didn't have the exact figures there but I knew that our record was equally as well as the previous admin istra tion.

During the last years of this government our job creation was 26.7 percent better than the last three years of the NDP ad ministration - that's with respect to job creat ion. Pardon? A. MEMBER: What year? MR. GOURLA Y: The last thr ee years of this admin itration have created 26.7 percent more jobs than the last three years of the NDP admin istration. MR. SPEAKER: The Hono urable Mem ber for Rupertsland.

Tuesday, 17 March, 1981 MR. BOSTROM: Thank you, Mr. Speaker. I would ask the Hono urable Mi nister, in vie w of his statements about job creation, if he would talk to the people of Norway House who are obviously not very happy with the government, in terms of their allocation of expenditures in that community where they have contractors from outside the community during work which could be done by community residents? MR. GOU RLAY: I wonder if the Member for Rupertsland would mind repeat ing that question, I couldn't hear it all. MR. BOSTROM: Cer tainly. Mr.

Sp eaker, my quest ion was related to No rway Hous e and the construction of a bridge in the community, where the residents are complaining at the present time that they were not given the opportunity to partici pate in that construction, in view of the fact that there are 80 percent unemployed in that community. MR. GOURLAY: Mr. Speaker, that's not true. The employers or the contractors that did do the work in No rway House area did have local workers participate on the project and for sure we want to see the contracts given to the local people.

But in many cases the bids that do come in are so much higher than the contr acts that are ev entually awarded, but despite that there is an agreement with the contractors that come in that they employ local people wherever possible, and they did that in the case of Norway House. MR. SPEAKER: The Honourable Member for St. George. MR. BILLIE URUSKI: Thank you, Mr. Speaker.

I dir ect this question to the Minister of Agriculture and I ask him, in view of the program that the Minister had to build roads or accesses to haying areas last year, could he answer to me specifically in the project to Marshy Point in the AM of Coldwell whether there was consultation with the municipality, municipal officials of Coldwell and local people in the building of access over a number of creeks in the area? MR. SPEAKER : The Ho nourable Mi nister of Agriculture. HON. JAMES E. DOWNEY (Arthur): Mr. Speaker, I'll have to take that question as notice and get that specific information for him. MR.

URUSKI: Yes, Mr. Speaker. Could the Minister, while he's taking the question as notice, could he indicate the reason for buildin g those crossings when people who needed those cro ssings had already barged themselves into the haying area prior to those crossings being constructed, Mr. Speaker. MR. DOWNEY: Mr. Speaker, I would think that it would be to allow those people to come out after being barged in but I will also see specifically why they were built and if there's any other reason will let the member know why. MR. SPEAKER: The Honourable Member for St. George with a final supplementary. 1779 MR.

URUSKI: Yes, Mr. Speaker. I ask the Minister now whethe r tho se temp orary crossings will be removed to prevent the problems that have occurred as I've been advised, to fishermen and the freezing of nets and wildlife in the Marshy Point area. MR. DOWNEY: Mr. Speaker, I'm not specifically aware of any particular ones that may still be in place. I know some were removed but if he would prO'Iide me with the specific locations then I can have them reviewed for him. He ind icates that it was Marshy Point, then we will proceed to find out that information for him. MR. SPEAKER: Order please.

The time for question period having expired we'll proceed with Orders of the Day. The Honourable Government House Leader. ORDERS OF THE DAY MR. MERC IER: Mr. Sp eaker, fir st in order to ac commoda te the opposition with respect to Estimates, following Finance in the House, Energy and Mines will follow Finance; then Education. Mr. Speaker, I move, seconded by the Minister of Finance that Mr. Speaker do now leave the Chair and the House resolve itself into a Comm ittee to consider of the Supply to be granted to Her Majesty.

MOTION presented and carried and the House resolved itself into a Commit tee of Supply to consider of the Supply to be gr anted to Her Majesty with the Honourable Member for Radisson in the Chair for the Department of Consumer and Corporate Affairs and En vironment; and the Member for Virden in the Chair for the Department of Health. CONCUR RENT COMMITTEES OF SUPPLY SUPPLY - HE ALTH MR. CHAIRMAN, Morris McGregor (Virden): Call the Commit tee to order. We're on Page 76, 5., on the second line, Personal Care Home Program. We passed Admin istration last night. MR. DESJARDINS: We go into Pharmacare, if you remember.

MR. CHAIRMAN: Okay, Pharmacare, the fifth line - pass - the Member for Transcona. MR. PARASIUK: I see an increase there of about $1 ,800,000.00. Giv en that type of increase, does this mean that the Minister is going to announce today a reduction in the utilizat ion fee from $75.00 to $50.00 or perhaps $35.00? Is that what the increase is geared for? I can recall last year the Min ister ind icated some sympathy with our position that the utilization fee should be gradually brought down to $35.00, $25.00, possibly even zero. I see that type of increase.

Can the Minister indic ate whether in fact that's what he intends to announce today? MR. CHAIRMAN: The Honourable Minister. HON. L.R. (Bud) SHERMAN (Fort Garry): No, Mr. Chairman, the increase represents an increase in the

Tuesday, 17 March, 1981 cost of the program, an incr ease in volume and costs of dr ugs, medications and prescriptions. MR. PARASIUK: Well, I think that increase is greater than inflation. Have there been a whole set of new programs added to Pharmacare or are we again in a process of doing catch-up from past years of cutback? MR. SHERMAN: Mr. Chairman, the explanation lies in the increasing costs of the program itself from the point of view of the increasing usage, the numb er of persons using the program, incr easing prescription fees and incr eased dispensing fees.

As the honourable member may recal l, in order to bring our pharmacists into line with those in other parts of the count ry, particularly with other parts of Western Canada, new fee

schedule agreements were struck with the Manitoba Pharmaceutical Association, which raised the dispensing fee from $3.80 to $4.00 as of this March 31 and to $4.25 as of the start of the new fiscal year, April 1. The average cost per prescription has risen over the years since 19 75 substantially each year, and stood at $8. 15 in 19 79; it was estimated at $9.65 for 19 80 and will be of course relatively higher in 19 81. The number of persons using the program has risen consistently and the average cost per registrant has risen considerably.

In 19 80 that was estimated at $114 .52; in 1981 it's estimated at $1 25.97. So this is to acco mm oda te the cost of pres cri ptions and dispensing services, the normal cost price increase which has occurr ed in the mar ketpla ce, the increasing number of demands made on the program and also to cover some expansions to the list of insu red dr ugs, which have been adde d to the spectrum new dr ugs coming into the pharma ceutical market - which are added to the list of Pharma care benefits. In total they add up to the requested bud getary incr ease. MR. CHAIRM AN: The Member for Seven Oaks. MR. SAUL A. MILLER: Mr.

Chairman, I'm wondering whether there's been any movement with regard to covering the cost of drugs prescribed by a doctor but are drugs that do not require prescription or to buy in the first instance. I'm thinking of - I can't remember the kinds of drug s or the kind of med ication - but there is medication which people have to take, are required to take, their doctor prescribes it and yet they are a medication which can be purchased without a presc ription. Is there any movement to cover that kind of pres cription medication? MR.

SHERMAN: The ho nourable member is ref erring I assume to non- pr esc ription dr ugs purchasable in drug stores and pharma cies in, I suppose what would be descri bed as almo st a regular course of today's lifestyles. Is he? Is the honourable memb er referring to items like aspirin and ... MR. MILLER: Aspirin could be, that's the most common kind of thing.

But I'm talking about a certain type of medication and I'm tr ying to remember the name of it and I can't, required, prescribed by a doctor because of the - and this is in the case as I recall - it has to do with the inability of an individual to digest food properly and this is a kind of a concen trated food substance, a food substitute which the individual would take and yet it wasn't something that you could only buy with a presc ription. lt was available from the druggist.

Yet, in the instance I'm aware of, that was pretty well all that the person was allowed to intake and the doctor prescribed that in lieu of normal food, yet could not qualify under the Pharma care Program because it was not listed as a prescribed drug or prescribed medication. MR. SHERMAN: Mr. Chairman, there are some drugs and medications of the type referred to by the honourable member, which are provided as insured benefits, insur ed services thr ough hospitals.

I'm aware now of what he's specifically referring to and cer tainly ther e are some specific cour ses of medication for cases such as he's cited that are made avai lable thr ough hospitals in the city and they're covered as an insur ed service by the hospital to that patient.

But the informational broch ure on Pharmacare which is dist rib uted by the Health Services Commis sion defines, at least in general terms, the items that are not covered un der Pharma care and that list embr aces a wide number of what one could refer to as common, everyday garden variety, non-prescription drugs ranging from antacids and cough-cold and acne preparations to lozenges, laxatives, vitamins and paramedical items, they are not covered. But th ere certa inly are situations in which specific types of food and medication are necessary and they are provided in those individual cases through the hospitals.

I think th at one of th e pr ograms tha t the Honourable Member for Seven Oaks is refer ring to is the hyper-elementation program and that's a drug program that's currently covered at the He alth Sciences Centre and at St. Boniface. lt would be that type of coverage that I'v e just described for those special cir cumstances. MR. MILLER: The Minister says they are covered at the Health Sciences Centre and at St. Boniface.

Does he mean that a person requiring this could get the medication through these hospitals or does he mean that someone who is an in-patient at one of these hospitals would get this kind of medication? I'm not quite sure I under stood that. MR. SHERMAN: They can obtain it either as an in­ patient or an out-patient, Mr . Chairman, as recommended by the their physician. MR.

MILLER: So, therefore, if somebody is on this type of medi cat ion and isn't necess arily in the hospital, they could apply through the doctor to go to the out-patient department or either of these two hospitals and qu alify to get the medication issued to them, is that right? MR. SHERMAN: That's right, Mr. Chairman. MR. CHAIRMAN: The Member for St. Boniface. MR. DESJARDINS: Mr. Chairman, I'd like to follow through. I think that this is a ridiculous practice and I think it should be changed. After all, it's a drug 1780

Tuesday, 17 March, 1981 program and should have nothing to do with the hospitals and, in fact, I don't think we should encoura ge people to go to the hospital when there is no need to do so. lt seems to me that we should look into it if this is the case. I was under the impression that the commission could appr ove, if it was with a note from a doctor, and if it was a drug such as my colleague has mentioned, if it something that the doctor is prescribing but, for some reason or other, you don't have to get it with a prescription normally.

In other words, it's a safe drug; it doesn't mean that it's not a good drug for certain things. That doesn't mean everybody that gets that drug - I'm not suggesting that all these drugs that you get over the counter should be covered. But if it is prescribed, with a prescription of your doctor, and if that was shown to the druggist, it seems to me that should be covered. But, okay, that's one point. The second point is that in some instances this is done but only if it is prescribed at two different hospitals and I don't see the sense of that at all. If this is done, the doctors that are practising at St.

Boniface and General are not any more capable than the others, or are not to be trusted less or more than the others and it seems to me that should be open. If a doctor, any qualified doctor in the province prescribed these drugs, it seems to me that we should open that and that should be covered . I wonder if the Minister could look into this. MR. SHERMAN: Well, I think it would be difficult to do that, Mr. Chairman.

I think the difficulty here lies in the fact that these are drugs or medications for cer tain specific and somewhat uniqu e medic al problems and there are programs that are carried on, in research into and treatment of those specific illnesses and ailments at the two tertiary care hospitals, Health Sciences Centre and St. Boniface. As a consequence, the patients who require that kind of medication would be in almost all cases, dealing with either on an inpatient or outpatient basis, with one or the other of those two hospitals.

The medic ation is specialized; the illness is specialized; the research into it and the treatment of it is specialized. There is some advantage to having some control and some evaluation and I think the answer to the honourable member's question is tied up in those aspects of it. We're talking here about relatively rare and unique ailments. MR. DESJARDINS: Mr. Chairman, it's the principle that I don't like. If the Minister is saying that this is part of a research, with volunt eers doing this and we don't know about these dr ugs yet and this is supervised at two hospitals, I could understand that.

But these are things that are not just research, it's been accepted, and I can't see that it would be only doctors who would have admitting privileges at these two hospitals that should be allowed to use this treatment. Secon dly, the Minister said himself that they wouldn't have to be inpatients or outpatients of that hospital. In other words, if my doctor in the Thorlakson Clinic for instance, would say this is the way to go, I'd have to go to the St. Boniface Hospital or to the Health Sciences Centre and only then would they give me these drugs and would give me a paper that would show that I'm covered.

I can't see this at all. 1781 Why say tha t it's got to be limited to these hospitals, if it's only these people that are using it? lt is just the principle of the thing, that you're singling out two hospitals and saying, here, you people, you'r e covered. What about the people up north, or the people that might not go to the hospital? What about the rural people? What about the people in Brandon? lt seems to me that the doctors have to go along with certain ethics and if they're not qualified, they shouldn't - and that's the next thing I want to cover - pr escribe these drugs.

If they do it, everybody should be treated the same. Everybody should have access unless as I say, it's a pilot project or some research and you don't want to put them on the market or recommend it at this time because it's not fully proven. Mr. Chairman, I want to leave that and I have another concern which I feel is to me anyway, much more of a concern.

I think that even the medical profession, in many instances, all over the free world, at least North America, are saying that all research in every thing the y found tha t there is an overpres cribing of drugs in many instances and I think every single one of us could probably relate to that and say, yes, either it's happened to myself or mem bers of my family or some friends. I cert ainly know of cases where the doctors are prescri bing, for every thing ther e are certain dr ugs. I'm talking especially the people that are treating mentally ill patients. I'm not worried about the cost here, Mr.

Chairman, I'm not just worrying, well, we're wasting money; that's a side effect as far as I'm concerned. I'm worrie d about what that will do to this genera tion, to the coming generation, and so on. I cer tainly am not blaming the gov ernment but I wonder, I'm sure the Minister has the same that I have, is there a real effort? When we started this program under my colleague, and later on when I was there, that was one of the concerns we had, we were just starting the program but we wanted to monitor this.

I remember visiting certain hospitals or clinics that they have in Isr ael and they had a pharma care program there that was covered and they had a lot of problems with that. I asked one of the doctors, what is it, that every body has a small dr ugstore at home? They said, correction, a large drug store; they had their clinic, automatically they all stop at the dispensary and they took their drugs and that was it. In fact, that was worse, financially they were in trouble, that program was breaking them and that's why I like to see that we don't pay every cent.

I don't know if I'd go as far as my friend from Transcona on that, I think that raising it to $75 was a little much. I think we have a good program. But going back to my main concern is this overpre scribing of drugs, especially in the field of tr eat ing me ntally ill patients and every exp ert, ever ything that I have read on that, they all come back with the same thing, there's way too much of that. I' ve heard different people, and you don't like to criticize a fellow doctor or physician and so on, so you don't say too much but some of them have told me that, yes, these people are not qualified.

The first thing you know they are giving out drugs and some have the reputation of certainly overpres cribing and I think there should be a real effort to stop that immediately because I think that's doing a lot of

Tuesday, 17 March, 1981 dama ge to this coming generation that relies so much on drugs. MR. SHERMAN: Well yes, Mr. Chairman, I agree with the point made by the Honourable Member for St. Boniface and we are very concerned about overpresc ription, overusage, cou ntereffe cts, inter react ions, and all the other anomalies and difficulties that have arisen in an age and in a society where there has become, perhaps not a dependency on drugs and medication in legal terms but in terms of practice it has become a very visible lifestyle.

We have, through th e Drug Standards and Therapeutics Commit tee, taken steps to deal with this issue.

The Executive Secretary of the Drug Standards and Therapeutics Commi ttee, which was originally a half-time position is being expanded into a full-time position and half of that official's duties will continue to be overs eeing the preparation of the formulary and the work of the comm ittee, but the other half of his time is going to be devoted very substantially to working with pharmacologists and with the Pharmaceutical Association and with the MMA in establishin g a system for moni toring prescription usage of drugs.

In addition to that the pharmcists themselves have just recently launched a Drug Caution Program, in which they are identifying for their customers, various non-prescription drugs and the effects and side­ effects that they have and the dangers of using them when the person has a certain medical condition; or the the dang ers of mixing them with other medications or with alcohol. So, efforts are certainly being mounted by the government, by my office, to get that problem under control. lt has also been a subject of intensive discussion by· Health Ministers across the country, generally.

At Health Minist er's Conferences it is recognized for the problem that the Mem ber for St. Boniface has described. MR. CHAIRMAN: The Memb er for St. Boniface. MR. DESJARDINS: I thank the Minister for his remarks. I'm worried that the comm ittee that is there, I think the main thing they're doing, they are quite busy and they are looking to see mostly, if the same patient is getting maybe drugs from two or three doctors, which happens and that is a concern.

But I think the problem I have, there is no way that could be licked without the help of the doctors thems elves and th e program that the Minister mentioned for the pharmacist is no doubt a very good one. I think it is less the MMA than the College of Physicians. it's an educa tion, I think, for the medical profession. I think they have to monitor and maybe suspend a few to show that they are serious. MR. CHAIRMAN: Line 5 - pass; Line 6 - pass - the Memb er for Transcona. MR. PARASIUK: Yes, the incr ease in the Ambula nce Program is less than the rate of inflation.

So we're in a situation where we're really actually having a real decrease in funding, if you discount the rate of inflation for the next year. We had a long debate on this last year, both in the Estima tes and in Pri vate Mem bers' Hour. The Minister at that time had indicated that there was a study being done. The study is out now. lt seems to indicate that there should be some combi nation of ambula nce and fire services in Winnipeg. We were debating the provision of the Am bulance Program throughout Manitoba but I can recall that we paid particular attention to the Ambulance Program in the City of Winnipeg.

The concensus of members on our side of the Ho use was tha t the fundin g was insufficient. The Minister agreed that there was a problem with funding. He indicated that there was a problem; that we'd have to correct this; we'd have to do a better job; and he awaited the study and that next year he would resolve the problem which he adm itted existed. This year he has given us, in his opening statement on Page 14 , an incorr ect sta tement. lt says, "Im provement of the Ambula nce Program in the province as rec ommended by the department's 19 80 Am bulance Services Review.

The initial thrust will be an Am bula nce Att enda nt Training Program and additional Am bu lanc e Gr ant Ass istance to mu nicipalities including Winnipeg". Now since the overall increase is something in the order of 7.5 percent, since the rate of inflation is expected to be something in the order of 11 to 12 percent in this coming year, how can the Minister tell us that he's going to be giving additional Am bul ance Gr ant Assistance when in fact the cost of living is such that the real impact of this progr amming is to have a decrease in the order of 3.5 to 4 percent overall?

So how can the Minister make that type of contradictory statement? MR. DEPUTY CHAIRMAN, Lloyd G. Hyde (Portage la Prairie): The Honourable Minister. MR. SHERMAN: Mr. Chairman, the initiatives that are being taken in the field of ambulance services and ambula nce program ming are not reflected under this particular appropria tion. They are reflected under this overall appropriation, the Manitoba Health Services Com mission, but this particular appropria tion ju st appl ies to the gr ant in the Am bulance Grant Program and the increase in the grant provided for in the Estimates being requested is 8 percent.

The other things that we want to do such as put in place a training program for ambu lance attendants particul arly in rural Manitoba, and offer what kind of practical co-operation and participation we can to the City of Winnipeg and moving in the direction which I think probably most of us agree with, that is, the amalgamation of fire and ambula nce services into a paramedical team, is provided for under the New Programs

section of the commission. So the impression that is left by this

part icular line is somewhat misleading. The New Programs spectrum being proposed is a range of programs that includes approximately $.5 million com mitment to an improved and expanded ambu lance service outside of th e direct gr ant referred to under this particular line of th e Estima tes. (I nterjection)- lt would come under the hospital appropriation, Mr. Chairman, the Hospital Program appropriation. We're proposing approxima tely $2 million in Ne\/\ Programs and one of those is assistance to ar appr oved ambulance program. Precisely what the ultimate forma t will be remains to be worked out tc 1782

Tuesday, 17 March, 19 81 some degree in discussion with the City of Winnipeg. It's my understan ding that the Executiv e Pol icy Commit tee and one or two other committees in the city, have endorsed the proposal for the two-tier fire department ambula nce system method of developing paramedicals in responding to ambulance call needs but I'm not sure that has passed full City Council yet. We're waiting for consultations with the city on that point. In the meantim e we intend to put ambula nce training instructors in place to the number of five.

I think we're proposing five ambulanc e training instructors in place in various regional centres in rural Manitoba to begin a much more intensive and sophistic ated program of trai ning of ambulanc e attendants. In total that Ambulance Program, outside of the Grant Program, is estimated to cost out at approximately $.5 million for fiscal 19 81- 82. MR. PARASIUK: Yes. Th at might explain the Minister's statement with respect to the Ambulance Attendant Training Programs, but it doesn 't say anything with respect to the Minister's statement about addit ional Am bulanc e Gr ant Assistance to municipalities.

I won't qui bble over .5 percent but an 8 percent incr ease when the Minister's own staff must be projecting something in the order of at least 10 percent inflation, it leads to a real reduction of 2 percent in the funding level. Now, the Minister last year ind icated that the amount of assistance of a grant na ture was insufficient. He did that in the House on Private Members' Resolution, on other debate, and we were led to expect that there would be an increase in the amount pr ovided for ambula nce services. The deterrent fee has gone up.

We argue that ambula nce services are one area where you don't want to take that extra 10 minutes to determine whether in fact if someone's collapsed, they are going to revive or n�t. There was a study by doctors indicating that there is insufficient coverage in parts of the city; that people's lives are at stake, especially those who have cardiac arrests. The Minister acknowledged that was a problem and he said he was going to do something about 11. One year later we know what the answer is. He's not going to deal with this particular problem.

It is going to be left for the local taxpa yer of Winnipeg to try and deal with. Last year, the City of Win nipeg virtually begged the provmce to cost-share the provision of ambulance services to Transcona. The Minister refused; the city had to act on its own. They in fact dealt with health problems that the provi nce had abdica ted responsibility for. I firmly believe that the people of Transcona, within Transcona and Radisson will hold this government accou ntable for their actio�s in that respect. We have other areas of the city that aren't being fully serviced by ambulance services as well.

The Minister knows of those. I expected to have a positive answer this time and we don't. Talk about amalgama ting, having a two-tier system between the fire department and the ambula nce department; they deal w1th management, they deal with admin istration but the y don't deal with the problem tha t the province is provi ding ins ufficient fundin g of a grant nature to ambu lances, and the Minister is trying to duck that issue. I asked him very clearly, is the rate of inflation projected to be at least 10 percent?

If the increase is only 8 percent, does not this constitute a real decrease of 2 percent in the funding that the province is going to give municipalities, including Winnipeg, regard ing ambul ances? MR. SH ERM AN: Mr. Chairman, the Ho nourable Member for Transcona is operat ing under a misconception here. I have already told him that approxi mately $.5 million over and above the 8 percent increase in the grant is being sought through the Estimates process. If he wants to recommend that $.5 million be turned over to increasing the grants, that's a legitimate position.

I don't accept it but it's certainly a legitimate position. That $.5 million will provide for the initiation of a program aimed at prov iding us with proper ambula nce attendant trai ning capabilities in rural Manitoba and will enable us to respond to the position that the City of Winnipeg ultimately takes with respect to their ambulance service. That $.5 million includes approxima tely $.5 million for the establishment of these ambulance training attendant instructors; and the other $.5 millio n can be distributed in the most practical way possible.

Now if the Mem ber for Transcona is saying the most practical way is to increase the grants, fine, that's a legitimate position, not an acceptable one but a legitimate one. What we are saying is, depending on what the City of Winnipeg wants to do, we want to have that kind of funding avai lable to respond.

The City of Winnipeg, since the last estimates were in front of the committ ee a year ago, the City of Winnipeg has commissioned a study of its own and the persons who conduc ted that study have recommended an ambu lance system similar to that in place in Seattle and some other American cities which involves this amalgamation between fire and ambulance.

There has been considerable enthusiasm for that in the city at the level of City Hall but it has not, to my knowledge, passed full City Council yet. 1 think it would be extremely anticipatory, premature and unwise for us to commit the application of those additional funds at this point till we determine what it is the city wants to do and what they would like us to do to help and partici pate. With respect to the general 8 percent increase in the grant system I don't have any qualms and 1 feel none of the intimidation that the honourable member would have me feel, Mr. Chairman.

The ambulance grant system which was initia ted in this province some years . ago was always based on the strongly­ held conv1C �1on that a local participation is extremely des1rable 1n ambula nce services and the grant system was a method of assisting that. It was assistance to that system, it was never intended to be a universally covered program. When he talks about the increase in the cost of living, there are w1de dis crepancie s between rural Manitoba and urban Manitoba and wide di screpancies even between different parts of rural Manitoba.

So the overall general 8 percent increase is, in our view, adequate to meet that cost increase. It's certainly not overly generous, it's adequate. The additional support will be provided through the new program's funding to which I've already referred . But I'm not going to anticipate the City of Winnipeg on this, 1 want to hear from them as to what they would like us to do. MR. PARASIUK: The Minister is stating something somewhat contrary to what he said last year when 1783

TuE:sday, 17 March, 1981 the issue was discussed in the Legislature. s,�condly, what he just said is completely contr ary to the opening statement that he presented us with, where he said that there would be additional ambulance grant assistance to municipalities. He's now saying that really isn't the case if one takes into account inflation and that was the point I wanted to rr ake. Last year he promised us one thing, this year he's doing something somewhat differently. That, I think, leaves the city in a situation where they won't get this problem resolved in the short-run.

I would have thought that the Minister would have commented in part on whether in fact he's satisfied with the present deterrent fee that people have to pay when they call an ambula nce is one which in a sense pro,tides for the best possible care being provided in the case of cardiac arrests. Should people wait 10 or 15 minutes before deciding to spend, what is it, $10 0.00 now if you call an ambulance? MR. SHERMAN: Mr. Chairman, one, I !;uppose, could debate questions of that nature at length becaus e they' re phi losophical in natu rE:.

In my opinion the need for an ambula nce i� al most universally instantly recognizable and the re!;ponse is in all cases to my knowledge immediate in terms of calling the ambulance. I've not had broug 1t to my attention any cases where anybody has stopped and said, well, I won't call an ambulance because it's going to cost me $50.00. What happens is that the basic problem is the respons e tim e of the ambula nces in some parts of Winnipeg.

Because the intensity of the traffic in the city has grown :md there has been some reconfiguration of hospitals into what were formerly suburban areas, so we have a concern with respons e time, and many cit ies in North America do. ·A few have developed a system like Sea ttle's that appears to provide a pre·tty good answer. But the funding that's being requested in the Estimates does indeed provide for an incre 3se in the grant program and it provides for a s treng•:hening of our training program, and it will provide for any one of a number of options in terms of meeting the city's ambula nce challenge.

I'm not going to rnake that decision in anticipation of final discussion:; with the City of Winnipeg. MR. DEPUTY CHAIRM AN: The Membe · for Fort Rouge. MS. WESTBURY: Yes, Mr. Chairperson. I'm really surprised. In a couple of speeches lc1st year I expr essed gratification that Transcona's ambulance problem had now been solved. I didn't knc·w that the situation for Transcona's residents as I gather now is different from that of people in East Kildo 1an. which at that time had only one ambulance or c1ny part of the city.

It doesn't matter where you live 1n the city, as long as you are in the city it's just as important to anyone in any part of the city to have prompt care. I can assure the Minister that there are people who stop and think about the cost of an ambulance before they call for a member of the family for an amb ulance. This is very sad I think, I think it's terrible. The Minister last year admitted a feeling of vulnerability and unhappiness that there wasn't more provincial support for the city ambulance. He said that more has to be done with respect to financial support for ambulance programs in the province.

I 1784 would like to ask if the Minister or his staff have been involved in talks with the city. I realize that city commi tte es have been making some interim decisions and recommendations on amalgamation for an ambu lance. But ha s the province been involved in conversations with them at all in regard to that proposed amalgamation? MR. SHERMAN: Yes, Mr. Chairman, very extensive conversations with the city.

Our Ambulance Services Review Commit tee, which was appointed through the Health Services Commission and went to work last Janu ary-Februa ry and concluded its work in approxima tely August-September, held discussions with in terested persons and organizaions and municipalities throughout the province, and certainly held many discussions with the City of Winnip eg Ambulance Commission. We have in fact been requesting a meeting with the city and the City Ambulance Commission to determine what precise direction we should now take on the basis of the additional funding being sought.

Councillor Ragsdill, who is the Chairman of the City Ambulance Commis sion has advised me and my office that they don't want to meet with us until after City Council has dealt with the proposal to merge the ambu lanc e and th e fire depa rt ment, but we'r e pressing for that meeting. I might also say, Mr.

Chairman, in that one-half million do llars that I refered to earlier ther e is provision for additional assistance for the City of Winnipeg and certain other municipalities and it can be made pr ecis ely on the basis of additi onal assistance in di rect assistance form if that's the decision that all parties come to.

But I do think that it is important that we explore the acceptability of and the enthu siasm for this new concept, which its track record in some other cities, and it's a limited track record thus far but on its track record in some other cities, appears to point the way to a much app roved ambu lance system within the City of Winnipeg. I must say, that in my opinion, I respect the opinions of Mem bers of the Comm ittee, Members of the Opposition, but in my opinion we have moved very expeditiously on this challenge. We establis hed our Amb ulance Services Revie w Com mittee last winter.

They worked exten sively through the province in meeting with groups and hearing evaluations of ambulance service. They put in front of me a report that included a wide range of responses and perspectives. On the basis of that we went into out Estimate pre parat ion pr ocess in September and have produced the first initial major change and step forward and breakth rough, on positive thrust in ambula nce programming since the Ambulance Grant system was established in the province some years ago.

And I've come with my first opportunity with my Estima tes for this new fiscal year to ask committee approval for these kinds of initiatives and this kind of spending. I don't know how we could have acted more forthrightly without act ing uni laterally and arbitrarily. MR. DEPUTY CHAIRMAN: The Member for Fort Rouge. MS. WESTBURY: Well, Mr. Chairman, the Chairman of the Medical Standards Committ ee of the Winnipeg

Tuesday, 17 March, 1981 Ambulance Service has called for an independent commission to be set up, this was some months ago, stating that standards are very minimum and very widely, he mentioned , especially rural areas. The Tribune about a year ago did a study which revealed that 96 percent of people with heart attacks, who suffer cardiac arrests outside of hospitals die and, you know, it would be very interesting to know what areas those people lived in, because I think the fact that some parts of the city are better served than others with ambulances must have an effect.

I also refuse to believe that people who have to stop and count every dollar in the budget will think twice about calling an ambulance. They'll think, you know, before they call an ambulance they'll stop and try to dia gnose the problem themselves, but the minutes lost may be fatal minutes, Mr. Chairman, and I think we have all heard of cases like this. Now I'd like to ask whether it is sti:l true that Charle swood, Tuxedo and River Heights are not covered by ambulance, except ambulanc es that have to come either across a railroad track or bridge. MR. SHERMAN: It is probably still true, Mr .

Chairman, but I'd have to check on that, but just visualizing the geographic layout of the city and the three districts to which the honourable member has referred I would have to suggest that it probably is still true. MS. WESTBURY: I'm surprised that the Minister's leader hasn't been hearing a lot about this since one of these areas is represented in the House by him and I know for quite some considerable time there have been complaints coming out of Ch arleswood about the poor service to that district and I want to point out that while we hear about five to 10 minute response time.

In the possibility of an ambulance being required in the rush hour and having to go across one of those bridges, either the Maryland bridge or the St. James bridge to get into the River Heights, Tuxedo, Charleswood area, they would take more than five to 10 minutes to get across. The only other way they could get there would be from Fort Rouge and there they have to cross two rail road lines. And I just don't think that this, if I was living out there I would not find this acceptable at all.

Where I live there is an ambulance within probably two minutes of my residence and I would think that any resident of the city would, in fact, it's probably only there because I live close to the municipal hospitals. If I remember rightly in the big ambulance debate, that's one of the reasons the ambulance was put down there on south Osborne Street. But I really think that everybody in the city is entitled to the same coverage for ambu la nce care; this is an emergency, just the same as we are entitled to the same coverage for Fire Department care. It's the same kind of thing. You can't wait for 10, 15 minutes.

I'm very di sappointed to hear tha t Councillor Ragsdill has declined to meet with the Minister on this. I can only guess at his reasons. I want to remind the Minister, Mr. Chairman, of the statements by the Manager of the Winnipeg Ambulance Service in the fall in which he was hoping the study would advise on the improvements, hope for improvement to the Winnipeg Service. He said then, that 5 to 7 percent of cardiac arrest victims recover compared to 25 to 1785 30 percent recovery rate in cities where there are paramedics. Is there any discussion going on about having paramedic training for ambulance attendants?

I know that one of the considerations was that fire fighters could serve this and I think about a year ago I mentioned in the House something that has been said by knowledgable people for years, half in jest - when I have my heart attack, make sure that the fire department rescue wagon is called. It's not much of a joke, Mr. Chairperson, but does the Minister know whether tha t is the intention that fire fighting perso nnel would be tr ai ned as paramedics or whether there is any intention of providing paramedic training in the city at all? MR. CHAIRMAN, Morris MacGregor (Virden): The Honourable Minister. MR.

SHERMAN: That's the whole nub of the merger proposal, Mr. Chairman, that the fire department personnel would be trained as paramed ics and inde ed the whole nub of the tr aining upgrading initiative that we want to undertake is to ensure that all ambu lance attendants are fully tr ained paramedics. So that is what is at the root of the merger proposal. MS. WESTBURY: Mr.

Chairman, at the present time I was told by somebody close to the city ambulance question, that if somebody is injured or has a heart attack outside a fire hall, the fire fighters are not allowed to attend to that person, they have to wait for an ambulance to come. MR. SHERMAN: Well, Mr. Chairman, I think we're rea lly getting into an area of Ci ty of Winnip eg responsibility, if I may say so. The City of Winnipeg Ambulance Program is administered by the City of Winnipeg.

All the province has done up to this point in time is provide the level of per capita grants, which have been criticiz ed and which have been referred to. Probably the main ob je ction and principle to attendance by Fire Department personnel in instances, such as that cited by the Honourable Member for Fort Rouge, would come in the area of qualification, whether they are qualif ied or not would be the medical question, but I can assure the Honourable Member for Fort Rouge that if I were the victim, I would have no objection even if the Member for Transcona wished to attend to me. MS.

WESTBURY: Oh dear, what interesting little pictures that conjures in one's mind. Mr. Chairperson, I wonder if the Minister knows this, whether the unio ns invo lved have had any discussions about how they're going to face this whole matter of amalg&mation. I understand there are three separate unions inv olved between the ambulance and the fire fighters. MR. SHERMAN: Yes, Mr. Chairman, and this is another example of the kind of consultation and communication that has to be applied in situations right across the health field to achieve consensus and achieve agreement and unanimity.

There have been discussions relative to the situations respecting the ind ividual unio ns that would be involved, prevai ling wage rates and contracts. That's part of

Tue �sday, 17 March, 1981 what would have to be worked out in any such merger. But I hope I've left no misimpression on the record with respect to Councillor Ragsdill. He is ver·y keen to improve the City of Winnipeg Ambula nce F rogram as rapidly and as responsibly as he possibly can. I'm not suggesting that he's not interested in meeting with us. I just wanted to advise the Commil' :ee that we're ready to meet, but he doesn't want I o meet until City Council takes a position on this subject. I think that's ab solut ely ju stifiable, ab�;olu tely necessary.

No point in the Commission meeting with us to invoke some major new plan and some major new concept if City Council isn't prepared to endorse it. MS. WESTBURY: Ju st one more ques tion, Mr. Chairp erson . In a report that was prepar·ed and approved by the Board of Commis sioners in 19 80, it was reported that the Provincial Government grant is for ambu lance services, and since it's made pursuant to a formula and per capita and is intended as a contribution towards the ambu lance service, and I'm . this a bit.

The city would be required to assure the province that the grant moneys would be used for ambu lance servic es and not for arry other purpose. I suppose we can take it for granted that the city has been advised that under the proposed arrangement, the grants would still be avail a )le. MR. SHERMAN: Well, it's still done that way, Mr. Chairman.

Certainly up to the present time, what is being committed or sought in the Estimal es for a municipal grant assistance to ambula nce programs would be so designa ted in Winnipeg's case�. as it is in the case of the other municipalities, a�d that's where the funds would have to go. But it m<ry well be - this is the area of uncertainty at this poirrt that we are into - I can't predict to the Honourabler Member for Fort Rouge what the City of Winnipeg'!; ultimate position may be, and I think we have to be flexible on it.

They may come to us and say that they would like to see the whole grant program in Winnipeg scrapped and they would like that money redirected into a program that City Council has endorsed. At that point in time, the province would certdinly have to consider it. MS. WESTBURY: So the city has not yel received this confirmation from MHSC that was referrred to in March last year in this report. I take it th·�Y haven't received any guarantee that the grants would still be forthcoming under an amalgamated progra n. MR. SHERMAN: Well they haven't asked us that question, Mr.

Chairman, and they certainly haven't received any ind ication in the reverse. They have been told what the grant to the City of Winnipeg will be for '8 1-'82 under the existing program. They've also been told that we're prepared to sit down with them when the y'r e ready and talk ab out new concepts and some money will be av ailabl e for those new concepts. MR. CHAIRMAN: The Member for St. Boniface. MR. DESJARDINS: Yes, Mr. Chairma n . my first question is these five instructors. wher·� are they now? Are they employees of the Co mmrssion? We were told that there were five instructors cr trainers. 1786 MR.

SHERMAN: Mr. Chairman, the Esti mates' request asks for money to hire training instructors. MR. DESJARDINS: They're not in place yet. MR. SHERMAN: No. MR. DESJARDINS: Okay, will they be employed by the Commission? Will they be employees of the Commission? MR. SHERMAN: Yes, they would be employees of the Commission, and they would be based in specific regional centres in the province. I'm not sure that I MR. DESJARDINS: Paid for by the Commission? MR. SHERMAN: Yes. MR. DESJARDINS: Well, Mr. Chairman, I think that a lot of the concern here is the way this is set up.

You know, we have a special line for ambula nce programs and it seems to me that's where it should be. Maybe the Mi nister would ha ve had less problems if that had been the case. I don't like to see this charged to the hospitals, when we talk about what improvement, what increases there've been in the hospital that is considered there. They're not employees of the hospitals to start with. Either that should be money for staff man years, or it should be charged to this program, one of the two. If they're regular employees, fine. That's a service that the Commis sion will perform, like they do other things.

It could be justified in putting them as part of their staff, that's where the money will come from to pay them. Or at least if they're going to be charged to the program, under the Ambulance Program. I think it was a mistake to say, 'H ere, they're going to go to the hospitals. and that's credited to the hospital, when we look at the Estimates for the hospitals, when we talk about what increase they have and so on, that's going to be figured in there. It might not be that much money now, but eventually it'll be more than that.

Now I think that the Minister has introduced some kind of a red herring today and I like his program. It's not a new program, it's not something that was just invented, or not his program, but I mean what he suggests that might come. I think this has been studied for a number of years but this program was in its infancy. It's not a very old program, that Ambula nce Program, the grant for the ambula nce.

It's not an old program at all and I think that many of the questions that were asked now, if this comes into force, you will have better coverage because you have to cover people, with fire stations, fire departments, and you will have more of that. You 'll have groups. I don't think that you'll have these specialists because that's what they'll be, specialists. They won't be ordinary firemen that it would be pulled out, not if they give the proper service. They might start like that but eventually it will be people that will be trained and that as paramedics but they will be stationed there.

They will be part of the department and I think that will make sure and I think we've come a long way with these programs. I remember not that long ago, the ambul ances were left to fune ral di rectors. No body else was

Tuesday, 17 March, 19 81 running it. the funeral dir ectors - a few funeral homes had ambula nces that they were running and then there was some improvement. So I think we've come a long way. But the concern here, the Minister is saying and that's where I say that there is a bit of red herring, saying that there is a possibility that will be a new concept, a new dir ection. But the responsibility - the Minister didn't say the responsibility will change, that's the responsibil ity of the municipalities and we're dealing with Winnip eg here, the City of Winnipeg.

In fact, technically they might not even have to come to the Minister to use the grant unless it's quite specific that the grants will be used for certain. But I think there is quite a bit of leeway, I think they should. I think there should be discussion and they might make a case for more money but in the meantime just becaus e tha t has not been approved as yet, it doesn't change anthing. The Mini ster is saying tha t the gr ants will be higher. This is what he announced and in fact they are not.

There's very little increase and the feeling and the critic ism here is not on that proposed program or certainly not on the training of personnel. We can only hope that this will be the case in the case of this paramedical and we can only congratulate the Minister for making sure that there's money in there and that the Health Servic es Commission will take on the responsibility of training them. They were getting some help I think; who is the man? I don't know if he's still there at the Commission who was in charge of am bulance. (Interjection)- Is he still there?

No, well, yes, that's right, but there's an improvement and I think that should go. But the main concern of my colleague is that we were not anticipating, we were expecting because of the statement from the Minister earlier during this debate and in fact this is not the case. I would imagine that if they change and if the Minister agrees to go to this paramedical, it would be a new form but the money will be requested. In fact, if anything, they will need more money so the suggestion that wouldn't go against that.

If there was a little more money for gr ants and if that was approved, fine, but in the meantime that program has to continue and now the Minister is more or less saying, well, that's finished. They won't be able to do that this year, they're a little late because they won't have the funds. I don't think it is related to the funds. The method that they do to make their service more efficient, I don't think has anything to do with the grants. If anything they might need more money.

Now I think the Minister probably should have left it at that and said, well, all right, I can understand and you might feel justified in asking for more grants, that's the job of the Opposition but I am satisfied that the grants are adequate, but not bring in all this other thing which I consider a red herring because it's so obvious that this is going to be a good program and it has worked in different cities. It's not everybody that has it. It is a costly program when you're talking about wages and that.

It is very costly but in the long run with a life saved and maybe less time in the hospital and so on, it could be of benefit. You know, you can't measure, it's a service industry, you can't measure it in production except in keeping the people healthy or helping them save lives. In that way it might be proven to be a cheap program but 1787 the concern is now, that right now, as of now, we're still under the same program that we've had for a number of years and it is felt that the Minister is not living up to the statement tha t he made in his opening statement. MR. CHAIRMAN: The Member for Seven Oaks. MR.

MILLER: Mr. Chairman, I take exception to the attempt by the Minister to justify a dimi nution in the grants payable, not just to Winnipeg, but throughout Manitoba, to the municipalit ies. Last year there was an 8 percent increase; this year it's 7.5 percent. Whether Winnipeg restructures its ambula nce service or rationaliz es it or whatever, it doesn't matter. The fact is that they are paying salaries, they have higher costs of motor fuel, the maintenance of the equipment of the vehicles.

They are all running far in excess of 7.5 or 8 percent and so for the two years running, it's thr ee years really, the provincial contribution to the Ambul ance Program has been slipping relative to the costs and it simply continues this year. So the argument about meet ing with Councillor Ragsdill or somebody else from Council, those have to do with the structure of the ambulance service in the City of Winnipeg.

What we're dealing with here has the financial support to a municipality to operate an ambulance program and putting aside the whole question of restructuring, there just isn't enough support being made available. It has slipped since the inception of this program as a percentage of the total cost. We're not, as I say, even keeping up with inflation. So the arguments, comments, by the Minister about five people who are going to assist in training or so on, that's very interesting but that really has nothing to do with the fact that the cost to the city and to other areas.

I suppose there are some areas that are able to live with these costs, with the expenses but in the City of Winnipeg we know and we know from last year when the City of Winn ipeg at council ind icated that they wanted greater support from the province to maintain their ambulance service. They didn't get it last year and they're not getting it this year and all the words spoken about new thrusts, etc., don't alter the fact that the property taxpayer in the city is now going to have to pick up a larger percentage of the costs than he did last year or either the year before. MR. SHERMAN: Mr.

Chairman, I would just like to apprise the commit tee of the fact that in the extensive review that was carried out by our Ambulance Services Review Commit tee there were very few complaints about funding and about the Grant Program. I think the Ambula nce Gr ant Program operates in 75 municipalities in Manitoba and with the exception of two, Swan River and Winnipeg, there were no complaints about and there was no criticism of the Grant Program. Their concern was with training.

We therefore accepted the findings of that Ambulance Services Review Committ ee as a guideline to enable us to identify the most important priorities. The most important priority with respect to those 70-plus rural municipalities did not have to do with the grant system or financial support. It had to do with training and training capabilities. Swan Ri ver is a unique problem because of distance and accessibility or lack of accessibility to hospitals and ambulance services over a wide and

Tuesday, 17 March, 1981 broad and in some ways remote area. Winnipeg has a problem that we're all familiar with and those were the two municip alities who did specify financ ial assistance, grant assistance, as being a problem for them. That is why in the $.5 million that I' ve talked about there is provision in there to provide additional assistance to munic ipalities of that kind who have identified it as a problem. But we don't want to make that decision with respect to Winnipeg until the other decision is made. MR. MILLER: Mr.

Chairman, it's interest ing, the Minister says there are 75 municipal ities in the program and only two expressed concern with regard to the grants, but of the two one of them has over half of the population of Manitoba. So to simply say, well other municipal ities didn't see it as a concern. I indicated in my comments that it's true; there are probably some rural mu nicipalities which can live with the present grant. (I nterjection)- The north is covered through the No rthern Air Transportation Program.

So that the Minister can't ignore the fact that over half the population is in Winnipeg and they have gone on record at council meetings indicating their concern about the fact that the rise in the ratio that they have to pick up for ambula nce services is growing annually. The go ver nment has not kept pace with the inflationary rate. We know the inflationary rate on gasoline and motor fuel, we know what it is. it's far mor e than the 7.5 percent or 8 perc ent. The maintenance of the vehicles, salaries have gone beyond 7.5 or 8 percent.

So that to simply say, well, Winnipeg is only one mun icipality; Winnipeg is half the population. So the Minister can't duck that issue by saying most of the other municip alities didn't request it and the province is meeting the request as indicated by the other mu nicipalities.

Some of the municipalities work through volunteers; some of them still have volunteer fire departments and so be it, they can't do it any other way, but surely in a metropolitan area such as Winnipeg the province can't hide behind, or shouldn't hide behind the fact, that the problems in a city are different than the problems in rural Ma nitoba or in any rural constituency. So I can't accept the explanation that the Minister is giving.

He simply isn't making enough available and frankly if he simply said, look, we just weren't prepared to give more money period and so be it, then I think that would be more factual and would really reflect probably what occurred in his department and in Cabinet. MR. CHAIRMAN: Line 6, Ambula nce Program - pass; Line 7, Northern Patient Transporta tion Program - pass - the Mem ber for Transcona. MR. PARASIUK: Yes. I notice that between 19 80 and March 31s t, 1981 that this program was kept constant.

There wasn't even a provision for an 8 percent or a 10 percent increase to take into account inflation and we complained about it at that time saying it was insufficient. Now all of a sudden we have the Minister coming forward with a $3 1 9,000 increase, which is a very substantial incr ease. Now either the Minister was mistaken in pr eviously holding back so long or there is something that has caused such a major increase in the program. If an incr ease in the order of 25 percent is warranted for the Northern Patient Air Transportation Program, then I think we deserve an explanation. MR. SHERMAN: Mr.

Chairman, the only explanation I can offer is that eval uation of the service and of the budgetary needs of the program and the different local comm ittees that administered the program in previous years influenced and dictated the budget struck for those years. In the past year there have been substantial incr eases in costs, all features of the program, and ther efore we have provided a 25 percent incr ease to address the cost-price situation that we face in the north in Ma nitoba in our projections in 1981- 82.

Additional to that there was a short fall in the program 's bud get last year of app roxi ma tely $11 5,000 and that accounts for something in the neighbourhood of a third or slightly more than a third of the budg etary increase that's requested this year. MR. CHAIRMAN: The Member for Churchill. MR. COWAN: Thank you, Mr. Chairp erson . The Minister and I have discussed this particular subject in the past both in the House and outside of the House in respect to the number of complaints which have come forward to me as a memb er for a northern constituency respecting the deficiencies of this program.

I think that it ranks foremost among the areas which have been expressed to me by great numb ers of people in respect to dissatisfaction with a particular government program. There are a few others, but it is one of the leading programs which people are dissatisfied with. The reason they are dissatisfied with it is because of the necessity of train transportation and bus transportation in place of air transportation in many instances. Those are the type of complaints that I get most of the time.

Someone comes to me and says, I have a certain requirement to go to Winnipeg, I'm only given a travel warrant for the bus, and I think that I should be given a travel warrant for air transportation. Or someone will come and say the same thing in respect to the train from Gillam. Not too many complaints from Churchill in respect to that because they have a better health facility in Churchill than they do in the other commu nities. When I brought this forward to the Minister in the past he's always indicated or he has on most occasions indicated that he has not received those type of complaints.

My first question to him now would be in the past year or since we've had opportunity to discuss this subject, has he begun receiving complaints of that sort in respect to the shortfalls and I'm not talking about the mo netary shortfalls but I'm talking about the program shortfalls with the Northern Patient Transportation Program. MR. SHERMAN: Mr. Chairman, I haven't received any recently. In the course of the past six to eight months I've received approximately four, certa inly no more than six. I certainly have received some from the Honourable Member for Churchill, but they would be included in that total. MR.

COWAN: I assure the Minister that I am forwarding those complaints to him on the basis of complaints which have been forwarded to me or on the basis of discussions which I have had with 1788

Tuesday, 17 March, 1981 constituents. I know that I have received numerous complaints from the commun ities primarily of Gillam, Lynn Lake and Leaf Rapids in respect to the inadequ acies of this prog ram. I would ask the Minister how it is determined whether or not a person will be given an air transportation warrant or a bus transportation warrant because there appears to be a great deal of discrepancy in the way in which individuals are treated under this program.

By that I mean, some receive bus tickets, others receive air tickets and yet they suffer the same complaints and undergo much the same process in dealing with those complaints. MR. SHERMAN: Mr . Chairman, of the gross program costs, which this year are estimated at $1 ,579,000; $662,800 is administered directly by the Commi ssion for payment of emergency transport and urgent hospital to hospital transport. The ot her $9 1 6,200 is ad ministered by the four local commit tees with which the Honourable Member for Churchill is familiar, who were established to offer such adjudication as he has referred to.

Those four local comm ittees are located in Thompson, Flin Flon, The Pas and Churchill. Those comm ittees decide on the spending priorities of certain elective cases and they also are instrumentally involved, fundamentally involved, in decisions having to do with the options for modes of transport. The two key opinions that are sought in dete rmining a mode of transport, an urgency of transport for such cases are the opinions that are offered by the physician of the patient in question and the opinion offered by the Advisory Commi ttee in the com munity area in question.

As the Member for Churchill knows, the program was originally admin istered entirely, I believe I'm correct in saying, th at at it's inception it was administered almost entirely by the Com mission. Then some years ago, prior to the election of this government, the decision was made, and it's one that I would not quarrel with.

He as a resident of and representative of the north may have other views and I would certainly entertain them but the decision was made to take a lot of the control out of the hands of the Com mission and pla ce it in the local commun ities, and th at was the reason for establishing tho se four local comm ittees. MR. COWAN: Well, we all know that there were problems with the former pr ogram which was a Patient Air Transportation Program; there's no doubt to that.

We have all adm itted to it and in fact as government did unde rtake the changes that were necessary to deal with the problems in the original program but that is not to say that the action which was taken at that time, which I underatnd was of an exploratory nature to some extent, that one wanted to look at different options, one wanted to determine if there was a better way to run the program and that the new system was not set in stone in any way whatsoever but should come under review and should come under revisement if that revisement was found to be necessary.

Since that time, I have been advised and I have in turn advised the Minister of many complaints with the way the system is working now, and I can tell hime, point blank, cat egorica lly, without fear of contradiction, tha t ther e are many people who believe that this program is not working properly, 1789 and those people are not the Commi ssion people. Those people are not, or perhaps they are, but I don't know them to be the Commi ssion people, I don't know them to be his staff, I don't know them to be the commi ttees.

I know them to be the constituents that come forward to me, time and time again, with concerns, and what I believe to be legitimate and well thought out concerns, complaints and problems with the way the program is being administered : I in turn try to encou rage them to bring those concerns to the attention of the Minister. Some do, some don't. I also attempt to encou rage them to bring th ose concerns to their local physicians and other persons who are involved in the program. Some do, some don't. Some just accept, what they consider to be the inadequacies of the program, without bringing complaints forward.

Some do, in fact, bring those compla ints forward. But I can assure the Minister, and I hope he would take my word for it that there is widespread dissatisfaction with the way this program is working in th e co mm unities, at least of Lynn Lake, Leaf Rapids and Gillam. I'm not certain about Chur c hill, again because they have a better medical facility there and have probably less use of the program, and if they do go out they probably fly because there is not road connection.

The main criticism of the program is the use of bus transportation versus the use of air transportion, and the criticisms boil down to two major ones. The first is that persons who are not, or who do not consider themselves to be in good enou g h health, and remember we're talking about sick people basically, that are using this program; people are being sent to Winnipeg for referral or people are being sent to Winnipeg for treatment, are not in good enough condition to suffer that bus ride.

Let me tell the Minister why. 1. think perhaps I have told him why in the past, but I think it is important that those persons who are interested and know of the difficulties of taking a bus from Leaf Rapids to Winnipeg, as the

schedule exists now. You get on the bus around 6:00 in Leaf Rapids, you travel all night long, you stop in Thompson for a short stopover, you travel all night long and you arrive in the city in the early morning on the day of your appointment. This is if everyt hing is working out perfectly. You then are at the bus station. You don't get reimbursed for your taxi fares to the hospital and many of the people coming from the north are not familiar with the public transpor tation system in the city.

They are sick, they are not feeling well, and they don't want to hassle with the public transportation system, so they find themse lves in a position of having to go into the washroom in the bus station, clean up after an extensive period of time on the bus, go to their appointment. Then if they are treated that day and if they in fact, accomplish all that they were sent down to do in that day, they get on the bus in the afternoon and they arrive back in Leaf Rapids around late morning or early afternoon the next day. Now that is an onerous trip at the best of times.

I'v e taken it myself, healthy and in good shape, and I don't like it. But when a person is going down. and I know of people with bad backs, who have been sent down. tha t is not a common occurrence but it certainly has been an occurrence in the past. I know of people who are going down for cancer treatment,

Tuesday, 17 March, 1981 for chemotherapy, that have been sent down by bus. I know that people with serious physical ailments have been sent down by bus and it is just not an appropria te way to treat Northern Manitobans; it is not an appropriate way to treat anybody. That bus trip is bad enough under the best of conditions but under the worst of conditions and that's what we are talking about, it is all that much more difficult. I've asked the Minister to review the situation, in depth, in detail; I've done so unsuccess fully.

I will ask the Minister again, if he will undertake a thorough and complete investigation of the Northern Patient Transportation Program to see in fact, if it is fulfilling the original intentions of the program, as well as, fulfilling the needs of northerners.

I would ask him if he would make such an investigation available or ma ke it possible for no rtherners to ma ke representation to that sort of investigation, if he would hold hearings or if he would hold meetings in the community so that northerners can come forward and in their own community explain to the Minister some of the difficulties that they have experienced with this program so they can come forward and explain to th e Minister some of the ideas, suggestions, and concepts which they would like to put forward, in order to make this a better program.

Because it is time to have an extensive and thorough review of this program, becaus e I can assure the Minister that there are great num bers of people who are forced to travel by bus who should not be forced to do so. MR. SHERMAN: Well, Mr.

Chairman, I recognize the sincerity of the honourable member's concern and I would certainly be prepared to have the Advis ory Comm ittee on Northern Patient Transporta tion, once again, investigate and evaluate the effectiveness and the accep tability of the program, but I must say to him, you know, when he suggests that he's asked me time and time again to look into it, th at the Commi ssion is in touch with those local comm ittees and is frequently in commun ication, both with them and the Advisory Comm ittee, and I must tell him that the local comm ittees have not raised this with the Com mission as a problem.

The local comm ittees are comprised of local residents insofar as the difficulties he describes in making lengthy trips in the north by bus, particularly if one is ilL I would sympathize with that and I would think that the individual patient's physician would sympathize with that, and that the local commi ttee would sympathize with that and the decision, as I have said as to what mo de of transportation is going to be used is made at those two levels, the local comm ittee and the patient's physician.

Now, there is an Advisory Comm ittee, a seven­ mem ber Advisory Comm ittee, which advises the Comm ission and the Minister with respect to the No rthern Patient Transportation Program and questions of this nature that arise in the experience of the Honourable Member for Churchill could easily be conv eyed by him to that Advis ory Committee. He says he's taken it up with me. I think in my responses to him, I'v e indicated that he should be dealing with the local comm ittees and with the Advisory Comm ittee, but I certainly can, and will, refer it to the Advis ory Commi ttee.

I ju st want to point out th at th at Ad visor y Comm ittee is not made up of a group of mandarins 1790 sitting 800 miles removed from the scene. it has, among its seve n-mem ber mem bership, a Doctor Schneider from Flin Flon, Dr. Ted Redekop from Thomps on, two No rthern Manitoba hos pital admin istrators repres enting the Man itoba Health Organizations, Mr. Pat Moore at The Pas and Mr. Bodan at Flin Flon. it has representation on it from the College of Physicians and Surgeons and it has repres entation on it from the Department of Health and the Commission and one citizen member from Northern Manitoba.

So we're not dealing here in an ivory tower or at arm's length from the program and from the perceived needs of northern residents. We're dealing with an on-site, on the spot comm ittee that is made up of persons in large

part living and serving in the north. We'r e dealing with local commit tees who make the decisions respect ing the situations described by the Honourable Member for ChurchilL So I think that while I go the Advi sory Comm ittee and ask them for a read-out on the situation, he should be talking to his local comm ittee and to the Ad visor y Commit tee too, and he should be deter mining, for himself, most assuredly whether the kinds of things that he thinks are happening are indeed happening.

Because we have not, and the Commi ssion assures me, it has not had, from the local com mittees, in discussion with them, the complaints raised and the criticisms raised that he is raising. That is not to say that they are not valid. Wha t it ma y be to sug gest is th at ther e is a breakdown of commu nication somewhere and part of the responsibility for that must rest with the Mem ber for Chur chill as much as it mu st rest with me because I'v e referred him frequently to those local comm ittees and to the Advisory Comm ittee. In the one ... MR. CHAIRMAN: We'll probably call it 5:30.

The hour of 4:30 having arrived , commit tee rise for Private Mem bers' Hour. Comm ittee rise. SUPPL V -FINANCE MR. CHAIRMAN: Abe Kovnats (Radisson): This Comm ittee will come to order. I would direct the honourable members' attention to Page 58 of the Main Estimates, Department of Fina nce, Res olution 61, Cla use 1, Ge neral Administra tion, Item (a), the Minister's Salary. The Honourable Minister. HON. BRIAN RANSOM (Souris-Killarney): Mr. Chairman, I'd like to take this opportunity to make a few brief introductory statements with respect to the Estim ates of the Department of Finance.

This is my first opportunity to present the Finance Estimates, and before doing so, I'd like to congratu late my colleague, the Honourable Don Craik, for his capable and efficient handling of the department over the past three years. In terms of organization, Mr. Chairman, the only change from last year involves the amalgamation of the Program Analysis and Review Branch with the Financial Ana lysis and Cost-Shared Agreements Branch of the Comptroller's Division. The Program

Tuesday, 17 March, 1981 Analysis function had been transferred to Finance from the former Management Comm ittee of Cabinet Secretariat. There turned out to be a good deal of common ground with the Financial Analysis Branch, so it was decided to consolidate and amalgamate these two branches.

Page 57 of the Main Estimates of expenditure contains a compa rative summa ry of the various pr ogram costs, the Department of Finance together with a reconciliation statement, and this re concil iation accounts for the difference between the 1980-81 Finance total voted and the 1980-81 adjusted vote as shown on the left-hand side of this year's Estimates. In terms of staffing, the Finance Estimates for 19 81- 82 include a total of 329.48 staff man years, made up of 319 .26 permanent, and 10 .22 term. This represents a decr ease of 3.32 authorized SMYs from 19 80-8 1.

In previous years, members were interested in the actual num bers of persons on staff in the Department of Finance. I ther efore advise, that as of March 1, 19 81, there were 299 emp loyees on staff, as com pared to 296 as of March 31,19 80. The Department of Finance levels have remained relatively static over the past year, with only minor adjustments necessary to accommodate chang ing needs.

I think tha t staff lev els are now fairly satisfactory and facilitate the increased empha sis we're now placing on enha nced financial systems and procedures throughout government, as well as on financial analysis and cost-shared agreement control and claiming procedures. A mention should be made of the method of operation of Treasury Board . The Board is now comprised of six Ministers, with myself as Chairman. Mr. Charles Curtis, Deputy Minister of Finance, acts as secretary to the Board . Staff support is provided as necessary by regular Department of Financ e personnel.

I'm bringing this information to mem bers of the Committee in explanation of the fact that Treasury Board has not requested any separate funding for '8 1- '82. I would also draw the attention of mem bers to Pages 17 to 24 inclus ive in th e report of the Provincial Auditor for the fiscal year ended March 31, 19 80. These pages review the functions and respon sibilitie s of Treasury Board and the Department of Financ e as they pertain to the govern ment's general mana gement systems.

I'm pleased to advise that the Provincial Auditor has commen ted favourably on Financ e Depart ment prog ress in the areas of ma nagement control sys tems, as well as central and de part mental accounting systems. We're continuing to produce quar terly financial reports for public inform ation. These statements have been a major step in our govern ment's commi tment toward mor e pub lic acc ountabil ity. If mem bers are interes ted, Mr. Chairman, I refer them to the Public Accounts for details of specific accounting policies.

As well, for the first time, we've produced an annual financial report, copies of which have been provided to all mem bers. This report provides, in an easily readable form, highlights and summa ries of the main financial statements and economic data for the year. Major items of expenditure and rev enue are highlighted, and a full statement of the gov ernment's acc ounting policies is includ ed . I feel this new publication is a significant step forward and should 1791 gr eatly assist mem bers and tax payers in understanding Manitoba's financial position.

Pr ogr ess is also being ma de toward implementa t ion of an appr opr iate ma nagement information system. I'm pleased to advise that the Department of Finance recently acquired the services of a manager, Personnel and Training Services, who has extensive training and experience in both personnel and training services, and is expected to add substantially to the department's effective and efficient use of our human resources. it is our intention to provide training services not only to Finance Department staff, but also to staff of other de partments, primarily in th e field of financ ial systems and procedures.

This is the first time that the Department of Finance has had a qu alified personnel manager on staff, and I expect many benefits will accrue from this recruitment. Mem bers may note that the $161. 7 million requested for the tax credit payments in 198 1- 82 is $14 .6 million lower than the $1 76.3 million provided last year. The figure which, of course, included $20 million in Supplementary Estima tes to provide for the higher minimum property tax credit to home owners, and the enhancements to the Pensioners' School Tax Assistance Program and its extension to pensioner tenants last year.

Primaril y this reflects a lower estimate of total cost of living tax credits to be claimed by tax filers in their 1980 income tax returns. In my int roductor y remarks when the Main Estima tes were tabled on February 3rd, I pointed out that the use of the fairer net family income definition to calcu late the tax cr edits, would permit the redirection of funds into mo re specifically ta rgeted programs geared to providing incr eased assistance to lower income families.

These programs include the Child- Related Income Support Program, Day Care Enrichments and Provision of Noon and After School Pr ograms and the enh ancements to Mani toba suppl ement for pensioners and its exten sion to pensioners over the age of 55. Provision for these programs is included in Es timates of the Department of Community Services and Corrections. As well, the new programs include the enrichments in the shelter allowance for elderly renters, the extension of SAFER over the age of 55, and the new shelter allowance for family renters, provision for which is included in MHRC Estima tes.

These programs, along with the $10 0 increase in the general pr operty tax credit maxi mum, and the $1 50 incr ease in maximum property tax credits for senior citizens are designed to give in total more substantial assistance to those people who are in the greatest need.

In overall terms, the 198 1-82 Es tim ates include provision for $19 6.4 million in payments under these White Paper Programs, an incr ease of $30.9 million, or 18.7 percent over the pre-White Paper of Main Estima tes provision of $1 65.5 million last year. it's worth noting perhaps that the total tax cred it appropriation itself, at $161. 7 million, is some $34.7 million higher than the $127 million recorded for tax credits in the '77-'78 public accounts.

As well for the current year, we expect a $70 million incr ease in direct provincial support for public schools to have a beneficial impact on educ ation taxes throughout the province. The Estim ates for public debt and hydro rate stabilization are both statutory and are not requir ed to be voted by the

Tuesday, 17 March, 1981 House. However, the differences in amounts provided for as compared to 1980-8 1 are sufficient to warrant an explanation to mem bers of the comm ittee. Public debt charges for 1981- 82 are estimated at $94.6 million, an incr ease of $14 .9 million over 19 80- 81. The major reasons for the incr ease are net incr ease in the service and costs on gene ral government program debt of $2 1. 8 million offset by an increase in the estimated Sinking Fund and short­ term earnings of $7 million.

These comp onents amount to a net incr ease of $14.8 million of the total incr eases on public debt charges. The Estimates for Hydro Rate Stab i1 ization are $35.8 million for 198 1-82, an incr ease of $2 1. 7 million over 19 80-81 and this increase is mainly attributable to an anticipated $27.2 million foreign exchange loss on a 100 million Swiss franc issue maturing in February of 19 82. Mr. Chairman, I apprecia te the opportunity to make these opening remarks and commend the Estim ates to the House. MR. CHAIRMAN: (

b) Executive

(1) Salaries - the Honourable Mem ber for Lac du Bonnet. MR. SAMUEL USKIW: Mr. Chairman, I, first of all, want to take this opportunity to express my good wishes to the new Minister in charge of the fiscal management of the Province of Manitoba.

I also want to say to him that he has indeed undertaken his responsibilities at a somewhat awkward moment in terms of the ability to manage economies, whether it's within the Province of Manitoba or the country as a whole; in fact the whole of the world is undergoing a great deal of stress in trying to come to grips with cost pushes and inflation pressures and things of that nature, and unempl oyment which is not generating revenue and deficit financing is very common place throughout all of Canada, certainly with few exceptions.

I have to mention that I guess one would have to recog nize the resource-rich provinces which don't have to worry about those kinds of economic pressures at the moment. But by and large ap art from res ource-rich provinc es every province in Canada is undergoing a great deal of difficulty in trying to come up with balances in their spending relative to income. Now that doesn't mean, Mr.

Chairman, that I reflect the view that there ought to be a balance because there is a legitimacy in not having balanced bud gets, legitimacy in having substantial deficits from time to time depending on the economic need of the provice or of the nation. So it's a policy of fiscal management that has to be looked at not on a year-to-year basis but on the basis of a given period of time, and that's perhaps where we are less hung up than the government across the way and indeed the Minister of Finance. Mr.

Chairman, notwithstanding those comments, I think it's fair also to point out that regardless of the posturing of mem bers opposite they have been unable to deal with that problem as much as they would like to and have failed completely in trying to bri