Manitoba Hansard — Sitting 07 (38th Legislature, 1st Session)

38-1-07

Manitoba — Debates (Hansard)

First Session - Thirty-Eighth Legislature of the Legislative Assembly of Manitoba DEBATES and PROCEEDINGS Official Report (Hansard) Published under the authority of The Honourable George Hickes Speaker Vol. LIV No. 7 – 1:30 p.m., Tuesday, September 16, 2003

MANITOBA LEGISLATIVE ASSEMBLY First Session–Thirty-Eighth Legislature Member Constituency Political Affiliation AGLUGUB, Cris The Maples N.D.P. ALLAN, Nancy St. Vital N.D.P. ALTEMEYER, Rob Wolseley N.D.P. ASHTON, Steve, Hon. Thom pson N.D.P. BJORNSON, Peter Gimli N.D.P. BRICK, Marilyn St. Norbert N.D.P. CALDWELL, Drew, Hon. Brandon East N.D.P. CHOMIAK, Dave, Hon. Kildonan N.D.P. CUMMINGS, Glen Ste. Rose P.C. DERKACH, Leonard Russell P.C. DEWAR, Gregory Selkirk N.D.P. DOER, Gary, Hon. Concordia N.D.P. DRIEDGER, Myrna Charleswood P.C. DYCK, Peter Pembina P.C. EICHLER, Ralph Lakeside P.C.

FAURSCHOU, David Portage la Prairie P.C. GERRARD, Jon, Hon. River Heights Lib. GOERTZEN, Kelvin Steinbach P.C. HAWRANIK, Gerald Lac du Bonnet P.C. HICKES, George, Hon. Point Douglas N.D.P. IRVIN-ROSS, Kerri Fort Garry N.D.P. JENNISSEN, Gerard Flin Flon N.D.P. JHA, Bidhu Radisson N.D.P. KORZENIOWSKI, Bonnie St. James N.D.P. LAMOUREUX, Kevin Inkster Lib. LATHLIN, Oscar, Hon. The Pas N.D.P. LEMIEUX, Ron, Hon. La Verendrye N.D.P. LOEWEN, John Fort Whyte P.C. MACKINTOSH, Gord, Hon. St. Johns N.D.P. MAGUIRE, Larry Arthur-Virden P.C. MALOWAY, Jim Elmwood N.D.P. MARTINDALE, Doug Burrows N.D.P. McGIFFORD, Diane, Hon.

Lord Roberts N.D.P. MELNICK, Christine Riel N.D.P. MIHYCHUK, MaryAnn, Hon. Minto N.D.P. MITCHELSON, Bonnie River East P.C. MURRAY, Stuart Kirkfield Park P.C. NEVAKSHONOFF, Tom Interlake N.D.P. OSWALD, Theresa Seine River N.D.P. PENNER, Jack Emerson P.C. REID, Daryl Transcona N.D.P. REIMER, Jack Southdale P.C. ROBINSON, Eric, Hon. Rupertsland N.D.P. ROCAN, Denis Carman P.C. RONDEAU, Jim Assiniboia N.D.P. ROWAT, Leanne Minnedosa P.C. SALE, Tim, Hon. Fort Rouge N.D.P. SANTOS, Conrad Wellington N.D.P. SCHELLENBERG, Harry Rossmere N.D.P. SCHULER, Ron Springfield P.C. SELINGER, Greg, Hon. St. Boniface N.D.P.

SMITH, Scott, Hon. Brandon West N.D.P. STEFANSON, Heather Tuxedo P.C. STRUTHERS, Stan Dauphin-Roblin N.D.P. TAILLIEU, Mavis Morris P.C. TWEED, Mervin Turtle Mountain P.C. WOWCHUK, Rosann, Hon. Swan River N.D.P.

619 LEGISLATIVE ASSEMBLY OF MANITOBA Tuesday, September 16, 2003 The House met at 1:30 p.m. PRAYERS ROUTINE PROCEEDINGS TABLING OF REPORTS Hon. Greg Selinger (Minister of Finance): Mr. Speaker, I have a message from His Honour the Administrator, as well as the Supplementary Estimates which I would like to table. Hon. Steve Ashton (Minister of Conservation): Mr.

Speaker, I have a number of reports to table: the Manitoba Tire Stewardship Board Annual Report; the Manitoba Association for Resource Recovery Corporation Annual Report; the Manitoba Hazardous Waste Manage- ment Corporation Annual Report; the Manitoba Product Stewardship Corporation Annual Report and the Manitoba Round Table Annual Report. Mr. Speaker: I would like to advise the House that I will be reading the message and tabling on behalf of the Lieutenant-Governor.

The Lieutenant-Governor transmits to the Legislative Assembly of Manitoba, Estimates of Additional Sums Required for the Services of the Province for this fiscal year ending the 31st of March, 2004, and recommends these Supple- mentary Estimates to the Legislative Assembly. Introduction of Guests Mr. Speaker: Prior to Oral Questions, I would like to draw the attention of honourable mem- bers to the Speaker's Gallery where we have with us today a group of former employees of Dominion Tanners. These visitors are the guests of the honourable Member for Inkster (Mr. Lamoureux).

Also in the Speaker's Gallery we have Mr. Todd Hardy, a member from the Legislative Assembly from the Yukon, and Mr. Alex Baldwin from Nunavut Territory. * (13:35) Also in the Speaker's Gallery we have Mr. Luc Paquet from Winnipeg. Seated in the loge to my right we have Mr. Jim DeWolf and Mr. Russell MacKinnon who are Deputy Speakers from the province of Nova Scotia. Also we have Mr. Hunter Tootoo, who is the member of the Legislative Assembly from Nunavut, and Hunter is my nephew. Inuktituk spoken On behalf of all honourable members, I welcome you all here today.

Also with us we have some of the members of the Public Accounts from across Canada who are here attending the conference that we are hosting. I would like to welcome them, on behalf of all honourable members. ORAL QUESTION PERIOD Rural Hospitals Closures Mr. Stuart Murray (Leader of the Official Opposition): Mr. Speaker, hundreds of Man- itobans showed up today at the Legislature, many of whom are present in the gallery today, to take

part in a rally aimed at saving their rural hospitals. Although the Premier has promised his policy is to not close hospitals, having also promised Manitobans that he would end hallway medicine in six months with $15 million, we all know how little his promises are worth. Will the Premier today assure Manitobans that not a single rural hospital will be perma- nently closed or converted to a personal care home or any other type of health care facility or, Mr. Speaker, is he going to fail those members as he has failed the families with regard to the BSE crisis?

620 LEGISLATIVE ASSEMBLY OF MANITOBA September 16, 2003 Hon. Gary Doer (Premier): Mr. Speaker, the Minister of Health (Mr. Chomiak) is presently meeting with representatives of the three com- munity hospitals who visited the Legislature today. We know directly that the people in these communities are very concerned about the level of doctors in their communities and the medical coverage that that represents to the citizens and patients in those communities.

I know the template we received from the former government dealing with staffing and human resource issues that led to recommenda- tions to convert five out of eleven hospitals in the southwest region, we rejected that in gov- ernment. We will continue to try to find solutions that go way beyond the report we received from the Tories in 1999. Mr. Murray: As we heard on the steps of the Legislature when the Minister of Health spoke, it is just not good enough for the people of rural Manitoba.

In an e-mail I received just last night, one concerned Manitoban described how he had moved to Erickson in large part because there was a good full-service hospital. This was a priority for him as his elderly mother lives with him and he needed to be close to emergency services. I will read part of the e-mail that he sent: Now with the closing, apparently perma- nently, of the emergency room, I must make a hard decision. When I took this position, I signed a contract with monetary penalty if I did not stay the full term.

Do I try to stay the term of the contract and risk something major happening to her, his mother, or do I take the financial penalty and move someplace that has a stable hospital? Mr. Speaker, I would ask the Premier, because he failed to keep his promise to keep our rural hospitals open: Is he prepared to provide this individual with the money to cover the financial penalty he would suffer, or is he prepared to do the right thing and assure that the Erickson hospital will be reopened with full mergency services? e * (13:40) Mr.

Doer: The Erickson hospital, I believe, had a temporary closure of the emergency ward in 1998 and 1999, and the issue for all of us, in all of the hospitals that are here today, and in the future for many of the hospitals across Mani- toba, is the issue of recruitment and retention of doctors. Mr. Speaker, it also deals with the funding for those regional health authorities and the sustainability of those health authorities. There have been, as I understand it, nine additional doctors in southwest Manitoba since we were elected.

We are continuing to try to get more doctors into the southwest region and all other regions of Manitoba with the increased numbers in the medical school. The members opposite have yet to tell the people of Manitoba how many hospitals they were going to close to implement their 1% funding in health care that they promised in the election in exchange for their tax cuts, Mr. Speaker. We have funded the southwest region at over 7 percent. Members opposite have a lot of explaining to do. Mr. Murray: Well, Mr.

Speaker, I said during the election campaign and I say today that our commitment is to not close one rural hospital. In 1999, the member from Concordia promised he would end hallway medicine in six months with $15 million. He failed. Mr. Speaker, in 2003 the Premier then promised again he would not close a single rural hospital. He failed again. It is more than evident this Premier will say anything just to get elected. The hundreds of Manitobans who made their way into Winnipeg to attend the rally were here to fight for equal access to care. That is all they are asking for.

Unfortunately, they appear to be dealing with a government that just does not care about rural Manitoba, and now they are being treated like second-class citizens. I say shame on this Government. I ask the Premier: Will he assure Mani- tobans today, those sitting in the gallery, Mr. Speaker, so they can go back to their com- munities to ensure that he will not close one rural hospital or, again, I challenge him, is he going to treat those families the same way that he has treated the 12 000 families that are suffering under BSE? What is it going to be?

September 16, 2003 LEGISLATIVE ASSEMBLY OF MANITOBA 621 Mr. Doer: Mr. Speaker, there is a lot of rhetoric from members opposite. They commissioned a report that was going to close or convert five out of eleven hospitals in southwest Manitoba. We rejected the Tory report. We rejected it. We have increased the number of doctors by nine in southwest Manitoba since we came into office, since the dark days of the Tories where they reduced the number of doctors in rural Man- itoba. We are funding the southwest region at 7 percent in this year's Budget. Their proposal in the election was 1% funding.

Nurses are getting 5 percent more to keep them in Manitoba. Where are you going to cut? Where are the nurses going to be cut? The doctors are getting 3 percent more to keep them in Manitoba and in rural Manitoba. Mr. Speaker, 1 percent, you would be firing more doctors. Members opposite should look in the mirror. We are working very hard to keep doctors in rural Manitoba. That is why Doctor Cram has been appointed by the Minister of Health (Mr. Chomiak) to deal with the doctor shortages in some of our communities.

We think it is very important for those communities to have doctors in the communities for patient care, and that is why we have nine more doctors today and that is why Doctor Cram has been hired by the Minister of Health to give us some ideas of how we can do a better job collectively in Manitoba for the people of this province. * (13:45) Rural Hospitals Closures Mr. Leonard Derkach (Russell): Well, Mr. Speaker, I have to say it is unfortunate that the First Minister of this province in his comments is a stranger to the trut h.

Our rural hospitals on the west side of this province and throughout this province, like the people who are suffering the BSE crisis, are facing a major crisis in our province. The Erickson hospital is now closed. The signs on the highway have not just been taken down but the poles have been yanked out. The people in Erickson have been told that their facility is going to be run like a northern nursing station with clinic services only. The Minister of Health is responsible for this, and I ask the minister: Why has he allowed the closure of this facility, and why will he not recruit doctors immediately, Mr.

Speaker? Hon. Dave Chomiak (Minister of Health): Mr. Speaker, as I indicated to the member several weeks ago in our conversation, I have instructed the regional health authority to try to recruit doctors to Erickson. Not only did I tell the member that, but in a letter that went from the municipality to other individuals, the Member for Russell was quoted as saying the minister has confirmed that the region has been told to hire additional doctors. From the member's own mouth, those words came, that we were com- mitted to trying to do that. We continue to try to do that. Mr. Derkach: Mr.

Speaker, I accept the min- ister's word. I have asked the minister to stop the conflicting information that is going out to the communities of Erickson, Rossburn and Birtle, in my constituency. Mr. Speaker, all he has to do is write a directive to the ARHA indicating that they are to recruit doctors immediately for those facilities and work with the communities to ensure that doctors are hired for those communities.

Why has the minister refused to give that directive in writing to the ARHA, with copies to the com- munity, so that ev erybody knows where the minister is coming from and where the ARHA is coming from? Mr. Chomiak: Mr. Speaker, not only did I give that commitment to the Erickson community that I just met with in my office, but I gave it to the member several weeks ago. I also indicate that one of the reasons we hired Doctor Cram is to try to see how we can improve the situation.

Even though we have more doctors in rural Manitoba now than we did when members oppo- site were in office, even though we brought back the number of medical students in training after members opposite cut it, even though we put in place an IMG program to train people in rural Manitoba, even though we have put in place a bursary program for the first time in history for

622 LEGISLATIVE ASSEMBLY OF MANITOBA September 16, 2003 doctors to go to rural Manitoba, and even though we have more doctors in rural Manitoba than when members were opposite, there is still work to be done. Doctor Cram is working with us to do that, Mr. Speaker. Mr. Derkach: Mr. Speaker, less than two weeks ago, the ARHA officials met with the com- munity of Russell and told the community of Russell that they would be beneficiaries to the closure of the Rossburn and Birtle hospitals, that indeed the emergency services and acute care services would be moved from the Rossburn and Birtle areas to the Russell area.

Mr. Speaker, that is not what the minister has been saying. I ask this minister once again to make sure that his directive to the ARHA goes in writing with copies to these communities to ensure that the people in the Rossburn area, the Birtle area and the Eric kson area are going to have the confidence that their hospitals are going to stay open. Mr. Chomiak: Mr. Speaker, I want to remind members and the Member for Russell, in fact we had this exchange about a week ago.

I reminded the member that in 1997, Gladstone hospital closed temporarily and the member from Russell indicated it was because of lack of human re- sources temporarily. We have been working, Mr. Speaker, since we formed office in '99 to re-open that facility. We are very confident we are going to have some success in that regard. The member oppo- site knows the challenges about rural Manitoba retaining doctors. The member knows that the Erickson hospital closed in '98, '99 and 2001. Their government, our Government assisted in trying to maintain doctors there. We have and we will continue to do so.

At the same time, it will be a continuing challenge. We have Doctor Cram in place plus all of those programs that I ave already made reference to. h * (13:50) Rural Hospitals Closures Mrs. Leanne Ro wat (Minnedosa): Mr. Speaker, in reference to the threat of the closure of the Wawanesa hospital, a Wawanesa resident who is present in the ga llery today, Diane Diehl notes that she will have to and I quote: "I will have to leave a community that I love, leave supportive friends, my church and volunteer work to go to a bigger centre to become a num- ber on some doctor's waiting list.

I live alone and on long-term disability. What am I going to do?" Mr. Speaker, on behalf of Ms. Diehl I ask the Minister of Health: hat is she going to do? Hon. Dave Chomiak (Minister of Health): Mr. Speaker, as I indicated to the member last week in Estimates when we discussed this issue, there is a family of three physicians who are father, mother and son who undertake a practice in Wawanesa who are leaving. They have not left yet. We have already recruited another physi- cian, Mr. Speaker, to Wawanesa and there is more work undergoing recruitment that is ongoing. Mrs. Rowat: Mr.

Speaker, I received a letter from Ms. McBurney, who is also in the gallery today, from Wawanesa, who wrote to express her frustration on the threat of the closure of the Wawanesa hospital. He r frustration extends beyond the health impact the closure will have. The economic impact is critical as this com- munity is already devastated with the BSE and the drought situation. Ms. McBurney is looking for assurances from the NDP government that her hospital will be maintained. Will the minister today commit to keeping the Wawanesa hospital open? Mr. Chomiak: Mr.

Speaker, as I indicated to the member in Estimates last week, there has already been a doctor recruited to Wawanesa and there are ongoing recruitment efforts. Mrs. Rowat: Mr. Speaker, rural health care is under attack from this Government and the minister pays lip-service to the concerns of my constituents and to the many rural Manitobans who are entitled to quality health care. Equal access to health care is a right for all Manitobans regardless of where they live. The community of Rivers was given assurances by this Premier that their hospital would not close.

Will the Minister of Health confirm that the Rivers health centre will be maintained as an acute care hospital?

September 16, 2003 LEGISLATIVE ASSEMBLY OF MANITOBA 623 Mr. Chomiak: Mr. Speaker, as the First Min- ister (Mr. Doer) indicated and we have indicated on numerous, numerous occas ions, it is not our intention to close any hospitals. Members opposite know that Erickson hospital closed in '98, '99, 2000, 2001. Members opposite know that Gladstone closed temporarily in 1997. We know that, for the first this year, there are more doctors in Manitoba than there have been since 1994, the first time. That means more doctors in rural Manitoba, that they are in- creased. That means more doctors in urban Manitoba, Mr.

Speaker, and it is one of the direct impacts as a result of in 1993 when mem- bers opposite cancelled and reduced by 15 every year. That is up to 120 Manitoba-trained doctors that are not trained because of their policies. Rural Hospitals Closures Mr. Leonard Derkach (Russell ): Mr. Speaker, I would like to begin with a quote that we heard on the Legislative steps this morning and I quote: We need better treatment for rural Manitobans and First Nations communities. Mr.

Speaker, Rolling River First Nation, Waywayseecappo First Nation, Birdtail Sioux, Gambler, Keeseekoowenin, these are all constit- uencies that are served by the hospitals of Birtle, Rossburn and Erickson. We need a commitment from the minister today to the people up here in the gallery to the communities back home and to the First Nations people that these hospitals will remain open. Can the minister give us that com- mitment and can he make that commitment in writing to the people of these communities? Hon. Dave Chomiak (Minister of Health): Mr.

Speaker, I met with repres entatives of all those communities in my office just moments ago. We had an excellent discussion. We gave our com- mitments to them. We said we would work with them, that we would continue to work with them. I want to add that First Nations people right across this province require enhanced services and we have tried to do that over the past four years and we will continue to do that the next four years. * (13:55) Mr. Derkach: Mr. Speaker, these are platitudes. I am asking the Minister of Health, specifically about the hospital facility in Birtle, in Rossburn and in Erickson.

I am asking the minister to make a commitment to these communities, to the First Nations communities in that catchment area and to assure that he will instruct the regional health authority that they are to actively recruit hospitals involving these communities for those hospitals. Will the minister give me that com- mitment? Mr. Chomiak: Mr. Speaker, it is very illus- trative that the doctor who is leaving Rivers, Manitoba told publicly his concerns about why he is leaving Rivers, Manitoba. He said it is not for more pay.

He said: It is because I do not get a chance to see my kids, I do not get a chance to see my family. He said: It is lifestyle, it is being n call all the time. o That is one of the reasons why we asked Doctor Cram, a well-respected rural physician, to meet with rural doctors to see how we can deal with this. One of the ways of dealing with keeping doctors in rural Manitoba is to have larger on call. That has been one of the meth- odologies. That is what doctors have told us. We have asked Doctor Cram to go out there, meet with doctors, see what the solutions are, Mr. Speaker.

I ask members opposite to join us to try to improve the situation for rural doctors in rural Manitoba and to work with us with all of these communities to ensure that happens and not let this turn into a straight political argument where they are trying to make political points on the backs of the patients. Mr. Derkach: The minister knows better. I went to his office directly to try to find a solution to this. To date, no solution has been found. Mr. Speaker, the doctor in Birtle gave notice last December that he would be leaving that community this December.

To date, I understand the Assiniboine Regional Health Authority has not moved on recruiting a doctor for that com- munity. I get that from the mayor and the reeve f that community. o I ask the minister whether or not he will commit today to ensure by letter that the regional health authority will start the active recruitment for doctors for Birtle, Rossburn, and Erickson.

624 LEGISLATIVE ASSEMBLY OF MANITOBA September 16, 2003 Mr. Chomiak: The Assiniboine Regional Health Authority has recruited 47 doctors in the last four years to the region. Also over that period of time 33 doctors have left practice. There is a problem. Even though there is a net gain, it is clearly a problem. That is why we asked Doctor Cram to investigate the situation, a local doctor, a doctor who has practiced in that area, a doctor who is committed to rural Manitoba, to talk to doctors, to talk to com- munities and to see if there is anything more we can do.

I am going to add to the member that the member for Wawanesa, the member for Rivers, the member for Gladstone would all say to me make it a first priority that my community gets their doctor recruited first, Mr. Speaker. We have asked the region to recruit, we have told the region to recruit, the region is recruiting and we have also said we do not want any facilities closed. Physician Resources Recruitment–Rural Manitoba Mr.

Mervin Tweed (Turtle Mountain): When the Minister of Health chose to amalgamate Southwest and Marquette, he did so without a plan, he did so without a study and he is com- mitted to no review of how it is working. Mr. Speaker, at the last minute he appoints a member of the medical profession from Souris to oversee this, and that creates some concerns. What we are seeing here, and I want to quote the paper of August 28, the Brandon Sun, where it says: the community is especially angered by the health authority's admission that it has no plans to recruit another physician who would be dedicated solely to Erickson.

Obvious- ly, we are hearing mixed messages here, Mr. Speaker. The minister is saying one thing, the RHA is saying another. Again, I want to ask the minister will he commit today to the people of Birtle, Rossburn and Erickson that he will inform the RHA that they are to begin active sincere recruitment of doctors for these facilities. Hon. Dave Chomiak (Minister of Health): First off, the member misinterpreted the role and function of Doctor Cram.

Doctor Cram, who is a long-standing Manitoba native who practices in Souris, has been asked to met with communities, meet with doctors, meet with all of the indi- viduals involved to– Some Honourable Members: Oh, oh. * (14:00) Mr. Speaker: Order. I would just like to remind all honourable members that we have a lot of guests in the public galleries and we have the viewing public, and when there is a lot of chatter back and forth it is very difficult for our guests to hear what is going on at the floor. I think it is only right that we give them the courtesy to hear the questions and the answers.

I would ask the co-operation of all honourable members, please. Mr. Chomiak: Mr. Speaker, we have asked Doctor Cram to look at how we can continue to improve the situation vis-à-vis physicians be- cause it seems to be that one of the key factors, and members opposite know this, is the whole issue of on call and rotation, as well as all of the issues concerning doctors. I would also like to table a copy of a letter from the Town of Erickson where it says: We understand from conversations with the Member for Russell, Mr.

Derkach, that you said that when we have a second doctor, our emergency and doctor on call will be reinstated at the Erickson hospital. That is dated August 22. I am happy to table that letter. Mr. Speaker: Before recognizing the honour- able Member for Turtle Mountain, I would like to remind all honourable members that when making reference to other members in the House it is members by constituency or ministers by the portfolio that they carry, not by their names. I ask the co-operation of all honourable members. Mr. Tweed: Mr. Speaker, further to the amal- gamation.

At the time the plan was presented or forced upon the people of rural Manitoba, Brandon was included in that amalgamation but at the last minute, I presume through political interference, it was removed. I think that is shameful too.

September 16, 2003 LEGISLATIVE ASSEMBLY OF MANITOBA 625 Mr. Speaker, on August 30, in the Brandon Sun, we have a young doctor in Wawanesa quoted in the paper as saying: I asked about specifically working in this area. I was told we do not want you in Wawanesa or Baldur. We want to close Wawanesa and Baldur hospitals. We are waiting for your parents to retire. Again the people of these communities are receiving mixed messages from the minister, the member and the leader of the RHA.

All the minister has to do is clear the air for the people that are in the gallery today, the people that have taken time out of their day to come in here and take an issue forward to the minister that he knows full well and can deal with. Will the minister now commit to the people of Wawanesa that he will recruit those doctors? Mr. Chomiak: Mr. Speaker, I have already answered that question on two occasions to a previous member with respect to Wawanesa.

With respect to the situation in Wawanesa, I can indicate, as I indicated before, that three mem- bers of one family who all practice medicine in Wawanesa are leaving Wawanesa. We have already recruited. They have not left yet. I prefer not to discuss personal matters in the Legis- lature. I do not think it is appropriate, but Doctor Cram will be speaking with all individuals concerned. Mr.

Tweed: Does the Minister of Health really believe that the people of Wawanesa are going to be satisfied with the fact that they are losing three doctors, two of whom have served more than 30 years in that community, and being replaced by one doctor? The Minister of Health does not have a recruitment problem, he has a retention problem. It says in the Brandon Sun dated today, in the last four years 33 of the 42 physicians to come into the region have left. I want to know why have they left. What is the minister doing in consulting with the RHA and protecting the people of these communities?

Why is the minister ignoring it, putting his head in the sand and was quoted today by one of the speakers, it is time to remove the eye patch and buy yourself a hearing aid. Mr. Chomiak: Mr. Speaker, I would like to table for the members opposite a copy of a chart that members opposite could perhaps look at. If members can look at it, we will see that in 1996, the province lost 19 doctors; in 1995, they lost 19 doctors; in 1996, they lost 75 doctors; in 1997, they lost 3 doctors; in 1998, they lost 19 doctors. The first time since 1994 there was an increase in doctors was 1999, 21.

Another in- crease of 21 in 2000. An other increase of 60 in 2001. Another increase of 40 in 2002. It is very noteworthy– Some Honourable Members: Oh, oh. Mr. Speaker: Order. I would like to once again ask the co-operation of all honourable members. Decorum in the House is very important. I ask the co-operation of all honourable members, please. Mr. Chomiak: Mr. Speaker, our northern and rural health office, our IMG program, our addi- tional bursaries to doctors, our program to admit more doctors into the medical faculty have all been working.

We cannot overnight undo the damage that occurred in the nineties, and in addition, we have asked Doctor Cram, a local doctor to review the situation. Rural Hospitals Closures Mrs. Myrna Driedger (Charleswood): Mr. Speaker, this minister keeps deflecting from the actual issues that are before him today. We have heard the Minister of Health say that it is not his policy to close rural hospitals. Yet Erickson hospital has already been closed and others are on the chopping block according to the RHAs.

Why should we trust this Minister of Health when he is telling us one thing and the RHAs are saying and telling us something else? Hon. Dave Chomiak (Minister of Health): As I indicated to the member last week and during the course of this week, the Erickson hospital closed in '98, '99, 2000 and 2001, and we fixed that situation, Mr. Speaker. I know, to the mem- ber opposite, '98 and '99 were periods when the member was the legislative assistant to the Minister of Health so she knows the situation, and we are continuing to work with Erickson hospital.

We have commitments that I have provided today, and we are trying in the face of difficulties to keep doctors on call to continue

626 LEGISLATIVE ASSEMBLY OF MANITOBA September 16, 2003 the practice in facilities all across the province of Manitoba. We have more doctors in rural Mani- toba than we did before. Mrs. Driedger: Mr. Speaker, the minister did not answer the question. He is saying that he will not close rural hospitals, yet he has not ruled out allowing the RHAs to close rural hospitals. Is the Minister of Health getting the RHAs to do his dirty business? Mr. Chomiak: No, Mr. Speaker. Mrs. Driedger: Mr.

Speaker, today at the rally somebody said, and I quote: "all people should be afforded the same level of health care." There are doctors out there who want to work in some of these rural hospitals, but they are not being allowed to. There are hospitals that have been closed and others that are on the chopping block. The Doer government is once more showing its lack of commitment to rural Manitoba. I would like to ask the Minister of Health (Mr. Chomiak) today if he will guarantee that he will keep rural hospitals open and that he will order the RHAs to do the same and to put it in writing to those RHAs. Hon.

Gary Doer (Premier): Mr. Speaker, there are more nurses in rural Manitoba today than when we came into office. There are more doctors in rural Manitoba than when we came into office. When we came into office, the commitment was made seven times to build the Brandon regional hospital. That promise was broken seven times when we came into office. For the first time ever in the history of this province an MRI machine will be put into the Brandon regional hospital to service all of southwest Manitoba. We need no lectures from members opposite about serving rural Manitoba in an equal way.

We are more than better than they were. Mr. Speaker: The honourable Member for River Heights. S ome Honourable Members: Oh, oh. * (14:10) Mr. Speaker: Order. If members wish to have a conversation, we have a loge that is free. I welcome any members that wish to have a conversation to use it because it is very impor- tant that our guests are able to hear the questions and the answers, and we have the viewing public also to be aware of. I ask the co-operation once again from all honourable members. Assiniboine Regional Health Authority Review Hon. Jon Gerrard (River Heights): Mr.

Speaker, there is a growing call for more respon- sible management in the Assiniboine Regional Health Authority, which is highlighted by a petition of 583 names which I table today and which petition expresses great dissatisfaction with recent events, and, in particular, the lack of effort to retain valu able doctors like Dr. Nicholas Abell in Wawanesa. Why is it that the only policy the Govern- ment has on rural physicians is to dial 1-800- South Africa? Why is it that the minister has appointed somebody from inside the Assiniboine RHA to review things happening in the RHA?

When will the minister appoint somebody who is really independent to make an inquiry under the RHA, and when will the minister table a plan for the future of the RHA? Hon. Dave Chomiak (Minister of Health): Mr. Speaker, the last time the Member for River Heights stood up in this House and accused me of firing a doctor, we called the judicial inquiry that showed everything the member said was wrong, inaccurate. It is wrong for the member to take the position that he has been taking in regard to hiring and firing of particular physi- cians. There are more physicians in rural Man- itoba than there were before.

There are problems in retaining physicians on call. Is the member attacking a lifetime physician in rural Manitoba who lives there, who works there, who has spent his life, who is on the MMA, Mr. Speaker, saying that that person is not qualified to look at rural Manitoba? I suggest he is much more able to give a better impression of what is going on in rural Manitoba than someone sitting in River Heights making that observation.

September 16, 2003 LEGISLATIVE ASSEMBLY OF MANITOBA 627 Mr. Speaker: Before recognizing the honour- able Member for River Heights, I would like to remind all honourable members when putting a question or giving an answer, please do it through the Chair. Mr. Gerrard: Mr. Speaker, the Koshal report said that many of the issues I have raised were right on, then and now, when we are looking at the future of the hospital in Wawanesa and health care in the Assiniboine Regional Health Authority. When will the minister table a plan for the future of the RHA?

When will the minister provide a clear plan for the future of Wawanesa? Will the minister meet with the people from Wawanesa who are here and talk about the future and the needs for a fair future for Wawanesa? Hon. Gary Doer (Premier): Mr. Speaker, would the member who was part of the federal Liberal Cabinet give us the plan that he had in place when he voted to cut $240 million out of the health care budget of Manitoba, the equiva- lent of closing every rural and northern hospital in this province? We need no lectures from the member opposite about their commitment on health care.

We will continue to meet with the rural communities, Mr. Speaker. The minister met with some of the communities. We will continue to meet with all the communities. We have nine more doctors today in southwest Manitoba than we did when we came into office. Obviously, we have to continue to work to have doctors in those communities so patients could get those services. The member should not feign interest in health care, given his voting record of the past. Provincial Nominee Program Preferential Treatment Mr. Kevin Lamoureux (Inkster): Mr. Speaker, my question is for the Premier.

Yesterday, I made reference to the Provincial Nominee Pro- gram. We have benefited, as I said yesterday, tremendously as thousands of new Manitobans have created a new life here in our province, and we need to do what we can at increasing the number of immigrants coming to our province. The Provincial Nominee Program has been an excellent program that has helped in facilitating more people coming. We have to protect the integrity of that program.

I have heard numerous concerns regarding issues related to the Provincial Nominee Pro- gram, more specifically one concern regarding a staffperson from a former minister, Ms. Becky Barrett. Has the Premier been made aware of any of these issues, and, if so, what has the Premier done to address them? Hon. Gary Doer (Premier): Mr. Speaker, if the member has a specific allegation, he can place it in the appropriate way. We will follow it up in the way appropriate. Manitoba Hydro Energy Saving Initiatives Mr. Tom Nevakshonoff (Interlake): Mr.

Speaker, it was a proud day for me when the previous Legislative Assembly equalized hydro rates for rural and nort hern Manitoba, thereby proving that New Democratic governments are not only good at building Hydro power dams but are truly fair to all Manitobans in terms of the distribution of power in our province. Could the Minister of Energy, Science and Technology inform the House what measures Manitoba Hydro is taking to make it possible for Manitobans to further lower their energy bills? Hon. Tim Sale (Minister of Energy, Science and Technology): Well, first, Mr.

Speaker, we are proposing to build clean run of the river dams in northern Manitoba. We do not cancel dams. We build them. The second thing, Mr. Speaker, is that we have been able over the last few years to save the equivalent of a new dam, a Wuskwatim-sized dam, 241 megawatts of power through our Power Smart program. I am delighted to tell the House that just today we announced we are reducing the interest rate on our Power Smart loans from 8.5 percent to 6.5 percent making it more affordable for more Manitobans.

628 LEGISLATIVE ASSEMBLY OF MANITOBA September 16, 2003 I can tell the House, as well, Mr. Speaker, that over the last three years we have loaned out over $34 million to Manitobans to help them save energy, to help us be able to keep our power rates low by exporting energy and selling it for more than it costs us to make it, thereby affording Manitobans the lowest rates on the continent, the lowest rates for business, resi- dences and for all of those who enjoy our standard of living in this great province. Mr. Speaker: Time for Oral Questions has expired. MEMBERS' STATEMENTS Pembina Valley Festival Mr.

Peter Dyck (Pembina): This past Saturday, my wife and I, along with the Honourable Lieutenant-Governor Peter Liba and his wife, Shirley, had the pleasure of attending the Pembina Valley honey, garlic and maple syrup festival at the Manitou fair grounds.

This festival provides an opportunity for the community of Pembina Valley and the town of Manitou to champion, to draw attention to and to create a venue where people from across Manitoba and other parts of our great nation come together to celebrate, to eat, to be entertained by local artists, to share life experiences and in plain words, celebrate and have a good time. On-site cuisine delicately flavoured with Manitoba grown garlic, honey and maple syrup was excellently prepared by the following food vendors: Manitou's Trappers at the Inn, Reds Cafe and Convenience, Mr.

G's Drive Inn, Darlingford's The Hitching Post, Winnipeg's Gilroy's restaurant and the festival committee's Buffalo Burger Hut. The food-filled day began with a pancake breakfast hosted by the Manitou Kinsmen, followed by the town-wide garage sale, a game of golf and more delicious Manitoba cuisine. The evening program consisted of a delicious buffet supper along with a wonderful play entitled What Glorious Times They Had, a Nellie McClung play. I vividly recall the first honey, garlic and maple syrup banquet that was hosted at the Manitou Legion where there was a variety of dishes served to many hungry people.

The food was great and plentiful and I definitely ate my fair share. The local talent that exists in this province is phenomenal. Festivities such as these provide our local artists with opportunities to share their talents with the rest of us. For some there was a shadow that hung over the festival as they continued to deal with the BSE crisis and are cont inuing to ask for a cash advance. On the other hand, though, Mr.

Speaker, I would like to take the opportunity to thank the organizing committee and various vendors for all the hard work and dedication they put into this successful community-wide event. * (14:20) Terry Fox Run Ms. Christine Melnick (Riel): Mr. Speaker, on September 14, the 20th Annual Terry Fox Run took place. I was proud to take

part in this important event by launching the opening cere- monies in St. Vital Park in my constituency of Riel. This year's run was a tremendous success. The Terry Fox Run is held annually across Canada to commemorate Terry Fox's Marathon of Hope and to raise money to help find a cure for the devastating effects of cancer. The 10-k run is held in other countries around the world and each year thousands of volunteers partic- ipate in the organization. The event is non- competitive and people from all walks of life, including families and children, come to run in the event.

I was honoured to be a part of such an honourable tradition that is carried out nationally and even internationally, an event that has raised over $200 million for cancer research. Mr. Speaker, I would like to thank all the donors, the organizers and the many participants who worked hard to raise the funds and whose enthusiasm keep this event such a success year after year.

We can hope that the money raised and all the hard work of the organizers and the participants will continue to support the fight against cancer and hopefully will some day alleviate the suffering and the pain of the people affected by this devastating disease, a disease

September 16, 2003 LEGISLATIVE ASSEMBLY OF MANITOBA 629 which not only took the life of Terry Fox, but sadly takes the lives of many people around the world. Thank you. Rural Hospitals Mr. Leonard Derkach (Russell): Mr. Speaker, I rise today on a member's statement with regard to the situation that came before the Legislature today. Hundreds of Manitobans from a long dis- tance away from this capital city, this capital of ours, today got in their vehicles and made their way to the city to express their concern and their resolve in making sure th at their hospitals were open.

People from First Nations communities, people from Hutterite communities, people from our urban and rural communities out in rural Manitoba joined hands today to express to this Government the importance of keeping our rural facilities open. When I say our rural facilities open, I am talking about emergency and on-call services. The minister and the Premier (Mr.

Doer) cannot say that a facility is closed temporarily when the posts that hold the hospital signs have been yanked out and the community has been told that the facility will revert to a clinic facil- ity, one that will be run on a pilot basis like a northern nursing station. That does not signal a temporary closing.

So today I simply want to acknowledge the people who organized the rally today, the people who took time from their busy schedules to drive a long distance, many of whom had to be up far before six o'clock in the morning, who drove here to give the legislators and especially the Minister of Health (Mr. Chomiak) and his Pre- mier a very sincere and direct message. That was: Keep our rural hospitals open. Thank you. Arthur V. Mauro Student Residence Ms. Marilyn Brick (St. Norbert): Mr.

Speaker, it is with great pleasure today that I bring attention to the product of one of our capital initiatives, the punctual opening of the new Arthur V. Mauro student residence at the Uni- versity of Manitoba. I was fortunate to be able to attend the grand opening of this outstanding building on August 25. The University of Manitoba has reached a hugely significant milestone in terms of enrol- ment. Enrolment at the University of Manitoba is at the highest level ever in its 126-year history.

The University of Manitoba is to be applauded for being proactive in ensuring ac- commodations are available to assist students in achieving their goals of attaining a post-sec- ondary degree. The design of this beautiful residence has been thoughtfully executed to present an attrac- tive, comfortable living environment for mature, foreign, and interprovincial students. This new complex is able to accommodate 310 students in 155 apartment-style suites. The rooms allow the students to live in a private, self-sustaining environment.

The students are provided with contemporary amenities such as free Internet connections, cable, a small kitchenette with a microwave and fridge and air conditioning. The students are especially appreciative of the fact that each suite contains a bathroom with a shower. The opportunities this building provides for enhanced learning are enormous. In addition to private amenities each floor is equipped with a communal study room, lounge and kitchen to ensure that the communal living experience is not lost.

In the future the residence will also contain an exercise studio on the main floor to encourage students in th e pursuit of their phys- ical well-being and health. A major consideration in the building design was to ensure the needs of disabled individuals are met. The other residences like Taché were built in the early 1900s. Accessibility was not a consideration 100 years ago. The new residences have five specially designed suites that feature larger bedrooms with showers to facilitate and allow wheelchair access.

The building also features signs that are in braille so people who have visual disabilities can find their way throughout. The alarms are visual as well as auditory to ensure the safety of all residents.

630 LEGISLATIVE ASSEMBLY OF MANITOBA September 16, 2003 I am pleased to announce that this residence opened on time thanks to the hard work and dedication of the committee. Provincial Nominee Program Mr. Kevin Lamoureux (Inkster): Mr. Speaker, I just wanted to emphasize the program that I have raised over the last couple of days now and that is the Provincial Nominee Program. It is a program that was actually started back in 1998 between the federal government and the pro- vincial government in which what we have seen is the popularity of that program has ultimately lead to en expansion.

Today we are probably talking somewhere in the neighbourhood of up to 4500 to 5000 potential immigrants coming to the province. It caters to that whole idea of family and friends reunification of sorts for very strong social benefits through that particular program. In addition to that, we get very strong eco- nomical benefits because of that particular pro- gram.

I, since the election, have had numerous people, whether it is through e-mail, whether it is through regular mail, I have had in-person discussions and I can honestly say there are individuals out there who are quite concerned about what has been happening within that program. I have raised the issue for two con- secutive days. I do plan to pursue it, whether it is through the Estimates, concurrence, or through Question Period. I am optimistic and hopeful the Government has also heard the types of concerns I have heard and that there is a government that is prepared to show that it is going to take some actions.

We have to protect the integrity of that program because it plays such a critical role to the future. I believe that program, no political party has an ownership of it. I believe all parties in this Chamber recognize the benefits of immigration to our great province and the future of this pro- gram is absolutely critical to the future of our province. Mr. Speaker: Grievances. The honourable Member for Russell. Mr. Leonard Derkach (Russell): Thank you very much, Mr. Speaker. Mr. Speaker: Order. Are you rising on a grievance? Mr. Derkach: No, I am not, Mr. Speaker. Mr. Speaker: Okay. Grievances. None. Okay.

MATTER OF URGENT PUBLIC IMPORTANCE Mr. Leonard Derkach (Russell): Mr. Speaker, I rise this afternoon to seek leave of the House to set aside the regular business of this Chamber and to deal with a matter that is of significant urgent public importance. I know that I did not meet the requirements to file this motion with you 90 minutes before the House sat, so there- fore I humbly ask for leave of the House to deal with this matter and I will read the motion so that it is understood before unanimous consent is given or rejected. Therefore, I move, seconded by the Member for Ste. Rose (Mr.

Cummings), THAT under Rule 36(1) the regular business of the House be set aside to deal with a matter of urgent public importance, being the urgent state of health care in rural Manitoba with the closure of a number of rural hospitals. * (14:30) Hon. Gord Mackintosh (Government House Leader): Mr. Speaker, on the point of order– Mr.

Speaker: Before recognizing the honour- able member, I believe I should remind all members that under Rule 36(2), the mover of a motion on a matter of urgent public importance and one member from the other parties is allowed not more than five minutes to explain the urgency of debating the matter immediately.

September 16, 2003 LEGISLATIVE ASSEMBLY OF MANITOBA 631 As stated in Beauchesne Citation 390: urgency in this context means the urgency of immediate debate, not of the subject matter of the motion. In their remarks, members should focus exclusively on whether or not there is an ur- gency of debate, and whether or not the ordinary opportunities for debate will enable the House to consider the matter early enough to ensure that the public interest will not suffer. Mr. Mackintosh: Mr.

Speaker, we recognize that the notice was not provided to your office; also, that there has been a great deal of time available in the Estimates of the Department of Health over the last four or five days to question and to receive answers on this issue, and, as well, of course, the Oral Questions. But we think that there is some recognition that the record of this side of the House and the Government to improve health services in rural Manitoba is something that should be talked about in this Chamber to a greater extent and, as well, Mr. Speaker, our commitment to rural Manitobans generally.

We are prepared to give leave for this debate, and we would agree that we could go immediately to the 10-minute debate on the MUPI. I have had a discussion with other mem- bers. We would ask leave of the House for the Committee of Supply meeting in Room 254 and 255 to continue to sit concurrently with the House with no votes or quorums in those two places. Mr. Speaker: Before continuing, I would like to give the opportunity to the honourable Member for Russell (Mr. Derkach) if he wishes to speak to the urgency of this debate. Mr. Derkach: Mr.

Speaker, I think the urgency is self-evident from the concern that com- munities have about their particular facilities. I think we see that to these communities, this is a crisis situation. There is a lot of stress on rural families today, not only because of the health care but because of BSE issues. Therefore, I am thankful that the Government has seen fit to give leave on this matter. We will certainly work with the House Leader to ensure that the two other committees will continue to do their work while the debate goes on in the Chamber. Mr.

Speaker: There are two conditions to be satisfied for this matter to proceed. The first condition has not been met in that I did not get the proper notice from the honourable member of this motion. I would like to advise the honourable members that, according to our Rule 36(1) a member wishing to move that the ordinary business of the House be set aside to consider a matter of urgent public importance must provide the Speaker with 39 minutes notice prior to the sitting of the House. I have not received the required notice. [interjection] Oh, I am sorry.

I am glad I am going to be having corrective surgery in my eyes. It is really 90 minutes. I guess I stated something else. In order for this ma tter to proceed, unan- imous consent of the House is required in order to set aside the requirements of Rule 36(1). The second condition is that debate on the matter is urgent and that there is no other reasonable opportunity to raise the matter. The Estimates for the Department of Health are now concluded, so it is not possible to raise this issue during those Estimates.

However, members still have the opportunity of asking questions during Question Period and can also ask questions during consideration of the concurrence motion. Despite these procedural shortcomings, there appears to be a desire to debate this matter. Given that this is a serious issue and given that the notice requirement must be waived in order for the matter to proceed, I will now ask the House: Is there unanim ous consent for this matter to proceed today? [Agreed] Mr. Speaker: Is there leave or agreement of the House for the two sides to be meeting in Com- mittee of Supply in the two committee rooms?

Agreed? [Agreed] Was the honourable Me mber for Portage la Prairie (Mr. Faurschou) on the– [interjection] I was putting a motion. The meetings in the two committee with no quorum.

632 LEGISLATIVE ASSEMBLY OF MANITOBA September 16, 2003 So that is the Committee of Supply in the two committee rooms, no quorum counts, and no votes. Agreed? [Agreed] Point of Order Mr. Speaker: The honourable Government House Leader, on a point of order. Mr. Mackintosh: Yes, Mr. Speaker. I just have two items of House business. I am wondering if we can dispose of that before entering into the MUPI debate. Mr. Speaker: Is there leave? Leave has been granted. House Business Mr. Mackintosh: By leave, seconded by the Minister of Agriculture and Food (Ms.

Wowchuk), that the business of the House after Routine Proceedings for Wednesday, September 17, 2003, shall be the consideration and completion of Interim Supply in the Chamber, with consideration of departmental Estimates to take place concurrently in committee rooms 255 and 254, the sections meeting in committee rooms 255 and 254 to operate under Friday rules regarding quorum and votes. Despite the sessional order agreed to on September 8, the House will rise on October 1. The only business for October 1 shall consist of Routine Proceedings and the consideration of condolence motions. Motion agreed to. Mr.

Mackintosh: I wish to see if there is an agreement to change the Estimates sequence such that in the Chamber section, the Estimates for the Department of Labour and Immigration are now to follow the Estimates for Culture, Heritage and Tourism. In 254, a new sequence of Estimates is to be established to consist of the following order: Education and Youth, Ad- vanced Education, Seniors Directorate, Status of Women, Conservation, Family Services, Leg- islative Assembly, Capital Investment, and in Room 255, the Estimates of Aboriginal and Northern Affairs to now follow the Estimates of the Department of Finance.

These changes are to apply permanently. Mr. Speaker: Is there agreement to change the Estimates sequence such that in the Chamber

section the Estimates for the Department of Labour and Immigration are to now follow the Estimates for Culture, Heritage and Tourism? In Room 254, a new sequence of Estimates is to be established to consist of the following order: Education and Youth, Advanced Edu- cation, Seniors Directorate, Status of Women, Conservation, Family Services, Legislative As- sembly, Capital Investment. In Room 255, the Estimates of Aboriginal and Northern Affairs are to now follow the Estimates of the Department of Finance. These changes are to apply permanently. Is there agreement? [Agreed] * * * Mr.

Speaker: It has been moved by the hon- ourable Member for Ru ssell (Mr. Derkach), seconded by the honourable Member for Ste. Rose (Mr. Cummings), under Rule 36(1), that the regular business of the House be set aside to deal with a matter of urgent public importance, being the urgent state of health care in rural Manitoba with the closure of a number of rural hospitals. * (14:40) Mr. Derkach: Mr. Speaker, today, we witnessed a situation that none of us is really happy about, but it is a demonstration of how committed com- munities are to ensuring that the services that their residents need remain in place.

Over the course of the last few months, we have seen a movement towards the closure of some of our hospital facilities in rural Manitoba. But during the election campaign, I was some- what relieved that the now-Premier (Mr. Doer) of our province moved through the rural com- munities and stated emphatically that his Gov- ernment, if they were elected, would not close rural hospitals. That was the same position, Mr. Speaker, that we held as a party as well, so it gave me some assurance that even if we were not successful in winning the campaign, that, indeed, the Government had made a

September 16, 2003 LEGISLATIVE ASSEMBLY OF MANITOBA 633 commitment to the rural residents of Manitoba that those very important facilities would re- main. The reality, Mr. Speaker, is that if you were to close any of these facilities or all of them, if you were to close Wawanesa, Rivers, Rossburn, Birtle, Erickson, Emerson, what you would save in dollars, in real dollars, would mean nothing compared to the magnitude of the Health budget of this province.

So, all of a sudden, we are going to put a hardship on people who choose to live in rural communities, a hardship that goes right to the heart of that family and that individual. Many of the people who live in our rural communities, our elderly, are on fixed incomes, and the proposal to close the Erickson hospital, as an example, would mean that insured services–emergency services are insured as are on-call services–those services would then be replaced by a service that has to be paid for by the client, Mr. Speaker.

All of a sudden, those people who are now on fixed incomes have to dig into their pockets to pay the cost of an ambulance from the Erickson hospital either to Minnedosa, to Shoal Lake or to Brandon. Those are significant costs and I want to demonstrate to the Chamber today what happens. Mr. Speaker, a patient comes into the Erickson hospital and has to be transferred to a facility because there are no acute-care emer- gency or on-call services in Erickson. That person is loaded into an emergency services vehicle, an ambulance, and is taken to either Minnedosa or Brandon.

Once that initial pro- cedure is done to that patient and that patient is ready to convalesce, that patient is then loaded back into an ambulance and is taken back to the Erickson hospital to recuperate. If a compli- cation arises, that patient is once again loaded into an ambulance and is taken back to either Minnedosa or to Brandon and then once again is transported back by ambulance to Erickson.

I ask whether it is reasonable for any Man- itoban or any person in government or any person in authority to expect that that single individual has to pay for every one of those trips that are taken on his behalf by an ambulance. So, Mr. Speaker, I sa y to the Government that, in fact, if medicine is moving this way in rural Manitoba, we had better have a serious discussion with the people in those communities as to what they should expect for health care for them and their families in the future. In my view, that kind of approach is unacceptable. It is not acceptable to close the facility.

It is not accept- able to have people without those essential services. Those services have to remain. Yes, I think all of us understand that they cannot be at the level that services are in Winnipeg or in Brandon or in the large centres, but those very essential and fundamental services of emergency care and on-call service when an emergency arises have to be protected and have to be aintained in our communities. m I know that the rural population is declining. I know our rural population is getting smaller.

If you look at the Erickson situation, and I use Erickson again as the example because it is an anomaly to rural communities. This is a growing region, Mr. Speaker. If you look at the Clear Lake area, the Onanole area, the Crawford Park area, the Lake Audy area, those are growing communities. There are more than 45 000 people in that area during the summer months. In addition to that, the First Nations communities of Rolling River and Keeseekoowenin are growing communities. These are communities whose populations are young and whose populations are growing. Mr.

Speaker, we go back to what Health Canada has to say about Aboriginal health. Although in Manitoba, they make up 10 percent to 12 percent of our population, the demands that they have because of their health issues on the health care system are beyond that, at about 25 percent of the health care budget. That is a reality. Is it good? No, it is not good. It is a reality and a challenge that these people face. This morning we heard on the steps of the Legislature about the problems that First Nations people have in dealing with such things as diabetes and dialysis that are required.

You know, when these people, when their members happen to go into shock, that facility has to be near to them. It cannot be an hour away from their community because people will not live.

634 LEGISLATIVE ASSEMBLY OF MANITOBA September 16, 2003 Many people will die before they get to those facilities. For that reason, Mr. Speaker, we think this is a matter that needs some debate in this Legislature. I am happy to hear the words of the Minister of Health and the First Minister with regard to a commitment to keep those facilities open. That message has to go loud and clear to the regional health authorities. I think the region- al health authority is acting as an agent of the Government. It is.

The members of the regional health authority are appointed by government, as they were in our term of office. Mr. Speaker, therefore, they are acting on behalf of the Minister of Health, carrying out the health policies of the Government. Something has gone awry here. The regional health author- ity, the CEO Penny Sorensen has been quoted in the papers saying that there are about 20 facilities too many in that region. The people in those communities do not think that those are surplus facilities.

When I go into any one of those facilities, whether it is Birtle, whether it is Rossburn, whether it is Erickson, any one of those, whether it is Hamiota, the waiting rooms are full of people. The doctors are busy, the nurses are busy, the hospital beds are being used to meet the needs of people in those areas. Mr. Speaker, we all try to be efficient and try to find efficiencies in the system. All of us have different approaches to that. That is a reality. We have to do that.

We should make a concerted effort and a commitment to all Mani- tobans that we will provide the best possible care we can to every citizen in this province. Every citizen in this province will have as much access to health care as any other citizen anywhere else in this province. Mr. Speaker, we have talked a lot in this Chamber about the cost of transportation of patients to hospitals. This has been an issue for me for many, many years.

Those costs are escalating to the point where people on fixed incomes cannot afford them. * (14:50) In northern Manitoba, the Government saw fit to take that $50 charge for a patient getting on an ambulance to come to Winnipeg, they took that off. They said that is not fair for northern Manitobans to pay. The Government took that fee away. Yet, in the rest of rural Manitoba, a patient getting into an ambulance on the west side of the province has to pay the full charge of transportation from that side of the province to a facility either in Brandon or in Winnipeg. Mr. Speaker, that is an issue we have to address.

There are ways around that. If, in fact, people have to pay for those services, then I say we better start looking at different ways of transporting people, like the stretcher service that we have talked about and debated in this Chamber. Therefore, if the Government wants an example, if they want a probable solution to reduce some of the costs to individuals, then I say keep the hospitals open and implement a stretcher service that can transport patients that are not critically ill in a far cheaper way than they do today. I see my light is flashing. That means I am coming to the end of my comments.

I only ask that members in this Chamber join me in supporting our rural communities and making sure the facilities remain open. Introduction of Guests Mr. Speaker: Prior to recognizing the honorable First Minister, I would like to draw the attention of all honourable members to the loge to my left, where we have with us Ken Krawetz, Member of the Legislative Assembly for Canora-Pelly con- stituency in the province of Saskatchewan. On behalf of all honourable members, I welcome you here today. * * * Hon. Gary Doer (Premier): Mr.

Speaker, first of all, it is certainly important that we talk and listen today about the concerns of the various facilities that are represented here at their Legislature and here before this Assembly. Let me start with the macro situation. In terms of rural health care services, and I mentioned this in Question Period, we have increased the number of doctors in rural

September 16, 2003 LEGISLATIVE ASSEMBLY OF MANITOBA 635 Manitoba, including southwest Manitoba. We have increased the number of nurses. We have increased the enrolment in medical schools and in the University of Manitoba from a cutback that took place in the early nineties that has resulted in a lack of graduates. [interjection] Perhaps each of us could speak without interruption and not be so rude in our debate on such an important item. Perhaps the rudeness could end and we could have an intelligent debate. Mr. Speaker: Order. I am sure all members who wish to have their input will have the oppor- tunity.

The honourable First Minister has the floor. Mr. Doer: Mr. Speaker, the enrolment that was decreased in the early nineties has been in- creased. We are increasing again in 2004 to try to stem the flow of doctor training and have more doctors recruited and retained in Manitoba. There are challenges. There is no question there are challenges. When members opposite cite the example of 33 doctors that have left southwestern Manitoba, that is true. That is why the Minister of Health (Mr.

Chomiak) has asked Doctor Cram to look at the issues of the relationship between salaries, working con- ditions, including on-call conditions, on the ability to keep doctors. When we saw the other day from Rivers, Manitoba, a doctor saying it is the on-call conditions that really concern him or her, why they could stay in a community, then I think we have a responsibility not to just use political rhetoric but to also look at ways to solve this problem.

We also knew in the past that many young doctors and new doctors were concerned to go to rural Manitoba because they were concerned about being out of the technological loop. One of the solutions to that has been to use more telemedicine. We have more telemedicine sites now in Manitoba on a per capita basis than any other province in Canada. Also, we have to recognize that it is funding for health care that ultimately will be able to keep our hospitals open, because 80 percent of the costs are nurses and doctors, and the other 20 percent are for heat, light and drug costs.

When members opposite promised in the last election campaign to have 1% funding for health care for the regional health budgets and we, in turn, have put 7.5 percent in the southwest region into funding this year, they have a moral respon- sibility to tell us where they are going to cut 6.5 percent; what hospitals they are going to close; what nurses they are going to fire; what doctors are not going to be hired. They cannot have it both ways. They cannot have it both ways, because the public is too smart. The public is too smart. I have had the opportunity to meet with the residents of Erickson just last May.

I had the opportunity to meet with residents of Rivers at the end of May last year and I have met with people in Erickson before, because we were involved in the capital plan for the Erickson hospital back in the mid-eighties. I was on the committee with the former Minister of Health. I think the former member for Minnedosa opened that hospital in '88, in probably June of '88, if I remember correctly, beca use we had authorized the money to build that hospital before then when we were in office in Cabinet. The member is right. Erickson's area is growing.

It is even growing further when you look at the tourism numbers, the quarter million numbers of people that visit that spectacular federal park that is just adjacent to those com- munities. We recognize that is a very, very important medical need that must be met with the recruitment and retention of doctors. I have also had the opportunity to meet with people in Rivers.

They were quite worried about the shortage of doctors and the situation dealing with the new economic and capital investment in the Brandon regional hospital, an economic investment, I might add, that will have a lot more out surgery and day surgery and will have an MRI machine, a few miles away from Rivers in terms of people that will not have to go to Winnipeg but will have that service in southwest Manitoba. I did commit that acute care facilities would remain in Rivers. The Minister of Health knows that before I went to that community I sought his advice before the questions were posed to me.

636 LEGISLATIVE ASSEMBLY OF MANITOBA September 16, 2003 The specific situation of Wawanesa, they have had a turnover of doctors. There is one already for the community to deal with the short- age. I know the Minister of Health, who now has nine doctors more in this region than when he came into office, will continue to work with the community, with the medical experts to try to fill that gap.

When the Minister of Health says to all of us that we are going to have to deal with this issue of on-call and our ability to recruit and retain doctors, I will defer to the opinions of Doctor Cram on the best advice he can provide to the Legislature. Mr. Speaker, let the people of the com- munities know that our budget today is 7.5 percent for southwest region. We came into office, it was 2.5 percent. The doctors that were in a decline are starting to increase, but not always in the places where we need them and the nurses we are training and will continue to train are in higher numbers. The equipment is more.

The surgeries we are performing outside of Winnipeg. Even making common sense decisions, the members opposite were involved in making a decision to have a separate med technologist and a lab technologist. We listened to rural Manitoba people and they said: Combine those positions like you did before because it is easier for us to recruit and retain one person than try to retain two half-people. We are taking that advice now in our training programs to make sure we can deal with some of the challenges in rural Man- itoba Mr. Speaker, we are not saying that rhetoric will solve the problem. Funding will solve it.

Training will solve it. Recruitment strategies will solve it. Listening to the people in the com- munities will be part of the solution, but also listening to the professionals that we have to recruit and retain will be part of the solution. I would ask members opposite to join us with this study that Doctor Cram is going to perform because he will be giving us some advice from the straight lines, direct lines of doctors. As a medical practitioner in Souris, Manitoba, I think we can all in this Legislature learn from the recommendations he will make.

In the interim we will continue to work on recruiting and retaining professionals for those communities. We know people in the communities are legitimately concerned. The hospitals and the programs hospitals produce to patients are the most important services the provincial govern- ment provides. We know how important it is for people. I particularly know how important it is for elderly people in those communities and their ability to retire in those communities with comfort and security, and also the ability to attract businesses to communities knowing there is an infrastructure there.

I am pleased to put my words on the record here today and I want to thank the members that visited, traveled long distances to come to this Legislature. I want to thank them for their efforts to be here today, and I wa nt to respect their right to stand up for their communities. Thank you very, very much. * (15:00) Mr. Stuart Murray (Leader of the Official Opposition): Mr. Speaker, indeed, this is a very serious issue. I think the fact that the House agreed to ensure that all members had a chance to speak on this issue shows how serious this issue is to Manitoba.

We saw a number of Manitobans in front of the Legislature today who are concerned for the obvious reasons, that they have no confidence in this Government to ensure that they have a rural hospital or a hospital in their community that will be there when the community needs that hospital. I think what we saw and heard on the steps of the Legislature were communities that were asking for this Go vernment to listen to them, to listen to their concerns, because after all they are the people who know best as to what is going to happen in their community. I am somewhat concerned when the Minister of Health (Mr.

Chomiak) goes out to address that group. Yes, I applaud the minister for taking the time to address them, but what did he say to them? What was his mess age? I think what we heard time and time again from our Minister of

September 16, 2003 LEGISLATIVE ASSEMBLY OF MANITOBA 637 Health is that, frankly, he does not have a clue. He does not have a clue what to do. The First Minister says, well, we should not have any rhetoric in this debate. That is all we heard from the Health Minister. There was no plan, no sense of decisiveness, no sense of com- mitment to those people who got up early this morning simply to come in and say: We know we have a problem and we know that this Government, the Doer government, said time and time again: We have no intention of closing any rural hospitals. What happens?

Wham, the Erickson hospital is closed. Mr. Speaker, we hear from one side of the regional health authority they have a set of rules. They talk to the communities about their mandate and their set of rules. Then, and not surprising, not surprising coming from the Doer government, the minister comes in with yet another message. So there is another set of so- called rules. The communities are simply saying to this minister, who has the ultimate authority and the constitutional right to deliver health care to all Manitobans, all they are saying to the minister is: Please, Minister, do the right thing.

Tell the regional health authorities that we must ensure that our regional hospitals remain open in our communities. It is not so much for the health of the community in terms of the hospital, it is the importance, the signal it sends to the health of those communities as a w hole. What are they to believe if they need to count on a hospital. I find it fascinating that once again we look out on the front steps of the Legislature, and what do we have?

Hardworking men and women from rural Manitoba, First Nations people, that are forced to get up at the crack of dawn and get on a bus to come into Winnipeg to stand in front of the Legislature so they can try to get the attention, the ear of the government of the day. I say, shame on the Government for not going out to their communities and listening to them in their communities. Why is it, when there are issues in rural Manitoba that they always have to get up at the crack of dawn and get on a bus and come into Winnipeg so they can get the ear of the Doer government? We saw that with the BSE issue.

We see it now with respect to rural hospitals in communities and First Nations. They have to come in to Winnipeg to get the ear of the Doer government. That is not what government should be about. Government should be about going out into the communities where the problems are and listening to those people. Why? Very sim- ply, because the people in those communities are the ones that know best. They know the chal- lenges they face. We heard the First Minister say there are challenges in retention of doctors in rural hos- pitals. We understand that. What is the answer then?

Is it to turn your back on those com- munities, shrug your shoulders and say: Well, we are doing the best we can? Can you imagine if those people in rural Manitoba that fight to keep rural Manitoba strong, if they took that kind of a weak-kneed, spineless approach every time they got up in the morning, what kind of a province would we have? What kind of a province would we have if those people in the morning, when they got out of bed, did not say, yes, there is a challenge. Yes, there is a challenge and a mountain to climb, but we are going to climb it. We are going to get to the top of that mountain.

That is not a challenge that we are going to turn our back on. It is a challenge that we are going to solve, but we do not hear that from this Doer government. We hear blaming. We hear blaming the previous government. We heard today in this Chamber, of all things, the First Minister standing up and blaming the Leader of the Liberal Party because something that happened when the previous Tory admin- istration was in. We did not hear the then-Leader of the Opposition at that time. We never ever once heard him stand up and say, yes, it is tough for the former government to make decisions because of the cuts.

They blamed and they blamed and they blamed. The people at the steps of the Legislature were simply asking for a commitment and a solution to a problem that this Government does

638 LEGISLATIVE ASSEMBLY OF MANITOBA September 16, 2003 not have, apparently, a clue on. If it comes to blame, they are the experts. They are the experts right across there when it comes to blame. But, when it comes to solutions, we hear nothing. We hear from this Government lots of press releases, lots of comments on the steps of the Legislature from the Minister of Health, lots of comments from this First Minister. At some point, that government across the way is going to understand that you cannot govern on words alone. People are going to be looking for some form of action, some kind of a plan.

I hear chirping from the other side, what should we do? I will tell you what to do. Do not close the rural hospital. That is what you should do. Do not do it. That is what you should do. I hope that they will listen to the rest of my comments. We all know that this is a very serious issue. Mr. Speaker: Order. Mr. Murray: I was waiting, Mr. Speaker, be- cause I thought by chance and with my fingers crossed that that might have been something that was, as the First Minister said, maybe an intelligent comment coming from that side. I am sorry that it was not.

We find today a situation where rural Manitobans once again, as we have seen with this entire BSE debate, we have seen a govern- ment that has completely dropped the ball. Now we find a situation in rural Manitoba with respect to the rural hospitals, we see exactly the same situation. What does it boil down to? Very simple, it is a very simple problem. Rural Man- itobans under the Doer government up until the last election were treated like second-class citizens. After the election of this Government, they continue to be treated like second-class citizens. I say, shame on that Government.

People of rural Manitoba need a better deal from this Government. This Government should do better for the people of Manitoba. This Government should do better for the people that are out in rural Manitoba, the people that came here today. I believe, and we said it out there, that we will stand shoulder to shoulder with those people that came, that large crowd that came and stood at the steps of the Legislature from all parts of rural Manitoba. We will stand shoulder to shoul- der with those people and ensure that not one rural hospital is closed.

We will ensure that those people get the same kind of treatment as the people in Winnipeg and Brandon get. If this debate is not about equality of health care, access to equality of health care for all Man- itobans, then I think they have missed the point once again. Clearly, we are here talking about access, equal access to health care throughout Manitoba for all Manitobans. I would just like to remind the government of the day that when they stand up and say they are not perfect, you do not have to tell us. You do not have to tell the people who were out in front of the steps of the Legislature.

But they are looking for an answer, a commitment, a com- mitment from this Doer government that there will be no closure of rural hospitals. On behalf of all of those people who were out there, I would like to be able to say to the Doer gov- ernment, it is the least they can do. So we stand and support those people, Mr. Speaker, because it is the right thing to do, and we would ask the Government to do the right thing and ensure that not one rural hospital is closed. Thank you very much. * (15:10) Hon. Dave Chomiak (Minister of Health): Mr.

Speaker, as I said, on the steps of the Legislature today–and it is interesting that the Leader of the Opposition (Mr. Murray) should say that this is not a question of rhetoric. I do not think I heard anything but rhetoric and rhetorical flourishes during the entire course of the member's state- ment. Not a single policy issue was discussed. All I heard was rhetoric and the question of blame. No rural hospital has been closed, but there are all kinds of discussions. Mr. Conrad Santos, Deputy Speaker, in the Chair

September 16, 2003 LEGISLATIVE ASSEMBLY OF MANITOBA 639 When the plan came forward in 1999, put in place by members opposite, to close five of eleven hospitals, put in place by members oppo- site, we rejected it, Mr. Deputy Speaker. We said we were not going to do what the Member for Emerson (Mr. Penner) wanted and what his Cabinet wanted. We rejected it. We said we are going to try to keep rural hospitals open, and we have over the past four years, Mr. Deputy Speaker. We put in place resources that had not been put in place over the past decade. Where was the Member for Russell (Mr.

Derkach) when 15 ph ysicians were reduced in the class of physicians in Manitoba in 1993 and 15 in '94 and 15 in '95 and 15 in '96 and 15 in '97 and 15 in '98 and 15 in '99? Where were the members opposite when they cut those classes? Those doctors, 120, would be practising today. We came in and we put in 15 new positions for doctors. We put in a program that gives bursaries. Over 200 students have taken advantage of bursaries to practise in rural Manitoba. Where were members over 11 years when they cut and slashed and moved doctors out of this province? Mr. Deputy Speaker, the facts speak for themselves.

Members opposite talk about doctors. More doctors are practising in Manitoba today than in 1994. You know, members op- posite, when they closed Gladstone emergency, ER never asked for a rally here at the Legislature at that time. They said it was a temporary closure, and it is still "temporary closure" until this day affecting a large region and a large area. We are trying to remedy that, as we have in Erickson. When in 1999 Erickson closed temporarily, it reopened. In 2001 when it closed temporarily, we reopened it. Now we are trying to do the same, Mr.

Deputy Speaker, but for members opposite to talk about a grand scheme is totally inaccurate and inappropriate. What have we done in rural Manitoba? For the first time in history, to members opposite, we have taken surgeries and moved them back to rural Manitoba, something that did not happen over 11 years. Steinbach, Ste. Anne, Thompson have additional surgeries, Mr. Deputy Speaker. They never had them before. Mr. Deputy Speaker, we have put actions in place. Yes, it is a challenge. Yes, it is a problem. Yes, we work on it. We did not close hospitals. We do not intend to close hospitals.

It is a hallenge to keep doctors on. c Let me quote from what a doctor said in Rivers, Manitoba, a doctor who is leaving: The sleep deprivation and time commitment required has stressed out the doctor and his family so much that if I do not do something right now, I might lose them. He has even taken a pay cut to move, but it is worth it because you do not have to do any on-call work. Mr. Deputy Speaker, the one and two on call has been a problem, and we have tried to address it. We have some of the highest rates for on call in the country.

Yes, we can get doctors in to do on call, but, no, they will not stay over a long period of time because they are burning out. One of the solutions is a larger on call, a larger breadth of services to deal with physicians. If the issue is retention, if members are truly interested in retention, then we have to take measures to retain doctors. The members opposite–we appoint a local doctor. We appoint a Manitoba doctor to give us more recom- mendations– Mr. Mervin Tweed (Turtle Mountain): Sham. Mr. Chomiak: – and members opposite, the Member for Turtle Mountain calls it a sham.

That is part of the problem of taking an issue that affects all of us and all Manitobans and turn- ing it into a political football, not allowing for proper and adequate solutions. We cannot put in place the solutions if we do not have the co-operation and commitment, which we have tried to do. But, no, the Member for Russell (Mr. Derkach) says that Erickson is going to be like a northern medical unit. First of all, I do not think any members opposite have ever traveled to a northern medical unit. I am not sure if they know what services go on in a northern medical unit. That is not what Erickson is all about.

Erickson's ER is closed now. The hospital is open. There are people in beds right now in Erickson. We are trying to recruit another doctor.

640 LEGISLATIVE ASSEMBLY OF MANITOBA September 16, 2003 Now members opposite say, from one region: make our doctor a priority, another area: make our doctor a priority. I cannot promise all of them that their particular doctor will be the No. 1 priority. I have said we are going to prior- itize. I have said we are going to hire, and we have; 47 new doctors have come in. Yes, 33 have left over the past four or five years. Part of it has been that issue of on call.

That is why we have asked Doctor Cram, a long-time doctor who has worked and lived all of his life in rural Manitoba, to give us some remedies, some solutions and some immediate things we can do to help to improve the situation. Members opposite have a tendency to be over the top rhetorically. Everything they say is over-the-top rhetoric. It does not matter what happens. Now, it is the claim that we are abandoning rural Manitoba, notwithstanding, I might add, the first MRI in the history of Manitoba outside of a hospital. Three new CT scans in rural Manitoba. Repatriated surgery to rural Manitoba.

More doctors in rural Manitoba. Nurse training programs in rural Manitoba that members opposite over 11 years only dreamed about. In fact, members opposite over 11 years cut those programs. When we brought back the diploma nursing program, there was a rally on the steps of the Legislature. Members opposite were opposing us in bringing back the diploma nurses program. Now that we are training more nurses where are those naysayers now. That is the problem. We bring back programs. We try to improve the situation and members go over the top. It is always over the top. We have said Erickson has been a problem.

We are trying to recruit in Erickson. We will try to recruit in Erickson. We managed to do it in 2001. There are other communities that members have not even mentioned where the ERs have been in danger of closing. We have worked long hours to keep those ERs open and we have managed to do it. We are going to continue to do it, but I have to admit it is a challenge. It is difficult. Even though we have more doctors in rural Manitoba, it is difficult to keep them on call. It is a challenge th at we are going to face. Hopefully, Doctor Cram will have some sug- gestions for us.

The commitment to rural Manitoba is so clear. I just want to contrast it. In 1999 when we came to office, members opposite had a report that said: close hospitals. We rejected that report. I remember the very member standing up and saying: you are going to close rural hospitals. We had the same debate four years ago, the very same debate with some of the very same mem- bers that I am looking across at right now. They accused us of closing hospitals. I said, this is your report. This is your report. We reject it.

We fought against that tendency for four years and we are going to fight against that tendency for the next four years. We want to keep all of our rural facilities open. Our rural facilities will stay open. I have to acknowledg e there are challenges, there are difficulties and there are problems. I cannot guarantee 100 pe rcent any more than members opposite can guarantee 100 percent, even though their actions and words now are totally different than the way they acted for 11 lean years.

If we had those doctors they cut, if we had those nurses they cut, if we had those lab techs they cut, if we had those radiologists, radiation therapists they cut, we would be in a much better position. Let us talk about what has happened in rural Manitoba. I was there at the Beausejour hospital opening. We are doing Swan River. We have expanded Steinbach. We opened Boundary Trails. We have expanded a clinic in Boissevain. The list goes on and on. Let us take a rural area like Steinbach, the ones members opposite ignore. We put more surgeries into Steinbach. There is more develop- ment going on there.

How can members opposite with any sense of intellectual integrity suggest there have not been initiatives in rural Manitoba? What about the nurse training programs that are in rural Manitoba that were not in place? What about the bursary program that is in rural Man- itoba? What about the IMG program? For 11 years, doctors who were trained outside of Man- itoba were driving cabs and working and not having jobs as doctors. We put in place the first program of its kind to recognize IMGs. When the doctors go to rural Manitoba–members oppo- site are saying, oh, thank you.

They are saying thank you in their own communities. They do

September 16, 2003 LEGISLATIVE ASSEMBLY OF MANITOBA 641 not come back here and say thank you. I do not expect that. * (15:20) There are 10 students in training to come out January 1st that were international medical grad- uates that can go into rural Manitoba. There are doctors we are recruiting right now to go into rural Manitoba. I know there are problems– [interjection] Well, Mr. Deputy Speaker, the member opposite–again, it is over-the-top rhet- oric, over-the-top reflection.

Every time we go out to rural Manitoba and open a facility, mem- bers opposite stand up and say: This is great, this is what is going on in this Government, and then come back here and give over-the-top rhetoric about, whoa, a happening in rural Manitoba. Yes, there is a challenge. Yes, we are going to meet it. Look at our record over the past four years. If you will look at the record for the past four years, it has been more doctors, it has been more nurses, it has been more services offered right around the range of rural Manitoba, and there is more to come.

We have already said that our efforts to expand surgeries in rural Manitoba are–we are going to be doing more of those services in other regions of Manitoba to get more surgeries back so Manitobans do not have to travel further, that they can do it in their own community. That is what is happening with the CAT scans in rural Manitoba. That is keeping people in their own communities. One of the issues is to keep and maintain doctors in rural communities. One of the ways you do it is with diagnostic and with equipment. We have committed millions of dollars.

There is more commitment to come with respect to rural Manitoba to keep individuals, to keep doctors, to keep professionals in those facilities and to keep up their skills. I do not know if there were any Telehealth sites when they were in office, but there are now 23 sites. I see my time is gone. I hope members opposite will look at the facts and will deal with the facts accordingly. Thank you. Mr. Jack Penner (Emerson): Mr. Deputy Speaker, I am always intrigued by the Minister of Health, how he portrays himself and his Gov- ernment.

I found it rather intriguing that he sort of turned the rhetoric to talk about the report that we commissioned on health care and then he said we rejected it. We did reject it, Mr. Health Minister. We did reject that report that stated a number of things, and the minister knows that full well. I am somewhat surprised that he is trying to portray that issue to the general public that appeared here today as something other. That is typical of this minister.

The minister fails to say that the previous government probably built better than a half a dozen new health care facilities in this province, including Boundary Trails, including Altona, including Vita, including Erickson, and the min- ister is right, they did start Erickson. We give them credit for that. But did we cancel that contract when we came into government as the minister did in Emerson? Emerson was slated for a brand-new hospital in 1999. When did the election occur and who took over government and who cancelled the Emerson Hospital?

The town of Emerson spent a hundred thousand dollars buying property to put a brand-new facility on. What happened to that hundred thousand? Well, that debt was incurred by the people of the town of Emerson, and no mention made of that in the minister's remarks. They closed that. Not only did they not build the new hospital that was scheduled, was in the budget that they took over. It was in the budget. He cancelled, this Minister of Health, that portion of the budget, $4 million worth of cancellation in the budget of health care to southern Manitoba.

That is what has happened to health care in rural Manitoba time and time and time again. I want to say this to the minister: Mr. Min- ister, you are forcing the transportation of acute care patients, such as heart attack victims, miles. I give you one example: Mr. Ray Culleton [phonetic], who lives in Wampum, extreme southeast Manitoba, he called the Vita hospital, a

642 LEGISLATIVE ASSEMBLY OF MANITOBA September 16, 2003 brand-new facility built by the Tories. He called that hospital, or his wife called, and he was told this: I am sorry, we cannot send an ambulance because we do not have staff to send with the ambulance to take care of a heart attack victim. It was fortunate that Mr. Culleton's [phonetic] wife works in Roseau, Minnesota, at the doctor's office. She called that doctor and said: Doctor, my husband is having a heart attack. Can I bring him into Roseau? The doctor said: Immediately. This is American medicine. The doctor said: Imme- diately.

The doctor examined him and said: You have to get immediate surgery, sir. In order to save your life you need immediate surgery. That doctor called Vita hospital: Can you send the ambulance out of Vita? And was told again: Sorry, we do not have staff to put in the ambulance. There is not enough staff here. The Roseau doctor said: Mr. Culleton, [phonetic] I am going to send you by American ambulance to Winnipeg. They sent him to Winnipeg and within a couple of hours he was on the surgery table and they saved his life. You know what the cost was to Mr. Culleton [phonetic]? $3,028 U.S.

Now do we have free medicare in this province or do we not? Do you think, Mr. Minister, that you might want to say to Mr. Culleton [phonetic]: We will only charge you the difference. We will only charge you the American rate and the health care system will pick up the balance. Well, we tried that, Mr. Minister, and do you know what your response was? Your response was, through your health care agency in south- east Manitoba: You are on your own, sir. You pay the bill. Now is that tough talk or is that tough talk? But that is the truth. You can call Mr. Culleton [phonetic].

I will give you the phone number if you want, sir. He lives at Wampum. The interesting thing is the reason we looked at Emerson for a new facility was this: Emerson is right on a four-lane highway close to one of the largest customs ports in western Canada. More than a thousand trucks a day cross that border and numerous thousands of cars. The traffic is immense. This minister saw fit to see to it that if and when difficulties occurred on that transportation route there would be no first re- sponders.

He pulled the services and he pulled the acute care service out of a hospital that if and when an accident does occur, they have to be put in an ambulance and taken either to Winnipeg or to Altona or Boundary health care services. Now, is that what the minister calls the kind of services–these are the kinds of things that the people from Erickson and from Minnedosa and from the rest of the province and Riverton were here today to say to the minister, they said: Look, Mr. Minister, we need to keep our health care services in our communities. That is all they asked for. Let us keep them.

They did not ask you to build a new one. Mr. Minister; they pleaded with you and they begged with you, but you are not listening. All the Member for Dauphin (Mr. Struthers) does is natter in the back seat. I think it is time that we paid some attention. I know the Premier (Mr. Doer) got up and indicated that the people of rural Manitoba were too smart. Well, I think they are too smart. I think they are too smart to listen or try and give reason to the rhetoric, the false rhetoric, Mr. Deputy Speaker, that the Premier, again, put on record.

I think it is time that this minister, that this Premier and the minister become absolutely honest with the people of Manitoba. If you are going to close the facilities then tell them you are going to close them. Do not tell them you have to change the services. Tell them you are going to close them as you did in Emerson. * (15:30) The two gentlemen from Emerson that were here today put it very clearly to the group that met in our caucus. They said: Do not let your community suffer the fate that Emerson suffered. He congratulated the group from Erickson, Riverton and Rivers that were here today, and

September 16, 2003 LEGISLATIVE ASSEMBLY OF MANITOBA 643 from Minnedosa. I think he said this to them. He said: Do not let the minister close your facility. Take action before they do it. I think that was a strong message from a community that has lost its services, where heart attack victims are now put in the backs of ambulances instead of into an acute care facility that can treat them. The First Nation Anishinobe at Roseau, Manitoba, just eight miles from Emerson, have to be put in ambulances now and transported to Winnipeg or Morris or to Altona or to Boundary Trails.

They cannot use the facility that is closest to them. Eight hundred people living on that First Nation community and they cannot access the services any more. I think it is shameful that this Government is trying to portray itself as the saviour of the health care industry. I want to say this in conclusion. Mr. Min- ister, you graduated 400 some-odd nurses in this province this year. You were very proud of that graduation class. How many of those nurses were hired as full-time staff?

I am told that the unions are telling you, sir, that there are better than a thousand nurses working in this province today under union contract part time that need two to four jobs in order to make a living. What kind of a health care system are you running when you force your nurses to go get three other part-time jobs so they can feed their families? Mr. Deputy Speaker: The honourable mem- ber's time has expired. Hon. Drew Caldwell (Minister of Family Services and Housing): Mr. Deputy Speaker, I am very proud to stand in this Chamber as a member of the Legislative Assembly from western Manitoba.

I am very, very proud to be standing in this Assembly being a colleague of the Minister of Health (Mr. Chomiak) for Manitoba, who is recognized in this country as the finest Minister of Health in Canada today. Mr. Deputy Speaker, this Chamber has heard a lot of rhetoric. It has heard a lot of chirping, some heckling by members opposite on a number of issues. The Premier mentioned that Manitobans, rural Manitobans, urban Mani- tobans, Manitobans are too smart to be fooled by the rhetoric, too smart to be distracted by political hyperbole.

I think we saw that in the result of the election in June where members on this side increased their majority by four seats, including seats in rural Manitoba. I think Manitobans understand that through- out the 1990s, certainly, western Manitobans understand, Mr. Deputy Speaker, throughout the 1990s that people, citizens in western Manitoba were very ill-served by the members opposite when they were in government.

Seven times there was a promise of a regional health centre, the first regional health centre to be established outside of the city of Winnipeg to address issues of transportation of ambulances from western Manitoba into the city of Winnipeg, to address issues of diagnostic services that people have to come to Winnipeg for, to address the absence of surgical support in western Manitoba that forced folks to come into Winnipeg for. Mr. Deputy Speaker, seven times a regional health centre for western Manitoba was prom- ised and committed to. Seven times that promise was broken.

It took a change in government for the 200 000 souls in western Manitoba, south- eastern Saskatchewan, the Parkland region to achieve the establishment of a regional health centre, the first one outside of the city of Winnipeg.

In relation to the regional health centre, I should add that last week my colleague, the honourable Minister of Transportation and Gov- ernment Services, turned the sod for the first magnetic residence infrastructure, MRI facility, outside of the Perimeter Highway in the pro- vince of Manitoba to address the very real diagnostic needs of western Manitoba citizens, Parkland citizens, sout heastern Saskatchewan citizens indeed, because all Manitobans, indeed, all people in this province deserve to have close at hand the best infrastructure, the best health care infrastructure they can possibly access.

That promise that was made first in the late 1980s by the members opposite, most members opposite–the member from, I am not sure what city he represents, the Leader of the Opposition, an urban seat, made that commitment back in the eighties. Again, it took a change in government to achieve a regional health centre in western Manitoba, an MRI facility in western Manitoba, to address the very needs that we on this side of

644 LEGISLATIVE ASSEMBLY OF MANITOBA September 16, 2003 the House have recognized have gone wanting for over a decade, to address those needs of western Manitoba citizens. So, Mr. Deputy Speaker, I am very proud to be part of a government that just does not talk before an election, does not make commitments, cynical commitments before an election, that does not just talk but actually acts to build regional health centers, acts to create MRI facilities outside of the city of Winnipeg.

One thing that has always been curious to me as well, has been very curious to me as a Westman MLA, why rural MLAs considered to support the family comp act in Charleswood and Tuxedo, the beneficiaries of the sell-off of the Manitoba Telephone System that directly affected and impacted negatively every single rural Manitoban, it is a mystery to me why we have rural MLAs that support the family compact in Charleswood and Tuxedo. We all know, Manitobans all know who those families are. You could follow the money directly back to them.

During their time in government, a thousand nurses were fired in this province, a thousand nurses gone during the member's time in office, the dark, dark days of the 1990s. That is not to diminish that there are many health care concerns and health care challenges in Manitoba, indeed in Canada. There are many, many chal- lenges.

It is how one addresses those challenges, whether by making promises and then failing to follow through after an election or making com- mitments and following through, building re- gional health care centres out in the province of Manitoba, building MRI facilities, restoring nurse training programs, restoring doctor, health, medical positions. You know, the Tories, during the 1990s, cut the medical spaces available at the Faculty of Medicine at the University of Manitoba from 85 chairs to 70 chairs. They cut the number of doctors graduating in this province by some 120 doctors.

So this indignation that we hear from the Member for Turtle Mountain and other indignant comments by MLAs from rural Manitoba about what a terrible situation we are in, in the province of Manitoba, well, they should know, because they are the architects of the health care system that this Government inherited in 1999. They are the architects of the nursing shortage, they are the architects of the medical school shortages. We are building.

It takes four, five, six years to build infrastructure in terms of a $70-million regional health centre in Brandon, in terms of a $7-million MRI facility in western Manitoba to serve the citizens of Wawanesa, to serve the citizens of Souris, to serve the citizens of my home community, where my family is from, Pipestone, Reston. All of my family, all of my friends, all of my communities and constituents, which includes all of western Manitoba, prior to this Government for every medical service of any degree of severity had to come to Winnipeg.

When the Brandon Regional Health Centre is up and running, when the regional health centre is completed outside the city of Winnipeg, the first time in the province's history, that will end when the MRI is up and running in western Manitoba.

When increased numbers of doctors– that we have put into place, in terms of funding seats at the University of Manitoba Medical School–come on stream, we will have more Manitoba medical professionals in the system, Manitobans born, raised and educated in Man- itoba to serve their home communities. * (15:40) We had last year the largest graduating classes of nurses in decades, in contrast to the thousand nurses fired by members opposite, the programs cut.

When you cancel medical chair positions at the Faculty of Medicine, when you cancel nursing programs at the colleges and universities, it does not take a rocket scientist to understand you are going to have a shortage and a crisis in the medical system. The architects of this crisis sit across the Chamber from us on this side of the House.

We have been working diligently each and every day to begin to address the crisis that was be- queathed to the citizens of Manitoba as a consequence of–I am speechless to describe the policies that were put in place by members opposite, other than to say they were disastrous, detrimental to every rural community, every urban community, every Manitoban citizen in

September 16, 2003 LEGISLATIVE ASSEMBLY OF MANITOBA 645 terms of health care. We do not have to look far to see that pundits across this country, com- mentators across this country are now recogniz- ing Manitoba as a leader in Canada in terms of restoring health care excellence to our province. Mr. Tweed: I find it ironic that the Minister of Family Services (Mr. Caldwell) talks about caring for the people of Manitoba. Yet, when he was asked a question in the Legislature about how many people or producers he had met during the latest BSE crisis, he could not name one person.

It certainly speaks to his dedication to the people that he so-called represents. It is interesting that we had a history lesson here today. The Premier (Mr. Doer) got up on his feet and talked about the cuts of the nineties that the federal government imposed on prov- incial governments across Canada. Actually, he even started to put some numbers out and he was talking hundreds of millions. Then we get the Minister of Health getting up and contradicting, saying: Well, no, this Government did all the cuts, because they were the ones that lost the money from the federal government.

I think they need to sit down together and at least plan a strategy that is coherent and co-ordinated in the sense of what direction they are going. We all know the federal government in the nineties withdrew hundreds of millions of dol- lars from all provinces and all provinces bore that load. Whatever they had to do, they had to do because of the withdrawal of money. I think it would be honest and integrous of the people across the floor to recognize that fact. It is interesting that we talk about why we are here today.

Why did the people from rural Manitoba come in here today to talk to the people of the Legislature? Why did they come to present their views? Well, it all started in the deep dark end of the night, I presume, in a room somewhere in Brandon and, again, similar to the school amalgamations, a group of huddled Cab- inet ministers and colleagues sat around the table and said: We can save one CEO's job. Think of the money we could save if we just amalgamate Assiniboine, Marquette, Southwest and Brandon. Great idea. Let us do it. It is a great idea. Move forward.

We can talk about the great savings to all the people in Manitoba. Mr. Speaker in the Chair What do we have? We have two ministers who politically engineer ed the withdrawal of Brandon from that document. We have the documents that say that was taken out at the last minute, at approximately 11:30 in the evening on the next morning's announcement. So we know the Government interfered. Why? I think because they could see the problems that were coming with this amalgamation. We know the Minister of Health came forward with the amalgamation with no plan.

He did not come out to the RHAs and say: Here is where we are going. Here is the outline. Here is the plan. No consultation, just do it. That leads us to why people were here today. Obviously, the RHA is too large to manage, or if it is not the minister's message is not getting through to the management of the RHA. He claims he is in constant contact with them. Obviously, they are either not listening to them, they do not care to listen to them, or they have their own agenda and the minister is irrelevant. I am beginning to believe that might be the answer. So we move forward.

We have communities and they talk about not closing a hospital. I do not know what you would call it when you go out and take the "H" off the highway that designates a hospital and rip the post out of the ground at the same time. Like, give me a break. You guys are all common-sense people. You understand when things close, you take the signs down, and that is exactly what you have done. So do not deny it and do not mislead the people of Manitoba in saying that you have not closed hospitals, because you have. We have three doctors resigning in Wawanesa.

Now, would the minister or some- body in charge of the health system not say, you know, gee, 33 out of 42 doctors in the last four years have quit in the southwest region of the province? Why? Would a light not go on and the minister say, and maybe he said it to his LA for Health, go out there an d solve that problem? But, obviously, nobody did. Nobody chose to, and they chose to ignore the problem. Now, we have a group of people that come to the Legislature to present their case to the minister and, basically, what they get from the minister

646 LEGISLATIVE ASSEMBLY OF MANITOBA September 16, 2003 today is lip-service. Do not worry, we are not closing it, we are looking after it, we are talking to people, we are even talking about bringing a doctor from within the same system where all the problems are and saying you review it, you get back to us, tell us what is wrong. Well, I want to read two things. One is the mandate that was given to Doctor Cram.

I can tell the members opposite, many of the people in rural Manitoba are referring to this as the "Cram Sham," and that is exactly what they see it as by this Government covering their butts once again to avoid dealing with the issues that are con- fronting them. The mandate given to Doctor Cram, he will consult and report on rural physi- cian recruitment and retention in the Assiniboine Regional Health Authority. Now I want to read another mandate that has been given to the director for the new Office of Rural and Northern Health.

The office will sup- port provincial efforts to increase the numbers of physicians practising in rural and northern com- munities. It goes on to talk about recruitment and retention. I say to the Government, you are papering this up. You have a $500,000 budget paying a guy to look after the new Office of Rural and Northern Health and now you are hiring, from within, from within your own organization, where you have all the problems and you are saying produce a report and tell me what is wrong. Well, I can tell the Government, and I will be happy to tell them. People are phoning our offices.

Doctors are phoning us. Nurses are phoning us and they are telling us because they fear retribution from the RHA, just as we have people in certain industries that are trying to deal with the Government that are being shut down out of sake of fear are not speaking truly what is on their mind. So you know it is ironic. People come here today to talk to the Government. They say: You know, we do not have a recruitment problem. We have a retention problem. Why are people leaving our communities?

The Minister of Health stands up and says oh, it is the stress of the on call and everybody is leaving because they do not want to work on call. Well, we had three doctors in Wawanesa, we had two in Glenboro and one in Balder that were working a one on six call. Who chased the three doctors out of Wawanesa? I say it is the Minister of Health because he has done absolutely nothing re- sponsible to show that he is in charge of this operation.

So do not hand me the crap about doctors are stressed out and doctor s are feeling that they are overworked, because this situation clearly identifies that it lies at the seat and the feet of the Minister of Health. He has to take responsibility, not give the people of Wawanesa, Erickson, Rossburn lip-service. He needs to stand up and take control like a good manager does. I had the opportunity to question the minister the other day in Estimates. I said: Are you aware about the three doctors leaving Wawanesa? Oh, no, no, I am not, could not read the paper.

Where was the Member for Dauphin- Roblin, his legislative assistant, did you not advise him? I mean, was he sitting in the dark? Does he not pick up the phone? Does he not phone the RHA and say, excuse me, we have a problem here? Why are 33 out of 42 doctors leaving our communities? Instead, the minister sits on his haunches.

He hides from the public, and only when we bring in a public display from people today, hard-working, honest, caring people in rural Manitoba that have many, many better things to do than to come here and lobby a government to do what is right and what they should do– They have ignored the situation in rural Manitoba, and, now, when it comes home to roost, they say, oh, you are an extremist; you are throwing fear out there. Well, these people are afraid, Mr. Speaker.

They are afraid that their hospitals are going to close because the Government has been lackadaisical in trying to understand the issues and get a handle on it and help the people out there solve the issues. Instead, they have buried their head in the sand and said, boy, if we just hide long enough, the problem will go away. Well, the problem is not going away and I advise all members across, go home to your communities because you have the same problems happening in your communities, and they are going to come to the minister's desk, and it is going to be the same situation as we saw today.

September 16, 2003 LEGISLATIVE ASSEMBLY OF MANITOBA 647 * (15:50) In closing, Mr. Speaker, I ask, I plead with the Minister of Health (Mr. Chomiak). I have asked him in Estimates and I ask him again. I ask him to conduct a review of all regional health authority boards in Manitoba. Are they working properly? Some are; some are not. Others have problems. Let us learn from that. Are they being financially accountable? We know that they are carrying about $20-million worth of debt that the Province refuses to put on their books and forces those communities to carry.

There is a myriad of things that are going right and wrong with regional health authorities. All I ask is that the Mini ster of Health, if he wants to blame it all on the Tories, let him do it, but let us get some action to correct the problem. I ask the minister to do that today, Mr. Speaker. Mr. Stan Struthers (Dauphin-Roblin): Mr. Speaker, I have lived all my life in rural Manitoba, northern Manitoba, rural Saskatch- ewan. I have represented rural Manitobans for eight and a half years now. These are friends and neighbours. These are people who matter.

These are people with real problems, who have prob- lems in health care and other areas. These are people who work very hard for their families and for their communities, and they understand what it means to be a Manitoban and to live in a community. We understand in rural Manitoba what it takes to make a community tick. So let members opposite not claim they have some kind of monopoly on the knowledge of what goes on in rural Manitoba. Today, Mr. Speaker, we watched as the members opposite turned a motion of urgent public importance into their own matter of urgent political expediency.

Rural Manitobans deserve one heck of a lot more than what I saw here this afternoon. This is a matter of urgent public importance. This is not a chance for either side of this House to point fingers back and forth at each other. This is not a chance for us to speculate. This is not a time to shoot our mouths off irresponsibly in the House. This is a time to make sure that we stand up for Manitobans. This is a time when we stand up for rural Manitobans who need our help. This is not a time for political games like I have seen this afternoon.

This is not a time for us to be looking at our own political hides and saying: How can I stand in front of the Legislature and whip up a crowd the best way I can so I can get a score in on the minister? This is not, Mr. Speaker, I would submit to you, this is not the time for that sort of stuff. This is the time when we as politicians have had an opportunity to rise above that and talk about what it is going to take to get more doctors into our communities i

Document details

Collection	Manitoba — Debates (Hansard)
Citation	38-1-07
Type	hansard
Volume / chapter	38th 1st hansardpdf 07.pdf
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	cf1b7cad6d70066a96adf8f95b1fe56da389f1d9

Source file is stored in the law ingest library (pdf).