Manitoba Hansard — 25 June 1991 (Sitting 72, 35th Legislature, 2nd Session)

35-2-72

Manitoba — Debates (Hansard)

MG-8048 Second Session -Thi rty-Fifth Legislature of the Legislative Assembly of Manitoba DEBATES and PROCEEDINGS (HANSARD) 40 Elizabeth II Published under the authority of The Honourable Denis c. Rocan Spesker VOL. XL No. 72-1:30 p.m., TUESDAY , JUNE 25, 1991 Printed by the Office of the Queens Printer. Province of Manitoba ISSN 0542-5492

MANI TOBA LE GISLATIVE ASSEMBLY Thirty-Fifth Legislature LIB - Liberal; ND - New Democrat; PC - Progressive Conservative NAME ALCOCK, Reg ASHTON, Steve BARRETT, Becky CARR, James CARSTAIRS, Sharon CERILLI, Marianne CHEEMA, Guizar CHOM IAK, Dave CONNERY, Edward CUMMINGS, Glen, Hon. DACQUAY, Louise DERKACH, Leonard, Hon. DEWAR, Gregory DOER, Gary DOWNEY, James, Hon. DRIEDGER, Albert, Hon. DUCHARME, Gerry, Hon. EDWARDS, Paul ENNS, Harry, Hon. ERNST, Jim, Hon. EVANS, Clif EVANS, Leonard S. FILMON, Gary, Hon. FINDLAY, Glen, Hon. FRIESEN, Jean GAUDRY, Neil GILLESHAMMER, Harold, Hon. HARPER, Elijah HELWER, Edward R.

HICKES, George LAMOUREUX, Kevin LATHLIN, Oscar LAURENDEAU, Marcel MALOWAY, Jim MANNESS, Clayton, Hon. MARTINDALE, Doug McALPINE, Gerry McCRAE, James, Hon. MclNTOSH, Linda, Hon. MITCHELSON, Bonnie, Hon. NEUFELD, Harold, Hon. ORCHARD, Donald, Hon. PENNER, Jack PLOHMAN, John PRAZNIK, Darren, Hon. REID, Daryl REIMER, Jack RENDER, Shirley ROGAN, Denis, Hon. ROSE, Bob SANTOS, Conrad STEFANSON, Eric, Hon. STORIE, Jerry SVEINSON, Ben VODREY, Rosemary WASYL YCIA-LEIS, Judy WOWCHUK, Rosann CONSTITUENCY Osborne Thompson Wellington Crescentwood River Heights Radisson The Maples Kildonan Portage la Prairie Ste.

Rose Seine River Roblin-Russell Selkirk Concordia Arthur-Virden Steinbach Riel St. James Lakeside Charleswood Interlake Brandon East Tuxedo Springfield Wolseley St. Boniface Minnedosa Rupertsland Gimli Point Douglas lnkster The Pas St. Norbert Elmwood Morris Burrows Sturgeon Creek Brandon West Assiniboia River East Rossmere Pembina Emerson Dauphin Lac du Bonnet Transcona Niakwa St. Vital Gladstone Turtle Mountain Broadway Kirkfield Park Flin Flon La Verendrye Fort Garry St. Johns Swan River PARTY.

LIB ND ND LIB LIB ND LIB ND PC PC PC PC ND ND PC PC PC LIB PC PC ND ND PC PC ND LIB PC ND PC ND LIB ND PC ND PC ND PC PC PC PC PC PC PC ND PC ND PC PC PC PC ND PC ND PC PC ND ND

3834 LE GISLATIVE ASSEMBLY OF MANITOBA Tuesday, June 25, 1991 The House met at 1 :30 p.m. PRAYERS ROUT INE PROCEEDIN G S READIN G AND RECEIVIN G PETITIONS Mr. Speaker: To the honourable member for The Pas (Mr. Lathlin), I have reviewed the petition, and it conforms with the privileges and practices of the House and complies with the rules. Is it the will of the House to have the petition read? An Honourable Member: Yes. Mr.

Clerk (William Remnant): To the Legislature of the Province of Manitoba The petition of the undersigned, The Pas Health Complex Incorporated, humbly sheweth: THAT your petitioner seeks to amend The Pas Health Complex Incorporation Act by striking out the word "tenn in paragraph 1 , line 4 thereof and substituting therefore the word "thirteen. n WHEREFORE your petitioner humbly prays that the Legislature of the Province of Manitoba may be pleased to pass

an act for the purpose above mentioned. And as in duty bound your petitioner will ever pray. PRESENT IN G REPORTS BY ST ANDIN G AND SPECIAL COMMI TTE ES Mrs. Louise Dacqua y (C hairman of Committees): The Committee of Supply has adopted certain resolutions, directs me to report the same and asks leave to sit again. I move, seconded by the honourable member for Fort Garry (Mrs. Vodrey), that the report of the committee be received. Motion agreed to. * (1 335) TA BLIN G OF REPORTS Hon. Eric Stefanson (Minister responsible for The Development Corporation Act): I have two reports I would like to table.

The first one is the Annual Report for the Manitoba Development Corporation for the year ending March 31, 19 91 . The second one is the Annual Report for 19 90-91 for the Manitoba Horse Racing Commission. Hon. Leonard Derkach (Minister of Education and Training): I have the pleasure of tabling the Annual Report of the Public Schools Finance Board; and the Annual Report for the Teachers' Retirement Allowances Fund Board for 19 90. Introduction of Guests Mr. Speaker: Prior to Oral Questions, may I direct the attention of honourable members to the Speaker's Gallery, where we have with us this afternoon Mr.

Andrzej Brzozowski, who is a Consul General of the Republic of Poland. On behalf of all our honourable members, I welcome you here this afternoon. Also with us this afternoon, we have from the Poplar Point School thirty Grades 1 to 6 students. They are under the direction of Dawn Larkin. This school is located in the constituency of the honourable Minister of Natural Resources (Mr. Enns). Also this afternoon, from the Austin Elementary School, we have thirty Grade 5 students. They are under the direction of Mrs. C. Cannon.

This school is located in the constituency of the Speaker of the Manitoba Legislative Assembly (Mr. Rocan). On behalf of all our honourable members, I welcome you here this afternoon. ORAL QUESTION PERIOD Chil d and Famil y Services Restructuring Mr. Gary Doer (Leader of the Opposition): Yesterday's announcement had a lot to do with substance and decision making, Mr. Speaker, and it had to do with the process of decision making. Yesterday's announcement was a culmination and a transformation of a government's style with the

3835 LEGISL ATIVE ASSEMB LY OF MAN ITOBA June 25, 1991 people of Manitoba, a style that in 19 88 in the Speech from the Throne said, we will be open with the public and we will be informing Manitobans of the decisions we are making prior to making them-open government. In 19 89, we heard that my government's approach to social challenges has been based on the broadest po ssible consultat ions with Manitobans. The transformation changed with the majority government, Mr. Speaker, but the Premier said in 1990: We will not have the elite backdoor accommodation decision making that we saw with Meech Lake.

Canadians are tired of it. Now we see the 19 91 majority vision and majority style of the Conservative Government. Decisions made in the middle of the night without any public consultation, and people brought in to be told of the decisions without any consideration to the children and the communities, and the children that are served by those communities. My question to the Premier is: Is this the process that he supported and agreed to, and is this the kind of decision making we can see in Manitoba in the future dealing with vital Manitoba services? Hon. Gary Fllmon (Premier): Mr.

Speaker, of course, the member opposite will know that we have had plenty of discussions over the past three and a half years in government with boards of the Child and Family Services agencies. What we are doing is attempting to improve upon a model that was badly flawed and that indeed was causing a great deal of problem with respect to the protection and services to children and families in this community. We are maintaining decentralized service delivery with a central administrative structure to try and overcome the problems that occur in the system.

I remind the member opposite, when he throws around those phrases about the kind of back-room decision making and threatening, and all those, to look at the coverage of the original decentralization as it occurred on July 14 , 19 83. This comes from my favourite newspaper, The Winnipeg Sun. The headline says: Evans threatens to replace CAS board s. The provi nce will restructure Children's Aid services, and any society board that balks may be replaced, Community Services Minister Len Evans said yesterday.

Evans said: Government must have some control over the boards to have them more accountable, and given that the province funds virtually 100 percent of Childr en's Aid Society operati ons, this is a responsible action and so he moved in. You want to talk about threats, Mr. Speaker, here is what he said: Community Services Minister Len Evans has refused to help the Children's Aid Society of Winnipeg with its financial problems unless it removes Executive Director Betty Schwartz, the agency president. That is what Evans said. That is the kind of high- handed dealing that he had.

That is the kind of taking them by the throat that we saw under the NOP when they restructured Child and Family Services agencies. * (1 340) Mr. Doer: Mr. Speaker, the Premier will note that the discussion he raised was in 19 83, and the decisions to go ahead with these ideas with tremendous public consultation took place a couple of years later, not a couple of hours later like this Premier. Chl l d and Famll y Services Restructuring Mr. Gary Doer (Leader of the Opposition) : Mr.

Speaker, maybe if some of the members opposite attended their community-based board meetings like I did last week, they would find out what is really going on in the communities instead of having this back- roo m, closed-door decision making. Members of northeast Winnipeg should have attended their meeting last week. They would have been proud of the money raised and the volunteer work in their own communities. They would have been proud of it, not putting it under as they have been with this cabinet decision.

My question to the Premier is: In light of the fact that the Reid-Sigurdson Report, which was quoted by his minister yesterday, quotes in the report, as a recommendation, that the government of Manitoba act to affirm the desirability of a community-based Child and Family Services delivery system, was the government appraised of this report? Did the Premier read this report, or did they just go on their ideology and their old-time biases about the Children's Aid Society of Winnipeg, and the going back to the future, as they have with the decisions they have made with the-- Mr. Speaker: Order, please. Hon.

Harold Gllleshammer (Minister of Family Services): Mr. Speaker, we have no disagreement

June 25, 19 91 LEGISLATIVE ASSEM BLY OF MAN ITOBA 3836 with that. The community-based service is what worked. The community-based service is what has been left in place. I am glad that somebody in the opposition raised the question of service because it is service that we want to improve. We needed a co-ordi nated approach to service. I can tell you of reports that have been done where children who live in the core area of the city move from one agency to another, the files get lost. They travel months behind that child. By the time they arrive at the new agency, the child has moved again.

There are a lot of tragedies in the system that a co-ordinated approach will solve, and improvement of service is what we are looking for. We need a sharing of information. Under the old system, there were walls built, there was turf protection. There was no sharing of information. This new system, with one administrative structure, will go a long way to solving these problems to improve services for children and families in this province. Mr. Doer: Mr.

Speaker, the community-based delivery system with volunteers, community-based people working in schools, in community centres, having ownership in their own communities, ownership of the problems between our most vulnerable children and their families, those kind of parenting programs, preventative programs, sexual abuse programs, all developed out of the six agencies in the city of Winnipeg . Were they perfect? No. Should they be improved? Yes.

Why are we going away from ownership in our own communities with volunteers raising money-I kno w NE W FACE SS raised $240,000 alone -ow nership of the problems and the ownership of the family difficulties and getting into the families at the earliest possible point where you can stop kids from being taken into placement? How many more kids are going to be taken into placement with a super agency, with a bureaucratic structure that is not the same as a community-based structure? Mr. Gllleshammer: The member is correct. We have a lot of children in care in this province.

In fact, we have more children in care than any other province in this country per capita. We want to be involved in the communities, and part of the new restructuring, if the member is up to speed on this, is community committees. From those community committees, committees made up of stake holders in those communities from the Justice department, from the Health department, from schools and from community volunteers, will be part of that community committee which is there to advise the new board. They also will have the capacity to elect members to this board.

I would point out to the honourable member that the new president of the association, Mrs. Helen Hayles, is the chairperson/director of the volunteer centre. We put a strong emphasis on volunteers. We think there is a place for volunteers in this system, and we welcome the contribution of the volunteers. I know that many social workers, many foster parents have been part of the boards and part of the volunteers, and we encourage their continued input into this system. Chll d and Famil y Services Restructuring Ms. Becky Barrett (Welllngton): Mr.

Speaker, when the issue of recentralization of Child and Family Services was raised by the minister in a media comment on May 13 and then in the House on May 14, he blamed the media, as is this government's wont recently, for reporting rumours and drawing conclusions.

When I asked him on May 14 about this issue he stated: "I am prepared to listen to any suggestions that are going to provide for better service for children and families in Manitoba." My question to the minister is: Why did he and his government unilaterally, literally, over the first long weekend, the first summer weekend, make these changes and dictate, not consult, with the affected agencies, volunteers and workers? • (134 5) Hon. Harold Gllleshammer (Minister of Famlly Services): Mr.

Speaker, I can tell you, in the eight months that I have been minister of this department, I have done a tremendous amount of consultation with service providers, with clinicians, with boards, with directors and talking widely in the community with people about improving the service to children and families. Ultimately, the minister and the government are responsible for the delivery of Child and Family Services in this province. Ultimately, the decision is the government's decision. We did this after a good

3837 LEG ISL ATIVE ASSEMBL Y OF MAN ITOBA June 25, 1991 deal of thought and a good deal of consultation with the community. I am aware that there are people involved in the system who have mixed reactions to a decision like this, but our decision was made to try and improve the delivery of Child and Family Services in this province. We want a co-ordinated approach, so the children in care and the children we serve are served in the best possible way with the resources we have available. Ms. Barrett: Yes, the government will be held accountable for its actions in this regard. Restructuring Costs Ms.

Becky Barrett (Wellington): I would like to ask the minister, how much, in total, including costs associated with the changeover and including costs estimated for the meetings of the new board of di rectors, who will now be paid rather than volunteers, will the recentralization cost? How much revenue will be lost as a result of community volunteers not performing the functions, raising money as they have with the fight back against child abuse, which raised a quarter of a million dollars in only one month? Hon.

Harold Gllleshammer (Minister of Famlly Services): The budg eted amount in this department-and we will be into Estimates in the next few weeks or months, I am sure-has been transferred to the new agency. I have said just earlier that we encourage the use of volunteers by the new agency, and I expect that the agency and the chairperson will be making tremendous efforts to include volunteers. If that volunteer component is involved in fundraising, we would encourage them to continue to be so. Regional Boundaries Ms. Becky Barrett (Wellington): Mr.

Speaker, the report also states that there will be four regions that the Child and Family Services delivery will take place out of. Could the minister table for us the boundaries of those four regions, and will he assure this House that the city core will be a unique and separate region so that the special needs of those children will be met and not subsumed under some larger grouping that has a majority of suburban cases in it? Hon.

Harold Gllleshammer (Minister of Famlly Services): I do not have that information with me, but I will be pleased to provide the member with the information on the boundaries, on the specific boundaries that are going to be created. Mr. Speaker, again, I would like to just mention that service delivery and service standards are a very important component of this new agency.

We want to be sure that every child and every family in the city should expect a consistent standard of service within this new agency, recognizing that the needs in Charleswood and the needs in central Winnipeg are different, but families should be able to expect the same consistent standards of service. This new agency will give us the capacity. If we have staff in the Charleswood area or in River Heights who could be better used in the core area of the city, we will have the opportunity to have those workers perform their service in that area. Chil d and Famil y Services Qual lty of Service Mrs.

Sharon Carstalrs (Leader of the Second Opposition): When we talk about Child and Family Services agencies, we talk about the first component the most, the children. These are children who are at risk, children who have been physically abused, children who have been sexually abused, children who have been deserted by their parents. Can this First Minister tell the House if his government did a single study to prove that the children will be better cared for under this model than they were under the other, since the other was supported by the foremost experts on children's physical and sexual abuse? * (135 0) Hon.

Harold Gllleshammer (Minister of Famlly Services): I can assure the member, in all our deliberations and thoughts, the service to children and families has been uppermost in our minds. We want to present a co-ordinated approach to the care of children. We want a sharing of information so that agencies are not fighting over particular turf but working together. Less than two years ago, we had a very tragic case in the city of Winnipeg, where four people lost their lives. As a result, the reports on that indicate that there were many social workers involved, 10 social workers, many of them not reporting to each

June 25, 19 91 LEGI SLATIVE ASSEMBLY OF MAN ITOBA 3838 other, some reporting to different agencies, a complete lack of co-ordination. I do not blame those front-line workers. They were trying very hard to do their job. One of the problems that impedes them is the fact that there was no co-ordination, there was no sharing of information. This new agency is going to give us that capacity so children and families like that do not fall through the cracks. We also have social workers working in the system, from the education system, from the health system, as well as the Child and Family Services agency.

We see the need for an automated system. We see the need for some co-or dination, so these families can be helped before tragedies like that happen. Mrs. Carstalrs: Mr. Speaker, the Child and Family Services agencies have been the victims of their own success, because what has happened is, with the development of more agencies, more and more parents and children and other adults came forward to report children who were physically abused, who were sexually abused. That was the strength of the regionalization of these services.

Why can this government not present a single piece of evidence that children will be better served under this new program? Mr. Gllleshammer: Mr. Speaker, the honourable member is having some difficulty separating service and administration. The service to children, the service delivery system remains intact. By the changes to the administration, we hope to enhance that service to protect those children and those families that we speak of. The member and her critic are the defenders of a status quo. They want no change. They want no reform.

As part of that package of reform, we mentioned a number of other things, the creation of a family fund, the creation of a child advocate, the adoption of the high-r isk indi cators and an automated information system. These are all part of the reform that this system needs. The member and her critic want to defend the status quo. We want to see change. We want to see reform. We want to see better service to children and families. Mrs. Carstalrs: Mr. Speaker, as a child, I was abused. There is no way I will accept the status quo on any government that does not move to protect children.

I cannot find, in this program of this government, a single example, a single study, a single new initiative that is going to protect the children. I want to know from the Minister of Family Services how he believes that the programs which are now being delivered in six regions will be better delivered in four, how he believes the programs that will have fewer volunteers will have more input from local people when he has dissolved those volunteer community boards? • (13 55) Mr. Gllleshammer: Mr.

Speaker, I will repeat again, forthe edification of the member, some of the reforms we see that are going to help children and families in the system. We said yesterday that we would be proceeding with a child advocate. We know from recent reports that there are children in the system who are in care of the treatment centres, who need somebody to talk to, who need an independent person to bring their concerns forward to. A child advocate is going to be created, reporting to the minister, who will be dealing with those problems within the system. We see that as a reform. We also announced an automated system.

I have told critics before, we have talked about it in the House, we have talked about it in Estimates, that there is a crying need for an automated system here. The files currently in place get lost. They travel months and months behind the child. We need an automated system. This was recommended years and years ago that, in this era of automation and computerization, an automated system will improve immeasurably the system we have in place. Deer Lodge Hos pHal Bed Openings Ms. Judy Wasylycla-Lels (St. Jo hns) : Mr.

Speaker, we have heard a lot of rhetoric from the Minister of Health, during the Estimates debate, about supposed action in response to the Extended Treatment Bed Review. Well, this minister has not even been able to open up the new beds built under the NOP at Deer Lodge Hospital that he promised during the election, that he promised on July 26, 19 90, in terms of an imminent opening that he repeated again in this House on October 17, 19 90, yet most of those 90 beds remain vacant. Could the minister tell us today, what is the status report of those 90 beds that he has announced and announced and announced?

When will he open up

3839 LEGISL ATIVE ASS EM BLY OF MAN ITOBA June 25, 1991 those beds and live up to his promise to the seniors of this province? Hon. Donald Orchard (Minister of Health): Mr. Speaker, lest Manitobans might believe my honourable friend where she indicated that the NDP rebuilt Deer Lodge Hospital, let us have Manitobans fully understand that it was federal government funds that rebuilt Deer Lodge Hospital under an agreement neg otiated between the fede ral government and the Province of Manitoba in 19 79. It was not NDP Manitoba money.

It was federal government dollars, so let my honourable friend not try to take credit for that. To answer her question on beds and their use at Deer Lodge Hospital, I will refresh my honourable frien d's memo ry that, in announcing the commissioning of those beds, it was to be for four program areas, with the last program area taking the longest in terms of its implementation, because of the complexity of service anticipated to be delivered there, as an interim measure, Mr.

Speaker, in moving those specialized programs for the head injured from Deer Lodge as a program to the redeveloped Municipal Hospital, which was also part of our announcement in acceptancy of the Extended Treatment Bed Review. Ms. Wasylycla-Lels: Mr. Speaker, it was this minister who promised on July 26 the immediate opening of 90 beds at Deer Lodge Hospital, and 66 of those 90 beds remain vacant today. All we have from this minister is empty promises, empty beds and full halls.

I want to ask the Minister of Health, why did he and this government decide to save $1 million for this government by delaying the opening of those beds and denying service and much needed beds for the senior citizens who have built this province? Mr. Orchard : Mr. Speaker, needless to say, I am going to try to calmly reject the rhetorical flourish of my honourable friend. I did not say that there would be an immediate opening of all beds at Deer Lodge, because there is a process of staff hiring, there is a process of bringing program in place.

I just indicated to my honourable friend that the one aspect of program at Deer Lodge which will not be immediately opened is the very specialized care for those head-injured Manitobans, a demand and a need for service that has existed for a number of years, which in the announcement of acceptance of the Extended Treatment Bed Review, we sought the concurrence of Deer Lodge Hospital to have that program commissioned and commenced at Deer Lodge as an interim measure to have that program then transferred, in whole, to the redeveloped Municipal Hospital site when construction is completed there.

There was no indication and no created expectation other than the incorrect statement of my honourable friend that that program would happen immediately. Ms. Wasylycla-Lels: The mi nister is not being forthcoming and straightforward with this House or the senior citizens of this province. He promised the immediate opening of 90 beds for chronic and rehab purposes, including a provision for a brain-injured person care unit. Mr. Speaker, I would like to ask the Premier (Mr.

Filmon), since this is something he promised in the election, since this is something he has talked about, will he review this situation, get a handle on the delays of this Minister of Health and make a commitment today that these long-promised beds will be opened immediately so the senior citizens of this province will have the attention and the services that they need and deserve? Mr. Speaker: Order, please. The question has been put. * (1 400) Mr. Orchard : Mr. Speaker, that process will happen.

In addition to the beds my honourable friend discussed, we have, in the period of time since the announcement of the acceptance of the Extended Treatment Bed Review, commissioned the temporary redevelopment of 60 additional beds on top of that. Those beds will be available to serve needs of personal care home placement in the community. There has been every opportunity to have that program proceed in a very meaningful and deliberate fashion. My honou rable friend cannot, as indicated-well, no, I will not say that.

I cannot indicate to my honourable friend and explain to her any more clearly than I already have, you do not-and I did not indicate that, immediately, we would have a head-injured program and unit operational at Deer Lodge. I explained very clearly to my honourable friend, at Estimates, on two successive occasions, that the commissioning of that complex care unit would take some more time. That in fact is the case.

June 25, 19 91 LEGISL ATIVE ASS EMBL Y OF MANIT OBA 3840 Hl ghw ay 22 7 Upgrading Start Mr. Edward Connery (Portage la Prairie): Mr. Speak er, this gover nmen t has contrib uted significan t inc reased dolla rs to high way construction in Manitoba. Many highways were left in disarray when we took office. The minister of Highways has performed admirably in repairing the roads that were left. I do have one concern over one highway. It is Highway 227, which cuts across the north end of the Portage constituency linking the north end of Winnipeg to Highway 16 .

I would like to ask the minister, in the light of that he had indicated last year construction would have started last fall or this spring, when construction on Highway 227 will begin? Hon. Albert Drledger (Minister of Highways and Transportation): Mr. Speaker, because this gove rnment recognizes the impor tance of transportation to the economy of Manitoba, I am proud to indicate that, in our capital program this year, we have $1 02.5 million for the construction of roads.

In this program, I am delighted to indicate to the member that the grade and gravel for Highway 227 in the Portage area, which is very important to him and the people in the Portage area, is included for this year's construction. 55-P lus Program De lnde xlng Mr. Conrad Santos (Broadway): Mr. Speaker, I wish to direct my question to the honourable First Minister and Premier of the province.

This Conservative government has once more shown the human inclination to injustice by cutting off the vital support increases to the 55-Plus program for senior citizens when, at the same time, it can gleefully give a $30,000 increase to a chief executive officer of the Manitoba Telep hone System, who already makes $1 30,000. This is a policy of making the rich richer and the poor poorer. Mr.

Speaker, I want to ask the honourable First Minister: Would he make this Seniors Day a truly memorable day by revoking the cut off of the increase of the 55-Plus and restoring the increases to the 55-Plus program for senior citizens of Manitoba? Hon. Gary Fllmon (Premier): Mr. Speaker, of course, the Manitoba Telephone System would have had a great deal more money if the NOP government had not lost $27 million on the sands of Saudi Arabia, just dumped tha t money indiscriminately in Saudi Arabia, much to the chagrin of our seniors who now pay higher telephone rates, substantially higher telephone rates.

I might say the increase has been much higher than any of the figures that he is talking about as a result of the NDP's actions, irresponsible actions. This government, of course, has increased its funding to health care by $90 million this year, $90 million despite the fact that our cash transfers from Ottawa for health and post-secondary education were reduced by some $36 million. We put $90 million more. That is for the benefit of seniors and people throughout this province, but seniors particularly, who depend upon the health care system.

We have chosen our priorities to ensure that health care is the highest priority so that our seniors can benefit from that, Mr. Speaker, and so that they can live in a province that provides high-qual ity health care and will continue to meet their needs on the health care side. We have had to make our various choices. We have chosen to put $90 million more into health care instead of dumping $27 million into the sands of Saudi Arabia like the NOP did when that member was a member of the government. Pharmacare Card lm plementatlon Mr. Conrad Santos (Broadway): Mr.

Speaker, if the honourable First Minister will not listen to the campaign of the Manitoba Society of Seniors to restore the 55-Plus, would he at least make the Seniors Day memorable by making a commitment to persuade his Minister of Health (Mr. Orchard) to institute the Pharmacare card so that senior citizens who are usually short of cash can immediately acquire medication without waiting, without coming up with cash up front and thereby waiting an unreasonably long period of time before making a refund? Hon. Gary Fllmon (Premier): Mr.

Speaker, again this government is putting substantial increases into Pharmacare funding for seniors this year. Indeed, I believe that the Pharmacare funding increase is something in the order of $6 million, again, because

3841 LEGISLATIVE ASSEMBLY OF MANITOBA June 25, 1991 we recognized the needs of our seniors in our province, unlike the NDP who took that money and built a bridge to nowhere in Selkirk; $30 million they spent on a bridge to nowhere instead of looking after the needs of our seniors with the various programs that they had. I ask the member for Broadway, if he really wants to help the seniors, why does he not urge his caucus to bring Bill44 to a vote? Bi1144, that bill that allows for a lock off of those who refused to pay their bills to Centra Gas, is resulting In every senior cltlzen- Mr. Speaker: Order, please.

Point of Order Mr. Steve Ashton (OpposiUon House Leader): Yes, Mr. Speaker, our rules are very clear. In fact, Beauchesne 417 states that answers to questions should be as brief as possible, deal with the matter raised and should not provoke debate. Mr. Speaker, the Premier has been asked about 55-Plus and Pharmacare. lt is his prerogative not to answer the questions, but if he is not going to answer, he should say that and be accountable to the seniors of this province instead of engaging this irrelevant debate.

I ask you to bring the Premier to order and answer the very straightforward and honest questions asked by our Seniors critic. Mr. Fllmon: Mr. Speaker, with due respect for the opposition House leader, I did In fact refer to our increase in Pharmacar.e funding, as I said, I believe an additional $6 million, but I want the NDP to save $10 a month for every senior in this building by passing Bill 44. Mr.Speaker: Order, please. We were dealing with a point of order.

On the point of order raised,! would like to remind all honourable ministers that answers to questions should be as brief as possible, should deal with the matter raised and should not provoke debate. Handl· Transit Government Commitment Mr. Conrad Santos (Broadway): Mr. Speaker, if the honourable First Minister would not restore the 55-Plus increases and would also not instruct his Minis ter of Health (Mr.

Orchard) to use the Pn�rmacare card for the benefit of senior citizens, would he now, on the Seniors Day, show real states manship and courage by restoring the privileges of senior citizens to use the Handi-Transit in the cold city of Winnipeg? •

(1410) Hon. Gary Fllmon (Premier): I might say that he is speaking to someone who, when he was on City Council, was one of the origina tors of the Handi-Transit System. This administration continues to support Handi-Transit not only for the senior citizens of Winnipeg, but it continues to be expanded and enhanced throughout rural Manitoba as well, Mr. Speaker. We have a commitment to Handi-Transit that continues and will continue as long as we are in office. Pi nes Project Funding Justification Mr. Paul Edw•ds (St. James): Mr. Speaker, my question is for the Minister of Urban Affairs.

Today is the day, of course, that we pay special tribute to the seniors of the province of Manitoba here at the Legislature, and it is therefore particularly appropriate, in my view, to ask the minister again to revisit his unequivocal and unabashed financial support for The Pines project on Portage Avenue. Mr. Speaker, the seniors of this province, as has been pointed out earlier, are facing ever-increasing fi nancial ne eds, yet at the same time, the government Is pulling back regul arly and consistently-a case in point, of course-the deindexing of the 55-Plus program. Mr.

Speaker, why does this minister have millions of dollars in interest-free loans and hundreds of thousands of dollars in outright grants to give to the proponents of a project that serves only those seniors who can afford a $30,000 to $46,000 entrance fee, as well as a $550 to $755 monthly rental fee, and at the same time, he does not have the funds to index the pensions of the poorest, most desperate seniors in this province? Hon. Jlm Ernst (Minister of Urban Affairs): Well, Mr. Speaker, before the member for St. James stands up and condemns a very much-needed senior citizens housing pr oject in St.

James-Assiniboia, he should get his facts straight. There is no interest rate subsidy associated with the Seniors RentaiStart program and, with The Rotary Pines project, no interest rate subsidy.

June 25, 1991 LEGISLATIVE ASSEM BLY OF MAN ITOBA 3842 There is a grant of some $350,000 that will be earned over 35 years at 1 /35 per year under the Seniors RentalStart Program for that particular project, so he needs to get his facts straight before he makes any statement with regard to that much -needed seniors project in St. James-Assiniboia. Mr. Edwards: Surely, after all this, the minister is not saying that he is not financially supporting the project. Of course, he is financially supporting it, Mr. Speaker, to the tune of hundreds of thousands of dollars. Commercia l Develo pment Mr. Paul Edwards (St.

James): For the same minister, the proponents of The Pines have always cast this primarily as a residential project. The commercial aspect was clearly secondary. Proof of that is their own leaflet which says: The Pines, A Sen iors Residential Development. The map attached says: Future Commercial Development. The residential aspect is the present, the future will come with the commercial aspect.

Given that yesterday the Planning Committee of the City of Winnipeg released a note from one of the proponents to Councillor O'Shaughnessy, which clearly indicated-I will ask the minister whether or not he will now reconsider his financial support for this project, given the fact that this note which went from a proponent to a councillor in 19 89 and which stated that the proponents could not guarantee the residential development would proceed quickly, but that they would like to proceed with the commercial as soon as possible, will he now reconsider this, given that clearly the proponents are out for a commercial development, first and foremost, Mr.

Speaker? Hon. Jim Ernst (Minister of Urban Affairs) : Again the member for St. James does not have his facts straight. The fact of the matter is, the proponent of the project, the Rotary Club of St. James-Assiniboia is dealing with a senior citizens project and none other-no commercial development, senior citizens project. That is what the government is supporting, Mr. Speaker, a senior citizens housing project. We are not supporting commercial development. We have nothing to do with commercial development, and the member better get his facts straight. Mr.

Edwards: For the minister's edification; I will table the leaflet- Mr. Speaker: Order, plea se. Time is of the essence. Mr. Edwards: -of the proponent which talks about the commercial and the residential. I will also table the note which talks about the commercial first and the residential second, simply to answer the minister's query. Finally, for the same minister.

What guarantees can this minister give that not one dollar of public money will go towards the commercial aspect of this project, in particular since the developers clearly are primarily interested in that commercial venture and not a seniors residential facility first and foremost? Mr. Ernst: Mr. Speaker, the arrangement that the Depar tment of Housing, the governmen t of Man itoba, has with the Rotary Club of St. Jame s-Assiniboia is for a seniors housing project-no other project but seniors housing. Chll d and Faml l y Services Im pact Abor l glna l Programs Mr. Oscar Lathlln (The Pas): Mr.

Speaker, I am directing my question to the Minister of Child and Family Services. Given the fact that this minister surprised everyone yesterday with his announcement of his sudden change in policy regarding Child and Family Services without having consulted anyone, I want to ask the minister: Can he tell this House today what positive impact this decision will have on child welf are agencies which are currently being operated by aboriginal people? Hon. Harold Gllleshammer (Minister of Famlly Services): Mr. Speaker, the positive impact we see is enhanced service.

Now I say that with the knowledge that there are many issues that we have to discuss with the aboriginal community. We have aboriginal service units which operate on reserve outside of the city of Winnipeg. We also fund Ma Mawi, which is a nonmandated service within the system. We anticipate to continue working with Ma Mawi and to have a good relationship develop between the new agency and that particular agency. At the same time, we have many issues that we have to resolve with Native agencies that operate outside the city of Winnipeg.

We have discussed this with them a number of times, the question of jurisdiction, the question of codes and standards and other issues that are the subject of ongoing discussions with those agencies.

3843 LEGISL ATIVE ASS EM BLY OF MANIT OBA June 25, 1991 Mr. Lathlln: Mr. Speaker, we know already what this government's attitude is towards aboriginal people, those not only living in the city but living on reserves in the North as well. What assurance can this minister give this House that he will not inflict the same misery to aboriginal child welfare agencies, or does he have a plan to do that already, because as I said before, he surprised us yesterday with this announcement? Mr. Gllleshammer: Mr. Speaker, I am pleased the honourable member is taking an interest in the Child and Family Services agencies.

We are aware, of course, that these agencies perform a valuable function outside the city of Winnipeg as well. We have a very complex system in this province where independent Child and Family Services agencies service the city of Winnipeg, the central region of Manitoba and the Westman region. There are areas of the province where the department provides that service, and we also have five mandated Native agencies which are funded in part by us and in part by the federal government.

I readily admit to the member, we have big issues that we have to resolve with the Native agencies over the question of jurisdiction, over the question of codes and standards. We have been meeting with a number of representatives from the Native community on Child and Family Services issues. We will continue to meet with them and attempt to resolve those issues. Mr. Speaker: The time for Oral Questions has expired. Committee Changes Mr. George Hlckes (Point Douglas): I would like to make committee changes, moved by the member for Point Douglas, seconded by the member for Swan River (Ms.

Wowchuk), that the composition of the Standing Committee on Law Amendments be amended as follows: The member for Swan River (Ms. Wowchuk) for the member for Thompson (Mr. Ashton), for Tuesday, June 25, 1991, at 8 p.m . The second committee change, moved by the member for Point Douglas, seconded by the member for Swan River (Ms. Wowchuk), that the composition of the Standing Committee on Public Utilities and Natural Resources be amended as follows: The member for Point Douglas (Mr. Hickes) for the member for Radisson (Ms. Carilli); the member for Flin Flon (Mr. Storie) for the member for Interlake (Mr.

Clif Evans), to take effect Tuesday, June 25, 1991, at 8 p.m. Mr. Speaker: Agreed? Agreed. Non pol lt lc a l Statements Mrs. Sharon Carstalrs (Leader of the Second Opposition): Could I have leave for a nonpolitical statement, Mr. Speaker? Mr. Speaker: Does the honourable Leader of the second opposition party have leave to make a nonpolitical statement? Agreed? Agreed. Mrs. Carstalrs: Mr. Speaker, today is a special day in this Assembly because we have seniors here, but it is also a special day for one particular senior, a senior who has close links with this Legislature.

Today is the 95th birthday of Tommy Hillhouse, who served for many years as the MLA for the Selkirk constituency. Unfortunately, Mr. Hillhouse is now in a personal care home and has been there now for several years. I joined with him in his celebration of his 90th birthday as did the former Premier, the Honourable Howard Pawley. I know that everyone in this Chamber would want to wish Mr. Hillhouse well on this his 95th birthday. *** Hon. Glen Findlay (Minister of Agriculture): Mr. Speaker, may I have leave for a nonpolltical statement? Mr.

Speaker: Does the honourable minister have leave to make a nonpolitical statement? An Honourable Member: Absolutely. Mr. Speaker: Leave? Agreed. Mr. Findlay: Mr. Speaker, it is indeed a pleasure to have the opportunity today to just say a few words of congratulations to Mr. and Mrs. Manitoba Farmer of the Year, Mr. and Mrs. Owen McAuley from McAuley, Manitoba, and I would like to congratulate the Red River Exhibition on the course of action in terms selecting the Mr. and Mrs. Manitoba Farmer. It is indeed a tribute to Manitoba Farmers that we recognize our peers. Mr. and Mrs.

McAuley have been farming for many years in the McAuley area on a family farm that was started back in 1894. They were selected because of their fina ncial management capacity, their abili ty to technologically manage their farm, their degree of

June 25, 1991 LEGISLATIVE ASSEM BLY OF MANIT OBA 3844 land use and in terms of their commitment to their community. In terms of community commitment, Mr. McAuley has been a councillor, he has been one of the chief leaders of the Keystone Agricultural Producers and he has also been on the national task force for safety nets to develop the GRIP and NISA programs. Mr. McAuley has also been on the Manitoba Farm Mediation Board and has served not only his community but all of the farmers of Manitoba very well and indeed, in his latter capacity on the safety net task force, all farmers of Canada.

It is indeed a pleasure to congratulate the Red River Ex on passing on this tradition year in and year out to recognize Manitoba farmers and help the urban-rural relationship that we need to develop in this province. Also at this time, I would like to recognize, there is one member of this House who has been a Mr. Manitoba Farmer, the memberfor Portage la Prairie (Mr. Connery). Commi ttee Changes Mr. Kevin Lamoureux (lnkster): Mr. Speaker, I move, seconded by the memberfor The Maples (Mr. Cheema), that the composition of the Standing Committee on Law Amendments be amended as follows: Osborne (Mr.

Alcock) for lnkster. Mr. Speaker: Agreed? Agreed. Mr. Edward Helwer (Glmll): I also have some committee changes. I move, seconded by the member for Fort Garry (Mrs. Vodrey), that the composition of the Standing Committee on Law Amendments be amended as follows: The member for Fort Garry (Mrs. Vodrey) for the member for Turtle Mountain (Mr. Rose). This is forthe June 25, Tuesday, 8 p.m. sitting. Also, I move, seconded by the member for St. Vital (Mrs. Render), that the composition of the Standing Committee on Public Utilities and Natural Resources be amended as follows: The member for Ste. Rose du Lac (Mr.

Cummings) for the member for Lakeside (Mr. Enns); the member for Turtle Mountain for the member for Lac du Bonnet (Mr. Praznik); and the member for Rossmere (Mr. Neufeld) for the member for Niakwa (Mr. Reimer). This is for the Tuesday, June 25, 8 p.m. sitting. Mr. Speaker: Agreed? Agreed and so ordered. ORDERS OF THE DAY Hon. Clayton Manness (Government House Leader): Mr. Speaker, before I move the motion, is there willingness to waive private members' hour? Mr. Speaker: Is it the will of the House to waive private members' hour? Is there agreement? Is it agreed? An Honourable Member: No. Mr. Speaker: No.

Okay, leave is denied. Mr. Manness: I thank the member for Thompson (Mr. Ashton). I move, seconded by the Minister of Environment (Mr. Cummings), that Mr. Speaker now leave the Chair and the House resolve itself into a committee to consider of the Supply to be granted to Her Majesty. Motion agreed to, and the House resolved itself into a committee to consider of the Supply to be granted to Her Majesty with the honourable member for Niakwa (Mr. Reimer) in the Chair for the Department of Health; and the honourable member for Seine River (Mrs. Dacquay) in the Chair for the Department of Rural Development.

CONCURRENT COMMI TT EES OF SUPPLY SUPPLY-H EALTH The Acting Chairman (Mr. Jack Reimer): Will the Committee of Supply please come to order. This afternoon, this

section of the Committee of Supply meeting in Room 255 will resume consideration of the Estimates of the Department of Health. When the committee last sat, it was considering item 2. Healthy Public Policy Programs (

b) Health Promotion, Protection and Disease Prevention: (1 ) Salaries $1 ,620, 10 0 on page 84 of the Estimates book and on page 41 of the Supplementary Information book. Shall this item pass? The honourable member for The Maples (Mr. Cheema). Hon. Donald Orchard (Minister of Health): Mr. Acting Chairman, I wonder if I might, before my ho nourable friend starts off, provide some information on tuberculosis that my honourable friend asked for yesterday. In 19 86 a total of 136 cases in Manitoba, 96 non-Na tive, 40 Status Indian. 19 87 a total of 12 5, Status Indian up to 44, non-Native down to 81 . In 19 88 a total for the province of 111, non-Native down slightly to 80,

3845 LEGI SLAT IVE ASSEMB LY OF MAN ITOBA June 25, 1991 Status Indian down to 31- a fairly significant decrease year over year there. In 1989, total cases 10 0, non- Native down fairly significantly to 71 , Status Indian down to 29. Total cases in 19 90 92, non-Native 67, a decrease again, and a decrease again in Status Indian down to 25. Mr. Guizar Cheema (The Maples): Mr. Acting Chairperson, can the minister give us a status report on Lyme disease? There have been a few cases and some media reports and there was some report from the minister's office as well.

Can he give us an indication, do we have any special programs for Lyme disease? Mr. Orchard : Now, I am going to try to get right down to-I am trying to find the area where it indicates the status of potential cases in Manitoba. We have provisionally identified, provisionally because there is, I guess, some uncertainty around Lyme disease, but Manitoba has provisionally identified 12 cases of Lyme disease diagnosed in 19 89. There are only a very few of the ticks which carry borrelia that have been found in the province.

That is the infectious agent that comes on a specific type of deer tick, lxodes dammini, I think is the scientific name. Now, we have continued to emphasize gener al kno wledge about the disease, its transmission through bites by ticks, and naturally part of our education prevention program is to emphasize avoidance of tick bites.

The workshop that was hel d which was sponsored by the Laboratory Centre for Disease Control, Health and Welfare Canada and the Canadian Infectious Diseases Society-th eir recent workshop will have the summaries distributed to all physicians to ensure that they are aware of the signs and symptoms of Lyme di sease, the recommendations regarding laboratory testing and the recommended treatments. In addition, public health agencies will follow up reports of erythema migrans to determine whether a particular area of the province may have become infected with the deer tick. Mr. Cheema: Mr.

Acting Chairperson, the minister, I am sure has received a communication from one of the patients. I would not like to mention the name, but her family is suffering from a lot of problems. This individual has Lyme disease and also some other members of the family. They continue to have some difficulty in terms of establishing diagnosis and they have expressed their concern that, as the minister has said, some of the physicians are not aware of the diagnostic tests or whether there were some diagnostic tests. They are not even sure.

This particular family, and I will give the minister the name off the record to probably have some communication with this family so that they can get some information. I will provide the name and the address and telephone number off the record. I just want the minister to be aware of the situation and even though the numbers are small, a lot of the individuals were concerned.

My specific question is, what is being done in terms of making aware to the physicians and the other healt h car e professionals to get themselves more familiar with this disease so that they can at least be able to direct the patient to the right source of information? Mr. Orchard: Mr. Acting Chairman, I guess the issue of Lyme disease is a very new one and it is multistage, multiorgan disease that can mimic many other diseases and that can make it difficult to diagnose.

The only diagnostic feature is erythema migrans, a characteristic rash which develops in up to two-thirds of infected individuals within a few weeks of the infection. The late effects of Lyme disease are not specific and Lyme disease is caused by a bacterium which is carried and transmitted by the deer tick, lxodes dammini, as I indicated. Now, as I indicated to my honourable friend, a recent international workshop on Lyme disease was sponsored by the Laboratory Centre for Disease Control, Health and Welfare Canada and the Canadian Infectious Diseases Society.

Now this group with representations from Manitoba looked at Lyme disease in Canada and the following conclusions were reached. Lyme disease is transmitted only by deer tick. The wood ticks which are so common in Manitoba are not good hosts for borrelia, which is the infectious agent. Field studies have been done by Dr. Galloway and are sufficient to demonstrate that Manitoba does not, and I emphasize, not, have an established population of lxodes ticks. This makes it very unlikely that someone will contract Lyme disease in Manitoba. It means that Manitoba is not an area which is endemic for Lyme disease.

When Lyme disease is as common as it is in the northwestern U.S.A., it is easy to diagnose because of the rash described above. There are no definitive

June 25, 1991 LEGISL ATIVE ASSEM BLY OF MANITOBA 3846 reports of the characteristic rash in Manitoba, again making it unlikely that Lyme disease is being transmitted here. The blood tests for Lyme disease are very inaccurate when used to test persons who likely do have Lyme disease, i.e., who do not-pardon me, when used to test persons who likely do not have Lyme disease, i.e., most Manitobans. In that case, most positive tests will be positive because other bacteria share the same chemical structure as borrelia.

It is recommended that testing not be carried out unless the patient has been to an area such as Connecticut where infective deer ticks are known to reside. Now, the Manitoba Health has continued to emphasize the general wisdom of avoiding tick bites. Summaries of this workshop will be distributed to all physicians in Manitoba to ensure that they are aware of the signs and symptoms of Lyme disease, the recommendations regarding laboratory testing and recommended treatments.

In addition, public health agencies will follow up reports of erythema migrans to determine whether a particular area of the province may have become infested with the deer tick. So those are the instructions that are going, I believe, have already gone out in fact to physicians in Manitoba, or will be very shortly. Mr. Cheema: Mr. Acting Chairperson, I will share the information, and some of the information really has gone though the minister's office. Also one of the persons has been in touch with the minister's office.

The other one, I am not sure about that, but this person was sent to Toronto to see a physician. They have gone through a lot of hassles and the patient is right in her own way. The person is not sure about the diagnosis and a lot of frustrations, but they need somebody to hear their concern and make sure that they have the right information, even though they have corn piled a lot of statistics to prove their case. The general line that they have used is general ignorance of the medical community of this disease. That is what she has really put forward.

She is extremely concerned that whenever she goes to a physician they are not aware of this disease. The minister has said they are going to circulate the notes from the conference, and that will be helpful to clear some of the misconceptions. I will share the information with the minister. Can the minister give us, on a separate issue, an update on the immunization record? As the minister has said last year and as I understand that Manitoba is probably, I think, really one of the best in this country as far as immunization records are concerned.

They are updating either through the schools or through the physicians. Is there any major problem the minister is encountering, or are they moving into the right direction as they have stated the last three years? Mr. Orchard: No, I think the system has been working exceptionally well, and giving credit where credit is due. This was introduced on a pilot basis in Westman area of the province, and in St. Boniface and St. Vital in 1980. The ensuing experience in those two regions led the government of the day, the previous government in 19 85, to introduce the program province-wide. That has been established.

Implementation of MIMS is complete in all provincial Health regions, of the city of Winnipeg and federal nursing stations. Immunization records on all children born since January 1988, and for the majority of children born since January 19 80, are available. Physicians presently access the system through the public Health staff. In future, it may be possible for them to have direct access. Approximately .25 professional SY in the directorate is devoted to MIMS. It is working I think most effectively, Mr. Acting Chairman. Mr. Cheema: Mr.

Acting Chairperson, have there been any major adverse reactions reported with the immunization? Are we making a record of those reactions, or are the physicians reporting those situations to the Department of Health? * (1 450) Mr. Orchard: No, I am informed, no major areas, problematic areas. Those would naturally emerge with the system. Mr. Cheema: Mr. Acting Chairperson, as we know, there are a lot of new Canadians coming to Winnipeg. Some of the immunization records they do not have practically in their own countries, and there are some problems dealing with those situations.

Can the minister give us an update? What are they doing to trace those individuals and make sure they have the records complete?

3847 LEGISLATIVE ASSEMBL Y OF MANIT OBA June 25, 1991 Mr. Orchard : I am inf ormed tha t federal Immigration undertakes that check through Medical Services. Mr.Cheema: Mr. Acting Chairperson, I am not sure about that. I do not think that is the case. I think that the individual cases when they come to this country, only if they are specified that this person will have a particular form of illness or possibility of having a problem.

For example, if somebody's X-ray had a problem in terms of possibility of tuberculosis or old T.B. those cases are being notified to the physician and through the Medical Services Branch and through the Immigration department. For immunization there is no such provision, and I think we should look at that. It is very important. We get a large number of new Canadians, so that they can be immunized as soon as they arrive and get their data updated.

Can the minister tell us, on one of the subjects where the minister made a policy announcement as to smoking prevention and that was a school project-no smoking by the year 2000-and how much money they have allocated for this special fund, is this a basic equivalent to your work or is the government having a specific person in charge of this special program? Mr. Orchard: What was it? Mr. Cheema: It was the anti-smoking campaign. Mr. Orchard: The individual who was really leading the issue, Anne Skuba, retired recently.

I have to say that I very much enjoyed working with Anne Skuba, obviously for her total commitment and absolute enthusiasm for the project. I never had an opportunity to ask if this was an original thought or concept that Anne herself had come up with, but I always indicated to her when the project was first suggested to me as a new initiative, that it sounded like a genuine winner. I am and remain totally committed to that Smoke Free Grads 2000 concept.

I think it is probably the absolutely best long-term prevention education program that we can bring into our school system to break the trend of starting to smoke. Smoking cessation is successful. There is no question about it. A lot of people have ceased being addicted to tobacco. let me rephrase that, I do not think they have ceased being addicted to tobacco and nicotine. They probably remain addicted, but they have ceased the activity of tobacco consumption. That is a very difficult- very, very difficult-and strenuous exercise.

I think a number around this table might even be able to indicate just how difficult an exercise it is through personal experience. The whole concept behind the Smoke Free Grads 2000 program is absolutely excellent in that, if you never start, you never have to stop. The enthusiasm that school children approach the whole Smoke Free Grads program, the community and corporate partnership in sponsoring the program that we achieve is just absolutely heartwarming to see.

My honourable friend made reference to the school in southwest Winnipeg, because I did my Paul Bunyan routine last year, I was not around for the official kickoff of Smoke Free Grads 2000. In its second year, I wanted to be with young students, with the young Manitobans, who were going to participate in the program. Hence, we went out to the school where "Sila" the polar bear activity was filmed for the antismoking videotape. Mr.

Acting Chairman, I tell you it is one of those days that you do not forget as an elected official because there are so many times when we end up agreeing to disagree and maybe in less than pleasant circumstances. The enthusiasm of those children and their teachers and the staff and everybody there, you just know that you are going to have a group of students who, in the majority, will never start smoking. You know, for that, I have expressed my personal thanks to Anne Skuba in terms of her efforts in bringing that and other programs to smoking cessation in Manitoba. Mr.

Acting Chairman, we have continuation of the program. It will be continued each successive year as an initiative of cessation of smoking in the province. Mr. Cheema: As far as I remember, I think it was well received by the media, as well as the public at large, and that is why I am asking the minister how much money is coming from the Department of Health for this particular project? Mr. Orchard: We will get you an exact figure on that, but it is a very modest-I cannot give you an exact number-commi tment of provincial dollars in that program for two reasons.

First of all, it is undertaken as part of the staff programming, so that those costs will be ongoing even if we do not have the program in part or in whole. Mr. Acting Chairman, the key reason why it is an economic program is that we have such

June 25, 1991 LEGISL ATIVE ASSEM BLY OF MAN ITOBA 3848 substantial private sector sponsorship. CKND television, I believe-and I am going by memory here-provided the television crews for filming the video. Great-West Life provided financial support and I am going to offend other corporate sponsors because I just do not have it in front of me as to who else participated financially. The corporate participation in this initiative has been just absolutely remarkable and has led to a very economic prevention program being part of government.

If I can be so immodest as to suggest is really where we have been heading in terms of healthy public policy and partnershipping in the community with support groups, with community interest groups, with the private sector through corporations. We are able to take modest resource of the taxpayers and use the good will and promotional efforts and financial resources of outside agencies and the private sector to build very strong and progressive prevention programs in the province of Manitoba. This is really a shining example of the Smoke Free Grads2000. Mr. Cheema: Mr.

Acting Chairperson, I just wanted to make one suggestion. In the area of health prevention and promotion, we always, of course, have the unusual from the department and from the schools and all those corporate sponsors. I think we should, or the minister should set up a plan where the students who are going to parties within this program could be awarded in the public forum. I think that enhances their ability to even encourage other individuals, and that was very well done in some parts of this country.

If the minister had read the Second Opinion book, it is very clearly indicated it was done in Toronto by the first medical officer of Toronto. It was very well received and really got people involved at an earlier age. They get real excited about them, and they really want to participate. Also, the communities and the parents and everyone really feel that they are part of the system. Mr. Orchard: Mr. Acting Chairman, I want to tell my honourable friend that is exactly where we are coming from. Now, again, ld o not want to pre-empt my honourable friend.

We have not got around to doing it yet, but the Minister of Education (Mr. Derkach) and I have discussed it because he is as enthused as I am about this program of providing a certificate of graduation at the completion of every school year in which the students have remained smoke free. That could be carried on by successive Ministers of Education and Health in the year 2000 or 2010 , when we are no longer here. • (1 500) Mr.

Cheema: Can the minister tell us, are they going to establish a community wellness resource centre either in Winnipeg or in other parts of rural Manitoba to make sure they have the diabetic education resource centre, for example, in either Dauphin or Swan River or Thompson? I think that will be a worthwhile project to make sure the community is involved, and it will really be a very ine xpensive way of delivering very expensive services. Mr. Orchard: The diabetes education program has been progressively extended to a number of areas of Manitoba.

Right now the community of Swan River is in discussions, I guess, with government in terms of attempting to focus-w ell, in part or in whole-on diabetes education in the Swan River Valley. Currently, they receive services one day every two weeks out of the Parkland region. They have made the proposal thatthey would like to move in that direction to try to further-and we have entertained discussions and proposals and are in the process of entertaining proposals and having discussions around that issue. Mr. Cheema: Mr.

Acting Chairperson, can the minister tell us how much money we are spending out of this branch for a program like this so far? Mr. Orchard: I cannot really separate it out because it is all part of the line allocation of resource. Mr. Cheema: Can the minister tell us on the other line here, in terms of the public and professional education on cardiovascular risk prevention-a nd the minister is smiling. He knows that he has done well on this issue, and I am just giving all the time to outline some of his achievements. One of the projects is at St.

Boniface General Hospital, and he is going to discuss it and I am going to listen to that. Mr. Orchard: My honourable friend, you know, understands the system pretty well, because the issue of the Heart Health Project is one that I think has had some pretty substantial success. The initial survey upon completion allowed us to identify high-risk activities and areas in the province. The next step is to build some focused workplace and community projects. That was subject to question

3849 LEGIS LATIVE ASSEMBLY OF MANIT OBA June 25, 19 91 yesterday, and I am seeking information in terms of the status of the project in the Tupperware operation in Morden, because they were one of the corporate entities outside of Winnipeg that was participating. Mr. Acting Chairman, I guess I will put itto you this way: It costs the system possibly $20,000 to $25,000 to do bypass surgery. It is a very invasive procedure, one of our most complex procedures that we do in Manitoba. It is undertaken in growing numbers each year and represents a pretty substantial financial commitment in health care.

I make the case, as I know my honourable friend makes the case, that if we can work with heart disease from the preventative side in terms of greater public awareness as to what high risk activities are, like smoking, like cholesterol, like stress, like lack of exercise and generally unhealthy lifestyles, that if we can achieve a gradual change in personal commitment to greater heart health, I think my honourable friend can see that even the simple delay of several years of the necessity to undertake bypass surgery will save the system considerable dollars.

If we can achieve a lowered rate of surgical intervention in terms of maintenance of heart health, everyone wins. The only ones who potentially would lose would be those practitioners who have become very skilled in bypass surgery. If there was nothing to do they would be the obvious losers, because their professional skills would not be needed. I do not think that we have a utopian opportunity to be there in the near future.

Certainly, every indication we have from across Canada indicates that provinces that have in the past undertaken successful risk identification and education in health promotion programs around the issue of heart health have shown some success. I believe that our sister province of Saskatchewan has undertaken a fair degree of heart health activity some five or seven years ago. The indications are that from a statistical comparison, they are healthier in some of the major indicators of heart health in Saskatchewan than Manitobans.

It is one of those opportunities for tangible result that is so often di sadvantagin g funding commitments to health promotion programs, because you do not have the instant tangible statistic to deal with. If I commit a budget of $1 million to more open heart bypass surgery, I can say at the end of the year that we have undertaken 50 more cases. If I put $1 million into the heart health project I cannot point to the saving of 50 bypass surgery cases.

The system tends to prejudice itself against decisions which would lead to improved health status through ownership of personal health issues and knowledge of risk activities so that one can conduct themselves in a lifestyle conducive to maintenance of good health. Mr. Cheema: Mr. Acting Chairman, as we have repeatedly discussed this same issue over the last three years almost on the same lines, I do agree with the minister that it is an area where you have to spend money, and it may take five, ten years. By that time you will see the good effects.

But definitely-maybe politics is not important here-I think it is important that you are saving money in the long run. That will show up, it is just a matter of time that you will save money from many areas if you are having a major impact on the health prevention and promotion. The minister has stated very well in terms of the anti-smoking campaign, for the education for the diabetic patients and the families, as well as the prevention of other communicable diseases. There is a decline in the tuberculosis area which is very, very positive in terms of the Native community.

The rate has come down substantially for the last three or four years. Some of the numbers that we are seeing, I think some of them may reflect the new Canadians. I think there is some element of people who come newly and there may be a possibility that we see the fluctuation and that may very well be the case. We agree with the minister that the healthy promotion and the Healthy Public Policy is a must. Whether the next government, be it NOP or Tories or whosoever, will enjoy the fruits of that hard work, but people will remember who started the program.

I want to go to the next issue which did get a lot of attention in '88-89, that was the so-called "hamburger disease," infection with the E. coll, and that was because of the raw meat. Can the minister give us, because there were some patients who did suffer major complications and the public education was not there at that time, can they give me the status report on the number of cases in '88, '89 and '90? • (1 510 ) Mr. Orchard: Mr. Acting Chairman, I think we are going to have to inquire directly of staff for that information and provide it at a later opportunity.

June 25, 1991 LEGISLATIVE ASSEM BLY OF MAN ITOBA 3850 Mr. Cheema: Sure. Can the minister tell us what specific measures have been taken to make sure that we do not have that kind of situation, at least not in the alarming numbers we had in 19 88, in terms of the public education plus how the meat inspection and all those things are being done, and how the store owners or the outlets are being notified that they have to cook the meat properly so that we do not have this problem?

There were very horrible stories of a few patients who suffered major damage in terms of the kidneys and other body systems. l think it is worthwhile to explore that and to make sure that the public is notified, provided the health care professionals are quite well aware of the situation. l just want to get some updated information. If the minister has it now, it is fine, otherwise we can wait-maybe later on. Mr. Orchard: Mr. Acting Chairman, I believe that we have partial figures for my honourable friend, so l will give them to my honourable friend.

In '88 there were 59 cases of bloody diarrhea and/or hemolytic uremla syndrome due to the E. coli in hamburger. In 19 89 that grew to 11 5 cases and in 19 90 only 58 cases were reported. A similar decline in number was seen in other markets. I think the inspection process is one side of it.

I think it has been certainly reinforced throughout our food system, but the major initiative that we have undertaken is to increase public awareness and use such avenues as public service announcements, press release fact sheets, ce rtainly media interviews, et cetera to emphasis to all, but more important to the consumers, the necessity of safe food handling, because two things can happen.

For in stance, if you perchance purchase hamburger, round beef with a presence of E. coli, that can be quite safe to consume providing you store it properly after bringing it home from the retail establishment so that you have stored it in an environment where the E. coli do not multiply rather alarmingly. Secondly, that you undertake complete cooking of the hamburger. That is really where we are attempting to come around the issue in terms of a prevention standpoint in the province of Manitoba.

The issue has been, as I said, publicized quite widely through public service announcements, press releases, etcetera but also close co-operation with the City of Winnipeg Health Department to assure that areas of education and prevention under their jurisdiction-that the message is consistent between the province and the City of Winnipeg. Mr. Cheema: Mr. Acting Chairperson, one of the problems the minister has outlined is the meat inspection and then, the second, setting of the protocol for these outlets and health care facilities. The other problem, in terms of the prevention, is small children.

The adults are in big parties in the parks there, and when they share the food, it could be easily spread if you are sharing the same food. I ask the minister is there any specific protocol for schools or daycare centres or any other public places so that they are aware of the situation? Mr. Orchard: Mr. Acting Chairman, there is a specific protocol that has been developed within the ministry to control spread amongst small children in daycare facilities, and that is one of the areas of co-operation that I mentioned earlier on between the City of Winnipeg Health Department and their provincial counterparts.

That information on the protocol has been sent to all licensed daycare facilities. Mr. Cheema: Mr. Acting Cha irperson, on a different issue now, can the minister give us the update on hemophiliac influenza vaccine? Are we still supplying the vaccine on demand to the physicians, or is there a strict supply quota-so much supply you are going to get-also, if there is any public awareness for this particular vaccine? It could be used in many, many conditions. It really works in many situations and saves money in the long run. I am just asking the minister if there is enough supply to supply to the physicians.

I am not advocating on behalf of anyone. I am just advocating on behalf of patients that there is no shortage of this vaccine. Mr. Orchard: We have sort of been the odd province out in terms of provision of the vaccine at 18 months of age . The reason we have not provided the funding for this program is because, in terms of the epidemiological evidence, it is still not clear how effective the vaccine is. The difficulty that we have in coming around this issue from a professional standpoint is that most of the infections can occur prior to the 18 -month age in Canada.

We have remained consistent with our policy over the last number of years, and when a vaccine is available for use in infancy so that it can protect those less than 18 months old or even where

3851 LEGISLA TIVE ASS EM BLY OF MANIT OBA June 25, 1991 the present vaccine has demonstrated its efficacy to the system, we would be prepared to reconsider the policy instruction to allow us to come around the issue. The issue is reviewed by the Manitoba Advisory Committee on Infectious Diseases. Mr. Cheema: Mr. Acting Chairman, I think we have discussed most of the questions on AIDS yesterday, but there is one issue I forgot to ask. That was the AIDS at the workplace.

Is there any specific committee, or are there any specific protocols put in place to make sure that the education is done at the workplace also as far as the AIDS prevention and AIDS education is concerned? Mr. Orchard: In the health care workplace there is quite regular in-servicing or opportunity for in-service in terms of methods of understanding the spread and protecting oneself as a care deliverer in the workplace.

What we have done in conjunction with Manitoba Labour and workplace safety and health is developed information sheets and have also developed policy guidelines which we expect to distribute shortly. Public Health Nurses and workplace safety and health officers are being asked to respond to the request for infor mation and in- service from workplaces. An AIDS in the workplace education guide has been provided to each public health region as a resource document. Public Health Nurses are conducting assessment of workplaces in their region to identify workplaces with AIDS policies and employee education systems.

An AIDS in the workplace policy for government is being drafted with my departmental staff. The Acting Chairman (Mr. Reimer): Item 2.( b)(1 ) Salaries. Ms. Judy Wasylycla-Lels (St. Johns): I would like to ask some questions pertaining to the issues of aboriginal health. I am pleased that the timing was such that my colleague the member for The Pas (Mr. Lathlin) could join us at this point. I would like to ask some general questions and then pass it over to my colleague in terms of this area. I trust that I am not repeating too much of this issue area that was raised by my colleague the member for The Maples (Mr.

Cheema) yesterday. *

(1520) The first question I have, Mr. Acting Chairperson, relates to the request before the minister, from Pukatawagan and the Mathias Colomb Band, in terms of follow-through with respect to their effective transfer of responsibility for health care. I am wondering if the minister has made a decision with respect to ensuring that there is a direct relationship between the minister or his department and this band in terms of the payment arrangement? Mr. Orchard : Which? I missed it. Ms. Wasylycla-Lels: Pukatawagan and Mathias Colomb. Mr. Orchard: I do not think there is any formalized arrangement. Ms.

Wasylycla-Lels: Could the minister indicate, what is the status of the request before him then? Mr. Orchard : No, I cannot. I do not think that we have-if there is a request, it is not to this area of the ministry. Can my honourable friend indicate to whom she understands the request has been made? Ms. Wasylycla-Lels: To the Department of Health. Mr. Orchard: Well, I am nottrying to avoid the issue here.

I want to get a little better handle as to what services were involved, because it is not within this ADM's responsibility that we have-a nd it may well have been that the information came directly to my attention, but I do not recall correspondence from Mathias Colomb. I have had communication from other organizations or other Native organizations, but I do not recall anything from Mathias Colomb, but that may well have happened. Ms. Wasylycla-Lels: First of all, I am raising these issues here since the minister has indicated aboriginal health falls under Health and Public Policy Programs.

He has a specific line on the chart, so there are a number of issues here that I hope we can deal with, at least in part, rather than referring them all to the Hea lth Ser vices Commission. However, if the minister does not have all the information, I hope that he will get it to us. The minister might recall that the issue in terms of Pukatawagan has to do with the question of holding beds at a nursing station and the way in which payments are dealt with and the fact that this band has effected transfer of responsibility and now is looking for a change in the way payments are made.

Currently, the nursing station bills the pro vince . The pro vince pays the federal government. The federal government then in turn, I assume, reimburses the band. Our question is,

June 25, 1991 LEGISL ATIVE ASSEMBLY OF MAN ITOBA 3852 when will the method of payment reflect the transfer in responsibility to this reserve? Mr. Orchard: I will have to seek an answer to that question. Ms. Wasylycla-Lels: Mr.

Acting Chairperson, while he is seeking an answer to that response, we would like to get some information from the minister in terms of this whole area of recognition of our aboriginal communities in the area of health, and the responsibility that they, in some cases, have assumed and have been authorized to assume and, in other cases, are in the process of seeking self-government arrangements around health care. I would like to ask a second question on another particular issue and that has to do with Sandy Bay.

The minister may be aware that Sandy Bay has initiated an application that is supported by, I believe, the six other municipalities in that region for approval for a salaried physician payment program. I am wondering if the minister can tell us what the status of that application is. Mr. Orcha rd: If that appli cation was being considered, it would be considered under the division of Mr. Decock wherein medical services would be considered for salaried physicians. Ms.

Wasylycla-Lels: Perhaps then the minister could give us some general philosophical policy responses to these issues which have all to do with the question of self-government and the changing situation with respect to our aboriginal community and their request for recognition and authority to provide services directly and to deal directly with the Province of Manitoba and to have their request treated as seriously as any other before this government.

Could the minister tell us, generally, since I will be raising a number of issues in this area, what is the general policy right now of this government with respect to requests from various aborigina l communities and bands for management of their health care services? Mr. Orchard: I know I will be corrected if my impression is wrong, but I believe that the issue of on-reserve health care services to bands is negotiated with the federal government, and the Province of Manitoba is not involved in either the construction of the nursing stations on reserve nor their staffing by either nurses or physicians.

That is an issue that has long been a service delivery by, for instance, northern medical services, with the federal government. Ms. Wasylycla-Lels: Mr. Acting Chairperson, we are also dealing with issues that in areas where it has already been established that the medical services are insurable, payable services under the Manitoba Health Services Commission, we are also dealing with issues and requests and applications from communities that are legitimate recognized authorities under the District Health and Social Services Act.

In terms of these requests, is the minister at this time prepared to look seriously at entering into a di rect funding relationship with abor igina l communities who come to this ministry with proposals, innovative and creative proposals, for serving broad communities and providing medical services in a variety of ways but, specifically-and I am thinking of the most recent request before the minister-on a non-fee-for-service basis? Mr. Orchard: Mr.

Acting Chairman, my honourable friend-and correct me if I am wrong-is my honourable friend saying that the province ought to now entertain requests from bands for on-reserve provision of health services, that the province ought to take over that responsibility? I want to tell my honourable friend, if that is the position she is making, I have some difficulty accepting that offload from the federal government. I do not know whether that is where the New Democrats are coming from, that we ought to pick up that responsibility for program and funding from the federal government.

If my honourable friend is saying that, that does not exactly square with my honourable friend's stated case on numerous occasions in the House of criticizing the federal government and demanding action by this provincial government to fight federal cutbacks and transfer payments which support the provision of health care services in Manitoba.

It appears as if my honourable friend wants us to fight cutbacks that she and her party indicate are potentially harming the health care system in Manitoba, to fight those cutbacks, those transfers of responsibility by the federal government; and now, my honourable friend appears to be saying that we should take over responsibility voluntarily from the federal government of a funding issue and a program responsibility issue that the federal government has traditionally had. Is that the case my honourable friend is making?

3853 LEGISL ATIVE ASS EM BLY OF MANIT OBA June 25, 1991 • (1 530) Ms. Wasylycla-Lels: Mr. Acting Chairperson, the minister likes to misinterpret and distort our questions on a regular basis. He is doing it once again. I have raised two issues where the provincial government is already involved, but is refusing to recognize the aboriginal community as a legitimate auth ority and establish a di rect reporting relationship.

In the case of Pukatawagan, we are talking about a situation where the province is picking up the claims, only doing it very indirectly and refusing to enter into a direct relationship with the Mathias Colomb Band. In the case of Sandy Bay, we are talking about an aboriginal community that has taken the leadership in terms of a region and, working together with a number of municipalities, put forward to this minister a proposal for accep tance in terms of a non-fee-for-service or salaried physician payment program.

That region is now recognized as a legitimate authority under The District Health and Social Services Act. There is an Order-in-Council, I believe, to which Sandy Bay is an official signatory. They have come forward with a very creative, innovative proposal to provide co-ordinated health care services to a region. They have yet to receive a response. They have been told that a decision is pending. I want to know why the delay in both cases. Why cannot the minister, with respect to these two requests, make a decision and respect the interests, aims an aspirations of our aboriginal community? Mr.

Orchard: Let us separate the two issues, in case my hon ourable friend has di fficu lty understanding them and understanding what she is saying. If I listen to my honourable friend, what my honourable friend is saying on behalf of the New Democratic Party is that the provincial government ought to take over responsibility for funding on reserve health care services for Status Indian population of Manitoba. That has not been our responsibility in the past; that has been the responsibility of the federal government.

That should remain with the federal government in terms of the financial contribution necessary to undertake that. Surely my honourable friend, in arguing in the House against cutbacks by the federal government to support the health care system for a million Manitobans, is now not turning around and saying, well, we are against the cutbacks by the federal government, but we are willing, on the other hand, to take over federal responsibility for health care delivery to Status Native Manitobans on reserve. Point of Order Ms.

Wasylycla-Lels: Perhaps the minister is not aware of his own arrangement in terms of paying to the federal government for claims submitted from nursing stations under a 30-year agreement. He should refer to his own Annual Report of the Manitoba Health Services Commission. The Acti ng Ch airman (Mr. Rei mer) : The honourable member did not have a point of order. It was a dispute over the facts. *** Mr. Orchard : Let us distinguish the two processes.

I want to tell my honourable friend that the provincial government does not have the financial capacity to accept continued offloa d of hea lth delivery responsibility from the federal government to the Native community. -(interjection)- Mr. Acting Chairman, my honourable friend wants to confuse two issues. If my honourable friend wants to know how this government approaches the issue of the Native communities being in a position to manage their own service delivery, I have no philosophical and I have no policy concerns with the management of programs on reserves by Native people.

I do not have a problem with that. My honourable friend from The Pas (Mr. Lathlin) knows that this gove rnment signed the first ever management-of-lotteries agreement with his band as a method of self-government, if you will. I do not like to use self-government because I do not completely understand the concept-it has not been explained to me adequately-but basically to give responsibility for service delivery, I do not have a problem with that.

Where I do have a problem is in a request from IC coming from the Health critic of the New Democratic Party, a request that the provincial gove rnment take over financia l responsibility for medical services, health care delivery services on reserve. I cannot accede to that because that is a responsibility the federal government has traditionally had. There is no question that in the process of unloading costs on the province, they would like to unload this one. So let us separate the issue. Rnancially, the responsibility on reserve is federal government; management-wise of the issue, I do not have any

June 25, 19 91 LEGISL ATIVE ASSEM BLY OF MAN ITOBA 3854 management-wise of the issue, I do not have any philosophical or program problem with the Native communities in Manitoba assuming a greater empowerment and management of health care delivery in their respective communities. Mr. Oscar Lathlln (The Pas): I would like to maybe enligh ten the minister just a little bit on the federal-provincial agreements that have been in place for a long time and are still in place today. First, I want to refer to him an agreement that has been there since about 1964. He knows it, and I am glad that he knows that.

The communities of Moose Lake, Chemawawin, Grand Rapids, I have been meeting with officials from the government, sometimes with the Department of Northern Affairs. I believe, the minister may have met with them at one point in time. Their main interest is, as the minister says, to eventually work toward the notion of having self-government. I believe the minister when he says, when our band signed the gaming commission or the Lotteries Commission, that was not an attainment of true self-government as aboriginal people see it.

In fact, it was just another milestone, if you will, or another evol utionary step toward the eventual true self-government that we have been after for a long time. For the com munities of Mo ose Lak e , Chemawawin and Grand Rapids, they have been meeting and negotiating with different ministries with government and officials. So far as I am given to understand by the tribal council, there has been virtually no progress made in these meetings and negotiations. I know the federal government is party to those agreements that I refer to.

Perhaps I can ask the minister to give this committee an update as to where those negotiations are and if, indeed, there has been any progress. * (1 540) I know that I have asked him once or twice in the House a question on the same issue. Perhaps I will stop there for now and ask the minister to give us an update, or to give this committee an update, as to where we are at in terms of negotiating those health transfer agreements that my colleague had been referring to when she was talking about Mathias Colomb Indian Band. Mr.

Orchard: The feder al gover nment, I understand, is committed to the initiative to transfer responsibility for administration and delivery of Community Health Services to Native control. As of July 27, 19 90, eight projects involving 32 bands across Canada had reached completion with signed transfer agree ments. Two of these signed agreements involve two bands in Manitoba, Mathias Colomb First Nation and Sandy Bay Band.

The Chemawawin Indian Band, adjacent to the Easterville community which currently receives health services from Manitoba Health, submitted a community health plan to Medical Services Branch, Health and Welfare Canada and Manitoba Health in June, 19 89, indicating the community's readiness to proceed with transfer of control discussions. To date, no formal mechanism has been identified in Ma nitoba for ne gotiations of new service agreemen ts between Indian bands and the provincial government.

Manitoba Health is not in the position to respond to the request for transfer of authority and resources for the administration of delivery of health services to Native communities without direction from cabinet. Nevertheless, the preparation of a provincial strategy is essential to prevent federal offloading of responsibility onto Manitoba for service provision to Native communities. That is the issue that has troubled not only this cabinet but previous ones, because clearly the federal government's age nda-they would welc ome a transfer of responsibility and financial responsibility to the province.

I think my honourable friend understands that. The Issue of transfer to Native health authorities has been a subject of discussion not only in this province but other provinces as well. I want to tell my honourable friend that in Charlottetown, Prince Edward Island, the provincial territorial Ministers of Health met and, because this is not a narrowed provincial agenda but rather one which has impact on all provinces and territories, we undertook to hold a meeting of provincial territorial ministers with the federal Minister of Health and Native leaders in order to attempt the next steps in process.

All provincial ministers, I think it is fair to say, want the federal government at the table, because Native admini strative responsibilities is the federal government's, not the provincial government's in terms of health service delivery. They would be glad to have us there alone as provinces and picking up the program and the financial commitment. That is not where we want to

3855 LEGISL ATIVE ASS EM BLY OF MANIT OBA June 25, 1991 be, and I do not think the Native leadership want that fo be. They believe the federal government has a financial and a program and policy obligation to the Native communities. Mr. Lathlln: Mr. Acting Chairperson, I know the minister was reading from a text that was given to him by his officials. The three communities that I mentioned are communities that are both Metis and Sta tus people together.

For example, in Chemawawin you have a provincial nursing station that is providing services to those people who are on the Metis side and presumably looks after people who are Status whenever the need arises, but primarily the Status Indian people go to The Pas for medical services. I worked for the Swampy Cree Tribal Council back in 1979, and even in '79 these talks were being carried out between the tribal council and the federal governmen t and the provincial gover nment. Subsequently, more recently the talks have picked up again.

It would seem to me, what is holding up any movement towards health transfer to the Status people is the fact that the expiry date of the federal-provincial agreement is still quite a ways off. At least that was the understanding I was given at one time when talking to provincial officials. I wonder if I can ask the minister to clarify that, whether that indeed is the roadblock, waiting for the federal-provincial agreement to expire. Mr. Orchard: I do not believe that is the roadblock. Mr. Lathlln: Is there indeed an expiry date on those federal-provincial agreements? Mr.

Orchard: I do not know whether there is or not, and my staff does not know whether there is or not either. Mr. Lathlln: Mr. Acting Chairperson, could I then ask the minister to, at some later date, perhaps give us or share that information with us, specifically referring to the federal-provincial agreement that is there, the terms and conditions and the expiry date and everything? Mr. Orchard : I am informed that there is no expiry date. I will confirm that at next sitting of the Estimates for my honourable friend.

The reason why I did not answer in any other way but by simply saying I am not aware of that being a problem is that in all of the discussions I have to date around the issue, this is the first time I have heard of any mention of an expiry date. It has not been part of any discussions I have had as driving the process as my honourable friend is concerned about. Mr. Lathlln: Mr.

Acting Chairperson, the other reason that has been given by officials from the Department of Health and Northern Affairs is that the department was not willing to transfer anything over to the Indian band in terms of health programs and services, because there are still people there who have not regained their Status. Although if you look at the community of Chemawawln, for example, there is only a handful of people who are Metis, and the majority of the members of the Chemawawin First Nation are Status Indians.

That is why the Chemawawin First Nation was so determined to gain control over the health services that were available in Chemawawin, whether they were federal or provincial. Could I ask the minister if he would consider, given the small number of Metis people who are left in Chemawawin, of going ahead with the tribal council, Chemawawin First Nation, and the federal government of transferring those programs and services to the community of Chemawawin? Mr. Orchard : I think, Mr.

Acting Chairman, that is exactly part of the process that my honourable friend indicates has been discussed since 1979, because this is not a new issue. It has been unresolved even by the Pawley administration, I think it is fair to say. The reason it has been unresolved is that whatever you do in the band that my honourable friend mentioned will be the pattern that you use right across the board for all other, a transfer of responsibility.

That is wherein, I think, all provincial governments, and this one not being an exception, want to clearly establish the fiscal framework with the federal government as to who has responsibility continued financial requirements are. • (1 550) We make the case that on reserve, Native health programs are a federal government's responsibility. The federal government, as I have indicated earlier on, I think it is fair to say would like to have the province assume that responsibility.

We cannot afford to be there, quite simply, because as I used an example earlier on to my honourable friend's colleague, the Health critic for the New Democratic Party, how many times in Question Period, how many times at the start of these Estimates has my honourable friend on behalf of the New Democratic

June 25, 1991 LEGISL ATIVE ASSEM BLY OF MANITOBA 3856 Party indicated that we should fight tooth and nail with the federal government to have them reinstate cash transfer payments to the province to support what, to support health care delivery. That is why in any kind of agreement or a negotiated process of transfer of management responsibility and program responsibility with the Native communities in Manitoba, we want to understand fully and completely how it is the federal government is going to provide ongoing financial commitment to the provision of those services.

We cannot on the one hand accept the legitimate argument of the NOP that we should be getting more money from the federal government to finance health care for Manitobans, and on the other hand simply put our hands up in the air and say we give up, we will take over yet ano ther federal responsibility, this one being provision of health services to on-reserve Status Indian people. Mr. Lathlln: Mr. Acting Chairperson, I do not believe the minister was listening to me when I was talk ing.

Perha ps he was preo ccupied with something else, because the answer that he gave is not really related to the question that I asked. My question was, there is a facility out at Chemawawin, it is a provincial operation. Most of the residents in Chema wawin are treaty Indian people. There is now only a handful of Metis people there because all of them have regained their Status through Bill C-31.

What would it cost the provincial gove rnmen t to agree to get out of the feder al- provincial agr eement if the federal government was willing to fund health transfer programs, which by the way, they have a policy that they do health transfer programs across the country? Mr. Orchard : Obviously, I cannot answer that question today. Let me seek my honourable frien d's cla rific ation around the issue.

The provision of service in this community stemmed from the 1964 agreement at which time, if I understand the general arrangements that were made , is that the province and the federal government jointly provided health care services. We did not make the distinction on a given program line whether the individual receiving the care-let us say for a doctor's care-was Status Indian or off reserve living in Metis community next to the reserve, neither did we ask for nursing service whether they were Status or non-Status.

We had a split of costs which approximated, at that time, the non-Status versus Status Indian population, so the costs were attempted to be split in some formula which reflected Status versus non-Status. In that way, we did not have to go through, as I understand the agreement, the ability of billing for physician services delivered through the clinic provided to Metis community members. We did not have to have the federal government bill us and vice versa for nursing services or others that we have provided. Now, the status of the community has changed. Recognize that.

The replacement of the agreement will be one which, I think, my honourable friend will have to ad mit, set the preceden t for other agreements in place. My honourable friend shakes his head. I will trust his wisdom in that. Where we are approaching the issue is in terms of the management of the system and the empowerment of the native community to manage their own care deli very.

I do not have any philo sophica l disagreement, but where we want to understand, we want to go into this as not day-old kittens but hopefully full-grown cats with our eyes wide open so that we do not have the federal government yet aga i n offlo ad ing, to pro vince, prov incial responsibility, provincial taxpayers, a financial responsibility that they have traditionally had, I guess, since this country was formed. I believe that therein lies part of the difficulty, because this issue did not just magically appear in May of 19 88.

A previous administration, of the philosophical persuasion of my honourable friend, wrestled with this agreement and were unable, I believe, to resolve it, or else we would not be discussing it today. It is not as simple as my honourable friend might indicate. It is an issue which requires a great deal of consideration and forward thought before the provincial government accedes to any new arrangement, because our commitment has to be to provision of services that we are required. We want to hold the federal governmen t to their obl igations in any new agreement.

Those obligations, we believe, are provision of health care services to Status Indian. Mr. Lathlln: Mr. Acting Chairperson, what I cannot understand is the-I do understand the provincial government's position on aboriginal people, treaty aboriginal people. Their position is that they have absolutely no responsibility for treaty Indians, except, of course, when it comes to election time. All of a sudden, we become very, very important,

3857 LEG ISL ATIVE ASSEM BLY OF MANIT OBA June 25, 1991 and we actually have people come to visit us on the reserves, knocking on our doors, even coming into our homes. That is the only time; we realize that. We know where we are in terms of the provincial government. The minister does not have to keep reminding the committee that you are a federal responsibility, except when it comes to election time.

The reason that I shook my head when you were saying-you know and because the minister, when he answers questions, whether it is in committee or in the House, always likes to come across as being very informative and well versed on issues that are asked of him, because he prefaces his responses by saying, let me correct my honourable friend because he or she does not know what she is talking about. So I am glad I caught him on this one because that would not be a precedent-setting exercise if you were to do it in Chemawawin. All you have to do is go to The Pas and look at the operation there.

There is a health transfer program there that has been going on ever since 19 72. You have a full range of programs and services that are being fully funded by the federal government, so if you do it at Chemawawin, you are not going to be setting any precedence. It has been done in Manitoba and elsewhere in the country, and they also are doing it in Pukatawagan, the Mathias Colomb Indian Band. The Acting Chairman (Mr. Reimer): Item 2(b)(1 ) Salaries-- Mr. Lathlln: Mr. Acting Chairperson, I paused because again the minister was not paying attention to what I was saying, he was too busy talking to his official.

I would kind of think that the minister would be courteous enough to listen, or at least pay attention, or at least appear to be paying attention to members asking questions during these committee hearings. So, for example, he mentions the Lotteries commission that we entered into. Did it cost the provincial government any money for us to enter into that kind of an agree ment? Did it cost the government any money when we entered into the Moose management agreement when I was still chief of my band?

No, it did not cost the government anything. * (1 600) I am just going to leave that part for now, and I want to finish off by referring to a letter that was written to the First Minister, the Premier (Mr. Filmon), regarding an agreement that has been in existence since 19 76 between the provincial Hea lth department on dental services with the Swampy Cree Tribal Council.

Now, the letter says here, and since 19 76, the Swampy Cree Tribal Council has had an agreement with the provincial Health to provide dental services to the children on the Swampy Cree Tribal Council member reserves and adjacent Metis communities. Your government's recently announced budgetary cutback will compromise oral health for our youth. So the program that was cut back had to do with funding that went to serving Metis children who were 13 and 14 years old.

What I would like to ask the minister is: Because he always seems to be so concerned about the health of everybody, including aboriginal people, why would he see fit to cut back what we thought was a very worthwhile program, an agreement that had been there since 1976? Mr. Orchard : Mr. Acting Chairman, I will deal with the dental health issue after I take slight umbrage. I believe I asked my honourable friend, "correct me if I am wrong," not that he was wrong. I know maybe he is a little sensitive when he does not get the answer he wants. I cannot help that.

I simply want to indicate to my honourable friend that, when he talks about the Lotteries Agreement, which was signed with himself as chief of The Pas Band, not between an NOP government that he is now part of, but between a Conservative government- An Honourable Member: Started with the NOP government. Mr. Orchard: My honourable friend has interjected the gratuitous piece of information, started with an NOP government, but my honourable friend makes the statement that the only time politicians come to the reserves and come into their homes is during election time.

I believe the agreement that was signed with him as chief was well before an election campaign, and he might reconsider some of those statements which stretch one's imagination and destroy one's credibility when they make them because they are not exactly accurate and factual. Now, Mr. Acting Chairman, my honourable friend indicated that The Pas had an arrangement of provision of medical services paid for by the federal

June 25, 1991 LEGISLATIVE ASSEM BLY OF MANIT OBA 3858 government and had existed since-what?-1 972, I believe my honourable friend said. An Honourable Member: Well, you must know. You know everything. Mr. Orchard: Now, my honourable friend does not know what he just said five minutes ago, but I am assuming my memory is correct in what he said five minutes ago.

If he might want to, we can check Hansard to see if my honourable friend did say it, if he does not now remember what he said, but my unde rstanding is that he is asking us at Chemawawin to take over or to allow the federal government to deliver the services there and pay for them. Is that what my honourable friend is suggesting, because he used the similar analogy between The Pas after discussing an issue of transfer of responsibility to Chemawawin? Is the federal government going to pay for the services in Chemawawin? Is that what my honourable friend is proposing? Mr. Lathlln: Mr.

Acting Chairperson, I believe the minister has advised us that there have been ongoing discussions and meetings and so forth, so I do not feel the need to really apprise him of developments that have taken place, because he is the minister. He has just finished telling us that there have been ongoing meetings. Surely he knows what is going on in his department. Mr.Orchard: Mr. Acting Chairman, I was just trying to determine what was ongoing in Estimates here, because you cannot use an example of medical services paid by the federal government at The Pas Band.

Unless I misunderstood my honourable friend, I belie ve he wa nted the provin cial government to pay for the service on Chemawawin. The two are not compa rable. If the federal government wants to pay for the services at Chemawawin, as they do at The Pas, that is a different issue. That is exactly the issue we discussed for about 10 or 15 minutes. The example my honourable friend used at The Pas as a comparable example may not be as comparable as one would like. Mr. Lathlln: You see, Mr. Acting Chairperson, that is why I was saying that the minister was not listening.

He was preoccupied with something, but then he very quickly told me that he is quite capable of sometimes doing two things at the same time. I believe him. What I told the minister is that The Pas Band has virtually full health transfer program. They have nurses, they have community health workers, they have a committee and now they are going into a full-blown health transfer mode with the federal government. The federal government will be paying for all of those services, because I have gone through the federal health policy over and over again and that is what it says.

What I was trying to make the minister understand, Mr. Acting Chairperson, and that is when he was either sleeping or talking to his official or thinking about something else, was that I could not understand why he would be so hesitant to turn over the facility, the programs and services over at Chemawawin when the federal government is quite willing to do a health transfer program to Chemawawin. The stumbling block has always been, no, the expiry date has not come around. We are committed to keep providing these services to the Metis people.

That is the only reason why I said I could not understand why he would refuse to agree to a health transfer program at Chemawawin when it probably would not cost the province anything. Mr. Orchard: I thank my honourable friend for that clarification.

On the issue of the children's dental health service provision a decision was made at the last budget that we would maintain the education and health promotion components of the children's dental health program, which ranges from no services in Brandon or the city of Winnipeg, up to age 14 service in some parts of the province, to age 12 in other communities, to age 10 in other communities. What we have done is maintained all of the promotion, education, fluoride rinse programs, for ages up to 14 , 12 or 10 depending on the community.

In terms of restorative and reparative work and extractions, we will be removing that service to ages 13 -14 where it is currently provided. *( 16 10 ) Mr. Lathlln: Mr. Acting Chairperson, perhaps I could ask the minister-I know when I was going to school on the reserve we used to have a visit from a dentist once a year. There was no education work done. There was no awareness work done. There was no prevention. The only time we ever saw a dentist was once a year when he came around.

I am telling you, even though he only came once a year to the community, after he would leave half the community would be toothless because that is how

3859 LEGISL ATIVE ASS EMBL Y OF MAN ITOBA June 25, 1991 bad our dental health was. That is the truth. I am not making it up. What would happen, you see, when I was executive director of the tribal council, if our staff was out in Grand Rapids or Moose Lake and if somebody came to them in terrible pain needing medical, dental attention, I would say, yes, go ahead help him. I mean who the hell cares about cost. The person is in pain; help him right there; it is only going to take you half an hour anyway.

My question for the minister is: What happens now, for example, in the area of prevention, dental hygiene, education and even extractions? Does that mean that people have to go to The Pas and have to pay $50 surcharge or do they have to come to Ashern or Winnipeg? What do those people do in terms of accessing dental services or do we send them a butcher of a dentist once a year, like what they used to do to us a long time ago? Mr. Orchard : I think my honourable friend indicated there was no awareness work, there was no prevention.

Those programs remain intact, as do the fluoride rinse, as do the hygiene education, as do the oral health promotion programs. What will not be there is the extraction at age 13 or 14 . That will have to be accessed by the individuals in wherever they, the communities, can provide that service. That is what parents face in the city of Winnipeg for the entire length of a child's school years. The same thing in the city of Brandon. (Mr. Gerry McAlpine, Acting Chairman, in the Chair) The education, the health promotion, the fluoride rinse, the opportunity for practice of good oral hygiene will remain.

That has always been the strength of the program, and I think my honourable friend in his earlier comments alluded to that, that all you had in his younger years was a dentist coming in once a year and leaving half of his community toothless, because there was no education, there was no oral hygiene, there was no fluoride rinse, there was no preventative measures and education programs undertaken. Those will be continued to be undertaken for the entire range of school children who are currently enrolled in the program. Mr. Lathlln: Mr.

Acting Chairperson, I am just going to ask one more and then I will be through. So the minister is telling us that those people who are going to have to have their teeth extracted will have to travel on their own wherever they can find a dentist. What about other preventative work, like braces and other special type of dental care like that? Would that still be available or are the people going to be left on their own to look after that as well? Mr. Orchard: Mr. Acting Chairman, for a child of age 13 or 14 they will now do what a child of age 15 has had to do.

In other words, when a child reaches 15 , they no longer have the services available in the program , and should they have needed an extraction, they would have had to seek that extraction through some other provision of service. The children's dental health program covered students only to the age of 14 in most communities, outside of Brandon and Winnipeg, to age 12 in one other community, to age 10 in one other community. So they will have to seek the service as the 15 - year-ol ds do as they come off the program whethe r that be in adjacent communities or Winnipeg, that is the choice of the individual.

My understanding is that braces and orthodontic services were not part of the children's dental health program unless, for instance, that happened as a result of an injury on the playground, but the program provided education, prevention, oral hygiene, fluoride rinses and, where necessary for younger children, repair of caries or possibly extraction. Mr. Cheema: Mr. Acting Chairman, I just want to add a few words here. I think I just want to indicate that the issue that the minister was trying to explain and the members for St. Johns (Ms. Wasylycia-Leis) and The Pas (Mr.

Lathlin) were asking, I think the issue is larger than that. The issue is who is ultimately responsible for the health care of Native people. I think the issue, as the minister has said, to try to outline, is a very complex and a major issue, and it is going to be a major issue of debate for the next, you know, probably a year. It is going to be a major responsibility for the new Grand Chief from Manitoba to have that kind of approach because the-as I understand the total determination of self-government and the Native health care, they are inseparable issues.

They are a major component of their well-being and which is very crucial and very important. As the minister has said and the member for The Pas (Mr. Lathlin), who is very well- known in his community and has done a lot of work

Document details

Collection	Manitoba — Debates (Hansard)
Citation	35-2-72
Type	hansard
Volume / chapter	35th 2nd hansardpdf 72.pdf
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	d14a6b0a61f289e091ad122bdb689662e487fa5a

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