Manitoba Hansard — Sitting 18A (35th Legislature, 5th Session)

35-5-18a

Manitoba — Debates (Hansard)

Fifth Session • Thirty· Fifth Legislature of the Legislative Assembly of Manitoba DEBATES and PROCEEDINGS (Hansard) Published under the authority of The Honourable Denis C. Rocan Vol. XLill No. 18A • 1:30 p.m., Monday, May 2, 1994 ISSN OS42-S492

NAME ASIITON, Steve BARRE'IT, Becky CARST AIRS, Sharon CERILLI. Marianne CHOMIAK. Dave 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, J'un, Hon. EVANS,Ciif EVANS, Leonard S. Fll...MON, Gary, Hon. FINDLAY, Glen, Hon.

FRIESEN, Jean MANITOBA LEGISLATIVE ASSEMBLY Thirty-Fifth Legis lature Members, Constituencies and Polltlcal Afftli atlon CONSTITUENCY Thompson Wellington River Heights Radisson Kildonan Ste.Rose Seine River Roblin- Russell Selkirlc Concordia Arthur-Virden Steinbach Riel St. James Lakeside Charleswood Interlake Brandon East Tuxedo Springfield Wolseley GAUDRY,Neil Gll.LESHAMMER, Harold, Hon. GRAY, Avis St. Boniface Minnedosa Crescentwood Gimli HELWER, Edward R. IHCKES, George KOWALSKI, Gary LAMOUREUX, Kevin LA'IHLIN, Oscar LAURENDEAU, Man:el MACKINTOSH, Gord MALOWAY,J'un MANNESS, Clayton, Hon.

MARTINDALE, Doug McALPINE, Gerry McCORMICK, Norma McCRAE, James, Hon. MciNTOSH, Linda, Hon. MITCHELSON, Bonnie, Hon. ORCHARD, Donald, Hon. P ALLIS TER, Brian PENNER, Jack PLOHMAN, John PRAZN1K, Darre n, Hon. REID, Daryl REIMER, Jack RENDER, Shirley ROBINSON, Eric ROCAN, Denis, Hon. ROSE, Bob SANTOS, Conrad SCHELLENBERG, Harry STEP ANSON, Eric, Hon. STORiE, Jerry SVEINSON, Ben VODREY, Rosemary, Hon. WOWCHUK, Rosano Point Douglas The Maples Inkster The Pas St. Norbert St.

Johns Elmwood Morris Burrows Sturgeon Creek Osborne Brandon West Assiniboia River East Pembina Portage la Prairie Emerson Dauphin Lac du Bonn et Transcona Niakwa St. Vital . Rupertsland Gladstone Turtle Mountain Broadway Rossmere K.irkfield Parle FlinFlon La Veren drye Fort Garry Swan River PARTY. NDP NDP Liberal NDP NDP PC PC PC NDP NDP PC PC PC Liberal PC PC NDP NDP PC PC NDP Liberal PC Liberal PC NDP Liberal Liberal NDP PC NDP NDP PC NDP PC Liberal PC PC PC PC PC PC NDP PC NDP PC PC NDP PC PC NDP NDP PC NDP PC PC NDP -

820 LEGISLATIVE ASSEMBLY OF MANITOBA Monday, May 2, 1994 The House met at 1:30 p.m. PRAYERS ROunYNE PROCEEDINGS RE ADING AND RECEIVING PETITIONS Child Care System Mr. Speaker: I have reviewed the petition of the honourable member (Mr. Schel lenberg). It complies with the privil eges and the practices of the House and complies with the rul es. Is it the will of the House to have the petition read? An Honourable Member: Yes. Mr. Speaker: The Oetk will read. Mr. Clerk (Willi am Remnant): The petition of the undersigned citizens of the province of Manitoba humbly sheweth that:

WHEREAS under the previous NDP government the province of Manitoba developed the best cbild care system in North America; and

WHEREAS this child care system wa s acc essible, affordable , of high qu ality , communit y-based and nonprofit; and

WHEREAS the current provincial government has cut salary enhancement grants , increased parent fee s, reduced the number of spaces for cbild care, red uced the number of weeks of cbild care for parents searching for work; and

WHEREAS many child care centres have seen children withdrawn , have been forced to lay off staff or roll back wages; and

WHEREAS ma ny child care centres are experi encing severe financial problems; and

WHEREAS child care is known to be money saving in the long term, including savings on unem ployment insurance , social assistance and other government programs ; and

WHEREAS in the 1994 provincial budget child care grants were cut by $300,000. WHEREFORE your petitioners humbly pray that the Legislative Assembly urge the provincial government to consider restoring funding and accessibility to high quality, affordable, nonprofit child care with decent wages for all child care employees. Curran Contract CanceD ation and Pharmacare and Home Care Reins tatement Mr. Speaker: I have reviewed the petition of the honourable member (Mr. Santos). It complies with the privileges and the practices of the House and complies with the rules.

Is it the will of the House to have the petition read? Some Honourable Members : Dispense . Mr. Speaker: Dispense . The petition of the undersigned citizens of the province of Manitoba humbly sheweth that: WHE REAS the Manitoba govern ment has repeatedly br oken pr omises to su pport the Pharmacare program and has in fact cut benefits and increased deductibles far above the inflation rate; and

WHEREAS the Pharmacare program was brought in by the NDP as a preventative program which keeps people out of costly hospital beds and institutions; and

WHEREAS rather than cutting benefits and increasing deductibles the provincial government should be demanding the federal government cancel recent cuts to generic drugs that occurred under the'Drug Patent Act; and

WHEREAS at the same time Manitoba government has also cut home care and implemented user fees; and

821 LEGISLATIVE ASSEMBLY OF MANITOBA May 2, 1994

WHEREAS the Manitoba government is giving an American health care consultant over $4 million to implement further cuts in health care. WHEREFORE your petitioners humbly pray that the Legislative Assembly urge the Premier to personally step in and order the cancellation of the Connie Curr an contract and consider cancelling the recent cuts to the Pharmacare and Home Care programs. APM Incorporated Remuneration and Pharmac are and Home Care Reinstatement Mr. Speaker: I have reviewed the petition of the honourable member (Mr. Dewar).

It complies with the privileges and the practices of the House and complies with the rule s. Is it the will of the House to have the petition read? Some Honourable Members: Dispense . Mr. Speaker: Dispense. The petition of the undersigned citizens of the province of Manitoba humbly sheweth that:

WHEREAS the Man itob a gove rn ment has repeatedly br oken promis es to support the Pharmacare program and has in fact cut benefits and increased deductibles far above the inflation rate; and

WHEREAS the Pharmacare program was brought in l7y the NDP as a preventative program which keeps people out of costly hospital beds and institutions; and

WHEREAS rat her than cutting benefits and increasing deductibles the provincial governme nt should be demanding the federal government cancel recent cuts to generic drugs that occurred under the Drug Patent Act; and

WHEREAS at the same time Manitoba government has also cut home care and implemented user fees; and

WHEREAS the Manitoba government paid an American health care consultant over $4 million to implement further cuts in health care. WHEREFORE your petitioners humbly pray that the Legislative Asse mbly urge the Premier to personally step in and order the repayment of the $4 million paid to Connie Curran and her firm APM Incorporated and consider cancelling the recent cuts to the Pharmacare and Home Care programs. •

(1335) MINISTERIAL STATEMENTS AND TABLING OF REPORTS Bon. Leonard Derkac h (Minister of Rural Development): Mr. Speaker, I have the honour today of tabling the Supple mentary Inf onnation For Legislative Review, 1994-1995 Departmental Expenditure Estimates for the Department of Rural Development Bon. James McCrae (Minister of Health) : Mr. Speaker, I am pleased to table the Annual Repo rt 1992-93 of the then-Alcoholism Foundation of Manitob a. Mr.

Speaker, I am tabling the Annual Report 1992-93 for the Department of Health, and I am formally tabling today the Supplementar y Inf onoation for Legislative Revie w, 1994-1 995 Departmental Expe nditure Estimates for the Department of Health, although I made copies available to the party critics on Friday afternoon. Bon. Bonnie Mitchelson (Minister of Family Services ): Mr. Speaker, it is my pleasure to table the Annual Report 1992-93 for Manitoba Family Services. Bon. Darren Praznik (Minister of Labour): Mr. Speaker, it is my pleasure to table the Annual Report 1992-93 of the Manitoba Labour Board. Bon.

Jim Ernst (Minis ter of Consu mer and Corporate Affairs): Mr. Speaker, I am pleased to table the Annual Report 19 93 of The Public Utilities Board. National Forest Week Bon. Albert Driedger (Minist er of Natural Resources) : Mr. Speaker, I have a statement. I wish to share with the members of this House some iofonnation on behalf of Manitoba Natural Resources. During the month of May, Manitobans of all ages will be celebrating three related events. - -

- May 2, 1994 LEGISLATIVE ASSEMBLY OF MANITOBA 822 The week of May 1 to 7 is National Forest Week. We are blessed with a vast we alth of woodlands which have played and continue to play a vital role in Manitoba's and Canada's well-being on many fronts . This is a most app ropriate time to reflect on the eco nomic, recreational and environmental impo rtance of Canada'sforests. May also marks the 75th anniversary of the Manitoba Fores try Association.

This local organization has worked continuously to educate and inform generations of Manitobans on the importance of forests and bow to protect these valued natural res ources for our future, and have provided the members of the House with trees that they see before them here today. While these two events are significant, I feel that this third is equally worthy of celebration. May is the 50th birthday of one of the most recognized and popular program mascots in North America. Smokey the Bear celebrates five decades of fame as a furry fire fighter and friend of forest fans everywhere.

His special message, Only You Can Prevent Forest Fires, has reached over half a million Manitobans with the excellent support of the Manitoba Forestry Association. Together, Smoke y and the association have made us more aware of the need to protect the forests while we enjoy them . I ask the members of the House to join me and the Depa rtment of Natural Resources in congratulating the Manitoba Forestry Association on 75 years of outstanding service to Manitoba and wishing Smokey a very happy 50th birthday and in urging all Manitobans to participate in the cel ebration of National Forest Week.

Thank you. • (1 340) Mr. Osc ar Lathlin (The Pas) : Mr. Speaker, I am pleased to rise to join the Minister of Natural Resources in commem orating National Forest Week and Arbor Day 1994. This week is National Forest Week . As the minister said, it is time for all of us to reflect on the economy , recrea tion and the environment and the importance of those resources not only to Manitoba but throughout Canada. I, of course, come from northern Manitoba where we still have some forests left. I sometimes comp are sou thern Manitoba and northern Manitoba in a lot of ways.

There is another comparison I regularly make when I look at our province of Manitoba and that is, at one time southern Manitoba was not unlike northern Manitoba with the forests and everything, but of course, as development came on, land has been developed to the point now where in southern Manitoba we do not have the forests we used to. Hopefully , northern Manitoba will never tum out to be like sou thern Man itoba in terms of sustainable development.

I only wish that when it comes to government policy and budgets , these kinds of statements are reflected throughout governm ent policy and in the budgets that governme nts present from time to time. I, for example, look at the operation in Repap. I wanted to mention that when I looked at the budget for this year, it again bad been reduced considerably. I also loo k at Clearwater Lake Nursery, about bow valuable a contribution that nursery bad made to the people of northern Manitoba. With those words, Mr. Speaker, I congratulate the Forestry Association for these types of educational programs. Thank you. Ms .

Norma Mc Cormick (O sborne) : Mr. Speaker, as well, on behalf of our Liberal caucus, I would like to express our appre ciation for the work of the Manitoba Forestry Association, and commend them on 75 years of service to our province . We must, indeed, recognize that prevention goes beyond forest fire prevention. It is evident that a comprehensive forest management plan is more important today than ever bef ore in ensuring the stewardship of our forests .

We are still waiting, after six ye ars of this government, for a comprehensive plan, and we look forward to an . equal commitment from our governm ent to leadership in protecting our fore st re sources. Thank you.

823 LEGISLATIVE ASSEMBLY OF MANITOBA May2, 1994 INTROD UCTION OF BILLS Bi113- The Cancer Treatment and Rese arch Foundation Amendment Act Hon. James McCrae (Minister of Health) : Mr. Speaker, I move, seconded by the honourable Minister of Education and Training (Mr. Manness), that leave be given to introduce Bil1 3, The Cancer Treatment and Research Foundation Amendment Act (Loi modifiant la

Loi sur la Fondation de traitement du cancer et de recherche en canc�ro logie), and that the same be now received and read a first time. His Honour the Lieutenant-G overnor, having been advised of the contents of this bill, recommends it to the House, and, Mr. Spea ker, I would like to table the message. Motion agreed to. Introduction of Guests Mr. Speaker: Prior to Oral Questions, I would like to draw the attention of honourable members to the Speaker's Gallery, where we have with us today, a gentleman celebrating his 50th birthday, the symbol of fire prevention, Smokey the Bear.

On behalf of all honourable members, I would like to welcome you here today and congratulate you, sir. Also this afternoon, I would like to draw the attention of honourable members to the gallery, where we have with us 18 Japanese social workers from Sappaur, Japan. [interjection] Order, please. These are our guests this afternoon. We have 18 guests from Sappaur, Japan, and these are social worlcers. On behalf of all honourable members, I would like to welcome you he re this afternoon. Now, from the Ne ss Junior High School, we have seventy -five Grade 9 students under the direction of Mr. Baydak.

This school is located in the constituency of the honourable Minister of Urban Affairs (Mrs. Mcintosh). Also this afternoon we have, from the Ken Seaford School, twenty-two Grade 9 students under the direction of Mr. Kraychuk. This school is located in the constituency of the honourable member for The Maples (Mr. Kowalski). On behalf of all honourable members, I would like to welcome you all this afternoon. • (1 345) ORAL QUESTION PERIOD Economic Growth Government Strategy Mr. Gary Doer (Leader of the Opposition): Mr. Speaker, my question is to the Premier.

Last year, to a lot of fanfare and public relations, the Premier announced to the people of Manitoba, in his Framework for Economic Growth, that Manitoba's economy is going to be performing relatively better than most of the country and it is well positioned for growth. The challenge now is to commit to the policy frameworlc that will enable Manitoba to take advantage of opportunities for sustained economic growth. Unfortunately, again the words have not met up to the actions of the Manitoba economy, and today Statistics Canada reports that Manitoba is tied for last place in economic performance in 1993.

Economic growth allows us to tell whether we are growing as a province, whether people are getting jobs, whether they are getting opportunities, whether our young people can stay in our province, build homes in our province, establish roots in our province, Mr. Speaker.

I would like to know, given the high degree of optimism in the Premier's p ress conference last year, and the unfortunate results at the end of the year, has the government made any adjustments at all in their economic strategy contained within their framework to deal with the reality of our growth rate rather than the op timistic pronouncements by the Premier? Hon. Gary Filmon (Premier): Mr.

Speaker, I recommend that the Leader of the Opp osition do a little analysis and fmd out just exactly what is contained within that Statistics Canada report, because were he to do that, he would find that the most negative impact and the major impact on that factor from a Manitoba perspective was the effect - -

May 2,19 94 LEGISLATIVE ASSEMBLY OF MANITOBA 824 of last summer's abnormally heavy rainfall which resulted in a $30 8-million loss to the farm economy. H the non fann-sector economy is separated from the farm-sector economy, he will find that Manitoba's economy outperformed the national average . According to Statistics Canada, the nonfarm GDP grew by 3.1 percent, well above the national average of 2. 7 percent.

As much as I know that he holds me responsible for everything that goes on in this pro vince, I for one cannot accept the responsibility for the heavy rainfalls and the devastation that they wreaked on the farms of Manitoba. As much as I would like to take that responsibility, I cannot accept it. Provincial Comparisons Mr. Gary Doer (Leader of the Opposition): Mr. Speaker, the government has produced these types of predictions over the last number of years and, unfortunately, we have had very negative resul ts. Mr.

Speaker, since the Premier has received a ma jority from the people of the province of Manitoba, a declining majority after the last by-elections, the government has had a growth rate of .8 percent when all three years are put together -less than 1 percent. We were tied for last or last place in 1991, we were at fifth place in 1992, and we are back to last place in 1993. The national average for those same three years is 4.5 percent. I would like to know from the Premier, why is Manitoba performing at one-sixth the rate of the re st of the country?

Why is the growth rate in Canada six times greater than in Manitoba? Why are you at 15 percent the national average in terms of growth and perform ance here in Manitoba? Bon. Gary Fllmon (Premier): Mr. Spe aker, as I pointed out to the Leader of the Opp osition in my response to the budget, if he looks next door at Ontario, under a New Democratic government, in that same period of time they have had negative growth over that period of time, and the same thing is true of his colleagues in Saskatchewan.

The fact is what we are talking about here in terms of 1993 is as a result of a very, very poor condition in the we ather that related to a $308-m ill ion decline in the farm income , in farm production last year. Those are things that most Manitobans can understand, Mr. Speaker. I would hope that the Leader of the Opposition could, as well. Employment Creation Strategy Mr. Gary Doer (Leader of the Opposition): Saskatchew an's growth rate was significantly higher than Manitoba's last year, in 19 93. Ontario's-[interjection] Well, maybe God is a New Democ rat, Mr. Speaker. You blame the oppo sition, you blame

an act of God, you blame Ontario; you blame Saskatchewan, you blame Mulroney, you blame the new Liberal government. You never take responsibi lity yourself. You never take responsibility . Mr. Speaker, over the first three months of this year, we have a 20 percent unem ployment rate for young people. Now, it did go down over the last month from the month previous, but the trend level is still above the national average. Young people are lining up 24 hours in advance to try to get a job.

Many young people are feeling the double pinch of not being able to find employment and having costs go up dramatically with tuition and other increases in costs, some of them directly due to the provincial government. Will this gover nment have a very active program to put our young people back to work again, so they can stay in Manitoba, so they can get an education in our province and we can start to see our economy growing again, instead of declining as it has under the Conservatives? • (13 50) Bon. Gary Filmon (Premier): Mr.

Speak er, I would ask the Leader of the Opp osition not to try and put words in my mouth or not to try and misrepresent what I sa id. I did not blame agricul ture on this. The fact is I quoted from Statistics Canada's analysis of it in which they said that the farm production was down by $308 million, and if you took aside that, the nonfarm economy ou tperform ed the national average. Now, be may not want to accept that. He may want to be

825 LEGISLATIVE ASSEMBLY OF MANITOBA May2, 1994 able to us e something for his own political p wposes, but that is fact and that is reality. I do not blame my colleagues in Saskatchewan or Ontario either, Mr. Speaker. The fact of the matter is I say to him that he ought to make comparisons, that he ought to know and understand what is happening elsewhere in Canada and elsewhere throughout the world, because those are important things.

With respect to the youth employment programs in this province, I would just say to him that last year, as a result of the programs of this gov er nment, 9, 457 youth were placed in employment through the Manitoba youth job centres and some 4,976 students were employed as a result of government programs in 1993- 94 government, Mr. Speaker.

He knows full well that the throne speech and the budget did indicate a strong commitment to job creation for our youth in Manitoba in 1994, and he knows, as well, that the youth unemployment dropped by I believe it was 5 percent month over month, and so there is a very strong improving trend as a result of initiatives being taken by this administration. EITC Project List Tabling Request Mr. Jerry Storie (Fiin Flon): Mr.

Speaker, I certainly do not want to put words in the Premier's mouth, but in 1991, when the Premier announced the yet again shuffling of his economic portfolios and the creation of the Economic Innovation and Technology Council, the Premier said that the government's record would be determined over the next 18 months. Mr. Sp eaker , we have seen today that the government's record is one of failure, and contrary to what the Premier says, in Ontario over those same three years the growth rate was five times what it was in Manitoba. Mr.

Speaker, my question is: After a series of faile d deals by this government, including MacLeod-Stedman, Royal Trust and Repap which is announcing more la yoffs or the possible downsizing of the wood room at The Pas, a failed deal, can the minister indicate, the First Minister, or the Minister of Industry, Trade and Tourism (Mr. Downey), what direct projects the Economic Innovation and Technology Council has invested in on behalf of the people of Manitoba? •

(1355) Bon. Gary Fll mon (Premier): Mr. Speaker, I say to him that there are more people employed today by MacLeod -Stedman's successor company, the company that bought them, Cotter Canada, than ther e was commitment-[interjection] When Repap, under its former incarnation, Manitoba Forestry Products, was being run by that very member, the member for F1in Flon, it was losing $30 million a year and employing fewer people than it is today. That is the way these things are. The taxpayer paid with huge losses, and still people were being laid off.

The Economic Innovation and Technology Council was not set up to invest in businesses, Mr. Speaker. He ought to look at its terms of reference and the manner in which it was set up. It was set up to spur the dev elopm ent of innovation and technology in this province. As a result of that, this province's new jobs are in areas of the new economy.

For instance, during the past year alone, as a result of telecommunications centres being opened up by Unitel, Canada Post and Canadian Pacific, as well as GWE in Brandon, almost a thousand jobs are involved in those four announcements, and those are in the areas of new technology. I think that is something the member opposite ought to be happy about, instea d of always preaching his doom and gloom here. Mr.. Storie: Mr. Speaker, I apologi ze for appearing to preach doom and gloom, as the FirSt Minister says. What I would like to be able to tell Manitobans is that this government has an agenda. Mr.

Speaker, my question was with respect to the Econ omic Innovation and Techno logy Council. It does have a mandate to facilitate the transfer of technology between industry and research facilities. - -

- - May 2, 1994 LEGISLATIVE ASSEMBLY OF MANITOBA 826 Mr. Speaker, my question was: What pro jects has the Economic Innovation and Technology Council invested in? Will the First Minister table a list of those pro jects and explain what benefit there might be to the people of Manitoba. Mr. Filmon: The Economic Innovation and Technology Council is there to stimulate the development of our innovation sector and our technology development sector.

In addition to those telecommunications jobs that I just referred to, for instance, a company such as Monsanto bad spent 10 years developing a dry form of glyphosate and looked worldwide for a place to locate that business, examined over 40 locations, and decided that the climate in Manitoba was the best available anywhere in the world. That is the kind of development of the new techno logies, the new investments in the new economy that are taking place as a result of the efforts of this government as well as its various other agencies such as the Economic Innovation and Technology Council.

EITC Project List Tabling Request Mr. Jerry Storie (Fiin Flon): Mr. Speaker, simply because the Premier refuses to answer or perhaps does not know the answer, my final question is to the minister responsible for the EITC. Can the minister explain why the largest single pro ject, the largest single amount of support from EITC, some $5 00 ,000, has gone towards an innovations video? Can the minister explain why that is a priority , and will the minister ensure that is not used like the Lotteries adver tising as some pre-election gimmick? Bon.

James Downey (Minister of Indust ry, Trade and Tourism): The Economic Innovation and Technology Council is a group of dedicated men and women throu ghout Manitoba working with the government, whatever stri pes, to put forward the best technology activity that they can . I believe, Mr. Speaker, that they are relatively new . They have put together a communication piece that I think will further communicate and advance the best interests of Manitoba in technology development.

Unlike the New Demo cratic Party, where they are going around throughout the province bad-mouthing Louisiana-Pacific, bad-mouthing the Ayerst Organ ics, bad-mouthing OWE in Brandon, we want to take a positive approach to the development of business to technology in Manitoba. • (1 400) Economic Growth Provincial Comparisons Mr. Paul Edwards (Leader of the Second Opposition): Mr. Spea ker, I, too , read the Statistics Canada report today, as obviously the Premier did, and I was interested in the Premier 's answers to my friend the Leader of the Opposition (Mr. Doer) on this sub ject.

The Premier appears to indicate , and cites the report in saying that because of the problems with the we ather in the agricultural sector, we perfonned poorly in 1993. I would like the Premier to answer a very simple question which flows from page 7 of that report. Obviously be is familiar with its conten ts. In ea ch of the last five yea rs we have unde :rperf onned every other province in western Canada. Accwnulatively, taken at a total of 3.8 percent growth over the last five years, ours has been 1. 9 percent That is half. That is taking the same measurement in the same years by the same organization.

The overall five-year total is not only half that of western Canada's average , but it is significan tly less than the national average which was 2.9 percent. We were 1.9 percent . Why every single year are we doing worse? Bon. Gary Filmon (Premier): The Leader of the Liberal Party obviously believes in the same philosophies as those espoused by, as he said, his friend the Leader of the Opposition, because I can tell him that one of the things that is a very

827 LEGISLATIVE ASSEMBLY OF MANITOBA May 2, 1994 fundamental part of any growth measurement is the amount of spending in the economy that governments do. I can tell him that the model, when eval uated, shows that if the gover nment increased its spending by 3 percent in any year, it would add 1 percent to the GDP growth of the provi nce. As a result, since this province has been on a fiscal frameworlc that has involved less spending than all of those other provinces which he compares us to, we are doing less towards that consumptive side of GDP measurement.

That consumptive side does not add one iota to the competitiveness, to the attractiveness for jobs or for investment in this province . All it does is consum e people 's tax dollars. I know that is what the Liberal Party wants to do, but that is not what taxpayers want done . Mr. Edwards The excuses just keep spinning and spinning and spin ning. Government Forecast Mr. Paul Edwards (Leader of the Second Opposition): Mr.

Speaker, given the Premier's comments, given that the Premier wants to indicate that there is some clear, cogent plan and that we are on track, and he has clearly said that so many times over the last years, why is it that each of the last five ye�it is not just that they have been wrong on predicting the economic growth, they have always overestimated it; they have always underestimated the deficit-have they consistently been wrong about growth and overestimated it and un derestima ted their deficit? Ron. Gary Filmon (Premier): Mr.

Speaker, this governmen t has maintained a record of fiscal management that is unmatched by any government in Canada. Mr. Speaker, that is not the analysis of members of a political party who want to achieve some kind of cheap hit in Question Period; that is the quote of the Dominion Bond Rating Service. They said, this government has been the most fiscally responsible government in Canada from 1987 to the present. This government has done that by meeting its targets, by and large , on the deficit and by doing it without raising any of the major taxes. We have met our targets better than anybody else . Mr.

Edwards: Two weeks ago when I questioned the Ministe r of Finance (Mr. Stef anson) in this area, he said, we rely on Statistics Canada. Mr. Speaker, I put my faith in Statistics Canad a, like the Minister of Finance, above the Dominion Bond Rating Service . They say we are tied for last. That is what they say: tied for last with Newfoundland If you think we have had problems with rain, their fisheries have basically been wiped out. We are tied with them for last place . My question for the Premier: Can the Premier exp lain the comment that he made to the business community in his Gary ill: Tory Iron Man

article in the Manitoba Business Magazine? Can he explain the comment to the rest of the community when he said in that inte rview, those who suggest that Canada through its own fiscal and financial policies can change job creation or economic growth in any dramatic way, are spe aking nonsense 71bat was his quote, Mr. Speaker. Can the Premier acknowledge and explain to us the Kim Campbell view that he appears to take, that it is all lost and we cannot do anything? Why is he leading us to believe that he can do something ? Mr. Fil mon: Mr.

Speaker, this government has been very straightf orward and said time and time again , we can cre ate the climate for investment that will attract business es, but we cannot be the ones responsible like New Democrats say they are, by spending $300 million or $400 mill ion at a shot of other taxpayers' money to try and do some artificial stimulation of the economy . The real long-term jobs in this economy are going to be the ones created by Ayerst, by Monsanto, by Unitel, by Canadian Pacific, by Canada Post, by OWE systems, by Louisiana Pacific, by those companie s.

It is the economic environment that we create, the fiscal frameworlc that we create, that will ensure that we get more than our share of inve stment. -

- - May2, 1994 LEGISLATIVE ASSEMBLY OF MANITOBA 828 Forest Management Divis ion ·Layoffs Ms. Rosan o Wowchuk (Swan River): Mr. Speaker, at the beginning of National Forest Week, I think it is important that we recog nize the importance of the forestry to the economy of this province , but the fore st must be developed and managed properly. To do this we have to have adequate staff in place. We need people who will ensure that it is managed properly. However, we hear nun ours that there are changes in the Fore stry department, and people are going to be let go.

I want to ask the Minister of Natural Res ources : How many people are being laid off in the Forest Management branch and what are the implications going to be on the forest management plan that is very important to the economy of this province? Mr. Speaker: Order, please. I would ask the honourable member for Swan River to ascertain the accuracy of her facts before bringing it to the -[inteJjection] Order, ple ase. Now we will give the honourable member an opportunity to rephrase her question. Ms. Wowchuk: Mr.

Speaker, can the Minister of Natural Resources tell us how many people are being let go from the provincial Forest Management branch and what is the implication on the forest management plan that is very important to this province? Bon. Albert Driedger (Minister of Natural Resources): Mr. Speaker, I want to assure the member that there is reor ganization taking place within the department of Forestry, and I think that is a very natural thing that happe ns .

Reorganization has taken place in the Department of Natural Resources in the various components , and this is the one component that had not been addressed yet We are doing that in tenns of the specifics of it, in terms of how many employees . Once we get into the Estimates process, I will go through it job by job if they want to, but I think nothing untow ard is happening. I feel very confident that by the time we do a reorganization, we will be able to deal with the challenges that are facing me and my department with fore stry issues. Ms. Wowchuk: Mr. Speaker, the minister said some people are being let go.

We want him to confinn today how many people are being let go from the Forest Management, Department of Natural Reso urces . Mr. Driedger: Mr. Speaker, I did not say that there were any being let go. I said we were reorg anizing the dep artment. I will get the specifics for the member once we get to that point. Forest Management Plan Duck/Porcupine Mountains Ms. Rosan o Wowchuk (Swan River): Mr.

Speaker, to the same minister: Since January, we have been raising the matter of the sawmill operators in the Swan River are a who are concerned about how they fit into the fore st management plan, whether there is going to be wood allocated to them . They were assured that they would have an announcement by the end of the month. Can the minister tell us: What is the plan? Has his department laid out a plan on how all the users fit into the fo rest management plan in the Duck and Porcupine Mountain area? Bon. Alber t Dr iedger (Minister of Natural Resources ): Mr.

Speaker, I just want to tell the member again, as I have in the past, that when the concerns were brought fo rward by the smaller operators or permit holders, by and large , I gave them the assurance that they would have enough wood allocations to bring them through this cutting period, while we were reorganizing exactly the whole picture in terms of allocations, how Louisiana-Pacific fits in there with the hardwoods aspect of it. Hardwoods, which are basically ash and poplar, were not even in demand two years ago.

This is why Louisiana-Pacific is coming fo rward, and because they are coming forw ard, all of a sudden there is major concern and maybe not unwanted concern by many of the smaller operators that there will not be work. Mr. Speaker, I want to assure the member that if we get Louisiana-Pacific to establish the industry here in Manitoba, our operators out there are not

82 9 LEGISLATIVE ASSEMBLY OF MANITOBA May2, 1994 going to be able to handle all the work that is going to be available to them. •

(1410) Mental Health Care Emergency Services Review Mr. Dave Chomi ak (Kll donan): Mr. Speaker, over one year ago today, when the then- Minister of Health announced community-based services for mental health, a $4-mi llion program, we welcomed that announcement. A month ago, when the present Minister of Health was apprised of the situation at St. Bonif ace and Health Sciences Centre regarding psychiatric patients clogging up the emergency rooms, the minister said on tape-we reviewed the tapes -that be would deal with the problem-a month ago. We did not raise questions because we took him at his word.

On Friday, when we raised the question of the clogging of emergency rooms with psychiatric patients, the minister did not say anything in this House, but went into the hallway and said be now was going to conduct a review. Can the minister today tell the House: What kind of review is being conducted? Who is conducting it? How long will it last? Wbat- Mr. Speaker: Order, please. The honourable member bas put his question. Bon. James McCrae (Minister of Health) : l have been very pleased over the last few months, Mr.

Speaker, to note that changes have been taking place in the delivery of mental health services in Manitoba. Consumers of mental health services have been delighted to take

part in partnership with the gover nment to provide better services, something that is long overdue, been ignored for 20 years by governments in Manitoba, and this government is doing something about those things . With respect to St. Bonif ace Hospital, Mr. Speaker, on Friday I announced, indeed, that Winnipeg Region of the Department of Health and the hospita ls-plural, not just St. Boniface Hospital-are all working together to make sure the beds that are available in Winnipeg are properly used .

Certainly, since the unusually high traffic that there was last week, the department and the hospit als, and then the St. Boniface Hospital, have agreed that some swing beds would be made available for people. Those beds have not yet been required. Mr. Chomiak: Mr. Speaker, what· I find difficult to understand, to the minister, is bow we got into this situation when a year ago, when the process was announced, the minister bad a special co-ordinating committee to monitor this. It was supposed to advise him what the situation is. What went wron g, Mr. Speaker? Mr. McCrae: Nothing went wrong, Mr. Speaker.

I think that everybody involved in the discussions agrees that in deliver y of emerg ency health services there are peaks and valle ys, and it is not, I am told, unusual that you have heavy traffic from time to time. You should always plan for it as best that you can as a whole health system, not one person working all by himself but all of the hospital people in Winnipe g.

I suggest, and no doubt the honourable member and I will have a chance to discuss that, that this points to a further need for hospitals in Winnipeg to plan together and to look at Winnipeg as a region and to wolk together closely to make sure that the beds that are available and ready to take patients that all of the players know where those beds are and what the availability is. I say, even though five swing beds have been open to relieve pressure, none of them have been used Mr. Chomiak: Mr. Speaker, the government bas been saying the same thing for six years, and it is clearly not working.

My final supplementary to the minister is: Will the minister table the terms of refe rence of not only this review committee reviewing mental health, but the review committee reviewing perso nal care homes that were also brought to light as a result of the documentary? - -

May2, 1994 LEGISLATIVE ASSEMBLY OF MANITOBA 830 Will be table the tenns of reference of both those reviews that are aiready reviewing things the government has already reviewed and supposedly reformed? Mr. McCrae: Mr. Speaker, I am sorry to have to take issue with what the honourable member said. He said that the changes that are happening are not worldng, but I have not seen him at very many functions that I have been at. He has not responded positively to my invitation made, probably half a dozen times now, for he and I to sit down together and have a chat about health care in Manitoba.

Why does the honourable member save his comments for the cameras or for this Chamber and not sit down with me directly, or sit down with the consumers of mental health services, look into their eyes and listen to them when they say thank you for finally responding to the calls we have been making for change to the delivery of mental health services in Manitoba? Social Assist ance Infant Ra te Increase Mr. Doug Martindale (Burrows) : Mr. Speaker, though this is the International Year of the Family, it is hard to tell looking at this government's budget, which for the second year in a row attacks children.

They removed $300,000 from the budget of the Child Day Care office, hundreds of thousands of dollars less money to foster families for their children. In addition, there is a serious under funding of infants whose parents are on social assistance. In fact, the amount is less than half of that of the City of Winnipeg-$84.90 per month for the province and $179.00 a month for the City of Winnipeg. Will the Minister of Fa mily Services give serious consideration to raising this amount to provide an adequate level as recommended by the Nutrition and Food Security Network in their April 1994 report? Bon.

Bonnie Mitchelson (Minister of Family Services) : Mr. Speaker, I wish my honourable friend across the way would look at the budget numbers when he makes certain allegations about what is in the budget, because quite frankly there is over $6 million more in the child welfare system as a result of this year's budget than there was last, and many, many millions of dollars more than there were under the NDP administration before we took over as government. So I want him not to leave on the record that there is not a commitment from this government for children in the province of Manitoba.

When it comes to social allowances we still are among the highest provinces across the country in funding for social assistance rates when our cost of living in Manitoba is among the lowest. Mr. Martindale: Will the Minister of Family Services increase the amount of money for infants on social assistance, since this is a serious poverty and health and economic problem for these families and Win nipeg has the highest child poverty rate in Canada 7 Will the minist er help these families and children get out of poverty by increasing the infant social assistance rate? Mrs. Mitchelson: Mr.

Speaker, and again my honourable friend is wrong in the inf onn ation that he puts on the record, because indeed we are not the province with the highest child poverty rate. That may have been the instance back some years, but it is not, in fact, today. So I want to clarify the record and tell him that he should look into his facts and the information that he puts on the record before he comes to this House with questions. Mr.

Speaker, I have indicated, and I will indicate again, that we pay among the highest, across the country, social assistance rates, and in Manitoba today our cost of living is one of the lowest. Mr. Martindale: Mr. Speaker, the fact is the province pays less than half what the City of Wmnipeg pays.

Will the minister, who, I assum e, is a member of the Human Services Committee of Cabinet, which is responsible for Healthy Public Policy, take to cabinet the recommendation of the Nutrition and Food Security Network since Healthy Pu blic Policy focuses on the underlying causes of good or bad health, of which lack of income is one,

831 LEGISLATIVE ASSEMBLY OF MANITOBA May2, 1994 according to the Minister of Health 's action plan for health? Mrs. Mitchelson : Mr. Speaker, I do want to indicate again and e nsure that the record clearly shows that in fact we do not have the highest child poverty rate across the country at this point in time.

I have written a letter to Stats Canada, as a matter of fact, to look at the way that they determine child poverty rates , because when you look at Manitoba in the context of all of the other province s, we are lmnped in with such cities-Winn ipeg is lmnped in with cities like Toronto and Vancouver, where the cost of living is considerably higher than it is in the province of Manitoba. That is not taken into consideration when the numbers and the statistics are developed.

So I have written-and I have made that a public issue, as a matter of fact-to e nsure that when those kinds of statistics are brought fo rward, they are looked at in the context of what the cost of living is, and ours, Mr. Speaker, is one of the lowest across the country. Department of Environment Louisiana- Pacific Advertise ment Ms. Norma Mc Cormic k (O sborne) : Mr.

Speaker, on April 13, 1994, in the edition of the Swan Valley Star and Times, the Manitoba Environment department ran an ad with the fo llowing wording: "If you are interested in and excited about Louisiana-Pacific coming to the Swan River Valley, ple ase let one of the people on this list know it." The people on the list are the director of environmental approvals, the municipal and industrial approvals

section chief, the assistant deputy minister, and the secretary to the Economic Development Board of Cabinet. My question to the minister is this: Given the experience of Raffe rty -Alameda dam, the Assinib oine River diversion, Nopiming Provincial Park and Oak Hammock Marsh, how does the minister justif y his department initiating an advertisement which appears to be taking a partisan position in favour of the proponent rather than respecting the process outlined in The Environment Act? •

(1420) Bon. Gl en Cu mmings (M inister of Environment): Mr. Speake r, I would like the member to table that quote s he just gave, so I can confinn whether or not that, in fact, came from the Department of :Environment . Ms. McCormick: Okay, I am prepared to table the ad. Louisiana-Pacific Plant Emission Levels Ms. Norma McCormic k (Osborne): My second question to the same minister is this: Last Wednesday we met with repr esentatives of Louisia na-Pacif ic.

During that meeting , Louisiana-Pacific informed us that they would be producing emissions out of this plant which would be the sub ject of government regulation and scrutiny. My question to the minister: Are there standards for these emissions which have been communicated to Louisiana-Pacific? Bon. Gle n Cu mmings (M inister of Environment): Mr. Speaker , we are waiting for the final docmn entation from Louisiana-Pacific on their application. That will give us some indication of whether or not the emissions can be -[inte rjection] The Liberal caucus thinks this is funny .

Apparently they are against Louisiana Pacific, too. Mr. Speaker, the standards for emissions in this province are set site -spec ific according to the air quality standards that are required in the area, and that is how the standards will be set. Ms. McCormick: My final supplemen tary, Mr. Speaker: Can the minister as sure this House that these standards will be set and made public prior to the granting of the licence to Louisiana-Pacific, given that the chief of the air quality

section is on record saying that while it would be his desire to add the chemicals that are coming from this plant to a list and expand its scope, re grettably the department does not have the resources to conduct the work? - -

May2 , 1994 LEGISLATIVE ASSEMBLY OF MANITOBA 832 Mr. Cummings: Mr. Speaker, the process will be fo llowed exquisitely to the letter of the law. We will make sure every. emission that is potentially to come from this plant falls well within standards . Parents Forum on Education Agenda Mr. John Plobman (Dauphin): Mr. Speaker, the Minister of Education proudly announced at his meetings on education on Saturday that this was a wonderful exercise in democracy.

I agree that it was an exercise in democracy that has come six years too late by this government The problem is that the exercise did not seek information from the parents that were there on the fairn ess of the funding model. It did not even refer to that issue. He also did not ask the parents for their priority issues on educational reform in this province. The agenda was set by this minis ter.

I want to ask the minister why he did not allow parents to prioritize the issues as they saw them when coming to that forum, and was the minister afraid that the one issue that he calls a nonissu e, that is fairne ss in funding across the provin�ot included as one of the main issues? Did he feel that it was going to be a high priority- Mr. Speaker: Order, please. Hon. Clayton Manness (Minist er of Education and Training) : Mr.

Speaker, I was wondering yesterday how it would be that the member for Dauphin would be able to criticize the fo rum, the first one held and indeed the most successful education event held probably in this province over many, many years. Mr. Speaker, I find it- An Honourable Member: Passing strange. Mr. Manness : No, the member for Dauphin (Mr. Plobman) is strange, Mr. Speaker. Mr. Speaker: Order, please. I would like to remind the honourable Minister of Education and Training that all honourable members are honourable in the Chamber. Mr. Manness: I accept your admonition, Mr. Speaker.

When I indicated that the forum was coming forw ard, I indicated, I think , to everybody in the province that funding would not be the essence, and indeed ed finance would not be the essence of that f orum . We called the parents forw ard to pass judgment as to the programming within the public school, bow to make the public schools work better. I dare say, having sat at many of the tables Saturday, ed finance, money in itself was not considered as the solution to some of the diffi culties we have had in the public school system-totally contrary to the view held by the member for Dauphin. Mr.

Speaker: The time for Oral Questions has expired. NONPOL� CAL STATEMENTS Excellenc e in Business - Education P artnerships Award Mr. Speaker: Does the honourable member for St. Johns have leave to make a nonpolitical statement? [agreed] Mr. Gord Mackintosh (St. Johns) : Mr. Speaker, on April 18, West Kildonan Colle giate was awarded, by the Conference Board of Canada, the prestigious National Awards for Excellence in Business- Education Partnerships. That was in the elemen tary and secondary school level cate gory.

This was a proud achievement for a high school in my constituency and a proud achie vement for Seven Oaks School Division, as well as the province. The Co-oper ative Voc ational Educational program at West Kildonan Collegiate competed with programs at 115 other schools in Canada The Seven Oaks School Division offers fo ur dynamic such programs: Food Preparati on, Hotel Hospitality, Introduction to Aviation Trades and Tech nology; and Health Care/Nursing Assistance .

At the colle giate, the 34-week course begins with a three week training period during which students learn the conventions and practices of the workplace. Over the year they spend one day a week in classes learning theory and fo ur days a week learning by doing in the business setting.

833 LEGISLATIVE ASSEMBLY OF MANITOBA May2, 1994 Given that the program is only six years old, this attests to the gr eat suc cess of this kind of inno vation in education. As a result of the award, the school has received $5,000 and will devote that money to computer upgrading for student use. Mr. Speaker: Does the honourable member for The Maples have leave to make a nonpolitical statement? [agreed] Mr.

Gary Kowalsk i (The Maples ) : I also want to add my congratulations to the Seven Oaks School Division and West Kildonan Collegiate and its partners Standald Aero, Radisson Suite Hotels and the Health Sciences Centre for this award. I think the teachers, the instructors involved in it-Lawrence Danylchuk, Brian Humniski, Leslie Fleming and Lana Woods, led by their teacher team leader Bob Baird should be congratulated. I want to add my congratulations to that group and the Seven Oaks School Divisio n. Thank you. ORDERS OF THE DAY Bon. Jim Ernst (Government House Leader): Mr.

Speaker, I move, seconded by the Min ister of Family Services (Mrs. Mitchelson}, that Mr. Speaker do now leave the Chair and the House resolve itself into a committee to consider of the Supply to be granted to Her Majesty. Motion 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 St. Norbert (Mr. Laurendeau) in the Chair for the Department of Health; and the honou rable mem ber for Seine River (Mrs. Dacquay) in the Chair for the Department of Executive Council. COMMITI'EE OF SUPPLY (Concurrent Sections) HEALTH Mr.

Deputy Chairperson (Marcel Laurendeau): Will the Committee of Su pply plea se come to order. This

section of the Committee of Supply is considering the Estimates of the Department of Health. Does the honourable Minister of Health have an opening statement? Hon. James McCrae (Minister of Health) : Yes. Mr. Deputy Chairperson, and colleagues, I am pleased to present today the working Estimates of the Manit oba Ministry of Health for the fiscal year ending March 31, 1995. I will be asking this committee to support my request for $1 ,854,500,800. It is a very, very large amount of money, and most people cann ot even imagine how much that is. It is about $1.85 billion.

Our government set a goal for itself to protect the healt h and qua lity of life en joyed by Man itobans, by improving health services and by promoting healthy communities. Manitoba was the first to recogniz e this need, and now virtually every province in Canada is following our lead. I am proud to be the first, and I am proud of the way Man itoba is working towards its goal. While some provinces have taken a top-down approach to decision making, we have made consultation the key to finding solutions that are both innovative and responsible.

As the Minister of Health for Manitoba, I have come to appreciate that Manitoba has a tremendous team of people working together to improve our health system. I am particularly fortunate because I have a dedicated staff that has been wo rking diligently to ensure Manitoba continues to have the best health care system in Canada, if not the world. Also, Mr. Deputy Chaitperson, I would like to thank the thousands of Manitobans who have given their time, their energy and their ideas to aid in the process of improving our health system. In fact, we have drawn from the contributions of · more than 13,000 Manitobans.

I repeat that for those who did not hear me. We have drawn from the contributions of more than 13 ,000 Manitobans who have been working in a variety of working groups, cons ultative forums and project teams. I may come back to that, if it is necessary, to underline the point that there has been very, very significant consultation, not only in the plann ing for changes to our health care system but also in - -

- May 2, 1994 LEGISLATIVE ASSEMBLY OF MANITOBA 834 implementation of chang es. Many, many thousands of consumers and care providers of all different kinds who deliver services to their fellow Manitobans have been consulted and whose services have been used in the impl ementation of plans. 1be co-operative approach bas made us the envy of other pro vinces. 1be number of partnerships we are building with Manitobans continues to grow. This community consultation approach reflects our gover n ment 's commitment to focusing on community-based services. I am pleased to note, Mr.

Deputy Chairperson, that our government 's current budget reinf orces that commitment by allocating inc rease d funding to communit y-based programs and servic es. Over the past few years, Manitoba Health bas been worlting progressively towards a shift away from institutional settings towards community based services. This shift helps to ensure that Mani toba's health services are more responsive to identify needs in the community. Sometimes it is this shift that catches people 's attention, too, because it means we are doing things differently.

We are trying to do them better for the people who need the services . •

(1440) We have already made significant progress in implementing in this gradual shift in services, and I say "gradual" because we have been evaluating and re-evaluating each new step taken to enhance community services . We are keeping people as our No .I prior ity, and we are giving ca reful consideration to each new initiative before taking action. This care and attention is paying off. Sometimes the care and attention takes a little longer, and I can acknowledge that, but I think you get a better product at the end of such a process. As I say , it is paying off.

I was very ple ased to make a series of funding ann ouncements in the last year, and we are alre ady seeing tremendous success from these initiative s. Many of these announcements have been in the area of mental health care, and with each announcement we are coming closer to our goa l for a new, more responsive and consumer-based mental health system . For example , I recently ann ounced a number of new programs and services for the Winnipeg region.

These initiatives include a new eight member Child and Adolescent Treatment Clinic , ongoing funding for telephone support services, one-year funding for the Employment Dimensions Program, ongoing funding for the operation of a saf e home, ongoing fun ding for in-home support ser vices for consumers who are living independently in the community , and funding for self-help groups . We have also successfully introdu ced mental health ref orms for rural Manitoba. The seven rural Manitoba health councils have done a tremendous job of worldng with my department to develop mental health plans for their regions.

As a result, we have seen the development of site -specific plans for each are a. These site-specific plans include special programs and services in the community such as self-help groups and crisis intervention teams that cater to the unique needs of that community. These achievements in the area of mental health care also improve the continuum of care within each community and enhance the overall system by reducing fragmentation and provi ding services in a way that is more responsive to identified needs at the most appropriate level of intervention.

Our success in these endeavours bas been made possible by the tremendous support provided by the mental health community. The renewal model that we adopted is an excellent example of bow successful we can be when we wor k together. We will continue to demonstrate our support for these initi atives by providing significant support to communit y-based mental health services in this new fiscal year. I am very proud of these achievements, but I am particularly proud that many members of the mental health community have told me that this is becomi ng the most progressive mental health system in Canada.

835 LEGISLATIVE ASSEMBLY OF MANITOBA May 2, 1994 The tremendous success of these community base d initiatives will act as an excellent model for the goals we have set for improving health care services. We are building on that success with a series of new communit y-based initiatives backed by provincial funding in this budget. As my colleague the Minister of Finance (Mr. Stefanson) announced in the provincial Budget Address, Manitoba Health is placing special emphasis on redirecting resources towar ds community -based care and ill ness prevention.

We will be providing special funding to enhance self-managed home care in rural and northern Mani toba. This special funding will expand on curre nt program s, which are designated for people who are living with a disabili ty, to include seni ors. This , in tum, will improve consumer empower ment by expanding the options available for Mani toba seniors who choose to live independently. We will also be establishing a home care appeal panel and an advisory committee to ensure there is an equitable application of program standards and policie s.

By implementing this appeal panel and advisory committee, we will be achieving three important goals: firstly, home care recipients will be ass ured a fair hearing of their concerns when they have them; secondly, my office will be provided with imp artial advice and recommendations respecting the application of some program decisions; and thirdly, Manitobans will have the added assurance that services are being provided equitably through the application of uniform criteria, standards and policies . I am not satisfi ed, Mr.

Deputy Chairperson, that we have been working with uniform criter ia, standards and policies. I think that with the help and advice that we can get, we can bring something more uniform .

By that, I do not mean inflexible , but I mean uniform criteria, standards and policies so the people in one part of the city or one part of the province will not be able to say that service in one area is inferior to service in another area The Continuing Care Programs Division in my department is placing special emphasis on support services for seniors, as part of the goals we outlined in the Quality Health for Manitobans document, which I am sure everybody bas read and reread, because it is important that they do that in order for them to engage in a debate around this table.

I see the honourable member for Kildonan 's (Mr. Chomiak) copy is well worn, and I am glad to see that. We are placing special emphasis on the service requirements in rural and northern communiti es. We have expanded community support services to seniors by adding 24 new support service pro jects and enhancing 19 existing ones. These support services will be further enhanced this fiscal year. In addition, we will be increasing the number of spaces in adult day clubs.

This increase is part of our government 's commitment to ensure Manitoba seniors have ever y opportunity to live independently as active members of our communities. I am proud of the new developments in these services to seniors , and again, I give credit to our partners in Health and to department staff for the work they are doing to promote these initiati ves. With these new programs and enhanced services in place, we will be increasing the options and improving access to these services in our rural and northern communiti es.

One of the things I learned while visiting 45 Manitoba comm unities and meet ing with Manitobans was that each community and each hospital or other care facility bas unique needs that require unique progr ams, services and staffing requirements . We also recognize that the best and only eff ective way to design a strategy for meeting those needs is by asking the people who live and wor k in these com munit ie s.

We used this consultative approach with great success in our mental health renewal process, and we will continue to follow this consultative approach as we examine new alternatives for improving health services in our rural and northern communities . Last fall I was pleased to announce that we are developing rural health associatio ns as part of the - -

- May 2, 1994 LEGISLATIVE ASSEMBLY OF MANITOBA 836 restructuring pro cess . Asso ciations would co-ordinate a strate gy for health setvice delivery for their regi on. They would develop a system where each community could maximize resource s and make the best use of services currently in pla ce. These associations would e nsure there is extensive comm unity input and that ea ch community 's unique needs were met. Since that time, we have been woddng to build on this basic model, and we have set some clear guidelines for Mani toba's approach: ( 1) There will be a cle arly established process for consultation.

(2) Any new design must be based on population health needs. We have North America 's best health database right here in Manitoba. The Manitoba Centre for Health Policy and Evaluation provides up-to-date analyses on health outcomes and identifies what is really making a differe nce to the overall health of Manitob ans. We have already made good use of this valuable resource and will continue to do so in the upcoming year. Each association will have access to this resource so that they can meet their needs.

They can examine all aspects of setvice delivery and adapt their programs and facilities to help improve the health of their consumers . Number three, any new plan must include a broader definition of he al th. That means identifying and addressing the determinants of health status and making a concerted ef fort to incorporate the concept of healthy communities through prevention. Each communit y must form partnerships enabling them to address other factors affecting health, including socioeconomic conditions, environment and education.

We are targeting a three-year implementation process, and the implementation plan will have four phases starting with public consultation. The seco nd phase would allow time for obtaining approval in principle for establishing the details of each association, including the regional advisory bodies and the infrastru cture necessary for connecting them to the database system at both local and regional levels. The next steps in this phase would involve making recommendations and developing a preliminary action plan which identifies priorities . •

(1450) In the third phase of this proce ss, the associa tions would develop demonstration · pro jects for evaluation. Finally , the fourth phase would be based on those evaluations in orde r to proceed with full implementation.

Once in place, the new system would be based on a regional governance model and a revised funding system . ill timately, through this proce ss, the northern and rural health associatio ns would, first, ensure opportunities for individuals, families and communities to manage and improve their health and well-being and to participat e in he alth pl anni ng, service del ivery, decision-making and governance; second, ensure the ongoing integrity and independence of the values and missions of facil ities that have religious affiliation; third, through commun ity participation, en hance programs sensitive to the e tbnocultural diversity of the po pulation of their region; fourth, be responsible for reducing setvice duplication and for the development and maintenance of an efficient, effecti ve, integrated and co-ordinated continuum of health setvices, including acute care, long-term care, home care, public health, mental health, diagnostic services and services of voluntary agencies and other health organizations; fifth, the associations would be in a strate gic position to foster working relationships with other service sectors in the communities and have an impact on health stat us, including those involved in the social service s, housing, education and environment, as well as voluntary interest groups; sixth, the associa tions would be phased in accor ding to time fra mes determined by the communities themselves and their readine ss to take on the management of their health care services.

This innovative and proactive approach to improving the delivery of health setvices in rural

837 LEGISLATIVE ASSEMBLY OF MANITOBA May2, 1994 and northern Manitoba is just one of several new developments underway in rural and northern areas. I hope that when we get into further discussion, I maybe will be able to point to models in other prov inces and . the way they have been doing it, as opposed to the way we have been doing it in Manitoba. Maybe honourable members already know about it, but I want to under line for them that we have probably the most consultative bottom-up appr oa ch anywher e in the country to the regionalization of health services.

We are also working to improve the access to some of the more specialized services. I have had the honour of making a number of announcements in this area. Manitoba is currently involved in a pilot project to provide psychiatric care training to six family phy sicians. The intent of this p rogram is to upgrade their skills in psychiatric treatment. It does not train them as psychiatrists, but people living in rural and northern areas who do not at this time have regular access to a psychiatrist will be able to visit these phys icia ns for imm ediat e intervent ion and refe rrals.

We have also introduced a new obstetrics and gynecology program at the Thompson General Hospital. We do not hear abou t that. The honourable member for Kildonan (Mr. Chomiak) has not asked me very many questions about that to this point The hospital will now host doctors in postgraduate residency training, spec ializi ng in obstetrics and gynecology. The pro gram has two key benefits. First, graduate students will have the opportunity to gain clinical experience while learning about the unique cultural and geographic fac tors influencing northern Manitoba communities.

Second, the program will also help to e nsure these specialty services are available to women living in Thompson and the surrounding area. In addition to this new obste tric ser vice for the North, our government will be introdu cing regulated midw ifery as an important component in a comprehensive obstetrical services plan. Other promising developments in the upcoming year will include working in pa rtnership with Manitoba physicians. This is an area where we are fortunate that we were able to resolve some of the issues affecting our relationship with doctors in Manitoba.

As a result, we have fostered a new positive working relations hip, and we are ready to tackle some of the long-standing and tough issues, such as putting the cap on doctors' billing numbers and introducing doctors into underserviced areas. I do not think very many people realize it: it is not very many doctors are required but everyone that is required is extremely important. If you are in a small community and there is no doctor, it is a big, big pro blem, and the number of physician s actually required to balance out our physician res ources in Manitoba is not that big of a number.

I think some people have a sense that it is, but it is not a very large number. I am please d to announce, Mr. Dep uty Chairperson, that as part of this budget we will be developing a new and historic agreement that is the first of its kind in Canada. Under this agreement physician resources will be managed using a partnership approach involving our government and the Manitoba Medical Association as well as consumers, other service providers and health researchers. I am looking forward to seeing the implementation of this new agreement, and addressing many outstanding issues in the days, months and year s ahead.

Doctors are the gatekeepers, have been the gatekeepers of our health care services, and working with them to find solutions is a trem endous step forward for Manitoba. We are also working to implement a new elec tronic Pharmacare system.

This new Drug Program Information Netw ork, DPIN, as we call it, will have some ver y im pressive benefits including instant rebates, a built-in security system that alerts the pharmacist when your current prescri ption should not be mixed with the drugs you are already taking, and a tracking system that will enable us to prevent fraud and abuse of our Pharmaca re that costs Manitobans millions of dollars every year. Fraud and misuse of our health -

- - May 2, 1994 LEGISLATIVE ASSEMBLY OF MANITOBA 838 care services cost each and every one of us as taxpayers, and we are working to reduce these costs by monitoring the system. 1bere were some suggestions around the first of the year when, regrettably, the government in order to addre ss the sustainable future of the Pbarmacare program bad to make changes to the deductible and the cost-share aspect of the program . There were suggestions that we were looking towards getting rid of the Pbarmacare program altogether at some point.

That is just simply not so, and the Drug Program Inform ation Networlt and all the wolk that bas gone into it by government and by pharmacists in Manitoba show that we are very interested in providing an efficient and good Pbarmacare service within the funds that we can make available . I think it is just not correct to suggest that we bad any other alternate objective in mind. If you look at the history of the previous administration, Mr.

Deputy Chairperson, I think that when you look at adjustments like that twice in one year, would that not just make the same kind of point that some honourable members are trying to make about the changes we made in January? Well, those were necessary then and necessary in January, too, but the new DPIN, I suggest, demonstrates a real commitment on the part of the government to a workable and efficient Pharmacare program for the future.

Just picking up where I was, talking about fraud and misuse of our health care servi ces, the Patient Utilization Review Committee monitored patient use of health services for one year and made a number of recommendations that will result in more eff ective use of health care services by Mani tobans who are found to be overusing the system . Some people think it is all right for people to overuse and abuse the system, but I do not. We will be acting on these recommendations and PURC, which is the Patient Utilization Review Committee, will continue to track overuse of the system in the upcoming year.

Eliminating fraud and misuse of our health service is one way to ensure that we are using our health dollam wisely. Those who argue against getting rid of the fraud and the misuse argue in favour of wasting and abusing the system. I am not going to do that. We are also achieving this by restructuring some of our services into centres of excellence. One example of this type of restructuring is the development of the new Ophthalm ology Centre of Excellence at the Misericordia Hospital.

We asked ophthalmologists what they recommended to improve ophthalmology services in Mani toba, and we acted on their recommendations. We created the new centre of excelle nce, and as a result, we are now performing 600 more operations a year and saving a million dollars while we do it. Sometimes I wish honourable membem would ask me about things like that, but they do not seem to ask those kinds of questions. Where is the member for Portage Ia Prairie (Mr. Pallist er)7 He may ask questions about that He is a very positive person.

Another example of the benefits of restructuring is the Lung Transplant Pilot program at the Health Sciences Centre . This program builds on the renowned wolk being done in respiratory disease re search and treatment at the Health Sciences Centre . With this new program in place, Manitobans no longer need to leave the province for lung transplants. We have already beard some very positive su ccess stories about lung transplants taking place at the Health Sciences Centre. This program speaks, I think, to bringing health services closer to home, which is another fundamental of health care ref orm.

As one who bas bad some family experience in this area, not lung transpl ant, but serious medical issues that take people away from their own provin ce, I know very well the kind of stress that it places on patient and family and anybody close to the patient. The more of this kind of thing we can do at home, the better, and the more we should remind our fe llow Manitobans that these are the kinds of things that our health system is trying to do with them and for them.

As we mentioned in the budget, we will be enhancing specialized services like the two I just mentioned by increasing funding for bone marr ow transplants and dialysis treatments.

839 LEGISLATIVE ASSEMBLY OF MANITOBA May2, 1994 I just had the pleasure of attending the official opening of the new local dialysis unit at Pine Falls. With this opening, area residents now have acce ss to dialysis treatments to sa ve them the cumbersome drive into Winnipeg. This unit is one of eight satellite dialysis units establ ished in rural and northern Manitoba under the Manitob a Local Centres Dialysis Program. I cann ot pronounce that acronym but it goes MLCDP. These units are an extension of the Health Sciences Centre Renal Failure Program. Here again, Mr.

Deputy Chairperson, I commend the many people who wolked together to co-ordinate development of these units . The management and staff at the Health Sciences Centre and the local hospita ls, consumers and their families and other conc erned individu als , including area band chiefs, all contributed to the successful development of these units-more partnerships . •

(1500) These are all exc ellent exa mples of the partnerships and the clear benefits of their success in terms of improving and preserving our health services. The pe ople who rea p the maximum benefit of these improve d health services are Manitob ans, and that is the No. 1 priority we all share . As stated in the throne speech, one of the fundamental values that unites us as Manitobans is our commitment to the health and well-being of our fe llow citizens. That means improving and preserving our health services, but it also means emphasizing the importance of prevention.

I enco urage all Manitob ans to make a commitment to healthy communities. That means taking steps to care for our health through prevention and healthy living habits . At the same time, my department will help to promote prevention by enhancing services such as breast cancer and cervical cancer screening programs. We have already received positive fe edback on our province-wide breast screening program pro posals . This new program will be providing 100,000 Manitoba women between the ages of 50 and 70 with the best scr eening techniques available for bre ast cancer dete ction.

With its dedicated centre of excellence in Winnipeg and satellite screening centres in Brandon and Thompson, this program streamlines the p roces s for women from the screening stage through to diagnosis. It also emphasizes women taking an active role in making choices that affe ct their health. Playing an active role in detennining our own health is an important part of prevention. I am proud of the attention we have given to providing education and information to those who visit our centres.

Prevention, healthy communities, improved health services and preserving our valued health care system for future generations, these are the goals we have set for ourselves , and these are the goals we are achievin g. It see ms that almost every day brings a new achievement to our health care system. We are at a very important point in our history as a province, because we are doing something that has not been done before. We are doing it because we recognize if we do not make the improvements to our health care today, we will lose it in the future. It will be gone . It will be history.

H we do not address the issues before us today, we will have no health care system to try to fix. That is not a legacy I am prepared to leave to my cbildren. I am proud to be part of the Manitoba team wolking to protect and improve health care for all Manit obans. Memb ers will have received copies of the supplementary inf ormation. I think I distributed it to the two critics on Friday. We can now proceed with detailed examination of the Estimates for Manitoba Health for the 19 94-95 fiscal year. I ap preciate the opportunity to discuss these matters with my colleagues from the other parties.

Hopef ully we can promote some better understanding with some of the members of our Legislature with respect to health care issues-and me, too, by the way. I can learn through this process, Mr. Deputy Chaitperson. Mr. Deputy Chairperson: We than k the honour able Minister of Health for those comments. -

- - May2, 1994 LEGISLATIVE ASSEMBLY OF MANITOBA 840 Does the critic for the official opposition party, the honourable member for Kildonan, have an opening statement? Mr. Dave Chomiak (Kildonan) : Mr. Deputy Chairperson, I would like to begin by welcoming the min ister to this proce ss. I have had opp ortunities to engage in the Estimates process with the minister in a previous critic area, and I am looking forward, as I am sure be is, to the process.

I also thank the minister for providing us with the copy of the Estimates book in advance, a fair enough period of time in advance to at least allow us to review it prior to the commencement of the Estimates today. I detect in the minister's opening comments and in several responses be bas made to questions we have raised in the House a sensitivity on the part of the minister and the department to criticism and I understand that.

I understand that and I understand the dilemma that the minister and dep artmental officials fe el when they fe el they are being const antly scrutinized and they are being constantly criticized, and then they perceive what any questioner may comment to be one of criticism, when, in fact, often it is very useful suggestions or good reasons for raising iL But I do not ap ologize for that, be cause we in the opposition are inundated with phone calls and letters and from our individual door knockings from comments of Manitobans who are concerned about the state of health care in the province of Man itoba.

We do not make these things up. These things come from the public. It may be that we tend to raise issues that are perceived as criticisms, but frankly that is part of the role and the job, and frankly that is my perception of what the public fee ls about what is happening in health care today. The process of health care ref orm began with the Quality Health for Manitob ans, The Action Plan, announced by the former minister with great fanf are. I believe the minister said it was the most innovative and advanced in all of the continent, if not the uni verse. He did not say universe; he said continent.

Fran kly, if you look through that document, one could glean from that document almost every positive or nega tive thing that bas been said about health reform in this country for the past 10 or 15 ye ars. I remind the minister that almost every single jurisdiction, with the exception of Manitoba, has bad a royal commission or a major study on health care reform in the last 10 years, and a lot of what is stated in the health action plan is basically a part of all governments ' reform plans across Canada. The minister is correct when be states that health care reform is taking place in other provinc es.

I had a meeting with an individual, who is very active in the health care field, about three months ago, and this is what she stated to me. She said that she was of the im pressi on that the initial stage s of health care reform were very positi ve, but that the government got caught in a fiscal crunch and that health reform became a cost-cutting exercise, not a reform plan. That was her view, and I get the impression that is largely the view in the public, and frankly, that is my view.

If I look at some of the initiatives and me asures that were proceeded with by the dep artment last year, that certainly reinforces the view. I do not intend to rehash all of last year's difficulties in the health care field, but certainly they are indicative of a governm ent that was intent on cutting rather than providing for quality hea lth care for its citizens. 1be minister bas stated on many occasions that we, the public, if only we would sit down, if only I would sit down, or if only other individuals would sit down, with him and discuss the issues we could resolve them and come to some kind of consens us.

I am often reminded of the phr ase, but it is often individuals who have gone through that process who have come back and said it is basically a monologue disguised as a dialogue. Many people have said to me, what is the use? The government appears to be intent on a plan and a program , and I have not been convinced othe rwise. I know the minister bas gone to great pains to meet with a lot of individuals and a lot of groups , and I give him credit for that, but whether that constitutes

841 LEGISLATIVE ASSEMBLY OF MANITOBA May 2, 1994 adequate consultation remains to be see n. I do not believe it adequately addre sses or re flects the viewpoints of Manitobans respecting health care and health care reform . The minister made mention in his comments about bringing health care closer to home , and he discussed the lung and heart transplant ann ouncement at the Health Sciences Centre as an example , and I agree, that is an example . But closer to home means more that just providing services in Manitoba for residents who had to leave the province.

Closer to home me ans providing services closer to home in terms of commun ity , in terms of community-based services. Despite comments to the contrary , this has not taken place in the province of Manitoba, and the area where it has been most advanced and most recognized is the mental health field. We have given the minister and the govenunent credit, but, frankly, even in the areas of mental health, it is clear there is a difficulty.

The min ister, as recently as last Fr iday, announced a review of mental health ref orm, I can assume, when this was an area that was somehow advanced. • (15 10) There is no question there are growing pains . There is no question there are diffi culties, but one would have thought the process would have-the committee that was set up to establish and monitor because it is in the government 's press release of March 17, 1993--detected or been utilized to pick up the difficulties in the system .

There was a documen tary a month ago that revealed the difficulties, and the minister said that they were working on it, but nothing apparently happened. Maybe last Wednesday was a glitch. But the minister has now put in place, I will accept -he has now put in place a system , but he has also ann ounced to review , and that indic ates to me that there is difficulty. I will be pursuing that because mental health is clearly a strong suit of what the government has done in heath care reform , and even at that, there are difficulties.

I think that, if the government is truly listening and truly consulti ng, they will implement some kind of process or procedures in place , that will utilize fee dback from the public and actually act on it. Now the minister and the government have gone to great pains to demonstrate that the new MMA agreement is part of the p roces s, and I will agree the fact that the government has finally gotten an agreement with one major player in the system , notwithstanding that the nurses-MARN is upse t, the MNU is upset, the LPNs are upset, health care administrators are upset.

Almost evetyone in the system is basically not onside with the governm ent's initiatives. The government, final ly, despite that, has gotten an agreement with the . MMA, but that is only one small step in the consultation process. The question still remains, who is the government listening to? The minister indi cates in his opening comments that he has listened to over 13,000 individuals. If that is reflected in the health care system, if that is reflected in the changes, then why have we not seen community-based service s? Why have we seen difficulties in the system to the extent we are seeing difficulties?

Why are we having continuing difficulties with home care, et cetera? But all of this will be pursued during the course of our discussions, I am sure . I am vety concerned about the health care, the system of home care. Last year, the government unilaterally changed the rules of the game with home care, and I will tty to stay away from dealing with that situation, but I am not clear if it has been clarified. The minister came in and said it was on pause, but still people are being cut off.

Yes, they are being given-the difference was they were being phoned and cut off last year, and this year, they are being given re-assessments, but the criteria, as far as I understand it for which people have been elimin ated from the Home Care program, continue as is, and I- Mr. McCrae: NDP criteria. Mr. Chomiak: The minister indicates NDP criteria. The minister continues the line that was forwarded by the previous minister that somehow nothing had chang ed, that so me how the government was not planning to lay off thousands -

- - May 2, 1994 LEGISLATIVE ASSEMBLY OF MANITOBA 842 of worlters, that somehow the government was not planning to cut off hundre ds and thousands of home care recipien ts. That is just not true. The government was planning, and I have seen the criteria, and we made them public. I am anxious to see if the government actually changed them. I will give the minister credit for putting it on pause and saying at the time that we are not going to cut off the young disabled definitel y, but the rest of the criteria continue. I would be anxious to see what those criteria are.

I am concer ned about the thous ands and thousands of nurses in the system who do not feel the government is listening to their concerns, who are concerned that the government is not paying attention to issues they have raised , and who are fe arful for their jobs. Now, the contrary argument that is made against the opposition is, all you do is feannonger, and you are the one who is causing the difficulty. But steadil y, as we continue to so-called feannonger, people keep losing their jobs or are being told they are going to lose their jobs.

Frankly, 90 percent of what we have indicated in the House, perhaps 95 or 99 percent , bas in fact come to fruition, and recently a government document stated that in the next several years up to 1,500 worlters could lose their job at Health Sciences and St. Boniface . Was that my document? Was that the wo rkers ' document, Mr. Deputy Chairperson? That was the government 's worlting document. Those were the criteria under which the government 's Labour Adjustment Committee was told to opera te. Those were not my criteria. I was not the one who raised the issue. We were not the ones who raised that 1,500 figure.

I bad known about it for some time. I bad been told it happened in meetings, but that was the first time we actually saw it in a government-related document. So it is not us, and I wish the government would give some kind of reassurance to those who worlt very hard and long, and the dedicated in the syst em, as to what is going to happen in terms of their futures. What about the role of LPNs? Has that been resolved despite many meetings? Is it that the LPNs-it seems, again, it is another case of a monologue disguised as a dialogue. Who is listening to the nurses ?

What about the case of the role of nurse practitioners and pilot projects in that regard? The government has made great claims about the fact that it has moved in terms of creating personal care home beds, and we acknowledge that. That has been part of the government 's platf orm and programs since 1988, and it has been reann ounced and reannounced. Notwithstanding that, I am pleased that the beds are up. I have concerns about the fact that we are moving towards privatization in the personal care home field, but that is a philosophical difference between us, and that can be dealt with.

But I am concerne d about standards and I am concerned about the fact there is not a recognition that, as you have moved from having people in acute -care beds into personal care homes, the acuity and the demographic makeup of those patients have increased remar kably, and the services that must be provided for those individuals must accordingly go up. I am not sure there bas been a recognition, and this is not philosophical or political. I am not sure that there has been a recognition within the system of that requirement, and I think that something ought to be done about that.

I think that is why we have examples of documen taries and coroners ' reports indicating that something should be done. I think those are valid points . The minister again bas announced that there is going to be a review of this area, and I am anxious to see what type of the review is taking place. We will be as co-operative as possible in resolving this issue. It is not a political issue. It is strictly an issue of demo graphics and acuity of level of care and enforcement of standards. That is straight for the public of Manitoba.

With respect to the hospit als, we see that there is a good deal of uncertainty in the hospital system . It is clear that the government bas cut back funding to hospitals and is continuing to cut back funding. The announcement that a funding cut of 10 percent to the hospitals was on bold; I do not think is on hold any longer. I think the 3-4-3 cutback over the

843 LEGISLATIVE ASSEMBLY OF MANITOBA May 2, 1994 next three years is still in place, and I would be interested to know whether in fact it is in place. I think most hospital administrators are functioning on that basis. We are still awaiting the finalization and the dribs and drabs of the Connie Curran exercise. The minister knows that I have mentioned that once or twice in the House, and that it has come up on occasion. Mr. McCrae: Yes, but we got one Michael Deeter. Mr.

Cbomiak: The minister says, anytime we talk about Michael Deet er-! am happy to talk about Michael Deeter or Coonie Curran or APM or the $4 million or the $800,000 in expenses tax free and the amount that was held back at 10 percent that is probably sitting in an account, and perhaps we can get that money back. At least they get something back from Coonie Curran.

I am happy to talk about that anytime or about the contract and to go on and on about it. [interjection] The minister says that we should get the beds back that Michael Deeter closed I will tell the minister that if Connie Curran had any recognition of the Canadian experience , perhaps we would not be in the dilemma that we are in now. Mr. McCrae: ... could ask Michael Deeter. Mr. Chomiak: If her people-we ll, the fact is, I know it for a fact, that they recognize one of their ma jor failings in the system was that they did not have Canadian expertise.

I know that for a fact, · and the minister ought to know that because they did not know what they were doing. When she came in here and was asked about Bill 22, she said, Bill 22 does not concern me. When she was asked about French language , she knew nothing about the French language experience . She bad no understanding of the Canadian culture and environment, and she miscalcula ted miserably .

The government suff ered and paid the price accordingly. [interjection] The minister indicates Michael Deeter unde rst ands-the minister is so intent on Michael Deeter that he ought-perhaps the minister is considering hiring him or something? I mean, this was- • (15 20) Mr. Deputy Chairperson: Order, please . Could I advise the honourable minister that he has had his opportunity to do his opening statement? This is not a time for debate, and I would appre ciate hearing the honourable member for Kildonan. Mr. Chomiak: Thank you , Mr. Deputy Chaiipe rson.

I was very interested to bear the minister 's comments this afternoon about the rural health experie nce . I am very interested to see that the minister said, this is the greatest example of consultation that has taken place in North America -1 think he said Notwithstanding that, I am very curious, and I hope we will have an opportunity to examine this during the Estimates process, because I had the impression that a lot of this process was botched by the government.

If I look at the health action plan or I look at the time lines and the guidelines in the health action plan, not only do you miss the guidelines, but there were instances where the government wrote to communities and said, fonn health care units of 10 to 12,000, and then they did that. The government wrote back and said, nope , we are forming larger health communities; reconstitute them.

I could argue now in a positive vein that perhaps the government is listening and reacting to the community expression, but I am very curious as to see how that process is developing and when and how it is going to be finalized I am concerned that if health care refonn in rural Manitoba follows the same course of action as health care and refonn in urban Wmnipeg, rural Manitoba is in for a rough ride. I am anxious to see what is happening in community-based care, other than that of dealing with mental health.

I note that whenever the minister and the gover nment talk about community based, they deal with their strong suit, which they admit is mental health, but we see very little action in tenns of community-based care outside of the mental health field. We are very anxious to see what is happening in terms of the Emergency Services Task Force - -

- - May2, 1994 LEGISLATIVE ASSEMBLY OF MANITOBA 844 report. It would be useful if the document was made public. The minister has said they are working on it. They have now hired the individual who created the working task force, who wrote the report, to wolk for the department in reform. I will be very anxious to see it because emergency reform was also an intim ate part of the recommendations in the government's blue book, Quality Health for Manitob am, The Action Plan. I am interested in terms of the dental care progra m.

I think, quite wrongly and inapp ropriately, the government killed the dental care program last year. It was done for budgetary reasons; that was made very clear by the previous minister. We think it was a wrong decision. We think the statistics show that it is resulting in rural Manitobans having less access to quality dental care and, in fact, as a result , poor dental health which runs contrary to a commitment towards preventative health.

We note that the government has put back-and I welcome the fact the government has put back in this year's budget-some of the funding that they cut out of the Pharmacare program and some of the funding that they cut out of the Home Care program. It still does not get us back to the point that we were before the government cut the money out, but that is at least welcome.

That is a recognition that, in fact, those areas require increased financial support beca use, by everyone 's acknowledgement, including the government 's, those are the preventative and the community based kinds of programs that the government should be implementing and placing a priority on. We would hope the government would give consideration to something like our Health Reform Accountability Act that provides for meaningful consultation, statutorily defined consultat ion, de legation, and a role for an ombudsman or a type of ombudsperson to deal with concerns in the health care field.

We note the go ver nment will soon be announcing something in terms of a policy on He althy Child Development, and we have advocated and welcomed that for some time. We can only hope for the benefit of all Manitobans and the children of Manitoba that this comes to fruition sooner rather than later. We were supportive of the government 's PIN, the ann ouncement with respect to the Pharmacare program, and we have been supportive of that from the start. We note that there have been some difficulties in the initial start-up, and we look forward with anticipation to the actual implementation of the system. Mr.

Deputy Chairperson, basically those are at least our opening comments in this regard, and we look fotward to this process. Mr. Deputy Chairperson: We thank the honoura ble member for Kildonan for those opening stat ements . Would the critic for the second opposition party, the honourable member for Crescentw ood, have an opening statement? Ms. Avis Gray (Crescen twood): Mr. Deputy Chairperson, I too would like to welcome the new Minister of Health (Mr. McCrae) into his portfolio as we go through the spending Estimates over the next number of weeks, and I am going to keep my comments fairly short.

I think that, as we go through the Estimates pro cess, the minister will have a sense of the issues that we have in regard to health reform and where it is go ing in this province .

I hope that we will have an opportunity particul arly today to get from the minister basically as a follow-up to the Quality Health documen t a sense of what the strategic plan and the actual implementation are of health reform in Man itoba, looking at some specific objectives in the next three to five years as well as if we can get a sense from the minister, as again was outlined in the Quality Health document, as to what the evaluation to date tells us in regard to bow the reform is proceedi ng.

I also see the Estimates pro cess as an opportunity to clarify some pol icies and procedures where nece ssary, and there are still some areas that I am not exactly sure what policies are in the Department of Health. So, for my benefit and also for some constituents who have inq uired,

845 LEGISLATIVE ASSEMBLY OF MANITOBA May2, 1994 I hope we have an opportunity to do that as we go through the spending Estimates .

The minister commented in his opening comments that consultation was the key and that communication with the various stakeholders was extremely important I am pleased to hear him say that I think that in a huge bureaucracy such as the Department of Health and when you are dealing with a health system that is so complex and multidimensional, it is oftentimes difficult to provide appropriate communication-and this is not a reflection necessarily on the Department of Health-but governments never seem to do a good job of communicating.

I say governm ents with an "s", regardless of political stripe or regardless of any particular department. We are oftentimes lacking in that regard , and so I would hope that there is a definite communication plan that is in place as well, so that in fact for the positive things that are occurring in health reform , that the community and the various stakeholders are aware of those. I think when we talk about comm unication, as well, I think the more information that is available to the public and to the stakeholders is probably a better way to go rather than withholding inform ation.

I know there is always inf ormation that is government policy or in a draft format that cann ot be released, but I think, by and large, if people are aware of what is going on and have knowledge , then often times they are more at ease with what the p rocess is and what is going to occur in the future. I was also pleased to see the minister speak about consulta tion with communities in rural Manitoba as well as in Winnipe g, and I look forward to discussions around philosophy, as well as implementation of the aspect of regionalization, what it could mean to Manitoba.

I know a number of the rural institutio ns and hospitals and reeves and municipal councils are quite interested in this idea of regi onalization and what it does mean. I think it is very important, as well, when we talk about health care in Mani toba, that we identify some of the dif fer ences and some of the flexibilities that are needed in the system, particularly because of some of the differences we have in urban Manitoba versu s northern Manitoba and rural Manit oba.

I also look forward to a discussion ofBill22 and the minist er's facts and his thoughts about the impact, positive and ne gative, of Bill 22 on his department and on other institutions that provide health care servic es. So I want to leave my remarks at the be ginning very short, because I think as we go through what I am sur e will be many weeks of spending Estimates, we will have an opportunity to talk about philosophy and direction of this government and of the Minister ofHealth. Mr. Deputy Chairperson: I thank the honourable member for Crescentwood for those brie f remarks.

Under Manitoba prac tice, debate of the Minist er 's Salary is traditionally the last item considered for the Estimat es of a department. According ly, we shall defer consideration of this item and now proceed with the consideration of the next line . At this time, we invite the minis ter's staff to join us at the table, and we ask that the minister introduce his staff present, please. Mr. McCrae: While he is taking his seat, I might just take one second to respond to each of the honourable members.

If they want to respond back, that is all right with me. [intetjection] Well, if anybody objects , I will slip it in later. Mr. Chomiak: I will certainly give leave for the minister to respond to our comments. Certainly, in my first question, I will ask the minister if he would like to respond to our comments . Mr. McCrae: Okay, thank you. Mr. Deputy Chairpers on, I am pleased to introduce Mr. Frank Maynard, not a stranger. He has been at this longer than I have. He is the Deputy Minister of Health.

We have Tim Duprey here, Assistant Deputy Minister responsible for Finance and Management Services, and Susan Murphy, Director of Administration and Fmance. These people will help me, I hope , get through the next little while . - -

- - May 2, 1994 LEGISLATIVE ASSEMBLY OF MANITOBA 846 •

(1530) I think the honourable member for Kildonan bad a question for me. Mr. Chomiak: Mr. Deputy Chailperson, I wonder if the minister has any comments in response to our opening statements? Mr. Deputy Chairperson: Co uld I ask the honourable members to just wait one moment until we get into a line , and then we will have the opportunity to discuss those at that point. I would like to advise the members of the committee at this time that the correct procedure for considering items in the Committee of Supp ly is a line-by-line manner. In order to skip ahead or to revert back to any lines already passed, unanimous consent will be necessary. At this time, we will move on to line l. (b)(

l) Salaries and Employee Benefits $608,600. Mr. Chomiak: Mr. Deputy Olairpers on, imofar as this line deals with the strategic direction of policy development, does the minister have any comments in response to our opening statements? Mr. McCrae: The honourable member is very kind , Mr. Deputy Chairperson, in all of the things which be said, which no doubt we will be talking further about. He made the point that I was sensitive to some of his comments.

It is bUe that I am, because I think if we do not do things right in this particular generation and this particular time in our history and if we do not worlc together more closely , we do run the risk that some of the refonns that we are trying to do will not work very well because of a perception of bad policy. You know, I am very quick to defend a lot of the policies because there is so much of Manitobans in those policies and so much input from people . I am not trying to have a monologue disguised as a dialogue . I am not trying to do that. I do get very sensitive .

I should not get overly sensitive , but I really think that we owe it to the next generation to leave them a health care system, too. If we always just responded to whomever shouted the loudest with respect to spending on this, spending on that-and we get it every day, spend, spend, spend, and criticism when we cut . 1be point is we have to have a health care system for the future because I am so proud of the one we have . So if I sometimes sound a little bit sensiti ve, there are reasons for it. With respect to the honourable member for Crescentwood (Ms.

Gray), she said a number of things, too. 1be one I liked the best was evaluation, interested in evaluation of the things we are doing. We ll, we are too. That is why we have things like the Centre for Health Policy and Evaluation, an independent group that, without all of the emotion that sometimes characterizes health care debate, can tell us in factual ways whether we are on the right track or not. When we are on the wrong track, tell us that, too, and we will adjust because that is what the people of Manitoba want us to do.

So I think we need to look at real results and not always just at the ones that the best debaters can raise the greatest perception about. So sometimes I am sensit ive , yes, but I am interested in evaluations, too. Those are just a couple of observations on the comments of my colleagues here today. Mr. Deputy Chairperson: Shall the line pass? Mr. Chomiak: Mr. Deputy Chairperson, in this very positive vein and the frank comments of the minister, perhaps we will commence the process by asking the minister, I think, one of the appropriate questions that was raised by my colleague from Crescentwood.

That is, is there an update or is there a strategic plan in place with respect to the refonn process, based on the 1992 plan? Is there an update or a priority list or some kind of process or check in place to detennine where we are at and where we are going? Mr. McCrae: Mr. Deputy Chairperson, we have not yet, to date, put out sort of a public report card as to bow far we have come, because many of the refonns are in pr ocess . As the member for Crescentwood pointed out, there is a very large bureaucracy here, and I might

847 LEGISLATIVE ASSEMBLY OF MANITOBA May 2, 1994 add to what she said, that we are dealing with many bureaucracies when we are dealing with the health system because many, many facil ities are very important in our health syst em, and each of them has their own administrati on and so on. There is a lot to report on, and I think maybe you are right I say to the honourable member that not everyone is aware in a precise form as to what we have achieved in the last couple of ye ars in Manitoba and even a little longer in terms of changing for the better our health care system and making it sustainable for the future.

Sometimes the good gets shrouded in a heavy traffic day in an emergency room or something like that, which really stretches the resources of an emergency room, and we have to look to make sure we have other resources available so those things do not become problematic. Those are the kinds of issues that tend to detract from the solid, positive progress that has been made. Here I have to be frank with the honourable member and say that I would like him to say as much about some of those more solid and positive things as he says about a heavy day in the emergency room. I acknowledge that they have busy, busy days.

It has happened twice these last few months, once at the Health Sciences Centre in Janu ary when it was really, really busy, for whatever reason, and then more recently as spring was-a ctually, it was not last winter. It was earlier this spring when we had a really nice day, and there was tre mendous pressure on emergency rooms, and then more re cently last week with respect to psychiatric patients at St. Boniface.

I am quite happy to engage in a very open discussion about that and a discussion about the plans that have been made that prepare us for better delivery of mental health services, not only acute but the whole spectrum of services that are required in the mental health field or any other field Yes, the honourable member is looking for a · report card, I think , of some kind. I am hearing what he is saying . We do not have one to place in front of him today, but I would like to have such a thing before very long. Mr. Chomiak: Mr.

Deputy Chairperson, one of the difficulties that arises when you have those , as the minister terms it, exceptional or periodic peaks , for example, in emergency rooms, is that we know the government has a task force on emergency services that has given a report to the minister. We know the government is worlcing on some kind of change to emergency, or evolution or reform of emerg ency. There is no question this has occurred in the past. The reason the government created a task force to revie w it was to solve the problem .

We know the government has a report, and we are faced, in the op position, with a situation where the problem contin ues. The government is studying it, and no apparent action has taken place. That is our dilemma and that is the issue. (Mr. Bob Rose, Acting Deputy Chairperson, in the Clair) Mr. McCrae: The honourable member is right to point out that we have had the services of an Emergency Services Task Force and that we have a report from which we can take advice and develop change to the delivery of services to make it so that we do not get piled up in some places and there is low traffic other plac es. •

(1540) In a city the size of Winnipe g, we should be able to organize our emergency services well enough that if there is heavy traffic at one area that it can be properly diverted, saf ely diverted to another area where there is a capacity there to pick it up. I think the honourable member is pressing for the release of an emergency services task force and the government 's response thereto. He is probably right to do that.

As I said a few minutes ago, and as the member for Crescentwood and the member for Kildonan agreed, health care has many, many dimensions and facets and in a reform time we are dealing with many , many of them all at once. Staff are worlcing extremely hard to assist the government in getting all of these changes pointed in the right direction, if you will, staff with the help - --

- May 2, 1994 LEGISLATIVE ASSEMBLY OF MANITOBA 848 of these task for ces which have utilized the services of the peop ie who know what is going on in these businesses. We are not wasting any time to try to get the changes that we need to bring about efficient day in, day out operational emergency services working. All that is not to say anything about those who have been in the business of providing emergency services. We have a lot of time for them . They do a good job.

They are very highly trained people -right from the ru st responders to the acute surgical teams that are required to help people who get into emergency situations. You see, if the honourable member would work with us on the issue of discharging people from hospitals, to<>-I have heard some people refer to hospitals for some patients as weekend hotels because we have not had a discharge policy that makes beds available that should be made available for people who need those beds more on an emergency basis. I need the member's support for those things.

I do not need his criticism when we try to get people out of hospitals who should be out of hospitals because we happen to use a particular kind of delivery service. Discharge policy is very much linked up with emergency services. I am looking for the member's supp ort. Mr . Chomiak: Mr.

Acting Deputy OlairpeiSon, it only took three questions to get the minister to steer the conversation toward the We Care issue, which in this spirit of hannony I was not going to bring up for at least a little while, but having been raised by the minister, I mean, there is no doubt that we are supportive of as early discharge as possible from the hospital. There is no doubt that every study indicates that should be the case . Mr. McCrae: Even if that means la yoffs. Mr. Chomi ak: The minister says from his seat, even if that means layoffs.

I can tell you that we do not believe the system can tolerate any more government layoffs that have been imposed. Mr. McCrae: How can you suppor t ea rly discharge ? Mr. Chomiak: The minister says, how can we support early discha rge . Let me just ask the minister why-the difficulty with the process was it was not public, it was not tendered. For the fiiSt time it is an example of a private nOISing company going onto the ward of the hospi tal. There was that process put in place .

The minister says, because we are opposed to the process and because we are oppo sed to the way it was done, we are somehow oppo sed to early discharge. Is the minister of the opinion that the more people we discharge earlier, the more people he intends to let off of the system? Mr . McCrae: Mr. Acting Deputy OlairpeiSon, I am saying to the honourable member, you cannot have it all ways.

If you agree with a move, a shift in policy from total reliance on high-le vel, acute care institutions to a community-based service delivery system, where that is approp riate, then you cannot support that on the one side and then not support changes in the hospitals that have to result from patients leaving hospitals . Short length of stay, early discharge , all of those things lead to empty beds in hospitals and people serving those beds . You cannot run a health system by having empty beds with nobody in them and a whole staff there ready to look after people who are not there .

Now the honourable member knows that. He is very aware of how this whole thing works, I am sure, and you just cannot have it both ways, whether you bring in a private firm or you do not use a private firm. You use the Home Care program, for example . It is the same shift going on. That is where the word "sensitive" comes in to descr ibe my fe elings, because it is a little frustrating to look at people who really do try to have it both ways. Another example of an issue that we should be addressing in regard to this shift in the area of delivery of services is the self-managed care aspect of our Home Care program.

I mean, it is really quite a thing to see the sense of independence that people can achieve when they make their own decisions about their home care deliv ery. How would you like it, I say to the honourable member, to be laid up, and when the time comes for you to go to the bathroom is set by somebody

849 LEGISLATIVE ASSEMBLY OF MANITOBA May 2, 1994 else? I am not really in favour of that ifl can avoid it, and I think we should build as much flexibility into our whole continuum-of-care system as we can. We should be promoting self-managed care as much as we can because, ultimately, there is X amount of care that is required, and X amount of care should be delive red, whether it is by people on the public payroll or indirectly to people through hospital programs like the pilot pro ject we have been bearing so much about, whatever method. I do not have a philosophy on the point, except care .

That is my philosophy. Let us get the care to people in the most effic ient way and empower people so they say when it is time to get the care they need. To the extent we can do that, we should. I wonder where the honourable member stands on self -m anaged care and on its expansion. Are we expanding it enough this year? One of the things that bas been said to me is that you are expanding it and that is the right thing to do, but you are not going far enough. I want to explore that with my departm ent. I wonder what the honourable member's viewpoint would be. (Mr. Deputy Chairperson in the Clair) Mr.

Chomiak: The minister, I think, is missing the point completely. The minister somehow bas missed the point that this government bas cut back on re sou rces offe red to members in the community . This governm ent bas studied the self managed care system for some time and bas a report on their desk that they are not releasing, as well, in that area and is saving it for a positive announcement as we move towards the election campa ign. Let us be frank. The minister and the department have all of a sudden discovered self-managed care .

The report has bee n received some time ago by the department-last year, the minister indicate s, I believe. Why did we not see an ann ouncement last year? Why are we making people wait for the implementation? Where is the consultation? It bas only commenced rec

Document details

Collection	Manitoba — Debates (Hansard)
Citation	35-5-18a
Type	hansard
Volume / chapter	35th 5th hansardpdf 18a.pdf
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	d7eb1ded401efed36d79efe8b10d41abf40078b7

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