Manitoba Hansard — 19 March 1981 (Sitting 41B, 31st Legislature, 5th Session)

31-5-41b

Manitoba — Debates (Hansard)

ISSN 0542-5492 Fifth Session - Thirty-First Legislature of the Legislative Assembly of Manitoba DEBATES and PROCEEDINGS 30 Elizabeth 11 Published under the authority of The Honourable Harry E. Graham Speaker VOL. XXIX No. 418 - 8:00 p.m., THURSO A V, 19 MARCH, 1981 Office of the Queen's Printer for the Province of Manitoba

LEGISLATIVE ASSEMBL V OF MANITOBA Thursday, 19 March, 1981 Time - 8:00 p.m. CONCURRENT COMMITTEES OF SUPPL V SUPPL V - HEALTH MR. CHAIRMAN, Morris McGregor (Virden): I call the committee to order. We're on Line 2, Personal Care Home Program. The Member for St. Bon iface was speaking as we adjourned so I will call on him. MR. LAURENT L. DESJARDINS: Yes, Mr. Chairman, I was saying that the Min ister made a point to say that he wasn't the Min ister of Labour and I agree and my concern at this time certainly was not with mana gement and the workers as far as settling their differences.

I'm not saying I'm not interested, I very much hope that they would do that pretty soon, but my main concern now is the standard and the health care that these people are getting. Now something is wrong, and I would think that the Min ister would realize that if his people, from what he is saying, are saying, well things aren't perfect but it's okay, and everything that we hear seems to claim the opposite. Now some body is mistaken or some body is falsifying reports or somebody is lying. it's as simple as that because it can't be that there is that much difference.

I personally would never take the word of the operator of this nursing home and I will say this outside the House, in the hall, anywhere, without any fear at all, and I would spend some time briefing the Min ister about this past operation, about the man, if I wasn't positive and sure that this has already been done because I kno w how the members of the Commission felt in those days and I can't see where there has been any improvement at all. Mr.

Chairman, the critique that I had mostly is that this is the only place where we can discuss on an equal footing with the Mini ster and the government, when we ask questions, we're being yelled at, to just ask a question, the Min ister can make a statement, then the press will get a hold of him and there's a statement and we're supposed to be doom and gloom people, we're supposed to be alarmists, and so on. (Interjection)- Yes, well, that's just it. lt shows what kind of people you are and it shows what you know and what you know about the role of the Opp osit ion, and if you think this is it. (Interject ion)- All right, and thos e two smart characters on the other side are experts on the situation on the topic that we're discussing, I'm sure, so maybe then they could tell us what's going on and what they think of the service and the standard that we are getting at the St.

Adolphe nursing home. Maybe they can tell me if they would like to see their mother or father there -(I nterjection)- what? Well then, you wouldn't want to see them there at this ti me. You wouldn't want to see - you see, Mr . Chairman, that's just it, automatically it's the strikers. it's nobody else, but many of these people in this govern ment, it's the strikers.

Yo u're supposed to take of the top, the elite in the society, and then the strikers, the people that are having a hard time making ends meet, they are supposed to yes, tighten 1903 the belt, and they're supposed to work for the betterment and to make sure that it's a good clima te and they want to make money and cut corners; and this is exactly what's happening.

Now the Mini ster, I'm surprised, the Minis ter is not getting only one side of the picture, he's getting both because I am getting some copies of letters that he is receiving, unless his staff has taken over and not showing it to the Min ister, and I'm getting phone calls from people who said they have been talking with that office. And I would like to know. Maybe we should sit down tonight and determine what, to see if we have the same ideas as to what standards should be in this area.

And maybe we should find out if, having to wake because of lack of staff, of having to wake the people up at 4:00 o'clock in the morning to start their routine of washing and so on, with these kind of people, if that is acceptable, then maybe we should find out to see if the time that they've had to wait before their meals, if that is acceptable, and also the conditions that they have when they're wet and sitting in filth, for hours, if that is acceptable. And then maybe we should find out if the staff, who is starting on their second shift at times, being bussed from St.

Norbert, who are coming in, all of a sudden as qualified people in that nursing home, if tha t is acceptable. Mr. Chairman, if the Mini ster, and the Min ister of course can't be everywhere at the same time, but it seems to me that he is looking and he is accepting as gospel truth one side and not the other. And he's saying he's concerned, and nothing will ever, he'll ma ke darn sur e that the standards will be maintained, but while he's saying that, the standards are going down and these people are suffering.

Th ere are people that are frigh tened that are living in this atmosphere, they are threatened with all kinds of thin gs or inn uendoes, or rumours that they will have to pay more; they're afraid to say any thing. The Min ister repeatedly said that the nurses are doing wonderful work and I agree with him, and that is another subject. That is one of the reasons why we can't keep nu rses here, we have a shortage of nur ses, it's not only pay, it is the working conditions tha t we have, especially in areas like that.

Now to protect themselves and they've had this restraint, they have these forms that I think the Member for Transcona mentioned, they have these forms that they file with the owner, with the operator, and he's refusing to accept that.

Now if the Min ister talks to the patient, if he talks to the relative of the patient, and if he talks to the nurses, he will find out because unless something's wrong, because the information that we're getting, and 1 haven 't been there, and I'v e never phoned anybody, I'm getting the calls on the phone, and the information that things are really bad. 1 have an example here, the latest letter that I received; I forgot the others at home. I got this today. This is a copy of the letter to the Min ister. I received a copy and the Min ister of Labour received a copy:· "Mr.

Min ister: I am certain that you are aware of the labour dispute between Mr. Brousseau and the support staff of the St. Adolphe nursing home. I would like to inform you that my father is a patient in the home and since the dispute has begun

Thursday, 19 March, 1981 I have visited my dad several times and I feel I must advise you that I am distressed with what I have seen. Mr. Brousseau said that the replacement which he has brought in are competent people. If they are, how would he explain the fact tha t an old sick person is left waiting hours for his meals? How would he explain that my father is left in a very wet bed for hours and no one noticed? "I understand tha t you would rather not get involv ed in this conflict, however, I feel that as Minis ter of Health you have no choice but to get in volved. Mr .

Br ou sseau is only in terested in maximizing his profits and shows no concern for the old people in the nur sing home. You must get involv ed in order to assure that the level of care is adequate. The nursing staff is certainly doing their utmost to see to the medical well-b eing of the patients but I can see that there are limits to what they can do when they are surrounded by untr ained staff. it may be against your political philosophy to put pressure on a pr ivate enterprise, but the circums ta nces in St. Ado lph e requir es your immediate attent ion, and either Mr.

Brousseau hires competent staff or else he negotiates with the union to assure that proper care is given to the patient. Si ncerely, Cecile Lagasse." This is not one of the persons on strike. This is somebody that, of course, like all of us wants to see this thing settled but in the meantime is certainly quite disturbed with the care that her father is receiving and I would think that every single one of us around this table would feel the same and we'd yell blue murder if it was one of our parents that was there.

The Min ister claims, "Well all right, you have to accept responsibility if you move him." You have to accept responsibility if you do nothing also. They've been moved. I know it's traumatic and it's difficult and it's the last thing that should be done, but that's happened before. I remember it was a lot worse when they had to move all kinds of people with iron lungs and so on during the flood and they were moved. Now these people, it doesn't ha ve to be confusion if that is the case. I don't know what the answer is because I don't know the options that the government has at this time.

The only thing I'm saying to the Min ister: You are saying to the press; you are saying to other people that we're exaggera ting. And if you're not, your colleagues are saying that we're alarmists. You know, that's the role of the Opposition; we have a few months to do it, we have the Estimates and we have a Question Period to do it in, and that is our role, our responsibility. We're not there to praise the gove rnment, the government can do a very good job of doing that themselves.

We're there to point out and to keep the Min ister on his toes and the government on its toes and I think the Minis ter in the past has suggested that this is the way to go, and I know that he wasn't as easy as we were when he was in Opposition. I remember in the same predicament, the name cal ling and so on tha t we had with the former Minis ter of Labour, Mr. Russ Paulley, who was very hard on the man personally who was accused of all kinds of things personally. (Interjection)- Not only Bud. but some of your other people and Bud was the leader. Mr.

Chairman, if this is going to be a joke, I would suggest that you ask these characters to get the hell out of this Comm ittee room. (Interjection)- You have no business coming here and trying to disturb the Committee and to try to make everythin g a joke. They ha ve no business coming here and trying to disturb the comm ittee and then try to make this a joke. MR. CHAIRMAN: Order, order.

The Chair is trying to ha ve one speaker at a time and it would be appreciated if we hear one member out and I'l l go back to the other side if someone wants to speak, but we won't get anywhere where everybody is jibing in, so the Mem ber for St. Boni face can continue. MR. DESJARDINS: Yes, Mr.

Chairman, sure I've had my share of jokes but there's certain times that people ha ve to have a little bit of to be a little serious when we are discussing things as important as that and the suffering of people. it's not just a joke between members who are trying to have fun. lt is somet hing that is very serious to people and they can onl y ask that the work and the case be discussed honestly here by different parties and our role is to show if there is any thing. We've been told many times, we are like ombudsman, every single one of the ML As and it is our role and our duty to bring the subject up. Mr.

Chairman, I would like to say also, I see this as an example of the danger that you have when you have a profit-orien ted personal care home. I hope that the Min ister, in a way, would not respond to this because I wouldn't want him to respond to feel that he's defended and to say that forever this is a policy and that won't be changed, because I think that he should look at it. He should read the articles that appeared last week in the Globe and Mail, and he will see, and then many of the books that were written on it.

I think tha t we are fortun ate in Winnip eg comp ared to many other places in the type of peopl e tha t we've had in the sh ort time as proprietors of those nursing homes, but the danger is there, and he is not one of the examples that I cite as a model, this operator. He is not one of them at all. In fact, I would much sooner see him out of this line of work and go back to making money in real estate than taking care of people, because I don't think he's doing a good job, and I don't think he ever did. Mr. Chairman, as I say, I think this is an example of the danger.

I am not saying you wouldn't ha ve a strike if it was a non-profit organiza tion, but I am saying th at I don't think th ere would be this bitterness, and I don't think that the government or the religious order, or that Fred Douglas or that group would allow this kind of thing. Now you have one man, and you can 't put all the blame on this man, to him it's a liveliho od, and we allow that.

We allow that and we call it - if he can make money, we're saying the only way he's making mo ney compared to the others - it has to be that because the others are spending every cent, there's no profit - he is more efficient, and unfortunately too often, efficient in running a nursing home means that you have everybody quiet because they are sedated and you don't need as large a staff. You can go in any tim e and lo ok at a personal care home, and especially if they know ahead of time, it will be a model place, everybody is sleeping or tied in a chair.

I think -(Int erjection)- Oh for Christ's sake, are we going to have this here again, God damn it. 1904

Thursday, 19 March, 1981 Well, Mr. Chairman, we have once a year during the Department of Health, we had a liquid dinner for some bloody guys and we have to face this. Well, I'm not going to . MR. CHAIRMAN: The Ho nour able Member for Portage Ia Prairie. MR. LLOYD G. HYDE: Mr. Chairman, I just sat as long as I think I can sit and listen to the crap that is going across from that man across there from St. Boniface. I made an enquiry to a family in Portage Ia Prairie whose father has been in the St.

Adolphe Personal Care Home for a number of - I shou ldn't say a number of years, a number of months - and they have been very well pleased with the care that they've had in that personal care home. I asked now that the strike is ... MR. CHAIRMAN: The Member for St. Boniface said MR. HYDE: You've had your say. MR. CHAIRMAN: All right, I recognize the Member for Portage. You have your say. MR. HYDE: It disturbs me to the utmost to think that we have people like this that's degrading the personal care system that we have in this province the way they are doing today.

This last couple of days in the House has been disgraceful as far as I'm concerned. Now, the family who I talked to are saying to me, have said to me over the supper hour, that they realize the position that the nurses are in. The young nurses are doing a good job. They may not be as well qualified medically as they should be to care for the patients, however, I understand that we do have medical doctors caring for their needs when the time comes.

But it's very disturbing for me to hear this here nit-na tting going on back and across just because some few people have decided to strike against the personal care homes of this province. It's a lot of junk to think that people from the Opposition tear us apart like this, when the senior citizens are not being torn apart and not being mistreated in this province. MR. CHAIRMAN: The Member for Transcona. MR. WILSON PARASIUK: I'm delighted that finally we have had the true colours of the Con servative backbenchers come out.

Here's a man who has become an instant expert on health care who has spoken out very little. He has become an instant expert on health care and immediately he has come to the defense of the private profit-making operator. That's his first concern on this, but saying somehow, somehow, that the people who have raised concerns over what's been going on, not only with respect to St. Adolphe, but a whole bunch of other private nursing homes, in terms of the difference in quality between them and the non-profit homes.

Last year we had the Golden Door Geriatrics Centre, if you can rec all, if you can recal l. (Interjection)- Obviously, obviously this has been a good supper for somebody . . but last year we had the Go lden Door Geriatrics Centre, we had that 1905 strike and the Minister at that time had to use some persuasion on the owner and if he checks through Hansard, he'll recognize the statements that he made at that time, indicating that possibly something would have to be done with respect to the owner in terms of trying to get some collective bargaining taking place.

This year we had a situation in the Selkirk Nursing Home. We had a situation now with respect to the St. Norbert one. If in fact a local priest living in that community will make comments about the quality of care being provided, they're not only over the last 10 days, but over the last while, obviously that person has concern and for the Member for Portage to say that the articulation of that concern, voiced by the residents of St. Adolphe, voiced by the relatives of the people in St. Adolphe, raised by the nur ses, is crap, then we on this side we reject that entirely.

I'd like the Member for Portage to check some other sources out . I'd like him to become an expert on health care if he's that inte re sted. (I nterjec tion)- I wou ldn't want him to join anyone. I'd just like him to find out some of the facts. One phone call, the instant one-phone-call expert. The instant one-phone-call expert. {lnterjection)- How many drinks have you had , buster? Ho w many; you know what? We have had this and I agree with the Member for St. Boniface, we've had a pretty good discussion, a rational discussion on health care. I'd call them goons but I don't think they warrant that.

When we have to try -{Int erject ion)- I don't get intimidated, Mr. Sherman, I don't get intimidated or threatened by any jokers coming around trying to disrupt the proceed ings as they've been trying to do ever sinc e the Member for St. Bon iface started speak ing. We aren't intimidated by tactics like that. {Interjection)- No, we're not heroes. We are just rational people, Mr. Chairman. MR. CHAIRMAN: The Member for Seven Oaks on a point of order. MR. SAUL A. MILLER: Mr. Chairman, on a point of order.

This is a committee meeting, you are in the Chair, it is a formal meeting of the House; now either the meeting takes place in order and people are recognized and others keep quiet, or frankly I intend to simply get up and leave because you cannot operate in these conditions; you cannot talk; you cannot think. Now if the government backbenchers or the government side thinks that by scream ing and hollering and baiting, they can bring this debate to a conclusion, they are right. We will leave, and we will make public our reason for leaving; I will do so. MR.

CHAIRMAN: All right, I think we do have to speak through the Chair. The Chair will recognize you, and I wou ld beg of you , if you ca n't hold yourself get the hell out cf here and let it go, but we do want to proceed. I don't want to be sitting here two hours from now on the exact line that we are on, when there is no real reason for it. We all know where the blame, if there is some . . . Now I'll try to recognize every man in turn, but for God's sake, try to hold yourself till you get a turn. The Chair will recogni�e every one when he -(I nterjection)- A point of order. MR.

HYDE: It isn't often that I speak, but I cannot tolerate a man calling us a bunch of goons on this side of the table.

Thursday, 19 March, 19 81 I made a personal call to find out what I could find out about the Ste. Adolphe matter, and believe you me these people are wrong and they're exaggerating the case that they are today. For the last two days in the House th ey've been just exaggerat ing the position that the Ste. Adolphe Personal Care Home is in today. MR. CHAIRMAN : I am not the judge, I am only a Chairman here, and I will recognize each side in rotation, and I don't believe the Member for Portage had a point of order. The Member for Transcona. MR. PARASIUK: Mr. Chairman, I specifically didn't call them goons.

If you look at the record, that's what the record will say. MR. CHAIRMAN: The Mem ber for St. Bon iface. MR. DESJARDINS: Mr. Chairman, things were going very well in this committee; we progressed well; we had some good discussions; and for some of the people that hav en't been here that long that don't realize what this is all about it, it is an opportunity for the Opposition to question, to scrutinize, to suggest, to criticize the government, and that in turn, in our form of government that they like to defend, this would pr om ote better gove rnment. But, Mr.

Chairman, it is a question now, you know, the people were threatening, you'd better stop right there. You know, they've got another guess coming if they think they scare anybody. I am not scared of any of those guys, I can tell you that, so that should be forgotten. Now. Mr. Chairman, everybody has a chance to talk. They can say what they want, we can defend ourselves. We ha ve talked about the things that we've heard.

I didn't try to talk about the strike as much as the standard of care, and I challenge any single member including the Member for Portage, if he wants to make a point on any platform to talk about the health care in this facility, any time, any pla ce, any day. Mr. Chairman, somebody gets one phone call, so he says, and everybody is happy. We are supposed to keep very quiet and not say anything. Well, this is not why I was elected.

I don't intend to follow the advice or suggestion of the members, especially the one from Portage, and if I have any criticisms to make, I'll make it, I hope it is constructive criticism. Now, Mr. Chairman, I've been in the House ... MR. CHAIRMAN: The Mem ber for Roblin on a point of order. MR. J. WALLY McKENZIE: Mr. Chairman, I regard, that I guess the sage of this House has made remarks and put on the record, that some people are here not too long, and therefore they don't have the right to speak; he said that.

He secondly went on and said that it's only the Opposition tha t's allo wed to scrutinize the Estimates of this Min ister. I think that's uncalled for, Mr. Chairman, and I think the Honour abl e Memb er for St. Bon ifa ce should withdraw those remarks. MR. DESJARDINS : they can read Hans ard. He should get the wax out of his ears, listens or sober up. or something. MR. CHAIRMAN: Order. I don't believe the Mem ber for Roblin had a point of order. MR. McKENZIE: Mr. Chairman, ... withdraw that remark, absolutely. I don't recall at any time of any member to say, "sober up". Mr.

Chairman, I ask him to withdraw that remark right now. MR. DESJARDINS : I don't intend to withd raw any remark. I said either he takes the wax out of ear, listens or sober up. He can have his choice. MR. McKENZIE: Mr. Chairman, he said sober up and I ask him to withdraw that remark. MR. DESJARDINS : I don't intend to withdraw any remarks. Not certainly, not the way . . . MR. McKENZIE: Take a ruling on it, Mr. Chairman. MR. CHAIRMAN: Well surely, to the members of the committe e, we can get to the line tha t's here, because we're getting nowhere except that knowing one another.

As long as we're sitting here and I would ... MR. DESJARDINS : Why, because we dare criticize, because we dare criticize the . . . has he got a point of order, you recognize him or what? MR. McKENZIE: The Honourable Member for St. Boni face who is the sage of this House and kn ows better and says to me that I have to sober up. I ask him to withdraw those remarks, period. MR. DES JARDINS : You'r e taking thin gs out of context. I said you either you listen or sober up. I don't intend, you can talk until you're blue in the face, I will not withdr aw, especi all y after the statement.

You interrupted me on a point of order and said, that I said, that those hav en't been here long have no busi ness talking and I never said that. I never said anything like that at all. I never implied that. I'm surprised to hear this character speak. I hav en't heard him for three years. I didn't recognize the voice. MR. CHA IRMAN: Now let's start off and take our turns. MR. McKENZIE: Let the Mem ber for St. Bon iface take the Chair. He's running the committee anyway. MR. CHA IRMAN: Do you want the public to know just how we represent our area going on like this from both sides?

I think the whole committee should be bloody well ashamed of itself, if the public knows what is going on. Now, I'll start again, one at a time, get on the second line, Personal Care and forget about our . The Mem ber from Roblin. MR. McKENZIE: On the same point of order, Mr. Chairm an. The Honourable Member for St. Boni face asked me to sober up. I ask him to withdraw that remark, period. MR. CHA IRMAN: Well he said it in conjunction with other remarks. MR. McKENZIE : How he said it; he said it and I want him to withdraw it, period. 1906

Thursday, 19 March, 1981 MR. CHAIRMAN: Well, I'm surely not up in all the rules of the House, but I doubt if the Chairman . . . MR. DESJARDINS: . .. the committee rise, Mr. Chairman, we're going to have to ask that committee rise, or it's going to be a waste of time. MR. McKENZIE: Mr. Chairman, for the last time I ask you to ask the Member for St. Boni face to withdraw those remarks, otherwise I retire from this committee and let him take over the Chair, because he runs the committee anyway. MR. CHAIRMAN: I think it would only be - the Honourable Min ister. HON. L.R.(B ud) SHERMAN (Fort Garry): Mr.

Chairman, I think what's happ en ing here really reflects the kinds of passions and emotions that are running in this

part icular dispute, and I think it accurately reflects some of the things that have been said to me by members of the work force at St. Adolphe, as recently as this afternoon in the hal lways of this building. There is no question that passions and emotions are running high on this issue. There is no question that the persons who are out of work in the industrial dispute have very deep concerns about their jobs, about their relationship with their employer.

They also had concerns about the residents, but they have very fundamental concerns about their jobs and their livlihoods, and so a lot of things have been said and I have said so in the House and I say again now, a lot of things have been said that have not been accurate. Some of the things have been accurate. Many of the things have been exaggerated and taken out of context. Many accusations and allegations that have been made were accusa tions and allegations that were probably valid, in fact we kno w that some of them were valid six months ago but are not valid today.

What's happened here is that there has been such a pola rization of positions in defense of the workers who are out in the ind ustrial dispute at the present time, on the part of members of the Opposition and a pol arizat ion on the part of my colleagues in defense of the difficulti es that the Mi n ister fi nds himself in, and any Mi nister would find himself in in these circumstances, that we're getting into areas of emotional bitterness, rather than reasoned debate.

And I think that no useful purpose would be served by continuing the sitting of the committee tonight un less we agree th at we can perhaps return specifically to the facts of the point at issue and the facts of the debate and I would ask for the co operation of both sides of the committee in that process. MR. CHAIRMAN: The Member for Min nedosa. MR. DAVID BLAKE: Mr. Chairman, on a point of order or if we're not, could I have the Chair on a point of order.

If I might bring some sense of responsibility to what has happened with the sitting of the comm ittee this evening, I witnessed the finality of the Question Period this aft ernoo n, saw the Min ister leave the House and attend the usual T.V. camera questions 1907 and be put upon by members of the people in the dispute at the St. Adolphe home, which I think was uncalled for and I suspect was orchestrated by the Member for Transcona, because he was standing back clapping when they put upon the Minis ter. This has exercised some of the members on this side of the House, Mr.

Chairman, and has caused what has happened in this House tonight and I hope I never see demonstrations like that allowed in this Cham ber or in the hal lways of this Legislature again, as long as I'm here. I'm sorry to see it and I think that's what has precipitated what has happened here tonight, and the Mem ber for St. Bon iface can say what he li kes, but th at's been simm eri ng all afternoon and I think you've cleared the air and I ag ree with the Min ister.

Let 's get on with the business of this House and handle the discussions of the committee responsibly and get forward with the business of the welfare of the citizens of Mani toba that are in care homes, unf ortunately as it may be. But that is what has precipitated this and I put the blame on the Member for Transcona. MR. CHAIRMAN: The Member for Transcona. MR. PARAS IUK: Mr. Chairman, when you have someone who has not been inv olved in the committee process in the Health Estimates, come in and start lecturing me on roles and responsibility, I find that somewhat difficult to take on the point of order.

We had some one come in saying that I was clapping, which is a direct lie. (Interjection)- That is a lie, that's a lie. We just have an admission of a lie right now by the Member for Min nedosa. MR. DESJARDINS: Mr. Ch airman, I move that committee rise. MR. CHAIRMAN: All in favour of the motion that Commit tee rise? Against? The motion is defeated. The Member for St. Bon iface. MR. DESJARDINS: Mr. Chairman, the Minis ter has tr ied perch ance to pr otect the action of his colleagues here tonight, but there's no way that that's going to go under silence that we will accept guilt on this at all.

Things were going well, we've had debates before, sometime it gets heated, and there are some members who come in, one by one, laughing and talking and interrupting even before they were sitting down, so it's not just a question of emotion and passion. They might have been that. I can tell you that I don't feel the kind of emotion that the Min ister is referring to.

I did not speak to any of the strikers; I have never received a call from any of them; I don't know any of them; I didn't see them in the hall; I was in the caucus room after the question; 1 had no idea they were in the gallery, if they were in the gallery when I asked my question. In fact I can inform that I wasn't here for caucus and inform the people that I asked somebody to inform the caucus that I had a question to ask.

There is not that kind of passion because I have not really looked and I don't know, really I don't know who's right and wrong fn this ins tance of striking , I haven 't the faintest idea, I haven't made a point to find out. My only concern has been the standards of care for the patient. That's my only concern. So there wasn't that passion at all.

Thursday, 19 March, 1981 Now as I say we are a disadvantage in that House, we can ask a question and that's it, we can't say anything else. The Min ister can make a statement, then he can make a statement outside the House, and this is why in this comm ittee we certainly intend to say what we have to say. We say it and try to get the Minis ter to agree. If not we register our protest and then we go to something else, and we were ready to do that. Whe Minis ter can try all he wants, this is not what happened tonight.

I sympath ize with the ba ck benche rs on government, I kno w it's difficult to stay quiet all the time and to have to be here, I realize that; but it doesn't make it any - it's understandable but not excusable to come in once or twice a year, and I guess boys will be boys, and have this kind of thing like we had last year when we were talking about Mount Carmel, that it was a Communist thin g and it would never be buil t becaus e it was run by Communists, and all of a sudden we heard that there's going to be money spent for the Communist clinic.

You know, these are the kinds of thin gs, and I don't mind a joke either, but when you haven't got a cha nce this gov ernment no w, some of the members in this govern ment, and that's what I referred to when I said some of the new ones who haven't been around in the days of Roblin, people of that would never have been tolerated. I have had some damn good debates in this House and we walked out as friends, and now there's so much bitterness on all sides, it's a damn joke.

You can 't ask questions, the Question Period is a joke. it is all orchest rated that the mem bers of th e govern ment, it is their right, they ask a question of the Min isters, we are allowed to go too far when we ask question, and the Minis ters can ramble all over the place and that's all right. You 're turning this into a mockery, you're turning this House into a mockery.

If you have the guts at least, don 't try to shout do wn or scare or th reaten th e Opposition in speak ing, because that is their duty and their responsibil ity, and I remem ber when I was the Min ister all that was said, and I remember the things that I thought were very uncharitable, to say the least. They tried to tar you with some things; like for instance, the confrontation with the doctors, those kind of things, and now we intend to have our say even if it's going to take all night. If you're going to try, we're not going to make it that hard, we're going to walk out, but I do not accept the ... MR.

CHAIRMAN: I wonder if we could return to the lin e that we really started out on, Personal Care Home Program . I've tried to be reaso nable and asked for some ... on the members. MR. DESJARDINS : Mr. Chairman, you allo wed the Minis ter to make a statement, which was a very smart statement to try to get the things, you know, to throw oil on disturb ed water and everything is fine, and then put the blame on both sides.

We came here ready to work today, like we did yesterday and we did the day before, and you know, you were in tha t Chair, you kno w that thin gs ha ve been progressing, and the Min ister knows that things have been doing very well, go od co-operat ion, no problems. Sure, we didn't agree on everything, and this is an area. All right. We'll go back on that. Now the Min ister keeps sayi ng, he said this afternoon that as far as he was concerned we were honest.

They didn't hear that, but he said that he felt that we were honest in our criticism and that's the way it was presented to us, but he's saying that some of the things are exaggerated and he said, I listened to the news today, he said that in the hall after the Question Period. I would like the Minis ter to tell what of the accusa tion, the thin gs that I said, what has been exaggerated? Does the Mini ster reject the fact that some of these people have been wakened up at 4:00 o'clock because of lack of staff? Does the Min ister say that that's exaggerated when I say that?

Does the Mini ster say it's exaggerated that they've had to wait, some of the patients have had to wait for a very long time before they got their meals? Does the Min ister think that it's exaggerat ing that the Member for Portage thin ks that this is the best of care, very proud, and he would like to have any members of his family there when they are left in a wet bed and wet clothes or dirty bed and dirty clothes for a number of years. Well, not years, but it would certainly seem like years for some of these people, people that are confused.

You know, we are playing games here when these people are having a hard time. Senior citizens that did a heck of a lot more for their province than we ever did. This is the time to discuss this, Mr. Chairman, and my concern, I was going to finish, until I was so rudely, and the rest of our group were so rudely interrupted so many times, I was going to suggest to the Min ister that it can't be all black on one side and all white on one side. Maybe there are some exaggerat ions, but maybe he's not getting the facts from the other side.

I can tell th e Min ister that the MONA representative came over and asked to see us to complain about that, and they're the ones that told us many of the thin gs. They told us also the nurses were not on strike and if it wasn't for the nurse in those present institutions, it would be an awful lot worse. They are doing a lot of work over and abo ve the call of duty, and the Min ister has recognized that himself, and they're not satisfied, and they ha ve complai ned to the owner and he will not accept these complaints. I'd like to know what has been exaggerated .

I'm not talking about the strikers, I don't kno w anything about that; I'm talking about the - I'm concerned, the Mi nister had a chance to talk to the strikers and maybe he was right, I'm concerned with the exaggeration of the things that I said because it has been said by a member that we are just trying to tear down the system that, Mr. Chairman, I think that we did our share in trying to build. I'm very proud of that, and that's the last thing I want to do is tear it down.

There's too many people working, there's too many people affected; just for political or partisan things to try to tear down something, it's the furthest away from my mind I can assure you, Mr. Chairman. But I would want the Minis ter to be able to tell me where the exaggeration is, or to tell me, I'll shut up right now if the Minis ter tells me all right, I've heard both sides, I'm going to make a point to find out.

I'll go myself, because right now I don't know who to believe, and to try to do something, but it's no good to have these pious statements and to say I will never allow the standards to go down, I will never allow it to do that in all that time. Things are real 1908

Thursday, 19 March, 1981 bad, and if I'm wrong I want to be proven wrong but not by somebody that's not never been around that doesn't even know where St. Adolphe is and I don't th1nk they know the difference between a personal care home or a senior citizen home. Mr. Chairman, I had enough of those people, I don't pay too much attention to what these members have to say, but I would like the Minister to tell me, where, what is exaggerated, then we' ll try to find out, and the people that give us this information will be put against the wall and they'll have to tell us what the score it, and that's all I want.

I'm certainly not blaming the Minister for all the problems that we've had. I've recognized that this afternoon, but I'm saying that obviously he's getting some information and we're getting different kind of information and somewhere along the middle somewhere there's got to be the report, but it's gone. There's too many conflicting statements. We are getting too many and I've never, as I've said phoned anybody or asked for anyth ing, I'm getting those. freely.

I'm getting phone calls from people I don't know and some people I know and the people are no t happy and there has been a lot of accusat ions, a lot of things said and I admit I'm repeating some of those things that . . . I wasn't there at all, I mean during the strike. I'm saying well, for the Minister, and he can stop all this debate and say well all right, I will find out because there must be some thing somewhere, and I'll see what is acceptable but not tell us repeatedly or exaggerating on what point I'm exaggerating; I would like to know where? Then, Mr.

Chairman, we'd like to know also what the situation is with the, whoever the inspectors are. I think that's the important thing, and I'm not as I say, the Minister is right, he's not the Minister of Labour. We're not here to settle the strike and I don't even think that you should, if you wish I would certainly support you if you said that if you ruled out anything about the strike just on the standards of the patients and that's all I'm concerned with, Mr. Chairman. MR. SHERMAN: Mr. Chairman, I don't know really what I can add to what I've said about this subject to date.

Obviously, what I've said is not accepted by the Op posi tion. Obviously th e cre dibility and the expertise of the Standards Division of the Manitoba Health Services Commission is not accepted by the Opposition. Obviously the contact that we have had with Dr. Miller is not accepted by Oppos ition. Obviously the contact that colleagues of mine have had with friends and relatives who are in that home is not accepted by the Opposition so I don't know what more I can say than I have said. The Member for St.

Bonif ace has made a great deal out of the fact that he disagrees with me over my statement that this whole situation has become laced with passion and that's one of the reasons why there was the rather bitter exchange between Government members and Opposition members tonight. I want to say that if the honourable member thinks that this thing has not become laced with passion and is not a highly char ged explo sive, volat ile emotional issue then he has distanced himself very considerably from the event.

The reason my colleagues have taken the position that they have taken, and I defend the position that they have 1909 taken, I don't agree with all the exchanges that have gone across, back and forth across the table, but this is a political arena and I can understand them. The reason they have taken the position they have taken is because the Opposition has steadfastly insisted that every opportunity in Question Period and elsewhere to present in as bombastic a fashion as possible, one side of the story. The Member for St. Bonif ace says to me that I'm accept ing as gospel truth one side of the story.

I say to him and I don't lay this at the Member for St. Bonif ace because I think really in fact his questions this afternoon were reasonable but I say that the lead critic on this question, the Member for Tr an scon a, has ta ken declamator y positions in Question Period and for the Member for St. Boniface to say that Question Period has become orchestrated by government is simply a joke - (l nterject ion)- MR. CHAIRMAN: One speaker at a time, committee - the Honourable Minister. MR.

SHERMAN: What has happened in Question Period because it is now the period of the Legislative day that is covered by television is tha t the Opp osition has chosen to use questions as an opportunity to make speeches, to make assertions and I challenge the Member for St. Boniface to read back the questions that have been put to me on this issue and many others by the Member for Transcona. They are not questions, they are polit ical diatribes, they are polit ical statements and no Minister, no Mi nister, and if he were Minister he would take the same position.

No Minister can allow those declamatory statements to be made under the guise of questions. So that the whole thing has become distorted in Question Period. Certainly I've gone outside the House and been assailed by the press or been questioned by the press and assailed by others as he was when he was Minister. That's par for the course, politically.

I'm not complaining about that, but if he expects me to fail to defend either my colleagues in government caucus and their feelings and their position or my officials in the Manitoba Health Services Commission, then I must conf ess, sir, tha t we will never be able to commun icate. Our standards officers of the Commission under Mrs. Kay Thom son who is here; under Mr. Reg Edwards who is here; under Mr. Frank DeCock who is here; have been on site at that home since this difficulty started. They have been there on an ad hoc bas is as well as a sched uled basis.

They have reported to me in detail and repeated ly on a continuing basis night and day as to the health care conditions in the Home. I've said inside committee and outside the committee; inside the House and outside the House that it is not ideal. You get an industrial dispute in a health facility, nob ody is happy, but the people who are most unhappy, the people who are mo st impassi oned and I can understand it, are the workers who are out of a job.

The people who confronted me in the hall this afternoon, the people who put their position and it was ver� good television and I saw the selective television and I repeat it and I extend it to both the CBC and to CTV-C KY, the selectiv e te levision reporting of that situation on the evening television news.

Thursday, 19 March, 1981 The government is fair game in a situation like this because a number of workers who are out of their jobs, out of work, and in tha t battle with their employer are able to take a position that becomes very colourful in terms of media coverage and present the case of hu man su ffe ring and manuf acture the case of deterioration of care for personal care residents. If there is deterioration of care for those personal care residents, my Premier and my colleagues and I will close that home, but I want to tell you something, Mr. Chairman, through you to the Opposition.

If I close that home, you face three problems, one of which is, where do we put the residents? The second of which is where do we get the nurses, and the third of which is, where do the employees go? If they think they're out of work now, they have a cha nce of gett ing back with their employer, I hope, and certainly my colleague, the Mini ster of Labour is doing everything he can to resolve it, but what would an authoritarian uni lateral declamatory order to close that home achieve for those workers? Now, I want to assure the Honourable Member for St.

Bonif ace that I've heard from MON A too, and I am the first to say that the professional nurses are owed a great debt of gratitude by this Government and by that Opposition and by the people of Manitoba for the extra mile that they're going and of the work that th ey' re doing and th ey may be reaching the breaking point and if they reach the breaking point, we will have to act. We may have to close the home, but I rely on Mrs. Thomson and Mr.

Edwards and their in spectors who are far more kno wledgeable in inspecting standards of nur sing care than either I am or the Member for Transcona is or the Member for St. Bon iface is, or than Anne Klassen and the demonstrators who were in this hallw ay today, are. They are not insp ectors of nursing care. The inspectors of nursing care with the expertise in this province repose in the Manitoba Health Services Commission Standards Division, and they have been out there, and they have examined the situation and monit ored it and th ey ha ve reported to me.

And it's confirmed by others we have talked to, including Dr. Mill er, that the care is all right. The danger is in the fact that the nurses are becoming overworked because they are working with non-oriented personnel, new staff who ha ven 't been properly oriented to the job, and also there is the whole business of the unf amilia rity of the situation for the residents.

So of course, I'm concerned, and if the members op posite are sug gesting tha t this government walk out of here tonight and close that place down at 11:00 o'clock tonight, fine, that's a legitimate request. but I want you to consider the consequences if we do that. We are trying to maintain nursing care at a proper level, and we are trying to see that some effort is made on both sides to resolve that indu strial dispute, and when the Honourable Member for St. Bonif ace asks me about exaggeration, I can cite a number of exaggerations, not from him, but from the Member for Transcona in the

preambles to his questions in the House. As an example the references ... for example the fact that certain people are got up at 4:00 o'clock in the morning. I am advised that's been the practise in that personal care home for years. Many of those residents are got up at 4:00 o'clock in the morning and many of them want to get up early in the morning. Many of them have a sleeping and living pattern that gets them up at 4 and 5 and 6 in the morning. Now, I don't think that's ideal.

I think people should perhaps be encouraged to sleep, stay in bed until 6:30 in the morning in those homes, but it's this kind of injection into the debate of situa tions that have prevailed for some considerable time, without any great disturbance for anybody, that I object to, because it's done in such a way as to suggest that all these things are terrible things that have happened within the last week.

Another exaggerat ion is the Member for Transcona's claim that the government has at least been acquiesent with respect to the operator saying that he is going to have to raise the per diem on them, and the government should be honest about it. Mr. Chairman, I just dismiss that kind of thing as cynical posturing.

The government two months ago wrote every personal care resident in Manitoba a personal letter advising them that personal care per diems would be going up by so much each quarter of the year over the course of 19 81- 82 , and explaining why it had to be done, and I might say that although I would admit there have been some minimal num ber of persons objecting to it, the number has been minimal, and I mean minimal.

Most personal care residents appr eciate that they'r e considered by this govern ment, as they were by the other go vernment, as proud people who are prepared to help pay their way, and they're happy to help pay their way, and they understand that the cost of the program keeps going up. Mr.

Chairman, to deal with exaggerations, I would have to go back over every question that's been raised in the House on this issue, and primarily, as I say, by the Member for Transcona, who uses the opportunity to make a speech in a declamatory way and to try to imply that these are things that are somehow out of the usual, out of the ordin ary, never were there before. The things that he has been right about are that the nursing staff is hard-pr essed and over-worked, and two, that the physical condition of the home has left something to be desired.

There have been some maintainance jobs that needed to be done, but nowhere near of the magnitude that has been impli ed in some of th ose questions. Certainly there have had to have been some repairs to some windows and to some lamps and to some other parts of the building, but they ha ve been things that can be done in a day, a day and a half. They haven't been major maintena nce or repair jobs as they have been portrayed by some critics in this situation. Finally, Mr. Chairman, I would just say that the demonstration this afternoon is one that is perfectly understood by me.

I can understand the position of those workers, but their passion mainly arises out of the fact that they don't like their employer, and I hold no grief for their employer, but to try to say that the government and the Minis ter of Health, have some particular reponsibil ity that we are not meeting because they have a dispute with their employer is a distortion. it's a colorful situation for the media, and coming from the media, as I do professionally, I can well un derstand that's the angle and the aspect that the media is interested in.

But I am telling this comm ittee the truth , th at my standards divis ion 1910

Thursday, 19 March, 1981 otf1cers sitting right here at this table have been there and have reported to me, and they say that the nursing care is adequate. When it ceases to be adequate we will close that home. MR. CHAI RMAN: I think the Member for St. Bonif ace; I believe he was first. MR. DESJARDINS: Mr. Chairman, I can assure you that I am not going to speak for the Member for Transcona. I know that he can well defend himself, but if there ever has been exaggeration it is by some of the last remarks of the Minister. The Minister has stated that I said that all the question period was all orchestrated.

I didn't say that at all, I said that some of it, and I gave some of the examples that were done. Now you know there is something - that nobody will be ahead. We can talk all we want and we are not naive. We know the politi cal in-fighting.

We know what politicians do for publicity, and I am surprised to hear that the expert - and I envy him when I say that - the best PR member in this House would, and I know he's done that before, and if anybody has been handled with care and has received favours from the media, it has to be the present Minister -(Int erjection)- Oh, no, well that I don't believe, but it's your right to say it. Mr. Chairman, for the Minister to say that other people have tried that, that to me is a bit funny. I wonder if the First Minister would keep quiet for a minute.

We know all that he is going to say and have his name cal ling. I wonder if he would keep quiet. (lnterjection)- MR. CHAIRMAN: Order, order, order please. One member at a time. (I nterject ion)- The Member for St. Boni face. MR. DESJARDINS: Mr. Chairman, if we are going to proceed, if not just tell me and I'll get my stuff and get the hell out of here because I am getting a little fed up. MR. CHAIRMAN: The Leader of the Opposition on a point of order. MR. HOWARD PAWLEY (Selkirk): I think it would be better for all the members of this committee if we could carr y on with the discussion with less interjection.

The Member for St. Boniface has the speaking order and I think that would be much more profitable for all members if some of the name calling could be cut out. MR. CHAIRMAN: On that point of order, I agree with him. We are getting nowhere by everybody chiding in. I don't know how the recording people can straighten out, but the Chair would appreciate each member getting the Chairman's eye and I will certainly give everyone his full time, but let's do it one at a time. Now, if not, then there's no point of being here. The Member for St. Boniface. MR. DESJARDINS: Mr.

Chairman, I think that the most partisan member of the government will admit that the Minister was allowed to make a statement which was a lengthy statement without any interruption at all. We didn't try to shout him down, we let him say what he had to say. 1911 Now my point, Mr. Chairman, I said I am not here to defend the Member for Transcona, I think he can do a darn good job. I am not here to talk about the striker as I said, and I'm not going to repeat myself forever. I don't know any of them.

I didn't talk about that at all and I am not interested at this time to talk about that, it is not the place, it is not the place, this is under the Department of Labour. I want to repeat, I'm talking only about standard and I certainly don't deny the Minister the right to his style of speaking, but I don't appreciate the Minister bringing in all his staff, one by one, and try to get us to fight against them, and I'm not going to fall into that at all. The Minister is the person respo nsible.

The Minister is responsible, it's not his staff, they are not there to defend themselves and we haven't got the facility or the chance to go and explore what's going on in there. If there's any responsibility to many members of the Commission, that's up to the Minister to determine, it's not up to us. The only concern that I have, and the question that I've asked today and I repeat, these are all things that I've been told by people that I bel ieve, maybe the y'r e exaggerating, in many ways.

Some of these things that were said to me, were said by the members of MONA who came over to see us, to tell us that this was an awful situation, and saying that their nurses were all fed up, that they thought they could not go on like this, it wasn 't good standards and they protested and their protests were not accepted by the member. Now either that's right or it isn't right, and I'd like to determine that. Okay, maybe we should call on these people and find out what the score is.

I am saying that the Minister - and I am not ready to accuse anybody or to say that they're right - and he started by talking, obviously I can't say anymore, but obviously you don't believe that, I can say the same thing. Ob viously all the relatives of the people that have relatives there and who give us complai nts, the Minister do esn 't bel ieve them. Obviously the nurses that are working there, that are saying that the conditions are not conducive to good standard are not to be believed. You know, we can say the same thing and we'r e no t going to get anywhere.

We are saying - and I consider this our responsibility or my responsibility, I don't give a damn about the strikers at this stage - I am saying that I would want the Minister to make cer tain, maybe it's past taking the words of all those people that he mentioned. Maybe it's time to go out and find out what really the situation is. Call the people working, talk to the patients, talk to the parents also, not just the one side, and if he's right, I'll apologize.

But it is my duty as long as there is a doubt in my mind and as long as the people are giving me that kind of information to bring it here at this table, is that wrong? If that is the case, if it's wrong, if we're supposed to just praise Allah in every department's Estimates, well we're wasting our time. Everybody, including the First Minister more than anybody else, knows that this is not the way our system works and he's the biggest defender of the system. So, Mr. Chairman, I'm not going to accept that I'm wrong.

It might be, and maybe I've got the wrong informat ion, but I am not convinced . (I nterjection)- I'll admit it, but you don't, you've

Thursday, 19 March, 19 81 never been wrong. Oh, stand up and say that, we've got to get this for posterity and history, that you said that you were wrong. HON. STERLING R. L VON (Char leswood): We did something for separate schools when you said we were gutless. yes. MR. DESJARDINS: You were gutless at the time and, Mr. Chairman, if you allow that, I'm ready to go on aid for private schools. I was the first one to congr atu late the Firs t Minister when he did something and I voted against my party with you on that. if you remember.

But in those days when I called you gutless, you were gutless and you weren't the Premier at the time. But that is another issue that I'd love to debate. MR. CHA IRMAN : Could this Comm ittee please return to the line? MR. DESJARDINS : Well, all right, it's exaggerat ion. -(I nterjection)- No, you hav en't been. You were elected before but you were away for a long time. I didn't think tha t I warranted so much watching, and I'm very proud that you felt that you should watch me all these years, I'm very proud of that.

You know, some people are talk ing, exaggera ting and other people are called arrogant, we all have our qualities and our faults. MR. CHAIRM AN: I wonder once more, could we bring this Committ ee to order. We're here to represent the people of Manitoba, line by lin e, member on member. I'll recognize you when you get my eye, but my god, what am I supposed to do? Everybody is jabbering from every side and if that is the case, we're accomplishing nothing. We'll still be at this line at 2:00 o'clock tomorrow morning with nothing done.

So is there any way of asking this Committee to discipline themselves as a Committee and as representa ti ves of the people should discipline themselves. I'll call the Member for St. Bonif ace once more. MR. DESJARDINS: Mr. Chairman, you 're absolutely right. You made only one mi stake. In all you admonition you looked at us, you should have looked at your boss because he started it all. MR. CHAIRMAN: I looked at everybody. MR. DESJARDINS: Maybe he was hiding under the table, because he didn't see you. Now I've got to start all over again, I lost the train. Now, Mr . Chairman, all this thing aside.

I am asking once more and I don't want him to answer the Member for Transcona or the strikers, I want him to answer me. Is the Min ister satisfied tha t he ha s all the information? Is he satisfied that all the information is correct? That he cannot have any doubt that there might be something in some of the statements that we made, some of the criticisms that we brought here, that we were asked to bring here. If he's satisfied, then there's no point going any further.

I would hope that he will say, well all right, I'll make an effort to have an independent assessment of this situation and do it right now and that's all I 1912 have to say on this. I think we've covered the whole thing. MR. CHAIRMAN: The Member for Transcona. MR. PARASIUK: Thank you , Mr . Chairma n. I'm surprised at the extent to which the Conservative Gov ernment wants to try and avoid and divert attention from the issue, by trying to attack me personally. I don't mind that, because it shows that they're obviously concerned about the issue and the tactic. it's not a parliamentary tactic, Mr.

Chairman. -(I nterjection)- No, it's a Fascist tactic. That's the simple point of it . This Fascist tactic by bullies, and that tactic was used in the Thirties, and I've had a good chanc e to take a look at Fascism in Manitoba and it's got a red head. I would like to now talk about the substance of the issue. That's right, despite the boy in short pants. I'd like to talk about the subs tanc e of the issue. (Interjection)- it's very simple to tell the truth. I'm having a hard time speak ing, Mr. Chairman, because the Leader of the Conservativ e Party keeps trying to start debates on the side. MR.

CHAIRMA N: The Member for Transcona. MR. PARASIUK: Yes, I'd like to talk about the substance. -(I nterjection)- Well, we have another intelligent comment by the Premier from Manitoba. lt not only embarrasses me, I'm pretty sure that his conduct emba rrasses the entir e provi nce. Mr. Chairman , I'd lik e to con tinue and discuss the substance, and if I can I'd like to, but I will have a very difficult time if the Premier of the Province keeps degrading himself in the way he's been doing. So can I continue? Okay, I'll continue. We ha ve a pale imitation of the original.

I would like to try and speak though, despite the fact that the Member for Pembina is trying to be a pale imitation of the Member for Char leswood. -(Int erjection)- Well, I'm having a hard time. Can I speak, Mr. Chairman, I'd like you to rule? MR. CHAIRMAN: The Member for Seven Oaks on a point of order. MR. MILLER: Mr. Chairman, you've asked members of this Committee to allow the person who has been recognized to speak without interruption. We have agreed to that. We have abided by that.

Would you now make sure, and with the authority of your Chair, that whoever has the mike is not interrupted so that the person at the mike can continue to say what he says without having to digress and prolong the time we're spending here. MR. CHAIRMAN: The Member for Transcona. MR. PARASIUK : I'm ha ving a ha rd time, Mr. Chairman, trying to speak, but I'll continue though. The Minis ter tries to say that all of these things, all the difficulties that existed in the St.

Adolphe home ha ve only become apparent now and we're trying to make mountains out of mole hills and if he looks carefully at the questions I asked him on Tuesday, March 17 th in Han sard - I asked him a whole set of questions regarding the facility and the operation - and I ended up asking in the House as well, and I'll

Thursday, 19 March, 1981 get back to the particular points you raised, I asked about the inspection procedures in that, I said that if you are going to have routine regular inspections where people know in advance that they're coming out, that there can be some attempt at cov ering up; and I thought that there should be spot checking. It would appear that the industrial dispute at St. Adolphe Nursing Home has brought to the publ ic's attention conditions that obviously have been existing there for some time, which does call into question the efficacy of the inspection procedures.

If indeed you do have broken windo ws inside which can lead to cuts on hands which have happened there, and they aren't fixed for six months, even though the Minister himself says these are things that could be fixed in a day, the question obviously is. well why weren't they? It's a normal inspection procedure. No w the Minister undo ub tedly has toured a number of personal care homes. I, as the health critic, have toured a number of them as well. I've gone through places like the Tache Home; I've gone through places like Park Manor; I've gone through pla ces like the Fred Dou gla s Home.

I' ve gone through the one that existed in Selkirk. I've gone through this one and now there are some problems with it. I have not seen broken windows in the other places, I don't think I've seen one. I saw three at this place that had been broken for some time and hadn't been fixed, now that's a minor point; but the point is, why wasn't it fixed in the first place? That is the real que stion. Secondly, why aren't the inspectors picking those types of things out?

If you walk around the outside of that building, you will see towels and sheets stuck in the windo ws and the windows taped up. -(I nterjection)- Well, the First Minister says if there wasn't a strike on we wou ldn't be ta lking about it. Maybe the publi c wouldn't know. But what we have to ask ou rselves since we've become aware of this, is that the right way in which a personal care home should operate?

Is it right that through a winter, a personal care home should have sheets and towels stuck in the windows of the patients' rooms so that they don't get undue drafts, is this what the per diems of the Manitoba Health Services Commission are going for? I don't think that's what we want, I think we'd want improvements to that. So when a situation arises that brings those things to light, we will raise them and we will highlight those particular points, and we will say, why has this been going on for some time when it becomes apparent that those things have been going on for some time?

The sheets in the window, the towels in the window, the broken glass, those things didn't arise because of this industrial dispute, they existed there before. So when I ask questions about the inspection procedures, I think they are valid questions about how are we inspecting these facilities, if those types of things exist. I think that's a very real question that we as a Committee have to address ou rselves to. The Minister himself this afternoon, admitted that there has been poor co-operation from the owner to date. We won't dispute that, in fact we say yes, that would appear app arent .

Then I raise the other question though in conjunction, if an owner isn't co opera ting, why is it that this government still will have under active consideration an application from the owner to build additional nursing home capacity? Again the Minister indicated a couple of days ago that yes, that file is still active. This is going on when non-profit institutions have been tol d, no. So I wonder why is this going on? It relates back to the inspection procedure. Perhaps the Minister didn't know that those things existed in that way.

If that's the case, he should be asking some very serious questions of the Manitoba Health Services Commission as to its inspection procedures. If he did know about these problems, because he says we haven't had the fullest co-operat ion, then I wonder what criteria he is using when he is considering applications for additional nursing home capacity in this province, because this isn't the type of operator I would want operating a personal care home. Now, I raised a particular point yesterday about the per diems and I would ask him to investigate that.

When a parish priest provides information to me, I'm pretty sure he would provide it to you, regarding statements that have been made by the owner to particular patients, raising fears in their own minds as to what is going to take place with respect to increases in the residential per diems, then I think that is a misleading statement on the part of the owner, and it's not fair. Despite the Minister saying that he sent out a letter to all the patients, I think if you asked people in this room the contents of that letter some time ago, they wouldn't remember it.

They wo uldn't remember tha t the Minister said we'll be increasing the per diem, and the per diem will continuously be increased on the part of residents until March 31, 19 82. That's a gov ernment decision and we might debate that government decision and say we think it's wrong, the proportion is too high, and we have done that; but we recognize that is a government decision and we would hope that the people in the homes recognize that is a government decision.

But when the owner of a facility goes around telling the patients that this type of dispute that's taking place is going to cause your residential per diems to go up, he's obviously trying to pit the patients against the workers, and it's not fair to the government. I don't think he has any right to make those types of statements. So if the Minister says that's an exaggerated point, or if that's an unfair point to raise, I disagree very much with him on that. MR. SHERMAN: It wasn't that, it was that you asked wouldn't the government be honest. MR.

PARASIUK: No, I asked if the government would undertake to inform the people as to what the real situation was, and obviously if you've had an owner who has, day to day, verbal communication with the patients there might be a tendency on the part of the patient to believe that what the owner tells him or her is true. I think that there is an obligation on the government's part at that time to inform people of what the exact situation is, and that's what I asked the Minister to do.

I didn't say that they were being dishonest, and I will check Hansard to see whether in fact that's the case. 1 did ask the Minister if he would go out there or have someone go out ther e and verbally make th at commun ication to people, if indeed they've been told that, and that's the word that I get directly from 1913

Thursd ay, 19 March, 1981 people who I have no reason to disbelieve, and these are not workers. I think we can dwell on whether in fact there's been exaggerat ions or not exaggerat ions. I think the points that I raise with respect to the quality of the facilities are in fact true. The points that I raised with respect to leaks are true.

Again, I heard this from another source, not from a worker, but when I am told that a patient had to cut off her per diems - I don 't know how she did that, but I'm glad that she had enough spunk to do it - in order to get her roof fixed so the water wouldn't leak in her room; then I say tha t somet hing is wrong with the inspection procedure if that is not just an isola ted incident. And from what I ga ther, it wasn 't an isolated incident, because there were many leaks in that facility.

So then it comes back to the whole issue that we've been talking about with respect to nursing homes, and that is whether in fact there isn't an inducement to private operators of nursing homes to squeeze the qua lity of service and try and somehow beat the insp ectors to derive their profit.

And wouldn't they also try and run down their facility and I would argue, and this might be seen as taking the position of the workers to a degree, that another avenue or an inducement for a private operator to squeeze some profit out of a personal care home facility is to try and squeeze it from the workers and pay them less than other operators pay their staff. In both these ins tances it would appear that's the situation with respect to the St.

Adolphe Home, and I say that gives me further justification for the position that if you do allow profit, and I would say it's unearned profit because there is no risk involved in the provision of nursing home care, that you do build in those economic incentives. The Min ister being a member of the Conservative Party should understand the sign ificance of economic incentives and should try and build in a system to prevent economic inc ent ives from decreas ing the qu ality of care provided.

We come back to the statements that I raised on Tuesday, March 17th, regarding the per diems; I asked specific questions about the capital per diem. I notic e th at th ere are some very subs tantial differences in the per diems being paid to the St. Adolphe Home and the per diems being paid to the St. Norbert Home; there is a very big disparity there. A 42-bed facility got $320,000 from the government for providing personal home care. The St. Norbert facility with 91 beds, twice as many beds, just under twice as many beds, got three times as much money, namely $1 ,044,000.00. Again, why the difference?

I should get an explanation for that, getting back to it. So what's been happening is that this is part of a larger debate, the St. Adolphe situation. The St. Adolphe situation is part of the larger debate as to whether in fact we should be trying to meet the needs of people in Ma ni toba who requir e institutiona li zed personal home care through ·p ersonal care homes, through the avenue of, what I would cal l, hu man itarian commun ity service and religious groups; or will we be trying to meet that need through the approval and funding of private profit-making corporations. The evidence in the case of St.

Adolphe leads me to again conclude that we shouldn't be using the private corporate route; that there are too many dangers built into that system. I have heard no one come out with anything against that; anyone refuting that in this particular instance. We have a situation where we don't have audited financial statements and I asked the Min ister, again on Tuesday March 17 th, does St. Adolphe provide audited financial statements with respect to the St. Adolphe fa cil ity or the St. Norb ert op era tion, because when he says I can't afford to do these things, then we will know.

You would have some idea of what went into maintaina nce and what didn't go into maintainance. I have been told something that I haven't been abl e to completely verify, but I have been told from too many different sources, that for a long period there was no hot water in the facility and that hot water had to be hauled in. That concerns me very much too.

But you see, if you don't have audited financial statements you can't do those types of checks, and yet I kno w that with respect to non profit facilities, that they are required to provide them and that they do provide them; I know that the Health Services Comm ission does its jobs very dili gently in tha t respect, and it goes over those audited financial statements, and it tries to make sure that the money that is spent or paid to the non profit facilities for their operations goes only for approved care, and that somehow a surplus isn't somehow gotten by the Manitoba Health Services Commission and pumped back into the operation as an enriched service.

You don't want to ha ve enrichment because you want to have your personal care dollar spread out; you don't want people sort of hoard ing little bits of surplus in one faci lit y or another facility to enrich the service. I think that's fair with respect to non-profit homes. They complain about it but I don't defend them for that on that basis.

I think the government is being correct in doing that. lt should be a matter of government policy as to whether there should be this type of enrichment or that type of enrichment. lt shou ldn' t be thro ugh some type of accou nting finessing or fooling of the government that there is enrich ing of services at the non-profit level. But surely if that holds for the non-profit facilities it holds for the private profit-making coporations as well.

The government should know how that money is being spent, and it should know whether in fact there is the proper operation and ma intain ance expenditur es being ma de so tha t the facility isn't run down, because that's the easiest way to make some short term profit, you run the facility down. Another easy way is to squeeze it from the qua lity of food or a whole set of other ways, and we don't even know; we don 't know what they are doing.

But every once in a while - because it's not that easy going through the private facilities - every once in a while though we get a window as to what goes on in the private facility and that real window gives us a very shocking picture. I don 't know why the Min ister continuously defends a private profit-making operator's right to keep his expenditur es secret. We have a situation where the government is conducting very detailed audits of students who have taken out student loans.

There's a presumption of guilt; we seize everything; we ask them to provide grocery bills, you name it, and we do that type of audit in the name of efficiency; saving taxpayers' money; doing that with indi vidual students right at 1914

Thursday, 19 March, 1981 the time when they should be studying for exams. Now, one could debate the severity of that, but no one is saying that we shouldn't be doin g the monitoring of students. But then on what grounds does the Minister turn around and defend, as he did publicly, a private profit-making operator's right to keep all of his expenditures secret, even though the auditor has told them time and time again. He can turn and come back at me and say, yes, but you know the NDP did that from 19 73-77; and I will say that I think that action was wrong at that time.

But they weren 't approving any more private nur sing homes and there were a number of small ones, but those small ones are going out, that grandfather situation has changed and we are being left with private corporations who should find it very simple to provide audited financial statements; a lot more simple to provide audited financial statements than individual students find to deal with the auditors that come and deal with them, or the various groups that have to provide audited financial statements if they receive grants from the government, as the auditor requests.

So as various cultural, religious, other groups, are required to provide those types of statements for the auditor, why in heaven's name aren't the private personal care home operators? Then we would know whether in fact there has been any type of skimming taking place; then we would know whether in fact the facility is being run down, because we are paying, virtually, the entire cost. In fact we are paying the entire cost either thr ough the ho spitaliz ation payments or the old age pension. We are talking about us as being taxpayers generally.

I come back to another point that I raised before, and I don't think this is an exaggeration, when the Minister says that points that we raise, or that the Workp lace Safety and Health inspector raised, about the health and safety conditions of the workers, that really those don't have any relevance to him because he's the Minister of Health, I say he's sadly mistaken when he says that, because if the conditions are not safe from the workers' point of view, how can one say and want to argue that somehow they are safe from the patients' point of view.

I would have thought that if he had any knowledge of a Workplace Safety and Health inspection saying that conditions weren't safe, that he would be terribly concerned because the people who are in the personal care homes are generally, by definition, much more immobile than the workers are. What we find ourselves in, Mr. Chairman, is a situation where we have been debating the general way in which the provision of personal care homes should be done; through the non-profit group or through the private group, and this has been a real topical example.

Unfortu nately we have been given this window that shows a number of horror stories, and when we raise those horror stories, because we're just doing so thr ough this window, the Minister, rather than saying, oh my god let's find out whether in fact this is the way it actually is, even though it might appear this way through this window; the Minister is saying things are okay. Things obviously haven't been okay.

Yesterday when I raised the points about the broken win dows the Minister said that I was exaggerating that they had been dealt with, when 1915 obviously I knew they hadn't been dealt with because I had been walking around that facility at 12 :30, at the same time, by the way, that the special inspectors came out; yesterday at 12 :30. I don't know if they were dealing 24-hour spot inspections before, possibly they were, but there were three special inspectors that came out yesterday. Today, there is lumber in there and there are windows in there and things are being done.

I am glad they are being done, I am really glad they are being done; I am sad that it's required the industrial dispute to bring this to the public's attention so that the matter could be raised before the Minister through the public forum that we have, namely question period or Estimates discussion, to prompt some action on the part of the owner I think in this respect, I question the inspection procedures, but I do really question the way in which the operator has been opera ting for some time, because when the issue developed the former Minister of Health knew that he had had problems when he was Minister of Health with this same operator.

I am quite certain if the present Minister of Health goes through the files he will find that he has had a set of problems with this operator that are quite different from the type of problems that he has had with non-profit facilities; I don't know if they're that different from the type of problems that he's had with other private profit-making corporations. MR. CHAIRMAN: Line 2 - pass - the Honourable Minister. MR. SHER MAN: I'm sorry, Mr. Chairman, the Ho nourable Member for Transcona asked me a number of questions. He asked about the difference in the per diem between St. Adolphe nur sing home and the St.

Norber t nursing ·home, and the fact that - I think I have his question correctly - that the effective rate paid per bed indicated in the annual report is higher for the St. Norbert nursing home than for the St. Adolphe nursing home. The answer rests largely in the categorization of beds, Mr. Chairman, also in

part in the fact that of the 42 beds licensed in the St. Adolphe nur sing home, and there are only 42 personal care beds among the 66 residents of the home, nine are the responsi bility of the Department of Indian and Northern Affairs for payment, and therefore they're not reflected in the net MHSC costs.

In both facilities the net per diem rate paid, which is always based on the median rate in non-prop facil ities was the same; and that effective rate, however, is calculated in terms of what shows up in the Annual Report and what shows up in the actual budgets of the individual nursing homes on the basis of the number of beds of particular category. Level 4 beds, of course, require a heavier level of staffing and therefore they receive a higher per diem than Level 2 beds. Level 2 beds are the lowest level except for Level 1, the hostel type bed in those hostel-type facilities still in existence in the system.

Level 2 is personal care; Level 3 and 4 get into the extended care category. So there's a differentiation on the basis of the categories of beds. Mr. Chairman, the Member for Transcona has made considerable of the fact that, as he puts it, the Provincial Auditor has requested the filing of audited

Thursday, 19 March, 1981 fmanci al sta tements. Mr. Chairman, that's not correct. The Provincial Auditor has not requested the filing of aud ited financ ial statem ents. What the Provincial Auditor has said is that if it is deemed unnecessary for audited financial statements to be filed , as it was so deemed by the previous government and as it to date has been deemed by the present government, then what is necessary is to change the legislation. The Provincial Auditor's concern is conformity with the legislation.

The point he raised is that if that item in the legislation is a mere anachronism - that's hardly the proper term, but is merely acade mic - if that item in the legislation is merely academic, then take it out and change the legislation so that the previous government and the present government can both demonstrate that they're abiding by the legislation.

I've attempted to explain to the honourable member the debate that has raged within two governments and within the Civil Service serving two governments over the question of aud ited financial statements, and I can assure him that he may - he claims that if they were government, and if it was up to him, he'd demand audited financial statements - I can assure him th at his col leagues, when the y were in gov ernment, examined that qu estion very assiduously, as we have done, and there's never been a consensus, either in the NDP or in the Progressive Conservative gove rnment, and there's never been a consensus in the Civil Service that I know of, and there's never really been a firm position on the su bject taken by the Provincial Auditor.

What he has said is either clean up the legislation or else do something about what the legislation says.

Now, I don't dispute the merits of requesting audited financial statements, and I've tried to say, and again I think this has been glo ssed over in criticisms levelled at the government, that the prop homes that are now being li censed , the five proprietary operations which I have described in earlier sessions of the comm ittee, who were phased down or closed down in the winter of 19 77-78 and are being re-licensed to come back into the field, do ha ve to file audited financial statements; tha t's a condition of their licences; and any prop home from this day forward coming into the system would have to file an aud ited financial statement, that will be a condition of their licences.

The anomaly, and the questions, arise with respect to those already existing in the field who never did have to file audited financial statements, and the Member for Transcona is quite right when he focuses on that item in the legislation. I would agree that it's time to do something about it. I'm not sure that I agree with him that audited financial statements are necessary, but I'm certainly prepared to accept his suggestion and look at it very conscientiously, and I'll withhold tny decision on it un til I have looked at it very conscientiously.

In any event, we do get what I think could be described virtually as de facto audited financial statements of much of their operations. We don't get statements on their assets, their financial condition, their financial situation, but we do ha ve audits of their payroll and their staffing and their care standards so as to be able to satisfy ourselves that they are meeting the conditions of the universally insured personal care home system, and those records are kept and checked and mon itored 1916 by virtue of monthly reports that they have to file and by inspections carried out by our standards inspectors. Mr.

Chairman, ano ther question tha t the honourable member raised had to do with the purported position of the Minis ter in def ending pr opri etar y operators. I'm not defen ding any proprietary operator, I'm defen ding the situa tion, in general, with respect to the right of those proprietary operators who were in the system when we came into office to continue in the system provided they meet the standards. If they'r e not meeting the standards they will not be permitted to retain their licences.

In this case we have an operator who has been in the field for some considerable time; it's not somebcdy that we licensed to come into the field. We have had some difficulty in recent days and weeks, and months really, in terms of the general attitude of management at St.

Adolphe and certainly, when the Mem ber for Transcona raises the question of an application from that operator to build another personal care home, I can assure him that the reasons for the strong reservations in terms of accepting such an application rests precisely in the lack of satisfaction that the government has to date in terms of that operator's general performance and general commitment to the kinds of things that the government expects personal care home operators, proprietary and non-pr oprietary, to meet.

The Honourable Member for Transcona raises the question about the inspection process, and I think I can assure him, Mr. Chairman, that there's nothing wrong with the inspection process. The fault isn't in the in spection process, th e fault is in the enforcement process. I put the question to him, rhetorically, that I've put to him before, what would the Honour able Mem ber for Transcona ha ve the Min ister and have the government do in a situation of this kind.

We had sotne of these difficulties that he's referred to brought to the attention of the commission; we issued instructions and orders to the operator of the home that they be addr essed; and we've had a difficult time persuading that operator and forcing that operator, if you like, to comply. That has not happened in other instances.

Usually when the inspectors find discrepancies and deficiencies of tha t kind tha t subject matter is brought to the attention of the operator, pr opr ietary or non proprietary, and they are issued with instructions or recommendation s to repair those situations and conditions, and the operator complies.

If you get an operator who is not particularly co operative, all you can do is continue to put the pressure on him because there are pawns in this game that I have referred to before, and I refer not only to the residents, I refer to the empl oyees of a health facility. lt certainly can reach a point, and it may well reach a point in this situation, where you finally have to take authori tative and final action such as moving the residents out and closing down the home.

I don't want to repeat myself, I've already referred to the considerations that have to be taken into account for any such measures, so the course of action normally is for the government to continue to insist of the operator that these recommendations be carried out and the Health Services Commission has done that strenuously in recent weeks. They ha ve contin ued to in sist that; they have con ti nued to

Thursday, 19 March, 1981 demand perf orma nce and perfo rmanc e is no w appearing; performance is now being delivered, but it has been slow in coming. But what alternative is there to a government when there are 42 personal care patients in a facility and there are some 20 members on a work force in a small community who depend on that facility, and the operator tends to be somewhat less than co operative with those orders. If the quality of nursing care were affected, in the judgment of our experts, then you have a certain and justifiable cause for definitive ac tion.

If it is being maintained at adequate levels then I suggest that the best course of action is to try to keep the demands and the commands and the pressures on to get responses from the operator in terms of meeting the deficiencies in his physical plant. That's what we have been doing and we are now getting that kind of action. If these conditions that the honourable member refers to have existed for so long one can only ask, why did the staff tha t is no w enga ged in the industrial dispute not complain about them much earl ier, or bring them to the attention of the Commission much earlier, or my office.

The Commission, in its regular inspections, found these things out a few weeks ago and insisted that there be action taken on them. So Mr. Chairman, I can't add much more to my responses to the Member for Transcona. He asked a series of questions, I'm not sure whether I have met them all but I have attempted to. I can also report that on the basis of the latest information I have received, that no family or no relatives have removed any residents, one single resident from that home, as yet.

That the parish priest to whom the Member for Transcona refers, is certainly welcome to advise our Standards people and talk to our Standards people, if he has information that we're not aware of. Our Standards people have been there, are there and will continue to be there. It's one thing to say that these people bring up all these particular complaints with a partisan politician, and we're all partisan politicians around this table, that's perfectly legitimate, but it is not necessarily either the most direct or the most complete cou rse for one to follow in these circumstances.

The parish priest and whoever else may have complaints and criticisms, would be far better advised to avail themselves of the opportunity that has existed there for several days, to take their complaints to our Standards people. Now it's true that th e Manitob a Organiza tion of Nu rses Asso ciation has done so and has taken their complaints to me, through the Health Services Commission, and they concern me very greatly.

But what concerns me is the stress that the professional nursing staff is under, and I can see it again as I did earlier toni ght, that there is a breaking point and they are being asked to do a tremendous service and I don't want to push them to the breaking point. If we can't get the thing resolved short of that, then other action will indeed have to be taken. I don't kno w whether I' ve om itted any of the questions that the member asked me earlier. MR. PARASI UK: I think there was only one specifically that I'll come to at the end.

The Minister has said that the workers should have brought this to the attention of responsible people. 1917 Well I think that if we have an inspection process, it's up to the inspection process. The primary onus is on the inspection process, not on the workers. Okay, we agree on that. I'd like to go a bit further though and say that ultimately, ultimately in this respect - and you'll have to check your records because I'm right on this - the problems with the facility were brought to the att ention of the Workp lace Sa fety and Health In spection Unit.

The workers acted through the Forum, an instrument that they have, and there was response, so the workers acted correctly. I wonder whether in fact there's not sufficient communication between the inspectors and the workers, when they go through these facilities. You said that inspectors have to give advance notice because they have to talk to the right people when they go through the personal care homes. The question is, who are the right people? I think that's the real question.

There was a breakdown somewhere and the breakdown finally was overcome by the workers contacting the Workplace Safety and Health inspectors, through The Workpla ce Safety and Health Act. I think that's sort of through the back door, I'm glad they did it. But as I said, the primary onus sur ely is upon the inspect ion pro cess of the Manitoba Health Services Commission. No w the Minister raises an intere sting point, though, when he says that workers should raise these concerns.

If the workers do, is the Minister then saying that he would at least investigate these concerns if they'r e raised by health care workers, and by health care workers I mean anyone involved? If people raise specific concerns, I assume then the Minister says, he'll respond. Excellent. I have before me, the Monday March 16 th edition of the Brandon Sun, which says the following, which strikes me as being very serious.

It says, "Twenty five percent of the personal care home nurses aides, who have answered a Canadian Un ion of Pub lic Emp loyees survey, say they gi ve medication to residents although it is illegal for them to do so" . I bring that directly to your attention. They may not have brought it directly to your attention, I bring it directly to your attention. I do not believe that it is inc umbent, I think having it brought to your attention, I assume you 'll act. I don't think I have to sit there and phone up Canadian Union of Public Emp loyees people and say, send that in.

It's been raised to the public's attention; I bring it directly to your attention. I assume then that there will be some investigation of that very very serious matter, to determine the validity of it and then to take the appropria te act ion. So I just leave that thing on the table with respect to that. Let 's get back to the audited financial statements for a seco nd. I don't deem it unnecessary for any groups providing personal care, especially when it's funded 10 0 percent, really funded 10 0 percent by the public, to file audited financial statements, they must file audited financial statements.

The Auditor's point was quite specific. It says, The Medical Services Act says that audited financial statements should be filed, th�y haven't been. He didn't say change the leg islation, or there's a conflict with past administrations or whatever. His statement in the Auditor's report says, the Act's regulations require it, it's not being done.

Thursday, 19 March, 1981 Now, it raises a very interesting point. The Min ister says well, we didn't have consensus prior to 19 77. I can assure him tha t sinc e this issue ha s been highlighted, we have consensus in our party as to what our position on this is and that is that people receiving funds of this magnitude for a vital priority like health care, should indeed file audited financial statements. I don't think the provision of health is a game of hide and seek between the funders of health care and the deliverers of health care. Surely it should not be a game of hide and seek.

When the Min ister says well, they don't have to necessarily file aud ited financial statements because as long as they meet the insp ection standards, ulti mately people are gett ing quali ty care. I would argue - and the evidence seems to bear this out - that St. Adolphe hasn't been providing good quality care; that they have been treating this whole thing as a game of hide and seek. That's why I think their application file , which is presently on the live file, should be put in the dead file.

I go to my final comment in this connection for now, because this is an unfolding saga, with respect to this particular window that we have in looking at what's going on in this pr ivate profit -making operat ion . But I am terribly concerned when the Minister says, what should the enforcement process be? it's not the inspection process that's bad, it's the enforcement process. I do not think that the people of Ma nitob a can someho w be held captive or blackmailed by a private operator, any operator.

I do not believe that people providing personal home care through institutions, want to hold the government captive. I think it's an abd ication of your responsibility of the Min ister of Health when you say that you somehow can't enforce the standards. What are my options, you ask? What were your options when there was a flood two years ago? I assume you acted. You acted within the manda te to carry out the responsibility that you have as Mi nister of Health. There are a num ber of things you can do. Abdi cating your reponsibility is not one of them.

You can hold back funds. lt strikes me as a very hungry operator right here. If you hold back funds you'd ha ve some bargai ning power. If he cuts back services when you hold back funds, and the hold back is a normal thing in operations, that's one of the ways in which a person tries to get the other person on a contract, to comply. If you build a building, there's always a 20 percent or a 15 percent holdba ck. There should be some holdba cks here or ultima tely you move them. I say if this is the way in which that private operator operates, that what you do is you say good bye, Mr.

Brousseau, and you build the alternative capacity because if you are engaged in this game of hide and seek, it will continue to be a game of hide and seek and the only way you can get out of it, is to build an alternative facility and go with an alternative method of delivery, which will end the game of hide and seek; and we'll lay the cards on the table; we'll lay the facts, the figures on the table and ensure that these types of games aren't played. I say to the Min ister that when you lock yourself into th at position of saying, I can 't do anything with a Mr.

Brous seau, then you ha ve abdi cated your responsibility. I cannot see how we can have any integrity to our personal care home system if a particular indiv idual can flaunt the standards. You know there's been a num ber of press photos of a particular indiv idual holding his nose, and what we're really having here is, figura tively another ind ividual holdin g his nose and flaunting this particular system and I think that's wrong. I think the people of Manitoba think it's wrong and I'm quite convinced that they would give fu ll support to the Min ister for telling Mr.

Brousseau that flaunting this, is wrong; that there are alterna tive ways of doing this. I think the Minis ter has to act. Now, my question tha t wasn't ans wered from before, because he's certa inl y tried thr ough the discussion once everything cooled down and we could talk rationally on this, he did try and answer most of the questions I raised on Ma rch 17 th regard ing this particular instance, except tha t he didn't explain the capital per diems. He talked about the operating per diems and he said that we have this difference in gross expenditure between the St. Norbert and St.

Adolphe homes, because of differing levels of care. I'm astounded that differing levels of care would create that much of a difference, but probably they could. Now, I just don't know the per diems and the levels well enough and I'll take the Min ister's word on this. I don't need to do all the arithmetic and get all the breakdowns of Level 1, 2, 3, 4, in St. Norbert vs. Level 1, 2, 3, 4 in St. Adolphe and what's paid by the Indian Affairs Branch.

If he says that's the case, fine, I'll accept his word on that. it's just that it did strike me as being quite a big differ ential, twice as many beds, but three times as much gross payment. But when it comes to capital per diems, I'd like to know if they vary from home to home and between non-pr ofit and profit- ma king homes. MR. CHAIRMAN: The Honourable Min ister. MR. SHERMAN: Mr. Chairman, I'll take two minu tes briefly before I deal with that question, just to make two points, so that everybody unde rstands the realities of the situation and the realities are on the record.

Firstly, I'm advised that it is not illegal for nur ses aides to distribute medication. it's not generally done but it's not illegal to do it. When it is done, the medication is prepar ed befor ehand by the professional nurses on the staff. The second point has to do with the member's suggestion that there were th ings we could have done and probably a very effective course of action would ha ve been to hold back · funds.

I want to tell the Honourable Member for Transcona that we were very close to doing that, that we, because of the frustrations we had encount ered after the Commission inspection process uncovered some of these deficiencies in the plant, we had reached the end of what we thought was a reasonable period of persuasion and a reasonable waiting period to have tho$e corrections carried out, and we were very close to withholding funds and this is something that Mr. Brousseau doesn't know and won't know until this moment, but a letter was prepared for me by my of ficials, dr afted for my sign ature, advising Mr.

Brousseau that that action was going to take place and it didn't go out because of the ind ustrial dispute. If it hadn't been for the rotating strike - and I want 1918

Thursday, 19 March, 1981 to emphasize, Mr. Chairman, that this is the first time I've used the term strike in this whole debate, but for a day at least it was a strike - if it hadn't been for that, that letter would have gone out.

But I say quite sincerely to the Member for Transcona that our feeling was, once that happened we were in something of a corner because then to lower that kind of a threat on the operator, who is somewhat distressed with the government at any rate because we have not approved his application for a new personal care home, then his course of action might well have been to simply say, "Well, that's fine, if that's the case, I'm closing down," then where do the strikers stand?

Now, it may well be that those people, some of them, have lost their jobs anyway but there's always the hope that they can settle the dispute and get back to their jobs. We felt if we issued that letter, once that industrial dispute took pla ce, that we were playing righ t into the operator's hands, and the Member for Transcona may have percept ions of that reasoning which would lead him to say that has flaws in it, and perhaps it does.

I'm not suggesting that our reasoning is always correct, but that was our reason ing, that was our sincere thinking on the subject, that to lower that kind of a threat, once the ind ustrial dispute got under way, was just playing into his hands; so we then went back to the pressure tactic and it appears to be producing the necessary results and the workers still have a chance of getting their jobs back, I hope. On his question about the capital per diem, Mr.

Chairman, the per diem that's paid to personal care homes, prop and non-prop, is actually two per diems, one operating per diem and one capital debt repayment per diem; the capital debt repayment per diem is the same for all prop homes. It varies for non-pr op hom es depen ding on the capita l debt incurred, I believe the capital debt incurred at the time of construction.

The median rate on the capital debt repayment per diem has been $2.40 per day, and the proprietary operators are paid the median rate in the same way that they are paid the median rate of the operat ing per diem, the median rate of the non-prop operating per diem. The proprietary operators are paid the median rate of the non-prop capital per diem and that's -(l nter ject ion) pardon? MR. PARASIUK: What is that again? MR. SHERMAN: $2.40 a day. That's the capital debt repayment per diem paid to the existing proprietary operators, $2.40 a day.

Now the new prop operators who are old prop operators who have been re licensed, the five projects of which members are aware, receive a much higher capital debt repayment per diem and members opposite are aware of that whole subject and our announc ement of it last year and the reasons for the higher per diem, it's based on the costs in today's construction market and money markets and mortgage markets, one has to remember that all the existing prop homes were built many years ago when interest rates and mortgage rates were as low as 3 percent and when wage rates and construction rates were substantially below what they are today.

In the case of the non-prop homes, they have been able to accommodate their capital costs through low 1919 cost money from Central Mortgage and Housing.

There's a quota allotted to the province every year of CMHC money for personal care beds and senior citizens beds, elderly persons housing I think, and it provides for a certain block, a certain number of beds that can be funded from a capital point of view at money which is loaned at 2 percent, in this day and age, at 2 percent; so obviously their capital costs are very low, but the prop operators of course don't have access to that money and indeed we have used up the CMHC quota available.

If non-prop operators were going to build today they would very likely have to go into the money market and borrow at the same rate as the prop operators until a new quota of beds for Manitoba opens up in CMHC funding and it's been running at, I believe, at about 10 0 a year; is that correct? This coming year it's 60 beds. So once that 60-bed quota is used up, even a non-prop operator then would have to go into the market and borrow at today's rates which are anywhere from 14 to 17 percen t.

So, the new capital debt per diem structure was agreed upon after lengthy study by the Department of Finance, by the Health Services Commission, and by my office to ensure our selves that these were the true costs that were going to be incurred by persons building personal care homes today and that the government and the people of Manitoba were going to be protected in terms of dollar value.

Those per capita per diems are based on the interest rates that the personal care home operators will have to pay for their mortgages, for their capital funds, on a sliding scale from 10 percent to 14 percent and we don't go beyond the 14 percen t.

If they have to pay more than 14 percent interest our per diem doesn't accommodate that but what it does do is that it picks them up at 10 percent money and provides them with a capital cost per diem differential of $7.00 a day and that figure goes up by 50 cents for every percentage point increase in the cost of their money up to 14 percent; so at 11 percent it's $7.50; 12 percent it's $8.00; 13 percent it's $8.5 0; 14 percent it's $9.00 and it cuts off there. And if they should get money at less tha n 10 percent the form ula pr ovides that the per diem reduc es accordingly; 50 cents for every percentage point.

Now, the interest rate is established as the lesser of the actual nego t iated mortgage rate or the prevailing CMHC rate at the time. In other words, when the operators, prop or non-prop, come to us and receive approval to build a 10 0-bed home at the cost of $35,0 00 per bed; that's $3.5 million, and they hav e to arrange their fin anci ng; they have to demonstrate to us what their interest rate is and this formula goes into effect at that time and is based on the lesser of their actual negotiated mortgage rate or the prevailing CMHC rate.

So if they're having to pay 16 percent for their money and the CMHC rate is, let's say hypothetically, 13 percent, all they'll get is that pervailing CMHC rate, 13 percent, in terms of the capital borrowing authority that they get from the government. Further to that, Mr. Chairman, their financing is subject 10 review by us every year so that they can't get into short-term financing and bridge financing arrangements that give them benefits outside of this formula and they have to file an audited financial statement every year. Further to that, Mr. Chairman,

Thursday, 19 March, 19 81 they are no t allo wed to char ge preferred acco mmodation rates and, as you kn ow, th e preferred accommodation situation has been a factor in our personal care home system since its inception and it has caused some difficulties; it has caused some differe ntiation between accommoda tion for residents.

Some personal care homes have charged, and ha ve been permitted to char ge un der the legislat ion , an additional $1.00 to $5.00 a day for preferred accommodation which they have applied in the case of private as against semi-private or in the case of larger rooms as against sl ightly smal ler rooms. The prop operators will not be permitted to dif fere ntia te and to cha rge for preferred accommodation. The charge will be the same for all residents and I believe I'm correct in saying that all accommodations must be private. Is that correct? All their rooms, all th eir accom modations must be private rooms. MR.

PARASIUK: The new ones? MR. SHERMAN: The new ones, yes. (Interjection)- I'm sorry, 10 percent can be semi private but they can't charge for it, they can't charge a different rate. They can't charge the other 90 percent preferred accommodation rates, everybody will pay the same rate. Some people prefer to be in semi-private so that's correct. There is a little bit of reserve there to acco mmodate those people who like to share rooms. Our experience is that most people don't like to share rooms but there's always I in 10 or 2 in 20 who do, so 10 percent will be semi-private but there will be no preferred charges.

Those, Mr . Chairman, th rough you, sir, to the Member for Transcona are the basic conditions and requirements of the program and the formula and I want to assur e the Ho nourable Mem ber for Transcona that every effort has been made to face the reality of the market today and to build in protection for the taxpayers of Manitoba for their dollar while still achieving the additional num bers of personal care beds that we need in the system. MR. CHAIRMAN: The Member for Transcona. MR. PARASI UK: I thank the Min ister for the comments on the capital per diems.

I'll look at Hansard to look at the form ula rather than just responding on it spontaneously off your verbal presentation today. I have two very small questions that I'll ask you indi vidually. First, you've app roved some non-profit homes, will they all have private acco mmodation as well? MR. SHERMAN: Yes, Mr. Chairman. MR. PARASIUK: I would just like to respond. I think the move toward private residence is a good move and I commend the Government for moving that way.

I would like to ask if a facility, private facility, gets a capital per diem of $2.40 a day, whether in fact the facility has been paid off or not. How do you know whether a facility has been paid off, I mean, the whole thing that exists with respect to private homes, in my explanation, or any private facility, is that if you build a public facility and you pay off the capital costs then, of course, that capital cost is then paid off, it's written off, it's done, you're finished with it.

But a private home can keep refinancing his facility or he can sell it to someone else and the public constantly keeps paying this $2.40, yes, $2.40 and I assume it might vary a bit in the future, it might go up a bit and my particular concern here is that what we are doing is paying for private re financing. Is th ere any way in which the Comm ission can determine that a facility has indeed been paid off and the public shouldn't be paying any more for the capital per diem? MR. SHERMAN: Mr. Chairman, the answer to the last question would be no.

We don't get that information as to whether they have paid off their capital debt or not. In fact the payment that is made to the personal care homes is not separated, it's only separated in our books; they get a lump sum per diem. What we say in our calculations is that of that $37.50 a da y, $2.4 0 of it is for capital debt repayment and the other $35.10 is the operating cost based on their nursing standards, their levels of care and categories of beds. So it's not differentiated at their end.

The justification for it is that th e homes presumably have to meet repair and mainten ance standards and also, in the case of the prop homes, they don't enjoy the tax exemptions that the non prop homes receive, so there is extra cost incu rred by the propr ietary operators as compared to the non-prop rietary operations. MR.

PARASIUK: Without getting into a long drawn out debate on this, I think that there are instanc es where the public could be in fact, paying extra for something that has been paid off entirely; and we have no way of knowing it unless we do get aud ited financial statements; and we'd know it I think if we had audited financial statements. Secondly, I think that from what I've seen of some of the private homes, they haven't been using that $2.40 to upgrade the facility.

I've seen linoleum on concrete floors in the basement, I haven't seen the type of insula tion, rugs that I think should ha ve existed - and I refer to the Selkirk home, I refer to the St. Adolph e home - so there's no way of ensuring that that $2.40 is going into the facility to upgrade it. This is one of the complaints I have with some of the rundown private facilities that I have seen. If they're making a profit and they're getting this capital per diem, part of it should be going in to almost like a sinking fund to improve the facility and they're probably writing off depreciation for tax purposes.

That certainly is something that they are doing. They are depreciating the faci lities, claiming depreciat ion, but not really putting in the upgrading. I think th at is something tha t one should very seriously think about changing. The tax argument can be debated the other way as well. Non-profit facilities do not get inv olved in tax write-off real estate ventur es or energy ventures or any 'of the other things that these other companies, with their high guaranteed cash flows, in fact do.

I see Villa Cen tres as one of the companies tha t operates here in Man itoba, and Villa Centres is beco ming a div ersifie d real estate and ener gy company using the the guaranteed cash flows that they're getting from personal care homes. So one 1920

Thursday, 19 March, 1981 could argue the tax question at some length but I just make it as a passing comment. MR. CHAIRMAN: The Member for Seven Oaks. MR. MILLER: Mr. Chairman, to the Mi nister, the $2.40, to continue on this theme, $2.40 per day was paid to the operators to cover capital. What about in non -profits? Was there any amount or was th at depending on what the books required? MR. SHERMAN: That, Mr. Chairman, is the actual median of the non-prop costs and financing. MR. MILLER: I realize that's the median and that's how you arrived at $2.40.

The question is, when the per diem is calculated for non-profit, and let's say it's paid off, then does the Commission calculate the amount, the per diem to a non- proprietary home? Do they calculate on the basis of looking at the audited statement of their costs of operation, the level of care, and the capital repay ment? If there is no capital repayment then I assume they just don't get anything. So there is a distinction. MR. SHERMAN: That's right. lt's calculated on an individual basis. MR.

MILLER: So there is a distinction, and this is a distinction that I'm curious about, because on the one hand the Minis ter said well, they do have - even though they may be paid off some of these old proprietary ones, still they ha ve maintenance costs so you 're paying th em $2.40 on th at basis because that's the mean of the capital repayment of the non-pr oprietary. But in the case of the non proprietary, the amount paid is not a nickel more than what actually they have to pay out.

If in fact they've paid off the debt, whether it was because they paid in cash for it through their organization or whatever, there is no money flowing for that purpose. So the prop rietary ones do ha ve a cash flow of $2.40 per bed per diem which the non-proprie tary in fact, don't enjoy. So there is a distinction being made between the two. I can see why, for the private entrepreneur, this may be a very good deal and I can see now why shares of these proprietary homes are so good on the stock market because they are going to do very well on that basis. Mr.

Chairman, the other question I ha ve is this, what is the length of amortization on these new facilities? MR. SHERMAN: Thirty-five years, Mr. Chairman. MR. MILLER: So one of th ese new facilities is coming on stream now, whether he has a 35 year mortga ge or he hasn't, it doesn't matter, but you calculate it on the basis of 35 years? MR. SHERMAN: That's right, Mr. Chairman. MR. MILLER: I believe, if mem ory serves me correctly, the CMHC funds were for 50 years, was it? MR. SHERMAN: I understand they're for 35 years, Mr. Chairman. MR. MILLER: Also 35, I see.

Now the Min ister said that the funds through CMHC of course are far less 1921 expensive than what a private entrepreneur would have to pay, they're as low as 2 percent. Now, I heard the staff mention they were down this year to 60 beds· that's the allotment for

Document details

Collection	Manitoba — Debates (Hansard)
Citation	31-5-41b
Type	hansard
Volume / chapter	31st 5th hansardpdf 41b.pdf
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	d95bd5ea8a35cba77a8bfbffc96c36d142e401f8

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