Manitoba Hansard — 16 April 1996 (Sitting 18, 36th Legislature, 2nd Session)

36-2-18

Manitoba — Debates (Hansard)

Second Session - Thirty-Sixth Legislature of the Legislative Assembly of Manitoba DEBATES and PROCEEDINGS (Hansard) Published under the authority of The Honourable Louise M. Dacquay Speaker Vol. XLVI No. 18- 1:30 p.m., Tuesday, April 16, 1996 ISSN 0542-5492

Name ASHTON, Steve BARRETI, Becky CERILLI, Marianne CHOMIAK, Dave CUMMINGS, Glen, Hon. DACQUAY, Louise, Hon. DERKACH, Leonard, Hon. DEWAR, Gregory DOER, Gary DOWNEY, James, Hon. DRIEDGER, Alben, Hon. DYCK, Peter ENNS, Harry, Hon. ERNST, Jim, Hon. EVANS, Clif EVANS, Leonard S. FILMON, Gary, Hon. FINDLAY, Glen, Hon. FRIESEN, Jean GAUDRY, Neil GILLESHAMMER, Harold, Hon. HELWER, Edward HICKES, George JENNISSEN, Gerard KOWALSKI, Gary LAMOUREUX, Kevin LATHLIN, Oscar LAURENDEAU, Marcel MACKINTOSH, Gord MALOWAY, Jim MARTINDALE, Doug McALPINE, Gerry McCRAE, James, Hon. McGIFFORD, Diane MciNTOSH, Linda, Hon.

MIHYCHUK, Mary Ann MITCHELSON, Bonnie, Hon. NEWMAN, David PALLISTER, Brian, Hon. PENNER, Jack PITURA, Frank PRAZNIK, Darren, Hon. RADCLIFFE, Mike REID, Daryl REIMER, Jack, Hon. RENDER, Shirley ROBINSON, Eric ROCAN, Denis SALE, Tim SANTOS, Conrad STEFANSON, Eric, Hon. STRUTHERS, Stan SVEINSON, Ben TOEWS, Vic, Hon. TWEED, Mervin VODREY, Rosemary, Hon. WOWCHUK, Rosann MANITOBA LEGISLATIVE ASSEMBLY Thirty-Sixth Legislature Members, Constituencies and Political Affiliation Constituency Thompson Wellington Radisson Kildonan Ste.

Rose Seine River Roblin-Russell Selkirk Concordia Anhu r-Virden Steinbach Pembina Lakeside Charleswood Interlake Brandon East Tuxedo Springfield Wolseley St. Boniface Minnedosa Gimli Point Douglas Flin Flon The Maples Inkster The Pas St. Norben St. Johns Elmwood Burrows Sturgeon Creek Brandon West Osborne Assiniboia St. James River East Riel Ponage Ia Prairie Emerson Morris Lac du Bonnet River Heights Transcona Niakwa St. Vital Rupertsland Gladstone Crescentwood Broadway Kirkfield Park Dauphin La Verendrye Rossmere Tunle Mountain Fon Garry Swan River � N.D.P. N.D.P. N.D.P. N.D.P. P.C. P.C. P.C. N.D.P. N.D.P. P.C.

P.C. P.C. P.C. P.C. N.D.P. N.D.P. P.C. P.C. N.D.P. Lib. P.C. P.C. N.D.P. N.D.P. Lib. Lib. N.D.P. P.C. N.D.P. N.D.P. N.D.P. P.C. P.C. N.D.P. P.C. N.D.P. P.C. P.C. P.C. P.C. P.C. P.C. P.C. N.D.P. P.C. P.C. N.D.P. P.C. N.D.P. N.D.P. P.C. N.D.P. P.C. P.C. P.C. P.C. N.D.P.

769 LEGISLATIVE ASSEMBLY OF MANITOBA Tuesday, April16, 1996 The House met at 1:30 p.m. PRAYERS ROUTINE PROCEEDINGS PRESENTING PETITIONS Home Care Services Mr . .run Maloway (Elmwo od): Madam Speaker, I beg to present the petition of Diane Favell, George Koutro ubis, D. Downey and others requesting the Premier (Mr. Filmon) and the Minister of Health (Mr. McCrae) to consider reversing their plan to privatize home care services. Ms. MaryAnn Mihychuk (St . Jame s): Madam Speaker, I beg to present the petition of J. Havelock, V. Lemon. G.

Star gardter and others reque sting the Premier and the Minister of Health to consider reversing their plan to privati ze home care services. Ms. Marianne Cerilli (Radisson): I beg to present the petition of Michelle Pinsonneault, Rachel Preston, Colin Hiebert and others requesting the Premier and the Minis ter of Health to consider reve rsing their plan to privatize home care servic es. Mr.

Doug Martindale (Burrows): Madam Speaker, I beg to present the petition of Karen Mazowta, Susan Gigliotti, Elizabeth Morsette and others requesting the Premier and the Minister of Health to consider reversing their plan to priva tize home care servi ces. Mr. Kevin Lamoureux (Inkster) : Madam Speaker, I beg to present the petition of Theresa Scott, Marvyn Cohen, Cecilia Breyese and others requesting the Premier and the Minister of Health to consider reversing their plan to privatize home care servic es. Mr. Tim Sale (C resce ntwood) : Madam Speaker, I beg to present the petition of Mary Matewi sh, Helen T.

Abbott, Nelson Bourdon and others requ esting the Premier and the Minister of Health to consider revers ing their plan to privatize home care servi ces. READING AND RECEIVING PETITIONS Home Care Services Madam Speaker: I have reviewed the petition of the honourab le member fo r Inkster (Mr. Lamoureu x). It · complies with the rules and practices of the House. Is it the will of the House to have the petition read? An Honourable Member: Yes. Madam Speaker: The Clerk will read. Mr.

Clerk (WiUiam Remnant): The petition of the undersigned citizens of the province of Manitoba humbly sheweth : THAT on at least six occa sions during the 1995 provincial election, the Premier promi sed not to cut health servi ces; and THAT on Decem ber 16, 1995, a plan to priva tize home care services was presented to Treasury Board; and THAT this plan calls for the complete divestiture of all service delivery to nongovernm ent organizations, mainly private fo r-profit compa nies as well as the implementation of a user- pay system of home care; and THAT previous cuts to the Home Care program have resulted in services being cut and people 's health being compromi sed; and THAT thousan ds of caring front-line service providers will lose their jobs as a result of this change; and THAT profit has no place in the provision of vital health services .

WHEREFORE your petitioners humbly pray that the Legisl ative Assembly of Manitoba may be pleased to request the Premier (Mr. Filmon) and the Minister of Health (Mr. McCrae) to consider reversing their plan to privati ze home care services. * (13 35)

770 LEGISLATIVE ASSEMBLY OF MANITOBA April 16, 19 96 Licensed Practical Nurses Madam Speaker: I have reviewed the petition of the honourable member for Kildonan (Mr. Chomiak). It complies with the rules and practices of the House. Is it the will of the House to have the petition read? Some Honourable Members : Dispense. Madam Speaker: Dispense. mAT many LPNs have been eliminated from most acute care facilities in Manitoba, including St.

Boniface, Seven Oaks, and most recently HSC; and, THAT the LPNs of this province are valuable members of the health care system, providing professional, competent, skilled and cost-effective services; and THAT staffing cuts will only result in declining quality of health care and potentially tragic outcomes; and THAT it will not be long before the negative results of this shortcut effort are realized, including higher costs and poorer services.

WHEREFORE your petitioners humbly pray that the Legislative Assembly of Manitoba urge the Minister of Health to recognize the value of LPNs and to consider reversing the decision to cut LPNs in Manitoba. TABLING OF REPORTS Bon. Linda Mcintosh (Minister of Education and Training) : Madam Speaker, I am pleased to table the 19 96-97 Departmen tal Expenditure Estimates, Supplementary Information for Legislative Review for the Department of Education and Training. Bon. Jim Ernst (Minister of Consumer and Corp orate Aff airs): Madam Speaker, I am pleased to table the 19 95 Annual Report of the Public Utilities Board.

Introduction of Guests Madam Speaker: Prior to Oral Questions, I would like to draw the attention of all honourab le members to the public gallery where we have seated this afternoon, huit militaires canadiens du ministere de Ia Defense nationale, sous Ia direction de Pauline Kennedy. [Transla tion) ... eight members of the Armed Forces from the Department of National Defence under the direction of Pauline Kennedy. [English) This institution is located in the constituency of the honoura ble member for Sturgeon Creek (Mr. McAlpine). On behalf of all honourable members, I welcome you this afternoon. *

(1340) ORAL QUESTION PERIOD Home Care Program Privatization- Study Release Mr. Gary Doer (Leader of the Opposition): Madam Speaker, my question is to the First Minister (Mr. Filmon). Madam Speaker, day after day we have been asking this Premier, who has approved the plans to privatize home care , to give us any studies, any evidence, of why the best home care program in North America would be privatized under the ideology of his governm ent. The Premier has repeatedly refused to answer any questions or table any reports in this Legislature dealing with this very, very important health care service.

I asked yesterday and my colleague asked the week before to table the Connie Curran study on home care, a report paid for by the people of this province, as a courtesy to the people of this province. I would like to ask the Premier whether he could table Connie Curran 's report today. He approved it as head of the cabinet of government. I would like to ask the Premier whether he has any study to validate his position to privatize home care, and would he agree today to stop the privatization and keep home care services in Manitoba as built by Manitobans in this provi nce?

April l6, 1996 LEGISLATIVE ASSEMBLY OF MANITOBA 771 Bon. Vic Toews (Minister of Labour): Madam Spe aker, that gives me the opportunity to advise the House of the status of the matter relating to the strike regarding the home care services. I would indicate that the government's position in this matter has been that we had offered a 12-month status quo agreement and we were prepared in an initiative to deal with contracting out of services for 25 percent of Winnipeg. There would be in fact no contracting out of services outside of the city of Winnipeg. The issue is not an issue of privatization, Madam Speaker.

This is an issue of contracting out for the services. We in fact have indicated to the union that we are prepared to hear any bids from them in respect of the provision of these services. If the services are provided by the union, we have no objection to that. Privatization Mr. Gary Doer (Leader of the Opposition) : Madam Speaker, I suppose the minister is continuing on under the leadership of the Premier not to table the Connie Curran report, a report paid for by the taxpayers of this province, because they have no study to validate their position.

Now, given that the buck presumably stops at the Premier's desk-and he is the one who has initiated this privatization, he is the one who is in charge of policy of the government-yesterd ay I asked the Premier whether in fact the governm ent had listened to Mr. David Martin, who is president of the Manitoba League of Persons with Disabilities. The Minister of Health (Mr. McCrae) in Hansard yesterday went on to say that Mr. Martin did not know the details of their decision� he commented without knowing any of the details of what was being put forward. "They did not know, ... .

" Madam Speaker, I want to table a letter from the Manitoba League of Persons with Disabilities that clearly contradicts the minister that they do know, that they are · blaming the governm ent of Manitoba, the Filmon governm ent, for creating the turmoil and trauma on behalf of home care privatization, and they are calling on the government to stop privatization. I would ask the Premier today, in light of the answer we received from the Minister of Health yesterday, would he please stand up and stop the privatization of home care services as requested by the Manitoba League of Persons with Disabilities? Bon.

Gary Fihnon (Premier) : Madam Speaker, I want to point out to the Leader of the Opposition that in seven other provinces home care delivery is done in a variety of diff erent mann ers that offers choice and competition within the system to people who require the service, seven other provinces.

In addition to that, our province institu ted a pilot project with the Seven Oaks Hospital that was reported on extensively publicly in which the satisfaction rate for those who receive the services was extremely high, and in the process of discussion of that it was stated publicly that the governm ent would look at further utilization of choice and competition within the system to ensure that we had the flexibility to offer the servic es that the people of Manitoba depend upon and require through home care.

Madam Speaker, with respect to different proposals that this governm ent has been prepared to consider and the flexibility that this governm ent has been prepared to consi der in discussion with the Manitoba Government Empl oyees' Union, just yesterday in response to a request by the union negotiators for consideration of a moratorium to be placed on this decision, we responded to their unconditional request just for a moratorium that we would consider and indeed agree to a moratorium of 60 days so that further discussions could take place, so that the conciliator could work and so that the Governm ent Employees' Union themselves could consider whether or not they wish to put in their own proposal with respect to the delivery of home care on a competitive basis.

That was rejected by the union. *

(1345) Mr. Doer: Madam Speaker, I remember the government putting a moratorium on all the cuts in health care and the privatization of health care after the by-elections in '93 right until after the election, and look what happened after that. Look at the seniors dealing with their Pharmacare, another moratorium placed by this governm ent before the election versus after the election, so I would recommend that the moratorium be basically, we have a policy in this province that is a made-in Manitoba policy to keep privatization away from home care.

772 LEGISLATIVE ASSEMBLY OF MANITOBA April l6, 1996 Madam Speaker, Manitoba was the first province to establish home care in North America, and we were one out of 10 when we started home care in the early '70s. We started it as a nonprofit service. It has been evaluated as the best home care service in North America. The Manitoba way is not to have profit in home care. I would ask the Premier to stop the privatization and go back to the made-in-Manitoba way of stopping privatization of home care. Mr.

Filmon: Madam Speaker, I hesitate to correct the Leader of the Opposition, but home care began in this province as it was delivered by the VON and developed by the VON in the '60s, almost a decade before government adopted the elements of home care and institutionalized it with a bureaucracy. The concept of home care and the development of home care happened in the private sector by the VON, and I would wish him to correct the record. Home Care Program Privatization Mr.

Dave Chomiak (Kildonan) : Madam Speaker, the Premier ought to realize that the reason the government introduced home care as a government nonprofit public plan in the 1970s was because it was not working in the private sector and that is why it was brought in as a public plan in the first place. Madam Speaker, the most important relationship in health care is that between the caregiver and the patient. Many caregivers in this province have spent years with the patient.

Why is this government jeopardizing those relationships, those caregiving patterns that have grown up over the years by their hell-bent desire to privatize a system that is already working in this province? Hon. James McCrae (Minister of Health): Madam Speaker, the honomable member would do well to choose his words carefully when he wants to make disparaging comments about organizations like the Victorian Order of Nurses, which has served our province so well for so long.

The honomable member has been told and others have been told many times of the commitment of this government not only to the health system in general, for which funding has increased under our government very significantly over the fimding of the previous government in Manitoba, but he has also been reminded that spending in home care in the city of Winnipeg and throughout Manitoba has increased very significantly, in Winnipeg to the tune of 113 percent over the last eight years.

In those eight years, growth in the program and deman d on the program has grown significantly and the government has kept pace with that with annual funding increases. Indeed, with changes in the future to our hospital system and the fact that our population continues to age, there will be very, very significant pressure in the future and we need to have a variety of service deliveries available to us so we can have the flexibility we need. Mr. Chomiak: Madam Speaker, our home care workers are amongst the lowest paid in the country, yet we have the best system.

My question for the Minister of Health is, will the governm ent not listen to the people who provide the care, the people who receive the care, the people, associations that have said, this is the government's fault for putting us in the situation we are in? Not play games about 60- day moratoriums and then let out tenders. Stop this privatization plan today and go back to the system we had in the first place. Madam Speaker: The question has been put. Mr. McCrae: Madam Speaker, the honourable member says he wants us to go back to the system we had in the first place.

I have just been handed a report, which I am advised was commissioned by the previous New Democratic Party government, and these honourable members , they put great stock in reports. Well, this one recommends user fees. This is something that the New Democrats commissioned. Some Honourable Memben: Oh, oh. Madam Speaker: Order, please. The honourable Minister of Health, to complete his response. *

(1350) Mr. McCrae: Madam Speaker, this NDP commissioned report also would put limits on the hours of service to people. This is the kind of report that hono urable members commissioned, and then they are critical if you go along with reports. You are critical if you disagree with reports or people who make them;· they are critical if you agree.

April 16, 1996 LEGISLATIVE ASSEMBLY OF MANITOBA 773 For example, let us look at the design teams, which is composed of all kinds of- An Honourable Member: Barb Biggar. Mr. McCrae: The honourable members do not want to hear this part of the answer. Mr.

Chomiak: Madam Speaker, why is this governm ent which was so convinced that their private sector friends can deliver home care when in fact we are advised that the home care companies, some of them, are refusing to send workers today into the inner core of Winnipeg because they are afraid of what conditions exist there, why are they so hell-bent on working with their private sector friends when they will not even send workers into the core of Winnipeg? Madam Speaker: The question has been put. Mr.

McCrae: I would like the honourable member to tell us about the kinds of conditions he is talking about so that we can understand that and address the issue. Madam Speaker, the same report to which I referred a few minutes ago was very critical of the Home Care program, the program that the honourable member for Kildonan simply says, let us just go back to the way we were.

If we simply just go back in everything we do in health care- it is simply, go back to the way it was-every Health minister across this country will tell you that if that advice were followed, in very short order our health system would come crum bling down around us. That is not a legacy I or my colleagues would like to leave to future generations. Ifh onourable mem bers want that, so be it, but they are not going to have that opportunity. More responsible people will prevail, and there will be a health system in the future. Home Care Program Privatization Mr.

Steve Ashton (fhompson) : Madam Speaker, on a daily basis we are seeing the government's true agenda on home care. It was never something promised in the election. They have no objective studies to support privatization. Most importantly, they have no support from the users-disabled, those with Alzheimer's, multiple sclerosis-for the moves that they are making right now. What I would like to ask the Minister of Health is what his real agenda is.

I would particularly like to ask the Minister of Health. when he first raised the issue of private home care with some of the private care operators, including, in particular, that of We Care, which is operated by a very close personal friend of his from Brandon, when did he first raise the issue of privatization of our home care system with those private operators? Bon. James McCrae (Minister of Health): Madam Speaker, the honomable member-! will not dignify some of the comments he made in his

preamble by responding to them. They are simply scurrilous and inappropriate. I recall when Seven Oaks Hospital contracted with a private company by the name ofWe Care back in 1994. Honourable members have suggested that there is no mandate for any change in our health system, which I certainly disagree with. I say to the honourable member that he should ask his seatmate, the honourable member for Kildonan, who attended at Seven Oaks Hospital the day the report of that project was made public, the honourable member for Kildonan very grudgingly, but nonetheless did so, supported the results.

He supported the very, very positive outcome that was reported at that time. This was February 3, 1995, that it was reported, and may I suggest to honourable members that they- Madam Speaker: Order. Mr. McCrae: I am sorry, Madam Speaker. Mr. Ashton: Madam Speaker, I would appreciate it if the minister could dignify this House by answering the question. *

(1355) Madam Speaker: Order, please. The honourable member for Thompson was recognized for a supplementary question, which requires no

preamble or no postamble to the minister's response.

774 LEGISLATIVE AS SEMBLY OF MANITOBA Apri116, 1996 Mr. Ashton: Thank you, Madam Speaker. I will ask the minister then, whether he in fact, as early as 1989, was making public statements with Bev McMaster, the head ofWe Care based in Brandon, indicating support for the privatization of home care. Will he come clean and put his own personal agenda on the record? When did he first raise the issue of privatization? Mr.

McCrae: Madam Speaker, I remind the honourable member that a good portion of our Home Care program in the city ofWinnipeg is already privatized through the auspices of the Victorian Order of Nurses, a private nonprofit organization. [interjection] Well, if the honourable member wants to talk about profit and nonprofit, let him do that. That is fine with me, but do not imply that the Victorian Order of Nurses is not a private organization because that is exactly what it is.

The honourable members, on the one hand, suggest, oh, this is all new, and on the other hand now today through the honourable member for Thompson, want to draw some long history of this. Well, I can certainly go back to before the election back in 1995 when the report from the Seven Oaks project came out, and there was plenty of notice. I believe it was on page Al-l think that is the front page of the Winnipeg Free Press-which talks about, watch for more of this sort of thing to come, and in increments. That is what we are seeing now. Mr.

Ashton: Madam Speaker, will the Minister of Health-he will not answer the first two questions-confirm, and this is based on a statement which I will table in the House made by a former senior employee with We Care who is here at the Legislature today, that at a gala for We Care staff and mana gement held at the Victoria Inn in Brandon in June 1989, Bev McMaster, with Jim McCrae at her side, said that we-that is We Care-were in the best position because home care would be privatized in the future? Will the minister admit to the fact that he has a personal agenda for the privatization of home care? Mr.

McCrae: Madam Speaker, the honourable member can quote what someone else says. I cannot be responsible for what somebody else had to say. I do not mind what people say. I sit here every day and hear a variety of statements made by honourable members from all sides of the House, and, ultimately, they will be responsible for their own statements.

Madam Speaker, what I do understand is that there is a dynamic and growing requirement for home care services, there are people who are willing and able to provide home care services and that they will be offered an oppo rtunity, along with the Manitoba Gov ernm ent Employees Union, along with the Victorian Order of Nurses. I remind honourable members that it was not so long ago there was a tender call for home intravenous therapy services, for example, at St Boniface General Hospital and everybody lined up and put their tenders in.

Honourable members will recall, the Victorian Order of Nurses was the successful bidder. Point of Order Mr. Ashton: On a point of order, Madam Speaker, Beauch esne Citation 417 is very clear that answers to questions should be as brief as possible, deal with the matter raised and should not provoke debate. I asked whether the minister was there in 1989. He made no reference whatsoever to his connection with We Care in his answer to the question. I would like to ask you to call him to order and ask him to finally answer some of the serious questions we are raising about home care in this House.

Madam Speaker: Order, please. The honourable member for Thompsoo indeed does have a point of order. Beauchesne Citation 417 states that answers to questions should indeed reply to the question asked; however, I must add that I believe the minister was within the time limit allowed. *

(1400) Home Care Program Privatization-Impact on Women Ms. Diane McGifford (Osborne): Madam Speaker, last week, when I pointed out to the Minister of Health that 98 pezcent of home care workers scheduled to be laid off in June are women and therefore privatization targets a vulnerable and recognizable group, he said that he bad

April l6, 1996 LEGISLATIVE ASSEMBLY OF MANITOBA 775 high regard for the contribution home care workers made to their fellow citizens. Yet yesterday in this Legislature, the minister showed no respect as he railed against home care workers. I want to ask the minister today to stand by his claims of regard, to support the women of Manitoba who are providing the best home care in North America, and to immediately cancel his implicitly sexist plan to privatize home care. Bon. James McCrae (Minister of Health) : Madam Speaker, I hope the honourable member will allow me to make this very clear.

At no point have I railed against home care workers and at no point will I ever do it. If occasionally I become agitated, it is more likely to be at honourable members opposite and some of their sidekicks at the head of the unions in this province, but I have-{inteljection] If the honourable member wants to go back and review the records, he will see that when I was Labour critic sitting over on that side of the House, every time I spoke it was on behalf of workers and it was not on behalf of union bosses and, of course, not on behalf of honourable members opposite with whom they have regular councils.

Som e Honourable Members : Oh, oh. Madam Speaker: Order, please. I would remind all honourable members that every single member in this Chamber deserv es the same equal amount of respect, and I would ask that when people are answering questions the members respect that that individual member has the floor. I would ask for the same return courtesy when a member is responding to a question. Ms. McGifford: Madam Speaker, it comes as no surprise to me that the minister does not know what he was doing- Madam Speaker: Order, please.

The honourable member for Osborne was recognized for a supplementary question which requires no

preamble. Ms. McGifford: Will the minister listen to clients, many of whom are elderly women who have opened their homes, hearts and bodies to their workers and who support their workers, who put their faith in home care and not We Care, and in the wisdom of Evelyn Shapiro and not Connie Curran ? Mr. McCrae: Madam Speaker, when the New Democrats commissioned this Price Waterhouse study back- An Honourable Member: Is there an answer to this question, ever? Madam Speaker: Order, please. Mr.

McCrae: Madam Speaker, in studies commissioned by the previous government or any work done by the present governm ent that has been done, it has been done because there is a need expressed very often by our clients and made very clear to us that there are indeed issues to be resolved in the Home Care program. The New Democrats recognized it back in '86, '87; we recognize it now. The complaints that come forward, and they come up all the time, have to do with the effi ciency of the program; the respons iveness of the program.

It has to do with focusing an the patient for our efforts instead of focusing only on the governm ent or on the care provider, but let us put some focus on the client. Is there anything in the system that brings about innovation? Is there anything there to trigger or give incentive for innovation? Those are issues that our clients are very concerned about and so are we, and that is the focus of what we are trying to do, and we are very mindful of the workforce involved here. The honourable members forget, too, that in addition to the workforce, we have clients as well.

Regional Health Boards Appointment of Women Ms. Diane McGifford (Osborne): I want to ask the minister again, as I asked him yesterday, to appoint some women to his regional boards and so protect the health needs of Manitoba women and so ensure that implicit sexism does not continue tainting Manitoba's health care policies and practices. Bon. James McCrae (Minister of Health): Madam Spe aker, I can reply again for the honourable member that in partnership with the Manitoba Cancer Treatment

776 LEGISLATIVE ASSEMBLY OF MANITOBA Aprill6, 1996 & Research Foundation, we have established two of the three breast screening centres in Manitoba. I am told that we have already made moves that have saved the lives of our fellow citizens in Manitoba who are women. That is something we should all support and be proud of, and I am mindful also of the points raised by the honourable member yesterday and again today. Home Care Program Labour Dispute Mr. Kevin Lamoureux (Inkster ): Madam Speaker, my question is for the Premier.

The Liberal Party believes that the client is far too often left out in this whole debate. The Minister of Health (Mr. McCrae) constantly talks about the need and the importance of the client. We have seen the client during the emergency services at our hospitals being left out there. We once again are seeing our clients being left and pushed to the side by this governm ent. The Minister of Health has gone out of his way to blame the health care professionals once again for the clients-passing it on to the clients.

My question to the Premier: Is the Premier today prepared to accept the responsibility of this strike, and what is the Premier prepared to do to put an end to this strike? Bon. Gary Filmoo (Premier): Madam Speaker, I point out to the member for Inkster that in any dispute there are two sides involved and engaged in an attempt to settle a dispute, and the leadership of the union has determined that it is in its best interest to ask its members to withdraw services from those in need. An Honourable Member: Whom do you think decided? Mr. Filmon: The union leadership decided- An Honourable Member: The workers voted.

It is called democracy, something you would not know very much about. An Honourable Member: Before there was anything on the table. Mr. Filmon: -before there was anything on the table, before any negotiations took place. In anticipation of the strike, we have in the last couple of days at the request of the union, firstly, appointed a conciliator. We are happy to do that in an effort to tiy and resolve it without having strike action. Secondly, in response to the union's request to create a moratorium or a delay on the decision, we offered a 60-day delay. The union rejected that.

I think at every opportunity this governm ent has shown that it wants to do what is reasonable in order to avoid that WOik stoppage, but ultimately the decisions that will affect the lives of, regrettably, those who need the services, whcm we feel very badly about, those decisions are being made by union leadership, I guess, against the best interests of those who are receiving and depend upon the services. Privatization Mr.

Kevin Lamoureux (Inkster): Madam Speaker, I am wondering if the Premier can indicate and at least acknowledge what the clients know, and that is that the privatiza tion of home care services will mean a decrease in the quality of services being delivered to home care services. This is what the Minister of Health is taking- Madam Speaker: Order, please. The question has been put. *

(1410) Bon. James McCrae (Minister of Health): Absolutely not, Madam Speaker. The honourable member could not be more wrong. If he looks across this country he will see that in most jurisdictions there is a mix of service delivery in the various places. You know, only Manitoba and Quebec do not have user fees. The honourable member says he supports home care, which we on this side certainly do. Does he not have a view of the health care system that is in a context of the world we are living in, or is it in some other place where reality is but a figment of his imagination? Only recently-and I quote from the Halifax Mail-Star where it says home health care could be privatized.

April l6, 1996 LEGISLATIVE ASSEMBLY OF MANITOBA 777 Health Minister Ron Stewart is about to privatize home care. By year's end, those who make all those meals, change bandages and administer morphine in homes across the province will have to bid for the job. We are designing a whole new system, the minister said. Madam Speaker, we are talking about 25 percent of competition in the city ofWinnipeg, and the honourable member is in some other world somewhere. Privatization-Study Release Mr . Kevin Lamoureux (Inkster): Madam Speaker, the world I am in is the province of Manitoba.

My question to the Minister of Health: Can the Minister of Health table any document that would clearly demonstrate the privatization of home care services is not going to degrade or bring down the quality of home care services that is currently being delivered today by a system that is working? Bon. James McCrae (Minister of Health): The honourable member wants something-here is a Price Waterhouse report that was commissioned by New Democrats in 1986-87 dealing with the-[interjection] Some Honourable Members: Oh, oh. Madam Speaker: Order, please.

Point of Order The honourable lll1D.1Ster had barely started his comments, so unfortunately I am not able to rule that there is a point of order due to the fact that I did not even hear a portion of his response before the honourable member for Inkster was on his feet to raise a point of order. The Speaker stood to maintain order and decorum in the Chamber because there was definitely noise erupting from both sides of the Chamber. The honourable Minister of Health, to complete his response. * * * Mr.

McCrae: Madam Speaker, my memory is not clear on whether the honourable member for Inkster was also at Seven Oaks Hospital the day the report that was the result of that project was released to the public. The report speaks in very positive terms of the patient outcomes and speaks in very positive terms of the patients' point of view with respect to the services that were delivered. As I was trying to say-the honourable member puts his question in the context of a privatized system-the report that the NDP commissioned, the Price Waterhouse report, was all about a privatized system.

That is the system where, without tender, the Victorian Order of Nurses, a private nonprofit agency, had control of a lot of the Home Care program here in the city of Winnipeg. So, you know, there has been plenty of study over the years. It is time to do something for the clients of home Mr. Lamoureux: Madam Speaker, on a point of order. care. In Beauchesne's, it makes reference to the fact that we put forward the questions. We appreciate a straightforward answer. The question was would he table the infonnation that the minister might have.

If he feels that the infonnation that he continuously quotes from is the only infonnation he has, then table that infonnation. What we want and the workers want is infonnation. Madam Speaker: Order, please. I would remind the honourable member for Inkster, this is not a time for debate, and it is clearly not a time to dispute what other members are putting on the record. Home Care Program Labour Dispute Mr . Gord Mackintosh (St. Johns) : My question is for the Minister of Health. With the public argument between the First Minister (Mr.

Filmon) who says that profit care will save $10 million over three years and the Minister of Health, on the other hand, who says, no savings, while home care clients are now displaced or without service, would the minister tell us whether the likely financial costs of the minister's strike will be factored into a proper costing of the profit care plan when he gets around to it?

778 LEGISLATIVE ASSEMBLY OF MANITOBA April 16, 1996 Bon. James McCrae (Minister of Health): Madam Speaker, this is not the minister's strike, believe me. My colleague the Minister of l..abour (Mr. Toews) and myself and others have been very, very active in trying to forestall this sort of activity on the part of the union leade rship. We had a strike vote taken and a decision made on a deadline even before discussions began. The honourable member knows all that, and yet he has the gall and the nerve to stand on his feet to put a question like that. Shame on the honourable member .. Mr.

Mackin tosh: A supplementary: Would the minister admit that this strike, and I perhaps correct myself, that this governm ent brought on could cost about one-half million dollars a day, more than twice as much as home care costs yesterday? Is that the cost of this minister's stubbornn ess? Mr.

McCrae: Madam Speaker, I know a couple of things: We are not going to be paying people not to work, No. 1, and No. 2, we are going to continue to press the union, if they insist on having a strike, to recognize that there are certain people in these circumstances whose needs are absolutely needing to be met on an essential basis.

I mentioned those groups yesterday in the House and elsewhere, and I cannot understand an opposition party that would not urge a union with which it has this organic fusion, I do not understand why they would not urge them to recognize people with Alzheimer's disease, people with Parkinson's disease, multiple sclerosis, severe cases of arthritis and others who need home care services. Why will honourable members not stand up for those people? Why, Madam Speaker? Revenues Gm·emment Estimate Mr.

Tim Sale (Crescentwood): Madam Speaker, in the Third Quarter Report for 1995-96, the Finance minister suggests that revenues for 1995-96 net of the $145 million one-time lottery transfer will exceed $5.480 billion. I would like to ask the minister if he believes that these revenue predictions remain reasonable for the year just past. Bon. Eric Stef anson (Minister of Finance) : Madam Speaker, the short answ er is yes. *

(1420) Mr. Sale: I thank the minister for that answer. Could the minister then explain why the revenue estimate for 1995-96, after deducting the $145-million lottery transfer, after deducting the net cut in federal transfers, is still $50 million greater than he now projects for this year, 1996-97? Last year's revenues are bigger. How come? Mr. Stefanson: Madam Speaker, whenever it has come to numbers in the past, I have had difficulty with the accuracy of information that this member brings to the House.

He obviously may be misreading the two reports, but I can tell him today that if he looks at our 1996-97 budget, our own source revenues are up by approximately 3. 6 percent in terms of our taxation revenues and our direct revenues, Madam Speaker. As he mentioned, our transfers from Ottawa are down by in excess of a hundred mill ion dollars , and our overall lottery transfers are down. Mr.

Sale: Madam Speaker, will the minister acknowledge that in my first question I took those matters into account, and does he still wish to defend his ridiculously low 1996-97 revenue Estimates, which are now seen to be $50 million less than he expected for the past year, and that he has deliberately underestimated revenue for this year as part of the camouflage for the cuts to those who receive home care, Pharmacare, eye care, hospital care? This is just camouflage. Will he finally acknowledge his revenue Estimates are nonsense? Mr.

Stef anson: Once again, the member for Crescentwood is absolutely wrong, and I will provide him with all of the detailed information in terms of the 1996-97 revenue Estimates. In terms of our own source taxation revenues, they are up by 3. 6 percent. Obviously, as has happened with him on many occas ions, the comparison he is doing is inaccurate. He is probably comparing apples to oranges. Madam Speaker, in terms of our own source revenues, taxation is up 3. 6 percent. In terms of retail sales tax revenue, it is up 6.3 p ercen t.

Where our revenues are down are in the areas of transfers from Ottawa-they are down by in excess of $100 million-and in terms of

April 16, 1996 LEGISLATIVE ASSEMBLY OF MANITOBA 779 combined transfers from lotteries, they are also down, but our own source revenues are up and they are up reasonably. Mental Health Care Housing Ms.

Marianne Cerilli (Radisson) : Madam Speaker, I have written the governm ent recently about the move to place mental health patients in Manitoba Housing Authority vacant bachelor suites and elderly persons housing blocks, and I am concerned that these clients are not going to have the necessmy home care support and that the Manitoba Housing Authority staff are not properly trained to deal with the increasing deman ds.

I want to ask the Minister of Health, how many outpatients have been placed at 185 Smith Street or other elderly persons apartment blocks, and what numbers of trained support staff have been also placed there to make sure that these people are integrated safely into the community? Bon. James McCrae (Minister of Health): Madam Speaker, I certainly share the honourable member's concerns . The details of her question we can address as we get into the process of review of my department's Estimates, which comes up pretty shortly. Madam Speaker: The honourable member for Radisson, for one very short question. Ms.

Cerilli: I want to ask the Minister of Health how his department has responded to a letter from the Winnipeg regional director for Housing that says, my staff have neither required time nor appropriate training to adequately address the needs of this segment of the ten ant-client base. Not only does it exhaust our human resources, it can also cause a wave of distress to the general building population. Has the Department of Health- Madam Speaker: Order, please. The question has been put. Mr. McCrae: Madam Speaker, I will obtain the response and provide it to the honourable member.

MEMBERS' STATEMENTS Home Care Services Mr. Mervin Tweed (Turtle Mount ain) : Madam Speaker, as the MLA for Turtle Mountain, I have expressed pleasme in standing and addressing the House in the past. Unfortunately, today, I do not feel as much pleasure. Growing up, it was always engrained in me that the truth-that there are two sides to every story; however, when I look around myself and my colleagues today I see a different scenario. Madam Speaker, the Manitoba Government Employees' Union voted to strike without any consultation with the employer and that is not fair.

Quite :frankly, without negotiations, how can the union even call a strike? This is most unfair now because those whom the unions apparently care so much about are being held hostage to the actions of their irresponsible union. Some Honourable Members: Oh, oh. Madam Speaker: Order, please. We are now at Members' Statements in Routine Proceedin gs and all members deserve respect and courtesy. Mr. Tweed: Madam Speaker, I am receiving many phone calls from the rural home care workers who are upset.

They tell me that they are being told by their unions and the NDP that they have to go on strike, that they have no choice, that they are being threatened by unions and other- Some Honourable Members: Oh, oh. Madam Speaker: Order, please. Mr. Tweed: So much for democracy, but I want to impress upon this House that home care workers in my constituency have as their primary concern the people that they work for- Some Honourable Memb ers: Oh, oh. Madam Speaker: Order, please. Mr. Tweed: Madam Speaker, would it be fair if I Madam Speaker: Time for Oral Questions has expired. started again?

780 LEGISLATIVE ASSEMBLY OF MANITOBA April16, 1996 I do want to impress upon the House that home care wotkers in my constituency have as their primary concern the people that they work for and with, and that, Madam Speaker, I assure you, is the correct perspective. It is high time that the unions realize that it is being extremely irresponsible by voting to strike without first consulting the employer. Some Honourable Members: Oh, oh. Madam Speaker: Order, please. The honourable member for Turtle Mountain, with 10 seconds to quickly complete his remarks. Mr.

Tweed: If the union cares so much about the people they serve, then how can they leave them in the lurch with this undemocratic strike. Meet with the employer and then discuss a strike vote. This is hypocrisy at its worst, Madam Speaker. Manitobans are not being told this side of the story and for that reason I state these concerns so that they are recorded in the minutes of this House. Mr. Conrad Santos (Broadway): Madam Speaker, I would like to make a statement on home care. Today we witnessed governm ent's attempt to plan and priva tize home care services against the interests of the pat ients.

Home care patients do not support the privatization move. Home care workers do not support pri vatization of home care. This government is forcing the home care workers to display their opposition by going on a strike. This Filmon government disregards the rights and needs of the patients. They disregard the rights and needs of the disabled people. They pay no attention to the interests of the public. This arrogance of this government is leading to a systematic destruction of the home care system and generally of our health care system.

This Filmon governm ent refuses to hold province-wide hearings regarding the future of home care, more likely than not because they are afraid of what they would hear. While making money is the engine that drives our economy, there are certain circumstances where it becomes morally objectionable. When it is done on the backs of the sick and the poor, then it is no longer acceptable. Those who run this governm ent avoid consultation systematically because they know what they would like to hear. They just cut governm ent services, including home care, on the verge of destroying health care in this province.

Thank you. Winnipeg AAA Bantam Monarchs Hockey Team Mr. Mike Radcliffe (River Heights): Madam Speaker, today I would like to draw the attention of the House- An Honourable Member: Speak up a little bit. Mr. Radcliff e: Having had trouble hearing there, the honourable members on the other side, I would like to draw the attention of this House to a significant achievemen t of the Winnipeg AAA Bantam Monarchs hockey team . Last week, in Lethbridge, Madam Speaker, this team represented Manitoba in an exemplary fashion, winning the bronze medal in the Western Canadian Bantam Championship.

The players on the team come from throughout southwest Winnipeg, including my own constituency of River Heights. The Bantam Monarchs finished second in the regular league play in the city and won the right to represent Winnipeg in the provincial bantam championship by winning the city's championship playoff series. The Bantam Monarchs, Madam Speaker, won the provin cial championships in Brandon, setting the stage for the team's strong effort in Lethbridge, where they represented Manitoba so proudly.

The goaltender for the Bantam Monarchs, Ryan Olenick was named the all-star goalie for the Western Canadian Bantam Championship tournament. I would ask all members of the Legislature to join me today in extending our congratulations to Ryan and the Winnipeg AAA Bantam Monarchs hockey club on a very successful season. Thank you very much, Madam Speaker. *

(1430) Home Care Services Mr. Kevin Lamoureux (Inkster) : Madam Speaker, I want to respond to the member for Turtle Mountain's (Mr. Tweed) political statement.

April 16, 1996 LEGISLATIVE ASSEMBLY OF MANITOBA 781 The member for Turtle Mountain should be fully aware of history bef ore he starts to talk in terms of making a statement that he put on the record. Absolutely amazing, Madam Speaker, he has taken the same line of the Minister of Health (Mr. McCra e), and to a certain degree that the Premier (Mr. Filmon) has somewhat evaded, and that is to pass the blame, to blame someone else. This government has to take the respo nsibility fo r the actions that it is putting on the clients in the province of Manitoba.

I spoke to a client by the name of Ollie Maksymowicz earlier today. This is a client who said, look, We Care came buzzing at her door earlier today, and she refused to have We Care ultimately because she believed that the governm ent services of home care services is a far better, superior, quality ofhome care service s. So, on principle, Madam Spe aker, she realizes that it is in her long-term best interest that this not be priv atized for profit. The member fo r Turtle Mountain and other Conser vative members have to open their eyes, start consulting with some of these clients .

This should have been taking place prior to a decision being made. This government did not consult, Madam Speaker, with anyone regarding home care services and the changes that they were moving into. This governm ent should have been doing the consulting. We suggest that this governm ent should in fa ct put a one-year morator ium, go out and do their homework, do the consulting, then come back. This governm ent did not consult. Someone in the government members says , we did.

Well, Madam Speaker, they did not do any of the consulting because I have not fo und one individual that told me that this government has consulted them. Madam Speaker, I trust I will get another opportunity to speak during an emergency debate . Thank you. Ms. Becky Barrett (Wellington) : Madam Speaker, I, too, would like to respond to the member fo r Turtle Mountain's (Mr. Tweed) comments in his memb er's statement earlier.

It is unconscionab le, absolutely unco nscionable that the member for Turtle Mountain and, by extension, the entire governm ent caucus, says that home care workers do not care about their clients. That is unconscionab le. The Minister of Health (Mr. McCrae), the Premier (Mr. Filmon) when he has deigned to stand in this House and now the back-bench members of this caucus, the governm ent cauc us, are attributing the worst possible kinds of ideas to home care wor kers , 3,000 of them in this province who care desperately fo r their clients , who have worked fo r years fo r the same clients .

Madam Speaker: Order, please. Point of Order Mr. Steve Ashton (Opposition House Leader): On a point of order, the Premier (Mr. Filmon) , Madam Speaker, once again is making comments across the way, talking to our member about being honest. Apart from the irony of that coming from the Premier, I would like to ask that you ask him to withdraw those unparliamentary comments . Madam Speaker: The honourable governm ent House leader, on the same point of order? Bon. Jim Ernst (Government House Leader): Yes, Madam Speaker. Just a fe w moments ago the member for Thomp son (Mr.

Ashton) and a number of his colleagues were sitting in their seats yelling and screaming almost at the top of their lungs at the member fo r Turtle Mountain (Mr. Tweed) . When some comments are returned during the statement by the member fo r Wellington, he pops up on his fe et because he is co ncern ed. When was he concerned when the member fo r Turtle Mountain was up there and when he was yelling and screaming from his seat? Madam Speaker: Order, plea se. On the point of order, I did not hear the comments uttered by the honourab le First Minister.

I will take the matter under advisement and, if ne cessary, report back to the House. * * * Madam Speaker: The honourable member fo r Welling ton has one minute, five seconds remaining. Ms. Barrett: Thank you, Madam Speaker . I would like to also take exception to the comments made by the member fo r Turtle Mountain and also wish that he would share with the Minister of Labour (Mr. Toews) the reality about the democratic process of membership in a union and the process that is undertaken. It was not the union

782 LEGISLATIVE ASSEMBLY OF MANITOBA Apri1 16, 1996 bosses who voted to strike. It was the home care workers who were pushed to the wall by this government's lack of consultation. Those home care workers voted overwhelmingly that in order fo r them to protect their clien t's well- being, their clien t's best interests and the best home care system in the entire North American continent, they had no other option but than to go on strike.

For the member fo r Turtle Mountain and the Premier and the Minister of Health and the Minister of Labour to say that it was the union bosses is a total disregard fo r the whole free collective bargaining process and no wonder this government is in such trouble with its own workers. MATTER OF URGENT PUBLIC IMPORTANCE Home Care Wor ken' Dispute Mr. Dave Chomiak (Kildonan) : Madam Speaker, I move, seconded by the member for Concordia (Mr. Doer), that the ordinary business of the House be set aside under Rule 27.(1) to discuss the home care workers' dispute. Madam Speaker: Order, please.

Prior to acknowl edging the motion moved by the honourable member fo r Kildonan, I regrettably neglected to identify Grievances on the Order Paper. Befo re recognizing the honourable member fo r Kildonan (Mr. Chomiak), I believe I should remind all members that under our subrule 31.( 2), the mover of a motion on a matter of urgent public importance and one member from the other party in the House is allowed not more than five minutes to explain the urgency of debating the matter immediately.

As stated in Beauchesne's Citation 390, urgency in this context means the urgency of immediate debate, not the subject matter of the motion. In their remarks , members should foc us exclusively on whether or not there is urgency of debate and whether or not the ordinary opportunities fo r debate will enable the House to consider the matter early enough to ensure that the public interest will not suffer. Mr.

Chomiak: Madam Speaker, I rise today to urge this Assembly do something that has not been done during the whole course of this debate, ever since the government secretly tried to put through a plan to privatize home care , and allow the public, allow the elected representatives of the province of Manitoba to discuss the issues and the ramifications of the governm ent's plan to privatize. As we speak in this Chamber, this governm ent is sending out clerks and other clerical people from the Department of Health to go out and visit home care patients-as we speak, Madam Speaker.

They are doing that because their friends in the private sector, the ones that they are going to rely on to privatize home care do not have the capacity or the ability to deal with home care in the city of Winnipeg. As we speak, the governm ent plays games in the negotiation process. They say a 60-d.ay moratorium on the strike. What is a 60-day moratorium? They are going to hold off tenders fo r 60 days, and then 60 days later they are going to give tenders out. What satisf action is that? That amounts to nothing. That amounts to absolutely nothing.

The major issue at stake here is the privatization of a service that is recognized as the best in North America. What is at stake here are clients who unanimously deplore the governm ent's plans to privatize and workers who deplore the governm ent's plans to privatize and every single study and every single expert in the province of Manitoba. Madam Speaker, we require an opportunity to debate in this Chamber the ramifications of what the government is doing, because as we speak the governm ent is putting in place a so-called contingency plan in order to deal with this issue.

Perhaps if members could hear arguments rather than simply the dictates I presume of the Premier (Mr. Filmon) or the Minister of Health (Mr.

McCrae) who have said what they are going to do in home care, if they could hear arguments from members on this side of the House as to why privatization is not in the best interests of Manitoba, if they fo r once could open their ears and not just their mouths to spew fo rth the rhetoric that they do in this Chamber, if they had an opportunity to listen to what the arguments are against their move to privatize, perhaps the governm ent could stop this entire process in its tracks, and we would be able to stop the

April 16, 1996 LEGISLATIVE ASSEMBLY OF MANITOBA 783 potential difficulties that could occur as a result of this dispute . Madam Speaker, I am to speak to the urgency of this debate. As we speak, the home care clients are having sent to them clerical people from the Department of Health trying to do home care, and why do we have that? We have that because the governm ent is refusing to budge on the fundamental issue of privatization * (1 440) Even though the Estimates are starting shortly in this Chamber, that aff ords us an opportunity to review questi ons on a line- by-line.

The Home Care line is not until much further down in the pr ocess. We require an opportunity to debate the issue of privatization right now, because as we speak the gov ernm ent is playing games with off ers, playing a public relations game, trying to blame the unions, trying to blame the workers, trying to blame evecybod:y, but where in fa ct the blame lies is with themselves and their ina bility to listen to reason, to listen to logic, to listen to policy.

If there is not an issue that requires debate in this Chamber, I dare say there is no single issue in the province of Manitoba requiring a debate more urgently and more at question than the whole issue and the whole plan of this government to privatize home care. With their lack of study, with their lack of inf ormation, there is no issue in this province that requires a more urgent discussi on, an urgent debate, as we fa ce a labour dispute that has been brought on by this gov ernm ent and this governm en t's inability to listen.

If we had a debate, perhaps the members could stand up and fo r once perhaps we might hear even a reason as to why they are privatizing, perhaps one reason, and maybe if we had a debate they could even come up with two reasons but, I dare say, the reason members opposed the debate and the reason that they have not been able to give us any reasons fo r the privatization of home care is that they do not have any.

They do not have any reasons fo r pri vatization other than their own ideological bend and their own recommendations and reports of their friends in the private sector who have said, privatize, give us the profit, we will take the money, Madam Speaker, and their friend Connie Curran , who recommended privatization. So I suggest and I urge, given the seriousne ss of the labour situation facing us, given the fa ct that the government has chosen to play games in the negotiation process by putting up token gesture s, we in this Chamber, in fa ct, it is our duty to debate this issue .

It is our duty to discuss the policy ramification s. It is our duty to look at this issue so that we can resolve this issue as soon as possible. Thank you, Madam Speaker. Madam Speaker: I would like to draw to the attention of all honourab le members that the motion just curr ently moved is not identical in wording to the MUPI that was sub mitted to my office earlier this morning. On February 17 , 1992, the Speaker ruled that the MUPI was out of order because the original text was not identically the same as the motion that was served as notice earlier in the day.

Is there leave to permit the honourable member for Kildonan to revert or rescind the motion he proposed and resubmit the motion the same as notice was served on this morning? [interjection] Order, please. I have asked the House if there is leave. Some Honourable Members: No. Madam Speaker: No? Leave has been denied. Mr. Kevin Lamoureux (Inkster) : Madam Speaker, I would then move, seconded by the member fo r St. Bonif ace (Mr. Gaudr y), that under Rule 31 .(1 ) the ordinary business of the House be set aside to discuss a matter of urgent public importance, namely, the strike by home care service workers .

Madam Speaker: The motion indeed is in order and before recognizing the honourable member fo r Inkster I would remind all members that under subrule 31 .(2) the mover of a motion on a matter of urgent public imp ortance and one member from the other party in the House is allowed not more than five minutes to explain the urgency of debating the matter imm ediately. As stated in Beauchesne 's Citation 390, urgency in this context means the urgency of immediate debate, not of the subj ect matter of their motion. Mr. Lamoureux: Madam Speaker, I would like to demonstrate to the House that in fa ct this is an urgent

784 LEGISLATIVE ASSEMBLY OF MANITOBA April l6 , 1996 matter that does warran t the debate of this Chamber. In filet, we would like and encourage all members to be able to participate in an active debate to talk about the whole issue of privatization of health care. Why? Primarily because what we have to start looking at is the health and well-being of the clients of the province of Manitoba. This is something that we believe that the governm ent is not doing, and we want to hear from the governm ent in terms of what they believe is in the best intere sts of the clie nts.

We heard earlier from the member for Turtle Moun tain (Mr. Tweed). What I want to hear from is more of the cabinet minist ers. I want to hear from the Premier (Mr. Filmon) in terms of what he believes is important in terms of home care services. We have to be able to understand the fear that is out there, that is in the minds of the many home care clients that are scattered throughout the province of Manitob a. I make reference to this Ollie Maksymowicz, an individual elderly lady that I talked to earlier today and I made reference to it in a nonp olitical statement.

The fear that she has is that if the government moves towards the privatization for profit of home care services, then at the end of the day she is going to see the quality of care being downgraded, and that is a legitimate concern. There are many other argumen ts, Madam Speaker. I could talk, for example, about how the privatization of home care services is going to lead to the establi shment of a two-tier system, one that will be more enhanced and in a better position for those that have more of the economic means as opposed to those who do not have the same sort of economic resour ces.

We have clients scatt ered throughout the province that rely on home care services. We have an individual like I just finished citing who wants to be able to have those home care services del ivered to her but is not prepared to cr oss the picket line because what she believes is fundamentally that this is the government that is causing the problem.

We have a responsibil ity in opposition to clearly demonstrate that it is this government that is causing the problem and the only way that we can do that and, hopefully, be successful is if we allow all members of this Chamber to let Manitobans know, through this Chamber and the constituents that we represent, what our thoughts and our opinions are. [inteijection] Well, the Minister of Highways (Mr. Findla

y) will have to excuse me if I am somewhat emotional on this issue. It is an important issue to all Manit obans, and I will speak as loud as I so choose. Madam Speaker, I believe ultimately that if there is any reason to believe whatsoever by allowing this debate to occur that we can prevent the strike from continuing, that alone is worth all owing this debate to proceed.

The costs that are being in curred by allowing the strike, if you like, to continue on-you have individ uals going into instituti ons, whether hospital s, personal care homes; you are having a growing reliance on members of the family and other nonprofit organizatio ns; you are puttin g into jeopardy the care that is being provided-ultimately this is something that does warran t the attention of an emergency debate . I would ask that you give consideration or possibly even canv ass the House to see if there is the support to allow this debate to go on.

Ultimately, yes, Health Estimates does follow this, but it does not allow the opportunity for all members to be able to participate in that debate and we want to talk about the home care services. Home care services is not the first thing up on the agen da. The Minister of Health (Mr. McCrae), the Premier (Mr. Filmon) know about that, so let us stand up for the clients in the province of Manitoba. Let us do what is right. Let us allow this emergency debate to occur . Thank you very much. Mr.

Steve Ashton (Opposition House Leader): It is ironic that earlier today we had admon itions from members of the governm ent about democratic process, which, I think, shows their fundamental disdain for just the common sense and intel ligence of many home care workers who have made a very difficult decision, a decision that has been forced upon them by the actions of thi s governm ent. But I say that it is ironic that the governm ent talks about democratic process, because when it comes to home care, never once have they ever campaigned on privatizing home care.

Never once in this House have they debated privatizing home care. Never once have they submitted it to a vote of this Legislature . That is not democracy. They have no right to lecture home care workers or anyb ody in this province about demoaacy . Madam Speaker, that is why we want to see an emergency debate today in this Legislature on home care . As we speak, I believe that there are people at risk. This governm ent, driven by the agenda, the private agendas of private home care companies and the private agenda of this minister, is bringing us to the brink-

April 16, 1996 LEGISLATIVE ASSEMBLY OF MANITOBA 785 Madam Speaker: Order, please. *

(1450) Points of Order Bon. .nm Ernst (Government House Leader): Firstly, Madam Speaker, your admonition at the start of the member for Kild onan 's (Mr. Chomiak) address to the matter of urgency, your admonition to the member for Inkster (Mr. Lamoureux) with respect to urgenc y-and somewhere in there, I suppose, there might have been something about urgency-but in the address for the member for Thompson (Mr. Ashton) not yet has he mentioned any urgency at all, and he has been speaking for two or three minu tes. So, Madam Speaker, I ask you to call him to order. I have been very patient.

I listened to the member for Kildonan not talk about mgency; I listened to the member for Inkster not talk about urgency-save one or two comments-when your admonition clearly said that it is urgency that is the matter of debate . Secondly, Madam Speaker, the member for Thompson just imputed motives, serious motives to the Minister of Health . I think that is highly inappropriate, and the member ought to withdraw that immediately, for clearly that is beyond the rules. Mr.

Ashton: I will just ask for some advice, Madam Speaker, as I believe, the minister raised two separate points of order, and I would like to comment on both. I would just like to ask for your advice on how we should proceed in dealing with those two separate points of order. Madam Speaker: Indeed, the government House leader did raise two distinctly separate points of order. I will deal with the first point of order, the matter of urgency, first. The honourab le member for Thompson, on the first point of order. Mr.

Ashton: Madam Speaker, I believe that, if the government House leader would have listened to my comments, I made reference to the fact that people are at risk currently, and I was just addressing the very degree of urgency that is required for a matter of this importance to be discussed by the Legisla tme as our rules and our traditions in this House. Whenever we get a matter of such importance, we often debate it. I also have some comments on the second point of order, too. I do not know if I should make those here.

Madam Speaker: I indicated to the member for Thompson earlier, I will deal with them as two explicitly separate points of order. On the governm ent House leader 's point of order, indeed, the governm ent House leader had a point of order, and I explicitly referred to the urgency of debate .

Beauchesne 's Citation 390 is very clear: '" Urgency' within this rule does not apply to the matter itse lf, but means 'urgency of debate ', when the ordinary opportuniti es provided by the rules of the House do not permit the subject to be brought on early enough and the public interest deman ds that discussion take place immediately ." The honomable member for Thompson, on the second point of order. Mr.

Ashton: Madam Speaker, on the subsequent point of order, my comments were based directly on a sworn sta tement that I raised earlier in Question Period which point very clearly to the fact that as early as 1989 the Minister of Health was working with We Care and one Bev McMaster towards the privatization of our home care system, and indeed that was an agenda and it was a private agenda. It was never once revealed to the public of Manitoba- Madam Speaker: Order, please.

My understanding of the governmen t's point of order was that the honourable member for Thompson had imputed motives of the honourable Minister of Health. Now, I have not ruled on that point of order. Does the hono urable member for Thompson wish to further comment on the point of order? Mr. Ashton: Yes, Madam Speaker, I do. Madam Speaker: Very quickly. Mr. Ashton: Thank you, Madam Speaker. I mention this because I did indeed and I have said earlier and I will

786 LEGISLATIVE ASSEMBLY OF MANITOBA April 16 , 1996 say again that the minister had a private agenda related to home care that was one of privatizing home care. Indeed it was revealed as early as 1989 in con junction with We Care. That is a statement of fact; it is not impugning motiv es. The fa ct is this Minister of Health has always been pushing for the privatization of health care.

I would say that the ref erence to a private agenda is the fa ct that it was not made public in any election by the Minister of Health or the Premier, so in fact a private agenda is not only not impugning moti ves, it is a statement of fa ct and it is a very accura te description of what occurr ed. Madam Speaker: Order, please. On the second point of order, I will take it under advisement.

I will indeed check Hansard and review all comments made on the point of order and report back to the House if necessmy. * * * Madam Speaker: The honourab le member fo r Thompson, who has three minute s, twenty seconds remaining. Mr. Ashton: I want to once again, fo r the benefit of the government House leader and other s, point to the very urgency of this matter. As we speak, I believe that the health of home care clients in this province is being placed at risk by a government that is curr ently now seeking individuals with clerical experience to take care of home care clients .

Madam Speaker, you ref erenced Beauchesne 390. We have no other opportunity to debate home care, the urgent situation. The minister knows , the government House leader knows that we do not even reach the line in Health Estimates on home care-it could be some weeks if not months befor e we reach that line. We have people at risk curr ently. We have no other opportunity to try and bring this government to its senses bef ore something very serious happens in this province .

I am raising this today as a member of this Legi slature because I am concerned on behalf of my constituents and many other Manitobans that this government is pushing ahead with its private agenda at the expense of home care clients in this pro vince. I am extremely concerned that if we do not have any kind of debate it may be a fait accomp li, and something serious will happen. I ask only one thing of this government now. I would like to see them drop the privatization of home care, but I ask them only to do one thing today.

At least give us, the members of the Legislature, the opportunity to speak out on behalf of the thousands and hundreds of thousands ofManitobans who oppose what they are doing on home care. If you are so sure of what you are doing, why are you not going to agree to a debate on this matter, I ask the government House leader. An emergency debate is two hours of the time of this Legislature. Is it not two hours that would be well invested to try and get some sense of what this government is doing?

Madam Speaker, I believe we have had precedents in this House where prev ious speakers have given the uniqueness of this occas ion, similar occas ions of the past, we have canvassed the House on whether there should be an urgent debate . Indeed, I would urge you as Speaker and I would urge the government to allow us one thing today on the day that I believe is a very serious day for Manitoba It is a very unfortunate day.

At least allow the elected members of the Legi slature who represent one million Manitobans one thing, and that is to debate the very serious concerns that are being expressed about the private agenda of this government. That is why I would urge you to allow us to have the House decide on whether there should be a debate on this very urgent matter . Thank you. * (1 500) Mr. Ernst: Madam Speaker, as I said earlier, I patiently listened to the member fo r Thomp son, the member for Kild onan (Mr. Chomiak) and the member fo r Inkster (Mr. Lamomeux) all relate their story with respect to this issue.

The fa ct of the matter is, though, that yes terday you ruled a matter of urgent public importance out of order for reasons that are no diff erent today than they were yesterday . As a matter offuct, today it is even less urgent than it was yesterday, because this afternoon, depending upon the timing of your ruling, within five minutes we can be discussing this issue in the Estimates of the Department of Health. While the member says , well, we cannot deal with it because it does not come up until later in the Estimates of

April 16, 1996 LEGISLATIVE ASSEMBLY OF MANITOBA 787 the Department of Health, that is true. Home Care does not come up Wltil later. But everything 1mder the SWl has always histori cally been discussed under Administration, which is the first item in the Estimates of the Department of Health. * (1 510 ) As a matter of fact, the memb ers opposite, in proposing this motion, are actually shortcha nging themselves because, Madam Speaker, if we start within five minutes they will have two and a half hours to discuss Health as opposed to two hours in the House here.

So they are going to get an extra half an hour by ignoring their own motion, and they will also get an opportunity not just to put their point of view on the record but to ask the Minister of Health questions . I mean, that is the whole portent of Estimates, to have that discussion. I heard the member fo r Kildonan on a number of occasi ons say, we must have a discussion about this issue of home care, but in an emergency debate in the House there is no discussion. They put their point of view on the record, we put our point of view on the record, end of story.

But, Madam Speaker, in the Estimates of the department there is an opportunity fo r discussion. There is an opportunity to ask questions . There is an opportunity to seek clarificatio ns, all of which is more to their own advantage than the motion put fo rward by the member fo r Inkster. So on that alone, you should rule it out of order. Madam Speaker: I thank all honourable members fo r their advice. The honour able member fo r Inkster (Mr.

Lam oureux) has moved a motion which reads that the ordinary business of the House be set aside in order to discuss a matter of urgent public importance, namely the strike by home care service work ers. As members know, the Speak er's role in a matter of urgent public importance is examining whether the requirements set out by this House 's rules and practices have been met. Firstly, I would advise that the required notice of 90 minutes was given. The second requirement is, are there are no other opportunities fo r the matter to be debated.

On this point, the Estimates order indicates that the Estimates fo r the Department of Health will commence today, so the member will have the opportunity to rai se the issue in that fo rm. Also, the honourable member on future days can use the vehicle of a member 's statement and grievance . The third test is, will the public interest suff er if the matter is not debated today? Because the member has another opportunity to discuss the matter today, I would rule that the public interest will not suff er if the home care worke rs' dispute is not debated in the form of a matter of urgent public importance.

There is no question the dispute is a serious matter ; however, I must rule that the motion prop osed by the honourable member fo r Inkster (Mr. Lamoureux) does not meet the procedural requirements of the rules and practices ofthis House. ORDERS OF THE DAY Bon. Jim Ernst (Government House Leader): Madam Speaker, I move, seconded by the Minister of Education (Mrs. Mcintosh), that Madam Speaker do now leave the Chair and the House resolve itself into a commi ttee to consider of the Supply to be granted to Her Majesty; Health in Room 255 and Executive Council here in the Chamber.

Motion agreed to, and the House resolved itself into a commi ttee to consider of the Supply to be granted to Her Majesty with the honourable member fo r La V erendr ye (Mr. Sveinson) in the Chair for the Department of Health; and the honourab le member for St. Norbert (Mr. Laurendeau) in the Chair fo r Executive Council. COMMITTEE OF SUPPLY (Concur rent

Section

s) HEALTH Mr. Deputy Chairperson (Ben Sveinson) : Will the Committee of Supply please come to order. This

section of the Commit tee of Supply will be considering the Estimates of the Department of Health. At this point, I would just like to inform committee members of some changes to the rules with regard to speaking times in Comm ittee of Supply . Please note, the address of a minister introducing a new department and the corresponding opening address of critics from official reco gnized opposition parties are limited to a maximum

788 LEGISLATIVE ASSEMBLY OF MANITOBA Apr il l6 , 1996 of 30 minute s. After opening remarks, all speeches by any member or questions or comments are limited to 10 minutes . Does the honomable Minister of Health have an opening statement? Bon. James McCrae (Minister of Health) : Mr. Deputy Chairperson, I propose to be brief in my opening comments today. I am pleased to be back with my colleagues in the Legislatme to discuss the Estimates of Expenditure fo r the Dep artment of Health. The last year has been extremely eventful for the health system in Canada, and certainly Manitoba is no exception.

The coming year, I suggest, will be eventful, as well, as we attempt with om partners in health to address the kinds of changes that will need to be made in order fo r us to rebuild a health system that would be sustainable fo r those who need the health system now, but also fo r futme generati ons. The things we do now are extremely important fo r the future .

The things we decline to do now may even be more important in that, should we decline to embrace the kinds of challenges that confront us, we will have given up, we will have said we just cann ot do it, we just cannot sustain or we cannot preserve a health system fo r om country. To me as a Canadian, Mr. Deputy Chainnan, that is not suffi cient if we are to be doing om work.

I know that the staff of the Department of Health have been fa cing, along with honourab le members and I and the rest of society, these challenges these past fe w years, and I would like to take just a moment to make a comment or two about the department itself , which itself has undergone and must still undergo change in order to be ready to addres s the challenges that confront us.

I would like to pay tribute to the personnel in the Health department for the work that has been done , and perha ps, in my paying tribute to them, I continue the plea that they continue their good work fo r the future in health care. * (152 0) I think we sometimes tend to take for granted the good work that is done by people, not only at the level of community health or in om hospitals, but I am confining these commen ts to people who work in the Department of Health.

Challenging times, even troub ling some times, as we addr ess gravely important matters, and we do it in an envir onment that sometimes does not seem to offer too much appreciation fo r what is being done. I would just like to place on the record, all the way from Dr. Wade, Deputy Minister of Health, all the way through the ranks of the Health department, and say thank you fo r services that have been rendered and thank you in advance for the efforts that will be undertaken as we go fo rward for the next little while.

Similarly, all of those in funded institutions and working in om commu nities, whether it be in the Home Care program or the long-term care program or fo r proprietary or nonproprietary personal care homes or wherever they happen to be where they are working day in and day out to provide assistance to their fe llow human beings, I use this opportunity to say thank you fo r that and to ask that everyone take whatever part they fe el is appropriate in addre ssing the changes that lie ahead and also to keep in mind the needs that om system is trying to addre ss, all of which revolve around the client or the patient or the customer or whatever is the appropriate nomenclatme fo r those who are co nsum ers of om health care system .

That being said, Mr. Chairman, I think the governm ent is trying to play a strong role as partner in om health system . Certainly this governm ent is when you look at spending in health as a percentage of total governm ent spending. Here in Manitoba we rank highest in om country in that regard, which talks somewhat eloquently, I suggest, of the commitment and the priority the Filmon government places on the health of the people of Manitoba.

Within that expenditure, which is the highest level in the country as a percentage of budget, about third highest as a per capita expendi ture, we have some very important things to do. At one time I think it was fe lt that really the only responsibility the public system had was to insme services provided by doctors and hospitals. Certainly right across Canada that has expanded very, very significantly , in recent years especially. Even in not so recent years governments have seen the value of placing some empha sis in areas of prevention and health promotion and so on.

Certainly as om so-call ed baby boom generation approaches om sunset years, the need fo r services fo r senior citizens is going to be on the increase, and we have to be geared up and ready fo r that.

April 16, 1996 LEGISLATIVE ASSEMBLY OF MANITOBA 789 My honourable colleagues from the other political parties I think share similar viewpoints when it comes to the greater vision or so-called bigger picture, but when it comes to the implementation of change it is sometimes easy to fa ll into the habit of responding to those who might be aff ected by changes in the workplace without perhaps thinking the whole thing through, and it is easy to do that when you are in opposition.

In government, I do not think any of the members, the New Democrats around the table had the opportunity to be in a position where they had to be accountable fo r their decisions and impl ementations, and the same is true of the Liberal members. They have not had to do that and sometimes, today, fo r example, when a very unf ortunate strike situation occurs in one of our most important programs it is easier, I suggest, to be on the side that would simply level the criticism than it is to be on the side where the accountability rests, that being with the governm ent. I accept that responsibility, Mr. Chairman.

It is onerous and I take it very seriously. I want honourable members to know that I will do everything I can during these Estimates to be as accountable and as for thcoming with inf ormation as I can realistically and reasonably be so that we can make some progress here. It is important to engage in exchange of ideas, exchange of inf ormation. It is important to do that as public policy is being developed. Ultimately decisions have to be made. You get criticized fo r making them, you get criticized fo r not making them.

Ultimately decisions do have to get made and we can be pretty well assured that there will not be unanimity on every move. In fact , there may not be unanimity on very many, if any, moves that get made in the health system, whether it is in this jurisdiction or anywhere else. The only thing I ask, through honourable members, to the members of the public is that we remember that the commitment is there on the part of the government, and the efforts are being made on the part of the governm ent and on the part of all of the people with whom we work and consult.

Ultimately, the decisions get made, and that is the time when all of those who disagree with the decision make use of the opportunity to say, well, what about me, or, you know, you did not listen to me because you did not do it my way.

That is a difficult thing because those people have a legitimate reason for bringing fo rward their point of view, especially if the decision has a negative impact on them in some way, usually by way of employment or the way they do their work, and I think we certainly have to be sensitive to those people, but we cannot simply not proceed with change, which is what is being urged on us. If that were to be our role, well, we would really have cast aside the responsibility that we were elected to carry out. So, with those comments, Mr. Chairman, I will stop and allow honourable members to proceed. Mr.

Deputy Chairperson : We thank the Minister of Health fo r those comments. Does the official opposition critic, the honourable member fo r Kildonan, have an opening statement? Mr. Dave Chomiak (Kildonan) : I thank the minister fo r his comments, and I will commence by echoing the comments of the minister with respect to commending and recognizing the work of all of those people in the Department ofHealth, both within the Ministry of Health itself and all of those extensions of the Department of Health through a variety of programs, services and institutions around the province of Manitoba.

I think that it is incumbent upon us to recognize that, in fa ct, they are doing the work of which we speak, and they are delivering the care fo r which we debate, and I think it is incumbent upon us to recognize their role and to compliment them on their activities. I also wish to indicate that any of my criticism, and it is considerable, directed toward the Department of Health is not directed toward those individuals and those people, but, rather, it is toward the policy makers at the Department of Health fo r whom I have a good deal of criticism. * (1530 ) Normally, in this process, Mr.

Chairperson, I do not make lengthy opening statements. I fe el on this occas ion the necessity and the need to make some extensive comments at the commencement of this Estimates process. About a year ago, at this time, Mr. Chairperson, we were in the midst of a provincial election, and arguments

790 LEGISLATIVE ASSEMBLY OF MANITOBA April 16 , 1996 have been made long and bard by all members that health care was discussed during the course of the provincial elec tion, and, in fact, it was. Health care was undoubtedly one of the ma jor issues attracting attention and inte rest during the last provincial election, but, you know, it is very, very intere sting that prior to the last provincial election, the government was aware of cutbacks in health and social transf er payments from the federal government.

Nonethele ss, the minister went before the people ofManitoba and before the Chamber to announce a massive capital program . Just days before the election, he announced a massive capital program. It signified this government 's commitment to the future of Manitoba and to the infrastructure of our health care system, and this was at a time when they were aware of the cutbacks in transf ers from Ottawa. At the same time, Mr.

Chairperson, the minister went before the same audience, the same public of Manitoba and put together a program to reduce waiting lists because waiting lists were most ext ensive in the province of Manitob a. Mr. Deputy Chairperson: Order, please. We listened intently to the comm ents of the minister, and I would ask all members to listen attentively to the honourable member for Kildonan while he makes his comments . Mr. Chomiak: Thank you, Mr. Chairperson.

The minister went ahead and made a commitment toward reducing waiting lists and found the time to do that, and the minister also went out and talked about a child strategy that was being put forth by the province, all his commitmen ts. We went into an election campa ign with all of these commitmen ts. We had the provincial election; mem bers opposite were returned. It is interesting, all of a sudden, that commitment, that long-term commitment to the capital program, was not there.

All of a sudden, the program to reduce waiting lists would not be renewed, and, all of a sudden, there is no plan or no stmtegy dealing with health strategy. What is more, programs like Pharmacare, that the government promised they would not touch during the cam paign, have now been decimated by the policies of this government. Programs like Home Care, which the government campaigned on and promi sed and commit ted to maintaining, are being turned on their head by the policies of this government- An Honourable Member: What? Be honest, Dave. Mr. Chomiak: The member will have his opportunity to speak.

He could do me the privilege of allowing me to address my commen ts. Point of Order Mr. Tim Sale (Crescentwood) : On a point of order, very clearly, you will have heard the member opposite asking the member for Kildonan to be honest. He is reflecting on the motivation of the member and is calling it into question.

It seems to me, if we are going to get thro ugh this process with a minimum of nastine ss, you are going to have to, as chairperson, recognize when members are using inappropriate language , and I would ask you to rule that the use of the language is inappropriate and ask the member to withdraw it unconditiona lly. Some Honourable Membe rs: Oh, oh. Mr. Deputy Chairpersoo: Order, please. Could I have order, please? 1bere were comments made of which I am not sure, and I am not sure if they are on Hansard either, but, if they are, I will have the wording.

If it is there, I will peruse it, and I will come back with a ruling on this , but I would in turn also ask all memb ers and caution them to use their words cautiously and try to do it in a nice fashion if we can. I would like to see these Estimates proceed in a good mann er and would ask the co-operation of all members . [interjection] * * * Mr. Chomiak: If the member for Assiniboia (Mrs. Mcintosh wants to continue to comment, maybe she can explain something the minister has never been able to explain, the home care.

Perhaps she, at some point in this Estimates process, can try to do something that has never been done by the Department of Health, and that is explain their rationalization of their privatization of home care.

April 16, 1996 LEGISLATIVE ASSEMBLY OF MANITOBA 791 Mr. Chairperson, as I was indicating earlier, this government-it is very, very difficult, in the context of change and in the context of this environment, fo r members on this side of the House or for indeed the public of Manitoba to attach credib ility to the capacity of this government to bring about meaningful change and meaningful, adequate reform in 1he Department of Health, given the track record with respect to how frequently and how often 1he government has gone back on its word with respect to what they have said in health care .

It is very, very diffi cult fo r us on this side of the House to attach credib ility to the statements of the governm ent when 1hey fly in the fa ce of governm ent actions over and over again. I am sorry to say, Mr. Chairperson, that one of the difficulties in health ref orm is the ina bility of the public and the opposition representing the public to accept at filce value the comments and the arguments put fo rward by the governm ent on a whole variety of sub jects as concerns health ref orm.

The overri ding issue presen tly facing us-we just came from the Chamber dealing with this-is the area that concerns the home care dispute that is now bef ore us. We are in a situation fa cing a strike, in a strike situation, because of the inability of the governm ent to consult, to study, to indeed provide one single, rational argument in fa vour of their move to privatize. Mr.

Chairperson, I am convinced that if we had not leaked the cabinet document to the public of Manit oba, the governm ent would have, by stealth, introduced this privatization home care in the s umm ertime without even allowing fo r the limited public discussion that we have been able to invoke by virtue of releasing the document. This governm ent has not been able to provide one single study, one single expert, one single official, either inside or outside the governm ent, who can rationalize or can provide a justification fo r their plans to privatize home care.

If we just take a step back from this issue, and we argue it on a rational policy basis, and we say, let us put our cards on the table-and let us try to do that in the course of these debate s. Put your arguments fo rward as to why you are privatizing home care. Perhaps you can convince the public. Perhaps you can convince the opposition about the validity of your argumen ts, but if you cannot even put fo rward argument s, are members opposite surprised that we do not believe them when they talk about their plans to privatize home care?

Are members surprised when the public attaches absolutely no credibility to their statements concerning home care when they have not put together any arguments whatsoever, any policy arguments, any studi es, any rational thought, any objective viewer who can justify their decision to privatize home care? In light of that vacuum of argument, is it any wonder that people speculate outside this Chamber and inside this Chamber as to the reason and the rationale behind the governm ent 's initiative to privatize home care?

Is there any doubt that 1here are rumours rampant, that there are all kinds of allegations being made concerning the privatization of home care, in light of a complete absence of evidence, absence of data and absence of inf ormation justifYing the government 's move to privatize home care? Mr. Chairperson, the members opposite who sit back and make arguments about home care should come fo rward. They should provide the studi es; they should provide the policy initiativ es. Then we could have a debate .

One of the reasons that we have not had a debate is because there have been arguments only on one side because the governm ent side cann ot put fo rward any meaningful arguments justifying the decision to privatize home care . :11: (1 540) Since we have met last, the governm ent has also decimated the Pharmacare program as we know it, the Pharmacare program that 1he governm ent campaigned on. In fa ct, it is ironic that the Minister of Health spends more time talking about Sask atchewan, I dare say, on occas ion, than he does talking about Manit oba.

They put out a pamphlet during the election campaign saying that the Manitoba plan was so much better than the Saskatchewan plan, and what did they proceed to do after being elected? They put in place a program that is even more, that is even worse now, than the Saskatchewan plan. You know, again, at the stroke of a pen, without warning to the public, without consulting with the pub lic, wi1hout con sulting with seniors, without consulting with individuals who require this care, they decimated and virtually eliminated the Pharmacare program from the

792 LEGISLATIVE ASSEMBLY OF MANITOBA April l6 , 1996 vast maj ority of Manitobans. Again, if they were being intellectually honest-[interjection] Mr. Deputy Chairperson: Order, please. I am having trouble hearing the comments of the honourable member for Kildonan. Could we restrict our conversations at the table until you are recognized. Mr. Chomiak: Thank you, Mr. Chairperson. I understand the sensitivities of members opposite when you are given very little to def end your polici es. I understand how difficult it must be, how very difficult it must be to try to defend these initiatives.

So we have had the situation since last year of the virtual elimination of the Pharmacare program, the decimation and the turning on its head of the Home Care program. We are in a strike situation with regard to home care, Mr. Deputy Chairperson, and what do we come out of? We are coming out of a situation of a debacle in the emergency wards strike .

What other juris diction in this country has had the debacle that we saw the last fe w months with respect to the emergency wards where they were being opened, they were not being opened, they were justified opened, and the lack of studies and the lack of justification and the complete flip flopping of policy and the lack of direction from this government as respects the emergency ward?

We have had that since the last time we met, and is there any wonder that, again, members on our side of the House and indeed the public question the competence of the minister to deal with health care in the province of Manitoba? Further, Mr. Deputy Chairperson, we have bef ore us recommendations from an urban advisory committee recomm endi ng the closure of a number of health care facilities in the city of Winnipeg, more specifically, Misericordia Hospital and Seven Oaks Hospital. Now, the minister argues that these are only recommendations, and that he is looking at them.

Is it not interesting that we have had recommendations made for the closure of fucilities prior to financial data and a financial evaluation being done on those specific proposals? Is it not typical of the pattern and the mis management by the minister at the Department of Health that we would have recommen dations for closures of hospitals prior to the financial data and the financial cost benefit analy ses being done?

Is there any wonder why the public and why members on our side of the House question the cre dibility of this governm ent and the ability of this governm ent to manage health care in these very difficult times, to manage the change that is necessary , that all agree is necessary in health at these times, when you look at instances of mis management over and over and over again at the Department of Health? Mr. Deputy Chairperson, I do not know how many times the Province of Manitoba has spent the money that has been cut back from Ottawa with respect to health care.

When they froze the capital plan several months ago after prom ising in the election campaign and saying it was a fum commitment, they said that was the fe deral transfer payments. When they decimated the Pharmacare program, that was the fed eral transfer paymen ts. When they could not pr oceed with the cancer institute, that was the federal transfe r payments . When they got rid of eye care examinations, that was the federal transfer paymen ts.

You know, that money has been spent more often, I dare say, than probably fourfold-fourfold that money has been spent When they cut $53 million at a hospital budget this year , that was the federal transfer payments . At some point they are going to have to stop relying on that crutch in their arguments . They are going to have to face up to their own respo nsibilities as they relate to health care, and they are going to have to take the responsibility on their own.

This brings me to a very significant concern about the minis ter's and the governm en t's approach to health care-that is, the constant finger pointing that is being made in the health care field against those individuals who have disagreements with the governm ent policy.

First, it was the nurses that were causing all of the trouble in health care; then it was the doctors that were the straw men of the government; then it was the fe deral Liberal governm ent that was the straw man of the governm ent, that was the person ca using all of it; then it was the home care workers that were the problem in the system; then it was the hospital administrators that were a problem in the system, and then it is the opposition that is the problem in the system.

At some point, the government is going to have to take responsibility for its own policies, and it is going to have to stop finger pointing and blaming gro ups and blaming individuals and blaming others for what is happening in

April l6 , 1996 LEGISLATIVE ASSEMBLY OF MANITOBA 793 health care and accept the responsibilities for which they are elected and at least have the intellectual honesty to admit that these policies are their own policies. There is much change that is going on in health care. There will be much change that will be going on in health care in the future. It certainly is not helped when the government is not prepared to be forthcoming and provide adequate information and data to the public to allow them to discuss the issues in front of us. I cite the example of the physical examinations.

There is an agree ment entered into between the MMA and the government concerning the MMA agreement that was to last for a number of years . As part of the agreement, there is a negotiation be tween the government and the MMA and the setting up of a committee that was to determine cost savings in medicare, et cetera. One of the recomm en dations was for the elimination of physical exams every five yea rs. Now, when that was revealed publicly by us again that in fact this was a policy consideration, how did the government respond? Did the government come back and provide its arguments as to why? No.

The minister said he had only conditionally approved the recommen dation. Heaven knows what "conditionally approved" me ans. It is new in the lexicon that I have heard, but he has conditionally approved those recommendations and that they were waiting for more studies. Could the government not have said this is what we have been advised, this is what is bef ore us, this is what we want to save, this is what the rationale is, and this is what we are looking at? No. It was deep -sixed.

The information was not provided to the public, and the minister, because he was caught with the memo that said he had approved it, came back and said, well, this was not real approval, this was only conditional approval. Is it any wonder that when we hear about closures and potential closings at hospitals that we question the government and the minister when he says he has not finally approved it, when we have the games played with respect to conditional approval and nonconditional approval? * (1550 ) There is much change occurring in rural Manitoba, as well .

As we speak, the government is trying to set up its regional bodies and its regional boards. Again, it has been poorly administered, it has been poorly put into place, and we have the very unfair situation of having some boards appointed, some boards not appointed, gaps in boards appointed, a lack of repre sentation, and like so many initiatives of the provincial government, the regional health boards are up in the air, and it is unclear as to where they are going and what they are doing. We do know one thing, Mr.

Deputy Chairperson, that these boards are going to be charged with the responsibility and are to be given envelope funding to make major changes-read that cuts-from the Department ofHealth, major cuts with respect to services and health care in the communities that they serve. It is not helped when the government, again, is not forthright and is not able to provide the public with directions and ideas .

Can the government not provide a listing and a public documen tation as to what constitutes core services for these regional boards, what services are to be provided by the regional boards, what are not, whether or not there will be government home care services avai lable for these re gional boards to choose to offer to patients in their regions, or whether or not the only option for these boards will be privatization? Can government not at least offer to these boards and to these communities the opportunity of knowing what the param eters are in terms of the government approach?

I dare say that either it is not available, and if it is availab le, the government is ne glecting to make this information public, to provide it to the public and to provide it to the people of Manitoba to allow them to make adequate decisions as to what is happening and what is to happen in the future health care of Manitoba. Mr. Deputy Chairperson, we have seen in this budget the most massive cut to hospitals ever in the history of the province of Manitoba. We have seen the institution of a transit of some kind of a fund, of a $38-million fund, to deal with changes in health care .

Again, we have no information whatsoever about what is entailed by these changes, why the government is so precise in terms of the $53-million cutback, but why they cannot provide us infonnation as to how and where these changes are being made . We do not have any ideas as to who administers this $38-million fund. We do not have any understanding as

794 LEGISLATIVE ASSEMBLY OF MANITOBA April 16 , 1996 to how it is to be applied. We do not have any understanding as to what the future direction is of urban hospitals in Winnipeg. Again, it shows up, and it appears to be like so many other things that I have seen by the Department of Health. It seems to be hodgepodged on and more an effort to gain public rel ations credib ility rather than to deal with meaningful public policy initiatives by the governm ent. Mr.

Deputy Chairperson, we will probably spend a good deal of time during the course of these Estimates dealing with the home care initiative of this governm ent and dealing with the governm ent 's headstrong attemp t to privatize completely home care in Manitoba. I hope for the sake of the public of Manitoba that the minister is prepared to provide the rationale behind-you know, the minister keep s talking about his $8-milli on initiative in home care, and we recognize that the governm ent is providing $8 million in home care this year.

You know what, it is very interesting for the past three years we have been using statistics with regard to home care that-[inteijection] Perhaps the member for Assiniboia (Mrs. Mcintosh), who is so versed in health care policy with respect to 19 86-87, can enlighten this House by telling us what Connie Curran recommended with respect to home care, a report that was done as recently as two years ago, but is afraid or unable to provide the recommendati ons for that, Mr. Deputy Chairperson.

I doubt very much that we will hear from members opposite what was in the Connie Curran report, and I welcome the opportunity for the members opposite to provide us with the details of that so that we can disc uss the home care issue. But, Mr. Deputy Chairperson, the government has provided $8 million to home care this year, and I ask the government, is that money directed towards profit? This is the first significant increase in home care allocation and :fimding, the first significant incre ase.

Now that they have provided the first significant incr ease, is that money going to be directed towards- Point of Order Bon. Linda Mcintosh (Minister of Education and Training): On a point of order, Mr. Chairperson, I distinctly heard the member offer to give the microphone over to me, but then he did not pause in his speaking to allow me to take up his cballenge. I do not believe it was a bl uff; I hate to think it was a bl uff. But he did not then follow through on his offer- Mr. Deputy Chairperson: Order, please.

The honourable Minister of Education and Training does not have a point of order; rather a dispute over the facts. * * * Mr. Chomiak: Mr. Chairperson, I want to close by indicating that we will be looking for the governm ent to provide some kind of information and some kind of rationalization for their privatization initiative with respect to home care.

We will be looking for the government to provide us with information and with justification for their move, and we will be pressing the governm ent to do the right thing, to put the privatization plan completely on hold, to stop that program, to permit the changes to occur in home care within the public system that can and should occ ur.

Members on this side of the House have never suggested that changes cann ot and should not occur in home care, but to continue in the public sector to allow for the improvement in home care, not to take a system that is recognized as one of the finest in North America and turn it on its head and not permit the public, the caregivers, the patients who receive home care to have any input whatsoever into this ill -advised policy.

We will be looking for members opposite to try to justify that decis ion, and we only hope, for the goodness of Manitobans, that they will see the light and recognize the danger of what they are doing, that they will recognize the fallacy of their decision and they will put the plan for privatization on hold and permit us to go continuing to offer to clients in the home care system the best possible service available to them, and allow us to change and ref onn the H<me Care program along the lines that ought to be undertaken to permit for a variety of service, to allow for those additional individuals who require home care , to allow them to develop in the system, to allow for a more expanded system, to allow for a more flexible system and to permit that under the auspices of the present home care system as it operates now.

Thank you, Mr. Chairperson .. Mr. Deputy Chairperson: I believe at this point the honourable member for Inkster has a request of the commit tee.

April l6 , 1996 LEGISLATIVE ASSEMBLY OF MANITOBA 795 Mr. Kevin Lamoureux (Inkster): Mr. Chairperson, I would request leave to be able to give some sort of opening remarks to this department. Mr. Deputy Chairperson: Is there leave fo r the member for Inkster to make opening comment s? There is leave? It is agreed? Mr. Steve Ashton (Opposition House Leader): Mr. Chaixperson, it is certainly agreeable to our caucus. We are not setting any precedent now, but given the importance of a lot of the issues here, I think it would be only appropriate for the member fo r Inkster to be given leave. Mr. Lamoureux: Mr.

Chairperson, there are a number of things that I would like to say. Health care is indeed a vety passionate issue. It was just under a year ago that I was app ointed the Health critic fo r our party, and there is no doubt a fa irly significant learning curve that is applied whenever someone is given a new respo nsibility. This is a portf olio that has proven to be most challenging and interesting at the same time, and we notice that there has been a lot that has happened over the last 11 months since the last provincial election in health care that is having a very dramatic impact.

As a result of that, what we see is emotio ns, as I say, running high on a number of diff erent areas. What I want to do is take this particular opportunity to comment on five or six diff erent areas in which there has been a lot of pro file publicly on issues in health care and right at the beginning to start off by giving the governm ent somewhat of a compliment, a compliment in the area of what I would classify as a good idea, that of course being the SmartHealth contract. We do have some concerns with that particular contract, the primary one being that of secrecy, ensuring confidentiality.

We will, no doubt, want to question the government in terms of what is being done to ensure that that confidenti ality is . not going to be breached at any point in time, but we recognize, having said that, Mr. Chairperson, that when we look at the concept or the idea as a whole that it is a step in the right directi on. * (1 600) This is, in fa ct, not the first time where the Liberal Party has supported health care initiatives, whether it was mental health a number of years ago or the action plan back in 1992 when we had supported the concept of deinstitutionalization ofhealth care.

We are not reluctant to say to the governm ent when they are doing a good job that we appreciate the eff orts and so fo rth, but there are a number of areas in which I believe and the Liberal Party believes that the government has to rethink what direction they are taking the province of Manitoba. I would suggest to the government that it is not bad for government per se to reflect and change their minds if they in fa ct recognize that a statement or a rec ommendation or a policy position does need to be changed.

I tried to ref er to this earlier during the MUPI and the Members ' Statements and in previous que stions whether it was in this spring ses sion or last fal l's session that we have to make sure that we have our priorities right. The priority that we have and will maintain is in fa ct the patient or the client of the services that are in fa ct being delivered. That is why, Mr.

Chair person, when the government does do something good, relatively well, we will ap pla ud them in that area but, as an opposition party, our primary responsibility is to look at where government is not doing things properly and to try to rectify that problem . I want to pick up on a fe w of those points . One of them which I believe is ultimately just a real bad idea is the whole way in which we are handling our hospitals, our urban hospitals in particular in the city of Winnipeg. Last November, we had the Minister of Health (Mr. McCrae) put together a commit tee which was chaired by Mr.

Wade, the Deputy Minister of Health, and befor e I get into this I should, in essence, compliment all members of the civil service within the Department of Health for no doubt the amount of eff ort that they put in to providing a system of health which en masse a vast ma j ority of Manitobans are quite satisfied with, but, in some cases, I would have to indicate to some, in particular the curr ent Deputy Minister of Health, that I am going to have to agree to disagree with the direction that is being taken. Why do I say that?

Well, primarily, what we have seen is a number of recommendations that are going to change the direction of the way in which we are administering our health care through our community hospital s, a

796 LEGISLATIVE ASSEMBLY OF MANITOBA April 16, 1996 significant change which is goin g to be extremely difficult to reverse once we find, and I believe ultimately that we will find, that there is a need for expansion of connn unity hospital facilities, that in fact we are moving in the wrong direction. I would go back to the former Minister of Health, Mr.

Orchard, and the former deputy minister, where they in their action plan talked about how wonderful the connn unity hospitals and the concept of connn unity hospitals were to the province of Manitoba, again focusing a lot of that attention on our urban hospitals. Well, our Liberal Party had supported that concept, as I earlier had alluded to.

That is why we were quite surprised when we saw a recommendation-that reco nnn endation was chaired by the Deputy Minister of Health-that saw the Seven Oaks Hospital converted over to a geriatric centre and the Misericordia Hospital converted into a glorified, if you like, walk-in clinic as opposed to its current role. Mr.

Chairperson, I find it very difficult to understand how it is that reco mmen dations of this nature could have come into being, given that I have had discussions with individuals that have sat on that particular committee in which they fee l that there is very little merit to these reco nnn end ations, and these are individuals that participated in the decision-making process for these recommenda tions. I am talking about, in particular, a number of CEOs, not only from community hospitals, that in fact a number of individuals have implied to me that vested-int erest groups around the table won the day.

Our community hospitals need to be addressed in such a fashion in which the best interests of the community as a whole, not only the city of Winnipeg because our community hospitals service more than just the city of Winnipeg, but all Manitobans are in fact going to be addressed. What we have seen is a 180-degree turn from the action plan. (Mr. Frank Pitura, Acting Chairperson, in the Chair) Because the governm ent has said that they have not accepted this recommenda tion, I would like to see the Minister of Health (Mr.

McCrae) hold, in particular, this committee which was chaired by the deputy minister, more accountable. That is why we as a Liberal Party fe lt that if we were provided the opportunity to challenge the recommendations put forward by the deputy minister and his committee, we would be able to demonstrate that in fact these recommendations were not in the best inte rest of Manito bans.

At the very least, what we should have seen is a number of options provided to the Ministry of Health, provided to the elected officials that said, here are different visions , if you like, that are quite viable , one that would have seen comnnmity hospitals playing a more significant role. We ultimately believe that there was very little financial accountability or analysis that was done, and we have seen recommendati ons that were based on speculation in most part and turf protection.

There are other areas, such as the home care services, which we find is more conservati ve philosophically being driven than anything else. We have an ideological governmen t that is saying, look, we want to privatize this area, and they have not demonstrated to the clients , to Manitobans, to the workers , that this will in fact save tax dollars or this will in fact deliver a better quality of service s.

The governm ent has failed to do that, and we have to impute a number of motives as to why the governm ent has been unsucces sful in providing that information so that they would be able to allow for good, healthy debate . We as a party look at it and fear that this so-called privatization will have a very demeaning impact on the health care profession as a whole in terms of those individuals who provide this service, that the quality of service that is going to be delivered is in fact going

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Collection	Manitoba — Debates (Hansard)
Citation	36-2-18
Type	hansard
Volume / chapter	36th 2nd hansardpdf 18.pdf
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	f0054094c65b9919a07090730c7732ea6204844f

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