LEGISLATIVE ASSEMBLY
OF
Monday, June 7, 1993
The House met at 8 p.m.
ORDERS OF THE DAY
(continued)
COMMITTEE OF SUPPLY
(Concurrent Sections)
EDUCATION AND TRAINING
Mr. Deputy Chairperson (Marcel
Laurendeau): Good evening.
Will the Committee of Supply please come to order.
The committee will be resuming
consideration of the Estimates of the Department of Education and Training.
When the committee last sat, it had been
considering item 2(a)(1) on page 35.
Shall the item pass?
Hon. Rosemary Vodrey (Minister of
Education and Training): Mr. Deputy Chairperson, I said
earlier this afternoon that I would table for the members a copy of Seeking a
Balance: Parents' Guide to Help Children
Succeed, produced by the Native Education Branch of the Department of Education.
Ms. Jean Friesen (Wolseley):
Mr. Deputy Chairperson, we were at the end of last time looking at the‑‑what
I was hoping for was at least a standard basis that we could agree to have some
discussion about, but there does not seem to be a standard basis for
discussion, so any questions about changes, improvements, success rates,
improvement in program expansion and program impact do not really seem to be
very helpful since we do not have any basic assumptions that we can start from.
Let me ask another question which is again
arguing from the line that this section of the department is supposed to
encourage success, support the success of native students. One of the elements of success for native
students has been the increasing ability of
I want to ask the minister what changes
there have been in that area. What are
the changes in the numbers of native teachers in
* (2005)
Mrs. Vodrey:
Mr. Deputy Chair, that information would not be available under this
line of the Native Education Branch. We
might have this information under 16.5(b), which looks at teacher
certification, but again teachers may only declare themselves by language of
preference; they may not declare themselves by ethnic group. So that seems to have been one of the issues
we have been looking at over the past few hours, whether or not people wish to
declare their membership as part of an ethnic group or not.
Ms. Friesen: Mr. Deputy Chair, but the department does
support programs precisely for the production and graduation of native
teachers, and it seems to me that should be part of the consideration of the
minister in the context of native education.
That is why I am asking, what have been the graduation rates in the last
few years of native teachers?
Mrs. Vodrey:
Mr. Deputy Chair, I have said to the member that she might like to look
at it under a specific area where we look at teacher certification.
I would also remind her that the Native
Education Branch's mandate is to deliver programs and services to both native
and non‑native students.
Therefore, all schools are potential clients of this particular branch
regardless of the number of native students enrolled in a particular
school. So we do have some data, as I
said, on some key programs.
Mr. Deputy Chairperson:
Order, please. There has been a
recorded vote requested in the other Chamber.
The committee will resume after the vote.
The
committee recessed at 8:09 p.m.
After
Recess
The committee resumed at 8:29 p.m.
Mr. Deputy Chairperson:
The committee will come to order.
Ms. Friesen:
Mr. Deputy Chair, well, the minister was trying to divert my question
again, as usual, not wanting to answer questions this time about the graduation
rates of native teachers, in spite of the fact that this is a section of the
department which does provide professional development to teachers and which I
would have thought would have had an interest in the number of aboriginal
teachers who were in the system, coming into the system, and who are in need of
professional development.
I wonder if I could pose the question
again. Could the minister tell us how
many native teachers are now in the
* (2030)
Mrs. Vodrey:
Mr. Deputy Chairperson, the member is absolutely wrong in anything she
says regarding the efforts to answer her questions. The answers have been provided to her. She may not like them, but the answers are
provided. So I must say that I object
strongly to anything that she says in that regard, and the record will speak
for itself.
As I explained when I answered the last
time, we do not have those numbers.
Those numbers would only be available if we were to go to each school
division, ask each school division to poll the teachers within their school
divisions and ask those teachers to self‑declare. We do not have the information on those
teachers who are aboriginal and, as I explained to the member, we do provide a
service to education in
Ms. Friesen:
But the minister does have programs in her department which support the
production and graduation of native teachers.
Those are the ones I asked about since those are ones that she
presumably has numbers on. The minister
then tried to answer this by referring to the other section of the department's
role, which was to deal with cross‑cultural education. That is what I meant by trying to divert the
answer.
The question was quite simple. How many native teachers are being graduated
and how is that rate changing in the programs in which the minister does have
responsibility?
Mrs. Vodrey:
Mr. Deputy Chair, as I said to the member, this information might be available
in the lines which look at post‑secondary education, Universities Grants
Commission and also information on the Advanced Education and Skills Training
section of this department.
Ms. Friesen:
Does that mean that this section of the department, which provides
professional development to teachers, has no knowledge of, no concern about
dealing with the number of native teachers in the
Mrs. Vodrey:
Mr. Deputy Chair, let the member not be critical of the members of the
staff of the Department of Education, let her not be critical and say that the
members of the Department of Education staff do not have concern for‑‑
Point of Order
Ms. Friesen:
At best, I assume that the minister misunderstood what I was
saying. At worst she is trying her
McCarthyite tactics again, which is to put words into my mouth. I am speaking through you to the minister. I am not speaking about the staff. She has done this before.
Mr. Deputy Chairperson:
Order, please. The honourable
member did not have a point of order. It
is a dispute over the facts.
* * *
Mrs. Vodrey:
Mr. Deputy Chair, now the member and the record will show what the words
were that the member used: did the staff
not have concern for. So I will remind
her please not to make those comments about the staff of the Department of
Education and Training.
I will also tell her now that this
division does work collaboratively. We
work collaboratively with the field and we provide in‑servicing for
teachers. Those teachers may be
aboriginal, may have aboriginal backgrounds, or they may not. We provide in‑servicing and support to
teachers and school divisions within
Ms.
Friesen: Mr. Deputy Chair, I will
remind the minister that my comments are directed at the minister and her
responsibilities, and I believe that the words I used were "section of her
department," so I reject what the minister has said. I reject her manner in this particular answer
to the question. The question still is‑‑
Point of Order
Mr. Deputy Chairperson:
Order, please. Could I ask the
honourable members to put their questions through the Chair? It will avoid a little bit of the decorum
problem we are having at this time.
* * *
Ms. Friesen:
Mr. Deputy Chairperson, the question I have been asking the minister
is: What are the graduation rates of
native teachers, the ones who form part of the groups whom this section of the
department deal with in terms of professional development and indeed deal with
in committee terms as well. I notice,
for example, a number of committees have native teachers on. It would seem to me that this would be a
concern of the minister in this section of her department, that native teachers
are one of the most important elements of success in native students, which is
the focus for this section of the department, and I am quoting from the Annual
Report, to increase native students' opportunities for academic success. One of the things that
I am asking the minister, in those
programs which are under her jurisdiction, how have those graduation rates been
over the last two or three years?
Mrs. Vodrey:
Mr. Deputy Chair, as I have explained to the member, those statistics if
available would be best discussed under the Universities Grants Commission,
which provides us with information from the university programs or from the
Advanced Education and Skills Training section which provides us with
additional information regarding programs such as ACCESS. The numbers are 16.7 for the UGC and 16.6 for
AEST. I can tell the member, however, as
she looks forward to those sessions, that we do not identify students by ethnic
origin, and we cannot give a precise accounting of the number of aboriginal
students that
Ms. Friesen:
Mr. Deputy Chairperson, then I understood that the term BUNTEP stood for
Brandon University Native Teachers' Education Program. Has the minister perhaps misunderstood the
question, or what information is she relaying in that they do not ask students
to identify themselves? There are
certain programs which are directed particularly towards native people, and
that is one of them. I am looking at the
graduation rates and the changes of those graduation rates in
Point of Order
Mr. Deputy Chairperson:
At this time, I would just like to inform the members of the committee
that the words "McCarthy tactics" have been ruled as an expression
that would cause intervention on the part of the Chair when it is brought
forward. So I would ask the honourable
members to choose their words carefully when they are bringing forward, so we
can keep the decorum to a good level.
* * *
Mrs. Vodrey:
Mr. Deputy Chairperson, again, as I see there is no acknowledgement
coming from the member regarding your comments, let me continue.
My answers are the same, that these
numbers would best be discussed under the area of the department in which we
would have the staff available and also the numbers which are available to us.
But I would remind the member again that
students would have to have declared, regardless of the program, that that is
their particular background. The member
has spent quite a long time looking and wanting to discuss very specifically
the native ancestry, particularly of certain employees of school divisions,
certain students who are served by this department.
I will remind her again that the
information, the amount to which it exists, would be available under 16.7 and
16.6. The Native Education Branch is not
mandated to gather stats on the teacher graduation rates.
Ms. Friesen:
The Native Education Branch, however, is mandated to provide
professional development to teachers of native students and of non‑native
students. Since the minister is not
prepared to discuss the numbers of native students in
Could you tell us about the impact on
professional development activities of this section of the department as a
result of the government's policies on professional development days?
Mrs. Vodrey:
Mr. Deputy Chairperson, I am pleased the member will direct her
questions now according to the line that we are covering.
Although the branch plays a leadership
role in school planning, it encourages schools to take ownership for their
decision making and to establish a school community network which is integral
to the Native Education initiatives. In
addition to the school‑based in‑service delivery, the Native
Education Branch has collaborated with the
* (2040)
The Native Education Branch co‑operated
with the Winnipeg Education Centre to deliver the Native Education Summer
Institute in July of 1992. The Native
Education Branch also will assist the
That is an example of some of the
professional development work which the Native Education Branch has been a part
of in the past year, and I know that the member has been interested to know
about the kind of professional development in‑service work that the
department has been a part of.
She asks again how any changes that school
divisions may wish to make about the number of in‑service days which they
provide, and we have discussed this before.
School divisions will make the determination as to how many, if they
choose to use any or all or some of the days.
We have also talked about the fact that in‑service training can
also be delivered in a number of ways and that school divisions have available
to them a certain amount of money for professional development, and they may
choose to send a member to a professional development training course,
particularly in the area of native education.
School divisions are the employers and they will decide the amount of
time that would be made available for this in the coming year.
Ms. Friesen:
Mr. Deputy Chairperson, I assume the minister has some deadlines by
which she would need to know, for the purpose of planning in her department,
when or if school divisions are going to take the government's advice on
professional development days.
Could the minister give us an idea of what
kind of timetable the government is looking at in this sense?
Mrs. Vodrey:
Mr. Deputy Chair, school divisions are not under an obligation to notify
the Minister of Education regarding their plans. They do notify the Minister of Labour (Mr.
Praznik) and they are to notify the Minister of Labour 30 days prior to their
implementation. So, in that way, the
Department of Education does not necessarily have to receive an official
notice.
I can tell you though that the Native
Education Branch does have some programs already planned for next year, one
which involves parents. It involves
parents and children in terms of an education in‑service, and it will
take place in the early part of November 1993.
Ms. Friesen:
Mr. Deputy Chair, presumably, however, some of the activities of this
section of the department still will be oriented towards teachers. The department is not necessarily going to
know very long in advance how many and where and when teachers will be
available. So I am looking at the impact
on this section of the department, which presumably depends, in some cases at
least, on the gathering together of teachers from different school divisions
for professional development days or for in‑service days.
How is the department going to plan for
the next year under those conditions?
Have they, for example, decided only to deal with parents?
Mrs. Vodrey:
Mr. Deputy Chair, no, we do not plan to deal only with parents, though
we certainly believe that parents are a very important part of the education
process and are very pleased to have some programs already in place which will
involve parents. But, as I have said to the member, we do not know yet exactly
how many divisions are taking advantage of exactly how many days. So we believe that divisions who wish to have
in‑servicing in the area of native issues and cross‑cultural issues
will still be able to be in‑serviced, but the in‑servicing may, as
we have said before, take place in many different ways. I have referenced the funding available
through the funding formula for professional development. Some divisions may choose to use some of the
in‑service days, and I have also spoken about some of the co‑operative
work in which the Native Education Branch is going to be working with
Ms. Friesen:
I do not think that the minister is answering the question. I am asking about the planning in the
department under the conditions where the government has, in fact, set in
motion a series of decisions by school boards and by teachers where planning is
made very difficult. It seems to me that
this area of the department is, amongst others, where that kind of planning
will be most difficult, and I am wondering how the minister is going to deal
with that‑‑(interjection)
Point of Order
Mr. Deputy Chairperson:
Could I ask the honourable members to tone it down just a little
bit? I am having trouble hearing the
answers from the minister, so I do not know how the members can hear. So if we can just keep it down to a mild
roar, I will be happy.
* * *
Mrs. Vodrey:
We undertake planning when we hear from a number of divisions or we have
a number of requests for in‑servicing in the area of native education and
cross‑cultural issues, and we have heard from some divisions
already:
Ms. Friesen:
Mr. Deputy Chairperson, one of the often quoted, in recent days at any
rate, statistics about
* (2050)
Mrs. Vodrey:
Mr. Deputy Chair, throughout the Department of Education and Training,
we recognize the needs to support students who are perhaps at risk in some way,
and the Native Education Branch does provide some support as does our Student
Support Branch.
When we first began the Estimates of the
Department of Education and Training, we spoke about the department forming a
view where members of the department who worked in various areas could
understand and also take some responsibility for the concerns that were
presented in all of education and not to just have simply a very segmented view
of education.
So I remind the member of that, but I can
tell her that the Native Education Branch focuses on strategies which are
effective in promoting the retention and the academic successes of native
students. We have one, the support for
school‑based planning, to help teachers adapt their curricula, their
classroom resources and teaching styles to build on the strengths of native
students.
Secondly, an implementation of an
integrated in‑service model which aims at involving schools and parents
and other government departments and native organizations in a collaborative
planning and a delivery of in‑services.
We also offer program support for
divisions or districts funded under the English Language Enrichment for Native
Students Program. Its goal is to promote
academic success by enhancing the English language skills of students who speak
a native language or a nonstandard dialect of English.
Also the promotion of the Stay‑in‑School
programs designed to strengthen the linkages between education and employment;
promotion of the Aboriginal Career Awareness Days which featured native role
models; early intervention programming that stresses the importance of home and
school partnerships and the role of native parents as their child's first
teachers; the Cultural Awareness and Anti‑Racism Workshops with native
and non‑native students to build positive relationships and interpersonal
communications and to develop self‑esteem.
So that is some of the active work
undertaken by this particular branch to assist native students. I believe that is who the member was
referring to. She spoke about young
people who live in poverty, and then she spoke about a‑‑in her
words and this is my paraphrasing of her words‑‑disproportionate
number of those young people who may be aboriginal. So these are some of the initiatives which we
have undertaken to assist those students.
Ms. Friesen:
Mr. Deputy Chairperson, the minister has argued that we should look at education
holistically, and yes that is true, but her answer addressed really only the
issues of child and family.
Does this section of the department, does
any section of the department‑‑did the department's submission to
the Northern Economic Commission, for example, look at whole communities which
are poor, communities where in fact people are not just looking for role
models, but where they are actually hungry?
I do not necessarily mean just the city of
Mrs. Vodrey:
The member has asked to, in her second question, move beyond the issue
of the nuclear family, the immediate family, into the area of community. The Student Support Branch, using the 1986
census data for each school community, each school community was assessed using
the incidence of low income and single‑parent family data. In the
Using the 1990‑91 school base data,
schools were asked to identify the number of students in the school that had an
absenteeism rate of more than 30 days.
For example, out of a population of 315 students,
Using the most recent home reporting
student assessment information, again through the Student Support Branch, for
the 1991‑92 school year, schools were asked to identify the number of
students who were two or more years below their age group in reading and in
numeracy skills. For example,
Then using the 1990‑91 data, schools
were asked to document the total number of students entering school from October
1, 1990, to June 30, 1992, and the total number of students leaving school in
the same period.
I will say to the member that last year in
its first year of operation the Student Support Branch was funded at $10
million, and this year in the second year of its operation, the funding is at
$10.5 million.
* (2100)
Ms. Friesen:
Could the minister tell us how this kind of information and this
recognition of what are some very dramatic situations, whether you look at it
in terms of migrancy or in terms of other criteria that the minister has just
discussed, what is the impact of this on curriculum development in this
particular section? For example, what I am
trying to get at is that there are two roles for this department.
One is to ensure increased native
students' opportunities for academic success, and you are starting from a
situation in a number of aboriginal communities, whether it is
Mrs. Vodrey:
One of the important things is not to establish a totally different
curriculum. That has been, I suppose,
one of the difficulties. We want to make
sure that all students have access to the most excellent curriculum. That is certainly what we are striving to do
with our curriculum in Manitoba Education and Training.
The key to the curriculum is really what
you do with it when you are working with the students. The key rests with teaching methodology. It rests with the grouping of students and it
also rests with some of the resources which may be provided to help the teacher
and the student work together through the curriculum.
In the Student Support Branch, the
following materials have been developed in support of some classroom
programs. The intent is to increase the
relevance to the experiences of students and to increase the hands‑on
experiences.
In the social studies area, we have
developed one called the Powwow Kit, and this kit is intended to assist
classroom teachers in recognizing and respecting the powwow tradition. This includes introductory activities at the
end of each section, the drum, the songs, the dance and the outfits.
The second example is Tapping the Gift, a
collection of aboriginal
Curriculum Services also promotes
implementation and program adaptation at the school division level in six
ways. We spoke about the adaptation of
the curriculum as being important in terms of the methodology. One of the first areas is through curriculum
support documents, as I said, which articulate practical implementation ideas
for teachers or which outline sample adaptations for areas such as remediation
or extension or differentiation. Secondly,
through regional presentations and workshops delivered by the Curriculum
Services consultant staff; and, thirdly, through sessions delivered at the
initiation of school divisions or regions which request presentations or
workshops, and again these are delivered by the Curriculum Services consultant
staff and co‑ordinated by Curriculum Services consultants. Fourthly, through Distance Education training
sessions, co‑ordinated and delivered by Curriculum Services, consultant
staff may work collaboratively with the Distance Education technicians and the
external agencies; fifthly, through collaborative support efforts with
curriculum leaders; and, sixthly, through consultant support to provincial or
national conferences related to curriculum implementation of program
adaptation.
So we attempt to support through those
five areas to assist in how the curriculum may be delivered and then we have
also attempted to assist through some of the additional resources, and I have
described a few to the member this evening.
Ms. Friesen:
So it comes back, as it so often does, to the teacher, and again I
express my regret that the minister in this context does not want to talk about
the role of native teachers in this particular section, or indeed
(Mr. Jack Reimer, Acting Deputy Chairperson, in the
Chair)
Could I ask, then, something that is
written in for this particular line and this particular section, which is the
improvement in teaching practices as one of the Expected Results of the role of
this section of the department? Can the
minister give us some indication of how teaching practices have improved in
We looked last time in Estimates, last
year in fact, of evidence of changes in the classroom, changes in attitudes
that were anticipated by new curriculums.
At that time I felt that the department really had very insubstantial
ways of documenting the changes in the classroom, so I am trying this year to
look at the changes in teaching practices which the minister may have more
information on and which may be perhaps more directly documentable.
Mrs. Vodrey:
Mr. Acting Deputy Chair, first of all, let it go on the record that I
have been very willing to speak about native teachers when we get to the line
which looks at the training of native teachers and when I may have available
more of the detail information that the member would like to have covered.
However, she has asked, do we have any way
to look at any benefits which might be occurring as a result of work being done
by the Student Support Branch or the Native Education Branch. We have collected through our student support
grants program implementation comments from eligible schools. I would just like to read a few to the member.
This one comes from Frontenac School
Division, School Division No. 3, and it is a quote: The opportunity to attend professional
development sessions, time for team development, and planning and the direct
assistance of personnel from the Student Support Branch have been invaluable
supports for our work to date.
Then from Morris School Division, No.
19: Numerous benefits have been evident
from the implementation of the program in their school from the Student Support
Branch. The school and the staff are
working and planning co‑operatively through inquiries about specific
special needs students. Teachers
attested that these students have greater awareness of social skills and have
improved their interaction. Teachers are
beginning to see themselves as resources to nourish the unique strength of each
student, thereby providing a means for students to share those strengths with
each other. This enabled at‑risk
students to achieve increased confidence and a higher success rate. From the classroom environment to the
lunchroom to outdoors, co‑operative learning strategies are helping to
reduce discipline tensions.
From La Verendrye School, the response
is: What have been some of the outcomes
of our Try Another Way program? We have
some trained teachers that feel that they have a handle on some of the problems
that we felt were outside of the realm of our solutions. We have families that believe an honest
attempt is being made to make their school a safe place, and we have students
that can see there are other ways to solve problems besides striking out. That one also carries on.
* (2110)
In the area of instructional strategies,
from
From Hastings School: I feel very positive about co‑operative
learning in our classroom after spending a lot of time focusing on developing
basic social skills. The class is now
able to incorporate academic goals well.
From
We have a number of other responses which
have come from schools.
So there have been a number of supports
which have been given to the field in which there has been anecdotal responses
where people have described the changes that they see.
Ms. Friesen:
Mr. Acting Deputy Chairperson, I think those are excellent indications
of the way teachers feel about professional development days, and perhaps a
reminder to the minister that it is not very productive for education in
Those were a few examples. They sounded very positive and it sounded as
though they had direct impact in the classroom.
I think everyone, including the minister, will welcome those and see the
value of professional development days.
I wanted to ask the minister, as a follow‑up
to that again, effective teaching and improvement in teaching practices, how
this kind of improvement and change is communicated to parents and how are they
brought into that circle?
(Mr. Deputy Chairperson in the Chair)
Mrs. Vodrey:
Just to comment on the member's remarks around in‑service, let me
remind her that in the kinds of programs which I have just spoken about, there
has been a shared responsibility. There
has been certainly support from the department in the areas of grants. So we certainly have provided for the
assistance to individual schools and teachers to deal with the area of in‑service
in the particular programs that I have spoken about.
In terms of involving the parents, it is
very much part of what happens within individual schools. We do encourage individual schools to set up
these relationships and to promote a local dialogue with any of the programming
which we have assisted through grants, because, again, a number of the programs
are at the ideas of a local school and that is how they have been funded. But just to give you some idea of some of the
programs, first of all, we have had some programs, home‑school programs,
and these are programs designed to promote more effective parent‑school
communication about school programs and children's progress. They include home visits, increased phone
communication, school newsletters, information on skills required of students,
increased parent‑teacher conferences and informal parent evenings.
There are also early school years language
development programs. These programs
assist children in the Grades K through 4 with language difficulties by
providing specialized programming and involving parents so that school learning
is supported in the home. This includes
providing specialized training for parents.
In addition, we have early literacy
programs. These programs promote parent‑child,
or kindergarten through 4, literacy activities in the home, and they are co‑ordinated
with the classroom reading and writing.
They include some home reading and some home writing programs.
We also have home math programs. These programs promote parent‑child
math activities that reinforce math skills by co‑ordinating the
activities with the children's classroom programs.
We have family intergenerational literacy
programs, parent educational programs, parent volunteer mentor programs,
services to immigrant students and families, and programs for adolescent
parents.
Ms. Avis Gray (Crescentwood):
Just a question on the Native Education section, does the staff in this
section work with the organization‑‑and I might not have the name
exactly correct‑‑Manitoba Indian Cultural Education Centre on
Sutherland?
Mrs. Vodrey:
I am informed that there is a consultative relationship with this group,
and we also use the people's library as a referral support. Also, we do refer people who are looking for
a very particular type of expertise to this particular place.
I would also, Mr. Deputy Chair, just like
to table‑‑I would have to ask you if you could prepare some copies‑‑but
just in response to the final question from the member for Wolseley, when asked
about the role of parents, I can just say that I refer to the Dauphin Herald,
and I am happy to table this, that there were two parent conferences held in
the Dauphin region. They were organized
by a committee with Native Education, school divisions and community
organizations, and they do say that the conference was well received. I am happy to table that newspaper article.
* (2120)
Ms. Gray:
Does this Native Education section actually use some of the
resources? Have they incorporated some
of the resources that the Manitoba Indian Cultural Education Centre have developed,
and have they incorporated that and actually used them to pass on to teachers
who are involved in teaching culturally appropriate programs?
Mrs. Vodrey:
I am informed that, no, we have not used many of their materials but, in
fact, have supplied them with materials from our Native Education Branch,
particularly in the area of videos.
Ms. Gray:
I actually want to ask a few questions in this area, this entire Program
Development and Support Services, in the area of special needs. I may be presumptuous in this, but I would assume
that the minister might agree that, when we are dealing with the education of
children with special needs, we probably have not reached an ideal or achieved
all of our objectives in this area in that there still are areas that need to
be refined and resources that are needed in the area of special needs. I am wondering if the minister could identify
for us what she sees as sort of the three or four major difficulties or
stepping stones, however you want to use the term, in terms of reaching better
education for children who have special needs.
(Mrs. Shirley Render, Acting Deputy Chairperson, in
the Chair)
Mrs. Vodrey:
Madam Acting Deputy Chairperson, first of all, in terms of initiatives
and areas of concern, I would like to speak about the initiative which we have
underway in the additional funding available at Level II and Level III for
emotionally and behaviourally disordered young people.
In the past, there had not been a
recognition and had not been the way to access funding on behalf of these young
people which then would provide them with the classroom supports that are
necessary. Certainly, having worked in
the schools and having been in many cases the person who was the resource as
part of a team in looking at the behaviour management for emotionally,
behaviourally disordered young people, I certainly see that as a development,
and we look for some feedback from the schools over this year as they begin to
use that particular funding.
We have also, through the changes to the
funding formula, provided that Level II and Level III funding for the deaf and
the hard‑of‑hearing students.
Again, that was a recognition of some of the supports that those young
people who may be called special needs would need in school and perhaps there
had not been the availability of funding that they could access in order for
support.
In a second area, I would say that there
has been a development in the ADAP process which is where school divisions identify
the kinds of supports that they would like to have in place, the policy that
they would like to have in place regarding special needs children. Certainly, the department has noted that
there have been some significant changes, that there has been policy
development occurring at the local level, that there has been increased
parental involvement.
We have spoken over the course of these
Estimates of the importance of having parents involved in a child's school
life. Where there is a special needs child, parents are very integral in the
child's school life also because, particularly in the area of behaviour
management, often there is a requirement that behaviour management which is put
in place in school to be reinforced in the home so that the child is getting a
single message as opposed to a variety of different messages.
As I said, we are noticing that there is
this implementation of policy at the local level and the increased use of the
ADAP process.
The third area that I would reference is
the whole area of violence prevention, and though I have spoken about the
funding available for the emotionally, behaviourally disordered young person,
the issue of violence in the school has been identified across Manitoba as a
real concern, and some of the young people who have been involved in violence
in the school may not in fact be classified as emotionally, behaviourally
disordered.
So we do have the interbranch committee
and we have just finished the consultation process. I spoke last week about the consultation
process which has been occurring with the community. It has involved approximately 40 people
representative from all areas of the community to begin to look at the issues
of violence in the school and come to some, at least, early identification of
how to cope better with the issues of violence in the schools.
Those are three areas which I can say are
seen as priorities and certainly are what we would see as evolving areas for
support.
Ms. Gray:
I thank the minister. In her
answer, she does talk about the extra funding available for Level II and Level
III. Can she tell this committee, with that extra funding, does she have an
idea of how many extra students that may provide some funding support for, or
will there be any extra students? Is it
just additional funding for students who are receiving existing services in a
particular level?
Mrs. Vodrey:
I can say that some of the students that this would fund are probably
students who are currently in the schools and who perhaps had not received funding
before. That funding has not been
available to recognize their particular issues.
We have now finalized the guidelines under
which schools will be able to access this funding. Those guidelines have been distributed to
school divisions, and we are now in discussion with school divisions as to how
they will identify those young people and then access funding.
Ms. Gray:
The minister referred to some students, does she have an idea as to how
many additional students or schools may be able to access funding for so many
extra students? Does she have a ballpark
figure?
* (2130)
Mrs. Vodrey:
Well, again, the criteria and guidelines have just been set and are
being distributed so we really are not able to guess with any degree of
accuracy exactly what the numbers may be.
I suppose if we were to really provide a very broad estimate, we might
say approximately 100 students for Level III and approximately 50 to 200 for
Level II.
Ms. Gray:
Given that the number of students obviously, because it is not really
known how many, was not really a deciding factor in looking at the extra
funding, what was sort of the rationale behind providing extra funding in this
area?
Mrs. Vodrey:
We certainly received ongoing information from school divisions. We received feedback from their special
education co‑ordinators. We also
received feedback from the superintendents around the kinds of students that
schools were dealing with and then this information was reviewed by the
advisory committee on Ed Finance. As
they looked at all of the areas that had been submitted to them for recognition
within the funding formula, this was one of the priorities.
Ms. Gray:
Can the minister tell us, the proposal from Manitoba Teachers' Society
and the Manitoba Association of School Trustees‑‑and there might
have been another organization there‑‑but the proposal that looked
at provision of medical services to children in schools, can she tell us what
her response has been to that proposal?
Mrs. Vodrey:
This has been an area identified particularly over the past year, the
issue of the medically fragile young person. I am not quite sure if the member
is speaking of the report between MAST and MTS and so on which identified a
look at the sharing of services among departments, or if she is speaking
specifically about medically fragile young people.
In terms of medically fragile young
people, I can tell the member that there has been a committee which has been
set up. It is an interdepartmental
committee. In Phase I of that
committee's work, they were to look at the issues that surround the medically
fragile young person in school. Also,
that committee looked at the emotionally behaviour disordered young
person. That Phase I report has been
submitted to me as minister and also shared with my colleagues.
The second phase was then to do an
inventory of service. The inventory of
service would look at the service provided through all of the affected
departments. It would be Education,
Health and Family Services. I have now
received that report and I will be looking to discuss that with my colleagues.
I can tell the member as well that it
certainly has been an area of priority and that we have devoted quite a lot of
staff time within our department to also work with other departments to look at
ways to resolve the issues around the medically fragile young person.
Ms. Gray:
Can the minister tell me, this committee that she has referred to
regarding medically fragile children and Phase I and Phase II, is that a
different committee than the committee that also is involved, of deputy
ministers who are looking at co‑ordination of services amongst the three
or four departments?
Mrs. Vodrey:
This is the same departmental committee that has been working. As I said, there is a committee of deputy
ministers, and that is chaired by the Deputy Minister of Education. Then there is the working group committee,
and that is chaired by the Assistant Deputy Minister of Education. They have looked at this as they have looked
at other issues, but there has been some specific attention paid to the area of
the medically fragile young person.
Ms. Gray:
So it is the same committee and the minister has said that there is a
Phase II that has been completed. She
has now received an inventory of services as well as information on Phase
I. If she could just clarify, I was not
quite sure if she said what the next step was or perhaps what the time frame
was.
Mrs. Vodrey:
I have said at other times during the Estimates discussion that we are
now going to meet as ministers to examine the reports and to give further
direction, and we will be looking to meet as soon as possible.
Ms. Gray:
Can the minister tell us what is the nature of the recommendations that
she has received in regard to co‑ordination of services? Is there a recommendation that a particular
department take a lead role in the provision of services, or what is the nature
of the recommendations?
Mrs. Vodrey:
The recommendations certainly focus on the issue of collaboration among
departments, and now as ministers we will have to look at how we can be the
most effective in the area of collaboration.
* (2140)
Ms. Gray:
Can the minister tell me, are there recommendations that refer to
funding and where the dollars should come from to provide funding for the provision
of these medical services for special needs children?
Mrs. Vodrey:
As I have said, I have received Phase II of the report. I will be sharing it with my cabinet
colleagues. At this point it would be a
little bit premature for me to look at exactly what we will do with the
recommendations or exactly what further direction we will give until all
ministers have had a chance to examine the information.
Ms. Gray:
Can the minister tell us, has she relayed the progress of the committee in
regard to the explanation she has given this committee this evening? Has she relayed that information back, either
her or her other ministerial colleagues to MAST and MTS, the individuals who
wrote that particular proposal on provision of services to medically fragile
children?
Mrs. Vodrey:
I can tell you that the Deputy Minister of Education meets regularly
with the organizations, MAST and MTS and MASS.
I can tell the member also that when I have had the opportunity to
dialogue with my colleagues and when we have further direction to be given,
then that information will also be relayed to those member organizations.
Ms. Gray:
Can the minister perhaps rephrase her answer because I still was not
quite sure. Can she tell me if the MAST
association and MTS have actually received a response back in writing from this
department indicating what has happened with the proposal and where it is at in
terms of looking at the proposal and looking at recommendations, et cetera?
Mrs. Vodrey:
To clarify for the member, the educational organizations are certainly
aware of the process that has been in place as the departments have come
together through the deputy ministers and also the working group.
In terms of the final results of that, no,
they do not know the final results yet, but I understand that MAST did put
forward a resolution in which they requested an update. We are certainly able to provide the update,
but I need to meet with my ministerial colleagues before I can provide exactly
what the direction will be and the next step.
Ms. Gray:
I know I have asked this question before, but can the minister indicate
to me since the last time I asked this question a couple of weeks ago, does she
have any update or information on when her cabinet colleagues will be meeting
and where on the agenda this particular issue is? I think it is very, very crucial. I mean, this is an issue that has not just
been in the departments for the last five years. This is an issue that goes on for eight to 10
years, so it has created very much frustration for professionals, for parents
and for the students themselves.
I am wondering if we could see a real
priority with this particular issue in terms of getting some kind of consensus
from the departments as to better co‑ordination of services, who is going
to be providing the dollars, et cetera, a protocol to put in place so that in
fact the students and the families do not end up falling through the cracks
because departments want to argue with each other about who is going to pay the
bill.
Mrs. Vodrey:
We think that it is important, too, as the member has said. I understand that it has really been a long
time coming to this point. As I have
said before in these Estimates, I sat in the early '80s with the Education
minister of the former government asking that minister to please take some
action, and none was taken. So where we
are now is that this government has taken some action. We have had the working group do their work,
and we will be meeting as soon as possible to make sure that we have had a good
discussion and can provide direction for the next step.
Ms. Gray:
Could the minister give a commitment today that in fact we could have a
response, some protocols in place, by September of this year?
Mrs. Vodrey:
Again, as the member knows, it is going to require several ministers to
look at their departments, so I would not be able to speak on behalf of my
other colleagues who would be involved.
We will have to wait until we have that meeting, but I do expect that
meeting to occur very shortly.
Ms. Gray:
Can the minister tell us, with the recommendations that are going to her
ministerial colleagues, will there be some opportunity for input from the
education officials, people in school divisions, et cetera, in terms of what
the proposed solutions are, so that in fact whatever the solution is, it would
be something that would also be sanctioned or would be seen as appropriate by
school divisions, et cetera?
Mrs. Vodrey:
The member organizations have asked to be involved when the ministers
have had a chance to look at this, and we will certainly make every effort to
make sure that they are involved in whatever the next stages are.
Mr. John Plohman (Dauphin):
I would like to follow up on that important point, that we take up here
where we left off the first night discussing the Estimates and the committee
that was set up. We have now been in
Estimates for three or four weeks, we want to see what progress has been made
here, and we do not know that a lot has been made. The minister is still giving the same
answers.
I just wanted clarification on this
particular matter, the time line for the decision making on the integration of
services, the establishment of some protocols as the member for the Liberals
that was just speaking said. Is that the
same as the time line for the medical services, that committee is looking at
both of these issues? Are they handling
them in lock step, or will one be dealt with perhaps on a more urgent basis?
For example, the medical services is one
on which The Teachers' Society has recently put out a policy statement to all
teachers which does perhaps place in some jeopardy the provision of these
services, because they are basically telling the teachers not to do it unless
ordered to do so. So the medical
services aspect of it, it seems to me, is very pressing as to who is
responsible and under which circumstances a teacher is responsible. So I am asking whether the minister believes
the time line or the relative urgency of those is the same, or whether she
would see the medical services portion of this being dealt with sooner?
(Mr. Deputy Chairperson in the Chair)
Mrs. Vodrey:
Again, I have explained to the member that I will be meeting with my
colleagues as soon as possible and we will be looking at all of the information
that is before us. I have explained that
the issue of medically fragile young people was looked at as a separate issue
because it was one which had been presented as one of great concern. When we have a chance to look at what has been
presented in terms of how the issues have been identified‑‑that was
one area‑‑and then what kind of services are currently available,
then the ministers will be able to provide the next direction.
* (2150)
Mr. Plohman:
Yes, so the minister believes then there are several steps yet before
establishing the policy. She had talked
about a Phase I report which she received, reviewed. Then there was a Phase II which she has
received but not reviewed with her colleagues.
Do you expect a Phase III and a Phase IV and Phase V, or just a Phase
III? What is the time line on this?
If the minister could shed some light on
this important issue for the committee I would very much appreciate it, because
it is not good enough to just talk about, well, you know, we are going to look
at this. Let us get some idea whether we
are going to see some actual movement on this.
We realize it is important. Maybe as much was not done in the past as
should have been done, but that is not the issue right now. We are at this situation. The issue is the
minister's action on this. People are
waiting. They need to know.
Mrs. Vodrey:
Mr. Deputy Chair, well, action has happened and the Phase I report
identified the issues; the Phase II report was able to identify all of the
services that are currently available by a number of departments. Now we are able to look in a very co‑ordinated
way at what is available for special needs young people and for medically
fragile young people.
As the member is asking for a specific
time frame, I can tell him that there are several ministers who are involved,
so it will be up to the ministers involved now to determine exactly what the
next step will be.
Mr. Plohman:
Yes, we are talking about medically fragile young people, and I believe
that after going through two phases, the minister should see some light at the
end of the tunnel, start to see something taking shape.
I am simply trying to get from the
minister, just assuming that by the end of June she was out of Estimates, when
could we expect a decision on this kind of thing? Do we see‑‑
An Honourable Member:
That is a hypothetical question.
Mr. Plohman:
No, I am just trying to put it in context. It could be middle of July, it could be
before the end of June. Let us just
assume that, if this is holding things up at all with the decision making for
the minister, what kind of priority is this going to get for decision, for
matters on the minister's plate?
She has her colleagues here, we have important
issues, she keeps saying, well, it is up to the ministers now. That means her, that means this minister and
her colleagues. Are they going to give
it priority; is she having difficulty getting them to look at this? If so, what can we do to try and press this
issue for her on her behalf to get some support here?
We have been around this and the members
are saying, you do not have to yell. The
fact is, we have been dealing with this for some time, trying to emphasize this
point because we are not getting any direct response. I do not know what we are going to do
here. What is going on? Are we going to get some action from this minister
or not?
Mrs. Vodrey:
Mr. Deputy Chairperson, let me give a reasoned response to the member's
question.
As I have said, it has been an issue of
importance. First of all, it has been an
issue of importance to myself because, as I have explained, my experience
within the school system has shown me that this is an important issue. So I have let him know that personally I have
taken this very seriously, my department has taken the lead role in terms of
chairing the committees at all levels.
Now, with his understanding that this is important to myself personally
and to my department, I will be taking it forward to my colleagues and we will
be looking at the information that is provided and then we will be looking at
the very best way to proceed. We fully
see this as an important area and, as I have said, certainly in Education we
have viewed it as a very important area.
Mr. Plohman:
Mr. Deputy Chairperson, can we expect this issue to be fast‑tracked
by the minister, compared to the other issues on her plate? Can we expect some real movement on this
issue? Can we expect the minister to go
through the sharing of this report with the ministers at the earliest
opportunity, and, secondly, can she see that there would be several more
phases? Are we nearly at the end of the
decision making here? Just a simple
answer‑‑first opportunity for sharing of this report, and are we at
the end of the process or are there a number of phases left?
Mrs. Vodrey:
As I have said, we are at the report stage. We have received a Phase I and a Phase II
report. Both are very important pieces
of information that we need. Now the
ministers will be viewing the information and I know that they see this as an
important issue, but I can speak best on behalf of the Department of Education
and Training and for myself as minister about how important I think that this
issue is.
The member asks how other colleagues feel
about it; in their Estimates process, I am sure he would like to ask them.
Hon. Linda McIntosh (Minister of
Consumer and Corporate Affairs): Good answer, good
answer.
Mr. Plohman:
No, this is not a good answer.
The Minister of Consumer Affairs talks about good answer. It is not a good answer at all. It is the same kind of stonewalling we have
seen for the last month almost in these Estimates. It is a deflection from the issues. It is not an attempt to answer directly.
Point of Order
Mr. Deputy Chairperson:
Order, please. Could I ask the
honourable member to put his comments through the Chair to the minister?
We will carry on with decorum. And could I ask the honourable members if
there is a full moon out there tonight?
* * *
Mr. Plohman:
Mr. Deputy Chairperson, there has to be something going on with these
members and with this government that is directing them. It certainly is not the issues on the ground
here that we are trying to deal with.
I am simply asking the minister if there
are other phases as she sees it at the present time, simply asking a question
that is straightforward here. Can she
answer that? Are there phases other than
the minister's looking at it and then writing up the protocols?
Mrs. Vodrey:
I have explained to the member, the next step is that the ministers
involved will be looking at the report.
Mr. Plohman:
Thank you, Mr. Deputy Chairperson, for gaining some order in this
committee so that we all may hear the very important questions being asked.
I am asking the minister whether there are
other phases involved. She says the next
phase is for the report to go to the ministers.
Did Phase I go to the ministers?
Mrs. Vodrey:
Yes, the ministers all received Phase I, which was an identification of
the issues, and what followed that was then to say, let us look at the services
provided in each of the departments. We
now have an inventory of the services provided, and now the ministers will be
making some decisions and providing some further direction. But, as I have explained to the member, there
is more than one minister involved in this, and there are, in fact, several
ministers who will be considering this as part of their responsibilities.
We have established this as an issue of
priority, and I have given the member the answer that we will certainly be
looking at it as soon as possible and that I will be bringing it forward as an
issue of priority.
* (2200)
Mr. Plohman:
Well, that is somewhat encouraging, but when we consider that Phase I went
to the ministers and then there was a Phase II, was Phase II planned before it
went to the ministers for the response to Phase I? If it was, then the minister should know if
there is a Phase III, another report that the minister is going to ask the committee
to prepare in anticipation of finalizing this issue.
Mrs. Vodrey:
Mr. Deputy Chair, again, we have approached this issue in a very orderly
way. We have, first of all, examined the
issues. We were aware that we also
wanted to look at the services provided in each of the departments. We did present the issues, and then the
committee got to work on the services which were being provided in response to
some of the needs identified.
Now we will be looking at the best way to look
at how the ministers will now look at what their response will be. The member seems to be having trouble
understanding that there will be several ministers who will be looking at the
information and be making decisions based on the services that their
departments offer.
Mr. Deputy Chairperson:
The hour being after ten o'clock, I will just canvass the committee and
see if there is a will to carry on.
(agreed)
Mr. Plohman:
Well, we have established that this is going to the ministers, and the
minister says she is going to make it a priority. Does she have any understanding of the
process from now on? In other words, are
the recommendations from Phase II as to the remainder of the process?
Mrs. Vodrey:
Mr. Deputy Chairperson, there is information in the Phase II report;
there are some recommendations in the Phase II report. They will be considered by the ministers.
Mr. Plohman:
Do they deal with action on these various services that are provided,
that have been identified now as to who should be providing specific
recommendations that the ministers can consider?
Mrs. Vodrey:
Mr. Deputy Chairperson, as I have said earlier, the ministers will be
reviewing this information first. When
the ministers have had an opportunity to review the information, then the
information and the result of that will certainly be shared and be shared with
the educational organizations who, I know, are interested in it. Right now it would be very premature for me
to discuss all of these issues before my colleagues and I have had a chance to
discuss it in a co‑ordinated way.
Mr. Plohman:
The minister should understand that I am not asking for specific
recommendations. I am simply trying to
understand if there are further phases before decisions can be made. So I simply ask the minister whether there
are specific recommendations in this phase that could lead us to understand
that the minister will have some decisions made after she consults with her
colleagues, or are we just going to get directions for further action for the
committee and a subsequent phase?
Mrs. Vodrey:
Again, I am not able to anticipate exactly what the outcome will be of
discussion that my colleagues and I will have.
I have explained that this is a priority, but the member is asking me to
prejudge exactly what my colleagues will say.
I am not going to prejudge what my colleagues will say. We will have that discussion, and then we
will make the determinations that we need to.
Mr. Plohman:
As I said before, the members of the education community are very
concerned about this being dealt with in a priority way. They want to see some action on it. So we are just relaying those concerns to the
minister and asking these questions, what kind of a time line can we expect
some action here‑‑within the next number of months, or are we
looking at a lengthy process that is going to go on for a number of years? So I have to just ask the minister, is there
any other impediment to this being dealt with?
Is there a major financial impact question that has to be considered?
Mrs. Vodrey:
Again, the information that is in that report will be shared with my
colleagues, and when my colleagues and I have had the opportunity to review it,
then we will look at the recommendations that are made and those will be shared
with the education community.
Mr. Plohman:
So the minister is not making a commitment to fast‑track this or
treat this with any degree of urgency in her department and with her
colleagues. Is that a correct statement?
Mrs. Vodrey:
I have explained that I see this as an area of priority. I have explained in the past and during the
discussion this evening that I see this as an area of priority on a personal
basis because of my experiences as I have worked in the schools, and I also
have seen it as a priority as minister because it has been brought to my
attention from a number of the educational organizations. It also is brought to my attention when I
visit schools.
I have made it a priority. I have made sure that Education has chaired
the committees and that there has been progress in that area. Now I will be taking the information to my
colleagues for discussion.
Mr. Plohman:
Okay, then, can the minister say then when she first began with this
committee on medical services for Phase I? What was the date?
Mrs. Vodrey:
Mr. Deputy Chairperson, I am informed that Phase I began their work in
February, March '92 and received their information in the fall of '92. From that then, the committee began its work
on Phase II. Phase II has been now
tabled, and we will be discussing it as ministers as soon as possible.
The member seems to have some difficulty
with that particular step‑‑
An Honourable Member:
The first phase was '91?
Mrs. Vodrey:
'92 was the beginning of Phase I.
An Honourable Member:
You said Phase II started in the fall of '92.
Mrs. Vodrey:
No, I said‑‑let me just go over again the dates for the
member who missed them.
Phase I was started in February to March
of '92. Then the receipt of that Phase I
report was in the fall of '92. Following
that, the work on Phase II began, and Phase II has been provided to me in the
spring of '93. That will now be looked
at by the ministers.
So there has been quite a lot of work that
has been done among a number of departments which have come together. As I explained, there has been work done by
the deputy ministers as well as work done by the working group.
Mr. Plohman:
This is very telling, because we see about a six to seven‑month
period between each phase here. If we
looked at that and project ahead, and we know the minister plans several
phases, we could easily find out what the time line is, but it looks like we
have not been able to determine‑‑I would assume, from what she
said, there is only one way to interpret this, and that is that the minister does
not really know where she is going on this. She does not know what the other
phases are. She is going to go to her
colleagues and hope they give her some direction.
It is unfortunate that we do not have a
minister taking more leadership in this area that is so important, to indicate
to her colleagues, this has to be dealt with, here is the time line, I am going
to you for your acceptance and support of the time line.
* (2210)
I think it is time that the minister took
that kind of leadership‑‑
Mr. Deputy Chairperson:
Order, please.
Point of Order
Mrs. McIntosh: On a point of order, Mr. Deputy Chairperson, I
hate to see an inaccurate statement on the record. I do feel this minister has shown extremely strong
leadership and been very courageous on a lot of the decisions she has made. (interjection) Oh, is that not a point
of order?
Mr. Deputy Chairperson:
Order, please. The honourable
minister did not have a point of order.
* * *
Mrs. Vodrey:
Mr. Deputy Chairperson, again, I would not want the member to have
inaccurate information on the record either.
So let me remind him that it was through the Department of Education and
Training who chaired the committees, both the committee of deputies and also the
committee of assistant deputy ministers, and that there has certainly been a
commitment to this.
Maybe the member is not quite familiar
with the process of a collaborative approach.
We have been working‑‑our government works in a
collaborative approach, and we certainly have used the collaborative approach
to this particular committee. The
collaborative approach has meant that it has required staff time from a number
of different departments, as well as from deputies of those different
departments. We now have that
information, and the ministers will be looking at it and then we will be
determining the next step, but the member seems to want me as a single minister
to speak on behalf of all the other ministers before we have had a chance to
have a discussion as a group.
Mr. Plohman:
That is not what I am saying at all.
The minister is misinterpreting what I said again. I simply wanted to know if she is
recommending a time line here and she is making specific leadership type of
recommendations. As the lead department
with the deputy ministers, the lead deputy minister on this issue, we are
simply asking if the minister is making some specific recommendations as to
time line and doing it on an urgent basis because of the urgency of the issue.
I would really implore the minister not to
try to misrepresent the questions that we are asking here.
Mrs. McIntosh: You are only asking one question.
Mr. Plohman:
Well, I have to keep asking. The
Minister of Consumer and Corporate Affairs (Mrs. McIntosh) is making some
statements from under her breath about me asking the same question. I am pursuing an issue with the minister in a
dogged fashion. I am not going to stop
until I get some answers. I do not care
about all this peripheral kind of talk that the minister gives. I simply want to cut through and ask specific
questions here and push the issue until I find out whether the minister is
giving this some urgency. Is she making specific
recommendations?
Mrs. Vodrey:
Mr. Deputy Chairperson, well, let me go to the leadership issue to say,
absolutely, as minister I have taken leadership. It has taken leadership to direct this very
complex and very comprehensive issue and to see that it has moved along to the
point that it has, and now the member wants me to speak on behalf of my
colleagues regarding a time line. I have
told him that I am not able to speak on behalf of my colleagues regarding a
time line. However, I have assured him,
as I have assured the Legislature, that this is a priority, that we will be
looking at it as soon as possible and that I as minister and as an individual
have taken this as a priority issue.
Mr. Plohman:
Mr. Deputy Chairperson, the record shows again that the minister has not
provided a definitive response, leadership on an issue that is required. We cannot go away from this committee tonight
with any feeling of satisfaction that this issue is in good strong hands being
dealt with expeditiously. I know that
staff want to deal with it expeditiously.
We do not know if the political will is there from this minister. She has not given us any comfort level on
this important medical services issue.
I can only say that this follows a pattern
we have seen so often in this committee, unfortunately, and it will ultimately
be the downfall of this minister.
Ultimately it will. The minister
may feel comfortable and feel some pride in being able to evade the questions,
which are answered and not answered with all of the straightforwardness that is
required in the committees. She might feel
good about that, but, ultimately, it is not going to help her situation.
Mr. Deputy Chairperson, I have not felt
any satisfaction with those answers.
They are not clear. They do not
indicate urgency‑‑(interjection)
The minister's colleague continues to mumble under her breath.
I want to ask the minister whether this
area of Child Care and Development is an area that the whole policy on teacher
abuse and/or violence in the schools is dealt with, or is this under another
area?
Mrs. Vodrey:
Mr. Deputy Chair, we have approached the issue of violence in the
schools, which we recognize as a very serious one, as a divisional issue, and I
have spoken about a number of divisional issues today. We spoke about native education also as being
very much a divisional issue, which is being addressed by a number of the
branches within PDSS. Violence in the
schools has been addressed similarly.
There is an interbranch committee within
the division. So, within the division,
we have a number of branches representative, and CCDB or the Child Care and
Development Branch is one of those. We
have had a number of issues which have come forward relating to the issue of
violence in the schools.
Mr. Plohman:
Mr. Deputy Chairperson, we are prepared to‑‑
Mr. Deputy Chairperson:
Item 2.(a)(1) Salaries $184,600‑‑pass; (2) Other
Expenditures $45,600‑‑pass.
2.(b)(1) Salaries $2,204,400‑‑pass;
(2) Other Expenditures $1,695,700‑‑pass.
2.(c)(1) Salaries $616,700‑‑pass;
(2) Other Expenditures $222,100.
Mr. Plohman:
You are on (c), Mr. Deputy Chairperson?
An Honourable Member:
You are on 16.(c)(2) Other Expenditures?
Mr. Deputy Chairperson:
That is correct.
Ms. Friesen:
I had a question on Supplies and Services. It shows a considerable drop, and I wondered
what the impact of that would be on the department's programs, on this
section's programs.
Mrs. Vodrey:
In that area of Supplies and Services the reduction relates to the
Native Education Branch reducing capital expenditures in the area of computer hardware
and work station furniture from the '93‑94 systems plan. The area of computer hardware, they will be
utilizing existing hardware, and in the area of work station furniture there
will be a realignment of the work station furniture from within the division.
* (2220)
Ms. Friesen:
On the Professional Fees, could the minister tell us who is involved in
it and what the contracts are?
Mrs. Vodrey:
Mr. Deputy Chair, the Professional Fees line refers to money paid for
the development of coursework materials.
An example is funds paid to Dr. Leo Pettipas, who is a writer who worked
jointly with our Native Education Branch, with INAT, with Frontier School
Division, and with Winnipeg No. 1 committee.
In addition, there were two videos
produced: the native artists series by
Jordon Wheeler, and also a native language video with the Continuing Education
department of the
Ms. Friesen:
And that was for last year, was it?
What are the expected programs or plans in that line for this coming
year?
Mrs. Vodrey:
Three of the projects for this year are with the Metis Women's
Association, a video production; with Frontier School Division, a video
production re band governance; and a Metis heritage kit with the MMF.
Ms. Friesen:
Just further clarification on the Metis Women's one. Is this the one that I have read about in the
press that is gathering genealogies and family histories?
Mrs. Vodrey:
Mr. Deputy Chair, no, it is not a video on the genealogy. It is a video comprised of footage which was
filmed in The Forks area and it focuses on Metis heritage.
Ms. Friesen:
Are any of these videos available either in French or native languages?
Mrs. Vodrey:
No, not at the moment.
Ms. Friesen:
Are there any plans to make them available in French?
Mrs. Vodrey:
We do not have any immediate plans to translate the videos into French;
however, the Parents' Guide, which I provided earlier this evening, has been
translated into French, and also Reaching for the Sun, which has supporting
documents as well‑‑it goes along with a poster series‑‑Reaching
for the Sun, a Guide to Early History and Cultural Traditions of Native People
in Manitoba. This also has been
translated into French.
Mr. Deputy Chairperson:
Item 2.(c)(2) Other Expenditures $222,100‑‑pass;
2.(d)
(e) Child Care and Development (1)
Salaries $3,201,500‑‑pass; (2) Other Expenditures $1,170,200‑‑pass;
(f) Instructional Resources (1) Salaries
$1,043,400‑‑pass; (2) Other Expenditures $716,500‑‑pass;
(g) Distance Education and Technology (1)
Salaries $1,612,600‑‑pass; (2) Other Expenditures $2,662,700‑‑pass;
(h) Student Support (1) Salaries $416,500‑‑
Mr. Plohman:
Just a brief question or two here.
The minister has indicated in the Supplementary Estimates that she is
dealing with‑‑that this is primarily this area for children,
students at risk. What definition is
used for determining students at risk?
Mr. Deputy Chairperson:
As long as we are waiting for the minister, I just wanted to make note
that there were two lines, Less:
Recoverable from Other Appropriations, one under (d), so it is (3), and
the other one is under (g) and it is (3) as well. (interjection) There is no dollar amount to pass; I still should
have recognized the lines, so I have done it now.
Mrs. Vodrey:
In the area of the Student Support Branch, to establish risk we look at
seven factors. The first factor is the
incidence of low income in the community expressed as a percentage, and we
discussed that a little bit earlier this evening regarding a specific
project. We look also at the percentage
of single‑parent households within the community. We look at the school migrancy rate for the
'90‑91 school year. We look at the
number and percentage of students referred for the English language development
for native students support in the '91‑92 school year. We also look at the number and percentage of
students referred for ESL support in the '91‑92 school year. We look at the percentage of students in the
school who are two or more years behind their age group in reading and in
numeracy skills during the '91‑92 school year, and we look at the
percentage of students who missed 30 or more days during the '90‑91
school year.
Mr. Plohman:
Does the minister have any statistical information about numbers? Is it by division, or where is the greatest
concentration? I imagine Winnipeg No. 1
would have a large concentration. What
are the other areas of the province and numbers?
Mrs. Vodrey:
This information is collected by school.
All 800 schools are included in this survey. There is an index rating of each school by
category, and by division we know then where there is the highest concentration
of at‑risk students. This year we
are looking to refine the seven indicators with the field so that next year
there will be another process of data collecting this fall so that we will be
able to update these statistics that we have.
* (2230)
Mr. Plohman:
So is the minister saying that the present statistics do not provide, as
far as the department and yourself are concerned, a comfort level insofar as
the statistical information is not as defined as they would like to have it?
Mrs. Vodrey:
This statistical data was collected in the first year of the Student
Support Branch program; that was in school year '91‑92, or the school
year just preceding this one. We do
believe that the information that we have is fairly accurate. However, we would
like to ensure that our data continues to be accurate, and because of that we
have engaged in this process of refinement to make sure that we have updated
the information and any changes which may be occurring within individual
schools so that we are able to make the very best decisions possible on behalf
of the young people in those schools.
Mr. Plohman:
Are there various classifications of at risk?
Mrs. Vodrey:
We do look across the province, and we do know that certain schools have
a higher concentration of at‑risk students. That is noted by the index rating
that is given, based on the seven risk factors.
Also the concentrations of at‑risk students are reflected in the
grants allocated. So I can tell the
member, for instance, Winnipeg No. 1 receives approximately 65 percent, over 65
percent, of the grants allocated to this program.
Mr. Plohman:
Well, that was my next question as to what kind of grants are available
for students identified as at risk and total amounts of money. I imagine those issues will be discussed in
Support to Schools. Could I get some
information about specific dollars allocated to school divisions for at‑risk
students? Then I get back to my previous
question which was not about the dollars, but whether there were various levels
of at‑risk designations just like there are for special needs kids: Levels I, II, III, IV, whatever. Do we have those same kinds of levels, and is
funding allocated on the basis of those levels?
Mrs. Vodrey:
Funding is not provided according to Level I, Level II or Level III
grants for special needs young people.
The funding is provided in three categories. There is funding through what is referred to
as the minimum guarantee. It is the sum
total of the '91‑92 compensatory and inner‑city grants. This funding is not intended to replace the
regular or the base funding. For '93‑94,
divisions can fund existing programs previously supported by the compensatory
or inner‑city funding.
Then there is funding in a category called
special projects. Schools eligible can apply for a $10,000 grant for the improvement
of existing services, and projects must be time limited within a three‑year
maximum. The deadline for renewals is
April 16, 1993.
Then there is a third category called the
innovations category in which we look for collaborative demonstration projects
between Manitoba Education and Training and the school division. We focus on services that do not currently
exist, which is why it falls into the innovations category.
There is a significant evaluation process,
and the time is limited to a three‑year maximum. Again, the deadline for renewals is April 16,
1993.
Mr. Plohman:
Who does the evaluation as to whether students are at risk or not, using
the seven criteria that the minister mentioned?
Mrs. Vodrey:
Mr. Deputy Chair, the member asks how these evaluations are done. They are done with a school division
committee which works with Manitoba Education and Training. Occasionally, we do
use the services of an external evaluator.
* (2240)
Also, we have a program evaluation
consultant within the Department of Education and Training, and also, to
support evaluation, there is a grant to support a half‑time consultant
for Winnipeg No. 1 under the minimum guarantee to assist in this.
We view the evaluation process as a
learning process for the development of programs. The information that we get in this process
is shared with other schools. We also
look to develop the process so that schools can improve their own
implementation.
Mr. Plohman:
Okay, so it is primarily in the inner city, but are there a lot of
divisions in the province that have some allocation of at‑risk students?
For example, take a look at the Parkland,
Mrs. Vodrey:
Mr. Deputy Chair, we most certainly recognize students at risk across
the whole province. There is funding
provided in at least one of the categories for, I believe, every school
division within the province.
I spoke to the member about the three
types of funding. Funding could be obtained through the minimum guarantee,
through the special grants and through the innovative grant. The exception to a division which receives
funding in any one of those categories is
So divisions across the province have been
able to qualify for funding for at‑risk students under at least one of
the categories, and, in some cases, divisions have qualified with all three
categories for funding for special needs students. So I think it is important for the member to
know that this particular branch and its grants recognize, across all
divisions, that there are at‑risk students.
I would remind the member that this was a
very innovative creation of a branch. It
is the only branch of its kind across
Mr. Plohman:
I notice the minister talks about special needs. We are talking about at
risk, and I do not know whether she is using those two terms synonymously, but
the minister has always said that there has been increased support. We argued that there was actually a decrease
because of the layoff of the clinicians and then now I see in this
appropriation that there is a decrease this year in staffing and in the total
allocation by some $72,000 or about 10 percent.
So we see a decrease there. I hope there is some increase in the
grants. Otherwise, the minister has
possibly been giving us a little bit of inadvertent false hope here.
Mrs. Vodrey:
Mr. Deputy Chair, there has been an increase in the grants available to
schools. The decrease, in terms of the
staffing in the department, was a decrease of a secretarial position. There is, in fact, an increase of funds
available to schools.
The member might be interested in the
program that the Dauphin‑Ochre School Division, Swan Valley School
Division had. The name of the program was Instructional Focus, Middle and
Senior Years, and the amount of money was $30,000 which was provided.
It focused on instructional strategies,
learning organizations, co‑operative learning, learning styles to be
developed at the senior years, and a staff development model be utilized that
includes theory, demonstration practice, feedback and coaching. This program involves collaboration between
the two school divisions and Manitoba Education and Training.
(Mr. Jack Penner, Acting Deputy Chairperson, in the
Chair)
Mr. Plohman:
Well, we will leave this; my colleague has a couple of questions.
Ms. Friesen:
Mr. Acting Deputy Chairperson, I wanted to ask about the federal Stay‑in‑School
Initiative. Could the minister tell us
how the money comes to the department for that?
Is there federal money in the department here for that particular program?
Mrs. Vodrey:
The Stay‑in‑School funds do not flow directly to the
department. There is a joint committee
which is established. The terms of
reference from the joint committee were developed when the Stay‑in‑School
Initiative began. This joint committee
then makes recommendations for program funding.
On the joint committee are two
representatives from the federal government and two representatives from the
provincial government. There is an ongoing
dialogue between the federal government, the Deputy Minister of Education and
Training and the Assistant Deputy Minister of Education and Training regarding
program directions.
So the Department of Education and
Training works as a joint partner in the program through this federal‑provincial
steering committee, and at the moment, the federal Stay‑in‑School
program will continue with its program initiatives during the '93‑94
school year.
The department will continue to provide
educational expertise to the issue of students at risk, of not completing high
school with adequate skills, and there will be a continuation of the current
joint structure.
Ms. Friesen:
Mr. Acting Deputy Chairperson, there is a joint program committee
composed of two federal and two provincial members. How much money is allocated from the
provincial part and how much from the federal part?
(Mr. Deputy Chairperson in the Chair)
Mrs. Vodrey:
Mr. Deputy Chairperson, this is not a program which requires matching
program dollars from the provincial government.
However, there are times when we do collaborate on initiatives. Such a collaboration is occurring with the
St. Vital School Division and the Stay‑in‑School Initiative to
offer a trainer of trainers seminar for individuals to train classroom teachers
in implementing the co‑operative learning strategies.
* (2250)
Ms. Friesen:
Mr. Deputy Chairperson, how much money is the provincial government
allocating to this program this year?
Mrs. Vodrey:
As I said, there are no specific program dollars required to match the
Stay‑in‑School Initiatives.
However, I would tell the member that the entire $10.5 million from the
Student Support Branch does go toward programs which ensure that the needs of
students at risk will be addressed.
So our Student Support Branch, which
again, as I have said, was a very innovative creation of the Department of
Education and Training in
Ms. Friesen:
I am still trying to understand this program. What I am understanding from the minister is
that there is no specific allocation; it is simply departmental co‑operation
in implementation.
Mrs. Vodrey:
The federal government designates dollars to the Stay‑in‑School
program, and they are managed through the federal system. There are targeted amounts directed towards
specific programs.
The Department of Education and Training
provides educational expertise to the issue of students at risk of not
completing high school, and this program compliments the work that the province
has been involved in with students at risk, which I have said we support
through our Student Support Branch.
Ms. Friesen:
How much federal money is designated for
Mrs. Vodrey: Mr. Deputy Chair, we would have to total up
the amount of money on all the projects of the federal Stay‑in‑School
Initiative to give the member an exact total.
I can give her an estimated total of federal project money of
approximately $1 million; however, there is then money also available for the
public awareness campaign. The member
may have seen those awareness ads. Then
there is national innovations project money.
Ms. Friesen:
How much is designated to the Frontier School Division project?
Mrs. Vodrey:
Mr. Deputy Chairperson, we do not have before us the money that the
federal government is putting into Frontier School Division for that
innovations program specifically. We
could get it for the member and I would pleased to give it to her tomorrow.
Ms. Friesen:
Mr. Deputy Chairperson, I would welcome the Frontier School Division
amount, but overall it is not so much the specific amounts that I am interested
in but the way in which the program works and the range of projects which have
been chosen. The minister mentioned one,
the St. Vital School Division, Training for Trainers.
I guess what my concern is, the federal
money and the provincial programs, how is it being targeted?
Mrs. Vodrey:
Mr. Deputy Chairperson, the federal Stay‑In‑School
Initiative dialogues with the Department of Education in
The federal Stay‑In‑School
Initiative I understand has a broader catchment area or a broader scope of
those who can apply. Their focus is
junior and senior high school, roughly Grade 7 through Senior 4. With our Student Support Branch, the
distinguishing factor is that we look at kindergarten through Grade 12.
* (2300)
The Department of Education and Training
also collaborates with the Gordon Foundation.
But the Gordon Foundation also looks at a focus of Grades 7 through
Senior 4, and they too have a broader definition of who can apply. The Stay‑in‑School initiatives
tend to focus on the transition from school to work. They look at work
education; they look at mentorship; and they look at career and personal
development.
Mr. Deputy Chairperson:
Item 2.(h)(1) Salaries $416,500‑‑pass; (2) Other
Expenditures $253,100‑‑pass.
Item 2.(j) Canada‑Manitoba Winnipeg
Core Area Renewed Agreement ‑ Education Development (1) Grants‑‑there
is nothing there to pass; (2) Less:
Recoverable from Urban Affairs‑‑there is nothing there to
pass.
Ms. Friesen:
As the Deputy Chairperson has said, there are no dollars on this page,
but my concerns are for the Core Area Agreement. I wanted to ask the Minister of Education,
who is not responsible for this, but who obviously is seeing a decrease in her
budget because of this, or the absence of a Core Area Agreement, and I wondered
if the minister had any comments on what had been lost, how the department was
changing its programs to cope with the absence of Core Area money, or whether
the minister does anticipate some version of renewed Core Area.
Mrs. Vodrey:
First of all, as the member knows, the responsibility for negotiating the
Core Area Agreement does fall to my colleague the Minister of Urban Affairs
(Mr. Ernst). However, I can say that funding which may have been lost or
expired with the ending of the Core Area Agreement really has been more than
matched by our Student Support Branch.
The Student Support Branch has maintained the commitment to the inner
city, and has also expanded the concerns that have been raised about students
at risk from the inner city, and expanded that to apply to the province.
I can tell the member that in the first
year of operation the Student Support Branch had increased funding for the
school year '92‑93, that increased funding by $3 million. This year, and I know we have just looked at
that line, we have increased the funding by 0.5 or half a million dollars for
the school year '93‑94. Again, as
I said to the member for Dauphin (Mr. Plohman), as he was looking at where some
of this funding occurs, 65.9 percent of the funding does flow to the Winnipeg
School Division.
Ms. Friesen:
Mr. Deputy Chair, the advantage of the Core Area Agreement was that it
drew money from three sources and was able to concentrate them on the same
programs in the same areas that the minister recognizes have to be addressed
and to which she has added some additions of monies. Again, I wanted to ask the minister, does she
as Minister of Education have any indication from her presence in cabinet of
the anticipation of a new Core Area Agreement of some kind.
I am sure she knows that this has been
talked about since at least 1990, that we have had ministers of Urban Affairs
who have said they are hopeful that preliminary negotiations have taken place,
that continued meetings have taken place.
The various parts of the federal government, as we get closer to a
federal election, even the most cynical of us do anticipate that there might be
some kind of an agreement with the federal government.
I am wondering what advantages the
minister sees in drawing together those three types of money and focusing upon
one of
Mrs. Vodrey:
Mr. Deputy Chair, I know that my colleague the Minister of Urban Affairs
has responded to questions in Question Period regarding the status of this
particular agreement, and I am sure in his Estimates he will be able to provide
the update that the member requires.
Mr. Deputy Chairperson:
Resolution 16.2: RESOLVED that
there be granted to Her Majesty a sum not exceeding $18,769,100 for Education
and Training, Program Development and Support Services, for the fiscal year
ending the 31st day of March, 1994‑‑pass.
We will take a 10‑minute recess and
come back and do the Bureau de L'Education Francaise if it is okay with the
committee.
An Honourable Member:
Who wants 10 minutes? Everybody?
Mr. Deputy Chairperson:
Everybody.
The committee recessed
at 11:05 p.m.
After Recess
The committee resumed
at 11:13 p.m.
Mr. Deputy Chairperson:
Order, please.
Item 3.
Bureau De L'Education Francaise:
Provides policy and program development and delivers services related to
French language education, including all programs emanating from the Official
Languages in Education Agreement with Canada; provides services to students and
teachers in Franco‑Manitoban schools, in French Immersion programs, in
French as a second language program in English language schools; provides
liaison with the College universitaire de Saint‑Boniface.
(a) Division Administration (1) Salaries
$106,900. Shall the item pass?
Mrs. Vodrey:
Excuse me, Mr. Deputy Chairperson, I would just like to take a moment to
introduce the two staff members from the Department of Education and Training
who have joined us at the table: Mr. Guy
Roy, who is the assistant deputy minister, and Mr. Roland Pantel, who is the
director of Official Languages and Administrative Services.
Mr. Plohman:
Can the minister indicate whether there is a federal‑provincial
agreement in place at the present time to deal with the Official Languages
Programs Administrative Services? I
understand one of the Activity Identifications indicates that negotiations are
part of the role and administration of the Canada‑Manitoba Agreement, and
I just wanted to know the current status of that agreement.
Mrs. Vodrey:
Mr. Deputy Chair, the Official Languages in Education agreement expired
on March 31, 1993. An evaluation of the
Official Languages in Education program has been conducted by the Department of
the Secretary of State. Also, an
evaluation of the Official Languages in Education protocol has been conducted
by the Department of the Secretary of State and the Council of Ministers of
Education Canada, the CMEC.
Indications are that a new five‑year
protocol will be negotiated between the Secretary of State and the CMEC on
behalf of the provinces, following which bilateral agreements will be signed
between the Secretary of State and each of the ten provinces and the two
territories. It is probable that interim
arrangements will be agreed upon for the '93‑94 year since the new
agreement has not been signed before March 31, '93.
Mr. Plohman:
I knew, of course, that the old agreement was expiring; but that a new
one is not in place, that an evaluation is just taking place now, that seems
rather odd. Is there not a provision for
this to take place, this evaluation, in the final year of the previous
agreement or in the third year of a five‑year agreement, and then a new
one that would take effect immediately, with negotiations commencing at least a
year in advance of the completion? What
has happened this time?
Mrs. Vodrey:
Mr. Deputy Chair, the same situation occurred as the previous agreement
expired. The federal government
evaluates their programs in the fifth year of the protocol, so, that being
their process, that is why the evaluation took place at the time that it
did. However, it does not stop both
parties from pursuing interim arrangements until the signing of the new
agreement. Negotiations have begun, and
the Secretary of State has written to the chairperson of the CMEC, who is the
honourable David Cooke from
Mr. Plohman:
It seems like a very inconvenient way to operate. Has this been standard
through successive governments over the last 20 or 30 years, or is this just a
new development?
Mrs. Vodrey:
This particular methodology has been in existence for the life of the
Official Languages in Education program.
The date, I am informed, has been since 1974.
Mr. Plohman:
What is the value of the current agreement, the magnitude of the current
agreement?
Mrs. Vodrey:
The OLE program generated $10,439,699 in revenue for
Mr. Plohman:
Has that escalated year by year by inflation or whatever else? Is a standard formula built in, or is it
renegotiated each year? How do they
arrive at the figure?
* (2320)
Mrs. Vodrey:
As I look historically at the amount of funding, there has been a slight
increase year over year since 1984. It
is, I am informed, very sensitive to enrollments.
There is also a minimum guarantee to each
province that says provinces cannot get less than they did the year before
unless there is a dramatic decline in enrollments.
Mr. Plohman:
Does that mean while the minister is cutting back support to public
schools for the province by 2 percent this year, that this area would not have
received a similar cutback because the province would not have gotten
less? Is it a matching grant, or is
there some formula so that it would be dependent on the province putting in
some money as well?
Mrs. Vodrey:
Mr. Deputy Chairperson, I am informed that we maintained our support in
the bilingual categorical grant for infrastructure. The province does match this, and it is
enrollment driven.
Mr. Plohman:
Mr. Deputy Chairperson, on a per‑pupil basis, the grant cannot be
lower than the previous year, or is that in total?
Mrs. Vodrey:
Mr. Deputy Chairperson, as the member refers to the reduction in terms
of funding of public schools, a base funding was reduced, and that included
schools which offer French language programs also. The categorical grants to schools across this
province did not go down. They did not
go down in the area of French language programming, and then they did not go
down to other schools across the province either.
Mr. Plohman:
I just want to know the total amounts on these agreements. Now the federal‑provincial agreement
that in '91‑92 yielded $10,439,699, and there is also an interprovincial
agreement regarding French language education, does that involve money, or is
that just standards? What does it
involve? I looked under Educational
Support Services, Activities Identification:
"Supervises an interprovincial agreement regarding French language
education."
Mrs. Vodrey:
Mr. Deputy Chairperson, under this particular interprovincial agreement,
it does not mean direct funding. What
has occurred under that agreement is that we have sent consultants to
So the money is simply to operate this
portion of the program. It is operating
dollars. The money is not provided in
terms of grant money through the interprovincial agreement.
Mr. Plohman:
So this is the sole source of revenue from the federal government, is
the federal‑provincial agreement.
Is there any other source of monies that has provided for French
language education in the province, other than through this agreement?
Mrs. Vodrey:
Mr. Deputy Chairperson, all the money which flows from the federal
government flows through the Official Languages in Education agreement.
Mr. Plohman:
I seem to recall an announcement by the federal government that for the
implementation of the Supreme Court decision for the Francophone division,
there would be some, as I recall, $112 million over six years, or five years,
whatever, to all the provinces collectively.
I do not know how much is coming to
I would like to know how much of that $112
million would come to
* (2330)
Mrs. Vodrey:
The exact amount of money which will flow to
Mr. Plohman:
So what the minister is saying is that 70 percent applies to those
provinces she mentioned, and a large province like Ontario then is not included
in that 70 percent. They would be
getting the other 30 percent?
Mrs. Vodrey:
The
Mr. Plohman:
Okay, just to get an idea of ballpark figures. The minister may not be able to give a
precise figure because she said it is still to be negotiated, but based on
historical basis on numbers, relative numbers, can Manitoba expect in the
neighbourhood of 20 percent of that total, or would that be high?
Mrs. Vodrey:
It is going to be very difficult to make that estimate because
Mr. Plohman:
Yes, have they indicated whether it will flow on the basis of student
enrollment or Section 23 population? It
certainly would not be, I would not think, on the broad population of the
province because that really has nothing to do with the Francophone population
and the demand for the service.
Mrs. Vodrey:
The federal government has not indicated to us on what basis they will
be flowing the money.
Mr. Plohman:
The minister is saying though‑‑well, has the minister taken
a position as to what she believes should be the criteria? Would it be Section 23, Population, or
Student Enrollment?
Mrs. Vodrey:
I can tell the member that we certainly will be looking in this process
to negotiate the very best deal for
Mr. Plohman:
I would assume the minister would be trying to determine the most
advantageous negotiating position for the
Are we dealing with a federal‑provincial
agreement here based on matching funds, or is that not even known?
Mrs. Vodrey:
Again, that particular issue is part of the negotiations which we will
be looking to do with the federal government.
Mr. Plohman:
We have to be careful since you have two sets of negotiations going on, one
with the OLE agreement and this one, that they do not try to throw the two of
them together with that money lost in the federal‑provincial
agreement. I just raise that as a
caution in these negotiations.
Has the minister any idea of how they
arrived at a figure of $112 million?
Mrs. Vodrey:
There was some consultation, I am informed, by the federal government
with Francophone groups across
Mr. Plohman:
There was no special requirement then for the federal government to pick
up these costs, and so they just pulled a figure based on what they thought
they could afford. Is that what the
minister is saying?
Mrs. Vodrey:
Mr. Deputy Chair, I did say that the federal government had consultation
with Francophone groups across
Mr. Plohman:
I have just one further question.
Did they consult with the bureau here and the department? What advice were you giving them‑‑to
look at a per‑pupil amount, an establishment grant to set up the new
division, or was this ongoing support?
Mrs. Vodrey:
Mr. Deputy Chair, the federal government did ask the Department of
Education and Training in
* (2340)
Mr. Plohman:
The minister's comments coincidentally raise the point that I was going
to ask the minister, and that is to the estimated costs of implementing or
establishing a new Francophone division.
Does the minister have a figure that was estimated based on data used
when putting together the bill that is before the Legislature and planning for
the Supreme Court decision?
Mrs. Vodrey:
Within the Gallant report there was estimated an expenditure figure, but
the Gallant report did assume that all students, all eligible students, would
transfer into the Francophone Division, and it was estimated by that report
that there might be a shortfall of approximately $600,000; that is with the
revenues expected and the costs incurred.
However, now we have a model which
Mr. Plohman:
There are two figures really, Mr. Deputy Chairperson. It seems to me there is an establishment
figure to establish the divisional office.
There is staffing, there is office and capital costs and various
establishment costs, and then there is the ongoing operations with the per
pupil grants coming in. I am not talking
about the ongoing operation based on per pupil costs. I am talking about the establishment of the
division itself, the initial costs that are one time only basically.
Mrs. Vodrey:
Mr. Deputy Chair, I believe the member is asking now about the work of
the board from the election of its trustees to the first students, because we
recognize that board will have to operate one year, almost one school year,
without students. There has been an identified cost for that particular year of
approximately $560,000, but, again, that is an estimated cost for the work of
that board and the hiring of its administrative people and so on in that first
year of operations before students.
Mr. Plohman:
So this is part of what the minister would anticipate the federal
funding would be used towards, and then the ongoing operation of the
administration of that division, is that part of the federal funding? It would not be per‑pupil grant
funding, would it?
Mrs. Vodrey:
Mr. Deputy Chairperson, in terms of the education of its students,
Manitoba is held responsible for the education of students, as we are now, but
we could look for some of the federal money to assist us not only with the
start‑up costs at $560,000 which I have mentioned, but also to assist in,
sort of one‑time only special projects which might be associated with the
starting up of the Francophone divisions.
For example, it might be initiatives such as the setting up of a central
office or a regional office or the programme d'accueil, which is the program to
support students whose language fluency is not necessarily at the point where
they could benefit directly and they do need some support, though they are
students who are eligible to attend that particular Francophone program.
Mr. Plohman:
We have asked the minister a number of questions at length about the new
Francophone division. She has indicated
in previous sittings that Justice Monnin is now out and gathering information
and registering students‑‑would it be appropriate to use that term?‑‑in
anticipation of becoming part of the new division.
Is there any new information on the
progress of the implementation committee since we last sat? Has there been a report made, any more
estimates on numbers of students that would be involved?
Mrs. Vodrey:
Mr. Deputy Chairperson, the implementation committee has been out in the
community doing its work. I am informed
that including a meeting which was held this evening, there have been five
public meetings held. Mr. Monnin will
not be tabulating the intent to register forms until the end of June, so we do
not have any information on that, but we do know that the meetings are in
progress. They are expected to be
finished by the end of June.
* (2350)
Mr. Plohman:
Can the minister just give us a quick indication, rundown, of where the
meetings are being held?
Mrs. Vodrey:
Meetings have been held in La Broquerie; in St.
Mr. Plohman:
These are the meetings that have been held. Is that right? I only got four of them, but I think the
minister said five or six. How many in
total are there going to be held?
Just to facilitate the activities of this
committee, if the minister could provide us with a list of those meetings, I
would appreciate that at another sitting.
I just wanted to ask a couple of questions
about interaction between francais and French Immersion schools and classes and
so on. There seems to be some separation
whether it be through interschool activities; there seems to be a line drawn
that francais program schools do not interact in a full way with French
Immersion schools. I wonder why that is.
I say this from some experience. My children are in French Immersion. They have been since kindergarten, and so
they go to College Beliveau in St. Boniface.
I note many competitions in track and field and other events do not
involve the French Immersion schools.
Yet it is a full French‑speaking school in terms of the
students. I think it would benefit the
students to have that interaction. I do
not think it would hurt them.
If the goal is to give them exposure to
French culture and to the language and so on, why would there be so many
limitations to that interaction, simply on the basis that their parents do not
speak French?
The other thing about it, I notice that
when I talk to the students of the French Youth Parliament, immersion schools
are not, I do not believe, invited to participate. They cannot participate in the French Youth
Parliament, and I think that would be a valuable experience. I just wonder what some of the thinking is
behind this, or what the policy of the minister is on this. It may not be the minister's policy or the
bureau's policy. It may be the
individual school division's.
Mrs. Vodrey:
Mr. Deputy Chair, it is, by and large, a school division policy which
determines whether or not there will be joint interaction between the francais
and the French Immersion programs.
The member has mentioned a number of
activities which are separate, but I am informed that, in fact, there are more
joint activities. I will not try and say
them in French, but I will give you a sense in English of what the activities
are‑‑the French youth theatre festival, and also the festival of
films or videos, and then the Festival du Voyageur.
Mr. Plohman:
I believe there are such things as the honour choir, the honour band for
all schools‑‑English, French Immersion and francais.
I understand that, but there are many
others that are limiting such as a francais‑only track meet, for example,
and the Youth Parliament that I mentioned.
The Youth Parliament is one where I would
think there is probably a provincial policy involved because it involves all of
There are now a number of immersion
schools in the city, at least Jeanne Sauve and Beliveau and others, but the
number is very small. So they are kind
of separated from the English‑only schools, and they are separated from
the francais schools, and they are kind of in the middle by themselves.
I think it is important to have that
interaction with the francais schools in all respects, as well as, if they
want, with the English schools, but they do have their own little entity. It is
a small number and it kind of leaves them, I think, without that feeling that
they are fully accepted in the French community.
Mrs. Vodrey:
Again, I can say to the member that this is the policy of school
divisions and how school divisions and schools provide groupings and
opportunities. I would also say to the
member that some decisions are based on choice, and they may be the choice of
the people participating or choosing not to participate. So some may be divisional policies and others
may be based on issues of personal choice.
Mr. Plohman:
I am not speaking, basically, where there is a personal choice
involved. It is a policy that certain
schools are invited to certain activities based on programming. I would ask the minister though to look at
this issue, which she has not commented on, of the Youth Parliament, from the
point of view of seeing whether there are some opportunities that can be made
available there.
I think that we are prepared to pass
through this division before we close tonight.
We may have some questions on the lines as we go through, but basically
we should do that fairly quickly.
* (0000)
Mr. Deputy Chairperson:
Item 3.(a)(1) Salaries $106,900‑‑pass; (2) Other
Expenditures $27,200‑‑pass; (3) Francophone Schools Governance
$116,000‑‑pass.
(b) Curriculum Development and
Implementation (1) Salaries $737,000‑‑pass; (2) Other Expenditures
$149,000‑‑pass.
(c) Educational Support Services (1) Salaries
$212,700‑‑
Ms. Friesen:
I wanted to ask a question about enrollments, which I think comes under
this. There is a popular perception that
enrollment in immersion programs is declining, and I wonder if that is the case
for
Mrs. Vodrey:
Mr. Deputy Chairperson, in looking at the enrollments beginning in 1980‑81,
there had been a constant increase. At about
'89‑90 we were in the range of 19,000 students. That was increased to 19,644 in '90‑91
and in '91‑92 to 19,751. So in
those years it was a slight increase over that time period. We had thought we might reach 20,000, but in
the year '92‑93 we had a slight decrease to 19,692, a decrease of 57
students.
Ms. Friesen:
Does the minister have any sense of how this compares to similar
provinces? I am thinking of
Mrs. Vodrey:
Mr. Deputy Chairperson, I am informed that, in general, this has been
the trend across
Ms. Friesen:
I would anticipate that there would be an expansion of high school
enrollments; that is, certainly the number of high school places has
expanded. Does the minister have a quick
reference on, say, how the distribution of these students has changed?
Mrs. Vodrey:
Mr. Deputy Chairperson, we only have available this evening the figures
from this year. The figures from this
year, I am informed, do indicate that there is an increase in the students who
would be attending the high school program as the larger number of students,
particularly in those years where there was the greatest increase, as I was
describing in the total numbers, are now approaching the high school years.
Ms. Friesen:
Can I look at the other end now and look at the intake over the last two
years? You said that there is a drop of
about‑‑what was it, about 50?
Where is that drop coming? Is it
coming from the junior high, Grades 8, 9, 10, or is it coming in the
intake? What I am really looking for is
what the future projection is.
Mrs. Vodrey:
Mr. Deputy Chairperson, the figures that I have before me show that
there is a drop of approximately 112 students in the kindergarten year, a drop
of approximately 263 students in the Grade 1 year, 68 students in the Grade 2
year, 41 students in the Grade 3 year, and then we have an increasing number of
students slightly until Grade 7 when we have a decrease of 76.
Ms. Friesen:
Just a comment on that. That drop
in Grade 1, I think, is really quite startling.
The drops in Grades 2, 3, you probably have always had as people switch
programs and realize that immersion is not for them, but that 216 for Grade 1‑‑this,
I assume, is not a drop necessarily of people who have gone from kindergarten
to Grade 1. This is actually a standard
intake into Grade 1, regardless of whether they have had kindergarten. It is not slippage in that sense.
Mrs. Vodrey:
Mr. Deputy Chair, I am not able to speculate on what the causes
are. We do not know exactly what the
causes are for that drop. I suppose the
causes could be many. It may even
reflect birth rate in that year.
Mr. Deputy Chairperson:
3.(c)(1) Salaries $212,700‑‑pass; (2) Other Expenditures
$68,600‑‑pass; (3) Grants $974,500‑‑pass.
3.(d) Official Languages Programs and
Administrative Services (1) Salaries $404,200.
Mr. Plohman:
The bursaries programs for teachers and students, what is available from
the province on that?
Mrs. Vodrey:
Mr. Deputy Chair, the amount is $140,000 available for teachers,
$346,000 available for students.
Mr. Plohman:
And a number of different programs for these or are these just under one
administrative program, one bursary kind of program, and have these been
affected by any of the decisions made about bursaries by the minister?
* (0010)
Mrs. Vodrey:
Mr. Deputy Chair, in terms of the teacher bursary, there is just one
teacher bursary program. That is for
teachers who study in the summer and they may either be teachers from the
francais program or teachers in the French Immersion program.
For the student bursary, this is a
different program than the bursary through our Student Financial Assistance
program. It is a bursary available for
students who will be studying at St. Boniface College or for students who study
outside of the province in French or bilingual programs.
Mr. Plohman:
So is it treated like a scholarship or is it strictly on the basis of
need?
Mrs. Vodrey:
These bursaries are not awarded based on need, and they are not awarded
based on academic achievement. They are
awarded based on a lottery system.
Mr. Plohman:
How many are awarded each year?
Mrs. Vodrey:
Mr. Deputy Chair, in 1992‑93, there were 591 student bursaries and
there were 141 teacher bursaries.
Mr. Plohman:
A couple of other questions, the minister had indicated earlier, in
negotiations regarding the Francophone division for the $112 million federal
available to all the provinces eligible, that she had not yet determined the
criteria. I had asked about whether it
would be based on per pupil or on Section 23 parents or what would be the
criteria?
I noticed that the minister has said under
this section, under expected results, the attainment of the best possible
financial return for the province on negotiating with the federal
government. So I ask her the simple
question, basing it on the number of Francophone or Section 23 parents,
eligible parents, as opposed to on student enrollment, which would give the
best financial return to the province?
Mrs. Vodrey:
I am informed that the result would be approximately the same.
Mr. Plohman:
One other area that I wanted to question the minister on, and that is
the issue of standards, or standings, relative standings on performances of
people, of students in immersion programs versus the English stream as to how
they perform overall.
There was all kinds of speculation years
ago about whether kids would be behind in their English language arts, and we
have found from our own personal experience that is not the case, as perhaps I
believe they are actually ahead, or perhaps it would be where they would have
been in English only.
Now that many years have gone by, we have
graduates from immersion that have gone right from K to Grade 12, what are the
results in Manitoba's experience on the relative performance of kids who have
gone through the French Immersion programs versus English programming only?
Mrs. Vodrey:
Mr. Deputy Chair, I am informed that on the provincial assessments which
we spoke about being done on a cyclical basis, the students in French Immersion
and francais scored at least at the same level as their English counterparts
and in some cases may have done better.
Mr. Plohman:
Is this math and social studies, or are we talking English only here,
English language arts?
Mrs. Vodrey:
The areas assessed are in all the areas we assessed through our
provincial assessment program. It
includes areas such as math and science and English language arts.
Mr. Plohman:
Is there any comparison done on performance on the CTBS testing?
Mrs. Vodrey:
No, that testing is done within the division.
Mr. Plohman:
So there is no central correlation or comparison by the province of
those results.
Mrs. Vodrey:
No there is not.
Mr. Plohman:
Did French Immersion and francais students also write national tests
that were written just recently in math for 13‑ and 16‑year‑olds?
Mrs. Vodrey:
Yes, the students did participate in the SAIP program in the math
testing which occurred this year. They
will also participate in the language arts assessment which will occur next
year. They also participate in our
provincial exams.
Mr. Plohman:
Is the minister aware that students, 16‑year‑olds, taking
these tests were by and large not enrolled in 300 courses because the majority
were in Grade 11, that they were being tested on information, on curriculum,
that was developed based on 301 courses, and that therefore they could not have
taken some of it because they are still in Grade 11 or Senior 3?
Mrs. Vodrey:
Mr. Deputy Chairperson, again, the SAIP assessment was done to look at
functioning of 16‑year‑olds.
Then the test was developed for francais and for French Immersion in
Certainly our information is that there
was quite a close match in terms of the skills developed. As the member knows, that particular test
tested a range of skill development. So
we know that not all students would be able to complete all forms of the
test. The test was to look at students
functioning within math in a series of concept areas at a series of levels of
functioning.
I am informed that we have had no
questions raised from the schools regarding the SAIP test.
Mr. Plohman:
The test that was written in math for 16‑ and 13‑year‑olds
was, as the minister said in the House, designed to compare Manitoba's
curriculum and how Manitoba students would perform as compared to other
students, but the problem being that the curriculum is‑‑well, the
minister can give us the objectives of the test then for participating in it,
if she wishes, if they are not correct.
* (0020)
In any event, the problem is that they
were being tested on a standard curriculum.
It is a standard test across the province. That does not exist. There is no national curriculum. That way it tends to be unfair to some
provinces. My understanding is that to
16‑year‑olds in
I wonder if the minister‑‑and that
is why I raised it in Question Period in the House‑‑was aware of
that and why she would have accepted to allow students to be put through that
kind of situation, and teachers, when in fact they were at a distinct
disadvantage before they even started, not because they were not performing
students and they could not perform, but because they had not been exposed to
curriculum under which they would learn those skills. It does not make any sense to put them at that
disadvantage. It certainly is not a realistic
comparison.
That is the information I have, and I
would appreciate if the minister could‑‑I perhaps should have dealt
with this under general curriculum earlier in the Estimates.
If the minister needs additional staff to
deal with this at some point, this is as it applies to the French programming,
but it is equally as applicable here as it is to the English perhaps unless it
was developed under different criteria completely. If that is the case, well, then it is not as
relevant to this section as I perhaps thought it was.
But I want to, under Support to Schools,
indicate to the minister that I would like to explore that a little bit further
as to what curriculum it was based on and whether Manitoba students were given
a fair chance in that test.
Mrs. Vodrey:
Mr. Deputy Chair, the testing and the test which was administered was
field tested, and, again, with that field testing and with the piloting, there
were adjustments made to the test. The
test was developed in Quebec‑‑the Francophone test, the francais
test; however, there was input by all provinces, and the test was not based on
any one provincial curriculum. It was
also not used to evaluate specific students or teachers. It was based on expected skill level and
performance expected at that age, and we were looking for levels at which
students of that age were able to achieve.
We believe that the match was really very
close, but we know that not all students would be able to complete all sections
of the test. The test was in seven concept
areas with five levels of competency, and so it is true that some students
would not be able to complete the whole test because their level of competency
or mastery of certain skills would not have had them reach that particular
level. We are aware that each student's
achievement level would not have allowed them to complete the test. We are looking to see, were some students
able to complete the test in
Mr. Plohman:
Did immersion students write this test as well?
Mrs. Vodrey:
Yes, they did.
Mr. Plohman:
Just to comment about the overall comparison to see how Manitoba
students did in relation to how students did in other provinces, the minister
would have to admit, though, that if the test was not as relevant to the
curriculum being covered in Manitoba to all areas as it is in some other
provinces, it does tend to distort the results through no fault of the students
or the teachers. Would the minister
admit that?
Mrs. Vodrey:
Mr. Deputy Chairperson, I think that the member has made an assumption
that, if our students were not able to complete all areas of the assessment, it
would somehow only be
As we said, the test was not developed based
on any one provincial curriculum that should provide a specific advantage to
any particular province. All provinces
had a part in developing the assessment.
We looked for skills and mastery of skills that would be achieved by
students at age 13 and 16, and the assessment was presented, as I said, in
seven concept areas of five levels. Our
students were asked to complete the test, to do the best that they could, and
then we will have a look at the results.
As I have said also, this was not meant to be a way to measure teacher
performance specifically or individual student performance.
Mr. Plohman:
Yes, but it could reflect negatively on
I understand that at least in the English
test there were math concepts that are traditionally just not part of the
curriculum in Grade 11 that were being tested; therefore, teachers and students
have told me that put them at a distinct disadvantage. It bothered them, because they want to do as
well. They feel some pride in this, even
as irrelevant as the comparison is, in my mind, between provinces, because it
is very difficult to have relevant comparison because of all the other factors
involved.
* (0030)
I am making the assumption that it did not
fit the curriculum as well, yes, based on information I have. It may not, as I indicated, be as relevant
for the French test. I am not saying
that. But I want to discuss this further
with the minister when we get to the public schools area. So I just wanted the minister to know that,
because I will give her specific information on where the testing did not fit
with the curriculum.
I think that is serious because we have to
question the motivation of the minister to participate in a test where, in
fact, it could place
Mrs. Vodrey:
I am not sure if the member would not have participated. As he knows, there has been a great deal of
work which has been done on behalf of the development of the safe assessment. We were looking at skill levels and mastery
of concepts. As I said to him in the
House in an answer in the Legislature, some concepts are also covered in the
areas of geography and science. Our
students did have the opportunity to have studied the concept areas that were
tested.
For some reason, the member wonders if
Mr. Plohman:
With age not being the relevant criteria, because it should be what
curriculum they have been exposed to.
The minister does not have to use a national test to determine whether
her curriculum is the same. She merely
has to look at the curriculum to determine if it is the same or not. You do not need a test to do that.
I am saying to her that there are areas
where the testing did not reflect the curriculum, and that is the part that I
do not think is fair for
Mr. Deputy Chairperson:
3.(d)(1) Official Languages Programs and Administrative Services: Salaries $404,200‑‑pass; (2)
Other Expenditures $345,600‑‑pass; (3) Assistance $486,000‑‑pass.
3.(e)(1) Library and Materials
Production: Salaries $369,900‑‑pass;
(2) Other Expenditures $192,200‑‑pass.
RESOLUTION 16.3‑‑RESOLVED that
there be granted to Her Majesty a sum not exceeding $4,189,800 for Education
and Training for the fiscal year ending the 31st day of March, 1994‑‑pass.
The hour being 12:33, what is the will of
the committee?
An Honourable Member:
Committee rise.
Mr. Deputy Chairperson:
Committee rise.
ENVIRONMENT
Madam Chairperson (Louise Dacquay):
Will the Committee of Supply please come to order. This section of the Committee of Supply is
dealing with the Estimates for the Department of Environment.
We are on item 1.(a) Minister's Salary, page
50 of the Estimates manual. Shall the
item pass?
Ms. Marianne Cerilli (Radisson):
Madam Chair, I move, seconded by the MLA for
Madam Chairperson:
Is the committee ready for the question, or do you wish the motion
repeated?
An Honourable Member:
Repeat it.
Madam Chairperson:
It has been moved by the honourable member for Radisson, seconded by the
honourable member for
Is the committee ready for the question?
Hon. Glen Cummings (Minister of
Environment): Is it a debatable motion? I would like to speak to the motion.
Madam Chairperson:
It is a debatable motion.
Mr. Cummings:
We had considerable discussion on this last week about whether or not
there was some federal responsibility that was not being discharged or whether
I or this government had not been approaching the federal authorities at the
appropriate time about a federal involvement in the Pembina Valley diversion
project.
I have to indicate, with some considerable
amount of umbrage, that there have been ongoing almost weekly, and certainly at
times daily, contacts with the federal authorities about where they are heading
with this project, but it is not the decision of this little minister to tell
the federal authority that they must have a joint review. In fact, their indication is, to us, very clearly
that they are not prepared to enter into their screening process until there
has in fact been a trigger. Those
triggers are primarily whether or not there are dollars involved, even though
one would anticipate that there might be some federal dollars involved. The fact is, that decision has not yet been
made. The federal authorities refuse to
enter into the screening process and provide an answer until that has occurred.
The member might well want to have a
little fun, at my expense, with this predicament, but this is what I have been saying
for years is wrong with the federal guidelines, the interim guidelines, and the
way they apply to environmental law across this country.
One only needs to look at most of the
court cases that have ended up over questioning whether or not the federal
authorities have exercised the correct jurisdiction. It seems to me that they almost all have come
down to a matter of process, not so much weighing on whether or not the
environmental concerns, one way or the other, were properly taken care.
The cases that ended up in court very
often were cases of procedure or whether or not the federal authority did or
did not adequately respond by simply making a decision in what were seen to be
their areas of responsibility.
Let me put it on the record again. There is one thing that I would prefer, that
we not end up with federal authorities coming in behind, if you will, and
attempting to run a second process. I would much rather that that was tidied up
and dealt with up‑front, but I find myself in the most bizarre of
situations where I cannot cause that to occur.
This province is one of the leading
provinces in the country in terms of co‑operating with the federal
authorities and, in fact, running joint environmental processes. We started the Conawapa process under that
agreement. We started the North Central
Transmission Line, and it is ongoing.
It, in fact, will probably be the one example of where a completed and
successful joint federal‑provincial environmental process has been
carried through.
So I find it a little bizarre that at this
juncture I am being chastised for not doing whatever it is the opposition
thinks I should be doing in terms of federal co‑operation. The authorities, even to exercise their
screening program, whether or not it is in or out of the federal screen, simply
have to make a decision. They will not
make a decision until the trigger has actually occurred.
It seems to me, Madam Chair, that we have
looked after the best interests of the environment, the best interests of the
public in attempting to begin the process at least under the provincial
environmental assessment process because the information garnered there will be
open, unfettered, as I have said before.
That may well provide some of the
information that the federal authorities will want to assume in terms of making
a decision, but I cannot predict what that decision will be, nor can I predict
how they will respond to the information that may be and, I believe, probably
will be provided adequately in front of the Clean Environment Commission.
This is not unlike this predicament that
we were faced with in Oak Hammock. It is
not dissimilar to the situation that we faced regarding the Pelican Lake
Diversion, a situation where federal dollars were involved, where there was a matter
of concern about whether or not we should issue a licence prior to the federal
screening process being completed.
That, in fact, is the crux of my problem,
the reason why, in my opinion, there are an awful lot of things about governing
and running environmental processes in this country that are wrong, that simply
are going to have to be addressed and, I hope, addressed through the new
Environment Act.
Madam Chair, I think all I wanted was the
opportunity to put a few word on the record in defence of the position that the
province finds itself in. I am not sure
if the opposition intends to have a vote on this motion but, whatever their
will, let them proceed.
Madam Chairperson:
Is the committee ready for the question?
All those in favour, please say yea.
Some Honourable Members:
Yea.
Madam Chairperson:
All those opposed, please say nay.
Some Honourable Members:
Nay.
Madam Chairperson:
In my opinion, the Nays have it.
Mr. Steve Ashton (Opposition House
Leader): I request a recorded vote.
Madam Chairperson:
A recorded vote has been requested.
Call in the members.
* * *
(Concurrent sections
in Chamber for formal vote)
Madam Chairperson:
Order, please. In the section of
the Committee of Supply meeting in the Chamber considering the Estimates of the
Department of Environment, the following motion was moved by the honourable
member for Radisson (Ms. Cerilli), that this committee regrets that the
Minister of Environment did not contact his federal counterpart to request a
joint federal‑provincial review of the environmental impact of the
Assiniboine diversion.
A
COUNTED VOTE was taken, the result being as follows: Yeas 19, Nays 23.
Madam Chairperson:
The motion is accordingly defeated.
Order, please. The two sections of the Committee of Supply
will now continue with consideration of the Estimates.
ENVIRONMENT
(continued)
Madam Chairperson:
This section is dealing with the Estimates for the Department of
Environment.
Item 1.(a) Minister's Salary $20,600‑‑pass.
Resolution 31.1: RESOLVED that there be granted to Her Majesty
a sum not exceeding $1,581,900 for Environment, Administration and Finance,
$1,581,900, for the fiscal year ending the 31st day of March, 1994‑‑pass.
This concludes the Estimates for the
Department of Environment.
SUSTAINABLE
DEVELOPMENT INNOVATIONS FUND
Madam Chairperson (Louise Dacquay):
We will now be dealing with Resolution 32.1, page 148 in the Estimates
manual.
The minister's staff, please enter the
Chamber.
Hon. Glen Cummings (Minister of
Environment): In going through the Sustainable Development
Innovations Fund, I have distributed information to both of my critics. I would like to thank Bob Sopuck and Ann
Didur for having assembled this information. Presumably that will make things
go a little quicker.
Ms. Marianne Cerilli (Radisson):
There are a number of issues that we could raise with respect to this
fund. It has been a fund that has grown
substantially this year, and there are a number of concerns about the uses for
this fund.
* (2030)
I am glad to see that there is a report
this time that has a little bit more detail.
I have not yet had a chance to go through that to look at where in fact
some of the money has flowed, but I want to start off by just inquiring about
the difference that appears between the Estimates document and the main budget
document.
The money that is indicated in the
Estimates for last year, $1,17l,000‑‑and then in the budget it says
that there is $836,000‑some approved and only $680,000‑some
spent. How does the minister account for
the difference?
Mr. Cummings:
Some approvals arrive late in the year.
We also have holdbacks, 50 percent in some cases, for approval of the
project in progress. Very often, we are
waiting for information.
One of the conditions of any of the grants
is that reports and information come back, so there is a holdback. That can be as much as 50 percent. It can be less, but that accounts for carry‑over
from one year to the next. That carry‑over
is not carried‑over dollars, but it is carried‑over liability and
it is taken from the second year's allocation if it is not spent the first
year.
Ms. Cerilli:
So it seems that there is a deferral of some $300,000.
Mr. Cummings:
That would be correct.
Ms. Cerilli:
What is accounting for the large increase? Where is the money coming from for the
increase for this year?
Mr. Cummings:
The allocation from the revenues of the removal of the exemption from
provincial sales tax for disposable diapers in 1992‑93 would return a
million. It is estimated that for a full
year, it will probably return a million and a half.
Ms. Cerilli:
Have there been changes in the criteria for the fund with the change in
the name and transferring it to the Department of Natural Resources or under
that department?
Mr. Cummings:
Well, the same basic criteria apply, but I think we also make it clear
that this would allow for, well, for example, some projects that the Department
of Environment and the Department of Natural Resources have encouraged people
or projects that they wish to get moving to apply to the fund, but they still
have to meet the same criteria and, basically, what we have found is that we
are getting a large number of smaller projects as opposed to a small number of
large projects.
I think in that respect we have reached an
increasing number of projects and we have been able to leverage other dollars.
Smaller grant allocations are generally as a result of the project being able
to obtain some funds from other areas.
It might well be the federal Partners Fund. It might be private dollars, it might be
existing programs, for example, in a community that has an existing tree
planting program and wishes to put a special emphasis on some expansion, and
that is sort of an imaginary example, but that is the type of thing the fund
seems to be reaching more to.
Hon. Harry Enns (Minister of Natural
Resources): I wonder if the minister could indicate to me‑‑I
cannot seem to find any provision in his Estimates for the salary arrangements
for the director of the sustainable development units. Where could I find them in his Estimates,
please?
Mr. Cummings:
I will not pay him. I mean, I do
not pay him.
Mr. Enns: Well, Madam Chairperson, I think it is
important for the record that it be noted exactly which minister in which
department does pay him.
Mr. Cummings:
I blush to admit that it is the Department of Natural Resources.
Ms. Cerilli:
I know that this fund is being audited, and I think that is
necessary. The minister himself has made
some derogatory comments about having slush funds. There are many people that would view this
fund as a slush fund, particularly with the vague criteria that has been used
with this fund.
I think that, as has come out with the
Estimates for the Department of Environment, the money has also been used
extensively for government departments which was initially not the intention of
the fund. There has also been some
concern about the fund being not used in a way that is evenly dispersing the
money throughout the province. There is
concern about the agencies that are actually doing the work for various
regional associations or groups that might be listed on the material that goes
out indicating who gets the money.
I would simply indicate that I think we
are going to look forward to getting the report from the auditor on the fund,
and I am not going to spend a lot of time during these Estimates going through
some of the details, even though we have concern about a number of the projects
that were done, Enviro‑Oil, the Reclaim magazine, and some other
agencies. I would simply ask if the
minister has any kind of breakdown of the percentage of money from the fund
that has gone to work being done by the government departments and government
agencies?
Mr. Cummings:
I do not think the member should pass off a couple of comments such as
she did regarding Enviro‑Oil, and I forget what the other comment she
made was. I particularly picked up on
Enviro‑Oil because there is an amount allocated here that is referred to
in the heading for Enviro‑Oil. But
she should take the time, and I presume she will, to look further into the
project listings.
I believe it would be made clear in
there. I have to look at what the notes
say, but the fact is I am well aware that what that is, is tax relief for the
sale of the product which is recycled oil.
It was done purely to encourage and enhance the sale of that product so
that we can have some assurance that is an industry that would continue and
expand. In fact, they are looking to
expand in the Virden area.
The fact is that this province and other
jurisdictions have a history of encouraging the use of environmentally friendly
fuels by using the tax system. Certainly
the Mohawk gasohol plant in Minnedosa is a perfect example. It has been in place for some 20 years or
more, I believe, and has received a considerable amount of tax relief in terms
of provincial motive tax, and that is what this is, quite simply. You will note in this year's budget that it
was referred to officially in the budget as being now handled in a different
way. That money will no longer flow out
of this fund. This was done as a one‑year
bridge to make sure that Enviro‑Oil was able to keep its recycled oil,
recycled into No. 2 diesel fuel, keep that fuel competitively priced, continue
to remove the used oil from the wastestream.
* (2040)
That is the kind of thing that I make
absolutely no apologies for, in terms of the fund responding to what some
people consider departmental initiatives or something the department might
better have budgeted for.
In fact, these dollars are not large, and
they allow response more directly to the kind of pressures that come on
companies like Enviro‑Oil, in this particular instance, or for proposals
that come in‑‑and I look just above the Enviro‑Oil proposals.
For example, the Manitoba Department of Environment, in putting forward our
beverage container program under the WRAP program, we did not have to bring
staff on board to deal with a beverage container program.
We were able to strike a contract with
Arthur Andersen. In fact, they run
beverage container programs in some other jurisdictions in the country and have
developed a computer program that is easily adaptable to our program and
others. For a very low cost we have a
contract in place that allows us to, by the 1st of August, be in a position to
regulate the beverage container industry in whichever way we see fit, whether
it is deposits or whether it is other means.
We now have the regulations fully implemented and a record of sales for
that product in the province.
I look at the top of that same page and
look at zebra mussels and recognize that this is something that is an immediate
problem, but one that cuts across a number of departments. We work very closely with the ministry of
Natural Resources. In this particular
case, some small amount of money was able to be put forward for warnings and
border crossing signs and, I believe, some information materials to supplement
what was printed the year before. At the
same time, we used a half‑year staffperson out of Natural Resources to be
on the trail, as it were, this summer doing promotions. At the same time, the Department of
Environment, internally, is doing a lot of water quality monitoring, which includes
monitoring for evidence of the zebra mussel in the critical areas.
All of that seems to me to combine very
nicely. With a small amount of money
with this fund, we were able to enhance the program that was already underway.
Ms. Cerilli:
I am just going to ask about the one project, the other project that I
mentioned then, if the minister is going to comment on that one, and that is
the Reclaim magazine. This is a project
that I think that got $25,000. The
charge for the magazine is, I think, $24 per magazine, plus they also had a
number of advertisements in the magazine, some of which were also government
department advertising.
I would just ask the minister, who put
together the magazine, and if there was a budget that is available on this
project that we could see, and if there is any information showing about how
that $25,000 was used in this project?
Mr. Cummings:
Madam Chairperson, this is an example of where we were able to use some
small number of dollars out of the fund to encourage an initiative that,
hopefully, would have a permanent and lasting opportunity within the
province. It is a one‑time
proposal. This was handled through a
combination of this fund and, I believe, was allocated through Industry, Trade
and Tourism, through the Environment Industries Development Initiative.
Frankly, one of the first things that I
have found, and I think other ministers and other members to the ministry would
confirm, is that in the business of environmental industry, whether it is
reclamation, whether it is new advances in technology, whether it is bringing
in people to do consulting for cleanup, one of the more difficult things for
the average citizen out there, or the average businessman, if you will, who may
not have ever been faced with finding this type of service before, one of the
more difficult things that they have had to do is to know whom to ask.
Then, when they found out who to ask, then
they are not sure how competitive the type of information they get is. So any kind of information that can be added
to that process is useful. There are a number of other useful processes out
there. Certainly some NGOs have undertaken to provide directories of different
lists, and we are all well aware of that, but this took a little bit of a different
approach and, as far as I know, was quite successful in its first launch. I would anticipate that now that they have
gone forward, we will see more of their paper in the future. It will serve as a directory that might not
otherwise be available. I am not talking
so much about it only available in
In terms of the original project proposal,
they did provide a business plan and projected cash flows, and we followed the
same procedure on this as we do in others, that the dollars were not allocated
carte blanche, that there was follow‑up and a certain amount holdback on
the original money.
Mrs. Sharon Carstairs (
Mr. Cummings:
Well, I am glad to put the criteria on the record. I would just make a general observation; I
would think one area that the member has probably picked up on is the number of
weed control districts that have received grants under this. Let me assure her
that it will probably be an increasing number this year, although I think that
in the overall sense of things, after this year, there may not be so many.
The fact is that most of them have been
working on biological control. In fact,
So, in a general sense, it is
correct. There are some of those things
that might have been funded through the department, but these are the types of
small projects which require a lot of local initiative. Very often the local weed districts are not
manned the same way as a departmental program would be.
Let me put the criteria on the record and
see if the member agrees that what I have said coincides with the objectives.
The fund is to promote innovations that
will change the future behaviour of individuals, households, businesses and
institutions in keeping with the goal of environmentally sound and sustainable
development. The fund encourages the
creation of partnerships to make a contribution to improving the environment.
Projects qualifying for support must be
consistent with the principles and guidelines of sustainable development and
must clearly demonstrate environmental benefits. Projects of an ongoing nature must
demonstrate financial self‑sufficiency after funding expires. Projects must be unique and innovative. One‑time
assistance will be considered for community groups, organizations, service
clubs, youth groups, businesses and groups working with local governments. There must be a demonstrated need for the
project, a high level of community support and stakeholder involvement.
I think the example I used earlier of some
of the biological control has community support and is an example of an
extremely high level of stakeholder involvement.
The final line is that preference will be
given to projects involving funding that also receive funding from other
contributing sources.
So I guess the fund is broadly based, but
the process of being reviewed and scrutinized by the appropriate departments as
the requests come forward and then receiving from them recommendations to the
committee as to whether or not there should be approval does provide a pretty
fair screening process.
* (2050)
Mrs. Carstairs:
Who does this screening process?
How many levels are there in the screening process, and who has the
ultimate approval?
Mr. Cummings:
First of all, the proposal would be sent over to the sustainable
development co‑ordination unit headed by Mr. Sopuck, sitting in front of
me here, and then the proponent receives acknowledgment that it is being
considered and the proposal will be sent to the appropriate unit of a
department for technical assessment. In
other words, there are a number of them that are attached to Agriculture and
Natural Resources. Environment has a large number but, nevertheless, a lot of
them are directly related to things that the Department of Environment would
have someone of the capacity that would be related to an assessment of that
particular proposal.
Once that assessment is completed it is
reviewed by the Sustainable Development Committee of Cabinet, which I
chair. The approved project funding is
then administered by the implementing department. In other words, once approval has been made
and if the Department of Environment had been the scrutinizing or the assessing
department, they would then be responsible for making sure that the project was
properly completed, in other words, doing some follow‑up with the
proponents.
Then the ones who are rejected at any one
of those levels are sent appropriate letters of rejection. We sometimes also send out letters of
deferral where there is not enough information or where we are short of funds
or, for whatever reason, there may have been other projects of a similar nature
underway and we need more information. I
should point out, I do not have the figure right in front of me. I will get it in a minute, but there are a
significant number of rejections as well.
Mrs. Carstairs:
My final question: How many
applications did you receive? How many
acceptances? How many rejections?
Approximate‑‑I do not need it down to the‑‑
Mr. Cummings:
Madam Chair, 115 applications, 79 approvals and 36 rejections.
Now there is a further category within
this that the member will see as she goes through the information that I have
sent over, and that is the Environmental Youth Corps. It is block funded to $200,000 per annum, to
a total obviously of $1 million over five years, but within that $200,000 per
annum, a fairly significant number of applications came in.
The member for Radisson raised earlier the
question about whether or not there was an even distribution of funds. In fact, one of the things that we try to aim
for is as even a distribution as possible.
I will give you the figures in a sec as to this past year, but the year
immediately previous to this had a different blend than the following year.
It is simply a matter of interest that we
noticed that two years ago a lot of the northern groups did not receive
approvals. I think it was perhaps
because they did not understand that the plan was mainly to involve voluntary
people and some small amount of capital and supervisory dollars, and they saw
it as a source of working capital for wages.
There is an element of that, but not to the extent that some of the
applications were demonstrating.
Then, when we came into the second year of
the program, the situation completely reversed, for the highest number of awards
were in northern Manitoba, as I recall; and. certainly on a percentage basis,
their hit rate, if you will, or their percentage of success went up very
rapidly.
Now the figures for last year for a total number
of youths that were involved was 8,720 and there were 279 projects‑‑that
cannot be right‑‑no, 79 projects.
This is smudged here. Am I
right? Seventy‑nine projects there
as well, but the distribution of the dollars were to
Now that seems Park‑West might have
received more than its share on a regional basis, but there were more
applications that came in from that area.
We very carefully looked at this to make sure there was not something
that we could be accused of having skewed the process or whatever. Obviously, one thing we did find was that
what you call the Park‑West region does accommodate darn near a third of
the province regionally. It happened
they had some very active environmental programs in the schools, and that is
the way they broke down.
Ms. Cerilli:
I just want to ask one final question.
One of the concerns about this, as the minister is aware of, is that all
the money maintain its place in the fund even if it is not allocated that
year. I went back and got notes‑‑
Mr. Cummings:
No, that is not quite what I said.
I can clarify that.
Ms. Cerilli:
Well, maybe I will finish my entire question, and then you can respond
to it. I think the intention of the fund
is that there is the money raised through tires, the diaper‑‑removal
of the exemption from the tax‑‑and then the liquor bottles. I wrote down the numbers that I was given
during the Environment Estimates under the WRAP section. The numbers given to me were $2.2 million
generated from tires; $1.8 million generated from diapers; and $1.2 million
generated from the liquor bottles and then that was halved, I believe, for the
amount that should be in this fund. So
do we have a commitment that all of that money is in fact going to this
Sustainable Development Innovations Fund?
Mr. Cummings:
Yes, but let me speak to the numbers a little bit more. I have the exact numbers in front of me. The numbers that I gave during the WRAP
Estimates, you will recall, I said were my best memory of what the numbers
would be.
First of all, the alcohol or beverage
containers for '92‑93, I believe I said it was $1.5 million. It was in fact $1.7 million. Out of that, about half of that goes back to
the Liquor Commission for running their program. In '92‑93, the diaper tax, the figure
that I gave you was the estimated for '93‑94, and I had given you $1.8
million. The fact is, the Department of
Finance is estimating $1.5 million which is a little less than I had indicated.
Tire revenues were $2 million. The tire revenues have not yet shown up in
the fund, because they will go through the fund to a specially dedicated fund
for administration and reimbursement to those who are disposing of tires in an
environmentally sound manner, recycling them in an environmentally sound
manner. Those dollars will show up in
the fund before the year is over, but they will be transferred on through to a
fund that will be nonlapsing, similar in fact to the
* (2100)
The management of the dollars under
So the information I provided under the
WRAP Act as I indicated was my best recollection. I think I was out a little bit but very close
to the averages that I indicated.
Ms. Cerilli:
Just to clarify then, what is the amount from tires?
Mr. Cummings:
In 1992‑93 it was $2 million.
At $3 a tire, obviously, if we had a million tires sold annually, it
would be $3 million less administration, but it will be a little bit‑‑it
is $3 million in total. Recall that this
levy was not implemented until the 1st of August 1992, and it expires the 1st
of August 1993. So there is $2 million
revenue in last year's books and $1 million in this year the way it breaks down
on the April 1st split between the two years.
Madam Chairperson:
Resolution 32.1: RESOLVED that
there be granted to Her Majesty a sum not exceeding $4,471,000 for Sustainable
Development Innovations Fund for the fiscal year ending the 31st day of March,
1994‑‑pass.
This concludes the Estimates for the
Sustainable Development Innovations Fund.
HEALTH
Madam Chairperson (Louise Dacquay):
Order, please. Will the Committee
of Supply please come to order.
This section of the Committee of Supply is
dealing with the Estimates for the Department of Health. We are on item 1.(b), page 77 of the
Estimates manual. Would the minister's staff
please enter the Chamber?
Item 1.(b)(1) Salaries $529,000. Shall the item pass?
Mr. Dave Chomiak (Kildonan):
Madam Deputy Chairperson, did the minister want to introduce who his
staff is at this point, where it is somewhat different than last session, when
we ended here on Thursday?
Hon. Donald Orchard (Minister of
Health): I want to introduce a couple of my corporate
veil participants, Mr. Fred Anderson, Assistant Deputy Minister, who was here
Thursday last‑‑and my honourable friend's memory must be as short
as his‑‑what did he say in the Estimates: But I am really surprising them. My train of thought is really not that
lengthy.
He proved it tonight in forgetting one of
my staff‑‑and Mr. Frank DeCock, Associate Deputy Minister.
Mr. Chomiak:
I am pleased to see that the minister is in his usual form and frame of
mind as we enter these Estimates.
During one of the Question Periods, the
minister talked about the fact that he was considering or had suggested or
alluded to the fact or in his roundabout way made mention of the fact that he
would like to send a brochure or a pamphlet talking about health reform to
every citizen of
I am wondering if the minister could
outline whether in fact that is a possibility under the government in terms of a
status report to be delivered around the province
Mr. Orchard:
Yes, Madam Chairperson.
Mr. Chomiak:
Sorry, I missed that response. I
wonder if the minister might repeat the response.
Mr. Orchard:
Yes.
Mr. Chomiak:
Is the minister considering any kind of an update of his May 1992 Health
Action Plan?
Mr. Orchard:
That is a possibility, Madam Chairperson.
Mr. Chomiak:
Is the minister saying he has not thought about it, like so many other
areas of health reform, or is the minister saying that he is considering
it? Has he thought about it? That is the first question.
Mr. Orchard:
Yes, Madam Chairperson.
Mr. Chomiak:
We have certainly moved a step forward.
We have the minister thinking about it, and I thank the minister for
that response.
Can the minister give us an update as to
the status of various health reforms in his blue document? Does he have a document that he is prepared
to table that would update the status of the various proposed reforms as
outlined in his May 1992 blue document?
Mr. Orchard:
Madam Chairperson, in essence, I would refer my honourable friend to the
substantive discussion we had Thursday last.
* (2110)
Mr. Chomiak:
I presume that is no, the minister does not have an update, because he
was unable to provide it Thursday last and he is unable to provide it today.
I will repeat the question in another
form. Does the minister have in his
briefing book, that he would be prepared to share with us, any information with
respect to an update as to the status of the various reforms as outlined in May
1992?
Mr. Orchard:
Which area would my honourable friend wish an update on?
Mr. Chomiak:
To start with, I wonder if the minister might provide us with a status
report as to the bed closures at the various institutions as announced in May
and November subsequently of 1992.
Mr. Orchard:
Yes, Madam Chairperson.
Mr. Chomiak:
Is the minister prepared to share that with us during this sitting of
the Estimates period?
Mr. Orchard:
No, Madam Chairperson.
Mr. Chomiak:
Is the minister prepared to share that information with us during the
next sitting of this committee?
Mr. Orchard:
Madam Chairperson, that would be a distinctly better possibility.
Mr. Chomiak:
Is the minister saying he will or he will not?
Mr. Orchard:
Madam Chairperson, I indicated that that would be a distinctly better
possibility than this evening. This
evening's Estimates are starting at 10 past nine. I had staff here this afternoon that might
have been able to accommodate my honourable friend's requests. I made the executive decision of having my
staff leave waiting in this building to return to their regular jobs, and I
suspect tomorrow, if we get into Estimates, I will have the appropriate staff
here to provide those answers, providing nothing unforeseen happens to delay
Estimates again tomorrow.
Mr. Chomiak:
Madam Chairperson, the minister indicated that he would table a number
of documents during our last sitting on Thursday. I wonder if he is prepared to table those
documents at this time.
Mr. Orchard:
Madam Chair, I think we can do that tomorrow as well.
Mr. Chomiak:
During the last session when we met, during the minister's opening
remarks, he talked about a sixth principle of medicare as envisioned by the
minister. He talked about effectiveness.
I wonder if the minister might provide me
with an outline as to what he terms effectiveness in terms of his sixth
principle of medicare as mentioned by the minister in his own opening remarks?
Mr. Orchard:
Madam Chair, again I would refer my honourable friend to the essence of
my opening remarks wherein he will find answers to many of his requests,
particularly that one.
Mr. Chomiak:
I can take, therefore, from the minister's answer that he does not have a
very good definition because, in reference to the Hansard comments, it is
pretty clear that the minister does not have a clear definition of that.
I would like to now go through some of the
specifics of the health care package.
The member for The Maples is now going to take that line of question
now, Madam Chair, please.
Mr. Gulzar Cheema (The Maples):
Madam Chair, I missed the last part of the first day, I think it was
Thursday, the Health Estimates, but I will certainly go through some of the
remarks that the minister and the member for Kildonan made.
Certainly, I would like to welcome again
Mr. DeCock and Mr. Anderson. This is
probably the sixth time we are seeing the Health officials. I must say that during my experience within
the department I have certainly learned from them and I think that has helped
me to perform my duties in a much more organized fashion.
Madam Chairperson, I just wanted to ask
the minister then: Has he received any written objections from any of the major
health care providers groups in
* (2120)
Mr. Orchard:
Madam Chair, to the best of my knowledge and recollection, I do not
think any major organization has communicated with myself and with senior
departmental officials in writing that they disagree with the Health Action
Plan that was tabled May 14. I think,
without taking too much liberty with some of the statements made at the
announcement, all organizations, with the possible exception of the official
opposition, endorsed the Health Action Plan.
I think they were unique in not knowing what position to take back in
May of 1992.
Most other organizations indicated that
they agreed with the principles outlined in the Health Action Plan. Some of them indicated their support in
writing but, to my recollection, none indicated opposition to the Health Action
Plan in writing.
Mr. Cheema: Madam Chairperson, my reason was to ask a very
specific question because this is very satisfactory when you are receiving
support from all the major groups, because that has not been happening in other
provinces as we have seen in the health action reforms in Newfoundland or in
British Columbia or in Ontario or in Saskatchewan. That did not happen. I read somewhere, I think it was in the
Medical Post about three months ago, that the major organizations inManitoba
did say the plan was reasonably good, and they agreed with the basic
principles. I just wanted to confirm: Even after one year, are those organizations
still on the side of the Minister of Health's Action Plan or have they changed
their mind?
Mr. Orchard:
Again, without wanting to speak for those organizations, we have not
received any formal communication where any of those organizations who either
indicated in writing formally or in terms of public pronouncements agreement
with the Health Action Plan back in May‑‑none of them have reversed
the position. I will say, however, that
all of them have provided objective criticism, if that is the appropriate
phraseology, over the past 12 months as varying issues and changes have emerged
out of the Health Action Plan. Some of
the constructive criticism we have been able to accommodate and work into the
process to obviously meet a real concern.
Some of the concerns expressed have been because their particular
organization or professional discipline maybe was affected by a given decision,
so there have been individual criticisms that have surfaced.
But in general, again, I say, with the
exception of the official opposition‑‑the NDP have not taken a
position on health reform to my knowledge publicly. They are the only group that has not believed
that change (a) is necessary, (b) must happen and that the changes, as outlined
in the health reform document, are sound in principle, I guess, would be the
fair way to say.
Mr. Cheema: Madam Chairperson, can the minister tell us if
his office has received any communication from any hospital board across this
province objecting to the Health Action Plan?
Mr. Orchard:
Madam Chair, again, no board of either hospital or personal care home
has communicated a position in opposition to the reform package and the plan as
outlaid in the Health Action Plan. There
has been, as one would expect, communication from a number of boards asking
questions about the process, trying to get a better understanding of what the
process means, because I think it is fair to say that in the political debate
that emanates from this Chamber from time to time, there can be varied messages
going out which cause undue concerns and confusion amongst the observers.
As I mentioned to my honourable friend the
member for Kildonan, in terms of our discussion around the children's pediatric
services, where he indicated that emergency services for children would close
at the hospitals, that caused a lot of concern.
It was not accurate information that the member for Kildonan put out,
but it caused a lot of concern amongst the public at large who were worried
about where they could access emergency room services for their children.
That, of course, causes individuals to
phone the question not only to my office but to the ministry staff to get
clarification, because there is still a certain amount of belief attached to
statements when they are made by elected people who theoretically have (a)
knowledge and (b) positions of integrity, and there is some believability to
them. When the information is not
accurate, it does cause confusion.
Mr. Cheema: Madam Chairperson, I just wanted to make sure,
because the basic thrust the government took, that was last year, and as far as
I could remember, we did not hear anybody who was opposing the Health Action
Plan.
Now it is almost one year that we are into
the Health Action Plan, and I just wanted to make sure that the organizations,
that individuals who are going to read this Hansard know that there was no
opposition from any major group. There
has to be some criticism on a few things here and there, and that is very
natural. That is going to come. But we want to make sure that people out
there know that the Health Action Plan is still being supported by major health
care providers as well as the hospital boards.
I think if you combine all of those
groups, which are very, very critical power lobby groups, if they are not
opposing the Health Action Plan, then I think we are on the right track.
My second question to the minister is,
what kind of communication has been going from the minister's office to these
various groups in terms of either inviting or in meetings or any other kind of
communication to make sure they are being properly notified about the Health
Action Plan?
Mr. Orchard:
Madam Chair, there is ongoing communication with the stakeholders in the
health care system from professional groups through institutions and organizations
involved in care delivery. Those
communications are primarily direct in terms of meetings, updates which happen
every three to four months.
About a month ago, five weeks ago we had
the retreat. My honourable friend was
not here Thursday afternoon, he had other commitments, but the member for
Kildonan asked about update on a number of the surgical committees. We are expecting reports to come in from them
over the next range of weeks and for the balance of this calendar year.
What we did to attempt, for instance, to
bring some knowledge to the stakeholders was we had the university, faculty of
medicine, we had the College of Physicians and Surgeons, the MMA, MARN, MNU and
then the CEO's board chairs and a couple of other senior officials from our major
institutions, our Urban Hospital Council at a retreat where we shared
preliminary findings in direction of the surgical committees so that they would
have some advance notice as to the thinking process of the expert committees to
date. It was an opportunity to basically
say, no, this is not going to work or you should consider a slightly different
approach.
I think that all of the committees left
that retreat basically with the same focus, is that fair to say?‑‑without
major flaws being identified in the process.
That was one of the more recent forms that we tried to not just explain
what the Health Action Plan meant and what its goals were, but to give an
update in terms of where we were in a number of different program areas that
were under study and review.
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I have got, Madam Chair, a list which is
almost two pages long, and I will share that with both my honourable friends if
I can get copies made. If I cannot get
copies made tonight, I will have it for tomorrow. This is a list of meetings that have been
held by my ADMs and others closely attached to the health reform process and to
the various groups and, just to give you a flavour, the advisory committee on
geriatrics, Altona high school students, for example, the Francophone community,
the long‑term care committee, Manitoba Blue Cross, the physician
resources group, the Pharmacy Round Table, the Shoal Lake Health Centre, the
Urban Hospital Council naturally, Tache and Foyer, the lab boards.
A number of these presentations have
happened over the last number of years and there have been anywhere from as few
people at the presentations as two, I can see on one presentation to the Red
Cross CEO, to in excess of 250 in attendance.
I will have copies of that made for
distribution to my honourable friends, because one of the points that was
attempted to be made by the member for Kildonan on Thursday was that there was
no consultation, there was no public presentation, there was no opportunity for
public discussion.
That list that you will see clearly
indicates that my honourable friend the member for Kildonan's premise is not
based on fact. It is that political
rhetoric that sometimes consumes us from time to time.
There has been more public information attempted
to be shared in this process of reform leading up to the May 14th health reform
document and certainly after that in communicating the direction and the intent
in bringing groups up to date in terms of what the reform process means.
I think that that maybe in part is the
reason why I can say that even a year later, the major organizations have not
said that the general direction of health care reform as outlined in The Action
Plan and in what we have been doing in terms of expediting the directions in
that reform plan are wrong and ought to be abandoned.
They are all, as you say, still supportive
of the process. They may not like every aspect of it and they certainly do not
agree with some of the areas which may affect their institution or their professional
discipline in some fashion but, in general, they understand the challenge of
restructure and reform in the health care system.
Let us remember that every single one of
those organizations, whether it be hospital CEOs, personal care home CEOs and
their respective board chairs or whether it be the College of Physicians or the
MMA, whether it be MARN or MNU or any of the support workers or any of the
professional groups supporting health care, are attached to a national
organization.
Their attachment to the national
organization leads them to a greater understanding, for instance, than the
member for Kildonan has in terms of what is happening in other provinces. They know that the process in
I think that is why you find them‑‑as
I say, I make no bones about it. None of
them are jumping up and down with joy on every single aspect of health care
reform, but they understand that for the agenda not to change will be more damaging
to medicare and its ability to exist and provide services into the future than
making changes to assure it is preserved and protected. I think that kind of attachment to a national
forum is most beneficial in terms of two aspects.
First of all, creating an understanding
that the process in
From that I think they have some‑‑how
would I put it best?‑‑grudging security that the process is a
necessary one and is probably being undertaken in as open a fashion as
possible.
Mr. Cheema: Madam Chairperson, as I said on Thursday,
during this Estimates process this year, we are going to focus mainly on the
policy issues. Those policy issues are
based on the Health Action Plan. That is
where we are starting the basic outline that the minister gave, how was the
reception in May of 1992, and how that perception has changed in '93.
It seems from my consultation with the
various groups, and we have met with many groups, most of them are saying that
the government is still on track, although there are many deficiencies and that
is going to come. We never said the
process is going to be perfect. We never
said everybody is going to be happy, but as long as they are being notified the
communication is there. Certainly, if
they have met with so many groups, and I will go through their list and that
will be helpful for us to understand when we get communications from those
groups, then we can at least tell them that you had been meeting. What is the outcome of your meeting? Are we really achieving what we said in the
Health Action Plan?
Can the minister tell us, are we on target
in terms of the basic plan? We are into
almost one year‑‑one year and a few days over‑‑are we
on exact target as far as the Health Action Plan is concerned?
Mr. Orchard:
Madam Chairperson, I am going to answer that in two fashions. In terms of the downsizing at the two
teaching hospitals, in essence, that is on track. Although not extensively mentioned in the
Health Action Plan of May, because we had dealt with it quite extensively in
terms of a January '92 mental health reform package, but it is all part of the
shift that we are making. I think it is
fair to say that we are now on track with what we intend to do in mental health
reform. We are delayed by probably
upwards of six months, I suppose, or maybe even a year in some areas where we
might have been able to move a little quicker but basically on track, only
slightly delayed in mental health.
We are finding that some of the surgical
committees and some of the program committees that had been studying the
various program delivery issues in our hospitals are probably delayed through a
whole combination of factors from agendas of reporting, some of the reports we
were to have already. In essence, the
only report that has been accepted and acted upon is the pediatric
consolidation in terms of our acute‑care programming.
The balance of the reports, as I indicated
Thursday afternoon last, have right now perspective completion dates and
presentation to myself ranging from maybe four weeks out to maybe
December. That is going to change some
of the second‑year shifts and the time frames for those, but I cannot say
as how, except for maybe a few months of delay, there is any fundamental change
from where we think we can be, if that answers the question appropriately.
Mr. Cheema: Madam Chairperson, the reason I specifically
asked that question is because so much credibility is attached to this
plan. There are factors: first of all, if everybody is onside;
secondly, whether we are having communication; third is whether we are on
target.
From my observation, it seems it will not
be unreasonable for us or anybody to expect that there could be some delay in
some area, if that is going to happen. I
mean, we have seen in the mental health care, it was supposed to be‑‑and
it took about four to six months of delay to make sure that everything was all
in place. That was the basic outline of
the plan.
We saw the next phase was Westman Region,
and that plan came out.
Now it seems like we have a plan for
across
At that time, we had the framework, and it
was the understanding that this could go within two to three years. At that time, we said, probably, it is going
to take four to five years, and then we could at least have some plan of
action.
I think it will not be unreasonable to
expect that. We are just asking the
minister to prepare from that point of view. Otherwise, you could be accused
very easily that you are not on target, because there are reasons why such an
action plan could easily go six months this way or that way. It is going to happen because you are dealing
with a very, very complex system.
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You have experience with the mental health
care system, which is a major, major change, and now when the plan came out and
everybody said it was the best plan, as far as I can tell. We have read from all the news articles and
the various interested groups, so everybody liked that we have the community
services put in place.
That was the one promise, and that is
going to be my next question. The one
promise was made over and over again in this Health Action Plan and at some of
the meetings I have attended in terms of just an observer or through the
various other groups we have, one commitment was given, that there will be a
community placement in terms of the community placement commitment to make sure
that you do not cut a single bed without putting in any alternative services.
It may be the minister has answered those
questions, but I just want to make sure that those things are put in place
because, as far as I know, for the mental health care system, there was bridge
funding. Then also you are going to
close beds over a period of time; that will give some time to shift some of the
dollars.
The problem comes when you are shifting
them in the middle of the budget year.
You already gave the money to a given hospital, so there could be a
problem because the hospital may spend money in terms of if they are given‑‑for
example, for 20 beds or 30 beds, they have given the money. Then if you are shifting the beds out of the
hospital to the community, you have to take those funds.
I remember the line that money will go
where the patient is going to go. So I
just want to ask the minister: Can he
tell us or can he give us assurance that that promise is still being kept?
Mr. Orchard:
Madam Chairperson, my honourable friend asks the appropriate question,
and I am going to take a few minutes to answer in a little greater detail.
The downsizing at our two teaching
hospitals, in essence, was a significant bed for bed replacement, and the other
downsizings were accomplished in part by pediatric consolidation because I
think St. Boniface had the most active pediatric ward and I think the occupancy
was something in the neighborhood of 33 percent or 38 percent, something like
that, I forget the exact number.
But I want to reiterate two quotations
that I used in my opening remarks, because I tried to indicate in my opening remarks
that this process of restructuring and reform in Health has not been undertaken
before, and we have established some underpinning principles, and we have
established some direction and some course of action in The Action Plan from
May 14 of last year.
We are constantly adding to the
information base which can help us to make those changes in the system, not
compromising the principle of putting the patient at the centre of change and
moving budget with the patient, but to learn from other investigation as we
proceed down the path of reform.
Subsequent to the release of the Health Action Plan, the reform document
of May 14, and my honourable friend might recall this, the Centre for Health
Policy and Evaluation completed another one of their research documents
entitled An Assessment of How Efficiently Manitoba's Major Hospitals Discharged
Their Patients, commonly known as the Efficiency Study.
There are two quotations that I think bear
repetition at this juncture. The first
one is, quote: We estimate that a
significant portion of the days currently invested in treating acute care
patients could be eliminated without decreasing access to hospital care.
And the second quote, beginning: The hospital system appears to have the
capacity to handle more patients or to absorb a sizable number of bed closures
without rationing access to hospital care.
The hospitals and the government have tended to assume that every bed
closed should be replaced by another service, possibly less intensive and less
expensive, but nevertheless a replacement.
These data suggest that at least some of the bed closures could be
accommodated simply through more efficient treatment of patients in available
beds. End of quotation.
I realize that the mental health system is
unique, in my humble opinion, in that we really did not have a lot of good
services in the community. There were a
lot of services in the community, and I am not downplaying the integrity of
them and the commitment to them of the staff that were working in the community,
but by far our concentration was on the institutional side. In terms of changing the mental health
system, you could not do that. Previous
attempts at changing the mental health system failed because they did not
create the supports in the community prior to downsizing the institutional
capacity.
If you think about it, often people, who
are in institutions having mental illnesses professionally assisted, do not
have a home environment to return to.
That is their home in a lot of cases, or certainly a major portion of
their life is represented in that institution.
If you are going to replace the service in the institution with the
community, you have to create those supports ahead of time or else you simply
run the risk of having people fall through the cracks. That is why, in terms of the mental health
system, we knew we had to create the infrastructure in the community first and,
in essence, we did that before we closed beds.
Let me contrast with the acute care
system. The acute care system, by and
large, and I will talk specifically acute hospital system here, not long‑term
care, but the acute hospital system, in essence, has as their inpatient census
individuals who generally have a home to return to and quite often, not always,
but quite often family or support systems to return to. We did not necessarily have to, in all cases,
have to reinvent the support services for individuals accessing our acute
hospital system.
That makes the process of downsizing and
shifting resource easier in the‑‑I use the word "easier"
with poetic licence because nothing is easy in health care when you are making
those kinds of shifts‑‑but less challenging to undertake because
you did not have to create the housing infrastructure and some of the living
and support infrastructure as you had to do with a lot of programs dealing with
mental health.
When the Rooses, at the Centre for Health
Policy and Evaluation, analyzed the relative effectiveness with which hospitals
admit and discharge patients for a pretty consistent patient group in each of
eight categories, they found a wide divergence and they found that there was no
improvement of health outcome by having a longer length of stay. They made their analysis that upwards of I
believe 200 beds could be retired across the urban hospital system simply by
bringing the average length of stay for any of those eight procedures not down
to the lowest or most efficient and effective hospital but to the second
lowest.
In fact, that is happening. St. Boniface, just as a small example, not a
small example, it is a pretty significant example, this fall I think will be
retiring some 39 surgical beds from their complement of surgical beds by
implementing across their surgical admissions and procedures planning a
different admission procedure and an earlier discharge procedure. They have tested this and they are absolutely
confident they will not compromise quality of care outcome of good quality
surgical delivery. The individual will
be in hospital less and they will require fewer beds. Now, that is a significant improvement in the
effectiveness of the system if undertaken.
I want to close off by‑‑I know
my honourable friend probably followed this in the paper, but I was absolutely
intrigued. I have asked staff to follow up
on this. The
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I do not want to tell my friend that we
are not going to be building community‑based services. We are.
We have added budget. We have
reallocated budget within the home care budget to provide for additional
service demands as we shift away from the institution.
We have also provided, and it is on page
83 of the Estimates book, the Health Reform $15‑million fund, which is
designed to fund programs as we shift.
As appropriate programs are identified in the shift, we have some
ability to access up to $15 million so that that process is part of the ongoing
identification of needs as we shift this system from institution to community.
I want to caution my honourable
friend. I think he is quite cognizant of
this, that we cannot get trapped into thinking that every time a surgical bed,
for instance, is closed, we necessarily have to create a new layer of community‑based
programming. Some of that can be done
simply through more effectiveness, and therein I guess is in part, and I hope
my honourable friend from Kildonan was listening, an explanation of the
effectiveness definition that he missed hearing on Thursday last.
Mr. Cheema: Madam Chairperson, actually, the reason I ask
the question is precisely for that because the‑‑out there in the
community, the perception is somewhat that every bed is going to close, then
you are going to get the same dollar flow.
As you have said very clearly, and I think
that message has to go across, that is why I separated both things, the mental
health services and the other ones. I
mean, if you are going to go through all the studies, definitely you are going
to go through all the effectiveness and various programs in each and every
hospital, you are going to cut down the length of stay.
You are going to have their preadmissions
done early. A lot of those services are
going to be provided and not necessarily are you going to need all those
beds. That is a fact and that is
true. But the question is, how do you
convey to the patient and the public?
That is the problem here because for them, the numbers are $5
million. They will not talk about a saving,
but effectiveness they will talk in terms of cuts.
Actually that is not a cut. That is basically efficiency and being
reinvested somewhere else and they are going to benefit eventually. Our concern is always on this problem and
when this came last year and we thought of that, I said, this is after one year
going to be somewhat changed because that is not what it is going to look like
because we are going to examine each and every issue and then you are going to
hear from all of these groups.
Certainly each and every one tries to
protect their turf, but when they are competing against the same dollar, then
effectiveness has to be improved. Based
on the scientific data, you cannot run away from that. So that is why each one of them, by coming to
grips with the reality that this has to be changed, but not necessarily every
dollar saved in acute care is going to be spent somewhere else. That is not possible. It is not going to happen.
We would like the minister to convey that
message to the patients. Somehow, I
think the whole thing is going to be workable as long as the public is going to
be notified. It is a very complex
issue. It takes a long time even for
somebody who is a health care professional to understand and even try to really
come to look at the issue in long‑term planning.
But for the public who is going to read
newspaper stories or see a 15‑second clip, they are going to understand
only cuts. So when I go out and I try to
explain and it takes time it really gets across, but how do you do as a
Minister of Health, as a Department of Health, how can you convince the public
that the Health Action Plan is really a good plan? It can work and it is already working, but
those few things have to be explained because each one of us is very, very
attached to those beds.
I mean, the beds were supposed to be the
health care system in the past. You
provide a bed because you are going to get transfer money from the federal
government and you are going to get money from the provincial government, and
then you are going to have a power base there.
Ultimately, you are creating some of the things which were not needed in
the first place, but nobody had the courage to say what was right because
basically it was a trap. The whole thing
was a trap.
You get 50 percent of the money from the
federal government, and it was all tied to the whole transfer payments. So I think there are many individuals to be
blamed in the whole medicare system. It
is not the present, it is the past which has caused many problems. That is why I think, if you are going to
correct the future, then we are going to have more problems, but I must say
that this can work. I am, more than
ever, convinced that this can work, because for the last one year, nobody has
really come out and said this plan is not going to be workable.
My next question to the minister is: How many jurisdictions‑‑your
department, either yourself or ADM or deputy ministers‑‑have made
presentations to the various other governments, in our other organizations,
when they are asking to look at this Health Action Plan as a blueprint for
themselves?
Mr. Orchard:
I am only going to go partially from memory here.
I have presented, on several different
occasions in
Similarly, I have to say as well, though,
that as other provinces move in terms of their reform agendas, they provide us
with information as well, but I think we had the benefit maybe of more
consistency at the minister and deputy minister level and senior staff level so
that we have basically worked as a team.
My honourable friend, when he opened his
remarks, he noted the familiar faces. I
mean we have had some changes at the senior level in the department, but mainly
additions. A lot of the same people are
there and have been consistently working with government to develop this plan,
and I think that adds maybe an integrity that other provinces did not
necessarily have because of the dynamics of change in provincial government, et
cetera.
I was thumbing through my notes, and,
Madam Chairperson, I know this is entirely out of character for me, but I owe
my honourable friend the member for Kildonan an apology because I indicated
that the New Democrats did not support the Health Action Plan. I was thumbing through‑‑I have
some notes here. One of them is from the former critic of the New Democratic
Party. Although the current critic, the
member for Kildonan, has not stated whether he is in favour or not in favour of
health reform, I have to apologize because Ms. Wasylycia‑Leis did say on
May 24, 1992: "We have no
disagreement with the health reform plan that places major emphasis on shifting
from an institution‑based illness treatment model to a community‑oriented
wellness‑focused system . . . ." and furthermore went on to say
there is no question that our health care system needs an overhaul. That was in May 24, Winnipeg Free Press.
She also said on March 28, there is no
question that health care reform is needed and that we need to move from a
institutional illness model to a community‑based wellness model.
Then the final endorsation from Ms.
Wasylycia‑Leis came on May 19 at the Portage Herald Leader Press,
philosophically, we cannot disagree with it, it being the Health Action Plan.
So my apologies to the member for
Kildonan. I look forward to his
endorsation of the reform process as well.
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Mr. Cheema: Madam Chairperson, as we are passing more
time, things are getting more and more smoother. That is positive.
I think it was very important for us even
to ask the minister and put those things on the record because the credibility
of such a major plan, if it is being appreciated in other provinces, that
should tell you something because each and every province does not have the
same political ideology as the minister has. So that tells us the Health Action
Plan, right across this nation, is being dealt as a very important social
policy which is at the juncture of a very major change. The change has to come in what we have today
and based on those five principles, but also developing some new guidelines
which are going to be sustainable in the long run.
So I would ask the minister now, and I am
just going to give you a hypothetical example in terms of what in the minister's
own views is going to happen, for example, if in 1994 things do not work
out? Do you have a backup plan or do you
have a process of continuity, because it was something very irresponsible and
now everybody knows in this nation that it was a very sad part to change the
ministers of Health in six months time, one year's time. You have a few beds being closed. The opposition makes noise, you get bad
articles, and the Premier comes and changes the minister. But that has not happened here. That is one advantage. With five years of continuity and with the
staff, you are giving credibility to the whole process.
So how are you going to ensure that, if
things do not work for your government, the Health Action Plan is going to be
workable in the long run?
Mr. Orchard:
I am going to deal with that hypothetical question hoping it never is
one we have to face necessarily.
My honourable friend asks a very important
question because there is absolutely no question that the way we approach
service delivery and health care has to change and change rather significantly
from
Now in terms of continuity of the process
in
I guess about 10 months ago there was the
rumour that there was going to be a cabinet shuffle. Of course part of the rumour mill was that I
was going to be moved out of Health to somewhere else. Mr. Toews asked me about that at the time,
and he was quite concerned because he did not believe we were far enough along
on the process of reform to the mental health system to give the process
integrity.
Sort of as a snowball rolling downhill
gaining momentum, we had not quite started rolling downhill yet. We had a lot of our plans maturing but none
of them had received the seal of approval, if you will, and been announced for
implementation.
Change is a very sensitive dimension of
policy to try and expedite because, and I do not say this critically, but
everybody who is part of the system looks for government to blink or to
hesitate or for there to be a change so they can sit back and not necessarily
change even though they know that change has to come. I mean, that is a natural reaction to the
system. That is the way the system has
sort of worked, not only in Health but right across government.
Now we have the process moving in mental
health reform. I had a discussion just
about three or four weeks ago, two or three weeks ago even, I cannot recall
now, with Mr. Toews, and he is quite relieved.
He thinks that the process of mental health reform now has that
integrity of process that regardless of what happens, government, minister, the
community of caregiving in mental health is behind the process of change and it
has a momentum of its own. So I think we
are all right there.
I also think we are all right in terms of
the acute care system, and I will tell you why I think we are all right there
in terms of process change.
My honourable friend the member for
Kildonan makes a great to‑do about the APM contract with Connie
Curran. You know, I cannot stop the
disinformation campaign that my honourable friend and his party has engaged in
but, you know, you cannot avoid the basic fact that government did not go out
and pick APM, Connie Curran to do this contract and impose it on the two
hospitals, St. Boniface and Health Sciences Centre. It was the other way around.
Those two hospitals knew they had a
significant challenge facing them. They
were impressed with some of the discussions they had heard about the
restructuring process that APM had undertaken with about 100 hospitals in the
Upon investigation they were urging
government and, I mean, we were willing partners because we think there is
integrity to the process of restructuring in our major hospitals, and we think
it will offer a lot to maintain longevity in acute care health delivery in the
The hospitals themselves asked to engage
the consultant. We agreed and provided
the money to do so, and they are providing the expenses that will support that
yearlong activity. I use that as an
example to indicate to my honourable friend that I think the same kind of
momentum is building in terms of change in the acute care hospital side as
well.
I think that we will see the system
reorganize itself, with leadership from the ministry, yes; with pushing from
the ministry, yes; with hard decisions from the ministry, yes; but with an
understanding that the changes have to be made and that the system will in fact
be better able to deliver services after the changes than a system which might
emerge without change.
So I think that realization is becoming
more firmly embedded at the leadership level outside of government in our
health care community. That may well
give the kind of integrity to the process of restructuring and reform in the
acute care side that I think we have on the mental health side to give the
process life after current personalities or current government is gone.
The second thing I say to my honourable
friend in trying to answer that question, let us theoretically deal with a new
government. If the new government was my
honourable friend's party, there would not be a change because I think there is
understanding in the second opposition party, the Liberal Party of Manitoba, of
the need for change. You may change some
of the approach but fundamentally the direction will remain intact.
I am not so certain how the New Democrats
might approach, and of course that is what we are going to find out in these
Estimates, because that is where the New Democrats have got a brand new critic
who is going to really give us some of the background thinking of the New
Democrats in terms of health care reform and where they go.
We may not have the openness of sharing of
information from the member for Kildonan‑‑I hope we do‑‑over
the next number of weeks, but what gives me some sense that the process will
carry on is
* (2210)
Now let us deal with
But they believe they can meet‑‑and
I am saying this not to be politically critical but to be objective in terms of
where they are heading in Saskatchewan‑‑the health care needs on
the acute side of health care with some 4,000 beds in the system.
British Columbia, with I think the fastest‑growing
population in Canada‑‑and if seniors are the driving force behind
the necessity for more acute care hospital services, British Columbia should be
the example because, quite frankly, it is a retirement haven for a lot of
Canadians‑‑they are moving their acute care bed ratio down, which
is going to see a downsizing of their acute care sector with a growing
population.
And in
Now if one translates the sort of
criticisms we get from New Democrats in opposition in Manitoba over bed
closures and their decrying that issue, one must always remember, all they are
doing is decrying the closure, they are not saying what they would do in
government. Because if they are decrying
the closure of the beds as compromising health status of Manitobans, then surely,
ergo, there should be people dying on the streets of Toronto, dying on the
streets of Regina and Saskatoon, dying on the streets of Victoria and
Vancouver. But that is not happening,
because the issues my honourable friends the New Democrats raise here in
opposition are purely political design to try to get them in the back door,
into government.
What gives me confidence is that New
Democrats, once in government, turn into, as one political writer in the
Saskatoon Daily Journal described them, neoconservative socialists. You have heard this neoconservative stuff all
the time. Well, the New Democrats in
I do not know what that means, but it
means that they are using policies that are pragmatic, that are not dissimilar
to policies of Conservative administrations or Liberal administrations. In other words, they have come to their
senses when they are in government and they do not tend to deliver on the wild
rhetoric they promised from the luxury of opposition.
From those two standpoints, I think the
process may well have integrity in the province of Manitoba, because there is
an understanding by leaders in the health care community that change is
necessary and that they can be part of the change to the benefit of their
respective part in health care delivery as well as be part of the process of
change to help move it along in an appropriate fashion.
Mr. Cheema: Madam Chairperson, I think it was in September
of this year when we had two by‑elections, one was in
What happened was most constituents
rejected that notion and they said, no, the health care plan has to come. We have to work with the Health Action Plan,
and I think that was a good test. I
think if you combine two parties' votes in that area that should tell you,
about 70 percent of people really approved the Health Action Plan if that was
the No. 1 issue, as we all said that was the No. 1 issue. I am sure when the new by‑elections
come, that issue is going to come up again.
My question the minister has answered very
quickly, and I think in a very organized fashion, that we have to have
continuity of the process. If you have a
process gone long enough it will work, but I am sure there are people in the
health care sector as providers as well as users of the system. If they are both going to co‑operate,
then I think it will function in the long run, but there has to be a decision
from the government point of view in making sure that they are going to
continue to have those basic principles which were outlined in this Health
Action Plan and the government is going to act as a unified force to make sure
those things are implemented.
I just wanted to reinforce that and make
sure that if the Premier (Mr. Filmon) could read those comments, because I
think it is very essential from my experience in this House and also as
opposition critic which has seen the official opposition party and the third
opposition party and met with many people, and I learned. I think it will be very, very unwise to
change ministers every second or third year, specifically in the social policy
when you are making changes which are going to be very essential for the long
run. We are hoping that the process will
continue, because otherwise it will take another few years to teach people and
educate themselves to try to make sure they understand what is required.
Madam Chairperson, my next question
is: When all these changes are
happening, who is making sure, other than the minister's office, that whatever
was said in the Health Action Plan, somebody is monitoring the whole process?
Mr. Orchard:
I know my honourable friend is going to make the suggestion again in
that if we wanted to ensure the integrity of the process, we would have to
seriously consider an independent group or individual that would do the status
update in terms of where the process is going, and how it is proceeding.
I accept my honourable friend's suggestion
in that regard. We have not moved on that suggestion directly, but we hope to
be able to provide some information update as to where we are at. That will not
answer my honourable friend's concern, I recognize that.
I guess I have to sort of go back to some
of the things my honourable friend said.
We have gone through some by‑elections, and certainly we have gone
through the process of Question Period now since March. If there were major flaws that compromised
the citizens of Manitoba and their access to quality health care through the
changes that have been happening, I am quite sure that my honourable friend
would agree that in the by‑elections, health care would have been the
central issue, and it was an issue but certainly not a central issue.
My honourable friend is correct when he
notes in essence, if I recall it correctly, on May 14 when the Health Action
Plan came down, as candidate for the Crescentwood by‑election, Mr. Sale
indicated, well, I think it is patient and quite friendly. I mean that shows an understanding of the
process that was rewarding.
(Mr. Ben Sveinson, Acting Chairperson, in
the Chair)
In terms of an individual who was
reporting to Manitobans, no, we have not got that. But in terms of a process of Manitobans
having full access to any glitches or any compromises of process that may occur
in the change in the reform process, I think this crucible of daily Question
Period is as good an indicator that the process‑‑I am not for a
moment saying it is without flaws and is moving perfectly and smoothly‑‑has
not had the major impact that some outside observers and the New Democrats to a
degree attempted to paint it as a disastrous sort of process. That has not happened, and it has not
happened because there has been a lot of co‑operation, a lot of good will
around the changed process.
I accept my honourable friend's
observation that to make the process have the sort of continuity and longevity
so that it achieves the end goals, we have to have better public communication
with the citizens of
* (2220)
I think if there is one observation that
government always has, it is that they can never get their message out. We always blame the media as not being
particularly friendly to what is going on.
You always run that very delicate balance as a government and as cabinet
members of where do you draw the line between public information, which is
genuine information designed to inform, versus partisan communication with the
public of Manitoba, using government resources to advance the objectives of the
governing party. That is a very delicate
balance.
I know, when I was in opposition, I have
seen pieces go out that I thought were partisan from the then‑government,
and I am sure they could make the same accusation of us when we are in
government, both now and before. It is a
delicate balance. We hope to achieve a
real information process in the next, I hope, month and a half in terms of an
update that we are trying to put together for communication with Manitobans at
large. But that will not, I fully
acknowledge, meet my honourable friend's long‑standing suggestion to
government of an independent individual or group of individuals who would
report quarterly or whatever on the status of change.
Mr. Cheema: Mr. Acting Chairperson, I am just going to be
somewhat philosophical here, because I have sort of grown up with this
process. For my own mental peace, for my
own satisfaction in the long run as a health care provider and also as a public
servant, I want to make sure when I am going to sit back somewhere in five
years time that I was part of the process which really achieved the goals
besides the politics, which can change.
For many factors, it is so essential, I do
not think there is any more risky thing that your government can do than the
Health Action Plan; this is the most risky thing. It is very, very risky politically, but it is
already one year, and things are functioning, other than some problems here and
there. We are just reinforcing those
points, that we do not have the exact plan, how that could function, but it can
be developed in terms of somebody who is monitoring the thing, whether it is
the minister's staff or through an independent body in terms of establishing a
group of people, not necessarily from the minister's office, but we could see
that even the former Minister of Health, on Peter Warren's show he said he
could have done the same thing.
Those individuals, there are many
professionals who are past presidents of associations and many individuals who
are past presidents of these organizations or past Deputy Ministers of
Health. Those individuals have real
insight to what was happening then and what they will expect. If you can combine something like that, it
will increase the credibility of this plan.
I think it will help the government, it
will not diminish the credibility. It
will really help the process move along, because it is very essential that
people should be part of it. We are not
saying they are not part of the process, but they should feel that they are
part of the process. There is a difference
in being part and being really involved.
These meetings are very helpful; Question Period is very, very
helpful. At the same time, there are
other forums which would be helpful, like putting ads in the paper.
I know some provinces are doing it. The
If you are not educated enough about the whole
system, you are scared, you know:
Somebody is taking away my health care system. That sticks in their mind, and it is not very
positive. So I think those things will help all of us because, ultimately‑‑I
will repeat it again‑‑somebody else may enjoy it, but that is a
risk you take when you are making a change.
So we are asking the minister to consider
and come up with something, give it a different name, whatever you like, you do
not have to take credit, do whatever is necessary to make sure the credibility
of this process is not only maintained in this House, but outside this
House. I think that is more important.
It is not important for us to impress you or for you to impress us or the other
opposition party with the news stories of day.
I think, ultimately, people have to feel
that they are part of the process. It is
their health care, and they are being involved.
Doing those few things, I think it will go a long way. It is helpful to go on the campaigns and try
to convey the message, but then it is taken as a political message. They think it is coming in as the minister
has said. It is very clear, it does not
matter how you put it. Still, it is
coming from a given political party.
The way we have done in it in this party
for two years now on the health care reform, almost two, we started out with
the 1990 campaign, we made a decision on what we are going to do. At least we should have a few policies going
into 1994. One of those policies was to
make sure we have a Health Care Action Plan.
As I said, anybody could simply come here, put their picture and put the
whole plan, and it could fit into any party's philosophy right now, and they
would love it‑‑but to make sure that people really know it and they
understand it and they will feel at ease and that will help all of us.
Mr. Orchard:
Mr. Acting Chairperson, I appreciate my honourable friend's openness and
the suggestion he has made. We may well
move in the direction he suggests. I
have not taken my honourable friend's suggestion because I did not want the
credit to lie with the part of‑‑that does not bother me a bit.
I have given my honourable friend credit
publicly and privately and at meetings where a suggestion has come from him
which showed an error in the process we were undertaking. I have been willing to make those kinds of
changes and give my honourable friend credit.
That is the strength of this forum that we are in right now.
If we cannot, as elected officials, take
good advice, regardless of where it comes from‑‑it makes sense. You do it and you do not hesitate to give
credit for it. That is the purpose of us
being here.
My honourable friend's question is a
twofold one. One part of it is the
public communications aspect and sort of the independent monitor of the reform
process so that it has a disattachment, or not an attachment to government, so
that it is not the minister or someone from government saying that this is what
is happening. That is one aspect of it,
to neutrally inform the public of
Equally as important is the simple
undertaking of monitoring the changes that we are undergoing currently in the
system and make sure that they are doing as we expected, in other words, that
they are working, they are not compromising an individual's access to health
care, they are not compromising outcome of procedure or process in health care
delivery.
The latter part is ongoing almost on a
constant basis with senior staff and Bernard Blais and the reform
committee. I mean, part of what they are
doing is making sure that when we make the shifts that they are made in a
fashion that has not endangered or compromised quality of care to individuals
and, when completed, that they are working effectively. That aspect of it is going on on a regular
basis.
That is part of what my honourable friend
wants to make sure happen. I can give
him the assurance that that sort of analysis of the change process is ongoing
constantly by my senior staff, by the partners in change, be it in our acute
care hospitals or other areas. That is
ongoing. What we are missing is sort of
that independent stamp of certification, if you will, that says, this is what
has happened and in general we believe this, thus and such happened
appropriately, but here were some weaknesses in the system. That sort of independent communication is not
part of the current reform process.
We are giving some concern or some serious
consideration on how to open up that process, and we have not come to a
conclusion that is worthy of announcement at this date.
* (2230)
Mr. Chomiak:
Mr. Acting Chairperson, the minister made mention of the fact that a
weekend seminar was held with hospital administrators and all of those involved
in the process, et cetera, where in general but not carved in stone, if I can
extrapolate from what he said, certain directions were outlined as indicated on
Thursday. I was made privy to, just
briefly, some of those basic announcements through attendance at some meetings
that I was attending, and I quite accidentally heard some reference to it.
I wonder if the minister could outline for
us today in the House and through us to the public‑‑generally,
without tying his hands in terms of the specifics‑‑if he could
outline for us today generally the direction of some of those changes and
directions that were outlined to the various people involved in the process at
that weekend seminar.
Mr. Orchard:
Mr. Acting Chairperson, I would not be able to provide my honourable
friend with a great deal of detail for two reasons. Firstly, I only attended the opening session
of the retreat to give a general outline of the challenge before us and to
attempt to engage an understanding and a co‑operation around the issues
of change. I did not attend the balance
of the retreat, and I did that very deliberately. I think my honourable friend can understand
that if the Minister of Health is there and is taking notes and listening‑‑and
some people are of the opinion that I never forget anything‑‑it
would have compromised the open discussion that we wanted to encourage amongst
the stakeholders to say what could be done, what could not be done, and
appreciate.
There is a good attitude towards change
and the necessity of change and expediting change in
As with all other investigations by
committees, I do not make public comment on any of the investigations in the
interim stage. I will only comment on
the report as received in the process of announcing the changes, if any, that
are being contemplated and accepted and offered by government as a result of
those committee investigations. Again, I
think my honourable friend can maybe see some consistency to the pattern of
dealing with major issues in that fashion.
I do not interject myself into the debate before a committee has had the
opportunity to make final recommendations.
That is the whole process of open consultation and discussion that I
think has served us exceedingly well to date.
I am not in the process of commenting on any interim reports such as
were shared with the health care stakeholders and leaders in that reform and
that retreat.
I am not hesitating to provide my
honourable friend with that information from any motivation of trying to deny
my honourable friend information. It is
simply the pragmatic approach to issue development that we have used, I think,
to some degree of success over the last five years, and I see no benefit, even
if I had the information, to share it with my honourable friend in an interim
stage.
Mr. Chomiak:
Mr. Acting Chairperson, on a related matter also discussed previously in
one of the minister's previous answers, he, in a discussion with the member for
The Maples, talked about a third‑party monitoring system or a third‑party
system that would account for changes and be an independent source.
One of the areas of concern and one of the
reasons we brought forward the private member's bill was the fact that there
does not seem to be any kind of a‑‑how shall I put it?‑‑an
appeal process or any kind of a third‑party ability to deal with
questions and decisions that have been made, notwithstanding that political and
policy decisions are made by expert committees and the like.
Having said that, one of the concerns that
I have is when individual problems arise at the various institutions, et
cetera, that the final area of recourse is through the minister's office. In principle, I recognize that that happens
in all departments and is the nature of government and the political process.
I am wondering if the minister or the
department has thought about any kind of a third‑party intervention in
matters of that kind. Because of the
nature of health care problems and the serious natures of them, et cetera‑‑and
the minister has mentioned many times how often these are perceived to be made
political‑‑I am wondering if the minister has or if the whole
process has in fact evolved or has any kind of anticipation of some kind of a
process being put in place for those kinds of difficulties. I do not know if I think them fairly clear.
Mr. Orchard:
Mr. Acting Chairperson, I am a little bit at loss to give my honourable
friend a specific answer because that was a very general and unfocused
question. I do not say that critically,
but I mean it covered a‑‑you could almost have anything covered in
that topic, but let me give my honourable friend an example.
About three years ago I guess now, and we
have only engaged the services of them on a couple of occasions, but for
specific instances where an issue, and generally some of these issues are
individual issues and involving an individual, we have three or four individuals
who I think are respected for their independence of opinion and view called the
quick response team where they will go in and analyze a given issue at a,
particularly an acute care hospital, and sort of get the‑‑how was
that described on one of those radio shows, sort of the fact behind the story
or whatever it is?‑‑and we have used that quick response team
twice.
The one instance that I can remember was,
a young teenager had his leg broken in, I think, a hockey game in the
Interlake, through a series of circumstances, was prepped for surgery, I
believe, three different times and was cancelled at the last, and it caused
quite a controversy. Of course, the
readily arrived at conclusion by some was that it was because of
"cutbacks" in health care. In
fact, the quick‑response team identified that was not the problem, that
it was a problem of lack of communication between facilities and co‑ordination
of service delivery on an emergency basis between hospitals, between
physicians.
* (2240)
Subsequent to that, I think there has been
a little better, not perfect, but a little better organization around some of
the emergency services so that kind of a circumstance does not happen. As I recall on that particular instance, the
evening the young man arrived from the Interlake by ambulance and was admitted
to Health Sciences Centre and could not be operated on that evening‑‑this
is an oversimplification, but wheeling the cart down the hall several floors
could have seen the surgery done at Children's Hospital that evening, and a
phone call to one of the other community hospitals could have seen the
individual admitted and operated on that evening in another community hospital,
but the communication was not there.
The easy accusation in the system is to always
when you have a problem say, well, it is because government has not given us
enough money. You know, we fight that
perception constantly in this province as does every other Minister of Health
and that, in essence, is what we talk about in part with effectiveness in
health care. It is nothing to do in that
particular instance with having a larger budget at the Health Sciences
Centre. That would not have helped the
individual that night unless you maybe doubled the capacity to do emergency
surgery at Health Sciences Centre and built a capacity there that was
unaffordable and unsustainable in the long run.
But effective use of resource across the system would have seen that leg
set and operated on that evening in two other hospital locations, if there had
been an effective communication between the hospitals, between admitting
physicians.
There are a lot of effectiveness examples
that we are coming to grips with through a number of the study groups that we
have with players in the system coming around the issues and aided very
expertly by the independence of the Centre for Health Policy and Evaluation
because they do not owe anybody anything in terms of developing their
reports. They are independent scientists,
independent researchers that take on, project by project, an analysis of the
facts as they are presented.
I want to tell my honourable friends that
the Health Action Plan, yes, was a popular document, but a more popular series
of documents at Health ministers' meetings and when the senior staff are out of
province are our Centre for Health Policy and Evaluation documents. They are considered to be some of the best
scientific analysis of health care delivery that is available. They have been
gaining substantial credibility in observing how we can build more
effectiveness into health care delivery.
Mr. Chomiak:
Mr. Acting Chairperson, the minister was right. It was not that specific a question. I agree with most of what the minister
responded to in terms of the effectiveness issue.
However, as tangential to that, I just
wonder whether there is any move toward the establishment of some kind of
institutional approach to dealing with these kinds of problems as they occur on
a daily and a regular basis, because the minister gets the calls in his office,
I am sure the member for The Maples does and I do as well in my office. I do not know if it has been discussed at a
higher level or if it is even instituted in other provinces, but it would
strike me of some benefit to have a kind of institutional‑‑well,
that is the wrong word, but a kind of a response team on standby that could cut
through some of the difficulties and provide some of the answers that would
take it out of the "political" arena.
Mr. Orchard:
Mr. Acting Chairperson, yes, there is no question that might be an
appropriate undertaking, but I think my honourable friend would have to provide
some examples where there was an inadvertent wrong perpetrated on a citizen of
the province as a result of some process of care delivery. We receive a lot of complaints. That is not unusual; that is not unique.
I sat in opposition and I had folks phone
me on a regular basis and write me letters on a regular basis complaining about
the system. I have some pretty awful
looking photographs in my files from opposition. That is not going to ever end, I would
suspect and humbly submit.
The process that we have undertaken within
the ministry is, upon receipt of a complaint, to initiate an investigation or a
response around the complaint. If it is
internal to a program of the ministry, initiate the response to that complaint
internally and to reply to it as quickly as possible either in writing or with
direct staff contact.
Secondly, where it is a complaint that
emanates from one of our institutions, to call upon the institution to quickly
investigate and provide a response as to the veracity of the complaint and the
allegation, and any course of action that is taken, that was needed to correct
maybe a problem in process or a problem in perception if there was no remedy in
the existing system, and that nothing had been done in an inappropriate
fashion.
We also have similar processes of
complaints that come in about professional conduct whether it be physician,
nurse or other caregivers. When we
receive those in our office, either written or through telephone calls, we
attempt to have those investigated by the respective organizations. I am not certain that at this juncture the
system would be better served by a formal investigation process of some of the
complaints on service delivery that come in.
I think the system may not be as rapid in
terms of getting a formal response back to the individual as one might wish,
because currently we are over a thousand pieces of correspondence of all types
into my office per month and probably up to in excess of 2,000 phone calls per
month. That is a significant workload
and sometimes the delays may not be as rapidly turned around, but in the five
years I have been here, I do not think anyone can legitimately make the case
that their health status was compromised by the process that has been in place
over the last five years.
Similarly, I do not think prior to my
being the Minister of Health, that similar and that same process was used. I do not think anybody could make the case
that prior to five years ago, under the previous government, the previous
administration, that anybody's health concerns or health status was compromised
by that response process.
I have to tell my honourable friend that
in absence of that kind of proof of necessity to change the process, I really
do not have the resource to commit to another sort of an independent process of
investigation where we have intractable problems presented by individuals‑‑and
my office has several of them. Some of them are around a specific disease
entity, and my honourable friends have probably received communications from
the individual because we see you carbon copied with their letters to us.
When you exhaust all of the investigative
procedures, there is the Ombudsman and there are other processes of
investigation to assure that there has not been an improper response by the
system to the individual's concerns and complaints. Again, I have to say to my honourable friend,
I do not know, in the five years, I cannot think of an individual who we have
not taken every step possible to attempt to get to the bottom of the problem
that has been brought forward by that individual, and to give a full
investigation, to take corrective action where corrective action was warranted,
and to give an explanation that the process could not have done anything
additionally.
* (2250)
It is unfortunate, but sometimes the
answer‑‑it may not be the answer the individual wants‑‑but
the answer is that under the system, we have done all we can do and there is no
more action we can take to try and assist, that we have exhausted the
specialist referrals or whatever has been undertaken. In those cases, we have had some
investigation go to the Ombudsman and basically the same kind of conclusion.
Now, if the Ombudsman had, in general,
taken every one of the complaints referred and come to an entirely different
conclusion, that would demonstrate to me that maybe our processes were not
appropriate and were not serving a beneficial decision‑making process for
the individuals who chose to raise the issues.
That has not been the case, and having that experience, I have to
conclude that without its flaws, because nothing is perfect, without some of
the flaws that are evident in terms of the investigation process, it generally
has concluded and acted upon complaints in an appropriate fashion. From that standpoint, I think we would
probably maintain that approach to handling complaints and disagreements within
the system.
Mr. Chomiak:
My final question is general on this theme, and I appreciate the
minister's response. Given the admitted
change, the dramatic changes going on in the system, has any thought been given
to something like a patients advocate or advocates at various levels of
institutions in the health care system?
Mr. Orchard:
Not from a formal standpoint of having someone appointed as an advocate
for patients but, for instance, in amendments to The Mental Health Act, I think
we have significantly improved an individual's ability to take circumstances to
an independent committee, if you will, which I think by and large has worked
quite successfully.
We started with quite a flurry of
activity, and now it has settled down to where there are not as many issues
brought before the three‑person panels as was the case in the first six
months of their institution.
Each facility, for instance, has people on
staff dedicated to try and get to the bottom of patient complaints. One might say, that is not good enough. That is sort of the judge and jury all being
in one room. Well, that may be an
appropriate criticism, and it may lead to the accusation that people tend
always to protect themselves and to cover their tracks, and that is a natural
accusation but, again, I harken back to the opportunity that a number of
circumstances, individuals have taken and gone to the Ombudsman, who is
genuinely that kind of an independent investigator and, with few exceptions,
there have not been conclusions that the complaint was improperly or
inappropriately handled by the respective institution or professional group.
In terms of professional groups, most of
them, as my honourable friend is well aware, where their professional acts have
been amended in the last two years beginning with the pharmacists of Manitoba, who
were the first to bring in progressive changes to the professional legislation,
all of them have a much more open disciplinary process for complaints against
professional misconduct, the opportunity for even public hearings of those
complaints.
I think the process has opened up quite
significantly, and I genuinely do not see at this stage of the game a
compelling necessity to create a patient advocate position within the health
care system. I think most of the processes
for investigating complaints are responding reasonably and effectively and are
taking appropriate remedial action where warranted and explaining process where
that has been the cause for concern.
Mr. Chomiak:
Mr. Acting Chairperson, I had occasion to attend the open public forum
held by the St. Boniface Hospital which other members of the Legislature also
attended, and I am not certain if all institutions at present are undertaking
those kinds of forums. I am wondering if
the minister is encouraging of that process or aware of that process taking
place by major institutions with respect to the reform process. I am talking about widely publicized meetings
that allow the public to be apprised of changes and offer suggestions and the
like.
Mr. Orchard:
Mr. Acting Chairperson, the two teaching hospitals are both undertaking
a fairly extensive internal‑external communication program. That commenced with The Action Plan from May
14. They actually had a number of
investigations prior to that, or open meetings prior to that. But my honourable friend will note that part
of the contractual arrangements and the process that both the teaching
hospitals have engaged in to date with APM, Connie Curran group, have been a
specific commitment to wider public consultation around the issue of restructuring
within those respective institutions.
(Madam Chairperson in the Chair)
I think if the open public meeting that my
honourable friend indicates he attended that was sponsored by St. Boniface Hospital,
I think that was as a result of the APM Connie Curran restructuring initiative
that is ongoing as we speak within that hospital.
Mr. Chomiak:
The minister made mention previously of the process of community
resources being put in place prior to bed closures and the discussion and
commitment to do so. The assistant
deputy minister responsible for Health Reform made it very clear at several
meetings that I attended that it would not be a bed for bed replacement. It would be something with an equivalent
service, and I made mention on Thursday again of the fact of a meeting that I
attended wherein Sue Hicks‑‑I cannot remember her exact title at
this point‑‑had made reference to the fact that the department was
just beginning to look at community resources and community services to be put
in place. That is post significant
changes in terms of the acute care beds and the like. I wonder if the minister might elaborate
about what the process is for community services to augment those changes.
Mr.
Orchard: Madam Chairperson, my
honourable friend might have not heard my statement in my opening remarks which
I repeated for my honourable friend the member for Maples earlier on tonight,
but with the indulgence of my honourable friend, the member for Kildonan, I
will attempt to answer his question.
First of all, my honourable friend, I take
from his question and the premise under which he posed the question that in the
acute care sector in our hospital sector that every time a bed closes, there
must be a replacement service created somewhere in the system, preferably in
the community.
* (2300)
If my honourable friend has that as an
underpinning belief that that is necessary to achieve reform and restructuring
within the acute care system, then with all due respect, Madam Chairperson, my
honourable friend has not been reading some of the literature and some of the
discussions and has not been talking to some of the key stakeholders in health
care and health care reform.
Let me give my honourable friend a couple
of examples. There was an announcement
approximately four, five or six weeks ago, St. Boniface General Hospital. If my honourable friend was at the meeting in
the last three to four weeks that St. Boniface had, if that is the meeting he
attended, I think the issue of the closure of 39 surgical beds would have come
up.
The closure of those 39 surgical beds is
being undertaken at St. Boniface because of a better management of how they
admit and discharge those patients who are receiving surgical services at St.
Boniface. They will be able to maintain
the level or the volume of patient services, is my understanding, using 39
fewer surgical beds by a pre‑admission procedure which is streamlined, by
a length of stay adjustment which was identified as possible through the Centre
for Health Policy and Evaluation study, and through the own experience of St.
Boniface Hospital because they have been testing this new process under the
guidance of Dr. Ross Brown and, of course, the new CEO, Jack Litvack. They have every confidence that they can
maintain quality surgical service delivery with fewer beds.
That does not imply, as my honourable
friend seems to conclude, that those 39 beds have to be replaced with other
services. Those 39 beds are being
replaced because of a more effective method of patient management within St.
Boniface Hospital in the area of surgical services.
I made reference earlier on this evening
to a Toronto Globe and Mail article out of the
They are replacing intensive resources
through better management of the patient without compromise of patient care.
They have not taken and put community services in place at the
I want to quote the Centre for Health
Policy and Evaluation, page 3803, in my opening remarks. I think the second quote is the one that
probably touches it as good as anything.
I will not bother with the‑‑well, no, I will quote both of
them.
The first quote: "We estimate that a significant portion
of the days currently invested in treating acute care patients could be
eliminated without decreasing access to hospital care."
The second quote says: "The hospital system appears to have the
capacity to handle more patients or to absorb a sizable number of bed closures
without rationing access to hospital care.
The hospitals and the government have tended to assume that every bed
closed should be replaced by another service . . . ."‑‑this is
kind of the assumption my honourable friend premised his question with‑‑".
. . possibly less intense and less expensive, but nevertheless a
replacement. These data suggest that at
least some of the bed closures could be accommodated simply through more
efficient treatment of patients in available beds."
As we have more scientific analysis of the
data and of how the system spends and how the system is managed, we find that
we can significantly reduce the level of activity, the size and the cost of
institutional care, without decreasing the volume of that care or, particularly
and most importantly, the quality of that care.
Now, I believe that if my honourable friend thinks about it, that is an
appropriate goal, that is a laudable goal for the managers of our acute care
system to attempt to achieve.
Why would we not in today's fiscal
environment, the challenge that is being placed on all governments, this one
not any exception, why would we not encourage the managers of our health care
system to utilize existing resources in a much more effective manner to
maintain the volume of service, the quality of care, the outcome of procedure
and to do it with fewer beds and less cost, ergo, and without having to replace
those beds with alternate services if you can do it through simply better
management of the patient whilst undergoing that surgery? That is what we are finding we can do, and
the system is finding they can do that, and that has changed in part the
premise that my honourable friend used in his question that if you close a bed
you have to create another service.
In today's changing environment that is
almost old‑think, and it is not old‑think that is
inappropriate. It is old‑think
that has taken the outcome, the care of the patient, the quality of service,
well into consideration before those changes are advanced or initiated.
Mr. Chomiak:
Madam Chairperson, the minister mentioned better managed system, and if
in fact the system were managed on that basis I would tend to agree with
him. I could also relate back to the
minister statistics that are offered by Bernard Blais at every one of his
seminars about spending whatever number of days in the hospital for gall
bladder surgery and now spending, you know, X amount of hours in the hospital
because of new techniques, et cetera.
Fair point.
The problem with all of that is that we
know patients are being almost forced out of hospitals for weekends. We know that there is a two‑week
waiting list in at least one hospital to get home care, where patients who were
supposedly discharged are not being discharged because resource co‑ordinators
at the home care system are not being replaced when they go on holidays and
therefore there is a two‑week backlog.
That is the problem in the breakdown in the management of this system
that causes patients to be distressed, families to be concerned and for
discredit to fall upon the entire reform process.
Mr. Orchard:
Madam Chair, I am intrigued with my honourable friend's preamble to the
questions. My honourable friend is
saying that some hospitals are having patients stay for up to 14 days longer
when they could have been discharged, and the reason that they are 14 days longer
in their hospital stays is because they have not had their home care co‑ordinator. Is that what my honourable friend is saying?
Mr. Chomiak:
That is what I am advised.
Mr. Orchard:
Well, Madam Chair, I would very much appreciate when my honourable
friend receives that advice, if he believes it is serious, to pass those
circumstances on to my office and we would undertake an investigation and see
whether the advice my honourable friend gets is accurate and, if it is
accurate, how we can resolve it, because those are the kinds of circumstances
that anecdotally come forward and from time to time they have substance, but
some of the times they do not.
If my honourable friend had the
opportunity, he could certainly share those instances with my office and we can
investigate and expedite any remedy if any remedy was required.
* (2310)
Mr. Chomiak:
So is the minister indicating that he is unaware of those kinds of
circumstances occurring?
Mr. Orchard:
I do not recall making the statement.
My honourable friend made the statement.
If my honourable friend is being so informed, my honourable friend might
want to pass that information on so I can do an investigation and advise my
honourable friend whether he is providing information that is accurate and
needs remedying.
I did not make the statement. My honourable friend did.
Mr. Chomiak:
Madam Chairperson, I wonder if the minister might outline for us, since
he made reference to it previously, the question of the consolidation of
pediatric services both inpatient, outpatient, surgery, and the decision to
move the process, to move the facilities all to the Health Sciences Centre.
Mr. Orchard:
That process was one of investigation at the Urban Hospital Council as
one of the suggestions for investigation that was before the Urban Hospital
Council.
I am going by memory, but I think in
approximately October, maybe it was November, I think it was October, we
accepted a recommendation that there could be significant consolidation of
pediatrics. At the time that that first
recommendation was made, as I recall, there was some discussion about a phase‑down
of the capacity at St. Boniface Hospital.
In other words, a certain capacity was
proposed to remain there and, within three to four weeks, as more information
became available in terms of the ability to accommodate all of the pediatric
inpatient services, medical and surgical, at Children's Hospital, a subsequent
decision that the Urban Hospital Council unanimously made was accepted by
government.
It was that decision of complete
consolidation that was expedited over approximately a three‑and‑a‑half‑month
period of time, was completed, I believe, March 31st and is currently operating
I think with a reasonable degree of success.
There are still, I think it is fair to
say, discussions ongoing in terms of some admitting privileges, I think,
amongst pediatricians that had admission privileges in other hospitals,
community and St. Boniface, but not necessarily at Children's Hospital. A number of those individuals have already
been accommodated at Children's.
Mr. Chomiak:
The minister indicated there were some discussions ongoing. Can the minister give us an outline roughly
of how many outstanding situations there are with respect to pediatricians and
others who require certification at the Health Sciences Centre and when can
that matter be resolved for both them and their patients?
Mr. Orchard:
I will attempt to seek that information and provide it.
Mr. Chomiak:
Can the minister outline what provision is being made for the accommodation
of French and French‑speaking facilities for those patients that were
formerly at the St. Boniface Hospital?
What ongoing provision has been made for the provision of French and
French language services to patients who are admitted and also patients that
require outpatient surgery?
Mr. Orchard:
Madam Chair, I think the process that was to be undertaken at Children's
was to attempt that French language service capability was available with the
staffing complement at Children's.
Mr. Chomiak:
Is the minister saying the same staff that were at St. Boniface are
shifting over to the Health Sciences Centre?
I do not quite follow that answer.
Mr. Orchard:
No. My honourable friend, I
think, is well aware of the answer to that.
There was an inability for direct staff transfer from one hospital to
the next. That was one of the
difficulties that has challenged the reform process because, as my honourable
friend well knows, although there is central bargaining with MNU, there are
local contracts at each of the major facilities and within those local
contracts there are the seniority provisions, et cetera.
Those seniority provisions are not
transferable from hospital A to hospital B.
As a result, the system, not through any lack of will to have it happen
on behalf of the government, I mean, this was not a prohibition or an
inhibition that we placed on the system, this was part of the governance of a
number of structures, a union contract included, which precluded a significant
amount of direct staff movement between the institutions. In terms of planning for consolidated
pediatric inpatient services at Children's Hospital, a bilingual staff roster
was prepared. It is my understanding
that bilingual services are available 24 hours a day as a result of that roster
identification of competency in both languages.
Mr. Chomiak:
I wonder if the minister could advise whether an option was considered
to maintain a portion of the pediatric ward at St. Boniface Hospital for a
period of time during the transition to see whether or not it would be
required, and if, in fact, that consideration was made, the reasons why it was
rejected.
Mr. Orchard:
Madam Chair, I indicated to my honourable friend that the second last
decision made by the Urban Hospital Council contemplated some acute care
capacity at St. Boniface Hospital. Subsequent to that initial recommendation,
or interim recommendation, whatever my honourable friend might want to call it,
within a four‑ or five‑week period of time the Urban Hospital
Council reconsidered the issue and, based on more current information in terms
of the capacity of Children's Hospital and advice in terms of how the
Children's inpatient needs could be met, the decision was unanimously taken by
the Urban Hospital Council to do a complete consolidation and to abandon the
original recommendation of leaving some inpatient capacity at St. Boniface
Hospital.
Mr. Chomiak:
Madam Chairperson, that is a very interesting decision. That is wherein I saw the policy weakness in
terms of the decision that was made, because presumably the Urban Hospital
Council, using the best advice, experts and statistical evidence, made a
decision. Subsequent to that decision, a
three‑ or four‑week period of time, the minister's reform package
went out and, as I read it, indicated that initial decision, and indicated that
decision would take place. The
minister's press releases went out, and the public was informed, presumably.
Subsequent to that, the situation was
reconsidered, and the minister said in his response, it was based on additional
statistical evidence that came forward.
But I find that an interesting policy decision. Let me juxtapose that with the decision in
terms of obstetrics.
A decision was made on obstetrics, and
then it was held back, as I understand it, and then Frank Manning came in to do
an adjustment or something along those lines.
But in this decision the government moved from an initial decision and
then reconsidered. It is curious that a
body of that kind would study and make a decision and then three or four weeks
later would then completely reverse that decision. I guess it begs the question that there might
have been other considerations.
Mr. Orchard:
Madam Chair, my honourable friend in his question says, a decision was
made in obstetrics and then was subsequently revisited. Is my honourable friend, in making that
statement, saying that as Minister of Health I announced the decision on
obstetrics‑‑no, my honourable friend shakes his head, no.
My honourable friend, in his opening
remarks, wanted to know who was accountable for decision making, because he
seemed to find something confusing where Mr. Blais indicated that the minister
makes all the final decisions.
* (2320)
Well, you know, my honourable friend
cannot play loose and free with language, saying a decision was made in
obstetrics, and then from his seat‑‑and he will get up and
acknowledge that he shook his head when I asked a specific question, who made
the decision that he referred to? I
asked him, was it myself as minister, and he shook his head in the negative,
because he knows that to be fact.
I do not know where my honourable friend
gets the ability to say a decision was made on obstetrics, other than to
advance some case for whatever purpose, political or otherwise, my honourable
friend wants to advance.
My honourable friend finds something
difficult to come to grips with, to understand in terms of the pediatric
decision of consolidation. Okay, I will
accept my honourable friend's concerns about the process, but let us have my
honourable friend answer a simple question.
Does he believe the decision was wrong to consolidate to Children's
Hospital?
Furthermore, would my honourable friend,
if he had the ability and the authority to do so, reverse that decision, and
would my honourable friend reinstate pediatrics at St. Boniface or any of the
other urban hospitals? Because that is
the essence of the issue and my honourable friend has to decide whether he is
ever going to get off the fence in terms of criticizing the process without
having to comment on the result of the process.
If my honourable friend, with his
knowledge as critic for the New Democratic Party, believes that decision is
wrong, my honourable friend has the opportunity tonight to so state and, furthermore,
to indicated what remedial action he would suggest to government based on his
knowledge as New Democratic critic on the issue.
As I have said to my honourable friend the
member for The Maples, from time to time he has pointed out where some of our
decisions have not considered all of the information and he suggested a
different course of action. We have
taken that where it has made sense and we have acknowledged that we would have
erred had we continued on the original course.
Now my honourable friend says he is not
happy with the process. He cannot
understand how we could have the process, give a decision and then have the
decision revisited and recommend complete consolidation. I accept my honourable friend's concerns
around that.
Having said that, will my honourable
friend now indicate whether the decision was wrong? If so, would he reverse it? How would he reverse that decision and how
would he change that decision should he be government?
Mr. Chomiak:
Madam Chairperson, the minister has evaded the question, has refused to
answer the question as to the three‑ or four‑week period.
An Honourable Member:
What was your question?
Mr. Chomiak:
The minister is asking from his seat, what was the question? I again ask it. What were the reasons behind the decision to
change what was announced in his program?
I have the program in front of me, as well
as the obstetrics announcement, which says, redirection of low‑risk
obstetrics, one program, two sites, one director, one budget, et cetera, out of
the minister's spread, the minister's overhead sheets in front of me but,
notwithstanding that, what were the reasons behind the change of the closure of
the beds at St. Boniface? One
recommendation three or four weeks later, another recommendation completely
changes it.
I think there were reasons other than new
statistical evidence coming forward.
Because I have not seen it, the minister has not provided me yet with a
copy of that subsequent report, I quite naturally, based on evidence of
information that has come to me that there were other reasons involved in it, I
am asking the minister to state those reasons now. Why can the minister not defend that
decision? Why can he not provide us with
the information?
Mr. Orchard:
Madam Chair, I have provided my honourable friend with the
information. A better decision was
recommended by the Urban Hospital Council, that complete consolidation could
occur to the benefit of the system without compromising the opportunity to
access care for children.
I have told my honourable friend‑‑he
makes allegations about other reasons that he was informed of but yet he does
not state them. Well, now is his
opportunity to state them, if he has them in fact, if he has anybody who would
give him these "reasons."
I am indicating that the Urban Hospital
Council, in their collective wisdom and their responsibility within the system,
said, we can do a complete consolidation based on information before us without
compromising access or ability to deliver quality care to children in Manitoba.
Now my honourable friend says that is an
improper decision, or does he not? My
honourable friend just said that I have evaded the answer. I have given him the answer that he seeks. It
is not the answer he wants, but it is the answer he seeks.
Now could my honourable friend give me the
courtesy of an answer? If the
consolidation to Children's was wrong, would he so state it, and would he tell
us what the policy would be of a New Democratic administration in this area so Manitobans
can know where you stand?
They know where this government stands,
but all we hear from my honourable friend is the what‑ifs, but we never
know what you would do. Would you
reverse the decision? Would you de‑consolidate? Would you distribute pediatric services to
St. Boniface and other hospitals, and if so, what would be your justification
for doing that?
So now is your opportunity not to avoid
the issue but to be very direct with the people of
One has to assume in the absence of any
better suggestion that you agree with the policy of this government.
Mr. Chomiak:
Can the minister indicate whether the decision to consolidate the
outpatient surgery as well as the inpatient surgery to Health Sciences Centre
was made at the same time, who made that decision and why was that decision
made?
Mr. Orchard:
Madam Chairperson, all of a sudden my honourable friend is now changing
questions without answering whether the inpatient services as consolidated was
the right thing to do. Could my honourable friend give me the wisdom of his
knowledge as critic for the New Democratic Party, government in waiting, as to
whether that decision was wrong?
Mr. Chomiak:
I wonder if the minister will answer the question. The question is, when
and why was the decision made to consolidate inpatient‑outpatient surgery
at Health Sciences Centre? Was it made
by the first Urban Hospital Council report, by the second one? Was it made by some separate other body? How did that decision come about?
Mr. Orchard:
The same process, the same discussion forum and the same general timing. Having that knowledge, would my honourable
friend now tell me whether both of those decisions are wrong and what my
honourable friend would do to replace those two decisions?
Mr. Chomiak:
Based on what the minister responded then, I have no choice but to
conclude that the original decision was not to consolidate surgery from the
community hospitals into the Health Sciences Centre because no mention is made
of it in the minister's overhead charts, in the minister's PR productions for
his changes. Subsequently, the decision
was made I guess by a second committee report, just like the decision was made
to close St. Boniface Hospital.
What was the data on the basis that that
decision was made, Madam Chairperson?
* (2330)
Mr. Orchard:
Madam Chairperson, the information that led to the acceptance of that
recommendation was in terms of capacity to undertake the needed services, and
that decision has been made and has been in operation now for approximately two
months, over two months.
Is my honourable friend, after having
danced around on the head of a pin for the last 10 minutes, able now to tell us
whether he agrees or disagrees with that decision by the Urban Hospital Council
based on information they had at their disposal and recommended as being a feasible
decision which I accepted after investigation by my ministry and have
implemented?
Could my honourable friend now tell me
whether he agrees or disagrees? If he
disagrees, could he offer me the suggestion on how we could make a decision
different which would in his opinion‑‑and hopefully my honourable
friend would have the statistical evidence to back up what he is going to
recommend‑‑make the service better for children? Does he agree with the decision or disagree
with the decision? I still have not
heard that from my honourable friend.
Mr. Chomiak:
Any citizen or interested observer who would have the time to read
Hansard I think would probably understand some of the frustrations felt by
people out there in the community in trying to get a reasoned response from the
minister to issues.
If one were to look at the discord and the
discussions happening in the last few minutes‑‑no less of an
organization than the Manitoba Medical Association was concerned about this
decision and was concerned at the lack of opportunity for input from the
minister. I am wondering why the
minister did not see fit to include that organization, that body, in
discussions as significant as this insofar as it affected so much of the caregiving
by members of the Manitoba Medical Association.
Mr. Orchard:
Madam Chairperson, my honourable friend is now expressing concerns about
the consultation process. My honourable
friend might, on behalf of the MMA, on that issue have a legitimate
observation. But that still does not
answer the fundamental question, was the decision wrong or was the decision
right? I have shared in this House in
Question Period information about inpatient days, about surgical theatre
capacity and the expansion of surgical theatre operating hours, about the
commissioning of a new surgical theatre, all of which point to the ability that
the Children's Hospital can accommodate inpatient and not‑for‑admission
surgeries.
All that information has been given to my honourable
friend in Question Period every time he has asked the question. My honourable friend wants to sit here
tonight and make out as if he has never heard any justification for the
consolidation, that it is all some Machiavellian plan of myself and this
government, when in fact it is based on information from experts, from the
people who manage the system, from the people who know the requirements, the
needs in the system.
Now, the decision was made based on that
information. My honourable friend now is
into criticism of consultation and process.
That is fine. My honourable
friend will always have those kinds of criticisms about consultation and input
because, in his opening remarks Thursday last, my honourable friend wanted all
Manitobans to have an input on health care reform but, yet, disagrees with
Total Quality Management in the workplace, which gives workers input into
changes in the system.
So my honourable friend cannot have it
both ways. You cannot say that all
Manitobans need an input and at the same time to have his NDP ideology to be
against Total Quality Management, which allows workers to have input, those
same workers that my honourable friend claims to represent and speak on behalf
of. He wants to deny them input into the
system but uses this grandiose public relations exercise of, all Manitobans
need input.
Now, my honourable friend has pointed out
one organization that did not like the level of consultation and involvement as
a specific organization on that process of decision making. Okay, I will accept that. My honourable friend has driven a stake
through my heart, but now will my honourable friend stand up and tell me as
critic for the New Democrats, as a party that if I listened to Mr. Doer, the
Leader of the Opposition, says they are going to be the next government, will
my honourable friend tell the people of Manitoba, was the decision to
consolidate at Children's Hospital wrong and would the New Democrats reverse
that decision if they are government?
Surely that is a fairly basic piece of
information that Manitobans and the managers of the health care system might
want to understand and know where you come from. I understand you are always going to
criticize the process, but let us talk about the decision. Was the decision wrong? Do you disagree with it? What would you do to
change it?
Be honest with the people of
Mr. Chomiak:
Madam Chairperson, I am glad the minister was able to admit, and I
admire that, that he was wrong in not consulting with the Manitoba Medical
Association. I would go further and say
that the minister should recognize for future reference that he did not consult
with patients, with many other caregivers including nurses, aides and the like,
with the organizations that represent a lot of the children.
They had to contact us in the opposition,
who had to raise it and finally after raising it in the House and after the
courage of many of these people to come forward publicly, and I give them much
credit, because it is still a democracy, for them to come forward publicly and
announce some of their concerns. The
minister actually then was forced to bring information forward to justify the
decision, although to this date we still have not seen the minister refuse
this, does not have the courage to table the reports, the empirical data.
He still has not provided it to the
Manitoba Medical Association as far as I know from the last correspondence that
I see in the Manitoba Medical Journal that just came out in May. Perhaps if he
has since, he will be kind enough to provide us with the empirical data and the
statistical data.
I can tell you, Madam Chairperson, that
even the data that I had, the initial data from the minister, was fraught with
difficulty, which caused a certain amount of damage control to be made by the
perpetrators of this policy to try to fix the situation. I think we did a good service to the public.
I admire the courage of the parents and
the patients and the caregivers who came forward. It takes a lot in the system to do that,
given the amount of insecurity in the system and given the amount of fear,
frankly, that is in the system for people who actually come forward and
criticize the government for a decision.
I give them credit for that and, as a result, some information came
through, but we still have not seen‑‑will the minister simply table
the data upon which the decision was made, particularly the second decision,
obviously the second decision, and to justify for us why that decision was made
different from the initial decision.
Mr. Orchard:
Madam Chairperson, I realize my honourable friend has difficulty in
attempting to politicize decisions in health care reform, and I realize that is
his sole objective and agenda. My
honourable friend now rolled in another series of groups that in his humble
opinion ought to have been consulted. For instance, the nurses, I think, were
one group that he mentioned.
Madam Chairperson, the Urban Hospital
Council, in terms of its membership, has the opportunity to seek within their
respective institutions, and did, whether it would be appropriate to undertake
a consolidation of program, even though it was dislocating to the staff
potentially, et cetera. Now, my
honourable friend, de facto, is saying that the members of the Urban Hospital
Council did not make a good decision, that they did not do their job properly,
but yet he, the New Democratic Party critic knows more about children's
pediatric service than the CEOs of all our urban hospital councils and the
managers of the program and certainly more than the leadership and the
administration of the Children's Hospital, who have said consistently without
equivocation that they can handle inpatient pediatric services and the NFA
surgeries for children at Children's Hospital.
That was the original design of the hospital. My honourable friend knows that.
* (2340)
My honourable friend also knows that on
several occasions in Question Period I have presented to my honourable friend
the information in terms of utilization, in terms of commissioning of extra bed
capacity at Children's Hospital which predicated this decision. All of that information has been made
available to my honourable friend, but it does not happen to fit with his
political agenda.
Now, Madam Chair, with regret, this is
probably going to be the pattern of the Estimates process that my honourable
friend is going to get up. He is going
to criticize the decision. He is going
to criticize it from the standpoint, well, you never consulted with this group,
that group, or this individual or that individual, but I am not going to take a
stand on the decision, because I do not want Manitobans to know what I believe
in, in health care. I only want
Manitobans to elect me and I will surprise them as to what I will do.
This is not the game that I play or this
government plays. That is the game my honourable friend is going to try to
play, and this is now the seventh time tonight I have asked my honourable
friend to do us the courtesy of simply saying, on behalf of the New Democrats
and your position as health critic, do you disagree with the decision of
consolidation of pediatric services to Children's Hospital?
Fairly simply question. It should not take too long to provide an
answer. If it happens to be yes, then I
realize your political case is gone. If
it happens to be no, I am interested and I want to know what alternatives you
would suggest. But in the absence of
neither a yes nor a no, and just this constant dancing on the head of a pin, I
quite frankly cannot help my honourable friend understand the system better,
because when I provide him with the information he requests, as I have done in
the past and as I have done tonight, that information does enable my honourable
friend to conclude the political approach that he would like to take on behalf
of the New Democrats. All I want is,
just where do you stand? If it is the
wrong decision, say so. If it is the
right decision, have the courage to admit that it is the right decision and
that you were in error in trying to thwart it.
At least have that courage.
Mr. Cheema: Madam Chairperson, I want to get into this
discussion because I think the issue is quite significant. It really has many aspects and I think people
have to know from a different perspective also.
As the minister has pointed out, there is
a 30 to 40 percent occupancy rate at that hospital and, ideally, if we want to
say what services should be in each and every hospital, I will first tackle
that part. That means we should have
every service in each and every hospital.
That would have been possible if everything was fine and there was lots
of money here, and you do not have to go and borrow and you do not have to
worry next year, you do not have to tax people.
That is not the case. That is not only in
It is a tough world out there. Somebody has to go sometimes half an hour
even with a very, very serious illness.
The question here is that if we have the resources, that would have been
the ideal situation, but if you read all the statements that I have read for
the last eight years about what has been happening, everyone was saying let us
consolidate, let us be efficient, let us do things in a more organized
fashion. This is one example where I
think there is at least a demand from the public to know.
I would ask even the member for Kildonan,
there has to be somebody else who knows how the services are going to be
delivered. The question here is, if the
primary health care services and their providers say at a distance of eight to
10 minutes, and if they can be effectively provided in an institution because
of the circumstances‑‑not because of the choice, but we are forced
into those situations now. It is no more
a choice.
If that is going to be very effective, and
you do not have to spend the extra cents at Health Sciences Centre, and the
services are provided in a way that Children's will get the same quality
services and the pediatricians are going to get their privileges done there and
they will have the same access. The
outpatient services are still being provided in those hospitals. The emergency services are still being
provided and even some of the admissions to the St. Boniface Hospital are not
even directly coming from that area.
They are outside
The question here is basic policy
direction. One has to make those
choices, and I think the time comes when you have to make those choices. So I will ask the minister now, out of the 30
to 40 percent admission rates at St. Boniface Hospital, can they provide us a
breakdown that will probably clarify some of the misconceptions? That may help all of us to understand that
some of the admissions done at that hospital can be directly made to Children's
Hospital where the environment is, if not more suited but equally suited, and
if you have the head of the department and department of pediatrics who have
said they will be able to provide those services, so why do we have a problem
then?
Mr. Orchard:
Madam Chairperson, to try and answer my honourable friend's question, it
is my understanding that the transfer of surgical patients from our other
hospitals and from St. Boniface in particular, because St. Boniface of the
remaining hospitals outside of the Children's Hospital, I think the level of
patient activity at St. Boniface was higher in pediatrics than at the other
community hospitals that had pediatric services.
Those inpatient services were accommodated
by two things. First of all, the funding of some additional beds at Children's
Hospital‑‑there were 118 beds in service at Children's. I am trying to find the right information
here‑‑118 beds at Children's‑‑and since it was built,
there were 11 beds that were never opened.
We commissioned six of those 11 beds to bring the commissioned bed
capacity at Children's up to 124. The
occupancy rate on the 118 existing beds prior to consolidation was
approximately 70 percent. By opening
some new beds or some of the beds that were never commissioned at Children's
and increasing the occupancy to 79 percent, they were able to accommodate the
additional patient days across the system.
* (2350)
There was a fairly significant restructuring
around the surgical theatres, and that was two initiatives. Prior to consolidation, there were four
operating theatres that were in service Monday to Friday, eight hours a day. To accommodate the increased surgical
activity, they commissioned an additional operating theatre which would be open
five days a week and add 40 hours of surgical theatre capacity. The operating hours of the existing four plus
the new one were extended by two hours a day to give an extra 10 hours of
surgery time at Children's. So between
the commissioning of an additional surgical theatre and the extra two hours per
day, there were 50 hours of additional surgical activity.
The estimate was, in terms of the
consolidation, that there would be just under 49 hours of additional surgery
time required to consolidate both inpatient and not‑for‑admission
surgeries at one location, that you would need 49 hours‑‑48.8 hours
was the exact estimate‑‑of additional operating time, and they have
provided for 50 hours in the consolidation.
So that allowed the Urban Hospital Council to accept the recommendation
of complete consolidation with some integrity that the capacity was there at
Children's with the new beds and a higher occupancy rate and 50 hours more
surgical time.
All of this is information that I shared
in Question Period some time ago, that they could handle the inpatient,
surgical and medical needs of children that were served at the other community
hospitals and St. Boniface and also serve the NFA surgery loads which they were
anticipating to transfer some 2,500 cases to not‑for‑admission from
admission.
To all the latest reports that I have
received, the process of consolidation has gone, I think, relatively
smoothly. As a matter of fact, one might
observe with very few challenges that were not resolvable in terms of the first
couple of months.
Mr. Cheema: Madam Chairperson, can the minister tell us
was there any opposition from the hospital board, from St. Boniface Hospital
when this move was being considered?
Mr. Orchard:
I think there was concern at the hospital board level and certainly at
the hospital administration level that they were going to lose Children's
services, and there was a pretty strong mission attachment to that at St.
Boniface.
They expressed those concerns, but when a
number of the issues were able to be addressed in a reasonable program fashion
with indication, as I indicated earlier on, that language service could be
accommodated on a roster system over at Children's, I think the decision was accepted
as part of what was going to happen in terms of restructuring across the
system. I received, at least to my
knowledge, no formal opposition from the board of St. Boniface to the
consolidation.
I think you have to appreciate, and I want
to pick up on a point that my honourable friend made earlier on, that every
hospital cannot be everything to all people.
I mean, we are into a time when‑‑and this is not new. The roles of hospitals have evolved and
changed over a number of years,
My honourable friend will well recall
that, what was it, about 1984 or 1985, obstetrics were consolidated from
It was certainly a controversial one at
the time and caused a lot of concerns. I
can almost sit back and probably hear a lot of organizations say they were not
consulted, and as my honourable friend, the member for Kildonan is wont to
observe today. I am not sure of the
rationale behind that decision making back then, but I am satisfied in terms of
the pediatric consolidation that a significant amount of study and investment
of professional opinion was focused on this decision in recommendation to
government, which we accepted, and the system has implemented.
Mr. Cheema: Madam Chairperson, can the minister tell us,
has there been any expansion of the outpatient clinic at St. Boniface to make
sure some of the work, which was done by the inpatient unit, will be maintained
by some outpatient clinic? That was one
of the proposals, I guess, that was given to the minister's office to make sure
those patients will still have outpatient services, and they will also have the
emergency services because that seems to have caused a lot of trouble at that
time.
Mr. Orchard:
Yes, Madam Chair, in terms of the transition of inpatient services over
to Children's, there were the outpatient clinic services that are provided at
St. Boniface and are still being provided.
In fact, I think there has been some enhancement of their ability to
deliver services at St. Boniface in the clinic to support the transition of
inpatient services over at Children's Hospital.
The other area, my honourable friend
mentioned emergency services, I think that is settling down now. There was a‑‑I make no bones
about it‑‑significant amount of damage done when my honourable
friend the member for Kildonan indicated that emergencies were going to be
closed to children in the urban hospital setting. I think that has, by and large, settled down
now that that has been established as incorrect information from the member for
Kildonan.
We are seeing the system settle into
accommodating this restructuring in shift and consolidation over to Children's
Hospital.
Madam Chairperson:
Is it the will of the committee to call it twelve o'clock?
An Honourable Member:
Sounds good.
Madam Chairperson:
The hour being 12 a.m. committee rise.
Call in the Speaker.
IN SESSION
Madam Deputy Speaker (Louise
Dacquay): The hour being 12 a.m., this House is
adjourned and stands adjourned until 1:30 p.m. tomorrow (Tuesday).