Hon. James McCrae (Government House Leader): Madam Speaker, I wish to obtain the unanimous consent of the House notwithstanding the sequence for consideration of Estimates as outlined in Sessional Paper 142, tabled on March 24, 1998, and subsequently amended to consider the Estimates of the Department of Industry, Trade and Tourism in Room 255 on completion of the Estimates of Status of Women. These changes are to apply until further notice.
Madam Speaker: Is there unanimous consent of the House to change the sequence for the consideration of Estimates, as tabled on March 24, to amend the Estimates to consider the Department of Industry, Trade and Tourism in Room 255 on completion of the Estimates of the Status of Women? This change until further notice, agreed? [agreed]
Mr. McCrae: Madam Speaker, just on a matter of House Business and prior to asking you to call Bill 57, so that the Minister of Health (Mr. Praznik) can very, very briefly introduce that bill for second reading, I would like to point out to honourable members that there have been discussions--[interjection] Yes, I was just describing the fact that there have been discussions between various members of the House. Those discussions will no doubt probably continue at least until the Minister of Health is prepared to introduce Bill 57 for second reading in this House.
So I just thought this would be an opportune moment to point out to honourable members the value of the working relationship that exists amongst the members of this House on all sides, and, of course, the ongoing relationship we have with the Clerk and the clerks at the table and indeed with each other as we attempt to carry out the work of the people of Manitoba.
I mean, just last week, for example, the honourable member for Thompson (Mr. Ashton) was unable to take part in the discussions. We had very fruitful deliberations between the honourable member for Burrows (Mr. Martindale) and myself and members of my staff. Sometimes the honourable member for St. Norbert (Mr. Laurendeau) gets involved and helps in ironing out little things that come along from time to time.
So, I know what the honourable member for Inkster (Mr. Lamoureux) and the honourable member for Thompson are talking about. I usually know what they are talking about. I am pretty good at reading lips after all my years as a court reporter. So I say that to some of the members opposite, even though I might not hear every word that comes from across the way, very often I know what kind of frame of mind honourable members are in simply by reading their lips.
If you look on page 8 of our Order Paper today, Madam Speaker, you will see listed there Private Members' Business. You will see resolutions ranging from Resolution 33, in the name of the honourable member for Interlake (Mr. C. Evans), dealing with the Offloading of Road Maintenance, and onwards to Resolution 34, in the name of the honourable member for Inkster (Mr. Lamoureux), dealing with public school funding. Now those two resolutions alone have been the topic of discussion the last little while amongst members, and actually Resolution 44, as well, standing in the name of the honourable member for Dauphin (Mr. Struthers), we will probably report later on that to you, Madam Speaker, but I wonder if in the meantime you would be so kind as to call Bill 57.
Hon. Darren Praznik (Minister of Health): Madam Speaker, I move, seconded by the honourable Minister of Environment (Mr. McCrae), that Bill 57, The Regional Health Authorities Amendment Act; Loi modifiant la Loi sur les offices régionaux de la santé, be now read a second time and be referred to a committee of this House.
Motion presented.
Mr. Praznik: Madam Speaker, this bill will amend The Regional Health Authorities Act to ensure that health service delivery by health corporations within a regional health authority that operate hospitals or personal care homes or other facilities, in the provision of funding for the health services, that that funding will be based upon written agreements between regional health authorities and the health corporation.
The agreement will have to meet basic mandatory requirements, including, generally speaking, what services are being purchased, how that facility will be funded, a dispute settlement resolution and other matters that may be directed from time to time, Madam Speaker.
The bill will also provide a process to assist regional health authorities and corporations operating within them in concluding such agreements. Experience in other provinces in the implementation of regionalization has shown that difficulties can be encountered in negotiating this type of agreement. These difficulties can prevent the parties from reaching agreement in a timely manner which can have a significant negative impact on the implementation of regionalization or the delivery of health care services within a region.
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During the negotiation of an agreement, the amendments will allow either party to request of the minister the appointment of a mediator to assist the parties in resolving any matter or matters in dispute. The intent is to assure that only the matters, in fact, that are in dispute trigger the requirement for a mediator or a settlement. We also have ensured that the parties can request more than once, so that a mediator can be appointed in what can be very complex agreements to resolve specific issues with which there may be a difficulty.
The mediator will be given a set period of time to conduct the mediation. This may, in fact, be extended if necessary. The reason that a set period of time is provided is that ultimately the time necessary may vary. Some issues may be very small and require a limited time. An entire agreement may require a mediator over quite a number of months, so we leave a fair bit of discretion in that area in appointing a mediator.
The mediator, upon the completion of their work as a mediator if there are still matters or matters in dispute, is to provide a report to the minister, it is proposed, in which any suggestions for resolving the issues may be made.
As ultimately the funding for all health services or the vast majority of health services in the province flows through this Legislature, Madam Speaker, and there is ultimate responsibility on government to ensure services are provided, if through mediation no resolution can come about, then one may be established by, ultimately, the minister.
Madam Speaker, there are also several provisions here that allow for extension of existing agreements during this particular period and some other housekeeping matters.
I am pleased to report to the House that in the Winnipeg Health Authority, in the Winnipeg Hospital Authority, I have been advised that most, in fact all of the operating agreements with the hospitals are very near conclusion, that the chairs of the boards today are very close to finalizing their document, that there are not, I would suggest, major issues that are likely to warrant the appointment of a mediator today or the use of this resolution process.
We know, as well, that the Winnipeg Long Term Care Authority is beginning their discussions with the large number of providers in personal care homes, for example, and health clinics, many of whom have a community or social group or religious organization as their base. So this is a relatively good time to deal with this particular amendment because there is not today an issue for which the minister is being pressed to appoint a mediator. In fact, at other times in the future, that need may arise, so it is a good time to bring in this particular mechanism. I would advise members opposite as well that they may wish to look at other provinces governed by the New Democratic Party who have gone through this particular process. I know our colleagues in Saskatchewan have used a mediation settlement process as well and included that in their act in a similar fashion as we have, somewhat after the first act was passed. Thank you.
Mr. Gary Doer (Leader of the Opposition): Madam Speaker, I know the government obviously on the one hand says there is no urgency to getting this bill through the Legislature. On the other hand, on Thursday, we would note that the government tried to get leave from opposition parties to waive the usual requirements of notice--
An Honourable Member: We did not.
Mr. Doer: Well, I was informed by our House leader that there was a request, or deputy House leader, but I want to speak to the contradiction not of the House business but of the minister's words. He says--and this is germane to my point and he said publicly--that there is going to be an agreement between the Minister of Health and the Winnipeg Health Authorities effective April 1, 1998. Then when we get closer in the mid-term break period to April 1, 1998, the Minister of Health says that it is going to be May 1, 1998, he is going to have an agreement. He says, Madam Speaker, this public comment, you know, and now he says he does not think he needs this act because there will be a voluntary agreement with the facilities that are negotiating with the WHA, but the government brings it in as a matter of legislation on a Monday when normally we have Estimates.
So, Madam Speaker, there is a whole set of what appears to be contradictions from a contradictory Minister of Health, and this is not becoming unusual. One day we are not going to have private profit home care, the next day we are, the next day we are going to extend it. Last week the MMA is irrelevant, a week later the MMA is not irrelevant, we are going to have binding arbitration.
This act could affect an agreement signed by the previous Minister of Health that was made with the faith-based institutions to deal with matters that--[interjection] I am prepared to debate this with the Minister of Health, as long as it takes, if he wants that to take place. Maybe we do not trust him because we have heard him say so many times so many different things on the same subject that usually when that happens from a minister, our antenna goes up and we become a little cautious in our approach to passing legislation that is (a) required by the government in an expedient way and (b) could affect agreements that they have entered into with other faith-based institutions in the past.
So the Minister of Health did not deal with his opening comments on how this would affect the whole status of the faith-based institutions. It was a point that was missed in his statement except to say, oh, trust me, we are really close to having an agreement with the faith-based institutions and all the other facilities in the WHA jurisdiction, and therefore we will not even need this legislation because we almost have an agreement. Well, if you have an agreement, why do you need the legislation? If you do not need an agreement, what kind of hammer are you giving yourselves in those negotiations when you are trying to amend a written statement signed by the previous Minister of Health, under the authority of the Premier, with our faith-based institutions? I believe that the document was signed, and I am just going by memory here, on October 28, 1996. It was a last minute effort to get legislation through dealing with regional health and because the legislation itself, Bill 49, if my memory serves me correctly, in essence amended an agreement that the government had made prior to the last election on faith-based institutions, the government was in a conundrum. They could not get agreement from the faith-based institutions for Bill 49, so they went behind closed doors and they amended the letter that they had signed with the faith-based institutions prior to the last election.
The amended memorandum was signed by the previous Minister of Health. It was as a result of a meeting that took place with the faith-based institutions with the Premier (Mr. Filmon). It was a signed memorandum of agreement between the parties. Interestingly enough, Madam Speaker, when we asked questions to the Minister of Health (Mr. Praznik) last March, March of 1998, he basically said that he could not live with the terms of the agreement and terms of the authority required by the WHA and the faith-based and community-based institutions here in regional health, a matter that is before this Legislature now with another amendment in Bill 57.
I say to the government, if they wanted this kind of process in place before, why did they not bring it in in Bill 49 to begin with, when they brought in regional health to start with? Why did they not bring in the comprehensive memorandum of agreement with the faith-based institutions, which amended their promise in 1995, and why did they not develop a position on the legislation, Bill 49, at the time they introduced it? Madam Speaker, they could not and did not because they were basically going to override their faith-based agreement with the legislation they passed in Bill 49, and they got around that broken promise by the memorandum of agreement.
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The memorandum of agreement signed by the previous minister provided for authority to manage the staff and resources in the faith-based institutions. It was a memorandum that was signed by the previous Minister of Health, and we have already had the public comments of Peter Liba and other volunteers who are members of boards of directors saying that they do not trust dealing with this government, and the government is trying to break their word with them. A similar comment was made by Concordia Hospital, by St. Boniface Hospital, by Misericordia Hospital.
What do we get from this Minister of Health? We get from this Minister of Health that he is confident that he will get an agreement, and the date he uses in the public arena and the date used by the WHA authority, which answers to the Minister of Health, is that they will have this agreement in place by May 1, 1998. So what happens at the end of May? What happens at the end of May? It appears to me that the government is now providing another bill. In 1996, they had the regional health bill; 1997 they amend the statute law amendments on regional health and promise us other legislation which they do not bring in; and in 1998 we have Bill 57. Now, I am just going by memory, but I challenge the Minister of Health to check my facts and see if they are not correct.
I also know that the memorandum of agreement was signed on October 28, 1996. Now, this should be a matter--I wonder whether the member for Rossmere (Mr. Toews) or the member for St. Vital (Mrs. Render), the member for Riel (Mr. Newman), the member for River Heights (Mr. Radcliffe), I wonder if members who have faith-based institutions adjacent to their constituencies have been involved in the new authority given to the regional health authorities under this bill. If this was a good, sensible long-term policy, why was it not introduced by the previous minister under Bill 49 when he was dealing with other matters that may be in dispute, for example employees and bargaining units and other issues, when the government introduced Bill 49 in October of 1996.
So, Madam Speaker, the minister, in my view, has not answered any questions about this bill in terms of why he introduced it and how it impacts on the faith-based institutions and the word of this government. I think that the minister of any government and the minister of any portfolio has a responsibility to explain properly to the House the powers that are in a bill and not to just simply say that the legislation may not even be required, because he is confident there is going to be a voluntary agreement between the parties on this issue.
Madam Speaker, I do not like the way this bill is being introduced. It is a xeroxed copy that has been circulated, not the normal form that is circulated in the House. It looks to me like a bill that is being introduced by the Minister of Health (Mr. Praznik) to provide the government and the WHA with more leverage in negotiating with the faith-based institutions, more leverage to negotiate with a body of volunteers that already have a voluntary agreement with the provincial government. So why is the provincial government not agreeing to the memorandum of agreement signed by the Minister of Health and the faith-based institutions in October of 1996? Why do they think they need another weapon or power to potentially be more leverage, at this crucial point of negotiations, for the government in dealing with the faith-based institutions? Now, maybe I am just seeing double in the detail here, but I have it confirmed that the date of the memorandum of agreement with faith-based institutions was indeed October 28, 1996.
This gives more power to the minister. If mediation is unsuccessful in resolving all or any matters in dispute within the time period which later on is stated, the minister may, if he or she believes, resolve the matter or matters remaining in dispute.
So here we have a situation--well, the minister says public money. Well, maybe you should have thought about that before you and cabinet agreed with the faith-based institutional memorandum of agreement in October of 1996. Maybe you should have thought of that when you brought in the regional health legislation in 1996 under Bill 49. What I do not like and what I really object to is one minister of this government signing off on behalf of the government a process to deal with the promise that they made on faith-based institutions, a memorandum of agreement in October of 1996, and a new minister coming in and really basically undermining the previous minister, which may be his right to do, but it is not his right to do so with an external group which is party to an agreement with this provincial government. There is a second party to an agreement.
It is not a question of the minister just totally changing the policies from the previous minister, because you have another group of people that are part of a memorandum of agreement to get their agreement to be either quiet or not present objections to Bill 49 in 1996, because, initially, prior to the act being developed in the Legislature, the faith-based institutions noted that they were not going to agree to Bill 49 because it broke the letter that was sent by the previous Minister of Health to the faith-based institutions in 1995 just prior to the election.
So here we have a situation where the government is changing again the powers it is giving to itself to establish and implement regional health here in the province of Manitoba. Now, if they would have done this all up front in 1996, Madam Speaker, then everybody would know the terms and conditions under which the regional health authorities were being established, and everybody then could comment on the substance of the bill before the Legislature in 1996.
I really object when the minister says it is public money, Madam Speaker. It was public money in 1995 when you signed the letter to the faith-based institutions. It was public money when you passed or brought forward to this Legislature Bill 49. It was public money when you signed a memorandum of agreement with the faith-based institutions in Winnipeg, and it is public money in this bill now. So nothing has changed in terms of public money. The only thing that has changed in terms of the bill that is being provided to this House is a breach of promise that was made and given to the faith-based institutions and the other community-based boards when they signed the memorandum of agreement in 1996.
I know this government, when somebody wants something through quickly or wants it introduced quickly, the antennae should go up by all of us. Sometimes it is in the public interest for us to pass legislation in an expeditious way. We have brought in legislation ourselves on the Good Samaritan bill, when the government brought in legislation on the Good Samaritan bill, and it was donations to food banks. Obviously it was in the best interest of this Legislature to make that change.
But sometimes a bill is just being brought in to give the minister more power to basically coerce organizations that have an agreement with the government from 18 months ago. It behooves this Legislature, I think, to stop, look and listen at the motivations of this minister and watch and see what kind of leverage he is trying to give his negotiators to reach an agreement that he said he would have on May 1, 1998, a period that has already been exceeded. Do not forget the Winnipeg Regional Health Authority was to come into place on April 1, 1998. Do not forget the Minister of Health (Mr. Praznik) said that he was going to bring in legislation to deal with the Winnipeg Regional Health Authority, and all he did was bring in a minor amendment that was passed under the statute law amendment period.
So, I am quite frankly concerned about this bill. I would prefer the government to have a voluntary agreement consistent with their word with the faith-based institutions here covered by the Winnipeg Health Authority. I think the government already has tremendous power. It already has a memorandum of agreement that was signed between the former Minister of Health and the faith-based institutions dealing with matters that are contained or could be dealt with in this bill that is provided to this Legislature.
An Honourable Member: We did get that agreement on May 1 on the issues we talked about on Labour Day.
Mr. Doer: Well, Madam Speaker, if you did have agreement, why do we need this legislation? Why do you need this hammer? Why do you have not only a hammer in terms of mediation, it is heads, I win; tails, you lose in terms of the minister's power, if mediation does not work? What is going to persuade one of the two parties that have the full unilateral right of the minister after the fact to mediate, when the minister--you know you have one party that reports to the minister, and they are also a party that is going to mediate, and the party that is going to mediate if there is no mediated settlement has the power of the minister to actually implement an agreement beyond the mediator?
Well, you know, any member of this Legislature has been around long enough to know that the Minister of Health (Mr. Praznik) has all the power with the faith-based institutions under this act. And you know what? Does this government not care about its own word to these people? Does it not care about the memorandum of agreement that cabinet had signed in October of 1996? You have basically said that we have a co-operative joint agreement in 1996 signed and authorized by cabinet, by the Premier (Mr. Filmon), to be implemented, and then you have a Minister of Health (Mr. Praznik) that does not like the agreement of the previous Minister of Health, and he is going to give himself all the power.
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Is there anybody in southeast Winnipeg concerned about St. Boniface Hospital? Has anybody over there been and had it explained to them by the Minister of Health (Mr. Praznik) that this is not mediation when the minister can impose a settlement? That is not mediation. One party is a party of mediation, another party that represents the minister has the minister able to implement a settlement. Do you think we all came up the Red River in a bubble? You know, this little happy-go-lucky presentation for the Minister of Health--oh, it is all love, trust, and pixie dust, and we do not even think we will need it because we think we will have a settlement anyway. But if we do not have a settlement anyway, well, you know, we have got to need this anyway. What do you think we are supposed to do with these people? These are religious volunteer organizations, and you will not keep your word to religious organizations.
Madam Speaker, you are right, so why did you sign the memorandum agreement in 1996? Did you fully intend to break your word then? This is about the Minister of Health having all the power in his own hands. This is about--
Some Honourable Members: Oh, oh.
Madam Speaker: Order, please.
Mr. Doer: So I think the minister's comments in introducing this bill--
An Honourable Member: Do not attack my minister.
Mr. Doer: Well, he may be your minister, but your brother may not agree with this legislation. But I have no difficulty in the government bringing in Bill 49 and having all these matters of public money and faith-based institutions up front. I have no difficulty with the government bringing in a memorandum of agreement with the faith-based institutions in October of 1996 to pass the regional health bill with public money at that time. What I object to is the government saying one thing 18 months ago and signing away that joint agreement with the faith-based institutions and coming back here and telling us that this is just a little kind of passive bill with passive powers to deal with maybe a passive problem in regional health.
It is not a passive piece of legislation. When you have the right of both mediation and implementation, it is not a mediation process because you are both Crown attorney and judge or defence lawyer and judge at the same time as being parties to a dispute. What this does is this bill, by using weasel words and weasel word introductions by the Minister of Health (Mr. Praznik), this bill overrides the memorandum of agreement that was signed by the previous Minister of Health in dealing with the faith-based institutions.
Now, Madam Speaker, if you are going to do it, why do you not have the honesty just to say we are going to break our word? Why do you not go back to them and say, I am going to break my word, I am going to break the word of the government because it is public money, and we never intended to keep our word if we did not get our own way with the faith-based institutions? Why did you not say that?
An Honourable Member: Our word is our bond.
Mr. Doer: Well, it is your bond this week, and the bond will change next week and changes the week after, and it may change the week after that.
It talks about funding during negotiations. The bottom line is the government likes to say, when it is convenient for them, when the Regional Health Authorities make a decision that is unpopular in the public mind and unpopular in the mind of the patients of Manitoba, then the Minister of Health (Mr. Praznik) is going to try to say, oh, that is not me, that is the regional health authority. That was not me that extended the private profit contract in home care, that was the regional health authority that did that nasty thing, but this bill makes it obvious that the government minister holds all the cards.
He sends one party in to negotiate, he sends one party to the mediation tables, and if the minister does not like it, then the minister can override all of it and get his own way and just sit there and do whatever he wants because he can in fact implement the powers that is given to him under the act: "The minister may, if he or she believes it to be in the public interest, resolve the matter or matters remaining in dispute."
Madam Speaker, this bill is the dictatorial rights of the Health minister bill to override the faith-based institution. That is all it is. You know, if you are going to do that, have the honesty to bring it in and say it. You know, if the Minister of Agriculture (Mr. Enns) thinks that is what we are going to do, at least have the honesty to say that is what we are doing. At least go back to your cabinet and caucus colleagues. I do not know whether you read these bills in caucus, but--
An Honourable Member: We commit them to memory.
Mr. Doer: Yes, I can see that, but I do not know whether you commit to memory your previous agreements with the faith-based institutions. Madam Speaker, but I think the glib Minister of Health (Mr. Praznik) with his flip-flopping and flip-flopping and his other--if the minister considers that a negative term, glib, I withdraw. Some people like to be called glib. We can hear the people who got under the skin of the former opposition critic for Natural Resources, the member for Lakeside (Mr. Enns). He is kind of the hall of famer. Those people who got under his skin during the opposite roles that were played based on the democratic process.
Madam Speaker, I wanted to just speak for a short period of time. I do have unlimited time, but I may want to give that unlimited time to another one of our members. But do not think Minister of Health (Mr. Praznik) that you can just take all these dictatorial powers onto yourself, break the previous agreement from previous ministers and just have us, you know, give leave on second reading to pass it quickly or not read the bill in terms of what it means. I suggest the Minister of Health go back and negotiate with the faith-based institutions, getting an agreement that is consistent with your memorandum of agreement. I do not know why you are bringing in a hammer like this unless you feel you need it. Obviously, this Minister of Health is not very skilled at negotiating with anybody. He cannot get an agreement with anybody around the system. He is probably the most unsuccessful Minister of Health in negotiating agreements with anybody in the health care field. He has got more disputes. He has got more peace in our time press releases of any Minister of Health in 18 months, with complete failure after that.
We have just begun to read this bill, but I think it behooves the Minister of Health (Mr. Praznik) to tell the people of this province and the faith-based institutions why he has to break his word from Bill 49, why he has to break his word from the memorandum of agreement, and why he gives us a passive presentation of something that gives him dictatorial powers in regional health. Thank you very much, Madam Speaker.
Mr. Daryl Reid (Transcona): Madam Speaker, I move, seconded by the member for Crescentwood (Mr. Sale), that debate be adjourned.
Motion agreed to.
Hon. Glen Cummings (Acting Government House Leader): On behalf of the government House leader, I wish to obtain unanimous consent of the House, notwithstanding the sequence for consideration of Estimates as outlined in the Session Paper 142 tabled on March 24, '98, subsequently amended to consider the Estimates of the Department of Culture, Heritage and Citizenship, followed by Industry, Trade and Tourism on the completion of the Status of Women in Room 255. These changes are to apply under further notice.
Madam Speaker: Is there unanimous consent of the House to change the sequence for the consideration of Estimates to amend the order as follows: the Department of Culture, Heritage and Citizenship, followed by Industry, Trade and Tourism, on completion of the Status Women in Room 255 until further notice. Is there unanimous consent? Agreed? [agreed]
Hon. James McCrae (Government House Leader): Madam Speaker, I move, seconded by the honourable Minister of Natural Resources (Mr. Cummings), that Madam Speaker do now leave the Chair and the House resolve itself into a committee to consider of the Supply to be granted to Her Majesty.
Motion agreed to.