LEGISLATIVE ASSEMBLY OF
Monday, March 23, 1992
The
House met at 1:30 p.m.
PRAYERS
ROUTINE PROCEEDINGS
PRESENTING PETITIONS
Ms.
Becky Barrett (Wellington):
Mr. Speaker, I beg to present the petition of Dolores Hebert, Louis R.
Marchildon, Manon Harvey and others requesting the Minister of Justice (Mr.
McCrae) call upon the Parliament of Canada to amend the Criminal Code to
prevent the release of individuals where there is a substantial likelihood of
further family violence.
Ms.
Jean Friesen (Wolseley): Mr.
Speaker, I beg to present the petition of Tammie Forsythe, Kirsten Lindal,
Daljeet Sanan and others requesting the government show its strong commitment
to dealing with child abuse by considering restoring the Fight Back Against
Child Abuse campaign.
Mr.
Speaker: I have reviewed
the petition of the honourable member, and it complies with the privileges and
practices of the House and complies with the rules (by leave). Is it the will of the House to have the
petition read?
The petition of the undersigned citizens of
the
THAT the bail review provisions in the
Criminal Code of
The problem of conjugal and family violence is
a matter of grave concern for all Canadians and requires a multifaceted
approach to ensure that those at risk, particularly women and children, be
protected from further harm.
WHEREFORE your petitioners humbly pray that
the Legislature of the
* * *
I have reviewed the petition of the honourable
member, and it complies with the privileges and practices of the House and
complies with the rules (by leave). Is
it the will of the House to have the petition read?
The petition of the undersigned citizens of
the
THAT child abuse is a crime abhorred by all
good citizens of our society, but nonetheless it exists in today's world; and
It is the responsibility of the government to
recognize and deal with this most vicious of crimes; and
Programs like the Fight Back Against Child
Abuse campaign raise public awareness and necessary funds to deal with crime;
and
The decision to terminate the Fight Back
Against Child Abuse campaign will hamper the efforts of all good citizens to
help abused children.
WHEREFORE your petitioners humbly pray that
the Legislature of the
I have reviewed the petition of the
honourable member, and it complies with the privileges and practices of the
House and complies with the rules. Is it
the will of the House to have the petition read?
The petition of the undersigned citizens of
the
THAT child abuse is a crime abhorred by all
good citizens of our society, but nonetheless it exists in today's world; and
It is the responsibility of the government to
recognize and deal with this most vicious of crimes; and
Programs like the Fight Back Against Child
Abuse campaign raise public awareness and necessary funds to deal with crime;
and
The decision to terminate the Fight Back
Against Child Abuse campaign will hamper the efforts of all good citizens to
help abused children.
WHEREFORE your petitioners humbly pray that
the Legislature of the
TABLING OF REPORTS
Hon.
Harold Gilleshammer (Minister of Family Services): I would like to table the Annual Report 1990‑91
for the Department of Family Services, also the Supplementary Information for
Departmental Expenditure 1992‑1993, Family Services.
Hon.
Darren Praznik (Minister of Labour): Mr. Speaker, I would like to table today in
the House the 1990‑91 Annual Report of the
Introduction of Guests
Mr.
Speaker: Prior to
Oral Questions, may I direct the attention of honourable members to the
gallery, where we have with us this afternoon, from the
Also, from the
On behalf of all honourable members, I welcome
you here this afternoon.
ORAL QUESTION PERIOD
North American Free Trade Agreement
Mr.
Gary Doer (Leader of the Opposition): Mr. Speaker, my question is to the Deputy
Premier.
Tomorrow, the First Ministers' meeting will
again start in
We also have at the same time negotiations
going on between
I would ask the Deputy Premier: Will the government of
* (1335)
Hon.
James Downey (Deputy Premier): Mr. Speaker, there is no secret as to the
position of this government as it relates to the North American free trade
agreement. The Premier last week again
spelled out the conditions of which any discussions or negotiations in fact
would be taking part.
The Leader of the New Democratic Party last
week, and his party, missed the opportunity to help all Manitobans and those
people in
Mr.
Doer: Well, all
the Manitobans watching the government's position on free trade with
North American Free Trade Agreement
Labour Adjustment Strategy
Mr.
Gary Doer (Leader of the Opposition): Mr. Speaker, a further question to the First
Minister on the proposed free trade with
The government has not told us whether they
are going to make a statement tomorrow at the economic meeting, and I do not
know why they would miss that opportunity.
The government has stated that they will only support free trade with
Notwithstanding the fact that we have had
training budgets cut in net terms over the last two budgets that the provincial
government has brought in in
I would ask the Premier: What agreement does he have with the federal
government for a labour adjustment strategy with the federal government, and to
whom will that adjustment strategy be applied to? Which workers in
Hon.
Gary Filmon (Premier): Mr. Speaker, in the case of the Free Trade
Agreement with the
The fact of the matter was that it is fail‑safe
so that regardless of where there might be adjustments within the economy, it
would apply. There was an identification
of particular areas prior to the Free Trade Agreement.
The Minister of Industry, Trade and Tourism
(Mr. Stefanson) has indicated that his department is doing the same kinds of
consultations with specific sectors of the economy, and we are aware of areas
that are of concern to us. Those areas
will obviously be ones in which any adjustment strategy would be applied.
Mr.
Doer: Mr.
Speaker, let the record show that we were opposed to the Free Trade Agreement
with the
North American Free Trade Agreement
Impact Crown Corporations
Mr.
Gary Doer (Leader of the Opposition): A final question to the First Minister (Mr.
Filmon).
In light of the fact that he does not have a
negotiated deal with the federal government on labour adjustment strategies, or
he has not come forward with one to date, Article 402 of the proposed draft
agreements may change or will change, as drafted, the conditions under which
Crown corporations and provincial governments operate vis‑a‑vis the
Free Trade Agreement with the
I would wonder whether the Premier has any
analysis of whether in fact this will impact on the Crown corporations. What will be the impact on jobs and services
in
Hon.
Eric Stefanson (Minister of Industry, Trade and Tourism):
Mr. Speaker, I think as the honourable member knows, we recently received a
copy of the draft text from the federal government, a text which outlines a
Canadian position, a
We are in the process of reviewing that entire
text, as I said the other day in the House, consulting with various sectors of
our economy, various industries within
I should point out that other jurisdictions
have not even adopted positions to date.
For instance, I received a document at the end of last week from
We now have a draft text that we are working from,
Mr. Speaker. We will analyze that in
consultation with Manitobans and come forward with a position at that point.
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Health Care Facilities
Bed Closures
Ms.
Judy Wasylycia-Leis (
In response to questions on Friday, the
Minister of Health suggested that he has not asked the Health Sciences Centre
anything specific in terms of budget cuts or bed closures. We have, Mr. Speaker, a memo from Mr. Rod
Thorfinnson, who is president of the Health Sciences Centre, to all staff,
dated March 20, 1992, indicating that there has been a clear message conveyed
to the Health Sciences Centre about restructuring the system. There are grave tones in this memo, talking
about working with staff in these difficult days.
Mr. Speaker, it is clear that there is a
restructuring plan. There are budget directives and cutbacks going to
hospitals. I want to ask the Minister of
Health if today, finally, he will let us know in this Chamber, let all
Manitobans know how many beds are being cut or requested to be cut at the
Health Sciences Centre and St. Boniface.
How many dollars are being reduced from the budgets of our urban
hospitals?
Hon.
Donald Orchard (Minister of Health): Mr. Speaker, I simply want to welcome the
critic for the New Democratic Party into health care reform of the 1990s.
The system clearly is going to go through
restructuring exactly as the memo from the president of the Health Sciences
Centre to the staff of the various departments of the Health Sciences Centre is
stating. If my honourable friend thinks for
one minute that that restructuring is not going to happen in this province and
across
Mr. Speaker, the difference in
The restructuring, yes, will go on. Mr. Speaker, whether my honourable friend
understands the process or not will remain to be seen as we debate the Health
Estimates over the next number of hours.
Health Care System Reform
Consultations
Ms.
Judy Wasylycia-Leis (St. Johns): Mr. Speaker, in light of concerns being
expressed by the Manitoba Medical Association, which the minister dismissed
with contempt on Friday, and now concerns expressed by on‑the‑line
doctors working at the Health Sciences Centre, will the minister indicate to
this House whether he is prepared to consult now with doctors, with nurses,
with health consumer groups, with patients and with the Manitoba public at
large about its restructuring plan so that we can all be informed and
understand the direction this government is taking our health care system in?
Hon.
Donald Orchard (Minister of Health): Mr. Speaker, those discussions have been and
will continue to be going on. That is
the whole focus of the
Specifically, since my honourable friend
wishes to offer concerns that she has in echoing the MMA, I wonder where my
honourable friend stands as official party critic for the New Democrats and the
concern I have that we cannot afford the MMA's asking price of last year's
contract of 12.1 percent. I have a great
concern about that, and as I stated in the paper correctly on Saturday, if 12.1
percent more resource goes to physician services, there will naturally be less
of them performed.
I wonder if my honourable friend shares that
concern, or is she in bed with the MMA union?
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Ms.
Wasylycia-Leis:
That is, Mr. Speaker, how the minister treats the head of orthopedics,
the head of pediatrics‑‑
Mr.
Speaker: Order,
please.
Health Care Facilities
Bed Closures
Ms.
Judy Wasylycia-Leis (St. Johns): Mr. Speaker, I would like to ask the Minister
of Health about these bed closures, specifically ask how many beds are being closed
at the Health Sciences Centre and St. Boniface Hospitals in order to open the
beds promised two years running in the capital Estimates of this Minister of
Health and this government, at Concordia, beds at Deer Lodge and beds at the
municipal, how many beds are being‑‑
Mr.
Speaker: Order,
please. The question has been put.
Hon.
Donald Orchard (Minister of Health): Mr. Speaker, my honourable friend quite
rightfully identifies a number of capital construction projects which have been
undertaken by this government. I need
only remind my honourable friend that the last time she sat around cabinet
table, in the glory years of Howard Pawley and the NDP, the entire capital
budget of the
I recognize my honourable friend's sensitivity
when a number of construction projects have been ongoing and will continue to
be ongoing to meet the legitimate care needs of
In terms of restructuring the system, yes,
there are going to be patient services moved from our high‑cost centres,
such as our teaching hospitals, with the patient to a lower‑cost centre
of delivery. The patient, the consumer
of health care, will not be compromised in this, Mr. Speaker, because the
service will move with the patient. I
hope my honourable friend finds the goodness in her heart to consider the
patients in all of this.
First Ministers' Conference
Government Agenda
Mrs.
Sharon Carstairs (Leader of the Second Opposition): My question is to the Premier.
Mr. Speaker, the recession and the bad
economic outlook have Manitobans confused.
They have them angry, scared and, if one goes by the behaviour in this
House, particularly on Fridays, very testy.
Tomorrow the Premier is leaving for a First Ministers' Conference on the
economy to try and develop, one hopes, a national co‑ordinated strategy
to bring our country out of this recession.
Can the First Minister tell us what new
initiatives, proposals or plans he will be bringing to the First Ministers, in
that his Finance minister seems to think that everything the federal government
is doing is just fine, if one uses his reaction to the last federal budget as
an indicator?
Hon.
Gary Filmon (Premier):
Mr. Speaker, I just want to say that the Leader of the Liberal Party
should not misrepresent the comments that were made with respect to the budget
by the Finance minister. The Finance
minister applauded the fact that taxes were being held down, something that
does not happen often enough by federal governments. Certainly, those of Liberal persuasion who
were there for so many years throughout the '70s and early '80s did nothing but
raise taxes in this country and raise the deficit. The fact that the federal government's budget
kept taxes down, kept the deficit down was something that was applauded by the
Minister of Finance (Mr. Manness).
The Leader of the Liberal Party should know
that the meeting we are embarking upon tomorrow and carrying on Wednesday is a
continuation of meetings that began in December. When at the first meeting, we established
certain directions and certain agreements about priorities and put on the table
certain ideas, some of which were incorporated ultimately into the federal
budget, things like reduction of the down payment for CMHC mortgages, use of
RRSPs for financing new home purchases and so on, carried on with a second
meeting in the first week of February that established a series of six priority
areas that we wanted to work upon because we felt they had the greatest
opportunity for improvement in the near term of our economic prospects as we
come out of the recession in this country.
* (1350)
I could go into detail, but I am sure that the
Leader of the Second Opposition has the newspaper and media coverage at her
disposal in which we laid out those six areas.
They have been worked upon by committees of ministers and senior
officials, and they are putting now on the table for this meeting tomorrow and
Wednesday the results of those deliberations in the form of position papers or
proposals that we as First Ministers will deal with. The new ideas are a collection of the input
of all of the provinces, and they will be the basis upon which we will look for
individual actions and initiatives that we hope will be positive to the
economic growth of this province and this country.
Education and Training Initiative
Mrs.
Sharon Carstairs (Leader of the Second Opposition): Mr. Speaker, Premier McKenna at the last
meeting talked about the need for a co‑operative program to bring forward
a national education and training initiative.
In December, the First Minister also indicated his support of such a
training initiative.
Can he tell us today what kind of discussions
have taken place between this province and the
Hon.
Gary Filmon (Premier):
Mr. Speaker, because of a desire to move forward effectively with
respect to position papers and proposals, this province was given a lead role
in the area of trade, both external and interprovincial. In fact, that was split down between
Mrs.
Carstairs: Mr.
Speaker, in light of the fact that community colleges are being funded at 1990‑91
levels, in fact less than 1991 levels in this province, can the Premier tell us
today what specific ideas this province contributed to a national education and
training concept?
Mr.
Filmon: Mr.
Speaker, as the Leader of the Second Opposition knows full well, the budget
calls for about $2.5 million of new initiatives in the area of Education and Training,
particularly to be delivered in the post‑secondary level by, not only the
community college system, but through our Workforce 2000 program involving
training in the workplace. I am sure
that she will be interested in debating and discussing that with the Minister
of Education and Training (Mrs. Vodrey) when her Estimates come up for review
in this House.
Race Relations Policy
Education System
Ms.
Marianne Cerilli (Radisson): This government, Mr. Speaker, is not taking a
leadership role in preventing the proliferation of racism in schools. Like so many other responsibilities, schools
and school boards are expected to deal with this responsibility on their
own. This government chooses instead to
put new staff into the minister's secretariat while eliminating positions in
the Department of Education that work in schools.
Will the Minister responsible for
Multiculturalism work with her colleague the Minister of Education and Training
(Mrs. Vodrey) to ensure that all school divisions in
Hon.
Bonnie Mitchelson (Minister responsible for Multiculturalism): Mr. Speaker, at the outset, I want to say
congratulations to many of the school divisions and many of the schools that
really did undertake antiracism initiatives last week and especially on
Friday. I want to commend them and say
to them, yes, no one can do it alone.
Government cannot do it alone, and the school divisions cannot do it
alone. We need to develop partnerships,
and we need to have people out there in the communities speaking against racism
wherever it might occur. I do know that
many schools throughout the
Ms.
Cerilli: It would
be good if the minister would answer the questions. They are very direct questions, Mr. Speaker.
Will the minister also ensure with her
colleague in the Department of Education that school divisions will have
programs in place, specific programs, to ensure that all staff in school
divisions are in‑serviced on a crosscultural training?
Mrs.
Mitchelson: Mr.
Speaker, we are working together with the Department of Education with my
department and with the Multiculturalism Secretariat. I know we are at the present time looking at
a multicultural education policy that will be announced in due course.
* (1355)
Programs Funding
Ms.
Marianne Cerilli (Radisson): Mr. Speaker, will the government get its priorities
straight then to put resources into the community and into schools rather than
into the minister's escort staff?
Hon.
Bonnie Mitchelson (Minister of Culture, Heritage and Citizenship): Mr. Speaker, as a result of our restructuring
and moving the Citizenship Division within the Department of Culture, Heritage
and Citizenship, we have reorganized. We
have set up and established an Immigrant Credentials and Labour Market Branch. We have also set up a Citizenship
Branch. Within that Citizenship Branch,
we announced last week‑‑and I think it was a very positive
announcement because we often hear criticism from members of the opposition
that we are not doing enough within government.
We have restructured that branch so that in
fact we will have an antiracism co‑ordinator who will be dealing
internally with breaking down barriers within government that might prohibit
some people from accessing government services and government jobs.
I think it is a positive move in the right
direction, and I am really disappointed that members of the opposition are not
coming forward and applauding this government on the positive moves that they
are making and the positive direction that we are taking.
Legal Aid Services
Labour Dispute
Mr.
Dave Chomiak (Kildonan):
Mr. Speaker, my question is to the Justice minister.
Last year's annual report of the Legal Aid
commission talked of crisis conditions amongst Legal Aid staff and warned the
minister that unless he undertook discussions with all those involved in the
legal aid system, serious problems would develop.
Now that the government has failed to follow
this advice, what contingency plans, if any, does this minister have to deal
with the possible labour action to occur in the North and perhaps throughout the
province?
Hon.
James McCrae (Minister of Justice and Attorney General):
Mr. Speaker, we are determined as a government to provide services to
disadvantaged people in this province under our Legal Aid program. I understand that some of the members of the
legal profession in Thompson, led by one Bob Mayer, who is not unknown to
honourable members in the New Democratic Party and is on a first‑name
basis with pretty well every union boss in this province‑‑
Mr.
Speaker: Order, please.
Point of Order
Mr.
Steve Ashton (Opposition House Leader): Mr. Speaker, on a point of order. The minister was asked a very serious,
straightforward question about contingency plans for legal aid. He ought not to
stoop to personal attacks, and he also ought to check with some of his
political confreres in Thompson who also are opposed to this government's cut
in terms of legal aid.
Mr.
Speaker: The
honourable member does not have a point of order.
* * *
Mr.
McCrae: There
can be no question that other lawyers besides Mr. Mayer would be disappointed
with the necessity for tariff reductions this coming fiscal year. The bottom line for the government is
delivery of service to disadvantaged people.
I do not know how it helps disadvantaged people in the civil law side of
legal aid, which is not the subject of any tariff reduction. I do not know how
it helps disadvantaged people to withdraw services from them.
On the other hand, the government of
* (1400)
Mr.
Chomiak: Mr.
Speaker, I would like to ask the minister how he proposes to deal with those
legal services in the event that they are not available, since already Legal Aid
staff are unable to deal with the volume of work that is occurring presently
today. How does the minister propose to
deal with the withdrawal of services, because today, already, there are Legal
Aid certificates being passed on from staff lawyers to the private bar?
Mr.
McCrae: As I said
to the honourable member, Mr. Speaker, the government of
This government has placed in the Legal Aid
account this year an increase in funding of $1.3 million. That is about 11 percent for the Legal Aid
account. The reason for that kind of an
increase, the major reason, has to do with dwindling resources at the Law
Foundation, which normally grants $2 million to the Legal Aid account. Well, that is down this year to $1.2 million.
There is $800,000 there which had to be made up, and in addition, since 1989‑90,
the federal government capped its share of its contribution to the Legal Aid
program. That had to be taken care of,
for a total of $1.3 million additional into the Legal Aid account this
year. That is an increase of about 11
percent, Mr. Speaker. To me that sounds
like a commitment to the people of this province.
Mr.
Chomiak: Mr.
Speaker, my final supplementary is: Can
the minister assure this House, since the family bar and the criminal bar are
one and the same in the North, that no domestic violence cases, no cases of
abuse and no other cases of that nature will suffer and people will not be put
back out on the streets as a result of this government's lack of action in
dealing with this matter?
Mr.
McCrae: Mr.
Speaker, I know that an option being put forward by members of the bar, of
which the honourable member is one, is to cut back on the eligibility of people
for Legal Aid services and also to bring in user fees. I say to the honourable member that perhaps
he should use whatever powers of persuasion he has to talk his colleagues out
of that kind of idea. We looked at those
suggestions, Mr. Speaker. I have
undertaken to look at them again, but that is not our preferred‑‑[interjection!
Mr.
Speaker: Order,
please.
Mr.
McCrae: User
fees and reduced eligibility, Mr. Speaker, are not really the first priorities
of this government. Maybe the honourable
member wants to put those ideas forward, but I do not immediately accept them.
We have in place plans to ensure that service
delivery is not in any way reduced, Mr. Speaker.
Headingley Correctional Institution
Psychiatric Care Facilities
Mr.
Paul Edwards (St. James):
Mr. Speaker, my question is also for the Minister of Justice.
This minister appears quite clearly to be
seeking to escape the intent and spirit of the new amendments to the Criminal
Code of
Mr. Speaker, my question for the minister: Can the minister table in the House today
accreditation documentation showing that Headingley qualifies for this
minister's designation as a psychiatric hospital in compliance with that new
federal law and in compliance with the Supreme Court of Canada?
Hon.
James McCrae (Minister of Justice and Attorney General):
Mr. Speaker, there are five cases presently at Headingley Correctional
Institution identified as not criminally responsible, and the designation made
earlier of Headingley was done on a temporary six‑month, interim period
basis.
The honourable member will know that later
this year, there will be a 20‑bed psychiatric facility constructed at the
Health Sciences Centre. In addition,
there are possibilities for a designation of spaces at the new provincial
Remand Centre, the medical floor which is separate from all the other floors.
The key to the future, of course, is a long‑term
forensic treatment facility, hopefully at Selkirk. There are problems in this respect. The honourable member knows about the
evolution of laws and how laws that get changed quickly sometimes create
problems, such that the honourable members opposite in the New Democratic Party
will know that in
We have some short‑term, interim
difficulties to get through, and we will do so as sensitively and as carefully
as we can, keeping in mind the federal involvement that is required for the
long‑term planning for these people.
Mr.
Edwards: Again for
the same minister, Mr. Speaker, this minister has known that this was coming
for a year. It was a year ago that the
Supreme Court of Canada handed down its decision, so the minister's definition
of "quickly" has to be questioned.
Why after a year can he not give members
conclusive evidence that this government is prepared and able and willing to
comply with the law which, again, was set down by the highest court in this
land, because the individuals he is keeping in custody, if it is illegal, will
be let go‑‑does he not understand that?‑‑possibly
injuring themselves and members of society?
Can he deal with that?
Mr.
McCrae: Mr.
Speaker, I have a very clear understanding of this issue. The Department of Justice, over a long period
of time, has engaged in frequent correspondence with the federal government,
working at the officials' level in developing the new law.
We are not happy with all of the aspects of
the new law, but that is not for lack of input on the part of the
Here, the honourable member will remember,
most of the people found not responsible, if they were found to be sane, would
be serving federal time in federal penal institutions, so there is no way I
suggest that the federal government ought to be trying to evade responsibility
for helping in putting together facilities to deal with the long‑term
care of the people whom the honourable member is asking about.
Mr.
Edwards: Mr.
Speaker, only this Minister of Justice would presume guilt without a
trial. These people are not guilty‑‑
Mr.
Speaker: Order,
please. Question, please.
Mr.
Edwards: Mr.
Speaker, my final question for the Minister of Justice‑‑I am glad
that his department has been involved.
Can he table in this House a legal opinion from his department
indicating that this facility qualifies as a facility in keeping with the new
law and in keeping with the Supreme Court of
Mr.
McCrae: Well, the
honourable member knows, Mr. Speaker, we do not generally table internal legal
opinions made available to the department.
Maybe he, together with the honourable Leader of the Opposition (Mr.
Doer) and his New Democratic Party colleagues, would ask Premier Romanow or
Attorney General Mitchell what kind of legal opinions they are following with
regard to four prisons in
Retail Trade Sector
Sales Decline
Mr.
Leonard Evans (Brandon East): I have a question for the Minister of
Finance.
Mr. Speaker, statistics released today show
that retail sales in
Mr. Speaker, my question to the Minister of
Finance is: Why are retail sales
continuing to sag in
* (1410)
Hon.
Clayton Manness (Minister of Finance): Well, I guess, Mr. Speaker, I could ask the
question: Why is the member opposite so
happy? See the smile. I make my point.
I have not seen the article in question, and I
have not seen the analysis. I can tell
the member I have seen my sales tax revenue for the month of January, and
certainly it was increased over that which was budgeted for. I would say to the member opposite, that was
also the case for the month of February.
I have to believe that on the consumption side over the last three
months, there has been a growing optimism within this area and that the trend
is looking favourable.
I am hoping that events over the last two
weeks, particularly the interest rate jump, are now over. I hope that indeed the bank rate continues to
drop so the consumers once again can have this developing feeling of confidence
overtake them and that they will continue to purchase durables in the fashion
as they were over the last two months.
Mr.
Leonard Evans: Mr.
Speaker, we are talking about actual over actual, not actual over budgeted amount.
Mr. Speaker, will the minister now concede
that our weak retail sector in
Is this yet another sign of poor economic
performance in
Mr.
Manness: The short
answers to all those questions are no, no, no, no and no.
Mr. Speaker, let me say to the member that as
he is well aware, consumer confidence, of course, is very much dependent upon
expectations around interest rates, expectations around security of employment,
expectations around government taxation.
Let me say, after we brought down the fifth
budget, as we have, where there have been no increases in taxes, there have
been signals of decreases certainly on the business side. I would say to the member that one of the
conditions has been met with respect to re‑establishing confidence within
the consuming public, that is, the provincial government is not interested, as
indeed most other provincial governments will be, in increasing taxes. I would have to say that will certainly help
consumer confidence.
First Ministers' Conference
Goods and Services Tax Elimination
Mr.
Leonard Evans (Brandon East): Mr. Speaker, I would like to ask the Premier,
will he be prepared to advocate a reduction in the GST, if not the total
elimination of it, at the forthcoming economic summit meeting of First
Ministers in order to stimulate the consumer spending in this province and in
this country and help us to get out of the longest recession experienced since
the 1930s?
Hon.
Gary Filmon (Premier): Mr. Speaker, I find it interesting that the
New Democratic critic from
When he was in government, he sat at the
cabinet table that increased our sales tax by 40 percent in this province, from
5 percent to 7 percent in just six budgets; that put in a 2 percent tax on net
income that devastated every wage earner in this province; that put in a
payroll tax that destroyed thousands of jobs; and that increased the tax on
personal incomes in this province by 138 percent, the personal income tax take,
over a space of six years.
That is the kind of tax‑tax‑tax
approach that member had when he was sitting at the cabinet table, and now he is
very anxious to spend somebody else's money, but he has no positive ideas about
the economy, about what to do with the huge impact of taxation that he
personally, with his colleagues in cabinet, placed on the people of this
province. Shame on him, I say, Mr.
Speaker.
Abinochi Preschool Program
Closure
Mr.
George Hickes (Point Douglas): Mr. Speaker, my question is to the Minister
of Native Affairs.
Last week I asked the minister to look at the
funding of Abinochi preschool program, which is vital to aboriginal people in
all of
Recently, the minister advised Abinochi
preschool that they must close their doors.
I would like to ask the minister to tell this House whether this was his
decision alone, or did he take this to cabinet?
Hon.
James Downey (Minister responsible for Native Affairs): Mr. Speaker, I do not accept the
preamble. I did not tell Abinochi to
close their doors. In fact, last June
they received a letter from the Deputy Minister of Education saying that there
would be no funding this year, and in October, the Minister of Education and
myself forwarded a letter again saying that there would be no funding for this
coming year.
We are sympathetic to the whole question of
continuing of native languages, but as I said last week, we have to sort out
what we are capable of doing. One has to
look at the educational needs of all the people who fall within the
jurisdiction of the Department of Education.
This is a preschool program that there is not any program funding
available for.
Mr.
Speaker: The time
for Oral Questions has expired.
NONPOLITICAL STATEMENTS
Ms.
Becky Barrett (
Mr.
Speaker: Does the
honourable member for
Ms.
Barrett: Over
this past weekend, several of the athletic teams in our city and our province
have shown themselves to be remarkably competent athletes, and I would like to
congratulate several of those teams, if I may.
First, in the provincial boys' championship,
an incredibly exciting game took place at the Duckworth arena with the Daniel
McIntyre Maroons, from the provincial constituency of
On the young women's side, the Glenlawn Lions
made it two out of two by being the provincial champions in both volleyball and
basketball this season, beating the Dakota Lancers in the final game of the
basketball, and congratulations go to them as well.
Finally, the
Also, the
* * *
Mr.
Neil Gaudry (St. Boniface): Can I have leave for a nonpolitical statement?
Mr.
Speaker: Does the
honourable member for St. Boniface have leave to make a nonpolitical
statement? Leave? It is agreed.
Mr.
Gaudry: Mr.
Speaker, on March 19 to the 21, the Nelson McIntyre Collegiate's Grades 11 and
12 girls' varsity team participated in the provincial AAA basketball championship
that was held in the city of
Congratulations not only to the Nelson
McIntyre girls' varsity team and their coaching staff but also to Heidi Weber for
having been selected as the second all‑star player for this tremendous
championship. Job well done! Thank you very much, Mr. Speaker.
* * *
Mrs.
Shirley Render (St. Vital):
Mr. Speaker, may I have leave to make a nonpolitical statement?
Mr.
Speaker: Does the
honourable member for St. Vital have leave to make a nonpolitical statement?
Some
Honourable Members: Leave.
Mr.
Speaker:
Leave? It is agreed.
Mrs.
Render: Mr.
Speaker, it gives me great pleasure to once again stand up in the House and say
congratulations once more to the Glenlawn Collegiate varsity girls. This time, they have won the provincial
championship, and in fact, they beat out another St. Vital team to do this.
This is twice in just a few months that I have
been able to stand up in the House and say congratulations to the coaches and
to the Glenlawn Collegiate girls for winning another sports event. They have shown once more that they are at
the top of their class in everything.
Thank you.
* (1420)
Committee Change
Mr.
Edward Helwer (Gimli):
Mr. Speaker, I would like to make a committee change.
I move, seconded by the member for Sturgeon
Creek (Mr. McAlpine), that the composition of the Standing Committee on
Municipal Affairs be amended as follows:
the member for La Verendrye (Mr. Sveinson) for the member for Emerson
(Mr. Penner).
Mr.
Speaker:
Agreed? Agreed and so
ordered.
ORDERS OF THE DAY
Hon.
Clayton Manness (Government House Leader): Mr. Speaker, I move, seconded by the Minister
of Environment (Mr. Cummings), that Mr. Speaker do now leave the Chair and the
House resolve itself into a committee to consider of the Supply to be granted
to Her Majesty.
Motion agreed to, and the House resolved
itself into a committee to consider of the Supply to be granted to Her Majesty
with the honourable member for St. Norbert (Mr. Laurendeau) in the Chair for
the Department of Health and the honourable member for
* (1430)
COMMITTEE OF SUPPLY
(Concurrent Sections)
HEALTH
Mr.
Deputy Chairperson (Marcel Laurendeau): Will the Committee of Supply please come to
order. This afternoon, this section of
the Committee of Supply meeting in Room 255 will be considering the Estimates
of the Department of Health. Does the honourable
Minister of Health have an opening statement?
Hon.
Donald Orchard (Minister of Health): Yes, Mr. Deputy Chairperson. Prior to the opening statement, I want to
make two apologies to my honourable friends the critics from each of the
respective opposition parties. First of
all, I think it is fair to say we were not necessarily going to be starting
Estimates until after next week, so I have only just received before walking in
here the departmental supplementary on the Estimates, which I will distribute
to my honourable friends.
The second thing is I have a copy of my
statement that I will make in my opening remarks. Page 1 is a covering letter, so it starts at
page 2. I will apologize ahead of time
for any potential typographical or other errors, because as my honourable
friends have been working on their statements, so have we been working on this
one. I assume all responsibility for any
of the errors that may well be in there and will attempt to correct them if I
catch them during the opening remarks.
Mr. Deputy Chairperson, with the will of the committee, I will commence.
I am pleased to present today the working
Estimates of the
Once again, I wish to pay tribute to the many
dedicated workers throughout the health care system. Thousands of dedicated people within the
system can be commended for their willingness to put foremost the well‑being
of the Manitobans whom they serve.
In particular, I want to especially commend
those committed professionals who have continued to give of their time, effort
and creative ideas to facilitate the process of change that the health system
is experiencing. I know I can count on
them and on all the other dedicated members of the system to continue to
support the reform needed to maintain and enhance Manitoba health as the best
in Canada and one of the best, if not the best, in the world.
Also, Mr. Deputy Chairperson, I would again
like to thank the community groups, professional associations, universities,
volunteer agencies and individuals with an interest in the health of Manitobans
whose counsel continues to make contributions to decision making as we continue
to build on the partnerships which are a key feature of the ministry's
activities.
Since I became Minister of Health, I have
announced a number of significant initiatives such as the development of goals
for health and health care; the Health Advisory Network; the establishment of
Manitoba's own bone marrow transplant program at the Health Sciences Centre;
reform of the mental health system, establishment of a Quick Response Team to
investigate emerging issues in health services; the Health Services Development
Fund; Health Human Resource Planning, including among other initiatives a
National Nursing Symposium and a physician human resource strategy in
conjunction with other provinces and the federal government; $3.7 million
linear accelerator for the Manitoba Cancer Treatment and Research Foundation;
$2‑million joint federal‑provincial heart health project in
partnership with the Heart and Stroke Foundation and the University of
Manitoba, Faculty of Medicine; Strategic Health Research and Development Fund;
the introduction of Healthy Public Policy; World Health Organization
Collaborative Study on Quality of Life in Cancer Care, a grant of $1.2 million
over four years to the Manitoba Cancer Treatment and Research Foundation;
Manitoba Centre for Health Policy and Evaluation; the Substance Abuse Strategy,
including establishing a Women's Centre for Substance Abuse; the Urban Hospital
Council; strengthening Continuing Care services and a large number of other
program policy, legislative and organizational changes.
In addition to these and other
accomplishments, we have been able to significantly increase the Health budget
each year that I have been Minister of Health, over 9 percent in 1988, almost 7
percent in 1989, 6.4 percent in 1990, 5.4 percent in June of 1991 and this
year, as I have already mentioned, the increase will be over 5.7 percent. This represents an increase of over half a
billion dollars in the four years that I have been the Minister of Health.
Now, Mr. Deputy Chairperson, I do not intend
to dwell on these achievements, and I would prefer not to open a sterile and
lengthy debate with members opposite, should some of them once again try to
suggest that an increase of over $101 million in 1992 is somehow a cutback or
that the list of achievements somehow represents underfunding. Instead, I would prefer to build on the
expressions of support I have received from members opposite about the approach
we are taking to restructure the health care system. That is the kind of positive and supportive
co‑operation we will need if we are all to work together to protect and
improve the health status of Manitobans in the years to come, because let me
declare at the outset, as long as I am the Minister of Health, the health
status of Manitobans and the interests of patients are my first and foremost
concern.
That is the principle that has guided me since
before I became Minister of Health, and that is the principle that will guide
me in the future. That is the principle
that is guiding me now as we launch into the most comprehensive and far‑reaching
reform of any health system in
Mr. Deputy Chairperson, I do not say this to
boast. I say this because I want to
convey to you the immensity and complexity of the tasks we have undertaken, and
I want to convey to you the enormity of the challenge faced by
Provincial governments across
The cost crisis is as real in
The
Life expectancy at 76.8 years for 1987 is just
behind that of
Mr. Deputy Chairperson, we know that throwing
more money at the health care system will not lead to better health. We know that many of the determinants of
health, such as healthy lifestyles, environmental factors, socioeconomic
factors go beyond the health care system.
Emerging research is also beginning to discover that ever‑escalating
expenditures can actually have a negative effect on health. In fact, a growing body of research is showing
that our health status improves in direct correlation to the wealth and
prosperity of our nation, that the best health program is the availability of
secure employment in a growing and vibrant economy. The best health program is a secure job. We see over and over again in economies that
are growing that do provide those secure jobs with relatively high incomes to
the citizens of their nation that health status improves.
* (1440)
What the growing body of research is saying is
that what is more important to the improvement of one's health status,
longevity, infant mortality and other indicators of improved health status is a
healthy economy providing secure jobs so that the individuals in those
countries can buy better housing, better food, better recreation and enjoy
better lifestyles. The high tech,
expensive institutional and medical approach, characteristic of the North
American, Canadian and
Again and again, nations have demonstrated
that they have improved the health status of their citizens through provision
of services beyond the formal health care system, such as clean drinking water,
effective sewage disposal, better diet, better housing, all of the underpinning
social amenities that we take for granted in this country and in North America
and the free world, but those are all products not of a health care system with
increased spending, but of a vibrant economy which has created the wealth to
enable the individual citizens of that country to buy better water systems, buy
better sewage disposal systems, buy better diet and food, buy better housing
and buy better recreation for a more perfect lifestyle.
If the economy and the provision of secure
jobs is important, how ought we to approach that, Mr. Deputy Chairperson? Today's economy is going through a tremendous
shift because we are facing global competition.
We are no longer competing in
When we compete globally, how do we
survive? How do we create the jobs that
can allow our citizens to buy the amenities in life that improve their health
status, as a growing body of expertise would say, in a greater amount than our
formal spending on health care? How do
we do it?
Well, we are going to accomplish secure jobs
that provide good economic returns for the individual citizens of our country
when we can produce goods that can be effectively and competitively sold on the
world and global markets and when we make sure that more of our dollars go
toward doing the research and development spending, the retraining and the
restructuring needed to make us competitive, rather than an even greater share of
our provincial dollars going toward illness care, illness instead of health.
Even if we wanted to go down that road of
greater and greater spending for less and less resulting health, we are no
longer in a position to do so. Over the
past 10 years,
Since
For example, the government in
The government of
In
In
In other words, the health cost crisis is a
truly national problem. No government in
In
We do not believe that simply reducing
government funding for health services is the answer either. Reduction in spending increases that are not
backed by an overall strategy for change just disrupt the system and place the
quality of our health services in jeopardy.
Closing hospital beds or removing other
institutional services without developing lower cost but equally effective
alternatives as a part of an overall strategy is not an acceptable strategy for
Over the past four years, since I have become
Throughout these consultations I have made two
things very clear. The first is that I
do not believe the challenge we face in
The second point I have made very clear
throughout these consultations is that I do not believe that the government or
any other single group can answer the challenge alone. It is not just a government problem. It is not a doctor's, or a nurse's or a
hospital's problem, it is a problem that affects everyone in
The only way we can succeed is to form an
effective working partnership in which all parts of the health services
community and all parts of the community at large play a positive and
responsible role in discovering ways we can make health services both better
and more affordable without compromising the spirit of medicare.
There have been some disagreements. Some in the health services system have been
tempted to focus on protecting their own turf rather than finding the better
ways of providing health services that
We face difficult adjustments as people learn
to look at the whole health system rather than focusing on their own
institution or their own fields of practice.
We need to learn new ways of thinking, to abandon the old ways where the
bed is the symbol of power, where the threat of loss of professionals is the
second symbol of power, or traditional union thinking is the third symbol of
power, or frightening the public with the spectre of loss of services, it is a
fourth symbol of power. Because these
symbols of power have nothing to do with the improvement of the health status
of Manitobans, or with keeping the interests of patients first and foremost.
We are fortunate in
Working together, we have laid the foundations
for a restructuring action plan that would let us do exactly that. The strategy calls for careful management and
planning. It calls for some hard choices
and adjustments within the health services system. It provides for a greater role for patients
and their families in health care decisions, along with the systematic efforts
to make sure that individual Manitobans have the information they need to play
that role. It is based on a fundamental
change towards a much clearer focus on the health needs of individual
Manitobans, rather than on the interests of various professions or
institutions.
In
* (1450)
We need to strengthen development of
preventative and community‑based parts of that continuum of
services. For example, too many
Manitobans have been placed in mental health institutions, who, with
appropriate community‑based services and supports, could have remained in
their homes, and could have enjoyed far richer lives. That is why I implemented
For example, thousands of other Manitobans,
primarily senior citizens, with appropriate community supports, can remain in
their own homes and avoid hospital or personal care home admission, can retain
their independence and continue to live in their own homes with their own families
in their communities. That is why we have increased spending on home care from
less than $45 million a year in 1988 to almost $68 million in this year's
budget‑‑34 percent more in only four years.
The imbalances in Manitoba's health services
system with their unintended bias towards the highest cost, the most intrusive
health services, has operated across the entire spectrum of our health services
with little evidence that this contributes positively to the overall health of
our population. We have a pattern of people moving from community hospitals to
the even higher‑cost teaching or tertiary hospitals. There is no certainty that the bulk of this
movement contributes to better health outcomes.
It is certain that it contributes to higher health costs.
So, Mr. Deputy Chairperson, one of the
fundamental foundations of Manitoba's strategy for restructuring our health
services has to be supporting the full continuum of services, so that we can
shift more of our total services from high‑cost institutional settings
towards lower cost and more affordable programs of prevention and support
services and home care to help people avoid illnesses and avoid delay or reduce
their need for institutional care. The
basic logic we have been describing here, of a shift towards lower costs but
equally effective health services, is not news to those who have been involved
in health services in
Common sense would tell us that if we expand
our programs of community‑based services so that these services are
available to many more people in Manitoba who might otherwise have had to be
hospitalized, or have had to stay longer in hospital, the incidence of
hospitalization and/or the average length of hospital stay should go down, and
hospital and total health care costs should be reduced. Historically, that has not been the way the
health services system has worked in
Clearly, it was not enough simply to add new
services and assume that these resources would result in a lower increase in
overall system costs. The real need is
to manage all of the elements of the continuum of health services to ensure
that they work effectively together to meet the needs of the population.
Because that is true, our action plan for restructuring the health system
addresses the need for overall strategic management of health services in the
province.
Mr. Deputy Chairperson, the restructuring of
the health system, not the health care system, the health system, will be
accomplished in the context of sound principles, and they are as follows:
Foremost in consideration, improved health
status of Manitobans and protect the interests of patients and families;
It must be consistent with goals for health;
The highest priority will be assigned to
providing services to those individuals or groups who are most at risk or in
need of services;
The integration of institutional and community
health services along a continuum of care, ranging from prevention through
treatment to palliation and rehabilitation, in the context of healthy public
policies;
Services shall be planned, developed and delivered
in the context of appropriateness, cost effectiveness, efficiency and efficacy,
in terms of outcome and value for money based on current scientific evidence;
Restructuring will involve a phased approach
to ensure appropriate alternative services are put in place to accommodate the
shift;
The focus for restructuring will be on the
most appropriate locus and level of care to enhance accessibility in
communities where families live and work;
Patient empowerment through education and
enhancement of patient choice will be a major feature of restructuring; and
Monitoring and evaluation of impact on patient
care and health status outcomes will be by external evaluators, including
medical consultants.
Mr. Deputy Chairperson, these are sound principles
and a sound vision, and I have made the commitment that we will be guided by
those principles and that vision as we restructure the system. But, Mr. Deputy Chairperson, principles are
not enough. Making changes in a system as complex as the health care system
requires the development of strong foundations on which to build.
Mr. Deputy Chairperson, when I became Minister
of Health, I recognized the importance of building these foundations. That is why we established our goals for
health and health care. That is why we
restructured the ministry to integrate the role of Manitoba Health Services
Commission with the ministry's community health services along a continuum of
care, instead of the two solitudes that existed between community and
institutional services.
That is why we established a number of
important mechanisms to build partnerships and to build consensus among the
many stakeholders, such as: the Health
Advisory Network; the Urban Hospital Council; Regional Mental Health Councils;
the Westman Integrated Strategy for Health Project; the National Nursing
Symposium; community consultation on substance abuse; joint workshops with
Manitoba Health Organizations incorporated to develop strategies and objectives
for improving the health status of Manitobans; a range of partnership policy
documents‑‑Mental Health, Phases I and II, Health Promotion,
Continuing Care, et cetera‑‑collaboration with MHO to develop
mechanisms for a rural equivalent of the Urban Hospital Council.
That is also why we have established a number
of committees of key stakeholders to take a comprehensive look at particular
programs and disease entities across the entire spectrum of services ranging
from Healthy Public Policy through health education, early detection, treatment,
rehabilitation, continuing care and palliation.
That is why we have established the Health
Services Development Fund, a unique funding mechanism that provides health care
institutions and others in the health system with the flexibility to make the
transition to a more balanced system.
That is why we have implemented the Healthy
Public Policy Steering Committee. That
is why we established the Manitoba Centre for Health Policy and Evaluation, to
give us the sound scientific basis for our planning, which makes
I would like now to turn to our action plan
for restructuring and rebalancing the health care system. Number one, the first and foremost component
of our action plan will be to strengthen and develop appropriate alternative
services including: strengthening resources to the continuing care program,
including the development of ability to respond more quickly to emergency home
care requirements; an array of community mental health supports, including the
Mental Health Crisis Mobilization Team; opening appropriate personal care beds;
opening acute care beds in community hospitals close to where families live and
work; redirect acute and long‑term psychiatric beds in the system
consistent with Mental Health Reform.
Number 2, the second major component will be
to develop mechanisms to put the individual and the patient first and foremost
through public education and patient empowerment. For example, we have seen that our approach
to mental health reform is demonstrating that patient empowerment through
mental health advocates including patients, former patients and their families,
is leading to more appropriate services.
I know that informed choices and decisions of
individual health care consumers can be a powerful force that will lead to
better and more affordable health services.
That is why I am committed to ensuring that there are realistic
alternatives, that individuals have the best and most current scientific
evidence and information about the existence and implications of those
alternatives, and most importantly, that individuals have the right to choose.
That is why we will be working with Dr. John
Wennberg and others at Dartmouth‑Hitchcock Medical Centre, at the Centre
for Clinical Evaluative Sciences, to provide patients and their families with
effective information about the nature and value of various medical
interventions. For example, testing in
the
* (1500)
We will provide similar information resources
on a variety of subjects, some of which will be developed here under the
guidance of leading
A good example of informing Manitobans about
the true risks and benefits of interventions is the recently released report by
the committee on breast cancer screening regarding mammography screening. There appears to be no evidence that
widespread mammography screening leads to reduced incidence of breast cancer,
nor that it contributes to improved health outcomes for individuals who are
affected.
There is also significant uncertainty as to
the longer term health impacts that frequent exposure to X‑rays may have
on otherwise healthy women who are subjected to this procedure. Therefore, our
approach will be to fully inform
In particular, we will continue to work
closely with the medical profession to encourage all women to use breast self‑examination
to detect irregularities or other possible early symptoms of breast
cancer. Manitoba Health will sponsor the
development and dissemination of an educational program on breast cancer,
including a video tape, to provide women and their physicians with the most
current medical analysis of the risks and value of mammography and other
screening techniques.
Mammographic examinations will continue to be
available to all women who, for whatever reason, be it family history,
perceived breast irregularities or simple concern, feel themselves to be at
risk of this disease. Manitoba Health
will establish an ongoing advisory group of leading health experts to monitor
advances in breast cancer screening to ensure that practice here reflects the
highest possible standards worldwide.
At the end of the day, I believe the patient
or potential patient must have information about all the alternatives and about
the implications of each. Then she, in
concert with her family and her family physician, must make the choice as to
the best means of screening for this disease, and mammography will be available
for those who choose to use it either as a regular part of a check‑up or
in response to other symptoms or concerns.
But mammography will not at this time become routine in
(Mr. Jack
Reimer, Acting Deputy Chairperson, in the Chair)
The third component of our action plan for
restructuring the health care system involves reforming the hospital
system. There is growing scientific
evidence that
For example,
In addition, hospital resources and the
highest technology hospital resources in particular, are relatively heavily
concentrated in
In part, this overdependence on hospital care
reflects the gradual imbalancing of health services that has occurred in
One of the greatest sources of pressure on
hospital facilities and hospital services is from patients who do not need to
be there. Research done in other
jurisdictions indicates that up to 40 percent of admissions to hospitals are
inappropriate. That is, the admissions were either not necessary or would have
been unnecessary if alternative services were available.
Preliminary indications in
The management approach we are using to
address the question of numbers and kinds of hospital beds has been to engage
representatives of the hospitals themselves in identifying services they are
now providing that could more appropriately be provided in a lower‑cost
hospital, an alternate institution or in the community.
Once these services have been identified,
resources will be moved from teaching hospitals to urban hospitals, to
community hospitals or long‑term care facilities and from institutions to
the community‑based services where that is appropriate. In the process, each hospital and each kind
of hospital will define its role more clearly, and this will lead to improved
quality of services and to a reduction in duplication and inefficiencies in the
system.
It is not and cannot be simply a question of closing
hospital beds. The reduction in bed
numbers cannot occur in isolation. Alternative services appropriate to the
person's needs have to be available to replace those institutional services,
but where there are lower costs but equally effective ways of providing
services, resources will be reallocated to ensure that those alternatives are
provided.
Mr. Acting Deputy Chairperson, the rebalancing
of the system will be done in consultation with health care professionals on
the basis of the best scientific evidence available. We will implement ongoing evaluation and
monitoring in conjunction with outside medical consultants to ensure that
appropriate patient care is not affected.
Mr. Acting Deputy Chairperson, we will take
the same approach when we look at waiting lists and priorities in the hospital
sector. The ever‑escalating demand
in
To meet that need, I have established the
Appropriate Access Review Group. This
group includes the medical vice‑presidents of
The group's work will be assisted by Dr. C.
David Naylor, the Director of the Clinical Epidemiology Unit at Sunnybrook
Health Centre in
The group's mandate is to develop better
mechanisms for managing urgent referrals scheduling in the
Another aspect of the action plan for hospital
reform will review the way hospitals are funded. The Manitoba Centre for Health Policy and
Evaluation is producing a report on hospital funding to be released
shortly. Throughout the next year, my
ministry will work with the hospital sector to develop mechanisms to strengthen
funding accountability and to redirect funding more precisely to the range and
mix of services provided by hospitals.
That is also why in this throne speech there
was reference to the Health Status Improvement Fund. The fund will be implemented to provide an
important incentive for continuous quality improvement, also known as total
quality management in the hospital sector.
TQM has been endorsed by the Canadian Council of Health Facilities
accreditation as an integral component of effective utilization management.
Mr. Acting Deputy Chairperson, the fourth
component of our action plan for restructuring will look at health human
resource requirements and allocation.
One of the greatest strengths of
Physicians themselves are also a very
significant element in total health costs, directly through the fees they are
paid under medicare and indirectly through their control of access to hospital
and other health services resources. Any
serious effort to achieve better and more affordable health services must also
involve the medical profession.
Our action plan has three key goals for its
interaction with the medical profession in
The number of physicians in
Between 1968 and 1988, the number of
physicians in
Mr. Acting Deputy Chairperson,
At the same time, we will be working closely
with the profession to ensure adequate medical services in rural areas. This
represents a challenge, both to the profession and to medical training in
Government will do its part in ensuring that
appropriate facilities exist to support rural practice and that the financial
rewards are commensurate with the value of the contribution physicians can make
to these parts of the province, but we also look for leadership from the
profession in meeting that challenge.
Mr. Acting Deputy Chairperson, we are in
discussion with the Faculty of Medicine to establish new funding mechanisms to
achieve deliverables related to rationalizing the number, mix and allocation of
postgraduate medical education positions in the context of identified Manitoba
population health needs, including reduction in funded positions, reallocation of
funded positions between areas of practice to address specialty
maldistribution, establishing programs to train generalist specialists for
nonurban‑based practice, rationalization‑regionalization of
subspecialty training programs.
Mr. Acting Deputy Chairperson, another
critical group, the nursing profession, including registered nurses and
licensed practical nurses, play a key role in both institutional and community‑based
health care services in
The number of people registered and employed
as nurses in
* (1510)
But there is a very significant uncertainty in
efforts to forecast nursing requirements arising out of changes in the nursing
mix that are being adopted in major care institutions. There is an additional
set of uncertainties arising from the wide range of new career opportunities
and new requirements for the skills that nurses can bring to bear throughout
the growing system of alternate health services in
In light of this uncertainty, our action plan
calls for the development of a five‑year nursing resource plan. I have asked the main employers of nurses in
both health care institutions and community‑based programs to provide
information on their current nursing staff and their five‑year
projections of requirements for nurses, including specific information on the
mix of RNs and LPNs they expect will be required.
In addition to providing sound base line data,
this nursing resource survey will provide us with a forecast that can be used
in developing longer‑term training strategies. The forecast will be monitored against real
trends as these emerge to ensure that our education strategies continue to be
responsive to
There are thousands of people who earn their
living as service providers within
The services providing professions that have
played the most dominant role in health services, physicians and nurses, will
face different and evolving requirements and opportunities in the health
services system of the future in
As resources are redirected down the spectrum
to more appropriate health services, there will be employment impacts that may
affect some of these men and women.
Clearly health services managers of government have an obligation to
redeployment and retraining as a fundamental challenge to assuring that our
human resource strengths are focused on reform strategy.
Number 5, Mr. Acting Deputy Chairperson, I
would now like to touch on the final major component of our action plan to
restructure the health system. The final
component has to do with technology assessment and management.
Medical technology, and diagnostic technology
in particular, has had an amazing growth in recent years. Emerging technologies have led to huge and
rapid investment especially but not exclusively in the hospital sector. While
The action plan will address these
issues. That is why the Health Services
Development Fund is providing the financing for an evaluation program to
establish protocols for access to the MRI scanner at St. Boniface General
Hospital. The study will relate use of
this high‑cost technology to patient benefits and will focus on
appropriate choices among various kinds of imaging technology. This is also why we have established a review
of the demand for additional CT scanners and why we are continuing to develop
guidelines for the purchase, operation and evaluation of CT scanners.
Mr. Acting Deputy Chairperson, in conclusion,
this action plan will lead to the kind of restructured health system that
Mr. Acting Deputy Chairperson, I am not
naive. I know that even though the best
minds and the leading health professionals in Manitoba and elsewhere, even
though the public have all said, yes, this is the right approach, these are the
right principles, the best scientific evidence supports what you are doing,
even though we have this support, there will be some who will find it hard to
resist the temptation to play pure politics to protect their turf, to frighten
the public with misleading statements about service cuts, people dying, the
like, to put pressure on the government to back down, to accede to narrow
interests.
But, Mr. Acting Deputy Chairperson, I urge
those people to resist the temptation because we will not back down. Instead, I urge everyone to join in the
partnership which puts the interests of patients and the health status of
Manitobans first and foremost.
Mr. Acting Deputy Chairperson, I have been
told elsewhere that
Mr. Acting Deputy Chairperson, I present my
Estimates for the fiscal year 1992‑93.
Thank you.
The
Acting Deputy Chairperson (Mr. Reimer): We thank the honourable Minister of Health
for those comments. Does the critic for
the official opposition party, the honourable member for
Ms.
Judy Wasylycia-Leis (
There are many areas where we will have very
substantial disagreement, very significant disagreement. There are some areas where we clearly support
the government and have said so in the past and will do so in the future. I think our recent discussion on the issue of
mammography and breast screening is an example of where we do see eye to eye
and where we can work together. When the
minister made those comments in the House and again he has repeated those
sentiments and that direction here in his opening speech, we indicated our
support for the minister's decision, and this government's decision, to in
effect review a previous election promise to reconsider the wisdom of that
decision in light of new and emerging data as it affects the lives and health
of women.
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We appreciated the fact that this minister
indicated a willingness to review new forthcoming data in that context and to
consider the ramifications on women's health.
We certainly support that approach, and we will continue to look for
areas of common ground where we can work together in a very complex, ever‑changing
policy field. In fact, as the minister
has no doubt experienced, this is probably the most rapidly changing policy
area of any before government these days.
It is very difficult to keep pace with the latest developments, with the
latest statistics and the new approaches being developed with respect to health
care delivery.
There is no question from our perspective that
health care reform is absolutely essential.
We have no disagreement with the minister's statements that
restructuring is necessary. We have no
disagreement with his emphasis on some of the areas that need to be addressed,
areas that have to do with physician supply, areas pertaining to technological
developments and, in that context, the benefits of those new advancements in
terms of impact on patients' lives and health.
We have no quarrel with the willingness of
this minister to look at the whole area of adequate or reasonable mix of
service deliverers and types of beds or of services in our health care
system. We have always said that any
health care reform approach must address the current weaknesses in our system. Those weaknesses, in our view‑‑and
I think we have some agreement here with the Minister of Health, those
problems, current difficulties‑‑include an institutional‑based
system, a system therefore that is very expensive to manage and to deliver.
In our view, it is also a doctor‑driven
system which fails to consider the needs of patients sometimes and the ability
of a whole range of health care professionals to make a contribution to our
health care system. We believe firmly
that our health care system must move from that institutional doctor‑driven
illness model to one that is more rooted in our communities in tune with family
needs, having the patient at the centre with the whole range of health care
professionals involved in delivery of health care services, and with an
emphasis on wellness and prevention and health promotion.
Those are the broad parameters of health care
reform thinking from all political parties and groups throughout our society.
Where we have disagreement and where we will continue to have serious and
sometimes heated debate will be on how we achieve those objectives, and whether
in fact that is the impact or the outcome of the government‑stated
agenda.
For me and for my party, we begin our focus on
health care reform with respect to the current situation status of medicare and
going to the heart of that matter, of course, deals with the question of
financing and recent, or not so recent, cutbacks by the federal
government. For me and for the New
Democratic Party, one cannot begin to address health care reform unless one has
dealt with and tried to address some current difficulties with respect to
financing of our medicare system.
Since last year's Estimates, developments have
taken place on that front. Some very
serious changes have occurred. The
minister knows that I have raised over the last two years the whole question of
federal financing and changes to Established Program Financing as it relates to
health care. We have raised probably
more questions on this issue and on this general matter than probably all other
health care issues put together. It has
been a fundamental area of concern for us.
Over the last couple of years we have seen the
changes to federal financing become more, we have become more familiar with
those changes, we have become more knowledgeable about the impact of federal
changes and more vigilant and outspoken in our criticisms of those changes.
Since our last set of Estimates, Bill C‑20
became law. We had some discussions in
our Estimates about Bill C‑20, very brief discussions, and they were in
the context of this government's intentions to fight the negative changes
coming from the federal government, and the cutbacks involving Established
Program Financing. Bill C‑20, as
the minister and everyone else should know, further froze the formula as it
relates to funding of health care in terms of direct transfer of dollars and
speeds up the day when federal dollars for health care, for medicare, will dry
up.
We now know that if nothing else happens, no
other changes for the better or the worse are made, that
That poses serious difficulties for
Mr. Acting Deputy Chairperson, one of our
areas of greatest concern and criticism has been the inaction of this
government around federal changes to the EPF formula. For two years we expressed concern about the
fact that this government has not been outspoken, vociferous in its actions and
words around these cutbacks, has not been front and centre of the debate, has
not headed up a coalition of interests and concerns throughout Manitoba to
oppose federal cutbacks, has not clearly expressed the concern of Manitobans
around this disastrous federal policy which will, in fact, see the end of
medicare unless it can be reversed.
Most recently, around Bill C‑20, we expressed
the concern that this minister and this government did not take the concerns of
Manitobans to
* (1530)
It would have made a difference, I believe,
perhaps not a great deal of difference, given the absolute deliberate
intentions on the part of the Mulroney government to proceed with Bill C‑20
at all costs. In fact, shortly after my
presentation to Ottawa on November 26, the bill was pushed through committee,
pushed through the House of Commons and was given rapid assent in the Senate,
much to the concern of many across this country.
I think probably every national organization
involved in health care appeared before that committee or made representation
to that committee expressing strong concerns about this erosion of
medicare. The same held true for
Bill C-20 became law, and we are that much
closer to the death of medicare, that much closer to the Americanization of our
system, and that is not being extreme in my comments. That is not to exaggerate the situation. That is to reflect a reality because in fact
we have to keep in mind as we review the situation since before, during and
after, I should say, Bill C‑20, many governments across this country,
many provinces in
Several provinces have already indicated or
have started to move towards a system of user fees. These suggestions, these actions, this
breakup of our medicare system and this abrogation of those five fundamental
principles are not just coming from Conservative governments; they are also
being expressed by Liberal governments in this country. I think we all were very worried when Frank
McKenna came forward with his comments recently at one of our constitutional
rounds to express some support for pursuing the notion of user fees.
I hear my Liberal critic, to my right,
suggesting that that may have also come from the NDP. Well, he knows from reading the reports and
delving into this issue that that is absolutely not the case, that in fact all
NDP governments stood up loudly and clearly in opposition to any movement
towards implementation, introduction of user fees anywhere in our country.
I refer the Liberal opposition critic to a
letter we all received today from the National Federation of Nurses' Unions
expressing concern to our Premier, Gary Filmon, about discussions,
deliberations, considerations being made with respect to user fees. In fact, in that letter, and I will quote
from that letter, the third paragraph:
At the February First Ministers' Conference the issue of user fees for
health care was raised by New Brunswick Premier Frank McKenna.
It goes on to say: Nurses were also involved in our conference
involving health care reform. Nurses'
delegates to the conference directed that I provide you with the perspective of
nurses on the issues of user fees in health care reform. Nurses believe that
governments must dismiss the concept of user fees once and for all. User fees should never provide a means of
controlling growth in the volume of medical services and never be seen as a
source of additional funding for the system.
The letter goes on for several pages outlining
concerns about Frank McKenna's comments as well as actions of some Conservative
governments undertaken in that respect.
There is concern across this country about
this government's intentions when it comes to medicare and about the
fundamental principles of medicare. We
have heard from
Over the past year, since our last set of
Estimates, many Manitobans have come forward with concern about the impact of
government decisions on their ability to access health care services. We have heard from northerners who are
worried about being able to access health care services because of the
imposition of the $50 user fee in terms of transportation. We have heard from Manitobans concerned about
the application of the decision by this government to deinsure a number of
items and how in fact that has led to, in reality, user fees in parts of our
health care system. It is in fact at the
beginning of a move to require people to turn to certain parts of our health
care system to pay for certain services that previously had been considered
part of our universal health care system.
We are very concerned about what is in store for Manitobans in terms of other
services that this government is considering with respect to deinsurance.
There was no statement, no clear‑cut
indication when the budget was handed down 10 days ago or so about this
government's intentions with respect to deinsurance. We know the discussions, however, are taking
place between this government and health care professionals around deinsurance
of further items. I would hope that we
would have an opportunity in this set of Estimates to discuss such plans, such
considerations and deliberations before in fact they become final decisions
sealed by a change to regulations under Order‑in‑Council. I hope that the minister is, on this
particular issue, consulting widely about any further attempts to deinsure
services under our health care system.
* (1540)
Also, since last year's Estimates, there have
been some new developments, some new decisions taken, some new directions
pursued that were not indicated in last year's Estimates, that are clearly part
of an overall agenda of this government.
All of those issues and concerns have caused a great deal of worry and
concern among Manitobans and among health care professionals and consumers.
Time does not permit, in these opening
comments, to go into all of those decisions, and I am sure that we will have
chances and opportunities to pursue each and every one of them. I think, of several that come immediately to
mind, the concern among licensed practical nurses is certainly one. The minister has indicated in his opening
remarks that he is reviewing the whole question of the mix of nursing
professionals in our health care facilities.
He has not, however, in his opening remarks put to rest concerns being
raised by the Manitoba Association of Licensed Practical Nurses that their
whole profession is in jeopardy and that the St. Boniface School of Nursing is
scheduled to be closed in the very near future.
There is no satisfaction from the minister's
remarks in terms of those concerns and no clear statement that nothing will
change, that no moves will be taken to put at risk the entire profession, nor
that educational opportunities will be lost while this minister studies the
situation further. We are left, at this
point, at any rate, to believe that once again the minister has two different
agendas with respect to something as basic and fundamental as an appropriate
mix of nursing staff, nursing professionals, because in fact he again
delineates a process for study and review and consultation but, at the same
time, does not address the fact that decisions are being made in other circles,
in other places.
It is similar to, leading up to this whole
critical situation, knowing that decisions were being made at one level while
supposedly this council on nursing education was responsible for making decisions
or at least making recommendations‑‑something as fundamental as
levels of education and mix of nursing staff in our facilities. I hope that some of this will get clarified,
and that we will be able to put to rest some of the fears and worries among
long‑standing licensed practical nurses, some of whom have been working
in the field for over 20 years and have either lost their jobs or believe that
they will see the end of a career that they love and cherish.
I think also over the past number of months of
decisions pertaining to our hospitals, and the fear and concern that patients
and consumers and professionals are experiencing because of a quiet agenda
being pursued without the benefit of public input and deliberations. Over the last number of months we have raised
concerns when news was received that this government was moving quickly to make
significant, substantial changes to our health care facilities and our urban
hospitals.
I think particularly of the news around the
If I could just get clarification on the time?
The
Acting Chairperson (Mr. Reimer): I think we would not mind if you would just
carry on.
Point of Order
Ms.
Wasylycia-Leis:
Just on a point of order. Sorry,
Mr. Acting Deputy Chairperson, I was sort of assuming that we had roughly equal
amounts of time. I was not about to take
as long as the minister, but I certainly was not watching my time very
carefully. However, perhaps you could
clarify the general parameters around which opposition critics make remarks.
The Acting Deputy Chairperson (Mr.
Reimer): According to Rule 65(1), a speech
in Committee of Supply, including those of the minister shall be restricted to
30 minutes. However, if it is the will
of the committee to‑‑[interjection! Pardon me, but the minister
shall be restricted to 60 minutes when introducing the department. If it is the will of the committee to proceed
longer than the 30 minutes for the critics‑‑what is the will of the
committee?
An
Honourable Member:
Proceed.
The
Acting Deputy Chairperson (Mr. Reimer): Proceed.
It is the understanding of the committee that the time restriction will
not be in effect.
* * *
Ms.
Wasylycia-Leis:
Thank you, Mr. Acting Deputy Chairperson, I will try to move along more
quickly. I was certainly prepared to
equal the minister in terms of time being taken in introductory remarks, but I
certainly do not have to go that long. I
will try to speed up my remarks.
As well, over the last number of months
concerns have been raised with respect to the impact of government decisions
with respect to Pharmacare. I just want
to very quickly indicate that the increase, unexpected increase I might say, of
this government passed by Order‑in‑Council just before the end of
1991 came as a surprise to not only those of us in the Chamber but also to
Manitobans generally and most particularly to senior citizens.
The decision by this government to delist
dozens and dozens of drugs under the Pharmacare program is having an impact and
causing some serious concerns among all Manitobans, but particularly more
vulnerable groups such as senior citizens and single‑parent women and low‑income
Manitobans. We would certainly like to
pursue that issue.
I want to speak very briefly and generally
about some concerns we have with respect to the so‑called restructuring
policy and program of this government, which I might say comes as a bit of a
surprise to us. The first mention of
this word came from a memo that I referred to in the House today from the
president of the Health Sciences Centre, who indicated quite clearly that the
hospital was making decisions and having deliberations in response to the
government's plans for restructuring.
There has been, unfortunately, no statement,
overall indication of this government's intentions to restructure, reform,
review, revise our health care system.
It has happened very subtly and very quietly. It has in fact happened out of leaks and
rumours and reports that individuals in our communities or those of us in the
Legislative Assembly have been able to get their hands on. So there has not been an up‑front, open
process for reforming our health care system as has happened in just about
every other province in this country.
The minister has spoken a great deal about
I have several concerns that will not come as
a surprise to the minister. I have
concerns very much about what I would see to be a smoke and mirrors approach to
health care reform. The $100‑million
increase announced in this budget is coincidentally perhaps but interestingly
around the same amount that this government has lapsed over the last number of
years for all the time that it has been in government.
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It has lapsed money in certain areas for
reasons that really do not seem to have much basis in fact. As I mentioned in my comments in the House,
developments around the Health Services Development Fund are most curious and
do need explanation on the part of this minister. The sums allocated for this fund seem to go
up and down rapidly according to reasons unbeknownst to us. Certainly they do
not appear to be related to the health reform agenda of any political
stripe. It does not seem to be at all in
tune with demands from the community for help and assistance to pursue some
initiatives that would be very important for health care reform.
A second concern that we have pertains to the
number of studies, task forces, reviews that this minister has undertaken since
becoming Minister of Health. I have no
more confidence today after hearing the minister's speech that we are moving
from a period of study to one of action.
In fact, what we were handed today was a list of many more studies, many
more reviews without an accounting for the previous studies and reviews.
For example, a new group is mentioned, the
appropriate access review group, which appears to be a group designed to study
the whole question of procedures and so on at our teaching hospitals. Sorry, I have read this very quickly, and I
will be reading it in more detail over the supper hour and before we come back,
but it would seem to me that the minister has put in place another study for
which he said the Urban Hospital Council was involved in previously and prior
to that the teaching hospital review and prior to that the advisory
network. We are not clear at all about
what happened to those previous studies.
What were the results of those efforts, where did they lead, why is
there need for more studies and reviews when in fact we have not heard the
recommendations of the previous studies and really do not understand how all of
this fits together?
We know that we have dozens of studies under
the advisory network that the minister still has not presented to Manitobans or
at least to the Legislative Assembly.
There are final reports on the minister's desk for many months now that
have not been released. There are over
40 urban hospital working groups that are hardly referenced at all in today's
address. There is now talk about a
similar effort in rural
There needs to be a clarification, Mr. Acting
Deputy Chairperson, and an accounting for each one of those studies embarked on
by the minister since 1988. Where are
the results of each one of those studies?
Where are the recommendations?
Why do we need another whole set of studies? Where does it all end? When do the studies
stop and the action begin?
Related to this whole question of numbers of
studies is a question of the openness of this government around health care
reform. There is no question in my mind
and I think in the minds of many Manitobans that the approach of this
government on health care reform has been particularly secretive. It has not been the kind of open review that
other provinces have indeed carried out.
As I have already indicated, in just about
every other province there was an open public process to review health care
reform. Whether they were looking at the
B.C. royal commission or the Ontario Premier's council or the massive Nova
Scotia commission or the Quebec review, the Alberta commission, just about
every province in this country held a fairly lengthy wide open public process
so that health care professionals, consumers, patients, the public as a whole
would have an opportunity to express views on future directions in health care,
with those plans then becoming the basis for future discussions and actions by
the government of the day.
In
There is no question that, at least when it
comes to the Urban Hospital Council, that study effort, that review process has
been closed and limited to a select group of hospital administrators and health
care and doctors. There has not been the
opportunity for the Nurses'
The final comment I would make about the whole
present government's health care reform process, and it really does follow on
the smoke‑and‑mirrors, study‑to‑death, secretive
approach: what one ends up with is a lot
of conflict and a lot of tension between health care groups and individuals and
professionals at the very time when you need their co‑operation and their
support.
We are left with a very tense situation in
There are many other areas to address at the
outset of health care Estimates. I would
have liked to raise concerns about this government's approach with respect to
home care, because again it appears to be‑‑and we obviously will
seek clarification‑‑a smoke‑and‑mirrors approach, with
the minister announcing considerable new dollars for home care; yet, at the
very same time, we are faced with an incredible growth in the number of cases
and concerns being raised with us about cutbacks in home care.
I would have liked to have spent a great deal
of time talking about mental health reform.
Again we will come back to that, because this in my view is an example
of the government being very successful at propaganda, at public relations, at
studies, and at rhetoric, with very little substance behind those statements
and announcements.
Not too long ago, the minister announced
further developments, in his mind, about health care reform that appear to be
not much more than a repeat announcement of a previous announcement that
repeated a previous announcement, which was not dissimilar from the very first
one of this government and this minister back in 1988.
We have concerns about the whole approach of
this government on aboriginal health care, about women's health, and the list
goes on and on. We will come back to
those in great detail.
Let me conclude my remarks by saying, while I
hope that the minister will see these points being raised at the outset as
constructive, they are reflections and an indication of what is happening in
the broader community. They do not come
from my own political bias or an agenda.
They are very much being expressed in circles, broadly, and they are the
cause for a great deal of concern and unrest among Manitobans, generally.
* (1600)
I want to say, in conclusion, that I would be
most willing and interested to see some of these concerns addressed, and to
find areas of common ground to develop meaningful health care reform, because
as I said at the outset, we have little time to lose. There is some urgency about reforming our
health care system in order to meet changing, growing needs of Manitobans when
it comes to health care.
It is certainly my intention to, at every
opportunity, go back to the very fundamentals of our health care system, the
basic principles of medicare, and to reiterate over and over again that the
basis for our comments‑‑and I am sure for all of our collective
involvement in this area‑‑is to ensure that health care is
maintained and preserved as a fundamental right for all individuals regardless
of their economic position in life or their geographic location or their
socioeconomic status.
(Mr. Deputy
Chairperson in the Chair)
So on those rather lengthy comments, Mr.
Deputy Chairperson, I look forward to the many hours ahead of us on health care
Estimates.
Mr.
Deputy Chairperson: We
thank the honourable member for
Mr.
Gulzar Cheema (The Maples):
Mr. Deputy Chairperson, let me start by saying that this is my fifth
Estimates; it is more than 230 hours of Health Estimates I have done with the
Minister of Health (Mr. Orchard). In my
remarks I will put our party's number of clear‑cut directions on the
record and reinforce some of the things the minister has done and also ask some
of the questions we have.
Let me first say that the minister's statement
is 41 pages and has certainly documented many major initiatives that the
government has done in the past and some of the new directions they will take
in the future. I think that will give us
some idea during the Health Estimates debate how we will look at each and every
issue, and I think it will take me some time to go through some of his
statements.
Mr. Deputy Chairperson, I want to express our
appreciation to the staff in the minister's office who have been very helpful
in a nonpolitical basis to all of us, as a member of this Assembly. I have
worked with them for five years, and certainly say that we have some of the
best people who are working in the department, and doing a very good job to
preserve our health care system.
For me, health care is more than a bed in a
hospital or working for a special group, or working for a special political
platform. For me, and our party, it is
an issue of defining‑‑redefining the health care system in
I would like to discuss the first issue, which
is very essential, that what we have today‑‑and everybody has made
those remarks, and for a number of years we have said that we have the best
system. I would say that we may have one
of the best systems, but it may not be 100 percent accessible. It is clear from all the jurisdictions in
this country that it is true. The
minister acknowledged, even in his opening statement, that we may not have what
we thought we had in the past, the accessibility of the system, and also the
definition of the health care.
If we look at the basic five principles and,
as I discussed, that was two weeks ago, those five basic principles out of the
1966 Canada Health Act that was initially started by the NDP and CCF in
Each one of us knows them, but I want to put
those things on the record as a comprehensiveness, universality, portability
and accessibility in public administration.
As I said earlier, those five basic principles do not hold true in all
the provinces. Simply, that is not true because each and every province has
developed its own definition to suit the time and the need under political
pressure.
If we look at the simple men who have coverage
from coast to coast, we will find so many services which may be covered in
So, I think first of all, we in
I cannot help if I do not comment on that from
the member for
I would like to be clearer on those things
because first we are saying, well, let us not cut the beds or let us not do
this, and then come here, let us have reform.
Reform has to be looked at as a reform, but not attached to a bed or a
profession or a specific interest group because we will not be serving our
purpose. That is the issue, and I think
maybe with time we will have those things cleared up.
Maybe I am making a judgment too early, but I
want the member for
That is why it is very essential that we have
the opportunity right now in this room for 40 hours to put our policies on the
table. Let us have a discussion and see
how we are going to fund the basic medicare system as we all agree with the
basic principle. I am not going to
defend or argue on a specific bed or a specific working group. I am going to argue on behalf of the taxpayer
keeping those five basic principles in mind, that is the Canada Health Act.
That is going to be my aim throughout the
whole 40 hours and to see where we can maybe tell the minister these things can
be done in a different fashion and maybe we can improve here, because
ultimately, as I said on March 5, 1992, this Minister of Health (Mr. Orchard)
or any Minister of Health will stay or go, that will depend upon many other
factors, but what a person in his or her seat is going to do today is going to
have a major impact in the long run.
It is a very, very risky area right now in
terms of the Health ministers and we can see all around this country what is
happening in British Columbia, or we can discuss what is happening in Toronto,
we can discuss what is happening in Newfoundland, New Brunswick, and as the
member for St. Johns (Ms. Wasylycia‑Leis) was saying, even some Liberal
Premiers are talking about something which is not the answer. I want this committee to be very clear that
from our point of view we are going to discuss health care as a package, as a
reform and are not going to put each group against the other. I think we could do it very easily and send
all these press releases to a specific area without telling the other group
that it is the same tax dollar each and every person has to share.
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As the minister has said, and the member for
I think I would agree with the minister on a
major statement that at least people in other jurisdictions are taking very
serious note of what is happening in
Mr. Deputy Chairperson, it is very essential‑‑I
think I still have 40 minutes. I want to
discuss those things. There are going to
be a lot of specific questions I will go into detail with, because I want to
make sure that members of this committee and people who will read my comments
have a basic understanding that we are not for a specific group, we are for
patient care and how we spend $1.8 billion for 1.1 million people; that is the
answer.
I would sincerely hope that something in that
regard can be done and we can at least define what is the basic health care
system. One thing which is missing from
the major reform right now is one I feel very strongly about, and I agree with
the member for
The second aspect we would like him to deal
with from the peoples' point of view is to educate people and start a campaign
in terms of how much money we are spending on health care so they should know
when people would know they will make a decision and we will find it out. You see what is happening with the city of
Winnipeg taxes, what is happening with our taxes‑‑when they would
know that you are spending 33 cents out of $1, they would be very careful. Do not be afraid of anyone accusing the
government that it is going to restrict health care services. That is not the issue. It is how we are spending. If we have to spend $200,000‑‑just
putting a figure‑‑to educate people, so be it. It will teach them a very important aspect of
day‑to‑day living.
As I said on March 5, there is no way that any
services‑‑you go into any hospital or any clinic‑‑when
you tell the people how much it is costing them, I think the issue here is they
think it is somebody else. It is their
money and they will be very, very careful.
That is why we said the other day when there was‑‑MMA had a
major letter in terms of how many people they have on a waiting list and also
Fraser Institute put their own not very scientific data, but it still had some
valid points. We have to have a central
registry. That could be one part, but I
will go into that in detail at a later stage.
I think the public education campaign is a must. I do not think we have any choice.
When people would know how much it is costing
them they would realize, and I think from there we can learn, ask them to give
their suggestions on how we can spend our money smart, whether a person would
accept to go to five doctors in one month, whether he or she will realize
whether going to two emergency rooms for the same treatment, whether people
will start realizing to have four X‑rays done for the same thing in one
month is the right way. I think those
things have to be. We have no choice but
then to explain. That is why we think it
is very valuable to have a public education campaign, because when you are
spending $1.8 billion you have to. I do
not think we have any choice.
Mr. Deputy Chairperson, I think that will
address some of the major global issues of health care and certainly people
would know that what we have today is valuable, but if we do not deal with it
in a meaningful way we cannot preserve it.
As the member from
I think it is very unfortunate that‑‑it
does not matter whether we have a Tory government today or NDP or Liberal. Any minister could be blamed easily, because
people do not know that the federal government who put in the law are not
footing the bill, and I think that should be one education of the people,
because there could be a federal campaign and then each and every M.P. should
tell people if they are going to work for the people or are they going to work
for their own pensions and long‑term benefits.
I think it will be very healthy that the
Minister of Health will do one of the most important surveys he has ever done
in the public life, because people would be very appreciative to know exactly
what is happening. They want the
truth. They are not accusing whether you
are Tory or NDP or anybody else. When
each and every party has a commitment, and I have no belief in five years that
there is any undermining hidden agenda to harm people. That is not the case, because basically when
each and every one of us has‑‑we are trying our very best and the
minister has taken the major responsibility, so I would like‑‑I
should not say I, but I think we would like him to look into that area and, as
I said, the mental health reform has come.
Some people will say it is a PR relationship, but I think without
educating them you would have never been successful. Now you have primed them for a change. Now is the time for a change. The change, as we said the other day on the
debate, there is two to four years. Whether you want to do it earlier than that
it is going to be impossible. The
transition has to come. That is why the
education then transition and then have the real thought how we are going to
implement the system.
I would disagree with one comment from the
member for
I think the kind of debate we see in this
House, I was told in B.C. and
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Mr. Deputy Chairperson, the other issue that I
want to discuss affects patient care. As
we were discussing, each one of us said the patient is right up there at the
top, and we start with the funding formula.
We can go with the services delivery of acute care, intermediate care
and chronic care, and then the gatekeepers of the health care. I think that is a major issue because no
reform is possible without impact, either directly on them, what they do, or
the other thing is, "directly" means a monetary gain from
professionals; secondly, where there is specific protection of turf. That is going to come. No question.
I think it will be very beneficial to prepare
the data on each and every category of health care providers and compare with
the rest of the country, but also compare with the social policy. There is an article I was reading that there
is no right or wrong number for health care providers; it is what society can
afford and what we can balance. I think
that is the issue because the only answer you can give us are the numbers, but
they are not practical for our nation.
We have to see how much we can afford. As the minister has said very well, the mix
of health care providers, so the nursing profession and the LPN profession have
to be given a major thought, and the other profession which is extremely
important is the social services. There
is no way that we can exclude the social services department from health care
in the community‑based health care.
I think we need to look at those issues very
carefully and develop‑‑I mean we do not have all the resources as a
member of the opposition, but ministers do have. I think we should proceed on those directions
on a very positive note.
The physician supply and the maldistribution
of physician numbers in our province is a major problem. Physicians will talk about that, but when it
comes to real life, I think most people run away from that, they do not want to
tackle that problem.
The
I think that issue has to be discussed very
openly. This much money we have, how can
we use it effectively? You tell us how
you are going to use it. That is why
when they are all sitting at the same table and discussing with the Minister of
Health (Mr. Orchard) and explaining to the people of
Collectively, I think we are failing in that
way. I know what I am saying is very,
very risky politically for an organization, but I do not think for taxpayers,
because they are taxpayers too. You go
and talk to them, and they are paying 40 percent to 50 percent of their taxes,
so they want money to work for their own tax dollars. We have to talk those issues very openly.
That is why we said that we believe very
strongly that the continuation of services in the Department of Health must
continue for a period of four years.
When there was talk that there has to be a change in the ministry, we
said it very openly that nobody is perfect and nowhere are you going to find
the master in the health care system, but what you have, we can all improve
upon that.
To continue the policy of health care system,
you have to have a long‑term plan.
It does not work; it is not going to show up for election time. It simply is not true. We would like the minister to continue on
some of the major policies but continue to inform
The other issue of the health care provider is
the LPN. The member for
How much retraining would they need? How will they fit into the system? Those issues have to be resolved and put into
place now, because as you make major changes, it will become very difficult to
find professionals to fit into those needs, otherwise people will start
complaining. I think there the education
is going to be very important, that we are on the major health care
reform. As the minister has said, focus
has to be on the health not on the cost.
When you are focusing on the cost
effectiveness of health care, you will save money. No question.
Everyone knows it, but that money is going to go back into the
taxpayers' pocket. They can spend on
their own things, and they will stimulate more economy. It is basically the human circle.
If we come here today and only talk about
health care as an isolated issue, I think we are just failing. That is why even when I was speaking on the
budget speech, we made it very clear that the Minister of Finance (Mr. Manness)
made a good statement that the best job of social services is to have a job but
everyone is not born with all the capabilities.
Sometimes the environment is not there, we have a recession, so many
factors are playing a role. I think it
is very difficult at this time to expect that statement to materialize, but in
the long run if we keep that in mind and if we keep a person in the middle and
you have a healthy economy, healthy environment, protect society and social
values, I think we can achieve a lot of goals.
The area of poverty and how many children are
hungry in
I think that issue has to be dealt with. That is why we are proposing there should be
a major economic balance in terms of involving the education of social services
in health care reform and make sure that nobody is being left out of the health
care reform. The creation of a job is
the creation of a healthy person and a healthy economy and a healthy family
because they will use less services, they will be more productive, they will contribute
more, they will pay more taxes, they will use less resources. That is basic human nature, it has to be
there. There is no other choice. So I
would like us to proceed in that direction, that there has to be co‑ordination
between the Department of Education, Social Services, and the Department of
Health.
* (1630)
Mr. Deputy Chairperson, the other changes that
have to be looked at, we believe there are five major areas, and the minister
has pointed out most of them. First, health
care reform must be looked at from technology and research but with a practical
approach in terms of how much technology is giving us good health, rather than
how much it prolongs life without meaningful productivity or a meaningful
equilibrium in the long run. I think
that is why we would like to have a serious debate in this committee in terms
of Bill 16. We will hope that the
government will bring a bill, because if the government will bring a bill we
will be very supportive. It does not
matter to us who does it as long as we have a bill which will give patients a
right. That should be a part of the
reform. Without their right, that is one
part of the campaign in terms of their involvement and also the public
education that this is you and you have the right. These are their tax dollars even though that
should be the last thing in their living will, but that is still a
benefit. People know that, but they are
afraid to make decisions, because the law is not there. They are feeling guilty about something which
may or may not be true, so I think they have to be educated. So we hope that Bill 16, either our bill goes
through or the government will bring it.
The next part which is ignored many times is
the tremendous amount of drug costs under Pharmacare, not only in
The other issue which is very essential from a
structural change point of view is the physician and the health care providers,
the way of paying them, whether it is a fee for service or it is a combination
of fee for service plus salary and plus whether we are going to have a salaried
physician or health care provider who will be specifically assigned to do
certain jobs in terms of the community clinics or a setting of wellness
centres. Right now, we do not have even
an area where a physician is rewarded or nurses being rewarded to do a job to
promote health, because that is not considered acute care. So I think those issues have to be discussed. The physicians' remuneration part has to be
discussed. I think each and every
province would have to. They have no
choice.
The other issue in structural changes, the
fourth one, is the in‑hospital bed utilization. Each and every party, I believe, from what I
have heard in the four years, wants to have a balanced institution versus
community‑based care, so when that model is approached, there has to be
consolidation of services. No question.
When you are going to have high‑tech medicine delivered in the
teaching hospital, there has to be some adjustment made. I think it is very essential that the
teaching hospitals are taking care from that point of view, plus also research
and the educational component, because without that component we will miss not
right now, but in the future. So I think
we should look the health care institutions not only from bed point of view,
but from teaching and research, because there may have to be some changes made.
In terms of the community hospital and the
rural hospital, I think major evaluation has to be done, because there has to
be not one hospital against others. That
had been the approach in the past, a very wrong approach to deceive
taxpayers. It has to discuss the
utilization of beds in all the community hospitals and in the rural hospitals,
taking into account the occupancy rate, the needs in the community and also
developing new policies. If beds have to
be sacrificed because they are not being used, that space must be used for the
out‑patient clinics in terms of expanding the role of that hospital. That myth that the hospital has to have only
beds and without beds the hospital does not exist, that simply is not
true. One could have a mix of hospitals
with outpatients' clinics. That is the
fourth structural change that we would like the minister to proceed on.
Number 5 is the emphasis on prevention and
increased emphasis on prevention in education and health promotion. That has to be one of the major platforms,
because without the emphasis on the prevention of illness where many diseases
can be prevented, people can be educated on how to have a healthy lifestyle,
how to prevent one of the major debilitating diseases. I think we will save money in the long run,
no question. That is a little risky area
because money you put in today will not show for your next election. It simply is not true. It is going to take five to 10 years to have
any beneficial effects. So those are
five major areas of structural change that I would like the minister to proceed
with.
Mr. Deputy Chairperson, can you tell me how
much time I have?
Mr.
Deputy Chairperson:
About 10 minutes.
Mr.
Cheema: Mr.
Deputy Chairperson, I will finish within five minutes. I just wanted to end up by saying, let us
have a frank and open discussion and focus on one thing: how we can save the future of medicare in
One area that I should have pointed out
earlier is that there has to be co‑operation from the other provinces,
because this area is an area that crosses all the provincial boundaries. In terms of the requirement for the standard
of health care provided, it has to be uniform across this nation. If you see one area where you have a shortage
of professionals and the other provinces have qualification requirements which
are different, you see the brain shifting from one part to the other part of
the nation on the basis of trying to attract them with more financial
gain. I think in the long run provinces
are not doing service for the taxpayer as a whole because, basically, there
should be one standard of practice in this country.
I was encouraged to see that the Canadian
Council of Hospitals and the Canadian Medical Association has developed a two‑year
internship policy and that will take care of some of the problems. Other issues such as the basic discussion
about the medicare system, the minister should be very open and frank with
other Ministers of Health and ask them to look at
Mr. Deputy Chairperson, I would again
emphasize that we will be raising many issues in terms of each and every
section but, certainly, let us have an open and frank discussion and be honest
with the taxpayers, who are sending us in this Assembly to do a job for them,
not for a single political party.
* (1640)
Mr.
Deputy Chairperson:
We thank the honourable member for those remarks.
Under
At this time we invite the minister's staff to
join us at the table, and we ask that the minister introduce the staff present.
Mr.
Orchard: Mr.
Deputy Chairperson, I have my Deputy Minister, Mr. Frank Maynard, who has been
deputy since July of '88; Assistant Deputy Minister Fred Anderson; and Denis
Roche, who is Director of the Evaluation and Audit Directorate, under the
essential reorganization around our research and planning‑‑he is
director of that function.
Mr. Deputy Chairperson, I thank my critics for
their opening remarks. I think, if I can
be so direct as to conclude, that those are some of the most reasoned remarks
that we have had. From time to time we tend to maybe get a little chippier than
we should when we open our remarks. I
think what it demonstrates, if I can be so presumptuous, is that all of us have
been around as either minister or critic of the health care system long enough
to recognize that there are not too many easy answers anymore, and recognition
of that is evident no matter where you examine the process of change in the
health care system across Canada.
If I might, before we get into the line‑by‑line
discussion, both my critics mentioned a discussion around the funding issue of
health care, and particularly my official critic. This is a topic I think that has to be
discussed possibly over the next few hours before we move into more definitive
line by line, because it is a topic which the federal government is an easy
target for blame.
I agree with my honourable friend from the New
Democratic Party that the federal government‑‑and it is now a trend
that started I guess in the early '80s so it is not unique to the current
administration, but you know, I simply want to say, try and transpose yourself
to where the federal government‑‑I say this with jeopardy, but my
honourable friend the member for Maples (Mr. Cheema) challenged us to get into
some frank and open discussion, so I want to leave this thought out for you.
All of us in here have read Second Opinion,
the book by Dr. Rachlis. In that book,
he clearly criticizes our current spending in the health care system, and he
says very openly that we spend inappropriately.
He is not alone in that statement to the general public.
Just recently‑‑and I simply want
to offer this up as food for thought‑‑my counterpart in the
The difficulty that we have in coming at the
federal government and trying to bell the cat with the federal government is we
have such a growing body of outside analysts who say we do not spend smart
enough with what we currently spend.
That diffuses the argument that all of us would like to make at the
federal level to increase or to reinstate former funding practices, because
they will come back as they have, and they will say, well, if more money is the
answer, why does a Dr. Rachlis write Second Opinion? Why are statements being made by other
Ministers of Health that there is inappropriate spending throughout the system?
The issue of funding debate has to be much
broader than simply coming to the federal government for more, It has to focus on how the federal government
ought to legitimately participate in the process of change that all of us as
provincial administrators of health care have to get involved with.
When that was mentioned by both critics, I
think it is a really good open area for discussion, and could carry us for some
period of time as we open the Estimates.
Mr. Deputy Chairperson, I would like to just
attempt to answer any questions my honourable friends might have on the next
section of Estimates, or indeed comments in response to what I have just said
too.
Mr.
Deputy Chairperson: I
thank the honourable minister. Item
1.(b) Executive Support: (1) Salaries
$497,600, on page 82.
Ms.
Wasylycia-Leis:
Mr. Deputy Chairperson, yes, this is usually the opportunity to begin
some general comments on some broad issues that do not really fit in any
particular line. I certainly would like
to spend a few minutes at any rate speaking of and having a dialogue on
financing and the question of changes at the federal level.
It is clear to me that we do have somewhat of
a continuing disagreement around this issue.
From all of my readings of Dr. Michael Rachlis, and others who have
critiqued our health care system and have come up with some constructive
suggestions for reforming our system, there has never been a call for increased
dollars, but at the same time there has not been a call for decreased dollars
in terms of our health care budgets.
Those proponents of health care reform, like
Dr. Michael Rachlis, have been equally vociferous about calling for a
reinstatement of federal financing in the health care field. They have not
called for an increase, they have called for a reinstatement, and out of
respect for a formula that has allocated to health care, a certain percentage
of taxpayers' dollars as a percentage of GNP.
It is that formula that has been changed, and it is that which has
resulted in a decrease in dollars going to our health care system, which has
had a considerable impact on all provincial health care systems, particularly
Manitoba's, and has made it very difficult for provinces like Manitoba to
really go gung ho on health care reform, because of the need for resources to
spark reform at a time when, clearly, one level of government is cutting back.
So I just want to start off my comments by
emphasizing that point and indicating that nobody of repute, of notoriety, of
profile in this country on the issue of health care reform, has called for a
reduction in health care budgets. Yes,
they have said we are spending inappropriately.
Yes, they have said we need major changes in our health care system, but
they have all said we need to reallocate within and keep those dollars in the
health care system and not see any dollars lost. The problem is that we have seen dollars lost
from the federal government, significant dollars.
I would like to ask the minister if his
comments are an attempt to explain the fact that this government and this
minister did not make strong representation to Ottawa over the changes in the
formula, in particular with the latest freeze in the formula, Bill C‑20,
or if, in fact, they did make those concerns known in other ways and, if so, in
which ways? Could the minister outline
the position taken specifically with respect to Bill C‑20?
Mr.
Orchard: Well,
Mr. Deputy Chairperson, when we met the first time with the current Minister of
Health, the Honourable M. Bouchard‑‑I guess the first meeting was
Toronto in June or thereabouts, and as I indicated earlier or at other times,
that was the first time that we, as Ministers of Health, had been invited to
meet by the federal minister for well over a year and a half. At that meeting, a number of issues were
discussed, but we talked about stability in funding and an attempt to achieve
that kind of stability in funding with the federal government.
Most recently, at our federal‑provincial‑territorial
meeting that I hosted this past fall in
* (1650)
What I shall do for this evening is provide a
copy of the communique that emerged from the September federal‑provincial‑territorial
meeting for my honourable friend, for this evening's discussion.
We, I think it is fair to say, as Ministers of
Health, were reluctant simply to say to the federal government, give us more
money. That was not the nature of the
communique that the provincial and territorial ministers put out. What we wanted, though, and what we asked
for, was a stability in the funding. We have been receiving more funding in
The difficulty is that our costs are growing,
or have been growing, at a faster rate than the increase in growth from the
federal government in terms of their support.
So what we have in
That gets me right back to the issue that I
introduced prior to this question.
Certainly, none of the experts that are there, Rachlis or others, are
saying give us less money because we are spending inappropriately. Nobody is saying that, but the federal
government, faced with the challenges that they are faced with in trying to
create an environment of economic renewal and the other challenges that they
have‑‑challenges, I think, that all of us recognize‑‑they
are saying that in those circumstances we cannot provide the provincial
ministries of health of provincial governments across Canada with the kind of
increased resources that they would like to see.
You know, that is a reality that we may not
enjoy and certainly do not enjoy, but it is a reality that before one suggests
to them, cure it immediately, you have to ask the next question, where are they
going to get the resource to cure it immediately? That is the same problem we face in
That is the case with the current federal
government. When they were in opposition,
they criticized the then Liberal government for changing the formula. The formula was changed in 1977. At that time the negotiators of three of the
lead provinces were New Democratic Premiers, Schreyer, Blakeney and
Barrett. So, you know, in government‑‑and
I am sure the opposition parties back in '77 all said, you know, this was wrong
or inappropriate, and when these opposition parties become government as has
happened in Ontario where the New Democrats moved from opposition to
government, they have changed their funding position.
They are not offering 10 percent increase in
funding in
We indicated to them that we need predictable
financing that will allow us to get on with the job of reform that all
provincial, territorial ministers and ministries recognize has to be done. That is why we were careful, as Ministers of
Health representing the three major political parties, not to give the
impression that the simple cure was more money.
I cannot state it any more eloquently than Ms.
Simard from
Mr.
Deputy Chairperson:
Is it the will of the committee to call it five o'clock? Agreed?
(Agreed)
The time is now 5 p.m. and time for private
members' hour. I am interrupting the
proceedings of the committee. The
Committee of Supply will resume consideration at 8 p.m.
EXECUTIVE COUNCIL
Madam
Chairperson (Louise Dacquay): Will the Committee of Supply please come to
order. This section of the Committee of
Supply will be dealing with the Estimates of Executive Council. Does the honourable First Minister (Mr.
Filmon) have an opening statement?
Hon.
Gary Filmon (Premier):
Madam Chairperson, I understand that I have been given permission by
members opposite to remain seated so that I do not have to risk falling over in
the midst of the debate on my Estimates.
I want to begin by acknowledging the fact that
members opposite have once again given me the honour of being in the leadoff
position in the Estimates debate, and I would say to my honourable friends that
while I appreciate their attention it is an honour that I do not necessarily
feel that I must preserve. If there is any time that‑‑just because
I am called First Minister, it does not mean that I have to be at the top of
the Estimates list every year. If there
is any time they want to change the order, I am sure that I would be happy to
accommodate them.
However, I am always happy to be able to talk
about the Estimates of my department, and the activities that are carried on in
Executive Council. There is an obvious
advantage to being first on the list. It
gives me an opportunity in a formal way to recognize the long hours of
dedicated work that went into the preparation of these Estimates. I know, as someone who has sat at Treasury
Board now through the development of five sets of Estimates, that there is a
tremendous commitment put in by not only every member of the Treasury Board but
every person who works for Treasury Board and in the senior staff of each
department.
I say to my successor, as chairman of the
Treasury Board, the Minister of Finance (Mr. Manness), that he and his staff
deserve a great deal of credit, but so do all of those who work very hard to
ensure that we could prepare the Estimates earlier this year, and get the whole
process of financial approvals in government made earlier this year than we
have had for many, many years. I can say
that members spent many, many hours up to and surrounding Christmas. Aside from the fact that they did take a
break at Christmas, the period of the late fall and throughout the winter culminating
in about the first week of February were very, very busy periods of time for
all of the people who participated in the Estimates process.
I believe that our government's overall Estimates
reflect a balanced set of priorities, with emphasis on economic development and
improvements in our social programs. To
help support those priorities, we have continued to hold regular operating
costs down, and that is demonstrated in Executive Council Estimates. The
Executive Council Estimates for the 1992‑93 fiscal year total $3.2888
million, an increase of $87,700 or 2.7 percent over the Adjusted Vote for 1991‑92. Though the 1992‑93 Estimates are
marginally higher than those for the year we are just finishing, they are still
below the total of two years ago, 1990‑91, when we had major
responsibility for hosting both a Royal visit and two large‑scale
intergovernmental conferences.
Virtually the entire increase in the 1992‑93
Estimates reflects salary adjustments.
The largest component is the adjustment for general salary increase, but
there are also allowances for merit increments.
In fact, Madam Chairperson, I just want to
point out that the funding requirements for Executive Council resulting from
the new MGEA agreement are $98,500 more than the entire increase in our
department's Estimates. Of course, the
difference is because we have been able to contain other nonsalary operating
expenditures and in fact have reduced them overall within the department.
Perhaps a word of further explanation would be
useful at this point. Executive
Council's 1991‑92 Estimates were adjusted through the allocation of a
general salary increase of $16,900. This was some $20,000 less than the actual
cost to the department resulting from the implementation of the MGEA agreement
on '91‑92 costs.
* (1430)
It was possible to fund the difference through
the underexpenditure of other salary dollars within the department during the
fiscal year. This practice was generally
followed throughout the government departments with departments receiving a
prorated adjustment depending on the amount of unexpended salary dollars
available within their appropriations.
On another point, the size of Executive
Council has not changed year over year.
We still have 46 staff years, the same as last year and down two from
the previous year. The staff complement
in place when we assumed office in 1988 was 59.
In other words, we are operating with a staff complement that is 22 percent
smaller than that in place at the end of the previous administration.
As I said earlier, nonsalary expenditures have
been reduced from last year's total, while the amounts allocated to
International Development have been maintained at the same level as in 1991‑92.
The annual grant in support of the
International Development Program remains at $474,600.
As members of this Chamber are aware, the
grant is paid to the Manitoba Council for International Co‑operation
which distributes the money among its member agencies that are involved in
Successive provincial administrations for
almost two decades have continued this grant in recognition of our obligations
to international development.
Every year MCIC conducts an open house here in
our
Although I will be away at the First
Ministers' Conference, I certainly urge all members of the Legislature, and
staff in the building, to take advantage of this excellent opportunity to meet
many of the Manitobans who are involved in worthy projects throughout the
developing world.
This year there will be some 28 displays set
up in the Rotunda and second floor corridors.
Again MCIC will be serving refreshments in Room 200.
I know that many hard‑working MCIC
volunteers look forward to this opportunity to demonstrate to the elected
members of this Chamber the very real progress that the funding we provide is
able to achieve. The projects will
include many related to sustainable development, agriculture and food
production, forestry, water supplies, and education and social development.
The 1992-93 Estimates total for the French
Language Services Secretariat does not reflect any change in emphasis in the
coming year. The small reduction results
from the fact that last year's Estimates provided extra salary authority to
cover a period in which the new senior advisor and his predecessor worked
together on transitional issues.
Madam Chairperson, in a few weeks I will be
completing my fourth year and entering my fifth as Premier of Manitoba. In that time‑‑I recognize the
enthusiasm of the member for
About a year ago, when I introduced the 1991‑92
Estimates, I referred to the fact that despite repeated requests from
provincial Premiers, the Prime Minister was refusing to convene a conference of
First Ministers on the economy. Although
we still have not had a full‑scale conference, as members opposite know,
I will be leaving tomorrow for the third in a series of First Ministers'
meetings on economic priorities which began in December. I am pleased to say that
Our first meeting in December was a direct
response to a joint request made by the Premier of Ontario, the Premier of New
Brunswick and I, following a meeting that we had in
I proposed a number of initiatives to
encourage recovery and help build confidence across the country: firstly, a tax freeze; secondly, an agreement
to control government spending and deficits; and as well, efforts to use
capital works expenditures to encourage employment and build up
Other Premiers also offered suggestions and
these were reviewed by First Ministers at our second meeting in early February
prior to federal and provincial budgets being tabled. The evening before our
February conference, I hosted a meeting which was attended by the majority of
Premiers.
During those discussions, we agreed on a set
of priorities which we felt deserved further work. We presented those suggestions to the Prime
Minister the following day. He agreed to
them, and we set up a series of working groups to identify options for joint
action. The work which has been done to
date will be reviewed by the first ministers' in
The work covers a wide range of subjects. Investment in infrastructure, interprovincial
trade, international trade, effectiveness and efficiency in social programs,
training, agriculture, fisheries and cross‑border shopping. Our hope is that the federal, provincial and
territorial governments collectively can take some immediate co‑operative
action on each of these priorities. For
example, on the first issue, investment in infrastructure, there is a strong
consensus among the provinces that it is time to move ahead with the national
highways policy.
Much of the preparatory work has been led by
It is too soon to say whether the national
highways program will be given formal approval at the
Here in
The
I should add that I have asked the Minister of
Finance (Mr. Manness) and the Minister of Industry, Trade and Tourism (Mr.
Stefanson) to join me in representing
As far as I know,
As my colleague the Minister of Justice (Mr.
McCrae) reported to the House week before last, the Ministers responsible for
Constitutional Affairs have launched an ambitious work plan aimed at helping
develop a satisfactory
While I believe it is essential to keep
working, even without
Of course, as the Minister of Justice pointed
out to his colleagues in
Although there are problems with the proposals
which the Dobbie-Beaudoin committee has put forward, some of them serious, the
recommendations are a reasonable basis for moving ahead with discussions. We have made our concerns clear, concerns
about the Senate provisions, concerns about the need to strengthen the
equalization section and concerns about the division of powers that appears to
lead to too much devolution.
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At the same time we have not slammed any doors
or issued any ultimatums. There is still
ample time and there is still a reservoir of good will. But the clock is ticking, and we are losing
precious days and weeks. If
Those statements, I am sure, were welcomed by
all Canadians. However, I continue to believe that it is in everyone's best
interest, including
I believe every province is prepared to
respond positively to
The national recession was not caused by the
impasse in the constitutional negotiations, but uncertainty about the future is
clearly affecting our recovery, and that is perfectly understandable. The statistics show that the
Thank you.
Mr.
Gary Doer (Leader of the Opposition): Madam Chairperson‑‑[interjection!
well, see the Deputy Premier (Mr. Downey) is up to his usual ways. I cannot even get my mouth open before he is
heckling. I would be very disappointed
if the Deputy Premier did not work at a style that is consistent with his past
behaviour. He probably would have been
more productive asking some of the other backbenchers to hush up their private
conversations instead of having the Premier's (Mr. Filmon) opening statement
being blocked off by his own colleagues.
Now I will move on to my statement. Madam Chairperson, we will have a number of
questions to ask the Premier. We are
glad that we are coming up first, because I think the First Minister is the
person in charge of co‑ordinating all the departments and some of his
comments will lead to questions in other departments, obviously, in other sets
of Estimates. I think it has always made
logical sense for us to have the First Minister's Estimates up early, so that
we can get an overview of the government operations, government priorities, in
the Estimates process, and that can carry on to other departments.
The Premier obviously co-ordinates and is in
charge of every other minister in government, and therefore I think it is
consistent with that. We will try not to
keep him up too late tonight, because we do know that he is representing
We will be raising the question of the
priorities of the government in terms of the economic areas of government. This is an area that, of course, the Premier
has assumed increased visibility. He
declared his own declaration last September, I believe, was‑‑in
fact, I think he announced the economic committee of cabinet not on one
occasion but on three occasions. I noticed he resigned from Treasury Board in
three separate press releases, so we were thinking we were getting a specific
message from those messages. There are a
lot of concerns in
The member for Brandon East (Mr. Leonard
Evans) mentioned the retail sales situation, 10 out of 10 in January of 1992, a
serious problem when you consider that a great deal of the economy, the GDP of
Manitoba, is related to the situation of retail sales.
We will be asking about the optimism that the
Minister of Agriculture (Mr. Findlay) has provided us in this Chamber. The Minister of Agriculture is indicating to
us in questions and answers that the agricultural crisis is over and
agriculture will lead the province out into the 1992 year in terms of economic
recovery. I hope the Minister of
Agriculture is correct, but we will want to check with the chair of the
economic committee of cabinet and what his projections are in terms of prices
and the agricultural situation. We are
getting some increased optimism in the farm sector ourselves based on feedback
we are receiving, but we want to see what analysis the Premier has as chair of
that economic committee in areas of agriculture.
In the area of tourism‑‑the third
largest industry of this province is tourism.
Last week we were questioning the government on the tourism strategy of
the government, which we understand to be in a state of chaos, and the fact
that
We were encouraged that the unemployment, in
terms of raw numbers, went down last month from 57,000 to 52,000. We were discouraged with the labour force
increasing in
The Premier likes to mention other "NDP
provinces," and I am sure that we will hear that right from here to the
next election day. I expect that, Madam
Chairperson, but one would note that the increased labour force in
We are very concerned about the massive
increase in social assistance in
It has gone up across the country, and the
Premier cites statistics from other jurisdictions, primarily NDP jurisdictions,
but
We have economic indicators that are very
worrisome‑‑10 out of 10, nine out of 10, eight out of 10. On the other hand, the kind of human misery
index we see in
I would suggest very clearly to the Premier in
dealing with the positive announcements that he will have to make or the
positive news he will have to make that he cites unemployment rates. That is a very important indicator of the
province.
I would note that
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You cannot look at unemployment without
looking at labour force numbers, which reflect the kind of vitality of a
province and the attraction of new people and the maintenance of people to live
and raise families in our province.
We want to ask questions to the Premier (Mr.
Filmon) about the economic ability of government. How could it be so wrong on major, major
economic projects in this province?
Where is the economic forecasting?
Then the Minister of Finance (Mr. Manness)‑‑I
have raised this before in terms of Repap‑‑how could it go with an
expanded operation and chlorine bleach when the whole industry was being phased
out, when all over the world the economic predictions, the market predictions,
not just the environmental predictions, but the whole prediction for the future
was that chlorine bleached products were totally unacceptable to the consumers?
How could we just three short years ago, with
the Premier's signature, agree to something which was so fatally flawed
economically and environmentally that we went into the largest economic
endeavour, when everybody else was going in a different direction, for
I would witness again this last week where
Time magazine and People magazine and Sports Illustrated and Fortune magazine
all have decided to not use chlorine bleached paper. Many, many companies have announced they are
not going to use that kind of product.
How can the government, with all its
resources, be that ill equipped in forecasting some major, multimillion dollar
deals in the
I mentioned Repap because I think it is the
largest economic decision the government had to make. It was fatally flawed in terms of the
analysis that was provided to the government and, therefore, the decision which
flowed from the draft agreement which the government is now trying to
renegotiate with the Repap corporation.
I want to raise questions on trade. The Premier (Mr. Filmon) has not taken a
stand on trade. He has not in terms of
the pace of trade, the substance of trade and the secrecy of trade.
I know he has put out six conditions through
his minister, but many of those conditions now are in jeopardy in the draft
documents that his government has.
What kind of analysis is going on in
government? Has the Premier been briefed
as chair of the economic committee of cabinet on the draft documents? Has he read the draft documents? Is he concerned about them? Will he be putting his concerns in a
statement to the Prime Minister tomorrow or the next day when they meet in
public?
We are very concerned about again the analysis
that is going on in terms of trade, because analysis is very important in terms
of where the government is going and what kind of support it will give to the
federal government in its pace.
We continue to be concerned about federal‑provincial
relations. How many jobs, how many
federal opportunities are being lost to the
We are concerned about the lagging and lapsing
agreements with the federal government and the provincial government. All the federal‑provincial agreements
that are being announced, whether it is mining, or tourism, or a southern
initiative compared to the ERDA agreement are not to the same level as previous
federal‑provincial agreements, and therefore will have an impact on our
economy, on our infrastructure, and on the jobs of this province.
We would wish the Premier well in terms of
some federal‑provincial initiatives that are ongoing. We would wish him well on the national
highways scheme, a proposal that the member for Dauphin (Mr. Plohman) made in
the '80s, I believe, a proposal that has been carried forward by his
government. It is now on the national
agenda as opposed to just on the Transportation minister's agenda. We would be interested to know, and we will
be asking the Premier (Mr. Filmon), where he would see that going in
We are very concerned about the process and
the chairing of health care reform as we move from the economy to other
important issues. There is absolute
chaos now in terms of what is actually happening. We think Manitobans who own the health care
system through their provincial government, which is elected on a temporary
basis to provide the stewardship and management of that system, should be
telling us a lot more than just leaks from doctors, and leaks from staff, and
leaks from administrators. We should
know from the First Minister how many jobs are at stake. I asked the First Minister
a week ago Friday, how many jobs are at stake?
What hospitals are they at stake in?
What is going to replace the existing acute care beds? Are we going to see a situation where
Manitobans are longer and longer in their lines for health care services in the
We are trying to deal with this
responsibly. When the Fraser Institute
does a study and that study is incomplete because of the nurses' strike, we do
not come back here in Question Period and ask the First Minister and the
Minister of Health (Mr. Orchard) a question based on inconclusive evidence, but
we do think that Manitobans deserve, through the First Minister, a more
definitive idea of where we are going and who is going to be impacted, instead
of getting into this back‑and‑forth debate and never really getting
any straight answers from the government on a very vital issue facing
Manitobans. Their economy and health
care are the two most important issues that Manitobans expect their government
to deliver to them from the elected bodies‑‑health care, the
largest spending item, and the economy, one of the most important issues in
everybody's daily life.
Yet, on health care, with the largest amount of
expenditures that the Premier is in charge of as the First Minister, we still
do not know today what is the actual situation.
I expect from the health care Estimates that
are going on simultaneously to the Estimate process with the First Minister, we
will still be left, after a number of hours, with more questions than answers
on the very important decisions the government is conducting.
How are they being co-ordinated? How are these decisions being made. The Health Sciences Centre said today in writing
that they are being co-ordinated through the government. We want to know what role the Premier (Mr.
Filmon) has with the Minister of Health (Mr. Orchard) and what his cabinet
colleagues on health care reform, and how these decisions are really going to
reform the system as opposed to just cutting it back.
We have been involved in shutting about a
hundred beds in the past and there were eight out‑care surgery beds,
facilities, provided, eight day surgery facilities provided, out‑patients
reduced the waiting lists in Brandon and many hospitals by close to 70
percent. If that was the kind of
solution the government was coming back to this House with, then we would
listen to it, but we worry that the doctors‑‑and not just the MMA
but other doctors‑‑what they are saying is that it is not going to
be reform, it is going to be reduction in the amount of elective and vital
surgery that is available to Manitobans in those two very important hospitals,
and it will not be reform, it will be, in fact, cutback. We do not know. We do not know. We keep asking and we do not know.
We want to ask the Premier what kind of
decision‑making process he has in place for his Minister of Health. The last time we saw a bed reduction with the
government was in the respiratory section of the Health Sciences Centre. This was contrary to the Premier's own
promise in 1988 when he said they would not close any beds and they went ahead
and closed the respiratory beds of the Health Sciences Centre. Do you know what we see today? If we walk in those hallways today, and I am
willing to give the Premier a tour of that same facility, there are offices for
administrators. Now, that is not health
care reform. That is health care
cutbacks. We are interested in the
process that proceeding in the government's own health care area.
In the area of Education, Madam Chairperson,
we are also very concerned about what is going on. Last year we saw a major reduction in the
community college area of government, some $10 million. We have huge waiting lists now for all the
courses, yet the Premier in his own statements to the Prime Minister talks
about retraining and development being a national priority, a national
priority. He says in the House that
there is going to be $2.5 million back in retraining and development. Well, I suggest to the Premier, if you read
the Estimate book of the Department of Education, the $2.5 million that was in
his budget is not correct because that includes the courses they cut last year
which do not expire to '93, the engineering courses and some of the other
courses at
When the Premier (Mr. Filmon) raises the issue
of a national retraining strategy and a national labour adjustment strategy, we
say, how can you reconcile that with your own decisions? We will be asking the Premier those questions
in his Estimate process, because clearly he is putting that very high on the
national agenda.
We will continue to raise questions about the
round table that is chaired by the Premier.
I know he gets exercise when we mention the Chamber of Commerce report
about it being allegedly a public relations exercise, but I think the Chamber
of Commerce did raise some interesting issues about substance versus style, and
as the chair of that commission, as the Premier is chairing it with a number of
cabinet ministers on that committee, we will be asking the Premier some
questions on those issues.
The Premier mentions the level of spending in
his budget. There are some areas that are up slightly from previous years.
There are some that are up over inflation.
There are some that are down below inflation.
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Generally, I believe and I know that the
Premier's Office, the Leader of the Opposition's office, the Leader of the
Liberal Party's offices, and resources in caucuses, and resources to members,
generally are the lowest in
But there has been an Economic Secretariat
established, some $880,000‑‑a secretariat that is shared by the
Premier. We will be asking questions
about that department to the chair of that body. Generally there are some percentage increases
that we will ask about, but I would say on the whole, the Premier's Office in
We are concerned about other bodies that the
Premier chairs: the Sustainable Development Centre and its public relations;
the Economic Secretariat is chaired by the Premier, $880,000 in that body, and
we cannot get answers of how many jobs are impacted. Health care when we ask
the questions; cannot get questions answered on free trade with
The Premier has indicated why the French
Language Secretariat has been reduced in his opening statement. We will be asking the Premier questions on
where the government is going on the whole issue of French language governance
in the school boards. We heard some
indication from his minister last week, and we still are very unsure where the
government is going. It is close to 12
months since the decision of the courts, which was not as definitive as the
Minister of Education (Mrs. Vodrey) would indicate in terms of a specific
direction to the government of the day.
We have mentioned the federal‑provincial
relations, we will be asking particular plans on that issue. We would note that the economic meetings are
taking place in the next couple of days. This is the third meeting, and I think
Canadians will go from being very delighted about the fact that Premiers and
ministers are meeting on the economy, to very skeptical if nothing of a
concrete nature comes out of the meeting this week. This is the third one, we have working
groups, we have all kinds of studies going on, and every time we see First
Ministers coming out and saying that we hope that this and that will be in the
next budget, we hope that this will mean some kind of a plan, a national plan
in Canada. I do not think Canadians will
tolerate, quite frankly, a third meeting where nothing specific comes out of
the meeting except we had a good meeting.
I think it is now at the point where we have
to see some results. The Premier (Mr.
Filmon) smiles. I do not know whether he
is smiling because he agrees with us or because what can you expect over four
months, but my sense of listening to people in the coffee shops and listening
to Manitobans, they are very worried about the economy. They are very scared about their own job and
the future of their children, and they want some specific action from the
federal government and some specific action from the provinces.
So we hope that there is something specific
this time around. We would note that
many of the recommendations the Premier made to the First Minister and to the
other Premiers in his own recommendations on the economic summit did not
happen, did not happen in the last budget, the Mazankowski budget. I think, in terms of the economic
development, the markets and the other economic indicators reflected that, with
what has happened in our country since the Mazankowski budget has been tabled,
and what is happening in our country today, and what is happening in
The Premier also mentioned a considerable
amount on the Constitution. He mentioned
the talk is clicking, or ticking‑‑ticking, I think, he said‑‑and
that we have a very short period of time based on the meeting with the
ministers responsible for the Constitution.
I would agree with the Premier not to close any doors, not to draw any
lines in the sand, not to get into either/or situations.
That is why I was very concerned a couple of
weeks ago when the
It kind of makes me wonder, if the Premier of
Quebec would have just agreed to that Canada clause that we were talking about
a couple of years ago in June, when we were trying to get this thing resolved,
how much further ahead all of us would be concentrating on the economy, and not
dealing with some of the same issues we were not able to resolve, that we could
have resolved with some greater flexibility at the June 1990 meetings.
The international relations office, we
continue to be very hopeful about the international relations area that the Premier
chairs. It is a very important area of
government, and I think the volunteers, the thousands of volunteers that work
in the international community, have an excellent window on the world to try to
work citizen to citizen as Manitobans with the other parts of the world.
I did attend the last numbers of
displays. We try to keep in contact with
many of the groups ourselves in opposition that are working with the
international relations office of the government. Certainly I think it also is not only good
government policy on international relations, but we believe it is also
positive in terms of future trade. When
you work with groups to develop their own resources and skills, in the long run
people remember, and it helps Manitoba trade as well as reiterating the point
that we are indeed a benevolent province with benevolent people that work
tirelessly on behalf of not only our own people in our own province, in our own
country, but also on behalf of people across the world.
Just a last point on the Estimates of the
Premier that we are debating today, I want to say that as we go through many of
the items in his Estimates there will be some areas we agree on and there will
be some areas we disagree on. I would say
to the Premier (Mr. Filmon) that we continue to be ready to work with the
Premier on initiatives that will arise on the Constitution. We are prepared to
again work with the all‑party format that we used in the past to show
that Manitobans speak with one voice, that we do not speak in three separate
solitudes with three parties in this Chamber.
I think it will add to the strength the Premier takes to the table, to
have not only a majority government that he has now but all three parties
working together.
I would just say in conclusion in my comments,
notwithstanding the disagreements we will have in the Premier's Estimates as we
go through them, that I want to say to him again that we stand ready, willing
and able to co‑operate with the government and the First Minister on the
very, very short time line that we do have.
We may have a lot longer time than the Premier thinks if the
I cannot read the entrails of the Premier of
Quebec's comments. They do seem to be
quite curious from time to time and quite interesting, one week condemning the
Beaudoin‑Dobbie report, the next week praising considerably at the
Liberal convention the assets of Canada and the need to stay in Canada. I
cannot quite figure out what the Premier of Quebec's position is in terms of
the first referendum versus the second referendum, so I do not know whether we
are on a tight time line or a longer time line.
I do recognize though that most Canadians want this thing resolved and
they want to get on with their fundamental priority, and that is their job, the
education of their children, the health care system, our environment that we
all are responsible for, and not be preoccupied with the Constitution of the
day.
Thank you very much.
Mrs.
Sharon Carstairs (Leader of the Second Opposition): Madam Chairperson, I join in on a discussion
today on the Executive Council Estimates with some enthusiasm. I am particularly appreciating the quiet that
seems to have descended on this Chamber.
Except for a few minutes earlier when the Premier (Mr. Filmon) was
speaking, it has been delightful.
I have to say that yesterday when I was
entertaining the caucus and their children at a party at the lake, the
aboriginal foster child of Anne and Paul Edwards decided that throwing cherry
tomatoes might be the order of the day.
I used what had always been very effective in the classroom, which was a
steely glance and a very strong no, and Joshua stopped in his tracks and
immediately deposited the cherry tomato back on the tray where he got it
from. I have often wished that such a
steely glance and a firm no would work in this Chamber. Unfortunately, Madam Chairperson, it does not
seem to. I welcome the silence today and
hope that we can continue this until we complete our discussions later this
evening.
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There are a number of areas that I want to
dialogue with, with respect to the Premier.
First and foremost is the economic priorities of the government and the
lack of job creation in the Estimates that we have seen across the board.
I wanted to point out to the Premier that we
were looking for a very specific form of job creation and not a quick‑fix,
$5.50‑an‑hour job. It seemed
to me that if we could find dollars for job creation one very clear avenue
where that could be spent was to move from the traditional, hospital‑based
model of health care delivery into a more community‑based health care
delivery system. We have not seen that.
My one concern about the Minister of Health
(Mr. Orchard) is not that we will see the occasional bed closure here or the
occasional bed closure there, because I think that is inevitable if we are
going to deliver health care effectively.
What I am not seeing is the kind of openness about what alternatives he
is going to provide for that care, so that if we are going to be able to do
less surgery at the Health Sciences Centre, then are we going to be able to do
more day surgeries at Concordia Hospital or more day surgeries at St. Boniface
Hospital? If we can see that kind of
quid pro quo and the public can see that kind of quid pro quo, then I think
there will be an acceptance of some of the decisions that are being made.
Unfortunately, the openness of that kind of
decision making does not seem to be readily available to the public. There is a sense of unease, and some of that
sense of unease, I have to say, comes from the official opposition that tends
to raise it over and over and over again.
It also comes from the Minister of Health, because I do not think that
the openness is there to describe what alternatives are going to be there.
If we do not start working on this effectively
within this year and the next year, then we are going to see a deterioration of
service. That is not what anybody
requires in terms of health care, but there is no reason why we cannot look at
alternative care.
Just a simple example, the Health Sciences
Centre has worked very carefully at decreasing the number of Caesarean sections
they are performing in that hospital so that we are quite a bit closer to
western European figures as opposed to North American figures for Caesarean
sections. Not only is this less costly,
it is far healthier for both mother and child.
I think that we have to move to more and more
of that kind of initiative, but some of that movement is costly because we have
to decide what kinds of alternative services are going to be available. Job creation in that kind of area, I think,
would bode well for reduced costs and a long term in the delivery of health
care.
I also want to debate in a positive way, I
hope, with the government's attitudes towards sustainable development. I noticed once again a commitment to the
centre of $1.375 million. I do not quite know what that centre is yet doing and
again a lack of communication perhaps on just what their programs and plans are
for the future, but also I see other things happening in the budget which cause
me concern.
How can you be spending money on an
International Centre for Sustainable Development to the tune of almost $1.5
million and at the same time be making 16 percent cuts to silviculture, which
is fundamental to the regrowth of our forests in the
I want to really talk about how we can balance
those two in order to ensure that we are not just preaching a gospel, we are
actually practising that gospel in the
I was very concerned, and I am glad the
Minister of Agriculture (Mr. Findlay) is here, with regard to his lack of
willingness to sign a document, prepared by the supply management people,
granted, but which did in fact recognize in its opening paragraph a balanced
position. The Minister of Agriculture
was only one of two in all of
Certainly, when we negotiated the U.S.‑Canada
free trade deal, we were told that we did not have to worry about marketing
boards under that particular agreement because we would be protected under
Article 11 of GATT. Well, no sooner of
course had we entered into the U.S. Free Trade Agreement than all of a sudden
GATT Article 11 seems to be under dispute.
It is the American government along with western European governments
that are leading the battle to somehow or other get rid of Article 11, which
controls and protects our supply management system. It is a concern that I think we had the
opportunity to adequately defend, and we did not do it. I was disturbed at that.
It leads me to say, in what ways are we going
to approach the whole North American free trade agreement? Are we going to have that same type of
shyness about being up front about what exactly are the areas of grave concern
to us and the issues that are gradually filtering out? I think everyone will admit that the North
American free trade agreement is being done even much more secretively than the
U.S.‑Canada Free Trade Agreement and little information is filtering out.
The amounts that are are of concern to all of us,
whether it is the fact that they are going to open up the U.S.‑Canada
Free Trade Agreement because of the textile trade and traffic between the
United States and Mexico, while we have been guaranteed all along that the
reason we are at the table is that we do not want the U.S.‑Canada Free
Trade Agreement opened up as part of the North American free trade agreement,
whether it is the fact that the U.S. trade representative consistently talks
about the need to put culture on the table, despite the fact that we keep
getting assurances that culture is not on the table. Those have to be concerns of all of us.
I suspect that at the meetings over the next
two days there will be that dialogue with regard to NAFTA, as it has become
known, that the Premier is very clear in his statements, not only in the
statement given earlier in the House, but to be up front with the other First
Ministers in terms of clearly identifying areas of concern for Manitobans.
The issue of the Constitution is one that
concerns us all. Like the other two Leaders, I do not know how to read Robert
Bourassa; I do not think any of us do.
What concerns me, however, is one clear message that he seems to give no
matter how warm and friendly his speech is, and that is
The concern that I raised when these
multilateral negotiations began is the concern I still have, which is, you
know, we come up with a deal and we allow one Brian Mulroney to negotiate for
the nine plus one with
The only person who has that authority in this
House is the Premier (Mr. Filmon), and I do not want to see this Premier or
indeed any other Premier give that authority to the Prime Minister of this
land, because the quid pro quo, if you will, the obverse of multilateral
negotiations of nine plus one, is then that being negotiated with the remaining
province. That is not, in my opinion,
the way in which a successful completion of a constitutional deal will be
signed, because it simply will not pass the nine Legislatures across this
nation or even seven of them if we are going to use the seven, 10, 50 percent
formula.
* (1520)
I am also concerned, however, with regard to
certain issues in this House. We have
all signed an all‑party agreement with regard to the inherent right to
self‑government of our aboriginal people, and I was very shocked when the
Minister of Justice (Mr. McCrae), in a day of pique or whatever, launched into
an attack on the chiefs of this province.
Well, the reality is those chiefs are duly elected. They are elected by their people. We may not like a particular chief, but quite
frankly that is irrelevant. I do not
like all of the elected representatives in a number of instances.
So it does not surprise me that an individual
may not like this chief or that chief or indeed that chief may not like the
Minister of Justice, but to use the issue of aboriginal children and women to
kind of castigate the way in which chiefs govern does not bode well for our
acceptance of the inherent right to self‑government. That inherent right to self‑government
must obviously have within it a recognition that we will accept their
democratic processes.
I had the distinct feeling in that particular
day of debate that that was not the position of the Minister of Justice (Mr.
McCrae), and I would like to dialogue with the First Minister (Mr. Filmon)
about what he believes the inherent right to self‑government means. Is it just a phrase or does it in fact have
some teeth, and if it has teeth then what are those teeth?‑‑because
I certainly feel one of those teeth must be a recognition of their democratic
processes.
I am also concerned about Charter issues. The Premier is well aware of the fact that
the Charter is very dear to my heart, and the concern that I have is that it is
once again going to be sacrificed. I was
somewhat surprised at the Leader of the Opposition (Mr. Doer), who indicated
that he thinks that the wording presently in Beaudoin‑Dobbie is
acceptable with respect to Charter. It
is not, as far as I am concerned. I
would like to hear what the Premier has to say about that because it is not, in
my opinion, an adequate protection for Charter issues.
I recognize that we have a concern in the
government about the recent report of the Clean Environment Commission. I spoke about this briefly in my speech on
the budget and the Premier, I think, knows where I am coming from on this. I do not always like the decisions of the
Clean Environment Commission either. Had I had my druthers, I would not have
liked to have seen them accept the office complex at Oak Hammock Marsh, but I
made a commitment and the caucus made a commitment that we would respect
process, that if this was going to go to the Clean Environment Commission‑‑they
were going to hear witnesses, they were going to make a decision‑‑we
would abide by that decision, even though we might not necessarily,
individually and as a group, agree with that decision.
There comes a point in environmental issues
where I think we have to respect the process.
Now we have had a Clean Environment Commission report which is obviously
causing some dismay because of the requests it is making, not just now, but
several years down the line. I think we
have to find a way to accommodate the viable economic needs of communities,
also with the sustainable development aspects of the report of the Clean
Environment Commission. I think they
have given some room to find that accommodation within their report, but I
would like to see a commitment to the principles that are laid out by the Clean
Environment Commission.
As to the salary adjustments and the overall
budget of the Premier himself, I also noted that the staff has remained
relatively stable. The picture is not
quite as glowing as the Premier indicated because of a 14.6 decrease in French
Language Services Secretariat; there was an increase in the other two salary
lines, of 6.8 and 5.8, but they are not out of line in any dramatic way, quite
frankly, when one considers both merit increases and the general salary
increase. I would much rather we left
this debate on the issues of policy making rather than on the specific nitty‑gritty
about what A is being paid or what B is being paid. So I will not be asking any questions in that
particular area.
I would like very much to get into a dialogue
about the future of this province, where we are going. I will close with the following. I am‑‑and I think the Premier
(Mr. Filmon) and the Leader of the Opposition (Mr. Doer) know full well, and
probably because of my many years in education‑‑very concerned
about job training and academic planning and training for our young
people. When I look at the economic
figures year after year and month after month, I become most disturbed at the
very rapidly rising increases for young people between the ages of 15 and 24.
In January, it was almost 22 percent for young
men between the ages of 15 and 24. That
decreased a little bit in February, I think down to 19‑point‑something
percent, but young women bounced up 2 percent in the same month.
Many of our young people simply do not have
adequate skills. In this province we still have 30 percent of our young people
not getting a high school diploma. We
have to find strategies to stop that, because there are no jobs out there for
young people who do not have high school diplomas. In fact, there are getting to be fewer and
fewer jobs for those who do have high school diplomas as we require more and
more in the way of post‑secondary education.
When I see the budget for the community
colleges still significantly below what it was in '90 and '91, then I wonder if
we have a strategy. I have to say I do
not think we do, because the other places where we are putting money, quite
frankly‑‑and I have tried very hard to find accommodation within
the Department of Education and within the Department of Family Services to
find out what kind of evaluations are being done on those programs. The answer
I get back is somebody else is doing it, over and over and over again.
If we are offering job training programs out
there, nobody is evaluating them. Nobody
is saying, is this valid? What happened
to the graduates? How successful were
they at finding a job? That kind of evaluation is going on in our community
colleges, but it is not going on in the millions of dollars we are giving out
in other forms of job training.
I think unless we find that accountability, we
do not have a strategy that is going to turn these young people into effective
workers for the future.
With those comments, I look forward to joining
in, I hope, a quiet and positive debate.
Madam
Chairperson: I
would remind members of the committee that debate on the salary for the
Premier, 1.(a), is deferred until all other items in the Estimates of this
department are passed.
At this time I would invite the Premier's
staff to take their place in the Chamber.
Does the honourable First Minister wish to
introduce the members of his staff to the other members of the committee?
Mr.
Filmon: Yes, I
would like to introduce the members of my staff in no particular order: The Clerk of the Executive Council, Mr. Don
Leitch; Karen Popp, who is our Director of Administration and Finance; my
principal secretary, Jonathan Scarth; and the Deputy Minister of Federal‑Provincial
Relations, Jim Eldridge.
* (1530)
Mr.
Doer: Yes, I
would like to also welcome the Premier's staff.
I think we have one change at the table from a year ago. I welcome Mr.
Scarth to the table. I know he took good
care of‑‑
An
Honourable Member:
Careful, he went to Ravenscourt.
Mr.
Doer: Well, I
went to
An
Honourable Member:
Sorry about that.
Mr.
Doer: That is
okay. I know you are sensitive about
Ravenscourt. I do not know whether the
Liberal Leader taught Mr. Scarth or not, but I do want to say that he did take
good care of us when we were dealing with the June 1990 meeting and want to
officially thank him for that and welcome all the Premier's staff here today.
I do have just one question for the record on
the staffing numbers. The Leader of the
Liberal Party (Mrs. Carstairs) said she would not ask any questions; I am just
going to ask one or two questions and then I will be moving to deputy minister
assignments and cabinet shuffle decisions in terms of the sequence. I would suggest that by agreement that we do
the whole department or the whole Executive Council together and pass it as one
item tonight. I think that has been our
practice on Executive Council, but that is subject to the First Minister and
the Chair.
The salary increases in a management administration went up 6.7 percent and 5.7 in Intergovernmental Relations Secretariat. The Premier mentioned that was the general wage increase and the merit increments.