LEGISLATIVE ASSEMBLY OF
Monday, April 13, 1992
The House met at 8 p.m.
COMMITTEE OF SUPPLY
(Concurrent Sections)
HEALTH
Mr. Deputy Chairperson (Marcel Laurendeau): Order, please.
Will the Committee of Supply please come to order. This evening this section of the Committee of
Supply meeting in Room 255 will resume consideration of the Estimates of
Health.
When the committee last sat, it had been considering item 1.(b)
Executive Support: (1) Salaries, on page
82 of the Estimates book.
Shall the item pass?
Mr. Gulzar Cheema (The Maples): Before we proceed with the questioning, I will
just ask the member for
Ms. Judy Wasylycia-Leis (
Hon. Donald Orchard (Minister of Health): Mr. Deputy Chairperson, you know how much I
enjoy the Estimates process and carrying on till midnight or one or two in the
morning, but I will be guided by my honourable friends. Each of us was at a debate this morning that
the MNU hosted circa ten o'clock, and our day started fairly early. Do you know whether the House leader has had
any discussion around this this evening?
* (2005)
Ms. Wasylycia-Leis: My
understanding is that the committee in the Chamber will end at ten o'clock, and
it is my understanding that as long as there is all‑party agreement that
it would be appropriate to do so in this committee as well.
Mr. Orchard: I am not
one who pushes water uphill. Ten o'clock
or 10:30, if we went for another half an hour, depending on the tenor of debate
we may want to go past, so let us say circa ten o'clock, but if it turns out to
be 10:15 or 10:30, I do not think anyone would argue.
Mr. Deputy Chairperson: In
that case I will ask the question at ten o'clock whether the committee should
continue sitting or not.
Ms. Wasylycia-Leis: A few
more questions on this line‑‑I am hoping we can move along at some
point this evening on Executive Support.
I hope by posing the question that I would like to put to the minister
that it will not be considered so controversial that I will start the evening
off on the wrong note and cause us to sit all night.
I do note the raise in wage for the deputy minister. It is an increase of $2,800. I also note that is in addition to the
increase last year, when the deputy minister's salary went from $88,300 to the
$92,100 mark and that in fact there was also a significant increase from the
'89‑90 year when the deputy minister's salary was at $75,600.
In the space of about three fiscal years, the deputy minister's
salary has jumped an additional $16,500.
It is an issue I have raised in the past. It is still disconcerting, and I am wondering
if the deputy minister has been handed additional duties from the previous
year, or if there is another explanation for this fairly major increase in
salary.
Mr. Orchard: I am
going to seek clarification on this year's increase and it should be coming
right away, but bear in mind that the original increase‑‑when we
came into government several things took place.
First of all, we terminated the contract that the previous
administration had drawn with Mr. Kaufman and at that time circa the end of
June, Mr. Edwards who had been deputy minister and executive director of MHSC
for a number of years, retired. To
replace the deputy minister, I appointed Mr. Maynard, the current deputy
minister, on an acting basis. That was
confirmed as deputy minister about, I guess, six or eight months after that.
* (2010)
Subsequent to that, we‑‑and I would be much more
comfortable if my honourable friend would discuss this issue during the
Premier's (Mr. Filmon) Estimates, but I will give you the genesis of what we
undertook as government in terms of a review of our deputy ministers' salaries.
Departmental responsibilities were given a review, and the
review was intended to reflect the complexity of the deputy minister
responsibilities, and as a result, my deputy minister, having come in as an
ADM, or come in from an ADM slot with a modest increase in 1988 as a flow from
that review, was placed because of health, in the ministry of health, in the
senior compensation level for deputy ministers.
So that led to a fairly significant increase about two years ago, I
think.
The increase this year is an increment which is reflective of a
year's dedicated and successful professional endeavour as deputy minister, plus
the 3 percent that was awarded to our senior personnel in parallel with the
MGEA settlement.
Ms. Wasylycia-Leis: Mr.
Deputy Chairperson, could the minister tell us who the five individuals are
under the Professional/Technical category?
Mr. Orchard: Does my
honourable friend want the names?
Ms. Wasylycia-Leis: Yes,
please. That could be done at another
time if the minister would like to provide that later on. That is fine.
In Other Expenditures, there are some major jumps in
expenditures from approved levels last year.
There has been an increase of about $20,000 in transportation; an
increase of about $20,000 in communications; and an increase of over $30,000
under supplies and services. So we are
looking at doubling and tripling of budgets in a very short period of time, and
I wonder if the minister could give us some explanation for that.
Mr. Orchard: The three
Professional/Technical staff that my honourable friend was inquiring about are
my special assistant, Catherine Evanson, my executive assistant, Allan Hiebert,
and includes the one vacant position that has been vacant for some time of
special adviser to the minister.
(Mr.
Jack Reimer, Acting Deputy Chairperson, in the Chair)
Ms. Wasylycia-Leis: The
other question I had raised was with respect to the major increases in the
areas of transportation, communication and supplies and services from the
levels approved from last year's budgetary process.
Mr. Orchard: Mr.
Acting Deputy Chairperson, in general terms, you might recall that I indicated,
I do not know whether it was last week or the first week we got into the
Estimates process, that my deputy minister‑‑he is the senior
serving Deputy Minister of Health in
* (2015)
Now, with those kinds of national responsibilities there is an
additional requirement for him, himself, to travel, and as well my deputy,
because of the significant input to some of these committee duties, will be
travelling with another individual from the deputy's office and, of course,
that has compounded some of the travel costs.
Ms. Wasylycia-Leis: Mr.
Acting Deputy Chairperson, I have raised in very broad terms previously
questions about morale in the department and relationships of trust between
health care professionals and the department.
I would like to ask more specifically about that major concern, very
pervasive pattern of relationships vis‑a‑vis the department in the
context of the deputy minister, since it appears that as the chief
administrative officer for the department this would be the appropriate time to
raise those concerns.
I would like to begin by asking why it would appear, at least
in my estimation, that so many highly qualified, trained medical practitioners
particularly in the areas of community medicine, disease prevention,
communicable diseases, community promotion, healthy promotion policies and so
on have left the department. When I look through the history of the department
over the last few years, I sense that there has been an exodus out of the
department of very highly qualified medical people.
I am wondering if the minister can give us a breakdown of the
numbers of medical people who have left the department, the reasons for those
departures, and how many postgraduate physicians are left in the Department of
Health.
Mr. Orchard: Mr.
Acting Deputy Chairman, I want to add a little more information to the first
line of questioning.
In terms of actual expenditure on the line my honourable friend
was questioning, the increase, the increased travel is part of the increased
budget. I am also informed that it more
accurately reflects the actual expenditures over the past number of years on
that line, which ranged from 166,100 in '87‑88 to a projection of 175,900
this year.
Mr. Acting Deputy Chairman, I am a little bit at odds to scour
the department to identify physicians who are working within the ministry. My honourable friend made some fairly direct
accusations and laid the case of wholesale leavings of individuals from the
department. It might be appropriate that
if my honourable friend can and has the authority to discuss individual
circumstances of the type that she has alluded to of people leaving the department,
maybe she might consider giving me the individual's name and I will, to the
best of our ability tonight, give my honourable friend the circumstances
surrounding that change in employment status either within the department or
external to the department.
* (2020)
Ms. Wasylycia-Leis: I would
be happy to provide some more specific information to get the minister's
reaction. Let me first say in terms of
the overall concern, or the issue that I am raising, I remain concerned about
our Department of Health, the level of expertise from the medical field,
particularly in the areas of community medicine and community‑based
health delivery system in the context of moving towards health care reform,
about the level of that expertise remaining in the department.
I have no reason to believe that the people who have left in
great numbers have been replaced, and whether or not the expertise has been
restored within the department for expert and experienced advice on such
important matters as health care reform.
I am sure as I go through these names, the minister is going to
have different reasons for each of those individual's departures, but the
concern is still an overriding one about the numbers who are leaving. The fact that some have clearly left for
reasons that are pertinent to the administration of the department, that being
the‑‑and I have said this before in Question Period, and I will say
it again‑‑low morale, chaos in terms of decision making, poor
relations, and a lack of a collective collaborative approach in terms of
decision making.
Let me give you a list of names of those that I know and
indicate that I obviously do not have a complete list, there would still be
others. I go back to Dr. Ian Johnson‑‑community
medicine‑‑Dr. Linda Poffenroth, Sharon Macdonald, Chris Greensmith,
Margaret Fast, Peter Cooney, Gary Tipping, Richard Voss, John Wade, Larry
Wiser, and others.
That is a preliminary list and I do not have any research.
Mr. Orchard: Would you
repeat those a little slower?
Ms. Wasylycia-Leis: The
minister has asked me to repeat them. I
would be happy to: Dr. Ian Johnson, Dr.
Linda Poffenroth, Dr. Sharon Macdonald, Dr. Chris Greensmith, Dr. Margaret
Fast, Dr. Peter Cooney, Dr. Gary Tipping, Dr. Richard Voss, Dr. John Wade, Dr.
Larry Wiser.
All of those individuals have left the department, and I know
that there are probably different circumstances with some of them, but I think
what is first of all clearly a serious matter is the exodus of such a large
number of postgraduate medical practitioners from the department.
* (2025)
The other concern is that there are some who have clearly left
for morale reasons. I am wondering,
first of all, what is the minister's assessment of this situation? How is he trying to redress it? When will the department be back up to a
certain level of highly qualified, experienced individuals in the area of
community medicine and healthy public policy?
Mr. Orchard: First of
all, I think my honourable friend, in terms of introducing this subject, in
talking in terms of chaos and low morale, et cetera, leaves the impression that
each of these individuals have made that accusation to her.
Ms. Wasylycia-Leis: I
clearly said the opposite.
Mr. Orchard: Now my
honourable friend from her seat says, clearly I said the opposite.
Point of Order
Ms. Wasylycia-Leis: Just on
a point of order, the minister will know that I did not make any generalization
with respect to all these individuals, and that I clearly said some of these
individuals have indicated that they have left for morale reasons, and that the
broader concern was the loss to a Department of Health of just about every
highly qualified postgraduate medical practitioner.
* * *
Mr. Orchard: Mr.
Acting Deputy Chairperson, this is exactly what I find offensive with my
honourable friend's style. Because when
she talks about her sources at the various hospitals, she maligns every person
as being a source. She named a group of
people, and when I caution her that she is maligning the whole group, she says,
oh, no, I am not, I did not say anything about them all. Then she immediately
turns around and says that some of them have indicated to her that they have
left because of low morale. That is what
you said. You just said that some of
them have said to you personally that they have left because of low morale.
Now having named all of those individuals, and then making that
statement without naming those individuals, you have maligned the whole works‑‑exactly
the point I made to start with.
Now I realize you do not recognize you do these things in your
wanton drive to create a political issue, but let us deal with some of these
individuals.
Dr. Wiser: One year
contract, contract not renewed.
Richard Voss: I do not
believe he is a doctor. He was executive
director in terms of mental health reform, is now working for the government of
the
Dr. Cooney: I have dealt
with Dr. Cooney in the House. He is
working with the federal government. We
are on close working relationship with the department with Dr. Cooney and he
is, in fact, on a leave of absence from the ministry. I have had personal discussions with Dr.
Cooney, and he has indicated to me that should I need advice, he is willing to
provide that kind of advice. Hardly leaving
in disgust, as my honourable friend might indicate.
Dr. Margaret Fast:
Working now in Cadham Lab in the same area that she was in, in terms of
communicable diseases from the Cadham Lab aspect, probably more able to utilize
her unique medical experience in that area.
Dr. John Wade: I think
my honourable friend mentioned Dr. Wade.
He is working for the department two days a week and chairs some
committees for me, including the Health Advisory Network‑‑hardly an
individual who has left in disgust, hardly one who should be given that kind of
shadow over his head that my honourable friend put in.
Dr. Sharon Macdonald:
Working at the Community Health Sciences Department, Faculty of
Medicine, was an ADM in the department and left the department of her own
will. I cannot make career decisions for
individuals, but Dr. Macdonald is now working quite closely with Heart Health
Project and other areas of the department.
We have a good working relationship, in my humble opinion, with Dr.
Macdonald. [interjection] Right. My deputy reminds me that Dr. Macdonald was
at the invitational MHO conference.
* (2030)
Dr. Poffenroth left to work for the City of
I cannot give my friend details about Greensmith, Johnson or
Tipping, but surely already my honourable friend might be willing to reconsider
the blanket accusation she has placed on all of these individuals, that they
have told her, one or two or three or maybe them‑‑I do not know
them all‑‑that they left because of chaos and low morale in the
department.
My honourable friend has some of that, that she is now
sharing. Does she have the individuals'
permission to share those thoughts at committee and remove the blanket
suspicion over the rest of these professionals?
No, of course she does not. She just wants to carry on with her games,
that this is a sort of a cutesie little way to get around the issue, that there
is a chaos, there is low morale.
This department happens to have gone through one of the most
significant reorganizations that it has ever gone through. That has been something that was in the
discussion stages for approximately a decade and not undertaken. Why?
Because I suppose the previous government did not want to upset the
apple cart. They did not want really to
bring divergent and noncommunicating areas of the department together in a
public policy way of reorganization.
Certainly, I will admit to my honourable friend that in that
reorganization I know of one of the individuals whom my honourable friend
referred to who was dissatisfied that the leadership in that area was not given
to the individual. That caused some
dissatisfaction. But not wanting to get
into that area, because I do not think it is germane to the public debate, I
simply want to indicate to my honourable friend that the leadership in that
area is very excellent leadership.
If my honourable friend wants to question the hows and the whys
and the wherefores, I will be glad to get into it with her. But I consider us
to be fortunate, in one of these areas, to have an individual with medical
training, who is providing probably some of the best leadership we have ever
enjoyed in the province of
So, you know, my honourable friend‑‑and that is why
I indicated that my deputy should come down and listen to this dissertation by
my honourable friend because we are all deeply interested in hearing her
thoughts about the organization of the department. I will be pursuing her with specifics,
because I will not accept a blanket accusation which maligns a full 10 or 11
professional people with my honourable friend saying that some of them have
told her that they left because of chaos and low morale in the department,
thereby maligning all of them, a number of whom I have clearly indicated to you
what they are doing now and why. Some of
them are still working with the Department of Health.
Ms. Wasylycia-Leis: Well,
clearly this is a sensitive area for the minister, given his overreaction first
of all to some of the different areas of concern that I raised. It is not untypical when we have hit a
particularly sensitive issue with this minister for him to react in this way.
The minister will know that I have raised two or, one could
say, possibly three concerns here with this matter. Number one, the fact that there are
individuals that have clearly left out of disgust because of the management and
morale in the department‑‑the minister should pay a little
attention and perhaps pick up some of the issues that we are certainly being
informed of from his department and do something to address some very serious
problems in his department.
I am not going to name names, because the minister has a very
clear record of being spiteful and vindictive and is known for his attempt to
keep anyone from talking and information, of course, secret and under
wraps. That was one concern, and it is a
real concern.
The second is the major loss to this government and Department
of Health of so many highly qualified, experienced individuals in the area of
community medicine and healthy public policy.
I do not know about you, Mr. Acting Deputy Chairperson, but it
sure strikes me as a fairly serious issue to see that kind of medical
experience leaving the Department of Health, leaving what I would believe to be
a significant gap in policy and an absence of necessary expertise at this
critical juncture in our time, so I raised the general question of that
significant number of highly qualified medical practitioners from the
Department of Health. I have asked very
clearly what steps are being taken to replace those individuals and that
expertise.
Mr. Orchard: I guess
the best I can do is sort of chase phantoms with my honourable friend because,
again, you know she is saying that she will not name names of these people who
have left the department in disgust, according to her allegations. If they have left the department, how can
they possibly be concerned about my honourable friend's allegation that I will
be vindictive toward them? How could I
possibly be vindictive as Minister of Health to a person who my honourable
friend alleges is already gone from the department? That really does not make a whole lot of
sense when you think about it, does it?‑‑which brings me right down
to what my honourable friend has tried to do for two, three years now to create
this phantom of chaos, low morale in the department. This is the third or fourth time now my
honourable friend or her predecessor as Health critic has attempted this tactic.
My honourable friend has the permission to bring even one of
these individual's circumstances up. I
will be glad to discuss it openly, because there are probably a few more
details than what my honourable friend is aware of. Such things as salary‑‑does my
honourable friend know that the City of
Now, does my honourable friend want to lay those details out,
because I do not have the authority to do that for any of the individuals so
named here? Does my honourable friend
have that authority from them? If you
are going to lay an accusation, you better be prepared to back it up. You are not prepared to back it up because
you cannot. Again, you are chasing
phantoms.
Ms. Wasylycia-Leis: I am
wondering if the minister would like to answer the question about how he is
replacing these individuals. If he could perhaps give us some indication in
each and every case if that individual has been replaced or how the necessary
expertise is being provided to the department.
Mr. Orchard: Mr.
Acting Deputy Chairperson, we have replaced some of these individuals with
either direct hiring or, in some cases, contractual arrangements, and that varies
depending on the nature. If my
honourable friend had a specific name, I could try to give her a specific
indication as to whether there is yet a replacement recruitment in process or
whether we do not intend to replace, if that might be the case.
Ms. Wasylycia-Leis: Let me
try it from a different angle. How many
individuals are there in the department now with a postgraduate degree in
community medicine?
Mr. Orchard: I think
we would have to do a little research into finding that out for my honourable
friend.
Ms. Wasylycia-Leis: In terms
of the overall hiring pattern of this minister or this department, in terms of
the overall hiring policy in the department, it appeared to me from the
discussion in the last Estimates, partly as a result of the reorganization,
that on that chart there were a considerable number of vacancies in fairly
senior positions within the department.
I am wondering how many of those vacant positions were filled by
competition or by direct appointment.
* (2040)
Mr. Orchard: Our
medical officer of Health area is always one that we find difficulty to recruit
into.
Mr. Cheema: Mr.
Acting Deputy Chairperson, I would just ask one question about Dr. Fast. I want to also offer some comments about her
services to the Department of Health, as she is in charge of the clinical
diseases. We have worked very closely
with her during the last four Estimates, and I just wanted to say that she has
done a wonderful job. We wish her all
the success in her new position which is equally important and very vital right
now. From our point of view, we hope we
can continue to communicate with her and get advice from time to time. She has been a very valuable source on a very
noncritical basis.
My question is to the minister:
Has there been any direct recruitment from outside this province for a
major position in the Department of Health?
Specifically, I am raising a question in terms of the executive director
of the urban hospitals. I understand
there was a new position created and there has been recruitment from outside
the province. I just wanted to know
whether that is a fact. Can the minister
give us the information about the qualification of the person and whether that
position was advertised in
Mr. Orchard: Mr.
Acting Deputy Chairperson, in December‑‑let me back up a step or
two. We have had an executive exchange
with St. Boniface Hospital which had Mr. Kalansky serving as 2IC to Frank
DeCock in the commission. Now, as you
well know, Mr. Kalansky successfully acquired the executive director position
at Seven Oaks‑‑I believe it is executive director‑‑and
subsequently left the department. To
carry on with the exchange with St. Boniface, a recruitment effort was
undertaken and a Mr. Ken Clarke from
Mr. Cheema: Mr.
Acting Deputy Chairperson, I am not questioning the qualification of the
person. I just want to make it very
clear, Mr. Clarke may have one of the best qualifications in the whole world
and his service in the
Mr. Orchard: We had
input into the hiring process, but St. Boniface, because of the exchange aspect
is the actual employer and to my knowledge I think they did an open competition
on it and sought candidacy from within the province and external.
Mr. Cheema: Mr.
Acting Deputy Chairperson, my reason for my questioning is, as the minister
will understand, because some people have raised that issue with me in a very
serious way. I told them very frankly
that we have to discuss in a very direct way and see whether anything was
violated as far as the
I just wanted to be sure that somebody in the Department of
Health was given the opportunity, and if that is the fact then we have no
problem, but if somebody was brought, and somebody was already there in
Manitoba who had all the training, who had served us very well, and if some
person is not given the chance to promote his or her chances of promotion in
the department, I disagree with that. If
that is not the case then we have no problem with the appointment.
Mr. Orchard: Mr.
Acting Deputy Chairperson, two things, and I will back right up again as to
where the exchange commenced. We did a
personnel exchange with St. Boniface.
Mr. Searcy from the department went to St. Boniface and is serving with
St. Boniface, and at that time Mr. Kalansky came over from St. Boniface and his
subsequent departure, so in fact Mr. Clarke is the exchange individual now in
place for Mr. Sherase out of the department.
Mr. Clarke assumed responsibility at the Urban Hospital Council
for two reasons. Not at all questioning
the dedication of the individual that we had working there, but Mr. Clarke's
experience was both as an executive director of a major tertiary care facility
in western Canada, Saskatoon to be exact, as well as experienced at the senior
levels within the ministry of Health.
That sort of hands‑on experience on both sides of the system in a
senior level made him quite a reasonable candidate to slot in and work with the
The individual that was there put in a lot of dedicated
hours. We are even going to lose that
individual's services due to a transfer out to the northwest region of the
province.
Mr. Cheema: Mr.
Acting Deputy Chairperson, we just wanted to make sure that the process was
followed. It was not a question of the
credibility of the person. I made it
very clear, because his reputation is very, very good, and that is without
question. We just wanted to make sure that somebody from
Mr. Orchard: I can
give my honourable friend that assurance.
Ms. Wasylycia-Leis: If I
could just for a moment pursue the appointment of Ken Clarke from
* (2050)
Mr. Orchard: Nineteen
eighty‑nine was when that first exchange took place. It was a new initiative that we undertook as
government, knowing full well that the ministry‑‑without provoking
a political fight‑‑there was too much tendency when I came into
government as the Minister of Health that the whole system dealt with issues on
a them‑and‑us basis, and there was too much head‑to‑head
and too much controversy and too much lack of understanding of the role of the
ministry and of the ministry legitimately not understanding the role of the
facilities.
We undertook investigation around an exchange program where
each of us could benefit. Someone from
the ministry would see the inside operations of a hospital and someone from a
hospital would see the kind of challenges that senior management in the
ministry of Health deal with on a day‑to‑day basis. That kind of openness benefits the ministry
as well as senior hospital management in terms of understanding‑‑sort
of, walk a mile in my shoes and you understand the circumstance a little bit
better.
I think it has been a worthwhile initiative that has been
ongoing now for about three years to try to make each other familiar with our
respective roles, one in management as senior health care facilities and the
other, of course, in management of the highest‑spending ministry in
government.
Ms. Wasylycia-Leis: If I
could just get clarification that Mr. Ken Clarke is on this payroll of the St.
Boniface Hospital, seconded to the Department of Health, what is the exact
position that he holds?
Mr. Orchard: The
Executive Director of Hospital and Community Services.
Ms. Wasylycia-Leis: I would
like a few more to follow this up first.
Although he is on St. Boniface's payroll, could the minister indicate
what his salary is and also where he shows up in terms of the organizational
chart or organizational presentation for the department?
Mr. Orchard: The
salary is one which is negotiated by St. Boniface, and I do not have that
information at my disposal. I suppose we
could provide the information of what the salary of Mr. Searcy is, which is our
end of the bargain, if you will. In
terms of location within the ministry it is, as I indicated, within the
administration area of the Hospital and Community Services Division, under the
Associate Deputy Minister Frank DeCock.
Ms. Wasylycia-Leis: Thank
you. Mr. Ken Clarke would report to
Frank DeCock, who is Associate Deputy Minister of Hospitals and Community
Services. Mr. Acting Deputy Chairperson,
I would like to raise a question from that information, and again it is a
concern. I hope the minister will treat
it as a sincere and serious comment. In
my estimation it would seem that the two individuals heading up this whole are
of Hospital and Community Health Services, are both from hospital backgrounds,
and that at a senior position in that whole area, the minister does not have
someone whose first area of expertise or major area of experience and expertise
is community health services.
I am wondering, if that is the case, how that is then dealt
with in terms of this reorganization which was to ensure better integration
between institutions and community facilities, but also to move from an
institutional‑based system to a more community‑based system.
Mr. Orchard: Mr.
Acting Deputy Chairperson, one must appreciate that within the ministry we
have, if you will, attempted to level the organization and bring in a closer
working relationship within divisions and ADMs' responsibilities. In that regard, I have to indicate to you,
we, in my humble opinion, have one of the best Community Care individuals in a
senior executive level of Assistant Deputy Minister in the person of Betty
Havens, and the working relationship between those two is excellent within the
ministry.
In addition we have on an acting basis, Ms. Sue Hicks in terms
of the ADM on Healthy Public Policy, again with a fairly substantial amount of
community experience. Our Assistant
Deputy Minister of Mental Health Services Mr. Toews, prior to leaving the
provincial ministry of Health, was a regional director responsible for
community service programming in the ministry of Health and spent some
substantial amount of time working through the Mennonite Central Committee on a
lot of community service delivery prior to his return and subsequent retention
by the ministry as ADM in Mental Health.
We have in addition brought in John Gow, a regional director from the
community side, to get a more hands‑on sense of operations on the
hospital side to further enhance that working relationship.
Ms. Wasylycia-Leis: Just one
other question before I pass it back to the member for The Maples (Mr. Cheema).
How many other such people are there involved in exchange
agreements with St. Boniface and who are they?
Mr. Orchard: Two, Mr.
Acting Deputy Chairperson. We have Mr.
Clarke, as we discussed earlier on, and Mr. Roch who is right across the table
from you.
Ms. Wasylycia-Leis: So the
exchange for Mr. Clarke is Mr. Roch?
Mr. Orchard: Mr.
Acting Deputy Chairperson, we do not have the‑‑how do I put this in
genteel terms‑‑we do not have a body exchange in terms of Mr.
Roch's exchange with the St. Boniface, but rather our position and the salary
attachment went to St. Boniface for their recruitment internally in exchange
for having Mr. Roch serve with the department.
Mr. Cheema: Mr.
Acting Deputy Chairperson, can the minister tell us who is the head of the
Health Advisory Network now?
Mr. Orchard: Dr. John
Wade chairs it now.
Mr. Cheema: Mr.
Acting Deputy Chairperson, is that Dr. John's, then, two days of involvement
per week a major commitment as a part of the Health Advisory Network?
Mr. Orchard: Mr.
Acting Deputy Chairperson, it is a two‑day per week commitment by Dr.
Wade to the ministry, and that can undertake a number of different roles and
responsibilities. I think it is fair to
say we are getting him as chair of the Health Advisory Network outside of those
two days.
* (2100)
Mr. Cheema: Mr.
Acting Deputy Chairperson, it seems that Dr. John is working very hard.
Mr. Orchard: We get
good value for our two days.
Mr. Cheema: Mr.
Acting Deputy Chairperson, can the minister tell us now‑‑he promised
us last week that there are two or three reports out of the Urban Hospital
Council that will be coming in a final form from the Health Advisory Network‑‑when
can we expect some of the final reports?
Mr. Orchard: There are
some of the Health Advisory Network final reports that are translated and are
ready for tabling. I have to confess to
my honourable friend that over the last three weeks with the preparation for
and expedition of the Estimate process, and I have another confession to make,
I took a total of 10 days and did not do anything with the ministry of Health
during the mid‑term break, so I think it is fair to say that we are a
little bit delayed in terms of the tabling of those reports.
But I give my honourable friend this commitment. If we can arrange to have those reports‑‑like,
I do not want to just lay them out without some background as to their genesis
and what government might wish to implement from the recommendations, because I
think that would give short shrift to the work that many people put into
development of those reports. On the
other hand I sense that my honourable friend's desire to have those as part of
the debate, that would be appropriate at the time of Health Estimates. So I am going to try and walk a fine line and
see what we can table in terms of those reports, not this week but as soon as
next week.
Mr. Cheema: Mr.
Acting Deputy Chairperson, this morning, and I think it was last week also, I
think it was made very clear that some of the major package of the health care
reform is going to come by the end of this month or early next month, so I
think it would be at least to our advantage to inform ourselves to understand
the whole process so that we can at least make informed judgments. So that is why I am requesting that we should
have the information also in time, because, then the minister can also hold us
responsible if we are saying something different. My next question is, we do not see any line
of funding for the Health Advisory Network now in the expenditure. Can the
Minister of Health tell us who is so generous to the province, who is giving
all the free time to compile all the reports?
Mr. Orchard: Mr.
Acting Deputy Chairperson, we have included the budgeted funding for the Health
Advisory Network on page 88, where we have the Manitoba Health Board at
$469,300. Some $250,000 of that is
budgeted, potentially, for the Health Advisory Network and completion of a
number of its studies and initiatives.
I think my honourable friend would find it explained on page 83‑‑no,
that is not the right page. The dollar
amount is not specified in the Detailed Estimate, but of the $469,000 we are
estimating a $250,000 commitment towards the Health Advisory Network.
Mr. Cheema: Can the
minister tell us exactly how much money we have spent on the Health Advisory
Network as of 1988?
Mr. Orchard: We will
have to compile that for you, but it should be available tout de suite.
Mr. Cheema: Can the
minister tell us then how much money we have spent on this new report on the
study of anesthesia manpower? The report of March 1992 from
Mr. Orchard: We will
try to have that answer tomorrow afternoon.
Mr. Cheema: Mr.
Acting Deputy Chairperson, can the minister tell us how much money was paid for
the report that was in December 1990 for the mental health services. It is called the Drysdale report. How much was paid for that report?
Mr. Orchard: We will
bring that information tomorrow afternoon as well.
Mr. Cheema: Mr.
Acting Deputy Chairperson, can the minister tell us how much money was paid to
develop a policy out of this province?
That was the reporter who got the contract to tell us what was wrong
with our health care system. I do not
have the exact name, but I am just curious to know how much money we have spent
in total in all of these reports.
Mr. Orchard: We never
pay anyone to tell us what is wrong with the system, we pay them to tell us
what is right. I jest, my honourable
friend. Are you referring to the
teaching hospital cost overview?
Mr. Cheema: Mr.
Acting Deputy Chairperson, it was one of the reporters who first used to work
here, and then she was working for one of the papers in
Mr. Orchard: I think I
got the one you mean. We had retained
the services of this writer who worked with the Canadian Institute for Advanced
Research. Is that the same person? Yes.
I will have to bring you exact details, but it seems to me that
it was under $10,000 that we retained her writing services for. We will have to get the name for you as well
too, because I have forgotten the name of the individual.
Mr. Cheema: Is any of
that study right now going on for which the Department of Health had paid or is
supposed to pay? Is there any other
study at this time?
Mr. Orchard: The
teaching hospital cost overview‑‑we still have probably some cash
flow through the Health Advisory Network on that one. We have one other contract outstanding that
will be less than $10,000 in terms of putting a framework around the discussion
paper on the reform of the acute care side of the health care system.
Mr. Cheema: Can the
minister please give us copies of those reports if they are ready, at least for
both of us as critics so that we can also gather some information on behalf of
the taxpayer and see if we can learn something from those reports?
Mr. Orchard: I can
answer positively for both of those. It
is a matter of when they are available.
I am hoping that the latter one is available this month and for certain
not too long into May, if it is not this month, on the reform of the acute care
side of the health care system.
The teaching hospital cost overview, as I indicated to my
honourable friend on a previous occasion, the interim report has been at both
St. B. and HSC, and we are receiving feedback.
That is why I had to say that we may have to retain the consultant for
some finalization work. As soon as that
report is ready and I receive it from the Health Advisory Network, the
intention is to make it available.
* (2110)
Mr. Cheema: Mr.
Acting Deputy Chairperson, I am just going to ask a very sensitive
question. I want to be very careful,
because I think everybody needs comforts in life and you want to have the best
things in life, but I just want to know, when the Department of Health travels,
are they travelling in first class or the economy class?
Mr. Orchard: If you
are asking how I travel, I travel on the business class.
Mr. Cheema: Mr.
Acting Deputy Chairperson, how are the other members of the staff, the senior
members of the staff, if they have to travel, are they travelling within the
country on economy class or business class?
Mr. Orchard: My deputy
travels on business class as well.
Mr. Cheema: I think
that given the difficult circumstances we are in, and I have said that the
ministers in this province are not paid very well, and each and everybody's
comfort and their lifestyle is very important, but I am a little bit
disappointed because I think when we are talking about so much of taxpayers'
money, we can save some of the money on trips by travelling in economy, as long
as we are travelling within the country.
If you are travelling outside the country, if it is a long distance, I
understand the matter of convenience, but I think it does not really send a
good message to the public, because it seems that we are taking advantage of
the situation.
Mr. Cheema: It may
very well be everybody else is doing it in this country, but I think it will be
worthwhile for us to consider‑‑I do not know whether other deputy
ministers and other department heads do that, and it is no reflection on the
deputy minister, I am very fond of his capabilities and I admire his work in
the department, but it is a matter of basic principle. I am just raising a concern that maybe it
needs to be reviewed.
I would even, if there is the opportunity, maybe we should ask
the Premier (Mr. Filmon). If the Premier
can travel in economy class, why not the ministers and deputy ministers? If you are travelling within the country, I
think that is the way it should be.
Mr. Orchard: Well, I
accept my honourable friend's advice, but normally‑‑although this
probably does not cut a whole lot of ice‑‑when one is travelling,
you are often on a very tight time schedule, you are not taking extra
time. I have a habit of flying back the
same day if I can, and that involves an early morning flight out and a late
evening flight in. In fact, if the
flight itself is not an opportunity to do some work, it is an opportunity to
sleep.
I know that is a sensitive area. As a matter of fact, I received an unsigned
note the last time I flew. I know that
the individual who sent the unsigned note to me made a similar case to what you
are making today and I know phoned at least one of the political parties
because the individual informed me so.
(Mr.
Gerry McAlpine, Acting Deputy Chairperson, in the Chair)
I guess you could always make the case that we should not even
travel at all if we wanted really to ultimately save the money, and I guess I
kind of regret from time to time that the debate gets personalized like
that. At no time did I ever criticize
the travelling habits of cabinet ministers.
I mean, I suppose in an ideal world, we might even take the bus, but the
reality is that, you know, I put in 70‑plus hours a week in trying to
understand and trying to expedite issues in this portfolio. I travel maybe a maximum of four times a year.
I guess maybe I will have to sustain the wrath of those who
might say I do not deserve that, but you know, I do not think I abuse travel
and I often try to combine the efforts of a plane trip with either expedition
of work or catching up on some sleep.
If that offends some individuals, then I guess maybe my simple
advice would be to those individuals, they should get involved in elected life
and seek to become a cabinet minister and enjoy all of the wonderful benefits
and exorbitant and extravagant pay, the lack of pressure, the genuine love and
affection expressed to them by all Manitobans for doing exactly the right thing
100 percent of the time, and then maybe some of those individuals who from time
to time‑‑it has only happened to me once‑‑have sent me
an unsigned note, might reconsider the narrowness of their approach. I guess I am trying to be as genteel as I
can, but I am not too much apologizing for myself flying in business class and
I am not apologizing for my deputy doing the same thing because I put in 70
hours, and I swear he puts in 90.
If we are down to the judgment of our abilities as ministers
and deputy ministers as to whether we fly economy or business class, I guess we
are down to a pretty narrowed understanding of government today.
Mr. Cheema: Mr.
Acting Deputy Chairperson, I just want to assure the minister and the deputy
minister, I think it is worth discussing because if somebody will read those
comments, they will appreciate what I said from the beginning. If I had my choice, I will probably be more
generous than the minister is or the deputy minister, because as I said from
the beginning, for 80 hours a week it is not more than $3 to $4 extra the
minister makes than all of us in this House and that is very tough.
We live in public perception and the reality of life. The minister said he will not apologize, and
I said the same thing to the person and individual who raised the issues. I said there is no need for those things, but
I said, I will still, as in my responsibility to just make sure that the people
would know that ministers and deputy ministers are not having a fun flight to
They are doing their jobs, and I have no difficulty with
that. I want the minister to be 100
percent sure and positive that if I had my way, then he should probably be
getting more than the Deputy Minister of Health. That is a pity because this is the only
country in the whole world where the deputy ministers are paid more than the
ministers. So I would‑‑
Mr. Orchard: You know,
the hell of it is he will not even share it with me.
Mr. Cheema: Mr.
Acting Deputy Chairperson, I hope that I made myself very clear and not
offended anyone in a real way because that is not my personal intention. That is why I was very clear. I was very sensitive. I did not want to cause undue pressure or
undue discomfort to anyone. I hope that
you do whatever you think is morally and otherwise good for you. I have no difficulty with that.
My question is with the minister in regard to the Standing
Committee on Medical Manpower. Can the
minister tell us, who are the chairs of those committees? Are they the same individuals as they were
last year? What is the budget of that
committee and have they been spending the money allocated to them on a yearly
basis or has there been a substantial savings?
Mr. Orchard: The
Standing Committee on Medical Manpower is still co‑chaired by Doctors Dow
and Postl. Now in terms of the budget we
will gather as much information on actual expenditure for the past year. Do we have that close by?
If it is all right with the member for The Maples (Mr. Cheema)
could we provide you with that information tomorrow in terms of the actual
budget this year, and what their actual expenditures were last year to give you
an idea of any lapse of funding?
I know that they have undertaken a number of new initiatives
over the last two years with the increased funding that we made available to
the Standing Committee on Medical Manpower, not the least of which is the Pro
Show at the Faculty of Medicine which was held again this year and I think
quite successfully, the Dauphin family residency program and then an enhanced
ability to provide support to students in two of their graduate years.
* (2120)
I think my memory is correct here, but I believe we are
providing twice as many scholarships at twice the dollar value per scholarship
today then what we were when I first came into office. I think that has gone some way to helping
successful recruitment and retention of our new graduates in rural and northern
Mr. Cheema: Mr.
Acting Deputy Chairperson, I want to go into a lot of detail on the Standing
Committee on Medical Manpower at a later time, but I just wanted to ask the
minister, has the minister consulted the committee on one of the
recommendations which was made at the
Mr. Orchard: No, I
would have to say that we have not had a direct discussion with the Standing
Committee on Medical Manpower as a committee or with the co‑chairs, but
we have had some discussions with Dr. Postl, not as necessarily directly tied
or linked to his co‑chairing of the SCOMM, but rather his position at the
Faculty of Medicine.
That is only part of a much larger discussion that we have
undertaken with the dean and the Faculty of Medicine per se, but let me tell my
honourable friend‑‑I am having a little trouble because I raided
the candy bag there, so I am glad that by the time they translate this through
the word machines, your garbled words come out reasonably cogent‑‑how
it fits with a reduction in faculty size.
I think the two can work very effectively together, and that of
course is the nature of our discussions with the Faculty of Medicine, because
for some time, and I will share with you the directness I have shared from time
to time with the dean of Medicine and indeed, I guess, at a meeting at Portage
la Prairie about two and a half years ago around the issue of physician
training in Manitoba and a Manitoba‑made solution, if you will, of
recruitment retention into rural and northern Manitoba.
Currently I think it is fair to say that a significant portion
of our physician recruitment to urban centre physician supply has been
fulfilled by graduates of foreign medical schools. We need to create that solution internally,
and there are a number of initiatives that we have undertaken already and more
to come with the Faculty of Medicine to assure that our recruitment retention
problems will be solved to a greater and greater degree, as years go by, by
The argument from some of the other provinces, like Ontario,
like British Columbia, is that these physicians, once they put in their two‑year
stint in Manitoba, end up moving to Toronto or to Vancouver and causing an
exacerbation of their already oversupply of physician problem.
There is pressure on one end to restrict graduates of foreign
medical schools. We have resisted that,
because we do not have our act together provincially to assure that we have the
ability to fill medical personnel needs outside of
I think that is a very open and very direct indication of, I
think, what I perceive to be the public will of
Mr. Cheema: Mr.
Acting Deputy Chairperson, this issue of the manpower supply in training and
postgraduate training is a very extensive one.
I would pursue it probably tomorrow or some other day. I think there are a number of issues on the
whole in terms of the whole issue of the national standards and national
training and postgraduate spots and how the scene is going to be made, which
school is going to have less numbers, which province has more medical schools,
which province has more medical students per capita population.
I think all those things have to be considered, and certainly I
would like to go into detail on those issues.
I think it is very important for us in
Ms. Wasylycia-Leis: A few
more questions on this area, and maybe we can even pass a line tonight,
although I am not so sure. Over the
dinner hour my fortune in the Chinese cookie said, depart not from the path
which fate has you assigned. So I am not
so sure it would be wise to move on, but perhaps we might since some of these
questions could be asked at any point, anywhere in the Estimates.
Just on a couple of points as follow‑up to the member for
The Maples (Mr. Cheema). The questions
of the advisory network and SCOMM reporting are now under the Manitoba Health
Board, I think, in my mind denotes a significant departure from previous
arrangements and a further problem in terms of the integration of these
important areas into the department.
* (2130)
I am not sure why the minister has those two important areas in
his department in effect now reporting to what I would assume to be a
politically appointed board.
Mr. Orchard: Mr.
Acting Deputy Chairperson, the Manitoba Health Services Commission board
assumed to be the Manitoba Health Board with passage of the amendments that I
introduced on Friday, under the change, yes, it is appointed by Lieutenant‑Governor‑in‑Council
as it always has been.
The difference being in this reorganization is that now the
Manitoba Health Board will have a role and responsibility beyond the function
it enjoyed as the commission board. In
other words, now the Manitoba Health Board will have the opportunity to review
and give comment on all of the areas of the department, not narrowed to the
commission responsibilities that are outlined in Resolution 71.
The Health Advisory Network, in terms of its role, was a consultative body on a number of areas of the ministry of Health. Some of them‑‑Continuing Care, for instance, was investigated under Services to Seniors.