LEGISLATIVE ASSEMBLY OF MANITOBA

Thursday, April 16, 1992

       

The House met at 1:30 p.m

 

PRAYERS

 

ROUTINE PROCEEDINGS

 

PRESENTING PETITIONS

 

Mr. Oscar Lathlin (The Pas):  Mr. Speaker, I beg to present the petition of Phillip Buck, Lloyd Easter, Leonard Naskapow and others requesting the government to show its strong commitment to aboriginal self‑government by considering reversing its position on the AJI by supporting the recommendations within its jurisdiction and implementing a separate and parallel justice system.

Mr. Gregory Dewar (Selkirk):  Mr. Speaker, I beg to present the petition of June Phillips, Monika Hansen, L. Olafson and others requesting the Minister of Family Services (Mr. Gilleshammer) consider a one‑year moratorium on the closure of the Human Resource Opportunity Centre in Selkirk.

 

READING AND RECEIVING PETITIONS

 

Mr. Speaker:  I have reviewed the petition of the honourable member for Radisson (Ms. Cerilli), 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 province of Manitoba humbly sheweth that:

       WHEREAS the Dutch elm disease control program is of primary importance to the protection of the city's many elm trees; and

       WHEREAS the Minister of Natural Resources himself stated that, "It is vital that we continue our active fight against Dutch elm disease in Manitoba," and

       WHEREAS, despite that verbal commitment, the government of Manitoba has cut its funding to the city's DED control program by half of the 1990 level, a move that will jeopardize the survival of Winnipeg's elm trees.

       WHEREFORE your petitioners humbly pray that the government of Manitoba may be pleased to request the Minister of Natural Resources (Mr. Enns) to consider restoring the full funding of the Dutch elm disease control program to the previous level of 1990.

       As in duty bound your petitioners will ever pray.

* * *

       I have reviewed the petition of the honourable member for Transcona (Mr. Reid).  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 province of Manitoba humbly sheweth:

       THAT the bail review provisions in the Criminal Code of Canada currently set out that accused offenders, including those suspected of conjugal or family violence, be released unless it can be proven that the individual is a danger to society at large or it is likely that the accused person will not reappear in court; and

       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 Province of Manitoba may be pleased to request that the Minister of Justice (Mr. McCrae) call upon the Parliament of Canada to amend the Criminal Code of Canada to permit the courts to prevent the release of individuals where it is shown that there is a substantial likelihood of further conjugal or family violence being perpetrated.

       

PRESENTING REPORTS BY STANDING AND SPECIAL COMMITTEES

       

Mrs. Louise Dacquay (Chairperson of the Standing Committee on Municipal Affairs):  Mr. Speaker, I beg to present the Third Report of the committee on Municipal Affairs.

Mr. Clerk (William Remnant):  Your Standing Committee on Municipal Affairs presents the following as its Third Report.

       Your committee met on Tuesday, April 14, 1992, at 8 p.m. in Room 255 of the Legislative Building to consider bills referred.

       Your committee heard representation on Bill 45, The City of Winnipeg Amendment, Municipal Amendment and Consequential Amendments Act; Loi modifiant la Loi sur la Ville de Winnipeg, la Loi sur les municipalites et d'autres dispositions legislatives, as follows:

       Deputy Mayor Dave Brown ‑ City of Winnipeg Mr. John Bock ‑ Private Citizen Mr. Marcel Taillieu ‑ Private Citizen Mr. Don Fleming ‑ Private Citizen Ms. Elizabeth Fleming ‑ Private Citizen Mr. Jarl Johnson ‑ Headingley Taxpayers Association

       Your committee has considered Bill 45, The City of Winnipeg Amendment, Municipal Amendment and Consequential Amendments Act; Loi modifiant la Loi sur la Ville de Winnipeg, la Loi sur les municipalites et d'autres dispositions legislatives, and has agreed to report the same with the following amendments:

       MOTION:

       THAT the proposed subclause 4(1)(b)(i), as set out in section 3 of the Bill, be amended by striking out "town, village or".

       MOTION:

       THAT Section 3 of the Bill be amended by adding the following after the proposed subsection 4(3):

       Study of impact required 4(4) The Lieutenant Governor in Council shall not exercise the powers under subclause (1)(b)(i) or (ii) unless a study of the impact of the proposed incorporation or the proposed transfer of part of the city has been conducted and made public.

       MOTION:

       THAT the proposed clause 4.1(a), as set out in section 3 of the Bill, be amended by striking out "town, village or".

       MOTION:

       THAT the proposed section 4.2, as set out in section 3 of the Bill, be struck out.

       MOTION:

       THAT the proposed subsection 38.1(1), as set out in section 10 of the Bill, be amended

       (a)  in the proposed clause (a), by striking out "town,  village or";

       (b)  in the proposed clause (c), by striking out "new town,  village or rural municipality or the part of The City of  Winnipeg transferred to the adjoining municipality" and  substituting "new rural municipality or the part of The  City of Winnipeg transferred to the adjoining  municipality or to persons in that new rural  municipality or part of The City of Winnipeg", and by  striking out "new town, village or rural municipality or  adjoining municipality" and substituting "new rural  municipality or the part of The City of Winnipeg  transferred to the adjoining municipality or to persons  in that new rural municipality or part of the City of  Winnipeg"';

       (c)  in the proposed clause (d),

        (i) by striking out "town, village or" where it first  occurs,  (ii) by adding "under and in accordance with The City of  Winnipeg Act, The Municipal Assessment Act and any other  Act of the Legislature and any regulation under any of  those Acts" after "perform the duties", and  (iii) by striking out "town, village or rural  municipality" before "to make payment" and by  substituting "rural municipality or its inhabitants";

       (d)  in the proposed clause (e),

        (i) in the proposed subclause (iii), by striking out  "mayor or",  (ii) in the proposed subclause (vii), by striking out  "town, village or" in the English version,  (iii) in the proposed subclause (viii), by striking out  "town, village or" and substituting "new".

       MOTION:

       THAT section 10 of the Bill be amended by striking out the proposed subsection 38.1(3) and renumbering the proposed subsection 38.1(4) as subsection 38.1(3).

       MOTION:

       THAT the proposed subsection 38.3(1), as set out in section 10 of the Bill, be amended by striking out "town, village or" wherever it occurs.

       MOTION:

       THAT the proposed section 38.4, as set out in section 10 of the Bill, be amended by striking out "town, village or".

       MOTION:

       THAT the proposed clause 38.6(1)(a), as set out in section 10 of the Bill, be amended by striking out "town, village or".

       MOTION:

       THAT the proposed subsection 38.6(2), as set out in section 10 of the Bill, be amended by striking out "town, village or" in the English version.

Mrs. Dacquay:  Mr. Speaker, I move, seconded by the honourable member for La Verendrye (Mr. Sveinson), that the report of the committee be received.

Motion agreed to.

* (1335)

 

MINISTERIAL STATEMENTS AND TABLING OF REPORTS

 

Hon. Donald Orchard (Minister of Health):  Mr. Speaker, I have a ministerial statement on the report of the CT Scanning Committee and our radiologist consultant's report‑‑copy of the statement, copy of the two summary reports for my honourable friends.

       Mr. Speaker, in addressing issues related to the health of Manitobans, I have made a commitment and demonstrated an approach which seeks the widest possible consultation and the best advice available in formulating policy and programs aimed at maintaining and improving the health status of Manitobans.  New technologies are reviewed in terms of appropriate protocols, cost effectiveness and contribution to health status outcome, including issues of safety and public protection.  Examples of this commitment include the research from the Centre for Health Policy and Evaluation and the report of the Working Group on Breast Cancer Screening.  In this context the government of Manitoba and all governments across Canada are concerned about the rising cost of technology and proliferation of technological options and choices available to our consumers and health professionals alike.

       The demands being placed on our system have to be evaluated in the context of questions such as:  Can the technology improve the health status of Manitobans; how can it be integrated into the delivery system; and what are the future operating costs? These questions must be posed to determine whether this expenditure of scarce resources will achieve a greater improvement to general health status than other new spending options regularly presented to the ministry of Health.

       The provincial radiology consultant, Dr. Douglas MacEwan, provided us with a report entitled An Analysis of the Current Clinical Activity to Assist in Policy Development Regarding the Purchase and Operation of Additional CT/MRI Equipment in Manitoba.

       Dr. MacEwan reports that Manitoba has an adequate supply of scanners in operation now, and following a review of the scanner usage and waiting list, he concludes at this time Manitobans have appropriate access when scanning is required.

       Manitoba currently has six CT scanners in operation for a population of one million people which is comparable to the Canadian average.

       Dr. MacEwan's report says there were nearly 34,000 CT examinations performed for patients in the last year covered by his initial study.  He states such significant usage shows that with the six CT scanners currently in operation, the public has reasonable access to imaging services.

       Since 1976, Mr. Speaker, costs for medical imaging have risen from $16 million to $68 million.  In the past three years, four urban hospitals, four rural and northern hospitals and the Manitoba Cancer Treatment and Research Foundation have requested permission to purchase and operate CT scanners in addition to the six scanners currently in operation.

       I am gravely concerned about the proliferation of new CT scanners without appropriate clinical justification and access protocols.  My foremost consideration is for the health status of Manitobans and the protection of patients.  I was concerned that Dr. MacEwan's report be reviewed by a cross section of experts and for this reason the CT Scanning Committee was formed.

       Today I am pleased to provide you with the report of the CT Scanning Committee.  The work done by this committee challenges the escalating costs and choices associated with the technology and has developed recommendations based on scientific data and on an analysis of the services which are being provided in the context of the health needs of our citizens.

       I accept the report and the recommendations of the CT Scanning Committee which states:  1. That available funds contemplated for an additional CT scanner installation be used for patient needs at the present sites, and that no money be allocated for the acquisition or operation of additional CT scanners at this time; and secondly, that an ongoing committee be established to deal with all future issues regarding computed tomography and magnetic resonance imaging scanning.

       Given the challenges, both financial and program reform, facing all governments today, including the government of Manitoba, I accept the recommendations and will take immediate action to implement them.

* (1340)

       In taking this decision, I want to acknowledge the various fundraising efforts directed to CT scanners.  Manitoba Health endorses community fundraising for new hospital programs, but at the same time, government must proceed cautiously to ensure that these actions are integrated into overall provincial planning for optimum health care delivery.

       It is understood that CT scanners have been purchased by community hospitals and are planned in rural hospitals based on public fundraising and support.  Our older policy allowed such action if no new costs were to be incurred or actual savings were anticipated.  This has been the basis of similar hospital actions in the past.  Manitoba Health has found that almost all such optimistic projections have been wrong and acceptance of the recommendation of the CT Scanning Committee means a change in policy.  We will not approve the acquisition or operation of additional CT scanners at this time and will await the recommendations and advice of the CT Scanning Committee to deal with all future issues regarding imaging services.

       To achieve such anticipated benefits, Manitoba Health will require the implementation of protocols for patient access to all existing provincial CT scanning services including those not approved.  Frequent financial statements from all hospital scanner services will be required to ensure that there will be no impact on approved budgets or cause closure of beds or layoff of staff.  No funds will be committed to the operation of additional scanners without the prior input and advice of the provincial CT and MRI committee and the final approval for operation by the Minister of Health.

       Today I am announcing the establishment of a provincial CT and MRI committee which will have the responsibility to deal with all future issues regarding provincial scanning programs.  Dr. Blake McClarty, Director of MRI at St. Boniface Hospital has agreed to chair this committee which will begin its work immediately.  I have requested that the committee include in its early deliberations investigations and advice on the operating practices of all the current CT centres, continue the ongoing assessment of the imaging waiting lists and develop protocols for utilization of imaging services.

       In addition, I would also like to announce further action taken by the ministry in response to the report of the CT Scanning Committee.  We will establish a Manitoba Imaging Advisory Committee to co‑ordinate the activities of all the imaging subspecialties including CT/MRI Committee, the provincial Ultrasound Advisory Committee, the Nuclear Medicine Advisory Committee and the Radiology Advisory Committee.  This new overview committee will include representatives from the clinical, hospital and professional bodies and the chairs of the designated subcommittees, which will better enable the development of health imaging policies for the future of Manitoba.

       I will ask the committee to emphasize patient access and benefits and to provide an overall provincial program which establishes the context for approving future capital and operating imaging dollars.  In the future, there has to be a priority to introduce new technology as a replacement of existing technology and costs as opposed to add on costs and services. Our difficulty in the past has been a proliferation of technology and related costs whenever new services are introduced.  As I mentioned earlier, costs of imaging in this province have increased 450 percent since 1976, and this cannot continue or it will place at risk our ability to deliver all our health services to the people of Manitoba.

       The CT Advisory Committee will be directed to immediately address the question of how the current global dollars can best be spent and reallocated if this is deemed more appropriate.

       In closing, I want to thank the chairman and the members of the committee for the professional and technical advice which they have provided to us in addressing this very complex and important policy issue.  Committee representatives will be present today at 3:15 p.m. in Room 254 to present their findings and respond to questions.  All of us are aware, Sir, of the benefits which can be derived from the appropriate use of available technology in the diagnosis and treatment of illness.

       This government's commitment is to the health and well‑being of all our people.  This government is committed to ensure that all of our health programs are kept in balance and that they are managed in a way which preserves the integrity of the spectrum of all services necessary to maintain and improve the health status of Manitobans.  Thank you.

* (1345)

Ms. Judy Wasylycia-Leis (St. Johns):  Mr. Speaker, let me say at the outset that I will not be making a definitive statement on the part of the New Democratic Party in response to such a detailed technical statement.  This the first time we have seen this material.  There is much to review, and we will be making further comments at some point in the future.  I can say on a preliminary basis that we acknowledge this is one important part of a health care reform agenda.

       We on this side of the House have always said that part of the need to change our system must be to get a handle on escalating costs tied to new technologies, new drugs, new treatments for which we have not done proper tests and determined if the outputs justify the expenditure.  So, Mr. Speaker, let that be clearly noted since the Minister of Health (Mr. Orchard) and the associate Minister of Health like to leave the opposite impression.

       Let me say that this whole area of CT scanners is a very major one for our hospitals, for our patients, and our community services.  We know that there are a number of hospitals with CT scanners sitting, not being operated in their facilities.  They are engaged in a number of fundraising activities to try to see those scanners operational, and they have requests before this government for operating those scanners.  I do not know on the basis of this statement if those scanners now purchased will receive operational dollars through the provincial government.  I do not know if the minister has included those scanners in the overall assessment of what is the optimum number of scanners.  I do not know if those communities have been told‑‑and those community facilities have been told to stop your fundraising efforts, we will ensure a comprehensive system and all patients' needs addressed through this proposal and this committee and the work of this committee.

       We do not know, Mr. Speaker, if this study has assessed the needs of those facilities to have standards in the context of the costs associated with transporting patients with nursing staff, with assistants, with medication and machinery to hospitals where that scanner is located.  We will have to assess all of those questions and this announcement today in that context.

       I want to say two other things.  This is one small part of that whole issue of whether or not new technology is warranted vis‑a‑vis the outcome for patients.  There are hundreds and hundreds and hundreds of tests and treatments and procedures and surgeries and drugs which are now being used for which we do not know if the output for the patient benefits the expenditure. What we hope for at some point in the near future is some idea from this government of how they will handle such a massive undertaking.  We believe that such a massive undertaking is really almost impossible without the benefit of federal government involvement and a federal health care policy role.

       That, Mr. Speaker, is one of the reasons why we have been so concerned about federal policy which will see the end of federal dollars for provincial health care systems in a few short years leaving our systems in serious disorder and without the universal principles we believe in.  How does it make sense for each province to be going off doing these separate expensive assessments with all these committees and using the time of professionals and experts when it could be done centrally by the federal government for the benefit of all provinces?

       One thing, Mr. Speaker, we would like to urge today is that this government once and for all speak up about federal cutbacks in health care spending, speak up to save medicare and in the process guarantee themselves a much more cost‑effective, sensible way to go in terms of quality assurance of scanners, tests, procedures and drugs.

       Finally, let me indicate that this from the basis of what we can see is a positive step.  All too often, the minister and the Liberal critic have suggested we have not been constructive in our approaches.  When we have seen some sign of progress, when we have been presented with some plans, we analyze those as objectively as possible and, in this case, on the basis of preliminary knowledge we can say that the government is moving in the right direction.

       However, Mr. Speaker, we remain concerned that we are still operating primarily in a vacuum without the benefit of an overall plan in terms of the continuum of care from community‑based services right through to hospitals.  We need to know on an urgent basis the minister's plans in that regard.  We once again put to him our plea on behalf of all Manitobans to tell us what is your plan and your vision for health care in Manitoba.

* (1350)

Mr. Gulzar Cheema (The Maples):  Mr. Speaker, we are very pleased to receive this report.  It says basically two things.  First of all, the process is opening up.  That is another example that the judgment call on all the health care reform has to be made by the public at large.  That is one step.  When the committee is going into Room 255, that will be another evidence that the people can have full knowledge of these reports that are very, very important.  That has never been done in any part of this country so far.

       Mr. Speaker, the focus has to be the patient care, how we spend $1.8 billion.  As we have said for the last four years, we cannot deal with the fragmented part of the issues.  We have to deal with first of all what is our Manitoba prospective, how we are going to deal with our own population here.  All the policies have to be based on our experience.  Our experience in Manitoba, as it says from this report, says very clearly that the CT scanners, whatever we have right now are sufficient.  I think we will let the expert be the judge, and with the battery of information the minister has provided and the knowledge of these individuals, we have no doubt that they are doing the right thing.

       Mr. Speaker, the issue here is how much we can afford and what is possible.  The technology, as we said from Day One, has its merits but also has some limitations.  We have to see what is necessary, what we can afford, and not what is required all the time.  The issue as I said many times is that in health care for us is how we are going to save whatever we have and then we can improve.  That is another example.

       The minister has made a commitment that he is going to come up with two or three more reports by the end of this month.  We will ask him again to continue with his public education campaign, tell people how his government is going to spend their tax dollars.  That is the essence of the whole matter, rather than every day the patients in Manitoba right now would get information from the vested groups. They have their own interest.  What we want to see is each and every group on the same table.  Let them tell us how they are going to spend $1.8 billion, not what is good for each group.  That is again, very important.  I will emphasize again that does not necessarily deal with this report but that is the basic issue, how we are going to spend the money in the long run.

       We want to make sure that this health care debate is taken out of the hands of politicians and that is one way of doing it, by having a public education campaign.  The more information we have, the more informed judgment we can make.  We will again commend the minister to continue to follow the process of opening the health care reform to all Manitobans.  It does not matter which party they voted for, absolutely, we have to work for all of them and that is our aim.  We must keep one thing in mind, patient care is the most important thing and the money will and should move where the patient goes, not to any particular interest group in this province.

 

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 Mr. Obie Baizley, who is the former member for Osborne.

       On behalf of all honourable members, I welcome you here this afternoon here, sir.

       Also, with us this afternoon, we have from the Teulon Collegiate, thirty Grade 9 students. They are under the direction of Mr. Al Reisch.  This school is located in the constituency of the honourable member for Gimli (Mr. Helwer).

       On behalf of all honourable members, I welcome you here this afternoon.

 

ORAL QUESTION PERIOD

 

Federal Government

Untendered Contracts

 

Mr. Gary Doer (Leader of the Opposition):  Mr. Speaker, Manitoba has been working for decades to maintain its aerospace industry in Canada.  We have had ups and downs in our aerospace industry and jobs connected to the aerospace industry.  We have had terrific development that has taken place in our province.  We have also seen the removal of the Air Canada maintenance base and we saw the tragic result of the federal Conservative government tendering process with the CF‑18 decision awarded to Quebec without any merit at all being considered.

* (1355)

       Mr. Speaker, today again we are advised that a company that was given a $245‑million grant from the Canadian taxpayers to the province of Quebec to establish a Bell helicopter company was given a $1‑billion untendered contract from the federal Minister of Defence and the federal Conservative cabinet, Marcel Masse and the Conservative cabinet in Ottawa, for a contract for helicopters that is double what was anticipated to be necessary by the department of Canadian defence.

       This, of course, has implications for Manitoba.  Any time we see a situation where there are absolutely no tenders available for other players in the aerospace industry is a tragic situation, Mr. Speaker.

       I would like to ask the Minister of Finance, what action has this government taken dealing with their federal Conservative counterparts on the process which has absolutely no tendering to award a very important contract in the aerospace industry to the total neglect of other companies in Canada and in Manitoba?

Hon. Clayton Manness (Minister of Finance):  Mr. Speaker, I suppose I should probably take the question as notice.  I have been on the plane this morning back from Toronto, and I am not conversant with that particular issue at this point in time.

       I can indicate to the member opposite, however, that certainly we are concerned about all untendered contracts from the federal perspective.  We have always sought balance with respect to Government of Canada or defence provision of services by way of contract.  I would say to the member opposite that given his information and given the representation he makes by way of questions, I am sure the Minister of Industry, Trade and Tourism (Mr. Stefanson) will want to inquire as to the federal government.

       I remind the member, it was a decision that was made in Ottawa.  It was a decision obviously not made in the council chambers within this government, and I think his question would be more appropriately addressed to probably a federal member.

 

Federal Government

Untendered Contracts

 

Mr. Gary Doer (Leader of the Opposition):  Mr. Speaker, there are Manitoba companies located within this province that have to have the benefit of Manitoba representatives from Manitoba's cabinet that sits opposite us here today.  So the question is very much in order as many other decisions of the federal government affecting jobs in Manitoba and the position of one of our most important industries.

       The aerospace industry has been identified by all sides as a very important industry in this province, an industry which quite frankly we are always on constant vigil to protect because of the preferential treatment of the federal government, not just this federal government but the previous Liberal government as well, with the change in the Air Canada maintenance base.

       I would ask the Deputy Premier, given the fact that the contract was awarded without tender on April 7, can the Deputy Premier advise us, has the Chair of the Economic Committee of Cabinet, the Premier (Mr. Filmon), picked up the phone and talked to the Prime Minister of the country about a tendering process that does not allow for other companies in Canada to be involved, a tendering process that was no tendering process, a process that doubled the purchase of equipment and may have some long‑term harm for our own companies in terms of the existing overhauled contract for Huey helicopters that are being performed in the province of Manitoba?

Hon. James Downey (Deputy Premier):  Mr. Speaker, as far as any details of the question are concerned and any contacts that have been made or discussions, I will take this as notice from the Leader of the Opposition.  But I can assure the member that this government, on behalf of the aerospace industry or any other industry, are prepared to take on their behalf to the federal government their argument and our argument in support of all the activities possible in this province, and we do believe in the fairer open tendering process.

* (1400)

Mr. Doer:  Mr. Speaker, I would ask again the Deputy Premier, in light of his statements:  Has this government been alerted by our Ottawa office about the lack of tendering process in this area? Has the government been in touch with Bristol?  Bristol is obviously very worried about raising this publicly because obviously the federal government is their major client, so they have to be very diplomatic in their comments.  Our information from Bristol is that they are very worried about the future maintenance because the size of the contract has been doubled now for new helicopters.  Have they been in touch with Bristol?  Have they been in touch with their Ottawa office?  Did we get an early warning, and was the Premier (Mr. Filmon) in touch with the Prime Minister of the country about another example of preferential treatment in this country in the aerospace industry at the potential detriment of Manitoba?

Mr. Downey:  Mr. Speaker, we were informed that it was an untendered process that was carried out after the fact.

 

Health Care System

CT Scanner Fundraising

 

Ms. Judy Wasylycia-Leis (St. Johns):  In the Minister of Health's statement today, the Minister of Health acknowledges that there are a number of fundraising efforts happening in community and rural hospitals pertaining to either the purchase and/or operation of a CT scanner.  I wonder if the minister today could share with us the information concerning how many CT scanners have been purchased by community urban hospitals and rural hospitals which are not operational.  What will be the status of those CT scanners in the context of this policy?

Hon. Donald Orchard (Minister of Health):  Mr. Speaker, I am informed that there is one scanner purchased and currently in operation without the approval of the provincial government in the city of Winnipeg.  That installation, because it is not approved, the facility has not asked for, nor have they received operational funding for that scanner.  That is exactly the issue that the CT/MRI Committee will come around in terms of attempting to put budgetary parameters around our global expenditure for CT imaging in the province of Manitoba.

       What has tended to happen in the past, when new technologies have been introduced, when first introduced‑‑and certainly this was the case, as my honourable friend will recognize‑‑in 1979, when we were last in government and the first CT scanner was installed, there were very effective protocols put in place for patient access to that imaging technology.  They worked, but with the proliferation of more scanners, those protocols tended to be, as observed by Dr. MacEwan, our provincial radiologist, not effectively adhered to and hence the statistic that I shared with my honourable friend, the 450 percent growth in imaging cost.

       So the committee is trying to come around the global budget for CAT scanning in the province of Manitoba so that we do not simply use the technology because we have more of it available.

Ms. Wasylycia-Leis:  Let me just try to ask this question again in terms of some specific examples because I am still not quite sure how it is going to work.

       We know that at Concordia Hospital, there is a CT scanner sitting, having just been purchased and waiting to be operational.  What will happen now?  Has the minister approved the operation of that CAT scan in the context of this plan, or will the community be allowed to proceed to fundraise for that CAT scan?  Where does it fit in terms of this plan?

Mr. Orchard:  The installation referred to, it is my understanding that community fundraising has already supported the capital cost of the purchase of that scanner.  Hence, the scanner has been purchased, but there has been no approval given to the installation and the budgetary commitment to operate that scanner.

       The case made by this facility, I believe, is that they can operate this facility from within their current global budget. That is why, Mr. Speaker, I have indicated in my ministerial statement, and possibly I might quote directly from my statement because I think it summates‑‑we are asking for frequent financial statements from all hospital scanner services.  This will be required to ensure that there will be no impact on approved hospital budgets or cause closure of beds or layoff of staff by diversion of budget to unfunded operations such as the CT scanner.

       In other words, Mr. Speaker, we are not prepared as government to accept criticism that we are not providing enough money within the global budget when some of it is able to be diverted to nonapproved operations, Sir.

Ms. Wasylycia-Leis:  Well, that does beg the question that we have been asking for months‑‑what is the overall budget policy for hospitals in urban Manitoba?  However, I am not going to get into that now.  We will pursue that later in Estimates.

       Let me ask this question giving another example.  Seven Oaks General Hospital is involved in a community fundraising effort to purchase a CAT scanner, I believe, unlike Concordia where it has already been purchased.

       What direction will this minister give Seven Oaks?  Will it be encouraged to carry on the fundraising?  Will it be directed to try and‑‑

Mr. Speaker:  Order, please.  The question has been put.

Mr. Orchard:  Mr. Speaker, that is why I recognized in this statement that for a number of purposes in our hospital system, fundraising efforts are underway.  Some of them are focused on the acquisition of CT scanners and I say that, Sir, with the full knowledge that provincial approval for the installation of that was required.

       Mr. Speaker, I applaud the volunteer effort and the voluntary contribution toward fundraising by Manitobans.  Currently, the tri‑hospital lottery is ongoing.  Two of the three hospitals are wishing to dedicate those dollars, those profit dollars from the lottery, toward the acquisition of CT scanning capacity.  That is exactly where the policy of this government has to come down in terms of funding.  We have indicated that within the global budget that is currently there for imaging via CAT scanning, we will want to assure that needs are met, not wants.

       As I have indicated in my earlier answer, when new technologies have been introduced, they have been used propitiously but with proliferation of the technology, protocols for access have gone to the side, and we are insisting that those protocols be established and adhered to by the advisory committee we are setting up under the chairmanship of Dr. McClarty.

 

Health Care System

Out-of-Province Patients

 

Mr. Gulzar Cheema (The Maples):  Mr. Speaker, my question is for the Minister of Health.

       According to the information provided by the minister during the Estimates process, there is about $80,000 per year for the last three years of uncollected bills by the patients out of this country who have not paid their bills and have been getting treatment from our hospitals.  Taxpayers' money must be treated with respect.

       Can the minister tell us what measures he is going to take to ensure that the $80,000 per year tax drainage out of this country, out of this province, will not happen ever again?

Hon. Donald Orchard (Minister of Health):  Mr. Speaker, I would like to be able to say that we could give that assurance within the policy development that the hospitals adhere to.

       We dealt with this issue a couple of weeks ago in Estimates, and I think it is important to put in context the $80,000 per year that we have not been able to recover.  We provide services to some, particularly American citizens, and where those services are prescheduled or electively booked, our hospitals or physicians make the recoveries of the charges appropriate.

       Where our difficulty has come in with these approximately $80,000 per year, Sir, is these are American citizens and citizens from other countries who were involved in an accident and require emergency services.  The compassion of our Canadian health care system applies here in that we do not check to see if the person is going to pay the bill before we provide the service.  That has left us in the difficult circumstance where up to $80,000 per year has been uncollected because after providing the service and recovery of the individual, they have left the country, and we have not been able to collect those dollars, as hospitals.

Mr. Cheema:  Mr. Speaker, can the minister tell us, what is the impact of these uncollected bills on particular hospitals because some of the hospitals were serving those patients?

Mr. Orchard:  Mr. Speaker, the obvious first effect is that they are out the money, because they have provided those services and did not recover them from the person who was not a Canadian, so that the costs assigned to providing those services have been absorbed in previous years within the budgets of those hospitals.

Mr. Cheema:  Mr. Speaker, can the Minister of Health tell us what measures are going to be put in place to make sure that only in the case of emergency situations there could be compassionate reasons, but in other cases, where patients are getting treatment on an elective basis, they must pay their bills in advance?

Mr. Orchard:  Mr. Speaker, I think basically most of the out‑of‑country services are provided in that fashion.  I cannot say that it is perfectly applied because there may well be circumstances where advance arrangements for an elective procedure may be left unpaid after the fact, but those, I am told, have tended to be very few and far between.

* (1410)

       It is the very difficult issue where most of the dollars are uncollected and remain outstanding debts in the provision of emergency service caused by an accident wherein the person recuperating leaves the country.  Those are the very difficult ones because I think as cost‑conscious as we want the system to be, it is pretty difficult to make that judgment that if they are from out of country that we should get a cheque first before we provide the service, and that is always the quandary health professionals are in, Sir.

 

Agricultural

Land Taxation Levels

 

Mr. John Plohman (Dauphin):  Mr. Speaker, while this government on the one hand talks about lower property taxes for farmers, it is with the other hand reaching deep into farmers' pockets to pay for the agricultural budget.

       They are reaching into hard‑pressed farmers' pockets, Mr. Speaker, by shifting the burden of property taxation away from the residential category onto the farm category through portioning changes that have been made this year and by a reduction in the residential mill rate, thereby increasing the special levy to record levels.  The Minister of Rural Development is using Bill 20 as well to perpetuate an unfair assessment system and to stifle appeals to that unfair system.

       Why has this Minister of Rural Development abandoned the stated policy of this government of lowering taxation on farm land, and why has he chosen this duplicitous act on farmers to force them to pay more?

Hon. Leonard Derkach (Minister of Rural Development):  Mr. Speaker, I have to remind my honourable friend opposite that it was this government that removed the ESL on farm land for the farmers of our province.  We were then compelled to do the reassessment and indeed to make up the revenues from general revenue.  The farmers of our province have been able to access themselves of a benefit in terms of having a reduction in the ESL and the school taxes on their farm land.

       Let me say, Mr. Speaker, that Bill 20 which is before the House at the present time in no way removes the right of a farmer to appeal if there are some extraordinary circumstances which impact on the value of his or her property.  When I go back to the discussions that were held in the assessment bill last year, it is evident that the member who asked the question was very much on the same wavelength in committee when that matter was discussed.

Mr. Plohman:  Mr. Speaker, I am not in favour of the shift that is being made by this government now and secretly.

       I will ask the minister a specific question.  Maybe this minister can explain why he has shifted a greater burden of property tax onto farmers by significant reductions in the portioning on residential properties which results in a greater proportion of the property taxes being borne by the farm category, and that is clear in many municipalities.

Mr. Derkach:  Mr. Speaker, the member knows very well that the reassessment was based on the 1985 value, and that as we move to reassessment in 1994, as is recommended in the proposed bill before the Legislature, that assessment‑‑[interjection] Well, it is 1993, true, but the effect will be in 1994‑‑in fact, then we will be moving the value of farm land closer to the actual time.

       There are adjustments that are going to be made in the process.  The portioning is really meant to make sure that we indeed are more fair in the way we approach taxation from a global sense.

Mr. Plohman:  The special levy is at record levels, Mr. Speaker. Will the minister now admit that he and his colleagues, the Minister of Finance (Mr. Manness) as well, are engaged in a secret act to claw back the meagre benefits that cash‑strapped farmers are receiving under GRIP and NISA, that they are reaching back into the pockets of those farmers?  That is what this government is doing.

Mr. Derkach:  Mr. Speaker, I would have to say that the suggestion is somewhat hideous.  Let me say that special levies are not the responsibility of the provincial government.  Special levies are set by local municipal organizations and indeed school boards.  Therefore it is the responsibility of those organizations to determine what their budgetary levels should be and how they should assess taxation from their perspective.

 

Agricultural

Land Taxation Levels

 

Ms. Rosann Wowchuk (Swan River):  Mr. Speaker, my question is also for the Minister of Rural Development and relates to Bill 79.

       When the bill was introduced, this was considered real tax reform.  We were going to see educational tax removed from farm land and placed on residence as it should be, and farmers would be paying a lesser portion of educational tax.  However, this is not true.

       Councillors and farm groups have indicated, as a result of a shift in portioning and increased special levies, taxes have increased dramatically.  Taxes on a quarter of land have increased in some cases by $50 to $80 per quarter.

       Will the minister admit that there is a flaw in the taxation system that has been implemented and as a result farmers are picking up a larger percentage of educational tax?

Hon. Leonard Derkach (Minister of Rural Development):  Mr. Speaker, that question almost duplicates what was just asked a moment ago, but let me give the response in the same way.

       Let me indicate, first of all, that it is this government that removed education taxation on farm land.  I think the cost of that‑‑and I stand to be corrected‑‑was somewhere in the neighbourhood of $22 million as the cost to the provincial Treasury, so that was a direct benefit to the farmers of this province.

       We have done everything we can to keep taxes down.  As matter of fact, our fifth budget this year froze taxes, did not increase taxes to Manitobans.  When the member opposite makes the allegation that we are shifting the tax burden onto farm families, indeed that is a false allegation.

Ms. Wowchuk:  Mr. Speaker, can the minister confirm to the House that despite the adjustment, the ESL of one point, the tax burden on rural residents and in particular the farmers has increased significantly and that through the special levy, taxation will reach historical levels?  Up to $300 million will be raised through this special levy in the 1992 tax year.  How is the minister going to address this‑‑

Mr. Speaker:  Order, please.  The question has been put.

Mr. Derkach:  Once again, Mr. Speaker, the question is duplicated from that posed by the member for Dauphin (Mr. Plohman), and I say to you again and to the House that indeed special levies are not something that are determined and set by the provincial government.  The members opposite should understand that special levies are set by local municipalities and local school boards, and they have a responsibility in terms of addressing their budgetary requirements and then assessing the tax levies from there.

 

Education Support Levy

 

Ms. Rosann Wowchuk (Swan River):  I want to ask the minister: How is he going to deal with the fact that although provision has been made to exempt farm properties from educational support levy, farm homes were added to the tax roll?  All other farm buildings, including grain and storage