LEGISLATIVE ASSEMBLY OF MANITOBA

Monday, May 2, 1994

The House met at 1:30 p.m.

PRAYERS

ROUTINE PROCEEDINGS

READING AND RECEIVING PETITIONS

Child Care System

Mr. Speaker: I have reviewed the petition of the honourable member (Mr. Schellenberg). It complies with the privileges and the practices of the House and complies with the rules. Is it the will of the House to have the petition read?

An Honourable Member: Yes.

Mr. Speaker: The Clerk will read.

Mr. Clerk (William Remnant): The petition of the undersigned citizens of the province of Manitoba humbly sheweth that:

WHEREAS under the previous NDP government the province of Manitoba developed the best child care system in North America; and

WHEREAS this child care system was accessible, affordable, of high quality, community‑based and nonprofit; and

WHEREAS the current provincial government has cut salary enhancement grants, increased parent fees, reduced the number of spaces for child care, reduced the number of weeks of child care for parents searching for work; and

WHEREAS many child care centres have seen children withdrawn, have been forced to lay off staff or roll back wages; and

WHEREAS many child care centres are experiencing severe financial problems; and

WHEREAS child care is known to be money saving in the long term, including savings on unemployment insurance, social assistance and other government programs; and

WHEREAS in the 1994 provincial budget child care grants were cut by $300,000.

WHEREFORE your petitioners humbly pray that the Legislative Assembly urge the provincial government to consider restoring funding and accessibility to high quality, affordable, nonprofit child care with decent wages for all child care employees.

Curran Contract Cancellation and

Pharmacare and Home Care Reinstatement

Mr. Speaker: I have reviewed the petition of the honourable member (Mr. Santos). It complies with the privileges and the practices of the House and complies with the rules. Is it the will of the House to have the petition read?

Some Honourable Members: Dispense.

Mr. Speaker: Dispense.

The petition of the undersigned citizens of the province of Manitoba humbly sheweth that:

WHEREAS the Manitoba government has repeatedly broken promises to support the Pharmacare program and has in fact cut benefits and increased deductibles far above the inflation rate; and

WHEREAS the Pharmacare program was brought in by the NDP as a preventative program which keeps people out of costly hospital beds and institutions; and

WHEREAS rather than cutting benefits and increasing deductibles the provincial government should be demanding the federal government cancel recent cuts to generic drugs that occurred under the Drug Patent Act; and

WHEREAS at the same time Manitoba government has also cut home care and implemented user fees; and

WHEREAS the Manitoba government is giving an American health care consultant over $4 million to implement further cuts in health care.

WHEREFORE your petitioners humbly pray that the Legislative Assembly urge the Premier to personally step in and order the cancellation of the Connie Curran contract and consider cancelling the recent cuts to the Pharmacare and Home Care programs.

APM Incorporated Remuneration and

Pharmacare and Home Care Reinstatement

Mr. Speaker: I have reviewed the petition of the honourable member (Mr. Dewar). It complies with the privileges and the practices of the House and complies with the rules. Is it the will of the House to have the petition read?

Some Honourable Members: Dispense.

Mr. Speaker: Dispense.

The petition of the undersigned citizens of the province of Manitoba humbly sheweth that:

WHEREAS the Manitoba government has repeatedly broken promises to support the Pharmacare program and has in fact cut benefits and increased deductibles far above the inflation rate; and

WHEREAS the Pharmacare program was brought in by the NDP as a preventative program which keeps people out of costly hospital beds and institutions; and

WHEREAS rather than cutting benefits and increasing deductibles the provincial government should be demanding the federal government cancel recent cuts to generic drugs that occurred under the Drug Patent Act; and

WHEREAS at the same time Manitoba government has also cut home care and implemented user fees; and

WHEREAS the Manitoba government paid an American health care consultant over $4 million to implement further cuts in health care.

WHEREFORE your petitioners humbly pray that the Legislative Assembly urge the Premier to personally step in and order the repayment of the $4 million paid to Connie Curran and her firm APM Incorporated and consider cancelling the recent cuts to the Pharmacare and Home Care programs.

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MINISTERIAL STATEMENTS AND

TABLING OF REPORTS

Hon. Leonard Derkach (Minister of Rural Development): Mr. Speaker, I have the honour today of tabling the Supplementary Information For Legislative Review, 1994‑1995 Departmental Expenditure Estimates for the Department of Rural Development.

Hon. James McCrae (Minister of Health): Mr. Speaker, I am pleased to table the Annual Report 1992‑93 of the then‑Alcoholism Foundation of Manitoba.

Mr. Speaker, I am tabling the Annual Report 1992‑93 for the Department of Health, and I am formally tabling today the Supplementary Information for Legislative Review, 1994‑1995 Departmental Expenditure Estimates for the Department of Health, although I made copies available to the party critics on Friday afternoon.

Hon. Bonnie Mitchelson (Minister of Family Services): Mr. Speaker, it is my pleasure to table the Annual Report 1992‑93 for Manitoba Family Services.

Hon. Darren Praznik (Minister of Labour): Mr. Speaker, it is my pleasure to table the Annual Report 1992‑93 of the Manitoba Labour Board.

Hon. Jim Ernst (Minister of Consumer and Corporate Affairs): Mr. Speaker, I am pleased to table the Annual Report 1993 of The Public Utilities Board.

National Forest Week

Hon. Albert Driedger (Minister of Natural Resources): Mr. Speaker, I have a statement.

I wish to share with the members of this House some information on behalf of Manitoba Natural Resources.

During the month of May, Manitobans of all ages will be celebrating three related events.

The week of May 1 to 7 is National Forest Week. We are blessed with a vast wealth of woodlands which have played and continue to play a vital role in Manitoba's and Canada's well‑being on many fronts. This is a most appropriate time to reflect on the economic, recreational and environmental importance of Canada's forests.

May also marks the 75th anniversary of the Manitoba Forestry Association. This local organization has worked continuously to educate and inform generations of Manitobans on the importance of forests and how to protect these valued natural resources for our future, and have provided the members of the House with trees that they see before them here today.

While these two events are significant, I feel that this third is equally worthy of celebration. May is the 50th birthday of one of the most recognized and popular program mascots in North America. Smokey the Bear celebrates five decades of fame as a furry firefighter and friend of forest fans everywhere. His special message, Only You Can Prevent Forest Fires, has reached over half a million Manitobans with the excellent support of the Manitoba Forestry Association.

Together, Smokey and the association have made us more aware of the need to protect the forests while we enjoy them. I ask the members of the House to join me and the Department of Natural Resources in congratulating the Manitoba Forestry Association on 75 years of outstanding service to Manitoba and wishing Smokey a very happy 50th birthday and in urging all Manitobans to participate in the celebration of National Forest Week. Thank you.

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Mr. Oscar Lathlin (The Pas): Mr. Speaker, I am pleased to rise to join the Minister of Natural Resources in commemorating National Forest Week and Arbor Day 1994.

This week is National Forest Week. As the minister said, it is time for all of us to reflect on the economy, recreation and the environment and the importance of those resources not only to Manitoba but throughout Canada.

I, of course, come from northern Manitoba where we still have some forests left. I sometimes compare southern Manitoba and northern Manitoba in a lot of ways. There is another comparison I regularly make when I look at our province of Manitoba and that is, at one time southern Manitoba was not unlike northern Manitoba with the forests and everything, but of course, as development came on, land has been developed to the point now where in southern Manitoba we do not have the forests we used to. Hopefully, northern Manitoba will never turn out to be like southern Manitoba in terms of sustainable development.

I only wish that when it comes to government policy and budgets, these kinds of statements are reflected throughout government policy and in the budgets that governments present from time to time. I, for example, look at the operation in Repap. I wanted to mention that when I looked at the budget for this year, it again had been reduced considerably. I also look at Clearwater Lake Nursery, about how valuable a contribution that nursery had made to the people of northern Manitoba. With those words, Mr. Speaker, I congratulate the Forestry Association for these types of educational programs. Thank you.

Ms. Norma McCormick (Osborne): Mr. Speaker, as well, on behalf of our Liberal caucus, I would like to express our appreciation for the work of the Manitoba Forestry Association, and commend them on 75 years of service to our province.

We must, indeed, recognize that prevention goes beyond forest fire prevention. It is evident that a comprehensive forest management plan is more important today than ever before in ensuring the stewardship of our forests. We are still waiting, after six years of this government, for a comprehensive plan, and we look forward to an equal commitment from our government to leadership in protecting our forest resources. Thank you.

INTRODUCTION OF BILLS

Bill 3‑‑The Cancer Treatment and Research Foundation Amendment Act

Hon. James McCrae (Minister of Health): Mr. Speaker, I move, seconded by the honourable Minister of Education and Training (Mr. Manness), that leave be given to introduce Bill 3, The Cancer Treatment and Research Foundation Amendment Act (Loi modifiant la Loi sur la Fondation de traitement du cancer et de recherche en cancérologie), and that the same be now received and read a first time.

His Honour the Lieutenant‑Governor, having been advised of the contents of this bill, recommends it to the House, and, Mr. Speaker, I would like to table the message.

Motion agreed to.

Introduction of Guests

Mr. Speaker: Prior to Oral Questions, I would like to draw the attention of honourable members to the Speaker's Gallery, where we have with us today, a gentleman celebrating his 50th birthday, the symbol of fire prevention, Smokey the Bear.

On behalf of all honourable members, I would like to welcome you here today and congratulate you, sir.

Also this afternoon, I would like to draw the attention of honourable member to the gallery, where we have with us 18 Japanese social workers from Sappaur, Japan. [interjection] Order, please. These are our guests this afternoon. We have 18 guests from Sappaur, Japan, and these are social workers.

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

Now, from the Ness Junior High School, we have seventy‑five Grade 9 students under the direction of Mr. Baydak. This school is located in the constituency of the honourable Minister of Urban Affairs (Mrs. McIntosh).

Also this afternoon we have, from the Ken Seaford School, twenty‑two Grade 9 students under the direction of Mr. Kraychuk. This school is located in the constituency of the honourable member for The Maples (Mr. Kowalski).

On behalf of all honourable members, I would like to welcome you all this afternoon.

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ORAL QUESTION PERIOD

Economic Growth

Government Strategy

Mr. Gary Doer (Leader of the Opposition): Mr. Speaker, my question is to the Premier.

Last year, to a lot of fanfare and public relations, the Premier announced to the people of Manitoba, in his Framework for Economic Growth, that Manitoba's economy is going to be performing relatively better than most of the country and it is well positioned for growth. The challenge now is to commit to the policy framework that will enable Manitoba to take advantage of opportunities for sustained economic growth.

Unfortunately, again the words have not met up to the actions of the Manitoba economy, and today Statistics Canada reports that Manitoba is tied for last place in economic performance in 1993.

Economic growth allows us to tell whether we are growing as a province, whether people are getting jobs, whether they are getting opportunities, whether our young people can stay in our province, build homes in our province, establish roots in our province, Mr. Speaker.

I would like to know, given the high degree of optimism in the Premier's press conference last year, and the unfortunate results at the end of the year, has the government made any adjustments at all in their economic strategy contained within their framework to deal with the reality of our growth rate rather than the optimistic pronouncements by the Premier?

Hon. Gary Filmon (Premier): Mr. Speaker, I recommend that the Leader of the Opposition do a little analysis and find out just exactly what is contained within that Statistics Canada report, because were he to do that, he would find that the most negative impact and the major impact on that factor from a Manitoba perspective was the effect of last summer's abnormally heavy rainfall which resulted in a $308‑million loss to the farm economy.

If the nonfarm‑sector economy is separated from the farm‑sector economy, he will find that Manitoba's economy outperformed the national average. According to Statistics Canada, the nonfarm GDP grew by 3.1 percent, well above the national average of 2.7 percent.

As much as I know that he holds me responsible for everything that goes on in this province, I for one cannot accept the responsibility for the heavy rainfalls and the devastation that they wreaked on the farms of Manitoba. As much as I would like to take that responsibility, I cannot accept it.

Provincial Comparisons

Mr. Gary Doer (Leader of the Opposition): Mr. Speaker, the government has produced these types of predictions over the last number of years and, unfortunately, we have had very negative results.

Mr. Speaker, since the Premier has received a majority from the people of the province of Manitoba, a declining majority after the last by‑elections, the government has had a growth rate of .8 percent when all three years are put together‑‑less than 1 percent. We were tied for last or last place in 1991, we were at fifth place in 1992, and we are back to last place in 1993. The national average for those same three years is 4.5 percent.

I would like to know from the Premier, why is Manitoba performing at one‑sixth the rate of the rest of the country? Why is the growth rate in Canada six times greater than in Manitoba? Why are you at 15 percent the national average in terms of growth and performance here in Manitoba?

Hon. Gary Filmon (Premier): Mr. Speaker, as I pointed out to the Leader of the Opposition in my response to the budget, if he looks next door at Ontario, under a New Democratic government, in that same period of time they have had negative growth over that period of time, and the same thing is true of his colleagues in Saskatchewan.

The fact is what we are talking about here in terms of 1993 is as a result of a very, very poor condition in the weather that related to a $308‑million decline in the farm income, in farm production last year. Those are things that most Manitobans can understand, Mr. Speaker. I would hope that the Leader of the Opposition could, as well.

Employment Creation Strategy

Mr. Gary Doer (Leader of the Opposition): Saskatchewan's growth rate was significantly higher than Manitoba's last year, in 1993. Ontario's‑‑[interjection] Well, maybe God is a New Democrat, Mr. Speaker. You blame the opposition, you blame an act of God, you blame Ontario, you blame Saskatchewan, you blame Mulroney, you blame the new Liberal government. You never take responsibility yourself. You never take responsibility.

Mr. Speaker, over the first three months of this year, we have a 20 percent unemployment rate for young people. Now, it did go down over the last month from the month previous, but the trend level is still above the national average. Young people are lining up 24 hours in advance to try to get a job. Many young people are feeling the double pinch of not being able to find employment and having costs go up dramatically with tuition and other increases in costs, some of them directly due to the provincial government.

Will this government have a very active program to put our young people back to work again, so they can stay in Manitoba, so they can get an education in our province and we can start to see our economy growing again, instead of declining as it has under the Conservatives?

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Hon. Gary Filmon (Premier): Mr. Speaker, I would ask the Leader of the Opposition not to try and put words in my mouth or not to try and misrepresent what I said. I did not blame agriculture on this. The fact is I quoted from Statistics Canada's analysis of it in which they said that the farm production was down by $308 million, and if you took aside that, the nonfarm economy outperformed the national average. Now, he may not want to accept that. He may want to be able to use something for his own political purposes, but that is fact and that is reality.

I do not blame my colleagues in Saskatchewan or Ontario either, Mr. Speaker. The fact of the matter is I say to him that he ought to make comparisons, that he ought to know and understand what is happening elsewhere in Canada and elsewhere throughout the world, because those are important things.

With respect to the youth employment programs in this province, I would just say to him that last year, as a result of the programs of this government, 9,457 youth were placed in employment through the Manitoba youth job centres and some 4,976 students were employed as a result of government programs in 1993‑94 government, Mr. Speaker.

He knows full well that the throne speech and the budget did indicate a strong commitment to job creation for our youth in Manitoba in 1994, and he knows, as well, that the youth unemployment dropped by I believe it was 5 percent month over month, and so there is a very strong improving trend as a result of initiatives being taken by this administration.

EITC Project List

Tabling Request

Mr. Jerry Storie (Flin Flon): Mr. Speaker, I certainly do not want to put words in the Premier's mouth, but in 1991, when the Premier announced the yet again shuffling of his economic portfolios and the creation of the Economic Innovation and Technology Council, the Premier said that the government's record would be determined over the next 18 months.

Mr. Speaker, we have seen today that the government's record is one of failure, and contrary to what the Premier says, in Ontario over those same three years the growth rate was five times what it was in Manitoba.

Mr. Speaker, my question is: After a series of failed deals by this government, including MacLeod‑Stedman, Royal Trust and Repap which is announcing more layoffs or the possible downsizing of the wood room at The Pas, a failed deal, can the minister indicate, the First Minister, or the Minister of Industry, Trade and Tourism (Mr. Downey), what direct projects the Economic Innovation and Technology Council has invested in on behalf of the people of Manitoba?

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Hon. Gary Filmon (Premier): Mr. Speaker, I say to him that there are more people employed today by MacLeod‑Stedman's successor company, the company that bought them, Cotter Canada, than there was commitment‑‑[interjection] When Repap, under its former incarnation, Manitoba Forestry Products, was being run by that very member, the member for Flin Flon, it was losing $30 million a year and employing fewer people than it is today. That is the way these things are. The taxpayer paid with huge losses, and still people were being laid off.

The Economic Innovation and Technology Council was not set up to invest in businesses, Mr. Speaker. He ought to look at its terms of reference and the manner in which it was set up. It was set up to spur the development of innovation and technology in this province. As a result of that, this province's new jobs are in areas of the new economy. For instance, during the past year alone, as a result of telecommunications centres being opened up by Unitel, Canada Post and Canadian Pacific, as well as GWE in Brandon, almost a thousand jobs are involved in those four announcements, and those are in the areas of new technology.

I think that is something the member opposite ought to be happy about, instead of always preaching his doom and gloom here.

Mr. Storie: Mr. Speaker, I apologize for appearing to preach doom and gloom, as the First Minister says. What I would like to be able to tell Manitobans is that this government has an agenda.

Mr. Speaker, my question was with respect to the Economic Innovation and Technology Council. It does have a mandate to facilitate the transfer of technology between industry and research facilities.

Mr. Speaker, my question was: What projects has the Economic Innovation and Technology Council invested in? Will the First Minister table a list of those projects and explain what benefit there might be to the people of Manitoba.

Mr. Filmon: The Economic Innovation and Technology Council is there to stimulate the development of our innovation sector and our technology development sector. In addition to those telecommunications jobs that I just referred to, for instance, a company such as Monsanto had spent 10 years developing a dry form of glyphosate and looked worldwide for a place to locate that business, examined over 40 locations, and decided that the climate in Manitoba was the best available anywhere in the world.

That is the kind of development of the new technologies, the new investments in the new economy that are taking place as a result of the efforts of this government as well as its various other agencies such as the Economic Innovation and Technology Council.

EITC Project List

Tabling Request

Mr. Jerry Storie (Flin Flon): Mr. Speaker, simply because the Premier refuses to answer or perhaps does not know the answer, my final question is to the minister responsible for the EITC.

Can the minister explain why the largest single project, the largest single amount of support from EITC, some $500,000, has gone towards an innovations video?

Can the minister explain why that is a priority, and will the minister ensure that is not used like the Lotteries advertising as some pre‑election gimmick?

Hon. James Downey (Minister of Industry, Trade and Tourism): The Economic Innovation and Technology Council is a group of dedicated men and women throughout Manitoba working with the government, whatever stripes, to put forward the best technology activity that they can.

I believe, Mr. Speaker, that they are relatively new. They have put together a communication piece that I think will further communicate and advance the best interests of Manitoba in technology development.

Unlike the New Democratic Party, where they are going around throughout the province bad‑mouthing Louisiana‑Pacific, bad‑mouthing the Ayerst Organics, bad‑mouthing GWE in Brandon, we want to take a positive approach to the development of business to technology in Manitoba.

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Economic Growth

Provincial Comparisons

Mr. Paul Edwards (Leader of the Second Opposition): Mr. Speaker, I, too, read the Statistics Canada report today, as obviously the Premier did, and I was interested in the Premier's answers to my friend the Leader of the Opposition (Mr. Doer) on this subject.

The Premier appears to indicate, and cites the report in saying that because of the problems with the weather in the agricultural sector, we performed poorly in 1993.

I would like the Premier to answer a very simple question which flows from page 7 of that report. Obviously he is familiar with its contents.

In each of the last five years we have underperformed every other province in western Canada. Accumulatively, taken at a total of 3.8 percent growth over the last five years, ours has been 1.9 percent. That is half. That is taking the same measurement in the same years by the same organization. The overall five‑year total is not only half that of western Canada's average, but it is significantly less than the national average which was 2.9 percent. We were 1.9 percent.

Why every single year are we doing worse?

Hon. Gary Filmon (Premier): The Leader of the Liberal Party obviously believes in the same philosophies as those espoused by, as he said, his friend the Leader of the Opposition, because I can tell him that one of the things that is a very fundamental part of any growth measurement is the amount of spending in the economy that governments do.

I can tell him that the model, when evaluated, shows that if the government increased its spending by 3 percent in any year, it would add 1 percent to the GDP growth of the province.

As a result, since this province has been on a fiscal framework that has involved less spending than all of those other provinces which he compares us to, we are doing less towards that consumptive side of GDP measurement. That consumptive side does not add one iota to the competitiveness, to the attractiveness for jobs or for investment in this province. All it does is consume people's tax dollars.

I know that is what the Liberal Party wants to do, but that is not what taxpayers want done.

Mr. Edwards The excuses just keep spinning and spinning and spinning.

Government Forecast

Mr. Paul Edwards (Leader of the Second Opposition): Mr. Speaker, given the Premier's comments, given that the Premier wants to indicate that there is some clear, cogent plan and that we are on track, and he has clearly said that so many times over the last years, why is it that each of the last five years‑‑it is not just that they have been wrong on predicting the economic growth, they have always overestimated it; they have always underestimated the deficit‑‑have they consistently been wrong about growth and overestimated it and underestimated their deficit?

Hon. Gary Filmon (Premier): Mr. Speaker, this government has maintained a record of fiscal management that is unmatched by any government in Canada.

Mr. Speaker, that is not the analysis of members of a political party who want to achieve some kind of cheap hit in Question Period; that is the quote of the Dominion Bond Rating Service. They said, this government has been the most fiscally responsible government in Canada from 1987 to the present.

This government has done that by meeting its targets, by and large, on the deficit and by doing it without raising any of the major taxes. We have met our targets better than anybody else.

Mr. Edwards: Two weeks ago when I questioned the Minister of Finance (Mr. Stefanson) in this area, he said, we rely on Statistics Canada.

Mr. Speaker, I put my faith in Statistics Canada, like the Minister of Finance, above the Dominion Bond Rating Service. They say we are tied for last. That is what they say: tied for last with Newfoundland. If you think we have had problems with rain, their fisheries have basically been wiped out. We are tied with them for last place.

My question for the Premier: Can the Premier explain the comment that he made to the business community in his Gary III: Tory Iron Man article in the Manitoba Business Magazine? Can he explain the comment to the rest of the community when he said in that interview, those who suggest that Canada through its own fiscal and financial policies can change job creation or economic growth in any dramatic way, are speaking nonsense? That was his quote, Mr. Speaker.

Can the Premier acknowledge and explain to us the Kim Campbell view that he appears to take, that it is all lost and we cannot do anything? Why is he leading us to believe that he can do something?

Mr. Filmon: Mr. Speaker, this government has been very straightforward and said time and time again, we can create the climate for investment that will attract businesses, but we cannot be the ones responsible like New Democrats say they are, by spending $300 million or $400 million at a shot of other taxpayers' money to try and do some artificial stimulation of the economy.

The real long‑term jobs in this economy are going to be the ones created by Ayerst, by Monsanto, by Unitel, by Canadian Pacific, by Canada Post, by GWE systems, by Louisiana‑Pacific, by those companies. It is the economic environment that we create, the fiscal framework that we create, that will ensure that we get more than our share of investment.

Forest Management Division

Layoffs

Ms. Rosann Wowchuk (Swan River): Mr. Speaker, at the beginning of National Forest Week, I think it is important that we recognize the importance of the forestry to the economy of this province, but the forest must be developed and managed properly. To do this we have to have adequate staff in place. We need people who will ensure that it is managed properly. However, we hear rumours that there are changes in the Forestry department, and people are going to be let go.

I want to ask the Minister of Natural Resources: How many people are being laid off in the Forest Management branch and what are the implications going to be on the forest management plan that is very important to the economy of this province?

Mr. Speaker: Order, please. I would ask the honourable member for Swan River to ascertain the accuracy of her facts before bringing it to the‑‑[interjection] Order, please. Now we will give the honourable member an opportunity to rephrase her question.

Ms. Wowchuk: Mr. Speaker, can the Minister of Natural Resources tell us how many people are being let go from the provincial Forest Management branch and what is the implication on the forest management plan that is very important to this province?

Hon. Albert Driedger (Minister of Natural Resources): Mr. Speaker, I want to assure the member that there is reorganization taking place within the department of Forestry, and I think that is a very natural thing that happens. Reorganization has taken place in the Department of Natural Resources in the various components, and this is the one component that had not been addressed yet. We are doing that in terms of the specifics of it, in terms of how many employees.

Once we get into the Estimates process, I will go through it job by job if they want to, but I think nothing untoward is happening. I feel very confident that by the time we do a reorganization, we will be able to deal with the challenges that are facing me and my department with forestry issues.

Ms. Wowchuk: Mr. Speaker, the minister said some people are being let go. We want him to confirm today how many people are being let go from the Forest Management, Department of Natural Resources.

Mr. Driedger: Mr. Speaker, I did not say that there were any being let go. I said we were reorganizing the department. I will get the specifics for the member once we get to that point.

Forest Management Plan

Duck/Porcupine Mountains

Ms. Rosann Wowchuk (Swan River): Mr. Speaker, to the same minister: Since January, we have been raising the matter of the sawmill operators in the Swan River area who are concerned about how they fit into the forest management plan, whether there is going to be wood allocated to them. They were assured that they would have an announcement by the end of the month.

Can the minister tell us: What is the plan? Has his department laid out a plan on how all the users fit into the forest management plan in the Duck and Porcupine Mountain area?

Hon. Albert Driedger (Minister of Natural Resources): Mr. Speaker, I just want to tell the member again, as I have in the past, that when the concerns were brought forward by the smaller operators or permit holders, by and large, I gave them the assurance that they would have enough wood allocations to bring them through this cutting period, while we were reorganizing exactly the whole picture in terms of allocations, how Louisiana‑Pacific fits in there with the hardwoods aspect of it.

Hardwoods, which are basically ash and popular, were not even in demand two years ago. This is why Louisiana‑Pacific is coming forward, and because they are coming forward, all of a sudden there is major concern and maybe not unwanted concern by many of the smaller operators that there will not be work.

Mr. Speaker, I want to assure the member that if we get Louisiana‑Pacific to establish the industry here in Manitoba, our operators out there are not going to be able to handle all the work that is going to be available to them.

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Mental Health Care

Emergency Services Review

Mr. Dave Chomiak (Kildonan): Mr. Speaker, over one year ago today, when the then‑Minister of Health announced community‑based services for mental health, a $4‑million program, we welcomed that announcement.

A month ago, when the present Minister of Health was apprised of the situation at St. Boniface and Health Sciences Centre regarding psychiatric patients clogging up the emergency rooms, the minister said on tape‑‑we reviewed the tapes‑‑that he would deal with the problem‑‑a month ago. We did not raise questions because we took him at his word.

On Friday, when we raised the question of the clogging of emergency rooms with psychiatric patients, the minister did not say anything in this House, but went into the hallway and said he now was going to conduct a review.

Can the minister today tell the House: What kind of review is being conducted? Who is conducting it? How long will it last? What‑‑

Mr. Speaker: Order, please. The honourable member has put his question.

Hon. James McCrae (Minister of Health): I have been very pleased over the last few months, Mr. Speaker, to note that changes have been taking place in the delivery of mental health services in Manitoba. Consumers of mental health services have been delighted to take part in partnership with the government to provide better services, something that is long overdue, been ignored for 20 years by governments in Manitoba, and this government is doing something about those things.

With respect to St. Boniface Hospital, Mr. Speaker, on Friday I announced, indeed, that Winnipeg Region of the Department of Health and the hospitals‑‑plural, not just St. Boniface Hospital‑‑are all working together to make sure the beds that are available in Winnipeg are properly used.

Certainly, since the unusually high traffic that there was last week, the department and the hospitals, and then the St. Boniface Hospital, have agreed that some swing beds would be made available for people. Those beds have not yet been required.

Mr. Chomiak: Mr. Speaker, what I find difficult to understand, to the minister, is how we got into this situation when a year ago, when the process was announced, the minister had a special co‑ordinating committee to monitor this. It was supposed to advise him what the situation is. What went wrong, Mr. Speaker?

Mr. McCrae: Nothing went wrong, Mr. Speaker. I think that everybody involved in the discussions agrees that in delivery of emergency health services there are peaks and valleys, and it is not, I am told, unusual that you have heavy traffic from time to time. You should always plan for it as best that you can as a whole health system, not one person working all by himself but all of the hospital people in Winnipeg.

I suggest, and no doubt the honourable member and I will have a chance to discuss that, that this points to a further need for hospitals in Winnipeg to plan together and to look at Winnipeg as a region and to work together closely to make sure that the beds that are available and ready to take patients that all of the players know where those beds are and what the availability is.

I say, even though five swing beds have been open to relieve pressure, none of them have been used.

Mr. Chomiak: Mr. Speaker, the government has been saying the same thing for six years, and it is clearly not working.

My final supplementary to the minister is: Will the minister table the terms of reference of not only this review committee reviewing mental health, but the review committee reviewing personal care homes that were also brought to light as a result of the documentary?

Will he table the terms of reference of both those reviews that are already reviewing things the government has already reviewed and supposedly reformed?

Mr. McCrae: Mr. Speaker, I am sorry to have to take issue with what the honourable member said. He said that the changes that are happening are not working, but I have not seen him at very many functions that I have been at. He has not responded positively to my invitation made, probably half a dozen times now, for he and I to sit down together and have a chat about health care in Manitoba.

Why does the honourable member save his comments for the cameras or for this Chamber and not sit down with me directly, or sit down with the consumers of mental health services, look into their eyes and listen to them when they say thank you for finally responding to the calls we have been making for change to the delivery of mental health services in Manitoba?

Social Assistance

Infant Rate Increase

Mr. Doug Martindale (Burrows): Mr. Speaker, though this is the International Year of the Family, it is hard to tell looking at this government's budget, which for the second year in a row attacks children.

They removed $300,000 from the budget of the Child Day Care office, hundreds of thousands of dollars less money to foster families for their children. In addition, there is a serious underfunding of infants whose parents are on social assistance. In fact, the amount is less than half of that of the City of Winnipeg‑‑$84.90 per month for the province and $179.00 a month for the City of Winnipeg.

Will the Minister of Family Services give serious consideration to raising this amount to provide an adequate level as recommended by the Nutrition and Food Security Network in their April 1994 report?

Hon. Bonnie Mitchelson (Minister of Family Services): Mr. Speaker, I wish my honourable friend across the way would look at the budget numbers when he makes certain allegations about what is in the budget, because quite frankly there is over $6 million more in the child welfare system as a result of this year's budget than there was last, and many, many millions of dollars more than there were under the NDP administration before we took over as government.

So I want him not to leave on the record that there is not a commitment from this government for children in the province of Manitoba.

When it comes to social allowances we still are among the highest provinces across the country in funding for social assistance rates when our cost of living in Manitoba is among the lowest.

Mr. Martindale: Will the Minister of Family Services increase the amount of money for infants on social assistance, since this is a serious poverty and health and economic problem for these families and Winnipeg has the highest child poverty rate in Canada? Will the minister help these families and children get out of poverty by increasing the infant social assistance rate?

Mrs. Mitchelson: Mr. Speaker, and again my honourable friend is wrong in the information that he puts on the record, because indeed we are not the province with the highest child poverty rate. That may have been the instance back some years, but it is not, in fact, today. So I want to clarify the record and tell him that he should look into his facts and the information that he puts on the record before he comes to this House with questions.

Mr. Speaker, I have indicated, and I will indicate again, that we pay among the highest, across the country, social assistance rates, and in Manitoba today our cost of living is one of the lowest.

Mr. Martindale: Mr. Speaker, the fact is the province pays less than half what the City of Winnipeg pays.

Will the minister, who, I assume, is a member of the Human Services Committee of Cabinet, which is responsible for Healthy Public Policy, take to cabinet the recommendation of the Nutrition and Food Security Network since Healthy Public Policy focuses on the underlying causes of good or bad health, of which lack of income is one, according to the Minister of Health's action plan for health?

Mrs. Mitchelson: Mr. Speaker, I do want to indicate again and ensure that the record clearly shows that in fact we do not have the highest child poverty rate across the country at this point in time. I have written a letter to Stats Canada, as a matter of fact, to look at the way that they determine child poverty rates, because when you look at Manitoba in the context of all of the other provinces, we are lumped in with such cities‑‑Winnipeg is lumped in with cities like Toronto and Vancouver, where the cost of living is considerably higher than it is in the province of Manitoba.

That is not taken into consideration when the numbers and the statistics are developed. So I have written‑‑and I have made that a public issue, as a matter of fact‑‑to ensure that when those kinds of statistics are brought forward, they are looked at in the context of what the cost of living is, and ours, Mr. Speaker, is one of the lowest across the country.

Department of Environment

Louisiana‑Pacific Advertisement

Ms. Norma McCormick (Osborne): Mr. Speaker, on April 13, 1994, in the edition of the Swan Valley Star and Times, the Manitoba Environment department ran an ad with the following wording: "If you are interested in and excited about Louisiana‑Pacific coming to the Swan River Valley, please let one of the people on this list know it." The people on the list are the director of environmental approvals, the municipal and industrial approvals section chief, the assistant deputy minister, and the secretary to the Economic Development Board of Cabinet.

My question to the minister is this: Given the experience of Rafferty‑Alameda dam, the Assiniboine River diversion, Nopiming Provincial Park and Oak Hammock Marsh, how does the minister justify his department initiating an advertisement which appears to be taking a partisan position in favour of the proponent rather than respecting the process outlined in The Environment Act?

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Hon. Glen Cummings (Minister of Environment): Mr. Speaker, I would like the member to table that quote she just gave, so I can confirm whether or not that, in fact, came from the Department of Environment.

Ms. McCormick: Okay, I am prepared to table the ad.

Louisiana‑Pacific Plant

Emission Levels

Ms. Norma McCormick (Osborne): My second question to the same minister is this: Last Wednesday we met with representatives of Louisiana‑Pacific. During that meeting, Louisiana‑Pacific informed us that they would be producing emissions out of this plant which would be the subject of government regulation and scrutiny.

My question to the minister: Are there standards for these emissions which have been communicated to Louisiana‑Pacific?

Hon. Glen Cummings (Minister of Environment): Mr. Speaker, we are waiting for the final documentation from Louisiana‑Pacific on their application. That will give us some indication of whether or not the emissions can be‑‑[interjection] The Liberal caucus thinks this is funny. Apparently they are against Louisiana‑Pacific, too.

Mr. Speaker, the standards for emissions in this province are set site‑specific according to the air quality standards that are required in the area, and that is how the standards will be set.

Ms. McCormick: My final supplementary, Mr. Speaker: Can the minister assure this House that these standards will be set and made public prior to the granting of the licence to Louisiana‑Pacific, given that the chief of the air quality section is on record saying that while it would be his desire to add the chemicals that are coming from this plant to a list and expand its scope, regrettably the department does not have the resources to conduct the work?

Mr. Cummings: Mr. Speaker, the process will be followed exquisitely to the letter of the law. We will make sure every emission that is potentially to come from this plant falls well within standards.

Parents Forum on Education

Agenda

Mr. John Plohman (Dauphin): Mr. Speaker, the Minister of Education proudly announced at his meetings on education on Saturday that this was a wonderful exercise in democracy. I agree that it was an exercise in democracy that has come six years too late by this government. The problem is that the exercise did not seek information from the parents that were there on the fairness of the funding model. It did not even refer to that issue. He also did not ask the parents for their priority issues on educational reform in this province. The agenda was set by this minister.

I want to ask the minister why he did not allow parents to prioritize the issues as they saw them when coming to that forum, and was the minister afraid that the one issue that he calls a nonissue, that is fairness in funding across the province‑‑not included as one of the main issues? Did he feel that it was going to be a high priority‑‑

Mr. Speaker: Order, please.

Hon. Clayton Manness (Minister of Education and Training): Mr. Speaker, I was wondering yesterday how it would be that the member for Dauphin would be able to criticize the forum, the first one held and indeed the most successful education event held probably in this province over many, many years.

Mr. Speaker, I find it‑‑

An Honourable Member: Passing strange.

Mr. Manness: No, the member for Dauphin (Mr. Plohman) is strange, Mr. Speaker.

Mr. Speaker: Order, please. I would like to remind the honourable Minister of Education and Training that all honourable members are honourable in the Chamber.

Mr. Manness: I accept your admonition, Mr. Speaker.

When I indicated that the forum was coming forward, I indicated, I think, to everybody in the province that funding would not be the essence, and indeed ed finance would not be the essence of that forum.

We called the parents forward to pass judgment as to the programming within the public school, how to make the public schools work better. I dare say, having sat at many of the tables Saturday, ed finance, money in itself was not considered as the solution to some of the difficulties we have had in the public school system‑‑totally contrary to the view held by the member for Dauphin.

Mr. Speaker: The time for Oral Questions has expired.

NONPOLITICAL STATEMENTS

Excellence in Business‑Education Partnerships Award

Mr. Speaker: Does the honourable member for St. Johns have leave to make a nonpolitical statement? [agreed]

Mr. Gord Mackintosh (St. Johns): Mr. Speaker, on April 18, West Kildonan Collegiate was awarded, by the Conference Board of Canada, the prestigious National Awards for Excellence in Business‑Education Partnerships. That was in the elementary and secondary school level category. This was a proud achievement for a high school in my constituency and a proud achievement for Seven Oaks School Division, as well as the province.

The Co‑operative Vocational Educational program at West Kildonan Collegiate competed with programs at 115 other schools in Canada. The Seven Oaks School Division offers four dynamic such programs: Food Preparation, Hotel/Hospitality, Introduction to Aviation Trades and Technology; and Health Care/Nursing Assistance.

At the collegiate, the 34‑week course begins with a three week training period during which students learn the conventions and practices of the workplace. Over the year they spend one day a week in classes learning theory and four days a week learning by doing in the business setting.

Given that the program is only six years old, this attests to the great success of this kind of innovation in education. As a result of the award, the school has received $5,000 and will devote that money to computer upgrading for student use.

Mr. Speaker: Does the honourable member for The Maples have leave to make a nonpolitical statement? [agreed]

Mr. Gary Kowalski (The Maples): I also want to add my congratulations to the Seven Oaks School Division and West Kildonan Collegiate and its partners Standard Aero, Radisson Suite Hotels and the Health Sciences Centre for this award.

I think the teachers, the instructors involved in it‑‑Lawrence Danylchuk, Brian Humniski, Leslie Fleming and Lana Woods, led by their teacher team leader Bob Baird should be congratulated. I want to add my congratulations to that group and the Seven Oaks School Division. Thank you.

ORDERS OF THE DAY

Hon. Jim Ernst (Government House Leader): Mr. Speaker, I move, seconded by the Minister of Family Services (Mrs. Mitchelson), that Mr. Speaker do now leave the Chair and the House resolve itself into a committee to consider of the Supply to be granted to Her Majesty.

Motion agreed to, and the House resolved itself into a committee to consider of the Supply to be granted to Her Majesty with the honourable member for St. Norbert (Mr. Laurendeau) in the Chair for the Department of Health; and the honourable member for Seine River (Mrs. Dacquay) in the Chair for the Department of Executive Council.

COMMITTEE OF SUPPLY

(Concurrent Sections)

HEALTH

Mr. Deputy Chairperson (Marcel Laurendeau): Will the Committee of Supply please come to order. This section of the Committee of Supply is considering the Estimates of the Department of Health.

Does the honourable Minister of Health have an opening statement?

Hon. James McCrae (Minister of Health): Yes.

Mr. Deputy Chairperson, and colleagues, I am pleased to present today the working Estimates of the Manitoba Ministry of Health for the fiscal year ending March 31, 1995.

I will be asking this committee to support my request for $1,854,500,800. It is a very, very large amount of money, and most people cannot even imagine how much that is. It is about $1.85 billion.

Our government set a goal for itself to protect the health and quality of life enjoyed by Manitobans, by improving health services and by promoting healthy communities. Manitoba was the first to recognize this need, and now virtually every province in Canada is following our lead.

I am proud to be the first, and I am proud of the way Manitoba is working towards its goal. While some provinces have taken a top‑down approach to decision making, we have made consultation the key to finding solutions that are both innovative and responsible.

As the Minister of Health for Manitoba, I have come to appreciate that Manitoba has a tremendous team of people working together to improve our health system. I am particularly fortunate because I have a dedicated staff that has been working diligently to ensure Manitoba continues to have the best health care system in Canada, if not the world.

Also, Mr. Deputy Chairperson, I would like to thank the thousands of Manitobans who have given their time, their energy and their ideas to aid in the process of improving our health system. In fact, we have drawn from the contributions of more than 13,000 Manitobans. I repeat that for those who did not hear me. We have drawn from the contributions of more than 13,000 Manitobans who have been working in a variety of working groups, consultative forums and project teams. I may come back to that, if it is necessary, to underline the point that there has been very, very significant consultation, not only in the planning for changes to our health care system but also in implementation of changes. Many, many thousands of consumers and care providers of all different kinds who deliver services to their fellow Manitobans have been consulted and whose services have been used in the implementation of plans.

The co‑operative approach has made us the envy of other provinces. The number of partnerships we are building with Manitobans continues to grow. This community consultation approach reflects our government's commitment to focusing on community‑based services. I am pleased to note, Mr. Deputy Chairperson, that our government's current budget reinforces that commitment by allocating increased funding to community‑based programs and services.

Over the past few years, Manitoba Health has been working progressively towards a shift away from institutional settings towards community‑based services. This shift helps to ensure that Manitoba's health services are more responsive to identify needs in the community. Sometimes it is this shift that catches people's attention, too, because it means we are doing things differently. We are trying to do them better for the people who need the services.

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We have already made significant progress in implementing in this gradual shift in services, and I say "gradual" because we have been evaluating and re‑evaluating each new step taken to enhance community services. We are keeping people as our No. 1 priority, and we are giving careful consideration to each new initiative before taking action. This care and attention is paying off. Sometimes the care and attention takes a little longer, and I can acknowledge that, but I think you get a better product at the end of such a process.

As I say, it is paying off. I was very pleased to make a series of funding announcements in the last year, and we are already seeing tremendous success from these initiatives. Many of these announcements have been in the area of mental health care, and with each announcement we are coming closer to our goal for a new, more responsive and consumer‑based mental health system.

For example, I recently announced a number of new programs and services for the Winnipeg region. These initiatives include a new eight‑member Child and Adolescent Treatment Clinic, ongoing funding for telephone support services, one‑year funding for the Employment Dimensions Program, ongoing funding for the operation of a safe home, ongoing funding for in‑home support services for consumers who are living independently in the community, and funding for self‑help groups.

We have also successfully introduced mental health reforms for rural Manitoba. The seven rural Manitoba health councils have done a tremendous job of working with my department to develop mental health plans for their regions. As a result, we have seen the development of site‑specific plans for each area. These site‑specific plans include special programs and services in the community such as self‑help groups and crisis intervention teams that cater to the unique needs of that community.

These achievements in the area of mental health care also improve the continuum of care within each community and enhance the overall system by reducing fragmentation and providing services in a way that is more responsive to identified needs at the most appropriate level of intervention. Our success in these endeavours has been made possible by the tremendous support provided by the mental health community.

The renewal model that we adopted is an excellent example of how successful we can be when we work together. We will continue to demonstrate our support for these initiatives by providing significant support to community‑based mental health services in this new fiscal year. I am very proud of these achievements, but I am particularly proud that many members of the mental health community have told me that this is becoming the most progressive mental health system in Canada.

The tremendous success of these community‑based initiatives will act as an excellent model for the goals we have set for improving health care services. We are building on that success with a series of new community‑based initiatives backed by provincial funding in this budget.

As my colleague the Minister of Finance (Mr. Stefanson) announced in the provincial Budget Address, Manitoba Health is placing special emphasis on redirecting resources towards community‑based care and illness prevention. We will be providing special funding to enhance self‑managed home care in rural and northern Manitoba. This special funding will expand on current programs, which are designated for people who are living with a disability, to include seniors. This, in turn, will improve consumer empowerment by expanding the options available for Manitoba seniors who choose to live independently.

We will also be establishing a home care appeal panel and an advisory committee to ensure there is an equitable application of program standards and policies. By implementing this appeal panel and advisory committee, we will be achieving three important goals: firstly, home care recipients will be assured a fair hearing of their concerns when they have them; secondly, my office will be provided with impartial advice and recommendations respecting the application of some program decisions; and thirdly, Manitobans will have the added assurance that services are being provided equitably through the application of uniform criteria, standards and policies.

I am not satisfied, Mr. Deputy Chairperson, that we have been working with uniform criteria, standards and policies. I think that with the help and advice that we can get, we can bring something more uniform. By that, I do not mean inflexible, but I mean uniform criteria, standards and policies so the people in one part of the city or one part of the province will not be able to say that service in one area is inferior to service in another area.

The Continuing Care Programs Division in my department is placing special emphasis on support services for seniors, as part of the goals we outlined in the Quality Health for Manitobans document, which I am sure everybody has read and reread, because it is important that they do that in order for them to engage in a debate around this table. I see the honourable member for Kildonan's (Mr. Chomiak) copy is well worn, and I am glad to see that.

We are placing special emphasis on the service requirements in rural and northern communities. We have expanded community support services to seniors by adding 24 new support service projects and enhancing 19 existing ones. These support services will be further enhanced this fiscal year.

In addition, we will be increasing the number of spaces in adult day clubs. This increase is part of our government's commitment to ensure Manitoba seniors have every opportunity to live independently as active members of our communities.

I am proud of the new developments in these services to seniors, and again, I give credit to our partners in Health and to department staff for the work they are doing to promote these initiatives. With these new programs and enhanced services in place, we will be increasing the options and improving access to these services in our rural and northern communities.

One of the things I learned while visiting 45 Manitoba communities and meeting with Manitobans was that each community and each hospital or other care facility has unique needs that require unique programs, services and staffing requirements.

We also recognize that the best and only effective way to design a strategy for meeting those needs is by asking the people who live and work in these communities. We used this consultative approach with great success in our mental health renewal process, and we will continue to follow this consultative approach as we examine new alternatives for improving health services in our rural and northern communities.

Last fall I was pleased to announce that we are developing rural health associations as part of the restructuring process. Associations would co‑ordinate a strategy for health service delivery for their region. They would develop a system where each community could maximize resources and make the best use of services currently in place. These associations would ensure there is extensive community input and that each community's unique needs were met.

Since that time, we have been working to build on this basic model, and we have set some clear guidelines for Manitoba's approach: (1) There will be a clearly established process for consultation. (2) Any new design must be based on population health needs.

We have North America's best health database right here in Manitoba. The Manitoba Centre for Health Policy and Evaluation provides up‑to‑date analyses on health outcomes and identifies what is really making a difference to the overall health of Manitobans. We have already made good use of this valuable resource and will continue to do so in the upcoming year.

Each association will have access to this resource so that they can meet their needs. They can examine all aspects of service delivery and adapt their programs and facilities to help improve the health of their consumers.

Number three, any new plan must include a broader definition of health. That means identifying and addressing the determinants of health status and making a concerted effort to incorporate the concept of healthy communities through prevention.

Each community must form partnerships enabling them to address other factors affecting health, including socioeconomic conditions, environment and education. We are targeting a three‑year implementation process, and the implementation plan will have four phases starting with public consultation.

The second phase would allow time for obtaining approval in principle for establishing the details of each association, including the regional advisory bodies and the infrastructure necessary for connecting them to the database system at both local and regional levels. The next steps in this phase would involve making recommendations and developing a preliminary action plan which identifies priorities.

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In the third phase of this process, the associations would develop demonstration projects for evaluation.

Finally, the fourth phase would be based on those evaluations in order to proceed with full implementation. Once in place, the new system would be based on a regional governance model and a revised funding system.

Ultimately, through this process, the northern and rural health associations would, first, ensure opportunities for individuals, families and communities to manage and improve their health and well‑being and to participate in health planning, service delivery, decision‑making and governance; second, ensure the ongoing integrity and independence of the values and missions of facilities that have religious affiliation; third, through community participation, enhance programs sensitive to the ethnocultural diversity of the population of their region; fourth, be responsible for reducing service duplication and for the development and maintenance of an efficient, effective, integrated and co‑ordinated continuum of health services, including acute care, long‑term care, home care, public health, mental health, diagnostic services and services of voluntary agencies and other health organizations; fifth, the associations would be in a strategic position to foster working relationships with other service sectors in the communities and have an impact on health status, including those involved in the social services, housing, education and environment, as well as voluntary interest groups; sixth, the associations would be phased in according to time frames determined by the communities themselves and their readiness to take on the management of their health care services.

This innovative and proactive approach to improving the delivery of health services in rural and northern Manitoba is just one of several new developments underway in rural and northern areas. I hope that when we get into further discussion, I maybe will be able to point to models in other provinces and the way they have been doing it, as opposed to the way we have been doing it in Manitoba.

Maybe honourable members already know about it, but I want to underline for them that we have probably the most consultative bottom‑up approach anywhere in the country to the regionalization of health services.

We are also working to improve the access to some of the more specialized services. I have had the honour of making a number of announcements in this area. Manitoba is currently involved in a pilot project to provide psychiatric care training to six family physicians.

The intent of this program is to upgrade their skills in psychiatric treatment. It does not train them as psychiatrists, but people living in rural and northern areas who do not at this time have regular access to a psychiatrist will be able to visit these physicians for immediate intervention and referrals.

We have also introduced a new obstetrics and gynecology program at the Thompson General Hospital. We do not hear about that. The honourable member for Kildonan (Mr. Chomiak) has not asked me very many questions about that to this point. The hospital will now host doctors in postgraduate residency training, specializing in obstetrics and gynecology.

The program has two key benefits. First, graduate students will have the opportunity to gain clinical experience while learning about the unique cultural and geographic factors influencing northern Manitoba communities. Second, the program will also help to ensure these specialty services are available to women living in Thompson and the surrounding area. In addition to this new obstetric service for the North, our government will be introducing regulated midwifery as an important component in a comprehensive obstetrical services plan.

Other promising developments in the upcoming year will include working in partnership with Manitoba physicians. This is an area where we are fortunate that we were able to resolve some of the issues affecting our relationship with doctors in Manitoba. As a result, we have fostered a new positive working relationship, and we are ready to tackle some of the long‑standing and tough issues, such as putting the cap on doctors' billing numbers and introducing doctors into underserviced areas. I do not think very many people realize it: it is not very many doctors are required but everyone that is required is extremely important. If you are in a small community and there is no doctor, it is a big, big problem, and the number of physicians actually required to balance out our physician resources in Manitoba is not that big of a number. I think some people have a sense that it is, but it is not a very large number.

I am pleased to announce, Mr. Deputy Chairperson, that as part of this budget we will be developing a new and historic agreement that is the first of its kind in Canada. Under this agreement physician resources will be managed using a partnership approach involving our government and the Manitoba Medical Association as well as consumers, other service providers and health researchers. I am looking forward to seeing the implementation of this new agreement, and addressing many outstanding issues in the days, months and years ahead. Doctors are the gatekeepers, have been the gatekeepers of our health care services, and working with them to find solutions is a tremendous step forward for Manitoba.

We are also working to implement a new electronic Pharmacare system. This new Drug Program Information Network, DPIN, as we call it, will have some very impressive benefits including instant rebates, a built‑in security system that alerts the pharmacist when your current prescription should not be mixed with the drugs you are already taking, and a tracking system that will enable us to prevent fraud and abuse of our Pharmacare that costs Manitobans millions of dollars every year. Fraud and misuse of our health care services cost each and every one of us as taxpayers, and we are working to reduce these costs by monitoring the system.

There were some suggestions around the first of the year when, regrettably, the government in order to address the sustainable future of the Pharmacare program had to make changes to the deductible and the cost‑share aspect of the program. There were suggestions that we were looking towards getting rid of the Pharmacare program altogether at some point. That is just simply not so, and the Drug Program Information Network and all the work that has gone into it by government and by pharmacists in Manitoba show that we are very interested in providing an efficient and good Pharmacare service within the funds that we can make available.

I think it is just not correct to suggest that we had any other alternate objective in mind. If you look at the history of the previous administration, Mr. Deputy Chairperson, I think that when you look at adjustments like that twice in one year, would that not just make the same kind of point that some honourable members are trying to make about the changes we made in January? Well, those were necessary then and necessary in January, too, but the new DPIN, I suggest, demonstrates a real commitment on the part of the government to a workable and efficient Pharmacare program for the future.

Just picking up where I was, talking about fraud and misuse of our health care services, the Patient Utilization Review Committee monitored patient use of health services for one year and made a number of recommendations that will result in more effective use of health care services by Manitobans who are found to be overusing the system. Some people think it is all right for people to overuse and abuse the system, but I do not.

We will be acting on these recommendations and PURC, which is the Patient Utilization Review Committee, will continue to track overuse of the system in the upcoming year. Eliminating fraud and misuse of our health service is one way to ensure that we are using our health dollars wisely. Those who argue against getting rid of the fraud and the misuse argue in favour of wasting and abusing the system. I am not going to do that.

We are also achieving this by restructuring some of our services into centres of excellence. One example of this type of restructuring is the development of the new Ophthalmology Centre of Excellence at the Misericordia Hospital. We asked ophthalmologists what they recommended to improve ophthalmology services in Manitoba, and we acted on their recommendations. We created the new centre of excellence, and as a result, we are now performing 600 more operations a year and saving a million dollars while we do it. Sometimes I wish honourable members would ask me about things like that, but they do not seem to ask those kinds of questions. Where is the member for Portage la Prairie (Mr. Pallister)? He may ask questions about that. He is a very positive person.

Another example of the benefits of restructuring is the Lung Transplant Pilot program at the Health Sciences Centre. This program builds on the renowned work being done in respiratory disease research and treatment at the Health Sciences Centre. With this new program in place, Manitobans no longer need to leave the province for lung transplants. We have already heard some very positive success stories about lung transplants taking place at the Health Sciences Centre.

This program speaks, I think, to bringing health services closer to home, which is another fundamental of health care reform. As one who has had some family experience in this area, not lung transplant, but serious medical issues that take people away from their own province, I know very well the kind of stress that it places on patient and family and anybody close to the patient. The more of this kind of thing we can do at home, the better, and the more we should remind our fellow Manitobans that these are the kinds of things that our health system is trying to do with them and for them.

As we mentioned in the budget, we will be enhancing specialized services like the two I just mentioned by increasing funding for bone marrow transplants and dialysis treatments.

I just had the pleasure of attending the official opening of the new local dialysis unit at Pine Falls. With this opening, area residents now have access to dialysis treatments to save them the cumbersome drive into Winnipeg. This unit is one of eight satellite dialysis units established in rural and northern Manitoba under the Manitoba Local Centres Dialysis Program. I cannot pronounce that acronym but it goes MLCDP. These units are an extension of the Health Sciences Centre Renal Failure Program.

Here again, Mr. Deputy Chairperson, I commend the many people who worked together to co‑ordinate development of these units. The management and staff at the Health Sciences Centre and the local hospitals, consumers and their families and other concerned individuals, including area band chiefs, all contributed to the successful development of these units‑‑more partnerships.

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These are all excellent examples of the partnerships and the clear benefits of their success in terms of improving and preserving our health services. The people who reap the maximum benefit of these improved health services are Manitobans, and that is the No. 1 priority we all share.

As stated in the throne speech, one of the fundamental values that unites us as Manitobans is our commitment to the health and well‑being of our fellow citizens. That means improving and preserving our health services, but it also means emphasizing the importance of prevention.

I encourage all Manitobans to make a commitment to healthy communities. That means taking steps to care for our health through prevention and healthy living habits. At the same time, my department will help to promote prevention by enhancing services such as breast cancer and cervical cancer screening programs.

We have already received positive feedback on our province‑wide breast screening program proposals. This new program will be providing 100,000 Manitoba women between the ages of 50 and 70 with the best screening techniques available for breast cancer detection. With its dedicated centre of excellence in Winnipeg and satellite screening centres in Brandon and Thompson, this program streamlines the process for women from the screening stage through to diagnosis. It also emphasizes women taking an active role in making choices that affect their health. Playing an active role in determining our own health is an important part of prevention. I am proud of the attention we have given to providing education and information to those who visit our centres.

Prevention, healthy communities, improved health services and preserving our valued health care system for future generations, these are the goals we have set for ourselves, and these are the goals we are achieving. It seems that almost every day brings a new achievement to our health care system. We are at a very important point in our history as a province, because we are doing something that has not been done before. We are doing it because we recognize if we do not make the improvements to our health care today, we will lose it in the future. It will be gone. It will be history. If we do not address the issues before us today, we will have no health care system to try to fix. That is not a legacy I am prepared to leave to my children. I am proud to be part of the Manitoba team working to protect and improve health care for all Manitobans.

Members will have received copies of the supplementary information. I think I distributed it to the two critics on Friday. We can now proceed with detailed examination of the Estimates for Manitoba Health for the 1994‑95 fiscal year. I appreciate the opportunity to discuss these matters with my colleagues from the other parties. Hopefully we can promote some better understanding with some of the members of our Legislature with respect to health care issues‑‑and me, too, by the way. I can learn through this process, Mr. Deputy Chairperson.

Mr. Deputy Chairperson: We thank the honourable Minister of Health for those comments.

Does the critic for the official opposition party, the honourable member for Kildonan, have an opening statement?

Mr. Dave Chomiak (Kildonan): Mr. Deputy Chairperson, I would like to begin by welcoming the minister to this process. I have had opportunities to engage in the Estimates process with the minister in a previous critic area, and I am looking forward, as I am sure he is, to the process. I also thank the minister for providing us with the copy of the Estimates book in advance, a fair enough period of time in advance to at least allow us to review it prior to the commencement of the Estimates today.

I detect in the minister's opening comments and in several responses he has made to questions we have raised in the House a sensitivity on the part of the minister and the department to criticism and I understand that. I understand that and I understand the dilemma that the minister and departmental officials feel when they feel they are being constantly scrutinized and they are being constantly criticized, and then they perceive what any questioner may comment to be one of criticism, when, in fact, often it is very useful suggestions or good reasons for raising it. But I do not apologize for that, because we in the opposition are inundated with phone calls and letters and from our individual door knockings from comments of Manitobans who are concerned about the state of health care in the province of Manitoba.

We do not make these things up. These things come from the public. It may be that we tend to raise issues that are perceived as criticisms, but frankly that is part of the role and the job, and frankly that is my perception of what the public feels about what is happening in health care today.

The process of health care reform began with the Quality Health for Manitobans, The Action Plan, announced by the former minister with great fanfare. I believe the minister said it was the most innovative and advanced in all of the continent, if not the universe. He did not say universe; he said continent. Frankly, if you look through that document, one could glean from that document almost every positive or negative thing that has been said about health reform in this country for the past 10 or 15 years.

I remind the minister that almost every single jurisdiction, with the exception of Manitoba, has had a royal commission or a major study on health care reform in the last 10 years, and a lot of what is stated in the health action plan is basically a part of all governments' reform plans across Canada. The minister is correct when he states that health care reform is taking place in other provinces.

I had a meeting with an individual, who is very active in the health care field, about three months ago, and this is what she stated to me. She said that she was of the impression that the initial stages of health care reform were very positive, but that the government got caught in a fiscal crunch and that health reform became a cost‑cutting exercise, not a reform plan.

That was her view, and I get the impression that is largely the view in the public, and frankly, that is my view. If I look at some of the initiatives and measures that were proceeded with by the department last year, that certainly reinforces the view.

I do not intend to rehash all of last year's difficulties in the health care field, but certainly they are indicative of a government that was intent on cutting rather than providing for quality health care for its citizens.

The minister has stated on many occasions that we, the public, if only we would sit down, if only I would sit down, or if only other individuals would sit down, with him and discuss the issues we could resolve them and come to some kind of consensus. I am often reminded of the phrase, but it is often individuals who have gone through that process who have come back and said it is basically a monologue disguised as a dialogue. Many people have said to me, what is the use? The government appears to be intent on a plan and a program, and I have not been convinced otherwise. I know the minister has gone to great pains to meet with a lot of individuals and a lot of groups, and I give him credit for that, but whether that constitutes adequate consultation remains to be seen. I do not believe it adequately addresses or reflects the viewpoints of Manitobans respecting health care and health care reform.

The minister made mention in his comments about bringing health care closer to home, and he discussed the lung and heart transplant announcement at the Health Sciences Centre as an example, and I agree, that is an example. But closer to home means more that just providing services in Manitoba for residents who had to leave the province. Closer to home means providing services closer to home in terms of community, in terms of community‑based services. Despite comments to the contrary, this has not taken place in the province of Manitoba, and the area where it has been most advanced and most recognized is the mental health field. We have given the minister and the government credit, but, frankly, even in the areas of mental health, it is clear there is a difficulty. The minister, as recently as last Friday, announced a review of mental health reform, I can assume, when this was an area that was somehow advanced.

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There is no question there are growing pains. There is no question there are difficulties, but one would have thought the process would have‑‑the committee that was set up to establish and monitor because it is in the government's press release of March 17, 1993‑‑detected or been utilized to pick up the difficulties in the system.

There was a documentary a month ago that revealed the difficulties, and the minister said that they were working on it, but nothing apparently happened. Maybe last Wednesday was a glitch. But the minister has now put in place, I will accept‑‑he has now put in place a system, but he has also announced to review, and that indicates to me that there is difficulty. I will be pursuing that because mental health is clearly a strong suit of what the government has done in heath care reform, and even at that, there are difficulties. I think that, if the government is truly listening and truly consulting, they will implement some kind of process or procedures in place, that will utilize feedback from the public and actually act on it.

Now the minister and the government have gone to great pains to demonstrate that the new MMA agreement is part of the process, and I will agree the fact that the government has finally gotten an agreement with one major player in the system, notwithstanding that the nurses‑‑MARN is upset, the MNU is upset, the LPNs are upset, health care administrators are upset. Almost everyone in the system is basically not onside with the government's initiatives. The government, finally, despite that, has gotten an agreement with the MMA, but that is only one small step in the consultation process. The question still remains, who is the government listening to?

The minister indicates in his opening comments that he has listened to over 13,000 individuals. If that is reflected in the health care system, if that is reflected in the changes, then why have we not seen community‑based services? Why have we seen difficulties in the system to the extent we are seeing difficulties? Why are we having continuing difficulties with home care, et cetera? But all of this will be pursued during the course of our discussions, I am sure.

I am very concerned about the health care, the system of home care. Last year, the government unilaterally changed the rules of the game with home care, and I will try to stay away from dealing with that situation, but I am not clear if it has been clarified. The minister came in and said it was on pause, but still people are being cut off. Yes, they are being given‑‑the difference was they were being phoned and cut off last year, and this year, they are being given re‑assessments, but the criteria, as far as I understand it for which people have been eliminated from the Home Care program, continue as is, and I‑‑

Mr. McCrae: NDP criteria.

Mr. Chomiak: The minister indicates NDP criteria. The minister continues the line that was forwarded by the previous minister that somehow nothing had changed, that somehow the government was not planning to lay off thousands of workers, that somehow the government was not planning to cut off hundreds and thousands of home care recipients. That is just not true. The government was planning, and I have seen the criteria, and we made them public. I am anxious to see if the government actually changed them.

I will give the minister credit for putting it on pause and saying at the time that we are not going to cut off the young disabled definitely, but the rest of the criteria continue. I would be anxious to see what those criteria are.

I am concerned about the thousands and thousands of nurses in the system who do not feel the government is listening to their concerns, who are concerned that the government is not paying attention to issues they have raised, and who are fearful for their jobs.

Now, the contrary argument that is made against the opposition is, all you do is fearmonger, and you are the one who is causing the difficulty. But steadily, as we continue to so‑called fearmonger, people keep losing their jobs or are being told they are going to lose their jobs. Frankly, 90 percent of what we have indicated in the House, perhaps 95 or 99 percent, has in fact come to fruition, and recently a government document stated that in the next several years up to 1,500 workers could lose their job at Health Sciences and St. Boniface. Was that my document? Was that the workers' document, Mr. Deputy Chairperson?

That was the government's working document. Those were the criteria under which the government's Labour Adjustment Committee was told to operate. Those were not my criteria. I was not the one who raised the issue. We were not the ones who raised that 1,500 figure. I had known about it for some time. I had been told it happened in meetings, but that was the first time we actually saw it in a government‑related document. So it is not us, and I wish the government would give some kind of reassurance to those who work very hard and long, and the dedicated in the system, as to what is going to happen in terms of their futures. What about the role of LPNs? Has that been resolved despite many meetings? Is it that the LPNs‑‑it seems, again, it is another case of a monologue disguised as a dialogue. Who is listening to the nurses?

What about the case of the role of nurse practitioners and pilot projects in that regard? The government has made great claims about the fact that it has moved in terms of creating personal care home beds, and we acknowledge that. That has been part of the government's platform and programs since 1988, and it has been reannounced and reannounced. Notwithstanding that, I am pleased that the beds are up. I have concerns about the fact that we are moving towards privatization in the personal care home field, but that is a philosophical difference between us, and that can be dealt with.

But I am concerned about standards and I am concerned about the fact there is not a recognition that, as you have moved from having people in acute‑care beds into personal care homes, the acuity and the demographic makeup of those patients have increased remarkably, and the services that must be provided for those individuals must accordingly go up. I am not sure there has been a recognition, and this is not philosophical or political. I am not sure that there has been a recognition within the system of that requirement, and I think that something ought to be done about that.

I think that is why we have examples of documentaries and coroners' reports indicating that something should be done. I think those are valid points. The minister again has announced that there is going to be a review of this area, and I am anxious to see what type of the review is taking place. We will be as co‑operative as possible in resolving this issue. It is not a political issue. It is strictly an issue of demographics and acuity of level of care and enforcement of standards. That is straight for the public of Manitoba.

With respect to the hospitals, we see that there is a good deal of uncertainty in the hospital system. It is clear that the government has cut back funding to hospitals and is continuing to cut back funding. The announcement that a funding cut of 10 percent to the hospitals was on hold; I do not think is on hold any longer. I think the 3‑4‑3 cutback over the next three years is still in place, and I would be interested to know whether in fact it is in place. I think most hospital administrators are functioning on that basis.

We are still awaiting the finalization and the dribs and drabs of the Connie Curran exercise. The minister knows that I have mentioned that once or twice in the House, and that it has come up on occasion.

Mr. McCrae: Yes, but we got one Michael Decter.

Mr. Chomiak: The minister says, anytime we talk about Michael Decter‑‑I am happy to talk about Michael Decter or Connie Curran or APM or the $4 million or the $800,000 in expenses tax free and the amount that was held back at 10 percent that is probably sitting in an account, and perhaps we can get that money back. At least they get something back from Connie Curran. I am happy to talk about that anytime or about the contract and to go on and on about it. [interjection] The minister says that we should get the beds back that Michael Decter closed. I will tell the minister that if Connie Curran had any recognition of the Canadian experience, perhaps we would not be in the dilemma that we are in now.

Mr. McCrae: . . . could ask Michael Decter.

Mr. Chomiak: If her people‑‑well, the fact is, I know it for a fact, that they recognize one of their major failings in the system was that they did not have Canadian expertise. I know that for a fact, and the minister ought to know that because they did not know what they were doing.

When she came in here and was asked about Bill 22, she said, Bill 22 does not concern me. When she was asked about French language, she knew nothing about the French language experience. She had no understanding of the Canadian culture and environment, and she miscalculated miserably. The government suffered and paid the price accordingly. [interjection] The minister indicates Michael Decter understands‑‑the minister is so intent on Michael Decter that he ought‑‑perhaps the minister is considering hiring him or something? I mean, this was‑‑

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Mr. Deputy Chairperson: Order, please. Could I advise the honourable minister that he has had his opportunity to do his opening statement? This is not a time for debate, and I would appreciate hearing the honourable member for Kildonan.

Mr. Chomiak: Thank you, Mr. Deputy Chairperson.

I was very interested to hear the minister's comments this afternoon about the rural health experience. I am very interested to see that the minister said, this is the greatest example of consultation that has taken place in North America‑‑I think he said. Notwithstanding that, I am very curious, and I hope we will have an opportunity to examine this during the Estimates process, because I had the impression that a lot of this process was botched by the government.

If I look at the health action plan or I look at the time lines and the guidelines in the health action plan, not only do you miss the guidelines, but there were instances where the government wrote to communities and said, form health care units of 10 to 12,000, and then they did that. The government wrote back and said, nope, we are forming larger health communities; reconstitute them.

I could argue now in a positive vein that perhaps the government is listening and reacting to the community expression, but I am very curious as to see how that process is developing and when and how it is going to be finalized. I am concerned that if health care reform in rural Manitoba follows the same course of action as health care and reform in urban Winnipeg, rural Manitoba is in for a rough ride.

I am anxious to see what is happening in community‑based care, other than that of dealing with mental health. I note that whenever the minister and the government talk about community based, they deal with their strong suit, which they admit is mental health, but we see very little action in terms of community‑based care outside of the mental health field.

We are very anxious to see what is happening in terms of the Emergency Services Task Force report. It would be useful if the document was made public. The minister has said they are working on it. They have now hired the individual who created the working task force, who wrote the report, to work for the department in reform. I will be very anxious to see it because emergency reform was also an intimate part of the recommendations in the government's blue book, Quality Health for Manitobans, The Action Plan.

I am interested in terms of the dental care program. I think, quite wrongly and inappropriately, the government killed the dental care program last year. It was done for budgetary reasons; that was made very clear by the previous minister. We think it was a wrong decision. We think the statistics show that it is resulting in rural Manitobans having less access to quality dental care and, in fact, as a result, poor dental health which runs contrary to a commitment towards preventative health.

We note that the government has put back‑‑and I welcome the fact the government has put back in this year's budget‑‑some of the funding that they cut out of the Pharmacare program and some of the funding that they cut out of the Home Care program. It still does not get us back to the point that we were before the government cut the money out, but that is at least welcome. That is a recognition that, in fact, those areas require increased financial support because, by everyone's acknowledgement, including the government's, those are the preventative and the community‑based kinds of programs that the government should be implementing and placing a priority on.

We would hope the government would give consideration to something like our Health Reform Accountability Act that provides for meaningful consultation, statutorily defined consultation, delegation, and a role for an ombudsman or a type of ombudsperson to deal with concerns in the health care field.

We note the government will soon be announcing something in terms of a policy on Healthy Child Development, and we have advocated and welcomed that for some time. We can only hope for the benefit of all Manitobans and the children of Manitoba that this comes to fruition sooner rather than later. We were supportive of the government's PIN, the announcement with respect to the Pharmacare program, and we have been supportive of that from the start. We note that there have been some difficulties in the initial start‑up, and we look forward with anticipation to the actual implementation of the system.

Mr. Deputy Chairperson, basically those are at least our opening comments in this regard, and we look forward to this process.

Mr. Deputy Chairperson: We thank the honourable member for Kildonan for those opening statements.

Would the critic for the second opposition party, the honourable member for Crescentwood, have an opening statement?

Ms. Avis Gray (Crescentwood): Mr. Deputy Chairperson, I too would like to welcome the new Minister of Health (Mr. McCrae) into his portfolio as we go through the spending Estimates over the next number of weeks, and I am going to keep my comments fairly short. I think that, as we go through the Estimates process, the minister will have a sense of the issues that we have in regard to health reform and where it is going in this province.

I hope that we will have an opportunity particularly today to get from the minister basically as a follow‑up to the Quality Health document a sense of what the strategic plan and the actual implementation are of health reform in Manitoba, looking at some specific objectives in the next three to five years as well as if we can get a sense from the minister, as again was outlined in the Quality Health document, as to what the evaluation to date tells us in regard to how the reform is proceeding.

I also see the Estimates process as an opportunity to clarify some policies and procedures where necessary, and there are still some areas that I am not exactly sure what policies are in the Department of Health. So, for my benefit and also for some constituents who have inquired, I hope we have an opportunity to do that as we go through the spending Estimates.

The minister commented in his opening comments that consultation was the key and that communication with the various stakeholders was extremely important. I am pleased to hear him say that. I think that in a huge bureaucracy such as the Department of Health and when you are dealing with a health system that is so complex and multidimensional, it is oftentimes difficult to provide appropriate communication‑‑and this is not a reflection necessarily on the Department of Health‑‑but governments never seem to do a good job of communicating. I say governments with an "s", regardless of political stripe or regardless of any particular department. We are oftentimes lacking in that regard, and so I would hope that there is a definite communication plan that is in place as well, so that in fact for the positive things that are occurring in health reform, that the community and the various stakeholders are aware of those.

I think when we talk about communication, as well, I think the more information that is available to the public and to the stakeholders is probably a better way to go rather than withholding information. I know there is always information that is government policy or in a draft format that cannot be released, but I think, by and large, if people are aware of what is going on and have knowledge, then oftentimes they are more at ease with what the process is and what is going to occur in the future.

I was also pleased to see the minister speak about consultation with communities in rural Manitoba as well as in Winnipeg, and I look forward to discussions around philosophy, as well as implementation of the aspect of regionalization, what it could mean to Manitoba. I know a number of the rural institutions and hospitals and reeves and municipal councils are quite interested in this idea of regionalization and what it does mean.

I think it is very important, as well, when we talk about health care in Manitoba, that we identify some of the differences and some of the flexibilities that are needed in the system, particularly because of some of the differences we have in urban Manitoba versus northern Manitoba and rural Manitoba.

I also look forward to a discussion of Bill 22 and the minister's facts and his thoughts about the impact, positive and negative, of Bill 22 on his department and on other institutions that provide health care services.

So I want to leave my remarks at the beginning very short, because I think as we go through what I am sure will be many weeks of spending Estimates, we will have an opportunity to talk about philosophy and direction of this government and of the Minister of Health.

Mr. Deputy Chairperson: I thank the honourable member for Crescentwood for those brief remarks.

Under Manitoba practice, debate of the Minister's Salary is traditionally the last item considered for the Estimates of a department. Accordingly, we shall defer consideration of this item and now proceed with the consideration of the next line.

At this time, we invite the minister's staff to join us at the table, and we ask that the minister introduce his staff present, please.

Mr. McCrae: While he is taking his seat, I might just take one second to respond to each of the honourable members. If they want to respond back, that is all right with me. [interjection] Well, if anybody objects, I will slip it in later.

Mr. Chomiak: I will certainly give leave for the minister to respond to our comments. Certainly, in my first question, I will ask the minister if he would like to respond to our comments.

Mr. McCrae: Okay, thank you.

Mr. Deputy Chairperson, I am pleased to introduce Mr. Frank Maynard, not a stranger. He has been at this longer than I have. He is the Deputy Minister of Health. We have Tim Duprey here, Assistant Deputy Minister responsible for Finance and Management Services, and Susan Murphy, Director of Administration and Finance. These people will help me, I hope, get through the next little while.

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I think the honourable member for Kildonan had a question for me.

Mr. Chomiak: Mr. Deputy Chairperson, I wonder if the minister has any comments in response to our opening statements?

Mr. Deputy Chairperson: Could I ask the honourable members to just wait one moment until we get into a line, and then we will have the opportunity to discuss those at that point.

I would like to advise the members of the committee at this time that the correct procedure for considering items in the Committee of Supply is a line‑by‑line manner. In order to skip ahead or to revert back to any lines already passed, unanimous consent will be necessary.

At this time, we will move on to line 1.(b)(1) Salaries and Employee Benefits $608,600.

Mr. Chomiak: Mr. Deputy Chairperson, insofar as this line deals with the strategic direction of policy development, does the minister have any comments in response to our opening statements?

Mr. McCrae: The honourable member is very kind, Mr. Deputy Chairperson, in all of the things which he said, which no doubt we will be talking further about. He made the point that I was sensitive to some of his comments. It is true that I am, because I think if we do not do things right in this particular generation and this particular time in our history and if we do not work together more closely, we do run the risk that some of the reforms that we are trying to do will not work very well because of a perception of bad policy.

You know, I am very quick to defend a lot of the policies because there is so much of Manitobans in those policies and so much input from people. I am not trying to have a monologue disguised as a dialogue. I am not trying to do that. I do get very sensitive. I should not get overly sensitive, but I really think that we owe it to the next generation to leave them a health care system, too.

If we always just responded to whomever shouted the loudest with respect to spending on this, spending on that‑‑and we get it every day, spend, spend, spend, and criticism when we cut. The point is we have to have a health care system for the future because I am so proud of the one we have. So if I sometimes sound a little bit sensitive, there are reasons for it.

With respect to the honourable member for Crescentwood (Ms. Gray), she said a number of things, too. The one I liked the best was evaluation, interested in evaluation of the things we are doing.

Well, we are too. That is why we have things like the Centre for Health Policy and Evaluation, an independent group that, without all of the emotion that sometimes characterizes health care debate, can tell us in factual ways whether we are on the right track or not. When we are on the wrong track, tell us that, too, and we will adjust because that is what the people of Manitoba want us to do.

So I think we need to look at real results and not always just at the ones that the best debaters can raise the greatest perception about. So sometimes I am sensitive, yes, but I am interested in evaluations, too.

Those are just a couple of observations on the comments of my colleagues here today.

Mr. Deputy Chairperson: Shall the line pass?

Mr. Chomiak: Mr. Deputy Chairperson, in this very positive vein and the frank comments of the minister, perhaps we will commence the process by asking the minister, I think, one of the appropriate questions that was raised by my colleague from Crescentwood.

That is, is there an update or is there a strategic plan in place with respect to the reform process, based on the 1992 plan? Is there an update or a priority list or some kind of process or check in place to determine where we are at and where we are going?

Mr. McCrae: Mr. Deputy Chairperson, we have not yet, to date, put out sort of a public report card as to how far we have come, because many of the reforms are in process.

As the member for Crescentwood pointed out, there is a very large bureaucracy here, and I might add to what she said, that we are dealing with many bureaucracies when we are dealing with the health system because many, many facilities are very important in our health system, and each of them has their own administration and so on.

There is a lot to report on, and I think maybe you are right. I say to the honourable member that not everyone is aware in a precise form as to what we have achieved in the last couple of years in Manitoba and even a little longer in terms of changing for the better our health care system and making it sustainable for the future.

Sometimes the good gets shrouded in a heavy traffic day in an emergency room or something like that, which really stretches the resources of an emergency room, and we have to look to make sure we have other resources available so those things do not become problematic. Those are the kinds of issues that tend to detract from the solid, positive progress that has been made.

Here I have to be frank with the honourable member and say that I would like him to say as much about some of those more solid and positive things as he says about a heavy day in the emergency room. I acknowledge that they have busy, busy days. It has happened twice these last few months, once at the Health Sciences Centre in January when it was really, really busy, for whatever reason, and then more recently as spring was‑‑actually, it was not last winter. It was earlier this spring when we had a really nice day, and there was tremendous pressure on emergency rooms, and then more recently last week with respect to psychiatric patients at St. Boniface.

I am quite happy to engage in a very open discussion about that and a discussion about the plans that have been made that prepare us for better delivery of mental health services, not only acute but the whole spectrum of services that are required in the mental health field or any other field.

Yes, the honourable member is looking for a report card, I think, of some kind. I am hearing what he is saying. We do not have one to place in front of him today, but I would like to have such a thing before very long.

Mr. Chomiak: Mr. Deputy Chairperson, one of the difficulties that arises when you have those, as the minister terms it, exceptional or periodic peaks, for example, in emergency rooms, is that we know the government has a task force on emergency services that has given a report to the minister. We know the government is working on some kind of change to emergency, or evolution or reform of emergency. There is no question this has occurred in the past.

The reason the government created a task force to review it was to solve the problem. We know the government has a report, and we are faced, in the opposition, with a situation where the problem continues. The government is studying it, and no apparent action has taken place. That is our dilemma and that is the issue.

(Mr. Bob Rose, Acting Deputy Chairperson, in the Chair)

Mr. McCrae: The honourable member is right to point out that we have had the services of an Emergency Services Task Force and that we have a report from which we can take advice and develop change to the delivery of services to make it so that we do not get piled up in some places and there is low traffic other places.

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In a city the size of Winnipeg, we should be able to organize our emergency services well enough that if there is heavy traffic at one area that it can be properly diverted, safely diverted to another area where there is a capacity there to pick it up.

I think the honourable member is pressing for the release of an emergency services task force and the government's response thereto. He is probably right to do that. As I said a few minutes ago, and as the member for Crescentwood and the member for Kildonan agreed, health care has many, many dimensions and facets and in a reform time we are dealing with many, many of them all at once.

Staff are working extremely hard to assist the government in getting all of these changes pointed in the right direction, if you will, staff with the help of these task forces which have utilized the services of the people who know what is going on in these businesses. We are not wasting any time to try to get the changes that we need to bring about efficient day in, day out operational emergency services working.

All that is not to say anything about those who have been in the business of providing emergency services. We have a lot of time for them. They do a good job. They are very highly trained people‑‑right from the first responders to the acute surgical teams that are required to help people who get into emergency situations.

You see, if the honourable member would work with us on the issue of discharging people from hospitals, too‑‑I have heard some people refer to hospitals for some patients as weekend hotels because we have not had a discharge policy that makes beds available that should be made available for people who need those beds more on an emergency basis. I need the member's support for those things. I do not need his criticism when we try to get people out of hospitals who should be out of hospitals because we happen to use a particular kind of delivery service. Discharge policy is very much linked up with emergency services. I am looking for the member's support.

Mr. Chomiak: Mr. Acting Deputy Chairperson, it only took three questions to get the minister to steer the conversation toward the We Care issue, which in this spirit of harmony I was not going to bring up for at least a little while, but having been raised by the minister, I mean, there is no doubt that we are supportive of as early discharge as possible from the hospital. There is no doubt that every study indicates that should be the case.

Mr. McCrae: Even if that means layoffs.

Mr. Chomiak: The minister says from his seat, even if that means layoffs. I can tell you that we do not believe the system can tolerate any more government layoffs that have been imposed.

Mr. McCrae: How can you support early discharge?

Mr. Chomiak: The minister says, how can we support early discharge. Let me just ask the minister why‑‑the difficulty with the process was it was not public, it was not tendered. For the first time it is an example of a private nursing company going onto the ward of the hospital. There was that process put in place. The minister says, because we are opposed to the process and because we are opposed to the way it was done, we are somehow opposed to early discharge. Is the minister of the opinion that the more people we discharge earlier, the more people he intends to let off of the system?

Mr. McCrae: Mr. Acting Deputy Chairperson, I am saying to the honourable member, you cannot have it all ways. If you agree with a move, a shift in policy from total reliance on high‑level, acute‑care institutions to a community‑based service delivery system, where that is appropriate, then you cannot support that on the one side and then not support changes in the hospitals that have to result from patients leaving hospitals.

Short length of stay, early discharge, all of those things lead to empty beds in hospitals and people serving those beds. You cannot run a health system by having empty beds with nobody in them and a whole staff there ready to look after people who are not there.

Now the honourable member knows that. He is very aware of how this whole thing works, I am sure, and you just cannot have it both ways, whether you bring in a private firm or you do not use a private firm. You use the Home Care program, for example. It is the same shift going on.

That is where the word "sensitive" comes in to describe my feelings, because it is a little frustrating to look at people who really do try to have it both ways.

Another example of an issue that we should be addressing in regard to this shift in the area of delivery of services is the self‑managed care aspect of our Home Care program. I mean, it is really quite a thing to see the sense of independence that people can achieve when they make their own decisions about their home care delivery.

How would you like it, I say to the honourable member, to be laid up, and when the time comes for you to go to the bathroom is set by somebody else? I am not really in favour of that if I can avoid it, and I think we should build as much flexibility into our whole continuum‑of‑care system as we can.

We should be promoting self‑managed care as much as we can because, ultimately, there is X amount of care that is required, and X amount of care should be delivered, whether it is by people on the public payroll or indirectly to people through hospital programs like the pilot project we have been hearing so much about, whatever method.

I do not have a philosophy on the point, except care. That is my philosophy. Let us get the care to people in the most efficient way and empower people so they say when it is time to get the care they need. To the extent we can do that, we should.

I wonder where the honourable member stands on self‑managed care and on its expansion. Are we expanding it enough this year? One of the things that has been said to me is that you are expanding it and that is the right thing to do, but you are not going far enough. I want to explore that with my department. I wonder what the honourable member's viewpoint would be.

(Mr. Deputy Chairperson in the Chair)

Mr. Chomiak: The minister, I think, is missing the point completely. The minister somehow has missed the point that this government has cut back on resources offered to members in the community. This government has studied the self‑managed care system for some time and has a report on their desk that they are not releasing, as well, in that area and is saving it for a positive announcement as we move towards the election campaign. Let us be frank.

The minister and the department have all of a sudden discovered self‑managed care. The report has been received some time ago by the department‑‑last year, the minister indicates, I believe. Why did we not see an announcement last year? Why are we making people wait for the implementation? Where is the consultation? It has only commenced recently.

I do not want to have this already deteriorate into a philosophical disagreement, but I do not think the government has ever addressed the issue adequately of resources based in the community. I do not think the government recognizes it, and as they have cut back their acute care beds and as they have cut back resources to hospitals, they have not provided resources in the community commensurate with those cutbacks.

Indeed, they have certainly drawn back some services, and I think the government misses the point. The minister says the hospital is being innovative in terms of providing the We Care resources. The hospital had its budget cut back $6.2 million, which is even greater than 10 percent of its budget. Of course, they are desperate and scrambling to find resources in order to replace other programs.

Having said that, my question for the minister is, can he outline for us the reorganization plans of the department?

Mr. Deputy Chairperson: Order please. I would like to remind the honourable members that we are dealing on a line‑by‑line area here, and Home Care‑‑

An Honourable Member: I appreciate that.

Mr. Deputy Chairperson: Are we moving on to Home Care?

Mr. Chomiak: On to Home Care, Mr. Deputy Chairperson. That is why, as I went through my speech, I recognized the fact that I perhaps had been slipping off of the line and that I would quickly return back to the line‑by‑line item, which is why at the end of my monologue, I asked the minister if he could outline for us what the changes are in terms of the reorganization of the Department of Health.

Mr. Deputy Chairperson: I am sorry for that. I misinterpreted your question because I understood you were in the Home Care section‑‑so long as the question was related to the Executive Support category.

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Mr. McCrae: I really have to commend the honourable member for acknowledging that yes, he did wander a little bit from the topic in front of us, which is something most of us never, ever do, just the honourable member. He was moving from cutbacks right back to where we should be, which is the lines in the Estimates, where we are supposed to be at. We will have the time to talk later about what the honourable member calls cutbacks and which I call something else. I call it significant enhancement. I think this budget gives us a very good opportunity to prove the enhancement in community‑based services.

The honourable member did ask about the reorganization of Manitoba Health, and that is an important question. We have been asking, as the honourable member pointed out, facilities and providers across this province to try to direct their dollars toward service delivery and not toward the building of larger administrations. We felt that it was not fair for us to ask hospitals and others to keep biting the bullet on issues, especially issues like administration in the most recent times, without the government itself being an example.

I think that over the last six budgets this government has indeed been looking very carefully at how best to deliver services with the least amount of funds available. Maybe the Health department, maybe the deputy could talk better about the previous years' experience than I could, but I know that I am asking the Department of Health to be thrifty as well, and not just carry on without putting‑up‑or‑shutting‑up sort of thing.

So we have looked at our own organization, and I can tell the honourable member that the objective here is‑‑the honourable member will know that for every executive branch of government there is a layer of bureaucracy. We are reducing the number of branches in the department, and thereby the number of assistant deputy ministers, and by doing that, we can also go a little bit further down the line and see changes at levels of director‑‑the whole concept of removing layers of management that I think in this modern technological age we can probably do without.

As much as we appreciate all the efforts that have been put in by people that are working for the Department of Health over the years, we too have to show by example that certain things can be done. So we have announced to the department that Mr. Frank DeCock will serve as Associate Deputy Minister in the Healthy Communities Office. Mr. DeCock was formerly the Associate Deputy Minister responsible for Hospitals and Community Health Services Division. Sue Hicks is appointed Assistant Deputy Minister for Community and Mental Health Services. Ms. Hicks was formerly Assistant Deputy Minister for the Healthy Public Policy Programs Division. Mr. Tim Duprey is with us this afternoon. He is the Assistant Deputy Minister for Finance and Management Services, and formerly he was executive director of the Hospitals and Winnipeg Community Health Services. You will know that Mr. Duprey comes to us from the Addictions Foundation.

The honourable members should know too that Mr. Reg Toews, who has done such an excellent job in the area of mental health reform, as the honourable member has pointed out, and we appreciate the recognition. I am sure Reg does too because he has done a very good job with all of the people involved in mental health, and he, during this transition phase, will remain responsible for Provincial Mental Health Services as an assistant deputy minister. That is for the transition phase, and we expect to keep Mr. Toews busy in the future as well. I say to the honourable member that this transformation is going to be an ongoing sort of transformation which will include further changes.

Mr. Chomiak: Mr. Deputy Chairperson, so the reorganization that the minister just pointed out is not reflected in the Supplementary Estimates plan that we have in front of us dated April 1, '94?

Mr. McCrae: It is true, Mr. Deputy Chairperson, that the thing dated April 1, 1993 as Schedule 2 in the book is dated.

Mr. Chomiak: Thank you. Well, just for clarification. I want to understand the process. The minister indicated that Sue Hicks will now be‑‑can the minister indicate how many ADMs have now been created? Formerly, from this chart, it appeared there was, I think, six ADMs.

Mr. McCrae: Mr. Deputy Chairperson, before the changes, there were six assistant deputy ministers in the department. After the changes there are three, plus Reg Toews who remains an assistant deputy minister for the time being. I expect that in the future that we will end up with three assistant deputy ministers from the six we had before.

Mr. Chomiak: Mr. Deputy Chairperson, I wonder, would it be possible for the minister to table the document that he read from so‑‑just for our own clarification?

Mr. McCrae: Mr. Deputy Chairperson, indeed, if maybe the Clerk could make a copy for my honourable colleagues.

Yes, I should say, I called Frank DeCock an assistant deputy, but he is an associate deputy. So it is an associate plus two assistants, three for the time being until further notice. I think what I will do is also include an organizational chart for the honourable members.

Mr. Chomiak: My next question is twofold. Can the minister indicate who has been responsible for health care reform since the departure of Mr. Blais, and who is responsible for health care reform presently?

Mr. McCrae: They could say the whole department has been responsible, and the ministers, too. But, for the most part, I would say Mr. Maynard, Mr. DeCock; and Mr. Duprey has been very instrumental as well.

Mr. Chomiak: Within the context of this reorganization, will there be a line person responsible for reform directly?

Mr. McCrae: Mr. Deputy Chairperson, reform is something that happens everywhere in our society and must happen everywhere in our society. Mr. DeCock is associate deputy minister responsible for the Healthy Communities Office, which will really be taking over or really be helping drive some of the main reform items as the honourable member might know it.

The honourable member referred earlier on to budgetary changes last year as reform changes. They were not reform changes. They were budgetary changes. We only had so many dollars to spend, and so changes had to get made, reductions had to be made. The honourable member calls that reform which it was not. So that is why I think we have to maybe try to clear up once in a while what we are talking about.

Maybe the member's suggestion of a report card type of thing a little earlier on is the right way to go, and we will maybe look very seriously at the member's suggestion of a report card that we could put out to the people so that they will understand what we are doing.

The thing is, Mr. DeCock heads up the Healthy Communities Office. If you look in the Estimates, you will see a line for the reform initiatives, and that drives that part of the budget, that office.

Mr. Chomiak: Mr. Deputy Chairperson, under whose‑‑I would assume; well, I should not assume. I will ask the minister where the Continuing Care Program fits within this structure.

Mr. McCrae: That comes under the Community and Mental Health Services Division and Ms. Hicks.

Mr. Chomiak: The former MHSC functions that were folded into the department, do they come under Finance and Management Services Division now?

Mr. McCrae: The Finance and Management Services Division will look after the finance and management part. The program part will come under the Community and Mental Health Services Division. There is going to be a lot of working together by these assistant deputy ministers in their executive capacities. I think it will result in a better co‑ordinated department.

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Mr. Chomiak: I wonder, for purposes of the committee, whether or not we might have a revised Manitoba Health schematic chart here pointing out where all the functions are, because I have a lot of questions about this structure now. To whom and how does the Provincial Nursing Advisor report? Where does the advisory Committee on Mental Health Reform? Do they now report to the Community and Mental Health? I mean, there are a whole series of questions that now arise from this change, and it probably would save us a fair amount of time if we would come back to that, or just simply have a revised chart tabled.

Mr. McCrae: Mr. Deputy Chairperson, my deputy minister tells me that we can have something like that as early as tomorrow for the honourable member. That would probably avoid a lot of necessity for a lot of questions, but if the honourable member wants to ask some, that is fine. We can get a better schematic for him as early as tomorrow.

Mr. Chomiak: Yes, I appreciate that. I think it would be much more useful, and it could actually save the committee a fair amount of time rather than pursuing each of these individual items one by one in terms of understanding the issue. I am sure the committee will have no problem if we are on a different line item in returning to deal with some questions, if there are any, in that area.

My question to the minister is, and how does one pose this one? I understand that one of the five projects undertaken by Ms. Connie Curran, APM consultants, was a review of the departmental organizational structure. I am wondering if this end result that we are seeing here today is as a result of that exercise.

Mr. McCrae: I think you could say partly without being misleading. There were certain principles that were looked at by a lot of parties. Do not forget this whole APM business brought many, many people together, many Manitobans. This is the misinformation that sometimes my friend does not mind seeing disseminated. However, a lot of people have been involved, and our department determined that we have to do our part here, too. We just cannot just let the rest of the world change while our department does not. So to what extent the APM business had to do with the department, I do not know, but I would have to say partly because we were in a change time frame here. There was no way my department could tell everybody else to change and not change itself, so I do not know quite how to answer the honourable member except to say, for part of the whole scheme of things, yes.

Mr. Chomiak: I will not dispute the fact that people were working together as a result of that exercise. I am not certain if the purposes or the actual end result were at all justified by it, but I will avoid sliding down that path till we get to that specific line item, unless at some point.

The reorganization of the department was based, I would suspect, largely or partially‑‑the minister has indicated partially‑‑on the review undertaken by APM consultants, but I wonder if there was a report that was provided to the government or the department specifically outlining it, and if there was, whether we can have access to it.

Mr. McCrae: Mr. Deputy Chairperson, I would like to make a distinction for the honourable member. I have been involved in asking for many task forces and reports and things like that, and at the end of the exercise, you get a neatly bound document that has recommendation No. 1 and recommendation No. 2, and if it is the Aboriginal Justice Inquiry, right up to recommendation No. 300 or so.

That is not the way it was in this particular situation. Suggestions, recommendations might have been made, but they did not form the basis of a written report. So that is the best I can do in terms of answering the honourable member's question. I do not know of a document. Maybe there are a series of letters or something that sets out that this might be a thing to do or that might be the thing to do, but I do not have a document that I have looked at that says, 1, 2, 3, 4, 5 and then you have done the job, so it is not quite that simple.

Mr. Chomiak: Mr. Deputy Chairperson, can the minister indicate who the head of Continuing Care is, and who the head of Home Care is now?

Mr. McCrae: The Continuing Care Division reports to Sue Hicks in her capacity as assistant deputy minister, and responsibility for the Home Care program rests with Tammy Mattern.

Mr. Chomiak: Mr. Deputy Chairperson, the government has approximately or at least 45 committees that are functioning, and for the most part, all report, I assume, to the deputy minister. I wonder if we could have a list or have tabled a list of all of the committees, who the representatives are, and what the goals are of those various committees. I believe the minister last year provided us with such a list, and it would be useful for the discussion. I ask if the minister could provide us with that list.

Mr. McCrae: The list is extremely large. As I told the honourable member, we had some 13,000 Manitobans involved in reform process in one way or another, and my deputy is getting a bunch of papers together here now, but we have asked physicians and nurses and Manitoba health and hospital personnel, research people and consumers all to be involved in the many, many task forces, working groups, committees, advisory committees, implementation committees, steering committees. I know it sounds like a lot of committees. You cannot, on the one hand, ask us to take a bottom‑up approach and really and truly listen and have a dialogue that really is not disguised as a monologue‑‑I get that wrong every time.

That is what happens when you try to plagiarize somebody else's expressions, you get it wrong sometimes. But the people involved in all of these committees have been extremely helpful to government. We continue to review their reports, their advice, their work, their implementation and everything, and, you know, we recently also were able to include the members of the medical profession on a large‑‑they were invited to join many, many committees. I think they accepted the invitation for‑‑

An Honourable Member: Twenty‑seven.

Mr. McCrae: Are there that many? I did not think it was that many, but quite a few anyway. My deputy minister has provided me with a package of information, so we will have to get it made for both my colleagues here, and it kind of sets out the large, large number of people involved in a large, large number of committees, advisory and otherwise.

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Mr. Chomiak: Mr. Deputy Chairperson, I thank the minister for providing us with that list. It will be quite useful to the whole process, and I wish we could find out who those people are that are criticizing the committee structure and the people out there, because I agree, I mean, we certainly need more consultation, not less.

To return to my line of questioning: Can the minister indicate whether or not provisions of Bill 22 apply to the administration aspect of this line item?

Mr. McCrae: Let us be clear about the question. Is the member asking about Bill 22 with respect to government people?

Mr. Chomiak: I am asking‑‑the question is as it relates to the staff years in this particular line item. There are 12 staff individuals on this line item.

Mr. McCrae: Yes, it does, except I guess we are not on the minister's line. I do not get the pay, but I do not get the days off either. Actually, there are a number of senior staff in the Department of Health who do not take the days. They work anyway, even though they are not getting paid for it, and it is very much appreciated.

Mr. Chomiak: Mr. Deputy Chairperson, I certainly understand that.

I wonder if the minister can outline for us what the salary is for the deputy minister, because I note that it has increased from $99,200 in '92‑93 to $106,700 this year, and I am obtaining those figures from the previous Estimates book. So it has gone from $99,200 to $104,000 to $106,000. I just wonder if the minister can confirm what the salary is for the deputy minister.

Mr. McCrae: The salary that you see, Mr. Deputy Chairperson, set out in Supplementary Information for Legislative Review, I am informed is correct. I think in the course of employment, employees, whether they be senior people or otherwise, if they are in a scale you can move from one mark on the scale to the next by means of being meritorious and doing a good job. Then, of course, you still have to be subject to those rules dealing with Bill 22 and other government‑wide initiatives like that.

Mr. Chomiak: Mr. Deputy Chairperson, what I never understood about the way this works is that last year in the Estimates we estimated the salary at $100,400, but then the revised Estimates showed it at $102,400. So there is an increase of $2,000, and I do not quite know where that came from.

Mr. McCrae: In addition to merit increases, there are general salary increases that everybody gets or does not get depending on what year we are talking about. [interjection] I just do not remember where I was exactly, except to say that there is a general salary increase. There are increments that people get, just like everybody else in the Civil Service, and Bill 22 would be applied at that point. That is how you come up with these numbers. If there is a arithmetic mistake or something, maybe, I do not know. I do not think so. I am told that the numbers are correct as they appear in your supplementary information.

Mr. Chomiak: Mr. Deputy Chairperson, then what I do not understand is the minister has indicated this year the salary of the deputy minister is $106,700. Last year, the salary was shown as $100,400 but the revised figure shows it as $102,400. Does that mean, extrapolating next year when the Estimates come out, we will see a salary of $108,700‑‑another $2,000. I do not understand‑‑

Mr. McCrae: What the honourable member is saying is that it was at one level and then it comes out a little bit less last year. [interjection] Oh, a little more. Maybe I can get a more full response for the honourable member at a later moment, but all I know right now is that the rules applying to every other civil servant apply to the Deputy Minister of Health.

Mr. Chomiak: Mr. Deputy Chairperson, in fact, I am not questioning that. As I note back in my review of the‑‑this happens consistently year over year. I do not understand, if we are saying one salary and then next year it is always a figure higher, why we do not target for the higher figure in the first instance in terms of the Estimates. There is obviously some kind of an accounting principle or aspect to this that I do not understand.

Mr. McCrae: The Deputy Minister of Health for Manitoba has not yet reached the top‑level scale of a Deputy Minister of Health. So if his work is meritorious, as it has been, he will continue to move up like other civil servants do. They will move up in their classification. In addition to that, if there is a general salary increase, the deputy minister would also benefit from that. If there is also a Bill 22, that also applies, which reduces it then.

That being said, I do not know quite what the honourable member is getting at. Maybe we can explore that and get some further answer for him that might clear it up in his mind. I do not know. We will try.

Mr. Chomiak: Okay, I appreciate that, if we will come back to that.

From the minister's comments, it appears at this point that the salary is set at one level and during the course of the year, because of merit increases, the salary is bumped up. We do not know that at the time the Supplementary Estimates are produced.

Mr. McCrae: Are you saying, why do you not budget for that in the first place?

Mr. Chomiak: Yes, that is my question.

Mr. McCrae: Maybe it is because we do not assume the increase. I am told that is probably the explanation. We do not assume that the performance evaluation will be positive until we have the evaluation.

Mr. Chomiak: Thank you, that is a fair explanation, except that I note when I look throughout, in a lot of areas the salary levels seem to go down not up, in some areas. Perhaps we can come back to that after, but that makes some logical sense.

Mr. McCrae: Mr. Deputy Chairperson, in some areas you will see salaries go down because it will reflect fewer people perhaps, it will reflect a person at the top of their scale, suffering the Bill 22 effects or some other reason. It will also reflect some reassignments which would be part of the reorganization that the honourable member and I discussed a little while ago, not that that results in fewer positions in the Department of Health, that delayering that we talked about a little while ago. It means that some people will move to different levels in the department, sometimes unfortunately a little lower, but that happens in a reorganization. That might account for some of that too.

If the honourable member has specific questions, we will try to deal with them. I think we have answered the question about the deputy minister.

Mr. Chomiak: Mr. Deputy Chairperson, for the record I have very many questions to continue, but I think I will pass the floor at this point to the critic for the Liberal Party.

Ms. Gray: Mr. Deputy Chairperson, I wanted to get back to the first question that my colleague the member for Kildonan (Mr. Chomiak) asked about the government document, quality health care, and where that was at in regard to evaluation.

I guess my first question would be: Other than this document, there must be something within the Department of Health that has actually outlined specific objectives and a strategic plan as to how you want to implement this document over the next three to five years. Is there a policy document that exists that you can share with us?

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Mr. McCrae: Mr. Deputy Chairperson, I think that individual officials who are in the planning functions for government might have working documents, but they are not really in a form that you could share. I have not seen them anyway, so it is not in a form that you could share. It does not take a neat report format like the honourable member has in her hands there.

I think the honourable member for Kildonan referred to the regionalization process and sort of was saying, you know, you should impose deadlines. I realize there were some time frames talked about and maybe written up somewhere, too, in letters sent out to various people in rural Manitoba, but I do not favour that approach and maybe it will take a little longer than set out in those things. I think that when you deadline people, you end up with the same kind of result we got in the constitutional discussions. I am a veteran of those wars and I do not want to be re‑engaging in deadline wars.

If there are written materials that talk in the regionalization aspect of it that say it is going to happen by this time‑‑I know we have extended the deadline for appeals, as a matter of fact, for rural association building, and I do not make any apologies for that, because there were a lot of people out there thinking the government had some kind of agenda that it was going to get its way and use the people. That was the sense. It was not the reality, but that is what some people thought.

There were some people who actually thought like the honourable member for Kildonan that there was a monologue disguised as a dialogue and the fact is we have made our intentions very clear. Some people, who want to move ahead more quickly than the government, have said, hurry up, hurry up. Once it is explained to them that there are some people in Manitoba who want us to slow down a little and we can do that, that is what we are doing.

To make a shorter answer out of a long one‑‑I am sorry, I apologize to the member‑‑I do not know of a document like that to which the honourable member refers.

Ms. Gray: Mr. Deputy Chairperson, perhaps then I will speak to the first foundation as outlined in this document, that being the focus on Healthy Public Policy. In this document it talks about a deputy minister's steering committee of Healthy Public Policy and it talks about the Human Services Committee of Cabinet being responsible for this area.

Can the minister outline for us the key areas that his department or he sees under the Healthy Public Policy, just identifying the key areas and perhaps giving us a bit of a synopsis as to where those are at? I know they give an example in here in regard to looking at substance abuse, which obviously would be one initiative under Healthy Public Policy. Can he really outline the major areas and talk about where they are at?

Mr. McCrae: Mr. Deputy Chairperson, we have some specific items of Healthy Public Policy, preventive health, Healthy Child Development issues that we can refer to, and I will, but I also want the honourable member to know that we see regionalized health services working to the advantage of those who are interested in the promotion of Healthy Public Policy policies.

By asking a region, rather than a single hospital district, to look at all of the needs in a region, asking people to do that together and within a funding envelope in the future, we can see that we think that people will respond to the call for more attention to be paid to preventive health and Healthy Public Policy issues. I did refer to a Healthy Child Development committee. I refer the honourable member to the province‑wide breast screening program, which we see as a preventive health measure.

Those are specific kinds of things, but I am talking about setting out a framework for policy making in the future that will indeed point more to healthy communities models. It is very important, but we cannot get away from the fact that many of the dollars that we spend in health care are spent on the last illness, and the honourable member will understand about all of that.

Maybe there are people who can benefit from preventive programs. I am thinking of the dialysis education program that goes along with the dialysis that is set up in various places in Manitoba. So I expect the process to bring us closer to a preventive health thrust than we have seen in the past.

Ms. Gray: Mr. Deputy Chairperson, in the Healthy Public Policy focus, my question would be then, is one of the key elements of that Healthy Public Policy to focus on prevention and promotion activities?

I am specifically interested in primary prevention. I would ask, what work has been done in that area regarding primary prevention focus in regards to Healthy Public Policy?

I think, as well, that the minister had one of the committees in the Health Advisory Network really look at those areas of Healthy Public Policy. I am wondering if that report has been acted on or where that is at.

Mr. McCrae: While my deputy minister helps me with more detail, there was a primary care committee, and its work will be and is useful to us in the development of policy.

There is the primary care shift at the Health Sciences Centre program. There is also support by our government for community health centres and their programming which is expanding. The movement of Street LINKS from the City of Winnipeg to Mount Carmel Clinic has been completed. It is now known as Street Station. The change was made in November of '92 as an effort to consolidate the service with similar services that were being offered by the Mount Carmel Clinic. They now provide the services called Street Station.

The antenatal home care program provides an alternative to hospital care. This is for women with pregnancy complications. It was piloted at the St. Boniface General Hospital to care for women with pregnancy‑induced hypertension and expanded to include other high‑risk conditions in November of 1991.

The program then expanded to include the Health Sciences Centre women's hospital in April of '93. The Health Sciences Centre women's hospital antenatal home care program steering committee was established to explore the feasibility of implementing the program at the Health Sciences Centre with representatives from the hospitals. Winnipeg Public Health, Manitoba Health and federal Medical Services‑‑should I go on with that? That is more detail about that program.

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With the postpartum referral guidelines now being used in five Winnipeg hospitals, and if this year's births match last year's, 11,831 families will have the transition from hospital to the community according to the guidelines. The postpartum referral guidelines provide a framework for postpartum discharge and community follow‑up. It is based on assessed need for health care services and is a result of collaboration among the woman, her family and health care providers.

These guidelines were used in the development of a co‑ordinated discharge program proposal by Brandon General Hospital and Westman region. A co‑ordinated post‑partum discharge program in Brandon has been in effect since October of '93 with a total of 132 families involved as of December 31 of '93.

In 1992‑93 there were 1,086 births in Brandon, so an additional 1,000 families will make the transition from hospital to the community based on assessed need using the guidelines.

I mention the diabetes education program. Just to give you an idea of what was happening, in '91‑92 all clients involved, there were 7,289 of them. In '92‑93 there were 8,468, and that represents new clients at 1,179.

With respect to aboriginal clients, included in the previous total I gave the honourable member, in '91‑92 there were 538 aboriginal clients of this program, and in '92‑93 there were 646. That makes 108 new clients, and I guess we will have to update this for '93‑94 when we can.

Those are a few things that are going on.

Ms. Gray: The minister spoke of support for community health centres. I am wondering if he can elaborate on that?

Mr. McCrae: Mr. Deputy Chairperson, we have an ongoing relationship, a working dialogue, with community health centres, and we have asked them for proposals from them as to how they see their role being enhanced. They have some ideas‑‑and the honourable member will know what they are‑‑but we provide a lot of services directly from government, too. Maybe community health centres can do a better job at that. We are inviting them to look at all of those kinds of things and make proposals to us.

Ms. Gray: Mr. Deputy Chairperson, can the minister tell us what are some of the kinds of services and programs that he feels that possibly community health centres could look at providing as opposed to a government directly?

Mr. McCrae: The trouble with answering a question like that is that rather than it being the idea of the community health centres from whom we are asking for proposals, it all of a sudden becomes my idea and I am not the health care expert around here. The people who deliver these services directly and look at services being delivered in another way that could be improved on are really in the best position.

So, as I have said, we have asked them for their advice, and I do not think that it is right for me to speculate on how they should be running their operations and which services they would do best. They know best. They know better than I do.

Ms. Gray: Can the minister tell us where he sees nurse‑managed centres fitting into this whole area of community‑based health programs?

Mr. McCrae: We have been having discussions with nursing organizations about this. As I say, we have begun the discussion of this. I think the Manitoba Nurses' Union might have been a little surprised last fall when they put out a report on certain incidents that they had reported in hospitals, came to the conclusion that somehow that is directly linked to having nurse‑managed care, but I do not really see the link yet. I think they were kind of surprised that we responded by saying that is something that we are prepared to explore with you.

But, you see, the trouble with nurse managed or nurse practitioners is that to some people this is the taking away of certain things from one group and giving it to another, and if you happen to be on the side of one, then it is really a big win. If you happen to be on the side of the other, it is a really big loss. That is the traditional way of doing things with some people. It is not with me, and it is not with my government. We like to work and bring people together. An example of that is last week we asked the various nursing professional groups to get together and talk together instead of always when the other group was not around. That was what was always happening. I would have a meeting with a nursing group in my office, and they would say, well, the doctors get to do this and LPNs get to do that. Then another group would come in and say registered nurses can do this and cannot do that and so on.

The point I am getting at is we are having a dialogue of the deaf or something when it comes to health professionals. It is really bothersome.

There was a news story about it recently, about me being the referee or some such thing or in a tangle of all of this. I do not see myself very well qualified to sort out all these things because that is the old way. That way you choose whose side you are going to be on and you ride with them. If it is not a very rough road, then do not be surprised‑‑this is the '90s.

My approach is to try and maybe bring people together. That is what I did last week. I was very glad because we were able to bring together the Manitoba Association of Registered Nurses, the Manitoba Association of Licensed Practical Nurses, the Registered Psychiatric Nurses Association of Manitoba and representatives of nurses' aides together with people from the department and a moderator‑‑I do not know if that is the right word but an independent person to chair the meeting.

The first reports I got were relatively positive that there might be some meeting of the minds here. The next thing you know, if we can get enough meeting of the minds there, we will bring the medical profession into the room too. That is the way we are going to discuss nurse‑managed care or nurse practitioners. We are not going to do it in an effort to make one group the winner and the other group the loser.

I am very sad to have to report that at the last minute the Manitoba Nurses' Union decided not to come because they had other priorities. I appreciate that we all have priorities, but it would have been helpful if anybody representing the organization had at least come so that they could report back to the leadership. They did not come. I am sorry to say that it was awfully reminiscent of all those times I have asked the member for Kildonan to join me and have coffee or talk. It has not happened.

Is it a coincidence that it is the member for Kildonan and the MNU that want to absent themselves from these meetings? I think we need the MNU's input. Sometimes we even need the member's input, and we appreciate it when it is helpful. We do want people to work together. I appreciate the member's question. I am interested in exploring the possibilities.

We know that nursing stations in remote Manitoba‑‑you do not find too many medical practitioners around there at two in the morning or even in a hospital at two in the morning. Who is running the show? It is nurses basically.

I think there is room for us to explore possibilities. I am heartened by some of the things that I am hearing representatives of the medical profession saying with respect to these things. I think there is a chance that we can pull people together, bring people together. I really hope people will come when they are invited.

Ms. Gray: Mr. Deputy Chairperson, the nurse‑managed centres, I know that the MARN organization had a pilot project and a proposal they had put forth to the Minister of Health. I am just wondering if you can tell me where that is at, what status that proposal is at in terms of the MARN nurse‑managed centres? They want to do some pilot projects.

Mr. McCrae: We have a preliminary report. There is such an example operating at the Youville Clinic in St. Boniface. We like to learn things from projects like that.

Ms. Gray: Can the minister tell us, though, is he prepared to support MARN's proposal to look at an expansion of the nurse‑managed centres, perhaps one in rural Manitoba as an example, one in northern Manitoba?

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Mr. McCrae: The honourable member asks for what my position will be or something like that. I think there was something about, am I prepared to consider. I am certainly prepared to review it, but to review it with other people, too, besides just the one group. There is always, I have found, another group of people whose role might be impacted by the change in one group's role. Some people advocate for one group and one group only and to heck with everybody else. I do not do it like that, and I do not think the member for Crescentwood does either.

The role of nursing is one of the things that I am asking all of the nursing groups to get together and to discuss. That was one of the main features of the‑‑I do not know what I would call that‑‑meeting or forum or something that we had last week, was to examine the role and the whole education issue for nursing professionals. We are discussing this with MARN right now, so what the honourable member says is something that could end up being an upshot of all of these discussions. We will continue working with them.

Ms. Gray: Is the minister suggesting that‑‑is there some type of formal vetting process of a number of disciplines other than nursing professions including the physicians? The minister mentioned the physicians. Is there some formal group that is in place that is going to look at projects such as nurse‑managed centres to determine whether in fact the department should look at funding that kind of a service?

Mr. McCrae: While I am interested in looking at all these things, I am not interested in stampeding it toward that objective until I can get the nursing professionals to iron out some overlaps that already exist. I mean, let us not forget all three of the nursing groups, the LPN, the RPN and the R.N., all have legislative sanction, and there is some overlap here and there that I am afraid is sometimes troublesome for the various groups. I want them, rather than have me impose solutions, to see if there is not some common ground that we can find to iron out those problems, and then it makes getting into the kinds of programs the member refers to so much easier because you do it with the agreement of the parties instead of beating up on one group as opposed to another.

Ms. Gray: Mr. Deputy Chairperson, is the minister saying that before any pilot projects or any expansions in community‑based services go ahead that involve the nursing profession, there has to be a decision made as to very clearly what is the role and mandate of each of the various types of nursing professionals? Is he saying that (a), and (b), if that is the case, what is the formal mechanism that is in place to actually look at that?

Mr. McCrae: If there is any evidence of lack of good will or something, then that will be exposed through the kinds of processes we are in now. If some group is not dealing in good faith with us, then it is going to make it hard for them as we do move toward the kind of models of service delivery the honourable member speaks of. The group I referred to a little while ago, over the various nursing groups, have been meeting, and they are going to meet more. I understand they are going to make a report to me by June 15. Maybe by then, I am hoping some reason will prevail and we will get a proper definition. I do not think we can go forward without that definition. Certainly, we need to make some peace. There are some people out there fomenting, and it would be better if they did not foment because then it would be easier for us to make peace and get on with better service delivery for our fellow citizens.

Ms. Gray: Mr. Deputy Chairperson, although I think it is very valuable that the various nursing professions talk amongst each other and look at their role and mandates and the overlap or possible fragmentation of any kind of service between LPNs, R.N.s, registered psychiatric nurses, et cetera, I guess I am not quite sure why you would use that as a potential reason not to move ahead with some community‑based services.

The reason I say that is I do not think we have a standstill with any type of service expansions in regard to physicians, and we have signed an agreement with the Manitoba Medical Association. We have gone ahead with that. I would imagine, as well, that most people who are nurses and/or physicians and people in the Department of Health would recognize that the role and mandate of physicians versus nurses is not even clear. So I am not quite sure why this clarifying the role and mandate, albeit important, is being used as perhaps the reason to not move forward with some community‑based services.

Mr. McCrae: Mr. Deputy Chairperson, I did not mean to imply that everything is going to be ground to a standstill unless and until we get some meeting of the minds. I do not use that as a reason not to move ahead. That is why I mentioned the June 15 date, because I am hopeful that something will happen.

I had talked earlier about the diabetes education program. I talked earlier about breast screening and perhaps some other things as well. Those things are going forward, and we have nursing professionals helping us with them. There is all kinds of expansion of these kinds of programs. There is expansion of the personal care program in Manitoba, expansion of the Home Care program, and it is going to require different kinds of people.

So I do not think we are not moving ahead, but I do not think it is unreasonable to say that if they can achieve something positive by June 15, that is not that far off, so I do not really feel like I am holding that much up.

Ms. Gray: Mr. Deputy Chairperson, can the minister tell us where within the government structure, in the department structure, are decisions being made as to what type of community‑based expansion the services occur, and who would provide that kind of service? The minister spoke of Home Care which is currently through the government as an example of an expansion of community‑based services, but under which part of the Department of Health? Where is that decision made in terms of what expansions are gone ahead with?

Mr. McCrae: It would be under our Community and Healthy Public Policy, whatever the name of that, Ms. Hicks' branch. Community and Mental Health Services Division is where those kinds of policy issues are dealt with.

Ms. Gray: Can the minister tell us, does that particular section then have a specific amount of new dollars to look at some projects, pilot or other kinds of projects for community‑based services?

Mr. McCrae: I do not think you will see that if you look at the line. I should also have mentioned the health reform line of the Estimates if the honourable member is looking at it because‑‑is that what it was called, health reform? That is where you see the money movement away from reliance on acute care. Savings at hospitals is used directly for community options that are made available. I think that there is more. Yes, there is money in that particular line as well.

Ms. Gray: Exactly how much money then has supposedly been saved from institutions and is being directed to community‑based care? Does the minister have a document or something that can sort of break down where exactly that money is going into the community that has come from the institutions?

Mr. McCrae: We might be able to put together a savings here and spending here because, ultimately, if you look at the budget, we are only down by .2 of 1 percent, I think, about $4 million. It is a lot of money, but I say "only" because I look at where the money is going to. I am quite heartened I see it in Mental Health. I see it in Home Care. I see it in dialysis and things that are quite important and pressing and needed if we are going to have a meaningful reform strategy.

We will try to pull it all together, and I think we can, but if you look at the whole package for Health, you will see that there are reductions in some places and increases in some other places and only a relatively small net reduction, so you can do that too, but we will put a paper together for you, for the honourable member.

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Ms. Gray: Mr. Deputy Chairperson, I thank the minister for that information.

Getting back to again this first foundation and looking at Healthy Public Policy and this blueprint, this document talked about making sure that there was evaluation that was done in regard to every major action and policy of government.

I would wonder then, given that I am sure that that was done, as it has been outlined on page 10, if the minister can tell us: In regard to the changes that were made to the Home Care program last summer, was there an evaluation of the impact of that, and what was the result of that evaluation?

Mr. McCrae: I do not think the Manitoba Centre did an evaluation on the reductions to cleaning and laundry services. The centre did, however, do an analysis of the hospital bed reductions and the results of that, and the honourable member for Crescentwood, I am sure, would be interested in that. I do not know about the member for Kildonan, but the member for Crescentwood might be very interested in seeing those results.

Ms. Gray: Mr. Deputy Chairperson, is that particular report already out by the health policy group?

Mr. McCrae: It was not put out by way of a public report, but it has been the subject of discussion amongst all the health care facilities who have been involved in any bed reductions, to demonstrate what the result is, what happens when you close beds, you know, in certain‑‑it talks about hospital re‑admissions as a result or, I think, people's passing away, how long after a hospital stay, pre‑bed‑reductions, how long after a hospital stay after bed reductions, those kinds of indicators which are known in the analysis and research and evaluation industry as the proper indicators to use to measure how these things are working.

Mr. Maynard reminds me, what it showed is that the bed reductions are doing the job they were designed to do. That means the people who need them the most are the ones who are now in them as opposed to previous to that. Hospitals are looking very carefully at their admissions policies and making decisions that have more regard for making sure bed space is available for people when they really need it. In the past there has been a tendency to admit too many people when there were other options available, contrary to what some people say.

Ms. Gray: Mr. Deputy Chairperson, I go back to the statement that every major action and policy of government will be evaluated in terms of its implication for the health of Manitobans, and it may not be the Centre for Health Policy and Evaluation at the university that evaluated, but surely someone in government must have done an evaluation as to what the impact would be or was as a result of the changes to the Home Care program, changes such as the home care equipment program changes, changes to laundry services and home support work, those kinds of changes. Was there some evaluation done or an impact study done either before the changes were made or at least after the changes were made?

Mr. McCrae: Mr. Deputy Chairperson, I understand the point the honourable member is making, and it goes back, too, to a comment I made a while ago about reform and budgets. Some people like to confuse the two and bring the two together. Last year was a difficult budget year. There is no denying that. Difficult, difficult choices were made, no denying that either.

Because I was concerned about the kind of thing the honourable member is talking about with respect to evaluations and is this the right thing to do, I put in some measures that I thought might cushion the potential impact on some people. We also think that appeal panels and advisory committees will help us as well, but it was based as much on some principles that those who could afford some of those services ought to be able to contribute to paying for them or pay for them themselves or seek options.

Do not forget, within the global budget last year‑‑we keep coming back to Home Care, and I think we will probably continue to do that‑‑there was a net increase in the allocated amount for Home Care last year. This was within the Home Care budget. This year, of course, the amount is going up again. I mean we can go back over the years and talk about that. What did they do for cleaning and laundry services prior to 1976, I believe it is, when the Home Care program began in Manitoba? We can go back and talk about that and look at how the budget has increased in the last seven years by 93 percent and talk about cuts if you want.

It is an interesting game to play for some people, but I also recognize that for some people cleaning and laundry services or equipment issues can have an impact on whether they are getting the best care. I recognize that, but I think it is important that we do not look at that issue to the exclusion of all the other ones, because if you know as I do that service provision level and quality was higher in some regions than in other regions‑‑and you say to yourself, is that fair? So do we bring it up or stabilize it, make it equal for everybody? Which is the best way to do it? That was the effort last year in the context of a very difficult budget year.

With respect to an evaluation program specifically on that issue, that apparently has not happened. That is another good reason why you need to put in some of the measures that I did bring in immediately after being appointed, to make sure that we were not hurting anybody.

Ms. Gray: Mr. Deputy Chairperson, what exact measures actually did you bring in once you were appointed? I am not clear about that either. I have more questions on Home Care, which I will save until we get to that section, but if you could just maybe briefly outline what they were.

Mr. McCrae: I could try very quickly, if that is okay with everybody.

When I was appointed, what was happening was people were being reassessed on paper, I guess, which means their cases were looked at to see if they really had to have that cleaning and laundry service. The case co‑ordinator function in the department was making these decisions, and I guess just telling the workers or putting it on the file or whatever that for this particular recipient they do not get cleaning and laundry services anymore.

Well, that was not good enough to suit me and a lot of other people too. My thought was, well, I do not disagree with the idea of people having to pay if they can possibly do it or having to look after themselves if they can possibly do it or with the help of their family or other community supports that might be in existence, which indeed there were in many areas throughout Manitoba, maybe a better developed Support Services to Seniors program for example.

My concern was some people were saying to me that somebody is going to end up in the hospital, readmitted. Somebody is going to end up in personal care prematurely, or somebody is going to have to go on welfare to try to afford these cleaning and laundry services. I said, well, hold it right there then, let us do a better job of this reassessment. Let us do it face to face and let these co‑ordinators make these decisions after they have had a personal interview with the recipients of these services that were proposed to be terminated. That was one thing.

Another thing had to do with supplies. I can recall, very shortly after being appointed, meeting with the ostomates' association of Manitoba. They came to me. They said, Mr. Minister, we agree with your approach that people who can afford their own supplies should pay for their own supplies.

That was not me talking. That was the ostomates' association. They said, but we can tell you, Mr. Minister, of a very small number, perhaps only a handful, but a small number of ostomates people who just maybe cannot afford this, and besides, Mr. Minister, there is a sign in the home care depot that says ostomates, cash up‑front or some such thing like that.

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I was appalled. I did not like that very much at all. So that same afternoon, I believe, Frank‑‑or the next morning anyway, that sign was down, and we discontinued the policy of cash up‑front. Because of the nature of ostomate supplies, you do not wait for those.

We will pick this up, I guess, later on.

Mr. Deputy Chairperson: The hour is now 5 p.m. and time for private members' hour.

I am interrupting the proceedings of the committee. The Committee of Supply will resume consideration at 8 p.m. this evening. Thank you very much.

EXECUTIVE COUNCIL

Madam Chairperson (Louise Dacquay): Order, please. Will the Committee of Supply please come to order.

This section of the Committee of Supply will be dealing with the Estimates for Executive Council, page 13 of the Estimates manual.

Does the honourable First Minister wish to make an opening statement?

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Hon. Gary Filmon (Premier): Madam Chairperson, indeed I do have a brief opening statement that I would like to share with the committee. I certainly invite fullest participation by my colleague Leaders and any others who wish to participate in the discussions of the Estimates of Executive Council.

Before I discuss the Executive Council Estimates, I thought it might be helpful for the committee, as we embark on another 240 hours of Estimates debate, to go over some of the modifications in this year's main Estimates of Expenditure.

The 1994‑95 Estimates are in the same basic format as last year; however, there have been a few changes which are worth noting. Over the past several years the government has been pursuing a policy of better identifying the total costs of program operation throughout government by allocating overhead costs directly to the department as opposed to leaving them within the Department of Government Services in many cases.

Last year for example, we implemented an accommodation cost‑recovery system under which departments and programs are charged for the office space they utilize. I understand the results have been positive as program managers have become far more conscious of controlling these important costs in their department.

For 1994‑95, in addition to expanding the scope of the accommodation cost‑recovery system to other facilities, we are also implementing a cost‑recovery process to allocate the costs of certain employee benefits to departments and programs. Salary appropriations in this year's Estimates book have been renamed Salaries and Employee Benefits to reflect this change. To ensure comparability between years, the 1993‑94 Estimates, included alongside this year's Estimates, have been adjusted in the same way. These changes should help ensure a better understanding of the total costs involved in operating government services.

As noted in the budget, this year's Estimates also reflect the establishment of two new special operating agencies, the Vital Statistics Agency under the Department of Consumer and Corporate Affairs and the Organization and Staff Development Agency under the Civil Service Commission. Because these agencies are self‑financing through their various rates and fees, funding is not required in the annual Estimates of Expenditure. We now have four special operating agencies, including the Fleet Vehicle Agency and the Materials Distribution Agency which were established previously.

A final change in this year's Estimates relates to the establishment of a new service heading, Other Appropriations, near the end of the Estimates book. In previous years, several separate service headings were included in the Estimates to provide expenditure authority for programs that are delivered by a number of departments or where the allocation to departments was not determined at the time the Estimates were printed. For 1994‑95, several of these programs have been combined under the Other Appropriations heading to provide a more orderly presentation and to facilitate review in committee.

This year's Executive Council Estimates total $3,158,700, a decrease of $22,000 or 0.7 percent from the adjusted total for last year. We continue to have 44 staff years in Executive Council, the same number as last year. For those members who may not be fully familiar with the department, I might just say that it operates as a very much scaled‑down version of Ottawa's Privy Council office and Prime Minister's office rolled into one.

The Clerk of the Executive Council is the administrative head of the department and of the Civil Service. He supervises a group of people who handle cabinet administration and operations, central policy co‑ordination and a variety of other functions including protocol and intergovernmental relations. The office also includes the Premier's Secretariat and other staff who handle scheduling, correspondence, research and communications. I have had a number of opportunities to tell the staff in Executive Council how much their work is appreciated, but I do not mind putting it on the record once again.

In the next few weeks, many of the staff will be involved in working on this year's Western Premiers' Conference which Manitoba will be hosting in Gimli starting Wednesday, May 18 and running through Friday, May 20. This will be Manitoba's sixth opportunity to host the western Premiers and territorial leaders, and we are working diligently to make it a productive conference and an enjoyable one for our guests.

The agenda for this year's conference is not final, but on the basis of discussions to date, it appears the economy and jobs will be the main focus. There is a lot of ground to cover‑‑the national infrastructure program; training; the social security review and other social programs; international and interprovincial trade including the reduction of barriers between provinces and artificial competition for investment; agriculture, including U.S. trade harassment; transportation, both east‑west and north‑south and overlap and duplication. We will also want to talk about western regional co‑operation and opportunities for improving services and reducing costs by working more closely together, and I believe we will want to discuss fiscal issues as well, including cigarette smuggling, an issue on which the western provinces have been able to put forward a strong, united position.

I believe all western provinces and territories are committed to working as co‑operatively as we can with the new federal government. In some areas, progress has been encouraging, to say the least. Here in Manitoba we have been in the lead in implementing our infrastructure agreement and are considerably further ahead than most other provinces. The discussions concerning the new Winnipeg Development Agreement are also proceeding well, and we are looking for similar progress in other areas.

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The future of Churchill remains a top priority for our government, and a strong ongoing federal commitment is obviously essential. At the same time we have been disappointed and concerned about a series of federal decisions which we believe have been ill advised. Our position on the tobacco taxation issue is well known and certainly has not changed. Similarly, we felt that the decision to award the headquarters of the North American Commission on Environmental Co‑operation to Montreal was highly questionable.

We also remain concerned about federal offloading as well as a lack of adequate consultation in some key areas. There is a growing uneasiness among provincial governments, I believe, about the extent of the federal government's commitment to real partnership with the provinces and territories. I suspect the western Premiers will want to talk about that subject too when we meet later this month.

Here in Manitoba we are also anxious to work out a satisfactory agreement on federal support for Francophone Schools Governance. Agreements were signed with Alberta and Saskatchewan last fall, but to date the federal government has not offered Manitoba a fair and comparable level of support. We have raised the issue with the Prime Minister and the federal minister responsible and look forward to an early resolution of this issue. Having said that, I would be remiss if I did not compliment the federal government for the support it has offered us in our effort to secure the 1999 Pan American Games for Winnipeg and Manitoba. Their help has been welcome.

Before concluding, I think it is important to take note of the events in South Africa and the progress that nation is making in transforming its government and its place in the world. Several months ago, in line with the request from our Department of Foreign Affairs and in line with the stated wish of the leadership of the ANC and others, Manitoba lifted the economic sanctions our province had applied since the 1980s. Other provinces have done so as well. I know everyone in this House wishes the people of South Africa and their new government well as they embark on their new course. I believe we will all support efforts to build stronger trade and economic links with South Africa in recognition of the new respect they are earning in the eyes of the rest of the world.

Thank you very much.

Mr. Gary Doer (Leader of the Opposition): It does not feel like a long time ago when we did these Estimates last. I guess time moves quickly along, as they say, as we proceed with these Estimates. I believe these are the fifth set of Estimates since the majority government was obtained in September of 1990.

We will have a number of questions to put to the Premier (Mr. Filmon), areas of interprovincial issues, federal‑provincial issues, international trade, and other issues where the Premier has had the file or seized the initiative in terms of his role as Chair of the Economic Committee of Cabinet and initiatives that he is involved in.

I would like to start off by saying that we too are very, very pleased with the South African election and the votes are coming in, but the fact that everyone in South Africa is participating in a democratic process‑‑I know that some members of our caucus have participated for years in the struggle to support South African people in terms of obtaining the vote and obtaining freedom for many of the political prisoners.

I know that the former attorney‑general, Roland Penner, the former member for Fort Rouge, participated with the anti‑apartheid organization here in Manitoba. It was only a small sanction, I suppose, in terms of South African wine. It was criticized in terms of the choices that people could make, but it was a way in which the government of Manitoba could participate with the people of South Africa.

I would say that on this score, I think the former Prime Minister Mulroney did a very good job on the South African file. I was not always pleased with his position in terms of trade at the same time we had sanctions, but I thought he took a very strong stand against Margaret Thatcher, the former Prime Minister of England, and gave Canada a very unique role in the Commonwealth in standing firm on this issue. I have been critical of some aspects of the former Prime Minister's performance here in the country, and I think it is important to give credit where credit is due. I think Canada took a more aggressive role on South Africa actually in the late '80s and early '90s than we did perhaps in some of the earlier years.

I am hoping that we can use trade and human rights for other countries as well because clearly, if the history of South Africa is to be looked at, sanctions did work and trade sanctions did work, even though for a short period of time it did hurt some people in South Africa, and it did hurt some people trading from Canada. But I note that the Prime Minister of Canada is going to visit China shortly, and the Premier (Mr. Filmon) has been to Indonesia where there are terrific numbers of human rights issues there, even though there are tremendous trade potentials.

I would ask the Premier, in his role as a trade ambassador for this province, to keep mindful the human rights records of countries. I do not believe this is an easy issue, not for one moment, but I do believe it is an important balance to be maintained. I do not think ever‑‑as Manitoba is a fair‑loving province and likes fairness worldwide, I believe it is important to keep that ethics of Manitoba in play and in place in the values we take to other countries and the discussions we have with other countries.

I wish the Premier well on the Pan Am Games, and we will obviously be asking questions on that shortly. As a person who worked with his father, and as a volunteer in the Pan Am Games in '67, I was involved in driving around with my dad with the old diving teams and old swimming teams back in the Pan Am Pool and remember those events very well. As a person growing up in this province, I think it would be tremendous for us to get the games again in the year scheduled.

The issue of the Premier's Estimates, we will deal, as I say, with a number of ranging issues. The Premier (Mr. Filmon) is head of the government, and he is Chair of the Economic Committee of Cabinet. In September of 1991, the Premier said that he would put his, quote, government's reputation on the line in terms of what would happen in the economic performance of this province.

And sadly, Madam Chair, the report card has come out again today for 1993, and when we look at the record of this government, particularly after they received a majority government in 1990, you will see that in 1991 we were second to last in terms of economic performance, in 1992 we were fifth, and in 1993 we were tied again for last place. If you look at the whole three years of that actual growth rate, Canada grew by 4.5 percent, and Manitoba is under 1 percent for all three years added together.

Madam Chairperson, if you are not growing, you are not developing as a province; you are not increasing your population; you are not keeping your young people here; you are not creating jobs; you are not creating economic opportunity. The growth figure is the most important statistic we get, and, unfortunately, that growth number is not very positive for a government who said that they would put their so‑called reputation on the line in 18 months after 1991.

We remain convinced that the government has drifted along in terms of education for six years. This is also a very important issue: to have after six years a "parents forum" on education when leadership has been begging for year after year after year in terms of education, and the government has flip‑flopped on their initiatives.

One year they cut back dramatically in the community colleges; the next year they are trying to get political credit and public credit for investing in our community colleges. It is a government at sea in terms of post‑secondary education and our public education system. It is more important, unfortunately, for this government to be allocating resources to private training grants than to the public education system. When you just look at the raw numbers, Madam Chairperson, then you look at a government at sea in terms of education.

We think the Premier over three Education ministers has really not performed to the level at which Manitobans would expect‑‑[interjection]

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Well, the member for Lakeside (Mr. Enns), of course, was a person who helped build the community colleges, and his Premier helped, I would say, decrease our investment in those radically if you look at the numbers.

Finally, on a couple of other points, Madam Chairperson, the Health situation, again six years later, continues to drift along from crisis to crisis and from review committee to review committee, to reform committee, to review committee, to reform committee and back again. We do not even know sometimes where to start asking questions.

You know, the government has a 1992 reform action plan with no action in it. Then it has a plan where it is going to close all the mental health beds at St. Boniface Hospital and spent $45 million on a new health care facility at the Health Sciences Centre. It builds the new mental health facility at $45 million, and then we get the Bell‑Wade Report six years later saying, close the psychiatric beds at Health Sciences Centre and reopen the ones at St. Boniface. The minister says that this is just one example, mental health is one of the better areas of government health care. Some of the other areas are in even more jeopardy and more chaos and more confusion for the public, six years later.

The government says that every government in Canada is transforming the health care system. They are right, but nobody, six years later, is still sitting there with crisis after crisis, and five years after this government allegedly had a plan to deal with health care, it brings in Connie Curran. The Premier (Mr. Filmon) approves the contract, because it has to be approved in cabinet across three departments. That is their plan, five years later, to have an American consultant.

We will be raising questions about the staffing of the Premier's Office. We know that the staffing levels are constant, but we are concerned about the role of some of the staff in the Premier's area. We will be asking questions on that area. Finally, we want to end off by saying we wish the government well on the Winnipeg Development Agreement negotiations, on maintaining Churchill and our rail lines and our transportation sector, on dealing with the federal government on tax fairness. In terms of tax reform, we will be asking questions on that. We also wish the government well in the role of hosting the western Premiers' meeting in Gimli.

I know it was only a few months ago that the governments met in November in Alberta, and so it is only about five months since the last meeting. I think Gimli is a beautiful location. I am glad to see they are taking advantage of a facility that was built under the former Canada‑Manitoba Tourism Agreement, notwithstanding some of the questions we asked on that facility. We hope that the government has the agenda prepared for the western Premiers and will deal with the economy.

Again, Manitoba was in last place of the four western provinces last year. It looks like it could use a lot of help in terms of economic performance and economic growth and jobs, infrastructure, social review, agriculture, transportation, duplication and co‑operation. We will be raising specific questions, but we wish the government well at that very important forum. We wish the meeting to go well.

It is a very proud moment when Manitoba hosts any important meeting of ministers, but particularly the Premiers. It will be a very good meeting. I know the people in Gimli, the community of Gimli is really looking forward to hosting this meeting and really looks forward to finding out from the government the agenda and the timing and how they will be involved in some of the events that may be planned. Thank you.

Mr. Paul Edwards (Leader of the Second Opposition): Madam Chairperson, I want to start by indicating that‑‑and perhaps this is one time in the Estimates when we can be friendlier than in the rest‑‑I hope it goes in an extremely friendly level. Although, I suspect that it may not from time to time in these particular Estimates, but I do want to say that while we are speaking about the Executive Council and the Premier (Mr. Filmon), in particular, I think it is important to acknowledge that it is a very difficult job. I was very pleased to see that Mr. Fox‑Decent and his committee acknowledged that and the enormous responsibility, regardless of how that job is actually done and the differences which we have. I think, on a personal basis, we all acknowledge in this Chamber that this is not an easy life and that the Premier, in particular, has substantial burdens on his time and on his talents in this particular job.

I would venture to say that there are very few, if any, CEOs that put up with the type of accountability, and, as well, the type of financial challenges, budget constraints and social challenges that a Premier does.

It is a difficult time to govern any province anywhere in the world. I think we have to acknowledge that, and I think this is the appropriate time to do that.

With respect to the particular operations of the Executive Council, in addition, I join comments with the Leader of the Opposition (Mr. Doer) that we will be asking questions on specific line issues about the duties and responsibilities and what changes have occurred, what changes are anticipated in the staffing under the Premier and president of council‑‑or I am sorry, under the Intergovernmental Relations Secretariat, as well as the Premier's personal staff and the staff which serves cabinet.

Madam Chairperson, one of the issues that we will want to be asking about is the continuing practice of not attaching details of contracts to Orders‑in‑Council appointing members positions under Executive Council. That has been a practice which has been developed over the years, and I would like to question the Premier again in these Estimates on that practice and get further details.

I do think that all of the specifics of salaries and benefits, whatever they may be, with respect to any civil servant, should be available to the public. Having not participated directly in these Estimates in the past, I am not aware of whether or not the Premier (Mr. Filmon) is in the habit of tabling that when specific questions are asked, but we will want to explore that area.

With respect to the areas that the Premier mentions, obviously we share concerns about the economy in general. We share concerns about some of the specifics he mentions, Churchill, as well as, in particular, he mentioned them today in Question Period, the agricultural economy and how Rural Development and Agriculture need to dovetail in the coming years to ensure that we have viable communities in rural Manitoba, that remain viable and as well that the family farm remains a viable, realistic goal for our young people to stay in those rural communities.

Specific to Churchill, I note that last week, I believe it was, the actuate proposal apparently got the go‑ahead in some form or other. I saw that mentioned publicly. Perhaps the Premier will be familiar with the specifics of that. I am not familiar at this point with the specifics of the proposal timetable. Of course, we are all familiar with the proposal, but not the timetable and how it is going to come about and whether or not there are still hurdles to overcome. With respect to the specific mention of the Pan Am Games, again, we will want to ask questions about that and, quite frankly, whether or not the Premier sees that there is a role for any assistance from either, I am sure, of the opposition parties.

I noted the comments of support from the Leader of the Opposition (Mr. Doer). I think we all understand the economic benefit of the Pan Am Games in direct dollars but as well in terms of being a showcase for the world. The City of Winnipeg, the Province of Manitoba have hosted, obviously, events of this magnitude in the past and done extremely well. I think we all understand the benefits which flow from that, so I know that the Premier will be travelling to, I believe it