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HEALTH

Mr. Chairperson (Marcel Laurendeau): Would the Committee of Supply come to order, please. This section of the Committee of Supply has been dealing with the Estimates of the Department of Health. We are in item 1.(b)(1) and the item before the committee is the motion of the honourable member for Kildonan. Question?

Voice Vote

Mr. Chairperson: All those in favour of the motion, please say yea.

Some Honourable Members: Yea.

Mr. Chairperson: All those opposed, please say nay.

Some Honourable Members: Nay.

Mr. Chairperson: In my opinion, the Nays have it.

Mr. Steve Ashton (Opposition House Leader): On division.

Mr. Chairperson: On division.

At this time we would invite the minister's staff, if they are present, to come in and--[interjection] We can recess for a minute, if you want. Order, please. We might recess for just a little while until we--[interjection] Okay.

At this time we are dealing with item 1.(b)(1).

Mr. Dave Chomiak (Kildonan): Mr. Chairperson, in the Estimates the government has allocated $38 million for transition in the hospital sector. My question to the minister is very specific. Who is controlling those funds? How is it being designated and can he provide us and table documentations about the transition funding and how it will be utilized?

Hon. James McCrae (Minister of Health): Mr. Chairman, the expenditure of that $38 million will be carried out throughout the course of a good part of the fiscal year, because the fiscal year began on April 1, and we have not yet begun to act on any of the recommendations, for example, of the urban planning partnership or the KPMG or any of those mechanisms. A responsible thing to do is to have that $38 million there, so that those $38 million are presently being used today to fund the operations of Winnipeg hospitals which have not yet been impacted by any change. If you are going to save $53 million, you kind of need to start on the first day of the year, because that is a large sum of money. Knowing that we cannot do that because we have not made decisions about the recommendations from the design team, recommendations concerning geriatric care, for example, because we cannot do that right from the beginning of the year, we do need to have that bridge funding. So that basically answers the honourable member's question about how that money will be spent. It is being spent to fund the operations that have not yet changed prior to the end of the fiscal year 1996-97.

Mr. Chomiak: I thank the minister for that response. Does the minister have guidelines with respect to that funding and information that would help members in the Legislature determine what parameters and under what conditions that money will be utilized, as well as to trace the factors of control on the expenditure of that sum of money?

Mr. McCrae: My staff are busy, Mr. Chairman, so I cannot really answer the question right at the moment, but I will undertake to discuss this with staff and attempt to respond at a later time.

Mr. Chomiak: I again thank the minister for that response. With respect to the $53 million that the minister mentioned in his preceding answer, is there a breakdown between how much it is determined is going to be saved within the urban hospitals, including Winnipeg and Brandon and those outside of Winnipeg and Brandon? As I understand it, when the deputy minister had occasion to speak to the urban planning team, he indicated that there would be a breakdown of something in the vicinity of--when the original designation was at $75 million--a $43-32 million breakdown. Can the minister give us a breakdown of the $53 million?

Mr. McCrae: I hope someone is keeping track. Maybe the honourable member can write these questions down because you see, Mr. Chairman, my staff are very busy. They are trying to make sure that the home care clients of this province get the service they need at a time when we are in a labour disruption supported by the honourable member. My staff will be here a little later and maybe we can answer these questions at that time.

(Mr. Mike Radcliffe, Acting Chairperson, in the Chair)

Mr. Chomiak: Since we are dealing with item 1.(b) as it relates to the deputy minister's office, can the minister indicate, and it is normal practice that the deputy minister is made available for this section of the Estimates, whether or not the deputy minister will be available?

The Acting Chairperson (Mr. Radcliffe): Would the honourable member for Kildonan please summarize his last question.

Mr. Chomiak: It is an item of appropriations and it specifically deals with Executive Support and specifically deals with the office of the deputy minister. Normally the deputy minister is available to answer questions under this appropriation, so I am wondering whether or not the deputy minister will be available to deal with questions under this particular appropriation.

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Mr. McCrae: Not today, Mr. Chairperson. Because we are in the Estimates, I am not able to be with the deputy minister on the trip to Ottawa, federal-provincial-territorial Ministers of Health meeting. The agenda items are very, very important. Dr. Wade needed to be part of that process because I was not able to, so I do not expect that he will be able to be here today.

Mr. Chomiak: Can the minister table a position paper that the province has taken with respect to the meetings in Ottawa, so that we can familiarize ourself with the positions that are being taken by the deputy minister at those particular meetings in Ottawa?

Mr. McCrae: Number one on the list for the agenda for the discussions is the Canadian blood supply. The Vision of Health Care for the Future is next on the agenda there, has to do with Manitoba's leadership role in working with all of the other provinces and territories in the federal government in developing some kind of a common vision for health care in the future.

We are all worried the federal government's vision is pretty blurred when it comes to health care, and it is a problem because Canadians from coast to coast are very concerned about the future of health care what with all of the cutbacks that are happening in funding from the federal government. If you can all understand the cutbacks, I think some people can, and I would not blame them if they could, but there has to be some kind of partnership here if we are going to have a national health care system from coast to coast to coast, so that is on the agenda.

Aboriginal health issues are on the agenda for discussion, and I do not have the agenda in front of me but I think there was one other item. But those are the types of issues that ministers from across the country--oh, doctor-physician remuneration issues are also a part of the agenda, an important matter. There is a growing recognition that we need to do something in that area, Mr. Chairman, because there seems to be a general commitment across the country, an enduring commitment to our health system in our country.

There are some though in the country who want to face the realities that we live in in the '90s and some who do not, and it is those who do that are gathering together to try to address the challenges that we face if we do want to preserve our health system. I am sure that is exactly what we want to do. So those are the kinds of things that are on the agenda. I do not have any position papers to offer the honourable member today.

Mr. Chomiak: I thank the minister for that response. Will the minister table, when he has opportunity, those position papers so we can have an opportunity to acquaint ourselves with the positions that will be taken by the province of Manitoba with respect to these very fundamental issues affecting national health?

Mr. McCrae: The kinds of positions that we take are usually--the vision we have is basically shared by everybody. Everybody agrees that we want to have a health system that we can preserve for the future. Everybody agrees that if we go back to the system we had in the first place that we will not have a health system. Everybody who is in a position to take part in these discussions agrees that is not something that we can do as a country. The honourable member sort of sees these various jurisdictions coming together and some of them ganging up on the other or something like that. That is not the way these conferences work. There is really quite a high level of working together and co-operation that goes on between the various jurisdictions.

I will review the question with my deputy minister and see what kinds of information we can make available for the honourable member.

Mr. Chomiak: Mr. Chairperson, in the minister's preceding response he talked about remuneration to physicians as a topic or an item, I understand. On that very point, I note in the Estimates there is a $10-million fund set aside from the existing fee-for-service pool to be used to establish alternative physician funding mechanisms. I wonder if the minister might outline for us precisely what that fund is meant to do and how it is to be applied and implemented.

The Acting Chairperson (Mr. Radcliffe): At this point I am advised that the minister's staff are in the antechamber, and I would inquire whether it is appropriate to invite them in at this time. Would the minister's staff please enter the Chamber.

The honourable Minister of Health to be responsive to the question that was put.

Mr. McCrae: Could we get the last part of the question again, Mr. Chairman?

Mr. Chomiak: Yes, the Estimates indicate $10 million is being set aside from the existing fee-for-service pool to be used to establish alternative physician funding mechanisms. I wonder if the minister might outline what that mechanism is, how it would be applied, and what the process is for the application of those funds.

Mr. McCrae: I apologize, Mr. Chairman, for the delays. The delays are occasioned because we, in our department, take our responsibilities to our home care clients very seriously. When 3,000 people decide after listening to their union bosses that they are persuaded by those union bosses, cajoled, threatened, intimidated, whatever, not to go to work and provide service to their clients, that leaves us in the position where we have to do our level best to make sure our clients are getting the care that they need. So I hope the honourable member will understand that that is what we are trying to do. He shakes his head in the negative. He supports us not doing that and allowing clients to go without service. Let him explain that to the people of Manitoba.

The honourable member asked about the $10-million appropriation. We also have issues to deal with with respect to certain specialties in medicine and certain geographic deficiencies in our province when it comes to the delivery of medical services, and we need that as an amount that we can use to address those issues.

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Mr. Chomiak: Mr. Chairperson, for the record, let it be clear that the minister was spending considerable time in private conversation with the Minister of Northern Affairs (Mr. Praznik) after I had asked the question. The minister is here to deal with very important questions relating to health and was having a private conversation with the Minister of Labour, so let us not let the minister go off and try to attribute motives and try to misconstrue the actual facts as to what happened in this Chamber. It is one thing for the minister to say that his staff are preoccupied with the strike, and we have been very accommodating and very accepting to the minister on that point. It is another thing for the minister to be engaged in a private conversation with another member of this Chamber and not answering questions from this side of the House.

Point of Order

Mr. McCrae: Mr. Chairman, the honourable member for Kildonan (Mr. Chomiak) is suggesting a discussion that I had over on this side of the Chamber with the honourable Minister responsible for, oh, a lot of things, Northern Affairs, Native Affairs, Energy, languages, a very busy minister, but the honourable minister and I were discussing issues related to home care, and the honourable member calls it a private discussion, and indeed that is what it was, but I think the honourable member might be interested to know that the honourable Minister of Energy has constituents who require home care services just like the rest of us. The honourable member wants to stop us from trying to provide services to the clients of home care? I am sorry, I am not going to let him stop us.

Mr. Chomiak: Mr. Chairperson, the minister did not even make one scintilla, one single bit of evidence towards a point of order and went on and tried to debate a point. He has ample opportunity. Clearly the minister did not have any motivation whatsoever to raise that as a point of order.

Mr. McCrae: Wisdom, sir.

The Acting Chairperson (Mr. Radcliffe): Thank you very much, most honourable members. The Chair would rule at this point that this was a dispute on the facts and would invite the honourable members to continue with the examination at hand.

* * *

Mr. Chomiak: Mr. Chairperson, there is a specific appropriation--[interjection] I would think that the Minister of Health would have ample opportunity to converse with his cabinet colleagues in cabinet or other occasions and would perhaps devote and pay some attention to the questioning in this Chamber. It is only respect for other members of this House that will permit us to deal with this expeditiously and permit us to go forward. After all, we are working on behalf of the constituents of Manitoba. My specific question to the Minister of Health (McCrae)--[interjection] If the Minister of Labour (Mr. Toews) continues, perhaps the Minister of Labour would like to answer questions.

Point of Order

Hon. Vic Toews (Minister of Labour): On a point of order, is the member asking that I ask questions directly of the Minister of Health, because I am certainly prepared to ask questions of the Minister of Health this afternoon.

Mr. Chomiak: Yes, Mr. Chairman, on the same point of order, my point is that if the Minister of Labour and the Minister of Health wish to have private conversations they should do so outside of the Chamber and not use up valuable committee time having private conversation during the course of our discussions.

Mr. McCrae: For the last number of weeks I have sat, quietly I hope, most of the time and listened to what is going on in this Chamber. I repeatedly listened to honourable members in the New Democratic Party somehow trying to impose their will not only on the Chair in this place, but also on other honourable members by insisting that they answer questions in a certain way, that they stand up, that they sit down, that they shut up. Honourable members opposite ought to know that freedom of the individual has to do with a little bit of respect for the other individual, too. If we could see a little bit of that from honourable members opposite, I think we might move things along somewhat better in this Estimates process.

The Acting Chairperson (Mr. Radcliffe): The Chair thanks most honourable members for the point of order that has been raised by the Minister of Labour, finds that the Minister of Labour did not have a point of order and would invite the honourable members to continue with the examination at hand.

* * *

Mr. Chomiak: I again reiterate my question that I had asked previous, and that is, a $10-million fund has been set aside to be used to establish alternate physician funding mechanism. This is a very specific new addition to the Estimates process. It is a very specific fund. It affects dramatically physicians in the way the remuneration is paid. Can the minister outline what are criteria for that fund and how is it being applied?

Mr. McCrae: Mr. Chairman, there are certain programs in Health in Manitoba relating to medical services such as the northern medical unit services in areas where we are having trouble accessing medical services. The government needs to have the ability to begin to look seriously at alternatives to straight fee for service in our province. There is general support for such a thing. I think there support residing amongst honourable members opposite. As a matter of fact, I think they have said that the fee-for-service system ought to be looked at very carefully.

I know that the Manitoba Nurses' Union has said that and other organizations as well. In fact, very shortly after I was appointed Minister of Health I remember being at a forum at which the present Deputy Minister of Health was there. He was not deputy minister then. He did not work for the government at that time. A friend of mine, a former deputy leader of the Liberal Party, Mr. Jim Carr, was also present, and I think about 150 family practitioners, and there was quite a discussion going on. Either Jim Carr or Dr. John Wade rose and said: How many would be interested in working on a salary? It was estimated that something over 60 percent of these doctors raised their hands. A lot of them were younger people, too, and it was a bit of a surprise for myself. Of course, everything surprised me at that point because I did not know that much about what was going in Health, having been just newly appointed. I think Dr. Wade and Jim Carr were surprised at that result.

Of course, the next question did not get asked, like, what should the level of that salary be, but, as a matter of principle, all those family practitioners or a large number of those family practitioners were indeed interested in the opportunities that an alternative method of remuneration might provide those physicians. Not only those physicians but also their practice and their patients might well benefit from a review of the present fee-for-service system.

It was the fee-for-service system which basically was the foundation of the medicare program, so we have to be respectful of that when we address change because there are some physicians who have worked many years with the fee-for-service system, and that is the only one they really want to continue working with. I think we have to bear that in mind as we look at opportunities for change.

At the same time, there are clinics in Manitoba where some are doing well and others not doing very well, and it is claimed by some that it is the system of remuneration that lay behind some of the problems. So I think we have to be open minded. I think we have to be pragmatic about this. I do not think that any one system, to the exclusion of all the other systems, is the appropriate way to go for the future. I think the future will see more than one system of remuneration; indeed we have it now.

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We have some physicians in Manitoba working under salaried arrangements. In some places where that happens there is a very positive feeling about it, a positive response in the community, and the physicians are happy with it as well. In other areas, it might work out that a block funding approach could indeed resolve some problems. Contractual arrangements for the delivery of services could be looked at. I have found in my travels, which have been fairly extensive in the province, that there is an open-minded approach being taken by everybody.

I remember, last Fall, when there was a minister's meeting and the release of a report about physician remuneration, that the National Family Practitioners Association, if I have that name right, put out a press release, and they were very concerned that, oh, everything was going to get changed overnight. It was a bit of an early reaction because, at that point, the ministers were simply talking about exploring alternatives, and we still are. I think that we have come to some appropriate alternative arrangements that time and evaluation, it is hoped, will demonstrate have been the right thing to do. It is that sort of issue that we are wanting to address. There is no one way, I am satisfied of that, to remunerate physicians.

The other one is the concept of the capitation method, where you sort of divide up the number of dollars amongst the number of population that you have, and you pay the doctors accordingly. That is another way to look at it, too, and it has been suggested by some that that is an excellent system. Well, it might be in some applications; it might not in some others. So that is why it is important that none of us get our mind focused only on one particular system, because I think the world is so diverse these days, and circumstances differ from place to place so much, that an open-minded and pragmatic approach would be the wisest kind of approach to be taking.

Mr. Chomiak: Would it be a correct observation to state that the remuneration under the fee-for-service medical has been reduced by approximately $10 million and the sessional fees and medical salaries are up by approximately $10 million, so that is the trade off? It has gone from fee for service to the salary area. Is that a correct observation?

Mr. McCrae: That is correct, Mr. Chairman.

Mr. Chomiak: Thank you, minister, for that response. Would it be also correct to assume that the $2-million or $3-million savings on the elimination of eye examination for asymptomatic people for the ages of 19 to 64 is an area that has been reduced under that $10-million category, and then corresponding funds moved into the salaried item?

Mr. McCrae: There is a reduction of $750,000 in the medical fee-for-service schedule, and that represents the reduction that the ophthalmology section of it would experience as a result of that change in insurance policy. The $2,250,000 would represent the optometrists part of that. If you take those together, it is about $3 million.

Mr. Chomiak: Can the minister give some indication as to where the other $7-million reduction will take place?

Mr. McCrae: No, Mr. Chairman. At this time, the Medical Services Council continues its review of the schedule or the medical fee schedule and they have been working, as the honourable member knows, on certain initiatives, if you want to call them that, relating to the physical examination, for example, relating to the special house call. We do not have final recommendations on those things yet. That might account for some of it. If the recommendations after further evaluation have come through in such a way that the health of Manitobans is not negatively affected, then we could look at those, but we have not got those yet.

Mr. Chomiak: I thank the minister for that response. Mr. Chairperson, I was going to return to the line of questions that I had posed earlier when staff were not in. It relates to the reduction of $53-million reduction to hospitals. I wonder if the minister can outline for us a breakdown, as best as possible, as how that $53 million is seen by the department to be allocated over the upcoming fiscal year.

Mr. McCrae: Mr. Chairman, the design teams have been working. I think the honourable member referred to a number that Dr. Wade had used some time back, and the $53 million is kind of the expectation towards the achievement of which is what the design team have been working toward, so we do not know yet.

The honourable member for Inkster (Mr. Lamoureux) is often asking us about, for example, the Seven Oaks Hospital; or the member for Kildonan, (Mr. Chomiak) I forget which hospital he is working for these days, but he is working for Seven Oaks, I know, and for Misericordia and I guess any other hospital where there might be any possible change--he will be working against that.

The point is it is that whole exercise that the honourable member is very familiar with that has to do with this $53 million. The $38 million is there to make the transition as smooth as possible, and at this point, until we get further information from the urban planning partnership, with the assistance of the KPMG Consulting organization, those announcements will be coming in due course.

Mr. Chomiak: The $53 million is a specific and a relatively specific figure and I have been able to extrapolate based on funding announcements and funding reductions and the rolling budgets that are given to hospitals to a percentage or a number. I have been able to extrapolate that from the public announcements of each of the urban hospitals, roughly accounting for some of those funds.

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I have been roughly able to accommodate for something in the neighbourhood of $25 million out of the $53 million based on reductions already previously announced by the government with respect to most of the urban hospitals in Winnipeg. Does the minister have any figures, similar to the lines of the figures given by the deputy minister previous, as to a breakdown between urban and rural, for example?

Mr. McCrae: No.

Mr. Chomiak: So the minister is saying that the $53 million is based on what therefore--where did the $53-million figure come from? Is it a percentage? Is it a percentage of overall expenditures? Is it based on target figures based on ability of hospitals to operate services? Where does the $53 million come from?

Mr. McCrae: The people involved in the process have an expectation that $53 million is an amount that can be worked with, but they do not need to work with that much. They can work with a smaller figure because there are some items that really do not have anything to do with their work, items like interest costs and things like that. The design teams really do not have to work with that. So really $43 million to $45 million is what we are talking about.

I know the honourable member is probably looking for something more specific than that, and I am not able to give it to him at this time, because it is simply not available. It is the reasonable expectation of all of the people with whom we work that $43 million can be taken from hospital budgets, but not overnight, and that is why you need to have that kind of transition fund in place, to help us make that transition. That transition would have to do with making sure services are there for patients, making sure that replacement services are available in the community, making sure that we can continue to make the transition as smooth as we can for the staff of our hospital system.

I would like to give an example. The honourable member for Brandon East has raised the issue of the speech therapy services at Brandon General Hospital and a proposal by Brandon General Hospital to stop providing that service. It conjures up in the mind of the honourable member for Brandon East the kind of worry that, oh, there will not be any service anymore. Then, of course, you go out and you do your lobbying out there in the public and whip up as much attention and emotion as you can that, oh, there are not going to be any speech language services for people in southwestern Manitoba. That is what happens when members opposite get out there with information before decisions are made, before the work has been done.

I guess the reason that it gets out is that we have such an extremely open process in Manitoba. The government and the hospitals are involved in a lot of consultation. My opponent in the last election was involved in one of those processes. It had to do with the panelled beds at the Assiniboine Centre at Brandon General. This person was asked to be involved because of his medical expertise, to be involved in a committee that is discussing how we are going to deal with this situation at Brandon General Hospital. As soon as he gets a piece of paper or any hint of information that something might change at Brandon General, he is out there proclaiming to the world that this is what is going on, organizing black ribbon campaigns and having public meetings and all the rest of it.

That is what happens when you politicize health care to the extent that, in this case, it was my New Democratic opponent that I am talking about that politicized it so very much, the whole health debate in the city of Brandon. It is unfortunate too, because there are a lot of really decent people in the city of Brandon and southwestern Manitoba who care a lot about their health system, but they do not want to be working from information of the type that comes out in the way it came out. This happens and this is the kind of environment we work in.

I think of the likes of Michael Decter. Michael Decter was the clerk of the Executive Council in the Pawley-Doer government. Michael Decter, after they were unceremoniously thrown out of office back in 1988, Michael Decter sought his fortune east of here, where there was a New Democratic government under Bob Rae, and Mr. Decter became Deputy Minister of Health there. It was in Ontario under Mr. Decter's leadership in the Health department that they closed 10,000--10,000, Mr. Chairman--acute care hospital beds in the province of Ontario.

It is interesting. I know the honourable member for Kildonan (Mr. Chomiak) does his homework, he does his reading and everything like that. One of the books he reads is by Michael Rachlis. All I am saying is that you should read Michael Decter. He is, like, joined at the head to people like the honourable member for Kildonan, or at least he was.

Interestingly, too, after he finished his term as Deputy Minister of Health, after shutting down all those hospital beds in Ontario, Connie Curran comes along and says, Michael, will you be my chief person in Canada? We need a Connie Curran Canada leader, and we would like you, Michael Decter, to do that. That is what he did. He accepted that job. He is the top person in Canada for Connie Curran Canada. Members opposite sometimes do not like being reminded about that. [interjection]

Mr. McCrae: I personally have never met Connie Curran, but I am sure Michael Decter has and knows her very well.

But it is just the kind of things that misinformation can do. It is bad enough everywhere else. We can live with it, I guess, or we have to. We have to live with it here, too. It is not for me that I am so concerned, Mr. Chairman; it is a lot of vulnerable people in our society who, when they are fed this sort of drivel, they get frightened.

Picture yourself--I know it is hard for you to do this because you are such a robust, strong, energetic person but think of yourself as a somewhat more fragile, vulnerable person, living at home, relying on a home care attendant to come and help you with your toileting, for example, and your bathing and your feeding and your dressing and moving you from your chair to your bed and that sort of thing. Your worker, prior to the strike, is told by his union boss friends to go and tell you that tomorrow you will not get any care unless you pay user fees. Put yourself in that position. This is the kind of stuff that my friend opposite here supports.

He has been out there himself. He was the person who began the story in the first place about the changes, this honourable member for Kildonan (Mr. Chomiak), yet he is proud of it. Well, so be it, power to him. That is not a problem for me. I have no quarrel if the honourable member for Kildonan comes across some information from whatever source and wants to go and get his name in the newspaper. That is his business, but the thing that bothers me is he accompanies his outbursts that day with the threat of the user fees and the cuts in service.

I mean, if the truth were known, it is an NDP report that they, the Doer-Pawley NDP government, commissioned. [interjection] Pawley-Doer, Doer-Pawley, what is the difference?

An Honourable Member: Well, nothing, neither of them did anything.

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Mr. McCrae: Well, one of them is the real union boss. That is the Doer part, the member for Concordia part. But that group commissioned a study. They like studies, Mr. Chairman. They put a lot of reliance on studies and reports.

Here we have one from Price Waterhouse. I do not know how many millions and millions of dollars the NDP paid for this, and I do not know how many American people were involved in the production of this report--probably quite a few . But on page xix--these are little x's and i's--it says: the program should require regional program managers to manage their budgets more actively and to stay within approved levels and should give programs staff greater discretion over service levels per client; i.e., permitting dilution of services--this is NDP policy--in order to achieve budget targets.

Another one: the program should give consideration to introducing measures that would serve to encourage clients to meet their needs through their own resources, e.g., user fees, waiting periods prior to receiving nonprofessional services, user fees during the initial period of service and limiting hours in which services are provided.

Maybe the honourable member for Kildonan (Mr. Chomiak) can tell us how many millions the NDP paid for that advice?

Mr. Chomiak: Mr. Chairperson, I am really sorry. I thought we were making progress during the course of these Estimates with respect to answering questions, and I am really sorry the minister has again gone off on tangents, and I feel compelled--[interjection]

Mr. McCrae: On a point of order, Mr. Chairman, as I made known a little while ago, we have something important to do with respect to the delivery of home care services, and I am asking if we can have a recess for 15 minutes.

The Acting Chairperson (Mr. Radcliffe): This is not a point of order, but if it is the will of the committee to recess for 15 minutes--agreed? [agreed]

The committee shall recess for 15 minutes to reconvene at 3:45.

The committee recessed at 15:32 p.m.

________

After Recess

The committee resumed at 15:49 p.m.

The Acting Chairperson (Mr. Radcliffe): The committee will resume after the recess.

Mr. Chomiak: Mr. Chairperson, I feel compelled to respond to some of the comments of the minister prior to recess. He made reference to the member for Brandon East (Mr. Leonard Evans) who has an impeccable record of constituency representation.

I can indicate to the minister that one of the reasons the member for Brandon East brought it to the attention of the minister is he was asked to by constituents, by the public, by consumers and by individuals who had an opportunity to take part in that particular service. So he was doing his duty as a duly elected member of the Chamber in raising that issue, something that I think members of this Chamber could learn something from. Perhaps that speaks to the reason as to why that member has been elected year after year after year with increasing majorities and why he is so well respected, Mr. Chairperson. So for the minister to suggest that his raising it was anything but a reflection and a response to his constituents is inaccurate.

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I also find it very curious that the minister constantly wants to refer to his good consulting friend/firm of Connie Curran, and perhaps it is a question of trying to ascertain why that money was wasted. Perhaps that is why the minister brings it up, but I am surprised the minister constantly refers to Connie Curran.

But, more importantly, Mr. Chairperson, the minister again deals with the Price Waterhouse report, both the minister and the Premier (Mr. Filmon), and it is now part of a Tory text and dogma to repeat that report. I just point out to the minister, I gave some instructions and some advice to the minister last week about dealing with the Price Waterhouse report, and I advised him that he had an implementation team. I do not believe the minister was aware of that, but I was able to inform him that he had his own implementation team concerning that report.

I just want to add for the minister that the report was tabled in the Legislature by the Honourable Don Orchard on October 6, 1988, and I want to quote into the record, Mr. Chairperson, what the Honourable Don Orchard had to say, and I quote: This report is a comprehensive attempt to analyse the strengths and weaknesses of this very important program and to prescribe the changes which will be required to ensure the needs of Manitoba can be met in the future.

What was the result of that, Mr. Chairperson? The minister set up an implementation team chaired by Frank Maynard. That committee has been meeting on a regular basis to implement, and I ask the minister, will he bring members of that committee here to deal with how the minister is implementing and dealing with his Price Waterhouse report? The minister might want to turn it around and try to twist the facts and try to put up some little bit of defence with respect to his privatization scheme but, as weak as that defence is, I again urge the minister, bring forward the recommendations of your own implementation committee. Now that you know you have one, bring it forward, bring it to this House, let us ask them questions.

Further, I again reiterate to the minister, I have a full copy of the report. I know the minister only has a photocopy of the executive summary that he refers to. I am prepared to forward to you the whole report to read, Mr. Chairperson, so the minister will know of what he is speaking, as he constantly refers to this report in only a partial way and in a very distorted way, on a regular basis in this Chamber, as an attempt to deflect attention away from what is a fundamental issue with respect to home care, and that is the lack of any data, the lack of any analysis, the lack of any substance to the government's argument as to why they are privatizing home care.

I felt compelled, despite the fact that we were making some progress with respect to moving along in the Estimates process, the minister did make some rather inaccurate statements, and I feel compelled to correct the record. In that regard, returning to the Estimates book, I note that this year we are increasing the funding for blood transfusion services by $2 million. I wonder if the minister, given that that very issue was on the agenda of the minister's meeting taking place in Ottawa, might outline for me what the proposal and plans are for that additional $2-million funding to blood transfusion services as indicated in this years appropriations.

Mr. McCrae: The honourable member referred at length in his question to the Price Waterhouse report which his colleagues Mr. Pawley and the member for Concordia (Mr. Doer) ordered. We do not know how much they spent for probably multimillions of dollars. In any event, he dealt with at length and he has compelled me to respond.

Indeed the Price Waterhouse report as set out by my predecessor, the Honourable Mr. Donald Orchard, in his comments about it was quite correct. I have had an opportunity to review the Price Waterhouse report and the honourable member for Kildonan wants to sort of cherry-pick a word here or a phrase there or a recommendation here or a finding there, and that is okay. The thing is there is a multitude of them to choose from, Mr. Chairman. The honourable member's policy on home care is very simply put by him as the Health critic for the New Democratic Party, and that is go back to the system we had in the first place.

What we had in the first place was, indeed, looked at by the Price Waterhouse study commissioned by the NDP, and as I pointed out on page xix, there are a couple of recommendations that the NDP received from that study that it paid so many dollars for dealing with allowing services to be diluted, and allowing user fees, and allowing delays, and allowing cuts, vicious cuts in services. Well, the NDP might well stand for that, Mr. Chairman. When you look at the performance of NDP governments, that performance bears out what I have just said.

The member, his policy is to go back to the system we had in the first place, and here is what we had as set out in Price Waterhouse, and I quote: The review found that the mandate of the program has drifted as the program is increasingly used to serve a hospital replacement function. If the program is to adequately fulfill this additional role, it will have to place a greater emphasis on guaranteeing the availability and delivery of complex care services.

The member now says, as his policy shifts from day to day, go back to what we had. He wants to go back to a system where we cannot guarantee the availability and delivery of complex care services just at a time when we need to be able to guarantee the availability and delivery of complex care services, just at a time when the honourable member knows everyone is looking at the hospital system in the city of Winnipeg. Everyone says we have got way too many hospital beds--although the member for Inkster (Mr. Lamoureux) only says we should cut either a hundred or 700, and we are not sure which one, he has not said that how many beds we should take out. He said at one point that we should take 700 beds out of the system in Winnipeg. He has not told us where or how or anything like that, just hack and slash.

Well, that is not good enough, Mr. Chairman. It may be okay for an opposition member to want to hack and slash or another opposition member to want to go back to what we had in the first place, but I suggest it is not good enough for the clients of our system not to have guarantees of availability and delivery of complex care services. If we do not have that, we cannot address the issue of the hospital situation in Winnipeg. Even though the member for Inkster does not agree with some of the recommendations that are coming out, he does agree that there is a need for some change. I hope, at least, I am correct in saying that much.

* (1600)

Back to Price Waterhouse, the multimillion-dollar, I am told, multimillion-dollar report commissioned by the NDP which ultimately recommends user fees and dilution and cuts in services, I quote from page iii: It also identified a need for a comprehensive quality assurance program that would gather and report information on service quality across all regions.

No requirement for consistency, if you ask the member for Kildonan (Mr. Chomiak), because he just says let us go back to what we had in the first place--which his own report says does not have comprehensive quality assurance. We need that. He says, no, you do not need that; let us go back to what we had in the first place.

The Price Waterhouse report says that the review identified that the program lacks a comprehensive information system that collects and reports client service management and financial data on an automated basis. It also says there is no strategic date of plan. It also says the open-ended nature of the program raises questions as to whether there is a need for appropriate mechanisms for capping costs or services. It also says the review found that there are inadequate hospital discharge planning practices which lead to inappropriate discharges to home care, lack of proper discharge preparation and, Mr. Chairman, get this, potentially unsafe client situations.

The Health critic for the New Democratic party says as a matter of policy for the NDP, go back to what we had in the first place. Well, Mr. Chairman, what we had in the first place, according to the NDP itself through its Price Waterhouse report, were potentially unsafe client situations.

What kind of philosophy is it that says let us go back to potentially unsafe client situations? Is this the way the New Democrats would go about doing the business of running a health care system if, and this is a big if, they ever had an opportunity again in the future of this province to do so?

Mr. Chairman, if I were your constituent or the constituent of the member for Kildonan (Mr. Chomiak), my face would just tighten up immediately in concern that we could ever even think of electing a group of people who want us to go back to potentially unsafe client situations. Why should I really want to listen very hard to the member for Kildonan and his bleatings and urgings when he wants us to go back to potentially unsafe client situations? I cannot see that as a responsible position. I cannot stand here as the Minister of Health and say I will knowingly and willingly return our home care program to a point where we have potentially unsafe client situations.

It was enough of a worry this week and last week when the member for Kildonan and his friends wanted to remove services from our clients, that we have very much concern as we try to cope with labour disruption brought out by the leadership of the union movement, with the full endorsement of the New Democratic Party. That concerns me enough as it is, that they should be like that, but I certainly am not going to take very seriously the urgings of the member for Kildonan when he wants us to go back to potentially unsafe client situations.

Well, it does not end there. If you look further to little v, little i, that is the page number, in this Price Waterhouse report commissioned by the--this is in the executive summary of that report--New Democrats, word has it that it is multimillions of dollars that they paid for that. We do not know, and they have not told us. They do not want to come clean with this information. Do you know why? Because it is a big cover-up. They are really afraid that the real New Democratic spirit for elderly and infirmed people in our province will become known. This is a big fear, so they sit on that kind of information and hide it and keep it from the public.

But this report which I have, which they commissioned, which recommends user fees, dilution of service and drastic cuts in services and waiting periods for home care services--imagine, the NDP wants to have waiting periods for home care at a time when our hospitals desperately need to be--how do you put it?--unplugged in the sense of we have people in those hospitals that would be receiving better care at home. The NDP does not want that to happen, and it causes me great concern that that should be the position of a political party that calls itself responsible and ready to embrace the '90s and beyond.

The Acting Chairperson (Mr. Radcliffe): The honourable member for Kildonan, on a point of order?

Mr. Chomiak: No, I thought the minister's time was up.

The Acting Chairperson (Mr. Radcliffe): The honourable minister, having had about 30 seconds to go, I was just giving him some advance warning.

Mr. Chomiak: I almost hesitate to rise at this point to deal with the minister because the minister has been so contradictory in his tirade during the last 10 minutes that I think any objective reader of this debate--it is interesting. Let us deal with this. The minister says that we want to go back to the old ways. The minister accuses us of wanting to implement all these recommendations of his report that had his implementation committee, that was tabled by his minister.

Then he says, we want to go back to the old ways of the report that made these recommendations that we somehow supposedly supported. At the same time, the minister is indicating that he would not have implemented those particular recommendations despite the fact that he has an implementation team.

It is contradiction after contradiction, but, more important, the real issue here is the minister's December 16 Treasury Board document, signed off by the minister, James McCrae, submitted to cabinet. What did that document say? That document said user fees would be imposed in the home care field. The minister has yet to deal with that. He can go on, and he can talk about 10-year-old reports or 15-year-old reports. He can talk about Connie Curran all that he likes, but he will not deal with the fundamental issue as to why his own Treasury Board submission said user fees would be imposed on home care in the future in Manitoba under his government. It says that. The minister ought to have been more careful before he signed off that document, if he wanted to argue that there were no user fees.

So, Mr. Chairperson, the minister can blow long and the minister can blow hard about a report in the 1980s by the NDP, and he can say we want to go back. What we want to go back to is a public system. We want a public system, not a private system, that is the point, and that is the point the minister fails to get. We do not want a system with user fees. Do we have user fees? Which government imposed user fees in home care?

If the minister would only pay attention, what government imposed user fees in home care? This government. Home care equipment. The minister can say all that he wants. They imposed use fees on home care equipment and home care supplies. The minister can talk all they want and now they want to impose user fees on home care, per se, because it is in their own Treasury Board document.

The Deputy Premier can say all that he wants, but it is his document, signed by his minister in his cabinet that says we will impose user fees. So try as you might, it is in black and white. If we did not have the document, you could have gotten away with it, but you cannot get away with it because we have the document signed off by your Minister of Health, approved by your cabinet, saying there is going to be user fees imposed in home care. So the minister can try to deflect attention away from the issue, and the minister can try to argue all of the old reports that he wants, and he can try to misconstrue and move the items around, but the bottom line is this government, this minister has failed to even acknowledge their own Treasury Board documents signed off by the minister saying that user fees will be imposed.

I tabled the document, Mr. Chairperson. I tabled it. I was hoping that the government might photocopy it and present it to the backbenchers who I believe were not aware of this particular submission and this particular government policy.

The minister can try all the tactics that he wants to deflect attention away from the reality, Mr. Chairperson, but it will not work, because the document says in black and white, the document submitted by the minister, that there will be user fees imposed on core services. So if elderly patients are concerned, and if the public is concerned, and if the home care workers are concerned, they have good cause and good reason to be, because the government has said it in its own document: what will be will be user fees imposed on core health services.

* (1610)

(Mr. Chairperson in the Chair)

I do not expect the minister to change his line of defence which is to go back to the issue of the Price Waterhouse report. No one is buying it, Mr. Chairperson. No one attributes any credibility to that line of argument, but it is a defence for you, I recognize that. It is sort of a little thing that you can hang onto to try to defend your position. The fact of the matter is you have yet to deal with the issue as to why your Treasury Board document talked about the imposition of user fees. You have yet to deal with the contradiction as to why your document said that the service would be given over wholly in rural Manitoba, effective April 1, 1997, to the regional boards. You have to deal with the document where it says a Crown corporation or agency would be set up to control the provision of these private services, and you have yet to do that.

You have to deal with the fact that the day we released the document publicly, the minister confirmed that it was a go. A few days later, they put out a press release saying it was little bit different. A few days later the policy was a little bit different. A few days later the policy changed. Now, the line they are trying to say is it is only 25 percent. The Premier (Mr. Filmon) said, oh, it is only 25 percent. You are also privatizing completely. You are also putting out the tender completely, the nursing component, but, no, you do not like to say that.

Twenty-five percent, now they are saying of a demonstration project. The only reason that the Treasury Board document states that you are proceeding to privatize this year a portion and that the Department of Health policy that all service will be delivered by nonpublic health, that it would be privatized completely. Your own document says it, divestiture of all service delivery. You have yet not once, in this three weeks of debate, has the minister been willing, and it is very interesting, the minister has been unwilling and unable to defend his own Treasury Board document. He has been completely avoiding it. He has avoided the user fee issue and he has avoided the rural Manitoba issue and he has avoided the Crown corporation issue.

Why is that? Because it is indefensible. Because the minister knows what it says, he does not want to defend it and, further, he has no documentation to back up his decision, and that is the other issue, why the minister signed that document off and handed it out to his colleagues and they approved in cabinet.

Why did he do that without proper evidence, without proper facts? Where are the arguments, where is the data, where is the cost analysis that had the Minister of Finance say there would be a saving of $10 million. The Premier said $10 million, the minister said no saving and the associate deputy minister of Health said, well, do not count on it, we are not sure.

Is that any way to run a department? How can we trust this minister and this government to implement health care policy when they cannot even get their own propaganda straight? The Premier says one thing, the minister says another thing, the deputy minister says something else. How can anyone have confidence in the ability of this government and this minister to deliver on this policy in face of those contradictions? In light of the fact that the minister has refused to deal, and I challenge the minister, I challenge the minister to come forward and to deal with the questions we have asked over and over again concerning his Treasury Board document, his submission, signed off by him, given out.

I am proud of the fact that we made it public, because I am afraid that the government would not have and that the government would have slipped in this policy over the summertime and not advised the public as to what they were doing. We did a great public service by releasing this document to the public and allowing for public discussion, because the Minister of Health, who is not even prepared to talk about the document, I dare say would have hoped that he could have slipped in the policy in the middle of the summertime without having members of the public have access to this information.

Let not the minister go off on tangents contradicting himself about Price Waterhouse reports and go off into other jurisdictions and other provinces. Will the minister not deal with the facts as they relate to the Province of Manitoba, as they relate to his own Treasury Board document that it is very clear as to where they want to go on home care. Defend that policy. If it is defensible, defend it; if it is not defensible, then give it up. Give it up if it is not defensible.

There is nothing wrong with admitting you made a mistake. In fact, we on this side of the House would be the first to laud you if you were to recognize your error and if you were to recognize the fact that for whatever reason you have made an error and you are prepared to go back on that, we would laud you on that. Are you prepared to deal with your own Treasury Board document, Mr. Chairperson?

Mr. McCrae: Well, if the honourable member is offering to actually support something, in my eight years in government, I can attest it would be the first time, and I would have a hard time believing--we could offer the honourable member virtually everything he ever asked for and he would still suggest, if there was a vote to be found anywhere in the province or a union to please anywhere in the province, he would be quick to jump on such things, but he would certainly not ever admit that this government had done something that he approves of.

Frankly, the fact that the honourable member is so riled up about this tells me that it is just another piece of evidence that we must be on the right track, because I know what CKY television said at the time of the release of the report on the Seven Oaks project. CKY television reported, and I quote, the patients love it, the NDP hates it.

That sort of tells me where the NDP's priorities are, but I would be quick to say that that would be only one measure that I would use. We would like to use all the traditional ones, as well, but if the honourable member for Kildonan likes it, look at it hard, Mr. Chairman, before you decide to implement something like that.

The member talks about avoiding issues. I asked for this information last week from him and Mr. Doer and Mr. Pawley and whoever it is within the New Democratic Party that can bring me this information. I asked how much the Price Waterhouse report cost. I asked how many Americans were working on the Price Waterhouse project. They have not told us, so I can only assume that most of the people involved come from Dallas, Oklahoma City, Kansas City, Denver, New York, places like that, and probably places in Louisiana and California, as well.

I can only assume that because of the cover-up on the part of the New Democratic Party. They have avoided this Price Waterhouse report like the plague because they know it exposes them for what they really are, but those things need to be exposed. The people of Manitoba need to know what the NDP really stands for. There was some discussion yesterday about what the NDP stands for, and, of course, it was reported in the newspapers today about their support for the union movement and some of the tactics that the union movement resorts to, and that is all in the public record today and still no denial, no standing on their hind legs and saying, you know, we condemn this horrible, horrible behaviour on the part of the union bosses.

The NDP would never do that, but I heard somebody over on the opposite side use that awful expression, bought and paid for. Maybe they should look in the mirror once in a while when they make those kinds of comments, and maybe they will see looking back at them Peter Olfert, Bernie Christophe, people like that, Daryl Bean. We all remember Daryl Bean. We know what Daryl Bean stands for. He stands for abusing little, old female persons. There were two grandmothers at the time of--and, you know, Sharon Carstairs would not even stand up and condemn that sort of behaviour, but Daryl Bean wanted to either hang or drown little old ladies who wanted to go to work when Daryl Bean was having a precious strike, Mr. Chairman.

Point of Order

Mr. Chomiak: Mr. Chairperson, notwithstanding that we in this Chamber have liability for statements we make in this House, I think it is completely inappropriate for a member of the Crown to suggest that any individual would want to drown or hang someone.

Mr. Chairperson, I think it is completely inappropriate and unparliamentary for a minister of the Crown, notwithstanding he has liability to this Chamber, to suggest that, and I ask you to ask the minister to withdraw those comments.

Mr. McCrae: There he goes again, Mr. Chairman, defending Daryl Bean, the man who puts in writing the way he feels about people who want to go to work for a living. He quotes Jack London, a writer from earlier this century, who said that people who go to work when there is a strike on should be either hanged or drowned, and now the member for Kildonan stands in his place under the guise of a point of order to defend that sort of mentality.

Well, let him defend that sort of mentality, but maybe he ought not to do it under the guise of a point of order.

Mr. Chairperson: Order, please. I thank the honourable members for their advice. Just give me a minute.

Order, please. The honourable member for Kildonan does not have a point of order, but I would caution all honourable members to choose their words very carefully. Hypothetical cases should not be brought forward, as well as conveying direct imputations toward individuals, should not be entering into the debate at this time. The honourable minister, to conclude his statement.

* * *

Mr. McCrae: Mr. Chairman, I cannot help but observe that it is awfully interesting how quick you can get a New Democrat to his feet. All you have to do is say something nasty about somebody like Daryl Bean and they are right in there just as quick as it can be to defend the behaviour of those people. I remember the situation very well. I wrote to Mr. Bean, I asked that he resign because of his attitude towards elderly women working in the public service of Canada, and, of course, he sent back some long-winded defence of his indefensible behaviour.

What is really telling is Sharon Carstairs--Senator Carstairs today--sat over on the other side of this Chamber and refused to come to the aid of those two grandmothers who were really seeking the aid of politicians and others in leadership positions across our country in their plight, facing threats like that from people like Daryl Bean, supported by members of the New Democratic Party and acquiesced in, I guess, by members of the Liberal Party, because they never did speak up. Do you know why? Because the Liberals in those days--

Point of Order

Mr. Chomiak: Yes, Mr. Chairperson, I believe I posed the question to the minister concerning the Treasury Board submission as relating to Home Care or as it relates to these particular Estimates. I fail to see what a labour dispute or a relationship to Senator Sharon Carstairs is even remotely connected, is relevant to the minister's answers.

Mr. McCrae: Mr. Chairman, I am not sure what the honourable member's point of order is this time either. I suggest maybe you will not be too clear on it in your ultimate ruling for which we will all have respect. The point is the honourable member knows the rules of this House, he knows he cannot bully people on this side of the House to fit into his little Procrustes box.

Mr. Chairperson: Order, please. I would ask the honourable minister to retract the phrase he just used. “Bully” has been ruled out of order in the past. He is at this time, during his point of order, baiting the honourable member, and I would appreciate if he retracted that and refrained from that angle and speak to the point of order.

Mr. McCrae: Of course, if it is unparliamentary I would withdraw it, Mr. Chairman.

Mr. Chairperson: To the point of order.

* * *

Mr. McCrae: You ask us to try to choose our words. I am working very hard, wracking my brain, to try to figure out a better word than “bully,” and I will continue to try to find a better word than “bully” to describe the behaviour of members opposite when they try to force members on this side of the House to answer only in the way that they want to have the answer to come out, or to address themselves to this part of my question or that part of my question. It would not matter if you had 16 ideas thrown into a preamble to a question.

Mr. Chairperson: I thank the honourable members for the advice. The honourable member for Kildonan did have a point of order. Under Rule No. 70. (3), speeches in Committee of the Whole must be strictly relevant to the item or clause under discussion. I had been carefully listening to the minister for six and a half minutes, and I would ask the minister to attempt to be a little bit more relevant towards the question.

* * *

Mr. McCrae: Mr. Chairman, I respect your ruling, of course. We are on item 1.(b), which is Executive Support. If the honourable member has a question about Executive Support, I guess I could answer that. I understand item 1(b) allows a kind of a latitude, not just for the member for Kildonan (Mr. Chomiak), but for anybody else who is taking part in the debate on item 1(b), including me, so I hope that is what you meant when you were making your ruling, of course, which I respect and would without hesitation humbly obey.

The honourable member for Kildonan asks questions about home care. I am trying to deal with home care. He cites documents which I have already told him was not a Treasury Board submission, keeps calling it that. I am not going to answer questions about his idea of what something is. We know what his idea is. It is from some other planet, Mr. Chairman. This report is not from some other planet. This is a report that has been commissioned by the New Democrats.

If he wants to compare policies, that is what politics is all about. I have got a policy, he has got one. This is Parliament. This is the Legislature. That is what you do, you talk about these policies. His policy, Mr. Chairman, is go back to the system we had in the first place, which I hope brings it all into the realm of relevancy to the point at hand.

The Price Waterhouse should not be left out of this. Who knows how many millions the NDP paid for it, so do not tell me it is not relevant, I say, to the honourable member for Kildonan. He would like it very much if this was totally forgotten and that the people of Manitoba never had to pay for this or that the people of Manitoba never had anything to do with it. He certainly wishes the NDP never had anything to do with it because it exposes their agenda, their secret agenda, I suggest, their secret agenda for user fees and massive hacking and slashing in the Home Care program. I mean, that is the wrong place for that sort of thing, because it is a program which our policy, as clearly set out in our budget documents over eight years, is to support to a very, very significant extent.

Speaking of that, I will refer to those levels of support in detail, Mr. Chairman, to remind honourable members about that, because we keep hearing suggestions to the contrary by honourable members in the New Democratic party.

In the meantime, back to Price Waterhouse. The member's policy is to go back to the system we had in the first place. The system we had in the first place, as set out by Price Waterhouse, which was paid for by the New Democrats and has a lot to do with the way they see the world, quotes on page vi of the executive summary: It also found gaps in services that are outside the scope of the Continuing Care Program.

* (1630)

This is just after the part that I referred to a while ago where it appears that the NDP want us to go back to potentially unsafe client conditions. I disagree with that policy and this is the right place for me to say that. It says it also found gaps in services that are outside the scope of the Continuing Care Program. In some regions the Continuing Care Program is perceived as the deepest pocket program and is being used to fill some of these gaps. This results in serious departures from program guidelines, inconsistencies among regions and a sense of unfairness among staff and clients in those regions that are complying with the program's scope.

I would like to read that again, because this is what the honourable member stands for when he says we should go back to the system we had in the first place. This is what the honourable member wants: serious departures from program guidelines, inconsistencies among regions and a sense of unfairness among staff and clients in those regions that are complying with the program scope.

Mr. Chairman, I was going to say I am sorry, but I am not sorry. I just do not accept that as a policy and I quite unabashedly would stand on the rooftops and tell the people of Manitoba that being NDP policy, I have no time for it; I do not want that. Why does the honourable member want staff and clients to have a sense of unfairness about the program? Why do they want that? What useful purpose could that possibly serve, and how could it possibly improve the Home Care program? Maybe there is something we should be taking from the NDP that is not being said in words. It has to do with inefficiency.

I have this theory, Mr. Chairman. Maybe this is not the place for theories, but here goes anyway. My theory is that the NDP likes inefficiency. Now, I would like the honourable member to defend that theory of mine or to refute that theory of mine, I should say, because he probably does not want to go and tell the world he likes inefficiency, but almost everything I have ever seen a New Democrat do in my lifetime has inefficiency written all over it. In fact, if you look in the dictionary under the word “inefficiency,” you would probably see a picture of Howard Pawley sitting right there.

Mr. Chairman, I will let the honourable member take over for awhile.

Mr. Kevin Lamoureux (Inkster): I have a few words that I would like to talk about with respect to home care services. In fact, last time I had the opportunity to ask some questions, I had mentioned to the minister that I was going to deal with some hospital questions, followed then by home care.

I want to make reference to what I believe the minister had and that was options. I see a number of options that the minister should have given more serious consideration.

First and foremost, the option that this government chose to take was the one where we see the government say, well, we have an idea, we have not talked to anyone or consulted with anyone about it, because we never heard anything about it until the government made some sort of an announcement, but it fits nicely with our philosophy, and it is something which cabinet is going to ultimately approve, and they brought it forward, and, now as a result of that, ultimately today we are in a strike situation.

The government ultimately will put the blame on home care workers, that the government had nothing to do with the home care workers actually going on strike. Mr. Chairperson, I do believe the government is being most unfair to the home care workers and is, in fact, somewhat misleading the clients of home care services.

That is one of the options, the option which the government chose. There are other options, and I want to make reference to three other options that came to mind. The first option--and this is an option which the government can still take today. It has been suggested. It would end the strike, and that option would see a one-year moratorium put on the privatization of home care services.

Mr. Chairperson, if the minister was prepared to take that option, I believe ultimately what should have been done in the first place would, in fact, be allowed to occur, and that would have seen the government actually consulting with clients and home care workers, with Manitobans, with health care experts, with those individuals who have an interest and want to be able to participate in providing input to the government. It is not totally new to the government. I can recall the Parents' Forum on Education. What they actually did with the results of it one might question, but the idea of getting people involved in a process that will lead to a much better system is, in fact, something which we believe would have been far more legitimate, and for the government, it is not late to take that particular option.

The Minister of Health could stand up in response to my stating the option that has been put on the table for a number of days already, and say: The one-year moratorium is on, and we are going to consult. The strike will, in essence, come to an end, and the clients, our first priority, will in fact be the biggest benefactors.

Another option would have been, no doubt, the status quo. The status quo, as pointed out from the Minister of Health, is not a viable option. We in the Liberal Party also believe the status quo is not a viable option. The minister makes reference to the Price Waterhouse report, and the Price Waterhouse is no doubt the only tool that can be used to measure the need for change.

Another option, of course, is that if the government is not prepared to do what is right-- that is, institute a one-year moratorium--will they, at the very least, demonstrate flexibility, open up the government's mind, collective mind, if you like, and listen and put together alternatives that might at least attempt to appease those individuals that are watching very closely in terms of what the government is doing?

One of those, for example, is the preferential treatment. We have indicated to the government that preferential treatment to nonprofit organizations such as the Victorian Order of Nurses is a viable alternative and something that should be given by the government if they feel that they have to move towards privatization.

These are the types of options the government has chosen. My question simply to the Minister of Health is: Is the Minister of Health prepared to accept that there are other ways at resolving this particular issue that is in front of us today, other than the one that he is taking currently?

Mr. McCrae: Well, the honourable member has really piqued my curiosity on this one because he has raised it now. He must have thought this through quite a bit, because he has raised it on a number of occasions now that somehow nonprofit organizations, as they approach the tendering process, should be granted special treatment or some kind of preferential treatment. I would like to know what form the honourable member is suggesting that preferential treatment ought to take. If I knew that, I might be in a better position to respond to what he--[interjection]

My colleague here on this side suggests the member simply wants to gerrymander the system and achieve the same system we have, which is the same policy as the NDP's, which is to go back to the system we had in the first place. Well, if that is not what he is saying, that is fine; let him explain that. But I would like the honourable member to tell us what form that special preferential treatment ought to take, and does he not think the preferential treatment they already have is not sufficient?

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When nonprofits approach the tendering process, they will do so without having to factor in any profit margin, as businesses do, which mark up the cost of their labour, mark up the cost of their supplies and their equipment and their administration and whatever else they have, which is the direct cost. Then, at the end of it all, they put in what they think they can achieve by way of profit. Well, the nonprofits approach the same exercise, and they have to do all the same stuff, except for that last one. They do not have to put in their tender documents, the bids, any percentage or anything like that for profit, so they already have an advantage over the profit makers in the system.

I assume the honourable member had that one figured out, so there is already a preferential treatment in place for nonprofit organizations. I am asking the member what additional special treatment he would accord nonprofit organizations, knowing they already have preferential and an advantageous situation as they go in to the tendering process. So the honourable member will, no doubt, use his next question to clear that little matter up. The reason I am not able to agree with him is because I do not know what it is he is proposing. They already have that preferential treatment, and I am just wondering what more.

If we add something else like--I do not know what it is; I guess I can only guess--that the nonprofits get a grant or something--I do not know. The honourable member can explain that to us because it is his proposal, not mine. I am saying that they already have a preferential treatment because they do not have to factor in any profits, unless the profit organizations want to become nonprofit ones, which would suit the New Democrats just fine because they do not really care about expansion of anything. You see, that is how things happen in this world. Profits are made, and then there is expansion.

There is one company that gets referred to more often than the others. It is the We Care Home Health Company. That company has indeed expanded over the years to the point where it now employs some 4,000 people and has about 40 franchises across the country. I simply say, how does a company do that with no customers? If they provide such bad service as the New Democrats would suggest, how come this happened?

The member for Kildonan (Mr. Chomiak) says, this is not wieners we are selling. Well, I agree it is not wieners, but let us look at a company that sells wieners, if you like, and they are working on a profit motive. The more wieners they sell, the better wiener they produce, the more likelihood of some kind of a success in the system, the more likelihood that they can stay in business. By keeping the customer satisfied, that is simply good for business and good for the customer, in this case, the client. I have to be thinking about the member for Kildonan who has some philosophical objection to the word “customer.”

I have been in business places where they have a sign on the wall, in this establishment, the customer is king, or, in this establishment, everything we do, we do to please the customer, or, in other businesses I have been in, the customer is always right. Those are positive statements about the client, the patient, the focus of all of the things that we are trying to do. Our friends in the New Democratic party have this almost religious distrust of anybody out there who wants to make a living unless it is made through the public system.

The honourable member for Radisson (Ms. Cerilli) said it all very clearly for us, and set out NDP policy in quoting Karl Marx, when she quoted Karl Marx as having said that: from each according to his ability, to each according to his need. Then the member for Radisson said this was a very fine, fine man that said this.

I think I know where the NDP is coming from, but I am having a little more trouble figuring out where the Liberals are coming from, because they want to add on more preferential treatment to the preferential treatment that is already there. I hope the honourable member for Inkster (Mr. Lamoureux) will be clearer about that when he asks his next question, because I believe this place is a place to analyze and debate over different proposals. He is making a proposal. I would like to understand it better.

Mr. Lamoureux: Following along the line of the question and wanting to answer, and hopefully if I demonstrate the general will to answer a question directly, the minister will do likewise when I pose a question.

When you establish the criteria, you can give so-called special treatment. It can be done in many different ways. For example, if you say in the criteria prior to going to tendering that you can only provide core services at no cost, you cannot provide extra services at a cost, I would imagine that the private sector would be quite disappointed with that, and that would have an impact on their bid. Will it have more of an impact than it would on a nonprofit organization? My argument would be that, yes, it would have more of an impact.

When you look at the core services in which the minister has been reluctant to respond to, what in essence is the nonprofit sector, if you like, going to be competing against? Well, We Care and other for-profit private companies are looking for the cream of the home care services, and that is going to be found in the extra services being provided.

You use the core services as the bait, if you like, to attract the clients. Once you have the clients, then you sell and promote and possibly even give commission incentives for the client to buy into those extra services. The extra services are where you are going to have that much more of a higher rate of a return. That is what is going to be motivating the for-profit organizations, private companies. That is why ultimately we will argue from within the Liberal Party that, if you are going to privatize home care services, and you are not prepared to consult with the clients, the home care providers and other Manitobans in advance to privatizing, then at the very least give a concession and say that we are prepared to give special treatment to nonprofit organizations.

If you are prepared to do that, then ultimately what we are likely going to see is better services if the nonprofit sector is allowed the opportunity to participate in a more significant way. I believe ultimately that the Minister of Health even recognizes--as I say, I gave a fairly direct answer to his question; hopefully, he will give an equally direct answer to this question: Does the Minister of Health concur that a nonprofit home care service such as the VON is in a better position to be able to provide a higher quality of core services for home care work than a private sector? Are they not in a better position to be able to do that? If the answer to that is yes, then why does he not allow them to do that?

Mr. McCrae: Sometimes, when members are asking their questions, I am also engaged in a couple of other matters at the same time. I do not always hear all the parts of the question. The honourable member may well have put his policy on the record, and we will have to review Hansard to make sure that we understand what it is he said, but he did make one point which--I have another question for him. He said that he did not think there should be any extra services at extra cost beyond the core. That is a big problem in our country because what he said is a little bit akin to the position taken by his federal colleagues, that being that those who want more should not be allowed to have more, kind of an imposed mediocrity--maybe that is the right expression.

It sounds to me what the honourable member is trying to do is impose limitations on what the client can get. Again, the client is not the focus here to the Liberals, and that disturbs me. I think that we have probably the best program in the country, and I think that we have the best standards in the country, the best variety and menu or services paid for by government in the country. Yet there might be somebody out there who says, well, you know, I think I would like more. In fact, I am going to try to get more, so they can go to the appeal panel for home care and have their assessment reviewed by people involved in care delivery and fellow consumers of home care services. That is what our home care panel is all about. It has had a very good impact on our Home Care program.

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Even then, if the client fails to convince the program that they should get more services, but they want more--let us say the program allows for a bath three times a week and you want four or you want five baths in a week. Why should you not be able to have four or five baths in a week? Why is the honourable member for Inkster so insistent upon denying people the number of baths that they want, but the program says you can have three, and the government pays for that, but you want four or five, and the member for Inkster says, no way, you cannot have that. Why? Is it, as has been suggested, that the honourable member for Inkster is all wet? I do not know.

I think we are into another philosophical fight because, you see, the federal Liberals want so much to put the kibosh on anything that you can pay for yourself. They do not mind that you can drive your car or fly your own Lear jet, which the member for Elmwood might be able to do with his--I do not know if he has a Lear jet or not, but we know he does very well, and all the power to him. The member for Elmwood might want to get in his Lear jet or rent one or whatever and fly to Minneapolis and have some kind of service done that cannot be done here or is not quick enough to suit him or whatever it happens to be.

I do not know why the federal Liberals want to put a stop to that. They do not like it. They cannot stop it, by the way, but they do not like it, and that is why they say to the Province of Alberta, any clinic that is subsidized by government in any way ought not to impose any additional fee on the patient. Well, I can see some good intentions involved there, but I do not see the logic. The Gimbel Eye clinic is often used as an example for this argument. There are people who are against government having any part to play in the Gimbel clinic because they charge these tray fees and whatnot like that.

We respect the five principles of medicare, and we are trying to work our way through this little dispute that we have got going with the federal people, and Alberta and some other provinces, as well, because we do not want to be fined by the federal government all the time. My problem is that there is some narrow thinking going on in this whole debate because Ottawa does not understand health care. The reason it does not understand health care is it is not in the business of health care delivery. The provinces are. The federal government is a funder, and they say, we got this Canada Health Act that Monique Bégin or Pierre Trudeau or somebody wrote up, or whoever it was before that, and, by golly, it does not matter that this is the '90s and we cannot afford it anymore. You are going to fit in that box that we have crafted for you.

Well, it is generally agreed amongst provinces that the federal interpretation of what that box is all about is not always the same as everybody else's. What do the federal people know about it anyway because they are not in the business of delivering health services. We would like to think we know a little more about it because we are into it day in and day out.

That is the nature of that discussion. I digressed a little bit but not very much because the honourable member is talking that same mentality here with this point where he says that you should not be able to get extra services at extra cost. I am saying, why not? I am saying, why not, whether it be from a nonprofit agency or from a profitable agency? Oh, I think the honourable member will come back with some argument: why should the private people be able to get their foot in the door by working in a publicly funded program so that then they can get more business? He shakes his head in the negative, so he is not saying that. So I do not understand that one.

I just, off the top, want to tell the honourable member that I do not agree that somebody who wants more services than the core services should not be able to get them. I do not agree with that, and I do not mind saying so. There are people in Manitoba who want more and can afford to pay more. The difference between the member for Inkster and me is that he is saying no. Those who can afford to pay more should accept what they would see as enforced mediocrity. I am not saying that I think the core of our services is a mediocre core of services, but there are some people for whom that level of services, for their own reasons, is not good enough. Why should they not be entitled to get more? Can the honourable member explain that to me?

Meanwhile, everybody else gets services that are appropriate to their needs, as suggested by the member for Radisson (Ms. Cerilli), who quotes Karl Marx and says that everybody should get what they need from those who can afford to give more. I mean, it is the old NDP, communist, whatever, make-the-rich-pay formula. That is okay. It is all right for her to believe in that. As a matter of policy--[interjection]

The honourable member for Elmwood (Mr. Maloway), I have got his attention. Now, see, you go digressing for the member for Inkster (Mr. Lamoureux), and then the member for Elmwood wants to get in the act. He asks why the member for Thompson and he should be criticized for joining the picket lines in 1987 when there were all these things going on that were talked about so broadly and recently. Why should he not have been able to be part of taking things out of people's shopping baskets and throwing it on the ground and sneering and all these things? Why should I not be able to do that? Well, you can do that. It is your business if that is what you want to do, just it does not seem very appropriate for publicly elected persons to be engaged in activities like that, that really, really represent the--[interjection] He says he is showing support for workers. If you have to show support for that kind of behaviour to do it, there is something wrong with our system, Mr. Chairman, when the member for Elmwood (Mr. Maloway) has to sit there and from his seat suggest he should be able to do those things. Well, there is no law, I guess. He did not break any laws, so he can go and just be a genuine nuisance out there and be an unpleasant person all he wants.

I am telling you, my friends and neighbours and fellow citizens think that is goonery and thuggery and all those things, and it is not very nice, to come right down to it, to make it as clear as I can. It is just simply not very civilized behaviour. Honourable members in the NDP want to defend uncivilized behaviour. Let them go ahead; let them go ahead.

My point is, back to the honourable member for Inkster who asked the question after all, I want to know why it is he is against allowing people to pay more and get more, why it is he is against that. This is not a Canada Health Act program and is not going to be. There is not a Health minister in the country who would agree to that. That being the case, why is it that the honourable member wants to deny people the right to have additional services if they want them?

Mr. Lamoureux: It is not a question of denying individuals the right that have the economic means to purchase extra benefits through home care services, through We Care, other outside organizations or even from within. The minister makes reference to the baths. He says, well, look, if you have a client that--let us say the core is set at three times a week, and then you have someone, using his example, that wants to have a bath done five times a week. Well, ultimately, if you privatize for profit, what you will find is that anyone within the business world who wants to be able to make a profit, who wants to be able to get as much of a rate of return as possible, is going to encourage, is going to say, look, at such and such a fee, you will be able to get an additional two baths a week.

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Who, then, is going to be in a better position to be able to get that extra service? Well, those individuals that have the economic means, obviously, are going to be in a better position to be able to get that extra service. Well, why do I have some concern with respect to that? Primarily because what will happen in the private sector is, you have your employees, you have a certain amount of transition that occurs. Where you have the core services and those individuals that are simply taking the core services and nothing more than the core services, there might be a tendency from private, for-profit companies to have the trainees or the individuals that are going to be, maybe not sticking it out as long as those that are more inclined to make a career, those that are going to be receiving a bit better of a wage, those that as they hit the higher scale, those individuals will, in fact, be sent to those clients that are requesting the extra service. After all, that is where these private companies are going to be making more money. That is what gives them a bit better of that competitive edge, to a certain degree, over the nonprofit groups.

That is why the question I posed to the minister and was hoping to get a very direct, short, simplistic as possible, response from the Minister of Health, and that is: Does the Minister of Health believe that a nonprofit home care service delivery does provide a greater opportunity to have more equal client service treatment than a private, for-profit company. Would he not concur with that?

Mr. McCrae: No, Mr. Chairman. The important thing to think about here is the standards that all of these vendors, these providers, are bound to work within or exceed. That is what we are talking about here. If we do not get what we need from a nonprofit or a profit agency, they are not going to be working for us for very long. If the MGEU decides to accept our offer and put in a bid, and they decide that they do not want to provide the services up to the standards that we insist on, they will not get the contract next time, guaranteed, or they will lose their contract midstream. We are going to make sure that there is appropriate contract cancellation language in the contract so that we can boot them out if they are not going to a good enough job.

That is necessary and should be there at all times if you are going to put the clients first. You should protect the clients and your own integrity as a contracting agent here to build that kind of language into a contract. You know, the honourable member surprises me sometimes because either he is not thinking clearly or he is taking a massive step to the left. Maybe he thinks that is what he needs to do for whatever is going on in the Liberal Party these days. He does not want extra services for extra costs. Where was he from Day One when he was elected in this House on the issue of the public wards in the hospitals, the private rooms and the semiprivate rooms, where you pay extra if you want to have a semiprivate or private room? Where has he been on that point all this time? Have not heard from him.

An Honourable Member: What did Sharon have to say?

Mr. McCrae: Yes, what did Sharon have to say? That is a good point. What did Sharon have to say? She wanted to charge for a lot of things, but now the member for Inkster wants to distance himself from that sort of point of view. She wanted to kick everybody out of the personal care homes; he is not saying that, I am sure.

What about this analogy that someone should be considered? What is different here, what is different in what the honourable member for Inkster (Mr. Lamoureux) is asking from the situation where the honourable member--well, let us not use him for an example. Mr. Smith and Mrs. Smith are looking at the necessity for Mrs. Smith to go to hospital and have an operation. They are of upper middle income, and Mr. and Mrs. Smith talk about this, and Mrs. Smith says, well, you know, I think I would kind of like to have a private room. Could we do that? They check their resources and they say, yes, we could do that, we do not have to pay very much, but we have to pay some to get a private room.

What is the honourable member's position on that? Should we be changing our policy in our hospitals?

Mr. Lamoureux: At times I have fallen into a trap, and that trap is answering the questions that the Minister of Health quite often poses. To a certain degree I enjoy the questions and, therefore, I do not mind giving my own personal insights to it. Hopefully, there will be a kind of quid pro quo, like, I answer some, and then maybe you answer some, kind of a novel idea. Sounds pretty good to the Minister of Health. Let me attempt to address that.

I guess in essence, I am not overly concerned in terms of if you are paying an extra fee in order to have a television inside the hospital room or a private, semiprivate room and so forth. I tell you where I would be concerned, and that is, for example, there was a study from the Fraser Institute, and the Fraser Institute said with respect to cardiovascular surgery under the urgent category in the province of Manitoba, average wait was 12 weeks. Now, this is back June 28. In fact, we had posed some questions regarding this particular issue. The minister says there has been some improvement, and I hope and trust that there has been.

Where I would have a problem, would I rely on the Minister of Health's comments? Well, it is debatable. Rely on Fraser Institute's research? No, I never assume everything that is in print is actually accurate. At times you need to further look into it, and that is why we raised the issue in Question Period last June.

Mr. Chairperson, where I would have a problem is if, in fact, a Manitoban could say, well, here is $2,000, instead of the 12-week wait, now I only have to have a four-week. In other words, they could be bumped ahead. I see that as entirely different from paying an extra fee for a television at your bedside--big difference.

Getting back to home care services, does the private sector have a role, private, for-profit sector have a role? I would feel a lot more comfortable in talking about this issue if the Minister of Health had provided some sort of a forum for input from Manitobans, from clients, from home care service workers.

You know, I am not prepared on behalf of the Liberal Party to say, this is the direction in which government has to go prior to not seeing studies and reports and consultation myself. That is why we asked the minister for hours, endless hours in regard to, let us see the type of information that specifically recommended that private-for-profit is the way to go. The Minister of Health has not provided us that, and if he believes he has, not only table it, indicate which page it is that I should read where it will actually say that that is in fact the direction that we should be going in.

I look at it and, trying to be as objective as possible, if you are not going to give that one-year moratorium and allow for that input, Mr. Chairperson, at the very least before you put out the tenders, because the criteria are absolutely essential and the standards that the minister himself alludes to are absolutely essential, demonstrate to the Chamber, and the best time is right now during the Health Estimates, that there is no benefit in giving special treatment to nonprofit organizations. It is not a question of denying extra services. VONs and nonprofits can also provide extra services, but their motivation is going to be entirely different than the private sector. The private sector’s primary motivation is going to be profit, rate of return on investment. That is their primary motivation.

The primary motivation for a nonprofit group is more community and client based, and I believe, ultimately, that if in fact the nonprofit community is prepared to take on this particular issue--the Minister of Health, I heard him on CJOB commenting and saying, look, let us see the nurses get more involved, form groups or whatever else might be available and participate in the process. From his seat, he says, right on. Well, to say it is one thing, Mr. Chairperson, to actually mean it is another thing. If the minister is true to his statements, then why is he not prepared to make that extra step and see if in fact there are things that can be done to allow nonprofit organizations, in particular, such as the Victorian Order of Nurses the opportunity, or community clinics, whatever that might be out there? We do not know, because the minister has not gone out and consulted. Why does he not provide that opportunity? Does he not see the difference?

I answered the question on hospitals. I would wonder if the minister would answer the question with respect to this?

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Mr. McCrae: Mr. Chairman, with all due respect, I do not think the honourable member has defended his point of view very well. Somebody must have told him to come in here and ask for that sort of a thing, and it is there. There is a built-in advantage for nonprofit agencies, because they do not need to make any profit, so they can come in with a lower bid or they can come in with a bid that is the same and prove they can do a better job and then use whatever money they do not need to finance other operations or whatever. That is what can happen. The honourable member did not really deal with the inconsistency in his proposal where he says that clients ought not to be able to get any extra services and pay extra cost for them.

Why? I mean, this is a free country the last I checked. It is supposed to be one of the freest countries in the world, and now he wants to turn us into some kind of a system where people are told, you cannot have this, you cannot have that, even if you can afford to pay for it. I mean, surely to goodness, he has got to re-examine that, especially if he wants to put his policies in front of the public of this province to be properly examined.

See, what he does, he lets those New Democrats set little traps for him, and then he just lively walks into them. He should be careful. This is political advice now, Mr. Chairman, which is relevant to the point, but maybe he does not want to take any advice from me.

Why would a Liberal in the 1990s want to watch what the NDP do and then just do what they do, or say what they say? Really, that is not original, obviously. It does not take much effort, I know that, but do they not want to play a more meaningful role in representing the people of this province than simply watching what the NDP does and then doing the same thing. Surely there is more to a Liberal in the '90s than that.

I sense it sometimes when I look at the federal government and see the odd thing coming out of there that they did not pick up from the New Democrats.

Trudeau is finished. He is gone. Those days are over, and our country is stronger for it, I must say, so that when we do see some things coming out of Ottawa that, whether they are good or bad, at least they are original. They are not borrowed from a left-leaning group like the honourable members opposite in this House--so a short little lecture for the honourable member on politics. Maybe he does not appreciate it, but the fact is I do not think he should go to the public with this suggestion of his that we should impose mediocrity on the public of this province.

We are a very positive bunch of people here in Manitoba, and the economic performance of the last few years demonstrates that Manitobans will not be held back by the kind of thinking that is being put forward by the member for Inkster today. Manitobans are much prouder than that; they are much more expansive than that.

Someday the honourable member, he might have a nice big MLA pension and all that stuff, and he might need home care services so that he can live comfortably at home. He might say, three baths a week, gee, I wish I could have four. He might not mind if his home care worker said, well, you know, Mr. Lamoureux, you can have four, if you really want that. For an additional charge you can have four. Why does he not want four baths? If he can afford it and wants it, why can he not have it? Why are we going to have a publicly run system impose those kinds of limits on our fellow citizens who want something more?

So that is the one thing that separates us is the sense of imposed mediocrity. I am not trying to say that our program is mediocre, but for the honourable member to suggest that the program that you get is what you get and you do not get anything else, even if you want to, I mean it is an open invitation for some people to leave the country, is really what it is.

Why are you wanting to kick people out of Canada? This is the most wonderful country in the world. Why do you want to make our country limit our growth, limit our ability to fulfill our ambitions and our aspirations and our dreams? Why? Why do Liberals want to do that? Why do New Democrats? Why are New Democrats so afraid of everything? That is why I am not a New Democrat, because I am not quite so afraid as they are, afraid of anything big, afraid of anything successful, envious of anybody else’s achievements. I just find that totally strange to my way of things.

I find that there are a number of colleagues on this side of the House who share that particular approach, who see the opportunities in this province and in this country something that is boundless, that only your imagination might limit where you can go in this country and what you can do and achieve and get if you go out there and work for it and want it bad enough. So I hope the honourable member will review that more and come out with something to present to the people of Manitoba that is just a little more positive than that.

You know, think about it this way too. The more people rely on their own resources in the conduct of a country, the more resources can also be made available for those who cannot, simply cannot provide for themselves.

See, what the philosophy the honourable member is putting forward leads us to down the road again is a system we cannot afford, which is what we encountered just a few years back and we have been trying to address. So we will get right back into that cycle espoused by the New Democrats especially, but now I see the Liberals hanging on to their coattails. That is the philosophy that says, let us just kind of keep going the way we have been going or, as the honourable member for Kildonan (Mr. Chomiak) says, go back to the system we had in the first place and, well, we will not have any system in less than generation, any system at all. It will go back to survival of the fittest.

Those who are weak can beg in the streets, and those who are strong will be just fine, thank you very much. Is that what you really want? Is that what honourable members opposite really want? I do not think it is, frankly, but why do they not think it through? Why do they not use a little bit of vision? You do not even have to be a genius to see that the proposals of the New Democrats would destroy the country we know and love here in Canada.

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The honourable member for Inkster (Mr. Lamoureux) might try to be consistent. If he wants to preserve a nonprofit system, let him bring forward something that can justify such an argument, because he has not done it yet.

Mr. Lamoureux: I guess ultimately what it is that we would want to advocate is that there is a one-tier system of home care service delivery. In a one-tier system you still can have extra services being delivered over and above, Mr. Chairperson. That happens today and there is no reason why we cannot prevent that from happening in the future for many of the reasons which the Minister of Health has alluded to. The concern of course is that the direction that the government is prepared to take home care services ultimately I believe and the Liberal party believes will lead us into a two-tier system of home care service delivery. That is where the concern comes from. I beg to differ with the Minister of Health in terms of, well, have we been successful or the opposition as a whole been successful in pointing out some of the flaws in what the government is doing. I believe that there are a number of flaws in the way in which the government is addressing this particular issue.

Again, I want to reinforce the position which we have taken on this is to see the one-year moratorium put in place with the government making a commitment to consulting with the clients, the workers and other interested Manitobans that want to be able to contribute to what sort of a system would be best able to provide not only current home care recipients but future generations of home care recipients, the best quality service that is going to be available. I am not convinced. The minister has not convinced me with all of the waxing that he has done, and skating around, that private, for-profit is the way to go. I still maintain that it will be a mistake if we go private, for-profit. Until the minister is able to prove to not only me but, I would ultimately argue, a majority of Manitobans that this is the direction to go, that the minister has an obligation to put it on hold and to consult, to work with those individuals that want to be able to participate, as I have indicated, in this particular decision.

Having said that, Mr. Chairperson, I want to get back to this whole tendering process. The minister is, at some point in time, going to issue a tender. When, I am not too sure. What I am hoping is that the minister does have in place some standards, the criteria that is going to be incorporated into this whole tendering process. I would like, and would appreciate very much, having a copy of what the minister has in place today or what he is working on prior to the issuing of the tender itself. Thereby, or hopefully therefore, we will have the opportunity to point out where the government might want to make some modifications. Failing the Minister of Health (Mr. McCrae) providing the opposition this information, I would look for a commitment from the Minister of Health that in fact there will be a sincere attempt by this government to consult with individuals that are clients, that are home care workers and other individual Manitobans that in fact the criteria that the minister is putting together, along with the standards, is not one based on political philosophy, but rather it is based on what is in Manitoba's best interest for the client.

Mr. Chairperson, that to me would be most beneficial and most productive, at the very least, if the Minister of Health would make a commitment to sharing that valuable information with us that would include things such as the core services. After all, the private companies, whether they are for profit or not for profit, need to know what the core services are. Will the minister share with us and make the commitment that he will share with us that information in advance of the tendering going out?

I do not want to receive, whether it is the Victorian Order of Nurses or from We Care, the standards and the criteria and the core services. I would like to be given some advance notification of what this government is in fact looking at in terms of those core services so that in fact it would be nice if we could actually have a debate inside the Chamber before the government actually issues it. I think, for the Manitobans, in particular for the clients, that that sort of debate would be most useful, and I would request that the Minister of Health give that, not only consideration, but see fit to allow that to take place. After all, he is the only individual out of the 57 MLAs that has that opportunity to do just that.

If he was to give that sort of a concession, at least we could say that today was somewhat productive or more productive than previous days in terms of the Health Estimates. I wonder, because I know there is not too much time, maybe the minister could keep the answer as short as possible, and then we could possibly get another question.

Mr. McCrae: Considering that the proceedings in this committee will last precisely three more minutes, a little less than three minutes, my answer will of necessity be brief.

Yes, Mr. Chairman, the tender documents will be public documents. This minister will play no role in the evaluation of any bids that come forward because for obvious reasons the members of the union movement, Peter Olfert in particular, through innuendo has made certain incorrect, but nonetheless made them, comments about my association with a particular company. So I will have no role in the evaluation of bids or in the decision as to which nonprofit or profit agency will be the successful bidders when this all happens.

The honourable member referred to the tiers. Yes, we have a two-tier system in many ways, and there is nothing new about that. Up until a few years ago, there was not any system so we had to start somewhere. What we have started with is a two-tier system, and that is what the honourable member wants to put an end to. I think I have argued that matter with the honourable member. I disagree with his point of view. We have a one-tier system in our hospitals, and a one-tier system in our Home Care program in regard to those services that are required. That is what you call the core services. Beyond that, we have two tiers and that is a reality; it exists. The honourable member wants to do away with it. I do not because I cannot understand the concept of taking people's freedom away.

Every time I speak, it is to try to preserve the freedoms of the people of our country. Members in the New Democratic party and the Liberal party want to limit people's freedoms and I do not.

Mr. Lamoureux: Would the Minister of Health table or provide us information prior to the actual issuing of the tender regarding the standards criteria core services?

Mr. McCrae: I have said, that there will be the requirement as set out in the tender documents about what services are being tendered for, and there is a requirement with respect to the fact that those services will be very closely monitored and evaluated. There are standards that must be met or exceeded. Those standards will be referred to in the tender documents.

When those documents are ready and the public sees them, the honourable member will see them, too. So he is talking about special treatment for him in the same way he wants special treatment for nonprofit agencies, which they already have special treatment, but he wants more special treatment for them. The fact is these tender documents are public documents, and the honourable member will see them when everybody else does.

Mr. Lamoureux: What I am looking for is the opportunity to be able to debate a very important issue prior to the actual tendering going out.

Would the minister not concur that it is, in fact, in Manitoba's best interests if we have that information on the table so we can actually talk about it before a decision is made?

Mr. McCrae: That is about all we have been doing around this place for the last, is it a month now--three weeks or so. This province is debating exactly what the honourable member wants to debate more. Well, we will debate this until the floodwaters stop and maybe beyond, we will see.

Mr. Chairperson: Order, please. The hour being 5:30 p.m., this committee is recessed until tomorrow morning (Friday) at 9 a.m.