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 on line 1.(b)(1).

Would the minister's staff enter the Chamber at this time, please.

Mr. Dave Chomiak (Kildonan): Mr. Chairperson, yesterday we discussed briefly the Health ministers' conference that took place in Ottawa yesterday. I also asked the question about the additional $2-million expenditure in the Estimates concerning transfusion services, and I have not seen the communique that was issued as a result of the conference yesterday, but I did read a report in The Globe and Mail concerning the results of yesterday's conference.

I realize it is not a final position, but there seems to be a move towards the establishment of a different kind of regime or agency or administrative apparatus dealing with blood transfusion services in the country. Putting aside the issue of the Krever commission, that has major implications for how we are dealing with the blood transfusions in Manitoba in the future. From the comments, I assume (a) that the Red Cross will continue to be the agency that will deliver the transfusion services in Manitoba. I am looking to the minister to confirm that firstly, and secondly, what kind of regime is being looked at and the relationship between that regime and the Canadian blood agency? I wonder if the minister might inform the House where he sees this going or how the structure may or may not look in the future. I realize this is tentative, but just to give some understanding as to where we are going so people in the system will have some idea as to where the province is taking us.

Hon. James McCrae (Minister of Health): Mr. Chairperson, I will be able a little later today to give the honourable member a better report. Dr. Wade returned from Ottawa last night and we have not had an opportunity as yet, because of meetings Dr. Wade is attending this morning, for a debriefing on the discussions in Ottawa. But Dr. Wade will be with us a little later today for some time, and perhaps the honourable member might raise that question at that time.

Mr. Chomiak: Mr. Chairperson, I thank the minister for that response, and we will pursue that line of questioning further on during the Estimates process.

Mr. Chairperson, the department has sent a letter to the hospitals separately asking them to account for their expenditures in relation to the labour dispute that is going on now concerning home care. I am wondering if the minister can outline for us under which appropriation of the Health budget will these additional funds that are being expended to deal with patients in institutions come out of? Which budgetary appropriation will that come out of?

Mr. McCrae: In a situation like this our first priority is to ensure that the clients of the home care system get what they need in terms of additional costs that hospitals are put to as a result of this disruption--not something we wanted, and not something that anybody supports it seems.

The hospitals of course, in a situation like this when similar things have happened in the past, they have to keep careful records of expenditures that they have had to go to in order to assist us get through a disruption like this. At the end of the strike, which we hope will be just right away, there will be an appropriate accounting on the part of all hospitals who took patients in from the Home Care program and then adjustments made at that time. As to which appropriation we are talking about, that is not something that is clear at this point. It will be made clearer as we get to that time.

The resources of this department are really being used--quite serious about this to assist our clients. We have people at all levels in our department who are providing service to people while the union has withdrawn its services to the clients. Someone has to be there for the clients, and we have some pretty wonderful people in this province, I can tell you, at all levels of our department. I daresay there are volunteers from other departments and other parts of society in the province of Manitoba that are moving to assist their fellow citizens.

It is quite a tradition we have in Manitoba. We have people like yourself, Mr. Chairman, helping out with the flood conditions, sandbagging and one thing and another. This is not new in Manitoba. This is what we do. I remember a few years back there were forest fires. A number of communities just linked arms with others and helped their fellow Manitobans in a time when it was important to do that. So that is one of the reasons we can all be very proud to be Manitobans.

There are a lot of people who work as home care attendants who have my respect. Some are providing services; some wish they were and would be except for some of the things that are being said to them and some of the ways they are being treated by others in the system, especially those involved with the union movement who are finding ways to discourage people from providing services to their clients. They do not want to be abandoning their clients, and yet that is what they are being forced to do. We find that very troubling but nonetheless we sympathize with those people. I do not think that the withdrawal of services is something that the rank and file home care attendants in this province ever wanted in the first place. We have union leadership leading people in directions that I am quite certain they do not want to be going in.

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So when it comes to how we do the accounting at the end of an unfortunate dispute like this, that will become clearer as we get to the end of that strike, which we hope will be very soon.

Mr. Chomiak: Mr. Chairperson, when we ask questions often in Question Period related specifically to expenditure items as they relate to the budget, ministers, and this minister as well, often refer us to the Supplementary Estimates process where we can get the specific information on a specific budgetary appropriation item.

We have had a long debate in here about the merits or the nonmerits of the strike, and the minister has gone on at length on the issue, but my question, however, is highly relevant and I wish the minister--there was recently a strike in the health system concerning doctors. Can the minister indicate--and as well there was a procedure put in place by the Department of Health to reimburse those institutions for the incurred cost of that particular dispute.

Can the minister tell me, did that expenditure come out of the direct Hospitals line expenditure, item 4.(c) of the expenditure items, or did it come out of some other contingency or some other fund from the Department of Health?

Mr. McCrae: The costs, the expenditures associated with the delivery of emergency health services comes out of the Hospitals budget as set out in the Estimates for the department, so that expenditures related to that particular disruption would have come out of that line. That was for 1995-96.

There may be some difficulties getting the kind of information the honourable member wants. I just say to him, as I have said to him before, the resources of this department are pretty stretched. When it comes to a review of the Estimates and some of the things the member brings forward, I have said to him, help us get this strike resolved and the staff of the department will be in a more traditional mode when it comes to dealing with the Estimates here. But it is very difficult, Mr. Chairman, for me to promise the honourable member speedy responses to the detailed kinds of questions he asks when we have people at senior levels and every level of the department out there providing service to people, helping them as volunteers and helping them with whatever skills they have, applying them to the task of making sure that our home care clients are properly cared for.

It is a difficult time when you get thousands of people being led off the job by their union leadership without even knowing what the government's proposals are, voting to do that without having anything negotiated. That sort of thing creates a difficulty for me right here in these Estimates. Within the Estimates review, I am usually I think pretty forthcoming with information when it is asked for, and I would be that way now except that we have staff in the Department of Health whose attention is directed towards a dispute and services that need to be provided in the light of a withdrawal of services.

We have a union that will not even agree to essential services, and the honourable member, I have implored him a number of times to use his considerable weight with respect to, you know, a close association with the union leadership to use whatever influence he has as the Health critic for the New Democratic Party to try, if he cannot find it in his heart to ask the union leadership to abandon this foolishness, at least to do the right thing and have a little bit of compassion and sensitivity for fellow citizens who require services like toileting assistance, services like feeding and bathing, dressing and moving from chair to bed and bed to chair, that sort of thing. The union is refusing to assist with that sort of thing.

The honourable member and his colleagues, his own Leader, who is a former president of the MGEU, it seems to me there is a close association. Well, we know there is a close association between the NDP and the union movement, and I would appeal to the honourable member’s sense of compassion for his fellow citizens to get together with his union boss friends and say, you know, there are people who really require these services. This is totally unkind. It is callous and it is insensitive, and we in the New Democratic Party do not want to stand for this sort of insensitivity and callousness so why do you not help us out here, help us out by--even if you cannot agree with the government on the bigger issues, why can you not at least provide essential services?

My colleague the Minister of Labour (Mr. Toews) apparently was talking to somebody yesterday about this, and even in a war, there is a Geneva Convention that provides that there be these types of basic services. Here we are in one of the most civilized places in the world and we have a recognized political party in our system here, the loyal opposition in this Legislature, who will not come to the aid of their fellow citizens at a time like this. It boggles the mind, Mr. Chairman.

Mr. Chomiak: I take it from the minister's response, Mr. Chairperson, that the last year expenditure, the additional expenditures as a result of the emergency doctors strike came out of the appropriation of the hospital appropriation. I take that from the minister's response. If I am incorrect, I would hope the minister would advise me because it is last year's expenditure and surely the minister ought to know that.

My question continues, hospitals have been told in a letter, dated April 12, to make specific budgetary provision and allocation based on the cost as a result of this dispute. Now I have accepted the minister's response previously that it is very difficult to ascertain the costs, that he will provide a cost accounting at some future period, and I recognize the fact that the department staff are very occupied, but there are some very legitimate questions that I think the minister ought and should be able to answer in this Chamber.

The question, therefore, is, with respect to these additional costs that are considerable, that are occurring as a result of this dispute, will those costs come out of the line hospital item which has been reduced by $53 million this year? Will they come out of the $38 million transition that has been put in place to deal with changes in the Winnipeg hospital sector, or will they come out of the additional roughly $8 million put into the home care budget this year to deal with home care costs?

Mr. McCrae: Mr. Chairman, no one is saying that the member's questions are not quite legitimate. They ought to be answered, and I do not say there is anything unreasonable about that, but the honourable member did not answer my entreaty. I wonder will he please answer the question? Will he go to the union bosses and insist that unless they provide for essential services, their relationship is at an end?

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Mr. Chomiak: Mr. Chairperson, can the minister outline for me whether or not the additional costs incurred during this particular dispute--there is a letter dated April 12, '96, that went to all institutions from the department, asking them to make specific allocations in their budget and in their accounting. Will that money come out of the hospital line item, which has been reduced by $53 million? Will it come out of the $38 million that has been put in place for transition as a result of changes occurring in the urban hospital sector in Winnipeg, or will it come out of the $8-million home care additional funding, or the home care budget per se that has been allocated this year?

Mr. McCrae: Mr. Chairman, the time has certainly come when the honourable member has to be responsive to the responsibilities that he has as a spokesperson for the second largest represented party in this House. You know, the honourable member cannot run and hide from the issue at hand. Will he use his considerable influence to insist that his union boss friends provide essential services to people in Manitoba who have Alzheimer's disease, people in Manitoba who have Parkinson's disease, people in Manitoba who have multiple sclerosis, people who have severe cases of arthritis?

Point of Order

Mr. Chomiak: On a point of order, Mr. Chairperson, I asked a very specific question on a very specific issue relating to a line appropriation item in the course of these Estimates, and the minister has responded with completely--I look to the question of relevancy again. While we have been debating and discussing the home care issue in great detail back and forth, the minister's response bears absolutely no relationship with the question as posed.

The minister cannot draw even a minute association with the question as posed, and I am wondering if you might call the minister to order based on relevancy.

Mr. McCrae: Mr. Chairperson, throughout the course of the Estimates review for the Department of Health, the honourable member has been raising issues related to home care, and so have I, to be honest. That is an appropriate topic for discussion, I suggest.

I think the honourable member is very often listened to; he is very often quoted in the public media. People look to the honourable member for Kildonan for leadership, and frankly, so do I.

This is a time in the history of health services in Manitoba when leadership is something that is cried out for, and from Her Majesty's loyal opposition here, you would think the people of Manitoba would be entitled to expect some kind of support for the clients of the home care system. Will the honourable member use his--

Mr. Chairperson: Order, please. The honourable minister has given me enough information on the matter. Just give me one minute, please.

For the information on the honourable member's point of order; he does have a point of order towards Rule No. 70.(3) “Speeches in a Committee of the Whole House must be strictly relevant to the item or clause under discussion.” I do believe we have had a fairly open discussion on home care over the past three or four days. The item questions that the honourable member is asking are pertinent to certain line expenditures. The concern I have as the Chairperson at this time is that under the line we are dealing with we can almost go into a very open debate on just about any area. I would request the assistance of the honourable members in maintaining the lines of questioning and the answers towards the issues that are before the committee at this time.

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Mr. Chairperson: The honourable minister, to conclude his answer.

Mr. McCrae: The questions, as I have said, raised by the honourable member are indeed important and there is a time for answering them. I do not think that during the dispute is the right time, frankly. Why would the honourable member want to know how our contingency plan is being financed at a time when the dispute is still on if it is not to--there is no reason why that information ought to be shared until the strike is over. When it is over I will be happy to tell the honourable member all the things that arose from that. We have a job to do, and so do the home care attendants in this province. They want to do their job. They are being held back from doing their job by their union boss leaders who are very close to people like the honourable member for Kildonan.

So I am saying, we have people in Manitoba whose needs are such that they require--it is not a question of something being optional. These are the kinds of people that, as my friend and colleague the Minister of Labour (Mr. Toews) has pointed out, would be protected under such instruments as the Geneva Convention in a time of war. But here we have a New Democratic Party in Manitoba who refuse to stand up for people in Manitoba who have Parkinson's disease, who have Alzheimer's disease, who have multiple sclerosis and who have severe cases of arthritis and others as well who are functionally dependent upon home care services. Not once since the beginning of this labour dispute has the honourable member for Kildonan done a press conference, rose in his place in this House and stood to his feet and said, yes, I demand that the union provide essential services to those people.

You know, it is reasonable for a New Democrat to maybe agree with the union about the substance of the dispute. I am not arguing that right at this moment. I will at some other time. But certainly when it comes to the issue of essential services, a responsible opposition would cry out from the rooftops and say, enough of this foolishness, what about the people in Manitoba who require these services?

You know, when the nurses went on strike back in 1991, there were essential service arrangements in place. Any decent, responsible union in this country--this is the most civilized, supposedly, country in the world--any decent and responsible union leadership would say, yes, we have to be able to have a right to fight out our issues with the government of the day but certainly we are not going to make victims or hostages out of the very vulnerable clients of our home care system while we have our fight with the government. It is quite appropriate that that fight be had, that the discussion be had, that there be a dispute and so on. I am not saying that should not be happening, certainly not for the moment. What I am saying is that there are people who need services on an essential basis. I want the honourable member for Kildonan to have the courage of what he says. He says he cares about the clients of the home care system. Let him use his good offices and his considerable influence with the union movement to demand of Peter Olfert that today, within the next hour, they agree to arrangements for the delivery of essential services to the clients of our home care system.

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Mr. Chomiak: Mr. Chairperson, I am advised that the government has so incompetently handled this matter that they were not prepared to have a proper contingency plan, and still do not, relating to this particular issue. I am advised that this government, who knew they were facing a strike situation, was unable to negotiate and have had eight years in office to negotiate an essential services agreement in this area and were so incompetent in that application they were unable to do so. They knew they were facing a strike. They were unable to put in place an essential services agreement. They had eight or nine years, and all they have done is be on the defensive and blame everybody but themselves--blame the unions, blame the home care workers, blame the clients--when in fact it is this government's and this minister's incompetence that have put us in the situation we are in. It is this minister and his failure to negotiate an agreement over eight years of office. How long have they been the government? How long have they had the opportunity? How long ahead did they know this strike was upon them?

I am advised that they are so ill prepared, ill equipped to deal with the strike, that it is one of the reasons why they were forced to get clerks and financial people to go into people's homes, Mr. Chairperson, to deliver home care. This government does not even understand home care. This minister does not understand the implications, the intimate relationships between home care clients and home care workers, the very intimate and long-standing relationships. If they did, why would they put in place a plan that would remove the home care workers and put in place a private agency for a determined--they are going to tender. They are going to take away peoples' home care workers and tender to private companies in a monopoly situation, and at some point that contract may or may not be up, and they will change the workers again.

The biggest criticism of this government's privatization policy is the lack of continuity, the lack of understanding of the relationship between a home care worker, Mr. Chairperson, and the client. So, I do not fault the home care workers, and I do not fault the clients. Who I find fault with is a government that was ill prepared, ill advised, did not have in place an essential services agreement, knowing they were facing a situation, knowing they were facing this. They did not believe there would be this kind of situation and are thus unprepared and, consequently, we have a minister who is attacking everyone instead of looking internally and saying how can we solve the situation, how can we get out of this situation.

Mr. Chairperson, there is no report, no study, no foundation whatsoever that supports the government's privatization. Evelyn Shapiro does not. The Connie Curran report does not. There is even a graph in the Connie Curran report that indicates the present system is more cost-effective than the proposed privatization, in their own documentation, and yet they continue to privatize. So the issue is not one of ideology, the issue is the government's insistence on privatization. If the government position is so sound, why would you not consider a year moratorium to review the situation?

Mr. Chairperson, there are people of upstanding character all across the province. We have ex-Premiers, Duff Roblin, Ed Schreyer. We have ex-Health ministers, Bud Sherman, Larry Desjardins, ex-Conservative Leaders, Sidney Spivak, any one or combination of them could be given a task to study over the next year the merits of the government privatization plan. If the plan is so sound, if the need is so sound, why would the government not be prepared to put it on hold for a year, have some individual or individuals review it, study it and come back? Why would the government be unwilling to do that? That would end the strike today. That would put the home care workers back to work. That would allow the clients to get the kind of care they need and deserve.

(Mr. Peter Dyck, Acting Chairperson, in the Chair)

So why would the government not consider that option in order to end this situation, rather than constantly attacking, constantly looking for scapegoats? And that offer is made. The minister did it as Minister of Justice on several occasions. The minister did it as Minister of Health. I believe it was Don Orchard, who brought in an outside party to deal with the original doctors' dispute. Why, if the government position is so sound, would you not put it under scrutiny, let it be studied for a year and then come back? If you are so confident of your position, why are you unwilling to have it come under public scrutiny, under that vehicle or, in fact, under some form of public hearings? If the position is as sound as the minister says it is--and his is the only voice we hear other than the We Care proposal from 1993 advocating it. He is the only voice. If that position is so sound, why would they not open it up to some kind of moratorium for a year and have it studied by eminent people who are familiar with the situation and have some public hearing process? Why would the minister be unwilling to do that?

Mr. McCrae: Mr. Chairman, I listened fairly carefully to the honourable member, and I did not hear any position put forward with respect to essential services. He suggests that I am blaming everybody; no, I am not. I certainly blame union bosses who take a strike vote without even knowing the position of the government, simply because they wanted to have a strike. Yes, I do. I certainly blame the honourable member for Kildonan who not once has stood on his feet to defend the interests of the clients of our system.

He has defended the union bosses; he has defended the status quo. I have known since I was a young fellow that the New Democrats oppose anything other than public ownership and public operation and public control and all of that. That is no surprise. So, when we moved in this direction, it was no surprise to me that this would not enjoy the support of the honourable member or the union bosses. It was interesting that, when that Seven Oaks project report did come forward, the honourable member for Kildonan very, very, sheepishly had to admit that all of the patients that were part of that project were extremely pleased with the outcomes and that they were getting better care and the medical people were also of that view. So the honourable member had to handle himself very, very carefully in those circumstances because it was a private company, and this, of course, bothered the heck out of the member for Kildonan because he has got this sort of thing about anything that is not run by government.

It is really quite an insult, too, to hear the honourable member talk. If I worked for a private company, no matter what kind of private company, whether it was manufacture of wieners, which is one of the examples he gave, or if I worked for McDonald's--we have heard the NDP talk in very disparaging terms about that particular corporation and the employees who work there--no matter who I work for, if I work for a government organization or a private one or a nonprofit one, as an individual human being, I know I speak for everybody when I say this, you do your level best, you take pride in your work, you care about the product, you care about the service, and you care about the person who is receiving the service. I have talked to enough people to know this, Mr. Chairman.

Just because you happen to pay union dues, you are somehow a special kind of human being. Give me a break. That is not the real world. The honourable member seems to think that, unless you have a union card and pay your union dues, you are a second-class citizen. I do not subscribe to that sort of thinking and the patient does not either. I do not know a patient anywhere in this province who is going to demand to see your union card before they receive services from them. I think it is time that the member for Kildonan and his colleagues over there were exposed for what they really are, and that is that they are totally against individual human beings out there in our society doing their level best to put in a good day's work for a day's pay.

I do not care whether you work for the government or who you work for, Mr. Chairman; you are an individual human being and you are supposed to have a little bit of dignity and be accorded a little bit of dignity by the honourable member and his colleagues. They insult ordinary Manitobans day in and day out around this place, and somebody has to stand up and talk about that and expose them for what they really are and for what they really do.

In this particular case, the question cries out for a response. Why is it that the honourable member, even today at this late hour, continues to refuse to stand up for people who have multiple sclerosis, Parkinson's disease, Alzheimer's disease, severe cases of arthritis and other people who are functionally dependent on home care services? He will not go to his union boss buddies and say, I demand. Union bosses demand enough of the NDP. Is it not time for a little payback? Is it not time for the NDP to have a chance and a turn to demand that somebody do the right thing for vulnerable people in this province? This is the main issue right now. I do not expect the union bosses will ever agree with any sort of competition, although we have offered that opportunity to them. They must be afraid of their ability to compete or something because they have not accepted any offer put forward by the government to allow them to bid on these contracts and provide work for their union members and to provide care for their patients. You see this is what is hard for the honourable member to accept. I do not care whether you have a union card or not. I am here representing the client of the system. The client deserves better.

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The honourable member wants to go back to the system we had in the first place. That is the position of the New Democratic Party as put forward by its own Health critic, the honourable member for Kildonan. I repeat, go back to the system we had in the first place. Their own report, Mr. Chairman, the Price Waterhouse report, commissioned by the NDP--I do not know how many millions they paid for it. Maybe the member can answer that question today. He has refused to answer that question: how many millions the NDP paid for the Price Waterhouse report, which on page xix, if I can find it, calls for the following, and I quote: The program should require regional program managers to manage their budgets more actively and to stay within approved levels and should give program staff greater discretion over service levels per client, i.e., permitting dilution of services in order to achieve budget targets.

The NDP had a lot of concern about budget targets in those days, I guess. This was in the later part of their term, and they were starting to talk about trying to live within their means, although they never came anywhere close to it.

And that quote again, Mr. Chairman: 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--making them wait--and user fees during the initial period of service--in other words, patient pays up front, that is what the NDP is talking about, and limiting hours in which services are provided.

The honourable member wants to talk about reports, well here is a dandy one. I go back to where I was yesterday before the end of the day arrived, and he says--I think it was last week in Question Period, the position of the NDP was put forward when the honourable member said, go back to the system we had in the first place. Well, the system we had in the first place was like this. 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 potentially unsafe client situations. That is what the honourable member wants us to go back to.

This report from Price Waterhouse, Mr. Chairman, is rife with references to problems in the home care system, and since we have been in office, every attempt that has been made to try to address the issues raised in the NDP's own report has been met with condemnation from the member opposite. It makes you wonder about what drives him. Is it his slavish friendship with the union bosses, or is it simply an opportunity to call attention to your own party, not to your position, but to your own party, because we have not heard a position from the honourable member other than go back to the system we had in the first place? Well, that is not good enough. Our patients have been telling us--a thousand of them in the first year of operation of the appeal panel had concerns to raise with the appeal panel. You cannot say we have the greatest program and there is nothing wrong with it. Well, we do have the greatest program, but there are things wrong with it, and we are not going to address them unless we admit it. This honourable member cannot admit it, and I appeal to him again to answer the question. Will he today prevail upon his union boss friends and insist that the relationship between them and the union will cease unless immediately essential services are delivered to the clients of the home care system that I referred to earlier?

Mr. Chomiak: Mr. Chairperson, I pointed out to the minister on many occasions and he was not aware of it, but I told him that he has an implementation committee for the Price Waterhouse report. His government tabled that report. This minister has an implementation committee. The minister keeps referring to the appeal board. The appeal panel was put in place to deal with changes put in by the Minister of Health when they cut back home care services in 1993. The appeal panel was put in place when the government changed the nature of the home care system so that we went from 13,139 people being assessed for admission down to 11,395. That is when the minister put in a home appeal panel and it was put in because government was cutting people off of home care.

So the minister is getting completely distorted in terms of his--Mr. Chairperson, the minister talks constantly about relationships. I would like the minister to table all of the meetings that he has had with private companies. Would the minister be prepared to table all the meetings that he had with private companies, private caregivers, the principals of the private companies? Would he be prepared to come to this Chamber and deal with that issue so that we will know where the input is coming with respect to this decision?

When the government's Treasury Board document--which the minister refuses to deal with in this Chamber--that he signed off that proposed the privatization of home care, when that document was released, the Department of Health held meetings with home care staff. I do not know if the minister had occasion, but I attended one of those meetings, and Mr. Chairperson, the staff were in shock. There were maybe 500 people at that meeting, and the department officials stood at the front of the meeting and tried their best to try to explain the government policy on privatization, but they did not have the answers. They did not know whether the staff would be fired. They did not know whether the staff would be eligible for UIC. They did not have any answers to the 500 or so staff, many of whom were crying, who were concerned about their clients, saying you are going to take me away from my client whom I have worked with for years and years and years.

There was no recognition of that continuity. Does the minister not see the point? You have longstanding relationships develop between clients and caregivers. The government is taking, at least in the start, 25 percent of the city of Winnipeg and saying we are giving you all new caregivers, firstly. They are taking all of the nursing service, 300 nurses, the entire VON service that provides home care in the city of Winnipeg, and they are saying we are giving that to a private agency. Does the minister not recognize that there might be a little bit of concern on the part of not just the workers but the client when you are saying we are dismantling, we are taking away your workers, the people that you have developed these intimate working relationships with? And they are intimate, Mr. Chairperson, let us have no mistake about it. The relationship of an orderly to his or her patient is as intimate as you can get.

This government, without consultation, without study, is ripping apart those relationships, so is there any wonder that clients and caregivers are concerned? Not only have they decided to take away the relationship between at least 25 percent in Winnipeg, soon to be all, and all of the nursing service, changing the caregivers, changing the approach, they are going to give it out to contract. And how long will the contract last? The minister will not give us any information about the tenders. Will it be a year? And after a year, will they then give it to another company who will then have to change all of their workers and change all of those relationships, and then another company and another company? What will that do to the relationships between the clients, the patients, the community and their caregivers. Is there not even a recognition, is there not an understanding?

Mr. Chairperson, Evelyn Shapiro has indicated the most condemning aspect of the government's privatization plan is this question of continuity and the question of relationships, and there is absolutely no recognition on the part of this government or this minister of the essence and the importance of it, which takes us back to our initial point. Why will you not be prepared to put a year-long moratorium, have it studied by a group or a group of individuals, have public hearings, do something to deal with those concerns. If at the end of the day you can justify your position, which you have yet been unable to do, then so be it.

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This whole debate going back and forth and back and forth and blaming the unions, it is not productive, and I could counter just as easily and say table all of the meetings you have had with private caregivers; table all of that. Come to this House and tell us when you have met with the principals of private home care companies so we will know what impact and influence they have had on this particular decision. But it gets into a war of words.

What is at stake here is the relationship and the care being offered to Manitobans and the lack of understanding and sensitivity on the part of the minister and the government of the importance of the relationship between caregivers and those requiring the care, those very intimate relationships. Your policy of privatization, by saying we are going to tear away all of your workers and we are going to tear away the system, a large portion in Winnipeg, the entire nursing service, is the reason why we are in the dispute that we are in today. There is no recognition on the part of the government and the minister of the significance of that aspect.

What is worse, what does the future hold? You will not give us information about the tenders. You will not tell us what is happening in the tender process. Will it last a year and then will it be doled out to another company and another company and another company, and the relationship will change and change and change, Mr. Chairperson? That does not even take into account the fact that we heard statistics from Evelyn Shapiro that the turnover rate for private companies was something in the area of 60 percent, if memory serves me correctly. All of that causes grave concerns. All of that is unrecognized by the government's policy.

So let us debate in this Chamber the government policy. Will the minister acknowledge and recognize that the privatization plan, by completely overlooking the essence of the relationship, is the reason that we are in the situation we are today? Let us not try to go off and blame every--and talk about report. Mr. Chairperson, the minister defends himself with reports that are over 10 years old. The minister talks about strikes and disputes in 1987. We are talking about a very serious situation affecting the patients and affecting Manitobans today. Will the minister not face the reality of it? We have offered solutions. I have offered the minister, I have asked the minister, why would you not today consider a year moratorium, have the matter studied, have public hearings, if your position is so, it would end the strike today. It would end the strike today. We would not have the additional expenditures. We would not have a strike situation; and, if the minister's position is so sound and the minister is so convinced of the soundness of the position, then he will be vindicated.

But the government seems totally reluctant and unable to deal, to recognize that they have a responsibility as well. They have a responsibility to those requiring home care. They have a responsibility to the home care workers. They have a responsibility for maintaining the public health and the health of Manitobans. These are our expenditures. This money is given to us by the people of Manitoba who pay their taxes for us to use it soundly and wisely, Mr. Chairperson, on their behalf. They expect some leadership, and they expect to be cared for. It is the No. 1 issue in Manitoba with respect to what citizens desire from their government. This minister and this government have a way of ending this dispute. They can put a year moratorium on it. I have given names this morning of prominent Manitobans, and they are not--some are New Democrats, some are Conservatives. I even heard the name Monique Begin raised as another possibility. So it is all political stripes.

Mr. Chairperson, the minister has the ability and the means to end the strike, if the minister would put down his defences, face the issues as they exist, the question of the privatization, the question really of the relationship between the clients and their workers and those that provide the service. It is a question of continuity of care, and it is a question of trust. The minister has the opportunity today, will he be willing to take the step and try to end this dispute?

Mr. McCrae: Mr. Chairman, will the Health critic for the New Democratic Party prevail upon his soul mates, who are at the highest levels of the union movement, to prevail upon them at least to do what the Geneva Convention calls for and that is to provide essential services to our home care clients? Will the honourable member do that? Perhaps this morning we could have a recess and he could do that, and we could get the services being provided to the people who need it.

There is all kinds of rhetoric going on here today. Let us cut to the chase. Let us deal with the issue, the issue being essential services. The honourable member wants to change government policy because of his philosophical idealistic leanings which are shared by the union. That is something that we understand, we do not agree with; but that aside, there are people who are being held hostage by the union here. Will the honourable member agree to recess this House until he can prevail upon his union boss friends to get services to those people who need them on an essential basis?

Mr. Chomiak: Mr. Chairperson, as has been the case from the very start of this issue, the minister has not heard. There are some Biblical expressions about listening and not hearing, and it aptly applies in this case to the minister.

If the minister will not listen to me, I am going to read in the record a letter from an individual who is a registered nurse who lives in Gary Filmon's riding. She wrote a letter to the Premier.

Dear Mr. Filmon, I am writing to you in your capacity as my MLA. This is regarding the recent news release announcing the government's intention to privatize home care. I am deeply concerned about this proposal on many levels, and I am writing to you to seek your intervention as my representative in the Legislative Assembly.

I am a registered nurse employed as a community health nurse by the Victorian Order of Nurses. I am writing as a concerned nurse and citizen and not as a representative of my employer. My concerns regarding this proposal are in four areas: quality of health care for my clients and my family and the citizens of Winnipeg; professional issues and standards; issues as a woman in a largely women's profession; for profit versus nonprofit agency.

Number one, quality of health care. I am very concerned about the fragmentation and inconsistency that will inevitably result from the division of the city into four quadrants with four different service providers. Manitoba is widely regarded as a model for home care delivery. I fail to understand why the core of the professional service provided by nurses is being dissembled. Our goal is to help clients remain as independently as possible in their homes.

When an organization must realize a profit, there is no doubt the goal of care will not be to foster independence. The more service provided, the more profit. Mr. McCrae has stated that home care is not an insured service. Regardless of his assurances to the contrary, I have no doubt many services now considered core services will easily become noncore in the future. I agree there are areas where home care can be more efficient. However, Mr. McCrae should be looking at changing the source of that problem, the home care bureaucracy, not the frontline nursing services provided by the VON. I believe friendship with private business is overshadowing common sense and quality care.

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Two, professional issues and standards. There are some things about a profession that are impossible to know to an outsider, but as a member of the profession one has access to, there is not another health care provider in this city who has the high standards and ethics of the organization I am associated with. In particular, I would not risk my nursing licence or my professional standards by working for We Care Health Services. Inside the nursing profession they have a very poor reputation.

Three, women's issues: Nurses have worked hard for decades to earn the respect they deserve and decent wages for a largely female profession. I went into nursing so that I could do a particular type of work. My clinical specialty is palliative care. I did not enter nursing to become rich. However, as a university-educated professional, I expect to be fairly reimbursed for the life and death decisions I must make on a daily basis. I expect to be able to help support my family, to have medical benefits and to have a pension plan. These will not be available to me if home care is privatized in the manner planned. All for-profit agencies employ their nurses on a casual basis and provide no health or pension benefits. They also pay their nurses $10 to $12 per hour, some as low as $8 per hour. I took a 4.5 percent rollback a year and a half ago. I made $38,000 last year.

Personally, I will leave nursing before working under these conditions. I believe that this would not be happening if nursing was not a primarily female profession. I had thought that as a society we had made progress in the valuing of women's professional contributions. I am saddened and angry that this work is being demeaned and devalued.

Four, for-profit versus nonprofit: As a taxpayer, I am appalled that companies are going to make a profit off illness. The largest percentage of any organization's expenses is salaries and benefits, therefore the way for profit agencies to make their profit is at the expense of their employees. The cost of home care is not going to decrease, according to Mr. McCrae. These agencies will make their profit at the expense of all the front-line workers, the professionals, paraprofessionals and nonprofessionals who provide the care to you, me and our families.

As my MLA--and this letter is directed to the Premier (Mr. Filmon)--I am requesting that you investigate this proposal for change in the delivery of home care. I welcome the opportunity to discuss my concerns with you further. I look forward to your response at your earliest convenience. Karen Fletcher, R.N., B.N. I was copied on the letter, Mr. Chairperson.

Mr. Chairperson, I acknowledge that the minister is not listening to what we have to say, but I do not understand why the minister has not listened or talked to people in the community who provide the service. The minister has said from his seat that he has listened for two and a half years.

If the minister had listened for two and a half years, he would have known and understood the significance of what this privatization plan would do to care and the continuity of care. If the minister had listened, he would have had some understanding of the relationships that have been built up. If the minister had listened, he would have understood some of these points, not made by me, and I do not know this person. He would have had some understanding of how this policy will diminish the quality of health care, how it affects professional issues and standards, how it is directly related to women's issues, and I might add at this point that the women's issues are far broader, because most of the home care support and attendants are women, and they feel, as this nurse feels, that their work is being devalued, and their future capacity to earn for their families is being devalued, and the very work, the most intimate work, perhaps one of the most important works and things that we do in our society, providing care for our loved ones, is being devalued by this policy.

Finally, if the minister had been listening for the past two and a half years and had talked to people, he would be cognizant of the effect of profit versus non-profit in the health care sector, Mr. Chairperson, because it really does come down to an issue that if we are in a situation where dollars are hard to come by and where budgets are being constrained, it seems ludicrous in the extreme to be providing private companies with health care dollars for profit. It is so much the antithesis of everything medicare stands for, and the minister should acknowledge that.

This whole question of providing profit in our health care system is the antithesis of what the system was to stand for, but if the ministry had been listening for two and a half years and had talked to as many individuals--I have had a home care committee, since I was a health care critic, of workers and of clients. I talk with them on a regular basis, and I knew what this was going to do. We had heard rumours a year ago about privatization, and we had heard grave concerns raised then, but they were unacknowledged by this government. Thank Heavens that we had the Treasury Board document which we were able to provide to the public which permitted at least some form of public debate.

Mr. Chairperson, whom is the minister listening to? Whom is the minister listening to with respect to this policy and the continuing dispute as it goes on?

(Mr. Chairperson in the Chair)

Mr. McCrae: Mr. Chairman, the honourable member has not been listening. We have documented all the reasons in the world for moving to address whatever shortcomings exist in our home care system, which, everyone acknowledges, is amongst the best there is.

The only weakness that I am finding in so many of these arguments is that some people take an ideological approach to this and say, you know, we would rather you left patients at risk and had potential dangerous situations than do something that might upset our union boss friends. That is where I draw the line, Mr. Chairman.

Every single time in my 10 years experience in this Chamber, every single time that the

interests of ordinary Manitobans have conflicted with the interests of the friends of the New Democrats, the union boss friends, they have always come down on the side of the union boss friends, and the rest of the population be damned. It is sickeningly consistent, and these people should be exposed for what they are.

Mr. Chairman, I am requesting now that this House recess, and that honourable members agree that this committee recess to allow the honourable member for Kildonan to prevail upon his union boss friends to agree immediately to essential services provision in home care for those people with Alzheimer's disease, those people with Parkinson's disease, those with multiple sclerosis, severe cases of arthritis, and other conditions that render an essential requirement of home care services for our clients. So I am requesting recess of this Chamber until the honourable member can make that happen.

Mr. Chomiak: I find it very, very curious that several weeks into a strike, after nine years in office, Mr. Chairperson, after knowing a strike was on the horizon for approximately three weeks, after two weeks of a dispute, the minister is now saying he wants to look for an essential services agreement.

Point of Order

Mr. McCrae: Mr. Chairman, I have asked for a recess to allow the honourable member to prevail upon the unions to get us an essential services agreement. Will the honourable member please address that? Will he agree or not?

Mr. Chairperson: Order, please. The honourable minister does not have a point of order. The honourable member for Kildonan is putting forward his views.

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Mr. Chomiak: Thanks, Mr. Chairperson. The government has been in office for eight years and was unable to negotiate, or unwilling to negotiate, an essential services agreement. They knew the strike three weeks ahead of time was coming. They did not even propose an essential services arrangement.

Mr. Chairperson, they have now been on strike since about one and a half weeks and the minister finally understands. He finally understands the significance of the kind of care that is being delivered in the community. I could cite to you a Free Press article where the head of VON said people do not understand how much care goes on in the community. Clearly, you did not understand. This government did not understand. They did not understand--

Mr. Chairperson: Order, please. Could I ask the honourable member to put his comments through the Chair. It would assist in keeping the decorum.

Mr. Chomiak: Thank you, Mr. Chairperson. The minister did not understand the significance, the volume, the quality and the type of care that is being carried on in the community. Only now that we are in the situation has this government, who is incompetent, who did not have a plan of contingency we are told, and who are fumbling the contingency plan, now find themselves in the situation they are in. I have offered to the minister a way out, and I have asked the minister if he would consider a year moratorium, and I have asked the minister--[interjection]

Mr. Chairperson, I am having a little trouble because the minister keeps--he will have his opportunity to speak, I believe.

Mr. McCrae: Will you agree to a recess?

Mr. Chairperson: Order, please. The honourable minister will have his opportunity when the honourable member has concluded his statement.

Mr. Chomiak: Mr. Chairperson, it is very, very difficult to understand why the minister is now chirping from his seat and regularly looking for some kind of a recess. The minister and his colleagues have been handling the negotiations.

I do not understand why the minister has now realized he needs an essential services agreement only this morning. Perhaps that is indicative of the problem with this government who have been in office for eight years, who knew in advance, three weeks, that they were entering a strike situation, who have been unwilling or unable to negotiate that kind of an agreement, who now find themselves in a situation where they have a very poor contingency plan to deal with the strike. I certainly admit the situation is getting difficult. We do not have to be where we are at.

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I recognize that the hospitals are in a very difficult situation. Already the flexibility in our hospital system because of cuts of the government, because of the government's slashing and cutting for the past few years, the capacity and the flexibility in the system is at a minimum. There is no more flexibility in the system. On top of that, we are now faced in the situation where the government has taken--where individuals have to be institutionalized. I recognize that it is a very difficult situation. I also recognize that the government could stop, could end the situation today. They could end the situation today if they would only be willing to put their plan under scrutiny and put it on hold. They seem unwilling and reluctant to do so.

I do not think it furthers the debate or the discussion by the government who have the responsibility, who have been elected with responsibility to care for health care, to try to blame and to try to push the issue off onto anyone that they can find in the system to take attention away from their inability to deal adequately with this situation, Mr. Chairperson. We started off this process asking specific questions on contingency and funding. The minister was unable to answer.

We have now gone back into this debate where the minister has now recognized that an essential service agreement might be useful in this kind of a situation, and the minister recognizes that it might be significant. Perhaps, the minister finally recognizes the acuity of care that is being conducted in the community now and the significant kind of care that is required.

The VON took a strike vote in March. Did the government have in place or did the government at that time try to deal with a contingency--with an essential services agreement in that? No, the government sat on their laurels. They did not know what to do. They were confused. At that time the government ought to have been considering and looking at that entire situation. What they did, like most aspects of the home care issue, the government has bumbled and fumbled the ball, and we are now facing this difficult situation which I think we ought to be able to get out of, and we can get out of it by a year moratorium and by having some individuals or group of individuals study the situation, hold public hearings, and Mr. Chairperson, the strike would end today.

I do not know what more I could say or how many more letters from home care clients or home care workers I could read into the record to try to convince the minister otherwise. I do not know how much more of this I would have to do. I do not know if there is anything I could do, but I implore the minister to consider the option that he has utilized in the past in several instances, in the Pollock matter when Judge Hughes was brought in, in the emergency doctors strike when Wally Fox-Decent was brought in and to consider that as a useful, meaningful way of getting an end to this dispute, permitting clients, permitting patients and caregivers to go back to providing the quality care that patients deserve and need, and allow us and allow the public to have an examination of the government's motivation and rationale behind their privatization scheme.

I again reiterate, Mr. Chairperson, we are charged, the minister is charged with the responsibility of looking after the welfare and health. He is the minister responsible, and that ought to come first and foremost above all of our disputes in this Chamber. There is a way out, there is a means to deal with that, that I think is honourable and would permit an end. So I implore and I again ask the minister if he would consider something along those lines.

Mr. McCrae: Mr. Chairman, everything that I have been doing has been with the focus on the client of the home care system and the health system. That is a fundamental principle underlying the policy respecting the approaches that we take as a health department and as a government in Manitoba, focus on the client. I will not let the honourable member get away from the position that he does take.

We have heard a lot of talk, but we have not heard much in the way of position except go back to the system we had in the first place. The NDP's own report, the Price Waterhouse report, is replete with shortcomings but is acknowledged to be a very good program but problems that require addressing. We have bent our efforts in the direction of addressing those things. Meanwhile he says just go back to what we had in the first place. If we try to go back to what we had in the first place, we will lose it all. That is the fiscal and economic reality of the environment in which we are all working nowadays.

The world is changing. Our friends in the New Democrat Party should start to realize that the world has changed very significantly in the 50 years or so that the New Democrats have been a political force in this country. I am asking the honourable member to agree to recess this committee while he prevails upon his union boss friends to do at least what you find in documents like the Geneva Convention, to at least do the right thing for the clients in terms of those people who require, on an essential basis, home care assistance. Why will the New Democrats not stand up for people with Parkinson's disease, people with Alzheimer's disease, people with multiple sclerosis, people with severe cases of arthritis and people who are functionally dependent for their existence on the Home Care program?

Will that honourable member agree to recess this committee until he can prevail upon his union boss friends to bring in immediately an essential services component, leaving open the opportunity for the honourable member to disagree with the policy of the government?

I never found a policy they have agreed with yet anyway. So they can disagree, but do they disagree with the whole idea of essential services being delivered to vulnerable, needy, elderly, disabled, infirm Manitobans? Why will the New Democrats not stand up for those people? Why? Will the honourable member agree to recess this committee so that he can prevail upon his union boss friends?

Mr. Chairperson: Order, please. For clarification, seeing as I am the humble servant of this committee, I would ask for the minister to clarify--is he asking for a recess at this time?

Mr. McCrae: Mr. Chairman, I have asked for a recess three times. We have not heard of a response from the member for Kildonan.

Mr. Chairperson: Is it the will of the committee to recess at this time?

An Honourable Member: No.

Mr. Chairperson: No. Denied.

Mr. Chomiak: Mr. Chairperson, I will agree to a recess if the minister will agree today to put on hold the moratorium and to appoint a commissioner body to study this issue so that we can get out of this dispute today. I would be prepared to recess if the minister will agree to do something like that. I would be prepared to recess for 10 minutes if the minister will agree that he will put a one-year moratorium on the privatization of home care.

Mr. Chairperson, the minister ought not to be playing political games in here. This is a very serious matter and a very serious dispute. Why, today, has the minister finally realized an essential services agreement is actually important in this province? Why, after eight years of government, after knowing three weeks ahead of time a strike was possible, after the VON workers, the nurses took a strike vote at the VON, does the minister finally realize that perhaps an essential services agreement--you know what that speaks of, incompetence, incompetence on the part of this government and incompetence on the part of this minister who is unable to manage the health care field.

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I am sorry to have to say that, Mr. Chairperson. It is so obvious from everything that we have seen in the last little while in the Department of Health, from the mishandling of the emergency doctor situation to the mishandling of the urban hospital situation, to the mishandling of the home care issue, so the minister ought not to come in here now and try to make some political point by suggesting or finally recognizing that an essential services agreement might be helpful in the health care field.

It was negotiated during the nurses' dispute. It was negotiated during other disputes, but we find a minister who has been in office, who has been the minister now for two and a half, three years, unable to recognize that. We have a minister that has put us in a situation where we are in a strike, who was aware for weeks that a dispute might take place, who had a strike vote with the VON that provides some of the most fundamental services.

Mr. Chairperson, I normally do not take the bait from the minister when he accuses us of going against multiple sclerosis patients and going against arthritis patients, et cetera. I just want to point out a couple of things to the minister.

I attended a support group for cancer victims the other day and spoke to them, and as far as I could ascertain, the majority if not all of those people were against the government's privatization plan. Further, I have a constituent who suffers from multiple sclerosis. My constituent, unfortunately, has had to go into the hospital. [interjection] The minister says thanks to me. My constituent has been taken from his family and does not have the opportunity, and I felt quite bad about that situation, and I phoned him. I was moved by the fact that he articulated the issues, and he recognized how difficult it was, and that he supported the situation, and he closed by saying God bless what you are doing in this thing, because it is important.

So, Mr. Chairperson, I do not normally respond to the minister's attacks. I do not think anyone in this Chamber does not care. I think we all care, and I think we all are doing our best under the circumstances. I just think the minister has himself a policy that does not fly. It has no justification, and I think the government is in a corner, and I think the government ought to recognize that and ought to consider some measures to try to get out of that situation and will permit clients, patients and workers to go back to receiving the kind of health care they need and they deserve.

I am not going to go back and forth, as the minister might choose to do all morning, and he might choose to do it for the rest of the day. I am not going to go back and forth on this debate, debating the same point over and over again. My preference is to move on to the Estimates and to deal with the line-by-line items, Mr. Chairperson.

Mr. McCrae: No.

Mr. Chomiak: The minister is saying no. If the minister wants to filibuster and be obstinate, that is fine. We are not going to--

Mr. McCrae: You have to be exposed for what you are, Dave.

Mr. Chomiak: The minister says I have to be exposed for what I am. The minister has ample opportunity during the course of these debates, but I think we are not doing the public of Manitoba a service by going back and forth on this. I have proposed options and a way out to the minister. The minister can choose or not choose to accept them, but I would hope that we can get on with dealing with what we are here to do this morning and this afternoon, and that is--[interjection] The minister says not very likely. Well, we will do our best.

I was elected to try to do the best for my constituents, Mr. Chairperson, and I will continue to try to do so in the course of these Estimates. The minister's Treasury Board submission dated September 16, 1995, that outlined a privatization plan said that in 1995-96 there would be an expenditure of $150,000 to set up the Crown corporation or the holding agency to deal with privatization, and that there would be a further expenditure of $150,000 this year and much more additional expenditures in subsequent years to fund this agency. Can the minister indicate whether or not the $150,000 in last year's Estimates was expended and whether they are going to expend the $150,000 in this year's Estimates?

Mr. McCrae: All we get from this honourable member is rhetoric, Mr. Chairman. We want action. It is an appropriate role for Her Majesty's loyal opposition to use its powers of persuasion, to use its powers working with organizations in society, and we all know of the very close association between the NDP and the union. Professor Allen Mills has referred to it as an organic fusion. I do not know how much closer you can get than that sort of thing. They are literally joined at the heart and brain.

I demand that this House recess so that the honourable member for Kildonan, the Health critic for the New Democratic Party, can use his considerable powers with respect to influencing senior members of the union for whom he and his colleagues work. His seatmate, the Leader of the Opposition (Mr. Doer), is a former president of the Manitoba Government Employees' Union. Surely, the New Democratic Party can play a useful role today for the clients of our home care system. They can disagree all they like about what they call privatization and the government's policies. They do it all the time. They think that through the use of the strike weapon, they can use that to change government policy. Rather than just looking out for the interests of workers, as unions are supposed to do, here they are wanting to set government policy. The member for Kildonan wants to be part of that. That is fine, too. I do not quarrel with any of that stuff. I do not agree with it, but they are entitled to.

But let us get a sense of priority here. Let us try and understand what is important right now, and what is important right now is not criticizing government and unions for not having put in place essential services agreements previously. Mr. Chairman, we need one. We need one now, and as the First Minister (Mr. Filmon) has pointed out, the initiatives that are underway will guarantee that no union can ever make hostages of all of the people in the home care system ever again in the future in Manitoba. They are against that. They want to have that tool to withdraw services from people. I profoundly disagree with that.

That aside, we need essential services for our clients now, and so now is the time for us to recess this House, for the member to do the honourable and the proper thing and use his considerable powers of influence with the union movement, and call them up today, now. Go and see them. Do what you have to do, and we will resume the sitting of this committee once the honourable member has achieved for us an essential services agreement.

What higher calling could there possibly be, Mr. Chairman, for a health critic in an opposition party than to assist in bringing life-giving, life-saving services to people in their homes. The honourable member is the one complaining about people being in hospitals. Well, I do not want them in hospitals. We have been forced to move people to hospitals because the union disagrees with the policies of the government. It is okay to disagree with the policies, is my point, but not at the expense of the removal of essential services. So I ask the honourable member to agree to recess this committee.

Mr. Kevin Lamoureux (Inkster): Mr. Chairperson, I want to continue on the line of Home Care, but to go back to what we ran out of time yesterday with respect to--

Mr. McCrae: We are talking about recessing this committee.

Mr. Lamoureux: The Minister of Health is talking about recessing the committee, and the Minister of Health--[interjection]

Mr. Chairperson: Order, please. All members will have the opportunity to put their comments on the record. At this time the honourable member for Inkster is putting forward his question.

Mr. Lamoureux: Mr. Chairperson, yesterday, we were talking about criteria, standards, and making sure that members of this Chamber have the ability to be able to discuss and debate, exchange thoughts and ideas about that criteria prior to the tendering process getting underway.

Again, I would ask the minister, is he prepared to provide us that information so that we can evaluate and add to that criteria?

Mr. McCrae: Mr. Chairman, I wonder if the honourable member for Inkster would agree to recess this committee, so that the member for Kildonan (Mr. Chomiak) can carry out an important public service; i.e., bringing forward some essential services for our home care clients. Would the honourable member for Inkster agree to recess this committee?

Mr. Lamoureux: Mr. Chairperson, again, in an attempt to get an answer from the minister, I will answer his question. The simple answer is no. Now will he answer my question?

Mr. McCrae: Mr. Chairman, the Liberal Party has now placed itself firmly in the pockets of the union bosses, right along with our friends in the New Democratic Party, and, you know, that is really not a very nice place for a Liberal to be.

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I will tell you, the Liberals have usually stood up for something a little more than that. We can expect this kind of behaviour from New Democrats, but I thought maybe the honourable member for Inkster had a little more to offer the people of Manitoba. We are talking about people who have Alzheimer's disease. We are talking about people who have Parkinson's disease, people who need services like daily toileting, help with their dressing, help with washing and bathing, help with feeding, people who cannot even do those things for themselves, and the honourable member for Inkster wants to turn his back on them. Mr. Chairman, I am astonished.

Mr. Lamoureux: Mr. Chairperson, a while back just prior to getting underway in terms of this session, I had a conference out in Committee Room 254. We had about 55-60 people that showed up and one of the issues under discussion was home care services. There were a number of questions that were posed and one individual strictly dealing with home care services, and the type of questions were, and these were questions that were in essence put to the Minister of Health if they had the opportunity.

One of the questions was, how have you used the principles of Total Quality Management, i.e., focus on the consumer, involvement of frontline staff to find solutions, efficiencies, in your decision to tender out home care services? What specifically are the outcomes you hope to achieve through the tender process? What criteria will be used to determine whether service provider is providing quality care? How will you define quality care, and how will it be measured? Will the lowest bidder win the tender? If not, what criteria will be used to select the successful bidder? Will the tender specify a minimum rate of pay higher than what is currently being paid for-profit organizations or agencies? What process will be in place to prevent profit agencies for overservicing?

Mr. Chairperson, these are the types of concerns which I had brought to the minister's attention yesterday during the Estimates process. We have persistently pressured the government because it is so focused on privatizing home care services and is unwilling to bend to service the needs of the clients by allowing for that one-year moratorium. We have persisted and asked the Minister of Health to provide the criteria, the standards, those core services that the Ministry of Health believes is essential prior to putting it into tender.

Why is that important? We believe ultimately that there needs to be given preferential treatment to nonprofit organizations if in fact the government is pushing for privatization. Why? Again, because we believe that for-profit organizations such as We Care, their first priority is going to be profit. As a result of that first priority we are going to see the establishment of a two-tiered system, one in which those clients who have the economic means, who are going to be able to pay for the extras, are going to get the service providers or the health care workers that are in there for a career, the long-term, the higher wage, because it is going to be the cream of the services, the extra services, that is going to bring in the extra dollars, if you like, for that company. Increase the bottom line, the bottom line being that of profit. So what you are going to have is, you are going to have for those individuals or those areas of home care services or those individuals with the economic means that are going to get a better quality service, not only for what they are paying extra for, but also for the core areas. It is those core areas which we are talking about, making sure that that core is administered in a fashion that is equitable to all citizens because we are using public dollars. The only way in which we can assure that will take place is if there are going to be standards, and that is why it is we have been calling on the government to demonstrate, to show us the standards, to show us those core services that the minister is referring to.

Mr. Chairperson, we believe a nonprofit organization such as the Victorian Order of Nurses, on the other hand, their primary objective is for the community and the client. They have demonstrated that over the past nine decades. The Minister of Health and backbenchers often talk about how wonderful the Victorian Order of Nurses is. What we are suggesting is give them the opportunity to be able to provide that service if the government is not prepared to provide that service. Do not make the mistake of changing home care services into private for-profit, because in the long term what you are going to see is the establishment of that two-tier system, and in the long run we do not believe that is in the best interests of Manitobans.

We--and I have challenged as I indicated yesterday--the Minister of Health was on CJOB where he said nothing prevents the nurses from banding together and putting forward a proposal. Again, what we would ask of the Minister of Health is to go the extra step and to provide a mechanism that will allow the nurses in particular the opportunity to participate in some form of a nonprofit group. Maybe it is through community clinics. We have Nor'West Health up in the north end. We have Mount Carmel Clinic. There are many different ways in which nonprofit organizations can participate in the process.

Mr. Chairperson, time is of the essence, and that is the reason why we believe there are so many ideas, good ideas, that there needs to be put into place a moratorium that would allow for the minister and the government to be able to get the feedback from the nonprofit community in particular, but also the clients and the home care workers and any individual Manitoban that would like to be able to express their thoughts, their ideas on the future of home care services.

We are not talking about a widget. We are not talking about a service that is through computers or any other area of service that is currently privatized. What we are talking about is home care services which is clearly identified as a part of our health care system. Time and time again we often talk about the deinstitutionalization of health care. The deinstitutionalization of health care has always meant to bring health care services more into the community. The best way we can do that is through home care services.

We have heard, during the debate of the minister's censorship motion, members stand up, talk about the free market process and so forth. Mr. Chairman, we do not oppose the free market process. The free market process can be a wonderful thing and can in fact contribute in many different ways in many different aspects of our economy. What we are talking about is a health care service, and Manitobans, Canadians as a whole feel very strongly. They ultimately feel as a part of that Canadian identity that each of every one of us--there, by the grace of God, walk I. It is not just seniors that receive home care services. Through a vehicle accident, any one of us could rely on home care services in the future. Quite frankly, if I cannot have home care services being delivered directly through the government, I would like to see nonprofit organizations delivering that service because I believe that their primary goals and objectives are entirely different, and in the long term, in my best interests as a single Manitoban or as an individual, and ultimately in the best interests of all Manitobans.

Why I bring this up again is because I want to leave a very strong message to the Minister of Health (Mr. McCrae). The Minister of Health has a responsibility, and that is to provide the criteria because through that criteria we are going to be able to find out, is the Minister of Health being fair. Is the Minister of Health giving an advantage to nonprofit groups?

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

There are many different ways. The Minister of Health does not have to say, look, we are going to give a 5 percent--or whatever to nonprofit groups. The Minister of Health can say, for example--and I will conclude on this--we are going to guarantee a minimal salary structure for home care services. That is one of the ways in which preferential treatment can be given. Is the Minister of Health prepared to share with us the criteria prior to sending out the tender?

Mr. Chomiak: Mr. Chairman, I just wonder if--the staff have been here a long time--whether we might take a five-minute break if the staff so desire. Some of us members can move about and get in and out, but it is not as easy for the staff. So if the committee agrees, perhaps we could have just five minutes to permit the staff--

The Acting Chairperson (Mr. Radcliffe): Is the committee agreed for a five-minute recess to facilitate the staff?

Mr. McCrae: Mr. Chairman, I, of course, agree that staff should be able to have the kind of breaks that they need to have. It occurs to me that there are people who require assistance to do what the staff in this room can do on their own steam, and they are not getting it. If this recess could be used for the purpose that I have asked for, I would be very happy to have a recess. I have been asking for one all morning for that purpose.

Obviously, we are going to have to get the agreement of the honourable member to have a recess for the purpose I am asking for. I agree of course that the staff should have an opportunity for a short break, but I renew my request--no, my demand, that this committee recess for whatever length of time it takes for the honourable member to prevail on his union colleagues to ensure that essential services are delivered to people who cannot go to the bathroom on their own, for example, for people who cannot feed themselves on their own, people who cannot dress themselves. Those are the people the New Democrats are turning their backs on, and the Liberals, shame on them, are saying the same thing. I think that is absolutely shocking. I did not expect that from the Liberal Party but here we have it.

I will agree to the five-minute recess for the purposes of the staff, but I will be renewing my demand for a recess so that the member for Kildonan (Mr. Chomiak) can do the right thing and actually do something positive for the people of this province.

The Acting Chairperson (Mr. Radcliffe): Upon hearing the agreement of all members of the committee, this committee shall stand recessed for five minutes.

The committee recessed at 10:43 a.m.

________

After Recess

The committee resumed at 11:01 a.m.

Mr. Chairperson: Committee, come to order.

Mr. Lamoureux: Just before the recess, I had posed the question to the minister, and I am sure he has had the opportunity to have somewhat of a debriefing in terms of the preamble leading into the question, but the question still remains in essence: Is the Minister of Health (Mr. McCrae) prepared to be able to share with us prior to going into the public tender the type of criteria standards, core services, that the government is looking at?

Mr. McCrae: I would like very much to engage in a discussion with the honourable member about standards and the tenders and how the tenders are going to be designed to ensure that we protect the integrity of our home care standards and core services and the quality and all of that. But there is a more urgent and pressing issue right now, and that is that we have clients in our home care program who are not getting services delivered by their home care attendants because they have been pulled off work by their union bosses. I would like to ask that the committee recess to give the honourable member for Kildonan (Mr. Chomiak) an opportunity to do something very important and to do the right thing for the clients of our home care system.

Mr. Chairperson: Order, please. The minister had asked the committee for that request just prior to the last recess and it was already turned down, so I do not believe--if the minister would clarify, is he asking me to make the request again?

Mr. McCrae: Mr. Chairman, precisely that. I think it is important that honourable members think about this very carefully, and I do not think there is anything wrong, Sir, with all due respect, with asking for a recess.

The honourable member for Kildonan asked for one a little while ago and everybody agreed with it, and it was simply so that staff could have a break and I appreciate that that is appropriate. I am asking for something which I think is very appropriate, too. We have some 7,200 home care clients who have been abandoned by the honourable member for Kildonan and the union, and now with the support of the Liberal Party it is time that somebody got serious about essential services in the home care program.

I suggest that somebody is the honourable member for Kildonan and that he approach his union buddies and see if we cannot get something done about that immediately, and it is for that reason I am asking for a recess.

Mr. Chairperson: Is it the will of the committee to have a recess a this time?

An Honourable Member: No.

Mr. Chairperson: No.

Mr. Lamoureux: Mr. Chairperson, the Minister of Health (Mr. McCrae) is very persistent in always wanting to have this recess for the clients of home care services, and I can appreciate the gesture. One has to question the sincerity in the sense that if the minister really wanted to overcome the strike that is currently going on, or push for an essential service agreement, there has to be some give and take from the Minister of Health.

The Minister of Health has not provided any sort of give and take--

Point of Order

Mr. McCrae: On a point of order, Mr. Chairman, the honourable member for Inkster has called my sincerity into question, and I take offence when that happens. There is not a soul here who can successfully challenge my intentions when it comes to the clients of the Home Care program. I would like the honourable member to think about what he has said very carefully when he talks about asking for something like essential services, that we are supposed to make a reasonable trade-off for such things. Well, there is always time for reason, of course, but this is a priority. We have asked from the beginning for essential services. The union has never, never provided anything except services for people who are terminally ill--

Mr. Chairperson: Order, please. I thank the honourable member, but I do not think this is a time for debate. The honourable minister was recognized on a point of order, if he could put the point of order before me at this time.

Mr. McCrae: Yes, indeed. The point of order is that the member has questioned my sincerity in terms of my representation in this place for the clients of the home care system. I resent that. Nothing I have done is inconsistent with that. It is not a matter for--I mean, it is a matter for debate if the honourable member wants to have a debate. That is fine and dandy, but do not call into question the sincere motives I have with respect to the clients of our home care system by taking the side of the union bosses, then saying that there is something wrong with my sincerity here offends me very greatly.

Mr. Chomiak: On the same point of order, I believe, if you review the record, the member for Inkster was very clear that he questioned the sincerity of the minister in proposing the recess, constantly over and over again, Mr. Chairperson. On that basis, I think, given that in fact it does not go to integrity but simply the sincerity of the minister imposing a particular action in this Chamber at this time, I think it is not a point of order.

Mr. Chairperson: I thank the honourable members for their advice. I will review the Hansard and get back to the honourable members with my decision.

The honourable member for Inkster, to continue.

Mr. Lamoureux: Mr. Chairperson, just to save you some time, if the Minister of Health takes objection to anything that I say in the sense of imputing motives or something of that nature, I will humbly withdraw that. Having said that--

Mr. Chairperson: Order, please. I would like to thank the honourable member for that. That will conclude the matter that I had taken under advisement.

* * *

Mr. Chairperson: The honourable member for Inkster, to continue.

Mr. Lamoureux: Mr. Chairperson, agreeing in principle with the need to have essential services put into place for our clients and having acknowledged that, today in the next 55 minutes what I would like to be able to do is talk about other aspects that might assist in alleviating some of the concerns that the union has. Hopefully, the minister is in a position in which he can share some of this information with us. He appeals for, in particular, the member for Kildonan (Mr. Chomiak), to be able to talk to individuals he might know. I know it would be of great benefit for me in our party if the minister would provide us with information which, who knows, ultimately might assist in some of the negotiations that are actually taking place, especially around essential services.

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The specific question to the minister is, will he share with Manitobans or this House the criteria that he has established? I do not want to presume or I should not assume that he has established the criteria. Does the minister have a draft or a completed standards criteria in place that is getting ready for the tendering process? If so, will he share it with us?

Mr. McCrae: I answered that question yesterday. I would ask this committee to recess, so that the member for Kildonan (Mr. Chomiak) can prevail upon his friends in the union movement to ensure that the clients of the Home Care program can benefit from an essential services agreement.

Mr. Lamoureux: Does the Minister of Health have the criteria today?

Mr. McCrae: I answered that question yesterday, Mr. Chairman, and I would ask that the committee recess.

Mr. Chairperson: Is it the will of the committee to recess?

Some Honourable Members: No.

Mr. Chairperson: No? The honourable member for Inkster.

Mr. Lamoureux: Yes, Mr. Chairperson, just for future reference for the Minister of Health, I am not going to agree to a recess until we get something coming from the minister that will provide hope for the clients.

The question is, does the minister have the criteria? He says he answered the question yesterday. I do not believe that he has answered the question. Is the criteria complete, and if so, will he table it?

Mr. McCrae: The documents are being prepared for the tender process.

Mr. Chairman, we have a dispute going on. We have proposals on the table. We have offered a moratorium to the union of a certain length, and that has been, I think, negotiated to some extent. There is a conciliator at work. I am not about to get out in front of a process that is underway with the union, which is a process of negotiation, so rather than discussing things here that ought to be discussed at the negotiating table, rather than discussing things here which will be part of a public tender--and they will be public documents so the member will see those documents at that time.

I cannot understand the honourable member's strange priority here. Does he not care? Am I reading this wrong? He is saying he cares about the people who rely on our home care system, and yet he will not roll up his sleeves and get into the act of trying to bring about an essential services arrangement for people who have Alzheimer's disease, people who have Parkinson's disease, people who have multiple sclerosis, people who have severe cases of arthritis and people who are functionally dependent on home care attendant services.

The member for Inkster will not stand to his feet to support an essential services arrangement. I cannot believe this. I thought that the Liberals were different from the New Democrats. Why do they not just all join together into the same party and go to the same caucus together, invite their union boss friends to join in, and the Liberals can make friends with them, because they had a terrible time when Paul Edwards was their Leader, or maybe he was not even their Leader at that time, but they had a terrible time with the whole issue of final offer selection. The Liberals embarrassed themselves all over the place. They tried to jump into bed with the union, and the NDP and the union got together and stung the Liberal Party rather badly.

Why can the Liberals not learn that you cannot get ahead in this world by jumping into bed with the union bosses? [interjection] I think you are right about that. The honourable member for Transcona (Mr. Reid) corrects me, that the Liberals stung themselves, and I think that is probably correct, but the point is, what is it about the Liberals that they think they can occupy territory which the NDP seems to have a lock on?

The NDP does not get very much support, but what support they get, they get from their union boss buddies. That you can count on. Why is it that the Liberals think they can move in on that territory? I do not think they can. Good luck. You can try anything you want. It is your own business, but really and truly, there are clients here. I think the member for Inkster (Mr. Lamoureux) sometimes forgets in his fervour to curry favour with the union bosses. I think he forgets that there are clients of the home care system. There are some union bosses out there that I get along with just fine, but they have different requirements than the clients of the home care system.

Union bosses have to have employees that they can sort of push around and tell them what to do. They have to have union dues that they can confiscate from people, so they can finance their operations and stuff like that, none of which has anything to do with the delivery of essential home care services. I cannot understand the honourable member for Inkster, and I am wondering, his colleagues in this Chamber, his Liberal colleagues, how they have arrived at this decision to take the side of the union bosses and to continue to hurt people in our home care system. Maybe they can give me some documents or something to set out the process they used to arrive at their position to turn their backs on people with Alzheimer's disease, to turn their backs on people with Parkinson's disease, to turn their backs on people who have severe cases of arthritis, to turn their backs on people who have multiple sclerosis, to turn their backs on people who are functionally dependent on home care services?

How is it that the Liberals find themselves so close to the position of the union bosses and yet they do not have the support of the union bosses yet? How is that? Or maybe they do. Maybe I am wrong about that. I remember Daryl Bean. I remember asking Sharon Carstairs to get up on her hind legs and to do something about Daryl Bean and his abusive behaviour toward women in society, especially elderly women, grandmothers. He talked of drowning them and hanging them. I could not get Sharon Carstairs to agree with me that Daryl Bean ought to be removed from office.

Is that still the position of the Liberal Party? I thought it had changed since Sharon abandoned her principles and took her place in the Senate.

An Honourable Member: There are good appointments and bad appointments.

Mr. McCrae: I know. I think it was Sharon Carstairs who said that there are good appointments and there are bad appointments. If it is Sharon Carstairs, that is a good appointment, and all the other ones might be bad; but, if it is Sharon, then that is a good one.

I cannot forget that Sharon Carstairs refused to stand up for elderly women in our society. I thought now that she was gone that the member for Inkster would have used his leadership to make a change in the Liberal Party in that regard, but it apparently has not happened because he repeatedly says no. In fact, he has told me in his last comments, so there is no point asking for that recess anymore because his answer is still going to be no.

I am still going to ask because you see hope springs eternal in the human breast, and I have hope. I am a very optimistic person. I find that people survive and thrive better if they are optimistic rather than pessimistic. Rather than nattering their negativism all the time, people should be optimistic. Not unrealistically optimistic, but optimistic. Recognize the realities and accept challenge and turn them into opportunities. That is what we want to do for our Home Care program. The honourable member for Inkster just wants to go back to the system we had in the first place, as the New Democrats want to have. Why?

An Honourable Member: When you have not got any ideas, you might as well repeat the old ones.

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Mr. McCrae: My friend and colleague for Crescentwood says, when you do not have any ideas, repeat the old ones. I have a better analogy. I may have mentioned this one before, but it is about the lawyer. [interjection] My friend for River Heights is here, so he should just sort of just plug his ears while I tell this next little story.

Mr. Mike Radcliffe (River Heights): I see, you would not want to offend my sensitivity.

Mr. McCrae: I would not want to offend the sensitivities of the legal profession. See?

Mr. Radcliffe: I see. Be careful.

Mr. McCrae: I will. My friend and colleague reminds I should be careful, and I will, but it is a lawyer joke, a lawyer story told by lawyers probably all around the world. I have told it in this place before, but I have only a minute to tell you. In the legal profession it is well known--and the member for Crescentwood (Mr. Sale) reminds me of this--if you are kind of weak on your facts, pound the law, and if you are a little weak on the law, pound the facts, and if you are weak on both, pound the desk. We have got a lot of desk pounding going on amongst some honourable members opposite, Mr. Chairman, and now we include in the ranks of the union boss supporters the Liberal Party. The Liberal Party has jumped in with the NDP. They have jumped in with both feet, and now they are in for a real ride. Let them fasten their safety belts.

Mr. Lamoureux: In the first minute of the minister's response, I believe there was an answer. The last nine minutes, I am not too sure what was there, Mr. Chairperson, but let us pick up on that first minute. The minister indicated that, yes, there is some documentation, preparation that is going currently. I am wondering if the minister is prepared to share with us some of the principles of that documentation.

Mr. McCrae: I would be pleased to do that, Mr. Chairman. You see, we have protocols and standards in our Home Care program that we consider inviolable, and this is the area where members of the New Democratic Party like to scare people. They are taking a leaf from their own book about user fees, for example. One of the standards and protocols here is that there are not user fees for those core services that are part of the program. The other thing that the NDP wants to do is cut those core services, hack and slash services for seniors and infirm and disabled people in our province. It is in their own document, so you do not have to take my word for it. That is what they want to do. That forms part of our standards and core services. You see, we want to provide the services that people need, so we think that if a client is referred to the program by a medical person, that is appropriate. That is one of the standards that are a part of the Home Care program. You must be assessed, and that is one of the principles of our Home Care program, and when the clients condition changes there should be a reassessment.

This is an area where the member for Kildonan (Mr. Chomiak) does not want that to happen. He says let us go back to the system we had in the first place, and that system we had in the first place allowed some people whose conditions improved not to have any reassessment or those persons whose conditions got worse not to have any reassessment so that they could get more services. The NDP are against that, and I am not, Mr. Chairman. I think that reassessment is an appropriate, very proper thing to do, and that is part of the deal. We want to work towards getting our services guaranteed, so that when we say that you are going to get service, you are going to get it, not like the member for Kildonan who wants to go back to the system we had in the first place where we could not guarantee services, where we just phone in to Mrs. Jones or Mrs. Smith and say, oh, sorry, your worker has called in sick today, can you manage on your own? This is the way it is, and I do not think that is good enough. To the extent that we can possibly improve on that, we should. None of that has been possible under the system we have, and we need to make further improvements.

You see, by calling attention to the shortcomings in the system my honourable friends opposite like to say, oh well, I am condemning it. Well, I am not here to condemn the system. I am here to improve it and to sustain it for the future, and that is exactly what we are about. But if we follow the NDP, and I quote, go back to the system we had in the first place, that really is not going to achieve what we need, and we are going to continue to throw large amounts of money into our Home Care program and not get any benefit from all of that cost.

The NDP platform on this issue is to bring in user fees. Well, Mr. Chairman, I disagree with that. The people in our government working on the NDP report have rejected that. We do not agree with user fees in the Home Care program, even though the NDP--and I assume the Liberals agree as well. Since they are agreeing with the unions on these issues, they must agree on this one too. Although I do not know, because the Liberals did not commission this. They were not in office, but they have not said they do not agree, so I assume they do.

We are talking here about user fees, waiting periods, I mean, having a deliberate wait for services, forcing clients to go to the private companies in the first place, forcing them to do that for a period of time before home care clicks in. This is what the NDP stands for, and I assume the Liberals as well. I do not. That is not an improvement; that is going the other direction.

I cannot for the life of me understand why New Democrats and Liberals would favour downgrading our Home Care program like that. Why do they want so much to defend potentially unsafe client situations which is brought to our attention in the NDP Price Waterhouse report? It says right here on page little v, as in victor: Potentially 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 potentially unsafe client situations.

And the honourable member for Inkster (Mr. Lamoureux) and the honourable member for Kildonan (Mr. Chomiak) want us to go back to the system we had in the first place.

The NDP report describes the system we had in the first place. I do not want to go back to that, Mr. Chairman. I want better for the clients of our home care system. In the short term and immediate term, while we have the union bosses out there, supported by the New Democrats and now the Liberals, refusing to provide services to people with Alzheimer's disease, people with Parkinson's disease, people with multiple sclerosis, people with severe cases of arthritis, people who are functionally dependent on these home care attendant services--and the Liberals and the NDP will not agree to recess this committee so that they can get in touch with the union bosses to ensure that an essential services arrangement is arrived at immediately. I say, shame on them both.

Mr. Lamoureux: Mr. Chairperson, I thank the minister for some of the information that he has put on the record. I understand that what we are looking at is services are guaranteed, reassessments when the clients' conditions increase or decrease, that there must be an assessment prior to entering into it. There must be a referral by a medical person; there will be no user fees, core services. Those are the points that I picked up on the answer.

My question now is, can the minister indicate to us, does he have any documentation on what core services are?

Mr. McCrae: Mr. Chairman, when a patient or client enters the Home Care program, they are given information about the program describing the services that the government will make available to them.

To put it very simply, the core services are those services that you need to remain safely in your home so that you do not have to be admitted to hospital or to personal care. The core services include assessment of need for care. The core services include care planning, co-ordination of service, nursing service, therapy assessment with respect to occupational or physiotherapy; health teaching; cleaning and laundry; meal preparation; personal care; respite and family relief and access to adult daycare. Those are among the core services, Mr. Chairman, and members opposite know that they exist, but they would lead the public to believe that they do not.

Those are the services that are provided, and if you do not think they are provided look in the budget for the Home Care program: $38 million in 1988; in 1995-96, $91 million--83 last year, I guess, it would be. So we are talking extremely significant increases in funding overall in this province between '89 and '95-96, 107 percent increase in spending but only a 62 percent increase in the number of units of service.

I want the members who oppose everything to explain why it is we should not want to get value for money? I would like them to explain that, because they are the ones who just said go back to what you had before. They are the ones who say go back to where you just keep throwing money into a program and not getting enough value for the money--you see, we are all elected to represent the taxpayers. The members of the Liberal Party, they do not care about that. They prove that very, very well by making demand after demand for further spending of money and never having to be accountable for it. So we know they are not responsible.

The New Democrats, well, they are the ones who got us into the mess in the first place, so New Democrats in this province tripled the debt in this province in the space of about seven years. That is astounding, and yet they still think they have the credentials actually to be in here and speak for people. Well, the fact they speak only--to the exclusion of everyone--they speak only for union bosses, it kind of exposes the New Democrats for what they really are, mouthpieces of the union movement under the guise of being elected and representing all the people of our province.

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You know, we are talking about 107 percent increase in the expenditure increases, but we are only serving 11.6 more clients. Well, that is pretty significant. But to serve 11.6 more clients we are spending 107 percent more dollars, that means those clients are getting a lot more service than they used to get, and that is appropriate in my view--[interjection] The honourable member says why. You know why? Because they need it, that is why.

So the honourable member for Kildonan really does not have much to offer until he agrees, Mr. Chairman, to recess this committee and to do the right thing for the clients of home care and intercede on their behalf with his union boss buddies. That means get us an essential services agreement right now. If the honourable member does that he will have my gratitude and he will have the gratitude of the people who benefit from the home care program. All my colleagues are already getting gratitude from people in Manitoba for fighting for what is right and for fighting for the clients' best interests.

But now, because of the way this has all gone, do you know who is going to get all the attention when he does the right thing? The member for Kildonan. Frankly, that is okay with me. I hope my colleagues on this side will agree on that point that even at this late date for the member for Kildonan to come forward and do something courageous. Goodness knows, it would take some courage for a New Democrat to actually demand something of a union boss, but it is the kind of courage that should be respected by everybody.

An Honourable Member: Actually, he should have done that before he came in here.

Mr. McCrae: Well, what is past is past. I agree that he should have done it a long time ago, but it is never too late to do the right thing, Mr. Chairman, and the honourable member for Kildonan can distinguish himself enormously by doing the right thing for the clients of home care today, now, by agreeing to recess this committee, so that we can achieve essential services for our clients.

The honourable member for Inkster (Mr. Lamoureux), I do not know. I sometimes think he does not know what he is doing. I have a lot of regard for him, because I know he wants to do the right thing, but he gets led very easily in different kinds of directions, which demonstrates--well, you judge what it demonstrates--but he kind of is led by others too much, and that is not leadership. Leadership is where you do the leading, not where you get led around by this group, that group or the other group, trying to pander to this special interest group, pander to that one, pander to the other one. I have learned one thing in politics, and I have been on both sides of this House, that pandering to special interest groups does not provide for too much political longevity.

We have seen that--[interjection] That is right. The honourable member for River Heights (Mr. Radcliffe) reminds me that somebody must have got to the member for Inkster because he is in here championing the whole idea that not-for-profit organizations ought to be given special privileges in the tendering process, which ignores altogether that they already have a special opportunity because they do not have to build profits into their bids. But he wants something more, in other words, skewer the system, gerrymander, play little games so that basically you destroy the whole concept of competition right from the start. If I am going to do that, why am I doing anything? Why do you think I have gone through all this trouble, Mr. Chairman, taken all this abuse from all the honourable members and a few others, not very many but a few others in society, union boss leader types, for example, who do not agree with me and therefore do not like me, so heap scorn on me and call me names and do other things that are not very nice? Why do you think I put up with all that if it simply--you think I like that sort of thing? No, I do not.

Mr. Chomiak: No, it is evident you do not, Jim. It is quite evident from your manner, you do not.

Mr. McCrae: Right. But leadership says--you want to show some leadership, sometimes you have to stand up for things. You cannot stand up for things if you just sort of lie down for everything. You cannot be seen to be exercising leadership when you just sort of, whatever way the wind is blowing, that is the way you are going to go today. Today I think I will see what the union bosses want me to do and I will go with them, or maybe I will listen to this other group over there, this other one over there, this other one over there, and if there is a chance to score a political Brownie point or two, maybe that is what I should do. That is not leadership, and the honourable member for Inkster has been around long enough to know that, and I think that he should take note.

Mr. Lamoureux: Mr. Chairperson, just to add on to the comments that the Minister of Health has just put on the record. It is also not leadership to make a decision without going through a process that allows for the average Manitoban and the clients of home care services to be able to participate in a system which is going to have a severe impact, not only for today but for many generations to come. Having said that, the minister again, in responding to my last question, said that core services are those services that you need in the home that will allow you to remain in the home, and that is at least somewhat of a definition. I would anticipate that the Minister of Health would even have more detailed information that maybe he might be able to share with us regarding the core services that might be able to complement that particular statement that he made.

I would also ask the minister, has the Minister of Health given any consideration in terms of putting in some sort of a minimum-wage scale in part of the criteria?

Mr. McCrae: I answered that question already, Mr. Chairman. The honourable member was talking about core services, and I told him what they are. Those are the kinds of things that the New Democrats want to begin to hack and slash. They want, I guess, to put an end to assessing care needs. They want to put an end to co-ordinating home care services, and they want to put an end to having nursing services, at least not what the government is going to pay for.

All of those core services are at risk under the New Democratic point of view and the New Democratic way of looking at things.

Point of Order

Mr. Chomiak: Mr. Chairperson, I have listened to the minister's diatribe and his putting facts on the record that are completely inaccurate. Will the minister please source specifically where the New Democratic Party has made those claims with respect to eliminating nursing services, et cetera, because I think it is not doing any good to the community to have the minister putting falsehoods on the record.

Mr. Chairperson: Order, please. The honourable member did not have a point of order. It is a dispute over the facts.

Mr. McCrae: Yes, Mr. Chairman, I agree that the member did not have a point of order, but nonetheless--

Mr. Chairperson: Order, please. The honourable member for Kildonan during his point of order used a word that has been ruled unparliamentary many times. I would ask the honourable member to retract the word “falsehood.”

Mr. Chomiak: Mr. Chairperson, I will retract the word “falsehood” and substitute false facts.

Mr. Chairperson: Order please. I did not ask for him to replace the word, just retract the word.

Mr. Chomiak: I retract the word “falsehood.”

Mr. Chairperson: I thank the honourable member.

* * *

Mr. Chairperson: The honourable minister, to continue.

Mr. McCrae: The honourable member for Kildonan has graciously complied with your ruling, Mr. Chairman, about which we are all very pleased, but in his point of order, which was not a point of order but nonetheless relevant to the issue that we are talking about, relevant but not a point of order, he talked about how--something about facts that are not correct or something along that line.

You see, I only go after the New Democrats the way I do because they start it. When I was a little boy, I never liked to start fights, but I never liked to shy away from them when they got going either because there is a sense of, I do not know what you call it, appropriateness, that you do not just allow yourself to be kicked around all the time without somehow standing up for what is right.

Well, it is the NDP that tells us that it is because of some document they brandish every day that the government wants to impose user fees, and the NDP and their union boss friends went out and told the clients of home care that they can expect to see user fees and cuts in services tomorrow. I cannot sit still for that, Mr. Chairman. You have to understand that that sort of talk is mischievous, and if that is unparliamentary, I will change it to unhelpful, if you like, but the point is, it is wrong to do that.

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That is when they get my dander up, the New Democrats, when they say things that are not true, or they encourage their union boss friends to do that. It is one thing to tell a reporter for the newspaper something that is not true. That is one thing. It is another thing to go right to the doorstep of the client of our home care system and spread this kind of misinformation.

So I am simply engaging in a little bit of the same thing that the New Democrats engage in. I am referring to a report that the New Democrats, Mr. Gary Doer and Mr. Chomiak, who was an employee at one time for the NDP, as I understand it, or for one of the ministers or something like that.

(Mr. Gerry McAlpine, Acting Chairperson, in the Chair)

He shakes his head. No? You did not work for anybody? [interjection] Who? [interjection] Okay, that would help. The member for Kildonan (Mr. Chomiak) is going to give me his résumé so I will know who it was he worked for, because he does not want to tell me right now. But he worked for the NDP anyway, which works for the unions, and it is the NDP and the unions that commissioned this Price Waterhouse report that I am looking at right now.

It is this report that--they are covering up I am sure, Mr. Chairman, because they are not telling me what they paid for the report and stuff like that, or how many Americans were involved in its production. We know there were Americans. Oh, my goodness, Jay Cowan was a former American. Oh, and he sat on the government benches opposite. Woe, this is terrible. I understand there is one or two honourable ones on the benches opposite right now that are formerly citizens of the United States. Oh is that not awful. These are my fellow Canadians we are talking about right now, and somehow the honourable member for Kildonan wants to taint his own colleagues by his continuous blasts at the Americans, their flag burning and all that stuff that goes on with the New Democrats. I think you cannot talk at cross purposes to yourself all the time. You should not do that because after a while, people stop believing anything you say.

What are we supposed to do with this NDP report that says, let us have user fees and let us cut services in the Home Care program? What are you supposed to believe? Do not stretch my credibility and I will not stretch yours. If you are stretching my credibility and the people's credibility by spreading information around that is not correct--and it does not bother me so much, except that you have upset the clients of the home care system. You have upset them, and they deserve better than what you are dishing out. They deserve a lot better. In fact, right now they deserve essential services.

So I would like to request, Mr. Chairman, that this committee recess, so that the honourable member for Kildonan (Mr. Chomiak) joined by his sidekick, the honourable member for Inkster (Mr. Lamoureux), together can go to their union boss friends and ask--not ask, demand--that essential services begin today for the clients of our home care system, that essential services begin today for people with Parkinson's disease, for people with Alzheimer's disease, people with multiple sclerosis, people who have severe cases of arthritis, people who are functionally dependent on these services, functionally dependent. Do not turn your back on those people anymore.

Let us recess this committee, send these members off to their friends to get this matter solved right now. You can come out a big winner, and I will be the first one to congratulate you, because I need that on behalf of the clients of home care. I should not have to beg people in this Chamber. Can they not see, Mr. Chairman, their duty as representatives of the people? You are not here to represent union bosses. If that is what you think you are here to do, how come you are taking your pay cheques from the people of this province? They are very different. Union bosses are not the general population. They are well-paid people who wield significant powers over other people. They are the ones who are leading decent, hardworking people to abandon their clients.

(Mr. Chairperson in the Chair)

Give those clients a break today. Let us adjourn this discussion. Let us recess this cmmittee. Get that job done. Report to us at one o'clock when we resume, and then we will get into the regular kind of examination of Estimates, and there will be all kinds of information. I can get my staff here. They are busy. I cannot get the kind of staff I need, with all due respect to Susan and Frank here, who do excellent work, but they can only spread themselves so thin, too. I would like to answer all the questions that come at me, and I need the staff resources to help me do that because the Estimates review is a detailed review of the spending of the government. But, my goodness, you take 3,000 people and you get the union bosses to abandon their clients, we have got problems. We have got work to do, and that is what my people, that is what the people in the Department of Health--God bless them; they are doing a great job--but they are working very hard.

We are getting volunteer assistance. Manitobans are responding beautifully, Mr. Chairman. Our clients are getting service, but it is not the service they are used to getting. It is not as reliable as we would like it to be. It is not something we can guarantee as well as we would like to guarantee it. I mean, we are in a strike. We have essential services being withdrawn, withheld from people who need it, people with Alzheimer's disease, people with multiple sclerosis, people with Parkinson's disease, people with severe cases of arthritis, people who are functionally dependent on these services. These two honourable members can change that. The member for Kildonan (Mr. Chomiak) and the member for Inkster (Mr. Lamoureux), they can make a real contribution to their fellow Manitobans simply by agreeing to recess this committee so that they can go and demand that the union bosses relent and provide services to these very, very vulnerable people. So I repeat my request that this committee recess.

Mr. Lamoureux: Mr. Chairperson, the Minister of Health has the power to be able to resolve this particular issue on behalf of the clients. He knows what is being asked of him, and, you know, one might wonder in terms of has the Minister of Health taken an opportunity to sit down with Peter Olfert, appeal to him to come to his office to see if in fact if between the two of them they can see if there is a compromise or a consensus that is there. If the minister was quite serious in wanting to be able to sit down with individuals like Peter Olfert and go to the table with the idea of being able to compromise for the sake of the clients, I think then that the Minister of Health would be doing all Manitobans a decent job, at least in attempting to resolve the strike, let alone the essential services and the need for the essential services.

I asked the minister, my question actually was prior to him standing up and giving that response, was the Minister of Health prepared to look at some sort of a wage scale as a part of the criteria? He listed off some of the standards and criteria that he was looking at. My question to the Minister of Health is, is the minister indicating that he is not prepared to look at a wage scale or salaries in the health care Estimates?

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Mr. Chairperson: Order, please. Could I ask the honourable member to turn off the device that he has in the Chamber? Thank you.

Mr. McCrae: The honourable member is not putting this question on behalf of the clients, obviously. So I am having a little trouble with it. Again, he has allowed himself to be lulled into this business of being led around by the nose by the union bosses, and it is showing in some--if I were the member I would be mightily embarrassed.

Mr. Lamoureux: Mr. Chairperson, unfortunately, I had to go all the way and get the telephone, and so I was not able to actually pose the question in the fashion in which I would have liked to have posed it. So let me rephrase the question for the Minister of Health. There is in fact a need to be able to address the whole issue of what sort of standards are going to be put into place to ensure that there is going to be quality care. One of the ways in which you can ensure quality care is by those individuals that are providing that care, and one of the ways in which you can ensure that quality is through the pay structure in which you pay employees, whether you are in the private sector, public, private for profit or private not for profit.

One of the questions that was actually again from that committee meeting that I had hosted in terms of trying to get feedback was from one individual who stated where does the minister expect to find the nurses to provide the community needs? Does he believe all the health care workers will jump to the new job demands in the private sector? Does the Minister of Health believe that the hundreds of home care service workers today are not worth the dollars that they are currently being paid? What gesture, sincere gesture is the Minister of Health prepared to incorporate into a tendering process to ensure that there is going to be a decent wage given to those individuals providing a very important quality service to Manitobans, keeping in mind, Mr. Chairperson, that if there is no attempt to address this particular issue, what you will see is a lot of individuals that will be constantly entering into the home care services as a minimum wage type of job, providing a service that will see a lot of transients, individuals just entering to fill in for a short amount of time and then going back out.

That is not in essence in the best interest of the client, I would argue, and that is one of the reasons why we feel that there is a need for the government to come out and say, look, as part of the criteria this is going to be the expectation in terms of how much a home care service worker should be receiving. If you incorporate that into the criteria, what will happen is you will allow for organizations such as the Victorian Order of Nurses the ability to be able to compete that much better. If you do not incorporate that in, then you are allowing organizations such as We Care and others that might be in a better position to employ individuals at a minimum wage some form of preferential treatment. In other words, indirectly you could be providing for preferential treatment if you do not incorporate some sort of a wage scale structure.

Mr. McCrae: Mr. Chairman, the honourable member is being pretty insulting to people. I do not know if he knows he is being insulting to people, but he is.

If you take a nurse who trains for his or her profession, they are required to meet the standards and the rules set down by their professional organization. The honourable member is now saying that these dedicated people will provide less service or fail to meet the standards of their profession if you do not pay them X number of dollars, which in my view is nonsense.

I would ask honourable members to agree to recess this committee.

Mr. Lamoureux: Mr. Chairperson, it is absolutely amazing how the minister time and time again will stand up and ask for us to recess. Is it for the purpose that ultimately he can go to the public and indicate that he tried to get opposition members to agree, to score some political points? I do not understand why it is the minister does not want to accept responsibilities, answer questions that are being posed to him. If he wanted the essential services put into place, he has the means in which he can actually get that accomplished. He is not going to sacrifice the principles of the Tory agenda. He might have to put it off or put it off in such a fashion that will allow for a genuine input into the decision-making process.

What I do not understand is why it is that the Minister of Health is not taking advantage of the position that he has and taking direct action on behalf of the home care clients, and he does have the capacity to end, if not end, to put into place essential services. All the minister has to be able to do is sit down with the so-called union individuals, with the home care workers and ultimately with the clients, Mr. Chairperson, and be prepared to compromise. Is the Minister of Health going to say that under no circumstances, even on behalf of the clients of Manitoba, is he prepared to compromise today in order to get that essential service in?

Mr. McCrae: We have put compromises forward, Mr. Chairman. They have all been rejected out of hand. They only looked at them for an hour or something like that or less and rejected everything. Their minds were made up. Does the honourable member for Inkster not understand that? The union bosses had their minds made up. They wanted a strike because they had other things on their minds, too. They wanted a strike. If it were otherwise they would have at least looked at what the government was going to offer, but they went and got a strike vote before anything even happened and out they went. They had their deadline set. All of that was a done deal. Is the honourable member for Inkster so naive that he does not know that, that he cannot see what has been happening in this province? The NDP and the union bosses are trying to sort of make hostages of the clients of our Home Care program. Does the member not see that?

Point of Order

Mr. Chomiak: On a point of order, Mr. Chairperson, I think it is totally inappropriate for the Minister of Health, a member of the Crown, to say not only that the union but the NDP are trying to make hostages of clients in the home care system. I think that is unbecoming and inappropriate for a minister to indicate. In fact, that is a criminal offence, and the minister is making allegations of those kinds in this House, I think it is totally inappropriate and only serves to diminish the capacity of this minister to serve in that function.

Mr. McCrae: On the same point, the honourable member for Kildonan knows that I would not attribute criminal--

Mr. Chomiak: Why did you say it?

Mr. McCrae: I am making it clear right now, Mr. Chairman, I attribute no criminal imputation here and the member knows that.

He is very, very sensitive; he is totally despondent. There was a vote held the other day. I asked an expert in this field, when is the last time a union put a strike vote and lost it to such an extent, and this expert was unable to say except that it must have been a very long time ago. They totally misread what the people of this province--

Mr. Chairperson: Order, please. The honourable member for Kildonan did not have a point of order, but I would ask all honourable members to choose their words carefully. It will aid in the decorum of this House, and I think if we carry on in that fashion, we will go as we have in the past three or four days and we will get along real well.

* * *

Mr. Chairperson: The hour being twelve o'clock, this committee will recess until 1 p.m.

The committee recessed at 12 p.m.

________

After Recess

The committee resumed at 1 p.m.

Mr. Chairperson: The Committe of Supply, please come to order. This section of the Committee of Supply is dealing with the Estimates of the Department of Health. Would the minister's staff please enter the Chamber at this time. We are at Resolution 21.1, item 1.(b)(1).

Mr. Tim Sale (Crescentwood): I wonder, Mr. Chairperson, if we might have leave to ask questions from the front bench for the duration of this session of the Estimates.

Mr. Chairperson: Would the second critic for the official opposition have leave to ask his questions from the front row for the remainder of the Estimates of the Department of Health?

Some Honourable Members: Leave.

Mr. Chairperson: Leave has been granted.

Mr. Sale: Thank you very much, Mr. Minister, member for Inkster, I appreciate it.

I would like to move to the question of the urban advisory group and start by referring the minister and staff to page 28 of the Quality Health for Manitobans: The Action Plan document tabled in May of 1992, by the previous Minister of Health, the Honourable Donald Orchard.

From the time that this document was issued, I have been struck by what I think, to put it charitably, was a very unhelpful graphic on page 28 at the top, and I want to ask the honourable minister and his staff if they might respond to this perception, at least on my part, that this is a very unhelpful graphic.

The assumption that Manitobans and the Legislature were invited to believe were that costs per day in community hospitals, such as Grace or Deer Lodge geriatric centre or the municipal centre, were in the order of $400 a day or $200, $234 a day in the case of Deer Lodge, instead of $775 per day at Health Sciences.

The minister of the day indicated that as beds closed in Health Sciences that beds would be opened in other centres, and the implication was that there would be substantial savings because people were invited to do the arithmetic and to multiply the difference in the costs which amounted to, in the case of the first example, Health Sciences and St. Boniface to Grace, of about $365 per day implied savings. I wonder if the minister could comment on the usefulness of the diagram and the assumptions that are contained in it.

Mr. McCrae: The question raised by the honourable member about costs in the various acute care settings and the potential savings by closures and reductions all hinges on our ability, for example, in our home care program to be able to respond to the requirements of earlier discharges and less reliance on acute care. We cannot very well even have a Home Care program if the union is going to take the employees and invite them to abandon the clients. So it all comes back to home care every time, and for that reason, if we are going to have a labour disruption in this crucial area of health care, we at least need to have essential services. So I would request the member for Crescentwood (Mr. Sale) and the member for Inkster (Mr. Lamoureux) to agree that this committee recess, and the honourable member for Crescentwood could join his colleague, the member for Kildonan and go and see their union boss friends and arrange for some essential services to be made available immediately.

Mr. Sale: Mr. Chairperson, it is difficult to penetrate that answer and find any logic or any connection to my question, but let me try another way. Could the minister tell the committee how many beds have been closed at Health Sciences Centre between 1992 and the present time? How many rated beds have been closed at that particular facility in the approximate four year period?

Mr. McCrae: Mr. Chairman, whatever number of beds have been closed at Health Sciences Centre has been made possible by the fact that we have a Home Care program, but right now our Home Care program is under vicious attack by the NDP and their union boss friends, and while that vicious attack continues we have people who require essential services. Now, the Minister of Labour (Mr. Toews) pointed out yesterday that even arrangements that deal with international warfare provide for certain minimum levels of services, and you would think the NDP and their union boss friends would at least have enough compassion in their hearts to deal with this in a sensible way. There are people who have multiple sclerosis who are clients of ours, people who have Alzheimer's disease, Parkinson's disease, severe arthritis and other debilitating conditions that make them functionally dependent on home care services.

I ask honourable members to agree that we recess this committee so that members opposite who have such significant influence with their union boss friends--or maybe it is the other way around, maybe the union boss friends have all the significant influence on them. Maybe it is time to reverse that and do something that is right for the clients of home care. So I would ask that the member for Crescentwood agree that we recess this committee so that he and his colleagues can work with their union boss friends to bring about the immediate restoration of essential services.

Mr. Chairperson: Is there leave to recess at this time?

An Honourable Member: No.

Mr. Sale: Mr. Chairperson, I would appeal to the minister to think about how foolish he appears on the record of Hansard with his accusations in regard to bombs and shopping carts and groceries which were certainly the subject of CBC's morning program today in which the minister appeared very foolish when he continues to use the mantra that he uses of union boss friends and other mantras that have become part of his lexicon in the last 10 days. Readers of the record are going to wonder just what possessed this minister to continue to make such foolish responses to questions which are attempting to get at some fundamental issues of health planning in this province. The minister can, of course, under our rules, not answer the question, but I would respectfully ask the Chairperson to call the minister to order when he continuously provides specious and irrelevant answers. He is quite free not to answer, but I do not believe that under our rules he is continuously free to wander off into, as I say, specious allegations and the repeating of mantras which are in no way, shape or form connected to the question being asked.

* (1310)

I would like to ask one more time, would the minister confirm then that in the report prepared by his own policy institute, the indication was that somewhere in excess of 300 beds have been closed in the four years from 1992 to l996 at Health Sciences Centre in Winnipeg?

Mr. Chairperson: Order, please. Within the honourable member for Crescentwood's question, he had asked if the Chairperson could intervene when the minister is not being relevant. The member for Crescentwood is quite correct that the relevancy of the answers is part of the rules, but under this section which we are in at this time, which is 1.(b)(1), it is also very open for the minister or the critic to flow just about anywhere within the department as long as we are dealing with administrative or issues relevant to that line.

It is very awkward for the Chair to intervene until it disrupts the House. If there is disruption, I will intervene at that time because we do attempt to keep the decorum at a certain level, but I would like you to understand that there is a bit of an awkward situation for the Chair at this point. I would ask the co-operation of all honourable members in the Chamber to aid the Chair in maintaining the decorum, and we will carry on at the point.

Mr. McCrae: The honourable member referred to that publicly owned broadcaster, Canadian Broadcasting Corporation, and the reference made to myself on one of its programs. I have received a disturbing allegation respecting the activities of, I believe it was, the Canadian Broadcasting Corporation, but it was recently planned, an interview with one of the clients of home care on television, and the allegation is that the union asked this client if it would not be too much trouble if she would not mind crying for the camera.

This is the kind of thing that we are working with, that the member for Crescentwood seems to want to support when he says no to a recess for this committee so that we can put an end to this nonsense. He says no to people who have Parkinson's disease; he turns his back on people who have Alzheimer's disease. He more or less is saying to people with multiple sclerosis that they can go and eat cake or those with severe cases of arthritis, people whose bodies are such that they cannot even go to the bathroom without help; they cannot feed themselves. They cannot bathe themselves, dress themselves or move from their bed to their chair without help, and this honourable member sits there, Mr. Chairman and tells me how foolish I am for standing up for those people. I do not accept that. He does not embarrass me a little bit when he calls attention to some of the things that I have said about him and his union boss friends and the things that they have allowed to go on without any condemnation whatsoever, without any denial, even, of the involvement of New Democrats in regard to those activities. It is not me. I raise the activities; it is up to them to condemn them. I remember when I was Attorney General sitting over there and complaining bitterly about Daryl Bean, the president of the Canadian public service. I think it is the Public Service Alliance or some such union like that.

He wrote a letter to a couple of grandmothers who wanted to go to work during a strike. He wrote a letter to them saying that people like them should be either hanged or drowned. This is the kind of activity that New Democrats sit here and stand here in this place all the time and defend. I simply want the people of Manitoba to see these people exposed for what they really are. They go out into the public, they put their name on the ballot, and they say, vote for me because I stand for everybody. There is no evidence of that here.

Everybody includes people who have Parkinson's disease; everybody includes people who have multiple sclerosis, people who have Alzheimer's disease and severe and debilitating cases of arthritis and other conditions that render them functionally dependent on home care services. The members opposite support abandoning. I really think that that is what needs to be made known, that this is where these people stand. I think this is the appropriate place to do it; this is our Legislature.

Here we are discussing a program and something even more urgent than that, a withdrawal of services, a virtual abandonment by the union and the NDP of the clients of the home care system. They want to shut me up; they want to tell me what I should say. I mean, they do that to their membership. The unions use threats and intimidation to make people conform to their way of doing business, which means to turn your back on people with Alzheimer's disease, Parkinson's disease, multiple sclerosis, severe cases of arthritis and other debilitating conditions that render people functionally dependent on home care services.

That is what they do around here every day under the guise of caring about some group in society or some other group in society. Well, you do not care for these functionally dependent people by turning your back on them and abandoning them. That is why I ask again: Will honourable members agree that this committee should be recessed so that New Democratic members, who enjoy a organic fusion type relationship with the unions, will have an opportunity to demand of those union bosses that a stop be put to this nonsense and that the essential services be provided to those people who need them?

Mr. Sale: Approximately 340 beds or so have been closed at Health Sciences Centre over the period of time that is in question. The diagram to which I have referred, and attempted to have the minister refer, on page 28 of his Action Plan, indicated that the cost of those beds was $775 per day. The implication of the arithmetic is that we would be saving in excess of $240,000 per day as a result of the closure of those 300 beds. That is certainly the implication that Manitobans were invited to believe; $775 times 300 beds, you round it off a little bit, and you will find that it is close to $240,000 a day.

Now, that is a lot of money, and when you take it over a year, it is a heck of a lot of money. The implication is that we would have saved well in excess of $100 million a year by that expedient of closing that number of beds. I am sure that the deputy minister and the staff from the administration department know and can tell the minister that the problem with this diagram is that it uses the concept of average costs. As the deputy minister will, I am sure, tell the minister, there is no such thing as an average bed in a hospital. Many of the beds which were closed actually cost in the order or $250 to $300 a day in real terms and perhaps less. When you do not make a distinction between average costs and marginal costs in any system, you certainly invite the public, who are not particularly trained in that kind of thinking, to believe things which are simply not the case.

Most simply, the average member of the public understands that when one child leaves a classroom, the school division is not saving the average cost of a pupil in the school division of $5,000 or $6,000 per year, nor, when one child more enters into a classroom, are we going to spend the average cost of a child in a school division of $5,000 or $6,000 more. In fact, costs in any institution do not vary directly with the population it serves, but they vary in a jagged and step-wise fashion, in increments, in effect so that, to use the analogy of schools again, when you can lay off a teacher because you do not have any more need for that number of students in a classroom--they have disappeared, 20 or 25 of them, however many-- then there is a substantial saving, but, until you can reduce the cost drivers in a system, the actual volumes do not make a terrible amount of difference. They simply drive the average cost up or down slightly, but they do not make a lot of difference to the overall expenditures.

* (1320)

So really what the minister should have said when he issued this book was that we are going to have to do some very careful work to discern the difference between marginal costs and average costs and find out what we really would save if we closed 100 beds or 200 beds or 300 beds. Similarly, when we open beds, we are going to have to do the same kind of work to point out the difference between average and marginal costs and make sure we are not fooling ourselves. Mr. Chairperson, this government, I think, fooled itself and in the process misled Manitobans into thinking that if we could only close some reasonably large number of beds in our acute care system, we would have amazing savings because, as the minister points out, home care at a much cheaper cost can replace unnecessary acute care, and community-based hospitals are cheaper. The problem is that they either mistook for themselves, or at least they invited the public to mistake, average costs for marginal costs.

Would the minister confirm that in the years since the issuing of this report, the actual base budget of Health Sciences Centre has only varied by a very small amount of money and that the implied savings in the closure of such a large number of beds have never materialized in spite of Connie Curran's report? There have been improvements in productivity which are to be welcomed, but the magnitude of savings implied by this document have never, ever been even approached, let alone achieved.

Mr. McCrae: Mr. Chairman, I am sure these are items that can and should be discussed during the Estimates process, but I think we should all try to understand what our priorities should be. Maybe the member opposite disagrees about priorities, but priorities to me are people who need essential services right now in the Home Care program. If we can get that matter resolved, then it would be so much easier to get on with some other things that are of interest to the honourable member.

It is very nice that he is interested in all these numbers and everything, and I am, too, but there is a more compelling matter on my mind. I am trying to encourage the honourable member to place some priority on the clients of home care. In furtherance of that, I would ask that he agree to recess this committee until he and his friends can get together with their friends in the union movement and put a stop to the foolishness and bring about on an immediate basis some essential services for the clients of the home care system.

Mr. Chairperson: With all due respect to the minister, I have put the question of whether we should recess a number of times, and it has been rejected. The honourable member for Crescentwood is dealing with the matter which falls under the jurisdiction of 1.(b)(1) at this time, so he is being relevant.

Mr. Sale: Let me just say, without wanting to move to the minister's agenda of home care at this point, that I have great confidence in the collective bargaining process, and I am sure that if the government is prepared to be flexible, that the home care workers certainly are not asking much.

The government has indicated that it does not think it is going to save any money through its process of privatization, at least that is one of the stories that it gives, and so the process of appropriate public hearings shared by someone whom the minister trusts, for instance, Noralou Roos or Brian Postl, both of whom have done many reports for this government, that that would be a useful process and might allay the fears of the clients of the home care system and the public about the process of privatization.

I understand the minister's anxiety when he is facing a situation where no one agrees with him or his government, where the clients are not supportive of his approach, where organization after organization flays the government, where its own best experts tell it it has not got a shred of dignity, intellectual or otherwise, to stand on in this whole process. It is very embarrassing and I sympathize with the minister to be in such a situation, but it is entirely of his own making, him and his Premier (Mr. Filmon) who have caused this strike by refusing to be up front about the process and by basically threatening workers with not just their incomes but their jobs.

I am sympathetic to the patients and to the clients of the home care system, but I have to tell the minister that overwhelmingly the clients support the workers not the government, and that also must be very difficult for the minister.

Now, Mr. Chairperson, I want to go back to the question of this urban hospitals cost issue. The minister has indicated the intention to close two hospitals as acute care hospitals; convert one to a geriatric centre and convert the other to a walk-in clinic. He made that announcement, indicated that policy direction, and to, I think, his embarrassment and the embarrassment of his colleagues, again, he did not have a shred of evidence to support this from a policy perspective or from a financial perspective.

He attempted to use some ratios from Calgary as justification for cutting the number of acute care beds further in Winnipeg, having already reduced them substantially and in a number of occasions from December onwards indicated that costing studies were underway. Informal contacts with those involved in the costing process have indicated to the public, to us, to the press, that the anticipated savings are simply not there and that we are perhaps looking at saving $5 million to $7 million out of $97 million and that even that number does not take into account all of the adjustments that have to be made in the current system before the closures could take place. Could the minister tell the committee when he expects to have a final and public, or at least a public report, interim or final, from the committee undertaking the costing that is under the immediate direction, I believe, of Dr. Brock Wright? Could he indicate when that costing will be made public so that members of the public might understand better the rationale for closing these two valuable facilities?

Mr. McCrae: I am sure the question the honourable member is addressing here is very, very important, but I cannot think of anything more pressing, urgent and requiring more immediate prioritization than the plight of the clients of the home care system who have been denied services with the active support of the New Democratic Party along with the unions. So I would ask that this House be recessed so that that matter--

Point of Order

Mr. Sale: Mr. Chairperson, I am sure you have in front of you the appropriate citation from our rules. With great respect, you indicated earlier that during the process of Estimates, particularly this section of Estimates, committee has a history of being able to move across a department. I believe though that if you will review carefully, the intention of that section is to enable questions to be addressed which address a broad range of issues.

With great respect, the questions which I have asked this afternoon address acute care hospitals, planning and financing. The minister has persisted in asking for a recess which he knows will be denied and which the Chair has asked him not to request, and he has persisted in answering with remarks that bear no relationship to the question at hand, so I believe that the purpose of our rules is being violated by the minister's behaviour. I would ask that you consider calling the minister to order and, if he does not come to order, consider naming him, Mr. Chairman.

Mr. McCrae: Mr. Chairman, the point of order raised by the honourable member for Crescentwood demonstrates a clear lack of priority recognition when it comes to the health of our fellow Manitobans. He wants to talk about anything but home care today, anything but the clients of home care. He wants to talk about anything but the plight that he and his friends in the union movement have put our clients into, and I believe that we need his help. Having done so much to put them in the position they are in, we now need the help of the New Democrats to help get the clients out of this problem that he and his--

An Honourable Member: You have a clear way to climb down from your embarrassing position; all you have to do is take it.

Mr. McCrae: Mr. Chairman, I was attempting to address the--

Mr. Chairperson: Order, please. If the minister could wrap up on the information on the point of order at this time.

Mr. McCrae: Yes, Sir. In short, the honourable member does not have a point of order.

Mr. Chairperson: The member for Crescentwood brings forward an area that I have some concerns with, but I will take the matter under advisement and come back to the Chamber with my ruling on this. But I ask all honourable members at this time, relevancy is not the only thing in question; repetition also comes into question at this time. To assist the Chamber--and that is what I am here as, just to assist you in seeing that this committee runs in an orderly fashion--I would ask all honourable members to help me in maintaining the decorum--and we have been doing a fine job of that over the past while--but also in trying not to direct imputations towards each other or towards where we are headed here today.

I will take it under advisement and return to the House.

* * *

Mr. McCrae: Mr. Chairman, I recognize the delicate and difficult position all of this puts you in as we attempt to focus some attention on the issues that we believe to be important in this wide-ranging aspect of the review of the Estimates.

To the honourable member, it is some analysis of what it costs to run a hospital bed or some such thing. To me it is to get service to people who need it, and I guess we are in a little bit of a competition to see whose agenda item or issue should be given the most priority. Certainly today on April 26 I think it is, 1996, I cannot think of anything more important than restoring for our clients services that they need and through no fault of their own whatsoever have been removed from them.

I did not remove those services, the NDP and their union boss friends did, and how did they do it? They did it by misleading people. They did it by telling people that they were going to face user fees, something the NDP themselves were putting--

Mr. Chairperson: Order, please.

Point of Order

Mr. Sale: Mr. Chairperson, you just said no more than three minutes ago that repetition was an issue. This must be the seventh or eighth time this afternoon that we have heard the same mantra. I would ask you to call the minister to order.

Mr. Chairperson: Order, please. On the member's point of order, he is quite correct. I did ask for the issue of relevance and repetition to be looked upon by the honourable members, but at this time I am holding back on that other ruling which I have taken under advisement.

What I am asking for is the assistance of the members this afternoon to attempt to abide by those rules as we see them before us today. This is a very difficult situation you have put me in from both sides of the House. That is why I am asking for your consideration on this matter. I need your co-operation if we are going to have the matter resolved, and I will attempt to bring back a resolution to this problem, but I will not be able to do it today. I understand the member's concerns, and I understand the pressure we are under within this committee today, but I would just like to further study the matter before I make any recommendations on my ruling.

* * *

Mr. Chairperson: The honourable minister to conclude, with one minute remaining.

Mr. McCrae: I am not trying to make life difficult for you, Mr. Chairman, by making reference to the Home Care program and the clients thereof. I will try to stay within the rules to the extent that I can, but you see, I guess I would maybe ask the members to waive the rules if we get so close to breaching them that we need to do that in order to bring to the public's attention the requirement for us to get the NDP to see the light, to come to their senses, and do the right thing for our clients.

I will try not to break any rules, and I will try to be relevant, but it is something that will require all my strength and all my effort and, frankly, all my understanding of the rules of this House to use those rules for the maximum benefit of the people of this province, and not to make life difficult for you, Sir. Life is difficult enough having to sit between the opposing sides in this Chamber.

You cannot talk about a hospital without talking about home care. In that sense, every time a hospital comes up in discussion, the whole issue of home care comes up. Do you want to talk about doctors? It is home care. You want to talk about nurses? It is home care, because we are trying to build a continuum of health services here in this province, and you cannot think of health care in Manitoba without thinking about home care.

It seems to me that while we are at it, the honourable member wants to talk about beds; he is a bed counter, I guess. The age of bed counting in measuring the quality of your health system is over. Surely the honourable member who has called himself a health consultant--he passes himself off as a health consultant--should understand that we are talking about what goes on within these buildings, not just counting beds. If we are just counting beds, I can do that. How many beds are there in a dozen Toronto hospitals? We know that there are 10,000 beds that Michael Decter and Bob Rae--you know, Michael Decter, do you not? I think the member for Crescentwood--

Mr. Chairperson: Order, please. The honourable minister's time has expired on that one.

* (1340)

Mr. Sale: Mr. Chairperson, I appreciate the difficulty of the situation that you are in. Something in the order of 60,000 Manitobans have signed petitions asking that Seven Oaks and Misericordia Hospitals remain open. Approximately 100,000 families are served by the family physicians and specialists who use those hospitals. They number about 125 family practitioners who have admitting privileges to those hospitals.

Would the minister confirm that the proposed closure was done without any plan for dealing with the admitting privileges of those physicians, and that the Manitoba Medical Association has accordingly written to the minister very strong letters suggesting that they best take into account the admitting privileges question and the capacity of the remaining system to meet the needs of the 100,000 Manitobans who are patients of doctors who have privileges in the two hospitals in question? Will he confirm that he has correspondence to that effect from the Manitoba Medical Association?

Mr. McCrae: No. Yes.

Mr. Sale: I appreciate the minister's answer. Mr. Chairperson, I asked earlier and I do not think it is repetitious of me to ask again because the minister did not respond. I asked him if he could indicate the date by which there would be a public release of the costing estimates that are being developed under the direction of Brock Wright, I believe, and others in his department and in his working group in regard to the closure of Seven Oaks and Misericordia hospitals.

Mr. McCrae: I hope I understand the honourable member's question, but I have to put it in the context of something he was saying awhile ago that these various proposals represent government policy. Well, they do not and so, therefore, I do not know how to answer any questions that flow from that. The direct implication of what the--

Mr. Sale: With respect, I could not hear the minister's response, and I wonder if he might be so kind as to repeat what he said. I was not hearing his words.

Mr. McCrae: Earlier on the honourable member was sort of passing off as government policy recommendations made by the design teams and they are not government policy, so that questions that flow therefrom have to be taken in that context. The member was not leaving the record in the correct form when he left the impression that the policy of the government was to shut down these hospitals and stuff.

The shutting down of hospitals is what happens in Saskatchewan, NDP Saskatchewan. The shutting down of hospitals is what happens as a result of NDP Ontario. The shutting down of 10,000 hospital beds is something that Bob Rae and Michael Decter, with whom the honourable member used to work, are directly responsible. Michael Harris has to clean up one heck of a mess left by the New Democrats under Bob Rae, but it was not Mike Harris who shut down 10,000 acute care hospital beds. It was the dear friend of the honourable member for Crescentwood, Mr. Bob Rae, and Mr. Michael Decter, who is a dear friend of the honourable member, I think a former workmate and brother to my opponent, my NDP opponent in the last election. The 52 hospital beds shut down in Saskatchewan, you know, that is what happens there when you are counting beds, there are 52 hospitals there in rural Saskatchewan shut down by the NDP.

You do not have to look very far to know what the NDP policy is. You can look at the Price Waterhouse report and recognize that NDP policy is user fees and cuts in home care. You know that it is massive bed cuts in the hospitals. It is a good thing we take a more evolutionary approach here. They were beginning their approach to hospital reform or whatever you want to call it back in 1987, and just for a little testing ground they have decided to use my community of Brandon as their little guinea pig and decided to begin hacking and slashing hospital beds at Brandon General Hospital.

I do not need to take too many lectures from honourable members opposite, but on the other hand, it is not just the NDP that have these issues to address. Whether it be in Ontario or Saskatchewan or B.C. where they are shutting down home tertiary care centres and stuff like that, there are problems going on in Alberta where there is a Conservative government. I guess it is a PQ government in Quebec where they are closing down seven hospitals in Montreal; the Liberal government in Halifax where they are making one hospital out of five.

And here we have our New Democratic friends here in Manitoba who seem to, by implication, have you believe, Sir, that, oh, those are things that go on everywhere else but do not go on here. Well, frankly, they have not gone on in that way here, but we cannot ignore the fact that we have over capacity in our acute care sector. Members opposite agree with that but it depends, they will agree today and not agree tomorrow depending on which way the wind is blowing.

I just do not want the member to think that recommendations by the design teams passed on to the urban planning partnership have become government policy, that is all. They want me to accept their protestations that what is in the Price Waterhouse report calling for the cuts in the user fees is not NDP policy. Somehow someone makes a recommendation now in the '90s, and it is all of a sudden PC government policy. The fact is, as I have said many times here and publicly and privately and everywhere else anybody would listen, that the design teams were there as a group of professionals with a particular expertise in the various medical disciplines and stuff to make recommendations, which they did. It must have really got some people going because they actually made recommendations to do something rather than go back to the way things used to be like it is official NDP policy.

Rather than go back to the way things used to be, which is a sure prescription for the death of health care, which is the NDP prescription, we are listening to what the professionals have to say, and yes, there has been criticism that there were too many academics, and yes, not enough from my hospital and too many from the other guy's hospital, I believe in reform unless it is to reform somebody or to reform something, I believe in it, but by golly, do not reform anything because that would be reform which I believe in, which I cannot let you do. This is more or less the circumloquatious argument that we get from honourable members opposite.

It is all a game to the New Democrats. They have been out of government for so long, they are so badly out of touch that they have decided to have a little fun out of it while they are at it. They are getting paid to be here anyway, they might as well say something, but do not say anything that makes any sense, because somebody will pin you with it. They will pin you down and make you explain and make you stand up for what you believe in. That is what they will do to you. If you actually say something, that would be just far too courageous for New Democrats to do, so they do not. They take the easy way out all the time, which is okay, they are in opposition. You are not fooling anybody. You have not been anywhere and you are not going anywhere, because you do not have anything to offer the people of this province.

Mr. Sale: The minister continues to wander in circles and have nothing much to offer in regard to answers to what I think are very important questions, and the 100,000 patients of those two hospitals may feel that he is not exactly serving their interests very well by refusing to at least give some indication of when they might know whether there is any substance to the notion that there are substantial savings to be made to the closure of these hospitals, and when they might know what plans are being put in place to provide for their care when it is no longer available within a reasonable distance of their home. The people of Stonewall would be very interested in the answer to that question.

* (1350)

In terms of the minister's foolish accusations about substance, the platform of this party has always focused on community based care. We instituted community clinics under our leadership. The minister has not set up a single one, although he bows on their direction from time to time. If he really believed in community based care, he would have established a community based clinic system and supported that system. He would have dealt with walk-in clinics, he would have dealt with the sharply escalating costs identified in his own report in regard to private laboratories.

There are any number of things which have been in our platform for years and on which when we had an opportunity we made significant progress, and we will make great progress again when we form government.

I would like to ask the minister in response to his reference of overcapacity, what is the current estimate on the government's part? What numbers do you use to indicate to yourselves the scale of the overcapacity of acute care beds in Winnipeg at the present time? What is the actual number?

Mr. McCrae: Mr. Chairman, at this point, it is very hard to be totally precise because, depending on a hard look at the demographics of our population and the different population health indicators that come into play when one is doing this sort of analysis, you could go anywhere from all the way down--what is the name of that measurement from the States?

There is a measurement that they use in the United States, which goes all the way down to one bed per thousand population, all the way up to well over four where we are already here in Winnipeg. So, certainly not interested in one, I do not think we can do that here. Calgary, which has 2.5, I believe it is, has a different population mix than we do, so we probably would be looking at something higher than that. So we are narrowing it a little bit, but I cannot be more precise and say it is 2.8 or 3.1 or something like that. Four is agreed by everybody to be more than we need per thousand, especially with the burgeoning growth of the Home Care program and also the tremendous growth of our long-term program, and the capacity that we are building into those programs. We do not need the acute care that we presently have.

The honourable member knows, but does not talk about this very often, that, for example, there was a time not so many years ago that if you had a heart attack, you would be in the hospital for five to six weeks. I met recently with a cardiologist who tells me it is five to six days now for a hospital stay as a result of a heart attack. That is just one. A very close relative of mine recently was a long-stay patient for gall bladder removal--two days. Long stay, two days. This person, in her mid-'70s, was in her car driving to Calgary within 10 days to visit relatives. In the olden days, everybody knows that was a 10-day stay and longer than that before you would be back at work.

The concept of health care is now that you do not convalesce at hospitals, you convalesce somewhere else. You might as well not even bother sending a get well card except to the person's home address nowadays if you hear about somebody having an operation; that is how much things have changed. Our hospital system has not changed. The bed counters of the past are still with us--some of them are anyway--and they are still there to complain each time you close a hospital bed, when the focus for the system should be services and not the number of beds. That is the old style when we did not have all these other supports in place. Now we do.

Technology is such that it is things like laparoscopic surgery that have brought about the less intrusive procedures like gall bladder removals, for example. I was at the opening of the new surgery centre at Victoria General Hospital recently, and they let me play doctor but they did not let me at a real patient.

An Honourable Member: Thank goodness.

Mr. McCrae: Thank goodness is right. They gave me a little jar of gummy bears and laparoscopic equipment and I was to take the gummy bears out of the cup and put them somewhere else. I do not know if, Mr. Chairman, you got to do that that day or not, but with a little bit of practice people who are skilled in these matters can really make a difference in the care of our patients.

Eye care is an example that the president of the Manitoba Association of Registered Nurses referred to recently to make the case that, when we do about 6,000 cataract surgeries a year at the Misericordia General Hospital--this was a move, by the way, that the NDP opposed-- but what we did was we saved money and we did more surgeries there.

But here is the rest of the story on that one. It used to be a 10-day, two-week stay to get your cataracts removed. Now it is done on an out-patient basis, and because we have this centre of excellence at the Misericordia General Hospital which the NDP oppose--but I guess they oppose it because it is better for the patients; that is typical--the fact is 60,000-plus bed days per year are now saved because of the different way of doing just that one procedure.

So now we have talked about heart attacks, we have talked about gall bladders and we have talked about eyes. How many other procedures are there where technology has made such a difference in the length of stay in our hospitals? I know that in Brandon, for example, they are doing the 24-hour mom and child release where mom and child go home after birth, and I think they are doing that elsewhere now, too. It used to be six, seven days in hospital to have a baby. Now you have a public health nurse visiting mom and baby at home where they are interacting with each other in their home environment, and the outcome in that situation is very positive and saving again in bed days.

But try to close a hospital bed and listen to the critics. Then you ask yourself, why are the critics being critical? Is it about care or is it about something else?

Mr. Sale: The initial response of the minister in regard to scale is very helpful, and he appeared, at least, to say that the range the province was looking at was somewhere between 4 and 2.5, which is a fairly big range, and I hope that he will narrow that range somewhat more in further answers to this question.

The point of the question, Mr. Chairperson, is simply to point out that unless you have some idea of a relatively clear range--it does not have to be an absolute number, but from 2.5 to 4 is a huge range. You look at the number of people effectively served by Winnipeg's hospitals, which is in the 800,000 region, the population of the city, plus the immediate outlying areas that depend on Winnipeg for a great deal of their health care, approximately 800,000 people.

Now, at 2.5 per thousand, that would suggest that we need 2,000 acute care beds in Winnipeg. At 4 per thousand, that would suggest 3,200. He has suggested that the range for acute care beds in Winnipeg is somewhere between 2,000 and 3,200 based on an effective catchment area of about 800,000 people.

I wonder if the minister would be prepared to confirm that the implication of his over- capacity discussion at the beginning of the answer to my previous question would indicate that the number of acute care beds in the city optimally at this point in our technological history might lie somewhere between 2,000 and 3,200 acute care beds in total; rated beds, that is, that are actually occupied and staffed and functioning. Of course, I expect that he will distinguish between the capacity of the hospitals which is much higher than their actual staffed beds at the present time.

So I would ask that he respond to that, and just in closing my remarks I would completely agree with him that the style of care has changed dramatically, and the average length of stay, as has been pointed out by many commentators, including those in his institute, is that the average length of stay in Canada is finally coming down, not just here but elsewhere, to be more in line with what is possible. That is not a bad thing. That is a good thing, and I agree with him that that is a good thing.

The issue is, do you have in place in the community the resources available to support that style? The minister has indicated that that is the direction that he would like to go and we applaud that and support it, but I would like first if he could confirm that the implication of his scale is somewhere between 3,200 and 2,000 staffed, functioning active acute care beds in Winnipeg.

Mr. McCrae: It is nice, Mr. Chairman, finally to hear the honourable member acknowledge that significant work has been done to lay the groundwork in Manitoba, and that is borne out, of course, by looking at the tremendous increase in funding for Home Care over the last eight years, the tremendous growth of the long-term care, the personal care program. It is nice that the honourable member for Crescentwood (Mr. Sale) has acknowledged that we have laid the groundwork in the home care and in long-term care for changes that are required in the acute care sector.

You do not just pick a number and then build your case around that number. You find appropriate methodologies for you to arrive at that number in the first place, and those appropriate methodologies depend on things like the health of the population; what kind of environment do we live in; our water, does it support a good healthy population; do we have any unusual heredity issues that somehow impact our population in a way that somehow hurts our health or makes it so much different from some other population? All of those things have to be taken into account.

So you do not just find a number and then try to make everything work around that number. You have to become very evidence based when it comes to arriving at a number, and I will not engage with the honourable member in a discussion today about how many beds there should be or should not be.

* (1400)

The member for Inkster (Mr. Lamoureux) has given us his opinion, but it is very hard to know what to do with that opinion, because he said in one case you can close 100 beds. I do not know. Maybe we need to close more than 100 beds. In another sentence he said you can close 700 beds in Winnipeg. I do not know. If it comes that easy for him, why not 800 beds? Why not no beds?

Mr. Lamoureux: Are you suggesting 800 beds?

Mr. McCrae: No, that is what the member was suggesting, 700, and I am saying where is your science behind it? Where is your science behind your 700 beds that the Liberals are suggesting can be closed? Where is the science behind the 100 beds, which, in another breath, the Liberals are suggesting could be closed? We are going to be a little more scientific than the honourable member.

He is asking me about all these reports and things in Home Care, and I have been tabling them as if there were no tomorrow and he has never read any of them. Yet he has got all these highfalutin' expert opinions that he wants to share with everybody and he has not ready any of that stuff. So, Mr. Chairman, we have to be kind of careful. I think it is important not to try to substitute our judgment all the time for the judgment who know more than we about these things, even those people who try to make you believe they are health consultants, try to make you believe they know a whole bunch of things about health. Some of them do, and some of them do not know so much. The thing that you have to do is get people working together, which is what our government does. We have been doing it a lot.

The member referred to the 1992 document relating to Quality Health for Manitobans-- The Action Plan. He was being critical of something in there; that is okay. It is just that that report enjoys unanimous agreement. If the honourable member is saying today it no longer does, then let him tell us why. He has told us about one graph he does not like. You can dislike a graph and still agree with the policy. That is okay. If the honourable member wants to go further now and change NDP policy by the seat of his pants, let him do that. The Liberals, the NDP, everybody agrees with the document the honourable member was referring to, and I have said, without fear of contradiction, throughout this province, that it is virtually unanimous.

Now the honourable member shakes his head, so it is interesting, the NDP seem to be changing policy by the seat of their pants. Maybe the honourable member for Crescentwood (Mr. Sale) can explain that to us.

Mr. Lamoureux: You know, Mr. Chairperson, the member from Crescentwood actually put forward a fairly straightforward question, and the minister really has this fixation about putting words in the mouths of individuals on this side and then not answering a question, which ultimately does not make it as productive as the Health Estimates could be.

The point, of course, that is being made is that the minister we know has looked somewhere between 2.5 to 3.25 beds per 1,000. The total acute care beds that we have today in Manitoba--I should not say today--as of November back in 1995 was at 2,543. What we do know is that the minister is looking at closing down a number of beds. What number? Well, the Minister of Health wants opposition members to say numbers, to give specific numbers and yet he himself, as minister, is not prepared to share with us the numbers that, in fact, he is looking at.

I have speculated in the past that I am anticipating it to be somewhere between the range of 100 to 700. I think that he has given serious consideration just through what I hear and most of it is hearsay and rumors or speculation, whatever it is that you want to call it, that it is somewhere between 350 to 600.

The Minister of Health is in a position to be able to indicate the type of global or an estimate of the type of numbers that he is looking for. Then the minister takes those numbers and he says, well, you know, the opposition recognizes that to a certain degree that, yes, there is a need for change, but when we suggest change that they are not necessarily supportive of change.

In other words, we say, okay, yes, there is a need, and I will say that now, yes, the Minister of Health given the acute care numbers of 2,543, we could justify seeing some beds being closed. Well, does that then mean that we are supporting the closing down of acute care centres, whether it is the Misericordia or the Seven Oaks Hospital or the Concordia Hospital? No, we are not saying that at all. It is a question in terms of how you want to administer those services. Where can you, in fact make, those acute care bed savings?

The recommendations that the deputy minister, and I am a little bit disappointed, I was hoping that the deputy minister would have been able to be here not only now, but when I had raised the questions the other day regarding hospitals. I believe that there is a fundamental flaw in the recommendations that this committee has brought to the Minister of Health and I am glad to hear the minister has not made a decision, but what he needs to do is he has got to recognize that fundamental flaw. There was a heavy bias, there was turf protection that took place, there is no justification for the closing of acute care services at the Seven Oaks Hospital or the Misericordia Hospital.

Come forward with some numbers. There is a valid argument to be made that, yes, you can close down acute care beds, but there are no valid arguments that will demonstrate that the Seven Oaks Hospital, in particular, should be shut down of its acute care services. That is why I challenge the minister the other day, not only in committee, but also in writing, to provide me the opportunity with some health care professionals to cross-examine the Deputy Minister of Health and the CEOs. I have talked to CEOs, both in tertiary and community hospitals, who have pointed out that there are flaws, that there are other options. This minister has not looked at or, at least, provided, or acknowledged any credibility to other potential options. Those options will see our community hospitals continue, while at the same time allow for the reduction in acute care beds

The Minister of Health (Mr. McCrae) does a disservice by not allowing for us to get more of a debate. He can use, I guess, to a certain degree the home care crisis and the strike that is currently out there as one of the ways in which he can say, I do not have the staff to be able to bring into the Chamber to be able to articulate more of the details.

Mr. Chairperson, there is one thing that the Minister of Health can do. The Minister of Health can talk about the other options, and other options that would see, for example, if there is a need to cut acute care beds, acute care beds being cut at the Health Sciences Centre where money can be saved because the Health Sciences Centre, quite frankly, does many operations that could be done in our community hospitals, those sorts of beds, and that is nothing that is new. There are reports, The Action Plan makes reference to that. That is under Don Orchard and Frank Maynard. The Health Policy Institute with the University of Manitoba, this minister's guru of health policy, if you like, makes reference to tertiary hospitals doing services that could be done in our community hospitals. There is a viable option that will allow for the Seven Oaks Hospital and the Misericordia Hospital to provide acute care service. There are valid arguments as to the need for emergency community services.

When I look at it, quite frankly, in the way that it is being proposed, I have to question whether or not the right thing is, in fact, being done by this government. I have to give the benefit of the doubt, I guess, to a certain degree to the Minister of Health. He says a decision has not been made. All I would like to hear from the minister more than anything else through this afternoon dealing with the hospital issue--and the only reason why I bring up the hospital issue is that this is something in which the member from Crescentwood (Mr. Sale), and the Minister of Health have been talking about for the last hour, and that the Minister of Health made reference to me and my suggestions.

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All I really would like the Minister of Health to make a commitment towards is that, yes, there are other options, we are looking at those other options, and possibly to start talking about some of those other options to give that some hope, if you like, to those individuals who are advocating on the benefits of those community hospitals. That is what I am looking from the Minister of Health to do, and then we will continue on with the Home Care questions.

Mr. McCrae: This may, indeed, be an area where the honourable member for Inkster (Mr. Lamoureux) and I can collaborate more closely than perhaps we do on other matters. I would like to defend my deputy minister who was here. I told honourable members earlier today that he would be here for a little while this afternoon, and I cannot help it if honourable members did not want to ask questions when he was here. The fact is, the deputy and all the members of my department are very busy, as they always are, but certainly more so than ever right now because the NDP and the unions do not want to provide services to our home care clients, so we have to do it. We are doing it and we are doing the best we can. We have placed the highest priority on this. It does not mean it is easy, so I have told honourable members as long as this strike is on not to expect to see very much by way of staff representation here.

If the honourable members are not happy with some of my responses, because I do not have all the information sometimes, it is simply because the staff who provide me with that information are engaged in something even more important than answering the questions that get raised in here. They are looking after the clients of our Home Care program.

The union and the NDP have abandoned those clients and somebody has got to look after them and with some sensitivity and compassion. That is what is happening. Thank goodness for the wonderful people that we have working in the Department of Health, and thank goodness for the wonderful people who are providing their services to us on a volunteer basis, not to us, but to clients in the home care system.

I am very critical of the member for Inkster (Mr. Lamoureux) in this area, because he has gone all the way over to the NDP on this, and I think it is shameful, shocking and horrific, really, if you think about it in all its dimensions that one would allow oneself and a whole party to be drawn in by people like the ones that we have opposite here in this House in the New Democratic Party who do not represent people, they represent unions.

I am sorry to see the Liberal Party sliding down that particular slope, but as I said to the honourable member, I appreciate what he is trying to do with regard to the hospital configuration in the city, and I am not trying to be unduly unfair to the honourable member. It is just that I do, indeed, wish to see proposals coming from him. He says, are you looking at options? Well, I want to know what options the honourable member wants me to look at.

I have private conversations with CEOs and people like that, too, same as he does, and those people are only trying to help. They are trying to help the system and I very much appreciate it. These are hard decisions to be making, and no matter what decisions get made, they are going to be hard because we know that fewer dollars are going into the hospital system. We know that, and so therefore the decisions will be hard because some people's jobs are going to be involved.

We cannot save every job, and the honourable member for Inkster knows that. All I ask of him in our collaboration--he used the word “debate,” I prefer the word “collaboration.” Debates fine, we have got to have it, but let us also try to work together on this. I am inviting the honourable member to do that. I do not want to take aim at any particular community hospital in this city for any unfair kind of treatment or anything like that. I have patients that we need to keep foremost in our thinking. We have got geriatric patients in this city.

All these years that I have been involved in politics, everybody talks about elderly Manitobans and their needs. Now, all of a sudden we want to do something about it. Oh, yes, well, no, no, that is a downgrade to look after elderly people. That is not an important part of the health system. You can forget about that part. We have got to have acute care, that is the only thing, acute care, we have got have that, acute care, acute care, acute care; never mind the old folks.

Well, the old folks are our pioneers and they deserve better than that whether it is at Seven Oaks Hospital or somewhere else in the city. Our senior citizens deserve not to be sloughed off like this. I find that a little bit upsetting that all of a sudden, when my corner of the city is somehow impacted here, that senior citizens do not matter anymore. Well, that is the one flaw in the arguments of the honourable member. I can understand him wanting to preserve acute care--okay, that is a given, I understand that--but all of a sudden a total disregard for geriatric issues. It is as if, well, you can look after the geriatric stuff somewhere else, and let us be what we are and have always been and what we fought so hard to have 20 years ago and all those arguments.

They are all fine arguments, but do not leave the geriatric people out of this. Those are the people that require some proper attention. We have got them languishing in hospital beds when that is not fair to them. That is no life lying around in a hospital bed when there is some other better way to be cared for in long-term care or at home or some specialized chronic care unit or something like that. That is a far more compassionate way to deal with our senior citizens. Simply because a hospital is affected by somebody's deliberations, all of a sudden just to forget all about old folks, because there are people signing petitions and because it is the popular thing to do right now, to save our hospital. Go ahead and try to save the hospital. I do not disagree with that, but do not disregard our senior citizens and people in long term care circumstances. All I am saying by all of that is let those who say we are going the wrong direction put their reputations behind what they think is the right direction. Put something on the table. I am not just going to pick away at it. I do not have any reason to.

I have a need to provide for Manitobans the right services. It is not a question of going around punishing this area and rewarding another area and this, and the give and take, and all like that. That is not what this is about. If I could get the honourable member for Inkster (Mr. Lamoureux) to understand that, then I think we would be making better progress than we have been. I do not think we have not been making progress, but the process, I can guarantee you, Mr. Chairman, I can put together the best kind of process in the whole world. If that process does not yield the result that the honourable member for Inkster likes, he will attack the process. If we came out with absolutely no background evidence or science or data or anything else, came out and said in all those changes we are going to do, one thing we are going to do is leave Seven Oaks Hospital just the way it is, that honourable member would not come asking me what data I used to arrive at that decision. He would say, that sounds like a pretty good decision to me, right? That is the nature of this political beast.

The honourable member for Kildonan (Mr. Chomiak), it does not matter where change is happening or what change is happening, or who is affected and who is not affected, if it was a Tory government that made the decision, it had to be wrong. I mean, that is a given. So that is why we tend to dismiss sometimes the points of view brought forward by the member for Kildonan, simply because they are totally, totally politically--there is too much political consideration attached to each and every comment that is ever made. I have never seen more political people in my life than New Democrats, Mr. Chairman. It is astounding to see that. Even Liberals every once in a while try to look at what might be the right thing to do, which I appreciate. That is why I am still listening to the honourable member for Inkster.

Mr. Lamoureux: I guess I like to think it is more than just the Seven Oaks Hospital. Yes, it happens to be in an area which half of my constituents utilize. The other half of my constituents utilize the Grace and Health Science Centre, as two other hospitals, but when they had the emergency strike going on, I was down at Victoria Hospital in the south end of the city of Winnipeg, primarily because again I believe in emergency services being provided for the different communities. I listened with great interest in terms of the remarks and the challenge that the Minister of Health (Mr. McCrae) puts forward. Bring forward a proposal and the minister will, in fact, go over the proposal.

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Mr. Chairperson, nothing would make me happier with respect to this particular issue to put forward a proposal that would actually have the opportunity to be given very serious consideration. Now, if I started first thing after we adjourn today at three o'clock and worked endless hours into some point in time where I say, okay, my proposal is all together and here you go, Mr. Minister, give it consideration. Number one, with the limited resources that I have, I do not know if I am going to be able to put together the type of proposal that the minister would need in order to bring back to whomever it is that is ultimately making these decisions or providing the input in order to make the final recommendation, if you like.

Now, if I had the resources and the minister recognized those individuals who were sitting around me and gave them credibility, and then I brought forward a proposal in which individuals who participated in that proposal had the respect of the minister and vice versa, then I believe that there would be a real chance of that actually occurring.

Mr. Chairperson, I would, in fact, accept a challenge of that nature, even knowing how much effort it would involve on my behalf, but it would be well worth the effort if I believed that the minister was not looking at the other option, that option which I believe is absolutely essential, the option that includes the community hospitals and the saving of dollars. I will acknowledge, yes, there is money that not only can be saved but needs to be saved. If the minister, because of the home care strike or whatever, does not have that option, then I believe ultimately, even in an opposition position, that I have a responsibility to ensure that that option is, in fact, worked out in the best fashion that I can.

I am prepared to make that sort of a commitment if the minister would be prepared to make a commitment to allow me to have the resources that would allow me to put together such a proposal, that the same sort of weight would be given to that proposal as the proposal provided by the deputy minister, and I must admit, Mr. Chairperson, that many of the individuals that the deputy minister had access to would be the same individuals that I would require to have access to, primarily because these are the individuals that know the system.

Having talking to them much like the minister himself has talked to many members of that particular committee, I believe that he has recognized that there are many problems with those recommendations. The question ultimately is, does the minister feel comfortable that there are other options there and that those options are being explored in as much detail as the recommendation that the deputy minister has provided him? If the answer to that is yes, then, quite frankly, it would be a waste of my time and the resources the minister would give me to be able to come up with an option because he feels quite comfortable with the information that has been provided to him.

(Mr. Chairperson in the Chair)

If he does not, then there should not be too much of a problem in the sense of saying, well, look, we are still trying to get more input on the other options--and I know that the minister has requested both from Seven Oaks and I believe also the Misericordia and possibly other groups to provide more input, possibly providing ultimately that second option. If the minister is still in that sort of a process, in other words, wants to avoid duplication as opposed to setting up another committee of any degree, avoid duplication, get in all those other alternative ideas, and then if that is the stage the minister is at and my best guess is, I believe that is the stage he is at, if there is a way in which I can participate, I would be more than happy to participate.

Quite frankly, I do approach this issue with a very open mind. If the minister is prepared to share, and some information might want to be kept in a confidential manner, I would be able to entertain even doing that if, ultimately, it is in the public's best interest, and discretion would, in fact, be used.

I believe on this particular issue, at least, the minister has given the impression that he is approaching it with an open mind. Time is of the essence, and that is the reason why, once again, I do believe that there is some benefit, if the minister has not done it, to allow for the deputy ministers and other individuals who have sat around the table who brought forward these recommendations, to allow individuals who have the expertise to question them, and if not question them directly, to question them through the minister. That is absolutely essential because I sincerely believe that if, in fact, that has occurred, the minister is not going to accept these recommendations. I really believe that.

Having said that, Mr. Chairperson, I will give the minister the option if he wants to respond to that. The question that I was wanting to pose, to carry on from this morning, was to ask the minister if he believes that there is a correlation between the amount someone gets paid and the quality of service that ultimately they deliver.

Mr. McCrae: I have not detected any lack of good faith on the part of the honourable member in this whole hospital discussion. I know where he is coming from. I think I understand the concerns that he has for a couple of reasons. He represents an area of the city that is affected by some proposed recommendations, and if I were in his shoes, I would be asking many of the same questions. I do not detect any lack of good faith in terms of what he is offering to do in regard to this debate. I am not offering to provide him a bunch of resources, but I am offering to--and I would not pick apart any proposal that he would make in good faith, a serious proposal, certainly not in any way publicly, or to ridicule or anything like that. I know he does not have the resources to back up a proposal with all kinds of statistical data and all of that.

We have resources that we can bring to bear on a proposal the member might bring forward, and we could do some analysis and compare that with some of the other things that are being looked at. That is the kind of thing that I am offering here. I am not able to say to the honourable member that we can set up another Department of Health for the honourable member to analyze, but we will use our own resources to look at alternative proposals and options.

I know the honourable member is talking to some people who have a lot to offer the health care system. Some of them are probably the same people you and I are talking to, Mr. Chairman, and I do not know if any of them want to talk to the member for Kildonan (Mr. Chomiak), but maybe some of them do out of courtesy, because you have to be careful when you talk to the member for Kildonan and people in his party. You never know where that conversation might end up.

That being said, I welcome the input of the honourable member for Inkster, and I say that sincerely. I do not have all the wisdom and I never claimed to, but I do know that I have been given a job that gives me access to people who do have a lot more wisdom than I do and we ought to listen to them. Sometimes, even when we do not like what they tell us, maybe after a careful analysis of what they have told us, maybe we should do what needs to be done. Ultimately, we know we have to, and I have not spent a whole lot of time in this Estimates castigating the honourable member for Inkster (Mr. Lamoureux) for what his federal cousins are doing to us, or anything like that, because I recognize that, whether I like it or not, the dollars flowing from Ottawa for some of these things are reducing.

There is no point whining about it and doing that for the duration of our mandate. We have got a job to do for Manitobans and they want us to do it. They do not want us to be the official whiners for Canada in terms of things like fair share and the kind of stuff that the NDP used to do in terms of--the centrepiece of all that they stood for was to fight somebody.

Well, some people would rather fight than win, and that is not me. I would like to come out a winner. I would like the people of Manitoba and the health care system here to come out a big winner in all of this, and so I sincerely say to the honourable member, you want to put forward alternative proposals and you want to do it on the basis that you do not want to have it publicly shot down. I welcome informal input from the honourable member, and we would treat his concerns seriously. I am not saying that because I am stumbling around looking for proposals. There are going to be lots of proposals, but I am interested in knowing what the honourable members' might be and whether they can be backed up by some logic and data and stuff like that.

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So we would apply the data. We have got it, we can do it. The cost-benefit issues, we are in the process of that. It is a long process, but once we have our methodology in place, we could probably apply it to the honourable member's model relatively easily once we have the model in place or once we have the methodology in place. I will make the honourable member this commitment, that if he does not want me to--we can work in a preliminary way, so he does not have to be tied to any particular proposal that he makes until he finds out himself whether the data or the evidence is there to support what he is suggesting.

There are proposals ranging with respect to the geriatric issue to the total transformation, for example, of Seven Oaks Hospital into a geriatric centre. Well, then, you can do it the way we presently do it, only get a little better organized at it, and see that function spread throughout the system.

There are all kinds of different ideas that can be looked at, but I do say to the honourable member, he knows the numbers--$53 million has to come out of the hospital system of this province and has to come out this year. We do not pretend that we can just not make any decisions; we have to make them. The more we do not do it right, the more we end up with the NDP solution which is just to hack and slash.

So that is not my approach. It has not been to this time. The only closure going on is the Brandon Mental Health Centre, and that has is being done in a staged manner. It was the total subject of debate for a long time, and an election was even fought over it. Those who wanted to cling to the asylum-type approach to mental health care delivery, i.e., those in the New Democratic Party lost that battle, and the patients won, thank goodness for that.

You can call that a closure, if you are a New Democrat, or you can call it a better way to deliver mental health services if you are everybody else. So we are pleased with that.

The honourable member wanted to talk again about home care and about, yes, the concept that if you are paid less, you are going to deliver an inferior service. I was asked that today by a reporter for a privately owned television company, that same question. I said, I do not know if you make as much as the employees in the publicly owned television company, but are you seriously suggesting that you do your work less well than somebody over in this publicly owned broadcasting company? Are you trying to tell me that because maybe your wage rate is a little less that you approach your job in a different way than the person over in this publicly owned company, this broadcaster?

Well, it was hypothetical and rhetorical. I was the one being interviewed, so he did not really want to answer that question. But I could see in his eyes that he accepted that I had a point there, and I gave a little example of my own experience, and maybe it is always a dangerous thing to do because somebody in the New Democratic Party will probably make that the subject of some public information campaign where they can smear and maybe have a little more fun. But, Mr. Chairman--

Point of Order

Mr. Chomiak: I sit here and constantly hear the minister make accusations that are not factually correct, but to indicate that the NDP are engaged in a public smear campaign I think is not an appropriate choice of words, not an appropriate thing for a minister of the Crown to say, and I ask you to ask the minister to withdraw that statement. A public smear campaign, Mr. Chairperson, I think is totally inappropriate for the minister to suggest.

Mr. McCrae: I am not so sure that is what I said. I did not mean to imply that the member for Kildonan or his colleagues are engaged in some organized smear campaign against me personally, but I know that a lot of things have been said about me personally that are very, very unpleasant and unkind, profoundly unkind.

Mr. Chairperson: I am going to take that matter under advisement and see what was put on the record. I did not quite hear what the minister had to say, so I will just take it under advisement.

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Mr. Chairperson: The honourable minister, to continue.

Mr. McCrae: Well, what I was getting to, looking at my own experience, my first job was, I guess the New Democratics would call it a McJob, because my job was in a hamburger place, and it was my job to make hamburgers and sweep the floors and peel onions and chop onions and clean out the chipper, and all those sorts of things you do in a restaurant operation, and my pay was 80 cents an hour. That tells you a little about how old I am; that was a little while ago. Eighty cents an hour and I was proud of myself. Someone actually had enough confidence in me to hire me and to keep me for quite a long period of time on that job.

Well, then I got another job after that and I will be darned if that job did not pay me $1.45 an hour which is a big increase from 80 cents. I do not remember putting more into the $1.45-an-hour job than I put in the 80-cent-an-hour job. I was proud to have the job, I did the best I could for my employer and for those who were the customers of the employer.

The NDP and their union boss friends would have you believe that a person's attitude can be bought and paid for. That is implicit in the member for Inkster's question. I hope he does not mean that. I will bet that every job he has ever done he has done it well. I say that because I see the way he does his job as an MLA, and I bet every job he has ever done he has given it his level best. Is the honourable member trying to say that his fellow Manitobans are different from he and I?

Mr. Lamoureux: Ultimately, if you privatize and for profit, what will happen is the companies, private companies, will say here is the criteria that has to be met, or the standards that have to be met. Now it is a question in terms of who can we get to administer what has been requested of us, and ultimately they will try and attempt to get the cheapest labour possible in order to administer that.

If you can get someone for $5.50 an hour to do a job and those individuals that are more inclined to take that $5.50 job are provided another potential job at $6 an hour, there is a very good chance that they will take that $6-an-hour job. That does not necessarily mean that they did not give it their very best at the $5.50-an-hour job. Whatever job anyone has, one would anticipate that they do the best that they can, and I think that that is a fair assessment of people as a whole, generally speaking, .

If you want to be able to retain individuals, if you want to be able to give incentive for individuals to get further training programs to enhance their skills so that they can deliver a better service, if you expect individuals to make more of a long-term commitment, to make a career out of a job, the wage and the amount that is actually being paid does have a very significant, I would say at the very least, is possibly the second priority that many people that enter the workforce actually have. So, if you want to promote the type of individual that wants to take this occupation as a career, you are going to find it very difficult to attract someone at a borderline minimum wage job. What you are likely going to end up seeing is a structure within the private sector that will have those individuals that have the benefits or the extra services in addition to the core services, the individuals that are administering those jobs will be the employees that are more career oriented. Maybe they have been there for a year or two, they have shown initiative, and they are upgrading their skills and so forth.

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The individuals that receive the bare core services, unfortunately, from a private company's perspective will get the individual employee that might be at the lower end of the scale, and taking that job and doing a wonderful job, doing the best that they can with their abilities and the experience and the training that they have been provided, and continue on that job until quite possibly another job becomes available that pays a little bit more, depending on whatever that employee's economic needs are.

So what you are doing by not allowing for some sort of wage scale, if you like, Mr. Chairperson, is that you are in essence going to have many people that we could have retained in this area of home care services and upgrading themselves to deliver a better quality service leaving, because they will not be able to afford to remain in an area in which they could, in fact, not only enjoy but want to be able and have a desire to want to be able to continue on in that particular occupation.

Mr. Chairperson, what would happen--if we have construction and the construction industry set wages that are quite often attributed to individuals that have expertise. I do not know, and I guess this is where it would have been beneficial, if the minister could indicate in other home care services throughout Canada, are there in fact wage scales in the private sector that are followed? These, I think, are very valuable questions that need to be answered. Is there benefit to the client by ensuring a certain standard through a wage scale?

I believe that the answer to that question is, yes, the client will benefit by instituting some sort of a wage scale. The member from, I believe it was, Emerson (Mr. Penner) was saying, well, tell us at what level, at what dollar do you want to start it off at? Again, I am very reluctant to say, here is a dollar amount. One might want to look at the VONs and see in terms of what it is, the type of service that they are providing compared to what the services being provided through the Manitoba government, and possibly come up with something. What actual amount I could not say per se. All I do know is that the borderline minimum wage is not necessarily going to be, in the long term, in the best interests of the client, especially the client that is going to be receiving the core services and does not have the economic means to receive anything more than that. What I would envision is that, if you do not have some sort of a salary floor, what will happen is the higher, more transient employee will end up going to that sort of a client.

Mr. McCrae: I do not think the honourable member for Emerson was trying to make life difficult for the honourable member for Inkster by asking, well, how much? How much should a person whose job it is to do cleaning and laundry, how much should that person be paid?

What standards are associated with doing laundry? What kind of training ought a person be required to have to wash clothes, for example, or to vacuum the floor? What kind of training ought there to be for the preparation of a meal? What kind of wage rate ought to be in effect for the preparation of a meal, for someone who assists someone with their toileting routines? What training ought to be required that is set down, I think, in the kinds of standards that we require in these areas? What kind of pay ought to be in place for people who provide these different kinds of services?

The honourable member said earlier today, I understand, that he trusts the free market system and he believes in it. Well, if that is true, why does he want to make an artificial market in these particular areas? They argue, certainly the member for Kildonan (Mr. Chomiak) wants to argue that you get a bad nurse if you do not pay them a lot of money. Well, excuse me, what does the Manitoba Association of Registered Nurses have to say about that? That is a professional organization. There are no bad nurses or else they do not get a licence, and if they are bad, they do not keep a licence.

But members opposite in the NDP say, well, if you pay a nurse $5 more, you are going to have to get a better nurse out of the deal. Well, I go back to where I was, flipping hamburgers. It did not make me a better hamburger flipper to pay me a nickel more or a dollar more or whatever; 80 cents is what I was getting, by the way, but I was the darndest best hamburger flipper around, and I was proud of what I did. [interjection] Well, I do not know what my future is or anybody else's future is, but I do know that if people in the future are like the people now and in the past, they simply are prepared to give you a good, solid day's work or a good, solid hour's work for the pay that they have agreed to accept in return for that. That is what people are like.

The people I know simply want to work and do their darndest best for what they are being paid. I do not know how the member for Kildonan felt when he got his first job or his second job, but I know how I felt, happy and proud that someone would have enough confidence in me to hire me to do something and pay me money to do it, even though at 80 cents--that tells you a little bit how old I am, 80 cents. It was a little while ago.[interjection] It was not that good. It was the minimum wage.

But the honourable member for Inkster (Mr. Lamoureux) wants to inject something artificial into all of this, and do you not think it is having an artificial economy that has got us into all of this trouble in the first place? Why do you think $600 million is being spent this year to pay interest on debt? Because governments of the past liked to borrow money, even though they did not need to. They taxed like never before in the history of the world, and that was not enough to satisfy their spending appetites. They had to borrow money to boot.

The legacy is there. Future generations, I am sorry to say, are going to be impacted by that, but here is the good news. Thanks to our balanced budget legislation, in only 30 years we will have paid off the debt in this province, just 30 years, and yet there are people in this House who want to carry on that debt, the piling of debt onto debt onto debt for year after year and never pay it off, just pay it back, every single year.

Do you know how much money $600 million is? We were talking a little while ago about Seven Oaks. What is it, about a $40-million budget over there at Seven Oaks? [interjection] Forty-two? Well, just round it off to 40, so what is that? Do your arithmetic. How many Seven Oaks hospitals are run with $600 million? My arithmetic is terrible.[interjection] About 14 or so? I will take your word for it. The point is the New Democrats would rather send all of that money to the bankers in New York and Tokyo and Zurich and all these places than to spend it on health care. Why can I say that? Because they stood to their feet, and they voted against living within our means by way of a balanced budget legislation. They voted against that. Shame on those New Democrats for doing that.

* (1450)

Now the Liberals, what did they do? They voted against it, too. I mention that because it is important that we put a stop to this. It is a very bad example to set for young people, that you can just borrow your way through life. We have to stop doing that because we are robbing a future from them. It is their tax dollars that are going to keep on paying these hundreds of millions of dollars every year for at least 30 years to pay off the horrible, horrible debt mountain that we built for them in this province, and we are one of the better provinces. Think of the poor young people in the other provinces where it is so much worse. Anyway, I am glad that we are not the worst, because we are not. We are far from it.

We have people in this House, over on that side, who go public and speak to the public and say, oh, this is not a bad deal; it is only about 10 percent of all of our spending. But think about it this way. We are talking around here in this House for hours and hours and hours about 0.000 percent of spending when we are talking about the reduction of a program or something like that, and members make a really big deal about that. They forget that spending for health in Manitoba with the Filmon government has been at the highest levels ever in the history of this province, the highest level as a percentage of all of our spending in health.

No government has ever shown the priority for health care like the Filmon government has, and yet we spend hours and hours and hours talking about it. It makes you kind of wonder why. There is certainly no question about anybody's commitment to health care. Those who have the biggest hearts, in my humble opinion, Mr. Chairman, are those who use their brains when they think about the future.

Introduction of Guests

Mr. Chairperson: Order, please. I would like to bring to the attention of the committee, we have a group of visitors with us today, the Lloydminster Malanka Dancers under the direction of their president, David Skoretz.

Mr. Chomiak: I just wanted to say on behalf of all members in this Chamber, Bitaemo da nasha Legislature [phonetic] which is welcome to our Legislature. Thank you, Mr. Chairperson.

Mr. Lamoureux: With the member for Kildonan's background in Ukraine, I would not even attempt to repeat what he said, but welcome to the Chamber.

* * *

Mr. Lamoureux: Mr. Chairperson, the minister makes reference to the free market process, that we should not be overly fearful in the sense that if we have faith in the free market process, we should not have to put up a safeguard of this nature.

Well, I am wondering if we had faith in the free market process, I can guarantee the Minister of Health that we could find 57 Manitobans that would love the opportunity to do exactly what we are doing at minimum wage, yet we do not see MLAs being paid at a minimum wage. Mind you, if you factor in the number of hours that many put in, it might get pretty close to minimum wage, but, in essence, we are not paid minimum wage.

If you have the conversion over to privatization of home care services, there are going to be a number of nurses, in particular, or health care professionals that are now going to be receiving a substantial decrease in pay. Substantial, you know, could range anywhere from 10 percent to 40 percent; those are the numbers that are being talked about.

For many of those individuals, they will not be able to continue on in health care or home care service delivery, not because they do not care or there is a lack of concern for their clients, but rather because economic reality will not allow them to. Just as I am sure that if tomorrow we decided to make being an MLA a minimum wage job, there might be a number of the MLAs that might not be able to run in the next provincial election or would step down.

I appreciate the trust as expressed by the Minister of Health with the free market process, but at times there is a need to give some assurances to different occupations that there is a standard that is expected. That standard can be ensured by the government through the tendering process and the criteria that it sets out in that process.

If the government states, for example, that we anticipate that all individuals that submit a bid will have a pay structure that will reflect whatever, what will happen is that we will see more individuals that will be able to participate in home care service delivery as a career. Ultimately, we believe in the Liberal Party that it is, in fact, a worthwhile career, that people do it not just for the money. You are right, they do not do it just for the money. They do it primarily because they care, they want to provide a very compassionate service.

If they are strictly minimum wage jobs, you are limiting many of those individuals from being able to participate. My question to the minister is: Does the minister believe that, with the layoffs that are going to occur and all of those individuals that are going to be expected to work in the private, for-profit companies, are they going to be able to continue on in a profession in which they have enjoyed? I am talking about the individuals that have been there for 12, 14 years. What assurances are these people going to be given that this is not going to be a minimum wage job, that there are going to be standards and expectations that these companies, the private companies in particular, are going to be held accountable for?

That is why, if the minister was more willing to share some of the more detailed information that he has in terms of the criteria and the standards, that it might alleviate a lot of the concerns. A lot of the concerns would be alleviated if the minister said, look, we look at this aspect of home care services, anything that is medically related in terms of a service treatment, as warranting this sort of a standard, and it is dictated through a particular salary scale, Mr. Chairperson, I would hazard a guess that many individuals that are currently out on strike today would feel a bit better and not as intimidated or fearful about what the government is ultimately doing.

Now keeping in mind, Mr. Chairperson, I say this only because I believe the government needs to be more open minded. I still believe and maintain that we are making the mistake in terms of moving in the direction of privatization or additional privatization of home care services, that really that one year moratorium is needed. I hope that the Minister of Health (Mr. McCrae) will respond at the next opportunity and give us some reasons as to why the correlation between wage and service that is being delivered--

Mr. Chairperson: Order, please. The hour being 3 p.m., committee rise.

Call in the Speaker.

IN SESSION

Mr. Deputy Speaker (Marcel Laurendeau): The hour being after 3 p.m., this House is now adjourned and stands adjourned until 1:30 p.m. Monday afternoon.