Madam Speaker: On the proposed motion of the honourable member for Inkster (Mr. Lamoureux), Bill 200, The Health Services Insurance Amendment Act (Loi modifiant la Loi sur l'assurance-maladie), standing in the name of the honourable Minister of Northern and Native Affairs (Mr. Praznik).
Is there leave to permit the bill to remain standing? [agreed]
Madam Speaker: On the proposed motion of the honourable member for Rupertsland (Mr. Robinson), Bill 201, The Aboriginal Solidarity Day Act (Loi sur le jour de solidarité à l'égard des autochtones), standing in the name of the honourable member for St. Norbert (Mr. Laurendeau).
Is there leave to permit the bill to remain standing? [agreed]
Madam Speaker: On the proposed motion of the honourable member for Thompson (Mr. Ashton), Bill 203, The Public Assets Protection Act (Loi sur la protection des biens publics), standing in the name of the honourable member for Gimli (Mr. Helwer).
Is there leave to permit the bill to remain standing? [agreed]
Madam Speaker: On the proposed motion of the honourable member for Wolseley (Ms. Friesen), Bill 205, The Dutch Elm Disease Amendment Act (Loi modifiant la Loi sur la thyllose parasitaire de l'orme), standing in the name of the honourable member for St. Norbert (Mr. Laurendeau), who has 11 minutes remaining.
An Honourable Member: Stand.
Madam Speaker: Is there leave? Stand? [agreed]
Second readings, public bills, Bill 202, The Home Care Protection and Consequential Amendments Act (Loi concernant la protection des soins à domicile et apportant des modifications corrélatives)--
Mr. Gerry McAlpine (Sturgeon Creek): I move, seconded by the honourable member for River Heights (Mr. Radcliffe),
WHEREAS the federal government has announced a reduction in the level of transfer payments for health services in Manitoba; and
WHEREAS given reduced financial resources to devote to the health care system, emphasis must be placed on the prevention of illness as opposed to the treatment of disease; and
WHEREAS citizens and health providers have recognized the need for the creation of preventative health measures in order for Manitobans to achieve and maintain healthy lifestyles; and
WHEREAS the provincial government has initiated numerous programs delivered by the health and wellness branch of the Department of Manitoba Health which are designed to promote health for Manitobans and to assist in the prevention of disease.
THEREFORE BE IT RESOLVED that all members of the Manitoba Legislative Assembly urge Manitobans to adopt healthy, active lifestyles with the goal of preventing illness and disease; and
BE IT FURTHER RESOLVED that all members of the Legislative Assembly support the Department of Health and the provincial government with their goal to provide programs aimed at preventing illness and thereby improving the health status of Manitobans.
Motion presented.
Mr. Gerry McAlpine (Sturgeon Creek): Madam Speaker, as you know, this is a very important topic that I have always shown interest in, and I think that Manitobans generally have changed over the last 15 years in terms of their approaches and thoughts about living healthier lifestyles. I say that because I think today, compared to 10, 15 years ago, we as a society exercise more. We support smoke-free spaces, in spite of what my honourable colleague and seatmate ahead of me here references. We even go to the point where we are recycling garbage rather than littering and cluttering the landfill sites and make more careful decisions about our lifestyle choices.
So I think that society in general is leading towards a healthier environment. Not only does that include the environment that surrounds us but also the environment within which we live, and mainly I speak of our bodies. Today many Manitobans view health as more than jogging regularly or reducing the amount of sugar and salt that we eat because it is not always what we eat that affects the environment with which the body that we live within. It is a lot deeper than that, and I think it takes a lot more to deal with that.
I think that there is a lot of emphasis that is put on what we take into our body. Granted in some cases that does have a tremendous amount of impact, but I think that it should also be known that some people can eat salty foods or foods that contain a lot of fat and have no adverse effect on them at all. But I think that the people who choose to eat and know what their own capabilities are and what affects them individually as individuals is what makes the difference in whether or not you are healthy and consequently will be free of disease and consequently referencing preventive health.
As a society we see health as a state of total well-being, and that includes the physical, the mental, the social, the emotional and the spiritual body that we live within in times of economic and social stress. Having meaningful work and support of family and friends becomes increasingly important to our health. Health in turn affects our ability to cope with the stress and enjoy life to the fullest.
It is amazing the effect that stress has in terms of our body and how our bodies react and will continue to do that unless we are able to understand and be able to deal with that in such a way that it is not going to have the adverse effect on our bodies, the same as the food that we take in. The food that we take in that has adverse effect on us not necessarily will affect everybody the same way.
At the present time, the biomedical model of health dominates our ideas and views about health. I think that taking into consideration there are lots of people--and even in the medical profession--that even say that the more frequently we visit the doctors, sometimes that is a sign of the sicker we are going to be. So consequently many doctors will even say, if you are ill, the last place you want to go is to go and see a doctor because you are not necessarily going to be better off by doing that.
The model views health as the absence of illness and only treats people when they are sick. That is what the medical model is today, is treating the sick. They know sickness and they know death, and I think that is the wrong philosophy. That is the wrong message in terms of what we should be doing in terms of communicating about preventative health.
The model also has a compartmentalized view of the individual and their body, wherein the body part in which an illness exists is treated without regard to the external determinants that caused the illness in the first place. It is the same thing in terms of when I referenced the food that different people would eat. Some people can eat food that is maybe not perceived to be healthy, but it is what each body does with that food and everyone is going to react differently. That is how I reference that in terms of how it is the external determinants that cause the illness in the first place.
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Population health, on the other hand, looks at an abundance of factors that determines health in an individual. It recognizes that as individuals we are not separate from the world we live or work or eat and what we eat and breathe in the world that we cannot control. In many cases we cannot. Our bodies have to adjust to our environment and what is in the environment that affects our health, and that includes what we eat and what we drink and how we deal with that and how the body reacts to that. The definition of health as the absence of illness does not fit into this model and the scope because this scope is far too narrow.
Back in 1984, the World Health Organization came up with a definition of health that is more encompassing. They defined health as, and I quote: the extent to which an individual or group is able on the one hand to develop aspirations and satisfy needs and on the other hand to manage or cope with the environment. Health is therefore seen as a resource for everyday life. It is seen as a positive concept emphasizing social and personal resources as well as physical capacities.
While this definition is long and difficult to operationalize, it gets across the point that health is important to everyday life, not just the absence of illness, and we can work to ensure that as individuals we remain healthy rather than simply seek treatment when we are ill. This will help reduce the demand for health care by making people healthier before they come into the current health system. This requires recognizing the vast number of determinants for health, and developing strategies.
I guess this bears some explanation in terms of often when people are sick or they go and see a doctor--the first place they go to, the first person they turn to--the first thing that the doctor does is prescribes a drug or some medication that the person who is dealing with this illness has to deal with. What happens is, because they make an interpretation on the basis of their diagnosis, what happens then is the drugs will throw that system out of balance, and it is only a matter of question in terms of really what the doctor is prescribing. Often the medication and the treatment that the doctor is providing is not healthy; it throws the body out of balance. Our bodies will react to what the environment is, and by changing that environment to what the doctor wants it to do is not necessarily going to work for that body because the body will react and counteract to what the doctor has given you and to correct that illness or that disease.
Hon. Harry Enns (Minister of Agriculture): Can you switch bodies?
Mr. McAlpine: The honourable member for Lakeside (Mr. Enns) suggests switching bodies. You know, I only have to deal with this lifetime, and I am sure that he has thought many times about living in the life--
Mr. Enns: Shirley MacLaine and I, we have been here many years, many times before. You know, I believe in--
Mr. McAlpine: Moving into the next life way before his time, and certainly I can appreciate he has that wisdom, I mean, being around here so long that he is able to do that. I have not reached that level yet, Madam Speaker, but I do appreciate his comments, and I hope that he will share them with me on other occasions as well.
Madam Speaker: The honourable member for Radisson, on a point of order.
Ms. Marianne Cerilli (Radisson): I am wondering if the member would entertain a question considering the fourth WHEREAS in his resolution. It talks about the numerous programs that the government has initiated in this area, and I am waiting to hear about them. We are wanting to hear about all the things that this government is doing in relation to health prevention and positive lifestyle. I do not know if that is part of his speech.
Madam Speaker: Order, please. The honourable member for Radisson does not have a point of order; however, is the honourable member for Sturgeon Creek prepared to entertain a question?
Mr. McAlpine: I think the honourable member, as you have ruled, is not in order. She does not have a point of order, and I am not prepared to. I am quite prepared to answer any of her concerns outside this time that is allotted to me. If she wants to do that, I am quite prepared to share my knowledge, experience and understanding of health. If she wants to learn from that, I am quite prepared to give her whatever time she would like.
Madam Speaker: The honourable member for Sturgeon Creek, to continue speaking to the resolution.
Mr. McAlpine: Madam Speaker, in terms of as far as our health care system in the province of Manitoba, and the honourable member does make some interesting points in terms of as far as we are talking about on all the things that the initiatives that we have to deal with in society, as an example, and something that she should be very much aware of, the Wellness Institute at Seven Oaks Hospital is an example. These are things, the wellness centre of the St. James Senior Centre at the Deer Lodge Centre.
Madam Speaker, the institute of these natures will provide a community outreach and education I think that we as a government are leaning towards and asking people to think about their health and take responsibility for their health, not what the honourable member across the way will do, to have somebody else do it for them. I mean that is the wrong message, that is what is wrong with society today, because every time they feel a little bit ill or something like that, the idea is to run to the doctor and go and support the medical profession and the drug companies.
You hear about the honourable members across the way talk about the drug companies and how big and bad they are. In some cases they are and in some cases they are not. But the thing is we have to take responsibility for our own health and with the initiatives that we are asking and in putting in place for people to think about their own health is what we have to communicate. Government cannot take responsibility or create health, nor can the medical doctors create health. As a matter of fact, too often, they know little about health, they only study about disease, and that is not what we are interested here when I talk about this resolution.
I am talking about preventative health, and that boils down to the matter of creating responsibilities. She talks about the other aspects as far as creating opportunities, or what has this government done, developing midwifery and providing the women greater alternatives for childbirth. Again, it is women who are about to give childbirth making the decision and taking responsibility for that childbirth, and I think that is really healthy, because they are taking responsibility for that.
The ambulatory cardiovascular educational projects at Brandon and Carman Hospitals, targeting most post heart attack patients, encouraging them to make lifestyle changes, delay the onset of heart disease, prevent complications and avoid hospitalization for hypertension. Madam Speaker, those are things where I think we are moving in the right direction.
We will not take total responsibility for health. I congratulate the Minister of Health (Mr. McCrae) in the direction that he is taking. It is not an easy task. We are spending far too much money on our health care budget today, at $1.8 billion and soon to be $2 billion. Well, we cannot as a population afford to do that.
I think what this resolution and what I am trying to communicate to all Manitobans is to create health in society, not to treat disease, because we are not going to win in society by treating a disease, for the simple reason that as soon as you go and treat a disease with a drug that deals with that disease, the body will react and create another difficulty with that disease.
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We are not talking about disease as such. We are talking about imbalance in the body, and you have to balance the systems in order to create health. Unfortunately, there are a lot of people who do not understand that, because they would much sooner look at having somebody else create the elements of health for them. All we are doing as a government is asking people to take responsibility and put less drain on the health care dollars in this province and create a healthier society in Manitoba. Thank you.
Ms. Cerilli: Madam Speaker, I am interested in listening to what the member has had to say. I have listened quite intently to the remarks from members opposite, and if I understand it correctly, what we are being asked to do in this resolution is to support the Department of Health in its endeavours in prevention of illness and the promotion of wellness and promotion of healthy lifestyles.
I completely support the sentiments that the member is putting forward, but the question I was asking was for him to get to the points that were alluded to in the fourth WHEREAS, which was talking about all these initiatives through the Department of Health and the wellness branch. The two that he did mention, one was the Wellness Centre at Seven Oaks, and I have to tell you, in the community what they call this is the wealthness centre at my end of town, because no one can afford to go there. The membership at that centre is extremely exclusionary when you look at the kind of initiatives that this government has had in terms of the north Y where, again, there was a community facility that they allowed to close down that would have dealt with health and wellness and fitness and lifestyle.
The other example that the member had to give to us when I asked to give some examples of all the things that have been going on in the Department of Health related to prevention and wellness was to do with midwifery. This is the government that is now sending women home after 24 hours of giving birth in a hospital. The failure rate of breast-feeding has gone up astronomically, and that is having a huge detriment not only to the health of the new mothers who are stressed out and do not have the time to ensure that their new child successfully begins to breast-feed, but the long-term health implications of not having breast-fed babies is going to be paid down the road 10 to a hundredfold because we know that healthy babies are breast-fed babies nine times to 10.
So we look at the kind of health policies that this government is coming down with that are basically trying to save some cash. What they are doing is in the end they are going to cost more money, because in the example of babies going home with their moms from the hospital after only 24 hours, they have to go back and are readmitted to the hospital. They have to go back and have other health care, and I know that is happening.
So on the one hand where there are positive things to be said for moving towards the option of having midwives operate in Manitoba--and I would completely support that--the policies of this government in terms of maternal health have not helped with either the health of the babies or the health of the mothers. It is those kind of policies, sending women home--not if it is a choice but just, you know, 24 hours, you are on your own--especially if they have children at home where there are other demands on them. I know that the success rate of breast-feeding has gone down in this province. It is a direct result of this government's policy, and it is going to have a long-term effect on the health of children in the province.
So those are the two examples that the member opposite has given us. I would have hoped that there would have been more perhaps that I had not heard of. I talked to a few people today if there are other things that have been done that would be related to prevention. I know that there were some nurse-managed clinics that were supposed to be brought in. I think there was supposed to be four but there have been one at the Youville Clinic. There has been some healthy heart programs, I understand, that have been brought in which was a pamphlet related to healthy heart. I think that there has been something done in the area of diabetes. Maybe the minister is going to give us more information on that.
There was supposed to be some deinstitutionalization for mental health patients. That could be a positive thing in terms of lifestyle, but what has happened is there has been deinstitutionalization with no supports in the community for these people. When you combine that with what they have done to the Pharmacare program and the delisting or the deinsuring of a number of drugs, the health of mental health patients has diminished because of the insecurity that they have of being able to stabilize themselves with the medication that they need.
The Pharmacare cuts and the deinsuring of medication under the Pharmacare program has also had ramifications for many other people. I have talked to diabetics in my own constituency who have talked about how it has been a huge stress, as well as impingement on their health, with the changes in the Pharmacare program.
Some of the other things that have gone on that have been a regressive step in terms of prevention and healthy lifestyles have been the limitations on eye exams. That is going to seriously affect the sight and the health of people in the province. When they eliminated the children's dental health program, again another preventative program to make sure that kids are getting checkups and are going to take care of their teeth, this government decided, oh, that was expendable. The same thing that they have done with limiting physical exams. Primary health care can be very preventative.
They are encouraging people to self-diagnose. I heard the member opposite's comments about people not automatically turning to the doctor every time they feel an ache and pain. I do not think we want to be having people avoid going to the doctor so that down the road they are going to have more serious medical treatment required when, if they had gone and caught something early with a regular checkup, they could have avoided more expensive hospitalization or treatment down the road.
They have had no real increase in public health nurses. That is one area that is recommended in a number of reports across the board. Also, people now have to pay for a flu shot. Again, the member opposite may have opposed the use of some things like flu shots, but having now a fee attached to it is not going to help with the number of families that need the protection that it would offer.
I could go on with a number of other things when you look at the health indicators in our province. The rate for sexually transmitted diseases is going up. The rate for teen pregnancy is going up. Obesity, particularly obesity among children, has gone up; it has doubled in the last number of years. More people are smoking at a younger age, particularly young women. All of these indicators are going up. They are all related to lifestyle and would be related to prevention of health problems. So maybe the Minister of Health (Mr. McCrae) is going to be able to list some other things that this government has done, but obviously the health indicators in Manitoba are getting worse. When you look at the diabetes and other illnesses, particularly among aboriginal people, there are serious problems in terms of lifestyle.
I think there are lots of things that could be done. I know in my role as the Fitness critic for our party that I have sat time and again with the Minister responsible for Fitness (Mr. Ernst). I have gone into the Estimates for Health, and I have asked about some specific programs. I know that our Fitness directorate in Manitoba, I think, is down to two people now. We have two people in Manitoba responsible for Fitness for the entire province. One of the things they do is certify fitness instructors, and the other thing they do is go and be a part of committees. But to implement any kind of cross-province program related to lifestyle is pretty difficult when you have only two staff for the entire province.
We could look at community health clinics. It would be a tremendous boost to be able to have a full range of health care professionals in a community clinic that could deal with the full cross section of health needs that we have. The member across the way had alluded to this in terms of our emotional, physical, intellectual and spiritual health, so that we have some fitness and lifestyle, dietitian, nutrition people in a community health clinic, so that when someone goes to the doctor, it may not necessarily be a medical-related solution that is found in terms of drugs or other kind of treatment. It may be that they get some kind of fitness and lifestyle assessment done, and that would be the prescription.
We have to look seriously at workplace safety and health and the implications that that has for prevention and lifestyle issues. We have to look at environment; the enforcement of environment regulations in this province has been abysmal. Issues like housing, the member for Brandon the other day raised an issue of two apartments in his constituency being condemned. We know there is a direct relationship to health, its being related to housing.
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Another thing that this government has gone nowhere on is employee fitness programs. That was a big trend back before I was elected. There was a big push, it seemed, to move in that direction to make sure that people had facilities at their workplace, that there was time allocated. This building, for example, I cannot understand why there are no showers here. That is one of the very small kind of things that can be done to encourage people to make time for fitness and health in their day. We have to recognize too that the costs are prohibitive and that, when people are on social allowance--single individuals are expected to live on $411 a month--there is not much money for a lot of individuals to be able to afford things like cross-country skis or a membership to the Y or even running shoes that are going to be good for them to use to exercise. There has to be some recognition in medicare and coverage of things like fitness tests and fitness assessments. I think there is only place in Winnipeg where you can get a fitness test covered.
I think we have to recognize too that if we are really going to have prevention, a focus on prevention in our health care system, then it means that we have to recognize that there are costs that go along with lifestyle choices, healthy lifestyle choices.
I know that I am a member of the Y downtown. I think it costs me almost $450 for a year membership, and that is something that I know a lot of people could not afford. When we have the Y in the north end that is closed down, it seems like this government has just had no concern about that in making sure that there are accessible facilities like the north-end Y available in every community.
In my own area, North Kildonan, they are opening this month the Chief Peguis fitness centre, and it is going to be a co-op that is operated in co-operation with the Parks and Recreation branch with the city. I think they are endeavouring to ensure that that is going to be very much accessible to the community with, I think it is, a $2 fee for students. I know that at the Y it is $10 for a drop-in, so that is quite a difference, but even for a youth, $2, when you are 14 years old, can be a lot of money if you want to go there two or three times, four times a week.
So we know too that this government has sat by while poverty has increased in this province, and I have not had a chance to talk about the effects of poverty on health, and one way that they could deal with prevention is to do something about the increase in poverty. But I see that my time is up, so I just want to await the comments from the Minister of Health (Mr. McCrae) and see if he is going to tell us about any other initiatives through the Wellness division of his department that could give us something to support. Thank you.
Hon. James McCrae (Minister of Health): Madam Speaker, I would like to begin by offering a commendation to the honourable member for Sturgeon Creek (Mr. McAlpine) for seeing to it that honourable members in this Legislature have an opportunity today to discuss the issues that are referred to in the resolution that he has placed before us.
I think you would not have to go much further than virtually any constituent in the constituency of Sturgeon Creek to find out about the commitment of the honourable member for Sturgeon Creek to the health of his constituents and the health of Manitobans generally. I believe the honourable member has become extremely well known for his efforts in this area.
I had the privilege just a week ago to be a witness to some of the work of the honourable member for Sturgeon Creek when he and I and the honourable Minister responsible for Seniors (Mr. Reimer) attended the grand opening of the newly renovated and expanded Metropolitan Kiwanis Courts. After a very difficult and challenging set of issues, we were able, working with the community, to bring about an amicable solution or a consensus with the assistance of certain very key people in the community, bring about a solution that seems to meet with everyone's approval. It was a very happy occasion and just one rather significant example of the kinds of things that can happen when you put a person like the honourable member for Sturgeon Creek to work on an issue in a constituency.
So I am sure I am joined by hundreds if not thousands of residents of the city of Winnipeg and particularly those of the constituency of Sturgeon Creek when I offer a great big thank-you to the honourable member for Sturgeon Creek for his efforts.
I listened to the honourable member for Sturgeon Creek's contribution to this debate today, and I listened to the contribution made by the honourable member for Radisson too. There were many positive things referred to by both honourable members, but what came through for me as I listened to the two was an obvious difference in approach.
The approach taken by the honourable member for Sturgeon Creek (Mr. McAlpine) seems to be predicated, to some extent at least, on the principle that all of us are here and all of us have to take some responsibility for our own health, too. From the day one is born, Madam Speaker, we make that part of our life's work, to ensure that the health of ourselves and those near and dear to us is safeguarded to the extent possible. Then I listened to the honourable member for Radisson who, while saying I think a number of positive things and identifying a large number of very positive programs that the government is involved in, somehow left me with the impression that her approach is predicated on the principle that the government is responsible for every part of our existence.
Even the honourable member for Brandon East (Mr. Leonard Evans) does not agree with that one. The honourable member for Brandon East, I know, agrees that we do have to take some responsibility for our own health and our own well-being. But I do not fault the honourable member for Radisson because the honourable member for Radisson clearly wants to achieve the same kinds of ends that the honourable member for Sturgeon Creek and I want to achieve, and that is a perfectly healthy and balanced population with each of its members being in a healthy and well state of being. So the end is the same for all of us; the means seem to be somewhat different.
At a time when the honourable member for Radisson (Ms. Cerilli) gives us a virtual catalogue of all the very, very positive things that we are doing in health care and in our social service sector in Manitoba, she manages somehow to bootleg into that discussion some kind of a negative comment on each and every thing. That only bespeaks a negative attitude. But what cannot be glossed over, even by the honourable member for Radisson, is the virtual catalogue of programs that she has mentioned in the course of her comments. She talked about nurse-managed care. She said, well, we got some but we do not have enough yet. Well, I can say that too. I will be happy when we have much more nurse-managed care and a much more integrated and team approach to wellness and health in Manitoba. So we are on the right track is what the honourable member for Radisson seemed to be saying and seemed to be encouraging us to carry on, which is what we are doing in places like Thompson and Parkland and Norman.
The honourable member for Radisson talked about healthy heart and diabetes programs. The honourable member for Brandon East (Mr. Leonard Evans), I believe, was with me just a couple of weeks ago when we officially opened a new service in Brandon in partnership between Brandon General Hospital and Manitoba Health dealing exactly with heart health and dealing with issues related to diabetes. People working there are nursing and other professionals who work with people to assist them to ensure that they do look after their hearts and that they look after the health of their heart. Diabetes education is offered there and nutritional advice is offered there, and it was generally agreed by everyone there that it was an excellent thing to do. I guess I should be thanking the honourable member for Radisson for calling these things to the attention of the people of Manitoba because, as I say, Manitoba Health is a partner in these things.
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The honourable member referred to mental health reform, and then made the comment that there are no supports in the communities. Well, here again, just open up the middle of your Winnipeg phone book, Madam Speaker, and have a look at all of the services in mental health that have sprung up since the advent of mental health reform in Manitoba. That just gives you a partial list of all the services that are available to people in our communities not only in Winnipeg but throughout Manitoba. I think we have some 52 new services opened up in mental health to replace the institutional care that is being wound down at Brandon Mental Health Centre. She, in passing, referred to housing and made some kind of negative comment with respect to the fact that two apartment buildings in Brandon were condemned. Well, the fact is, who do you think condemned them? Manitoba Health. If you did not have a Manitoba Health out there doing that sort of work, there would be no message to other landlords in Manitoba about the kind of conditions that they should be providing for their tenants in exchange for the rent that they receive. So in that area and in other areas of housing, there are indeed activities going on supported by or actually performed by the government of Manitoba.
The honourable member referred to Pharmacare. Now, I have to hesitate when I talk about Pharmacare when it is raised by the honourable member for Radisson (Ms. Cerilli), because the last time I did I nearly had some serious problems. Sufficed it to say, the Pharmacare program in Manitoba is one of the purest expressions of an old principle, and that principle can be summed up by saying that from each according to his or her ability, we should direct our resources to each according to his or her needs.
That is exactly what you see in our new Pharmacare program, and it is passing strange that the honourable member for Radisson, of all people in this House, should mention Pharmacare in any further contributions she makes in debate in this House.
She referred to a number of other programs. She referred to the fact that there ought to be more work done in the area of sexually transmitted diseases and teen pregnancy and obesity and smoking and all of these things. If you go through all that list, on each item ask yourself, what responsibility does the individual have in each of those areas? Is there any responsibility whatever on the part of the individual citizen of our province, or are we supposed to try to meet the expectations of the honourable member for Radisson, which would have government involved in every aspect of your life from the moment you are born until the moment you leave this Earth?
Even you, Madam Speaker, I suggest, would object to having government involved to that extent in your life. Yet that is the message we get from the honourable member for Radisson, unlike the positive message we get from the honourable member for Sturgeon Creek (Mr. McAlpine) which says, take a reasonable amount of responsibility for your own health. Do those things that common sense tells you makes sense to do. Do not do those things that common sense tells you you should not be doing. After all of that, there is a place for a health care system, and that is what governments across this country continue to try to sustain and preserve so that there will be health services for people who need them after all else has failed.
I think that any comment in this debate that leaves out a comment about the role of the federal government would not be complete, and I may not have heard all the words of the honourable member for Sturgeon Creek, and he may well have canvassed this carefully, but if he did not and if I do not get enough time, perhaps our colleagues from the Liberal Party will participate in the debate today and will remind us about the role of the federal government in health care in Canada and in Manitoba.
The only thing about this resolution that I take issue with is the first WHEREAS, which says that the federal government has announced a reduction in the level of transfer payments.
An Honourable Member: Well, they have done it, have they not?
Mr. McCrae: That is the point. The honourable member for River Heights (Mr. Radcliffe) says, well, they have done it, have they not, and the honourable member for River Heights is correct.
Now, it may be a function of when this resolution was drafted, I am not sure, but for years now the federal government, the past one and the present one, have been taking very large amounts out of social transfers for provinces like Manitoba, and any discussion of this that leaves that out is incomplete, Madam Speaker. Unfortunately sometimes honourable members in the New Democratic Party tend to gloss over that. The Liberals, of course, prefer not to talk about it at all, but the New Democrats gloss it over as if all of the problems that we encounter in health care and social services are the sole responsibility of the provincial government.
We are certainly prepared to take our share of responsibility for those things that are our responsibility and, if we fall short, we are prepared to be shown up for that and to make improvements where that is called for but, because this is an ongoing issue. Let us not forget. I do not mean necessarily, Madam Speaker, to make this into a partisan shot--[interjection] The honourable member for The Maples (Mr. Kowalski) says that I am already too late and I have already done that. But what I mean to say is that the reality is, for better or for worse, for right or for wrong, leaving the partisanship out of it, the dollars from Ottawa are indeed shrinking.
Even a Liberal is going to have to acknowledge that. Those dollars are shrinking. Our Liberal Premiers from down east and their Health ministers certainly like to talk about it a lot, so why do honourable members from the Liberal Party in this House not screw up their courage and just make passing reference to it at least?
But the point I make, Madam Speaker, whatever the reasons for it, whatever the history behind it, it is a reality, and I wish honourable members in the New Democratic Party would come to terms with the fact that we live in a real world, not in some airy-fairy, Alice-in-Wonderland world of 50 years ago when the manifestos and all these things were coming out and when all the partnerships with organized labour were happening. Read The Globe and Mail of a couple of days ago. There is a bit of a precis of a book written by the Honourable Bob Rae, former Premier of Ontario, and it will tell you about the mistakes that New Democrats when they get belly to belly and toe to toe and chin to chin with the leadership of the labour movement, because when the labour movement goes down, so does the NDP. That is what happened in Ontario, and that is what we are going to continue to see happening in Manitoba. Thank you very much.
Mr. Gary Kowalski (The Maples): Madam Speaker, it gives me pleasure to rise and talk about this resolution. There are parts of this resolution that I could support very strongly, and the Minister of Health (Mr. McCrae) asked me to talk about the first WHEREAS. I think the member for Morris (Mr. Pitura) quoted me the other day about talking about my roots. My roots as a Manitoban run deeper than any other roots, so I always stand up for Manitoba first.
But I also remember as a school trustee that, when we were facing revenue cuts from the provincial government, we could have whined and cried about it, but instead we went on from that and said, okay, this is the reality; let us get on with the job of working with what we have. I would be the first one to scream and cry for more funds from the federal government and making sure that we have our share; but, once having said that, now we have to work within what funds we have. So enough said on that subject.
The second WHEREAS, "WHEREAS given reduced financial resources to devote to the health care system, emphasis must be placed on prevention of illness as opposed to the treatment of disease," I think that WHEREAS can be taken out because, whether or not we have reduced financial resources, the prevention of illness as opposed to the treatment of diseases should be the case, regardless of how much funds we have. Why wait until there is disease before we deal with the matter?
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I think the member who moved this resolution mentioned the Seven Oaks Wellness Centre, and that happens to be in my constituency. I was at the sod turning, not that it was announced that my presence was there, but I was at the sod turning, and I have had an opportunity to tour the facilities and wonderful facilities they are. There is some reluctance in my community about paying the fees for the Wellness Centre, and when I mentioned that to my father who is a person who attends the Reh-Fit Centre, he said, what are people complaining about? The fees at the Seven Oaks Wellness Centre compare to the Reh-Fit Centre, compare to any private health spa, and as he said, people will gladly spend $2 a day on cigarettes, but then they object to spending $41 a month on wellness at the Wellness Centre.
I think some of the reluctance of members of my community to pay the fees for the Wellness Centre is the philosophy that this is attached to the hospital, and for some they view this as part of the health care system. Of course there is always a concern about user fees being introduced into the health care system, but once people get past that concern and they look at investing in their wellness, I think $41 a month, which is the fee for belonging to the Wellness Centre, is more than reasonable.
Members of the House may have noticed a dramatic change in my condition over the last several months. I have lost 25 pounds. I am now decided that before I turn 45 this year I want to run a Manitoba marathon, so I am in training for that.
The idea brought forward in this resolution about an emphasis on wellness and prevention can be supported, but there are some concerns and I would address them further, but I know the member for Brandon wants to put a few comments on the record in regard to this resolution, so with those few words I will conclude my remarks.
Mr. Leonard Evans (Brandon East): Madam Speaker, I rise to add a few comments to the debate on this particular resolution which is very difficult to oppose. I think everyone in this House supports the need to enhance prevention of illness, to do more to prevent disease and indeed support the Department of Health in some of its programs. I have no problem with some of the initiatives that the honourable minister and his government have taken.
He mentioned the wellness centres in different places, and indeed the one in Brandon. I think Prairie Health Matters is the name they have given to it, and in co-operation with the Brandon General Hospital, the Department of Health has established this centre which goes beyond a heart program, a well heart program. It goes into diabetes, and it is an extension, as I understand, of the heart program that was operating previously at the Brandon General Hospital, the ACE, yes. Also the breast screening program, I do not believe he mentioned it, is a great program, and we had many words over that a couple of years ago urging the government to get on with breast screening for cancer. I think there is more and more evidence that that type of a program throughout wherever it exists does help to detect cancer at an early stage and hopefully to correct cancer in the women unfortunately afflicted with that disease.
Having said all that, I just want to comment that governments that I have had the privilege of being with years back, both under Mr. Schreyer and Mr. Pawley, took a number of initiatives to promote wellness and to encourage people to live healthier lifestyles, but it goes beyond medicine per se. It goes into so many facets of our society. Housing, for instance, is one element, and I think it is hard to tell our citizens and encourage them to be living a very healthy lifestyle without adequate housing. It is extremely important, especially in our particular climate, and we had a massive program of social housing in both the Schreyer and the Pawley years.
We developed nursing homes. We provided a generous program of social allowances to help poor people have sufficient income with which to live. We set up a series of community clinics including the one that is called Klinic. I believe it originally was funded back in the Schreyer years. I would also remind members of the House that we initially brought in the Pharmacare program. The Pharmacare program was set up in 1973, and indeed it is a program of purchase of drugs, but it is indeed very, very important to enable people to take the medicine that their doctors have prescribed so that they can hopefully not get any worse, hopefully be able to cope with their illness so that they can stay out of an institution. We have lots of examples we can give, I am sure, members on the other side, of individuals who because of certain kind of medication are able to live longer or are able to live without having to go into a nursing home or be rushed into a hospital.
I have many constituents who have written to me who have complained about the cuts in Pharmacare and how they have hurt them particularly, and what bothers me is that there is a marginal group there who, having to pay more now for medicine because of changes in the program, will not obtain the medicine that they should. They will make a choice and make a choice of spending the money elsewhere and not taking the medicine that they should be taking according to their doctor's instructions because of the cost.
There are many things that the government can do, that we can do, through government to help prevent disease from occurring in terms of education of people. Lung cancer I notice surpassed breast cancer among women. It is the leading cause of premature death among women, and certainly more can be done and should be done to prevent smoking, to curtail smoking. The honourable member says it is individual decisions that have to be made, and indeed that is one important individual decision that we should encourage our citizens to make, and that is to stop smoking. Also, there could be in this area, I think--prevention program should particularly be targeted to young women, to girls, young women, because there seems to be some evidence that smoking continues to be prevalent, indeed, may be increasing.
There are other programs for eating disorders, and these are educational programs we are talking about--eating disorders--especially required for adolescent girls. There are no programs currently available other than there is one counsellor at the women's health centre and two user-pay counsellors are available, and there are very extensive waiting lists apparently. More has to be done to help these people cope with bulimia and anorexia nervosa. If we want to take a holistic approach, as I was suggesting a moment ago, we should note that there are long waiting lists for women's counselling services all over this province. If we can eliminate those waiting lists and provide the service to those women, we might help them lead a healthier lifestyle.
Elderly women living in poverty--75 percent of women live the last 15 years of their lives in poverty, and this is terrible. How can we expect them to afford the food that is essential to healthy living and their well-being? As a matter of fact, Madam Speaker, there is a lot of data, many statistics show that there is a direct correlation--
Madam Speaker: Order, please. When this matter is again before the House, the honourable member for Brandon East will have nine minutes remaining.
The hour being 5:30 p.m., this House is adjourned and stands adjourned until 1:30 p.m. Tuesday next.