Hon. James McCrae (Government House Leader): Madam Speaker, would you be so kind as to call Bill 35.

Bill 35--The Mental Health and Consequential Amendments Act

Madam Speaker: To resume adjourned debate on second reading, on the proposed motion of the honourable Minister of Health (Mr. Praznik), Bill 35, The Mental Health and Consequential Amendments Act (Loi sur la santé mentale et modifications corrélatives), standing in the name of the honourable member for Kildonan (Mr. Chomiak), who has 10 minutes remaining.

An Honourable Member: No.

Madam Speaker: No? Is the House ready for the question? The question before the House is second reading of Bill 35, The Mental Health and Consequential Amendments Act. Is it the will of the House to adopt the motion?

Some Honourable Members: Agreed.

Madam Speaker: Agreed? Agreed and so ordered.

Hon. James McCrae (Government House Leader): Madam Speaker, I would like to announce that the bill just passed, Bill 35, would be among the bills referred to the Law Amendments committee, Friday morning at 9:30. I just look to my honourable friend from Burrows for confirmation that that is our understanding, and that being the case, Bill 35 would be on the list for consideration with the other bills at Law Amendments, Friday morning, 9:30.

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Mr. McCrae: Madam Speaker, I move, seconded by the honourable Minister of Natural Resources (Mr. Cummings), that Madam Speaker do now leave the Chair for the House to go into Committee of Supply to consider the resolution respecting the Capital Supply bill.

Motion presented.

Mr. Doug Martindale (Burrows): It was my understanding we were doing concurrence. [interjection] That is the same thing. Thank you.

Motion agreed to.

COMMITTEE OF SUPPLY

Capital Supply

Mr. Chairperson (Marcel Laurendeau): The Committee of Supply will come to order, please. We have before us, for our consideration, a resolution respecting Capital Supply. The resolution reads as follows:

RESOLVED that there be granted to Her Majesty a sum not exceeding $124,766,000 for Capital Supply for the fiscal year ending March 31, 1999. Shall the resolution pass?

Mr. Leonard Evans (Brandon East): Just on a point of order, it says no debate if the 240-hour time limit has expired. Has the 240-hour limit expired?

Some Honourable Members: Yes.

Mr. L. Evans: So there is no debate.

Mr. Chairperson: For the member for Brandon East's information, the 240 hours has expired, so this is not a debatable motion.

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Mr. Chairperson: Shall the resolution pass?

Some Honourable Members: Agreed.

Mr. Chairperson: The resolution is accordingly passed.

Concurrence Motion

Hon. James McCrae (Government House Leader): Mr. Chairman, I move that the Committee of Supply concur in all Supply resolutions relating to the Estimates of Expenditure for the fiscal year ending March 31, 1999, which have been adopted at this session by the three sections of the Committee of Supply sitting separately and by the full committee.

Motion presented.

Ms. Jean Friesen (Wolseley): Mr. Chairman, I have some questions for the Minister of Health (Mr. Praznik). The Minister of Health I think is well aware of how my community has expressed its concern about the closure of the Misericordia Hospital and about the concerns amongst senior citizens in particular, and those who are without telephones and those who are without cars, at the loss of a hospital in their midst, a hospital of which they have come to depend upon and to which they feel very close.

The minister is aware that I have spoken on a number of occasions about the way in which this closure was accomplished. In the minister's own riding, I know that the health authority is doing health assessments. He has been doing health assessments of the community for over a year. Local meetings have been held in Grand Marais and elsewhere.

That was not accorded to my community, but resources were taken away before any health assessment was done, a health assessment which could have looked at the economic conditions of people in the area, of the way in which people had related to the hospital, of the patterns of usage of that hospital, of the percentage of surgeries which are done in that hospital, and the way in which those relate to the community and to the community's accessibility to hospital services.

That was not done. It is being done elsewhere in Manitoba. It was not done in my community, but before even any health authority could be put in place, before the health authority even had--and I will give them the benefit of the doubt--the intention to conduct any of these assessments, the resources were taken away from the hospital, and it was essentially to be turned into a long-term care facility. That is one of my serious concerns. I think it is a deliberate choice on the part of the government. I have called it asset stripping, and I think that is what they have done in the health facilities of my community.

I want to draw to the minister's attention, in particular, two letters. I have chosen two. They are not the only ones I have received. I am sure they are not the only ones the minister has received, but they are representative of the way in which people think and speak of this hospital and of the services they have received there.

One letter from a gentleman on Furby Street speaks of the emergency room that he went to with an ulcer and an infected gall bladder that came up very suddenly. He was kept in for a week and recovered and thankfully is back at home. He says: What would happen, how many deaths will occur because the people who walk into the new urgent care facility will lack equipment, people and beds? With this hospital gone there is no hospital in the downtown area to serve those with low income, and less access to cars and funds for taxis. He believes that the minister is deserting those most in need of care. They will probably wait longer for care because of the extra expense, and this will make healing them even more expensive. It will also make it more difficult for family and friends to visit and to keep their morale up for the same financial reasons. This is not good health care, he says.

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Another family of senior citizens on Fawcett Avenue writes to me and said: As do many neighbourhood senior citizens--and, Mr. Chairman, I can certainly add my confirmation of that--we depend on the close proximity of the Misericordia General Hospital. We have had two emergencies requiring immediate attention. Recently, due to dental surgery a day earlier, an artery had bust unexpectedly in my mouth, my constituent writes. I would have bled to death, he said, had I not received emergency surgery at the Misericordia General Hospital. They go on to speak of the conditions that they had found at Health Sciences Centre.

I know that the minister has received this letter or at least it was certainly also sent to him. I want to ask the minister if he can first of all tell us and tell these people who have depended upon the Misericordia what is meant by the urgent care centre that he is to establish there? How will that serve the needs of people, representatives of whom I have spoken here?

I would like to ask the minister to tell me, too: what kind of surveys, what kind of research did he do? What kind of examination did he do of the health care needs of the inner city that led him to believe that the best answer to those needs was the closure of an inner city hospital?

Hon. Darren Praznik (Minister of Health): Mr. Chair, first of all, I appreciate where the member for Wolseley is coming from. As the MLA for this constituency she obviously has a duty and responsibility to ask the questions behind the decision that was made. I say very clearly. It was a decision made by government together with the Winnipeg Hospital Authority for the larger planning scheme for Winnipeg hospitals in delivery of the service, and I accept that responsibility.

I appreciate her role and her responsibility to ask these questions on the part of her community and her constituents who are very close geographically to that particular facility. But if one accepts the principle that everything that is has to remain without change and that the fact that a hospital has been there for some 100 years means it has to or is required to be there forever, or that particular level of service in living so close to the hospital is the standard that all are entitled to, this province would not be able in any way to guarantee that same standard even to everybody in the inner city.

Mr. Chair, there are very few places in this province or even in the city of Winnipeg that have that kind of close proximity to the hospital. People in those areas become ill. People in those areas are poor and do not have cars and have to have health care needs. They go to other facilities, and, you know what, they survive, they are treated, and they are treated well. So I appreciate the benefit to having a hospital right next or almost next to one's door, but that is certainly not the norm for most Manitobans and most Winnipeggers.

The rationale behind the change that we undertook is a very simple one. We have, in Winnipeg, seven acute care facilities. The needs in acute care have certainly changed. They have changed for one reason, a very significant one, because of medical technology, the advent of laser surgery. A whole host of other new diagnostic and treatment tools mean that people do not require as long of stays in acute care facilities and that the need in our system, what has put pressure on our system, by and large, has been a shortage of long-term care beds--and we can debate decisions on freeze and rationale, and I accept it, that is fair debate--but the need has been for long-term care beds, and that within our system--and this is not Darren Praznik speaking, these are the people who manage our system. They say to me, the physicians delivering programs and the administrators say to me, that we did not require that capacity of beds if we are using our beds correctly and we have the additional long-term care beds in our system.

We also faced another issue with respect to the Misericordia Hospital. Of all of our urban facilities, of the nine urban facilities, Misericordia is probably the one, with the exception perhaps of Health Sciences Centre, that is our major tertiary hospital, that is in need in the long term of a great deal of capital expenditure. It is an old building. It has many old components to it that need to be replaced. It needs capital expenditure to be able to live up to fire and safety standards.

So we do not require seven acute care hospitals in our system. Misericordia has some of the oldest infrastructure in need of major capital investment. So, if you are going to make that capital investment, you want to make sure you are making it where you really need it, not just to necessarily maintain a facility for the sake of saying we have it when it may not be needed within the system or is not necessarily needed within the system. The third part is that we have three downtown hospitals in Winnipeg.

You know, I walk by the Misericordia on occasion in the evening, and from the Misericordia Hospital, particularly from the roof of the Misericordia Hospital, you can see two tertiary hospitals. It is not as if that part of the city does not have access to hospital care. In fact, it has access to our two tertiary hospitals, a relatively close access. In fact, probably much closer access than many other poor areas of the city of Winnipeg.

So let us not for one moment--I appreciate the sensitivity in the Wolseley area, and I appreciate her responsibility as the member for that community, but in the larger picture one has to put that into context. So just simply for those factors, the need to get the right number of tertiary care or acute care facilities, the needed capital renovations that would be at that particular facility, and the fact it was in the inner city with two other hospitals, St. Boniface and Health Sciences Centre, already relatively close or in that area serving those communities, made it the candidate, in essence, for change.

I say to the member for Wolseley that I have had many people involved in health care planning for both Conservative and New Democratic Party governments over the last while speak to me and tell me that dealing with the Misericordia Hospital has been an issue in government and in health planning in this city for over 20 years, and it has never been able to be resolved because of the politics around the Misericordia Hospital. What we have managed to do with the Winnipeg Hospital Authority--and their recommendation to me was that we take exactly this approach. That is why Neil Fast and I, Neil Fast being the chair of that hospital authority, actually put the proposal together and visited the bishop early last fall to make this proposal to their board, because it made sense for the whole Winnipeg scene.

So, in that context, I think it is a very justifiable decision. It is a logical decision, given the overall planning, and although I appreciate the loyalty of many patients and I appreciate how wonderful it is to live in a neighbourhood that has a hospital located in it, ultimately the responsibility for myself as minister and for the Winnipeg hospital system is to build a system for the whole city and do it on a logical basis.

So the advice from our planners, the advice from people working in the system, was that this hospital needed to find a role. One thing I am very proud of in all of this is that, unlike, I think, attempts in the past to deal with the future of the Misericordia, we recognized that just the closure of that facility, the elimination of it was not a good idea. First of all, one would lose the support base around the Misericordia, that there were health needs in the Wolseley area of that city, and that the central location of that facility did provide some tremendous advantages to the Winnipeg Hospital Authority in providing particular ambulatory services to the whole city and even some provincial programs because of the location and the parkade, which made it a very likely site and an easily accessible site in terms of the geography of the city. Far better than putting some of those services in any one particular community hospital where they would be a long distance from other quadrants of the city.

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So we did make a proposal to give the Misericordia a new life, and we did, in a lot of discussions with them and within the Winnipeg Hospital Authority, develop a plan that would see them become essentially a long-term care facility--in fact, the largest one in the province--and its parking facility and location made it very desirable from that point of view.

We have talked about it as being a home for a host of ambulatory programs. Some of those have been identified; others, we are working on. I suspect there will be a continuing change in that as new needs and opportunities arise. But, with respect to the primary urgency care centre, what we envision--and I know there is a lot of concern around title, and the member for Crescentwood (Mr. Sale) shared with me a document that had been put out by the WHA that left some concern and that I think it could have been better phrased. But our intention is to have a facility in that area that does really two things. One is to be a primary health care clinic with a wide range of physician services with the ability to see physicians for one's primary health with nurses, other health care providers, so that it becomes an easily accessible place for health care, and the second part of this is to have an urgency care capability. Defining that further, identifying what will be in there is part of what is going on now, but I would like to ensure that it has as many urgency care services as possible, that it be on a 24-hour basis.

The difference, I guess, is with emergencies. Emergency in the true sense is there to be able handle trauma and a variety of things that, quite frankly, often end up at the Health Sciences Centre, because that is where our trauma capability is, that is where our high tertiary capability is, et cetera. But many of the things just below that in terms of emergency or urgency rating should be able to be done at that particular facility.

One of the issues, of course, is holding beds, observation beds, which may work itself into that configuration, and that is part of the discussion that is going on to make sure that it is a highly used and relevant facility, not just to her constituents--and I appreciate her asking because it gives me an opportunity to talk about this in a public form--but we also envision that that facility has the potential to provide some citywide services. It has been identified by the WHA as being the home or situated with it is the sexual assault receiving area, so that victims of sexual assault will be treated in a facility other than an emergency room because that often creates a fair bit of concern and discomfort for them, so that sexual assault cases taken by the police or others could be directed there. They would specialize in that particular service.

We have also identified that internally as having the potential to be a flu clinic in flu season, so that it can gear up and staff up to deal with people wanting in for treatment for the flu. That is very important. We had success in some of the clinics we ran, particularly in Courts of St. James last year. So we see that as another purpose. We want to keep it open enough to add services to it. There is a great potential, I think, to see it be an urgency primary care facility, those two kinds of roles, 24-hour basis, access to the community.

The other component I mentioned to the member is that the WHA is now looking at its interfacility transfer arrangements, because we recognize, as you change and specialize the functions of facilities, people will access a facility. They may not be able to be treated in that particular facility, particularly if they need some specialty care, and part of how we transport is being addressed. A transport service of some type is being contemplated, and it is part of that planning. So, if someone does walk in with a condition that ultimately cannot be treated there or requires a medical or surgical bed, they can be stabilized in that particular setting and transported to the appropriate facility or emergency room, quite likely the Health Sciences Centre, which is almost within eyesight of the front of the Misericordia Hospital.

I say this sincerely to her and the member for Crescentwood (Mr. Sale), despite the debate that we have had over how one achieves that goal--I do say this sincerely to her and the member for Crescentwood and my colleague the member for River Heights (Mr. Radcliffe) and for Fort Garry, as that facility grows and develops, there is, I believe, a fair bit of room for the four MLAs from that area to have some input and participation in helping with the community to find the roles it needs that that centre will be there. I do not want to say to her today that everything is hard and fast and written in stone. There is evolution, but it is our intention and our purpose--and we intend to support that financially--to make that a highly successful primary health care and urgency care centre.

Ms. Friesen: Mr. Chairman, the minister may be able to see two hospitals from the roof of the Misericordia, but those hospitals have people on their waiting list, people in hallways, people who are there for 48 hours, 72 hours, waiting on gurneys in hallways. This is what you see from the roof of the Misericordia. It is not a system which is open to accepting all of the people who arrive there by taxi or by bus, or who do not have the facilities to go and come that other people do, so the minister is painting an extremely rosy picture of the ability of the existing facilities to take the traffic, to take the patients that the Misericordia has taken in the past. Twenty-one percent of surgeries, the second or third busiest emergency room in the city, those are the statistics that have always been there, that have not gone away from the Misericordia. The minister is essentially giving me a response based not upon medical service but upon location and age of building.

What I am asking for is an evaluation of the health needs of that community and of the ability of hospitals and clinics in Winnipeg to meet the needs of that community, and I do not think the minister has addressed that at all. What he has addressed is a planner's dream of age of building, fire codes, safety codes. I remind the minister that in Europe and parts of the United States, there are hospitals which are many, many years--perhaps even centuries--older than the Misericordia, which are still giving good service to the citizens of inner Paris or inner London. So the age of the building to me is not the issue. There has been a great deal of capital work at the Misericordia Hospital, the creation of new wings of the hospital. In the 1960s there was reconstruction of the kitchens, a very modern kitchen that was put in, I might remind him, by one of his own predecessors, Don Orchard, so I am not sure that that argument holds water at all.

What my constituents are concerned about is that they are not going to get the service no matter where. It is not just that you are taking it away from a, quote, very convenient location, but you are distributing it to hospitals and to institutions which are not capable of meeting the needs. I think we have raised that not just on behalf of my constituents, but on behalf of many people over the last number of months in this House.

I want to ask the minister finally if he can tell us, because there is a great deal of confusion about what the urgent nonemergency care centre is going to mean. It is clear from the minister's answer that there are many possibilities, and I appreciate him putting that on the record.

There are certainly many ways of looking at this, and it is not yet decided. The minister indicates that the community--I expect that, when he says MLAs, he means the community, I hope he does, and, certainly, I know that all of us, including those on his side of the House, would be very interested in taking part in that. I should remind him that so far we have not--the community has not been invited, has not been spoken to, has not been consulted, not even constituted part of any consultation on the future of any part of the role of the Misericordia.

So this is a first, and I certainly appreciate the minister, some years into this process, effectively offering that opportunity. It certainly comes again after the assets have been stripped and after the options for the Misericordia and for the health needs of the community have certainly been narrowed. I would like to ask the minister what he exactly believes is the situation at the Misericordia today. Is the emergency department open 24 hours? Is it able to accept patients to be admitted to the hospital from emergency, or is it simply now a triage system where they are sent to other hospitals? If that is the case, how long is that situation going to last, when does the transition occur to urgent, essentially, outpatient care of a 24-hour variety? When do these shifts occur, and how are people going to be informed about them? Is there any time in that period, in that shift, for any kind of community consultation?

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Mr. Praznik: The member has flagged a number of issues that I would like to address again in context. I appreciate her comment about people saying, well, will I get the service at the other hospitals, is there room? To answer that I think one has to understand the complexities in the world in which those facilities are operating today. The problem in our other facilities, in terms of shortage of beds, has very much been the need to use primarily medical beds, at one point nearly 300 of our 700 medical beds in the Winnipeg hospital system to house those individuals waiting for long-term care. With the announcement--and members opposite may criticize us for not having done it earlier, and that is part of fair debate, and there are reasons we would argue why that could not be done, but that aside--those additional 550 beds, the vast majority of which are being built in the city of Winnipeg, will go a long way to taking that pressure off the current use of hospital beds, not for the purpose for which they were intended.

So, quite frankly, that should free up a major number of beds in those facilities. Part of the Misericordia plan, as well, is--and she has referenced the capital works and investments, and quite rightly so, that have been made in that hospital. I imagine the Cornish wing was built in the '60s; it looks about that vintage. Those parts of the facility, quite frankly, are surviving. In fact, they will have significant renovations, some of which I understand are being discussed to begin this fall, as we are doing the safety and fire upgrades to complete the entire renovation at one time, which is more cost-efficient. The Misericordia plan will have 280 long-term beds and approximately 170 or 175, depending on how the architect's work comes out, transitional beds. Those transitional beds, in essence, are for people who are waiting for placement in the personal care home of their choice.

Right now we house those people throughout our hospital system in Winnipeg. The plan here--and some of that will begin this winter, and I will touch upon that in a few moments--is to be able, as those beds are available, to move those transitional patients, in essence, to the Misericordia, thereby freeing up medical beds in other facilities.

With respect to emergency and concerns that emergency wards across the city, I do not have the numbers in front of me. On our analysis of what emergency wards are being used for today, there is a high preponderance for people to use those wards to visit doctors, not being an emergence situation or even an urgent situation. We have also found that many hospitals use their emergency wards for admitting, both of which tend to not be efficient uses of a true emergency room.

Part of the plan with the Winnipeg Hospital Authority is making some of the adjustments and changes which will quite frankly get better use out of our existing emergency rooms in the system. Developing and using primary health care/urgency care clinics or facilities also, I think, will take pressure off emergency rooms because that is where you go if you are sick, your child is sick with the flu, maybe you have cut yourself and you need to be sutured. Many of the minor things that tend today to plug our emergency rooms, particularly in emergencies where you have trauma coming in, because those more minor injuries or illnesses wait while the trauma is being addressed.

So if we can develop our health care clinics to take on a larger role, and I envision this clinic at Misericordia, with the centre urgency primary health care centre, should take up a large percentage of the work that is currently being done in the emergency ward at the Misericordia hospital, that the amount of trauma cases or emergency, obviously high-need cases, is probably the smallest percentage of what they do. I do not have the numbers in front of me. So it is really those that are diverted to other centres, so that is part of the balance and the planning.

I say to the member, as well, one thing we learned last winter going through the flu season, we had a success at the Courts of St. James where we worked to put in a clinic to deal with the flu. There is a high preponderance of seniors in those blocks at the Courts of St. James. They are right next door to the Grace Hospital, and so when you are ill, you need to see a doctor and you go to the emergency ward at the Grace. That tends to be a problem because it quite frankly fills the emergency room there with not really emergencies, but people who need to see a physician, have medication prescribed, et cetera. I think we would all agree that is really not what an emergency ward is there for.

So we did work to put in a clinic last year in the Courts of St. James to deal with flu, and that is something with the Long Term Care Authority we want to expand. We are looking at this fall for some expansions, particularly in areas where you have a high number of seniors blocks. Misericordia will be added to that. Within the community clinic system across Winnipeg--I am thinking of Mount Carmel and Aboriginal Health and Wellness in Norwest and others--we are looking now, we are having the Long Term Care Authority looking at our ability to use those to pick up and extend hours in those clinics, to be able to pick up a lot of the stuff that finds itself in the emergency ward because their doctors' offices are not open, or they do not have physicians.

I would imagine that is part of the issue, as well, in the Wolseley area, having had friends who lived there in their university days, that there is an elderly population that has its physicians and services, but there is also a fair turnover of students and other people in that area who may not come with physicians and need the care, go to the emergency ward at that time.

So this clinic and this kind of walk-in service--

An Honourable Member: When is it going to change?

Mr. Praznik: Okay, yes, I will just get to that. We will be there. Now, with respect to about two things, the process of change and involvement of the community, we made the announcement of principle, about what we are trying to achieve, and the Winnipeg Hospital Authority, with the Misericordia Board of Directors and management, have struck an implementation team that was agreed between the two parties. They are working now with the care providers, physician groups in that area to devise the plan for implementation. There is a great deal of work and effort going into that because if one step is out of place, you can cause a plug somewhere else in the system, or have something fall through the cracks.

So they are working on the detail of that particular plan. We have encouraged them to involve the community. One of the issues that is there, and I recognize, is community involvement. I do not mean to touch again upon a touchy subject, but when the member for Crescentwood (Mr. Sale) and I had an exchange on this matter in Estimates, the member for Crescentwood flagged the Misericordia board, although very caring and compassionate, has not over the years been able to necessarily build the level of community involvement that he was, in fact, comfortable with. This obviously is a shortcoming he has identified, and it is one that I am going to be encouraging our people to be suggesting to Misericordia very strongly that they have to ensure, particularly in this primary urgency care clinic, that they are involving the community, and the community represented by MLAs, city councillors, by the public themselves, should have a role. I am not the owner of that facility. They are. They are the governing board of that facility.

The reason I referred to the Member for Crescentwood's (Mr. Sale) remarks, and I stand by my statements, is that what he was asking for me to do in operating agreements with the Misericordia Hospital, which by the way I thought were very thoughtful and very wise on his part, and that he identified a shortcoming. He was asking that I ensure that--put these in and insist they be in and put in operating agreements--and the point I made with him that day is I do not have the power to do that. That is part of why we are seeking that in the Legislature.

But the member's point is valid and that message will be conveyed through the Winnipeg Hospital Authority to Misericordia. I am hoping that that board of directors pays heed to that message that they should be involving people in the community in the development particularly of their community-based particular needs in that clinic. I will convey that.

Ms. Rosann Wowchuk (Swan River): Mr. Chairman, when we saw the capital spending that the government put forward under one of the items listed under a major project, the nursing station for Sapotaweyak Cree Nation, and when we saw that, in fact I was very pleased to see that the government had recognized the importance of establishing a nursing station in that community. However, when we did some checking, we found out that although it was listed as a major project and other projects that were not listed as major projects were getting up in the range of $300,000 for renovations to facilities, but Sapotaweyak Cree Nation for their nursing station were only getting $80,000, if I understand correctly the funding.

Mr. Ben Sveinson, Acting Chairperson, in the Chair

I wonder whether the minister can explain this situation. This is a very important nursing station. It provides service not only to Sapotaweyak Cree Nation but there is also Pelican Rapids, which is a Metis community right next door. We are all looking for ways to provide better health care services for people. One of the problems, and I do not know whether the minister is aware where this community is located, but they are about a mile--an hour and a half out of Swan River. At the present time, a tremendous amount of money is being spent transporting people back and forth when they need services, but also there have been losses of life because people have not been able to make it to the hospital quickly enough.

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The facility is very important, but I also think that the province, if they list the project as a capital project, that they should show more commitment than they have. I would ask the minister to explain why this project was listed as a major project and then find out that there is only $80,000 attached to it, because the minister is well aware that any renovations to hospitals--$80,000 is actually a very small amount compared to some of the amounts that have to be spent on renovations. So I would ask the minister if he could explain why that decision was made, and whether there is any possibility of revisiting that decision in order to ensure that the assistance that was required to help Sapotaweyak fulfill their dream of having a nursing station and providing services for the people of that area can actually happen.

Mr. Praznik: An interesting discussion on location because I know the concerns about Misericordia and I appreciate those. If I was the MLA for Wolseley, I would be asking exactly the same questions and making the same case. The member for Swan River and I, who both represent areas of this province that have much larger distances between communities, appreciate that to have a hospital right in your own community is such a rare privilege or event for most Manitobans, for many of us in our communities, that we are an hour--I think it varies in the Rupertsland constituency, like Bissett and Manigotagan that are over an hour to the Pine Falls facility.

So, when one is sort of weighing these things in terms of priorities, obviously there is a recognition that in many parts of this province, the distances--even within the City of Winnipeg, the distance to various hospitals is far greater than one in--it is such a rare privilege to be in to have a hospital. The member nods in agreement. She knows of what I speak; it is part of that balancing.

I have addressed this issue I think three times. I think we discussed it somewhat in Estimates. It was raised with me the other day by, I believe, the member for Thompson (Mr. Ashton) in the Estimates committee. I have no problem addressing it again because I appreciate it is of concern to that community.

We are only a small party in this particular project. This is a federal project on a First Nation, and what we have done, though, is--the member has rightly flagged the Metis community that is next door which is a provincial jurisdiction community, and we provide a number of services in there. So, consequently, rather than reinventing the wheel twice, we have agreed to be part of their clinic or their building and to purchase by way of a capital contribution the space in that building that we will use for the delivery of provincial programs and services in our area of responsibility.

It was determined, I believe, in discussions with the federal government, who have the responsibility and are the lead in this project, that our share would be the sum $80,000 or whatever is listed in our Estimates as what we have approved. But we are not the owners of the building, we are not the project managers of the building, we are not the developers of the building. We, in essence, are buying a piece of the building for the provincial services. So the work to deliver the project and the lion's share of the dollars, because it is a First Nations community, will come from the budgets within, I gather, the federal Department of Health and Welfare, Medical Services branch. I believe that is where they come from.

I indicated last Thursday to the member for Thompson (Mr. Ashton) in our Estimates, at the conclusion of our Estimates, that my staff would endeavour to find out for us exactly what the status is on the federal side. I would suggest sincerely, I do not say this to you in a partisan way, but perhaps it is time for a few letters from local politicians, M.P.s, councillors, and communities to Mr. Rock, again just to flag the issue and indicate its importance. I can assure her that the provincial co-operation and dollars for our share of the building are there and will flow when the building construction begins and we would normally flow those dollars.

Ms. Wowchuk: Mr. Chairman, that is good advice about writing letters, and I will take that advice. I hope the minister recognizes that although they provide a small amount of services to the Metis community that the dollars that are going to be saved on the provincial coffers by having the service there, the transportation dollars, the province will recoup their capital very quickly. I think for that reason that the minister should give some reconsideration as to whether or not the amount of capital being put in is sufficient for the amount of service that is going to actually be gained because of dollars that will be saved in transportation costs and in lives that will be saved, I am sure.

But, you know, it is going to mean, if services are going to be provided right there, people are not going to be going out for blood tests, people are not going to be going out for treatment for diabetes or testing, and many of the tests will be able to be done right in the community, which will improve the quality of life in the community but reflect on the provincial expenses. I hope the minister will consider that in his decisions and maybe reconsider the amount of money that is being put in there.

I want to move on to another topic that is important to rural Manitobans. That is the service of mammograms. I was very concerned when I heard about what was happening at Misericordia Hospital and the fact that mammogram services were going to be fragmented and moved to different parts of the city, because rural women many times were the ones who were taking advantage of having the residential facilities right in Misericordia, to be able to have complete treatment as far as surgery, plastic surgery afterwards, treatment, counselling, and it was all in a very compact area. So I was disappointed to hear that that service was being fragmented, and I hope that the minister can address how he feels that that is going to be addressed.

But another issue that I am very supportive of and one that I have lobbied the government on many times was that we would have mobile mammogram service in rural Manitoba. The government has made the announcement that we are going to have it, and I want to commend all of those people who have done fundraising in order to enable us to purchase that first mobile mammogram unit.

However, I would like to ask the minister how soon we can expect that service to be delivered in rural Manitoba and whether it is the plan of the government to ensure that during the winter months when winter roads are in place that we also have mammogram service in many of the outlying communities where women many times do not have the necessary tests that are required because it is so difficult to access this service.

Again, by taking the service out to the community, in the long run this is preventative health, and in the long run, as a province, we save many, many dollars and, indeed, save lives.

Mr. Praznik: A couple of issues just on the clinic. I appreciate the member's comments about savings. I do not know what the analysis would produce because there are still many reasons why they would be transported to Swan River to the hospital there. But those same savings will also come to the federal government because the same savings will be there for First Nations people.

We did negotiate, I understand, with the federal government and agreed that our contribution would be $80,000 or whatever it is. The holdup is not us. It is the feds who have to make a decision to go within their budget, and that is really the issue. If that can be resolved, we are there and we are going. We certainly do not want there to be any holdup on that particular project. I appreciate its importance to the community.

With respect to mammography, there has been a lot of discussion and I think some confusion over breast care issues in the city of Winnipeg. It should be noted that we did not have just one program at Misericordia. We had four different programs across the city, with surgery being delivered in seven hospitals. So on an overall basis within Winnipeg, in the total breast care package, we have a very fragmented program today.

The mammography part of it, although located at Misericordia, is not technically part of the Misericordia program. It is operated by the Manitoba Cancer Treatment and Research Foundation, the mammography clinic which is a screening clinic, and is there, will continue. It is an ideal location because of the parkade being there. It is a central location in Winnipeg and obviously the province.

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So as the general breast care program is being refined and put together, I know many of the community organizations with an interest in this area are at the table and have been invited to participate in designing that program, and it is going quite well. I do not have an up-to-date report on its status, but I know, if I remember correctly, the mammography portion at Misericordia is located there. That is the one centre I believe we have in Winnipeg for mammography, so it is not going to be split up with machines all across the city.

With respect to the rural program and the two machines, community organizations undertook fundraising for the capital cost of one machine, and they did a superb job in raising those dollars. I thank them for that tremendous effort and contribution. We agreed that when the dollars were in place for the machine, we would fund its operating. We recognize that one machine may not be enough, and so we as a province are funding the second machine, the second unit, and its operating.

I do not today have in front of me--and I apologize to the member. I have checked through my briefing book and notes, and I do not have before me an updated list with the start dates. I know the work is being done now to put the team in place. There is training to be done. I would say, as well, to the member, we learned a number of things about this program from our colleagues in Saskatchewan where they have the machine. Saskatchewan is considerably different from Manitoba in that they have a lot of small cities and small centres, whereas Manitoba has one gigantic centre in Winnipeg, some larger centres in Portage, Brandon, Steinbach, Dauphin, Thompson, Flin Flon, The Pas and then a number of smaller centres, but we do not have the same kind of distribution. So our needs are somewhat different in terms of geography.

We did look at their program in Saskatchewan. We sought their advice and what they learned in getting into the program. What was described to me was an interesting component to this. In Saskatchewan, they have a motor-home type facility in which they have their machine. They found a couple of things, and the member hit upon one, the weather. They found that it was very awkward for the operators driving this, particularly in the winter. They found that it was often not suitable for delivering service in cold weather, just a small confined space, et cetera. So their recommendation to us, or at least to our officials, was that a better way to deliver the program would be to use vans, put the equipment in vans, move the equipment into a public building or public place in the community, set up the clinic and operate it in a building, then pack up the equipment and move on to the next community.

So that is the approach, I understand, that we are taking in putting this together. It is simply learning from the experience of those who have walked before you. So our two machines will be on that basis.

With respect to using the North, I would hope that as part of the schedule--in fact, I expect, and I guess as minister when I expect something, it should be done, that northern communities, of course, will be part of that. I do not know how we are handling the winter road or those issues, but that has to be part of the consideration. There are some issues around funding, I guess, with the federal government, but that should not preclude service from being provided. Those are things to work out.

I would suggest that the member may want to just drop by my office and have a word with Bob Rauscher in my office, and he can probably get for you the up-to-date information on timing and expectation.

Ms. Wowchuk: Perhaps if I do not get a chance to drop by the minister's office, if the minister could provide us in writing the anticipated start-up dates, because we have a lot of interest and a lot of calls coming in for this service. So I will follow it up there.

I only have one more question to ask, and that is one issue again that I have raised many times with the government. It is a rural service and one that was provided for a year, I believe, and then the government withdrew the funding. Given the situation we have in rural Manitoba with an increased amount of stress amongst many people, changing environment, stress within the farming community, I wonder whether the minister is giving any consideration to reinstating the additional funding that is required to ensure that the rural stress line operates and provides the necessary services. I know that we have the services that are provided through an organization in Winnipeg that people can tap into, but the minister is a rural person. He knows that the needs and issues in rural Manitoba are different many times.

There is a staff of people in rural Manitoba who have been trained to address the concerns and handle the calls in rural Manitoba, but the service is not being provided anymore as a rural service, and I wonder if the minister, if he does not have the information with him, if he could update me on any information that he has on the future possibilities of reinstating the rural stress line services.

Mr. Praznik: Mr. Acting Chair, first of all, I appreciate the need for that line when we were going through a few years ago a terrible situation with low commodity prices, terrible weather, and just everything that could go wrong seemed to for particularly our agricultural community. Obviously, things have improved considerably, and, consequently, needs change for that kind of a stress service.

By way of a bit of an aside, we have approved the extension of the mental health teams that have been operating in the flood areas of rural Manitoba from last year. I think I have extended their operation until September, October. I do not remember the exact date, but if they are required to be extended again, we will, because there is certainly a need. There are still some families who have been very traumatized by what they suffered last year.

I do not have my notes in front of me, but what I remember of this issue from some time ago, one of the difficulties is as the demand for that service declined, the cost of it on a per-call basis became just so exorbitant to maintain it as we did, so we did make arrangements with the service in Winnipeg that she has referenced to be able to provide that assistance, primarily because the service was not being used sufficiently which is a good sign, I would think, of improving conditions, and it made the cost per call just so prohibitive in terms of use of resources.

So we have made those alternative arrangements, and I say to her if there ever arose a situation again where the demand was obvious, because we are getting calls on the other line from time to time, if the demand grew where it was again better to have a dedicated line to that, we would certainly consider it.

Mr. Chairperson in the Chair

Mr. Dave Chomiak (Kildonan): I was prompted by a comment of the minister earlier on with respect to the dilemma of the flu season to a commitment the minister had made during the course of Estimates to provide statistics on the flu-related illnesses that afflicted our emergency rooms during the winter and the spring of this year, and I wonder if we will be getting access to that information.

Mr. Praznik: Mr. Chair, if I have made that commitment, you certainly will be. I would guess at this time that it still has to be or is being compiled. Obviously, under the old regime, as we move through a transition, our tracking information to get specific numbers for him does take some time. When that is available, if I have in Estimates committed to that--we keep a list of those commitments--we certainly will provide him with that information.

Mr. Chomiak: Also during the course of Estimates, with respect to the United Shared Services and the food services provision, the chairman of USSC indicated that the savings as a result of the shared food services would be in the range of $3.2 million with respect to the hospital and with respect to the cafeteria services, something like $2 million, for a total of about $5 million per year.

I am wondering if the minister can confirm, in fact, whether that is the figure.

Mr. Praznik: As part of a more meaningful Estimates process, I had Mr. Sheil attend, as the CEO of Urban Shared Services, to answer those questions. As the member knows, I have my briefing notes on a number of issues. That is not one which I have, so I think we would have to check back to Hansard. The number does sound somewhat familiar, but I cannot confirm specifically. I do not have that in front of me here today.

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Mr. Chomiak: Also during the course of Estimates, and the fact it might have not come out is not a fault of the government or the minister, but we had discussed with respect to the amount of capital required to convert the kitchen facilities at Health Sciences Centre, et cetera. The minister had used a figure of $35 million, and that figure is in Hansard. We had talked both with capital people about arriving at some specifics as to that figure, and then when Mr. Sheil was in, we talked to Mr. Sheil specifically about how he arrived at that figure and neither with the capital people nor Mr. Sheil did we get to that particular issue.

I am wondering if the minister will commit to table, as a result of the Estimates, the specific information as it relates to the $35-million expenditure that has been indicated by the minister that had to be expended in order to upgrade the kitchen facilities.

Mr. Praznik: That number is one I recall from my staff in capital planning and with Urban Shared Services as the estimate as to what the Winnipeg hospital system was facing in its upgrade of kitchen facilities. I will endeavour to firm that up in terms of how that was estimated.

I can tell the member that like all preliminary estimates on capital construction, because we face this in our own estimates of building costs on facilities, particularly renovations have the nasty problem when you get into them of sometimes producing some surprises that you have to deal with. As well, when you get into tendering, sometimes you get some pleasant or not so pleasant surprises on your estimate. So they were, like all estimates at the beginning of the process, certainly not your final number, but those were the numbers that I was provided with, and I will endeavour to see what information we can provide to give a background to those numbers for the member.

Mr. Chomiak: Just for the information of the minister, I should advise I probably will not be as issue specific or area specific as we go through the course of these questions as we normally do because of the nature of this process, so I apologize for jumping back and forth on occasion from one area to another, but I am attempting to do in an hour and a half what normally might occur over a many, many-hour period.

An issue came up with respect to the seven-month waiting list as it applies to the bone density scanner several days ago. The minister indicated there was a plan as it related to the bone density scanner that was going to be put in place.

Can the minister outline specifically what is being done on a short-term and a long-term basis in order to deal with the seven-month waiting list as it applies to the bone density scanner issue? What is going to be done in the short term, the long term in relation to the present seven-month waiting list as it applies to bone density scanners in Manitoba?

Mr. Praznik: As the member knows, I was given a mandate to bring down the 1,200 on the list, which we did quite successfully actually a little bit ahead of schedule, if I remember correctly. We also wanted to ensure that the list did not go up again. The Winnipeg Hospital Authority, Dr. Blake McClarty, has been in the process of organizing, getting control, taking over this particular area. I understand there was a short period of time in which temporary dollars and new funding did not match as they should, as I have discovered. There was a period where there was a reduction in the number of bone density scans being performed of some weeks. That contributed somewhat to the numbers going up again. That has been corrected in that the dollars have flowed. The number of procedures, of course, per week is going up, which stabilized the list.

The other problem, I understand, that happened is there was a fairly pent-up demand, I gather. No one quite knew how pent up that demand was or would or would not be. So consequently, as the lists came down, they have filled back up again, certainly not a two-year waiting list as before. I understand they went up to something like eight months, stabilized, and are now back again on their way down. This was brought to my attention, to be blunt, just a few days ago, the list having gone up to that point. Although it was coming down, it was not coming down as fast as I wanted. I had asked my acting deputy Mr. Potter to ensure Dr. McClarty had the resources he needed to be able to bring it down at a faster pace, and I understand that is happening, so a little glitch in the financing flow, and secondly, a great pent-up demand putting names on the list.

I understand, as well, that the protocols about who should be getting and who should not be getting bone density scans are just coming into place. I was told by our operational staff that those on the list currently, there are a number of those who may, in fact, not qualify on the protocols and quite frankly are on the list but do not require the particular densitometry. So that has to be sorted out somewhat, and I am hoping within the next couple of weeks that list will have come down or be on its way to coming down, back to kind of the stable level where we intend it to be.

The member for Kildonan (Mr. Chomiak) has always, I think, appreciated the difficulties in managing the system, and some occasions has indicated these things are not always about money. There is a sense of how we organize and put these things together.

We have been over the last year in this transition to the Winnipeg Hospital Authority. The ability of a Dr. Blake McClarty and others to get their job done is growing daily, and there are going to be some kinks in this to work out. This is one that had that. As I said, when it was brought to my attention just the other day that there had been a problem with the list going up, we have moved to ensure that the additional resources are in place to bring it down to what should be a reasonable and acceptable waiting period for this diagnostic procedure.

Mr. Chomiak: Will the minister undertake to provide us with the protocols of all of the various protocols that are being established as it relates to diagnostic procedures similar to the bone density scanners so that we would have some idea as to qualifications in that regard?

Mr. Praznik: That is an excellent idea. I would imagine these are public documents. Barring something that I am not aware of that prohibits me from doing this in law or ownership, I have no problem with doing that. In fact, I would take it a step further. I think for some of these protocols it would be probably very effective to provide them to every member of the Legislature, because I know from time to time we get calls from constituents about why or why not services are available, and I am sure all members might be interested in being able to at least see the protocol.

They, in fact, are being developed by physicians, not by bureaucracies and planners, but by physicians, to ensure that services are being appropriately used and can be effective, so that resources are not wasted and spent when they have no health outcome in a particular case. I am fairly certain that the member agrees with that type of purpose in establishing protocols.

Mr. Chomiak: Mr. Chairperson, we have had some discussions with respect to Victoria Park Lodge at Souris, Manitoba. We have made a suggestion, similar to the situation that developed as it relates to the Odd Fellows hall in Winnipeg, whether or not the government would consider some kind of a provision or a transitional arrangement so as not to cause dislocation in the community, particularly at a time when there is generally a shortage of long-term care beds.

I wonder if the minister might comment on the government position in that regard.

Mr. Praznik: Mr. Chair, perhaps the member for Kildonan (Mr. Chomiak) and I cut some new ground in the field of this Legislature, and we were both somewhat innovative in our approach. My legislative assistant has been handling this particular matter and meeting with parties, and if the member would agree to indulge the committee, I would ask of him as my legislative assistant if he could address this specifically, rather than have him say it to me and I repeat it to members of the committee. Would there be leave to allow that to happen?

Mr. Chairperson: Is there leave to allow the minister's legislative assistant to answer that question?

Mr. Chomiak: Mr. Chairperson, philosophically, I do not have a problem with it, but I would rather not be charting new ground at this point, given my relative inexperience in this Chamber compared to other members of this august body.

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Mr. Praznik: Mr. Chair, I appreciate the position of the member, and although I have some different views on legislative reform and the roles of legislative assistants in this Legislature and working in process, perhaps today is not the day to cut new ground, even on a temporary basis.

The member for Turtle Mountain (Mr. Tweed) advises me, and under instruction, I asked him to meet with the parties to see if some resolution could be found. I understand that he has done that. He has spoken to all those involved, including the residents, and that they, in fact, are working currently on a proposal that would see that facility converted into some form of housing, assisted-living housing, under some new organizational structure. That would allow for it to continue in a role for which it is appropriate with that new organizational structure and the other issues of long-term care being addressed.

I understand that part of the issue is that it is on a very beautiful site, and the community would like to see that remain in some form of community housing, given how beautiful it is. Yet there is a recognition that there is a need for Level 3 and 4 long-term care beds and that this facility just does not need that particular need or would not meet that need. So I think a good compromise is in the works. It is not so much as a transition. It would be a personal care home in appropriate beds and appropriate place, and this particular building ending up some form of an assisted-living seniors housing complex on the current site under some community organization or arrangement. If that can be worked out to the satisfaction of the community, I am certainly going to be supportive of that resolution.

Mr. Chomiak: Mr. Chairperson, one of the issues that was significant by its absence from the plan of the Winnipeg Hospital Authority and that we did not have an opportunity to discuss in Estimates was the whole issue of labs and the future of labs in Manitoba insofar as there have been some developments in the past few months. I wonder if the minister might update us as to the status of that particular project.

Mr. Praznik: Mr. Chair, the member asks a timely but perhaps even too timely question, because I have been working with our Treasury Board to develop the options that I have not yet taken for the consideration of my colleagues in cabinet. My intention is to do that relatively soon because we recognize that a decision has to be made to allow people to get on with their lives and planning.

I do want to say to him this: that this is not a matter that is ideologically driven. It is one that I think is very practical, and the options that are available to us, I think, are very practical, and even some of them the member for Kildonan (Mr. Chomiak), I suspect, could heartily concur with.

So we have been negotiating, as the member knows, with the MDs for some time. We have looked at all of our options, including a contract with them, although I can tell the member the expected savings were not as great as we had initially been led to believe. So we have a number of options, and the specifics around those options we have been developing with our Treasury Board, and at some time in the relatively near future I will be taking the matter to cabinet for a decision.

Mr. Chomiak: Mr. Chairperson, I will ask two questions. The first I anticipate probably not a response to; the second, I am hoping for a response to. I wonder if the minister might outline the options that he is considering, and the second question is: can the minister give us an answer in terms of timing? This obviously affects people involved and who have been on tenterhooks for some time now. Are we talking weeks, are we talking months in terms of a resolution of this issue so people can have some ideas as to how they can get on with their lives?

Mr. Praznik: Mr. Chair, the great dilemma of a minister, knowing the answers to the questions, wanting to provide the answers but recognizing that I have an obligation and responsibility as a member of the Executive Council. As I have indicated in the previous answer, I have prepared a number of options. Obviously there is a recommendation I am making to cabinet, and in fairness to my cabinet colleagues I would not want to prejudice their right as members of the Executive Council to explore those options and come to a conclusion.

So, obviously, I cannot go into those options with the member. If I were to give a time frame around it, I might find that that is not the time frame of cabinet. So I have to refrain from doing that, but I can tell the member that we do recognize that this was a matter we were hoping to have resolved last fall because we did not identify in the negotiations the level of savings we had anticipated, and we have been negotiating very hard with MDS. It has taken somewhat longer to do, but I recognize there are people who are waiting, and any decision cabinet is going to make is going to have to be made on a very timely basis. Obviously these matters cannot hang around for too much longer.

Mr. Chomiak: Can the minister outline for us, briefly if possible, the status of the hepatitis C negotiations as well as the status of the new blood agency scheduled I believe to commence operations September of this year, if I remember correctly?

Mr. Praznik: Mr. Chair, there was a conference call this afternoon at one o'clock of provincial ministers of Health. Most regrettably, I was meeting with the chairs of the regional health authorities for their monthly meeting, and I was not able to get back to the building until 25 after one, and then come to Question Period, so I have not been briefed by my deputy minister who represented me on that particular call yet. So to give him the most up-to-date briefing, I am regrettably not in a position to do that.

I can tell him that on the hepatitis C negotiations, the smaller provinces have obviously taken the view that because of the shifting position of Ontario and somewhat of Quebec and the need to have a significant federal presence in any expansion that it is fundamentally important that those parties resolve where they want to be on this issue and that once they have done that with some certainty, then the rest of us, I think, are very prepared to be there to put together a program that will be national in character.

The difficulty, though, of getting into it today and being asked for specifics on positions is that whatever we say or do is not going to matter at all if it is not acceptable to Ontario and the federal government. They are the key players in making this happen, and they have been having a relationship that has been a difficult one to be at the table.

I share with him very candidly that I find it somewhat disturbing when we have had meetings of officials recently where position papers and information that are brought to these meetings for the purpose of fleshing out options, the member knows from his experience as a councillor and in other roles that it is very hard to have meaningful negotiations on the pages of newspapers or in the media.

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You have to have the ability to explore and discuss and speak candidly about where you can and cannot be. What we found most disturbing is when our officials met the next day, all of the documents appeared, I think, in one of the Ontario newspapers, in The Ottawa Citizen, and I do not know where they were leaked from. I have my suspicions, but that has been a problem with this process. So there is a great reluctance, to be blunt, of the smaller provinces to be taking positions on specific components today for fear that either Ontario or the federal government will then turn around and attack us or use us as an excuse for whatever they are or are not doing.

Just for example, if we all said we would do a program to a certain level, and Ontario initially had talked about doing something a little bit richer, well, it would give them the ability to say, well, we are bringing ours down but it is not our fault, it is the rest of the provinces and get into that kind of political game. We have been burnt once in this process as provincial ministers and, quite frankly, there is a reluctance to be burnt a second time. So the reality of this situation, and I say this very sincerely to the member for Kildonan (Mr. Chomiak), is that the Government of Canada has to tell us what they are really prepared to put into this. The Government of Ontario has to say what they are really prepared to do so they are not out changing the game after everybody has agreed.

When they come to that resolution and complete their political maneuvering, then we will know what is on the table for the vast lion's share of it. Again, if it is reasonable and deliverable in Manitoba, because we want to be part of a national program, we will be there and participate in it. So I wish it was another way, believe me, but it is not. All of us smaller provinces have had that general perception of where we are at. As I say, I do not have an update as of today's telephone call, but that is where it was as of this morning.

Mr. Chomiak: Can the minister briefly update us with respect to the blood agency that is going to be set up, I believe, as of September 1 of this year?

Mr. Praznik: I forgot my reference. The board has been appointed and is in operation. They are getting themselves up and ready to take over from the Red Cross. The agreement with the Red Cross for the transfer has, in fact, I think, been very close to being worked out and concluded. There are still some issues being fleshed out.

The financial arrangements that will be required to put the blood agency in operation are currently making their way through Treasury Boards across the country, and we in Manitoba are in the process of working through the financial issues in our province. As far as I am aware, we are still on track for a fall takeover of the blood system from the Red Cross.

Mr. Chomiak: Just for my understanding with respect to the financing of that, is the minister saying that there is an additional appropriation to that that is already contained in the Estimates book to deal with transition, or is the transition funding already contained within the Estimates for this year?

Mr. Praznik: Mr. Chair, as the member can appreciate, we can attempt to book at budget time what we expect to need, but the negotiations for the purchase of assets--and the federal government is providing funding for a share of that--one could only anticipate. So I know we tried to book an appropriate amount of money in this year's budget for what we anticipated. I am not sure if that is adequate or not. I do not have those specifics in front of me, because I have not seen the latest numbers. But our intention was to give the best guess for this year's Estimates, but it has been a somewhat dynamic and evolving process. I am sure within the next week or two that we will be able to answer that specifically.

Mr. Chomiak: Mr. Chairperson, one of the issues that is on a recurring basis actually occurred in this Legislature and has occurred across the country, the whole issue of nurse problems, and there are a variety of issues. It is not nurses who are the problem; rather, nurses are having difficulties in the system.

The MNU did a report that was provided to the minister. Has there been any specific follow-up, and is there anticipated to be a specific follow-up to the issues raised by the MNU in their report that was recently provided to the minister?

Mr. Praznik: Yes, Mr. Chair, I am just looking for a series of letters from the nursing organizations. I think I had them in my House book yesterday for tabling, and I do not have them here. I think my staff is going to get them, and I would be prepared to provide them to the member.

The Manitoba Nurses' Union's survey--and they have done that survey for many, many years, and it is one based on their reports. The Manitoba Nurses' Union has a role to play in the small "p" politics of health care and advancing their issues and causes on behalf of their members, and I recognize that. I also recognize, too, that one should not just dismiss their report on that basis, that there are things to be learned from it.

What I am attempting to do is, rather than solve things on an ad hoc basis, although sometimes one has to do that, I am trying to address--and we have talked about this somewhat before. Many of those nursing issues stem from ability for hands-on relationships with patients, their workplace issues. Some, by the way, are the way we hire nurses, and I have recognized very fully Vera Chernecki's, their president's, comments about part-time, short-term jobs, and one of the interesting things that is happening out of the regionalization process is I have been very strong on the RHAs to be developing ways of having more full-time employment of nurses because you are managing them on a larger basis. In Winnipeg, that is going to be very important to give people that stability. So that particular issue, I think, is on its way to being addressed. It will not happen overnight.

With respect to certain issues around nursing shortage, number of nurses in various facilities, what the right skill sets are, et cetera, rather than try to address things in some ad hoc manner, last winter I invited the nursing professional bodies together, the regional health authorities, the Manitoba Nurses' Union to be in the tent as an observer to this process, and I have charged them with a number of tasks. One is to be able to sort out the professional responsibility of the various organizations.

The member well knows that there has been an ongoing dispute within the profession about how LPNs and RNs relate. The irony of it is, in the workplace, they relate very, very well. But in terms of professional responsibility and turf, who is responsible for what, what is the future of their training and their role in health care, there has been a large debate between those organizations over the last number of years. So I wanted that sorted out.

There is enough room, I would suspect, given all the changes in nursing, the four-year nursing program, the expansion into health care aides where obviously there is a need to standardized training. There is more than enough room for both nursing organizations to define their respective roles, define their overlap and how they will handle those roles and get on with each doing their own thing.

I tell the member, one of my frustrations is that I have seen RNs and LPNs looking at some of their future needs, overlapping what they do, and it just looked very counterproductive, I think, to everyone from the outside. So we brought them together in that particular process. I have had the RHAs, through their Council of Chairs, really drive this process, because what has been missing I think in the past is that the purchasers of the nursing service have to be driving the process to say: what do we really need? What are the makeup and the skill sets? How do we educate people so that they can advance those skills for the ones they need?

The LPN association said to me that many times LPNs are denied a particular work role because a particular matter is not in their training program. Yet, it only may take a day or two-day course to gain those skills. So we want to see a greater degree of skill-based staffing as opposed to profession-based staffing. We want those associations to be part of that being put together. We want the RHAs to drive it and being very clear what kind of staffing needs they need, how we assess those kinds of things.

It would give us, I think, a far better understanding of where we have to direct more resources, quite frankly, money, to ensure that facilities and wards and services are properly staffed, adequately staffed, for the work that they are doing. I am not expecting that to take forever either, and I do not want any organization to be bogging down that particular process. Where I see that going, and this comes back to the implementation issue, the next stage, of course, is to more formalize this process and to ultimately involve the educational organizations in it.

I see this thing working almost on an annual basis. The RHAs should be able to assess what their nursing staff needs will be one, two, three, four years out and that in a collective way be able to give very clear indication to the trainers, educators, as to the number of enrollments that are required, changes in skill sets, et cetera, in a much more productive way than we have done in the past. I think within the Ministry of Health we tried to address it without having the purchasers at the table and in a way that becomes very direct and very much a normal and regular part.

I want to table for the benefit of the member four letters we have received, one from Carmel Olson, who is the chair of the Provincial Health Programs and Services Executive Network on behalf of the regional health authorities; a letter from the Manitoba Association of Licensed Practical Nurses; a letter from the Registered Psychiatric Nurses' Association of Manitoba--they are very much a specialty group, but they are important to be in the tent; and, of course, a letter from the Manitoba Association of Registered Nurses, all indicating their concurrence to be involved in this particular process and as we move forward. I provide those for the member here today.

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Mr. Chomiak: I wonder if the minister might outline what steps are being taken at the central level to deal with the issue of a retention and attraction of nurses to Manitoba, not dissimilar, I would suggest, from the situation as it relates to physicians.

Mr. Praznik: Just one addition. The Manitoba Nurses' Union is not a professional body, so this is really driven by professional bodies and the RHAs. They have been invited to be part of this process. They have indicated that they will be because they are the union that represents both LPNs and RNs and others within that system. So they are in the tent. They always will be welcome to be in the tent, and the essential part of the letters, of course, is because these are the professional bodies who make the decisions as to professional responsibility.

So that is why there is no letter from the Manitoba Nurses' Union, although I indicate that they are invited to be, will be, have been part of this process. Their role is somewhat different, because they represent employment issues and have a different role. I just wanted to flag that with the member. There is not a bad reason why there is not a letter from the MNU. It was the professional bodies who were invited to be part of that. MNU is part of it as an observer.

With respect to retention and recruitment issues, we know there are a number of issues that we can address rather quickly. Job stability becomes very important, and we have asked the Winnipeg Hospital Authority to investigate and develop within their structures the ability to eliminate as much as possible the casual, part-time, et cetera, pools, and be able to combine those in a manner that gives job stability within the pool, you know, on a full-time basis, so you still have a pool, but it may be the regional health authority who maintains it. Employment is full time and it might be between one or two or three facilities, whatever works in a practical way. So we hope that we can eliminate some of that.

We know that having adequate hands-on support at the bedside is part of a better working relationship, and I suspect a good deal of the issues raised in the MNU report stemmed from the ability to have enough time to do the job. That is part of one of the things that I am expecting out of this process is what are the right hands, what are the right expectations of those hands in providing bedside service.

The other part of this is ensuring that our educational institutions who are training nurses and the professional bodies are so well tuned to the marketplace, and that is why the RHAs are leading it, that they can adjust and provide their training opportunities to meet in a much better way the specific demands that will be there in the system. So I think that goes a long way.

I think the member has heard me make reference on the Mr. Warren's Action Line when he asked me are we opening up the nursing contract. I have indicated that there are some issues there that there has been a willingness to discuss with the MNU, and we have had some very preliminary discussions in that way. So there are a host of things that are ongoing to address the issues the member has outlined.

Mr. Chomiak: Mr. Chairperson, I believe we are making arrangements for another minister to be in this process. Just prior to that occurring, I wonder if the minister would be able to give me an update with respect to the issues that the minister acknowledged he was concerned about, as well as we were, as it relates to the VON and the provision of VON service.

Can the minister give us an update as to what follow-up has taken place and what, if anything, further the department or the long-term group is going to be undertaking in this regard?

Mr. Praznik: Mr. Chair, I am not sure whether or not they have, in fact, settled their labour dispute. [interjection] They have settled it, yes. I have had a chance to speak with Ken Holland, who is the chair of the Winnipeg Community and Long Term Care Authority, which is the contracting party with them. I have spoken as well with their CEO, Marian Suski. I have indicated to them that because this is somewhat new ground for them, if they believe that helping with a management team to work with the VON to improve their management skills and their board skills is something that would be useful that they should feel very free to do that.

He, of course, pointed out to me that that would require, and I am aware of that, concurrence of the board of the VON to participate in that kind of a process. I think that they would be very wise to do that, and Mr. Holland assured me that those efforts would be made if they would be well received. If they do not, and they do not correct their fundamental problems, and they are not able to deliver service because of that, then I feel no compulsion to renew or have their contracts renewed if they are not able to provide the service that Manitobans and Winnipeggers expect.

Mr. Chomiak: Mr. Chairperson, can the minister give us the status of the nursing adviser position? In the Estimates, the minister indicated that position had not been filled, and the minister talked about the possibility of that position being filled at the regional level. Can he update us as to what the status is in that regard?

Mr. Praznik: Because of this huge change in function from Manitoba Health where we are no longer or very rarely a provider of direct service, the regional health authority is taking over many of the services we have provided. Because our role as a ministry changes more to policy, administration of that policy through finance standards check, et cetera, we are in the process of planning what the Ministry of Health will look like and needs to be to deliver service.

This nursing process that we have embarked on and is kind of fleshing itself out as it goes and figuring out what it wants to be and what it can do, I am keeping that position open of a nursing adviser to see how, in fact, if there are support staff required to this process on a regular basis so that quite frankly the policy advice that I am getting on nursing issues is coming out of this process of the professional bodies and the RHA and the MNU sitting at a table together.

Mr. Peter Dyck, Acting Chairperson, in the Chair

So until we see how this kind of works and what it needs, I am keeping that position open to be able to accommodate that new process. If I were to fill it now, quite frankly, I think it would be somewhat at odds or maybe at odds under its old form with where we see this process going with getting people at the table. So once we have a little bit better idea of what skill sets are going to be needed to accommodate this new process and report back to myself and my executive in a working relationship manner, then we will be able to adjust that position and skill sets to meet that need, and then we will fill it.

Ms. Friesen: I wanted to ask the Minister of Health a question that I have asked him in Question Period, but I was not sure from his answer that the Minister of Health actually understood the question I was asking. It dealt with Winnipeg No. 1 and community nurses in the schools. The minister gave me a reply which gave his policy for the whole province, which was not the question I was asking. I had asked about the lack of an agreement between the Winnipeg Long Term Care and Community Health Authority and their provision for public health nurses in the schools.

I think the minister thought that his questions were over. I did actually have another question for him, and I do not think he has heard the beginning of it. So let me start again, Mr. Chairman. The issue is a question that I raised with the minister in Question Period. It dealt with the Winnipeg Long Term Care Authority and public health nurses in the schools in Winnipeg 1. The minister gave me an answer as to the Minister of Education (Mrs. McIntosh) which dealt with the provincial policy, but there is a very specific case here for the centre of Winnipeg, for Winnipeg 1, which did have, unlike all of the surrounding communities, public health nurses in the schools.

The situation has been in limbo for some time. People have not been assured that they were going to be able to get the funding to continue that program, so nurses who retired or moved were not replaced. So what has happened is that, I think as we speak now, the staffing of public health nurses in the city schools is now at just slightly over half strength, so we were having teachers being assigned to do what formerly had been medical duties. At the moment it is dealing with issues of head lice, but clearly it could be more than that, given the staffing and the uncertainty. My concern is that teachers are not trained to do this and that we have no long-term plan, publicly at any rate, for the maintenance of public health nurses in the schools.

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The minister is aware of the Postl report, of the Healthy Child policies, and I am sure--and I think he said this in his answer--he is concerned that the schools do play an important part in the delivery of public health. So now that the minister has the full information, could he give me a sense of when that agreement is going to be reached, when we can begin to see some stability return to the public health system of nurses in the schools and if he would give me an assurance that public health nurses will indeed be returned to the schools of Winnipeg?

Mr. Praznik: Mr. Chair, I appreciate the member's question, and I do not take issue with the intent of it. I guess the only difference one may have--and if I recollect the issue well enough--is the nurses who were in those inner city schools were employed by Winnipeg School Division No. 1. Is that the case, I ask the member? Yes, I suspect as we see some changes in delivery, I do not expect that the Winnipeg Long Term Care Authority will be likely funding the school division to put nurses in schools. Perhaps the member would clarify.

Ms. Friesen: I believe it is an agreement with the public health authorities of Winnipeg and the Winnipeg No.1 schools. I do not believe it is entirely funded by the schools.

Mr. Praznik: Mr. Chair, I know we are trying to just understand the issue. If I gather from the member correctly, it is that the current public health services in the schools in Winnipeg are partially funded from the public health program of the City of Winnipeg, and she is referencing the amalgamation agreement.

I just look to my assistant. Those are being worked out, I understand, to ensure that there is a role. It may change somewhat in how it is delivered. It may not be funded necessarily through the school division. It may be a service that the Winnipeg Long Term Care Authority provides in the schools, but I would agree wholeheartedly with her. I know the Minister of Education (Mrs. McIntosh) and we have recognized the need for some of that service.

In rural Manitoba, I know that the public health nurses that used to be employed by the province and are now with the RHAs provide many of those services in schools. We certainly will want that to be continued. It may not be continued in the same form in terms of who the employer is, but I think that agreement is just about done. It is very, very close between the Long Term Care Authority and the City of Winnipeg to do the transfer service.

The real key point, of course, is that the service be there delivered through the schools. Particularly, in the inner city in some of our poorest neighbourhoods, that is probably the best vehicle to deliver that public health, and we certainly recognize that.

Ms. Friesen: The minister says close. Can he give me an assurance that when the schools open in September, or at the end of August, that system will be in place, that agreement will have been made?

Mr. Praznik: Mr. Chair, I would love to be able to do that. The only thing, of course, is that we are negotiating with the City of Winnipeg and I do not control both sides of the bargaining table, but we certainly do not want to see a disruption of service. The whole intent here is to improve services, so I would love to be able to do that. I continue to put pressure to have it done, and I will continue to do that. We should have it, and the reasonable expectation should be that it be in place for the return to school, but, as the member, I am sure, would appreciate, I am not both parties at the table. There are always things that can happen at City Hall that can put a wrench into it. I do not want to make a commitment to her in the House today that I do not have the tools or I am not in a position to fully live up to.

Ms. Friesen: Mr. Chairman, I have some questions for the Minister of Education (Mrs. McIntosh). I want to ask the Minister of Education--

Mr. Praznik: Mr. Chair, if I may just indulge, I know she has had a number of Health questions. As the member can appreciate, I have a meeting in my office. If that could conclude, I thank her for that.

The Acting Chairperson (Mr. Dyck): We thank the minister.

Ms. Friesen: I want to ask the minister about the issue of students being asked to pay for the cost of substitute teachers in the Assiniboine South School Division. I am referring back to an article in the Metro of Tuesday, April 22, 1997. I know that the minister has written letters on this, which I have seen copies, but I think that the letters were not as clear as they might have been.

I wonder if the minister would take advantage of this opportunity of this time we have to put clearly on the record the position of the government on the requirement for students to pay for the cost of substitute teachers.

The minister may remember that it dealt with students at Oak Park High School who received letters from the school asking that members of the boys' basketball team cover the costs for a replacement teacher to replace the teacher who would be accompanying them. Could the minister tell us very clearly what the position of the government is on this?

Hon. Linda McIntosh (Minister of Education and Training): I apologize to the member. I do not have those letters here. The member has indicated that I have received some letters that she has seen, but I do not know which ones she is referring to. If she has them there, I would be pleased to take a look at them because I know I did indicate at one point the member had asked a question and there was an article in Metro One that said user fees were being charged for students to pay substitutes in schools.

Of course, no school division can charge parents for instruction. Certainly, throughout history, the member knows very well, as does the system, that user fees have been charged for field trips and those kinds of things forever in school divisions. What is not illegal was the money that was charged, I think, for a field trip in Assiniboine South, I believe it was, for students who went on a field trip out of town, and they had to pay a fee to go on the field trip. Part of that fee went to cover a lot of expenses that the school incurred because the students were going on a field trip. Some of that then went to pay a substitute that come in. That is not illegal because the fee was collected for the purpose of the field trip.

I do not have those letters here. The member referred to me receiving several letters. I do not recall receiving several letters on it, but the member says she has them or has seen them. Perhaps she could provide those to me. Then I could give a more clear answer based on those. I did receive, I think, two letters on the topic based on the newspaper article, and then, of course, questions that the member had raised, but it was not expressed as a general concern by the people.

User fees have always been in place. School divisions cannot charge for instruction, but it is not illegal to redirect some of the funds that are used for field trips to substitute costs when the regular teacher is still with the class in the field on that trip.

Ms. Friesen: I understand what the minister is saying about what Oak Park High School did because the fund is not illegal, because the funds were received, or at least were given indirectly to pay for the instruction and not directly. So it would be illegal if a school division asked students to pay directly, but if they ask for it indirectly, then it is legal. Is that what the minister is saying?

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Mrs. McIntosh: No, that is not what I am saying. I am talking about specific events, such as particular kinds of field trips where the regular classroom, the instructional teacher, is with the students of her class in one location who maybe also has some other students back at the school. The cost of the field trip, I understand that Assiniboine South, well, perhaps you could say that they did not use the money for the substitute then, that they used it for the cost of the field trip and their own money for the substitute. But out of the money that was collected for the field trip, there were certain expenses. One of the expenses of the field trip was the cost of a substitute teacher.

We have had occasions in the past where teachers have gone on field trips with students to France or to Israel. Substitutes are brought in for that purpose to teach the remaining students when the teacher is away. School divisions do not charge the parents for that, and it is not a common practice.

Ms. Friesen: Let me try again. Is the minister saying that what Oak Park High School did in asking students to pay the cost of a substitute teacher is legal?

Mr. Chairperson in the Chair

Mrs. McIntosh: The member is going to have to refresh my memory. Again, I have asked, she has referred to this issue as emanating from some letters that I apparently received that she has seen, and a subsequent article in the paper upon which she asked me a question in the House.

If that is the incident she is referring to--and I do not know that it is because all she is saying to me here is that Oak Park High charged students to pay a substitute--if the incident she is referring to specifically is the one that we responded to at the time through the department, we checked it out and determined through legal counsel there had been no violation of The Public Schools Act. If that is the incident that she is referring to, then, no, there was no violation of The Public Schools Act. If she is referring to some other incident, I would have to know the details of it because, to my knowledge, other incidents of that sort have not been brought to my attention.

Ms. Friesen: I was referring to the April 22, 1997--I think I read that into the record--issue of the Metro which talked about Oak Park High School, letters dated December 17, 1996, and February 13, 1997, according to the newspaper report, and the boys' basketball team was asked to cover the cost which included the teacher's substitute fees. I do not think I said actually letters that were written to the minister. We will have to check the record on that. I certainly did not intend to say that.

What I did say was letters that the minister had written on this were not clear and, in fact, were very similar to the first answer the minister gave today. No, this is not dealing with any additional issues. It is dealing with that original issue. The minister said that she had a legal opinion on this, and I wonder if she would be prepared to table this.

Mrs. McIntosh: I would have to call legal counsel in. It was a verbal thing, but we could get them if the member wants, bring in the legal counsel to reiterate the opinion they provided me. It was not in writing.

I thank the member for clarifying that because I did not recall receiving letters on the topic. I do recall the incident. I believe it was around the date the member mentioned because it was spring, but I do not have my materials here with me to look at my response which, at the time it was written, indicated that the Assiniboine South School Division had not contravened any funding rules or The Public Schools Act. I thought at the time that the letter was fairly clear. It seemed to have answered the question for the people to whom it was written. They seemed to understand it, as did other observers.

I do not have a copy of that letter here, and, again, I ask if the member could provide it since it is the subject of her concern. I could take a look and perhaps clarify what is not clear to her, although it was clear to the people to whom I wrote and to others who had read it. It said that the Assiniboine South School Division had not contravened The Public Schools Act by charging user fees, taking the total expense of the trip and using it to offset the costs that they incurred for that particular field trip.

Ms. Friesen: Would the minister be prepared to table the written legal report that she could obtain from her legal counsel? I do not think it is normal practice to bring legal counsel into the House. The Chair is shaking his head. I do not think that is possible. So I think the way for us to receive that would be for the minister to request legal counsel to draft a brief note on this that refers to the sections of The Public Schools Act on which he or she is basing the opinion. Would the minister be prepared to do that?

Mrs. McIntosh: I can certainly have our legal counsel proffer a written opinion. The member wanted a report? How many pages? Legal counsel has provided us a verbal opinion at the time. We did not request it in writing because lawyers, as the member knows, are very expensive, but if she would like us to spend that money that way to clarify for her the contents of a letter that were clear to all the other readers, we would be pleased to do that. Again, if she would be good enough to provide me a copy of the letter which she is referring to here in the House, I could perhaps clarify it for her myself by reading it and finding out which sentence is not perfectly clear.

The letter states: Assiniboine South did not contravene The Public Schools Act. That sounds pretty clear to me. It was clear to them, it was clear to me, it is not clear to the member, and she has now asked that we have legal counsel prepare a report for her rather than accept their verbal opinion. Of course, we will do that because my staff has spent a great deal of time this session doing research for the NDP's questions and for the NDP's policies. We are here to serve, and I guess if the NDP wants to use our legal counsel as their researcher, far be it for me to argue. I will have him reiterate in language that is more understandable the language that is already in the letter that she has.

I think it is a bit redundant, but I can understand she is having trouble understanding, and I will do that for her. When would she like it? Shall I have legal counsel--

Ms. Friesen: Mr. Chair, what I am asking for is some substantiation of what the minister believes is the interpretation of The Public Schools Act. I do not think anybody used the word "report" except the minister. I believe the record will show that I asked for a brief statement from the lawyer giving the sections of The Public Schools Act which he or she is interpreting, a substantiation of what the minister believes to be a nonviolation of The Public Schools Act. It may well be.

I am not a lawyer and neither is the minister, but she has had legal advice. The minister refers to the cost of legal advice. I understand that the government does have Legislative Counsel. I asked for a brief statement, and I asked for a substantiation of work that has already been done for the minister.

Mrs. McIntosh: I am pleased the member clarified that all she needs--excuse me. [interjection]

That is interesting. I can see you are really concentrating on the content of this exchange here. Well, I am pleased to see that the member for Burrows (Mr. Martindale) is so interested in the topic we are discussing since he is busy talking about something completely different.

But I understand the member now would just like a brief paragraph or two saying the sections of the act--if the member would like to listen, I am trying to get some clarification whether this is what she is seeking. Perhaps if I could get her attention, or maybe I should wait until she is ready to listen. I would like to get her indication if what I am interpreting is correct. But she is busy in conversation now, so I will give the request. Maybe she can read Hansard and let me know tomorrow. I understand that the--

Mr. Chairperson: Order, please.

Mr. Doug Martindale (Burrows): Mr. Chairperson, on a point of order, the member for Wolseley (Ms. Friesen) is listening to the answer. There is no requirement that she has to look at the minister. She is listening, and I am sure she will have another question if the minister ever gets around to answering the previous question.

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

* * *

Mr. Chairperson: The honourable minister, to conclude her response.

Mrs. McIntosh: Thank you, and, of course, I do not need the member to look at me; I just need her to stop talking to other people, unless she is one of those gifted people that can talk and listen simultaneously. [interjection] She is very talented that way, the member for Burrows (Mr. Martindale) calls across the floor.

Mr. Chairperson: Order, please. Could I ask honourable members to refrain from what I call a little fishing expedition. I think if we get back to answering the questions and dealing with the questions that are asked rather than searching for something that might cause a little bit of disruption in the committee, I think we might go a little further. The honourable minister, to conclude her remarks.

Mrs. McIntosh: The member has asked me to expend some money and time to address a concern that is in writing very clearly for her. This is not a fishing expedition. I am trying to ascertain just how far the member wishes me to go, beyond what has already been done for her. So I understand she would like a paragraph or two indicating--

Mr. Chairperson: Order, please.

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Ms. Friesen: Mr. Chairman, the minister is putting words into my mouth. I did not ask her to spend money. I asked her to provide the legal opinion, which has already been given to her.

And, Mr. Chairman, if you could direct the minister to deal with the issues on the table, I think we would get on much better in this House.

Mr. Chairperson: The honourable member for Wolseley does not have a point of order. It is clearly a dispute over the facts.

* * *

Mr. Chairperson: The honourable minister, to answer the question.

Mrs. McIntosh: The member then would request a simple paragraph or two from legal counsel to verify what I have already told her, that The Public Schools Act says Assiniboine South is not in violation.

So I have said that, I have written that, and she now wants a lawyer to write it, as well, so that it can be credible. I will certainly do that for her. That, of course, does necessitate a call to the lawyer again, and, Mr. Chairman, the member surely knows that lawyers do not work for free, but maybe she does not. So I will do that and provide that to the House as quickly as I can.

That information, by the way--the member is correct--has already been given, and she did state in her question both times that the information has already been given to the minister verbally, written, transmitted to the field, provided to her and released to the public. But we will do it again because when it comes from the lawyer, it will be credible to her and not any other way, and I want it to be credible.

Ms. Diane McGifford (Osborne): Mr. Chair, earlier in the session, several parents whose children attend alternative programs were I think disappointed and chagrined when the minister referred to them as yesterday's parents, or yesterday's people--my memory does not quite serve me, but, anyway, either of those terms.

As the MLA for a constituency where several alternative programs take place in local schools, I did have some concerned parents calling me, and I wonder if the minister would like to clarify for the record exactly what she meant when she referred to these parents as yesterday's parents.

Mrs. McIntosh: This question was asked in Question Period by the same member and was answered in Question Period. The answer does appear in Hansard, but if the member wants to ask it a second time, I am pleased to answer it a second time. But let the record show that the same answer will be found in Hansard from Question Period. So, again, I will provide information that has already been provided to help them understand the first answer which maybe was not very clear, I do not know, but this information is the same.

The alternative parents have a program whereby students are not necessarily going through one grade at a time. I believe the member knows because in her first question to me during Question Period, she identified herself, I believe, as an alternative--that her children had gone through the program. So I think she is familiar with the program which would perhaps mean I do not have to explain the program to her, although I am quite willing to do that.

In no way, shape or form are standards tests contradictory to or not complementary with the alternative program, and in being asked a question about this issue by the reporter, the member has taken a quote out of context, as a stand-alone quote, and believes it is referring to the program or to the parents themselves, when, in fact, it is referring to the fact that denying people the opportunity to have standards tests diagnosis is to condemn them to becoming yesterday's people and is not preparing them well for the future. So--[interjection] I will maybe wait till they are ready to listen, because there is no point answering if no one is listening.

Ms. McGifford: On a point of order, I was sitting in my seat listening intently to the minister. I know that she feels that she has the right to control public schools and dictate who can be on and off stage, but, Mr. Chair, I think that you saw me sitting in my seat, listening to the minister. So for the minister to suggest that I was not listening I think is an insult. It is not true, and I want to correct the record.

Mr. Chairperson: The honourable member does not have a point of order. It is a dispute over the facts.

* * *

Ms. McGifford: Well, fact or not fact, the point is that I was here, I was listening to the minister, and I do not know how the minister can put such misinformation, clear misinformation, on the record. No, the minister does not have to describe to me the alternative program, as I do have a child who went through the alternative program--perhaps I should not say went through; it sounds like cruel and unusual punishment--who was educated in the alternative program and enjoyed it thoroughly. The reason I have to ask the question again is quite clearly because this minister never provides any answers, so that we keep trying to get information. We keep trying to get her to answer. I think today that I am finally beginning to understand, and perhaps the minister could provide a bit more information.

My understanding, then, is the minister was not referring to the parents as yesterday's people but was suggesting that students who do not have the benefit--and "benefit" is the minister's word--of standardized diagnostic testing will grow up to be yesterday's children. I guess the minister means by this that these children will not be employable or will not be able to participate in the marketplace. Perhaps the minister could provide a little bit of clarification on this point.

Mrs. McIntosh: I believe if the member wants to reread Hansard from the day she asked her question in the House, she will get the clarification that she seeks. I will indicate to her that the alternative program is a perfectly good program that is respected and fits the bill very well for many people. We have no objection to the alternative program. In fact, for many people it is the best program, and people choose that for a variety of reasons.

The very nature of the alternative program makes it ideal for a standards test, because children are not necessarily at the end of the year finishing curriculum at the same pace. So therefore it is a very good program to use a standards test to measure progress. It is a diagnostic test. It is an enhancement to the other kinds of assessment that are done during the year.

In talking about the conversation which the member is fixated upon here, the member needs to understand that it is my--

Some Honourable Members: Oh, oh.

Mr. Chairperson: Order, please. Could I ask the honourable members who want to carry on such a conversation to do so in the loge rather than across the way. It is interrupting with my ability to hear what is going on here. Thank you. The honourable minister, to conclude.

Mrs. McIntosh: It is my understanding and belief that a person who believes that standards tests do not fit in with an alternative program, the very alternative program the member is referring to, the one at Laura Secord School, for example, standards tests are a perfect augmentation to that program. People who do not understand that either (a) have never been through the standards test process and therefore do not understand how it could connect with any program, and it could be a particular benefit with this one, because it is purely diagnostic.

So the attitude that they have towards testing is yesterday's attitude because the information that was provided to me, which I presume would be correct because it has come from parents from that program who wrote to me at the time and said standards tests are, and then described a very inaccurate picture of a standards test based upon their belief that a standards test, the type we administer today, is like the old standardized tests that used to be done in the '60s and '70s, and, of course, that is not true.

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So I had parents saying in their letters to me that standardized tests--calling them "standardized" instead of "standards"--measured the teacher, forced children to conform and be all the same, did a whole series of other things that are just absolutely wrong. The standardized tests of yesteryear that you used to buy off the shelf were like that, but the standards tests of today are not like that.

So the attitude towards the test was a past attitude, an attitude that was prevalent yesterday not today. The attitude towards the test was yesterday's attitude described to me, in writing, by people who clearly had a very confused picture of what a standards test is really all about and what it is attempting to achieve. It also showed a very clear misunderstanding of how the student profiles were used; again, yesterday's attitude, not prepared for the future, not relevant to today. That was the one part of the reference to seeing things as they were in the past as opposed to how they really are in reality today.

It was nothing against the alternative program, nothing against the parents of the students in the alternative program and nothing against the students in the alternative program. It had everything to do with a misconception of what standards tests were all about, what they were designed to achieve, how well they fit into particular programs of education because current understandings were missing. The understandings were yesterday's not today's, and the preparation for the future for the children then would be based upon impressions of yesterday rather than a preparation for the future in terms of assessment, in terms of diagnosis, in terms of student profiles.

The alternative program, of all programs, is one where a standards test would be ideally understood by the teachers of the alternative program. I have parents who are going to say to me that the teachers would not know what to do with an alternative test or the test in an alternative program, and I think that is wrong. I think the teachers in that program would have a better idea than most because they are assessing on individualized-type education programs all along. They are doing constant assessing with students at different levels of learning with differentiated instruction, differentiated teaching, learning at the child's pace, not completely perhaps, but more closely attuned than a grade-by-grade way.

So they are in a perfect position to take a student profile which says John needs some extra work on spatial relations. This showed up in question 2. Here is where his gaps are and here is what needs to be done to strengthen them, or Susan has done extremely well in her understanding of patterns and the early stages of probability, because those questions are there, and they can say Susan does understand the early understandings of probability and you can build on that strength to accelerate her at her own pace, because she has shown that she is advanced in that area.

The standards test for Grade 3 is particularly ideally suited to the alternative program, because it also has the ability to identify those students who have reached beyond the Grade 3 standard. In reaching beyond the Grade 3 standard, the alternative education teacher then can identify those students who can be moved into areas of deeper understanding at a more rapid pace. These are excellent diagnostic tools.

When I say "yesterday's"--and I am talking about attitudes, understandings, perceptions, patterns of behaviour--and I talk about the tests from yesterday that you used to buy off the shelf and give and they were standardized tests, and I compare them to these standards tests, the member will have to agree these are good tests. They are good tests, excellent, and they have been praised as such. They are prepared by practicing Manitoba math teachers.

If the member wishes to imply that the tests are bad or not relevant, then the member, if that is what she is implying, that standards tests have no place in the classroom because they are not in the best interests of students, if there is an implication in there that the test itself is bad, as was in some of the letters I got from the parents in the alternative program, then she is saying that those practicing Manitoba mathematics teachers who prepared them do not know what they are doing, and I believe they do. They are master teachers.

The framework for the Grade 3 mathematics curriculum was prepared again by master teachers from provinces across the west. British Columbia, Alberta, Saskatchewan, Manitoba, Yukon, and Northwest Territories developed the outcomes and framework upon which our Grade 3 curriculum is based and upon which those tests are written. They are curriculum congruent with those outcomes.

Those outcomes are outcomes that students in the alternative program should have no trouble achieving. They should have no trouble achieving them if their work is being done well in the alternative program. They should be able to do this test with no problem, and it is not traumatic for them if the adults in their lives do not wish it to be traumatic for them.

Again, I come back to the member wanting me to explain what I meant about yesterday. Yesterday is an era when tests were surrounded with a pass/fail mentality. When I took my senior high, I wrote my exams, 100 percent pass/fail departmental exam. We are not doing that anymore. The test was not based necessarily upon my understandings as much as it was on the drill. The language arts exam, for example, was not based so much upon literacy as it was upon whether or not you had memorized well a portion of a speech from The Merchant of Venice. A good thing to memorize, a good speech, I remember it still, but it was not a literacy test the way today's is. So today we are measuring, because the people of Manitoba have asked to have measurable standards. They have asked very clearly and overwhelmingly and indicated their support for measurable standards.

I have had students where the adults in their lives have a different attitude from the one displayed by the member for Osborne (Ms. McGifford) and those parents who wrote to me from the alternative program. I have had students write to me saying: I had one whole class write to me. The teacher had them write about the Grade 3 test and send me their remarks. I got the tests, I got these letters, and the students wrote things like: Dear Mrs. McIntosh: My favourite question was question number such and such. I really liked that question because it was in the quiz book my grandpa gave me for Christmas. Those kinds of things.

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So the attitudes of those students towards the test was not that it was something to be feared and traumatized over, it was, oh, today we are going to do the types of things we do in some of these mind-puzzler quiz books that kids get for Christmas from their grandpas. Those questions can be fun, and they are fun. The member should sit down and do the Grade 3 test. I invite her to do that. She will find that it is a lot of fun to do. If it is approached with the right attitude, that today we are going to do a test, we are going to see how much we can remember of the things we have learned, there will be some questions in there that will be fun to do, and when you are done, we will see how well you have been able to learn these things and what more you need to learn to carry on. Those are very good things to have happen, not bad things.

But if the adults in a child's life say to the child repeatedly day in and day out for two months, you are going to write a test, it is going to be terrifying, if you fail your life will fall apart and you are going to be sick every morning, guaranteed the child will live up to those expectations. So it is, again, which is the attitude for today and which is the attitude for yesterday.

In terms of preparation for the future for the child now--I am just waiting until she is listening.

An Honourable Member: You have a long wait, because I gave up listening a long time ago.

Mrs. McIntosh: Well, okay, the member has said I have got a long wait because she gave up listening a long time ago. She asked for a detailed response to a question that she said I had not given enough detail on in earlier times. She said I did not give enough detail to my answer in Question Period. She wanted a detailed answer today, so she can clearly understand what I meant by yesterday versus tomorrow. I am trying to give her that because when I talk about yesterday, it is a very big thing I am talking about, she does not want the answer she asked for, and she is yelling from her seat something or other.

Does she or does she not want to have an intelligent dialogue about standards tests, what they are all about, why they are different from yesterday, and how they apply to tomorrow? Because I still now would like to talk about the children, and how standards tests apply to them in terms of preparing them to be tomorrow's people rather than leaving them behind as yesterday's people. If she does not want the answer, and it does cost $10,000 a day to run this Chamber, then I will sit down and we can save the taxpayers some money.

Mr. Martindale: Mr. Chairperson, on a point of order. I would like to refer the Chair to 46.(2) Decorum in Debate, which concludes a discussion about disrespectful or offensive language against any member thereof, and I would contend that this minister is using disrespectful language. So this is not a dispute over the facts. I think there is a rule that covers this, and I would ask you to request the minister to answer the questions rather than to attack members on this side. Thank you.

Mr. Chairperson: The honourable government House leader, on the same point of order.

Mr. McCrae: Yes, Mr. Chairman, I commend the honourable member for Burrows on the research he has done with respect to the rules of the House. I think that it can be an extremely subjective matter if one happens to be one side of the House or the other, depending from which direction the alleged disrespect emanates.

So, I think, what we have here is a situation where we will have a discussion going on about an issue, and as happens from time to time in legislatures right across our country, indeed in parliaments and legislatures going right back to the Mother of Parliament at Westminster, I suggest that debate often gets to a point, sometimes on a warm afternoon in a legislative Chamber, where members perceive a lack of respect, or sometimes that flows from a perceived lack of respect coming from the other side. Who is really to judge at the end of it all as to whether indeed these events give rise to the matters complained of by the honourable member for Burrows?

My reason for rising is not to take so much issue with the honourable member for Burrows (Mr. Martindale) in raising his point of order, but perhaps to ask you, Mr. Chairman, to, of course, consider the matter raised by the honourable member for Burrows but in the context of where are we and at what particular period of time are we there and look at the matter with the backdrop of all of the contributing factors that go into the consideration of such a point raised by the honourable member for Burrows.

By that I mean here we are at the 17th day of June, in 1998, some people, and I know when I return to my constituency on the weekends--I am trying to provide some help for Your Honour in arriving at a decision with respect to the point raised, and this is relevant, Mr. Chairman. I go to my constituency, and first they want to know, well, is the House sitting and how are things down in Ottawa these days? This happens sometimes, forgetting momentarily, of course, that I work here at the Legislature in Winnipeg, but the key point here is, is that Legislature even sitting? Some people--

Mr. Chairperson: Order, please. You cannot raise a point of order on a point of order, but could I ask--[interjection] I have stopped him for one second anyway. [interjection] Order, please. No, you cannot raise a point of order right now, but I will let you up in a minute.

The honourable minister, I would like to thank you for your presentation. I have heard enough on the point of order.

The honourable member for Burrows (Mr. Martindale) did not have a point of order. There are times in the House that we sometimes start to use words that drag us a little heavier into the debate than we tend to want to get to, but I do think that we as members should reflect on the words that we choose, as the Minister of Agriculture once said. Those words can sometimes drag us a little further into debate than we care to travel down that road.

So if I could ask members of both sides to choose their words very carefully as we are entering further into debate, I would appreciate it to aid the decorum of the Chamber.

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Ms. Friesen: Mr. Chairman, to the Minister of Education, during Estimates, the minister had agreed to table the teachers' comments on the marking of the standard exams, and she has not yet done so. I wonder if the minister could tell me when she intends to table those comments.

Mrs. McIntosh: Mr. Chairman, yes, I did absolutely commit myself to tabling the comments that the teachers made on how much they valued marking the examinations. The assistant deputy minister, Carolyn Loeppky, was gathering those from the archives to have them all typed up on a sheet, so that they would not be revealing the teachers' handwriting. They should be ready--I had thought they might be ready by now, but I will check when I go back to my office to find out when we can expect to bring them in, and if they are not completed, I will submit the ones that are completed. But there were, as you know, many, many thousands of comments, and so it takes a long time to transcribe them all. I will submit either a full or a partial list before the session is completed, as promised.

Ms. Friesen: Mr. Chair, as the minister is aware, I had not anticipated that they would be transcribed. I thought I was looking for the archival documents. Of course, I had offered to come and read them at the archives, but the minister, I gather, has decided to transcribe them and to present them in that format. I could assure the minister that I am not familiar with the handwriting of any teacher, nor would--[interjection] Well, the minister says from her seat that that was decided in Estimates, and the transcribing and typing of them I do not believe was. A transcribed document is not the same as an archival document, and it was not simply what I had expected.

I would like to ask the minister what her plans are for the Scurfield report. I gather that consultations have been continuing. I would like to ask the minister what kind of consultations she has done, the range of people who she has asked for written reports from and when she anticipates that process will be complete, and what she anticipates the next step will be.

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Mr. Chairperson: When this committee meets again, the minister can answer the question at that time.

The hour now being five o'clock, time for private members' hour. Committee rise. Call in the Speaker.

Committee Report

Mr. Marcel Laurendeau (Chairperson): Madam Speaker, the Committee of Supply has adopted a certain resolution regarding Capital Supply, directs me to report the same and asks leave to sit again.

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

Motion agreed to.

PRIVATE MEMBERS' BUSINESS

Madam Speaker: The hour being 5 p.m., time for private members' hour.

Proposed Resolutions. Resolution No. 41.

Mr. Gord Mackintosh (St. Johns): Madam Speaker, I believe there was agreement to go to bills today in private members' hour. You could solicit the House on that.

Madam Speaker: Agreed? [agreed]