4th 36th Vol. 16--Oral Questions

Madam Speaker: Prior to Oral Questions, I would like to draw the attention of all honourable members to the public gallery where we have this afternoon fifteen Kindergarten to Grade 9 students from Home Schooling under the direction of Mrs. Sandy Noble. This school is located in the constituency of Charleswood.

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

Mr. Gary Doer (Leader of the Opposition): Madam Speaker, St. Boniface Hospital has had a proud tradition of working for our community and working for the citizens of this province. It has had people who have worked as volunteers, have worked as staff, have worked in the communities, have worked on fundraising events and other endeavours that they have a lot of pride in. They were absolutely shocked yesterday to hear this Premier, who has reduced the staff and cut the beds, blaming them for the situation and crisis at St. Boniface, and for the risk that their accreditation is on, pursuant to the letter that we tabled here yesterday. This Premier has cut over 200 staff; he has cut over 200 beds. I would like, on behalf of the people of St. Boniface and the many volunteers and staff that have worked tirelessly on behalf of patient care, for this Premier to take responsibility for his decisions and apologize for his comments of blaming the people of St. Boniface yesterday.

Hon. Gary Filmon (Premier): Madam Speaker, I recognize that the member opposite likes to play political games every day that he lives in this House and in this political environment, and it is that kind of disservice that he does to the people of this province that results in his being in opposition all the time. He has no credibility. At no time, at no time did I blame the staff or the people who work or the people who volunteer at St. Boniface Hospital for those circumstances, and the member does a disservice to himself and his own credibility for even attempting to put that position forward.

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Mr. Doer: Again I am very disappointed that the Premier does not recognize that the volunteers that are on the board are the ones that hire the management. I remember and I recall the former Minister of Health, two Ministers of Health ago under this Premier, in implementing this Premier's cuts in health care, said patient care at St. Boniface Hospital would not be adversely affected by the Premier's decisions to cut operating funds for the hospital and cut the beds in that hospital.

Mr. Gary Doer (Leader of the Opposition): I would like to ask the Premier today: does he take any responsibility for the fact that according to nurses, in collaboration with management at the hospital, incidents that jeopardize patient care, incident reports that have been filed documenting jeopardy of patient care have gone, over the last two years, from 187 to 262, a 40 percent increase based on budget cuts that this Premier made and his former Minister of Health said would not impact patient care? Will this Premier start taking responsibility and stop pointing fingers at everybody else except himself?

Hon. Gary Filmon (Premier): Madam Speaker, I take responsibility for everything that our government does every day that I am in office, unlike the member opposite who has the luxury to be able to criticize each and every day, to be able to change his position at will from day to day, from hour to hour, to be able to come up with a twisted, distorted point of view no matter when he wants to come up with his position on any issue just so that he can ensure that he is always being critical of this government.

I will tell him that I am very proud of the fact that since we have been in office for 10 years, we have increased our funding to health care by $600 million a year, that we have been able to provide more than 34 percent of our budget to health care, the second-highest percentage of any province in Canada, that we have been able to increase the number of personal care beds, that we have been able to triple the funding that we give to home care, that we have been able to continue to offer new and better ways for us to adjust a system that was built based on the needs of 30 years ago that has new and emerging and changing needs for an expanding seniors population. Those are the kinds of things that we will continue to do to improve the opportunities for our health care in future and to be able to assure Manitobans that when they need health care it will be there for them.

Mr. Gary Doer (Leader of the Opposition): The Premier did not apologize on the first question. He did not answer the question about the 40 percent increase in patient jeopardy in incident reports over the last two years under his stewardship in terms of the crisis in health care.

Madam Speaker, we have given this government lots of ideas. We told him not to close Odd Fellows nursing home until he had some place to put the patients before. We said you had to have a long-term plan in health care which, of course, this Premier broke in terms of his broken election promise by promising one thing after the federal budget before the election and doing something else.

I would like to ask this Premier: why should we ever believe this government again when this former Minister of Health said no patients would be in jeopardy on the basis of the cuts that this government has made? Why will the Premier not take responsibility for closing over 200 beds at St. Boniface, firing over 200 staff and leaving the hallways and the hospital in crisis, rather than blaming management, Madam Speaker?

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Hon. Gary Filmon (Premier): Madam Speaker, the member opposite knows full well that there are changes taking place throughout Canada in the health care system and that the things that he is accusing this government of are the same policies that are being adopted by New Democratic provinces in British Columbia, in Saskatchewan that were implemented--hundreds, in fact, thousands of beds cut in Ontario under New Democratic administration.

The only thing that the public knows is that if they relied on the New Democrats under this Leader, all they would have is greater chaos in the system because of the mismanagement that they represent by changing their position every day, every month and every week. That is the kind of chaos that they would not want to have, Madam Speaker, I can assure him.

Mr. Oscar Lathlin (The Pas): Madam Speaker, in the spring of 1995, as I was walking down the hallway here one day, the minister who was then Minister of Health came chasing after me and grabbed my hand and told me to congratulate him. He remembers that. When I asked him what for, he said: because I just announced a $600-million capital, and that will include the construction of the personal care home in The Pas. Then he told me afterwards, he said: and you said it would never be done. Well, we all know that right after the election, that budget was scrapped and there went the personal care home in The Pas.

My question to the Minister of Finance (Mr. Stefanson) is: who should the people from The Pas believe, the CEO of Norman region who said it will never happen this year or the press releases of this government?

Hon. Darren Praznik (Minister of Health): Madam Speaker, I believe it is the St. Paul's facility in The Pas that the member refers to, which is a replacement of 60 hostel beds with a personal care home facility--is a project that is very much needed in that particular community. We would have wished that we could have proceeded with that full capital plan when we did, but we have had to manage the budget. We managed it in a way that we put a freeze on for the whole province, not just one community.

We now have the resources to begin that capital program and, as was announced in the budget, the financial authorities to build that facility are included in this year's package. I am not sure of the status of the work that has to go on with the planning, but I would hope that it can be done as expeditiously as possible to be in the ground. Regrettably, I am not an architect or an engineer, but the financial authorities to proceed on that basis are now in place.

Mr. Lathlin: Madam Speaker, my second question is directed to the Minister of Health. I would like to ask him to explain how it is that even now his government still does not have any design work or planning being done for this project, and yet he knows that his own government reports have shown that The Pas Health Complex is a firetrap.

Mr. Praznik: Madam Speaker, I am not quite sure which facility the member is--

An Honourable Member: St. Paul's.

Mr. Praznik: St. Paul's as opposed to The Pas Health Complex. I think the department has been aware. That is why the replacement project is certainly on our priority list and one that has been approved. I would be very happy to share with the member for The Pas an update on the status of that project in terms of the architectural and design work, where it is at. I do not have that in front of me today. I would invite him, as we move through this project, to be a part of it and to share information for the benefit of his community. I would certainly make him aware of it as we progress, but the important point is that the financial authorities to proceed with that project are now in place with this budget, and we are going to get on with it.

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Mr. Lathlin: Madam Speaker, I would like to ask the Minister of Health if he can explain the statements made by CEO Gerry Hildebrand when he says here, and I quote him: Plans need to be drawn up before renovations and building can occur. He went on to say: This project will not happen this year as the government has not yet spelled out exactly what is going to happen.

Mr. Praznik: Madam Speaker, I cannot explain the remarks the CEO reported in the paper other than to say this: The capital budget was tabled as part of the budget statement of the Minister of Finance (Mr. Stefanson). Our department is in the process now of advising all the regional health authorities on their approvals. I can tell you that my Deputy Frank DeCock and I have spoken about ways of ensuring that we staff up our Capital Branch to move every project along as fast as is humanly possible. The details on each I do not have in front of me.

I am hoping that we are going to be able to move very quickly on all of these projects. Specific projects, I do not have an update on the timing or the state of the architectural plans for that project, but the financial authorities are in place. We will gear up that particular branch to work as quickly as possible to get these projects into the ground.

Mr. Dave Chomiak (Kildonan): Madam Speaker, my question is for the Premier (Mr. Filmon). Only in Manitoba is there an inquest going on into the death of children at a children's hospital. Only in Manitoba has there been an inquest into death at a personal care home after we had warned the government. Only in Manitoba has a tertiary facility like HSC been faced with loss of its accreditation because the government cancelled its capital plan. Only in Manitoba is the other tertiary care facility facing loss of its accreditation because of government cutbacks.

Now, after 10 years, Madam Speaker, the Premier said this morning: we can look to improvements in our health care system after a year and a half. How do Manitobans expect us to believe this Premier after 10 years of terrible, inadequate management and not caring for the people of Manitoba?

An Honourable Member: Heartlessness.

Mr. Chomiak: Heartlessness.

Hon. Gary Filmon (Premier): Madam Speaker, virtually every one of the kinds of circumstances that the member opposite paints have occurred at various times in the recent past in many different provinces in Canada.

An Honourable Member: No.

Mr. Filmon: Absolutely.

Madam Speaker, in Manitoba we commit over 34 percent of all of our spending to health care. That is the second-highest level of any province in Canada. In Manitoba, because of the commitments of this government, we have tripled the investment that we make in home care and have been lauded all across Canada as having the best system in home care anywhere in Canada. We in Manitoba have added a thousand beds in personal care homes to make the transition to the community-based system for caring for people. We in Manitoba have made a commitment to hundreds more beds on the personal care bed side that have been announced by the Minister of Health (Mr. Praznik), that have been committed in the budget of--

Some Honourable Members: Oh, oh.

Madam Speaker: Order, please.

Mr. Filmon: Madam Speaker, if the members opposite do not want to hear the answer, then they should not ask the question.

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Madam Speaker: The honourable member for Kildonan, with a supplementary question.

Mr. Dave Chomiak (Kildonan): Madam Speaker, in Manitoba we have lost, according to MARN's statistics, 11,500 nurses down to 11,000. In light of what we have heard today with reports about the nursing incidents, will the Premier guarantee there will be more nurses hired back? How are you going to find those nurses to hire them back in a system that has been decimated by these bed cuts and the loss of confidence in this system, in this Premier and the way you have operated this system?

Hon. Darren Praznik (Minister of Health): Madam Speaker, several of the points that the member for Kildonan has raised in both his question and his supplementary question flag some of the fundamental problems in health care delivery systems across Canada. No one's fault; they developed over 30 years of building a system--[interjection] Now members opposite really do not want to listen, but I think this is a very key point, and if they spoke to New Democratic Party Health ministers in other provinces, they would have a better appreciation of it. We built a system when we brought in medicare, beginning in Saskatchewan, of an insurance scheme with private providers. We brought in a Canada Health Act with restrictions in funding, and we have built layer upon layer of administration and governance.

We are undergoing one of the major changes in health care probably in this century, as significant as bringing in the medicare system, right across the country. One of those shifts was from the acute care side to the community side. That resulted in those layoffs. Many of those nurses were picked up in other systems. As the system stabilizes, as we now see, there are many opportunities for people to go into the nursing profession. They will be there because the opportunities are there.

Madam Speaker: The honourable member for Kildonan, with a final supplementary question.

Mr. Chomiak: Madam Speaker, how can the minister explain the government's inability to hire nurses when the plan for just one--just one of their 12 or so regional health authorities is planning to hire a CEO, a VP corporate services, a VP regional programs, a VP support services, a VP human resources, VP administration, VP professional practice, chief financial officer, chief operating officer, VP health services, executive assistant and on and on and on, and they cannot hire nurses to man the beds that are resulting in loss or potential loss of accreditation in our health care system?

Mr. Praznik: I assume that the member is speaking about the Winnipeg hospital board.

An Honourable Member: No, he is not.

Mr. Praznik: Well, Madam Speaker, I am not sure which one in their plan, but in the case of our regional health authorities, as they gear up, all of them had to put in place their staff and operations to be able to do the job. The plan and the reality, as they work through those changes, is that they will be absorbing those dollars from what is normally spent on administration and facilities and to do it at the end of the day spending less. So it will result in a saving that will go directly back into health care. Does it happen overnight? Absolutely not. In fact, if they did it that way, the members would criticize us for not having in place a transition. So you cannot have it both ways.

Madam Speaker, when we last winter realized that we were facing the flu issue coming upon us, we did authorize funding for additional beds which meant the staff and the nurses for those beds to staff them, and they were hired.

Mr. Steve Ashton (Thompson): Madam Speaker, if there was any doubt that after 10 years this government is becoming increasingly aloof, arrogant and out of touch, it is the statements made by this First Minister blaming the St. Boniface Hospital, suggesting that they can fix the problem by cancelling surgery, blaming the management, blaming everybody except himself. I think anybody in this province right now knows there is a crisis in health care. I would like the minister to perhaps take the lead from some of those great, compassionate Tory Premiers, who have admitted their mistakes in recent days, and admit that his health care policies in this province have failed this province and apologize to the people of Manitoba.

Hon. Gary Filmon (Premier): Madam Speaker, the member for Thompson can play all the political games that he wants and attempt to misrepresent my comments in any way he wants. The truth of the matter is I have not blamed the people in the hospitals. That is his assertion and he is wrong.

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Mr. Steve Ashton (Thompson): Madam Speaker, the people of Manitoba heard what the Premier said.

Madam Speaker: Order, please. Would the honourable member please pose his supplementary question now.

Mr. Ashton: As a supplementary, I would like to ask the Premier what hope they can take from this rather incredible statement today made by the Premier that says that there will be a massive improvement noticeable by probably the middle of next year. When is the Premier going to recognize that we have a crisis in health care today and we need action today, not in 18 months?

Hon. Gary Filmon (Premier): Madam Speaker, many of the things that we are doing will have immediate impacts, positive impacts. Just last evening I was out at a gathering at which a number of women approached me and said how pleased they are that we are going to be funding two mobile breast screening units in the province.

The commitments that we have made that triple the amount of funding for home care are ones that we have had many countless people stop us and thank us. They have immediate day-to-day impact in a positive way on the system.

What I was speaking about in the transcript that the member opposite quotes is the fact that when you are building personal care home beds, the time between the design, the engineering, the architect's work, the local--

Some Honourable Members: Oh, oh.

Madam Speaker: Order, please.

Mr. Filmon: And the construction is approximately a year period. We have made the commitments. The construction will be done, and the work is underway. But I will not, Madam Speaker--if I were to have said that it is going to change it tomorrow, the members opposite would have been up tomorrow saying that it cannot be done by tomorrow. We operate with realism. We do not operate with fantasy and wishing that the members opposite--we do not stand and criticize and criticize without offering positive alternatives, and we are being realistic.

Madam Speaker: The honourable member for Thompson, with a final supplementary question.

Mr. Ashton: Thank you, Madam Speaker. When will this Premier recognize that the only person in this province living in fantasyland is this Premier who after promising in 1988 and 1990 and 1995 these kinds of planned improvements for health care that today, 10 years with his government in power, we have a crisis in health care? When will the Premier come out of fantasyland and deal with the people who are suffering because of his health care policies?

Mr. Filmon: Madam Speaker, every year that we have been in office we have been adding and adding and adding to the expenditures and investments in the system. I have been present at the opening of two personal care homes in North Kildonan, numbering I believe around 240 beds. We have opened the Riverview Health Centre with 140 beds, something of that nature.

An Honourable Member: Replace.

Mr. Filmon: Well, they are yelling "replace." I remember when they were in government for seven years and refused to deal with that issue. One of the oldest facilities, one of the most time-dated facilities that was in our system, and they refused to deal with it.

I have been at the opening of hospitals in areas such as Altona, in areas such as Minnedosa and all of those areas. These are commitments we are making. That is why we are spending $600 million a year more on health care than they were when they were in office, and that is why the people of Manitoba can rely on us to continue to make that investment, because they know those improvements have been made and will continue to be made.

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Mr. Kevin Lamoureux (Inkster): Madam Speaker, my question is for the Minister of Finance. What Manitobans expect is a sense of fairness when they have to pay taxes. The people who live in Winnipeg School Division No. 1 do not get that sense of fairness. When I contact Beausejour, for example, if you live in a house of value of a hundred thousand dollars, you will pay $760 in school tax. If you live in Winnipeg School Division No. 1, in a house of the same value, you are paying well in excess of a thousand dollars. I am pleading to the Minister of Finance: will he finally acknowledge the inequities of the financing of public education and make a commitment to deal with that issue?

Hon. Eric Stefanson (Minister of Finance): Madam Speaker, this is the same issue that the member for Inkster and I discussed just a day or two ago. I think if he looks at a property tax bill, he will see that it has three components. It has the municipal portion, which is about half of the tax bill. The other half is related to education, and that is split basically in half again with roughly half of it being for the education support levy and half of it being for the special levy. The education support levy is uniform across the province. The special levy varies significantly by individual school divisions based on choices they make in those divisions in terms of services, costs and so on.

So that is how the system currently works. That is one of the reasons why there are differences in terms of taxes in various parts of our province. Again, I challenge him--he is onto this issue--be constructive. Provide some alternatives, some suggestions as to how he sees--if he is suggesting shifting from property tax, how does he suggest those funds be provided?

Mr. Lamoureux: Madam Speaker, I am asking the Minister of Finance to acknowledge the inequities that are there in the financing of public education. I know what it is that he is speaking of in terms of the splitting of the taxes. The bottom line--and I ask the Minister of Finance--is to finally acknowledge today that there are serious inequities when you have people who live in a house of the same value paying well in excess of a thousand dollars in one area of the province and others who are paying well below $800. There is a serious inequity there. When is this Minister of Finance going to deal with that issue?

Mr. Stefanson: Madam Speaker, if the houses are of the same value--and we currently in Manitoba have a market assessment which adjusts the values every three years--the difference in the tax bill is a result of the mill rates, either a combination of the municipal mill rate or the special levy mill rate, because the education support levy is the same province-wide. So those are decisions on the municipal--those are decisions made at the municipal level in terms of the kinds of services they are going to provide to those communities. On the special levy, again those are decisions made at the individual school division level in terms of the types of services, the quality of services, how they end up settling with the collective bargaining with their teachers, with their other employees and so on. So those are the factors that cause the kinds of differences that the member is referring to.

Mr. Lamoureux: Madam Speaker, the Minister of Finance is wrong.

Madam Speaker: Order, please. The honourable member for Inkster was recognized for a final supplementary question on which no preamble is required.

Mr. Lamoureux: Madam Speaker, can, then, the Minister of Finance tell my constituents why collectively every year they have to pay millions of dollars more towards public education than other constituents throughout the province of Manitoba? Why do those constituents have to do that? Can the Minister of Finance explain to my constituents that simple question?

Mr. Stefanson: Madam Speaker, I would suggest to the member for Inkster that that might be a good question that his constituents ask the school trustees for that area because, as I have already explained to him, the education support levy, the mill rate for that levy, which is set by the province, is uniform right across the province. Where we have differences are on the special levies which are different for each individual school division across our province, and that is for a range of reasons. It is for the level of teachers' salaries, other salaries, other services, other costs and so on. So that certainly is an appropriate question for him and his constituents to be asking the trustees in that particular school division.

Mr. Gerard Jennissen (Flin Flon): Madam Speaker, my question is to the Minister of Finance. Further to the questions posed earlier by my honourable colleague from The Pas, Flin Flon was also promised a personal care home on March 16, 1995, and this project, along with many others, died after the election.

Could the Minister of Finance tell the residents of Flin Flon why he is quoted in the Flin Flon Reminder as stating that funds have been slated to renovate a second dialysis station at the Flin Flon General Hospital, when the CEO of the Norman Regional Health Authority says this project and other renovations at the hospital will not happen at all this year?

Hon. Darren Praznik (Minister of Health): Madam Speaker, I have not had the opportunity to speak with the CEO of that health authority to determine exactly what the CEO has said. I seem to get the sense that a line out of a story is somewhat reverberating here and being applied to every particular situation. I will endeavour to find out exactly what the timing is on those projects. The authority, the financial authorities are in place. I am not sure what work has to be done in terms of architectural design, engineering, et cetera, but it sounds like providing for a dialysis unit should be able to move forward relatively quickly, and I will endeavour to find that out, the specifics, for the member for Flin Flon.

Mr. Jennissen: To the Minister of Health, Madam Speaker: if the projects listed in government press releases are not going to actually happen in the same year of the releases, why other than to try and confuse the public did this government put out these releases?

Mr. Praznik: You know, Madam Speaker, I have followed politics most of my life, and I remember growing up in the Selkirk constituency, our MLA in 1969--then became MLA--Howard Pawley, promised a hospital in 1969; he promised it again in 1973; he promised it again in '77; and the Conservatives under Bud Sherman built it in the 1980s. So I make that point only to illustrate that there are a number--and if the member would like a detailed discussion on the process for capital improvements, whether they be in Health or Highways or other areas, I would be delighted to do it, but there are a number of processes that have to be gone through. One has approval in principle, one has design, et cetera, funding for construction. Each step has to be gone through. We have the financial authorities in place to build these projects. If the designs and plans are not there ready to go, that work has to be done. Surely to goodness the members would not want us putting out the contract without having a plan for the contractor to build.

Mr. Jennissen: To the same minister: when will the Minister of Health list the actual dates of construction, costs and details of any of these proposed renovation projects at the Flin Flon General Hospital so that Flin Flon residents can judge for themselves whether these are indeed real commitments and not just more so-called announcements?

Mr. Praznik: Madam Speaker, the member certainly flags what I would consider to be a reasonable expectation. As we work through the details on each of these projects, we will want to convey that to the communities. With respect to things like specific costs, as the member may note, we have estimates of costs for projects, but ultimately until they are tendered and we have the results of tenders, the specifics of course will not be known, only our estimates. But I would invite the member, as we develop the details of this plan--and as I have indicated earlier, I have asked my deputy to ensure that our Capital Branch is staffed sufficiently to be able to get on with these projects as quickly as possible. We appreciate the urgency of them. We are certainly not happy that there was a delay in many of those projects, and I would be delighted, through my office, to keep the member informed so that he can ensure his constituents are well aware of the progress of these projects.

Mr. Leonard Evans (Brandon East): Madam Speaker, I would like to address a question to the Minister of Health, who should know that we are now in a crisis situation in Westman because the two remaining pediatricians have now formally advised that they intend to withdraw their on-call services at the Brandon General Hospital tomorrow because they are overworked, underpaid and frustrated after many, many months of fruitless negotiations. The CEO of the regional health authority has publicly stated that he has no role in the dispute and that negotiations are directly between the minister's department and the Manitoba Medical Association. He said that regardless, he has no money to pay--

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Madam Speaker: Order, please. Would the honourable member please pose his question.

Mr. Leonard Evans: Will the minister now take necessary action to deal with this crisis and ensure the people of Westman that pediatric services will continue to be offered at the Brandon General Hospital after tomorrow?

Hon. Darren Praznik (Minister of Health): Madam Speaker, the member is quite right in quoting the comments of the CEO, and the CEO is very accurate. The issue as to levels of remuneration for services that physicians provide is a matter that is dealt with by the Ministry of Health, the Province of Manitoba with the representatives of physicians, the Manitoba Medical Association. The last thing I think we would want to get into is what we had happening across the province on occasions in the past where special arrangements were negotiated between individual hospital boards with physicians, and we ended up with a very, very different system of remuneration.

I can tell the member that the Ministry of Health did offer to recruit a pediatrician from South Africa. That was not accepted by the regional health authority. That person may have been able to have been recruited to come into that place. We also worked with them to convert our fee for service into an alternative payment arrangement which would have resulted in a payment of nearly $175,000 a year per physician, which I think the member would agree is not an underpayment.

Madam Speaker: The honourable member for Brandon East, with a supplementary question.

Mr. Leonard Evans: Exactly what will the minister do to deal with this crisis tomorrow that is a threat to children and their families in the Westman area? Because the solutions he talks of are long-term solutions; they may work in the long term, but they will not address the crisis that exists right here and now.

Mr. Praznik: We use the word "crisis" sometimes loosely, and sometimes it becomes used for issues. Surely when we have a significant amount of dollars on the table, this is really a negotiation. We are beginning the process of negotiating a new contract with the Manitoba Medical Association, and that has to be dealt with on a province-wide basis; otherwise it will just not work. It would not be fair to other physicians.

I understand that the Brandon Regional Health Authority has done work to provide provision of service for people in Brandon in emergency situations. It is not the most desirable situation, but the member well knows from his background in labour that when you have these disputes happen, sometimes they are not always resolved quickly or the way one would like it, but alternative arrangements, I understand, have been made by the Brandon Regional Health Authority.

Madam Speaker: Time for Oral Questions has expired.