HEALTH

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

Mr. Gerry McAlpine (Sturgeon Creek): I too would like to put a few remarks on the record with regard to this motion by the honourable member for Kildonan suggesting to this House that the Minister of Health (Mr. McCrae) has been less than kind in terms of the home care people and the clients that are out there, in the best interests of providing the service to them.

Mr. Chairperson, I represent a constituency in Sturgeon Creek that has one of the highest populations of seniors in the entire province. It really troubles me to see what the honourable member and his colleagues are trying to impose on the public and the society in terms of Manitoba when we talk about health care. The issues that we are facing today in terms of the home care issue is not an issue of privatization or cutting salaries as the honourable members across the way would like us to believe and what they would like to communicate to the media, which seems to be prevalent when you look in the media today, that those are the issues.

I think really it is a philosophical difference that we will always have between the official opposition and this government. It is one of competition versus monopolies. I think the monopoly that is in place today has failed. The example that it has failed is because the people who are there within the monopoly to provide the service to these vulnerable clients, many of them that live in Sturgeon Creek, that service has been withdrawn by this monopoly. That really concerns me, and I think what we have to do as a government--and we have all been elected to do this--is to provide the service to those people whom we are elected to represent. That is why I stand here in this Legislature today to do that very thing.

But it seems that there are some mixed messages in terms of the honourable members across the way, because I do not really believe they are speaking from their hearts when they talk in reference to those people whom they say they are representing, as to the clients who are in need of this particular service. I do not really believe that is their utmost purpose, and when they stand in the House and speak about those people, they speak about other people, people who are heading up the monopoly and would like to use these clients that are in need of this service and hold them in less desirable situations than they should be.

What we look at here, Mr. Chairperson, is in the constituency of Sturgeon Creek. I dare say that there are a large number of those people who live in Sturgeon Creek who are affected by this. But I have had the experience over the last week or 10 days since the strike of April 16 when these people, in their wisdom, withdrew the services to those vulnerable people, went on strike on the 16th of April. The government put in place an alternative opportunity to provide the service to those people and that has been working. It has been working extremely well, and I commend the Minister of Health (Mr. McCrae) and this government for the effort and the initiative that they have taken and the responsible care that they are providing to all of these vulnerable people who are less able to look after themselves.

I think it has to be put on the record that it is the Manitoba Government Employees’ Union or the association that voted not to strike--57 percent of those people voted not to strike--because it was only 30 percent or something to that effect, 40 percent, that actually voted and there was an 80 percent vote that was given. They said that 80 percent of the people who voted, but there were only 37 percent or 57 percent of those people who did not vote. I think that is something, that they are representing the minority over there in terms of this issue. To me, I am representing the people of Sturgeon Creek, a high population of seniors and a growing number of people who are going to want to have that service in the years to come.

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I think that what we are doing as a government, we have to expand on the home care service that is available and improve on the system that is there. If we continue to do what we have been doing over the last number of years, the home care system is going to be in absolute chaos because of the numbers that we are going to be dealing with, and when you consider what we have done here in the last eight years that we have been in government in putting from $38 million, we have increased that home care budget to $91 million. But yet the number of clients that that amount of money is serving and providing service for, the number of clients has not increased. I think that, again, is a message that the public is not maybe aware of, that we have to try to find better ways to do this.

You know, the honourable members talk about the matter of privatization. This is interesting, that the privatization that they talk about, they do not take into consideration that we had people who were in private business before, and that is the Victorian Order of Nurses, the home intravenous therapy program. The department has funded St. Boniface General Hospital for the co-ordination and delivery of the home intravenous therapy program with the VON, and they were the successful bidders.

The Central Health Services is another that have been given that private opportunity to invest and to work in the Home Care program. Ten Ten Sinclair, the department has a contract with Ten Ten Sinclair Inc., which is a private nonprofit agency to co-ordinate and provide personal care service to 60 residents of the four Fokus housing units and the two cluster housing units in Winnipeg.

Community Therapy Services, the Luther Home, the H-I-D-E Qu’Appelle Project, and we have another one, the self-managed care, in addition to the department contracts with 53 individuals under the self-managed care program.

Mr. Chairperson, I think that since 1988 the fact that we have increased the budget from $38 million to $91 million tells the story here as what our commitment is to this Home Care program. I think that if we are going to improve on this system, we are going to have to have the competition within the system in order to make it work better, because I firmly believe, being the entrepreneur that I am, being in the free enterprise system that built this country, that this is the best way to go, and the best opportunity is right now in terms of serving those people who are the most vulnerable.

The replacement workers that are going out, I have had good reports from the people, the clients that are in vulnerable situations, that they are very pleased with what kind of service they are getting. I think that what we have to do is to exercise a little bit of patience, because in the long term, this system is going to be far better off than what we are experiencing now and what we have experienced in terms of the complaints that have been coming forward from the Home Care people, the clients that have had difficulty for whatever reason. Those things could not be addressed under that monopoly that we have in the system today. I support the minister, and I support this government in the initiative that they are going forward on this Home Care program. Thank you, Mr. Chairperson.

Hon. Vic Toews (Minister of Labour): Mr. Chairman, I was just advised a few minutes ago that our public service here in Manitoba voted 57 percent against a strike. I understand that there are still some news conferences going on with the MGEU, and clearly we are going to have to examine the situation.

Point of Order

Mr. Dave Chomiak (Kildonan): Mr.Chairman, on a point of order, while I appreciate the minister making an announcement, I do not see how the minister’s statement has any relevance whatsoever to the motion that has been brought forth by ourselves that we are debating in this Chamber relating to the censuring of the Minister of Health (Mr. McCrae) concerning his handling of home care. I know that the minister is anxious, and I am not trying to take away the minister’s opportunity to make a statement, but I think this is the inappropriate forum given your directive earlier in this committee on relevance concerning topics.

Hon. Darren Praznik (Deputy Government House Leader): On the same point of order, Mr. Chair, I think the important point here is that the context in which the issue is being debated, the member for Kildonan (Mr. Chomiak) has moved a resolution about plans for home care. Part of the result of the proposed plans is a strike, which has brought into question a lot of issues and brought to the debate a lot of issues about home care. That strike takes place in the context.

Those people who are on strike are employees represented by the Manitoba Government Employees’ Union. Many of the services that are filling in are also offered by MGEU employees working for the province. Bringing that information to this debate is extremely timely to set the context for what is happening in the province on home care from which the member’s motion flows.

Mr. Chairperson: I thank the honourable members for their advice, but the honourable member for Kildonan does have a point of order. I would ask the honourable minister to refer to the motion within his statements. This is not the appropriate time.

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Mr. Toews: I think that it is very important in the context of this motion to understand that it is not just a minister who acts by himself or herself. A minister acts in the context of the Civil Service, of the public service and the public servants that work around him. The public servants in Manitoba have demonstrated over and over again that they are up to the task of meeting the challenges of Manitoba. When they are met with concerns, when they have concerns, they exercise their responsibilities in a responsible way.

The Minister of Health (Mr. McCrae) relies very much on those public servants in the same way that any minister in this House relies on public servants. Those public servants who support the programs that the government puts into place in the best interests of all of Manitobans, these public servants put their time and their effort into these programs. Not always do they agree with the government. Sometimes the public service has concerns about the way certain things are implemented but ultimately the public service will, I think, as demonstrated in this particular situation, the fact that they voted against a strike when health services are already under pressure shows the very responsible way that they are willing to undertake the challenges that meet Manitobans today.

When we talk about a minister’s actions or a minister’s policies, I think that has to be seen in a much broader context. I know that yesterday I led certain comments onto the record, and I, as the Minister of Labour and also as the Minister responsible for the Civil Service Commission, have a responsibility to the Civil Service. I have a responsibility to the public at large. I feel it very important when called upon to ensure that public servants who wish to continue their work should make sure that they understand that the government supports them.

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If employees in the Department of Health say even if their membership is on strike that we feel dutybound to continue to take care of those who are sick and vulnerable, we as government should be sure to commend them for their performance. This is a very important issue for many of these people in our health care system, people who carry out the day-to-day policies of the minister whose actions are being put under scrutiny. These people are put under tremendous pressure, and yet for moral reasons or other reasons, they feel compelled to come to work and to protect those who cannot protect themselves.

I note that in the MGEU’s material which was given to people before entering into the strike vote, they asked this question, and I think this is very timely in the context of this debate. They asked, will the government not welcome a strike since it would save money? This is the union asking this question. Will the government not welcome a strike since it would save money?

The union’s answer, of course, is strikes reflect badly on the government’s ability to manage. If MGEU members go on strike, the government will come under pressure from Manitobans who are affected by reductions in service. Unlike in Ontario, MGEU members are not obliged to provide essential services during a strike; essentially saying, turn your back on the poor, turn your back on the vulnerable. That is what these public servants were being advised to do.

You know, the public service, they read this material. They looked at the tremendous pressure that they were in from a union driven by ideology, a union that did not care about who is vulnerable, who is sick, but the union membership said to its leaders, no, it would be irresponsible to go out at this time.

Sometimes we underestimate the intelligence of the public, and we should never, never do that. We have to be responsive to the public, and we have to be responsive to the public service, because these are the voices that ultimately put us on this side of the House. We recognize that. These are the voices that are now telling us, we have not gone on strike. We want to work with the government in resolving this very, very difficult situation, and I am saying to you, Mr. Chairman, if the rank and file of the union are saying, let us work with the government to resolve these problems, then where are members opposite? Where are members opposite?

If the rank and file are saying, there are problems to work out, and we will deal with them in a rational way, we as government have an obligation to say, let us work together, and I call upon members opposite, where are you? Where do you stand in resolving these problems?

Mr. David Newman (Riel): Mr. Chairman, this is a great day because the public servants of this province have stood up as individuals severally and made a statement in spite of all the efforts of both the official opposition--

Point of Order

Mr. Chomiak: A point of order, Mr. Chairperson, I believe you just ruled that--on my previous point of order, I asked what the relevance was. I do not want to take away a member’s right to comment, but we are dealing with a resolution in this Chamber dealing with the home care issue, and the member, like the previous member, is starting off dealing with a matter that is not relevant by any stretch of imagination with the home care situation. The fact that a particular strike vote has or has not taken place with respect to the public servants’ union is not relevant to the issue at hand.

Mr. Newman: This is directly relevant, Mr. Chairman, to the motion which is talking about the failure of the Minister of Health. The failure that I am talking about is that these allegations are absolutely false, and the failure is the failure of the people making those allegations to back them up.

Mr. Chairperson: Order, please. I thank the honourable members for their advice. On the member’s point of order, at this time I would have to rule that he did not have a point of order. The member had just started to speak, and I do not think he had gotten into full swing yet. I think we will give him the opportunity to get into his speech, and if he is not relevant at that time, I will rule him out of order, but we will give him that opportunity.

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

Mr. Newman: What I want to do is to put the motion to condemn the Minister of Health in a historical context. You know, we are focusing on what seemed to be immense crises of the day inflated often by the rhetoric in this Chamber. But, if we go back to the days of the Depression and the days of the Second World War and what I am reminded of every time I look outside and see the floods and see what is in the media, the flood of 1950, and all of those challenges of those days that I know my parents were involved in dealing with, taking years of their lives to participate, investing their time and their resources and energy constructively to deal with the forces of nature and the forces of evil in countries throughout the world, the forces of an economy beyond control--and I say years of their lives, maybe 10 years, maybe 12 years in some cases.

Then we had the days of the ’60s and the ’70s when we had medicare and pensions and the Canada Pension Plan in 1966 coming into being. We had a social security network built up in this country, the envy, in many cases, of the world, but never did we fully until recently recognize, I guess, the cost of that and the tremendous privilege of having it, because now we are looking at to what extent we have to go to preserve it and we are making huge investments in time and energy and money to do that. You know, it was back in the ’60s, too, that the public sector started to be given the right to strike and the right to lock out. They were able to hold the public up to ransom. What we must recognize, we as honourable members, I submit, is, we must recognize that we have a responsibility in this Chamber and outside the Chamber to educate people, to inform people with facts, not to try and sweep them up in negative emotion generated by leaders of interest groups and the like, interested in resisting change and perpetuating a status quo which can no longer be supported by thinking people.

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If you look at the Canada Pension Plan as an example, a plan that was never to go beyond 5.5 percent of contributions, this year we are at 5.6 percent. It is projected to go to 14.2 percent by 2030. We know we have to change. We have to change for the sake of the younger generation who are going to contribute to that. Are they going to support the baby boomers and others to the degree to which we have become accustomed when they are taking more than twice as much out of their disposable income to pay for it?

We have to look at these things. We have to look at the health care system, as is being done in this home care situation. It is not a failure, submitted. All honourable members should see this initiative dealing with home care as another one of those kinds of necessary things to build a stronger and more viable system that respects consumer choice, because that is what has happened. We have come of age when, rather than government and government employees and those dependent on government directly coming first, the taxpayers and the consumers come first, and that is being demonstrated in this home care situation.

The failure that I am submitting is at issue here is not the failure of a Minister of Health, is not the failure of the initiative. It is the failure of honourable members opposite, the Liberals and NDP, both to stand up and lead, to stand up to resisters to change, to stand up for knowledge, to educate union leaders and employees and seniors and generally the people of the province about relevant facts and trends and responsibilities.

Challenge people to be better, to change, to adjust. Do not diminish them by allowing them to manipulate you so that they can be less than they can be. I submit the honourable members opposite are diverting with a motion like this, diverting attention from the real issues. They are not focusing on quality care, the best way of delivering services, freedom of choice, the best use of taxpayers’ money. The goal of the motion ultimately is to remove an effective minister with the real interests of people at heart and who because of his effectiveness is doing a job. They want to remove success.

The failure to stand up to union leaders for a moment, why are union leaders doing this? I submit, they do not want workers to have freedom of choice of unions. They are protecting the monopoly. They do not want to lose dues, so they protect the monopoly. They do not want to have to go out and recruit and retain new members in competitive enterprise organizations, so they protect the monopoly. They prefer to deal with a monopoly, one employer owned by taxpayers and managed by government, rather than businesses which compete against one another and strive each to be better and more cost-effective. Ample protection exists under labour laws for workers who want union representation and union rates. This has nothing to do with what they assert as union undermining or union busting; to the contrary.

Speaking about the New Zealand situation, Mr. Douglas was quoted recently as saying, too often in government policy we are locked into the means of delivery of the programs, and we lose sight of the end goals. We get captured by people maintaining the programs in their narrow focus, and we lose the overall picture. This is particularly true in social policy. He pointed out that we place higher moral value on protecting the rights of poor-quality teachers--this was referring to New Zealand--than we do in protecting the rights or the impact of those poor teachers on the 20 or 30 children being taught by them. In his view, competition beats a controlled monopoly and regulates markets every time. The only time the government has the right to spend a dollar of your tax dollars is when the government is spending it better and more effectively than you can. Otherwise, you should be making the decision to spend that dollar. Otherwise, he felt tax dollars are wasted, and the waste always impacts on the poor in society.

What is this all about, this reform? TQM is an example of what is happening in the private sector. If you translate that in here, you ask questions like, will the response time be faster than competition? Do you have the capacity to take on new products and services? Is your customer satisfaction higher than the competition? Do you have effective and efficient business process throughout your organization?

I thank you for the opportunity to speak on this motion, and I hope all honourable members will take to heart their need to be leaders of the people out there who are looking for leadership. Thank you.

Hon. Darren Praznik (Minister of Energy and Mines): Mr. Chair, it is a privilege to participate in the discussion in committee here today of this resolution moved by the member for Kildonan (Mr. Chomiak).

It is interesting to observe at this particular day of debate that the party that has put forward this resolution has seemed to abandon the field to make its case in this House. Speaker after speaker today has come from the government side because opposition members, members of the New Democratic Party, have not been prepared to come here today to make their case. This is the place where that case is to be debated and to be made, and I think, Mr. Chair, that is most indicative of the substance behind their argument.

They have made this debate into one that is really not dealing with some of the fundamental issues, and I would be the last person to condemn a good debate on home care if it were truly a debate that had to deal with the issues that are faced by government in the delivery of service, on finance, how does one expand, customer need, rather than a debate on rhetoric, fear, ideology and support for particular vested interests in the labour movement.

(Mr. Frank Pitura, Acting Chairperson, in the Chair)

Mr. Chair, what I have seen time and time again in Question Period, day after day, on the same issue is members of the New Democratic Party continuing to try to manipulate this very important issue, and it is a very important issue, worthy of great public debate, but they have attempted to manipulate that even with their language. One day they talk about privatization. When we point out that privatization also involves deliverers of care such as the Victorian Order of Nurses, the words change, and now they are “private, for-profit.” Again, just making the point that any negative words, any type of connotation that they can put that somehow implies that people are going to be cast out on the street, will not get proper care, will have miserable home care workers and not have services, is the image they are trying to cast, and that is not what this debate is about at all.

It is not what it is about at all, Mr. Chair, because anybody who is sincere in studying the issue of home care has to acknowledge that the home care system is facing a major, I would say, fork in the road. It has the potential for great expansion. The whole thrust of this government, which has been fought almost tooth and nail by members of the New Democratic Party, and I must say not by members of the Liberal Party. The former member for The Maples, Dr. Cheema, was very supportive of the initiatives and he gave us some very good caution and care and points to be concerned about in his discussions in this Chamber, but members of the New Democratic Party have opposed absolutely every major change that health care has to face, and they have done it, I believe, purely on the grounds that they are opposition and their role is to oppose blindly without thought or reason.

Where are we coming from? We know that we have made great changes and technology has resulted in great changes, where our hospital system today is able to deal with people in expensive hospital beds far faster with far better results. The Minister of Health (Mr. McCrae) has pointed out on a number of occasions, I think it is Victoria Hospital now does more surgery than ever before, and two-thirds of it is on a day basis. Only one-third has an overnight stay, and that is a complete reversal from just a few years ago.

So that has meant a greater and growing demand for home care services in our province. So we have to look at, how will the home care system adapt to that?

In the time allotted to me I want to talk a little bit about my constituency. In my constituency there are many seniors who use home care. I have a large number of seniors, particularly in the retirement areas of the beaches and around Lac du Bonnet as well as in the town of Beausejour, and I can tell you, the home care workers who deliver that service in a variety of different methods now are by and large very, very good and do an excellent job, and I commend them for their efforts. They are very dedicated.

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But one of the ongoing complaints that I get from seniors on a regular basis is the wish for many seniors to be able to obtain additional services that we in government do not provide, cannot provide and, they would even say, should not provide. I hear it time and time again, particularly in the area of cleaning, that many of the seniors in my constituency are looking for someone who they can trust, are happy with, know who will do additional cleaning for them at certain times of the year, who will maybe pick up groceries for them. You know what they tell me? Even the poor seniors in my constituency tell me that they are prepared to pay for that service.

If one simply looks at the growth in home care and where we are going with home care and the seniors and the customer base that is using it, which has been an expanding customer base, there is a growing and even, I would argue, there will be a huge demand in the future for additional services. Can we provide that as government? No. How can those services be provided efficiently? They are not going to be provided efficiently and in a cost-effective manner if we have two services coming into people’s homes. They are not going to be able to afford that if you have one government worker coming in to bathe you and then another worker coming in an hour later to provide you a particular cleaning service or additional service.

The efficiency comes in the fact that one person can come in and provide you with the whole range of services that you want, government insured and funded services, as well as the additional services that you want to buy. Can government put that together? Absolutely not. Government does not have the capability to provide those kinds of massive additions in home care, in just organizing it efficiently, that the market, the people, the customers, the consumers, the constituents of mine and of the member for Kildonan (Mr. Chomiak) want, need and desire in the days ahead.

Mr. Chair, I am looking forward to the kinds of changes that are coming in my constituency. The Minister of Health has indicated that home care is one area that is going to come under control of our local boards.

I can tell the member for Kildonan, if he would have a realistic conversation with people about this issue, that in my constituency there are groups already who are looking at, with the health district, being able to take over that Home Care program. Home care workers are interested in that in order to provide the expanded services.

I believe when we see this kind of system develop in our province, we see this happen, the fear that home care workers’ salaries are going to be lost and diminished and all these things will be for nought, because, quite frankly, those additional services, the efficiencies of that, will ensure that home care workers receive reasonable remuneration for the work that they do. But it means that more services will be offered.

The member today did raise one concern about people who may not have the competence to know whether or not they really want a service or if they are dealing with someone who has a great deal of pressure, and, yes, that is a concern. That happens now all the time in the province in home construction and renovation and other things with seniors, and, yes, that has to be addressed and dealt with. But is that a reason to throw the future away; to throw improved and efficient service away; to throw the meeting of customer needs away, simply because of a concern that some people might end up being forced to purchase services that they do not want?

We have to address that issue, but that is not a reason to throw away the better system.

Mr. Chair, I think anyone who examines this in a thorough and complete fashion will come to the conclusion that there are lots of opportunities out there for everyone to benefit. We as a government are putting more money into home care this year, not because it is going to fund the profit of companies and all of those kinds of things. It is there because we need more home care. The reforms we have brought in as a government, through two ministers of Health, mean that people are getting more care in their home rather than expensive institutions.

By the way, that was opposed in every practical move by members opposite. So they cannot have it every way in the world. They have to get into the 1990s; they have to realize that the world is changing, and that you have to adjust your structures and methods to meet that change, and not entrench themselves in methods, whose ability is no longer adequate to serve the needs of the times. Thank you, Mr. Chair.

Hon. Glen Findlay (Minister of Highways and Transportation): I want to spend a few moments putting a few comments on the record. To put it bluntly, I am going to make these comments because I am incredibly disappointed by the attack of the member for Kildonan on our Minister of Health, on the government, and really, in a broad sense, an attack on all the care providers in health care who are not members of a union.

I think the member has really got a very narrow view of health care in this country, in this province. Health care came in a number of years ago, has been expanded, and we all believe very strongly in the principle of universality, that everybody should have reasonable access to essential health care.

Over the course of the last 10, 15, 20 years, the base of health care provided, so-called free, from the taxpayers’ pockets has expanded dramatically. Along the way, the cost of delivering the services the people want and need and should expect in a country that is No. 1 in the eyes of the United Nations has expanded.

We cannot go on forever throwing more money into health care. I defy the members opposite to find one province, one jurisdiction in this country that does not say that and believe that.

The NDP in opposition in Manitoba are trying to avoid everything that is going on in this country. Obviously, they are going to now be looking at what is the impact of the vote today, which said 57 percent of MGEU does not want to strike, a tremendous slap in the face for the NDP in their approach here and the union leadership in Manitoba in the broad sense of delivery of government services, but specifically to health care.

The NDP governments in Ontario did not listen to the people, were defeated. In Saskatchewan they listened to the people and followed the same agenda we are on here and were re-elected. British Columbia is in a quandary right now, whether they will or they will not; they are drastically trying to change the direction under a new leader. These are the realities of the world. The public is a lot smarter than the NDP gives them credit for. The public has been very adamant that we want the best health care we can afford, as broadly based as possible in the context of universality.

(Mr. Chairperson in the Chair)

We have delivered on that, and we have worked aggressively through two ministers of Health to be able to deliver the essential services of health that the public wants and are affordable to the taxpayer. Members opposite totally and utterly reject that approach. They try every means possible to denigrate the Minister of Health (Mr. McCrae), and it is certainly culminated in this resolution put on the floor by the member from Kildonan (Mr. Chomiak).

It is astounding that they put the resolution forward and do not have the courage to stand up and debate it. Maybe it is because the press are not here, maybe it is because their union friends are not sitting upstairs, but it is appalling they would bring it to the House and not have the courage to debate it--courage, not to debate it. If the member from Selkirk (Mr. Dewar) wants to debate, I would gladly sit down. If he would just indicate now he wants to speak, I would sit down, and he could stand up and speak. We will get a change to vote on it, do not worry, but the member opposite should have the courage to at least stand up and debate it. They had the courage to bring it forward. Did they think somehow it would not draw our attention, that we would not stand up and talk to it? It gives us the perfect opportunity to talk about the system we have, how it has developed and the essential decisions that have to be made to keep it healthy.

Clearly, in our economy in Manitoba and in Canada, choice and competition are wanted by everybody. People do not want to have one grocery store; they do not want to have one place to buy a car. They want choice; they want different colours, different models. Competition creates efficiency. Absolutely anybody out there in the real world will tell the member that. If you did not have choice, you do not have as effective a service or as efficient a service or as cost-effective a service.

Any element of competition brought in will improve the level of service to the client, and that is the bottom line to us, must improve the level of service to the client. We are not here to guarantee jobs; we are not here to guarantee salaries. We are here to be sure we maximize the ability to deliver the services needed to the clients at large in the process of home care. And the argument is obvious. We talk in favour of the client, we say competition and choice of service provided will allow that client to have the best, most cost-effective, responsible service possible within the available dollars.

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The members opposite are arguing not for the client. They are arguing strictly job security in a monopoly and a salary. They are prepared to have their union members walk away from their clients, walk away; that is the ultimate disrespect for the client, to take that position and to come to this House and argue every day that we should throw money at the problem instead of finding a constructive solution that allows responsible people to deliver the services.

For the members opposite to say that only members of the union of MGEU can deliver those services, that is irresponsible. That is denigrating all those other service providers out there who are responsibly day in and day out delivering services to their clients because they care. They are still out there doing it today, and to them I want to say, I highly respect what they are doing, they have successfully done it over the course of time and I know they will continue to do it in the future.

I wish the members opposite would get off their hidebound approach of being deliberately driven by the unions and start to respond to what is good for the clients in the province of Manitoba. You cannot throw money at solutions anymore. They should have known after losing three elections in a row that that cannot be done. The public will not put up with that. This is not the day and age for that.

Mr. Chairman, this debate is essential to have at this time because we are on two totally different tracks of ideology, theirs on a tired, old, worn-out, backwards-to-the-future kind of approach, that monopolies can exist and monopolies are effective. The public at large is saying, that is not so, it is not cost-effective, it is not efficient in terms of creating an innovative way of delivering services.

We have some 17,000 people out there receiving some form of home care. That is a lot of people, and it is a good service because it allows health care to be delivered more closely to where the individual wants to be involved, and that is in their home. They want to be there. They do not want to be tied up in an institution until they absolutely have to be. They want services close to home. It allows people to get out of the hospital sooner and be in the home environment, which is much more comfortable than staying in the hospital.

So, Mr. Chairman, I am really disappointed in the attack that the opposition is taking on our Minister of Health (Mr. McCrae), on the government and all the service providers out there who are currently doing their job. If the member for Kildonan (Mr. Chomiak) has any courage to stand up and debate this, I would be interested in hearing from him, because that--

An Honourable Member: That is unparliamentary, come on.

Mr. Findlay: Well, how many members opposite have stood up and debated on this particular motion when the members opposite brought it forward? Okay, none. I take it the answer is none. [interjection]

Mr. Chairperson: Order, please. I would ask the honourable members to try and maintain debate. I know that the honourable minister is tending to almost bait the opposition into this debate. I am trying to choose my words carefully right now. I would ask the opposition and the minister to speak to the motion before us.

Mr. Findlay: I accept the Chairman’s caution. I might do that once in a while, yes, I am sorry. The fact of the matter is, if you look at private service providers or competition in home care, seven out of 10 provinces are doing it. It is not like we are an island, isolated, and we are doing something that is totally untried anywhere else.

The member has asked for studies. The only real study is when you are out there doing it, and if seven out of 10 are doing it, I do not know that that is sort of breaking totally new ground. It is a matter of getting on, be sure we deliver the services to the people in their homes, and the members opposite are saying, no, we should pull the workers out of those homes. We are saying, get them back there. I wish they would see the light and say the client is No. 1, because that is the way we view it.

Thank you very much, Mr. Chairman.

Mr. Chomiak: Mr. Chairperson, I welcome the opportunity of rising in this debate and dealing with some of the comments made by members opposite. I am tempted to respond to some of the illogical statements, inconsistent statements, that I have heard in this Chamber by members opposite, and I listened very attentively and very carefully, and I have been astounded at the inconsistencies and lack of logic that I have heard from members opposite.

I want to again in the course of this debate inject a little bit of reality to members opposite, and by virtue of--[interjection] The Minister of Health (Mr. McCrae) says, that is a good thing, and I am glad the Minister of Health is paying attention, because what I would like to do, Mr. Chairperson, is discuss the genesis and the reason as to why we are having this debate today, the reason why there is a strike going on in Manitoba today and the reason why the public of Manitoba has risen up in opposition to what the government and the minister is doing.

Mr. Chairperson, the Minister of Health signed off a document under his signature, sent it into cabinet, had it approved by cabinet--

An Honourable Member: Did it have all the pages in it?

Mr. Chomiak: And it had all the pages in it, Mr. Chairperson, Treasury Board submission, December 16, 1995. What did this policy say? Let me point out--I am not sure the backbenchers have had opportunity to review this document, the cabinet document, but what did it say? It said divestiture of all service delivery. Now let me halt at this point. It is government policy to divestiture of all service delivery in Health.

Now, Mr. Chairperson, where is the justification? Where are the policy guidelines? Where are the reasons why the government has decided to do this? There are none. We have been sitting in debate for two and a half weeks in this Chamber, and the minister and the government are yet to table one document supporting their position. They are yet to table the opinion of one expert supporting their position. They are yet to table one study supporting their position. In fact, to the contrary, every study that has been forwarded in this House has said no to privatization. Every document that has been tabled has said no to privatization. Is there any question why we doubt the minister’s policy, and any question why we should question it?

Mr. Chairperson, I dare say the backbenchers who have not had an opportunity to review this document ought to spend some attention on it and ought to spend some time reviewing this document.

Now, Mr. Chairperson, let me again review this cabinet document that set out the privatization policy. Let us see what it says. Over and over again the minister insists that we are making up this user fee issue, and the minister talks about user fees across the country and says, there are no user fees in Manitoba. What does the cabinet document say? Let me quote from it, What Will Be, Services To Be Categorized. That is, home care services will be categorized. Core services, government funded. Core services, government/ customer share costs. What does that mean? Let me repeat: Core services, government/customer share cost. It does not say, government funded. It says, government/customer share costs. That is called a user fee. Now the minister can call it anything else that he wants to. He could call it a partnership fee. He could call it a tax when, in fact, it is a tax, but the minister’s own cabinet--I note the minister is holding up the Price Waterhouse report, and I am glad--[interjection]

Mr. Chairperson: Order, please. The honourable member for Kildonan (Mr. Chomiak) has the floor at this time, and I would appreciate it if we could have a little bit of decorum.

The honourable member for Kildonan, to continue.

Mr. Chomiak: I have told the minister that we ought to bring his own officials in. He has an implementation committee for the Price Waterhouse report, I informed the minister in this Chamber for the first time. He is now aware we have an implementation committee, and I have urged him to bring his committee, his members in, so we can discuss the Price Waterhouse report.

Returning, Mr. Chairperson, to the substance of my comments, why does the government cabinet document state: Core services, government/customer share costs? It is because the government intends to impose user fees on the home care services, and they cannot deny it because it is in black and white in the cabinet document, signed by the minister, approved by this government.

So that is what we are debating in here. We are debating (a) why the government decided to privatize home care and precipitate a strike and put us in the terrible situation we are in; and (b) what that document says.

Further, Mr. Chairperson, that document states that there is going to be established a Crown corporation, a home care agency that is going to be responsible for co-ordinating the service. What activities is this co-ordinating Crown agency going to undertake? Research,

technology, evaluation, assessment, care planning, and telemarketing.

Mr. Chairperson, probably the first time in Canadian history that a government, Crown corporation to do home care, is going to be undertaking telemarketing, and the minister has yet to deal with that Crown corporation, which he indicated, by the way, in one of the local papers, that it would be set up. In fact, funds were allocated last budgetary year and this budgetary year for the establishment of this Crown corporation. So what we are debating in this Chamber is the government’s program to privatize which they have been unable to justify, unable to account for.

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They can try to attack the unions, they can try to attack the patients, they can try to attack the caregivers, they can try to attack the opposition, but the reality is, it is their policy, approved by this government and this cabinet in this document.

An Honourable Member: This is a good policy.

Mr. Chomiak: If it is a good policy--the member for Springfield (Mr. Findlay) says it is a good policy--then justify it. Come forward, show us your studies, show us your documentation, show us the justification for why you are taking a system that has been recognized as one of the best in North America, turning it on its head and precipitating all of the difficulties.

It is astounding to me how members opposite can try to debate in this Chamber without dealing with the fundamental issue of privatization, why they are failing to talk about their own cabinet document, their own submission, the very document that has precipitated the circumstances that we are in today.

Members opposite talked about the provision of home care by rural caregivers. The member for Lac du Bonnet (Mr. Praznik) talked about groups being anxious to take over the provision of home care in his own constituency. It is clear--

Mr. Chairperson: Order, please. Things have been going real well in the committee for the past two days. Those members who want to carry on their conversation across the way, I would appreciate it if you did so out in the hall or the Loge so that I would not be interrupted when I am listening to the honourable member’s presentation.

Mr. Chomiak: Aside from trying to justify their cabinet document and aside from their lack of any support for this, there are many questions that members opposite have to answer. They have to answer why the We Care presentation in 1994 by Ron Hoppe exactly mirrors the government proposal in this cabinet document. They have to answer that question. They have to answer why they are going to take public money and allow public money to go to profit making companies, take money from direct caregiving and give it right into the pockets of profit making. They have to answer the question that I asked in Question Period today as to why people who carry out home care for We Care are out selling extra products and get commissions for selling additional. They have to answer that question.

They have to outline for us what standards, what regulations they are going to put in effect and in place if they should go ahead with this foolhardy scheme to privatize home care. Until members opposite are prepared to justify and defend their own cabinet document, until they are prepared to answer questions with respect to home care, until they are prepared to actually deal with the facts, all we are going to hear from members opposite is attempts to defend a policy that is indefensible.

Hon. Rosemary Vodrey (Minister of Justice and Attorney General): Mr. Chair, I am pleased to have a little bit of time this afternoon to speak against this motion, to speak against the ideas which have been put forward by members opposite who clearly want to preserve a monopoly only, who have an objection to any kind of competition, who have an idea that there should not be competition in any way. They do not want competition in services to home care. They do not want competition in schools. They do not want exams. They are just totally against that in any form whatsoever.

Mr. Chair, as I said, I do not support this motion. I am astonished by the lack of understanding by members opposite. I am astonished by the fact that they do not seem to be in possession of the facts, and that is a great concern, because they go off and they talk as if they know what they are talking about, and they continually miss the point.

The Minister of Health (Mr. McCrae), I believe, certainly deserves our support and also our respect for the way he operates as Minister of Health in this province. First of all, he is a listener, and, Mr. Chair, I think that it has been very clear as we have watched media reports, as we have talked to the Minister of Health, that he has been available to people across the province to explain the conditions and concerns about our health care system, the continually rising costs of our health care system and that some steps must be taken to look at continuing to provide that service and not have costs run totally out of control. He has met with groups across the province, and I believe that his style has been one which has been a very thoughtful style. I believe his approach has been one which is very personable to the people of Manitoba.

But, Mr. Chair, the question is, somehow the members opposite seem to think that these concerns about costs of health care, providing health care, are strictly within Manitoba alone. They need to open their eyes.

This is what astonished me, that somehow they have not understood that across this country, every province across this country is facing concerns about the provision of health care and is having to look at ways to do this in the most efficient way where the health outcomes are the No. 1 issue, where the client is the first person to be thought of. When I listen to the members across the way, it does not seem to be the health outcome that is a concern to them. It does not seem to be the comfort and the emotional security of the person who relies on home care that is important. It, instead, seems to be a philosophical idea that they cling to which has really nothing to do with a person. Mr. Chair, this government has understood that we are, in fact, dealing with people, that we have to provide the best service for the people of Manitoba and that we are, in fact, dealing with individuals and not just ideas.

Mr. Chair, one of the ways that this government has looked at the changes in health care is to say that people really do not want to stay in institutions for a long time, and, in fact, they need to move from institutions and would like to move from institutions into their homes and be provided with a home care system. There are lots of reasons for that. If perhaps they had the opportunity to talk with people, people could tell them that first of all, they are more comfortable in their own homes. There is a reason they do not want to be in institutions. There is an emotional security in being with those things that you know about, being in your own home and not being in a place that seems to be in many cases strange, and there is a lot of technology that a lot of people, particular seniors, do not really understand.

People seem to just do better. They seem to heal faster and with an aging population have a much greater level of comfort and hopefully maintain better health, because they are, in fact, within their community. In order to do this and to allow people to have the opportunity of home care, Mr. Chair, I think it is very important to understand the financial commitment of this government, because this government has never walked away from making sure that the financial resources were in place.

I just would like to stress that since 1988 until now the home care budget has more than doubled, that it has moved from $38 million to $91 million. That is a significant contribution. As I listen to members across the way, I seem to always be hearing them talk about reductions, and I have to say, where have they been, because there is no reduction when you talk about such a huge and steady increase, a very significant contribution from this government.

Mr. Chair, I am not only speaking about the financial contributions. I would like to speak about the plans that this government has put in place, because this government has said that the monopoly alone is not the way to do things, that there must be some competition within the system. So government introduced a plan to have a competition in approximately 25 percent of one part of the city of Winnipeg.

Now, if you were to believe the members opposite, you would somehow think that this was a plan that applied everywhere and everyone should be thinking about this when, in fact, the plan applies to 25 percent of the city of Winnipeg. Those are the facts. They are not the facts often put forward, but they are the facts of the plan.

The other part of the facts is that it is no cost to home care clients. There has been some question put forward by the other side. I just heard to member for Kildonan (Mr. Chomiak) talking about user fees. User fees have not been part of this government’s plan. User fees were part of a plan put forward to the NDP government, and we have an idea of where it may have gone had they been in government, but user fees are not part of the plan of this government.

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Also, there is no change in services. Somehow people have been led to believe that there is going to be a change in their services. Talk about frightening people in their more vulnerable moments, as individuals who require home care. The other side has engaged in a campaign to frighten people, to make them feel more vulnerable and to not give them the true facts which, if they had them and which when members on this side have the opportunity to speak to people, were able to allay a lot of those fears and allow people to be more comfortable.

But what has happened? Our plan has been put forward. Our plan has been very clear, but the other side has tried to present facts which are not the case. So what happened, Mr. Chair? Home care attendants went on strike. Home care attendants went on strike on Tuesday, April 16, and our concerns about that strike are that we see that they, in fact, have engaged in a profession which is a caring profession, which is a direct-services-to-people kind of profession but, because of the union direction, because of the union concerns, these individuals have now gone on strike. Those individuals who depended upon them every day--[interjection]

Mr. Chairperson: Order, please. If the honourable member would like to put some statements on, he may want to reserve them until the time that he has the floor.

Mrs. Vodrey: I think it is very important to note what has happened. Let us think of the people. When the home care attendant went away and went on strike, there was an individual who was sitting at the other end who was left and did not always have all the facts, because members from the other side do not want to talk about it. It is up to this side of the House to make sure that the appropriate facts, the real facts, get out so that those people are not frightened. Some of the home care workers, as was mentioned by our colleague the Minister of Labour (Mr. Toews), do not want to be on strike, they do not want to be away from their jobs, they do not want to be away from the clients that they would prefer to be working with. Some of them are afraid under these circumstances to, in fact, go and be with their clients.

Mr. Chair, I want to say that a number of these of home care workers are women. Members across the way are always asking about sensitivity towards women. My concern is that a number of these home care workers who are women feel frightened to go and actually be with their clients, because they somehow have the opinion that they are then, you know, the union who has given direction, that they should not in some way balk at that direction. That is intimidation, and that really concerns me, for workers, people who have a direct service to people, people whose work and profession is a nurturing profession.

So I remain concerned about the clients. I remain concerned about those workers who want to continue to work. I want to put forward on the record the facts of what this government’s plan is. I want to continue to provide support to the Minister of Health as he works in a very difficult area to make sure that the facts get out on behalf of the people of Manitoba.

Mr. Frank Pitura (Morris): Mr. Chairman, I would just like to put a few remarks on the record in opposition to this motion moved by the opposition. I would like to start out by first saying that since I have come to this caucus that I have had the pleasure of getting to know the Health minister and I have the very highest regard for the minister. I think that he is a very sensitive, caring person and only wishes to make sure and ensure that the health care system in Manitoba is there now and in the future for all Manitobans to enjoy. I think that this period of time in his life will go down in the history books as one of the most important eras in Manitoba history, because 20 years from now we will still have a health care system that we can enjoy.

We have a good health care system in the province. We have probably some of the top acute care systems. The personal care system is also tops, and the home care system. We are not really taking really major issue with the home care system in terms of what our proposal is. If you want to take a look at the resolution and look at the word “recommendations” in there, we have made recommendations. The recommendations are to go ahead with a 25 percent contracting out of services in the city of Winnipeg only, with all the quality and maintenance control in there by the province still in place. Nothing is going to happen in rural Manitoba. So that is part of the recommendations that we are following and implementing.

I would also like to add that I have had some personal experience with the use of government home care and with private care. In this regard it happens to be an uncle of mine that required the care. I would have to say that the honourable member opposite talking about home care workers being on a commission to get more services is totally untrue. These people sat down with all the family members and my uncle and worked out an agreement that was suitable to all of us and no way did they try to sell extra services to us, and we only chose those services which we felt were appropriate for the case. So that is totally untrue.

The direction we are heading is in fact that we have always been after the federal government to try and balance their books. Well, they are heading in that direction. But they chose to see fit to cut the health care transfers to the provinces, and now we are feeling the pain of that cut, you know. They should be making the cuts in other areas where we have duplication of services. We have mentioned that to the federal government many times, that they should be doing this.

So in order to be able to address this situation where we are working with fewer dollars in the health care system, it means that we must change to meet the future needs of this province in terms of health care. But why are we suggesting the details of contracting out of services? No, we are trying to attempt to introduce competition for 25 percent of home care services only within the city of Winnipeg. There will be no cost to home care clients--no cost to home care clients--no change in services provided and, most importantly, in the area that I represent in the constituency of Morris, there is no change in rural or northern service delivery.

Also, another thing to keep in mind is that seven out of 10 provinces have already moved to a mix of government and nongovernment provision of home care services. Seven out of 10 provinces also charge user fees. User fees are not being contemplated in Manitoba, now or in the future.

But let me share some numbers with you and then beg the question. If you take a look at the Home Care budget and the services provided--I know that the honourable Minister of Health put these numbers on record in Estimates, but I think that it bears repeating them.

In 1988-89 the budget for home care in Manitoba--

Point of Order

Mr. Chomiak: Mr. Chairperson, I am trying diligently to hear the member from Morris, but the Minister of Health (Mr. McCrae) seems to be heckling his own speaker, and I wish that you would call him to order so that I could actually hear the member from Morris deliver his comments.

Mr. Chairperson: The honourable minister, on the same point of order.

Hon. James McCrae (Minister of Health): Yes, Sir, I do apologize to the honourable member for Kildonan, and, certainly, if my friend and colleague from Morris felt that I was interrupting him in any way, I apologize to him too because I certainly was not making any comment about the very fine presentation being made this afternoon by my colleague the honourable member for Morris. It is my understanding that the Minister responsible for Seniors (Mr. Reimer) with whom I work very closely in matters related to home care and others--

Mr. Chairperson: Order, please. Enough has been said on the matter. The minister has apologized for speaking.

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Mr. Chairperson: We will carry on with the honourable member for Morris.

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Mr. Pitura: As I was indicating, I think it bears repeating some of the numbers that were brought out in Estimates a few days ago, that in 1988-89 the budget for home care in Manitoba was $39 million in round numbers. The number of patients on home care was 23,403, and the number of unit services was 3,398,819.

If we follow that for the next year, 1989-90, the budget went up 8.2 percent to $42 million. The number of patients declined by minus 2.1 percent to 22,922. The units of services went up 3 percent to 3,500,213.

In 1990-91 the budget for home care was increased 20.6 percent, up to $50,890,000. The number of patients on home care was 24,022, or an increase of about 4.8 percent. The number of units of services was 3,868,329, or an increase of 10.5 percent, but still probably not in line with the 20.6 percent increase in budget.

In 1991-92 the budget went up 11.6 percent to $56,783,600. The number of patients went up 4.6 percent to 25,116. The units of service were at 4,187,310, or an 8.2 percent increase. Everything is going in the right direction.

In 1992-93 the budget was increased again by 10.7 percent, or up to $62,837,000. The number of patients went up 3.2 percent to 25,909, and the number of units of service went up to 4.4 million, or about 5.6 percent increase.

In 1993-94 the budget was $64,201,700, a 2.2 percent increase. The number of patients was 25,121, down minus 3 percent. The number of units of service was 4,079,569, minus 7.8 percent, and the budget went up 2.2 percent.

In 1994-95 the budget was set at $66,172,000 or up 3.1 percent. The number of patients again declined minus 1.4 percent to 24,774, and the units of service went up 3.8 percent to 4,235,028. In ’95-96, Mr. Chairman, the budget is set at $82,572,300 or a 24.8 percent increase. The number of patients went up to 26,129 or plus 5.5 percent. The units of service were 5.5 million approximately, which was an increase of 30.7 percent, the largest increase in the number of units of service supplied in the whole program.

Now, Mr. Chairman, here are the interesting numbers, is that the budget went up 111 percent, the number of patients went up 11.6 percent, and the number of units of service went up 63 percent. The cost per patient in 1988-89 was $1,667. The cost per patient in ’95-96 is $3,160 or an 89 percent increase. Now, if we project that over the next ten years, we would have 52,000 patients on service through this program, and if we extrapolate that, our budget would come out to something like $310 million in 10 years time. Can we afford to pay that kind of dollars in terms of budget over the next while?

So for every patient added to the system since 1988, Mr. Chairman, which is 2,726 patients, we have added $43 million. The dollars spent per patient added is $15,980 per patient added to the system. So then the question begs itself. It says, if the opposition is saying, well, why change anything in the system, we have something good, I ask the question, why not? We have to try a new approach to the way home care is delivered. If we do not try that, even in the small amount of contracting out at 25 percent of the services, we will never be able to maintain the system.

Thank you very much, Mr. Chairman.

Hon. Jack Reimer (Minister of Urban Affairs): This is a pleasure for me to stand up and put some comments on the record regarding the motion that was put forth by the honourable member for Kildonan (Mr. Chomiak) in what he words as a condemnation of the Minister of Health (Mr. McCrae) for his failure to provide any research or recommendations.

I would like to say that these are interesting times to stand up in this House and talk about what is happening, because, indeed, these are changing times. I guess what we have before us is a change of philosophy and the resistance to change for the sake of the status quo and the fact that the opposition is of the opinion that the status quo is a way of doing business and that we should not be tampering with anything that looks at a different approach or different priority of spending that we are bringing forth.

The Minister of Finance (Mr. Stefanson) brought forth his budget just a very short time ago, and we all had a chance to stand up in this House and debate that budget. One of the lines in the budget that was brought forth was actually an increase of funding to Home Care. As was pointed out by a lot of my colleagues in the last little while, we are looking at a budget now that started back in 1988, I believe, of around $37 million, and just recently we passed a budget that brought the figure up to--not brought the figure, but it has steadily crept upward to where now we are talking about $91 million in our Home Care budget, and this was a figure that was brought forth of $9 million, I believe, which was an $8-million or $9-million increase in the Home Care budget, and it was the opposition that stood there and voted against this increase.

They voted against it, Mr. Chairman, and now we stand here in the House again talking about them saying that we are cutting back, we are changing the direction, we are rejigging the formulas and all these other types of accusations and the fact that this government does not have that type of care and concern for home care and the people that it is serving.

As Minister responsible for Seniors I have the opportunity to meet with seniors on a very regular basis. In fact I put a high priority in meeting with seniors and seniors groups of all sorts in all areas, whether it is here in Winnipeg or out in the rural area. Seniors in general are saying that they are concerned about government. They are concerned about the spending of government. They welcome the idea of a balanced budget. They welcome the idea of the fact that we are now looking at bringing our house in order regarding the spending and the priorities of what they as senior citizens have grown accustomed to and what they have grown up to adopt in their lifestyle of being accountable and approachable in their finances. They now see this as a welcome change in government which we have embarked on. They recognize that in this government that our priority has been over the years and continues to be funding in health.

(Mr. Frank Pitura, Acting Chairperson, in the Chair)

Health consumes the largest portion of our budget. In fact, I believe here in Canada our percentage is the highest of any province in Canada in our commitment to health care here to the citizens of Manitoba. So the commitment is there. The commitment is growing. We now spend over $1.8 billion in health care, and a large portion of it is in our seniors population because, as we are all aware, this segment of our population is growing. As the Minister responsible for Seniors I take very seriously the fact of being in contact with seniors to get their input, to get their views, along with the Minister of Health. We have had the opportunity to tour facilities together, to talk to groups together, to get an input from the group as to what their concerns are. This is an ongoing dialogue that I feel is not only necessary but is something that we as a government have to continue.

I was just recently out at a function down in Steinbach, a seniors meeting, and this was just two days ago. The topic of home care did come up, and the seniors there were wondering what was happening and where this government was going with home care. When I talked to them and I explained to them that what we are talking about is a contracting out and a prioritizing of funding in Winnipeg only, and in Winnipeg it is not necessarily all of Winnipeg, we are talking about 25 percent of the home care market, a lot of them expressed surprise. They thought, from what they had been reading in the paper or what the fearmongers of our opposition have been saying, is the fact that we are looking at the so-called whole home care project, whether it was in the city of Winnipeg or whether it was in the rural areas. So that was one area that we cleared up with the group that I was talking to down in Steinbach.

At the same time I had the comment made by one of them saying that we do not like the idea of some of these city--I will use her words specifically because they stuck in my mind--she said, we do not like the idea of some of these city goons coming down to the rural area and telling us that we have to be on strike.

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These are not my words. I say, these are not my words. I will emphasize that. This was conveyed to me by an older lady in this group that said that this was what she resented very much, that they were coming down into her rural town--I will not tell you the town that she was from, but she was not from Steinbach; she was from another town--saying what they should be doing to their home care people and the people that they looked after. She was very upset about that connotation that they were being dictated by someone from the city, as she called it, telling her what she could or could not do with her patients. So I was kind of surprised at this type of commentary that came out from this lady.

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

So, Mr. Chairperson, these are areas that we as a government should be aware of in trying to come to a resolve on what direction we are taking. It is an evaluation. It is a prioritization of funding. There is an accountability that has to be brought into the fact that the people, not only in home care but the taxpayers of Manitoba, are asking us to be aware of where the money is going. The Minister of Health (Mr. McCrae) and the Minister of Family Services (Mrs. Mitchelson) and the Minister of Education (Mrs. McIntosh) recognize that their departments, which consume the largest portion of our budget--and the fourth largest consumer of funding, if you want to call it, in our government, is debt. That is the fourth largest department within our government.

So we--[interjection] Is it now No. 5? Eric moved it to No. 5. Pardon me, I thought it was the No. 4 department. Maybe, with all our prudent management and our efforts that have come forth in the last while in our management, it is starting to come down in the budget. Maybe you are right; as one of my colleagues has pointed out, it is now department budget No. 5. You see, it happens so fast sometimes, you do not recognize all these things. That is how fast this progress is happening with our government.

I see, Mr. Chairperson, that time is fleeting by, and I have hardly had a chance to put into content a lot of the other comments that were brought forth to my department and to me as an individual, not only as the Minister responsible for Urban Affairs, Housing and Seniors, but also as an MLA for the constituency and as a person that when you are talking to people--so I would just like to put those remarks on record for this. Thank you.

Mr. McCrae: Mr. Chairman, I am pleased with the contributions that have been made in this discussion by honourable members, notably the members of the government side, but also members from the other side of House, with respect to this matter. I do not even like to have to rise in a debate to defend the personal attack implicit in the resolution before the House today, but I do believe that we should remember that if our intentions are good and honourable, then we ought to be able to defend them, and indeed that is what I propose to do at every opportunity.

The honourable member for Kildonan (Mr. Chomiak) has chosen a strategy which I have described already by way of an anecdote, Mr. Chairman, and the honourable member will remember it. That is, the practitioners of the law who sometimes confide in each other--and very often senior members of the bar work with the younger members of the bar. On this occasion, on one occasion, the senior member of the bar was trying to assist the younger member in preparation for a trial before a jury. The articled student asked the senior member of the firm, well, what do I do if I have good strong facts, but I do not have much in the way of the law? The answer was, you pound the facts. What if I do not have any facts? Well, you pound the law. The articled student then asked, what will I do if I do not have the facts or the law? To which the senior partner responded, pound the desk.

Mr. Chairman, what we have seen since the beginning of this resumption of this session has been an awful lot of desk pounding on the part of the members of the New Democratic Party. They simply do not have the support of the people of Manitoba in the matters they are putting forward, and the people of Manitoba are making that clear. Indeed, every thinking person around here knows that no government sets out to do anything but make improvements in the system of health care delivery that we have or any other government service that we provide.

Even New Democrats, I respectfully suggest, do not go out in some deliberate way to do harm to their fellow citizens, as honourable members opposite like to suggest that the government of the day would want to be doing. [interjection] One of my colleagues asks if it is the simple suggestion that New Democrats do not know any better. My humble and respectful suggestion is that they made a very serious mistake from the very day that the CCF was invented in this country and the very day that New Democrats came into existence. That was an organic fusion that exists, a partnership, shall we call it, that exists with organized labour in this country.

We all want friends. Everybody wants friends. We strive to be happy, and, in order to be happy, we need friends. The New Democrats did not have any policies, so they went for friends instead, and they aligned themselves with the labour movement in this country. It helped them get started as a political party, as a political force in our country. It brought together people of high ideals, people like Tommy Douglas. I mentioned him the other day, and I had the honour of working in the same building as he for eight years. I had a lot of respect for him and people like Stanley Knowles. I did not, obviously, always see their way, but I respected those gentlemen and people like--even those honourable gentlemen seemed to believe in the political connection between the New Democrats and the union movement, something that Professor Allen Mills called organic fusion later on.

An Honourable Member: Those men had principle, Jim; that was one important difference.

Mr. McCrae: I am reminded that some of those pioneers of the socialist movement in our country brought principle to bear on all of their deliberations. I accept that. But there is a consistency and then there is a foolish consistency. Sometimes, as Emerson said, a foolish consistency can be the hobgoblin of little minds.

In the event, what we have today in Manitoba is a classic example of that foolish consistency where they allow that loyalty to a group of people to come ahead of their duty to serve the interests of those people in our society whose interests they were elected to serve. And they have a problem with that. They will not prevail as long as they put their narrow political interests ahead of the interests of genuine needy people in our society. That is what this debate is about. It is not so much about me as the Minister of Health or that personal condemnation that is contained in this resolution, it has to do with the--

Point of Order

Ms. Becky Barrett (Wellington): On a point of order, Mr. Chair, I let it go by the first time the minister said this, but I cannot let it go by the second time. I have read and I have in front of me the motion that we are debating today in the House and there is not one iota of evidence, nor can you read into anything that was said in this motion that says one thing about a personal innuendo or a personal attack. This is simply a condemnation of government policy as expressed and illuminated by the Minister of Health. There is not one scintilla of personal attack in this resolution.

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Mr. Toews: On the same point of order, Mr. Chairman, I think you sitting here as Chair and you sitting here in the House every day understand exactly what has been going on in this House. That motion simply reflects the tip of an iceberg. That does not reflect the comments that have come daily across this floor by members opposite attacking very, very personally what the member for Brandon West has been doing, and I think it is very relevant to this debate, this discussion, that there are personal attacks being made--

The Acting Chairperson (Mr. Radcliffe): I would invite the Minister of Labour to address the issue of the point of order which is on the floor.

Mr. Toews: I would submit, Mr. Chair, that the direction of my colleague’s argument is directly on point.

Mr. McCrae: On the point of order raised by the honourable member for Wellington, maybe it is coincidence that the Minister of Labour came to assist you, Sir, in coming to an appropriate resolution of the point raised by the honourable member for Wellington because, indeed, it was the Minister of Labour against whom? That very member addressed her venom the other day in Question Period, and the honourable member for Wellington took a personal shot at the honourable Minister of Labour the other day.

The Acting Chairperson (Mr. Radcliffe): The honourable member for Kildonan, on the same point of order that is under discussion.

Mr. Chomiak: No, on a separate point of order, Mr. Chairperson.

The Acting Chairperson (Mr. Radcliffe): I would invite the member for Kildonan to--

Mr. Chomiak: Then I will comment on the same point of order.

The Acting Chairperson (Mr. Radcliffe): --defer his remarks on the new point of order until I have ruled on the existing point of order which is on the floor at this point in time, but I would invite the member for Kildonan to address the existing point of order.

Mr. Chomiak: Mr. Chairperson, the government and the member for Brandon’s argument is so without substance that his comments are completely irrelevant to the point of order as addressed by the member for Wellington. I would ask you to call the member to order, because his comments on the very point of order bear no relevance or relationship whatsoever to the point made by the member for Wellington because, if you recall, the minister and the member was making the comments about some item that occurred in Question Period several days ago. So he is completely out of order.

The Acting Chairperson (Mr. Radcliffe): I would thank all honourable members for this discussion and the advice that they have furnished to the Chair on this issue. I believe that the member for Wellington did have a point of order, and I would invite the honourable Minister of Health to continue his comments, but addressing the motion which is under debate at this point in time.

An Honourable Member: What was that point of order?

The Acting Chairperson (Mr. Radcliffe): The point of order from the member for Wellington was to, I believe, direct the comments of the Minister of Health to the motion which was on the floor, under debate, and that this was not a personal attack against the minister or his credibility or any personal innuendo but rather the points which were on the order paper.

The minister has two minutes remaining.

* * *

Mr. McCrae: Well, Mr. Chairman, I certainly accept your ruling, and whatever it was that motivated the honourable member for Wellington to raise it, I accept that must have been an honourable thing, too.

However, I guess when one is named and condemned in a resolution, one does get a bit defensive about it, Mr. Chairman, and maybe it is my zeal or the sense of passion with which I approach the job of ensuring that our home care clients in this province receive their service, that I might be given to occasional excesses. So if I did that, certainly I would like to conform with the rules of this Chamber and all of its customs and traditions, as represented so ably this afternoon by the honourable member for Wellington.

However, the honourable member for Wellington has not left out from her comments certain people who are not in this Chamber and who are not able to defend themselves, saying from her seat that they are not honourable people who live among us, Mr. Chairman--[interjection] Oh, is that what it is. Is my time up?

The Acting Chairperson (Mr. Radcliffe): I believe the honourable minister’s time has now expired on this matter, and I would recognize the honourable member for Pembina.

(Mr. Chairperson in the Chair)

Mr. Peter Dyck (Pembina): Mr. Chairman, I welcome this opportunity to speak on this issue of home care within our province. I have listened intently to what our Health minister has been saying for the last few minutes. That reflects very much the feeling that the constituents in Pembina feel, as well, and that is one of feeling compassion towards those who need help, and, certainly, I want to say that I support home care. I support a home care system that is sustainable, and it is around that comment that I would like to just add a few comments and put them on the record.

I believe that in order to have a sustainable home care system, we need to be fiscally responsible. To be fiscally responsible, like, I guess, some of the members opposite, we need to live within the dollars that are allocated to us. Mr. Chairman, in 1998, we were spending $38 million on Home Care. We have added to that now and, in fact, are projecting that we will be spending $91 million in Home Care. Certainly, that shows that the government and the Minister of Health is committed to home care, towards the area of looking after those who need it and need it desperately.

Mr. Chairman, with that, I would just like to bring in a few comments in talking about a process and a system that is sustainable. In the area that I represent and the area surrounding where I live, several instances have been brought to my attention within the last week or so from people who are involved in home care.

First of all, those who are involved in home care find it unacceptable to walk on the strike and the picket lines. They find it unacceptable to be pushed into a situation where they are not allowed to give the care, the much-needed care, to those who need it so desperately. Therefore, I cannot understand how the members opposite take the approach that this is the only way to solve a problem, that they continue to encourage this kind of strike mandate. I would just like to say that the members of my constituency do not in any way foster and promote what is taking place.

To give an example of how we need to work at improving the efficiency of our home care system within our area, one example was cited of a home care worker driving 20 miles in the morning in order to service a client; then returning back the same distance; returning after lunch to serve another client, again 20 miles one way. That is a total of 80 miles in one day to service two clients and feeling absolutely comfortable in doing that. The mileage that is given to that home care worker is more than the home care worker is receiving for doing the actual work. That is simply an example of what I believe is taking place and--I could cite other examples--within our province at this time.

Therefore, in order to show our commitment towards home care, to show that we are committed to a system that is sustainable, we need to go out and to offer others to become involved in that same system. To this point we are looking at providing that home care to private agencies within 20 percent of the urban area. I believe that this is an example of where we could possibly start to cut and to curtail some of the costs that we have.

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I believe it is important that we continue to do this in a way that is methodical, and I believe that our Health minister (Mr. McCrae) has been showing ongoing that he is well in charge of this situation. I believe that he is in fact giving the leadership that we need as a government in order to direct the 25 percent of privatization within the urban area. I believe that he is, together with his staff, looking at areas of assisting those, and, on the other hand, though, also opening up to others who wish to become involved in that area of privatization.

The other area that I would like to address is the fact that, at this point in time, we do not see at all where we will be adding any services towards our home care clients--rather, that we will not be adding any costs to our home care clients. We want to do this in an area that is sustainable as we move on as a government and as we move on within the home care area, certainly it is our intention to be able to service the 17,000 Manitobans who are today receiving home care. We want to be able to do it in a way that is going to allow them to be able to participate in an improved manner, in fact, from what they had been receiving to date.

In 1988-89, the cost for home care was $1,667, and in 1995-96 the projected cost is $3,160, and that is per client. This is an increase, Mr. Chairman, of 89 percent. One of the previous speakers was stating, if we project into the future as to what some of these costs will be it becomes unaffordable and so, therefore, it is imperative for us as a government to look at ways and areas of trying to streamline a system that is quickly becoming unaffordable. That has been looking at the fiscal end of it.

I believe the other area that we need to look at and look at very seriously is the ability for us to continually give better home care to those who need it. I believe it is important that on a continued basis that this improvement be given to those who cannot look after their own needs. We certainly have that responsibility, and I believe that our minister has on a daily basis been showing through the comments that he has made and answering the questions within the House, he has been on an ongoing basis stating that he does want what is best for the clients. That is his No. 1 objective. Certainly, I support him in doing that. I believe that as he looks at this area through his department that certainly he is doing his utmost in trying to provide the services that the clients need within our province.

The other area that I would like to stress is the fact that within the rural areas, and this of course applies to the constituency I represent, certainly there is no change that we foresee within the future. The home care that they are being provided will continue. The objective, of course, that we have is to continuously provide better home care, and I believe that as we look at other options as they are presented to us that certainly we will be able to do that. I also believe that as we continue to challenge the way things have been done that with that also comes improvement.

It is interesting that listening to the members opposite that status quo seems to be the phrase that is used on a continuous basis. Things have worked this way, we do not want to change. I guess when I look at the businesses that I have been involved in, if we would have taken that approach on an ongoing basis we would not be in existence anymore.

So I certainly support our minister in the route and the way that he is going in looking at the whole area of home care. I want to thank you for the opportunity to speak to this motion. Thank you.

Mr. Mike Radcliffe (River Heights): Mr. Chairman, I rise too today to commend the tireless activities of our Minister of Health in this management of this crisis. I would suggest with the greatest of respect to my honourable colleagues on the other side of the House that instead of bringing a motion of censure at this point in time, they ought to be lauding the tireless efforts of our Minister of Health. I would bring a certain perspective to this Chamber this afternoon that I would like to share with my colleagues and that is that I received information this morning from my constituency worker that my constituency office was being picketed by the home care workers. So I had occasion to immediately attend to River Heights, to my constituency office, and I want to tell you and my colleagues here in the Chamber that I found a number of women who were home care workers picketing in front of my office, and I attended on the picket line with them.

I want to tell you that these people are most unhappy at the position in which they have been put. These are caring, concerned, hardworking, honest individuals in the home care field, and they feel bitterly uncomfortable being placed in an adversarial position against their employer, the government of Manitoba, and walking away from their customers or consumers, their patients. They have real trepidation for the future and the outlook of their patients, and several women told me today that they are, in fact, praying for an end to this strike.

I asked them what they knew about the ongoing negotiations, and these individuals are being kept in the dark. They are not up to date on the issues at hand, and I think I can bring some further light to this issue in the fact that I have had the advantage of being consulted and advised by a number of physicians who reside in the constituency of River Heights. They tell me that really the issue, the root of this issue, is not privatization. We have heard, like an endless broken record, the issue of public versus private and privatization and for-profit being bickered and bantered back and forth in this House, and I would suggest with the greatest of respect to the honourable colleagues across the way that, in fact, this is not really the heart of the issue that we are facing in this Chamber and on the streets of Winnipeg today.

In fact, the real issue is quality management of the home care that is being delivered to the sick, to the elderly, to the frail in the province of Manitoba. We look across the country of Canada, this vast dominion of ours, and we can cite province after province where individual provinces have let the contracts on a competitive basis to all sorts of different care delivery models and functions, and, in fact, we are opening this issue up for competition. We are moving the home care delivery of care from the monopolistic, centralized, institutionalized approach of governance to open competition, to efficiency, to flexibility, and these are the real issues that we ought to be addressing and speaking about.

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These are the issues that we ought to be taking to the front steps of the building and to the workers and to the patients and to the public at large, Mr. Chairperson. In fact, what I would cite and lay before this Chamber today is that by the very virtue of the structure of our civil service, and we have a hardworking, dedicated, committed civil service, and I am not for a moment deprecating their efforts, but what we face is a group of individuals who do not have the skills at hand in order to monitor, to direct and to plan a future for the home care which is going to be delivered in our province in the years to come.

I have received this information from physicians who are intimately involved with the delivery of this service. I have received this information from physicians who are crucial care deliverers in the secondary and the tertiary hospitals in our province, Mr. Chairperson. All of these individuals are really struck with the risk to which our population has been placed. I would suggest, with the greatest of respect, as pawns, that they are making our consumers, our patients, our frail, pawns to a labour dispute, to a bunch of organizers who are saying that they feel that they will be done out of a job personally themselves. I do not see a real concern for the people whom we ought to be addressing and the concerns that we ought to be addressing in this struggle.

We are looking at a portion of government where spending has increased from a million dollars to $91 million this year. This administration of this portion of government care, of health care, has expanded and exploded like Topsy. Now, one of the things that our honourable Minister of Health must ensure, when he is in charge of a department, is that the people of Manitoba are getting the most efficient model possible, that they are getting the best product for the tax dollar that is being spent.

I would suggest, with the greatest of respect to my honourable colleagues across the way and to their associates in the labour movement, that the way this present home care delivery is structured is totally, grossly and alterably inefficient. I can tell this House that we have experienced a total of 11 percent increase in numbers of consumers since 1988-89--11.6 percent. But we have experienced a 62 percent increase in the cost of service units over that same period of time. There is more money, six times the amount of money, being spent to deliver care to our sick and our elderly.

Why this is so important, Mr. Chairperson, is because we are going to be facing, we are going to be living with, hospitals without walls. This is going to be the model that the way that our health care will be delivered in the future. We no longer can place people in institutions, secondary or tertiary institutions, to convalesce. The best place for somebody to convalesce is in their own home, and there must be individuals who can consult and contact them on a regular basis to see whether they need the services that are being afforded to them through home care.

There is absolutely no reason to continue delivering home care to somebody on an early release program after they have recovered, but with the way this current program is structured, who is going to make the change, who is going to break the continuum of the status quo? Will it be the hardworking caring individual health care worker who is being dispatched to the resident? I would suggest, with the greatest of respect, no, that is not his place or her place to do this. They are going out to do a job, to establish security, to establish harmony in a relationship with the people whom they are serving, and they will do that job and do that job very well.

I am told by the physicians who have consulted with me on this issue that because of the caseload, the incredible caseload, that our home care co-ordinators are unable to keep in touch with the consumers that are using our product, and therefore we are wasting endless dollars of public money by the continuation of services when they are either inappropriate or not needed or should be changed or increased or improved but, in order to get effective, flexible, appropriate service on the home care, we need competitive, concerned people who can only be delivered from the private sector.

We are looking at introducing competition, as I think has been said before, in the delivery of home care to 25 percent of the services within the city of Winnipeg. I would like to reiterate, because we have heard fearmongering voiced abroad these days, that we are moving to a private system. This is hogwash. This is mindless prevaricating on the part of fearmongering individuals who are trying to be incendiary and to raise alarm in the minds and hearts of our consumers. There will be no change in services provided. There will remain a single payer.

The government of Manitoba will continue to monitor the quality of the standards that will be delivered in the way of home care, and I would suggest, I would invite some real thought on the part of the union negotiators, on the part of the advocates for the union as well as my own colleagues that some sort of alternative delivery of care be considered. I think that there are many, many individuals, concerned individuals in the health field who have directed their attention to these issues and would welcome the opportunity of introducing some alternatives to the present status quo.

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It is ironic perhaps that as we wind through these days that we are in fact the party of change, we are the party of reform, we are in fact improving the status quo. We are not looking back and trying to maintain an empty history of something that was just for the sake of maintaining it.

We want to say it can be done better, and that is the only way that we will be able to spend the taxpayers’ dollars with thought, be able to function in the new environment in which we are faced with diminishing federal dollars on our revenue, increasing demand--

Mr. Chairperson: Order, please. The honourable member’s time has expired.

Mr. Radcliffe: Thank you, Mr. Chairperson. Thank you very much for that. I would heartily commend the services of our Minister of Health in his administration of this issue.

Mr. Kevin Lamoureux (Inkster): Mr. Chairperson, it has been a while since I have had the opportunity to speak during the Health Estimates. Given the last number of hours, we have seen a number of the government members stand up in defence of the Minister of Health, and I guess one has to appreciate the sensitivity and acknowledge right from the word go that ultimately what we are seeing is a number if not virtually all government members in support of the government’s actions with respect to home care services. It does cause, I guess, to a certain degree, some concern in the sense that we as an opposition party have attempted, first and foremost, to indicate to the Minister of Health that the current direction the government is taking on home care services and the privatization thereof are not in the best interests of Manitobans as a whole. The reason, and the primary reason for that, is the lack of any sort of solid information being provided that this government has taken into account in making its decision to privatize home care services. [interjection]

There are numerous reports, as the member for River Heights (Mr. Radcliffe) alludes to. Yes, there are reports, but I have challenged and requested on numerous occasions both in the Health Estimates and Question Period for the government to provide specific information or specific recommendations that are there that have been well thought out, researched, that say that privatization of home care in the fashion which this government is approaching it is, in fact, in the best interests of the clients that receive home care services. The Minister of Health (Mr. McCrae), to date, has not done that, and the member for River Heights alludes to what quite often the Minister of Health says, well, look what is happening in other provinces. Mr. Chairperson, what we are talking about in essence is the province of Manitoba, and, believe it or not, at times it can be bold. There is nothing wrong with a province attempting to lead as opposed to looking in other provinces and trying to do something in a half-baked, not well-thought-out fashion.

The Minister of Health has not presented the information that he has said is going to benefit directly--how the clients are going to benefit through this process--other than a bit of rhetoric and a philosophical approach that this government is taking with respect to this issue.

I am having to--not completely conceded, but recognizing that the government is quite content on forcing privatization in home care services. Again, we as a party have attempted to get the government to do a couple of things. One Question Period I stood up and I asked the government to consider giving preferential treatment to nonprofit organizations--

An Honourable Member: Which we do.

Mr. Lamoureux: Mr. Chairperson, the member for River Heights (Mr. Radcliffe) said, which we do. Well, I would challenge the member for River Heights to indicate on the record that preferential treatment in the putting out of the tenders will be given to nonprofit organizations. Why should that occur? Quite simply, it is that there are completely different objectives and priorities from a nonprofit association such as the Victorian Order of Nurses and a private company such as We Care. Ultimately, that sort of consideration should be given.

Again, today, Mr. Chairperson, we tried to indicate to the government, look, if you are going to continue to steamroll ahead or go in full gear towards the privatization, why will you not consider giving some sort of a province-wide wage scale? Made reference to the construction industry [interjection]

Well, the member for River Heights says, why should we dictate that? If the government is not prepared to take some sort of action on behalf of the client to ensure that there is going to be quality service being delivered, then I think that again the government--and it reinforces the Liberal Party’s position in terms of put that year of moratorium so you know what it is that you are actually doing before you actually implement something.

There is a valid argument for continuity of care and if you turn these jobs into minimum- wage type of jobs--some say it is fearmongering, you can call it whatever it is that you want. If you do not believe that that is not going to happen, then why would you oppose putting in some minimum standards when you put out the tender for call of contracts? Why do they not believe in doing that? What is going to be the cost of doing that? Well, ultimately, what you will see, if you put in that, is you are giving a guarantee at least that there will be some wage above the minimum wage that is being offered on the home care services. [interjection] Well, you cannot compare apples and oranges. We are not talking about a widget or a service that--

Mr. Chairperson: Order, please. I am having great difficulty hearing the honourable member for Inkster. There seems to be a little bit of disturbance.

Point of Order

Hon. Jim Ernst (Government House Leader): On a point of order, Mr. Chairman. I am having great difficulty in hearing the member for Inkster. Perhaps you might bring the members present here in the committee under control, so that I could have the opportunity of hearing my honoured colleague.

Mr. Chairperson: The honourable minister does have a point of order, and I would ask all honourable members to abide by the rules.

* * *

Mr. Lamoureux: May I commend the government House leader and thank him for his assistance at trying to control and contain some of the reaction from the government benches.

As I have been trying to indicate, there needs to be more attention given to this particular issue. The clients, the home care workers, the average Manitoban have to be provided the opportunity to be able to participate in the decision-making process. They have been denied that process in the sense that we did not hear about this until after the fact. Once the government has made the decision, then we hear about it. Had the government done it in a proper fashion having the horse ahead of the cart, for example, then what we would have seen was a higher sense of co-operation amongst the clients and the workers and the average Manitobans that we referred to amongst the opposition party so at least I can speak on behalf of the Liberal Party.

When you introduce a program that is completely different--this is not a minor modification, this is a significant change which is going to have a long-term impact on the quality of service being delivered for individuals that are in need. The member from Sturgeon Creek (Mr. McAlpine) says it is only 25 percent. You are right. It is only 25 percent, and it is going to be expanded. It is only 25 percent today--[interjection] Well, the member from River Heights (Mr. Radcliffe) says we are going to monitor it. Well, that is good that you are going to monitor it. These are maybe things that you should have been doing before you made the decision, and why were those things not done? Why did you not talk to the clients? I wonder if, in fact, this was a cabinet discussion. [interjection]

Mr. Chairperson: Order, please. All honourable members will have plenty of opportunity during this debate to put their words on the record. I would appreciate it if we allowed the same courtesy to the honourable member for Inkster.

Mr. Lamoureux: Mr. Chairperson, I wonder if, in fact, this whole privatization scheme was brought to the caucus as a whole, and I see I only have a minute left, and no doubt I might get another opportunity in order to continue putting some more comments on the record, but I do not believe that the caucus in its entirety was even informed prior to this particular issue being made public. If, in fact, members have been, then I challenge those members to put on the record the people that they talked to, because I have yet to find a client, a home care worker, an outside Manitoban who has actually been consulted by this government prior to the decision being made.

I leave that as an open challenge in hopes that members will actually speak on it.

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Mr. Jack Penner (Emerson): Thank you very much, Mr. Chairperson, for giving me the opportunity to bring a few more comments on this extremely important issue to this Assembly. I would like, first of all, to say that some of the fears that I have heard expressed by some honourable members in this Chamber are simply fears, and they are simply fears because they speak these words out of ignorance.

Ignorance, of course, always does breed fear. The unknown is always something that we worry about and we wonder about, and I find it very interesting that the honourable member for Inkster in his comments that he made a few minutes ago referenced some other countries and how they provide services to their clients, whether these countries were, in fact, U.S.S.R. members or were other countries that had similar types of government that restricted and enforced and simply manipulated people to accepting the fact that there was only one way to do business, and that way, of course, was determined by the dictatorial approach of an administration that needed to exercise total control.

That, of course, is the mentality, Mr. Chairperson, of most of the members, not all of the members, but most of the members sitting in the opposite benches, and I was somewhat surprised to hear the honourable member for Inkster (Mr. Lamoureux) reference these kinds of comments, simply because of the fact that he has always put himself off as a free enterpriser in this Chamber, yet today he confirmed my worst fear, that the Liberal Party of this province would simply revert back to the old way that politicians used to do business in this province and as they are currently doing in Ottawa, and that when anybody has the gall to oppose an issue in their caucus or in public, they are immediately extricated from the party.

That is, of course, the mentality that the honourable member for Inkster brings to this Chamber, and that is, of course, the kind of leadership that he would want to impose upon his party and the people of this province. I think the people of this province clearly have demonstrated that they will have no part of that kind of an approach to government.

I want to reiterate some of the things that have been said here today and reflect, Mr. Chairperson, on the resolution that was put before this House just a few days ago by the honourable member for Kildonan. That, of course, exemplifies the whole approach to government that we have seen in the past in this province. It is the socialistic approach and dictatorial kind of an approach to making sure that the menialization of the services provided are provided equally to everybody and no matter at what cost.

You see, our province has always prided itself on one thing. Number one, we pride ourselves in the fact that our civil service is top notch and they are professional and we pay them for what they do and we reward them for good thinking, good, sound business principles and the application of services to the people that they represent. We, as members of the Legislature, should stand proudly in this Chamber and speak for the people and speak on the people’s behalf that we serve. We are, after all, servants, and the resolution that is being put before us by the honourable member for Kildonan is a dictatorial type of an approach to totalitarianism the likes of which I have not seen before.

That has been rejected solidly. That approach has been rejected solidly today by our civil service in a strike vote that they held in supporting their true principle, No.1, of serving their client, and that is the people of Manitoba. That is what our people, our civil servants want to do, and that is what they are good at and that is what we as a government will support them in doing. The service that they provide is in many cases extremely, extremely valuable, and we do not underestimate them and we should not underestimate them.

The home care issue is an issue where the word “competition” seems to strike fear in the hearts of those members that sit opposite that simply have no knowledge of what the true principles of service mean. The true principles of service to the ultimate ability are competition, because we compete with one another to be able to provide the service to you better than anybody else can do it. That is true competition.

Now, I will give you an example. If we only had one automobile dealership in this province, need that automobile dealership pay any attention to what the price of the product was that they sold? Would they need to pay any attention to the service that they presented to the customer? No. The U.S.S.R. demonstrated this clearly. They needed only to provide the services at the lowest possible, possible level, and that became the standard. That is, of course, what our members opposite are being proponents of. There are a few on the opposition side that do not subscribe to that kind of principle, and I am glad to see that, but most of the opposition members, and I should exclude the honourable member from St. Boniface (Mr. Gaudry) from those kinds of comments, because he is a man that understands true business principles and the application of it and he knows what the word “service” means.

Simply, I say this to you, that the principles of providing service to our elderly people are no different than providing services to an automobile customer. The elderly people want good, quality care. They want it provided when they need it and they want it provided to them by professional people that know what they are doing. I believe that we have those kinds of people in this province. I believe that most of our home care workers are those kind of people, but we have no way of knowing whether we can do better. We have no way to judge currently whether we could do better. What the honourable Minister of Health (Mr. McCrae) is suggesting is that we try and look at different ways of providing those services to find out whether we can actually weigh our values that we apply today compared to some others that might be applied.

The fear that inhibits the opposition from accepting those principles is the fear that somebody might, in fact, have a better idea than they had. We spend today roughly about $90 million, $91 million on Home Care. When we took office, the opposition, the NDP government of the day spent $39 million. Our home care component has increased by roughly, the clientele has increased by roughly about 11 percent, yet we have more than doubled, almost tripled our expenditures to home care. [interjection] The honourable members opposite, the opposition party, the NDP have at every chance possible voted against increased spending to home care. They voted against this last budget and this last budget contained an $8-million item increase to Home Care, and the opposition NDP party voted against it.

Mr. Chairperson: Order, please. The honourable member’s time has expired.

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Mr. Edward Helwer (Gimli): Mr. Chairman, I would like the opportunity to say a few words on the motion put forth by the member for Kildonan which condemns our Minister of Health and also our home care system. I want to say, I think we have an excellent Minister of Health (Mr. McCrae). I think he has done an excellent job and certainly deserves our support and the support of all Manitobans and, that is right, he will certainly get our vote and I think the next election will prove that we will get the vote of many more Manitobans also.

As far as our health care system, I think we have one of the best systems in Canada, really.

Mr. Chairperson: I am having great difficulty. I am not sure if it is the microphone that is not working, but for some reason I am having a great difficulty not hearing the member for Gimli, so if we could keep it down in the Chamber I might be more able to hear.

Mr. Helwer: I am getting lots of help here. It is okay. I was talking about the good health care system that we have in Canada and the fact that we are doing it even in spite of our friends the federal Liberal government in Ottawa, reducing the expenditures. The member for Inkster (Mr. Lamoureux) talked about--

An Honourable Member: The GST.

Mr. Helwer: No, he did not talk about the GST, but he talked a little about the home care system and health care. One of the reasons that we have our problems in Manitoba with trying to fund the services that the people are asking for is because of the federal Liberal cutbacks. That is where the problems begin. They have deducted not only--we lose $116 million this year, another $104 million next year. How are we going to manage and provide the same services?

Our minister is just doing an excellent job of a balancing act, of trying to balance his budget and also provide the services. At the same time we are spending some $91 million on home care, which is about $8 million more than we spent last year. So we are certainly not walking away from the health care system; we are there trying to improve it at all times.

An Honourable Member: It is a responsibility.

Mr. Helwer: It is a responsibility we have. Our Premier (Mr. Filmon) has said over and over again, the main core expenditures--Health, Education, and Family Services--we must look after those three departments, and we have over the past very well. We are really pleased that we are able to continue and provide the home care system that is needed today.

Also, with the strike as it is, the home care workers have not gone back to work because of their strike--there is no strike in rural Manitoba. There are no services affected in rural Manitoba, so there is no need for the home care workers outside of Winnipeg to be out on strike. In most of my constituency very few workers are actually out on strike. Most of them are working and providing the service to the--[interjection]

Whatever, that is right. They are providing the service to the clients, the home care clients, as they were before, even though they are being harassed by the unions. The unions are telling them that they are going to deduct their wages, that they are going to hold up their pay. The unions are being ruthless. They are threatening the home care workers that want to work and provide the service. It is unconscionable of the union to do this, but they are getting away with this. We could never get away with this as a government, I can assure you. We would be just taken apart by the news media. Yet the news media plus the union get away with this kind of actions. I do not know why.

On the privatization or the competition, the fact that they ought to put part of the services out for competition in Winnipeg, there is nothing wrong with that. In 99 percent of the cases where things go out for tender, they always come back less. They come back and cost the government less. Private enterprise can run, whether it be home care or businesses, any kind of business--it always does a better, more efficient job than the government can. If we have a bureaucracy to contend with, the private companies can always do a better job, and not only in home care, but in many other things that the government has done. They can contract out, whether it be in Highways or Natural Resources or in other departments. These services can be provided by private companies, smaller companies much more efficiently than we could do it through a government department. So home care is no different really.

There is nothing wrong with putting out 25 percent of the services required in the city of Winnipeg out for competition, out for bids. I think this will prove to be a good move and should work quite well.

We have another service that we provide through the Department of Health, and that is our senior resource centres. This is seniors working for seniors. This program has worked very well in my constituency. I have one in each of the larger communities, Stonewall, Teulon and Gimli. The one in Gimli has been operating the longest, and we have an excellent co-ordinator there who just does an excellent job in co-ordinating services.

How this works is that she provides services to seniors and hires people to do the job. It is not free. They charge the seniors and the seniors do not mind paying for some of the work that they get done, so we call it Seniors Helping Seniors. In some cases, they are a fee-for-service; in other cases they are seniors who are volunteering to do some of this extra work, and it has worked very well, especially in the area of Gimli. We have an excellent co-ordinator, and the service has kept expanding and is working very well, and this helps take the pressure off some of the home care system, and it works very well.

Just a little more on health care, some of the experiences I have had on a health board of a small community health centre, these smaller centres have always provided excellent service to local clientele. We have always had excellent medical staff in the rural areas, have excellent people. I think some of our home care workers who are maybe only part time, who do other things, help their husbands with farming operations, with other operations, they provide just excellent service for the home care system.

This morning, I had the opportunity to speak to a couple of Grades 11 and 12 classes in the collegiate, two different classes. After I spoke a little about the budget, about health care, about home care and about some of the services we provide and some of the things we provide for economic development, we opened the floor to questions, and I thought they would have questions about maybe home care or Pharmacare, some of the changes we made.

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That is not what they were interested in. They were interested in jobs, in their careers. There was more talk about the Constitution than there was about home care, health care and Pharmacare, so it really was not an issue. It is not really an issue out in the country because I think the services are being provided by home care. I think the co-ordinators who co-ordinate the home care system in rural areas have done just an excellent job of keeping the services there and keeping our clients serviced for the needs that they require.

As far as I know, there have been very, very few people with long-term ailments moved to hospitals because of the fact that most of the home care people have been able to continue with their service and it is just great.

So with that, Mr. Chairman, I want to thank you for the opportunity to say a few words on this issue.

Mr. Mervin Tweed (Turtle Mountain): I, too, would like to make some comments to the, what is it called, resolution put forward. I would, first of all, like to start out, I guess, just by refuting everything that the resolution states and also would like to suggest that I would like to commend the Minister of Health (Mr. McCrae). I certainly know in the past travelling with him throughout the province of Manitoba and throughout the city of Winnipeg that I think when you are facing tough decisions that the government is, and the minister obviously is, that the decisions are not always going to meet with favourable approval from the people. From time to time they will express themselves in different ways, and I think that the minister has made himself available to all groups and all people on both sides of the issue. I think he is to be commended. I think the job that he is doing is to be commended in the sense that he has faced the people; he knows and understands the realities of the world today.

I think that the suggestion that we introduce some competition into the health care industry and the home care industry particularly is a valid suggestion. I think that for far too long governments have been faced with the decisions of controlling expenses. I think that the honourable minister has taken these challenges and moved forward in a very positive way, in a positive way for all Manitobans.

There are certainly segments of the society that will disagree, and I know that the honourable members opposite will always disagree. They seem to have the mentality that as long as you sit and watch it, it will never change and therefore people must be satisfied with what you are doing.

I would like to speak personally about the home care workers in my particular constituency. I think that they are a sincere, hardworking group of people that are under great duress. I think the attitude of a rural Manitoban, from my perspective, is that they want to work. They are willing and capable, and sometimes from time to time when decisions are made beyond their control that they feel that they have a commitment also, I guess, in the sense of serving the union. I think that they sincerely have a real desire and a sense of urgency to get back to serving the clients, serving the people. I do not think you will find anybody in rural Manitoba that is afraid of competition. I think that is something that has to be discussed openly and clearly amongst the members in here.

I notice that the member for Inkster (Mr. Lamoureux) has suggested that we have--I am not sure exactly of the term--but I guess he would say preferential treatment for some of the bidders in all areas of government tender. I would suggest to you that certainly would open up a can of worms.

I guess we would all be looking for the angle to get into that preferential list that he would suggest would send contracts our way and perhaps lead to a more profitable preferential group of people, but I wonder if it would be actually providing better service, or a better service at a better price, to the people of the province of Manitoba, the people, who I might add, are the people that we represent when we make budgetary decisions, when we make decisions that affect the province. I do not think we do it carelessly or callously. It is something that we do and make decisions on what we feel is right.

I think definitely we are in a time of economic restraint. I think that is obvious by every jurisdiction in Canada, no matter of what political stripe. Decisions are being made and decisions are being made on the basis of economics and also of what the population really wants to hear.

It is quite easy to stand up and defend the status quo. Again, from rural Manitoba, I think the attitude out there is that every day it changes, and, if we are not prepared to change, we will never move forward. Unfortunately, the members opposite with their head-in-the-sand attitude are basically hoping that these times will pass and pass without anyone noticing as to where the economy is going and to what the people are saying.

I would also like to suggest that today’s results, I certainly commend the MGEU on their decision as far as voting in favour to not withdraw services from the people of Manitoba. I think that every member on this side has suggested that the home care workers in the province of Manitoba are the best, and I think we feel that the government employees’ union and the people are probably the best providers of service compared to the other provinces and jurisdictions within the country. I certainly commend them on their fine decision. I know, again, speaking from my constituency, we are a group of people that want to work, want to serve the people and that is why they voted not to strike.

Getting back to the resolution put forward by the honourable member for Kildonan (Mr. Chomiak), I would like to suggest that when you are forced to make reductions because of a federal policy that withdraws X amount of dollars from your funding, hard decisions have to be made. I certainly commend the Minister of Health (Mr. McCrae) on not only his ability to make the hard decisions, but also on his ability to go out and face the public and speak with them as he has done at several public functions. I think it shows a real commitment to the communities that he is serving and to the province on a larger scale. I think the honourable members across the aisle could probably take a lesson from the Minister of Health in the sense of his commitment to the people.

I think that as anyone might suggest, if you had an option to not deal with the issues, it would certainly be easier. I think any time you are dealing with the economics of it and there is a way to avoid the situation, in days gone by it was traditionally done by throwing more money at the problem but not necessarily dealing with the problem. It is quite easy to overlook it when the money is plentiful, and the people are demanding that the services be increased.

Currently, I think, what the government is facing is the fact that the people of Manitoba have spoken. They have asked the government to control the fiscal spending of this province and taken responsibility and, again, I would say that the honourable Minister of Health has shown to the people that he is capable of doing this. I think he has met the challenge, he has identified what the obstacles are, and he has set up a path which will lead all Manitobans in the future to the end that we all hope that we have, which is a better health care system, a better home care system and doing it within our means, which I think is the bottom line for all of us.

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It is, again, quite easy to avoid the situation if we have the money to throw at the problem, but this is not the case and I do not believe it is the case anywhere else in Canada. I would suggest that he is doing a very admirable job and probably is considered amongst his peers as a leader and--

An Honourable Member: The dean of Health ministers.

Mr. Tweed: --the dean of Health ministers, as my honourable friend has just suggested. I think that there is no one in this House on either side that would envy the position, but I think we all have to sit and stand and admire the work that is being done. With the straightforwardness that he has shown in the House and to the province and people of Manitoba, I think it is to be commended, and I would suggest that members opposite, instead of dealing with personal insults and personal trivialities of the situation, should stop and take a long, hard look at what the minister is doing, the tough decisions that he is making and the way that Manitobans are responding to them.

Again, I reflect back to today’s results. I think it has been a very positive turnout, and I think it shows that all people in Manitoba want to work for the betterment of the people of Manitoba.

So with that, Mr. Chairman, I would like to just put on the record that I commend the Health minister on what he is doing, and I wish him a long future in the position.

Hon. Brian Pallister (Minister of Government Services): I appreciate the opportunity, Mr. Chairman, to put some brief comments on the record at this time and look forward to a further opportunity to speak to this motion because although lacking in substance, it is one that calls for a response, and it will get a response, I think, by a number of other members and probably additional responses thereafter as necessary to answer some of these unfounded and insubstantial allegations by the member opposite in his motion.

I want to begin by telling you a little anecdote, Mr. Chairman. There was an old gentleman sitting on his porch one night, watching the sun set from his porch, and a neighbour, another old bachelor, came across the pasture to visit him, and they were sitting on the porch watching the sun go down, sharing a drink, and the dog began to whine. There was dog laying on the porch there. It was an old bloodhound. He began to whine and he continued to whine with increasing fervour and enthusiasm until finally the visitor said to the old gentleman, Bill, your dog is whining, and Bill said, I know. He said, why is he whining, and Bill said, he is probably lying on a nail. Why does he not move, and Bill said, I guess it does not hurt enough yet.

We have just been subjected in this past year in this province for whatever reason to massive, massive reductions in funding support for Health that are unprecedented in the history of Manitoba. I am not here today to be critical of the federal Liberal government, though Heaven knows there is great legitimacy to attacks, I think, on the basis of these reductions in funding from the federal government, but I cannot, as someone who is in a position of leadership in this province, along with my colleagues on this side of the House, ignore the reality of those cuts.

Mr. Chairman, we are on a nail and it hurts. It hurts enough that we have to move. We have to manage differently. We have to change our approaches. We cannot, as is the luxury of members opposite, sit on the failed ideologies of past years and believe that there is not nails in there somewhere because there really is.

The pain of the status quo is very great, and the pain of passing on ongoing deficits to future generations is far too great for any of us on this side to in good conscience accept. We will not accept it, and we have the strongest balanced budget legislation as a testament to the reality of our commitment to the future of our children and ourselves. We have that balanced budget legislation in place, and we will abide by it as it is the law of this province.

Although it may be news to members opposite, it is not news to the members on this side of the House that there are new and creative and innovative approaches to public management, to delivering service to the taxpayer and to infrastructure management, and we are practising those. There are a number--I could elaborate, but in the current time I am allotted I will not, on our own department’s innovative approaches to improving the quality and the services we deliver, not at additional cost, in fact, at reduced cost, the taxpayers of this province.

What is lacking in the debate and in many of the arguments that come across our way from members opposite is evidence of a rational approach. We have taken a rational approach to the management of these difficult issues that concentrates its efforts on providing the highest level of service we possibly can to the people who depend on that service, while considering what the costs are of providing those services and knowing what the costs are of being unable to provide those services in the years ahead.

We understand, with foresight as all good managers have, that it is necessary to manage within our means and we do that. We do that not by cutting, as the members opposite so often wrongly accuse us of doing, but rather by searching out innovative and creative ways to manage. It is that improvement in management that the Minister of Health ( Mr. McCrae) has exhibited more aptly than, perhaps, any of us on this side of the House, and the way in which he has responded to these challenges creatively.

One of the ways that many other governments across the western world, whether the national, provincial, territorial or civic level, have managed successfully to derive better quality service at reduced cost is through what is called managed competition. Rather than a public, private debate, which is so often entered into by members opposite, really what we are talking about here, is a debate around whether you believe competition is good or bad. It is clear from the members opposite and their comments they believe competition is bad, something to be feared. I do not, nor do the members of the Conservative Party in this province. We believe that competition is, in fact, a good thing and, managed well, it can work well to serve our ratepayers. What is managed competition? Well, what that means is that you allow your public sector to be an equal competitor in providing services to the taxpayers of a jurisdiction. It works very, very well. You let the public sector enter into a tendering process.

An Honourable Member: This is an innovative approach.

Mr. Pallister: Now this is an innovative approach as the member for Charleswood (Mr. Ernst) wisely observes, and the approach has been established and proven effective in many jurisdictions. Competition is the name of the game. It is not just an issue of privatization, it is a management tool to provide better services at lower cost. Now the member for Inkster (Mr. Lamoureux), and I am glad to see that he is participating in the discussion, has made the observation or suggestion, and I respect the fact that he has made a suggestion despite the irony of the fact that his federal cousins cut tremendously the amount of financial support that we have for Health. The member to his credit unabashedly, unashamedly, is willing to spend more here in Manitoba. Despite the fact that we have less from the Liberals in Ottawa, he says we should spend more here.

Now how should we spend more? What he suggests is that we should buy votes from our nonprofit sector. Buy votes from them, he says, by giving them preferential advantage--it is hilarious, I am sorry I laughed there, but it is hilarious to me--preferential advantages in a tendering process. The member clearly does not understand even the most basic element of a tendering process. But the fact is when you stack up your costs to projected revenues derived and you put in a bid and you respond to it, the thing that the members of the New Democratic Party constantly attack private sector companies for doing is for factoring in--what?--profit.

Nonprofit agencies do not factor that in at all and they have an innate, built-in advantage in the tendering process for that fact, for that very simple reason. They are advantaged by these tenders and should not fear them for they should, by the very fact that they do not require the additional expense and profit in their proposals and responses to tender, should bear an immediate and very real advantage over private sector competitors.

The member for Inkster (Mr. Lamoureux), if he gets his wish, should support us certainly and totally on this issue, because if he wants advantages for nonprofit agencies, there is no surer way for nonprofit agencies to derive advantages than to participate honestly in a tendering process.

I have faith in the Victorian Order of Nurses and other nonprofit agencies the member appears not to have because I believe--

Mr. Chairperson: Order, please. The hour being 5:30 p.m., committee rise.

Call in the Speaker.

IN SESSION

Mr. Deputy Speaker (Marcel Laurendeau): The hour being 5:30 p.m., the House now stands adjourned until tomorrow at 1:30 p.m. (Wednesday).