Mr. Mervin Tweed (Turtle Mountain): I move, seconded by the member for Pembina (Mr. Dyck),
"WHEREAS physician recruitment and retention in rural and northern areas is an ongoing issue of concern recognized by the Government of Manitoba; and
"WHEREAS Manitoba Health is committed to working with the College of Physicians and Surgeons to maintain the high standards we have all come to expect as well as being proactive with multiple new initiatives; and
"WHEREAS Manitoba Health has increased off-shore recruitment initiatives, announced a Locum Tenans Program and has lobbied the Manitoba College of Physicians and Surgeons to bring their rules in line with other provinces; and
"WHEREAS Manitoba Health, Rural Health Authorities, the Manitoba Medical Association and other stakeholders have developed a new and unique model for renumerating emergency physicians; and
"WHEREAS Manitoba Health will continue to work with foreign medical graduates by reviewing current tutoring and resident programs; and
"WHEREAS starting in the 1998/99 academic year all family medicine residents will be required to do 2 rotations in rural or northern communities; and
"WHEREAS rural and northern communities have a role in the long-term plan for retention of new physician; and
"THEREFORE BE IT RESOLVED that the Legislative Assembly of Manitoba support the Department of Health in its efforts to find sustainable and innovative solutions in recruiting and retaining physicians for rural and northern Manitobans."
Motion presented.
Mr. Tweed: Madam Speaker, I certainly rise today to speak on this issue. I think that it is an issue of great importance to rural and northern Manitobans, and I think it gives an opportunity for members on both sides to put some of their concerns and issues on the table regarding doctor recruitment, particularly in the rural and northern areas.
I would like to just start out by explaining some of the things that have happened in recent months within the department and with the rural RHAs that have been involved in the recruitment and the retention of physician services.
The RHA, in conjunction with Manitoba Health, provided a list of doctors that were needed in communities in rural and northern Manitoba and provided that list to the Department of Health at which time we took the list and refined it down to what the needs of each RHA and community, developed a plan to address those needs on the immediate issue which we saw was the recruitment.
Government and the RHAs worked together to set up a plan in which a recruitment mission took place. In that period of time there were a series of presentations made to, at this point in time, particularly South African doctors who met all the requirements of the Province of Manitoba to allow them to come here to work. This recruitment process stretched over a period of six days, at which time we had approximately 59 doctors from South Africa make application to come to Manitoba, of which upon credential checks and over the period of time I believe boiled down to about 33 of them being qualified and capable or available to us out of that number, of which to date we have managed to recruit and the paperwork is now being finalized to have these people come to rural and northern Manitoba. I believe it is 23 physicians.
So I think that in the next little while, it is my understanding this recruitment drive, the initial arrival of the first doctors I believe is April 15, and then over the next period of six to eight weeks the total of 23 will show up. I know from my communities particularly, where it is certainly I think a real positive signal to the communities of the viability and the survival of the health care that they have come to know and expect, it is a very positive step. I certainly know that other areas--and I think that was one of the real benefits and probably pleasures from my involvement in this particular project was the fact that we had communities from all over Manitoba with requirements, and we were able to fill many of those voids that they saw in their system. I know that some areas were short as many as three and four doctors and were able to fill their rosters. Those doctors will be showing up in the very near future.
Some of the other things that we have tried to do in the department to enhance the direction of health care in rural and northern Manitoba, the province had signed a new emergency agreement with the MMA and other stakeholders. It is a new model, and I would suggest to you that this model of remuneration is one that is being studied by other provinces throughout Canada. In return for the emergency services, concerns expressed to us by physicians, through extended clinics they will increase their access to doctors and also increase the compensation side for the physicians.
There is new contract negotiations on right now. Alternate payment contracts for rural and northern physicians are currently under negotiation. I think by continuing to explore and discover new options and new ideas and listening to what people are telling us, listening to what the doctors are telling us, we have been able to come up with some pretty positive plans to recruit new physicians to these areas, not only recruitment but to retain them. I think probably one of the most important aspects of this project was the fact that quite often when doctors move to a community, be they a Canadian doctor or a foreign doctor, the contact with the community had to be ongoing or, it was explained to us by these people, that they enjoyed becoming a part of the community. We, through the RHAs and the communities directly involved, have developed some plans, and we are working on a model for all communities in Manitoba that they will be able to see a process that has worked and could work for any and all communities.
I do know that the community of Arborg in particular have been very, very aggressive in their recruitment process, not just at the recruitment level but at the retention level, how they are planning to keep doctors in their communities, how they introduce them to certain aspects of their communities and responsibility of the people that once they come they are not just going to be left standing. They will be looked after by the people.
Another initiative that we have taken is to ask the University of Manitoba to work on a re-entry program which gives graduating doctors an opportunity to work in rural Manitoba and northern Manitoba for a period of time with the idea that for the time that they serve or spend in rural and northern Manitoba, they will be allowed a re-entry back into the university at the end of that time to complete their specialist training that they wish to choose. I think the benefits that we see for this is the fact that these young doctors will have an opportunity to work in rural Manitoba.
We will have an opportunity as rural Manitobans and northern Manitobans to give us an opportunity to spend time with these people and let them see and experience what we have to offer and perhaps captivate a few of them to continue to work in the communities and hopefully spend their lives there and serve the people of the communities. I think all communities in rural and northern Manitoba have lots to offer people. What we have to do is get these young doctors to our communities and get them to experience what we have to offer, and I think we stand a lot better chance of sustaining our doctors in our communities.
The re-entry plan is a new plan. It has been discussed in several provinces across Canada, and, if I am not mistaken, when this comes to fruition for the government and for the university, this will be the first project of the provinces. I can stand to be corrected on that, but that is my understanding at this point, that it is just under discussion with other provinces.
Some of the other things that have happened in the area of initiatives that have taken place is with the international medical graduates who are currently working on a process to have more of them involved in the learning process through the university site, that they can upgrade and bring their levels to our standards. A lot of it is not that they are not capable or are not qualified. It is just a matter of getting the hands-on experience that they need to bring their qualifications back up to par. They certainly served as doctors in the communities that they came from.
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They are Canadians, they are Manitobans, and I certainly feel that they should be given an opportunity with some training to bring their skill levels up to the qualifications that we need. Plus they have made a commitment to us, and I think it is very positive that they would be willing to work in the rural and northern communities as part of their commitment to the training that we would provide. We are working very closely right now with the university to try and help these programs, to get them set up and make them happen so that it gives us another pool of qualified people to move into our rural and northern communities to serve the people of those communities in the health care field.
Also, one of the things that we discovered in the undergraduate program with doctors is that the students in their third and fourth year have been supported with a dollar amount based on a return-of-service agreement. The discussion that we had ongoing, and continues to on go and I believe will come to an end in the near future, quite often what happened was the third- and fourth-year students were financed by us with a return-of-service agreement but upon becoming doctors had the opportunities to explore, particularly into the United States, at which time the recruitment teams down there were picking up the coverage, the costs of the third and fourth year that we were paying here. It is a fair agreement that they do that, but what we tried to do was set up some sort of a program, either by increasing the amount of funding or extending the period of time to the second year, so that it would be a larger amount of money at that time which may discourage some of the recruiting that is going on.
I think all countries are recruiting from each other. We find that wherever we went with the recruitment process, be it across Canada, be it to other countries, there were always other countries there recruiting, and also in Canada we found that there were several countries recruiting our graduate doctors and practising physicians. I think the way the world is today that is something we can come to continue to expect, but I think what we have to do is try and put systems and programs in place that at least give us the ability to continue to recruit doctors. I think we really need to continue to try and recruit Canadian and Manitoban doctors. I think that is something that a lot of these new initiatives we will be seeing in the near future and that we are undertaking and exploring right now will bring forth. I think the benefit to us is that we will have Canadian doctors working in Canada and, hopefully, we will have Manitoban doctors working in Manitoba, and I think that is very important to us all.
One of the other programs that we have introduced is the rural and northern resident education program. In the past, there was one University of Manitoba professor, residing outside of the city of Winnipeg, providing the resident education services. Starting in 1998-99, we have increased that number to five, and these people will be working in the communities and dealing with the resident students. Again, by going to five, we were able to allow each student to do two rotations in rural and northern Manitoba as opposed to one, and it will also increase the number of students that are accessible to this program, so I think it has been a real positive thing.
I think many of the members opposite, as well as on this side, will all agree that we all represent great communities, but probably one of the biggest obstacles we have is getting people to come for the first time and see what we have to offer. I think this again will provide another opportunity to bring young graduate doctors or young practising doctors to our communities and again have them experience what we are and what we are all about and what we have to offer, and again it enhances our opportunities to captivate these young doctors.
One of the other things that we have initiated and has been ongoing in the past few years was the rural students entering medicine. We felt that as a province, and we are certainly encouraging the RHAs now to go out and start making presentations to the communities, particularly the schools, and start talking to the schools to encourage high school graduates to consider the field of medicine, the practice of medicine.
We have allowed for 10 spaces in the university program to be designated for rural Manitobans, for rural students, and I think that is another opportunity for us to enhance our chances of recruiting doctors for rural Manitoba. The studies have shown us that rural students graduating quite often will return to rural areas of the province, or of Canada, and we certainly want to give them that opportunity in Manitoba as well.
It is certainly my pleasure to speak on this resolution, and I would ask that all members stand and wholeheartedly support it. Thank you.
Ms. Rosann Wowchuk (Swan River): Madam Speaker, I listened with interest to the member for Turtle Mountain (Mr. Tweed) as he made his comments, and he was certainly trying to give his government a pat on the back for what they have done. I do not blame him for doing that. It is his government. They have been in power for 10 years, and the situation of doctor shortages in rural Manitoba is worse than it has ever been, so I do not blame him for wanting to--[interjection]
The member across the way says it is not as bad in rural Manitoba. I would ask him to look across the province, in northern and rural Manitoba, and really look at the situation. I mean, just the other day, we heard about pediatricians leaving Brandon, withdrawing their services in Brandon, because there is not enough support there. They just cannot handle the workload, and this government does not recognize that they have to take the necessary steps to ensure that there are adequate doctors.
Another example, Madam Speaker, is in Stonewall, just 30 miles out of the city. Doctors were threatening to go on strike there, again, because they could not work in the conditions that have been created by this government. This government has not created a very good environment or a very attractive environment for doctors to want to practise, and we are losing them at a very great rate. My colleague, the member for Transcona (Mr. Reid) raised the issue of neurologist, and in my own constituency I have a patient who has to go to Saskatoon. And, of course, the government has to pay the costs of sending that patient to Saskatoon because there are no neurologists in Manitoba.
So I know that the member for Turtle Mountain (Mr. Tweed) would like to paint a very pleasant picture, as if they have done so much to attract doctors to rural and northern Manitoba, but, in fact, they have failed quite dismally. One of the areas that they failed in--he talks about recruiting and educating more Manitobans, and I agree. We have to educate more rural Manitobans and northern Manitobans.
An Honourable Member: Right.
Ms. Wowchuk: One of the programs that we had was the Access program which was a very good program and people trained under it. People from northern Manitoba were encouraged to go into medicine, because we know that, if people from the north or rural areas are trained in a specific field, they always want, most often want to go back to their communities.
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But this government fails to recognize that we are spending 50 percent more to treat children in northern Manitoba, and they refuse to recognize the importance of training northern people, so that they can go back to their communities.
The other thing, he talked about creating 10 more spaces for rural students. Well, along with creating spaces for rural students, I think the government should recognize the cost of getting a medical education, and that it costs a rural person a heck of a lot more than it does for an urban person. This government has not seriously addressed education funding and, in fact, the changes that they have made to student loans is going to put even a greater burden on students from rural Manitoba and, in many cases, will discourage them from entering those fields that require a lot of years of studying. We have to recognize that although the government tries to paint the picture that they are doing a lot, in fact they are not.
The other area where they are not putting their money where their mouth, so to speak, is bringing doctors back to Manitoba. This morning we heard about a doctor who is from northern Manitoba, who wants to come back to northern Manitoba, but the health authority in The Pas does not have the resources to bring him back; the funds are not there. They could use the extra doctors, but, again, this government does not recognize that there have to be special incentives.
Now, if you look at other provinces such as Saskatchewan, where they have an excellent incentive program to bring doctors--
An Honourable Member: Yes, they are doing a good job there.
Ms. Wowchuk: Saskatchewan is recognizing that to bring doctors into rural and northern Saskatchewan, there have to be special incentives. I believe in Saskatchewan the incentive is somewhere around $20,000 or $30,000. They have also put in place a team of people that will support the doctors in rural areas, so that they can have time off and have a family life.
Under this government's administration, doctors really do not have the opportunity for family life because they are working continually. There is not the staff for replacement. As a result, we are losing very good people from the city and we are having a difficult time to attract people to northern Manitoba.
I have to say that, in my constituency the program brought in to remunerate for emergency physicians has worked for one of the doctors in my area, and that is Dr. Johnson of Winnipegosis, who is the only doctor in the community. As a result of this funding, he has been able to have some time off, take one day off a week to spend with his family and do his own personal business. So in that sense it is good, but, again, it is not long term. It is put in. Last week, the people of Winnipegosis did not even know whether they were going to have emergency services, because nobody had communicated with them as to whether this funding was going to continue on or was this one of those usual stopgap things that this government does when they see that there is a crisis out there.
An Honourable Member: Yes.
Ms. Wowchuk: I guess the other area, Madam Speaker, the member talked about doctors from South Africa and the recruiting that they had done. I am very pleased that we have been able to recruit doctors from South Africa, but I am very disappointed in this government in their lack of action when it comes to foreign doctors who are right here in Manitoba right now. We have lots of foreign doctors, but this government refuses to address this, people who have their training, people who are willing to take the necessary testing to ensure that they can practise.
Again, government is not recognizing that there are people who are trained who are now sweeping floors or working selling hamburgers trying to keep their family alive, and this government will not look at a solution to get these people working. If these people could get their accreditation, then they could work in rural and northern Manitoba where there is a shortage.
Now, my colleague the member for Kildonan (Mr. Chomiak), our Health critic, worked with the foreign doctors and foreign physicians and came up with a plan. The plan says that these foreign doctors that provide Canadian doctors who have trained and practised in other countries and who have passed evaluations exams would have residency positions in Manitoba. They also suggested that the government offer contracts to these physicians to oblige them to practise in underserviced regions, following their residency, for a specific period of time. After passing their licencing, during their time of residency and filling full licence requirements according to the existing policies, doctors would be offered full licences if they returned to their contracted areas.
So here is a solution. Now, I heard somebody say that there is money for all kinds of things. Well, yes, there is money for all kinds of things by this government. This government has money to make millionaires out of their friends and relatives of government. They have money for that. They have money to sock away in their stabilization fund so they can make election promises, but they do not have money to address the real problems that are facing rural and northern Manitobans. They do not believe in preventative health, they will just look after their friends.
So, Madam Speaker, I cannot support the member on this resolution because really they are just trying to pat themselves on the back and really camouflage what they have really done and that is to ignore the many suggestions that have been put forward by various groups as to how we could address the shortages of doctors in rural and northern Manitoba. If they were serious about having healthy communities in rural and northern Manitoba, they would take some of these suggestions very seriously, for example the suggestion of establishing more nursing stations and using nurses to a much greater degree than they have.
I guess the one other issue that I want to address is the lack of commitment of this government to recognize women physicians who just recently said that it was becoming much more difficult to work in this province. Many, too, are looking to other provinces. So we train people, and then other provinces benefit from the education that they get in this province. We definitely have a shortage. This government does not have a good record. Ten years of their administration has not improved the health care system and has not--I should say, Madam Speaker, 10 years of this administration has not improved the situation for doctors in rural and northern Manitoba, therefore I move, seconded by the member for Dauphin (Mr. Struthers),
THAT the resolution be amended by deleting all words after the word 'Manitoba' in the THEREFORE BE IT RESOLVED clause and substituting the following: "condemn the Provincial Government for failing to deal seriously with problems in recruiting and retaining physicians for rural and northern Manitobans."
Madam Speaker: I will take the amendment under advisement.
Mr. Peter Dyck (Pembina): Madam Speaker, first of all I would like to speak in support of the resolution and against the amendment. But what I would like to do is put on record the situation as it currently stands within our own area, and that is the Pembina constituency. With that, I would like to congratulate the honourable member for Turtle Mountain (Mr. Tweed) for his resolution and the fact that he has, through his efforts, been contributing towards the good health within Pembina. That is not saying there could not be better health and better opportunities there. However, the work that has taken place over the last number of months has certainly contributed towards the well-being of the people within the Pembina constituency.
As you are aware, the Pembina constituency, comprising Winkler, Morden, and Manitou, the three towns, is one of the fastest growing areas within the province of Manitoba in the rural area. Consequently, we are in need of good staff and good physicians, and I want to applaud our doctors, our physicians out there, for the work that they are doing. The work that they are doing is certainly at times under trying circumstances, but doing a very good job in meeting the needs of the people.
As I indicated, this is the fastest growing area rurally and, consequently, the need for staff is great, and they are meeting the needs out there as they are required. Now, that does not mean to say that we do not need the efforts of more physicians and also the fact that we are not recruiting them. It has been brought to my attention and, certainly as of today, we have been given another seven doctors, who are going to be coming to the area known as Boundary Trails region and are going to be able to assist the doctors who are out there in order to meet the health needs of the community.
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I would like to just at this point relate a little story. This is regarding in direct response to what the member for Swan River (Ms. Wowchuk) was saying regarding the poor health, as she indicated, and the things that we hear about the awful things that are taking place within the province.
I have a very good story to tell, and that is of my father-in-law, who had his hip replaced at the Misericordia Hospital about a month ago. I went to visit him after he had had his hip replaced. It was about four days after the operation.
I think, as the story would go, our news media, they have a habit of, as do some members opposite, of showing all the people who are out in the hallways and the terrible situation that is out there. Well, my father-in-law was on the second floor and I went to visit him and, yes, as I rounded the bend, I saw that he, together with three other people, were in their beds in the hallway, and I thought, my goodness, this is very interesting.
So, I went to visit with him and I asked him during the course of our conversation, why are you in the hallway? The comment was very straightforward. Because I want to be. I checked this out with the other three people lying in their beds, and they all indicated that they want to be. As I am visiting, a nurse comes along and asks them whether they would like to go back to their rooms as of yet, and they said, no, we like it here, we like the activity that is in the hall, and this is where the action is. So I found this very interesting, because I could have taken a very beautiful picture out there of people lying in the hallway.
So just to add to this, I have a brother-in-law who is working in palliative care and has been working in the Misericordia and at Concordia hospitals. He has been working in the palliative care area for the last four years. He is a retired schoolteacher and, as a result of his wife passing away about seven years ago, he committed himself to working with palliative care, and I admire him for doing that. So he spends on the average anywhere from eight to 10 hours a day in the hospital, in both the Misericordia and Concordia hospitals.
So I asked him, you know, tell me what you see as the situation being here in the last year, the last two years, the last few months. Is it as bad as it is said to be, as we read in the newspapers and also as we see on television? After a few moments of hesitancy he said, you know, he says, I have to be very honest, he says, I cannot in one instance fault our health care system for the way they are treating the patients in the hospital or for the log jams, if you can use that term, that they have had within the system here. Now, that does not mean to say that when an emergency, when there are a number of people who come for treatment, that you do not have a waiting list of a few people, but generally speaking they have been moved through very quickly, and he was very appreciative of the health care that we have.
So members opposite are using all kinds of instances of how terrible the system is out there. I would agree that we need to continue to work on improving the system, though I fail to see that it is as terrible as members opposite say it is. So that is one instance, Madam Speaker, that I just want to put on record, because I was very surprised at what was taking place. Yet, though, if I had not checked out what really had happened in this case, I myself would have been appalled at the situation.
Yes, we need to continue; we need to look at the recruitment of doctors. Certainly we want to assist our medical people in the field in the work that they are doing. I also know--I have several friends who are physicians--the work and the time and effort that they put in. Again, it is interesting, as you talk to some of the senior doctors who have retired, you know, they will categorically state that times have changed. They went into the area of medicine in order to help people, in order to assist them, and they did this very often to the detriment of their own families, in having spent the time there, and they recognize that.
I believe that today's doctor is saying that, generally speaking, they would like to have more of a family life, that they need a little more of that free time, and certainly they should have that. So, consequently, we are in changing times. We have changing times in every area of our economy but, specifically in health, we are looking at some of the changes that need to take place.
In order to accommodate these changes certainly we need to bring more doctors into Manitoba. We need to bring more doctors into our communities to be able to assist those who are out there and to accommodate their needs. As I indicated before, I believe it is within Boundary Trails that we are going to be receiving seven extra doctors. These are coming in from South Africa. I had the opportunity several months ago to meet with some of them, had an opportunity to talk to them and certainly they are highly recommended, and I believe they would fit in very well into our community.
Just to add to that, within our community presently we have several doctors who have come from South Africa who are residents of the community and who have been there for a number of years and fit in very well and have certainly integrated well into the community. So we look forward to the efforts of our member for Turtle Mountain (Mr. Tweed) for the work that he has done in recruiting these doctors and bringing them into the community.
The comment that was made here about needing to retain and to keep the doctors within the area reminded me of building walls. You know, we have people within our communities, within our province, and we need to keep them here. Certainly, we want to do everything possible to accommodate them, but we still live in a democratic world and a democratic country. People choose to live where they want to live, and they will move.
Madam Speaker, it also reminds me of the opportunity I have had to speak with a lady who is an administrator of a large hospital in North Carolina. In fact, she is the administrator of a 400-bed hospital, and we were talking about physicians and the mobility that physicians experience nowadays. I think on this as well, it is interesting how it is always greener on the other side of the fence. As we were comparing notes, she also indicated that some of the doctors who were moving from the North and going south were finding that the contracts certainly were fairly lucrative. However, the work that was demanded of them was also very directly related to the amount of work that they did. Meaning that if they had a contract--and I will just use the term for $300,000--there was a certain quota that they would need to meet, and this was not always possible because of the time that they spent in filling out forms and also defending some of the situations that they were in. So the bottom line was that many of them were starting to look at Canada and Manitoba again as possibilities for practising the talents that they had.
So people certainly have the opportunity to move where they want. We would like to see them stay in Manitoba. I, personally, would like to see them stay within the rural area because I believe that rural areas have a lot to offer. We have the mobility of driving to the city within an hour and a half and, yet, being able to enjoy some of the features of country living.
I believe the resolution, as the member for Turtle Mountain (Mr. Tweed) has brought forward, certainly does speak for it in a positive way towards the recruitment of doctors and the work that they are doing, and I certainly do support that.
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One other area I would just like to briefly mention on, and that is the whole area of change as we see it in the area in the health care field. On the one hand, we have a situation where our doctors and certainly the people involved in health care want the latest in technology, and so they should have it. I believe as any one of us involved in business or in whatever profession we are in, we like to use the latest in technology and have that at our disposal. Certainly, we see the same thing happening in the field of health care. We want to supply our medical people with the best tools possible, so that is the one side.
The other side that I see and find it fairly interesting is the fact that we need to also have a way of tracking this system, so that we know exactly where our health care is going in that we know exactly what is taking place. The introduction, as I see it, with the SmartHealth card would certainly be something that would accommodate this process, so that we could have a very quick way of tracking the health care needs within the province.
I know members opposite in the few years that I have been here and when this issue has come up have spoken against it. I see it a way in today's world of being able to accommodate our health people in being able to track what is taking place, and on the other hand also, though, financially to be accountable for the dollars that are used.
I would encourage all members present that we continue to encourage this concept of moving towards a SmartHealth card and use this in a way that we would be able to track the system, so I ask you to do that.
In conclusion, I just want to say that I support the honourable member for Turtle Mountain (Mr. Tweed) and the resolution that he brought forward. I would ask members opposite to take a real serious look. I know that they have put an amendment out there, but I speak in favour of this resolution and would ask them to support it. Thank you very much.
Mr. Stan Struthers (Dauphin): Madam Speaker, I rise in support of the motion that the member for Swan River (Ms. Wowchuk) put forward to try to amend. I do not speak in favour of the attempt by the member for Turtle Mountain (Mr. Tweed). I do not support the attempt of the member for Turtle Mountain in papering over what is a serious issue in this province. What this province needs is a government that is going to show some leadership in bringing doctors out to rural and northern Manitoba. What we do not need is a government, and a member from Turtle Mountain, bringing forth simply a self-congratulatory document that he will probably be using in some political way come the next election.
I listened very carefully to comments from both the member for Turtle Mountain and the member for Pembina (Mr. Dyck), and I must admit I was quite astonished to hear some of the remarks put on the record by the member for Pembina. It is beyond me how a member of this Legislature can stand and talk about one isolated case in his riding and then project that isolated case over the course of the whole province of Manitoba and then try to have people believe that everything is fine and dandy in the delivery of health care in the province of Manitoba. That seems to me to be exactly the way this government is approaching the health care issue, and that is the wrong approach to take.
Just because something happened in his riding that he can pawn off as being somehow a positive thing in health does not mean that there are not serious grave problems throughout the rest of this province. There have been too many cases come through my office in Dauphin of people who are coming across very strong needs in our health system, people who are being mistreated within the health system because of the decisions of this government. There have been too many people just in the Dauphin regional hospital alone who have suffered because of this government's action and, in some cases, inaction when it comes to health care for me to believe that the member from Pembina thinks that everything is hunky-dory across the province just because he came across one case in his local hospital that he considers to be possible. That is not the way to do public policy; that is not the way to put together health care decisions in the province of Manitoba. The member should know better than that.
Unfortunately, I think the Minister of Health (Mr. Praznik) operates the same way as what the member for Pembina and the member for Turtle Mountain have displayed in the Legislature here today. Manitobans want a serious approach to a very serious issue.
But, Madam Speaker, as well, I want to give some credit here to some of the people who are involved in health care delivery in our province, including doctors, including nurses, including support staff, including orderlies, including all those people who volunteer and work with the regional health authorities, the people who have been appointed to regional health authorities, the CEOs in health authorities. These people are doing the best job they can despite the decisions that are being made on a day-to-day basis by this government. Despite the laying off of nurses of this government, the nurses continue to act in a very committed and caring way. Despite doctor shortages and despite bed shortages, despite funding cuts, despite the unfriendly, shortsighted approach of this government, there are some success stories, but I want this government to know that they are stretching these people to the limit. You want to know why doctors are leaving Manitoba? You have put the system in crisis. There is a crisis in Manitoba. You cannot wallpaper over this with fancy speeches in the Legislature and self-congratulatory, pat-on-the-back types of resolutions as we have before us here today. You have to do something to help people in rural and northern Manitoba.
The main thing that I want to get across is that you have put Manitoba Health into a crisis. You have now had 10 years to put the system into a crisis, and you have done very good at that. Now you have the responsibility of taking us out of this crisis. The decisions you make are putting us further into crisis, I am afraid. Several times since I have become an MLA I have listened as colleagues of mine in the opposition have approached this government to try to point out the urgency of this doctor shortage problem that we have in rural Manitoba. On several cases we have put forward to the government some good, positive ideas that we could use in order to solve this problem. Is any of that reflected in the resolution that the member for Turtle Mountain (Mr. Tweed) brings forth today? No, it is not.
Madam Speaker, this is the government who cut Access programs. They cut the Access program in this province, a program that was training northern people to take the positions as nurses, as doctors and as other professionals going back into rural and northern areas. This government cut that program. Is that a commitment to solving this doctor shortage program? If the member for Turtle Mountain had included a reinstatement of the Access funds, I could consider supporting this resolution. But you cannot, on the one hand, cut a program that was serving well the needs of rural and northern Manitobans and then walk into this Legislature and expect me to support you. That is not being credible or realistic.
Madam Speaker, the member for Turtle Mountain talked about a new model, some kind of a new day for Manitoba. We are taking all this responsibility, and we are giving it to the regional health authorities. Well, I want to point out to the member for Turtle Mountain, he can talk all he likes about how good the regional health authorities are going to do, but if he does not and his Minister of Health (Mr. Praznik) does not or if his Finance minister (Mr. Stefanson) does not provide the funds to these regional health authorities to recruit these doctors, then you are not going to see the regional health authorities solve this problem.
Some Honourable Members: Oh, oh.
Madam Speaker: Order, please. The honourable member for Dauphin has the floor.
Mr. Struthers: Madam Speaker, two years in a row the Parkland Regional Health Authority has sustained cuts from this government, two years in a row. If the Minister of Industry, Trade and Tourism (Mr. Downey) doubts what I am saying, go and check it out with the CEO of the Parkland Regional Health Authority. Two years in a row: last year in excess of $400,000; the year before in excess of $400,000.
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Hon. James Downey (Minister of Industry, Trade and Tourism): I wonder if the member would accept a question, Madam Speaker.
Madam Speaker: On a point of order?
Mr. Downey: Yes, on a point of order, Madam Speaker.
Madam Speaker: The honourable Minister of Industry, Trade and Tourism does not have a point of order.
Mr. Struthers: The Minister of Industry, Trade and Tourism can go and check in the Parkland region. Maybe the minister should just simply turn around and ask the member for Roblin-Russell (Mr. Derkach), who falls within that Parkland Regional Health Authority, what has happened with the funding in the PRHA. He should be able to tell him that in our Parkland Regional Health Authority, two years in a row we have been cut; one year in excess of $400,000; the next year in excess of $400,000. How does this government expect the Parkland Regional Health Authority to do all the funding it is expected to do plus recruit for doctors?
Let us start taking a serious approach to this. Do not come into this Legislature waving a resolution to pat yourself on the back when you have cut that kind of funding out of the regional health authorities. It is not just the Parkland Health Authority; it is all the health authorities that are suffering through this.
I have mentioned the fact that several of our MLAs on this side of the House have brought forward these concerns to the minister. In 1995, my colleague for Flin Flon, just as one example, brought this to the House, brought this doctor shortage problem here to the House during Question Period, and he was told by the then Health minister that every resource possible available to resolve those issues before they become critical. Well, Madam Speaker, the government has done nothing. Now the time has become critical. It is fine to make fancy statements in Question Period as well, but now you have got to come through.
I want to touch on a couple of more issues. The one issue that I want to deal with is the way in which this government can actually take a tangible step towards solving this problem of doctor shortages. The member for Turtle Mountain (Mr. Tweed) did say one thing in his speech that I did agree with, and that was that if you train local Manitobans in medicine, they will return more of a chance to returning back to their hometowns to provide medical services. That is good. I agree with that.
Why then does this government, on the one hand, say that, and then turn around and continue to increase tuition fees to universities for Manitoba students? Why has this government not twigged to the fact that many students in our public schools in rural and northern Manitoba decide in junior high and the middle years and in the early high school that they are not going to be able afford to go to university, so they select courses that would not get them into university to begin with?
Finances are a major barrier for rural and northern students to attend university. Tuition is much too high, and it is increasing and will continue to increase under this government, and room and board costs are simply, in most cases, too much of a hurdle for rural students to jump over. Is it any wonder why there is a lack of rural students taking medicine? This does not add up with what the member for Turtle Mountain (Mr. Tweed) said in his comments here earlier today.
The other issue that I would like to deal with briefly is a course in Dauphin, the Parkland training centre in Dauphin, who despite the minister does have a good reputation and good results that they have produced throughout the course of this training program in Dauphin. Last summer, however, the minister got into a game of chicken with the University of Manitoba, putting in jeopardy the whole program.
Now, Madam Speaker, I find it really amazing that the Minister of Health (Mr. Praznik), who purports to be concerned about the rural doctor shortages and northern doctor shortages, would get into a fight with the University of Manitoba and put out into the record the words abysmal when it comes to the results that this program is producing. I just want to quote Dr. Peter Kirk, who rebutted many of the statements that this Health minister made last summer. Dr. Kirk said that we have graduated 120 residents over the past years between 1992 and '96. Of those 120 residents, some of them come from other provinces for training, so I want you to remember that 80 of the 120 are still in Manitoba, or 70 percent still in Manitoba. Of those 80 family doctors, 34 while I speak are presently practising in rural Manitoba and 46 are in what we would term urban Manitoba, which includes Portage and Brandon. So I think the minister, wherever he is getting his information from is entirely incorrect.
There are a lot of good reasons why doctors should choose to come to rural Manitoba to practice. One of them is the opportunity that these doctors will have to teach other doctors their skills. That is the advantage of the Parkland training program. That is one reason doctors would choose to come out to rural Manitoba. So on the one hand, this government has a lot of flowery speeches and a lot of self-congratulations, but when you come right down to the hard cold facts, this government is failing rural and northern Manitobans in the area of medicine and rural and northern doctors. Thank you very much, Madam Speaker.
Mr. Edward Helwer (Gimli): Madam Speaker, I appreciate the opportunity to be able to put a few comments on the record regarding the resolution by my friend the member for Turtle Mountain (Mr. Tweed). I think it is an excellent resolution because it certainly talks about--
An Honourable Member: The vital spots.
Mr. Helwer: That is right. It talks about things that are important to us as members of the government.
But the member for Swan River (Ms. Wowchuk) made a few comments about my medical staff at Stonewall, and I want to inform her that she does not know what she is talking about because I met first hand with our medical staff at Stonewall. We have an excellent medical staff. Certainly, they did have a legitimate concern. It was sorted out and settled. [interjection]
Well, that is great, but I think that is part of the discussion. We can work with people. I think our Department of Health can work with the medical staff and make sure everything works.
Madam Speaker, I want to give you an example of how when the former government was in power, I was chairman of a hospital board, and I can assure you, that was when the confusion--it was just a disaster how the former government was operating the Department of Health. I can tell you first-hand, I was the hospital chairman and saw first-hand how the former Minister of Health, Mr. Desjardins, at that time, who--I can give you one example of how the department was so mismanaged and there was such confusion in the whole of the department. He could not get a handle on the finances. One particular time he called us in for a meeting to talk about how he had to cut down the expenses in health care. Let me tell you.
Our government has never cut any costs, any money in health care. We keep putting more money into it to improve the system. I am glad the government changed when it did in 1988 so that we, our first Minister of Health, Mr. Orchard, and Mr. McCrae, and now the Honourable Darren Praznik, could straighten the system out. At least now we are making a system in health that is going to work and serve the people of Manitoba. The medical staff that we have in this province and my colleague from Turtle Mountain that worked on the doctors recruiting of some medical staff for Manitoba has certainly helped a lot of rural Manitobans and a lot of rural Manitoba communities.
Arborg, in the constituency of the member for Interlake (Mr. Clif Evans), that got some medical staff, there is a great community. They need the medical staff. This is what our government is doing, making the system better, improving the system.
Madam Speaker: Order please. When this matter is again before the House, the honourable member for Gimli will have 12 minutes remaining.
The hour being 6 p.m., this House is adjourned and stands adjourned until 1:30 p.m. tomorrow (Wednesday).