When the committee last sat it had been considering a motion moved by the honourable member for Osborne (Ms. McGifford). The text of the motion reads as follows: that this committee recommend that the Legislature support the content of the motion adopted by the Quebec National Assembly and further that the Legislature urge the Minister of Health (Mr. Praznik) to contact the federal government and press for the existing compensation package for victims of tainted blood to be reopened and reviewed with a view to extending compensation.
The honourable member for St. Norbert (Mr. Laurendeau) had been speaking to the motion and had 28 minutes remaining.
An Honourable Member: He is not here.
Mr. Chairperson: Well, I would ask the committee to consider this for a minute, and that is simply that he told me that he had to start the committee in the Assembly and then he would be coming directly here.
Mr. Tim Sale (Crescentwood): Mr. Chairperson, we have no problem with allowing him to continue when he arrives at the committee, but I do not see much point in waiting.
I want to again make a very few comments. Partly, I think it is very important that we do put our position again. I think it is clear, but we should put it again clearly on the record in this particular debate.
We started this process in December when we became aware of the Krever inquiry's view of compensation in regard to people who had suffered HIV infection through the blood system and Krever's position after a tremendous amount of testimony over a number of years and careful thought on many people's parts, that basically those who were economically ravaged by HIV infection should be compensated without question as to fault or negligence, that simply it should be accepted that these people had suffered a grievous loss in their lives and that there was a duty of compassionate compensation owed to them, not on legal grounds but on ethical and moral grounds. We raised this issue in December in a motion in the House. Unfortunately, the government did not share our view at that time, and that, of course, is their right.
So we have been clear, I believe, from the outset that our view is that where persons who have received a blood-borne infection have been economically disadvantaged in a significant way, they should receive compassionate compensation. The minister and others have pointed out they do receive health care, and, of course, that is both a truism and an important truism. All Canadians receive health care for illnesses regardless of whether they assisted in causing their own illness or whether they received their illness in an accident not of their own fault or whether it involved their own fault, but the issue is not asked when you arrive at hospital whose fault is this before we provide health care. So, while it is an important point in some ways, it is also a truism. It is true for all Canadians in all health matters with the exception of those that governments have disallowed over the years or have failed to move to insure over the years.
I think the third important point that I want to reiterate is the ethical absurdity, Mr. Chairperson, of a nurse who accidentally injures herself in administering blood or dealing with blood products and becomes infected and is entitled to wage compensation, economic compensation if she suffers economic loss as a matter of entitlement through the workers compensation function. So she accidentally injures herself, or himself, and is entitled to compensation, but the patient whom she deliberately administers a substance to and who then becomes ill as a consequence of deliberately having been administered a blood substance is not compensated. Though their circumstances might be identical, their ages might be identical, their family situations might be identical, the one who accidentally injures herself or himself at work is compensated for economic loss; the one to whom the substance is deliberately administered is not compensated if she or he happens to have received that prior to 1986. I think that is an analogy, an example of the ethical dilemma that we find ourselves in when we make decisions about compensation based on arbitrary dates where there is a significant group of people affected.
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The fourth point I want to make is that I have tried over the last few days to ascertain some sense of the numbers involved here in Manitoba, and perhaps the minister will be able to shed some light on this issue himself in response. I am told that at the present time there is a cumulative total of some 1,500 Manitobans who have tested positive for hepatitis C, that that is an approximate total from 1990 forward from the time that there has been, in other words, a specific antibody test that is specific to hepatitis C. I am told that the vast majority of those--the doctor I spoke to was not able to give me a specific number, but that the vast majority were because of needle exchange or drug injection; in other words, pure negligence on the part of the person involved, because it is obviously well known, the risk involved in injection drug use. I was told that the new infections are running at the rate of about 25 a month, or roughly 300 a year and that they are all basically because of dirty needles injection drug use.
Now, the estimate is that we know about, in other words, roughly 1,500 confirmed cases, and if the number of injection drug users are 25 a month at present--I do not know what they have been over the last five years, but even if they had been 25 a month since 1993, that would account for all 1,500. So I do not know if we have a sense yet of the scale of the problem we face in Manitoba, but I am told by this particular doctor that it is quite modest, certainly in the low hundreds, and perhaps the minister would be able in response to shed some light on that number more accurately. I believe Dr. Minuk probably has the best handle on this in the province, and it would be interesting to have his views on this.
But the last thing I want to just put on the record is my appreciation for many very good interventions that have been made by various members on both sides of the table, who raised various very interesting and useful points. There has also been a great deal of blathering that has been not useful at all, and in this particular case I would like to refer to the remarks of the honourable Minister of Justice and Attorney General (Mr. Toews) who twice in the last few days has put on the record errant nonsense about the Workers' Compensation Board of Ontario and the record of the Ontario NDP government of Premier Rae.
I am not a particular defender or opponent of that government, but it struck me that his comments were so extreme and exaggerated that it might be interesting to go and actually get the annual reports of the Workers' Compensation Board of Ontario and just find out whether the Attorney General had any substance to his remarks or not. Sadly, I find that his remarks are so wildly exaggerated and so at variance with the fact that it would be appropriate, I think, to challenge whether or not he was deliberately misleading the committee because the facts are a matter of record; they are not a matter of dispute in that they are in print in the form of the annual statements of the Workers' Compensation Board of Ontario.
Now, I am a relatively new member of this Legislature, Mr. Chairperson--three years is not a long time--and I still have the naive notion that there are at least a couple of ministries where one has a high expectation of circumspect approach to the truth, that particularly the Minister of Justice, the Attorney General (Mr. Toews) has a duty to not shade the truth, to not exaggerate wildly, to not put on the record obvious misstatements, and yet this minister not only did it once--he might be excused for having a faulty memory at that particular time--but he went on and did it twice. So I want to simply for the record table a 10-year history of the Workers' Compensation Board, and I just want to make a couple of comments about it. I will table three copies.
The Workers' Compensation Board in Ontario, indeed, has a serious problem of its unfunded liability. When the NDP government took office in late 1990, the Workers' Compensation Board ended that year--presumably these are March 1990 figures, so prior to the end of the Peterson government they had a $9-billion liability, unfunded, and three months after the Rae government had taken office, or four months after, the liability was reported as $10.347 billion, a very serious liability. I agree that it is serious.
I think it would be reasonable to think that in the first three or four months of office a new government would likely have a great deal of difficulty turning around that scale of a liability or slowing down its growth because indeed it had grown from $6.2 billion in 1986 to $10.3 billion in 1991.
Now, the Attorney General (Mr. Toews) made some absolutely wild statements about this. He talked about them running up bills at $100 million a month. He talked about, and I am quoting now from Hansard: "At the end of their tenure, the board was somewhere and still is $12 billion to $15 billion in debt."
The truth is, at the end of the Rae government's time in office at the end of 1995, they had an unfunded liability of $10,892 million. They came in with an unfunded liability of $10,347 million. They managed to slow its growth, reverse its growth and bring it back down almost a billion dollars from its peak and put it on a road that would be, in the long term, sustainable.
So it is a very interesting comment, that in the process of a debate on compensation of people who have been affected by hepatitis C, the senior law official of the province goes off on a wild exaggeration bearing no relevance to the issue at hand, but simply a narrow partisan attack on a government that has ceased to be government in Ontario, for no reason other than a shallow attempt to somehow link stewardship of a government in another province with the ethical position of the opposition in this province, that all people who have been affected by economic loss as a result of exposure to hepatitis C should have compensation as a matter of ethical right and not as a matter of having to proved legal negligence or legal liability on the part of the government.
So I hope that the honourable Justice minister's colleagues, who are here, will communicate with him about the concern that he ought not to put false and misleading information on the record, and that to do so twice in the same debate either displays a very shallow understanding of his role as Attorney General, or it displays the kind of bitter and nasty partisan approach which he often takes in response to questions. I think it demeans his office when he does that. It demeans it in particular when he puts such false information on the record.
So I think that we have had some highlights and some low lights in this debate. Unfortunately, that minister's contribution was mainly the latter. I hope that, as we continue to discuss this, it will focus on the issue and not bring in such specious and misleading arguments as were put forward by that minister.
Mr. Chairperson: The honourable member for St. Norbert--
Mr. Marcel Laurendeau (St. Norbert): Thank you, Mr. Chairman.
Mr. Chairperson: --to complete his--
Mr. Laurendeau: I can start over again.
Mr. Chairperson: Well, okay.
Mr. Laurendeau: It is a new day. I do not believe I will use up 30 minutes, but thank you to the committee for waiting for me. I had to start the other committee before coming over.
Mr. Chairman, as I said yesterday, I find this a very heartfelt debate in a lot of cases. I hear us going around, but in all, I think this is going to be known in the future as the shame game, because that seems to be where we are going from, not only in Manitoba but throughout the country. We have the NDP in Saskatchewan that moved a motion and it was defeated. They ended up passing something expressing sympathy. We have the Ontario government that came out and started threatening to sue the federal government. We then had them yesterday bringing forward a resolution of their own. We have the NDP in Manitoba bringing forward this resolution supporting the Quebec resolution.
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Mr. Chairman, to see what everyone is up to really bothers me. It says to me that this federal system is not working. I thought that is what we were attempting to do was to try and bring a federal system back into operating condition. I thought that our premiers and the Prime Minister and our Health ministers had come to an agreement where they could sit around a table and negotiate how our social services across this country would be serviced and handled, so we did not have a two-tiered system throughout the country.
I think we have a system that we should be proud of. I think we have a system that other countries will look upon and say it works and they want to come here. It is bringing everybody to the table to do that negotiating. I do not think the negotiations should happen within this committee or within this Legislature in a sense. I think it is at the table when those people who are involved are there.
But what I do find that will work from having this debate at this committee, Mr. Chairman, is that our Health minister and those involved in the debates will know where each of us stands when they get there. They will know where we put our positions or our strength behind their negotiating. I would not want to put any handcuffs on my minister because I understand when you are negotiating, as I am sure the NDP would understand when they are negotiating--they have been there through a number of union contracts--you do not like to table too much of your position because you do not want to lose too much of it. So you take your position when you go to the table and you come out with the best results.
We have taken a position, Mr. Chairman, and that position will be brought forward at that committee, and when that position is brought forward to that committee at the federal level with the other ministers present, I would like the minister to understand that I have some concerns that I would like to have brought up when it is being brought forward to discuss.
My position is quite clear. I do understand that we have to have on compassionate grounds as Justice Krever had put it within his report--I think it was on page 1045 of his report: Compensating some of the needy sufferers and not others cannot, in my opinion, be justified.
Now, Mr. Justice Krever put that very clearly in his report, and he went through all the dates of when hepatitis C was first basically discovered. You can date it back all the way down to 1974 when they were not sure what it was and they were saying it was non-A, non-B and all the other medical terms that were involved in it, but it was not until 1989 I believe--I could be wrong on the years, but it was 1989 that they finally came up with something that some said worked but it was not, according to others, good enough to do all the tests.
But in 1991 they finally came up with the test that was approved to do a lot of the testing and proved successful. I could be wrong on those dates, but I believe it was '89 to '91. If I am wrong, I am sure the member can correct me. [interjection] '86 to '90, but in 1989 was the first test, and 1991 was the next test that was developed. There was no test between 1986 and 1989. It was in the late part of 1989 that the first test was developed, but that is here for argument. I will find you the stats on it when I go through my papers later. I do not have it here because I handed it out on the way in.
But, when I look at this and I say where is the culpability, and I can understand the lawyers coming around the table and saying, well, culpability then ends up between '86 and '90, and I can agree with that compensation level that they are dealing with at that level, but I still want to see some type of a solution for those who fall outside of that. Would I want the agreement opened up that we have now? No. I would not want that agreement reopened.
Mr. Chairman, the reason I would not want that is I do not trust our federal government. It is shameful to say it, but they are playing the shame game. When I hear our Minister of Health federally, Mr. Rock, saying that our ministers across the country are hypocrites, I am sorry, he has lost any faith I ever had in that minister. This man has overstepped and does not belong in the ministry anymore. He has taken this and turned it into a shame game. He has taken this and is trying to relate it back on the provinces' shoulders, and that is wrong. It is wrong because culpability lay directly with basically the Red Cross and, after them, the federal government. We as provinces have accepted part of that culpability within the negotiations. But we as provinces, if we start taking our own shares of culpability, will have a two-tiered system of how we are dealing with this in the end, and that is what would not be fair not only to us as a province but to the victims of hepatitis C.
That is why it is important that our ministers and the federal government understand that we have to have a system that the federal government is truly responsible for not only in the short term but in the long term, because we will not know, Mr. Chairman, in the short term, how many victims there truly are. It might be 25 or 30 years from now before we have the full extent of how many people have been damaged throughout the system. So can we come up with a true dollar amount today? I do not believe we can. Can we come up with a system that might be able to establish dollars? That I will leave up to the ministers to come up with those dollars and how the dollars would be allocated.
But I think we have to be very careful when we are allocating that money, because if the dollars are being allocated in such a sense that five years from now there is a cure, some of these victims may not ever need the money. Some of these victims might live longer than you and I, and then we would end up with the area of have we compensated somebody for something that was not really necessary. So we have to be very careful how this plan is put in place.
I understand at this time we have a memorandum of understanding, and we have to iron out the fine detail in the end. But I would like to see that we took into account what if the cures come into place, and then when we start talking about cures, how many dollars that we put into the system could have brought forward the cure a little earlier. I mean, the research and development aspect is a very important part of our health system in Canada. We have developed some of the cures to some of the diseases that were worldwide right here in Canada. Diabetes, the cure was developed here in Canada.
So, if we can develop some of the cures for some of these diseases--and it is not only hepatitis C; there are other diseases as well--we can actually start saving the health care system money in the future. But to be compensating someone for something that might be in the future and never happens would not be right. So it cannot be open-ended. Is that being uncompassionate? I do not believe so. I believe you are being compassionate as long as you are saying you will compensate someone who is in need at the time and if there is a damage and they are not able to work or they are incapacitated in some way by the disease. But I think we have to be very careful how we approach that.
So--if you do not mind, I am going to go through some of my notes. So how do we bring the federal government back onside here? I really have concerns. If all of a sudden they put more money in, does this mean next year we are going to lose more on the other side? Is the federal government just going to say: well, that is fine, we will come to the table today; we are going to put another $1.2 billion. But they are going to come back next year, and they are just going to pull it out of our budgets again. That is what they have been doing to balance their books. I am afraid that is what they will do in the future if we do not make sure we have something that has been negotiated in such a fashion that even their bean counters and their legal beagles down in Ottawa cannot find themselves a way around it. They have to be married to this thing without any possibility of a divorce. Too easily nowadays, we are having these annulments, and these annulments are happening throughout government because they marry themselves to a program, but three years later they are passing the buck and passing it down. That has to stop. If we are going to have a social network within this country that is going to help unite us instead of tearing us apart, then we have to work together.
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I have full faith in my Minister of Health (Mr. Praznik) to go to Ottawa and negotiate on my behalf. Will he come back with everything that I would like to see in a proposal? Probably not. Will he come back with everything that would make the Premier of Ontario happy? Probably not. But will he come back with what is probably the best possible deal for Canadians? I believe so, because our Minister of Health cares, our Minister of Health cares that we have a system that works, not only for today but for tomorrow. He has got a bigger responsibility than just today. He has got to see that he helps build a system that is there for my children and my children's children, because if we do not have that system in place, the whole health system across this country will not be worth anything in a few years.
If that health system goes down, I am afraid we are going to lose part of our country, because our country is relying on this. This is turning into a unity debate. This is exactly what Quebec wants. You take your separatists in Quebec, this is exactly what they want. They want us fighting across the country on an issue. They want us saying we cannot come to a resolution to satisfy the needs of Canadians because they do not want there to be a Canada. Well, I say we as Canadians can put it together, and we as Canadians, who believe strongly in a system that has worked, can put it together. When our ministers meet in Ottawa or Halifax or Edmonton or Saskatoon, I know that they can come together and do what is right for Canadians. Will it satisfy everybody's needs? No. But let us just hope it can satisfy the needs of Canada, because that is where we are headed: down a very slippery slope. If we continue to play this shame game with the federal government, that is where we will be.
In three years we can find out if that federal government still wants to continue to play when they are getting closer to their election time, because that is not the way we resolve issues by trying to shame someone else, and that is what they are attempting to do right now. I do not want to play that game. I respect the honourable members for bringing their views forward. I do not agree with the position they have taken because of wanting to reopen the negotiations. I also do not accept it because they are basically saying they want us to adopt the Quebec resolution which I disagree with because it is saying that the federal government is on the hook for the whole nine yards and that is all there is to it. Well, that is not true. We are picking up a good chunk of the health care system already, and we have already agreed to put some money on the table. For us to walk away from that would not be right. Our minister has made his commitment that we would have that on the table, and I believe it should be there if that is the commitment he has made. So I cannot support your resolution. I support the issue that you bring forward, but if it were up to me, I would probably request that you take this off the table so we no longer had to debate that resolution. It is not going anywhere. I would vote against it when it comes to a vote.
But let us work towards one thing. As the opposition your job is to critique what we do, and I accept that, and criticize if you want when we are doing wrong, but in this job, my minister has done what was right. He made a deal and he abided by it. If he had not abided by it and he had been one of the weak-kneed that came out first, crying the blues that he did not have a good deal, I would have lost faith in my minister. But he did not; he stood strong because he had made a deal. There is nothing wrong with standing by your commitments once you have made a deal, but there is nothing wrong with coming back and saying we can always start another deal, but let us get back to the table and negotiate the other deal. But the other partners have to be willing.
When you have a Minister of Health like Rock out there who could not defend his way out of a wet paper bag unless he had the help of all the rest of his little--Finance Minister Martin behind him toting him along. I mean, give me a break. These guys have gone down to nothing. The shame game will not work, but that is all they know. Sheila Copps and the rest of her boys--they have lost Nunziata. I mean, Nunziata was smart enough to go to the other side of the floor because he saw where they were headed.
So I only hope that my minister can go to Ottawa and meet with these ministers, because I know if I had to I would have a hard time keeping it down when I met with Mr. Rock. So you will have my support when you go and meet, Mr. Minister, and I hope you can do what is best for Canada and what is best for Manitobans and keep in mind that a victim is a victim is a victim. Thank you, Mr. Chairman.
Ms. Diane McGifford (Osborne): We thank the member for St. Norbert (Mr. Laurendeau) for his comments. Very interesting. We heard his suggestion that the motion be withdrawn from the table, and I put back to him that we are ready to vote on the motion, and we are just hearing his members out. I am sure that they will soon be ready to vote on the motion as well. I wondered if I could, though, just ask the minister something that is on my mind. We have been talking about the issues related to hepatitis C and various responsibilities and who is responsible for what, and I wondered if the minister could tell me how long the Canadian Blood Agency has been a participant in the Canadian blood system.
Hon. Darren Praznik (Minister of Health): Mr. Chair, I am advised by Mr. Wendt that it was 1991, approximately. He is going to confirm that date in which the Canadian Blood Agency was initially established by the provinces and territories, and it replaced the Canadian blood committee which was really the body, an informal body--I understand it was not a legal entity--that acted as the co-ordinator of the provinces and territories in the purchase or funding of the Red Cross. When all of the issues began to emerge over the way in which the Red Cross was managing the blood system, the Canadian provinces and territories--my understanding from Mr. Wendt--created this agency as a more formal way of managing the provinces' response and issues as opposed to the informal blood committee.
Again, I was not around at that particular time. I am only repeating to the member what, in fact, information is provided to me by Mr. Wendt who--that information, as I indicate, is coming from Mr. Wendt who has been our province's point person on these particular issues.
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Ms. McGifford: Mr. Chair, the reason I bring up that question is that I have a document that says the three principal participants in the Canadian blood system are the federal government, through the Health Protection Branch of Health Canada, the Canadian Blood Agency, and the Canadian Red Cross. Then I understand the ministers to say this would have been approximately 1991 and that these three principals were not participants in the Canadian blood system prior to 1986. At least let me rephrase my question--that the Canadian Blood Agency was not a participant in the Canadian blood system prior to 1986. Is that the case?
Mr. Praznik: Mr. Chair, I understand that, from the information provided to me, that was the case, that the agency in fact was not created until the early 1990s. We will get an exact date for the member.
Ms. McGifford: Mr. Chair, I would very much like to have the specific information. It would be important, so I look forward to receiving that information.
Hon. Frank Pitura (Minister of Government Services): I have been watching and listening to this debate from the time that it began, listening to or seeing when the Krever report was brought down and the recommendations made in that report, and then following that with the federal-provincial negotiations that took place with regard to compensation for hepatitis C victims, and eventually arriving at a package that saw the victims being compensated between the years of 1986 and 1990. To me, at that time, it seemed like this was the resolve of the issue.
However, the various groups came forward and started to ask the question about the hepatitis C victims prior to 1986. I guess it was at that particular moment that I felt a great deal of sympathy for all victims of hepatitis C, because inadvertently they received the disease through no fault of their own.
The motions that were put forward by the opposition, when you read them of course I could see that there was a lot of validity in them. At the same time I had to keep asking myself the questions as to whether this was the right direction that we, as Canadians, should be proceeding. Throughout the framework of this country, the federal and provincial governments have always been in a sharing process, and I think that I can probably expound upon that when we get into areas of disaster financial assistance, because I think within that example, I could probably show you just what happens when there is not the continuity and agreement across the country.
But getting back to the issue at hand, which is the issue concerning hepatitis C, there are many, many different views from people about whether or not the compensation should be beyond 1986. Interestingly enough, on CBC Radio talkback, a person had called in and had indicated that his wife had contracted hepatitis C in 1980, at which point she became ill over the years. The reason she got this hepatitis C was through a gamma globulin shot, I believe it is called, prior to going on an assignment to India. So it was through no fault of her own that she received hepatitis C, and she was quite ill over the years. Her husband shared with the radio program that, I believe it was 1993 she received a liver transplant, and since that time has been doing quite well and is almost fully recovered. However, he pointed out that they are themselves affected by this. He said that if the compensation were to be extended beyond 1986, which would include his wife in that case, that he did not feel right about it because it would establish a very difficult precedent across the country with regard to that compensation.
Another question I always have to keep asking myself is how far back would we go with compensation? Blood transfusions have been occurring for decades.
An Honourable Member: Since the Spanish Civil War.
Mr. Pitura: The Spanish Civil War?
An Honourable Member: That is when it started.
Mr. Pitura: So would we be looking at then some sort of compensation for families who had traces of hepatitis C from that time where they felt that the individual died of a diseased liver that some compensation should be there for that family? So it is always a question as you start going back: Where do you draw that line and say is it now from 1950 to 1986 or is it from 1940 to 1986, or do you keep going back to when the time transfusions were first begun?
Mr. Mervin Tweed, Acting Chairperson, in the Chair
The other aspect, too, I believe my colleague for St. Norbert said that the test for hep C was perfected in the late '80s, that you have to ask the question: What if there was never a test developed, and at this point in time would we be talking about this issue? It is because the test was developed that it actually revealed the fact that we could ensure a clean blood supply. At odds here I think is the fact that since 1986 when the test I guess was first used in the United States that the Canadian government, which was I think as our Health minister pointed out, the regulator for the blood supply in Canada, chose not to adopt that test. Therefore, it clearly establishes the fact that since 1986 that there was liability for the federal government and the Canadian Red Cross with regard to the supply of blood because they in effect could be deemed to be mismanaging the blood supply because there were protections in place.
I think as our Health minister pointed out, and it is a very important part of the issue, is the fact that the provinces were indeed customers of the system, so as a customer we should have been given a blood supply that was something that we could count on. As it turned out, because of the Canadian Red Cross mismanagement of the supply and the Canadian government's lack of regulatory powers being exercised in the supply, we as provinces received some blood that eventually infected people with hepatitis C.
So, when we take a look at this whole area and say: well, why are the provinces even at all involved in the compensation? We are a consumer. We should actually be in front of the court filing a statement of claim against the Canadian Red Cross and the federal government as well as a buyer of blood. However, as the way the Canadian system works, that is, the federal-provincial partnership, we have got to the point in this process where both levels of government proceeded to come together and establish I believe it is a $1.3-billion compensation package for those victims of hepatitis C between the years of 1986 and 1990. That is a lot of money.
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But you have to go back, or at least what I would like to do right now is, the deal that was stuck between the federal and provincial government Health ministers I think was an honourable arrangement between the 10 provinces and the two territories and the federal government. However, we have other federal-provincial sharing arrangements in terms of sharing costs.
I would like to spend a little bit of time discussing what I just recently went through as the minister responsible for the Emergency Management Organization and the Disaster Financial Assistance program. I would have to say at the outset that I say it is very fortunate that we, as Canadians, have a Disaster Financial Assistance Policy in place that responds very quickly to the needs of victims of a disaster. For that I am very thankful because, when I take a look at some of our neighbours to the south and indeed some other areas of the world that were affected by disasters, their individual governments could not respond as quickly as the Canadian and provincial governments here to a disaster.
However, since 1974 we have had the Emergency Measures Act in place. That act was redrafted to replace I believe it was the act that was used through the October Crisis in Quebec.
Mr. Praznik: The War Measures Act.
Mr. Pitura: The War Measures Act, thank you, Mr. Health Minister. It replaced the War Measures Act and, in fact, became the Emergency Measures Act across the country. But, as to disasters in the early '70s and throughout the '80s, there were not that many of them across the country, the policy that was in place was basically left there unattended, never updated.
Mr. Chairperson in the Chair
Essentially the basic bottom line or the basic objective of the act stated that the federal government would enter into a cost-sharing arrangement with the provinces when indeed a province that had a disaster was going to endure undue hardship. So it was a pretty broad definition that was put into place for this program to be activated. However, because of the fact that there was no such thing as a regular disaster, which I am glad we do not have, the programs were not tied together nationally. As each province addressed a disaster, they would make their own arrangements with the federal government and that would be the program that they would offer to victims of that disaster, whether it be a tornado, whether it be a flood, or whether it be from forest fires or what have you.
When we got into the '90s, the frequency of disasters increased to the point that almost annually, sometimes twice annually, we had a disaster occurring in this country somewhere. So what happened at that point was that the then arrangements that were made between that respective province and the federal government were fresh in the minds of those people within that province. As well, they were able to be accessed by other provinces. So as other disasters occurred, what we tended to do was to rely on the previous province's negotiations with the federal government to use that as a base for entering into a new arrangement with the federal government when the disaster struck our province.
Even in the flood of 1997, and I believe my colleague from St. Norbert brought this up, was the fact that he did not trust the federal government. In a way, that is very true, and you sort of get gun-shy of anything that the federal government says that they will do and promise. Essentially, when the federal government was asked about participation in the various programs within Manitoba, the federal government's response was that the province can do anything it wants, and that is true.
But what it did not say in that statement was that the federal government will be there with the province when it does anything it wants and therein lies the problem that existed with the arrangements with the federal government and also ate up some of the time involved in trying to get some sort of a negotiated agreement in place. You just could not go on a verbal commitment and a handshake as being part of the process that said, yes, we are going to be there. Often the statement was made that, yes, Manitoba can do anything it wants, but when push came to shove, the federal government probably would not be there to cost-share. So we had to make sure that the federal government would be in a position to cost-share.
However, having the frequency of disasters that we had across the country, it allowed us as provinces to have more open communication with each other, and, in fact, very shortly we have had our--this will be our second or third delegation coming in from Quebec. We have had visits from Alberta, visits from Ontario, visits from eastern Canada, and, likewise, we have attempted to visit other provinces so that we are now establishing a uniform approach provincially to disaster financial assistance.
We are at the present time now asking the federal government to come forth and act as a leader and bring all the provinces to the table so that we could have a uniform and fair and equitable Disaster Financial Assistance Policy across the country. Now you say: well, why is the member talking about the Disaster Financial Assistance program in this light? I think that one of the areas with the hepatitis C issue was the fact that all the provinces and the federal government, I think, had demonstrated in the early part of the discussion that they could all get together and arrive at a suitable agreement if there was a willingness to do that. We are asking the federal government now to have that willingness to also treat the Disaster Financial Assistance program in this same light.
The other area that I would like to just mention as well within the Disaster Financial Assistance framework is that it is a policy that is put into place and it is not a broad enough policy to cover all of the issues that are faced within the disaster. Say it to the federal government: well, why do we not broaden the policy to make sure that--entering into these memorandums of agreement for all these side programs is a time-consuming exercise and a frustrating exercise to have to do this on each and every occasion.
There has been a reluctance for the federal government to accept the fact that a Disaster Financial Assistance Policy should be that broad. We hope, and we are pushing as provinces, to bring the federal government to the table to have this frank discussion about looking at a broader policy that will apply in all situations with very little left to be falling through the cracks.
So that is the direction we are hoping to head, but it has taken from 1974 until now for all of us as provinces to get together to be able to chase this issue. I think that on the hepatitis C issue you are looking at the agreement there being right up front. I tend to agree when I look at it and I take a step back and say: well, yes, there is definitely liability between 1986 and 1990 when the blood supply could have been checked and was not. So, therefore, yes, the federal government should pay. I am not sure that the provinces should be involved at all. However, I think that the initial response was that, yes, the provinces will take a minor partnership role in the compensation package.
Since that adoption, though, the whole system has started to unravel, and what we are doing and what we are seeing happening is exactly the same thing that we are attempting to solve in the disaster financial assistance area. We are going back to that type of a situation where indeed each individual province will have its own agreement with the federal government, and there will be good packages in some provinces and not so good packages in other provinces, and that would be an unfair system because I, myself, think if we are going to compensate victims outside of the '86 to '90 period, that whatever is done is done nationally, and it is done uniformly, and it is done equitably, and it would respond to an individual's needs.
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That is one of the things, of course, that is really, in terms of the discussion that has taken place thus far, is that, yes, there seems to be that willingness on the federal government's side now to reopen the discussion with regard to the compensation package. The question is what kind of shape will this package take prior to 1986, and I would have to say, Mr. Chairman, that right now I would not like to see the initial package agreement opened anew to try to see what kind of a package can be struck prior to 1986.
I think if that is done, it has to be done on its own basis, its own merit, because as I like to point out, once we have established and committed to liability back for as many years as it is decided upon, then on any issue that comes up that suggests that there may be liability, the precedent has been set as to what that federal and provincial government liability should be for anything else that might happen in the health care system.
Mr. Chairman, in a sense, the way that it is happening now is kind of scary to me because I think that we could end up with a helter-skelter type of compensation package. I am happy to hear that Mr. Rock is planning on bringing the health ministers back together to have a discussion because I think that is where it has to be. I do not think that Manitoba can go into that process with a very definitive agenda as to what they would like to see happen or come out of the process.
You can have an idea of what you would like to see occur as a result, and, of course, there are many arguments to suggest that the federal government should be paying 100 percent of the shot. That would probably be a good jumping-off point in the negotiation process. However, it is also the reality of the fact that there could be a joint partnership, and then what would be the responsibilities of the province? Is it going to be the same percentage as it was in the original agreement? Is it going to be a higher percentage? Is it going to be the same?
Mike Harris has suggested he is willing to go into the agreement on the basis of the previous agreement. I would dare say that the federal government will probably come back and say, well, yes, we are willing to go into the agreement, but, I am sorry, the percentage has changed. Besides, the provinces took the first step to open it up, and Mr. Rock will probably challenge all the provinces to come up with more money. So that is going to be the issue in and around the table, is how to make this agreement.
Now, the other area, too, is if you are going to compensate the victims prior to 1986, how do you compensate them, to the same level as the victims between '86 and 1990, or do you compensate victims on the basis of their need? If so, how do you begin the identification of that need? I can see a tremendous amount of paperwork occurring as a result of that kind of a process. I think, as my colleague from St. Norbert said as well, are there many, many hepatitis C victims out there that as yet have not shown any symptoms, and that they do not even know they have it? When they find out they do have it, will at that point and time the window of the program be closed? If it is, then we are going to have perhaps thousands more people saying: it is unfair; you cannot do that. I did not know I had hepatitis C in 1997, and now you are telling me that the window is closed.
You are going to open up the whole issue again and say: well, now, does this compensation package even expand to that group that did not know they had hepatitis C during that time? So this whole area of compensation at the best is a smudgy gray because I do not think there is an answer to this issue that is right.
The best that one could come up with in this issue is probably something close to what one would feel that they would be comfortable with at the time of putting it together because somewhere along the way--and I think the member for Inkster (Mr. Lamoureux) mentioned it the other day; he made the point about January 1, 1986, versus December 31, 1985. Well, unfortunately, with all programs there has to be a beginning and a start, or a line drawn, a geographical line.
Now, with my being in agriculture, I know that on one side of the road a farmer is covered for 35 bushels of wheat to the acre under crop insurance; on the other side of the road, the farmer is covered for 28. Now the farmer on the other side of the road cannot believe why his field is not as good as the farmer across the road. But, sorry, there is a line drawn, and the line had to be drawn somewhere, and, unfortunately, it was drawn right down the middle of that road where--yes. So programs like this do have--
An Honourable Member: The ag rep always got blamed.
Mr. Pitura: The ag rep always got blamed, right, but I always passed it on to the Minister of Agriculture at that time. [interjection] Well, sure.
So in a compensation program, Mr. Chairman, for hepatitis C, you run into the difficulties that, if compensation is agreed upon for those victims prior to 1986, how is that compensation program package to be drawn up? That is going to take the wisdom of Solomon, I think, to be able to put that type of a package into place because there are so many unknowns, unforeseens, within that area. It was very definitive between '86 and '90. Prior to that, it will be very difficult, I think, to put that kind of a compensation package into place.
I think just to end my remarks--and I appreciate having the opportunity to take part in this debate; this is my first time. The basic fear that I have personally about this in the way this whole issue is moving--my biggest fear is that I am at an age where I kind of want the health care system there for me when I need it. I am closing in on it fast. Essentially what could happen, and I hope I am wrong, with this whole issue is that the future of medicare, I think, is at stake here. So it is not just a case, I do not think, of trying to decide whether hepatitis C victims should be compensated or not compensated, but I think the deep, underlying question to this is the future of medicare. Are we, indeed, weakening that ability to maintain medicare in the future as a result of this or are we going to be able to maintain it?
I think that, as a growing population of seniors increases, that is going to be a very important concern for them because they have what they consider a good health care system now. They would not like to see that jeopardized through one action of federal and provincial governments to virtually blow medicare out of the water. I for one would not like to see that happen. That is a fear that I have, that I think will be the bottom line in the future.
So, with those few remarks, Mr. Chairman, thank you very much.
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Mr. Sale: Just a couple of comments on the minister's remarks. First of all, he quotes or cites a friend, an acquaintance, who is troubled by the idea of compensation prior to '86. I would say to that person, by all means, if you feel that this is something that you do not wish to apply for, do not apply for it. You may not need it. Maybe he has means that provide him with a livelihood--
An Honourable Member: It does not work that way.
Mr. Sale: It does, in fact, work that way. You have to apply for compensation.
First of all, I think people would never be forced to accept compensation they did not wish to apply for. Secondly, the problem that he cites with the design of the program because of the long latency, or not latency, but incubation period, that problem has already been dealt with in the design of the current program. It is really no different for people prior to '86.
I just cite a paragraph from a part of a website from Public Health Canada which we pulled off yesterday. Only 5 to 25 percent of people with newly acquired infection have symptoms which are similar to but often milder than those of hepatitis A or B. Up to 90 percent of infected persons continue to carry the virus indefinitely through their whole life. These people are at risk of clinical sequelae, meaning things that follow after the illness is first established, outcomes such as profound fatigue, 50 percent at 10 years; cirrhosis, 25 percent at 20 years; and liver cancer, 5 percent at 30 years. Liver disease related to HCV infection is the leading reason for liver transplant in Canada.
So there are many situations where people continue to appear for many years to be healthy and they may indeed reach retirement age with adequate resources if they continue to be asymptomatic or relatively asymptomatic. Among a sample of blood donors in Montreal who had HCV infection but were otherwise apparently healthy, 37 percent had chronic hepatitis without fibrosis; 43 percent had chronic hepatitis with fibrosis; 20 percent had cirrhosis. There are a great number of outcomes to this disease. It is not very predictable either as to time or as to what will happen.
I think we have always only been talking about compensating people who are economically impacted by the disease. We are not talking about compensating those who are not impacted in that sense.
The other thing I just wanted to note is that we have now had two government members making essentially what sounds very much like the beginning of a policy. I really welcome that. Both the member for St. Norbert (Mr. Laurendeau) and the minister who just spoke have indicated that they personally are comfortable with the notion of extending compensation via a separate agreement. They do not want to reopen this agreement. They both made the point, which I think we all agree with on all sides of the House, that it needs to be a national program. We cannot have provinces going their own way for all kinds of good reasons.
So perhaps this debate, which seems to be a bit endless at some times, is in fact leading us towards a position that the government will finally be able to adopt. I would just note that generally when a minister of the Crown makes a statement, he is speaking with some authority, not as a backbencher, and the minister of the Crown indicates he is speaking with his heart. Nevertheless, he is a minister and I would think his statements to the committee carry some weight, that he essentially is very close to adopting the view that there should be a new agreement negotiated on equitable terms to extend compensation to those affected before 1986.
I would have no problem endorsing that position personally. I think a new agreement is an appropriate way to go because the existing agreement is there, and that battle should now be laid to rest, but only if there is a commitment to extending compensation pre-'86, with a new, separate, equitable agreement. We are not, as opposition, nor are government members who are not in the Health department probably in a position to say what that would mean in specific terms, but to say that they favour extending compensation in cases prior to 1986, on equitable and fair terms, I think, is the kind of policy direction we wish to have on the record. The last two speakers from the government side have been very close to making that position, and I welcome it. So maybe this long debate is, in fact, producing a direction.
I do have a question for the minister. He may not be able to answer it, but perhaps he can undertake to get an answer. I indicated in my earlier remarks that we had information from a physician that about 1,500 cases existed currently, HCV confirmed, that the vast majority of those, in his estimation, although he could not give me a percentage, were as a result of lifestyle choices, specifically needle-injected drug use. Does the minister have or is the department working on a rough approximation of numbers of this 1,500, how many are assumed to have been nonneedle caused? Could he give us a breakdown of pre-'86 and post-'86?
Mr. Praznik: Mr. Chair, I am going to ask Mr. Wendt to explain exactly where we are in terms of our numbers, and some of the difficulties we have in obtaining the kind of information that members would ask for.
Mr. Ulrich Wendt (Manitoba Representative, Hepatitis C Working Group): Mr. Chairman, this is a difficult area, and I am not an expert entirely either. I understand from Dr. Minuk that one of the difficulties he has is that he is unable to match--[interjection] Sorry, Dr. Minuk is a hematologist in Manitoba, one of the foremost experts on hepatitis C and blood-borne diseases. He is also unable to determine what proportion of his samples are due to the blood supply and what proportion is due to other causes.
I think that an epidemiologic approach, I am told, would be to instead work through hospital records and a blood test record as much as possible to try to get as much precision as possible on the numbers. That is quite difficult. That is why there is such a range of estimates right across Canada, not just in Manitoba. There is quite a range of estimates both from the federal epidemiology department and in every province in Canada.
Mr. Sale: I thank Mr. Wendt for having a run at the question, even though it is not an easy question to answer. Could the department then give us confirmation as to the figure that I have put forward which comes, I believe, from the same source that since 1991 the cumulative running total of confirmed HCV infections by test is in the neighbourhood, within a hundred in other words, of 1,500? That is what the department official to whom I spoke indicated; cumulatively that is what we have got that we know about as of today.
Mr. Praznik: We will check on that information to confirm it. Mr. Wendt advises me he is not able to confirm that with the member today.
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Mr. Sale: I looked through the Department of Health's reports on the expenditures on average on blood-borne diseases from annual reports. The expenditures vary from year to year on average, but they are in the $60,000 to $70,000 per case region. I am wondering whether the minister or his officials could tell us whether the very substantial sums that are being quoted as the cost of HCV infection across the country, first of all, are they the average lifetime costs? In other words, the cost of treating a case to its conclusion, whether it is at the death of the patient or whether it is through a course of treatment that is to recovery or to a stable lifestyle. First of all, is it based on that kind of an estimate?
Mr. Praznik: We as provinces, in assessing the cost on our health care system for the 20,000 or so cases that were in the 1986 to '90 group on which we are basing our assessment and going to the table with the federal government, did detailed work here in Manitoba. British Columbia, I think, was another province that we shared, and Ontario. I am going to ask Mr. Wendt to provide the detailed information that the member is requesting. So our estimates of cost are based on that '86 to '90 group; the $1.6 billion is based on the 20,000 or so assumed cases. So one can work off those numbers, I would imagine, although people prior to '86 might have a different distribution in the advancement of the disease, but I would suspect that there are similar results in costs, although at a different point in time given earlier infection.
Mr. Wendt: Again, these costs are difficult to estimate. They are partially based on B.C. data and partially based on Manitoba data and partially based on Ontario data. What was attempted to be done was to compare the difference between people who are HCV positive, who were recipients of the blood supply, against people who are HCV negative, who were recipients of the blood supply, and compare the health care costs differences between those two groups. That is where the health care cost component of those numbers that you are referring to would have come from, Mr. Chair.
There was also an attempt made to estimate the social service cost and so on. The average cost of health care system therefore would include people who are only mild users of the health care system, people who have very low symptoms or were asymptomatic, as well as people with severe symptoms such as liver disease, end stage liver disease, and cancer.
Mr. Sale: Just a final question. I appreciate the department's willingness to try and get us some clear answers on this. It seems to us that if in Manitoba in total, if the official that I spoke with, the physician with whom I spoke, was accurate in his statement--and I have no reason to doubt that--the total number that we know about that are positive, let alone symptomatic, just the total positives are only 1,500 in the province. He is indicating that the vast majority, he said, and certainly the largest number would have come from injected drug use. So, even if we took a small percentage, 40 percent, let us say, that would be 600 people who are HCV positive, and the causation was blood system or something other than injected drug use.
Then, when we look at the asymptomatic percentage, which, again, we are told, is very high, it seems puzzling to us that the cost for care is estimated to be so large when the numbers involved seem to us to be quite low. Talking to the Hemophilia association, it seems that it is well under 100. The sense that we have here is that we may be talking a great deal about a relatively small number of people in Manitoba at least. If to 1998 we only know about 1,500, this seems to us to be a modest number of people, particularly since that includes, in the official sense, about 300 a year in the last two years that have been coming as a result of injected drug use, and virtually no new cases of blood-borne, because from 1991 on, the blood system was free of HCV infection.
So I am puzzled that we have all of the debate and discussion. Yet we do not seem to have a handle on numbers, and the only number that we can come up with would seem to be overwhelmingly as a result of injected drug use and not as a result of the blood system.
Mr. Wendt: Mr. Chair, that would be true for numbers post-1990. There would be relatively few new blood-borne diseases, because wet heat treatment, which was adopted in 1990, has made the blood supply relatively safe, although there will probably always still be some infections in the blood supply.
Mr. Mervin Tweed, Acting Chairperson, in the Chair
I would have to check and find out where that number of 1,500 came from because I do not think that refers to all of the hepatitis C infections in the province, particularly prior to 1990. I think that probably refers to the particular set of samples that Dr. Minuk might have, but again I am not certain of that. I would have to check on that.
We were trying to base our numbers on the best epidemiologic evidence that was available at the time, and we have no particular reason to change those estimates at this stage. The relatively small number from the Hemophilia Society that has been referred to from time to time would be a number only from people with hemophilia, not from the rest of the population that would have used blood transfusions. So that would be the reference to that number. Anyway, I am sorry I cannot be more definitive at this point, but I am not sure if anybody in the country can be it right now.
Mr. Sale: Just so the staff member and the minister knows, this 1,500 number was stated to me as the cumulative number of the specific tests for HCV. I do not know whether the right term is the sero positive test, but it is the test specific for HCV that came in, I believe, in '91--it was either late '90 or early '91 that it came into common use--and the statement that was made to me was that that was the cumulative number since that test began to be used in Manitoba of positives. Now, I am trying to be as clear as possible so you can check your own sources and find out what this may refer to.
I guess my question would be would someone who was showing the symptoms of HCV infection, whenever it was caused, whether it was 1980 or 1990, would they not have had, at some point in the last few years, that test to absolutely confirm that what they were looking at was HCV infection, because that test was the first one to be very specific for that particular virus. The diagnostic procedures prior to that ruled out lots of other things, but they were not specific to the virus itself, so would not all patients now have been tested using that test to determine whether or not they were HCV infected?
Mr. Wendt: I am not a physician, so I do not know that aspect of the health care system. But it is my understanding that many people would be asymptomatic and would not have had a test. Other people would be symptomatic and would be known. I am not entirely certain how we could get that number until people come forward.
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Mr. Sale: Is that not exactly the point, that we are very anxious about the scale of the cost of this program, and we are using numbers, but it appears that the more we delve into it, we have virtually no numbers, and that we are not able to speak about the scale of this problem with any clear understanding? What we do know since the very specific test was brought in is that cumulatively it is not that big. It is 1,500.
So I really am puzzled that the ministers of the country and the health systems of the country are grappling with an issue that they claim to be, as in the words of the previous speaker, the minister, threatening to bankrupt the Canadian health system, and we do not apparently have any data that we can point to with any sort of certainty or even a vague level of confidence.
It sounds to me like we have been extrapolating from some samples or something and drawing conclusions with extrapolated data and that we do not even know around this table, with all the health resources we have, how many HCV-positive tests we have had in Manitoba. The number of 1,500 has been put forward by us, but it is not able to be confirmed. I mean, where is all our expertise?
Mr. Praznik: Mr. Chair, I am going to ask Mr. Wendt to inquire in our department to actually confirm that. The member has indicated he spoke to one of our officials. He may want to provide us with whom he spoke to. I have no problem with that official speaking to the member, but it would make it easier to confirm the number at this committee.
Secondly, Health and Welfare Canada, Mr. Rock's shop, along with the provinces did a great deal of work in determining the body around the compensation group, around 20,000 or so individuals who would be eligible within the current package, and although one cannot be absolutely firm, that is part of the nature of this disease, that there are people there who are likely yet unfound who are carriers of hepatitis C. So there is a lot of extrapolation, and there is a lot of guesswork involved in numbers, but here is a fundamental problem.
As the country or the media and many parliaments and legislatures in the country drive toward expanding or having an additional program, and as Minister Rock now calls us to a meeting to discuss this, what are we discussing? A fundamental problem here--what are we discussing? It took a great deal of work to be able to determine a group around that 1986 to '90 period. We do know that most of the people in that group who are identified now are involved in legal action. I mean, that gives some firmness to those numbers. Around the other group and how many in this open-ended compensation plan, how many people are we really talking about? No one has presented very firm numbers. I have seen estimates of 20,000 to 60,000 being generated.
But here is a fundamental question. As everybody advises us to compensate, what do we put aside to compensate? A fundamental problem. Do we say: here is a package that is available for ever and a day as individuals come forward and have difficulty with ever knowing what is in that package, or do we book, as ministers, a block of money? I have noticed Mr. Harris has committed $200 million, which may sound like a significant amount of money, but is probably a rather meager sum if, in fact, 60,000 is the right number.
So do we book a pile of money and put it in a fund and slap ourselves on the back and say we have done it and the media hype dies down and then the fund turns out to be grossly inadequate to do anything?
The way this whole debate has progressed, far from principle, about what one is doing, that may be, in fact, what happens. The sad part of it all is that this thing gets driven towards that end, and what I find most troubling as the Minister of Health is that we are now creating three categories of people within our system. We are creating those who are harmed by the system by act of negligence, and I do not think there is a person--in fact, our legal system provides opportunity for redress.
Mr. Chairperson in the Chair
Then we are creating a category of people who suffer harm in our health care system, not from negligence, but from the assumption of the ordinary or the risks inherent in that system, who are able to grab such public attention that they get compensation. Adequate or not, we do not know. If it is inadequate and they cannot get more public attention, they live with it; if they can, they get more.
Thirdly, the individual who suffers harm in the system who is not able to get the public and media attention and support of parties and legislatures and gets no compensation, and that is what Canadians are doing. That is where we are heading, because we have abandoned principle here about why we are compensating and for what. Because I have yet to hear Mr. Harris. I have yet to hear Premier Clark, I have yet to hear Premier Bouchard come out and say: let us put together a no-fault compensation plan for anybody who is injured in our health care system.
I have yet to hear anybody argue--well, I should not say that. The member for Thompson (Mr. Ashton) has implied it in this debate and we have discussed it about enhancements that may be needed in our Canadian social safety net, but we have not heard on the national stage Preston Manning, Alexa McDonough, Elsie Wayne, or any of the senators in the opposition suggesting we should be enhancing our safety net. I have yet to hear them say we need some sort of no-fault insurance scheme for anybody who is injured because of a reaction to anesthetic, reaction to drugs, the risk inherent in medical procedures.
I have heard them pick a category of people who are injured in the system and say we should compensate them. The country may be marching to that conclusion, but all of us as legislators have to at least for a moment pause to reflect upon what in fact is happening here. That is part of the difficulty.
The member for Crescentwood (Mr. Sale), I think, nodded when I made the comment, we do not know, if we have a meeting next week, what we are putting together--$400 million, $1.2 billion, $2 billion? How much do we put in a pot? How much do we? I know that was one of the great problems when we announced the $1.1 billion of government assistance for the negligence group, with another $100 million or so from the Red Cross. Is that going to be enough? There were a lot of people who did the quick addition of 22,000 divided by that number and said this is a paltry sum. It worked out to $50,000 or $60,000 a person. What does this buy? You are right if you do that, but the whole intent of that capital fund was to invest it, put money away, and to provide an income assistance top-up for needs, et cetera, down the way as people who have the disease progress. Will it be enough?
That is an issue that the courts will have to pass judgment on because we wanted that to be a court-approved settlement, and the details there are not yet done. So as we see this roller coaster or juggernaut develop across the country to do something--and I am not going to speculate at this time on the motivations behind it. I am not referring to any member of this committee, but the motivations by many on the national scene that one has to reflect on: is this the right way to make public policy? I do not believe it is, because there are so many things here that are difficult, if not impossible, to put together.
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If that is where the country wants us to go so we can all put a pile of money into a fund and pat ourselves on the back, and this issue is done and five or six years from now find out it was basically meaningless and there is no more media attention to expand it, then my words may be very prophetic here today. But the member asks very good questions, and that is one of the difficulties that we, as ministers of Health, if we meet and get a consistent position out of some of our other provincial colleagues, are going to have to grapple with. What are we putting together? It is not an easy question because, quite frankly, we do not know. If it is $60,000 or it is $20,000, it makes a big difference in the goal, but I get the great sense that those kind of details do not really matter to the national debate that is raging.
An Honourable Member: It matters a great deal.
Mr. Praznik: Well, I get the sense though that they do not really matter to those who are driving this on a national basis. The member for Crescentwood (Mr. Sale) and his colleagues, to their credit and I recognize that today, are asking the kind of detailed information that any, I think, logical individuals trying to deal with this issue would want to have. Yet, I have not seen that at all in any of the national debate that rages on our television screens every night as this juggernaut.
An Honourable Member: Once again Manitoba is a leader.
Mr. Praznik: Well, perhaps we are a leader in this thing, but I think what concerns me the most is the principles that are here. I know it is easy to say a person injured in blood system should get compensation, all treated equally, but that is not the case. Injury is not always the same, or the insurance coverage we carry is not all the same. Two individuals enjoying the same hobby of boating, one takes out insurance, the other does not. They are hurt in a boating accident, one gets coverage, one does not.
I come back to the analogy that the member for Crescentwood (Mr. Sale) drew of the nurse working in a hospital who becomes, in the course of her work, infected with hepatitis C who will have a compensation package through the Workers Compensation Board, and the patient injected with blood in that system will not, unless it was in the negligence period of '86 to '90. Well, we collectively as a society, going back to 1915, thought about a compensation plan for people injured on the job.
We realize that maybe today it is only probably less than 10 percent of workplace injuries would actually result in a successful negligence claim, brought in a no-fault system in 1915 in Manitoba and Ontario and other provinces where we said fault will not be an issue. We will not provide all of the damages of tort, like pain and suffering, but we will provide a basic income replacement and medical costs so that people injured during work will not be left destitute and will require employers to pay for it. We arranged how we would finance it, what were the terms and conditions, what were the qualifications. But here in our health care system, we are not being asked to build a no-fault insurance scheme for people injured in health care for all, we are being asked to provide for compensation outside of negligence for a group of people who were injured in normal risk, for which we had no planning. We prepared no system. We put no dollars away. We had no provision for funding.
I think even worse yet, we have made no provision. I have heard no discussion in the national debate at all about what about individuals who are injured in other ways in the health care system, or what about individuals who will be injured by the next round of blood-borne diseases that we are not able to detect. I have not heard that anywhere in this national debate, and those are very real and haunting questions, because all who participated--and I am really referring to the national debate here. No member opposite should take this personally. It is not meant that way--but in this great debate we see raging now about everybody getting into the act nationally.
I see the Progressive Conservative senators in Ottawa, in their great wisdom and judgment, have joined the debate as well. I must admit their contribution to it does give me some concern about the need for a senate, but perhaps Stanley Knowles' ghost lives on in this Chamber at this moment. But, as we see everyone going in this debate, I do not see the fundamental questions being addressed by these advocates.
In fairness to the member for Crescentwood (Mr. Sale), he has asked some of the telling questions and, yes, we do not have the answers to them today. You are right. That is part of the administrative difficulties one takes on, but also those fundamental questions about where do you go after we all pat ourselves on the back and put a chunk of money away, if that is what happens. What do we say to those other individuals who suffer harm in our system, including our blood system? Inevitably someone will. How do we deal with them? How do we deal with them when the day comes when they are not able to muster the kind of support from the Globe and Mail and the CBC and the national media and groups across the country?
Mr. Steve Ashton (Opposition House Leader): Mr. Chairperson, on a point of order, I am just wondering if we might ask the informal meeting in the spectators' chairs to perhaps be moved to the Conservative caucus room or in the hall. This has been going on, and I did not mind a few discussions. We all have private discussions, but this looks like quorum at the Conservative caucus. I wonder if we could ask the meeting to move outside.
Mr. Chairperson: The honourable member for Thompson does have a point of order.
Mr. Praznik: Hear, hear. They should be here listening to their minister.
Mr. Chairperson: And I would ask all honourable members and guests, I guess we could term it as, if they wish to carry on a conversation, perhaps they do so at a very low tone or move out in the hallway, please.
Mr. Chairperson: The honourable minister, to finish.
Mr. Praznik: So these are the issues that come out from the debate that is now raging for which no answers are being offered, or few answers. They are very valid questions, because this is a major, fundamental move in policy. When all of the public limelight has dispersed and many have patted themselves on the back and taken credit for their great show of compassion, as I am sure will happen throughout the land, there will be many left to deal with those very real issues.
When people talk about bankrupting the medicare system or the health care system, they are not talking about hepatitis C per se, and they are not talking about putting another billion dollars or whatever it will be on the table, and I flag again my concern that whatever the federal government puts on the table in the next few weeks will be coming out of provincial pockets somewhere else. So we will end up footing the whole bill. I flagged that. I flagged that from day one.
But what we are going to do with that principle, that advancement, and what will bankrupt the Canadian health care system is if we continue to move to the principle that every risk that results in some injury or ill to befall a citizen using the health care system will result in a compensation plan. Health care cannot assume that cost. That will bankrupt the health care system, and that is the direction in which we as a country are moving. It scares some of us. It scared Allan Rock, and I am sure it scared the Prime Minister, and it scares me because I see it continue to grow and grow and grow. How it will be reflected is that health care systems across the country will now start to want to be able to provide protection from this kind of growth and expansion in, I would not say liability but in gratuitous payments.
We were just chatting about this now. I think we have to be very clear in the new Canadian blood system. I think every conceivable risk should be flagged, absolutely, with everyone taking blood, so that people have--if there is an argument that has been made in the past that people were not necessarily aware of all the risks, well, I, for one, believe they should be aware of absolutely every risk and accept the responsibility that comes with that risk. Maybe that is a good thing; maybe that is a good advancement that will come out of this.
What does it do if we are adding these gratuitous payments of compensation on to our health care system? What does it do in pricing products like blood and blood products? How do we insure our system against negligence that can happen from time to time? These are going to be very real and difficult issues, and I just hope that the level of support that we see now across the country will be there when some of these difficult issues also come up. That will be the true test, I believe, of compassion.
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Mr. Chairperson: If the member for Osborne has one or two questions, then I will allow that, and then we will go on.
Ms. McGifford: Actually, I have a comment, a brief comment, and then a brief question. I wanted to sympathize with the minister and say that it must be very difficult to pass public policy when information is so scanty and when he feels that decisions are being made in the dark. I am sure that the minister is equally sympathetic with those individuals who feel public policy is being passed which excludes them, and decisions are being made in the dark without complete ideas of numbers and expenditures. It is also very hard for us as an opposition to be supportive when we do not have information. So I think it is something that we all share, this being in the dark on numbers, on costs, where we are going. These are very serious issues, and I sympathize with the minister.
My question was that the guesstimate of the number of those infected between 1986 and '91 is 20,000 cases? Is that accurate?
Mr. Wendt: Mr. Chair, approximately 22,000.
Ms. McGifford: Then the figure that I had understood to be the best guess for the number of Manitobans who would be affected was approximately 800.
Mr. Wendt: Mr. Chair, approximately 840.
Ms. McGifford: I wonder if Mr. Wendt could tell us, of this 840, these are people who have tested positive for hepatitis C. They are not necessarily symptomatic at this time. They are not necessarily suffering from the disease. They would not necessarily be in a position where they would need compensation. Is it true that many of these people are working, making a living, carrying on with life as normal?
Mr. Wendt: That is an estimate of everyone who would have obtained hepatitis C through the blood supply.
Ms. McGifford: So a percentage of those 840 persons would be healthy, would probably not be desirous of compensation at this time.
Mr. Praznik: Mr. Chair, I think the principle that we looked at in setting aside the dollars for the '86 to '90 package, there was a considerable debate on how the package should be divided. I was always of the view that Manitoba's position should be that the package should try to put as much, if not all, the dollars, but as much as possible, into the side of income replacement. In all the discussions I had with hepatitis C victims through the Hemophiliac Society, they recognized that their health care costs were covered through the provincial plan, drug costs through Pharmacare, and that of course is income tested here, so if a person was not able to work, their deductible we were talking about was likely to be relatively small. Home care was covered by the province. That was not the case in every province, so there were some issues about how those would be covered. That is still one of the credit issues we have to deal with between us as provinces.
We should not use our share of this to provide a backdoor for other services in other provinces that do not have home care or support, but that is really an internal accounting matter between us. We believed in Manitoba that the bulk of the money should be put into a pool, a capital pool, that those who are party to that pool should have control and responsibility for it. The money should be invested and produce income and the capital and income over the 30 or some years in which we expect to see the people who are victims in that '86 to '90 group, that there would be a fund on which they could draw for income replacement, perhaps similar to the WCB system, tax free as top-ups to their existing income replacement programs.
We certainly did not want to replace CPP disability pensions or any of the other public insurance schemes that might be there for income replacement for those who are disabled and unable to work, that there should be a top-up. The rules around that of course would have to be negotiated with the group. Mr. Rock and several of the provinces thought it would be best to have some up-front payment to each in that category, the remainder being available for income replacement. There was some thought that some of that money should be used to cover, as I have said, drugs or home care costs in provinces that do not have that. If that is the case, Manitoba will want an accounting between us so that we, in fact, are not subsidizing services in other provinces. That was the logic behind the fund.
We do not have lots of experience here, but we have some idea that over a lifetime you will see an increasing number of people who will not be able to work and require income assistance, so that is up to the actuaries and the people with that kind of data to determine. When that is available, if I do have the power to make it public, because there may be confidentiality with respect to litigation that is part of that, but if I have the ability to make it public, I certainly will. Then I think one can see the work of how that system was put together. But at least we had a group that was fairly well defined around the 22,000 or so.
We also know that some of those people have passed away. To be eligible at least for a lump sum payment out of the lump sum portion of this, we would require a death certificate, we determined, that indicated that the cause of death was hepatitis C related, you know, the normal kinds of things. But at least we had some ability to be able to put some numbers around that. Part of it, I suspect, in hearing Mr. Wendt speak about this on a number of occasions, part of this, I understand, was that the recordkeeping in the blood system has been improving over the years, so the records from '86 to '90 would be more recent and probably better than they would prior to '86, and that is part of the issue here as well.
We have all kinds of guesstimates as to whether it is 5,000, 20,000. I have heard 20,000 to 60,000. So if you provide the exact same packages we are offering at $1.2 billion today--which, by the way, has not yet been accepted by those groups--then if it is 20,000 cases, we are looking at another $1.2 billion. It if it is 40,000, we are looking at $2.4 billion, and if we are looking at 60,000 cases, we could be looking at $3.6 billion. I do not know how all that plays out in terms of numbers and how many have passed away, but that is the kind of work.
But, again, not a lot of work was done by us on that area because we went into the discussions on the basis of dealing with negligence, on the basis of dealing with the area in which there was a potential legal liability, so why would one spend the effort in doing the detailed work? Some work was done to get some handle on it, but you know obviously that was not the reason why everyone was really at the table. We will never have as accurate information for the pre-'86 as we have the '86 to '90.
Ms. McGifford: Mr. Chair, speaking of the Manitoba numbers, then I understand that our best estimate is that there are 840 persons who today have tested or there are 840 persons who are positive, and then I am hearing the minister saying new cases may crop up. Does this 880 include those who may pop up or those who are? The other question I wanted to ask: Is it the minister's understanding that approximately 50 percent of those persons who would test positive will remain asymptomatic throughout their lives?
Mr. Praznik: Mr. Chair, first of all, I believe the 800-and-so cases is our estimate of the number of cases that will be in the pool of the 22,000, based on our percentage of population expectation. So all of those individuals have not yet been identified, but that is the estimate on the pool. So again, you know, I mean if you just do some quick extrapolation, if the total number of cases are 60,000--sort of three times the '86-90 group who would be outside of that--I am sure we would have something similar in Manitoba. That is the kind of numbers that we as ministers have been working with.
Mr. Chairperson: The honourable member for Osborne, with the last question.
Ms. McGifford: Yes, Mr. Chair, I wonder if the minister has an answer to the second part of that question and that is: is it the minister's understanding that approximately 50 percent of those persons who would test positive will lead their entire lives as asymptomatic, that is, not appear to have the disease although they are carrying the disease?
Mr. Praznik: Mr. Chair, Mr. Wendt may want to respond to that detail, but we do recognize there are some people get very sick very quickly, and then over a period of time more and more people suffer the symptoms. Inevitably, there will be some who suffer none, and there are sort of some percentages developing of what one can expect. That is the kind of numbers that the actuaries will be working on in developing the plan for the $1.2-billion fund, because obviously it has to be able to have a life to be able to deal with that full range of those 22,000 people. Some of them have passed away and will only get a lump sum if they are eligible. Others may live a completely normal life and have virtually no cost or maybe only a few things in terms of drugs, et cetera, but there will be that whole range in between. So the fund has to be able to have enough income in capital to be able to carry the income replacement portion for the life of those people until expected retirement age.
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So it is a great deal of work and undertaking to be able to do those calculations and work out those arrangements, and we as ministers could not impose that. It was part of a settlement in litigation which we wanted to have approved by courts, particularly in the three provinces where there were class actions taking place. That is the kind of very detailed work that has to go on and be negotiated by our representatives and by the lawyers representing those victims.
The simple comment to extend the plan, and I think members are starting to appreciate the great difficulty in doing this--
Mr. Sale: With respect, on a point of order, Mr. Chairperson. I know the minister is not trying to be argumentative, but this is ground that has been plowed. The question was: Is it correct that as in the statement made in the page pulled off the web that approximately half of all positives will live most of their life with very little consequences from the disease? I think the member was trying to establish some sense of relative risk, and I appreciate the minister's breadth of concerns, but we have gone over most of that. I think you should ask him to either take the question as notice or to respond to the question.
Mr. Chairperson: It was a dispute over the fact, of course.
Mr. Praznik: Mr. Chair, I am not being argumentative. This discussion has had a rolling nature to it. I know myself from the meetings that I have attended, each time we go through this detail, more and more sinks in as the consequences and the difficulties of which we are talking. So I did not mean to be argumentative, and I do not intend to be.
Mr. Wendt advises me that that concurrent thinking may be right, but nobody really knows. He may want to respond further to it.
Mr. Wendt : Mr. Chair, I really do not have a lot more to add to that. I am not a physician, and I cannot really comment on the sequela of the disease, but my sense is that is about right.
Mrs. Shirley Render (St. Vital): I just want to put a few remarks on the record. Regretfully, I have not been in here for all of the discussion, but I was most interested in the questions from the member for Crescentwood because I thought they were very valid. I came in unfortunately just at the tail end, so I did not get the whole thing.
It seemed to me the drift was, he was concerned that we did not have the numbers. To me that is a very valid concern. The minister mentioned that we at least have a sense of the numbers for 1986 to 1990. It is far easier, I believe, to come to some sort of consensus or agreement when you know the numbers, but we do not seem to be at that point yet.
So I am just going to go back very briefly to the resolution. I guess what disturbs me about the resolution is the word "reopened." I think if I were one of the victims and finally, after all of this time, federal government, the provincial governments and the territorial governments had come to some kind of an understanding and things seemed to be progressing, and then all of a sudden a resolution was passed to reopen things--and to reopen things when it seems to be on such shaky ground--I as a victim would be very upset. There is a saying, it seems to me, Mr. Chairman, that a bird in the hand is worth, what is it, two in the bush, and I really very much believe that if--[interjection]
An Honourable Member: A dozen in the bush.
Mrs. Render: A dozen in the bush, okay. If an agreement, if the start of an agreement, if we have got that far, let us leave that agreement intact. If we are going to be looking at victims before 1986, let us make that a different settlement so that we do not scuttle or slow up anything that is now in process. As I say, this has gone on for quite some time. The inquiry also took a fair bit of time. As I say, if I were one of those people and finally, after all of this time, I saw some sort of conclusion coming, I would be extremely upset if all of a sudden this memorandum of understanding were scuttled and put into a whole fresh set of talks, so I just simply make that comment that if for--this would be my reason. As I say, I am concerned about the wording, that if we have something that is settled and everyone has agreed to it, let us stick with that and let us go back now, if this is what the question is, to look at people who were infected before 1986.
However, the Minister of Health (Mr. Praznik), about 10, 15 minutes ago, also made a couple of very good comments which I will just touch very briefly on and that was, you know, what is it we are discussing; what happens if this just turns into a game of politics; are we going to say, well, let us put $300 million on the table, let us put $800 million on the table. Then pat ourselves on the back and say, well, we have done our good deed for the day; we have settled this question. The whole idea of settling a question in a committee room or on Legislative Assembly floors when we do not even have a grasp of the numbers that we are talking about, we do not have that overall picture in mind, I just think is really playing politics and politics at its worst.
So I think we have to be careful that when we are looking at the people who have been affected before 1986, we do it in a proper fashion. I guess that brings me to the second point. Again it disturbs me that each of us, and I say each of us as provincially, not each of us sitting around this table, are talking about this at a provincial level. To me, this is something that has to be discussed at the national level. I think it was made very clear that the federal government must assume the lion's share of responsibility, so for any of us to be discussing this in our own Legislatures, in isolation from the other provinces, from the other territorial governments and mainly from the federal government, I just do not think is a proper way to go.
The Canadian Red Cross was operating under rules and regulations that were set by the federal government, and the federal government simply has to be at the table. We should not be making suggestions without doing this in concert with the rest of the provinces and with the federal government. I think a very valid concern, and it is certainly one that was raised before, is the fact that if each of us do this on our own, what happens with the provinces who have lots of money? Are they going to put a lot on the table, and they are going to be seen as the best guys? What happens then with people who are, say, from the provinces who cannot put as much money on? Do they pack up and move to the province which seems to be offering the best deal?
Mr. Chairman, again, I just do not think that is the way to make policy, and this is why it is absolutely imperative that when we sit down, we sit down together. Now our Premier (Mr. Filmon), our Minister of Health (Mr. Praznik) are on record a number of times as saying: we are available at the call of the federal government. That is correct, but somebody has to make that call, and that somebody is the federal government. As I said earlier, the Canadian Red Cross is operating, was operating under rules set by the federal government, so the federal government simply has to take the initiative and make that move.
One of the things, too, that I think all of us tend to forget because most of us know of someone who has been affected by this, but I think sometimes we sometimes allow our heart, our compassion to overrule some of our other thoughts that we must bring into this picture. Again, I hate to talk about dollars and I hate to talk about numbers, but it is absolutely vital that we talk about it.
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We have in the health care system many aspects really which are risk-taking. You can go into the hospital and an anaesthetic, you could have an allergic reaction to it. You could be paralyzed. I know somebody who is paralyzed at the throat and it was apparently from an anaesthetic that was given to him.
I am just going to quote from the, I guess it is a news release. I see the words Saskatchewan Health at the top, so maybe this is coming from the Saskatchewan government, but I think there are valid points, Mr. Chairman, and I am quoting here: There are potential risks and benefits associated with virtually every aspect of the health system. Risk must be balanced against the often lifesaving benefits of the various medical procedures that are performed in the health system.
It goes on to say: It would be unrealistic to expect governments to provide financial assistance to individuals for risks associated with the health system, risks for which governments have no control.
The Minister of Health (Mr. Praznik) mentioned just a short while ago that I guess what we may have to start doing is telling patients about every conceivable risk and perhaps patients are going to have to accept this kind of a responsibility. But again, do we--I can think of people, as I say, who have been tragically affected by things that are no one's fault, just something has gone wrong or an allergic reaction that nobody had anticipated.
So the discussion for the patients prior to 1986 who have received this virus, as so many people have now put on the record, is a very complex discussion. When we move into that discussion, I think we have to make sure that we move into it properly so that we are ensuring that we cover all aspects of it.
Something that I had not thought about and which was on a talk show, I believe it was, was the fact of do we compensate on income. Is that going to be the criterion that somebody gets money? Do we compensate on how devastating this illness is to somebody? What happens if that person's whole lifestyle, their whole way of being is just knocked right out? But what happens if that person is very well off? Do they still get compensated? So it is not an easy thing. Do we compensate strictly on the quality of life, the loss of quality of life? Do we compensate strictly on topping up the finances? Do we say there is a cutoff, if you earn $50,000 or more you are not eligible? There are just so many questions that need to be asked. Trying to make a decision in a hurry, particularly if there are some politics being played, I think, would be very, very detrimental to the people who have this disease. I think they deserve to have the whole subject treated in a proper manner. Again, I will just repeat it, it needs to be done in unison. It needs to be done with the call of the federal government. It needs to be done with all the provinces, the people from the provinces and the territories sitting there at the table so that we are not going to institute something that perhaps could be a two-tiered health care system.
Just a couple of things that I want to mention. Again, I am just reading it off a briefing paper. I think it is worth noting that the provinces and the territories, under the understanding that we have right now, will be providing medical, hospital, home care, drug, social assistance and other services that will cost governments an additional $1.6 billion over the next 30 years.
Now, again, picking up on the question from the member for Crescentwood (Mr. Sale) when he was asking the minister: do we have any sense as to the kinds of numbers that we are looking at? The minister has been very clear about the fact that, you know, what happens if we put a number on the table and then we run out before we have done our duty to these people. As I say, Mr. Chairman, having a quick answer for political reasons I just think would be doing a disservice to people who deserve better than just trying to look good in the short term.
There is one other point that I wanted to make, and I guess it is that some people out there have the feeling that these victims, if they do not get any money, are going to be just totally right out of the loop. I do not believe that is correct. I believe that this is more--I think the proper word would be sort of a top-up. They may already have a Canada Pension Plan; they may already have a disability plan; they may have other forms of compensation. So I think it needs to be clear that no one is suggesting that these individuals do not have any kind of a safety net at all. My understanding is that there is an overall safety net, but again--and I know that there are others here who want to speak, so I will sort of conclude my comments.
I think the main thing is to make sure that we have all of the governments at the table and in particular the federal government because this is a national problem. We cannot just say, well, you know, Ontario has most of the victims so let Ontario make their own deal, or Manitoba has X number of victims, let Manitoba do their own deal. This is a national problem, and we have to treat it in the proper manner, which means all governments come to the table including the federal government.
I think that is about all I have to say, Mr. Chairman. I think all of us, as I say, feel--it is just terribly devastating for anybody at whatever time they contracted this, whether it was before 1986 or after 1986. I guess all I am saying is that the motion, as it reads now, to reopen--if I were a victim between 1986 and 1990, I would hate to have an understanding reopened. I would want to get what I have settled, because going back before 1986, I think that could take a fair bit of time to get that settled, and I would not want to prolong the agony of those who think that they have a settlement on the table right now. Thank you.
Mr. Chairperson: Would one of the opposition members wish to speak?
Mr. Peter Dyck (Pembina): Mr. Chairman, I too want to thank you for the opportunity to put a few comments on record regarding hepatitis C. I have not been able to be a part of this discussion throughout the last few days; however, I have had an opportunity to read in Hansard some of the comments that were made. Also, in the course of the debate that has been taking place, I have had opportunity to read in numerous magazines of people or victims who have hepatitis C, who are victims of this and certainly there are many heart-rending stories out there. You know, I am compassionate, I feel for them and I am concerned as to what we can do, what we can do as governments to assist them. The stories out there speak of lives that are disrupted in their family units, children whose parents are affected. Certainly, this is something that I feel badly about, and this is something that has taken place over the years. I guess my response to the resolution, as we have it here, is the same as my honourable colleague for St. Vital (Mrs. Render) has indicated, that to reopen something that already has been put in place is dangerous, I believe reopens the whole discussion again. What does that do for those who now feel that they have come to some sort of resolution? Are they needing to now go and rethink what they are doing? So I have grave concerns about that.
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Certainly there are other concerns that I have; again, as many have mentioned here, regarding the dollar value that is being placed on this, and certainly, you know, how can you put a dollar value on life? You cannot do that. Life is fragile. Life is delicate. You cannot put a value on it.
However, as governments, we look at this very seriously and we say: what in fact does this do? I know that the honourable Minister of Government Services (Mr. Pitura) in his concluding comments talked about the fear that he had regarding our whole health care system, and something that I think very often we take too for granted, but what does this do to the medicare system as we have it? Does this put it at risk if, in fact, we are going to be paying out many, many dollars?
With this, Mr. Chairman, I want to relate a personal experience that I had back in June of 1996. I believe it was June 7. I am going to use this illustration just to try and emphasize some of the concerns that I have in reopening the issue. It was on a Saturday afternoon, and I had the opportunity to help my wife as we were serving at a wedding. It was two o'clock in the afternoon, and I felt a tingle just below my knee. Within an hour, I had excruciating pain, and of course this continued. To make a long story short, by eight o'clock in the evening I was on the operating table.
What actually happened here was that, again, the prognosis by the doctors was that I had in some way contracted necrotizing fasciitis, which is a form of the flesh-eating disease. It went extremely rapidly. It moved extremely quickly. In fact, it moves at a pace of about one inch an hour, and it eats your flesh. This is what happened to me. Again, I had no open wound. There was no indication that this should have taken place. My concern and the reason I am bringing up this illustration is the fact that to date I do have problems with my knee when I do extensive jogging, but am I going to go back now and blame the doctors or those who were involved in the health care system? Will I blame them for something that they did?
They did what they felt needed to be done, and they did it very quickly. The diagnosis was correct. I firmly believe that they did the right thing, but this is going to be something that I will be afflicted with for the rest of my life. I am quite prepared to take that. I am very happy that I am here today. The minister made a comment before: what are the options? What would have been the options for me? The options for me would have been that I guess I could have lost a limb. I was chastised with having the political disease. We know that the member from Quebec, Mr. Bouchard, in fact, did lose a part of his limb due to that. I mean, that was said in jest and that is fine. I take it the same way.
But what would the alternatives be, and I believe it is the same thing when we start talking about hepatitis C. What are the options? Are the options that I do not have a blood transfusion. I remember very vividly when I went into the operating room that I needed to in fact sign a paper stating that they would--they being the physicians--do what was necessary in order to try and resolve the problem that I had, but that ultimately I would not hold them responsible for it. If by some error in judgment they would have removed the limb and later on found out that it was not necessary, that I would not be back there and holding them responsible for this. It could very easily have happened.
The minister just indicated that this could happen, and I am sure there are times when that does happen. Consequently it is the same thing with receiving tainted blood. Is this something that people knew? Certainly, as has been illustrated here time and time again, in the period of 1986 to 1990, the government or the Red Cross was aware of it, that there was some tainted blood out there, and certainly they did have a responsibility. I believe that is exactly what the illustration is given here. Also, read the resolve of it, that the government is taking responsibility for it during the period of time they knew that there was a problem. But the resolution here states now that we want to reopen this, and we want to reopen it to a period before, we want to open it to a period after, forever and a day. Is this forever now that when something goes wrong, that immediately we go back to government and ask them to compensate? I do not believe we can do that. I think that somewhere there has to be a finality to what we can do as government. The treasuries are not limitless and so they cannot continually compensate.
I want to come back to the other point again. I think that is something that as individuals, as people in Manitoba, in Canada, that we take so for granted, and that is the health care system that we enjoy from day to day. I drive, and I do a lot of driving, but certainly we know too, that statistically the opportunity to be in an accident is there, that possibility is there, so I would want to have a health care system out there, one that is responsive, one that can meet my needs when I need it.
So, Mr. Chairman, those are some of the concerns that I have regarding the reopening of what we had felt was something that the province had agreed upon. The governments have set aside, and I think it was indicated before, between $1.1 billion and $1.2 billion, where the federal government will provide up to $800 million and the provinces and the territories would be putting in up to $300 million.
The other area of responsibility I believe that we so often overlook, and that is that are we not assisting these people. Certainly, I believe that we have a responsibility to them, those who are prior to '86 and after 1990, and I believe that we are also supplying or giving them assistance. We are giving them assistance packages in the provinces and the territories. We would provide medical for them, we provide the hospital care for them, the home care, the drugs that they need, social assistance and other services. This will cost governments an additional $1.6 billion over the next 30 years. Now I would assume that is an estimate, because I also heard the Minister of Health (Mr. Praznik) making the comment that, yes, we are looking at anywhere from 20,000 to 22,000 persons, but it could go as high as 60,000. So where does this stop? Where do we finally have conclusion to this?
So, Mr. Chairman, these are some of the concerns that I have regarding the resolution that has been put on the table here, the amendment to that resolution, and I just believe that we cannot go and reopen this issue again for several reasons, one being that we are concerned about the people who feel that they have finally had a resolution to their problem. They have been waiting for this and waiting for this for many years, and now to ultimately have this reopened again makes it very, very difficult for them and for their families. So we need to deal with the one area first.
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Then also the understanding that I have from the Minister of Health (Mr. Praznik) is that they will be continuing to meet as provincial ministers and of course the federal minister in the next week or week and a half, I believe, and they will be discussing the issues here. But, again, I believe that as elected people we have a responsibility to advise them as to what our thinking is, you know, how far can they in fact go in dealing with compensation packages. What opportunity does this give to those who feel that they might in fact eventually show signs of having been infected? I think the Premier (Mr. Filmon) gave the example this afternoon in Question Period of an individual who found out that he had been infected, though at this point in time did not feel any consequences of it. How many more of these are out there? Where does this stop?
So, in conclusion, Mr. Chairman, I again want to reiterate some of the fears that I have. One is that right today we do not have a perfect health care system, not by any means, but I do believe and I know that it is getting better all the time. We are working at it. It is something that progressively we are working at. [interjection] Yes, an honourable colleague here says under the good administration of the Minister of Health. So that is something we want to continue to value, that we want to continue to uphold. That is looking at it provincially. But then looking at it federally, the whole area of our medicare system, I really feel that it is something that again we value, we want to retain.
Just another comment I would like to put on the record is that I have a sister-in-law who is the administrator of a 400-bed hospital in the U.S. It is a large hospital, and certainly they meet many people obviously coming in and people who need to have their needs met there. Their system is not a perfect one either. I know that many times in our Question Period, we have been talking about and questions have been asked: is this the direction that we want to go? That is when we look south of the border. It is certainly not. They have their problems, and they recognize that they have their problems there as well.
So I think continually as Canadians, as Manitobans, we value what we have, and certainly I would like to see us do everything possible to retain and to keep the health care system that we have and to keep it intact as best possible. So, with those few comments, Mr. Chairman, thank you very much.
Hon. Mike Radcliffe (Minister of Consumer and Corporate Affairs): Mr. Chairman, I would like the opportunity to again come to this table and put a few remarks on the record with regard to this new motion--[interjection] Because as the honourable member for Thompson (Mr. Ashton) quite correctly indicates, I did speak previously on the prior motion of the honourable colleagues opposite and I put a few concerns and issues on the record. But, as the resolution has changed--
An Honourable Member: The Clapham omnibus.
Mr. Radcliffe: Ah yes, quite rightly, the honourable member for Osborne--I must have made an impression because she recites that she does recollect that the rationale of the reasonable man on the Clapham omnibus is, in fact, a pervading principle of law, and I will ask--[interjection] The honourable member for Thompson (Mr. Ashton) is making some aspersions about filibustering. Recollecting his record in these halls in days gone by, he is perhaps somebody who could be somewhat of an expert on that, and I would never think that I would come close to his record or his skill in oratory, but he is perhaps one who knows well about what he speaks. It is an old saying that people who live in glass houses should not throw rocks, but I would not want to be deprecating of the honourable member opposite on that issue.
However, to the point, Mr. Chairman, I do not want to review what I have already said about writs of action, which was the original basis for compensation to individuals. In fact, originally at law in the Queen's Bench up until about the 1890s, if one were run over by a train or run down by a horse, at common law one had a cause of action against the individual object, and one could seize the railway carriage in question or seize the horse and sell the horse to follow up with one's remedy. However, we have come a long way from that, and as I recited to my honourable colleague opposite, the snail and the ginger beer--[interjection] Well, the snail and the ginger beer did change the course of litigation in the British common law, but we now are looking at an issue which I think the honourable Minister of Health has indicated we are touching on strict liability, and this is the slippery slope to perdition, because as many individuals have stated to date, we do not know the nature and extent of the problem which is under discussion at this point in time.
While the honourable member for Osborne (Ms. McGifford) was attempting, through some very skilled cross-examination of the honourable witness here who had been brought forward by the Minister of Health, to minimize and limit and put some certitude to the issue, I would suggest, with the greatest of respect, although her attempts were well skilled, that in fact she did not achieve the object of which she was attempting to address herself which was to put limits on the numbers on the issue.
But I think that what we must do is address oneself to the actual motion at hand which the honourable colleague for Osborne has put on the table. While at the outset I would like to say that I commend her for her compassion, I commend her for her interest in this subject, and I think that it is admirable that members opposite should have feeling and sensitivity on the issue, but we must bring reason and regularity and some sort of control to the good feelings which the members opposite are bringing.
I think that it is quite proper, and the object of the opposition is--perhaps their role is that of bringing in blue-sky concepts and challenging the status quo, and I think that the honourable member for Osborne has done that. But, having said all of that and admiring her for her creativity and sensitivity in the issue, I think that we must then address what it is she is actually saying.
The first part of her motion says that she moves that the committee commend our Legislature to support the content of the motion adopted by the Quebec National Assembly.
I am advised, Mr. Chairman, that the Quebec National Assembly, after having come to the table with all the rest of the provinces, territories and the federal Government of Canada to adopt a very specific compensation package in response to threat of class action, have widened their perception, their perspective, and they have asked that--or challenged really. They have challenged the federal government to compensate all individuals who have suffered from hepatitis C, not only directly but through their spouses, through indirect actions, through hemophiliac victims. This motion, I would suggest, with the greatest of respect to our colleagues in Quebec, although it may be based on good will and concern for victims in our community, may well imperil our health care system, imperil our fiscal probity, and, in fact, I would suggest is premature. We are being told that our honourable Minister of Health (Mr. Praznik) will be discussing these issues further with his colleagues in the other provinces and the Minister of Health.
We must be very cautious, and I am sure we would urge our colleague, our Minister of Health, that he is not to do anything that would jeopardize Manitoba's standing as a modest province in the Confederation of Canada that would result in a two-tier medical health care system, that Quebec being a much larger community come forward perhaps at the demand or the administration of the federal government and lay large amounts of money on the table that are beyond the ability of the Manitoba government to come up with. We have looked at the issue of the Ontario government, who have offered to put $200 million on the table at this point in time, but there is a hook to Mr. Harris's offer I believe, Mr. Chair, and at this point he is saying that he wants to try and collect this money back from the federal government, and that indirectly he is saying that the entire responsibility still lies with the federal government.
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Well, this motion which my honourable colleague is moving, I would suggest is confusing. It is premature, and probably I would speculate that if my honourable colleague had the opportunity to reflect upon what she has actually done, she might well suggest that she might want to withdraw this motion. I do not know, but I would leave that of course for her wisdom to consider in the future, because what she further goes on to say is not only does she want to get on board with the Quebec legislature in challenging our federal colleagues, but what I think the honourable member for St. Vital (Mrs. Render) has so adequately and clearly articulated, our honourable member for Osborne (Ms. McGifford) wants to open up the existing settlement which has been hammered out between all the provinces, between our federal government and the territories.
Mr. Chair, we can only look back in our recent past in this country and see how difficult it has been for any of us to achieve consensus in this Confederation. We have had two crucial constitutional discussions and better minds than ours have come to the table to try and reach consensus in this country. Both attempts have ended in failure. Here, for once, the ministers of Health across Canada and the federal government have reached a consensus on compensation on a very restricted and certain issue, and they are, I think, to be commended.
What the honourable colleague from Osborne is now recommending is that we undo this good work. I would suggest that proposal is outrageous and ought not to be contemplated or supported for one nanosecond.
We would lose for these victims, from the '86 to '90 category, the $1.1 billion that is on the table. We would go back to square one. Everybody's agenda that comes to the table in this country of ours is often at odds. As we can see from looking right now at the reactions from the press that I believe have been playing this issue and our Reform colleagues in the House of Commons, who have been, I would suggest with the greatest of respect, getting the optimum coverage that is possible out of this, there are many different agendas at work on this issue. Perhaps all the individuals who are involved might not have the ultimate of compassion about the victims of hepatitis C prior to 1986.
However, on the motion that we are being asked to address--and that is why I felt it was important to speak again, not to review all the litigation history that I reviewed before and outlined for the benefit of my honourable colleague, but rather to address this specific issue and to say that it is very dangerous. We put the flexibility of our situation in peril if we try to bind the hands of our Minister of Health (Mr. Praznik) when he goes off to Ottawa to try and discuss this matter further and reach new agreements, because what the honourable colleague for Osborne is saying is that our Minister of Health should press for the existing compensation package for victims of tainted blood to be reopened and reviewed. Therefore, I am sure that on sober second thought and reflection, quite honestly the member for Osborne (Ms. McGifford) might wish to review and withdraw that comment. However, I would not want to put words in her mouth at this point in time.
There are a number of other issues which I think our Minister of Health will carry to Ottawa to discuss with his colleagues. One issue, of course, is the rules or the limits or the concepts or precepts upon which compensation ought to be awarded to individual victims. The issue at hand right now which has been agreed upon by all parties was that the settlements that are given to hepatitis C victims would be reviewed and approved by the courts.
Now, it does not say, we do not have material at this point as to what court level this would be, whether it would be the federal court because the federal court covers issues involving the federal government or an individual trial court or Queen's Bench or superior court in each individual province, but under the present arrangement there is review of the settlements by the court system in our country, presumably to validate and ensure that nobody is taken advantage of.
The motion that my honourable colleague across the way has presented, of course, throws out this check and safeguard that the ministers of Health and the federal counterparts have put into the system. She does not involve herself or address the issues of what level of compensation is to be given to these victims, and as I said earlier, is there going to be an award for pain and suffering? Is there going to be an actuarial determination of loss due to diminution of wages earned? [interjection]
Well, one would seriously question that. I mean, the honourable member for Roblin-Russell (Mr. Derkach) raises a very cogent point here, but nonetheless putting the best possible interpretation on the motion raised by the member opposite, I would caution our Minister of Health (Mr. Praznik) that he must be very much aware of the difficulties which are involved here. He having legal background, I am sure he is very much aware of these points, that we would look at individuals who are suffering from hepatitis C, and if they are asymptomatic, which has been addressed earlier, whether they have in fact reacted positively, are they entitled to compensation, or is it only people who have suffered liver damage? How are we to discern what level of compensation should be given to these people? This motion does not address any of those issues, and I think that those are some of the real concerns that the people of this country ought to be discussing and considering at this point in time.
So, when one is rushing willy-nilly to say that you want to extend compensation, one has to know firstly what it is that we are extending. I have always maintained that in a perfect world it would be very easy to follow the economic precepts and the political precepts of members opposite if we had unlimited purses, if there was money growing on every tree. But in fact we live in a real world, Mr. Chair, and I would suggest, with the greatest of respect to members opposite, that these principles, while perhaps idealistic, are a little bit unrealistic in the real world that we have to deal with, with the budgets, with the rules, with the limits to our laws that govern compensation for individuals. As I say, I go back to the original precept which I think members opposite, although they have not articulated it, is an underlying principle in this motion, which is that they are proposing that there be strict vicarious liability for victims of the health care system, that the people who run the health care system, who are responsible for the health care system, ought to compensate people, and this is somewhat hazardous, Mr. Chair.
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The other thing, of course, is that the provincial ministers of Health have worked out a ratio of compensation. The Red Cross have been at the table, and they have participated in the existing transaction. Are we now to rip up this settlement, which is what this motion suggests, and walk away from it?
I believe that we are starting to reinvent the wheel. I do not think that this is in the best interests of Manitobans with hepatitis C, and I do not want members opposite, or anyone, to construe from the concern that my colleagues and I are bringing to the table that there is any lack of concern or compassion for individuals who are suffering from this affliction. But we have got to look at this motion on a realistic basis. I look forward to the advice which our Minister of Health (Mr. Praznik) will bring back from Ottawa, when he sits down at the table with the Minister of Health for the country, with all his colleagues from the other provinces, and also I believe members of the public who have an interest in this issue, and see what sort of consensus they are able to reach. But, in the meantime, while we do not want to fetter our good minister's ability to reach any consensus that is in the best interests of Manitoba, we must be very wary of not getting carried away with emotion on this issue, with falling prey to the--[interjection] I am sorry, there is no chance that the Minister of Health will fall prey to his emotions--[interjection]
Well, Mr. Chair, there is a place for emotion, and there is a place for passion; but, when we are handling the finances of our nation, this is really trust money that we are challenged to handle. We have to make sure that we are eminently just and eminently fair to all our citizens and that we do not get carried away with emotion on one particular issue, however well intentioned it may well be. I would perhaps characterize the motion of my honourable colleague opposite as being well intentioned, but perhaps she has not thought--
An Honourable Member: But misguided.
Mr. Radcliffe: Misguided. There it is indeed. Out of her own mouth comes such eminent wisdom that I would commend the member opposite and then perhaps after this discourse is finished she may well want to readdress this issue and perhaps withdraw some of the motions and rethink it and perhaps even give some advice to the Minister of Health (Mr. Praznik) that may be of benefit to him when he does go to Ottawa to meet with his colleagues.
An Honourable Member: I look for good advice.
Mr. Radcliffe: Yes, indeed. And so in conclusion, Mr. Chair, I would say that we must be very careful that we do not create a two-tier system, that we do not undo the good work that our Minister of Health has reached to date, that we define or address our minds to the extent of compensation that is going to be discussed, the process by which compensation is going to be awarded, that we encourage our minister to work assiduously to reach consensus with his colleagues, that we come back with a clear picture as to what we are being asked to vote for and to endorse. But just to willy-nilly dash off and tilt at windmills, to tilt at windmills, I would suggest with the greatest of respect might be castigated as a feckless and inopportune action.
Therefore, I was unable to support the member's previous motion and, for the reasons stated, although well intentioned and compassionate, I feel that I cannot support the current motion which she has brought forward to try and amend her previous position. I would suggest to the member opposite that perhaps the smartest thing to do would be to withdraw the motion completely, give her best wishes to our Minister of Health, and await his return from Ottawa. Thank you very much, Mr. Chair.
Mr. Ashton: Mr. Chairperson, in the spirit of trying to get this as a statement that reflects the concerns of members opposite, we are quite willing to amend a rather innocuous section of the motion, which seems to have been picked upon as a debating point for members who wish to nitpick, I think. I look at the member opposite and I do not know why nitpicking comes to mind, very eloquent nitpicking, but I digress.
I think the concern is, and by the way, I do not know how anyone can read a motion that says that the package be reopened and reviewed with a view to extending compensation is in some way, shape, or form restricting existing compensation in the package. I say that, Mr. Chairperson, because--
An Honourable Member: Let me respond.
Mr. Ashton: Well, I do not think the minister will have to respond because, quite frankly, we are quite willing to take out the words "to be reopened and reviewed" and put in a provision that clarifies it to deal with the supposed concerns of members opposite. I say that I think the last four or five speakers have all picked on this point as if somehow by saying you want to extend compensation that you would somehow tear up the existing agreement. That is not what anyone anywhere in the country has argued, nowhere, not a single legislature, not certainly in the House of Commons. Rather than get down this blind alley, we are quite prepared to take out the words "to be reopened and reviewed." I think we would consider the suggestion as a friendly amendment, and we are quite willing to move a further clarification by way of amendment, which we would also take advice from members opposite.
Mr. Chairperson, I would like to start by suggesting that we are quite prepared to delete the words "to be reopened and reviewed," accept that as a friendly amendment.
Mr. Chairperson: Has the honourable member for Thompson moved an amendment?
Mr. Ashton: I am suggesting, by agreement of the committee, we consider this a friendly suggestion from the other side.
Mr. Chairperson: The honourable minister would like to ask a question?
Mr. Praznik: Well, Mr. Chair, I would just like to comment on this, because I would like to just see the member--if he could provide me with his proposal in writing. The concern, of course, there is that by asking to reopen the existing agreement, and it is a very--[interjection] No, no, no, I am just saying to members that I--
Mr. Chairperson: Order, please. Before we go on, I would like to get this off on the right track, if I may. Do we have unanimous consent?
Mr. Radcliffe: A point of order. I would ask members opposite if they could read the phrase with their proposal the way they are proposing to amend it, so that it is clear as to what the amendment is going to be.
Mr. Chairperson: The honourable minister, to pose a question or a comment.
Mr. Praznik: Mr. Chair, no, I am not here to pose a question; I am here to make a comment. The fundamental concern with reopening the existing agreement, quite frankly, is where we currently have an $800-million federal commitment to a $300-million provincial commitment. If we are urging the federal government to reopen that, my guess is Mr. Rock will come back and say, all right, I will throw in a couple hundred million more, where is your billion? That might bring me up to a billion, where is your billion?
An Honourable Member: That is what we are saying we will take out.
Mr. Praznik: Exactly. So if members are proposing that we take out any reference to reopening the existing agreement--and that is why I would like to see their exact wording which I would be prepared to comment on before we give consent to that change--we would certainly be prepared to entertain it.
The principle here is that members opposite are asking for a further package for those outside the excluded group, and I think it is very fundamental here that the existing package remain intact, not be reopened, not be dealt with, that what members opposite are saying is that we should provide--their advice would be to provide a package for those people who do not have a negligence claim, and that in essence is what members are suggesting. If they have some wording along that line, I would certainly be prepared to entertain it on behalf of the government.
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Mr. Chairperson: If the honourable member for Thompson would put forward a copy.
Mr. Ashton: Mr. Chairperson, if the minister has a copy in front of him. We are essentially dealing here with this in two stages: one is we are trying to get common ground on that which is something that five members in a row from the government side have expressed concern about, making it clear that we are talking about not reopening the existing agreement to reduce coverage to any of the people who are covered from '86 to '90. That can be accomplished by taking out the words "reopened and reviewed." I mean I do not see that as being a problem, but if it is a problem, we can actually strike out "with a view to extending compensation."
I suggest we deal with that first one by unanimous consent, because I do believe there is consensus on that. There may not be consensus on the second amendment we wish to move, but if the minister prefers we can move to delete that and add the second section as part of a motion which can then be debated.
Mr. Praznik: Mr. Chair, I did not follow what the member is proposing. He is saying that they are prepared to take out the words "reopened and reviewed." So what he would be asking us, then, is to press for the existing compensation package to be extended. I think the member may--you know, if the member would like to take a few moments to give some consideration to his wording, I think the committee would--
An Honourable Member: I suggest, Mr. Chairperson, we recess for about two minutes and we can accommodate the minister..
Mr. Chairperson: Order, please. It is agreed to take a few minutes while the honourable member for Thompson (Mr. Ashton) thinks about his amendment? [agreed]
The committee recessed at 5:32 p.m.
The committee resumed at 5:44 p.m.
Mr. Chairperson: Order, please. Is there unanimous consent that the honourable member for Thompson move an amendment--
Mr. Ashton: It might be easier, Mr. Chairperson, if I might be of some assistance, if the member moves it as an amendment to her own motion and I think there may be some consensus on hand.
Mr. Chairperson: Is there unanimous consent for the member for Osborne to amend her motion? [agreed]
Consent has been allowed for the member to move her amendment.
Ms. McGifford: Thank you, Mr. Chair. We have listened to the members opposite and taken their advice seriously. We certainly wish to protect the initial package, and therefore I move, in the original motion, that everything after the phrase "tainted blood" be deleted and that the following be substituted: "be maintained, and that an extension of the existing agreement be entered into which would provide compensation for all victims of hepatitis C infected by contaminated blood or blood products."
Mr. Chairperson: The amendment is removing the words "to be reopened and reviewed with a view to extending compensation" and replacing it with "be maintained, and that an extension of the existing agreement be entered into which would provide compensation for all victims of hepatitis C infected by contaminated blood or blood products."
The amendment is in order.
Mr. Ashton: I think there might be a consensus to allow the original motion to be amended and this be accepted as a friendly amendment. We are not asking the government to necessarily agree to all of the amendment but just allowing the motion to be amended by leave, so that essentially what we will be debating is the original motion as amended by this motion without, as I say and I want to put that on the record, that this is not indicating the minister or the government necessarily agrees with this, the content of the amendment in full, although they might agree with part of it. The advantage of this, though, is it allows us to focus the debate on, I think, what are some of the key issues, and I can get into how we can continue that in a few moments if there is leave on that.
Mr. Praznik: I thank the member for Thompson for his comments on this motion. I think this does refine an issue that is evolving rather quickly. I thank the member for Osborne (Ms. McGifford) for this motion, and I believe the Chair will find that there is unanimous consent of this committee to have the original motion amended as proposed by the member for Osborne.
Mr. Chairperson: Is the amendment agreed to? [agreed]
The motion is amended, and as such, now there is discussion or can be discussion on the motion as amended.
Mr. Praznik: During the course of our recess, we had opportunity to talk, some of us, and just to update members of the committee, the federal minister, Mr. Rock, has requested, as well as Mr. Serby, the provincial co-chair, that we meet some time next week to discuss this matter further. As our Premier (Mr. Filmon) indicated in the House today, and as I have indicated on previous occasions, whenever ministers of Health meet to discuss issues, I try my best to be there, and it is our intention to have me there. We will be making the appropriate pair request of the opposition, which I do not believe will be a difficulty, but we may as a committee, given the way in which this is evolving--and I think we have made great progress in this committee in discussing the intricacies of a very complex issue. I really do thank sincerely the member for Osborne (Ms. McGifford) for bringing it on to the floor of this committee.
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I know at times one may think that we want to get to a vote quickly, but there are so many matters in play across this nation over which we have no control, and positions are developing and changing. We are, again, as we all recognize here, only a 4 percent player in any national package, and we have also all recognized the need to have a national solution. I have heard that from members of the New Democratic Party and the importance of having a national solution to any of these issues.
We certainly have one for the negligence area. Is there some extension or package to be made available in the nonnegligence area? And if there is, I think we have all, listening to this debate, recognized the importance of a national position. Manitoba has always taken the position, I think, through a variety of governments, to be part of national solutions to issues and problems. So I might suggest that this committee may, because we have been going over in great detail--and many of the comments made by members have been instructive to me as Minister of Health and helpful as this has developed--we may, in fact, want to consider putting over our debate until we have seen this matter develop somewhat further on a national basis. So I look to the member for Thompson, who is also the opposition House leader, for some advice.
Mr. Ashton: Yes, Mr. Chairperson, I would suggest that what we do is, first of all, in a couple of minutes, call it six o'clock. I would suggest we also look at the scheduling of Estimates. There are some other issues involved. It may be advisable to not only adjourn today but perhaps continue in Estimates probably after the meeting that the minister will attend, not just for the reason of this particular issue but for other factors as well, including the availability of our critic. But I think that will continue, in terms of discussion, probably with the government House leader, who, I understand, will be returning tomorrow morning.
I just wanted to put on the record before we do adjourn for today that we might not be coming back into Health Estimates immediately. Certainly, I want to put on the record, too, if there is anything that we can do to help the minister go to that conference in the best possible position--and I think everybody knows what our intents are in this, and I think for the government as well, we are certainly willing to accommodate that. That is one of the reasons why we may not be continuing with Health Estimates until probably after that meeting. But it is not the only reason. We are not just holding up the entire Department of Health, but we may have some further advice in the House on that tomorrow afternoon.
I would suggest we call it six o'clock right now.
Mr. Chairperson: Is it the will of the committee to call it six o'clock? [agreed]
Committee rise.