Mr. Chairperson (Marcel Laurendeau): Will the Committee of Supply come to order, please. This section of the Committee of Supply has been dealing with the Estimates of the Department of Health. We are on Resolution 21.1 (a) Minister's Salary.

Mr. Kevin Lamoureux (Inkster): Mr. Chairperson, I just have a few very brief questions, comments, if you will, and then would be prepared to give a final comment to see the Department of Health pass sometime in the not-too-distant future with a half-hour, hour-type thing.

At the beginning of the Estimates, quite often what happens is there are individual cases that are brought forward to the minister. I had one individual who called me fairly recently and had indicated--and I can provide the minister the name, if need be, or I will provide the minister with the name and maybe he can get back to me with respect to it. This particular individual has a rare bone deformity called Madlung deformity and needs orthopedic shoes. Now, the cost of orthopedic shoes is approximately $150--cannot necessarily afford it, and of course they are not covered by Manitoba Health.

I think there is, no doubt, a number of cases of this nature, and I guess what I would ask the Minister of Health is: Under what sorts of circumstances could financial assistance be given? I am sure, possibly somewhere within the Department of Family Services, there might be something. Or is there something within the Department of Health? Again, I will provide the minister with the name, and he might just want to take it as notice.

Hon. James McCrae (Minister of Health): Mr. Chairman, I will do that. Quite often honourable members, the honourable member included, bring to my attention individual cases, and I believe that is an appropriate role for an MLA to bring forward issues of concern to constituents. In the ordinary course we take each such request for attention to be directed to a particular case quite seriously. We raise the issue with departmental personnel, explore what options are available to us and to the client or the patient, and sometimes we are able to help, sometimes we are not. But we always give it our attention so that when the honourable member brings this to my attention in more detail, I will be sure to raise it with the department.

Mr. Lamoureux: Mr. Chairperson, the other day I was talking to the Minister of Health with reference to the whole question of capital and had asked the minister if in fact he might be able to provide me some information with respect to process from the tendering aspect, once a project has been assigned, to seek some sort of assurance that it is an open-tender type of a process and the ways in which priority decisions are made with respect to capital projects that would both be driven from, let us say, the smaller community to the larger community, if you like, hospital versus clinic type of request and the process. Just to be on the record, if you will, in terms of asking for that information, again I would appreciate receiving that.

I wanted to conclude my remarks on the Department of Health by, in essence, making reference to the fact that this has been my first time going through the Health Estimates, and I anxiously await next year when we can possibly spend a bit more time going through the lines of health care. Throughout the health care debates, the minister has been most helpful in terms of providing information to the critics. I do applaud the minister for doing that because, ultimately, I believe that it will provide for much healthier debate, questions and so forth. I do appreciate, as I say, the information that he has provided thus far. I will be going through Hansard to see if there is other information that may help facilitate me for the next round. I found this one to be somewhat of a learning experience for me. I have enjoyed participation from both the minister and the official opposition critic.

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I wanted to make reference to something, once again, because I do not believe I can reinforce it enough. You know, during the debates and so forth, the member from Kildonan would make reference to the Minister of Health's speeches by one, two, three, four--it ended up being at nine. The minister would respond that, you know, if it is really important, sometimes it is worth repeating. One of the things which I feel is worth repeating--and I would ultimately argue that it is my No. 1, if you like--is to underline the importance of health care to every Manitoban.

I think that this Chamber can do a service to Manitobans by trying wherever and however we can to depoliticize this particular issue. Mr. Chairperson, it does not necessarily mean letting government get off for where it has made some mistakes or some of the ideas by being critical when some of the ideas that they are talking about--no doubt there are going to be areas and, in all likelihood, many areas, in which there will be an agreement to disagree, if you will. That is, in fact, something that can be very healthy again for us.

I am concerned, as all members of this Chamber, that it is very easy for us to stand up and to take the political easy route of attempting to score political points at the expense of what really needs, in many cases, to be done in health care. I recall, for example, some of the discussions, some of the responses in particular from the Minister of Health. I will pick out one of those examples, the tobacco. When the Minister of Health was in here, I was actually in the Finance Estimates for a period of time and I asked the Minister of Finance what he thought about the tobacco tax reduction impact on the province of Manitoba. The Minister of Finance indicated that it was really a minimal impact on the province of Manitoba in terms of new people starting up smoking or smuggling and so forth. This is what he had somehow implied.

Then I came into the Chamber and, as coincidence would have it, shortly thereafter I posed that question that the Minister of Health was talking about how bad Ottawa was and how that was expanding--and endangering so many other lives and trying again to give the impression that that particular decision had a very dramatic impact on health care in the province.

I do not want to underestimate because, after all, I too did not support the reduction of the cigarette tax. I feel that in fact the higher the cost of a pack of cigarettes, the better it is, but I do not want to overexaggerate something in order to plant the seed of doubt or fear.

So many times I heard the Minister of Health comment about, you know, planting the seeds that cause seniors in particular to get upset because they are fearful of what is happening in health care. Whenever there is change people get uneasy, and if you misuse facts or spread rumours that really do not have any solid grounds, what you are doing in many ways is, you are planting fear in the minds of people when it is not necessary.

Some of these individuals, I recall a lady that I knocked on on Burrows Avenue, and she was very pleased to see me. She started to cry, and she talked about the importance of health care, and after about 10 minutes at the door, the lady indicated to me that she cannot vote for me, she is going to vote for the New Democratic Party, and the member for Burrows asks why? Because that particular senior believed that the New Democratic Party was the party that was best able to deal with health care needs.

I had indicated to this senior that in fact it is individual MLAs that have more of a role to play in terms of the overall survival of medicare, of the five fundamental principles that we talk about, that no political party owns the health care agenda.

As I have referred to so many times in speeches before this one, you know, if one wanted to be political and strictly talk about the politics of health care, I could say the Liberals talked about it first in 1919 in a policy conference. I could talk about, it was a federal Liberal government that put it across Canada. I could talk in terms of what has happened.

Well, the member from Burrows says, the dismantling of it. He believes because he is a New Democrat that he owns the issue of health care. Need I tell him, look at what is happening across Canada? It is just as much a political issue in every province where you have all political stripes that are trying to come to grips with the need to change health care.

I have seen governments that appear on the surface in treating of health care to be more right of centre, if you will, of traditional thinking in dealing with health care that you would be very surprised to see and, likewise, in terms of governments that have been left of centre, and seen some of the positions they have taken. That gives me a great deal of concern, but I go back to my No. 1 statement. That No. 1 statement is that each and every one of us can contribute to positive health care reform, can contribute to the health care changes that are needed that every province of every political persuasion is trying to come to grips with. The question is, is the political will there to do it? I believe from our perspective, from our party's perspective, that the political will is in fact there to do it, and I hope in the few questions that I did get to ask the Minister of Health (Mr. McCrae) that I was able to demonstrate that.

Mr. Chairperson, I hope that when we go into the health care Estimates the next time round that we will see more of the goodwill questions, answers, being responded to in a short, concise fashion; that we see government being not just criticized, but constructively, creatively critiqued where they are doing a job where we believe that they can do better, and not to be shy to take positions. I think that we could virtually sit down and have a debate, for example, for 60-70 hours in Estimates, just dealing with the one issue of comprehensiveness, what is health care, very easily as the Minister of Health points out. We could do that, and you will find that, yes, there will be some difference among the three political parties that are sitting here--but to come up with what we feel collectively through a consensus of what is comprehensiveness. What are the things in which we are in full agreement on? Then we go into the other aspects, the other fundamental principles, and be able to articulate on that. That in itself would garner a tremendous amount of good political will to be able to see a positive debate on those issues.

We all must concede at the onset that there is going to be a tremendous amount of disagreement, but there is no doubt in my mind that there would also be a tremendous amount of consensus that we would have achieved.

Mr. Chairperson, I just wanted to say those few words. As I have indicated, I appreciated the opportunity for the first time of being the health care critic, assigned to me as a part of my legislative portfolio. I look forward to next year's Health Estimates, and I look forward to receiving what other information was requested from the Minister of Health so that we will be able to further the dialogue in the upcoming session and possibly even arrange for some meetings. I know personally I would like to be able to tour a couple of the larger facilities and some of the smaller facilities that are out there so that I can get a better understanding in terms of the everyday workings of our health care system because I believe it would better prepare me going into the next year's Estimates.

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With those few words, Mr. Chairperson, I thank the minister for his co-operation at this juncture.

Mr. Clif Evans (Interlake): I want to just thank the minister first of all for the opportunity to ask a few constituency matters and questions on some issues in the Interlake constituency. One of the most up-front ones that I have had to deal with in the last four-and-a-half years, and the minister has dealt with this for some two years now, I believe, since he took over the portfolio, is the personal care home in Riverton. Questions are still asked of me as to what the minister's actions are on this matter, what the minister's department is doing with this.

First of all, I would like to ask the minister whether there has been any further correspondence from his office prior to the election and since the election to the committee in Riverton with respect to the personal care home, and if there has been, what message did the minister provide?

Mr. McCrae: I thank the honourable member for his interest in the issues related to Health in Manitoba as well as his constituency. Very quickly, in reference to comments made by the honourable member for Inkster (Mr. Lamoureux) who spoke of the Estimates process as a learning experience, it is a learning experience for all of us. It certainly is for me as well. I learn from questions that arise, contributions to debate and discussion that happens in this House as well as elsewhere. This is, as I recall, my second examination of Estimates, unless we did it in the fall of 1993. I do not think we did. I think we are something over 100 hours of discussion and debate in totality. Sometimes it can seem a little bit tedious. Sometimes it seems a little tiring, but taken as a whole these discussions are very good for all of us, and they are very good for Manitobans.

The honourable member wanted to avoid the tendency of repetition, and there is one are of repetition that is always in order, I suggest, and that is when it comes to saying thank you. I have the honour to be government spokesperson for Health, but there are so many people involved in the delivery of health services and health care services that I just do not know where to start. There are so many in Manitoba who embrace some of the things that were said by the honourable member for Inkster with all sincerity. I am very pleased to repeat again, again and again: Thank you to all of those people who assist their fellow Manitobans, assist the government, assist institutions and communities in delivery of sound and safe health and health care services.

With respect to the question raised by the honourable member for Interlake (Mr. Clif Evans) respecting health services in the town of Riverton, there has been mail both prior and subsequent to the election. I recently received another letter signed by the mayor of the town of Riverton, and there seems to be a single-minded determination in the mayor's mind that there will be a personal care home in Riverton. That approach is making it somewhat difficult for us to have a meaningful discussion of the health care needs of the population in that region.

I have been to Riverton. I have met in a town hall type setting with the people in Riverton. I have met on repeated occasions with the mayor and delegations from Riverton in my office. I have made it clear, I believe, in my correspondence that I support the facilities and/or services in Riverton that would be appropriate to a population health outcome-based analysis of the needs there.

My position has not changed in that regard working with the community and working with my department. I just encourage the community to work with the department in developing whatever health services might be enhanced or sustained or made available in Riverton. I am not committed to a personal care home and I have not been until I can be shown that is the appropriate thing to do. I recognize the desire amongst the people of Riverton for personal care capacity. I also look at what the rest of us have to do in the context of the province as a whole and the various regions of the province.

I owe Mayor Bjarnason a letter. I received one recently, and his letter is very clear that he sees simply the building of a personal care home in Riverton as the best outcome for him and his community. I do not agree with that at this point and that is the point I have made. It does not make me agree more to just discuss it in the absence of a discussion of the relevant health facts that would go into an appropriate determination of need for a personal care home.

I am very interested in the health care and the health needs of communities in every community in Manitoba, including the town of Riverton. All I would do is rather than keep having one-on-one meetings with the mayor, or meetings with the mayor and his consultant or others who might join, rather than continuing that process to attempt to persuade, I will be persuaded by the population health assessment that is made by the department in consultation with the community.

I encourage that approach. I encourage the community to work with my department. There seems to be some sense that in the community, or certainly on the part of the mayor, that the department does not wish to move toward a personal care home. Well, the department does not walk into the discussions with that in mind. The department walks into the discussions with a view to planning for what is the most appropriate services for the town of Riverton, taking into account all of the circumstances. The mayor walks into the discussions with only the personal care home on his mind. So there has to be a better meeting of the minds than there has been, and any more personal involvement from myself will not assist in that endeavour. I intend to be corresponding with the mayor with that message.

Mr. Clif Evans: Mr. Chairman, I thank the minister for those words. It seems that the whole process--as the minister says that the community is dead set on a personal care home and nothing else. I think that perhaps some of that stemmed from when the consultant was indeed hired and put together the numbers and that that there was a fair amount of discrepancy between the consultant's numbers and the community's numbers as to the needs of a personal care home, or an institution such as, with their numbers and requirement as what the department felt was indeed perhaps not a requirement with their numbers. I think perhaps that is where some of this discrepancy may have began, and this is where the determination of the community to specifically stay with the personal care home comes from.

The minister indicates that there may be another direction that we may be able to go instead of specifically a personal care home. I believe in the last correspondence that I have read from the mayor to the minister, it indicates--I may be reading it wrong, between the lines, and I will share my thoughts with the minister and the copy of the letter, but I think perhaps we should get together very soon with the committee and the mayor and satisfy ourselves, and satisfy everybody, not only the department but the community as to what direction we should be taking. Is it specifically a personal care home, or is it some other type of institution that we can provide so that the community will have access to proper health care?

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I would ask the minister, has his department or is he planning to put together a proposal in lieu of the consultant's report? And the committee's suggestions, is there something in the very near future that we can take to the table with the community, with the minister's department? Hopefully, I would ask the minister that. I am sure this would be all right with the mayor and the community. I would certainly like to get a little bit more involved in some of the discussions, not only between the minister and the community but the department, if the minister would agree to that.

I have stayed out of this pretty well, excepting bringing it up to the minister's attention of course. I have stayed out of the meetings. I have wanted to have the committee present to the minister's department exactly what was needed. Not in light of any sort of thoughts that we are getting too political or we are getting too this or too that, but is there something in the process? Is the minister preparing something for the community so we can bring this to them?

Mr. McCrae: Mr. Chairman, I hope the honourable member did not detect that in any way I would be critical of his role. The honourable member for Interlake (Mr. Clif Evans) has played, I think, an appropriate role as a member of the Legislative Assembly representing as well as he can the interests of a community. Let that be very clear for the record.

Also, if the honourable member feels that he would like in some way to be of assistance in any further discussions, I would feel quite comfortable for the honourable member to get involved. I say that with some trepidation for the honourable member because, as I said in my previous response, I make myself as accessible and available as I can.

I have attended a number of meetings with Riverton folks respecting this matter. I do not see, at the present time at least, any further help that I can be until I am satisfied that the committee in Riverton has exhausted its discussions with representatives of my department.

I do get feedback from the mayor--I will not quote him because I do not have his letter in front of me--about the way the department is conducting itself. It is not always positive or laudatory. I really do not know if I should accept that as a criticism of the department. I am normally very much one to challenge the Department of Health or any department I happen to be fortunate or honoured enough to lead. I think that is the role of a minister to challenge a department. In this case, indeed I have done that.

I just find that a meeting of the minds has not been possible to this point. I would not venture to guess why exactly. I am trying very hard to keep an open mind myself, but to this point I personally have not been pursuaded that the best population outcome would be served by the construction of a free-standing personal care home in Riverton.

I have discussed other possibilities with the committee and the population through the public meeting. I remember one woman at the meeting said, we will not back down. I thought, well, that is a pretty firm kind of position to be taking if we are going to look at population health outcome data in order to arrive at the appropriate services to be delivered in Riverton. We are not getting off to a very good start if some people have a personal care home on their mind and nothing else and they will not back down. That makes it very hard for the sort of population health planning that I am trying to talk about here.

I say, I have tried very hard, and I have worked with the community and met on numerous occasions. I invite the honourable member indeed to attend some of these meetings if he feels he can help. I certainly think there is a role for a local member.

There is apparently a long history here in Riverton. It is not just something that has been on the minds of the people in Riverton since my government took office. Reference is made by others to that point, and I will not bother going over that right now.

All I say--because after all they are voting on my salary this afternoon, Mr. Chairman. To the honourable member, if he is volunteering to get involved in this, I say, God go with you.

Mr. Clif Evans: Mr. Chairman, I thank the minister for those words and encouragement and the blessing that he has passed on to me.

I will be actually, Mr. Minister, getting more involved with the committee. I have had some discussions with the mayor and some of the other people on the committee. I think what we will be doing is--I would like to get together with them first and discuss other options, the pros and the cons of it, and certainly come back to the minister with it.

In light of that, and if such discussions can come about for the future of some type of institution or service in Riverton, I hope that if the community sees fit to come to the minister with a new agenda or new plan that the minister and his department do whatever is necessary to expedite any sort of service that we can provide to the community.

I would also like to say that for the Fisher Branch home the ground has been turned, if you want to call it that. They are ready to go on that. I am pleased to see that. That is part of what I was saying to the minister last year. You have these communities and these people who are working together to get something for their communities, and with the will of their hard work and proposals, financial input, I think we will all benefit with communities like that.

If I might ask the minister, we are all aware of the doctor shortages. I was at the Arborg meeting a couple of weeks ago that the minister was unable to attend because of the Estimates. I think one of the questions I would like to ask the minister is with respect to this. Talking to both doctors that are left right now in Arborg, their duties and their schedule are just tremendously overloaded. They are looking for some relief, summer relief for a weekend or two through the months of July, August, perhaps September.

The question that was asked of me by the doctors is, would the minister or his department be willing to perhaps do some cost-sharing with the Arborg area in respect to the doctors that they may be able to come and relieve them, the cost to that from Gimli? There are doctors that are willing to come over, but, as the minister is aware, it is a cost factor that right now the Arborg community and Arborg district board cannot themselves take on. Is there something that the minister's department can do to help?

Mr. McCrae: The honourable member and I discussed a meeting to be held on the 5th of June and, being unable to attend, Dr. Peter Kirk, I believe, attended and from reports I have heard probably added something to the meeting that I would not have been able to do, and I appreciate Dr. Kirk's attendance there. I understand that there was a good exchange of views there and that the meeting ended on a fairly positive note, which is very good to hear.

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I do understand, having discussed this with the honourable member in the past privately, I do understand the gravity of the concerns felt by people in some Manitoba communities when physician shortages loom or when physician shortages happen. I also understand that when there is a physician shortage, the physicians remaining are faced with very much increased workloads, their time is virtually never their own, their family life is impacted in a very significant way, negatively, I might say, to the point where in some cases if does not take very long until the burnout becomes so unbearable that the remaining doctors are not comfortable about staying around.

So I want the honourable member and all honourable members to know that I understand that, and you know that has not changed from the circumstances that have existed in rural and remote areas of Canada for years and years. Unfortunately, the solutions that have been brought to bear on that problem over the years have to some extent worked in isolated cases--a new initiative will be applied to a problem in a certain community and the problem is solved. I have been experiencing it myself in recent months, that we can solve sometimes on a short term, sometimes on a longer-term basis, a problem, but the looming nature of the problem is something I would like to avoid.

I find it very hard on the nerves of people in the community and hard on mine too, because I think it is a very serious concern.

If you live in the city of Winnipeg and a family practitioner decides to cease practice and go somewhere else, well, it might be an inconvenience to those patients who have become involved or have retained the services of that physician in Winnipeg, but there are other physicians they can go to, and arrangements are made and it is not such a serious problem.

In a place like Arborg it is a serious problem, and if this happened 10 years ago in Arborg, it would have been a serious problem and was when it happened and did happen. So we have to continue, it seems, with this particular problem looking for new and different solutions.

A solution in one community may not work in another community. That is why the members of the Physician Resource Committee, that is why the College of Physicians and Surgeons of Manitoba, that is why the Department of Health for Manitoba have all turned their attention to this problem with a view to solving all the short-term issues we have right now, but also to looking at the longer-term solutions that can be resorted to so that physician resource issues can be resolved, hopefully, once and for all. I do not have any magic for the honourable member today on those long-term solutions. We have put on the record quite a number of times various things that are being done and they are solving some problems short term. I continue to look for that final report from the Physician Resource Committee which will come later this year.

The honourable member asked about cost-sharing for locum tenens programs or for shorter-term services coming from Gimli and what role the department plays. At this point I can take the question as notice and get some information for the honourable member. I take it he is putting forward a proposal or a representation on behalf of the district in Arborg. At this moment I am not prepared to say, but I will undertake to find out more about that and get some information to the honourable member.

Mr. Clif Evans: I thank the minister for that. I just want to refer back, if the minister does not mind--I did find the letter from the mayor that I got a copy of, and it was March 2. If the minister at his first opportunity would go back to that letter, I believe the third page of that letter does indicate perhaps some changes in the scope of exactly what the committee and the community are looking at. I think we can get together on that and discuss that further.

I do have two very short little questions. One of them is a concern that was brought to my attention last year from some people in the Hodgson area about dialysis machines and the need for dialysis machines in Hodgson. Just lately I received a letter and a request from some people in around the Ashern area. I have done some investigating. I have talked to some people from different areas about this, trying to get a better sense of it. I understand some of the criteria that has to be put in place to have a dialysis unit brought into an area. I understand about the training program. I have gone through all of that, but there is a letter and I would like to--I am sure the minister because of the Estimates has not had time to peruse all of his correspondence. I would just like to provide the minister with this letter from the folks out in the Hodgson area.

The letter was addressed to the minister. There are support letters. I am really asking the minister's assistance on this. Is there something that we can do? I was basically told at one time that we should not as politicians, believe it or not, be sticking our noses in health areas where we should not be. I found that rather strange because we are not sticking our noses in it; we are inquiring about it. When I kept pressuring about, have there been studies done, there has to be a certain amount of people--and, from my understanding, there are a lot of people, or a fair amount of people, enough people that would provide for a dialysis unit to be put in place. On a scope--I mean, there are people from Ashern, from Hodgson, from Peguis, some who had to move to Winnipeg because they cannot travel back and forth, and it has caused some hardships.

I think between the whole scope of all that whole area, I think that perhaps we should be seriously looking at a dialysis unit for the area, somewhere perhaps central. Hodgson has got the facility available as far as a hospital there goes. I know that there is training for nurses involved. I am basically asking the minister's support in this and will follow up with a letter to him this week in response to the letters from LaFrenieres in Hodgson--and his assistance in putting together and getting the Health department, if it so be, to find a comprehensive analysis and numbers that we can see whether a dialysis unit should be put in place in the Interlake. It is very important, and it would be very, very useful to a lot of people in that community, so I am looking for the minister's help on that.

Mr. McCrae: I thank the honourable member for bringing this letter to my attention. It is dated June 12. I have been through my mail. The honourable member may have got this copy before me, and that is all right, because it is talking about something that is very important to the people in that region.

If the honourable member is going to follow up with some correspondence from himself to me, I will be watching for his correspondence too.

There are a few regions in Manitoba where requests for dialysis services come forward, and we have certainly added a lot of support to the provincial dialysis program. It is something that, fortunately or unfortunately, keeps on growing. What dialysis does is saves people's lives, and the more lives that are preserved, the more dialysis is required. It is something that, tragically, is growing in Manitoba. I wish we did not have to continue to increase funding for dialysis, but there is no choice in the matter. It allows people to keep living in, we hope, as independent a lifestyle as possible. It is not very convenient, I recognize, to travel great distances to a central location for dialysis services, nor is it convenient or something people want to do to actually move their home and possessions so that they can be near that sort of service. It is not a lifestyle I would wish upon anyone.

I look forward to hearing further from the honourable member. We will follow up at that time.

Mr. Clif Evans: Just one last, quick comment. From my understanding that there are--through my checking into this, I understand that there are units available, and there seems to be a problem between the units being available and initiative to find out is there really a need in a certain area. That is where I am having my problem.

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Just on policy, one last question on policy, I have had a constituent come to me who had taken his wife to the doctor, right to the hospital. From one hospital the doctor indicated they had to send his wife to Winnipeg via the ambulance, local ambulance. That was done, and two or three days later, once the medical situation was corrected, the husband went and picked his wife up and for that received a bill for about $275 to pay for the ambulance cost. Now it was not up to the constituents themselves; they were told that she had to go via ambulance to Winnipeg. The situation in return was not necessary for an ambulance, but yet he still had to pay the bill. Can the minister explain that?

If they were to go both ways, they would not have had to pay, but if there is no need from a hospital from Winnipeg back to the community, not only are you saving the money basically for the ambulance, but why are you then paying for both trips?

Mr. McCrae: I hope I have understood this correctly, Mr. Chairperson, but it needs to be said that when medicare began in Canada, it was not a totally comprehensive program, "comprehensive" meaning everything that you can think of being covered. Ambulance service has never been part of insured services. There are certain exceptions for things like interfacility transport and that kind of thing. I take it the honourable member is referring to a trip from home to a Winnipeg hospital.

If I have this right, if I am understanding the issue correctly, it is my recommendation always when I talk to people about our health care system, there are some people who are surprised that our health system does not cover everything. That is why we have private insurers too, to provide supplementary coverage for those things we do not cover.

Here again, maybe if the honourable member would not mind putting something down for me on paper, we will follow this particular case up. I am disturbed sometimes when I see cases of people thinking that ambulance service is part of medicare; it is not. There are certain exceptions, but ambulance service was never insured under medicare from the beginning. It was not insured in Ed Schreyer's day or Sterling Lyon's day or Howard Pawley's day or now, except in certain particular hospital circumstances.

We will get to the bottom of this, I say, Mr. Chairman, if the honourable member will remind me, privately, with the name of the patient concerned. If there is some opportunity for coverage, we will follow that up too.

Mr. Chairperson: Shall the item pass?

Mr. Dave Chomiak (Kildonan): Just a few brief comments to close out, at least from our perspective, this particular Estimates process.

I indicated on Friday that it was a very useful exercise and a very useful interchange and exchange of ideas. I am very tempted to comment in response to some of the comments made by the member for Inkster (Mr. Lamoureux) concerning his interpretation of the role and duties of members of this Chamber concerning health care. But I am resisting that, as well as resisting some of the tendency to reflect on issues that are of a controversial nature that have come up during the course of Estimates or during Question Period or, frankly, that came up in the recent provincial election. I am actually avoiding that and basically closing on the basis that it was a generally useful exercise of information. We do not agree certainly with all that is proposed or contemplated by the government, but I think we have been able to have a useful exchange.

There has been one issue, however, that is paramount in this particular regard that has not been dealt with, and we think it would be most useful if by moving a motion in this House we would have the opportunity to deal with it, Mr. Chairperson. It is a very specific point, and it is very, very directed toward this government and a failure, we think, on the government's part to make adequate and proper representations concerning the recent Bill C-76 before the federal government.

This particular piece of legislation will forever change the way that we deal with health care and post-secondary education in this country. This particular bill is of such significance that we think all elected members provincially, federally and municipally should be actively involved in trying to salvage what we can and in trying to convince the federal government of the wrongness of their direction with respect to how they are heading with Bill C-76.

We have had discussions during the course of these Estimates concerning this, but there has been a failure on the part of this provincial government to make adequate representation in this regard. It has been brought home to bear, particularly when one considers that during the recent debate over the gun control legislation the provincial government sent two cabinet ministers to Ottawa to lobby with regard to gun control. We find for a bill that is going to see $87 million removed from the province next year, $160 million in the following year, that is going to fundamentally alter the way we deal with universal health care in this country, there has been no representation made to the federal government.

I know the minister said during the course of these debates that he is going to discuss this matter at a federal-provincial conference that is scheduled, but this is not enough in light of the fact that the provincial government saw it necessary to send two ministers to deal with the gun control legislation, in light of the fact that we have had a nonpartisan relationship of dealing with issues of this kind. In fact, there was an all-party committee that went to Ottawa when the federal government began the cutbacks to health and post-secondary education in the '80s, an all-party committee went to Ottawa to make the provincial case.

Now one of the most fundamental pieces of legislation to affect medicare, to affect health and post-secondary education has been passed by the House of Commons, Bill C-76, and we did not make adequate representation to the federal government with respect to what is wrong.

So, Mr. Chairperson, I move, seconded by the member for Thompson (Mr. Ashton),

THAT the Minister's Salary, line item 1.(a) of the Estimates of the Department of Health, be reduced by $950, an amount roughly equivalent to one round-trip ticket to Ottawa which would have allowed the Minister of Health (Mr. McCrae) to appear before the House of Commons committee that reviewed Bill C-76 legislation that reduced federal support for health and post-secondary education.

Motion presented.

Mr. McCrae: Mr. Chairman, I do appreciate some of the things the honourable member said about the quality and nature of our procedures here in the examination of these Estimates. It has been an extremely sporting affair in the sense that honourable members have treated me with kindness and respect which I have tried most of the time to reciprocate.

*(1530)

Getting right to the issue that really has me preoccupied now, Mr. Chairman, this latest resolution moved by the honourable member for Kildonan, he must not have known the efforts we have made in light of the actions by the federal government to very, very seriously scale back funding for transfers to the provinces, various types of transfers, health, post-secondary education, CAP, equalization and all of those things.

The honourable member for Crescentwood (Mr. Sale) and I engaged in some very useful and helpful discussions. I think the honourable member has also engaged the Minister of Finance (Mr. Stefanson) in the same type of discussions. We are very concerned about these very, very serious cuts. I know the problems faced by the federal government. I do not excuse this federal government. I say it had a chance last year to begin in a more serious way addressing the extremely sticky problem that federal governments have created for themselves and by extension all Canadians in the way they have been spending our money.

I take this back to some time ago when this cycle of taxing and spending began. It began, basically as I have suggested, in the early '70s or perhaps slightly before that with the Pearson and Trudeau governments, and it got really bad '72-74 when there was a Liberal-NDP coalition in Ottawa. This is back in the '70s, I say, to those who now find themselves in the situation of wondering how we got here.

Well, it did not just happen in the last few years. I am critical of the Mulroney administration for not addressing this problem sooner and leaving it to the Liberal administration to leave it still one more important budget opportunity, which they missed, to lower the boom on us in 1995 on February 27. I made the point very clearly that what happened on February 27 in the federal budget makes Meech Lake and Charlottetown look like relatively unimportant debates.

The honourable member for Thompson (Mr. Ashton) knows that what I am saying is true, that that budget alone undid whatever might have been undone by Meech Lake and Charlottetown combined because we are into very serious sledding in the years ahead. I am critical of all of those governments, and I guess, by extension, all of us as Canadians; we put them there, and they delivered what they delivered.

I am told I am supposed to have appeared before the Commons committee that reviewed Bill C-76. Frankly, I can accept any kind of criticism you want to level at me when I deserve it, and I have done so. I do say, just what is it that honourable members opposite are trying to do? Do they think they can stop the people of Canada from insisting that they cease and desist gouging and pulling money out of the pockets of Canadians? Canadians have had it up to here with taxation. I just saw in the papers a few days ago that--what is the name of that date?--tax freedom day is getting later and later every year, not because of new taxation policies, but because of prolific spending 20, 25 years ago.

We are still trying to pay for it. We are asking the next generation to pay for it by saying we ought not to address that problem; well, we have to address the problem. I am critical of the--

An Honourable Member: Mr. Chairperson, is this a filibuster?

Mr. McCrae: No, sir. No filibuster here. I am critical of the federal Liberals because their budget does not demonstrate much in the way of priorities in terms of some of the items of spending in it. I remind honourable members that there is a meeting of federal and provincial Ministers of Health coming up on July 4, and I will be there. Manitoba's point of view will be heard loudly and clearly about the lack of priorities in the federal budget and about other matters relating to the financing of our programs.

I do humbly, however, appeal to my colleagues in this Legislature not to take $950 away from my salary, because I--

An Honourable Member: How much?

Mr. McCrae: Mr. Chairman, $950, they want to take from my salary.

The point is, I ask honourable members not to be taken in by this sort of approach to--

An Honourable Member: Irresponsible of them.

Mr. McCrae: We have been involved in this too at one time or another, but surely taking $950 from the salary of a Minister of Health who has just undergone over 50 hours of merciless grilling at the hands of honourable members opposite, unrelenting attacks on the spending priorities of this department. I put my fate in the hands of all honourable members in this Chamber.

Mr. Chairperson: Is the committee ready for the question?

Some Honourable Members: Yes.

Mr. Chairperson: Is it the will of the committee to adopt the motion?

Some Honourable Members: No.

Some Honourable Members: Yea.

Voice Vote

Mr. Chairperson: All those in favour of the motion, please say yea.

Some Honourable Members: Yea.

Mr. Chairperson: All those opposed to the motion, please say nay.

Some Honourable Members: Nay.

Mr. Chairperson: In my opinion, the Nays have it. I declare the motion defeated.

An Honourable Member: Recorded vote.

Mr. Chairperson: A formal vote has been requested by two members. Call in the members. Let the bells ring.

* (1600)

The committee will come to order. In the section of the Committee of Supply meeting in the Chamber considering the Estimates of the Department of Health, a motion was moved by the honourable member for Kildonan (Mr. Chomiak). The motion reads:

THAT the Minister's Salary, line item 1.(a) of the Estimates of the Department of Health, be reduced by $950, an amount roughly equal to one round-trip ticket to Ottawa, which would have allowed the Minister of Health to appear before the House of Commons committee that reviewed Bill C-76, legislation that reduced the federal support for health and post-secondary education.

The motion was defeated on a voice vote, and subsequently two members requested that a formal vote on this matter be taken.

Formal Vote

Mr. Chairperson: The question before the committee is on the motion of the honourable member for Kildonan.

All sections in Chamber for formal vote.

A COUNT-OUT VOTE was taken, the result being as follows: Yeas 23, Nays 31.

Mr. Chairperson: The motion is accordingly defeated.

The three sections of the Committee of Supply will now continue with the consideration of the department Estimates.

HEALTH

(continued)

Mr. Chairperson (Marcel Laurendeau): Order, please. We are dealing with (a) Minister's Salary $22,800.

Mr. Kevin Lamoureux (Inkster): Mr. Chairperson, I find it very interesting. At the end of my comments regarding the Estimates of Health, I talked about how important it is to all Manitobans that we start taking the politics to the degree that we have been playing over the years out of this Chamber. That was the focus of my comments at the end.

Mr. Chairperson, if you look across from one province to the next, coast to coast, you will see every political party acknowledging the need for change. I am disappointed, very disappointed in that we have once again seen an attempt by the official opposition to try to politicize a very important issue to every Manitoban in the province. I take great exception to any individual who will try to say--

Some Honourable Members: Oh, oh.

Mr. Chairperson: Order, please. The Minister's Salary is what is under discussion at this time; that is line (a) for $22,800. The motion that was brought forward by the honourable member for Kildonan (Mr. Chomiak)--

* (1610)

Mr. Lamoureux: Yes, and--

Mr. Chairperson: Order, please. The debate has been concluded. The motion has been defeated, and it is no longer to be discussed. The honourable member, on the Minister's Salary.

Mr. Lamoureux: Mr. Chairperson, then it is not appropriate to be able to say anything at this point in time?

Mr. Chairperson: I would just like to inform the honourable member that the debate on the motion that was brought forward by the honourable member for Kildonan has already been defeated.

Mr. Lamoureux: So now we are on the ministerial salary?

Mr. Chairperson: We are dealing with the ministerial salary at this time.

Mr. Lamoureux: That is right. Mr. Chairperson, at the end of my remarks, I will definitely pose a question to the Minister of Health.

I am concerned because I believe that there is no one inside this Chamber, and I do not want to say that I am better than anyone inside this Chamber, but I believe, Mr. Chairperson, that I am second to no one when it comes to defending that which all Manitobans care so very much about, those five fundamental principles. I talked, we talked for hours and hours about how important it is to acknowledge the need for change in this province. It is only the New Democrats in opposition in the province of Manitoba who defend the status quo. We will not progress in real health care reform unless the New Democratic Party takes some responsibility in dealing with this issue.

Yes, it is important for us to critique the government on health care, and we will do that, Mr. Chairperson. When the opportunity comes, when the government is doing something which we believe is wrong, we will critique the government on this very important issue, but we also acknowledge like every other political party across this country, whether you are an NDP in government or at least to a certain degree NDP in opposition in other provinces, that there is the need for this change.

Mr. Chairperson, the NDP will constantly and consistently argue, constantly, that health care in the province of Manitoba is in a crisis because they are, for all intents and purposes, a one-issue party. They need and they believe that it has to be a crisis in order for them to be elected. They are wrong. In fact, Manitobans are smarter than that. The other day I was reviewing 1990 campaign literature, and they were saying that health care was in a crisis. In the 1995 scenario, they were saying health care was in a crisis.

Yes, there is a need for change in health care. Every province has acknowledged this. Every political party of all stripes has acknowledged this. We have seen cuts in all sorts of different areas, reforms in many different ways, from all political parties. We will continue to see that.

The minister and the NDP brought it forward, and we had dialogue about the $416 million transfer payments, Mr. Chairperson, and the loss of revenue from Ottawa. At the time, I asked the Minister of Health what percentage of that is actually designated to go towards health care, and there was no definitive percentage that was designated to health care, even though the federal government does have funding formulas that have been established.

The federal government has provided opportunities for the government of the day to set health care as a high priority. I will be disappointed if the federal government does not live up to its obligation in terms of ensuring that provinces do what is needed in order to preserve health care, but I do not need to get a lesson from New Democrats on how to protect health care because I refuse to participate in the scare tactics that the New Democrats have used in the past.

I will not participate in that fashion. I will provide constructive, creative critique of this Minister of Health (Mr. McCrae). I believe I have done that during the last series of health care Estimates. I anticipate and will look forward to next year's health care Estimates where, as I have indicated just prior to the vote, I am anticipating that there will be a great deal more hours dedicated to health care so that we can enter into the discussions on the whole idea of comprehensiveness and how important that we address that particular issue, and the other fundamental principles that are out there.

I look forward at that time, and I hope that the New Democrats will look at their principles instead of trying to operate solely on the purpose of bashing the federal government and trying to misquote what Liberals are doing in the provincial Legislature and saying that we are supporting everything that the federal Liberals are doing.

Instead of doing that, why do the New Democrats not get some principles on the whole issue of health care and do what every other New Democratic Party has done when they are in government, Mr. Chairperson? Why will not the New Democrats look on what has happened in the province of Saskatchewan, the province of Ontario under the Bob Rae administration, the province of British Columbia? If the New Democrats in opposition only did and reacted the same way in which they saw their cousins in different provinces react, this would not be the New Democratic Party that it is today.

I believe this is an official opposition that will do and say absolutely anything to try to tell Manitobans that their health care system is in an absolute crisis.

Yes, there is some need for change. I will acknowledge that there is a need for change. Yes, this government has made mistakes. We did not support, contrary to what the New Democrats say, Connie Curran.

When the health care reform package came out, Mr. Chairperson, what happened? We saw unions supporting the initial idea of health care reform. There was only one advocacy group of any sort, from what I could understand, that opposed the health care reform package even before it was released. That was the New Democratic Party, because they know where it is that they are coming from. It is important for the--

Some Honourable Members: Oh, oh.

Mr. Chairperson: Order, please. I am having a very difficult time hearing the honourable member for Inkster in his presentation. I would ask the honourable member for Inkster to maintain the relevancy of the debate. We are dealing with the Minister's Salary. I am trying very hard to hear what the honourable member is saying.

Mr. Lamoureux: Mr. Chairperson, I should keep my comments somewhat limited in the sense that I am needed in the other committee room where I am going to be talking about many other issues such as citizenship and, hopefully, if they are still on the line, to continue on talking about government contracts for advertising.

Suffice to say, Mr. Chairperson, it is important to me, it is important to the constituents I represent that health care and the importance of health care and preserving, enhancing and improving the quality of health care to the patients is in fact my No. 1 priority. I am prepared to do what is necessary in order to ensure that the positive, creative, straightforward and constructive criticism of the government is in fact done. I am not endorsing. We had numerous disagreements during the Estimates. We will continue to have disagreements.

I do believe that there comes a time when we have to start putting the patient first and foremost and acknowledge the hard work of so many thousands of health care providers that are out there. I will conclude by asking the Minister of Health--yes, it is important that the federal government knows where the Province of Manitoba is coming from. You have a Health ministers' conference that is coming up. We anticipate strong representation from this government.

I can assure all members of the Chamber, even the New Democrats, that my concerns I have talked about this afternoon will in fact be expressed to my federal counterparts in Ottawa. Then, hopefully, Mr. Chairperson, the patient will be the first priority to every elected MLA inside this Chamber. I would like very much to see the same sort of an attitude adopted when we pass the all-party resolution inside this Chamber talking about the importance of those five fundamental principles.

Thank you very much, Mr. Chairperson. I do have to get to the other committee to deal with other Estimates.

Ultimately, as I say, the question to the Minister of Health is to give a response on what he believes are going to be the important issues in going to the Ministers of Health conference.

* (1620)

Hon. James McCrae (Minister of Health): I listened with careful attention and no small amount of interest to what the honourable member for Inkster (Mr. Lamoureux) had to say.

Mr. Chairman, I have to admit being on the receiving end of the resolution that was brought forward today that the member for Inkster really does raise some issues that are very relevant to a minister's salary but also very relevant to this discussion today and for the last nearly 50 hours, I understand, of discussion and debate on the Estimates of the Department of Health.

I have pleaded many times for the same thing the honourable member for Inkster is raising. That is that we all get together as Canadians and agree on those principles the member for Inkster talked about, the member for Kildonan (Mr. Chomiak), the member for Crescentwood (Mr. Sale) and myself and others talked about, an appeal for a less partisan approach to the health issue.

We only need to look at what is transpiring in all of the jurisdictions across this country to know that every province and every administration, no matter what its political persuasion, is faced with the same very fundamental, extremely important challenges.

What I am still happy to report is that I sense a national feeling of support for our national health care arrangements. That means, make them work for all Canadians wherever they happen to live. I am more concerned for some jurisdictions than others, but they are concerned too.

I just respond to the honourable member that the priorities for health remain the priorities that are very amply and very carefully laid out in the Estimates of Expenditure for the Department of Health for this fiscal year.

With those brief comments, Mr. Chairman, I will again thank honourable members for their participation in the discussions we have had respecting the expenditures for the Department of Health, which I remind the House are the highest level of spending as a percentage of budget anywhere in this country, right here in Manitoba. The Leader of the Opposition (Mr. Doer) disagrees with that, and I am sure we will have further opportunities and further debates and future Estimates to debate that. If we are not the highest, we are right up there equal with the highest level of commitment to health.

Now let us commit ourselves to quality health services, Mr. Chairperson, and sustainable health services. Health services that we can pass on to the children and the grandchildren rather than through the profligacy which is urged by some honourable members and some political persuasions in this country. Let us pull together, as the member for Inkster (Mr. Lamoureux) has said, to preserve the best of our health care system for future generations.

Mr. Dave Chomiak (Kildonan): Mr. Chairperson, I feel that it is necessary for me to rise and respond to the tirade of the member for Inkster (Mr. Lamoureux) on this matter of the Minister's Salary. I am quite surprised at the fact that the member for Inkster should make comments about the fact that we should become nonpartisan when dealing with the Minister's Salary and the particular issue at hand when at the very same time he stood front and centre as soon as the federal government was slightly criticized by members of this House in terms of their cutback on expenditures.

Even the Minister of Health (Mr. McCrae) was indicating that there is great difficulty, given what the federal government is trying to do with Bill C-76, and the Liberal member for Inkster, like all Liberals, stood up and said, yes, Mr. Axworthy, yes, Mr. Chretien, we will do whatever you say in Ottawa. We will do whatever your federal Liberal counterparts say.

If one wants to talk about being nonpartisan, if the Liberals in Manitoba had the intestinal fortitude to stand up and say to their federal cousins, no, we are not going along with your cutbacks, no, we are not going along with your reneging on your promises in the red book, perhaps this Confederation would work to a greater extent. But, no, they have to stick with their federal cousins.

Mr. Chairperson, we have had a fairly good discourse and discussion during the course of these Estimates dealing with the minister, and I think that part of the best of what we see in this Chamber has occurred during the course of these Estimates. I also indicate that no cause is advanced by the perpetual sitting on the fence of the members of the Liberal Party and their refusal to acknowledge that when there are problems in the health care system and their continued reliance and their continued inability to even remotely criticize their federal cousins.

We are facing a crisis and the member for Inkster (Mr. Lamoureux) has indicated there is not a crisis. We are in a crisis situation and part of the difficulty is the federal Liberal Party and their cousins in Manitoba do not recognize the financial situation that they are placing this Minister of Health (Mr. McCrae) and this province in by virtue of Bill C-76 without even discussing or without even calling federal-provincial ministers in, federal ministers of Finance in, to discuss how best to deal with the financial constraints that are placed upon the federal government. No, they have gone ahead and passed, without consultation, Bill C-76 and without embracing in the context of that legislation any mention whatsoever of the so-called five sacred principles that the member for Inkster pretends to support like most Liberals. There is not a single mention in Bill C-76 about preserving, legislatively or otherwise, those particular principles.

It is typical of the Liberal Party, both provincially and federally, to talk and not do the walk, to pronounce platitudes and to do very little. I sat in this Chamber for five years and watched the Liberal Party say nary a word about health care because they supported the changes. They voted in favour of Connie Curran and they saw the consequences of their actions. The members opposite say--and the member for St. Boniface (Mr. Gaudry) is saying, fearmongering. If it was not for the New Democratic Party, the issue of Connie Curran would not have come to the public's attention.

If it was not for the New Democratic Party, the issue of the Home Care cuts would have stayed as a nonissue and the public would have been more affected by those cuts. If it was not for the New Democratic Party any change made by this government in the last few years in terms of softening the reform process would not have happened if we had followed the dictates of the Liberal Party that were prepared to stand up and say yes to anything that was going on, Mr. Chairperson.

I do not want to prolong with debate. I held off for some time from dealing with the Liberal Party, who somehow can come to this Chamber and pretend that they are nonpartisan in health care and yet as soon as the federal government is criticized, stand up and defend the federal government right to the core. I find it hypocritical on the part of members of the Liberal Party to purport to be nonpartisan and then to follow the party line 100 percent in this regard.

Having said those few comments, Mr. Chairperson, I am prepared to pass these Estimates.

Mr. Chairperson: Shall the item pass? The item is accordingly passed.

Resolution 21.1: RESOLVED that there be granted to Her Majesty a sum not exceeding $6,373,900 for Health, Administration and Finance, for the fiscal year ending the 31st day of March 1996.

This concludes the Department of Health. We will now move on to the Department of Justice.