Mr. Chairperson (Marcel Laurendeau): Order, please. Would 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 Administration and Finance (a) Minister's Salary.

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Mr. Stan Struthers (Dauphin): I would like to point out for the record that we will be starting with Estimates today, and I will be speaking for my party for the first short little bit.

What I want to make my comments on is the sorry state of health care in Manitoba these days. In particular, I want to be specifically talking on the way the Home Care program has been handled by the current government and its minister who is supposed to be in charge of providing home care and the benefits of home care for all Manitobans.

I recently came into contact with a person, an elderly lady, who expressed her concern about what is going on in home care. She said that her husband was a receiver of home care services and that now he had been forced to move into a hospital where he was being taken care of. She was very unhappy about this situation, and she pointed out to me that in all her 63 years of marriage to her husband they never before had been apart and that now they were.

Mr. Chair, I want to make it absolutely clear how upset this woman was that this situation had been foisted upon her. I want to also be sure that everybody knows that she points the finger directly at this Minister of Health (Mr. McCrae) for this situation. I want to make sure that everybody understands that she lays the problems of her and her husband directly at the feet of this government, not the union bosses, not the NDP, not any other fantasized excuse that this government has come up with. She puts the blame exactly where it should be, with this Minister of Health and the government that has decided to destroy Manitoba home care.

Mr. Chair, I find it very hard to disagree with this woman after what I have seen happen in this House over the last several weeks in terms of the statements that have been coming forth from this minister and this government having to do with something as important as taking care of the elderly and the disabled and the sick. I have heard some things in this House that quite honestly tell me that this government and this minister are out of touch. I have heard things in this Legislature, in Estimates and in Question Period, and in statements to the media that indicate that we are dealing with a government that is absolutely uncaring. We are dealing with a government that does not deserve to be government and a minister that does not deserve to be minister.

I think no better example is the fact that the minister would not have the courage to go and listen to public hearings when they took place in this Legislature, when one person after another told Manitobans of their particular situations and their lack of service from home care providers. Not a single one agrees with the minister as to where this blame should go. This minister has to take responsibility for what is going on in home care, and this minister in the final end-all and say-all will have that responsibility on his shoulders.

All those people who are right now suffering without the benefits of home care are the responsibility of this minister. Why is he doing it? It is ideology, pure and simple. It is ideology. The minister and this government believes it is perfectly fine to take a program that is benefiting many Manitobans and reduce it to a program that becomes a scheme to put a lot of money into the hands of very few. Now that is ideology. That is traditional Conservative ideology. That is Edmund Burke ideology upon which the Tory party is based.

The minister has no reports. He has no answers to questions. The minister has no reasons for this decision that he has made on home care. The minister has failed even once to provide one good reason why we should tear apart our home care system as he is doing. There is no reason for what he is doing other than ideology. Mr. Chair, what we have heard from the minister are clichés. We have heard name-calling. We have heard personal attacks. We have heard a lot of rhetoric. We have not heard of any kind of evidence to support what this government is doing, not a single shred.

What the minister faces is a situation where he has no support from clients. He faces a situation where the workers do not support what he is doing. Maybe the one reason why a settlement was brought forth, was agreed to late last night, was that public opinion is not on the side of this minister either, not at all.

My question for the minister is very simple. Given the fact that he does not have anything to substantiate what he is moving toward, given the fact that home care workers and clients disagree with what he is doing and have courageously demonstrated that for the last number of weeks in this dispute, given the fact that public opinion is definitely against him on this one, will this minister finally put an end to this ridiculous plan to privatize home care?

Hon. James McCrae (Minister of Health): Mr. Chairman, none of what the honourable member said by way of preamble to the question, which came at the end, is true, and so, therefore, I cannot oblige the honourable member by answering the question in the way that he would like me to.

Mr. Chairman, I would like to bring to your attention something that disturbs me somewhat. I had a personal undertaking from the honourable member for Kildonan (Mr. Chomiak) that these Estimates would have been completed the other day, and I was told that anything that was going to happen today would be a matter of moments. The honourable member may not be aware of that, but I have that personal undertaking from his critic, the Health critic for the New Democratic Party, and in the absence of any explanation, I cannot quite understand why that commitment is not being honoured today.

Mr. Gord Mackintosh (St. Johns): Mr. Chair, I think it is important to talk for a brief period of time about the perspective that I have had of the home care issue. My background in the community, and the minister is well aware of this, is as a former convenor for many years of the Patients Rights Committee which later became the Health Care Consumer Rights Committee.

This committee had as its message, health care is our say too. It was saying that the consumers of health care, the reason why the health care system exists and the people most affected by the health care system were being left out of decision making, not only insofar as their own personal health was concerned, but because of policy making in the area of health care.

It was our position that we tried to raise the awareness of the government in particular on this issue that this had to change. It had to change not only for the sake of the dignity of health care consumers in Manitoba, but it had to change because health care consumers know best about how health services should be delivered in Manitoba. If the health care providers, and I include the minister in that, do not know from users how the services are being received, how can we truly have an effective health care system?

Mr. Chair, the government was not receptive to that message, and I recall committee meetings in this building. The current Minister of Health (Mr. McCrae) listened, but the then Minister of Health refused, refused to meet with us, refused to be in the committee meetings when the presentations were being made. I will say one thing, I commend this Minister of Health, the current Minister of Health, not only for listening but for responding and acknowledging the views of health care consumers as expressed through our committee.

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Now, I do not know what happened because now that he is in a position to do more than acknowledge the legitimate views of health care consumers, he has closed his mind to those views. I do not think anything was clearer than when the hearings were held in this building right down the hall, the minister could not so much as bring himself to go down there and listen to the health care consumers, the people most affected by home care. Why? How is it that the health minister could be so threatened, so threatened by those most affected? What an unfortunate mindset, Mr. Chair.

It is one thing to make the case that health care consumers should be more involved, given more decision-making ability in the health care system, but no stronger is the case than involved in decisions regarding home care. Why? Well, philosophically, it was stated in the federal-provincial territorial working group on home care that home care inverts the traditional power structure in the health system.

In the hospital there is a hierarchical structure headed by a doctor with a patient at the bottom. The patient is sick in an unfamiliar setting and generally in no position to take control of his or her fate, but home care takes place on the client's turf, an enormous shift in the balance of power, says the report. Physicians are rarely deliverers of service; clients and families, at least in theory, are encouraged to participate in decision making.

Then on the practical level, with home care you are receiving services about toileting, dressing, feeding, bathing--there is nothing more intimate than that--and receiving those services in one's own home, not a hospital room, in one's own castle. That is why it is so important that there be a standard ensured, a continuity of care, one which a profit care system cannot ensure.

I am sorry, Mr. Chair, that the Minister of Health is continuing the pattern of his predecessor in continuing to close his ears to the views of the consumers of health care, as he does so as I speak. When I look at the health care attendant job description issued by this government, the first standard that is listed there says this. The HCA must demonstrate a knowledge of client's routine and lifestyle. There has to be a knowledge of pattern. There has to be continuity. It is required in the job description.

We can go on and look at other standards: Demonstrates an ability to accept client's beliefs, values and lifestyle; observes changes in client's physical condition and functioning; demonstrates knowledge of client's past eating habits.

Continuity is a prerequisite. It is in the job description, Mr. Chair.

Now, we have heard from workers, hundreds and hundreds of home care workers. They do not say, what about me, Mr. Chair. What they are saying loud and clear is, what about my client?

I want to quote from a letter from a health care attendant of 11 years who, after trying to get a hold of the Minister of Health time and time again and was turned down by the receptionist in that office, wrote, and I quote: Have you ever visited the homes of people on home care and those on private care and compared the two, Mr. McCrae?

She goes on to say: Since last fall my client has endured pain and suffering at the hands of private attendants. It was a horrifying experience for her whenever they would fill in on Monday afternoons and Tuesday mornings. The private company did not phone to say who was coming. The attendants were untrained. One of the attendants came one day at the end of my shift and did not introduce herself and said, when do I feed her? When do I change her diaper? I called her into the kitchen and said, she is not mentally disabled, ask her. She knows what she wants and when. I then asked several of the attendants, do they not give you information about the client, and they all stated that the private company just gives them a name, address and phone number and told them they do not need to know anything else.

How can you take care of a client if you do not know their needs, Mr. McCrae, she writes.

And, indeed, how can you fulfill the requirements, the job description for the HCA, if there is not that continuity, if you do not know your client?

The letter goes on, Mr. Chair, but I will leave it at that. The minister has a copy of that letter dated April 12. I urge him to read it personally. The government has been engaged in negotiations with the workers. I now ask that the minister engage in a survey of the users of home care, those most affected, especially those who have used profit care, and will he listen to the stories?

I will tell the minister, I know he is afraid of that because one of the stories was Nancy Whiteway, who a number of years ago, as someone with chronic constipation, an MS patient, was denied the continuity of a home care worker, an HCA, to help her with toileting, and all she could do was go on a hunger strike. That is the only tool she had. She went on a hunger strike. She was willing to put her life on the line. Thankfully, the public system did respond; albeit too slowly, it did respond.

I am afraid, Mr. Chair, that a private system with the first obligation to a shareholder, the first legal obligation not to the client, would not respond.

I ask the minister, talk to the users, listen to the users, listen to the patients, the health care consumers. Thank you.

Mr. McCrae: Mr. Chairman, one of the first things that I did upon assuming the office of Minister of Health for Manitoba was to set up a Home Care Appeal Panel. That appeal panel has been there for that very purpose, the purpose of listening to the clients of our home care system and correcting the problems that confront them.

We have worked with that Home Care Appeal Panel, and we have resolved the problems between the program and our clients, and we will continue to do so.

Ms. Diane McGifford (Osborne): Mr. Chair, I had originally thought I would speak to the minister about home care, but being as one of my colleagues has just done that, I think I will confine my remarks more to women's health issues and possibly talk a little bit about Pharmacare, as well.

Last week, I spoke with the minister during Estimates, and he talked to me about a Women's Health Strategy. He said, by his own reckoning, the development of a Women's Health Strategy has been going on for several years. He spoke of this strategy as having four particular concerns. These were female cancers, midwifery, new contraceptive and reproductive technologies, and eating disorders.

Now, Mr. Chair, these are all very important concerns. Last night, I met with a group of community women, women who are all very concerned about health care issues. I talked to them about the minister's health strategy, and they were very pleased to see that these issues are being investigated.

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They were less pleased to learn that the strategy had been in the developmental stages for several years. The minister tells me that he hopes there will be a draft paper ready this summer. I do not know that we have much confidence that it will really be ready since, as I say, it has been in the draft stages for several years.

One of the reasons why it is hard to have confidence in this paper is that midwifery, one of the four focuses of the strategy, is still, strictly speaking, illegal. While I know that there have not been any charges laid recently, I also note that there are no plans to introduce legislation to legalize midwifery during this session of the Legislature, so it is very hard to imagine that the strategy will indeed be ready when said.

The group of community women that I spoke with last night agreed, as I said, that all the issues were very important, but we are aware that there are some very large, and I suppose you might even describe them as glaring, holes or gaps. For example, one of the major concerns affecting women's health these days is smoking, and I believe that lung cancer has now surpassed breast cancer as the leading cause of premature death among women. I understand that young women, teenage women, women in schools are beginning to smoke more and more. I think I am right in saying that there is a greater percentage of young women beginning to smoke than there are young men.

I think that there is also evidence that smoking women may be more susceptible to lung cancers than men are. I refer the minister to the Tobacco Free Times which is a publication that I believe comes out of Ontario, for details on this matter. My concern is that in the Women's Health Strategy, according to the minister's own reckoning, there is nothing about smoking cessation. There is no strategy on women and smoking, and it is a very, very serious concern.

Secondly, the group of community women were very concerned that there was nothing in the minister's strategy about pre and postnatal care and pre and postnatal well-being. This, again, is particularly important for teenage women who are pregnant, and I believe that Winnipeg is the teenage pregnancy capital of Canada. I think that is correct. So we are very concerned about this gap in the Women's Health Strategy.

We are also disturbed that there is no recognition that economic circumstances and social conditions are major determinants in the health of women. There does not appear to be a holistic view of women's health concerns. There appears to be no focus in the minister's Women's Health Strategy of the special needs of mature women. Osteoporosis, for example, is a very serious condition affecting postmenopausal women, and I bring that issue to the minister's attention, especially since increasingly we have an aging population and osteoporosis will be increasingly an issue for women.

I might also add that the minister's strategy for women does not mention AIDS and women, and AIDS is increasingly a problem for women, and I think as we have said many times in this Chamber, when AIDS affects women, it will affect their children. So I bring those five points to the minister's attention.

Something else I would like to bring to the minister's attention is to remind him that the majority of health providers and health consumers are women. I would like to remind him that women experience health reform often as layoffs, as having to assume additional care-giving roles for family members.

This is, of course, one of my fears. It has always been one of my fears with the move toward privatization that when the user fees that are sure to accompany this sooner or later come in, we know who is going to be expected to care for the family members who cannot afford services, and that, of course, will be women. The kind of squeeze that women who provide health care endure is really classic. Caught between their children and their parents, the situation is stressful. It is isolating. It is fatiguing. Moreover, it is a situation that often affects women who are over 50. Often these women bear the brunt of the increased home health care just at a time when they are looking for some respite and just at a time when many of them are developing their own health problems. So I would like to bring that to the minister's attention, too.

I want to remind the minister that 98 percent of home care workers are women and that a very large number of these women are also immigrant people. I bring this to the minister's attention to point out that this is a very, very vulnerable group and that these people have certainly suffered enough. I think it is time to treat these workers with a little bit of respect and dignity. It is time to work on the perception that many Manitoba women have, that the health care policies of this Minister of Health (Mr. McCrae) are sexist.

I also want to bring to the minister's attention the fact that 80 percent of health care workers in Manitoba are women--I am not confining myself here to home care workers--of all health care workers are women and that these women are living with layoffs. They are living with shifts from full-time to part-time work. They are living in many cases without job security and, in many cases, they are living with very few benefits. It seems to me that these health care workers live and work under inordinate stress and the government has really done nothing to relieve this stress.

In closing, I want to say that there was a time in Manitoba when women could count on a responsive health care system, when the principles of the Canada Health Act indeed inhered, and I am very disappointed that that is no longer the case, that we are moving nearer and nearer to a two-tiered, American system and that the minister has lost the confidence of Manitoba women when it comes to their health care. Thank you.

Ms. Rosann Wowchuk (Swan River): I want to ask the minister if he realizes the impact these changes that he is proposing to privatize home care are going to have on women.

I had the opportunity to meet with many of the people who were in the home care field and very concerned about this government's plan to privatize, and those people said to me, both men and women, do you not think this is a women's issue and that this government is being very heartless in not recognizing the impacts that this decision to move toward privatization is going to have on women, many of whom are single mothers, many who are sole breadwinners of the family?

I would ask the minister if he would recognize the impact of his decision to move in this direction to privatize and reduce the salaries of the deliverers of home care, and will he recognize that is a wrong decision because it hurts the women of Manitoba?

Mr. McCrae: Mr. Chairman, it is with due regard for the women of Manitoba that we have approached the bargaining table in respect to the recent labour disruption in home care. A majority of the clients of our home care system are women, and we want to improve our home care services for them in the future. That is what we expect to do.

In carrying out the terms of any collective agreement arrived at, that will also be carried out according to the terms of that collective agreement. In other words, we expect to keep our commitments. The honourable member might speak to the honourable member for Kildonan (Mr. Chomiak) to understand what I mean when I say we intend to keep our commitments.

Ms. Wowchuk: The minister indicated that many of the clients are women, and I am indicating that many of the workers are women, and this government's plan to privatize home care will result in a reduction of close to 40 percent in their pay when the private companies take over and have to make their share of profit of this issue.

Now, the minister says he will keep his commitment. I want to ask the minister if he is also going to be keeping the commitment that his department made in writing to all the workers in rural Manitoba indicating that there would not be any privatization of home care in rural Manitoba.

Is he making that commitment that there will not be privatization? Will he send that clear message to the workers and the clients in rural Manitoba, because that was the letter that he sent out prior to the workers having to take action against this government's plan to privatize the home care system.

Mr. McCrae: Mr. Chairman, the honourable member's comments are duly noted.

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Ms. Wowchuk: Mr. Chairman, I just want to ask the minister the question again. He says comments are duly noted.

The question is, does the government intend to privatize home care in rural Manitoba, as a Treasury Board document says, that home care will be going under the regional health boards, and once it is under the regional health boards, the minister had indicated there is no guarantee that it will stay with the government.

Can the minister make a commitment that there will not be privatization of home care services in rural Manitoba as was indicated in the letter that went to the deliverers of home care a few weeks ago?

Mr. McCrae: We intend to carry out the terms of whatever collective agreement is arrived at between the parties.

Mr. Kevin Lamoureux (Inkster): Mr. Chairperson, I have a couple of questions that I want to ask the minister.

My colleague from The Maples had a discussion with a constituent who had asked if I might be able to raise this with the minister, and this might be an appropriate time to do that. It is regarding the Pharmacare deductible and the levels of income that have to be incorporated in determining the deductible. This particular individual has workers' compensation, a pension. Would that be included in the calculation of his Pharmacare deductible, would the minister know offhand?

Mr. McCrae: Whatever is determined to be income under the rules that determine what income is, that income is used to decide the person's deductible. I do not know what different classes of dollars are considered income, but I can find that out.

Certainly, the whole idea behind the new Pharmacare is the ability to pay, that principle whereby those who can afford to pay for their own medicine will pay for their own medicine, and those who cannot afford to pay for their medicine will get assistance from the program.

Those who need a lot of medicine will get a lot of assistance from the program, such that nobody will pay more than 3 percent of their income for a pharmaceutical product. It is 3.4 percent in Saskatchewan, I believe, but it is 3 percent in Manitoba, and if you are really poor, it is 2 percent.

Mr. Lamoureux: Mr. Chairperson, I am wondering if the minister could maybe take the specifics of the question, and as opposed to getting back to me, if he could get back to the member for The Maples (Mr. Kowalski). I do not have the constituent's address, or I would give you the constituent's address, so that you could write directly sometime in the next week to 10 days.

Mr. McCrae: Yes, if the honourable member would have the honourable member for The Maples call my office or call my office himself, we will take the specifics from him and go from there. I do not have any staff here now.

So if he calls my office, we will take the specifics from him and look into the matter for the honourable member.

Mr. Lamoureux: Mr. Chairperson, I did have a few questions also with respect to the home care situation. It seems that we have a tentative agreement in place.

I asked the question earlier today about the whole question of wage. It was fairly clear from a B.C. report that indicated that privatization for profit actually had seen a 50 percent turnover in the workforce compared to 37 percent in other sectors, particularly the nonprofit.

I wonder if the minister has given any consideration to the impact of the private for-profit and what impact that is going to have on the turnover of employees.

Mr. McCrae: Yes, I have given that consideration, Mr. Chairman, and I know that some people who argue about this whole concept of turnover ignore altogether some of the findings of our Home Care Appeal Panel. The appeal panel has dealt with many, many complaints dealing with people going on holidays or people calling in sick and not being available for work. It creates a lack of continuity. The honourable member cannot pretend that in any work--this is not a fault. This happens in workplaces and amongst people who work. They get sick and they call in sick. Their client may have a disruption.

We would like to do something about that. We are doing something about that. But do not ignore the fact that the turnover is only one part of the equation here. For those who are not turning over, if that is the right word, they have holidays, they have illnesses, they have emergencies in their families. They are human beings. They have issues that arise from time to time which result in a break in the continuity of service for the client. This is unavoidable. Do not ignore that. Do not pretend that is not already there, because it is.

Mr. Lamoureux: Mr. Chairperson, I would not necessarily argue that there is not 100 percent continuity of care that is being provided today, but I would argue that this particular table that I tabled earlier today, from the B.C. studies, is fairly clear in terms of, when it comes to privatization for profit, there is a higher percentage of worker turnover. When you have a higher percentage of worker turnover, that will lead to less continuity compared to other areas, whether it is unionized, nonprofit, and that is what it was being compared to.

What I am looking for specifically from the minister is to acknowledge the fact that what is currently happening in B.C. could, and many would argue, including myself, will likely happen here, where we will see a higher percentage of worker turnover in private, for-profit companies that deliver home care services.

Would he not at the very least acknowledge that this in all likelihood would occur, and if he is not prepared to acknowledge that, then indicate what evidence the minister has to demonstrate that this will not happen in the province of Manitoba.

Mr. McCrae: I acknowledge the document tabled in the House today by the honourable member for Inkster. It is called: Table 56, Average Turnover Rate by Total Homemaker Expenditures, Ownership, and Union Status for British Columbia Homemaker Agencies, 1992/93 Fiscal Year. I acknowledge having received that.

The honourable member arrives at an interpretation that he wants to arrive at, but he ignores some of the facts. They are not just insignificant, little facts. He does not mention, for example, that user fees are a part of virtually every home care system in Canada but not in Manitoba. I guess Quebec shares that distinction. He does not mention, Mr. Chairman, that many provinces have means tests for people, and he does not mention that most provinces have contracting out with private and nonprofit and profit of one kind or another in their systems.

So I guess it is easy to pick and choose when you want to make a philosophical argument. I am at a disadvantage. I am not making a philosophical argument; I am making a pragmatic argument that says competition does bring about excellence. That is not something that is new, and it should surprise no one that I would argue that. There are those who have an ideological aversion to profit, so, therefore, anything associated with profit is evil and bad.

Last week, the member for Kildonan (Mr. Chomiak) raised with us, one of the companies is putting out a promotion for its employees. They have, what do you call those, points that you get for every hour’s work you do. You get a point, and your name goes in the hat. You draw, and you get a television set or a trip or something like that. This is somehow evil. An incentive to promote excellence is somehow evil and wrong, and they try to confuse the public by throwing in the whole concept of profit. This was not a television set for the owner of the company. It is a television set for the workers who are out there providing services to clients, and, in order to get them to provide the best service they can, companies offer these kinds of promotions.

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Governments do it in various ways, too, through the pay stub, I suppose, but certainly in the private sector those are the kinds of promotions that go on. The member sent it across to me, and I thought, oh, oh, I guess this is something really horrible that he is talking about. Really, when you think it through, any kind of promotion that brings about excellence is not something we should be making fun of in the Legislature. People who work for other people and provide care, whether they work for the government or for a nonprofit agency or some other kind of agency--I had a reporter who seriously suggested that if you work for the government, you are going to do a better job. Well, I do not hear that argument very often, but I did. The question was asked by a reporter who works for a proprietary television company. I said, well, are you trying to tell me that you do not do as good a job as the reporter over at CBC? Funny, they did not play that part of the interview, Mr. Chairman. How come?

Human beings are human beings. Most human beings are perfectly honest people and hard working and have integrity. They accept a job; they give it their level best. When they cannot give it their level best anymore, they quit because there is no satisfaction in not doing your level best. The honourable member, is he really trying to say that Canadians who work for companies or for nongovernment agencies are somehow inferior to everybody else? I would say that is a pretty big insult to most Canadians because most Canadians do not work for government. Think it over. You are talking about your fellow citizens here, and you are insulting the majority of them.

Mr. Lamoureux: Well, Mr. Chairperson, for hours and hours, we try to get a better understanding as to why the Minister of Health has made the decision that he has made. In essence, what he has decided is that--let us say we use the budget of $70 million for home care services. By privatizing for profit and using that $70 million--and he can argue it is 25 percent today, but ultimately the government’s intentions are to fully privatize--what you are doing is, a business for profit is going in there with expectations of getting a return for their money.

That rate of return, Mr. Chairperson, is no doubt debatable or arguable. I would speculate that a private company is going to want to get somewhere between the neighbourhood of a 10 percent to 14 percent rate of return.

Well, what you are talking about is $8 million to $10 million, if you like, of a return for profit that is going to be required in order for private companies to be interested.

That takes a great deal of money out of home care services, and where are they going to get that dollar from? The services, in essence, will still be there. The quality will be called into question, but, in essence, that $8 million to $10 million is going to be taken out of the salaries of individual home care workers who are there today, and it is going to be given to those companies that have acquired the contracts.

So the argument of a few people are going to become rich as a result of this and the home care worker is going to be deeply penalized, some would argue up to 40 percent, including me, Mr. Chairperson, 40 percent in some cases, is it a sense of fairness not only to the home care worker but ultimately in the long run to the client?

That is why, if we were to speculate as to why it is that you have a higher turnover rate in B.C. in the private, for-profit home care services compared to nonprofit or unionized home care services, I would argue that the primary reason is likely, and I am speculating, and obviously the Minister of Health would have to speculate because I do not believe that he has done his homework on this particular issue, is that there is a lower rate of pay.

When you marginalize labour costs, you are going to have more people entering into home care services and exiting because of the rate of pay. You cannot say, well, if you are committed to delivering this quality service, then the rate of pay should not have an impact.

Well, I will not buy into that argument and, if the minister wanted to, I could probably speak for a while as to why that argument would not win the day but, ultimately, and specifically for the Minister of Health, would he not agree that the private for-profit, what gives them the strategic advantage, if you like, is that they are prepared to pay considerably less, but as a consequence of paying that wage at considerably less, you are not going to have as much continuity of care.

Ultimately, following that argument through, I would argue then that in the long term, not only the long term but in the short term, the quality of care that is being delivered is going to deteriorate.

That is the reason why the privatization for profit just cannot work as the government is trying to portray it. We believe in the Liberal Party that it is absolutely essential, even with the tentative agreement now reached, that the Minister of Health agree to this 12-month moratorium. By agreeing to the 12-month moratorium, then and only then will the minister have the time to do what he should have done in the first place, and that is to consult with the clients, to consult with the home care workers, to consult with the individual Manitobans who have the experience, who want to give the government direction on home care services.

We ultimately believe that if you take a look at home care services and the amount of money that home care services has saved the government over the years through the deinstitutionalizing--they bridge the personal care home, the hospitals, along with the community as a whole, and the direction that the government is taking is, even from a philosophical point of view, if you believe in medicare, the five fundamental principles of medicare, ultimately, we would argue that home care services is a natural extension of that.

You can still have private companies participating in and around, complementing these core services that are being provided; there is no doubt. We are not saying that should not exist. It exists today even within our health care system. So the specific question--and I see the Minister of Health wants to converse with the New Democratic critic, but I was going to sit down and then let the Minister of Health respond, so I will extend the question. [interjection]

The member for Turtle Mountain (Mr. Tweed) likes one of the suggestions that we have talked about. I say that with tongue in cheek. He does not really support it. But maybe what I will do is I will appeal to the member for Turtle Mountain while I wait for the Minister of Health to finish his conversation with the New Democratic critic. That is, if you believe ultimately that you have to privatize and if you want to privatize in a way in which you are going to maximize those dollars that are being allocated, I would recommend that special treatment has to be given to nonprofit organizations.

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

That can be given in different ways. It could be given directly, or it could be given indirectly, and let me cite an example of both. Indirectly it can be given through having or instituting a wage structure or a wage scale that says that when you set out the criteria for everyone to bid in, in order to be able to bid for this contract, you have to meet this specific wage scale structure.

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By doing that, you are ensuring the quality, if you like. You are ensuring, to a certain degree, quality. How are you ensuring quality? You are ensuring quality because you are allowing those individuals, the many people who deliver--and this is what the government has lost out on. Home care services today are single parents, are individuals who--whether you are a single parent or not, these individuals--Mr. Chairperson, I am told I only have two minutes. I am not going to have enough time to expand on that particular point.

The other form of direct assistance or special treatment, Mr. Chairperson, is of allowing a certain percentage for nonprofit, or ultimately you could argue that it is just for nonprofit agencies. Imagine if you allowed community clinics the opportunity to be able to deliver this service. Currently today our community health clinics provide all sorts of programs. Look at what is happening in the province of Quebec. But whether it is something that is happening in the province of Quebec, or it is some statistics in the province of B.C. that clearly demonstrate that the government is moving in the wrong direction in the province of Manitoba, all we have asked the minister to do is to do his homework, to know what it is that he is actually doing. That is ultimately the reason why we have called for the 12-month moratorium. The 12-month moratorium would allow him to do his homework.

So, Mr. Chairperson, I have put forward a number of questions. The Minister of Health appears to be ready to answer the question. Unfortunately, my time has run out. So I look forward to the response from the minister.

Mr. McCrae: Mr. Chairman, that question has been asked and answered a number of times.

Mr. Lamoureux: Mr. Chairperson, because the minister was taken to the side, the New Democratic critic had some comments, I guess, that he wanted to express to him, so maybe he did not quite catch the question. I cannot recall it being asked on numerous times in the past.

The question specific to the minister is, here you have a significant percentage in the province of B.C. where there is a comparison between private for-profit and nonprofit and unionized. The private for-profit clearly indicates that there is a higher turnover rate of workers. That does have an impact on the quality of service being delivered.

The question specifically to the Minister of Health was, would he not agree with me and speculate, as I have done, that the primary reason for that in all likelihood is because of the wage structure that is in the province of B.C.? I cannot say, being conclusive for 100 percent, for the simple reason, is that I do not have the same resources that the minister has at his finger tips, but if I did, and if I had to make a decision of this nature, I would have done my homework, and I would have looked at what the privatization for profit is going to do for the workforce and the impact it was going to have. I would have done my homework, as I talked about earlier, and that is maybe where it could get somewhat repetitive with the province of Quebec on the nonprofit side.

That is the question, and put in that frame, I do not believe that the minister has attempted to answer.

Mr. McCrae: Mr. Chairman, the honourable member simply wants to engage me in debate. We have debated for many, many hours, and we have answered these and many other questions many times. Repetition sometimes has some effect, but in this case, I think, maybe not.

Mr. Gary Doer (Leader of the Opposition): I will defer for one more question.

The Acting Chairperson (Mr. Radcliffe): The honourable Leader of the Opposition is deferring to the honourable member for Inkster for one more question.

Mr. Lamoureux: I appreciate the gesture.

The Acting Chairperson (Mr. Radcliffe): The honourable Leader of the Opposition has indicated that the honourable member for Inkster is to finish his train of questioning.

Mr. Lamoureux: Mr. Chairperson, I appreciate the Leader acknowledging what the process has been in the past, and that is to be able to continue on asking some questions.

Mr. Chairperson, this specific question which the minister has not answered is, does the minister believe that the wage structure of the private for-profit, as compared to nonprofit or unionized, has an impact on the worker turnover? Does he believe that that, in fact, will have an impact?

Mr. McCrae: Mr. Chairman, the honourable member has asked a lot of questions, and I have answered a lot of questions, each and every one. Many of them have been repeated many, many times. That seems to be the pattern today.

Mr. Lamoureux: Mr. Chairperson, maybe the Minister of Health will humour me and answer this question, and then I will see if, in fact, he has answered it in the past. To the best of my knowledge, the Minister of Health has not answered the question. So I would ask that the Minister of Health listen very carefully to the question.

The question, once again, is, there is evidence in B.C., and the minister has made reference to the table that I tabled earlier today that clearly shows, that clearly demonstrates that worker turnover in the province of B.C. is higher in the private for-profit, approximately 50 percent, compared to unionized and nonprofit, which is substantially less than 40 percent. Would he not agree that the primary reason for that, in all likelihood, is because of the wage structure that they have incorporated? How would he justify that worker turnover in the province of B.C.?

If he feels that we do not need to be concerned about that because that is in B.C., tell us why we should not be concerned that that will not be the same case in the province of Manitoba.

Mr. McCrae: The problem here, Mr. Chairman, is that the honourable member concludes that people who work for private companies will not provide good service to our clients. I do not agree.

He suggests that this continuity issue is the real issue that ought to govern the day when he refused to comment on what I said about continuity issues in the present system. So continuity and turnover are two different things. The honourable member chooses only to talk about turnover. He does not want to talk about the Home Care Appeal Panel and all of its findings and complaints relating to continuity with employees who have not left the system. They become ill, they go on vacation and all of those sorts of things.

So the trouble with taking a philosophical approach is, you also take a very selective approach to is statistics. When you take a pragmatic approach, you look at them all, this statistic, that statistic and the other and then, on balance, you make a decision. That is what is happening here.

Mr. Lamoureux: Mr. Chairperson, this will be my final question I am going to be asking with respect to home care service. [interjection] Well, on the prodding of the government, maybe I will not quit.

I am inclined to disagree with what the Minister of Health is saying in the sense that I believe that there is a valid argument to be made that what has happened in B.C. and is demonstrated in the table that was presented is that there is and there should be concern from the Minister of Health's perspective on the turnover of home care service workers.

As a result of privatization for profit, we are going to see a higher percentage of turnover. We believe that to be the case. The Minister of Health appears not to believe that that is the case. Unfortunately, the Minister of Health cannot provide us with any information whatsoever to justify that that is not going to be the case.

So I would jump to the conclusion that I have jumped to in many other questions that I have posed to the Minister of Health. I once again would leave it with the Minister of Health, and that is, if the Minister of Health wants to do what is in the best interests of quality home care services today and tomorrow, what the Minister of Health needs to do is, he has to agree to a 12-month moratorium, allow for the proper consultation so that a better decision can be made, because there is absolutely no information that the Minister of Health has provided us to indicate whatsoever that the direction that his government is choosing to take home care services is in the betterment of the clients, not only for today, but well into the future. We find that that is, in fact, most unfortunate.

If the Minister of Health would do the right thing and agree to some sort of moratorium, that would allow him to do what he should have done in the past, and that is to consult the people who know what needs to occur in order to enhance the quality of service, not to take it down. Ultimately, what the minister is proposing will do that.

Mr. McCrae: I thank the honourable member for his comments.

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Mr. Steve Ashton (Thompson): I want to speak on the Minister's Salary to, first of all, indicate my own disappointment of some of the things we have seen in recent months and particularly coming from this Minister of Health. What has been happening is unfortunately not an isolated incident, and there was a bit of a precursor to this. I want to put this on the record because I had attempted to work co-operatively with the Minister of Health on a number of issues in my constituency, and he even attended a meeting in my constituency just shortly after he was appointed minister. In keeping with that same spirit, during the lockout, the hospital support staff in Thompson, I contacted the Minister of Health, along with the mayor of the city of Thompson and the city manager. The minister will remember that discussion.

What was interesting is that much of what the minister said at the time was the same kind of rhetoric he later used in regard to the home care situation and home care workers. What he said was, how can anyone call themselves a caregiver if they withdraw their services? This was very interesting because, in that situation, what had happened was that the employees, the 85 support staff at the Thompson General Hospital, had been locked out by their employer, but that did not stop the Minister of Health from spending most of the time that we had hoped to discuss ways of solving the problem, for the minister continuing with this kind of rhetoric.

Mr. Chairperson, I think it is unfortunate again that when we got into the home care situation, we saw much of the same kind of rhetoric. The minister made comments in the press of a very similar nature. The minister then, in an attempt to relive a situation in 1987, when he was ejected from the House for comments, made comments about bombs and slashing tires and saying that this is what the NDP stood for. Those kind of comments have no place in this House, but, you know, beyond that, I think a very serious question has to be raised of how a Minister of Health, who has to deal with the public, users of health care and health care employees, can deal in a good faith manner while at the same time making those kind of attacks.

I find it very ironic that today, this is the first time in about a month that we have not heard the Minister of Health, in response to a question, get up and talk about union bosses or get up and attack home care workers, as he has done on a continuous basis for the last month. Is it not amazing? There is a tentative agreement now; well, all that rhetoric has been pulled back.

Mr. Chairperson, I ask the question because I really think this is important for the people of Manitoba to look at, whether we had to have the kind of situation we have had the last month. Did we really have to have the situation where home care workers felt they had no other choice, remembering that through their own Treasury Board document, the government had signalled very clearly its intent to privatize? They felt they had no other choice than to fight back.

Mr. Chairperson, there has been a lot of impact on people throughout this province, and I really wonder if a lot of this has not been driven by some very personal agendas of members opposite. I mention the Minister of Health because his comments on the record were absolutely unacceptable. We have another dispute with the Minister of Education (Mrs. McIntosh), which seems to have upped the ante in quotes, who yesterday made reference again, and, by the way, I have had similar comments made to me privately by the Minister of Education.

By the way, to the member, it is very relevant because it shows what happens when you get your own political blinkers in the way of dealing with the good of the province. We have a Minister of Education, who is making dramatic changes to collective bargaining for teachers, we have a Minister of Health who has to sit down and try and work with the health care workers, who are making personal and direct attacks, not only against those workers but us, as New Democrats, for doing what?

We were accused of all these various things, including by the minister yesterday, for doing what? We were accused of all these various things, including by the minister yesterday, for doing what? For saying that we supported the fight and we are part and parcel of the fight against privatization.

I said to the minister yesterday and I said this to the members of the caucus opposite, we had a lot of very courageous people. You can take whatever side you want and you can throw whatever rhetoric out that you want, but when you walked by a lot of the people who were out in front of this building on a regular basis fighting for what they thought was right, something you disagreed with, I am talking about the home care workers, I really wonder how you could have looked them in the face. How could you look them in the face and then go to the press scrum outside of this Chamber or in this Chamber and then make the comments about the union bosses and the comments about not being caregivers because they were walking the picket line?

Mr. Chairperson, this minister has to understand that there were one million Manitobans who have diverse views, come from diverse backgrounds. No one in this province can exclude the democratic right of workers to unionize if they so wish and to take a stand, as the home care workers did. That is democracy. This is what makes Manitoba a great province. We have that ability to do that.

(Mr. Chairperson in the Chair)

What I found interesting was the experience of some of the home care workers I talked to, because many of the home care workers I talked to come from countries where democracy is not something you take for granted. I know. We have seen the waves of people throughout the world who set up people's movements, who fought against dictatorships, who fought for democracy, and I really wonder what kind of message we sent to many people. I had this reflected to me from people asking, is this the way our democratic system works? When the people, and it was the people, not just the home care workers, not just the clients, the people of Manitoba who were so clear on an issue, when you have such disrespect shown for the political process by a government that breaks its campaign promises and then launches into personal attacks against union leaders, not bosses, union leaders democratically elected and on the workers themselves, I say, Mr. Chairperson, let us learn from this experience.

Democracy is not about having an election once every four years. Democracy is about the living, breathing exchange of ideas. It is about differences of ideas and, in some cases, very strong disagreements.

What I say to the Minister of Health is that he should reflect upon this because, even though he may not have had any sympathy with the home care clients and the home care workers who took a stand, he should at least, I believe, have shown more respect to the home care workers and the clients than he did on numerous occasions.

I understand that the minister has had a very long record in this House, a vendetta against many organized workers in this province. It goes back to the mid-1980s. I am not going to relive those debates, but we have to put that aside at times. We have to put aside some of our differences, even some of our own personal agenda and work for the betterment of the province.

That is why I want to say we moved a motion to reduce the minister's salary, and in a few moments when we are dealing with the Minister's Salary, we will regrettably have to vote against the minister's salary. I regret this because I remember the Minister of Health (Mr. McCrae) a few years ago being a far more co-operative individual. It just seems sad that we have gone through this whole wrenching experience that we have gone through this past month which hopefully soon will at least partially be resolved with a tentative settlement.

I believe that if this Minister of Health and this government had shown more respect for the courage and dignity of the clients, yes, and the home care workers for what was a very difficult decision that they took, first of all, we would not have had the strike situation develop in the first place. Second of all, it probably could have been resolved a lot sooner. I believe, thirdly, Mr. Chairperson, perhaps most importantly, we could have had a real discussion on the real issue that they took a stand on, which was the privatization of home care.

We believe that discussion will continue. Quite frankly, it will continue into the next election if the government does not change its course. One of the first things, I am sure, that the next NDP government will be doing will be getting rid of the privatized vision of health care that is being put forward by this minister.

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We are one million people. We are a small province. We have a tradition of tolerance, and we have a tradition of agreeing to disagree and respecting our democratic right to do so. I say to the Minister of Health, one of the reasons we will be voting against the minister's salary is because he has in the last period of time not shown that kind of respect to many Manitobans who disagreed with him. We are going to say, and the only way we can today, Mr. Chairperson, by voting against his salary that that simply is not good enough.

Mr. McCrae: Mr. Chairman, in his usual eloquent fashion, the honourable member for Thompson has today placed a big fat juicy worm on the hook for me, and today in light of all of the very positive developments, I am simply not of a disposition to bite.

Mr. Doer: Mr. Chairman, I just want to make a few comments, potentially closing off, of course, the line dealing with the Minister's Salary. We have already placed a motion before the House, to dramatize our concern for home care workers, for the minister to take a 40 percent wage cut. It is the kind of symbol that we think is important, and the kind of message we think is important to the minister, not for personal reasons, but for professional ones. The minister's original Treasury Board plan to contract out all across the city of Winnipeg, a plan now that seems to have no author, no owner, no parent, is drifting out there with the Minister of Finance (Mr. Stefanson), the Minister of Health (Mr. McCrae), the Premier (Mr. Filmon), Jules Benson.

Of course, it was a broken promise. It was not what the government campaigned on. It is not the philosophy that you articulated in the campaign. It was not the ideology that you proposed to the people of Manitoba. You did not propose profit and competition in home care in the election campaign. Therefore, you had no mandate to proceed with this plan as articulated in the Treasury Board document.

This plan is both a disaster for our health care system and an economic message of the priorities of members opposite, a message that says to Manitobans that it is the philosophy of the Conservative Party, the Progressive Conservative Party, dare I use that term, and I should not. It is the philosophy of the so-called Filmon team, and I do not know whether everybody is on the team or not. It is the philosophy of the so-called team that the economic vision of the members opposite is sort of the ultimate extreme example of trickle-down economics where four individuals, some of whom are close to the Minister of Health, would get potentially millions of dollars through the profit in home care while 3,000 people, at least, in Winnipeg would receive a 30 percent to 40 percent wage cut.

What does that mean for consumer confidence? What does that mean for an economic vision? What is the kind of philosophy behind this in an economic sense as well as a health care sense? It is wrong. It is an agenda of greed, an agenda of greed that we totally reject. It is an agenda of profit in health care which we totally reject, and we have been proud to work with the workers and the clients in home care and the public in home care because the public has totally rejected your vision of a profit home care system. They have totally rejected, across all political lines, your vision.

Of course, the government can pretend one thing and pretend another; but if you drive through River Heights, as I am sure the member for River Heights (Mr. Radcliffe) does every night, if you drive through Tuxedo--I have even seen home care signs on Park Boulevard, and I know there are no voters for the NDP on Park Boulevard that I know of. Thousands of signs in Brandon West--[interjection] Well, you cannot be too sure now because some people are saying to us now that we were Tories and we voted Tory in the last election, but these people and this Minister of Health (Mr. McCrae) and this Premier (Mr. Filmon) remind us of Grant Devine, a scorched-earth philosophy and scorched-earth policy to burn down all the things that mean something to our communities, a scorched-earth Brian Mulroney policy that has no place in that kind of community.

I drove down Kingston Crescent on Monday night, and you know what? I drove from the Osborne Bridge, where it curls around the Canoe Club, to St. Mary's. There were all kinds of home care signs. I was on Kildonan Drive last evening, and, you know, it was a relatively good poll for the present member for Rossmere (Mr. Toews), the soon-to-be former member for Rossmere. Home care signs all down the streets, and they were Conservative homes, Liberal homes, undecided homes, nonpolitical homes, a New Democratic home or two, all with home care signs on those areas. You could go on and on and on.

The public of this province has totally rejected the vision of the Minister of Health (Mr. McCrae) and the Premier (Mr. Filmon). Now, this is not the first time this minister has blown a huge major public issue. Remember the promises on the emergency wards. Remember in the election campaign, we are not going to close the emergency wards of our hospitals. I use those hospital wards, he says. He lowers his voice and says, I use those wards myself. We are not going to close them after the election.

Of course, in September of 1995, another broken promise from the Minister of Health. But did they have any plan in place? Did they have any strategy in place? Did they have any people in place? Did they have any studies in place? Just like in home care, they did not have the public with them; they did not have the studies with them; they did not have any people that were working with them.

The emergency wards is the same situation. No plan. No strategy. No idea of breaking your promise. Then the minister limply or regrettably comes back to this Chamber with really weak comments in November and says, oh, we are going to reopen those emergency wards in our community hospitals because holidays are coming. Do you not know that holidays are coming? We have a Minister of Health that is responsible for the stewardship of a $1.8 billion department, and he does not know that Christmas is coming in November. This does not give us any cause for any confidence, regrettably, for the health care department.

Pharmacare, home care, emergency care, rural health care--the member for Swan River (Ms. Wowchuk) two or three days in a row had to point out that you do not build incentives into a community-based health care system in rural and northern Manitoba by reaching in and grabbing the surpluses that they had produced over long years of volunteer work.

That just deals with a few of the items. We started this week off again with the Health Sciences Centre, another broken promise from the Minister of Health. What are they saying in Winkler and Morden about the hospital that was scheduled to go into Winkler and Morden? The two communities came together to build a hospital in a growing area of south central Manitoba, another broken promise from the Minister of Health.

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The Health Sciences situation is now, according to the devastating report, critical. Emergency wards, operating rooms for both children and adults are in critical working condition. We believe that this Minister of Health is no longer able to fulfill the duties on behalf of the people of Manitoba. We believe this Minister of Health is not fit for the task.

The people of Manitoba deserve better, and, regrettably, we will have to vote against the minister's salary because we must oppose the broken promises and lack of vision in a profit government for our health care and for our future. Our children, our grandchildren, our grandparents, our communities, deserve better, and we will vote for a better future, for a better health care system and against this scorched-earth policy of the present Minister of Health. Thank you very much.

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

The question before the committee is Resolution 21.1 Administration and Finance (a) Minister's Salary. Shall the item pass?

Some Honourable Members: No.

Voice Vote

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

Some Honourable Members: Yea.

Mr. Chairperson: All those opposed, please say nay.

Some Honourable Members: Nay.

Mr. Chairperson: It is accordingly passed.

Formal Vote

Mr. Steve Ashton (Opposition House Leader): I request a recorded vote.

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

Both sections in Chamber for formal vote.

Mr. Chairperson: In the section of the Committee of Supply meeting in the Chamber considering the Estimates of the Department of Health, a formal vote was requested on the item 1.(a) Minister's Salary.

A COUNT-OUT VOTE was taken, the result being as follows: Yeas 27, Nays 24.

Mr. Chairperson: The motion is accordingly carried.

Mr. Doug Martindale (Burrows): Mr. Chairperson, I was paired with the honourable Minister of Natural Resources (Mr. Driedger). Had I not been paired, I would have voted against the motion.

Mr. George Hickes (Point Douglas): I was paired with the Premier. Had I not been paired, I would have voted against the motion.

Mr. Chairperson: This section of the Committee of Supply will now consider the consideration of the departmental Estimates. We are on the resolution.

Resolution 21.1: RESOLVED that there be granted to Her Majesty a sum not exceeding $6,009,300 for Health, Administration and Finance, for the fiscal year ending the 31st day of March, 1997.

This completes the Estimates of the Department of Health. The next set of Estimates that will be considered by this section of the Committee of Supply are the Estimates of the Department of Labour.

The hour is now 5:10. What is the will of the committee?

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Hon. Jim Ernst (Government House Leader): Mr. Chairperson, if we could adjourn the Committee of Supply and seek leave to call back the Speaker, I could then change the Estimates schedule for tomorrow, which is in the best interest of everyone, I believe.

Mr. Chairperson: Is there leave to recess the committee for five minutes to call back the Speaker to deal with the order of the Estimates for tomorrow? Leave? Leave has been granted. Call in the Speaker.

* (1720)

IN SESSION

House Business

Hon. Jim Ernst (Government House Leader): Mr. Deputy Speaker, earlier today, I announced a schedule for the third committee for Estimates that will sit starting at 9 a.m. tomorrow.

At that time, I had announced Urban Affairs, Culture, Government Services and Status of Women, in that order, for tomorrow. I would like to change that order now and delete Urban Affairs and replace it with Energy and Mines. Culture would remain. Government Services would start in the afternoon, and Status of Women is removed.

Mr. Deputy Speaker (Marcel Laurendeau): Is that agreed to? [agreed]

Mr. Ernst: I move, seconded by the Minister of Education (Mrs. McIntosh), that Mr. Deputy Speaker do now leave the Chair and the House resolve itself into a Committee of Supply.

Mr. Deputy Speaker: Order, please. There cannot be a motion moved twice in the same day. All we need is leave to go back into committee.

Is there leave for the House to go back into committee? [agreed]

Mr. Ernst: I believe that there may be a will of the House to call it 5:30.

Mr. Deputy Speaker: Is it the will of the House to call it 5:30?

Some Honourable Members: No.

Mr. Deputy Speaker: No, there is no leave. We will be starting with the consideration of the Department of Labour.

COMMITTEE OF SUPPLY

LABOUR

Mr. Chairperson (Marcel Laurendeau): Is it the will of the House to call it 5:30, by the committee, I mean?

The hour being 5:30 p.m., this committee is now recessed until 9 a.m. tomorrow (Thursday).