LEGISLATIVE ASSEMBLY of MANITOBA Monday, 6 April, 1987. Ne
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LEGISLATIVE ASSEMBLY OF MANITOBA Monday, 6 April, 1987. Time - 8:00 p.m. Management and Analytical Services have now been transferred over to the Health Services Commission. CONCURRENT COMMITTEES OF SUPPLY Now, presumably, later on, when we get into the Health Services Commission and the administrative line there, SUPPLY - HEALTH will that be where we would be more appropriately able to discuss the - we hear rumors about an amalgamation MR.' CHAIRMAN, C. Baker: You were mentioning this of the department with MHSC. Now, we can wait till afternoon that we just sort of wanted to go through them informally, but can I take it that we are done, with 1.(b)(1)? HON. L. DESJARDINS: I suggest that maybe it would The Honourable Minister. be better when we attack mostly the Manitoba Health Services Commission. So on that line, when we start HON.~., ·L. DESJARDINS: No, Mr. Chairman, they suggest Administration of the Manitoba Health Services that they",e) would go all over it and then everything would Commission, that might be the best place. be passed at once, the whole resolution, so they can come back. MR. D. ORCHARD: Just a simple question then: Is this transfer of the .eight from Management and MR. CHAIRMAN: Will ii be resolution-by-resolution Analytical Services an indicator of the kind of then, section-by-section? Is that what you wanted? amalgamation that's going to happen? Is that our first step? HON. L. DESJARDINS: Well, this one anyway. let's see how this works. HON. L. DESJARDINS: No, because that's going to the Commission as well. In this sense, that we're trying MR. CHAIRMAN: Okay. to coordinate and not duplicate things, yes, in that sense. HON. L. DESJARDINS: The others, Mr. Chairman, it might be a little more difficult because there's staff MR. D. ORCHARD: Mr. Chairman, I want to spend a who I would want here. I wouldn't want to have people wee bit of time on Research and Planning before we running back and forth. move off that topic. Now Research and Planning over the past two or MR. CHAIRMAN: One resolution at a time, so we're three years have been undertaking a significant number dealing with Resolution No. 1 now. When we're done of reviews. I haven't had access to and I haven't seen with that, we'll pass it and go on to the next. a number of the studies that have been done, but Manitoba and Medicare Report was the one that was HON. L. DESJARDINS: Well, the others we might go probably one of the more comprehensive studies done by numbers. on the Manitoba health care system to give it a comparison basis to the system across Canada. I know MR. CHAIRMAN: Okay. I've gotten into this topic on two other occasions at this stage of Estimates. On other occasions as well, HON. L. DESJARDINS: In answer to one of the I've used information from Manitoba and Medicare. questions that was asked, I'll try anyway. I guess I'd have a few simple questions and - In the 1986-87 Estimates, the following branches were (Interjection)- Yes, I see there is a copy of it there. identified. There was Personnel Management Services, Going to such pages as 26 and 27, 27 particularly, Human Resource Management, Management and where you're talking unit costs, costs per patient day, Analytical Services. During '86-87 the following changes etc., and then in other areas, you compare the utilization were made which are reflected in the '87-88 Estimates; days per 1,000 of population and all the various charts, that is, Human Resource Management was and then of course you end up with page 33 with the amalgamated with Personnel Management Services and gross salary and wage cost per patient day. The basic is now identified as 21(1)(g) Human Resource question is: Have those gaps narrowed? Has this report Management, and Management and Analytical Services, been updated so you know whether the gaps have comprised of Systems and Computer Services as well narrowed, or has the trend to having a bigger spread as Internal Audit. During '86-87 Assistant Computer in cost per patient day, salary and wage cost per patient Services were transferred and amalgamated with the day, is that gap widening further in Manitoba compared Manitoba Health Services Commission. 21(1)(h) Internal to the rest of Canada? Audit remains with the Audit Division. HON. L. DESJARDINS: No, this has not been updated. MR. CHAIRMAN: The Member for Pembina. This would take another year or so. This, of course, is ammunition for recommendation. There is no MR. D. ORCHARD: Mr. Chairman, the Minister has recommendation. It's mostly facts and information that indicated that eight from what used to be presumably is needed. This was used very extensively by the Health 695 Monday, 6 April, 1987 Review Committee at this time. Now we're using that, same teaching hospitals were $6.04 or 11 .5 percent also we're very, very worried - I don't know if I mentioned below the national average - you've gone from 11 that last year, I know I mentioned it in some instances, percent below in '71 to 16 percent above in'82-83, the concern with the teaching hospitals. But we want even though you've got mitigating factors which should to make sure. It's difficult to make sure we're comparing say that Manitoba should maintain a relatively lower apples and apples and oranges and oranges, because average cost on salary, just because of the wage there are different setups in different jurisdictions. But schedules. So that sort of backs up, and I would there is a big enough difference that we know we have presume, led to the statement that in teaching hospitals concern on that. That is the teaching hospital mostly we use a lot more labour. that we are looking at on that. That is where I have my difficulty with the Minister Now as far as the staff, there is no doubt we felt and I've posed some questions to him this Session. that, compared to the private sector, the people were Because we have hospitals now that are developing underpaid, for a time were getting less pay a few years plans to come in with no deficits. In doing that, some ago and now they're caught up and they might be a of them are contemplating, as Brandon General Hospital little ahead of the private sector. Those are the people has already done, the closure of beds, of active employed in the hospital other than professionals. treatment beds. Now the Minister has got a policy imposed by his MR. D. ORCHARD: As I read the Manitoba Medicare Cabinet, presumably, wherein there are no-cut contracts Report, there are two things impacting and this is where in place, there are no layoffs that can be made. Now the Minister and I got into a mini debate last year and in Brandon Hospital what they're doing to get around I want to continue it again this year. Because if you that, as I understand, is there may not be any layoffs; take a look at page 33, table 5, where you've got the I think there's been one layoff in Brandon General gross salary and wage cost per patient day, you go Hospital. But what they are doing is they are taking down - and unless my arithmetic is out, but it won't · the part-time staff and a part-time staffer that may be out by very much - you've got a range in there for have been putting in 30 hours a week is now down, public general hospitals now being $12.22 a day to the for a figure, 20 or 15 hours a week. So there's no actual teaching hospitals being $39.04 per day above the layoff of individuals, but the number of hours are down national averages; whereas, you know, as recently as and that's the way the hospital is coming in. 1971, we were below the national averages in all of The point I'm making with the Minister is that if you those categories. expect hospitals to live within a budget that you are Now comment is made on page 38 where it says, now prescribing to them, that they cannot have a deficit, "Thus Manitoba hospitals paid less for their labour but you explained to us this afternoon that you're going used more of it, in teaching hospitals a lot more." Then to pick up some $11 million in the Budget base line further at the bottom of the page, the last sentence for the hospitals. says, "But while wages were moving towards national levels, paid hours per patient day and patient days per HON. L. DESJARDINS: Anyway, the second column capita, especially in Manitoba teaching hospitals, have been moving out beyond the national levels by a substantial margin. Now I appreciate that if you're not MR. D. ORCHARD: We won't get hung up on numbers, comparing - it's my understanding that when you're whatever the value of the second column was in your talking gross salary and wage costs, you're not only presentation this afternoon. talking your service unions, if you will, you're also talking nursing staff, support staff, you're talking management HON. L. DESJARDINS: If you include personal care staff, as well, and physicians. Now it strikes me as homes and rural hospitals, that might bring it to 19, being, particularly in the teaching hospital - and let's maybe that's what we're .