Bill 10 - an act dealing with certain health care issues and with the use of virtual meetings by corporations

On Monday March 7, I spoke on Bill 10 - which deals with various health care issues in Manitoba.  My comments (from Hansard) are below. 

Hon. Jon Gerrard (River Heights): Bill 10 is An Act respecting Amend­ments to The Health Services Insurance Act, The Pharmaceutical Act and Various Cor­por­ate Statutes.

      Let me talk first about several sort of house­keeping issues around the bill.

      First, in subsection 2(2) of The Pharmaceutical Act, the clause is added to show that nothing in the  act  prevents other persons from administers–administering and interpreting a COVID‑19 point-of-care test. We were told in our briefing that a point-of-care test can include not just a rapid antigen test, but also a point-of-care polymerase chain reaction, or PCR, test. One presumes that if this PCR test is more difficult to administer than the rapid antigen test, that there may be regula­tions provided which will further specify details of where these may be administered, by whom and what quality standards are needed.

      Secondly, in section 236(4) and 254(4), there is a part which deals by voting by ballot. Now, I asked during our briefing and I raised this in the questions to the minister, whether this wording meant or included secret ballot. I was told, yes. The minister, when I asked her today, didn't clarify this. But it seems to me that the bill would be clearer to the average reader if the word secret was added before ballot. Now, the word secret may be parti­cularly im­por­tant with respect to votes done virtually because special pro­cedures may be necessary to ensure votes done virtually are secret. This is part of the reason why I believe that the addition of secret is im­por­tant when we're talking about virtual as well as in-person meetings.

      Now, I want to make several comments about recent experiences with the Province in relationship to rapid antigen tests. During the briefing, I was told that require­ments that pharmacies only provide or sell rapid antigen tests to individuals who are travelling was waived in November or early December, so that individuals who were not travelling could get rapid antigen tests at pharmacies.

       I can indicate to MLAs that I'm aware of an individual being told on about January 6th that the pharmacy which was approached made it very clear to their customer who asked to purchase a rapid antigen test kit, that the tests were only available for in­dividuals who were travelling. At that point in time, the gov­ern­ment's stock of rapid antigen tests was only available to the general public in Manitoba at COVID testing sites and only available to individuals with symptoms. The individual in question had recently had a COVID infection, was now asymptomatic, but was required to get a rapid antigen test to show that the individual was negative in order to visit his barber. The individual in question had to wait until he had further symptoms, this time unrelated to COVID, as it turned out, before being able to access the test at the COVID testing site in order to get access to his barber. Clearly, the com­muni­cation with the minister's office to pharmacies in this instance in Manitoba was not optimal.

      Let me relate another recent ex­per­ience which illustrates this further. This relates to an individual who was at high risk because of age and other medical con­di­tions of getting a severe COVID‑19 infection and ending up in hospital or ICU. This individual recently tested positive and–for COVID and had symptoms and explored the possi­bility of getting the approved anti-viral drug, Paxlovid. This is a drug which 'contrains' two medically active ingredients with anti-viral activity: nirmatrelvir and ritonavir. The combination has been shown to drastically reduce the severity of COVID‑19 in individuals who are at high risk of severe COVID and, in parti­cular, in individuals who've not been vaccinated.

      Now, the individual to whom I talked, who is in high-risk category, explained to me what happened to her. She found out about the drug Paxlovid. She recog­nized she was at high risk. She was now at day four or five. After symptoms, she talked with her physician.

      Initially, her physician didn't even know what Paxlovid was. But on reviewing the literature, her physician decided it was ap­pro­priate to–for her to prescribe it–that it could be prescribed in Manitoba. And so her physician prescribed Paxlovid for her.

      She then called her pharmacy, where the physi­cian had called in the prescription, to ask about the Paxlovid. The pharmacy told her that they did not have the drug in the pharmacy. The pharmacy said they had then called Health Links to get more infor­ma­tion. The responder on Health Links was unable to provide any infor­ma­tion on Paxlovid or how a person could get treated with Paxlovid.

      The pharmacist then called Manitoba Health for assist­ance, and once again, Manitoba Health was unable to provide any infor­ma­tion as to where or how a person could receive Paxlovid.

      Now for those who know about Paxlovid, which is an im­por­tant antiviral drug effective against COVID, including the Omicron variant, one of the im­por­tant characteristics is that it must be given within five to seven days after the onset of symptoms.

      Now the person in question by this time was already at least four days after 'symson' 'onsef'–onset and she was anxious in part because she needed to get it quickly and in part because it was a weekend and she was getting des­per­ate not under­standing what was happening and why this drug was so difficult to get answers about.

      Now she called me and I was able to find out where the hard-to-link infor­ma­tion–almost secret, it appears–about getting Paxlovid was to be found. And things proceeded well from there.

      But once more, as this example shows, that com­muni­cation of the Minister of Health (Ms. Gordon) and her de­part­ment with pharmacists clearly needs to be improved so that pharmacists are aware of new drugs available for COVID and how these are accessed as well as aware about the latest rules with regard to rapid antigen tests.

      I bring up these issues because I believe it's im­por­tant that the minister is aware of ongoing issues related to individuals getting access to rapid antigen tests and that this is relevant to this bill because it deals directly–this bill does–with issues relating to access to rapid antigen COVID tests and to health care and to treatment related to COVID.

      Now, in this context, I want to talk briefly about other items which might have been included in this bill related to health care and which might have addressed some of the sig­ni­fi­cant concerns that exist today with the delivery of health care.

      Let me start by–several stories of dif­fi­cul­ties accessing health care and how these stories relate to the current bill and what it could have or should have had.

      I'll put these stories in the context of some recent comments. First, as many have probably read, Allan Levine wrote in the Winnipeg Free Press about health care in Manitoba. He said, and I quote: The cuts and closures of several Winnipeg hospital emergency rooms imposed by the Pallister gov­ern­ment before COVID‑19, all in the name of centralization and cost efficiency, have instead wrecked havoc and caused undue stress.

      We are all too familiar with some of these problems. This opinion was echoed, though with different words, in an article by Tom Brodbeck who wrote recently that the Minister of Health's de­part­ment appears to be grossly mismanaged right now.

      I can tell you that these sentiments are echoed in comments that I have received from those working inside our health-care system, and though–comments from individuals that I have encountered when I've been going door to door in Fort Whyte.

      Let me give several examples. First, Jean Hodgson and her son, Chris. Chris was Joan's–Joan Hodgson–Chris was Joan's primary caregiver. Joan and Chris were mutually supportive of one another. Joan, a senior, was transferred to Russell in January. Sadly, without her mother's support, Chris died. We know from Kate Hodgson, who lives in Vancouver, that separating Chris from his mother by transferring his mother, who was receiving health care in Winnipeg, all the way to Russell, hundreds of kilometres away, had had a major impact on Chris.

      As his sister said, Chris, who worked in health care as a health-care aide in a seniors home, had a difficult time physic­ally and mentally after his mother was transferred away from Winnipeg to Russell. Kate said taking people away from their support systems in a pandemic has a massive toll. She continues: Both my mom and my brother were critical supports to each other, and he definitely was doing worse when she was in hospital, and it was breaking his heart not being able to see her. I think there would be very different out­comes for both of these–both of them right now if it wasn't for COVID, and if we had systems that worked in a better way and funded in a much more robust way.

      It's to be noted that more than 300 Manitobans have been transferred to facilities outside their home com­mu­nities during the COVID‑19 pandemic fourth wave. Transferring individuals who need health care from hospitals in Winnipeg, or from hospitals in their home com­mu­nity, to com­mu­nities far away not only affects the individual who is transferred, but it also affects their relatives. And this connectedness, this human connectedness between people and among people, has to be recog­nized as critically im­por­tant in the well-being of individuals. And sadly, in the transfer of more than 300 individuals away from their home com­mu­nities to health-care in­sti­tutions elsewhere, this has been forgotten.

      Second, Sue Roberts was a retired nurse, indeed, the nurse co-ordinator for neonatal transport in Manitoba. She is waiting for spinal stenosis surgery. She needs this surgery to stop the fingers on one hand from further bending and becoming like claws. She's been waiting many, many months, and there continues to be uncertainty as to when she might be able to get this spinal stenosis surgery that she needs so badly.

      A third example: Glen Orvis. He is 84 years old. He has dementia. He was taken by ambulance last Thursday, March the 3rd, to Concordia Hospital. But because his wife was not allowed to join him in the ambulance to be with him, he walked away from the emergency room and was only found after an extensive search, hours and hours and nine kilometres later. He was lucky to be still alive.

      A fourth example, Clarke Gehman, aged 84, was transferred from Victoria hospital to the hospital in Russell, 340 kilometres northwest of Winnipeg, and then later to Reston hospital, 160 kilometres south of Russell. In Reston, he contacted–or, contracted COVID; tested positive for COVID on February 3rd, about three weeks or a little more after he'd left Winnipeg. His health deteriorated and he died in Reston on February the 11th never having been able to return to Winnipeg, the com­mu­nity he called home.

      Mr. Speaker, I submit that we have individuals who are dying because of these transport arrange­ments; that they are going to distant places. They are away from their loved ones–not only they, but their loved ones are suffering and this is not a situation which should continue. Indeed, it should never have started.

      There could have been additions to this bill to make sig­ni­fi­cant changes, for example, to emphasize that all possible steps should be taken to keep patients and their caregivers together. Secondly, that Manitobans should have a legal right to prompt access to care, especially if the wait will be associated with worse in short- or long-term health. Third, that the ap­pro­priate training about dementia to all health pro­fes­sionals who maybe encounter individuals with de­men­tia is needed, and that provision for caregivers of those with dementia to accompany patients with dementia is vital.

      I saw this several years ago with a dear friend who ended up going to hospital, and in the hospital he was separated from his caregiver. He had dementia. His caregiver was distraught and bad things happened which should not happened and which could easily have been avoided if his caregiver was allowed to go with him to X-ray de­part­ment and other places in the hospital–which did not happen as it should have happened.

      Four, clearly, before a patient is transferred out of their community, all other options including home care should be thoroughly evaluated before the trans­fer is made. We have seen examples where the patient could have gone home with home-care support, but, instead, was transferred hundreds of kilometres away.

      Five, that health-care in­sti­tutions have a respon­si­bility to ensure that the number of nurses and other health-care pro­fes­sionals doesn't fall below some number like 95 per cent of funded positions. We've got examples now where we've got vacancy rates of 10 and 20 and 30 per cent. This is completely not acceptable and is a further example of poor manage­ment of health-care resources, of people–poor care for staff and health-care pro­fes­sionals which is just as im­por­tant as caring for patients.

      There are but a few examples of items which could have been considered in this bill to better ad­dress some of the major problems in health care in Manitoba today. It's too bad that the minister and the gov­ern­ment didn't spend more time and do a little bit more work and bring forth a more fulsome bill than they did in this one.

      Thank you. Merci. Dyakuyu. Miigwech.