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Health Estimates Questions Wednesday April 4 - Closing of laboratories in medical clinics, Grandview ambulance station, Telemedicine

Hon. Jon Gerrard (River Heights): Just a couple of points of information for the minister to start with.
Meth Crisis St. Theresa Point
      When I was up not long ago in St. Theresa Point, there were a lot of attention being paid to the meth crisis, a lot of posters in the–near the Northern food store. And they were obviously designed and done by the kids themselves, so this is something that they feel very passionate about and I thank the minister for his interest.
      I believe, last night, they [the youth walking from St. Theresa Point to Winnipeg] were in Grand Rapids. They're walking about 5 kilometres an hour. It's not clear precisely when they will arrive, but it might be later tomorrow or it might be Friday, or if things are not as fast, it might even be Saturday. But I think there'll be an attempt to keep your office up to date in terms of exactly where they are.
Cystic Fibrosis
      Second point of information has to do with people with cystic fibrosis. As we've been discussing, there were 51 people, I believe, who were under the special drugs program. Figures that I was given was that the total number of adults with cystic fibrosis was about 57, I believe. So that, in case of the cystic fibrosis, the large majority were actually covered under the special drugs program. And, in fact, that's not too dissimilar from what is happening in other provinces where most other provinces have a cystic fibrosis special drug program.
      I want to thank the minister for extending for six months the coverage for those with cystic fibrosis. It at least is a recognition that this is a significant issue which people with cystic fibrosis need a little bit of time to adjust their personal finances so that they can plan. I know, for example, it was one individual who had immediately decided, as a result of the change, to move to a lower cost apartment because he would not be able to afford it and had, at the same time, decided that he would have to postpone his wedding for a year because of the changes until things got sorted out and he could figure out exactly where they were going to be financially.
Closure of Laboratories in Doctors' offices
      My first question is actually related to the laboratories in doctors' offices, and this is an issue which I've raised in petition and question period, and I know that the minister commented in the Free Press that his officials were going to be meeting with Dynacare and that this was an issue that he had some interest in seeing what could be done. And I wonder if the minister has an update in terms of the status of this issue of the many labs which were closed which are in doctors' offices.
      And this, clearly, has, you know, significant ramifications for a number of physicians' offices where traditionally you see a doctor, then you get your blood drawn and then you   wait for the results. But now, under these circumstances, somebody will have to be seen by a physician at one place and then go to another place to get their blood drawn for all these clinics where the labs have closed.
Mr. Goertzen: Now I thank the member for raising the issue. I mean, he'll know, of course, that, you know, there's some issue of private labs being purchased and then, you know, this isn't something that the government has a direct involvement in always, and that this isn’t unusual in other places in   Canada. And we've seen this happen in Saskatchewan; we've seen it happen in other provinces as well where there's–there is some of this consolidation and I think, you know, recognizing that there's inconvenience that can be involved with individuals.
      We also, you know, had heard situations where, you know, there were two labs sort of sharing the same parking lot, they were that close together and so, you know, there are some, you know, decisions that are made that are really just based on efficiencies, but then others, of course, can be challenging for individuals if they have a particularly long way to access a clinic.
      And so my understanding is that officials did meet with Dynacare and there was some of the different discussions about the concerns that were raised, some that were raised by the member himself and others that, I think, were raised specifically at the Dynacare locations. I understand from officials that we were supposed to get a report back on those discussions either today or tomorrow and, you know, I'm happy to update the member on that in the next few days, either at committee here or if he wants to speak to me individually. My expectation is we'll be here for at least one more day, according to my friend from Minto, so we'll–we can certainly update him either on the record here or individually if he chooses.
Mr. Gerrard: I thank the minister for that update. Yes, it is a significant issue and I look forward to hearing what the next step is and how that's going to be–what's going to happen.
THERE WERE ALSO LATER COMMENTS DURING ESTIMATES
Mr Goertzen 
So, to try to close the loop–not entirely, but somewhat on the last question, my friend, my long-time friend from Morris, the MLA for Morris, I guess had taken a picture at the Dynacare lab in La Salle, his home community. And I'll just read the picture now. So this isn't an official channel that we're getting this through, but I'll trust the picture for being what it is.
      Dynacare will be reopening the lab here at La Salle Medical Centre. The new lab hours will be Tuesday and Thursday, 9 a.m. to 3 p.m.
      So that's from the member for Morris (Mr.   Martin), who's angling to be the deputy minister of Health, I think, but the–we appreciate–I appreciate the information that he's provided.

Mr. Gerrard:  I thank the minister. I'm glad to see that there has been some response to the concerns about the situation, at least in the laboratory in La   Salle. That was one which was particularly problematic because if the laboratory was not there, they might have had to go quite some significant distance, so I'm pleased for that progress and I hope that the other sites will be looked at more carefully.
      One of the concerns, clearly, was that in creating a monopoly that the government needs to make sure that it's not an exclusive monopoly granted and that the labs or medical clinics would have alternative options in some fashion if Dynacare did not decide to reopen their labs.


The Planned Ambulance Station Closure in Grandview
      One of the other issues that the member has known that I have raised a number of times in the Legislature is the future of the ambulance service at Grandview, and I have been there several times now to talk with people to understand the situation and get an appreciation for the different members of their health-care team and how it is important that the paramedics are part of that team and that the community of Grandview is working closely with the community of Tootinaowaziibeeng.
Mr. Chairperson in the Chair
      So I would just ask the minister if he has any update on the situation of the Grandview ambulance service.
* (16:50)
Mr. Goertzen: You know, in terms of Grandview, and I'll speak, you know, maybe more generally around the issue of the Toews report and moving ahead on what I see as providing a better, more predictable service in Westman generally. This is an emotional issue, as every issue is in Health, and it is often tied into many different things–a sense of community, a sense of safety–and I understand all of that.
      I hope that this budget, which I know the member didn't support, but I hope that this budget demonstrates, through our commitment to hire 60 new paramedics–and we'll announce the location of those paramedics, I think, relatively shortly–but certainly, you know, Westman would be a benefactor of many of those paramedics, that it is about providing that predictable 24-hour service from highly trained paramedics.
      Now, the active deployment or the geo-posting, whatever you want to call it, that's done out of the 911 centre–which I think the member's probably seen, and if he hasn't seen it, I'd be happy to set up a tour for him at the 911 centre to see where the deployment happens, so that the ambulances are being posted in positions, maybe not sitting in a garage, but where they're most likely to get a call from.
      And so sometimes, and I'll hear this from my own constituents that see an ambulance sitting at a gas station, and they go, well, why is the ambulance just sitting at a gas station? That seems like a waste of time and resources.
      Really, that ambulance is geo-posted, because the expectation is based on past data, that they're most likely to get a call from there or from near there, so they can quickly deploy and be there. The idea of ambulances sitting in garages isn't the way we do things anymore. And we get, you know, better response if we have enough paramedics doing it through this sort of active and rapid deployment. So the hiring of new paramedics, the fulfilling the recommendations of the Toews report, is a big part of that.
      But I know it impacts in communities differently, individually. Now, Grandview might very well see an ambulance geo-posted at that location as often as not, because of the data and because of the numbers, but that doesn't mean the change is ever easy in these situations. But I would hope that people in Westman generally would believe that it's based on data and evidence.
      And if they don't believe me, and sometimes–you know, I think my friend from Minto used the   word suspicious before–people be suspicious about  politicians. And I understand that. But the paramedics themselves are out there saying that this is important and we need to act on the Toews report. And not to be overly political, but the member himself, the member from River Heights said that in this House not long ago, that he chastised the former government for not acting on the Toews report, not acting quickly on it.
      So I get it, that there's a political issue, and the member wants to raise it, and that's his job. I'm not being critical of that. I spent a lot of years in opposition. I get what the role is and I admire him for the work that he does in that.
      But in an overall view, on an overall picture, when it comes to the EMS review and what's happening in Westman, we do believe that this is   better for the communities as a whole. The paramedics believe it, the evidence shows it and we hope to prove it out as we hire more paramedics and people see their level of service not just maintained but enhanced.
Mr. Gerrard: The issue of Grandview–yes, I know that the people in Grandview have put forward a strong argument that it would be advantageous to have extra paramedics positioned in Grandview and that that would serve that region very well and I just welcome the minister's approach, using evidence, because I think that there is substantive evidence which would suggest that Grandview would be the strategic place to post ambulances and that's something that we can follow up on.
Telemedicine
Mr. Gerrard:      One of the things which was pointed out when I was in Grandview recently was that the situation of telemedicine, which they have in Grandview, could be improved if there was more access to specialists in Winnipeg when the specialists were needed for helping physicians in Grandview, and I wonder what the minister is doing in terms of working with specialists in Winnipeg to get more access for people in rural areas like Grandview–it really applies to the  whole of the province–to access to specialists, because this would clearly be a positive thing and it would enable some reduction, for example, in the number of people who have to travel to Winnipeg, because if you have immediate access by physicians to specialists through telehealth in places like Grandview, you're able to get things solved without necessarily having to have people come into Winnipeg.
      So I'm interested in the minister's comments on that.
Mr. Goertzen: I mean, I think it's one of the issues, you know, that will be tackled somewhat by Shared Health, and it's one of the reasons why Shared Health, which is now a two‑year‑old infant–a two‑day‑old infant, sorry, having officially started that upon April 1st. I don't want to heap too many expectations on them yet, but, certainly, I know that that is one of the things that they're looking at more broadly in terms of, you know, how can we co‑ordinate services well through the province. They're examining that from a rural perspective in particular.
      There was some discussion about that within the wait times task force as well, but I do think that that's part of the work that'll be looked at.
      You know, we've had success when you look at rural Manitoba in having teams of doctors sometimes do a bit of a rotation in certain areas. That's worked well. I think that we've seen doctors, emergency room doctors, come down from Churchill and work at HSC at times for relatively short periods of time but to keep their skillset up, and the issue of telemedicine is one where I think we could probably do more work in and more advancement, but I do think that that's something that Shared Health, as a relatively new entity, will be well equipped to look at, to break down some of those barriers that exist between regions.
      Now, regions will deliver their own services that they're mandated to do individually, but I do think that there can be more sharing of some of that  expertise when we have an entity dedicated, as   Shared Health is, to looking at some of these   province–problems from a province‑wide perspective.
Mr. Gerrard: I'll complete this tomorrow but give the minister an alert. I'll be asking about the situation of a doctor for Snow Lake.
Mr. Goertzen: I thank the member for the heads up. If he wants to let me know what he'll answering–asking in question period, I'll give him 10 more seconds to provide that too.
Mr. Gerrard: Tomorrow one of my colleagues has a question for question period.
Mr. Chairperson: The hour being 5 p.m., committee rise.

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