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The Pallister government has no specific plan when it comes to addressing the diabetes epidemic in Manitoba.

Thursday June 21, I asked the Minister of Health in the Manitoba Legislature about the Pallister government's plan to address the diabetes epidemic, and specifically to prevent now cases of diabetes in Manitoba.  It is very apparent that the government does not have a specific plan, indeed does not have a preventive services plan for our province.  For more on the latter, see these links - link 1, link 2  Instead of presenting a plan, the Minister tries to put the blame the federal government.   In an area as critical as diabetes, one would expect to see more leadership from the provincial government.   My questions and the Minister's responses are below: 
Mr. Gerrard: Yes, thank you. There is a concern  also–and I'll just mention them without necessarily asking the question–about the orthotics funding being reduced, the–what's called a telecommunication subsidy in health care being reduced, but I'd like to come back now to one of the things that I did talk about earlier on, and that is a provincial preventive services plan.
      And the area that I would like to discuss is the area of diabetes, which is a major issue. We have far too many people who are developing diabetes in Manitoba. We have had–in the late 1990s there was a lot of effort put into a plan to address the diabetes epidemic, as it was declared, in 1996, I believe.
      But the number of people with diabetes in Manitoba has continued to go up and up. And I think that part of the problem has been the focus has wandered, that the–was even a central unit within the department related to diabetes was disbanded, and so I have a lot of concern about, you know, where the government, you know, may or may not go.
      And part of the reason for needing a preventive services plan is that there be people within–if it's a Shared Health responsibility–within Shared Health who are focused on developing this preventive services plan, including preventing conditions like diabetes and having–getting the results, measuring the outcomes, making sure that we know what works, what doesn't work and that we're measuring results.
      So I would ask the minister, what is going to be his approach with regard to a major, expensive, disabling condition like diabetes?
Mr. Goertzen: No question that Manitoba disproportionately has a challenge when it comes to diabetes. It's one of the issues that the Premier (Mr.   Pallister), I think, led when it came to discussions around the health funding negotiations, led that as a specific desire to get additional support when it came to diabetes in Manitoba. We had some success, but I think overall, of course, we're disappointed in the response from the federal government when it came to that particular issue around chronic disease and diabetes. The–quite apart from my disappointment in the federal government's willingness to engage in this.
      And I'm sure that the member opposite, the member for River Heights (Mr. Gerrard), has written to the federal government, has given specific correspondence to his colleague in Manitoba, the federal minister. I haven't seen any of it, but I'm sure that it exists, and I'm–I'd be happy if he would share it with me. I'd love to read it.
      But in Manitoba, certainly, we–despite the fact that the federal government has kind of vacated the field in that support more generally when it comes to health-care funding in Manitoba, we've taken a number of specific initiatives.
      Great research that's being–at Seven Oaks hospital. Met with a number of doctors of there in terms of their research, not the least of which was Dr. Paul Komenda, who I've had a number of different discussions with on the Manitoba renal team, and as–got some, you know, really strong ideas in terms of how we can continue to be a leader in research and in action–him and a number of doctors, a number of young and tremendously talented and gifted individuals doing work there.
      Part of that work is to look more towards home hemodialysis, which I know is more responsive than it is proactive, but nonetheless, we have a situation today that requires a great deal of dialysis when it comes to those who are dealing with end-stage kidney failure. And so the home hemodialysis program continued to work to ensure that there are people who can train individuals who are eligible for home hemodialysis, who would be a good fit for it.
      That means also training doctors to try to promote that as an option. Obviously people are often risk-adverse when given an option between doing something, you know, within an institution or doing something at home. They might just default to doing it with an institution, not thinking that they might be able to do the home hemodialysis, but where that training and support is available, and we're doing more to provide that training and support–it is almost universally, although entirely universally–but when we talk to people who've done home hemodialysis, they prefer it over having to drive to an institution and being in a facility for a number of hours going through their dialysis. They'd much sooner do it at home. And the outcomes are as good, and certainly for the patient it's better.
      So, there are a number of things happening on the preventative side, you know, looking at the research that's happening within Manitoba and being really one of the leaders, I think, in the world for that. We're talking about–or not talking about, we're actioning more work on the home hemodialysis side of the equation. And I spoke with the former minister of Health, Minister Philpott, after the summit in–on opiates in Ottawa, where I think some good action came out of that.
      That–we should do more of those kinds of summits because, you know, to be able to just bring in experts and talk about a particular issue in health for a couple of days isn't always afforded to Health ministers because we're off dealing with a number of different issues at times, but to concentrate solely on a particular issue, I found it to be particularly helpful, and I suggested at the time we'd be happy to see that kind of a summit hosted by the federal government on diabetes in Manitoba. And I still think that that would be a great idea, if he would like to speak to the new minister, Petitpas Taylor, I'm happy to add my voice to that again.
      But that would be something, I think, that would be a great learning experience for not just us but all provinces.
Mr. Gerrard: One of the problems, clearly, has been that, when we're looking outcomes, as the minister has often talked about looking at results, that the results with diabetes has been a steadily increasing number of people with diabetes from the   late 1990s when there was about 50,000 to something well over 100,000 people with diabetes now in Manitoba.
      And so this focus, which is needed, needs to look at, you know, not just where the dollars, or what dollars are available, but at the–how, in fact, things are going to be organized so that we will be evaluating, looking at results and moving forward, changing the direction of the curve from one that goes up to one that starts to come down in terms of the number of people with diabetes.
      So, you know, that, I think, is a particularly important aspect. And I would offer the minister an opportunity to comment on this question of, you know, outcomes and results when it comes to something which is a preventive approach or preventive need.
      What are his plans in that respect?
Mr. Goertzen: And certainly the member is not wrong when it comes to diabetes and variety of lifestyle changes that can either better the outcome for those who are dealing with diabetes or prevent it from happening–and certainly when it comes to type 2 diabetes.
      But–and I'm not one to give a lot of lectures when it comes to healthy lifestyles, and so I won't give a lot of lectures in the House on that. But I do know that, you know, there's been strong efforts, both provincially and to some extent nationally, in terms of, you know, looking at how we can provide a younger generation more understanding when it comes to the lifestyle that they have and the potential outcomes of that. And so whether that is issues around packaging or healthy eating, a lot of those efforts have happened, and sometimes, they can take years to see the result of.
      There's, you know, obviously, different areas of responsibility. There's responsibility for parents, of course, in raising their own children, but there's responsibility on the federal government's side as well. And the member will know that on-reserve, that is, you know, an effort that could be undertaken more strongly by the federal government, and I think that they have an understanding of that, and I hope that they'll be taking additional action.
      So it's no doubt an effort that is happening in Manitoba. I expect it'll be happening at the federal level where they have jurisdiction as well. And I think that there has been a lot of action taken when it comes to trying to promote a healthy lifestyle, often of which you don't see the results of for many years, of course, because you're sometimes speaking to a younger generation and hoping that the outcomes come from that.
      So, difficult challenges, not ones that aren't being taken on at the provincial and federal levels to some extent, but often those results take some years to see.
Mr. Gerrard: I thank the minister, and–but I would point the minister to an article which I tabled in a recent question period demonstrating that preventive approaches can have remarkably short timelines, under some circumstances, in having impacts. And so I think that the minister may talk about things being very, very long term, but there is an opportunity to begin thinking about shorter time frames for preventing conditions like diabetes and having an impact, and there's a need to do that.


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