On Wednesday March 24th, I spoke at the Manitoba Legislature on Bill 10 The Regional Health Authorities Amendment Act, a bill which establishes the organization Shared Health. My comments (from Hansard) are below.
Bill 10–The Regional Health Authorities Amendment Act
(Health System Governance and Accountability)
Hon. Jon Gerrard (River Heights): I want to talk about Bill 10 and the ramifications of this bill. First of all, this bill, with only minor modifications since, was first introduced December 2nd, 2019 – a year and a half ago, roughly, now. It was debated at second reading last year, but then the government decided that it was going to take June, July and August off, and so the bill sat there.
This is an important bill, and it has taken five years to get to this point from where we are now. One has to ask why this government took so long.
Now, I'm going to address several things: first of all, CancerCare Manitoba and concerns that the CancerCare network–especially the network as it now organized–will suffer. CancerCare has been unquestionably the best specialist network that we have.
It has got outreach centres around the province. It is organized well so that there are centralized epidemiology and research and forward-planning, as well as the clinical care organized so that while the protocols can be set up centrally, a lot of the care can be distributed all over the province and carried out all over the province under very high standards.
I am concerned whether CancerCare will be able to adequately continue in the future. I hope so. I hope, in fact, that the organization of CancerCare can, in fact, be a model for some other specialist networks around the province to be able to deliver care.
Second I want to talk about the relevance of the principle of subsidiarity, and that is that actions, management, care be looked after at the level where it is most appropriate to look after it. And we see that there are certain functions which need to be done at the provincial level: procurement; specialist networks, looking after them; some emergency services; following up on medical errors; having an oversight with regard to research provincially and provincial prevention services. That is the framework for the delivery of prevention services in an effective way.
The government has set up Shared Health to do this. This is, in fact, an additional layer of bureaucracy. They continue to have the regional health authorities, as well as the local community hospitals and care homes.
What we believe it would be smarter, instead of another layer of bureaucracy, that the Manitoba Health directly deliver those services which are critical provincially and that, rather than have the requirement, as we have now, for the regional health authorities, that there could be much more local control with local hospitals and local care homes under the framework provided provincially to ensure high-quality care. So we see that the government has actually increased the level of bureaucracy in Health, rather than decreasing it rather than streamlining it, and we're sorry that that's what the government has chosen to do. Even as they talk one way about reducing bureaucracy, they continue to increase it.
I want to talk a little bit about what happened under the COVID pandemic. There was clearly poor preparation for the second wave, that the organizational structure was not as good as it could have been. The attention to preparation for the second wave was nowhere near what it should've been. I see good clinical research in hospitals, in intensive-care units, going on in Manitoba, but I don't see the preventative research, which could have helped a lot, being followed up and performed with a central view as to ensuring that the options for improving prevention were thoroughly studied, investigated and implemented here in Manitoba.
We had huge problems in personal-care homes. The standards for personal-care homes were not what they should have been. That is partly the fault of the NDP government over many years and partly the fault of the Conservative government which didn't pay attention to personal-care homes and ensuring that the standards and approaches to having people work in personal-care homes were there in a way that would have been much more effective than has happened.
We think that the government has a long way to go in terms of improving the situation in personal-care homes, and that is something that we'll be watching very closely, including, as my colleague, the MLA for Tyndall Park, has proposed and has been a long-time advocate for many years for a seniors advocate in the province. We had a forum just last night, in fact, talking about the steps that need to be taken to really get this implemented well, including a virtual Zoom meeting which involved BC's seniors advocate to help us better understand the situation there.
There is clearly a need to make major strides in mental and brain health, including addictions. The situation at the present time clearly leaves a lot to be desired. There are long waits for detox because there isn't adequate service in this area. There are big gaps in helping those with addictions.
The situation with eating disorders is that the wait times are very, very long at the moment. And, clearly, the government has not been very quickly responsive in this area. One of the things that you really need to do is to have a government which is going to be able to respond as a situation changes, and eating disorders–not just here, but elsewhere–have increased, and yet the government has not provided an approach that would address this. And so instead of it being well addressed and people being well served, you have long, long and longer wait times–I think about two years at the moment.
So there is a lot to do in mental and brain health and addictions. It is, of course, a challenge for the new minister, and I wish her well, but I was disappointed that the overall Minister of Health, the MLA for Tuxedo, was not better able to provide details of, who within Shared Health was responsible for mental health and addictions and brain health, and more about the organizational structure and how this was working so it would actually solve some of the critical issues which exist today.
When I spoke a year ago on this bill at second reading, as it was then, I mentioned that there had been a young lady who had died as a result of suicide - Taylor Pryor. We're still waiting for a report and some major changes to health care as a result of the unfortunate things that happened in her care, and I hope that will be forthcoming and that the minister can release such a report in the near future to let us know what is happening.
With those comments, I look forward to this moving on. We will not support it because we don't believe this is the right approach.