Mr. Speaker, I will be splitting my time with the member for New Westminster—Coquitlam—Burnaby.
I am pleased to speak to the health crisis in Canada. I want to speak from the Manitoba perspective. Having actively been involved with this issue for many years in Manitoba, I can certainly tell the House that Manitobans are not happy campers when it comes to their health care services.
The cuts from the federal government have had a huge impact on all the people of Manitoba. The whole health care system in Manitoba had to be reconfigured to deal with the drastic cuts the government made to the tune of about $24 billion in the early 1990s.
It forced the provincial government to centralize the health system. It is sad that this was forced upon the Gary Filmon government. Unfortunately it may have been one of the factors that cost him the last election because people are still angry about the health care delivery system in the province of Manitoba. As a result we now have a number of regional health authorities who are unelected and appointed by politicians. It is another political game which we have to put up with.
What did I do about this, going back six or seven years? At that time I organized a provincial health meeting with municipal and aboriginal leaders to deal with the health crisis. We had a forum on health. We asked the then Manitoba minister of health, Darren Praznik, to appear before the angry delegates and he did. He found himself in a very difficult situation. He had been appointed to that position about a month prior to the meeting.
Unfortunately all the municipal and aboriginal leaders attacked the province of Manitoba and blamed it for the problem, which in essence was wrong. I can see with 20:20 vision in hindsight that the blame should have been put squarely on the federal government. In fact, no one even wanted to hear that the problem was created by the federal government. Can you believe that, Mr. Speaker? We still need to place the blame on the government that created this problem in the first place, the federal government.
Today the problem still exists. People are still not happy with the system that is currently in place. There are still long waiting lines. There are still shortages of beds. There are overcrowded clinics. Doctors are overworked. In other words, we need to remind Canadians how this big problem started in the first place. It all started with the big cuts at the federal level.
I would like to talk about a client central health care system that exists in my riding of Dauphin—Swan River, the Hamiota District Health Centre. It has been around for at least 50 years.
How do we measure the health of a community? Do we look at the number of medical office visits and days of hospital care and assume that greater activity indicates better health? Or is the reverse true? Current priorities in Canada's health care system are contested by community health centres which nurture health as a positive attribute to be protected, restored and enhanced.
Medical health centres are not new. Most of the dozen or so in Manitoba are unique in scope, ranging from a single specialized service to the Hamiota District Health Centre, the classic example of a comprehensive integrated centre. Located in southwestern Manitoba, the HDHC has been around since 1974. It provides a broad range of services geared to community needs, limited only by available means.
I would like to pay tribute to Dr. Ed Hudson who in 1945 took over his father's practice in Hamiota. His father, Dr. E.D. Hudson, began his practice in 1907. Dr. Ed Hudson is still actively involved in helping to deliver quality health care. Between his horses and the health centre, he certainly keeps busy in his senior years.
The Hamiota District Health Centre began with a belief in the health centre potential for improved quality of care. The providers of that care know the satisfaction of delivering care programs that are effective but definitive assessment is difficult. An evaluation concentrating on results of programs is limited in scope.
The 1972 white paper on health policy states, “a health system must also be judged by the numbers of people who in fact never succumb to disease or accidents or social distress”. A method of measuring quality of care is elusive.
Cost saving efficiencies were envisaged. There is the co-ordination of care by many disciplines, resulting in decreased numbers of diagnostic tests, the pooling of supplies and equipment, and more efficient use of physical facilities. There is the ability to use the most appropriate care provider in patient care and the appropriate level of care for the patient. There is the freeing of physicians to use their time and expertise more efficiently in preventive care and health promotion to reduce hospital stays. There is the use of home care, mobile meals and support services to reduce hospital patient days. There is the economy of using only one administration and one governing board in an expanded system of care. There is the active involvement of the community in establishing support for the programs and identifying needs.
Thirty years of experience seems to support all these tenets. Controlled spending has to date precluded any unapproved deficits that would become the responsibility of the municipalities of the district.
The centre lacks the information and statistics required to do a self-evaluation or a comparative one, but has co-operated with governments in several assessment surveys and questionnaires. Results of research, if any do exist, have never been publicized.
Quite apart from statistics but evident to a visitor to HDHC is an atmosphere no one had predicted. Staff morale is exceptional.
The current position is to devote half a day per month to a strategy meeting to critically assess the role in terms of efficiency, effectiveness and goals. It is expected that gains in health care in the next decade will be in preventive care, with emphasis on nutrition, health promotion, physiotherapy and occupational therapy, as resources are geared to keeping people well.
The expansion of existing programs or the introduction of new ones in times of fiscal restraint are largely matters of trade-off between priorities. The flexibility of the system is conducive to change to improve care and to respond to community needs.
Turn of the century health care in rural Manitoba was delivered by the dedicated and selfless family medical doctor. As the century closes we find a burgeoning multiplicity of health disciplines in a tangled web of administration by government departments, subsidized public offices and private agencies. The system has grown without plan or co-ordination in an expensive add-on fashion which encourages health care professionals to concentrate on protecting the turf of their own specialty, competing for limited resources and denying any vision of total care.
One health worker suggests “I am sure if I were to start all over again in health care there would be no doubt as to the direction it would take. Interdisciplinary health care management would be the only way to go”.
Wishful thinking, you say, Mr. Speaker? Perhaps, but this small community in Hamiota, Manitoba, has found it to be possible. I would invite hon. members, if they have the time this summer, to visit this place to see how client-centered health care takes place.
I would like to close by quoting from a letter that was sent to me from the Council of Chairs of the Regional Health Authorities of Manitoba. The letter reads in part:
Every day, members of the RHAM see the serious effects that cuts in federal transfers are having on our national healthcare system. The significant decline of public confidence in our healthcare system is compelling evidence that Canadians feel the system will not be there for them and their families when they need it. Federal/provincial/territorial co-operation to build a truly accessible, integrated, client-centered continuum of care is essential to restore the confidence of all Canadians in our health care system.