Monday, November 27, 2017

It is vital for Manitoba to reduce nitrous oxide if we are to reach our greenhouse gas reduction goals.

The most potent of the three major greenhouse gases is nitrous oxide.   It is 300 times more potent than carbon dioxide.   It makes up approximately 15% of the greenhouse gases produced annually in Manitoba, when expressed as carbon dioxide equivalents.   It is produced primarily as the result of the application of fertilizer containing nitrogen onto fields in Manitoba to help the crops grow.  Especially under wet conditions, the nitrogen applied is converted to nitrous oxide which is a gas and goes up into the atmosphere.  The conversion of nitrogen to nitrous oxide results in a loss of the nitrogen fertilizer for farmers and the production of a potent greenhouse gas which warms the planet.  Its importance is even greater when one considers that its residence time in the atmosphere is more than 100 years - usually given as about 112 years.

The NDP produced a climate change plan with a target to reduce greenhouse gases in Manitoba.  They failed to reach their targets largely because they forgot to consider agricultural emissions of nitrous oxide and methane.  Nitrous oxide production increased by 44% from 1990 to 2015 making it very difficult to achieve an overall reduction in greenhouse gases with such a big increase in nitrous oxide alone.

In their recently introduced climate change plan, the Pallister Conservatives similarly forgot to include nitrous oxide.  In fact, in their plan, they did not even mention nitrous oxide.  I raised this concern in question period today.   It was apparent that the Pallister government really does not know what it is doing when it comes to nitrous oxide.  This is sad, as there is benefit to farmers and to our climate from reducing nitrous oxide emissions and recent studies suggest there are effective ways to reduce the conversion of nitrogen to nitrous oxide to help farmers and our planet. For methods to reduce nitrous oxide emissions see this blog.

You can watch the video of my questions and the governments responses at this link - Manitoba and nitrous oxide production.

The full text of the exchange from Hansard is below:
 -

Agriculture Industry - Nitrous Oxide Emissions

Hon. Jon Gerrard (River Heights): Madam Speaker, the government's climate change plan completely ignores fully one third of Manitoba's greenhouse gas emissions, including almost all methane and nitrous oxide, which, of course, come from agriculture. In fact, nitrous oxide is never mentioned in the government's plan, even though reducing a single ton of nitrous oxide emissions is the equivalent to reducing 300 tons of carbon dioxide.
      Helping farmers reduce nitrous oxide emissions would be better for the environment and for farmers' pocketbooks. Can the Minister for Sustainable Development explain why the government is doing nothing to help farmers reduce the most potent greenhouse gas?

Hon. Eileen Clarke (Acting Minister of Sustainable Development): I thank the member opposite for that question. And our Auditor General clearly reported that in previous years, the NDP totally failed to meet targets that were so unrealistic that they would have required the equivalent of every gas- and diesel-powered vehicle off of the road. The Auditor General noted that there was a lack of progress in reducing greenhouse gas emissions as well as in developing a plan for adapting a climate change impact.

Madam Speaker: The honourable member for River Heights, on a supplementary question.

Mr. Gerrard: It's true the Auditor General's report was pretty damning in terms of what happened under the NDP. But at the same time, Madam Speaker, the NDP failed, in part, because they forgot about agriculture.

Mr. Gerrard: Now, the Pallister government unfortunately has more holes than Swiss cheese. It ignores working with farmers to reduce the most potent greenhouse gas, nitrous oxide, and to ensure it goes into the ground to grow crops instead of into the air to warm the planet. I table 18 different ways to reduce nitrous oxide more than 30 per cent. Reaching this goal would cut greenhouse gas emissions equal to heating every home in Manitoba or driving every car in our province.  
      Does the minister think that farmers don't care about the environment? 

Madam Speaker: Order.

Ms. Clarke: I thank the member opposite for his comments. I think our government has been really going to task, meeting and talking to people all across this province about climate change and our new plan. And farmers are very engaged in these conversations. We listen not only to our farmers but we listen to every Manitoban, and they have the opportunities to be part of this process.

Madam Speaker: The honourable member for River Heights, on a final supplementary.

Mr. Gerrard: Sadly, nitrous oxide was not even mentioned once in this government's climate change plan. In fact, nitrous oxide, which is 300 times more potent as a warming agent than carbon dioxide and persists in the atmosphere for more than 100 years, is pretty important. On the NDP's watch, though, it went up by 44 per cent.
      This government talks about value for money. Now, reducing nitrous oxide would provide the biggest bang for their buck.
      Why is this government once again following in the footsteps of the NDP and ignoring one of the most effective and inexpensive ways to combat climate change?

Madam Speaker: The honourable minister of indigenous and municipal relations.

Ms. Clarke: I thank the member opposite.  Our government's very proud that we've developed not only a practical, but a measurable and realistic Made-in-Manitoba Climate and Green Plan that will protect our environment; it will foster green growth and spur innovation. And our plan will reduce emissions by 80,000 tons more than the federal carbon plan and cost Manitobans $260 million less. 


Wednesday, November 22, 2017

The Emergency Medical Services station in Grandview must be saved

In Question Period November 22,  I presented a petition of 1,000 signatures of people urging the government to continue and to expand the Emergency Medical Services station in Grandview. I presented additional petitions of 500 signatures each on November 23 and 24th.   There are many reasons why it would be wrong to close the Grandview ambulance and emergency medical services station   There is tremendous community support for keeping it open.  I called on the government to keep the Grandview EMS station open and to keep their promise not to cut front-line services.  You can see the Minister of Health's response in the video by clicking on this link - video on Grandview EMS services  The written text from Hansard is at the bottom of this post. 

November 25th, Naomi and I were in Grandview to meet with people in the community and to enjoy a community dinner together.  We were pleased to meet so many community members and to see the close working relationship between the community of Grandview, with their Mayor Lyle Morran and the community of Tootinaowazibeeng First Nation with their Chief Barry McKay.  It is one of the reasons why there should be an EMS station in Grandview.   Thank you to all the people in both communities for a great evening together.  I will continue working on your behalf at the Manitoba Legislature until we get the EMS in Grandview.  
Community Dinner in Grandview last night
Dr. Jim Rae speaking passionately about the importance of having the EMS station in Grandview.  

FROM HANSARD:
Rural ER Services - Government Intention
Hon. Jon Gerrard (River Heights): Health care is important to Manitobans.
      High-functioning emergency services in rural Manitoba face closure because the PCs are following a failed NDP strategy.
      I table today 1,000 signatures on a petition asking for the government to reverse its decision to close emergency medical services in Grandview. Rossburn and many other communities are also affected. These decisions are based on bad data, old data, and break the government's promise to spare front‑line services.
      Will the Premier (Mr. Pallister) keep his promise, or will he betray rural Manitobans by taking away critical health services from communities like Grandview and Rossburn?

Hon. Kelvin Goertzen (Minister of Health, Seniors and Active Living): Madam Speaker, certainly we know that the EMS system throughout Manitoba, but particularly in rural Manitoba, is a lifeline for those who live in rural Manitoba. The recommendations of the Toews report, which was commissioned by the NDP government, set out a standard that there should be service within 30 minutes from those who are getting called.
      We, of course, would like it to be even better than that, Madam Speaker, but that requires full‑time paramedics. It's one of the reasons why we were pleased to announce 29 new full-time paramedics. That was also again discussed yesterday in the Throne Speech, things that the member opposite voted against.
      You need paramedics to get that service. We're investing in paramedics, we're hiring paramedics, and we're employing paramedics for exactly that reason, Madam Speaker.


Monday, November 20, 2017

A Forum - The impact of the Pallister cuts - and finding a way forward

Sunday November 19th I hosted a Forum to explore the impact of the Pallister government cutbacks and to chart a course forward.  Three panelists joined me.  From left to right, in the photo above, they are Shelley Kowalchuk, Judy Walker and Alex Arenson.

Alex Arenson, a Winnipeg lawyer and an advocate for the Corydon Primary Care Clinic, was the first of the panelists to speak.   He covered the history of the events since the government first announced that the Clinic would be closing in July 11, 2017.  According to the latest plans, the Corydon Primary Care Clinic will close in mid-January 2018.   As Mr. Arenson discussed, the closure of this clinic makes no sense either in terms of service for people or economically.   Just as people who went to the Misericordia Urgent Care are not going to the Victoria Hospital Urgent Care because it is too far away, few people from the immediate area around the Corydon Clinic will travel to near Bishop Grandin Boulevard for their primary care - for that is where the Corydon Clinic will move.  Eliminating the Corydon Primary Care Clinic is thus another blow to the provision of primary care service to people in the Fort Rouge, River Heights and Wolseley area.

Judy Walker, whose son has an intellectual disability, next talked of the planned changes in support for adults with disabilities. She spoke of the great concern that the Conservative government might try to reverse the decades long effort to enable people like her son to live in the community.   She was passionate about the need for support in the community and the large benefits her son has had from his ability to be able to live in the community. She also expressed concern over plans to offload costs of care to families who are unable to afford it.

Shelley Kowalchuk, a physiotherapist who serves on the executive of the Manitoba Association of Health Care Professionals, talked about the impact of the cuts to outpatient physiotherapy services.  While a small remnant of the previously existing outpatient physiotherapy services will continue at the Health Sciences Centre, large areas of need will now be left to individuals to seek private physiotherapy services.   As Ms Kowalchuk indicated, their assessment shows that only 15% of the clients currently served by outpatient services have insurance which will cover private physiotherapy services.  This means that 85% of those who need the services will likely not be receiving the services because they can not afford it.  The absence of these services for those in need will, sadly, result in many having to come back into hospital because they will not be able to fully recover.   This will result in extra costs to the whole health care system instead of savings.   The Pallister government is sadly so misguided in so many of its health care changes that they will not achieve the savings estimated and will in the end have more sickness and less recovery.

A sizable crowd came out and participated in the discussion.  There was a lot of concern raised in particular with respect to the impact of the loss of the Corydon Primary Care Clinic at a time when improved primary care is essential.   There was also a lot of comment and discussion about the impacts of the outpatient physiotherapy, recreational therapy and audiology cuts. At a time when we need to be very vigorous in helping keep people healthy, these cuts are in the wrong direction.  Keeping people well enhances their health and also is cost saving for governments as it saves on expensive emergency and hospital care.  
Manitoba Liberal Leader, Dougald Lamont, provided welcoming remarks and an incisive summing up at the end of the Forum. 
For me, the vigorous discussion with varied comments and questions from the audience was helpful in shaping our approach to the Pallister government's changes to health care.   Many of the changes being made are clearly problematic, and we need to do everything we can to help Pallister and the Conservatives see the errors in their ways and make changes which will improve care instead of changes which will lead to worse care and higher costs.  At the same time, we need to be ready with effective alternatives as we move toward the next provincial election in 2020.  We have already put forward many good ideas on brain and mental health.  We received some excellent and helpful comments in this direction from members of the panel and from the audience, in particular how we might improve the health of our citizens while saving expensive hospital costs.  We will be putting these ideas together to increase the impact of our advocacy and to prepare plans that are much better and that we can deliver if we have a Liberal government provincially in 2020.  We welcome suggestions.   You can reach me by email at jon.gerrard@leg.gov.mb.ca

If you are interested in our proposals with respect to Brain and Mental Health see our report at this link - http://www.jongerrardmla.ca/report-item/optimal-brain-health-manitobans/



Monday, November 13, 2017

Building health care which puts patients first


In my remarks to a panel on health care in April I spoke about the importance of patient-centred care.   A health care system needs to be founded on a number of operating principles.   One of these is the importance of putting patients first.

While this may seem obvious, achieving care which puts patients needs first is often not in place.  Indeed, in many respects much of today's health care is organized around the needs of health professionals.   Hospitals and clinics are often designed using input from health care professionals, and they will frequently choose options which are most convenient for health professionals, not always thinking of the need to put patients first.

The book "The Putting Patient's First Field Guide - Global Lessons in Designing and Implementing Patient-Centered Care" edited by Susan Frampton and her colleagues should  be required reading for people looking at the organization of patient care.  One of the points that is made is this (pages 110-111) "In most health care delivery systems around the world, activating patients and encouraging shared decision making represents a paradigm shift.  In a person-centered health care setting, medical degrees and extensive training are no longer the exclusive measure of expertise.... partnership, joint goal setting, shared decision making and reciprocal communication between patients and caregivers [are central]. ...Activating patients to make their health care priorities and preferences known is not only empowering for patients but for clinicians as well, better enabling them to incorporate patient preferences into treatment recommendations."

To continue (page 109) "Patient activation not only leads to more meaningful interactions and richer dialogues between patients and caregivers at the point of care.  Is is also strongly related to a broad range of health related outcomes. ... more highly activated patients were more likely to report higher physical and mental functional status scores, as well as higher satisfaction."

During the summer, I received many emails from people who have called on me and others to make sure we are putting patients first.  These have been written in part over concern that the Pallister government's approach is putting costs first and cutbacks in spending first.   On November 19th, I am hosting a Forum which will look at the impact of the Pallister government's cuts, and which will look at charting a course for the future.  One of the important considerations will be ensuring that future decisions will put patients first.   The Forum is being held at the St Andrews River Heights United Church on Sunday November 19th from 2 to 4 pm.  Come and share you concerns and your ideas for how we build a system which will put patients first.

Thursday, November 9, 2017

Speech on Bill 24: The Red Tape Reduction and Government Efficiency Act:

This evening, I spoke in the Manitoba Legislature on Bill 24: The Red Tape Reduction and Government Efficiency Act.  My speech is below:

I rise to talk in opposition to Bill 24, and also to clarify several issues:

In the Manitoba Liberal Party, we support the reduction of red tape and making things simpler for citizens and for businesses to deal with government.   There are many ways of doing this – for example

- improved coordination between provincial and federal governments.  I recall when I was the federal Minister responsible for Western Economic Diversification it was routinely much easier to get federal and provincial governments working together to help businesses in Alberta than it was to work with the then PC government in Manitoba.   Mr. Speaker, things have not changed, the current PC government is always ready to criticize the current federal government but rarely ready to try to work together to solve the issues that citizens and businesses need addressed to improve the lives of all citizens and to help our businesses thrive.

- Using simplified forms which unable citizens and businesses to provide needed information.

But, decreasing red tape should not be used as a mechanism for reducing badly needed environmental protections.  This bill, sadly, is to a considerable extent about the misuse of red tape to reduce environmental protections.

This government often says they want to make Manitoba more competitive. But instead of trying to compete on quality, and on being the best, they seek to outcompete other jurisdictions on who can have the lowest standards especially on the environment.

In this matter, the PCs are picking up where the NDP left off. Despite their posturing on the environment, when it came to oil exploration in Manitoba, under the NDP the only jurisdictions with weaker regulations and fewer giveaways to oil companies were Alabama, Mississippi, Kansas, Arkansas and Saskatchewan.

Alberta and Texas are among the jurisdictions that have a higher bar than was set by the Manitoba NDP.

It might be cheaper in the short run to run a ship without radar, without sonar, without lifeboats and without safety equipment, but in the long run it runs the risk of an accident that is far more costly.

For example, in today’s fast changing world where climate change is giving us less predictability as to what will happen, it is wrong, as Bill 24 does, to reduce the oversight and assessment of drinking water infrastructure and water sources from every five years to every ten years.

As another example, Bill 24 will remove the requirement to provide a report on ecological reserves every five years.  The argument the government has made is that currently these reports are often late in being released, and they want to address what they see as a problem.   That is hardly a way to improve the oversight of ecological reserves, reserves which protect rare and unique species and landscapes. 

For many unique species and landscapes, we should in fact have some form of yearly monitoring.   As the studies at the Experimental Lakes Area have shown gathering annual data on species provides a critically important window on species and landscape changes as a result of climate change or other factors.  The work which I have been involved with, on a low budget, in northern Saskatchewan, to monitor bird populations including Bald Eagle populations annually for 50 years is another example of an important data set. 

While it is not likely possible for government employees to do much of this work, there are people in Manitoba, who, given a framework for action, are likely ready and able to keep track of what is happening on the ground.  Surely government should be able to work in partnership with people and organizations interested in monitoring species populations as occurs in breeding bird surveys, in annual Christmas bird counts and other exercises to keep an eye, annually, on critical habitats in our province.  So this change by this government to decrease environmental monitoring is wrong.  It is a continuation of the approach under the NDP when the NDP government lost track of what was happening with moose populations and failed to adequately protect moose populations.

The elimination of the prohibition on winter spreading of livestock manure is legislation is misguided and wrong.  Though this may be still present in regulations, regulations can be easily changed and are not sufficient protection against the potential for a government, like the present PC government, which is not particularly concerned about the environment to act to change the regulations. Michael Stainton, representing the Lake Winnipeg Foundation put it well when he said:

The Environment Act, section 40.2, Prohibition of Winter Spreading, currently, The Manitoba Environment Act prohibits the spreading of any livestock manure on agricultural fields between November 10th and April 10th. This is widely recognized, and well-established best management practice supported by broad scientific consensus. 

Arguably, the ban on winter spreading is the most important pollution prevention that has been put in place to protect Lake Winnipeg over the past two decades. When manure is spread on saturated, frozen or snow-covered ground, phosphorus cannot be incorporated into the soil. On the surface of the soil, this phosphorus is not available to support plant growth and is highly susceptible to runoff during winter storms; in particular, during the spring melt.

So what Lake Winnipeg Foundation urges is that Bill 24 be amended so as to not repeal section 40.2 of the Manitoba's environment act. The ban on winter spreading of all manure should be maintained in legislation, the highest form of protection for Manitoba's water.

When questioned by the Minister whether the regulations would not suffice He replied:
a few lines of ink [in the Legislation] are not a high overhead to maintain”.

We would also argue that some form of transparency and accountability should be maintained with respect to Public Private Partnerships.  Rather than end accountability, which seems to be a common approach from the present PC government, why not make changes to preserve some level of accountability where such partnerships are concerned – to ensure for example that the long run costs and benefits of the partnership are known, and risks are known and addressed ahead of time.  Why is the government so keen to end any accountability?
Madam Speaker, we do not agree with the approach taken by the NDP to demonize the hog industry in Manitoba.  Our approach is to ensure there are good regulations and enforcement to ensure good science-based environmental practices by those in the hog industry in our province and that phosphorous in hog manure is used to help in fertilizing crops and is not running off into our watersheds.  Our environment is a crucially important natural infrastructure for all Manitobans that needs to be protected.  At the same time the hog industry has provided good employment opportunities for many Manitobans and has resulted in the growth of many rural communities in our province. 
Protection of Lake Winnipeg should not be addressed by abandoning the hog industry, or by putting the industry under a moratorium straightjacket which does not allow those in the industry to modernize and develop improved humane and environmental approaches to raising hogs.  We believe that all hog manure, with very few exceptions should be injected into the land and that we can move the yardsticks to have more of the hog manure in Manitoba injected into the land instead of being spread on top of the land.   We also believe that improved enforcement can help, and that much better monitoring is needed.   To this end, we congratulate the Lake Winnipeg Foundation and its efforts to better monitor our waterways and encourage the government to support this citizen led effort to help our environment.   Such monitoring can lead to better measures to reduce phosphorous in Lake Winnipeg.   We can and must have conditions where the hog industry is not causing problems for Lake Winnipeg.
We also believe action to help Lake Winnipeg can and should proceed more quickly.  There have been far too many delays under both NDP and PC governments in the removal of phosphorous from the sewage from the City of Winnipeg.  The delays have continued and continued when action is needed.   Concern for the future of Lake Winnipeg, which suffered severe algal blooms this past summer, should be much greater than it is, and action should be taken more quickly.   Recent research of Diane Orihel shows that a considerable proportion of the phosphorous in Lake Winnipeg in the summer is phosphorous released from the sediments.  A real action plan to address the future of Lake Winnipeg including the phosphorous in its sediments is badly needed.

Manitoba Liberals oppose Bill 24.  We believe that elements of this bill misuse the approach of red tape reduction to remove important environmental safeguards. 

Very poor time management by the PCs and NDP in this session results in a lack of accountability as estimates for many departments were never completed.

Today is the last day of the Legislative Session.  Many bills were given royal ascent.  But at the same time there were remarkable problems with the way the PCs and NDPs managed the time of the Legislature.  As an example of the problems, we were unable to complete the 100 hours of time in estimates that is usually taken for this process.  Even more surprising is that many departmental estimates were never even considered. 

Departmental estimates for Growth Enterprise and Trade, for Municipal Relations, for Sports, Culture and Heritage, for the Civil Service Commission, for the Legislative Assembly, for Employee Pensions and other costs and for the enabling and other appropriations were not considered at all.  It is in fact astonishing that the estimates for Growth Enterprise and Trade were never considered since this is the main economic department for the government.   How could such a thing happen?  Well, sad to say, it was terrible organization by the PCs and the NDP in how time was managed during this last session of the Manitoba Legislature.

I brought this forward earlier today in the Manitoba Legislature as a Matter of Privilege.  In my  view, a Legislature which does not even consider the Departments of Growth, Enterprise and Trade, Municipal Relations and Sports, Culture and Heritage has a major problem.  Manitoba Liberals will continue to stand for much better democracy and much better accountability of government than this. 

Wednesday, November 8, 2017

Does the Pallister government's decision to cut lactation services in the WRHA hold water?

On Monday this week, I received an email from Karen Dunlop, Chair of the Board of the Winnipeg Regional Health Authority.  In her email Ms Dunlop wonders if the decision to cut lactation (breastfeeding) services at the Health Sciences Centre "holds water", and whether the evidence really supports this decision.  Ms. Dunlop is a nurse herself, and a well respected one, so her concern has the weight of her professional background as well as her position as Chair of the WRHA.   I raised this issue with the Minister of Health on Tuesday.  As you will see in the Minister's response, he was not able to defend the WRHA's decision and in desperation he opted instead to blame the federal government, and to accuse me of come sort of conspiracy theory.  Below are my questions and the Minister's responses from Hansard. 

Winnipeg Regional Health Authority - Response to Cuts to Lactation Services

Hon. Jon Gerrard (River Heights): Madam Speaker, recently, a mother approached me about the WRHA's decision to terminate two lactation consultants. She said, in a letter to the WRHA and copied to the Minister of Health and me, that she had only found the care that she and her son needed from specialized lactation consultants at the Health Sciences Centre. I received a response from the WRHA's RĂ©al Cloutier and an email from the chair of the WRHA, criticizing Mr. Cloutier's response for emphasizing cuts over care and wondering, and I quote, "if this decision holds water."
      Does the minister agree with the chair of the WRHA that his government puts cuts before care for newborn children and their mothers?
Hon. Kelvin Goertzen (Minister of Health, Seniors and Active Living): Madam Speaker, certainly the member opposite knows a little bit about cuts when it comes to the federal government reducing support here in Manitoba. There continues to be a decline of support from the federal govern­ment. We used to have a partner, a 50‑50 partner, many years ago; now we have a 19 per cent partner when it comes to health care from the federal government.
      I'm glad that the member opposite is now concerned about funding for health care. I wonder where his concern was a few months ago when we needed his voice. [In fact, I have raised concerns about health care cuts many times in the last year].
Madam Speaker: The honourable member for River Heights, on a supplementary question.
Mr. Gerrard: Yes, Madam Speaker, my concern is about services; his concern is only about cuts.
      Madam Speaker, the letter from the chair of the WRHA on the interim president's response to cuts in lactation specialists is twofold. She says the letter, which I table, acknowledges negative impacts and then says, we must promote evidence‑based care, particularly where there's evidence of long‑term benefits and access to that care. The current draft suggests we are not sure ourselves whether the decision was sound and if the new approach is the right one.
      The Health Minister also received this email. Are he and the WRHA more concerned with messaging than with making sure that new mothers can breastfeed their newborn children?
Mr. Goertzen: Well, we have lots of concerns, of course, Madam Speaker. One of the great concerns we have is the lack of support from the federal government. There used to be, at a time many years ago, that the federal government was a 50‑50 partner in health. That was always the great compromise when it comes to health care in Manitoba: federal government would set the rules but they would provide 50 per cent of the support to provinces over time, and particularly under the federal Liberal government that 'cline'–has been reduced to the point where the federal Liberal government now only provides 19 per cent support when it comes to health care, yet they still insist on setting 100 per cent of the rules.
      I'm glad that the member opposite has found his voice when it comes to support. I only wish he had found it a little bit earlier, Madam Speaker.
Madam Speaker: The honourable member for River Heights, on a final supplementary.
Mr. Gerrard: Madam Speaker, the minister only seems to deflect, instead of taking responsibility. At the very highest levels of the WRHA, it's clear there is doubt about the government's plan to break their campaign promises and fire front‑line health‑care workers.
      The RHAs were created by the PCs in the '90s to have health care at arm's length from government, but the most powerful people in the WRHA now have no independence and no choice when the Premier (Mr. Pallister) and his Health Minister order them to make cuts, and little freedom to speak the truth.
      Will the Premier and his minister listen to the board of the WRHA and reverse this decision to cut lactation specialists, or will the people who have spoken get trimmed for speaking their minds?
Mr. Goertzen: Well, Madam Speaker, there were at least five different conspiracies in that question. I would ask the member to remove himself from the grassy knoll.
      What we are doing is ensuring that there is a health‑care system that is sustainable. We are looking at evidence. We are hearing from experts. Dr. Peachey, who was hired by the NDP govern­ment, is one of those experts. We've heard from many different experts. [It is important to know that Dr. Peachy did not specifically recommend getting rid of lactation consultants.  It is also important to know that the cabinet signed off on the WRHA cuts.] 
      I would encourage the member opposite to also listen to experts. There have been national experts who said that health care isn't sustainable without a true federal partner.
      That is an expert that the member opposite doesn't want to listen to. I would encourage him to listen to the many voices around Canada who said we need the federal government to be a real partner, to make sure that health care is sustainable.
      He can stand here in this House and he can defend Ottawa all he wants, but he's elected to defend Manitobans, and he should stand up for Manitobans for a change, Madam Speaker. 

Thursday, November 2, 2017

Pallister PCs disappoint many who had hoped for support in the effort to reduce discrimination based on a person's height or weight

Dougald Lamont and I meet with Lindsey Mazur and Elaine Stevenson about Bill 200
Samantha Rayburn-Trubyk with Judy Klassen and me.   Samantha was in the gallery, along with Lindsey Mazur and Elain Stevenson, for the vote. 

This morning the Pallister PCs voted against a much needed measure, Bill 200, to put physical size and weight as protected characteristics under Manitoba's Human Rights Code.  Over the course of the last two years I have met with many people who know of the critical need for this legislation.   The people include as examples, Samantha Rayburn-Trubyk, President of the Little People of Manitoba, Lindsey Mazur, with Manitobans Against Weight Stigma, and Elaine Stevenson, Co-administrator of the Alyssa Stevenson Eating Disorder Memorial Trust. 

Discrimination against people based on their physical size or weight is a serious healthcare issue.    This issue is not currently adequately addressed under Manitoba's Human Right Code.  The evidence from other jurisdictions suggests this can help improve the workplace. 
1)   It is a serious healthcare issue:  It has been documented that a considerable proportion of physicians (40 per cent) have a negative bias toward obese patients.   More than half of doctors ascribed negative characteristics to obese patients. These attitudes affect the quality of care.    Indeed, it has been demonstrated that obese patients are less likely to receive appropriate care of medical problems that have little if anything to do with their weight.  Furthermore, though losing weight may be beneficial, patients who were discriminated against because of their weight were less likely to lose weight. All these findings are described in Brian Goldman’s book “The Secret Language of Doctors” published in 2014. 
2) It is not adequately addressed under our current human rights code.  Weight discrimination even when significantly impacting a person, is not covered under present human rights codes because being overweight is not considered a disability as two cases (below) in Canada have shown.  The details of these cases are below, at the end of this post. 
3) There are indications this bill will be helpful in the workplace.  Other jurisdictions have enacted laws which provide protection from discrimination on the basis of physical size or weight. these include the state of Michigan which prohibited discrimination based on a person’s weight in 1977.    The cities of Santa Cruz (1992) and San Francisco (2000) in California have also passed measures which protect against discrimination based on a person’s weight.   In none of these instances have there arisen significant issues for employers.  Indeed, evidence suggests that ending discrimination in the workplace can improve employee health and productivity and result in a healthier workplace.   The cost of anxiety and depression in the workplace has been estimated to cost Canada about $50 billion in lost productivity.  Decreasing such mental health issues in the workplace, by having a fairer workplace can provide significant benefits for businesses as well as for individuals. 

Canadian Cases where weight discrimination was allowed due to the absence of legislation to protect people from discrimination based on physical size or weight. 

The Ontario Board of Inquiry undertook an extensive analysis of weight discrimination in the employment context in Ontario (Human Rights Commission) v. Vogue Shoes.  The complainant, Carolyn Maddox, worked as a salesperson for Vogue Shoes, and at five feet, four inches, her weight varied between 177 and 200 pounds.  After seventeen years of employment, during which all parties agreed she was a very good worker, the shoe company told Maddox that she would need to lose a large amount of weight in order to keep her job.  She subsequently resigned and lodged a complaint with the Human Rights Commission alleging discrimination based on disability (called “handicap” in the statute at the time).
The Board of Inquiry found as a fact that Vogue Shoes had imposed a restrictive condition on Maddox’s employment because of her obesity, which fit the definition of discrimination from the relevant case law. Significantly, the Board also recognized that obese individuals in general face significant stigma and discrimination in society.  However, the Board ultimately held that obesity did not qualify as a disability under the Ontario Human Rights Code’s definition unless “it [was] an ongoing condition, effectively beyond the individual’s control, which limits or is perceived to limit his or her physical capabilities.” In Maddox’s case, although her weight was an ongoing condition it did not limit her physical capabilities, nor was it perceived as limiting them.  The shoe company’s discrimination was motivated by simple distaste for Maddox’s appearance rather than any perception that she was disabled and, thus, she had no redress under the Code.
Another important human rights case involving obesity as a disability, which was unsuccessful for similar reasons, is Saskatchewan (Human Rights Commission) v. St. Paul Lutheran Home of Melville, Saskatchewan.  The complainant, Sandra Lynn Davison, was a nurse’s aide whose application for employment at the St. Paul Lutheran Home was turned down for the sole reason that she was obese.  Davison was five feet, four inches tall, and weighed 330 pounds. She was described as being “punctual, pleasant, neat, courteous and in excellent health,” and as being otherwise completely qualified for the position.  She alleged discrimination based on physical disability, due to her weight.  The Saskatchewan Court of Appeal upheld the denial of her claim, but not before condemning the type of discrimination she experienced.
As in Vogue Shoes, even though Davison was clearly discriminated against in a way the Court considered deplorable, this discrimination was not based on a ground that fit under the definition of disability in The Saskatchewan Human Rights Code  and was thus permissible.
We would not tolerate similar attitudes limiting people’s employment opportunities if they were in relation to race or gender rather than weight. As such, the legal solution to the problem of weight discrimination should at least hold the possibility of addressing all kinds of weight discrimination, not just the kind motivated by real or perceived disability, and not just the kind directed at the medically obese.

Luther, E. (2010). Justice for all Shapes and Sizes: Combatting Weight Discrimination in Canada . Alberta Law Review , 48(1). Retrieved from https://www.albertalawreview.com/index.php/ALR/article/view/167/167.

Wednesday, November 1, 2017

Let us remember Welsey Elwick who died a year ago, and dedicate ourselves to the improvement of addictions services and to preventing tragedies like his death.

Wes Elwick (photo above) was a 25 year old man with a lot of promise and a lot of potential. Today in Question Period I asked about the need for improvements in addictions services in Manitoba and the need to  prevent tragedies like the death of Wesley Elwick.   Below is from Hansard - sadly our Premier is doing everything he can to direct blame elsewhere instead of taking the situation seriously, taking responsibility and acting.   


Addiction Services - Access Options

Hon. Jon Gerrard (River Heights): Madam Speaker, last Thursday, I asked in question period about crystal meth. The Premier (Mr. Pallister) did not take my question seriously and never even mentioned meth in his answer.
      Twenty-five-year old Wesley Elwick died a year ago because the Main Street Project and the health-care system in general are not provided with adequate resources to give the services that addicts most need when they need it.
      When the actions needed to help people with addictions are known, when the government has received millions of dollars for mental health from Ottawa, why has the Premier not addressed this in the year and a half he's been in office?

Hon. Brian Pallister (Premier): Crystal meth's a problem, Madam Speaker. It's a tremendous problem. The opioid crisis is real. The minister is addressing it and addressing it well.
      But, again, the member should not confuse my disrespect for his lack of opposition to his federal colleagues cutting health-care support in our province with my disdain for the issue he raises. Those are two different things.
      The member has said not a word in opposition to a $2.2-billion reduction in health-care resources from Ottawa to our province, not one word. And then he stands in this House today and talks about resources being made available for a very real crisis that needs attention? There's a real contradiction in those points, Madam Speaker.
      The member needs to re-examine–he needs to re-examine his lethargy, his disdain for the people of Manitoba in the face of his acquiescence, his bowing to the east, Madam Speaker.

Madam Speaker: The honourable member for River Heights, on a supplementary question..
      Order.

Mr. Gerrard: Madam Speaker, the Premier might start by thanking the government of Ottawa for providing billions dollars more in health care.
      Indeed, as Robert Lidstone observed – 
Some Honourable Members: Oh, oh.
Madam Speaker: Order. 
Mr. Gerrard: –recently, people who decide to stop using drugs like crystal meth and opioids in our province have to jump through a series of unnecessary hoops and wait far too long to access a safe, supportive environment.
      We need to look at creating stabilization programs that can bridge the gap between active substance abuse and rehab or treatment programs which often have wait times of one or two months before a person can be admitted.
      What is the Health Minister doing to bridge this gap?

Mr. Pallister: In the 1990s, the federal Liberal government, of which the member for River Heights was a part, got a transfer of funding for health care to all provinces, including Manitoba. I decided to leave provincial politics, run for a two-person party, to fight for health care because we need health-care support from Ottawa.
      We used to have equal support, then we had a junior partner, and now we have a mini-me partner that doesn't–thinks it can call the shots while funding health care less and less each passing year.
      Half of the Liberal Cabinet spoke against these measures, which see a reduction, during the run-up to the last election. But now, suddenly, they've embraced the position where they are reducing transfers for health-care support across the country of Canada and the member sits on his hands and says that's fine with him.
      It's not fine with this government, and it never will be fine with this government, Madam Speaker.

Some Honourable Members: Oh, oh.
Madam Speaker: Order.
      The honourable member for River Heights, on a final supplementary.

Mr. Gerrard: Madam Speaker, if the Premier's going to request more money, he better have some good plans. And all we've seen is bad plans in health care so far.
      In Manitoba, there are many stories of addicts–
Some Honourable Members: Oh, oh.
Madam Speaker: Order.
Mr. Gerrard: –leaving emergency rooms, crisis centres, or even welfare offices, in despair because they didn't get the help they needed.
      Often today, this is for addiction to drug combinations like meth and opioids together. In Ontario, hospitals operate withdrawal-management centres that directly admit people without having to go through an emergency room and are open 24 hours a day, seven days a week for those who want to get clean and access help.
      When will the government consider moving to the more successful Ontario model? Minister?

Mr. Pallister: Well, Madam Speaker, the Premier of Ontario's not any happier with the health-care reductions from Ottawa than I am, but she's just a little more reluctant to talk about it publicly, I suppose.
      The member speaks about health care as if it's a priority. It is. It's the No. 1 priority for this government; it's the No. 1 priority for Manitobans. [interjection] I believe it's the No. 1 priority for Canadians. The member from Minto speaks up now, but says nothing when the federal government cuts health care to Manitoba.

      The NDP say nothing, the Liberals say nothing. One political party in this House is standing up for health care for Manitobans, and that's the Progressive Conservative Party. We stand up for health care, and we will oppose federal cuts to health care now, as we did in the 1990s, when that member was part of gutting and cutting them then, as he is now supporting them today. 

The Premier's statements are full of misinformation, half truths and falsehoods.  He would have done better to address the real needs of Manitobans and the steps that need to be taken to address the very serious crisis in Manitoba with meth and opioid addictions.   We need an approach which will prevent the tragedies which are happening and which will prevent deaths like that of Wesley Elwick.   Let us, in his name, do what is needed to improve services for those with addictions, and prevent future tragedies. There have been too many already.   This week's story from Brandon only confirms the seriousness of the situation - click on this link.  The story says Brandon has a serious drug problem. And if we don’t do something — and fast — it is going to turn into a full-blown community crisis. Meth is Everywhere. And it just may be the tip of the iceberg."