Mr. Assistant Deputy Chairperson (Gerry McAlpine): Would the Committee of Supply please come to order. This section of the Committee of Supply will be considering the Estimates of the Department of Health.

Does the honourable Minister of Health have an opening statement?

Hon. James McCrae (Minister of Health): Mr. Chairperson, I am pleased to present to this committee the Estimates of the Department of Health. They represent a very, very significant commitment to the health of our fellow Manitobans. I look forward to a useful discussion with my legislative colleagues about the priorities of the government of Manitoba with respect to social services in general and health services in particular.

I have to thank the Department of Health for the service they have provided throughout the year and, more specifically, just in the last 24 hours in helping me to get supplementary information to honourable members in as timely a fashion as we could do that. I have tabled earlier today in the Legislature the required number of copies I believe of the Supplementary Information for Legislative Review for this fiscal year.

I do not propose to make much further of an opening statement and look forward to the--well, I hope I look forward to the discussion that will follow. We have had quite a discussion over the last 21 months or so since I became Minister of Health in Manitoba. It has been a privilege to be able to serve in this capacity, a privilege to serve with dedicated people, not only in the Department, but throughout this province in the delivery of health care and health services to Manitobans.

It is a very big job but one that I enjoy doing and take very seriously, and I value the partnerships and friendships that flow from being involved in such an important activity, and that includes my colleagues in the Legislature and my counterparts in the other parties as well. We seem not to agree from time to time on things, but that does not seem to get in the way of what I would call a courteous working arrangement, which I enjoy, and I hope I do not do anything to spoil that relationship throughout these discussions in the Estimates.

So with that, Mr. Chairperson, I thank you for the opportunity to make a few opening comments and, as I say, I look forward to providing as much information as is possible throughout the course of this Estimates review.

Mr. Assistant Deputy Chairperson: We thank the honourable Minister of Health for those comments. Does the official opposition critic, the honourable member for Kildonan, have any opening comments?

Mr. Dave Chomiak (Kildonan): Mr. Chairperson, I just have a few brief comments. I would like to commence by thanking the minister for providing me expeditiously the Supplementary Estimates book. I appreciate the fact that he and his staff worked together to put the information together to assist us in our deliberations.

I would also like to thank the department for their work over the year. You will probably hear a fair amount of criticism of the work of the department, but it is not directed at any individual and it certainly does not question the integrity and dedication of anyone who is working in the department. It is simply a difference in philosophy and a difference in opinion as to how matters should be dealt with in the province of Manitoba.

I also look forward to an informative exchange of ideas and information. Certainly, we take this process very seriously. The review of the expenditure Estimates on a line-by-line basis is something that is fundamental to our parliamentary system and also fundamental to the effective operation of the government of Manitoba and the Department of Health in particular. We look forward to the opportunity to have our questions answered and the information provided. Not solely for our purposes but through us hopefully information can be communicated to all Manitobans. With those few comments, I look forward to the continuance of these Estimates.

Mr. Assistant Deputy Chairperson: We thank the critic for the official opposition for those comments. Under the Manitoba practice, debate of the Minister's Salary is traditionally the last item considered for the Estimates of a department. Accordingly, we shall defer consideration of this item and now proceed with consideration of the next line.

At this time we invite the minister's staff to join us at the table, and we ask the minister to introduce his staff present.

Mr. McCrae: Very quickly I would like to introduce our relatively new Deputy Minister of Health, Dr. John Wade, who is going through his first Estimates' review process, certainly as one sitting in the Deputy Minister's chair. I also have Tim Duprey with us. I am not very good with the titles, but he is Assistant Deputy of Finance and Management Services. My friend has the organizational chart, and Susan Murphy of that office is also with us. Thanks to Ms. Murphy's heroic efforts last evening, we were able to get that information to honourable members. I want to get that on the record. Thank you.

Mr. Assistant Deputy Chairperson: The first line item is 1.(b) Executive Support (1) Salaries and Employee Benefits $594,800 on page 77 of the main Estimates book. Shall the item pass?

Mr. Chomiak: I would also welcome the new Deputy Minister of Health. I have heard very good comments about your past career, and I look forward to a long and fruitful career with the Department of Health. I also welcome back the other officials and thank them for also expediting this process.

At the commencement, in terms of clarification, generally we try to keep on the lines in order to make things as efficient as possible. I wonder at this time if I can give notice to the minister that there are several pieces of information that I would appreciate being forwarded as soon as possible to the committee that can relate to this line. It can relate later on, but I would like access to them as soon as possible.

Those items include the list that has been provided regularly by the department of the status of the various committees that are under the auspices of the Department of Health. I wonder if that information can be provided at an early date.

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Mr. McCrae: I have a 14-page summary of the activities of the various health reform committees, Mr. Chairperson. It contains, I think, similar information to that given to the honourable member last year, however updated to account for activities over the past year. Very, very significant for this reason, and I pass this to the honourable member. I am tabling it so that the honourable member and others can access this information. It is a significant report in the sense that so much input into the reforms that are going on in Manitoba comes from Manitobans who are working in the various health professions in the various geographic locations of our province. So many times suggestions have been made that so much that is being done is being done without the benefit of very significant consultation with health care professionals and others, including consumers.

The document produced last year, the document produced again this year seems to indicate quite the reverse is what is actually happening. So I am pleased to provide honourable members with this information today.

Mr. Chomiak: Mr. Chairperson, that was quick. I appreciate the fact that this was provided forthwith.

The other information that we would like to have before the committee is information about the SmartHealth endeavour and preferably the contract. I wonder if that can be provided to us.

Mr. McCrae: I am glad the honourable member asked about this because, of course, we are just, all of us, off a hotly contested election in the province of Manitoba, and one of the parties attempted to make SmartHealth a central feature of the election campaign, indeed estimated at about a hundred-million-dollar contract. Although there is nothing in these Estimates for SmartHealth, one of the parties in the election campaign had spent that $100 million dollars seemingly over and over again, a hundred million dollars that does not exist.

In any event, I am bound, I believe, to proceed with this automated system for health care delivery in the province of Manitoba. We have very, very significant partners in the endeavour. It is, again, not simply a matter of the Royal Bank and a few highly placed individuals deciding that this is the way it is going to be. It never was that way and is not going to be that way.

In planning for SmartHealth, we have consulted very significantly with our partners in health care. In fact, it is those partners, those so-called stakeholders, that have been demanding a better information management system in our health system. After all, we have a very good data base in our province, said to be the best anywhere. Just think of the opportunities that exist for better service to patients and health consumers than a system that can be very responsive, responsive in a hurry when that is necessary.

I do not really need, I guess, to argue the merits so much because the honourable member is simply asking for a copy of the contract. The contract does not exist yet, at this point has not been signed. There sometimes is a sense or a conclusion reached that this contract has already been entered into. It has not. As I say, the contract will be something entered into extremely carefully.

We want to have multiple areas or modules, I guess you call it, in a contract like this. There are so many parts to our health system that there need to be a number of parts to this contract, and there have to be many places at which our committee that oversees the work can say, well, no, this is not going to be in the public interest, or this is going to be in the public interest, or this could be so much better if you did it this way or that way.

We need to have a contract that allows for that sort of approach, because the honourable member should remember who the partners are. I have outlined that for him before and he knows. We value their input, and if it is a no-go, then it is a no-go. It would be totally irresponsible for us to fail to proceed with the SmartHealth arrangements. We will make as much information available to the honourable member as we can when it is available.

Mr. Chomiak: Perhaps the minister can explain why on December 12 the government issued a press release that said, and I quote: The contract for development of the $100-million computer network was awarded by tender and subject to regulatory approval to SmartHealth.

That implies explicitly or implicitly to me that in fact there is a contract. I do not want to get into legalese, but the point is, the press release says there is a contract. There is an office set up, structured and running, information has passed hands.

Clearly, the press release and the activities to date do not just strongly suggest a contract, in fact, indicate a contract. I have a good deal of difficulty understanding what the minister means when he says there is not a contract.

Mr. McCrae: The honourable member is a lawyer, and it is refreshing to hear a lawyer say that he does not want to get into legalese, because that is important for me, especially in these discussions, that we not get into legalese.

The honourable member must have missed out on some really important developments in the last few months. It is true that in December or whenever the date of the press release is, it was announced that SmartHealth got the contract. It does not mean the contract has been signed. I mean, surely the honourable member would understand that what was being announced was that after all of these requests for proposals and all of that--I think there were some 33 invitations sent out for requests and about 11 returns, I believe it was, out of which the SmartHealth was the one chosen by the multisectoral committee that was involved in choosing which vendor was going to be the one to get the deal. The decision was made that the contract should go to SmartHealth and from that point forward you get to work on finalizing the details of the contract.

The reason I say the honourable member kind of missed out on something is that I recall fairly early, I think it was in the election campaign or maybe even before--I think it was a few days into the campaign, and the Premier (Mr. Filmon) of this province made it clear that no contract would be signed until after the election. This was an important matter. You know, New Democrats were saying, do not sign any contracts. I do not understand the honourable member coming along today and saying he thought there was one back in December when he is telling us not to sign one in the month of March or April.

So anyway, whatever, there is no contract signed to this point so, therefore, there would not be one that I could make available to the honourable member when one has not been signed yet. I expect that in due course there will be one signed and that we will be moving forward, because that is the thing to do.

Mr. Chomiak: So the minister is saying, there was a contract awarded but not signed.

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Mr. McCrae: We had a group that invited 33 vendors to make proposals. What we have is a little problem with nomenclature here. The vendors were asked to make proposals, and they did, and from the 11 that were submitted the committee that reviewed these proposals awarded the tender to SmartHealth. From that point, you get down to the business of finalizing--the whole idea was to figure out, now, who is the best one, which organization is the best one to provide this very, very large, integrated information system for Manitobans so that having assisted Manitobans in putting that together they would go away and leave us with our information.

We have people in Manitoba, who actually went around telling people that the information would belong to the Royal Bank. Now give me a break. Nobody had that in mind and anybody who would put a thing like that across is simply trying to scare people. That is not what we are trying to do at all. Everybody knows it, but some people tend to put across something that they know is not the real state of affairs.

I am not in the business very often of awarding tenders and so on, but SmartHealth was chosen and from that decision then we get into the business of setting out work plans and putting that into contractual language and writing up in a contract, signing a contract and moving forward from there.

Mr. Chomiak: Mr. Chairperson, it is indeed unfortunate that the press release does not indicate what the minister just indicated and there seems to be a diversion and so we have now arrived at the fact that the deal with SmartHealth has not been signed.

Will the minister therefore undertake--I want to make that clear, because the press release says one thing and we know that SmartHealth is up and running and doing things and that implies a lot, but I will get back to that later. The question is now will the minister assure this committee and the Legislature and the people of Manitoba that prior to the signing of this deal, this contract and the terms and the conditions, because the minister has stated that people were going around irresponsibly making assumptions about this contract when in fact people have had to assume aspects of this contract because the government has not been very forthcoming at all with information on a $100-million expenditure which is probably the largest single expenditure ever undertaken in the health care field and the government has been unwilling or unable to provide any information. Therefore, will the minister assure this committee and this House--surely, it would be I think incumbent upon the government to do so--that they will guarantee that this contract will come before the Legislature prior to them signing on the bottom line?

Mr. McCrae: First of all, as I said, the honourable Leader of the Opposition (Mr. Doer) was out merrily spending and spending and spending $100 million that did not exist. There is nothing in this year's budget for SmartHealth and even SmartHealth. The financing of that contract is to spread over about five years. So how many times can you spend money that does not exist, and people do not believe you after awhile and that seems to be what happened on April 25, in my view, that people just--not enough people anyway--could not believe what the Leader of the Opposition and his colleagues were saying about some of these things. So that is why we are left where we are today.

But there is nothing in the budget for this year, so I do not even know how we got into this. On the area of Executive Support here we are talking about SmartHealth. But I guess we have sort of been a little bit flexible on these matters as we have gone through Estimates in the past and I do not really mind. It is just that I hope the honourable member is not going to ask a bunch of questions that I do not know the answers to and the only way I can get them is from the staff who are present. I might not have the right staff there for that although the staff that is here are very knowledgeable on many parts of the operations of the department.

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I told the honourable member that I would be as open and forthcoming as I can possibly be when it comes to all of the dealings in health care, and I am going to be doing that. After all, we have many, many people involved in these very important matters. We have no intention of entering into any contracts that are not in the public interest. That is what we were elected to do is to govern in the public's interest and to enter into contracts that are in the public interest and, as I say, with the help of the various parties to the public health information system--I will just very quickly, if I can find it, make a reference to those partners for the honourable member. On the advisory committee to the SmartHealth--

Point of Order

Mr. Chomiak: Mr. Chairperson, the question was very, very explicit: Will the minister table this contract prior to signing?

The minister has gone on in the House on many occasions listing the members of this committee of this contract that he says does not exist, but the question was very explicit. I think the rules state that the minister should basically deal with the question, and the question was very explicit: Will the minister table this agreement prior to signing? It is very simple.

Mr. Assistant Deputy Chairperson: The minister is, I believe, getting around to answering the question, so I would ask the minister to continue with his remarks and to be as brief as possible in his remarks to the question.

* * *

Mr. McCrae: Mr. Chairperson, I was just about to tell the honourable member, or to put on the record the membership of our advisory committee for the public health information system.

They include the Assembly of Manitoba Chiefs, Cadham Labs, the Consumers' Association of Canada, the Canadian Mental Health Association, the College of Physicians and Surgeons, Emergency Services, Epidemiology--these are Manitoba Health branches--Healthy Public Policy Programs Division, the Manitoba Association of Registered Nurses, the Manitoba Cancer Treatment and Research Foundation, the Manitoba Centre for Health Policy and Evaluation, the Manitoba Medical Association, the Manitoba Nurses' Union, the Manitoba Pharmaceutical Association, the Manitoba Society of Pharmacists--

Point of Order

Mr. Chomiak: On a point of order, can the minister outline for me what question he is answering?

Mr. Assistant Deputy Chairperson: That is not a point of order that the member is raising. I would ask the minister to continue with his response.

* * *

Mr. McCrae: I thought it was out of a sincere wish on the part of the honourable member for Kildonan to learn as much as he could about the public health information system, and I am trying to impart information to him that I think will be helpful to him.

It should be helpful to him to know--now I have lost my place--that in addition to those organizations that I have already mentioned who are represented on the advisory committee, we also have: the Manitoba Pharmaceutical Association, the Manitoba Society of Pharmacists, the Manitoba Society of Seniors and the Provincial Lab Committee.

Because the issue of the privacy of people's health information is so very important to Manitobans, and it is to me, we have a special committee set up for that. These are the committees the honourable member says we should not have, but this is an important committee because, on the issue of privacy and confidentiality of records, if this committee says, this is a no-go, then it is a no-go.

On that committee are the Consumers' Association of Canada, the Canadian Mental Health Association, the College of Physicians and Surgeons, the Manitoba Association of Registered Nurses, the Manitoba Pharmaceutical Association, the Manitoba Association for Rights and Liberties, the Manitoba Society of Seniors and the Provincial Lab Committee.

Point of Order

Mr. Chomiak: I believe in your previous ruling you indicated, the minister was about to provide his answer and we have now gone on seven minutes or so since the minister attempted to answer the question. I believe you ought to call the minister to order to ask him to answer the question as asked.

Mr. Assistant Deputy Chairperson: The honourable member does not have a point of order and I ask the minister to continue with his response.

* * *

Mr. McCrae: Well, I am basically finished, but the thing that really bothers me about what the honourable member just said, that is his third point of order in one response that I have tried to give. It is a little bit intimidating to have someone like the honourable member interrupt an answer three times and insist that the answer be in such and such a form.

In other words, he wants maybe to be the ventriloquist and I am supposed to be the dummy. I am not going to do that. I will do my best to be as responsive as I can, but I am no dummy--to the honourable member.

Mr. Chomiak: Mr. Chairperson, I had hoped we could get off to a better start in terms of these Estimates and have the minister provide information.

The question was very clear and direct to the minister. Will he or will he not assure the people of Manitoba that this contract will be made public prior to the signature by the government, a commitment of over a hundred million dollars in expenditures for supposed savings of $200 million, I might add?

If the minister expects us to accept on face value a $100 million expenditure on this government's track record of savings, that they are going to somehow save $200 million, then I would be astounded. Manitobans simply will not accept that assurance. The question remains, will the minister or will the minister not provide us with a copy of this contract prior to signature?

Mr. McCrae: Mr. Chairperson, I do not expect the honourable member for Kildonan (Mr. Chomiak) to accept my assurances on anything. History has demonstrated very, very clearly that he accepts my word on basically nothing, so I am really left to do my best to communicate directly with the people of this province because there is no point trying to do anything through the honourable member because he is not going to pass on to Manitobans the correct information.

Indeed, I am sorry he feels that we got off to a wrong start. He says that every time we do this. No matter what we do, if it is not done just the way he wants it, Mr. Chairperson, then we are not off to a very good start or it is not a very good exercise. It is his way or no way, and I am sorry that is not the way the Legislature works.

The honourable member asked a specific question, I grant you. My answer is that I will be as open and forthcoming as I believe it to be in the public interest to do so.

Mr. Chomiak: Mr. Chairperson, is the minister refusing to make this contract public?

Mr. McCrae: An hour into cross-examination and the honourable member maybe wants to set some ground rules now. Is this going to be a useful exercise, or is this going to be fun and games for the honourable member for Kildonan (Mr. Chomiak)? I am serious about health care in this province and I wish the honourable member would be serious too.

Mr. Chomiak: Mr. Chairperson, I will ignore the personal accusations of the minister. I am used to that. It is certainly common.

I will repeat my question at commencement of this exercise of Estimates. Is the minister going to undertake to provide the public of Manitoba with a copy of this contract prior to its signature--simple?

Mr. McCrae: The answer I gave last time is the one that stands, Mr. Chairperson.

Mr. Chomiak: It is very clear that the minister is refusing to provide us with information with respect--providing us with this contract. Will the minister provide us with an update to today as to what has been done on this particular project to date?

Mr. McCrae: Yes, Mr. Chairperson, last July 18 the Drug Program Information Network came on line. That was the combination of work that went back from that point--what, a year, a couple of years? A very significant amount of work went into the development in partnership with the pharmacists of this province of our Drug Program Information Network.

I did not hear very much praise being offered by the honourable member ever since last July 18 for the Drug Program Information Network. It has been used to help form the first spoke in that public health information system wheel that has provided significant benefit to Manitobans, especially seniors who have been getting instant rebates on their Pharmacare account. All of us have benefited, I suggest, by a better level of information being available to health professionals who dispense pharmaceutical products.

I do not have any numbers today, but one of the things that Drug Program Information Network is designed to do is to prevent negative drug interactions in our population. Statistics are very high.

Maybe Dr. Wade, I know he would be aware of this, about hospital admissions due to negative drug interactions. It is at an alarming, high level, and it does not need to be so if health professionals are working with the appropriate tools to prevent negative drug interactions. That is just, never mind the cost of hospital stays for people who unnecessarily get into this situation. What about the pain and suffering that people go through to go through a hospital admission and the negative drug interaction on its own?

So we were very proud to get on with that program last July l8 and to remind the members of the public that safety was enhanced, that abuse was less likely to happen--I will talk about Leon in a minute--but abuse was less likely to happen and that the ease and convenience of our Pharmacare program had been enhanced because of the existence of this Drug Program Information Network.

As I say, this is the first spoke in this wheel of public health information that the NDP opposed all throughout the piece and continue to oppose. That is what you call progress and they are against it, and that is why they are where they are today and that is why it turned out the way it did.

From that point, the next step is to enhance and enlarge that Health Information System that was part of the Drug Program Information Network, and we are into those stages now.

Now, with respect to Leon, I think it is necessary when we are discussing abuse that Leon come into the story. Leon, as honourable members will know, was widely reported as having abused allegedly--I see the Attorney-General is here; you have to throw that word in from time to time--allegedly abused our Pharmacare Program and our medical services program and perhaps, allegedly, some others did too. Of course, some people would use that particular experience, a very unfortunate one, to bring negative attention to our Drug Program Information Network.

Well, if everybody uses it the way they are supposed to, you know, that Leon situation would not have developed, and so the Manitoba association of pharmacists and the Manitoba College of Physicians and Surgeons and the Department of Health are all working to ensure that those sorts of things do not happen again, that anybody who was engaged in any wrongdoing is dealt with very seriously and also the programming of the computer which runs the Drug Program Information Network is being looked at to ensure that we are not overloading our pharmacists with information that leads to perhaps some frustration with this automated system.

So, in a way, the Leon situation probably has more positive outcomes than some people would like to have you believe.

I would be very happy, by the way, not to try to get away from a discussion right now, because we can certainly have a general discussion, although maybe not quite so specific as you might like, but when we get to that line in the Estimates dealing with Information Systems, it is 21.2(c). I do not discourage the honourable member from raising whatever questions he wants to raise. It is just that I am probably going to have more detailed information for him when we get the manager of that particular branch in here to assist me.

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Mr. Chomiak: Mr. Chairperson, if the minister will recall when I commenced this line of questioning it was to try to alert the government and the minister to information that I would be asking for during the course of the Estimates, and the call for the contract was an attempt, or an update as to what is happening on the contract, is forewarning of the information that we will be asking during the course of these Estimates.

So I am not asking the minister to provide specific answers to questions that may not be answerable at this point. I am simply forewarning the minister that we are going to be asking specific questions in this area, and matters could be expedited by, for example, providing the contract and certainly by providing us with an update when we reach that particular line or prior to our reaching that particular line during the course of these Estimates.

Mr. McCrae: Mr. Chairperson, it is very important that, certainly, with a thing like the SmartHealth proposal which is so very, very important in respect to the future delivery of services, that virtually every single Manitoban identifies with in one way or another or at one time or another, health services, that we bring as many people as we can into the discussion, that Manitobans be very much a part of the building of their health care system. It is not mine. It is not the honourable members'. It does not belong to the department. It does not belong to the doctors or any one particular group. It belongs to all of us, and we value it and treasure it very highly.

So I want the honourable member to understand that my wish is for as much information as can appropriately be made available to be made available so that we can have a good and honest discussion about the issues. I do get frustrated, however, almost daily, but quite often, about how some information is--how shall I put it without being unparliamentary?--misused. I just think that there are a lot of seniors in this province who have really been mistreated in the last few years and certainly during the course of the election campaign by the NDP and by certain unions out there who have very clearly misled seniors in this province and frightened seniors in this province. On behalf of those seniors, I resent that very much and respectfully demand an apology, but I do not suppose I am going to get one from members of the New Democratic Party.

You know, the time is over when you can attempt to frighten elderly Manitobans. I know again this election--I have been through four of them now--that the New Democrats and their supporters did all kinds of things to try to frighten senior citizens and vulnerable people in our province. I think it is despicable, but that is just one person's opinion, Mr. Chairperson.

Mr. Chomiak: Mr. Chairperson, I just wonder, does the minister realize the election is over and perhaps that we are into a different phase? Does the minister realize he has now made, I would say, more political comments about the election than he has actually answered questions during the course of these Estimates? I just wonder if the minister is aware that the provincial election is over, and perhaps he can purge himself in some other forum than taking valuable public time for the minister to go on and on in his political statements. Perhaps the minister can purge himself somewhere else rather than going on during the course of these Estimates so we can get the proper information from the minister. It was not a political question. It is a question providing the information.

If the minister is refusing or not able to provide the information, fine, let him say that, but to go on politically over and over again does not accomplish anything. I do not like having to go back on these discourses, back and forth. I am asking the minister questions. It is my responsibility as a member of the opposition and all members of the opposition to ask questions regarding the line-by-line expenditure items. If the minister does not want to or cannot answer, that is fine, but if the minister wants to go down the political road and rehash the election, that is fine, then we will waste the public's time here doing something that we are not supposed to do, and I think that is an inappropriate use of time. If the minister wants to continue down that course, so be it, and he will just simply take up the public's time.

The question was: Will we be getting an update as to what the status is of the SmartHealth when we reach that line in the Estimates? It is a simple question.

Mr. McCrae: Mr. Chairperson, if the election is over, then why is the honourable member fighting it all over again? They made a centre plank in their election campaign, this business about the health information system, the SmartHealth, one of the first issues he raises in the debate on these Estimates. If the election is over, then why does the honourable member not accept the verdict of the population with respect to SmartHealth? I told the honourable member I would do everything I could to bring forward all the information that I can appropriately bring forward. That is what I will do because it has worked well for me so far in terms of my relationship with Manitobans to tell them what you are thinking and to hear what they are thinking and to go forward that way. It has worked well. It has worked well for this government, and it did not work well for a former New Democratic government in Manitoba, because they did not understand what it means to really develop a relationship between the governed and the government.

So, yes, I will get on. I will try not to fight the election over again. I wondered if these Estimates were going to be a rehash of the election, and now we found out, that is exactly what it is.

The honourable member cannot get it through his head that the people of Manitoba said yes to SmartHealth.

Mr. Chomiak: Mr. Chairperson, the level of debate has deteriorated on the one side--it is surprising. My question is--well, to continue down this course is probably fruitless, given the minister's response.

We will continue our line of questioning on SmartHealth, and the minister somehow suggests that a contract that has not been signed, that he says has not been signed, has somehow been approved by the public of Manitoba, therefore no one should ask questions on it, is laughable, Mr. Chairperson. It is a laughable response, frankly, and I do not see where the minister is coming from.

The department is again re-organized, and we see that there is a new re-organization chart. I do have a line of questioning on that, but I note the member for The Maples (Mr. Kowalski) has some questions and I will cede the floor to the member for The Maples.

Mr. Gary Kowalski (The Maples): Mr. Chairperson, because I am a member of the Liberal Party and we do not have official party status, we are not allowed to make an opening statement. I will consider this my opening statement.

Some Honourable Members: Leave.

Mr. Assistant Deputy Chairperson: Leave has been granted.

Mr. Kowalski: Thank you. I am not the Health critic for the Liberals in this Manitoba Legislature, but because our numbers are small, I had this opportunity, although, when I sit in this room with a lawyer, a court reporter, attorney-general and a police officer, I think it should be the Estimates for the Department of Justice not the Department of Health.

Before I go on I have to say something about our former critic, the member for Crescentwood, Avis Gray, who from what I understand is out golfing right now, and after the start of these Estimates, I am very envious of her.

I follow in a tradition of Liberal critics. The constituency that I represent, The Maples, the former member was Gulzar Cheema, who, I think, was recognized by many to be an excellent critic, a fair critic, criticized the government when necessary, supported the government. I think this goes on, a tradition in Manitoba going back to Larry Desjardins, Bud Sherman, where because of the importance of health in this province that both critics and ministers have worked together to get the best health care system for Manitobans. I hope that my involvement will be as constructive as the tradition that has been established by former critics in the Manitoba Legislature.

Gulzar Cheema, I understand, is now a nominated candidate in B.C. as a member of the Legislative Assembly. I am hoping that in the near future he will be the Minister of Health in British Columbia and I will be able to use him as a resource to fulfill a role as critic of the health care system here in Manitoba.

So with those few comments, I will sit here and be envious of Avis Gray out on the golf course today.

Mr. Assistant Deputy Chairperson: We thank the member for those comments.

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Mr. McCrae: Not that any question was asked or anything, Mr. Chairperson, but I would just like to add to something the honourable member said. I felt that both Dr. Cheema and Ms. Gray carried out their responsibilities with some distinction as health critics. I say that because they did not just criticize for the love of being critical or for the love of trying one-upmanship or some such thing like that. They criticized because in the areas when they did criticize they felt they had something to criticize, and they genuinely felt that.

I felt that with Doctor Cheema and with Ms. Gray when it came up. They said they supported reform, and their actions demonstrated that they did. When we as a government made mistakes or fell by the wayside a little bit, they would tell us about it. That was their job and they did it. But they did not just find the issue that they felt could generate the most heat and then go after that as some other people do, and I think that they conducted themselves in a responsible and dignified way.

Mr. Kowalski: Yes, when we get to the area about the health smart card, my brother, who recently got his doctorate in computer science in Sweden, happened to be in the gallery when the government made their announcement about the health smart card, and although I do not have the information before me right now, I will be asking questions about international standards in computer technology about security. Apparently, I cannot remember the name of the standard, but I understand there is a North American standard and an international standard. If an assessment has been done or if part of the contract will be a clause that it meet those standards--I will be asking that question when we come to that line.

Mr. McCrae: Forewarned is forearmed.

Mr. Chomiak: Mr. Chairperson, I wonder if the minister might give me an explanation as to the rationale behind and the basis of the new organization--I think it is about the third or fourth since I have been critic--about the functioning of this new organization chart.

Mr. McCrae: I will try, Mr. Chairperson, as the honourable member says, this is about the third or fourth chart since he has been critic, and that has been since when--about 1993?

As much as anything else, I suggest changes reflect changes in the reality of the health care map, as it were, right across this country. There are different objectives today than there used to be. The objectives today are achieving health, which has never really been a very big part of Health departments in the past. It goes to the basic philosophy of what is happening right across this country amongst the 10 provinces, of which Manitoba is the leading province when it comes to reforms, or if not the leading province, perhaps No. 2. I am led to believe we may be very high up there in terms of our performance as a reforming province.

So you are going to see organizational changes. It is not fair to ask hospital administrations across the province to address the layering of management that occurs in institutions like that without doing a little addressing of our own right in the department, and that happened last year about this time, that there was some major downsizing going on in the Department of Health itself at the so-called bureaucratic levels. So that would be reflected in organizational charts, too.

This one that he has in front of him is not brand new because it was tabled about a year ago, this particular one, I am advised. Is this different from last year's table? I do not think it would be very different unless last year reflected what had been going on before that.

A single sheet last year. Okay. So that would have been different than you might have seen in the official documents because it was right around this time when those organizational changes were happening last year.

We want to put the emphasis on health. For the first few decades of medicare the emphasis was on health care. That is where the honourable member still is, on health care, hospitals and nurses and unions. That is where he is.

We have gone far beyond the simple union approach to things that the honourable member supports to the exclusion of everything else. We are into working with people instead of dividing them. We are into trying to bring the best out in people rather than trying to bring out the anger in people. That is the philosophy we are developing.

This organizational chart, I hope, will help us do that. We are doing not so much different from other jurisdictions; maybe we are a little slower at it and that is because we can maybe afford to be a little slower at it, because we started sooner than most jurisdictions. We are not Saskatchewan, so we do not have to do it the way Saskatchewan does it. We do not have to build as many hospitals as they did. We do not have to close as many hospitals as they did. We do not have to shut down 10,000 hospital beds as they did in Ontario. We do not have to shut down seven hospitals in Montreal as was recently announced. We do not have to move in the drastic way that Alberta is moving, because we did not leave it as long as they did.

It took some provinces longer to recognize that there was trouble ahead if we did not smarten up. We are lucky to have the leadership we have in this province, in our departmental and in our hospital sectors where people are willing to say, I am willing to put aside my turf or my own personal interests and put the patient first. That is what is happening in Manitoba.

I see the chairperson of the Manitoba Home Care Advisory Committee is with us today; Paula Keirstead is here. There is another person and many more like her across our province who are willing to give so much of themselves to create a better health care system, not one that preserves only what the union bosses want. The union bosses are important. They have a role to play, but they are not health professionals. We have to recognize that.

If we want to tie all of our policymaking to the whims of the union bosses, we are in serious trouble as a country. It is something I rejected years ago and I continue to reject. I am critical of those who only look to their union boss friends before they make any decision about health care or anything else.

This chart reflects what we are trying to do. If it is necessary for us to adjust this chart for next year's Estimates, because it is necessary to keep moving toward the services in the community, to keep putting emphasis on health promotion, emphasis on disease prevention and emphasis on the postponement of disabilities that come very often with old age.

If another change in the chart is required to continue to make our health care system better and to make our health care system deal with the real determinants of health that are out there, things like our environment, things like our economic system, things like heredity and all of those things. Really, only a health-care, an institutional-based system does not really address all of those things.

That is the folly of the argument put forward by some people that says, just keep doing things the way we were doing it and spend more money on it, even though we do not have it, but go ahead and tax the people more, run up hugh deficits and ultimately strangle our health care system.

We will not be here. The kids will have to sort it all out. That is not good enough for Manitobans. That is not good enough for me.

Mr. Chomiak: The minister, I think, had trouble grasping the question. On this flow chart there are little bitty boxes that have little lines around them, little hyphenated lines, not straight solid lines. Why are those particular boxes delineated in that fashion, and what do they represent? Are they temporary manifestations or are they permanent line items? Are they given hyphenated lines around them because they are temporary, or what is the reason for that?

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Mr. McCrae: I did not actually draw the picture. I hoped the honourable member would realize that, but as long we have a home care system under which there is not a high, high level of satisfaction with the actual delivery of services we are going to need an appeal panel for home care.

As long, too, as we do not have the kind of perfection that we are looking for in the delivery of home care services, we are going to need an Advisory Committee to Continuing Care Program. As long as we have AIDS in our world and in our society, we are going to need advisory committees and other groups of people who can keep us informed on not only the latest developments but also on the latest needs that are out there and committees of the Health Board.

The Health Board is into different things at different times, and I am sure it will continue to have committees. I do not know why some boxes have little shadows beside them and some have dotted lines. Here is another one, an Advisory Committee on Mental Health Reform. Well, our mental health reforms are not finished. We talked about that a lot during the election campaign, especially in Brandon where we have had the Brandon Mental Health Centre for a long time, so as long as we need them we are going to have them.

Also, these committees are not staff people, so that is another reason for having a dotted line I guess. The ones in the solid boxes with the little shadows beside them I suggest are staff people, so they do not have the same kind of a box.

Mr. Assistant Deputy Chairperson: For the committee's reference, the discussion, the Organization Chart on page 9 is referenced in the Supplementary Information for Legislative Review.

Mr. Chomiak: I take it from the minister's long answer that those are nonstaff members. The minister's staff are nodding the affirmative. The advisory committee to the Continuing Care program, this was I believe the body that was set up about a year and a half ago to make recommendations concerning Continuing Care specifically. What is this body, the Advisory Committee to Continuing Care Program? Can the minister outline what body that is?

Mr. McCrae: Not too long after I became minister--and the honourable member remembers when that was and remembers all of the circumstances at the time--the Home Care program was not getting the kind of approbation that one would hope to get from the general public. I certainly could sense that, and I certainly knew that as a new minister I was not going to be able to address the problems that exist in a relatively new program developed--when I say that I mean 20 years or so old--but developing and trying to stay afloat in a very changing environment.

Problems are evident in a situation like that and there is no secret about that. I did not see how I could get through as a minister without first of all giving the clients of the Home Care program some kind of comfort, that there is an independent group there somewhere between you and the people making decisions about your life.

It was not good enough for me to ask people, well, if you do not like the decision made by the department go back to the department and tell your story again. It is not likely to work. The honourable member would know that you do not go to the same judge who made a decision to file an appeal. So that was a good reason for having the Home Care Appeal Panel, not unlike the Manitoba Health Board, which adjudicates disputes that members of the public would have with the Department of Health, with regard to their assessment at personal care homes. So at the health board we have this group that the health board reviews appeals of personal care assessments.

It is interesting that both the Manitoba health care appeal group and the appeal panel for home care do make adjustments to decisions made by the department, and the department becomes, I suggest, more sensitive to the issues that are out there, because many, many disputes, I am told by the appeal panels, are resolved before they ever have to go to an adjudication, which is really important because it brings out a sensitivity in the department. It also brings out an understanding on the part of the client as to what is really achievable in the home care department, unlike what the honourable member would have people believe. There are limits to what can be provided by the public to a client of the home care program, and that is where the advisory committee comes in. The advisory committee is there to tell us what is reasonable and achievable and what can provide the best levels of service for the whole population.

We are into a changing environment for home care, I suggest, and we are going to need the continuing advice of our advisory committee as we address changes. Indeed, the advisory committee is asking for changes, and we are moving towards implementing those changes.

Mr. Chomiak: Mr. Chairperson, I am glad the minister actually followed through and set up those committees as we had recommended prior to his establishment of these committees.

Can the minister give us a listing of all of the members of the various committees that are included on this organization page, which amounts to one, two, three, four, five committees? That is the appeal panel for home care, Advisory Committee to the Continuing Care Program, Minister's Advisory Committee on AIDS and the Advisory Committee on Mental Health Reform, the various committees under the Manitoba Health Board as well because I do not believe that any of those specific committees are listed on the health reform document that has been provided. But, notwithstanding that, can we have a list of all the membership of those committees?

Mr. McCrae: Yes, Mr. Chairperson.

Mr. Chomiak: Mr. Chairperson, the reason I asked the question prior to the most recent question was because there was a committee established following a documentary by CBC Television concerning nursing homes. That committee is not on this organization chart, and I do not see it, I stand to be corrected, on the health reform established committee by types of members listing. If it is there, can the minister advise me as to what committee that is and what the status is of that particular committee?

Mr. McCrae: Mr. Chairperson, that was not a Manitoba Health committee. That was a committee headed by the Seniors Directorate, and it had membership on it from the Department of Health and the Department of Family Services. I think that is correct, subject to check, but I am quite certain that is correct. They have produced a report, and that report will be forthcoming soon.

Mr. Chomiak: Thank you, Mr. Chairperson, so the minister is indicating we will see that report soon. Can we get a listing of the committee members to that committee as well?

Mr. McCrae: It was not a very big one. Some of our committees are quite big, but this one, I think, had basically one or two or something like that members from each of the agencies, the departments involved. So it was not a big committee. But, yes, I will give him the names of the people involved on that committee too.

Mr. Chomiak: The department has been changed in structure, and I note that the Supplementary Estimates have also been adjusted to reflect some change in terms of how matters are dealt with. I guess probably the best way to proceed on dealing with those is to deal with the individuals when they appear on the various lines in Estimates. So I will probably leave the specific questions on these until we get to the line items in the Expenditures.

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Having said that, I would like to continue along in this particular portion of the Estimates and ask the minister, under Executive Support, will the minister table for us today--it does not have to be tabled today, but for as soon as possible--reference in this committee, a listing of all the contracts, all the consulting contracts and the like that have been entered into by the department?

Mr. McCrae: We will consider the honourable member's request. I do not know whether to answer yes or no off the top of my head, so we will take his question under advisement.

Mr. Chomiak: Mr. Chairperson, I will return to that. I hope the minister will take it under advisement and consider that, because I think it would be useful to the process.

Can the minister outline, under the line item 1.(b)--I recognize what the Managerial support is, but again, can he go through the various positions in this particular line item and outline what Professional/Technical positions are there and what Administrative Support positions are there?

Mr. McCrae: Under 21.1(b) Executive Support, we have 12 staff years in total, which includes the minister's office and the deputy minister's office. There is a secretary to the minister, special assistant to the minister, a professional officer, an executive assistant, an administrative secretary and two clerical support positions shared by three people.

In the deputy minister's office, we have a deputy minister, an administrative officer, a secretary to the deputy minister, a clerical support person, and the professional nursing advisor is, for Estimates purposes, attached to the deputy minister's office.

Mr. Chomiak: Can the minister indicate who the professional officer is and what role that person fulfills?

Mr. McCrae: The professional officer in the minister's office is Debbie Vivian.

Mr. Chomiak: The second part of this question is: What role does this individual fulfill?

Mr. McCrae: A very important function. Ms. Vivian is a nurse by profession as well as a lawyer by profession and is charged with responsibilities which range from serving as a liaison between my office and nursing, the Manitoba Association of Registered Nurses, and our relationship has, I believe, grown stronger thanks to the efforts of Ms. Vivian.

The pharmaceutical community, the medical community, the medico-legal community and certainly our Home Care offices, the Home Care appeal and advisory offices, along with Kathleen Hachey, Debby Vivian has been involved in some of our ongoing working relationships there too. So that is just a few examples, not to mention the kind of work that comes across her desk on a daily basis that relates to any of those or other areas of concern to the busy office of a Minister of Health.

Mr. Chomiak: Can the minister indicate how long this person has been employed in that capacity?

Mr. McCrae: I do not have the precise date for you. I can get that, though. I think it is pushing a year or so, or maybe a little more. But I will check for the honourable member if I can be reminded to do that.

Mr. Chomiak: Thank you. Has that new position, professional officer, displaced another position in the offices of the minister and the deputy minister insofar as if we look at the Estimates from the previous year as well that there were only 12 staff years, but now we have a position of professional officer? In other words was there someone else fulfilling that position before? Is it a new position? And that is basically the question.

Mr. McCrae: That position existed before. Someone else was in it, someone else moved on to something else, and this person has taken that position.

Mr. Chomiak: Can I get a job description of what that role is?

Mr. McCrae: I do not think so. I will check, but I do not think a job description per se in the public service sense of the word exists. These are out-of-school people, so they do not really have the same sort of job description as you might have in a union shop.

Mr. Chomiak: The minister is saying there is no job descriptions that fit these out-of-school positions?

Mr. McCrae: I said I will check. I do not think so, but I will check. There is probably a contract of some kind governing the arrangement within that contract. There might be reference to duties as assigned, and we will come back to this if the honourable member wishes.

Mr. Chomiak: The new Deputy Minister of Health, I assume, is fulfilling his role on a full-time basis in the department and this question is--there will be others that the minister will probably construe as political, but this one is not political, even in the minister's incredible capacity to read politics into questions. This question--the deputy minister is also on faculty--is the deputy minister still on faculty? Does the deputy minister still undertake duties in that capacity at the university or how does that work?

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Mr. McCrae: We are fortunate that the deputy, that the University of Manitoba agreed to allow us to second him from the Faculty of Medicine at the University of Manitoba.

Mr. Chomiak: So the deputy minister is on secondment from the University of Manitoba on contract via Order-in-Council from the government.

Mr. McCrae: Yes.

Mr. Chomiak: The $110,800 that we are paying the deputy minister, is that the sum total that is remunerated to the Deputy Minister of Health?

Mr. McCrae: Dr. Wade is on secondment from the University of Manitoba, and when I said we were fortunate, I meant so literally and financially, because he is paid on the salary of a deputy minister, which ranges at this particular classification from $96,200 to $116,100. Dr. Wade is at the top of the classification.

Mr. Chomiak: So his total remuneration, therefore, comes from the Department of Health via the deputy minister's salary.

Mr. McCrae: We pay the university the amount that we would pay a deputy minister at that level, and the university pays Dr. Wade. There is no additional remuneration other than that.

Mr. Chomiak: How is the level determined in terms of what is paid to the deputy minister?

Mr. McCrae: Negotiation.

Mr. Chomiak: The minister will undoubtedly recall that I raised this issue during the last Estimates, concerning the increase in salary for the deputy minister over the past several years. It has been a fairly dramatic increase from the previous period with regard to the actual salary level. This is no reflection on the current holder of the office, but it has gone up substantially in relation to the other levels of salary of other individuals and people employed in the executive level of the department, and it is a fairly significant increase.

I am wondering if the minister might have a comment on that.

Mr. McCrae: No, I do not think I need to add anything to what the honourable member has said, as I said, with respect to the present income. This matter was negotiated and, in my view, as the honourable member has been gracious enough to say so, we are indeed fortunate to have someone of the calibre of Dr. Wade heading up the Executive branch of our department.

Mr. Chomiak: When one reads through the Activity Identification and Expected Results under this particular subappropriation, it certainly suggests that there are specific highlights and priorities that have been adopted by the department in terms of its direction.

I am phrasing this question very carefully so that hopefully I can get a specific answer to the question, and that is, during the course of the Estimates last term, we suggested that perhaps the government ought to do an update or review of the blue book as to what the status is of the various categories under the blue book.

I think the blue book, the 1992 reform plan that was much--well, it was brought about by the previous minister and adopted by this minister--[interjection] The minister is commenting. I am resisting the temptation to go down that path, but if the minister can indicate whether or not there is an update or a status report with respect to the 1992 plan.

Mr. McCrae: In a way, Mr. Chairperson, you could say that we just went through that. We had a very public airing of all of the health issues in the approximately 35 days prior to April 25. There was a lot of public discussion about that. I am not saying it this way for any other reason except to say, that is exactly what happened. There was a major consultation with the people of Manitoba about where we are going in Health. The whole issue of health and health care became a very major election issue and, I suggest, appropriately so. A full airing was had, decisions made, and we go forward.

However, the 1992 plan was very much heralded and approved. I have yet to find anybody in Manitoba who says they are against the Quality Health for Manitobans - The Action Plan. If anybody is, they have not said so to me. That is really important, because we already developed a consensus on what we should be doing.

Now, the honourable member, I understand, never says one way or the other about this, except that I understand they have agreed at one time or another with The Action Plan. Now, of course, every step of the way, for whatever reasons they do the things they do, they will be critical. That is what we talked about already, so I do not want to go on at length about that.

However, I think what the honourable member is saying is something that the department is indeed working on, a sense of finding ways to give the public perhaps a better update than has been given thus far. I think that if the public had been given a better update, the honourable member might not have got as much attention as he got in the last while, and I give him credit for that, but if we had done a better job of communicating with the public, we might be in a better position to move forward even more effectively than we are.

I suggest we are moving forward effectively with transformation of the health system, but you can always do things better. Anybody who ever says that it could not be done better than we are doing it is sort of living in some other world that does not resemble reality.

So what plans do we have? Well, the honourable member will see the general public, I think, taken into the confidence of all of the players in the health system more and more, not less and less, as the honourable member sometimes likes to imply, but more and more. That is the best thing we can do, because it will dismiss all the myths that some people like to float around about health and their health system. It also reinforces the values that we want to work together to achieve in an effective health system.

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So I do not have a really good answer for the honourable member about when you can seize something that you could call an update or anything like that. But I know that there are people doing a lot of thinking about how to achieve just what the honourable member is asking for. I think it is necessary and I think his suggestion is helpful and meaningful, and whatever costs might be incurred in bringing the public more into the debate than they already are, or into the discussion, whatever costs might be incurred in public education, that we can expect the honourable member's support. I really welcome that, because we need to do that.

Mr. Chomiak: We sincerely look forward to the government actually including the public in its deliberations and its decision-making process. It has been something that has been seriously lacking to this process, and I might suggest that we have brought before the House the last two years a bill called The Health Reform Accountability Act that could, in a legislative way, sort of set out a broad guideline to allow the public to be involved. We certainly would welcome the government supporting us and assisting us in bringing the public into the process because surely we can all agree that the government has done not a very good job of providing for public input in the health care field.

That is probably one of the reasons that 57 percent of Manitobans voted against this government in terms of the last provincial election, and a majority of Manitobans voted against this government's health reform plans. That is one of the few political comments I have got in, but I suggest it was nigh time, given the minister's constant reference and constant attempt to refight the election campaign and not basically deal with the specific questions as outlined by myself as we go along.

I believe the member for The Maples has a question. I will pass.

Mr. McCrae: I do not know if I detected the question in what the honourable member said. I do want to hear what the member for The Maples has to say. But, you know, I guess he was saying, what about this public health accountability act that we New Democrats keep pushing? He says 57 percent of the people I guess voted for that. I guess everyone is going to have their own interpretation of what the vote was. I do not know how reliable it would be for me to offer my judgment on that because it might not be something the member agrees with, or anybody else for that matter. Everybody has their own interpretation of what the vote meant.

But we are accountable to the people. Here we are--what was it last year, 50 hours that the honourable member put us through, and the Liberals too, of accountability in health? That is accountability.

The honourable member says, well, we want to have accountability, so let us go with this legislation. Yet the member for Brandon East (Mr. Leonard Evans), in a very convoluted and circumlocutional sort of argument, puts forward the idea the legislation does not mean anything anyway. You see, you cannot, on the one hand, argue that you need to have legislation like the public health accountability act, because legislation is really powerful stuff, and when it comes to balanced budget legislation, the New Democrats argue that legislation is not carved in stone. It is not a constitutional amendment. I mean, the honourable member for Brandon East--it is going to be a long, long time before I let him forget what he said yesterday in the Legislature about legislation not having any teeth or not being engraved in stone. I guess the next thing is that we are going to have another Charlottetown round to build the honourable member for Kildonan's (Mr. Chomiak) health accountability act into it so that it can have the power and the teeth that the honourable member wants it to have. I do digress just a little bit.

We are accountable through the Provincial Auditor of our province. We are accountable through this Legislature. We are accountable through this Estimates process, and the ultimate in accountability we just all went through. The honourable member does not like me to mention it. We just had an election, and the results are now clear on that. I congratulate all the members who found their way back here and all the new ones that found their way here. That is what accountability and democracy is all about.

I do not believe in building bureaucracies for the love of building bureaucracies so that I can say, there, I spent another million dollars on some bureaucrats to look over our shoulders, even though we already have a Provincial Auditor, even though we already have boards at all of our various institutions who are made up of volunteer citizens of our communities, even though we have the Legislature, even though we have a 240-hour Estimates process through which the Health department was put through some 50 hours last year. I do not know what the average is, but it is over 40 hours, I think, each time. This time the member for Kildonan (Mr. Chomiak) is saying maybe 80 hours for the Health department. He does not know for sure, but he did say--maybe I should not have said that. You also said 30, 40, 50, 80. So we do not know for sure how many hours--

Mr. Chomiak: Mr. Chairperson, I certainly can clarify. If the minister continues to digress, I am certain we will be here that long. If the minister would stick to the answers to the questions, then perhaps we could expedite this matter. I said that in my opening comments and I hold to that. If the minister will answer the questions, we can certainly expedite the process, and I think it is in the interest of all Manitobans that we do so.

Mr. McCrae: There again, Mr. Chairperson, more threats and intimidation. The same thing the New Democrats did to the seniors of this province in the recent election campaign, and here they are doing it here again. As my old friend Mr. Mandrake, the former member for Assiniboia, used to say, there he goes again.

Anyway, I know the honourable member for The Maples (Mr. Kowalski) has something to offer that may bring us back to earth, we hope.

Mr. Kowalski: Before I ask my question, I just want to mention that I remember when I was on the police force arresting two people who were fighting on Main Street--

Mr. Assistant Deputy Chairperson: Could I ask you to bring your mike closer forward, please?

Mr. Kowalski: Certainly. I arrested two people who were fighting on Main Street, one an obvious winner and the other one lying on the sidewalk. We handcuffed the winner, and because I was walking a beat, we had to use a patrol wagon. We put them both in the back of the patrol wagon, and they just did not know when the fight was over and they continued to fight. It reminds me of the two members here today. They do not know when the fight is over and when to stop.

My question very simply is, are there any ongoing costs to do with the severance of the former deputy minister, Frank Maynard, that would be reflected in this year's budget Estimates?

Mr. McCrae: No, Mr. Chairperson.

Mr. Chomiak: I wonder if the minister might outline for me under this particular section what the priorities are, what the deputy minister sees as the priorities perhaps with respect to the upcoming fiscal year of '95-96 that are reflected in these particular Estimates?

Mr. McCrae: The fiscal year '95-96 is the one we are in and that is the fiscal year that is reflected in our budget documents,and the priorities are very clear. They are set out in the numbers that are there in the budget. In terms of health as a priority, I think I mentioned that at 34 percent of the spending it clearly the top priority of this government but it is also a higher priority here in Manitoba than it ever was under any other government in Manitoba, including the one the honourable member would like to have been part of,and it is a greater priority than any other government in the country.

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The priorities are set out in the various appropriations here. Hospitals, personal care homes, community health centres are getting an amount this year similar to the amount they got last year, about $1.2 billion. Within that number--this bears on the question raised, I believe, yesterday by the honourable member about Seven Oaks Hospital--you will see shifts for the most part from the acute care sector into the primary sector or community sector.

Of course, that is the trouble--I guess ministers of Health right across the country have the same problem. If a member of the opposition for political gain or purposes raises a question about a reduction in funding for an acute care centre, in the absence of everything else that is going on, bingo, points have been made, brownie points. That is what we live with. Luckily the people of Manitoba see through that sort of stuff.

The fact is if there are X dollars coming away from hospitals, then there are X dollars going to somewhere else in that system that I have referred to, because it is $1.2 billion this year, $1.2 billion last year.

The honourable member knows that most of the reduction in the overall budget this year for the Health department has to do with that line dealing with the medical doctors and the medical services appropriation--most of it. I do not know if there is much else anywhere else. There would be maybe some small amounts somewhere, but I think it is about $8 million that comes out of the medical appropriation. That is the subject of today's questions by the honourable member dealing with eye care. Well, eye care is something that is part of that appropriation, and the Medical Services Council, I am told, is looking at eye care with a view perhaps to making recommendations, but they are a long ways from that at this point. I have been asked to veto recommendations that do not yet exist. They may exist, and I fully expect that the Manitoba Medical Services Council will review this matter logically, and if at the end of its review it feels that it ought not to make any recommendations about eye care or optometrists' fees, then it will not do so. If it feels that it should in the interests of the public and the sustainability of our health care system, then they will. Then I will look at them and the honourable member and I can go over those matters at that time.

I think the honourable member is referring to the role and mission statement set out on page 7 of the Supplementary Information for Legislative Review document. In that role and mission statement there is a discussion about how the department operates within the government structure and operates also under certain statutes and responsibilities that are charged to the minister. We have a legislative mandate in some areas and we have emerging health care issues, so we need to establish a proper framework upon which could fit the planning and delivery of our services.

We want to put more emphasis, as it sets out in this description, on improving and promoting the health status of Manitobans. If there are any qualities, which there are, we want to deal with that. In other words, people in the core area of the city of Winnipeg, they are not as healthy as people in other areas of Winnipeg. People in the North are not as healthy as people in the south. Why? They have relatively equal access to the system, to the health care system. They do not have equal access to the economic system that some other people have. They do not get sometimes a good breakfast, the kids, before they go to school and that impacts on their health status, or their moms from the time of conception on maybe did not get looked after or looked after themselves as well as somebody who lives in Tuxedo or one of the more affluent areas of Manitoba, or Kildonan. The children in those areas get a better deal from the day that they are conceived than the children in the core or in the North. I am speaking on average.

There is something that needs to be done about that, and we are trying really hard as a department to make the shifts to start addressing that. We are doing that at a time when we cannot just keep throwing more money into the pot. It just does not exist, more money. We know that our partner in Ottawa is disappearing, with no criticism for the present partner. It is not the first partner that has begun this decline in their partnership. There are big-time worries here, mind you, for those of us--not those of us, because I think Manitoba is exempt from this comment. Provinces that have not seen this coming are not very well prepared today, and we are seeing evidence of it in Montreal and in Alberta and in the NDP provinces especially. They did not make the appropriate plans except to hack and slash. That is not the way we do things in Manitoba and that is not the way we propose to.

So the health status, reducing the inequalities in health status, is a very, very laudable goal, I suggest, and probably one that is shared by honourable members around this table. But that does not just happen, as honourable members already know. As our friend Michael Decter tells us, it does not just happen. Those who like to read Dr. Rachlis's book, fine, read that, but read Michael Decter's too because probably the message is not dissimilar. Certainly Michael Decter's message is not dissimilar to what is going on in Manitoba and in varying degrees in other places. It is a question of how you get there. I do not think there is that much debate about where we want to get to, because I still have not heard the honourable member for Kildonan say that he disagrees with the action plan. He has not said that. He very carefully, I suggest, has not said that, but he has not said it. If he would say that is the right plan, well, that would be fine. I do not crave that to happen. I mean, it does not matter if he says it or not. It is common sense what is in that plan. It is the implementation that is raised by opposition parties, certainly one of them, as basically their whole election platform.

But we are all trying to get to the same place and who can get there best? Well, I suggest to you, the government that espouses balanced budgets is going to get there more likely and is more likely to stay there than a government that has no regard whatever for the financial aspects of the running of the health system. Those are the philosophical differences that come between us.

I probably have said enough about this but--none of this is going to happen without an eye to the innovations, without an eye to the technological changes and improvements that have been occurring for many years. Sometimes people put forward positions totally in isolation from other changes that have been happening in the system. I will stop right there and let the member try again if he needs to.

Mr. Chomiak: Mr. Chairperson, I am glad the minister referred to the announcement on November 22 about new health facility funding because at the time of that announcement, the government suggested, in fact, the government indicated, that there would be a 2 percent cut to the hospitals.

At the time there was the announcement of the stay-the-course, in terms of the actual funding, at one point $2 billion, there was a recommendation that the hospitals would be cut by 2 percent, and, in fact, that amounts to approximate--and that is actually at the core of some of the questions we are going to be getting at during the course of these particular Estimates, that is there was a 2 percent reduction of the hospitals, and there was a suggestion at the time that there would be expansive community-based services and various other procedures, which we will be also dealing with in the course of these events.

The fact is we will want specific information on that money allocation and money flow because, frankly, the argument that the minister is making, that the decrease is as a result of the MMA agreement and only in the medical sector is wrong and not accurate, because it contradicts what was announced on November 22 in fact.

It also is ironic that the minister is saying there is no attempt to winnow down the procedures offered when in fact they have put into the Estimates book the decrease as a result of the Manitoba Medical agreement, so clearly, there is money that has to come out. The minister is saying no decisions have been made, no final decisions have been made. That does not change the fact that as a component part of the MMA agreement, there is a section of the agreement--I pointed it out to the minister in the House that there is in fact a section that mandates there shall be a cut in '95-96, in the agreement, in the MMA agreement, and at least a portion of that cut is reflected in the '95-96 Estimates.

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In addition to that, there is a 2 percent cut to the hospitals, as announced on November 22. It was announced, not actually by the Health minister, but by the Minister of Finance and the chief accountant for the province, Mr. Jules Benson, who in fact, in this very room--

Mr. Assistant Deputy Chairperson: The hour now being five o'clock and time for private members' hour. Committee rise.