4th-36th Vol. 30-Committee of Supply-Health

When the committee last sat, it had been considering item 21.1.(b)(1) on page 71 of the Estimates book. Shall the item pass?

Hon. Darren Praznik (Minister of Health): Mr. Chair, just by way of logistics, I would like to table for the committee a list of our medical officers of Health which was requested by the member for Kildonan (Mr. Chomiak).

I would also like to table a sample of our central bed registry, which I believe currently is in use on a paper system, and I would ask the member, when we return to Ms. Hicks and regional health authority and the WHA--that would probably be an appropriate time to ask specific questions about it. I have a couple of others; I just want to have a quick perusal before I provide them to the member.

As well, by way of logistics, I think the member wanted to discuss today the Urban Shared Services, and if I may introduce, with his--[interjection] Good.

Mr. Dave Chomiak (Kildonan): Mr. Chairperson, just planning ahead for purposes of the minister. Yes, I appreciate the minister working on this, that we are going to deal with the Urban Shared Services today. Presumably, if we get done Thursday, we can do the capital. Is that still on for capital?

Mr. Praznik: Yes.

Mr. Chomiak: The minister is in the affirmative. Then I was contemplating for next week, we could start the regional health authorities segment next week, and that would include Ms. Hicks' portions, because she is gone after Friday, if I understand correctly.

Mr. Praznik: Mr. Chair, with respect to capital, we had discussed some issues around the community contribution policy, and I can tell the member that I have some information that will likely be going out tomorrow afternoon. So I flag this with my staff; we will provide it to him in advance of Thursday if that is practical.

Mr. Chomiak: Mr. Chairperson, I guess then we should proceed and try to get through as much as we can today. Hopefully, we can cover it today, but there is no guarantee. So I will leave it to the--

Mr. Praznik: Mr. Chair, before introducing the individuals who are joining us, I would just like to put on the record by way of structure that Urban Shared Services is, as anyone who examines will realize--and I know the member does--a corporation that is owned by the nine Winnipeg hospitals. It was created by them. They, of course, do co-operate and co-ordinate and discuss matters with the Minister of Health--I do not deny that--but it is owned by the nine hospitals.

There is not always agreement, of course, between those hospitals and the province with respect to issues. I do flag that; that happens from time to time. So I have asked if Urban Shared Services would make available their chief executive officer to deal with a number of technical issues that the member may in fact want to discuss or a conveyance of some of the policy of Urban Shared Services as appropriate.

I have also asked Gloria O'Rourke--I have asked the Winnipeg Hospital Authority to join us as well, represented by Ms. Gloria O'Rourke, who is the director of the labour relations secretariat, because a number of the issues around Urban Shared Services involve the placement of labour relations issues.

So I have asked both to join us, should that become a matter of issue. But I did want to put that qualifier on that both of these people do not work for the Ministry of Health, nor are they directly answerable to me, so I am not their employer. They are here on behalf of their organizations, but both of their organizations obviously work very closely with the ministry. I am sure the member does appreciate that particular point.

Mr. Chairperson: Might I have the agreement of the committee that indeed these people may answer questions during committee? [interjection] They do not work directly for government, so that is why I am asking.

Mr. Chomiak: Mr. Chairperson, I do not have a problem with that.

Mr. Chairperson: Is it agreed then? [agreed]

Mr. Chomiak: Can the minister indicate specifically what the legal relationship is between the provincial Department of Health and the Urban Shared Services Corporation in the legal sense?

Mr. Praznik: Mr. Chair, Urban Shared Services, as I understand it--and Mr. Sheil may correct me if I am wrong here, but I understand it that Urban Shared Services is a corporation that is incorporated under the laws of the Province of Manitoba. Its shareholders are the nine existing Winnipeg hospitals. It was created, and Mr. Sheil may want to elaborate, but my recollection is it was created for the purposes of finding areas in which those hospitals could co-operate in developing shared services between them. Needless to say, I think when this was in fact created, it was done--I was not minister at the time--but with the concurrence of the minister of the day.

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Legally, Manitoba Health now, after April 1, provides its funding and policy direction to the Winnipeg Hospital Authority. That hospital authority is in the process of negotiating its operating agreements with each of the nine hospitals. They in turn are the shareholders of Urban Shared Services.

In some of the planning for the Winnipeg Hospital Authority--and at some point in time, my understanding is that we will have Mr. Fast and Mr. Webster here to discuss some of their issues as they may arise with this committee. But, in my understanding, there is some contemplation at some point in time--Urban Shared Services--and this would not be fair for Mr. Sheil to answer; it is not in his purview--but there is some contemplation that Urban Shared Services may, if their shareholders are in agreement, become, in fact, an operating part of the Winnipeg Hospital Authority. Certainly in the discussions I have had with the WHA, that is a possibility at some time in the future but one which the WHA quite frankly has not had time to address.

Mr. Chomiak: Can the minister confirm whether or not the associate deputy minister is a member of the board of directors of the Urban Shared Services Corporation?

Mr. Praznik: Mr. Chair, no, the associate deputy minister, Mr. Potter, is not a member of the board of directors, but the board of directors has allowed him to observe at their meetings, and obviously the WHA, the relationship there is one that is developing as we restructure the organization of health care. Certainly, the option of having Urban Shared Services move into the WHA as an operating arm of the WHA is a possibility and something we certainly want to ensure is properly canvassed.

Mr. Chomiak: I am looking at a publication of Urban Shared Services dated, I believe, June '97, which indicates the board of directors of the Urban Shared Services Corporation consists of Mr. Ted Bartman and Mr. Bill Patmore, Don Potter, Norm Kasian and Marion Suski, Ken Tremblay, Tom Woodward, Jan Currie, Pat Matthews, John Bulman, Deborah JohansenYoung [phonetic], Major John McFarlane, Rod Thorfinnson, Robert Vandewater, Derek Johannson.

Can the minister indicate if that is an accurate list, and if it is not, can I get an updated list of who consists of the board of directors?

Mr. Praznik: That is correct. Yes, Mr. Chair, we will provide you with an updated list, but Mr. Potter is not a member of that board of directors. He may want to indicate when in fact he left the corporation as a member of the board of directors.

Mr. Don Potter (Associate Deputy Minister, Internal Programs and Operations): Yes, I am no longer on the board of directors for the corporation.

Mr. Praznik: I understand that Mr. Gordon Webster is also a regular invited guest or observer at board of directors' meetings, and I think that makes absolutely good sense, given that we are in a period of transition.

Mr. Chomiak: The minister said in his opening comments that the shareholders--perhaps I will not quote the minister. I will ask the minister to precisely outline for me how Urban Shared Services Corporation is funded, and whether any direct provincial funding goes to the Urban Shared Corporation, one form or another.

Mr. Praznik: Yes, Mr. Chair, I understand that Urban Shared Services is today funded by the hospitals on an allocation of resources to Urban Shared Services, but this does come into the realm of policy direction as to how we are moving in our funding models for facilities within the system.

Part of the whole regionalization process, and again Winnipeg is somewhat different from rural, in that currently the existing boards remain, although I understand some of the facilities have had discussions about evolving into the WHA directly, so this may in fact change over the next number of months.

But certainly, as we develop new models, what is key with regionalization is going to program deliveries with one program head, and the funding for that program, even though it may be delivered in multisites, being within one envelope. Consequently, over the next number of years, there will be very significant changes in the way that provincial taxpayers' money is allocated for the delivery of service within the hospital system.

So, over the next few years, as this develops and is fine-tuned, the tradition of Manitoba Health, now the Winnipeg Hospital Authority, simply providing a block of funds to a particular institution to deliver all of the services within their purview, will be evolving into something very different where the specific programs run by the WHA will be funded by the WHA, and the hospitals will be funded for the particular things that they in fact do. That is why over the next while, it is quite possible, although that certainly that policy decision is yet to be made, but it is quite possible that the funding for Urban Shared Services, for many of the things they do, if not all of them, would be directly from the Winnipeg Hospital Authority.

That is why when some of your colleagues continually talk about privatization of the service, if anything, we are taking it out of those hands and really are centralizing it, if this in fact happens, with its financing over a period, directly under a government-appointed agency.

Mr. Chomiak: What check does the government have on the funding allocations at present that go to Urban Shared Services Corporation, and the ultimate disposition of that money in whatever kind of contractual form or whatever kind of arrangement?

Mr. Praznik: Under the old system in which we delivered health care, quite frankly, none because we block-funded each of the facilities to deliver services, and this has been one of my continual debates, or one of the continual points that I try to make in the need for regionalization and reform, is that we are taking--in fact, in virtually all of our hospitals, even the faith-based, some 99 percent-plus of their operating budget is public money paid for by the taxpayers of this province. Yet the levels of accountability for program choices--and I am not for one minute implying that people are stealing money, not at all, but what I am saying is that the choices that are made and how dollars are spent within that system become the choices, to some degree, of that board of directors, and they may not always be the choices of the public or the public's trustees would make. Consequently, having a greater degree of accountability for how dollars are spent and for the choices that are made is absolutely an essential part of where we are heading.

So, under the old system, there is not accountability. It is very indirect. Urban Shared Services dollars come from the budgets of the nine facilities. We traditionally have block-funded those nine facilities. The level of accountability in terms of information flow and knowing what we are getting often is one that I would indicate is somewhat lacking. As we develop our new budget systems, the degree of accountability is expected to be far greater, when we will be able to know what we are buying, what we are paying for, what choices that we can make in the delivery of service that is far more accountable to the public of Manitoba.

Mr. Chomiak: Mr. Chairperson, the minister implies that the new structure will provide for more direct ascertaining of where funds may go, but the accountability function of government is no different under the new structure as under the former structure to the extent that money is simply flowing to trustees in one form of trustees to another form, albeit nonelected at that, and they are simply allocated the funds on that basis, so in that sense, in terms of the overall accountability and the ability of government, it does not change one iota.

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Mr. Praznik: Well, Mr. Chair, I beg to differ. The member's comment would only be correct if, in fact, we block-funded and did not appoint the boards. A big difference is we today, other than I believe Deer Lodge which is a provincially appointed board, do not appoint those boards. By and large, they are appointed by their own mechanisms, so the accountability for their decisions does not rest with a public agency.

That is one, whereas the Winnipeg Hospital Authority is appointed by the Minister of Health, and I recognize--the member shakes his head somewhat--that that in itself may not ensure accountability. What becomes very important is the funding mechanism, the model that one uses to fund and that we are in the process of building, and that is part of Mr. Potter's job with the Winnipeg Hospital Authority. We are not there yet and it is going to take a number of years to do, but we want to have a much more accountable funding mechanism, where we, as the Ministry of Health, know what we are buying and paying for and what choices are made within those dollars, and we continually have seen example after example within the existing system where there is limited accountability at best, where choices often get made that are not necessarily the choices of the Ministry of Health or we as public trustees, as a Legislature.

Every time those choices are made and things do not necessarily get done, the argument is always made that there was not enough money in the system, but what the existing facilities do not tell you is where they spent that existing money, and in some cases it is not in places that I am sure the member for Kildonan would put on his priority list, nor would I.

So the accountability has to be there in the mechanism for funding. It has to be a much more direct model, one in which we know what services we are buying with taxpayers' money that are being delivered by a regional health authority, whether it be rural or in Winnipeg. Is it going to happen overnight? Not at all. But is it going to happen over a number of years? I believe it has to if we are going to be able to make good decisions and have good planning in the delivery of our health care system.

So if we just relied on the appointment of the board, and I know the member was shaking his head, I would agree with him. That is it not going to assure accountability. It is a little bit more accountable than not appointing the board, and if you left the old system of block-funding in place, I would agree with him wholly, you are still not going to get the accountability. You have replaced one system with another.

But if you change the method of funding and if you have much more accountability on the lines for what we are paying, to know what we are paying for and what choices are made between various lines, then you will have that public accountability, and, ultimately, those lines will have to come to this table for scrutiny, as well, in the Estimate process.

Mr. Chomiak: Could the minister indicate what the budget for Urban Shared Services Corporation is this year and where that money is being allocated from?

Mr. Praznik: Mr. Chair, again, one of the dilemmas of the current system. I do not have that information. It is with their board. It is only in the purview of their board to release it publicly, and I understand they have not yet done so. So, again, given this relationship, I am not in a position to provide that to the member. All that I would have in my lines traditionally is what each hospital would receive in its funding.

In this case, the Winnipeg Hospital Authority which would be purchasing those services were providing for those hospitals. So, again, the member's question which should have some answer is one because of the nature of the system that does not. I am not happy with that particular fact and that is one of the reasons why we are changing things.

Mr. Chomiak: The minister has made my point very clearly. The minister counters that he thought I made his. It is very clear to me that as an elected representative of the people who is supposed to purview expenditures, I have no access to the information of significant sums of taxpayers' money that is being spent on a project or projects for which I do not have the opportunity to question or to query. Consequently, the level of accountability is diminished, if anything, and that is one of the reasons why there is so much controversy regarding this scheme and this program that was put in place.

Now I do not want to go down this road and get into a huge debate because it will eat up all the time, but I was there at the initial founding of the USSC, when grandiose schemes were laid out and when plans and promises were made that have not come to fruition. We are now several years into this and we are now into major capital expenditures, major construction, major job loss, major controversy, and it is very difficult, even impossible, to deal with the numbers and the figures concerning this project.

Mr. Praznik: Mr. Chair, the member has made my point, I would argue very strongly. I would remind him that in debate in the Legislature just the other day, his Leader talked about the greatness of these volunteer boards we have administering hospitals, and they are volunteer boards and they are so important to our system. Well, that structure of the boards keeps independent health care institutions in operation that do not have that public accountability, and I am as equally offended by that fact as he is, because I as minister am responsible for the delivery of service.

In the case of a hospital like St. Boniface, for example, over 99 percent of its budget is paid for by the taxpayers of this province, yet we provide the dollars and they make their decisions and, yes, we put some guidelines around it, but is there that accountability? Does the St. Boniface Hospital Board come to this committee of the Legislature to justify their expenditures as every other government department has to do? Not at all.

So here we are fundamentally changing that delivery set system. One of the places we still have a difficulty in that change, which I have discussed in the House, is the relationship under the faith-based agreement and some of the things we believe we need to have to be able to have accountability, to be able to have the flexibility we knew to improve programming. When we discuss this in the House, I hear his Leader defend the whole independence of volunteer boards. Well, with that package comes exactly the type of lack of accountability that the member talks about. I do not for one minute think that the member and I are on the wrong track. I believe fundamentally in listening to the member for Kildonan. Having worked with him and knowing where he is coming from, he is absolutely right. He makes the point that this is public money and it should be accountable, and those decisions and choices that are made within it should be answerable to us as the legislators of this province, entrusted by the public, who vote some nearly $2 billion a year for the expenditure on health care services.

One of the frustrations that I have seen with Health minister after Health minister is we go to Treasury Board asking for those dollars realizing that we are not responsible, or we do not have power, over how actually they are used in the delivery of services, and that is not the way in my view to run a modern health care system in an industrial country. I am a very strong believer in our public health care system. I believe it gives us the most efficient system around, but there has to be accountability in it. There has to be choices that we make in how we expend dollars.

As long as we are using independent bodies with their volunteer boards--and I know this was not the member's statement, but it was his leader's statement. I would like to think it was one without a great deal of thought that was uttered across the Chamber.

But, if one takes that position where all we do is turn over dollars to independent bodies with their own volunteer boards, at the end of the day how do we become accountable? How are we accountable to the public for the choices that are made in the expenditure of those dollars?

I am not happy with that at all. Obviously, part of regionalization, and it does not all happen overnight, but in the discussions that we have had with the WHA, if one looks at their planning and their structure, they obviously are moving to the opinion that Urban Shared Services, because it is a major part of the operation of facilities in terms of the structure, ultimately have to end up as an operating part of the Winnipeg Hospital Authority, which makes it a public agency, part of a public agency and publicly accountable. And does this minister support that? Absolutely. Are we there yet today? No, we are not. If the member's advice to me is we should move there posthaste to be able to have that accountability, you bet; I am with that.

Mr. Chomiak: Can the minister indicate whether there is still the existing nine shareholders of the Urban Shared Services Corporation?

Mr. Praznik: Yes, I understand that is correct.

Mr. Chomiak: In addition to the nine shareholders, can the minister indicate who the 14 facilities are that the Shared Services Corporation serves?

Mr. Praznik: I am going to ask Mr. Sheil to answer.

Mr. Joe Sheil (Chief Executive Officer, Urban Shares Services Corporation): The 14 facilities that we service are the nine Winnipeg hospitals and five nursing homes.

Mr. Chomiak: Can I have the name of the nursing homes, please?

Mr. Sheil: To the best of my knowledge--and I may be incorrect and will gladly give better information--they are Tache, Foyer Valade, St. Joseph's, St. Amant and Holy Family.

Mr. Chomiak: Is there any intention to expand the operations to include other facilities?

Mr. Praznik: Mr. Chair, that obviously is a question that the current board has to answer. If the WHA is to eventually take over Urban Shared Services, that would certainly fall in its purview. I know the member appreciates we are in a transition period. I cannot answer that question because I am not responsible for the corporation today. Mr. Sheil is not in a policy position to answer that.

I will tell him this: that I would expect that the public of Manitoba should see this operation operate on a common-sense basis. Where it makes common sense to provide services, it should; where it does not, it should not. I do not think one could ask for anything more or anything less. I would hope and expect that that is in fact what is happening today, and I certainly have some power over it, Urban Shared Services, if and when they become part of the WHA.

Mr. Chomiak: So if I take the minister's response, there is presently the nine urban facilities, plus the five nursing homes--Tache, Foyer Valade, St. Joseph's, Holy Family and St. Amant that are operated by Urban Shared Services, but the minister cannot tell me whether or not other facilities will be taken within the purview of Urban Shared facilities either this year or in the future.

Mr. Chairperson: The honourable member for Kildonan, could you please repeat.

Mr. Chomiak: The minister is indicating that the sole authority or range of services of Urban Shared Services at present are the nine shareholder facilities, plus the five nursing homes as mentioned by Mr. Sheil, which include Tache, Foyer Valade, St. Joseph's, Holy Family and St. Amant, and that the minister does not know whether other facilities, either this fiscal year or next, will be brought under the auspices of the Urban Shared Services Corporation.

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Mr. Praznik: I want to be very careful with this question because there are a variety of services that Urban Shared Services offer, some of which in sharing make good sense, others that do not. By giving a carte blanche answer in an area that I am quite frankly not up on all the detail--and I really should be--because it is an administrative matter of those facilities today, I would not want to leave an impression that is going to be boomeranged back to hit me to say that we have committed to take over the kitchens and all personal care homes or anything of that nature. So I want to be very cautious with my answer. Obviously, when Urban Shared Services, if and when the WHA's role expands to deal with them, they will have to look on what services they were offering and common sense has to be, I think, the rule that applies.

I know that there has been some concern with respect to food services in personal care homes. I know that an argument has been made with me, I think a very strong one by many of those facilities, about the need to maintain kitchens in those places just for issues of aroma and other in the home that it is part of someone's home. It is where they live; they are there for a long period of time. That does cause some difficulty with centralization of food services and that is certainly worthy of consideration. It is certainly a point that I think is valid and needs to be looked at.

So there is a lot of work to be done by the WHA and the WCA, and I am certainly not going to make a comment here today at this committee that is going to lead to an interpretation that is certainly not there.

Mr. Chomiak: Can the government indicate what the policy is with respect to the construction or renovation of new or existing nursing homes with respect to kitchen facilities?

Mr. Praznik: Mr. Chair, it is a matter of reviewing each case. We have not made a policy on it. I do know that in rural Manitoba where we can have services in one community delivered out of one kitchen, they have made sense. In fact, if you look at our capital plan, I think we have put the dollars into Minnedosa this year to move the kitchen. Currently, the kitchen at the hospital supplies the personal care home and the hospital. There was a whole bunch of reasons why that should be reversed. So in our capital program this year in Minnedosa, for example, we are putting the kitchen facility--I look to my staff just to confirm if that is accurate--into the personal care home, as opposed to the kitchen; and, there is a much better delivery system, the nature of the facilities.

I know that part of the discussions around the Beausejour Hospital in my area, whether we renovate or add on, build a new facility as part of the personal care home, there are issues around a kitchen supply there that have to be dealt with ultimately. I know that when the personal care home was renovated a few years ago--the kitchen and laundry services--it was anticipated that if we built the hospital onto the Beausejour Hospital that those two services would be provided out of those kitchens. But, I think there is some technical issue that has happened in the meantime that has to be sorted out.

So if you are looking for a carte blanche policy that government is saying we want all kitchens everywhere to be serviced centrally, that is not the case. We have not made that policy.

Mr. Chomiak: Can the minister undertake to table, when we get to the capital portion of the Estimates, the specific allocation for each personal care home and/or hospital construction or renovation and the government plans with respect to kitchen facilities and/or laundry facilities and material handling facilities for those particular sites?

Mr. Praznik: Mr. Chair, those will not all be finalized, but we will endeavour to deal with each one that has been. They vary, I imagine, across the province--that has been my experience--as people look and regions look at ways to best deliver services within their community, but I do not think there are many people out there in the public who would object to, again, common sense applying.

The member is trying to get some policy. I know there are many who would try to make that suggestion that we are going to want everything centralized in one big laundry, in one big kitchen for large parts of the province: (a) it just is not practical, and (b) there are other considerations. As I mentioned, part of personal care home facilities--and the point has been made with me--in many cases is where you have people living in a facility where--the average length of stay now is some 20 months, particularly with dementia, Alzheimer's, and other things--having a kitchen facility also has other good purposes in terms of the care.

So it is something that has to be looked at, examined, and discussed as we move forward, but certainly no carte blanche policy has been made authorizing Urban Shared Services or anyone else to take over every kitchen and laundry in the province of Manitoba, although some might argue that.

Mr. Chomiak: Can the minister indicate specifically what the estimated savings were with respect to the food portion of the business plan for Urban Shared Services as it relates to the food services?

Mr. Sheil: We have stated historically, and continue to state, that we will provide about $5.9 million in savings to the province, $3.3 million in patient food services, 2.6 in nonpatient food services. In addition to that, we have identified a between $30-million and $35-million capital expenditure that can be avoided as a result of our project.

Mr. Chomiak: Can we have that data tabled as to the capital expenditures? Obviously, this information is available for the proposed renovations, this $30 million to $35 million, because it has been used many times by the minister. Can we have that information tabled as to what those proposed changes are that would entail expenditure of $30 million to $35 million?

Mr. Praznik: Mr. Chair, when Ms. Bakken is here, I believe, on Thursday, who manages our capital program--because, again, those numbers are coming out of our capital area in terms of expectations and project requests from facilities--I am sure she would be glad to provide that.

Mr. Chomiak: I think the minister misunderstood the question. Mr. Sheil has indicated that the Urban Shared Services Corporation--and I can be corrected if I am wrong--would prevent expenditures of $30 million to $35 million in capital expenditures as a result of their project. I am asking for those tabled figures so that we could see specifically where that saved $30 million to $35 million is.

Mr. Praznik: We will certainly provide that. I understand Urban Shared Services does have that detail, but because the existing capital, any capital investments in rebuilding kitchen facilities in existing hospitals, is normally funded through Manitoba Health's capital program. We would also have it available there, so we will endeavour to provide it to the member.

Mr. Chomiak: So, from the minister's response, we will get those figures for next time when we discuss the capital. I am getting an affirmative response. I thank the minister for that response.

Can I get some assertion as to the $5.9-million figure that was used by Mr. Sheil, and the $30 million to $35 million? What facilities do those specific figures cover? Does it cover the nine, the nine plus five, or some other scope? What specifically do those figures cover?

Mr. Sheil: The saving estimates that we have put forward cover savings that would be delivered on behalf of our nine hospitals. They are a result of our efforts in patient and nonpatient food services. They cover no additional institutions.

Mr. Chomiak: So the proposed savings of $5.9 million in food services are related exclusively to the nine urban facilities and do not include the five additional personal care homes that were mentioned earlier?

Mr. Sheil: Yes, that is so.

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Mr. Chomiak: In one of the publications of Urban Shared Services Corporation, they indicate in April 1997 that a savings of $6 million had--and I can be corrected if I am wrong--already been achieved by Urban Shared Services Corporation. Can I have some detail as to where the savings had been achieved?

Mr. Sheil: Those savings are a result of our contracting efforts; the contracting business unit, which is an operational division of Urban Shared Services, has been working since 1994 to consolidate contracting on behalf of the nine hospitals. The savings estimates are a result of their success.

Mr. Chomiak: Would it be possible to get more details as to what the breakdown of that $6 million is across the system?

Mr. Sheil: That is not public information.

Mr. Chomiak: Can the minister indicate why that information is not public, the success from 1994 of Urban Shared Services, why we as legislators, who are responsible for ultimately the long-range plans of this corporation and many of its claims, cannot get the information as to the already realized savings? I do not understand what the policy reason would be as to why we could not get information with respect to the $6 million in savings. I cannot see any competitive or other reasons as to why this information should not be public, and in fact, if I were the Urban Shared Services Corporation, I would want this information out in order to justify the continuing operation of the corporation.

Mr. Praznik: Mr. Chair, I could not agree with the member for Kildonan more, and he makes my point again. One of the difficulties in this period of transition is that here we have our nine--or our independent hospital boards at work where there is not a degree of public accountability. That is what we are in the process of providing.

I do not have the legal authority today to have Mr. Sheil answer that question. He works for Urban Shared Services Corporation which is owned by nine currently independent hospitals. They each appoint a director. He advises me that that was a decision that his board of directors has taken. Again, it raises the question: where is the public accountability for the expenditure of public money? It is not there, in my opinion, and that is part of what we are changing.

I would hope that those who believe in public accountability would be encouraging those independent boards to ensure that the steps are taken to become fully part of the regional system that will ensure that that public accountability exists, including his Leader, including the member for Kildonan's (Mr. Chomiak) Leader, who from time to time makes those comments in the House that would suggest he does not support these particular moves that this government has been taking.

Mr. Chomiak: Urban Shared Services Corporation is estimating savings of $3.3 million on food services in the nine urban hospitals. Is it not correct that $2.5 million of those savings are in fact the paydown of the capital agreement entered into with Newcourt Capital? Is that not correct?

Mr. Sheil: We will use the savings, we will use a substantial portion of the savings, $2.8 million to be exact, to pay down our debt annually to Newcourt Capital--standard business practice.

An Honourable Member: Who is holding the mortgage?

Mr. Sheil: They are holding the mortgage, yes.

Mr. Chomiak: So I want to get this clear. The $2.8 million in savings is going--there are savings of $3.3 million. Is Mr. Sheil saying that in addition to the $3.3 million, there is also an additional $2.8 million in savings for a total of $6.1 million, and of the $6.1 million, 2.8 is going to be used to pay down the debt, or is Mr. Sheil saying that $3.3 million in savings, of those savings, 2.8 are going to be expended on the paydown of the mortgage?

Mr. Sheil: Yes, again, we will produce $3.3 million in patient-related savings. We will use 2.8 of that to pay down our debt.

Mr. Praznik: Mr. Chair, what should also be added onto this ledger, and perhaps Mr. Potter would like to comment, is if dollars have to be expended on the Manitoba Health side of the ledger in terms of capital, that money would have to be borrowed and financed over a period of years which would also add a cost, a capital cost to the system. So I think when people are using the comparisons in terms of costs, that particular number also has to be worked into an equation if one is interested in doing an apple-to-apple comparison.

Mr. Chomiak: Yes, I will get to that question, and the minister will have an occasion to compare the apples to apples as he sees it.

But I want to pursue this question of the paydown of the mortgage and the savings because it has not been clear in the publications, and I am not quite certain yet in terms of the business case that has been put forward in order to justify USSC with respect to these particular expenditures. Is Mr. Sheil saying that in terms of actual saving cost, last year's expenditures versus this year's expenditures, that USSC will save $3.3 million in decreased costs as a result of this agreement?

Mr. Sheil: Our business case is based on the difference of operating two systems. Our new system will cost $3.3 million less annually to operate than the current system, and, again, we will from that $3.3 million take 2.8 to pay down the debt of having constructed the system.

Mr. Chomiak: Can you outline for me what the figure is on the current system for total expenditures of the current system on which you are building your case?

Mr. Praznik: Mr. Sheil has advised me that he will get you that exact number. It is a matter of public record.

Mr. Chomiak: Can the minister indicate what the projected cost of the USSC service is?

Mr. Praznik: Mr. Chair, is the member asking us for Urban Shared Services, the food expenditure? I do not know how hospitals do their budgets currently. We do not have in place the direct accountability that I have spoken of. Again, that is part of the reason for change here in accountability.

Currently, the WHA receives a budget line from us with which they are negotiating their operating agreements with each facility. We have a number of years of transition, but, ultimately, at some point in the not-too-distant future, I would expect that these issues will be able to come to this committee for thorough debate because they are not hidden behind the veils of independent health corporations with their volunteer boards, as is now the case.

I am not happy that complete information cannot be provided, but it is the nature of a system we have taken 30 years to develop that needs a major overhaul and is now getting one and I would hope with the support of members opposite.

Mr. Chomiak: Is it not correct in your business case that the total current costs annually estimated by Urban Shared Services Corporation is $20,271,391?

Mr. Sheil: Once again, I did not bring that information with me today. If the member is relying on information that he sees before him, I would imagine that the information is information that we have published in the past.

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Mr. Chomiak: Yes, I am looking at a memo that was provided from Mr. Sheil to the chief executive officers of the Urban Facilities, and under it it says current cost of patient food services is $20,271,391. Would Mr. Sheil like me to provide him with a copy of that? Or the minister, I should say, would he like me to provide him with a copy of that?

While that copy is being prepared, I want to return to a question. Can the minister indicate whether or not at any time there has been any proposal or discussion of a proposal of extending the range of Urban Shared Services beyond the Perimeter Highway?

Mr. Praznik: Mr. Chair, if I recall, I have heard the member mention it, I have heard other people mention it, I have had some people go out and tell everybody it was going to happen. I can tell you that as the Minister of Health, it is not my intention to see things happen that do not make sense, and common sense should be the rules that apply. I know as a rural member, there are other issues surrounding the delivery of services. I mentioned with personal care homes that even if one could deliver the service, it may outweigh some of the benefits of delivering service.

At this stage of the game, I cannot predict what others will do after me, but certainly at this stage of the game, I do not see that as a possibility. I would just hope that over the next while, Urban Shared Services can get up and running smoothly and perfect their system and deliver what they have indicated they can deliver within the Winnipeg hospital system.

As I mentioned to the member my tour of many personal care homes in the city of Winnipeg, there were other issues around the delivery of food services that become very important, I think, in terms of the quality of care and the homelike atmosphere that facilities have in fact that have to weigh into the decision making.

Mr. Chomiak: Mr. Chairperson, I guess, I am now looking again at this sheet that was provided to the CEOs of the various facilities which indicates total current costs of patient food is $20 million. Proposed costs, including debt services, 19; net improvement of $563,000; value improvement plus debt, $3.3 million; and then the nonpatient food services for a total of $5.9. Mr. Sheil had earlier referred to the $5.9 total figure and the $3.3 and the $2.6, so I guess this confirms basically the information being provided now is simply in more detail.

The proposed costs include debt service. Is Mr. Sheil saying therefore that the actual costs, if one excluded a debt service, would only be somewhere in the neighbourhood of $16.3 million?

Mr. Sheil: Yes, I believe that would be correct.

Mr. Chomiak: Can Mr. Sheil indicate whether or not the $20.271 million also includes the debt service cost or any of the amortizations or related accounting figures for the current cost of those figures?

Mr. Sheil: I am not sure I understand the question.

Mr. Chomiak: What I am asking is what does the $20,271,391 figure include?

Mr. Sheil: Mr. Chair, the $20-million figure referred to is the operating budget for patient food services for the nine Winnipeg Hospitals projected for the fiscal year 1996-1997.

Mr. Chomiak: So these figures are based on '96-97 expenditures. Do those include actual operating costs only? Do they include any capital?

Mr. Sheil: These are operating costs.

Mr. Chomiak: So very clearly then, I want to get on the record that according to the figures, as put forward by the Urban Shared Services Corporation, the net cost of providing the services, exclusive of debt service, would only be somewhere in the neighbourhood of $16.4 million?

Mr. Sheil: Mr. Chair, yes, that would be correct.

Mr. Chomiak: But the $3.3 million in debt servicing costs to Newcourt Capital, can Mr. Sheil indicate whether or not that is actually a saving, or how does he ascertain that the total improvement will be $5.9, when in fact $3.3 million is going to effectively pay down the mortgage?

Mr. Sheil: We have used the standard business practice of reinvesting in the corporation.

Mr. Chomiak: Mr. Chairperson, my accounting experience is limited to the course that I am sure the minister took in the Bar Ad, but to that extent is value improvement in debt a generally accepted accounting figure that is utilized?

Mr. Sheil: I am not an accountant either. I can only say that these are the figures that were accepted and approved by the board of directors as value, as savings, the net savings. The net value is $3.3 million.

Mr. Praznik: Mr. Chair, it is important to note that the board of directors is appointed by the current hospital board of directors of the nine facilities, and I just think it is worthy to note that point.

Mr. Chomiak: Is it correct to say that on this figure the net improvement, the actual food savings costs alone are approximate, are the $563,000 as noted in this sheet that was provided?

Mr. Praznik: Before Mr. Sheil answers I want to say that what is missing from this, because this of course is the Urban Shared food services on the budget that they have developed based on their expenditure, but what we are missing from this is the servicing cost of Manitoba Health's debt, if in fact we had a major capital expenditure. Again, it is the diffuse nature in which these things are funded and accounted the need to bring accountability and these numbers together.

That is in fact what we are in the process of changing. So whatever savings this would generate, the capital here is financed out of savings on the operational system. What is missing, of course, because it was not in the purview of Urban Shared Services, would be our capital financial costs for having to make any upgrades in existing food services throughout the system.

Mr. Chomiak: Of course, what also may be missing is the cost of capital that went into the actual annual calculation of the capital of $20.271 million. So in that sense it does not compare apples and apples either.

Mr. Sheil: We have strictly spoken to operating costs. We have not considered capital costs in our calculations.

Mr. Chomiak: The figures were also given for nonpatient food services. Can Mr. Sheil indicate how many of the nine shareholder facilities nonpatient food services will be operated by Urban Shared Services Corporation?

Mr. Sheil: Yes, I can. The answer is two.

Mr. Chomiak: And what is happening to the other seven facilities?

Mr. Sheil: The other seven facilities are remaining self-operated.

Mr. Chomiak: What two facilities are buying in, if I can use that word, into the USSC operation?

Mr. Sheil: The two facilities are Misericordia General Hospital and Seven Oaks General Hospital.

Mr. Chomiak: Has the Urban Shared Services Corporation done a revised business case based on the fact that of the nine facilities, two of the smaller facilities only are participating in the nonpatient food service delivery?

Mr. Sheil: No, we have not.

Mr. Chomiak: Has a revised business case or any new business case gone to the boards of directors with respect to their case summary based on the fact that there has been a significant change in the business case as it relates to Urban Shared Services Corporation?

Mr. Praznik: Mr. Chair, just to put this in context, because there is a larger policy issue here, during this process it was identified, I think it was some $2.5 million, was lost by the independent boards running our nine independent facilities, in the subsidization of their cafeterias that there was a net operating loss on their public food, not their patient food but public food system. I can tell you that we have in our budget for this year taken that $2.5 million out of the WHA's funding, and that $2.5 million the WHA will be passing on to their respective facilities. That, I think most Manitobans would agree, subsidizing public food services in hospital facilities, is not a good use of dollars. The $2.5 million ultimately will work its way back into direct purchase of patient care through the variety of areas where the WHA is putting in additional dollars.

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So I just want to make very clear, because it is an important issue, that public dollars should not be used to subsidize public food services in those facilities, and there is no expectation it will. If facilities want to do that, they will have to find the resources from other areas, maybe from their own funds or their sponsors' funds but certainly not with public money. Our intention is to make sure that those dollars are not lost to the health care system but are prioritized into direct patient care where the dollars are needed in fact, rather than subsidizing meals in public eateries in our hospital system. So what we are talking about, when we talked about revising business plans, was taking over areas that generally had a net loss to the system.

Mr. Chomiak: The minister often uses those figures and has used them on many occasions to justify the creation of the USSC. It is a significant point that money has gone into the non-patient food services, but in fact USSC is, with the exception of two smaller facilities--is it not fact?--operating those facilities. So I think the minister's case has been somewhat weakened by virtue of that particular point.

Mr. Praznik: Mr. Chair, the point that I make with the example, under the current structure of administering health care in a public system where you have facilities with independent boards making decisions within their block budget, is that they set the priorities within those budgets, rather than the trustees of the public, rather than this Legislature and the government of the day, and that it would not be a matter of policy of this minister or this government to include a budget line to subsidize public cafeterias in any hospital. I do not think there is one member of our Legislature who would stand up and vote for that kind of expenditure. If they do, they certainly have not come forward.

The point I illustrate is that as long as you continue to maintain the delivery of health care through a diffuse system of independent institutions with their volunteer boards that the Leader of the Opposition (Mr. Doer) tends to support, you will have that kind of decision making take place. Really the essence is that it was the wrong set of priorities for public money. If any of the sponsors of a hospital, whether they be a religious organization or otherwise, want to raise resources in their own constituency and community to provide for nonmedical services in their facility, including subsidized cafeterias for the public, they are welcome to do it, but they are not welcome to do it with public money.

So I use this example, and I have used it on many occasions, to illustrate the need for regionalization, for public accountability for the expenditure of public money and a great deficiency in our current system for the delivery of public health care. That is the context in which I have used that particular story on many, many occasions as an example of the wrong way to run a health care system.

Mr. Chomiak: Mr. Chairperson, I am looking at a copy also provided to the CEOs of the urban hospitals, which was provided by Mr. Sheil, which outlined the expenditures for the construction developmental costs for the project. I wonder if I could go through some of those costs with Mr. Sheil. Now I can provide him with a copy.

Mr. Praznik: Mr. Sheil has advised me--and I think members appreciate the position he is in--in answering to this board representing the volunteer boards of our independent hospitals, that he does not have the authority to discuss the business case. I regret that very much. It is part of the process that I want to change and am changing, and I think it illustrates very much the problems with our current governance system in health care which this administration has decided to change.

Regrettably, if there are issues surrounding the business case and the detail, Mr. Sheil does not have the authority to answer those questions to my regret and the regret of the members of the committee. If there are questions that are within his authority, he would be pleased, of course, to answer them.

Mr. Chomiak: Is the minister saying that the cost breakdown, construction and other developmental costs, of 21.463990 of the USSC that is currently being expended, that neither the minister nor Mr. Sheil is in a position to comment on those?

Mr. Praznik: Mr. Chair, I am advised by Mr. Sheil that his board of directors--and, again, not a board of directors appointed by this minister or this government but one that represents the current model or the model we are phasing out of governance, and I think it illustrates the point--has declared this to be proprietary in nature and has not authorized Mr. Sheil to speak about it publicly, and I am not in a position to speak about it, and I regret that very much because the member, I believe, has a right to access this information. That is why, in fact, we are in the process of changing significantly, and I would hope he would continue, in fact, to more actively support our efforts with respect to some of the positions taken by current volunteer boards at independent facilities.

Mr. Chomiak: That only begs the question of how I can support or not support a plan of which it has already been admitted the business case is substantially altered and of which the specific expenditures of $21 million cannot be discussed here, so I have no opportunity, one way or the other, to comment or deal with this, Mr. Chairperson, and, consequently, how is it that the Ministry of Health is supportive of this venture?

When, in fact, the minister has no knowledge of these figures and is not prepared to comment on them, how can the minister be surprised when I dare say there is a fair amount of skepticism amongst the public with respect to this proposal?

Mr. Praznik: Mr. Chair, within the ministry, I am not in a position to be able to answer his questions specifically, but Urban Shared Services has apprised us of those details. But the point he makes is an excellent one and one I am fully in support of, and I think arising out of this meeting today, I am going to endeavour to speak to the board of directors of Urban Shared Services, and I believe that they have an obligation to come and answer for the expenditure of public money. I am going to indicate that that request is being made of them. They have a responsibility, as do the boards, the volunteer boards, in my opinion, in each of these independent facilities. That is why we are changing the system, because this is inappropriate.

It is inappropriate when you spend hundreds of millions of dollars of public money and are told by whatever hospital board that this is not a matter--that they are not going to speak about issues publicly. They have an obligation. It is public money. It illustrates the point, and the member's point is an excellent one. I am supportive of it. I think he has a right to ask these questions. As the minister, I am privy to some of this information, but, again, there is a proprietary--it is not information that I am in a position to release publicly, but should be, and I am going to endeavour to make that request of the board of directors of Urban Shared Services, and I will do that relatively quickly.

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Mr. Chomiak: How are we to be assured that in fact the business case or the proposal that a facility that is actually being structured or literally hundreds of peoples' lives that are being affected by this proposal is in fact what is best for health in Manitoba? How can we have any assurances, when in fact we have no way of confirming whether or not the information provided in the business case is in fact justified? I do not see how we can proceed legitimately on a process like this, unless we can have that information before us.

Mr. Praznik: I just say to the member, I believe very much in accountability, and that is why I am in the process of changing the system, but when his Leader in the House talks about the importance of the volunteer boards, he supports that system. I guess the only comfort today that I can give to him is that those volunteer boards that the Leader of the Opposition, the member for Concordia (Mr. Doer) has defended in the House have approved this model. So, obviously, when his Leader defends that structure, he must accept what comes with it. I can tell the member that much of this information has been shared with the Ministry of Health, but it does beg the question. It is the expenditure of public money and should be debated publicly, not within the confines of independent boards just because they are volunteers.

When I hear the member's Leader, the member for Concordia, Mr. Doer, in the House yell across, they are volunteer boards, we have to keep our volunteer boards--this is what the member for Concordia is proposing we keep, with all of its frustrations, with all of the inability of the public to direct the expenditure of public money, with all of the lack of accountability that we see here. I would hope that members of the New Democratic Party, and I know the member for Concordia understands these issues far better than anyone else in his caucus--I would really hope that his caucus would become far more supportive of the effort of regionalization, particularly when we face some difficult issues around employing authority, where we have a variety of boards like St. Boniface indicating no, no, they must continue to make all their decisions and keep their independence because it is so much more in the public interest.

Well, St. Boniface is one of the directors of Urban Shared Services. They are one of the people who elect a director and their director, I am assuming, has voted to keep this information proprietary, not in the public realm. Well, I would hope that the Leader of the Opposition would be writing to Mr. Liba at St. Boniface or whoever and indicating that that is unacceptable as well. I would hope he would join me in what is a very significant change in the administration of health care. I know the member for Kildonan appreciates these issues far more than his Leader and members, his colleagues, but these are very legitimate frustrations and issues.

Arising out of this meeting today, I am going to write to Urban Shared Services and share with them this Hansard and the member's request and the member asks a legitimate question. Why should he take this on faith instead of figures? Well, I agree with him wholeheartedly, and it is incumbent upon me to change the structure in the system so that accountability is there, and I will. I am not going to defend the structure that I did not create, nor do I support.

Mr. Chomiak: Is the minister saying that he does not support the Urban Shared Services Corporation?

Mr. Praznik: Mr. Chair, I do not support a structure of governance in administration in a public health care system in which the government and Legislature of this province's only role is to vote a level of expenditure to facilities that are independent, run by volunteer boards that the member's Leader supports, that expend that public money, that accounts for some 99 percent of the expenditure of those facilities, and those expenditures and that service is not open to public debate and public review, and the choices that are made within it are not open to public debate and public review and that members of the Legislative Assembly that vote that money each year are not in a position to question the administration of those dollars, of those public dollars on expenditure.

Urban Shared Services in principle was created to find better ways between our facilities in delivery of service. In fact, the whole urban planning process which was initiated years ago, not only to deal with food services, support services, and pharmacy and other things, but how we can develop programs that were one program for a city of Winnipeg or a province delivered on multisite with one team leader. In fact, today one of the frustrations of the Winnipeg Health Authority in dealing and getting their operating agreements in place or reporting relationships, even though under a faith-based agreement the faith hospitals agreed to one program, one leader, multisite, there are still issues around reporting.

It illustrates all that is sick with the Canadian health care system. You cannot have a publicly funded system delivering public services with the expenditure of public money when you are dealing with independent facilities with their independent volunteer boards making their own decisions and wanting to have the control of how the money is spent without the accountability for the decision making or, I would argue, the centralized decision making that gets the best use of service, and that is what regionalization is all about.

If Urban Shared Services in this committee process today--and in fairness to Mr. Sheil, he is here as my guest as minister to answer as many questions as he is authorized to do. Am I happy with the restrictive? Not at all, but this makes the point about what is wrong with our current delivery system and what we are attempting to change. I am not asking the member to take the leap of faith, because I would not in his shoes, because the only leap of faith he can take is that the volunteer boards that his Leader continues to support have made the right decision, and that is not good enough for any of us as legislators. It is not, because we have seen time and time again where sometimes the right decisions are not made or priorities that the public would want are not made.

So am I happy with this today? Absolutely not. Do I support the system, the structure that has this kind of situation? Absolutely not. Am I doing something about it as Minister of Health? Absolutely. What I am asking? I am asking this of the member for Kildonan, I am asking this of his party, I am asking this of the labour unions that are involved in health care, I am asking their support to fundamentally change the structure of governance in administration in health care so that we can have a public health care system that has the kind of accountability to the Legislatures of this country, and ultimately to this province in Manitoba, that we need.

I am going to take this Hansard, and I am going to write to the chair of Urban Shared Services this week, and I am going to say this is what it is about. It is the expenditure of public money. There are questions that need to be answered, and Mr. Chomiak has issues that he would like to discuss which he has a right to do, and that Urban Shared Services, are they going to accept that responsibility or not, and I am interested to see the answer.

But I can tell the member this, if you ask this minister what his opinion is as to where Urban Shared Services should be housed within the structure, I think it is very clear that they should be part of an operating arm of the Winnipeg Hospital Authority. That has to be worked out in the months ahead, and ultimately they have a public accountability through that arm to this Legislature for the $670 million or $700 million a year that is spent or will be spent by that authority.

Mr. Chomiak: Mr. Chairperson, the associate deputy minister indicated he is no longer a member of the board of directors of Urban Shared Services. Can the minister indicate for how long he was, from what period to what period he was a director of the Urban Shared Services Corporation?

Mr. Praznik: Mr. Chair, if I could indulge the member. If we could have a 10-minute break or so, Mr. Potter just wants to check on that time frame. He has been a member of many different boards, and he will get that for the member exactly, and then we could proceed. It is about time for the break now.

Mr. Chairperson: Is it the will of the committee to take a 10-minute break? [agreed]

The committee recessed at 3:50 p.m.

The committee resumed at 4:01 p.m.

Mr. Chairperson: We will continue now with the Estimates of the Department of Health.

Mr. Chomiak: Can the minister indicate what the cost of the Versa contract is with respect to the Urban Shared Services Corporation?

Mr. Sheil: The Versa fee is $600,000 annually.

Mr. Chomiak: What is the term of the contract?

Mr. Sheil: The term of the contract is five years.

Mr. Chomiak: To the minister: would it be possible to have a copy of the Versa contract tabled?

Mr. Praznik: It is not mine to table and those who are, the volunteer board members of our independent hospitals, are not prepared to table that, so perhaps we could ask them to.

Mr. Chomiak: Mr. Chairperson, has the provincial government approved the USSC plan and the USSC operation?

Mr. Praznik: Please repeat it; I did not hear.

Mr. Chomiak: Has the provincial government approved the USSC plan?

Mr. Praznik: Mr. Chair, I was not minister at the time that this whole thing started with Urban Shared Services. I gather the mandate that the--I guess you go back some time when all of us were looking for better ways of managing a system and realizing that there were benefits to be shared in working co-operatively among facilities, when the nine Winnipeg hospitals decided to create Urban Shared Services. Yes, it had the general support of the Province of Manitoba, I do not deny that. When they looked at ways of reducing costs and providing better services and being able to update the kinds of support services that hospitals require in a system-wide basis, yes, in principle, the province approved. But let us remember that, yes, we have had a relationship to see what they are doing because ultimately the dollars flow through, but they are the ones who are accountable within their budgets.

I will indicate to the member that last spring, as a new minister coming this last spring, when CUPE, which represents, I understand, five of the nine locals currently involved, raised this issue--in fact, the member for Kildonan helped sponsor an event here at the Legislature with CUPE to which I was invited and I attended, and this issue came up. Because there were very legitimate issues around how staff were going to be treated and what the transition would be, I did at that time make inquiries on Urban Shared Services. I asked them actually to delay their project until the staffing issues had been dealt with in a satisfactory way, that it has never been my intention to be putting people out on to the street, that the system, surely to goodness, if it was going to result in some staff reductions in one area, could absorb those people, offer a decent VSIP program for those who want to leave, the kinds of things that I think most people deem as a reasonable way of managing change--that that was put into place.

I did have occasion to be briefed on their plans after they were more fully developed. Also, my knowledge comes from briefings with our people financially on their numbers that they as a group developed in their business plan, some of which is public, some of which is not. There is no reason in my mind in a public system where this kind of information, other than that that may be proprietary in nature to those who are providing services, et cetera, to the group, should not be public, but the nature of our current structure creates this kind of difficulty.

The member for Kildonan asks a very legitimate question. If you want the public to be able to accept the choices that are made in systems, those should be justified publicly. We should not just have to rely on the decision-making abilities of volunteer boards, as the Leader of the Opposition (Mr. Doer) would have us do, or on necessarily the minister or his staff being comfortable with a decision that is being made because we have been brought in and made privy to otherwise confidential information.

It should be a matter of public debate and the sharing of public resources or information, and I can concur with that, and that is why we are changing the structure of the system. We hope we will have the support of the New Democrats in our endeavours, particularly when you have those current volunteer boards and their independent facilities wanting to retain the kind of control over the expenditure of public money that today frustrates both the member for Kildonan and myself.

Mr. Chomiak: Mr. Chairperson, did the Ministry of Health approve or agree with the shared service food services-patient food services agreement between USSC, Winnipeg Hospital Authority and Newcourt Capital entered into on the 27th of June, 1997?

Mr. Praznik: Mr. Chair, as part of that, as I indicated, I think the Ministry of Health has had information shared with it on the structure and how things were to be developed, and yes, our concurrence of the ministry did go into those particular plans, again within the restrictions of information that--I wish again that all of this could be public. I am not in a position to do that because of the nature of the system, but I will not deny that the ministry has given concurrence to the financial numbers and plans that were provided as information to us.

Mr. Chomiak: Did the ministry also concur and approve of the business plan as submitted by the USSC?

Mr. Praznik: Mr. Chair, in developing and making--and I want to just clarify because there is the idea of approval versus nonapproval. Urban Shared Services has to make a decision. Did they do it with the concurrence of the ministry? Yes, I do not deny that. I am not sloughing off that responsibility. Is it done with the approval in the sense that we have the decision-making power over that corporation? No, because it is not our corporation.

So it did not require our formal approval or approval of the ministry to say yes, you can or cannot do it and if we had said no, they would have legally been prevented from doing so. That is not the case of the relationship. I regret otherwise for other reasons, because I think there has to be that accountability for public expenditure, but that is not the case. However, was it done with the concurrence of the ministry, where numbers shared with the ministry? Yes, they were.

Mr. Chomiak: In light of some of the information that has come out this afternoon, is the minister prepared to take another look at the numbers that were shared with the Department of Health as a result?

Mr. Praznik: Mr. Chair, I think the key point out of numbers that have been shared this afternoon is really--there are a number of points to be made. Number 1, the nine Winnipeg hospitals, through Urban Shared Services, in an attempt to deliver a better product and service in a number of areas and a more cost-effective manner, developed this plan, yes, with the concurrence of the ministry on detail. We have no reason to doubt the numbers that have been provided to us. Our concurrence is based on the numbers that were provided by those facilities, and you have to appreciate that the numbers on which this is based come from numbers within the existing facilities which are quite frankly the property of those facilities, not the property of the Ministry of Health.

So if any of the premises are wrong, I cannot accept responsibility for that, but based on the numbers that were there, we did concur with this particular plan. It was done to provide better service at a more economical price and move our food system into, I think, the new technology that is developing across North America.

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It also, from a ministerial or ministry point of view, meant that we did not have to engage in some significant capital construction in our current facilities, which we would have to fund over a number of years to replace or upgrade the current kitchens. So here we could have some savings and the capital needs of the system managed through this process and save the taxpayer the financing costs of some very significant upgrades in our existing kitchen facilities. So that is the reason why I think concurrence was granted to this plan. It gave us, we believe, at the end of the day, from what has happened in other jurisdictions, a better food system, one that can manage its capital needs and produce savings, not huge but savings, and prevent, at the end of the day, some additional major capital expenditure in our kitchens.

Now the caveats that I have added to this as minister, coming out of CUPE's intervention or issue that they raised last spring in this Legislative Building, was to ensure that a proper human resource management plan was put in place. Ultimately I hope that we can accommodate virtually all those employees in one way or another. That had to be done and that was put in place and is being worked through. So that has in fact been done, and there is no reason to revisit this particular decision. It is well underway. In fact, the capital building is under construction as we speak. Mr. Chair, with the operation of the Winnipeg Hospital Authority, who now ultimately has responsibility for these dollars and is accountable to myself as minister, ultimately that is another check on this system, from my point of view, that is now in place. That is not diffuse. So I see no reason to change this.

Some of the policy issues that you, the member for Kildonan, have highlighted with respect to personal care homes, expanding USSC out of the city, if there was any planning by Urban Shared Services in the days gone by that this would have to happen, it was done by--let us put it in perspective--the boards of nine Winnipeg hospitals. There are other issues surrounding both those expansions that, quite frankly, have to be weighed on the scale of those expansions. Now that the Winnipeg Hospital Authority has a much firmer role in developing this, I do not think one would find the same concurrence.

Let us get this operating. We have no reason to doubt that it will work effectively. I think as I have mentioned before, some of the issues around delivery of services and food services in personal care homes and outside the Perimeter have to be weighed on a balanced scale. I cannot bind future governments or future ministers, but I can tell you today it is not on my agenda as minister to see that expansion.

Mr. Chomiak: Can the minister explain why the Deputy Minister of Health would have written to the various institutions recently, and as a precondition for their payment of their accumulated debt, that they participate fully in the USSC arrangement?

Mr. Praznik: Yes, Mr. Chair, that reference was with respect to the developing, the planning within the Winnipeg Hospital Authority to actually move USSC into the WHA administration as an operating arm. That was the intention in discussion that has been going on. Obviously, if it makes more sense--and I am coming to the conclusion it does--to have Urban Shared Services, rather than as an independent or as a corporation owned by nine facilities out there through this very difficult structure of governance and reporting relationships, where it makes eminently more sense, and I believe it does, to have Urban Shared Services as really an operating arm of the Winnipeg Hospital Authority, that it should ultimately move into that role. Its funding ultimately is the taxpayers' money. It is not the property of any religious order. It is not the property of a hospital per se. It is public money. So it makes eminently good sense that the reporting relationships, the decision making be much more direct.

So in the discussions we have had with the Winnipeg Hospital Authority, I believe they see that as where we want to be with Urban Shared Services. Over the next while I would suspect there will be discussions, but for that to happen we need the current shareholders to agree to that kind of transfer to make it a smooth one. That is the co-operation that is being asked for and is expected.

If I may just add, as well, there is an expectation that facilities will use them for appropriate system-wide services, and it makes only common sense that if they are able to deliver services at a more effective rate to the system, we expect the system to be using them, because ultimately what it does is--if it saves dollars in the delivery of logistics, those dollars are going to be available for health care. I want them in health care. I mean, I have to continually go back to Treasury Board for additional dollars here and there.

We needed another million last year for the oncology program to recruit oncologists. We needed a million and a half in the diagnostics program, et cetera. That is $2.5 million. That is the equivalent of what was lost in the public cafeterias in the system last year. That is not the health choice of Manitobans in the health care budget, and so, yes, ultimately we expect the facilities that remain with an independent structure, that they will be expected to get the best value on the purchase of services.

By the way, we have done that rurally. We have expected that if RHAs are able to incur savings by purchasing services on a regional basis, and I give you examples of things like accounting services, legal services, payroll services, et cetera--because a facility, and there are a few in Manitoba that remain as independent entities--but if they remain as independent entities, they should not expect to have within their administrative dollars budgets for accounting, or legal, or payroll, or any of those services that are above what it costs us to buy the same services within the regional health authority and their appropriate proportionment, because all that is going to do is take dollars away from health care delivery, from patient care, to fund the luxury of an independence in an institution.

By the way, I have had this discussion with some of the faith-based facilities in a number of communities. I know the member for Dauphin (Mr. Struthers) has this issue with respect to one facility in his community, and then when we get into some discussion, there is an expectation on the part of some that within our budget we should be funding for additional or higher-cost payroll, or legal, or accounting, or auditing services, because we are independent. Well, I am sorry, those dollars come from health care. If you want to do it on your own, if you want to be independent outside of the public system, then you should be doing it at the same cost as what we can purchase the service for within the system.

That is going to be a bit of an ongoing debate, et cetera, but I think it means if we get the best price on purchasing system-wide, then of course the public expects us to do that because that frees up dollars for health care, and that is really what it is about is patient care.

Mr. Chomiak: I do not know if I asked this, I may be repeating myself, but can we have the Versa contract and the shared logistics contracts tabled, please?

Mr. Praznik: Mr. Chair, I think the member is repeating himself. I have indicated that those are the property of Urban Shared Services, and their authority would have to be garnered to release that. I am prepared to forward the member's request to their board.

Mr. Chomiak: I guess I am happy to hear the minister say that he is looking for ultimate savings. There were two studies prepared, two analyses prepared by Wintemute Randle and Kilimnik on behalf of CUPE with respect to the shared food services and with respect to the shared logistics services, and I am aware that the shared food services proposal indicated an actual savings of--as contrasted with the business plan of USSC--additional savings of somewhere in the neighbourhood of $4 million. I wonder why, if that is the case, the government did not choose to go with the more cost-effective program as submitted in that documentation.

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Mr. Praznik: Mr. Chair, I am going to have Mr. Sheil respond. He is aware of those; he has done the analysis on them; he should have the chance to comment.

But, again, I hear it in the member's voice about why does the government not go with--you know, I honestly wish, as Minister of Health, I had the kind of power to be able to manage the system that would meet the expectation of the public to manage it. One of the great difficulties that I have had as Minister of Health, and my predecessors have had before me, is that you talk to health care professionals, you talk to providers, you talk to people in health care unions, and you say that we should do this, and you say that it makes absolutely good sense, and then you get into the logistics of making it happen. Let me tell you, and I look to some of my senior people here, when you are dealing with independent organizations who use public money, and you have the turf battles that are in place between them, and their own expectations of their roles in the system, and you have to get into dealing with all the logistics to make a simple change happen, it saps the energy out of everybody who is involved with that change.

Maybe the member did not intend it, but I always notice that people say, why do you not just do this in government? And you sit down and you say, okay, let us do it, and then you start figuring out all the players, and then you have members of volunteer boards of directors that the Leader of the Opposition (Mr. Doer) supports so strongly, and they come forth: Oh, no, you cannot touch my turf; I need this turf. You cannot touch this, and you cannot touch that, and look at the great contribution we make here, and you cannot touch this because we need to do this.

The next thing you know, what should be a simple matter has become so complex and so bogged down that you end up maintaining all the inefficiencies and all the stupidities and all the outdated delivery models just because you cannot make change.

I have watched Health ministers across the country and I have talked to them across the country, and you see it over and over again. If there is one thing that is needed to happen in this process, it is to change the way we deliver the system. That regionalization has been part of that; and, as the regional health authorities have a greater and greater role, and their ability to operate develops because it is going to take some years, I think ultimately when the member says, why does the government not do this, it will have a lot more effective meaning than it has had over the past number of decades.

I apologize for philosophizing here, but it is an ongoing frustration of ministers of Health. I am going to ask Mr. Sheil specifically the question from the member for Kildonan.

Mr. Sheil: In response to the question, there was a report prepared by KPMG to the Wintemute Randle studies. That report was presented to USSC's board of directors and accepted by the board. I do not have the report with me today, but I will forward it to the minister's office. It essentially dismisses the two studies.

Mr. Chomiak: Will the minister table that report with us?

Mr. Praznik: Mr. Chair, if those who have commissioned it so give me authority, I do not have a problem doing that.

Mr. Chomiak: I do not know if I quite understand that response. Can the minister clarify whether or not he would table that report?

Mr. Praznik: Mr. Chair, it is very interesting about this, and I share this frustration with the member for Kildonan. This is not a criticism of him in any way. How many times I have sat here in two years as a minister, and I have had questions asked of me, and I turn to my staff, as is the custom, and I say, well, what is the story? I get the story, and then I get told, but you cannot say that because that belongs to St. Boniface Hospital or it belongs to this hospital and they have not released it publicly. It is one of those great frustrations, and it does carry on.

I believe it is Urban Shared Services--that is their report. They issued it--or they commissioned it, they have received it. If they are prepared to provide it and make it public, I have no problem--I would encourage them to do so; but, if it is, as their property, they refuse to do so, I do not today have the legal power to compel them to do so. So that is the comment I make.

I think the member for Kildonan has the right to ask for that report, and I am certainly going to endeavour to urge Urban Shared Services to make it available.

Mr. Chomiak: Recently in debate in the Legislature, the minister indicated that something like--and I stand to be corrected--60 percent of the food presently utilized in our hospital system is already frozen. Can the minister elaborate on that, please?

Mr. Praznik: I think it was in the 40 to 50 percent range, not 60, but I am going to ask Mr. Sheil who has done this analysis on what is frozen. I can tell him this, I do not suspect any of the peas consumed in our hospitals in January are flown in from California and shelled by workers in our hospitals and delivered. I suspect the Jolly Green Giant has had something to do with them, but I am going to ask Mr. Sheil to answer that question.

Mr. Sheil: Yes, the minister is correct. Approximately 40 to 50 percent of the food that is prepared and served in hospitals is frozen, chilled or otherwise outsourced.

Mr. Chomiak: I am quite interested in those figures. Can we obtain an analysis? Can we be tabled with an analysis of that information?

Mr. Sheil: Yes, Mr. Chair, I will do my best to make it happen.

Mr. Mervin Tweed (Turtle Mountain): Just for clarification, and I apologize for not paying full attention, was the question how much would be supplied or how much is currently being supplied frozen? [interjection] Currently? Through the new system or the old system? [interjection] Okay, all right.

Mr. Chomiak: When reference is made by Mr. Sheil to "outsourced" and the figure 45 percent, is that the nine urban facilities that we are dealing with and can he perhaps elaborate a little bit on what he means by the outsourcing?

Mr. Sheil: Mr. Chair, the USSC is speaking about the nine urban facilities, the hospitals. The products that we are referring to, outsourced products, include food that is prepared and cooked and either frozen or chilled. It includes foods like portioned sugars and jellies and jams, containers of milk, containers of juice, slices of cheese, slices of bread, frozen lasagna, and a variety of prepared foods that have been traditionally served in hospitals for a long, long time.

Mr. Chomiak: The information that is going to be tabled with us will specify any more detail of what types of food and the range of meals, for example, that are being served. What kind of information will you be tabling? That is what I am getting at.

Mr. Sheil: I believe I can provide a list of the types of products that are currently purchased by the hospitals that are purchased in a prepared fashion.

Mr. Chomiak: And when you say "prepared fashion," does that mean things like frozen vegetables, for example, that come in a packet? Is it that type of food?

Mr. Sheil: More likely I would be speaking to things like convenience foods such as frozen perogies, frozen cabbage rolls, lasagnas, containers of milk, containers of juice, portioned sugars, jams, jellies. [interjection] Yes, and in addition to that there would be regular frozen vegetables, frozen peas; again, the vegetables that are served in the hospitals today are largely frozen vegetables.

Mr. Chomiak: Can it be indicated what will be the source of the food that is going to utilized once USSC is up and running? What are going to be the sources of the food that is being purchased?

Mr. Sheil: At present we cannot indicate that because we have not gone out to tender. We are preparing that procedure to occur over the month of May.

Mr. Chomiak: Your expectation?

Mr. Sheil: Our expectation is that we will make every effort to promote as much business as possible locally. Today, 100 percent of the foods that are served in the hospitals are purchased from local suppliers. It is our expectation that irrespective of where foods are prepared, they will be purchased locally.

Mr. Chomiak: Does that indicate that volume food will not be purchased outside of the province?

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Mr. Sheil: Again, our expectation is to continue to do as much business within the province as we possibly can, just the way we do today.

Mr. Chomiak: Mr. Chairperson, are there any percentages that USSC is looking at with respect to local versus nonlocal?

Mr. Praznik: I just ask the member to clarify, is he talking about the supplier of that food versus the manufacturer-producer-processor of that food? Obviously, there are a lot of foods that are not grown or processed in the province of Manitoba, orange juice being one of them, but the supplier of that product may be in the province, so if he could clarify what he is referring to.

Mr. Chomiak: Mr. Sheil indicated that presently 100 percent of food is purchased locally, so I am wondering what the comparable figure will be or what the comparable breakdown might be under the new proposal.

Mr. Sheil: Mr. Chair, it is difficult for me to say today what that percentage would be. Our expectation, again, is that relying on the regulations of the Internal Trade Agreement by which we will be bound--that is the way we operate today--we are not preassigning percentages of businesses to any suppliers anywhere. We are doing our business the way we have to do our business.

Mr. Praznik: Mr. Chair, just in terms of context, that does not mean, and it makes obvious sense, that the 100 percent of Manitoba suppliers would continue to exist anyway. It is not a static marketplace. You could have a supplier of a particular product who goes out of business or is bought out by someone out of province and supply from another place. Those things happen all the time.

I mean as a provincial expectation, I would hope that Manitoba is competitive enough and has a well enough developed food services industry and food supply industry that it will be 100 percent, but that is a matter of being competitive and having industries and suppliers that are going to meet that need. Certainly, for a market the size of Urban Shared Services in the Winnipeg hospitals--Mr. Sheil may just want to indicate the size of that market--surely to goodness, that is going to be a very attractive customer for food processors and suppliers in the province.

Mr. Sheil: I can say reliably that today for several suppliers here in the Winnipeg marketplace, our business represents about 25 percent of their business, and I speak of, for instance, Independent Fish or To-Le-Do meats. Our expectation is that those suppliers will be given every opportunity to participate in the tendering process, allowing them to broker products that would allow them to retain their business. They tender now. They have tendered historically.

Mr. Chomiak: Mr. Chairperson, could we have a list of the major suppliers that are presently in place? I am sure the USSC must have that information.

Mr. Praznik: Mr. Chair, that may not even be the property of Urban Shared Services. That may be the property of each hospital today, so, again, it outlines the point of information control. I imagine, as well, it would be also a static list because I understand food service is regularly tendered in the system--I look to Mr. Sheil today--and I am sure tenders change from time to time.

Mr. Sheil: Yes, what the minister is saying is accurate. We do have a list of suppliers with whom we contract. I can make that list available. However, it is not a static list. We are currently and in an ongoing sense in a condition of change where we are constantly tendering and awarding new contracts.

Mr. Chomiak: Mr. Chairperson, I appreciate that commitment. I appreciate that it is not a static list, and I look forward to receiving a copy of that particular list.

Both the minister and Mr. Sheil indicated that there was going to be a process that is going to take place in May. Is that an actual tendering process? Will tenders go out in May, or will a process be defined in May specifically? Can you outline what is going to happen in May?

Mr. Sheil: Mr. Chair, we are preparing now for a tendering process which would be our normal tendering process with specific reference to contracts for food for our shared food services system, and we expect to release those tenders in May.

Mr. Chomiak: Any idea on the value of the tender proposal?

Mr. Sheil: In very rough terms, the value of the food products that we would be purchasing over an annual period would be roughly between $6 million and $8 million and would be dependent on the results of the tender and would also be dependent on the individual contract awards. There could be dozens.

Mr. Chomiak: What is the time line with respect to USSC with respect to the actual operations and the running in the various institutions?

Mr. Sheil: We are currently projecting a turnover of the facility that is under construction in the St. Boniface Industrial Park for no later than August 27. That will allow us to begin serving meals in the middle part of September. We will be completed with the transition of all nine hospitals sometime in November. The formal dates for the transitions will be forthcoming in June.

Mr. Chomiak: Why would those dates be coming up in June specifically?

Mr. Sheil: We are still finalizing some of the renovation projects--actually all of the renovations projects at each of the nine facilities--and the actual transition dates are subject to the length of time it will take to perform construction at places like the Health Sciences Centre where it could take between eight and 12 weeks. Consequently, it is necessary for us to get a little bit closer on the actual details of that before we release the transition plans. However, we are in a position to say no earlier than the middle of September for transition.

Mr. Chomiak: Now that is for the nine urban facilities? What about the other five personal care home facilities?

Mr. Sheil: The other facilities are not involved in this process.

Mr. Chomiak: When is it planned for them to become part of this system?

Mr. Praznik: Mr. Chair, if I may just for a moment, I think the point is that the current plan is for the nine hospitals in the system. There are five personal care homes that are associated with Urban Shared Services who do some of their purchasing and other products, et cetera, through them in certain purchasing. That does not mean they are included in the food services. As we structured the Winnipeg Long Term and Continuing Care Authority where we needed to get the benefits of amalgamation of administration and system-wide planning has been in the hospitals. It has not been in the personal care homes. They are usually single-function facilities. They have a support base, often a religious organization or community group. It is long-term care, and those volunteer boards in those situations play a wonderful role because it is a whole different structure and setting.

So in the new administrative system in the personal care home side, they will be continuing with their independent boards, they will be continuing to manage their affairs. There will be virtually a flow-through of dollars through the Long Term Care Authority to them, and they will make decisions with respect to their services and purchasing as we move forward. So they have a choice as to what to do because they are maintaining a governance model, and there are some issues we have discussed around the food services. I think Holy Family has made that point very clear about part of their care and other things, so it is a very different scenario. So those particular facilities, five or so who are part of Urban Shared Services now, are there for not food services reasons, as I understand it.

If they wanted to join, I mean that is part of governance, but in talking to many of them now I do not particularly see that happening in those cases. There may always be an exception, but I do not see it as being the rule.

Mr. Chomiak: Turning to a logistics area, what is the plan in the expenditures with respect to the logistic size of this process?

Mr. Sheil: We are presently revisiting our logistics project. The board of directors has asked that we go back and perform a study to reconfirm the business case numbers. We projected savings of approximately between $5 million and $6 million as a result of the logistics business case that was approved in December of 1996.

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Quite frankly, time has not been our assistant in this and we feel that it would only be appropriate for us to go back and revisit that. We are going to be launching that actually later this week, and we will be asking each of the institutions to give us some new information, allowing us to go back and reconfirm the business case.

Mr. Praznik: Mr. Chair, if I may, and I do not know how this is appropriate in fitting in, but it is a story I just share with the member for Kildonan. After I was appointed, I had a group of doctors from Concordia Hospital pay me a visit, and Dr. Krahn was one; there were a number of others.

I remember one particular doctor, his name now escapes me, who did work in the area of heart surgery and did the installation of pacemakers and made the comment to me that he could very ably deliver or do the surgical work on installing pacemakers at Concordia Hospital, but he was not allowed to. He had to do them at St. Boniface.

I said, well, why is this? He said, well, St. Boniface was crowded, you know so much room, there is a lot of pressure on, it would be much easier to do at Concordia. I said, well, why is this happening? He said, you know, Mr. Minister, it is because the budget for the pacemakers is in the St. Boniface stores, and they will not allow me to take the pacemaker from St. Boniface to actually do the installation in Concordia.

I thought to myself, if this is true, this is ridiculous. Again, it is all public money. It is getting the best use out of the system. We should never let our administrative structures take away from the delivery of the best possible care. I am sure if one digs there are many, more examples where the way in which we make these decisions end up deciding where care is delivered, even if it makes no sense other than the logistics of how we pay or we budget for things.

So it is part of a larger issue, but I just thought I would mention that to give the member a sense of some of the frustrations that I see within the system as minister. Perhaps there are other questions for Mr. Sheil.

Mr. Chomiak: I do have other questions, just before we go on. It is pretty clear to me that I would like to continue this on Thursday. Do you think that that will be possible? It would be Thursday morning or, alternatively, it would be Thursday afternoon.

Mr. Praznik: I do not know whether we will be able to do it on Thursday. I would like the opportunity to be able to speak to the board of Urban Shared Services for some of the additional information. Perhaps we could schedule this for next week, but I will endeavour to find out and get back to the member for Kildonan on it. There may be some other commitments or issues.

Mr. Chomiak: Just returning to the logistics side, when we talk about logistics, we are talking about central purchasing. Does that also include the laundry and the related services or is that a separate category?

Mr. Sheil: We have three core business areas that we are active in right now. They are shared food services, logistics and shared laundry, so laundry is separate from logistics. Logistics is central purchasing, warehousing, distribution.

Mr. Chomiak: This is an excellent opportunity to take the minister's words to heart. Since the USSC food plan is up and running and the minister did express some reservations, we now have an opportunity with logistics and with the food services to examine them in detail, a priori, that is prior to the actual implementation. I am wondering if we could have those plans brought before this committee for review.

Mr. Praznik: I certainly believe in public accountability. The Urban Shared Services, they are doing their internal work. The Winnipeg Hospital Authority has a role to play in all of this, and I do not think that it would probably be appropriate at this stage to bring certainly these kind of things forward, not knowing all of the detail, of course, that has to be developed.

The member's point is a valid one. Ultimately there has to be accountability for decision making. Currently Urban Shared Services is very indirectly related to this ministry; it is through this whole myriad of administration. I am not sure exactly where they are going in this area, but the Winnipeg Hospital Authority obviously now has a bigger role to play, and perhaps when we are discussing their role, that would be a very appropriate time for this issue to again be discussed at this committee.

Mr. Chomiak: I wonder if we might be provided with the number of EFT positions that are going to be lost through the Urban Shared Services project as it relates to food services.

Mr. Praznik: Mr. Chair, I am going to have staff sort that out. I am advised they have those numbers, but there is some change with them because of the nonpatient care side in public cafeterias. So when we next convene, we will have those sorted out a little more accurately for the member.

Mr. Chomiak: I wonder if we might have it possibly tabled, a copy of the VSIP, the plan for dealing with employees.

Mr. Praznik: Yes, absolutely, and we will have it for the member.

Mr. Chomiak: Can the minister give any indication as to how much money will be spent on labour adjustment?

Mr. Praznik: Mr. Chair, that is still being calculated depending on the number of VSIPs, placements, and the choices that people made, but obviously there must be an accounting for that at the end of the day.

Mr. Chomiak: Can the minister indicate whether the funding for that program will come entirely from USSC or whether the funding for those unrelated programs will come from other sources?

Mr. Praznik: I believe it is jointly funded through our regular labour adjustment dollars for health care, which we budget for separately, and partially by Urban Shared Services. I am going to have Associate Deputy Minister Ellis respond because she is very much involved with this.

Ms. Roberta Ellis (Associate Deputy Minister, Human Resource Planning and Labour Relations): We will actually be compiling final report on all of the activity that we have taken with regard to training, retraining, and adjustment measures. Staff have to be given a little bit of time to make a choice as to whether or not they are choosing a retraining option or choosing an employment option. As soon as we have that information, Mr. Chairman, we will bring it forward to the member's attention.

Mr. Praznik: Mr. Chair, when I asked a year ago, after CUPE's intervention to ensure a proper strategy, there is obviously a number of components in that. One is we wanted to ensure that all of the new positions in the new organization, that the current people had an opportunity to be placed in those positions. We wanted to ensure, as we have done in our own provincial civil service, that there was a VSIP program, which I think started as Voluntary Separation Incentive Program. Started at 15 weeks, I think it was doubled to 30 weeks which is certainly attractive to someone nearing retirement or who is only temporarily working there and is looking to go on to school or some other occupation. There has been a fair number of requests and interest in this program that we would still be sorting out.

Thirdly, I thought to myself, heavens to goodness, when you have a system with literally thousands of employees and many people involved and a host of similar type support services or other support services, hospitals, surely, the turnaround rate across the system should generate enough vacancies over a period of time to accommodate anyone who did not find employment in the new food structure or who chose not to take the VSIP program.

So those three thrusts--and, of course, with the other comes retraining dollars to ensure people are trained for other opportunities that are there in the system. With the Human Resource people there working through now--and I look to Ms. O'Rourke--later on this spring, we should have a final calculation as everybody has either been placed, VSIPed, gone into a training program, or made decisions about where they want to be. If people are not able to be accommodated, I do not think it would be for lack of trying on the part of the system, but I am not going to judge its success until it is completed.

Mr. Chomiak: I take it that the information on both the numbers, the extent and the description of the package, as well as the financial costs both to the province and the USSC as it relates to these various labour adjustment programs, will be tabled and provided to members of the committee.

Ms. Ellis: We do make regular reports to the Provincial Health Labour Adjustment Committee, which has both management and labour represented on it with regard to the VSIP program. So, in any case, we always expect to make those numbers public and we would obviously be doing that; but we will provide the member, through the Chair, any such information as we can, as soon as we can.

Mr. Chomiak: Just returning to the food issue again, I wonder, one of the issues that has arisen on many occasions has been culturally appropriate food, and I wonder if we might get a description as to what is being done in that regard.

Mr. Sheil: USSC will support over 150 different diet types through its new system. We are finalizing the menu today. We finalized the basic menu, and all of the other menus; the other 149, are basically spinoffs from that menu and will accommodate a wide variety of ethnic, religious, cultural dietary types and should allow us, to our best, to make sure that all of the individual and cultural preferences are met. That will be an ongoing effort to make that program and products increasingly available.

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Mr. Chomiak: The two issues, of course, that have been brought to my attention are food as it relates to aboriginal and Inuit people and kosher food. I wonder if you might specify what is being done in those two instances.

Mr. Sheil: I do not have that information today, but I can find out and report back.

Mr. Chomiak: Is it within USSC's plan to provide food for Meals On Wheels?

Mr. Sheil: Today all of the nine hospitals provide--well, not all nine hospitals--I believe seven of the nine hospitals are currently providing meals to Meals On Wheels volunteers as a result of their provision of patient food services. It is our expectation that we will be doing exactly the same thing. We have been meeting with Meals On Wheels since the fall, are working very closely with them and their board of directors to give them some comfort that their volunteers would be well served by our program, and we have done very well in that regard.

We have been able to introduce to them, again, a wider variety of products than is available to them today. We have been able to give them a better packaging system, a better delivery system. We have encouraged them to make a modest investment in an information system that will allow them to communicate directly with us; we will continue to work with them; and we hope to reach a final agreement with them prior to the summer break.

Mr. Chomiak: Will the changes require capitalization on the part of Meals On Wheels, and, if so, who will provide the funds for that?

Mr. Sheil: I believe that there is no capitalization required on the part of Meals On Wheels, with the exception of a minor investment in software, which is not a significant figure. However, I believe that that would be a discussion item for the board of directors of Meals On Wheels.

Mr. Chomiak: So, in terms of the structure, the meals will come out and be delivered in the pre-existing tray and related structure that Meals On Wheels now utilizes. Is that your response?

Mr. Sheil: We will be introducing new packaging materials to standardize them. The Meals On Wheels today uses a variety of packaging: some old, some heavy, some light, some plastic, some steel contraptions. We will be introducing a plastic serving container that will be a part of our project, is capitalized by our project, because of the changes that we are introducing, so it will be neutral to them.

Mr. Chomiak: It is probably a good juncture from my perspective to probably cease at this point on the assumption that we are going to get back together at some other date to follow up on questioning.

I guess I am assuming that, for planning purposes, we will go into Capital on Thursday morning. It is a question whether or not we will need the entire Thursday morning and Thursday afternoon for Capital. In the event that we get through Capital, I am sure we can find something that we could deal with to move it along.

Probably for planning purposes, I suggest that we think about bringing in the regional health authorities on Monday to commence on that front and then I guess sometime in the next week or two or four or five or six or seven, however we go, refitting the Urban Shared Services issue back into the agenda.

Mr. Praznik: I gather when we are speaking of the health authorities, we are talking about the Winnipeg Hospital and the Winnipeg Long Term Care. We will check on availability.

Mr. Chomiak: Yes, Mr. Chairperson, that is an interesting issue because there are broader issues, of course, than simply the Winnipeg Regional Health Authority. My assumption would be that if we have the people from Winnipeg Regional Health Authority here, then we will try to do the bulk of our questions when they are here, and then later on, the next day or whenever, try to deal with other regional health authority questions for those that can be here, sort of something along those lines.

Mr. Praznik: Mr. Chair, we will endeavour to have Associate Deputy Minister Hicks and Arlene Wilgosh who has been managing the regionalization on the rural side available to follow up the two Winnipeg health authorities.

Mr. Chomiak: That seems to work out. Of course, it is always subject to availability and to arising issues.

Mr. Chairperson: Order, please. The hour being five o'clock, it is time for private members' hour. Committee rise.