Mr. Chairperson (Marcel Laurendeau): The committee will come to order. This section of the Committee of Supply has been dealing with the Estimates of the Department of Health. Would the minister's staff please enter the Chamber at this time.

We are on resolution 1.(b) on page 46, but, as yesterday, I do believe the critic and the minister had agreed we would be dealing in general at this time, not with line by line. Is that the way we will carry forward again today for a little while? [agreed]

Mr. Leonard Evans (Brandon East): Mr. Chairman, I welcome the opportunity to raise a few questions relating to my area in the province, the city of Brandon and, specifically, the Brandon General Hospital, under this particular line where I understand we have an opportunity to raise various miscellaneous policy questions. My concern, of course, is to the future of that particular structure. I know a good hospital means more than bricks and mortar. It takes a good nursing staff; it takes adequate equipment; it takes good doctors. Nevertheless, we still need a roof over our head to do these things, to care for people.

The history of the redevelopment or modernization of the Brandon General Hospital is rather sad. I go back to the previous government of Mr. Pawley when a Mr. Larry Desjardins was the Minister of Health, who had a firm plan that had developed over some years for a new, reconstructed, modernized Brandon General Hospital.

Unfortunately, we were unable to carry through with that because the government changed in 1988. One of the first acts of the new Minister of Health at that time, Mr. Donald Orchard, Donnie Orchard, you may recall that gentleman–one of his first acts as Minister of Health was to cancel a whole array of capital construction projects, including the Brandon General Hospital.

This was a real setback because we have always felt, and I trust the government shares this view, that the Brandon General Hospital was a major regional centre, not only serving the city of Brandon and the immediate area, but also western Manitoba. Indeed, it does attract people from parts of Saskatchewan.

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For it to be a major regional centre it had to have modern equipment, a modern structure. It had to have rooms that were big enough for various purposes; it had to have rooms that, for instance, should have oxygen supplies into them, and so on. I believe that a lot of the rooms, the acute care facilities do not have the level of equipment such as piped-in oxygen that we have in the major hospitals in Winnipeg.

In fact, my information is that Brandon General Hospital is the only major hospital in this province that has not been modernized. We have modernized the, if I may call them, regional or district hospitals in Greater Winnipeg. I am comparing the Brandon hospital with places like Concordia or Seven Oaks or Grace and so on. This is more or less the scale that we are talking about. All of these facilities have been modernized except the Brandon General Hospital–the only hospital of its size in this province that has not been modernized. It is not a matter of changing a model for the sake of changing a model, as we often get with automobiles. We are talking about a need for important structural improvements so that we can deliver care that is fitting for this end of the 20th Century as we go into the 21st Century.

Mr. Orchard, the then minister, cancelled the construction program. It was a number of years before, I believe, he announced that we were going to look at another plan and we would work on it–"we" meaning the government and the hospital officials. Indeed, they did. They worked on this for some years and eventually developed a plan. It was a very frustrating exercise, as I understand from talking to some of the staff at the hospital. Nevertheless, they felt that some developments were going to occur. The hospital board approved the purchase of land in the area, and they made other decisions with the thought that they would be able to go ahead with the support of the government to construct the new facility. Indeed, we eventually got a plan that was put into a form of an actual model.

A beautiful model was developed, and everyone was very interested in it. The Minister of Education, the MLA for Brandon West (Mr. McCrae), made a big to-do about it. After I had issued a statement criticizing and listing a long–providing a long list of deficiencies of the hospital that I obtained from the hospital itself, he said: Yes, these are all things that are wrong with this hospital. A long list, everything from the state of the operating rooms to the state of some of the acute care bed facilities to the state of the elevator. I think there was at one point even the emergency buzzer in the operating room that was to be used by staff if necessary to bring in other staff if there was a crisis, even that was not working. Of course, more recently, we have heard of mice in the building, mice getting into the hospital. How that happened, I do not know.

At any rate the fact is that we had this beautiful model presented. In response to our criticism, the minister came forward for the government and said: Here is what we are doing; we have developed a plan. Here is the model. It was on display in the foyer for a long time, the lobby of the Brandon General Hospital, for all to see and admire. Lo and behold, we are now told that that model and that plan are out the window. That thing is totally kaput; it is not any longer the plan of development for the Brandon General Hospital or the Brandon regional health care facility.

Having said that, I realize there is a development of the energy plant, the power plant. I know that; I was there with the Minister of Health at that time, the MLA for Brandon West, and others. It was very nice, and we are glad that that is going ahead. That had to go ahead anyway. This is a separate facility that was badly needed; it had to be put in place. I know that the minister will get up and say: Look at all the other developments. We have psychiatric care facilities and so on. I would remind the minister that what we are doing is simply replacing a huge hospital complex, a health care complex known as the Brandon Mental Health Centre, which was totally shut down. A huge complex has been totally shut down by this government. This other facility, the psychiatric facility building beside the BGH main building, is more or less replacing the BMHC, which has been abolished.

I realize that there are some other elements, and I realize that there is a development of community care. I am not opposing that. I am simply saying there has not been any work done on the main hospital building to modernize it. So the latest information is, and this is where I am getting to my question of the minister, we are back working on a new plan. We are starting from scratch. We have erased the blackboard. We have erased the chalkboard. The old plan is out, and now we are looking at another plan. Goodness knows how long this is going to take.

So, the question, Mr. Chairman, is: is it correct that we are developing a brand-new plan for that health facility? What is the time frame for some action? In other words, where do we go from planning to architectural drawings and then from architectural drawings, I guess, into the actual physical development of that facility? So I would really appreciate it, and I know the people of the Brandon and Westman area would like to know as well.

Hon. Eric Stefanson (Minister of Health): Mr. Chairman, I certainly do not have a problem with the question. My discussions with the member for Kildonan (Mr. Chomiak) yesterday were that today would be some general questions and then we will start going line by line either later this afternoon or on another day. So I think, as the member for Brandon East knows, I have the Deputy Minister of Health and the assistant deputy ministers here. I do not have specific people from our capital projects and so on.

Having said that, I am certainly prepared to respond as best I can at this point. I am more than willing to provide additional information relative to the situation in Brandon, particularly all of their capital projects, but I think what is important to point out, Mr. Chairman, are the significant number of initiatives that have been put in place and are currently being worked on in the city of Brandon. Obviously, the Brandon Regional Health Centre is an extremely important health care facility not only for Brandon but for that entire region. That is why I think I would like to just remind the member of a number of things that are being done and have been done.

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First of all, when you look at the Brandon Regional Health Centre, there was the addition of a 25-bed adult acute psychiatric unit and psychogeriatric assessment and rehabilitation unit. That was completed in March of 1998 at a cost of about $4.4 million. As well, the Westman Child and Adolescent Treatment Centre was completed in July of 1998 at a cost of about $3.2 million. There have been roof repairs done at the nurses residence, the auditorium, and the mechanical room. That was about $140,000, completed a couple of years ago. Additional roof repairs at Assiniboine Centre, the skylight roof for about $155,000. That was completed in 1997. Hemodialysis unit expansion was completed in August '96 at a cost of $665,000. Mr. Chairman, as well, we have the whole redevelopment Phase 1 of the energy centre, which is currently under construction, and this project is expected to be completed by October of this year. It is under construction at a cost of about just under $15 million.

There is also the issue of the whole redevelopment that the member is asking about, and that redevelopment for the clinical services and building services, Mr. Chairman, has been approved for construction. The scope did change to include the OR, the emergency, the admitting, sterilization and ambulatory care, but that project is now in design. Design development has commenced for this Phase 2, the clinical services, which includes all of those areas that I have outlined, and that is expected that the tender will be let for that particular project within the next couple of months. That is a $38-million project, approximately, again a significant commitment to the redevelopment of the Brandon regional centre.

As well, in our recent capital budget, we also outlined the expansion of the critical services redevelopment project to include new space for obstetrics and neonatal intensive care services. The estimated cost of that, which has just been recently approved, is almost $5 million, Mr. Chairman. As well, there was another conversion project included in the current budget having to do with renovating existing space in the general centre to improve the efficiency of several support service programs, including imaging, reception and a number of other functions. That is a new approval of about $250,000, and the Westman Lab has had approval for a conversion project for some renovations and expansions to increase their pathology and nuclear medicine. Again, that is in the range of about $300,000.

Now I do not have a calculator here with me, but just looking at that very, very quickly, Mr. Chairman, I think all of those total in the range of about $65 million focusing on all of the redevelopment needs of the Brandon Regional Health Centre. I think a very, very significant commitment to the improvements and enhancements of that very important facility.

As well, Mr. Chairman, a number of other initiatives have been put in place at Brandon dealing with issues relative to waiting lists having to do with bone density procedures and testing. In fact, just in January, the government announced the approval of some operating fund and some medical remuneration close to $200,000 to provide that very important service in the Brandon Regional Health Authority, and I certainly could go on with some other issues relative to the operating support and so on for the Brandon Regional Health Centre. So, again, I think this is important information for the member for Brandon East (Mr. L. Evans) to have. I am not sure that he is necessarily aware of both the numbers of projects, the amount of resources dedicated to these projects, the numbers that have been completed, but, just as importantly, the numbers of projects that are currently either under construction or in design.

So we certainly recognize the importance of the Brandon Regional Health Centre, and that is why we as a government have committed the kinds of resources we have to continue to enhance and improve that facility for the very important services that it provides to Brandon and surrounding area.

Mr. L. Evans: I thank the minister for that information but I might add that most of it I have heard about and been involved in, as a matter of fact. I guess I was at the sod turning for that psychiatric unit; I was at the official opening of the Child and Adolescent Treatment Centre; and I was at the sod turning at the energy centre, et cetera. But, as I said earlier, Mr. Chairman, the minister has to appreciate that some of those initiatives–the psychiatric unit and the Child and Adolescent Treatment Centre–are repercussions, I suppose, or tied in to the closure of the BMHC. It is a huge complex, a multibillion-dollar complex that has served this province over many, many a year and for various reasons has been closed by this government. In fact, there was a debate in the last election in the community. It was in the election itself as to whether that centre, the BMHC, should be entirely shut down, as it is now, or whether it should have been modified somehow, perhaps allowed to carry on in a modified or perhaps reduced scale and offer the various psychiatric services required to adults and to adolescents.

When we talk about the energy centre, my understanding is that was absolutely necessary. The energy centre, the power plant had to be renovated or replaced. That is going on. I appreciate too some of the miscellaneous things the minister refers to. Bone density, I have been asking a couple of years ago about the need. I have been urging the government about the need to bring in that program and stated all kinds of instances where people were being denied service because of the lack of facilities for bone density screening at the Brandon Hospital, the Regional Health Centre, as it is now called.

At any rate, the minister referred to a $38-million item. I imagine that is the main building that he is talking about. I just want to get a little more clarification as to the time line. He gave me some information, but I am not totally clear as to when is his best estimate of actual construction starting for the main building that has to be modernized. The last major hospital of this level in this province has not been modernized. It should have been modernized 10-11 years ago, but we were all set to go with Mr. Desjardins, who was then the minister.

Mr. Stefanson: Mr. Chairman, well, I touched on that and again it is a major commitment. The preliminary capital cost estimate is about $38 million for all of those redevelopments we talked about in terms of the combination of the emergency, the nuclear medicine and pharmacy, the Westman Lab, the scope change that I referred to in terms of the OR, the emergency admitting, the sterilization, the ambulatory care, and so on.

That project is currently in design, Mr. Chairman. I am told that we can anticipate it being out for tender by July of this year, July of 1999. Obviously, depending on what kind of a timeline they put on tenders, whether it is a month or whatever, I would expect that construction will begin for some elements of the project starting this fall. So again it is moving forward. It has our total support and it is moving forward at a very reasonable pace at this particular point in time. So, again, I think that is good news for the people of Brandon and the people of the surrounding area.

Mr. L. Evans: I thank the minister for the information and certainly people will be relieved to think and believe that something is going to happen, but you could appreciate that they have been frustrated over the years.

I would simply ask a small related question: is the minister going to come up with another model of this new designed building? I sort of laugh when I say that, but seriously, will his department be forthcoming with some sort of a model after the design work has been completed to show the community exactly what is now being proposed for construction?

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Mr. Stefanson: Madam Speaker, I think the member for Brandon East (Mr. L. Evans) knows that the architects basically work for the regional health authorities, and I would expect that when the design is complete that the regional health authority would want to obviously be able to provide those designs to the public and to show the public, the people of Brandon East and surrounding communities, what the design elements are. So it is obviously up to them if they have a model. I am not sure that a model would necessarily be utilized by them. I guess it might, but for sure I would expect that once they have the detailed design elements that they will want to show the detailed design elements to the people of Brandon and surrounding communities so that they know all aspects of this very comprehensive redevelopment project for the Brandon Hospital.

Mr. L. Evans: Mr. Chairman, as I said, the former Minister of Health and the MLA for Brandon West (Mr. McCrae) made a great to-do about this model, and as I said it was front-page picture, front-page story and big news conference and display in the lobby and so on. There was a lot of interest in it, and I would believe that at some point there is likely to be a model on display somewhere just for public interest. So we will keep our fingers crossed and hope springs eternal and let us hope finally after all these years something will develop, because we were, as I recall back in '87-88, on the verge of going to tender and having a new facility developed at that time.

I wanted to ask a specific question. The minister has made a lot of announcements about different initiatives and so on, including the Westman area, but in the cost-cutting that occurred a few years ago, I believe the palliative care unit was totally eliminated. I wanted to ask the minister specifically: where does that stand now, the palliative care facility or unit, in that hospital complex?

Mr. Stefanson: Mr. Chairman, I just want to assure the member for Brandon East, he talks about hope springing eternal, and so on, I have already outlined for him significant projects that have been completed in Brandon, other projects that are underway at various stages, obviously the construction of the energy centre, the design elements of the whole redevelopment of the Brandon Regional Health Centre. These are very important projects for Brandon and surrounding community, Mr. Chairman, and we are very dedicated to those projects and seeing them move along expeditiously. We fully expect that on the major redevelopment, as I have said, it is in design and it should be to tender I am told by July of this year and under construction by the fall of 1999, very important capital projects that we wholeheartedly support.

He talks about palliative care. To the best of my knowledge I am not aware of any dedicated funds that were provided to the Brandon Hospital at the time relative to palliative care. Individual facilities made choices about the level of palliative care they were providing and whether or not they dedicated beds or took other steps, Mr. Chairman, but I think what is really important is that the member may have noticed recently that we made an announcement relative to the expansion and enhancement of palliative care services throughout the province of Manitoba where each regional health authority will receive some dedicated funds to provide support for an individual to deal with the whole initiative of palliative care in their region. That is a very important initiative. So all the RHAs receive some operating funds to hire staff to deal with palliative care.

There is also some significant capital dollars being invested here in the city of Winnipeg for some expansion at the St. Boniface Hospital. Certainly we are very committed to continuing to improve the services in the whole area of palliative care, Mr. Chairman.

Mr. L. Evans: Well, if my memory serves me correctly, and I have not had a chance to go back into the files where I could perhaps verify this, as part of the cost cutting that was required a few years back, there was a palliative care unit within the structure, X number of beds. I believe, I serve to be corrected, but I believe that it was just eliminated, this palliative care unit, or however it was administratively described within the Brandon General Hospital. I think if we went back into the records just a few years ago, you will see that.

Mr. Chairman, I wonder, again, you know, I recall a former CEO of the Brandon General Hospital, a Mr. Larry Todd, who resigned and was subsequently replaced a couple of years ago, a year or two ago. I remember him saying to me prior to leaving that for every year that he had been president or CEO of the Brandon General Hospital he had to suffer a cut. Every year his budget was reduced, one year after another, like going down the steps. He said it was a very frustrating exercise, and he said there is no question that the quality of care diminished at the Brandon General Hospital because of these cuts. The nurses were overworked. We had insufficient nursing staff. There were a number of beds that were eliminated, and there were all kinds of problems. Although staff worked very hard and diligently and did their best to offer the finest care they possibly could and people were looked after, nevertheless the overall quality of care had diminished, had deteriorated, this coming from the president, the CEO of the Brandon General Hospital.

I would like to ask the minister specifically whether he can tell me the number of nurses on staff today or the number of nursing positions at the Brandon General or the regional centre, as it is called now, today, as opposed to, say, four or five years ago. Can he give me that information? Because my understanding is that we have fewer nursing staff today than we had a few years back.

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Mr. Stefanson: Mr. Chairman, first of all, just to conclude on the palliative care, I just want to make it clear for the member for Brandon East that certainly we, as a provincial government, did not remove any program or any initiative from Brandon Hospital relative to palliative care. I am certainly prepared to look into the background in terms of the history of palliative care at Brandon, what services they did have, what service adjustments they made. But I think, more importantly, as I have already outlined for the member, we recently made an announcement of significant enhancements of palliative care services working with Winnipeg, Brandon, the rural northern health authorities, to continue to enhance a program for palliative care services in both home and institutional settings. Some of the goals of that program are to ensure there are no system barriers for people who wish to remain at home, that they improved standards of care for people in the hospital and the community, and decreased emergency room visits and enhanced client or patient service and satisfaction.

There was an approval of some $1.2 million in this budget that the member for Brandon East supports to the WHA, the WCA and the Brandon and rural and northern RHAs as the first of a two-year phased program to enhanced palliative care right throughout the province of Manitoba. So, again, palliative care is a very important service. We recognize that and we are continuing to provide resources to enhance that service.

I am a little concerned about some of the comments the member puts on the record about the quality of care diminishing because of cuts in funding, Mr. Chairman, and I am certainly prepared to go back in the records and provide him with a summary in the history of the support for the Brandon Hospital and the Brandon region. I remind him of course what we were facing as a government in the early to mid-'90s with the significant funding cuts from the federal government. I read the other day from a brochure tabled by one of his federal colleagues, a member of Parliament–I am not sure what the constituency is now called. It is Mr. Martin, it is Winnipeg Centre, I believe, or Winnipeg North Centre, and he points out very clearly the significant funding reduction to health from the federal government during the '90s and is very critical about decisions as we have been. So we certainly have, and certainly a former member here, Judy Wasylycia-Leis who was the Health critic, I believe, before the member for Kildonan, I have read many comments from her about the funding reductions from the Liberal government for health care and so on.

During all of that period, Mr. Chairman, we backfilled that entire amount that was taken out of the system by the federal government and still put more resources into health care. Our health care spending in this budget from 11 years ago is up $800 million or 60 percent, and I would certainly compare that commitment to any province right across Canada. As we all know in this Chamber, 35.5 percent of all of our spending goes to health care, only one province spends a higher percentage. So if we want to talk about dollars and the commitment of our government, I am certainly prepared to do that at length. I think that is one of the reasons that members opposite have supported this budget is because of the significant commitment that we are making to health care. That is an additional $195 million, 10 percent more, and I am assuming that is one of the reasons that they voted for our 1999 budget.

In terms of nursing staff, I do not think there has been many adjustments, but I am certainly prepared to get the numbers for the member for Brandon East.

But I guess if he wants to talk about, I guess the other issue is on funding. Just recently we approved over $600,000 more for the Brandon Regional Health Centre, Mr. Chairman, to help them deal with the whole issue of waiting lists. The Brandon authority has implemented a number of measures to reduce waiting lists. It includes the recruitment of two additional anesthetists for a total of six now, I believe, in Brandon. It includes the recruitment of nursing resources, includes the expansion of the day surgery services, includes the additional daily operating room scheduling. They have done a number of things to significantly reduce waiting lists for the people utilizing the Brandon Regional Health Centre.

But if the member for Brandon East (Mr. L. Evans) wants to get into the rhetoric of quality of care diminishing again, that is certainly a debate I am prepared to have at length.

I have a series of articles here, written, interestingly, back in–this one happens to be dated December 24, 1983, by one of our local newspapers, the Winnipeg Free Press. The headline part of it: Hospitals in crisis, it says, Mr. Chairman. I could certainly read these many articles, but I will just read one short paragraph here, and it says–this is 1983. We recognize and we know what the government of the day was and what people were members of that government. One section out of this, if we want to get into this kind of discussion: More than 1,000 people are on the waiting list for surgery at Brandon General Hospital, and some are going to the United States rather than waiting more than six months.

Mr. Chairman, that is not the case today. Certainly if we want to talk about what has happened to health care services in Brandon, compare what was happening back in 1983, in 1984. I am certainly prepared to take the time to use this and read these many articles into the record to remind the member for Brandon East of many of the challenges that he faced when was in government, many of the criticisms that were being directed at them when they were in government, many of the issues that they did not address when they were in government.

So I will certainly get him the numbers on nursing staff today compared to the last several years and provide that.

Mr. L. Evans: Well, the member can use all the selective statistics he wants, but the record is clear, and I would be very pleased to match our performance with the performance under this government over the period of years. There is absolutely no question.

I invite the minister to go and look at the annual reports of the Brandon General Hospital and see, or look at his own documents, where the basic funding was cut year after year after year, like going down the steps. Throughout the whole period of Mr. Todd, who was the former CEO of the Brandon General Hospital, he told me himself, and I could see it myself, every year they cut. Even today, for all the announcements that have been made and all the initiatives the minister likes to brag about, even today my information is that the current base fund is still not where it was a few years ago when it was at its maximum. It is still below that.

Mr. Chairman, if you take inflation into account, it is seriously below what it was six, seven, eight years ago, seriously below. That is something we never seem to talk about here, the phenomenon of inflation, which does exist. The hospitals have to pay for heating, they have to pay for food supplies, they have pay for medical supplies, surgical supplies, and so on. These prices go up. This is the way our economy works, inflation. Yet not only was their level of funding not increased, it was decreased for those many years, year after year, while inflation was taking place.

Even today, and I had a number here I raised in Question Period about a week or so ago, the actual number of how much inflation there was in this period of time under this government and what happened to the level of funding. The level of funding was cut and it is still, as I say, even with some monies being put back, over a million below the base, but when you take inflation, it is seriously below what that hospital had to operate with when this government first took office.

I would like to also remind the minister that beyond hospitals there is a lot of other deterioration that has taken place in the health care protection offered by a province to its people. I mentioned Pharmacare, for example. That program has been cut and decimated in such a way that it does not provide for a great many people in this province the kind of security and assistance required for people who need to have medication as prescribed by their doctor.

In another area, the rural and northern Children's Dental Health Program, one of the best in the world, which was basically needed in remote areas, rural areas, was totally abolished. Mr. Orchard came in here and said: I am sorry, it is out, completely out. It was a low-cost, efficient method using dental nurses under the guidance of dentists, but using dental nurses. It was delivered well and effectively and using, by and large, the school system–not entirely, but by and large the school system. That is all gone. It is all eliminated. As I said, when you look at what is happening to our hospitals, and I am using the Brandon General Hospital, because I am more familiar with that, obviously, when we look at the number of staff, the number of beds, and the other factors that are so important to the delivery of health care, one wonders whether we will ever go back to the quality that we had some years ago.

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I would like to also before I conclude, Mr. Chairman–of my concern of the very retrogressive, backward-looking system of capital finance of our health care facilities in this province. When we became government under Mr. Schreyer in 1969, we very soon changed the previous policy which did require hospitals to get assistance, to get capital contributions, from local municipalities, from local groups, and so on. We abolished it because we said that it was not fair. The health care responsibility was that of the province and, to a large extent, supported by the federal government, and it was not fair to say to a municipality or to a particular area: Well, if you want your hospital upgraded or expanded or renovated or whatever, you have to come up with a percentage of the money, without any concern for whether one area was more wealthy than another. That is the case in this province. Some areas are more able to contribute financially to such facilities than others. I believe it is totally inequitable for that reason, and therefore a bad policy.

It is also a poor policy because it is tantamount to double taxation. In the Brandon General facility, renovation that the minister talks about, the modernization, the City of Brandon is asked to come up with a substantial contribution. It has agreed to it, but, as some councillors point out, this is tantamount to double taxation. They pay their provincial taxes to hopefully get a health care system that is going to care for them, and then they have to turn around and pay municipal taxes as well.

Recently the Town of Virden, the town council, agreed to put in its share. Again, quite clear example of double taxation. Often I wonder what would happen if these councils or community groups did not, or could not, come up with their so-called share. What would happen? Would you say: Sorry, we are not going to go ahead with this project now because the local share was not forthcoming, and, too bad, you do not meet the rules, and away we go, and forget it?

I am not only talking about Brandon; I am talking about the whole province. There are some areas that are not as wealthy as other areas. Those are two reasons, but there are other reasons why I would consider this to be a very backward step. The government should really–and for all the time and energy that it is put into this, to collect money locally, and goodness knows, how many bake sales and so on are going to be required in some communities to come up with the dollars as a so-called local share. Totally backward, totally retrogressive. I do not care, the minister may get up and say: well, in this province, they do it this way; in that province–I do not care. We had a very progressive policy. We assumed, the province assumed a responsibility. We went forward and built the structures that were needed to provide first-class health care.

I do not accept the argument: Well, other provinces do it this way where they require local contributions. If they want to be regressive, it is too bad. That I would object to what is going on there as well. That is no reason for us to turning the clock back, and there is no question in my mind that we have turned the clock back in the way we finance the construction of health care facilities in this province.

I think the people remember this. I have talked to a lot of constituents, and they remember this. They remember, well, years back when you built the Westman Lab in Brandon we did not have to come up with a share for the new Westman Lab. We did not have to come up with a share for a new Assiniboine Centre, a beautiful Assiniboine Centre, which was actually a renovation of an existing building, but it was like a brand-new building. It is still a very lovely building. No one asked the City of Brandon Council to come up with half a million dollars or whatever might be required, or a million dollars, as the local share. We just went ahead and did it because it was our responsibility. It was needed. It was badly needed. We assumed the responsibility and went forward and constructed the Assiniboine Centre. Similarly, I can point to other examples around the province.

I would hope that somewhere, when he ponders this, the minister will reconsider this whole policy and simply wipe it out and say we are going to go forward and we are going to assume a hundred percent of the capital costs because we want to have modernization of health care facilities around this province, and we do not want any inhibitions caused by lack of local funding. If the minister wants to respond to that, fine, but I certainly wanted to get this on the record, because we are being very, very regressive in this area.

Mr. Stefanson: The member makes a number of points that I think are worth responding to. He starts by talking about inflation and inflation factors in terms of additional expenditures. I would just point out to him that spending on health care in this budget from 11 years ago is up 60 percent. He can go into all the calculations he wants, and I think he will find that when it comes to inflation over that period of time, it is not at that level. Again, I think that points very clearly to the significant priority and commitment that we have made to health care throughout that period of time, Mr. Chairman.

I guess reading just one small excerpt out of about 15 articles set the member for Brandon East (Mr. L. Evans) off. I am certainly not intending to do any more of that, but I would encourage him to read these many articles from late 1983, early 1984, where–I think all I need to do is read him some of the headlines of some of the articles, and he will get a sense of what was happening during his tenure in government.

One headline: Squeezing the hospitals. Another headline: Patient decries bed wait. Another one: Heart surgery wait worries doctors. These are all in late 1983, early 1984, Mr. Chairman. People going blind waiting for eye surgery, doctor says. This is on December 27, 1983. Emergency wards wage uphill battle. Shortage of acute care beds mean long waits for admission, doctor says. This one is on December 28, 1983: Intensive care beds short again–part of that same article, December 28. Another one here: Aging medical equipment worries MDs, technicians–December 29, 1983.

These are only the headlines I am reading. I am certainly prepared to read the articles into the record to remind the member for Brandon East (Mr. L. Evans), who was here during the time. It would probably be useful for the member for Kildonan (Mr. Chomiak), who was not here during the time, to get a sense of some of the challenges, some of the decisions that that previous, previous government was a part of.

Another headline: Equipment breakdowns seen occurring virtually daily at hospital's laboratories. Another one here: Doctor shortage plagues rural areas. That is on December 30, 1983. I think I have a couple more here: Rural operating room underutilized as city hospitals overburdened–December 30, 1983.

Here are a few more. Here is another one. This was the one on December 24: Experts warn of second-rate hospital care. That is where I read a specific quote relative to Brandon: And more than 1,000 people are on the waiting list for surgery at Brandon General Hospital, and some are going to the United States rather than waiting more than six months.

And I know, Mr. Chairman, and I am certainly prepared to provide the statistics, that the number of residents going to the United States is down significantly from that period of time under a previous administration. Here is another headline. This one is January 6, 1984: Hospital forced to limit admissions.

That is just a sample of the headlines, and I am certainly prepared to provide more details directly from these articles to provide more background on the state of health care under the previous administration, Mr. Chairman.

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But the member also talks about our Pharmacare program. This budget that he voted for on Monday, our 1999 budget, includes $72 million for Pharmacare. That is an increase from the previous year of $10 million. The budgeted amount in 1998-99 was $62 million, a significant commitment to our Pharmacare program that is described by most as one of the most comprehensive in all of Canada. It certainly is a fair program in terms of trying to balance the needs of patients with their financial ability to pay for pharmaceutical requirements.

He did not mention the Home Care program, but I am certainly pleased to remind him of our Home Care program, which just last year at a national conference was described as the most comprehensive in all of Canada. I believe our budget amount here in Home Care is $147 million. I am just looking for it here in our detailed expenditures. I will just give him the exact amount in a moment. It is right here, Home Care Services, $147,220,000. Just last year, the budgeted amount was $126,737,000, a $20-million increase in the most comprehensive home care program in all of Canada. Again, I am pleased that the member for Brandon East (Mr. L. Evans) with his colleagues supported that increase in funding for Home Care by voting for our 1999 budget.

He talked about the community contribution policy, Mr. Chairman. I think it is important to remember that Manitoba has always had a form of community contribution. If we go back many years, it used to be in many cases 50 percent, where municipalities would contribute 50 percent. I think that is why some of our facilities were called municipal hospitals, because of the significant role in contribution. That changed over time. A few years ago the policy was that while there was no cash contribution from communities, communities were required to contribute serviced land for their facility and also other amenities to their facility. So there has always been a contribution coming from communities in one form or another.

That was formalized through an official community contribution policy, Mr. Chairman, that includes basically the total costs of the project, and it now has that a community will contribute, if they make their contribution right at the front end of the project, 10 percent of the capital cost. If they decide to do it over 10 years, they will do it at 20 percent interest free over that period of time.

So it is certainly in keeping with the fact that there has always been a contribution. It formalizes the policy. I think it is very important for our communities to be very involved in the kinds of health care facilities that are being put in place in their community and servicing their community and their surrounding areas. I think it is very important for the people of the community to have a strong sense of ownership of their facilities. After all, they really are their facilities. They and their neighbours and the people who visit them are the ones who utilize these communities. It is very important that it is an inclusive process, which means that we get the most appropriate and the very best facility that is required for that individual community or that individual region. So I think that is a very positive thing, to have people involved in the process.

The member pooh-poohs what other regions are doing, but I think it is important to remind him that the Province of British Columbia has a 40 percent community contribution policy in the Province of British Columbia. The Province of Saskatchewan, our neighbouring province to the west, has a 35 percent community contribution policy. Our neighbouring province to the east, Ontario, has a 50 percent community contribution policy. One of the Maritime provinces, the Province of Nova Scotia, has a 25 percent community contribution policy.

So, again, you can certainly see from what the situation is right across Canada that the concept of community contribution policies is not something that is unique, and it is not something that is necessarily an ideological or political decision. You have got NDP governments in B.C. and Saskatchewan with community contribution policies; you have got Liberal governments in the Maritimes with a community contribution policy, and so on. So certainly the concept behind having communities involved in the development of their project, the nature of their project, making a contribution–again, when you compare Manitoba's 10 or 20 percent, it certainly compares very well to all of these jurisdictions.

Those are just a few comments in response, and I am certainly prepared to continue this discussion about the state of health care in Manitoba back in the 1980s.

Mr. Chairperson: Before we carry on, I do remember that when we started today off we said we would be dealing with wide-ranging discussions. I would like to remind members that, when we do move into the line by line, I will be expecting some relevance to the questions on that line and answers that are relevant to those questions. I will not be allowing the wide-open discussion that we have at this time. It just will help with the decorum at that time.

Mr. Oscar Lathlin (The Pas): Mr. Chairman, thank you for giving me the opportunity to speak to the minister.

My purpose here this morning is to try to ascertain the depth and the scope of understanding and knowledge that the minister has on the two states of health care that I referred to in Question Period the other day. Six years ago, when the health reform policy was announced, I for one did not have a whole lot of trouble with the direction that it was going to go, provided that certain accommodations were made. Some of those accommodations, as I pointed out to the minister yesterday, were that the new policy placed a great emphasis on prevention and education and so on, which is all fine. I mean, that is good, but what I think the minister and his government and others have failed to take into consideration is the fact that–and this is all evidenced, you know, by numerous reports that have documented the state of aboriginal health. As recently as six months ago, a report said that the state of aboriginal health is worsening, and they give examples like tuberculosis and diabetes, and so on, those two that I can remember.

So the point I was making was, when this policy was devised, does the minister, he is the Minister of Health now–did his colleagues, as they were sitting around the table devising this policy, take into consideration the wide gap that existed between aboriginal health and nonaboriginal health? By that I mean aboriginal health right now, as is documented almost every day, is very much in the treatment mode. We have diabetes, people have to get dialysis, so on and so forth, heart problems, so on and so forth. We are not at the stage yet where his people are right now, where in the city of Winnipeg, yes, we can talk about prevention and education, it is very good, but the policy, I am afraid, took a very big shortcut when it came to aboriginal people because all of sudden aboriginal people were expected to operate in this education and awareness area while they were still about 10 years behind. We are still operating in the treatment area.

I want to ask the minister: did they take that into consideration when they were devising the health reform policy?

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Mr. Stefanson: Mr. Chairman, I guess to give the answer, first, did we take into consideration–the way I understood the question after some outline by the member for The Pas, did we take into consideration the status and needs of aboriginal people with our health policy, I think was sort of the ultimate question. If that was the question, the answer is certainly yes.

But I want to move on to some of the specifics that he raised when he talked about diabetes and tuberculosis, and the fact that there really are the two sides to the issues. There certainly has been a great deal of focus on the treatment side, and I think, as he knows, we have continued to significantly expand dialysis services right across Manitoba, and certainly aboriginal people are some of our citizens that are utilizing the treatment side of those services. I can get him the dollar amount in terms of the significant expansion in the treatment side. They are very significant. I had a chance recently to compare them to some other jurisdictions, and certainly again we stack up well on a comparative basis in terms of directing resources to deal with the treatment.

Again, if I partly understand his question, it is: what are we collectively doing as governments, the provincial government, the federal government, in part on the whole issue of prevention? Obviously the more that we can prevent people from getting an illness or getting a disease, I state the obvious to him. It is obviously better for the individual and it is better throughout society and for our health care system.

One of the main initiatives that we announced as part of our health policy reforms late last year was the whole issue of a diabetes strategy, which I think he is quite familiar with. It was released in November of last year. Over a thousand Manitobans contributed to the development of the recommendations. There was a strategy committee, a multisectoral strategy committee, which included First Nations representatives on that committee, along with some of the academic sector, the government sector and other key stakeholders, to develop the diabetes strategy. It makes a number of recommendations. I am not sure if the member has had the opportunity to see that document, but I am certainly prepared to provide him with a copy of it. Manitoba Health has already started to implement some of those strategies.

We have also committed additional resources to strengthen our ability to implement some of those recommendations. That includes some additional funding that is in place to address diabetes, to develop the Manitoba diabetes care guidelines, obviously the expansion of dialysis services and various projects that are taking place throughout our province.

I have also indicated in response to the question that he referred to that he asked me yesterday about the whole issue of a policy framework for aboriginal people in the province of Manitoba, we have done extensive work on that document, mostly internally, with some consultation with representatives of the aboriginal community. It is certainly my expectation that that would be a document that we can very shortly take out to individuals in our aboriginal communities, to the leadership of the aboriginal communities and have discussions whether or not they are the appropriate strategies in terms of meeting some of the areas of greatest needs.

As I said to him yesterday in Question Period, in my short time in this portfolio, one issue that I do not have a great deal of patience for is this area of jurisdictional squabbling when it comes to the health care of all Manitobans, but certainly our aboriginal people. I have already experienced that with a couple of issues that we are dealing with relative to the federal government and the issue of services to First Nations people on reserve versus off reserve, and so on.

I think the member for The Pas (Mr. Lathlin), I am sure, would be familiar with some of the initiatives that communities are looking at, whether it be nursing stations or whether it be personal care home requirements and a number of initiatives that really are fundamental requirements in some of our communities that have to be resolved collectively between the federal government, provincial government, and the aboriginal community.

I am certainly committed to doing just that, but I think if one part of his question was the need to focus on doing what we can to prevent illness in the first place, whether it is through information, through services, through some fundamentals on reserve, I agree with him, that we should be taking all those steps. That is probably the most important thing we can do, to be sure that people are healthy and lead healthy lifestyles for their own well-being and for obviously our entire health care system.

Mr. Lathlin: Mr. Chairperson, the question that I was asking the minister was, and I think he was trying to answer it, but my question specifically was: what is his understanding of the gap that I keep referring to? Because I am getting the feeling from his answer that he does not really have a full understanding of the gap that I am referring to, that being: what do you do with those of our people who are in a treatment category? Do we just forget about them and let them die and not give treatment?

Again, I am not sure if the minister is aware, but oftentimes when people from the outlying areas are being medivacked out, hospitals are quite unwilling to take the patients as they come in to places like The Pas, Flin Flon and Thompson. As a matter of fact, a lot of times the nurses who work in these nursing stations have to more or less shop around. Okay, you do not want us? We will go to Thompson. You do not want us? Well, we will try The Pas, you know, and that is the kind of gap I am talking about. What is his understanding? Maybe he would like to share his knowledge about that because he is the one charged with the responsibility of devising these policies. If he is not working with enough information base, then sure as hell he is going to miss in some places. What I am suggesting to him now is he has missed the aboriginal people and they are being left behind.

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Mr. Stefanson: Yes, I do understand the issue that the member for The Pas raises here today. If he has any specific examples of difficulties with accessing a bed or what he referred to as having to shop around to find a bed, and so on, I would welcome receiving those because the whole issue is one of co-ordinating access to our beds and our hospital beds, and so on, whether it is First Nations people on reserve or off reserve or Manitobans elsewhere who need a bed in our hospital system, whether it is to come in to Winnipeg to Health Sciences Centre or whatever. So, if he has specific examples, I would welcome receiving those because the whole objective is to make sure that people do have access when they need it. Even more so, the other part of his question is a continual focus to try and provide them in regions that make more sense in terms of service and economics. Obviously, in northern Manitoba, the more services that Thompson can provide, the better that can be in terms of service to the patient and actually the efficiency of providing that service. So, again, we continue to look at the kinds of services we can provide outside of Winnipeg to meet the needs of First Nations people on reserves or other Manitobans. I could certainly go through various instances where we continue to improve the ability of communities to provide services closer to home.

Another issue that has been raised with the regional health authorities is this whole issue of where people go, including our aboriginal people, where they go to access their care. They were directed back in the fall just of last year to do work on that whole initiative so that we can obviously have that database as a resource to then say how can we improve it, how can we address the very issue that he raises in terms of providing the services where and when people need them. I do not have that report back from the RHAs at this point in time, but I will certainly follow up with them because obviously that can improve access to care and quality of life for individuals.

I also had a recent experience of an issue, and I touched on it relative to a personal care home request from a northern reserve community. I have since written the federal government about that issue and their policy where they–I think as the member for The Pas knows–currently have a policy of a moratorium on personal care beds on reserve. So, in effect, what that policy does is people who are at the stage of requiring a personal care home are basically driven out of their community if the personal care home is the most appropriate and the type of service that they want or need or their family wants them to have. So, instead of being able to stay in their community with their family and their friends, they then end up going to another community and getting a personal care home bed.

So I have written the federal government. My deputy, along with I believe the deputies from the other prairie provinces, are working to address that issue. It comes back to that point that I touched on that I am having difficulty accepting, this issue of jurisdiction that continues to get in the way of co-operating to provide the services that are needed, and that is one good example that I have had to–when I say good, not good in the sense of not being able to meet the need immediately, but it is a good example of this whole issue of jurisdiction and the fact that the federal government has a moratorium on personal care homes on reserve, but yet they will provide a certain level of funding for I believe Level 1, 2 and 3 in a personal care home. Surely we can get on the same page in terms of an approach and a policy that we can co-operate on to meet the needs.

So I would say, yes, I am aware of the issue that he raises, and I share his concern. I think we have made some progress. We are taking steps to address it. We have the RHAs doing the work that I have already outlined, and we are trying to work with the federal government on the issue and taking a number of initiatives to I think address the very issue that he has raised here this morning.

Mr. Lathlin: Mr. Chairperson, I thank the minister for those responses. However, if he were to ask for my advice as to how he was to avoid any jurisdictional disputes, right off the top the first advice I would give him is to once and for all–the staff sitting around the table will attest to this–the long-standing issue of the 1964 agreement regarding Moose Lake, Easterville, and Grand Rapids. The former ministers have taken the position that they did not want to opt out of that agreement for reasons I am not aware of.

It is an agreement whereby the federal government contracted with the provincial government to provide health services for First Nations people who were situated right adjacent to Metis communities back in 1964. For a number of years now, the Swampy Cree Tribal Council have been negotiating with the provincial government to do away with that agreement so that the First Nations people can get control of everything and deal directly with the federal government instead of having to deal with two provincial governments who are often not on the same page when it comes to funding issues.

The second part of my question to the minister is: I would like to ask him if he is aware of just exactly how many nurses are short, in other words, how many nurses do we need in the North, particularly in the First Nations communities? Not long ago, I was in a conversation with the Health Canada representatives from Winnipeg and they advised me–and I was aware of this all along, having been chief for a while–that there is a formula that they use to determine the number of nurses to go into a Health Canada nursing station on Indian reserves. For example, in Cross Lake, the formula might call for 13 nurses but they only have six. Mathias Colomb calls for eight nurses, but they are lucky if they have three, and so on and so on. The MKO bands, there are 26 of them.

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When I talk to people like MARN because, again, there does not seem to be any interest because my point with MARN was, you know, if there are supposed to be 13 nurses carrying on this type of workload according to government formulas, would there not be a tendency to run into trouble with standards and so on. So, it is a three-prong question, I guess.

Mr. Stefanson: Mr. Chairman, I do thank the member for The Pas for his advice and some of his outlining of the 1964 agreement. My understanding of the current status–and he would know better than I that there have been ongoing discussions for a long period of time. I gather the current status, if this information is accurate as of today, is that the Swampy Cree Tribal Council filed a statement of claim I guess against the federal government on March 9, 1998. Manitoba was served on October 6, 1998, as a co-defendant. Obviously that has had an impact on the ongoing negotiations, which for all intents and purposes have been suspended during this process of legal action.

I am certainly prepared to have a lengthier discussion with the member and to get his views and thoughts on the issue. I understand that the province certainly made certain offers relative to the whole issue of doing away with the agreement, made certain financial offers, and an agreement was not able to be reached during that process. I would certainly welcome any further suggestions the member for The Pas might have.

His question about nurses in the North. Again, I am certainly aware of the nursing shortage in the North; I would think most people would be just, if for no other reason, from the media coverage, let alone other ways of being made aware of it. From our department, as we discussed in this House, we have a provincial need for more nurses, but we certainly have a need on our reserves in many cases in Manitoba. My department is certainly working and committed to work to bring more nurses onto the reserves to meet the needs.

The member for The Pas, I believe, yesterday asked me about the opportunity to access the nurse recruitment fund of $7 million, and I indicated to him that I felt there was no reason that that could not or should not be the case, that that fund should be available to help with just that and that still is my view. I am following up with that committee to make sure that they are aware that that is our view. I do not anticipate that being a problem at all, that they should be using that fund to help with recruitment in the North.

I want to follow up and I will follow up on the final point that he raised, which I would agree is an important one, where he talks about a formula being in place. I need to get a little more information on the nature of this formula to determine nurses. He obviously makes the connection that if there is a formula in place for a certain number of nurses, how does that then relate to standards of care and quality of care. So I will definitely undertake to review the formula, confirm the nature of the formula and follow up on that issue.

Mr. Lathlin: Mr. Chairman, perhaps this will be my last question, but I want to assure the minister that–I know he is new in the portfolio that he has now, and I am quite encouraged by the responses that he has given me so far.

I just want to tell him that it does not make a person less of a person if one admits I do not have information, I am not aware of this, I did not know, but after having found out, you know, to do something, because I went through that experience, and I do not think I am such a bad person today. Before I ever came to Winnipeg I had no idea what Winnipeg was all about–no idea. I did not know there were that many people in Winnipeg, as a matter of fact. When I first came to Winnipeg, I was just amazed by what I saw. It was a new experience. There were a lot of things I had to learn and adjust to. So today I can say I think with some authority that I do have the best of both worlds. I have a good understanding of where I am from: the culture and the environment that I come from, and I am also, I think I can say safely, that I have a pretty good handle of the other culture that I deal with almost every day. I know the language, I know the culture a little bit, the history. So therefore I can sort of operate in two houses.

Unfortunately, the minister does not have that luxury, because I am afraid he is being disadvantaged by not really knowing what happens in Gods Lake Narrows, for example, where if–let us take the Minister of Justice (Mr. Toews) for example. If he was living in Gods Lake Narrows and he, for some unfortunate reason, broke his leg, he would have to be taken to the nursing station first, be examined, not by a doctor, by a nurse, diagnosed, and then put onto a truck down to the lake onto a boat, up a steep embankment, onto another vehicle, and finally into the plane to come to Thompson or Winnipeg. That is the reality that exists in these communities. I am not trying to be negative or anything. I just want the minister to know that I know at what level he is operating when he comes to the northern–because he does not know. He has been there to visit maybe, but he has to do that more often to get a real good understanding.

So I thank him for the information that he has given me, and I would also ask him to perhaps follow up his verbal answers that he has given me today. I would like to ask him to follow it up in writing at his earliest opportunity. Thank you.

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Mr. Stefanson: I am assuming the final question was to follow some of these issues up in writing to the member for The Pas. There is certainly a record in Hansard, but I am prepared to follow up in terms of how we continue to go forward and some of the issues that I also said that I would be pursuing, the issue of the formula for nursing and the shortages in those areas and so on. So I will definitely do that with the member for The Pas.

Again, I appreciate his closing comments about–well, first of all, people acknowledging that you maybe do not have enough information in certain situations. I agree with him on that–nothing wrong with admitting that you need more information; you need to get a better understanding of an issue. Far better to do that than to try to deal with an issue in the absence of reasonable information, so I certainly agree with that.

His comments about his fortunate opportunity to have a good understanding of his own history and culture and communities and, of course, now Winnipeg, again I cannot disagree with. I have certainly travelled to northern Manitoba. I have been on some of our reserves. I have many contacts and friends who have had significant dealings. They would certainly raise many of these issues that he has touched on today, and his description of what would happen to you at Cross Lake if you broke your leg or something happened to you–

An Honourable Member: Gods Lake Narrows.

Mr. Stefanson: Or Gods Lake Narrows. I can certainly, again, understand it, but obviously I have not experienced living in any of those communities or spending very much time in any of those communities. So I, in this portfolio, do look forward to the opportunity to get a better understanding of that by at least being able to meet some people in their home communities on the reserves and get an even better appreciation. It is one thing to have something like that described to you. It is obviously somewhat different to deliver that on a day-to-day basis.

So, again, I cannot disagree with what he is saying in terms of my personal experiences or my background relative to many of the challenges that our people are facing on reserves. But I very much look forward to the continued opportunity to get a better understanding and a better appreciation and be able to be a part of continuing to address them to improve services for people on our reserves, certainly in northern Manitoba and throughout Manitoba over the next weeks and months, Mr. Chairman.

Mr. Dave Chomiak (Kildonan): I just want to indicate for the record that I thought the last 40 minutes of exchange was one of the most useful I have heard in this Chamber during the course of all of the years I have done Estimates. I am very impressed with the educative role that is played by the member for The Pas (Mr. Lathlin), whose experience and whose overall commitment is so strong. I am very impressed with the fact the minister did not take a defensive posture, but rather took a role and a position of wanting to listen and learn. I think that is a very positive step to build on, and I think is part of the role and the nature of what this Chamber should do. So I am encouraged by the comments, and I only urge the minister to continue. If the minister continues in that vein, particularly in listening to the words of the member for The Pas and some of our other northern members in particular, then I think there is a chance of some advancement and some improvement in terms of the conditions. So I take that very much as a positive.

I would just like to ask the minister if he can give an outline as to what legislation he is proposing or will be coming forward during this particular session of the Legislature.

Mr. Stefanson: I am not sure if we are in Estimates this afternoon–

Some Honourable Members: We do not know.

Mr. Stefanson: We do not know yet? I am certainly prepared to return with a listing and just a thumbnail sketch of the acts. I know three of the acts that were referred to I think in the throne speech all have to do with the various nurses acts, The Licensed Practical Nurses Act, The Registered Nurses Act and The Registered Psychiatric Nurses Act . We are looking at introducing amendments in those areas relative to the role that nurses are playing in our health care system. I tabled–I think it was two acts– on our Order Paper The Chiropodists Act, and The Ophthalmic Dispensers Act, I think, is the other one. I believe those really have to do with the whole issue primarily with internal trade in terms of the mobility of individuals in those particular areas to comply with the mobility provisions. Those are a few of the acts. I know there are a couple of other amendments that we were looking at potentially to The Medical Act and one or two other acts, but what I will do is I will give the member an overview of the acts we are looking at and a thumbnail sketch of the key elements of the amendments, Mr. Chairman.

Mr. Chomiak: Mr. Chairperson, I thank the minister for that response. We will be dealing with the privacy act and issues surrounding issues of privacy in a particular line item in the Supplementary Estimates, but I am wondering if the minister can update me as to whether or not he has received any correspondence or follow-up with respect to his letter that he wrote several weeks ago concerning the issue of chiropractic potentially inappropriate use of information.

Mr. Stefanson: Mr. Chairman, I thought I had the letters here with me, but I do not, but I did receive a response. As the member knows, I wrote to both the Ombudsman and I wrote to the Chiropractors' Association, and I did receive a response from both organizations and I will provide a copy of both of those responses to the member. I believe, and I am just going from memory now, that the Chiropractors' Association indicated they were going to look into the issue and that the Ombudsman indicated the same thing from his perspective under the personal privacy protection act. So I will certainly provide the member with a copy of both of those letters.

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Mr. Chomiak: Mr. Chairperson, has the minister, again this is just a general question, there may be more specifics down the line item when we are dealing with mental health–has there been any follow- up with respect to the recent amendments to The Mental Health Act and any data or information the minister can provide, not necessarily today but perhaps later on in the Estimates process, as to how in effect the new system and the new regime is working. Specifically I am talking about the amendment that went through recently.

Mr. Stefanson: I do not have any of that information with me here this morning, but I will definitely provide a status report to the member on those amendments and that issue and what activity there has been to date.

Mr. Chomiak: Mr. Chairperson, yesterday during Question Period the minister talked about the number of individuals waiting for personal care homes in acute care facilities and beds and had some data and statistics. I wonder if the minister–again I appreciate it may not be available today, but in the near future–can table that information.

Mr. Stefanson: The member is correct in response to one question, I believe, from him. I refer to the fact that approximately a year ago there were about 250 panelled individuals in our acute care settings, in our hospitals. I said that today that number is down around 50. I believe that number is even lower than 50 today in terms of what I am told from officials here this morning. So, again, I will provide him information of what the number was roughly a year ago and show him the changes over the recent period of time and what that number is as of now.

Mr. Chomiak: Mr. Chairperson, just to inform the minister as to, from our perspective, what we see developing. I anticipate several hours of general questions followed by a movement of the line-by-line items. I think the minister and I ought to have a discussion in terms of how it can best be allocated next week, in terms of bringing in staff, because I anticipate something like moving relatively quickly through down to the portion dealing with the information services where we will spend some time. Then we will be relatively quickly into the major expenditure items which will be the acute care, the personal care homes, Pharmacare, which is now by virtue of the Estimates all bundled up into one area. The minister may have suggestions as to who he wants to bring in and what we want to do to best utilize staff resources.

I wanted to let the minister know roughly a couple more hours on general questions, and then we will start moving, at least from my perspective, down the line items into info services, and then we will be getting into those issues. The minister can determine in terms of what staff he wants to bring in. Certainly, last year the minister brought in staff from the WHA and the Long Term Care Authority, as well as officials from USSC. We may want to talk about how the minister feels he wants to deal with those issues. I anticipate, if we are into Estimates all of next week–and everything is a hedge, I recognize. I recognize we are all kind of looking at this Tuesday pivotal date, but if we are in Estimates all next week then we will be down into the latter part of next week into some of these issues where the minister may have to bring staff in.

My final question, I assume, for this session is I notice there is now a disaster management component of the department. That has not been identified before, and I wonder if the minister might outline for me. It may have existed, but I was unaware of its existence. It may be formalized now. Can the minister give me an update or information in respect to that?

Mr. Stefanson: I appreciate the member's comments about how we will proceed on a go-forward basis. I certainly agree with that. If we are in Estimates this afternoon, then I assume we will have the same people and the same format that we followed this morning. Really, there are no changes other than to hive that element out, the disaster assistance, on the organizational chart. In fact, there is not a separate appropriation when we do get into the detailed expenditures. They are still included under appropriation Emergency Health and Ambulance Services, which is appropriation 21.3.(e), so the appropriation is the same.

Really, I believe just on the organizational chart was separating what the disaster assistance unit, which provides education, information to the RHAs in terms of that entire issue and how to prepare and how to be ready–really I am told has always been in place and just was hived out on the organizational chart. But the money is allocated in the same area. It just shows it separately, and the other part of it is just a continued provision of our northern patient medical services and other emergency medical service provisions.

Mr. Chomiak: Just for my own understanding, would it be possible for the minister to provide a note in terms of the function and role of that component, that management component, disaster management? I assume we saw its function during the recent flood, and I am curious as to the functioning and the structure and the design, more the operation, actually.

Mr. Stefanson: I will definitely provide that information, and I just received a copy of the two letters that the member asked me about, the one from the Ombudsman, a brief letter, and the Ombudsman concludes that in consideration of the circumstances and further to your letter, the letter I sent him, this is to advise that we will be contacting the trustee to advise of our intention to investigate this matter. Our office will advise you of the outcome of our investigation. Once again, thank you for raising your concerns with our office. That was dated April 14. I have not received the outcome of his investigation yet.

The chiropractic association wrote me on Tuesday, the 20th, and basically, I believe: This matter has been brought to the association's attention and pursuant to the act's regulations and by-laws was immediately forwarded to the complaints chair for a review of the findings and a recommendation of required action.

So both of those organizations are following up, and I will provide copies for the member.

Mr. Chairperson: The hour being twelve o'clock, committee rise, with the understanding that the Speaker will resume the Chair at 1:30 p.m. today.