Mr. Chairperson (Marcel Laurendeau): Would the Committee of Supply come to order, please. 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.

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Hon. Eric Stefanson (Minister of Health): Just following up on some requests for some information, I am tabling three copies of the Manitoba Drug Benefits and Interchangeability Formulary. As well, the member for Kildonan (Mr. Chomiak) asked for a summary of the community contribution policy, so again I have three copies of that. I could almost read these into the record. He asked about health care aides, the nurses' aides.

As well, Mr. Chairman, he asked for the listing of the positions and individuals in the minister's office and deputy minister's office. As well, he asked for information on the Canadian Blood Services Centre. The last one, the member for Kildonan had asked for information on the systems applications products and data processing, the SAP system. That is what this represents.

Mr. Chairperson: I thank the honourable minister for that. We were dealing with line (f) Human Resource Planning and Labour Relations.

Mr. Daryl Reid (Transcona): Mr. Chairperson, I have a question for the minister. Perhaps if we are not on the appropriate line he could advise and then take the question as notice for the more appropriate section of Health Estimates.

I had a call from a constituent who unfortunately has encountered or has had breast cancer diagnosed. She has been going through some treatments in an effort to arrest or control the spread of the disease. There has been also some medication that has been prescribed for her in the course of treatment. Tamoxifen, I think, is the name of the drug. What my constituent has asked is that, she references the fact that the Province of Saskatchewan covers or pays for the cost of the medication, Tamoxifen, for patients or women who are suffering with breast cancer, and pays for 100 percent of the cost. In her case, she finds that Tamoxifen is a part of the listed drugs in the province of Manitoba but she has to pay for that according to the deductible for herself and her family. She would have to pay 100 percent of those costs until that deductible is reached and then, of course, the lower level would be achieved.

I guess I should ask the question: is Tamoxifen considered to be a life-preserving drug? Should it be on the list that would be required to preserve life more so than enhance a condition in these situations? It would be more appropriate for Tamoxifen to be on another list that would be covered 100 percent, similar to what the Province of Saskatchewan does versus the regular drug listing here that has it that you would have to reach your deductible before the province would cover any of those costs. Perhaps the minister can advise or staff can advise on that so that I might let my constituent know as well.

Mr. Stefanson: I really do not have the most appropriate staff here for that today. I think rather than try to speculate on some aspects of this, we will return early next week with the details and bring them back to this Chamber and make sure that copies are provided for the member for Transcona.

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Mr. Reid: I thank the minister for that undertaking. I look forward to the information. Just by way of further information for him and his staff, it is my understanding that if women suffering with breast cancer do not have the benefit of having Tamoxifen supplied for them as part of the lifesaving drug program, if my constituent was on a clinical trial, those drugs would be paid for. So I am wondering why the cancer treatment centre would not be able to provide that drug to cancer patients, in this particular case, for women suffering with breast cancer, so that we do not have a discriminatory practice, if I can use that term guardedly, against women who are on clinical trials versus those who are not, one group having Tamoxifen costs paid for while another group does not. I leave that with the minister by way of information and perhaps he can search out an explanation for us. Then I can advise my constituent on that matter.

Mr. Stefanson: That is fine. That was one of the reasons, the additional comments the member made, I wanted to return with all the details early next week.

Ms. Becky Barrett (Wellington): I appreciate the opportunity to ask a few questions today. I hope I am in the proper area. I would like to ask some general and specific questions, first about nursing and the numbers of nurses and the mix of nurses that the government foresees, particularly in the hospital settings.

I know that over the life of this government and the four Health ministers, my understanding is that there has been a major shift in the mix, if you will, of nurses and nursing functions in the hospital setting in the province of Manitoba. I am open to correction by the minister on the percentages and the proportions, but my understanding is that there used to be a mix of nursing functions, not nursing functions necessarily, but nursing occupations that provided the bedside functions in hospitals in Manitoba. They included, I believe, a few bachelor of nurses, although I believe that that degree program is fairly new and certainly the emphasis that is currently being placed on the B.N. is fairly new, a number of registered nurses, licensed practical nurses, nurses' aides and orderlies, et cetera.

So there was a range of at least three different staffing components providing the nursing function. It appears now, and I may be overgeneralizing this, that today, as a result of government actions and as a result of, I would suggest, a fair degree of implementation of Connie Curran's recommendations, that we have far less of a mix of nursing occupations in hospitals and we have more of a reliance on the B.N. program, the B.N. level, and then the orderly, nursing aide and a narrowing, a reduction in the registered nurse and the licensed practical nurse in the general mix in the hospitals. I am wondering if the minister could tell us what the general mix of nursing occupations is in hospitals and how that has been determined. Is there a specific kind of recommendation?

Mr. Stefanson: Maybe just before I respond, I have always introduced the staff. We have two staff who have not been with us here until today this year: Barbara Hague, the director of workforce planning; and Linda West, the Executive Director of Human Resource Planning and Labour Relations.

In terms of response to the question, I am sure the member knows, I know she knows that our health care system today really has four nursing types, nursing professions based on the historical educational patterns in Manitoba, the baccalaureate nursing, registered nurse, registered psychiatric nurse, and the licensed practical nurse. I think she is also aware, on a go-forward basis, we really have three programs now. We have the bachelor program, which is normally a four-year program, but they have introduced an accelerated program where, under certain circumstances, situation, you can do it in three years. There is still the registered psychiatric nurse program, and then there is also the LPN program, which is, I believe, a 14-week–14-month program. Fourteen weeks, yes, I am sure some wish–14 months, that we have discussed at some length. [interjection] That could deal with our nursing shortage issue fairly quickly.

It is run by Assiniboine Community College. It has six intakes now under the new program going forward, two of them at Misericordia, two at Brandon, and two are going to be rotating sites.

In terms of the current mix, actually, I cannot recall if it was the member for Kildonan (Mr. Chomiak) or the member for Inkster (Mr. Lamoureux) who asked for a breakdown by RHAs of the nursing type position. We have undertaken to provide that to give a snapshot of what our current mix is.

There is no doubt that during the last few years there has been a shift in our acute care facilities, with some reductions in LPNs over the last few years. I think we are going to see a change in that going forward. Again, as members in this House know, the last year's class for LPNs had an intake of about 90 students. We have more than doubled that to 190 going forward. So we believe that all three nurses will have important and vital roles to play in our health care system, whether it is our acute care facilities or our long-term care facilities or our Home Care program.

So I will be returning with a breakdown on a regional basis showing B.N.s, R.N.s, LPNs, and registered psychiatric nurses, which I think would give the member a sense of the distribution across our system. Now, whether I could break that down further and show the breakdown between acute care facilities, personal care homes, home care, I would have to check with staff as to how feasible that is, but we certainly are going to be returning with more information on the overall breakdown as it currently exists in Manitoba.

Ms. Barrett: I appreciate the answer of the minister and again apologize if I am repeating questions that others have asked. Maybe my question is unanswerable, but my question is not so much what is the current breakdown of the categories per RHA or however detailed you can break it down, which would be very helpful, but what is the ideal mix?

There has been some sense, particularly on the part of R.N.s in the last while, that R.N.s were in a sense, and certainly LPNs have had this feeling, maybe not so much anymore, that they were being pushed out and let go. I think that was actually what happened with many LPNs as the programs were cut, the positions were reduced or eliminated and the mix changed.

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Far more emphasis on the B.N. as the nurse, I do not even know how to say it, but where the R.N. used to be the linchpin of the process, the B.N. was now becoming or looking to become more of the basic nursing component around which the rest of the staff would be based. I guess I am asking a policy question here. Is it the policy now to have more B.N.s than there used to be, to have a reduction in R.N.s maybe starting now again, it appears, an increase in LPNs and then the registered psych nurses? When a hospital administrator looks at the mix that is in their hospital or in their personal care home, what is it that they are looking to achieve? If they had an ideal mix, what would it look like?

Mr. Stefanson: It is a good question but not an easy one to answer, because there is no ideal mix. Obviously the combination of nursing services will vary depending on the facility. It will vary at our acute care facilities and even within our acute care facilities. It will vary at our tertiary hospitals versus our community hospitals. It will obviously vary again at our personal care homes and it will vary again on our Home Care program. There is no doubt there is a need for all of the nursing categories or skills, the R.N.s, the LPNs and, of course, the registered psychiatric nurses right throughout the entire system.

The ultimate decision in terms of what that mix should be is really made by each individual facility in terms of the programs they are providing. Really the issue becomes focusing on the level of care. If you look at our personal care home system, it is funded today to levels of need based on the people in our personal care homes. Even more so, going forward it is going to be funded towards levels of care, towards personal care plans, and so on. What the appropriate mix is to meet those needs or those levels of care is really decided by the individual facility.

Right across the system, in each of those different settings you will see an entirely different mix. I think I am stating the obvious in terms of the kinds of mix you will see in a personal care home versus a tertiary hospital. We do not have, as I say, a model or a plan that says if you are a tertiary hospital, here is the mix of nursing types you should have, or if you are a personal care home. It really comes down to the individual facilities meeting the needs of the types of people and patients that they are serving.

Ms. Barrett: The minister said, and I think he was talking about personal care homes, but saying, funded towards the levels of care. I guess maybe another way to get at this is to ask a funding question. Hospitals are funded now, my understanding is–let us use Winnipeg–through the Winnipeg Hospital Authority. The Winnipeg Hospital Authority gets its funding from the government. Ultimately the government funds the Winnipeg Hospital Authority and then the hospital authority puts the money into the various facilities.

Nursing staffing is, I would imagine, a very large component of each of the hospitals budgets. There is a differential between the various categories of nurses, as far as funding goes, as far as salary levels go, starting from the B.N. at the highest level. Generally speaking, if you talked about an entry level B.N. versus an entry level R.N., entry level LPN, et cetera, the ranking would go B.N., R.N., LPN. There has to be an assumption made by the hospital in putting forward its budget and by the hospital authority in sending that budget or the request for funding based on those budgets to the province and back down again of what kind of nursing salaries are going to be paid. Hospitals must be making those kinds of assumptions. I am just wondering if there is now an increased reliance in budgeting on the B.N. nursing component as compared to, say, past years or the last decade.

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Mr. Stefanson: Madam Chair, how the member outlined that is basically correct. The hospitals are funded–we will use Winnipeg as an example–through the Winnipeg Hospital Authority. The Winnipeg Hospital Authority receives their funding from the provincial government. As we discussed earlier, the facilities make the decisions around the kind of staffing complements they need to meet the levels of care and the levels of service that they are anticipating.

You are right that obviously salaries on a combined basis at our hospitals would be 70 percent to 80 percent, that is nurses, other salaries, and so on. Wages and salaries would be 70 percent to 80 percent. How you outlined everything is basically correct. I think the final question was the issue of whether or not there has been an increased reliance on the B.N./R.N., and within our tertiary hospitals, definitely in the last few years as a proportion, they would be a higher proportion today and to a lesser extent probably in our community hospitals as well.

Now, on a go-forward basis, I think we are going to start to see some shifts again. We discussed that briefly here this afternoon that we certainly view the LPNs as having a role to play in our acute care facilities. I think that is recognized now by the majority, if not all, of the facilities, so I think we will see some shifts in that mix again on a go-forward basis.

Ms. Barrett: Madam Chair, I understand the minister's statement is that in the tertiary hospitals there is now a heavier reliance on B.N.s than in the past, or did he say B.N./R.N.s?

Mr. Stefanson: I said B.N./R.N., lumping the two of them together, and as the member knows, there is a difference in salaries for those two distinctions.

Ms. Barrett: Madam Chair, there is not only a difference in salary. My understanding is there is a very large difference in training and focus and the way you look at where traditionally those nurses have found positions, so I will leave that part of it. I guess I have some concerns. I have had for a long time about the increasing reliance on B.N.s. What I need to do, I think, for myself is to find out more about–I understand that the university training for B.N.s has changed now to reflect more of the clinical elements than perhaps there was in the past, but I know situations, and maybe this is "older" B.N.s, but that there have been some challenges in the past between B.N.s and R.N.s, for example, on the hospital floor as to what the particular role was for the two nursing fields there.

The minister is talking about heavier reliance on the B.N./R.N. component of the nursing staffing in hospitals in particular. That is some concern because I have some information here, actually from MARN last year, I believe, that says that the four-year B.N. program has room for over 300 students per graduating class, but there were only 150 first-year students in 1998, which means that even if 100 percent of them graduated, half of the space would be empty, and we know that not 100 percent graduate.

The estimate is that in this year, only 99 will complete the degree. Next year only 114 will complete it. In 2001, 131 will complete the degree, and in 2002 only 160 will complete the degree.

I will give the minister the fact that these are estimates and they could be out by a proportion, but we are looking at maximum of one-half of the spaces in the program actually graduating. So one-half of the allowable spaces or the available spaces in the B.N. program, at maximum, are graduating in each of the next four or five years, or four years, and actually far fewer than that in the last couple of years. So if there is a heavier reliance on B.N. and R.N., and I would suggest that there is an even heavier reliance on the B.N. than the R.N. in the current mix, particularly in tertiary hospitals, if there is a heavier reliance in the planning and the staffing scheme and we are not graduating even half of what we could be in the B.N. program–and of course we all know that not all of those people who do graduate are going to stay in Manitoba–how is the government planning to address this what would appear to be increasingly critical shortage of nurses?

Mr. Stefanson: We did discuss this somewhat earlier, but again I certainly welcome the opportunity to do it again. I am sure the member is well aware that there is a nursing shortage everywhere, including the province of Quebec, west all across Canada, and that is why we are seeing all of those provinces taking various steps to be able to bring more nurses into the health care systems in their provinces.

Obviously education is one key way of doing just that, and I will bring back the most current information. The information I have on the Bachelor of Nursing program at U. of M. is in 1999 they are expecting to graduate about 115 nurses, and the enrollment in the program is obviously increasing.

In fact, this last year alone it increased by 23 percent, and it is estimated by the year 2001 it will be at 190 graduates. Some of this information is also information provided through MARN, but it does have the capacity and it has set a target of admitting 400 students. Those numbers are really provided in advance of a number of initiatives that the Faculty of Nursing is undertaking and has been undertaking.

Just to cite a few examples of their recently aggressive recruitment campaign, I am sure the member has seen some examples. They have developed videos regarding nursing education and distributed them, I believe, to every high school. They are obviously encouraging faculty and students to attend nursing functions, job fairs, to promote interest in the nursing program. They have established a website. They have developed print ads appearing in Winnipeg, Brandon, Thompson, Flin Flon, The Pas, developed radio advertisements to be aired in Winnipeg, Brandon, Thompson, Flin Flon, and The Pas. They have created Winnipeg Transit ads to appear on buses here in the city of Winnipeg. They have recruited students from a new potential student pool, such as first-year students at St. Boniface College and the Mennonite College. They continue to develop and implement jointly strategies to recruit students to all nursing programs.

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So that gives the member a sense of some of the things that the Faculty of Nursing at the University of Manitoba is doing. They do have the capacity to deal with 400. That is certainly the target that they are working towards. Obviously that will go a long way to meeting the nursing needs here in the province of Manitoba.

We referred earlier to the fact that our licensed practical nursing program had an intake of 90 students last year. That has now been increased this year to 190 students, with additional funding being provided to Assiniboine Community College.

Outside of using education as an initiative to bring more nurses into our health care system, again the member I think is well aware of the $7-million nurse retention and recruitment fund that has been established. It is administered by six nurses, two of them appointed by the Manitoba Nurses' Union, two appointed by the employers, and two who are appointed by the government of Manitoba. Their mandate is to do a number of things, both to keep nurses in the system here in Manitoba, to bring nurses back into the system here in Manitoba who may have left for various reasons, and to bring nurses back to Manitoba.

That fund can be used for a number of initiatives, from various recertification, retraining, upgrading. It could also be used for moving expenses to bring nurses into Manitoba, and so on. So there are a number of steps being taken on various fronts to address that very important issue of bringing more nurses into the system. That is why this budget, the 1999 budget, includes some $32.5 million for 650 nursing positions that have to be filled. Through a combination of education, retention, and recruitment, immigration to a limited extent, all of these factors will contribute to bringing more nurses into the health care system in Manitoba.

Ms. Barrett: Of the 650 nursing positions, is there a breakdown of the types of nurses, B.N., R.N., LPN, registered psych nurse, that are being looked at, or is it just a global figure of 650 without any planning as to where those nurses would come from, which level of training?

Mr. Stefanson: I do not have that information here. In fact, I have discussed that as well with I think the member for Kildonan (Mr. Chomiak). We will be returning with more information on that. We have had breakdowns based on requests from the regions, from the RHAs, the WHA, WCA, and the majority of this information is coming from them, but I believe we are also able to produce it along the lines that the member is referring to in terms of B.N.s, LPNs, and so on. We will certainly be returning with that information.

Ms. Barrett: Finally on this, I think finally, in the graduating class of this year for the B.N. program, how many B.N.s are anticipated to stay in Manitoba?

Mr. Stefanson: I am told that all efforts are being made by the employers, by the RHAs, that all of the graduating class have had contact made with them in terms of encouragement to look at specific jobs here in Manitoba and to pursue their careers here in Manitoba.

The way the process works, I am told, is that there is one more exam to write in August, the final Registered Nurse exam. So it cannot be determined until they do that whether or not they pass the exam, whether or not they then are able to accept employment. Based on everything we are hearing, we fully expect a very significant number of the graduating class to stay in Manitoba, but that information is not available yet until they write that exam in August and make their own individual decisions as to where they are going to stay. But as information like that becomes available, we will certainly provide it because I think we can disagree on lots of things in this house, but I think we probably all agree on the objective of keeping as many of our graduates here in the province of Manitoba as we possibly can whether it is from nursing, medicine or any other educational programs that we have in our province.

Ms. Barrett: I guess this may be a crystal ball question as well, but let us assume that all of the graduates that are currently in their fourth year will graduate and that they all decide to stay here in Manitoba, the best of all possible worlds, I am assuming there because there is such a critical shortage of nurses that there would be jobs for every single one of those B.N.s, the question is would they be full time or part time or a mix? It would appear to me that one of the major deterrents for people entering the nursing profession and staying in the nursing profession today is the fact that so much of the positions that are available are casual and part time.

So I am wondering if it is being made clear to these graduates that any one who wants to work full time in Manitoba will be able to work full time at their chosen profession.

Mr. Stefanson: The member raises an issue that has certainly been brought to my attention on many occasions. It is the whole issue that many nurses in the profession today and, obviously, new grads really want the stability of a permanent position. That position can be permanent part time or permanent full time depending on the individual's needs, wants, but the key is the permanency. Again, we have been working with the employers. The stats I saw recently showed that more and more of the positions are permanent positions and more and more of them are permanent full-time positions as well.

We fully expect that from the combination of permanent part-time and full-time positions, we can certainly address the job aspirations of the graduating class here in Manitoba. We would not want to be in a position where somebody who graduated from the Faculty of Nursing in the province of Manitoba and wanted to stay in Manitoba was not able to get the kind of job that they want. So collectively from the employers, from the RHAs, throughout the entire system, the focus is on permanent positions, and it certainly is on continuing to create as many permanent full-time positions as can be done in the system.

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So I fully expect that if all 115 decided to stay in Manitoba, which I think we all would like to see happen, that we–when I say we, the collective we of the RHAs, WHAs, and facilities–recognizing the need for 650 nurses in our system today would be able to accommodate that and be able to hopefully address all of their individual preferences in terms of jobs. When it comes to the permanency, in some cases initially it might be a permanent job even at two locations, but if the issue is permanency, which I believe it is in many cases, that certainly can be addressed.

Ms. Barrett: I have just one final question, and then my colleague from Transcona has a couple of questions. Could the minister, and again the minister may have been asked and may have already provided this information, so if so I apologize, but could the minister provide, probably at some later date, a breakdown of the categories of nurses and within that category, full time and part time, and if possible permanent casual? I would like a sense of what the full-time, part-time staff mix is currently.

Mr. Stefanson: Madam Chair, I was just looking at some preliminary information on that, and, yes, I will be able to return with that kind of information.

Mr. Reid: I have a question continuing along the lines of nursing and their employment prospects. If you look at the latest annual report coming out of Red River Community College, the 1997-98 graduate employment report, it references the latest information with respect to the diploma nursing program at Red River. In the graph there it references employed training-related, full-time employment of the nurses that graduated. There were 54 graduates for that particular year, but the full-time employment was only 44.7 percent. If you look at the employed, training-related, part-time jobs it is 47.4 percent, so it is almost a dead-even split between full and part time.

Is it the fact that there were no full-time jobs that were available, or is there something that I am missing here that could explain why only half of those people that graduated, half of the 54, found full-time employment when it is quite apparent that we have and have had a shortage of nurses within the health care system of the province? I am not sure how the minister would be able to explain that.

Mr. Stefanson: I think that would be the '97-98 report probably, because that would be the last year of the old R.N. program which does not exist anymore today, but having said that, the point is still the one that the member makes, that of that graduating class, I think the stats were 44.7 percent full time and 47.4 percent part time, and that is exactly the issue we are talking about. Nurses who are currently in the system and also recent graduates are saying they certainly want permanent positions. We have heard that time and time again, and there is more and more request and demand for more full-time positions, so that is exactly what we are now addressing in the system. I will be returning with more information for the request from the member for Wellington (Ms. Barrett), but there are continually more permanent positions being created in these last couple of years. There are more full-time positions, and it continues to address that. But there is definitely more to be done there in terms of what we are hearing from nurses both in the system and graduating.

I guess the only other point, it would be interesting–it is always difficult to do–to update that and see what those individuals are doing today, even the part-time ones. I do not know how they would survey that. I guess it is possible that you might call yourself part time, but you still might work part time in more than one facility and you might have the equivalent of full-time hours. Now, for many individuals, they would still prefer to have the full-time job in one facility as opposed to at more than one facility and not have to travel and so on. But the issue is, that summary illustrates the issue we are talking about, that they are going back to that point in time, forward to today and still going forward, there continues to be more and more of a need to convert more of these positions to both permanent and full-time positions, and that is being done but it is not complete yet.

Mr. Reid: I agree with the minister. It would be nice to know or to have an update on the survey that was done, because Red River does try to track, and they do a three-year comparison of the employed respondents and the people that were graduates of the program. It would be nice to know that information.

I do not know if there has been any contact with Red River in an ongoing survey to make sure that the graduates of that program, and in subsequent years are looking for full-time employment, whether or not they have been contacted or if there is some way to communicate with them that those opportunities are available. Or do we just leave them to kind of float free will within the system and seek out their own opportunities without making any contact with them? I am not sure of the process or the procedures that are in place for the department. Perhaps if the minister has some information he can share with us on that, I would appreciate some update on that part.

Mr. Stefanson: Mr. Chairman, maybe just before I respond to that question, on May 25 the honourable member for Inkster (Mr. Lamoureux) raised some serious concerns where he had received some information suggesting that there was some unauthorized dental surgeries possibly being performed on Saturdays using hospital supplies and that during an audit, an individual reported this fact and has since been laid off, I believe.

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Manitoba Health did contact Dr. Brock Wright, the vice-president of HSC, and Dr. Wright reports that the physician heads of adult and pediatric dentistry at the HSC, Health Sciences Centre, are unaware of any dental clinics or dental surgery on Saturday. There are occasional emergency dental procedures performed on Saturday. So that is just some preliminary information, but I think what would be helpful, again, without breaking confidence is if the member has any additional information he could provide us. Then obviously we will pursue the matter further, but that is just the first response that I have received from information that was just brought to our attention a couple of days ago.

An Honourable Member: I will get back to you on that. I appreciate it, thank you.

Mr. Stefanson: As the member indicated he will get back to me on it, so that is helpful.

In terms of the question from the member for Transcona, we actually have a nurse resource task force, I think is what it has been called, and one of the functions of that group has been to update the database of all nurses in Manitoba in terms of the type of education they have, whether they are working permanent, whether they are working part time and so on, and that is scheduled to be completed very, very shortly. Not as early as I had expected, but we will have that available in January of next year.

That certainly will be a great resource to do exactly what the member is talking about: to have ongoing contact with nurses determining if they are working part time is exactly what they want and a chance for us to go after them and have discussions with them and see whether there is an opportunity for them to work more, if they want to work more, and address some of their needs. Again, it just becomes another vehicle to help us with our nursing needs in Manitoba. So that is just one of many steps that is being done that will make it much easier to contact nurses to know what their status is and to be able to address this issue we are talking about.

Mr. Reid: Well, I look forward to that information being made available when you finish collecting the data on it.

I have another question dealing with LPNs. I know when your government went about changes in your restructuring of the health care system, there were a number of LPNs. In fact, I think most of them were purged from the system. Of course, I had a number of them who were living in my community and are now, after a number of years later having gone for a period of time without any employment, occasionally finding jobs within their field. For the most part, they have been part time and not at the level of care or the type of care that their first preference would be.

In one particular case, the LPN who had called me just this week is asking me the question now and, to put it quite bluntly, is quite furious at the government after terminating her position after some 20 or 25 years of working at St. Boniface Hospital. She then had to as a single parent go out and try and find work and has been unable to find full-time work in her field.

The question she has now, because there was no severance that was given to the LPNs when they were eliminated from the system because apparently there was a long or extended notice period that was in effect at the time, not only did she lose her 20-25 years of service, there was a loss of benefits, a loss of seniority as a result of termination of the employment.

I guess the question that she is asking me to ask is: what is going to happen now for the LPNs? Because if you are encouraging LPNs to come back into the hospital and health care system and perhaps training others to become LPNs, will they be able to move into those jobs at St. Boniface Hospital, for example, where this individual had lost her employment? What is the plan with respect to the restoration of LPNs into St. Boniface Hospital with respect to levels of pay? Is it going to be at the same levels of pay? Is it going to be different than before when they lost their employment? Higher or lower? Are there benefit changes, benefit package changes that are going to occur? Will these LPNs who were laid off or terminated as a result of the government's plan be given some preference into hiring back into those facilities, into hospitals like St. Boniface? Can you tell me some background on what your overall plan is with respect to reintegration of the LPNs back into the hospital system?

Mr. Stefanson: I see we are running out of time. We have discussed this somewhat earlier in the process, but a couple of key points the member raises are, first of all, for any of the LPNs that left the health care system in the early '90s as a result of the changes that were taking place, the change in structures at the hospital, the change in focus on types of nurses and so on, I am told that today the numbers that would be affected by that would be about a little over 100-125. But whatever that number is, for those individuals, if you have a name of an individual, if they want to come back, take a refresher course or whatever needs to be done to come back into the system, that nursing fund is there to do just that, that $7-million fund I referred to.

If you want to give us some names, or we can certainly give you the names of the individuals on that task force–in fact, Sue Hicks, the associate deputy minister, is one of the members on that–that is a vehicle to get a refresher course, to get any retraining or upgrading to come back into the system.

There is a need for, as we have already talked about, a significant number of LPNs in the system right throughout the system. So we can use them. The specific question about St. Boniface Hospital and what opportunities there might be there, I would have to contact that individual facility. There is no doubt whatsoever, we need more LPNs, whether it is through our educational or people prepared to come back into the health care system.

Mr. Chairperson: The hour being six o'clock, committee rise. Call in the Speaker.

Mr. Deputy Speaker (Marcel Laurendeau): The hour being six o'clock, this House is adjourned and stands adjourned until Monday at 1:30 p.m.