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

Mr. Dave Chomiak (Kildonan): Mr. Chairperson, as I indicated, my colleague the member for Osborne (Ms. McGifford), the future member for Lord Roberts, has several questions she wanted to inquire of the minister. But I wanted to ask the minister one or two questions just before we commence.

This afternoon in Question Period, I asked the minister about the situation at St. Boniface which the minister did not answer, effectively said that there is a press conference going on at St. Boniface, and that is that. So I went down to St. Boniface to attend the press conference to find out what was going on, and I am a bit distressed as to questions of that nature, the rationale and the reasoning behind the govern-ment not informing the House as to what was going on.

Hon. Eric Stefanson (Minister of Health): Well, Mr. Chairman, I am a little surprised by that question because this issue was obviously brought to our attention, there is no doubt about that, and I was made aware that St. Boniface Hospital was going to be dealing with it today. They are putting the process in place in terms of how to deal with it publicly, how to deal with their patients, their internal process, the internal decisions they are making and so on.

Our role is going to be to continue to be sure that this issue–we will be working with them to be sure all appropriate steps are taken, all appropriate steps in terms of dealing with patients and so on. But, again, they were the ones who were going to be communicating this issue. It is an issue internal to St. Boniface Hospital, an operational issue internally that has impact on citizens and on patients. It is certainly not appropriate, I do not think, even though I have some initial knowledge of some aspects of it, for me to be the first one out there talking about an issue which has various sensitivities. I did answer the question as best I felt I could when the member asked it, until the hospital and the people in charge of the facility and the people dealing with this issue have the opportunity to communicate it publicly and to start the process of communicating to the patients.

So I am concerned with the nature and tone of that question, because I answered as best I could, knowing that I am aware of this entire issue but not about to start putting out any speculation or any information in advance of the individuals who have the responsibility and the knowledge to be dealing with this issue in a very appropriate manner.

If the member did go over there, then he can appreciate the sensitivity of the issue, and we talked earlier today about nonpartisanship and so on in terms of health care issues, Mr. Chairman. This will certainly test that because, again, of what I know of the issue, it is internal. It is an operational error. It is being dealt with by St. Boniface Hospital. It is a very serious issue to be dealt with and not one that I should be making any preliminary remarks about before it is dealt with in an appropriate and com-prehensive way.

So I answered the question in Question Period as best I could. I remained in Question Period for obvious reasons, that I have a responsibility to be here to answer questions on behalf of Health and as Deputy Premier in the absence of the Premier (Mr. Filmon). I apologize for being a few minutes late for Estimates because of having to deal with some issues subsequent to Question Period. We are back here now to discuss this issue as much as we can at this particular stage.

Mr. Chomiak: I guess, Mr. Chairperson, my concern is that if the minister would have indicated during the course–the minister had a whole series of questions in a whole bunch of areas to answer on a whole bunch of issues. But I would presume that when an issue of this seriousness and this nature does come up and when it is asked, it just seems to me that perhaps the minister should inform the House of the nature and of the sensitivities and the like, rather than presuming that there is not enough maturity or understanding in this House to deal with an issue of this kind in a responsible manner.

Mr. Stefanson: It is certainly not a reflection on the maturity of members in this House to deal with this issue in a responsible manner. It is really two things. First of all, the lesser, I think this was the second supplement of a question from the member for Kildonan (Mr. Chomiak). I think we led with some questions from his Leader, and then I think the member for Kildonan was next. He asked me two entirely different questions, and the third question was this one, a very general question about St. Boniface, and I indicated to him that St. Boniface Hospital, I understood, would be dealing with the matter this afternoon and providing comprehensive details.

That is the root of the issue in terms of the maturity of this House to deal with the issue. For this issue to come into this House, I think it is incumbent on all of us to bring it forward on a comprehensive basis in terms of the details behind it, what actions are being taken and so on. I am not a believer in any way of taking any action that could unnecessarily cause alarm or concern or fear to people out there.

All kinds of health issues have that potential. We know that very well. In fact, sometimes we see politicians try to fuel just that, try to do just that, to almost scare people relative to a health issue or something else. I do not believe in that for a minute, Mr. Chairman. Certainly, as the Minister of Health, that would be absolutely unacceptable and irresponsible. So if I am going to start talking about this particular issue, I am going to do it from the basis of complete knowledge of the issue itself, what action is being taken, what is the implication to the patients from that facility, and all of those issues.

Even as we stand here today, I am prepared to have this discussion. I still only have a portion of that information, because even though the hospital informed us of this, has given us certainly some information relative to it, Mr. Chairman, we are still waiting for even more information on the entire issue before we as politicians or as a government start talking about it. Obviously, we are going to be working in close contact with them. Our Department of Health will be in very close contact with them to be sure the issue is dealt with in the most appropriate fashion.

As I say, I am prepared to discuss it in a general sense here, but before I am going to start, if the member is suggesting at 1:30 or whatever time it was to try to respond to a question in two minutes on an issue of this nature, knowing what I knew about the issue, I just think that would be irresponsible.

Mr. Chomiak: Well, I will accept the minister's explanation. I mean, that is a fair point, but I still suggest that it would have been useful to advise members of the House in general terms as to the nature in order to inform us, because that is, in fact, our job. I mean, we play as much a role in terms of dealing with issues as do members of the media in terms of education. I just think that matters of this kind when asked are asked in all seriousness. I think it should have been dealt with in that respect. In that regard, I as a result of the press conference have several specific questions in this area.

Now, I am not intending to ask them in the Estimates, but I do want direction from the minister.

An Honourable Member: It is a phone call, Dave.

Mr. Chomiak: Not now, chief. I do want to know to where I should and how I should direct those very serious questions relating to the press conference today. In fact, I do have several questions that I think are going to arise and are going to be asked about. So I am wondering if the minister could give advice as to where those questions should be directed so we can get some specific responses to those concerns.

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Mr. Stefanson: I think we have a couple of options there. First of all, some of our main connections to this issue have been with our Acting Chief Medical Officer of Health and the Public Health branch, obviously. We had some of the best expertise we could offer to St. Boniface Hospital on this issue. They have continued to provide us with materials. So I think we have a couple of options.

I certainly would not be opposed to having those individuals have contact with the member for Kildonan if they were questions of a nature relative to those specifics, to the specific functions of the Chief Medical Officer of Health, and so on. Another option is if the member wants to give me his questions written out. I am certainly prepared to undertake to give him then written responses or whatever kind of response he wants to that.

I am really open to any one of a number of avenues to provide him with information. We could dedicate some staff who would bring a certain degree of expertise but, again, only in certain areas. If the member wants to just give me the written out questions I could provide a written response very quickly, I would think, to that.

Ms. Diane McGifford (Osborne): I want to ask some questions about AIDS and HIV-AIDS. I wanted to begin by reminding the minister that it was in 1996 that his government, under the former, former Health minister, the member for Brandon West (Mr. McCrae), released the provincial AIDS Strategy. I wonder if the minister could update me on the status of that strategy and what is happening with it, because I am finding it very difficult to get information.

Mr. Stefanson: Mr. Chairman, I thank the member for Osborne for that question. Just a few points, implementation of the initiatives that the member refers to to meet the goals of the provincial AIDS Strategy, as she indicated, have been underway for the last two years, and the AIDS Implementation Advisory Committee which will oversee the implementation of that provincial AIDS Strategy actually just began their regular meetings in January of this year, January 1999.

I think, as the member probably knows, the committee is chaired by Ms. Tessa Gilmore and reports to the Human Services Committee of Cabinet via the Minister of Health, and I do not think I need to read all the members' names of the committee, and there is an ad hoc committee, but I could certainly provide to the member a listing of all of the people who are on that committee. Just to give her a sense, represen-tation on that committee includes persons living with HIV-AIDS, rural, urban and northern representatives, as well as caregivers. So I think it is a representative committee. As well, the ministers of Justice, Housing, Education and Training, Family Services, Native Affairs, Children and Youth Secretariat, the Addictions Foundation and Health are represented on the Implementation Advisory Committee facilitating an intersectoral approach to HIV-AIDS programs and services right across government.

A primary goal, as the member I am sure is well aware, of the AIDS Strategy is the whole issue of the consolidation and co-ordination of AIDS prevention and care services, and that is currently underway. Over the last period of time, Manitoba Health has been working with four AIDS service providers, the AIDS Shelter Coalition, the Village Clinic, the Manitoba aboriginal AIDS task force and the Kali Shiva plus the Winnipeg Community and Long Term Care Authority with other stakeholders to facilitate this consolidation.

That consolidation is finally taking place. It is taking place here on Broadway, at 705 Broadway, which is the building at Broadway and Sherbrook, I think. So that consolidation is taking place. We are providing financial support for that consolidation. We are also increasing some of the operating dollars as a result of that consolidation, and even currently, Manitoba Health provides over $1 million to community-based AIDS programs and will add several hundred thousand dollars for the capital costs. I can certainly provide the member with that, but I think it is in the range of about $500,000 to $600,000, the capital costs, and actually the increase in operating costs will be about $63,000 more a year for this integration and co-ordination of AIDS-related services. I am told from all of the people on these committees and these four organizations, that that was viewed as one of the highest priorities, was the consolidation of the organization into one location and the ability to co-ordinate their services. So that is taking place, and, as I have outlined, we have the Implementation Com-mittee.

I guess what I could point out is I tabled earlier a summary of all of the committees that report to the Minister of Health at the request of the member for Kildonan (Mr. Chomiak), and on that listing, of which copies were provided, is this committee that we are talking about, the AIDS Implementation Advisory Committee. It gives the terms of reference of the committee in it, and it lists both the committee members and the ad hoc committee members.

So this has been circulated. It is available to the member, but if she needs another copy, we can certainly provide a copy of who is on that committee.

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Ms. McGifford: I thank the minister for his answer, too. The minister talked about con-solidation of these four groups, Kali Shiva, I think Village Clinic, the aboriginal AIDS task force, and the housing group, AIDS Shelter Coalition, and indicated in his response that his department would be offering some funding to the consolidation. My understanding has been that operational funding for those groups has for several years, I think since the '80s, come from the federal government and from the federal government only. So I am very pleased to hear that the provincial government will now be offering some money.

I wonder if the minister could tell me, first of all, how much money that is and whether the province is offering money to cover the process of consolidation or whether he will be offering operational money to those organizations.

Mr. Stefanson: The member, I think, is basically right that there are the four organizations. The federal government is still a partner in all of this, along with the WCA, in this co-location at 705 Broadway. When we are making a capital contribution of which I will return with the exact amount, but I believe it is in the range of about $600,000–I do not have the figure here, but I will get the precise amount.

As a result of the co-location, we are making a contribution to that whole co-location–the original number I had was $63,000, but, again, I think that number is slightly higher now, based on this location. At one point in time they were looking at a different location. The capital costs were going to be a little lower and the contribution to these operations was going to be a little lower. I will provide the member for Osborne with the accurate capital cost amount that we are contributing to this whole co-location and what we are going to be contributing as a result of ongoing costs relative to bringing all of these groups together.

Ms. McGifford: I am a little unclear. I am not sure that the minister answered the whole of my question. Maybe I have misunderstood him. But I do understand him to say that he is providing some capital costs, which is presumably for the establishment of this group, but the other part of my question is: is he going to be supplying operational money on a yearly basis to run this coalition of AIDS service organizations?

Mr. Stefanson: I think I should be able to make this clear for the member for Osborne. I will start by saying that I do not believe this could or would be happening without our support. That is certainly the feedback that we have had from the organization. You will have the four organi-zations that we have named and she has repeated back into the record along with the WCA all housed in this new location. So there will basically be five organizations.

The federal government pays for the location. Operating costs of three of the organi-zations, the AIDS Shelter Coalition, the Manitoba aboriginal AIDS task force and Kali Shiva are all paid for by the federal government, and they continue to do that. What we pay for in there as a provincial government, what we fund, is we fund the WCA and we fund the Village Clinic. So as a result of that, our contributions to moving them into this co-located facility are going to go up by originally it was estimated about 63,000. That is where I said I will return with a more exact number because I am told that number is now slightly higher because of this new location.

At the same time, we are making a contribution to the overall renovations for every-body in there, all five organizations, which is in the range of $600,000. So, again, I think every-body acknowledges this is the right thing to do and by us making those contributions, we are obviously a catalyst to help make it happen.

Ms. McGifford: I understand that the federal government provides operational money for three of these organizations. The minister must be aware that that money is provided on a project basis, and my understanding is that the funding to those organizations will soon run out. It has happened, I believe at least twice in the past, that the federal government has said it will not fund those programs and then has changed its mind and continued to fund them. My understanding is that the federal government is quite adamant at this point that it will not continue to fund those programs.

While I am sympathetic with the province in that the province should not be expected to pick up every program that the federal government starts and then does not continue; nonetheless, I hear the minister saying that he is putting $600,000 plus $63,000 into this centre. If it is forced to close because there is no money to operate three of the five groups, then it would seem to me that it is not a very wise decision. I am very supportive of AIDS services, having worked in that community.

So I wonder if the minister then or the provincial government has any plans to pick up the operational funding of those three organizations when the federal funding ceases. I think that the federal funding ends on March 31, 2000. It might be a year later. I am not quite sure.

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Mr. Stefanson: Madam Chair, I guess firstly we will continue to do everything we can to ensure that the federal government maintain their funding for these organizations, and we fully expect them to maintain their funding going forward. This new location that all of these organizations are going into will have a 10-year lease on it, and we will have a memorandum of understanding with the federal government on the issue of the space, on the issue of the lease and the operating costs of the space.

So that unto itself is a partial commitment from the federal government towards, obviously the concept which they were a part of. They supported this consolidation of all of the organizations into the one location. They are going to sign an MOU with us on the rent and on the space.

Now, there still is the issue of the operating funding on a go-forward basis from when the agreement comes to an end, but we will continue to press the federal government for ongoing commitments in that whole area. We believe that they do have a responsibility, and I continue to be optimistic that they will continue to fund these organizations and uphold their responsibilities in this area and just the whole issue of their share of contributing to health costs in Manitoba and across Canada.

So the member is right that it does come due in a fairly short period of time. I recognize it is a cause for concern, but I am not even prepared to accept or get into a discussion about the possibility of the federal government getting out of this. I think it is incumbent on us as a government, and certainly with the support of the opposition, to continue to press the federal government to maintain this funding on a go-forward basis. So I think the fact that we have a 10-year lease, the fact that they support this, the fact they are entering into a memorandum of understanding is all very encouraging in terms of their overall commitment. I recognize there is a vulnerability there in the years ahead, but I think we can continue to convince the federal government to continue to fund these organizations.

Ms. McGifford: Well, I am impressed by the minister's optimism. He can certainly be satisfied and rest assured that we will be as "go ahead" as he will in pressing the federal government to continue the funding. But, of course, one of the problems for organizations who are caught between, at least they may perceive themselves as being caught between, federal government funding, which may expire, and a lack of commitment from a provincial government is that it is extremely difficult to do programs and planning. So I understand that many of these organizations are concerned and are not as convinced as the minister is that their funding will be in place, that the federal money will continue, and would like some assurance that there will be funding if the federal government does not renew its commitment. I do not know whether the minister wants to respond.

Mr. Stefanson: I appreciate the concern the member raises for any organization that you want a degree of predictability and certainty in terms of your funding. We have certainly argued that for years with the federal government in terms of the funding we receive from them.

I am partly being a little repetitive, but I think it is very encouraging that the federal government has been supportive of this consolidation, very positive about the con-solidation. I think in many ways it strengthens all of these organizations on a go-forward basis. If the expiry is March 31, 2000, of some of the federal funding commitments, I will confirm that, and then I think, collectively, we should be aggressively pursuing that issue now, ourselves as a provincial government, along with these organizations, to get an extension of a longer-term commitment from the federal government.

So certainly that would be my immediate action on this, because far too often we have had examples where the federal government has backed away from what I think should be their ongoing commitments. In this case, everything I have seen, the federal government are supportive. They support these organizations. They support the consolidation. They encourage the consolidation.

We should be, and I think we are, in a very strong position to go to the federal government and get those agreements extended. So I will confirm the dates of when these funding commitments are expiring with each of these organizations, and if it is getting as close as March 31, 2000, which is nine or ten months away, then it is incumbent on all of us to start pressing for an extension of those agreements. I will certainly undertake to do that.

Ms. McGifford: I wonder if the minister still has an advisory committee on AIDS.

Mr. Stefanson: Madam Chair, well, the AIDS Advisory Committee has now basically been replaced by the AIDS Implementation Advisory Committee because we are now into the implementation stage. That committee actually reports to the Human Services Committee of Cabinet because it does cross other departments, but it does report to them through the Minister of Health. So they are now the committee that provides us with that advice.

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Ms. McGifford: I wonder if the minister could tell me the process of reporting. Does the chair of that committee meet with the Human Resources Committee of Cabinet, and if so, when was the last time that meeting took place? How many meetings have there been?

Mr. Stefanson: Madam Chair, I think, as I indicated when we were talking about the committee, as I said, they are chaired by Ms. Tessa Gilmore, but more importantly relative to the question, they began their regular meetings in January just of this year. We have an individual from Manitoba Health, our AIDS program co-ordinator, Ms. Pat Matusko, on the committee. So that is the direct link into the Department of Health. As I say, this committee reports to Human Services but through myself, through the Ministry of Health.

I have not met with this committee yet. I fully expect that I probably will be doing that fairly shortly, but at this point, to the best of my knowledge I have had no request to meet with them. The focus has been really on this issue of consolidation, certainly from a department perspective from everything I have been hearing, and that is why we have been moving it through our process to have the capital money in place and so on. So I would expect that I would be meeting with the committee fairly shortly.

Ms. McGifford: I know that the statistics on AIDS used to be compiled every six months, and then I think that changed and they were compiled once a year. I used to get them automatically, but I have not received them, I do not believe, for some time.

I wonder if the minister could ask his staff to send me a copy of the most recent statistics on AIDS. First of all, could he assure me that this is still being done and how frequently it is being done? Could he then have the most recent set–because I am assuming it is being done–sent to me?

Mr. Stefanson: Mr. Chairman, I will definitely send the member the most current information I have, and I will confirm whether or not that information is being produced semiannually or what the current status is and the timing of the production. But I will definitely undertake to provide her the most recent data I have very shortly.

Ms. McGifford: I wanted to ask a question that I have been asked to ask on behalf of some community members. I do not know whether the minister remembers the unfortunate death of a young man named Wesley Kent who attended at the Health Sciences Centre and for reasons that were at that time disputable, at least there was a dispute between the family's contention and the hospital's contention, and later on this young man, I believe, was admitted into the emergency room at St. Boniface Hospital where he died apparently quite unexpectedly and suddenly.

The family was extremely upset because they felt that he had been treated quite unfairly by Health Sciences Centre. Some members of the community believe that there should be an inquiry into the death of Wesley Kent, and I wonder if the minister has considered this, if he has received this request.

Mr. Stefanson: I think rather than test everyone's memory, I am better off to return with the specifics to the member on this entire issue.

Ms. McGifford: I am sure the minister and his department are aware that the numbers of persons with HIV-AIDS infections, and particularly among marginalized people, whether these are aboriginal people, intravenous drug users or gay youth, have continued to rise in this province. I wonder what preventative measures his department is taking. I am sure that members of his department are familiar with the–is it the Winnipeg Injection Drug Epidemiology study? I think the epidemiologist was Dr. Jamie Blanchard. I think the study found that 12.6 percent of the city's IV drug users tested positive for HIV, and I believe that in an earlier study, '86 to '90, only 2 percent of I.V. drug users tested positive.

So this is quite an alarming increase, and I wonder if the minister would comment.

Mr. Stefanson: Obviously the member is quite familiar with this issue, and just to put on the record maybe a little bit of background. The Winnipeg Injection Drug Epidemiology study, or what is called the WIDE study, a proposal was submitted actually by Manitoba Health to Health Canada and was successfully funded for $170,000 from Health Canada and $20,000 from Manitoba Health. The principal study inves-tigators are Dr. Jamie Blanchard and Dr. Lawrence Elliott in close collaboration with the AIDS program co-ordinator for Manitoba Health.

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I think in total the WIDE study identified about 1,068 injection drug users. Of those, some 610 participated in a full interview. The final results are really, as the member has indicated, a prevalence of about 12.6 percent. A full presentation on the study was just recently made to the AIDS Implementation Committee, in fact, just on April 13, just under a month ago. So, obviously, that data is all being analyzed now by the committee. That committee is also in discussion with the Winnipeg Community and Long Term Care Authority, with community leaders, with service providers and obviously with the Department of Health to review how best to structure the programs and services to address these new findings.

Again, the activities to address these findings are being co-ordinated across depart-ments like Justice, child and family services and so on. So it is really an issue that I expect I will be receiving a full report on very shortly, and I am sure that full report will include recommendations relative to programs and services, Mr. Chairman.

Ms. McGifford: Well, I agree that the numbers are new. I am not sure that the information is new because we have known for a long, long time that one of the ways that HIV is spread is through IV drug use. I guess the real tragedy with regard to HIV-AIDS is that it is entirely preventable and we know it is entirely preventable, and yet it is 1999 and the minister seems to be implying that there is not a preventative strategy in place. I do know that the AIDS Strategy itself does have information on or does highlight prevention, but it remains upsetting that it is still 1999 and this is where we are when it comes to prevention with regard to AIDS. I do not know if the minister would like to comment.

Mr. Stefanson: Well, I think in fairness to the issue and the data that this WIDE study has put forward, the member is basically correct. I think it is just confirming in many cases what was already expected or known, but in terms of action and steps being taken, without being too repetitive here, I know from the information I have that the organizations themselves indicated a need for much better co-ordination, co-operation to consolidate. That really has been one of the immediate steps being done and is being dealt with.

You know, there are a number of initiatives in place, whether it be initiatives through Mount Carmel Clinic like the street station needle exchange, other initiatives in terms of public health nurse educational initiatives and obviously community health clinics like Klinic, Women's Health and Nor'West, and so on, but I will give the member for Osborne a more comprehensive listing of a number of the initiatives that are in place.

I certainly agree with her on the whole issue of prevention. We had a lengthy discussion with the member for Kildonan (Mr. Chomiak) on the issue of prevention. In that particular case we were talking about smoking but our objective in so many of these areas should be to prevent things happening in the first place, and any initiatives, any steps we can be taking, whether it is through education, whether it is through services, programs or whatever, I would agree that we should continue to focus on that, that if we have illnesses or diseases that are preventable, whether it be diabetes or any of these kinds of situations, like HIV, we should be focusing on that. I would welcome any specific suggestions the member would have in that area, and we are always more than prepared to look at the impact that they could have.

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Ms. McGifford: Actually, I do have ideas on prevention. I am glad the minister mentions Street Connections, because I have an article from the Winnipeg Free Press, dated Wednesday, April 21, and in it the program manager, Gloria Enns, is quoted as saying, since they have moved their office, their needle exchange program has dropped by half. I think that they were formerly on Main Street, and obviously the minister is not responsible for that office's closing down and having to move, so I just put it really out as a comment, because it is unfortunate that we have to have needle exchange programs. But we do know that this is one way of preventing HIV-AIDS and also hepatitis C which I wanted to talk about in a minute.

I also wanted to say–and the minister probably knows this–that there is evidence, and I believe it is in the WIDE report as well, that those who are being infected with HIV-AIDS are younger in Manitoba than they are anywhere else in the country, so this seems to me that it is something that should be looked into by this minister with certain of his colleagues, maybe the Minister of Family Services (Mrs. Mitchelson), maybe the Minister of Education (Mr. McCrae), because quite clearly, as the minister recognizes, in the AIDS field, joint and co-operative efforts are extremely important in dealing with these issues. That is more of a comment than anything.

I wanted to ask the minister if he could tell me how many of his staff in the Department of Health are working full time on AIDS, either prevention or delivery of service or in that field.

Mr. Stefanson: The direct service employees that used to be with Manitoba Health are now with the WCA and the RHA, so I will have to get that information and provide it to the member. Within Health, we do have the AIDS program co-ordinator I referred to earlier, and we do have the epidemiology unit which is really focused more on the research side of the issue. I will get a precise number of how many people are in that unit, but the actual service delivery side that used to be in Manitoba Health is now out in the RHAs and the WCA. I will get a summary of that for the member.

Ms. McGifford: The epidemiology people would be working not only in AIDS, I am assuming, but in other infectious diseases. What I wanted to do, and I hope this is all right with the minister, is ask a few questions about hepatitis C and then ask some questions about women's health issues.

First of all, then, hepatitis C, I know we asked some questions in the House about 10 days, two weeks ago. The member for Transcona I believe was the person who brought up the question of waiting periods. He had a constituent who had unfortunately tested positive for hepatitis C. This individual had no idea how he had contacted hepatitis C. People often do not. He had no idea when he had contacted hepatitis C. The person had been notified when he went to donate blood that he had the virus.

As I am sure the minister can imagine, as all of us can imagine, this individual was quite devastated, and yet had to wait I believe till next February to see a liver specialist, a hepatologist. I wonder if this is standard or if this individual just happened not to phone the right place at the right time or what is going on with specialists.

Mr. Stefanson: I will just make some general comments. I think I will have to either return with the detailed information or when I get to this section of our detailed Estimates and have the appropriate staff here. I know it is part of the negotiations with the federal government for Manitoba's share of this $300 million that is made available for additional services. Some of the things that are being looked at in the case of Manitoba would be additional hepatitis clinics in the viral hepatitis investigation unit at HSC, some additional community-based nurses at the WCA to deal with risk factors and counselling and monitoring cases and providing education and some specialized diagnostic tests.

I am also aware that we, Manitoba Health, have approved additional resources for the recruitment and/or training of a hepatologist. That has already been approved. I would have to confirm what the status is of that recruitment and/or training. So there are various steps being taken, initiatives underway. I would certainly be more than willing to return with a more comprehensive briefing for the member and/or when I have appropriate staff here at that stage of Estimates.

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Ms. McGifford: I have two other questions. They probably are questions that the minister would prefer to answer at another time. Maybe I will ask them, because they are very closely related to the material that he just presented.

I understand that when an individual sees a specialist, an individual who has tested positive, then usually that individual must then have a liver biopsy unless that individual is a hemophiliac. Then there is another kind of testing, I understand, because I assume a biopsy for a person who is a hemophiliac is more serious than it might be for somebody who is not, and that that test requires an additional wait of about four months, that that is about how long that waiting list is. So that is a concern.

I also did want to ask the minister about the Manitoba portion of the $300 million, that one-time transfer payment, which he just mentioned. I know that he indicated in the House last week or two weeks ago, specifically what our share of that money was. I am sure I could find it in Hansard, but maybe he would be good enough to reiterate what that amount is. What I did want to ask is what specifically was going to be done with that money. He seems to have outlined some of the initiatives. Perhaps that is as much detail as he can get into right now.

Mr. Stefanson: On the first part of the question, I will return the details for the member on, I guess, the protocol behind the liver tests, the liver biopsy, but also confirm with her the status of waiting times and whether or not there are any issues that need to be addressed there.

In terms of the $300-million commitment from the federal government, Manitoba's share would be approximately $7.8 million. Now, we have to recognize that that is over 20 years. The federal government is talking about front-ending some of it. In fact, they are talking about making available maybe as much as about $1.3 million in the first year. The total allocation for Manitoba is about $7.8 million over 20 years. That does give us the opportunity, as we have discussed before, to look at some enhanced treatment, to look at the whole issue of training and recruitment of hepatologists, and so on. Hopefully that is the information the member wanted.

Ms. McGifford: Mr. Chair, I know the minister knows, because I mentioned in the House that the Province of Quebec is advocating, agitating, whatever, to be able to use their portion of the $300 million to extend compensation to cover individuals who were infected outside the window. I personally think that this is some-thing that we should consider in Manitoba, and I wonder if the minister's position on not extending compensation is firm.

Mr. Stefanson: Madam Chair, in terms of a specific commitment, the most recent information that I have is that it is still only Ontario that has actually agreed to a cash payment from pre-'86, and I believe the payment is up to $10,000 per claimant, regardless of the burden of illness. They have also capped their total contribution, I am told, at about $200 million, I think. Quebec, I know, did indicate some time ago that they would be looking at a similar program, but I have not seen further details. I am not sure whether the member has further details other than that intention that was indicated some time ago by Quebec.

Beyond that, we have the federal government and all of the other provinces committed to utilizing this $300 million to provide additional levels of care and treatment. We have talked about some of them, and, obviously, I am awaiting a final detailed submission on the elements of care that we can continue to enhance here. So, at this point in time, other than Ontario and some uncertainty around Quebec, others are waiting to see what happens. We have all of the provinces and the federal government dedicating this money from the federal government to additional care.

Ms. McGifford: But the minister has not told me what his position is.

Mr. Stefanson: Madam Chair, we have agreed with all of the other provinces and with the federal government to utilize this money for additional care in the province of Manitoba.

Ms. McGifford: In other words, the minister is not committed or interested in extending compensation to those persons who fall outside the January 1, 1986, to December 31, 1991, period? Madam Chair, can I just add that I meant, of course, individuals who acquired hepatitis C through contaminated blood or blood products?

Mr. Stefanson: I am probably being repetitive, Madam Chair, that we are committed to use this money, like almost all the provinces in Canada and with the support of the federal government, for additional elements of care. We are committed to certainly continue to provide all of the existing levels of care that we provide through our health care system. These additional resources give us an opportunity to expand some programs, to enhance some levels of care. We are certainly committed to do just that.

Ms. McGifford: I would suggest to the minister that the least of his sins is being repetitive. He is also being, what I consider more serious, evasive, but I guess that is his privilege. So, leaving that, I know that the minister I understand did outline for the member for Kildonan (Mr. Chomiak) the status of the $1.2-billion package for those who fall inside the window, so I know I can get that information from him. But I wonder if I could just ask the minister when he thinks Manitobans will actually get some compensation, those who fall inside the window we are talking about now.

Mr. Stefanson: Madam Chair, as the member knows, the total settlement is $1.1 billion. In the case of Manitoba, that amounts to about $12 million, and we have set that money aside here in Manitoba in 1998-99. I think we are all hopeful that negotiations will be concluded very soon. They are ongoing, the negotiator on behalf of the federal government and provincial governments along with the negotiators on behalf of the plaintiffs. I am told that they are close to concluding negotiations, down to a handful of items, and I think we all expect that should be concluded fairly shortly, I would hope.

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Ms. McGifford: I wonder if I could change and just ask the minister a quick question about the Manitoba Health library, because I had some phone calls about it. My understanding is that there was a Manitoba Health library in the building on Empress Street and that it was available for department staff, for public health nurses. In fact, I was told that lots of teachers access these resources, that these resources were available across Manitoba for health education, I guess, in public schools and that this health library was, in short, a really rich resource and was well used, and that lots of health libraries in Manitoba depended on these resources, that they collected Manitoba government publications and national publications and that these resources were very necessary to health professionals and, well, just all kinds of people.

I understand that the library was used by, I suppose, policy makers, health professionals, et cetera, by practitioners, nurses, and also by consumers, and now I have been told that the library is closed and that I believe it has moved to the Health Sciences Centre medical school. Some people are concerned that this will mean that these resources are not available in the way that they were previously, because it has been–I suppose a university is a public building, but the medical school, I am not sure that anyone can just walk in there and have access to these resources, which I understood was the case in this Empress Street library. I wonder what the answer is.

Mr. Stefanson: I think I should return with a more detailed explanation, but I guess a general one is the member is correct. This has been consolidated at the U of M medical school, John Maclean Library. I gather the access is still there in terms of audio-video to teachers, schools and community health care nurses. I am also told that there were only something like five contacts per day at the previous site. Again, my understanding is this will continue to provide the service, and it is really just consolidating it at this one additional location. But I will certainly return with some further details on the whole issue.

Ms. McGifford: I wonder if the minister knows if people using the John Maclean Library have to pay to access materials from that library or if that is free.

Mr. Stefanson: Just again, Mr. Chairman, I think I should return with a few more details, but my understanding is there is an arrangement with MARN, an overall arrangement allowing access for nurses. They might have to pay for some specialized services or whatever, but there is an overall arrangement with them. Other than that, it is membership based so individuals would be members to access the services. I am also told that through the other library services, the Winnipeg Library Service, you could access interlibrary transfers, and I would have to confirm what the fees or charges are for those kinds of things. So MARN has an arrangement, there is a membership base, and there is the opportunity for interlibrary transfers, but I have to confirm the fees relative to membership and relative to interlibrary transfer.

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Ms. McGifford: The reason I bring up this issue is because we have just been talking, at least indirectly, about the importance of prevention of illness and disease, specifically when we were talking, I think, both about HIV and about AIDS. I know that the minister indicated that public contact with this library, which was on Empress Street, was limited, and there was something like five contacts a day.

It is encouraging to know that there is an arrangement that nurses have to access the materials from the John Maclean Library, but I understand that teachers were able to go to the Empress Street library, and sometimes when you are browsing in the library, you see things, and seeing things is, well, seeing things is believing. It is very important, you stumble across resources that you did not know were there and they prove very helpful.

I think the minister would agree that one of the important places to begin prevention, or one of the very important locations where we should be teaching preventative medicine, is in the school system and, consequently, perhaps down the line preventing some of the illnesses that are so troublesome and so tragic in our society.

The other thing is I understand that consumers had some access, at least to this Empress Street library, and my understanding is that when consumers educate themselves on their illnesses–and I am thinking, for example, on breast cancer–that their chances of survival increase.

I know there is no answer to what I was just talking about, and I do not expect an answer. I was just explaining to the minister why I think it is important that we do have materials publicly available both to our educators and to consumers of the health system, and that they be easily available. I had understood that this particular library filled that niche. I do not know whether the minister wants to respond. I do not necessarily expect a response.

Mr. Stefanson: Mr. Chairman, I did indicate I will return with a few more details on this, but I am reminded that there are so many more ways now to provide information and education to our teachers through our educational system, whether it be through the Internet or other vehicles which is happening more and more or whether it be through a number of initiatives, through public health with brochures and information.

Really, this particular library at Empress that we are talking about, really was mostly an internal library. It was not so much a consumer library, even though teachers could access it, but teachers can still now access the various components at the John Maclean Library, and they can access the audio-video and so on. So I think that resource is still there and still available, and we do continue to provide information in a number of other ways as well.

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Ms. McGifford: I am aware that there are a number of ways of obtaining information, but you can only obtain information if you know it is available. Perhaps the minister feels confident that everybody knows where the information is and how to get it, but I will just leave it at that.

I wanted to ask some questions about the Breast Screening Program, the Manitoba Breast Screening Program. Maybe I can begin with the one that is across the street from the Misericordia Hospital, because I understand that this program is restricted to women who are under 60, or there is an age restriction. I may have that age restriction incorrect, but I have during my canvassing, actually, encountered a couple of women who were denied access to those facilities because of their age. They were upset, and maybe understandably so, but maybe there is some very good explanation as to why they cannot seek service there. I wonder if the minister could enlighten me.

Mr. Stefanson: The member is correct that the Breast Screening Program is for women between 50 and 69 years of age, and I gather that is based on the research and scientific evidence and so on. I gather it is also fairly consistent right across Canada. I think maybe one province has a lower age but I think, by and large, I am told, that that is fairly consistent. Obviously any woman who either has a family history or is concerned can go through her own doctor, her own family doctor, and go through a separate–so long as he or she refers her through the process–testing process. So that is available if a woman is concerned and is obviously younger than 50 years of age, but the screening program itself is for 50 to 69.

Ms. McGifford: Mr. Chair, I appreciate the information. However, the case I am referring to is a woman, and I did find the age, that 69 is the cutoff, and this woman is 71, and she had been a patient of the Misericordia Breast Clinic. It was very convenient for her to attend the breast clinic and to attend the screening unit across the street. Then, when she turned 71, she was told that she could no longer seek service there or have service there. This woman was used to the service; she was very impressed and pleased with the service.

I also may as well take this opportunity on the record to compliment the workers there. It is a wonderful place to have this work done. But here is an elderly lady, this is something she is accustomed to, and suddenly she becomes a certain age and she is told that she can no longer be served at this particular centre and was upset. I think we can all understand why she was upset.

I wonder if the minister would consider changing, making some changes. I heard him say that across Canada the ages that are recognized as the important time to have breast screening are 50 to 69, but women, of course, do get cancer when they are older than 69. In fact, I could be quite misinformed, but I thought the incidence of cancer increased with age, so you are more likely to get it when you are passed 69. I could certainly stand corrected.

This refusal of service because of age seems to me to be, well, just not quite right. I do not know whether it is a human rights violation or not. I presume it is not or the government would not be practising it, but it is upsetting. I wonder if the minister might consider changes or might explain in more detail his rationale, because just simply saying, well, it is from 50 to 69 across Canada does not really satisfy me.

Mr. Stefanson: Well, Mr. Chairman, it is not really my information or my decision that 69 is the most appropriate cutoff. I am told that is fairly common and is based on clinical evidence and so on. Having said that, if the member for Osborne, in confidence, is prepared to give me this individual's name, we could certainly deal with her particular situation and find out more about it. I was not clear whether it is the screening program or the clinical side of the program that this individual is continuing to access, and we certainly would be prepared to look into her individual situation.

I gather there is also a national review committee on this entire issue that do make the recommendations. Obviously, if they recom-mended a change in age, then we would comply with that. So, Mr. Chairman, I am more than prepared to look into this individual's particular circumstances and see if anything can be done.

Ms. McGifford: I will check with the individual and then, if that is fine with this person, contact the minister's office. I greatly appreciate his willingness to look into it and also his willingness apparently to recognize that what might be clinically viable is not necessarily viable from a humane point of view. I think this is a kind of human interest question and a human interest concern.

I wanted to ask the minister about the mobile testing units, if the same age restriction applies there, because I know these units go out into isolated areas where women cannot necessarily just access a laboratory that would do the screening. In fact, I understand that the reason for the mobile breast screening unit is that there is not service there. So I am hoping that the age restriction does not apply.

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Mr. Stefanson: The short answer to the question is, yes, the same age restrictions do apply for the mobile screening program, again based on the same clinical information and so on, again a different situation from an individual who might have either a family history or some reason to require ongoing diagnostic services beyond the age of 69. But beyond those kinds of situations, just the screening program does have the same restrictions of 50 to 69.

Ms. McGifford: But the screening program is one of the essentials and one of the first places for diagnosis. Maybe I am missing something here, but my understanding was that a breast screening unit would be in a community where an individual did not have access to another form of testing. Do the screening units not go to remote communities, so that if you are 70, and you do not qualify, what do you do? Where do you have screening?

I understand my information from my physician and information I received at the breast screening clinic across the street from Misericordia was that once you reach 50 you should have a test, I believe, every two years. So it seems to me that if women are cut off once they reach 69, and they live in–I do not know where–a northern remote community, they do not have access at all to screening.

Mr. Stefanson: I think what is important to recognize is the screening program is a program for basically asymptomatic women, women who want and should be having the screening done. Any woman who has any concern or any history obviously would go to her family physician or her doctor and go for a much more detailed diagnostic testing that would be required in that particular case. So wherever they are in Manitoba, that would be the process that they would follow. If they are concerned for some reason, then they should be making that contact and going for the more detailed diagnosis as opposed to just the screening.

So those services are available to varying degrees right across the province, and certainly if a woman beyond the age of 69 or under the age of 50 has any family history of any symptoms, as opposed to being asymptomatic, has any symptoms that cause her concern, then she should be making that contact with her doctor and going for the more comprehensive diagnostic testing that would be required well beyond just the screening, which is really a universal program for all women between the ages of 50 and 69.

Ms. McGifford: With respect, I think it is important for the minister to recognize that one of the principles of the Canada Health Act is accessibility of service. Secondly, I think it is important for the minister to recognize that many women living in remote communities do not have a family physician. My understanding is in many of these remote communities there is not even a physician, period. So I do not know how these referrals would take place or who these referrals would go to.

I understand that the minister is talking about asymptomatic women, and if a woman is symptomatic, presumably whether she is over 69 or not, she could access service through the breast screening unit. But in the spirit of prevention, I would suggest to the minister that he consider, at least in these rural communities, dropping this age limitation.

Mr. Stefanson: Mr. Chairman, I think what would be useful from my point of view, in terms of the issues the member is raising, if she has not done this already, I would welcome putting her in contact with my associate deputy minister and the people involved in the program to sit down and have a thorough discussion on the clinical background, why it is 50 to 69, and on the basis that there are other services available, if women do have a concern and so on. So if she would be interested in that, I am more than prepared to arrange that. I think, from my point of view, that might be very helpful in terms of either clarifying the issues or then being able to pursue the issue.

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

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Hon. Darren Praznik (Government House Leader): Madam Speaker, as we discussed with the House earlier this afternoon following Question Period, in order to accommodate passage of the amendment to Bill 27, The Essential Services Amendment Act, as members are all aware, that will require unanimous consent of the House to do a number of things, as I had indicated earlier. So in keeping with that, I would ask now if there is the unanimous consent of the House for leave to revert to report of standing committees.

Madam Speaker: Is there unanimous consent to revert to report of standing committees?

Some Honourable Members: No.

Madam Speaker: No, leave has been denied.

Mr. Praznik: Madam Speaker, I just want it to be noted that the ability of this Legislature to pass into law that amendment to The Essential Services Act would require leave to proceed in each step. With that denial by, I believe, one of the members of this House, although there was agreement between the New Democratic and the Conservative parties to proceed on that basis, that prevents that legislation from becoming law today with the consequences, if anything happens over the weekend, the responsibility will have to rest on those who deny that leave.

Mr. Kevin Lamoureux (Inkster): Madam Speaker, given the serious nature of the comments that were made by the government House leader–

Madam Speaker: Are you on a point of order?

Mr. Lamoureux: Yes, on a point of order, Madam Speaker, given the important comments that the government House leader has put on the record, he is definitely imputing motives on behalf of myself and the member for The Maples (Mr. Kowalski).

We recognize the importance of the legislation that is before us. We believe that the sense of urgency is not there. We have faith and trust in what we heard at the committee level, and the government and the NDP are working together to try to expedite this bill. We do not believe that the bill needs to be expedited. We do believe in the importance of all Manitobans and the patients, whom we put first. We believe that the opportunity is still there. Therefore I am not prepared to give leave.

Mr. Steve Ashton (Opposition House Leader): Madam Speaker, I think we are in a bit of an unfortunate situation, but with all due respect to the government House leader (Mr. Praznik), I think his comments were basically leading into debate on this matter. Leave was requested. We were prepared to grant leave, but since it has not been granted, the only appropriate thing to do is to move on the next item of business.

I could put on the record all sorts of comments, but I do not think it is appropriate in keeping with our rules, and I would suggest we either adjourn the House or go back to Estimates. We should not be debating the bill or any action related to the bill on points of order or else on comments related to House business. That is getting into debate. It is not to deal with procedure.

Madam Speaker: The honourable member for Inkster (Mr. Lamoureux) did not have a point of order.

Mr. Praznik: Madam Speaker, it has all been put on the record. I would then ask if there is leave to go back into the Estimates debate for the remaining time of today's sitting. If there is leave in the House, then I will move the appropriate motion.

Madam Speaker, I will defer to the will of members opposite. [interjection] And, yes, I would like to have a life. I think if Madam Speaker would canvass the House, she will find that there is a willingness to call it 6 p.m.

Madam Speaker: Is there unanimous consent of the House to call it 6 p.m. Agreed? [agreed]

The hour being 6 p.m., this House is adjourned and stands adjourned until 1:30 p.m. Tuesday next.