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

We are on Resolution 21.2. Program Support Services (f) Human Resource Planning and Labour Relations, on page 84.

Mr. Dave Chomiak (Kildonan): Mr. Chairperson, I asked the minister yesterday whether it would be possible to accommodate our questions Wednesday and Thursday dealing with regional boards, hospitals, USSC and the like, by having officials attend, and I wanted to give notice so the minister could arrange–or those people, it would not cause their schedules too much difficulty. Can the minister advise whether or not those officials can be in attendance?

* (1450)

Hon. Eric Stefanson (Minister of Health): The reason I was having a brief discussion with staff now is I did not get a chance to discuss this last night. I went straight into meetings and then went straight into meetings when I came in this morning. I was going to try and call the member for Kildonan and have a further discussion. I never did.

I do want to indicate I am a bit of a traditionalist. Really the normal practice has not been that you bring in arm's-length organizations that receive funding from government. I am trying to sort of envision it in other departments. It would be like Education bringing in all of the universities, or universities' heads, or bring in all the school divisions. Where do you begin and end with that? I know last year there was also some direct responses from staff during Estimates which again was a bit of deviation from traditional Estimates. I am not intending to do that. I am going to answer every question and so on.

I am certainly prepared to have a discussion with the member for Kildonan on this issue, but my inclination is to do it in the more traditional way which is me responding, having appropriate staff here. I am certainly prepared to do whatever I can to provide him whatever information I possibly can on all of these issues. I know he is concerned about information in a few areas like Urban Shares Services and so on. I will certainly do my best to provide as much information as I can in all of these areas. I am prepared to have a further discussion with the member, but as of right now I would prefer to proceed on what I would call the more traditional approach which is myself responding to questions and having the appropriate departmental staff who are here who are ultimately the ones that are responsible for departmental policy and departmental expenditures, Mr. Chairman.

Mr. Chomiak: I am prepared to discuss that with the minister at some point. I will not use up valuable Estimates time on that particular point. I am very concerned about what is meant, on page 47, of the subappropriation. One of the activities is to determine appropriate workload measurement systems. I wonder if the minister can give me a specific answer to specifically what that is. That is the second last item under Activity Identification.

Mr. Stefanson: What I am told is basically page 47 pertains mostly to doctors, to medical, and 48 is more nurses and other people in our health care system. If you look at the top of page 47, under Objectives, you see reference to medical remuneration, medical professionals. The only reason I say that is that this really pertains more directly to some of the issues relative to doctors.

In fact, one example of this, and I am certainly prepared to return with more detailed examples, but I will give the member one example, what is meant by this, is the establishment of a relative value guide. I think the member would have probably noted when we announced the funding adjustment for anesthetists, but it was done on the basis of a relative value guide, looking at the qualifications, the nature of the work, and a number of variables in terms of the whole issue of the fee adjustments in that area. So that is one example of determining appropriate workload measurement systems, the introduction of a relative value guide which we used in the case of anesthetists. I can certainly undertake to return with additional information on that, and, of course, when we get to Medical, we can have a broader review, a broader discussion, if the member wants, but that is really what was meant by it as it relates to doctors' services in Manitoba.

Mr. Chomiak: I thank the minister for that response. I understand that, while the workload measurement system is a term to be applied to issues relating to doctors' remuneration, it does beg the question of something that is quite fundamental to what I am sure the minister has heard as often as I have heard, and that is the workloads on nurses and nurses' aides in the institution. I am wondering what response the minister has to the issue.

I do not think it can be denied in any quarters of the incredible strain and the incredible workload being placed on caregivers in the system, as manifested by many comments, thousands of comments, of individuals who are in the system, increased stress leave and the like. I could go on on this point for a long time, but I wonder if the minister can indicate for us today what response the government has to that.

Mr. Stefanson: A good question because the most immediate issue that has been brought to my attention in this area is the need to fill the vacancies. I am talking now specifically about nurses, but it can apply in some other areas, obviously, but particularly nurses. I am going to return with the breakdown of the 650 positions for the member, the combination of vacancies versus new initiatives, but obviously vacancies are a significant amount of those 650 positions. By having vacancies, what it is doing to nurses in the system is that either they are having to work overtime or, if they only want to work less than full time, they are working more hours than they want to work. So that is the immediate strain on the system, so by bringing more nurses into the system, by all the things that we have talked about, that will go a long way to reducing that requirement to work overtime and work extended shifts, which will relieve some of the pressure.

That nurse task force that we talked about yesterday that is going to give us the overview of the numbers of nurses, numbers of vacancies in the system, its next phase will also be to look at the mix in the system in terms of the issue we discussed yesterday, the types of nurses, types of functions and so on.

But I think when the member asked me what can we do and what should we be doing, I would say the most immediate thing we should be doing is addressing the filling of the vacancies that are already existing in our system. That will be a very good first step to significantly relieve some of the pressure on our nurses in our health care system.

* (1500)

Mr. Chomiak: Mr. Chairperson, it is very clear that there is some controversy surrounding the mobility agreement that is presently a subject of concern, and I do not want to, again, get into a long discussion about this because it could be argued all afternoon, and there are all kinds of different dynamics, but to my mind, the bottom line and difficulty with the mobility agreement is frankly the nurses do not trust management to keep their word with respect to the provisions of the mobility agreement.

Now, I am wondering what the role of the minister will be with respect to (a) giving assurances to nurses and (b) ensuring that management lives up to what they have said and stated with regard to the provisions of that mobility agreement because, frankly, in my mind, from my discussions, that is what it boils down to. It is a question of trust.

Mr. Stefanson: Well, the member is right, that I believe the one area of concern has been this issue of mobility. We now have the two facilities, Seven Oaks and Grace, that meetings are taking place on Thursday of this week to work on the outstanding issue, which is really the outstanding mobility issue. I continue to be optimistic that a solution can be found for those two facilities.

I think the member for Kildonan (Mr. Chomiak) will have seen a letter that was sent by management, I believe on May 14. If he has not, I am certainly prepared to provide a copy. It tries to outline very clearly this issue of short-term mobility, that it will only be done in–I cannot recall exactly the words that were used but basically saying extenuating circumstances, urgent circumstances and so on. We agree with that, that those are the only situations where that should be the case.

So management has put that in writing. We certainly agree with that. We have indicated we agree with that, and, obviously, we will be working with management to be sure that that is exactly how that whole initiative is applied in the facilities. Obviously, if any concerns are brought to my attention by any nurses in the system, I will follow up on those, as well.

So we support that kind of application that has been put in writing by the management, and we will work with them to be sure that it is applied on that kind of a basis, Mr. Chairman.

Mr. Chomiak: I do not want to debate the provisions of the contract. I will leave that to the negotiators on both sides, but since the minister did mention the term "extenuating circumstances" in terms of the definition, and this has come up to me, one could easily argue, politics aside, that the people have been in the hallway of St. Boniface Hospital literally for the past eight to 12 months.

One could have deemed that is extenuating circumstances, that entire period, and would justify the implication of that provision. I think that is part of the problem with the application of that kind of terminology and a justification by management, because what does constitute extenuating circumstances when you are in a situation where one could very easily say that, for example, St. Boniface, or Grace for that matter, or Seven Oaks right now or Concordia are in extenuating circumstances presently for whatever reason without getting into politics. That is extenuating circumstances which could invoke the provisions of the agreement.

Mr. Stefanson: Mr. Chairman, I, too, do not want to get into sort of negotiating the agreement. I am prepared to return with more information. I guess, in particular, we still have two facilities that the employers are hopefully going to reach agreement with fairly shortly. But, the pressures that the member refers to in individual facilities, even some of the pressures where there have been individuals in hallways in our hospitals, have been dealt with in those facilities. I should bring the letter back because I cannot recall all of the words, but certainly my interpretation, my understanding is that it has to be extenuating or urgent situations where for some reason a nurse would have to go on very short notice to help out at another facility.

There also is a system in place as to how the nurse going would be arrived at. The majority of nurses would have to volunteer. There is a process in terms of how it would happen. If the member is not aware, I do not want to leave the impression that just any nurse in any facility could be forced on short notice to go to another facility. That is not the case. That clearly is not the intention here of that particular provision. It is just that for whatever reason we end up with an emergency situation in some facility in Winnipeg where additional nursing staff would be absolutely critical and important to providing those services that a nurse could be moved to help out in that situation. I think the letter does outline it quite clearly. Certainly all of the feedback I have had from the facilities, that is the overriding intent. It is not to be moving nurses between facilities on short notice. That is not going to serve anybody's best interests.

Mr. Chomiak: Can the minister indicate what is meant by, on page 48 under this subsection, implementation of new training programs for allied health professionals that would be more responsive to employer needs. Now I know the minister has made mention of standards in legislation, but what does it mean by implementation of new training programs? Who is going to be implementing those programs? What are those programs? What do they deal with?

Mr. Stefanson: An example in that area would be the introduction of training programs for technicians as early as the fall of 2000 through the community colleges, I think Red River basically. We are looking at an integrated technician program for lab, X-ray, ultrasound. In fact, I, along with some staff, met with one of the associations recently that has the support of the people working in the system, has the support of the employer. I think that would be the best example I could give of the introduction of the program that will be taking place, not this fall but the fall of 2000.

* (1510)

Mr. Chomiak: Will the minister table a list of the various programs that the government is contemplating implementing?

Mr. Stefanson: Just for clarification, I take it the member is asking for any other examples of programs in this area that he is asking about that we could table. Yes, I will undertake to return that information.

Mr. Chomiak: Now, I do have questions relating to physicians in this area, but I think we had agreed that we would defer that until we got to the medical section. Having said that, I am prepared to let the line pass.

Mr. Chairperson: 21.2.(f) Human Resource Planning and Labour Relations (1) Salaries and Employee Benefits $1,039,200–pass; (2) Other Expenditures $342,900–pass; (3) External Agencies $30l,100–pass.

21.2.(g) Grants for Evaluation and Research (1) Manitoba Centre for Health Policy and Evaluation $1,850,000.

Mr. Chomiak: Mr. Chairperson, as I indicated earlier, I hope we can move right along the rest of the Estimates. I do not think I have too many questions in many areas, just specific questions on a whole series of items.

On this particular section, I noted last year that this area had a function: to co-ordinate a contractual fee-for-service or grant funding for policy evaluation and research initiatives. That has now been eliminated. Can the minister explain that?

Mr. Stefanson: Mr. Chairman, I apologize. We do not have a copy of last year's Supplementary Information here which we normally do. I will look into that issue and return, but I am told there have been no changes, no functional changes, no operational changes in these areas, so as to why there was a change in–whether it was under one of these identifications, activity, or whichever, the member referred to activity. I will get back, but there have been no functional changes in this area.

Mr. Chomiak: Just for my own understanding, the government makes a grant of $1.7 million and change to the Manitoba Health Research Council, and the Manitoba Health Research Council then carries out its studies. Can the minister provide us with a list of all these studies, or should I obtain that from the annual report? Well, actually, if the minister could provide it, that would be more helpful because the annual report will be dated.

Mr. Stefanson: Again, I know the member knows that the most recent annual report that is available is '97-98. I am sure he has had a chance to look at the functional areas. Obviously we do not have the '98-99 annual report yet, but I will undertake to provide him what information I can on a preliminary basis based on '98-99.

Mr. Chomiak: Can the minister provide us with a list of the ongoing contracts for studies between the Centre for Health Policy and Evaluation and the province?

Mr. Stefanson: Mr. Chairman, an example of some of the deliverables for 1998, you do not have it?

Mr. Chomiak: I know the '98s.

* (1520)

Mr. Stefanson: You know the '98s. Really, I am impressed. There were six of them. Six deliverables in 1998, and we are looking of course at a further six in 1999.

In terms of the 1999, then approved deliverables to date, they are an update of the surgical wait time report on participation in the Western Canada Waiting List Project. Another will be Understanding Patterns of Influenza: Toward a Better Strategy for Prevention of Winter Pressures in the Hospital System, which I know the member will be very interested in seeing; No. 3, Assessing the Health of Children in Manitoba; No. 4, Alternatives to Acute Care, an Update; No. 5, Population Based Patterns of Use of Home Care Services; and No. 6, which I gather there are still some issues around data availability, is the issue of use of medical care by aboriginal populations.

At this point in time those are the six tentative deliverables.

Mr. Chomiak: Mr. Chairperson, I note for the past three years the grant to the Research Council has been fixed at $1,752.6, is there any reason for that?

Mr. Stefanson: This mostly represents core funding for the programs which the member is very familiar with, from their scholarship renewal to the fellowships and various student awards and so on. But I do not want the fact that this amount is at the same level to leave the impression that health care research has not been continuing to expand in Manitoba because it has.

As the member knows, we are matching the Manitoba innovation fund, which is matching the Canadian Foundation of Innovation. We also have expanded the core support through Industry, Trade and Tourism by an additional million dollars for our health research facilities this year. We have also done projects through programs like the Canada-Manitoba Partnership Agreement, where we provided support for projects at facilities like St. Boniface Research. I certainly would be prepared to provide a summary or a compendium of the numbers of things we are doing related to health research for the member, but this amount has remained at the same level for the last few years, I believe.

Mr. Chomiak: Mr. Chairperson, the minister anticipated my next question. I would appreciate an analysis of this, because I can tell the minister in about three or four or five months, the minister, presumably I, and the Leader of the Liberal Party, a research doctor, are going to be engaged in political debates, and I can assure the minister that one of the first questions or one of the first comments from the Liberal Leader will be Manitoba's lack of support to research, and I want to afford the minister the opportunity to practise his response here in Estimates with respect to what Manitoba has done in research. So can the minister provide us with a complete listing of that area?

Mr. Stefanson: Absolutely. I appreciate the opportunity to do just that because we have significantly enhanced our funding for health research in Manitoba on a number of fronts. So we will prepare a summary document for the member, and perhaps we can have a further discussion at that time.

I, too, look forward to the debate that the three of us will have sometime in the next few months, and probably rolled into that debate will be what the federal government was doing during the 1990s when the current Leader of the Liberal Party sat around a caucus table and a cabinet table and significantly reduced funding for health care in Manitoba and right across Canada. But we will save any other comments on that for that debate or another day, Mr. Chairman.

Mr. Chomiak: Is the government basically satisfied with the data and the evaluation, the kind of materials and the support it is receiving from the Manitoba Centre for Health Policy and Evaluation?

Mr. Stefanson: I have had an opportunity to meet with representatives on two occasions and obviously to read some of the reports. I am very impressed, and I think it is incumbent on us to obviously have good research at our disposal, good information at our disposal. I think that allows us as elected people to make better or the best possible decisions. I think the key challenge for us is when we have an opportunity to access this kind of research talent, that we choose the right projects to be reviewed.

Again, of what I have seen of the outcomes, in spite of the odd comment made by some people, it really is done on the basis of pure research and providing all sides to an issue. The member for Kildonan (Mr. Chomiak) and I can disagree on lots of things, I am sure, but it sure enhances our ability to discuss issues if we have good information at our disposal.

I think this organization is extremely competent, of what I have met of the individuals, of what I know of the organization, and I think they do excellent research on behalf of the people of Manitoba. I think it allows us to have healthier discussions about priorities, but it also allows us to make better decisions.

Mr. Chairperson: 21.2.(g) Grants for Evaluation and Research (1) Manitoba Centre for Health Policy and Evaluation $1,850,000–pass; (2) Manitoba Health Research Council $1,752,600–pass.

Resolution 21.2: RESOLVED that there be granted to Her Majesty a sum not exceeding $25,739,800 for Health, Program Support Services, for the fiscal year ending the 31st day of March, 2000.

We now move on to Resolution 21.3. External Programs and Operations (a) Administration (1) Salaries and Employee Benefits $313,000.

* (1530)

Mr. Chomiak: Mr. Chairperson, the minister has previously made reference to an update of the goals and objectives of the provincial health care system. In light of the activities of this part of the department, is this basically where it is coming from or is there some other area that it is coming from?

Mr. Stefanson: Mr. Chairman, I gather the member is really working out the first objective on page 56, I believe. Really, what that is referring to is the planning for the programs within this section, but I understood his question to be the more overall planning of the Department of Health, which would really include similar aspects from all of the departments working its way through our deputy ministers, associate deputy ministers and assistant deputy ministers and so on.

Mr. Chomiak: There are four people in this particular branch, and they are supposed to oversee the development and implementation of best practices throughout the provincial health services. I do not know how four people can do that. Having said that, what is meant by the development of best practices throughout the provincial health service delivery system? That is item 4 of the objectives.

Mr. Stefanson: Mr. Chairman, actually, the objective, I am sure the member knows, applies to this entire department. Really, these four people are the associate deputy minister and staff, but we are obviously talking about whatever the total complement is in this area, which I am sure I can provide him with 696 EFTs in this section alone.

Mr. Chomiak: I have kind of addressed my questions on a line by line, but I recognize that, in fact, there may be a crossover. Well, I will just keep asking questions, and we will pass the lines. The minister is not anticipating changing staff for this section, is he?

Mr. Stefanson: I think that is appropriate. We have a few other staff available, but the member is right. We can either return with answers or maybe have somebody come down, if there is a detailed question, but I think we can carry on.

Mr. Chomiak: We received–I do not know if it was last Estimates year or the year before in Estimates–a listing of the core services as offered by the department, both at a central level and a regional level. I wonder if we can have a listing and an update of those particular programs.

Mr. Stefanson: Mr. Chairman, I am told the core services document really is unchanged, so, if the member still has his copy, he could use that as a resource. If he needs another copy, we can certainly undertake to provide that.

Mr. Chomiak: I am essentially moving to 21.3.(b), so we can pass 21.3.(a) or come back, because I will be asking general questions.

Mr. Chairperson: Item 21.3. External Programs and Operations (a) Administration (1) Salaries and Employee Benefits $313,000–pass; (2) Other Expenditures $267,300–pass.

21.3.(b) Regional Support Services (1) Salaries and Employee Benefits $1,927,900.

Mr. Chomiak: To lead off in this section, I am very interested under Activity Identification, the last item: "Develop a plan for all imaging services in Manitoba that includes funding (capital and operating), operations, benchmarking, best practices and training programs."

Now, the minister has talked earlier in the Estimates process about a putting together of a committee or a group of individuals to deal with this area, but perhaps the minister can start off by commenting on this particular activity, because this is a fairly significant and fundamental operation.

* (1540)

Mr. Stefanson: Really, the last two bullets under the activity are directly related. I know we discussed, I think, somewhat in Estimates, I am trying to recall, we discussed the whole issue of the new integrated lab services, the idea of one program on more than one site, having got the RHA, WHA working on a proposal for government on that service for the public laboratory. So that includes imaging services outside of Winnipeg and other lab services related too.

We are in the process of waiting for that proposal from that working group, even though we were involved with them in the sense of providing information on the issue. That, then, will form a significant part of the overall plan for imaging services in Manitoba. Some other aspects are the aspects that we have already touched on, the issue of the training program. We have had the ongoing discussions with technicians. That is one of the reasons we are looking at the integrated program for the fall of 2000 as being an important part of these services. So a significant part of it really is the proposal that we are going to get from the RHA, WHA on the integrated lab services across Manitoba.

Mr. Chomiak: Now the integrated model is an old idea that was proposed and has come back again. So can I get a sense from the minister where we are going in terms of labs and imaging, both in the city of Winnipeg, outside of Winnipeg, Brandon and northern and rural Manitoba?

Mr. Stefanson: Mr. Chairman, I may be confused. I thought we discussed this a little bit in Estimates, but maybe I am wrong there. I am probably about to be repetitive. I think, as I have indicated, we have a working group of the RHAs and the WHAs that are giving us a proposal on the lab and imaging for Manitoba for the public labs, Winnipeg public labs and outside of Winnipeg. The objective is basically one program but more than one site, more than just a Winnipeg site, probably a Brandon site and perhaps another site.

So they are in the process of preparing a proposal to submit back to government. We have shared with them information because as the member for Kildonan knows, this issue has been around for a while, the issue of lab services. That information is being provided with them, and I am waiting for them to return with that proposal. I am not sure what else I can say about that area. I am certainly open to any questions.

Mr. Chomiak: Mr. Chairperson, can we get copies of an inventory of the lab and imaging services available throughout the province?

Mr. Stefanson: Yes, we can provide that.

Mr. Chomiak: Mr. Chairperson, again we come across the words "best practices," and I am trying to determine where in the department the concept and the determination is made of best practices with respect to protocols and the like for the provision of lab and imaging services. If it is not here, can the minister outline for me, or if it is here, regardless, what the protocols are for best practices for the various major testing areas in labs and imaging services?

* (1550)

Mr. Stefanson: Mr. Chairman, I am told there are protocols for most tests. I am certainly prepared to return with more information on those protocols. An important part of this proposal from the RHA, WHA, will also be protocols that will be recommended to be in place for various tests. So it is an opportunity to review those protocols in terms of the functions of the public labs and of the labs and imaging outside of Winnipeg. So I can certainly return with an outline of some of the protocols as it relates to the current lab and imaging procedures.

Mr. Chomiak: This is relatively significant, and I do look forward to receiving that. I will be doing follow-up on that because this issue is all tied up in a very complicated process that is sometimes difficult to answer.

But I think I would like to know where the initiative is coming from. I see Best Practices; I see initiatives from SmartHealth to reduce various lab tests in an amount of $20 million to $30 million. I know that primary care providers are frustrated because, if they have to go beyond the particular protocol, they have to fill out a form in quadruplicate in order to justify particular tests. I know that the MBS proposal is tied up in this. I know in terms of reducing costs, and there are additional costs. I mean this area is extremely rife with difficulties, and I really do want to have a bit of a discussion on this. So I am alerting the minister that when he comes back with that information, I will be following up on that fairly extensively.

Did the minister indicate he would provide for us a listing of all of the lab and imaging sites in the province?

Mr. Stefanson: Yes, I did, and I too look forward to that discussion because the member is right: they are all interrelated, the advancements that we are going to make in terms of information technology, but also the whole issue of appropriate protocols being in place for lab and imaging services. So I look forward to that discussion as well.

Mr. Chomiak: I think this is the appropriate point for this question; if not, we can return to it at the appropriate point. There are at least three areas where it is clear, or it has been at least indicated, that there are problems with integrating the particular activity within the regional activity. That conclusion could vary across the province, but I will name the three areas: mental health, aboriginal health, people with disabilities.

It seems to me that what is required is a mechanism at a regional level or an administrative mechanism, some kind of structure, to integrate all three of those areas into the provision of regional services. I am wondering if the minister can comment on that.

Mr. Stefanson: Mr. Chairman, I would welcome the member giving me some examples in this area because, again, I am told that when it comes to the area of mental health and disabilities, that the structure is to integrate these into the regional services. They are being provided at the regional level. The one area that continues to have some issues and some challenges is the issue of aboriginal health, and the issues there are similar to what they have been I guess in the past. We have discussed it here, in part, when we had the member for The Pas (Mr. Lathlin), the whole issue of federal jurisdiction versus provincial jurisdiction. So even when we get down to the regional level, we still get into various issues in that area that have to be addressed.

I think the member for Kildonan knows and probably shares my frustration in terms of dealing with the federal government on really trying to sort that out in a meaningful way and on some kind of a long-term basis to go forward in terms of the federal government clearly accepting their responsibilities and defining them and allowing us to integrate that with everything that needs to be done for the aboriginal community. So that area definitely has room for significant improvement, but I am told the other two areas are integrated into the regional services, so if the member can provide me some specific examples or some issues to address there, I am obviously willing to do that.

Mr. Chomiak: Mr. Chairperson, in my most recent meetings with the Canadian Mental Health Association and at the town hall meeting and the convention that I attended on Saturday with the Manitoba League for the Disabled, in both instances both groups expressed as a primary priority concern the lack of recognition of their particular problems in the regional health care system and both expressed a need for a mechanism in order to ensure that their voices are heard.

Mr. Stefanson: Well, Mr. Chairman, I certainly agree with the objective of opportunities for their voices to be heard, and there are various avenues to do just that starting with the regional health authorities, the boards themselves. Individuals can be nominated or even self-nominated to the boards. We have our district advisory committees in all of our regions, again, which individuals serve on. There are opportunities to meet with boards through the various meetings that they have. I believe the CEOs, board chairs of the RHAs meet monthly. I am sure there would be opportunities to meet with them.

* (1600)

There are opportunities to meet with Manitoba Health staff, opportunities to meet with myself, which I have done to date with some of these organizations. So there are a number of vehicles to ensure that the voices are heard of individuals involved either in mental health or on behalf of the disabled. So, again, if the member has something more specific–I know the only other thing that has been mentioned is whether or not there is a separate committee on behalf of mental health or on behalf of the disabled that would report through to the boards or whatever. I think that is the only other thing that has been suggested.

I guess the caution or concern with that is then where do you begin and end with what organizations you should do that with, when the process itself is meant to be very inclusive and to create opportunities for individuals to have input through all of these means that I have outlined. I am always open to suggestions to enhance input and hearing from individuals and groups, and I would welcome any specific or further recommendations the member has.

Mr. Chomiak: Mr. Chairperson, can the minister indicate whether there has been any update on the community health assessments that were provided last year, and if so, can he provide it to this committee?

Mr. Stefanson: I think the member has already asked me for copies of the community needs assessments for all of the regions, and we agreed that we are preparing that and we will provide that to him.

Mr. Chomiak: Mr. Chairperson, clearly the department must do at a central level an analysis of the budgetary needs and requirements of each of the regions. Can the minister provide us with that information?

Mr. Stefanson: Mr. Chairman, I am not sure if this is a test or not to see if I am consistent because I think we discussed this last time as well. I believe we indicated that for '98-99, we are in the process of basically finalizing all of those–

An Honourable Member: I think it is a test.

Mr. Stefanson: You think it is a test? All of those allocations, the final year-end adjustments in any particular situation. I did indicate that once we are concluded with that, I would undertake to provide the member with that information. I think he also then asked me on a go-forward basis what information I could provide on the budgets for '99-2000, and I think I indicated I would be looking into what information I could provide. I hope that is consistent with what I said last time.

Mr. Chomiak: I do recall that. What I was actually trying to do was to get a sense of a central analysis, for example, a sense of what area of the province certain needs are required, what other area of the province certain other needs are required, and how the budgets are adjusted accordingly. That may or may not be available.

Mr. Stefanson: I am not sure if I am even answering the question here, but all of the budgets from the RHAs come into the Department of Health. They are dealt with by one central unit. That unit then meets with the individual RHAs to go over their requests, their priorities. So it is done on a combination of working directly with the RHAs in terms of what they have requested, what their priorities are, but then that unit also looks across all of the RHAs before they bring forward recommendations through our system, through our budget process and so on and so on. I think that answers the question.

Mr. Chomiak: Yes, thank you, Mr. Chairperson. Can the minister indicate what the policy is in terms of funding for the program? Does it follow the individual? How is it worked between the various regions?

Mr. Stefanson: I think again, as the member knows, the funding currently is provided to the regions, to the facilities to provide the services. They are not funded on a per-capita basis, they are funded on the needs within the regions and the needs within the individual facilities. I think I have indicated to the member I have met with the RHAs, the CEOs and the chairs, and we have discussed a number of issues.

One issue we discussed there is the whole issue of–I will describe it as a funding model. We had discussions earlier today about funding models, and we talked about various funding model options going forward that relate more to needs and services, as opposed to historical funding and so on. That group has put together a working group internally to work with Health and, again, return to me with some thoughts and ideas and recommendations in that area.

So I see a system where we start to get away from funding on historical patterns and so on, and we fund much more related to needs and services. We are starting to make some progress in that area, but there is still more to do, Mr. Chairman.

* (1610)

Mr. Chomiak: So I take it that there is a working group that has been prepared, that is looking at this. Is the group planning to tender for consultative services for any funding model?

Mr. Stefanson: Well, Mr. Chairman, I do not know if the member is thinking of putting in an RFP for this or not. We are at the stage right now where the RHAs have just designated whom they want on the working group, and we are about to designate our people. That working group will then start their process, and with all seriousness they will decide early on whether or not they feel they have access to the information and skills that they require internally or whether or not they need some resources to draw on some external help.

So I am sure that will be one of the early decisions that that committee makes once they start the process.

Mr. Chomiak: Mr. Chairperson, I wonder if perhaps it might be appropriate to take a break at this juncture. We can pass this item. We are going to move into the Chief Provincial Psychiatrist next. I was anticipating to ask not a lot but some mental health related questions at this juncture because of the nature of the department's setup, and I am assuming I should ask them at this juncture before I move on.

So perhaps we can pass the item and then take maybe a 10-minute break.

Mr. Chairperson: Item 21.3. External Programs and Operations (b) Regional Support Services (1) Salaries and Employee Benefits $1,927,900–pass; (2) Other Expenditures $645,700–pass. 21.3.(c) Chief Provincial Psychiatrist (1) Salaries and Employee Benefits $165,900.

Is it the will of the committee to just take a few minutes? [agreed]

________

Mr. Chairperson: The committee will come to order.

Mr. Chomiak: Can the minister give us a sense of who and where the process of mental health co-ordination and reform, where it is located and who is overseeing that particular function?

Mr. Stefanson: Mr. Chairman, if the member were to look on page 73 of the Supplementary Information for Legislative Review, the second bullet under Objectives in this particular section, it deals with "to promote the co-ordinated delivery of a comprehensive continuum of health services encompassing home care, long term care and mental health."

I think that was the question, where that service is provided relative to the co-ordinated delivery of mental health.

Mr. Chomiak: Under whose auspices is it in the Department of Health?

Mr. Stefanson: The executive director of these health programs is Marcia Thomson, who reports to Sue Hicks, the associate deputy minister.

Mr. Chomiak: Probably my questions in this area will bounce around between questions relating to the Chief Provincial Psychiatrist and questions relating to mental health programs in general. But I assume that that is appropriate with the staff members. The minister is nodding in the affirmative.

I wonder if we can get an accounting or an update of the community-based mental health programs that are available both in urban and rural and northern settings in Manitoba and a listing of beds that are designated for psychiatric or mental health patients in those jurisdictions as well. I appreciate that that cannot be accomplished today, but if we can get those up-to-date listings, I would appreciate it.

Mr. Stefanson: Yes, Mr. Chairman, we can provide that information requested.

Mr. Chomiak: The minister is in receipt of a memo dated May 20, as I am, directed to Carolyn Strutt, director of Mental Health from the PACT steering committee relating to a Program for Assertive Community Treatment. I am wondering if the minister can indicate what the status is of the implementation of that program and that pilot.

Mr. Stefanson: The individual referred to I believe is the director of program services for the WCA, so I can certainly undertake to get this information for the member.

Mr. Chomiak: Just for terms of clarification, PACT, or the Wisconsin model has been reviewed and studied by the department. It has been advocated by virtually everybody in the system. I understand that there is an effort and an attempt to discuss with the minister an implementation of that kind of a program. I guess I am wondering of the minister (a) if he can give me his preliminary comments of the departmental view of the implementation of a project like this, and, (b) if he could indicate what the status is from a departmental view of a program like this. Maybe I asked the same thing in (a) and (b), so I want actually an update from the minister as to what the departmental view of the program is.

Mr. Stefanson: Well, Mr. Chairman, I think I would rather confirm and review the issue with the WCA and with the department and get back to the member.

* (1640)

Mr. Chomiak: Just by way of advice, Mr. Chairperson, the minister will be in receipt of another letter from myself this week dealing with an individual whose family is concerned about their well-being because of the concern about a follow-up of treatment. I have asked the minister to provide us with statistics and information as to what processes are in place with respect to programs to deal with follow-up treatments, specifically in relation to the legislation that was passed last year.

The minister will regularly get letters from myself and I am sure other MLAs respecting individuals who are in the community whose families are concerned about their well-being in the community. Having said that, I think that it ought to be of the highest priority, the highest priority, to put in place measures and a program like this or similar to this. It has been done in some jurisdictions, and given the frequency with which we encounter these problems, and given the need in the community, I cannot over-emphasize strongly enough the need for this type of or some related programming.

Mr. Stefanson: The member referred to another letter to me this week regarding follow-up treatment. Again, I will certainly follow up on that. I think he realizes when he does correspond with me on these issues, I do take them seriously. I get them into the department very quickly to do the appropriate follow-up and try to get back to him within a reasonable period of time. So, again, any letters in this area that he is sending me with specifics related to an individual, we do take those seriously and will follow up.

Mr. Chomiak: Mr. Chairperson, I am not suggesting otherwise. In fact, that is one of the reasons that I employ that method of communicating. I was just using the letter that I gave to the minister this week as an illustration of another example of what seems to me to be lack of follow-up programming in the area and my strong recommendation to the department or to the minister to put in place a system and a program to deal with these issues, so we do not have to go through–I mean, we will always have difficulties, but we need a system and we need a program and we need a series of supports in place in order to deal with the next phase of mental health reform, period.

Mr. Stefanson: I know the member is well aware of the significant number of support programs that are already in place and are community-based, and I am certainly prepared to return with a summary and more information on those support programs. But in terms of the specific issue he has raised here relative to the correspondence, I will be following up and reporting back to him, Madam Chair.

Mr. Chomiak: Madam Chairperson, can the minister indicate the number and regional breakdown of psychiatrists in Manitoba; secondly, the number of physicians that participate or are acting in their capacity as psychiatrists as a result of programs that were introduced by the department about three years ago; and, thirdly, where the minister sees the additional need for psychiatrists and psychiatric resources that are offered by psychiatrists with relation to the program the former, former minister, Mr. McCrae, put in place, a program to–I do not know if accreditation is the right word–permit family and other physicians to offer psychiatric services to individuals where psychiatric services perhaps were not available?

Mr. Stefanson: I can certainly return with a listing of psychiatrists. I think the question was by region or by RHA and by program. We can definitely do that. The issue of where there were some cases of family physicians providing some of the psychiatric services, we will certainly determine how readily available it is to provide a listing of that.

I just want to be clear that I understand the third question, which was: where is the need for additional resources? If the question is, where is the need for additional psychiatric resources, again I can return with a listing of that. I think there are a few areas that we need psychiatrists. I can provide that information as to where that is required. I think those were the questions.

* (1650)

Mr. Chomiak: Yes, the third question may be answered by the first two. It was just the question of trying to gauge some sort of need. That was the purpose of the question.

Psychogeriatric services available, I do not know if I should ask questions at this point, but there has been a lot of difficulty determining both location and services available for psychogeriatric services. I wonder if the minister can provide us with information with respect to those kinds of services and an inventory of where available and where plans are to provide psychogeriatric services in Manitoba.

Mr. Stefanson: Madam Chair, I can return with the information. The question was location and services, an inventory of where they are now on the basis of our personal care homes having dedicated psychogeriatric beds and other services being provided through our hospitals, other health care facilities. So I will be able to return with an inventory of where the services are provided and the nature of those services. We also have a geriatric team as one of the project program teams at the WHA, and I will certainly contact them, because the latter part of the question was some of the future initiatives, and return with information in that area as well.

Mr. Chomiak: One of the areas that I often return to through the Estimates process in the area of mental health is two areas. Firstly, if we talk about prevention, probably, next to the nonuse of tobacco, the single biggest area of prevention in my view, would be in early intervention and early education concerning mental health. I would like to know if the minister can indicate what initiatives the department may have or will undertake in this area. The second area is something that has been referred to before as well, and that is in respect of youth suicide, whether or not the province has any undertaking in this regard.

* (1700)

Mr. Stefanson: In the whole area of prevention and early intervention and education, really a good portion of that comes down to our mental health workers in our schools, in our communities. They are certainly providing those kinds of services. I will return in more detail some of the elements of the services they provide.

Related to the question the member asked, as well, Manitoba Health has entered into a partnership with Family Services and Education and Training and Justice to develop the youth emergency and Crisis Stabilization system, which, again, I think the member is familiar with. It meets the needs of most youth who are in crisis. It obviously responds to crisis or emergency situations in the community. There are four beds at psych health that are being funded on a permanent basis to support this service where inpatient hospitalization would be the most appropriate resource. Manitoba Health has contributed close to $300,000 towards the development of a brief-treatment team as a component of this service. As well, Manitoba Health is funding four child and adolescent psychiatric beds. Those are some examples of that particular program.

The whole issue of youth suicide, just to I guess put some statistics on the record first of all, in the case of Canada, only three provinces have shown a decline in overall suicide rates during the 1980s and early '90s. Manitoba was one of them. The Youth Suicide Information Centre health programs monitors youth suicide rates in Manitoba, but, more importantly, the Youth Suicide Information Centre provides information and training to professionals and the public to try to reduce the impact of youth suicide throughout the province. In 1998, the Youth Suicide Information Centre held programs, cohosted the ninth national CASP Conference on Suicide in Winnipeg. Over 180 people attended from across Canada and the U.S. One of the main themes of that conference was the issue of aboriginal suicide. Many aboriginal people from across Manitoba attended the conference. Community mental health workers, as part of their job, assist individuals in communities with suicide issues and concerns. There are 25 adult and adolescent community mental workers in the North alone.

That is a combination of some information on the issue but, more importantly, some of the initiatives that are in place to deal with those issues.

Mr. Chomiak: Would the minister be prepared to table a complete inventory of those programs?

Mr. Stefanson: Yes, definitely.

Mr. Chomiak: I have a series of more questions in this area. For the hundreds of thousands of readers of Hansard, though, I am just apologizing in advance, because I want to move on to a whole number of areas. I am going to ask some questions. I guess we can pass this. Can we pass this?

The Acting Chairperson (Mrs. Driedger): 21.3. External Programs and Operations (c) Chief Provincial Psychiatrist (1) Salaries and Employee Benefits $165,900–pass; (2) Other Expenditures $43,000–pass.

21.3.(d) Selkirk Mental Health Centre (1) Salaries and Employee Benefits.

Mr. Chomiak: I do not have to ask whether Selkirk is going to become a special operating agency, because the minister has given his assurances that that is not, in fact, the case as I understand it.

My next question is that I note that there are 25 forensic patients in–perhaps the minister can clarify. There are 25 forensic patients at Selkirk. If that is correct, what is capacity? Do the present facility and arrangements meet the needs of the province?

* (1710)

Mr. Stefanson: Madam Chair, as the member was pointed to under Expected Results, there are 245 inpatients and 25 forensic patients, for the total of 270. At the facility, there are 18 high-risk, high-security beds for long-term patients, which was developed by renovating one of the existing patient care units at Selkirk Mental Health Centre. So those other seven patients would still be in the facility, but in other beds.

Just to clarify the first comment or question, yes, Selkirk Mental Health Centre will not be established as a special operating agency.

Mr. Chomiak: Mr. Chairperson, just for clarification, do we now have capacity for the need for forensic patients in Manitoba in line with the recommendations that have been made by numerous inquests and related bodies for the provision of proper accommodation for individuals who have been found needing this type of facility?

Mr. Stefanson: The answer to his question is, yes, as we have outlined, we have the 18 high-risk, high-security beds. By being at 25, we are able to accommodate the other seven elsewhere in the centre. So we do have the capacity to meet the needs, Mr. Chairman.

Mr. Chomiak: A comparison of last year's Estimates book and this year's Estimates book bears an analysis. I wonder if the minister can explain why, in last year's Estimates book, it indicated that 400 outpatients were treated at Selkirk Mental Health Centre, and this year's Estimates book indicates 50 patients are treated annually. I assume it may or may not be related to Brandon, and it may be just a definitional difference, but I wonder if the minister can provide an explanation of that. In last year's Estimates book, it says, and I quote: "Treatment of approximately 300 inpatients and 400 outpatients at Selkirk Mental Health Centre."

Mr. Stefanson: We probably should not spend any more time on it now. We will check on it, and I am sure it is one of a combination of things. It might even be a typo error, or it could be, as the member for Kildonan (Mr. Chomiak) referred to, the combination of Selkirk and Brandon because, really, all of those services have, by and large, been shifted to the community. So we will check on that issue and report back.

* (1720)

Mr. Chomiak: I wonder, and I do not expect the minister to have this response today, if the minister can provide us with an update as to the status of all of the former patients in Brandon, location and plans for the allocation of resources in that regard. In other words, what has become of them, where are they going, what are the plans for the future?

Mr. Stefanson: We will certainly return with information on that issue, as the member knows, not that he is requesting individual patients, but a sense of where those patients have gone, whether it is into a personal care home, into community living. So we will return with some further information on that.

Mr. Chomiak: I wonder if also the minister could provide us, again, not today, with an analysis of the number of beds available at the forensic unit at the Health Sciences Centre, occupancy levels and the status of that particular unit.

Mr. Stefanson: The psych health facility, which opened back in January of '93, has 20 beds for the assessment and treatment of short-term patients, and I am told that generally those beds are full.

Mr. Chomiak: I am not sure whether or not I asked this specifically. We will be getting a bed count, et cetera. I did ask for an assessment of all the community-based programs and the like. I do not know if I, in my question, asked to provide a count of all of the psychiatric beds available in the province, but if I had not, I am asking the minister if he could also provide us with that update.

Mr. Stefanson: We can provide that as well.

Mr. Chairperson: 21.3.(d) Selkirk Mental Health Centre (1) Salaries and Employee Benefits $18,425,900–pass; (2) Other Expenditures $3,326,900–pass.

21.3.(e) Emergency Health and Ambulance Services (1) Salaries and Employee Benefits $1,005,200. Shall the item pass?

Mr. Chomiak: Mr Chairperson, the issue of provision of emergency services specifically outside of Winnipeg has been the subject of several questions in the Legislature recently. I wonder if the minister can specifically clarify for me what the status is of the working group that is meeting or what their objectives are, and when they plan to come down with recommendations.

Mr. Stefanson: I will table three copies of just the summary, because I think we did discuss this briefly before about the terms of reference, the membership of the committee and the scope of the working group, so I think that answers the question the member has asked.

Mr. Chomiak: Can the minister table the recommendations of the Emergency Medical Services working group?

Mr. Stefanson: The one part that I did not respond to was just to reconfirm that I am expecting the report around the end of June is the date that I have been provided. Obviously we will deal with that report, and I fully expect the report will become available publicly, so we will receive it hopefully at the end of June and obviously have a chance to go through it. Then I would expect very shortly thereafter that that report will become publicly available.

Mr. Chomiak: I might have been confusing in my last question. The minister is providing me with a copy. Is the information the minister is providing me dealing with Emergency Medical Services working group? Do I understand that correctly from the affirmative? [interjection] Okay, then I will ask the minister, there was another working group that made recommendations with respect to emergency services. Now I do not have it in front of me and if I can I will come back with the specific name of that, and I will ask that when we next meet.

The Lifeflight Air Ambulance Program is expected to deal with approximately 600 acutely ill patients. Can the minister outline what the contract costs are for that purpose?

Mr. Stefanson: Mr. Chairman, we do not have that breakdown here right now, but we can certainly provide a breakdown of the cost of the 600 patients.

Mr. Chomiak: Can the minister provide us with a breakdown of the present existing funding arrangements for providing interfacility transportation in emergency services?

Mr. Stefanson: Just to give a sense of the quantity of interfacility transfers, throughout rural Manitoba, there are roughly 16,215 interfacility patient movements each year in the Emergency Medical Services system. In the city of Winnipeg, the City of Winnipeg transported approximately 5,700 patients within the EMS system. As the member knows from previous discussions here and during Question Period, the City of Winnipeg and the Winnipeg Hospital Authority are working on the issue of transferring the responsibilities for the interfacility transports to the WHA from the City of Winnipeg ambulance system. They have just set aside 90 days to do it and those discussions are ongoing.

* (1730)

Mr. Chomiak: Mr. Chairperson, the minister is saying that the WHA and the city are examining interfacility transport as opposed to emergency transport. Do I understand that correctly, as opposed to a transport from the place of injury or the accident to the facility? Do I understand the differentiation?

Mr. Stefanson: Yes, the member is correct. It is the interfacility transfer issue between hospitals in Winnipeg and, as well, from the airport to hospitals under certain circumstances. So those are the issues that are being reviewed by the City of Winnipeg and the WHA.

I have been provided with some information. The City of Winnipeg about two weeks ago, I think, put out a press release on the issue, so I am certainly prepared to provide the member with that press release and any other information on this review. I am fairly certain it is 90 days that they have set aside to conclude these discussions.

Mr. Chomiak: The minister provided me with statistics. Those related to interfacility, did I understand correctly that they relate to interfacility transports? Are there also statistics which relate to transports in general, emergency transports as well that the minister can provide us?

Mr. Stefanson: Mr. Chairman, I believe we can provide that. I understand the question is the overall utilization of the ambulance system both outside of Winnipeg and Winnipeg. The total numbers, I believe, we can provide those.

Mr. Chomiak: Mr. Chairperson, I apologize. I was distracted a few moments ago when I was asking this question, but will the minister be providing us the present funding models for the provision of emergency services both urban and rural Manitoba? If I have not asked, the minister did not respond directly to that, can we obtain that information?

Mr. Stefanson: Well, Mr. Chairman, we can certainly provide information on the amount of funding we provide on a per RHA basis, as well as, the funding we provide to the City of Winnipeg for ambulance services.

Mr. Chairperson: 21.3.(e) Emergency Health and Ambulance Services (1) Salaries and Employee Benefits $1,005,200–pass; (2) Other Expenditures $3,694,200–pass; (3) External Agencies $51,900–pass.

21.3.(f) Public Health (1) Public Health and Epidemiology (a) Salaries and Employee Benefits $1,793,800.

Mr. Chomiak: Mr. Chairperson, can the minister give us an update as to what the status is of the national harmonized food inspection system?

Mr. Stefanson: Apparently last year there was a detailed briefing note on this. I guess we did not expect the member would ask it again this year, so there is no detailed briefing note. I am told I can return with that update very shortly.

Mr. Chomiak: I appreciate the comment. The minister can simply seek an update on the ongoing development. Can the minister provide an update of the status of the hepatitis B vaccination program?

Mr. Stefanson: As the member knows, last year the hepatitis B vaccination program was introduced in Grade 4. That is going to be continued again this year, and it is going to be expanded to include newborns as well as high-risk groups, like certain health care workers. By starting with newborns and having a Grade 4 program, ultimately the gap will narrow, and they will come together. So there is additional money in this budget for the expansion of the hepatitis B program.

* (1740)

Mr. Chomiak: I would like assurances from the department as to the ongoing review and study of the efficacy of offering a mass immunization program. I am still not convinced from data that I have received from the minister's office that we have adequately considered the ramifications of the French experience, that is, the experience in France, as well as some of the other jurisdictions. I know the minister has probably been lobbied by individuals, as I have. I am wondering what kind of ongoing evaluation is done on the process to ensure that we are effectively promoting health by virtue of the immunization program.

Mr. Stefanson: I think what I should do, if the member is so inclined, is arrange for a personal briefing with Dr. Greg Hammond, which I have had the benefit of in terms of discussing this issue at length in terms of doing exactly what the member is referring to, being sure that we are continuing to review and evaluate any information, any international information, positions of organizations like the World Health Organization and so on. I believe even the French situation was a removal in school, but that they are still doing it for newborns, so I can assure him that we are watching the latest information, latest events, and certainly after my detailed briefing, I was very comfortable that we are doing the right thing in Manitoba.

Mr. Chomiak: Can the minister indicate and, again, not today, what water and food testing is done by the Department of Health, who does it, and how it is paid for?

Mr. Stefanson: I will return with more details, but when it comes to water testing, we have a contractual arrangement with the environmental lab that I will return with the terms of that and the dollar amount of the contract. When it comes to food testing as well, I believe we still have responsibility for food testing in restaurants and other related facilities, and I can again return with more details on the nature of that service and complement and costs.

Mr. Chomiak: Is there any kind of–I have not seen it and perhaps I have just not noticed it, but do we have an epidemiological analysis of some of the major public health concerns and issues in Manitoba? I am thinking of issues like flesh-eating disease, as well as, some of the diseases that affect children in terms of statistical information. Is that available, and if it is, could it be tabled?

If it is not available, I am not asking for any statistics to be compiled, but I am assuming that there are some kinds of studies that are conducted by Public with respect to frequency and location of occurrence, that type of information.

Mr. Stefanson: Mr. Chairman, I will return with details on any studies that are available and have been done in recent years, if that is appropriate.

Mr. Chairperson: Shall the item pass? The item is accordingly passed. 21.3.(f)(1)(b) Other Expenditures $8,781,500–pass; (c) External Agencies $238,100–pass.

21.3.(f)(2) Cadham Provincial Laboratory Services (a) Salaries and Employee Benefits $4,080,000.

Mr. Chomiak: I would like to get a sense of the operating capital requirements of Cadham Provincial Lab in terms of what has been requested and is available to serve their needs. In other words, has there been any input of operating capital at Cadham Provincial Labs recently, or is there any in the budgets and any sense from the government as to short-term or long-term needs from the lab?

Mr. Stefanson: I am told that if you look at the appropriation on page 69 under Other Expenditures, you will see Minor Capital of $69,300. That is available for ongoing equipment requirements. Beyond that, there is no additional capital commitment to Cadham Lab.

* (1750)

Mr. Chomiak: Mr. Chairperson, can we get a listing of–and I know this could be fairly extensive, but there must be a listing in terms of the services provided and volumes from Cadham Provincial Lab. I am not asking for it today, but effectively I am just looking for an update as to services provided and volume, et cetera, effectively an annual report of the functions of Cadham Provincial Lab. Is that available?

Mr. Stefanson: Mr. Chairman, we could certainly provide a copy of the annual report. We will look at whether or not, depending on if it is a '97-98, there is any more current information available.

Mr. Chairperson: Shall the item pass? Pass. Other Expenditures $3,325,200–pass.

21.3.(g) Medical Officers of Health (1) Salaries and Employee Benefits $1,250,800.

Mr. Chomiak: The only question that I intend to ask in this area is a listing of all of the medical officers of Health and their location.

Mr. Stefanson: No problem, Mr. Chairman, we will return with that.

Mr. Chairperson: Shall the item pass? Pass. (2) Other Expenditures $51,100–pass.

21.3.(h) Health Programs (1) Salaries and Employee Benefits $5,523,400. Shall the item pass? It is accordingly–[interjection] Health Programs.

Mr. Chomiak: Mr. Chairperson, we are sort of into a bit of a different approach to the Estimates in terms of how this item is lined up. What I intend to do is ask some specific questions, and then some of them may be dealt with in Section 4, which we will most definitely reach when we next meet. But what I am saying by way of introduction is that it might be a little difficult to not cross over between this section and the next section.

Well, I will start off this way. Can the minister give an update as to all of the pilot projects being undertaken in the primary health care under this section?

Mr. Stefanson: Mr. Chairman, I will return with that information.

Mr. Chairperson: Is it the will of the committee to pass this one and deal with the questions that the honourable member is bringing forward within area 4? Is there a good enough cross over there for the member to deal with everything in 4?

21.3.(h) Health Programs (a) Salaries and Employee Benefits $5,523,400–pass; (2) Other Expenditures $3,303,900–pass; (3) External Agencies $5,474,200–pass.

Resolution 21.3: RESOLVED that there be granted to Her Majesty a sum not exceeding $63,688,900 for Health, External Programs and Operations, for the fiscal year ending the 31st day of March, 2000.

We now move on to No. 21.4. Health Services Insurance Fund (a) Funding to Health Authorities.

An Honourable Member: Let us call it six o'clock.

Mr. Chairperson: Is it the will of the committee to call it six o'clock? [agreed]

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 now adjourns until tomorrow at 1:30 p.m. (Wednesday).