Mr. Chairperson (Ben Sveinson): Order, please. Will the Committee of Supply please come to order.
This afternoon this section of the Committee of Supply meeting in Room 255 will resume consideration of the Estimates of the Department of Health. When the committee last sat it had been considering item 1.Administration and Finance (b) Executive Support (1) Salaries and Employee Benefits on page 68 of the Estimates book. Shall the item pass?
Mr. Dave Chomiak (Kildonan): Mr. Chairperson, as discussed, I note that the minister has brought in some officials as requested with respect to some of the areas of questioning we will be proceeding down today.
I wonder, perhaps we should start out by, perhaps the minister can update us specifically as to what is happening or what is the present status of the contractual arrangement entered into between the government and MDS at present.
Hon. Darren Praznik (Minister of Health): Mr. Chair, first of all, I would like to introduce my other staff who are here today. We have Brenda Nylund, Bob Harvey and Chris O'Neill, as well as Tom McCormack, who join us at the back, who deal with many of the issues we will be addressing.
First of all, with respect to MDS, the consolidation of labs, the process that we conducted that I inherited as minister on my appointment in January was one where we had put out a call for proposals that involved a number of pieces. We received those proposals. We evaluated the pieces. We are not proceeding at this time with some of the pieces that we had asked for proposals, such as looking at a plan for the whole province, but we evaluated those and eliminated those proposals that were not able to meet our call, and ranked, based on the assessment, the three of the proponents who were felt could potentially provide us with a consolidation.
Under the process that we embarked upon in ranking those three, we are just beginning now to enter into negotiations with the first choice to see if we can conclude a contract with them for the consolidation of labs pursuant to their proposal. If we are not able to do so to our satisfaction, then we will proceed to negotiate with one of the other two proponents and so forth. So we are not committed to conclude a contract or committed to attempt to negotiate one.
We also in preparation for this, as the member can appreciate, we have had our staff--first of all, the Associate Deputy Minister for Internal Operations, Mr. Don Potter, is in charge of these negotiations. He is putting together our team. They are in the process of putting together the issues and positions that we will advance as a province putting together our bargaining framework, and once we have approval for that framework they will enter into the detailed negotiations in an attempt to conclude a successful arrangement.
As the member, I am sure, can appreciate, the details of that framework and strategy that surrounds it are something that I would prefer not to--would not be in, I think, the province's best interest to get into a public discussion, given the fact that it is a pretty high-level negotiation. I know the member appreciates the sensitivity around that. But that is where we are today.
Mr. Chomiak: Mr. Chairperson, can we attempt to narrow down two things, the time frame under which the process is proceeding, firstly, and, secondly, can we narrow down specifically what portions of the SOI we are specifically dealing with with respect to the present negotiations with the preferred company?
Mr. Praznik: First of all, the piece we are dealing with is the consolidation of the urban labs. That is the piece of the proposal call that is the urban public labs that we are talking about.
Mr. Chair, we are conducting now with the hospitals our preparatory due diligence work, and we hope to actually begin negotiations in about three to four weeks. Obviously, we have a fair bit to prepare in doing that, and the length of time, we will set a reasonable time to conclude a contract and see how our arrangements are going. If we are not able to make significant progress in a reasonable length of time, given the reports I received from Mr. Potter, then we will conclude we cannot reach a deal and move on to another party.
But I do not want to be in a position where we are absolutely committed to conclude an arrangement. We have to conclude the best arrangement. MDS and their partners, the Manitoba Health Care Professionals organization or union did come up with, in our analysis, the best proposal.
We hope we can come up with an arrangement, but we are not tied to getting a deal here at all costs. We want to make sure we do it right, as I know the member would expect us to.
Mr. Chomiak: So we are concerned with the eight urban hospitals, and how many other health centres? Can we be specific on that?
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Mr. Praznik: Yes, I know this will help, Mr. Chair, members of the committee. For the purposes of our letter of intent, the laboratories referred to or that we will be consolidating are those located in the Health Sciences Centre, the Manitoba Cancer Treatment and Research Foundation, St. Boniface General Hospital, Concordia Hospital, Grace General Hospital, Deer Lodge Centre, Riverview Health Centre, Misericordia General Hospital, Seven Oaks General Hospital, the Victoria General Hospital, Klinic and Mount Carmel Clinic.
Mr. Chomiak: Do you think the minister could table the letter of intent?
Mr. Praznik: Mr. Chair, I appreciate the member's question. If he would give me until tomorrow to review the letter to determine whether or not I can table it, I am prepared to consider that request.
Mr. Chomiak: Can the minister outline for us specifically what deal, what contract, the province is attempting to achieve with respect to the negotiations that are ongoing?
Mr. Praznik: I have to be somewhat careful. I do not want to give away, of course, all our strategy, but some of our considerations--obviously the intent is to see us have a more efficient and cost-effective laboratory system in the city of Winnipeg.
When I say efficient, that is not only in terms of cost but certainly in terms of its delivery mechanisms, one that is giving us modern technology, which becomes important, and a plan, also, that provides for good labour relations. A labour adjustment strategy is also one of the factors that enter into discussions.
Beyond that, I do not want to get into too much detail since we are beginning those negotiations, and it would be somewhat prejudicial to our position if all detail were to be provided to the people we are negotiating with, and I know the member appreciates that.
Mr. Chomiak: I am trying to get an idea as to, at the end of the day, what kind of lab system we are going to see in Winnipeg. I wonder if the minister might elaborate on that.
Mr. Praznik: I appreciate what the member is trying to--the information he is trying to obtain, and I do appreciate he is also respecting the confidentiality of detail in negotiation. I appreciate his consideration. Under the scenario that has been drawn, I think what we are looking at, if in fact--well, I share with him one of the observations that was made to me by Ron Wally who was the president of MDS's partner, the Manitoba Association of Health Care Professionals, the union representing the employees in our labs, and Mr. Wally made the comment to me that if you look to where the future of laboratory services are going in most major centres, they are going to consolidated, very efficient, often highly mechanized, robotic facilities that have a high degree of proficiency, I guess, in the handling of samples. Very efficient, can do a great deal of work in a short period of time, are very, very high quality, high standard facilities, consistent standards. I know the member, just in the area of crime labs, I know we have seen the concern in Ontario with their crime lab and a host of issues around standards and efficiencies and the results that flow from not being as good as one can be.
So we are looking at high standards, high quality, cost effective, efficient, leading-edge technology. Obviously, their proposal was for a centralized lab system that would have the vast majority of work being conducted in probably a highly capitalized facility. The other key to this, obviously, is the ability to move information quickly throughout that system, and that ties in very much with where we are going in SmartHealth and data movement throughout the health system so that results can be communicated very quickly electronically to those who need them within the system, and that is what makes it work, of course, in one central place.
So that is what we envision happening. One of the other proponents in their proposal, I believe, also talked about a centralized lab system. Also another very critical point for health providers is that the system has to be a rapid responder and be able to move from sampling to analysis to reporting back very, very quickly. As Mr. Wally said to me, his union and the people who work in the current labs looking around the continent and seeing what has happened in other places and examining in detail how they work, his group became convinced that this really was the wave of the future in delivering a higher quality, efficient, fast-response product, and that is why they chose to become part of that particular proposal.
So that is what we are trying to aim for in moving us into the next generation of laboratory services. Also pointed out to me, and I just want to check on one point, Mr. Chair, it should also be noted under the proposal that we have that each facility would still retain a rapid response lab of much smaller proportions to do those things that have to be done very quickly, and current technology or systems do not allow it to be done in one central point. So that is where we are heading and what we are looking for and what we hope to achieve.
Mr. Chomiak: Mr. Chairperson, it is a difficult area to try to conceptualize not so much because of what we are seeing happening in other jurisdictions, as much as we have had conflicting messages from the department with respect to direction and with respect to where they are going.
I guess my next question is how consistent is this proposal--and I queried the minister in previous Estimates processes with respect to the recommendations of the laboratory task force. How consistent is this proposal and this direction with those recommendations which included autonomous boards, dividing the city into regions and the like?
Mr. Praznik: Mr. Chair, I believe the reference to regions pointed out to me by my deputy was the four regions in the province, it was not four regions in the city, and that comes down to part of our decision to only move at this stage to the consolidation in Winnipeg. Obviously, there are some concerns about being tied to only one provider of lab services. That is something that has to be weighed out. We obviously want the regional health authorities to have an opportunity to look at their laboratory needs over the next while. I know that Brandon is very interested in the Westman Lab, how that fits into it, and at some point we may even look for another provider or another contract for other parts of the province. But at this stage this was the largest piece of our laboratory services in need of consolidation, and so we are moving on the Winnipeg phase today. So, I guess, it sort of fits in that we have not moved to a consolidation of one lab system for the whole province. We are still open to our delivery system being somewhat different or have other providers in other parts of the province.
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Mr. Chomiak: Under whose jurisdiction will this consolidated public lab system fall?
Mr. Praznik: Our intention--since we are ultimately the payers of this and this is our initiative-- will be to consolidate, obtain a contract and then inevitably or eventually we will transfer the contract and the funding that goes with it to the Winnipeg Hospital Authority, so administering the contract will be part of their operation.
Mr. Chomiak: How will this negotiation, these contracts relate to the oft-expressed concerns concerning the other labs in the city of Winnipeg, most notably the private labs?
Mr. Praznik: Today, specifically, the private labs in the system are not part of this contract or negotiation, but I think if one looks down the line a little bit, you know, if you have a large provider who can be extremely efficient and is on the leading end of technology, they will be a very competitive force in the laboratory industry or business in the city of Winnipeg. They are likely to have some effect, what it will be at the end of the day, we are not sure, but you cannot--I do not think it is unreasonable to anticipate that a very significant provider with a very large operation is going to present a competitive force within the city of Winnipeg.
Mr. Chomiak: Two immediate concerns with respect to lab consolidation are the individuals who want assurances they can attend at their local primary health care centre and be able to have tests taken and lab turnaround done efficiently and, secondly, surgeons and others who provide primary health care being assured that they could have rapid turnaround with respect to the procedures that they are involve in.
Can the minister give us guarantees and assurances that those two significant groups will have their needs accommodated in the new structure?
Mr. Praznik: Mr. Chair, I guess as politicians we are always reluctant, or should be, to give guarantees, because those are hard to do. It is certainly, I would concur with the member--those are the expectations of the public and they have to be significantly the goals of our system. We would not want to be going into a new system that extended turnaround times or made it very inconvenient for people providing samples or practitioners in the system. The key to making this work and having a benefit to us is, in fact, a more efficient system that is convenient to the users and has faster turnaround times, et cetera, and we hope we are able to achieve that. That is certainly a goal and something we will work towards in the negotiation.
I should just point out to him, as well, that for many rural facilities, and my constituency included, the length of turnaround time in having tests taken and results for tests that cannot be done in labs in rural facilities is a rather lengthy one. So I know what he speaks about, that our current structure in rural Manitoba certainly is not a speedy one, in many cases, and the provision back of results is also a bit of a concern. So, at the end of the day after Winnipeg, we would also like, particularly with the new electronic technology, the ability to improve the system overall right across the province, and I would suggest in northern Manitoba, that issue is even more severe in terms of length of turnaround time on tests.
Mr. Chomiak: Mr. Chairperson, what are we negotiating with MDS? Is MDS going to be a manager? Are they going to own the assets? Are they going to provide capital? What are we negotiating for MDS to do?
Mr. Praznik: Mr. Chair, I appreciate the breadth of the member's question, because these are some very important issues. I know on the USSC consolidation of food services contract, what in essence they were doing was contracting the management of the system function. I think we are doing more than that here, but the detail of how we work this out is subject to the negotiations that we are now entering. I just flag with him, the way one structures these sometimes can result in savings that we obviously may enjoy. We are looking for what works out to be the best cost-effective way of delivering a higher service, higher quality product. So I do not want to get too much into the detail because, as we get into those negotiations with them, these kinds of issues will get sorted out as to what elements they will actually own and build and operate.
So I appreciate the breadth of the question. It is an important one. My staff who were involved in these negotiations are somewhat reluctant to get into greater detail, given the fact that we are narrowing some of these things down, and they get into our own strategy and planning for those negotiations.
Mr. Chomiak: Mr. Chairperson, will the minister give assurances to us in the committee that when the contract is concluded that all information will be made public with the exception of obvious information that for proprietary or competitive reasons would, obviously, not be something that would be made public but that all of the respective details will be made public?
Mr. Praznik: Yes, Mr. Chair, with the caveat that the member has placed on that with respect to proprietary information, I think as public money it certainly should be public, and we will do that when we have reached that point.
Mr. Chomiak: The process that took place, with respect to the amalgamation of the EITC labs and some of the other labs, saw them move into being special operating agencies and then ultimately privatized. Are we going down a similar road with respect to the public labs in this process?
Mr. Praznik: Mr. Chair, we are not, in the proposal calls and the proposals that were made, looking at a special operating agency scenario here. That is not part of it. So it is a somewhat different trail than we embarked on on those other laboratories.
Mr. Chomiak: Has the EITC lab or Cadham lab been considered for part of this total package by the government or MDS?
Mr. Praznik: Yes, Mr. Chair, at the current time, and under the negotiations that we are entering into, the list, as I have outlined, is the laboratories that we are looking at. Obviously, once we have concluded this lab at Cadham, we would want to see how it all fits into the picture in the long haul, as we would with all of our rural laboratories, but at this current stage of events, we are only dealing with those labs that I have outlined in the letter, and only those will form part of this contract that we conclude.
Mr. Chomiak: Insofar as the proponents of MDS and their partners, as I understand it, have an arrangement with respect to the provisions of jobs, is the government prepared to guarantee, as well, at least job levels commensurate with those containing the agreement between MDS and their partners?
Mr. Praznik: Mr. Chair, I am not quite sure what the member--perhaps he might want to give a little more detail. Obviously, labour relations costs and strategies were part of the evaluation of proposals. MDS and their partners have an excellent strategy in place to ensure that staff who currently work our labs are not left without employment. They obviously will need whatever level of staffing to do the job in whatever system we negotiate in the contract.
I believe, as part of their arrangements, I do not know how much they have talked about this publicly, but as part of their agreement between the union and MDS, they have provided for other opportunities for staff, I believe either within their company or by increasing the workload, attracting extra business in essence from out of the province to a centralized facility that would increase their volume above the staffing levels they would need to run the operation efficiently. So at the end of the day, we would not be seeing people leaving unless it was because they chose to do so. I do not know if the member is looking for something more to that, but that is the information I have to date.
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Mr. Chomiak: I think that generally covers it to the extent that the minister seems to be saying to me that it is the government position, as well, that they agree with the provisions contained in the agreement between MDS and their other partners, that certain staff levels will be maintained.
I guess the second part of my question is: Is the government prepared to assist NICRIS? That gets into negotiations, so I probably cannot get a response to that. But I will try.
Mr. Praznik: Mr. Chair, I think what the important thing to note in this, and I have had the privilege of a briefing from Mr. Wally, the arrangement between his union and MDS is a contractual agreement between the two of them as parties. Based on that contractual agreement, MDS was able to describe their strategy as part of their proposal.
So we will want to ensure that any matter in a proposal is ultimately worked into the agreement, but it is legally enforceable as well, most importantly, I guess, by MDS's partners, and they are satisfied that their interests in employing their members have been satisfied in their MDS agreement. So that is enforceable by them, and it would not be appropriate for me to involve myself in their contractual obligation. My role here would be to make sure that the proposal as made by MDS for their relations is part of our agreement, but that particular union is a party to another agreement with MDS.
I think the two interesting points that Mr. Wally briefed me on was that their members viewed this as moving our laboratory system into the next century in being leading edge which is good for Manitobans, and their members saw greater job security and opportunity in being part of a leading edge operation as opposed to one that is declining.
Secondly, MDS as a company provided the opportunities because, obviously, a consolidation is going to result in fewer positions providing the same service to our system today, but by having leading edge technology, the opportunity to attract other work to that facility from out of province thereby increasing employment opportunities and also being part of a system that operates in many places also gives opportunities for those people within the laboratory industry, not only to ensure they have a job, but I would imagine, just speculating here a little bit, too, it gives them opportunities to advance and grow in that industry, into management and other positions that they would not have had within the current structure in the province of Manitoba.
So when they weighed out their options, I am advised that they saw this as moving into the future which had more opportunities for them than staying with the status quo. I would not think Mr. Wally and his members would have embarked on this arrangement if they were not satisfied that it was ultimately in their best interests.
That formed part of their proposal. I do not know all the details of their arrangement. It is not my purview to, but what was part of their proposal, ultimately the thrust of their proposal, which was weighed into the assessment process will be an issue that we will want to incorporate or define into our contract.
Mr. Chomiak: So if I understand correctly, those particular aspects of the proposal, for lack of a better word I will use to maximize employment, would be part of the government's position with respect to the signing of a final contract.
Mr. Praznik: By maximizing employment, yes, we obviously want to make sure that there is a good labour strategy here, but, also, too, I believe that the additional opportunities, if part of this leads to more work being done in the province, we certainly would welcome that as well.
Mr. Chomiak: Can the minister indicate with respect to the documentation and the proposal that came back what the time line was with respect to MDS for the formation of the system that the minister dealt with earlier, because the SOI had very specific time lines and deliverables attached to it with specific dates?
Mr. Praznik: Until we have completed negotiations with those firm time lines for completion of MDS's part of the bargain, I would not want to make a commitment on it, but we are very anxious, as they well know, to get on with this and see it happen as quickly as possible. I share with the member as well that part of our capital strategy in redeveloping the Health Sciences Centre, by consolidating laboratories we free up a significant amount of space at Health Sciences Centre, somewhere near 100,000 square feet of space, and that space is in great demand in the capital reworking program for the Health Sciences Centre. In fact, it allows us to advance some of our projects there significantly. There is also a capital saving involved in that, so we would like to see this all happen as quickly as physically possible in order to move, not only to get into the better lab system but also to make that space available for other capital needs at HSC that we have to address.
Mr. Chomiak: Will the minister be able to provide us with details on the utilization of space and the capitalization when we get to the area of Estimates dealing with capitalization, just so that I have some idea as to where that 100,000 square feet is coming from and those kinds of details? Would that be possible?
Mr. Praznik: Yes, Mr. Chair, I think we are planning on tomorrow dealing with capital, that was the plan, or Monday. So it will be Monday. Then we will have Linda Bakken, my Facilities person here on Monday. We can just make a note, and we will be able to get into those details.
Mr. Chomiak: Just on administrivia here, since we are into the hundreds of thousands of readers, I am sure, of this Hansard debate, so that they will know some idea of where we are going, I am a bit afraid I am going to go on far too long in this area, because I have a tendency to do that, so I am not going to go much more extensively in this particular area, and my plans were to move into SmartHealth and then to start moving down the line by line in the Estimates to then allow us to go into Thursday to deal with, to move into Continuing Care, allow us to go through there and probably, as it was indicated earlier, wrapping up Monday or Tuesday or probably Monday I guess with respect to capital and all those other areas we have not covered. So that is what I am probably targeting for. I just have one or two more questions in this area before I move on.
Can the minister indicate whether or not there has been any difficulty with respect to obtaining information from the various facilities, from the eight facilities and two clinics with respect to putting together the package for the review and the negotiations?
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Mr. Praznik: I am advised by our people who are working in this area that ensuring everybody was happy with the processes of gathering information, that hospitals were comfortable with this, that all of that work has been done and that both the facilities and MDS are comfortable with the process of obtaining information or getting what one needs to be able to conclude this contract.
Mr. Chomiak: Mr. Chairperson, I am happy to hear that insofar as we know that some of the facilities had another proponent and insofar as the minister has indicated two points, that, should negotiations fail, there is a possibility of moving somewhere else and, alternatively or in addition, there is a possibility of other proponents taking part in a province-wide perhaps future consolidation. There could be a tendency for some interesting negotiations between participants in this venture.
Mr. Praznik: Mr. Chair, the member for Kildonan and I, perhaps because we are both north end or I am north of the north-end boy here, we both know that one should never put all one's eggs in one basket when one is negotiating. I am pleased to say today that we are not so committed to anyone that we would not be able to negotiate the best possible contract. I do not think we would ever want to be in that position, and I appreciate that he has gathered that is, obviously, where we want to place ourselves.
Mr. Chomiak: Mr. Chairperson, I was going to move now down the road of the SmartHealth contract and arrangement. This is another area where we have spent literally dozens of hours in past Estimates and time is not going to allow us to do it on this occasion. So I think I would like to commence by--I wonder if the minister might outline for us structurally what is happening with respect to his department and the interrelationship between his department and SmartHealth at present?
Mr. Praznik: Yes, Mr. Chair, if the member will bear with us. I only have one copy of this handy. Staff could make a couple of photocopies, and I would be delighted to table the organizational chart as to how we put this together. I think it makes it much more clearer than explaining it orally.
Mr. Chomiak: I thank the minister. In the interim, I wonder if the minister can indicate what, if any, money has flowed with respect to the interim trust operating arrangement that was structured and set up wherein money was supposed to flow after 18 months, and I believe we are past that period or before the first deliverable.
Mr. Praznik: Mr. Chair, to date, no funds have flowed, I am advised, although there are some, I believe, that are due this fall.
Mr. Chomiak: Mr. Chairperson, can the minister indicate what is flowing this fall and for what purpose?
Mr. Praznik: Mr. Chair, I believe it is about $450,000, and it is for work that was done going back to last year, I believe, as part of this.
Mr. Chomiak: Mr. Chairperson, I thank the minister for this chart. The chart is entitled Integral Communication.
I wonder if the minister might briefly outline for me who basically comprises the steering committee, the Health executive management, the Health program management? What I am effectively looking at is an integrated working relationship between, I assume, the Department of Health and SmartHealth and the various governmental committees, so maybe the minister can put it together for me.
Mr. Praznik: With all the committees we have in health care, maybe the minister can put it together for himself, as well, while I am doing this and going through it, just to refresh my memory.
The health information system steering committee to which all of this ultimately reports--and under my tenure I think I have had one meeting of this committee, by and large to be briefed--it consists of myself; the Honourable Eric Stefanson, Minister of Finance; Mr. Frank DeCock, Deputy Minister of Health; Mr. Julian Benson, Secretary to the Treasury Board; Eric Rosenhek, Provincial Controller; Bob Swain, who is Secretary to the Economic Development Board, and that is the steering committee.
Now, the Health executive management group would be--the same structure as mine organizationally--my deputy minister, Mr. DeCock, and my three associate deputies, Ms. Hicks, Mr. Potter and Ms. Ellis. Obviously, health program managers would be the managers of each of the program areas in Health.
So, really, all of this is coming together through our normal management system, our new management system that has been in place, that just recently we put in place within the ministry, answering to the steering committee, which is really Eric Stefanson, myself and our appropriate people who we have to have there.
Then, under all of this, we have a number of committees working in a variety of areas. The Multi-Stakeholder Advisory Committee--has the member seen a list?
Mr. Chomiak: Yes, I have one. I could just indicate now, when we get to this level, I do have previous documentation, and I am familiar therein with the structure, and I thank the minister.
So where does SmartHealth per se integrate together with this structure?
Mr. Praznik: The Health Information Network, this whole system, in essence, we as the ministry have contracted with SmartHealth. They provide the facilitation. They do the administrative work. They also, most importantly, are doing the technical work in putting this system together for our program managers.
So this is very much an internal operation. It is not like we have said to a contractor, go and come back in so many years with a system for us. We are really saying we want to build the system. Here are our own people who have to be part of building it. They know what they need, and we have gone to the experts who have experience in putting together complex systems. They are working with all of our various areas and advisory committees to do their respective pieces.
So at the end of the day, we will be able to, piece by piece, put this system together. So that is SmartHealth's role, really, as our consultants, technicians, technical people, to be able to build this system with us, and they are very much integrated in this organization.
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Mr. Chomiak: All of this technical and all of this work that is being done by SmartHealth is being financed by?
(Mr. Jack Penner, Acting Chairperson, in the Chair)
Mr. Praznik: Mr. Chair, I would just like to revise one of my previous answers somewhat in being advised on this financial matter. The payment we spoke about earlier, the 400-and-some thousand dollars which is due this fall is due because the contract period of 18 months is reached, but I understand we are attempting to negotiate.
We obviously require some more time to get all of these things together. Obviously the privacy legislation is a critical part to this puzzle, so it may take us somewhat longer than 18 months to be in an operating position. The plan obviously in this contract was to pay for the cost of the system through the savings. I know the member has been through this with Minister McCrae. It is important that we obviously match our payments with savings. Because of a few factors in getting the system running, there might be some difference here. We have to work that out with our contractors who are helping to build that system.
It is important to appreciate that we also have within this contract, if we cannot achieve savings, if we cannot achieve better efficiencies to pay for it, we will not proceed. But the full expectation is that we are going to be able to do it. I guess one of my difficulties as a minister today is that the contract, or the ability to start implementing, is very dependent on having privacy legislation in place. It has taken a great deal of effort to put that together. We have advanced that at a phenomenal rate.
Just to share with the member, one of my dilemmas when I took over this portfolio is that the work of the privacy committee, the expectation in January or beginning of February is they were four to five months away from completing their work, which meant we would not have had a bill for this session. So we have had to advance that in leaps and bounds and dedicate a lot of resources. Chris O'Neill has been involved in that, who is here today, a huge amount of effort and time to be able to get that bill in.
As the member knows, I introduced it for first reading today and will be distributing it tomorrow, I believe in the morning, to each member of the Legislature. So again that piece is critical to advance the other pieces. So it is coming together, maybe not exactly how we initially envisioned but pretty close.
Mr. Chomiak: So I take it that the $26-million borrowing authority is still in place and still intact and has not been drawn on, but that the minister is saying he envisions that $400,000 will have to be drawn upon in the fall.
Mr. Praznik: Yes.
Mr. Chomiak: Mr. Alexander has left. Who is replacing Mr. Alexander?
Mr. Praznik: Mr. Chair, we are currently--we have advertised it and are running a competition for that position. I understand that we will be interviewing shortly for it. The position has changed somewhat in our organizational chart, as the member appreciates, as well.
Mr. Chomiak: Can the minister indicate what that position will be?
Mr. Praznik: Mr. Chair, instead of being an assistant deputy minister position before, it will be an executive director position that reports directly to the Associate Deputy for Internal Operations, Mr. Potter.
Mr. Chomiak: Mr. Chairperson, is the minister aware of where Mr. Alexander went?
Mr. Praznik: Pardon me, it was to Sue Hicks, the Executive Director of External Operations.
I understand that he is now president-CEO of Rx Canada Incorporated in Toronto.
Mr. Chomiak: Mr. Chairperson, so the individual--I guess, in terms of responsibility, I am trying to isolate who is responsible in the ministry for the carrying forward of this project. Ms. Hicks and the individual underneath who will be executive director--where is it sitting in the organization of the department?
Mr. Praznik: Mr. Chair, the member refers to the organizational chart we put out. The project responsibility is with the executive director we are hiring, and who will report to Sue Hicks, the Associate Deputy Minister for External Programs and Operations. So that within my executive, she will have the responsibility to ensure this is done; and on the operations level, it will be the person we are hiring.
Mr. Chomiak: Mr. Chairperson, though Mr. Potter is responsible for health information systems, computer systems and operations, that is where I get confused.
Mr. Praznik: Mr. Chair, that is our day-to-day current operations within the department. Once the system is up and operating, it may move over to that part of the department. As my associate deputies when I appointed them, I charged them to go in a room and sort out who would be looking after what in a logical way. It was felt because so much of this network has to deal with building our relations with those who are delivering care, the vast majority of which are outside of the department and regional health authorities, that the building of the system would be best housed there.
Once it is building and operating and it is a matter of just administrating the central system, then the likely place to be is in the internal program side. So this organizational chart does give us the ability to move some things around in reporting relationships depending on their current state of affairs. In some cases where we are building a system and we are working very closely with the regional health authorities, it is best it be there. When it is up and running and the kinks are worked out of it, then it is likely to be better placed once it is out of the construction phase in internal operations. So this gives us the ability and we envision that happening in our organizational chart.
The other area where this will probably be even more the case is under Roberta Ellis's part, the Human Resource planning and projects. Some of the things that we may take on may require an associate deputy, hands on, to get them developed, operating, kinks worked out, and once the construction phase is finished move them to where they are best suited administratively. So we designed our organization to be able to accommodate and have that flexibility.
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Mr. Chomiak: Mr. Chairperson, last year when I queried the minister on the whole issue of technology and computerization--and I am not going to go down that road--I got faint assurances from the minister that the co-ordination was basically in the ministry through Mr. Alexander, and between the ISM contract, between hospitals procuring their own systems and between the SmartHealth agreement. I am not totally convinced that there is a consistent theme on this. I wonder if the minister might comment on that.
Mr. Praznik: Mr. Chair, whenever it comes to information technology, particularly as we reach this year-2000 problem that our computer experts are discovering now in the last years of the 20th Century, these are very valid concerns that I share with him. I think it is going to be very incumbent upon the person we hire, and certainly with Mr. Potter's responsibilities in the department and our executive, to ensure that we are not building systems that are incompatible with one another, that they must be able to interconnect. They must be able to deal with the year 2000.
Mr. Webster has spoken to me about this as one of his big concerns because all of the hospitals very shortly have to make decisions in this area. He has advised me that he is already into discussions with them to make sure it is done consistently, and we will want to make sure it is done consistently with us as a ministry and also with the regional health authorities. All the RHAs' CEOs have also agreed, and their chairs have agreed, that we have to take a consistent province-wide approach. So now it is making sure that it is handled. This Health Information Network has to be part of it. Mr. Potter is also well aware that all of our other computer information systems on accounting, et cetera, have to be compatible as well. So they all know their charge from you and I as legislators, from me directly as minister, and I would expect that we will be able to succeed in this important task.
Mr. Chomiak: Mr. Chairperson, we have spent considerable time in years past dealing with the issue of specific--and I will use the departmental term "deliverables" with respect to the SmartHealth deal and the various stages. I wonder if the minister can update me and us specifically as to where we are at?
Last year the minister outlined five highlighted areas, five areas that they were prioritizing. Those included DPIN, lab design services, et cetera. I wonder if the minister can specifically outline for us where we are at with respect to each of the deliverables?
Mr. Praznik: Mr. Chair, if I could endeavour to have your staff make a photocopy of this project forecast, with all the appropriate caveats that this is an administrative forecast, I am sure the member will not hold me to it necessarily to the day and I would hope not the month, but if I could have copies made then I will gladly table that. I think that answers the question in a better way than if I were to try to verbalize the information on it.
Mr. Chomiak: Mr. Chairperson, just awaiting that, the minister made reference earlier with respect to the public lab consolidation. Is it the plan of the government--and I have not looked at the chart--that the consolidation will integrate one of the components or a number of the components with respect to this project? Now, I know it is certainly the plan within the long term, but I am talking about the short and medium term.
Mr. Praznik: Very obviously, yes, there is a huge relationship between the two, because part of making a consolidated lab system work is the flow of information from the lab, when test results are there, very quickly to the care providers, whether it be at a hospital or a nursing station or they be in a doctor's office. So the two are very much dependent upon another. Obviously, in consolidating labs, we expect to have financial benefits there, and with our information system we also intend to see benefits of not having to repeat tests unnecessarily.
I know my own experience when my daughter was ill a couple of years ago, and we took her to Health Sciences Centre, I know she had a blood test in the emergency admitting when we came in. Three hours later when we got her into a room, which was a reasonable time to wait, I guess, we found that the nurse was coming to give this little two-year-old another drawing of blood for another blood test. I said, well, she just had one. The nurse said, well, I do not have it on my chart. I said, you are going to give another test, we just did one three hours ago. So she went and she found it. But it is that kind of--the member knows those inefficiencies are there. So this system allows us to prevent unnecessary testing, and so the two fit together, but you need a good information system to make a consolidated lab system work.
With respect to the document I have just tabled, Mr. Chair, I think these are forecasts as to when we expect a number of these things to happen and where we expect them to happen. As I said, in this business there are lots of things that can delay implementation, so this is a rough guide of expectation, not something I would expect to be held firmly to.
Mr. Chomiak: Mr. Chairperson, I think that goes without saying, and I think it had also been widely predicted that this probably would be the case with respect to this kind of a project. I wonder if the minister can specifically outline for me detail on this chart, that is, so that I understand it correctly, and going through it item by item, that sometime in mid-1997, all hospitals will have access--no, within, obviously the time frame is flexible--a drug profile of every patient that is being admitted in E.R. Is that what is meant by this initial item?
Mr. Praznik: Mr. Chairman, acceding to your request, I really wish I could have the indulgence of the committee to have Mr. O'Neill explain the great detail of this chart. Would that be permissible? Mr. O'Neill, perhaps you would like to address the committee and explain the operation of each.
Mr. Chris O'Neill (Senior Finance Manager, Health Information Network Project): Mr. Minister, Mr. Chairperson, members of the committee, first of all, DPIN stands for Drug Program Information Network. That is the existing information system for retail pharmacies. The intention of that project is to expand that information into the hospital sector, primarily in the emergency rooms and possibly admitting, although we are still looking at the feasibility of doing that, but essentially to provide that information so that when people require health services, the providers in the hospital have access to that information to speed up the process, because right now they are gathering that information manually, and it is very time consuming.
First of all, where we are at on that is we are just at the end of what is known as Stage 1 which is the conceptual design and the initial design, and we have submissions for Stage 2 which is the detail design that are in the process of going through the approval process in government. Our intention is to get that design done over the summer and start building toward late summer to be rolling out some time in fall this year or winter this year or early next year with that functionality into the hospital sector. So that is what the DPIN is.
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DSIN stands for Diagnostic Services Information Network. That is also currently in Stage 1. It is not quite as far ahead as the DPIN, but very much in Stage 1, in the initial design, and very shortly also we will be starting Stage 2 which is the detail design. The physicians, we are at Stage 0. We have a proposal before Treasury Board for Stage 0 to begin the process of putting that together in terms of our consultation and feasibility study. We also have a proposal before the minister right now to start working on the Stage 0 for community health, so that those we will start doing the feasibility late this summer, early fall, so that as DSIN and DPIN start coming on-line, we will start working on the design of those.
In terms of the infrastructure, we have finished the design, what we call the target architecture. It is the technology design and the technology concept including, I hesitate to use a technical term, but data-entity relationships; in other words, what data is in the system and how it flows between care providers and the ministry. We just in the past couple of days received a work plan to actually start the process of building that infrastructure with, of course, the intention, once DPIN and DSIN start rolling out, the infrastructure will be in place to carry them.
So that, in general, and hopefully in understandable terms, is the current status of the project.
Mr. Chomiak: I thank the minister and the Chair. That was a very useful experience. I have some questions though. We are at the first phase, and I now understand why the lines proceed through on this basis. I did not pick that up, and, again, that is very useful.
When we say DSIN, are we talking about all lab tests in general, or what are the parameters, what is the range of DSIN?
Mr. Praznik: Mr. Chair, if the committee will indulge me, I would like Mr. O'Neill to answer this very technical question.
The Acting Chairperson (Mr. Penner): Proceed.
Mr. O'Neill: What will be on DSIN will be a diagnostic profile, so it will be a summary of all of your diagnostic history, both laboratory and imaging; for instance, in the imaging, not the X-rays per se but a summary of what X-rays you have had and what the general results of those were and also information as to if a care provider requires the actual image or more detail in terms of the results as to how to obtain that, the location of where the results are and the name of the person to contact, that type of information.
Mr. Chomiak: Now, that is the profile that will be on DSIN. How does that differ from test reporting that is indicated on the chart to come into place for mid-'98?
The Acting Chairperson (Mr. Penner): I would interject here, and I would suggest that we are as committee--during the nine years that I have been in this building, this is somewhat of a precedent, asking staff to answer questions, which I welcome as Chair.
I think we should probably have done this much sooner, because I think much of the information that you are seeking is of a technical nature, and certainly there is nobody better qualified than the person answering the question dealing with these issues everyday.
Therefore, I welcome the approach that the minister is taking in this matter, although it might be a bit precedent setting. I hope that maybe others in committee can take some measure of comfort in allowing this to happen. So I would ask that we continue on this basis until we have addressed this issue, if that is the will of the committee.
Mr. Praznik: Give it to Policy, we will get back--
The Acting Chairperson (Mr. Penner): Certainly, so proceed then?
Mr. O'Neill: Sorry, now I have forgotten the question.
Mr. Chomiak: Perhaps the question was not put that well, but what is the test reporting there for, on the next line, that is, and how does that differ from the DSIN?
Mr. O'Neill: That is the results of the tests that I was referring to, and that information will be retained on the system. So, if for instance, you have a test done, the results are reported to your physician. Then the next time you access the system, you go to the hospital or you see another physician, the second physician or the hospital can look up the information, and they will see a summary of that.
Mr. Chomiak: I see the time line as we move toward--okay, I think, now I am understanding the flow chart. What does the reference to cards in mid-to-early 1998 refer to?
Mr. O'Neill: We are actually still working on that. That is one of the things that we have to look at when we get into the actual design phase.
Mr. Praznik: This is obviously one area I know a little bit about, but as Mr. O'Neill has indicated on the cards, obviously, the access point to the system becomes the card, plastic card. I know we have talked about the Royal Bank being involved, but it is, in essence, like your banking card with your information. There are a number of details that I believe have to be worked out about what information--will it be an access strip or contain information on the strip. There will be questions about what will the card look like. Obviously, we want it to be something that Manitobans find attractive and are happy with.
There are also security issues related to the card having access numbers, so all of these things have to be worked out and that is what it is about. That becomes as public a matter as politicians, that becomes a very important point, because that is going to be the point at which the public accesses the system. That card, in essence, becomes the focal point of the system. So I would think that is an area that is going to require a great deal of our attention, my attention as minister, and also to make sure it is worked out properly and that it has a high degree of public comfort and acceptability. So that is what the card is about. Mr. O'Neill may have other things he may want to add to it.
Mr. Chomiak: This is probably to the minister. It is a reiteration of a point that I made. Basically, the card will become the means by which to access the system, but not the carrier of information. Is that correct?
Mr. Praznik: Yes. Although we have not formally seen that decision made yet, it is very likely that is going to be the case because of the inability to store all that information on the card, and also security issues that I imagine would arise with it. Quite frankly, in our financial institutions that have a reputation of high security, their current system is an access card that accesses the system as opposed to the bearer of information.
I guess the equivalent would be a telephone long distance card that contains a certain amount of cash, or information on it that runs out and makes the card irrelevant at some point. That would not be a good system for us. I also would just like to flag with the member one of the questions I had is the need, obviously, for an override ability. If someone is in an emergency situation and the card is not usable or the personal identification number is not able to be conveyed or utilized by that individual, there has to be some way to override the system in the emergency, and that is part of the kind of policy decisions and questions that have to be worked out in this time frame around the general issue of card access.
Mr. Chomiak: I wonder if Mr. O'Neill might take us through the test-ordering portion of the chart as well as electronic prescriptions and perhaps describe specifically what is meant by both of those terms on the time line.
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Mr. O'Neill: Again, we have not worked out the exact specifics. That is what we will do once we get into stage two, but on a conceptual level, the intention of the DSIN project is to start with the test results reporting, and also I should add--no, I am sorry it is not on this--but also management reporting practice profiling. So, for instance, physicians who receive the test results electronically will be able to look at a history of that patient's tests or information as to their test ordering patterns, that kind of thing.
So that is information flowing from the labs back to the care providers. Once we have that in place, then we are looking at coming back the other way with the care providers actually ordering the tests electronically so that we have a complete loop.
Mr. Chomiak: What is the breadth and the scope? Are we talking about dealing initially with, say, the large urban hospitals in Winnipeg and then extending it out, or are we starting in the north and rural Manitoba and extending within? Is there a plan? I do not know, this may be more appropriate to the minister. Is there a plan with respect to how the system will be phased in?
Clearly, it is not going to happen all at once in the province, or maybe it will. Perhaps Mr. O'Neill can outline for us what the scenario is in that regard.
Mr. Praznik: Yes, Mr. Chair, the member is quite right. One would have to phase--and I am just being advised here now that the recommendation to us to administer will be to begin with three pilot projects, one in northern Manitoba, possibly one in rural, and an urban one. That is the recommendation that my technical people will be making to us, and ultimately we will have to make a decision.
Mr. Chomiak: Has there been any major changes or developments with respect of the DPIN program or any new initiatives taken with respect to DPIN since last year?
Mr. Praznik: In looking at how the system was operated over the last year, our staff recognized that one of the gaps was in the hospital sector. So their recommendation--I do not know if we have put it in there yet but it will be. Part of their plan is to put the DPIN into hospital emergency rooms. That was a void that was discovered in our initial planning that I gather now we are planning to fill.
Mr. Chomiak: And that would account for the drug profile issue and on the chart for targeting for 1997, and that is what we are referring to. Is that correct?
Mr. Praznik: Mr. Chair, I am advised that is the case.
Mr. Chomiak: I must admit in a few short minutes of explanation I probably understand more about the process than I did in hours and hours of questioning on previous occasions. No reflection on--it could be a question of my ability to integrate information.
I think this is a fairly concise and accurate explanation. Where are we at in terms of the other projects, though, with respect to the longer-term projects with respect to the SmartHealth project?
Mr. Praznik: Mr. Chair, I am going to, again with the committee's kind permission, ask Mr. O'Neill to update members on this. I think it is a very useful way of getting one's mind around a very complex area and, I admit very candidly, as a new minister, I am still in the process of familiarization with so many of these details. So, with the committee and Mr. Chairman's concurrence, I would like to have Mr. O'Neill answer that question.
Mr. O'Neill: Mr. Chairperson, to finish off the list and go through them, the physicians' component--and by the way I apologize, that is a misspelling, after physician it should not say PCP, it should say PCH, personal care homes. Oh, wait a minute. I am sorry, primary care providers. I am confused myself. Anyway, that is to provide Health Information Network functionality into physician offices and into physician clinics. We have a submission before Treasury Board to proceed with the Stage 0, which is your high-level feasibility study and identification of what it is and what the possible benefits are.
The community health component is, of course, all of the community clinics, health promotion, public health, that sector. We have a document that has not yet gone to Treasury Board, is in the ministry at this point, that is requesting to put together the work plan for a Stage 0 to go forward to Treasury Board to start the high level on that. We have not started on the hospitals or the consumers yet. We anticipate, though, that once we near the completion of the physicians' component and Stage 0 of the physicians' component and community health, then we will be starting the Stage 0 of the hospitals and consumers.
Mr. Chomiak: Mr. Chairperson, so where do personal care homes fit into this profile?
Mr. O'Neill: Mr. Chairperson, under the hospitals. The hospitals should actually say hospitals/personal care homes.
Mr. Chomiak: The long-term projects, the preventative projects and some of the issues that the minister talked about two years ago with respect to notifications to consumers of congenital and hereditary defects and things along those lines, where do they fit into this chart?
Mr. O'Neill: Mr. Chairman, I am not sure I understand the question, but if the question relates to the consumers and allowing consumers access, again, we have not started work on that. We are awaiting the outcome of the passage of the privacy legislation on the regulations, and given a number of the privacy, confidentiality, security issues that particular piece probably will not come for quite some time. However, within the ministry and within the Health Information Network project, we understand very clearly that our mandate is to not only try and cure illness, and what not, but to promote health and wellness. We understand very clearly that one of the ways of keeping people healthy, and when they get ill to make them well better, is to empower them with information and involve them in their care. So that is a very important piece, but because of some of the complexities of it, it will probably come later.
I do not have any specific answer, Mr. Chairperson, in terms of timing on that, but that is the general concept that we are working under.
Mr. Chomiak: I thank you for the answer. I guess I was trying--and you did answer it--to understand whether the reference to consumers here was--it is a broader reference. Each of the projects is a broader reference than the long term that the minister, two years ago, was speculating in terms of the ultimate design of SmartHealth and where you are going.
Is it possible, and this is to the minister, is there an update and a status, other than this chart, as to the present status and direction of SmartHealth that the minister might be able to share with us in terms of description in writing?
Mr. Praznik: I am going to commit to have Mr. O'Neill provide the member with one. He has indicated that we can give him that update. He will forward it to me and I will have it forwarded to the member.
Mr. Chomiak: I thank the minister for that information. Can the minister indicate what the status is of the DUMSC project, whether or not that is proceeding and how it may or may not relate?
(Mr. Chairperson in the Chair)
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Mr. Praznik: The Drug Use Management System and Concept is one that makes some very good sense. I know there are many who are promoting this. To date, we have not really gone very far on it for a variety of reasons, probably one of which is we only have so many hands to put onto issues, and minds. But it is one that has been brought to my attention in the last few months and one that we would like to progress on when we are able to put our resources into making it happen. Obviously, the flood was one of the things that put us behind as well.
So I have no further update than probably what the member had last year if he had asked the same question of the minister.
Mr. Chomiak: Administrative matters, again, I--actually I would love to go down this line for a long time, but time is at a premium. I wonder if we might take five minutes and then I am projecting that we can start going through the line-by-line items that should start moving us into tomorrow, and I am assuming tomorrow that we will get into the issues of Continuing Care and the like.
The only qualification, I think, and it may be there may be one or two questions that might arise with respect to the SmartHealth as a result of some of this information that we are looking at, but I do not want to change the departmental plan, so I do not think that we will have to come back to this--I do not think at this point.
Mr. Praznik: In the interests of accommodating the member, we will have Mr. O'Neill here tomorrow at the first part, should a question arise. I must say to the member, in all the years I have done Estimates I have always preferred to do them in a more--a manner like we are doing them today that gives members the freedom to be able to deal with issues and tie them together. I am quite enjoying the discussions we are having.
I fully concur we probably need a five- or 10-minute recess here at this time in the afternoon.
Mr. Chairperson: Is it the will of the committee to take a five- to- 10-minute break? [agreed]
The committee recessed at 4:03 p.m.
The committee resumed at 4:16 p.m.
Mr. Chairperson: Will the Estimates of the Department of Health come back to order.
Mr. Chomiak: I wonder if it is possible at this point for the minister to table a list of all outside contracts with all consulting and other agencies with the Department of Health.
Mr. Praznik: I am advised that the standard answer to this question is that they are all available on Public Accounts--the list of untendered contracts. I guess it boils--and I would love to be able to provide a complete list to the member. I guess it is, do I take some staff time in the next while to have somebody sit down and compile the whole list. Is there something that the member is looking for specifically? Perhaps we can be a little bit more accommodating.
Mr. Chomiak: I appreciate the minister's response. I will not give my standard reply. The areas I am looking at are the areas of contracts with KPMG, as well as the contracts with outside parties dealing with the regionalization
Mr. Praznik: Perhaps if the member could give me a little bit sense of the time frame, maybe we could be a little more specific.
Mr. Chomiak: Perhaps all major contracts entered into since the last period--a year ago to now since the last Estimates period.
Mr. Praznik: Yes, Mr. Chair, my staff are just searching their collective memories here. We have not had many, and we will get for him for tomorrow a list of our consulting agreements. I know with KPMG, the only contract they are working on for us now is with respect to implementation, as we discussed earlier in Estimates.
I am not aware of Mr. Hugh Goldie being on contract with us at the current time, certainly not in my tenure as minister, but we will get that list for the member.
Mr. Chomiak: I appreciate the response. Is Barb Biggar and her communication group also still under contract, or has that expired?
Mr. Praznik: Not since completion of the Pathways document, so she is not on contract at the current time.
Mr. Chomiak: Can the minister give us--
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Mr. Chairperson: A vote has been requested in the other committee room. We will proceed to the Assembly.
The committee recessed at 4:20 p.m.
The committee resumed at 4:45 p.m.
Mr. Chairperson: Would the Committee of Supply please come back to order. Before we recessed, we were dealing with the Estimates of Health.
Mr. Chomiak: I wonder if the minister has figures for me on the amount of money that has been held back in the preceding year from the federal government with respect to transfer payments as a result of privatization or, pardon me, the operation of certain clinics in the province of Manitoba.
Mr. Praznik: I will have that amount for the member tomorrow. My staff do not have that exact number today.
Mr. Chomiak: In a letter to me concerning the utilization of graduate doctors who are foreign trained, the minister indicated that 50-plus doctors, as a result of the conditional registry, were now working in rural Manitoba. I wonder if the minister could table or provide for us information as to the number of doctors and where they are located. Fifty seems like a high number to me.
Mr. Praznik: I will have my staff have that number for me tomorrow, with their locations as well.
Mr. Chomiak: Can the minister indicate whether there has been any change of policy with respect to the utilization of CT scans both within and outside the city of Winnipeg?
Mr. Praznik: My deputy points out to me that there has been an increase in total what there has been of exams, but there has not been a change in policy that either of us are aware of.
Mr. Chomiak: Would it be possible for the committee to provide in the next couple of days a list of the specific policies with respect to CT scans around the province?
Mr. Praznik: I am just trying to get focused on where the member is coming from and the policy issue that might be here. Would it be somewhere centred around the issue of the ministry not allowing CT scans in the community hospitals on an outpatient basis?
Mr. Chomiak: That is precisely the area.
Mr. Praznik: I appreciate the nature of this issue, having followed it under previous ministers. I know one of the things that governments everywhere are trying to achieve obviously is to have the right number of diagnostic tools or pieces of equipment and have proper utilization of them. I know we may get into a discussion on--or we did already--bone scans, et cetera, and the issue, you have the equipment, you need the operator, and we have to address that.
It is my hope with the advent of the Winnipeg Hospital Authority, and one of their charges I have given them and the community hospitals as well as the tertiary hospitals, in my meetings with their boards, I stress this: we are trying to get a rationalization, and I say that in the fully broad sense of the word, really a rational use of our diagnostic equipment. So that particular policy may very well change under the Winnipeg Hospital Authority as we co-ordinate the use of our equipment.
I think the genesis of that policy obviously has to do with facility-base funding, each facility wanting to have its own pieces of equipment, raising money to purchase them, not fitting within an overall utilization scheme, and we get into those issues.
So whether one agrees with that approach or does not agree with the approach, the fact of the matter, it does kind of look silly, I think, to the public and to the users of the system. I am hoping that the Winnipeg Hospital Authority, within some of the first issues it tackles, will be able to put into place a utilization plan for diagnostic equipment that will treat it citywide, maximize the use of the equipment that is available, obviously, having proper operating protocols, et cetera, so that this really does not become an issue of outpatient, inpatient, community hospitals. We have to approach it, I think, from a sort of broader perspective and move forward from there. So I offer him my perspective on that particular issue.
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Mr. Chomiak: Mr. Chairperson, is the ministry considering any change in policy with respect to patient transfer to take into account the concept that is being voiced with respect to--particularly, the urban centres--the movement from hospital to hospital? Is there any incentive or any change in policy that the department is presently proposing with respect to transfers of patients from centre to centre?
Mr. Praznik: Mr. Chair, we are not at this time specifically looking at a change in policy, but it makes eminently good sense that, with the creation of the Winnipeg Hospital Authority, the development of single programs, multisite, the better use of resources that I would expect, and I certainly do not want to stand in the way of the system looking at methods to ensure that if you are going to utilize resources properly around the city you may have to provide for transportation between facility transfers, and as part of your overall operation that makes some logical sense as you move away from individual facility-based programming, per se. So, obviously, reviewing that whole area in the proper context, the new context is going to have to happen.
So, although we are not doing it today, that is a discussion we are going to have to enter into with the Winnipeg Hospital Authority. You note, if one blue-skies a little bit, there may be some innovative ways to be able to provide that kind of transfer system in a more cost-effective way than necessarily using ambulance, et cetera. Clearly, if we are building a system-wide organization with multiple site, multiple hospital, and we are expecting to get best use out of resources, that having the mortar or the glue of a transportation system between those facilities becomes part of it. So that is an issue that is going to have to be addressed. We are not addressing it today, but it will have to be addressed over the next few years in putting together the Winnipeg Hospital Authority.
Mr. Chomiak: Mr. Chairperson, the other day when I was canvassing, when we were questioning the whole issue of labour relations, I recall asking a question about the Voluntary Separation plan. I wonder: Has the plan changed from its--and can the minister provide us with an update as to the present Voluntary Separation plan that is in existence with the department?
Mr. Praznik: Mr. Chair, just for my clarification, is the member talking about a VSP in facilities or in the department or in what area, because, obviously, it applies somewhat differently across government as opposed to--we try to be consistent, but there are different circumstances here. If he could refine his question a little bit more for my benefit.
Mr. Chomiak: Mr. Chairperson, the plan that I was familiar with and had access to and viewed last year was the plan dealing with employees vis-a-vis the institutions.
Mr. Praznik: Mr. Chair, I understand the member, we are aware, raised this a couple of days ago. My staff tell me they are still checking with the facilities and the numbers that are there. So we hope to have that information for the member shortly.
Mr. Chomiak: Several days ago I asked about the home care strike costs. Do we have that information?
Mr. Praznik: Mr. Chair, I think we have the document. I will table it with the committee.
I understand that his caucus requested this under Freedom of Information. It has been provided already, but I have no problem tabling it with the committee. I believe the date which this was provided to his caucus was May 23--the covering letter is dated May 23, 1997.
Mr. Chomiak: I have not seen this sheet. It may have not made its way--hard to believe, but that is not the case. I thank the minister for this document.
Last year when I asked the minister about the changes, I was under the impression that we were going to see an amendment to The Mental Health Act. There have been long-term discussions. Are we going to be seeing that this year, and if we are not, is it possible to table the draft discussion paper or white paper in regard to the amendments to The Mental Health Act?
Mr. Praznik: Mr. Chair, the member is quite correct. The department's plans were to introduce some amendments to The Mental Health Act. The trouble we got into this year was in the drafting capacity within Justice. We only had so much capacity, and each department was asked to prioritize what legislation it brought forward. As the member can appreciate, The Midwifery Act was already drafted and ready to go when we sort of reached this resource shortage. We had The Personal Health Information Act which needed to be in place this legislative session to accommodate changes in the fall, and we obviously needed to have The Regional Health Authorities Amendment Act to deal with the two Winnipeg health authorities and Brandon Health Authority.
So just, quite frankly, from a departmental point of view, I was advised that those amendments to The Mental Health Act could wait another year to another legislative session. Because of the inability to have the resources, or the lack of resources within Justice just to get the amount of work--and, by the way, in many cases, it was, given the hefty legislative session that we have in terms of some major pieces of legislation, complex pieces of legislation, not necessarily controversial but complex, we were not even able to obtain those resources to complete the work outside government.
So this act was not completed. I think it was a third or two-thirds done, but we just had to set it aside for other priorities. I say to the member today and to members of the committee that, it is our intention once this legislative session is completed to, over the fall, have that bill, the drafting on it, completed when Legislative Counsel has some time on their hands and to move it through our process for introduction in the next session of the Legislature.
Mr. Chairperson: The time being five o'clock, committee rise.