Manitoba Hansard — 17 May 2013 (Sitting 43C, 40th Legislature, 2nd Session)

40-2-43c

Manitoba — Debates (Hansard)

Second Session - Fortieth Legislature of the Legislative Assembly of Manitoba DEBATES and PROCEEDINGS Official Report (Hansard) Published under the authority of The Honourable Daryl Reid Speaker Vol. LXV No. 43C - 10 a.m., Friday, May 17, 2013 ISSN 0542-5492

MANITOBA LEGISLATIVE ASSEMBLY Fortieth Legislature Member Constituency Political Affiliation ALLAN, Nancy, Hon. St. Vital NDP ALLUM, James Fort Garry-Riverview NDP ALTEMEYER, Rob Wolseley NDP ASHTON, Steve, Hon. Thompson NDP BJORNSON, Peter, Hon. Gimli NDP BLADY, Sharon Kirkfield Park NDP BRAUN, Erna Rossmere NDP BRIESE, Stuart Agassiz PC CALDWELL, Drew Brandon East NDP CHIEF, Kevin, Hon. Point Douglas NDP CHOMIAK, Dave, Hon. Kildonan NDP CROTHERS, Deanne St.

James NDP CULLEN, Cliff Spruce Woods PC DEWAR, Gregory Selkirk NDP DRIEDGER, Myrna Charleswood PC EICHLER, Ralph Lakeside PC EWASKO, Wayne Lac du Bonnet PC FRIESEN, Cameron Morden-Winkler PC GAUDREAU, Dave St. Norbert NDP GERRARD, Jon, Hon. River Heights Liberal GOERTZEN, Kelvin Steinbach PC GRAYDON, Cliff Emerson PC HELWER, Reg Brandon West PC HOWARD, Jennifer, Hon. Fort Rouge NDP IRVIN-ROSS, Kerri, Hon. Fort Richmond NDP JHA, Bidhu Radisson NDP KOSTYSHYN, Ron, Hon. Swan River NDP LEMIEUX, Ron, Hon. Dawson Trail NDP MACKINTOSH, Gord, Hon. St.

Johns NDP MAGUIRE, Larry Arthur-Virden PC MALOWAY, Jim Elmwood NDP MARCELINO, Flor, Hon. Logan NDP MARCELINO, Ted Tyndall Park NDP MELNICK, Christine, Hon. Riel NDP MITCHELSON, Bonnie River East PC NEVAKSHONOFF, Tom Interlake NDP OSWALD, Theresa, Hon. Seine River NDP PALLISTER, Brian Fort Whyte PC PEDERSEN, Blaine Midland PC PETTERSEN, Clarence Flin Flon NDP REID, Daryl, Hon. Transcona NDP ROBINSON, Eric, Hon. Kewatinook NDP RONDEAU, Jim, Hon. Assiniboia NDP ROWAT, Leanne Riding Mountain PC SARAN, Mohinder The Maples NDP SCHULER, Ron St. Paul PC SELBY, Erin, Hon. Southdale NDP SELINGER, Greg, Hon. St.

Boniface NDP SMOOK, Dennis La Verendrye PC STEFANSON, Heather Tuxedo PC STRUTHERS, Stan, Hon. Dauphin NDP SWAN, Andrew, Hon. Minto NDP WHITEHEAD, Frank The Pas NDP WIEBE, Matt Concordia NDP WIGHT, Melanie Burrows NDP WISHART, Ian Portage la Prairie PC Vacant Morris

1407 LEGISLATIVE ASSEMBLY OF MANITOBA Friday, May 17, 2013 The House met at 10 a.m. ORDERS OF THE DAY (Continued) GOVERNMENT BUSINESS COMMITTEE OF SUPPLY (Concurrent Sections) HEALTH Mr. Chairperson (Mohinder Saran): Order. Will the Committee of Supply please come to order. This

section of the Committee of Supply will now resume consideration of the Estimates for the Department of Health. As had been previously agreed, questions for this department will proceed in a global manner. The floor is now open for questions. Hon. T heresa Oswald (Minister of Health): Yes, and I appreciate the member for Morden -Winkler (Mr. Friesen) allowing me to start this morning. I did want to begin the morning on a solemn note.

News reports this morning are identifying the passing of a great Manitoban and great Canadian, Elijah Harper, and I just want to extend our heartfelt condolences and, indeed, deep appreciation for the profound and meaningful change that Elijah brought to–well, our world, really. Secondly, Mr. Chair, I do have some information that the member requested yesterday, and I would be quite prepared to put that information on the record today before we begin our line of questioning. I'm acknowledging his consent.

I did want to say that the chief financial officer of Health baked a pie last evening, and we do have said pie for the member for Morden -Winkler. This– she works fast, and indeed we have information here showing the pie chart– Mr. Chairperson: Order. Order. Before the minister wants to keep –continue, I think the member for Lakeside wants to say something. Mr. Ralph Eichler (Lakeside): Yes, Mr. Chair. Just before the minister started on the next chapter, I thought it was important that we all agree in committee of the contributions that Mr.

Harper made and certainly want to pass on all members' condolences to their family, of course, and thank the minister for her opening remarks. I think it was very timely and very appropriate and, certainly, I think all members of the House want to ensure that Mr. Harper and his family just appreciate how much we all have to offer, and thank the minister for her comments. Mr. Chairperson: Honourable minister, to continue. Ms. Oswald: Yes, I thank the member for those words. They're very generous and compassionate , and they're much appreciated. To continue, then, Mr.

Chair, last year we know there were two pie charts summarizing the distribution of expenditure for Manitoba Health. One chart repre sented the department , and one represented the Health Services Insurance Fund. The department pie chart does represent less than 4 per cent of the total health budget,

whereas the Health Services Insurance Fund represents approximately 96 per cent of the b udget, and we have indeed merged those two charts into one. But here, you know, both charts are attached for comparison purposes. And so I would like to table this particular chart for the member and offer it to him. He will see that we have a distributio n of funding to regional health authorities at close to 64 per cent; capital funding, 3.19; Pharmacare at 5.14 per cent; medical at 21.87; and provincial health services at 2.65 per cent. So I will provide that to the member now, and I'm ready to start que stions.

Thank you very much for the opportunity to put that information on record. Mr. Cameron Friesen (Morden -Winkler): And I also want to express condolences to the family of Elijah Harper, who is an individual and a figure who figures prominently on the landscape of Manitoba and in our history, in the history of this province, who made a contribution that Manitobans will remember. And so today, on learning the news of his passing, certainly the condolences of our party go out, and we join with the minis ter in marking with sadness his passing.

I thank the minister for providing that information, and I wanted to just go back this morning–I wanted to actually begin by going back a

1408 LEGISLATIVE ASSEMBLY OF MANITOBA May 17, 2013 bit and tidying up a few things from yesterday. And I know that we're not yet in possession of the Hansard from yesterday's exchange, but I thought that I might just ask for a clarification regarding the department vacancy rate. I am not certain that yesterday, when I requested information to be provided, whether I indicated I would like to receive that departmental vacancy rate to exclude Cadham and Selkirk.

Can the minister indicate if that information, the vacancy rate could be provided in a way that would show separately Cadham and Selkirk and then separately calculate the vacancy rate for the Department of Health? Ms. Oswald: I do think that we did cover this yesterday, but let me reiterate that currently there are 100.69 positions or an 8.32 per cent vacancy in the department which does not include vacancies at Selkirk Menta l Health hospital, which include 57.2 or an 11.6 vacancy rate at present, nor does it include Cadham Provincial Lab which has 8.1 or an 8.4 per cent vacancy rate. So that should cover that.

Mr. Friesen: I thank the minister for that clarification. Now, also on that same subject, we may have asked this, but I may have also neglected to ask yesterday. When we were talking about the employees in the Department of Health, I wanted to also ask about contracts that the department is working with and I wanted t o know if there are –if the Department of Health has a process of contracting out for work that is done and, if so, now if the minister could also supply a list of what contracts are currently in place through the Department of Health. That's probably it. Ms.

Oswald: Certainly, we can share with the member the nature of contracts that the department would have, which is to say yes, they do exist. There are, of course, hundreds of contracts concerning drugs and so forth, but I believe the member's speaking specifically about people in this case. And, you know, certainly we have contracts with individuals that will be working on the implementation of the EMS review, for example, or in some cases of northern nursing stations.

Those kinds of contracts would exist , so I can signal to the member that I'll have my department work on providing that information to him post haste. Mr. Friesen: And , by post haste, does the minister mean that she can provide the information before the conclusion of Estimates? We're on our second day of Estimates. Could she provide it by the next time we would go into Estimates, just so I can understand?

It might be something I'd like to return attention to at some point in these proceedings, and also, if she's going to supply that information, just to be specific, I would like a list of the names to whom those contracts have gone out to, perhaps the length of the contract, the dollar amount for the contract and also the nature of the work being performed–or the title of that contract. * (10:10) Ms. Oswald: Yes, I felt that Monday was a little bit too swift, but the CFO reminded me it's Tuesday. It's great news. Okay. We will try our best; it might be more like end of day so perhaps for the next day.

But certainly I have every confidence that the department will do their best to provide the information as requested. Mr. Friesen: Thanks for that commitment, or I thank the minister for that commitment. I'm back on page 15 of the Estimates and I'm looking at the administration and finance costs. I'm looking at that 15.00 FTE calculation there and we were chatting about this yesterday. On the way out, leaving the room from Estimates yesterday, I bumped into Keir Johnson, and that reminded me that I had not spoken about Keir's role in the office.

Now again because we're asking a lot of questions and a lot of information is being relayed, it may the case that the minister mentioned Keir's function in her office yesterday, and in my haste to take down names, I might have neglected to do so. But I didn't have Keir's name recorded. I went back and checked last year's Estimates and there I saw that the minister had indicated that Keir Johnson had indeed left her office, that he had occupied a position of project manager, and then he had moved to Priorities and Planning Secretariat at Cabinet so that he was no longer with the minister.

A number of weeks ago I had requested a meeting with the minister –going back a few months now and it had to do a project taking place in my constituency. And the minister indicated that she was not able to meet in a time period that would probably satisfy the need there, and so instead she sent Keir Johnson to meet with me . And I appreciated that meeting with Keir, and he was able to provide some information to me that was helpful.

May 17, 2013 LEGISLATIVE ASSEMBLY OF MANITOBA 1409 I am wondering at this point now , is Keir Johnson back working in the minister's office , and if so, what is his title and has he indeed returned to his former position as project manager? Ms. Oswald: Yes, Mr. Chair, indeed, he is working in the Priorities and Planning Secretariat, as indicated last year. He rem ains in that post. He does oversee the health files, among others in things in that secretariat. And as you know, he has a great deal of historical knowledge and–well, he's super smart generally, I think we could both agree.

And so he does still consult with me and other members of government, but he is in the Priorities and Planning Secretariat. Mr. Friesen: Mr. Chair, could the minister , then, indicate to me, if indeed he is still working out of the Priorities and Planning Secretariat of Cabinet, whether there would be any of his position that would be indicated under executive support , 1.(b), under 21.1 on page 15, or whether there would be no accounting for his position within the framework of the departmental Estimates for Health? Ms. Oswald: No, he's not accounted for there, or anywhere in the lines as described. Mr.

Friesen: Mr. Chair, for a moment it sounded like there was just no accounting for Keir , but I understand that that's just having to do with the departmental Estimates for Health. I wan ted to just ask about the position he occupied. Now I know that last year it was indicated that there were three project managers working for the minister. And I believe that those individuals named as Breigh Kusmack, Brad Hartle and Tim Smith; that was in last year's Estimates process.

Are those the individuals who continue under the title of project managers and indeed do we continue with three project managers in the minister's office or has there been a gain or a loss of those positions? Ms. Oswald: Yes, Mr. Chair, as we spoke about yesterday, there are indeed three project managers that work in the office of the Minister of Health. One of those is Brad Hartle, sitting right over there; one is Cotelle Mackintosh ; and one is Tim Smith. Breigh Kusmack has left the office, replaced by Cotelle. So though–Brad, Cotelle and Tim are the existing. Mr. Friesen: I thank the minister for that answer.

With regard to Cotelle Mackintosh –so she takes a new position as project manager in the minister's office, was th at position advertised and was it competitive or was it an appointment? Ms. Oswald: Cotelle Mackintosh worked previously in my office as intake coordinator and developed a lot of experience for –or in the context of that position. She is also pursuing education and left the office for some time but , at present , is back in the office on a temporar y basis. She is, I would argue, second to none, and I'm delighted to have her back even if just for a while –so it was a direct appointment. Mr.

Friesen: So do I understand correctly, then, that Cotelle Mackintosh's position would be a 1.0 EFT on a term? Ms. Oswald: I actually don't know what word they used in the contract or arrangement, but it is for that period of time, end of April, and she'll be here until school resumes in the fall. So that is a term. Mr. Friesen: I thank the minister for that answe r, and I'm just wondering then, will there also be –will this position be advertised when Ms. Mackintosh goes back to school ? So will that–at that time, will the minister seek to fill that position of the third project manager position? Ms.

Oswald: Certainly, we will look at the circumstances that are before us at that time. We know that we went for an extended period of time with a vacancy in my office at special assistant , and it was appropriate for the pacing and workload at the time. We will cert ainly evaluate, as we always do, and seek to fill the position if necessary.

It's really important to me that we have staff available to work with the public on whatever it is that their issues, whether it's a specific piece of casework concerning a health -care matter; if it's a special project that a community group might be interested in; whether it's something from the Health Workforce side, an advocacy group that wants to come forward with ideas about workplace health and safety.

Certainly, the Departme nt of Health does an excellent job in co-ordinating and meeting with individuals like this, but folks in my office can provide additional support and interface, and so I always want to be evaluating our ability to reply and to consult in an expedient manner. So that particular situation when it becomes vacant in the fall will undergo an evaluation and we'll make a determination at that time. Mr. Friesen: I thank the minister for that answer. I'm wondering now, just returning back to our discussion of Keir Johnson, I know that Keir does

1410 LEGISLATIVE ASSEMBLY OF MANITOBA May 17, 2013 have a handle, like the minister says, on a number of the health initiatives , and he's available to give answers on a regular basis and things like that. So I know he's–he occupies an important role with respect to the minister's office. I'm wondering if there are other individuals who have perhaps been seconded or moved to Priorities and Planning S ecretariat of Cabinet or other committees, who, then, also lend considerable assistance to the minister's operations , even though they may not appear in the calculation of FTE equivalence of 1.0. * (10:20) Ms.

Oswald: Well, I think the simple answer to that question is, no, there isn't, you know, anybody that is any–in any sort of unofficial capacity dedicated to the office of the Minister of Health. But, broadly, there are a number of folks across government and across our staff that are of unbelievable help to me, staff that would not specifically be assigned to me. For example, with the Healthy Child Committee of Cabinet, they would belong to a different department–are folks that provide a lot of insight and information to me, so they wouldn't be listed there.

But, if I tried to say that, no, they don't help me, that would be foolhardy at best. So, certainly, I get all kinds of help from people, and I make no apology for that. I think that there's all kinds of wisdom across the government that, with something as broad and as big as Health–the member himself said yesterday that he was somewhat taken aback by the sheer volume and the systems that we're dealing with.

So while there aren't official individuals –you know, there aren't official individuals –I do seek the good counsel of folks, whether it is in something like Healthy Child, whether it is from folks in Aboriginal issues, folks that have expertise in communications. You know, there are a variety of people that I think help me every single day, but, no, they wouldn 't be written down on this list. Mr. Friesen: I would agree with the minister wholeheartedly that she should not apologize for the people who assist her in her role and neither we ever ask her to do so.

We're just simply trying to follow the stated execut ive support in the Estimates and then consider how resources are allocated to her operations to assist her to do her role. And that gets, you know, from my perspective, you can understand that it gets interesting because we have–government is a big operati on, and there are many people who assist and whose duties are defined in separate categories. And so we're trying to just see who is assisting the minister as she goes forward and fulfills her role.

Just as a point of clarification, I think when I stated yesterday, is I was indeed quite taken back by the volume of correspondence that comes across my desk, emails, phone calls, faxes, and that, you bet, that there's a lot of that that comes with this territory. But, yes, the operation of Health is large as well.

Continuing on, we had spoken yesterday for a little while about the fact that at this point in time the MGEU agreement, that two -year pause on incremental increase is, of course, now over, and I do notice there is a –an increase on that same Executive Support line from 1.012 to 1.035, of course , measured in thousands.

I'm wondering, just so I can understand better, I know that the minister has working with her both political staff and then technical professional staff, for lack of a better word–maybe that would be like civil service staff – and I'm wondering, do incremental increases, are they consistent across both of those categories of employees in the minister's office? Ms. Oswald: As I suggested yesterday, I believe the categories are subject to the same processes, increases, constructs as the civil service, but I am going to endeavour to double -check to make sure that that is certain and will report back to the member.

Mr. Friesen: Could the minister also indicate , then, and this might be difficult to say without –I don't have a great working knowledge of the most recent collective bargaining arrangements within the MGEU, but could she indicate what the percentage increase was for the civil servants working within her executive support for this past year? Ms. Oswald: I would have to do some homework to find that information. I can get back to the member. Mr. Friesen: I'll try to fast-track this, thank you, Mr.

Chair, and just indicate to the minister where I 'd like to go in this is is I would just like to understand better in terms of incremental increases to the people who assist her in her role. I would like to establish how much of this increase of $23,000 for this year would have gone towards technical and professional staff and how much of that would have gone towards political staff, and whether the percentage increase in salary remuneration would have been consistent between the civil service staff that she has and the political staff that she has in her office. If she could

May 17, 2013 LEGISLATIVE ASSEMBLY OF MANITOBA 1411 apply–or provide that information, it would be most helpful. Ms. Oswald: Yes, again, project manager staff would fall under professional -technical, but in order to peel all this out, as I said to the member, I understand the question that he's asking and we can commit to get back to him on, you know, where each of those individuals lay. For example, I believe, yesterday, in speaking about political staffing, I referred to the intake co -ordinator as political staff. I do think, in fact, it's admin staff –I made an error when I was speaking about that.

So I will embrace the line of questioning that the member is asking me and confer with my officials and get back to you on where–who sits in professional -technical, who sits outside of that, how are they captured by civil - service increases, what those increases were, and the like. Mr. Friesen: And could the minister also commit to a timeline in which –you know, in which she could provide that information. Would she be able to provide it by the next time we sit in Estimates? Ms. Oswald: I believe so. We'll try our best. Mr. Friesen: Thank you.

I'm not much of a fisherperson–I guess we say fisherperson these days, but I find that looking through the Estimates, I have to go fishing because I don't always know where to locate certain pieces of information, and I know that we have the right people at the table today who can assist me. I was looking to see if I could discover where the minister's travel would be recorded in the Estimates.

Now, I may be wrong here, but I was looking at pa ge 21, and I see under 21.1, administration and finance , there is a line at the bottom of the page that indicates the salary and the executive support and finance and central services . I don't know if central services would be where that kind of expenditur e is recorded.

So perhaps my question to the minister to start out this area of inquiry would be, where do I locate the expenses for the minister's travel, if that travel was either in the province or out of the province or out of the country, and whether, indeed, that information actually is available as a line item in the E stimates, which it may not be? Ms. Oswald: I believe the member will find on page 25 some information.

The information there , though, is the combined expenses and travel of the deputy and the minister which may be less specific than the member wants, but certainly the minister's expenses and travel is posted online, so he can–if he wants to peel out the exact amount there, he is welcome to do so. I can assure him it isn't going to take him very long to add up the numbers. Mr. Friesen: I thank the minister for that response. So thank you for helping me locate that information.

So that's page 25, I'm under executive support , and I'm loo king under other expenditures, transportation–is that the line to which the minister is referring and the number which is consistent, I believe, from last year to this year at $44,000? * (10:30) Ms. Oswald: That is correct. Mr. Friesen: Would the minister be able to provide this morning information about what trips that she did make in this past fiscal year and whether those trips were in province or out of province or out of country and the pertinent details of that travel: location, purpose, dates, costs and who went along? Ms.

Oswald: I can inform the member that my travel out of province, limited as it may be –certainly, you can have a look at Manitoba Health's website and click on reports and expenses, and what is reported in the most recent quarter is nil. Does it really say that? Nil. I travel out of province to FPT meetings, which, as tradition, tend to occur one time per year.

And, of course, the Council of the Federation in days past have taken it upon themselves, as a result of–well, really, I believe, some frustration with a change in texture and dialogue with the federal government concerning health, the Council of the Federation have taken it upon themselves to establish two sub-working groups, one on health finance and one on health innovation. And the Health Innovation Working Group, chaired by premiers Wall and Ghiz, is–has called Health ministers from across the nation together, I believe, on two separate occasions thus far. I may stand to be corrected on that.

I believe it's two where we have been asked to physically travel. We also have had a variety of conference-type calls. So I believe in the last year I've attended the FPT meeting and I've attended the Health Innovation Working Group. Either two appear in one year, or one in one year and one in the next; I don't honestly know which way that cookie crumbled, but that would be it for out-of-province travel, and there is no out-of-country travel. Mr. Friesen: Now, when the minister and the DM travel–and, again, this might fall into the category of

1412 LEGISLATIVE ASSEMBLY OF MANITOBA May 17, 2013 educating the new guy –would other members of the minister's or the DM's team travel with them? And then, if so, would thos e travel costs also be captured on this line, or would there be another place in the Estimates where we would refer to for that travel that is incurred by other members of the staff? Ms. Oswald: The answer is one I'm sure he'll love, and that is that it depends. So, if I have staff that travel with me, it would appear here.

If there's staff from the federal-provincial unit, for example, in Manitoba Health, then it would appear in that cost centre. If a deputy minister –assistant deputy minister, pardon me, were to attend, then it would fall under his or her cost centre. So it really does depend on who goes. And I'm not sure if the member asked this, but there isn't a –sort of a standard team that attends every time. It certainly does depend on the natur e of the meeting and the agenda items contained in that meeting, so it does shift from time to time. And I would add–sorry, Mr.

Chair–that I do, as a rule, always take a political staff with me when I travel. Mr. Friesen: And just one last question on that. I see that there is no increase from the Estimates from last year to this year. I s there a– is this number adequate for the purposes of transportation? Does the minister project that next year, again, it will be the same or increasing or decreasing? Ms. Oswald: Well, certainly, the very nature of this book is that it is an estimate, so that's what it will be. Having said that, I am the minister of the largest department in government and I have a 7- year-old.

So I haven't exactly gone around the world. If you look historically it's been pretty consistent, my time out of province, and so I don't expect that to change. Mr. Friesen: Just a couple of things to tidy up before we turn our attention to something brand new, and I just wanted to ask if the minis ter would indicate, please, if she could provide a list of all the fees charged by the department. Are there other fees that the department charges for anything? We're just trying to get to the cost of the department. We've talked about salaried employs, w e've talked contracts.

Is there any –are there any fees that the minister can indicate that the department charges and the rates of those fees? Ms. Oswald: I'm wondering if I could seek some clarification from the member on the issue of definition of fee. It's broad, the department. I know that we have, since forming government, you know, worked really hard to do our best to eliminate fees to the patient. We've taken fees off ostomy supplies, for example, and removed tray fees that doctors used to charge an d, you know, so we're working in the direction of having previously assigned fees come off.

There are other kinds of charges that exist and have existed historically. One could argue, perhaps, that a Pharmacare deductible might be that or a residential charge fee that, you know, since the dawn of time, really, has been adjusted each year. So could the member just maybe clarify a little bit where it is that he might want to go? I don't want to spend an hour talking about that sort of thing if I’m not getting it. Mr.

Friesen: I agree with the minister wholeheartedly, and if she would permit me, we'll come back to this question and I'll dig a little bit more, too, so I can make my questions very clear so that we can spend only as much time as is required on that item. I'll just proceed on. We're still on page 25. Now, I may have this correct, I see under other –under expenditures that we do also have an allotment for a communication at $46,000. I'm just wondering, is this a statement of advertising costs thro ugh the minister's office? Is that what this item pertains to? Ms.

Oswald: My staff have pointed out to me that – was this –wanted me to signal that the executive's support for 2011- 12 were, indeed, $135,000 compared to the estimate which was 164. So they're signalling that actually they did achieve some savings in this area. We're just working at the moment to confirm a page for you, on page 25, right.

So, on page 136, the member will find a definition of communication which would include devices, telephone, electronic communication, postal services, advertising/program promotion, that would include things like immunization and get your flu shot and so forth, radio systems and other kinds of devices. That's where one would find that captured. * (10:40) Mr. Friesen: Thanks for that answer and, yes, I'm aware of the glossary of terms there and how it indicates what's underneath there.

What I find interesting is that–and, of course, as a member of the Legislative Assembly, all members have a similar allocation in their budget where they can charge for things like telephones and electronic communication

May 17, 2013 LEGISLATIVE ASSEMBLY OF MANITOBA 1413 services and postal services. What I find interesting in this calculation is that we lump together those technologies along with advertising and program promotion. And of course we're aware of some of these program promotions because we, you know, hear them on the radio and we see them on the TV. I guess what I'm wondering about is –could the minister then provide a breakdown of this amount at $46,000?

I mean, I know it's a small item compared to the overall size of this department, but I would like–I would appreciate a chance to receive a breakdown of costs, either a dollar amount or a percentage amount that would indicate exactly, in reference to the stated areas of expenditure, how much of that $46,000 for telephone, how much for electronic communication, how much–because what I'm trying to get at is how much would actually go for advertising and program promotion, as opposed to those other areas of expenditure. C ould the minister provide that? Ms. Oswald: Yes, Mr.

Chair, we would be happy to work to provide that. I know that the member would be acknowledging that, comparatively speaking, of course, this isn't a large number, but we would be happy to provide the breakdown, and we'll include in that also that our current number, at 46, is just slightly lower than the 1998- 99 number of 47.5. So I know that he will be issuing a letter of commendation or some such for the great efficiency that we have been able to work through in that area of communication. But, sure.

This–the staff says that they can break down some of it, so that you can understand how much we're spending to help mothers find assistance on breastfeeding and get immunization and sign up to donate an or gan and all those other kinds of really good programs that are so important to Manitobans. Yes, we'll be happy to provide that. Mr. Friesen: Mr. Chair, and I know that the minister understands that in no way are we stating that somehow that information should not go out to mothers on breastfeeding programs and all those other very important notices to the public that do go out.

But , if the minister could now help me to understand–and I don't want to go exactly into this area right now, but just so I could understand it, and we both understand that this is a very small amount, but that the Department of Health does a lot of advertising on radio and on TV and throughout media for many things, so now where in the Estimates expenditures do I find the much large r budget for communications and advertising that goes to the many, many other areas of advertising that the department does? Ms.

Oswald: Yes, and again I would signal to the member that certainly it would depend on the nature of the communications. For example, if the Chief Provincial Public Health Officer is releasing his report, it would come out of that cost centre, so it really would be dependent on the nature of the communications that were being provided. Mr. Friesen: Mr. Chair, we'll come back to that issue, I'm sure, as we go forward.

We understand that a very large amount of the expenditures of the department flow through the RHAs, and we're all aware that the RHAs have their own advertising budgets as well, and so we'll drill down a little further, but not at this time. I just want to wrap up with some questions on the issue of the department and of staff, and I want to turn our attention just very quickly to the –I have a

summary in front of me for the orders -in-council for the Department of Health –and it turns out people do read these–and so, as I've acquainted myself with this role, I've been always interested to see what orders - in-council have been published for the department. We certainly will not go line by line through the orders-in-council of the Department of Health, but a few of them I wanted to flag to the minister's attention and ask if she could clarify it. For instance, if I start with April the 10th, 2013– we'll just work from the more recent to the lest recent.

There was an indicat ion there–this might be redundant because we might have talked about this already. We might now be coming through a different avenue to the same information that was already provided, but it says special assistant appointed to the Minister of Health, and c ould the minister tell me who that was? Ms. Oswald: Clair Cerilli. Mr.

Friesen: And the second question, from November 14th, 2012, the –there's a notice given of – that there's an appointment of member of the Health Professions Advisory Council revoked, and I wonder if the minister could indicate what that was and who that was and why that was revoked. Ms. Oswald: My–off the top of my head, I seem to recall someone that had consented to be involved found some circumstances that did not enable them to continue in that work. I think there was a decision made to avoid a conflict of interest with which –I think it had something to do with a law firm and

1414 LEGISLATIVE ASSEMBLY OF MANITOBA May 17, 2013 conflict of interest. I believe it might be Silvia de Sousa, and so after doing some work and discovering that there may be a conflict of interest the individual had to revoke their consent to serve. I believe that's the case. Mr. Friesen: Thank you for that response, and I would ask the minister just to double -check that and then if it is otherwise, that she could ge t back to me and let me know. And, if that's indeed the case, that is fine.

Turning the page, on October the 31st, 2012, I see another notice, appointment of member of the Mental Health Review Board also revoked. Again, in this instance, what were the conditions under which this position was revoked? Who was the individual? What was the rationale for the decision? Ms. Oswald: Well, again, we'll have to do some digging to find out the circumstances on this subject.

What I can say to the member broadly th ough, there are a number of boards under the Department of Health, as the member well knows from doing his homework, and we certainly do our best to be proactive in approaching individuals that might be willing to serve. We also have individuals that proactively contact us and say that they are very interested in serving on a board, and through the course of that process we endeavour to arrange appointments onto boards. But circumstances change in people's lives that make them either ineligible in the case of the conflict of interest, or even perceived conflict of interest.

We have to revoke names of individuals that pass away and it may be possible that that's the case in this example. So there are a variety of examples of circumstances that cause revocat ion having to go through OIC. I honestly cannot recall any circumstances since I've been in the chair. I'm not sure where I –there has been a revocation of somebody on a board because of performance or any such thing there. It's generally circumstances concerning the circumstances in their lives. * (10:50) Okay, I –let me correct that –I was mistaken about the Mental Health Review Board.

Their –the revocation also can occur, it's important for me to say, when people reach the end of their terms. We know the office of the Auditor General has done some work in this regard and has asked across government that ministers and departments pay close attention to terms, and so this has to happen as well. But on the specific one of October 31, 2012, I believe it was Bar bara Manning who was removed from the board. She was replaced by Velma Kreshewski, and I believe in this case it was an end of term. So I did misspeak before when I suggested that this was a circumstance of somebody being deceased.

That has occurred in oth er situations; this wasn't that one. So let me just be sure that I'm clear that Ms. Manning is alive and well. Mr. Friesen: I'm sure she appreciates those assurances too. But I thank you for that 'clarificay' – or I thank the minister for that clarification . I wasn't aware that the term revoked was used when an individual would reach the end of their term. It seems like such a harsh word to apply to someone who's performed good service on a board or other agency. September the 19th, just a clarification I'm seeking here.

There is an indication there of an appointment of the executive assistant to the Minister of Health from September the 19th. So my guess is that that could be Sandra Little –I'm just guessing here–or Keir Johnson. Could the minister indicate who that would be on September the 19th who was added as executive assistant? Ms. Oswald: I was going to ask you what the question was–who was added as EA? In the current EA position, I believe, is Sandra Little; that's who it is.

So I believe that that's what that particular OIC would be regarding, and I can just go back to the member to answer his question brought up from before. My staff's done calculations, so of that 46K under communication: telephone, 35; postage, 3; public communication, 8. Mr. Fri esen: The last one on my list from the order-in-council notices is July the 23rd. There is an indication there of an appointment of–oh, it's another revoked position–appointment of member of the Mental Health Review Board revoked.

Again, if the minister has the information, the individual and the rationale for the–why the position was revoked. Ms. Oswald: This indeed was the individual that passed on, his name was Merv Jones. Mr. Friesen: I thank the minister for that information. So, if I could just ask , then, so I understand the process of this, would I then understand correctly that we then have a vacancy at this point on that review board, the Mental Health Review Board, until such a time as I would receive a notice through an

May 17, 2013 LEGISLATIVE ASSEMBLY OF MANITOBA 1415 order-of-council report that would indicate a new one coming on? So do we have this vacancy there, and do we indeed have those other vacancies like the one from October 31st with the Mental Health Review Board? Ms. Oswald: On the issue of committees and boards and so forth, I thi nk we did speak a bit yesterday about providing the member with some details about membership on these boards.

I gave a rather exhaustive list yesterday of those kinds of committees, and certainly when we have gathered this information–and we're working as swiftly as we can–we can indicate who's existing on that board, and also we'd be willing to signal vacancies that would be on the board, so that would speak to this case. I believe you said the Mental Health Review Board was the last one. So we would be happy to provide information on this specific one and on any board.

So we will most definitely get that information to the member and also provide clarity about process as to, if there's a revocation and that position is filled, does it indeed get fille d by way of OIC or is there another protocol for that. Mr. Friesen: I thank the minister for providing that information, and I know we could have a very full and long and complete conversation on these things, and I'm sure that, in my role, as I become more acquainted with the work of these groups, I'll have questions, as well, pertaining to those.

But I'll –we'll move on for now and I thank the minister for providing the information that she has. We've been talking –we talked just briefly about advertising and I'd like to return to that theme, but just before we do, one last question pertaining to the–to employees within the department. And we talked about employees, we talked about contracts and we talked about various parts of those. I don't know if I also included a question, a request to provide information about severance packages.

We noted yesterday that the number of employees within the department was incidentally static; it had not changed from a year ago, which is interesting. But, be that as it may, of course, employees come and employees go. Some retire, some leave for other pursuits, and new ones come on all the time. What is the number of severance packages or incentives that were pr ovided in the previous fiscal year to people leaving the department, and, perhaps, what is the total envelope for the severance that was provided for individuals leaving? Ms.

Oswald: I can confirm for the member that the Department of Health doesn't offer incentives for retirement, so that's a non -issue in terms of the amount. And conferring with my staff, they are not drawing to mind any severance that has been paid over the last year. * (11:00) It would be –it's possible that, in the case of Dr. Joel Kettner, I believe that that may have been captured in last year. We're going to double -check and the circumstances around disclosure of those details I also have to know what, you know, what my responsibilities are concerning third parties and confidentiality.

So I will need to review those rules. But, certainly, I believe he would be captured in the public disclosure documents. So I will take that question from the member and review, but from my department right now they don't believe that there are any in the last year. But of course we'll review that. Mr. Friesen: And in the interest of being comprehensive, just so I understand that I've covered the bases, so we have no incentives that are paid out from the department. We have no indication of severance. Would there be any other form of payment or remuneration upon release from contract that I hadn't already asked?

Ms. Oswald: Certainly, I am informed that when an individual retires they are subject to, you know, whatever provisions are existing in the collective agreements, like the standard payout of vacation pay and so forth. And–but no, I don't think that the member is leaving out any nomenclature for a kind of payment that would happen at that time. It would just be standard within the collective agreement. Mr. Friesen: I thank the minister for that response.

And the reason, of course, I ask it is because in lieu of the fact that the minister disclosed yesterday that the current vacancy rate for positions in the Department of Health is in excess o f 8 per cent, I wondered if there had perhaps been any kind of an internal strategy to provide an incentive or to give employees an option as has been done many times within both public and private sector. People who are approaching retirement or maybe on the verge or – and it's a legitimate way of realizing cost savings

1416 LEGISLATIVE ASSEMBLY OF MANITOBA May 17, 2013 within departments. It can result in bringing new people on and removing some of the salaries and other expenses that are paid at the very top of the scale, and it sounds like that is not being done in this case and there's no framework within which that is being done. So I thank the minister for that response and I'd like us to move along. We were talking earlier about advertising and so I would like to just turn our attention to advertisin g. Of course, as the minister knows, we regularly request and receive information that has to do with advertising.

But I want to transition to a conversation about RHA advertising, and perhaps on the basis of that we could segue into a conversation about other themes within the RHAs. And so if we could start with advertising. I know that the minister often makes a note of the fact that she says that Manitoba has one of the –well, I won't put words in her mouth. But let's just say –let's talk about the advertising costs within the RHAs because we were talking just previously about the advertising costs as a line item within Executive Support. So everything changes now, of course, because we're combining 11 RHAs into five.

But I noticed that I have informatio n here indicating that the total cost if we combined them and we took all of the previous 11 RHAs, that the total cost for advertising in the year 2010-11–now that's not completely up-to- date–that was $3.6 million, approximately, and then that for 2012 that number has again gone up. I wonder if the minister could indicate –and I know this is going to get challenging in our discussions as we proceed, we now have five RHAs– but what would be the total allotted cost to advertising for the combined new five RHAs , and is that information at this time available? Ms.

Oswald: Yes, Mr. Chair, certainly, as we said before, there is a considerable budget that is available from a variety of sources for advertising information in the case of the Health Department and the RHAs. We know that there are a variety of circumstances under which we have public awareness campaigns that are launched, campaigns that are launched at the request of our medical officers of Health or the Chief Provincial Public Health Officer, things like West Nile virus or Lyme disease or, you know, that –the nature of that kind of advertising that is health promotion and prevention.

Certainly, there are advertising budgets in our RHAs that are very aggressive in terms of recruitment for front-line staff. That would be a very important component of the advertising, and I'm sure that the member would agree that we want Manitobans to have the best possible information available to them about protecting themselves and their family, and so that's why we see an advertising budget of that nature.

I can inform the member that the new RHAs are just going through their year-end audits for their first year of existence, and so we anticipate that information such as this on advertising will be available, likely to wards the end of June. So those audits are currently under way. Mr. Friesen: And I would thank the minister for providing that information when it comes available to me for the–to show a breakdown of the advertising costs for each of the new five RHAs, an d then we can derive some numbers out of that.

On the same subject, I wondered if this would probably be the appropriate time to bring to the minister's attention. I filed a FIPPA request on February the 1st to the WRHA to receive information on advertisi ng for 2011- 12, and the reason I brought to the minister's attention the 2010-11 numbers for advertising is because we received them; we received numbers for each of the previous RHAs, including the WRHA. And, in 2010-11, that number was stated for the WRH A as $338,000. That was the advertising cost by that RHA.

Now, that's –it's interesting to me because that number is far less than other numbers stated, like Parkland and NOR -MAN. I just can't understand why that number would be so low. But, be that as it may, when the request was put in on February the 1st, it was returned with a statement that said that the request could not be met, that the request was declined, and the rationale given was that if the request was repetitive or incomprehensible or is for information already provided, that it would not be made available.

So I'm wondering if the minister could indicate why it was the information was requested and received in the previous year and then, all of a sudden, it was met with a response that it wa s repetitive or incomprehensible. What changed in the time period? * (11:10) Ms. Oswald: I thank the member.

May 17, 2013 LEGISLATIVE ASSEMBLY OF MANITOBA 1417 On the issue of information being provided at one time and then not subsequently being provided, I'll have to do some investigation about why that is so. You know, I would just ask the member to give me a little bit of time to do that particular investigating. My folks says that I might be able to provide you with some more detailed number -type information in just a moment, but , rather than sitting and waiting , we can move on and I can either get back to him in the, you know, as this session unfolds, or as soon as we can. Mr.

Friesen: I thank the minister for providing that information, and it is more than a curiosity to me, if I could just take us back in time. And I know that sometimes ministers of this government love to take the Chamber back in time, and so, perhaps, today she'll indulge me to go back in time a little bit. When I look at the information that I do have in front of me, the information that compares the 2009-10 expenditures for advertising to the 2010- 11 figures for advertising, what I notice is that advertising is a little bit up and a little bit down depending on the RHA you're talking about.

But, by and large, it's consistent and there are small increases and small decreases, with the exception of the WRHA where we have stated advertising costs by the RHA in 2009- 10 at almost a million dollars – 901 and change–and then the same RHA declares advertising costs of $338,000. So thi s is a tremendous–this is a significant decline in advertising over one year. Except, that if I remember back, I don't seem to remember any kind of perceptible decrease in what I would see as the public advertising, the public activities of the WRHA. The printed materials I would see.

The radio advertisements–and I'm wondering if, indeed, what we are seeing is a realizable savings within the WRHA, a determination to significantly drive down the cost of their advertising or whether, instead, perhaps the adve rtising expenses were captured elsewhere and not reportable in this framework. Could the minister speak to that? Ms. Oswald: Yes, again, I will commit to the member to, you know, provide him with more details about the nature of the advertising that was done and if, indeed, there were, you know, other lines or places. It's not my understanding that that is true.

I do believe in relation to some of the FIPPA's that were being cited comparing rural and WRHA, that you mentioned a few minutes ago, I do believ e that there was an issue with FIPPA responses that had been corrected. And I want to make sure that (

a) in fact, is accurate, and (

b) that information that the member is in possession of is the most up to date. So these are some of the issues that my st aff is working through right now trying to seek clarification on–bad sentence.

But, certainly we will provide that information and ensure for the member that he has a good understanding of what it is that our RHAs are communicating with the public about, whether there're messages in promoting, you know, public health messages, whether there are, you know, notices of a more urgent nature that go out concerning of –protecting the public, notices about immunization, or access to QuickCare clinics, or what have you.

We want to provide for the member an understanding of the nature of the work that's going on, and if there are fluctuations in the different years from year over year, we certainly would want the member to know that. We do know that there are circumstances existing over time that cause, you know, a need for very intensive and heavy communications.

A very good, somewhat recent example of that would be H1N1 where there were bits of advertising done , more than once a week in some cases, about the availability of vaccine, about information concerning symptoms and information about–for the public to be very aware of for at -risk populations, if they were to have any kinds of symptoms that they would need to seek emergency care without delay. So comparing a year like that to a year where there is no pandemic issue or, you know, very low risk of West Nile, for example, these are the kinds of things that can show really considerable fluctuation.

But, in the name and the spirit of answering the question as the member has asked it, we will certainly have a look at the information that was FIPPA'd, the veracity of responses, any amended responses that were provided and, indeed, an overview of the nature and the kind of advertising. And I think t he heart of what the member is trying to get at here is why does there appear to be such a shift, in particular in the WRHA, and I commit to the member to provide him with as best a rationale for that as I can. Mr.

Friesen: And I concur with the minister that the scope of my questions in that regard were not as to the, you know, the rationale undertaken for the –for particular advertising endeavours or initiatives but more exactly, as she says, toward the fluctuation that we see from 2009-10 to 2010-11.

1418 LEGISLATIVE ASSEMBLY OF MANITOBA May 17, 2013 And then, of course, I'm sure the minister would appreciate that, as the critic, then, you know, my curiosity is piqued when our request for information the following year comes back and says, we can't provide you that information. So we look forward to receiving the information about the total amount spent on advertising the WRHA for 2011- 12 and be able to compare some numbers and see where we are with that. And we don't –we would hope that, in the future, that when this request will again be made it won't be met with a refusal to provide information.

So, if we can segue from there, then, into a discussion that will take us into adver –sorry, administrative costs for the RHAs, I would like to turn our attention briefly to a discussion about administrative cost s as a comparison of overall expenditures in the RHAs. And I know the minister has made, on occasion, the statement, even recently, that she says we have one of the lowest administration rates of any Canadian jurisdictions. As a matter of fact, I think she made the statement only recently in Hansard.

Yes, here it is, and it says : Today we are, according to the Canadian Institute for Health Information, among the lowest in hospital administration costs. And I would like to look at administration costs and maybe unpack this a little bit so I can understand to what the minister is referring when she makes that statement. I'm aware of the fact that, as a party, we've requested for a long time to know administrative costs, but specifically to be able to deter mine the specific costs of corporate administration.

And, while I can appreciate that the minister and the deputy and the department want to measure administration across the board in all areas of operation within the framework of health care, it's of particular importance to understand what corporate administration accounts for as a measurement against the total administration costs. So we used to request and receive that information. As a matter of fact, in 1999 the WRHA admin costs were just under 6 mil lion, about 0.6 per cent of the costs.

I see in my notes that by 2003 that cost had risen to 16.6 million, and then after 2004 we could no longer receive administrative cost as a separate line item. So I know that, in 2010-11, the WRHA reported administrative costs –administrative costs, all combined–as $105 million, and I have the information here that's received from a FIPPA that would indicate the same, that it had risen from –in 1999 they indicated 5.6 and then up to 105 million.

I guess what I'm wonde ring today is, is it possible to return to a time in which the minister would disclose corporate administration costs for the WRHA, and if, indeed, there is an apparatus there that would allow her to capture that data, because I can assure her we'd be interested in receiving it. * (11:20) Ms. Oswald: Yes, I can inform the member that corporate and administrative costs are reported in the regions' annual reports each year. Mr. Friesen: The minister says that those costs are reported in each of the regional health authorities' annual reports, which is great.

Can I clarify then– would the minister clarify and indicate that that is – that would not be costs for hospitals, as she has made statements about lowest admin –some of the lowest administrative costs, I think she said, in hospitals, but this would be a separate item that would indicate the corporate costs within the administrative structures of each health authority, and that's the inform ation that would be captured. If so, can she share today what that number was for the previous year? Ms.

Oswald: Yes, so, again, just to make sure the record is clear, it is not me saying that Manitoba's hospital admin costs are the–among the lowest in the nation. It is the Canadian Institute for Health Information that is reporting that and I'm just reading from their report, so I do want to be explicitly clear about that. Again, I can say to the member that corporate costs and admin costs are in the an nual reports each year, and we could get a copy of that for the member.

Certainly, though, it does speak to the issue that I've spoken about with the previous Health critic, you know, arguably for 25 hours, but let's just go down this road now for a little bit. Certainly, at the national level, there's a lot of conversation going on about the definition of corporate and admin costs. And across the nation there is some concern, I think, about how various entities report or define what these items are. You know, is the assistant who produces material to recruit doctors in an RHA or is directly involved in doctor recruitment, you know, would–is this a corporate position?

This is a position that directly affects the provision of care on the front lines. And so, there–I don't purport to have the answer to that. It

May 17, 2013 LEGISLATIVE ASSEMBLY OF MANITOBA 1419 is certainly my view that an individual such as that is very, very different from an accountant responsible for, you know, board expenditure, for example. They're very different

definitions of what dire ctly effects the front line and what is a corporate expenditure. So it certainly is why , in our Regional Health Authorities Act, we wanted to ensure that, as accurately as possible, we were able to peel out the front-line kinds of services versus what I t hink the public would more traditionally define as corporate. And it's why, of course, we have given our –an–our RHAs' a corporate spending cap, the RHA being 2.99 per cent and they are falling below that now, we're pleased to say.

So this is a discussion t hat's going on in the national stage so that there is consistency and validity in 'comparassing' – comparing jurisdiction over jurisdiction in this regard. It's a conversation that I think is critically important as we continue on a dialogue about the sustainability of publicly funded health care. So, what I –again, I can say to the member is that the WRHA shows their facilities and, indeed, the non-devolved facilities separate in their annual report.

And you can see corporate and you can see admin there, and we can endeavor to provide copy of those, you know, for the member, or he can–you can also get them online, I believe, so. Mr. Friesen: I thank the minister for providing that information, and I'll be interested to check there and we could perhaps bring this conversation back there.

I will go back, though, one more time, to the minister's statement that I find in Hansard –and I've heard her say it publicly in the community as well– that indicates that yes, and , as she says, according to CIHI, she quotes them as saying we're among the lowest in hospital administration costs. I also make extensive use of the CIHI database, and I find different conclusions there than the ones that the minister has drawn and put on record.

As a matter of fact, in information that I've just brought in today, information that is current as to 2012, it shows here that Manitoba still has more administrative expenditures than seven other provinces and territories, which would mean that we are not in the low range, but rather we're kind of more in the middle of the pack and not exceeding many jurisdictions. We're not even in the upper range of those six other provinces and territories, you know, that do a better job.

If you take out the territories, from the information that I have, which comes right from their database and information current as of 2012, we are right in the middle, at No. 5. Manitoba, with a population of 1.267 million, reporting administrative expenditures of $257.4 million as a line item. So this is–it's information that CIHI captures. They indicate administration and then capital and then drugs in hospital and down in goes; I know the minister's familiar with this information.

It also shows, year by year, annual increases in the cost of administration that seem to exceed the actual increases to the Health budget, and I would have to check again to make sure I'm accurate in saying the latter. But certainly it seems to be that I'm accurate in making the former assertion that Manitoba is not at the bottom. Could the minister respond to that statement of this information that I clearly see coming from CIHI, that shows us as leading not a lot of jurisdictions? And perhaps I could just add, when I said it was coming from CIHI, it's coming from the National Health Expenditure Database. Ms.

Oswald: Yes, again, Mr. Speaker, and– An Honourable Member: Chair. Ms. Oswald: Chair, Mr. Chair. It's a force of habit, you understand. Yes, so, again, I would say to the member that certainly we have, from a decade ago, according to CIHI, gone from among the highest to among the lowest. It does fluctuate, that's for sure, and I will commit to the member to review the items that he's speaking of today in this item.

But what I would g o back to is this whole issue and this discussion that I've had with the previous critic, concerning the measuring of these costs that certainly does–that came out of the external review of regional health authorities, and what that regional health authori ty review said is that there is considerable confusion, I think, about how administrative costs are portrayed and how they're defined.

And this, as I say, is a conversation that's going on at a national level, but we know that the external review–RHAs said, without a doubt, that all RHAs have taken actions to reduce admi nistrative costs and that there's a constant focus on cost savings and evidence of reduced costs. * (11:30)

1420 LEGISLATIVE ASSEMBLY OF MANITOBA May 17, 2013 But they did raise concerns in that external review about the wide scope of the administrative cost indicator and that it includes patient -related functions that may not, indeed, by the general public, be considered to be bureaucratic spending. And they recommended improved transparency and the proviso of a–of corporate cost indicator, and that was developed to separate out this corporate executive kind of cost from patient care: related admin functions like infection control and quality assurance and doctor recruitment, as I said before.

So we want to ensure that as we're measuring, where is the money going? Is it going directly into that which affects a front-line person? Is it going directly–oh, a front -line patient, I should say. Is it going more towards that which would be by the broad public considered corporate? So we have worked very hard to make sure that we're providing the kind of definition that the external reviewers, led by Jerry Gray, dean emeritus of the Asper School of Business, the kind of definition that we recommended that we use and the kinds of

definitions now that are being recommended on the national stage. So, again, we know that the reviewer saw admin costs as an old definition, if you will, trending down across the regional health authorities and that there was a constant effort. And we're also seeing now being able to define in a more precise differentiation between patient -related functions and more typical corporate-related functions, we are seeing a decrease happening in that regard as well. So I take the member's suggestion that I need to review this particular database in the context of hospital costs, and I would –will do that, of course.

And, at the same time, I would suggest to the member that we are also acting –as are the RHAs at our insistence –are acting to respond to what the external reviewers ask them to do and to be clear about administrative functions related to patient care and more traditional corporate functions that may be less so. So though–that kind of innovation has happened, and we think that that's the kind of information that's useful to the public which is why it's contained in their annual reports. Mr.

Friesen: I thank the minister for that response and for her commitment to go back and review that data, because as I've mentioned, as I've heard her say that we are among the lowest –I think the word among can be somewhat misleading. It would be analogous to the Liberal Party saying they are among the parties with the highest number of seats in the Manitoba Legislature because they're in the top three. But I think it is important, and we know, across the board it does –as the minister say –it does depend what you measure. And I thank her for that commitment to go and look again at that.

I think that provides an excellent segue to my next area of inquiry today. The minister has said that there is –she used the term considerable confusion when it came to figuring out what would fall within the scope of administrative costs. And, certainly, for us in the Estimates for this year, as we move forward the minister would've probably projected that we would have a discussion about the regional health authorities and the amalgamations.

And what I have noted is it provides a real challenge to me, but I know it also provides a tremendous challenge to the people who are working with the minister who are tasked with bringing together all of the apparatus of 11 agencies into the context of new –a new five agencies.

But I wanted to focus our attention–and I should say, of course, like, that would've been a function that was largely undertaken by areas like the Health Workforce and I imagine that there were to be other ADMs and I'm sure the deputy minister has been up to his eyeballs in a lot of the work that goes with all of the mechanical aspects of bringing this together under new five RHAs.

But on that th eme of considerable confusion, what I have been trying to do, and what I hope that we can do better today, is to arrive at a clearer understanding of the indicated cost savings that the minister has stated–I heard her state for the first time in her response to the Budget Address. So in budget debates a few weeks ago, the minister stated: I am pleased to report to this House, Mr.

Speaker, that as a result of these mergers–those being the mergers of RHAs from 11 to five –we've already eliminated more than 100 board and executive positions and we have indeed saved $11 million in our first year alone, two years ahead of schedule, and those savings are being reinvested to support front-line care. I believe that that statement of the minister's would provide a good foundation for us to proceed in a discussion right now, and I can indicate to the minister there's just really no good way to go through this. I've been trying to think of a way we can efficiently move through this.

And I'm aware, as she has said just e arlier, that we are exactly at that stage in the game where we're only going to be now looking at the financial statements for the previous

May 17, 2013 LEGISLATIVE ASSEMBLY OF MANITOBA 1421 year, for the first year of operation of these new RHAs. So there is incomplete information for us today simply beca use those calculations are still being made. But what I have in front of me is the–is basically the organizational chart for each of the previous 11 RHAs. And when the minister makes this –the statement that we have reduced the number of executive positions and board positions by 100, and I look at the previous organizational charts for all 11 RHAs, I think it'd be worthwhile exploring this to find out where were those savings achieved.

I'd be very curious to know a number of things. So, then, rather than asking a very large question, I'm going to try to chip a little bit off at a time and ask some very specific questions about how we can get to where these savings have been achieved. This is a, I guess, in the minister's eyes, a tremendous success story. I'm a little reticent to accept, on its face, the idea that we've managed to save $11 million in the first year.

So I just want to know that we're comparing apples and apples, and I also want to be sure that our discussion will be a fulsome discussion and it will also include other areas of expenditure that may indeed have arisen as a result of the decision to amalgamate RHAs. So can I start here? Could I start by asking the minister just to indicate for us, in the previous Assiniboia RHA, how many positions would there have been on the–in the corporate executive? So that would be the CEO and the senior vice -presidents.

Basically, if I use the minister's own terminology of executive positions –and the reason I'm going to proceed this way is you can imagine, as I've gone through the RHA organizational charts, there didn't seem to be a standardized format. It's alike–a lot like going to the–to use your bank card at a business and you notice there's just no standardization across those machines, and so it's a li ttle bit more difficult to find the buttons. And so, when I look at this sheet, I noticed there wasn't a standardization. There were some of these former RHAs that had a great way of stating their org chart.

In other cases, I find my – found myself a little confused about how to understand who was a VP and then who might not be included as a VP. So, using the minister's own statement of senior add–no, not senior administration, what was the term used–it was executive positions. Could the minister indicate, in the former Assiniboine Regional Health Authority, how many executive positions were there as of most recently, just prior to amalgamation? * (11:40) Ms.

Oswald: I can let the member know that the Assiniboine Regional Health Authority had six executive positions, Brandon had seven and Parkland had five, for a total of 18 executives. The new Prairie Mountain region now has seven, which was a net reduction of 11 executive positions, and, of course, correspondingly, those boards will have been amalgamated into one board. Ms. Sharon Blady, Acting Chairperson, in the Chair The Acting Chairperson (Sharon Blady): Member from–for–for Morden-Winkler Mr. Friesen: I wasn't going to save you on it. Thank you, Madam Deputy Chair.

Just to clarify –and I thank the minister for providing the information. I missed the first part of it. I heard Brandon had seven, I heard Parkland had five, and I missed the statement of what Assiniboine had. I think the minister indicated Prairie now has a total of seven, which would have resulted in elimination of 11, so excuse my bad math, but could she just indicate one more tim e what was the previous Assiniboine? Ms. Oswald: I'll just repeat what I said to make sure that we're on the same page. Assiniboine had six executive positions, Brandon had seven, Parkland had five, for a total of 18.

The new Prairie Mountain has seven, for a net reduction of 11 positions. Mr. Friesen: Now, so that I understand correctly, if I compare the minister's information to the most recent copy that I have of the organizational chart for Assiniboine–I'm just trying to understand and, like I said, th ere isn't a uniformity about the way these things are represented. Some I found to be more transparent, others a little bit more hard to read. If I read this org chart correctly –and I apologize for not bringing copies I could have just sent over the table.

I know it's difficult to have everything at your fingertips when we're coming into this kind of environment and there's only so many briefcases you can bring into the room with you. But what I see here is there is a statement that shows a VP of communit y health services and a VP of corporate services and on and on, so I see one, two, three, four, five, six executive positions. But , in addition to that, I'm wondering if the minister could

1422 LEGISLATIVE ASSEMBLY OF MANITOBA May 17, 2013 indicate, is the CEO included in the calculation of the executive positions? Ms. Oswald: Yes. Mr. Friesen: Is the medical officer of health included in the calculation of executive positions? Ms. Oswald: I'm almost positive I heard what you said. The Chief Medical Officer is indeed not considered an executive position. Mr. Friesen: The minister's correct. I mentioned medical officer of health. I'm not sure if the term chief is attached to the medical officers of health that are–that exist within the apparatus of the former RHAs.

Could the minister indicate if the chief officer for EMS is considered to be an executive position within the framework of the RHA? Ms. Oswald: Thank you very much, Madam Acting Deputy–fabulous Chair. Sorry. The chief EMS individual would not be considered executive. That individual would report to a VP and so that's what would be counted as an executive. It's also worthwhile to note –perhaps as an aside–that as a result of recommendations from the EMS review, that we are going to be looking at consolidating and amalgamating these positions as well, which I think will be good. Mr.

Friesen: Right, so I think I'm learning as I go here, in terms of how to read your organizational charts–and this is very helpful to me. So then, Madam Deputy Chairperso n, if I can just concentrate again on the Assiniboine Regional Health Authority organizational chart–and I'm sorry; I should have indicated to the minister the most recent one we had in our position was 2010- 11, that might have –there might have been a more recent one, from '11 -12, prior to the amalgamation, I know that was done mid-year.

But, if I read this correctly, then, let's say I take a look at that same VP position for community health services. Now there's a number of roles that are articulated und er the authority of the VP for community health services. Those roles are public health services, home -based care services, community mental health services, Aboriginal health primary care services; now, those positions would then exist within the administration of that RHA but those positions–am I correct in assuming they would each–that title would then correspond to a particular officer?

Those functions would not all be housed within the work of one VP for community health services, can't imagine that wo uld be the case, but that these other five areas I mentioned just now – Aboriginal health, primary care services –those would not be considered to be executive management team positions? VP and up would be the executive management positions. Ms. Oswald: Okay, I felt we went down the rabbit hole for a minute there and I got a little bit off the track.

But I think I can answer this question by saying that the positions that we are speaking about, in terms of those that have been eliminated over the overall in the RHA amalgamation, indeed, were senior management positions. Now, as we go through the process of this first year and there's new leadership and there is a new streamlined senior management, it certainly may unfold that there will be restructuring that may naturally evolve.

But, when we speak about over a hundred executive and board positions having been eliminated, we are talking about the boards –that's obvious–but we are talking about senior management positions. Does that answer the question you were asking me? Mr. Friesen: Thank you, Madam Deputy Chairperson. That's helpful. Can t he minister also clarify for me, then , when we were –terminologies are important –so when we're talking about senior management, that is analogous to saying executive position. Senior management and executive, those are the same terminologies –we can use those interchangeably? Ms.

Oswald: I would say, yes, we could. * (11:50) Mr. Friesen: And at risk of going down the same rabbit hole one more time, let's say I was that individual who was working in that former Assiniboine Regional Health Authority, and it was my responsibility to co -ordinate home -based care services and that was what my business card read and that's what it said in my title , and I had my desk and my office an d my–the resources that flowed to me to do that job.

I would be considered to be management within the structure of the RHA, but I would not have been considered to be senior management nor would I have been considered to be executive. That would have been on the organizational chart the individual above me, the

May 17, 2013 LEGISLATIVE ASSEMBLY OF MANITOBA 1423 individual to whom I report. In this case that would've been called the VP for community health services. Is that correct? So , if I'm in that position, home-based care services, I'm management, I'm administration, but I am not senior management, I am not executive. Ms. Oswald: I would say that what the member is saying–if I'm understanding him correctly –is mostly accurate. I don't think that we would refer to somebody in a managerial role of a progr am like the one he described as administrative. I think we would refer to that person as a manager.

But , when we are speaking about senior management or executive it tends to be those that have a direct report to the CEO. I hope that that helps to clarify. Mr. Friesen: That is very helpful for me to clarify. So–and I thank the minister for providing that information about Assiniboine and Brandon and Parkland. If we can proceed then. We talked about Brandon. We talked about Parkland. Could the minister indicate in the former Burntwood RHA how many positions did exist in senior management, and indicate for us–yes, that information to begin. Ms.

Oswald: Burntwood had six executive positions and NOR-MAN had nine executives for a total of 15. The new northern region has seven for a total net reduction of eight executive positions. Mr. Friesen: I thank the minister for that information. Now, a supplemental question, I guess, would then be –and that explanation makes sense to me because it seems consistent with what I read just as I'm reading it on the organizational chart that I have which is effective March 31st, 2011, for Burntwood.

But so that I understand it correctly, would an executive assistant position or a communications officer position, which are sometimes indicated on these organizational charts above the vice-presidents, would those positions also be considered to be executive management team, executive assistant or communications? Ms. Oswald: In the case of an executive assistant, the answer to that question would be no. It is my recollection, however, that there was in the NOR -MAN Regional Health Authority, a communications person that was at a senior level, and so they may have been captured in that way.

I do want to go back and double-check that fact. But, as a rule, someone written as executive assistant would not be captured in that definition of executive or senior management. Mr. Friesen: Could the minister indicate, for the former Cen tral RHA, the number of senior management positions? Ms. Oswald: The former Central Regional Health Authority had nine positions. The former, I'm guessing, South Eastman– you want me to go there – had six positions. The new Southern Health, Santé Sud, now has seven executive senior management positions for a net reduction of eight exec positions. Mr.

Friesen: I thank the minister for providing that information. I'm seeking a clarification with regard to Central's stated senior positions? Because the math doesn't jive with what I see on their organizational chart, and I'm just checking again to make sure. I see vice -president positions indicated for corporate services, finance, human resources, medical services, planning, northern services, mid-central services, southern services, the position of the CEO, and then a communications officer as well.

I mean, it would amount to nine as long as there wasn't also a communications officer or anyone else that would be captured. We know that the medical offic er of Health does not exist in that calculation of management positions. We know that the chief officer for EMS does not exist in that position. But is it–can she just, once again, state whether that number was nine or 10? I may have failed to state one more position– maybe I state it right now, I'm not sure.

Communications and french language services, that seems to be the additional –from what I can see, that would be the additional position that would make the calculation higher than what the minister in dicated, by one. Mr. Chairperson in the Chair * (12:00) Ms. Oswald: And we're having a debate over here, to be frank, about communications, French language services and VP medical, which we did not count as– you know, in other circumstances. So we're going to work through this . I believe this number is correct, but I want to be absolutely sure and clear in my explanation of how that unfolded.

So I will commit to the member to come back with that information when we next meet.

1424 LEGISLATIVE ASSEMBLY OF MANITOBA May 17, 2013 Mr. Friesen: I thank the minis ter for that commitment because, yes, if I read it correctly, then Denis Fortier was in–VP medical services, Claudette Lahaie was in communications, French language services. So, if those positions were not included in the calculation of executive management team , we would arrive at a number of eight. If they were included we'd arrive at 10, and then I'd invite her to get back to me with respect to that. We can clear up that number.

Let me say, as an aside, I really like the centrals– the Central RHA's orga nizational structure as stated on the website. Now that was clear, and my compliments to whomever the –whoever the web designer was who put that information up there. Positions, the individual staffing, the position and very clear, and then on a separate page an indication of who some of those managers were on that thing. Ms. Oswald: I will be sure to send hearts and flowers to the Central and South Eastman Regional Health Authority.

I would, of course, point out that both of us coming from the educational f ield, you know, we all learn in different modalities. It's entirely possible that the member for Lac du Bonnet (Mr. Ewasko) beside him might indeed find the chart from the northern region to be one that he would embrace. So it's quite interesting that, you know, we all learn in different ways, but I certainly do embrace what the member is saying about consistency and standardization, and I am –I will take his advice forward and his vote.

And, if we are going to standardize what these charts look like across the regional health authorities, that the new southern health one certainly does get his vote and I will take that to heart. Mr. Friesen: And in the spirit of that kind of broad based co-operation, let me also state for the records, it's not just the critic for the portfolio that finds the information presented in that way to be helpful, but I know I have had compliments from the community as well because the community and individuals seek this kind of information.

And it is always good when more informatio n can be provided in a comprehensive and clear way, and I certainly think that website goes there. Let's move along and I'll just ask the minister to provide an indication of how many executive management team members there would have been for the Churchill RHA–in the former Churchill RHA. Ms. Oswald: So the former Churchill Regional Health Authority had five positions in it: CEO, chief financial officer, a director of clinical services, a director of human resources and director of community services planning.

And at that point, I would humbly ask the committee if we might be able to take just a brief recess. Mr. Chairperson: Is everybody agreed? [Agreed] Okay. Five minutes recess. The committee recessed at 12:04 p.m. ____________ The committee resumed at 12:08 p.m. Mr. Chairperson: Order. Committee resume. Ms. Oswald: Oh, thank you very much, Mr. Chair, on so many levels. Yes, to resume, I want to correct something that I said before. I did note from the original process of amalgamating regional health authorities, the medical officers were not counted as part of the corporate structure.

As we went forward and the regional health authorities were starting to reformulate and reshape, it did become evident to those working on the ground that peeling out VP medical or VP and chief medical officer was becoming confusing in the communication, so it did actually transition into an executive position in the count. So I gave you information from the beginning of the journey and did not update what has been subsequently decided, so, in fact, as our numbers are differing here, it is on the point of including the VP medical. * (12:10) So I apologize to the member.

I did misspeak about that, but, indeed, there had been a change in protocol on that. So, going back, I believe, to the Southern Health issue, I can clarify now that –and maybe the member can help me if I'm not fully clarifying this issue–that the Central Regional Health Authority had counted as senior management positions: CEO, VP corporate; VP financ e; VP human resources; VP planning; VP programs and mid-central services; VP programs and north services; VP programs and south services; and VP medical.

But, indeed, as the member enquired, communications and French language services were not captured i n that group. So I hope that that helps to clarify the calculation of nine.

May 17, 2013 LEGISLATIVE ASSEMBLY OF MANITOBA 1425 Mr. Friesen: I thank the minister for that correction because that does actually take some questions off the table for me. Now, do I understand correctly, then, that as we were d iscussing the complement of senior executive member –management team members for Assiniboine and Brandon, Parkland, Burntwood, NOR-MAN, as well, is there a correction to be made in the numbers that she supplied as to the executive management team members wh o are on those groups?

Because now that we've made that correction, I'm wondering, if I go back to that same organizational chart for Assiniboine, I don't see the numbers adding up any more according to the amount of stated positions. I still see one, two, three, four, five, six, seven and then I see an eighth position for Assiniboine if we are indeed counting the medical officer of health as executive management team. The number I originally was supplied was six. I count eight. But I do see a note in the c hart that says the VP capital planning and support services position was vacated and not filled.

So all things considered, it would tell me we have a discrepancy of one position, unless we're now just adding on one more because we're going to now factor in the medical officer of health, and I would invite the minister to clarify that for us. Ms. Oswald: So I believe that what I heard the member ask me–thank you, Mr. Chair, by the way –I believe what I heard the member ask me or state as a reclarification is accurate now that we count the VP medical. But I am going to go back and review the Hansard of this to make sure that what I'm confirming for him now is true. There was a rather long list of items there.

So I just want to be clear that it was decided th rough the process, based on communications with the communities and with people in the region, that it was difficult to communicate that when there were a list of VPs and then there was one that had VP Medical, it was difficult to differentiate and so that change was made during the process. So I believe what the member has stated is correct. But I am going to go back and read it back and make sure that that corresponds with the numbers that I have. So I will do that. Mr.

Friesen: In an endeavour to just t idy up our numbers then, then I would also invite the minister just to come back with an updated number, because then in Brandon I would count eight instead of seven and in Park –sorry, in Burntwood I would count seven instead of six if we are indeed includ ing that same medical officer of health. And I do note that on the organizational chart for Burntwood, I do notice that they actually did connect that box with a line and that might have been an indication–because that was a more recent organizational char t–that they might have been including that in the calculation.

And so I think as we continue on we'll come back to those numbers perhaps in the next day of Estimates and that will provide a good clarification. But I would maybe suggest that today we just push on so I have a framework of understanding. We're almost there in terms of going through the former 11, and so I think even if we get a number –one position clarified back or forth for the next day would be helpful. But at least we can get on paper today just so that I'm understanding correctly what that total envelope would have been for executive management team.

So I'll allow the minister to add a clarification here, and then I will soldier on. Ms. Oswald: Yes, I thank the member for that, and I'll be brief. I think, in this conversation, the issue of the transition midway through the process on the issue of VP medical is one issue. I also think the fact that I'm looking at a list and he's looking at a chart might be muddying the dialogue somewhat.

So what I'm going to endeavour to do for the next time that we meet is to be able to provide the member wit h a copy of the sheet from which I'm working, and we should– [interjection]–yes, you can give me the charts –no, it's okay –and we should be able to have clarity on that. I would also just ask–we can push on to finish this conversation as the member has suggested. I wanted to say I do have a brief update on another question he asked me from yesterday; if we can leave a couple of minutes at the end, that would be grand. Mr.

Friesen: So, yes, we'll leave a few minutes at the end to provide an opportunity for the minister to give that clarification or that update and then we will continue on. We had just finished talking about the Churchill numbers, and I will go to the Interlake numbers and ask the minister just to supply the numbers for the total executive management team for the former Interlake RHA. Ms. Oswald: The former regional health authority for Interlak e had –let me start again.

The Interlake Regional Health Authority had six positions: CEO, VP planning, VP health services, VP corporate services, director human resources, VP medical.

1426 LEGISLATIVE ASSEMBLY OF MANITOBA May 17, 2013 The former North Eastman Regional Health Authority had six positions: CEO, VP finance and support services, VP quality and organizational development, VP programs and services, director of human resources and VP medical. In the new Interlake -Eastern Regi onal Health Authority, there are now seven executive senior management positions, for a net reduction of five senior management positions.

And, just for the record, I'll state , then, that the existing now in the Interlake-Eastern RHA: CEO, VP acute health services and chief nursing officer, VP community services, VP primary care and chief administrative officer west, VP finance and chief financial officer, VP corporate services and chief administrative officer east, VP and chief medical officer. Mr.

Friesen: I thank the minister for providing that information, and I neglected to state earlier when the minister agreed to provide those lists of information, she's going to provide both those lists for the former RHAs and also ones for the new -formed five RHAs because that information we have had a dickens of a time trying to find just online somewhere to find where it's stated with the organizational chart for these new five RHAs. We would welcome that information. Can I say dickens of a time in the record?

And, just to clarify, if that information could also include not only the title of the position but the name of the individual who occupies that role. Ms. Oswald: Yes, we can do our best, and I want to apologize for the aforementioned dickens that the member had to go through to get that information. We will endeavour to provide that in the form that he's requested. Mr. Friesen: I'm seeking just a small clarification in relation to the Interlake RHA. I thank the minister for indicating those positions as we ll in the calculation of the number of former executive management team positions.

I do count seven; she stated six. I was wondering if the vice president of medical services was included in her calculation of VP positions, because I would get VP planning, VP health services, VP corporate services, VP medical services, medical officer of health, human resources director–as she stated –and CEO for seven. So, if, indeed, the medical officer of health is included in this calculation, I'm arriving at seven. * (12:20) Ms. Oswald: And may I just confirm that the member's speaking about Interlake-Eastern still? Mr. Friesen: I was speaking about the former Interlake RHA. Ms.

Oswald: Not to confuse matters any further– I think this is clear –VP medical or chief medi cal officer would be counted as senior management. But a medical officer of health is a public health part of that branch and so would not be considered counted in the senior management. Does that clarify what the member's asking? Did I hear him correctly? Mr. Friesen: I actually think that the minister's statement just now is not consistent with the ones she made a few minutes ago.

Now, I might be misunderstanding, but I made notes about the fact that we were now including–because of a shift, we were now including the m edical officer of Health under that umbrella of executive management team. I think I heard the minister now say that although the VP of medical services would be included, m edical officer of Health would not. I thought we had come to the conclusion that it would be, so I am seeking that clarification one more time. Ms. Oswald: Yes, if I misspoke earlier, I apologize to the member.

But I can state clearly for him that that which is listed as VP medical or chief medical officer, CMO, would be –would indeed be captured as senior management, but medical officer of Health not. And I apologize if I misspoke a few minutes ago. Mr. Friesen: I think that as the minister stated previously and as we agreed, we'll get these numbers exact in the next day of Estimates. That's going to help us a great deal. This is just –we're ballparking for now. We're –we understand it, and I'm working from materials that do –they are a year old, and so there might have been positions unfilled. So I do appreciate that.

I think there was a slight lack of consistency. I had made some notes to clearly indicate for Assiniboine starting –I crossed out medical health and I added it back in and said, yes, include it under executive positions. So we will–we'll figure that out as we go along, and I'll thank the minister for providing that information as we continue. Just to clean up our list then, I think we have already talked about NOR -MAN, we have already talked about NEHA, we have talked about Parkland–

May 17, 2013 LEGISLATIVE ASSEMBLY OF MANITOBA 1427 yes. We have talked about South Eastman, and we have talked–we have not talked about the WRHA. I believe that the WRHA is the final former RHA, and, of course, now, the scope of that, when the WRHA doesn't change per se, but it takes now Churchill– lists Churchill back in, so there are structural changes to that group as well. I have a more recent organizational chart, and I thank the WRHA IT people for providing that one.

Could the minister indicate then, for the organizational structure of the Winnipeg Regional Health Authority, what is the complement of the executive management team there for the former region? Ms. Oswald: Mr. Chair, I can confirm for the member that there's actually no change, so this is the easiest one of all. I would note, though, that we do have, living in Churchill, an individual that functions as a chief operating officer because I am sure the member would agree how important it is to have leadership in the Churchill community as we go through this change.

This would not be considered part of the senior management, however. It would be very much like a chief operating officer of one of the hospitals here in Winnipeg, as –in terms of their reporting relationship up through the senior management. But w e very much do embrace and value the people of Churchill broadly, and also the importance of having leadership on the ground in Churchill to be managing the health services that are offered there and, of course, we service individuals from Nunavut and the surrounding area in that environment.

But that chief operating officer certainly does play a hugely important role in understanding the unique needs and challenges of the folks that are living in that community. So, while the structure of executive has not changed per se, there is an important role that the leader in Churchill is playing now and will continue to play into the future. Mr. Friesen: Mr. Chair, so the minister indicates there's no change in the size of the WRHA corporate structure, the senior management team. Could she indicate that's no change from what? So what was the number that we were at?

I'm looking at the organizational chart here and I have an idea of what that number should be according to what I see. Ca n she provide a number for us? Ms. Oswald: Yes, so the former –Winnipeg had seven senior management position; it has seven today. So, combined, the Winnipeg- Churchill RHA would see a net reduction of five. Mr. Friesen: Now, I know we wanted to leave time for the minister to make a –some final statements about some information she wanted to leave, so why don't we–I would ask the minister at this time if she has other information to share. I would welcome that at this time. Ms.

Oswald: Yes, I thank the member for affording me this opportunity. We had some discussion yesterday about the Blue Cross medical claims processing system. We –I can confirm for the member that the amount that we estimated for Manitoba Health's costs in 2013- 14 is $606,000, which does find itself under the budget for the Insured Benefits branch. I can just elaborate a little bit and let the member know that the medical claims system, of course, is used to process billing by Manitoba doctors and other providers.

The current system is old, sort of from the time of disco, needed to be replaced and it is not a small cost, of course. So, we announced last year that we're partnering with Manitoba Blue Cross, as the member knows, non -profit, health insurance organization to build that new system together. We estimate that the –by developing the new system together with Blue Cross we're going to save roughly $3 million for taxpayers. The Blue Cross also needs a new system , so we are collaborating and joining forces to share the costs and save that money.

Manitoba Blue Cross is building the system and will provide system services to the province, while Manitoba Health is leading in the policy development for medical claims and will continue to process all Medica re claims in -house with provincial employees. So the new system itself will allow for faster processing using much more modern technology to deal with the claims electronically, but it will still, indeed, maintain the security of provincial data.

I think that should do it, unless you'd like me to go on about how nice we think the people are at Blue Cross and the work that they do and the fact that they form such a– Mr. Chairperson: Order. The hour being 12:30 p.m., committee rise.

1428 LEGISLATIVE ASSEMBLY OF MANITOBA May 17, 2013 FINANCE * (10:00) Mr. Chairperson (Rob Altemeyer): Will the Committee of Supply please come to order. This

section of the Committee of Supply will now resume consideration of the Estimates for the Department of Finance. As previously agreed, questioning for this department will proceed in a global manner and the floor is open for questions. Technically, I understand the minister might have some answers that were carried over from yesterday so we will begin there. Hon. Stan Struthers (Minister of Finance): That was a good start to the morning, wasn't it? An Honourable Member: Choked up already? Mr. Struthers : Yes, that's right. The coffee went down the wrong pipe.

Good morning, everyone, and, yes, we do have some follow up from some of the questions that the member for Charleswood (Mrs. Driedger) asked yesterday. One–the one question that we haven't yet got information on and it'll –it will take some time is on the advertising campaign for this coming year. Yesterday, as you recall, we talked about a projected number, a number that we're forecasting that we'll be spending on the campaign. We'll –until we get some actual invoices and bills and things, then, we can–at that point we can come up with a more precise number.

But for now the projected number is what we're working with. She had asked about infrastructure and a breakdown of the $1.8- billion number, a breakdown of capital and operating. What we have for the member for Charleswood emanates from the budget document that we were working from yesterday, which I see she has in front of her right now. Roads and highways, including preservation and winter roads: the budget number was $622 million, 468 of that is capital, 154 is operating. University, colleges and public schools: the budget was $228 million, capital 216 and operating 12.

Health facilities: the budget is $350 million with a $350 million in capital and zero for operating. The Manitoba floodway and water-related infrastructure: 48 is budgeted for that category, $37 million in capital, 11 in operating. Housing: $333 million budgeted, $332 million capital, $1 million operating. Assistance to third parties: $123 million is budgeted, $9 million is capital, 114 is operating. And I'll see that the member for Charleswood gets that in hard copy as well. The member also asked about some flood-related expenditures.

Some Part A operating expenditures from the emergency expenditures –a number of projects that fall into that category. Again, this a number that we project for this year and it is dependent on the types of emergencies, whether they be fire or flooding or who knows what these days with climate change developing as it is. But we budget for that amount and then we see how –what Mother Nature throws at us. Under DFA expenditures, there's $2 million. The continuation of 2011 flood recovery and restoration work at $23 million.

The Department of Infrastructure and Transportation, there's $3.7 million in flood mitigation initiatives. Of the Department of Local Government, building of municipal dikes, and that's funded through the Building Manitoba Fund, at $15 million. There's some Part B , capital investment through the Department of Infrastructure and Transportation, $35 million in several projects. The member for – members for southwest Manitoba would be interested in this.

There's a–work on PTH10 at Souris River, PTH2 at Souris River, PTH21 at Souris River, PR227 at the Assiniboine River Diversion, and PR251 at the Souris River at Coulter. So those have been identified under the $35- million infrastructure in Part B. And there's some water -related infrastructure, $17 million, and those are for Assiniboine River dikes, the Portage Diversion and the Oak Lake Dam. And, as I said yesterday, $9.3 million connected to the floodway here around the city of Winnipeg. I have a lso–there was some questions about the prebudget consultations that we had done.

And I have here, for the member for Charleswood, two copies of the worksheet that people were given at the consultations themselves. And also two copies of the slide presentat ion, the one that the member for Tuxedo (Mrs. Stefanson) has –could of shared, I suppose, with the member for Charleswood, but for some reason, doesn't. I don't mind helping them do their homework over there every now and then, Mr. Chairperson. I –it would b e nice if they'd shared amongst themselves, but obviously they don't. I will point out, though, that for the member for Charleswood, hers will be in colour as opposed to

May 17, 2013 LEGISLATIVE ASSEMBLY OF MANITOBA 1429 those black and white ones that were flashed around by the member for Tuxedo. So nothi ng but the best for my colleague from Charleswood, you know. The other thing we have is a –we were asked about attendance at the prebudget consultations. On Wednesday, January 3rd, we were in Brandon, we had 69 citizens come to that meeting and 44 questionnaires were filled out; Tuesday, January 29th, we were in–up in the northeast quadrant –I know the member for River East (Mrs.

Mitchelson) was asking about this yesterday as well –34 citizens came out and 19 questionnaires were filled out; on Monday, January 28th, we were in –we're just north of God's country, up there in Swan River, 33 citizens came out to that meeting, 24 questionnaires were filled out; on Monday, January 28th, later that – earlier that day actually, we were in Flin Flon, 15 citizens, 14 questionnaires; Wednesday, January 23rd, we were in Niverville, 19 citizens braved the very cold evening that evening and came out to speak with me there and they filled out 15 questionnaires; we were in Gimli on the 22nd of January where we had 17 people c ome out and 17 questionnaires–good for Gimli, 100 per cent filled out their questionnaires; Monday, January 21st, we were in the south end of Winnipeg, Fort Garry, 29 citizens came out and 26 questionnaires were filled out there.

The total number of people who signed the sheets as they came in was 216. Not everyone signed the sheets so that number would actually be a little bit higher than that. It wasn't mandatory that people sign in. It wasn't mandatory they fill out the questionnaires. So this is what we actually obtained from those consultations. * (10:10) What I can do is to –for the assistance of the member for Charleswood and her colleagues, I'll give them all this in hard copy. Do you want it now? Okay. Mr. Chairperson: Would the minister like this to be officially recognized as tabled documents? Mr. Struthers: Sure. Mr.

Chairperson: So be it. All right, so while the hard -working person who knows what's going on better than anyone in the room deals with the paperwork, I'll –we'll return to the floor being open for questions if, Minister, you were done. So questions from honourable member for Charleswood. Mrs. Myrna Driedger (Charleswood): I do want to thank the minister and the department for pulling all of that together overnight. That might be the first time, as a critic, that I have had things returned to me, period–or so quickly. So I appreciate that there was some work that went into this after 5 o'clock last evening.

So I thank everybody for that. Something came out this morning, a nd I just want to quickly touch on it and see what the minister has to say in terms of our inflation numbers. They came out this morning from Stats Canada saying that Manitoba once again is tied for the second month with the highest inflation rate amongst the provinces. Can the minister give us some indication of the analysis that his department might have done this morning to explain that? Mr. Struthers : Well, obviously, I think every Finance Minister–Canada, the provinces –I think we need to keep our ey e on the inflation rate.

We need to see inflation as part of the overall big picture and not simply hive it off as on its own. I think we need to make –all of us across the country need to make decisions that have a positive effect on inflation, and I will say that my colleagues right across the country, including the federal minister, do watch carefully this as one of the rates that we make decisions by. Manitoba's rate, at 1.6, is the same as it was last year at this time, at 1.6.

So, if this morning's numbers had showed a wild departure from that, I think it would be more of a worrisome number, but it has remained fairly stable over the course of the longer term. We are tied with Newfoundland and Prince Edward Island at point–1.6 and virtually no different than Nova Scotia and Québec at 1.5. So, again, if we were wildly different from the other provinces, that would be something that we would be concerned with. It's not that we're not concerned about the rate of inflation, but it does look like it's pret ty much within the norm as compared to other provinces across the country.

So, if another number comes forward at a later date that shows us out of whack, then I think we would view that differently than this number that seems to keep us placed competitively amongst other provinces.

1430 LEGISLATIVE ASSEMBLY OF MANITOBA May 17, 2013 Mrs. Driedger: Well, another number's going to come forward right away. The minister said 1.6. My information from Stats Canada this morning is that the inflation rate was 1.8. Can he explain why his number is not the same as what Stats Canada is reporting? And this is for April; are we talking about the same month? Mr. Struthers : Yes, the 1.6 number is actually a better number to use. It is averaged out over the course of a longer period of time, over the course of a year. Th e 1.8 number is simply a month -to-month comparison.

What we look at is how Manitoba stacks up with all the other provinces on a more reliable kind of a annualized, year-to-year basis. So that does explain the difference in the two numbers. Mrs. Driedger: But does the minister not have some concern, because this is the second month already with Manitoba having the highest inflation rate amongst the provinces, and year over year, this is 3.5 times the Canadian rate? Does he–is he actually saying that he has a comfort level with this? Mr.

Struthers: Well, I think every Finance minister in the country is concerned, and every Finance minister in the country looks for the trends that are happening. Whenever you look month to month, you're going to–whether it's inf lation numbers or whether it's employment numbers, it doesn't matter what numbers you want to take, you're going to see more volatility in every province when you look month to month.

If this was a –if what she says is a trend and is something that's long- lasting, then I think that requires a different response than simply kind of knee -jerking it and, you know, making decisions based on very short -term, narrow kind of analysis. What is very apparent when you look at the Canadian number, the Canadian number is an average of all of those kind of variables up and down month to month across the country. So if a province somewhere is really–really struggles and really has a tough time, that has a negative impact on the overall Canadian number.

If another provinc e, especially a bigger province, is pretty stable, that has a positive influence on the Canadian number. What we find in Manitoba is that our variance doesn't vary much in terms of the longer term, year - to-year kind of approaches that produced, I think, better decision making. * (10:20) Mrs. Driedger: I need to go back to just seek some clarification from the minister from yesterday's questions, and just so that I'm clear, I did go home and I looked at all my numbers. As I said to him yesterday, I'm a rook ie at this so this is all new for me.

So I'm just wanting to be clear as to my understanding. So if I–if he can indulge me a little bit. With the PST increase it's –it is going to be $277 million. Yesterday he indicated that that is collected and it goes into general revenue first. Is that correct? Mr. Struthers : Yes, the 277 is the annualized number over a year that we will correct –collect as of the 1 per cent increase. It goes into general revenue and then the equivalent amount is forwarded on into the Building Canada Fund–plan –the Building Canada plan, sorry. Mrs. Driedger: And the Building Canada plan, that's not right.

An Honourable Member: Can I correct myself there? Mr. Struthers : My–I'm not –I guess I'm not much more of a rookie than the member is . I misspoke there. It–the money, $277 million, is an annualized number that is collected into general revenue and then it's passed on to–that's right –an equivalent amount is spent through the Building and Renewal Plan. I have the federal plan on my br ain. Sorry about that. Mrs. Driedger: Okay, so I understand that that plan is a fund that is guaranteed to go into infrastructure.

Is there a specific line in the budget that actually shows this, or how will it actually be visible to people? Mr. Struthers : The money –the 2 per cent equivalency that we were talking about yesterday, which this year comes to $512 million, is collected into general revenue. And that is according to the generally accepted accounting principles that we adopted, I believe, in 200 7. We've adopted those principles so we follow those principles of GAAP. That money, then, is earmarked for infrastructure in Manitoba.

We were–we spent some time yesterday on page 17 of the budget, the $1.8 billion and the categories that I read into t he record and handed to

May 17, 2013 LEGISLATIVE ASSEMBLY OF MANITOBA 1431 the member here this morning. Between that and the Manitoba–the Building Manitoba Fund, which is also dedicated to infrastructure, that is where that money will go from the PST equivalency that we've been committed to earmarking for infrastructure. That's what will happen as a result of Bill 20, our commitment to earmark money for infrastructure in Manitoba. Mrs. Driedger: The minister was indicating yesterday and referencing page 17 and indicating that $1.8 billion is set aside for infrastructure, and last year he had indicated it was 1.4.

Can the minister then explain–I went back to the books from last year and from last year, if I looked at those numbers, it's 1.7. So where does he get 1.4? Mr. Struthers: Yes, when we budget, we de al with forecasts. We deal with setting a number that could be attained in terms of infrastructure. What we found last year was that a number of projects that were to be undertaken, because of weather conditions or because of ground conditions, engineering advice that we've got, either started late or were delayed or didn't get off the ground at all.

So every year that we put out tenders, we put out–do all the things we need to do to get the ball rolling and get the project done, if Mother Nature doesn't co- operate, then we don't spend that money. We don't want to spend money on, you know, something for nothing, so we–if we're not–if it's not– if conditions aren't there to do the projects, we save the money and we build it into the next round of infrastructure development.

I know a number of road projects last year that just couldn't go because of the wet conditions that we had early on and some of the weather conditions that prevented companies from actually –construction companies from actually getting out there and doing the work. Mrs. Driedger: But I'd say to the minister that $320 million then of infrastructure did not see the light of day. Can he provide then a breakdown of those projects that were listed last year and did not happen, to the value of the $320 million? * (10:30) Mr. Struthers: Yes.

The difference that the member for Charleswood has put her finger on, is –would be part–part of that number would be projects that did not see the light of day. Some of them would be simply projects that were delayed, that were cash-flowed but not act ually completed and held off and completed in the next fiscal year, so it'd be a combination of that. If these –if they were roads or highways that were in that category, she'd need to get the details from MIT –[interjection] Well, yes. We don't have the information here. That's–we cash-flow the big number just like we were talking about yesterday.

We make available the cash. If Mother Nature gets in the way, there's not too much that the Department of Finance can do about that, but we make sure that we have available the cash that's necessary to do these infrastructure projects. Mrs. Driedger: And my colleague from Tuxedo makes a good comment here –where did that money go then? We're talking about a difference here of $320 million, what happened to it? Mr. S truthers: Well, Mr. Speaker, what the–this department does is provide the authority to spend that cash up to that certain limit. We don't give them a bunch of cash.

We don't give departments a bunch of cash and tell them to go out and spend it and then they keep the money somewhere if they don't spend it. We give the authority to spend the money that then–and then cash -flow that as it's required after that. So the–it's not like there's pots of money out in departments hiding somewhere. I'm certain if there was pots of money, that this fine crew of people that I have with me would find those pots of money and save the Manitoba taxpayer those dollars. But it's a – we give authority to spend the cash; we don't actually give out the cash. Mrs.

Driedger: Then how does the minister account for it? Is it carried over in infrastructure budget, or where would that money actually then show up? Like, where does that go? Mr. Struthers : I want to stress again that this is – we're not dealing out dollar bills to people. Thi s is authority–this is authority to spend money up to a certain limit, and every year every department goes through Estimates, and in those Estimates they determine what their priorities are.

If they have a project that, for whatever reason, can't move forward, it's not that they have –if it's a hundred-million-dollar project, they don't have a hundred million dollars sitting in their –sitting on their desk to be used on another project. Well, we have the authorities to –we give th

Document details

Collection	Manitoba — Debates (Hansard)
Citation	40-2-43c
Type	hansard
Volume / chapter	40th 2nd hansardpdf 43c.pdf
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	4ba683a5693770fbb7398763fbe66dc288977e04

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