Agreed.

---Agreed

Bill 1, Appropriation Act, No. 1, 1994-95

Committee Report 3-12(4), Review of the 1994-95 Capital Estimates

Thank you, Mr. Chairman. The Department of Health capital budget for 1994-95 fiscal year provides for the upgrade of health facilities and medical technology and addresses the planning requirements for replacement and new regional health facilities. The total budget identified for 1994-95 is $8.374 million.

The Department of Health continues to work with hospitals and health boards to develop community and regional health service plans. The health centre replacement projects in both Fort Good Hope and in Clyde River have had full participation by the community in the planning and design of the facilities. The department proposes to continue with this cooperative approach during the construction phase of the projects scheduled for 1994-95.

Mr. Chairman, additional opportunities for the renovation of health facilities to extend their useful life-span have been identified in Fort Providence and in Fort Resolution, both now in the design phase.

Proposed allocations for minor renovations and code upgrades will complement the improved facility maintenance programs. Future capital projects will be identified and priorized on the basis of periodic evaluation of the condition and functionality of a facility.

This 1994-95 budget provides funding for dental equipment for elementary schools. This is a joint initiative between the Department of Health and the Department of Education, Culture and Employment.

Replacement and upgrading of medical equipment which have cost containment potential will be a priority consideration. The installation of an oxygen concentrator at the Baffin Regional Hospital, for example, will reduce the reliance on sea-lift delivery of medical gas in cylinders, and provide long-term savings. The introduction of the controllable assets tracking system by all hospital and health boards will greatly enhance the capability to manage medical technology applications.

In summary, Mr. Chairman, the key elements of the 1994-95 budget are:

1. continued support of planning for the health system;

2. renovation and upgrading of health facilities;

3. further development of information management and medical telecommunication links;

4. improved health technology assessment and the rational replacement or upgrading of medical equipment; and,

5. expanded facilities for school-based dental services.

Thank you, Mr. Chairman. At the appropriate time, I would request the committee's indulgence to bring in witnesses. Thank you.

Thank you, Mr. Chairman. The Minister and the committee discussed at some length, the problems associated with finalizing the role study, programming and design for the new regional health facilities in the Baffin and Inuvik regions. Members noted a number of specific problems, including the following: plans continue to be delayed; funding included in previous budgets is lapsed or carried forward; amounts shown for the current and forecast years are inconsistent with those reported in the previous year's document; the amount of federal cost-sharing and the accrual of federal funds paid, are uncertain; maintenance costs continue to rise particularly in the Baffin region; and, full community consultation is not always evident.

In spite of these difficulties, committee Members are optimistic that most of the concerns will be addressed this year. Further, the committee expects that realistic estimates for both the Baffin and the Inuvik Regional Health Centre projects will come before the committee to review next year.

Members also supported the need for thorough planning in the development of a Keewatin Regional Health Facility. The committee concurred with the Minister that a full and comprehensive needs assessment, involving all Keewatin communities, should now proceed. An economic analysis, comparing the cost of existing arrangements with the province of Manitoba to the expected cost of delivering health care services through a new regional facility, must also be completed.

In its previous report on the review of the capital estimates, the committee recommended that, in order to achieve economies of scale, the Departments of Social Services and Health assess the feasibility of integrating drug and alcohol treatment programs with health and hospital facilities. Therefore, the committee expects to see plans for all new drug and alcohol treatment programs linked with health facilities and included in the capital budget of the Department of Health.

Finally, negotiations for federal cost-sharing of the Keewatin facility should begin now. The goal of such negotiations should be to see if arrangements, similar to those made with respect to planned regional health facilities in the Baffin and Inuvik regions, could be concluded.

Committee Members noted with interest, the pilot project that involves providing a birthing unit for low-risk mothers in Rankin Inlet. The results of the pilot project will be reviewed to assess future expenditures for similar initiatives.

In at least one instance, community representation on regional health boards was called into question. It was determined that one community was without representation on a regional health board for a period of almost two years -- a period of time during which significant decisions were made. The committee appreciates the action taken by the Minister when informed of this particular situation. The department must monitor community participation on regional health boards to ensure the active participation of each community.

The committee was critical of the administration of health care in the North Slave, South Slave and Deh Cho regions. Decisions governing the delivery of health care services in these areas are made at the Department level, or by Mackenzie Regional Health Services, without the opportunity for community participation.

Members noted that, in two communities now falling within the jurisdiction of the Mackenzie Regional Health Service, conditions in the health centres were very poor. Further, it was noted that the design of some health facilities compromised patient confidentiality.

The committee is requesting that the Department re-examine the existing centralized decision-making structure in the Mackenzie area and look to replacing it with a structure that is more responsive to community needs.

With that, I move that this committee recommend that the Department of Health undertake the necessary capital planning and budgeting initiatives to deliver, as a priority, the new Baffin and Inuvik regional health care facilities, which were promised in the transfer of Health from the federal government.

Question.

I have a second motion. I move that this committee recommend that the Department of Health complete a comprehensive, community-based needs assessment and economic analysis for the proposed Keewatin regional health facility. The committee further recommends that the results of this analysis be provided to the Standing Committee on Finance prior to the expenditure of additional capital funds.

Question.

Mr. Chairman, I have a third recommendation. I move that this committee recommends that the Department of Health implement a process which ensures that community needs are identified and addressed by regional health boards. The committee further recommends that the details of this process be provided to the Standing Committee on Finance during its review of the 1994-95 Main Estimates.

Question.

Question.

Agreed.

---Agreed