Thank you, Mr. Chairman. On my left is David Kinloch, deputy minister of Health, and on my right is Elaine Berthelet, assistant deputy minister of Health. Thank you.

Territorial Hospital Insurance Services

Territorial hospital insurance services, page 12-12, operation and maintenance, total O and M, $115.268 million. Agreed?

Agreed.

---Agreed

Thank you. Mr. Gargan.

Mr. Chairman, what page are we on?

We are on section 12, page 12 of the 1993-94 Main Estimates, activity summary, territorial hospital insurance services, operations and maintenance, total O and M, $115.268 million. Mr. Gargan.

During the recent review of activities which were carried out by the Standing Committee on Agencies, Boards and Commissions, several boards expressed concern about a practice which has been used to account for the fact that staff positions with health and hospital boards remain vacant. The Standing Committee on Public Accounts heard concerns about the same thing during its review of the Auditor General's report, especially from representatives of health boards in the Baffin and the Keewatin. Some of those vacancy rates account for approximately $450 to $200,000. Recognizing this is a serious concern for some of the health boards, can you tell me if the same practice will be used to apply the arbitrary four per cent vacancy against this budget for health or hospital boards?

Thank you. Madam Minister.

Thank you, Mr. Chairman. I will let the deputy minister respond to that.

Thank you, Mr. Chairman. In previous years, the department applied what is called a vacancy rate to boards based on estimated experience of vacancies within the facilities, either four or two per cent, depending on the institution. However, in the most recent year the actual experience of the board is used as the basis for projecting the future year's budget. There is no arbitrary application of a vacancy factor. Thank you.

Thank you. Territorial hospital insurance services. Mr. Gargan.

Those vacancy rates, the money which is theirs for the boards, what happens, does it actually go back to the department? What is it used for?

Thank you, Madam Minister.

Thank you, Mr. Chairman. I will have Dr. Kinloch respond.

Dr. Kinloch.

Thank you, Mr. Chairman. At the beginning of each year the boards are provided with a target, a budget amount within which they are expected to operate the facility. Staffing and O and M within the facility are guided by the amount of the target. If that requires the holding of some positions vacant, then they are held vacant. There is no application of an arbitrary figure at the beginning of the year. We begin with the actual expenditures of the preceding year.

Merci. Mr. Gargan.

All the boards have operating budgets. At the end of each year they do not get $500,000 to operate. Basically what happens is the billings system is asked for services provided, and the money is put in.

Dr. Kinloch.

Mr. Chairman, if I understand Mr. Gargan's question correctly, the answer is no. The boards are provided with a budget, and they must manage and stay within that budget subject to the appropriation of any additional funds through a supplementary budget request. At the beginning of each year, boards are advised by the department on the basis of approvals of the Legislative Assembly the amounts of monies which will be available for the operation of each board. It is then up to each board to manage their budget within that set level.

Qujannamiik. Mr. Gargan.

What is the political direction taken by your department? Under the Strength at Two Levels report and the community transfer initiatives, they are looking at devolution to the community or local level. Are you still operating on that basis as opposed to creating new health boards?

Thank you. Madam Minister.

Thank you, Mr. Chairman. We are not creating new health boards. There are going to be some improvements made this year when the Territorial Hospital Insurance Services Act is revised and through MOUs, which Dr. Kinloch spoke about yesterday. Those are the areas which we are going to be working in, realigning the boards' functions and improving the relationship between the boards and the Department of Health. Thank you.