Mr. Monleilh (Perlh):

I understand, Mr. Chairman, that the hospital in Ontario would collect directly, not the government of Ontario. The hospital in Ontario would collect either from the government of Newfoundland or from the individual patient who then, on his return to Newfoundland, would collect from the government of Newfoundland.

Mr. Carter:

Mr. Chairman, that seems an extraordinary way of doing it, for a person to pay the cost in one province and then be under the necessity of collecting it himself. What would happen if a service were provided in Ontario to a person from Newfoundland which is not ordinarily provided to a person living in Ontario? Who sets the rate? Are they regular hospital rates?

Mr. Monieiih (Perth):

I think I mentioned this last night, Mr. Chairman. He would get the same service to which he was entitled in Newfoundland.

Mr. Carter:

But who charges for that and at what rate, the rate prevailing in Ontario?

Mr. Monieiih (Perth):

Yes, so I understand, Mr. Chairman; it is at the Newfoundland rates, what they would pay for the service in their own provinces.

Mr. Carter:

If a person were hospitalized in Ontario, then he would not have to pay Ontario rates if the Ontario rates were higher; he would pay the lower Newfoundland rate to that Ontario hospital?

Mr. Monieiih (Perth):

No. I understand, Mr. Chairman, there would be circumstances where he might have to pay extra. It would depend upon the point of view of the province of Newfoundland. In other words, if he were hospitalized in Ontario he might have to pay some charge over and above what similar hospitalization would cost him in Newfoundland. He would pay to the hospital in Ontario and he would then claim against the government of Newfoundland. Whether or not he would collect that extra I cannot say at the moment.

Mr. McMillan:

Mr. Chairman, I understood the minister to say last night that the provinces would pay directly from one province to the other and the individual himself would not have to pay his bill.

Mr. Monieith (Perlh):

If that is so, I was

wrong at that time because the hospital would undoubtedly collect from the individual. I think that is the way it would work out practically and the individual would then collect from his government when he returned.

Mr. Milchell:

May I ask the minister a question and probably he realizes why I am

Hospital Insurance Act asking it. It seems to me that the explanatory notes are slightly ambiguous in connection with in-patients and out-patients. According to the explanation, no medication is available to a patient on a take-home basis, but (b) of the explanatory notes reads:

To permit necessary accommodation, meals and drugs being provided in the hospital as part of out-patient services-

The explanation I would like to get is whether a patient needs to be confined to the hospital to receive this medication, or whether an out-patient can come back and forth to the hospital, to the dispensary or to wherever it might be where his medication is obtained. I realize that if it is in the form of hypodermic injections it would be handled in the hospital but if the medication is in the form of a daily dose of a certain type of drug could the patient come back to the hospital every day, or would that be considered in conflict with no medication on a take-home basis?

Mr. Monieith (Perth):

I understand that this particular type of service would be medical treatment and as such would not come under the hospitalization plan at all. If I understand what the hon. member wishes me to deal with, it is, can the patient come back to the hospital on an out-patient diagnostic basis for one, two or three days in a row? Is that the thought? Well, he can, as I understand it, in Newfoundland but in Ontario it is only on an emergency basis.

Mr. Mitchell:

That is what I wanted to clear up.

Mr. Bourque:

Mr. Chairman, can the minister tell the committee the reason why he has not been able to obtain the signatures of the provinces of Alberta, Manitoba and British Columbia? I have already asked this question two or three times, and so far I have not been able to get a satisfactory answer.

Mr. Monieiih (Perlh):

I will try to run

over it all again, Mr. Chairman. I think I have given the answer half a dozen times to the best of my ability. First of all, let me go back a little farther. Immediately I assumed office last August 22 I did start to study the Hospital Insurance and Diagnostic Services Act. The work had been going on in the meantime before I ever took office. My officials had visited in the provinces; there had been provincial officials in Ottawa, and this thing started to roll. Certainly, as I intimated when we took office, we were going to continue to give it impetus, which we did.

As time went on we had a technical conference. We had a technical conference last December 13 and 14, or some date in

Hospital Insurance Act there, at which time all officials of provinces were invited to attend. At that time all provinces did attend except one, namely the province of Alberta. The province of Quebec, I believe, had an observer there. From then on there were several visits to and from the provinces, all toward the development of an agreement and regulations. There was another technical conference held in April of this year at which Alberta officials were present and again Quebec had a couple of officials there as observers. All of the provinces were faced with the problem of making sure that their legislation was in conformity with the act.

There is a great deal of work attached to the preparation of one of these agreements and the necessary regulations, and I do happen to know something of that because I know how assiduously my officials and the officials of all the provinces concerned have been working toward the development of these agreements. But certain legislation had to be changed in some of the provinces to conform with our act. The whole program, has been developing. It was obvious last January when I made the announcement of this amendment that July 1 could be the date for some. As a consequence I announced at that time that we would move the starting date forward to July 1. We are working to that end now. Agreements have been drawn up and completed and are before the government for consideration with the provinces of British Columbia, Saskatchewan and Manitoba and, as I mentioned yesterday, officials of the province of Alberta are in Ottawa today and tomorrow. I do not think I can say any more.

Mr. Denis:

With respect to Quebec, can the minister say whether the province of Quebec has said no, yes or maybe? I know that when there was a Liberal government the premier of Quebec said no, but there was an election and the Tory party came into power. We have seen reports in the newspapers that maybe he will enter into an agreement. I saw in the newspapers recently that he was supposed to be preparing some kind of agreement to submit to the federal government. As the legislation before us will come into effect on July 1, does the minister not think that the premier of Quebec is rather late in trying to take advantage of this wonderful legislation?

Mr. Monieiih (Perth):

I do not think it is for me to say what I think. All I can announce is that there has been no indication from the province of Quebec as to what their intentions may be.

Mr. Denis:

There was no letter, no telephone call, no correspondence between the premier of Quebec and the federal government?

Mr. Monteith (Perth):

No indication.

Mr. Denis:

Nobody took the chance of writing to him or sending a telegram as was done with regard to the dominion-provincial conference on fiscal matters?

Mr. Monteith (Perth):

No. I mentioned earlier that officials from Quebec were at both technical conferences as observers. They are quite well aware of what is available to the province.