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May 4, 2010

39th Parliament, 2nd Session

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Hansard Transcripts

Votes and Proceedings

Orders and Notices

Hansard Transcripts 2010-May-04 (PDF)

L026 - Tue 4 May 2010 / Mar 4 mai 2010

LEGISLATIVE ASSEMBLY OF ONTARIO

ASSEMBLÉE LÉGISLATIVE DE L’ONTARIO

Tuesday 4 May 2010 Mardi 4 mai 2010

ORDERS OF THE DAY

EXCELLENT CARE FOR ALL ACT, 2010 /

LOI DE 2010 SUR L’EXCELLENCE

DES SOINS POUR TOUS

INTRODUCTION OF VISITORS

LEGISLATIVE PAGES

MEMBERS’ PRIVILEGES

ORAL QUESTIONS

SENIOR CITIZENS

HYDRO RATES

TAXATION

TAXATION

TAXATION

CORRECTIONAL SERVICES

PUBLIC TRANSIT

PHARMACISTS

SERVICES FOR THE DEVELOPMENTALLY DISABLED

ASTHMA TREATMENT

SERVICES FOR THE DEVELOPMENTALLY DISABLED

PUBLIC TRANSIT

AGRI-FOOD INDUSTRY

CONSERVATION

CONSERVATION

TAXATION

MEMBERS’ PRIVILEGES

INTRODUCTION OF VISITORS

MEMBERS’ STATEMENTS

DOUGLAS CRAIG BLAKE

DUTCH LIBERATION ANNIVERSARY

CHILDREN’S MENTAL HEALTH

NORTHUMBERLAND–QUINTE WEST DAY

COMMUNITY LIVING DAY

NATURAL RESOURCES

SCHOOL FACILITIES

LINDA JOHNSON

AGRI-FOOD INDUSTRY

VISITOR

REPORTS BY COMMITTEES

STANDING COMMITTEE ON GOVERNMENT AGENCIES

INTRODUCTION OF BILLS

PHYSICAL FITNESS DAY ACT, 2010 /

LOI DE 2010 SUR LA JOURNÉE

DE L’APTITUDE PHYSIQUE

PETITIONS

ONTARIO PHARMACISTS

ONTARIO PHARMACISTS

WIND TURBINES

ONTARIO PHARMACISTS

ONTARIO PHARMACISTS

ONTARIO PHARMACISTS

ONTARIO PHARMACISTS

CLIMATE CHANGE

ONTARIO PHARMACISTS

MENTAL HEALTH SERVICES

ONTARIO PHARMACISTS

ONTARIO PHARMACISTS

ONTARIO PHARMACISTS

TAXATION

ONTARIO PHARMACISTS

CHANGEMENT DE CLIMAT

PRESENTATION OF PETITIONS

ORDERS OF THE DAY

LOWERING ENERGY COSTS

FOR NORTHERN ONTARIANS ACT, 2010 /

LOI DE 2010 SUR LA RÉDUCTION

DES COÛTS D’ÉNERGIE

POUR LES ONTARIENS DU NORD

ADJOURNMENT DEBATE

TOBACCO CONTROL

CHILDREN’S SERVICES

The House met at 0900.

The Speaker (Hon. Steve Peters): Good morning. Please remain standing for the Lord’s Prayer, followed by the Hindu prayer.

Prayers.

ORDERS OF THE DAY

EXCELLENT CARE FOR ALL ACT, 2010 /

LOI DE 2010 SUR L’EXCELLENCE

DES SOINS POUR TOUS

Ms. Smith, on behalf of Ms. Matthews, moved second reading of the following bill:

Bill 46,

An Act respecting the care provided by health care organizations / Projet de loi 46, Loi relative aux soins fournis par les organismes de soins de santé.

The Speaker (Hon. Steve Peters): Debate?

Hon. Monique M. Smith: I’ll be sharing my time this morning with the member from Scarborough–Rouge River.

Mr. Bas Balkissoon: It is with great pride that I rise on behalf of the Minister of Health and Long-Term Care to speak to the second reading of our government’s proposed Excellent Care for All legislation. I do so in the hope that all members of this House will agree with me when I say that this is the right piece of legislation at the right time for health care in Ontario. It is a piece of legislation that will, if passed, improve the quality and the value of the health care that Ontarians receive. Quality and value: two characteristics that no health care system should be without. If you’re not getting both, you’re not getting either.

This bill, if passed, would lay the groundwork for a fundamental culture shift that we want to see take place in health care in Ontario, a fundamental culture shift that we believe must take place. We believe that Ontario health care providers and executives should be accountable for improving patient care. We believe that money should follow the patient, meaning that funding should be clearly linked to the services that are provided in our system. We believe that there should be an independent expert advisory body to provide recommendations on clinical practices guidelines.

Basically, we believe that future investments in health care should get results and improve patient health, period. And we believe that the Excellent Care for All bill is an absolutely necessary first step to achieving all of these things.

We are at a very important juncture in the development of the Ontario health care system. The last six years have seen tremendous developments, from the establishment of LHINs to the creation of family health teams to the launch of wait time systems. We have, in the process, here and there begun to look at tying increases in spending to improvements in quality, but it’s time to stop looking and time to start doing, because we are running out of time. The demands being placed on our health care system are virtually infinite; government resources are not.

Twenty years ago, 32 cents of every dollar spent on government programs were spent on health care; today, we’re spending 46 cents of every dollar; 50 cents, half of our budget, is right around the corner. If we continue the way we’re going, it will be 70 cents. We can’t continue the way we’re going. Ontario health expenditures this year are projected to be $43.5 billion, and they’re expected to grow by 4.4% and 4.9% over the next two years.

If we continue the way we’re going, by 2020, which is not that far off, the gap between the demand for health care services and what we would need to spend would be roughly $26 billion. We can’t continue the way we’re going.

Thus, the government has introduced this bill because we looked at the health care system, of which we’re all very proud, of which we know Ontarians are very proud, but it is a system that is threatening to become so expensive that it will crowd out all the other priorities, the other public services which we and Ontarians are so proud of: investing in our schools, helping our vulnerable, protecting the environment and building our infrastructure. How do we continue to fund health care without allowing this to happen?

The answer, which is why we introduced the bill we’re discussing today, is that we need to do a better job of getting value for money in our health care system. Quality and value: If you’re not getting both, you’re not getting either. That’s what I’m referring to when I said we must tie the increases in spending to improvements in quality. Right now, we know that’s not happening, and there is ample evidence that improvements are there to be found—ample evidence.

Some 40,000 patients were admitted to the hospital last year with conditions that could have been better managed in the community at a lower cost; 140,000 patients last year had unplanned readmissions to hospital within 30 days of their original discharge—140,000 unplanned readmissions. This is very costly and inefficient.

Another example: the use of typical unnecessary preoperative tests, such as X-rays and electrocardiograms before cataract surgery. Evidence shows that these tests seldom yield any clinical benefit, yet more than 50,000 X-rays and 49,000 cardiograms were performed on patients about to undergo cataract surgery last year. You ask yourself, why?

Yet while we have patients receiving tests they don’t need on one hand, on the other hand, research shows that many Ontarians with diabetes and other chronic diseases are still not receiving all the care recommended by clinical guidelines. Why not? The answer, we need to be clear, has nothing to do with a lack of effort or a lack of caring. The health care providers in this province are as committed, compassionate and hard-working as anyone anywhere. But we have a health care culture where quality and value for money are not absolutely integral, as they should be.

Situations like the one I just cited arise because there is a lack of accountability for quality within the governance structures of our health care organizations. That is something we are determined to change. If there is a central message that I want to get across to my colleagues today, it is simply this: If we want a health care system that delivers the best possible care to patients today and is able to do so in the future, we have to act now. The action we have to take is to pass the Excellent Care for All bill that is in front of us.

In drafting this proposed legislation, we were informed and driven by four basic principles: Care must be organized around the patient to support his or her health; continuous quality improvement is a critical goal; payment, policy and planning must support both quality and the efficient use of our resources; and quality care must be supported by the very best evidence and standards of care. I defy a single member of this House or a single health care provider in this province to find fault with any one of these basic principles.

If you can’t find fault with any of those principles, I don’t believe you can find fault with any of the changes that this legislation, if passed, would bring about in our health care system.

Health care organizations, beginning with hospitals, would have interprofessional quality committees that would report to the board of directors on quality-related issues. Every organization would have quality improvement plans publicly posted, and executive compensation would be linked to the achievements of outcomes identified in those plans. That would bring about a top-down focus on quality that would permeate the organization and drive better patient care in the future.

This legislation implements a patient relations process to address complaints and concerns. There would be regular patient-client-caregiver surveys, with publicly posted results. The results of those surveys would be used to inform the annual quality improvement plans.

We would also expand the mandate of the Ontario Health Quality Council to enable that body to provide recommendations on clinical practice guidelines for services delivered by health care providers, as well as recommendations on possible changes to the way health care is provided and paid for in our province. This would help to ensure that future investments in health care get results and improve patient health, because that, as everyone in this room knows, is what it is all about: getting results and improving patient health. Quality and value: If you’re not getting both, you’re not getting either.

On the subject of changing the way health care is covered and paid for, there is one significant policy shift that our government is planning, and I want to speak about that here today. The plan is to gradually reform how hospitals are funded to better align funding with efficient delivery of high-quality patient care—to ensure, in other words, that money follows the patient. This is a necessary step. At present, the global funding system does not support quality improvement, and it does not reward efficient provisions of care.

The fact is that, at present, financial incentives actually work against hospitals improving their quality and efficiency. Money does not follow the patient. A patient’s choice of provider is not reflected in the funding that hospitals receive.

If we look around the world, we see that a great many jurisdictions have implemented patient-based payment approaches that allow for the incorporation of incentives for quality and productivity. In fact, nearly all developed nations use more advanced patient care funding approaches than we do here in Ontario. These approaches have proven successful in improving access and reducing wait times, and they’ve also increased hospital cost efficiency and transparency in terms of quality and quantity of services delivered.

Surely it’s time we adopt these successful approaches here in Ontario. Surely it is time that we have transparency in terms of how much care should cost and why, based on good clinical evidence. Surely it is appropriate for us to have clear expectations about the quality and volume of services that hospitals are delivering, and that we receive value for our tax dollars. And surely it is appropriate for us to deliver more funding to hospitals that are delivering more services and higher-quality care to more patients.

I believe that something we share in this House is a commitment to better, more sustainable health care for Ontarians, pure and simple. It is something we all want. We might, sometimes, have different views about the best ways to get there, but other times, isn’t it obvious? Isn’t it obviously the right thing to do to eliminate inefficiency in our system? Isn’t it obviously the right thing to do to eliminate waste? Isn’t it obviously the right thing to do to instill in our health care organizations an absolute focus on quality and value for money? Of course it is.

Of course it is the right thing to do to reward high-quality care, create a better patient experience and ensure the sustainability of a system we all cherish here in Ontario.

I said at the outset that this is the right piece of legislation at the right time for health care in Ontario. It deserves to be passed, and I would encourage everyone to support this piece of legislation.

The Acting Speaker (Mrs. Julia Munro): Questions and comments?

Mr. Steve Clark: I’m pleased to rise to provide some comments to the member for Scarborough–Rouge River. I listened to his comments about quality and value, and also about accountability in this Excellent Care for All bill.

On Friday, I met with one of my constituents, Arnold Kilby from Lansdowne, who I think has emailed every member of this Legislature hundreds and hundreds of times with a concern about the system. His daughter, Terra Dawn Kilby, passed away in 2006, 12 hours after her release from a Toronto-area hospital. He has many unresolved issues with respect to the care she received in that hospital.

I know that he’s written to the Minister of Health and Long-Term Care and also to the Minister of Community Safety, expressing his concerns that the system let her down; that there wasn’t an accountable system; that he can’t seem to get answers on the fact that there should be things put in place at the hospital and in the health care system that make the government accountable for what happens at these facilities; and the fact that, in his case, with his daughter Terra Dawn, he still, three years after her death, cannot get answers from this government or from the hospital involved.

You know, it’s not an issue of taking the government to court. All he wants is a bill that puts some accountability back in the system and puts measures in place in hospitals that would ensure that what happened to him and his family never happens again.

I’ve looked at this bill, Bill 46. I looked at Hansard from yesterday, at what the minister said, and I don’t see that this bill has that accountability for Arnold Kilby, that it has that accountability with a hospital so that it adequately addresses his concerns. I would like someone to address that at some point in the future.

The Acting Speaker (Mrs. Julia Munro): Further comments and questions?

M me France Gélinas: I certainly was happy to listen to the comments from the parliamentary assistant to the Minister of Health this morning.

I want, first of all, to say that when I speak on a bill, I like to have read the whole bill. My technical briefing was at 3:30 yesterday. I was given part A and part B of the bill, which, with the bill itself, amounts to hundreds of pages of things to read. On Mondays I get up at 4 o’clock so that I can be here in time for question period, which means that last night at 10 o’clock, my eyes were crossed; I couldn’t read anymore. So I was not able to read the whole bill.

I don’t understand why, when we’re talking about accountability, when we’re talking about doing things right, we have a bill that is introduced on Monday afternoon and we are debating it on Tuesday morning. A day to read all of those papers would certainly have been appreciated on my part.

From what I have read so far, I have lots and lots of questions. A lot of things have been put out without being defined. The first one that rings all sorts of alarm bells is that the money follows the patient. I’ve been in health care long enough to know that not every patient is created equal. There are patients who are easy to handle and there are patients who take a little bit more care, knowledge and skill in order to be successful in their treatment. All I’ve read so far is that the money will follow the patient. This is very worrisome to me, and it should be worrisome to anybody who has a developmental delay, anybody who has a mental illness, anybody who needs a little extra care.

The Acting Speaker (Mrs. Julia Munro): Further comments and questions?

Mr. Khalil Ramal: I listened carefully to my colleague the member from Scarborough–Rouge River as the parliamentary assistant to the Minister of Health, and I want to congratulate him on his speech, because his speech outlines the vision of our government and the Ministry of Health for the future of health care in the province of Ontario.

Madam Speaker, all the people who are listening to us and all my colleagues from both sides of the House, everybody knows of our commitment to publicly funded, accessible health care in this province of Ontario. Also, the people of Ontario know exactly what we mean by that. We want every person who is facing some kind of health issue to be able to go to the hospital and see a doctor anytime, anywhere in the province of Ontario.

In the past, 20 years ago, we used to spend almost 32 cents of every dollar on health care. In this budget, 47% of our total budget goes to health care. If we grow in the same way, I guess in 12 years’ time we’re going to spend almost 70% of our budget on health care. Therefore, there won’t be enough money for education, for roads, for recreation facilities, for our social agenda and for many different issues around the province of Ontario. I believe strongly that our government is trying to find a way to manage our spending on health care and, in the meantime, maintain the quality of health care in the province of Ontario.

That’s why I believe that the Minister of Health and our government introduced such a bill, in order to see how we can manage health care in the province of Ontario and how we can maintain our ability to serve the great people of Ontario. We’re facing challenges; there’s no doubt about it. That’s why we want to go to a creative way to make the doctors and hospitals more accessible and lower wait times in the hospitals. All of these elements are important for all the people in the province of Ontario. That’s why I want to support the member from Scarborough–Rouge River for his excellent outlining of the vision of the government.

The Acting Speaker (Mrs. Julia Munro): Questions and comments?

Mr. John O’Toole: I did listen intently to the member from Scarborough–Rouge River, and I commend him for the goals, the laudable objective of the bill, for sure.

But the evidence on the ground is much different. What I’m hearing in my community, in the emergency rooms, from professional health care providers is quite the opposite. In fact, I can’t explain this seemingly all-out war on front-line health care personnel. For instance, the nurses who have been attacked in the Peterborough and Northumberland Hills Hospital recently are but two examples. But then last week in Bill 16 we had the pharmacists. Professional, young pharmacists from small communities within my riding were outraged at these assaults on that profession. It just doesn’t add up with the objectives here.

This weekend, I was in a long-term-care facility and I noticed—because I’m there fairly regularly—a diminishment of the standards there. I think that even their bill on the retirement home provision is a way of slipping in another provider on the health care. There are people waiting for doctors. The evidence now is that they’re forming these new types of family health networks or family health teams where they’re rostering patients under a doctor so that they have a doctor, but now they’re waiting longer to get to see the doctor. So the evidence on the ground is quite contrary to these goals.

The explanatory notes in the bill are worth looking at. There’s a requirement for the Ontario health council, established under the Commitment to the Future of Medicare Act, 2004, and these quality councils are going to be tied to the remuneration of the CEOs. Paying for results, I agree with. I think that’s a laudable objective. But let’s be honest about it: The patient, at the end of the day, is receiving less and paying more.

The Acting Speaker (Mrs. Julia Munro): The member for Scarborough–Rouge River has two minutes to respond.

Mr. Bas Balkissoon: I just want to thank my good friends from Leeds–Grenville, Nickel Belt, London–Fanshawe and Durham for their comments.

Let me just say to the member from Leeds–Grenville, this bill clearly introduces a standard patient relations process in all hospitals across the province. This is definitely a change, and it’s a change for the good, I would say, to make a difference in our system. We clearly accept his comment that patients having difficulty in hospitals have found barriers in trying to get the answers they’ve been looking for, and certainly we believe this change will make a difference.

We all accept that we have a great system in Ontario. But if you remember, our government has spent a lot of money in the last couple of years improving the system that was lacking resources. Now that we’ve got our resources up to par, we’re looking to see if we can build a system that is efficient and responsive to public demands and public needs, and we want to make sure that that system is transparent and accountable. This is why, in this bill, we’re actually dealing with the issues. Patient care, patient services and performance in our hospitals will be tied in to the salary and compensation given to executives of those hospitals.

It’s a definite change in the right direction. I think my friends across the way should really look at this as a move in the right direction to get some efficiency and make our system responsive to those people that we represent here in the Legislature.

The Acting Speaker (Mrs. Julia Munro): Further debate?

Mrs. Christine Elliott: I’m pleased to rise today to outline the preliminary response of the Progressive Conservative caucus to Bill 46,

An Act respecting the care provided by health care organizations, known by its

short title as the Excellent Care for All Act, 2010. I do say “preliminary response,” because this bill was only introduced in this Legislature yesterday afternoon, which was my first opportunity to see and to read it.

Therefore, like the member from Nickel Belt, I did have a preliminary briefing with the ministry officials yesterday late in the afternoon, so I’ve not had the opportunity to speak with the many health care providers who will be affected by this legislation, nor have I had the time to review it in detail—all of which is more reason for having full hearings on this matter and consulting widely on the bill, not just to pay lip service to consultation, as this government so often does.

I also should add that I’m a little bit surprised that the Minister of Health herself hasn’t chosen to speak on second reading of this bill. This is a little bit surprising, given the apparent importance of this bill.

Before I begin my comments with respect to the specifics of the bill, let me say that the PC caucus is fully aware of the current pressures on our health care system. We realize that right now, 46 cents of every tax dollar is spent on health care. This is scheduled to reach 50 cents within the next few years and will rise up to 70 cents on each tax dollar within the next 12 years if nothing is done. Clearly, this present system is not sustainable, and something has to be done, but what should that be?

The fact of the matter is there are very few choices here. No one wants to pay higher taxes. We are already paying a separate tax for health; $15 billion so far, in fact, has been paid. Whether or not we have a better health care system—I would certainly say, no—as a result of that is a question for another day. We also don’t want to cut back on health care services and programs because we know that with the boomer tsunami coming within the next few years, we’re going to have more and more baby boomers—myself included—needing more and more health care programs and services. So now is certainly not the time to be cutting back.

One solution I would suggest, and this is being reflected in the government’s bill, is that we need to spend smarter and not necessarily more on health care. This bill purports to do this, but I would say that if the McGuinty Liberals are serious about finding these efficiencies in our health care system, then they need to take a look in the mirror with respect to their record in a number of other areas. They have a pretty sorry record when it comes to finding efficiencies.

Let’s take a look at a few examples. Number one, the McGuinty government has been caught raiding hospital budgets to pay the half-million-dollar salary of the former deputy health minister. Number two, they’ve spent $176 million at the local health integration networks with no improvement in front-line health care—nothing to show for it. And e-health: Need I say more? A billion precious health care dollars wasted with no electronic health care records in sight and not even on the immediate horizon, while we’re being surpassed by other Canadian provinces and many other countries around the world.

The e-health records are absolutely essential for us to be able to move forward into the world of 21st-century medicine. They’re necessary for better patient outcomes to prevent toxic drug interactions and patient deaths every year. They’re needed in order to find true efficiencies in the system. We’re clearly failing in this respect.

Transparency and accountability, clearly, are not hallmarks of this government. Before having the same expectations of our health care organizations, the McGuinty Liberals need to get their own house in order.

In any event, our review of this bill indicates there are three major objectives in the overall plan to strengthen the focus on quality, value and evidence-based health care in Ontario. They are as follows: first, a change in the funding model for hospitals; second, an increased emphasis on continuous quality improvement as a means of reducing costs and improving patient outcomes; third, a focus on evidence-based guidelines that health care providers should adopt.

In principle, the PC caucus agrees with these objectives, subject to a number of caveats that I will raise as I deal with each objective in turn.

First, essentially this bill will substantially change the hospital funding model, moving away from global block budgets and towards pay-for-performance and patient-based funding. As I’ve indicated, in theory, the Progressive Conservative caucus supports this move.

In April 2004, the Ontario Hospital Association released a report entitled Advancing Accountability Through Hospital Funding Reform: A Policy Framework to Promote Greater Access, Efficiency and Quality of Care. It’s a pity that the McGuinty Liberals sat on this report for some six years before bringing this matter forward, but I suppose better late than never.

As in many other areas, Ontario lags behind many other developed countries of the world and, in fact, other Canadian provinces, including British Columbia, Alberta, Saskatchewan and New Brunswick, in bringing forward these reforms. In those international jurisdictions where variations of patient-based funding have been introduced, including the United States, England, all of western Europe and Australia, significant benefits have been realized. Using this system has led to improved access and decreased wait times, improved efficiency, improved quality of care and increased patient choice in where they receive care.

Three funding models will be used to drive these reforms: the health-based allocation model, the patient-focused funding model and the pay-for-performance model. The bill proposes, with the new payment system, to deliver transparency in how much care should cost, based on clinical evidence; clear expectations of the volume of services to be provided; and more volume and funding for hospitals that deliver high-quality care.

This last point raises serious concerns about how the Ministry of Health will deal with small rural and northern hospitals, which simply won’t be able to achieve the volumes that might entitle them to receive additional funding. The minister has indicated that this new funding model will not apply to these hospitals, but the devil is in the details, and we are anxious to hear about what the cut-off will be and what the minister will offer as a fair and reasonable solution to these hospitals to allow them to continue to stay in business and be able to compete with their larger counterparts.

Secondly, the bill will attempt to move towards a continuous quality control plan and intends to tie executive compensation to achievement of the plan. Again, these are laudable goals, and the PC Party supports them in principle because we know that every year, thousands of Ontarians are readmitted to hospital for unforeseen complications within 30 days of their original discharge. I believe the parliamentary assistant mentioned that there were a total of 140,000 patients in this predicament last year alone.

The evidence strongly supports a focus on quality as a means to lower health care spending by reducing readmissions and eliminating unnecessary tests and procedures. More importantly, patient outcomes and satisfaction also improve.

What does the bill contain that will purport to achieve these goals? Well, the bill requires each health care organization to establish a quality control committee that will set out annual performance improvement targets and the justification for those targets, and set out information with respect to the manner in and the extent to which health care executive compensation is linked to achievement of these targets.

If requested by the relevant local health integration network, or LHIN, the health care organization shall provide the LHIN with a draft form of the annual quality improvement plan for review before the plan is released to the public. It is important to note that this plan will be available for public review and scrutiny.

The first question that I asked during the briefing that I had with the Ministry of Health yesterday afternoon was, “How are you going to tie executive compensation to the success of the quality improvement plan? That’s a pretty tall order.” I was advised that the Ministry of Health doesn’t want to over-regulate, wants to leave it up to local governments, and will essentially leave this to the discretion of the local hospital board to determine.

I’m a little concerned about this, because I’m not sure that all hospital boards will have all of the information necessary in order to be able to deal with this and may not wish to deal with this directly, but I certainly look forward to the committee hearings on this bill to clarify this and, certainly, a number of other issues related to this quality control issue.

I’m told that the new policy will be based on consultations and simulations with hospitals, LHINs and stakeholders. The simulations, I think, will be particularly important, where they will actually be put into practice in local hospitals. I do believe this is essential in order to be able to ensure that we understand all of the parameters of this policy and that all of the local hospitals are going to be in a position to make sure that whatever they implement will actually achieve the quality control that they’re trying to achieve.

Again, this is an essential thing that I believe needs to be dealt with, both in committee and with the consultations and simulations with the stakeholders, because this is too important to get wrong.

Finally, the bill proposes to expand the functions of the Ontario Health Quality Council to include promoting evidence-based health care and clinical best practices. Again, how can you argue against that? The Progressive Conservative caucus supports this proposal in principle as long as it is truly used by the Ministry of Health to share and promote best practices, leading to excellent patient care, and not simply as a means to cut costs that has everything to do with funding quick and easy financial efficiencies and nothing to do with enhancing patient care and improving outcomes.

We’ve seen this government do this before. The truth is that there are no quick and easy solutions in health care anymore.

Efficiencies have already been obtained and anything that we do in order to change anything in our health care system is going to need to be based absolutely on best practices and recognizing that you can’t take money out of a system, as we’ve recently seen with the pharmacists, where the government has attempted to take $750 million out of our health care system by eliminating the front-line care that our pharmacists provide, pretending that there aren’t going to be any ramifications of that.

Clearly, we know that there will be, that the $100 million that the government is offering in return isn’t going to go nearly far enough to allow the pharmacists to be able to continue to deliver the wonderful care that they do to patients across the province of Ontario.

We’ve also seen it, as the member from Durham has pointed out, with the cutting of nurses in hospitals and health care organizations across the province of Ontario. This is a sign of a system that’s deeply under strain. We need to make sure that we do this right.

We do have a lot of significant concerns. We do support the goals, in principle, that the government is putting forward. We probably will have some further questions and concerns with respect to the implementation of these goals and how this is going to be put into practice.

I urge the government to allow full and complete consultation on these and other issues to make sure that we understand the full parameters of this as a Legislature and that all stakeholders are given the opportunity to fully comment on this as we go forward.

Thank you very much for giving me the opportunity to at least raise a few preliminary points.

The Acting Speaker (Mrs. Julia Munro): Comments and questions?

M me France Gélinas: I will start by echoing what the member has just said, that to have an introduction of a supposedly very important bill on Monday afternoon and second reading on Tuesday morning presents some challenges. The bill is considerable. It touches on a number of different legislations and could be interpreted in many different ways if you don’t have time to do the full reading and fully understand what it is that they’re trying to do. This is a little bit problematic.

I would like to pick up on the accountability that the member has been talking about. We all agree that we want more accountability. The sunshine list has shown us that we now have a $700,000 club in Ontario. Some of the hospital CEOs who were present when the minister made her announcement publicly yesterday are people who are paid $800,000 a year to be a CEO of a hospital. I have a hard time with this when we talk about a bill that is talking about accountability in the health care system and you have a Minister of Health who is silent on this.

Can I remind the people of Ontario that Premier McGuinty makes $208,000 a year? That’s his salary plus benefits, and he manages a budget of close to $100 billion. Yet we have people, paid by our taxes, who make four times the salary of our Premier and manage 1% or 2% of the budget that he manages. Why, when we talk about accountability, doesn’t the Minister of Health say clearly that this is not acceptable and that things have to change? We’re now tying salaries with—

The Acting Speaker (Mrs. Julia Munro): Thank you. Comments and questions?

Mr. Bas Balkissoon: I’m happy to provide a few comments to the member from Whitby–Oshawa on this particular bill.

Let me make it very clear: The minister spoke yesterday and clearly indicated that our funding model was not working. I know she’s expressed some concern about funds following the patient and she’s worried that the current system is based on a global budget.

Let me just repeat what the minister said yesterday. She said, “Our current funding model penalizes hospitals when their volumes increase. Global budgets deliver a set amount of money for a year, and any increase in the number of patients coming into the hospital is a cost or financial liability. The result is that hospitals may delay or deny care in order to balance their budgets.” That’s not an efficient system; that’s not a system that responds to public needs. Therefore, this bill is introducing a different model of funding that will respond to public needs, and I hope I can convince the member on the other side that this is the right thing to do.

On top of that, the bill is based on four very positive, strong pillars: clinical practice guidelines, evidence-based health care, a patient relations process that is standard across the province—and I would have to say the minister commented yesterday that we do have a concern about small and rural hospitals, but certainly, if you look at the four pillars, those rural and small hospitals can also benefit from those small efficiency changes.

Hopefully, everything will work well in the future. I certainly believe it can.

Mr. Steve Clark: I’m pleased to provide some comments in regard to the address made by my colleague the member for Whitby–Oshawa. I want to echo her comments about the fact that this bill was just presented yesterday. Certainly, from our caucus’ perspective, we’ve barely had a chance to talk about it in this Legislature, let alone as a caucus. I appreciate some of the comments that my colleague has brought forward to the Legislature today.

My first day in the Legislature, I talked about the concern in my community in regard to the Brockville General Hospital with the front-line health care cuts that they have been forced to make because of this government: bed closures, nursing layoffs. As well, later on in my first day, I talked about the Brockville Mental Health Centre; the fact that, again, front-line mental health services are leaving our community to go to Ottawa, and all of that expertise that has been there for a century is lost.

The member for Scarborough–Rouge River talked about quality and value. You have to just pick up a newspaper or to listen to concerns in local communities about the health care sector. To my colleague from Peterborough, the Peterborough Examiner this morning talks about city council wanting the LHIN to report on the hospital bed closures and the job cuts. They want those jobs and health services protected in their communities. As well, you can look at the North Bay Nugget where their council is expressing concerns about psychiatric transfers from North Bay to Sudbury.

These local health integration networks can almost be called local health disintegration networks because of the concern that they’re raising throughout communities without any accountability. We’ve talked over and over about their lack of accountability. Again, I want to challenge those on the other side to deal with that as well.

Mr. Shafiq Qaadri: I’d like to first of all just state, both as a physician as well as a legislator, that I think we can quite reasonably say that the health of the body, like the health care system itself, is always a work in progress. I’m quite proud to be part of a government that not only invests but takes seriously the mandate that we’ve received from the people now twice, possibly a third time, with regard to the maintenance, strengthening and fortification of our health care system.

There are a number of different options. Given the expense, given the rising costs, the exponential annual increases, we could adopt, as some governments around the world have done, the privatization of it, the selling of health care as a profit centre, making it a source of income for for-profit corporations, but that’s not really the mandate.

As we seek to strengthen public education, we seek, also, to strengthen public health care. That’s, of course, why we’re attempting to institute all these various changes, bringing to light and essentially inviting physicians and other health care practitioners to practise evidence-based medicine, as well as something called clinical practice guidelines. These are basically the best and brightest suggestions and protocols for a whole long list of diseases. The problem, of course, is that it’s so complex and there are such a number of them that we now have guidelines to the guidelines.

There’s something, for example, on the order of about 1,500 different clinical practice guidelines, as we speak, for every disease that you can name and then some.

It’s in order to engage our communities and, yes, to engage the LHINs, our hospital boards in, of course, the broader conversation with Ontarians that we need to move forward with this particular bill. I’m honoured and pleased to support our Minister of Health.

The Acting Speaker (Mrs. Julia Munro): The member for Whitby–Oshawa has two minutes to respond.

Mrs. Christine Elliott: I’d like to thank the members from Nickel Belt, Scarborough–Rouge River, Leeds–Grenville and Etobicoke North for their comments.

The member from Nickel Belt spoke of accountability and the need to ensure that hospital executives also heed this and had some concerns with respect to their compensation. I think we need to bear that in mind, certainly, as we go forward. That is something that we want to make sure is held in check as appropriate.

The member from Scarborough–Rouge River talked about the funding model not working. I would certainly agree, but I still do have residual concerns with respect to the plight of small and rural hospitals. How will you define a small hospital? What will be the cut-off? What will be the solution for them? It’s not just large hospitals we’re speaking about here; we’re speaking about hospitals across the board. They all need to be given a fair opportunity in order to be able to operate their organizations.

The member from Leeds–Grenville mentioned his concerns about decisions that are being made by LHINs, particularly with respect to mental health decisions and closing organizations and programs that have been in operation for many, many years. I share those concerns.

Finally, the member from Etobicoke North spoke about a number of things, including the need to move to evidence-based medicine and clinical practice guidelines to achieve excellent patient care. I would certainly agree with that.

He also spoke of his party’s commitment to strengthen public health care. I must reiterate, on behalf of the Progressive Conservative caucus, that we also agree that one of the most fundamental aspects of our health care system that differentiates us as Canadians and that we’re all proud of is that we too believe in universal access to a publicly funded health care system that provides excellent health care to all Ontarians.

I thank all of the members for their comments and look forward to further debate and consultation on this matter.

The Acting Speaker (Mrs. Julia Munro): Further debate?

M me France Gélinas: Certainly New Democrats support a universal, high-quality public medicare system. We support a program where people’s needs decide the care they get, not the size of their wallet. We support excellence in quality of care and we welcome changes that would lead to better health care and health outcomes for all Ontarians.

There are some positive aspects of the bill. I’m not sure I will have time to talk about them today, but in my hour lead I certainly will cover some of the very positive aspects of the bill, some of them having to do with the expansion of the mandate of the Ontario Health Quality Council, the development of best practices and the development of clinical practice guidelines.

There are some good initiatives in there, but there are also very many opportunities lost. One of the big issues that I have been worried about and that we have brought forward a number of times is the exponential growth of hospital executive salaries under this government. I’ve talked about the sunshine list and the $700,000 club, where this club is filled with hospital presidents and CEOs whose salaries have grown by 7% in 2009—the heart of the recession, the reason that motivated the government to put a two-year cap on the salary of everybody who is not unionized. Yet hospital CEOs are not unionized and in 2009 they got a 7% increase.

Name me any other group of workers in this province, first of all, who make over $700,000. There are pretty few. Even if you look at the ordinary guy who makes $30,000 to $50,000 a year, no workers’ group got a 7% increase in 2009, but the CEOs, the people at the top, did. Since the McGuinty government has been in power, their wages have increased by 40%. This is a lot of money, especially when you’re already at the top, but there’s nothing in this bill that would curb this.

To tie their salary to performance is not the same thing as sending a clear message by the Minister of Health that the $700,000 club is not acceptable in this province. She should send the clear message that those wages have to be rolled back, and if the board of directors of the hospital is not willing to act upon this, then she should send a clear cap—that we are not willing to spend that amount of money on CEO executives while our health care system is short of money in so many areas.

So in Bill 46, the bill we’re talking about, we do not see anything that will curb those excesses. The Minister of Health had assured Ontarians that she was concerned with the excess of executive salaries, and now she tells us that this bill is not making any progress in pressing the issue forward. I have quotes from the minister that say, “I would like to assure the member opposite”—she was talking to me at the time—“that I share her concern about hospital CEO compensation. I think Ontarians are concerned about that as well”—I’d say she is right—“especially when so many of them are struggling to make ends meet.

That is why we will be introducing legislation that will make those health care executives more accountable for improving the quality of the services in their institutions.” We all agreed that this is excessive, but we don’t agree to do something about it.

I believe that the minister should take steps in this regard. New Democrats believe that you cannot assure quality care while allowing such a high percentage of precious health care dollars to flow to executives.

I also have serious concerns about the failure to implement transparency and accountability initiatives. In the bill, we see nothing that would put a hospital under the freedom of access to information request. I understand that there are some privacy concerns when it comes to your particular medical chart, but this is not what we’re talking about; we’re talking about being able to ask for a freedom-of-information request as to how much money was spent on consultants. Why isn’t that information available to people?

How come our hospitals, which account for—something around $20 billion of taxpayer expenses are spent through our hospitals, yet they are under a cloud of secrecy. They are not covered by the freedom of access to information. We cannot know how our taxpayers’ dollars are being spent. We know in general terms how much on salaries, how much on operations, how much on capital; that does not answer fundamental questions as to how our hospitals are governed and operated.

They’ve also put forward what they call a patient relations process. I think this is a fancy word to say a complaint mechanism—that is, if the patient is not happy about what’s happening, every hospital in Ontario has a complaint mechanism that is a set of steps that you have to go through to get your complaint answered. I was told some hospitals do very good at it, some of them not as good, but they all have one.

If you have a complaint, you go to your hospital. If you are not happy with the way they’ve handled your complaint or with the results of that complaint mechanism, what do people in Ontario do? They phone the Ombudsman. They phone the Ombudsman, who is this neutral third party who has the knowledge and skills to investigate complaints. This is why we have an Ombudsman in Ontario, so that we have an independent third party who has the ability to investigate complaints. And he has done a fantastic job. He has brought forward to us systemic discrimination issues that we didn’t know existed.

Because of the good job that he has done, he has motivated change, and I would say that because of his work, the working of the Ontario government has improved.

So what does the minister do? Right now, I want everybody to know that the Ombudsman is not allowed to investigate complaints in a hospital. People call him, and he will tell you that they log the complaints. They have hundreds—some 360 complaints last year alone from people who have called the Ombudsman because they had a complaint in the hospital. They had gone through the complaint-handling process of the hospital and were not satisfied. They called the Ombudsman, and what did the Ombudsman do? He said, “I’m sorry. The government does not allow me to investigate complaints in a hospital.”

So I was all happy that we are putting forward a patient relations process. “Finally, the Ombudsman will have jurisdiction over a hospital, because this is what we want.” But no; that won’t be the case. We will have some kind of an internal process which, in my view, already exists. It certainly exists in any of the hospitals that I have been in contact with—and I’ve been in contact with many.

Now we are going to make it law that something that already exists should exist, but we’re not going to change it and give the people of Ontario the access that they want, which is access to the Ombudsman, when the internal process has not been successful. I would say, why are we doing this, again? It’s something that already exists. The people have already told you what they want, but you’re not giving them what they want. It’s not exactly what I had in mind when I was hoping for more oversight of our hospitals.

Ombudsman oversight is a fundamental tool that Ontarians need. This bill will give us a patient relations process that the vast majority of hospitals already have in place, but what happens when your complaint cannot be solved internally? The answer is, absolutely nothing. It will end there. Ontarians still won’t have anywhere to turn to, and Bill 46 is not going to open the door for Ombudsman oversight of hospitals.

Another area of worry for me is, we are concerned about the interprofessional advisory committee that will look into the continuous quality improvement process. I must say that continuous quality improvement is not something new. I remember, about 20 years ago, I was on my hospital’s continuous quality improvement committee. It was headed by a person named Marielle Hortness. I worked at Laurentian Hospital, which is now part of Sudbury Regional Hospital. I can tell you that I have left the hospital, but 20 years later, Mrs. Hortness is still there, and the continuous quality improvement committee is still there.

They have done some good work. They have brought forward some innovative ideas, they have motivated change; they have done some good things. So here again: not exactly a new idea. Those committees have been in our hospitals for the last 20 years. We are bringing them forward as if all of a sudden we are making a 90% shift towards quality improvement. Quality improvement has been in our hospitals. It has been part of our health care system for a long time. It has made strides forward.

So when they talk about wanting a culture change, I’m all for change. I think that, yes, there is a need for improvement, but where is this fundamental spark that says, “Here is change. Here is something that we’ve never done before that will completely change the path of our health care system so that we will be driven by quality”? When we bring forward something like continuous quality improvement, which has been in place for 20 years, what am I missing here? Where is the spark? Where is the motivation to do things differently?

We’ve talked about clinical practice guidelines and best practices. I agree with my colleagues that best practices and clinical practice guidelines are the way to go. We now have a system in place that is driven by volume. In the hospital sector, we say the physician brings the water to the mill. The hospital, being the mill, has to process that water. Hospitals have very little control as to how many patients come through their door, how many procedures the physicians order etc.

We presently have a system that is driven by volume, and some of the experiments of the past to try to decrease volume have not been successful at all. When we look at what happened in the 1990s when the Tories were in power, we looked at a decrease in the volumes that the hospitals were able to do. This continued through all of the McGuinty years. What happened out of this? We got waiting lists. We got procedures that were no longer available. We got people looking elsewhere at a private system to jump the queue and make things happen faster. None of this is good, and none of this leads to increased quality care.

I can tell you that the government often boasts about their family health teams. The health quality council in their last report had a focus on primary care. They said clearly that most of the cases in primary care have to do with chronic disease management, diseases such as diabetes, asthma and high blood pressure, diseases that people have and will have to manage for a long time. That accounts for close to 80% of the visits to a primary care provider.

The health quality council also said the best way to deal with chronic disease management is through an interdisciplinary team approach, and they had some brilliant examples of what is happening right here right now in Ontario in our community health centre model that has an interdisciplinary team model. Then the government comes forward with their family health teams.

They give the name “teams,” but don’t be fooled. If you look at the physicians that work in family health teams, we’ll put it at about 10,000 just to make the numbers easy, and look at every single other primary care provider that works in a family health team—we’re talking about nurse practitioners, nurses, RNAs, dieticians, social workers, physiotherapists, occupational therapists, psychologists, chiropodists—all of those professionals put together, you won’t come up to 10,000. We don’t even have a dyad here, never mind a team.

A team approach would be a physician who works with a nurse practitioner, a nurse, a social worker, a dietician, a health promoter, a physiotherapist. Let’s say you do have 10,000 physicians; you should have about 60,000 of all of the rest of them put together. That would be a family health team, wouldn’t it? You would have a physician working as part of a team. That is not what we have in family health teams at all. It doesn’t even resemble a team.

What it is is an alternate payment plan. Let’s call it what it is. I have no problem with putting an alternate payment plan out there for family physicians. More power to them; they seem to like it. A lot of family physicians are joining those teams.

But to say that a family health team is an interdisciplinary care model is not true. It is, at best, a stretch. Are there some exceptions out there? Yes, there are some exceptions. There are community-based family health teams out there that have put together a team where a physician has the opportunity to work with a nutritionist, a chiropodist, a social worker and a nurse. There are some that are successful, but if you look at 175 or thereabout family health teams out there, a lot of them are not teams at all.

Here we have the health quality council. They have already done the work on primary care; they have already said what the best practice would be. The Minister of Health and the Ministry of Health bought it hook, line, and sinker and thought that teams are really the way to provide primary care in Ontario; this is the way we should do things. Then you look at the implementation and you see that they can talk about family health teams all they want and give them the name they want, but they are a far cry from being a team. I’m a little bit sheepish as to: What is going to be the difference now?

The Ontario Health Quality Council will continue to do their excellent work, like they have done in the past. They will continue to tell the truth about what constitutes best practices in health and what doesn’t, and they will be able to do this and demonstrate that clearly. They will put forward a tool box and ways of implementation. And then this won’t apply to the little, wee part that is called primary care in Ontario anymore; it will apply to this great big mammoth health expenditure that we call hospitals.

If we look at the amount of success that this government has had in primary care, and we say, “Well, the same agencies did the recommendation. They followed the same pattern of focusing on best practices, and here’s the result that we got,” and here’s the same recipe that is being followed to change the hospital system, allow me to be a bit skeptical that we’re actually going to see any change here.

Two of the fundamental pillars of their reform are fundamentally good. Continuous quality improvement: Who would disagree with this? But this is not a leverage for change. Continuous quality improvement has been in our hospitals for a long time. The second one will be driven by clinical practice guidelines and best practices. A second pillar of what they see in this new bill is something that exists in other parts of the health care system, in a much more manageable part of the health care system, and yet the results are not there. The results are far from an implementation of a best practice that has been documented and scientifically backed.

Here they are following the same recipe book. If you do the same thing, what would lead you to believe that you will get a different result? I saw what happened in primary care and the results were not an interdisciplinary team-based approach to manage chronic disease, like the health quality council wanted. So here we have the same recipe being followed, but now in the hospital sector. What would lead me to believe that we will now have success with that? I hope it’s in the pages of the bill that I haven’t had time to read, because so far, in the parts that I have read, none of this is covered. None of this is there to give us a sense that we have success coming.

I see that I only have five minutes, and this stresses me to the utmost. I still have lots to say, but I don’t have very much time. I’m wondering where I should go next.

Let’s talk a little bit about the declaration of values. I agree that when you talk about governance, when you talk about fixing strategic objectives, the best way to motivate any organization is to have a good set of values that will basically ground the organization in the population they serve and help the entire collective of the organization. Whether they are the workers, the physicians, the midwives, the nurse practitioners, the volunteers or the patients themselves, a good set of values is something that ignites people, that motivates them, that moves them forward.

It is something that our hospitals all have. If you go into any hospital in Ontario, whether you’re in the elevator, in the bathrooms or in the hallway, you will see their set of values posted out there for everybody to read, for everybody to be motivated by and for everybody to join.

So here again, in

section 7, it says that it would require that every health care organization develop a patient declaration of values and make it available to the public. Those are all things that exist. We are surrounded by hospitals where we are. Go down University Avenue, walk into any one of those mega-hospitals we have down here, go into any washroom or any elevator and you will see that they all have a set of values. They have a mission, they have a vision, and they share it with everybody. So what’s so revolutionary in what we have now?

I’m out of time. I can see you coming up.

Second reading debate deemed adjourned.

The Acting Speaker (Mrs. Julia Munro): The time has come to recess until 10:30.

The House recessed from 1015 to 1030.

INTRODUCTION OF VISITORS

Hon. Laurel C. Broten: I’d like to welcome to the gallery the sister of page Joshua Rossetti, Olivia Rossetti, who’s here today from my riding in Etobicoke–Lakeshore.

Mr. Ted McMeekin: I’d like to introduce Laila Alaichi, mother of page Jacob Alaichi, who’s with us here this morning.

Mr. Paul Miller: I’d like to introduce in the west gallery Steve Miazga. He’s the Hamilton Conservation Authority CAO; Brad Clark isn’t here with us; Rita Giulietti, press secretary for Friends of the Eramosa Karst; and Tom Zietsma, board member, Friends of the Eramosa Karst. Thanks for coming.

Hon. Deborah Matthews: Given that today is World Asthma Day, I am especially delighted to introduce Christine Hampson, the president and CEO of the Asthma Society of Canada; Joanne Di Nardo from the Ontario Lung Association; and Carole Madeley from the Ontario Lung Association. Welcome to you all.

Hon. Harinder S. Takhar: I would like to welcome to the Legislature grade 5 students from the Edenrose Public School. They will be here shortly.

Mr. Tony Ruprecht: Canadian and Lithuanian soldiers are fighting today as partners against terrorism in Afghanistan. The members of the trade delegation from Lithuania in the east gallery are also looking for Canadian partners, but in the information and communications technology sector. Since the ICT sector is a major driver of both of our economies, we welcome these CEOs and presidents and wish them the best of luck. They are being led by Vilija Jatkonienė—

Applause.

Mr. Tony Ruprecht: Well, they’re already clapping; that’s great.

They are being led by Vilija Jatkonienė from the Embassy of the Republic of Lithuania. Welcome, and we hope for the very best of luck to you.

Mr. Rick Johnson: I would like to welcome Blake Frazer from Kawartha Dairy, in my riding. He will be serving ice cream this afternoon at the Alliance of Ontario Food Processors reception.

LEGISLATIVE PAGES

The Speaker (Hon. Steve Peters): I’d like to take this opportunity to welcome our new group of pages and allow them to assemble for introduction.

Jacob Alaichi, Ancaster–Dundas–Flamborough–Westdale; Emma Allen, Bruce–Grey–Owen Sound; Nirosha Balakumar, Scarborough–Guildwood; Vrajesh Dave, Mississauga–Streetsville; Rhett Figliuzzi, Guelph; Luke Goralczyk, Leeds–Grenville; Tristen Groves, Parkdale–High Park; Michelle Hendrikx, Sarnia–Lambton; Sarah Klapman, Trinity–Spadina; Michelle Lutsch, Essex; Mary McPherson, Thunder Bay–Atikokan; Ana Méndez, Wellington–Halton Hills; Lars Moffatt, Algoma–Manitoulin; Nicole Pal, Eglinton–Lawrence; Caroline Robertson, Ottawa–Vanier; Joshua Rossetti, Etobicoke–Lakeshore; Yidu Sun, Windsor West; Dylan Thompson, Burlington; Stig Tripp, Northumberland–Quinte West; and Katina Zheng, Mississauga East–Cooksville.

Welcome to our new group of pages.

MEMBERS’ PRIVILEGES

The Speaker (Hon. Steve Peters): On March 25, 2010, shortly after the House had resumed meeting at 4 p.m., the member for Renfrew–Nipissing–Pembroke, Mr. Yakabuski, rose on a point of order just after the Minister of Finance had moved the budget motion but before the pages had begun delivering the budget papers to members in the chamber. The member indicated that members of the official opposition who were in the budget lock-up had not been allowed to leave the lock-up in a timely manner and that they were still on their way to the legislative chamber. The member from Wellington–Halton Hills, Mr.

Arnott, added that the reason for the delay was that the Ontario Provincial Police were waiting to hear from the office of the Minister of Finance before releasing members from the lock-up. Members will recall that I delayed proceedings for a few moments so that more members could arrive, after which the budget papers were tabled and distributed to members and the Minister of Finance presented the budget.

On April 6, I received from the member for Parry Sound–Muskoka, Mr. Miller, a notice of intention to raise a point of privilege, and on April 12, the member raised a point of privilege on this matter in the House. In the notice and in his oral submissions, the member invited the Speaker to find that a prima facie case of privilege had been established on the basis that members of the official opposition were physically obstructed, impeded and interfered with when they tried to make their way to the chamber for the budget presentation.

According to the member, this obstruction occurred against the members’ wills and contrary to the lock-up protocol issued by the Ministry of Finance. The member for Welland, Mr. Kormos, the government House leader, Ms. Smith, and the member from Whitby–Oshawa, Mrs. Elliott, also spoke to the matter at the time. I also received written submissions from the government House leader, the member from Parry Sound–Muskoka and the member from Welland.

Having had the opportunity to review the notice, our Hansard, the written submissions and the relevant precedents and authorities, I will now rule on the matter.

First, dealing with the issue of timeliness raised by the government House leader, I will say that the procedural authorities, but not standing order 21(b), indicate that members should raise points of privilege in a timely manner. In the case at hand, the matter was initially raised in the House within minutes of the members being released from the lock-up. Admittedly, it was raised at the time on a point of order as opposed to a point of privilege, but it cannot be denied that the matter was brought to the attention of the House within minutes of the member’s release from the lock-up.

Given the time it can take to prepare a meaningful, comprehensive notice of a point of privilege and that the Easter long weekend and a constituency week intervened during this period, I cannot say that the member for Parry Sound–Muskoka failed to exercise due diligence in raising his point of privilege.

The second consideration in this matter is the issue of whether the alleged interference prevented members from attending their parliamentary work. According to the procedural authorities and many previous Speakers’ rulings, parliamentary privilege protects members in the execution of their strictly parliamentary duties, not the constituency or other duties that may be fairly said to be part of their job descriptions.

On this point, the second edition of Maingot’s Parliamentary Privilege in Canada states on pages 222 to 223, “The interference, however, must not only obstruct the member in his capacity as a member, it must obstruct or allege to obstruct the member in his parliamentary work.” The demarcation between members’ parliamentary and non-parliamentary duties that Maingot addresses is important, because the members of the official opposition who were in the lock-up did not want to leave the lock-up in order to attend to their constituency or other non-parliamentary duties; they wanted to leave the lock-up in order to make their way to the precincts and, in particular, to attend and participate in the parliamentary proceedings.

Those members who spoke to or made a written submission on the point of privilege raised by the member from Parry Sound–Muskoka did not dispute this important point.

In the case at hand, there is no issue taken with the protocol set out for the lock-up itself. Indeed, it seems clear that if the terms of the protocol had been followed and members released in time to make their way to this chamber for the start of proceedings, we might not be dealing with this point of privilege at all. Let me be clear: We are concerned here with an allegation that certain members were obstructed in their attempt to leave the lock-up at a time when they should reasonably have expected to be allowed to leave in order to attend the proceedings of the House.

This brings me to the nub of the point of privilege raised: that is, the right of members of this Legislative Assembly to attend to their parliamentary duties without interference or obstruction. I note that the House of Commons Procedure and Practice states the following: “In circumstances where members claim to be physically obstructed, impeded, interfered with or intimidated in the performance of their parliamentary functions, the Speaker is apt to find that a prima facie breach of privilege has occurred.”

The case before me is one in which members are indeed claiming they were prevented from getting to the legislative chamber, thereby obstructing them in their performance of their parliamentary duties. Moreover, the government House leader acknowledges that members of the official opposition were detained in the lock-up longer than they should have been. Specifically, she says that members were delayed by OPP personnel. But the government House leader says that in mitigation, members were in the chamber when the budget was presented.

This contention presumes that it is more important that members be in the chamber for the presentation of the budget than for moving the budget motion itself or for any other proceeding. I cannot agree with such a presumption, because it would require the Speaker to accede to the questionable proposition that some parliamentary proceedings are more important than others and that members should not get worked up about missing the so-called less important parliamentary proceedings. It is not the responsibility of the Speaker to slice and dice proceedings in Parliament.

To my mind, it is for individual members—not the Speaker, not the government, not security personnel—to decide whether they should be in the chamber for the moving of a budget motion, the tabling of the budget, the presentation of the budget or all of them.

In the case at hand, there appears to be no disputing that some members of the official opposition missed the moving of the budget motion, that they missed it because they were not released from the lock-up in a timely manner and that, had I not delayed proceedings for a few moments shortly after 4 p.m. on budget day, they might have missed part of the budget presentation itself.

For a prima facie case of privilege to be established, it is enough to ascertain that members wanted to attend the House and were, at least for a time and against their will, prevented from doing so. It is of no significance where such—

Interjection.

The Speaker (Hon. Steve Peters): Order.

It is of no significance where such an obstruction occurred or what parliamentary proceeding members were prevented from attending.

Further investigation may well reveal a plausible explanation or mitigating circumstances for what occurred in the budget lock-up on March 25, but I do believe that such a further investigation is warranted.

I find, therefore, that a prima facie case of privilege has been established, and, as there has been some confusion in the past, I want to clarify what this finding means.

Maingot states: “A prima facie case of privilege in the parliamentary sense is one where the evidence on its face as outlined by the member is sufficiently strong for the House to be asked to debate the matter and send it to a committee to investigate whether the privileges of the House have been breached or a contempt has occurred and report to the House.

“While the Speaker may find that a prima facie case of privilege exists and give the matter precedence in debate, it is the House alone that decides whether a breach of privilege or a contempt has occurred, for only the House has the power to commit or punish for contempt.”

In short, a prima facie finding by the Speaker does not mean that the Speaker has found anyone guilty of such an allegation. Rather, “prima facie” means that the Speaker has determined that on the face of it, the information presented points toward the likelihood that a breach of privilege has occurred, and that it is in the interests of the House to give priority consideration to such a serious matter, and for a parliamentary committee to inquire into it.

When he raised this matter on April 12, the member for Parry Sound–Muskoka indicated that he was prepared to move a motion to refer the matter to a legislative committee. Having now found that there is a prima facie case to investigate, I will call on the member to move his motion. Pursuant to standing order 21(b), this debatable motion, upon being moved, has precedence and will displace the consideration of regular business until it is disposed of.

In closing, I want to thank the member for Parry Sound–Muskoka, the member for Welland, the government House leader, and the member for Whitby–Oshawa for speaking to this matter. I also want to thank the government House leader, the member for Parry Sound–Muskoka and the member for Welland for their written submissions.

Mr. Norm Miller: Thank you, Mr. Speaker, for your thoughtful deliberations.

I move that the matter of the delayed release of certain members of this House from the March 25, 2010, budget lock-up be referred to the Standing Committee on the Legislative Assembly for its consideration.

The Speaker (Hon. Steve Peters): Mr. Miller has moved that this matter be referred to the Standing Committee on the Legislative Assembly. Further debate?

Mr. Norm Miller: Thank you very much, Mr. Speaker, for first of all ruling and allowing the committee to look further into this matter. I’ll certainly be looking for—because we aren’t usually successful with these matters—the table’s assistance as to what happens next.

I think it important that the members of the Legislature be able to carry out their business in a free and open manner. On the day of the budget lock-up, we took on a new tactic for that day and that was we that had all of our caucus in for the budget lock-up so that they might be able to take more time to review the budget prior to the actual speech being given, and thereby able to be right up to speed on it and be able to analyze the budget more fully and provide a critical analysis of the budget.

On that particular day, taking this new strategy, which was to have pretty much our whole caucus—

Mr. Peter Kormos: On a point of order, Mr. Speaker.

The Speaker (Hon. Steve Peters): Stop the clock, please.

Mr. Peter Kormos: My apologies to the speaker. Speaker, this is a very modest proposal, and that is to say, the motion. I’m wondering if a five-minute recess would not be appropriate so that House leaders could discuss an effective, meaningful disposition of this motion.

The Speaker (Hon. Steve Peters): Mr. Kormos seeks the consent of the House to recess for five minutes to allow the House leaders the opportunity to discuss the issue. Agreed? Agreed.

This House stands recessed.

The House recessed from 1050 to 1057.

The Speaker (Hon. Steve Peters): Government House leader.

Hon. Monique M. Smith: Mr. Speaker, I’d like to thank you for your ruling and the opportunity to confer with my fellow House leaders, the member for Renfrew–Nipissing–Pembroke and the member for Welland. We have come to the conclusion that it should move forthwith to the Standing Committee on the Legislative Assembly. We believe that the lessons learned will provide some guidance to all governments, and we appreciate the opportunity to have that heard in the Standing Committee on the Legislative Assembly.

The Speaker (Hon. Steve Peters): Mr. Miller moves that the matter of the delayed release of certain members of this House from the March 25, 2010, budget lock-up be referred to the Standing Committee on the Legislative Assembly for its consideration. Is it the pleasure of the House that the motion carry? Carried.

Motion agreed to.

ORAL QUESTIONS

SENIOR CITIZENS

Mr. Tim Hudak: This is a question to the Premier. If the Premier’s failure to mention seniors in the throne speech raised any questions about what Dalton McGuinty thinks of Ontario’s seniors, his recent attacks on seniors’ budgets make it clear. Premier, you’re attacking the pocketbooks of Ontario’s seniors on three fronts at once: the HST tax grab, hydro rate increases and now your smart meter tax grab—all at the same time.

Premier, do you think Ontario’s seniors are living the high life, or just how out of touch have you become?

Interjection: How much more can they take?

The Speaker (Hon. Steve Peters): Order.

Hon. Dalton McGuinty: There’s some energy there today, Speaker, which is always a good thing.

I want to thank my honourable colleague for the question and take this opportunity to thank the older generations for everything that they have done. After all, it was through their good efforts that we have the health care system that we have today, that we have the education system that we have today, that we have colleges, universities, roads and bridges and the like.

So obviously, we sense a great deal of responsibility to ensure that seniors enjoy a good standard of living and a good quality of life throughout their lives—which makes me ask: Why is it that if seniors are so supportive of our determined efforts to reduce the cost of generic drugs in Ontario, we don’t have the support of my honourable colleague opposite? Get on board with seniors and help us get the cost of generic drugs down.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Tim Hudak: That’s not a pat on the back Ontario seniors are feeling from their Premier; it’s a hand in their pocket. You’re attacking them through hydro bills, the HST tax grab, and now your so-called smart meters tax grab. In fact, Premier, the only time you mentioned the word “senior” in your budget speech was when you said that you’d reduce OPS senior executive pay, but then again, that promise lasted for less than 24 hours.

On May 1, you hit seniors with $350 more per year on their hydro bills. You also hit them with a surprise attack through the HST on May 1. I’ll ask you, Premier, how much is too much? How much more will seniors pay, thanks to your so-called smart meter tax grab?

Hon. Dalton McGuinty: My honourable colleague is nothing if not creative, inventive when it comes to the particular numbers that he’s just raised, and I think Ontario seniors recognize that.

I can say that in terms of some of the things we’ve been able to do for and with our seniors, we have, through our Ontario senior homeowners’ property tax grant—that is a grant that was doubled to $500 this year, as announced in our 2008 budget.

Hon. Dwight Duncan: They voted against it.

Hon. Dalton McGuinty: And that’s a provision against which my honourable colleague voted.

I can also say that the government is providing $1 billion over the next five years through that particular grant to more than 600,000 Ontario seniors who have low to middle incomes who own their homes. We think that’s a positive step that demonstrates our continuing support for our seniors.

The Speaker (Hon. Steve Peters): Final supplementary?

Mr. Tim Hudak: The only thing inventive here is your attempts to raid the pocketbooks of Ontario seniors any way you can. Your so-called smart meter tax grab is going to charge seniors higher rates to turn on their lights, to use the computer, to spend a day at their home. On July 1, you’re going to hit the seniors with an HST tax grab on their hydro costs, their retirement funds, gas for their cars and their home heating costs. This Premier is even going to charge seniors for taking a vacation to visit the grandkids.

I ask you, Premier, how much do you think Ontario seniors are sitting on? When is enough enough? When will you tell your ministers to stop their attack on the pocketbooks of Ontario seniors?

Hon. Dalton McGuinty: Let me say that in addition to the increase that we provided for benefits for our seniors through the property tax grant, and in addition to our determined effort to reduce the cost of generic drugs and why that’s so important to seniors who are covered by our drug benefit plan in the province of Ontario—because the last time we attacked high drug costs, we were able to list 184 new drugs since 2006, including Lucentis, which treats macular degeneration, which is very important for our seniors.

What I want to say as well is that, as we continue to pursue our lowering of generic drug costs, with those savings we will cover still more new drugs for Ontario seniors, who are beneficiaries. We will also find ways to invest still further in our health care system. Over 60% of our lifetime-related health costs are accumulated after the age of 65. Seniors are very concerned about the quality of their health care. We’ll keep working—

The Speaker (Hon. Steve Peters): Thank you. New question.

HYDRO RATES

Mr. Tim Hudak: Premier McGuinty told Ontario families and seniors that his so-called smart meters will pay for themselves: “It’s all designed to ensure that you are in fact saving money over the long term.”

Premier, you have a well-earned reputation for saying one thing and doing the complete opposite. Why did you say that your smart meter tax grab will save money when in fact it does the complete opposite?

Hon. Dalton McGuinty: I’d ask my honourable colleague to develop a better understanding of the smart meter and what we’re going to do with it. With a smart meter, an Ontario senior, an Ontario family, will be able to, for the first time, pay differential rates depending on the time of the day when you use your electricity. We want to create the possibility for families to use an appliance at an off-peak period during which electricity will be at a lower rate, and we can’t do that right now unless we have smart meters in place.

This is all about ensuring that Ontario families can conserve electricity and can reduce their electricity bill by taking advantage of new technology. Many other parts of the world are already there. We’re working as hard as we can to catch up.

The Speaker (Hon. Steve Peters): Supplementary.

Mr. Tim Hudak: What this is all about is a Premier who continues to betray the trust of Ontario taxpayers, a Premier who continues to break his word to say one thing and do the opposite.

Now Premier McGuinty will charge seniors, when he promised 4.3 cents per kilowatt hour in a previous election, up to 9.9 cents—more than doubling the cost of hydro for a senior to have the privilege, in Dalton McGuinty’s Ontario, of turning on a computer, a radio or TV during the daytime.

Premier, you committed when you brought in these smart meters that they would be able to reduce their hydro costs, when in fact Toronto Hydro has said that some 72% of their customers are now paying more for their power thanks to your smart meter tax grab. Did you bungle this smart meter initiative? Did you bungle flexible pricing? Or did you—

The Speaker (Hon. Steve Peters): Thank you. Premier.

Hon. Dalton McGuinty: One of the greatest concerns that weighed heavily on the minds of Ontario families and businesses as well, when we first earned the privilege of serving Ontarians as a government back in 2003, was whether or not we could keep the lights on. They were concerned about the vigour and vitality of our electricity system. They knew that under the previous government electricity rates had been frozen, which was just not sensible. They knew that there was no free lunch and that we needed to invest in the system, and we’ve done that dramatically.

Since 2003, we’ve built 8,000 megawatts of clean, reliable power; that’s enough to power 1.9 million homes. Through our clean energy program, we’ve leveraged over $16 billion in new investment. We’re talking about some 36,000 jobs.

All families know that we needed to invest in our system. They know there’s a cost connected with that, and I believe they feel it’s well worth making that kind of investment to ensure that we have electricity that’s there for all of us when we need it.

The Speaker (Hon. Steve Peters): Final supplementary.

Mr. Tim Hudak: I can’t believe the Premier is talking about keeping the lights on. Sir, when you’re increasing the hydro bills of Ontario seniors by $350 per year in this year alone and then hitting them on top of that with your smart meter tax grab, Ontario seniors are going to be challenged to keep the lights on in their own homes because of this train wreck of an energy policy.

Premier, Ontario seniors are going to pay more to put on their computers, to do their baking, to do their laundry, to listen to the radio, and you dismiss them by telling them to do their laundry or the dishwashing at midnight. And they’ll be even harder hit when the smart meter tax comes into play.

Have you engaged in a three-front multiple attack on the pocketbooks of Ontario seniors because of incompetence or because you’re out of touch, or both?

Hon. Dalton McGuinty: I want to remind my honourable colleague and his party what it is that they left to Ontarians in terms of their electricity system. The system was unreliable. We were experiencing electricity shortages—blackouts—and there was no plan to meet Ontario’s growth. The energy sector was very hesitant when it came to investing in Ontario. Dirty, coal-fired generation increased 127% from 1995 to 2003. Prices were frozen, but with health and environmental costs included, coal was costing over $4 billion per year in Ontario. We’re talking about premature deaths, hospital admissions and visits to the emergency room.

We said we were not prepared to accept that. We said we had to make investments in our electricity system. We had to clean it up. We had to strengthen it. We had to bring in new technologies, like the smart meter, that will give more control to our families and businesses when it comes to their own particular bill.

TAXATION

Ms. Andrea Horwath: My question is to the Premier. This past Saturday, much to the surprise of many Ontarians, Dalton McGuinty’s HST started to kick in. We know that this government has estimated how much money their unfair new tax will take out of family budgets. Will the Premier finally reveal what he knows and tell Ontario families how much the harmonized sales tax is actually going to cost them?

Hon. Dalton McGuinty: It was something that was in the budget, it was something that was put on a website quite some time ago, and I can, if my honourable colleague asked us to do so, make reference to some of the information.

For a single parent on Ontario Works with two kids ages five and seven, they will benefit by $585 overall. For a single senior with a pension income of $20,000, the net impact will be a positive $105. For a single individual with a $30,000 income, the net impact is $255. For a couple with a $70,000 income, with two kids ages five and 10, the net impact is a positive $365. This information has been available for quite some time.

The Speaker (Hon. Steve Peters): Supplementary?

Ms. Andrea Horwath: Anybody can go to the government’s website and get their spin, but the reality is that since the Premier is not going to fess up to the reality, I’m glad to provide Ontario families with some of the reality and clarity around the cost certainty of this particular tax.

New Democrats actually used Statistics Canada’s well-respected social policy simulation database and model to calculate the full impact of the HST on Ontario families. I know that the Premier is actually a numbers guy, given the way he likes to spout off numbers in question period as he just did, so would he like to guess what the HST is going to cost Ontario families?

Hon. Dalton McGuinty: I can understand why Ontarians might be confused, because we put out some numbers through the Ministry of Finance and my honourable colleague has put out some numbers. I think Ontario families should be able to have confidence in independent, arm’s-length, third party assessments of the consequences of our tax reforms.

I refer to two in particular. One is put out by the school of public policy at the University of Calgary by Professor Jack Mintz. He says that over the course of the next 10 years, we are going to experience a capital investment of $47 billion, we’re going create up to 600,000 net new jobs and increase annual worker incomes by up to 8.8%. That’s one. The other one my colleague refused to acknowledge even exists is put out by the Canadian Centre for Policy Alternatives. The title says it all; the title of that paper is, Not a Tax Grab After All.

The Speaker (Hon. Steve Peters): Final supplementary?

Ms. Andrea Horwath: I’m sure the Premier knows that the Canadian Centre for Policy Alternatives has actually indicated quite clearly that they do not support the HST, and I have the letter which indicates that. If he would like to have it, I can certainly send it across the way.

Let me tell you this: The average family will pay more, a lot more—$792 more each and every year. That’s the average; half of Ontario’s families, in fact, will be paying more than that. When was the Premier planning on telling families that they’ll be paying nearly $800 more a year in new taxes?

Hon. Dalton McGuinty: Again, I cannot accept the calculations put forward by the NDP and I would encourage Ontario families to bring the same sense of healthy skepticism when it comes to the NDP calculations.

I would recommend to them once again two independent, arm’s-length, third party reports. One says that this is the way to create 600,000 new jobs over the course of the next 10 years. It will result in $47 billion worth of new capital investment to help us strengthen our economy. The other is put out by the Canadian Centre for Policy Alternatives. It’s entitled Not a Tax Grab After All. It says that for low-income families, they’re going to come out ahead; for middle-income families, it’s a wash; and for our wealthiest families, they’re going to end up paying more.

Again, I’ll leave it to families. They can look to the NDP for numbers or they can look to independent reports.

TAXATION

Ms. Andrea Horwath: My next question is to the Premier, but I do want to quote from the Canadian Centre for Policy Alternatives. I quote from a letter: “Accordingly, it is not correct to state that the CCPA supports the HST, or indeed that the authors of the paper in question do so, and I would request that your campaign issue a statement correcting the error.” That’s from your member from Toronto Centre’s campaign quoting the CCPA improperly.

The question is this: We know the Premier likes to talk up his tax cuts and his credits, so we included them in our model. We actually put his numbers into our model. After paying $800 more in HST, the average Ontario family will get back $322 in the cuts and credits that the government likes to brag about. Can the Premier tell us how paying $800 more and getting $300 back actually makes families further ahead?

Hon. Dalton McGuinty: I just have a healthy skepticism when it comes to NDP math. I would recommend to Ontarians that they bring the same approach.

What I can say is that I know that families can be confused by all of the numbers, and I’d recommend to them two independent reports which I think introduce a little bit more light and a little less heat into this important debate.

I also want to reaffirm something that I’ve said several times over: We know that what we’re asking of Ontario families is not an easy thing to do, but we think it’s something that is the right thing to do. We think that we need to do it. We’ve just gone through this terrible recession and we’ve lost 250,000 jobs. Growing stronger in Ontario is no longer an option; it’s a must. This is the single most important thing that we can do to create jobs, not just for us today but for our kids tomorrow, and I believe that parents and families are prepared to make that commitment.

The Speaker (Hon. Steve Peters): Supplementary?

Ms. Andrea Horwath: The Premier likes to claim that businesses are going to lower prices because of all the money that they’re going to be saving with the harmonization. Even if businesses put every single penny they save into cutting their prices, the average Ontario family will still pay $638 more in taxes.

Does this Premier agree that Ontario families deserve to have this information before the tax finally kicks in?

Hon. Dalton McGuinty: Again, I know that what we’re asking of families is not easy. This will, in fact, affect the cost of 17% of their consumer purchases, but we’ve worked as hard we can to make it manageable for our families.

Some 93% of Ontarians are getting a personal income tax cut, and that happened on January 1 of this year; and 2.9 million families and individuals are going to get our new annual tax credit of $260 per person. Then there are our transition payments: There’s $1,000 for a family earning less than $160,000 and $300 for an individual earning less than $80,000.

We’ve done everything that we possibly can to make this manageable and acceptable to families. I will be the first to say, at the end of the day, that we are in fact asking families to do more, but we think they’re prepared to make that commitment to strengthen our economy.

The Speaker (Hon. Steve Peters): Final supplementary?

Ms. Andrea Horwath: Make no mistake, and I’ll be fair to the Premier in this regard, there are some who will benefit because of the HST. Banks will increase their profits and accountants will see a lot more business, but the average Ontario family will absolutely lose, and they’ll lose big time.

Will this Premier finally admit that his unfair HST will do one thing and one thing only: It will cost Ontario families more each and every single day?

Hon. Dalton McGuinty: I can’t accept that, of course, and I might say, in passing, that I think banks are taking the biggest hit as a result of our going ahead with the HST.

What I do want to return to—I think what is the essence of this—is why we are doing this. We believe that we have to strengthen our economy. We believe that in an era of profound globalization, where our businesses here in Ontario do so much by way of exporting—they’re exporting their products into a highly competitive, globalized economy, and they’re competing against people in other places where they have this value-added tax—we have to have the HST, together with our other package of tax reforms, to ensure that we grow stronger.

I think parents are motivated by the same ideal—every generation. We’re prepared to do whatever it takes to build a stronger economy for our kids to secure a bright future. Fundamentally, that’s what this policy is all about.

TAXATION

Mr. Garfield Dunlop: My question today is to the Minister of Revenue. There are just 58 days until Dalton McGuinty starts adding the greedy HST to his hydro rate hikes, to charges for smart meters, to the $53-million backdoor energy tax, to the $437-million Samsung subsidy—and the list of energy taxes goes on and on.

Mr. Jim Willis of Barrie doubts that hydro companies will pass along the value of input credits to customers, but he can say with certainty that you’ll make seniors pay 8% more on their condo fees.

The member for Barrie didn’t ask Mr. Willis’s question, so I will: Minister, what makes you think you’ll get away with attacking the budgets and the pocketbooks of Ontario seniors?

Hon. John Wilkinson: I agree with the member from Barrie that what her riding needs, what your riding needs and what my riding needs are more jobs, and that’s exactly why we’re reforming our tax system.

I remind the member and the good people in his constituency that their member voted against reducing the personal income tax rate to the lowest of any province in this country on the first $37,000. I want to remind the people in his riding, when they get the HST rebate, that their member voted against that new rebate, that he voted against increasing the senior property tax credit by an additional $250. He voted against that as well, much, I think, to the surprise of his constituents.

I remember when that member believed that what we should do is reform taxes. That’s what his former Premier said, that’s what his leader said. Today they’ve changed their positions conveniently, but they—

The Speaker (Hon. Steve Peters): Thank you. Supplementary.

Mr. Garfield Dunlop: I’m sure Mr. Willis in Barrie is going to be really excited about that answer.

Seniors are on to the McGuinty Liberals. Mr. Willis knows you’re handing out severance packages to the HST tax collectors who won’t miss one day of work.

Members of CARP wrote to say, “The tax ‘rebate’ to us is a transparent trick,” and the money you’re handing out is from the pockets of taxpayers.

Mr. John Hinman of Cobourg puts it more bluntly when he says, “The HST is a monumental tax grab.”

The member from Northumberland won’t ask, so I will: Minister, what made you think you could pull the wool over Ontario seniors’ eyes and fool them about your greedy HST tax grab?

Hon. John Wilkinson: Another thing that the member voted against is the transition payments that are provided by people like Jim Flaherty, Helena Guergis and Patrick Brown, who also thought that the best thing that we could do to build a stronger Canada is to have Ontario reform its tax system so that we’re competitive in the 21st century.

I want everyone in Ontario to understand that that party opposite said, “No, you should not receive the transition benefit,” and when that $333 cheque shows up in your family’s home in June, or that $100 cheque shows up if you’re an individual, that there was a party in this place that voted against that. They decided that Jim Flaherty and Stephen Harper were wrong. They decided the best thing we should do is not make sure that consumers have that money. It is important for consumers to have that money so that it gives us time to get our permanent tax cuts, the ones that you voted against, right into our economy—

The Speaker (Hon. Steve Peters): Thank you.

Interjections.

The Speaker (Hon. Steve Peters): Order. Stop the clock.

New question?

CORRECTIONAL SERVICES

Mr. Peter Kormos: To the Minister of Community Safety: Why won’t this minister ensure that vulnerable, mentally ill inmates are in appropriate hospital settings instead of hellholes like the Don jail?

Hon. Rick Bartolucci: My ministry continues to ensure that adequate resources are provided so that within our correctional facilities, there are both the human resources and the physical resources to ensure that those with mental illness are treated and have the necessary services available to them.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Peter Kormos: Speaker, 32-year-old Jeff Munro, suffering from severe mental illness, including schizophrenia, was battered and stomped to death while in the Don jail. Now the government is being sued.

Why won’t the government admit it was wrong, apologize, settle and really do something to ensure that this never happens again?

Hon. Rick Bartolucci: As the member knows, I’m not going to comment on any specific case, especially a case that’s before the courts. The member knows that. But the McGuinty government is committed to the fair and compassionate treatment of people—

Interjection.

The Speaker (Hon. Steve Peters): Withdraw the comment, please.

Mr. Gilles Bisson: I withdraw.

The Speaker (Hon. Steve Peters): Stand and withdraw the comment.

Interjection.

The Speaker (Hon. Steve Peters): Thank you.

Minister?

Hon. Rick Bartolucci: Let me repeat, because it’s worth repeating and it’s important that we repeat it: The McGuinty government is committed to the fair and compassionate treatment of people with signs of or a diagnosis of a mental illness. The people in our correctional services facilities take that very, very seriously, and we provide those services.

PUBLIC TRANSIT

Mr. Ted McMeekin: Good morning, Mr. Speaker. Mr. Speaker, I think you’re doing a swell job. I just wanted to sneak that in.

My question is for the Minister of Transportation. The people of Hamilton understand better than most how important a comprehensive, efficient transit system in a community is. A good transit system not only takes cars off our streets and reduces gridlock and emissions, but is good news for the environment. It also provides people who don’t have a car with an easy and accessible way to get around town.

Minister, can you explain what your government is doing to improve transit in my beloved city of Hamilton?

Hon. Kathleen O. Wynne: I’d like to thank the gracious member from Ancaster–Dundas–Flamborough–Westdale for his question. We know how vital transit systems are to communities across the province. The gas tax is a prime example of the support that we are providing to municipalities. This year, we’re investing $316 million in 93 municipal transit systems in 119 municipalities—that’s almost $11 million for Hamilton.

Furthermore, Metrolinx has completed a benefits case analysis study earlier this year to look at different rapid transit options for Hamilton. The benefits case analysis shows that there are a number of options, all of which would work for Hamilton. This is a really good opportunity for the people of Hamilton to talk about which option will work best for Hamilton, and that community discussion is ongoing.

The Speaker (Hon. Steve Peters): Supplementary.

Mr. Ted McMeekin: Thank you, Minister. My constituents certainly value the service improvements made in Hamilton and the government’s investments there. Expanded services for newer buses have certainly encouraged people to get out of their cars and to choose public transit.

Minister, with our proximity to Toronto, many people in my riding regularly make the commute to downtown Toronto for work, for appointments and to meet friends. Speaker, through you to the minister, what is the government doing to improve GO service and make it faster and more efficient for Hamiltonians to visit Toronto?

Hon. Kathleen O. Wynne: The question is a really good one, because what we are trying to do is to get people across the greater Toronto and Hamilton area to make a greener choice, to take public transit across the region, and to create a regional transit network. That’s exactly why we created Metrolinx. It’s about building that comprehensive regional network.

GO has made a number of changes that will improve service for Hamilton. Last year GO added a fourth daily train trip out of the Hamilton GO centre in the morning. In 2008, GO introduced more 12-car trains on the Lakeshore West line, which adds 20% more capacity than the 10-car trains. As was announced today, we’re investing in the revitalization of Union Station. That’s a revitalization that will benefit all GO riders because those GO riders from Hamilton come into Union Station. It will be—

The Speaker (Hon. Steve Peters): Thank you. New question.

PHARMACISTS

Mr. John O’Toole: The question is to the Minister of Health and Long-Term Care. Minister, last week the committee on finance and economic affairs reviewed your government’s pharmacy cutbacks contained in Bill 16. Committee members heard from pharmacists who described the impact of your legislation on their customers. The presenters included pharmacist Peter Meraw, a former Durham riding resident who is co-owner of the Minden Pharmasave with his partner, Richard Smith. He said your government will take away services and impact on seniors. This means fewer services for patients, loss of jobs and the possible closure of many small community pharmacies.

Minister, what will it take to convince your government to delay these cutbacks until there are fair consultations with consumers?

Hon. Deborah Matthews: I am delighted to talk about our proposed drug reforms. This is all about getting fair and substantially lower drug prices for all Ontarians. We are paying far too much for drugs now. We can save people hundreds of dollars per year through these changes, and we’re going to do that.

This is also about being able to cover more drugs for more people, and it’s about cleaning up a system of these so-called professional allowances that even pharmacists now are admitting it’s time to get rid of.

We are concerned about maintaining access in rural communities. We are concerned about making sure that people have access to pharmacies and pharmacy services. Our plans include special support for—

The Speaker (Hon. Steve Peters): Thank you. Supplementary?

Mr. John O’Toole: Minister, whether it is a topic of sex education, the harmonized sales tax or industrial wind farms, your government has refused to listen. In fact, the people of Ontario are sick and tired of Premier Dad’s attitude.

At the Bill 16 hearings last week, your government clearly cut about a billion dollars from Ontario pharmacists. These cutbacks have profound implications for front-line health care in Ontario.

Minister, why won’t your government learn from past mistakes and have genuine consultations with pharmacy professionals, patients and stakeholders before making these reckless decisions—a detrimental impact on health care in Ontario?

Hon. Deborah Matthews: We are very, very anxious to talk to pharmacists. In fact, we’ve had not one but two meetings cancelled by the pharmacists’ association, and we are anxious to have a new one.

The member opposite has been talking about seniors. Let me quote from Susan Eng, in advocacy at the Canadian Association of Retired Persons: “Lowering the cost of all prescription drugs is a major priority for our members, regardless of whether they are covered by the Ontario government, private drug plans or paid out of their own pockets. They and all Ontarians will benefit from the direct savings in drug costs and redirection of the public savings from these measures towards more patient services and support of pharmacies in rural and under-serviced regions. We welcome the improvement to affordability and the potential for more access to new drugs and encourage”—

The Speaker (Hon. Steve Peters): Thank you. New question.

SERVICES FOR THE DEVELOPMENTALLY DISABLED

Mr. Michael Prue: My question is to the Premier. This was to have been Community Living Day at Queen’s Park. For more than a decade, Community Living Ontario has brought together MPPs and families to celebrate in Ontario where everyone has a right to participate in their community. Regrettably, they have cancelled this year’s celebration. They had to because your government, the McGuinty government, has broken its promise and reneged on its 2007 four-year funding commitment. The developmental services sector’s agencies and staff already struggle to provide services for their clients.

Why did the McGuinty government fail to keep its commitment to Community Living Ontario and cancel its promise of a full four-year funding arrangement?

Hon. Dalton McGuinty: To the Minister of Community and Social Services.

Hon. Madeleine Meilleur: I’m very sorry that Community Living cancelled their day at Queen’s Park because it would have been a great opportunity to come and tell all of you the good work that they are doing. So I’m very disappointed about that.

However, I can say that we have done a lot for the developmental sector in Ontario. We have passed new developmental services legislation that will make the system fairer, simpler and sustainable. We have invested nearly half a billion dollars to strengthen and expand services. Almost half of this investment, $245 million, has been committed to agency-based increases and wage enhancements for front line-workers in this sector. I want to—

The Speaker (Hon. Steve Peters): Thank you. Supplementary?

Mr. Michael Prue: Listening to the minister, I want to put this into the frankest terms I can. This government has earmarked about $20 million for so-called undefined transformation costs. At the same time it has cancelled its 2010 funding commitment to Community Living. Community Living needs the $22 million it was promised. This unfunded $20 million would fulfill most of that urgent need.

Will this government reverse its disastrous decision to break its 2007 funding promise or, at the very least, reallocate the so-called transformation funds to address the urgent needs facing thousands of Ontarians and their families, those with special needs?

Hon. Madeleine Meilleur: Again, this government has invested a lot in developmental disabilities in Ontario since we came into power. For example, in 2008-09, there were 27,385 families who received special services at home. This is a 35% increase in people served. Again in 2008-09, there were more than 27,000 families who received other much-needed services for their families.

In this difficult economic time, we are increasing funding by $36 million to provide critical support and services for people in—

The Speaker (Hon. Steve Peters): Thank you. New question.

ASTHMA TREATMENT

Mr. Dave Levac: My question is for the Minister of Health and Long-Term Care. Asthma affects approximately 13% of our children who are under 12 years old and 8.4% of all Ontarians over the age of 12. It’s a leading cause of hospitalization among children and one of the largest causes of school and work absenteeism. When I first started teaching, the average number of puffers in a school was three to four per school. When I left, it was about three or four per class.

There are constituents in my riding whose children are directly affected by asthma. They are concerned about the adverse health effects that are associated with asthma. Many years ago, I lost my father to asthma.

I ask the minister: In light of World Asthma Day and for all of us who have gone through the pain of asthma, could you please tell us what our government is doing to better serve Ontarians who live with asthma?

Hon. Deborah Matthews: Thank you to the outstanding member for Brant. When it comes to asthma, one of the most important things we can do is phase out the use of coal-fired power generation.

Today, it’s the lowest it has been in 45 years—down 70% since 2003. This is good news for our health. The air pollution caused by coal-fired generation has been linked to 670 premature deaths a year, 1,100 emergency room visits a year and over 300,000 other illnesses, including headaches, coughing and other respiratory symptoms. By closing these plants, we’re bringing down the number of respiratory-related illnesses in the province, including asthma.

We’re also bringing down the cost of generic drugs for all Ontarians, including people with asthma—

The Speaker (Hon. Steve Peters): Thank you. Supplementary?

Mr. Dave Levac: I thank the government for its work in improving the causes for people with asthma. I’m very proud of the work that the government has done, especially for the kids. However, my constituents would be interested to know where the results are in regard to the asthma action plan. The plan itself in investment is good, but results are better.

Interjections.

Mr. Dave Levac: Unlike the heckling that’s going on from those who don’t understand about asthma, I would ask you to give us specific examples of how the implementation of the plan and the investments are working so that our communities can better deal with asthma.

Hon. Deborah Matthews: I’m very encouraged by some of the results that we are seeing in our asthma plan of action. Last year, we invested $4 million, and we’re starting to see the results. Let me share those with you.

We have a primary care asthma pilot project involving 1,400 children and adults with asthma in eight sites across the province. Here’s what they found: a 50% reduction in emergency room visits for asthma and significant improvements in asthma control, including a 46% reduction in nighttime symptoms of asthma. The patients are very satisfied with the care they’re getting, as are the staff.

These reductions are a significant result. It really is encouraging that we know we can do more when it comes to looking after people with asthma.

SERVICES FOR THE DEVELOPMENTALLY DISABLED

Ms. Sylvia Jones: My question is for the Minister of Community and Social Services. Linda and David Russell have been working with Brampton Caledon Community Living to find a residential home for their daughter Joanne, who is developmentally disabled. This family has provided daily support for Joanne for 29 years. As parents, they’ve accepted this great responsibility but are now finding themselves mentally and physically exhausted.

Six hundred people are currently on a wait-list for residential services through Brampton Caledon Community Living. Joanne is just one. Minister, when can families like the Russells expect action from your government to decrease these waiting lists?

Hon. Madeleine Meilleur: First of all, let me say how sensitive I am to all these families who have an individual, a son or a daughter, with developmental disabilities. I know much about what they are going through because I have some in my own family. I will say that this government has been investing, since 2003, a lot of money in developmental disabilities. We have a new piece of legislation, and, again, we know that we need to do more. We have invested a lot of money to reduce these waiting lists, we have invested money to develop the new Passport program, and we will continue to work to help these individuals.

The Speaker (Hon. Steve Peters): Supplementary.

Ms. Sylvia Jones: Minister, legislation is words. Linda Russell and her daughter Joanne need action. You know that there are over 12,000 people on wait-lists waiting right now for residential care; 80% of these parents are over 70 years of age.

As you know, Community Living Day was supposed to be held today to celebrate, but they’re not celebrating because they feel betrayed by your government. Minister, what should I be telling families like the Russells, who have been sitting on waiting lists for years?

Hon. Madeleine Meilleur: I think that what you should say to these parents is tell them to work very closely with our ministry out in your area; that we have closed institutions and have opened new opportunities out there in the community; and that we are continuing to work with our partners like Community Living to make sure that individuals like the family that you just talked to us about have the services that they need.

If there is no place—I know that we need to invest more. Every year we invest more, and this year we have a budget to help those who have an urgent need of coming into service. We will continue to work with these families, and let’s hope that your constituents—

The Speaker (Hon. Steve Peters): Thank you. New question.

PUBLIC TRANSIT

Ms. Andrea Horwath: My question is to the Premier. On April 14, the Toronto city manager asked the McGuinty government to clarify when, if ever, the $4-billion cut from Transit City funding would finally flow. The McGuinty government has refused to answer the question. If, as the Premier insists and as they’re all chirping over there, his government is simply delaying rather than cutting Transit City funding, why won’t he say exactly when the $4 billion will actually flow?

Hon. Dalton McGuinty: I appreciate the question. I know that my honourable colleague would not want to contribute to the mythology that plays well in some parts, and that she understands that what we’re talking about is taking the investments that we’re going to put in place over the course of eight years and now extending that over a period of 10 years. The investments remain the same nonetheless.

We’re looking forward to the advice from Metrolinx with respect to some of the specifics in terms of when we would start and how it would work. Our commitment to public transit in Toronto and other parts of Ontario remains as strong and as firm as it has ever been.

The Speaker (Hon. Steve Peters): Supplementary.

Ms. Andrea Horwath: Until this Premier provides a timeline for flowing the $4 billion, it’s actually a cut, a cut that will mean decades more of long commutes, gridlocked streets and worsening air pollution.

We’re told that a new Metrolinx plan will delay the start of the Eglinton line by at least two years and the Finch West line by at least three years until after the next provincial election, curiously.

So I have to ask this question: Is this the new McGuinty re-election strategy? Break your promises today and then run on them in the next election?

Hon. Dalton McGuinty: She cuts me to the quick. I don’t know what to say.

Just so that my honourable colleague gets a better understanding of our specific commitment on this score, there was a letter sent to Mr. Joseph Pennachetti, the city manager at city hall, and it comes from the Deputy Minister of Transportation. It says, among other things, “Initial work by Metrolinx suggests that the four Transit City projects can reasonably be completed in 10 years, while achieving the required savings of $4 billion in the first five years. The province looks forward to receiving the recommendation of Metrolinx in this regard.”

Let me say one thing further, something that has been asserted several times over by my Minister of Transportation. The city of Toronto folks have a tremendous amount of expertise when it comes to public transit. We need to find a way to come together and to work together to deliver on these projects as soon as we possibly can. Working together, there is nothing that will stop us from moving ahead with these projects in the interest of the people of Toronto.

AGRI-FOOD INDUSTRY

Mrs. Maria Van Bommel: My question is for the Minister of Agriculture, Food and Rural Affairs. The food and beverage processing industry is a major economic driver in our province, employing over 110,000 people and purchasing 70% of Ontario’s farm production.

As you know, continual investments are necessary to help our agri-food sector remain strong in today’s economy and to help it to grow and expand. For example, the demand for gluten-free products is increasing every year. In order to take advantage of this new product, Wallaceburg’s International Food Products, Inc. in my riding of Lambton–Kent–Middlesex needed to modernize their operations so that they could increase productivity and develop new product lines. Because of the provincial support that company received through the rural economic development program, they are enhancing their position.

Could the minister please provide the House with an update on the role that the province is playing—

The Speaker (Hon. Steve Peters): Thank you. Minister?

Hon. Carol Mitchell: Thank you for the question. The food and beverage processing industry is now the second-largest manufacturing sector, and the greater Toronto area is the second-largest food processing cluster in North America. Agri-food exports for 2009 totalled $8.9 billion. For each dollar spent on the ministry’s export program, more than $20 is generat