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October 15, 1998

36th Parliament, 2nd Session

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Hansard Transcripts

Votes and Proceedings

Orders and Notices

L044 - Thu 15 Oct 1998 / Jeu 15 Oct 1998 1

PRIVATE MEMBERS' PUBLIC BUSINESS

HEALTH CARE ACCOUNTABILITY AND PATIENTS' BILL OF RIGHTS ACT, 1998 / LOI DE 1998 SUR L'OBLIGATION DE RENDRE DES COMPTES À L'ÉGARD DES SOINS DE SANTÉ ET SUR LA DÉCLARATION DES DROITS DES PATIENTS

PALLIATIVE CARE

HEALTH CARE ACCOUNTABILITY AND PATIENTS' BILL OF RIGHTS ACT, 1998 / LOI DE 1998 SUR L'OBLIGATION DE RENDRE DES COMPTES À L'ÉGARD DES SOINS DE SANTÉ ET SUR LA DÉCLARATION DES DROITS DES PATIENTS

PALLIATIVE CARE

MEMBERS' STATEMENTS

HIGHWAY SAFETY

ÉDUCATION POSTSECONDAIRE

DIABETES

PROPERTY TAXATION

DIABETES

HERITAGE FESTIVAL

HOSPITAL FUNDING

SCHOOL CLOSURES

APPLE FESTIVAL

ORAL QUESTIONS

EMERGENCY SERVICES

LONG-TERM CARE

PALLIATIVE CARE

TUITION FEES

EDUCATION FUNDING

ONTARIO HERITAGE FOUNDATION

SCHOOL FACILITIES

GAMING REVENUE

MUNICIPAL RESTRUCTURING

MENTAL HEALTH SERVICES

MINISTRY OF HEALTH OFFICE

TRAFFIC CONTROL

PETITIONS

MUNICIPAL RESTRUCTURING

HERITAGE CONSERVATION

HOSPITAL RESTRUCTURING

EDUCATION FUNDING

GOVERNMENT ADVERTISING

SCHOOL SAFETY

HEALTH CARE

RAIL SERVICE

HOSPITAL RESTRUCTURING

SCHOOL PRAYER

HOTEL DIEU HOSPITAL

PALLIATIVE CARE

SCHOOL CLOSURES

ORDERS OF THE DAY

LEGAL AID SERVICES ACT, 1998 / LOI DE 1998 SUR LES SERVICES D'AIDE JURIDIQUE

The House met at 1000.

Prayers.

PRIVATE MEMBERS' PUBLIC BUSINESS

HEALTH CARE ACCOUNTABILITY AND PATIENTS' BILL OF RIGHTS ACT, 1998 / LOI DE 1998 SUR L'OBLIGATION DE RENDRE DES COMPTES À L'ÉGARD DES SOINS DE SANTÉ ET SUR LA DÉCLARATION DES DROITS DES PATIENTS

Mrs Boyd moved second reading of the following bill:

Bill 50,

An Act to promote patients' rights and to increase accountability in Ontario's health care system / Projet de loi 50, Loi visant à promouvoir les droits des patients et à accroître l'obligation de rendre des comptes dans le système de soins de santé de l'Ontario.

The Acting Speaker (Mr Gilles E. Morin): Pursuant to standing order 95(c)(i), the honourable member has 10 minutes for her presentation.

Mrs Marion Boyd (London Centre): I must say how pleased I am to finally be at a point where we're doing second reading of this bill. It's high time the people of Ontario understood what their rights as patients are and had a clear picture of how the government of the day will be held accountable for Ontario's health care system.

Before I continue, I want to acknowledge the support and help of a number of organizations in developing the bill. The Registered Nurses Association of Ontario, the Ontario Nurses' Association, the Ontario Hospital Association, the Service Employees International Union, the Canadian Union of Public Employees and the Ontario Public Service Employees Union have all worked with us in terms of the content of this bill and we are very grateful for the support they have given us.

This is actually a very simple bill. It is not a bill that will be earth-shaking to people out there in their communities because they may believe they already have the kind of rights that are enshrined in here, but in fact they do not. It is important for us to ensure that there is great awareness among people of the need for a codification of the kinds of rights patients have, particularly when, as we know, the health care system is under real stress.

The

preamble of the bill simply outlines what the basis of having patients' rights defined is all about. It basically says that the principles enshrined in the Canada Health Act ought to be principles wherever people receive their care, whether it's with hospitals and doctors currently covered by the Canada Health Act, or in their homes, their communities, a long-term-care facility and so on. Many people don't understand that those protections are not there for them in settings other than hospital and physician care.

We're basically saying that access to health care services is a social right that should be enjoyed by all citizens of Ontario.

The second

section of the bill is what has been dubbed the Patients' Bill of Rights. I think I can do no better than simply read out what it is we are proposing.

Subsection 2(1) of the bill reads:

"Every resident of Ontario has the following rights:

"1. The right to receive all necessary health care services in a health care system that,

"i. is accessible, universal, comprehensive and publicly administered and funded,

"ii. offers freedom of choice,

"iii. provides timely treatment,

"iv. does not allow personal income to determine access to health care services, and

"v. recognizes that every provider of health care services is a valued member of a multidisciplinary health care team.

"2. The right to give or refuse consent to the provision of health care services.

"3. The right to all information necessary to make fully informed health care choices, including information about who will provide particular services and about the qualifications of those providers.

"4. The right to receive publicly funded health care of high quality in the home and in the community as well as in health care facilities.

"5. The right to receive information, whether in a health care facility or in the community, about choices that promote good health and measures that prevent illness and accident.

"6. The right to be dealt with by health care service providers,

"i. with courtesy and respect,

"ii. in a manner that recognizes individual dignity and privacy and promotes individual autonomy,

"iii. in a manner that recognizes and responds to individual needs and preferences, including those based on ethnic, spiritual, linguistic, familial and cultural factors,

"iv. without mental, physical, sexual or financial abuse.

"7. The right to participate in any assessment of personal care requirements and in the development of plans for care.

"8. The right to make complaints, raise concerns and recommend changes without fear of interference, coercion, discrimination or reprisal.

"9. The right to be informed of,

"i. the laws, rules and policies affecting providers of health care services, and

"ii. the procedures for initiating complaints about providers of health care services.

"10. The right to confidentiality of health care records in accordance with the law."

I dare say there are people in Ontario who imagine they already have these kinds of rights, but the reality is that story after story, experience after experience, research after research shows us that in fact this ideal is far from the practice in many areas.

We believe very strongly that a responsible health care system needs to have both responsible health care providers and responsible patients. There is a tendency these days for health care providers to blame patients for the fact that the system is, and I use quotation marks, "overused," that patients "demand too much." If you don't know what you are entitled to have, it's easy to demand too much.

We are saying that the information that patients ought to have is essential for their making good health care choices, for their being appropriate and responsible citizens in the use of that health care.

How would we ensure that these rights were met? We have a very simple solution, that we have a Health Care Standards Commissioner similar to the Environmental Commissioner, who would oversee the evolution of the standards and would report to this Legislature about the success of various institutions and indeed the system as a whole and, of course, the ministry in meeting those needs.

The commissioner would be an officer of the Legislature, not a creature of the Ministry of Health. The commissioner would not develop the standards because that would be inappropriate. The commissioner would work with the colleges of the registered health professions, would work with the OHA, the Ontario Nursing Home Association, the Ontario Association of Non-Profit Homes and Services for Seniors, the Association of Community Care Access Centres and, indeed there may be others like the Community Hospice Association of Ontario, with whom they would work to develop standards for care, clinical best practices and the standards that health care facilities need to meet.

It would be up to the professionals to set those standards. It would be up to them to reach a consensus about what those standards are. Then it would be the job of the commissioner to let us all know what those standards are, so we know whether those standards are being met.

There are many people in this province who think that if they go into an emergency room with a cut finger they should be served within 30 minutes, regardless of whether someone is having a heart attack in the bed next to them or a road traffic accident has been brought in. If people understood the standards of care, if there were consistent standards of care, if we knew what to expect, we wouldn't be in the position of being accused of having inappropriate demands on the system.

The commissioner would let us know what those are. The commissioner would then report yearly to this body, to all of us, as the responsible representatives of the people of Ontario, on the success of meeting those standards, and would simply in that act ensure that whatever government of the day is in power, if the government is shown to be failing to fund facilities appropriately, if the government is showing that it's failing to give the policy directives that meet those standards, then the government of the day would be held responsible.

But so would the health care providers, so would health care facilities, so would all those working in the system. It would become a much more accountable system.

The last element is that there needs to be whistle-blower protection for those health care providers who work for an employer and who know that the employer is not meeting standards. There needs to be a way to maintain the confidentiality of patients and of providers who make complaints under this system. Otherwise, the fear of reprisal is very great. We are never more vulnerable than when we are ill or injured. We are quite literally at the mercy of our health care providers.

We ought not to be afraid to complain when standards are not being met in that vulnerable position, and neither should providers be who blow the whistle on their employers when their employers are failing to meet the standards that have been set by their professional association.

We believe this is the way to make this system more accountable. We know the minister has promised similar legislation; we have not seen that. She promised it last April to the Registered Nurses Association of Ontario and the Ontario Nurses' Association. We have not seen that legislation. This is an opportunity for the government to support this legislation.

Mr Tim Hudak (Niagara South): I'm pleased to rise and respond to the bill put forward by the member for London Centre. I do have to commend her for bringing this piece of legislation forward. It's an interesting observation that the third party has brought forward some sensible principles that will form part of its health care platform, I would assume, in the next election. I think they're hitting some important notes. It's good to see a constructive bill brought forward in this House from across the floor, as opposed to something that's more into fearmongering or some resolution that's used for a political trap or something. It's good to see something substantial from across the floor.

From the health care perspective it is agreed that the goal of any kind of health care reform is to ensure that we have the best-quality care provided to patients on a timely basis, at the most appropriate place, from the most appropriate caregiver. At the same time, it's important to make sure patients and health care professionals are involved in improving that system. I would state that we have made great strides in improving the health care system in Ontario in terms of working to coordinate care, making sure that dollars are going into priority services like cardiac care, kidney dialysis, cancer care, and hip and knee replacement surgeries.

At the same time, as I said, the member for London Centre makes a good point: It's important to get the patients involved in that process. One method that she has brought forward is the Patients' Bill of Rights, which would describe to patients what they can expect from our health care system.

We have to realize that the government, in a publicly provided service like health care is in Canada and in Ontario, is a monopoly deliverer of services. As such, it's important to have checks and balances on the system to ensure that those who pay for the system and pay into the system receive the quality care they should expect as Canadians and as Ontarians.

The notion of a patients' safety act is very important. If you look at other jurisdictions across North America, and the United Kingdom as well - their approach has been on a standards basis, to try to reduce waiting times, to indicate to people who pay into the system what would be an appropriate waiting time for cardiac surgery, hip and knee replacements. Interestingly, by and large the standards they set in the UK are actually weaker than we are currently achieving in Ontario, but there is an example of something that's going on in another jurisdiction.

In the US House of Representatives, a bill was brought forward similar to this, in this vein. The goal there was ensuring there would be appropriate standards in the HMOs, what patients could expect as a minimal level of service.

The member for London Centre had said, correctly, that the Minister of Health, Minister Witmer, in her discussions with nurses and other health care providers across the province has said she is very interested in this type of legislation, whether it's a patient safety act, a Patients' Bill of Rights - some way of ensuring there are standards across the system so patients will receive the quality of care they deserve and that there are checks and balances in case they aren't.

Or you could approach it, as I said, as in other jurisdictions, where you would set standards of care to make sure health care providers would either achieve those standards or report on them, to make the system as transparent as possible.

I think the minister would be wise to evaluate the merits of this bill, to look at what's going on in other jurisdictions, to confer with stakeholders like the hospital association, the nurses' association, the different colleges, to see how the complaints system is currently working, how we can improve it. Bill 25 you could even say is part of that process. We're trying to reduce the red tape so complaints through the colleges can be solved in the quickest time frame possible.

Generally, I commend the member for London Centre for bringing forward a positive principle, a very important suggestion for a policy plank. This government has shown interest in these principles. That is also typical of the member for London Centre, who tends to bring forward weighty matters that she is interested in providing advice on, improving the health care system, unlike her counterpart in the official opposition, who tends to be more like the Jerry Springer of health care, trying to bring forward whatever horror stories, his flyers on windshields.

I don't find the approach of the member for York South to be nearly as responsible or as productive as the evidence they're bringing forward from London Centre on the Patients' Bill of Rights.

I might say one thing, somewhat facetiously, but I need to say it at the same time: One important part that I would suggest adding to the Patients' Bill of Rights is a right for patients in Ontario to have a fair share of health care dollars from the federal government in Ottawa. Certainly, after $2 billion in cuts to health care to the province of Ontario and the federal share of health care dollars slipping to about eight cents on the dollar, one could say that Ontario patients have a right, from all the taxes they've put forward to Ottawa, to expect a fair share back from the coffers in the capital city.

The last time we were here in this chamber we had asked the member for York South, when he had Allan Rock at his fundraiser and they were dancing cheek to cheek, to whisper in his ear and say, "Listen, Minister Rock, could you please increase the transfer payments to the province of Ontario, put back some of that $2 billion that you took from the system." I haven't heard if, when they were dancing cheek to cheek at the fundraiser, the member for York South brought this forward. Hopefully he did. I certainly hope the federal government will reconsider its move to slash $2 billion in health care funds to the province of Ontario and reinvest that.

To sum up - I have a couple of colleagues who want to add to this bill; I'm getting the time-out signal - I commend the member for London Centre. I support the principles of this bill. There are some issues in the bill that my colleagues may address, but again I commend her for bringing forward a very positive policy plank. We thank her for bringing it to the floor for debate today.

Mr Rick Bartolucci (Sudbury): I look forward to being able to speak to this bill. First of all, I want to commend the member for London Centre for bringing forth, again, such

an act to protect the people of Ontario. It wasn't too long ago, approximately two years ago, that the then member for Oriole, Elinor Caplan, brought forth Bill 41,

An Act to protect the Rights of Persons receiving Health Services in Ontario. We know it received first and second readings and then was referred to the committee of the whole by this government, knowing full well that it would never ever receive debate.

We have an opportunity now to look at the bill in depth. This is an extension of Bill 41, but Bill 50 spells out initially in some of its proposals exactly what the then member for Oriole, Elinor Caplan, had said was going to happen and what we needed protections from. Indeed, the member for London Centre paints an even worse scenario, and she's absolutely right. The critical need for this legislation has grown over the course of the last two years, so I commend her for bringing forth this legislation.

There are certainly many aspects of this legislation that must be debated more fully, but the underlying principle is that everyone - everyone - in Ontario should have a health care system that is accountable, a health care system that is accessible and a Patients' Bill of Rights that is truly meaningful and appropriate for each specific case brought forth to our health care system. That is certainly a part of our health care system.

The government sometimes forgets, and the member for London Centre will remind us with her bill, that the health care system is owned by Ontarians. It is not a government health care system. The health care system of Ontario is the people's health care system, and our people, Ontarians, must understand, must be assured, must know that it is equal, accessible and affordable, and that built within that system there are rights they have. That's why this legislation, Bill 50, is an excellent stepping stone to what was begun with Bill 41 by our former health critic Elinor Caplan.

I commend the member, because she outlines very specifically what must be done to ensure those safeguards. I look forward to - at least I hope that the people of Ontario can have confidence that this government will support this bill on second reading, that it will send this bill to committee so that the front-line workers, the people who use the system, will have an opportunity to reinforce the message that this is critical to the people of Ontario. People in Ontario want to have confidence that indeed their health care system is the best health care system in Canada or in the world.

They clearly don't have that confidence right now. We've heard, over the course of the last two and a half or three years, the horror stories. The member for Niagara South says there are horror stories out there and that we bring them up in the House. These are real stories, and if he chooses to use the adjective "horror," then that is a condemnation of his government's performance in the health care system today.

I suggest to the government that it's time you listened to what the people of Ontario are saying. It's time you listened to what the opposition has been telling you. It's time you listened to the realities out there in Ontario. Our health care system is not at the level it should be. Our health care system is lacking in both resources and in response times. Our health care system needs fixing. It's your responsibility to ensure that happens, and I suggest that Bill 50 is a very good step in that direction.

Mr Tony Martin (Sault Ste Marie): When it comes to health care in the province today, the question I hear asked most often by my own constituents, and as I've crossed the province I gather it's a universal sentiment, is, where's the caring? Where is the healing that used to go on in the health care system? Where's the comfort? Even in a very sort of hokey way, the people I speak to about health care, those who have experienced health care in the last three years and those who have been in support of those who have been in our health care system, is, where is the love?

Where is that compassion that used to be in the system, that little extra that people used to do and have come to expect, that made all the difference re the question of actual and real healing?

This bill we're talking about here this morning will go a long way to determining just what the level of health care should be and is necessary to be in this province, something that we together as a collective determine is what we all deserve when we get sick and go to a health care facility to get cured, to get healed and, at the end of the day, hopefully to get better.

In my community, the feeling these days is that going to a health care facility is akin to going to Canadian Tire to get your muffler fixed or to get your carburetor replaced. It's not about healing any more. It's about efficiency, it's about the bottom line and it's about cost. This bill today will go a long way to determining what health care really means and to bring back into the system those things that are so valuable in health care.

Another term you hear when you speak to hospital officials today, as they try to explain why some of these things are missing when people go into the hospital, is that we no longer give what they call hotel care to people, the stuff that speaks to the question of healing, speaks to the question of caring and comfort.

The love in the health care system - things like a glass of water or perhaps a back rub - may seem to some superfluous or out of the ordinary or extra, but for the person in the hospital who's trying to recover, who's trying to heal from a very serious and disruptive procedure of some sort, it's absolutely essential that those kinds of things be there. There's the question of who feeds somebody who can't feed themselves, not to speak of the issue of universality of access to care.

We have an issue in Sault Ste Marie that started with the question of the kind of care we provide to the people who live in the outlying district around us, Algoma, Thessalon and St Joe's Island. The member for Algoma will relate to this. What is the level of care that those people should expect and what are the timelines? What access should they have to facilities when they are sick or in crisis? We're moving more and more of what used to be taken for granted and necessary in that part of Algoma and we're moving it into the Soo.

Now we're finding that that which we took for granted would be available in Sault Ste Marie is being moved to places like Sudbury and Toronto. Sudbury is 180 miles away. When you need care immediately, 180 miles is a long distance, particularly in the wintertime and particularly over the kinds of roads that we sometimes experience up in that part of this province, not to speak of the cost to the person and their family as they try to be there with that person as they get fixed and get well.

This bill today will, in my mind, in my view, go a long way to answering those very important questions for those people out there across this province. I congratulate the member from London for bringing it forward and certainly I'll be supporting it here this morning.

Mr John L. Parker (York East): I find this bill typical of the member from London Centre, if I might say, and typical generally of the members of her party in that it is quite clear in its intent, its direction and its motivation; there's no doubt as to just what is intended by this bill and where this bill intends to take us. I congratulate her on that and I commend her for that and I commend the members of her party for that general approach. When it comes to the members of the third party, it is absolutely clear where they stand on the issues they bring forward. There is no equivocation and there is no doubt as to what their position is.

I contrast that with what we've come to expect from the opposition, the Liberal Party. In the case of health care policy, for example, the entire policy of the opposition party could be expressed within the confines of the average bumper sticker.

This bill is very clear in expressing certain principles and various methods of delivering on those principles, and I commend the member for that.

I certainly commend the principles of public accountability in health care policy: that where the public dollar is being put towards a policy, the public is entitled to know just what the goals of the system are and just what the expectations of the system are, and that there be mechanisms for accountability as far as those goals and expectations are concerned. Those are important principles and those are clearly at the heart of this bill, and I support the bill for that reason.

The public is entitled to know what sort of quality to expect from its health care system, to have certain service standards and to have certain access standards. To the extent that the bill stands for that, this bill is something to be supported.

The concept behind this bill is not a novel one. It's a concept that has been adopted elsewhere in the world. Certain principles are in legislation in the United Kingdom concerning standards for waiting time and standards for service to be expected. That is already in place in the UK. New Zealand similarly has certain investigative procedures. There are procedures in this bill as well. New Zealand has procedures that are part of its law, and there's no reason that can't be implemented elsewhere. So a number of recommendations in this bill are not new ideas, and they are certainly worthy of thorough consideration before this House.

I am encouraged to know that the Minister of Health is reviewing this very issue and is examining the legislation that is in place elsewhere in the world and is meeting with the various professional bodies involved in health care and is going to be taking all of those thoughts into account in the ultimate introduction of legislation on the government side here.

Mr David Christopherson (Hamilton Centre): Meetings and announcements.

Mr Parker: I hear from the opposite side that there's some criticism that the health minister hasn't done this already. The third party had five years in which to bring forward legislation like this. They didn't do it when they were in government. During the fifth year of their government, they hardly sat at all in this Legislature. They had the chance to bring this forward when they were in government. It's nice that they're bringing it forward now.

There is very much in this bill to support. There is a great deal in this bill that requires further debate and discussion, and I look forward to the whole issue being discussed more fully at another time, more time than we have available to us this morning.

Mrs Sandra Pupatello (Windsor-Sandwich): I'm very pleased to speak in support of the bill today being brought forward by the third party. I can tell you that it is long overdue. We should have had a bill like this in place for the last 20 years. There has been significant change in health care over the course of the last decade, certainly over the last 15 years.

When you come from a community like mine, Windsor, that has seen such dramatic change, only to hear the Minister of Health constantly talk about having done more for the health system than any other government, the people in Windsor say, no, you've done more to the health system, not for the health system. Windsor is a very good example, where something like a bill of rights for patients would actually be very useful.

The difficulty I see is that unfortunately people have to have the bad experience in the health system so that the bill then becomes enacted for them. There has to be a complaint. That's the difficulty. What we're trying to do is advocate for patients before they get in a position where they're the individual who's lying on a stretcher looking up at the ceiling in the emergency room, wondering, "Why am I still here?" after the second day. The point is that we are to advocate for patients before they get in that dire position.

We are amazed in Windsor to see that finally, today in the Toronto area, hospitals are rerouting patients who are arriving in ambulances to emergency rooms. Windsor has been dealing with this for three years.

In this past summer alone, Windsor has seen 230 code 7s, just in the months of July and August and the first week of September. That means that 230 times patients could not be removed from the ambulance into the emergency room because there was no room in emergency. What's worse is that it was entirely preventable and completely predictable. The worst part about sounding like a broken record is that it has been going on and on and we've been saying it and saying it.

These individuals, as difficult as it is to be in a very vulnerable position, are finally speaking out. They're saying, "This is not the kind of treatment I deserve," not after having been in business, like Lyall Browning, all his life, a 35-year businessman, retired, who entered the hospital system and left sicker than when he went in. He said: "This is not why I paid taxes all my life. I deserve better than this." If there is a bill of rights for patients, the unfortunate thing is that in this system, with this government, it still would have happened to him.

That's what we have to do: We have to look at why this is happening to patients and prevent it, and not just focus on what we do when it's happening. We're saying don't let it happen. Windsor was a perfect case that all of you should have learned from. I expect all those organizations out there that are supposed to be promoting good health to look very specifically at the Windsor scenario and say, "Don't let this happen in any other place in Ontario."

We travelled to Sudbury and the same thing is now happening in Sudbury. It's no surprise to us in Windsor, because we could see this coming. You took money out of the hospital budgets before you allowed proper restructuring, expected savings from the same organizations you cut, so any savings that were going to be found through restructuring you've already taken out of their hospital budgets. It is an untenable position for them. They are not dealing well with this change. The result is they are making choices: either cutting service or going in deficit.

As the OHA reported last Friday, 50% of all Ontario hospitals are now in debt. No surprise to us, who have been following this issue closely; no surprise because we told you it was happening when they were going into debt.

We go back to my place in Windsor and see a highway sign that the Premier put up that says, "Our tax dollars at work." We're trying to tell people, "We want our tax dollars back." When we suggested to people that we want to hear what they think about wasting taxpayers' money on propagandizing highway signs when our hospital system is in such desperate need of funding, this is what people in Windsor had to say:

Paolo Gattoni says, "It's a shame to have one MRI in a city with a population of our size." Mrs Renaud says, "Get your priorities straight." Roy Bertelli says, "Our hospitals need help, not signs." Mary Lovell says: "My father was treated badly, without proper care or compassion, because of overworked medical people. Then he passed away." These are the people you need to listen to. These are the people who would have to then enact a Patients' Bill of Rights. When you know this is coming to your own neighbourhood, don't let this kind of health care system put people in a position where they are going to need a bill of rights.

Ms Marilyn Churley (Riverdale): I'm very pleased today to stand in support of Bill 50, at second reading today, from my colleague the member for London Centre. I haven't heard all the Tory members who are going to speak today, but I'm disturbed so far by what I hear. I'm getting the impression that although they speak very kindly in support of the principle of this bill, they seem to be saying they're waiting for the Minister of Health to come forward with her version of such a bill.

My understanding is that the Minister of Health promised she'd look at ideas from the nurses' association last April. We haven't heard a thing since. I'm also disturbed to hear the member for Niagara South talk about US legislation, for instance, which as you know is a private system. We fear that's where this government's legislation and policy are taking us. The difference there is that patients there have a right to sue after the fact. They have a right to sue a private health care system if the standards aren't met. That is not what we're talking about here.

I'm further disturbed to hear him say that Bill 25, the red tape bill - I believe he said it was making health care more accountable. In fact, I'd like to point out to him and members of the House, it's the opposite. The red tape bill means that the health care board of appeal will no longer be required to report to the Legislature, so some protections and some accountability that are already in the system because of the red tape bill are being taken away.

I say to the members today that we have no time to wait for the Minister of Health to come forward with her ideas on a Patients' Bill of Rights, or whatever she's calling it. We have emergencies now. The minister is not flowing money, which she continues to announce and announce, to nurse practitioners, which are badly needed up north. Look at the problems we're having, the crises we're having, in our emergency wards right now. This government, although they don't like to admit it, have taken up to $1 billion out of hospitals.

They're quite correct when they say the federal Liberals have withdrawn funding from the health care system in Ontario, but at one point the leader of this government, the Premier now, said it was a good thing that the federal government was cutting money in transfer payments to Ontario. It's this government that took $1 billion out to pay for a tax cut that's mainly benefiting the rich. We all know that. So you cannot crawl out from under that responsibility. You have put our health care system in Ontario in a crisis.

You have an opportunity today to take some steps and say to your own government, "The member for London Centre came forward today with a step that will move us forward." If members here today truly believe that we should be bringing forward some kind of accountability system for patients in Ontario, they should vote for this bill today, let it go to committee, and if you want more discussion, that's the place to have it. A whole bunch of people in the health care sector who know where the problems are have consulted; they have talked about this. This is where the ideas came from.

It is time now to take it out to committee and have that discussion. We have no time to waste. The crisis is on us now.

I want to speak for a moment about nurses. I have talked to nurses in hospitals, as some of you may have. It will break your hearts. If you haven't done it, do it. They are sick at heart. They're overworked, they feel that patients aren't safe any more and they're worried about the level of health care they can deliver. That is directly because of the cuts. The nurses need our support today. They need to get this bill out there; they need the discussion happening. They need our help.

I have seen nurses close to tears because they're doing their best, in hospitals that are understaffed, to take care of badly injured or ill patients. They feel they don't have the ability to take as good care as they know they should be. It is not their fault, but they're often taking the blame because they're the front-line people that patients see.

I would urge everybody in this House today to let this bill go forward. Platitudes are not enough today. Let it pass and we will debate it and discuss it in committee hearings as soon as possible, I hope.

Mr Frank Klees (York-Mackenzie): I'm pleased to rise in the short time I have to express my support for this bill. I commend the member for London Centre for bringing it forward.

I would say to you that this government certainly has no apologies to make to the people of Ontario in terms of its management of the health care portfolio over the last three and a half years. The first responsibility we had was to restore fiscal responsibility to this province and restore accountability to the health care system. I believe we've done that.

But I must also agree with the member, and therefore commend her for bringing this forward, that our focus must shift from the bottom line to the patient, and I believe it's time to do that. I think there are specific items in this bill that will allow us in this province to do exactly that. I have been at meetings with CEOs of hospitals where I've heard presentations about their fiscal accountability, their fiscal responsibility and, quite frankly, I've been disappointed that I've seen very much about accountability to the bottom line but there wasn't very much said about patient service and patient satisfaction. I think it is time that we address those issues.

When the minister made her announcement in April that she was going to bring forward a Patients' Bill of Rights, she also indicated that that bill would contain such things as accountability and reports that would be required as to the number of nurses, the patient-nurse ratio in a hospital and death-and-disease rates. It would call for accountability on how long patients stay in the hospital and, equally as important, how often patients are readmitted into hospital. So it's not enough to simply talk about the fact that perhaps patient stay in a hospital has been reduced significantly; we have to begin to focus in this province on results, on service to patients.

I am concerned about some of the details of the bill. One of the things we will have to do is take into consideration the recommendations that were made by the member here. It will be very helpful in the discussions we're having with our minister to ensure that some of these very important issues are incorporated in the government legislation that will propose some of these issues.

Interjection.

The Acting Speaker: Member for Algoma, you don't have the floor.

Mr Klees: I hopefully join with all members of this Legislature in supporting this bill in principle. There's no doubt that what gets measured gets done. If we're simply measuring financial results, then we will get financial results. I believe we have to also measure patient care, the results that we're getting on the front lines, the kind of care that's being delivered by the medical professionals. I believe this kind of bill will also restore the responsibility of the patient, himself or herself, to become an active part of the health care team in this province. That will be very important.

Mr James J. Bradley (St Catharines): I'll be supporting this bill. I'd love to see it go through three readings today. With all the support I'm hearing on the other side of the House, I presume someone will move that it go through all three readings during this very day.

It's interesting to see the strategy of the Conservatives. It's not hard to determine what it is. They've been told by the Premier's office, "What you're supposed to do is you're supposed to praise the NDP for any of their initiatives and say how good the NDP is and those Liberals are the awful people." If the polls were different, if the NDP were at about 40% in the polls and we were about 12% in the polls, they would be doing exactly the opposite.

Interjections.

Mr Bradley: Exactly the opposite, as my friends know.

As Rosemary Spiers said in her article, she warned the NDP about getting into bed with the Conservatives and Reform and so on, so they're not going to. This kind of faint praise you're giving to them is not going to fool the NDP. The way you could actually show your good faith is to support this bill and all three readings today, because I think a lot of members - maybe all the Tory members - will vote for it and then they'll kill it somewhere in committee. They'll send it off to a committee and never really deal with it.

They will be currying favour with the NDP and then they'll dash their hopes behind closed doors. You won't fool the NDP. I know because they can't be easily fooled by that kind of trickery.

I'm always amused, and I'm glad the member for Riverdale raised this issue, because she knows that when they get the federal transfer payments they simply take those payments and give them away in a tax cut to somebody, largely the richest people in the province, including Conrad Black, the constituent of the chief government whip.

I can tell you what's going to happen. There are five hospitals in Niagara which are very vulnerable now to closing or severe alteration. Fortunately we're just before the election and now the commission, which was so non-political, it said for so long, is going to be very political. That's the hope we have in Niagara: that those of us who have fought against the closing of the Douglas Memorial Hospital in Fort Erie, the Port Colbourne hospital, West Lincoln Memorial Hospital in Grimsby, Hotel Dieu in St Catharines and the Niagara-on-the-Lake hospital will prevail, but only because there's an election coming up.

If they got past an election, you can be darn sure they would be doing in many of those hospitals.

I want to indicate what some of the members have said about this bill. We've seen a significant cut in the operating funds for hospitals and you're seeing it in the degree of care that can be delivered. Quite rightly, the member for Riverdale mentions nurses in this province near tears, exasperated at the fact that they're working extremely hard, many on 12-hour shifts, to try to provide service to patients but there are far fewer nurses around to provide that; that the hospitals are having a heck of a time keeping their places clean; that all of the services that are ancillary to the delivery of medical care are cut back severely.

I know people will remember that. Dr Beiko in St Catharines has had his patients writing to the MPPs locally saying they can't go to him any more because they've reached a cap, even though they have some severe problems that need the care of an ophthalmologist.

I note as well that they're kicking patients out of the hospitals now quicker and sicker. That's putting tremendous pressure on the home care system, and I note today that there are going to be some cuts overall in Ontario in the funding for that home care system.

Of course the seniors out there are still angry that they are being charged a user fee every time they get some needed medication from this government.

I'm going to support the bill, I'm sure the government will, but I would like to see this bill pass all three readings today.

Mr Christopherson: I would just say to the member for St Catharines that while we all recognize that politics makes for strange bedfellows, they snuck into our room and for the last while we've been asking for our bathrobe because we want out.

Let me first of all compliment my colleague from London Centre, who I think, without question, across the entire Legislature is one of the most highly regarded and respected members to walk these halls. I think anything she brings forward where she has done the kind of research and background she has here deserves to receive the kind of respect and attention that someone of her stature has.

When we talk about the Patients' Bill of Rights, we're talking about a fundamental cornerstone of what ought to be still the best health care system in the world. Unfortunately, I don't think it any longer is. The fact of the matter is that you cannot take $1 billion out of hospital budgets across Ontario and expect that somehow you've got better service. It's no different from your argument that taking $1 billion out of the education system somehow makes for a better education system. It's nonsensical.

Listening to the government members, they all talk about their Minister of Health, Elizabeth Witmer. I can remember saying to people at the time she moved from labour to health, "If you like what Elizabeth Witmer did for workers' rights, wait till you see what she does for patients' rights."

That's why at the end of the day this government that's in place now doesn't have the courage to send this to a committee and then put it on an agenda and let public discussion take place around the content of this bill. They won't do it. These backbenchers have learned from their ministers during question period to stand up and say the words and don't worry about any action afterwards because there won't be any. Words are cheap.

I look at what's happening in my own community of Hamilton-Wentworth with the Hamilton Health Sciences Corp, the second-largest hospital corporation in the entire country, and see that we're $38 million in debt, and they just announced the other day that they're looking at borrowing to make up that difference.

This is the government that talks about the problem of borrowing and debt ad nauseam, and here we have local hospitals, for the first time that I'm aware of in the history of this province, that are taking out bank loans to pay their current bills to keep some semblance of a health care system alive in our communities. Why aren't you talking about that when you're standing up talking about how wonderful your Minister of Health is and how wonderful your government agenda is?

I think two of the most important things that are contained in this bill - first of all is the recognition that publicly funded health care is a social right. We ought to be making that statement. We all like to talk about our health care system and the universality. Certainly as New Democrats, which was the successor to the CCF, which brought in the first universal health care system in the entire continent in Saskatchewan with Premier Tommy Douglas, we're always very proud. But this is the time to move forward and one of the ways to do that is to make the simple legislative statement that publicly funded health care is a social right. Put that in law.

The second thing that I find most important here is the establishment of a Health Care Standards Commissioner. Based on what we've seen as a result of the Environmental Commissioner, which we brought in - you probably couldn't hear it on the mike but at least one of the members of the government backbench went, "Huh." They don't like commissioners who are arm's length from their control who report on what is happening in key areas of government like the environment. It's not a wonder they're upset, because that Environmental Commissioner has belled the cat on a number of key environmental issues.

That's exactly what a Health Care Standards Commissioner would do and all governments of all political stripes ought to be held to that standard. That's the way we can actually give the public control and accountability of a health care system that's theirs. You don't have the right to destroy it, and that's what you're all about at the end of the day: destroying our health care system.

The Acting Speaker: Two minutes to reply.

Mrs Boyd: I want to thank all who spoke to the bill and hope that the kind words of the government party translate into this bill actually passing second reading today and going to the social development committee, where it belongs. That is their opportunity to look at the content and the detail of the bill, to do the further consultation in public that the minister says she's doing, in public with all of the players of the system where all of the concerns can come forward in an appropriate way.

I have no reason to assume that when the Minister of Health says she's going to bring something forward she's not speaking in good faith. I assume she is. But she said that in April. She has said it again and again. We haven't seen any action on it. We haven't seen any draft bill come forward. We haven't seen any public consultation - all behind closed doors.

We know that this Minister of Health is very good at allaying the fears of the people of Ontario by making announcements, by reassuring them, by holding meetings, by holding consultations, by saying she's consulting - and doing nothing. If the government members do not pass this bill today and get it into committee for hearings, we will know that this is simply another empty promise, another way of trying to soothe the very real fears that health care providers and health care recipients have in this province.

This is not a problem just for patients. This is becoming a serious problem for providers, who find themselves constantly in danger of violating their own standards, set by their own professions, because they do not have the resources to maintain those standards. It is time that the government, whoever the government is, takes accountability for the health care system.

PALLIATIVE CARE

Mr Bob Wood (London South): I move that, in the opinion of this House, since hospice palliative care is care which aims to relieve suffering and improve the quality of life of people who are living with or dying from advanced illness, or those who are bereaved, the government of Ontario should appoint a task force, representative of the public, recognized hospice palliative care experts, palliative care supporters and providers, both paid and volunteer, from throughout Ontario, to recommend the elements necessary to fully implement an effective hospice palliative care bill of rights.

These rights would ensure the best possible comfort, protection and support will be available and accessible to all Ontarians and their families in time of need. The task force would provide interim reports to the government and the public, and continue in existence to review the implementation of its recommendations.

This task force should consider but not be limited to the following issues:

(1) The provision of hospice palliative care that recognizes the need of all people for personal respect, control and dignity. A modern, fully developed hospice palliative care system enables most people to live in their own homes;

(2) The effective provision of the best medical treatments for pain control and the best symptom management practices for other physical suffering, using drug, and non-drug therapies;

(3) Ensuring the development of proper medical treatments for all patients of all backgrounds, social, cultural, or religious, and of any age or illness. The special problems of children and of individuals suffering illnesses of the nervous system, who face much shorter life expectancies, should be considered. Cancer Care Ontario's phased-in supportive care model should be examined for potential applications to the development of hospice palliative care;

(4) The interdisciplinary team care of hospice palliative care must be adapted to work with primary care providers. Standards for hospice home care, dedicated hospices, nursing homes, supportive housing and hospitals, should be integrated with a compensation structure for hospice palliative care that recognizes its interdisciplinary character;

(5) Medical specialties in hospice palliative care should be recognized in all medical fields. The need to provide a high standard of basic and specialized instruction in palliative care, pain management, symptom control, emotional and spiritual needs and team methods in every profession. An effective information system must update our medical teams with the very latest developments in hospice palliative care, pain control and symptom management;

(6) Research programs to explore new knowledge, in the areas of greatest value to Canadians receiving hospice palliative care, should be a continuing feature of Ontario's medical care system;

(7) The best possible programs to support, train and encourage volunteer care providers and their organizations should be identified and made an integral part of the hospice palliative care system. Volunteers providing hospice palliative care are the ultimate guarantee of community involvement, as well as comfort and concern for the needs of individual people and their families and their bereavement. Existing programs, standards, organizations and proposals ready for pilot projects or expansion should be encouraged. Programs that are individual and innovative, in their own way, can co-operate, providing patient-centred care for Ontarians;

(8) Revising, as required, medical, administrative and legal procedures to ensure effective safeguards for the rights of all those under care, but especially those who cannot, or can no longer, decide issues of medical care for themselves;

(9) How to meet the needs of most Ontarians, in these care programs, by finding the very best methods to gain the full confidence, and participation in patient care, of leaders from all religious, cultural and spiritual communities;

(10) The need for emotional, psychological, social and spiritual support appropriate to the needs of the patient and their family. The right to be treated as a person, and receive proper medical, emotional and spiritual treatment for times of depression and suffering. The need for family members to be consulted, treated with respect and kept informed;

(11) Setting reasonable limits on charges for care, to a patient's life savings, so loved ones need not be left destitute;

(12) Most care in Ontario is provided by spouses or family, to loved ones. A priority must be to consult with these care providers to find ways to encourage and support them, as they meet family responsibilities, with love and loyalty.

Hospice palliative care is care aimed at relieving suffering and improving the quality of life for those people who are suffering from life-threatening or terminal illness. This resolution urges the government of Ontario to appoint a task force representative of the public to recommend the elements necessary to fully implement an effective hospice palliative care bill of rights. It would ensure that the best possible comfort, protection and support would be available and accessible to all Ontarians. The task force would provide interim reports to the government and the public and continue in existence to review the implementation of its recommendations.

Hospice palliative care has made great strides over the last 30 years, and now is the time to start to make state-of-the-art care available to all Ontarians. On a personal note, my grandmother died some 38 years ago from cancer and my aunt died some three years ago from cancer. The difference in their care over the 38 years is quite astonishing.

In London, Toronto, Ottawa and Kingston, we have integrated palliative care now, in various forms. I might say that further information on this can be obtained through our Ontario legislative library. There are areas of the province where our service is state of the art today; there are other areas where it is very much at an early stage of development.

This resolution sets out in detail what the task force should consider. It has been developed as a result of consultations with experts, volunteers and persons who are receiving or have received care. I'd like to take a moment to thank all of them for the many hours of time they have put in to develop their expertise and to help us in developing this resolution.

The plan in this resolution would help to make life more comfortable and ease the suffering of individuals in care and their families. The best medicine available today that our professionals can offer is made available to help. The bill of rights would enable people to stay in their homes longer and be connected to their family and the small daily joys of life.

What can be accomplished is perhaps well set out by a true story that happened in the London area a couple of years ago. Loree Moores was diagnosed with cancer in 1996. Her health deteriorated. She had to go and live with a son. At the start of her last summer, she noted that she had a 33-year tradition of going to the cottage each summer, and that summer she and her family assumed she couldn't go. The caregivers got together with the family and with her, overcame the obstacles and she was able to go to her cottage. Her cottage became a small hospital.

When she arrived, even though she was ill, she noticed the loons and their calls, the smell of the air and trees, the clarity of the water. Three of her four children and six of her grandchildren came up to stay for parts of the summer, and many friends stayed or visited. Loree passed away a couple of weeks after she came back from the cottage, but she had not missed a year at the cottage in the last 34 years of her life.

That really demonstrates what I think we all should be working towards, that everyone can live every day of life to its full potential. I suggest to the House that this is an idea that's time is coming rapidly. I think it will ultimately help almost every person in Ontario.

This resolution, as you would note from a couple minutes ago, is not just the endorsation of a good idea but a very specific plan for action. It's a plan for action that we can start now. It's a very ambitious goal, but I think it's also an attainable goal.

When we talk about ambitious goals, I like to think of something the late US Senator Robert Kennedy often said. He said, "Some people see things as they are and ask why; others dream of things that never were and ask why not."

Perhaps as we contemplate this today and contemplate what can be done, we might want to consider that we owe ourselves, our children and our grandchildren no less.

The Acting Speaker (Mr Gilles E. Morin): Further debate?

Mr Mario Sergio (Yorkview): I am delighted to speak on the resolution of the member for London South. I compliment him for bringing this resolution to the House today. Having said that, I think it does deserve support; however, I wonder why we need another task force to look after this most important aspect of our health care system, especially where we have to look after the most needy, the older person, the very sick, the ones who have incurable diseases, the ones whose family members really care to have proper, good health care being provided by the government.

It's most unfortunate that we have to resort to this type of resolution or for the government to have to deal with something like this, because this is nothing less than an admission that the government of this province is not providing the care that it should be providing for those people affected with those types of illnesses.

There is a litany of cases that we have brought to the attention of this particular government, and they are not listening. What worries me is not the good intention of the member introducing this resolution; it is that this government won't do anything. We have the Minister of Community and Social Services and the Minister of Health who do nothing else but hash and rehash, announce and re-announce hundreds of millions of dollars to come on to the scene to help those in need, but we have seen nothing. Hospitals haven't seen a dime. They cannot provide the care that we are supposed to provide those people.

I don't think the government - it's immune to what's going on out there, we don't have to tell you, on a daily basis. We shouldn't be telling the government on a daily basis what goes out there with emergency rooms, hospital care. If you were a family member with a member who is in need of such care and they hear this daily news that hospitals are closing emergency rooms, you cannot go here, you cannot go there - 17 out of 19. How do they feel? How does a person feel when their government is letting them down?

I brought to the attention of the Minister of Health a particular case: six hours, a young man who was not even old and ready to go. But the situation is that we don't know when and how; we've got to be ready. When we are in need of such attention, we should be giving it to whoever needs it, whenever they need it. They couldn't find a room in Metropolitan Toronto after six hours, and another three hours later, they whisked the poor patient to Hamilton general hospital. In the meantime, the young man died on the way there. It was such a pathetic case, such an account from the family members, the family members who got to the hospital before the ambulance.

Every facet of the health care system is being affected, and it's being affected solely because this government wants to reduce the health care system to who can afford it, and if they can't afford it, forget it; you're on your own. It's not a case for the minister or the Premier to come into the House and say: "We have to make changes. We have to make reforms. If you don't get attention in one hour, you're going to get it in three or four hours." I'm sorry. I don't think the people of Ontario are expecting this kind of response or service from their government.

It is a very important issue. Unfortunately, my time is running out, but I would tell the member to listen to what the members of the opposition have to say because we do visit caregiver places in our community and we see the decline in the provision of health care. I would say, don't go into another task force unless you are sure to provide the health care that indeed our people deserve and want.

The Acting Speaker: Further debate?

Mr Frank Klees (York-Mackenzie): I am pleased to rise in support of this resolution. I'm surprised that the member for Yorkview questions the need for a task force to look at this very important issue. Clearly we then don't share the importance of the need to ensure that our health care system meets the needs of individuals in our province, particularly in the most difficult hours of their lives.

I've had some experience with the hospice system in our province, and I'm pleased to share with you the fact that we have literally an army of volunteers who very few people in our community know are active in this area of hospice work. They do their work quietly. They do it out of commitment and out of concern and care for individuals in their communities, many times not knowing these individuals personally, but very quickly entering into their lives in a very meaningful way.

I believe the resolution before us and the recommendation for this task force are very much consistent with our government's commitment to ensuring that home care, long-term care, care for the elderly particularly in our province, is enhanced. Previous governments have discussed doing something about long-term care, discussed doing something about matters such as those proposed in this resolution, but we have seen inaction, and another reason and purpose for such a resolution before the House today is that previous governments have not acted. Had they done so when they had the opportunity, we wouldn't need the task force today.

The member for London South is taking the initiative today, and I believe it's a natural extension of the community care access centre initiative that our government has taken. I have had some discussion with three of the hospice organizations in my riding that quite frankly do face difficulty in terms of their ability to deliver their services. Again, it comes back to financial resources. Having the volunteers there is important. Clearly this kind of work can't be done without the men and women on the front lines providing the care, providing the support, providing the counselling.

But nevertheless the infrastructure has to be there, the referral system has to be there, and that takes money. So there is an obligation, I believe, on the part of government, on the part of our Ministry of Health, on the part of our Ministry of Community and Social Services, to look at how this resolution and the work of this task force could be integrated in the overall health care system in our province.

It makes no great sense to me that we should be spending literally billions of dollars treating individuals for their health care needs and spending literally billions on surgical processes and not continuing that same level of service into the most difficult hours of patients in this province, when they need that help the most.

I believe there is nothing better that we can do for patients than, as the member so rightfully puts it, to give them the option to spend their final days with family in their homes if that's what their choice is and if that is a practical way of allowing individuals to have their final hours. That is truly an indication of a civil society, and it is civility that I believe brings us to the point of debating this resolution.

I believe there are men and women throughout this province who are willing to give of their time if they knew that the structure was available. I recently had the privilege of joining in the official opening of the Hill House Hospice in Richmond Hill. This is a project that was given leadership by Anne Gold of Richmond Hill, someone who has been involved in home care service for many years. In fact, she has dedicated her career to providing patient care and home care. It was quite an experience, because here we have truly an indication of partnership. The house itself was gifted by an individual in the community.

Fundraising took place. The municipality became involved. Through that creative partnership this home was dedicated to the hospice service.

It had its first patient not many weeks ago. The opportunity now was for this patient to live the last few days in a setting where family was able to come along and provide comfort, but at the same time have the professional care and service there. The professional counselling service and the nursing services were there, but it wasn't in an institutional setting. It was a setting where truly, as the previous speaker indicated, the comfort of home was there and the emotional support was able to be provided.

I will support this resolution and the work of the task force, and certainly would be pleased to become involved in the work of that task force as well in the months and years ahead to ensure that this final stage of patient care is in fact fully integrated into the health care system in our province.

I commend my colleague for bringing this bill forward and look forward to all members of the House supporting this resolution today.

Mr James J. Bradley (St Catharines): I wish to say that I believe the issue of palliative care is one that should be before this Legislature and I believe that many of the items contained within this resolution are certainly supportable. There is considerable discussion of this issue, but the ultimate is a task force. I think the government should instead be implementing many of the recommendations that have already been out there from people in the palliative care field, rather than setting up yet another task force to deal with this issue.

Palliative care, we must know, requires a substantial investment of public funds, something that many members on the government side aren't going to want to hear. Palliative care does not come cheaply, nor should it, because people are at a very vulnerable state in their lives when they are in their last days, and their families are also in difficulty at that time.

It reminded me of the taxpayers coalition meeting that was held in St Catharines a number of years ago, where people were up at the front with veins sticking out in their necks, chanting, "No new taxes," and, "Cut taxes." The result of that is that you have far inferior medical care as a result of money not being available for the hospital system and the hospice system, and as a result we face difficulty, particularly for our senior citizens.

Senior citizens, by nature of their age, are often going to be those who are going to require palliative care. Senior citizens and their families often fear what the last days will be like. When they see a system which now has far fewer nurses in it, far fewer other hospital workers available and restraints being placed on doctors, they are very concerned as they meet this difficult time in their lives.

They remember the promise of Premier Harris during the last election campaign when he said: "Certainly, I can guarantee you it is not my plan to close hospitals." They find now that there are 35 hospitals in this province that have either been closed or forced to merge, and other facilities which have been forced to curtail their services.

This is going to require a considerable investment. This is going to require a lot of hospitals and hospices that are going to be available to people if it is to be successful. I suggest the government could use the money that it is squandering on advertising - self-serving, partisan political advertising - in the health care services.

When they open up the newspaper and see the full-page, self-congratulatory ads, when they turn on the television set and hear the jingles and commercials extolling the virtues of the government, when they listen to the radio and hear those commercials, when they go their mailbox and see the glossy pamphlets that are provided by the government, again self-congratulatory, each time they can think that money could be spent on palliative care in this province where it would be most directly beneficial to people, not to the Progressive Conservative Party.

They would know that if you didn't have those road signs with the Premier's name on them, saying, "Your Ontario tax dollars at work - Premier Mike Harris," like some American Governor having these signs all over the province, they would know that money could be spent on palliative care.

They would know that the Ontario Jobs and Investment Board, established by this government, is simply a pre-election publicity boondoggle for the Premier, trying to get re-election on the back of this particular organization. Its first action was to send out a glossy pamphlet to every person in Ontario with government propaganda on it, and to issue newsletters, glossy and glittering, again extolling the virtues of the policies of this government. If only that money were available to palliative care in this province, I would be heartened.

I note as well that people will want to ensure there is publicly funded health care available to them. Dr Duncan Sinclair, chairman of the Ontario Health Services Restructuring Commission, learned first-hand what a difference private insurance makes when his back started to hurt. The treatment his doctor recommended was physiotherapy. His choice was to wait two or three months for the hospital to get around to it, or go the very next day for electric acupuncture, something covered only by private insurance.

He chose acupuncture. His back felt better the same day, but his moral sense felt worse. I quote him, "I worry very substantially about the growing inequity in Canada between people who are able to pay for private health insurance and those who can't," he said yesterday in Ottawa. Indeed, this is the man responsible, who has been given the chore and task of closing hospitals in this province.

Mrs Marion Boyd (London Centre): As members in this place know and certainly as people at home in London know, it's very seldom that the member for London South, Mr Wood, and I, as the member for London Centre, agree on anything, so I am really pleased to be able to stand today and speak to his motion.

While I understand the reluctance of the Liberals and indeed some of my own party to endorse a task force to look at palliative care, because I am a member of a country-wide committee that has been set up to look at this issue, I am also aware that the lack of public awareness and the lack of examination by government policy-makers, by those in the general community, about care for the dying is a very big problem.

I think the mechanism the member has suggested, the task force mechanism, may help us to raise public awareness. That's important because we are a death-denying society. We are a society that tends to focus on those kinds of services which can cure us of illness or resolve an injury issue, and we tend to bury, in our very modern way, the fact that all of us at some point or other will die.

The objective of palliative care, hospice care, is to ensure that our quality of life is maintained to death, that even though we may face short hours, days or months of life, there is some mechanism to make whatever time we have left a time when we can appreciate fully our own humanness and have the kind of dignity and respect and care we deserve.

It's interesting that most of us who have stood to speak have some personal experience with offering palliative care. That certainly is so in my case. Not only did my family work with my father for almost 19 years after he had been told he had less than a year to live and manage to maintain him at home almost to the point of his death, but similarly with my mother, who was diagnosed with cancer in 1989 and went through treatments and already had a serious problem with emphysema, for whom no more treatment was recommended in 1990.

She lived until 1995 and during those five years I, as the primary caregiver who lived with her during that time, and my brother and sisters and the rest of our extended family committed ourselves to providing the kind of end-stage experience that we would want for ourselves.

I think that's the important thing about palliative hospice care: It is very respectful of the desires and wishes of the individual who is experiencing their own mortality. People often make different choices than you or I think we might make under the circumstances. The purpose of palliative hospice care is to be very mindful that when we have very few choices left, the exercise of each of those choices is important.

Our party is very clear that we need to be providing health care services to everybody at each stage of life and wherever those services are offered. So the principles that are outlined in the member for London South's resolution are principles to which we can subscribe.

I spoke at the beginning about being part of a nationwide group looking at the issue of palliative hospice care and I'd like to tell people a little bit about it. This is a group that was brought together under the auspices of the employee foundation, a charitable foundation founded by employees of Glaxo Wellcome, a company that has a very large establishment out in Mississauga.

The employees chose - they had freedom of choice - to look at palliative care largely because they themselves, as family members, had experienced the issue of palliative hospice care and felt that there needed to be some nationwide concentrated effort on informing people about what palliative care was all about, outlining what issues are facing us and encouraging government and private funders to understand the importance of supporting appropriate palliative care.

One of the first things the employee foundation at Glaxo Wellcome did was to commission a study by Angus Reid, adding questions to an Angus Reid poll about hospice palliative care. That poll was undertaken in August 1997. A random representative cross-section of 1,500 Canadian adults was polled to see what their level of knowledge was on the issue of palliative hospice care. It's very interesting that in this poll only 53% of Canadians knew about hospice care. They recognized that term only in 53% of cases, and only three in 10, 33%, identified hospice care with that end stage of life, with care of the dying.

It was interesting to note that awareness was greatest where there had been leadership by governments, because of specific health care problems, in raising that awareness.

It's very important that a task force, if one is set up by this government, would use the work that has already been done. The Glaxo Wellcome employee foundation work is very important. Last November, we were all brought together. There were representatives from right across this whole country, people who worked in community hospices, people who worked in hospital-based palliative care, physicians, nurses, volunteers, family members, people who were themselves undergoing the experience of living through the end stage of their own lives. We were brought together for an intensive think-tank about how to get palliative care to the top of the agenda in the health care system.

The urgency, of course, is because so many of us are going to be moving into our senior years. The urgency of the numbers of us who will be entering into the end stage of our lives predictably over the next 25 years means that we have to find a better way of dealing with the reality that each of us is mortal and that each of us has a right to enjoy life to the very last second. We can't do that if we are not sure that we will be cared for appropriately.

One of the other studies that Glaxo Wellcome financed was a

summary of qualitative research. That was quantitative research in terms of people's awareness of hospice care, but this was qualitative research that was undertaken to try and determine what the issues were.

This study, which was written by a woman named Melinda Head and was, as I say, submitted to Glaxo Wellcome in August 1997, this research clearly showed some of the issues and it's very important. It would be the kind of base research the task force would need to look at. Let me read you a couple of things observed by people who participated in that qualitative research. It's very important because these are people engaged in hospice palliative care.

The first quote is:

"Unfortunately the dead don't vote and the dying don't have enough energy to affect policy change.

"There has to be a commitment (by government) to care in the home. If they are (committed), they should put in the adequate support to allow people to do that. We try to do the best we can" - this is a hospice worker speaking - "but we are really only gap-fillers. People often need professional help more than the government is funding. If we can't put in through-the-night nursing, this makes the difference between allowing a patient to stay at home or not. If we can't provide that support, the only other alternative we have is in-patient beds and they are sorely lacking."

Another quote:

"There is no money. We are told the country is broke, so they take it out of health care. Palliative care is all about providing dignity to people. It's sometimes difficult to ensure someone's dignity when there are no beds and they have to sit in emergency rooms, when males and females are mixed in four-bed units. Sometimes we can't provide medication due to cost factors."

Another quote:

"If you choose to die at home, you are confronted with big bills for very expensive pain medications because they are not covered by your provincial health plan. While in hospital, everything is paid for. Once you're home, certain things, but especially medications, may not be covered and will become a financial drain.

"Continuous pump control" - the medication that is pumped by the person as they need it - "in the home is very expensive and so are the drugs. If they can't afford it, they will stay in the hospital. Some people need one nursing visit a day and the rest of the family can pick up the slack, but once you are out of the hospital, nothing is covered by the government. There is not affordable respite care, nowhere for someone to go if the family can't take it any more.

"Medications and drugs are funded within the palliative care unit. Once a patient moves back home, it is their responsibility to fund it. This places a tremendous burden on families."

This one is from a person working in hospice care in Ontario:

"Top of the list is not having enough money to provide overnight care. In Ontario the number of hours is not enough. Someone gets 56 hours of care per week; that is eight hours a day. Either they can shift that support to overnight care, but then they have no one there during the day unless they have a spouse who doesn't work, or friends, or a partner or whatever that will be with them. At best, we can't get more than seven volunteers in who will do a shift of four to five hours. There's still more hours in the day that are left over. There's still a huge gap."

I've experienced that gap. It wasn't until January 1995, when my mother was confined to bed, that I finally realized I couldn't do all-night care and maintain my responsibilities here. That was when I became really aware of how little support is available in the community.

The member for London South said that we should look at making sure that families aren't bankrupted by looking after palliative care patients, and he's right. In our family, our only alternative was to hire additional help to make sure the care was provided. In the last months of my mother's life we were paying anywhere from $6,000 to $8,000 a month to ensure that that kind of care was there, and that was in addition to the entitlement we had through the palliative care provision of home care. Most families are not fortunate enough to have those kinds of dollars, yet those dollars are very small compared to the cost of keeping people in hospital.

The member is also saying we need to have care both in the hospital, when that's necessary, and the best place for care, at home. I couldn't agree with him more. Very often the desire is to keep someone at home, but there are different circumstances that make it necessary for the person to be in a hospital.

They shouldn't be going into hospital through emergency departments, where their entire care plan comes under question by an emergency doctor whose focus is dealing with the immediate symptoms and with trying to cure or save someone who may in fact be in a situation where they know they are in the process of dying, where they have made decisions about not wanting heroic efforts taken. We need to be very clear that there are ways to do that.

The member for London South and I know that the palliative care unit at Parkwood Hospital, for example, has an ongoing relationship with families going through this kind of situation. In the ideal circumstance a person would go directly to that unit and have the appropriate care based on their care plan rather than going through an emergency department, where the focus obviously is different than it is in palliative care.

At every single instance where I've attended an MPP briefing by the hospital restructuring commission, I have questioned the commission about the issue of palliative care. It is missing from most of the reports; in fact, we are losing palliative care beds in this province as a result of their recommendations. That is a very foolish move, not only in terms of the human needs of people, which I would say are paramount, but financially foolish. If we are providing appropriate palliative care, we are not doing expensive interventions that will not affect the length of the person's life and may actually affect negatively the quality of their life.

For those of us who have been engaged in this, we have a commitment and a sense that it is important that people become educated about the importance of this service. I have great faith that the people of Ontario believe this is a service that needs to happen. I think we need to take leadership in ensuring that it does.

Mr John O'Toole (Durham East): It's my privilege to speak this morning in support of the resolution by the member for London South on the very important issue of hospice and palliative care. I listened attentively to the member for London Centre, who has just spoken. Respectfully, I know her commitment to this and I'm very pleased to remark that she is in support of the member for London South's resolution, which clearly illustrates that there are issues that this House listens to and responds to.

How do I respond to this? In my role as a backbencher and a person who tries to listen to constituents, I know just how important this issue is not only to me but to every member in this House. It really starts with how you see your own world. On a personal note - I hate to digress, Mr Speaker - I will share with you a story very similar to the member for London Centre's story. Some years ago my mother passed away, fortunately in the care of her family. Also very fortunately - and not all families are as fortunate - I have two sisters who are trained nurses.

One, in fact, works in respite services as I speak, more or less. Both of them took time off to make sure that my mother's final days were marked with support and love and tenderness and trained caring.

It's extremely important that we recognize that the role of the family is instrumental in this. We can't allow government to take over all the responsibilities for people's lives. I think that's the intent of this resolution, to first recognize the importance of the hospice and palliative care role and the dignity of those who are in need of that service.

That's at the personal level. But I would like to also recognize what's actually happening in the region of Durham, in my riding. In my research, I was very impressed: On September 12 of this past month, Her Honour the Lieutenant Governor, Hilary Weston, attended an important recognition of volunteers working for Hospice Durham. She was there to hand out recognition to this very important group, primarily made up of volunteers. Out of respect for those volunteers, I did some research and found out that the Hospice Durham story is indeed a story of people wanting to make a difference, starting, as many initiatives do in this province, with the volunteers themselves.

Respectfully, I have to say that is an important initiative of this government as well. Marilyn Mushinski from Scarborough-Ellesmere is leading an important initiative to recognize the role of volunteers.

Hospice Durham's story started in June 1988 with its first steering committee meeting, made up of people with a sense of caring about the community. They did a needs assessment through the Durham district health council at the time, in 1989. So you can see that many governments of the day have had a role in this. I'm sure there were supportive dollars to get this initiative started. The inaugural board meeting was in 1990.

Just to bring us more up to date, in 1995 they had a total number of 63 active volunteers, in 1996 it grew to 83, in 1997 it grew to 91, and I'm pleased to tell you that as of September, it's my understanding, it has grown to over 100 volunteers, many of whom do it with quiet dignity, very much in the climate of the whole palliative care environment. It's people helping people, not essentially looking for recognition.

What I hear from volunteers today in Ontario is that just recognition, just a thank you - and I say today to all the volunteers, thank you for giving your time to people whose lives are coming to an end, and bringing dignity. Their homes are the appropriate surroundings; they're comfortable surroundings, with their friends, their family. They need support from the community.

I looked also at the current board that was just taken in. For the record I want to mention a number of people, many of whom I know: Reverend Richard Hamilton, who is a Free Methodist minister, is the president of Hospice Durham; the vice-president is Reverend David Smith - you can see the important role of the clergy and the church; the treasurer is Brent Farr; the secretary is a well-known constituent of mine, Jenny Walhout; and the past president is John Fowles, a very well respected member of the community in that area.

The volunteer board members, many of whom are known to me personally, are Neale and Shirley McLean, who live in Bowmanville, Cathy Plue, John Skinner, Diane Bennett, Peggy Dickerson and Guy May. This is just the immediate list of volunteers who serve in many capacities, some of which aren't board of directors or administrator duties but providing hands-on care to real people.

I always have to drive that down. I go back to the vision of my mother, my sisters, my family, and having the right skills in the right place at the right time. Clearly, all of us have to work together as a community in this area.

There was a very touching story related that day about a person who was a close friend of our family. He was a high school teacher at the time. In fact, his involvement in my life involved his son, who's a friend of mine, and he was also a teacher of my son at one time. He was a volunteer sports coach and participated in lots of activities. Mel Putnam passed away just over a year ago of cancer. His dying days were supported by his wife and the Hospice Durham organization. When the Lieutenant Governor was in Durham on September 12, Mrs Putnam made a very respectful comment and gave a testimonial.

It would be remiss of me not to recognize that there are more people, far beyond the names I've mentioned. I apologize if I've in any way perhaps embarrassed people by mentioning those names. But recognition and thank you is what I'm trying to say. For that reason, I expect every member of this House to respond to Mr Wood's resolution today. Think of your own family, if you want to be selfish, but think of your community. We each have a responsibility and a role to make the last days of those in the later stages of life respectful, graceful and supportive.

With regard to what the government has done, I have to recognize that the Honourable Cam Jackson is really trying to extend the whole initiative of long-term care. Many members would know that our initiatives are far-reaching. As we move people into the home, the home care component has to be there. Indeed, I'm familiar with his most recent announcement in July of some $550.8 million that has been allocated to this very important home care support system. But the money is only one piece; the rest, respectfully, is volunteers.

I'm saying thank you, and the best way for the members here to say thank you is to support Mr Wood's very important, very thoughtful and very compassionate resolution today. Thank you for your time.

Mr Rick Bartolucci (Sudbury): I stand in support and would like to commend the member for London South for bringing this resolution forward. It certainly is a timely one in light of the situation that's taking place in Sudbury now, where the Sudbury Regional Palliative Care Association is saying they're going to have to close their doors on December 31 if the government doesn't fund them adequately.

I want to tell the member for London South, if in fact this task force is created, you would do well to learn from the Sudbury experience. We are very proud of our palliative care association and our palliative care service. It began in 1989 under the tutelage of Gerry Lougheed Jr, and might I suggest that both the Minister of Health and the Minister of Long-Term Care would be well advised to include and involve him in any process when we're talking about hospice palliative care initiatives. He definitely has the momentum, the opportunity to share knowledge and the expertise.

I would suggest to you as well that it is important that any palliative care association ensures that it reflects the needs of the community. We started our first team of volunteers in 1989. We implemented our francophone training in 1992, because we wanted to assure ourselves that the 35% of the population which is francophone within the regional municipality of Sudbury was well served by these services as well. All our volunteers are trained and educated through and with the use of qualified trainers who donate their time. As of October 13 of this year, we have trained 461 volunteers in Sudbury.

We have supported over 1,330 families, because we believe the last stages of life are extremely important, and we believe it is essential and imperative that those people are reassured that their enthusiasm for life, although it may be shortened, is still appreciated and is still respected. These volunteers go out in the community and we service the people. In fact, over the course of the last little while there have been in excess of 12,000 volunteer hours during 1997 alone. Those aren't paid hours; this is volunteer service.

I suggest to you that the initiative of the member in bringing forth this resolution is well intentioned, but the good intentions of the member for London South must be accompanied by the commitment from the government to fully and adequately subsidize the funding of this type of service. It is imperative that the government commit additional resources, because in some cases the government is already donating. For example, in Sudbury they donate approximately $27,000. That's woefully underfunded when in fact there has been the estimate that $150,000 is necessary to continue the program.

It's essential that the service is provided in every community in Ontario. It's essential that you look at the Sudbury model, because they are well advanced from where this resolution is. It's an opportunity for the task force to shorten its mandate, provide the services and get the services into every community in Ontario.

At this time, the only caveat I would say to the government is that you have to make a commitment to your member for London South that you're going to put the appropriate dollars into palliative care services. Otherwise the exercise today, the exercise of the task force, will be fruitless and the reality will be that people in Ontario will consider this government, on an ongoing basis, as not caring about people.

The Acting Speaker: The member for London South, you have two minutes.

Mr Bob Wood: I'd like to express my thanks to all those who participated in the debate. I'd like to respond to a few of the concerns that have been raised.

The question has been raised as to why have a task force to deal with this. The answer to that I think is that it's a very complex issue and we need input and expertise to get it right. I might say that I share the concern that I know others have, that task forces sometimes sweep problems under the rug. That's they reason the resolution is so specific. If the resolution is adopted, we're going to see some action from what's there.

The issue has been raised that palliative care is going to cost money, and that of course is true. I suggest to you, it might not cost as much as some might think because such a large component is that of volunteers. I'd also point out to you that the program can be phased in over time, and in particular when the budget is balanced, I think there are going to be monies available. I suggest that after the budget is balanced, one of the top priorities for use of the surplus should be hospice palliative care.

The question of raising profile came forward and I think that is absolutely correct. Every member of this House can help in bringing this issue to the forefront of the public agenda.

What palliative care hospices are really about is letting people achieve the kind of end they want. It can be a very positive experience and very much a part of life. It was not a positive experience for my grandmother some 38 years ago, but it was for my aunt three years ago. She was able to die in her own home and she said to me a few days before she died, "I hate to go because everyone's being so nice to me." The fact of the matter is, that was the right way to end a life well lived.

What we do today can be an important step forward and I do hope all members of the House will support this resolution.

HEALTH CARE ACCOUNTABILITY AND PATIENTS' BILL OF RIGHTS ACT, 1998 / LOI DE 1998 SUR L'OBLIGATION DE RENDRE DES COMPTES À L'ÉGARD DES SOINS DE SANTÉ ET SUR LA DÉCLARATION DES DROITS DES PATIENTS

The Acting Speaker (Mr Gilles E. Morin): We will now deal with the first ballot item, number 25, standing in the name of Mrs Boyd.

Mrs Boyd has moved second reading of Bill 50,

An Act to promote patients' rights and to increase accountability in Ontario's health care system.

Is it the pleasure of the House that the motion carry? Carried.

Pursuant to standing order 95(j), the bill is referred to the committee of the whole.

Mrs Marion Boyd (London Centre): On a point of order, Mr Speaker: We ask for it to be referred to the social development committee.

The Acting Speaker: Majority in favour?

All those in favour, please stand.

All those opposed, please stand.

The majority is not in favour; therefore the bill is sent to the committee of the whole.

PALLIATIVE CARE

The Acting Speaker (Mr Gilles E. Morin): We will now deal with ballot item number 26, standing in the name of Mr Wood.

Is it the pleasure of the House that the motion carry? Carried.

All matters related to private members' business have been debated. I will now leave the chair, and the House will resume at 1:30 of the clock this afternoon.

The House recessed from 1200 to 1330.

MEMBERS' STATEMENTS

HIGHWAY SAFETY

Mr Michael Gravelle (Port Arthur): Two years ago, the former Minister of Transportation, Mr Palladini, agreed to install an advanced warning light at Balsam Street on the Thunder Bay Expressway. This came about as a result of strong lobbying from a variety of concerned groups, including the OPP and Thunder Bay city council, who were concerned about the number of vehicles that were running the red light at this particular intersection, sadly resulting in some tragic accidents and countless near misses.

Since its installation, there has been a major improvement at that intersection. However, it has become increasingly clear that these lights need to be in place throughout the expressway. This past summer, more accidents took place further down the system that were a direct result of vehicles not stopping at a red light. So for the sake of improved safety, I hope that Minister Clement will now listen and indeed act.

We all recognize that an advanced warning light is not the perfect solution to the problem. However, if we look at the experience of provinces such as Manitoba and British Columbia, where advanced warning lights are common, there already are some jurisdictions that believe they improve safety on the highways.

Minister, let me make a direct plea to you today. I recognize that your ministry installed the Balsam Street light as a three-year pilot project in order to gauge its effectiveness. Today I'm asking you to listen to the concerns of so many of my constituents and end the pilot project now. Surely two years is enough time to confirm that the advanced warning light has made a positive difference. Minister, surely you would agree that if this relatively inexpensive system can save one life, it will have been worth it. Show some flexibility. Do it now.

ÉDUCATION POSTSECONDAIRE

M. Gilles Bisson (Cochrane-Sud) : Je veux attirer l'attention du ministre de l'Éducation de la province à une situation que je suis sûr qu'il connaît lui-même. Patrimoine Canada du gouvernement fédéral, comme on le sait, a pris la décision de ne plus verser de l'argent vers nos collèges communautaires francophones ici en Ontario. C'est une situation très sérieuse.

On sait qu'en 1993, le gouvernement de Bob Rae a négocié avec le gouvernement conservateur de la journée, de verser 173 $ millions sur une période de cinq ans pour s'assurer qu'on a de l'argent en place pour être capable de financer nos collèges francophones ici dans la province de l'Ontario. Cet argent est utilisé pour développer des programmes dans le Collège Boréal, le Collège des Grands Lacs et autres. Et là on apprend que le gouvernement fédéral nous dit qu'ils ne vont plus verser de dollars du gouvernement fédéral de M. Jean Chrétien au gouvernement provincial de l'Ontario, ni aux autres provinces à travers le Canada.

DIABETES

Mrs Barbara Fisher (Bruce): It gives me great pleasure to introduce some very special guests who are in the members' gallery today.

Ayden Byle of Inverhuron, Ontario, was diagnosed with juvenile diabetes six years ago. He must constantly monitor his blood sugar level and requires up to five shots of insulin per day.

There are more than 1.6 million diabetics living in Canada today. That is close to 6% of our total population. Most of us either have diabetics as members of our family or know someone who does. Most of us pay little attention to this disease. Diabetics appear to lead normal lives. Nothing could be further from the truth. Diabetes is a devastating disease which will eventually take its toll. It is no different from cancer, heart disease or kidney disease. There is no cure.

On June 1 of this year, Ayden left Vancouver to run across Canada to raise money for diabetes research. He has run over 4,500 kilometres to arrive in Toronto today. He has raised nearly $90,000 and intends to reach Halifax by the end of November. Like Terry Fox, Ayden has suffered setbacks and disappointments during his run, but this young man's courage and determination is outstanding. The Canada Challenge slogan is "May We All Be Challenged." In keeping with this slogan, Ayden challenges all Canadians to support this cause.

I invite you to meet this outstanding young Ontarian, his team and his family in room 230 following question period today. I wish Ayden a safe and successful journey to the east coast. Good luck, Ayden. We look forward to your homecoming.

PROPERTY TAXATION

Mr Jean-Marc Lalonde (Prescott and Russell): I would like to comment on the Mike Harris plan to put money back into the pockets of Ontarians. When Mike Harris introduced the new value assessment system, he said it would be fair for everyone. Once again, Mike Harris has delivered a serious blow to low-income families in Ontario.

The new assessment system will have a negative effect for the Hawkesbury Housing Corp, which faces a 44% tax increase. The business community in Glengarry, Prescott and Russell is faced with a property tax increase of up to 574%, and this will have a serious effect on employment in Glengarry, Prescott and Russell, all of which is the result of this Mike Harris government downloading.

DIABETES

Ms Marilyn Churley (Riverdale): I would like to welcome and congratulate Ayden Byle, who is here today, I understand, from Inverhuron, Ontario. He is about to run across the country - there he is again; we're very proud of you and welcome you here today - to raise money for diabetes research.

I want to take this opportunity to say that my son has juvenile diabetes. He was diagnosed at about the age of 11. I'm quite familiar now with the problems associated with this kind of disease and how very important it is to raise funds privately for research. That's why I'm so very pleased, as my son is, that you're doing this.

I do have to say, though, that governments too have to take responsibility and make sure that funding is there, particularly in areas of prevention and health promotion. I know that when my son was diagnosed as a boy, and into adulthood, it was very important to him to learn how to take care of himself.

I have to note today that the Tory government has cut funds to public health programs which include these programs for prevention and health promotion. I would implore the government today to put those funds back so we don't lose those really necessary health promotion programs.

HERITAGE FESTIVAL

Mr Doug Galt (Northumberland): I rise in the House today to recognize the Heritage Festival that took place last weekend in Port Hope. Port Hope is well known for its 19th century homes and streetscape, and last spring the downtown was officially designated as a heritage conservation district. One of the most recent heritage projects the town undertook was the restoration of the Capitol Theatre in downtown Port Hope.

This was the first year for the festival, and by all accounts it was a tremendous success, with many people coming from across Ontario, as well as the United States. Some of the events included live entertainment, horse-drawn carriage rides, historical walking tours, harvest food samplings, a native dance and powwow by the Alderville First Nations group, and tents featuring Canadian arts and crafts.

I applaud the founders of the festival, Gary and Judi McWilliams, and the other members of the festival committee who volunteered their time to showcase Port Hope. I'm pleased to say that the marketing of the Heritage Festival was supported by Ontario Tourism through the Ministry of Economic Development, Trade and Tourism.

I would encourage all members of this House to visit historic Port Hope this fall, because there really is more to discover in Northumberland.

HOSPITAL FUNDING

Mr James J. Bradley (St Catharines): The state of health care in the Niagara region continues to deteriorate under the Mike Harris government. We have the hospital closing commission lurking around St Catharines and the Niagara Peninsula looking at closing hospitals or drastically altering the roles which our hospitals play.

We have hospitals in the area that have to carry huge deficits because of the cut in funding from the provincial government. We have people waiting for hip joint and knee joint operations and other operations of that kind. We have a need for nursing homes and increased funding for homes such as Linhaven so they can meet the needs of seniors in our area. I remind members of the Legislature that the Niagara region has per capita the largest number of senior citizens in the province.

We have emergency care which from time to time is not available because hospitals are on a bypass situation. Prescription drug costs are very onerous on many of the people who live in the Niagara region, and the senior citizens remember well the user fee which was slapped on them by the Mike Harris government.

We have a situation with Dr Beiko, an ophthalmologist, who has to turn away long-term patients simply because there isn't enough money to be able to carry out that particular responsibility.

Hospitals are discharging patients quicker and sicker at this time and what we require is a strong infusion of funds from the Ministry of Health of Ontario.

SCHOOL CLOSURES

Mr David Christopherson (Hamilton Centre): Last week I rose in my place and advised the government members of the rally I was attending at Allenby public school, where parents were outraged at the possibility of losing their community school as a result of this government's education agenda.

Last night I attended another such meeting at Central public school, again organized by the parent council. The meeting was chaired by Cathy Gazzola. Joining me at that meeting was our local school board member, trustee Judith Bishop, as well as local aldermen Andrea Horwath and Ron Corsini.

I want to emphasize the fact that at that meeting, the biggest issue at this point was the fact that these parents were not going to get a decent length of time to consider the important issues that ought to be considered. We have a process locally that provides for 18 months to allow parents and the community an opportunity to have input in these kinds of decisions. As a result of this government's agenda, those parents and our community are going to get two weeks to consider up to 25 school closures. That is disgraceful.

It's your responsibility to allow democracy to take place and you're stifling it. This is not just a building game or a numbers game. We've got to be looking at the programs that are available, the child care programs that are there. Is this a community centre? What are the other uses for this place? More and more you're killing education.

APPLE FESTIVAL

Mr John O'Toole (Durham East): I'm pleased to rise in the House today to share with my colleagues on the other side more good news about an event occurring in my riding of Durham East.

This Saturday, October 17, the Bowmanville Business Centre is hosting the annual Bowmanville apple festival and craft sale. This event runs from 9 am to 5 pm in the Victorian downtown of Bowmanville, thanks to the hard work of volunteers like Garth Gilpin and Ron Hooper and a number of other volunteers. I encourage all members to visit Bowmanville this Saturday.

The Applefest has an extensive and exciting

schedule of events. There will be a variety of fresh apples available, as well as baked goods, freshly pressed apple cider, a pie eating contest and hot apple fritters. There will also be a huge tent filled with crafts and live entertainment, and even a professional lumberjack competition. What better way to spend an autumn weekend than in downtown Bowmanville?

The annual Applefest provides the opportunity to reflect on the importance of the apple industry in Durham. There are many top-quality apple producers in my riding, for instance, Kirk Kemp; Empire Orchards, owned and operated by Bob and Gail Simpson; and Nature's Bounty, owned by the McKay family. There is also Archibald's Orchards and Estate Winery, with their prize-winning selection of apple wine. Fred and Sandy Archibald have established a very successful new business that will be part of the tour.

Apple production is an important part of the agricultural sector, not only in my riding but indeed across the province, and I would encourage everyone to attend Applefest in Bowmanville this weekend.

Mrs Marion Boyd (London Centre): On a point of order, Mr Speaker: I'd like to rise to ask for unanimous consent today for the following motion to be forwarded from this Legislative Assembly to Prime Minister Jean Chrétien and Finance Minister Paul Martin. The motion would read:

"That the Legislative Assembly of Ontario demands that the federal Liberal government take advantage of this year's federal budget surplus to begin restoring to the provinces the more than $6 billion it has cut from health care and education."

The Speaker (Hon Chris Stockwell): You are seeking unanimous consent to put the motion. Agreed? No.

Interjections.

The Speaker: Order.

Mr Gilles Pouliot (Lake Nipigon): Mr Speaker, on a point of order: With high respect, would you convey the courtesy of a name? Who was it who said no?

The Speaker: I have no idea. I just heard a no.

Mr Gilles Bisson (Cochrane South): Mr Speaker, on a point of order: Did it come from the Liberal caucus? Definitely that's where I heard it come from.

The Speaker: I have no idea where the no came from, none whatsoever. I heard a no.

ORAL QUESTIONS

EMERGENCY SERVICES

Mr Gerard Kennedy (York South): I have a question for the Minister of Health.

Interjections.

The Speaker (Hon Chris Stockwell): Stop the clock. Member for York South.

Mr Kennedy: I anticipate why the government won't like this question. It has to do with their mismanagement of health care and specifically, Minister, your personal mismanagement of hospital emergency rooms in this province.

Minister, on your watch, hospital emergency rooms hit a crisis last February. At first, you said it was the flu. You said it was something that hospitals should deal with themselves. Not until your Premier had to go to an emergency room himself did you agree there was a problem. Then you tacked on a committee that the hospitals had already set up, and when that committee reported to you, you said on April 20 that you were acting immediately. You said, "Every region of the province will benefit from our immediate action on the task force's recommendations." We're sitting here six months later and you haven't done anything - not one of the things you said you would do.

What I want to know is, will you apologize today to the people of Ontario for having mismanaged the situation in the emergency rooms of the province?

Hon Elizabeth Witmer (Minister of Health): I'm not sure if you were the one who just said no, that you were unwilling to support the NDP motion to get additional health funding from the federal government or not, but we did hear a no from the Liberal benches.

What I have always said is that our government, under the leadership of our Premier, has always indicated that health is a priority. We have said we would maintain health funding at $17.4 billion. Not only have we maintained the funding, we have increased the funding by at least $1.2 billion or $1.3 billion.

Our government made the tough decisions to restructure health care. Our government acknowledged the fact that we needed to deal with the emergency room situation and we set up a task force.

As you and I know, these issues that arise in emergency rooms have been there for a long time. I can look at the list in front of me here -

The Speaker: Supplementary.

Mr Kennedy: Minister, what you're saying verges on absolute neglect. For you not to have read page 1 of the report you've been trying to hide behind - on page 1 of this report, written by doctors and hospital administrators, it says, "The emergency room problems in Toronto began in October 1996," when you were the government. That's what it says. Further, this report says you are to act within 90 days. It gave you 90 days. Today, six months later, you've done nothing.

Donna Kline at Sunnybrook says there are staffing shortages, a high volume of patients, the beds are full and, as a result of those bed shortages, they can't serve people. In North York General, Donna Bloomfield is telling us that because of the lack of funding both for the services in their hospitals and for home care they can't discharge people, because you haven't done what you've promised.

Minister, when are you going to make things safe for patients in Toronto? All of these hospitals understand it is your fault. Will you act?

Hon Mrs Witmer: To the member opposite, if you had had the courage when you were in government to move forward rather than neglecting our health system and not having the courage, we wouldn't have had situations such as you had when it was under your watch, where it says in the Ottawa Citizen, December 26, 1987, "An elderly woman turned away from two area hospitals last weekend died Christmas day," and I could go on and on. These are the situations that we had the courage to correct. We had the courage to set up a committee with the Ontario Hospital Association.

The report was issued, we accepted the recommendations and we will be implementing those recommendations to improve health care in this province.

Mr Kennedy: Hiding behind the tiny shreds of credibility you have, you have to answer this question today. On April 20 you promised 1,700 short-term long-term-care beds to alleviate the emergency situation. When are you funding them? Six months later you haven't. That's almost criminal, Minister. You promised temporary beds for flexibility in emergency rooms. You said in your release you would act immediately. You've done nothing about it. You said you would provide capital to emergency rooms. You announced $3.2 million for the emergency room in Windsor and you gave them nothing. You said you'd put extra money into home care and you've done nothing.

Minister, today I want you to stand in the House and tell us exactly why there has been a delay in the money you personally specifically promised us on April 20. Is it politics? Are you waiting to get more benefit in the election? Or is just incompetence?

Hon Mrs Witmer: To the member opposite, I would encourage you to check the facts that you've just presented. As you know, the Minister of Long-Term Care has certainly been making additional money available in the area of home care services. We also have dealt with the situation in Windsor, and I'm very pleased to say that we are making long-term-care beds available. Unfortunately, it's as a result of the lack of planning that was developed under your government that we saw no long-term-care beds awarded for over 10 years, so we're now in a position where we're finally doing what your government should have done, and the government after you.

The Speaker: New question.

LONG-TERM CARE

Mr Gerard Kennedy (York South): I would go back to the other minister, but she talks about courage and she's avoiding the questions. I have to direct my question to the new minister for half of health care, for long-term care.

Minister, I want to refer you to the remarks of your colleague, who says there's lots of home care available. Toronto home care tells us they have a $12-million deficit coming at them this year. That is your specific responsibility. It is one of the reasons your other minister has not been able to provide service. She's not taking care of her end, but you're not taking care of yours.

I specifically want to refer you to Kingston, where they are facing a $1-million deficit. They've had a 15% to 20% increase in patients coming in. They are now cutting services to patients. I want to know, Minister, do you approve of cutting services to patients, why are you permitting it to happen and why won't you provide home care funding to offset the cuts to hospitals that the Minister of Health has made?

Hon Cameron Jackson (Minister of Long-Term Care, minister responsible for seniors): I want to thank the member for his question and I want to set the record straight, because he certainly still hasn't got the proper picture as it relates to home care right here in the city of Toronto. I want to advise the member opposite that before even one hospital has closed in this city, we have flowed, in Toronto alone, $25 million of new dollars in less than two years to the Toronto CCAC. Their budget is now over $60 million.

If you want to ask questions about why there is inequity, you look to your colleague sitting to your immediate right. He represents constituents in Scarborough, and in Scarborough for years, for over a decade, they have been receiving half the levels of care that your constituents were receiving in York. Your government lacked the courage to do anything about it and the subsequent government lacked the courage to do it. This government has the courage to have an equity model so that these dollars are shared equally for all the citizens of Ontario