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June 3, 2008

39th Parliament, 1st Session

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Hansard Transcripts

Hansard Transcripts

Hansard Transcripts

Hansard Transcripts

Votes and Proceedings

Orders and Notices

Hansard Transcripts 2008-Jun-03 (PDF)

LEGISLATIVE ASSEMBLY OF ONTARIO

ASSEMBLÉE LÉGISLATIVE DE L'ONTARIO

Tuesday 3 June 2008 Mardi 3 juin 2008

ORDERS OF THE DAY

ORDER OF BUSINESS

PERSONAL HEALTH INFORMATION PROTECTION /

PROTECTION DES RENSEIGNEMENTS PERSONNELS SUR LA SANTÉ

INTRODUCTION OF VISITORS

MEMBER FOR GLENGARRY–PRESCOTT—RUSSELL

ORAL QUESTIONS

AUTOMOTIVE INDUSTRY

INFECTIOUS DISEASE CONTROL

AUTOMOTIVE INDUSTRY

SKILLS TRAINING

SCHOOL CLOSURES

INFECTIOUS DISEASE CONTROL

HOSPITAL FUNDING

SEWAGE SPILL

ONTARIO DISABILITY SUPPORT PROGRAM

AFFORDABLE HOUSING

POLYGAMY

EVENTS IN TIBET

INFRASTRUCTURE RENEWAL

BEEF PRODUCERS

NORTHERN ONTARIO DEVELOPMENT

PETITIONS

LONG-TERM CARE

CHILD CUSTODY

LORD'S PRAYER

LORD'S PRAYER

SERVICES FOR THE DEVELOPMENTALLY DISABLED

HOSPITAL FUNDING

ANTI-SMOKING LEGISLATION

ANTI-SMOKING LEGISLATION

HOSPITAL FUNDING

COMMUNITY COLLEGES

COLLECTIVE BARGAINING

LORD'S PRAYER

HIGHWAY 138

HOSPITAL FUNDING

LORD'S PRAYER

ANTI-SMOKING LEGISLATION

MEMBERS' STATEMENTS

AUTOMOTIVE INDUSTRY

INTERNATIONALLY TRAINED PROFESSIONALS

RURAL ONTARIO

LABOUR DISPUTE

SENIORS' MONTH

SENIORS' MONTH

EVENTS IN AJAX AND PICKERING

JACK BYERS

HEALTH CARE

REPORTS BY COMMITTEES

STANDING COMMITTEE ON GOVERNMENT AGENCIES

SPECIAL REPORT, OMBUDSMAN

INTRODUCTION OF BILLS

PHOTO CARD ACT, 2008 /

LOI DE 2008 SUR LES CARTES-PHOTO

LABOUR RELATIONS

AMENDMENT ACT

(REPLACEMENT WORKERS), 2008 /

LOI DE 2008 MODIFIANT LA LOI

SUR LES RELATIONS DE TRAVAIL

(TRAVAILLEURS SUPPLÉANTS)

STATEMENTS BY THE MINISTRY

AND RESPONSES

PHOTO CARDS

SEXUAL HARASSMENT

SEXUAL HARASSMENT

PHOTO CARDS

SEXUAL HARASSMENT

PHOTO CARDS

NOTICE OF DISSATISFACTION

OPPOSITION DAY

RURAL SCHOOLS

The House met at 0900.

Prayers.

ORDERS OF THE DAY

ORDER OF BUSINESS

Hon. David Caplan: On a point of order, Mr. Speaker: I believe we have unanimous consent to put forward a motion regarding division of time for debate on government motion 60.

The Speaker (Hon. Steve Peters): Mr. Caplan seeks unanimous consent for debate on government notice of motion 60. Agreed? Agreed.

Hon. David Caplan: Thank you. I move that the time available until 10:45 a.m. this morning be divided equally among the recognized parties for debate on government motion 60, following which the Speaker shall put every question necessary to dispose of the motion without further debate or amendment.

The Speaker (Hon. Steve Peters): Is it the pleasure of the House the motion carry? Carried.

Agreed to.

PERSONAL HEALTH INFORMATION PROTECTION /

PROTECTION DES RENSEIGNEMENTS PERSONNELS SUR LA SANTÉ

Hon. John Wilkinson: I move that pursuant to subsection 75(

a) of the Personal Health Information Protection Act, 2004, the Standing Committee on Social Policy be authorized to review the act; and that, pursuant to subsection 75(

b) of the act, the committee shall report to the House its opinions, observations and recommendations concerning amendments to the Personal Health Information Protection Act, 2004, no later than one year following the assignment of this order of reference to the committee.

The Speaker (Hon. Steve Peters): Further debate?

Ms. Laurel C.

Broten: I'm pleased to rise and speak in support of this important legislation and the fact that it is important that we see this Personal Health Information Protection Act move forward to be examined by committee, so that we can make sure that in a world of information, data collection and new technology, as things are constantly changing and improving and innovating, we have an opportunity to make sure that our legislation, which was introduced in 2004 and came into effect in 2004—and at the time really set a gold standard in terms of making sure health information was protected and that Ontarians had access to their health information—it's absolutely critical that we make sure that we continue to have the gold standard in Ontario.

I'm going to take a few minutes this morning and let Ontarians have a bit of an understanding of the process that's taking place. As the minister indicated, this is a motion pursuant to subsection 75(

a) of the Personal Health Information Protection Act, or PHIPA, as we call it, for this piece of legislation to go to the Standing Committee on Social Policy so that they can review it and provide a report to this Legislature with their observations and recommendations determining how PHIPA might be amended in any way.

We were really pleased to deliver this information in 2004, and we have made sure, by way of this legislation, that rules are established for the collection, use and disclosure of personal health information by health information custodians. Health information custodians would include doctors, laboratories, long-term-care homes and hospitals. This legislation also provided Ontarians with the legislated right to request access to and correct their health records of personal health information.

It set rules that health information custodians needed to follow, including ensuring that personal health information was protected against unauthorized use or disclosure, informing an individual if their personal health information has been lost, stolen or accessed by unauthorized persons. Those are really critical things.

When we think about what has transpired over the last number of years as to how we collect and maintain data and information, we think back to many years ago where your doctor's office had their records in a file cabinet locked with keys and, as somebody who practised in the legal profession, I was certainly very knowledgeable about the fact that every cabinet needed to be locked at night, because we were very paper-driven.

As we move to a more information and database and computer regime, frankly there are issues, because a document that used to be locked away in a cabinet might now be accessible on a hard drive or could be e-mailed to somebody, firewalls can be broken down, so it is really critical that as we modernize society, we modernize the way we protect and maintain health records.

Under the act, the Information and Privacy Commissioner, who is currently Ann Cavoukian, is responsible for overseeing compliance with the legislation. Under the act, the Information and Privacy Commissioner has the authority to investigate complaints, undertake a review on her own initiative and has order-making power to ensure that health information custodians take steps towards complying with the rules set out in the act. So that really ensures that the act has a great deal of teeth when you have someone as prominent and well known in her ability to protect information as Dr.

Ann Cavoukian as the Information and Privacy Commissioner, that they have the ability to make sure that that information is well protected.

I want to share with this House that the act has really been widely regarded as a success since its passing in 2004. Some watching may know that the federal government passed a bill called the Personal Information Protection and Electronic Documents Act, or PIPEDA, as that one is called. In 2005, PHIPA was declared substantially similar to that federal legislation, and so becoming the only privacy legislation in Canada to receive the designation, making Ontario's health sector exempt from the federal policy because the Ontario policy provided as much or substantially similar protection.

PHIPA has served as the model for health privacy legislation in other jurisdictions in Canada, including very recently in Newfoundland, and the Information and Privacy Commissioner recently wrote to the New York Times that they should consider PHIPA as an excellent model for protecting medical privacy.

The review that we are proposing by way of this motion arises directly from the foundation, the early drafting and the early passing of PHIPA. It was contained in there that we needed to have a review, and irrespective of this great success, PHIPA contains a requirement that it be reviewed by a legislative committee. As I said from the outset, I think that's a really important thing, because it's critical that we circle back with those whose information we are trying to protect, with those custodians of the information, to see if there are ways that things could be done better. Is it working?

Is the legislation able to continue to provide that important protection of critical health information and allow those of us who need access to that information, to our own health records, to get those changed if there is information that is wrong? We need to make sure that it is accessible, modern and able to modernize itself with the times.

The review is set out so that it needs to be timely. It will take place within a year. The sharing, storage and use of personal health information is evolving and, as I said, it will continue to evolve as we move forward in this government with the important initiative of e-health records.

When I talk to my constituents in my home community in Etobicoke—Lakeshore, I have an opportunity to talk to people about things that are important to them: making sure that our health care system continues to be modern, continues to change with the times, and that we have access to critical information, because information is essentially the key to success.

We know that if a doctor has all the information about the patient, we'll make sure that that patient does not have contraindications in prescriptions, for example. If the pharmacist has that information and if all the various health care providers are able to coordinate, if we move to the continued development of a time where we have health records that are available electronically, that will provide patients across Ontario with an incredible amount of power to look after themselves, to maintain those records and to be knowledgeable about their own health experience, their own health history, and to make sure that that information is accessible and available.

I know that we look to the modernizing of health records, yet we still have some of our old ways of doing things. I recently had to take my sons, Zachary and Ryan, in for immunization. As you are trying to get out to the doctor's office, as you can imagine, with two-and-a-half-year-old twins, it's a little bit of a commotion to get out of the house. "Where are those yellow papers? Where are those immunization records that I need to bring back to the doctor's office?" Wouldn't it be great if we had that information available?

It is available electronically in our doctor's office, no doubt, but when we move to the system where it is there, you will have access to it. You can do your banking online now. You apply for a mortgage. You can do all sorts of things. Let's move to that system.

That's what Ontarians are asking, but making sure that PHIPA continues to be a very protective piece of legislation is absolutely critical as we move forward with the modernization of our health records system, because if we don't have adequate procedures in place, we will potentially have critical and important information that will go astray, that will get in the wrong hands and that will get out to someone who should not have it.

I know that we can all turn our minds to a couple of examples about why you would not want your health information available broadly. First of all, it's personal. This is exactly what this is about: personal health information. And that personal health information is yours to disclose to whom you want. Perhaps you have a history of an illness in your family, you've had some tests done for that and you got back whatever answer, yes or no, whether you were predisposed to have that illness. You don't necessarily want all sorts of others who are not to be privy to that personal health information to have it. That's why this legislation is very critical.

Personal health legislation needs to consider changes in the way health care is also being delivered and the way health information is being managed. We know there are very modern, new technologies happening in our hospitals right across this province and we're proud as a government to be leading the way and ensuring that that takes place.

In my own hospital in Etobicoke—Lakeshore, Trillium Health Centre, we now have a process where doctors, nurses, PSWs and others communicate by way of BlackBerry. They are able to have an immediate exchange: "I am at patient X's bed. This is the circumstance. What do you think?" It's much more efficient, and there are instantaneous answers given back to the health care providers so that they are able to give the immediate transition and medication necessary for the best care of that patient. At its heart, every step that our government is taking is to ensure that we provide the best health care for Ontarians.

We do that by putting Ontarians first, putting our patients first, at the centre of everything that we do. That is also the focus of PHIPA. The protection of personal health information puts our patients first and our Ontario citizens first, at the heart and centre of a system that is critically important to their quality of life here in Ontario.

Personal health information, as I said, needs to modernize and perhaps change in the way we do things. The use of new technologies such as patient portals allow patients to interact with their doctors online, view lab test results and request appointments. That's starting to take place in the province, and it is of critical importance that information is protected. But wouldn't it be convenient if you had a lab result done and you could have an opportunity to see that?

It's efficient for our patients, who don't need to take time away from work, who can have access to their information, as they would, for example, to review their stock portfolio. Why should they not be able to review those health records and have communications with the doctor professional whom they're interacting with, as they do with many of the other professionals in their life? But at the same time, this health information needs to be protected.

A growing number of health care registries are developing. That information also is critical and needs to be safeguarded. The use of databases and information for research and health system planning—those are all mechanisms by which your personal health information is made available, is put on a document on a computer network. We need to make sure that that is being protected.

The legislative committee review would listen to patients and stakeholders and provide advice to the Ministry of Health on how the legislation should evolve so Ontario can continue to be a leader in protecting personal health information. I think today, as we debate this motion, is a really great day, because it demonstrates the ability of this place to keep up with the times. I would suggest that sometimes our constituents might argue that here in the Legislature we don't keep up with the times and it isn't a very modern way of doing business.

We sought to remedy some of that this session and modernize the way we do business here in the Legislature. This is a modern time to be speaking. According to my watch, it's about 16 minutes after 9. It is very different for us to be here in the morning, and I think it's great, much more in keeping with when our constituents are up and at it, getting their kids off to daycare, getting their kids to school, then getting into the office and conducting the business of the people. That's what we're doing here.

This motion is about making sure that legislation that we put in in 2004, which was leading-edge at the time, has a mechanism built right into the legislation to make sure that we stay leading-edge, that if someone has a good idea somewhere else in the world or a new technology develops that we didn't think about and we need a new way to ensure the protection of that personal information, we are able to do that.

I think it's a very great day in the Legislature. I look forward to seeing this motion pass very quickly so that we can get PHIPA off to committee and the committee can examine whether or not we need to make any amendments in accordance with new technology.

We've come a long way. We know there's much more to do. The area of electronic health records and the modernization of the health system to use new technology is one that we are very focused on. We're very pleased with respect to a number of the initiatives that we've been able to move forward with since taking office this mandate and the last mandate.

We've made sure to look around the world and ensure that we have excellent health care being provided closer to home for Ontarians, that they have access to their health care professionals, and made sure that we protect their personal health information while at the same time ensuring that we are nimble and able to modernize the way we do the business of health for people in this province. Because it is all about putting our patients first and making sure that their information is accessible to them, that their records are protected.

Ultimately, that will make for better patient care, a better health system and a sustainable and modern health system for generations to come.

I'm pleased to have had an opportunity to speak to this motion. I will be sharing my time with two of my other colleagues: the member from Etobicoke North, and the member from Mississauga—Streetsville, Mr. Delaney. I look forward to seeing this motion passed quickly and getting this to committee so we can continue to have the most modern legislation here in Ontario.

M me France Gélinas: I'm pleased to rise to talk about the health protection information act, more particularly the review of this act. We certainly welcome the initiative of a review of the Personal Health Information Protection Act. It should be noted that the review is long overdue. It actually should have been started a year ago, according to the act. But we're doing it now. So I'll agree with the member from Etobicoke—Lakeshore: Let's move on with it.

When Minister Smitherman introduced this bill, he basically said it delivers on the principle of accountability: accountability within the health care system for the services they provide and for the information that they're keepers of. This has to be with accountability to us, to the public, to the clients of those health care agencies.

This step toward accountability is welcome, but it should be said that a number of other government actions are also needed toward accountability: to bring accountability to all of the parts of the health care system, to the clients, to us, the public of Ontario, who use those services. The health protection information act is certainly one piece of it, but I would say there's still a lot to be done in that direction.

The act is an important and necessary act. Privacy legislation in Ontario was a long time in coming. Researchers told me that there were four bills during the Harris government that were actually submitted toward more accountability and protection of health information, but none of them could be agreed upon. Basically, the Personal Health Information Protection Act extends the federal privacy legislation, which did not, in our view, go far enough.

It outlined serious and important responsibilities for health care providers and agencies dealing with the protection, disclosure and transfer of people's private health information. When you talk to people about health information, everybody will agree that this is something that they feel is very private to them, this is something that should be handled with care, should be protected—and they should know about it. When they sign a consent, it should be an informed consent so they know who will have access to that information and who won't have access to that information.

Then it becomes the agency's and the provider's responsibility to make sure that those wishes and directions are followed according to the act.

The NDP supported the bill back in 2003-04, and we will continue to support its full and effective implementation. When the bill was first introduced we had some concerns. Most were addressed and changes were made to the bill to make it stronger. But one significant concern was not addressed. Our concern was about the financial cost of effectively implementing the bill. If you have a bill that the people, the providers, the agencies are not able to bring into effect, then you're not protecting anybody.

This concern was raised by the number of community-based agencies but mainly by mental health associations and mental health providers during the discussion about this bill. Many of those organizations were concerned that they lack the basic infrastructure, such things as computer systems, to meet their obligation to protect, to keep and, where appropriate, to share personal information.

We expressed concern that small agencies might find themselves in a serious position of unwittingly disclosing information due to the lack of resources necessary to comply with the bill. This is one illustration of why careful monitoring and review of the bill is very important, to see whether it is being implemented properly and how to better support organizations in its implementation in the future.

We, too, look forward to having a review of this bill. If there are agencies and providers in the field that are having a tough time, we should know what they are so we can take remedial action to make sure that the full intent of the act is being respected by everybody covered under the act.

Ontarians have reason to be concerned about whether their health information is being properly protected. The NDP has regularly expressed concern about the lack of oversight and public accountability, specifically within our public hospitals. We have argued that Ombudsman oversight power should be extended to all hospitals, and the government has resisted. I don't understand why. The Ombudsman himself has said repeatedly that he should have the power to investigate complaints that have to do with hospitals.

He receives hundreds of complaints every year about our hospitals, and unfortunately, he has to answer back that he hasn't got the power to investigate complaints coming from hospitals. When people have privacy complaints, there are steps to follow through the act, but other complaints should be under the mandate of the Ombudsman, and we would certainly hope that the minister will see that it is a big step toward accountability to give the Ombudsman oversight of what goes on in our hospitals so that he and his office can investigate complaints.

Protecting people's private personal health information is really protecting people's dignity, and yet almost daily we hear examples of practices in all sorts of health care agencies that really are an affront to the dignity of individuals. One need only read Joe Fiorito's column in the Sudbury Star in which he shares quite a few of the many stories of lack of human treatment in Ontario hospitals and other health care settings—a total lack of respect for their dignity. In part, this act is there to change this.

There are systemic issues within the health care system. I would see the shift toward interdisciplinary teams so that more people gain access to primary care. There are still hundreds of thousands of Ontarians right now who do not have access to primary care. They don't have a family physician. They don't have access to a community health centre or a nurse practitioner-led clinic. They just don't have access. Moving forward with interdisciplinary teams under the governance of communities would go a long way toward restoring the dignity of those people who are basically on the sidelines, who are looking out into our health care system, but not able to gain access.

My colleague from Etobicoke—Lakeshore, across the House, talked quite a bit about the importance of adoption of electronic health records. I can tell you that at my community health centre, when we put into place all of the changes that were required to comply with the Personal Health Information Protection Act, a big part of it was dealing with our electronic health records.

We wanted to make absolutely sure that whatever information we stored in the electronic health records was only available to the people it was intended to be available to; that when the client gives consent, they give consent to different providers for different information; and that all of this was properly captured by our electronic health records so that only the people who the client had given permission to could have access to that part of their chart, that part of their electronic health record.

I agree with her that having electronic health records throughout the health care system in Ontario would change forever a lot of what is happening on the ground with regard to the health care system. I agree with her that it would be very beneficial for people to have access to their records, to be able to review them and better understand and basically take ownership of their health and their treatment.

It would also facilitate communications between the different health care providers so that they better understand what has been done in another agency, in another part of the health care system—if somebody has been hospitalized, exactly what happened; if they went to a lab, gaining access to their lab results. And the list goes on, whether it be a mental health agency or long-term care or home care etc.

None of this is feasible in Ontario right now because very few have adopted an electronic health record although time after time many, including the Ontario Health Quality Council, have said this is the key to making our system better perform and also better protect the information, as this act is trying to do.

We also talk about the lack of adequate standards in long-term care and how this relates to lack of protection of human dignity. We've had many stories, most of them reported in the press, of family members who are really saddened by the type of treatment that they see their loved ones getting in long-term-care facilities. We have been asking for an average 3.5 hours of hands-on care for everybody in long-term-care settings. The acuity of the people in our long-term-care homes is such that they deserve and need a minimum average of 3.5 hours.

Yet the government is very slow to move on this, which means that here again the human dignity of those people, the founders of this province, the people who have built what we have today, is not being respected. This is something shameful and this is something that has to change.

Understaffing in community home care is another one. Home care tends to be the poor cousin, where the working conditions are not good, the benefits are not good, the wages are not as good, yet those are the same providers; a nurse is a nurse no matter if he or she works in a hospital setting, in home care, in long-term care or in community-based care, yet a nurse can get way better wages and benefits if she works in a hospital setting than if she works in home care.

People will tell you that here again lots of the problems that we see within our emergency rooms, problems that we see within our hospitals are because of the weakness of our home care system. If we did a better job at maintaining people in their homes, that would go a long way towards preventing those people running into problems, having to access emergency rooms and ending up in a hospital bed where they are labelled as "alternative level of care." They are in a hospital but that's not where they should be, and that's not where the best care is for them.

At the base of it all is that if you ask, most of those people will tell you, "I want to stay home, but to stay home I need the proper support." Here again the basic dignity of those people is not being respected. We're not supporting them in their homes the way we should. They end up with problems, they end up in emergency rooms and they end up in a hospital bed—not the way the system should work, and again a lack of dignity to those people who needed us.

Yes, we need to treat people's information carefully and professionally. But we also need to ensure that people are treated justly and caringly.

In

summary, we look forward to seeing the results of a comprehensive review of this act. We hope very much that the report will be released within one year, something that is even more important, given that the review is so late in being started in the first place. We also hope that this will be the first step to a general improvement of monitoring and accountability of health care facilities, not just to ensure proper control of information, but proper and dignified treatment of people themselves.

Il me fait plaisir ce matin de vous parler de la

Loi sur la protection des renseignements personnels sur la santé. Selon la loi, nous devons faire une revue de cette loi. Cette revue devait être entreprise l'année dernière. Malheureusement, on est pas mal en retard, et on la commence cette année, mais mieux vaut tard que jamais.

La revue de la

Loi sur la protection des renseignements personnels sur la santé va nous permettre de nous assurer que toutes les agences et ceux qui ont la responsabilité de garantir l'accès à l'information ont les ressources nécessaires pour le faire et ont été capables de le faire d'une façon efficace dans toutes les parties du système. Lorsque la loi a été proposée, nous, les néo-démocrates, avons proposé plusieurs changements, et le gouvernement a écouté et a adopté la plupart des ces changements-là.

Par contre, il y a quand même une

partie qui nous laisse un peu perplexe : est-ce que toutes les agences, surtout les petites agences, et ici je parle surtout des petites agences de soins de santé mentale, ont les ressources nécessaires pour être sûrs qu'elles sont conformes à la loi ? Plusieurs de ces petites agences nous disent qu'elles n'ont même pas l'infrastructure nécessaire—ici on parle d'ordinateurs et de choses comme ça—pour s'assurer que l'information est gardée de façon sécuritaire.

On peut lire dans les journaux plusieurs fois des exemples où des personnes n'ont pas été traitées avec dignité dans notre système de santé. On parle ici des foyers de soins de longue durée, dans les hôpitaux. Plusieurs de ces histoires font les manchettes des journaux.

Quand on parle de protection des renseignements personnels sur la santé, on parle également de protection de la dignité humaine. Nos renseignements personnels sur notre santé, ce n'est pas des choses qu'on veut partager avec tous et chacun. C'est des choses pour lesquelles on doit être capable de dire, « Cette information-là, je suis d'accord de la partager avec tel et tel professionnel, mais je ne veux la partager avec d'autres. »

Ça, c'est notre droit absolu. Ça, c'est ce que la loi nous permet de faire. Mais dans la vie quotidienne de ceux qui offrent ce type de protection, ils doivent avoir les ressources nécessaires pour le faire. On parle ici non seulement de protection des droits, mais on parle également de protection de notre dignité humaine.

En revenant aux histoires qui se retrouvent souvent dans les manchettes, j'aimerais mettre l'accent plus précisément sur les organismes de soins de longue durée. Les maisons de soins de longue durée ont demandé depuis longtemps au gouvernement provincial de recevoir un minimum de 3,5 heures de soins personnels par bénéficiaire. Malheureusement, on est encore loin de là, bien que le niveau de besoins des gens dans les maisons de soins infirmiers continue d'augmenter.

Il y a quelques années de ça, on n'aurait jamais pensé que quelqu'un qui recevait de l'oxygène se retrouverait dans une maison de soins de longue durée. Avant, ces gens-là devaient demeurer à l'hôpital. Maintenant, on en voit de façon courante. Même chose avec des gens qui ont des problèmes d'alimentation : avant ça, ces gens-la devaient demeurer à l'hôpital. Maintenant, on en voit de plus en plus dans les maisons de soins infirmiers, et c'est un pas dans la bonne direction.

Ces maisons-là sont faites justement pour essayer d'être des maisons. C'est une résidence. Donc, c'est quelque chose de bien, mais il faut quand même être en mesure d'avoir les ressources nécessaires pour venir à bout de rencontrer les besoins toujours croissants de ces gens-là. Ça, c'est pour protéger la dignité autant de ce qu'on essaie de faire avec notre projet de loi.

Un autre aspect que l'on aimerait voir augmenter, c'est les pratiques interdisciplinaires. En ce moment en Ontario, il y a des centaines de milliers d'Ontariens et d'Ontariennes qui n'ont pas accès au soins de santé, qui n'ont ni médecin de famille, ni accès à un centre de santé communautaire, ni accès à une clinique d'infirmières praticiennes. Parce qu'ils n'ont pas accès, ils sont à l'extérieur, et vraiment nous regardent de l'intérieur.

Ça pourrait changer, et ça pourrait changer vite, en mettant en place des équipes interdisciplinaires qui sont gouvernées par la communauté pour s'assurer que dans les petites communautés, qu'elles soient rurales ou du nord, où il y a souvent un problème de pénurie, si le médecin vient puis repart, le centre, lui, qui est gouverné par la communauté, demeurerait là pour s'assurer que ces gens-là continuent d'avoir accès : continuent d'avoir accès à leur dossier médical, continuent d'avoir accès aux autres pourvoyeurs de soins de santé pendant que le recrutement continue.

On parle également d'avoir un mécanisme pour investiguer les plaintes, et là, on parle de l'ombudsman. Ici en Ontario, l'ombudsman demande le pouvoir d'investiguer les plaintes dans les hôpitaux depuis longtemps. Nous, les néo-démocrates, on le demande au ministre de la Santé depuis des mois. Je pense qu'il n'y a pas une semaine que je ne me lève pas à la Chambre pour demander au ministre de la Santé d'accorder à l'ombudsman le droit d'investiguer les plaintes dans les hôpitaux. Malheureusement, pour une raison ou une autre, le gouvernement refuse.

Bien que l'ombudsman ne puisse pas investiguer les plaintes, il reçoit quand même des centaines de plaintes à chaque année envers les hôpitaux. Malheureusement, tout ce qu'il peut répondre, c'est qu'il n'a pas juridiction. Ça aussi amènerait le système de santé un pas plus loin, et il serait important que ce soit mis en place.

En somme, nous, les néo-démocrates, appuyons la revue de la

Loi sur la protection des renseignements personnels en matière de santé. On pense que c'est une loi importante. Les agences de santé ont travaillé fort afin de la mettre en place et de s'assurer que toutes les parties de la loi étaient respectées parce que c'est quelque chose de bien pour nous, les consommateurs, les clients, pour ceux qui vont demander des services de santé. Mais une revue est importante pour s'assurer que toutes les parties du système ont été capables de la mettre en œuvre et ont des ressources nécessaires afin de la mettre en œuvre de façon cohésive et cohérente.

Donc, pour nous, la revue de cette loi servira à s'assurer qu'elle est bien en place, mais à s'assurer également un pas de plus envers le respect de la dignité des gens qui ont besoin du système.

Mr. Shafiq Qaadri: I think it's very important that we, as a Legislature as well as the government, move forward on this very important motion on the Personal Health Information Protection Act and improvements that will no doubt occur subsequent to its passage, as well as review.

The idea of information privacy is of course one that physicians are taught very early in medical school, as custodians, as stewards of what is no doubt the most personal, significant and impactful information there is about individuals—way beyond, by the way, credit cards, social insurance numbers, alarm code keys or whatever—information that deals with individuals and their personal health. By the way, Speaker, as all of us mourn, as you know, the loss of one of our chief medical officers of health, Dr. Sheela Basrur, all of this really underlines the fact of how important and personally significant this type of information is.

This has been true through the ages, and certainly when we were going to medical school about 20-plus years ago, but I think it's even more accented and highlighted now that we are truly in the information age.

I'll give you some personal examples. A patient who comes to a medical office, to a family physician, will no doubt share with them all sorts of information about their personal background, about their genetic history, about family problems, be they genetic or social. For example, are there conditions of things like alcoholism or depression or Alzheimer's within the family? Then the family physician will, hopefully, do an excellent physical examination, probing and prodding and measuring and essentially cataloguing all the various findings from top to bottom.

Then the patient will be asked to undergo a number of tests, whether it is with regard to blood or any kind of radiology imaging—for example, ultrasounds or what we call upper GI series. We really want to have a look at the insides as best we can.

Then comes the small matter of the results that we have to share with the patient. Of course, there is a certain amount of finesse, sensitivity, humanity and regard for a fellow human being who is, no doubt, at their most vulnerable. All of that information can literally make or break the person's day, the person's year and the person's life.

That sort of information, whether it is shared with the individual alone—there are people we will be diagnosed with very significant conditions, be it cancer or HIV or chronic hepatitis B or any number of conditions, and very often they do not want that kind of information disseminated to the public, but perhaps even to members of their own family or their own circle. Of course, there is legislation that governs those kinds of rules as well.

Altogether, these are very significant pieces of information. Therefore I think it's only appropriate that, as a provincial Legislature that has oversight for health care, we bring to bear our collective wisdom and initiatives and stakeholder consultations to make sure that we have the best legislative framework we can—the rules that govern this particular domain.

One of the privileges but also challenges of being a family physician is that you will actually have multiple generations of the same family. I've had even four generations of the same family: the great-grandparents, grandparents, parents and the kids. When you discover particular conditions or if, let's say, a teenage girl wants to come in and access various forms of medication, sometimes other members of the family will actually ask and try to intrude into the discussion. Again, there are very specific rules—and they're age-based, of course, in terms of age of consent—that govern all family physicians' conduct in these matters.

It goes beyond just the idea of conduct in an office setting, though. There are rules that actually talk about the protection of this information, be it the digital version or the hard copy version, for years and years after that patient encounter. I think there are probably a number of reasons why that information is kept available or made available.

For example, perhaps subsequent to the physician encounter, maybe two or three years hence, there may be an issue—whether it's medical or legal or maybe the individual is now up for kidney transplantation or heart transplantation or blood transfusion or any other number of scenarios—and there may be the necessity for actual review of those particular medical records. So there is very specific legislation in place that actually governs how those records are kept even decades after that initial patient encounter.

The other thing that's very interesting is that patients who will be diagnosed with things like elements of the cardiometabolic syndrome, basically the evils of obesity—none of my colleagues or members need think that I'm speaking of them specifically, although they often come and talk to me afterward. Elements of the cardiometabolic syndrome show elevated sugars, cholesterol, blood pressure, waist circumference and so on. They will often say, "Doc, please don't release this information to anybody, or if my insurance company calls"—or if this office or that office or an employer or anyone else calls.

Of course, what's always interesting and amusing is that we have to reassure the patient that until they allow us, with a signature on a specific form that essentially allows to us release that information, not even the Prime Minister of Canada, the Premier of the province, or even your own esteemed office, Speaker, can ask for that information without actual written consent. That is part of the law of Ontario, and of course other jurisdictions in this country, to protect the privacy of this very personal and deeply impactful medical information.

I say that to you as part of the larger context under which the medical information flows. But now I speak to you about the digital age, because all of those pieces of information that I was mentioning—whether it is lab tests; the results of radiology exams; pap smears; HIV testing; VD testing or any number of other tests; or, for example, the patient's own patient record, meaning the encounter with the patient, whether it's by the way of a psychiatric nature or a depressive nature—all of these things are now going digital.

This, of course, is not only increasing the flow of information, but the traffic and the points of intersection and the areas of flow are now literally increasing exponentially.

Very often, for example, some of us are signed up to alerts that are sent to us by e-mail. Let's say there's a patient who comes in and we're vaguely dealing with the condition of some kind of chest pain. We send the patient off for an electrocardiogram and cholesterol tests. We try to match their risk in terms of their overall picture. As family doctors, we have no doubt been watching them, tracking them and following them for years on end, and something is going on, some vague kind of chest pain.

Some of us are actually now signed up to e-mail alerts where the laboratory in question will send us directly, or possibly fax us directly, and/or all of the above, that there are some conditions that are very important and need to be acted on on an immediate basis.

That, of course, opens up a whole opportunity, unfortunately, for missed calls, misinformation, disinformation and the incorrect spread of that information. For example, some physicians will inevitability receive information about patients who are not their own. Sometimes it comes because you happen to be in the same building. Sometime it comes because perhaps your e-mail happens to mimic others. All of these issues are now in play and are amplified and accentuated because of the digital age in which we live.

It's extremely important that we talk about, as I say, this very deeply impactful personal information, as well as the whole area, which is a major discipline in and of itself: the idea of patient confidentiality; the consent that is required for a physician to actually release, use, redirect that information; the very personal and intense rules that govern physicians' custodial responsibility or stewardship of these records, whether it is access requests from individuals, other members of the family, other institutions, insurers and employers; and, of course, the overlay that is now so important because of the digital age that we are now in.

That's why, as Minister Bryant and others have talked about, it's extremely important for us to move forward, not only with this motion but also the review that it will eventually lead to.

Having said that, I think it's important for us to review the fact that the Personal Health Information Protection Act, 2004, was actually regarded as a model and really understood, incorporated and responded to, and talked to the idea that the management of health care information is of course changing, evolving, self-regulating and self-upgrading.

Part of what this motion speaks to is the idea that a legislative committee will actually allow us to consult with patients and stakeholders. And no doubt, as part of that consultation, we're going to have a relatively healthy dose of consultation with digital software providers, because time and time again we hear in the press and in the newspaper and elsewhere the idea not only of the sanctity of digital information but unfortunately the opposite: how it seems to be relatively easy to make off with it, to actually steal it, whether it's personal information, banking information or even the whole idea of identity theft.

This particular privacy act came into force, as you'll recall, on November 1, 2004, and has some fairly intense specifications for the rules, the usage and the ability to redirect and disclose personal health information by terms that need to be specified and amplified: "health information custodians," which of course include doctors, laboratories, long-term-care homes and hospitals.

I'll give you an example. I had the opportunity recently of chairing a medical conference on a new domain that is just becoming better and better appreciated in Ontario. It talked about cardiovascular disease, or heart and blood vessel disease, that is now unfortunately exploding. It now, by the way, accounts for something in the order of 40% of all the deaths in Canada. But one of the spins or skews or nuances that we're learning is that one of the risk factors, along with the usual suspects of blood pressure, smoking and obesity, happens to be one's ethnocultural background.

The Heart and Stroke Foundation has actually just allocated fairly significant resources to go after the health information on some of these areas for specific communities—for example, aboriginals, the Chinese population, the black population and South Asians.

I just say that to you in terms of the background, but what was extremely interesting is that one of our American colleagues, a physician, came back and said, "Listen, if there is a higher risk of cardiovascular heart and stroke disease in these particular populations"—and of course, God bless America, it's kind of an American question—"do we really want to tell anybody? Do we want to disclose this information?" Because from the American perspective, he was talking about a person's insurability, a person's ability to actually get health coverage. Of course, that's an entirely different kind of debate.

In America, it seems they were interested in perhaps the opposite—once again, God bless America—in terms of the suppression, shall we say, or the very specific targeted use of this kind of health care information.

In any case, all of these various issues, whether it is the extraordinary exponential flow that we now see on a day-to-day basis of information in the digital age, the very important regulations that we have been brought up on and are still living on and that still resonate in our medical offices with regard to privacy and patient confidentiality or the release of documentation, be it in the public domain, the private domain, electronically by fax and so on, I would say the deeper responsibility that we have as a Legislature is to make sure that the stewardship of this information accounts for all of these different issues and struggles and initiatives and challenges.

With that, I would urge members of this House to support this particular motion that was brought forward by our government so that we can offer best practices on the personal health information protection domain.

Mrs. Elizabeth Witmer: I'm going to share some words on behalf of our party regarding this motion dealing with the Personal Health Information Protection Act, 2004, which is going to be reviewed, in this motion, by the Standing Committee on Social Policy. That committee, once this motion is passed, will have the opportunity to report back to the House its opinions, observations and recommendations concerning amendments to this 2004 act.

I think it's already been mentioned that this review is necessary and it is, as has already been mentioned, overdue. It deals with the protection of personal, private health information. We have heard this morning repeatedly that people obviously want and require that their personal health information be protected at all costs. Certainly, the government in the province of Ontario has an obligation to make sure that happens.

This particular legislation dealing with the protection of personal health information—we have been trying to draft legislation since about the year 2000 and we are now at a point where we have legislation and we need to review the legislation. I don't anticipate that this review is going to result in a major overhaul of the act, but I think what this review will enable us to do is to ensure that the legislation is effective as we move towards the establishment of a province-wide e-health system. I guess that's what we are looking forward to.

That is a priority. Unfortunately, it is a priority that we have not yet seen the realization of in this province. But certainly coming out of this review, if not before, this government must—and I stress the word "must" because this is what we're doing and why we're doing it—clearly communicate to the public, the Legislature and the committee information as to where we are going with electronic health records. Of course, when this electronic health system is in place, we need to ensure that this legislation that we are reviewing is going to be adequate to maximize the potential of electronic health records.

We need to ensure that the legislation we are reviewing is adequate to protect the private, personal health information of Ontarians. I guess that is the missing information that we still don't have. What progress is being made on electronic health records? We really need that information in order to do the review that we are undertaking, and I think that's really been the missing ingredient.

This government spent $647 million on the Smart Systems for Health Agency between 2002 and 2008. This is a considerable amount of money, and we still don't know when people in this province can expect a full electronic health system that will give every person in the province a health record that all authorized health care workers can access. We do not have any final decisions on timelines or announcements on timelines for the full implementation of the electronic health record.

Regrettably, if we don't have that information, this review will not do all that is necessary, and that is ensuring that it's going to adequately protect the information in preparation for the full implementation of electronic health records.

Deloitte did a review of the Smart Systems for Health Agency in 2006, and regrettably that review indicated that despite the fact that this government has spent millions of taxpayers' dollars, there was still no strategic direction and the government didn't seem to be accountable for any of the spending and really had nothing to show for it. In fact, the report found that "significant questions exist relating to the effectiveness of certain decisions and the value obtained from significant investments." The report called for "an aggressive agency turn-around plan."

This electronic health record, which still has no timelines or goals, would help us to bridge physical distances, it would help us to penetrate the silos, it would allow for unprecedented communication amongst health care providers, and it would have tremendous benefit to patients. They'd be more informed. There would be the whole issue of safety. It would allow them to move also in a seamless transition along a continuum of care.

It would mean that no matter where you travel in this great province, if you become ill and require any services at any emergency ward, that ward will have all the information that pertains to your personal health history. That would save us tremendous costs because we wouldn't have to repeat tests, but, more importantly, it would ensure that all of the health care providers in this province who are entitled to your information have it available when it comes to your treatment.

Regrettably, we don't know when that electronic health record is going to be available for people in Ontario because we've not seen any timelines and we don't know what the goals are. In fact, we don't see any announcements of timelines.

In 2007, the Ontario Information and Privacy Commissioner, Ann Cavoukian, confirmed what I have just said, and that was that Ontario is far behind other provinces when it comes to implementing electronic health records. According to Canada Health Infoway, Ontario lags far behind other jurisdictions such as, for example, Alberta, British Columbia and, on the east coast, PEI, regarding the implementation and adoption of electronic health records. If we take a look at Alberta, they have an electronic health record system in place, and they hope to have all people in that province on the record by the end of 2008.

We don't have any timelines at all. If we take a look at British Columbia, they intend to build the infrastructure they need to develop a province-wide electronic system by 2009.

I think we can see that in Ontario, unfortunately, the health system is falling behind. We see this when it comes to doctors and the growing doctor shortage, and the fact that in 2005, we saw doctors leaving this province for the first time ever, really. In 2007, the number of doctors leaving this province to go to other provinces had tripled. We've seen the government's lack of action on C. difficile. We've seen that they failed to introduce the PET scanner, a new piece of diagnostic equipment which is available in provinces such as Alberta and British Columbia.

This province, when it comes to health, is falling behind. We're increasingly seeing gaps in our health care system. We know that the poll that was taken by SES just before the end of last year indicated that over 60% of the people in this province weren't seeing any improvements to the health system.

If we talk about e-health, in April 2007, Tony Fell, who was chairman of RBC Capital Markets, resigned from the Toronto Central LHIN because, as he said, he was "extremely disappointed with the low priority that had been accorded by the Liberal government to e-health." According to Fell, "An advanced e-health system could save many billions of dollars annually while, at the same time, providing vastly improved service and care to our citizens and a major reduction in medical errors." That was April 19, 2007, in the Toronto Star.

In 2008, the Ontario Hospital Association also reported that, "The evolution of e-health in Ontario has been hindered by the absence of a health system funding approach that recognizes e-health as a strategic investment priority." The OHA believes that "the current funding environment does not effectively support the adoption, collaboration and integration necessary to enable the timely realization of e-health's true value." According to the OHA report, "Improved availability, integration and communication of health care information will result in improved care for those with chronic diseases...." There are so many people in the province today—I want to deal with that a little later, about the impact of e-health on chronic disease.

They also said that if we had it, it would create "greater efficiency in interactions with patients, improved patient safety"—and, a very important fourth point—"improved patient participation in their own health...." This is critical.

Currently, if you try accessing the e-health strategy, you aren't going to get much except a phone directory.

Who else had something to say about the government's inaction, lack of timelines or goals towards the e-health strategy? The quality council. The quality council was quite critical of the government regarding the lack of activity and, again, they came back to the fact that it would enable the ministry to focus on the prevention and the management of diabetes and other chronic diseases. Also, e-health investments would support the government's diabetes strategy in the shorter term and form the foundation for the longer-term goal of creating electronic health records for all Ontarians.

In fact, when the Ontario Health Quality Council released their report recently, the council chairman, Ray Hession, said, "Ontario needs a province-wide electronic health records system to better monitor and treat patients with chronic disease." They actually went on to say that nearly 8,000 lives in this province could be saved annually if the province did better testing, treating and monitoring of patients with such diseases as diabetes and heart disease.

They indicated that currently, slightly less than half of those with diabetes have their blood sugar under control, while only 28% of patients with diabetes and high blood pressure have their blood pressure under control. As well, only one in three patients with coronary artery disease received all three drugs—Aspirin, beta-blockers and cholesterol-reducing medications—recommended to prevent their vessels from clogging.

We know what is necessary to deal with these chronic diseases. Electronic health records throughout the province would help us to better monitor and treat these patients. But Mr. Hession also said that the government has not released a plan with a budget and targets to "'get us from where we are to where it's widely accepted we ought to be. In the absence of that, it doesn't matter what we say about when it's going to happen,' he said." If there are no such prerequisites in place, it won't happen, and that is our concern.

Now, this is the Ontario Health Quality Council that was set up to look after what progress we are making, and in this instance they found there were failings in Ontario's e-health system: that the government had no plan, had no timelines, and as a result, lives that could be saved were simply not being saved.

We have no idea how the government plans to achieve its targets; we just know that we haven't seen any timelines. It is most regrettable that they are so slow when we know that this system could deliver better health care. I've just pointed out what actually could happen.

I'm going to conclude my remarks. I think we recognize that this review that we're undertaking is necessary. It is overdue. It will give our stakeholders an opportunity to tell us about the effectiveness of the legislation and what improvements need to be made. But it will do so because we are moving forward, we hope, to the establishment of a province-wide e-health system. We just don't know when that will happen.

Really, in the absence of that type of information, we probably aren't going to do total justice in this review, because it's going to be impossible to adequately ensure for what is ahead of us that we can adequately protect these electronic health records. At the end of the day, we need to have information about where we are with electronic health records, what are the timelines that the government has in place, when they are going to make announcements about the timelines, and what is their goal.

Because without that information, we'll never know whether this review of the legislation is going to adequately protect the privacy of Ontarians. We'll support this, but we certainly hope that in the interim, the government comes forward with a plan of action for electronic health records.

Mr. Bob Delaney: I'm pleased to join the debate on a subject that I find very interesting, that is, the government's notice of motion on PHIPA. Does the fact that a behaviour is permissible make it mandatory? And, indeed, does the existence of a technology or a capability mean that it must be either compulsory or forbidden? This is, I think, what this motion seeks to address. And while I'm not a lawyer and I don't bring a legal mind into the considerations, I was trained in science and mathematics, so I can bring an opportunity to apply some logic.

If one looks at where this motion is taking us, Ontario, with its aging population, is going to be looking at roughly twice the number of seniors in the next generation that we have now. With the evolution of technology, we're seeing the technology of connectivity and bandwidth expanding greatly, thus giving us the ability to look at data and health records in a manner in which, as we grew up, we couldn't even imagine. Add to this the technological savvy of not merely doctors, but also their patients, and what we have is the ability to share health records in a manner in which we have never been able to do so before.

The sophistication and stability of networks, distributed storage and delivery platforms using such applications as the browser and Internet portals will mean that health information that heretofore existed in silos is going to be something that doctors and their patients can use to advance the standards of care.

What this motion seeks to do is to bring together a body of knowledge and to position us not so much where we are now, but where we would like to be in 10 and 15 years, in which doctors and their patients can collaborate in ways that we're only beginning to imagine now, and do so in a manner in which a doctor and his or her patients can collaboratively determine where they're going in their treatment and how to share their diagnostics. I think this is a good, forward-looking motion that deserves the support of this Legislature.

The Acting Speaker (Mr. Ted Arnott): Further debate?

Mr. Wilkinson has moved government notice of motion number 60. Is it the pleasure of the House that the motion carry?

All those in favour of the motion will please say "aye."

All those opposed will please say "nay."

In my opinion, the ayes have it. I declare the motion carried.

Agreed to.

Hon. David Caplan: Mr. Speaker, I seek consent of the House to recess until 10:45 of the clock.

The Acting Speaker (Mr. Ted Arnott): Is there such consent? Agreed? Agreed. This House stands in recess until 10:45 a.m.

The House recessed from 1022 to 1045.

INTRODUCTION OF VISITORS

The Speaker (Hon. Steve Peters): We have a number of guests we'd like to introduce this morning and welcome everyone to Queen's Park.

On behalf of the member from Beaches—East York: Carmen Carrasco, Cheryl Duggan, Ken MacLeod, Sharon McPherson, Chris Sartor, Nancy Van der Plaats, Kyle Vose and Mike Yale, in the west members' gallery.

On behalf of the member from Parkdale—High Park: Choesang Dhenub, Tsering Dolma, Jigdel Kuyee, Tenzin Nyendak. These are members of the Friends of Tibet, in the west members' gallery.

On behalf of the member from Lanark—Frontenac—Lennox and Addington, I'd like to welcome in the public gallery today members of the Ontario Landowners Association, visiting from approximately 30 counties.

On behalf of the member from Oakville, I'd like to welcome the guests of page Natalie LaMarche: her mother, Shaida Tabatabai; David LaMarche, her father; Mina Hunt, her aunt. They are in the members' east gallery.

On behalf of the member from Glengarry—Prescott—Russell: in the east members' gallery, Richard Lalonde, Jeanne Charlebois, Conrad Lamadeleine, Jean-Yves Lalonde, Gary Barton, Robert Kirby, Denis Pommainville, Ken Hill, Grant Crack and Stephane Parisien. These are guests visiting today from the member's riding, and it's Glengarry—Prescott—Russell day here today.

MEMBER FOR GLENGARRY—PRESCOTT—RUSSELL

The Speaker (Hon. Steve Peters): I'd just like to take this opportunity as well: Today is a special anniversary for the member from Glengarry—Prescott—Russell. Today marks Jean-Marc Lalonde's 38th anniversary in public life. Let's acknowledge Jean-Marc and his contribution.

Applause.

ORAL QUESTIONS

AUTOMOTIVE INDUSTRY

Mr. Jerry J. Ouellette: My question is to the Premier. Premier, I could stand here today and blame your government for the impact on the auto sector over and over again, but it's not going to resolve one issue, and that's the issue of jobs and support for the number one industry in the province of Ontario. Premier, you've mentioned the plan that you have in supporting the auto sector and how it's going to ensure that we have jobs for future generations in the number one employer. Today's announcement at General Motors in Oshawa is only the beginning.

We're going to see five or seven times the number of those announcements coming forward as the support industries for that particular industry announce their layoffs.

Premier, the plan isn't working. Do you have an alternative form or way to support the auto sector in the province of Ontario?

Hon. Dalton McGuinty: Let me first of all say that our hearts go out to the workers affected by today's announcement from GM. My friend opposite will know that GM has decided, because truck and SUV sales have plummeted by 40% in the last year alone, that they are closing plants: two in the US; one in Mexico, which is rather extraordinary; and one here in Ontario.

We will do everything we can to lend support to those workers and those families. We understand that this is a particularly difficult time, but I'm also mindful of the advice I received from a worker recently in Windsor. When I said, "What can we do for you?" he said, "Keep fighting for the auto sector in Ontario." We intend to do exactly that.

Mr. Jerry J. Ouellette: Premier, certain sectors of the plan don't appear to be working. For example, the taxation of ethanol is one small method of deterring the sale of ethanol—which supports the E85, which is 85% ethanol—a method of deterring the sales of technology-leading advantages that General Motors and the other Big Three would have in the province of Ontario. Small things like that or just-in-time delivery service, with the cost of fuel, are not necessarily the way to go.

What I'd mentioned before in this Legislature was that we need alternative methods to support just-in-time delivery service such as having taxation for warehousing to make it more cost-effective, because bringing goods in from other jurisdictions may not be the way to go. We need to think outside the box and find alternative methods to support this. Do you have some other plan that we can look at and work on with you to make sure that the number one employer in the province of Ontario stays the number one employer?

Hon. Dalton McGuinty: I appreciate and do not doubt for a moment the sincerity of the offer coming from this particular member. But I can tell you, from day to day, it's hard to know where the Conservative Party is coming from on this score. Their single, most important economic priority is that we cut taxes, corporate taxes in particular. I can tell you, in talking to GM right now, they're not paying corporate taxes because they're not making a profit. They were paying capital taxes until we eliminated capital taxes for them, and they voted against that.

So it is difficult, from time to time, from day to day, from question period to question period, to know where they are coming from on this score.

I can say that we will continue to work with GM. Because we have invested together with them in their new Beacon project, which is a new flex plant, that means we are at the front of the line when it comes to landing a new car manufacturing investment in Ontario.

Mr. Jerry J. Ouellette: Premier, we've brought forward a number of alternatives. I've raised this issue in the Legislature on a number of occasions going back years. I have brought forward things such as the fuel-consumption tax as a method to reduce the taxation on some aspects, as a gesture to the auto sector, and particularly the truck plant in Oshawa, as one way of support.

In a previous government, one of the Premiers came forward with an all-party committee to address issues called the alternative fuel committee. Would you consider looking at an all-party committee on the auto sector and the number one employer on how we can move forward in making sure that it remains the number one employer in the province of Ontario?

Hon. Dalton McGuinty: We're pleased to give real consideration to this idea, but I must say that when we spoke with the auto manufacturers, they told us that their number one concern was capital taxes. They told us their second concern was business education taxes. We've also come to understand that, at the beginning of the 21st century, in a world where one of the states was prepared to put up $1 billion to land a new key investment, we have got to be at the table.

I would prefer to be at the table together with a strong partner in the federal government, so that we can work together to further strengthen the auto sector in Ontario. But until that day comes, I'm more than prepared to work with my colleague opposite, to continue working with the CAW and to continue to work with our auto manufacturers to ensure that we have a bright and vibrant future for our auto sector in the province of Ontario.

INFECTIOUS DISEASE CONTROL

Mrs. Elizabeth Witmer: My question is to the Minister of Health, who has taken a very incredulous position on C. difficile and the crisis in recent weeks. Minister, you have known since at least 2004 about the threat of C. difficile, but you have not developed a plan nor have you revealed the numbers.

We learned that between October 2006 and September 2007, 14 patients at University Health Network in Toronto died from C. difficile. At Mount Sinai, between April 2007 and March 2008, it contributed to three deaths.

Minister, we were able to get these numbers by simply contacting the hospitals. You can't continue to stonewall and say you don't have this information. I ask you: Will you release the C. difficile fatality figures today?

Hon. George Smitherman: As the honourable member would know, firstly—she talks about a crisis in the context of the last few weeks, and this is the difficulty with the approach by the honourable member, because maybe that's when she was first alerted to it, but the health care system has been working diligently on this issue for a long time. I've been in contact over the last few days, as an example, with some of the hospital CEOs, just to go through, step by step, the initiatives they've taken in their hospital environments. They've been grappling, struggling and working hard to address this challenge over several years.

On the matter of reporting, the honourable member knows that on September 30 we'll be implementing real-time reporting on C. difficile rates across the broad hospital platform in Ontario. That will be the first time that all that information is brought together in one place. I think that, under the leadership of Dr. Baker, this is going to dramatically enhance the amount of information that the public knows about patient safety circumstances in all of our hospitals.

Mrs. Elizabeth Witmer: The confidence in the health system in the province of Ontario has been badly shaken in recent weeks and months.

Today, we learn—in fact, the media just had a big story in the papers and on TV; I was watching—there are seven more C. difficile outbreaks at St. Michael's Hospital in Toronto and there are outbreaks at Stevenson hospital in Alliston.

Ontarians know what is happening, but you are not providing any comfort or consolation to them that you know what's going on and that you have a plan for their future. I ask you today, Minister: Will you develop a plan and will you let us know why you have failed the test of leadership these past four years?

Hon. George Smitherman: It's interesting to watch the honourable member, whose tenure as Minister of Health led to the dismissal of her government, talk about confidence and about leadership.

Ontarians know that the steps we've taken will dramatically enhance the amount of information that the public has with respect to a broad range of patient safety indicators.

We put out this release last week. I'll repeat it for the honourable member. On September 30, we'll have public reporting of C. difficile; on December 31, MRSA, VRE and hospital standardized mortality rates; and on April 30 of next year, rates of ventilator-associated pneumonia, rates of central line infections, rates of surgical site infections, and hand hygiene compliance.

Where the honourable member continues to miss the mark is that C. difficile has been well known as a struggle and a challenge in health care, and that's why those who lead our health care organizations have been working to address it in each of the 157 hospitals across Ontario. This is not a crisis just of the last few weeks; this has been an ongoing challenge.

Mrs. Elizabeth Witmer: The minister has one thing right: This has been an ongoing challenge. Unfortunately, he has refused to assume any responsibility. As a former Minister of Health, I know that the buck stops and starts with the minister. He has been evading his responsibility and the need to be accountable to the people in the province.

When SARS broke out, our government acted quickly in order to restore confidence in the health system, and we had the support of leaders in this province.

Minister, when are you finally going to take responsibility for the fact and not blame the hospitals or the front-line workers but acknowledge that it was your inaction over the past four years that has shattered the confidence?

Hon. George Smitherman: It's a ridiculous assertion that the honourable member makes. The health care system, including me, the ministry, all of those 300,000 or 400,000 people who work in health care—we all bear responsibility for improved performance and enhancing patient safety in health care. I bear part of that responsibility, of course, but it's not appropriate for the honourable member to pretend that it's about a piece of paper from Queen's Park when it requires front-line battling every single day by those who lead health care organizations. The honourable member, as a former Minister of Health, knows that and she knows it very, very well.

The initiatives that we're taking, under the leadership of Dr. Baker, will provide for Ontarians a degree of transparency which will dramatically enhance the knowledge that they have about a wide variety of patient safety—

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

AUTOMOTIVE INDUSTRY

Mr. Howard Hampton: My question is for the Premier. Premier, this morning General Motors announced it is closing the truck plant in Oshawa, eliminating the final 1,000 jobs there. This comes after General Motors received a $235-million cheque from the McGuinty government. The money is gone, and because there were no job guarantees, there will be 2,500 fewer jobs at the Oshawa truck plant than existed before you handed over the money. Can the Premier explain why the McGuinty government gave General Motors $235 million without getting job guarantees from General Motors in return?

Hon. Dalton McGuinty: First, I want to take the opportunity once again to acknowledge the tremendous contribution that the auto worker makes to the Ontario economy.

One of the things that the GM executives told me when I was briefed on this issue this past Sunday was that we continue to excel when it comes to quality and productivity, which is all about how quickly we can produce that quality.

I also want to take this opportunity to commend the CAW for the recent agreements it has entered into with some of our auto manufacturers and for the concessions they have made, which have been very realistic in a very trying time.

Mr. Howard Hampton: I was listening hard for an answer there. The question was, how could the McGuinty government give $235 million to General Motors, a huge multinational corporation, and get no job guarantees? I've asked that question for weeks and still don't have an answer.

The news is actually worse, because chief executive officer Wagoner said the plant will cease production in 2009 and "we don't have plans to allocate future products." This means it's a permanent closure. This means thousands of parts jobs will go as well.

Will the Premier finally admit that giving General Motors $235 million of public money without getting job guarantees in return was not a very good jobs strategy?

Hon. Dalton McGuinty: I think a few facts on this score would be helpful.

We landed a $2.5-billion investment; it's called the Beacon project. There was a $235-million co-investment; $60 million of that went to universities to help them conduct research to help us land the next-generation vehicle. All the remaining money that went to GM was a loan. That's point number one.

Secondly, although it was a car production facility, we looped in the truck plant so that if there were job losses in the truck plant, there would be early repayment of that loan required. If GM is, in fact, in breach of that agreement, then we will enforce it as such and seek early repayment on that loan.

Mr. Howard Hampton: This story becomes more interesting every day. When this announcement was originally made by the Minister of Economic Development and Trade three years ago, he said that this was going to guarantee thousands of jobs for GM workers in Oshawa, in St. Catharines, across Ontario. Then we found out there were no job guarantees. A few weeks ago, the Minister of Economic Development and Trade said they weren't in breach of any obligations. Now, today, the Premier says it was a loan and there is a breach.

Premier, can you tell us how much of the money is going to come back to Ontario, when is it going to come back to Ontario, and is it going to do anything for the 2,500 workers who've lost their jobs and the thousands more who are about to go?

Hon. Dalton McGuinty: We'll have to wait and see what happens at the end of 2009 in terms of actual job numbers, but there are specific provisions found within this contract.

Let me tell you why we still have reason to be optimistic. This investment that we made together in this new Beacon project was to build a new, flexible manufacturing plant. A flexible plant allows us to shift on the fly, essentially, and respond quickly to changing market conditions and new consumer demands. We know that North Americans buy at least 15 million new vehicles every year. We know that they're buying fewer trucks and SUVs because of rising gas prices. GM has told us they want to make new cars. Guess who's at the top of the line to land a new car investment in North America?

It's the Beacon project in Oshawa, because of our investment that we've made together. The fact is, we have positioned ourselves well for the future and we look forward to an ongoing dialogue with GM, working with CAW to land the next new investment here in Ontario.

SKILLS TRAINING

Mr. Howard Hampton: To the Premier: This is interesting. As thousands of workers lose their jobs every week, the Premier says this is good positioning.

But it's not just to General Motors that the McGuinty government has been handing out money and not getting job guarantees. Two years ago, at the Dell call centre in Ottawa, the Premier bragged, "High-value jobs like the ones announced today will help us continue to build more opportunity for Ontario families and strengthen our future prosperity." Well, today the call centre is closed, the jobs are gone, the workers say they received little training and, yes, Dell, a huge, profitable, multi-million-dollar corporation, got $11 million of Ontario's money. Does the Premier still say that the laid-off workers and the public got a good deal on the $11-million gift to Dell?

Hon. Dalton McGuinty: To the Minister of Training, Colleges and Universities.

Hon. John Milloy: I'm proud to be part of a government which offers over 150 apprenticeships in the province of Ontario, and I'm proud of the training that was received at Dell. The guidelines for the trades offered at Dell required approximately 4,000 hours of both in-school and on-the-job training, and the workers there received transferable skills.

I'd like to draw the member's attention to a quote in the Sun, where David Weedmark, managing partner of the AIM Group's IT services division, was asked to comment on the Dell situation. He said he "fields dozens of calls every week looking for exactly the type of employees who worked at Dell.

"'I would say over the next couple of months a third to a half of them should be able to find work. This is not a time to give up hope, because those skill sets are very much in demand. There are people like us scouring the streets looking to find'"—

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

Mr. Howard Hampton: The question was to the Premier, and I think I know why the Premier wants to duck the question. His hometown newspaper, the Ottawa Citizen, tells quite a different story. It points out that many of the workers were already fully trained. It points out that others who were contacted said they received little training for the $11-million gift to Dell. Dell was so worried about this—the workers speaking out—that it forced them to sign a gag order before they left the company.

I think Ontarians deserve to know how their $11 million in training money was spent since so many of the workers didn't get training. My question to the Premier: Will the Premier ask the Auditor General to come in and look at the Dell handout, where they got $11 million and 1,000 workers wound up in the street?

Hon. John Milloy: I find this a little bit offensive. We are talking about real people and real jobs. We are talking about people who are undertaking training and transferable skills.

The honourable member asked what the funding is used for. Let me tell you about the trades: information technology support agent, 3,340 hours of on-the-job training and 600 hours—20 weeks—of in-school training; information technology call centre inside sales agent, 3,730 hours of on-the-job training and nine weeks of in-school training; information technology call centre customer care agent, 3,730 hours of on-the-job training and nine weeks of in-school training.

We care about making sure that we have well-trained workers and we're not going to stand in the House and make fun of them as the honourable members do across the way.

Mr. Howard Hampton: Most people in Ontario think that an apprenticeship involves years of training with a skilled journeyman, an instrument mechanic, an electrician or a welder. But it appears that for the McGuinty government, if you can sign something that says you might provide three weeks of training for someone in how to answer the phone, you'll get apprenticeship money. No other province in Canada doles out apprenticeship money for this kind of thing. No other province in Canada doles out $11 million to a profitable, multinational corporation and then has 1,000 workers out on the street—and says it's a good deal.

My question to the Premier: When are you going to call in the Auditor General to look at what was a very bad deal for workers, a very bad deal for the public and a gift for Dell?

Hon. John Milloy: I'm very proud of the fact that we have an apprenticeship system in this province which recognizes the needs of the business community and the changing nature of our economy. Right now, we have 152 apprenticeships which are registered in the province, many of them providing similar training guidelines as the ones at Dell. I'll give you some examples: automotive glass technician, hoisting engineer, roofer, chef, construction craft worker, heavy equipment operator and automotive accessory technician. These are very similar training regimes as the ones offered at Dell.

We're in changing times. We actually recognize that, in a new economy, there are new skill sets that are needed, such as those offered at Dell. We don't sit there and make fun of hard-working individuals who receive transferable skills that will be useful throughout the Ottawa job market. I'm very proud of our record on apprenticeships.

SCHOOL CLOSURES

Mr. Randy Hillier: My question is to the Premier. Last September, you said the following: "For rural kids, few things are more important than being able to go to school in your own community, with your own friends. Rural schools help keep communities strong, which is why we're not only committed to keeping them open—but strengthening them." Those are your words, Mr. Premier, not mine.

Today, we have at least 50 rural schools closing, and many more are on the chopping block. These closures are another example and consequence of your relentless and uncaring attack on our rural culture, our rural heritage and our rural economy—

Interjections.

The Speaker (Hon. Steve Peters): Stop the clock for a moment, please. I just remind the members from the government side that heckling is one thing, but some of the personal shots that I'm hearing are not acceptable. I just remind the government members of that.

Member?

Mr. Randy Hillier: Mr. Premier, why are you once again betraying the trust of rural Ontario and breaking another promise? Do you know how to keep a promise? Do you know how to be truthful?

Hon. Dalton McGuinty: To the Minister of Education.

Hon. Kathleen O. Wynne: Yes, let's talk about records. Since we came into office, we have increased funding to rural boards by $632 million. On our watch, there have been 404 new schools opened, and that is in the face of declining enrolment. We all know that there will be 90,000 fewer students next year than there were in 2003.

I'm not sure which party the member's speaking for, but the record of the Conservative Party is that under their watch, there were 50,000 more students and 500 schools closed.

The Speaker (Hon. Steve Peters): Supplementary?

Mrs. Joyce Savoline: To the Premier: In 2002, in this very Legislature, you felt it was critical to keep Thames Valley district schools open. Now, on your watch as Premier, these schools are on the chopping block. That same year, you asked the Eves government for a moratorium on school closures. Now there are accommodation reviews starting in 300 schools across the province.

When are you finally going to stop playing politics with our students? When are you finally going to keep your promise, or is your legacy as education Premier going to be the closure of rural schools?

Hon. Kathleen O. Wynne: It is beyond rich for a member of that party to be talking to us about playing politics on education. It is absolutely absurd. Since we came into office, 690 new teachers have gone into our rural schools—$632 million.

The reality is that school boards in this province must be able to make decisions based on the program that they need for their students in their schools. They must be able to plan for the students who are in their schools. This is why we have put pupil accommodation review guidelines in place that require the board to consult with the community, that look at the value of the school to the community and look for alternatives, but at the end of the day, if schools must consolidate or close, boards must be free to do that in the interests of the students in our publicly funded education system.

INFECTIOUS DISEASE CONTROL

M me France Gélinas: Ma question est pour le ministre de la Santé et des Soins de longue durée. Minister, we know that hundreds of people have died from Clostridium difficile. Patients at St. Michael's Hospital, as recently as this morning, are reporting that there are no signs posted at the hospital warning them of a C. difficile outbreak.

How many more shocking disease outbreaks will occur before this minister realizes that health care facilities must clearly warn patients of disease outbreaks?

Hon. George Smitherman: I think that the honourable member's suggestion is one that merits consideration by Dr. Baker, but I think that a far more appropriate starting point for all patients, for visitors to hospitals and for people who work in hospitals and other institutional environments is to understand the necessity of the obligation to take steps to protect themselves and to make assumptions, frankly, about the risks that are occurring in these environments.

What has surprised me to some extent is that in the House, the characterization by both parties is that they became aware of this issue just a few weeks ago, but the health care system has known about the attendant risk associated with superbugs in hospitals. They've been taking proactive steps to manage it, but these are very serious challenges indeed.

I'll take the honourable member's suggestion under advisement and ask Dr. Baker to give us some advice around that, but at the heart of it, all of us who are in those environments must make assumptions and take appropriate steps to protect ourselves and especially to do the right thing to protect others.

M me France Gélinas: In the face of a public crisis, Ontarians are losing confidence in our health care system. One way to rebuild public confidence is to give them an opportunity to bring their issue to a neutral third party such as an Ombudsman. Why is the minister afraid to bring in Ombudsman oversight of hospitals?

Hon. George Smitherman: In the matter at hand, the honourable member uses a word like "crisis," then she calls for investigation by those who don't have express capacity in this area.

We have a different approach. We believe fundamentally that the important step forward is to ask Dr. Michael Baker, an accomplished expert in the areas of patient safety, to lead an initiative which will dramatically enhance the information that Ontarians have on a wide variety of patient safety indicators. We believe this is the approach which is prudent in the circumstances and delivers the most timely results and benefits to the people of the province of Ontario.

I remind the honourable member that C. difficile is not something that's come about only recently. This is something that hospitals and the hundreds of thousands of people who work in those environments, visit those environments and are patients in those environments have an obligation to be aware of and to take the steps that they can take, such as rigorous handwashing and dedication to cleanliness, that can provide very, very effective capacity in these circumstances.

HOSPITAL FUNDING

Mr. Phil McNeely: My question is for the Minister of Health and Long-Term Care. Minister, the issue of emergency room wait times is well known to all members of this House. This issue is not a new one, but something that my constituents of Ottawa—Orléans have raised with me a number of times. You recently made an announcement about new investments to reduce emergency wait times. Hôpital Montfort was one of the recipients of direct funding. My constituents would like to know how this money is going to reduce wait times and when my constituents are going to see improvements.

Hon. George Smitherman: Under the leadership of Dr. Alan Hudson, we've taken another significant step forward, which is to bring the successful Ontario approach to reducing wait times to one of the public's biggest battles, which is with wait times in hospital emergency rooms. A $30-million pay-for-performance fund will target and incent the practices that will enhance performance in our 23 poorest-performing emergency rooms.

But in addition to that are a wide variety of initiatives led by Kevin Smith, the CEO of St. Joseph's hospital in Hamilton, to provide better alternatives to hospital care so that we can reduce the proportion of alternate-level-of-care patients. That means providing more resources to home care and enhancing the number of hours that people can receive, $22 million in priority funding that each LHIN will have the opportunity to roll out and support local initiatives, $4.5 million for dedicated nurses for ambulances arriving, and nurse-led teams that will outreach the long-term-care homes—all in an effort to stabilize populations where they are.

Mr. Phil McNeely: Minister, I know my constituents will be glad to see that Hôpital Montfort is receiving some of this targeted funding. Hôpital Montfort is an important aspect of health care in Ottawa and provides very good care to my constituents in Ottawa—Orléans. While this $30 million in targeted funding will help the 23 poorest-performing emergency rooms, I would like to know what is being done to help the rest of the ERs across the province that are struggling with long ER wait times. I would like the minister to tell us what he is doing to ensure that all hospitals benefit from this recent announcement.

Hon. George Smitherman: Our efforts are to take coordinated steps to reduce wait times and enhance patient satisfaction in Ontario's emergency rooms—this is a challenge in many hospitals—but most precisely are focusing in on 23 hospitals where the performance has been the poorest. By targeting the $30 million, we're going to provide a pay-for-performance capacity where we incent the hospital and have expectations of improved performance on behalf of patients.

All hospitals in Ontario will benefit from the efforts to reduce alternate-level-of-care patient loads. Hôpital Montfort will be receiving $686,000 as part of an investment in the Champlain LHIN and in Ottawa hospitals that totals more than $4 million. With these initiatives and the alternate-level-of-care initiatives which complement them, we feel confident that we will begin to make substantial progress to reduce wait times and improve patient satisfaction in Ontario's emergency rooms.

SEWAGE SPILL

Mr. Norman W. Sterling: My question is to the Minister of the Environment. The city of Ottawa has been struck by unbelievable news that there were over a billion litres of raw sewage dumped into the Ottawa River by the city of Ottawa and their sewer system.

You found out about this in May 2007, according to the records. Your spokesman for the Ministry of the Environment says you started your investigation on May 26, 2008—last month. Why did you do nothing for a year?

Hon. John Gerretsen: I thank the member for the question. Obviously, we share Ottawa's concern as to what happened there in August 2006, but we have—

Mr. John Yakabuski: It's a cover-up.

The Speaker (Hon. Steve Peters): Member for Renfrew, withdraw the comment, please.

Mr. John Yakabuski: I withdraw.

Hon. John Gerretsen: In May 2007, when we found out about this, the ministry immediately contacted the city of Ottawa and the following steps have been taken to ensure that this kind of an event—

Interjection.

The Speaker (Hon. Steve Peters): The member from Welland will withdraw the comment, please.

Mr. Peter Kormos: I withdraw, Speaker.

Hon. John Gerretsen: Speaker, I'm somewhat surprised that the members opposite wouldn't want to hear what was actually done by the Ministry of the Environment when they heard about this in May 2007.

In any event, we take this very seriously, and we wanted to make sure that this kind of an event, which meant that the gates were open for an extra two weeks back in August 2006, wouldn't happen again. So what did we do? The ministry gave top priority to the certificates of approval that were required for the city's sewer system upgrade to be on track. It also ensured that all the certificates of approval for the city's sewer system upgrade included the enhanced and stringent monitoring, reporting, contingency planning of the combined sewer overflows.

We have been working with—

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

Mr. Norman W. Sterling: You still haven't answered the question as to why you began your investigation on May 26 this year. Mr. Minister, why don't you do what the city of Ottawa did, that is, have an independent investigation of its role in this whole matter? Why don't you agree to an independent inquiry into your role in this whole debacle?

Hon. John Gerretsen: The member still doesn't understand that the Ministry of the Environment started to work with the city of Ottawa as soon as it heard about this in May 2007. It wanted to make sure that the kind of occurrence that happened in August 2006 didn't recur. That's why it put more stringent monitoring systems into place to make sure that it didn't happen, and also to make sure that the certificates of approval that were in the process of being approved, were going to be adhered to.

Our main concern within the Ministry of the Environment is to absolutely assure the people of Ottawa that the kind of occurrence that happened in August 2006 won't happen again.

The investigation that he's talking about was as a result of what the city of Ottawa employee didn't do in August 2006, and that didn't occur until we were notified by the department of public health about two or three weeks ago.

ONTARIO DISABILITY SUPPORT PROGRAM

Mr. Michael Prue: My question is for the Premier. Thousands of Ontarians have disabilities. Those disabilities include mental, physical and emotional illnesses that pose serious barriers to their ability to work and earn a living. Through no fault of their own, people with disabilities who also receive ODSP payments are condemned by this government to a life sentence of poverty. ODSP benefits leave single adults $6,000 below the after-tax Statistics Canada low-income cut-off number. When will this government stop forcing Ontarians with disabilities to live on sub-poverty-level benefits?

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

Hon. Madeleine Meilleur: It's a very interesting question. This government has worked, since we have been elected, to improve the quality of life of those on ODSP. We have removed most of the barriers that were put in place by the previous government to prevent them from improving their quality of life. For instance, we consulted with them and some of them told us that they would go back to work if this government provided their medication. They were also telling us that they would like to be able to retain more of what they are earning. So we worked on that.

We have listened to them, and we have amended our processes to help them to improve their quality of life and to help them if they want to go back to work.

Mr. Michael Prue: To the minister: And you continue to claw back everything they earn above $350 a month.

Interjection.

The Speaker (Hon. Steve Peters): I'd just remind the members of the use of some language in here. Thank you.

Mr. Michael Prue: Six ODSP recipients are here with us today: Ken MacLeod, Cheryl Duggan, Kyle Vose, Mike Yale, Chris Sartor and Sharon McPherson. They're all here in the west gallery. They are here to ask the Premier to listen to their stories and to consider standing in their shoes. The meagre 2% ODSP increase that was in this budget amounts to 60 cents a day. What they want and what we all want is a commitment from this Premier that no Ontarian with a disability will be forced to live in poverty forever. Does this government believe that $2 a day is a reasonable amount for these people to have, after rent and food expenses, in their pocket?

Hon. Madeleine Meilleur: I will continue to let the people in the gallery know what this government has done since we came into power. We've listened to them. We have increased social assistance by—it's going to be 9% this November. We know that they have had a lot of challenges. Every time that we move forward to improve their quality of life, this party votes with their friends who reduced their benefits by 22%. We're listening to them. We want to improve their quality of life. We want to help those who are able to return to work.

We are improving their quality of life, so that they can keep their health benefits, they can keep their medication benefits, and they can keep more of what they are earning. We will continue to work with them to improve their quality of life.

AFFORDABLE HOUSING

Mr. Jean-Marc Lalonde: My question is to the Minister of Municipal Affairs and Housing. But first, I would like to take this opportunity again to welcome the mayors and councillors of Glengarry, Prescott and Russell who are here with us in the gallery. They are here for a very special day, Glengarry—Prescott—Russell day at Queen's Park. This is going to be done every year now.

The united counties of Prescott and Russell and the municipality of North Glengarry have many of the same challenges that exist elsewhere in the province, such as infrastructure deficit, shortage of affordable housing, growing transit needs and many more. Bien que ces problèmes soient fréquents—

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

Hon. Jim Watson: I want to congratulate the honourable member on celebrating his 38th anniversary representing the good people of eastern Ontario and Glengarry—Prescott—Russell. What a change to see constituents and municipal leaders from eastern Ontario here to support Mr. Lalonde.

About two weeks ago, the member from Lanark brought some constituents here, and do you know what? He had a press conference with them and they turned on him. They asked for his resignation. So I would encourage members to go to YouTube, type in "Randy Hillier," and you'll see quite a sight—

The Speaker (Hon. Steve Peters): I remind the member that we do not refer to individuals by their name, but by their riding.

Answer, please.

Hon. Jim Watson: I know that there will be a lot of hits on that YouTube site. Here he comes back again. So I'm very proud—

Interjections.

Mr. Tim Hudak: On a point of order, Mr. Speaker: I'd ask you to rule if this answer by the minister has anything whatsoever to do with his portfolio. This question should clearly be ruled out of order as a direct attack on a member of the Legislative Assembly of Ontario.

The Speaker (Hon. Steve Peters): The government House leader on a point of order.

Hon. Michael Bryant: On that point of order, I think that the question and answer are entirely consistent with the kinds of questions and answers that are undertaken by the official opposition and third party. I respect whatever latitude the Speaker wishes to undertake, but the idea that the opposition and third party do not engage in ad hominem questions and ad hominem answers is completely absurd, and I know—

The Speaker (Hon. Steve Peters): Thank you. I do agree with the member that that was, I believe, a personal attack at the member. I would ask him to withdraw the comment.

Hon. Jim Watson: I withdraw.

The Speaker (Hon. Steve Peters): The member for Glengarry—Prescott—Russell.

Mr. Jean-Marc Lalonde: We often hear the need for housing framed as an urban issue, but the fact of the matter is that it affects every municipality, large or small. Often, small municipalities can feel ignored over discussions around housing. The mayors of Glengarry—Prescott—Russell's diverse municipalities want to know that they have a partner in this government. What have the minister and his government done to assure these municipalities that their concerns have been heard and are being addressed?

Hon. Jim Watson: I'm very proud of the work that we've done with respect to social housing. For instance, $100 million was announced in the budget for rehabilitation and repair. In Prescott and Russell, $381,000 was delivered; in Stormont, Dundas and Glengarry, $774,000.

The Premier announced the continuation of the rent bank, a $5-million investment. Prescott and Russell received $29,000; Stormont, Dundas and Glengarry, $71,000. This is another example of a member of this side, of the government, working hard for their constituents. I can tell you, those men and women up there are not going to be calling for Jean-Marc Lalonde's resignation.

POLYGAMY

Ms. Lisa MacLeod: My question is to the Premier. Yesterday, just before British Columbia launched a criminal probe into the illegal polygamist marriages taking place there, I demanded the same in this chamber for Ontario's well-documented polygamy problem. Last night, I sent the Premier an urgent letter to ask him to heed BC's action and initiate a criminal probe here too. Will the Premier send a strong message of support for Canada's laws and immediately launch a criminal investigation into these illegal polygamist marriages taking place in Toronto?

Hon. Dalton McGuinty: To the Minister of Government and Consumer Services.

Hon. Ted McMeekin: I'll respond to the honourable member's question by reminding her of what the Attorney General said in this House yesterday. He said that in Ontario, where there are allegations of criminal activity, the police are responsible for investigating—

Interjection.

The Speaker (Hon. Steve Peters): I ask the member from Renfrew to withdraw the comment.

Mr. John Yakabuski: Withdraw.

Hon. Ted McMeekin: —and determining whether or not there are grounds for charges to be laid. I want to further highlight his point that political interference is not something that this government is desirous of getting into. In fact, it's not something that's proper. In the course of an investigation, the police can seek legal advice from crown attorneys—

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

Ms. Lisa MacLeod: Apparently they don't care about breaking the law either. This government is passing this issue around the cabinet table like a political hot potato. The Minister of Government and Consumer Services' responses often contradict federal law. The women's issues minister won't stand up for gender equality. Now you have the Attorney General, and apparently this minister, wanting to sweep this dirty little secret under the carpet.

So I ask: Will they do the right thing? Will they do what it took 20 years for British Columbia to do and launch a criminal investigation, or will they continue to pass the buck around for another 20 years, at the expense of the rule of law in this country and gender equality rights in this province?

Hon. Ted McMeekin: It's not my place to comment on criminal law. It is entirely my place to express in this House today that we have full confidence in the ability of the police to carry out their investigative responsibilities.

Repeated calls for interference in police investigations are not helpful and unfairly discredit the police, diminish public respect for the work that they do every single day, and unfairly jeopardize public safety. In the event that charges are laid by the police, they will in fact be prosecuted by the crown in the normal course of events.

EVENTS IN TIBET

Ms. Cheri DiNovo: My question is to the Premier. The Parliamentary Friends of Tibet of Ontario are asking, along with the Tibetans of Ontario and His Holiness the Dalai Lama, that the torch relay not pass through Tibet. Many are not aware that the epicentre of the earthquake was in Tibetan territory. This will add to the instability of the situation there and is not necessary. Will this government add its voice to those around the world calling to stop the torch relay through Tibet?

Hon. Dalton McGuinty: We've addressed this matter in this Legislature by way of a very specific resolution. It's not specific to this particular issue, but we indicated, as a government and as all parties—I'll read it: "That the Legislative Assembly of Ontario, as a long-standing friend of China, express concern with the current situation in Tibet and encourage the parties to engage in meaningful dialogue." I understand my friend's concern with this specific issue, but we prefer the resolution that we supported unanimously in this Legislature.

Ms. Cheri DiNovo: Again to the Premier: Not so long ago, we discovered that the Minister of Economic Development and Trade went on a secretive trip to China as Tibetans and others around the world asked for attention to be paid to the human—

Interjections.

Ms. Cheri DiNovo: We have Tibetans who are watching this in the gallery; they don't appreciate the laughter—and others around the world asked for attention to be paid to the human rights abuses that were taking place in Tibet.

Understanding that Ontario is home to one of the largest Tibetan populations in the western world, could the Premier give the House a list of any cabinet members who are attending the opening ceremonies of the Olympic games?

Hon. Dalton McGuinty: To the best of my knowledge, nobody is representing our government there—certainly not any elected representative.

We will continue, however, to support our athletes who want to participate, our Olympic athletes and those who are going to participate in the Paralympics. We've had funding through our Quest for Gold program, which has been set aside for quite some time now to help in that regard. But when it comes to this difficult situation between China and Tibet, we think that we gave expression to our values and our aspirations on behalf of both sides through a resolution that we endorsed unanimously in this House.

INFRASTRUCTURE RENEWAL

Mrs. Maria Van Bommel: A number of municipalities in my riding of Lambton—Kent—Middlesex, including Dawn-Euphemia, have been notified by the federal government that they were approved for funding important infrastructure projects. This funding comes from the federal municipal rural infrastructure fund that was announced in 2007. The support from the federal government, however, depends on assurances that these same municipalities can fully fund the remaining two-thirds cost of those projects.

In the case of the township of Warwick, their council will have to obtain over $4 million in order to receive the federal assistance. That's not an easy feat for a town of 600 households, in order to upgrade their sewage system.

My question is for the Minister of Public Infrastructure Renewal. Could the minister clarify for my constituents the criteria the federal government used to select projects that were actually submitted under a previous COMRIF?

Hon. David Caplan: I want to thank the member for the question. I want to let the House know how concerned the government is with announcements like the example the member has just brought forward. As the member mentioned, these announcements have created uncertainty and situations which I believe were completely avoidable. I wish I could tell the House how the federal government selected these projects, what criteria were used. Only the federal government can say for certain what they had in mind.

What I can tell the House is that Ontario welcomed the news of the so-called $200-million top-up and was fully prepared to make contributions on the same basis which had gone previously. It was a complete surprise that the federal government decided unilaterally to select projects and announce them without informing or engaging the province of Ontario. What we see emerging from the federal government is a list of projects that were not successful in previous COMRIF rounds that had been granted provisional approval based on—

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

Mrs. Maria Van Bommel: Earlier this year, I was pleased to announce that municipalities in Lambton—Kent—Middlesex had received over $21.3 million to fix roads and bridges as my riding's share of the $400-million investment this government made. As well, I was able to announce an additional $18.3 million for projects approved in Lambton—Kent—Middlesex under the municipal infrastructure investment initiative. But in making a federal municipal rural infrastructure fund announcement for the municipality of Brooke-Alvinston, my federal counterpart explained in the Glencoe Transcript and Free Press, "Communities and provincial governments will match it, one third each."

Minister, given that we have already made substantial financial investments in municipal infrastructure this year and, as you have stated, we were not consulted in any way on the recent federal projects approvals, will this government be participating in any of these federal municipal infrastructure projects?

Hon. David Caplan: An excellent question. In fact, I wrote to every COMRIF-eligible municipality to tell them that no provincial support should be presumed. This government works with our municipal leaders to make sure they have real dollars in hand to make projects happen. We've established a relationship with our municipal partners that demonstrates a responsible, balanced approach to recognizing the infrastructure priorities that vary across the province.

The municipal infrastructure initiative, for example: $450 million into 243 projects right across this province, projects that municipalities have under way because they have the cash in hand. That's a real commitment to infrastructure that goes beyond the federal government phony announcements.

We are very disappointed with the MRIF process and with the direction the federal government has chosen, the situation that several communities are facing, and we're looking forward to continuing and urging our federal colleagues to engage in a real partnership with us.

BEEF PRODUCERS

Mr. Ernie Hardeman: My question is to the Minister of Agriculture. Today, the Ontario Cattlemen's Association is here at Queen's Park to share the concerns of their members. I want to thank them for coming here to meet with us and for all the hard work they do on of behalf those members. I also want to thank them for inviting us all to join them for a barbecue lunch with great Ontario corn-fed beef, which is famous throughout the country, if not throughout the world. We hear from them about the tough times that our beef farmers are facing.

Minister, they have asked you for a $20-million safety net fund to guarantee a floor price for producers. Will you stand up today and commit to them that you will create such a fund?

Hon. Leona Dombrowsky: First of all, I would like to join the member from Oxford in welcoming the Ontario cattlemen, and we invite all members of this Legislature to come outside on the front lawn of the Legislature and enjoy some of Ontario's finest corn-fed beef.

Our government has, certainly, a history of working very closely with the Ontario Cattlemen's Association. Last fall, when the signs were very apparent that the industry was in difficulty, we met with the Ontario Cattlemen's Association, we met with the Ontario pork producers and horticulture producers in Ontario, and we came up with a program. The Minister of Finance, in December, announced a $150-million new program—$150 million in new money—to support cattle, hogs and horticulture in the—

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

Mr. Ernie Hardeman: Minister, people who know what's going on in the beef industry know that the CAIS program isn't working for beef farmers, because prices are steadily declining. They know that a lot of beef farmers in need were missed by your cattle, hog and horticultural program. We've been telling you about this in this Legislature day after day.

The cattlemen are here. They told us of the type of program their farmers need. Will you commit today to provide the $20 million to fund a guaranteed floor price for the producers?

Hon. Leona Dombrowsky: I would remind the honourable member that I do have a letter from the president of the Ontario Cattlemen's Association. It says, "I would ... like to thank our Premier, the Honourable Dalton McGuinty. It is very encouraging to see his government take a leadership role in recognizing the financial hurt that producers are currently" suffering. So they very much appreciate the reaction that our government has had to the crisis in the industry.

I would also like to say that, when you look across this great nation of ours, Ontario has stepped up to the plate to address the crisis there is in cattle, in hogs and in horticulture, unlike most other provinces. Geri Kamenz—again, the Ontario Federation of Agriculture—has offered very positive remarks. I think that it's very clear—

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

NORTHERN ONTARIO DEVELOPMENT

M me France Gélinas: My question is for the Premier. Yesterday, I attended the northern growth plan consultation in Sudbury. Part of the development of the growth plan is the work of G-North, the round table of the 17 ministries. Can the Premier tell us why the meetings of the G-North round table are not being held in northern Ontario?

Hon. Dalton McGuinty: To the Minister of Public Infrastructure Renewal.

Hon. David Caplan: In fact, this is a very unique process, where we have 17 ministers and 17 ministries coming together on a regular basis to bring the unique perspectives, the expertise in policy and the resources available to be able to work on this incredibly important policy initiative. It has never been done before. It is unprecedented in the history of Ontario government and, I would say, in government anywhere in this country. To be able to get that level of support and the coordination—it's an incredible thing.

This table of ministers has been incredibly welcome in northern Ontario. Northern Ontarians are very excited about the northern growth plan. They're excited about the consultations. They're excited to finally have a government who stands up for them, who's working for them and developing a plan which is going to see northern Ontario move forward and see the prosperity—

The Speaker (Hon. Steve Peters): Thank you. The time for question period has ended. It is now time for petitions.

PETITIONS

LONG-TERM CARE

M me France Gélinas: I'd like to petition the Legislature as such:

"Whereas understaffing in Ontario's nursing homes is a serious problem resulting in inadequate care for residents and unsafe conditions for staff;

"Whereas after the Harris government removed the regulations providing minimum care levels in 1995, hours of care dropped below the previous 2.25 hour/day minimum;

"Whereas the recent improvements in hours of care are not adequate, vary widely and are not held to accountable standards;

"Whereas there is currently nothing in legislation to protect residents and staff from renewed cuts to care levels by future governments; and

"Whereas care needs have measurably increased with aging and the movement of people with more complex health needs from hospitals into long-term-care homes;

"We petition the Legislative Assembly of Ontario to immediately enact and fund an average care standard of 3.5 hours per resident per day in the regulations under the new Long-Term Care Homes Act."

I support this petition. I will affix my name to it and send it with page Aaron.

CHILD CUSTODY

Mr. Kim Craitor: This petition is addressed to the Legislative Assembly of Ontario. The petition reads as follows:

"Whereas the people of the province of Ontario deserve and have the right to request an amendment to the Children's Law Reform Act to emphasize the importance of children's relationships with their parents and grandparents as requested in Bill 33;

"Whereas subsection 20(2.1) requires parents and others with custody of children to refrain from unreasonably placing obstacles to personal