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November 18, 1999

37th Parliament, 1st Session

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Hansard Transcripts

Votes and Proceedings

Orders and Notices

Hansard Transcript 1999-Nov-18 (PDF)

L014 - Thu 18 Nov 1999 / Jeu 18 nov 1999

PRIVATE MEMBERS' PUBLIC BUSINESS

DOCTOR SHORTAGE

HIGHWAY 17

MEMBERS' STATEMENTS

HOSPITAL RESTRUCTURING

GASOLINE PRICES

NORTHERN HEALTH TRAVEL GRANT

FAMILY RESPONSIBILITY OFFICE

OPTIMIST CLUB OF NEWMARKET

FORT HENRY

PAROLE SYSTEM

SOINS DE SANTÉ

TEACHER OF THE YEAR AWARD

MOTIONS

COMMITTEE MEMBERSHIP

STATEMENTS BY THE MINISTRY AND RESPONSES

NATIONAL CHILD DAY

SPENDING REDUCTIONS

NATIONAL CHILD DAY

SPENDING REDUCTIONS

NATIONAL CHILD DAY

SPENDING REDUCTIONS

LEGISLATIVE PAGES

VISITORS

ORAL QUESTIONS

SPENDING REDUCTIONS

CORRECTIONAL FACILITIES

CONSERVATION AUTHORITIES

OCCUPATIONAL HEALTH AND SAFETY

MINISTRY OF THE ENVIRONMENT

POST-SECONDARY EDUCATION

AIR QUALITY

MINISTRY OF CITIZENSHIP, CULTURE AND RECREATION

IMMIGRANT SPONSORSHIP

GOVERNMENT FACILITIES

STANDING COMMITTEE ON ESTIMATES

PETITIONS

EMERGENCY SERVICES

HIGHWAY SAFETY

HENLEY ROWING COURSE

MUNICIPAL RESTRUCTURING

SCHOOL CLOSURES

ORDERS OF THE DAY

TIME ALLOCATION

The House met at 1004.

Prayers.

PRIVATE MEMBERS' PUBLIC BUSINESS

DOCTOR SHORTAGE

Mr Bart Maves (Niagara Falls): Good morning. The resolution we have before the House today reads: If the government's current initiatives fail to correct the doctor distribution problem throughout Ontario, then the government should proclaim sections of the Savings and Restructuring Act, 1996, allowing it to attach geographic areas to all new billing numbers issued by the Ministry of Health.

I rise today to talk about a topic which all of us in this Legislature, save and except perhaps a few people in a few areas, deal with every day in growing numbers and with growing frequency, and that is the problem with doctor distribution around the province of Ontario. Many of us MPPs quite often have phone calls from people in distress who can't find a family doctor in their hometown; people who the odd time are mistreated by their family doctor because that poor doctor has so many patients they're looking at in their community that they're suffering from burnout.

One patient told me, "I wanted a second opinion and my doctor told me, `If you want a second opinion then I'm not going to have you on my patient list any more.'" I don't want to say all doctors are doing that. I just point out that these are some of the stresses some doctors are under with the problem we currently have.

We look at the problem and there are a lot of solutions-some of which I'm going to talk about today-being proposed and a lot of attempts being undertaken to address the problem. The public looks at the problem and says: "Why don't we just have more doctors in the province? Why don't we just open the floodgates to foreign countries and from other places in Canada and have other provincial doctors come in, open up more spaces in medical schools and so on?" But the problem with that is what we have in Ontario-and many people recognize this-is a problem with distribution, not necessarily supply.

In fact, a very recent study by Dr Ben Chan from the Institute for Clinical Evaluative Sciences says that the Ministry of Health and the OMA have long recognized that there's a geographic physician maldistribution problem in the province and have initiated a number of programs to address the issue, some of which I'll quickly refer to.

He goes on to say that the physician supply has remained remarkably stable over the seven-year time period of this study. His study is from 1991 to 1998. He further says that many models of physician growth developed by non-physician academics predict that physician supply will keep pace with the rate of population growth and aging, and that even with the 10% reduction of medical school enrolment there will be an accumulating surplus of physicians by the year 2010.

There are other studies that also indicate that right now we've got enough physicians in the province of Ontario. The problem is with the distribution. In many areas of the province there just aren't enough doctors. Doctors seem to continually set up practices in places where they're educated, be it in the Kingston area, Toronto, Ottawa. In fact, there's one quote I read in a recent newspaper from a doctor in my area talking about how there's such oversupply in Toronto that some doctors actually advertise for patients. I think most people around the province would consider this remarkable.

I come from an area, Niagara, which suffers from one of the biggest problems of poor distribution. We have one doctor for every 1,526 people, and that's one GP. That doesn't include specialists; that's one general practitioner. Kingston has 1 to 732; it's the best in the province and this is general practitioners. Ottawa is 1 to 859. Toronto is 1 to 871.

Specialists, of course, locate in many of these areas where there are teaching facilities and there's a problem of specialist distribution across the province. Interestingly enough, Niagara isn't as poorly off on specialists as they are on GPs.

The other problem that we have in Niagara is that we have the oldest practising doctors in Ontario. The age profile that we have is the oldest. So the problem is going to get worse and worse unless we do something.

There's several initiatives that the government had undertaken, many in co-operation with doctors. Incentive grants: They've been around for quite a while, ranging up to $40,000 over a period of time to get them to go to underserviced communities. There's recently $30 million to help 27 small rural hospitals retain doctors; a $70-an-hour sessional fee for doctors; a physician job registry. The Ministry of Health is hosting health professionals recruitment tours. We're discounting fees for doctors who go to overserviced areas to try to get them out of those areas.

We have brought in nurse case practitioners where they can work in conjunction with doctors to try to solve this problem and look at some of the less serious cases in their office.

It seems that back in 1996 this legislature passed Bill 26, the Savings and Restructuring Act, and in that bill we had a

section which would allow us to manage billing numbers. What this basically would do, in its simplest form, is that when new doctors come into the province or new graduates get ready to practise-right now they can get a billing number and they can begin to practise anywhere they want to in the province of Ontario. The trend is still that they continually locate in these overserviced areas and don't go to the underserviced areas. What managing of billing numbers would simply do is say, "Look, we no longer need physicians in the following centres: Toronto, Ottawa and a few others.

If you want to practise anywhere else in the province of Ontario, we need physicians. You can go anywhere but Toronto. You can go anywhere but perhaps Ottawa." Even if billing number restrictions are done maybe for a certain period of time so that people can go to other communities, even if they are surrounding communities of the Toronto or Ottawa area, nearby communities, they can get out and into those communities, as we're trying to do with medical training programs, get them out into communities to try to get new doctors to see what it's like to live in a community outside of a major urban centre.

Hopefully they'll like that and then we'll retain there.

Even if managed billing numbers are done for a three-year or five-year period, it will hopefully increase the exposure as we're trying to do the medical training right now and let these doctors want to practise in some of these areas.

I met yesterday with the folks from PAIRO, the internists of Ontario-very convincing arguments. They were concerned about billing numbers. They talked to me about several studies. They gave me quite a bit of literature and, to their credit, I think PAIRO is working very hard to try to find solutions to this problem. I think they deserve to be heard even more by the Ministry of Health of this province and by the OMA and I encourage that to continue.

One of the things that the folks that I talked to yesterday was a study by Morris Barer and Greg Stoddart. These folks did a study on improving access to needed medical services in rural or remote Canadian communities. They did a study in 1991 and they've redone this in 1999.

They say the worst thing we can do is nothing. They talk about a lot of different solutions that have been tried, including increasing medical school enrolment. What do they say about that? It won't work. Why? Because we have enough physicians, as I have already said, and with the increase in enrolment they'll likely continue the pattern of locating in urban centres.

They talk about financial incentives. They point out that financial incentives already exist. While they say financial incentives should not be dismissed, as a general strategy they have clearly not solved the problem. We have had this problem in other jurisdictions for many years, and they have not worked.

Recruitment of foreign doctors: We can recruit foreign doctors. We can open our doors and have more foreign doctors come in. But if they all just locate in the major centres, it won't solve the distribution problem.

They went on to consider many issues. They talked about a need for increased emphasis on educational initiatives, which I support. But I think that can be done in conjunction with managed billing numbers.

They did talk about the solution I am talking about today; that is, billing number allocations, managed billing numbers. What did they say? They said that a number of provinces have had or currently have these policies. Because these schemes have run into legal turbulence, none has ever been in place for a sufficient period to assess its effectiveness. Experience elsewhere suggests the administrative regulatory approaches can be effective in improving physician distribution.

Although they don't come out and support this, they do say that the nationally applied billing numbers option has the potential to be the most effective solution and the least costly. There is a case for it as an appropriate management mechanism to direct publicly financed physician resources to areas of public need.

I encourage the Ministry of Health, PAIRO and the OMA to continue their discussions. I await the McKendry report to see what is proposed in it. If we cannot solve the problem through these functions, then I urge the Ministry of Health to invoke managed billing numbers in Ontario.

Mrs Lyn McLeod (Thunder Bay-Atikokan): I will be sharing my too-limited time with the member for Prince Edward-Hastings and, I believe, the member for St Catharines and I trust that I, too, will have an extra minute added to my time this morning. I wish there were more time to discuss an issue which is of tremendous concern to anybody who comes from an area that's underserviced by physicians. I wish the government would bring forward some truly constructive suggestions so that we could begin to deal with this long-standing problem.

No one denies there is a problem with distribution of physicians. However, Mr Maves's resolution would make matters worse, not better. I am very strongly opposed to it.

There are two aspects to his resolution: The first is that if the government's current initiatives fail to correct the doctor distribution problem, we should move to billing numbers. Let me make it absolutely clear that this government's so-called initiatives to deal with the doctor distribution problem will fail for two very significant reasons.

One is because this government has failed to develop a truly workable plan not only to attract physicians into underserviced areas but also to retain physicians in underserviced areas. We're very successful in our home areas at attracting people. We're not as successful in keeping them there, which is what we want to do. The models this government has put in place-in their first term they promised $36.4 million over three years, almost none of which was used because the model that was developed couldn't possibly work.

It's not because there aren't models available. The Professional Association of Interns and Residents of Ontario has been working on this for six years and has put forward model after model, comprehensive plans to deal with both recruitment and retention. The government takes bits and pieces and doesn't even follow through on those, let alone put in place a comprehensive plan.

Proposals have come from northwestern Ontario, northeastern Ontario and southwestern Ontario. The important thing is that these proposals are not exactly the same. What the government fails to understand is that you have to deal with the needs of each community and each region a bit differently.

One of the communities I represent is the tiny town of Atikokan. They are facing a significant physician shortage. One of the reasons the government's group plan model won't work for them is that it's based on a minimum number of physicians. A minimum number of physicians in a small town like Atikokan isn't enough to give any family physician a reasonable quality of life. So the plan won't work and they have trouble attracting and retaining physicians in Atikokan. The primary need in Thunder Bay and other underserviced communities is not the same plan we need in Atikokan.

Until the government understands the importance of tailoring its plans to different areas, it's not going to be successful in dealing with the problem of doctor distribution.

The second reason the plans of this government will fail is because they refuse to recognize that it's no longer just a distribution problem but a supply problem, and the supply problem, the shortage of physicians in this province, must be dealt with. It's time for the McKendry report to be tabled so we can get on with looking at how we solve the problems of shortage. As long as there is a shortage, the acute problems of distribution which communities in this province have been facing for many years is going to get even more critical.

We have put forward a number of suggestions for dealing with the shortage problem, including increased medical spaces and an increased number of residencies for foreign-trained physicians, both of which the government could act on tomorrow if it had the will.

One thing that we know for sure will not work is the other part of Mr Maves's resolution, where he talks about instituting a form of billing numbers. I can tell you, as somebody who comes from an underserviced community, that we do not want physicians coming into our community who are coerced into being there and who are only going to be there for as long as it takes to fulfill any commitment they have made. We want people to come to our communities because they are attracted to practise medicine there and because the support they get is sufficient to allow them to have a quality of life practising medicine in our communities.

We have already seen the impact of a limited billing number with the restriction on the amounts physicians can bill in overserviced areas. The same Dr Chan, whom Mr Maves was quoting earlier, has made it quite clear in his report that the effect of that restricted billing approach was not to solve the problem of distribution. In fact, it made it worse because it simply drove physicians out of this province. He's hopeful that by ending the restrictive billing number we might be able to retain young physicians in our province, and that would certainly help both supply and distribution.

I urge this member, and I urge this government, to start to listen to the voices of people who have been dealing with the underserviced issue for years: the Northwestern Ontario Associated Chambers of Commerce, who are strongly opposed to this resolution; the Northeastern Ontario Medical Education Corp, which is strongly opposed to this resolution; the Chatham-Kent Health Alliance, which is strongly opposed to this resolution; and the Federation of Northern Ontario Municipalities, which is strongly opposed to this resolution.

Listen to the people who know what's needed when they say: "Do things that are positive. Do things like increasing the training, that's done in northern and southwestern Ontario, the most successful program to date in dealing with the distribution problem."

I trust this government will set aside this tired duck, which by the way has been found to be unconstitutional in other provinces. It will not fly. It should not fly. This government should be putting its energies into developing programs to deal with physician shortages and distribution problems that will actually work over the long term.

Mr Gerry Martiniuk (Cambridge): It is my pleasure and honour today to rise in support of my colleague and friend Bart Maves, the member for Niagara Falls.

The member has initiated this resolution on a most pressing and important point. A family doctor is not just a number. My family has had a family doctor. When I get calls at my office-because Cambridge is underserviced, like Niagara Falls, Oshawa, Barrie and many smaller communities in southern Ontario and northern communities-especially with children: How does one tell a constituent who phones with a sick child that she cannot obtain a family doctor in her vicinity? It's most difficult, and I have had a problem with it.

It's strange that one can live in a municipality and not really know it. I did not realize the extreme shortage of family doctors in our area until I was elected in June 1995. But shortly thereafter the calls started, and it troubled me. It troubled me to the extent that I took action, soon after I was elected, by applying for underserviced status. It troubled me to the extent that I formed a task force in my municipality. It troubled me to the extent that I started an initiative on a private bill to do away with the unequal distribution of family practitioners in our province.

I should say that in all my efforts, my good friend Bart Maves, the member for Niagara Falls, assisted and supported me throughout. Therefore, it is my pleasure at this time to speak to the public about this grave and serious problem for families not only in my riding but in many areas of the province.

Our government has proposed free tuition, and on July 23 Minister Witmer took one step closer to a possible solution by the appointment of Dr Robert McKendry, a fact-finding commissioner. I have faith in Minister Witmer's efforts and anxiously await her report and her plan.

The strange part about this problem is that everyone is in agreement that it is a severe problem, that we should do something about it, but there is not the will among all the stakeholders at this stage as to what we should do. Mr Maves has put forward a resolution which is strict but I think necessary. It is necessary to protect not only his constituents, the young families with children, but constituents throughout this province.

Mr Ernie Parsons (Prince Edward-Hastings): This is certainly a topic that I have a strong interest in. We have a profound shortage of doctors in our area, and I wish it, like so many other things in life, could be solved with a very simple solution. But life doesn't work that way. In fact, the entire concept is kind of intriguing.

If we can say to doctors, "You must live here, and you must practise there," we can extend it to other things. I think perhaps in a way I saw a model of that with the legislation that said to squeegee people they can't be on the streets. We've now moved them somewhere, and perhaps we could take the homeless and the people who don't have the finances for food and say, "If you want to use the food bank, then you've got to live in this part of Ontario." So we could clean up the streets of Toronto by simply hiding the problem.

I certainly don't believe the simple solution of just forcing people out of an area and into another is the answer to it. There have been a lot of people who have put a lot of energy into this and have still not found the ideal solution. I would suggest that if we order someone to practise in a certain area, they still have the option of practising in the US, they have the option of practising in another province, and this resolution would worsen rather than help the situation. It doesn't reflect the fact that our physicians are humans and they have family situations.

They may have parents that it's necessary to be close to. Their spouse or their partner may have a situation that requires them to be in a certain area. This is a very heavy-handed approach to a very complex problem.

The problem we're going to face is shortages. I'm a baby boomer. I know that my generation will be retiring. I know significant numbers of doctors in my age group who will be retiring. Unfortunately, at the same time as large numbers of doctors are retiring, we're seeing a need for increased medical services because of the aging population. We need to address the doctor shortage. We don't need to simply try to artificially shuffle people around the province. We need to address the doctor shortage. There are approaches that I believe can be taken.

I was at a meeting of our public health board last week and was intrigued by their concept of prevention: The number of hours of medical care that are required each year for people who fall, if we could reduce those falls, if we could reduce those injuries by 20%, the tremendous reduction in medical care by doctors that would result from that. Money into prevention is, in fact, money into solving the physician shortage.

Nurse practitioners: We've paid lip service to them in this province, and we have as a province put money into their training, but we really don't want to pay them. There are so many services that could be provided in remote communities or there are services that could be provided in a doctor's office that could be delivered by these people if they could be funded for the service. Ironically, they require consultation with doctors, and this government is not prepared to pay the doctors for the time that they spend consulting with the nurse practitioners. There's a resource that needs to be used more.

I believe savings could be accrued in physicians attracted if we went more to a one-stop approach. If we could have doctors and nurse practitioners and nurses and perhaps dentists and other health care providers in a cluster, it would certainly lessen the tremendous workload on doctors to cover after hours and to cover weekends. I believe there's opportunity there to attract doctors to an area, not with a big stick but with good working conditions.

Many young doctors, if not all, when they leave university have substantial financial debts. I think we could provide incentives, again, to attract them to an area rather than force them to an area. They're coming out with tremendous debts and at the same time they're being required to spend a lot of upfront dollars to set up an office, which consists of a loan on top of a loan, to get operating. This government could work with them to attract them into an area by helping them get started up.

In rural communities, we also face the problem of travel time, and I believe we could provide some incentive to doctors to serve more than one area by paying them not just the travel costs but their time.

I believe there are solutions that are attainable, but I don't believe this big stick is a solution.

Mr Bert Johnson (Perth-Middlesex): I'd like to begin by thanking the member for Niagara Falls for bringing this resolution for debate to the House today. I know for many members this is an important issue in their ridings, as many areas do not have enough doctors.

As a representative for the riding of Perth-Middlesex, I've spent a great deal of time, over the past four years particularly, trying to improve the health services available to my constituents. All too often in the past governments have avoided the issues surrounding health care in small communities in Ontario. It is the small communities in Ontario that have suffered.

In my riding of Perth-Middlesex there is a desperate shortage of doctors, especially in the western part of the riding near Mitchell. I can remember at one point there were six doctors in this town. The number of doctors went to an alarming two before climbing to where it is today at four.

I know this fluctuation in medical practitioners is not uncommon in small communities throughout Ontario. As a government, we're committed to all communities having access to the medical care they need.

At present, there are close to 70 communities in Ontario that lack basic physician services. We've been listening to the Ontario Hospital Association, the Ontario Medical Association and the association representing interns and residents, and we have acted on their recommendations to remedy the situation, but it is a complex problem.

The people of Perth-Middlesex see the need for effective and efficient health care services that are available when they need them. They know that I'll fight for those needs, and they know that I'll support the government initiatives such as the 70-hour sessional fee, the discounted payment policy, the re-entry training program, the globally funded contracts. There's more that needs to be done, and I think Mr Maves is on the right track with this resolution.

The health care needs of the people in the rural areas of the province are not the same as the needs of those in urban areas. The initiatives introduced by this government which I have just mentioned are the first steps toward addressing the difficulties faced in underserviced communities.

As well, during the election we made a promise that, subject to community needs, our government will offer free tuition to students entering medical school or already studying medicine. If they're willing to relocate and practise in underserviced areas on graduation, they have to commit to stay in that community for a minimum of five years. This should help, but it won't solve the whole problem.

I don't think it's unlike a situation where an engineer graduates from school and he goes to GM and GM says, "Yes, we absolutely need you, but we don't need you here in Oshawa, we want you in St Catharines," or Sainte Thérèse or at one of our plants somewhere else. In order to gain that employment, they go where their employer needs them. So I'm not averse to suggesting to our doctors that they should go where the need is.

I am ever so glad to see everyone in the House this morning, particularly Mr Bradley from the great riding of St Catharines, because he has been bringing to the attention of this House the shortage of ophthalmologists in the Niagara region. I would suggest there is not only a shortage of specialists, but of family doctors as well. We don't need an ophthalmologist in every store on every street in every town in Ontario, but we desperately need those medical services, both specialists and general, when we need them. That is why I am proud to stand in the House this morning and support this resolution by the member for Niagara Falls.

Mr Joseph N. Tascona (Barrie-Simcoe-Bradford): I am certainly pleased to join the debate with respect to the resolution from the member. We have to look at this situation as a very serious matter, and I think that's why the member who has brought this forward is on the right track. This is a very serious matter. The objective here is to get communities the physicians they need and deserve.

The ministry, as we know, has an underserviced-area program. The issue that is being raised by this resolution is: "If the government's current initiatives fail to correct the doctor distribution problem throughout Ontario, then the government should proclaim sections of the Savings and Restructuring Act, 1996, allowing it to attach geographic areas to all new billing numbers issued by the Ministry of Health."

I only can relate it to the situation in my riding. I'm the member for Barrie-Simcoe-Bradford. I want to refer to an

article that was in the Barrie Examiner this week. I'll read certain sections from it. It's entitled "Patients Face Long Waits at Hospital's Emergency Ward."

"And, as more and more people move into this burgeoning" area "bringing with them their growing health care needs, busy days are becoming the norm at RVH, which already has one of the busiest emergency departments in the province....

"Adding to the pressure on RVH's emergency department is a severe shortage of family doctors in the Barrie area. The doctor crunch means many people without family physicians are relying on the emergency department and the city's after-hour clinics for non-urgent medical care.

"`We see a large number of people who don't have family doctors.... It's very difficult for patients. We have people moving into the area to find, not only do they not have a choice in terms of location or gender, they may not have the opportunity to get a doctor, period.

"`So, many end up in emergency and after-hour clinics.'

"At the moment, none of Barrie's approximately 70 family doctors is accepting new patients. Counting specialists, the city has about 200 doctors at present....

"Provincial health care statistics show Barrie has 1,259 patients for every non-specialist. That compares to a ratio of 824 to 1 in Toronto.

"Unlike the situation in Toronto, where an outbreak of flu virus has been straining hospital emergency departments, Barrie can't blame the flu for a spike in emergency visits.

"`It's purely volume-the impact of population growth-that's pushing up the numbers.... Patient volume is up 10% in every department in the hospital.'"

I think it's high time that we address this very serious matter. I certainly join the member with respect to this resolution. I think we have to get communities the physicians they need and deserve. I look forward to the vote on this matter.

Mr James J. Bradley (St Catharines): Indeed, one of the very significant health care problems that we face in St Catharines and in the Niagara Peninsula is that of a shortage of family physicians. What we have to recognize, as well, are some other special circumstances, and that is, by and large, that the physicians who are in Niagara are older in age than the physicians in many areas of the province. Therefore, we can anticipate that there will be some significant numbers of individuals retiring from the medical profession in the relatively near future.

This problem has been brewing for some period of time, and those of us who have constituency offices-that is, all members of this Legislature-recognize that there are people phoning in desperation, trying to secure the services of a family physician.

We've had physicians who have passed away, that is, practising physicians, and those who have simply retired or moved elsewhere. The problem that we are encountering is that we're not having a sufficient number of physicians coming in to replace those. Certainly the Niagara District Health Council and individual communities, along with the Ontario government, have endeavoured to deal with this problem, but at this point I think it's close to 100 physicians who are really needed for the entire Niagara Peninsula.

I can tell you as well that there's a problem with specialists. I have raised in this House on a number of occasions the problem we have with ophthalmologists. Again because our area of the province has, on a per capita basis, the largest number of people who are senior citizens, we therefore have people who are bound to encounter the health care system more. Some of the parts of our body that deteriorate as we get older are the eyes, the ears and others, but certainly the eyes, and we have a situation where we have a shortage of ophthalmologists.

We're supposed to have, even under the rules of the provincial government's Ministry of Health, 14 ophthalmologists. We have only 13 at this time, and a number of those may be people who are not practising on a full-time basis. The provincial government's answer to this was simply to lump us in with Hamilton. Hamilton has 20 ophthalmologists. I'm informed by people who represent Hamilton that not all of those people are practising on a full-time basis and indeed their offices are backed up.

So if you want an appointment with an ophthalmologist in our part of the province, it's going to be at least two months, probably four or six months, if we're not talking about an emergency.

Clearly, we have a problem that can be solved at this time only by lifting the billing cap for ophthalmologists in our part of the province. Is it necessarily the ideal solution? Well, there aren't many ideal solutions in this world. An ideal solution would be to have more ophthalmologists. We don't; we're an underserviced area.

Similarly, with family physicians-and indeed I could say a few other areas where we have specialists-we have the same situation. Again, with the large number of seniors, we have people who need knee replacements, hip replacements and other work done to their body, which happens when all of us tend to get older. Billing caps there force those individuals into unacceptably long waiting times.

The member has come up with one suggestion on how this may be fixed. I believe there should be a lot of incentives out there for individuals to come to areas such as Niagara. I would like to see more of the actual teaching and training taking place in areas such as the Niagara Peninsula. The city of St Catharines, if I can be parochial, would be a reasonable place for that.

Raising this issue in the House is a good idea. It has to be addressed, and those of us who represent medically underserviced areas are going to be concerned that we have a program which attracts physicians of all kinds to our area. I think it's going to require an investment of money. If the government is going to be busy cutting taxes and cutting various ministries, it's not going to have the money to deal with a health care crisis in this province. What the people in my area want to see is their funds, their tax dollars, invested in a top-notch health care system.

Ms Marilyn Churley (Broadview-Greenwood): It's my pleasure to be able to speak to this resolution this morning. Let me first of all say that I agree with the member for St Catharines and others that this is an important issue to have before the House today. It is, as we all know, a long-standing problem in many of our communities across Ontario. I recognize that members of all parties over various times have tried to deal with this very vexing problem.

I'm an MPP in Toronto, and it's not a problem there. Indeed, as people know, one of the problems is that many physicians choose to stay in Toronto and other large urban areas. So I certainly don't speak from experience myself or my constituents'. I must say that my birthplace-my hometown is in Newfoundland-Labrador, from where I just returned, in fact, because my father is ill. I can tell you, as you can well imagine, that it continues to be a major problem, as here in Ontario, particularly in Labrador and rural Labrador-of course it's all rural in Labrador-to attract not only physicians but nurses.

In fact there was a press conference when I was there held by the nurses, talking about this very same issue: what kinds of incentives to bring forward to keep nurses and doctors in very remote areas, as in Labrador and parts of Newfoundland. Of course, having been a member of the NDP government, I remember very well sitting around the cabinet table trying to grapple with this indeed very disturbing and difficult problem.

I'm not going to support the bill today, and I don't think anybody should.

Mr David Tilson (Dufferin-Peel-Wellington-Grey): The resolution.

Ms Churley: The resolution. Thank you for clarifying that, member for Dufferin-Peel. I'm not going to support the resolution before us today because it is indeed a really draconian measure and, as has been pointed out by previous speakers, has already been ruled unconstitu tional in other provinces where it has been tried.

It is a measure that perhaps one day as a last resort, after trying all kinds of solutions that have been suggested and which so far this government, as indicated in many letters that my colleague, our health critic, Ms Frances Lankin, has received since the medical community became aware that this resolution was going to be debated today-they point out that they have indeed tried to get the minister to adopt some of the measures they're recommending and can't get her to do that.

I want to read you some examples from the letters that we have received and that I know Mr Maves has received as well from many groups and associations from the medical community in Ontario. As you will see from some of the excerpts I read from these letters, there is a real concern out there about this draconian measure that's been brought before us today.

I'm going to read to you, for instance, some excerpts from a letter from Dr Jeffrey Remington, which was copied to me and Frances Lankin. It was written directly to Mr Maves in response to this bill. He is the chair of the Niagara Physician Resource Planning Task Force. What he says is this:

"Dear Mr Maves:

"I am writing to you to with strong disapproval for your plan to begin attaching geographic billing number restrictions to new medical graduates. As you are aware, I am the chair of the Niagara Physician Resource Planning Task Force, a committee of the Niagara District Health Council. For almost two years, this group has extensively researched both the crisis in physician manpower, as well as potential solutions. I know first-hand the lack of primary care doctors in your riding, as well as the entire Niagara Peninsula.

"Our group has offered several solutions to the doctor shortage that could be effectively and promptly implemented both in our region and in other areas of the province. They include:

"-the hiring of additional community development officers for central, south and west planning regions

"-funding for medical students and residents to complete parts of their training in our region

"-pre-medical programs to encourage students from outside of the tertiary centres to enter medical training with the goal that they would be more likely to return there to practise (eg, medical experience plus program at Brock University)."

And this is something that our party indeed has been pushing, that is:

"-additional funding for nurse practitioners to work in group practices in rural and underserviced communities."

Let me add there that when we were in government, we, as everybody knows, enhanced and started a funding program to increase the number of nurse practitioners and their responsibilities and abilities to carry out certain practices. We know that there are nurse practitioners-there are some in my riding-who cannot get jobs, which is a real shame. It's been recommended time and time again that there be more community health centres in rural areas and the role of nurse practitioners be increased greatly.

He also recommends:

"-increasing the enrolment of Ontario's medical schools combined with specific changes in family medicine resident training programs to increase the proportion of family doctors graduating and to ensure they have the training and skills to meet the challenges of practice in non-urban centres."

His last recommendation here is:

"-address the issue of foreign-trained medical graduates, many of whom are native Ontarians, and facilitate some sort of training/certification programs for them."

He goes on to say, "Unfortunately, when we have attempted these ideas with Ministry of Health officials they have not been met with approval.

"We strongly agreed with the Minister of Health's decision to appoint a fact-finder on this issue." May I point out that this government's own health minister has appointed a fact-finder on this issue and these people have participated in what he says was a very successful three-hour meeting.

"It is most discouraging and detrimental to this process"-that is ongoing right now; those are my words-"that you chose not to wait for his report, but to immediately jump to extremely coercive measures to solve this problem.

"Mr Maves, you are no doubt aware that one of the strongest reasons that your riding is underserviced for physicians is that in the last decade a great number chose to move to the United States. ... If you and your government choose to implement coercive measures to redistribute family physicians around this province, I absolutely believe that we will be faced with the largest `brain drain' of young medical talent the province has ever seen."

What Dr Remington is suggesting here-he's urging the health minister and the cabinet to withdraw this idea immediately. Now, I recognize that this is a private member's bill and it is up to each individual member to vote on this today, but I would agree with Dr Remington. This bill should be voted down today. There are all kinds of other measures that have been suggested in the letter I just read and I have many more communiqués from various others from the medical field who express the same kinds of concerns I expressed today.

There is a letter here, for instance-I believe all MPPs received it-from the Professional Association of Internes and Residents of Ontario. They say they're writing to ask our party, and indeed I'm sure all of the other MPPs, to reject this resolution on the following grounds:

"

(1) PAIRO has worked for the past six years with close to 200 northern and rural communities and virtually all these communities have told us that they `prefer to have doctors who want to come and stay over doctors who are forced to come.'"

His second point: Again we hear that another group "has recommended a broad range of non-coercive solutions to the Ministry of Health," and "these recommendations are included in several reports" which are available to all of us.

He says, "While a few of these recommendations have been put in place, primarily in northern Ontario, many more significant measures recommended ... have not been implemented. (Some of the possible solutions identified include increasing the number of students admitted to medical school, increasing the number of international medical graduates admitted to the IMGs training system, voluntary return of service with financial incentives such as loan repayment, training more physicians in rural areas and substantially expanding training programs in rural areas, extending and implementing alternate payment plans so doctors can work on contract rather than on fee for service, setting up a regionalized quick response system for replacement doctors (locums), providing quality of life incentives to avoid physician burnout, recognition of spousal and family needs, implementing funded group clinic facilities, and restructuring of the underserviced area program.

"

(3) The McKendry report (on physician shortages)"-and let me bring this up again-"commissioned by the Ministry of Health, is due shortly. This report and the recommendations it will propose must be given sufficient time for implementation before contemplating the sort of resolution proposed by Mr Maves. In the meantime, PAIRO continues to work with underserviced and rural communities to help alleviate shortages in the short term."

He goes on to say the same thing as other correspondents have said, that this is a draconian measure and will in fact have the opposite effect. I know that Mr Maves is bringing this resolution forward in good faith, but when you get this kind of information from those in the medical community, who say, "This will not work; it will have the opposite effect, that in fact we will lose more physicians," just think about it.

We know there are more and more women entering the medical profession. There are more female doctors out there, who have children, who have spouses, who have family needs. We have situations and legal decisions that back up what I'm saying here. When you have a couple with children living in one area and that person is restricted from practising that profession, then it means it's a fundamental affront to their human rights, their constitutional rights, that they would not be able to get work or their spouse-and this applies whether it's male or female-would have to pick up and leave or not be able to work in that community.

So we have two reasons why we shouldn't support this resolution today. Number one, in many ways the most compelling, is that this government right now has a fact-finding commission out there which is going to make recommendations to the minister shortly. Why in the world would this resolution be brought forward today when that report is imminent? We don't know as yet how the minister is going to respond to it, but what we should hope for is that they will move really aggressively, which indeed may mean spending extra funds.

The worry we have here today, of course, with even more cuts coming, which we all know about, is that in fact there is going to be less money to be able to deal with the kinds of incentives and measures that are recommended by those who are in the field and know what needs to be done and know that there are solutions to this. I fear that the government may reject some of these solutions, but at least wait until we try all of those other measures before we get into a mess, that-and this is the second reason we should reject it today-it has already proved to be unconstitutional in other provinces.

Here we have a government that's in the process of having recommendations from the medical community to be delivered to them, and secondly, we know-the evidence is in front of us; I have copies of some of the court decisions here-that it has already proven to be unconstitutional.

Why waste the time of the Legislature debating something and perhaps passing something that indeed, at the end of day, if it is implemented by this government, will mean (1) that it's draconian, (2) will not work for the various reasons I've outlined, and (3) should the government still choose to go ahead with this, we clearly know that it is already unconstitutional and will just lead to expensive, messy court challenges. I will not be supporting this today.

Mr Toby Barrett (Haldimand-Norfolk-Brant): I am pleased to rise today to support the resolution put forward by the member for Niagara Falls with respect to our distribution problem of physicians in Ontario.

When I was first elected, I worked on this issue with the towns of Tilsonburg and Port Rowan, and very simply, there were just too many people for the number of doctors in those areas. We were successful in getting Port Rowan designated as an underserviced area very early on. Subsequently, all the other municipalities across Haldimand-Norfolk have been designated. However, the designation does not seem to be a magic bullet and it does not guarantee a new doctor anywhere in Ontario.

The member for Niagara Falls presented some statistics. In 1997, the University of Toronto did a report on physician distribution. Clearly, the results are a wake-up call. Their findings indicate that almost 90% of the inhabitants of underserviced areas are in southern Ontario. This U of T report hit home in my riding. The Haldimand-Norfolk region was deemed the second most underserviced area in Ontario, behind only the Sudbury district. Local people did not need a study to tell them there weren't enough doctors in their area. The problem has become quite apparent in the town of Simcoe in the past year.

In consultation with the Ministry of Health, I requested that caps be lifted on physicians' remuneration as a short-term measure.

However, throwing money at the problem does not solve the problem and we need a long-term solution, the kind of solution we are seeing here today from the member for Niagara Falls. I've been very encouraged by a number of pilot projects, for example in Paris, Hamilton and other areas, to roster doctors in co-operative groups to take care of patients. This is one very creative approach to the solution. But the heart of the problem that the member for Niagara Falls is trying to remedy with today's resolution is that the doctor distribution system and problem needs to be addressed very soon.

Our government has been working with the Ontario Medical Association for over four years to solve this problem. We have to ask ourselves: How much closer are we to solving the problem now? I have confidence in the Blueprint plan to offer free tuition to medical students. Again, that's going to help a bit in remote areas like Kapuskasing and Port Rowan, as I have mentioned.

Our member, in the resolution today, has suggested that all other avenues are failing. We should stop giving new OHIP billing numbers to overserviced areas. Some may think this is drastic, but the member-and I agree with him-believes that we need a plan B because plan A is not working.

Mr Maves: I want to thank all my colleagues in the Legislature for their input on this debate. It's a complex problem. I know that, and we've been trying to solve this in Ontario for many, many years. In 1996 we had this debate when we passed Bill 26. The OMA, PAIRO and others said: "Don't enact it. We'll work with you to solve the distribution problems." Four years later, the problem is worse-not necessarily for lack of effort, but the problem is worse and our constituents are still having this problem to greater and greater degrees.

Again, it's not a problem of supply. I talked about Ben Chan's study, which said it's not a problem of supply. The OMA has recognized it; the Ministry of Health has recognized it. Again, the report that was given to me by Barer-Stoddart recognizes it. They say:

"History does not support a supply expansion policy. For over 30 years, prior to the early 1990s, annual increases in the supply of physicians exceeded growth in the Canadian population. Since then, it has kept pace.... Therefore, it is discouraging that the problem of rural and remote access ... appears to be worse now than ever before."

We concur, and I think the citizens of Ontario concur. Today's debate shows that we indeed needed to renew this discussion. Barer-Stoddart also says, "Our intent is to stimulate discussion and further considerations, because it seems clear that real progress will require real change."

Folks, I support increased remote medical training initiatives. I support the use of nurse case practitioners. I support improvement initiatives. I support seeing the McKendry study. That was in my resolution before the desk edited it out, quite frankly. But we need to get something done and we need to get something soon. I hope you will support the resolution.

The Acting Speaker (Mr Michael A. Brown): The member's time has expired. This ballot item will be dealt with at 12 o'clock.

HIGHWAY 17

Mr Sean G. Conway (Renfrew-Nipissing-Pembroke): I move that, in the opinion of this House, the Harris government should keep its electoral promise to the people of Renfrew county to improve the safety of Highway 17 by immediately four-laning Highway 17 to the town of Arnprior and by immediately committing to a timetable for the four-laning of Highway 17 to the town of Renfrew.

The Acting Speaker (Mr Michael A. Brown): The member has moved ballot item number 4.

Mr Conway: I rise today to address a matter of urgent public concern to the people I represent in rural eastern Ontario, the Ottawa Valley. I do so recognizing that I'm not alone in this concern. I'm pleased to see my colleague the newly elected member from Carleton-Gloucester here today, someone who knows the Ottawa Valley well and who asked a related question to the Minister of Transportation the other day.

To give you some indication of how serious this matter is for my constituents, almost the very moment that my friend and colleague from Carleton-Gloucester was asking the Minister of Transportation his question about Highway 17 in this Legislature but 48 hours ago, the 22nd person was being killed on that highway in the last 12 months.

Highway 17 through the Ottawa Valley is, tragically, a killing field for my constituents, and for other people who must of necessity, for work or recreation, travel that very important artery through the Ottawa Valley.

Let me repeat to this House: 22 people have been killed on Highway 17 in the Ottawa Valley in the last 12 months. That is a carnage that is absolutely unacceptable. It is a carnage that is deeply troubling to the people I represent and, I know, to the people who are represented by my friend from Orleans and by the Minister of Intergovernmental Affairs.

You cannot read the Pembroke paper, the Arnprior paper, the Ottawa Citizen or the Ottawa Sun without understanding the palpable anxiety and anger that attaches to the fact that after years and decades of promises from provincial governments of all stripes, we still see a highway, particularly between Kanata and Arnprior, that is not four-laned.

Yes, there have been improvements, and I want to congratulate whatever government, whether it was the Peterson government or the Rae government or the now Harris government for the work that's been done. It was said here the other day, appropriately, that we've just opened nine more kilometres of four-laning east of Arnprior. But that's well short of the timetable that was promised years ago.

There is more than just the carnage. There are increased volumes, particularly because of the economic activity that's developing, not just in the Ottawa Valley but in Kanata, the so-called Silicon Valley North.

More and more of the constituents I represent in communities like Renfrew and Arnprior are driving daily into Kanata and West Carleton to work. People from the Upper Ottawa Valley, and places like Barry's Bay, Rolphton, Palmer Rapids and Petawawa drive routinely to the major health care facilities in the national capital area, and they do that often during very bad winter conditions. This highway is truly a matter of urgent public concern to everyone in eastern Ontario, most especially for my constituents.

We had an electoral campaign just a few short months ago. It is no surprise that in that electoral campaign, whether my esteemed Conservative opponent, Mr Jordan, or a very good New Democratic opponent, Mr Boyer, or I were in Arnprior or Renfrew or Pembroke or Petawawa, one of the issues that dominated the debate was: "What will you do as a potentially re-elected or elected member for Renfrew-Nipissing-Pembroke to add pressure to bring about those badly needed improvements to this highway?" All of us sang from the same hymn book, because you could not, as a democrat, do anything else.

We all heard the same cries of anguish from the parents and the loved ones of those 22 people and countless others who have met either a tragic death or a serious accident on that highway.

I will not soon forget the day-it was a very rainy day-Tuesday, June 1, 1999, when I, Mr Sterling, Mr Jordan, the mayors of Renfrew and Arnprior, the warden of Renfrew county and the candidates from West Carleton gathered in the pouring rain at the intersection of 17 and old 29, just east of Arnprior, to await the arrival of the then-Minister of Transportation, now the Minister of the Environment. On the eve of polling day, Mr Clement said-and I won't quote the papers, but I could-"Re-elect us and we will move on a priority basis to get the four-lane to Arnprior and move forward with the planning to Renfrew." We all applauded.

Two days later, the election took place. Conway was re-elected, and the Harris government was re-elected. But the people of the Ottawa Valley heard us all. They expect that the urgency and priority we all offered on that solemn, if wet, pre-election day would be met and discharged in this mandate.

Many of us are troubled that since June 3 we have our friend Mr Turnbull, the now-Minister of Transportation, writing to constituents. I'm not going to quote

chapter and verse, but I have in my hand a letter signed by the Minister of Transportation to a resident of eastern Ontario who has specifically written to the minister in the past few weeks wondering what the plans were for keeping the promise on four-laning Highway 17 to Arnprior. What was the answer? The answer is-and let me quote part of the letter-"Although I am unable to commit the ministry to a specific

schedule at this time...."

We need specificity. My constituents don't expect miracles, but they expect the promise to be kept, and on a timely basis. Yes, the minister said the other day to our friend from Orleans, Mr Coburn, "We will keep the promise," but there was no timetable. There was no commitment to when and where. As I say, we don't expect miracles, but we do expect the government to recognize the urgency and the priority.

Mr Speaker, on behalf of my constituents I want to tell you that we expect more clarity, more definition to the minister's so-called commitment. Precisely when do you propose to have the four-laning to Arnprior? Precisely when do you propose to have the four-laning to the town of Renfrew?

Some people would say, "There's a resource or a money problem." I understand that. As a long-time member of this assembly and as a former minister of the crown, I understand that there are always more demands than there are dollars. But let me cite a couple of data that are highly relevant.

Interjection.

Mr Conway: Mr Speaker, I want some order.

I understand, as my friend from Kitchener opines, that the federal government spends even less. I ran on June 3, not for the federal Parliament; I ran to come here to give an accounting of the stewardship and of the tax dollars provided to the provincial government.

Let me repeat: In the last few years, the Ontario government has downloaded 50% of the provincial highway system in eastern Ontario. At the same time, we have continued to collect in excess of $2 billion annually in gasoline taxes alone. According to the Canadian Automobile Association, we are committing at best only 40% of those gasoline tax revenues for highway capital and maintenance. That is not good enough and it is not fair to the rural people of the Ottawa Valley and elsewhere.

If we are going to be taking more and more of gasoline taxes to fund general government programs, let me tell you, that is not only unfair to the department of transportation, to the travelling public and to the motorists of this province, but it is a cruel tax on rural people, who by and large have no public transit and must depend on the car and the half-ton truck. We should not be using the gasoline tax for general government programs.

I take my seat by concluding that this is a matter of urgent public concern, and my constituents want and expect a much clearer, much more specific timetable as to when this Highway 17 will be four-laned to Renfrew and to Arnprior.

Mr Brian Coburn (Carleton-Gloucester): I'm pleased to rise today to speak to this motion by the member for Renfrew-Nipissing-Pembroke. In particular I want to speak with respect to commitments. This government has, I believe, an enviable track record in terms of meeting its commitments. In 1995, when this government was elected, they had a plan they followed, the Common Sense Revolution. It was an action plan which they were committed to and followed through on. From 1995 to 1998, we cut taxes 69 times, including a 30% cut in income taxes.

We pledged to create more jobs, and in fact a record 540,000 new jobs were created in under four years. We pledged to reduce the number of Ontarians on welfare, and as a result, Ontario has gone from the highest number of people per capita on welfare to the lowest in Canada. Back in 1995, the Mike Harris government pledged to complete Highway 416 before the end of the millennium. Not only was the highway built on time; it was also under budget.

Transportation Minister Turnbull reconfirmed the government's commitment in the House just two days ago with respect to the expansion of Highway 17 to four lanes through to Arnprior. This government has proven its ability to fulfill its commitments with the construction of Highway 416 in eastern Ontario, a highway that had been talked about for years and years. Promises were made, promises weren't kept until 1995. Now, a promise made is a promise kept.

We've also introduced the action plan for safer roads. In fact, before the Mike Harris government was elected it was estimated with respect to Highway 416, the 80-kilometre stretch, that it would take 10 years to complete. Instead the highway was completed before the year 2000 and under budget by $14 million. It was unveiled to the people of Ontario in September of this year in a lasting tribute to the veterans, as it was named the Veterans Memorial Highway.

In order to truly appreciate the commitments kept by this government, it's important to recognize the following facts: This year alone, the federal government will remove in excess of $2 billion in gasoline taxes from Ontario. Last year, they removed $2 billion in gasoline taxes from this province and reinvested a paltry $20 million. Last year, 1998-99, this government spent $151 million on capital construction and rehabilitation of eastern Ontario highways. The most the provincial Liberals spent was $43 million, in 1989-90.

This year, 1999-2000, it is the highest capital construction and rehabilitation budget in Ontario's history, almost $700 million invested in construction and rehabilitation of Ontario's highways, which had been left in a state of neglect during the latter 1980s and early 1990s-twice what the Liberals spent, $342 million, in 1989-90.

But simply widening Highway 417 will not guarantee increased highway safety, and for that reason Minister Turnbull outlined a comprehensive action plan with respect to safer roads in Ontario.

Some of the highlights of this action plan are increased enforcement by the Ontario Provincial Police and Ministry of Transportation, in which police will crack down on aggressive driving and rigorously enforce speed limits and other highway traffic legislation; in addition to that, the promotion of safer driving habits through public education, an intensive and long-term public education campaign designed to cut down on aggressive driving, speeding, following too closely, improper lane changes, and of course road rage.

We've also established an Ontario Advisory Group on Safe Driving. This incorporates input from a wide range of key stakeholder groups across the province who are interested in road use and highway safety. This group will meet regularly to advise the Minister of Transportation on better and safer driving habits and how to improve the rules of the road, and the minister will rely on them as a valuable resource and respected sounding board on which to implement new policies that will provide safer roads for Ontarians.

We mustn't overlook the fact of long-term infrastructure planning as well, to ensure that future development will meet rigorous safety and traffic requirements. To ensure that Ontario's transportation infrastructure and capital investment decisions continue to be based on solid research and knowledge, this long-term strategic plan will focus on such key transportation issues as road safety, free flow of goods and services on our highway system, and enhanced gateways and trade corridors that we need to keep Ontario's economy strong.

I'd like to point out and commend a volunteer group in Arnprior known as the Safe on 17 group. The spokesperson for that group, Mr Sean Allen, also recognized the importance of improving driver education and safe operating practices on our highways and recognized that driver error does play a large

part in some of the collisions that we have on our highways.

I don't think anyone in this House would not support an initiative to improve safety on our highways. When a person loses their life on our highways, it is indeed a sad and tragic situation, on any one of our highways, including the stretch up the Ottawa Valley. That's why this action plan will play an important role in how we build and construct our highways and change our rules on how vehicles should operate on those public highways in the future.

In conclusion, this government does honour its commitments. It was a priority of this government to finish Highway 416 on time and under budget: job done ahead of time; check it off. It is a priority of this government to ensure all Ontarians have safer roads to use throughout the province: The action plan and advisory group is another commitment kept. It is the priority of this government to widen Highway 17 to four lanes to Arnprior and initiate the process for extension to Renfrew, and with a great deal of confidence, I say this will be another commitment kept by this government.

Mr Michael A. Brown (Algoma-Manitoulin): I stand here in my place to fully support the member for Renfrew-Nipissing-Pembroke. He understands that in rural Ontario and in northern Ontario highways are our lifeline. In Algoma-Manitoulin, the air service that we once could count on exists no more in many of our communities.

Highway 17: Sometimes I think that maybe I am the member for Highway 17 rather than the member for Algoma-Manitoulin. Roughly 500 miles of Highway 17 is within the constituency of Algoma-Manitoulin, from Nairn Centre to the Hemlo gold fields. It is huge. It is one of the lifelines that we find most important. It would be inconceivable to not have highway improvements on 17 done today. I look in the constituency, and while we have had some rehabilitation work done on the highway, we are still experiencing huge stretches of 17 that need dramatic work.

I want to tell you that I, like the member for Renfrew-Nipissing-Pembroke, know that there's $2 billion of government revenue that is not being spent on our highways. That is a strange state of affairs. Merely nine years ago, almost exactly the same amount of money that was brought in from fuel taxes, licence fees etc were spent on our roads-just nine years ago. What's happened? What has happened is that two successive governments have decided that this is a great source of revenue, that people won't notice. The people don't seem to understand that we're not using it for roads any more.

It used to be called the road tax. When you went to your local service station and he submitted the tax claims to the province, it was called road tax. We no longer, apparently, call it a road tax because it doesn't go to the roads, or at least a very small proportion, about 40% of it, I guess.

We have the money in this province to invest in our infrastructure. In our area, we have to have it. I've noticed that, as governments do, they announce lots of highway projects just prior to elections. We expected, on the word of the parliamentary assistant to the Minister of Northern Development and Mines, that we would have Highway 6 from Espanola to Little Current done. I don't see much action. Maybe in the fullness of time, as they say. And there are other significant road improvements that need to be made, but no, Mr Eves and Mr Harris are using that $2 billion to finance some of their follies.

I want to tell the Minister of Transportation that this afternoon, when Minister Hodgson releases his savings, his $1 billion in cuts that he's going to take out, we are going to have a very close look at his capital budget, because we believe there will be less money spent on roads. We believe that the capital expenditures that this government had pledged will not take place, at least not within the time frame of the next year or two. We will probably see a group of announcements in about 2003 and an increase in capital spending about that time so we can look at those nice blue "Your Ontario Tax Dollars At Work" signs again.

But this afternoon, as we watch the Chair of Management Board enumerate the cuts, the minister of pleasantville, the Minister of Transportation, should know that we expect to see capital funding more than maintained, increased, and the projects on Highway 17, Highway 6 and others brought to the forefront and accomplished in a very certain time.

Mr John Hastings (Etobicoke North): I'm certainly glad to be here today to listen to the member for Renfrew-Nipissing-Pembroke. The member has presented a very good resolution in terms of what he sees as the interests of his constituents. Having worked in eastern Ontario a few years back, in Smiths Falls, in education, there is no doubt that back in those days 417 and a lot of the network of highways in eastern Ontario certainly needed improvement. If you look back through the years, I guess if you used a Richter scale or bar charts of overall road conditions, it would be interesting to see how things have evolved from those days up till 1999.

I'll go back to the history in a short time, but I wanted to review for the edification of this House what the government has already achieved in terms of improving road infrastructure in eastern Ontario. I'm glad that the member for Renfrew-Nipissing-Pembroke noted that this has to be done, in terms of road expansion, rehabilitation, infrastructure improvement, within the competing resources of an overall budget that is set out by cabinet and the respective professional management people in the various ministries.

It seems to me that when you look at the recent history of what has gone on in terms of road expansion improvement and rehabilitation in eastern Ontario, we in this government have done a pretty good job in terms of prudently balancing our expenditures with what we see as the need for infrastructure improvement, whether they be ongoing maintenance, upgrades, rehabilitation or expansion. We want to ensure that future generations have a safe road network throughout Ontario and also ensure that we recognize economic competitiveness.

The member for Carleton-Gloucester has pointed out that we have made our commitment and lived up to it on the expansion, improvement and completion of Highway 416. Now we're working on Highway 417. It's only recently that we had another nine kilometres committed to success, and that is the promise of the four-lane Highway 417 from regional road 49 west to Panmure Road, which was an $11-million contract. It's completed; it's open. At the current time there's ongoing engineering construction and design going on, as well as environmental approvals.

Let me remind the House that the design for the four-lane alignment for Highway 17 from regional road 20 to regional road 22 is currently under way, including the Mississippi bridge design. Property acquisition for the right-of-way is also in progress. Indeed, we're also commencing the preliminary design studies on the four-laning of the highway from Arnprior to Renfrew.

The question is, are we keeping the promise? Yes, we are keeping the promise.

Mr John Gerretsen (Kingston and the Islands): No you're not.

Mr Hastings: Well, if we aren't, then I guess the member for Kingston and the Islands hasn't been up to see what has been going on in eastern Ontario in the last few years. Since the member is so informed on this, I'd like to remind him-and it would be nice to see, when we vote on this particular resolution, and I'm sure his colleague from Pembroke would be interested in seeing, how we can explore with the federal government perhaps a renewal of the COIW program, the Canada-Ontario infrastructure works program that was done 1994-95. That is a way of looking at building on your road success in terms of what was accomplished then.

Going back to the history of this whole expansion of our roads network across this country, let me remind you that it was the Diefenbaker government back in 1959-60 that committed to a roads-to-resources policy, not just across the middle of Canada but in the far north. The author of that design, that vision, was the Honourable Alvin Hamilton. It resulted in the development of the Trans-Canada Highway across this great country.

In the current middle years, we haven't seen from federal governments, whatever their political stripe, the need and the necessity to renew our infrastructure in that particular regard. I may not be correct in my recall, but I believe Highway 417 through the valley formed an original part of that whole network from British Columbia to Newfoundland. We've noticed in the last few years that Minister Collenette has made frequent announcements, before he went to cabinet, that he was going to get us billions of dollars for public transit and highway improvement infrastructure.

About a year ago, when I was in northwestern Ontario, I had the opportunity to speak with several of the media at that point, when it was pointed out that we had made major investments, major expenditures, to the highway system and particularly the bridge network in northwestern Ontario. If you look at today's expenditure, nearly $700 million has been put into expansion, maintenance and rehabilitation of the road system across this province.

If Minister Collenette at the time was serious about trying to get a few more dollars for our national infrastructure, when you combine it with the whole NAFTA-highway thing that the federal Liberals are certainly very recently converted to, then perhaps we need to look at the possibility with the member opposite of developing that strategy further and seeing whether, when he talks about the immediacy, the urgent priority of completing and widening Highway 417 from Arnprior to Renfrew, we could work with the federal government in this regard.

If we're looking at an improved infrastructure-the widening of the highway is not only for safety reasons but also for economic development-then this is a particular strategy that I think we can work on together. I would commend the member to remark on this joint necessity.

Mr Gerry Phillips (Scarborough-Agincourt): I rise to support my colleague in urging the government to move quickly on the four-laning of this highway.

I would take up the point that the previous speaker just made and that is that, among other reasons, clearly there are economic reasons. I continue to remind ourselves that, as I think most members here know, Ontario now is perhaps the area in the world that relies the most on exports for its economy. The most important page in the budget for me was where the province acknowledged and pointed out that 10 years ago roughly 25% of Ontario's economy was exports; today it's 50%. We've gone from about a quarter of our GDP, gross domestic product, being exports to half of it now being exports. There's nothing in our economy that's more important than our trade, particularly with the US.

So one key reason is economic, that all areas of this province have to be assured that they're going to share in the economic opportunities of trade, particularly with the US, and for that reason it's important that we move quickly.

I would say that the funding of this is a matter of extreme concern. If you look at the budget documents, firstly, the Ministry of Transportation capital budget has gone down dramatically. Next year, the government tells us, it plans to cut its capital expenditures by about 40%. That was in the budget. They said that in the fiscal year we're in right now, 1999-2000, they plan to spend roughly $2.7 billion on capital and then next year they plan to reduce that to about $1.7 billion. They're going to reduce capital expenditures in Ontario by 40%. That's what they say.

I might add that the government itself has told us that in the province we should be spending about $4 billion each and every year on capital refurbishment for our infrastructure. How is the government going to do that? Historically, if you look at the capital budget for the province of Ontario, we have tended to spend roughly $4 billion. The Harris government has said, "No, we're going to cut that from $4 billion to $2 billion, on average, over the next five years and we're going to get $10 billion from the private sector." That's the plan for building roads. They're going to get half of the money from the private sector.

I say to the people of Ontario, the private sector is in the business of making money. That's why they're there. To think that the private sector is simply going to, out of the goodness of its heart, build these roads is naive at best. If we are banking on the future of our highway system being funded by the private sector, and that's what the government's told us, we're in for nothing but toll roads. In particular, I say the 407 users have really been sold down the road.

The government doubled the price of the 407, sold the road for 99 years and told the purchaser, "Listen, you can take the tolls up every single year for inflation plus 2%." It's a licence to print money for the purchaser of the 407. For the government, pre-election, Harris got an extra $1.6 billion, but for the poor users of the 407, for 99 years you're going to be paying off that nice little pre-election goody of Mike Harris.

The reason I raise this is, we already know what the government plans to do. They're going to cut capital expenditures in half. They used to spend $4 billion; they're going to cut it to $2 billion. They say, "We're going to go to the private sector and somehow or other they will magically give us $2 billion a year." It's not going to happen.

What is extremely important to the future of Ontario is clearly our infrastructure. Our trade with the US is clearly important. A key element of that is our highway system. Yet we already know the government plans to cut capital from what we used to spend, from $4 billion to $2 billion, and somehow or other thinks that miraculously we're going to find the money from the private sector. The only way it will come is by user-pay.

Those who happen to live in a part of the province where the road has already been built should say, "Thank you very much." But those in the areas that need their roads refurbished or need new roads should say: "My goodness, the future doesn't look particularly bright for me. I thought Harris was all about cutting my taxes, not imposing a brand-new tax in the form of a toll."

I support my colleague's motion. I say that it is imperative for our future economy that we refurbish our highway system and that the plan the Harris government has embarked on is, in my opinion, doomed to failure.

Mr Richard Patten (Ottawa Centre): It's a pleasure for me to support my friend and colleague from Renfrew-Nipissing-Pembroke on a very important resolution.

First of all, I'd like to address the comments made by my colleague across the way, from Carleton-Gloucester, in his revisionist view of history. I'd just point out that the four-laning of Highway 16, which at the time was an extremely dangerous highway, was announced in 1989 by the Peterson government, of which I was part. We were happy to make that announcement and begin that commitment. Unfortunately, the extension was too long, especially during the NDP period, but everyone has to agree that today that particular four-lane highway is safer, is being utilized and has improved the commerce by way of Ottawa through to the 401, Kingston, Toronto and points beyond.

The same must be said, of course, of Highway 17. We know it is doable. The government made a commitment during the election campaign and we know that, once it is done and it continues to be extended, that will be applauded.

The extension has been going on ever so slowly. In recent years we've seen the extension go from the city limits of Ottawa to Kanata, then from Kanata to the Highway 17 exchange, then from there to the Almonte turnoff, where it is today. That has improved the safety in that stretch of land, without question, but we still need the promise to be fulfilled.

I know that many of my constituents in Ottawa Centre use this highway, as do large numbers of businesses in my riding. It's a pipeline for Ottawa and eastern Ontario and the upper valley and, beyond, to northern Ontario. The fact is, it is as busy as it is reflective of the economic value to the city of Ottawa and the Ottawa Valley.

Quick and safe mobility of goods really is, as has already been stated, a building block of economic prosperity. Highway 17 is too overcrowded and unsafe to make that guarantee at the moment. Many trucks use it because it is the most direct route through that particular corridor. I know I speak for the business community of Ottawa, as my colleagues will vouch for the businesses in the upper valley, when I say that this highway is necessary and would be good for the economy of eastern Ontario and, by extension, for Ontario and Canada.

In terms of tourism, I know that many of my friends as well as myself like to travel to the upper Ottawa Valley to take in the great natural beauty of it, for example the Algonquin Park area and all along the Ottawa River. Almost everyone I know has a story about a close call, a mishap or witnessing a crash while travelling on the highway. I'm quite sure that it causes people to think twice in many circumstances.

Indeed, the government has made a commitment, and it was reinforced by the parliamentary assistant this morning and I'm delighted to hear that. The question is, of course, when will that begin? We've heard promises before that there would be an extension of this four-lane highway to Renfrew, ultimately to Pembroke and beyond and, hopefully, at the same time there will be an acknowledgement of another highway from Sudbury through to Parry Sound, Highway 69, which in and of itself needs some urgent attention as well. But we'll have that debate another day.

I'd like to complete my comments from a personal point of view. One afternoon last summer I was driving home with my wife down Highway 7 back to Ottawa, and we were diverted to another outlet back on to the highway back to Ottawa. We saw that there was a big crash, we didn't know who it was at the time and I was saddened to hear the next morning that the dad of one of my colleagues in our research staff had been killed in that particular accident. The driver, having had a heart attack, swerved into the other lane. My point is, that could have been avoidable had we had a four-lane twinned highway.

I hope that the government will respond as quickly. I'm happy to support the resolution put forward by my colleague.

Mr David Christopherson (Hamilton West): I'm pleased to join the debate this morning. Given the track record of the member from Renfrew-Nipissing-Pembroke-they've really handed you quite a label for your riding-I'm not at all surprised that, first of all, personal safety is a part of the member's resolution and, second, that it deals with an important matter in his riding. He often sets an example of ensuring that one's riding is given the priority that it needs.

I have learned a great deal from watching the member over the years I've been here; and I congratulate my colleague from Mississauga South-is it still, Margaret?-as we all have. I think it is not an over-the-top statement at all to suggest that many of us have learned many things from this member.

I just want to say-

Applause.

Mr Christopherson: Yes, go ahead and give him a round of applause. He deserves it. I believe he is also the dean of the House, or one of the co-deans. That makes you co-dean. You might want to think about that.

Our caucus is very supportive of this measure. Anything that involves people's safety: You know, the government talks a great story about caring about safety and caring about people, but oftentimes we find in this place-pardon the pun-when the rubber hits the road, the reality is that you're not there. You're there in words, you're great with the words but you're not there with the action.

What I think the honourable member from Renfrew-Nipissing-Pembroke would have hoped to hear today was a clear commitment or, at the very least, that we would get enough backbenchers from the government who care about public safety and road safety that we could carry a message from this House. Even though motions and resolutions passed here aren't binding, they carry a lot of weight and add moral support to our arguments that are made here in the House, but at this point from what I've seen of the debate it doesn't look like that's going to happen, and it really is unfortunate.

I travel the QEW a lot, obviously, from my riding to Queen's Park, and I tell the government you've got to start paying a lot more attention to transportation and the issues related to transportation such as public transit, and I know there are recent announcements about GO looking at extending their service, that should be a much greater priority. Again, given the downloading exercises we have seen from this government, that is now all the more difficult as a result of your dumping on municipalities all of these responsibilities.

That's not even yet to talk about urban public transit within our municipalities which-all of that responsibility-you, the Harris government, have dumped on to municipalities.

In our urban centres we're not just talking about the efficient movement of people and the right that people have to access all parts of their community through an affordable public transit system. The environment is such a key issue, and we know that one of the major pollutants is the exhaust fumes from vehicles, the clean air program notwithstanding, we still face a major challenge. So when you deal with transportation, I would agree that one of the issues is the economics of it.

Today we're going to see the beginning result of your winning the election on a platform of a 20% tax cut. Today we are going to see hundreds of millions of dollars that the government is going to claim is all about fat and efficiencies, and yet everybody else across the province will see it as cutting into muscle. We're going to see hundreds of millions of dollars announced today coming out of public service for one reason and one reason only: so that this government can give a continuing tax gift to their friends.

People are beginning to catch on. It has taken a few years for these things to settle in and the implications to take hold, but as we see the kinds of pressures building around our education, health care-which are the two big issues out there-there are incredible pressures on both. Now you have to find close to at least what you've announced publicly in a booming economy. That number changes if this economy starts to slide.

We're getting close to $1 billion that you've identified you have to take out. Anybody who has even a cursory knowledge of what happens with the accounts around here and where the money goes and where it's spent will understand and appreciate that a further billion dollars is going to put enormous pressure on important crucial public services, and transportation at some point is going to be hit.

People are now realizing that they didn't get much out of that 30% tax cut. Yes, it sounded good and they may even have voted for you, but as they watch what's happening in the classrooms, in hospitals, in terms of municipal services, at the library, with recreational services, they're beginning to see that this wasn't a fair trade-off for them. They're not one of those that make $250,000 a year who get $26,000 back after taxes. That's what people get who make $250,000. Under your first round with the 30%, they got $26,000 after taxes. It's completely understandable why they voted for you.

Any cuts you make in public health, public education, even public transportation, for that matter, since they now have the ability to use highways where they pay directly-we were the ones who introduced that. I'm not trying to dodge away from that. Nonetheless, it's always understood that if you want to pay that money, you can get around something.

It's one thing to talk about that in terms of how much is saving 15 minutes on a highway worth to me, versus the only way I can give my kids a decent education is to make sure I cough up the money to send them to a private school; God forbid, as we're seeing in Alberta, Ralph Klein is now-you know the thin edge of the wedge is there-introducing private hospitals.

Make no mistake, it's not going to be long before this government goes there too, because everything that Ralph Klein has done in Alberta, you have followed, or in an attempt to get even better coverage in the right-wing media-by that I mean those that are committed to right-wing Conservative supply-side, trickle-down theory. They've been hailing Ralph Klein as this great beacon of hope for the future and Mike got jealous. Where he can, the Premier likes to do one better than Ralph Klein.

I raise this in the context of this speaker because what the member from Renfrew-Nipissing-Pembroke needs in order to provide the safety that his constituents deserve is money. It comes down to money. As long as this government has decided that giving continuing tax breaks to their wealthy friends is more important than the safety of our citizens on the highway, more important than the education of our children, more important than providing adequate and sufficient health care services to our families, then we're going to continue to see these kinds of resolutions and motions coming forward and pointing out that you're not delivering.

It was interesting that in the annual report of the Provincial Auditor, tabled the other day, one of the things the auditor points out is that you've been trying to cook the books with regard to contracting out highway maintenance, and by including as a revenue stream the selling of capital assets; in other words, the actual machinery that the government used when they were providing the maintenance to the highways. You were trying to show that there's more money there than there really is.

The auditor cut away all your smoke and mirrors, and what was left was the realization that contracting out doesn't work, which we've been telling you for years. Obviously there are places for the private sector, but to believe holus-bolus as an ideology that everything in the public domain is better in private is simply not true. The auditor has now exposed you on this.

Ontarians are receiving less service in terms of the maintenance of our provincial highways and it's costing more money. The only ones who are benefiting are, guess who? Your pals who own the construction firms, who got the contracts when you took it out of the public sector and put it in the private sector.

Let's not forget that in the process of doing that, to make this as profitable as possible for your friends-because that's what this was about; it wasn't about providing better highways, it wasn't about improving Highway 17 or any other highway; it was about making sure your pals can make a profit off the taxpayer's back-what did you do to help grease the way? You took away successor rights.

What does that mean in plain language? It means that for everybody else in Ontario, if you sell your company, your corporation, your service and there's a collective agreement in place, by law that collective agreement and the benefits those workers fought for and are entitled to go with the sale-except that this government brought in a law just for public sector workers, because we know that this government thinks that anybody who works for the government is evil.

I haven't quite figured out how that doesn't apply to them, since they're in the public trough in terms of where their paycheque comes from, but everybody else in the public sector is deemed to be evil, inefficient, lazy and all those other negative kinds of connotations. This government brought in a law that said, "When we privatize a public service and sell it to our wealthy friends, the collective agreement is dead." Those wage rates that were guaranteed are gone.

Mr Wayne Wettlaufer (Kitchener Centre): On a point of order, Mr Speaker: I've been sitting here for the last 10 minutes and I've been wondering what the member has had to say yet that has anything to do with Highway 17.

The Deputy Speaker (Mr Bert Johnson): That is not a point of order. I would ask the member for Hamilton West to continue.

Mr Christopherson: Thank you very much, Speaker. I'm not surprised at the interjection. They often do that when you start to get at what is really going on around here; they get all upset. I would say to the member that I think my comments have been very much germane and to the point.

I'm talking about the fact that because you have taken every dime that you can find and have given it to your wealthy friends, there's not enough money to take care of the four-laning of Highway 17.

In addition, I'm arguing that not only is there not enough money for Highway 17, there's not enough money for the kind of expanded GO system that we really need, there's not enough money available for public transit in our major urban centres, which also attaches to the environmental concerns that you profess to care about at the same time that you're dismantling the environmental protections that we've built up over decades.

I'm arguing also that the money you're taking and giving to your friends by virtue of a continuing tax cut is affecting our ability to put our kids through the kind of education system they deserve and have the kind of health care system they're entitled to. I think that's very much germane to this point.

The fact is that you don't want to hear about what happens after you make the announcement about the tax cut. All you want to talk about is, "Hey, we're going to cut your taxes." That's a wonderful message. We all think that's fine and wonderful. Nobody wants to pay more taxes, but there's a price to be paid. When you're talking of the amount, the billions of dollars, that this government has taken out of health care, education, environmental protection, social services, and yes, transportation, I think it's very much germane to this resolution.

I think quite frankly that had you not given the billions of dollars to your wealthy friends that you did, there would be enough money to put the lives and the safety of the constituents of the riding of Renfrew-Nipissing-Pembroke in a much higher priority than you have done. I think that's very germane. You may not think so because you do not want to think past tax cut, tax cut, tax cut, money, money, money, money. Listen, we're talking about lives here. We're talking about the ability that you have a responsibility to provide in terms of the safety of the citizens of eastern Ontario, and you're not meeting that obligation because you're taking care of your rich friends.

Mr Conway: I want to thank all of my colleagues for their contributions to this debate. I want to say three things in

summary. First, about the money, I was encouraged by the comments particularly from Mr Hastings and to some extent Mr Coburn on the government bench. I understand the pressure about money.

But I'm sitting here as someone who imagines that I am someplace in the Ottawa Valley, and what do I know? I know that this year I will pay something in excess of $2 billion provincially in gasoline taxes. If I factor in the fuel tax and the motor vehicle registration fees or taxes, that's another $900 million. I will know that this year I will give to the provincial government nearly $3.5 billion of road and road-related taxes.

As my friend from Algoma rightly observed, it is a reasonable expectation that the vast majority of those road-related taxes will go to road-related spending; and we are not doing that. It is a very unfair tax policy to ask rural and northern people, who do not have OC Transpo, who do not have the Hamilton Transit Commission, who do not have the Toronto Transit Commission running subways. If you live in Palmer Rapids and Deux-Rivieres and Calabogie, your car or your half-ton truck, your neighbour's car and half-ton truck, is your way of getting to work, of getting to the hospital or getting to see some business colleague.

We cannot be imposing these road taxes without, as a provincial government, doing a better job of spending a greater portion of those monies provincially on the purposes for which they're intended.

Let me conclude by noting, as the editor of the Arnprior Chronicle Guide noted a few months ago on this question: "Will this highway be improved? Yes." But he said, in an editorial, "Will I live long enough to see it or will old age or a highway fatality on 17 take me before that improvement is made?"

What we need, I say to the government, what my constituents in the Ottawa Valley want, is a specific commitment, a specific timetable as to how and when Highway 17 will be four-laned to Arnprior and then to Renfrew.

DOCTOR SHORTAGE

The Deputy Speaker (Mr Bert Johnson): The time for private members' business has expired.

We will deal first with ballot item number 3, standing in the name of Mr Maves. Is it the pleasure of the House this resolution carry?

All those in favour, say "aye."

All those opposed, say "nay."

In my opinion, the ayes have it.

Call in the members. We will deal with this item concurrently with the other item.

HIGHWAY 17

The Deputy Speaker (Mr Bert Johnson): We will now deal with ballot item number 4, standing in the name of Mr Conway. Is it the pleasure of the House the resolution carry? Carried.

Call in the members; there will be a five-minute bell.

The division bells rang from 1205 to 1210.

DOCTOR SHORTAGE

The Deputy Speaker (Mr Bert Johnson): We are dealing with ballot item number 3 standing in the name of Mr Maves. All those in favour, please rise and remain standing until recognized by the Clerk.

Ayes

Baird, John R.

Barrett, Toby

Chudleigh, Ted

Coburn, Brian

Dunlop, Garfield

Elliott, Brenda

Galt, Doug

Hastings, John

Kells, Morley

Klees, Frank

Marland, Margaret

Martiniuk, Gerry

Maves, Bart

Mazzilli, Frank

Munro, Julia

Mushinski, Marilyn

O'Toole, John

Stewart, R. Gary

Tascona, Joseph N.

Wettlaufer, Wayne

The Deputy Speaker: All those opposed, please rise and remain standing until recognized by the Clerk.

Nays

Agostino, Dominic

Arnott, Ted

Bartolucci, Rick

Bountrogianni, Marie

Boyer, Claudette

Bradley, James J.

Brown, Michael A.

Bryant, Michael

Caplan, David

Christopherson, David

Churley, Marilyn

Cleary, John C.

Colle, Mike

Conway, Sean G.

Crozier, Bruce

Duncan, Dwight

Gerretsen, John

Kormos, Peter

Kwinter, Monte

Lalonde, Jean-Marc

Levac, David

McLeod, Lyn

Parsons, Ernie

Patten, Richard

Peters, Steve

Phillips, Gerry

Ruprecht, Tony

Smitherman, George

Wood, Bob

Young, David

Clerk of the House (Mr Claude L. DesRosiers): The ayes are 20; the nays are 30.

The Deputy Speaker: I declare the resolution lost.

This House stands adjourned until 1:30 this afternoon.

The House recessed from 1212 to 1334.

MEMBERS' STATEMENTS

HOSPITAL RESTRUCTURING

Mrs Sandra Pupatello (Windsor West): I wanted to speak briefly this afternoon regarding the Provincial Auditor's report yesterday and just to remind everyone in the House of the kind of discussions we have had in the Windsor area for the last four years around hospital restructuring. How must it feel today for residents from my riding in our area to know that the Provincial Auditor vindicated everything that our community has said since the restructuring process began?

When we turn the pages of the auditor's report, which is the most damning report that has ever been written in the history of the Ontario government's record on how it does its financing of appropriate services in Ontario, this one in particular is most scathing. What's difficult to accept is the fact that what you do is affecting people's lives, in particular our hospitals. We have both Windsor hospitals now running a deficit yet again, one of $8 million, another of $7 million. Your one-time funding of many hospitals across the board just before the last elec tion was just propaganda and meant to silence your foes before you got into an election.

If I may read "Implementation of hospital restructuring," what he said was, "It needed a careful sequencing of changes." All we can say to that is: No kidding. We have been telling you that for years and you should have been more attentive to the members who represent those ridings.

GASOLINE PRICES

Mr Joseph N. Tascona (Barrie-Simcoe-Bradford): I rise today to commend our government and the Minister of Consumer and Commercial Relations for forming a task force to investigate gasoline prices. For far too long now, we have watched the federal Liberals sit back and watch gasoline prices soar right out of sight in Ontario and across the country. In fact, a local federal Liberal member said she wished the gas price problem would just go away because she was tired of it. How dare she and the federal Liberals treat our gasoline consumers with such contempt.

It's crystal clear that the federal government is totally responsible for the gasoline marketplace in Canada, yet they choose to do nothing. Well, our government will do something. We will investigate gasoline prices and present our findings to the federal government, just like we promised in the speech from the throne.

I am proud to co-chair the task force with my colleague, PA for the Minister of Consumer and Commercial Relations and the member for Durham, John O'Toole, and serve with the member for Scarborough Southwest and the member from Halton. We've just seen another overnight five- to six-cent increase in the price of gasoline and our consumers are furious. They've had enough. We must get to the bottom of this seemingly endless round of gasoline price increases, and I believe our task force will do just that.

The federal government is responsible for the gasoline marketplace under the federal Competition Act, but they continue to do nothing. We hope our report will spur them to action, because our consumers are fed up and they want action now.

NORTHERN HEALTH TRAVEL GRANT

Mrs Lyn McLeod (Thunder Bay-Atikokan): I have in my hand the resolutions of municipalities across northwestern Ontario expressing concerns about the inadequacies of the northern health travel grant. I have petitions signed by hundreds of residents of northwestern Ontario communities expressing the same concerns. I have letter after letter bringing concerns about the unfairness and arbitrary administration of this grant. I have the submission from the Northwestern Ontario District Health Council asking the minister for a review of the travel grant.

And I have the minister's constant response to every constituent case we raise and to the health council itself, saying the ministry has no plans to amend the current policy.

The minister's letter defends a policy which is blatantly unfair and discriminatory. When cancer patients from southern Ontario have to travel to the United States or to northern Ontario for care they can't receive in a timely way in their home communities, all costs of transportation and accommodation are paid. But when northern Ontario residents have to leave their home communities to receive care that cannot be provided at home, they have only a portion of their costs offset. The only justification for this discrimination is that northerners have to do this on a regular basis. For people in southern Ontario, it is hopefully, a temporary necessity.

In fact, there is no justification for any resident of this province having to pay often thousands of dollars out of their own pockets to receive medically necessary care. There is no excuse for the rigidity of the way in which applications for the minimal support that's offered are being handled. It is unconscionable that requests can be refused because of inappropriate application of rules that distort the intent of the program.

It is time to review the northern health travel grant program.

FAMILY RESPONSIBILITY OFFICE

Mr Peter Kormos (Niagara Centre): The Provincial Auditor's report condemns once again and reveals the negligence and gross mismanagement by this government of the Family Responsibility Office, formerly the family support plan. The report confirms everything that opposition members have been saying about this program for over three years now, and it confirms what Shelley Martel and I revealed back in November 1996 when we brought videotape to this assembly to illustrate that the government's claims about the plan being up and running were nothing but pure gibberish and nothing short of an outright-fill in the blank, Speaker. It was an outright, and you know it.

Women and children suffer on an ongoing basis. This government clearly doesn't like women and kids. This government clearly doesn't want to serve their interests. It could be done with even a modest amount of political will, and this government has no interest in that.

This government's gross mismanagement of the family support plan leads to only one conclusion: that it wants to drive the FRO and the FSP into such a state that this government will indicate that it cries out for privatization.

This government continues to spend millions of dollars in a grossly negligent way. This Attorney General has exceeded the capacity of his predecessor, Charlie Harnick, in displaying incompetence and lack of interest in the adequate operation of the FRO system, a very important program for women and kids. This government had better straighten up soon.

OPTIMIST CLUB OF NEWMARKET

Mrs Julia Munro (York North): I rise today to congratulate the Optimist Club of Newmarket on their 50th anniversary. I recently had the honour to bring greetings from the province at the celebration to commemorate this wonderful milestone.

The Optimist Club, whose members number in the thousands across the world, was built on the philosophy of positive thinking and an upbeat approach to life and work. In this way, its members are able to make a positive difference in the lives of those around them.

For 50 years, the members of the Optimist Club of Newmarket have volunteered thousands of hours to their community, and particularly to helping their youth lead productive and successful lives.

Newmarket has grown a lot since 1949, and the Optimist Club has been equal to the challenge. Through their development of corporate partnerships with community-based businesses, they are particularly able to assist the youth of Newmarket in a variety of ways. They fundraise for the children's ward at York County Hospital; they provide the facilities for army, sea and air cadets to hold their meetings; they sponsor hockey, soccer and baseball throughout the community. Through their tireless efforts and dedication to helping others, the Optimist Club of Newmarket has helped many of our young people know the rights and responsibilities of citizenship, as well as the joy of helping others.

I want to thank the volunteer members of the Optimist Club of Newmarket for all of their excellent work, making the lives of our youth and other members of our community that much richer.

FORT HENRY

Mr John Gerretsen (Kingston and the Islands): On Tuesday, the Minister of Tourism was asked by a government member about the steps the ministry was taking to preserve Fort Henry, a major tourist site attracting 150,000 people annually and an integral part of our history.

The minister said, and I quote, that Parks Canada was "not putting any money into it in terms of a long-term commitment to ensure its preservation." He also patted himself on the back by saying he was proud of the fact that his ministry was putting in $1.2 million per year.

To set the record straight, what the minister did not say was that in fact the provincial funding over the last four years has decreased by 50%, from over $2.5 million to $1.2 million. He also did not say that Parks Canada has set up an endowment fund of $5 million, the interest from which the fort can use for restoration purposes. It's the first time any level of government has committed permanent funding for the fort.

If the minister is really interested, and I quote again, in preserving these "important heritage properties," let him show this by fighting in cabinet to restore funding to the 1995 level. It's good for Kingston, it's good for tourism, and it's good for our Ontario economy.

To quote the Premier, "On our side of the House, our code of conduct is to insist on the truth," something that seems to have escaped some members on the other side.

PAROLE SYSTEM

Ms Marilyn Mushinski (Scarborough Centre): I want to take this opportunity to make the House aware of a movement that is underway in Scarborough.

The former city of Scarborough was the scene of the Scarborough rapist attacks several years ago. Many neighbourhoods have forever been changed because of these attacks. It should come as no surprise that the community's reaction to Karla Homolka's potential parole has been one of complete outrage.

As an elected representative in Scarborough, I have had to deal with the aftermath of these crimes. I believe it is vital to provide the community with an opportunity to voice their anger over recent developments. That is why I have started a petition drive supporting further improvements to the justice system so that criminals such as Karla Homolka who commit unspeakable crimes will find it nearly impossible to gain early release.

Thanks to strong coverage by the Scarborough Mirror newspaper, over 500 copies of the petition have already been distributed. In the first two days of the petition drive, my office received over 200 requests for copies. I have been overwhelmed by the support that I have received from the public, and I look forward to this government building upon its already successful reforms of the justice system.

SOINS DE SANTÉ

M. Jean-Marc Lalonde (Glengarry-Prescott-Russell) : C'est dans l'intérêt des citoyens et citoyennes de ma circonscription que je dois porter à l'attention de l'Assemblée mon inquiétude à l'égard des coupures à notre système de santé.

Il y a quelques semaines, j'ai pris connaissance de l'annonce de la fermeture de quatre des six cliniques de radiographie dans ma circonscription. La compagnie Diagnosticare Inc est maintenant la propriétaire de ces cliniques.

La clinique d'Alfred a déjà fermé ses portes. Les cliniques de Plantagenet, Clarence Creek et Rockland feront l'objet de fermeture à compter du 30 novembre prochain. Une cinquième, dont celle d'Embrun, pourrait s'ajouter à la liste.

Nos médecins ont été avisés par cette même entreprise privée que les coupures budgétaires du ministre de la Santé étaient la raison de ces fermetures.

On doit comprendre qu'aucun transport en commun n'existe dans ma circonscription. Comment dois-je expliquer aux personnes âgées de ma circonscription qu'ils devront prendre l'autoroute pour se rendre à Ottawa ou à Hawkesbury pour obtenir une radiographie ?

L'autre alternative serait d'avoir recours aux services d'ambulance pour se rendre à la salle d'urgence de l'hôpital de Hawkesbury ou d'Ottawa pour obtenir ce service.

Imaginez l'impact de ces fermetures de services dans nos communautés. Les conséquences pourraient même porter au départ de quelques-uns de nos médecins.

Sommes-nous des citoyens de deuxième ordre, ou, à juste titre, sommes-nous dignes de recevoir les mêmes services que les autres citoyens de notre province ?

TEACHER OF THE YEAR AWARD

Mr Doug Galt (Northumberland): I rise in the House today to recognize Mrs Debbie Smith, a teacher at Terry Fox Public School in Cobourg, in my riding.

Mrs Smith is not an average teacher. Due to her recognition as a "compassionate educator," Mrs Smith will be receiving the 1999 Toronto Sun Teacher of the Year award. She is among 11 other winners who were chosen from about 1,500 nominations.

All of this attention and recognition is unarguably a result of her warm, caring and compassionate approach to education. The Teacher of the Year award was established to promote public awareness of teaching excellence and to encourage parents, students and teachers to focus on positive education practices.

Debbie Smith qualifies because of her positive leadership in education. Her young students even proclaim that "Mrs Smith is the best!" Her superintendent of schools, Beth Selby, refers to Mrs Smith as being energized by what she does for her students. What she is doing is fostering a positive school environment.

I applaud Debbie Smith for being recognized as a Teacher of the Year. I extend my warmest wishes to Mrs Smith, her students, and her family.

MOTIONS

COMMITTEE MEMBERSHIP

Hon Frank Klees (Minister without Portfolio): I move that the following amendments be made to the membership of certain committees: Mr Hoy replaces Mr Ruprecht on the standing committee on regulations and private bills; Ms Di Cocco replaces Mr Hoy on the standing committee on the Legislative Assembly; and Mrs Dombrowsky replaces Mr Smitherman on the standing committee on government agencies.

The Speaker (Hon Gary Carr): Is it the pleasure of the House that the motion carry? Carried.

STATEMENTS BY THE MINISTRY AND RESPONSES

NATIONAL CHILD DAY

Hon Margaret Marland (Minister without Portfolio [Children]): Today we celebrate children, our most important legacy for the future. I know that every member of this House recognizes the very special place that children have in our hearts and in our world.

On November 20, the United Nations Convention on the Rights of the Child will celebrate its 10th anniversary. This convention is the most widely ratified human rights treaty in world history. To mark this occasion, Canada joins nations around the world in observing a National Child Day.

The Convention on the Rights of the Child recognizes children's basic human rights and gives them additional rights to protect them from harm. The convention also acknowledges the important role of the family in raising children.

National Child Day reminds us that all children need nurturing, protection, love, respect and security to reach their full potential. As our province's first-ever minister responsible for children, I am proud that the Ontario government is working towards the goals of the convention.

Today, I would like to share with members of this House a few examples of our commitment to children. Early intervention and prevention are the cornerstone of our initiatives. We are providing a better start for approximately 150,000 newborn babies in Ontario each year by giving new mothers the option to stay in the hospital longer after the birth of their baby. Through the Healthy Babies, Healthy Children program, we are also providing screening and follow-up care within 48 hours of hospital discharge to see how the mother and child are doing.

Our $20-million preschool speech and language program is helping 70,000 young children with speech and language difficulties to get the help they need before they start school.

We will soon announce details on a new intensive early intervention program for two- to five-year-old children with autism. Funding for this program will grow to $19 million annually.

We also provide $2.5 million annually to our partnership with the Canadian Living Foundation. As a result, over 72,000 children receive breakfast each school day in over 1,330 local child nutrition programs.

Child care is another important support for young children and their families. Since March of 1995, the capacity of Ontario's licensed child care system has been increased by almost 19,000 spaces. This government spent approximately $700 million on child care services in 1998-99, the highest amount in our province's history.

Further, as many as 350,000 children in more than 210,000 Ontario families with low and middle incomes are benefiting from the Ontario child care supplement for working families.

Through the Ontario workplace child tax incentive, we are also providing businesses with a 30% tax deduction for the capital costs of building or expanding child care facilities in their workplaces and communities.

Clearly, our government's track record on child care is second to none. Every child has the right to grow up in a safe and secure environment. For this reason, our government made vitally important amendments to the Child and Family Services Act to put the interests of the child first. The threshold of risk of physical and emotional harm to children will be lowered, and the word "neglect" will be included as a result of this bill.

Another important government responsibility is to assist children with special needs. Following my discussions last fall with children, parents and service providers in communities all across Ontario, the government announced new funding for children's mental health services, growing to $20 million annually.

We will also enhance respite care for up to 1,700 families caring for medically fragile and technologically dependent children.

These are just some of the highlights of our government's record so far. I am very proud of our commitment to Ontario's children. But there is still much to do.

That is why Premier Harris commissioned the Early Years Study, and our government has embraced the study's findings.

In the recent throne speech, our government reaffirmed our belief that, to realize their full potential, children must have the best possible start in life. We have committed to build on the pioneering work of world-renowned expert Dr Fraser Mustard and noted child advocate the Honourable Margarent McCain. Ontario's early years program will extend early development opportunities to children and their parents across the province.

I recently announced the creation of five demonstration projects to test different community-based approaches to early child development and parenting.

Our government is also fulfilling another important recommendation of the study, through a task group which will advise us on the key elements and standards for an early years programs. Also, an early years challenge fund will help communities establish and support child development and parenting programs.

Indeed, the Early Years Study will also have a positive impact on children and families in other parts of our great country. Premier Harris feels so strongly about the need to move forward on this study that he made it an agenda item at this year's annual premiers' conference in August. As a result, the study has been enthusiastically received by governments all across Canada. At a recent meeting of the federal-provincial-territorial social services ministers, everyone at the table agreed to move forward as quickly as possible on early child development.

This government is determined to remain the national leader in early child development. We invite and encourage all levels of government and all sectors or our communities-including business, charitable and voluntary organizations-to join us in a partnership that will fulfill our promise to children.

Our children's hope for a future filled with opportunity, health, security and happiness rests with all of us today. Let us pledge to meet that hope to the best of our shared abilities.

SPENDING REDUCTIONS

Hon C