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February 14, 1983

32nd Parliament, 2nd Session

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Hansard Transcripts

Hansard Transcripts

STATEMENTS BY THE MINISTRY

RELOCATION OF MINISTRY OF REVENUE

VISITORS

TV CAMERAS IN GALLERY

TRANSFER OF CROWN TRUST ASSETS

ORAL QUESTIONS

STATUS OF GREYMAC AND SEAWAY

DEATHS AT HOSPITAL FOR SICK CHILDREN

ACID RAIN

EMPLOYMENT PRACTICES

BUY-CANADIAN POLICY

EXTRA BILLING

EMPLOYEE HEALTH AND SAFETY

KOZAK TREATMENT PROGRAM

ALLEGED HARASSMENT OF DON JAIL EMPLOYEE

EDUCATIONAL FUNDING UNDER BILL 127

MOTIONS

TRANSFER OF BILL PR34

STANDING COMMITTEE ON ADMINISTRATION OF JUSTICE

ORDERS OF THE DAY

CONCURRENCE IN SUPPLY, MINISTRY OF HEALTH

SUPPLY ACT

THIRD READING

MOTOR VEHICLE ACCIDENT CLAIMS AMENDMENT ACT (CONTINUED)

The House met at 2 p.m.

Prayers.

STATEMENTS BY THE MINISTRY

RELOCATION OF MINISTRY OF REVENUE

Hon. Mr. Ashe: Mr. Speaker, as the honourable members are aware, the Ministry of Revenue and the Ministry of Government Services have been preparing for some time to move Revenue's head office from Toronto to a building specifically constructed for its use in Oshawa.

I and Revenue ministers before me have from time to time informed this House of the progress of this relocation, and today my colleague the Minister of Government Services (Mr. Wiseman) and I are pleased to announce a most significant milestone in this relocation project. This morning the first large group of employees commenced work in the new head office building in downtown Oshawa.

More than 200 staff representing three branches took up their duties in our new corporate headquarters. Over the next five weeks the balance of the almost 1,600 head office staff will similarly relocate. This carefully organized and structured move will allow my ministry to continue without interruption the provision of its essential services and programs to the citizens of Ontario.

It was almost six years ago -- on April 5, 1977 -- that the then Treasurer of Ontario, Darcy McKeough, rose in this House to announce Revenue's relocation. This move and that of the Ontario health insurance plan operations of the Ministry of Health to Kingston represent a real and visible commitment by this government to its "Go East" policy, whereby government operations are relocated to areas east of Metropolitan Toronto. We believe there will be an associated economic stimulus in these areas.

This move also represents the first-ever relocation of an entire ministry head office function such a distance from its previous location. By March 21, all staff will be relocated to Oshawa. It is the intent of my ministry, again working closely with the Ministry of Government Services, to celebrate this historic occasion with appropriate opening ceremonies and public tours.

On behalf of the Minister of Government Services and myself, I would like to extend a personal invitation to the honourable members to visit our new head office. I think they will find the design of the building itself to be of great interest. In addition to being one of the most energy-efficient office buildings in Canada, it will most certainly stand as a benchmark for the design and construction of future government and, in all probability, private sector office buildings.

The dates for the opening ceremonies and tours will be announced in the near future. I am sure many of the honourable members will wish to share in this exciting and eventful

chapter in the Ministry of Revenue's history and achievement in the government's "Go East" economic policy.

VISITORS

Hon. Mr. Wells: Mr. Speaker, on behalf of all members I would like to welcome to the House one of our former colleagues, Margaret Campbell, the former member for St. George, whom we are very pleased to see in good health and attending today.

Mr. Peterson: Mr. Speaker, I think it should be noted she has recently been admitted as a Companion of the Order of Canada, a very well deserved honour.

Hon. Mr. Gregory: Mr. Speaker, I would like to call the attention of the members in the House to Mr. George Nixon who is in the gallery.

[Interruption]

Mr. Speaker: Did the government House leader conclude his remarks?

Hon. Mr. Gregory: Mr. Speaker, I think I had finished. I was introducing Mr. George Nixon.

Mr. Speaker: My attention was diverted for a moment.

TV CAMERAS IN GALLERY

Mr. McClellan: Mr. Speaker, I had the occasion on Friday to speak with the Sergeant at Arms about the possibility of precisely what almost happened. I think we have a very serious hazard in your gallery. If a camera ever did fall to the floor I do not think there is any doubt somebody would be killed.

I hope this occasion of a near miss will be used to have another look at the problem of television cameras and the likelihood of them falling to the floor. I hope we can again pursue with the Board of Internal Economy the possibility of an electronic Hansard.

Mr. Speaker: Perhaps we could build a restraining wall. This is a matter for the Board of Internal Economy and there are avenues to have it discussed and considered by that group. I would suggest the member follow those avenues and have it raised at the appropriate time.

TRANSFER OF CROWN TRUST ASSETS

Hon. Mr. Elgie: Mr. Speaker, I wish to advise the House that the agreement which has been reached among Crown Trust Co., Central Trust Co., the Canada Deposit Insurance Corp. and the registrar under the Loan and Trust Corporations Act has been approved by the Lieutenant Governor in Council and signed by the parties.

I will Be tabling this afternoon a copy of the agency and operating agreement, together with three ancillary agreements and a

summary explanation of their terms. Since I will be doing so, I will limit my comments to the principal financial consequences of the agreement which are set out in the

summary as follows:

(1) All normal operating expenses associated with the management of the estates, trusts and agencies business of Crown, the management and administration of its investment portfolio, other than the problem assets, and the payment of deposit liabilities will be paid on an ongoing basis by Central.

(2) Crown will receive an immediate payment of approximately $3 million as the purchase price for the fixed assets being purchased by Central.

2:10 p.m.

(3) Because all the assets and liabilities of Crown will continue to be assets and liabilities of the company, Crown will continue to earn a spread. This spread will be the difference between the cost of funds and the income generated by the investments purchased with those funds on that portion of its investment portfolio which does not include the soft assets.

(4) Crown will receive quarterly fees from Central, for a period of five years, equal to one quarter of one per cent of the dollar amount of deposit liabilities of both Crown and Central at Crown's existing locations at the beginning of each quarter. This will be subject to limited exceptions, with adjustment provisions in the event there is any consolidation of Crown branches with existing Central branches. These fees are subject to a maximum of $7 million during the five-year period.

(5) Crown will receive annual fees from Central for a period of five years equal to five per cent of the revenues from Crown's estates, trusts and agencies business. Various of the items referred to above represent expenses which Crown would have incurred but which are now to be borne by Central. Other items represent anticipated cash payments to Crown over the five-year period of the agency relationship. The amounts to be received by Crown from Central pursuant to the agreement and from the spread which I referred to earlier, quite apart from any cash outlays which Crown will avoid, are expected to aggregate approximately $27 million.

For its management services under the agreement, Crown is to pay Central a management fee which, during the first year, will be $450,000 per month. Following the first year of the agency period, the management fee will be an annual fee of one quarter of one per cent of the book value of the assets under administration at the beginning of the period.

The total management fee of approximately $5.4 million in the first 12 months amounts to one third of Crown's 1982 annual budget of $15 million for salaries, leases and administrative expenses. Virtually all these expenses have been assumed by Central. In future years, the management fee is expected to decrease from a level of approximately $1 million in year two to less than $200,000 in year five. The aggregate amount estimated to be payable by Crown to Central during the five-year agency period in accordance with these provisions is approximately $7 million.

With respect to the estates, trusts and agencies business of Crown, Central will be entitled to receive all the revenue from such business from and after the effective date of the agreement.

In

summary, the agreement contemplates an immediate sale of the fixed assets and management of the business on Crown's behalf, with the assets and depositors' liabilities being transferred to Central as they mature. The proceeds, estimated to amount to approximately $20 million net of management fees charged, will flow to Crown where they will augment any realizations from the soft assets excluded from this transaction.

These combined realizations will be available to meet the claims of CDIC and other creditors if there are any, and then the claims of the preferred and common shareholders.

Mr. Speaker: Could I ask the members to carry on their private conversations some place other than in the House, please?

ORAL QUESTIONS

STATUS OF GREYMAC AND SEAWAY

Mr. Peterson: Mr. Speaker, I have a question for the minister that is not with respect to the Crown situation. We are grateful to have the terms of the agreement some two weeks or so after the fact, but I want to address his mind to the question of the other two trust companies.

Over the past few days, we have been treated to a spate of rumours, press reports and leaks here and there about what may or may not be happening with respect to Seaway Trust and Greymac Trust. Various of the minister's officials are quoted in dribs and drabs in the newspapers talking about the nightmare and talking about the problems they have. There are also rumours the minister may be close to making a sale of the assets, at least, of Seaway Trust. What is going on? Who is speaking for the ministry?

Hon. Mr. Elgie: Mr. Speaker, in case there is some honest misunderstanding, I have not delayed two weeks in advising the House of the final details of the Crown sale. It was only on Wednesday that cabinet, by order in council, authorized the registrar to complete the signature. CDIC completed its part of it on Friday -- just three days ago. So I like to think I really was not delaying filing of the information, as I was required to do by statute.

I can understand that the rumours that have been in the press and other places can be confusing to the public, and I appreciate the honourable member's question from that point of view. I can only repeat that they are rumours -- they are speculation. We have received some information from Touche Ross with respect to Seaway Trust. Further information has been requested, and discussions are taking place with CDIC and with our registrar.

But to suggest an agreement is imminent or that one has even been reached in principle is stretching it a very long way. They are simply at the stage now of evaluating the material, still waiting for more material and at the same time carrying on some discussions about what we hope might be the ultimate resolution of the problems. But any other speculation is just that.

Mr. Peterson: Last Thursday I asked the minister how it was that Greymac's books could have been found to be in such disarray after the company had been very closely monitored by his officials in the summer and fall of 1982. He replied, and I will remind him of what he said:

"It was believed at that time it was due to the fact that the business was switching over to a new computer process. In any event, at that time it was not a matter that alarmed the registrar."

According to Mr. Taylor, the person appointed by the minister to manage Greymac Trust since January 7, the situation at Greymac is "a nightmare." The firm was months behind in its bookkeeping. Appraisals necessary for mortgage loans are nowhere to be found, and in some cases the mortgages are not even registered on the property. He says, "I can't recall looking at a file that has not got something missing."

How could that disorderly state possibly have developed when those companies were being so closely monitored by the minister's officials?

Hon. Mr. Elgie: I think one should evaluate a statement such as that in the light of the final report that comes out of Greymac and in the light of the report following the completion of the Morrison special examination. As for the part of the ministry, I have made it very clear we are reviewing our practices and procedures, keeping in mind these very issues and the issue of whether or not they have to be changed.

Clearly the registrar had concerns from time to time. One of them was about bookkeeping; the other was about the switch to the computer and the problems it appeared to be creating. But I think one should put the whole thing in perspective when one has all the information and that is what I intend to do.

Mr. Renwick: Mr. Speaker, my supplementary is in two parts.

First, what assurance or consolation can the minister now give to the preferred shareholders of Crown that out of this transaction with Central, sufficient assets will in all likelihood be realized and the final winding up or dispersal of the funds of Crown will be conducted so that the preferred shareholders will be protected?

Second, will he advise the House what discussions have taken place between Mr. Brewerton of Sterling Trust and the registrar of loan and trust corporations, Mr. Thompson, with respect to Seaway Trust?

Hon. Mr. Elgie: Mr. Speaker, as we reviewed in fairly great detail in committee, the soft assets that have been set aside make up something in the neighbourhood of six items. The registrar, acting on behalf of the trust companies, has issued what is called a rescission action requiring the repayment of moneys and the setting aside of the mortgages. The object of this, of course, is to receive some money so that those who have interests vis-à-vis the soft assets -- and I think now the preferred shareholders as well as CDIC, which has prior claim -- will have something.

Clearly the amounts that will flow from this sale, being something in the neighbourhood of $20 million over five years, will flow to those who have a right to receive money from that soft asset shell in the order of priority in which they are there. As the member knows, the Daon mortgage in British Columbia has been the subject of negotiation. It is my belief that things have now been resolved to the point where construction has started once again. In that case, I understand there will be a return of some moneys owed to Crown. So as there are any assets gathered by a variety of means they will be applied in order of priority to the benefit of those who have their claims.

2:20 p.m.

Mr. Renwick: Mr. Speaker, on a point of order: The second aspect of my question concerned the discussions between Mr. Brewerton and Mr. Thompson with regard to Seaway.

Hon. Mr. Elgie: The member is quite right. The registrar has had conversations with Mr. Brewerton, among many others. Again, I can only emphasize that these are discussions; they are not negotiations and they are not agreements that are pending. They are purely and simply discussions about options that might be available once the final story is all in.

Mr. Peterson: The minister is aware that Greymac was functioning on a monthly licence until October 29, 1982, and then it returned to an annual licence. Was the minister informed about the circumstances surrounding these acts on the part of his regulators? What was the nature of the report by his regulators which led him to conclude that Greymac Trust could be returned to the status of an annual licence?

There is a second part to my supplementary question. Why is it that although the cases documented, day after day, events going back some two years with respect to irregularities in these trust companies, we now find that the documentation was unsupportable, unexplainable and was lacking in appropriate references? Is the minister saying he has just now found out about this? Why did this go on for the past two years?

Hon. Mr. Elgie: I said clearly in my statement on January 17 that the registrar, acting as he does in the role of administrator and superintendent of insurance, monitors the activities of trust companies. It may well be the method of operation will have to be changed.

Without making any determination as to whether or not the monitoring up to that time was satisfactory, I am having a thorough internal review and an external one, if necessary, of those practices and procedures. I will put them together in the light of information that will be available from the final reports of the Morrison special examination, in order that there may be a full and proper review of those things, not a dribs-and-drabs review.

I understand the Leader of the Opposition would like to look at this thing openly and when all the information is available. To think otherwise would suggest there might be some partisan interest in this.

DEATHS AT HOSPITAL FOR SICK CHILDREN

Ms. Copps: Mr. Speaker, I have a question for the Attorney General. He may be aware of a study that was done at the Hospital for Sick Children on post-mortem redistribution of digoxin. The study was completed last August and has yet to be publicly released.

Its authors draw some conclusions on the

interpretation of post-mortem digoxin levels. Let me read to members two of these conclusions. The first conclusion is, "Ante-mortem digoxin intoxication cannot be implicated from high post-mortem levels of the drug."

The second major finding is, "Since the redistribution of digoxin depends upon the time after death, any extrapolation from post-mortem data to the physiological distribution of the drug as was done by various investigators may be tenuous."

One of the investigators he referred to with respect to the information provided at the preliminary hearing into the case of Susan Nelles was a Mr. Coe. The Attorney General will remember that a number of expert witnesses used Mr. Coe's findings in determining the level of digoxin in the blood before death.

Can the minister say whether or not his investigators agree with the conclusions of the report from the Hospital for Sick Children? I would also like to ask him whether this report has had any influence on his investigation.

Hon. Mr. McMurtry: Mr. Speaker, I am not going to comment on any of those questions pending the conclusion of the investigation.

I would remind the honourable member that the Centre for Disease Control in Atlanta has completed its report for the Hospital for Sick Children and the Ministry of Health, I understand. Obviously, a good deal of the report will be concerned with the important issues the honourable member has raised. We are awaiting that report with interest as well.

It would be inappropriate for me to comment any further at this time.

Ms. Copps: I am told the police have received the information from this report.

But the hospital's report says the study done by Coe may be tenuous. In effect, it says one cannot tell the blood digoxin level before death from post-mortem samples. It also says clearly that digoxin intoxication cannot be implicated from high post-mortem levels of the drugs. Bearing this in mind, does the Attorney General have any belief this study could draw into question any of the expert testimony in the preliminary hearing on Susan Nelles?

Hon. Mr. McMurtry: I have nothing further to add to what I said before.

Ms. Copps: With respect, almost two years have passed since the police first started their investigation. The minister mentioned the Centre for Disease Control in Atlanta is anticipating that it will give its study to the Minister of Health (Mr. Grossman) this week and the Dubin inquiry has reported with some valid recommendations. There are many questions that need to be answered, including the discrepancy raised by this report from the Hospital for Sick Children. Specifically, questions need to be answered. Does the Attorney General not think that once the Atlanta inquiry has been tabled it is time for a full public inquiry into this whole question?

Hon. Mr. McMurtry: We are naturally very interested in the report from Atlanta, which I have not yet seen, of course. But any decision about a public inquiry must await the decision on whether there are going to be criminal charges laid. I am sure the honourable member is well aware of the very important tradition of this province in our criminal justice system -- that is, not to put people on trial and at the same time hold a public inquiry into the same matter.

ACID RAIN

Mr. Laughren: Mr. Speaker, I have a question for the Minister of the Environment concerning the series of meetings held back in December between some of Ontario's biggest acid rain polluters and large acid rain polluters in the United States.

I wonder if the minister could tell me if he knew of Ontario Hydro's participation in those meetings and the meetings that are going on now in Toronto. Does he think it is proper for an Ontario crown corporation, an agency of this government, to be deliberately and flagrantly undermining government policy by negotiating a cap on acid rain emission levels?

Could the minister also tell us if he has had any meetings with Ontario Hydro or for that matter with Inco or Noranda, or has he exchanged any correspondence with those companies concerning that series of meetings?

Hon. Mr. Norton: Mr. Speaker, I was not aware of the joint meetings occurring between the two chambers of commerce in Canada and the United States. I believe it is correct to say there was an inquiry from someone -- I believe associated with the Canadian Chamber of Commerce -- asking our ministry for some background on acid rain. That is not an unusual request in view of the fact it was indicated the intention was to be in a position to better inform the membership on the issue. We encourage that kind of public examination of the issue.

It is my further understanding that the role of the individual from Ontario Hydro was to act in a purely advisory capacity on a bilateral committee to provide information from the point of view of a major utility on this issue. The position consistently taken by Ontario Hydro is one that is very supportive of the Canadian position, as it has been throughout. I think the report in the newspaper is anticipating something that has not yet occurred.

It is clear, if the member looks at the statements attributed to the chairman of Hydro, that there has been no change in Hydro's commitment to a 50 per cent reduction, and the recognition that must occur on both sides of the border. It is also my understanding that the specific individual who has been attending some meetings has consistently maintained that position in terms of any advice that they may have given.

2:30 p.m.

Mr. Laughren: While not forgetting that Ontario Hydro was at this meeting, and in view of that answer, may I assume the minister has read the reports which indicate that Carleton Scott of the Union Oil Co. of California, and head of the US delegation, said in a letter, and I quote:

"I am pleased to report that the only area of potential disagreement is related to the question of whether or not there should be a cap on current emissions of sulphur dioxide in the United States."

In view of the fact that international negotiations are going on to reduce emissions, and the stated intention of the Canadian government is to reduce them by 50 per cent, could the minister tell us how it is that Mr. Scott could make a statement like that since Ontario Hydro was at the meeting? It implies that for a consensus of people at the meeting the only question is whether or not to cap the emissions at the present level?

I do not think it is fair for the minister to give us the impression that Ontario Hydro is not part and party to this meeting.

I would like to know how the minister intends to deal with Ontario Hydro, which is clearly thumbing its nose at this minister and at the Canadian government's stated policy for self- serving reasons. How does the minister intend to deal with Ontario Hydro in this matter?

Hon. Mr. Norton: I totally and completely disagree with the member's

interpretation. I am not responsible, nor can I account for statements, perhaps self-serving statements, made by a representative of a major American corporation that has an interest, obviously, in trying to influence the outcome of negotiations. All I can say at this point is that any Canadian corporations that are involved, whether they be public utilities, or whether they be privately-owned corporations, know the stand of this government and this country on the issue.

That is what they must abide by. In fact, I believe it was in the same

article that the statement attributed to one of the vice-presidents of Inco is also supportive of our position, and is supportive of reductions in the United States.

I can assure the member that representatives of that corporation have, at times, been very eloquent spokesmen for the Canadian position in forums in the United States before any such meetings as this ever occurred.

I would also remind the member that we are talking about a free democratic country. This is not a totalitarian state where the government dictates to individuals what they may say in forums in which they may participate.

Mr. Martel: We thought that with Bill 179. That is what we thought Bill 179 was all about. Tell us about Bill 179.

Mr. Speaker: Order.

Hon. Mr. Norton: I am encouraged that corporations in a free country may feel free to go to the United States and put forward the position that is being espoused by this government.

Mr. Kerrio: Mr. Speaker, the question that I have of the minister would be to ask him if he feels satisfied that his ministry and the government of Ontario are doing everything possible to get people aligned against any easing up of the controls in the northeastern part of the United States, in which there would be many people who would be most interested in what is going to happen in the United States and in Canada, and those people in our sister provinces to the east of us, in the Maritimes and in Quebec?

Does he feel that his ministry is doing enough to bring together those people who are affected as much as we are, and to some degree even more? Is he bringing them together to help to form a lobby that would put up resistance to any kind of new thrust in the easing of controls?

Hon. Mr. Norton: Mr. Speaker, I think it is quite fair to say that Ontario has been the anchor in achieving the degree of co-operation and identification of the common interests in this issue that has been achieved to date.

As a matter of fact, through the efforts of this government -- and with some co-operation from our federal government, I might say -- we have brought numerous delegations from the United States to Ontario to bring them up to date on the accomplishments we have made in our scientific work, and to show them the problem graphically illustrated within the Ontario environment.

We have maintained ongoing communications with those states which have similar problems, and I think we could document that it is through the efforts of this province that the level of awareness in the United States of the problem of acid precipitation has so dramatically increased over the last couple of years.

Mr. Kerrio: The feds say the same thing.

Mr. Speaker: Order.

Mr. Laughren: Mr. Speaker, if you can convince the minister that he should put aside the dialectic in his response, I would like to ask him this question. Since it has now been two months since the federal-provincial task force on the Inco and Falconbridge emissions tabled its report, and since Inco attended that meeting in the United States along with Ontario Hydro and Noranda and perhaps others as well, could the minister assure us there is no relationship between this new and obviously very powerful polluter lobby and his failure even to comment on that federal-provincial task force or to take any new action at all?

Would he not be prepared at this time to show his convictions, to protect the environment by issuing a draft control order which will serve notice to people on both sides of the border that we are serious about cleaning up the emissions in this country?

Hon. Mr. Norton: I would be prepared to give up my dialectic if the member for Nickel Belt would be prepared to give up his commitment to dialectical materialism. In response to the other part of the question, I would only reiterate that it is identical to the question I was asked in the House last week, and if he would like to read Hansard the answer has not changed.

Mr. Speaker: New question, the member for Sudbury East.

Mr. Martel: The minister did not say anything last Thursday. That is why it had to be raised again today --

Mr. Speaker: Question, please.

EMPLOYMENT PRACTICES

Mr. Martel: Mr. Speaker, I have a question for the Minister of Labour regarding the Windsor Board of Education, which still insists on internal examinations and breast measurement for occupation with them. Since the minister was able to prevail upon the Essex board to eliminate internal examinations and chest measurements, and to make pre-employment and post- employment examinations job-related, can he explain why he has not succeeded to this time with the Windsor board to get it to drop its testing, which obviously is not job-related in any way, shape or form?

Hon. Mr. Ramsay: Mr. Speaker, in responding to that question, I would first like to correct a press report of a few weeks ago, which stated that at that particular time my ministry had not been in touch with the Windsor Board of Education despite a commitment from me that they would be. That report was erroneous. It was later established there had been members of my staff in touch with the Windsor board.

I want to clear up the feeling, perhaps, that I completely disregarded the question when it was first asked. It was followed up. It is true we have not been able to finalize this matter with the Windsor Board of Education, but I am quite confident we will be able to do so in one manner or another within the next short period of time.

Mr. Martel: Is my friend suggesting that if the Windsor board does not on its own want to drop its examinations, and since the minister himself views this as a violation of the spirit of the Human Rights Code as indicated in the Windsor Star, if the board is not prepared to move in a voluntary sense is the minister prepared to bring in legislation which will force an end to this sort of practice?

Hon. Mr. Ramsay: I do not think the introduction of legislation is the remedy required in this particular case. We have two alternative ways of proceeding at the present time. We are proceeding in the first case, and if that is not successful we have one other source of action that we can undertake.

2:40 p.m.

Mr. Martel: I am a little disturbed at what my friend says. Almost two years ago I asked the former minister to eliminate the use of questionnaires similar to the one used by Canadian Blower. The Windsor Board of Education is still using questionnaires that have questions similar to this: Females: breasts: nipple discharge; vagina: discharge; vaginitis; cervix: bleeding. It is the same with males.

I asked the minister's predecessor two years ago to write into the Human Rights Code that this sort of questionnaire should not be tolerated in this province, because it is not just Canadian Blower that is using them. Is the minister now prepared to bring in amendments to the Human Rights Code that will make it illegal to ask these types of questions, which are not job-related in any way, shape or form?

Hon. Mr. Ramsay: The human rights commission has been in consultation with many companies across the province that have been using various types of questionnaires. We have found, with only one exception, that wherever the human rights commission pointed out there could be a contravention of the intent those questionnaires were changed.

That has been our history, as I said, with only one exception. So why bring in legislation? Why paper the walls with legislation, as the third party would like us to do, when it can be done and is being done on a voluntary basis?

[Later]

Hon. Mr. Ramsay: Mr. Speaker, before I give that answer, would it be permissible for me, very briefly, to correct the record on an answer I gave to the member for Sudbury East a few minutes ago?

Mr. Speaker: Yes.

Hon. Mr. Ramsay: I referred at that time to an erroneous newspaper report. In thinking about that, the report itself was not erroneous. The report covered a meeting of the Windsor Board of Education, at which time a senior supervisor was quoted as saying that no one from the ministry had been in touch with them. That is what was incorrect, not the report itself.

BUY-CANADIAN POLICY

Mr. Bradley: Mr. Speaker, I have a question for the Minister of Colleges and Universities. Would the minister inform the House whether the Ministry of Colleges and Universities has a buy-Canadian policy when the price and quality are comparable to offshore products?

Hon. Miss Stephenson: Mr. Speaker, we do indeed have a buy-Canadian policy, which has been transmitted clearly to all post-secondary institutions. It is my understanding that the proposed purchase was based on the appropriateness of the machinery for teaching purposes. This seems somewhat questionable in my mind. I therefore have asked for a further review of the matter, and I will report to the House when that further review is completed. It is not as yet completed.

Mr. Bradley: The minister must have read my supplementary question ahead of time.

Since the manager of Lincoln Electric has stated that officials of Niagara College would not even come over to look at the equipment before making a decision on this purchase; since he contends that his machines are used in many industries in southern Ontario, including General Motors, Foster Wheeler, Port Weller Dry Docks and E. S.

Fox Ltd. and that the price of this equipment is very close to the price quoted by the US manufacturers; and since in these difficult economic times it would be desirable to produce job opportunities for residents of Ontario through a company that has co-operated in work programs with community colleges -- and here is where the minister has already said she is going to do this -- would she undertake to communicate specifically with Niagara College with a view to reviewing these specific tenders and with a further view to perhaps retendering this project if that is possible?

Interjection.

Mr. Speaker: Order.

Mr. Bradley: Is the minister listening? I read about the Minister without Portfolio (Mr. Gregory) in the Globe and Mail on Saturday.

Would the minister communicate with all community colleges in Ontario to ensure they are aware of her up-to-date buy-Canadian policy so we do not see a repeat of -- I will not call it a travesty of justice -- this indiscretion?

Hon. Miss Stephenson: Whether it has been an indiscretion or not I am not prepared to say at this point, because the colleges are very often -- in fact, most often -- guided in their purchases of specific equipment by the advisory committees that are set up within their communities. The advisory committees are made up, as I am sure the honourable member knows, of representatives of the industry within that community that relates to the program being offered.

This is the matter I wish to have reviewed, because if indeed there was something wrong with the tendering process it must be repeated. If there was not, I am not sure I am in a position to demand the tendering process be carried out again. However, I will report to the House when I have further information.

Mr. Swart: Mr. Speaker, is the minister not aware that about 60 per cent of all the electric welders used in Ontario are Canadian-made, Lincoln Electric Co. welders? On the face of it, does she not think it is a bit absurd they would import welders which are not being used to any extent in Ontario to train students?

Hon. Miss Stephenson: Mr. Speaker, it is my understanding that the representatives of industry in the area vigorously supported the purchase of the Hobart, which I gather they have been using or feel is more appropriate. None the less, this is a matter which will be examined. The Canadian company in question is not at a total loss because there is yet another round in this allocation process which I believe was completed last Friday. I think it has another bid in that area.

EXTRA BILLING

Mr. McClellan: Mr. Speaker, I have a question for the Minister of Health with respect to extra billing and opting out. Let me read what the Minister of Health said last November: "It is redundant for the federal government to insist that extra billing be kept under control because we already keep it under close scrutiny."

I want to ask the minister if his close scrutiny has acquainted him with the fact that 65 per cent of obstetricians and gynaecologists in Toronto have opted out of the Ontario health insurance plan, 67 per cent in Wellington, 71 per cent in Peterborough, 89 per cent in Peel and 64 per cent in Sudbury?

Is he aware the average surcharge inflicted upon a patient for a normal child delivery, assuming 11 prenatal visits, would be the difference between the OHIP payment of $290 and the Ontario Medical Association rate of $425, a difference of $134 or 46 per cent? Is the minister aware of this problem?

Hon. Mr. Grossman: Yes.

Mr. Martel: That's the shortest answer he ever gave.

Mr. Kerrio: That won't last.

Mr. Speaker: Order.

Mr. McClellan: Since the minister is obviously monitoring the situation very closely, I wonder if he is aware of the results of an informal telephone survey we did which produced the following amazing charges. Dr. Drutz at Mount Sinai Hospital charges $600 for what is called a total care, childbirth delivery. OHIP will pay about $350. That is a 71 per cent differential. Dr. Foster at St. Joseph's Health Centre charges $500 for a normal total care, childbirth delivery of which OHIP will pay about $300 for a differential of 67 per cent.

Dr. Pond at Toronto General Hospital charges $500 and the differential is 43 per cent. Dr. Robb at Mount Sinai Hospital charges $600 and OHIP will pay $300 for a surcharge of 100 per cent. Whatever happened to medicare in Ontario? Is it the policy of this government that childbirth, among other medical services, will soon be 100 per cent on top of the OHIP rate?

2:50 p.m.

Hon. Mr. Grossman: I am not aware of the survey the member conducted informally by telephone this morning. I might address the second part of his question at some length as a result of those short answers.

May I say, when one looks at the figures one must look at the counties in some cases -- and I think the honourable member specified specific areas in his remarks -- one has to look at the county and the real availability of opted-in services in those areas.

The raw statistics hardly tell the whole story. For example, the member cited the figures for Metropolitan Toronto. In Metropolitan Toronto, there are 3,460 opted-in physicians, and just over 1,000 opted-out physicians. That puts it into a little better perspective. The member may wish to suggest there are a great number of opted-out physicians and that those are the only ones that are available, when in fact 3,460 are opted-in and are quite available in Metropolitan Toronto. If the member were to assess the percentage of opted-in physicians to the public at large, he would find that the ratio is quite satisfactory.

The second thing the member has to assess, as he well knows, is how the doctors are exercising their judgement in these matters. While 15 per cent of the doctors are opted-out, only about 5.5 per cent of the accounts are extra-billed.

In looking at where the extra 10 per cent is going, the question is, how is this being done? If those figures the member recited are figures that are being charged to the most well-off people in society, people who can afford to pay that extra amount and who are willing to pay that extra amount, then I am sure he would join me in saying --

Mr. McClellan: Who decides that?

Mr. R. F. Johnston: Who decides that, Larry?

Mr. Speaker: Order.

Hon. Mr. Grossman: Mr. Speaker, as the member probably knows, during the estimates we were able to canvass a lot of the alternatives that we were developing to get people in some of the underserviced areas and to make sure they are basically opted in.

If the member looks, particularly at this time, at those areas which tend to be the underserviced areas, they are not the areas where we have opting out. The opting out almost always occurs in places such as Metropolitan Toronto, which is hardly an underserviced area; in fact, it is quite the reverse. If the member will recall the figures that I cited, 1,020 of all of the opted-out physicians are in the Metropolitan Toronto area,

whereas the next largest number is in Ottawa, which has 166. A great proportion of the opting out, province-wide, is centred here in Metropolitan Toronto. We do not seem, with the exception of one or two pockets of problems in other areas, to have a concern in that regard.

EMPLOYEE HEALTH AND SAFETY

Mr. Speaker: The Minister of Labour has a brief answer to a previously asked question.

Hon. Mr. Ramsay: On February 3, 1983, the member for Sudbury East raised the matter of two leaks of carbon monoxide and nickel carbonyl at the Inco pressure carbonyl plant at the Copper Cliff nickel refinery, which occurred during the midnight shift, January 29, 1983.

The ministry was notified of the leaks at 6 a.m. on the same day they occurred. All workers had since returned to work and there had been no injuries or work refusals. The cause of the leak had been identified and remedied.

When the leaks occurred, the emergency procedures as required by the Inco pressure carbonyl department emergency procedures manual were followed. Workers returned to work after building ventilation units cleared the contaminated air and monitors showed no nickel carbonyl.

Carbon monoxide tests and urine nickel levels of the 13 exposed workers were undertaken after the second incident occurred and all test results were below the action level.

Ministry of Labour personnel interviewed plant management and toured the plant with health and safety representatives and management on January 31. Five further ministry inspections were conducted between February I and 6, at which time discussions were held with plant personnel.

I am satisfied the ministry responded thoroughly and competently and that the health and safety of the workers during the two incidents was properly addressed through a joint labour- management response, by the internal responsibility system.

My staff have prepared a detailed

summary responding to all of the questions that the members raised. This is 12 closely typed pages long and I am sure members would like to listen to every word, but I thought it might be best if I would just send this across the floor to the member for Sudbury East.

Mr. Speaker: Thank you.

Mr. Martel: Mr. Speaker, I would ask the minister why it took two full days before his staff got to the site. The incident occurred on the 29th and the minister's inspectors arrived there on the 31st, after four more calls from the union. Why would it take 48 hours plus to get there to investigate a hazardous situation?

Hon. Mr. Ramsay: Mr. Speaker, the answer to that question and several other points that were raised earlier by the member are contained in the report.

KOZAK TREATMENT PROGRAM

Mr. Nixon: Mr. Speaker, I would like to direct a question to the Minister of Health, about the status vis-à-vis the Ontario health insurance plan and Pavel Kozak.

The minister has no doubt read the recent reports of the sharply escalating costs of the treatment for the rare skin disease which evidently only Mr. Kozak can cure. Since he lives and works in West Germany and the expensive medications are not available except by personal importation, what advice can the minister give me to pass on to my constituents, whose young son has been troubled with this disease in a most serious and disconcerting way?

He has been for the treatment on the basis of the $25,000 raised by the community, but funds are rapidly running out since the costs of the treatment have escalated from about $100 every two months to about $1,000 every two months, that escalation taking place in just a little over a year.

Hon. Mr. Grossman: Mr. Speaker, I think that recitation indicates the great concern we have over the treatments being provided to the residents of Ontario by Mr. Kozak at what are very high charges. As the member will understand, we think scientists like Mr. Kozak, who may or may not have developed important new methods of treating people, ought to make those things --

Mr. Nixon: That is not in question, is it?

Hon. Mr. Grossman: Yes it is, as I will explain if the member will give me a moment. We think they ought to make those treatments available to the medical community at large and to all of the citizens of the world really, as is the normal case.

As the member will understand, there are discoveries, as it were, by scientists working throughout the world every day of every year. Whenever these breakthroughs or apparent breakthroughs come, they are immediately made available to the medical community to administer to all of our patients.

3 p.m.

In Mr. Kozak's case he, almost uniquely, has decided that he should not and will not make his treatment available, but will give it himself -- only himself -- at charges that amount, as the member says, to $20,000 to $25,000. To put that in some perspective, one can have triple-bypass surgery in Toronto General Hospital here for the same amount of money. Yet Mr. Kozak insists on charging that sort of money to treat people who are very desperate for some help.

As a result of our endeavours and our efforts with Mr. Kozak, the member will recall we put him in touch with people at the University of Toronto and arranged for the elements of his treatment, as he shared them with us, to be provided through a research program at three of our hospitals. My specific advice, indeed my plea to the member's constituent and his or her family, is that they contact Dr.

Ramsay at the Hospital for Sick Children, suggest to him they would like an examination and an assessment of whether the treatment Kozak has shared with us, which is in part or perhaps totally available through this program, might be made available, free of charge, of course, under our system in Ontario.

There is no reason for any Ontario citizen to do anything other than to contact Dr. Ramsay with a view to entering the Ontario program. There is no reason for people to leave this province and spend $20,000 on a treatment that still remains to be totally proven to be therapeutic in value. It could be, but as Mr. Kozak has shared the information with our experts -- who, I might add, are among the world's leading experts -- it is quite clear that while some people have improved under Mr.

Kozak's treatment -- I do not believe he knows why specifically, our experts do not know why specifically, but there is some evidence that some people have improved -- whether that is as a result of the ointments or the intensity of treatment or whatever, no one seems to know.

In any case, there is no reason for any Ontarian to leave this jurisdiction and pay thousands and thousands of dollars to someone who refuses to share his treatment and make it available at no cost, like everyone else does. Those people should go to Dr. Ramsay, whom I am told indicates he has, through his treatment coming off the Kozak treatment, seen improvement in at least 12 patients who have been into his program here. I urge the member to urge his constituent to go to see Dr. Ramsay.

Mr. Nixon: Does the minister not recall announcing to the House that he had taken the initiative in arranging with Mr. Kozak to come to Ontario and bring his secrets, if I may use that word, to be used in the medical treatment of this disease in the centre of Toronto facilities, with other doctors participating? I do not recall the minister at that time indicating any doubt that Kozak had achieved a substantial breakthrough unmatched by the medical practitioners in the province.

Hon. Mr. Grossman: I think we were fairly careful at that time to indicate that it appeared some people who had been through the Kozak treatment had improved, but no one knew why. I will not repeat what I said a moment ago, but it was certainly, in the view of our experts here, worth while to investigate. We committed $900,000 to mount that investigation and research and to deliver some of the treatment here in Toronto. We made $900,000 available; and Dr. Ramsay made $10,000, plus $750 a day, available out of those funds to Mr. Kozak, who deemed in his judgement that was not enough to treat 50 or 60 patients here in Ontario.

So he turned down that offer, which I have to believe was an extraordinarily generous one, considering the state of medicine, the state of his treatment and the common practice, to which this would have been an extraordinary exception. We were willing to do it to bring that treatment here, and I emphasize that the essential elements of the Kozak treatment are available here through Dr. Ramsay.

ALLEGED HARASSMENT OF DON JAIL EMPLOYEE

Mr. Renwick: Mr. Speaker, my question is to the Minister of Correctional Services. It is about Mr. John O'Connell, a cook and long-time employee of the Don Jail. There have been some incidents relating to his employment which require explanation. Mr. O'Connell and his union, Local 530 of the Ontario Public Service Employees Union, are quite prepared to have the matter made public.

Will the minister review the chronology of incidents relating to the employment of John O'Connell from the beginning of 1980, when he first made allegations that equipment was missing from the kitchen at the Don Jail, up until the present, so we in this House can be satisfied that this man was not harassed in his employment?

Hon. Mr. Leluk: Mr. Speaker, I will have my staff look into that matter and I will get back to the member for Riverdale.

Mr. Renwick: In carrying out the review, will the minister specifically attend to the question of the authority of the then governor of the Don Jail to search Mr. O'Connell's car and locker on September 17, 1981; and will he also indicate why these matters have gone unresolved for such a long time? They have been a matter of immense concern to John O'Connell and the union that represents him.

Hon. Mr. Leluk: Again, I will have my staff look into that incident and I will get back to the member for Riverdale.

EDUCATIONAL FUNDING UNDER BILL 127

Can the minister give us an indication today of how the funding will be established to maintain these kind of programs, which are so necessary to the city of Toronto? How will she establish that funding once Bill 127 becomes law?

Hon. Miss Stephenson: Mr. Speaker, I am aware that the honourable member and the leader of the third party toured at least two schools in the city of Toronto during my absence. I was chairing the meeting of the Canadian Council of Ministers of Education at the time.

I was interested to note that most of the

article described the members' clothes, which I thought was poetic justice for male members of the Legislature. Women have been subjected to this ignominy for many years. I thought it was appropriate that the males should have exactly the same kind of treatment females have had for so many years.

I also noted it clearly stated that the member for Parkdale seemed to have difficulty relating to the children and talking to them. He spent most of his time combing his hair? That question was automatic when I read the

article saying he spent most of his time combing his hair with a pocket comb between visits to classrooms.

We have made, as accurately as we possibly can, an assessment of the impact of Bill 127 in terms of any significant change as far as the delivery of program, the establishment of program or, in fact, the actual need to hire or fire teachers. As the member knows, there are many factors involved in all of this. The first factor is the continuing autonomy of the local board to make decisions about the needs of the children it serves. Those decisions must be made at the local board level and will continue to be made at the local board level under Bill 127. Those matters will then, of course, be discussed jointly with the other boards in Metropolitan Toronto.

3:10 p.m.

Under Bill 127, for the first time, the formula according to which teachers are allocated on the basis of the weighting factors will be negotiated between the teachers and the boards jointly. It is not a matter to be determined autocratically or unilaterally by one part of this structure, but indeed is to be negotiated between the teachers and the boards.

The member for St. Catharines (Mr. Bradley) is complaining about this, but it seems to me this provides for the kind of flexibility and understanding of student needs that perhaps has not been perceived to have been there in the past.

In addition, the retention of the very significant level of discretionary levy for the purpose of hiring additional teachers, which will be available to all the boards but most significantly to the Toronto board to the tune of about $438 per elementary student in Toronto as compared to $37 per student in Scarborough, will allow the boards to determine whether they need to hire additional teachers and to hire those teachers.

We do not, as a result of our careful examination, perceive there will be any rationale at this point for letting teachers go or for firing teachers. There will, however, be perhaps a little restraint put on boards with respect to the additional numbers of teachers they might hire. Instead of 142, it might be 132 next year.

Mr. Ruprecht: Let me first point out, as the minister knows, we have no control over what some reporter has deemed important. When has the minister gone out to the city schools and tried to inform herself of what specifically is important to those students whom this bill is going to affect dramatically? Has she done that? If she has, we would like to know what schools she has actually visited.

The minister knows full well that when Bill 127 is instituted it will mean basically one thing, and that is a cutback in funding. This means some teachers are going to be out of a job; they will necessarily have to be fired. Will the minister tell us which programs she thinks will have to be cut when 45 teachers are going to have to be fired, as the Toronto Board of Education indicates?

Hon. Miss Stephenson: Since the estimates of the number of firings began, I believe, at something like 112 at the beginning of the discussion of Bill 127, they have been reduced gradually to 45. In our best estimates, however, we can see no rationale for firing any, because there will not be a reduction in funding to the Toronto board on the basis of Bill 127; that simply is not part of Bill 127.

If there is a reduction in funding it will be as a result of a very significant reduction in the numbers of students in the Toronto board's area of jurisdiction; but that has nothing to do with Bill 127 and it is unfortunate that the member continues to deliberately obfuscate Bill 127 by introducing factors that have nothing to do with the bill.

We do not understand that there should be a need for any firings as a direct result of Bill 127.

MOTIONS

TRANSFER OF BILL PR34

Hon. Mr. Wells moved that Bill Pr34,

An Act to revive Bargnesi Mines Ltd., now referred to the standing committee on regulations and other statutory instruments, be transferred to the standing committee on administration of justice.

Interjections.

Mr. Speaker: There seems to be a private conversation going on. Would the member for Nickel Belt (Mr. Laughren) like to carry it on outside with the member for Armourdale (Mr. McCaffrey)?

Are the members all familiar with the motion? Is it the pleasure of the House the motion carry?

Motion agreed to.

STANDING COMMITTEE ON ADMINISTRATION OF JUSTICE

Hon. Mr. Wells moved that standing order 72(

a) respecting notice of committee hearings be suspended for the consideration of Bill Pr34,

An Act to revive Bargnesi Mines Limited, by the standing committee on administration of justice on Thursday, February 17.

Motion agreed to.

ORDERS OF THE DAY

CONCURRENCE IN SUPPLY, MINISTRY OF HEALTH

Mr. Nixon: Mr. Speaker, I want to pursue briefly with the minister the matter of my concern with the Pavel Kozak business. He gave the House an answer that was quite lengthy, but it concerns me that so many people whose children are afflicted with the disease epidermolysis bullosa do not have confidence this can be properly cured in Canada.

There was a time when the minister must have agreed, because he undertook to bring to Toronto the only person in the world who had a sort of patented treatment available and made what I consider to be a princely offer to retain his services for our people in Canada who obviously need the treatment.

Now that he has turned the minister down, it is still obvious to the parents of these young people the special treatment is necessary if they are going to be cured or if they are even going to be maintained in anything approaching good health. They cannot possibly afford this service.

It is the first time I have heard the minister imply there is some element of quackery associated with the treatment. He indicates certain people feel there is some advantageous part to the treatment but, in the past, I have felt the minister was quite strongly in support of bringing both the man and the treatment to Toronto. I felt he considered it a feather in his cap that the individual concerned, Mr. Kozak, was even considering coming to this part of the world.

Now that the economic exchanges have broken down and we do not seem to be able to do this, I, for one, cannot see why the Ontario health insurance plan cannot provide the assistance to the restricted number of patients who, according to what appears to be the record, could really achieve, if not a full cure, at least a tremendous mitigation of the problems associated with the disease. I felt I should bring that to the attention of the minister.

I also want to say something about the minister's statement that, in his view, too many hospitals in Ontario are spending too much money. I noticed the Globe and Mail featured that this morning and it brought to mind a continuing problem in my constituency with the famous Willett Hospital.

Unlike most of his colleagues, the people in Paris think highly of this minister. He has not threatened to close it recently and, as a matter of fact, we now have under construction an expansion of the hospital amounting to almost $2 million. This, of course, is accomplished with funds approved and supplied by the Treasurer (Mr. F. S. Miller) through the Ministry of Health. The members will recall it was the Treasurer himself who went to Paris and announced the closing of that hospital at the same time as he announced the reduction in services at the famous Doctors Hospital in the city of Toronto.

Under the circumstances, I felt I had to play hardball with that issue. I am glad to report we were able to persuade the then Minister of Health to withdraw his guillotine decision and turn around to the extent that, as I have reported to the House, a large and impressive addition to the hospital is under construction. It is well in advance of the normal timetable because of the good weather and the commitment of the working people who are putting that hospital up.

3:20 p.m.

The administrator of the hospital has expressed his continuing concern to me that there has never been a commitment to the kind of budget the expanded hospital must have to provide the services that everyone expects. The minister's officials call on the hospital from time to time, dropping edicts behind them as if they were Hansel and Gretel dropping crumbs in the bush. They say the costs of running the hospital are not going to be approved. The local board wonders what it is supposed to do under the circumstances.

The minister is aware that the Willett Hospital rates right at the top of hospitals of that size in the province for the efficient use of their facilities. This is not in question. There is no one who is not prepared to assert and accept the figures, which indicate the hospital is extremely well managed.

We have a union there and the negotiations have been along the basis of the settlements elsewhere in the province. We are very pleased that the hospital is the largest employer in the community and has good labour relations. It has a good reputation. It utilizes its beds well over 100 per cent -- if members will want to contemplate that -- and in the impartial statistics made available by the ministry, it is at the top of the list in efficient use of facilities and funds.

But the minister's officials still apply the kind of pressure that makes the necessary planning almost impossible, particularly in the implementation of the service of a large new addition. I draw the minister's attention to the fact that this has not been settled. There does not seem to be any kind of a meeting of minds. I cannot help but think there is a basic and deep-seated misunderstanding between the minister's officials and the officials at the local level.

I do not know whether the minister is aware of this or not, but on the month-to-month basis of the transference of funds, there seems to be these continuing problems in spite of the fact that the efficiency of the hospital is unquestioned. I do not want to deal at any greater length with the specific issue, but if it occurs there it must occur elsewhere.

Personally, I thought the local health council -- imposed on our community by the minister's predecessors -- should have had a greater role in taking the pressure off the administration of the Willett Hospital in the allocation of public funds. This has not been the case. I am not particularly critical of the health council. I do not believe it is performing a useful function in our community, but I do not criticize it.

I criticize the ministry in its approach to the establishment of the health councils and the way it has, in my view, brushed them aside. When they are approached with complicated and embarrassing political issues, they like to shove them back on the health council and off the shoulders of various Ministers of Health who are troubled with the implementation of personal agendas.

We feel we are being well cared for as far as hospital services are concerned in our community. We are very glad public funds have been made available for expansion of the service, particularly the chronic care service, but we cannot understand why there has to be this continuing sort of tension in which the officials come from the ministry and give fiats to the local administrators which they simply cannot abide by.

For example, the one which really troubles me more than anything else is that they say they will not deal with anything but a balanced budget. Willett Hospital cannot possibly keep all of the beds in operation, with the money being made available, and balance the budget. Then they get a letter from the ministry saying, "You must not close any of these beds."

Short of hara-kiri, it is difficult to determine what they are supposed to do. They, very properly and in an orderly and businesslike way, bring this to the attention of their local elected member -- myself -- and it is my job to complain to the minister, which I now do, to say there is some sort of a flaw in his administration, a lack of communication or a lack of understanding.

If he is going to impose the smaller budget and indicate to the Welland County General Hospital that it must reduce its services, then I suppose we will have to live with that or at least respond to it as we have in the past, but right now that basis of the minister's operation is unsatisfactory.

Mr. McClellan: Mr. Speaker, I do not want to take a lot of time during these concurrences, because we had a generous allocation of time during the estimates which were completed fairly recently, but a couple of problems have arisen since we concluded the estimates, believe it or not, and I simply want to refer to them.

The first is the intrusion of American Medical International into Canada, and I regard it as an intrusion and an unwarranted intrusion. I have asked the minister about this a number of times, conceding the fact that we obviously disagree about the merit of bringing the number two corporate health purveyor from the United States into this province. We obviously disagree about that, and I will not pursue the debate. We can pursue that over the course of time.

I would like to ask the minister to tell us up front the identity of the six other hospitals that are in negotiations with AMI. The Ministry of Health was involved in the negotiations that led up to the contract at the Hawkesbury District General Hospital, as I understand it, from day one, and it is preposterous for the minister to say, as he did the other day, that he or members of his staff are not aware of the identity of the other six hospitals or when negotiations are taking place with AMI.

I find it impossible to believe that somebody in his ministry does not know the current status of these negotiations -- unless, of course, AMI is not telling the truth and negotiations are not taking place at all. This is another possible scenario, I suppose.

But I assume that if any negotiations are taking place, the Ministry of Health -- and I assume by this time the Minister of Health -- is aware of them and is in a position to let people know whether we can look forward to additional contracts with AMI or whether the one contract at the Hawkesbury District General Hospital is the beginning and the end of what the minister referred to as "this interesting little experiment."

The second problem is extra billing. By the end of this week, I suppose, we will have in place some version of the long-promised regulation under the Health Disciplines Act that will require doctors to give some kind of prior notification before they extra bill their patients.

A little trip down memory lane is perhaps in order. Not to put too fine a point on it -- don't look at the clock; I won't take that long.

Hon. Mr. Grossman: I was looking at Mr. Renwick.

Mr. McClellan: I believe it was March 1979 when the minister's predecessor, the member for Don Mills (Mr. Timbrell), stood in his place and announced the agreement between the government and the Ontario Medical Association that would solve the problem for all time. The agreement was that unless the opted-out doctor gave prior notification to the patient, the patient did not have to pay the bill. That was the agreement, and if the minister is fuzzy about the details he should look up the announcement, as I did the other day.

I had forgotten it was so definitive an agreement. Of course, I place the word "agreement" in quotation marks, because a woman who had been charged a 46 per cent surcharge by her anaesthetist took the case to the Ombudsman because she had not been given prior notification and yet had been sent a bill by a collection agency. She complained to the Ombudsman that this violated the letter and the spirit of the agreement the member for Don Mills had announced on March 26, 1979, in the Legislature.

What did the Ombudsman discover in the course of his investigation? He discovered there was no agreement. There is nothing in writing. There is no document that constitutes the agreement between the Ministry of Health or the Minister of Health and the Ontario Medical Association. That document is a fiction, as the agreement was a fiction.

I use the word advisedly. In the same report of the Ombudsman, the Honourable Mr. Morand, the executive secretary of the Ontario Medical Association -- this is the formal response of the OMA to the Ombudsman during that investigation -- told him that as far as physicians were concerned they had no obligation to give prior notification to patients that they were opted out.

Second, if prior notification was not given, so what? The patient still should pay the bill. That was the OMA's understanding of the agreement between this government and itself. In other words the agreement the Minister of Health announced in 1979 was pure, unadulterated poppycock.

3:30 p.m.

The Ombudsman's report was produced in June 1982. The matter was immediately referred to the Health Disciplines Board and in this case the board ruled it simply had no power to deal with the whole question of prior notification and the obligation of patients to pay bills when they had not been given prior notification by an opted-out doctor. That is why the regulation issue is before us again, as it was last fall and now this winter.

The minister said in October he would bring in the regulation; he said in December he would bring in the regulation; and he said it again in January -- or was it February? I have forgotten already. At any rate something is supposed to happen and we will just wait and see what it is. I do not know what good that is going to do when 65 per cent of the obstetricians and gynaecologists are opted out in the city of Toronto and 64 per cent are opted out in Sudbury.

The minister can say it does not really matter, that there are 3,000 physicians in Toronto who are opted in. However, the inference one could draw from that if one were going to be uncharitable is that specialist care is no longer available under the medicare plan. If one wanted childbirth covered by the Ontario health insurance plan, one must go to a general practitioner, not try to get an obstetrician or gynaecologist. One must not try to get specialist care to help with childbirth, because the specialists are all opted out and some of them charge 100 per cent above the OMA rate. One can go to them if one can afford it, or if one wants to arrange privately for charity.

That is the state to which medicare has descended as of this month in Ontario in 1983. I do not see anything happening within government that is going to respond to what is not just a clear threat but a clear crisis in the administration of our medicare program. For example, I do not know how one is supposed to get an operation unless one is prepared to do it without benefit of anaesthesia. Perhaps the minister could experiment with that for us and let us know how it works.

Hon. Mr. Grossman: The member first.

I have two final points on the Dubin report. First, all of us were extremely grateful for the work done by Mr. Justice Dubin in his report. It was an outstanding document -- thorough, comprehensive; pretty hard-hitting, I would say, despite the judicious use of language -- and it contained a good set of recommendations to deal with the problems he identified.

I suppose it is not the business of a commissioner in reviewing these problems to deal with the political implications. It is our business to deal with the political implications, not in a negative kind of way but in as up-front a way as possible, to make sure this kind of thing does not happen again anywhere.

I want to touch on some concerns I have, not from a partisan perspective but certainly and unapologetically from a political perspective. I am concerned that the minister, in his statement -- I cannot get my hands on it but I think I remember it said he expects the board of trustees to carry out the recommendations of the hospital review committee.

Mr. Conway: That old boys' club with a bad attendance record?

Mr. McClellan: As the member for Renfrew North says, the board of trustees is an old boys' club with a bad attendance record. That remark is not a quip; it is an accurate description. Although perhaps in colloquial language, it is still an accurate description of a finding of the Dubin committee. Some of the members of the board of trustees have been on that board for more than 20 years. It was Mr. Dubin who identified that they had a poor attendance record.

I want to deal with the issue of responsibility. There is an important question of accountability that seems simply to be going by the board. A number of children died at the Hospital for Sick Children, and two separate investigations are under way in the hope of determining responsibility, accountability and culpability. Either these were homicides and there was criminal culpability -- we do not know yet because the investigation is not complete -- or the problems were on the administrative side. In either case there are questions of responsibility and culpability.

Those questions will not go away. They have not been answered yet and perhaps that is entirely fair because the investigative process is continuing. But eventually those questions will have to be answered. It will not be enough for the criminal investigation to end with a finding of "no finding." That raises questions on the other side of the ledger, if I may put it that way -- on the administrative and management side.

There are matters of enormous concern identified in the Dubin report. In a nutshell, the Hospital for Sick Children expanded its clinical services enormously during a time of financial restraint on the part of the ministry and it was not able to develop the kind of support services the newly expanded clinical services demanded. They expanded, they did not have the resources to do it properly and they had to cut back, or neglect, the expansion of essential support services -- particularly laboratory and pharmaceutical services.

At the time Mr. Justice Dubin did his review he discovered that the Sick Children's Hospital did not have laboratory or pharmaceutical services adequate to the needs of a modern hospital. The death of Baby Murphy, who was given epinephrine instead of vitamin E in January 1982 -- not in March 1981 when the last of the so-called digoxin deaths occurred -- indicates that regardless of the mystery surrounding the digoxin deaths there were problems on the management and administrative side that also led to the deaths of children.

3:40 p.m.

Mr. Justice Dubin does not pull his punches. He talks about the laboratory services in

chapter IX. As a parent with two children who have occasionally used the Hospital for Sick Children, I found one remark quite frankly terrifying. He pointed out, "The results of the study indicate that appropriate adjustments to the drug regimen received by a patient are made in approximately only 40 per cent of the cases where adjustments are indicated."

In other words, only 40 per cent of prescriptions in this survey that were required to be adjusted for medical reasons had the adjustments made, because of the inadequacy of the hospital's laboratory services. That is not a very good batting average.

My second point concerns the fact that the pharmaceutical services at the Hospital for Sick Children were substandard.

I would like the minister's attention for the brief period of time I am dealing with this important subject.

I do not understand the circumstances leading to -- I am using the language of the report -- "the neglect to develop an adequate pharmaceutical service at the Sick Children's Hospital." The Sick Children's Hospital had obtained a report on its pharmaceutical services in July 1980 from Dinel and Summers. Ironically enough that is the very same month the first expressions of concern were felt within the nursing staff with respect to infant deaths in the cardiology unit.

The very same month the initial concerns were raised about infant deaths, this hospital received a report from Dinel and Summers on its pharmaceutical services. That report concluded that -- I quote from Justice Dubin -- "The medication system in use at the hospital at that time fell considerably short of the requirements." The requirements are the requirements of a modern hospital. I am sure the minister has read pages 197 and 198 dealing with the Dinel and Summers report.

The point is, the hospital knew in July 1980 it had a critical situation in its pharmaceutical services department. It had a report outlining the deficiencies and defects and it had a set of recommendations that Mr. Justice Dubin has had to readopt in his report because they have not been implemented. I do not understand how a board of trustees can receive such a critically important document and fail to implement it. I understand they even failed to bring it to the attention of their board of trustees. I have not been able to determine conclusively whether this report was ever shared with the board of trustees of the Hospital for Sick Children.

It is my best guess, and that is all I am able to do, that it was not even shared with the board of trustees. It is my best guess it was not shared with the Ministry of Health. It is my best guess the hospital did not bring this to the attention of the ministry and say: "We need help. We have a serious problem. We have expanded our clinical services in a way that has outpaced our capacity to support them. We need a lot of help to upgrade our critically essential support services."

The minister will have to fill in this gap but my understanding is this report was deep-sixed. It was not revived in any effective way until Mr. Justice Dubin began his investigation and discovered this critical problem had already been identified in the Dinel and Summers report. He discovered recommendations had already been made and the hospital had neglected to implement them. This was its second instance of neglect, the first instance being its failure to expand pharmaceutical services in tandem with its expansion of clinical services.

Yet, as I understand it, the minister asks us to leave the implementation of the Dubin review committee's recommendations with the same board of trustees that has presided over the deterioration of the Hospital for Sick Children from its once proud world-class status to its condition as described in the Dubin report. As a parent, it would cause me a lot of anxiety to send one of my children to a hospital without an adequate laboratory service and without an effectively functioning pharmaceutical service.

The task of the ministry and of the minister is now to convince the community that anxiety is unwarranted and that we can turn to the Hospital for Sick Children with the implicit trust we once had. It is not going to happen by the minister just pretending this board of trustees can go on being self-perpetuating, with business as usual. I have made some suggestions to the minister. They are suggestions Mr. Justice Dubin made himself.

His very first recommendation is: "The hospital should continue to seek to balance the legal, banking and investment background of the present board of trustees with persons representing other experiences when future appointments are made." As I have said, Mr. Justice Dubin uses judicious language. There is another way of saying the same thing perhaps more colloquially -- that is, the board of trustees should be replaced.

Is that not what accountability is all about? I have always thought it was. Does accountability not have any place in the health care system in Ontario? That board of trustees should be replaced as quickly as possible by a board of trustees more genuinely reflective of the composition of the community.

3:50 p.m.

Second, the minister should set up in his own office, if he has not done so already, an implementation team made up of ministry officials who have access to the levers of decision making. Their job should be to make sure the new board of trustees get whatever resources they need to upgrade the hospital's support services, in particular the laboratory and pharmaceutical services. That should be done immediately.

Third, Mr. Justice Dubin should be kept on commission, in a sense, with a mandate to do a follow-up study within six months. He would then report to the public whether a new board of trustees, working with whatever implementation unit the Minister of Health has been able to put together, has managed to implement the recommendations set out in that document.

It is not going to be good enough to try to pretend: "Oh well, the report is in. Some kind of work is under way, and it is really business as usual at the Hospital for Sick Children." It is not business as usual at that hospital, not with the kinds of problems that are documented in this report. It will not be business as usual at the hospital until the minister can say that all these problems have been solved. He must be able to say it is no longer true that 60 per cent of the medications that are supposed to be altered are not being altered and it is no longer true the pharmaceutical services are inadequate to the needs of a modern hospital.

Until he can say we have the best laboratory services in the province and we have the best pharmaceutical services in the province and can give us

chapter and verse as to how this is being accomplished, it is our responsibility to express concern. He may want to say, "The last thing people need at this point is some negative Health critic crying gloom and doom and running down the reputation of this world-class hospital" -- and he has used that argument. This is no situation for that kind of Kiwanis-like boosterism or that kind of Pollyanna nonsense.

The problems of the Hospital for Sick Children are objective and real, and Mr. Justice Dubin identified those defects. We will not be silent until the minister can convince us, program by program, that he has restored the level of service of this hospital to a world-class level.

Mr. Newman: Mr. Speaker, I will not be lengthy at all, because there are several other members from my own caucus who would like an opportunity to make a few comments.

I would like to bring to the attention of the minister that a young lady in Windsor was sent to Germany because the principal of the school and the good citizens in the community, including the students, raised sufficient funds for the purpose. They raised this money so that this young lady, Helen Gonzales, would have the opportunity to receive treatment in Germany. She came back substantially improved. I hope it is not true, but it seems now she is regressing a bit. I think it is the responsibility of the minister to see that this young lady does not go back to having the old effects of the skin disease, epidermolysis bullosa.

The young lady needs the medication. I think that if the minister does not intend to finance all of them, he should take several of the people who are going to be taking the treatment or did take treatment over there and use them as experiments with the treatment that he claims is developed in Ontario. He should bring them to Toronto and let them go through that same type of improved treatment he claims is available in Ontario. If it is available we are very pleased it is here, but to our best knowledge the young lady received treatment in Germany and came back into the community substantially improved.

I beg the minister to look into the case of Helen Gonzales to see if he can help the young lady. She is only one case. I know there are many others in the province and maybe in other parts of Canada. Since the minister has the responsibility for the health of Ontario citizens he should look into her case. She would appreciate being given the opportunity to get the same treatment here as she got over in Germany.

The other issue I wanted to raise with the minister concerns the matter of a chronic care hospital in my community. More than 10 years ago we were promised a chronic care facility. As a result of certain machinations it never developed. I believe there are more people in need of chronic care than there are facilities in the community to take care of them.

We were promised a completely new facility. We settled for the refurbishing of the Riverview Hospital chronic care facility. It is an excellent facility. They take first-rate care of their patients. I have no criticism whatsoever. But there are insufficient chronic care beds in the community. I receive calls, not on a daily basis but very frequently, from a parent or other family member concerning some member of the family who cannot get into a chronic care facility in the community because of extremely long waiting lists.

I would ask the minister to provide our community with its fair share of the ministry's chronic care dollars. Our citizens should not be neglected simply because they are 240 miles or so away from Toronto. They should be given the same opportunities, the same type of treatment, in satisfactory facilities. Those requiring chronic care should not have to suffer what is inferior care, in some instances, in some of our rest homes.

I do not intend to speak to this point any more, but Helen Gonzales needs that treatment and needs it now. The minister would be doing a young lady, the community and the health delivery services a real favour by treating her with the medication that is said to be available in the province -- I hope it is, in fact, available.

I also repeat that chronic care facilities are sorely needed in the Windsor area. The district health council sometimes is looked upon as the buffer between what is needed in the community and those who will provide the minister with an excuse for not providing it. I hope it is not that way. I hope the minister will provide what is sorely needed only because it is sorely needed and for no other reason.

4 p.m.

Mr. Lupusella: Mr. Speaker, I rise to speak to an important issue raised in the Legislature by my colleague the member for Sudbury East (Mr. Martel), which involves the treatment of cancer in a clinic located in Houston, Texas.

I am sure the minister is aware that the Ontario health insurance plan does not cover the expenses of that treatment because the treatment per se is not recognized by the Ontario Medical Association.

I sent the minister a letter on January 10, 1983, on behalf of a constituent of mine who was affected by a cancerous tumour. He was hospitalized in Toronto and was dismissed after several months, with the final diagnosis that he had a few months to live. As a last resort, he went to this particular clinic in Houston, Texas, to receive treatment and it now appears that he is well. He came to my constituency office and I had a long chat with him. He is not showing signs of distress.

For the record, I hope the minister will take note of the letter I sent to his office on January 10, 1983, urging him to get involved in that particular issue and to make sure the Ontario health insurance plan covers the expenses, which total $8,515.

I do not want to read the content of the letter, nor is it my intention to bring the name of my constituent to the minister's attention. As far as we are concerned, it appears that the treatment which the claimant received from Dr. Burzynski -- which is not recognized by the Ontario Medical Association -- is working.

I had an opportunity to speak with several people from different parts of Canada who have received treatment in Houston, and they all appear to be healthy. I am not a specialist or a doctor, so I cannot give a professional diagnosis of the progress of their recovery, but from what they told me over the telephone, they are not in distress and they feel well.

The minister is also aware that two doctors from Ontario visited the centre in Houston. They had an opportunity to spend some time with Dr. Burzynski and they came back to Toronto with a negative response. They spent one day talking with the doctor down there, but they were not satisfied that the treatment which is given to patients has a concrete and a scientific reason to be given.

I also understand that Dr. Burzynski was supposed to come to Toronto to talk to the minister in relation to the contents of the treatment. We really do not know at which stage this communication is as a result of that request Dr. Burzynski made to talk to the minister personally.

On behalf of my constituents, I have a lot of newspaper clippings which support the effectiveness of that treatment. The patients were happy and pleased with the treatment they received, and they are healthy now as a result of that treatment. I do not want to read all these newspaper clippings into the record, because I am sure the minister is well aware of this issue.

I hope the minister will send a reply to my letter dated January 10, 1983, on behalf of my constituent who, as I stated previously, came to my constituency office and is healthy again. He had been in the hospital for several months and was released with the diagnosis there was nothing further to be done.

The other issue I would like to raise with the minister is in relation to ex-psychiatric patients who have been dismissed from hospital and are now living in the community. One of the problems which has arisen in the past as a result of the transitional period from the hospital to the community is that all of the patients are now living either in Parkdale or in the area of Dovercourt between Queen and King Streets. This procedure is completely wrong. They are all living in rooming houses and the community at large is not pleased with this phenomenon which has been expanding on a monthly basis.

The minister is also aware that other municipalities have bylaws which prohibit ex-psychiatric patients from moving to different municipalities. The only municipality that has shown some sort of human concern is Metropolitan Toronto, but we do not want to have them living in ghettos in Metropolitan Toronto. Society at large has to undertake its responsibility to accept ex-psychiatric patients living in different communities across Metropolitan Toronto as a whole.

I hope the minister will urge other municipalities to follow suit with the same bylaw enacted by Metropolitan Toronto and to show some sort of humanitarian concern about this problem which has been growing at a faster rate in the area of Dovercourt between Queen and King Streets and in the Parkdale area.

A lot of constituents of mine have contacted my office about this problem. I think it is my duty as a member of this Legislature to voice the concern of my community so that the problem will diminish. I hope the minister will respond to those two issues because they are very important.

I would appreciate any action the minister undertakes in relation to my constituent who was affected by cancer and who now, I guess, has to pay $8,515. I hope he will be assisted through the intervention of the minister so that the Ontario health insurance plan will pay the expenses.

4:10 p.m.

Mr. Haggerty: Mr. Speaker, I want to address myself to the concurrence in supply for the Ministry of Health. I will follow the same train of thought other members have brought to the minister's attention. There is a serious problem in relation to our elderly population with the shortfall of chronic beds, nursing home beds and homes for the aged. It is a rather serious situation at the present time, particularly in the Niagara Peninsula.

It is difficult for many persons requiring special health care to find suitable accommodation. I believe I have brought to the attention of the minister before that I was a little put out about the nursing home program that is available to some municipalities. Some larger corporations providing nursing home care in the private sector are buying up beds from other communities. Eventually, a small nursing home of 20 or 30 beds is phased out and moved off into some other area in a larger community that may need additional beds. By allowing the licence to move out of a community, a shortfall of beds is created.

I am thinking particularly of a study done recently in the Niagara Peninsula that indicated there was a shortfall of some 95 to 100 beds in the Niagara Falls and Fort Erie area. Yet the minister, in his wisdom, permitted the sale of 20 beds from the town of Fort Erie. They were moved out and relocated somewhere west of St. Catharines. This created a serious shortfall of not only the 95 beds, but an additional 20 beds. I do not know what the minister is going to do about this, but he is going to have to do something, because there are no facilities there for elderly people. It is becoming a crisis situation in the Niagara Peninsula and, I suppose, in other areas.

Apparently the minister is bringing out a study now. He mentioned at the nursing home seminar some time in November that he was going to do a study on the needs of senior citizens in relation to a study on health care for the aged. This is something that is long overdue, but I am sure the Niagara District Health Council have done something in that area. I know it has, because it came up with the recommendation that an additional 95 beds are required in the two communities of Niagara Falls and Fort Erie.

I see no signs of the government or this ministry moving to relieve or assist the elderly people who require nursing home care or care in homes for the aged or even in the chronic wing. I appreciate the expansion that took place recently in the Port Colborne General Hospital. Additional bed facilities were made available at that hospital, but there are other areas where there is a shortfall. I know, as much as the ministry has tried to improve that, there still is a serious problem.

I suppose the minister has received the comments regarding health care funding in the proposed Canada Health Act that were presented to the federal Minister of National Health and Welfare by the Association of Independent Physicians of Ontario. The association does drive home a point I think the minister is well aware of, which is the shortfall in beds in hospitals that require additional funding and additional assistance. In the Niagara Peninsula, some hospitals have had problems, such as hallways being jammed up with people waiting to be admitted to emergency rooms.

Our critic on health care, the member for Hamilton Centre (Ms. Copps), has done quite an intensive study throughout Ontario. She put forward a report to the ministry from our party outlining some of the shortfalls in health care in hospitals and the growing shortages of treatment beds and chronic beds in communities. It was an exceptionally good report. The document that was presented to the federal Minister of Health pretty well sums up the report that was put forward by the member for Hamilton Centre.

It was a good document containing some good information, suggestions and recommendations that the government might follow to relieve some of the serious problems of providing proper health care in hospitals. The minister should be looking at it.

I also want to talk to the minister about chronic care or special care for persons who have a disability -- the medical term is aneurism -- affecting the function of the brain.

I am thinking of a young chap who had such a problem and required very intensive care in an American hospital. The incident happened outside of Buffalo, New York, and he spent six or seven weeks in the Buffalo General Hospital. The hospital care was expensive to the parents. The Ontario health insurance plan moved into the picture and picked up the major part of the cost. He was then moved to the Welland General Hospital for a period of time. He required nursing care around the clock because it was not known when he would come out of his coma.

The parents are now providing the necessary treatment for the youth at home. Extendicare provided approximately 80 hours, but now the funding in this particular area has been exhausted. It is now down to 10 hours of special nursing care for this patient. Surgery may be required in the long run. We hope he will come out of the coma, but meanwhile, it is a serious problem for the parents. Thirty to 40 volunteers come in 24 hours a day to provide special care for this youngster. Nurses also provide special care to keep his arms and other limbs moving to assist in rehabilitation.

In this particular instance, funds are running out to provide home care. I think the minister does have a program, but it has to be done through an order in council on a one-to-one basis. I have been informed of this, but I am not sure. If this is the case, I ask that some consideration be given to other patients who could be moved into their families' homes, perhaps at less expense than keeping them in a hospital with 24-hour-a-day special care.

The family has to be given much credit in this area. They are concerned for their youngster, but it is quite a burden for them when they have to be up 24 hours a day. Someone has to be constantly with him. I look at it that if he were in the hospital the cost for special care for this youngster would be phenomenal. It may be $150 or more a day and it may go on for six or seven months or a year. Instead, the family has the youngster at home. All I am asking for is some financial assistance for special nursing care at home.

They would like to maintain the care at 15 hours a week, three hours a day. They feel he is responding. In fact, they had him up walking one day but he went back into a coma. It is just touch and go.

If there is an order in council to provide the minister with special funds or if he can request that special consideration be given to a person who requires special care, I ask him to take a look at it. I can provide him with the name of the person and other information. There are other people who are doing the same thing and they understand the cost and burden under the public hospital system and the funds for special care.

If families can care for a patient in their home, I think we should be looking at these other alternatives besides the hospital to provide good health care for the patient in the hope that he will be rehabilitated.

4:20 p.m.

Mr. R. F. Johnston: There is a temptation with the Ministry of Health, as there is with the Ministry of Community and Social Services, for all of us to get up with our local concerns. Those two ministries touch an awful lot of our constituents and our case work.

There are a few things I would like to touch lightly on and one matter which I would like to raise with the minister. I will not take very long because I respect the needs of other members to get in.

He knows it is not black and white in most cases, and it is very difficult for us to come up with individuals who are going to say: "I had to pay $50 more. We had to sit down and try to decide whether or not we can afford to do this or that in a given month." Or there is the case of this $600 total pregnancy package that the member was speaking of, an extra $300 for the family trying to juggle how much money they put into other kinds of things in their family budget.

When I was watching TV the other day I saw a presentation from city hall in Toronto, a committee of the public health board with Anne Johnston and some others talking about the cost of birth control and their concern that all birth control methods were not available to people at costs they could afford. They were specifically giving an example of people who were on public assistance not being able to afford the pill, etc.

I would like the minister, if he could, to comment on his reaction to that presentation, which no doubt he is now aware of; and also to indicate whether or not he has had any thoughts about having coverage for birth control under the Ontario health insurance plan and other government programs, which might not make it difficult for people to make those kinds of choices and to have some protection.

Another thing I would like to raise, and maybe the minister can give us some basic information on it, is what is happening with respect to local levies and hospital funding. The history of the Toronto East General and Orthopaedic Hospital going to the local municipality to get funding for capital costs, and maybe in the future even for operational costs, worries me, because I can see a move towards underfunding from the provincial sphere.

Especially given the wonderful story the minister had today in the Globe and Mail about the overfunding and the terrible abuse of funds that is being perpetrated by the hospitals on this province, I am concerned that there might then be an attempt to have it shifted onto the local levy.

I would like to have some idea how much of this is happening around the province. The minister must have available for us some kind of listing of which municipalities have a portion of the mill rate going to operational costs, special project costs or special capital project costs in hospitals. I would really like to have an idea of what is actually going on there, because I have never seen it laid out for the province as a whole. If the minister can only report back today that the material is available but he does not have it and he would agree to tabling it, I would be very appreciative.

I am concerned because in the last number of months, as the minister knows, we have had the possibility of Dr. Morgentaler, or others with his support and counselling, opening a free-standing abortion clinic in Ontario, probably in Toronto. I gather that there is probably still a fair amount of planning going on for that kind of clinic here in Toronto.

We have heard the comments of the Attorney General (Mr. McMurtry) -- and the Minister of Health himself was quoted, I think, but at least I recall those of the Attorney General -- as to what he would do if such a clinic were established, given that it would not be a hospital according to the definition that is in the federal act, for the method of obtaining therapeutic abortions across the country and therefore would be open to prosecution if somebody were to lay charges. He would not say he would not lay charges.

I would like to back away from that issue and go back to why this is all coming about at the moment. I suppose there are those who might say it is being raised because there are those feminist pro-choice types out there who are clamouring to make this a big public issue in Ontario, and that is the only reason it is happening. I am not one of the people who would agree that is what is behind this.

In that context, it worries me a great deal if the right, and it is not even an absolute right but a right with some strings on it, passed by the federal government as to the right of a woman to receive an abortion is somehow not being applied equally across the province. In a way, that is jeopardizing the basic civil rights of women in Ontario.

For instance, the federal statute says essentially one must go to a hospital that is recognized and licensed under provincial jurisdiction and one must go through a therapeutic abortion committee. If that is in some way not available relatively equally, just in a rough sense, to all the women in Ontario, is that not abrogating their rights? Is it not something to which the Minister of Health should be addressing himself, forgetting the pressure of the imminent arrival of an illegal clinic which would not be licensed?

If that is the case, and I believe it is the case, what has the minister been doing? I remember some discussion a year or two back of women's clinics as part of the whole notion of community clinics around Ontario. As I recall, some study was being done at the Ministry of Health. I am wondering if there has been any move at all by the ministry to look at setting up those specialized clinics in Ontario.

4:30 p.m.

Mr. Ruprecht: Mr. Speaker, as the member for Parkdale, I would like to raise two points that concern me very much. I hope the minister will respond to them. They have already been mentioned, but I would like to reiterate them since we in Parkdale area are really feeling the brunt of some of the policies that, directly or indirectly, are the result of the minister's doing.

The first is the whole issue of the plight of psychiatric and former psychiatric patients in Parkdale. There are two points to remember. One is that wherever there is an overconcentration of ex-psychiatric or psychiatric patients, the minister is directly creating a ghetto; if not a ghetto in fact at least a ghetto mentality. It is not good for the patients because they themselves do not like to live next to another group home, next to another crisis care facility, or next to my house since I happen to live in the south Parkdale area.

The point is that whenever there are too many patients coming out of any psychiatric institution it is simply not good for the residents or for the patients. The whole concept of deinstitutionalization speaks to normalization, meaning getting back to normal lifestyles in the community. I think you will agree, Mr. Speaker, if a community has within it hundreds of other people with similar problems, that is not the most advantageous situation to be in.

Another issue related to overconcentration is aftercare. In Parkdale we have a community where there are literally hundreds of people who go to different psychiatric institutions, yet very few aftercare programs have been established. I am specifically referring to aftercare programs in life skills, cleanliness improvement, job skill training and nursing care.

I am sure the minister has heard these complaints before from myself, from the member for Dovercourt (Mr. Lupusella) and from others in the House, including our Health critic. It is nothing new. I appreciate that the minister is moving to some degree in that area by trying to deconcentrate Parkdale in terms of the ghettoization that takes place. I thank the minister for at least trying to understand, but I think he should have more sensitivity in that area. He does not get the calls; I do.

At the last public meeting we had just a few weeks ago to deal with residents' complaints, the temptation was there to provide them with the minister's telephone number and also that of Queen Street Mental Health Centre. I had a tough time trying to convince the residents that was not a good idea, because their phone calls to that institution would prevent the people who needed help from getting through. So I would like the minister to talk about the whole concept of overconcentration to see what he has in mind and how he can act.

It was the minister's party that closed down Lakeshore Psychiatric Hospital. Consequently, too many people are coming out of institutions. I understand there are 14,000 former psychiatric patients leaving our institutions in the Metro area. Unless we move expeditiously in terms of opening up group homes in the whole metropolitan area as well as other areas, we can only expect that concentration will be maintained in Parkdale. It should be ours and the minister's position to deconcentrate and do everything possible so that patients with psychiatric problems will have a better life and be looked after better than they now are.

The second point is the issue of Pavel Kozak which I have raised repeatedly. I have 12 affidavits with me, from Paul Raggler of London, Margaret Price of Hamilton, Sheila Cutler of Bracebridge and other people from Toronto. Each affidavit indicates the treatment being offered in our Ontario hospitals is not effective, especially in the three hospitals that are supposed to treat people who are sick with scleroderma and other skin diseases. These people believe they are being used as guinea pigs.

The minister has indicated to the House he did everything possible to facilitate Mr. Kozak's coming to Ontario. The minister knows he said this in the House, yet when we checked the record, when we checked the facts, it was the opposite. Neither he nor his staff has been at all helpful.

The minister's solicitor suggested to Mr. Kozak's solicitor there could be no meetings on a level other than between the two solicitors. When repeated phone calls were made to his own office, he not only refused to meet with the residents, he also refused to meet with Mr. Kozak himself.

Hon. Mr. Grossman: Mr. Speaker, on a point of privilege: I will deal later on with the inaccuracies the member has mentioned, but I would not want the comments which suggest we have not been helpful to go on the record in Hansard without my objection and the notation that I will be dealing with that in my response. Those remarks are simply inaccurate.

Mr. Ruprecht: I would accept that if I were simply an ordinary member sitting here listening to the minister. If I had not been part and parcel of the discussions and the committee that tried to reach the minister and help Mr. Kozak when he was here, I would believe it. Since I was part of the mechanism, the whole process of trying to bring him over here, I look forward to hearing the minister's comments. I will repeat this in and out of the House. I am not afraid to correct the record. The statement he has made that he was very helpful is simply not true.

The Acting Speaker (Mr. Cousens): I would ask the honourable member not to --

Mr. Ruprecht: Yes.

The Acting Speaker: You have just used unparliamentary language. I would ask you to make it less strong so you are not casting any intention on the people involved.

Mr. Ruprecht: What I am saying is the minister stated in this House he was helpful when Mr. Kozak was here. He said he and his staff did everything possible to meet and speak with him and I am simply saying that is false. I would repeat this out of the House as well as to the minister himself. I think the minister has shown a singular insensitivity when it comes to these patients and when it comes to Mr. Kozak establishing in whatever way, shape or form he would like to come to Canada, especially to Toronto. That is what I am saying.

The minister also knows full well it is not simply a question of Mr. Kozak establishing his own clinic. If the minister was simply saying to the people of Ontario, "I will meet with him and find out what this man wants," that would be a different story. He has not done that. Like Pontius Pilate, he has simply washed his hands and said, "I am simply not ready to deal with the situation." If he made a different statement we could believe him, but he has not done that.

If he were ready to meet with Mr. Kozak they could work something out. Mr. Kozak's last position was not that he would either establish a clinic or not come at all. If the minister or his staff would take the time to discuss the ins and outs of a new contract or new possibilities, he would find Mr. Kozak quite reasonable and he would come here under other conditions than were indicated by the minister.

In closing, I urge the minister to meet with the committee that is made up of people who have this disease. If he does not meet with this committee, he should at least sit down and meet with Mr. Kozak's representative. If he will not sit down with Mr. Kozak's representative, I hope he will establish a committee in this House and sit down with the committee to work out the details.

4:40 p.m.

I urge the minister to institute some kind of a mechanism that would indicate to Mr. Kozak or Mr. Karfilis, who is Mr. Kozak's lawyer, that the minister is ready to at least sit down and work out different options whereby Mr. Kozak could come and practise in whatever way, shape or form in Toronto. That would certainly include being supervised by the medical establishment here. Mr. Kozak has indicated he would not necessarily want to be the boss of the whole operation. He would be quite prepared to work under the medical supervision of our own medical establishment in Ontario.

Ms. Bryden: Mr. Speaker, I want to speak briefly about hospital funding, although we have already heard quite a bit about it today. In recent years the ministry's approach to hospital funding seems to have been too little and too late. Funding increases below the inflation level have resulted in serious cutbacks in services.

If there was any fat in the system, that was eliminated by most hospitals in the first years of the cutbacks. Now the cutbacks are resulting in overload on the remaining staff. They are resulting in an increase in employee fatigue and a decrease in morale. They are resulting in patient dissatisfaction with services. They also constitute a serious danger to the public in terms of delayed operations, delayed treatment, overcrowded emergency departments and bed and nursing shortages.

To find out what the people in my riding thought of the health services available to them in the east end of Toronto, I put a question on my riding report which I sent out in November of last year, asking: Are you satisfied with health care services in the east end? If not, specify. I was disturbed by the replies I received. I recognize the replies are mainly from those who have a problem with the services; it cannot be considered a Gallup poll inquiry into the attitudes of the total population of the area.

However, of those expressing dissatisfaction, there was corroboration of the overcrowding; the poor care, particularly for chronic patients; shortages of beds for acute patients; and shortages of nursing, medical and support staff. There were complaints of lack of attention and coldness in the attitudes of those providing the services. This stems mainly from the overload of work being placed on them.

The emergency services were considered very inadequate by those replying to the questionnaire. They referred to people having to wait from six hours to 24 hours to be admitted, and spending that time in the corridors. I have heard reports myself from other sources that the waits in the corridors can be as long as three days.

I sent these findings to the minister and the administrator of the principal hospital that serves my riding; namely, the Toronto East General Hospital. I have not yet heard from the minister, but perhaps I will today. The administrator of the hospital, in his reply to me, said the hospital had developed a master plan for overcoming the deficiencies in renewing the physical facilities that are old and inadequate by today's standards.

He said the ministry had approved this plan, and the district health council, which participated in the planning, had also recommended that action should be taken along the lines of the master plan; however, the cost price on the plan is $18 million and the hospital is expected to put up $6 million.

With the hospital operating at a deficit at present, under the kind of funding it is getting, it seems impossible for it to borrow $6 million and pay for the carrying charges, or get that $6 million from any other source.

The municipality has been asked to add a part of it to the tax base, but I do not think property tax is the best means of financing hospital expansion, particularly in our metropolitan area where hospitals specialize and serve far more than the municipality in which they happen to reside.

It would appear the present level of funding will not even sustain the level of activity and services which the hospital is now providing. That means further staff reductions, and the administrator stated that was the only alternative he could see. It does not mean any correction of the situations outlined by my constituents and by other people who have examined the hospital's lack of facilities.

The hospital does not yet have a CAT scanner and with the present grants it is not able to keep up with new medical advances in terms of equipment, much less overbuying on equipment as the story in today's Globe and Mail seemed to imply the ministry's officials were suggesting was going on.

The kind of kite flying that has surfaced in the story in today's Globe and Mail about hospital funding looks to me like simply a further excuse by the minister for continuing his policy of cutbacks.

I am not denying there is room for rationalization of some services and there may be substantial savings in the long run from such rationalization, but until that rationalization occurs the ministry cannot go on putting people's lives at risk through delays in treatment, delays in elective surgery, delays in admission to hospitals. He cannot ask patients to be patient while he gets some long overdue research and planning into effect. He cannot expect them to pay with their health for his failure to relieve the acute bed shortage by providing more chronic care beds and nursing home beds.

He cannot expect hospital usage to go down until he develops community medical centres which will do preventive work and ultimately reduce hospital needs.

In my view of the very serious inadequacy of our hospitals in the east end, it seems to me the next budget must include a change in government spending priorities which will see that the funds necessary to provide quality medical care to people, not only in the city of Toronto but throughout the province, are absolutely essential.

This is what the minister should be looking at and speaking to his cabinet colleagues about to see that the relieving of these serious deficiencies, serious life-threatening inadequacies in our hospital services, are met until such time as he is able to bring down costs through new rationalization procedures. Is the minister prepared to make sure the budget shows a turnaround in funding to meet these very serious deficiencies?

4:50 p.m.

I have one other point I want to raise. Part of the minister's responsibility is the field of mental hospitals and part of his responsibility in that field is the confinement and treatment of individuals sent to mental hospitals on a Lieutenant Governor's warrant; individuals who have been charged with a criminal offence but have been found not guilty by reason of insanity or have been found unfit to stand trial by reason of insanity.

The warrants are in effect until the Lieutenant Governor withdraws them, which means they could be in effect for life or for any period of time. I realize the public must be protected from people who have a serious mental disorder which may render them violent, but I think we must also realize that the power given to the Lieutenant Governor by the court to look after the individual is a very great power. It is a power that we in the Legislature and the general public should be monitoring.

I am not suggesting that the Lieutenant Governor's advisory board which reviews the cases every year is not doing its job. However, I think we need more information on the kind of procedures they follow and whether the rights of the individuals are fully protected