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November 23, 2010

39th Parliament, 2nd Session

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Hansard Transcripts

Votes and Proceedings

Orders and Notices

Hansard Transcripts 2010-Nov-23 (PDF)

L072 - Tue 23 Nov 2010 / Mar 23 nov 2010

LEGISLATIVE ASSEMBLY OF ONTARIO

ASSEMBLÉE LÉGISLATIVE DE L’ONTARIO

Tuesday 23 November 2010 Mardi 23 novembre 2010

ORDERS OF THE DAY

NARCOTICS SAFETY

AND AWARENESS ACT, 2010 /

LOI DE 2010 SUR LA SÉCURITÉ

ET LA SENSIBILISATION

EN MATIÈRE DE STUPÉFIANTS

NOTICE OF REASONED AMENDMENT

INTRODUCTION OF VISITORS

ORAL QUESTIONS

ONTARIO PUBLIC SERVICE

ONTARIO PUBLIC SERVICE

ENERGY POLICIES

NUCLEAR ENERGY

ENERGY POLICIES

NUCLEAR ENERGY

AIR QUALITY

HOSPITAL SERVICES

CELLPHONES

SERVICES FOR ABUSED MEN

ONTARIO DRUG BENEFIT PROGRAM

AGRICULTURAL LABOUR POLICY

WORKPLACE SAFETY

AGENCY SPENDING

EMPLOYMENT PRACTICES

DEFERRED VOTES

WATER OPPORTUNITIES AND WATER

CONSERVATION ACT, 2010 /

LOI DE 2010 SUR LE DÉVELOPPEMENT

DES TECHNOLOGIES DE L’EAU

ET LA CONSERVATION DE L’EAU

ENHANCEMENT OF THE ONTARIO

ENERGY AND PROPERTY TAX CREDIT

FOR SENIORS AND ONTARIO

FAMILIES ACT, 2010 /

LOI DE 2010 SUR L’AMÉLIORATION

DU CRÉDIT D’IMPÔT DE L’ONTARIO

POUR LES COÛTS D’ÉNERGIE

ET LES IMPÔTS FONCIERS

À L’INTENTION DES PERSONNES ÂGÉES

ET DES FAMILLES DE L’ONTARIO

GOVERNMENT ANNOUNCEMENTS

NOTICE OF DISSATISFACTION

INTRODUCTION OF VISITORS

MEMBERS’ STATEMENTS

ENVIRONMENTAL PROTECTION

OTTAWA CHINESE COMMUNITY SERVICE CENTRE

HYDRO RATES

HUMAN RIGHTS

ONTARIO ECONOMY

LABORATORY SERVICES

ONTARIO ECONOMY

ENERGY POLICIES

ENERGY POLICIES

REPORTS BY COMMITTEES

STANDING COMMITTEE ON

THE LEGISLATIVE ASSEMBLY

INTRODUCTION OF BILLS

REGISTERED HUMAN RESOURCES

PROFESSIONALS ACT, 2010 /

LOI DE 2010 SUR LES PROFESSIONNELS

EN RESSOURCES HUMAINES INSCRITS

VISITORS

KEITH NORTON

PETITIONS

PENSION PLANS

POWER PLANT

CHILD CUSTODY

MUNICIPAL PLANNING

BRITISH HOME CHILDREN

ONTARIO SOCIETY

FOR THE PREVENTION

OF CRUELTY TO ANIMALS

VETERANS

ONTARIO PHARMACISTS

DIAGNOSTIC SERVICES

CEMETERIES

HEALTH CARE FUNDING

HYDRO RATES

MULTIPLE SCLEROSIS TREATMENT

HIGHWAY IMPROVEMENT

REPLACEMENT WORKERS

CEMETERIES

OPPOSITION DAY

HYDRO CHARGES

ADJOURNMENT DEBATE

GROWTH PLANNING

FRENCH-LANGUAGE SERVICES

CELLPHONES /

TÉLÉPHONES CELLULAIRES

The House met at 0900.

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

Prayers.

ORDERS OF THE DAY

NARCOTICS SAFETY

AND AWARENESS ACT, 2010 /

LOI DE 2010 SUR LA SÉCURITÉ

ET LA SENSIBILISATION

EN MATIÈRE DE STUPÉFIANTS

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

Bill 101,

An Act to provide for monitoring the prescribing and dispensing of certain controlled substances / Projet de loi 101, Loi prévoyant la surveillance des activités liées à la prescription et à la préparation de certaines substances désignées.

The Speaker (Hon. Steve Peters): Debate?

Hon. Monique M. Smith: I’ll be sharing my time with the member from Guelph.

Mrs. Liz Sandals: I’m very pleased to be able to address the Legislature this morning on the third reading of our government’s proposed Narcotics Safety and Awareness Act.

I am absolutely convinced that this act, if passed, would save lives and protect individuals and families from the effects of the misuse of prescription narcotics and controlled substances.

At the same time, our goal with this proposed legislation is to restore the balance between providing appropriate pain treatment for those who need it, while preventing misuse, abuse and addiction. Our government took prompt action to address the misuse and abuse of prescription narcotics and other controlled substances with the introduction of this legislation.

Let me remind members of the serious crisis that is hurting families across Ontario and that has prompted our government to act.

Individuals, families, and indeed entire communities across Ontario have been devastated by this epidemic in the overuse of drugs containing oxycodone or other narcotics. These drugs can lead to addiction in the most unlikely people and in the most mundane of circumstances. It’s shocking, even shameful, for people and their families to discover that they are addicted to prescription painkillers.

People suffer from the stigma attached to drug addiction, the loss of self-esteem and self-reliance, and in the most extreme cases, the loss of family, friends and other community connections. Feeding their drug habit becomes the central focus of addicted people’s lives, and some resort to crime to support their addiction.

Prescription narcotics have become a highly lucrative street drug, resulting in widespread diversion from legal use into trafficking by individuals and organized crime groups. That means more pharmacy robberies, more violence and more drug trafficking, with all its related negative effects on communities all across Ontario.

Overuse and misuse also means higher rates of addiction and admittance to treatment centres, where admissions have doubled between 2004 and 2008. This in turn places additional pressure on the province’s 150 substance abuse treatment programs.

The abuse of prescription narcotics or painkillers has emerged as a public safety issue in jurisdictions around the world. These drugs are being overprescribed, they are being overused and they are being obtained illegally and sold on the street for profit while the people who buy them are getting sick and are dying.

Canada is one of the world’s top per capita users of prescription narcotics, and in Canada, Ontario is regretfully at the very top of the list of narcotic use on a per capita basis. You’ve heard the statistics before, but they are worth repeating: Since 1991, prescriptions for medications containing oxycodone have risen by 900%; that’s a ninefold increase over the level it was just a few years ago. The Ministry of Health spent $156 million on 3.9 million prescriptions for narcotics for Ontario drug benefit program recipients alone in just one year, 2009-10.

That’s an average annual cost of $260 per person taking narcotic painkillers. This equates to an average of over six prescriptions per person on these drugs, and that tells you that some individuals have a very high number of prescriptions indeed.

One of the groups most affected is First Nations. In fact, a majority of Ontario’s First Nation communities, including the Chiefs of Ontario, has declared a state of emergency over the abuse of prescription narcotics, particularly drugs containing oxycodone. The Matawa Chiefs also express growing concern about the development of an underground economy, with drug dealers targeting their communities and with rising crime. But I don’t want to suggest that this is uniquely a First Nation problem. In reality, it’s a rising problem everywhere in Ontario.

There is overwhelming agreement from all of our parties and stakeholders, including the all-party Select Committee on Mental Health and Addictions, on which I was pleased to serve, that there is a public health crisis around the misuse and abuse of prescription narcotics and that immediate action is required. When the select committee toured the province we dropped into all sorts of communities, but in particular we visited First Nation communities in northern Ontario and in eastern and southwestern Ontario.

We heard the same thing wherever we went: that the misuse of prescription painkillers had become a huge problem. We also heard that in our more formal hearings in other communities throughout the province, and that was why, when the select committee made its recommendations, this is the only recommendation where we said, “Government, you must act immediately in terms of putting in place some sort of means of addressing this outbreak of addiction to prescription narcotics.” Our government took immediate action, as asked, with the introduction of this proposed legislation along with the broader narcotics strategy.

A key element of the narcotics strategy is the development of our narcotics database, which will capture all prescription information for these drugs dispensed in Ontario. The support for the development of this database has been overwhelming. Right now, an individual can go to 20 different physicians, obtain 20 different prescriptions for narcotics, bill those prescriptions at 20 pharmacies, pay cash and no one will ever know. Well, the Ministry of Health needs to know.

It needs to be able to monitor and analyze this information to inform educational initiatives and to identify patterns of inappropriate prescribing, dispensing and use. But most importantly, we need to be able to provide this information at the point of care, where patients are actually receiving health care.

As a start, the database will inform the pharmacist. When the pharmacist goes to fill a narcotic prescription, they will actually be able to see whether there are a number of other outstanding prescriptions and whether there is abuse of the drug by this particular patient. Eventually, with additional technology in place, prescribers—that is, doctors, nurse practitioners, dentists, anyone who is authorized under the law to prescribe prescription narcotics—will also have access to the patient’s profile so that they too can assess whether to prescribe these medications.

So we’ll be able to get the information to people at the point where they’re making a decision about whether or not to prescribe. Obviously, if there’s abuse, then we know that our health practitioners will choose not to prescribe but rather to find out how to intervene in the problem.

The database lays the necessary foundation to ensure the success of the whole strategy. If this legislation is passed, the ministry is expecting to completely enhance the database by summer of 2011.

Following second reading, Bill 101 was referred to the Standing Committee on Social Policy. The committee received over 40 submissions, which identified the following key issues: the need for an appropriate balance between privacy protection and public safety; the need for a provincial chronic pain strategy; and increased access to treatment of addictions.

I’d like the members to note that the ministry already collects information on narcotic prescription for Ontario drug benefit or ODB recipients. At this point, we are obviously collecting the information for the purpose of paying the pharmacists who have dispensed the drugs. We are able to disclose this information to law enforcement agencies and regulatory colleges, as authorized under the Personal Health Information Protection Act.

The technology and privacy protections already exist in legislation, and the provisions of the proposed legislation would build upon those systems that are already in place. During committee, we heard from some stakeholders that there should be mandatory disclosure to regulatory colleges and law enforcement agencies in certain circumstances. But we also heard from other stakeholders that no disclosure should occur without a consultation process with the Information and Privacy Commissioner.

Our proposed legislation clearly outlines what information can be collected, to whom personal health information can be disclosed and under what circumstances. The act would extend the ministry’s authority to cover all Ontarians rather than simply limiting it to ODB recipients, which is currently the case, for prescriptions for narcotics and controlled substances. The only disclosure provision in addition to what currently exists would be to prescribers, dispensers and operators of pharmacies.

Secondly, with respect to the chronic pain strategy, while there is no specific pain strategy embedded in the narcotics strategy, there are areas that relate to the treatment of chronic pain. For example, a key focus of the strategy is the development of education for health care professionals, which will include education on appropriate pain management and the appropriate use of narcotic painkillers.

The Narcotics Advisory Panel to the Ministry of Health has a long-term mandate to provide advice to government on optimal pain management; and the Ministry of Health and Long-Term Care is working to establish a group of experts in the field of chronic pain, including physicians and other providers, to develop evidence-based recommendations for chronic pain management. This advice will inform a strategy to organize and deliver more effective treatment and management programs for those people who have chronic pain issues.

Considering all the submissions, we feel that we need to balance the issue of privacy of personal health information with the need to deal with the major public health crisis that is killing individuals and destroying families and communities across the province. We do not take this lightly, and with this proposed legislation I feel that we have struck the right balance.

The data is only part of our overall provincial narcotics strategy. We will also raise public awareness about safety, including youth education; we will incorporate more narcotic and pain management education into the medical school curriculum; and we will work to educate prescribers and pharmacists about the appropriate use and dispensing of prescription narcotics.

The broader strategy will also focus on treating patients with addiction, and investigating additional options for treating and supporting those addicted to prescription narcotics and controlled substances. The strategy will also develop educational workshops on the treatment of narcotics dependence and support the work with relevant partner treatment and addiction organizations and agencies, including the Centre for Addiction and Mental Health and ConnexOntario.

At the clause-by-clause reading on October 26, 2010, several amendments were made to the bill, as follows: Firstly, hospitals will be included within the narcotics database once the technology allows for it and a clear implementation strategy has been determined in consultation with hospitals. Again, we know from our conversations with the select committee that one of the points of abuse of narcotics is that sometimes people will shop emergency rooms looking for prescription painkillers, so it’s important that we include hospitals in the information loop.

Secondly, the act would specify that the executive officer of the provincial drug program would co-operate with other organizations, specifically including regulatory colleges, to achieve the purposes of the act, if passed.

Finally, we made amendments providing authority for the minister and/or the executive officer to disclose information to prescribers at the point of prescribing, if the act is passed.

I mentioned earlier how making sure that the prescriber has information about all the patient’s narcotics prescriptions at the time they are making the decision to treat the patient is very important, so that the prescriber, i.e., the treating physician or the treating dentist, the treating nurse practitioner, understands the prescription narcotic history of the patient as they’re making the decision around what sort of drugs to prescribe. The latter amendment allowing access to the prescription will therefore help to determine whether to prescribe a narcotic or controlled substance.

Originally, the bill only allowed for disclosure to a prescriber who had already prescribed a narcotic or controlled substance to the person, and we thought it made much more sense to allow physicians to see the information before they make that decision, when they can actually then choose more effective courses for managing pain.

Our government is focused on helping individuals, families and communities avoid in the first instance and recover from the effect of prescription drug misuse and abuse. As a government, we feel that we need to take strong action to turn the tide. That’s what we’re doing with this legislation and with our broader strategy. We need the support of every member for our proposed Narcotics Safety and Awareness Act to make this happen, and I ask all three parties to support this proposed legislation in Bill 101.

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

Mrs. Christine Elliott: I did listen with interest to the comments made by the member from Guelph with respect to Bill 101, and certainly we are intending to support this bill. But having said that, we have to recognize that this is only one small part of a very, very big problem.

Being a fellow member of the Select Committee on Mental Health and Addictions, we did have the opportunity to visit many communities across Ontario that are really being ravaged by prescription drug abuse of oxycodone products, OxyContin and Percocet being subsets of that. We know that while the registry is really an important part of the process to be able to hopefully stop the process of double-doctoring and having people visit multiple physicians and multiple pharmacies to obtain these products, there are many more things that need to be done.

The select committee did take a very hard look at this particular issue. We urged the Minister of Health to act immediately, and we do thank her for her efforts in this respect, but there is a lot more that needs to be done in terms of treatment, in terms of giving people the opportunity to get themselves off these drugs. There are some law enforcement issues that need to be looked at.

In terms of treatment, there’s a lot more to be done to make sure that there’s a basket of services in each community, because there are many parts of Ontario where detoxification programs and support programs simply aren’t available. When you look particularly in the north, in some of our First Nations communities the situation is so bad that up to 70% of the population is suffering from prescription drug abuse. So we really need to concentrate our efforts and move on and start implementing other parts of the program in addition to this very worthwhile initiative.

We look forward to working with the government on developing the response to this. It is something that is needed in all parts of the province.

The Acting Speaker (Mrs. Julia Munro): The member for Nickel Belt.

M me France Gélinas: Certainly we agree with the premise of what we’re trying to do, but allow me to take a few exceptions. When I hear my colleague talk about, “Anybody could go to 20 different doctors and then to 20 different pharmacies and nobody would know”—this, to me, who comes from northern Ontario, is like a speech from another planet. People in Sudbury and people in northern Ontario—35,000 of them don’t have access to a primary care provider, a physician or a nurse practitioner. If you can get to see your primary care physician within a month or five weeks, you are lucky.

This is a bill that has been brought together to help, basically, people in southern Ontario and people in large urban areas deal with prescription use and abuse. It is not a bill that is conducive to helping the people in northern, rural, First Nations, remote communities.

I represent rural northern Ontario. We don’t have 20 physicians, and we don’t have 20 pharmacies. What the bill will be good at doing is something that is completely inappropriate for the people of the north, and this is something that I will go into more detail on later. The use and abuse of OxyContin and opioids has reached alarming rates in the regions that I represent, in First Nations, in rural Ontario, yet we are coming with a bill that has good intentions and good objectives but really works on only one tiny part of this. This is the putting together of a database that, frankly, is not going to help us a whole lot.

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

Mr. Jeff Leal: Today you’ve heard some very articulate comments from the member from Guelph, along with the members from Whitby–Oshawa and Nickel Belt. We all had the opportunity to serve on the select committee for mental health services in the province of Ontario. Bill 101 is a piece of the puzzle, a building block.

I particularly recall, as the member from Whitby–Oshawa just made note of, our visit to Sandy Lake, which is a very isolated First Nations community in northwestern Ontario, only accessible by air and water in the summertime and by ice roads in the wintertime. The chief and his band council went to great lengths to describe to us the very appalling situation where Percocet and OxyContin were smuggled into that community from Winnipeg. The chief went to great lengths to provide, as best they could, a screening process to try to reduce the flow of those two prescription drugs.

Certainly, there’s no question that a lot more needs to be done. This is a start: an electronic database to collect, monitor and analyze information related to prescription narcotics and controlled substances.

While I’m on my feet today, I would really like to express our condolences to the Richardson family. Mr. Richardson played junior hockey for the Peterborough Petes. He just lost his daughter very tragically in the last couple of weeks as a result of a 14-year-old committing suicide. That’s something we all heard about during our deliberations, and it goes to show you that all of us, all three parties in this chamber, have a solemn obligation to do what we can in this field.

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

Mr. Steve Clark: I’m pleased to provide a small comment on the opening address by the member for Guelph. I’ve listened to some of the responses and comments from some of the other members.

I just want to highlight one of the statements. The member for Nickel Belt mentioned that there have been some good intentions by this initial bill, Bill 101. However, there’s such a larger picture that has yet to be tackled.

Certainly, mental health and addictions has been a topic of great interest in my riding. I have the Brockville Mental Health Centre, which is being moved, for all intents and purposes, up to Ottawa, to the Royal Ottawa Mental Health Centre, through that group.

In constituency week, I had a mental health seminar on October 15, on the Friday. I asked the member for Whitby–Oshawa and the member for Dufferin–Caledon, who were members from our caucus of that all-party committee, to come and speak. I was really impressed with the number of people from the mental health and addictions field and from the education field, and just interested members of the community, who came out that day to talk about the recommendations from the all-party committee.

I think some members of the public were a bit surprised when the two members from my caucus who were on that committee talked about the co-operation that we had between all members of this Legislature, of all parties, of every political stripe. I think that really changed the whole opportunity there.

What I’m trying to say is that we have so much more that we can do, and we’re looking to the government on sort of the next plans and the next steps that they have as part of that report.

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

Mrs. Liz Sandals: I’d like to thank the members for Whitby–Oshawa, Nickel Belt, Peterborough and Leeds–Grenville for their comments.

Certainly, I want to recognize that the government understands that Bill 101 is just a piece, and that’s why in my remarks I talked about the broader narcotics strategy, understanding that the response to the whole problem of addiction to prescription narcotics is much broader than simply tracking the use on a database.

We understand that we need to work with physicians, pharmacists, nurse practitioners and all those folks around the province who are health care providers on educating about best practice in terms of how we manage pain and what is appropriate use of prescription narcotics.

The reason that the database—the collection of and disclosure of data—is the item that is dealt with in Bill 101 is because that’s the only part of the narcotics strategy where we actually require legislative change, where we require the legislative authority to collect the information about prescriptions for narcotics that are made for people other than those people who are on Ontario drug benefit. At the moment, we only collect, as a government, information about the prescriptions that we’re going to pay for, for the people on the Ontario drug benefit, so we need the legal authority to go beyond what we’re currently collecting. That’s why the database focus in Bill 101.

Certainly, there’s a whole lot of other things that need to be done, and we will do them.

The Acting Speaker (Mrs. Julia Munro): Before we continue, I’d like to recognize Dr. Bob Frankford, the former member for Scarborough East in the 35th Parliament. Welcome.

M me France Gélinas: On a point of order, Madam Speaker: I believe we have unanimous consent to switch the order of the leads, with the third party lead going ahead of the official opposition lead.

The Acting Speaker (Mrs. Julia Munro): Agreed? Thank you.

Please continue.

M me France Gélinas: Thank you, Madam Speaker.

As was mentioned, I was one of the members on the Select Committee on Mental Health and Addictions, and we all know that bringing forward the quick action on the use and misuse of narcotics was one of the recommendations of the Select Committee on Mental Health and Addictions in its report. The ministry acted on that recommendation with this, Bill 101, and the previous member went to some length to explain what this bill is trying to do.

I would like to spend the first part of my time talking about some of the issues that were not part of the bill, although, through committee, we tried to bring modifications to the bill and bring motions forward that were not in it. That continues, to this day, to bring me quite a bit of angst, as to, this bill has the potential to not do exactly what we wanted it to, plus to do some harm in the process.

The first thing that is really troublesome to me is the regulatory college/privacy issue. What do I mean by this? Well, the bill creates an unprecedented search and seizure provision that we have never seen in Ontario before. Ontario has colleges, so whether you are a physician, a dentist, a nurse practitioner or a physiotherapist, you belong to a college. Your college exists to protect the public and basically has the tools in place to investigate their members. This is how we have always done health professional investigations. Now, through this bill—as I say, the bill goes in the right direction.

The bill has good intentions and good objectives. But through the bill, for reasons that are still unknown to me, we are creating those people, positions, who will be allowed to go into any physician’s office, any dental office, any nurse practitioner—anybody who has the right to prescribe a narcotic, those new positions, those people will be allowed to go in. This is something worrisome to me. I don’t understand why we didn’t work through the college, why we had to put forward those new positions in a bill.

So those people will come into, let’s say, a physician’s office. They have the right to summon medical charts: patients’ records. There is nothing in the bill that says how long those charts will be gone for and where they are going to take them. If things work like in some other areas of the ministry, it could take six weeks before we see them again. This has a direct impact on patient care, as those patients may very well go back to see their providers during that period of time. At the end of the day, the provider—my example was physicians—has to co-operate, but here, again, this has not been defined.

Is a physician who is doing a procedure in an examination room, saying, “You’ll have to wait a few minutes,” going to be seen as not co-operative?

I can speak for physicians, nurse practitioners and dentists in northern Ontario: When you look at the stats, we have one physician for 5,400 people. You look in the GTA and there’s one physician for 350. Do you figure physicians in northern Ontario are busy? Absolutely. Their caseload is full. Their agendas are full.

So if this person drops in at 2 o’clock in the afternoon and you have a waiting room full of people who have come from great distances to see that physician that day, and then you can’t really give this bureaucrat enough time, are you going to be labelled as not co-operative, or are you going to tell the people who have travelled often over 100 kilometres, waited for five weeks to come and see you, “I’m sorry, you’re have to come again. Your sick baby will have to wait”? This is very troublesome. Why didn’t we work through the college? They have provisions in place. They have done this before.

They have disciplined their members. They know how to do this in a way that brings results that are respectful of the clients that we’re trying to serve. All of this was pushed aside. I don’t understand why this was put into the law.

When I brought those issues forward during clause-by-clause, I got non-answers. This is something that is there. They modified it a wee bit, but this is something that will stay, and nobody can explain to me why we could not respect the college that was already there. We have self-regulation in Ontario. As far as I’m concerned, it works well. Why we didn’t build upon this will continue to be a mystery to me.

The second piece that is really troublesome to me is that when the minister first introduced the bill, she talked about how they had worked at length with the privacy commissioner because, let’s think about it, it is a serious issue of privacy. A medication that your doctor, your dentist or your nurse practitioner has prescribed to you will now be knowledge that the government will have access to. They will have access to who the prescriber—your physician—is, who you are, what medication you got, in what dosage, how many repeats.

This is the type of information that currently is not shared with the government, but through this bill, because we’re trying to do something good here and we’re trying to get a hold of narcotic misuse and overuse, we are really looking into sharing private medical issues with the government in a way that we’ve never done before.

The minister stood up and told us that a lot of her work had to do with sitting down with the privacy commissioner to make sure that we have this right. I was really comforted by this. But then the privacy commissioner came and made a presentation and wrote a letter that more or less said completely the opposite: She still has serious concerns about the way this bill will impact the privacy of sensitive medical health information of Ontarians.

So this level of comfort that I had—because that was one of the first things that came out of the minister’s mouth when she talked about this bill, and then we have the privacy commissioner herself standing in front of committee and telling us pretty much the opposite, that she still has great concerns, and writing us a letter outlining those concerns in black and white. When we tried to bring forward motions to address this, we were ruled out of order—anyway, it didn’t work. So the concerns that the privacy commissioner had are still there.

We all agree that the problem of narcotic abuse is complex, that it requires a multi-pronged approach and that there is a pervasive concern regarding whether Bill 101 will be effective in doing what it sets out to do. So when I hear about the privacy commissioner, I’m worried, and those worries are still there; they have not been addressed. We’ve tried to make changes. Those changes did not go through. The privacy commissioner is somebody who knows a thing or two about privacy. I tend to respect her opinion. Here we have an opinion from a member that really goes against what the Minister of Health had told us, and that continues to be worrisome to me.

We also have the idea that the bill, although it is really targeted at narcotics, includes other substances. Not only will we have a list of narcotics included in this database for which people will have to share the information with the government, but any other substances could be targeted and included in this act. This also makes me really worried. It makes me worried for many reasons. The first one is that we have one example here in Ontario, right here, right now, of a medication that has been proven effective in its own right but that comes with a whole series of bureaucratic rules. That’s methadone.

It is so complicated to prescribe methadone in Ontario that very few physicians bother with it at all. You really have to be dedicated to wanting to help the addicts get off of their addiction before you go through the process of prescribing methadone in the way that it has been bureaucratically managed.

Here, we are bringing about a substantive bureaucratic process that will oversee and govern the way narcotics are prescribed. But then the bill doesn’t stop at narcotics; it includes other substances. Here again, I’m not sure I was ever given a good reason as to why we have to go beyond narcotics. I was also not given any good reason as to why some of the other substances had already been put in there.

If you want quality care, let health care providers use their clinical judgment to say the best way to achieve quality care for a given patient. To come with a whole bunch of pre-set rules is not any way to lead to quality care. At the end of the day, a good relationship between a primary care provider and their patient—show them the decency of respecting their skills at what they do and deciding what is in the best interests of that patient, given all of their knowledge, given all of the best practices that exist and given the facts of the real live person in front of them. This is how you achieve quality care.

I understand that because of the situation we are in with the misuse and abuse of narcotics, we had to do something, and I don’t deny that. But to put in the act that other medications—“other substances,” actually, is I think what they use—could be added to this act is troublesome to me.

Some medication, some substance that has fallen out of favour for one reason, that finds its way to the front page of the papers for all the wrong reasons that have nothing to do with quality care, nothing to do with good primary care practice, will suddenly find its way onto this new database, with very little we will be able to do about it. It’s not going to come back and have an open debate in this House. It’s going to be a complete change in regulations.

The government will be able to—I agree that they will have to go through consultations, but, frankly, with a majority government, they never have to listen to any of those consultations. Sometimes, they set out to do something and it doesn’t matter how many people raise their voices, how many concerns are brought forward. They just plow ahead and do whatever they want to do.

Here we have, in this bill, this provision that is troublesome to me. I have brought that forward during second reading, during clause-by-clause. I didn’t get satisfaction on that and certainly was not able to move the government on that. Those are some of the concerns that I have.

Another huge area of concern—and these people were really, really vocal in coming and explaining to us what this would do—is the whole issue of chronic pain management. Narcotics are a treatment of choice for many with chronic pain. When they are used in the proper way and monitored in the proper way, they can do wonders. They can change people’s lives. People who can’t sleep, can’t work, can’t function anymore are given a second chance at life. They can sleep better; they can heal; they can work again; they can function. They can have happy, productive lives because their chronic pain is under control.

We already know that when you add a layer of bureaucracy by adding this database, which we all say is there for a good reason, it will have an effect on people trying to seek control of their chronic pain.

I can speak to hundreds of calls that I took, when I was the executive director of the community health centre, from people who had gone through the traditional system of getting physiotherapy and trying to manage their pain. They had finally found the right combination of drugs and exercise and relaxation and acupuncture and all of this that worked, but one piece of that management was the prescription of a narcotic. Then they find themselves, like a million Ontarians, without access to primary care.

They lose their family physician, they lose their link to a prescriber, so they depend on walk-ins, on emergency rooms, on anything they can find to get the same management that had worked well for them. But now nobody will prescribe narcotics to them. They go back into the hell that they were in before. That’s no way to treat people with chronic pain.

First of all, why is it that Ontario doesn’t have a chronic pain management strategy? Many other provinces in this country do, and it is effective and it works; but here we are bringing forward a bill that is squarely targeted at access. It will make access to narcotics a whole lot more difficult, for all of the good reasons that we’ve already stated, to look at misuse and abuse, but for people who legitimately need access to those medications it will also make life hell.

There is nothing in this bill that will help the hundreds of thousands of Ontarians—I think it’s scheduled to be 2.4 million Ontarians—who deal with chronic pain. Not all of them use narcotics, but a good percentage of them do. We will make access for those 2.4 million Ontarians a whole lot more difficult, with nothing to counterbalance this. How do you balance this? You balance this by bringing forward a good strategy for pain management for Ontarians.

We had stellar deputations on this particular topic. Heads of departments came forward and talked to us about how we could have good chronic pain management in Ontario: “Here are some live examples that work, right here in Ontario”—most of them chronically underfunded, but they manage to pull it together anyway.

Here’s how it works in other provinces. Here’s how you bring the balance, because let’s not kid ourselves: If your life is being overtaken by pain, you will do anything. You will self-treat, either at the LCBO or by street drugs. You will do whatever you can to control your pain. When good pain management is not available to you, doing nothing is not an option, because living with pain day in and day out is not living. Those people need help.

Here we have a bill that will seriously decrease those people’s already limited access to treatment, and we have nothing on the flipside to help them. Does anybody in Ontario ever think that because you don’t have access to this drug that you are depending on, because the access is gone, your addiction will suddenly disappear? That because you don’t have access to a medication that you’re addicted to, problem solved, the addiction will go away? Absolutely not. When those people don’t have access to those narcotics, their dependence will still be there. They will still be addicted and they will search.

They will search like only an addict can search for the next hit, for the next time he can get his hands on that drug—his or her. What does that mean? That means that the demand for black market narcotics goes through the roof. That means that if there’s another drug available, they will switch to another drug. But it doesn’t mean that we have solved any problems; it just means that we have shifted it. We shift it to the underground; we shift it to the black market; we shift it to another type of substance or drug.

To be effective, all of those steps have to be done together. Not only do you have to decrease access, but you also have to provide treatment. Now, we already know that the 100-and-some—130, I think—addiction treatment programs all have huge waiting lists. I can speak to northern Ontario, where it will take you six months to get your first appointment to say, “Yes, you qualify,” and about a year and a half before you will start your treatment, because of the wait-lists.

And that depends on your age group and if you fit into the program and if you are a First Nation or—anyway, it doesn’t matter who you are; the story is not going to be, we take away your supply of narcotics and we help you deal with your addiction. It will be, we take away your supply of narcotics and we leave you there with no help for weeks and probably months—and for some of them, years—to fend for yourself with an addiction that is almost impossible to get out of by yourself. You will need help. You will succeed, but you will need help.

Unfortunately, we’re only doing the first part: We’re taking away the supply, with nothing coming in to say that we will help the hundreds of thousands of people who presently live with an addiction. The reason why we are putting this forward is because we have so many people in Ontario addicted to those drugs that it has motivated the government to do something, yet we’re taking away the supply and leaving you there to fend for yourself—not exactly what I had in mind.

Coming back to the people dealing with chronic pain, there’s very little specialty training for pain management, so we have very few pain management specialists here in Ontario. Although health professionals try to do the best they can, very few of them are able to offer quality care best built on the evidence-informed decision-making that we want to see. The government does acknowledge this in their narcotics strategy announcement. They say that there is a need for additional education and collaboration between health professionals, but that’s all.

We have not yet heard anything about putting an emphasis on chronic pain management. I would say, go to Alberta, Nova Scotia or Quebec. They all have chronic pain management strategies. Their strategies are very similar. There are best practices developing out there. But not for Ontario. So people with chronic pain will stand to go through a really tough go when this bill comes into effect. I have no doubt that some physicians who are already very reluctant to prescribe those drugs will become even more reluctant, and people with chronic pain will be left with no help.

We all know that this is the consequence of this bill. Why aren’t we more proactive in saying, yes, we know this is there; yes, we realize that chronic pain management is the way to solve this; and, yes, we will do something about it, like those witnesses, so many of them, came and told us? But, no, none of this is being done.

The CPSO, the College of Physicians and Surgeons of Ontario, has done a very good report. It’s called Avoiding Abuse, Achieving a Balance: Tackling the Opioid Public Health Crisis. In their report, they make 31 recommendations. They talk about the need for a comprehensive strategy that deals not only with supply and access but also deals with the patients. They also deal with what that will mean for the people of Ontario—what does that mean for chronic pain? What does that mean for people who have addiction, and how do we deal with this—looking into every facet of the program.

It’s very well done, and I want to congratulate the College of Physicians and Surgeons for putting forward that public health paper.

Unfortunately, we are only looking at this tiny little piece of it. We’re looking at this database; we’re looking at the supply side; and the rest of it more or less falls apart.

As was mentioned, the Select Committee on Mental Health and Addictions spent quite a bit of time looking at addictions services. In our report, Navigating the Journey to Wellness: The Comprehensive Mental Health and Addictions Action Plan for Ontarians—we travelled for 18 months. We held 30 days of hearings; 230 presenters came, and we read 300 submissions.

We know that the province has 150 service providers for addictions services, but in spite of this, we still have so many Ontarians who cannot gain access. This is all documented in our document; this is all documented in the College of Physicians and Surgeons document; and this is all being completely ignored by this government as they move forward with Bill 101. We did try to be heard. People came and presented, but very few of the recommendations that were made for change were acted upon, and even fewer of them were accepted.

There are some huge variances from region to region in Ontario. Some of them are desperate, but none of them are doing very well, so the idea that we could re-shift resources is a non-starter. There are no areas in the province where people with an addiction can get the help they need, right here, right now, in a way that is close to their home, that is conducive to supporting them in their recovery. Some of them try. Some of them do a very good job with the resources that they have. But they all have long waiting lists.

I also want to talk about health professionals’ education. A rather interesting fact that was presented to us shows that physicians receive an average of 16 hours of pain education. Physicians who have gone through the standard training in one of the recognized faculties of medicine in Ontario will have received 16 hours of pain education. That doesn’t seem like much if you compare this to the 87 hours that the veterinarian students get.

I take it that managing pain within animals is more important than managing pain within people—this despite the fact that any GP, any nurse practitioner will tell you that one of the main reasons people come to see them is pain. If you go to the dentist, who also has the right to prescribe, and ask them how many of their clients have come because they have pain, the statistic goes through the roof. People unfortunately don’t always go to the dentist when they should; they go to the dentist when they can’t stand the pain anymore.

So although people do go and seek help because of pain, there’s very little that is being taught.

“Since the early 1990s, family physicians have been inundated with materials and information from pharmaceutical companies about the value of using opioids for ... effective pain management. This education was largely focused on the potential benefits” of those drugs “and failed to include education about the potential risks, including misuse, addiction and diversion. There was also little attention paid to the importance of appropriate goal-setting, screening, monitoring for safety and effectiveness and protocols for tapering or discontinuing opioids.

As a result of issues stemming from misprescribing and other problems, some”—and I would say many—“physicians have stopped prescribing opioids” altogether for chronic pain or for any other reason. “This has resulted in some patients being undertreated while other physicians continue to prescribe inappropriately.

“Education, based on the best available evidence, delivered from non-commercial sources”—so not from the pharmaceutical industry—“is paramount in helping all health professionals deal effectively with chronic non-cancer pain, including the effective and safe use of opioid medication.”

Chronic pain management needs to be approached in the same way that chronic disease management is: long-term planning and goal-setting. Primary care providers need the educational training, and they also need access to retraining, to determine whether opioids are appropriate, so that they can screen for the risk of misuse and set realistic goals in collaboration with their patients.

Currently, there is no comprehensive continuing education system for health care providers in Ontario, and it’s estimated that 50% of that is delivered by pharmaceutical companies. The CPSO and other colleges are working to develop standards of ongoing education, but they need the government’s support. So far, this support has not been forthcoming.

I want to talk a little bit about the technology. I’m conscious that I have 10 minutes left, and I still have lots that I want to say. Let me see if I’m going to jump over this or go directly to—no, I’m going to stick with technology.

Bill 101 is a good first step—nobody will deny this—when it comes to narcotics tracking. When this legislation passes, it will mean that the Ministry of Health can collect prescribing and dispensing data for every patient in Ontario when it comes to narcotics and other controlled substances. You have to realize that this is not a comprehensive drug-tracking system. It will not allow health professionals to access information in real time. Remember the example that my colleague gave you? She used 20 different prescribers and 20 different pharmacies. People in northern Ontario drool over those numbers, but I take it that in other areas of the province, it is feasible.

Those physicians who are confronted with that patient still won’t have this information in real time. So you may be physician number 20. This patient might have been going to 19 other physicians before you, and you are number 20, but you won’t know this. You don’t know this now and you won’t know this after the bill has come forward either. It’s not going to be accessible in real time to people who prescribe. However, it is supposed to send out alerts to health providers if they are concerned with the prescribing or dispensing pattern for a patient.

Health providers all speak about the dire need to have a full system of drug information for Ontario that would allow physicians, nurses and dentists etc., as well as pharmacists, to make full, informed decisions. You can’t help but think that if that $1 billion had been spent at eHealth in a different way, we could be in a very different spot right now. We could have a functioning electronic health record that would have a drug management system built in that would already be there for practitioners in Ontario and for patients to use. But we’re not there and, sadly, we’re nowhere near there.

We will have this database that will collect specific information about specific controlled drugs for specific reasons, and that won’t be available in real time. A step in the right direction, absolutely. Is it the tool that we really need to make informed decisions that lead to quality care? I’ll leave it up to you, but my opinion is that we’re still far away from this. With the system proposed in Bill 101, health providers will continue to have only a partial view of their patients. How can health professionals make well-informed decisions when they only have a small piece of the information that they need?

The government has been totally silent on the standard they will be using to measure the success of Bill 101. This is something, again, that we heard lots about. How do you know that this will be effective? How do you know that you will have an impact on society if you don’t set out evaluation criteria? This is an important step. This is not party politics. When you put something out, when you set out to do something, you should also set out to do how you will measure success, so that you can show success, or if you don’t, so that you can take remedies. We didn’t see any of this in Bill 1001; although we asked that it be put in there, we were not successful.

There’s also a significant concern that this will become a numbers game rather than ensuring excellent health care for all. I’ve talked about this a bit, where I say that if you have an addiction and all of a sudden you don’t have access to it, you will continue to have an addiction. Whether you have an addiction to OxyContin or you have an addiction to another street drug, you still have an addiction, with all of the societal problems that come with this. I don’t want this to be a numbers game. I want this to be something that will help the people of Ontario lead better lives.

I want this to be something that will improve the quality of the care that is delivered to the people of Ontario, whether you have chronic pain or you’re dealing with an addiction.

Let’s measure what we do and make sure that we don’t embark into a numbers game where, “Oh, the number of prescriptions of narcotics has decreased.” That could sound good. I could see this on the headline, you know: “Narcotic Prescriptions Go Down 60%.” That would make a good headline. But that means nothing if you don’t look at, what does it mean on the ground? Does that just mean that people have gone to other drugs? People have gone to the black market? People are dealing with addiction at the LCBO? You have to measure it so that we don’t play a numbers game on an issue that is as important as what we’re trying to deal with with Bill 101.

We can all see how primary care providers and pharmacists will be reluctant to prescribe and dispense narcotics, and the effect that will have. We already know that many providers are already reluctant to provide access to these drugs, but we cannot forget how important good pain management and good medication management are. Bill 101 is a step forward, but it is only one step when many, many more are needed.

The government announced the narcotics strategy with five elements. But we only see the details of one of these elements in this bill. As I said, the CPSO report has 31 recommendations. Only one of them is dealt with in Bill 101. This is a small piece of the puzzle. What’s next? How is the government planning to move forward with a seamless system that ensures high-quality health care for Ontarians and a real safety net and basket of treatment services for Ontarians facing addictions?

I would say that the answer to this is obvious to me: Implement the Select Committee on Mental Health and Addictions report, and we would have this. We could move forward, safely knowing that people are being looked after and that things will improve.

Why did the government choose to ignore the voices of so many communities when they rejected the idea of the committee travelling? I have said to you that when I hear people talk about 20 providers and 20 pharmacists, this is kind of disrespectful to the people in the north, in rural areas and in First Nations. This bill is really set for—you have a prescriber, you have a pharmacy, and you have a database. Well, in parts of the province that I represent, we have prescribers that are also dispensers. How is this going to work for them?

In parts of the province that I represent, we have primary care models that don’t look anything like what you have here in downtown Toronto. This bill is not made for all of Ontario. It is made for the masses, and it will help people in large urban areas, without a doubt. But I would have liked it to be inclusive of everybody in Ontario. I would have liked it to be inclusive of the people I represent in rural northern Ontario, and it is not. But I guess it will help some.

We wanted to go to the north. I wanted people in the committee to listen in and hear about those models and also hear their ideas about how they can help. But they refused to travel. We did not go to the north, and nobody from the north was heard when we had the public consultations; not one voice from the north was ever heard on Bill 101, I guess, except mine. But there are a lot of people who have a lot more to say, people who have lived experience on the ground, who also have good ideas and strategies as to how we can help this problem, but they were never given an opportunity to be heard.

We never did travel to the north, we didn’t travel to First Nations, we did not travel to remote areas, and we didn’t travel to rural Ontario.

I mentioned privacy issues. Are Ontarians satisfied with the complex privacy issues that have been brought forward? I know our commissioner still has questions. Will the regulatory college and health professionals be assured that this will be a seamless system that prioritizes excellence in patient care? How come we are at third reading and we still have so many large questions unanswered, like, shouldn’t we have dealt with this during first, second, public and clause-by-clause? How come all of those questions are still there for us to grapple with at third reading where, frankly, the chances of changing anything become slimmer and slimmer all the time?

This bill was a huge opportunity to provide a definitive direction forward, yet there are far too many wasted opportunities and far too many questions and answers. What a shame.

Third reading debate deemed adjourned.

The Acting Speaker (Mrs. Julia Munro): The time has come to the point where we now need to adjourn until 10:30.

The House recessed from 1014 to 1030.

NOTICE OF REASONED AMENDMENT

The Speaker (Hon. Steve Peters): I beg to inform the House that, pursuant to standing order 71(c), the member for Renfrew–Nipissing–Pembroke has filed notice of a reasoned amendment to the motion for second reading of Bill 135,

An Act respecting financial and Budget measures and other matters. The order for second reading of Bill 135 may therefore not be called today.

INTRODUCTION OF VISITORS

Mr. Frank Klees: I would like to ask all members to join me in welcoming to the House today Jean-Luc Pullano and his fellow students at Holy Spirit Catholic school in Aurora and their teacher, Ms. Margaret Prince.

Ms. Andrea Horwath: It’s my pleasure to welcome to the Legislature today Wayne Hanley, the national president of the UFCW, as well as Bob Linton of UFCW National.

Hon. Margarett R. Best: It’s my pleasure to rise today to welcome to the Ontario Legislature the parents of our page captain, Mr. Connor Wood. I’m very pleased about this because he’s from my riding of Scarborough–Guildwood. His parents, Susan and Dave Wood, are here today, and I would like to welcome them to the Legislature.

Mr. Jim Wilson: I’d like to introduce to Queen’s Park today one of my employees, Alexandra Ainley from my Alliston constituency office.

Ms. Cheri DiNovo: I’d like to introduce an organization from my riding with students from all over the world, the Parkdale Intercultural Association, to the House this morning.

Hon. John Milloy: I know all members of the Legislature would like to introduce all the representatives from Ontario’s college system who are visiting Queen’s Park today—and a reminder of the College Ontario reception in rooms 228 and 230 today from 5 to 7. We welcome all those representatives here.

Hon. Monique M. Smith: I’d like to introduce to the House my friend Louise Edmonds from Pembroke, Ontario. She’s a lecturer at Algonquin College and the University of Ottawa. She did a lot of work with us on our long-term-care strategy and plan, and I’m delighted that she’s here today.

The Speaker (Hon. Steve Peters): I’d like to take this opportunity on behalf of the member from Oshawa and page Kyle Fitzgerald to welcome his mother, Roxanne Fitzgerald, to the members’ gallery today. Welcome to Queen’s Park.

We have with us today in the members’ gallery Mr. Brian Charlton, who represented Hamilton Mountain in the 31st to the 35th Parliaments. Welcome back to Queen’s Park.

As well, we’d like to welcome Bob Frankford, who represented Scarborough East in the 35th Parliament. Welcome to Queen’s Park today.

ORAL QUESTIONS

ONTARIO PUBLIC SERVICE

Mr. Tim Hudak: My question is to the Premier. The Premier’s wage restraint plan has gone badly off the rails, and they seem to have no plan to get it back on track. Premier, you said that this was key to finally achieving a balanced budget, that you would lead by example. So let’s test this out: Premier, how many deputy ministers, assistant deputy ministers and directors in the Ontario public service are paid more than the maximum that your government set for their positions?

Hon. Dalton McGuinty: I’m always prepared to engage my honourable colleague in a discussion about the importance of respecting taxpayer dollars. I know that he’s going to want to do that in a way that demonstrates respect as well for all of our partners who work with us as we deliver public services that are so important to Ontario families.

I’ll remind my honourable colleague as well that we have the second-lowest per capita spending in Canada as a province, which I think speaks to our commitment to fiscal responsibility.

I’ll remind my honourable colleague as well that in comparison to the previous government, the use of consultants is down dramatically, travel expenses are down 23% and government advertising spending is down 20%. That’s, again, in comparison to 2003. I think that’s significant and it speaks to our continuing commitment to fiscal responsibility.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Tim Hudak: Premier, the problem with your leadership, frankly, is that you set rules, you ignore the rules and then there are absolutely no consequences. You, yourself, have set caps for deputy ministers at $220,000 a year, ADMs at $168,000 a year and directors at $131,000 a year. According to salary information obtained by the PC caucus, Premier, 367 senior bureaucrats in the OPS are paid more than the maximum cap that you yourself set. You even have one ministry, the Ministry of Government Services under Minister Takhar, that for some reason has three deputy ministers.

Premier, how can you ask Ontario families to pay more and live with less when you have blown past your own salary caps on 367 different occasions?

Hon. Dalton McGuinty: To the Minister of Finance.

Hon. Dwight Duncan: We are pleased to release to the public all that information, and the member opposite has done that.

We have some 67,000 people employed in the Ontario public service, which is about the level it was at in 2003 when we took office. We have, as the Premier pointed out, reduced the level of consultants year in and year out. Interestingly, though, when the Leader of the Opposition was in government, what they did was they fired civil servants, then hired them back as consultants and paid them more money. I remember that very clearly.

Then they hid Hydro One and OPG from public scrutiny. When we opened it up to public scrutiny, we saw a long list of Conservative operatives who worked for the Premier, who did all kinds of things, being paid excessive—

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

Mr. Tim Hudak: It’s unfortunate that the Premier did not respond to my question, because, Premier, leadership starts at the top.

Premier, these are the caps that you yourself set for senior bureaucrats and you’ve blown by them on 367 occasions. Let me give you one example: You have one assistant deputy minister, Ken Deane, who is paid almost half a million dollars per year; almost three times the cap for his position. Ironically, Mr. Deane is the ADM for health system accountability and performance. This means that Mr. Deane oversees eHealth Ontario, and he himself is a former board member at eHealth Ontario. eHealth, Premier, was not exactly a shining light in your administration, to say the least.

Meanwhile, Ontario families who are playing by the rules and paying the bills wait up to 21 hours in emergency rooms in our province.

Premier, how can you explain this kind of bloat?

Hon. Dwight Duncan: Of the roughly 67,000 employees of the Ontario public service—and let me, by the way, speak about the quality of our public service and the integrity of the people in the public service, those people who make their living delivering the best services we can ask for. By the way, the case he cited was less than they paid Paul Rhodes when he was a hidden consultant for Hydro One. It’s less than they paid Gord Haugh when he worked for the Minister of Health at the time as a short-term consultant.

That member and his party want to disparage the very people who work hard on behalf of us. We won’t engage in that game. We will continue to implement thoughtful policies that respect the taxpayer, unlike that member and his party, who abused the public purse, hid it from the public and then tried to advertise that they weren’t doing it.

ONTARIO PUBLIC SERVICE

Mr. Tim Hudak: Let me try the Premier again, because leadership should start at the top. Premier, the problem is that your answer to your spending restraint problem—when you’re trying to dig us out of holes you’ve already dug us into, your problem is you keep digging it deeper and deeper. How can anyone take you seriously in public sector collective agreements when you’ve blown past your own maximum caps on 367 different occasions? How can anyone take you seriously when one of your ministers, Minister Takhar, has three deputy ministers of his own?

Premier, you simply cannot achieve the wage freeze you promised because you lack absolutely any credibility on keeping spending in line or keeping your promises.

Premier, isn’t your problem in your collective bargaining negotiations that, quite frankly, nobody takes you seriously?

Hon. Dalton McGuinty: To the Minister of Finance.

Hon. Dwight Duncan: When we set about to restrain wages in the public and broader public sectors, we rejected the approach of a social contract. We rejected the approach of the previous government, which was to demonize public servants, to misstate facts about the important work that they do for us.

We have engaged in a process that is reported out in the fall statement. I’ll remind the member opposite of this: There have been some 40 public sector agreements reached since the budget. Four of them were arbitrated above the requests that we had—I felt those decisions and the language around them were not appropriate. But what the member forgot to tell people was that half of those agreements have achieved zero and zero. The average rate of settlement in Ontario is now below that of Canada, below that of our municipalities and below the public sector. We will continue to work with—

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

Mr. Tim Hudak: You know, I’ve asked the Premier now four questions on a very serious topic, about how he has allowed, on 367 different occasions, to blow by the maximum caps he’d set on senior civil servants. Premier, this also undermines your credibility, quite frankly, when it comes to achieving collective bargaining agreements that you promised would be zero and zero. Your finance minister is now boasting that half the settlements since the budget were tabled at zero and zero—which means half have not.

Your plan has gone completely off the rails. May I ask you at least this today, Premier? Will you table the collective agreement results to date to back up your finance minister’s claim—because we are not sure it’s in keeping with the facts—and then will you tell us how you’ll find the savings for those who have not agreed to zero and zero?

Hon. Dwight Duncan: We reject the tactic of that leader and his party. We’re not going to call nurses hula hoop workers. We are not going to fire meat inspectors. We are not going to fire water inspectors. The member opposite would have the people believe that there are easy, quick fixes to these challenges. We have chosen a thoughtful approach that is bearing results. These are always difficult issues, particularly when dealing with the broader public sector. We will continue to work both with management and unions in the broader public sector in an appropriate fashion, with respect for everyone involved.

I’m proud of the fact that our average rate of settlement is now well below that of the federal government, who simply gave up on anything. We’ll continue to work with them. I have confidence in our partners in the broader public sector.

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

Mr. Tim Hudak: Maybe I’ll try my luck one last time. To the Premier, to whom I’ve addressed these questions—because, Premier, I’d expect that you would give direction as leader of the government and Premier of the province on very serious issues.

Media reported that six public sector unions have ignored your hopeful rhetoric to cross your fingers, hope to achieve wage freezes at zero and zero and then spare Ontario families more McGuinty cuts to health care or education. Media reports go on to show that arbitrators continue to thumb their noses at your government because they don’t take you seriously. Your wage freeze plan has gone badly off the rails and the only savings you seem to achieve are on the backs of non-unionized public sector workers, setting up an unlevel playing field.

Premier, in how many unreported collective bargaining agreements have arbitrators awarded wage increases? What is the total cost of your fiscal plan? When will you get your plan back—

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

Hon. Dwight Duncan: This government is looking for fairness for taxpayers while that member and his party are looking for a fight. We don’t want to go back to the days of 26 million student days lost as a result of strikes.

Interjections.

Hon. Dwight Duncan: I wish they would have brought the same degree of passion to Hydro One and OPG in their years of administration. I just want to remind the people of Ontario that Mike Harris, the former Tory Premier, received $20,000 in consulting fees from Hydro One, unreported and hidden from the public. Paul Rhodes collected $1,074,000 during PC rule through unpublished contracts with Ontario Hydro, published with environment—that was on the Walkerton case, I might add—published with the Ministry of Health and LCBO—untendered contracts. Tom Long’s firm collected $3.1 million in unpublished contracts and hidden—

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

ENERGY POLICIES

Ms. Andrea Horwath: My question is to the Premier. Later today, the McGuinty government will unveil a new energy plan. Can the Premier tell us what happened to the last energy plan that his government produced?

Hon. Dalton McGuinty: I appreciate the attempted levity, but I think my honourable colleague understands that a few years back, we passed a law that requires that we have in place a long-term energy plan. There was no such law that existed before. We think that was an important step forward. We further required that that same plan be updated every three years as new technologies evolve and as we gain a better understanding of the future and the need for supply and those kinds of things.

I know that my honourable colleague, in fact, does understand that what we’re doing is updating a plan. It’s a long-term plan. It will speak to our continuing commitment as a government, on behalf of the people of Ontario, to ensure that there is a reliable supply of clean electricity. More than just that, it will at the same time lay the foundation for a new clean energy industry with new clean energy jobs right here in Ontario.

The Speaker (Hon. Steve Peters): Supplementary?

Ms. Andrea Horwath: Ontario families want affordable, reliable, clean electricity, and for seven long years, they’ve suffered as this government has lurched from plan to plan.

They promised to freeze rates and then let them climb by 75%. They promised to make conservation easier, and then they slapped a new sales tax on energy-efficient appliances. We’re now approaching the eighth anniversary of a solemn promise to close coal plants within four years.

After seven long years of government bungling, why should people take today’s energy plan seriously?

Hon. Dalton McGuinty: One of the things that Ontarians will be entitled to ask—particularly after the Minister of Energy puts out the latest revision, the third three-year revision to our long-term energy plan—will be, where are the plans from the opposition parties?

We’re going to make it perfectly clear as to where we stand. We stand, in particular, for clean energy. We’re shutting down our coal-fired generation—not as quickly as anybody would like, but we’re moving as quickly as we can responsibly do so.

We’re investing in a new industry. We’re creating thousands of new jobs. More than just ensuring that we’re providing Ontarians with clean, renewable energy, we’re also laying a foundation for a manufacturing centre to meet North American needs. We’re number one in North America in the auto sector. We want to be a North American leader as well when it comes to the manufacture and sale of new renewable technologies. That’s all part and parcel of a smart, responsible plan. Again, I ask, on behalf of Ontarians, because they’d like to compare, where’s their plan, and where’s their plan?

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

Ms. Andrea Horwath: This government’s energy policy is written on an Etch A Sketch: You never know when they’re going to shake it and start all over again.

Last month, the unfair sales tax on hydro bills was absolutely necessary. This month, it needs to be rebated back. Last week, the government had time-of-use billing just right; it was perfect. This week, it’s changing again. When will the government be shaking the Etch A Sketch on today’s plan?

Hon. Dalton McGuinty: I know that the leader of the NDP is eagerly putting together her long-term energy plan. We will have ours out, again, this afternoon. We speak to our commitment to ensure that we have in place a clean, reliable, modern electricity system.

We talked about some of the specific supports that we’re putting in place for families, whether it’s our energy and property tax credit or whether it’s taking 10% off their monthly electricity bill for the coming five years. There will be more assistance included in this afternoon’s announcement.

We’ve got all of our plan out there in terms of costs, priorities, commitments and a vision. Again, at some point in time, it seems to me it becomes incumbent upon the opposition parties to put forward their alternative. Talk is cheap; investing in electricity over the long term is not. So, on behalf of Ontarians, I would ask the opposition parties to put out their plans so we can all take a look at them.

NUCLEAR ENERGY

Ms. Andrea Horwath: My next question is also for the Premier. From more than a billion dollars on not-so-smart meters to sweetheart private power deals, this government has bungled the energy file.

Families are now wondering what’s in store for them today. Published reports indicate it’s a nuclear-filled future, this despite study after study showing Ontario doesn’t need to have half of its power generated by nuclear energy. There are far less expensive options available. When will this government finally realize that nuclear energy is nothing more than a giant financial sinkhole?

Hon. Dalton McGuinty: Again, I’ve come to understand what it is that the leader of the NDP doesn’t want. She doesn’t want us to invest in renewable electricity because that’s too expensive—but the fact that they were, and apparently remain, committed to shutting down coal is of no relevance in that particular matter. She also tells us that she doesn’t like emissions-free nuclear generation in the province of Ontario, which at present generates 50% of all of our electricity.

So she doesn’t like nuclear; she doesn’t like renewables. I assume she doesn’t like gas. She doesn’t want us to open up any new hydroelectric capacity in northern Ontario because that might cause some damage to the environment.

We’ve got our plan out, and we’ve got our costs out. We’ve been very clear; we’re upfront. So, again, I ask on behalf of the people of Ontario: Where do they stand, where is their plan, and what are their costs going to be?

The Speaker (Hon. Steve Peters): Supplementary.

Ms. Andrea Horwath: Speaker—

Interjections.

The Speaker (Hon. Steve Peters): Stop the clock. Members will please come to order.

Supplementary.

Ms. Andrea Horwath: This government likes to talk about a commitment to clean, affordable power, but they’re about to dump tens of billions more dollars into expensive nuclear power, while making very, very little effort at all on conservation measures in this province. Will we see a plan to help families who want to make responsible energy choices and cut their bills, or will they just be asked to pay more and more for new nuclear power?

Hon. Dalton McGuinty: My honourable colleague says that she’s in favour of more jobs for Ontario families. Does she really understand how many jobs are tied up in the nuclear sector in the province of Ontario? I think there are at least 25,000 jobs. Those are good, high-paying, clean-technology jobs.

The fact of the matter is, at some point in time, the opposition party is going to have to come clean. They’re going to have to tell the people of Ontario what they’re going to do about a very important matter of public policy. What are they going to do to ensure that we keep the lights on? That’s not just an important matter for us in our homes; it’s important to our schools, it’s important to our hospitals, and it’s important to our businesses. It’s the very foundation of our wealth creation in the province of Ontario.

We have put forward a very specific, responsible, solid plan. We’ve been very upfront with the details—the costs, where we’re going, why we’re doing it—and we’re committed to it.

What I’m saying now on behalf of the people of Ontario is, it’s time for them to come out of their shells. It’s time for them to tell us what exactly they are going to do to ensure that we have a clean, modern, reliable—

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

Ms. Andrea Horwath: People want to make responsible energy choices, but at every turn, those choices get more and more expensive. They were told the smart meters would help them save money and electricity; instead, they raised prices and didn’t reduce consumption. They were encouraged to invest in energy-efficient appliances, but this summer the government slammed an unfair sales tax on them. When will this government start helping people save money and energy instead of making it harder to do both?

Hon. Dalton McGuinty: The Minister of Economic Development and Trade.

Hon. Sandra Pupatello: I think it’s important to be clear to people who work in manufacturing, and in particular, in the nuclear industry, exactly where the NDP stand on what they say will be their views on the energy plan that will come out. We want to know.

We know full well that there are 70,000 jobs in the nuclear industry. The lion’s share of those are in the province of Ontario. Those are jobs from coast to coast to coast that rely on governments of Ontario providing 50% of the base.

I ask the NDP, where do they think the power is going to come from to fire up our industry, knowing full well that Ontario has the greatest cluster of industry in the country? We want to know what you’re going to tell those manufacturers, if you wouldn’t move forward with refurbishment of Darlington, if you wouldn’t move forward with new builds in nuclear. We want to know where the NDP stands on good-paying jobs that would support a nuclear cluster that is the best cluster in North America. Where—

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

ENERGY POLICIES

Mr. John Yakabuski: My question is for the Premier. Premier McGuinty is out of touch with Ontario families who cannot afford his expensive energy experiments. While former minister George Smitherman said that Ontario families would pay only 1% per year for his Green Energy Act projects, the Premier’s own numbers show they will pay 56% more for sweetheart deals he is making with foreign multinationals. Take, for example, his sweetheart deal with IKEA: IKEA will receive almost $700,000 a year for power that retails for $115,000 on the retail market.

Why can’t the Premier understand that Ontario families who struggle with their hydro bills cannot afford to pay six to seven times more for his sweetheart energy deals?

Hon. Dalton McGuinty: I appreciate the question. One of the things that the latest revision of our long-term energy plan will demonstrate this afternoon is that there’s a limit in terms of how far we envision going with respect to the makeup of renewable energy inside the entire complement, which I think is the responsible thing to do.

But this is really important, and I think this is the crux of it. We’re committed to shutting down coal in Ontario; they’re not. We’re committed to clean air; they’re not. We’re committed to reducing deaths, illnesses, hospitalizations and respiratory ailments; they’re not. That’s a fundamental difference. There, Ontarians can be very clear in terms of the contrast. We’re shutting down coal; they want to keep burning coal. I think Ontarians are going to want to keep that in mind.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. John Yakabuski: Premier McGuinty’s massive sweetheart subsidies to a foreign multinational have spawned more sweetheart deals with more foreign companies. IKEA says that it will produce enough power to light 100 homes. Under the feed-in tariff rates that you set, IKEA will receive over 71 cents for each kilowatt hour it produces. That works out to almost $6,800 a year for each of those 100 homes—well over the $1,500 average for families in the GTA. What makes you think that Ontario families can afford to pay $5,000 more per year for power—$5,000 more than it costs?

Hon. Dalton McGuinty: That’s an interesting fantasy, but I think facts are always more important.

It’s interesting that there’s a theme that the official opposition continues to weave more broadly through its policies. They’re against all things foreign. They never reference Samsung unless they talk about it being a foreign company. They’re not comfortable with the notion of foreign students studying in the province of Ontario. I don’t know why they’re afraid of the rest of the world, but we’re not. We’re open to the rest of the world. We’re open to new investment in our province. We’re open to new students coming here. We’re open to new ideas. We’re open to new wealth creation.

Let them be afraid of the world. Let them sink into the past. We’re for moving ahead. We’re open to a new Ontario. We’re optimistic. We’re eager to embrace the world. We’re going to build a stronger province.

Interjections.

The Speaker (Hon. Steve Peters): Members will please come to order.

New question.

NUCLEAR ENERGY

Mr. Peter Tabuns: For the Premier: The Pembina Institute says that replacing the Pickering B nuclear plant at the end of its life with renewable energy would cost up to 48% less than replacing it with a new nuclear reactor at Darlington. Investing in energy efficiency, cogeneration and even hydro imports from Quebec can meet Ontario’s electricity needs for less than the cost of rebuilding the Darlington nuclear plant.

Ontarians are already struggling to pay rising hydro bills. Why won’t the government invest in lower-cost alternatives to new nuclear power?

Hon. Dalton McGuinty: Again, here we are. This is the NDP, and at some point you no longer enjoy the luxury of offering criticism from the comfort, security and convenience of the sidelines. At some point in time, you’ve got to get into the game and you’ve got to declare yourself as to what are you in favour of.

I just want to revisit it. They’re against nuclear even though that generates 50% of all of our electricity today. They’re against clean energy because they say it’s too expensive. That implicitly means that they’re against shutting down coal, which means they’re in favour of keeping coal open, which means they’re in favour of more smog days, they’re in favour of deaths and illnesses that are connected with the burning of coal in the province of Ontario. That’s what they’re in favour of.

If they’ve got something different, if they’ve got a different plan, then let’s hear it. Let’s put it on the table. We put ours on the table, our costs on the table, our specifics on the table. Let’s—

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

Interjections.

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

Interjection.

The Speaker (Hon. Steve Peters): The member from Hamilton East.

Supplementary.

Mr. Peter Tabuns: Ontarians want clean energy and they want affordable energy. Nuclear power is neither clean nor affordable. The cost of building nuclear reactors is doubling while renewable energy costs are projected to fall. Why is the government locking Ontario into decades of new nuclear cost overruns without publicly exploring cleaner and more cost-effective alternatives?

Hon. Dalton McGuinty: There is no more aggressive jurisdiction in all of North America when it comes to building renewable energy than right here in Ontario. Every day they stand up and they say they don’t like it; they say it’s too expensive. We have at least 40 different energy conservation programs in place right now that we continue to fund. Now they’re telling us that in addition to not liking renewables because they’re too expensive—even though that means we can shut down our coal plants, even though that means we have cleaner air and fewer smog days, even though it means we’re creating a new industry with new jobs—they don’t like nuclear.

They can’t have it all ways. There is no magic when it comes to putting in place a clean, modern, reliable electricity system. It’s hard work. You’ve got to make decisions. You’ve got to act responsibly. That’s what we continue to do, and we’ll keep doing that every single day on behalf of Ontario families.

AIR QUALITY

Mr. Charles Sousa: My question is to the Minister of the Environment. Constituents in the great riding of Mississauga South want to help protect the air we breathe. They know they can do their part by taking transit, carpooling, biking or walking instead of driving.

As you know, Minister, the Southwest Greater Toronto Area Air Quality Task Force, chaired by Dr. Balsillie, completed their report over the summer. We’re fortunate that so many in the community were engaged throughout this process and continue to work to reduce our local emissions. But they also want to see our government continue its leadership in developing policies that conserve energy and reduce emissions. They want action to make sure their children have cleaner air. Minister, my constituents want to know, with much of the energy discussion focused on costs, is conservation still a government priority to protect the air we breathe?

Hon. John Wilkinson: I say to my friend, absolutely. The simplest thing that we can do and the least expensive thing that we can do is to conserve electricity. If we don’t need it in the first place, it saves consumers money and it saves us money. That’s why over the last few years we’ve had conservation measures that have resulted in some 1,700 megawatts of electricity being conserved. That’s the equivalent of taking some 500,000 homes off the grid. That’s all very good.

But on this side of the House, we are not going back to dirty coal. On this side of the House, we’re shutting down dirty coal. I know the members opposite have a love affair with dirty coal. They want to see those days come back when the amount of coal that we used rose by 127%. Under our government, that is going down because the price of clean air is priceless. We are going to have the cleanest sources of electricity in North America. We’ll continue to lead. It’s what our—

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

Mr. Charles Sousa: My community recognizes that the government’s commitment to conservation and renewables like wind, solar, nuclear and hydroelectric will make sure we have clean air to breathe and jobs for our children. We also know that investing in renewables and conservation is what allows us to shut down polluting coal plants like Lakeview and others.

It would not be fair to the next generation to go back to the failed energy policies of the previous government. These policies would see coal emissions increase, Ontario become a net importer of energy or diesel generators in downtown Toronto as part of their long-term energy plan. While it is clear that wind and solar are the better alternatives, I think you can agree that actions speak louder than words.

Minister, my question is simple: With the member for Sarnia–Lambton recently reaffirming the PCs’ commitment to coal, is the government still committed to eliminating dirty coal from our energy mix?

Hon. John Wilkinson: Absolutely. We are eliminating coal, and we’ve taken action. We’re already ahead of schedule. This year alone, we’ve shut down another four units.

I know it was a happy day in Mississauga South and for all the people in the southwest GTA when the Lakeview generating station was closed. That is the beginning of closing all of our coal-fired generation, because the days of burning dirty coal are coming to an end. Though there are people on the other side who have a love affair with dirty coal, we do not, because people deserve clean air, and clean air costs us a lot less money because we have universal health care.

At the Ministry of the Environment, we agree with the Canadian Association of Physicians for the Environment, with Environmental Defence and with the Canadian Lung Association that the right thing to do, the smart thing to do and the best thing that we can do for our children is to say no to dirty coal. That’s why we’re committed to do that.

I want to thank the member for his leadership in letting people know that there is a brighter, cleaner future for Ontario—

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

HOSPITAL SERVICES

Mr. Steve Clark: My question is for the Minister of Health. On November 4, the Ontario PC caucus gave the Acting Premier and media photographs of leaves strewn across the floor of the emergency garage at Credit Valley Hospital in Mississauga. Earlier that same week, the CEO of the Champlain LHIN spoke about dealing with McGuinty Liberal health care cuts that are affecting emergency rooms in Ottawa. He said, “We need to beg, borrow, or steal any good ideas.” Minister, will he beg, borrow or steal Credit Valley Hospital’s blueprints for converting a garage into the McGuinty wing?

Hon. Deborah Matthews: This is an issue that has come up in this House before, and I am astonished that the member opposite would raise this issue again.

I have a question: Have you or has anyone in your caucus visited the emergency department at Credit Valley Hospital? Have you or anyone in your caucus actually spoken to anyone in the emergency department at Credit Valley Hospital—the doctors, the nurses? Are you more interested in your politically motivated drive-by smear campaign than you are in health care for the people of this province?

It is completely unacceptable for a party that pretends to care about health care in this province to make attacks on the professionalism of front-line health care workers in this province. It is completely irresponsible—

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

Interjections.

The Speaker (Hon. Steve Peters): Order.

Interjections.

The Speaker (Hon. Steve Peters): Minister, you just answered the question. I need you to listen to the supplementary, please.

Supplementary.

Mr. Steve Clark: As the minister knows, I’ve sent both her and the member from Mississauga–Streetsville the photographs. As well, I shared an email from the chief communications officer of Credit Valley confirming the hospital renovated its garage “to include heating and other necessary utilities for patient care.” Just days before that email, the CEO of the Champlain LHIN said he was looking at Mississauga hospitals in particular for “best practices” for improving emergency rooms. He said, “There’s stuff that they’ve done that we need to import here.”

Mechanics will tell you that they have electronic records that do a better job of telling the oil change history of your car than eHealth records do for patient history. Which garage did you refer the CEO of the Champlain LHIN to for best practices?

Hon. Deborah Matthews: The party opposite is demonstrating their complete inability to understand health care in this province. They are not competent to criticize health care.

I ask you again: Have you, has any one from your caucus or has even any member of your staff actually visited the hospital to find out what was happening there? I have enormous respect for the health care professionals at Credit Valley Hospital, and I think you would too if you took the time to talk to them. You owe an apology to every single person who works at Credit Valley Hospital. You owe an apology to every single person who works in health care across this province. You owe an apology to the people of Mississauga.

Interjections.

The Speaker (Hon. Steve Peters): Members will please come to order.

Order. Minister of Finance, member from Durham, member from Simcoe–Grey, Minister of Consumer Services, Minister of Economic Development, member from Cambridge.

Interjections.

The Speaker (Hon. Steve Peters): It’s interesting, honourable members, and the pages have noted this: It seems like, day after day, it’s the same members that I need to call to order. There are so many of you in this House who do not have to be called, and I really don’t want to get into the position of having to name members for interjections. Interjections can be healthy—

Interjection.

The Speaker (Hon. Steve Peters): But it’s also healthy for members to listen when the Speaker is speaking, too, member from Simcoe North and the member from Cambridge as well. I think that’s three times I’ve mentioned his name.

New question.

CELLPHONES

M me France Gélinas: Ma question est pour la ministre de la Promotion de la santé.

Dr. Devra Davis is a world-renowned Nobel Prize winner, award-winning scientist and author, and expert on health risks of cellphone radiation. She’s in Ontario today. I had the opportunity to speak with Dr. Davis about cellphone risk. She is impressive.

Recently, the minister rejected outright my private member’s bill that would force cellphone manufacturers to move health warnings already in the small print in their manual to a sticker attached to the phone, saying that cellphones are not safe. The minister says that they’re safe.

Dr. Davis invited the minister to discuss science around cellphone safety, but the minister ignored the invitation. Why is the minister refusing to look at the ever-growing body of scientific evidence linking cellphone use to health risk?

Hon. Margarett R. Best: It’s a pleasure for me to rise in the Legislature to answer this question and address this issue. I want to, again, refer this member to the chief medical officer of health, our expert, who says, “I want to assure Ontarians that there is no established causal link between the use of wireless communication systems, including cellphones and adverse effects on human health.”

Our government takes the health and well-being of Ontarians very seriously. I also want to say that the medical experts at Health Canada say, “There is at present no scientific basis for the premise of health risk from radiofrequency electromagnetic energy at levels below the limits within [their] safety code. ”

I, again, refer—

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

M me France Gélinas: The body of scientific evidence is forever growing. Toronto Public Health and the Ontario Agency for Health Protection and Promotion—an agency of this minister—have both issued health warnings. Maine, San Francisco, Philadelphia, Portland—and the list goes on—are all taking action. But the Ontario Minister of Health Promotion says that she knows better.

Today, Cancer Care Ontario is requesting an extra $800 million for the ever-increasing number of Ontarians developing cancer, and the minister refuses to take proactive steps to decrease the risk of cancer.

Why is the minister ignoring Dr. Davis, her own agency, the precautionary principle, and leading scientists and not taking measures that do not cost a cent to the government and are essential for reducing cancer risks, especially to our children?

Hon. Margarett R. Best: Again, I would like to say to the member opposite that this government takes the health of Ontarians seriously, particularly the health of Ontario’s children.

I want to take this opportunity to say in this Legislature that parents have a hand to play in how much time their children are spending on cellphones.

I go again to the chief medical officer of health. I want to quote from a letter that was written to the member for Nickel Belt: “I would like to reassure you and the parents who have contacted you that the use of wireless communication systems does not pose a public health risk.”

I would again refer you to the Health Canada standards, which are responsible for setting the standards relating to cellphone use. The standards, according to our chief medical officer of health, are consistent with other jurisdictions—

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

SERVICES FOR ABUSED MEN

Mr. Yasir Naqvi: My question is for the Attorney General. There is a clear and recognized need for male victim and counselling services in our communities. Men who have suffered abuse deserve support and hope as they courageously address difficult and trying issues.

In my riding of Ottawa Centre, a non-profit men’s counselling agency called the Men’s Project is doing excellent work to assist male survivors of sexual abuse. I have been privileged to work closely with the organization, and I commend them for the support and healing programs they provide, programs that specifically address and support the unique needs of male survivors.

It is not only the individual who must overcome the trauma of sexual abuse, but whole communities and families that are affected as well. How is the government responding to those survivors, families and communities who are calling out for counselling and support services to assist male victims of sexual abuse?

Hon. Christopher Bentley: The member makes a very important point, because there hasn’t been, across this province, a coordinated, comprehensive approach to the needs of male survivors of sexual abuse. There never has been.

We want to thank projects like the Men’s Project for the excellent work that they’ve been doing. The ministry has been supporting that project.

But they have made the point—so many have made the point, so many who have not had access to counselling services: We need a comprehensive, province-wide approach, and that’s why we announced in the summer that we’re going to move ahead with a comprehensive, province-wide approach to make sure that male survivors and their families get access to the very important counselling and healing support services that they need, so that they can address the issues of the past and build a stronger future.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Yasir Naqvi: My community will be pleased to know that our government is committed to ensuring that Ontarians, both male and female, can live in a safe and secure environment in their homes and communities.

Sexual violence of any kind, on any person, is unacceptable in our society. We know it is devastating, and it’s something that will often need tremendous courage and support to overcome.

I’m glad to hear that our government is implementing plans to comprehensively address the very real concerns of male survivors, who, sadly, have been underserviced or unacknowledged in the past.

In meeting with the people in my riding who are themselves survivors of abuse, they tell me that it is important for them to be consulted in relation to the delivery of services under this plan. Can the Attorney General tell us how he intends to consult with survivors and support services in this province so that we can ensure that victims can have faith that they will receive the critical services they need to recover?

Hon. Christopher Bentley: I thank the member for the question identifying a very important issue. We want to make sure that the service that is developed is as strong as it can be and meets the needs, as disparate as they might be, across the province.

A lot of work and consultation and receipt of recommendations occurred over the course of the inquiry, and a lot of input from groups like the Men’s Project and the other services that have been offering assistance. But in spite of our wish to proceed as quickly as possible to build something that has not existed, we’ve taken advice and we’re taking some extra time to make sure that we can hear voices that have not yet been heard, receive advice from people who are concerned that hasn’t yet been received, so that when we implement this service, it is as strong as it can be and meets the needs of male survivors, wherever they happen to be in the province of Ontario.

ONTARIO DRUG BENEFIT PROGRAM

Mr. Ted Arnott: My question is again to the Minister of Health. Yesterday, in response to our questions concerning Lucas Maciesza, who is suffering from a rare blood disorder known as PNH, the minister implied that the efficacy of the drug Soliris has not yet been established. However, following question period, the minister said that hospitals can allow this drug to be prescribed if they have room in their global budgets. In fact, the North Bay hospital has done just that. We also now know that last night a two-week treatment of Soliris was prescribed for Lucas, now that he has been admitted to the Victoria hospital in London.

Why is the minister allowing random factors like geography and hospital budgets to determine whether someone gains access to this life-saving drug?

Hon. Deborah Matthews: Yesterday, we spoke about the Committee to Evaluate Drugs and the fact that it is no longer politicians who decide what drugs are covered under the Ontario drug benefit plan and what drugs are not. We have an arm’s-length expert group that reviews all of the evidence and makes the very difficult decisions about what drugs ought to be covered and what drugs are not covered.

The Committee to Evaluate Drugs has looked at Soliris on two different occasions. They have determined that it is not appropriate to fund that drug for all patients with PNH but that there might be a small subset of patients for whom the drug is effective. So the Committee to Evaluate Drugs deals with drugs outside of hospitals; hospitals make their own decisions about drugs within.

The Speaker (Hon. Steve Peters): Supplementary?

Mrs. Christine Elliott: We don’t have a lot of time to sit here and discuss and study this issue. This is a life-saving treatment for an individual, and there are seven other people in the province of Ontario who are deteriorating daily.

Soliris has been prescribed in 25 countries, including the United States, Japan and the European Union. Why are you continuing to deny access to life-saving treatment to all Ontarians who need it?

Hon. Deborah Matthews: This is, of course, a very, very troubling situation, and members from all parties have approached our government on this.

As I say, politicians do not make decisions about what drugs are covered, nor should they. What politicians should do, and what politicians have a responsibility to do, is ensure that there is a significant amount of money in our drug budget.

We have made significant reforms in our drug system—reforms that were opposed by the party opposite—that expanded the number of drugs that we can cover in the formulary and that expanded the number of people we can cover with drugs.

These are difficult decisions. We do have experts who review the case. I cannot speak to the specifics of any particular case. What I can say is that we have taken action to expand the number of drugs that we can cover and the people who are covered.

AGRICULTURAL LABOUR POLICY

Ms. Andrea Horwath: My question is to the Premier. Last week, the International Labour Organization ruled that this government’s refusal to recognize the collective bargaining rights of agricultural workers is a clear violation of international conventions. Why is the McGuinty government so hell-bent on denying basic human rights to the people who grow our food and help feed our families?

Hon. Dalton McGuinty: To the Minister of Labour.

Hon. Peter Fonseca: We do understand that the ILO has made some recommendations regarding collective bargaining within the agricultural sector. We are looking at and reviewing the report that has been put forward by the ILO.

The member, I know, is fully aware that the Supreme Court of Canada is looking at an appeal of this case. It has been before them since December 17, 2009, and it has reserved its decision. As this case concerning collective bargaining in the agricultural sector is before the courts, it would be inappropriate, as the member knows full well, for me to comment otherwise.

The Speaker (Hon. Steve Peters): Supplementary?

Ms. Andrea Horwath: UFCW Canada has been advocating for the labour rights of agricultural workers for more than 15 years. In fact, as I introduced him earlier, UFCW Canada national president Wayne Hanley is here with us this morning.

The government of Alberta and the one here in Ontario are the only governments in this country that continue to refuse and to deny agricultural workers these rights. When is this government going to finally do the right thing and do something positive? When are they going to finally stop violating international standards and commit to working with UFCW Canada to ensure the human rights of these workers?

Hon. Peter Fonseca: Again, as this case is before the courts, it would be inappropriate for me to comment. I do welcome the UFCW, Wayne Hanley and Bob Linton, who are here with us today.

We’ve made great strides when it comes to the agricultural sector. It should be noted that it is our government that extended the Occupational Health and Safety Act to this sector in 2006. It should be noted that we’ve trained over 100 inspectors on agriculture safety specific to farms. That’s under our government. Again, in June 2008, we started proactively inspecting farms. This is all under our government. We will continue to ensure that workers, in agriculture or in any other sector, are kept safe.

WORKPLACE SAFETY

Mr. Lou Rinaldi: My question is to the Minister of Labour. Minister, accidents involving conveyers can result in significant injury, or even loss of life. A couple of weeks ago, you visited the Weetabix manufacturing facility in my riding to announce that the ministry will be undertaking heightened enforcement, specifically addressing conveyor guarding hazards. Mr. Speaker, through you to the minister: Can you please tell the House more about the upcoming Ministry of Labour conveyor guarding blitz?

Hon. Peter Fonseca: I want to thank the member. I did have an opportunity to visit his beautiful riding and the many businesses that he has in his riding on November 1. We went to a business that actually has many conveyor belts working within that business, and that is part of our safety blitz right now, looking at conveyers.

We don’t have a whole lot of injures that happen with conveyers, but when they do happen, many times they are very serious injuries. That’s why we’re doing this through our Safe at Work Ontario strategy, which assists workers and employers in correcting any hazards that may exist within their workplace.

This is a proactive approach. It’s good for everybody. Our government is committed to ensuring that all workers, when they go to work, can feel protected and come home safe and sound to their families.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Lou Rinaldi: Just for your information, Weetabix is a manufacturer of cereals. They use all Ontario grains and export their products all over the world.

Minister, you mentioned a couple of things in your visit that really hit home. Between 2005 and 2008, two workers died and 48 workers were seriously injured in conveyor accidents alone. I understand the total cost of these injuries was more than $7.3 million.

Mr. Speaker, through you to the minister: Are there specific workplaces that are being targeted for this important blitz?

Hon. Peter Fonseca: We did have an opportunity to visit Weetabix. They make great products that they sell here, across Canada and internationally. Because they have many conveyers at that business, that’s why we were there. Other businesses that are being targeted as well are those that have many conveyers in place. With this targeting, we’re looking at where there have been complaints received by the ministry about a particular business with conveyers, as well as a history of non-compliance.

Keeping Ontario’s workplaces safe is in everyone’s best interests. Workplace hazards put employees at risk and affect the bottom line for employees. We all know that, and that’s why our health and safety strategy, through Safe at Work Ontario, takes a very proactive approach to safety in this province. It’s working, and we’re getting positive results for employers, for workers and for the entire system.

AGENCY SPENDING

Mr. Ted Arnott: My question today is for the Minister of Tourism. After it came to light last week that a former Niagara Parks Commission executive got away with cheating Ontario families on expenses for rollercoaster rides, nightclub tabs, alcohol and lavish trips to London, Korea and Las Vegas, the Premier stated in his media availability, and I quote, “Some people have said it is not taxpayer dollars, so it is not important.”

The “some people” the Premier was referring to that day was, in fact, the Minister of Tourism’s spokesperson, Mukunthan Paramalingham, who told media the previous day that public dollars were not being wasted by the former Niagara executive as the commission generates its own revenue.

Whose side does the minister take: the Premier’s or his handpicked spokesperson’s?

Hon. Michael Chan: Thank you very much for the question. This matter was brought to my attention by the chair of the Niagara Parks Commission. As I mentioned, these expenses were incurred prior to the implementation of new expense rules.

From inception, the Niagara Parks Commission has been a completely self-funded agency, operating at no cost to the Ontario taxpayer. That said, these expenses are not appropriate and are not acceptable. I have asked the chair to look into the matter. Ms. Booker has key skills in governance, accounting and auditing. She has made significant changes to the long-standing corporate culture and practices at the commission. I am confident that the new chair will take all the necessary steps to ensure that the new expense rules are strictly adhered to.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Ted Arnott: The Niagara Parks Commission expense scandal and this government’s response to it shows that the McGuinty Liberals do not take accountability any more seriously since the expense scandals at the OLG and eHealth.

Mr. Paramalingham was speaking for the minister. The Premier has now been reduced to correcting the record for his ministers. No one—not the minister, nor the commission—was blowing the whistle on these expenses, which we were told went through two levels of audits.

If the McGuinty Liberals cannot learn their lesson and change after the billion-dollar eHealth boondoggle, why would Ontario families believe they can ever change now?

Hon. Michael Chan: I want to thank the honourable member for that question again.

Our new chair, Fay Booker, has key skills in corporate governance and auditing. The fact of the matter is, Ms. Booker is changing the long-standing corporate culture and practice of the Niagara Parks Commission. She is changing the way expenses are reviewed and approved for the chair and the board. She is restructuring the operations of the commission to ensure greater accountability and transparency, and she’s moving forward on the implementation of the governance review.

Let us be assured that these are only a few of the many changes that Ms. Booker is leading. As I said before, she is looking into the matter. I have full confidence that she will take necessary steps to ensure that the NPC becomes a more accountable and transparent operation.

EMPLOYMENT PRACTICES

Mr. Michael Prue: My question is to the Minister of Labour. In Chatham, as you know, the unemployment rate sits at nearly 14%. Many young people who have been laid off good-paying industrial jobs have taken work in restaurant industries to try to make ends meet.

A woman named Helen from Chatham, who asked that her last name not be used because she’s afraid, wrote to me. She knows many servers whose tips are being stolen by their bosses, even though they earn much less than minimum wage, but these workers can’t afford to complain. If they do, they’ll join the growing numbers of unemployed. There’s nowhere else for them to go.

Why is this government still allowing restaurant owners in Chatham and elsewhere to steal their employees’ tips?

Hon. Peter Fonseca: Any story we hear that affects the life of a hard-working Ontarian affects us all. That’s why we’ve brought in further protections through our Employment Standards Act to protect our most vulnerable workers especially.

We understand the important hard work of those who are part of our hospitality sector, be it waiters or waitresses, hostesses, bartenders, chefs and others. They do some outstanding service for all of us because they represent us as our ambassadors.

Any worker who feels that they have been mistreated or that their rights have been violated, I encourage them to contact the Ministry of Labour so that our officers can look into an employment standards issue, or if it’s a health and safety issue, that our inspectors can come in and investigate.

The Speaker (Hon. Steve Peters): Supplementary.

Mr. Michael Prue: When workers across this province ask the ministry to do something about the egregious actions of tip-outs, this minister and his ministry say that there’s nothing they can do because they won’t change the law.

This minister continues with his rhetoric but says nothing to address the growing unfair practice. Young, low-paid restaurant workers in Chatham and across Ontario are being ripped off for the tip money that they have earned. The minister knows it. When will this government do the right thing and make it against the law for owners to steal tips from their servers? Please, give us an answer on the topic.

Hon. Peter Fonseca: What I think all Ontarians and all business people understand—managers and owners—is that by treating employees fairly, with respect, with caring, with understanding and ensuring that all rules are followed, that is the best way to conduct a business. To come here and to paint the brush across many businesses, many of them small businesses, here in Ontario I think is really unfair.

What we have to do is to continue to protect our most vulnerable workers. We do that at the Ministry of Labour by providing services in over 23 different languages, by working with worker advocacy groups and looking at our labour market to ensure that all workers are protected. That’s what we will continue to do. It’s our top priority.

I understand this is the member’s private member’s bill. He has presented a healthy debate, which I think is good—

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

DEFERRED VOTES

WATER OPPORTUNITIES AND WATER

CONSERVATION ACT, 2010 /

LOI DE 2010 SUR LE DÉVELOPPEMENT

DES TECHNOLOGIES DE L’EAU

ET LA CONSERVATION DE L’EAU

Deferred vote on the motion for third reading of Bill 72,

An Act to enact the Water Opportunities Act, 2010 and to amend other Acts in respect of water conservation and other matters / Projet de loi 72, Loi édictant la Loi de 2010 sur le développement des technologies de l’eau et modifiant d’autres lois en ce qui concerne la conservation de l’eau et d’autres questions.

The Speaker (Hon. Steve Peters): Call in the members. This is a five-minute bell.

The division bells rang from 1137 to 1142.

The Speaker (Hon. Steve Peters): Mr. Wilkinson has moved third reading of Bill 72. All those in favour will rise one at a time and be recorded by the Clerk.

Ayes

Aggelonitis, Sophia

Albanese, Laura

Arthurs, Wayne

Balkissoon, Bas

Bartolucci, Rick

Bentley, Christopher

Best, Margarett

Bradley, James J.

Broten, Laurel C.

Brown, Michael A.

Brownell, Jim

Cansfield, Donna H.

Carroll, Aileen

Chan, Michael

Colle, Mike

Crozier, Bruce

Delaney, Bob

Dhillon, Vic

Dickson, Joe

DiNovo, Cheri

Duncan, Dwight

Flynn, Kevin Daniel

Fonseca, Peter

Gerretsen, John

Gélinas, France

Hoskins, Eric

Jaczek, Helena

Jeffrey, Linda

Johnson, Rick

Kormos, Peter

Lalonde, Jean-Marc

Leal, Jeff

Mangat, Amrit

Matthews, Deborah

McGuinty, Dalton

McMeekin, Ted

McNeely, Phil

Meilleur, Madeleine

Milloy, John

Mitchell, Carol

Murray, Glen R.

Naqvi, Yasir

Pendergast, Leeanna

Phillips, Gerry

Prue, Michael

Pupatello, Sandra

Qaadri, Shafiq

Ramal, Khalil

Ramsay, David

Rinaldi, Lou

Ruprecht, Tony

Sandals, Liz

Smith, Monique

Sousa, Charles

Tabuns, Peter

Takhar, Harinder S.

Van Bommel, Maria

Wilkinson, John

Wynne, Kathleen O.

The Speaker (Hon. Steve Peters): All those opposed?

Nays

Arnott, Ted

Bailey, Robert

Barrett, Toby

Chudleigh, Ted

Clark, Steve

Dunlop, Garfield

Elliott, Christine

Hardeman, Ernie

Hillier, Randy

Hudak, Tim

Jones, Sylvia

Klees, Frank

MacLeod, Lisa

Martiniuk, Gerry

Miller, Norm

Munro, Julia

Murdoch, Bill

O’Toole, John

Ouellette, Jerry J.

Savoline, Joyce

Shurman, Peter

Sterling, Norman W.

Wilson, Jim

Witmer, Elizabeth

Yakabuski, John

The Clerk of the Assembly (Ms. Deborah Deller): The ayes are 59; the nays are 25.

The Speaker (Hon. Steve Peters): I declare the motion carried.

Be it resolved that the bill do now pass and be entitled as in the motion.

Third reading agreed to.

ENHANCEMENT OF THE ONTARIO

ENERGY AND PROPERTY TAX CREDIT

FOR SENIORS AND ONTARIO

FAMILIES ACT, 2010 /

LOI DE 2010 SUR L’AMÉLIORATION

DU CRÉDIT D’IMPÔT DE L’ONTARIO

POUR LES COÛTS D’ÉNERGIE

ET LES IMPÔTS FONCIERS

À L’INTENTION DES PERSONNES ÂGÉES

ET DES FAMILLES DE L’ONTARIO

Deferred vote on the motion for third reading of Bill 109,

An Act to amend the Taxation Act, 2007 to implement the Ontario energy and property tax credit and to make consequential amendments / Projet de loi 109, Loi modifiant la Loi de 2007 sur les impôts pour mettre en oeuvre le crédit d’impôt de l’Ontario pour les coûts d’énergie et les impôts fonciers et apporter des modifications corrélatives.

The Speaker (Hon. Steve Peters): Call in the members. This is a five-minute bell.

Interjection: Same vote.

The Speaker (Hon. Steve Peters): Agreed? No.

The division bells rang from 1146 to 1147.

The Speaker (Hon. Steve Peters): All those in favour will rise one at a time and be recorded by the Clerk.

Ayes

Aggelonitis, Sophia

Albanese, Laura

Arnott, Ted

Arthurs, Wayne

Bailey, Robert

Balkissoon, Bas

Barrett, Toby

Bartolucci, Rick

Bentley, Christopher

Best, Margarett

Bradley, James J.

Broten, Laurel C.

Brown, Michael A.

Brownell, Jim

Cansfield, Donna H.

Caplan, David

Carroll, Aileen

Chan, Michael

Chudleigh, Ted

Clark, Steve

Colle, Mike

Crozier, Bruce

Delaney, Bob

Dhillon, Vic

Dickson, Joe

DiNovo, Cheri

Duncan, Dwig