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February 8, 1989

34th Parliament, 1st Session

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Hansard Transcripts

L143 - Wed 8 Feb 1989 / Mer 8 fév 1989

MEMBERS’ STATEMENTS

NORTHERN HEALTH SERVICES

ASSISTANCE FOR THE DISABLED

WASTE MANAGEMENT

NORTHERN HEALTH SERVICES

FUNDING OF SOCIAL SERVICE AGENCIES

GLOUCESTER POLICE

OVERCROWDING IN SCHOOLS

STATEMENT BY THE MINISTRY

ACID RAIN

RESPONSES

ACID RAIN

ORAL QUESTIONS

GROUP HOMES

NORTHERN HEALTH SERVICES

HEALTH SERVICES

HOSPITAL SERVICES

NORTHERN HEALTH SERVICES / SERVICES DE SANTÉ DANS LE NORD

LITHOTRIPSY

INFRASTRUCTURE RENEWAL

ASSISTIVE DEVICES PROGRAM

TRANSIT SERVICES

ENVIRONMENTAL PROTECTION

NORTHERN HEALTH SERVICES

WORKERS’ COMPENSATION

LIQUOR LICENCE

NORTHERN HEALTH TRAVEL GRANT PROGRAM

GROUP HOMES

VOTING BY PRIVATE MEMBERS

PETITIONS

TEACHERS’ SUPERANNUATION

YORK REGION LAND DEVELOPMENT

HOSPITAL SERVICES

AUTOMOBILE INSURANCE

ABANDONED RAIL LINES

REPORT BY COMMITTEE

STANDING COMMITTEE ON REGULATIONS AND PRIVATE BILLS

INTRODUCTION OF BILLS

CITY OF LONDON ACT

LANDLORD AND TENANT AMENDMENT ACT

ORDERS OF THE DAY

HEALTH SERVICES

BUSINESS OF THE HOUSE

The House met at 1:30 p.m.

Prayers.

MEMBERS’ STATEMENTS

NORTHERN HEALTH SERVICES

Mr. Morin-Strom: While southerners are now suffering from a health care system that is not keeping up with their needs, three quarters of a million people in northern Ontario have put up for years without basic services. The health care crisis in the north is chronic and pervasive. While Toronto residents can get most of their health care needs met within minutes of their home, northerners must travel hundreds of miles just to give birth or to get a hearing aid fitted.

Last week, New Democrats received over 100 submissions at our hearings in Terrace Bay, Marathon, Chapleau, Wawa, Sault Ste. Marie, Elliot Lake, Little Current and Sudbury. Presenters before us echoed many of the concerns and solutions health care providers and consumers had raised in earlier hearings in northeastern and northwestern Ontario.

In three weeks of hearings, the New Democratic Party task force on northern health care has driven over 4,000 kilometres. It is clear that the problems caused by the lack of services and great distances cannot be solved solely with travel payments and costly institutional answers. What is needed are community approaches and an emphasis on keeping well, not curing illness.

Dedicated health care providers throughout the north are a lifeline for the people in their communities. Their example is not only an inspiration but a model of how health care services can be delivered. Unfortunately, a lack of government funding often limits or even threatens the work they do.

In reflecting a broad cross-section of the needs and ideas of northerners, our report on northern health care should act as a catalyst to prod the government into action, if it is willing to listen.

ASSISTANCE FOR THE DISABLED

Mr. Jackson: I wish to bring to the attention of the Minister without Portfolio responsible for disabled persons (Mr. Mancini) the case of 10-year-old Wally Elgersma. Wally is confined to a wheelchair and suffers from spina bifida.

While enrolled in a public school, Wally received the assistance of the Victorian Order of Nurses through the Ministry of Health, but the government has cut off Wally’s services as a handicapped student. They have cut off his VON services, because he has moved simply two miles from that school, because he is now enrolled in a Christian school.

The point is that this is not an educational program aimed at schools, it is a health program aimed at students, so it should not matter where Wally studies. Not only is Wally a victim of society’s attitude towards the disabled in general; specifically, he is a victim of this government’s policies.

His new school made modifications for a ramp; the provincial government has declined to assist. Wally’s parents have asked for continued health support assistance from the Ministry of Health and this government has declined.

Is it the minister’s position, as the chief advocate for the disabled in this province, that Wally should be discriminated against and denied needed medical service because of his Christian convictions? Unfortunately, the minister seems to be his own best example of his ministry’s slogan that “Our attitude towards the disabled is their biggest handicap.”

WASTE MANAGEMENT

Mr. Tatham: Will Rogers said, “All I know is just what I read in the papers.” Whether we read them or not, the local Toronto press certainly prints them. The Toronto Star uses 571 metric tonnes of newsprint per day. The Globe and Mail uses 112 metric tonnes per day. A source at the Sun said that the paper’s newsprint usage falls somewhere between the Star’s and the Globe’s.

We all love our cars. General Motors of Canada Ltd. operates five plants in Ontario. The number of vehicles projected for the 1988 production year is 3,566 per day. Chrysler Canada Ltd. operates four assembly plants. Its current, February 1989, daily production is 2,194. Ford Motor Co. of Canada Ltd., with three companies, has current production in February 1989 of 2,440 per day. Combined daily production is 8,200 vehicles.

After they have been used, would it make any sense to return our newspapers to whence they came and cars the same? It might reduce our solid wastes.

NORTHERN HEALTH SERVICES

Miss Martel: Last Friday in Sudbury, the New Democratic Party task force on northern health care finished the third leg of its tour in northern Ontario. The process originally began in 1988 after northern New Democrats received numerous complaints about the lack of adequate health care in communities across the north; eight months later we have visited 65 communities and received over 200 submissions from concerned groups and individuals.

I have participated in all three tours and have been struck by recurring problems with the northern health travel grant, the lack of community-based services, etc., but by far the most common problem was that of attracting and retaining specialists in northern Ontario, not only doctors but speech pathologists, nurses, audiologists, physiotherapists, psychiatrists, psychologists, etc.

The government’s response has been the underserviced area program which provides financial incentives to graduates to practise in the north. This is a Band-Aid solution. It is also the source of tremendous frustration to many communities which see specialists come and go as soon as the grant is used up. It is not solving the problem of a chronic shortage of badly needed specialists in the north.

The answer is the establishment of a medical training facility in the north, not a carbon copy of the University of Toronto medical school but one recognizing the special needs of the north, responding to the great distances and a rural, more generalized practice. This must include all specialties, not only training for doctors. It is time this Liberal government made a real commitment to adequate health care in northern Ontario.

FUNDING OF SOCIAL SERVICE AGENCIES

Mr. Villeneuve: Recently, I wrote the Minister of Community and Social Services (Mr. Sweeney) and the Deputy Minister of Community and Social Services concerning an upcoming strike by workers at the Dundas County Association for the Mentally Retarded. A tentative agreement had been worked out in mid-January, giving employees a seven per cent raise, based on indications from the ministry that funding could increase by seven per cent. However, because of ministry cutbacks, that promised seven per cent came down to 4.5 per cent, the agreement collapsed and the strike is on.

The workers at the Dundas County Association for the Mentally Retarded are among the lowest paid in the entire province. An aide averages $7.61 an hour compared to $11.86 in Ottawa. A counsellor averages $10 an hour compared to $15.30 in Ottawa. This 40 to 50 per cent gap is much too large and serious efforts must be made to narrow the gap. The seven per cent increase originally proposed would have been a financially responsible step towards fairness in remuneration. This government is increasing taxes by millions of dollars, yet when it comes to delivering services to people who really need them, the money just is not there.

The Toronto bureaucracy grows, but services in the field decline. Taxpayers’ dollars are not being wisely spent. I call on the minister and on the Ministry of Community and Social Services to live up to commitments to adequately support services such as the Dundas County Association for the Mentally Retarded.

GLOUCESTER POLICE

Mr. Morin: We recognize the many cultures in our society through a government policy that encourages cultural diversity. Although this policy is meant to foster understanding and acceptance, sometimes its practical application is problematic. In the case of police forces and the communities they serve, the last few weeks have shown how volatile situations can develop when two segments of a community both feel misunderstood and stereotyped by the other.

This government is engaged in an extensive program to ensure that all sectors of every community come to see each other not as adversaries but as partners working towards the same goal of a secure and peaceful society. I want to take this opportunity to commend the Gloucester Police force on its multicultural initiatives and its commitment to their implementation.

Gloucester has formed a recruitment advisory committee that encourages visible minorities to enter the police force. The force itself has developed an excellent two-day cross-cultural training program, through which officers develop a greater sensitivity to ethnic diversity and increase their ability to function effectively in a multicultural community.

I would encourage all communities to adopt similar programs to help them achieve harmonious community relations.

OVERCROWDING IN SCHOOLS

Mr. Cousens: Tonight there is a meeting with the York Region Board of Education and the mayors of York region and the chairman of the region to discuss ways in which York region can obtain necessary funding for new schools. Last week there was a meeting in the York Region Roman Catholic Separate School Board where people from Brother André high school came: they were soliciting support from their board for new schools.

Some people in this House forget that we are dealing with one of the fastest-growing areas in the province, York region, an area to which many more people are moving. We wait until 80 per cent of the students are available before schools are built, so as a result we have 33 per cent of our students in portables.

I sincerely hope the priority of this government is to look after our young people and their need for quality education and quality schools.

STATEMENT BY THE MINISTRY

ACID RAIN

Hon. Mr. Peterson: I would like to bring the members of the Legislature up to date on Ontario’s efforts to protect our people and our resources against the harmful effects of acid rain.

Canada is proceeding to meet its 1994 goal of cutting its sulphur dioxide pollution by 50 per cent from the 1980 levels. As part of that Canadian effort, Ontario is committed to a 60 per cent province-wide reduction. Most of the reductions in Ontario will come from the four big polluters which generate four fifths of the emissions.

Ontario’s emission reductions are taking place under the Countdown Acid Rain program, which was adopted in December 1985 and is now well under way and on schedule. Countdown Acid Rain sets specific emission limits for the Inco and Falconbridge nickel smelters in Sudbury, Algoma’s iron-ore roasting plant in Wawa and all of Ontario Hydro’s coal and other fossil-fuelled generating plants in the province.

Each regulation sets a permanent cap on emissions, to be reached by a fixed deadline in 1994. These caps are set at one third the sulphur dioxide pollution levels these four enterprises emitted in 1980.

The compliance reports we have recently received from the three companies and Ontario Hydro show they have all found ways of doing what they once said was impossible. They estimate that they will collectively spend a total of more than $3 billion to stop Ontario-generated acid rain.

Ontario and Canada are doing their part to significantly reduce sulphur dioxide emissions. At the same time we are mindful of the fact that half of the acid rain that falls on our province comes from smokestacks in the United States. If we are to reduce acid rain to levels which scientists tell us are necessary to protect the waterways and our resources, there must be a 50 per cent reduction in sulphur dioxide emissions originating in the United States.

During the recent US presidential campaign, Mr. Bush made some general comments about reducing acid rain. Although his approach was not outlined in specific terms, he spoke of reducing sulphur dioxide emissions by “millions of tons” by the year 2000.

More recently President Bush’s appointees have promised that an administration-sponsored acid rain bill will be introduced in the near future. This Friday, Prime Minister Mulroney will meet in Ottawa with President Bush to discuss a number of issues, including acid rain.

Ontario stands ready and eager to play a positive and constructive role in any discussions that may come about as a result of this initial dialogue. We look forward to working with the federal government and other governments in order to bring about real and significant reductions in acid rain.

At this very moment, Ontario’s Minister of the Environment (Mr. Bradley) is meeting with federal Environment minister Lucien Bouchard to clearly set forth Ontario’s position with respect to such discussions.

It is Ontario’s firm position that any program for reducing US-based sulphur dioxide emissions must meet at least the following two minimum requirements:

1. A minimum reduction in sulphur dioxide emissions of 10 million tons. An acid rain cleanup bill which calls for anything less will not protect Canada.

2. A permanent cap on acid gas emissions. It will do us little good in the long run if substantial reductions are achieved in 10 or 12 years, only to be followed by increases due to industrial growth. Reductions must be attained and maintained.

We believe that the most appropriate approach to accomplishing these objectives in a real and tangible way would be through US acid rain abatement legislation.

An alternative approach that is being suggested by some is the pursuit of a bilateral treaty between Canada and the United States. We believe, for a number of reasons, that a bilateral treaty is not the most effective means of achieving real and timely results.

A bilateral treaty would require a two-thirds approval by the US Senate, rather than the simple majority needed to pass an acid rain abatement law. Moreover, the prospect of treaty negotiations could easily freeze all action in the United States Congress, extending an eight-year period of inactivity with respect to acid rain abatement.

Ontario and Canada have taken a leadership role in the fight to stop acid rain. I am hopeful that our American neighbours will soon join us in our determined effort to battle an enemy that knows no political boundaries.

At the same time, I am concerned that no representative of the Canadian people embrace or give the appearance of embracing American acid rain reduction plans that do not adequately protect Canadians and Canadian resources. We are all eager to work with our American neighbours in stopping acid rain, but I would not like to see anyone here grasping at a straw under the mistaken impression that it is an umbrella.

My government places and will continue to place the protection and preservation of our environment and the promotion of a clean and healthy Ontario as its foremost priority. Ontario will continue to exercise a leadership role in both a national and international context in the battle to stop acid rain.

RESPONSES

ACID RAIN

Mr. B. Rae: We know the government must be desperate in its attempt to find some good news when the Premier (Mr. Peterson) makes a seven-page announcement in which he tells us absolutely nothing new with respect to the actions of the Ontario government. He is simply repeating policies of his government which were in place as a result of the accord which he and I signed at the end of May 1985. There has been nothing new announced or done since that date.

There is not a thing the Premier can point to on acid rain that does not stem from the decisions that he and I made nearly four years ago. Now he is standing up, because George Bush is coming on Friday and because the government is desperate for the impression of actually doing something, saying, “Here we are. We are announcing something,” which has been in place, which has been established and which has been there since 1985.

I find it unbelievable that the Premier would have announced today the following. First of all, he says: “I would not like to see anyone here grasping at a straw under the mistaken impression that it is an umbrella.” The government is not only grasping for a straw; it is grasping for a metaphor in its attempt to find a policy, because it does not have a policy.

The Premier then goes on to say that he does not want any representative of the Canadian people to “embrace or give the appearance of embracing American acid rain reduction plans that do not adequately protect Canadians and Canadian resources.” He says that on page 7.

On page 5 of his announcement, he indicates publicly, without a fight, without a battle, without determining what it is that American politicians are prepared to do -- and there are American politicians who are prepared to go much further than the reduction of 10 million tons; there are American politicians who believe that an even further reduction is possible -- the Premier, without so much as sending a single shot, says that 10 million tons is okay with us, 10 million tons would be satisfactory.

What kind of bargaining position is this, that Ontario would put its best possible position right out there on the table and say, “Now, you match that”? If this is getting tough, we are in for some very bad and sad times in this province.

Why does the Premier not pick up the phone to his friend Governor Blanchard in Michigan and do something about the fact that there are now gas emissions coming from the Detroit incinerator? Why does the Premier not do something about that? Why does he himself not look at the fact that even with the reduction that is being proposed, we still have enormous problems in this province? We have lakes that are still dying and we have many resources that are being cut back because his government is not prepared to do more.

The announcement is called Update on the Reduction of Sulphur Dioxide Emissions. Then it says, “Check against delivery.” This government ought to have that on every single thing it does. They ought to have little buttons that say that. They ought to have it monogrammed on their yuppie shirts, “Check against delivery.”

This is a government that has not delivered, that is not due to deliver until 1994 -- one of the longest periods of pregnancy known to mankind -- a policy announced in 1985, due to be arrived at in 1994. Then they have the nerve to say, “We’re going to be tough when it comes to dealing with the Americans,” and they say to the Americans, “By the way, here is our negotiating position, George, just in case you want to know whether or not you can match it or meet it.”

It is hard to take this government seriously in its effort to capture yet one more headline on a day when it is desperate for some kind of good news to save the sinking ship.

Mr. Brandt: I too want to respond to the “straw” and the “umbrella.” I think it is important that we all make a comment with respect to that particular sentence. It was excellently written and particularly well delivered. I want the Premier to know that our party joins with him in the collective fight. We believe it is our responsibility as a Legislature to fight acid rain.

I do, however, go back to some memories that I have about some other positions that were put forward by his government by way of ultimatums in an earlier fight that took place that involved the United States, the six conditions involving the free trade agreement and the “Here I stand” document that seemed to evolve and change and move rather rapidly.

Once again, we have a “Here I stand” document with ultimatums set forth by the government of Ontario that are very interesting when one reads them. One cannot take issue with them, obviously, because they are a move in the right direction, but at the same time I would suggest that there is nothing particularly new or innovative about the position being taken by the government.

I would remind the current government, however, of a fact that seems to have escaped it time and again in connection with the acid rain reduction policies of this government. The environmental critic for our party, the member for Mississauga South (Mrs. Marland), has reminded the government of this fact on a number of occasions. I will remind them of it again.

The collective policy on the part of the seven eastern provinces to reduce Canadian acid rain emissions was not put in place by the Premier’s government in 1985; it was revised by that government, but in fact was put in by a previous government that had concerns about acid rain, the first time in the history of this province that a collective agreement was arrived at to reduce sulphur dioxide emissions by some 50 per cent. It was an absolutely ground-breaking, innovative, new and never-done-before policy. I will tell the Premier who led the fight: it was the then government of Ontario and the Conservatives. That is who led the fight at that particular time.

What the Premier did was to come along with some 1994 promises, which he has not met yet, with some hopes for the future with respect to the co-operation of the private sector. If all those hopes and dreams come true, then perhaps --

Hon. Mr. Scott: It really is time for a holiday.

Mr. Brandt: The Attorney General has had a holiday recently, so he should not be speaking quite so freely. Those of us who have been here in this assembly, fighting the issues on a daily basis, have missed him and we are glad he is back and we welcome him.

Mrs. Marland: It is really interesting today to hear the Premier of Ontario say that he would like to tell us about Ontario’s efforts to protect our people. It was less than a week ago in this Legislature that I stood and asked the Premier how he was going to protect the people in Mississauga South in particular when the government was not planning to ensure that Ontario Hydro would be made to install scrubbers at the Lakeview generating plant.

How interesting that here today we have this pious statement telling us what the Ontario government is going to do with regard to the subject of acid rain. All it is doing is installing two scrubbers in eight coal-fired thermal units in this province by the year 2000, and those two will not even be in place before 1994.

How exciting this is and what reassurance there is for the people of this province when we have a Liberal government that does not seriously believe in protecting the people. If they did, they would ensure that the four chimneys, the four stacks at the Lakeview generating plant were to be fitted with scrubbers. In fact, there are no plans at all for scrubbers at that plant.

When I asked the Premier the question, he very flippantly said, “Oh, well, maybe we’ll drop toxic chemicals all over a Conservative-held riding in Mississauga South and maybe that won’t do any harm.”

Mr. Speaker: The member’s time has expired.

Mrs. Marland: That is what he said.

Mr. Speaker: Order.

Mr. Sterling: On a point of privilege, Mr. Speaker: I would like to welcome back the Treasurer (Mr. R. F. Nixon) and present to him a token of our appreciation for his conversion in Europe.

Mr. Speaker: Thank you. Order.

Mr. Breaugh: I do not think it will fit.

Mr. Eves: Is that extra, extra large?

Mr. Wildman: Is that supposed to be a shirt or a toque?

Hon. Mr. Nixon: If it is not double XX, forget it.

Mr. Speaker: I do not know if that was a point of privilege or a point of recommendation or what? Was it recognition?

Mr. Brandt: Whatever it was, we got away with it, didn’t we?

ORAL QUESTIONS

GROUP HOMES

Mr. B. Rae: The Minister of Community and Social Services will no doubt know that employees from the union which represents many employees who work in group homes held a press conference this afternoon just before question period.

I want to focus my questions on one particular request that they have made of the minister. I want to ask him why it is that he has refused to guarantee that no worker in a group home will be working alone, either during the day or at night. It is such a basic request. To quote from the union, “Unless it is met, it will mean that there will be more Celia Ruygroks and more Krista Sepps and the government will be responsible.”

I wonder if the minister can tell us why he has continued to reject that very fundamental request from the workers whose lives are at stake when it comes to caring for these kids.

Hon. Mr. Sweeney: As I indicated to the honourable member -- I believe it was on Monday, but I cannot be sure -- we had immediately sent out word to all of our offices across the province to contact in turn all of the agencies that deal with young offenders and ask them to review their staffing practices in light of what they believed were particular needs. If they had that need, then they should respond to it. However, in terms of making a blanket statement with respect to that issue, I have indicated that we are launching a review for that very purpose.

Mr. B. Rae: The workers who are out there cannot wait 90 days. If the minister thinks it is a problem and if he has recognized there is a problem -- and he has, because he has started the review -- surely that leads to the obvious question: Why does he not do something until the review is at least completed?

By way of supplementary, the male social workers who work in a group home which is either mixed or where there are women have asked, and it has been decided, that there will in fact be two on staff at all times in order to protect people against any charges of sexual assault. I would like to ask the minister, if it is good enough for the men who are being put in those situations, why it is not good enough for the young women who are being in put situations where clearly now, and this is no exaggeration, their lives are at risk, their health and safety are at risk.

Why is the minister not doing the same for the women who are in those jobs as the homes are doing for the men who are in those jobs?

Hon. Mr. Sweeney: If I understood the first part of the honourable member’s question, he seemed to be indicating that the decision has already been made that every worker in a single situation is automatically in danger. I do not know that. As a matter of fact, that is the purpose of the review.

Mr. B. Rae: Fifteen years ago, there was a controversy about whether there should be one or two policemen in a police car at night. An arbitrator ruled that there should be two policemen. The lawyer in that case representing the police association is now the Attorney General (Mr. Scott). The Attorney General was persuaded at that time, when he was in private practice, that police officers who picked up criminals and enforced the law, including the Juvenile Delinquents Act, needed to have two people because their lives were at risk. It is now a general practice in most municipal police forces that there are to be two police officers in a police car at night.

I want to ask the Minister of Community and Social Services this question: If it is necessary that two police officers be on staff when picking up a young offender at one o’clock in the morning, and it has been deemed that way since 1973-74, what is the logic of having one 19- or 20-year-old young woman on her own, caring for that same young offender after that young offender has been put into a group home? What is the logic of that clearly discriminatory practice?

Hon. Mr. Sweeney: The honourable member makes an automatic connection which is not necessarily so. I would expect that in most cases, when that young offender is picked up at one o’clock in the morning, he would be put into a secure facility, not into an open-custody facility.

The second point is he makes reference to the police. I would also have expected, although I do not know for sure, that there was a reasonably thorough review before that decision was made. I am going through exactly the same process.

Mr. B. Rae: The fact of the matter is that while the minister gets educated on what the problem is, people’s lives are --

Mr. Speaker: Order. The question is to which minister?

NORTHERN HEALTH SERVICES

Mr. B. Rae: I have a question for the Minister of Health. I have read numerous statements by the minister that she has made over a number of years that basically the problem of shortages, waits and delays is essentially a Toronto problem and that other communities do not face these problems.

I want to tell the minister about a case of a woman in Thunder Bay, a Mrs. Laura Forsyth, who in May 1988 was put on a waiting list for knee surgery. She finally had her operation on December 30, 1988, seven months later.

In correspondence with my colleague the member for Lake Nipigon (Mr. Pouliot), who is going to be asking a supplementary question, the administrator of the General Hospital of Port Arthur states that “the waiting list for necessary orthopaedic implant surgery in this hospital is very long....I can also tell you that in this hospital we have experienced a shortage of anaesthetists which has had a considerable impact on increasing the waiting list for all types of surgery.”

I wonder if the minister can tell us whether it is still her view that this is essentially a Toronto problem.

Hon. Mrs. Caplan: In fact, I have said in this House to the Leader of the Opposition and to others that waiting times are not new, nor are they unique to Ontario. What I have said regarding Toronto is that even in Toronto, waiting times vary from procedure to procedure and from hospital to hospital.

Mr. B. Rae: I do not think the minister dealt with my question with respect to waiting lists in Thunder Bay. Perhaps the minister could focus on this issue for a moment.

The doctor involved who finally was able to perform the operation on Mrs Forsyth after a seven-month delay again writes and he says, “It is true that waiting lists have escalated almost to intolerable levels” -- which means that we have a problem of a different level from ones we have had before -- “and at the present time, I have 90 patients waiting for total knee replacements, patients that are waiting to be booked for surgery but who as yet do not even have a specific date.”

I want to ask the minister again, in light of what I have just told her about the situation in the General Hospital of Port Arthur, is it still her view that this is essentially a Toronto problem?

Hon. Mrs. Caplan: In the development of provision of health services around the province, we acknowledge that services are provided as close to home as possible and in many communities across the province. The choice of institution or hospital, the choice of physician in fact, can vary the length of time that people wait. We know that physicians do their very best to prioritize based on need.

I can tell the Leader of the Opposition that the purpose of the Independent Health Facilities Act is to allow us to free up hospitals to do what they do best and to provide inpatient services and those services that require a hospital setting. I believe many of the new procedures that technology allows us to do in alternative ways will be addressed by that act. That will be a benefit, particularly in northern Ontario, as we look at many services that can be provided outside of the traditional institutional setting.

Mr. Pouliot: We have been telling the minister that there is a problem with waiting lists for essential services in health in northern Ontario. The minister does not seem to wish to be intent on listening. Perhaps if she hears the word of a practising surgeon in Thunder Bay, the point will at least begin to register.

This is what Dr. Porter says in his letter addressed to me on January 26, 1989:

“The surgical services provided at the Port Arthur general hospital traditionally over the years have been second to none in Canada, but these services are gradually being eroded away because of hospital cutbacks. The outlying physicians in northern Ontario are increasingly becoming frustrated with long delays in getting into surgery and are beginning to rely on other centres such as Winnipeg and areas in the United States for prompt service. If the latter occurs, the so-called ‘two-tier health system,’ a situation the government has been universally opposed to, will most certainly develop.”

My question to the minister is this: When will the minister act, at long last, to ensure that northerners are entitled to and are the beneficiaries, the recipients of a first-class system, not the two-tier system that inevitably under the present system they risk finding themselves in?

Hon. Mrs. Caplan: We discussed at length during estimates numerous initiatives to provide access to effective quality care to the people of northern Ontario. I am particularly proud of the northern travel grant program and of the number of medical specialists who have been placed in communities in northern Ontario and supported.

I would say to the member that he misinterprets this if he suggests that there have been any cutbacks in budgets in hospitals in this province. That is absolutely not true. The truth of the matter is that every hospital budget has increased. Since 1984-85, we have increased hospital budgets by $2 billion. This year there will be an additional $500 million, taking the total to $6 billion. Not one hospital budget has been cut back.

HEALTH SERVICES

Mr. Brandt: My question is to the Minister of Health as well. In anticipation of the debate we are going to have later today with respect to the crisis in health care, we have been in touch with a number of the health providers and professionals in this province to determine from those who are on the front lines exactly what the problems are.

Just to give the minister three examples of the concerns they are expressing to us in our party, the Ontario Chiropractic Association has indicated that there are significant legislative changes taking place without warning or without consultation with its particular profession; the Ontario Nurses’ Association is concerned about a lack of interest on the minister’s part and the part of her ministry in resolving the nursing problems we have been bringing to her attention in this House; as for the Ontario Medical Association, I do not think I need tell her that the doctors of this province have lost trust and confidence in the manner in which her ministry has dealt with their profession, the most recent example being the rather arbitrary increase she gave them of 1.75 per cent.

How can the minister hope to solve the present problems and the present crisis in health care when she and her ministry are seen as being part of the problem rather than being part of the solution?

Hon. Mrs. Caplan: To the leader of the third party, as I have said before in this House, we do not consider health care as a partisan issue. In fact, at the meeting in Moncton yesterday, ministers of health and finance from across this country agreed that the challenges facing us in every province of this country are the same.

We also agreed to work together co-operatively and to work together in consultation with the providers and the professionals in all of our provinces to seek the innovative and affordable solutions that will allow us to maintain, preserve and enhance access to effective, quality health care and appropriate health care in the future.

Mr. Brandt: When the minister talks about effective, quality health care, she also has to include in that context good management and good planning. On August 25 of last year, she indicated to the hospitals of this province that she was going to assist them in identifying certain areas where either cuts or reductions or some types of improved health delivery systems could be implemented in their particular institutions in order to help them meet the budget guidelines she and her ministry had developed.

Something longer than six months from that date, she still has not followed up on the promise and the commitment she made to assist the hospitals in attempting to get their budgets in below the guidelines she has established as the maximum. How can she expect these people to have trust and confidence in the system when she does not fulfil the very commitments she makes to the health providers, in this case the hospitals of this province?

Hon. Mrs. Caplan: The leader of the third party could not be more wrong. We have been working co-operatively with the Ontario Hospital Association on a transitional funding formula to make sure the hospitals receive a fair share of resources and that we have fair and appropriate funding for our hospitals. The level of consultation and co-operation with all of the associations speaks to their commitment to working with us co-operatively. The results of the conjoint review have been implemented and I can say we are making progress.

Mr. Brandt: I guess it is the old case of the minister not speaking to the same people we are speaking to, because certainly the people we are talking to in the health field do not see that level of consultation, trust and confidence she seems to think is there and which is certainly not evident in the health system.

Let me give the minister another example of why people are questioning some of the statements being made by her and her ministry with respect to how the health system is being run. Two years ago, her predecessor, who sits very close to her, made a promise to construct a new hospital in the Orangeville area. Her ministry now is indicating very clearly that it is not about to follow through on the commitment made by her predecessor.

If that is wrong, will the minister commit again to the construction of that hospital, or are we in another position where two years ago one statement was made -- namely, that there was going to be a new hospital in Orangeville -- and now she is indicating something different than that? Those kinds of mixed, confused signals cause --

Mr. Speaker: Order. The question was put.

Hon. Mrs. Caplan: Again, the leader of the third party is not fairly representing the facts. As with other capital projects, the ministry provides two thirds of approved cost. In this case, in the case of Orangeville and the Dufferin Area Hospital, the ministry committed to provide $20 million towards a $30-million project.

It is very important for communities to plan within available resources and to work within the ministry’s planning process. I can tell the leader of the third party that in fact ministry staff is working with the board to achieve that goal.

HOSPITAL SERVICES

Mr. Eves: I have a question for the Minister of Health as well. I am sure that we all, including the minister, recognize the difficulty with waiting lists, time and the number of procedures being performed with respect to cardiovascular surgery.

Would it make sense to the minister to consider merging two of the three adult cardiovascular surgery units we now have in Metropolitan Toronto; namely Toronto General Hospital and Toronto Western Hospital? Does it make sense to her to even talk about the merging of those two cardiovascular surgery units, which would result in fewer procedures per year being done in Metropolitan Toronto?

Hon. Mrs. Caplan: In fact, I am not familiar with the premise or hypothesis that the member presents. I would say to him that we rely on advice from planners, who present proposals and recommend to us how we can best and most appropriately determine the services that should be available and how they can be provided in the most efficient and effective ways. If he has any suggestions or has gotten into hospital planning, I would be interested to hear his ideas.

Mr. Eves: If the minister is unaware of this, I find that rather alarming, to say the least. There was a think-in on January 24. There was another one on February 6. For her information, there is going to be another one on February 11.

Let me read to the minister the recent record of cardiovascular surgery procedures in Metropolitan Toronto over the last few years, since her government assumed power: In 1985 they did 2,709; in 1986 they did 2,687; in 1987 they did 2,612; and in 1988 they sank to a new low of 2,558.

Last year St. Michael’s Hospital was capable of doing 1,000 procedures; it did 650. Last year Toronto General was capable of doing 1,150; it did 950. Last year Toronto Western was capable of doing 950; it did 958.

Mr. Speaker: The question?

Mr. Eves: A cardiovascular surgeon in the city estimates that the combined total of TGH and Western, which was just over 1,900 last year, if those two facilities were to be merged, as is being proposed or considered by the hospital board of the Toronto Hospital, the best they could do is 1,500 procedures a year. That is 400 less than they are doing now. Does this make any sense to the minister at all, and if it does not --

Mr. Speaker: Order. Minister.

Hon. Mrs. Caplan: I cannot comment on a proposal by the Toronto Hospital board which has not been presented to the ministry for review. The member knows full well that the hospitals are given global budgets and they then allocate resources.

My concern is the capacity in the whole system. I can tell the member that we know at the present time the capacity in cardiovascular surgery in six centres and nine hospitals across the province is approximately 4,400 and is being increased, as we know the capacity needs have increased. I can tell him that at the present time we are reviewing that to determine that the hospitals that are able to provide that capacity are doing so in a co-ordinated and co-operative fashion. We are working together.

Mr. Eves: I find it very difficult to believe that the minister is not apprised of this situation, because everybody else in the medical community seems to be apprised of it.

In fact, the nurses at the cardiovascular intensive care unit at Toronto Western Hospital wrote a letter to the members of the Toronto Hospital board on February 3. They are very concerned about this proposed merger of the two cardiovascular units. Their unit ranks among the best. It is the best in Canada. It is among the best in the world, and they have excellent morale.

They sent a carbon copy to Vickery Stoughton. The minister will remember who he is, will she? They say, in part, in their letter:

“We strongly believe that the best corporate plans are based on strengthening one’s assets, not destroying them. Recent media attention has highlighted the length of time patients in Ontario must wait for heart surgery.

“In health care, we have an obligation to be responsive to the needs of the public. We firmly believe that moving this excellent” --

Mr. Speaker: Question?

Mr. Eves: -- “and efficient program would impair the quality of care we currently provide. It would take years to develop a program at the TGH site which incorporates” --

Mr. Speaker: Order. Do you have a question?

Mr. Eves: Is the minister going to assure us that this merger will not take place?

Hon. Mrs. Caplan: I can assure the member opposite and the members of this House that my goal is to make sure that people have access to the care they need as quickly as the doctors say they need it. I can tell him that the ministry has recently taken a program approach so that we can look across the province in the area of cardiovascular care, as he knows, in emergency health services and others such as mental health services, to make sure our co-ordinator, in this case of cardiovascular care, knows exactly what is available in capacity across the province.

I can assure the member that this approach will result in the most co-ordinated and effective delivery of services across the province. We have improvements to make. We are moving forward, and I am seeking advice from experts.

NORTHERN HEALTH SERVICES / SERVICES DE SANTÉ DANS LE NORD

Mr. Reville: My question is to the programmed Minister of Health. My leader, the members of our caucus from northern Ontario and I just came back from another seven days of hearings in the north concerning health care. As I got into the car on Monday morning in Wawa for the three-and-a-half-hour drive to Sault Ste. Marie, I picked up a day-old Sunday Star and read under the headline “‘Vision’ holds Caplan in a tough job,” that in fact, the nursing shortage is “very much a downtown Toronto issue….”

The Minister of Health is wrong. Speaking to over 100 individuals in northern Ontario has convinced me that the minister is wrong and that the minister might do well to listen to some other voices. Health care professionals, hospital boards --

Mr. Speaker: Do you have a question?

Mr. Reville: -- nurses themselves have said there is a shortage of nurses in the north, and I want to know what it is the minister is going to do about the nursing crisis in the north.

Hon. Mrs. Caplan: In fact, as the member would know, vacancy rates in nursing vary widely across the province from relatively no vacancy rate in some communities to some seven per cent in downtown Toronto. We know that there are special challenges in meeting the needs of northern Ontario. That is the reason we establish co-operatively membership on the Northern Health Manpower Committee. I can tell him that these issues are being actively addressed.

Mr. Wildman: The minister must know -- I hope she knows -- that there is a 25 per cent vacancy rate for nurses in Hornepayne. On top of that, where we have a nurse practitioner practising in Dubreuilville, an isolated community at great distance from the nearest hospital, her ministry is continuing to harass that nurse and the operation on the basis that $80,000 a year to operate that nursing station is too much, when in fact it is less than a number of other nursing stations in northern Ontario.

Why is the minister continuing to take this position instead of supporting the nursing station operation in Dubreuilville?

Pourquoi la ministre continue-t-elle à harceler les infirmières pratiquant leur métier à Dubreuilville ?

Hon. Mrs. Caplan: The member opposite knows I have travelled extensively through the north. He knows of our commitment to the provision and access to effective quality care as close to home as possible. He knows of the numbers of initiatives we have taken in the north. I can say to him that if he has a concern about a specific issue, I would be pleased to look into it.

LITHOTRIPSY

Mr. Eves: I have another question of the Minister of Health. I would like to talk to the minister in the House this afternoon a bit about lithotripsy in the province. We know the minister has responded on past occasions as waiting for task force reports. We have a copy of the Scott task force interim report. I am surprised she did not announce it in the Legislature this afternoon.

I just want to quote one paragraph from this report:

“The members have reviewed the published evidence on the use of lithotripsy in the treatment of kidney stones and there is general agreement that expanded facilities for lithotripsy in Ontario could produce significant cost savings and provide the opportunity for more efficient reallocation of resources by reducing average lengths of hospital stay from about 12 to three days per patient and by reducing disability time from about 30 days after open surgery to less than five days.

“In the near future, lithotripters should be located in or under the direction of regional teaching hospitals that have educational programs for both urologists and technicians.”

When can we expect the minister to make an announcement about additional lithotripsy units in Ontario?

Hon. Mrs. Caplan: As the member would know if he were paying attention in the House, I announced a task force on lithotripsy, with expertise from across the province, to advise me on the specifics of introduction of new technology in lithotripsy. I expect to have their report by March 31.

Mr. Eves: This issue was first raised in the Legislature by my colleague the member for Burlington (Mr. Jackson) nine or 10 months ago. We asked the minister about this in the House last October. Part of the Scott task force recommendation, the very line before the portion I read, says, “The background material on which the task force recommendations are based has been referred to the minister’s committee on lithotripsy.”

By her own statement, the minister’s committee on lithotripsy was supposed to give her an interim report by December 31, 1988. We are now into February 1989. When are we going to get some action? Surely there is no doubt in the minister’s mind now that we need additional lithotripsy units. Will the minister commit to this --

Mr. Speaker: Thank you. You have already asked a question.

Hon. Mrs. Caplan: The member is wrong again. I announced when I convened the committee that it would be reporting by March 31. The Scott task force gathered information and has forwarded it to the lithotripsy committee. I can tell the member that I am expecting their report by March 31, as I asked them to.

Mr. Daigeler: My question is to the Treasurer and Minister of Economics --

Mr. Cousens: Is it on Sunday shopping?

Mr. Speaker: Order. The member for Markham is making it very difficult to hear. I think it is only fair that the members are allowed to ask questions.

INFRASTRUCTURE RENEWAL

Mr. Daigeler: My question to the Treasurer relates to an open letter that I wrote in December to my federal colleagues in eastern Ontario. I urged them to lobby the federal government to resume funding for infrastructure costs as they did up to 1984. I have also asked the library research service to give me the figures on how much money is being lost nationwide because of the federal government’s cutbacks.

According to this report, between 1974 and 1984, $200 million was given towards the neighbourhood improvement program, $128 million towards the municipal incentive grant program, $400 million towards the community services contribution program and $230 million towards the urban transportation assistance program.

Mr. Speaker: Do you have a question?

Mr. Daigeler: Given the magnitude of these dollars, may I ask the Treasurer whether he has brought up this matter of federal contributions to municipal infrastructure costs with Mr. Wilson and with his own provincial colleagues?

Hon. R. F. Nixon: I appreciate notice of the question having been given, which is the appropriate way if you want the details of the information requested. Actually, I wrote to the Honourable Robert de Cotret, Minister of Regional Industrial Expansion, on October 6, 1988, and again on January 5, asking that we at least initiate discussions leading to economic regional development agreement programs that would do precisely what the honourable member has suggested.

Under the previous federal regime -- that is, the Liberal regime -- there was a spectrum of programs designed to assist provinces and municipalities to maintain infrastructure. But in the last few years, because of the offloading of programs at the federal level, these costs are now going back to the municipalities and, to a great extent, still reside at the provincial level with really zero federal assistance.

Mr. B. Rae: Do you call that the ancien régime or what was that?

Hon. R. F. Nixon: That’s when you were up there criticizing.

Mr. B. Rae: That’s what made it good.

Hon. R. F. Nixon: There’s another vacancy there.

Mr. Speaker: Order.

Mr. Daigeler: I appreciate the actions the Treasurer has taken. In view of his very rich political experience that we recently applauded in this House, and in fact even moved by the leader of the third party, I would like to ask the Treasurer whether he has any advice to the members of this House as to how we might convince the federal government to resume its contributions towards this very important matter of municipal infrastructure costs.

Hon. R. F. Nixon: I am not sure how we can convince an intransigent government that should be assisting the provinces far more than it is. I think the honourable member is aware that because of initiatives taken at the federal level this province is short $1 billion this year alone in support of medicare programs and post-secondary education.

We, however, have taken some substantial local initiative in establishing a program administered by the Minister of the Environment (Mr. Bradley). It is called LifeLines and it is designed to assist municipalities in rebuilding the infrastructure in the communities across Ontario. It is designed to assist over a period of 10 years, and we have allocated $1 billion to it.

I wish there were more and I would expect in the future that however this is financed, it will require a good deal more money. It is my hope, along with the honourable member, that the federal government will see its way clear to assist the municipalities in Ontario and right across Canada in this essential and worthy program.

ASSISTIVE DEVICES PROGRAM

Mr. Wildman: I have a question for the Minister of Health, again regarding the assistive devices program.

During our visit to Elliot Lake, a Blind River pharmacist described a case of a veteran named Orville in Blind River, who had been receiving costly disposable ostomy appliances from the Department of Veterans Affairs and then later Greenshields.

When the ADP took over the program, it required an application for authorization of the vendor. It needed two recommendations. The closest registered authorizer was 142 kilometres away in Sault Ste. Marie. It took four to five months to process this application and by the time it was completed the patient had died. As Mr. Kennepohl put it. “The ADP has reached 100 per cent administrative purity; all the money is spent on administration and nothing on service.”

What is the minister doing to end this bureaucratic nightmare in the ADP to ensure that patients receive the devices they need when they need them?

Hon. Mrs. Caplan: As I acknowledged in this House during estimates, the assistive devices program has experienced some growing pains, but I am proud to say that our government has expanded the assistive devices program to cover a number of assistive devices for residents of all ages.

In fact, I would say to the member that funding for the 1987-88 program increased some 40 per cent over the year before and that program alone supported 135,000 purchases from over 800 vendors.

I recently announced an expansion of the program to cover hearing aids, which will benefit some 35,000 people in this province at an increased cost, taking the program from $1 million to $16 million.

Mr. Reville: These bureaucratic numbers do not do much for me.

In terms of the growing pains of the ADP, the growing pains extend all the way from Elliot Lake to Sault Ste. Marie where, in fact, a person who lives in Elliot Lake must go to get a registered authorizer to sign the damned bit of paper so that he can get his assistive device.

The cost of getting that signature is about $80. The device may be worth $10, $20 or $25. All those costs are picked up by the taxpayer and they provide a huge pain for the supplier of the assistive device, many of whom do not want any part of the government’s expanding program.

What is the minister going to do about it?

Hon. Mrs. Caplan: I acknowledge and have said on numerous occasions that in its massive expansion the program has experienced some growing pains. I can tell the member that I am confident we can make the kinds of adjustments necessary in our program so that people and clients can receive the necessary treatment as quickly as possible. There is more to be done, but we are making progress.

TRANSIT SERVICES

Mr. Cousens: My question is for the Minister of Transportation. Our party has raised this issue on a number of other occasions. My question deals with the minister’s so-called first priority for rapid transit in Metro Toronto; namely, the Sheppard subway line. The minister has refused to live up to his financial commitments for the Sheppard line, he has abandoned Metro Toronto and quite frankly he has dumped the responsibility of transit needs back on Metro. Why has the minister made this major departure in financial arrangements for rapid transit? Why has he not lived up to his commitment for the Sheppard subway line?

Hon. Mr. Fulton: I appreciate the member’s question, but as is often the case, he is badly misinformed once again.

Hon. Mrs. Caplan: Wrong again.

Mr. Eves: Is that the only briefing you guys get over there?

Mr. Speaker: Order.

Hon. Mr. Fulton: I think the only intelligent question that came from that side of the Legislature was from my colleague the member for Scarborough-Ellesmere (Mr. Faubert) who asked the same question about a month ago.

There has been absolutely no change in the financial arrangement with respect to this government funding transit projects.

Mr. Cousens: I wonder who is wrong. If only we could get the facts, then we would all be right. The fact is, people now realize that the $100 million being spent for a one-mile extension to the Spadina line has everything to do with Toronto’s Olympic bid and nothing to do with Metro’s transit needs. Will the minister admit that he has reneged on his commitment to make the Sheppard subway his first priority in his Metro transit strategy and will he admit that his overall strategy, if he has one, rests on the International Olympic Committee decision in September of this year?

Hon. Mr. Fulton: We know who is correct and who is incorrect. The member has demonstrated again that he is incorrect and in the absence of facts. You cannot put a subway line on Sheppard in a cost-efficient way without affecting how the cars get there. The member for Scarborough-Ellesmere asked the very same question in an intelligent way some time ago in this House, unlike today.

Mr. Jackson: It was the same question, but he was misinformed.

Mr. Speaker: Order.

Hon. Mr. Fulton: He was not misinformed. I would suggest that the member for Markham (Mr. Cousens), who has shown no previous interest in transit in and around Metro and Ontario, certainly not as a member of the former government, should perhaps ask some questions and be briefed by my staff.

Nothing has changed in the financial formula. We have an excellent relationship with members of Metro council and the transportation committee. The member is misinformed. I think he should take a look at what we have said with respect to effecting the Sheppard subway and the Spadina extension. I can assure him that the IOC had nothing to do with our deliberations.

ENVIRONMENTAL PROTECTION

Mr. Fleet: My question is for the Treasurer. There is a growing public consensus about the repercussions of abusing our environment. Within our highly industrialized and materialistic society, there is an increasing recognition that, as consumers and often inadvertent polluters, we all share responsibility for the environment. In addition to a strong desire to use less hazardous products, people are prepared to pay more money in order to have a cleaner environment.

In the next budget, will the Treasurer introduce a significant new tax, an environmental protection tax on all products made or sold in Ontario which create or become hazardous wastes, are not practical to recycle when disposed of or involve unnecessary packaging?

Hon. R. F. Nixon: I thank the honourable member for notice of this question. It is a very useful one, because I am sure all members of the Legislature share the concern of the government for seeing that our environmental programs are adequately funded and allowed to expand to meet the needs of the community.

In this connection, the excellent statement of the Premier (Mr. Peterson) today indicated the leadership which this province has taken on a North American basis and is certainly much to be congratulated.

I think we should be aware that in the past three years we have increased the budget for the Ministry of the Environment by well over 50 per cent. Year over year, this year compared to last, the increase has been 10 per cent. If the minister were here, instead of being busily engaged in cleaning up the environment elsewhere, he might be the first to say that even that very generous allocation is insufficient and we would certainly try to do better.

Mr. Fleet: The Treasurer will know of my interest in environmental matters. I have pursued that with him on a number of occasions. We now have substantial evidence, including public opinion polls, which indicates people are particularly willing to pay more in taxes, whether through an environmental protection tax or ordinary taxes, if they know the extra money will be spent fighting pollution and helping to clean up the environment. In addition to what we have done in the past, in the next budget will the Treasurer commit the government to a significant increase of the financial resources of the Ministry of the Environment?

Hon. R. F. Nixon: I think the honourable member is aware that the increase in gasoline tax for leaded fuel was greeted with considerable enthusiasm in most parts of the province as an environmental tax. As the honourable member knows, the money has gone towards environmental purposes in every respect.

The concept of specially related environmental taxes is an extremely interesting and valuable one. The honourable member, as a leading proponent of environmental programs, would know that many of the people who share his enthusiasm have written to me personally and indicated that there might very well be additional taxes, for example on disposable diapers. I, for one, do not favour that, but a person who looks at the environmental effects might see that there was some rationale there.

It is certainly a matter that bears very careful consideration so that we can continue to allow the environmental budget to grow at a substantial rate.

NORTHERN HEALTH SERVICES

Mr. Morin-Strom: I would like to bring to the attention of the Minister of Health a release from her own ministry in August 1986 in which the Minister of Health at that time, the member for Bruce (Mr. Elston), committed to 176 new chronic care beds across northern Ontario, at a cost of $25.3 million. The people of the north are wondering what happened to this promise.

I ask in particular with respect to a commitment to 28 beds to the Sault Ste. Marie General Hospital, with construction to begin in about two years. We are six months past that two years, and the ministry spokesman said last week that they are in the preliminary stages of review. What is happening within the ministry, when the government can make major announcements like that and then sit on them and do absolutely nothing? Where are these beds for northern Ontario?

Hon. Mrs. Caplan: I say to the member opposite that the announcements that were made by the former minister in 1986 are going through the normal planning process.

Mr. B. Rae: Well, why did he announce it in 1986? Is it a three year planning process?

Hon. Mrs. Caplan: It takes time.

Mr. B. Rae: Especially when you’re having fun.

Mr. Speaker: We will just wait until the interjections die down. Order.

Supplementary, the member for Sudbury East.

Miss Martel: I have to wonder how long the planning process is going to take. Of the 176 new beds promised in 1986, 60 of those were due to go to the city of Sudbury. The district health council agreed that those beds should go to Laurentian Hospital.

In November 1987, I met with the hospital administration because they had not heard a word from the ministry about when the funding would flow for those beds. At the end of November, they were advised that the allocation of beds and the necessary capital funding had been approved. Last week, in spite of all this, hospital representatives in the region came before the task force to say they had no new news on the 60 chronic beds and wanted to know when the funding was going to flow. I would like to ask the minister when we can see the establishment of the 60 chronic care beds in Sudbury.

Hon. Mrs. Caplan: As the member opposite knows, and as we discussed on numerous occasions in this House, we have a seven-stage planning process within knows, as well, that concerns have been expressed in some communities that often the parameters within which the planning was begun changed during that planning process and caused sometimes lengthy and frustrating delays. It is one of the reasons that I encourage communities to plan within the parameters originally set, established and approved by the ministry, so that the planning process can be expedited.

We are, of course, as the members know, reviewing the process itself to make sure that we plan for the future to meet the needs of the people of Ontario.

WORKERS’ COMPENSATION

Mr. Pope: I have a question to the Minister of Labour. The minister will be aware that the hearing officers’ appeals for the widows of miners who have died of lung cancer started in January of this year in Timmins and in other northern Ontario communities. He will be aware of the fact that those appeals have started. As a representative of these families, I have therefore been involved in the hearing processes and have had access to the information on the files of the claimants.

I would ask the minister why, in virtually every case, there is absolutely no information on the file with respect to exposure calculations in order that the miners can qualify or not qualify in terms of exposure units; why there is no information on dust levels in the various mines that these miners worked in; why there is no information on ventilation systems and the dates that these ventilation systems were improved; why there is no detailed medical information, including necessary autopsy reports and pathology reports; why there is no explanation of the X-ray --

Mr. Speaker: Order. That is four questions. Minister?

Hon. Mr. Sorbara: Mr. Speaker, you are right, of course; there are a number of questions there, and they are interesting questions. Obviously this is not the appropriate place to raise them because --

Mr. B. Rae: Where can you raise them if you cannot raise them here?

Hon. Mr. Sorbara: Now hold on a second, I say to the Leader of the Opposition, because the member for Cochrane South is talking about an adjudicative process that is happening within the worker compensation system. If he would like me to raise those questions with the board and bring back an answer, I would be perfectly willing to do that; but to suggest, as I think he is doing behind this question, that somehow the Ministry of Labour or the Minister of Labour should influence that adjudication process is inappropriate. I think my friend, the member for Cochrane South, knowing the system as he does, would acknowledge that.

Mr. Pope: I do not think it is inappropriate for the minister who has responsibility to the people of this province for the operation of this system to intervene, which he has been asked to do before, to provide for some better system of adjudication. Even his hearing officers are saying that they do not have adequate information on the file to make these decisions.

I have written on two occasions to the board, with copies to the minister, asking for generic hearings so that we can expeditiously deal with the claims of some of these widows who have had appeals pending for nine or 10 years. There has been no response from the board or from his ministry in order to expedite these hearings or provide basic information that widows and their families are entitled to. Now is the minister going to intervene and provide for full disclosure of all information for these families so that they can get a fair hearing in front of the system or not?

Hon. Mr. Sorbara: Let’s just step back a couple of steps and go back to the origin of this issue. It was about 18 months ago that the board finally arrived at a policy which would lead to appropriate compensation for some widows who had, I acknowledge to the member for Cochrane South, been waiting for a very long time. Those who advocated on their behalf did an extremely good job of finally making a case. In the end, when all the stuff is done, there will be some $30 million paid out in compensation in appropriate cases.

If there are problems with the adjudicative system, I want to make sure the board is dealing with those problems. So I will take as notice the questions that the member for Cochrane South raised. I will bring them to the attention of the board. But I want to assure my friend the member for Cochrane South, and every member in this House, that I and no previous Minister of Labour, Liberal or Conservative, would interfere with that adjudication process.

LIQUOR LICENCE

Ms. Collins: My question is for the Minister of Consumer and Commercial Relations. As he knows, the Hamilton Airport located in my riding at Mount Hope is increasingly becoming a viable alternative to Pearson International Airport for many Ontario travellers. For some time now, the airport has been trying to offer the amenities of an international airport; however, there are no duty-free liquor sales available at this time. Will the minister inform the House of the actions his ministry has taken with regard to securing duty-free liquor sales at Hamilton Airport?

Hon. Mr. Wrye: I thank the honourable member for the question. The member has brought to my attention privately in the past her concerns and desires to have the Mount Hope facility upgraded.

The problem is, as the honourable member may know, that in effect no nonliquor duty-free tendering process took place. What we have done is offer Mr. Stout, who owns the nonliquor duty-free outlet, the ability to tender for both liquor and nonliquor duty-free outlets should he relinquish the office he now has. He has refused to do so.

To move this matter forward in the way I know my friend wants so the airport can attract more international flights, the chairman of the Liquor Control Board of Ontario in early January, I believe, wrote to the airport manager, Mr. Ainsworth, and offered to open up a duty-free outlet run by the LCBO. That is where the matter stands. That offer is now under consideration.

Ms. Collins: Can the minister inform the House when the travellers using Hamilton’s Mount Hope airport might expect duty-free liquor sales at this facility?

Hon. Mr. Wrye: We have made some progress; As I understand it, that airport is undergoing an expansion that will free up some space that was actually needed before we could even consider this matter.

There have been letters, as I said, going back and forth. Mr. Ainsworth has replied and has referred in his reply only to a duty-free liquor tendering process, which is not what Chairman Ackroyd had suggested in his letter to the airport manager earlier.

We are currently undertaking some discussions. I want to move this matter forward, but I suggest to the honourable member that we want assurances that the tendering process we have established in this government, an open and aboveboard tendering process in which all people will be asked to tender, will be followed in this case, and that at the end of the day the Mount Hope facility will have the same duty-free facilities we enjoy in several other airports in Ontario.

NORTHERN HEALTH TRAVEL GRANT PROGRAM

Mr. Pouliot: My question is to the Minister of Health. The minister says she is quite proud of the northern health travel grant. I see the minister nodding her head in acquiescence. She has a right to be proud because she will remember very vividly that it was indeed New Democrats who were responsible for the work and therefore the grant.

However, the limitations the minister places on the grant make it virtually impossible for people living, for instance in the township of Schreiber or the township of Terrace Bay, who must travel 200 kilometres to Thunder Bay for medical services, to be compensated in the least. They do not receive one penny of assistance from the provincial government for medical services. The same thing applies, for instance, to the 5,000 residents of Wawa who must go to Sault Ste. Marie.

Mr. Speaker: Do you have a question?

Mr. Pouliot: They are not getting any money. My question to the minister is this: Will she give serious consideration, by virtue of the fact the economy in Ontario is doing very well and revenues are up -- taxes are up but so are revenues of course -- to decreasing the number of miles to fit the criteria so that the good people of the north, the people who need it the most, can finally have access to health services --

Mr. Speaker: Thank you.

Hon. Mrs. Caplan: As the member knows, the purpose of the northern health travel grant program is to ensure access for northern residents to the services of specialists that are not available in northern Ontario. That grant, I am very pleased to say, was introduced in December 1985 by this government; in fact, over 100,000 people have had travel grants made available to them, totalling in excess of over $1 million.

Since the beginning of that program, the travel limit has been reduced from 300 kilometres to 250 kilometres. We are always reviewing that. In fact, the kilometre guideline is established taking into account the distances people in southern Ontario travel as well.

Mr. Reville: Mr. Speaker?

Mr. Speaker: Yes?

Mr. Reville: Supplementary.

Mr. Speaker: Oh, supplementary.

Mr. Reville: Thank you. How are you doing?

Mr. Speaker: I thought you had a point of order.

Mr. Reville: No, Mr. Speaker, although probably I could think of one if I have to.

Everybody knows what the purpose of the medically necessary travel grant is. What we are concerned about is the limitations this government has placed on the travel grant. In addition to the mileage limitation, there are three other serious limitations that were raised by people in the north.

The first is that the travel grant, of course, does not begin to cover the cost of the travel. The second is that unless you are under 18 you do not get any money to take a companion with you. You can be blind or deaf or never have left your home town, but you do not get a companion: at least not one who is compensated for the travel. The third thing is that when you get to wherever you are going -- say you have gone from Elliot Lake to Toronto -- you have to get a hotel here and you carry the freight for that yourself.

What is the minister going to do about those limitations?

Hon. Mrs. Caplan: I think it is important to note that the program, which we believe is working well, has changed. We have added, I would say to the member, the travel assistance for addictions program and travel assistance for some dental procedures and for some optometric procedures.

As we review the program on an ongoing basis, we also have to take into consideration the fact that we are trying to make doctors in the north aware of what services are available in the north, because one of our goals is to encourage specialists to practise in the north so that people will have services available as close to home as possible.

We know that sometimes people are being referred out of northern Ontario when those services are available. We are doing what we can to let doctors know what specialty services are available in the north. Those have been increasing and are continuing to increase as we have constantly reviewed the travel grant program, which I would say is working quite well.

Interjections.

Mr. Speaker: It sounds as if the orchestra is a little out of tune.

GROUP HOMES

Mrs. Cunningham: My question is for the Minister of Community and Social Services. In our search around one of the tragedies this weekend, we have been given some information and we were wondering if he can confirm it or enlighten us.

Two facts have come to light. One is that the agency involved has been given the authorization and the funding to have two full-time individuals working at the home at night; that is the home where Krista Sepp was killed. The other fact that has come to our attention, and one we are concerned about, is that under the Young Offenders Act, staff at halfway homes do not have the right to search young offenders when they return from workplace assignments or other outside trips.

I am wondering if the minister can confirm or enlighten the House as to both of those pieces of information we have received that we are somewhat confused about.

Hon. Mr. Sweeney: Kinark Child and Family Services, being a service for children with serious emotional disturbances, has always had the authority to increase staff if, in its judgement, it believed it was necessary. That is a decision they must make. The member will recall that about a week before this incident, in fact they did double staff in that house because they felt there was a possible concern. That was recognized and the funding is there to provide for that.

I have also indicated to another member that we have now advised all of our agencies to review it, and if they have a particular need, then to deal with it as they feel is most appropriate. So that opening has been there and it was an internal decision.

With respect to the second question she asked, I am sorry but I do not have that information. I cannot either confirm it or deny it.

Mr. Speaker: That completes the allotted time for oral questions and responses.

VOTING BY PRIVATE MEMBERS

Mr. Harris: On a point of privilege, Mr. Speaker: Yesterday, the member for Brampton South (Mr. Callahan) rose on a point of order and provided information to the House accusing the member for London North (Mrs. Cunningham) of releasing part of his letter to the media with regard to a very controversial matter.

I rise today to correct the record and to point out that what was released by this member was the entire letter, the entire response that the member for Brampton South indicated he wanted released and wanted on the record in response to a letter from my leader. I think that information should be on the record, that indeed the wishes of --

Mr. Speaker: Thank you. I have listened very carefully. All members have the right to stand and correct the record, but only to correct their own record.

PETITIONS

TEACHERS’ SUPERANNUATION

Mr. McCague: I have a petition from 241 members of district 17, Superannuated Teachers of Ontario. It reads as follows:

“To the Honourable the Lieutenant Governor and the Legislative Assembly of Ontario:

“We, the undersigned, beg leave to petition the parliament of Ontario as follows:

“To amend the Teachers’ Superannuation Act, 1983, in order that all teachers who retired prior to May 31, 1982, have their pensions recalculated on the best five years rather than at the present seven or 10 years.

“This proposed amendment would make the five-year criteria applicable to all retired teachers and would eliminate the present inequitable treatment.”

I have signed this.

YORK REGION LAND DEVELOPMENT

Mr. Cousens: I have a petition from people from Thornhill, Gormley, Markham and Unionville:

“To the Lieutenant Governor and the Legislative Assembly of Ontario:

“We, the undersigned, beg leave to petition the parliament of Ontario as follows:

“Whereas the dramatic growth rate in York region has placed extreme pressure on the municipal planning process, and given that serious allegations have been made regarding the integrity of this process in York region, we strongly urge the provincial government to conduct a full and open public inquiry into the municipal planning process and land development practices of York region.”

It is duly signed and signed by myself.

HOSPITAL SERVICES

Mr. McLean: I have a petition signed by 870 people. It reads:

“To the Honourable the Lieutenant Governor and the Legislative Assembly of Ontario:

“We, the undersigned, beg leave to petition the parliament as follows:

“We would like to see expanded facilities for bypass surgery.”

This is a petition these people have gone to a great deal of work to gather 870 names for. It comes from the cause of delays in surgery for Lloyd Crawford from Oro Station who has been waiting for many months to have his heart bypass operation. His wife went to work and got this petition to bring it to the attention of the Minister of Health (Mrs. Caplan).

Mr. Speaker: And you have signed the petition, have you?

Mr. McLean: I have signed this petition to make sure it is legal and that you will accept it in good order.

AUTOMOBILE INSURANCE

Miss Martel: I have a petition forwarded to me by Dave Campbell, the president of the United Steelworkers of America in Sudbury. It is signed by literally hundreds of people in the Sudbury riding, who simply state:

“To the Lieutenant Governor of Ontario and the Premier (Mr. Peterson):

“We the people of Ontario strongly object to the proposed increases to our automobile insurance rates.”

I have signed my name to this and I agree with them entirely.

ABANDONED RAIL LINES

Mr. Pollock: I have a petition signed by 39 people, which reads:

“To the Honourable the Lieutenant Governor and the Legislative Assembly of Ontario:

“We, the undersigned, beg leave to petition the parliament of Ontario as follows:

“In favour of the CNR right-of-way abandoned lands being offered to the farm owners, and other abutting private owners, to purchase at fair market price for vacant land, where these lands divide their farms, and abut other private property from Stirling municipality west to Campbellford municipality east.”

I have a second petition which is signed by 17 people and reads as follows:

“To the honourable the Lieutenant Governor and the Legislative Assembly of Ontario:

“We, the undersigned, beg leave to petition the parliament of Ontario as follows:

“That the abutting property owners be allowed to purchase at fair market value the abandoned Canadian National Railway properties lying along the former rail line from the village of Stirling east to the township of Rawdon.” I have signed this petition.

REPORT BY COMMITTEE

STANDING COMMITTEE ON REGULATIONS AND PRIVATE BILLS

Mr. Furlong from the standing committee on regulations and private bills presented the following report and moved its adoption:

Your committee begs to report the following bills without amendment:

Bill Pr60,

An Act respecting the Sudbury Hydro-Electric Commission;

Bill Pr61,

An Act respecting The Sisters of Social Service;

Bill Pr76,

An Act to revive John Zivanovic Holdings Limited;

Bill Pr79,

An Act respecting the Town of Markham;

Bill Pr81,

An Act respecting The Windsor Light Opera Association.

Your committee recommends that the fees and the actual cost of printing at all stages and in the annual statutes be remitted on Bill Pr61,

An Act respecting The Sisters of Social Service.

Your committee further recommends that the fees and the actual cost of printing at all stages and in the annual statutes be remitted on Bill Pr61,

An Act respecting The Windsor Light Opera Association.

Motion agreed to.

INTRODUCTION OF BILLS

CITY OF LONDON ACT

Mrs. Cunningham moved first reading of Bill Pr74,

An Act respecting the City of London.

Motion agreed to.

LANDLORD AND TENANT AMENDMENT ACT

Ms. Bryden moved first reading of Bill 217,

An Act to amend the Landlord and Tenant Act.

Motion agreed to.

Ms. Bryden: The purpose of this bill is to ban the inclusion of no-pets clauses in leases for residential apartments, because they are being used by some landlords to evict responsible pet-owning tenants whose pets cause no disturbance to the other tenants or the landlord.

Hon. Mr. Conway: Mr. Speaker, if I might, before my friend the member for Parry Sound (Mr. Eves) rises to speak, I should indicate through you to the table that our whips have been discussing this afternoon’s timetable and there is an agreement among the whips that the afternoon’s time be shared in two ways: that the last hour, that hour preceding the taking of the vote, be shared on a 20-minute round robin for wind-up speeches, one from each party, and that the other time from now through to about 5:45 be shared among the three parties equally on a rotational basis.

Mr. Speaker: I guess I should ask for unanimous consent from the House so the table will know it is expected to keep track of the time and the last hour will be divided. I hope no one will feel hurt if the Speaker interjects during that last hour to remind him or her that 20 minutes is up.

Agreed to.

Mr. Eves: Speaking of unanimous consent, I would ask the permission of the House, in the absence of the member for Sarnia (Mr. Brandt), to move the nonconfidence motion.

Mr. Speaker: Is there unanimous consent to that request?

ORDERS OF THE DAY

HEALTH SERVICES

Mr. Eves moved, on behalf of Mr. Brandt, motion 4 under standing order 70(a):

That the government lacks the confidence of the House because of its failure to maintain a quality health care system, which the people of Ontario have come to expect, resulting in the increased suffering and mortality of patients, the closing of hospital beds, the increased waiting lists for health services forcing more citizens to seek health care outside the province, the deterioration in the co-operation between the government and health care providers in the province, and the frustration of all persons involved in health care in Ontario because of this government’s lack of planning and setting of priorities for capital expansion and improvements, lack of leadership in developing adequate support and funding to facilitate a more community-based approach to health care delivery, lack of action in reforming the Ontario health insurance plan system and systematic attempts to blame everyone else for the problems in the health care system.

Mr. Speaker: Just before the debate commences, I remind all members that under standing order 70 the Speaker will call the members to order at 5:50, and if a vote is taken, the bells will ring for five minutes.

Mr. Eves: I will at the outset, if I might, outline a couple of areas I plan to touch on very briefly this afternoon, first, with respect to the motion of nonconfidence put forward by the leader of our party.

We on this side of the House, and I know people in the health care professions generally, are very disturbed about the confrontational approach that this government has chosen to take with respect to health care in the province. We only have to look back a few months to see the disagreement between the Ontario Hospital Association and individual hospitals across this province and the Ministry of Health.

We have a Minister of Health (Mrs. Caplan) who professes to take a co-operative, consultative approach to the health care system. I would like to remind members in the Legislature this afternoon of that co-operative, consultative approach with respect to Cambridge Memorial Hospital as one example.

When the minister -- having a copy of the government’s task force report with respect to Cambridge Memorial Hospital in front of her and not being satisfied, I suppose, from her point of view, with the contents therein -- unilaterally sent in an inspector, Mr. Stoughton, to the hospital, without informing the hospital ahead of time, to do an investigation of the investigation that was already done; and when the Deputy Minister of Health said down at L’Hotel that he is going to have the head of the administrator of Cambridge Memorial Hospital on a platter, I do not think those things smack of a co-operative, consultative approach to government or health care in Ontario.

Then we have to look at the optometrists, who were in front of this Legislature just a few short weeks ago. They received unilateral imposition of a retroactive decrease of 4.35 per cent in their fee schedule, almost a year late, when an independent committee with an independent chairman -- this is the government’s own committee, its own independent chairman of its own choosing -- recommended to the person who appointed him that optometrists receive the same fees that ophthalmologists did for certain procedures.

The government disregarded his advice altogether and unilaterally cut optometrists’ fees by almost 4.5 per cent a year later. Is that a co-operative, consultative approach to government?

During the Ontario Medical Association fee negotiations, the government proposed a 1.75 per cent increase. The OMA asked for something more, in the neighbourhood, I believe, of 5.7 per cent, if my memory serves me correctly. There again an independent fact-finder was appointed by the government and the OMA together. They both agreed on this individual. The fact-finder’s recommendation was somewhere in between, on middle ground if you will. I believe this is the first time in the history of Ontario that a Minister of Health has not paid attention to a fact-finder’s recommendations with respect to the OMA fee schedule. That is not a co-operative, consultative approach to government.

The pharmacists in this province have received the same treatment as the other three bodies that I have just mentioned.

The Minister of Financial Institutions (Mr. Elston) used to be the Minister of Health, and he made a commitment to the physiotherapists three years ago. The gap in physiotherapist fees keeps widening instead of being reduced to nothing, which he committed his government to over three years ago.

This is indeed a confrontational approach to many individual groups in the health care professions.

We have a Minister of Health and a Ministry of Health which claim to be concerned about the nursing shortage in Ontario Let’s talk about the nursing shortage for a moment.

When members of the opposition first raised the question of a nursing shortage in this Legislature about a year and a half ago, the minister at first responded that there was no nursing shortage whatsoever in the province.

Then when we found out over a year ago now, around New Year’s of 1988, I believe, that we were flying newly born babies and infants to other jurisdictions and we were flying mothers and expectant mothers to other jurisdictions because we could not treat them properly here in Ontario, the Minister of Health stood in her place and said, “Well, I guess there is a nursing shortage after all, and it is the reason we have to do all these other things, because we do not have enough nurses who are adequately trained who are here in the province.”

Then the minister’s response a few weeks after that was: “Yes, we have a nursing shortage, but it is cyclical problem. It will solve itself.” I suppose it is like lemmings every seven years; the minister’s lemming theory about the nursing shortage in Ontario, if you will.

I believe her next response was somewhat in the neighbourhood of, “Yes, we have a nursing shortage, but don’t worry about it, because next year we will graduate more new nurses than we ever have before in Ontario and the nursing shortage will be solved.” That is another response the minister has given.

These are somewhat contradictory responses, I might point out, to a very serious problem.

Another response the minister often gives is, “Yes, there’s a nursing shortage, but nurses in Ontario are the highest-paid anywhere in Canada.” The minister apparently has lost the whole point. The nurses are leaving this jurisdiction and they are going to other jurisdictions, namely, south of the border.

Mr. Haggerty: They do it every year. They have been doing it for years and you know it.

Mr. Eves: They are doing it in increasing numbers now, more so than they ever have before.

The minister has on her plate four separate reports dealing with the nursing shortage in Ontario. It is remarkably coincidental that almost every one of these reports makes almost exactly the same recommendations. While the minister is quite correct to stand in her place and say that not all of the recommendations are monetary or fiscal in nature -- and that is quite true; there are some things the ministry can do that are not monetary or fiscal in nature -- they are not even doing those.

We have asked the minister to stand in her place, time after time, day after day, week after week in this Legislature, and explain what steps she is taking following the recommendations of the four reports she has tabled on her desk. For a year and a half, she could not act because she was waiting for the reports. Now she has them all. It will be a year in March. Almost a year today, 11 months ago today, she received the first one. She has taken no steps whatsoever to deal with any of these problems.

The main problems are fiscal in nature. It is fine for the minister and the Premier (Mr. Peterson) to say that the Ontario Hospital Association and the Ontario Nurses’ Association should go away and renegotiate their contract, but she will not give a commitment that she is going to provide the OHA with the necessary funding.

She knows full well that the hospitals receive 90 per cent of their budgets from the provincial government. She knows that 80 per cent of hospital budgets are in fact labour intensive, namely, nursing, and yet she absolutely and consistently refuses to do anything about this very severe problem.

Hon. Mr. Conway: How much is enough?

Mr. Eves: How much is enough? Obviously, a lot more than is being committed to nursing today. It is obviously not enough. When a nurse who has 25 years’ experience, and a lot of it in intensive care, makes slightly over $4,000 a year more than a nurse who graduated yesterday, there is obviously something wrong with the system. It does not take a Rhodes scholar to see why nurses are leaving their profession in droves in Ontario.

We have asked the minister on several occasions about waiting lists for cardiovascular surgery in the province. I think that just exemplifies the problems in our health care system today. We have had various occasions when the minister has told us that the waiting lists are not growing longer, and that has been absolutely disagreed with by every cardiovascular surgeon I have talked to in the city of Metropolitan Toronto in the last year. The waiting lists are growing longer, there are more people on them and more people are dying while waiting for cardiovascular surgery than ever before.

I just read out to the House this afternoon during question period the number of cardiovascular surgery cases performed in Metropolitan Toronto by the three adult cardiovascular surgery units since 1985. The number is not going up, with all due respect to the Minister of Health. These are supplied by cardiovascular surgeons. The numbers are going down. We are doing fewer and fewer procedures every year in Metropolitan Toronto, despite the fact that our technology enables us to do more and more.

The minister announced on June 9, 1988, that she was going to address this problem by finally funding the fourth cardiovascular surgery unit at Sunnybrook Medical Centre. She was also allocating money -- there was a total sum, I believe, of some $18 million -- to increase the capacity at the other cardiovascular surgery units in Metropolitan Toronto, to quote the minister, “almost immediately.” Those are the two words exactly that she used in her own press release and statement in this House. “Almost immediately” these changes would take place.

It is not almost immediately, with all due respect to the minister. We are now in February 1989. I do not think that anybody, under any definition of the term “almost immediately,” could consider eight months later and no action and no improved results in the system to be almost immediately. We are now being told that it will probably be the end of this year before the fourth unit at Sunnybrook hospital takes effect.

While all this is going on and we thought we had made these strides and at least taken some steps towards trying to deal with the problem, we now find out that there are negotiations going on between the Toronto General Hospital site and the Toronto Western Hospital site of the Toronto Hospital to merge the two cardiovascular units, which would have a net result of doing 400 fewer procedures a year.

What is this government doing? Do they not know what is going on? It sounded like that to me in this House this afternoon. I am sure the minister will correct me if I am wrong. She had every opportunity to do so during question period. She does not even know about these negotiations that are going on.

Hon. Mrs. Caplan: I kept saying you’re wrong all through question period.

Mr. Eves: Is the minister not aware of the negotiations that are going on to merge the two cardiovascular surgery units? Is she or is she not? She had every opportunity to say whether she was this afternoon.

Speaking of who is right and who is wrong, if members will refer to the Hansard of this afternoon, I said that the lithotripsy committee was to give an interim report to the minister by the end of the year. She steadfastly denied that.

I am reading from the minister’s own press release on October 21, 1988. These words came out of the minister’s own lips in this House, “It will prepare a progress report by the end of this year” -- that was 1988, I believe. When is the end of the year? I always thought it was December 31 -- “and make its final recommendations to me by March 31, 1989.”

Who is right and who is wrong? “Progress report” is what I said. It was supposed to be done by the end of the year.

I wish the minister would not keep on going in circles. I really wish she would take seriously the health care crisis that obviously exists in this province today. It is getting worse and worse by the day while we have a government that does study after study after study, and even when it gets the results of the studies -- it has four studies on the nursing shortage -- still does absolutely nothing about the very severe problem.

Unless we get a government and an approach to government that is going to deal with the health care crisis, the waiting lists are going to get longer. Unfortunately, more people are going to die on waiting lists. In five or 10 years’ time, we are going to have a health care system in this province that no government, however well-intentioned, is going to be able to reverse the trend on.

I think it is time for the government to act. The morale in the health care system is deplorable. It really is in a sad state of affairs. We have a government that gives lipservice to saying that it is co-operative and consultative, yet I have rhymed off about six examples of where it has directly taken a confrontational approach. It is 97 per cent of the population against three per cent, or 98.5 per cent against 1.5 per cent. That will get us 94 seats in the next election.

This is the same government that promised to eliminate OHIP premiums in both the 1985 and 1987 general elections and has not taken one step towards dealing with that problem either, I might add.

Unfortunately, with health care, the people of Ontario do not become concerned until it affects them, a member of their family or somebody very close to them. Unfortunately, it seems the media will not pay attention until people die. When those factors hit home to people, to somebody close to an individual in Ontario society, then they begin to see the crisis that our health care system is in. It is a service that you hope you never have to use, but when you have to use it, it had better be there.

If this government does not take a different approach to health care in the very near future, we are going to go down a road that it will be impossible to retreat from in this province. We used to have a world-class health care system. We used to have the best health care system in the world, I believe. We are going the wrong way.

If this government will not take some very direct steps to deal with these problems in a truly consultative and co-operative approach -- there is a lot more to listening than just sitting in a room while somebody says his piece and then doing whatever Dr. Barkin wants to do anyway. A truly consultative, co-operative approach to anything is actually participating with somebody in a dialogue, taking up on his good, new suggestions and following through on them.

The Independent Health Facilities Act is another example of that. How anybody could profess to introduce a system where Gestapo-type investigators can go into any health facility, not just an independent health facility -- the bill says any health facility and defines health facility, which includes a doctor’s office, which is not an independent health facility under the bill -- seize medical records, seize samples and do whatever they want with them and interrogate anybody in that health facility, including a patient, and not be accountable or responsible to anybody -- I do not know how any Minister of Health could ever introduce a piece of legislation with such powers.

This is the same minister who said on TVOntario two Thursdays ago that she had not introduced a Smart card system yet because she was concerned about patient confidentiality. If that is not the most hypocritical statement I have ever heard, when her own bill has this type of provision in it, I do not know what is. The minister had better start adopting a more consultative, co-operative approach or the health care system in Ontario is going to hell in a handbasket.

Mr. Campbell: The Ministry of Health is committing a significant amount of its financial resources to ensure that specialists, family practice and other health professional services are available to the people of northern Ontario. It was also this government that put into place the northern travel program to ensure that northern Ontarians are financially supported if they are required to travel to other regions to receive needed health services.

I am also pleased, as the former chairman of health and social services of Sudbury region, that it was as a result of our Sudbury regional council bringing that to the attention of this government. It was swiftly acted upon. Let the record show that in support of those two programs, this year alone the Minister of Health will spend an estimated $19 million.

We in the north are also proud of the excellent heart surgery services being undertaken at Sudbury Memorial Hospital, the regional cardiovascular centre for northeastern Ontario. About 75 per cent of all heart surgery for residents of northeastern Ontario is now performed at Sudbury Memorial Hospital. In 1968, this hospital was the first hospital in Canada to perform such service.

While we are on the subject of hospitals, I think it is incumbent upon me to set straight the record on the impression that was left in an earlier question regarding Laurentian Hospital. I stress the fact that this service is being provided. In fact, Laurentian Hospital knows it is at the block schematic stage or stage 3 of the planning process. The approval to the next stage should be forthcoming shortly. I might also correct the record by saying funding does not necessarily flow until the seventh stage of that planning process. So Laurentian Hospital is well aware of the fact it is well on the way for this facility to open in Sudbury.

This year Sudbury Memorial Hospital will carry out a projected 430 heart operations, an increase of 130 procedures over two years ago, a phenomenal increase if you look at the numbers. It has been funded to do that. As an example of its leadership in this field, the Minister of Health appointed Vicki Kaminski, assistant executive director of nursing at Sudbury Memorial Hospital, to help conduct an investigation into the scheduling of heart surgery at St. Michael’s Hospital here in Toronto. Members should be aware that Sudbury’s cardiac program has developed to such an extent that Sudbury Memorial is no longer referring heart cases to other centres.

There are instances when our residents do require the medical services of specialists in other parts of the province or in Manitoba. A major initiative of our government, implemented on December 1, 1985, and expanded since then to make more people eligible, has allowed northern Ontarians to travel for medical services without suffering financially.

The northern health travel grant program approves travel grants for northern Ontario residents who must travel 250 kilometres or 153 miles, or more, to a medical specialist or hospital service in Ontario, or Manitoba or to certain general practitioners in northern Ontario who provide specific surgical and other specialized services. As of September 30, 1988, nearly 28,000 northern Ontario residents had made use of this beneficial government initiative in just under three years of the program’s existence.

This government also recognizes the special challenges to be faced in order to provide proper health care to the citizens of northern Ontario. As an example, last year the Ministry of Health and the Ministry of Northern Development and Mines sponsored a recruitment tour of health care professionals for the province’s more than 220 communities designated as underserviced. In the past three years, the underserviced area program and the northern medical specialist incentive program have combined to recruit 72 family physicians and 85 specialists.

By 1990, our government will spend an additional $1 million annually on grants and bursaries to attract about 150 rehabilitation specialists to northern Ontario. As well, individual incentive grants will be increased to $15,000 over three years instead of the present $10,000 over two years.

For undergraduates who undertake to serve in northern Ontario upon graduation, bursaries will be increased to $7,500 in each of the last two years from the present $5,000 per year. In addition, individual bursaries have been increased in physiotherapy, occupational therapy, speech pathology, audiology and chiropody.

There has been a significant improvement in the number of services provided, including a number of new helipads provided and planned for strategic northern Ontario locations.

Last November, the Minister of Health also appointed a Northern Health Manpower Committee to assess the need for doctors and other health professionals and to rank specific requirements on a priority basis. For example, this committee will pinpoint the locations in greatest need. It will also encourage teamwork among professionals, hospitals, district health councils and teaching facilities to address manpower needs and issues.

Finally, I want to mention that in order to provide advice to the minister on the development of health services in the north, two new district health councils for the Muskoka and Parry Sound areas were inaugurated.

Mr. B. Rae: I am delighted to be able to participate in this debate, as I am in all the debates in the House. I particularly want to say that in my experience I think no issue has taken hold with as much force as this question of the integrity and future of our health care system.

I want to start on a somewhat nonpartisan note by saying I do not think any one of us in this House can pretend that the problems are easy or that the challenges in the health care system are necessarily easy to overcome. There have been many studies done of the health care crisis in Canada, the United States, England and indeed all of our western, industrialized countries. We face, I think it is fair to say, a number of challenges that are intense, difficult, and above all, shared. It is with these I want to deal now.

The first major change or challenge -- it is not new but the force of it is perhaps new and it is something of which I can speak with the voice of a bit of experience -- is the fact that when we look at our health care system, we have to appreciate that the technologies now available for the treatment of illnesses are far more sophisticated, expensive and complex than anything contemplated 10, 20 or 30 years ago.

I have not spent a lot of time discussing the fact last year that I was in hospital for surgery in an effort to help my younger brother, who has been struggling, and struggling very well and effectively, against lymphoma, but I do want to point out a couple of things I learned as a result of that experience.

The first is that the technology available for a bone marrow transplant is relatively new. I think it is fair to say that 15 or 20 years ago, we would not be having an extended debate on the expense of leukaemia treatment, because there was none. People died very quickly and very cruelly at the hands of a devastating illness, devastating in its severity and devastating in the speed with which it can attack the body.

As a result of advances that have been made in science and technology, we can now, through the help of medical science, begin a battle. Patients are enlisted in that battle and families are joined in that battle. I might add that in a socialized system such as ours, we are all joined in that battle.

When we compare the costs of the kind of treatment I am describing in our system with the costs in the United States or in other systems, there really is no comparison as far as patients are concerned. In the United States, the cost of a bone marrow transplant is anywhere between $150,000 and $250,000. It is hard for any of us to contemplate that kind of cost. It is hard for the vast majority of citizens in this province to even imagine what it would be like to be faced with that kind of bill.

So the first point I want to make to the minister, to society and to my colleagues in the House is, let’s not pretend that the answers are simple or that the problems are simple. There are very profound ethical questions in the sense that we now have technologies that allow us and permit us to fight these battles and to try to overcome these diseases.

It has to be done. I think society and people, certainly patients and their families, expect us to do it and expect the system to do it. Yet we must also be aware that in launching these battles and taking on these campaigns, which all of us are involved with in one way or another, it is expensive and there is no getting around that.

The second thing I want to say is that the strength of our health care system is how we respond to these issues. I still believe very strongly in the integrity of the system in the sense that when doctors make their assessment of for whom and when to give surgery, for the most part -- there are all kinds of stories of what happens on a waiting list -- doctors are making these decisions on the basis of who is the sickest, not who has the most money, or what colour you are, or what your last name is or whether they know who you are, but on the basis of how ill you are.

That is a very profound ethical and moral statement our society has made. It is one of which I am very proud. Obviously, as a New Democrat -- all New Democrats, I think, have a sense of parenthood when it comes to this system -- I am very proud of the way in which this system is different from others. It is different from the American system. It is different from the market system. It does not treat health care like a commodity.

The second reality is that we are ageing. With ageing comes costs. We are all ageing. The minister looks at me and she says I am ageing. We are all ageing, some of us more quickly than others. I have just passed my 40th birthday, so I can honestly say I am ageing too, though perhaps not as quickly as some members of the Liberal Party would like.

Hon. Mrs. Smith: I would like to keep you young.

Mr. B. Rae: She would like to keep me young. I feel young on most days, though on some days I do not feel quite as young as I do on other days.

Seriously, this demographic --

Miss Nicholas: I’m not quite so young as I used to be.

Mr. B. Rae: I hear the member for Scarborough Centre (Miss Nicholas), who has just had a child, say she is not feeling quite as young as she used to either. She obviously is not sleeping every night. Welcome to the crowd.

Seriously, we are an ageing society. It has been said on many occasions, but the expense of ageing, the costs of ageing and the effects of ageing on our social services and health care system are, quite simply, enormous. These new technologies, combined with this demographic pattern, with this change in pattern in terms of who we are and where we come from, mean the health care system becomes more expensive.

I say to members who think this is a Canadian problem or an Ontario problem that it is not. Every single modern economy is faced with this challenge. None of us is exempt from it. No particular political party can say that if it were in power these problems would disappear. When the New Democrats form the government of this province, the same issues will be in front of us.

We will have new technologies and pressure for new technologies from across the board and these will have an impact on decisions we make in our health care system. We will be dealing with a population that will be getting older and will be requiring more care and attention. Again, as we live longer, the costs of our health care system even then grow and expand.

In agreeing that this government does not have the confidence of this House, I want to say to the minister that there are problems any society has to confront and any one of us has to deal with and recognize, and none of us should think the answers are easy. However, I think it fair to say that what the government has done has made things worse and that what the government has failed to do has made things worse. That is the test we have to apply.

The hard reality is that the minister has talked, since she assumed office, a very good game about wanting to have a well-planned, well-managed system. There is nothing planned or managed about our system at all. It simply exists and goes from crisis to crisis.

Hon. Mrs. Caplan: That’s why we want it better planned.

Mr. B. Rae: The minister says, “That’s why we want to make it better.” I can tell her we are getting a little tired of hearing her read from her cue cards of the need for a well-planned and well-managed system, when everybody I talk to in the system, whether it is a doctor, a nurse or a patient, feels the system simply is not as well planned and managed as it could be.

The minister may say, “Well, we are doing the best we can.” Let me give her two or three examples of where I think the government has failed miserably to deal with the growing problem.

The first is the nursing crisis. Again, the minister can give speeches saying: “The nursing crisis is not unique. It’s part of a problem of the realities facing women. It’s a sea change in terms of the role of women in our society.” All these factors are very true, but I want to say to the minister that I have not seen a government show less leadership on an issue than this government of the Liberal Party when it comes to the nursing crisis in Ontario.

When a Minister of Health cannot speak before a rally of hundreds of nurses, out because they are so mad at the minister and so mad at the government for failing to address their needs, that says something about the failure of government in, strictly speaking, human terms to translate what is a real problem into action from the government. The minister cannot point to one major change that has been made in terms of the pay, the treatment or the recognition of nurses as a result of her having assumed the ministry and of the Liberal Party having assumed the government of this province; not one thing.

We hear it said, purely and simply: “Well, this is a collective bargaining process. We’re going to let it operate.” I say to the minister that she does not need to lecture the New Democratic Party on the importance of the collective bargaining issue, but I also say to the minister that when you have a labour market problem, as we have, an enormous labour problem, when you have a labour shortage and when you have people voting with their feet, it is not good enough for a government to sit back and say, “We’re going to wait for two years, because there’s an agreement in place and there’s nothing we can do.”

The minister does not have to touch the collective bargaining agreement to deal with a housing supplement for nurses who are working in Toronto, if that is where she says there is a problem. She does not have to touch the collective bargaining agreement to deal with a transportation subsidy for workers in Toronto, if that is what she is recognizing as a problem. These are all things that can be addressed quite independently, quickly and effectively.

They can also be addressed quickly and effectively by a government that is at least prepared to admit what is obviously and objectively true, that there is a nursing crisis in the province and that it is the problem of nursing that lies at the heart of the crisis in institutional care. We all know, because of the role institutions play in our system, that when you back up in the institutions, the whole system begins to come apart. That is the stress we are seeing in the system today.

I have heard, as I am sure every member has heard, from literally dozens, indeed hundreds of constituents, friends and all kinds of people who will say, and say in the most powerful of terms: “I never realized the problem was so bad until I got sick” -- or my mother got sick, or my father got sick or my brother got sick -- “I never realized what the problem was until I was faced with it myself.”

Mr. Dietsch: That’s not true.

Mr. B. Rae: The member says, “That’s not true.” I can tell the member, sure, there are success stories, and sure, there are wonderful stories in terms of what goes on in our health care system, but I can say to Liberal members opposite that they know full well that when patients are stretched out into the corridor waiting four days for a hospital bed, as they are today in several of our hospitals just down the street from here, we have a problem on our hands.

This is a problem that is different from something we encountered five or 10 years ago. We cannot simply rely on the fact that the trends and statistics are there and nothing has really changed. There is a problem.

I say to the government that my major criticism of this government is that in response to this problem, there has been no basic change. There has been no institutional change. There has been no change in the direction of the system. There has been no change in the way in which the system is funded. There has been no change in the dir