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May 11, 2010

39th Parliament, 2nd Session

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Hansard Transcripts

Votes and Proceedings

Orders and Notices

Hansard Transcripts 2010-May-11 (PDF)

L030 - Tue 11 May 2010 / Mar 11 mai 2010

LEGISLATIVE ASSEMBLY OF ONTARIO

ASSEMBLÉE LÉGISLATIVE DE L’ONTARIO

Tuesday 11 May 2010 Mardi 11 mai 2010

ORDERS OF THE DAY

EXCELLENT CARE FOR ALL ACT, 2010 /

LOI DE 2010 SUR L’EXCELLENCE

DES SOINS POUR TOUS

INTRODUCTION OF VISITORS

WILMA KWINTER

ORAL QUESTIONS

TAXATION

TAXATION

TAXATION

PENSION REFORM

TAXATION

ONTARIO PROVINCIAL POLICE

NURSES

TAXATION

PUBLIC TRANSIT

STUDENT ASSISTANCE

WASTE DIVERSION

NURSES

TAXATION

CHILDREN’S AID SOCIETIES

PUBLIC SAFETY

ABORIGINAL AFFAIRS

PRESENTATION OF PETITIONS

DEFERRED VOTES

POST-SECONDARY EDUCATION

STATUTE LAW

AMENDMENT ACT, 2010 /

LOI DE 2010 MODIFIANT DES LOIS

EN CE QUI CONCERNE

L’ENSEIGNEMENT POSTSECONDAIRE

INTRODUCTION OF VISITORS

MEMBERS’ STATEMENTS

COMMUNITY FUNDRAISING

DAKOTA BRANT

HIGHWAY IMPROVEMENT

SCIENCE FAIR

ATTORNEY GENERAL OF ONTARIO

BREASTFEEDING

THE BRIGADOONS

ROYAL OTTAWA

MENTAL HEALTH CENTRE

LEADING WOMEN AND LEADING GIRLS,

BUILDING COMMUNITIES AWARDS

ANNUAL REPORT, INFORMATION

AND PRIVACY COMMISSIONER

REPORTS BY COMMITTEES

STANDING COMMITTEE

ON GOVERNMENT AGENCIES

INTRODUCTION OF BILLS

STUDENTS AGAINST IMPAIRED AND

DISTRACTED DRIVING DAY ACT, 2010 /

LOI DE 2010 SUR LE JOUR

DES ÉTUDIANTS CONTRE

LA CONDUITE INATTENTIVE

ET L’IVRESSE AU VOLANT

ENVIRONMENTAL PROTECTION

AMENDMENT ACT (INDUSTRIAL

FACILITIES), 2010 /

LOI DE 2010 MODIFIANT

LA

LOI SUR LA PROTECTION

DE L’ENVIRONNEMENT

(INSTALLATIONS INDUSTRIELLES)

BUILDING CODE AMENDMENT ACT

(STORM WATER HARVESTING), 2010 /

LOI DE 2010 MODIFIANT LA LOI

SUR LE CODE DU BÂTIMENT

(RÉCUPÉRATION DES EAUX PLUVIALES)

OCCUPATIONAL HEALTH AND SAFETY

AMENDMENT ACT (SCENTED

PRODUCTS), 2010 /

LOI DE 2010 MODIFIANT LA LOI

SUR LA SANTÉ ET LA SÉCURITÉ

AU TRAVAIL (PRODUITS PARFUMÉ

S) PETITIONS

GREENBELT

TAXATION

GOVERNMENT SERVICES

GREENBELT

SCHOOL CLOSURES

FULL-DAY KINDERGARTEN

ONTARIO PHARMACISTS

CHILD CARE

TAXATION

ONTARIO PHARMACISTS

DIAGNOSTIC SERVICES

WATER QUALITY

ONTARIO PHARMACISTS

REPLACEMENT WORKERS

TAXATION

TAXATION

OPPOSITION DAY

PENSION REFORM

ADJOURNMENT DEBATE

INJURED WORKERS

The House met at 0900.

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

Prayers.

ORDERS OF THE DAY

EXCELLENT CARE FOR ALL ACT, 2010 /

LOI DE 2010 SUR L’EXCELLENCE

DES SOINS POUR TOUS

Resuming the debate adjourned on May 4, 2010, on the motion for second reading of Bill 46,

An Act respecting the care provided by health care organizations / Projet de loi 46, Loi relative aux soins fournis par les organismes de soins de santé.

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

M me France Gélinas: It feels like it was a little while ago that I started the first 30 minutes of my lead, but I will pretend that everybody remembers exactly what I said and where I was at the time. For those of you whose memories are not right on, I’ll do a brief

summary of what I talked about.

We’re talking about Bill 46, the Excellent Care for All Act, and I started by saying that one of the issues covered in the bill is executive compensation; executive compensation will now be linked to a performance-based model. But what people were asking for, fundamentally, was a way to curb executive compensation. Back then, I talked about the $700,000 club that is made up of hospital executives in this province, and how this bill, although it talks about hospital executives, falls short when it comes down to setting a limit that people in Ontario feel is more reasonable.

I gave as an example our Premier, Mr. McGuinty, whose salary is $208,000 a year, and who manages the budget of the province, which is close to $100 billion, and then we have executives being paid $700,000 and $800,000, who manage a budget that is one one hundredth of Mr. McGuinty’s. So certainly the need is there to make a conscious effort to look at executive compensation, and the bill does not address this. It brings forward a new mode of payment—part of the compensation will be based on targets that are met, quality etc.—but it certainly does not address the salient point, which is to curb executive compensation and the growth of it.

If you remember, I was talking about the executives, whose salaries were already very high, who were the only ones who got a 7% increase last year, when I can’t think of any other group of workers that did in 2009. That was the first

part I talked about—I’m just trying to refresh everybody’s memory.

The second thing that is addressed in the bill: The bill talks about the transparency and accountability initiatives. Certainly, this is something we support at face value. The more transparency and accountability in our health care system, health care providers and health care institutions, the better it will be for all. One of the main requests of people when they speak to accountability is the right to have their complaints heard.

Most hospitals in Ontario have an excellent complaint department where, if you are not satisfied with the care you or your loved one has received, you go to a special department in the hospital and they look after you. They look after your complaint and follow through to make sure that a resolution comes to whatever has happened, whatever prompted you to bring this complaint forward.

I would say that it works well in hundreds of hospitals in Ontario; I was told that in some of them it does not work quite as well. But the main thing is that if this internal process fails, what people want is access to the Ombudsman. They want access to this independent third party who will investigate their complaints and bring them to a resolution. The bill does not allow that.

Right now, Ontario is the only province in Canada—the only one—that does not let its Ombudsman investigate complaints coming from its hospitals or other health care institutions. The Ombudsman has requested it, patient rights advocates have requested it, and here we have this Excellent Care for All Act that talks about the need for more accountability and we figure that Ombudsman oversight of our hospitals is finally coming. But it was not to be; it is not a part.

What they will develop is that they will make sure that what exists in most of our hospitals exists in all of our hospitals. To me this falls short, and it is an opportunity missed. The Ombudsman of Ontario already gets over 360 calls—people naturally call upon the Ombudsman to help them when the internal hospital process has failed them—but there’s nothing he can do, because he does not have jurisdiction. This bill could, and I hope will, be amended to give the Ombudsman jurisdiction over hospitals.

Another piece of accountability that would go a long way to ensuring transparency and accountability for health care institutions, including our hospitals, would be the freedom-of-access-to-information legislation. I know that Ann Cavoukian, the Information and Privacy Commissioner of Ontario, will be releasing her report a few minutes from now. I hope she will continue to recommend that hospitals be covered under freedom of access to information.

Everybody understands that private health care information will never be made available, no matter that you are covered under freedom of access. That’s not what we are talking about. We don’t want to know the particulars of a person’s personal life and of her health. What we want is access to what is going on in our hospitals. How is the money being spent? I’m not allowed to have information as simple as how much money was spent on consultants in my local hospital last year; nobody is allowed to have that information. Hospitals are not covered under freedom of access to information.

The Information and Privacy Commissioner of Ontario made a presentation to the hospital association regarding this. She called it The Best Way Forward. The Ontario Hospital Association now sees that freedom of access is an enabler, not a barrier. We now have the association on board.

We have our commissioner for information and privacy in Ontario who is on board and says that hospitals and other health care institutions should be covered under freedom of access to information, so that Ontarians have a right to know how the billions of dollars—we’re talking $42 billion for the health care system and close to $20 billion for the hospital system alone. Ontarians should be allowed to know how this money is spent, and this is what freedom of access to information for our hospitals would do.

Unfortunately, Bill 46, Excellent Care for All, talks about improving transparency and accountability but does not include freedom of access to information for hospitals. Here again, I hope we will see an amendment to this bill so that people who want to gain access to what is going on within those important pieces of the fabric of their community or community hospital will gain this access.

Certainly, I encourage everybody to look into the report that Ann Cavoukian, the Information and Privacy Commissioner, will be putting forward this morning. I know that her position is to make changes to the legislation so that hospitals are covered, and as of recently, the Ontario Hospital Association is also on board. They see that it is a good thing for Ontario and a good thing for hospitals; it brings accountability and transparency, and this will be something good. But here again, nobody is asking about looking into private health care files; we are looking at the running of our hospitals.

That was the second topic that I had talked about that had to do with accountability and transparency.

Then I had an opportunity to talk about the interprofessional advisory committee that will be responsible for the continuous quality improvement process. There is a lot to be achieved through a good continuous quality improvement process. This is how best practices are developed. This is how we learn and share, and this is certainly something that the NDP supports. But this is something that has been in place in our hospitals for a long time. I had given the example—25 years ago—I’m old.

Some 20 years ago I was working at our local hospital and I was a member of our continuous quality improvement committee back then. This committee is still in place. This committee has done some good work and will continue to do some good work. Those committees exist in most of our hospitals in Ontario. They are a link, they share good practices and they learn from one another. Is this something good? Absolutely. Is this a powerful lever for change? Absolutely. Is this something that already exists? Absolutely. So I fail to see the difference that this bill will bring.

There is one piece where they talked about the Ontario Health Quality Council being given an expanded mandate so that they can make recommendations regarding quality and best practices. Here again, this is something that we promote and this is something that we are willing to support.

I talked a bit about the experience in primary care, where last year—no, the year before—the health quality council really focused on primary care and on putting forward some of the best practices that exist in primary care. One of the key recommendations—according to me, anyway—is their recommendation for an interdisciplinary care model for primary care to better enable primary care providers to provide top-quality care for chronic disease management. Chronic disease management is everything that has to do with diabetes, high blood pressure, asthma, high cholesterol, and a list of—

Mr. Ted Chudleigh: On a point of order, Madam Speaker: I wonder if we could check to see if there is a quorum present.

The Acting Speaker (Mrs. Julia Munro): I’d ask the Clerk to check.

The Clerk-at-the-Table (Ms. Tonia Grannum): A quorum is present.

The Acting Speaker (Mrs. Julia Munro): Thank you. A quorum is present. The member for Nickel Belt may continue.

M me France Gélinas: I must say that it’s a little sparsely populated in here this morning.

Interjections.

M me France Gélinas: Can I continue?

The Acting Speaker (Mrs. Julia Munro): Yes.

M me France Gélinas: I’m talking about continuous quality improvement and how this is certainly something that the NDP supports. This is how you develop best practices, but you also have to go a step further. Once best practices have been identified, it’s not a one-off seminar that will make health care professionals change the way they practise. It has to be supported, it has to be implemented at the local level and it has to become part of the fabric of the health care institution.

Although we know the theory of it, I have yet to see in the bill anything that would lead me to believe that the levers will be in place in order for best practices to really show their full potential. Quality is a strong motivator. Everybody in the health care system wants to provide the best-quality care. The last thing you want is adverse consequences from the care that you provide. God knows that last year alone close to 24,000 Canadians died from adverse turns of events in our hospital system. We can do better than this. A way to do this is through continuous quality improvement.

So although, as I said, the Ontario Health Quality Council had given out best practices in primary care, they talked about the need to have interdisciplinary team models of care to improve levels of care in primary care—all of the same ingredients as they are talking about in their bills already exist in other parts of the health care system but have yet to turn into levers for change.

To me, the part that is missing is the part where those best practices are communicated and—I would go past “share”; they are really encouraged by all of the care providers. I don’t see this in the bill. So we could have the same thing that’s happening now in primary care. We know that the best way to take on chronic disease is through interdisciplinary care.

We have this family health teams model that is supposed to be the end-all of it all, but basically what we have with the family health teams is a whole bunch of physicians on an alternate payment plan with one or two what they call staff members—not exactly my idea of interdisciplinary care, where everybody works as part of a team and is a colleague.

If the family health teams were truly teams, then for the 10,000 or so physicians who have registered in this, you would see 60,000 other workers. We don’t see this. There are more physicians than all other health care professionals put together. That’s what I talked about when I talked about continuous quality improvement.

We had the health quality council do the research. They came out with the best practices; they were well documented; they even gave very good examples from Ontario. Did the government follow through and use quality as a lever for change? My answer to this is that it fell flat. There are some exceptions out there, and certainly I would say the community health centre model is an exception; and the aboriginal health access centres; and some of the community-based family health teams; and I would say our one and only practising nurse-practitioner-led clinic, which is something that I’m proud of.

By the way, this week is Nursing Week, Madam Speaker, so allow me to send some congratulations to the Sudbury nurse-practitioner-led clinic, which is presently expanding. They will be opening up a satellite site in the community of Lively soon. Their team is also expanding, where they will have a nutritionist and a social worker added to their team. To me, those are real interdisciplinary teams. People are colleagues; they work together; they work as a team to tackle the challenges of chronic disease management, which makes up the bulk of the work in primary care. So much more can be done.

But here again the model that is being put forward is a model that is known, that is trusted, that has been tried before, but the government always falls short of using it as a lever to go to the next step where it becomes implemented and where it becomes the norm.

Here again there is nothing in the bill right now that leads me to believe that continuous quality improvement will be able to do the powerful work it is capable of doing—that is, motivating a culture change—because the bill falls short on some of the levers that are needed to go from an idea of clinical practice guidelines and best practices to actual care on the ground where people practise.

The bill also talked about how it will make it mandatory for institutional health care providers to have a declaration of values. I agree wholly that nothing motivates an agency like a good set of values, a mission statement and a vision statement. This is your strategic goal. Everybody knows the direction that you want to go in if you have a good value system and a good mission statement. I would like to quote from the Sudbury Regional Hospital; their vision is, “Leading and innovating for excellence in patient care.” The message is clear: They want to be leaders and they want to be innovators.

We have a new CEO, Dr. Denis Roy, at the Sudbury Regional Hospital. He is certainly a leader and he certainly supports innovation and research. I could see that under his leadership and with the clear vision that they have given themselves, they will bring the hospital there. So I agree that vision is a powerful motivator for everybody who works within a health care agency.

They also have their mission, and anybody who goes on the Internet can see it. It goes as follows:

“As a regional hospital serving the residents of the city of Greater Sudbury and northeastern Ontario, we:

“—deliver high quality patient- and family-centred care, in both official languages;

“—provide reliable and timely access to care;

“—support the development of employees, medical staff, volunteers and students”—I may add that we now have medical students;

“—participate in research and the development and application of evidence-based practices; and

“—respond to changing needs and advocate for resources and services that promote health and wellness in the communities we serve.”

This is their mission. It is posted on their website and throughout the hallways of the hospital. It is a strong motivator. So for the bill to say that they will regulate or legislate a set of values for each and every hospital—I say that hospitals already do this. Sudbury Regional Hospital is very good. It’s a hospital that covers my riding. But the other 150 or so hospitals in Ontario are just as good. They have a vision statement. They have a mission statement.

I will now read the values from the Sudbury Regional Hospital. When I was talking about the mission, you noticed that the fourth point in the mission statement is “participate in research and the development and application of evidence-based practices.” This is the link to their continuous quality improvement. This is the link to the best practices that they are trying to develop and implement into their hospital already as we speak and that has been there for some time.

Here again I want to make the link that although the goal of the government toward a cultural shift is good, some of the levers to get there are yet to be defined and are certainly not in the legislation that we see. But a lot of what they’re talking about, the pillars of their reforms, are things that are already living proof. Sudbury Regional Hospital is certainly living proof that it is already taking place in our hospitals and other health care institutions here in Ontario.

I will go on with their values: compassionate care; our employees, medical staff, volunteers and students and their quality of work life; respect for diversity; teamwork, collaboration and partnerships; learning, research and professional development; wise use of our resources; accountability within an integrated regional system; a safe environment for our patients and all who work at Hôpital régional de Sudbury Regional Hospital; and open, honest and ethical communication and decision-making.

That is the set of values that has been put together and agreed upon by the entire family that makes up Sudbury Regional Hospital, and they are values that they live with each and every day. Are they powerful? Absolutely. Do they serve as a motivator? Absolutely. Are they new and innovative? I would say, probably not.

Hospitals have been working with sets of values for many years. The boards of directors have spent many a meeting talking about what sets of values are needed. So it’s a little bit hard to believe that in Bill 46, the Excellent Care for All Act, one of the pillars would be to develop values, when this is something that already exists, that has already done its work. I fail to see how it can do different work, given the length of time that it has been in place and given the success that it already has.

If you want to motivate a cultural shift away from the volume-driven hospital system we have now toward a quality-based system, I’m all for the shift. But the pillars that you have identified fail to have the levers necessary to motivate that shift and motivate that change.

The bill also talks about a number of other things. One of the other things the bill talks about is patient-based funding. Patient-based funding is something that never sounds good to anybody who comes from a northern or rural area. If you’re from remote Ontario, forget it; you should run away from this thing as fast as you can. Let’s make it clear: The more concentrated care you do, the better you will be and the better the outcomes. There’s no denying this. If you do 1,000 cataract surgeries every month, you will be very, very good at doing cataract surgeries.

You will have excellent outcomes; you will have excellent best practices. Nobody denies that. But that comes at a cost. This concentration of resources to drive those volumes comes at a cost of access to care. In areas like northeastern Ontario, we will never have the types of volumes that downtown Toronto or downtown Ottawa will have. But that doesn’t mean that we don’t deserve equitable access to care. Patient-based funding is always a trade-off between developing centres of excellence that deliver good care with good outcomes to a mass of people, versus access to care.

I want to give the example, one of many, that in Sudbury right now there is a long wait-list for hip and knee replacements, versus in Toronto where, within a maximum of four weeks, you can get a total hip replacement. What does that mean? It means that people in Sudbury who have the means—they can take the time off, they have the money to go to Toronto and pay for the hotel room, they have the physical strength to make the trip down—go down to Toronto and have the surgery done within four weeks. People who are too weak or too elderly, are in need of follow-up care or have higher needs don’t go to Toronto.

They stay in Sudbury and have very good-quality surgery done with good post-surgical care.

What does that do? It skews the population. The population that is mobile, high-level and high-functioning goes to Toronto and feeds a system of volume that provides very good care. Anybody who is not part of those big urban centres continues to provide very good care, but to a skewed population that is more frail, that needs more care, that needs more follow-up and that often has higher needs. So right off, you’re not competing equally.

The patient-based funding model has an opportunity to deliver good-quality care with good outcomes, but it comes at a cost. I want to make sure that the balance is always there. The cost will be paid by decreased access for people who live in northern, remote and rural Ontario, and this has to be taken into account.

The Ontario Health Quality Council just did a 12-community tour of rural Ontario, where hundreds of people came and gave testimony about the decrease in access to care—often hospital care, but sometimes community care—and the devastating impact it has had on their communities. At this point, you’re not talking quality outcomes; rural, northern and remote Ontario is able to deliver quality outcomes and care. What we’re talking about is how this shift toward centralization of care is to the detriment of access to care in northern, rural and remote areas and also comes with an awful cost to those communities.

We hear things like their now having difficulty recruiting primary care and more difficulty recruiting physicians. We hear about outpatient physiotherapy services being cut back. We heard about an outpatient diabetes management centre being cut completely or curbed back. All of those have an impact on the fabric of a small community.

A hospital is part of the community. People invest themselves in it; it belongs to them. It is part of their community and part of the social fabric of who they are. They’ve invested; they’ve donated. In lots of communities you see that the volunteers are the ones who plant the flowers, who decorate the hospital, who do the volunteer work in the wards, who do all those extras that make hospital care, if you have to go to the hospital, that much more, if not enjoyable, at least tolerable.

But what are we doing? We are focusing on outcomes and big centres, to the detriment of rural Ontario, and I’m very much afraid. Although the bill is very high-level when it talks about patient-based funding models and does say it will protect northern and rural areas, it doesn’t say how, it doesn’t say when and it doesn’t give any details. I want to be on record that if you live in northern, rural or remote Ontario, this bill, with its patient-based funding model, has the potential to do more damage to the fabric of rural and northern Ontario because of the important role our hospitals play.

I’m from the north, and hospitals are part of our community. I would say that they are often the heart of our community. And as their services get cut, as their opportunity to continue to offer high-quality services are curtailed, then the community suffers at all sorts of levels.

I wanted to talk a little bit about elder care, which is something that sometimes is labelled as alternate level of care in our hospitals. Certainly, for excellent care for all, this is something that this province has to address, and it has to address it swiftly and quickly. We all know that the population in Ontario is aging, and there is lots of good that comes with having our elders around and with having an aged population as part of our communities, to be there with us, to share their wisdom and just to share their company.

But they often need a little bit of help to do that safely in their community, in their own home. If you don’t do this, the possibility of elderly people ending up in trouble is very high. When they end up in trouble, the ultimate social safety net is always the emergency department of your local hospital.

I can give you an example in Sudbury. On Sunday, there were 28 people waiting at the Sudbury Regional Hospital in the emergency department. There were six cases that had to do with mental health that were looked after well, and out of the 22 left, 20 of them were over 80 years old. They were all people whose community-based services had failed them. If we continue to fail our seniors, if we don’t provide good-quality senior care, they end up in the hospital. We end up medicalizing the aging process, which is completely wrong.

Elderly people should be supported in their community, and the way to support them is not by high-tech medical care; it’s by basic social support. It’s to make sure that they have something to eat, somebody to clean the house, to shovel the driveway, to help them with their laundry, to check that they take their pills when they’re supposed to—basic things that have very little to do with what hospitals can offer. But those people, when all else fails, get picked up by our safety net, end up in emergency, end up in our hospitals and, sadly, end up labelled as an alternate-level-of-care patient.

An alternate-level-of-care patient does not get good care in the hospital. That’s not what they need.

I don’t believe that building more long-term-care homes is the way to go either. I believe in working upstream. I believe that we have to curb the number of seniors that end up in trouble in our hospitals. How do we do this? We do this by having a good home care system.

Our home care system is broken. Since the competitive bidding process has been put into place, we have seen the deterioration of our home care. Because home care is not there to support people, with respect and dignity, in their own home, elderly people end up in trouble, they end up in emergency, they get admitted into our hospitals, and they become an alternate-level-of-care patient. We must do better than this.

This bill is called the Excellent Care for All Act. I hope it includes the elderly. I want excellent care for elderly Ontarians. They deserve nothing less. They don’t need fancy and high-tech; they need to be supported in their communities. Here, again, what a great opportunity. I love the title: Excellent Care for All. One would think that that would include elderly Ontarians. They’re part of this province. According to StatsCan, they are the fastest-growing part of our community.

Why don’t we set out to give them good care? Why don’t we set out to bring back homemaking and to provide good-quality care, where the agencies that provide the care are able to recruit and retain a stable workforce? Because quality care comes by continuity of care, and that means continuity of caregiver. When you pay your workers 11 bucks an hour, you get 11 bucks an hour’s worth of care. That means that as soon as your other part-time job—because all of the jobs in home care are part-time—which pays $11.50 an hour calls you, you dump your shift in home care and you go to Walmart.

Well, this is not a way to protect and provide good excellent care to our elders. The way to do this is really to invest into upfront care, give good-quality elder care, and support them in their communities, and then our hospital system will do better.

I see that I only have a few seconds left. The Excellent Care for All Act is full of good ideas but short as to what will be the levers to get there, and also recycles a lot of what already exists, whether in continuous quality improvement, in best practices, in accountability, in transparency, or in description of values. They are pieces of the puzzle that will go toward excellent care for all, but the bill fails to give them levers that will allow us to go from nice clichés to actual care on the ground where the people will benefit, and hopefully excellent care for all will include the elderly population of Ontario. They deserve nothing less.

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

Mr. Bas Balkissoon: I’d just like to add a few comments to the input by my colleague across the way from Nickel Belt. I just want to remind my colleague that all of us recognize that the system has to change, the system has to improve, and we all have to work together to do this and make this happen. I respect the comments of my colleague on the opposite side, because she has extensive experience in the health care field and I think she brings a lot of good input to this particular debate. But I just want to raise some statistical data with regard to some of her comments.

She mentioned that the Sudbury hospital has a lot of the things that are in the bill already being done. But I want to clarify to her that the OHA suggests that less than 50% of the hospitals in Ontario have a formal declaration of patient values, and without that, the whole patient relations process also gets affected. So what this bill does is bring a uniform process across the entire province. It also makes the process very public, and when you make things open to the public, you will see improvements. Many of us will remember the wait-times strategy of the government.

As soon as it was posted on the Internet, we started to see improvements in the system. So I believe this bill will certainly bring the same results as we move forward with this change to improve our health care system.

The OHA also suggests that approximately 30% of hospital CEOs have at-risk, variable-compensation contracts. This bill will make it across the province and hopefully improve things. So we’re hoping —

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

Mr. Ted Chudleigh: The member from Nickel Belt of course has a great deal of experience in this area, being a former nurse. Are you still a nurse or are you a former nurse?

M me France Gélinas: I never was.

Mr. Ted Chudleigh: Oh, you never were.

Ms. Cheri DiNovo: Physiotherapist.

Mr. Ted Chudleigh: Sorry; I assumed she was a nurse. I know she had a lot of experience in the health care system and speaks to the bill from the point of view of a patient receiving that care, the care that they have received and the care that they might receive under this bill.

She raises a number of red flags concerning small northern hospitals and rural hospitals, as to where the quality of care will come from and how that quality of care will be delivered. I think it’s a well-known fact, certainly in the medical community, that the hospitals that do the most volume, the operations that get the most volume and the doctors who do the most operations of a particular nature get the best results. Given those criteria, in theory it would be best to send all your patients to the areas that get the highest volumes; therefore, we would get the best patient results.

That may not be very practical, particularly when it comes to northern and small rural hospitals. That would gut much of their services and it would make them very difficult places to practise medicine. It would make it very difficult for them to recruit doctors and nurses and would not lead to better care overall in that particular area. So that’s how the government is going to handle those situations when it comes to this bill.

There’s much in this bill to applaud. As the speaker mentioned, the devil is in the details. It’ll be interesting to see the regulations of this bill and how they take effect in Ontario.

The Acting Speaker (Mrs. Julia Munro): The member for Parkdale–High Park.

Ms. Cheri DiNovo: Certainly Ms. Gélinas, who is our member from Nickel Belt and our health critic, is one of the pre-eminent defenders of health care and patient care in this province. It’s always a delight to hear her speak, because she knows her subject matter so well.

A couple of the points that she made that I think are extremely important: Her bill, our bill as the New Democratic Party, to demand Ombudsman oversight of hospitals is critical. We’re the only province in Canada that doesn’t do that. There’s no excuse for that. We have a good Ombudsman, and we need Ombudsman oversight.

Her point about making hospitals transparent in terms of freedom-of-information requests about expenses: That’s a good point. That’s absolutely essential. That should be in place. That should be in this bill.

Her point about access to home care for our elderly population is also excellent. Far, far too many people use the emergency room as their primary care stop. That certainly happens in my riding all the time. People who don’t have access to a family physician—a lot of Ontarians, half a million or so, do not have access to a family physician. If they have something wrong, they go to the emergency room. This is ridiculous. This is an expensive way of delivering primary care. Certainly, it’s not a place for our seniors, who, as she pointed out, simply need long-term assistance to be able to live healthfully at home.

It’s interesting when you look at European examples. My husband and I were in Sweden. They do health care very, very differently. There isn’t the emphasis on the institutions. There is the emphasis on providing high-quality home care. It’s cheaper; it’s better; it’s more humane. Again, all of these points are made by our member from Nickel Belt and our health critic. Hopefully, the government will listen and actually give this bill some teeth so it does what it purports to do in its title.

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

Mr. Lou Rinaldi: It’s a pleasure to comment on the member from Nickel Belt. As I was listening—obviously, she understands the system. I was delighted to hear the member talk about some of the things that have happened in a positive way. I would say that things have happened since 2003. For example, she spoke very highly of nurse-led clinics. They do a great job. They are something that our government has certainly been very supportive of, that we’re rolling out that weren’t there before.

CHCs: I have a brand new CHC in my riding and one that’s going to come online. I tell you, that’s something that these communities have been awaiting for a long time. The one in Port Hope—the former government closed the hospital, they left them totally shut out, but we opened a CHC. The work that the CHC has undertaken in the last couple of years has been phenomenal.

Family health teams: The cluster of primary health care professionals that we’ve created since forming government is leading to those things that—I think we’re making some headway. I was delighted to hear the member acknowledge those good things.

In the some seven years that I’ve been in this place on the government side, in every piece of legislation—it doesn’t have to be health care—there are always comments from the opposition that we need to do better. I think we recognize that, but I think most people, even the OMA, has recognized that Bill 46 is the right step. We need to do more—absolutely—but recognizing the giant that health delivery is in this province is going to take some time, so I was delighted to hear her acknowledge those things. And yes, we need to do better; I do agree with her on that part.

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

M me France Gélinas: I’ll start by thanking the member from Scarborough–Rouge River, the member from Halton, my colleague from Parkdale–High Park and the member from Northumberland–Quinte West for their comments. The Excellent Care for All Act is something that is needed. It is something that puts the emphasis on quality, and I think quality has the potential to move and motivate a lot of change. I would have liked to see stronger levers in the bill to enact this change, but nevertheless, the focus on quality is certainly something that the New Democrats can support.

I’ll take this opportunity, this being Nursing Week, to again echo the member from Northumberland–Quinte West that certainly the nurse practitioners’ clinic in Sudbury, the first, is something to be proud of. It is a very innovative model, and they do really good work. I would say that people who have the opportunity to receive their care from nurse practitioners are always very satisfied and in awe. Nurse practitioners at the basis are nurses. They teach like a nurse; they communicate like a nurse; they are nurses, and people really appreciate the type of care that those health care professionals deliver.

So, hats off to all of the nurses. Happy Nursing Week. Bonne semaine des infirmiers et infirmières. They are an important part.

I have a few seconds to say that the bill also makes it mandatory to have patient satisfaction. I have the 2008 patient satisfaction survey from the Sudbury Regional Hospital. It is something that, through their continuous quality improvement, they have been doing. It is a worthwhile tool and it motivates change.

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

Mr. Ted Chudleigh: My goodness, I’m surprised that the government isn’t taking an opportunity to say a few words on this bill. You would think that, at the beginning of second reading, just after the leadoff statement, the government would really want to talk about the attributes of this bill. It’s actually—coming from this government—not a bad bill. Of course, the devil may still be in the details. And as did the former speaker, I would also like to supply my congratulations and profound thanks to the nurses in this province who have made nursing a career and deliver so much of our health care system to the patient.

Having spent some time in a hospital last year with a hip replacement, I can attest first-hand to the fact that nurses in our health care system in this province certainly deliver the kind of health care that I think we all want and we feel that Ontarians should deserve. It’s delivered by the nurses. The doctor does the operation but the nurses make your stay in the hospital as comfortable as it can be and deliver the kind of care, the TLC, that is so important in people recovering their health.

This bill has a wonderful title: Excellent Care for All Act. It’s hard to argue against a bill that has “Excellent Care for All Act” as its title. This bill has three major objectives: The first is to change the funding model for health care organizations. Changing the health care model for health care organizations is a laudable goal but one which brings a few concerns.

I think the government would be wise to be aware of some of the pitfalls that something like that may have, one of which is that if you’re going to change the funding model for health care organizations, these organizations have to reinvent themselves. And whenever organizations reinvent themselves, particularly government organizations, the first thing they do is a study as to what they look like now, what they should look like in the future and how that transition will take place.

Of course, that study may be done internally, but more and more we see from this government, as we saw in the eHealth scandal—where $1 billion were spent on advisers and consultants who delivered very little. I think the government should be very much aware that those abuses can occur when changes are made.

I’m sure that the Courtyard corporation is reading everything that comes out concerning this bill and are putting their minds to how they can serve—in their minds, I’m sure they’re serving—this transition and how that might improve their bottom line. Let’s face it; that’s what they’re most concerned about: their bottom line.

I would suggest to the government that when we are changing the funding model for health care organizations, we be very much aware that the number of dollars that are dedicated to health care in this province are finite, and that those dollars that go to consultants come out of front-line health care workers. And the more dollars that come out of health care workers, the more the title of this bill, Excellent Care for All, is going to be held in ridicule.

We should, if the funding model for health care organizations is to change, make sure that the change is done in as effective and as efficient a form as can possibly happen. I can tell you that your track record is not good in this area, so I think it requires some additional focus in making sure that those things come to pass.

The second goal of this act is an increased emphasis on continuous quality improvement as a means of reducing costs and improving patient outcomes. Just a small aside: I’d like to see those two reversed. I’d like to see patient outcomes highlighted as being the most important thing in health care, and that, secondly, we control or reduce costs.

The increasing emphasis on continuous quality improvement, from what I’ve read in this bill—the concern that I would have in that area is that continuous improvement seems to focus on the organization that is doing the delivery of care: a hospital; long-term-care beds; or a LHIN, a local health integration network. It does not seem to compare the costs of quality improvements between hospitals: Which hospital is doing this function in a more efficient manner, delivering better patient care and getting the patient out of the hospital quicker and in a healthier state? Which hospital is achieving that?

This point seems to focus on how this happens within a hospital, not how it happens between hospitals. I think the comparison between hospitals sets up the competitive nature of the human species, and I think that would drive patient care much better than the internal nature that seems to be the emphasis of this bill. I’m sure that, again, the devil is in the details. Let’s see what the regulations say when it comes out. But I think that a comparison between hospitals would be a very important one to improving patient outcomes and patient results—leaving hospitals faster and healthier.

Thirdly, this bill focuses on evidence-based guidelines and best practices that health care organizations should adopt. Again, it’s a laudable goal, and one which I only wish this government might have taken up much earlier. This whole bill is based on recommendations made in a report by the Ontario Hospital Association that was submitted to the government in 2004. That’s six years ago.

These kinds of things have been introduced in England, Australia, other countries in Europe and some parts of the United States. In every single case, they have improved quality and reduced costs to varying degrees, depending on how they’ve been implemented, how it’s been run and how much money is available to accomplish those goals.

We could have been six years down the road on this, but this government sat on that report from 2004 until 2010, until we finally have it in the form of a bill. That’s a lost opportunity, I think. This government should have been a little more focused on improving quality of care in Ontario.

Let me say, first of all, that the PC caucus, under the leadership of Tim Hudak, is in full support of the concept of full transparency and accountability in health care. Again, those are laudable goals that this government espouses to support: transparency and accountability.

I would have to point out that your track record doesn’t lend itself to a great deal of faith in those areas. Transparency and accountability: If we look at the eHealth scandal, it was one billion front-line dollars that didn’t go to patient care, did go to consultants and delivered precious little when it came to the end results. That was not transparent; it was certainly not accountable.

Recently, we’ve seen a large number of consultants being paid—that we’ve been able to identify, anyway—somewhere in the order of $200 million, being financed through LHINs to consultants, to find out how to do things better, supposedly. Those are all laudable goals. But again, those are health care dollars that are coming off the front lines and going to consultants.

Health care dollars are finite. They’re limited. The budget for health care is only this much: about 50 billion bucks, which is a fair chunk of change, but it is limited. To spend those precious dollars on questionable consultancies I think needs a careful look, especially given this government’s record in that area.

Before having the same expectations—this government would like to have expectations of our health care organizations of delivering transparency and accountability—it would be reassuring to the people who are going to carry out these laudable goals in the health care system if this government got their own house in order and started practising some of that transparency and accountability that they are expecting of others.

A number of times we have requested information from this government and been turned down, only to get it through freedom of information, and found our worst fears: that things are not as they should be. If a government was truly transparent and accountable, those things would be available not only to the opposition but also to the public so that Ontarians know where their money is being spent. With this government’s record over the last seven years, there are serious questions about how Ontarians’ hard-earned tax dollars are being spent by this government.

We also agree with the underlying principles of the bill but would ask for full committee hearings so that we can understand how those principles will be translated into action and how the health care providers of this province will be asked to deliver on the Excellent Care for All Act.

If we look at the bill’s

summary, the health care organizations in Ontario—most of the general public, I think, thinks about public hospitals, but the other organizations would be long-term-care organizations and facilities, along with doctors’ offices, along with distribution of medicines, drugs. Each of these organizations, under this bill, must establish quality committees which will report to its responsible body.

The responsibilities of the quality committee include reporting on the overall quality of service, recommendations to improve quality, ensuring that best-practice information supported by available scientific evidence is translated into the distribution and monitoring of materials used in the health care organization, preparation of annual quality improvement plans, and/or other responsibilities provided for in the regulations.

That’s a lot of red tape, I would say, and I don’t see very much in there. I see a lot in there that is going to take up a lot of time of organizations. I see a lot of money going into the organizations in the form of consultancies, in the form of overtime pay, perhaps, or additional time spent in developing and providing this information. I guess it depends.

I would suggest that the patient is missing or is certainly not front and centre in that whole paragraph on what this bill purports to do. The patient’s recovery, the quality of that recovery, and the speed of that recovery is what I would say would be paramount in this process. I would certainly like to see it emphasized more in the outline so that when it does come to fruition and take effect in our health care organizations, the patient is the one who is focused on.

One of the other tenets seems to be that they are going to collect information concerning the satisfaction of patients, caregivers, and employees with the services that they have been provided; again, a laudable term. I might suggest that not too much emphasis should be placed on that area. As I recovered from my hip operation, I was in the hospital for, I think, four days. I was well cared for. The nurses were all very nice. I was pleased to get out; I was pleased to walk out of the hospital. I was walking the morning after the operation. It was amazing how quickly they get you up.

That’s a statement, I think, on how talented the surgeons are. When they put you back together, you’re in pretty good shape, and that’s a talent that certainly has been emphasized and developed over the last 20 or 30 years.

But the patient’s satisfaction is not necessarily a good measure. I think the patient’s speed of recovery in comparison to other patients, his speed and quality of recovery in comparison to those within other organizations, other hospitals, and, if it’s possible, to compare that speed of recovery and the quality of that recovery to other countries and other places where that same medical care is being provided, is the true measure of the quality of care that a patient receives.

I would have put my care down as “excellent” in almost every category, but I don’t know whether the average patient in another hospital got out in three days, got out and was able to manoeuvre better than I could at the end of a week, or at the end of four days, when I did leave the hospital. I don’t know that. I am not the best one to give a quantitative statement on how well I was performed on in that hospital. I was very satisfied, very happy. But that may not be the best way to measure a successful operation. So I would caution the government on going down that road too far.

It also says that, “Every health care organization”—hospital, doctor’s office, perhaps, or long-term-care facility—must have a publicly available “patient relations process,” so that a patient, if they feel something is wrong—and most times when something is going wrong in the hospital, the patient is one of the first people who knows about it, or the patient’s family. So I do think this one is very important, in that a patient must have access, when they are feeling that their recovery is not going as they would have expected, when their family or caregivers feel that they are not responding the way they should.

Sometimes, if they’re being well monitored by their family, if they’re cognizant of what’s going on around them, in many cases they are the first ones to know, and there should be some way for that to be translated to the medical staff. So I like this tenet of the program, that every health care organization must have a publicly available patient relations process.

Also, “Every health care organization” must have, within 12 months, a “patient declaration of values” developed in consultation with the public. Courtyard, are you listening? Every health care organization must have, within 12 months—there’s a time limit on it. Boy, we haven’t got time to do that; let’s hire a consultant to do that for us. That just reads, “Consultants, let’s go. Here you go; here are some bucks.” I see consultants all over this one, and I’m sure Courtyard is listening.

There are 150 or so hospitals in Ontario; there are 14 to 16 LHINs; I don’t know how many long-term-care facilities there are in Ontario. They all need to have, within 12 months, a declaration of values developed in consultation with the public. Boy, that’s a lot of work. That’s a lot of consultants’ fees. I’m not sure why they have to have that within 12 months, and I’m not sure what a patient declaration of values is, but the consultants will know that and they’ll develop just a wonderful report for you. I don’t know why—

The Acting Speaker (Mrs. Julia Munro): Thank you. The time has expired.

Second reading debate deemed adjourned.

The Acting Speaker (Mrs. Julia Munro): I would just say that this House stands recessed until 10:30 of the clock.

The House recessed from 1013 to 1030.

INTRODUCTION OF VISITORS

Mr. Bob Delaney: I have the distinct privilege of introducing, in the east members’ gallery, Mr. Snehal Avashia of Ahmedabad in Gujarat, India, a consultant to the Gujarat pharmaceutical sector, representing Eris LifeSciences; and my good friend Mukund Purohit of Scarborough, president of the Ontario-based Gujarati Business Association and my host recently during a wonderful eight days in India, mostly in the state of Gujarat. They’re visiting from Ahmedabad, a city of about the same population as New York City in the vibrant Indian state of Gujarat.

Mr. Wayne Arthurs: I’d like to introduce some guests, both on behalf of myself and the member from Ajax–Pickering, Joe Dickson: Shannon Corby and her son Andrew, of Ajax; Julie Gatley and her daughter Katherine, or Kate, from Claremont; Jillian Daffern and her daughter Katherine, or Katie, from Ajax; and my constituents from Pickering–Scarborough East, Claire van Dam and her daughter Alison, or Ali, both from Pickering.

Mrs. Liz Sandals: I’m pleased to introduce the family of page Rhett Figliuzzi: Rhett’s father, Rob Figliuzzi; his mother, Cheryl Figliuzzi; his brother, Quinton Figliuzzi; his sister, Haley Figliuzzi; and his grandparents Bruno and Diane Figliuzzi.

Hon. Sophia Aggelonitis: If I could, I just want to wish my dad a happy birthday. He’s probably watching at home, and I just want to say: Happy birthday, Dad.

The Speaker (Hon. Steve Peters): Visiting Queen’s Park today from the riding of Elgin–Middlesex–London, I’d like to welcome to the Speaker’s gallery Dan and Ann Marie Thompson and Dan Thompson Jr. Welcome to Queen’s Park.

We have with us today in the Speaker’s gallery senior staff members of the public relations department of the Parliament of Ghana: Miss Kate Addo and Mr. Prince Adu, and they are accompanied by the Consul General of the Republic of Ghana at Toronto, Mr. Kodjo Mawutor. Please join me in welcoming our guests to the Legislature today.

WILMA KWINTER

The Speaker (Hon. Steve Peters): I’d ask for the attention of the members. Last night, a good friend of all of us, Mrs. Wilma Kwinter, the wife of member Monte Kwinter, passed away. I’d like all members and our guests to please rise as we observe a moment of silence in memory of Wilma Kwinter.

The House observed a moment’s silence.

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

I would just say to the member from Renfrew–Nipissing–Pembroke, I’m very glad that everything worked out so well for your son and that it made for a great Mother’s Day for your wife.

There being no further introductions, it is time for oral questions.

ORAL QUESTIONS

TAXATION

Mr. Tim Hudak: My question is to the Premier. Premier, why did you say that the HST would be revenue-neutral for Ontario families when you knew all along that families would be paying more? Don’t you think you owe an apology to taxpayers in Ontario for saying that now for some nine months?

Hon. Dalton McGuinty: I think my honourable colleague knows full well that we’ve always talked about our package of tax reforms and how important it is to view this in a thoughtful, intelligent and comprehensive way. We’re talking about a package of tax reforms.

More good news today: The Conference Board of Canada is reporting that the Ontario economy has emerged from the recession. It will sustain rapid, real GDP growth. We will lead Canadian provinces with growth this year of 3.8%, and next year 3.7%. They attribute a lot of the success to our tax reforms.

Interjections.

The Speaker (Hon. Steve Peters): Order. Member from Lanark. Member from Nepean.

Supplementary?

Mr. Tim Hudak: Up until two weeks ago, the cornerstone of your pitch for your HST tax grab was “revenue-neutral.” You yourself, Premier, made that claim six times here in the House, and your cabinet ministers and caucus said it several times more. But you had a sudden change of heart and change of line last week when you finally admitted, and shocked your own caucus by admitting, that you knew all along that, “There will be an increase in taxation.”

Premier, why did you do this for nine months? Why did you lead Ontario families down a certain path for nine months? Doesn’t it say something about what has happened to the character of the Premier after six and a half years in office that you led people along on this untrue statement for nine months?

Hon. Dalton McGuinty: Again, I think my honourable colleague knows that what we have been saying—and once again, I simply want to acknowledge that moving ahead with this important public policy, moving ahead with this tax reform, would not have been possible without the support of the Conservative Party, and I want to thank them again. I want to thank Mr. Flaherty. I want to thank Ms. Ecker. I want to thank Mr. Baird. I want to thank Mr. Clement. I want to thank Mr. Harris. I want to thank Senator Runciman. I want to thank all those Conservatives who stand four-square behind this important policy initiative.

They know what this means to Ontario families. More than anything else, it means jobs for them and jobs for their children in the future. That’s why they stand behind it. Again, I thank the Conservative Party for standing in support of this initiative.

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

Mr. Tim Hudak: You have to wonder what has happened to Dalton McGuinty after six and a half years in office. For some nine months, this Premier stood in the assembly and out in the general public and said that his HST was going to be revenue-neutral. And then finally, when confronted with the facts that we’ve been bringing across the floor for some nine months, the Premier finally admitted that his HST was going to be a tax grab on the backs of Ontario families. But, Premier, you knew this for some nine months. You knew this all along, and yet you continued to say things that you yourself knew were not in keeping with the facts.

I ask the Premier: Why should Ontario families respect the word of the Premier when he has no respect for the facts himself?

Interjections.

The Speaker (Hon. Steve Peters): Order.

Premier?

Hon. Dalton McGuinty: With so much vigour, vitality, enthusiasm, and bravado, you would think that the party opposite would be firmly committed to rescinding this provision should they form the government. But they’re not going to. They’re not going to because they understand that they have this kind of provision in place in 140 other countries. They understand that our export-based companies here are operating in a highly competitive global economy with one hand tied behind their back. They understand that we’ve got to free up our businesses and make them more competitive. We’ve got to put them in a position so that they can create—

Interjections.

The Speaker (Hon. Steve Peters): Order on both sides.

TAXATION

Mr. Tim Hudak: Back to the Premier: Before his moment of cleansing honesty, Dalton McGuinty was far from forthright when it came to his plans to increase taxes on Ontario families. Premier, I remind you that in 2003, you actually took an oath where you pledged, “I will not raise taxes or implement any new taxes without the explicit consent of Ontario voters.” And we now see, some six years later, Dalton McGuinty back to his old tricks, where for nine months you said that the HST would be revenue-neutral and then finally admitted that it’s a tax grab on Ontario families.

Sir, you don’t care about Ontario seniors. You don’t care about Ontario families. You don’t even care about the Ontario Liberal caucus. All you care about is Dalton McGuinty himself. Why should we believe a word you say anymore?

Interjections.

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

Interjections.

The Speaker (Hon. Steve Peters): I think we’re going to have to turn the heat back down again. It was a lot cooler and calmer in here.

Premier?

Hon. Dalton McGuinty: I’ve been reading some stories lately about—

Interjection.

The Speaker (Hon. Steve Peters): The member from Cambridge: I just sat down and you just opened up.

Mr. David Zimmer: Throw him out.

The Speaker (Hon. Steve Peters): No. I can throw the member from Willowdale out, if he would like.

Interjections.

The Speaker (Hon. Steve Peters): Order.

Premier?

Hon. Dalton McGuinty: Perhaps it’s understandable why members of the Conservative Party of Ontario are raising questions and expressing doubts: They are “confused,” to quote them, about the position taken by their leader. They’re wondering why, if they are so adamantly opposed to the HST—why are they not prepared to rescind that provision? I want to answer that question for them, and I want to answer it again. The fact of the matter is that this provision is supported by the Conservative Party.

This would not have been possible without the support of Prime Minister Harper; Minister Flaherty; Minister Baird; Minister Clement; the former Minister of Finance, Janet Ecker; and the former leader of the party, Mike Harris. Together, we know that this is the right thing to do for our province. It’s the right thing to do for our economy—

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

Mr. Tim Hudak: This speaks to what has happened to your character after six and a half years in office and the tarnish that you have brought to the office of the Premier in this great province.

Dalton McGuinty promised he’d close down the coal plants by 2007. You did no such thing. You promised to stop housing development on the Oak Ridges moraine. You did no such thing. You even broke your promise to parents of autistic children in the province of Ontario, and shame on you, Premier, for doing that. You promised to freeze hydro rates, and now they’re going up some $350 this coming year alone. The health tax is $900 a year, and now your HST tax grab will take a big bite out of the pockets of Ontario families.

Why is it, Premier, that Ontario families pay the price for each and every one of your broken promises?

Hon. Dalton McGuinty: My honourable colleague says that he’s concerned about the impact of costs on our families. If that’s true, why does he oppose our new tax cut for Ontarians that took effect on January 1? Why does he oppose our efforts to reduce drug costs for Ontario families? Somewhere between two million and three million Ontario families pay for their drugs out of pocket. We want to reduce those costs by up to 50%. He opposes that. Why does he oppose our new Ontario sales tax credit of $260 every year for every member of the family? That’s going to benefit three million Ontarians.

Why does he oppose our Ontario property tax credit of $250 for non-seniors and $625 for seniors? Again, three million Ontarians will benefit. Why is it that every time we move to reduce costs for Ontario families, they stand in the way of those efforts?

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

Mr. Tim Hudak: Premier, here’s your problem: Nobody believes you anymore. In 2003, you said you wouldn’t raise taxes, and you raised them up to $900 a year. In 2007, you tried to—

Interjections.

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

Continue.

Mr. Tim Hudak: In 2007, you tried that trick again. And you brought in your HST sales tax grab. You didn’t have to pay severance to the HST tax collectors. You knew you didn’t, but you went ahead anyway. He claimed the HST would be revenue-neutral when, for nine months, this Premier knew that that wasn’t true.

I’ll ask you, Premier: Why do you keep saying one thing and doing another? Is it because you’re addicted to taxes, or you just can’t help yourself anymore?

Hon. Dalton McGuinty: I want to, once again, just seize this opportunity to thank the Conservatives for the support for the HST—

Interjections.

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

Premier?

Hon. Dalton McGuinty: As I was saying, I want to, once again, thank the Conservative party for their continued support for this initiative.

I want to thank the leader of the official opposition, who said, “To be clear, I believe that there’s little sense in allowing two separate governments to apply two separate sets of taxes and policies and collect two separate groups of sales taxes.”

Also, I want to thank him for the following statement, where he said, “The problem with the PST is it cascades, so every step along the way there’s a tax on tax on tax, which raises the cost of goods and particularly punishes exporters. So we understand how [a harmonized sales tax] can help the economy.”

I want to thank him above all for his unwavering commitment to keep the HST in place. I want to thank him for that, not only on behalf of our businesses but on behalf of our families, who are counting on us, together, to do everything that we can to strengthen this economy and create 600,000 more jobs.

TAXATION

Ms. Andrea Horwath: My question is to the Premier. Over the past 10 days, New Democrats have detailed the true cost to Ontario families of the McGuinty government’s HST. The Premier has repeatedly questioned our numbers, but he refuses to release his government’s own numbers. I want to give the Premier another chance. Will he finally get up in this House and tell Ontario families how much his government expects the HST to cost them?

Hon. Dalton McGuinty: We have the benefit today of yet another independent source that has reviewed our economic policies. I’ve spoken to my colleague in the past about the Canadian Centre for Policy Alternatives, which labelled their study Not a Tax Grab After All.

Today the Conference Board of Canada reports the following: Ontario households will also “benefit from income tax cuts and from temporary sales tax transition benefits as the province moves to harmonize the provincial sales tax system with the federal goods and services tax (GST) in July 2010.”

This is yet another independent third party—another independent source—passing judgment on our tax reforms and saying that we are about to lead the country in terms of economic growth because of the policies that we have in place. It would be nice to have the honourable member’s support for these kinds of initiatives that move Ontario to the front of the pack once again.

The Speaker (Hon. Steve Peters): Supplementary?

Ms. Andrea Horwath: Yesterday we revealed that the McGuinty government’s HST on gasoline will cost families with kids $232 a year—that’s nearly $900 million out of already stretched family budgets. Not long ago we released government documents showing that the HST on hydro and home heating will cost families $225 a year. How big of a bite will the Premier’s new tax on utilities take out of Ontario family budgets?

Hon. Dalton McGuinty: Again, we were very careful, in terms of putting forward these tax reforms, to ensure that we provided additional supports to our families. So in addition to the personal tax cut that took effect on January 1 of this year, we also have a new Ontario sales tax credit of $260 every year for every member of the family, which will benefit three million Ontarians. We also have an Ontario property tax credit of $250 for our non-seniors and $625 for seniors, benefiting three million Ontarians. We also have a senior homeowners’ property tax grant of $500.

We also have a new northern Ontario energy credit of $200 per family. We have worked very hard to ensure that we take into account those needs and those concerns of our families in their homes.

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

Ms. Andrea Horwath: Since the Premier continues to stubbornly refuse to give Ontario families the real story on the HST, New Democrats will do it. Using Statistics Canada’s economic model, we’ve run the numbers and have calculated the impact of the Premier’s new tax on utilities on family budgets. The total: $877 million, plus another $900 million of gasoline tax. When was the Premier actually planning to tell Ontario families that his new tax on gasoline, on home heating and electricity combined, altogether is going to cost them almost $1.8 billion a year?

Hon. Dalton McGuinty: I’ll ask the honourable member to forgive me, but I just bring a healthy dose of skepticism to the numbers that they choose to concoct here on a daily basis now. But I do have continuing confidence in independent third party sources. I have confidence in the University of Calgary and its assessment that our tax reforms will create 600,000 more jobs, and confidence in the Canadian Centre for Policy Alternatives, which said this is not a tax grab. I have confidence in today’s Conference Board of Canada report that says our tax reforms will move us to the front of the pack when it comes to economic growth.

I would counsel my colleague to take a long, hard look at independent sources when it comes to understanding the impact of our policies on Ontario families.

PENSION REFORM

Ms. Andrea Horwath: My next question is also to the Premier. This week marks an important milestone in the historic debate over the future of retirement incomes for the people of this province. Later today, this Legislature is going to debate an NDP motion calling for the creation of a public defined benefit pension plan that would provide workplace pensions to any Ontario worker who wants one. When the vote on our motion takes place this afternoon, will the government members be voting aye or nay?

Hon. Dalton McGuinty: First of all, I want to acknowledge the positive, constructive efforts being made by the New Democratic Party here in Ontario when it comes to this particular issue.

As I said before, this is a matter for debate, and members will vote as they see fit.

I do bring a slightly different perspective to this particular issue. I think it’s important that we keep our minds open not only to public solutions for this national challenge, but also to private sector solutions. Beyond that, I think we need to be open to a national response, which is why we continue to find ways to work with the federal government and other Premiers from around the country.

The Speaker (Hon. Steve Peters): Supplementary?

Ms. Andrea Horwath: Later in the week, there’s going to be another test of the McGuinty government’s position on the future of retirement income for Ontarians. On Thursday, the insurance industry gets their say in the form of a private member’s bill sponsored by the Liberal MPP from Peterborough. Some $8.4 billion worth of fees are already being taken from the retirement savings of Canadians and put into the coffers of banks and insurance companies. The bill sponsored by the member from Peterborough would enable these same banks and insurance companies to pocket billions and billions more of retirees’ money.

When the vote is recorded on Thursday on this blatant cash grab, how will the members of the McGuinty government be voting?

Hon. Dalton McGuinty: I also want to take the opportunity to thank the member from Peterborough for his positive contribution to important public policy debate.

I think it’s unfair and simplistic to make the assumption that somehow the solution is going to be found exclusively within either the public realm or the private realm. I just don’t think we enjoy the luxury of dividing up the world into black and white in that way. I think we’ve got to keep an open mind on these things, and I think what we’re going to witness is an important debate here and, perhaps in some sense, a collision of ideas. But I think the ultimate beneficiaries will be the people of Ontario.

We look forward to both of these debates. We’re going to keep an open mind, and we’ll bring everything that we’ve learned to the national forum, where we think we can, working with the federal government, find a national solution.

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

Ms. Andrea Horwath: Exactly: In a few weeks Canada’s finance ministers will be gathering to decide upon the future of retirement savings in this country, and despite repeated attempts by New Democrats to get an answer, no one knows where the McGuinty government stands. With our Ontario retirement plan proposal that we put forward, we’re on the side of public defined benefit pension plans. That’s where New Democrats stand.

I’m going to ask the Premier one more time: With decision day looming, with this upcoming ministers’ conference, which side is he going to be on—on the side of banks and insurance companies, or on the side of Ontarians?

Hon. Dalton McGuinty: Public is not always best. I would gently remind my honourable colleague that they decided in government that public auto insurance was not the best approach, and they backed away from that.

To restate what I said a moment ago, there’s an important debate that can, should and must take place, and we’re going to witness some of that here in this Legislature. I think that’s a good thing. We’ll benefit from that, and that will better inform the representations we make on the national level, when we’re working with the federal government and our counterparts from across the country.

There is surely one thing on which we can all agree: The status quo is not acceptable. There are going to be too many seniors in their retirement years who will have inadequate levels of support. Our shared responsibility is to find a solution, and we look forward to doing that.

TAXATION

Mr. Norm Miller: My question is for the Minister of Finance. Minister, in leading off debate on the HST in November of last year, you denied that this was a tax grab, before adding, “The effect is revenue-neutral.” But then Premier McGuinty admitted that the HST will be a major tax increase for Ontario families when it comes into force in just 51 days.

Did the Premier’s about-face surprise you as much as his flip-flop on sex education caught Minister Pupatello off guard?

Hon. Dwight Duncan: The government’s position has been clear and unequivocal that not only is this not revenue-neutral—in fact, even in the original documents we printed, when you look at the total tax relief package, the total tax relief package, including the proposed measures announced today, would reduce Ontario revenue by $3.4 billion over the first four years, net of federal assistance of $4.3 billion.

We put together a tax package that, again, the conference board today reaffirms will help drive job growth, will help drive increasing incomes and will help drive capital investment. It’s the right policy for Ontario. We’re delighted to have the support of the federal Conservative government on this.

It’s time to move to a bigger and stronger economy. This policy will help us do that.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Norm Miller: The minister has already increased taxes on the corporate tax, small business tax and income tax, and now he’s lowering them a little bit.

The Premier has a bad habit of hanging his ministers and caucus out to dry while they are defending a policy position that he has abandoned. He did it to Minister Pupatello and now he’s doing it to you. He used to say that the HST is revenue-neutral. Now Premier McGuinty admits that the HST will be a big tax increase for Ontarians. While you maintain the HST is revenue-neutral, the Premier admits that it will have a cost to Ontarians. He said that Ontarians should see tough economic measures like the HST as a kind of sacrifice.

Minister, did you know that the Premier was planning on contradicting you? Or were you just as surprised as the Minister of Economic Development and Trade?

Hon. Dwight Duncan: The Premier of Ontario has taken the tough decisions to create jobs, to create investment and to create growth in the Ontario economy. The only member who is inconsistent in this whole debate—and by the way, our corporate tax cuts will make us the most competitive tax jurisdiction in North America, according to their witness.

Let’s talk about consistency. Why did that member say, on February 25, that you’re in favour of those reductions for small business and corporate tax rates? You know they’re the right steps to take. You know they will create jobs, just like Mr. Flaherty, just like Mr. Baird, just like Mr. Clement, just like Mr. Harper, just like Mr. Tory, just like the experts. This is about a stronger economy with more jobs for all Ontarians.

ONTARIO PROVINCIAL POLICE

Mr. Peter Kormos: To the Premier: Why is Julian Fantino still the commissioner of the Ontario Provincial Police even after the Attorney General’s own lawyers say that Mr. Fantino is breaching

section 113 of the Police Services Act?

Hon. Dalton McGuinty: To the Minister of Community Safety.

Hon. Rick Bartolucci: First of all, let’s correct what the member said. The Ontario government has not taken a position. The Ontario government would not take a position when a matter is before the courts.

Julian Fantino is still the commissioner because we have all the faith in the world in his ability to make operational decisions.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Peter Kormos: This is a very serious matter. It’s about public confidence in our police. Four lawyers from the Ministry of the Attorney General, one of them very senior, say that Mr. Fantino has violated

section 113 of the Police Services Act. This is tantamount to an obstruction of justice. If Mr. Fantino doesn’t have the decency to resign, why doesn’t this government have the guts to just fire him?

Interjections.

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

Mr. Mike Colle: I withdraw.

The Speaker (Hon. Steve Peters): Minister?

Hon. Rick Bartolucci: To the Attorney General.

Interjections.

The Speaker (Hon. Steve Peters): Stop the clock. The member from Hamilton East and the member from Eglinton–Lawrence: If you have a disagreement, take it outside this chamber. I don’t need it interrupting the proceedings.

Interjections.

The Speaker (Hon. Steve Peters): Order.

Attorney General?

Hon. Christopher Bentley: The SIU is an independent agency. It acts independently of the government. It makes independent decisions. The lawyers advocating on its behalf, though employed by the government, are representing that independent agency. They take their instructions from them; they do not take their instructions from the government. I made that quite clear yesterday publicly. The member should know that.

When a matter is before the court, with the greatest of respect, some of the comments that he made are just not appropriate before our judicial system, which is the foundation of everything we do in here, reaches any conclusion whatsoever.

NURSES

Mr. David Zimmer: My question is for the Minister of Health and Long-Term Care. Yesterday was the start of Nursing Week here in Ontario, and my Willowdale constituents, indeed everyone in Ontario, are real fans and supporters of nurses. They really see them as the front line of health care here in Ontario.

Last year was a tough year with H1N1, and Ontario’s nurses were there again on the front lines to help with vaccines and the various care that we needed for those flu symptoms.

We’ve invested a lot in nurses over the years in various programs to help graduates get the new jobs they deserve here in Ontario. Minister, what continuing investments are you making for the nursing profession here in Ontario?

Hon. Deborah Matthews: Thank you to the member from Willowdale.

I’m very proud to be taking

part in many nursing-related events this week—Nursing Week, internationally. Nurses are the backbone of our health care system, and that’s why we have created over 10,700 new nursing positions since we took office; even this past year, 1,200 more nursing positions. We’ve invested over $900 million in nursing initiatives since we were elected in 2003. We’ve also made Ontario one of the few jurisdictions in the world to guarantee a full-time job opportunity for new nursing graduates. More than 8,000 new nursing graduates have taken advantage of this program.

This morning I was at Sunnybrook, where we announced—

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

Mr. David Zimmer: Minister, you talked about the expanding role of nurses here in Ontario. Many of us, and many of my constituents, want to find out more about this new nurse practitioners’ program.

I know that the nurse practitioner-led clinics are part of the government’s family-health-care-for-all strategy, which will improve access, and I understand that the nurse practitioner-led clinics will improve the quality of health care here in Ontario. But, Minister, can you give me a detailed progress report on the plan to expand nurse practitioner-led clinics in Ontario?

Hon. Deborah Matthews: Yes, I’d be happy to do that, but first let me tell you what we did at Sunnybrook this morning. At Sunnybrook, we announced permanent funding for 34 registered nurse-surgical first assist positions. This is great news for nurses in Ontario.

Yesterday, we announced that the next wave of nurse practitioner-led clinics would be rolled out. We’re accepting proposals until June 25. These nurse practitioner-led clinics—it will bring us to 25 in total—are providing excellent care. It’s a very important innovation that our government has made to ensure that more Ontarians get access to primary health care.

Not only will the NP-led clinics increase access, but they will focus on chronic disease management, prevention, community-based health promotion activities—

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

TAXATION

Mr. John O’Toole: My question is to the Premier. Premier, there are just 51 days left until the HST grab of 8% more out of each family budget. The fact that the Premier wasn’t straight about knowing that families will be paying more with the HST—it’ll start on gas, home heating fuel, power—wasn’t lost on Louis Desjardins of Belleville. Mr. Desjardins wonders what else you know but aren’t telling, like that the HST really won’t create more jobs. The member from Prince Edward–Hastings won’t answer Louis Desjardins’ questions so I will. When is the last time McGuinty was right about anything?

The Speaker (Hon. Steve Peters): Premier?

Hon. Dalton McGuinty: To the Minister of Revenue.

Hon. John Wilkinson: I want to thank Bev Oda and Daryl Kramp, Conservative members in the federal House who voted for our tax reform package. I want to thank them and let them know how important that is. They agree with this side of the House that for a strong Canada, one must have a strong Ontario, an Ontario with plenty of jobs. Our tax reform package is all about modernizing our tax system.

Now, I know there are people across the way who believe that there should be two governments taxing every transaction twice when once will do, but on this side of the House we know that to attract $47 billion worth of 21st-century investment in our province, resulting in 591,000 21st-century jobs in our province, we have to reform our tax system. I want to thank Bev Oda and I want to thank Daryl Kramp—

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

Mr. John O’Toole: If the Premier won’t answer Mr. Desjardins’ questions, how about Larry Maudsley of Peterborough, who just recently retired and is living on a fixed income? He doesn’t value the Premier’s word any more that the Premier himself does. He says: “Any tax relief will not offset what people have to pay in additional taxes.” Mr. Maudsley knows he will be paying more for heat, gas, power, Internet and a range of other things that you aren’t telling us.

The member from Peterborough won’t speak up for Larry Maudsley, when the Premier knew for months that the HST would cut into the budgets of seniors and families in Ontario. Why did you only admit now that the HST is going to seriously attack seniors?

Hon. John Wilkinson: I want to thank Dean Del Mastro—Dean is the federal Conservative MP for Peterborough—for voting for this reform package at the federal House.

Interjections.

The Speaker (Hon. Steve Peters): Order. Member from Oxford. Member from Nepean. Member from Leeds.

Minister?

Hon. John Wilkinson: We’re at a crossroads here. Now we can listen to the opposition and think that the status quo is acceptable, even though the world economy has changed, or we can take difficult but necessary decisions, because what people tell me and our government everywhere we go, and I think in your ridings as well, is, “We need more people working. We need people back to work.” The Conference Board of Canada says that we’re on the right track—those results are here—and though the prophets of doom and gloom over there are praying for some kind of a recession—

Interjections.

The Speaker (Hon. Steve Peters): The members will please come to order. Member from Hamilton East, member from Lanark.

New question.

PUBLIC TRANSIT

Ms. Cheri DiNovo: My question is to the Minister of Transportation. It is now clear that Toronto’s transit vision will be dealt a devastating blow by the McGuinty government’s cut of $4 billion in Toronto’s Transit City budget. The Metrolinx report to be released on May 19 will recommend that funded lines be dramatically shortened and completion dates be pushed back five to 10 years. Speaker, through you to the minister: What exactly does this government hope to accomplish by wilfully destroying Toronto’s transit vision?

Hon. Kathleen O. Wynne: What we’re attempting to accomplish is the development of a regional transit plan. We’re attempting to put in place the vision for transit that was developed by Metrolinx, that was developed in conjunction with municipalities around the city of Toronto and with the co-operation of the city of Toronto. The city of Toronto and the mayor were part of the discussions leading up to the budget. Understanding that some of the plans needed to be scoped, they were part of that conversation.

Now we’ve had to delay the funding, as I’ve said many times in here, but Metrolinx is convinced we’ll be able to, rather than completing the projects in eight years, complete them in 10 years. I think that’s an absolutely reasonable change, and the people of Toronto want to see the projects go forward.

The Speaker (Hon. Steve Peters): Supplementary?

Ms. Cheri DiNovo: The NDP is the only party in this Legislature that supports the full completion of the funded Transit City lines according to its originally announced timetable. The NDP is the only party in this Legislature that stands with the residents of the Eglinton corridor, who have been waiting 20 years for a dedicated transit line. The NDP is the only party in this Legislature that stands with the residents of Jane-Finch and Rexdale in demanding that the Finch LRT be built according to the original timetable, so that commute times of two hours or more become a thing of the past.

My question then for the transportation minister is this one: What does the government have against the residents of the Eglinton corridor, Jane-Finch and Rexdale communities?

Hon. Kathleen O. Wynne: The NDP is the only party in this House that has consistently opposed the building of transit in this city. The NDP is the only party in this House that has a member who has delayed and opposed one of the most important transit projects in this city, the Union-Pearson line. The member from Parkdale–High Park has consistently delayed, opposed and stirred up opposition to that line at every turn. We are committed to building transit in the GTHA; we are committed to getting these projects on line.

It is unconscionable that this party that is supposed to be progressive and that is and supposed to be forward-thinking would not be supporting the building of transit in this city.

STUDENT ASSISTANCE

Mr. Bob Chiarelli: My question is for the Minister of Training, Colleges and Universities. Minister, while experts predict the recession is turning around, I’m deeply concerned for students in this province who have trouble finding work during the summer break, which, as we know, helps them to pay for schooling and living expenses—

Interjections.

The Speaker (Hon. Steve Peters): I’ve already reminded the member from Eglinton–Lawrence and the member from Hamilton East–Stoney Creek. Take it outside, both of you.

Please continue.

Mr. Bob Chiarelli: Minister, according to Statistics Canada, the unemployment rate of full-time Canadian students between the ages of 15 and 24 years was reported in 2009 to be over 18%. Minister, what are you doing to help students find employment this summer?

Hon. John Milloy: I appreciate the question. It comes at a timely moment. As students are leaving college and university for the summer break, they’re looking for an opportunity to find summer employment that’s going to be relevant to developing their skills, create a source of income to support them this fall and also provide employees for many employers across the province. I’m very pleased that our government, recognizing that these are particularly challenging times for students, has stepped forward with over $90 million to help summer students in the province of Ontario look for and acquire work.

We’re anticipating that about 107,000 students will benefit from a series of programs offered by the government. These include things like the summer jobs service. It’s the largest component of the strategy, and it offers $2 per hour for employers as an incentive to help them find students. We’re also offering opportunities for those students who—

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

Mr. Bob Chiarelli: Minister, employment experts note that the transition between students graduating and landing a full-time job in their field is getting longer. In our post-recession world, it seems that recent graduates are finding that it takes longer to make the leap into their careers. Minister, what can we do for those students who are looking for a job opportunity that will help with their ongoing expenses and also with their professional development?

Hon. John Milloy: We certainly recognize that in this new economy it’s important that students leave their education having a varied background of skills and experiences, some not directly related to their study. That’s why we offer a wide range of supports to students. As I mentioned in my previous answer, we support students who are looking to start their own business. The government itself also offers opportunities where we hire students as part of the public service for the summer. We have programs like the Ontario Ranger program that’s run by the Ministry of Natural Resources.

Last year, the ministry provided close to $1 million to fund 529 Ontario positions in the Ontario Ranger program. For the civil service proper, we have Ontario public service summer employment opportunities as well as the summer experience program—just a few of the ways that we’re helping students in Ontario during these tough economic times—

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

WASTE DIVERSION

Mr. Toby Barrett: To the Minister of the Environment: As we now know, your waste electronics and electrical equipment scheme has people paying full fees for a program only achieving one third of its diversion promise; two thirds of e-waste is going overseas to the highest bidder or to landfills. Is that what people are paying these taxes for? It’s your program. Are you now prepared to accept responsibility for this abysmal failure, or will you continue pointing the finger at staff, pointing the finger at industry?

Hon. John Gerretsen: I know the program has had some challenges, but it also has had some successes: 17,000 tonnes of electronic waste is currently being diverted from landfill sites, and it is being properly recycled.

It’s absolutely important that the electronic waste be kept out of landfill sites so that the sites aren’t going to be contaminated and cause all sorts of problems for future generations. We’re working with the WDO. We’re working with the Ontario Electronic Stewardship council. We’re going to solve this problem. We’re going to be the most and best of anywhere in the country when it comes to recycling material in general.

The Speaker (Hon. Steve Peters): Supplementary.

Mr. Toby Barrett: Well, Minister, we know you’re working on it; you’ve planned some meetings in the future. Very simply, too-little-too-late planned landfill bans don’t cut it. Consumers have been paying this tax of between $2 and $26 an item to fund this program, and it’s a failure. How much are we paying for all the other waste diversion programs?

Your government promised 60% diversion by 2008. It’s now 2010, and we’re only at 22%. Why would anyone believe you, as you seem to wrap yourself in the green flag and plan for the future, when you have such an abysmal past, an abysmal record, with respect to waste diversion?

Hon. John Gerretsen: You know, it’s interesting: It’s that party that brought in the Waste Diversion Act and it’s that party that set up the funding system that is currently in place. We are making substantive changes to that to make the industries more responsible for the recycling. We are basically rewriting the—

Interjections.

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

Interjection.

The Speaker (Hon. Steve Peters): Member from Oxford.

Minister.

Hon. John Gerretsen: It is your legislation that basically provided how these funds are to be collected. We know there’s a problem with that, as has been shown over the last couple of days. That’s why we’re rewriting the act to make producers responsible for the waste that they in effect create.

We are going to get it right. That act didn’t do it. The new act will be getting it right so that we can divert electronic waste, as well as other waste, from our landfill sites.

NURSES

Ms. Andrea Horwath: My question is to the Minister of Health. It’s National Nursing Week, yet in communities like London, Hamilton, Sault Ste. Marie, Windsor, Toronto, Thunder Bay, Ottawa and elsewhere across Ontario a total of 2,045 nursing jobs have been cut. Front-line health care services have suffered as a result.

With the health of Ontarians at stake, will the Minister of Health commit to ensuring that not a single additional nursing position will be cut in the next year?

Hon. Deborah Matthews: I welcome the opportunity to talk about National Nursing Week. It truly is a time to celebrate the extraordinary work that nurses do in our province.

I would recommend that the member opposite actually look a little bit deeper at the numbers that she’s using. The College of Nurses is just one source of information; they will tell you that there are over 10,000 more nurses working today than there were when we took office. We have created, even in the past year, 1,200 new nursing positions across this province. We’ve invested $900 million more since we were elected so that we can hire more nurses and we can also expand the scope of practice for nurses. This morning—

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

Ms. Andrea Horwath: Sault Ste. Marie has been hit particularly hard, with nearly two dozen nursing positions eliminated. Patients are forced to go without thousands and thousands of hours of direct care. The Sault Area Hospital has to make reductions in oncology, critical care, primary care, coronary care, surgery and the intensive care unit.

Patients and nurses in Sault Ste. Marie want a guarantee from the McGuinty government that the senseless cuts to their local health care will come to an end once and for all. Will the minister use this opportunity of National Nursing Week to deliver this guarantee to the good people of Sault Ste. Marie?

Hon. Deborah Matthews: What I can tell the people of Sault Ste. Marie and right across this province is that we’re working very hard to improve the quality of health care and to improve access to health care.

Nurses are the backbone of our health care system. We rely on them very heavily to provide that patient-centred care that we are determined to provide across this province.

In Sault Ste. Marie, I’m sure the member opposite would be interested to know, there are 29 nursing positions posted at the Sault Area Hospital right now. Across the province, there are almost 400 nursing positions that are being advertised.

Nursing is a wonderful career for people, and it is just getting better in the province of Ontario.

TAXATION

Mr. Glen R. Murray: To the Minister of Revenue: As Ontario leads Canada out of the global recession with 3.8% GDP growth, understandably job creation for those able to work is a major focus of our government. Laying the conditions for the creation of good jobs is one of the most important things our government can do.

Not everybody will be able to get back to work overnight. Those still waiting for work have real concerns surrounding the effects of the HST on a limited income. My constituents want to know if the HST will place an additional burden on low-income Ontarians, forcing them to pay more when they can least afford it.

Hon. John Wilkinson: I want to thank the member for the question, because it goes to the heart of tax reform.

We are changing our sales tax in this province on July 1, but we’re also reforming our income tax system. Part of that has already started. We now have the lowest personal income tax rate of any province in Canada when it comes to the first $37,000 worth of income.

On July 1, we’re taking other measures. The first one has to do with what we refer to as the HST rebate. People of modest means receive today the GST rebate from the federal government, some $240 for adults and $140 for children. That will be maintained by the federal government. We are adding a new HST rebate of some $260 for every adult and child in the family. That’s very important for people to understand. It’s also why we’re expanding the property tax credit, both for people who own a home and also for people who rent.

I know that in your riding it is so important—

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

Mr. Glen R. Murray: Helping getting people back to work is the number one thing we can do to help low-income Ontarians who are able to work. Income tax exemption, tax credits and traditional cheques will help struggling families as we move forward with a new form of taxation. Exemptions include children’s clothing and footwear, all infant and child car seats, diapers, books, meals under $4, newspapers and feminine hygiene products.

Minister, because of their importance to families, many social advocates have endorsed these exemptions. What reaction are you getting from these groups to the HST and our government tax reforms?

Hon. John Wilkinson: I think it’s important, in this somewhat partisan forum that we have here, to talk to people who are independent of this place. And what are they saying?

“In terms of the net impact of the sales tax harmonization, we think that overall it will actually improve the incomes of low-income Ontarians for the most part.” That’s Michael Oliphant, the director of research and communications for the Daily Bread Food Bank.

Another quote: “This budget has moved the bar forward on housing, tax credits, and child benefits in ways that will make a tangible difference in the lives of many Ontarians.” That’s Pat Capponi of the 25 in 5 Network for Poverty Reduction.

Another quote: “When you start to think about an extra $42 per month per child and start to look at the one-time money coming back and the permanency of the tax credit, the harmonization tax credit, this will make some tangible difference—an extra $100 in these folks’ pockets is the difference between going to food banks and not going to food banks.” That’s Gail Nyberg—

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

CHILDREN’S AID SOCIETIES

Ms. Sylvia Jones: My question is for the Minister of Children and Youth Services. Last week, 11 children’s aid societies took an unprecedented step: filing for a judicial review of your

section 14 process. They feel that the

section 14 process was flawed and the outcome was predetermined.

I know you will not comment on the specifics of this case, but will the minister tell the House the last time that a funding partner had to ask for a judicial review just because they didn’t believe the process was fair?

Hon. Laurel C. Broten: I’m pleased to have a chance to speak in this House about the judicial review, which is a procedural tool available to any CAS in the province. It’s an arm’s-length review that will follow a

section 14 application.

Although I cannot speak to the specifics of what’s transpiring, I can say that in the context of the

section 14 review that was undertaken by my ministry, some $850,000 flowed to children’s aid societies across the province. That’s on top of the $26.9 million in additional dollars that was put into the sector this past spring.

We’re in the midst of a large-scale conversation about the future of children’s aid societies and that delivery model. At the same time, we continue to meet our commitment never to put Ontario’s children at risk.

The Speaker (Hon. Steve Peters): Supplementary?

Mrs. Christine Elliott: Here’s what’s actually happening out there. Last year, Durham Children’s Aid Society investigated 4,180 reports of abuse. It served 5,397 families and facilitated 6,787 visits in the family access centre. They’ve eliminated 31 positions and still have a funding shortfall of $3.8 million.

Minister, you have to admit that something here doesn’t really add up. Will you admit that the

section 14 process undertaken by your ministry, just like your consultation process with the pharmacies, was a fait accompli?

Hon. Laurel C. Broten: I’m so pleased to have a chance to talk about Durham region and let this Legislature know how much better the kids are in Durham region today than they were in the past.

Funding has increased for children’s aid in Durham by 31% since 2003, and over the last decade, funding is up over 250%.

Section 14 money that was provided to Durham is $142,000, and stabilization funding is $543,000. At the same time, we’ve increased funding to child care in Durham by 71% since 2003. We’ve put $63.5 million into child care, and that’s saving 300 subsidized spaces in your community. Twenty Durham schools will have all-day JK for four- and five-year-olds, servicing—

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

PUBLIC SAFETY

M me France Gélinas: Ma question est pour le ministre de la Sécurité communautaire et des Services correctionnels. On Friday night, a chimney collapsed at the Vale Inco smelter complex in Copper Cliff. The chimney fell and damaged a pressurized line that came from the oxygen plant. People in Copper Cliff are scared. They know the oxygen plant is a highly technical and dangerous industrial operation. We were all lucky last Friday that the oxygen line had just been turned off.

It is the minister’s responsibility to ensure public safety. What are you doing to ensure the safety of the residents of Copper Cliff in Sudbury?

Hon. Rick Bartolucci: To the Minister of Labour.

Hon. Peter Fonseca: I want to thank the member for the question. I do understand that this incident did take place. There were no injuries, and there was no potential harm to any workers.

Two Ministry of Labour inspectors have been on the site. These inspectors have expertise both in mining and in construction. They’re currently conducting an investigation into the incident, and they’re making sure that the worksite is safe going forward.

That being said, our government is committed to ensuring that all workers are protected from hazards on the job site. That’s what our inspectors are doing every single day out there in all workplaces across Ontario.

M me France Gélinas: Last December, I wrote to the minister and I explained to him that the people are concerned for their safety because Vale Inco has resumed operations with replacement workers.

The minister may not know, but in 1995 there was a sulphur trioxide leak from the acid plant that led to the evacuation of hundreds of people who had to be treated in our hospital. It overwhelmed our system. If the minister didn’t know, the people in Copper Cliff know.

Replacement workers tear at the social fabric of our community. In an industrial site, they also bring a level of insecurity to the residents of the neighbourhood. When will the government act and ban replacement workers?

Hon. Peter Fonseca: The member did write to me, and I personally spoke with the member to address her concerns around the safety of the workers. Again, our government is committed to ensuring that all workers are protected from injuries and major health hazards on the job.

What I can say is that the Ministry of Labour has met with officials from the company and the union to discuss the company’s plans as they operate. The ministry officials explained the company’s responsibility, under the Occupational Health and Safety Act, to ensure that all workers—all workers—there who are doing any work are adequately trained and qualified. We continue to enforce our Occupational Health and Safety Act by conducting proactive inspections at Vale and other mine locations.

We’re also front and centre when responding to complaints from any party, I say to the member. But I continue to address her concerns and speak personally with her.

ABORIGINAL AFFAIRS

Mr. Dave Levac: My question is for the Minister of Aboriginal Affairs. Minister, I know that there are aboriginal people trying to build vibrant and stable communities throughout this province. There are some disparities in the quality of life between aboriginal people and non-aboriginal people in this country, let alone this province. Aboriginal people living on- and off-territory can face a number of unique issues that may influence their lives in Ontario and, indeed, across Canada.

Can the minister please tell the House what initiatives his ministry is taking to best improve the lives of aboriginal people here in Ontario and across Canada?

Hon. Christopher Bentley: The member for Brant has been very involved in these issues. What we’re trying to do is provide economic incentives and opportunities so that those on First Nations territories can have the opportunities that many of us take for granted.

Not long ago, the member from Brant, the Minister of Energy and Infrastructure, and I attended a signing ceremony between Samsung and Six Nations. This signing ceremony, made possible by the Green Energy Act, will provide not only green energy development on Six Nations territories but, most importantly, it will provide jobs for Six Nations residents. It’s one of the many signings that have taken place under this world-leading green energy accord.

Now you say, “Who’s going to take the jobs?” Well, we’ve been working with the Minister of Training, Colleges and Universities to make sure that we have the appropriate training and related support so that Six Nations and other aboriginal residents can take advantage of these job opportunities—

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

Mr. Dave Levac: Minister, thank you for leading that into the next question I have, which is on education and contrary to what some people believe to be the truth. Some aboriginal students face a number of unique cultural, social and economic challenges in their lives throughout the educational field. The combination of these is sometimes very overwhelming, especially when pursuing post-secondary education. Contrary to the misinformation out there, aboriginal students may not always have the financial assistance or unique community support when pursuing post-secondary education.

Can the Minister of Aboriginal Affairs tell us what this government is doing to help create the climate for success for aboriginal students not only to succeed and to thrive in their post-secondary education, but also to help build their communities as they’ve always wanted to do from time infinitum?

Hon. Christopher Bentley: Once again, the member from Brant has been a leading advocate for opportunities for people throughout his riding and in First Nations communities.

In the last budget, the Minister of Training, Colleges and Universities has been given the opportunity to offer 20,000 more post-secondary spaces to students throughout the province of Ontario. That’s the start, particularly for the educational institutes in my colleague’s riding: Nipissing, Laurier and Mohawk.

But we’ve done more than that. I attended a ceremony with the Minister of Training, Colleges and Universities about a $26.4-million fund that will particularly assist aboriginal students to obtain the educational supports they require and the related cultural and educational assists on campus. And of course, we have the best student assistance program anywhere in Canada so that those who need financial assistance—aboriginal students and others—will get the financial assistance they require to attend the place and get the post-secondary education they require in the province of Ontario.

PRESENTATION OF PETITIONS

Mr. Peter Kormos: On a point of order, Mr. Speaker: This is pursuant to standing order 39 and with respect to a petition presented to this chamber yesterday by the member for Eglinton–Lawrence.

First, if I may refer to our friends Bosc and O’Brien, page 1159: “While the right of the citizens to petition Parliament for redress of grievances is frequently referred to as a fundamental, or as a fundamental constitutional principle, the written constitution is in fact silent on the matter. The recognition of this right is, however, well entrenched, based as it is on centuries-old tradition and established precedent.” Why I make reference to that is because it’s the right of the citizen. It’s not the right of any MPP to petition; it’s the right of the citizen to petition.

I then go to page 1170, Bosc and O’Brien again, which discusses the role of the MPP. While no MPP is obliged to present a petition and doesn’t necessarily have to agree with the petition to present it, most MPPs or MPs consider it their duty.

I know that it’s unparliamentary to misrepresent something to this House, and similarly unparliamentary to allege that a member made a misrepresentation, but the petition that was presented yesterday, the prayer in the petition, read, “We, the undersigned, petition the Legislative Assembly of Ontario to support the building of the Eglinton rapid transit line as soon as possible, and to say no to gridlock on Eglinton.” End of prayer. The member for Eglinton–Lawrence—and I have the Hansard for you, sir, if a page would like to come here and deliver it to the table.

Speaker, you’ll see that the presenter of the petition, when presenting the petition, inserted an addendum to the prayer in the petition. The addendum is clearly designed to generate some political spin. It may well have been a careless quip on the part of the member for Eglinton–Lawrence. However, the addition of that addendum completely distorts the prayer in the petition, which calls upon the Legislative Assembly to get on with its public transit construction, and indeed constitutes an attack on the mayor of the city of Toronto, who’s not referred to at all by the petitioners.

Standing order 39 prescribes the process for presenting petitions. Look, I know there are all sorts of things people do in the House from time to time, witticisms that are injected, but this is a citizens’ right, and we’re doing a disservice to the citizens who expect us to present their petitions when we alter them, when we add to them or when we belittle that prayer in the petition by turning into a joke or turning it into a partisan political comment.

I don’t intend and have no interest in bringing a motion for censure or a motion for contempt, but I do—

Mr. Mike Colle: Give me a break.

The Speaker (Hon. Steve Peters): Order.

Mr. Peter Kormos: —but I do understand that those motions are appropriate because they’re the only motions in which one can refer to a member as having committed an unparliamentary deed. I have no interest in doing that, but I am asking the Speaker to use his authority to (1) address the concern that I’ve raised and (2) to assist us in ensuring that we perform this very important duty to the citizens of Ontario. That’s one of our duties. Bosc and O’Brien talk about the MPP’s duty to read the petition and the citizens’ right to make the petition. I’d ask the Speaker to rule on that, please.

The Speaker (Hon. Steve Peters): Government House leader.

Hon. Monique M. Smith: Under standing order 39(b), “A member may present a petition in the House during the routine proceeding ‘Petitions.’ The member may make a brief statement summarizing the contents of the petition and indicating the number of signatures”—

Interjection.

Hon. Monique M. Smith: Perhaps the member would like to let me finish my statement. If in fact the member for Eglinton–Lawrence made a statement that was inappropriate in his summarizing of the petition, then I’m sure the member will be apologizing.

Thank you, Mr. Speaker. We should get on with our business.

The Speaker (Hon. Steve Peters): The member from Renfrew–Nipissing–Pembroke.

Mr. John Yakabuski: I do agree with the issues raised in the point of order by my colleague from the third party. For the member to imply in his reading—the Hansard would imply that his statement was part of the petition, which in fact it is not. I believe that the standing orders do not allow for—the petition must be read as presented to the House, and I do believe that the member for Welland and my colleague from the third party has raised a substantive and genuine bona fide point of order on this issue, and we would ask you to rule on that as well.

The Speaker (Hon. Steve Peters): I want to thank the member from Welland, and the government House leader and the member from Renfrew–Nipissing–Pembroke for their comments on the point of order raised by the honourable member. I thank the honourable member for his point of order.

As all members know, the Speaker has been struggling with the issue of petitions on a number of fronts because I do not have a copy of the petitions physically in front of me when they are presented to the House; they are approved by the table.

I want to just clarify some remarks, because it’s important for the members to know that there are actually two options that are available to them when they are presenting petitions. They can stand up and read the petition as it’s presented or, pursuant to standing order 39(b), they can make a brief statement summarizing the contents. I’ve said before, and I’m going to say again, that politicizing the petitions is not helpful to the procedures of this House, and again would remind all members and ask of them to refrain from doing so. I say that to members on both sides of the House.

The honourable member is correct that the members are to present petitions on behalf of those citizens who submit them.

To address the issue that the government House leader raised, the point in the standing orders regarding debate is during the time of petitions, and during the time of petitions it’s not to be used as an opportunity to engage in debate or put forward a member’s own opinion.

I thank the honourable member for raising it and would remind all members to either read the petition as it is presented or present a brief

summary, or they can table the petition as well.

DEFERRED VOTES

POST-SECONDARY EDUCATION

STATUTE LAW

AMENDMENT ACT, 2010 /

LOI DE 2010 MODIFIANT DES LOIS

EN CE QUI CONCERNE

L’ENSEIGNEMENT POSTSECONDAIRE

Deferred vote on the motion for second reading of Bill 43,

An Act to amend the Post-secondary Education Choice and Excellence Act, 2000, the Private Career Colleges Act, 2005 and the Ontario College of Art & Design Act, 2002 / Projet de loi 43, Loi modifiant la Loi de 2000 favorisant le choix et l’excellence au niveau postsecondaire, la Loi de 2005 sur les collèges privés d’enseignement professionnel et la Loi de 2002 sur l’École d’art et de design de l’Ontario.

The division bells rang from 1148 to 1153.

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

Ayes

Aggelonitis, Sophia

Albanese, Laura

Arthurs, Wayne

Balkissoon, Bas

Bartolucci, Rick

Bentley, Christopher

Best, Margarett

Bisson, Gilles

Bradley, James J.

Broten, Laurel C.

Brown, Michael A.

Brownell, Jim

Cansfield, Donna H.

Caplan, David

Carroll, Aileen

Chan, Michael

Chiarelli, Bob

Colle, Mike

Crozier, Bruce

Delaney, Bob

DiNovo, Cheri

Dombrowsky, Leona

Duguid, Brad

Duncan, Dwight

Flynn, Kevin Daniel

Fonseca, Peter

Gerretsen, John

Gélinas, France

Gravelle, Michael

Hampton, Howard

Hoskins, Eric