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February 18, 2009

39th Parliament, 1st Session

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Hansard Transcripts

Votes and Proceedings

Orders and Notices

Hansard Transcripts 2009-Feb-18 (PDF)

LEGISLATIVE ASSEMBLY OF ONTARIO

ASSEMBLÉE LÉGISLATIVE DE L'ONTARIO

Wednesday 18 February 2009 Mercredi 18 février 2009

ORDERS OF THE DAY

REGULATED HEALTH PROFESSIONS AMENDMENT ACT, 2009 /

LOI DE 1991 MODIFIANT LA LOI

SUR LES PROFESSIONS

DE LA SANTÉ RÉGLEMENTÉES

INTRODUCTION OF VISITORS

LEGISLATIVE PAGES

USE OF QUESTION PERIOD

ORAL QUESTIONS

ONTARIO BUDGET

ONTARIO ECONOMY

MANUFACTURING JOBS

MANUFACTURING AND

FORESTRY SECTOR JOBS

ONTARIO BUDGET

ONTARIO ECONOMY

HEALTH CARE

MINISTRY OF THE

ATTORNEY GENERAL

SPECIAL CARE HOMES

POVERTY

TOBACCO INDUSTRY

CONSUMER PROTECTION

MUNICIPALITIES

CHILDREN'S MENTAL

HEALTH SERVICES

HEALTH CARE

CORRECTION OF RECORD

MEMBERS' STATEMENTS

SCHOOL PLAYGROUND

EDEN MILLS SKI CLUB

WASTE DISPOSAL

CHILD PROTECTION

AUTOMOTIVE RESEARCH

AND INNOVATION

HEALTH CARE

SIR WINSTON CHURCHILL COLLEGIATE AND VOCATIONAL INSTITUTE

RURAL CONNECTIONS

BROADBAND PROGRAM

LEGISLATIVE INTERNS

REPORTS BY COMMITTEES

STANDING COMMITTEE ON

PUBLIC ACCOUNTS

STANDING COMMITTEE ON

PUBLIC ACCOUNTS

INTRODUCTION OF BILLS

TRUTH ABOUT CALEDONIA ACT, 2009 /

LOI DE 2009 CONCERNANT

LA VÉRITÉ SUR CALEDONIA

HOLODOMOR MEMORIAL

DAY ACT, 2009 /

LOI DE 2009 SUR

LE JOUR COMMÉMORATIF

DE L'HOLODOMOR

PETITIONS

ASSISTANCE TO FARMERS

PROTECTION FOR MINERS

POPE JOHN PAUL II

CHILD CARE

HOSPICES

ASSISTANCE TO FARMERS

FIREARMS CONTROL

MOTORCYCLE SAFETY

BATHURST HEIGHTS

ADULT LEARNING CENTRE

SALES TAX

SALES TAX

CHILD CARE

ORDERS OF THE DAY

CHILD AND FAMILY SERVICES

STATUTE LAW AMENDMENT ACT, 2009 /

LOI DE 2009 MODIFIANT DES LOIS

EN CE QUI CONCERNE LES SERVICES

À L'ENFANCE ET À LA FAMILLE

EMPLOYMENT STANDARDS

AMENDMENT ACT

(TEMPORARY HELP AGENCIES), 2009 /

LOI DE 2009 MODIFIANT LA LOI

SUR LES NORMES D'EMPLOI

(AGENCES DE PLACEMENT TEMPORAIRE)

The House met at 0900.

The Speaker (Hon. Steve Peters): Good morning. Please remain standing for the Lord's Prayer, followed by the non-denominational prayer.

Prayers.

ORDERS OF THE DAY

REGULATED HEALTH PROFESSIONS AMENDMENT ACT, 2009 /

LOI DE 1991 MODIFIANT LA LOI

SUR LES PROFESSIONS

DE LA SANTÉ RÉGLEMENTÉES

Resuming the debate adjourned on February 17, 2009, on the motion for second reading of Bill 141,

An Act to amend the Regulated Health Professions Act, 1991 / Projet de loi 141, Loi de 2009 modifiant la

Loi sur les professions de la santé réglementées.

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

M me France Gélinas: Thank you very much. I was locked out of the House, so I just came in.

I'm happy to rise today to speak to Bill 141, the Regulated Health Professions Amendment Act. There is no question that as health care consumers and health care providers, there is no greater objective than ensuring patient safety at all times. In fact, this is the express purpose of the Regulated Health Professions Act.

Since it was introduced in 1991, the purpose has been and remains to protect the public from unqualified, incompetent or otherwise unfit practitioners. The bill also encouraged the provision of high quality care. It allows the public the freedom to choose safe health care providers and it promotes flexibility in the role of health professionals to ensure maximum efficiencies of the health care system. This is what the Regulated Health Professions Act is all about, and we are about to modify it with Bill 141.

As medical procedures and the medical profession change over time, it is imperative that both the regulatory college as well as the province adjust to these changes and address any issue that could affect patient safety.

The bill before us today is, in part, a response to a tragedy that cost a young Toronto woman her life. In September 2007, Krista Stryland, a Toronto real estate agent, a 32-year-old mother, underwent a routine liposuction procedure in an out-of-hospital facility. Following the surgery, she went into cardiac arrest and, tragically, she died. The physician who performed Mrs. Stryland's liposuction was not formally trained in plastic surgery.

Plastic surgeons must have five years of specialized training. They must pass national exams and be certified as specialists in plastic surgery by the Royal College of Physicians and Surgeons of Canada. The physician who performed Mrs. Stryland's surgery had no hospital privileges. He was a general practitioner, better known to most as a family physician. Mrs. Stryland's untimely death was a wake-up call to the province, to the college and to us all that we must take a good look at the current system of regulations surrounding cosmetic surgery.

It is a great tragedy that nothing was done sooner and nothing was done to prevent this death, because dating back to 1989, a full 20 years before, a 44-year-old woman from Unionville died after undergoing cosmetic surgery. There was an inquest into her death and recommendations for greater regulation of cosmetic surgery were made at the time. That was 20 years ago. Unfortunately, there were few regulatory changes between the tragic death in 1989 and the one that I was just talking about that occurred in 2007.

Today, we have an opportunity to take the first step, although a tiny one, in closing this gap in oversight and patient safety. While there is no question that Bill 141 is an important step, it is also a small step. That is why we are looking forward to the conversation that is beginning today about how this bill could be pushed further and what next steps are needed to more fully protect Ontarians. This conversation affects us all and must be shared with Ontarians at large.

Some might say that cosmetic surgery is the wild west of medical practice. It is not true only in Ontario, but around the world. There have been deaths reported from Vietnam to Australia, from Thailand to the United Arab Emirates. It is likely no surprise to anyone here that we live in a world obsessed with beauty and the constant drive for perfection. Cosmetic surgery is something that more and more people are turning to as it becomes increasingly affordable and socially acceptable. But it remains surgery, with all of the dangers associated with such a procedure.

It is the obligation of both the government and the regulatory colleges to understand these trends, keep current with them and ensure that safety is a primary concern of any cosmetic procedure.

According to the CPSO survey, cosmetic surgery procedures climbed at an alarming rate–if you ask me—of 150% between 2002 and 2006. Toronto is the sixth-biggest market for cosmetic surgery in North America—right here. That means there are an awful lot of people undergoing these types of procedures that, like every other invasive surgery, are complex and always come with risks. It is these patients who count on the college and on us, on the province, to ensure their protection and their safety. Following the tragic death of Mrs.

Stryland, the College of Physicians and Surgeons moved quickly to create regulatory changes that would prevent a further tragedy like this. The College of Physicians and Surgeons recognized that the medical community had not kept pace with the expanding field of cosmetic surgery and that patient safety in Ontario was being compromised. They recognized the need to better monitor cosmetic surgery in Ontario. I guess one has to say that recognizing that you have a problem is the first step in trying to fix it, so I commend the college for taking those actions.

CPSO started by conducting a survey of more than 2,400 of its members, asking if they had expanded their practice to include cosmetic and anaesthetic procedures without having obtained proper training—quite a daring ask, I might say. They were basically asking whether physicians were advertising themselves as cosmetic surgeons without informing their patients that they were not formally trained and qualified to perform those surgeries. The result of the survey was revealing. There were, indeed, physicians across the province of Ontario who were performing those procedures and they were not adequately trained.

Following the results of this survey, the College of Physicians and Surgeons of Ontario moved on changes to fill in some of the gaps that they identified. For example, the college has now changed its policy of voluntary self-reporting, which resulted in some physicians, but not all of them, reporting and undergoing the training, supervision and assessment required by the policy.

In October 2007, the college made it mandatory for all of its members to submit a detailed account of the cosmetic procedures they were providing to their patients. That was new. Here again, kudos to the college. As well, a regulation will soon be forthcoming to limit the use of specialist titles such as "cosmetic surgeon" only to physicians who have received the proper training to safely conduct those procedures.

The details of this policy change are still under way, and while we support a well-thought-out strategy, we urge both the college and the province to move as quickly as possible, because hundreds of people in Ontario are receiving those types of procedures right now, not always from qualified plastic surgeons.

The details of this could have potential patient impact. Patients have the right to a system and to terminology that clearly distinguishes between physicians with different training levels and different specialties. The thought that a patient would think that a physician has the kind of training and experience in a specific medical procedure when they do not is a reason to move as quickly as possible. As was the case, the physician was a family physician—a general practitioner, if you want—but let it be known that he could perform cosmetic surgery and let it be known that he was a cosmetic surgeon, when in fact he was not. The thought was wrong.

From all of this work that the CPSO completed following the tragic death of Mrs. Stryland, the college submitted recommendations to the Ministry of Health that have formed the basis of Bill 141, the bill that we are talking about today. I must note that the college submitted a number of regulations and bylaw amendments to the ministry in March 2008 and it has taken nine months for the government to come back with this small amendment—not exactly the type of speed that we would have liked, but, regardless, there is no question that the bill before us today is a very important first step when it comes to protecting patient safety.

Many of the cosmetic procedures occurring in this province are occurring in clinical settings that are outside of hospitals, with very few regulations. Without this bill, the college has no right to go into these practices and directly observe physicians. This was one of the primary gaps identified by the college in the Regulated Health Professions Act and was a limit to the college's ability to directly observe their members in practice.

If you think about it, this is a rather serious gap when it comes to medical care. For professions like law or accounting, it is likely that virtually every major decision, and perhaps even the thought process of how a decision was made, is recorded on paper. If you have a question as to why your accountant came to the conclusion they presented to you, they will likely be able to walk you through each figure and column as they have recorded it. Well, this is not the same when it comes to medicine, and especially not the same when it comes to surgery—and, I would add, cosmetic surgery.

Surgery is hands-on and, I would say, as much an art as it is a science, relying on sometimes split-second decision-making, a type of thought process that may not be so obvious to an external person looking on. Bill 141 lays the groundwork for observing of the members, but merely observing physicians may not be enough in some situations. That is why the CPSO, the College of Physicians and Surgeons of Ontario, has highlighted the need to amend Bill 141 and include a provision that will allow the college to interview physicians about their practice and any concerns that have arisen following the observations.

The ability to interview a physician may make all the difference in clarifying whether the physician or the surgeon fully understands the implications of their practice or the surgical procedure and could help identify any gaps in knowledge before an accident happens. As we've seen, some of those accidents may have horrific consequences for the patients.

There is a second issue that this bill does not address. Bill 141 could be more effective if the college was permitted to directly observe physicians wherever they practise. Currently, the scope of the observation is tied to the facility rather than the procedure or the physician. Other provinces, such as Alberta and British Columbia, have moved faster on recognizing the importance of extensive monitoring. In these provinces, all surgeons and the surgical facilities they operate in must be licensed for each and every one of the procedures that they perform. This is the kind of oversight that may prove effective in preventing any further tragedies like we have seen here in Ontario.

This is the kind of discussion that needs to happen around patient safety and emerging areas of practice. This bill needs input from the regulatory college, from Ontario patients, from the medical schools and from all of the stakeholder groups out there so that we can get it right, protect the patients and avoid any future tragedies.

New Democrats strongly believe in oversight at our health care facilities. We believe that Ontarians deserve a place to turn to when something goes wrong for them or for a loved one across the medical system, or any other problems that they may encounter. There is perhaps no more important an area of oversight of issues and services than the one that affects our health and our well-being.

It would seem that this government has kind of an aversion to oversight, and this concerns us. New Democrats know that oversight is something we need to embrace and push for. That transparency is essential when it comes to good-quality health care and good health issues. This is why we have been pushing for Ombudsman oversight of this province's hospitals and long-term-care facilities in private members' bills, in question period and across the business of this House on a weekly basis.

Ombudsman André Marin has pushed to have his role as Ontario's independent public watchdog expanded to include hospitals and long-term-care homes. As Ombudsman André Marin himself stated, "Ontario is the only province in Canada whose Ombudsman does not have a mandate to oversee hospitals," despite Mr. Marin's office receiving many serious complaints about hospitals every year that he cannot investigate. Actually, in 2007 a total of 228 complaints about hospitals were received by the Ombudsman's office, but he does not have the mandate to investigate them.

It is clear that today we have another issue of oversight in front of us, and today we actually have an opportunity to put the appropriate structure in place to avoid future mistakes and needless deaths. I urge the ministry to continue working with all health regulatory colleges to make sure that proper safety standards are in place for all high-risk procedures, not just cosmetic surgery. The work done by the CPSO is a step in the right direction, and we strongly encourage this government to adopt the amendment and regulatory changes as fast as possible.

New Democrats think this is a conversation that needs to be had with Ontarians at large. We need their input on the type of changes and transparency they want to see to ensure a safe medical system, including cosmetic and anaesthetic procedures. I look forward to seeing the ministry act swiftly to strengthen patient safety so that all Ontarians have confidence in our health care system, and I look forward to the actions that will be generated out of our conversations today.

The Deputy Speaker (Mr. Bruce Crozier): Questions and comments?

Ms. Helena Jaczek: I'm pleased to rise in support of Bill 141,

An Act to amend the Regulated Health Professions Act.

This amendment is all about arming our health regulatory colleges with the tools they need to further Ontario's patient safety agenda. This is clearly extremely important to the McGuinty government, and we're taking steps in a prudent, incremental fashion to ensure that patient safety is paramount. So we've moved on a number of fronts.

In July 2008, an amended regulation of the Public Hospitals Act was enacted to require hospitals to disclose to patients and their families any critical event that resulted in serious injury or death. In September 2008, we started full public reporting on eight patient safety indicators, including C. difficile, as part of a comprehensive plan to create an unprecedented level of transparency in Ontario's hospitals.

In the course of the debate today and yesterday, there are some comments that perhaps there is excessive regulation in Ontario. In this particular case, I think it's clear that the number one reason for regulation is the health and safety of Ontarians—not for us the careless slashing of regulations such as the previous government pursued, where they privatized labs, and medical officers of health no longer received reports of water quality in this province, which led, and was a contributing factor, to the tragedy in Walkerton.

We're taking a careful, prudent approach to both looking at unnecessary regulation and ensuring that we have strong regulation to promote and preserve the health and safety of our residents.

The Deputy Speaker (Mr. Bruce Crozier): Questions and comments?

Mr. John O'Toole: It's always good to hear the member from Nickel Belt, the critic for the NDP. I think she is very committed to the file. But I'm very interested, as well, in the comments in a few moments by our critic from Kitchener—Waterloo.

Bill 141 is a very small bill; in fact, it really has one paragraph. I'm quite disappointed, actually: If you read the purpose clause, it says, "... is amended to permit health colleges to make regulations providing for the direct observation of members in their practices."

I know there has been a report filed with the Ministry of Health by many of the participants under the Regulated Health Professions Act, and they're waiting for other, I would say, more comprehensive changes to allow patient choices in the health care field.

Just recently, I was at the optometrist's in my riding and they were asking me, for the second or third time, about a bill that was passed but the regulations have not yet been set for optometrists to prescribe TPAs—topical medications. Now, that would actually be more convenient for the optometrist, when trained and approved by their college, as well as for the patient.

The patient wouldn't then have to go, as they have to today, to a general practitioner, who literally wouldn't have all that much training on the eye and some of the medications to deal with glaucoma and other things, and yet the GP can issue the prescription. With those kinds of changes, which make it more convenient and more professional, using the services of other professionals like pharmacists, nutritionists, psychologists and all the other practitioners under the Regulated Health Professions Act, I think this bill would have some substance to it. But once again, we have a government with no plan.

This bill will be supported by us and I don't know why it's on the table this morning.

The Deputy Speaker (Mr. Bruce Crozier): Thank you. Questions and comments?

M. Gilles Bisson: Ça me fait plaisir de commenter ces commentaires de la part de ma collègue M me Gélinas. Je pense qu'elle a bien fait le point que beaucoup d'ouvrage a été fait par cette législature faisant affaire avec toute la question de s'assurer que les chirurgies faites par les chirurgiens de la province sont faites d'une manière transparente. On sait que, si tu rentres au bureau du médecin et tu te fais référer pour une chirurgie, à la fin de la journée tu veux savoir qu'il y a une qualité, une qualification, et que la personne est compétente pour faire ce qu'il y a à faire envers les chirurgies.

C'est déjà le cas dans les hôpitaux, comme on le sait. Il y a déjà la situation où un collège peut aller visiter les hôpitaux pour voir ce qui se passe pour s'assurer que la qualité est là, et que la formation est en effet ce dont on a besoin pour être capable d'aller en avant avec les chirurgies d'une manière efficace et sûre. Mais il y avait toujours le problème avec ce qui se passe dans les cliniques privées.

Cet amendement regarde à donner aux collèges les mêmes droits qu'on a déjà en place pour ceux qui font des chirurgies dans des institutions publiques. C'est un pas important. Pourquoi ? Parce qu'on sait qu'il y a eu beaucoup d'occasions où des personnes qui sont médecins ont décidé d'ouvrir une branche de pratique, on va dire, avec les chirurgies de maquillage—« face surgery »; des fois on ne trouve pas les termes assez faciles. Mais quand ça vient aux chirurgies de figure etc., il y a eu certaines occasions où les personnes ont eu des complications faisant affaire avec leur chirurgie.

Donc, on a besoin d'avoir un meilleur régime en place pour s'assurer d'avoir une qualité : premièrement, que les médecins qui décident d'aller dans cette branche-là de la médecine sont qualifiés ; et deuxièmement, s'ils sont qualifiés, d'avoir l'habileté de se faire vérifier par le collège des chirurgiens pour s'assurer que l'ouvrage qui est fait, en effet, est sûr. C'est un amendement qui fait du bon sens, et on prend plaisir à voir ce projet de loi aller en avant.

The Deputy Speaker (Mr. Bruce Crozier): Questions and comments? Further debate? Oh, excuse me. Member for Nickel Belt, you have two minutes to respond.

M me France Gélinas: I'd like to thank the member from Oak Ridges—Markham for her comments. Certainly, I agree with what she said: that it is an important step in the right direction and it would lead to better safety for patients who undergo cosmetic surgery by ensuring that the physicians who perform those surgeries are properly trained and that their college has an opportunity to check that training.

I also support the member from Durham when he says that although this bill takes us a small step in the direction of patient safety, we need more comprehensive reforms to the health professions act. He talked about examples where different health professionals and the public of Ontario would benefit from an expansion in their scopes of practice.

I hope that those changes will be coming to this House shortly, if they need to come to the House, or the changes will be done to the health practitioners act in order to allow—he talked about optometrists, but there are also nurse practitioners, pharmacists, physiotherapists and a lot of other regulated health professionals who would benefit from an expansion of their scope of practice that would allow them to better serve the people of Ontario.

Finalement, j'aimerais remercier mon collègue de Timmins—Baie James pour ses commentaires. Certainement, on peut voir qu'il a à cœur la sécurité des gens de l'Ontario. Lorsqu'un médecin offre de la chirurgie cosmétique mais n'a pas eu la formation pour le faire, on met les clients à risque. Ses commentaires allaient dans le sens que le parti néo-démocratique veut que notre système de santé soit aussi sécuritaire que possible.

The Deputy Speaker (Mr. Bruce Crozier): Thank you. Now we're ready for further debate.

Mrs. Elizabeth Witmer: I'm very pleased to rise on behalf of the Progressive Conservative Party to respond to this legislation, which is entitled the Regulated Health Professions Amendment Act, 2008, and which we of course support. We do have some amendments that we hope the government will consider at this time. When the legislation is open is the time to make sure that the legislation becomes the best it possibly can be.

Once this bill is passed, it will give Ontario's 23 health regulatory colleges new powers to conduct inspections in settings that are currently unregulated. The changes would allow a regulatory college, such as the College of Physicians and Surgeons of Ontario, to directly observe a health professional's practice and watch a procedure being performed. Of course, much of the reason for the legislation having been introduced is the result of a Toronto Star investigation over the past two years that documented "a regulatory black hole" surrounding Ontario's growing cosmetic surgery industry.

I think we're all familiar with the September 2007 tragedy that happened to Krista Stryland, a Toronto real estate agent and a 32-year-old mother. She went to her doctor's office to undergo a routine liposuction treatment and, tragically, she did not survive. She died of cardiac arrest. Subsequently, the court documents showed that she had 23 incisions that had been made in six parts of her body during one surgical session. Sadly, this case is but one of several high-profile deaths which have put a negative spotlight on cosmetic surgery. Another example is in 2004.

We have TV producer Micheline Charest dying after she underwent a facelift and breast augmentation. In 2007, Olivia Goldsmith, author of the book The First Wives Club, also died while undergoing cosmetic surgery.

Regrettably, these are some of the situations that people find themselves in, so we need to strictly regulate those who are performing cosmetic surgery, as they do in other Canadian provinces such as Alberta and British Columbia. Unfortunately, we have been slower in Ontario to take action.

If you take a look at Alberta and British Columbia, all the surgeons and the surgical facilities must be licensed for each procedure they perform. As well—and I think this is extremely important—doctors cannot advertise themselves as cosmetic surgeons without holding a surgical specialty. We know that is a problem in this province as well.

So in 2008, the College of Physicians and Surgeons of Ontario proposed regulatory changes that would prevent doctors from calling themselves "cosmetic surgeons," a term applied to doctors who are not plastic surgeons and who perform procedures including facelifts, tummy tucks and liposuction. I would like to point out that this term is not formally recognized by licensing bodies.

According to the CPSO's website, the college, "since April 2007 ... has undertaken a number of initiatives, in addition to the proposed regulations on out-of-hospital facilities and use of specialist titles that are intended to improve patient safety." Really, that's what this bill is all about—the need for us here to ensure that the lives of the public are protected.

They go on to say on their website that they have done the following: They've passed a policy which requires doctors to report changes in their scope of practice—for example, if they suddenly decide they are going to call themselves a cosmetic surgeon without holding any surgical specialty. They have produced an information fact sheet to provide to Ontarians with important information they should consider before deciding to have cosmetic procedures.

You know, it's always important that people are totally familiar with what is involved when they are undergoing surgery of any kind, but particularly this type of surgery. As well, it includes asking all doctors who perform cosmetic procedures to give the CPSO information about their practice and their training, to ensure that doctors are only practising in areas where they have the necessary knowledge, skill and training.

In September 2008, the Ontario Supreme Court ruled that the CPSO has the authority to force a health professional to submit to an interview and observation by an investigator. According to the Globe and Mail

article on September 29, 2008, this decision "will push forward the stalled CPSO investigations of a handful of doctors, launched" after the death of Ms. Stryland. "With hundreds of family doctors performing cosmetic surgery in Ontario, the court's decision has set an important precedent."

The CPSO is trying to continue to do everything it can, in its power, to protect patient safety. The legislation that we're talking about today should give regulatory bodies like the CPSO more control over monitoring their members for the purpose of protecting the public.

When this legislation was introduced last year, I had indicated that we were quite interested in hearing what the colleges had to say about the legislation and also what the public had to say about this legislation. For the benefit of people who are watching today, I just want to share some of the feedback we have received since this bill was introduced.

"Bill 141 is a good first step"—and I emphasize "first"—"to improving patient safety at out-of-hospital facilities." We are talking here, of course, about places like these cosmetic surgery clinics. "However, ensuring the safety of patients in all settings across Ontario is of even greater concern." If we're going to do that, and I hope the Minister of Health and his staff are listening, "This will require legislative amendments that will explicitly codify a college's investigatory powers to ensure that physicians are meeting expected standards of practice."

We also have to remember—and this is feedback we received—that "full patient safety requires that a good facilities inspection system be complemented by an effective investigation system to provide adequate oversight of the health professionals that work at health care facilities.

"In addition to what is contained in Bill 141, amendments to the Health Professions Procedural Code (Schedule 2 of the RHPA) are needed to clarify the authority of health college investigators and confirm that they have the power to compel members to provide interviews and to observe members perform procedures.

"These amendments" to this bill "are needed because the colleges"—at least one—"are currently involved in litigation regarding the extent of their investigators' powers under the HPPC (i.e., requiring interviews and observing performance of procedures). The final outcome of this litigation will likely not be known for many months, if not years.

"While this legal challenge is contested at various levels of the court, the tenor of the investigations process is changing and some regulated health care professionals are taking a more adversarial stance." As a result, you have a college "facing difficulties in some serious investigations," and regrettably, the outcome is that we compromise patient safety. That's why the Ministry of Health and the McGuinty government need to consider making amendments to this bill at a time when the legislation is open.

If we take a look at interview powers, we know that "Interviews are an essential tool that must be available to investigators to conduct a meaningful investigation. Interviews are a usual and accepted manner of evaluating medical knowledge and judgment. The medical chart tells only one part of the story; the remainder needs to come from ... the health care provider. Whether care is simply poorly charted or is in fact poorly provided can often only be told from an interview."

By the way, most of this information that we have received concerning necessary amendments to Bill 141 comes from the College of Physicians and Surgeons of Ontario.

They go on to talk about observation powers: "In ... limited cases, a college investigator will need to observe a member perform a procedure or technique—for example, members who perform procedures but have not completed a formal surgical residency program.

"As surgery is a manual discipline, direct observation of the manual skills of the physician is important in order to thoroughly assess or examine the physician's surgical practice.

"A medical investigator will often be unable to draw any meaningful conclusion unless he or she is able to observe the member perform the procedure. It is through direct observation that an investigator can best assess the level of skill, knowledge and judgment of a surgeon."

So I hope that the ministry and the minister will take a look at making amendments to Bill 141 "to include HPPC amendments that codify these investigatory powers of health colleges to ensure public safety."

I hope, as well, that the government will listen very closely and consider all of the recommendations that have been put forward by Ontario's 23 regulatory bodies. As I well know, having served as Minister of Health, the time to make the changes that are going to fully protect the public should occur when the act is open. We know it will probably be a long time before it is opened again, so we must make all the necessary changes to help protect the safety of Ontarians.

Finally, I don't think anybody disagrees with this legislation. I would simply encourage the government to act quickly in order to ensure that Bill 141, with its amendments, passes as quickly as possible in order that we can protect public safety.

The Deputy Speaker (Mr. Bruce Crozier): Questions and comments?

Mr. Gilles Bisson: I listened intently to the comments and it's fairly clear that there is strong support for this move in this direction on all sides of the Legislature. I think it speaks to, far more often than people realize, a fair amount of agreement in regard to what needs to be done for the public good. Just for the record, I think people often look at this Legislature and say, "Oh my God, they're in there fighting like a bunch of kids. They can't get along.

If only they could work together." I think this is an example where we may not agree entirely with what the government has done as far as their amendments—and that's for committee—but that's the legislative process. Generally the direction being taken is something that I think we can all support.

As a member of the New Democratic caucus, we were actually the government that first came in with the Regulated Health Professions Act in the early 1990s. Since then, we've had to find ways to learn and to strengthen and to make sure that we put in place the safeguards necessary to protect the public when it comes to practices by surgeons and physicians in this province.

We need to say, for the record, that the vast majority—99.9%—obviously are doing the best they can and they're hopefully treating people with all due care, but there are cases where we need to have a bit more transparency, and that's what this particular bill does.

It allows what normally happens in hospitals, where the College of Physicians and Surgeons is able to go into a hospital surgery and take a look at the practices that are happening within the surgery as to how the physician—he or she—does the surgery and the process and procedures they follow, to ensure that there's quality at the end and that we're doing whatever is humanly possible to make the surgery a success. We need to have the same type of transparency within private clinics, such as people who do cosmetic surgery.

What this particular bill tries to do is take that type of transparency and give the college the same type of rights that we already have within hospitals. I think that's a step in the right direction, and we should see what happens at committee.

The Deputy Speaker (Mr. Bruce Crozier): Questions and comments?

Mr. Mike Colle: Just speaking to the comments of the member from Kitchener—Waterloo, I think she made some very helpful, positive comments on a piece of legislation which is really about public protection, where they're very vulnerable, because it's obvious that there are all kinds of procedures taking place under the auspices of so-called, in some cases, experts in plastic surgery. There are some very unfortunate catastrophes that have occurred, and the member pointed those out. That's why this ability by the College of Physicians and Surgeons to monitor and to supervise these medical practitioners is needed, and that's why this legislation is needed.

I know yesterday in this House we heard a different version from a member of her own party, though, who condemned this legislation and regulatory change as totally unnecessary and totally a waste of time. So I'm just trying to figure out how the critic could stand up and say that this is needed and very important and not a perfect piece of legislation but at least it's needed,

whereas yesterday in this House we heard members on the other side railing against this bill which protects the public from charlatans who are out there in the public, who are making millions performing plastic surgery on unsuspecting people who have faith in these people because they have these medical diplomas on their wall and are being abused. In some cases, again, people lost their lives as a result of the lack of protection.

This piece of legislation is about responding to a need. The public has been made very, very susceptible to these charlatans, and we have to protect the public when we couldn't do so under present legislation. So I support 141 and I support the member from Kitchener—Waterloo in her support of it.

The Deputy Speaker (Mr. Bruce Crozier): Questions and comments?

Mr. Ted Arnott: I'm pleased to congratulate my colleague the member from Kitchener—Waterloo on her comments this morning on Bill 141,

An Act to amend the Regulated Health Professions Act, 1991. It seems from the debate that we've heard this morning on this issue that there is a consensus in the Legislature that this bill should pass. I would predict that there's going to be unanimous support for this legislation; we're debating it at second reading. It is needed legislation, as was pointed out, and I would agree with that. But I would also say that we need to move forward on this bill quickly, because given the fact that there is support, let's get on with it. Let's move forward, let's pass the legislation so that we can move on to other urgent priorities.

Today's Toronto Star: "GM to Slash 47,000 Jobs." "Chrysler, GM Now Seek $39B" in terms of government support. We have a provincial budget that has been needed for some time. We had a government that indicated that it was going to bring forward a budget on a priority basis. Now we're hearing the budget isn't going to be presented in this House for weeks to come.

There is an extreme economic emergency in our communities, and this government is doing nothing in terms of sending a positive signal that it has a plan to resolve these issues, to work with the people of Ontario, to work with the opposition parties so that we can work together to work our way through this challenge. I think it's most unfortunate that this government is unwilling to bring forward those kinds of solutions or any kinds of ideas to deal with the economic challenge that we're facing. That's what we're talking about from this side of the House.

We call upon the government to bring forward its budget as soon as possible, so as to send a positive signal out there to the people of Ontario that it has a plan in place, that it has some credible ideas to work with them to send a positive signal for the future of Ontario. That's what's lacking and that's what's needed. That's what our party is calling for, and we're going to continue to call for this. We'll work with the government, from a perspective of opposition. We'll hold them to account but we'll work with them, and I call upon the government to recognize these urgent priorities—

The Deputy Speaker (Mr. Bruce Crozier): Thank you. I shouldn't have to remind members, but I will, that questions and comments are intended to be directed toward the speech that was given by the member. From this point on, I'll be more observant when applying that rule.

Questions and comments?

Hon. David Caplan: I'm pleased to rise and respond to the comments by the critic opposite. I appreciate the fact that she recognizes the importance of this legislation. I did find it curious, however, because I took a chance to read the transcript of Hansard from yesterday in this House and her colleague the leader of the official opposition says: "What are we debating in the Legislature this week? Cosmetic surgery? Young offender housing? Does that suggest a government and a Premier who know what they're doing? I say no."

So I say to the member that perhaps she does have some work to do to convince her colleagues about the efficacy of and the support that should be in place for significant patient safety legislation, as she herself does recognize.

Mr. John Yakabuski: What about support for the economy?

Hon. David Caplan: I hear the member from Renfrew say "support for the economy," and yes, this government does have a plan for the economy as well. But we have a plan for health care. We have a plan for patient safety. We have a plan in education. The work of this government—and we reach out to the opposition and ask them for their help and their support, their ideas in order to strengthen this. I want to congratulate and recognize the member from Waterloo, who brought forward some constructive ideas. I look forward to her fleshing those out and sharing them with us. Perhaps when the bill is in committee we would look toward her very sage advice in this matter.

I don't think any member on either side of the House has a monopoly on caring about the well-being of Ontarians and patient safety. I believe that all members, regardless of where they sit in this Legislature, do hold these very true. I urge the member from Waterloo to talk to her learned colleague from Brockville to perhaps get him on side and make him aware of the importance of patient safety. I again thank her for her support.

The Deputy Speaker (Mr. Bruce Crozier): We are now ready for the response from the member for Kitchener—Waterloo.

Mrs. Elizabeth Witmer: I appreciate the comments that have been made by the members for Eglinton—Lawrence, Timmins—is it St. James?

Mr. Gilles Bisson: James Bay.

Mrs. Elizabeth Witmer: Timmins—James Bay, sorry; and Wellington—Halton Hills and the Minister of Health. I do think it's incumbent upon all of us to ensure that this legislation passes through this House as quickly as possible, because there does seem to be a consensus of support for the legislation. I certainly would say to you that everybody in the Progressive Conservative caucus does support this bill. We also hope that the minister will be receptive to the amendments that we have brought forward today.

As I said, they're not our amendments; they're amendments that have been provided to us by the colleges, in particular, of course, the College of Physicians and Surgeons. They are going to be important because they are needed to codify the investigatory powers of health colleges to ensure public safety.

I also agree with my other colleagues, whether it's the Leader of the Opposition here or whether it's my colleague from Wellington—Halton Hills: We need to get this legislation passed. We need to make the amendments because there are some very pressing issues. The Legislature has come back four weeks early this year. People in this province are focused, regrettably, on the economic distress that many of them are suffering, and this government does need to develop a plan, obviously, to ensure that we can create an environment that is going to provide hope and opportunity and jobs for our citizens.

So I would say, let's move the bill forward, let's make the amendments that are needed and let's focus on the priority of the economy.

The Deputy Speaker (Mr. Bruce Crozier): Further debate? Further debate? Does any other member wish to speak?

If not, Mr. Caplan has moved second reading of Bill 141.

Is it the pleasure of the House that the motion carry? Carried.

Second reading agreed to.

The Deputy Speaker (Mr. Bruce Crozier): Shall the bill be ordered for third reading?

Hon. Monique M. Smith: I would ask that the bill be referred to the Standing Committee on Social Policy.

The Deputy Speaker (Mr. Bruce Crozier): Shall it be so referred? Agreed.

Orders of the day.

Hon. Monique M. Smith: There's no further business this morning.

The Deputy Speaker (Mr. Bruce Crozier): There being no further business, this House is in recess until 10:30 of the clock.

The House recessed from 0955 to 1030.

INTRODUCTION OF VISITORS

Mr. Tony Ruprecht: I'm very delighted today to introduce to the House two distinguished guests: the president of the Federation of Canadian Turkish Associations, Mr. Nedim Duzenli; and a person who has written 17 books—he's from the international relations department of Ankara University—Professor Dr. Türkkaya Ataöv, who also is the director of five organizations attached to the United Nations. Welcome to the House.

The Speaker (Hon. Steve Peters): Introductions?

I want to take this opportunity to welcome two guests of mine to the Speaker's gallery today: Jane Tucker and her daughter Rachel. Welcome to Queen's Park.

LEGISLATIVE PAGES

The Speaker (Hon. Steve Peters): I'd like to beg the indulgence of the House as we use this as an opportunity to introduce our new pages. Please assemble.

I ask all members to join me in welcoming this group of legislative pages serving in the first session of the 39th Parliament: Paurnika Anton, York South—Weston; Reed Bell, Bruce—Grey—Owen Sound; Danielle Boers, Ancaster—Dundas—Flamborough—Westdale; Zaman Dubey, Brampton—Springdale; Arjun Gandhi, Vaughan; Alexander Glista, Oakville; Rachel Goldstein, Kingston and the Islands; Xiao Yan Guo, Willowdale; Tariq Haji, Thornhill; Nancy Kanwal, Etobicoke North; Jacob Macpherson, Kitchener Centre; Ashton McInnis, Windsor—Tecumseh; Olivia Mew, Trinity—Spadina; Patrick Mott, Pickering—Scarborough East; Jordan Plummer, Ajax—Pickering; Grace Qu, Davenport; Andrej Rosic, Mississauga—Streetsville; Rachel Trow, York—Simcoe; Maddie van Warmerdam, Haliburton—Kawartha Lakes—Brock; and Emily Wilson, Wellington—Halton Hills.

Welcome to Queen's Park.

USE OF QUESTION PERIOD

The Speaker (Hon. Steve Peters): Yesterday, the member for Oshawa rose on a point of order at the conclusion of question period to take issue with a question asked of the Minister of Energy and Infrastructure respecting GO Transit. The member took the position that the minister's answer addressed the issue in a way that might more properly have been done in a ministerial statement.

The minister addressed the point of order by noting that the question and response related to a joint announcement that had already been made earlier yesterday by the Premier and the Prime Minister.

I undertook to review the matter and have now done so. The member for Oshawa is correct in his understanding that question period should not be used as a forum for the announcement of new government policy or initiatives. This has arisen many times before, and Speakers have consistently taken this view.

I would not categorize yesterday's occurrence as a blatant transgression of the Speakers' directions in this regard, it being more right on the line. But I will say to the minister that it is less about the timing of the announcement outside the House yesterday and more about the fact that the announcement did take place outside the House.

The Speaker, of course, cannot compel that government announcements first be made in the House, but many Speakers before have noted that it is courteous, where possible, to do so. Having said that, if the matter previously announced is subsequently brought to the attention of the House, then a ministerial statement is usually the proper vehicle to do so. Fairness to all sides is thereby observed since the standing orders permit the opposition to reply to such statements.

I thank the member from Oshawa for raising the matter yesterday and I ask the government side to be more vigilant about inappropriately using question period to make government announcements.

ORAL QUESTIONS

ONTARIO BUDGET

Mr. Robert W. Runciman: My question is to the Premier—and it's good to have you join us today, Premier. Yesterday we were—

Interjections.

Mr. Robert W. Runciman: Nothing out of order, Mr. Speaker. Yesterday—

Interjections.

Mr. Robert W. Runciman: A very sensitive group over there. I wonder why.

Yesterday we were unable to get any meaningful answers from your finance minister as to why, in the midst of a recession, with almost 74,000 Ontario jobs lost just last month, you were delaying tabling a budget weeks beyond its promised date. Premier, do you not recognize the urgency of the situation, or are you simply at a loss in terms of how to react?

Hon. Dalton McGuinty: I know that the opposition and Ontarians generally have a real interest in our upcoming budget, and we look forward to presenting that in this House. I must say, though, that I think Ontarians have an expectation that we will do everything we can to get it right. In particular, there are two expectations that we have to meet. One is, we have to speak to the urgency of the global recession and of the job losses that are affecting us and the downturn we are experiencing in the Ontario economy.

But at the same time they also want us to begin to build the foundation for a new and stronger economy for the future, and we will take the time necessary to get that right. But I can say—and I'll speak to this again in the supplementaries—that there is much that we have been doing and will continue to do before the budget itself comes out.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Robert W. Runciman: That offered a lot of clarity, didn't it?

I would suggest, Premier, that, given your recent flipping and flopping on economic policy positions, you have, in essence, panicked. You're in deep water and you don't know how to swim. As they say in Great Britain, your knickers are in a twist, and your indecision is the real reason behind the budget delay. Premier, how can the people of this province have confidence during this difficult and challenging time when you have no concrete plan on how to respond to our economic challenges?

Hon. Dalton McGuinty: Just to remind my honourable colleague that four months ago we announced $1.1 billion in new infrastructure funding for our municipal partners, four days ago we announced $1 billion in infrastructure for smaller Ontario communities, and yesterday alone we announced another half-billion dollars for GO Transit improvements.

The point I want to make to my colleague and to Ontarians generally is that while we continue to make preparations for our budget, while we do everything we can to make sure we get it right for today and for tomorrow, we are continuing to make investments in the kinds of things that will create jobs in the short term and enhance our competitiveness in the long term.

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

Mr. Robert W. Runciman: I'm going to quote from a column in the Ottawa Citizen, which commented on Mr. McGuinty's musings on the state of the economy: Mr. McGuinty, you can have a long conversation about renovations, but "You can't have a long conversation about renovations when your house is on fire."

Premier, in Ontario, we've lost 136,000 jobs since November—almost 74,000 last month—bankruptcies are up 50%, and I think most objective observers, not to mention the people losing their jobs, would agree that this house is on fire. And you apparently don't know where to find the hose, let alone turn the water on.

Premier, will you show real leadership, meet your original budget timeline commitment, and ensure that it includes a comprehensive and realistic economic action plan?

Hon. Dalton McGuinty: Again, I understand my colleague's eagerness to receive the budget, and we are just as eager to present it in this House, but as I say, we will take all the time that is necessary, and no more than the time that is necessary, to ensure that we get it right, both for today and tomorrow.

In addition to those recent infrastructure announcements—again, four months, four days and just one day ago—we're also going to be shortly introducing into this Legislature our new green energy act. That has an objective to create some 50,000 new, clean and green jobs in the province of Ontario. We're going to do that before we introduce the budget, and I hope I'll be able to count on my colleagues in opposition, to have their support as we move forward with yet another piece of legislation to create more jobs for the people of Ontario.

ONTARIO ECONOMY

Mr. Robert W. Runciman: Back to the Premier, and it has to do more specifically, Premier, with your jumping from pillar to post on economic policy at a time when Ontarians need to have confidence in the leadership of their government. Three months ago, you were boasting that your five-point plan was the answer to the province's economic challenges. Short weeks later, you've publicly discounted its effectiveness and started to muse about big ideas and make outrageous and inaccurate comments about being the first to come to grips with big questions related to our economic future.

Premier, do you appreciate that Ontarians are increasingly concerned with your leadership and about what some describe as erratic behaviour?

Hon. Dalton McGuinty: I always appreciate my colleague's particular perspective on these issues, but I think that what we've got to do is keep our eye on the ball here. The fact of the matter is that we are experiencing the negative consequences of a global economic recession.

Let me just come back to our five-point plan, because I know that my colleagues, in their heart of hearts, continue to support the principles and objectives behind this plan. We continue to cut business taxes in the province of Ontario. I know that my colleagues, in fact, support that direction. We continue to invest in infrastructure. Last year, it was $10 billion; this year, we had originally planned to spend $8 billion, but it will, not surprisingly, exceed that. We continue to invest heavily in innovation; I know that my colleagues support that. We continue to partner with business; they support that as well.

And we will continue to invest in the skills of our people; I know they also support that. We've done that in the past and we'll keep doing that.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Robert W. Runciman: I remember the Premier's comments about layoffs in the auto industry not too long ago: "It's just a little bit of a contraction."

Premier, if you're steering the ship, it's apparent you're doing it without a nautical chart and we're hitting the shoals. We have a recession gripping the province, people losing their jobs and their homes, businesses closing, communities suffering. You called the Legislature back into session to deal with what? Our agenda this week: cosmetic surgery and young offender housing legislation. Premier, please explain to people having trouble putting food on their table why you have no clear plan to address their plight.

Hon. Dalton McGuinty: Again, I talked about announcements we made four months ago, four days ago and just yesterday. I'll just speak in a little bit more detail about what we announced yesterday. Together with the Prime Minister, we announced $500 million for improvements in our GO Transit service. In particular, we're going to create 6,800 more parking spaces at 12 different GO Transit stations.

My friend says, though, that those are not a worthy investment, and I disagree strongly. Not only will those result in jobs—5,000 jobs alone for those projects—they will also speak to a cleaner environment and a greater quality of life for our families who rely on our GO Transit service. That's 5,000 jobs as a result of one announcement just made yesterday, to say nothing of the others that we made before that and the others we will continue to make, in some cases in concert with the federal government.

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

Mr. Robert W. Runciman: In October of last year, the Premier introduced what was described as an emergency motion on the economy. Very few government members participated in that debate. Both opposition parties introduced constructive amendments. That emergency motion is still sitting on the order paper, not being debated or voted on, and I think it's symptomatic of this government's apparent inability to act in the face of real challenges.

This is a leadership crisis as well as an economic crisis, and as a result, the province is suffering. Other jurisdictions have acted. Premier, I ask you again, when will you show real leadership? Bring in a budget, an economic recovery plan, by no later than the first week of March.

Hon. Dalton McGuinty: I say to my colleague, given his desire to create jobs in the short term for Ontarians, I fully expect that I will have his support when we introduce our green energy act in this Legislature very shortly, which has as an objective the creation of 50,000 jobs.

I want to remind my colleague of an announcement we made just last Friday of three particular projects, coincidentally in the riding of Leeds—Grenville. We're investing in the restoration and redecoration of the historic Brockville Arts Centre; we're investing in the King Street West infrastructure renewal project; and we're investing in the construction of a single building to house public works, fire, parks and recreation. I think those are significant projects, and I think they're important to people living in that particular riding. Those are the kinds of things that we will continue to support on a—

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

MANUFACTURING JOBS

Mr. Gilles Bisson: My question is to the Premier.

Yesterday, Premier, more bad news: General Motors and Chrysler have announced that 40,000 jobs are possibly going to be lost. We know there's going to be some effect on the Ontario economy.

Premier, you know it's an economic tsunami. Community after community is being affected across this province when it comes to job loss, and all you've been able to do is duck and hide. Your budget is not coming forward in order to deal with some of these issues. We, as New Democrats, have put forward a number of initiatives in order to respond to the situation that we're in. If we've been able to do that from the opposition side of the benches, why have you, as the government, not acted on what is a crisis now in Ontario?

Hon. Dalton McGuinty: I appreciate the question and I want to remind this honourable colleague of some of the measures that we have already put in place. Again, just four months ago, we invested $1.1 billion, through our Investing in Ontario Act, in new infrastructure funding to our municipal partners. That work is under way right now and creating jobs right now. Four days ago, working with the federal government, we announced $1 billion in infrastructure projects for smaller communities. Then, just yesterday, we announced another $500 million by way of new investment in GO Transit improvements.

Those are all government initiatives designed to create jobs in the short term and enhance our productivity in the long term. So of course I will disagree with my colleague when he says that we aren't doing anything between now and the budget. We've done much, and we'll keep doing more.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Gilles Bisson: Nobody is going to argue that investments in infrastructure aren't important. But the bedrock of this economy is the automotive sector, the forestry sector and other manufacturing sectors in this province, and they're bleeding jobs by the hundreds of thousands. Workers across this province are saying, "If I haven't already got the pink slip, I'm worried I'm going to get one tomorrow." So my question to you is not about what money you're putting into infrastructure. What are you going to do to attack the job losses in the manufacturing sector across this province?

Hon. Dalton McGuinty: Let me speak to the challenge being faced by our auto sector.

I understand the sentiment being expressed by my colleague. There is a great deal of anxiety being felt by Ontario families. In some cases, there's outright fear. What we're experiencing in Ontario is really without precedent; I understand that. But let me tell you what we're doing on the auto sector front.

The first thing that we're doing is, we're working as closely as we can both with the federal government and the United States of America's government, understanding we have a fully integrated industry, understanding that this is going through restructuring, but understanding that what's at stake here is 400,000 good Ontario jobs. So we have said to the auto industry—and my colleague is aware of this—we're prepared to put forward $4 billion by way of initial support for this particular industry. That's a significant contribution on the part of Ontario taxpayers. We'll expect that the auto sector, including the workers themselves, will bring something to the table.

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

Mr. Gilles Bisson: Premier, you just don't get it. You're like the person at the crime scene who saw the crime and said, "Oh, God, nothing I can do." Listen: We've lost these jobs over the last three or four years. We've seen job after job being bled out of southern Ontario and across northern Ontario, and your government has sat back and done hardly nothing. You've had to wait for Obama in the United States or Stephen Harper to do something and you sit here like an innocent bystander. So I say to you again, when are you going to take your responsibility as the Premier of Ontario and do something about trying to stop the massive job losses in this province?

Hon. Dalton McGuinty: Again, I appreciate the perspective my colleague brings, but I don't agree with it and I just don't think Ontarians agree with it. I think they understand that something is happening, which is pretty big and comes from beyond Queen's Park and Ottawa, that is affecting the global economy on the whole. I think they understand that. I think what they want us to do is everything that we can, and we will continue to do everything that we can.

One of the things I want to remind my colleague, in terms of recent supports we provided for Timmins—James Bay: Just last week, we've invested in the drinking water distribution system in that riding. We have invested in the Hollywood Boulevard construction, in the Timmins east end water supply improvement project and in the fire hall renovation. Those are continuing investments. Those are important for the people living in that community. They will create jobs in the short term and will enhance the productivity and competitiveness of that community in the long term.

MANUFACTURING AND

FORESTRY SECTOR JOBS

Mr. Gilles Bisson: Well, I have no idea where Hollywood Boulevard is in my riding, but that's a whole other issue.

Premier, you say that you're concerned; imagine those people who are in the situation of having lost their jobs. We saw last week Marathon, the only employer in town, shutting down and leaving those people high and dry with no jobs, as we saw in Smooth Rock Falls last year. We saw Terrace Bay, this morning, announce a layoff for some six or eight weeks. We see the same thing going on in Nairn Centre. What do you say to those workers who have been waiting for your government for the last five years to do something about stopping the loss of jobs in northern Ontario and the forestry sector, as they see more coming?

Hon. Dalton McGuinty: Again, I know that some parts of Ontario have been hit harder than others and northern Ontario, particularly because of its reliance on forestry and some of our resource-based industries, has been particularly affected by this. But I want to assure folks living in those communities that we will continue to do everything we can to lend some strength to their economies. I know, again, last week in Terrace Bay we invested in a community centre roof replacement, for example. That's a project that is close to $1 million. I know it's not everything, but it will create some jobs in the short term.

We will continue to do everything that we can but we can't do everything. I think Ontarians understand that. But we will do everything we can, particularly through our upcoming budget, to address some immediate pressures while at the same time building a stronger foundation for a future economy.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Gilles Bisson: Nobody in Terrace Bay and nobody in Timmins—James Bay or anywhere else argues that infrastructure investment is not important. We all agree on that. The issue is, what is your government going to do in order to assist those industries that are shutting down, one after the other, across this province? We saw just this morning, again, the issue of Terrace Bay and Nairn Centre. Last week it was Marathon. Before that it was Thunder Bay. The week before that it was Hearst. We are seeing town after town lose jobs across this province and your government's done nothing.

So I'm going to ask you this: Are you prepared, at the very least, to announce an industrial hydro rate in order to assist those industries that are most affected by the price of electricity in this province?

Hon. Dalton McGuinty: To the Minister of Energy and Infrastructure.

Hon. George Smitherman: I want to say to the honourable member that we recognize the north has experienced particular challenges, but Minister Gravelle and I had the opportunity recently to host the Grow North forum in Thunder Bay on February 4; 375 people from northern Ontario came together with a sense of enthusiasm about their communities.

As one example, the request for expressions of interest that the Ministry of Natural Resources and Ontario Power Generation have launched to create a made-in-Ontario supply of biomass for conversion of our coal-fired assets has created excitement in many communities in northern Ontario and for many of those who are unemployed related to the forestry sector. The Ministry of Natural Resources has worked with forestry companies to invest with them directly to transition them to lower-cost operations, so they use less electricity.

There are many challenges in the north. This government stands with northerners, working with them to look for opportunities in this difficult environment. We've demonstrated our willingness to invest and we will invest further to protect the jobs that are possible to protect in northern Ontario, to stand alongside those—

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

Mr. Gilles Bisson: Further to the Premier: We saw last week the question of what happened in Sudbury with Xstrata: 700 jobs lost. We, as New Democrats, my colleagues Shelley Martel at the time and the other northern members along with Howard Hampton, were in Sudbury with the municipalities and the unions and others two years ago calling on your government to make sure that we had guarantees when it came to the sale of Vale Inco to Xstrata and those companies, that there would be some protection for jobs in Sudbury and Timmins. But even more important is the protection of the services being sold to the companies.

Here we are; we've seen the 700 job losses. Basically, those agreements have not been kept.

Will you agree, finally, that you missed the boat two years ago in doing what should have been your responsibility in order to give protection to the people of Sudbury?

Hon. George Smitherman: To the Minister of Northern Development.

Hon. Michael Gravelle: Certainly in terms of the question itself, it was devastating news last week when Xstrata announced the layoffs of those workers. Our hearts go out to the workers. It has been a very difficult and challenging time, there's no question about it. If there's a silver lining, it is that Xstrata remains very committed to the Sudbury area. They're committed to the operation of their Nickel Rim South project and they have worked very closely with the union to try to extend the benefits for those who have been laid off for 16 more weeks.

There's no doubt this is a very challenging time in all sectors. Certainly, the mining sector is not immune from the global financial crisis, but I think it's important that we continue to work closely with the mining companies and with all those who are involved in the process while we go through these really difficult times.

ONTARIO BUDGET

Mr. Tim Hudak: A question to the Premier: One of the bland expressions that Dalton McGuinty used to pass off as leadership was "to do much to fix the roof while the sun was shining." Well, Premier, let's review your record since the last election: 72,700 full-time jobs gone; 86,000 private sector jobs gone; and 100,000 well-paying manufacturing jobs gone. Ontario has officially become a have-not province on the welfare rolls of Confederation. I hope the taxpayers got some kind of warranty, because if the roof isn't caving in, I don't know what that is.

Premier, it is finally time to act. Speak to the gentleman beside you and tell him to come forward with a budget immediately.

Hon. Dalton McGuinty: Again, I understand my colleague's impatience in this regard, but we're going to take the time to get it right. That may frustrate them, but so be it. We will take all the time that is necessary, and no more than the time that is necessary, to ensure that we put forward a budget that speaks to the expectations of the people of Ontario and that achieves two important objectives. One is to respond to the crisis as it's affecting our families and businesses today, and the other is to begin to lay a stronger foundation for a new economy.

The ground continues to shift under our feet. It is very difficult to get a consensus from economists as to where the economy is going to go during the course of the next six months, let alone during the course of the next 18 months. So we will take the time to get it right. In the meantime, we will continue to invest in new infrastructure projects.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Tim Hudak: The Premier says his priority is to find consensus. Premier, Ontario families want to see leadership in action.

Premier Wall in Saskatchewan, four months ago, brought forward his economic stimulus package that lowered business taxes. Three months ago, Prince Edward Island acted with a major stimulus investment. In British Columbia, Premier Campbell, four months ago, brought forward his 10-point economic plan.

Here in Ontario, Dalton McGuinty looks like he was on the losing end of a game of freeze tag. Premier, it's time to end the paralysis. Speak to the guy beside you. Tell him to get off his backside and bring forward a budget by the end of this month or the first week in March.

Hon. Dalton McGuinty: I wish my colleague was as well acquainted with the happenings in this Legislature as he is with the happenings in other Legislatures. It was four months ago, in our own fall economic statement, that we did a number of things, including investing $1.1 billion in new infrastructure projects with our municipal partners. Those projects are under way right now. We made that announcement in this House four months ago.

I can appreciate that my colleague has an interest in what's taking place in other parts of the country, but I'd ask him to pay a little bit of attention to what we're doing, through this Legislature, right here in Ontario.

ONTARIO ECONOMY

Mr. Paul Miller: My question is to the Premier. Here's the disastrous state of Ontario's economy by the numbers, Premier: January job numbers from Stats Canada show a collapsing job market, with 71,000 jobs lost in November alone. Over 300,000 manufacturing jobs have been lost in the last four years. Manufacturing shipments have declined by almost 10% in one month alone.

The NDP has a jobs plan. Where is the minister's plan? Also, the Premier stands up in this House and always says he wants to work with the opposition for the betterment of Ontario. It doesn't happen, because they don't pass any of our bills.

Hon. Dalton McGuinty: To the Minister of Economic Development.

Hon. Michael Bryant: The member knows, just locally, about the investments that have been made in the city of Hamilton through the communities in transition fund, investments made with the Dofasco Learning and Development Centre, investments made with Ironworkers Local 736 and the United Brotherhood of Carpenters and Joiners Local 18. These are just some of the investments that the government has made.

This government's approach has been to take a series of taxpayer investments and funds and provide assistance directly to communities and businesses. We have not been doing that for the last couple of months; we have not been doing that for the last year; this has been the strategy that this government has undertaken for the last five years.

So, yes, it is true that other provinces are making investments. But it is a strategy that this government has been undertaking over the last five years, and we will continue to make those investments in all of your communities out there.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Paul Miller: We've done the government a favour. We laid out a plan that would get Ontario's economy moving again. We need the NDP's aggressive Buy Ontario program not just in transit but in all areas of public sector procurement. We need a real, massive, aggressive infrastructure program. Not only will it put people back to work immediately, but it will lay out the groundwork for jobs of the future. We need a $10.25-an-hour minimum wage immediately, to put money in the pockets of people who can spend it directly in our economy.

We've done our part. We've laid out a good plan. Where is the minister's job plan, and why won't you co-operate with the opposition?

Hon. Mr. Bryant: The member refers to the need for massive investment. I remind the member of a $14-billion investment just last week—where? In East Hamilton Recreational Trail Hub and Waterfront Link. This is a $14-billion investment that's being made. Look at this investment as we go into the future, not only in terms of the investments in the city of Hamilton but in the province.

I recognize that when the New Democrats were in power, the unemployment rate was 9%. I recognize that when the Conservatives were in power, the unemployment rate was higher than it is today. But we will continue to work with the opposition parties to make investments such as this in Hamilton—millions of dollars of investments—

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

HEALTH CARE

Mrs. Carol Mitchell: My question is for the Minister of Health and Long-Term Care. Since I was elected in Huron—Bruce, my constituents have continued to ask me one very important question: Where can they find a family health care provider? Last week, I was very pleased to see the launch of a new program to help connect unattached patients with a health care provider. It is a tool that I know every member of this House will use to help constituents find the care they need close to home. However, I am wondering how effective this program will be in areas of the province where there may be a shortage of health care providers. How will patients in these areas get connected to care?

Hon. David Caplan: I would like to thank the member from Huron—Bruce for the question. I know that she is a very passionate and committed advocate in helping constituents find health care providers. Our new Health Care Connect service is a unique, made-in-Ontario solution that the Premier launched last week. It is a telephone hotline that will help Ontarians who don't have a family health care provider find one. By calling a special 1-800 number, Ontarians without a family health care provider can add their names to a registry.

A nurse, known as a care connector, will then attempt to match that unattached patient and their family with a family health care provider—a physician or a nurse practitioner—who is accepting patients. The strategy will help us ensure that more Ontarians are able to get access to family health care. We're still committed to rolling out an additional 22 nurse-practitioner-led clinics and 50 family health teams. Health Care Connect helps us target the areas that need these—

Interjections.

The Speaker (Hon. Steve Peters): Supplementary?

Mrs. Carol Mitchell: I can hear from all the members of the House that they do agree that it sounds like a very promising initiative.

In the last election our government committed to finding family health care providers for another 500,000 Ontarians. I think Health Care Connect will help us reach this very ambitious goal. In the meantime I know that a lot of Ontarians without a family health care provider are relying on emergency rooms to provide them with the care that they need. I have heard the Minister of Health and Long-Term Care refer to ERs as the "default doorway into the health care system." But for people with minor ailments or injuries, the ER probably isn't the best place to go for treatment.

Can the Minister of Health tell the House how he is going to ensure that Ontarians know about the health care options other than ERs that exist in their communities?

Hon. David Caplan: Again, I want to thank the member for the question. It's very germane and appropriate. I'm pleased to tell the House about another innovative initiative that we launched last week. It is a new website called Your Health Care Options. Using Google-style mapping and simple search terms, the site makes it easy for Ontarians to find health care services in their community. By typing in their postal code, Ontarians can find the nearest walk-in or after-hours clinic, urgent care centre, family health team, general practitioner and emergency room.

The site will link to other health resources, including information about Health Care Connect. Eventually, the site will be expanded to include information relating to all front-line health services in Ontario, including community care access centres, nurse-practitioner-led clinics, laboratories and long-term-care homes. I'm so excited about both these new initiatives. I have no doubt that our Health Care Connect phone line and Your Health Care Options website will reduce wait—

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

MINISTRY OF THE

ATTORNEY GENERAL

Mr. Frank Klees: The question is to the Premier. On July 26, 2007, the Premier accepted the resignation of one of his cabinet ministers following an investigation that revealed inappropriate distribution of taxpayers' funds through a program of the Ministry of Citizenship and Immigration. At that time, the Premier said this: "This is ... a government that believes in accountability. And in this circumstance, Mike feels, and I agree, the minister must be held accountable—and that stepping down is the right thing to do."

Will the Premier tell us if he believes that the out-of-control spending of $23.4 million on outside lawyers and consultants to recover $3.5 million is responsible administration by his government? And if not, which of his ministers does he believe should be held responsible? The minister responsible for the Ontario Realty Corporation, the Attorney General, or both?

Hon. Dalton McGuinty: To the Attorney General.

Hon. Christopher Bentley: My friend will remember that the case actually started under the government of which he was a part. But let's be clear: That's a lot of money. I think we can do better in our approach to private counsel, and that's why we've taken a number of steps. First of all we brought the case in-house, we concluded the case, we were successful and we're pursuing the costs from the losing party.

Secondly, we have taken the approach that we do not hire outside counsel on a regular basis now as was once the practice. We do everything we can in-house. Where we do retain outside, we partner up, and when we have to retain outside, there is a much more rigorous examination of accounts than there was. I can speak to further reforms that we've taken in the supplementary.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Frank Klees: The Attorney General himself attempted to keep the truth about these scandalous legal fees from the public.

The Speaker (Hon. Steve Peters): I would ask the member to choose more parliamentary language, please.

Mr. Frank Klees: On behalf of the government, he fought the Toronto Star's efforts to get access to that information, but he lost that fight. We now know that there were $23.4 million in outside legal and consulting fees paid. For eight years, this government signed blank cheques to Bay Street lawyers. There was no oversight and there was no accountability. As one veteran litigator said, "It was throwing good taxpayer money after bad. It was out of control. In all my years practising law, I had never seen anything like it."

Will the Premier agree that this out-of-control spending by his ministers is in fact unacceptable, and will he tell us if he intends to hold either one of them responsible—

The Speaker (Hon. Steve Peters): Minister?

Hon. Christopher Bentley: With respect to the release of information, our position on that from the beginning was that when the case was over, the information would be released. We will not release information that may affect the public interest in the course of a lawsuit. That's been our position all along.

Secondly, I say to my friend again that this case did start some years ago, and you may recall its beginning, because you were part of the government responsible for the agency that started it. But we're here now. We took the three steps I outlined and we've also taken steps to streamline the civil litigation process itself. Beginning January 1, 2010, we're going to have a much more simplified process that will make this and all cases faster, less expensive and more accessible.

SPECIAL CARE HOMES

M me France Gélinas: Ma question est pour le ministre de la Santé et des Soins de longue durée. A few weeks ago in this House, I raised the issue of sexual abuse allegations at the Goodfellow home for special care in Garson, in my riding. I asked the Minister of Health and Long-Term Care if his ministry had been inspecting the home regularly as per regulation. First the minister said that it was not his responsibility, but then last week the minister confirmed in a letter that homes for special care are indeed the responsibility of his ministry, and I thank him for that.

My question is, did the Ministry of Health inspect the Goodfellow home for special care in Garson twice monthly as per regulation?

Hon. David Caplan: The member is correct; I did clarify and expand on my earlier answer, and did provide that in fact the ministry has undertaken its statutory requirements. The homes for special care program is an important program where long-term-care residence is provided for people discharged from provincial psychiatric hospitals. I can confirm to you that the Minister of Health and Long-Term Care is responsible for licensing and the financial administration of homes for special care under the act.

In order to receive their yearly licence, each home must comply with inspections conducted by the fire department, public health and the psychiatric hospital field office. The Goodfellow residence has undergone these inspections on a regular basis.

The Speaker (Hon. Steve Peters): Supplementary?

M me France Gélinas: I want to make sure that I understood his answer clearly. What I want to know is, I want to have confidence that the inspection of the Goodfellow home took place every two weeks, like they are mandated to do to maintain their licence, as the minister said, because some of the residents at the Goodfellow home tell me that they never saw an inspector at that home. I'm really worried as to who is protecting those vulnerable residents in dozens and dozens of homes for special care in this province.

Are inspections occurring at all homes for special care twice monthly across this province, as the minister said and as per regulation from his ministry? We want reassurance. Thank you.

Hon. David Caplan: I believe I just provided a very clear answer to the member that in order to receive—

Interjection.

Hon. David Caplan: I know the member from Niagara may not care about this.

In order to receive their yearly licence, each home must comply with inspections conducted by the fire department, by public health and by the psychiatric hospital field office. I can confirm to the member that the Goodfellow residence has undergone these inspections on a regular basis, in compliance with the regulatory environment.

The member asked, related to an ongoing police investigation—since there is a police investigation that is currently underway, I can't comment further on the status of that investigation, obviously, as the member would well understand. I do want to thank the member, however, for her interest and for her advocacy on behalf of these vulnerable individuals who need and deserve the very best care possible that the province and our partners—

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

POVERTY

Mr. Yasir Naqvi: My question is for the Minister of Children and Youth Services. Two weeks ago, I had the opportunity of hosting a poverty reduction town hall in my riding of Ottawa Centre, and I'm very grateful that the minister attended that town hall meeting. We had representatives, from the large groups of people who came to this meeting, from the city of Ottawa, the youth services bureau, the social planning council, the Centretown Community Health Centre, ACORN, the Odawa Native Friendship Centre and many more.

The purpose of the meeting was twofold: one, to get feedback about the poverty reduction strategy, and also to talk about the next steps in terms of implementing the strategy. Those at the meeting were happy to have the opportunity to present their feedback to the minister on the poverty reduction strategy and express their excitement about being part of the solution.

My question is, how will the government continue to engage community partners so that they have a say in how the poverty reduction strategy is implemented?

Hon. Deborah Matthews: I was very happy to be in Ottawa with the member a couple of weeks ago to have a conversation with individuals and groups in his community about our recently released poverty reduction strategy. We heard first-hand from people about the challenges that they face, about the successes they've had in making a difference locally, but most of all I think what we learned is how committed people are to work together to implement solutions that work in Ottawa, that work in the local community.

I've had the opportunity to go to other communities—Mississauga, Peterborough, Ingersoll; tomorrow I'm going to Kitchener—Waterloo to talk to people there who are concerned about this issue.

For the first time, we have a plan to reduce poverty in this province. I'm proud of the plan, but the work has just begun. Our government is committed to working with our partners to make sure that we make the difference we know we can make.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Yasir Naqvi: I appreciate that my constituents and community partners would not only be listened to, but also empowered to put in place local solutions that work to reduce poverty.

There were some people at the meeting who were concerned that a poverty reduction strategy only sets a target to reduce child poverty. Poverty affects us all. Whether it's a child, a single adult or a person with a disability, we all suffer when someone doesn't get the help they need to achieve their full potential. I know that the poverty reduction strategy recognizes there are many groups disproportionately affected by poverty and includes initiatives to support them, but some groups have argued that we should also set specific targets for these groups or one general target for everyone.

Can the minister please explain why the poverty reduction strategy has an initial focus on children, and why the target is based on child poverty?

Hon. Deborah Matthews: I thank the member for this very important question, and certainly one I have been getting across the province. When we set out to create Ontario's first poverty reduction strategy, we knew we couldn't do everything all at once. If we wanted to make a real, tangible difference for Ontarians, we had to start somewhere. We learned that focusing on children first and giving them the tools and supports they need is the smartest long-term investment we can make. Dollars invested now in kids will create a more prosperous Ontario for years and, indeed, generations to come.

So we did make the choice to set our first targets with children. We have a plan to break the cycle of poverty by giving children and families the opportunity to achieve their full potential. Our target is to lift 90,000 children out of poverty over the next five years. It's the right thing to do. But we are by no means ignoring—

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

TOBACCO INDUSTRY

Mr. Toby Barrett: A question to the Minister of Agriculture: Tonight, the tobacco board is hosting a mass meeting for farmers to discuss the $300-million federal exit package for farmers forced out of business by governments, including Mr. McGuinty's government. Banks are calling in loans. Farmers have lost something like $500 million in equity. Tonight we will hear the federal plan. Minister, what is the McGuinty plan to carry tobacco country beyond this economic devastation?

Hon. Leona Dombrowsky: First of all, I would remind the honourable member that our government has provided a $50-million investment for transition for tobacco producers: $35 million went directly to tobacco producers; $15 million went to communities that would be impacted when the transition would take place. So our government has been quite proactive.

In addition to that, we have also, with our rural economic development program, been very open to hearing from those communities that have ideas around how they can co-operatively work in partnerships to assist with this transition.

So our government has been there with the $50-million transition. We continue to be there with our rural economic—

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

Mr. Toby Barrett: Minister, last August you received $157 million as your part of the civil settlement agreement with the tobacco companies. The farmers are looking for a bit more leadership from Mr. McGuinty here. The fiscal year is drawing to a close. We now need a made-in-Ontario solution. We need something to replace well over 9,000 jobs destroyed by the demise of this tobacco economy. You indicated previously that you would be part of this federally led exit program.

Minister, the question is, will you, at minimum, establish a mechanism for dialogue with the tobacco community and with tobacco farm families throughout southwestern Ontario?

Hon. Leona Dombrowsky: I would say the mechanism that I've been using with the tobacco farmers has been the telephone and face-to-face meetings. I've met with them very regularly. In fact, I have embraced the proposal that they brought to this government, as has this government, with respect to having a user-funded strategy. That is what Ontario committed to be a part of.

At this point in time, tobacco producers have been working with their tobacco board around the exit strategy that was announced by the federal government. We certainly are supportive of those efforts. I understand that the marketing board is meeting today with its members to provide the details of that plan.

We will continue to be there to assist in any way that we can, whether it's with the commission or providing supports to the board. We believe that—

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

CONSUMER PROTECTION

Ms. Cheri DiNovo: My question is to the Minister of Small Business and Consumer Services. An advisory board recommended that borrowing costs for payday loans be capped at $21 per $100. That's substantially above Manitoba's rate of $17, despite the previous minister, Ted McMeekin, saying in this very House, "I really am optimistic, as an honourable member, to do better than that." For low-income Ontario workers facing increasingly difficult times, the recommended rate is worlds away from Manitoba's, let alone my Bill 54, modeled after Quebec's 35% cap. Why won't the minister side with low-income families instead of the payday loan industry?

Hon. Harinder S. Takhar: I want to thank the member for asking this question. First of all, I really want to thank the board members for actually doing very extensive consultation with the companies that make payday loans and also the people who borrow these loans. They came up with very good recommendations, in my view at this point in time, that balance the interests of the industry but also the interests of the people who borrow these services.

Interjections.

Hon. Harinder S. Takhar: This is the recommendation that is made by the board. The government has not made any decision with regard to it.

The Payday Loans Act came into existence in 2008, and there are other measures we are taking in order to protect the most vulnerable in our society that I would be more than pleased to outline in my supplementary.

The Speaker (Hon. Steve Peters): Supplementary?

Ms. Cheri DiNovo: I miss the previous minister's optimism and ability on this.

The fact is that the recommended cap will only affect the fringe payday lenders. It's no wonder the Canadian Payday Loan Association called the recommendations "balanced"; they won't even be affected. Instead of standing up for the payday loan industry, why won't the new minister stand up for low-income Ontarians?

Hon. Harinder S. Takhar: I really want to congratulate the previous minister for actually coming up with the Payday Loans Act.

Let me just talk about some of the other measures that we are doing with regard to the Payday Loans Act. One is prohibiting the rollover of loans. The other recommendation that was made by this board is that most of the people who use these loans sometimes get used to these loans. That's why we are coming in with the education system, so that we can actually educate the people that these are expensive loans; they don't need to get into these again and again and again. So the education is an important component of this.

We are also making sure that these loans are posted so that people are aware of the cost of these loans. There is going to be full disclosure; there's going to be an education component to this. But at the same time, as I said before—

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

MUNICIPALITIES

Mr. Bas Balkissoon: My question is for the Minister of Municipal Affairs and Housing. Minister, recently I came across a press release from one of our NDP colleagues vying for their leadership and his plan for Ontario municipalities. Many of the items being proposed are ones that our government has worked hard on, in partnership with municipalities and other partners, to improve Ontario communities. I remember specifically when the government released a provincial-municipal review last fall. Minister, I would, however, appreciate you outlining what our government has done for Ontario municipalities and how we are working with them to strengthen our communities.

Hon. Jim Watson: I want to thank the honourable member from Scarborough—Rouge River. We're very fortunate in this caucus to have a number of MPPs who have municipal experience, as the honourable member does. They understand the challenges facing our 444 municipalities. That's why I was so pleased in October when we reached a consensus agreement with AMO and the city of Toronto for a report that talks about and implements an uploading strategy for the next several years. In fact, when all of the uploading takes place, municipalities across this province will save $1.5 billion.

But we're not waiting for the full implementation. In fact, this year alone, municipalities, as a result of uploading ODSP administrative costs, will save $86 million.

We look forward to continuing to work with the municipal sector. I thank my colleague the Minister of Finance, AMO and the city of Toronto for reaching this landmark agreement that finally gives the respect to municipalities they deserve.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Bas Balkissoon: Thank you, Minister. Like yourself, I come from a municipal background. I spent a number of years as a municipal councillor in Toronto and kept a close eye on the proceedings at city hall last week when Toronto unveiled its budget for 2009. Like many jurisdictions, Toronto is facing difficulties in the wake of global economic uncertainty. As the largest city in Canada and the financial centre of the country, it is critical that Toronto continues to be a strong and vibrant city able to compete globally.

Infrastructure projects have been cited a great deal recently to help stimulate the economy, but other measures such as investments in affordable housing, transit and providing relief to property taxpayers can provide needed support. What steps and what investments has the province taken to support cities like Toronto?

Hon. Jim Watson: I want to congratulate the Liberal MPPs from the city of Toronto who are non-stop advocates for their city, for their community, and they do an excellent job making sure that Toronto gets its fair share.

Let me just start by telling the member that support for Toronto—this is important to hear—from this government, the McGuinty government, since 2003 is five times higher today than it was when this government took over. Let me give you a couple of examples: the Investing in Ontario Act—Toronto received $238 million; $180 million for the affordable housing program; the rent bank, $6.3 million, which has prevented over 3,000 evictions to date.

As a result of the Provincial-Municipal Fiscal and Service Delivery Review, the uploads this year alone for the city of Toronto are close to $60 million, and when fully implemented, the upload savings to the taxpayers of Toronto will be close to $400 million.

CHILDREN'S MENTAL

HEALTH SERVICES

Mrs. Julia Munro: My question is for the Minister of Children and Youth Services. I'm sure that the minister is aware of the correlation between economic downturn and the demand for children's mental health services. My question is simple: What steps have you and Mr. McGuinty taken to anticipate this demand?

Hon. Deborah Matthews: The member opposite is absolutely right that an economic downturn does increase the demand for services across my ministry and others as well, whether it's children's aid societies, children's mental health or social assistance. We are all impacted by an economic downturn.

That is why we really strengthened services for children in the first five years of our government. That strengthening of services will pay dividends as the anticipated increase does in fact come to fruition as the economy does what it is already doing.

The Speaker (Hon. Steve Peters): Supplementary?

Mrs. Julia Munro: We already have evidence that the economic downturn is affecting the demand for children's mental health services. Since 2006, Windsor has lost thousands of manufacturing jobs. With unemployment soaring above 10%, children's mental health cases in Windsor and Essex have increased by 50% since the auto downturn. Is the minister aware of this, and what has she done to help the children of Windsor and Essex county?

Hon. Deborah Matthews: I think it's important that the member opposite acknowledges that we have actually made tremendous improvements in children's mental health—the first base funding increases in over a decade. In fact, when her party was in power, they froze children's mental health and kept it frozen. It was only when our government was elected that we began to reinvest in children's mental health.

We provided the first base increase in over a decade in 2004-05 and another $24.5 million in 2007-08. We've also expanded access in rural, remote and underserviced communities through the telepsychiatry program. We doubled funding for that. It went from one hub and 14 satellite offices to three hubs and 24 offices.

Children's mental health is a very important priority for our government. We're committed to continuing to improve it. We welcome the select committee's work on this—

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

HEALTH CARE

M me France Gélinas: My question is for the Minister of Health and Long-Term Care. Lyn Edwards, the NDP candidate in Haliburton—Kawartha Lakes—Brock, knows that people in her riding need solutions to the lack of access to primary care and the lack of physicians. Mrs. Edwards and her community support the development of a community health centre for Lindsay and Kawartha Lakes, a model of primary care that will provide access to doctors, nurse practitioners, social workers, dieticians etc. for people in her riding.

Will the minister admit that a hotline will not replace the need for community health centres, primary health care or more doctors?

Hon. David Caplan: It didn't take a by-election to get this government working on the problem of getting doctors and patients together. In fact, since 2003, 630,000 Ontarians who did not have access to a family physician now have one, because of the determined work of this Premier and this government. Because of the work of this government, we have doubled the number of community health centres in this province, and I'm very proud of that record. Because of the work of this government, we have rolled out new initiatives, like nurse-practitioner-led clinics.

The first one, as the member would be aware, is located in Sudbury, with a satellite in Walden. Three more are on the way to be awarded, and an additional request for proposals for the remainder will be going out this spring.

It doesn't take a by-election to get this government working to provide better access to health care. In fact, we started on day one.

The Speaker (Hon. Steve Peters): Supplementary?

M me France Gélinas: More than 25,000 people in Haliburton—Kawartha Lakes—Brock do not have access to primary care: They do not have access to a nurse practitioner; they do not have access to a physician. While this government has been busy promoting a phone line and a new website, they seem to have forgotten that solving the province's problems in health care takes more than phone lines and websites. Communities like Haliburton—Kawartha Lakes—Brock need real solutions—solutions that are tailor-made to their communities, like funding a new CHC; solutions which Lyn Edwards would be ready to bring to this House.

What is the minister planning to do regarding the new community health centre in Haliburton—Kawartha Lakes—Brock?

Hon. David Caplan: Ontarians remember that the New Democrats cut medical school spaces 13%. Is it any wonder that we experience these kinds of shortages? That's why on day one, this government began over doubling the number of med school spaces in this province.

I can tell you I've had conversations with Rick Johnson. Rick Johnson has been advocating for better health care in Haliburton—Kawartha Lakes—Brock, and in fact he wants to build on the record that this government has provided. Whether that's to more than double the number of international medical graduates, whether that is increasing the number of medical school spaces by 23%, I can tell you that Rick Johnson knows and gets it. Rick Johnson advocates for the people and wants to build on the results. We don't want to go back to the sorry NDP days where we cut doctors, where we cut nurses, and it's Ontario patients who paid the price.

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

The Minister of Economic Development and Trade on a point of order.

CORRECTION OF RECORD

Hon. Michael Bryant: Mr. Speaker, in my exuberance for the investment, and in the hurly-burly of question period, I did misspeak as to what the investment is. It is a $14-million investment in the city of Hamilton. That ain't chicken feed, and it's still a good investment—

The Speaker (Hon. Steve Peters): That is a point of order. The member is correcting his record.

The member from Hamilton East—Stoney Creek, on a point of order.

Mr. Paul Miller: I'd like the minister to have the balance of the cheque sent to my riding so we can build all those things he promised.

The Speaker (Hon. Steve Peters): That is not a point of order.

There being no deferred votes, this House stands recessed until 3 p.m.

The House recessed from 1138 to 1500.

MEMBERS' STATEMENTS

SCHOOL PLAYGROUND

Mr. Ted Arnott: This morning I had the opportunity to speak in this House about the extreme economic challenge we're facing and the government's lack of leadership in responding to it. This afternoon, I wish to call the attention of the House to a local matter of concern to many of my constituents in Acton.

Because of what the Toronto Star calls "pressure" from the Minister of Education, the Halton District School Board was pushed toward initiating a process to sell part of the playground at McKenzie-Smith Bennett public school. According to yesterday's Star, hundreds of people gathered on Family Day to support the children of their community and their children's right to keep their existing playground.

I've received numerous e-mails from constituents and I'm aware that the board and the town of Halton Hills council are working together to find a solution. But let's remember who started this schoolyard spat: It was this Minister of Education. Once a self-styled champion of local school board autonomy, she is now forcing school boards to take the heat for unpopular decisions, decisions that are, in fact, rooted in her own bad policy and evasion of responsibility.

Acton has spoken loud and clear. The community wants a solution to keep the school playground, but for that to happen, we need the minister to back off the board and let the children play.

EDEN MILLS SKI CLUB

Mrs. Liz Sandals: Cross-country skiing is a wonderful way to stay fit and have fun during our great Canadian winters. The Eden Mills cross-country ski club is located just south of Guelph. Their jackrabbit program provides children aged four to 14 with skills training, while also focusing on the lifelong benefits of active living and fitness. Eden Mills ski club also offers a wide range of skiing challenges for the more advanced cross-country skier. Their mission is to help children learn and enjoy cross-country skiing in a safe and supportive environment.

I'm very pleased that the Ontario Trillium Foundation has provided Eden Mills with a $15,000 grant to assist with the purchase of new trail-grooming and rental ski equipment. Eden Mills has been using aging, 20-year-old grooming equipment, hoping it would make it through just one more winter. The Trillium funding allows the club to acquire reliable, efficient and up-to-date equipment so that they can continue grooming the trails for prime skiing. The addition of rental ski equipment for children will permit more families to enjoy cross-country skiing.

Being able to rent ski equipment for kids, whose height and feet grow every winter, helps parents reduce the costs of participating in a great sport.

I'm thrilled our government is able to support such a worthwhile program.

WASTE DISPOSAL

Mr. John Yakabuski: On February 4, in the House of Commons, the member for Ottawa South, David McGuinty, implied in his questioning of the Minister of Natural Resources, the Honourable Lisa Raitt, that there was a connection between two truckloads of sewage from the city of Ottawa found to be radioactive and Atomic Energy of Canada's Chalk River nuclear facility.

There are two things that trouble me here. The first is the member's total lack of knowledge of how a municipal water and sewage system works. The second is his total disregard of the facts.

On the first part, I would urge him to spend some time visiting the system operating in his city, instead of conjuring up ridiculous scenarios that aren't even possible. On the second issue, I would remind him that, as a parliamentarian, he has a duty to accept the responsibility bestowed upon him. That responsibility would include not falsely attempting to create a panic by completely misrepresenting the facts. When this is done solely to gain partisan political points—

Mr. Dave Levac: Point of order, Speaker.

The Speaker (Hon. Steve Peters): Stop the clock. The member for Brant on a point of order.

Mr. Dave Levac: I let this one go on hoping that the member would get off that course, but in our standing rules,

section 23, "In debate" or a statement, "a member shall be called to order by the Speaker if he or she: ... charges another member with uttering a deliberate falsehood" or "imputes false or unavowed motives to another member."

That was not acceptable.

The Speaker (Hon. Steve Peters): I hear the point of order that is raised. I was listening very closely myself. None of the discussion that the honourable member had related to any member in this chamber. He was making reference to somebody within the House of Commons in Ottawa. I have no jurisdiction over that. I'm going to allow the member to continue.

Mr. John Yakabuski: When this is done solely to gain partisan political points, it calls into question the member's ethics. I ask that the Premier, who is also the MPP for Ottawa South, help deliver this message. After all, he enjoys greater access to his federal counterpart than I do.

The Premier knows that when one behaves irresponsibly, they can hurt a lot of innocent people. Surely he'll let the member know that it is time to grow up.

CHILD PROTECTION

Ms. Cheri DiNovo: There was once a little girl who lived very close to my riding and went to school and church in my riding. Her name was Holly Jones. Holly was born on September 14, 1992. She died in her 13th year, on May 12, 2003. There is no one in my riding who does not know the name Holly Jones and the horrible circumstances of her death. Many in our riding know about the valour, the courage and the incredible social justice activity of her parents—Maria Jones in particular, her mother.

Maria came to see me and asked that something be done, really, to commemorate the memory of her daughter Holly Jones, but also to prevent the abuse that Holly had suffered from ever happening to any child again. On her better instincts and on her advice, I introduced a motion: "That, in the opinion of this House, primary prevention programs such as the Boost Child Abuse Prevention and Intervention program be mandatory in all Ontario elementary schools as requested by the family of Holly Jones." I would certainly encourage this government to speak to curriculum committees across the province to make it so. It's a very inexpensive program, about $1 million.

The time to address the state of children or a child at risk is always the same; it's always now.

AUTOMOTIVE RESEARCH

AND INNOVATION

Ms. Sophia Aggelonitis: I have good news. Ontario is joining forces with a world-leading company that creates innovative infrastructure for electric cars. The California-based company called Better Place will establish a Canadian head office as well as an electric car demonstration and education centre in Ontario. Building on this partnership, we will be releasing a study in May which will look at ways to speed up the introduction of electric vehicles in this province.

In addition to establishing international partnerships, we have been making significant investments in automotive research and innovation right here at home, particularly in my hometown of Hamilton.

Keeping ahead of the curve, we have invested over $15 million in the initiative for automotive manufacturing innovation. This collaboration between McMaster University and the University of Waterloo is focusing on developing new technologies for producing lighter-weight, cost-competitive automobiles.

These partnerships and investments could not have come at a better time. They will ensure that Hamilton and Ontario remain at the cutting edge of automobile research and development in a transforming economy.

HEALTH CARE

Mr. John O'Toole: Yesterday, the citizens of Durham riding saw a new plan for the delivery of acute care services in hospitals. The clinical services plan was presented to the board of the Central East Local Health Integration Network.

The Central East Local Health Integration Network is a very large area, serving from east Toronto to Algonquin Park, including Peterborough and Northumberland. I want to emphasize that this plan must not reduce or detract from the local hospitals with dedicated teams who provide outstanding service in my riding of Durham and in many parts of the large area.

Health care is a provincial responsibility, and it is up to Premier McGuinty and his government to ensure that Durham region's hospitals receive their share of funding. Thanks to Dalton McGuinty, Lakeridge Health Corp., a part of the Central East LHIN, now faces a $10.8-million deficit. The Growing Communities Healthcare Alliance estimates that high-growth communities like Durham in the GTA/905 receive $255 less per resident compared to the rest of Ontario.

This is all about fairness for all Ontarians. It should be noted that the latest federal government budget has an additional $868 million for health care transfers to Ontario, and that gives me hope. I would urge Premier McGuinty to use this new federal health money to—

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

SIR WINSTON CHURCHILL COLLEGIATE AND VOCATIONAL INSTITUTE

Mr. Bill Mauro: Thunder Bay's Sir Winston Churchill Collegiate and Vocational Institute students are making dreams come true for seniors at the Versa Care Centre. Outstanding students such as Matt Smiley and Sarah Gogal, grade 11 students from Churchill, are part of the school's peer leadership class and new Dreamweavers program, which started in September 2008.

In the second semester, 24 students from grades 11 and 12 worked with 11 seniors. Created by peer leadership teacher Ryan McDonnell and former Versa Care Centre program manager Emily Bosma, students have been developing relationships with seniors at the home, getting to know them and determining what dream they would like help fulfilling.

Students have taken senior residents swimming. Other dreams included taking a resident to a play and treating a woman to a day at a spa with her daughter. Reuniting special people in their lives is often requested, as are learning to play the piano, seeing a special place and reliving past experiences. Dreams for fun-based activities are often requested, or simple things that can mean so much: a new dress to go to church in or a cup holder for a wheelchair.

I want to applaud the idealism and spirit of service of all the other students involved: Cathy Harmar, Christina Maitlains, Karly Olson, Dustan and Adam Zimmerman, Meighan McKillop, Erin Muller, Brennan Wright, Greg Fraser, Alex Stevenson, Janine Stajkowski, Brandon Myketa, Mark Bystrican, Evan Poile, Lloyd Claridge, Kyle Tang, Jordan Adams, Tyler Gasper, Liam McDonnell, Justin Grachowksi, Joy Vanesse, Paula Marsh, Brandon Charlebois, Mitch McKillop, Devin Breukelman and Corey Hoogsteen.

RURAL CONNECTIONS

BROADBAND PROGRAM

Mr. Jeff Leal: It gives me great pleasure to rise and share with this House the McGuinty government's commitment to improving access to technology for all Ontarians. The McGuinty Liberals recognize that we have highly skilled workers, dedicated business owners and tremendous natural resources. A strong commitment to investing in technology is essential to achieving sustainable communities and allowing them to compete in the 21st-century economy.

The Rural Connections broadband program is a four-year, $30-million program that will leverage municipal and private sector investments to bring high-speed Internet access to rural and remote communities, enabling Ontarians to get access to e-health, e-education and e-government services.

Rural Connections will continue to address broadband gaps across rural southern Ontario. Fifteen municipalities across southern Ontario have already qualified for over $8.8 million in funding for broadband projects that will have a positive impact on families, enhance economic development and improve access to public services. This funding builds on the one-time $10-million investment announced in the 2007 budget, which helped fund broadband infrastructure projects in 18 southern Ontario municipalities.

Our government recognizes that the Rural Connections broadband program is a key

part in developing successful and sustainable municipalities. We recognize there is more to do. The McGuinty government will continue to work hard for all Ontarians to ensure they have the tools they need to succeed.

LEGISLATIVE INTERNS

Mr. Dave Levac: With today's challenging economic times, the undeniable importance of young Ontarians' education is at the forefront of most of our minds. I can't help but look at this year's group of legislative interns and think how fortunate they are to be participating in a sponsored program that provides such a rich educational experience through exposure to the many facets of legislative, political and public life. But more importantly, as members, we are fortunate to meet such great young energetic men and women.

Since October, I have been pleased to host Emma as an intern in my office, and I have made sure to include her in as many aspects of my MPP activities as possible, since I am well aware that the internship is intended to be a period of gaining real-life experience in the many nuances of politics and serving the public. Emma has contributed to the various projects in my office, sat in on meetings and seminars, and spent time working in my constituency office, among many other activities. She tells me that this experience has been truly life-changing and has given her an opportunity to pair her academic background in public policy with practical political insights.

The internship is also non-partisan, and soon Emma will be leaving my office to work with a member of the opposition. While I'll miss her in my office, her learning will be enhanced through her opposition placement. That's what counts. Quality educational experiences are crucial to develop young Ontarians, particularly in the field of politics. This year's 10 legislative interns—Emma, Kim, Chelsea, Rosanne, Meghan, Angela, Igor, David, Waqas and Tejas—are fortunate to be able to gain, through this program, such a rich educational experience in provincial politics. More importantly, as members, we are fortunate to have had these bright, young political enthusiasts among us.

Let us all thank the interns, the coordinating team and the sponsors of this great program.

REPORTS BY COMM